AimsIntravenous iron therapy can improve symptoms in patients with heart failure, anaemia and iro... more AimsIntravenous iron therapy can improve symptoms in patients with heart failure, anaemia and iron deficiency. The mechanisms underlying such an improvement might involve chemoreflex sensing and nocturnal breathing patterns.Methods and resultsPatients with heart failure, reduced left ventricular ejection fraction, anaemia (haemoglobin <13 g/dl in men; <12 g/dl in women) and iron deficiency (ferritin <100 or 100–299 μg/L with transferrin saturation <20%) were 2:1 randomized to patient‐tailored intravenous ferric carboxymaltose dose or placebo. Chemoreflex sensitivity cardiorespiratory sleep study, symptom assessment and cardiopulmonary exercise test were performed before and 2 weeks after the last treatment dose. Fifty‐eight patients (38 active arm/20 placebo arm) completed the study. Intravenous iron was associated with less severe symptoms, higher haemoglobin (12.5 ± 1.4 vs. 11.7 ± 1.0 mg/dl, p < 0.05) and improved haematinic parameters. Ferric carboxymaltose improve...
Association of change in N-terminal pro-B-type natriuretic peptide following initiation of sacubi... more Association of change in N-terminal pro-B-type natriuretic peptide following initiation of sacubitril–valsartan treatment with cardiac structure and function in patients with heart failure with reduced ejection fraction. JAMA 2019;1–11; [Epub ahead of print]. 9 Singh JSS, Burrell LM, Cherif M, Squire IB, Clark AL, Lang CC. Sacubitril/ valsartan: beyond natriuretic peptides. Heart 2017; 103:1569–1577. 10 Zile MR, O’Meara E, Claggett B, et al. Effects of sacubitril/valsartan on biomarkers of extracellular matrix regulation in patients with HFrEF. J Am Coll Cardiol 2019; 73:795–806.
Dottorato di ricerca in fisiopatologia cardiovascolare. A.a. 1998-99. Relatore Alberto ZanchettiC... more Dottorato di ricerca in fisiopatologia cardiovascolare. A.a. 1998-99. Relatore Alberto ZanchettiConsiglio Nazionale delle Ricerche - Biblioteca Centrale - P.le Aldo Moro, 7, Rome; Biblioteca Nazionale Centrale - P.za Cavalleggeri, 1, Florence / CNR - Consiglio Nazionale delle RichercheSIGLEITItal
What underlies NYHA class in elderly patients with heart failure? role of diastolic dysfunction, ... more What underlies NYHA class in elderly patients with heart failure? role of diastolic dysfunction, functional mitral regurgitation and abnormal ventilation during exercise. G. Malfatto, P. Cuoccio, C. Bizzi, G. Branzi, A. Villani, F. Della Rosa, G. Parati, M. Facchini. Background - Color-Doppler ecocardiography and cardiopulmonary stress test are pivotal in the evaluation of patients with heart failure. Besides determining systolic
Ambulatory Advanced Heart Failure (AAHF) is characterized by recurrent HF hospitalizations, escal... more Ambulatory Advanced Heart Failure (AAHF) is characterized by recurrent HF hospitalizations, escalating diuretic requirements, intolerance to neurohormonal antagonists, end-organ dysfunction, short-term reduced life expectancy despite optimal medical management (OMM). The role of intermittent inotropes in AAHF is unclear. The RELEVANT-HF registry was designed to obtain insight on the effectiveness and safety of compassionate scheduled repetitive 24-hour levosimendan infusions (LEVO) in AAHF patients. 185 AAHF NYHA class III-IV patients, with ≥2 HF hospitalizations/emergency visits in the previous 6 months and systolic dysfunction, were treated with LEVO at tailored doses (0.05-0.2 μg/kg/min) without prior bolus every 3-4 weeks. We compared data on HF hospitalizations (percent days spent in hospital, DIH) in the 6 months before and after treatment start. Infusion-related adverse events occurred in 23 (12.4%) patients the commonest being ventricular arrhythmias (16, 8.6%). During follo...
AimsIntravenous iron therapy can improve symptoms in patients with heart failure, anaemia and iro... more AimsIntravenous iron therapy can improve symptoms in patients with heart failure, anaemia and iron deficiency. The mechanisms underlying such an improvement might involve chemoreflex sensing and nocturnal breathing patterns.Methods and resultsPatients with heart failure, reduced left ventricular ejection fraction, anaemia (haemoglobin <13 g/dl in men; <12 g/dl in women) and iron deficiency (ferritin <100 or 100–299 μg/L with transferrin saturation <20%) were 2:1 randomized to patient‐tailored intravenous ferric carboxymaltose dose or placebo. Chemoreflex sensitivity cardiorespiratory sleep study, symptom assessment and cardiopulmonary exercise test were performed before and 2 weeks after the last treatment dose. Fifty‐eight patients (38 active arm/20 placebo arm) completed the study. Intravenous iron was associated with less severe symptoms, higher haemoglobin (12.5 ± 1.4 vs. 11.7 ± 1.0 mg/dl, p < 0.05) and improved haematinic parameters. Ferric carboxymaltose improve...
Association of change in N-terminal pro-B-type natriuretic peptide following initiation of sacubi... more Association of change in N-terminal pro-B-type natriuretic peptide following initiation of sacubitril–valsartan treatment with cardiac structure and function in patients with heart failure with reduced ejection fraction. JAMA 2019;1–11; [Epub ahead of print]. 9 Singh JSS, Burrell LM, Cherif M, Squire IB, Clark AL, Lang CC. Sacubitril/ valsartan: beyond natriuretic peptides. Heart 2017; 103:1569–1577. 10 Zile MR, O’Meara E, Claggett B, et al. Effects of sacubitril/valsartan on biomarkers of extracellular matrix regulation in patients with HFrEF. J Am Coll Cardiol 2019; 73:795–806.
Dottorato di ricerca in fisiopatologia cardiovascolare. A.a. 1998-99. Relatore Alberto ZanchettiC... more Dottorato di ricerca in fisiopatologia cardiovascolare. A.a. 1998-99. Relatore Alberto ZanchettiConsiglio Nazionale delle Ricerche - Biblioteca Centrale - P.le Aldo Moro, 7, Rome; Biblioteca Nazionale Centrale - P.za Cavalleggeri, 1, Florence / CNR - Consiglio Nazionale delle RichercheSIGLEITItal
What underlies NYHA class in elderly patients with heart failure? role of diastolic dysfunction, ... more What underlies NYHA class in elderly patients with heart failure? role of diastolic dysfunction, functional mitral regurgitation and abnormal ventilation during exercise. G. Malfatto, P. Cuoccio, C. Bizzi, G. Branzi, A. Villani, F. Della Rosa, G. Parati, M. Facchini. Background - Color-Doppler ecocardiography and cardiopulmonary stress test are pivotal in the evaluation of patients with heart failure. Besides determining systolic
Ambulatory Advanced Heart Failure (AAHF) is characterized by recurrent HF hospitalizations, escal... more Ambulatory Advanced Heart Failure (AAHF) is characterized by recurrent HF hospitalizations, escalating diuretic requirements, intolerance to neurohormonal antagonists, end-organ dysfunction, short-term reduced life expectancy despite optimal medical management (OMM). The role of intermittent inotropes in AAHF is unclear. The RELEVANT-HF registry was designed to obtain insight on the effectiveness and safety of compassionate scheduled repetitive 24-hour levosimendan infusions (LEVO) in AAHF patients. 185 AAHF NYHA class III-IV patients, with ≥2 HF hospitalizations/emergency visits in the previous 6 months and systolic dysfunction, were treated with LEVO at tailored doses (0.05-0.2 μg/kg/min) without prior bolus every 3-4 weeks. We compared data on HF hospitalizations (percent days spent in hospital, DIH) in the 6 months before and after treatment start. Infusion-related adverse events occurred in 23 (12.4%) patients the commonest being ventricular arrhythmias (16, 8.6%). During follo...
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