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- Carrick, Richard T., et al.
(författare)
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Implantable cardioverter defibrillator use in arrhythmogenic right ventricular cardiomyopathy in North America and Europe
- 2024
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Ingår i: European Heart Journal. - : OXFORD UNIV PRESS. - 0195-668X .- 1522-9645.
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Tidskriftsartikel (refereegranskat)abstract
- Background and Aims Implantable cardioverter-defibrillators (ICDs) are critical for preventing sudden cardiac death (SCD) in arrhythmogenic right ventricular cardiomyopathy (ARVC). This study aims to identify cross-continental differences in utilization of primary prevention ICDs and survival free from sustained ventricular arrhythmia (VA) in ARVC.Methods This was a retrospective analysis of ARVC patients without prior VA enrolled in clinical registries from 11 countries throughout Europe and North America. Patients were classified according to whether they received treatment in North America or Europe and were further stratified by baseline predicted VA risk into low- (<10%/5 years), intermediate- (10%-25%/5 years), and high-risk (>25%/5 years) groups. Differences in ICD implantation and survival free from sustained VA events (including appropriate ICD therapy) were assessed.Results One thousand ninety-eight patients were followed for a median of 5.1 years; 554 (50.5%) received a primary prevention ICD, and 286 (26.0%) experienced a first VA event. After adjusting for baseline risk factors, North Americans were more than three times as likely to receive ICDs {hazard ratio (HR) 3.1 [95% confidence interval (CI) 2.5, 3.8]} but had only mildly increased risk for incident sustained VA [HR 1.4 (95% CI 1.1, 1.8)]. North Americans without ICDs were at higher risk for incident sustained VA [HR 2.1 (95% CI 1.3, 3.4)] than Europeans.Conclusions North American ARVC patients were substantially more likely than Europeans to receive primary prevention ICDs across all arrhythmic risk strata. A lower rate of ICD implantation in Europe was not associated with a higher rate of VA events in those without ICDs.
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- Toma, M, et al.
(författare)
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Left Heart Disease Phenotype in Elderly Patients with Pulmonary Arterial Hypertension: Insights from the Italian PATRIARCA Registry
- 2022
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Ingår i: Journal of clinical medicine. - : MDPI AG. - 2077-0383. ; 11:23
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Tidskriftsartikel (refereegranskat)abstract
- Pulmonary arterial hypertension (PAH) in the elderly is often associated with left heart disease (LHD), prompting concerns about the use of pulmonary vasodilators. The PATRIARCA registry enrolled ≥70 year-old PAH or chronic thromboembolic pulmonary hypertension (CTEPH) patients at 11 Italian centers from 1 December 2019 through 15 September 2022. After excluding those with CTEPH, post-capillary PH at the diagnostic right heart catheterization (RHC), and/or incomplete data, 23 (33%) of a total of 69 subjects met the criteria proposed in the AMBITION trial to suspect LHD. Diabetes [9 (39%) vs. 6 (13%), p = 0.01] and chronic kidney disease [14 (61%) vs. 12 (26%), p = 0.003] were more common, and the last RHC pulmonary artery wedge pressure [14 ± 5 vs. 10 ± 3 mmHg, p < 0.001] was higher and pulmonary vascular resistance [5.56 ± 3.31 vs. 8.30 ± 4.80, p = 0.02] was lower in LHD than non-LHD patients. However, PAH therapy was similar, with 13 (57%) and 23 (50%) subjects, respectively, taking two oral drugs. PAH medication patterns remained comparable between LHD and non-LHD patients also when the former [37, 54%] were identified by atrial fibrillation and echocardiographic features of LHD, in addition to the AMBITION criteria. In this real-world snapshot, elderly PAH patients were treated with pulmonary vasodilators, including combinations, despite a remarkable prevalence of a LHD phenotype.
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- Biema, Michael K. van, et al.
(författare)
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The Design and Implementation of System Level Language for the DADO Parallel Machine
- 1987
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Ingår i: Proceedings of the Twentieth Annual Hawaii International Conference on System Sciences 1987. Volume 3. - : IEEE and ACM. ; , s. 152-162
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Konferensbidrag (refereegranskat)abstract
- In this paper we describe necessary criteria for the design of parallel system level languages and their support environment. We base the criteria on our own experiences in building a system level language parallel PSL (Parallel Portable Standard Lisp) for the DADO machine developed at Columbia University. The DADO machine is a special purpose massively parallel binary tree structured architecture. We describe the process of language design and implementation on a 1023 node prototype machine. After generalizing what we have learned from this specific implementation to the generic task of building a system level language for a parallel machine, we conclude with a discussion of desirable characteristics such a language should have to allow the easy transition from a language with explicit parallelism to one where the parallelism is implicit.
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- Lerner, Mark D., et al.
(författare)
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An Overview of the DADO Parallel Computer
- 1985
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Ingår i: Afips Conference Proceedings. - : University of Chicago Press, 5720 S Woodlawn Ave, Chicago, IL 60637. ; , s. 297-306
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Konferensbidrag (refereegranskat)
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- Manca, P, et al.
(författare)
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The right ventricular involvement in dilated cardiomyopathy: prevalence and prognostic implications of the often-neglected child
- 2022
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Ingår i: Heart failure reviews. - : Springer Science and Business Media LLC. - 1573-7322 .- 1382-4147. ; 27:5, s. 1795-1805
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Tidskriftsartikel (refereegranskat)abstract
- Dilated cardiomyopathy (DCM) is a primary heart muscle disease characterized by left or biventricular systolic impairment. Historically, most of the clinical attention has been devoted to the evaluation of left ventricular function and morphology, while right ventricle (RV) has been for many years the forgotten chamber. Recently, progresses in cardiac imaging gave clinicians precious tools for the evaluation of RV, raising the awareness of the importance of biventricular assessment in DCM. Indeed, RV involvement is far from being uncommon in DCM, and the presence of right ventricular dysfunction (RVD) is one of the major negative prognostic determinants in DCM patients. However, some aspects such as the possible role of specific genetic mutations in determining the biventricular phenotype in DCM, or the lack of specific treatments able to primarily counteract RVD, still need research. In this review, we summarized the current knowledge on RV involvement in DCM, giving an overview on the epidemiology and pathogenetic mechanisms implicated in determining RVD. Furthermore, we discussed the imaging techniques to evaluate RV function and the role of RV failure in advanced heart failure.
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- Nuzzi, V, et al.
(författare)
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Left Atrial Reverse Remodeling in Dilated Cardiomyopathy
- 2023
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Ingår i: Journal of the American Society of Echocardiography : official publication of the American Society of Echocardiography. - : Elsevier BV. - 1097-6795. ; 36:2, s. 154-162
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- Stolfo, D, et al.
(författare)
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COVID-19: how things change in a short while
- 2020
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Ingår i: European heart journal. Cardiovascular pharmacotherapy. - : Oxford University Press (OUP). - 2055-6845 .- 2055-6837. ; 6:5, s. 280-281
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Tidskriftsartikel (refereegranskat)
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- Stolfo, D, et al.
(författare)
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Evidence-based Therapy in Older Patients with Heart Failure with Reduced Ejection Fraction
- 2022
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Ingår i: Cardiac failure review. - : Radcliffe Media Media Ltd. - 2057-7540 .- 2057-7559. ; 8, s. e16-
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Tidskriftsartikel (refereegranskat)abstract
- Older patients are becoming prevalent among people with heart failure (HF) as the overall population ages. However, older patients are largely under-represented, or even excluded, from randomised controlled trials on HF with reduced ejection fraction, limiting the generalisability of trial results in the real world and leading to weaker evidence supporting the use and titration of guideline-directed medical therapy (GDMT) in older patients with HF with reduced ejection fraction. This, in combination with other factors limiting the application of guideline recommendations, including a fear of poor tolerability or adverse effects, the heavy burden of comorbidities and the need for multiple therapies, classically leads to lower adherence to GDMT in older patients. Although there are no data supporting the under-use and under-dosing of HF medications in older patients, large registry-based studies have confirmed age as one of the major obstacles to treatment optimisation. In this review, the authors provide an overview of the contemporary state of implementation of GDMT in older groups and the reasons for the lower use of treatments, and discuss some measures that may help improve adherence to evidence-based recommendations in older age groups.
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