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- Ammirati, Enrico, et al.
(författare)
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Fulminant Versus Acute Nonfulminant Myocarditis in Patients With Left Ventricular Systolic Dysfunction
- 2019
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Ingår i: Journal of the American College of Cardiology. - : Elsevier BV. - 0735-1097. ; 74:3, s. 299-311
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Tidskriftsartikel (refereegranskat)abstract
- Background: Fulminant myocarditis (FM) is a form of acute myocarditis characterized by severe left ventricular systolic dysfunction requiring inotropes and/or mechanical circulatory support. A single-center study found that a patient with FM had better outcomes than those with acute nonfulminant myocarditis (NFM) presenting with left ventricular systolic dysfunction, but otherwise hemodynamically stable. This was recently challenged, so disagreement still exists. Objectives: This study sought to provide additional evidence on the outcome of FM and to ascertain whether patient stratification based on the main histologic subtypes can provide additional prognostic information. Methods: A total of 220 patients (median age 42 years, 46.3% female) with histologically proven acute myocarditis (onset of symptoms <30 days) all presenting with left ventricular systolic dysfunction were included in a retrospective, international registry comprising 16 tertiary hospitals in the United States, Europe, and Japan. The main endpoint was the occurrence of cardiac death or heart transplantation within 60 days from admission and at long-term follow-up. Results: Patients with FM (n = 165) had significantly higher rates of cardiac death and heart transplantation compared with those with NFM (n = 55), both at 60 days (28.0% vs. 1.8%, p = 0.0001) and at 7-year follow-up (47.7% vs. 10.4%, p < 0.0001). Using Cox multivariate analysis, the histologic subtype emerged as a further variable affecting the outcome in FM patients, with giant cell myocarditis having a significantly worse prognosis compared with eosinophilic and lymphocytic myocarditis. In a subanalysis including only adults with lymphocytic myocarditis, the main endpoints occurred more frequently in FM compared with in NFM both at 60 days (19.5% vs. 0%, p = 0.005) and at 7-year follow up (41.4% vs. 3.1%, p = 0.0004). Conclusions: This international registry confirms that patients with FM have higher rates of cardiac death and heart transplantation both in the short- and long-term compared with patients with NFM. Furthermore, we provide evidence that the histologic subtype of FM carries independent prognostic value, highlighting the need for timely endomyocardial biopsy in this condition.
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| 2. |
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| 3. |
- Causevic, Adnan, 1981-, et al.
(författare)
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Message from the nexta 2019 chairs
- 2019
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Ingår i: Proceedings - 2019 IEEE 12th International Conference on Software Testing, Verification and Validation Workshops, ICSTW 2019. - : Institute of Electrical and Electronics Engineers Inc..
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)
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| 4. |
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| 5. |
- Potena, P., et al.
(författare)
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Software architecture quality of service analysis based on optimization models
- 2016
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Ingår i: Intell. Syst. Ref. Libr.. - Cham : Springer International Publishing. ; , s. 421-446
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Konferensbidrag (refereegranskat)abstract
- The ability to predict Quality of Service (QoS) of a software architecture supports a large set of decisions across multiple lifecycle phases that span from design through implementation-integration to adaptation phase. However, due to the different amount and type of information available, different prediction approaches can be introduced in each phase. A major issue in this direction is that QoS attribute cannot be analyzed separately, because they (sometime adversely) affect each other. Therefore, approaches aimed at the tradeoff analysis of different attributes have been recently introduced (e.g., reliability versus cost, security versus performance). In this chapter we focus on modeling and analysis of QoS tradeoffs of a software architecture based on optimization models. A particular emphasis will be given to two aspects of this problem: (i) the mathematical foundations of QoS tradeoffs and their dependencies on the static and dynamic aspects of a software architecture, and (ii) the automation of architectural decisions driven by optimization models for QoS tradeoffs.
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