Valerio Zacà

University of Siena

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Sergio Mondillo

Laboratoire Lorrain de Recherche en Informatique et ses Applications

Mauro Biffi

Istituti di Ricovero e Cura a Carattere Scientifico

Marco Metra

University of Brescia

Hani N. Sabbah

Henry Ford Health System

Livio Dei

Associazione Nazionale Medici Cardiologi Ospedalieri

Matteo Cameli

University of Siena

Piercarlo Ballo

Azienda Usl Toscana Centro

Flavio D’Ascenzi

University of Siena

Margherita Padeletti

Santa Maria Nuova Hospital

Matteo Lisi

University of Siena

Cooperative Institutions

Bridgepoint (United Kingdom)

152

Istituti di Ricovero e Cura a Carattere Scientifico

137

Northwestern University

University of Siena

London School of Hygiene & Tropical Medicine

Imperial College London

University of Milan

University of Padua

Azienda Ospedaliera Universitaria Pisana

Centro Cardiologico Monzino

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Characterization of right atrial function and dimension in top-level athletes: a speckle tracking study

Flavio D’Ascenzi Matteo Cameli Matteo Lisi Benedetta Maria Natali A. Malandrino

Tracking (education)

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Citations (1)

Longitudinal variations of left ventricular mass and fat-free mass after intensive training in top-level athletes

Flavio D’Ascenzi Matteo Cameli Matteo Lisi Benedetta Maria Natali Alfredo De Giorgi

Fat free mass

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Citations (1)

Reference Values of Right Atrial Longitudinal Strain Imaging by Two‐Dimensional Speckle Tracking

Echocardiography (2011)

Margherita Padeletti Matteo Cameli Matteo Lisi A. Malandrino Valerio Zacà

The role of speckle tracking in the assessment of right atrial (RA) deformation dynamics has not been established yet. The reference ranges of RA longitudinal strain indices were measured by speckle tracking in a population of normal subjects.In 84 healthy individuals, peak atrial longitudinal strain (PALS), peak atrial contraction strain (PACS), and time to peak longitudinal strain (TPLS) were measured using a six-segment model for the RA. Strain rate (SR) was also measured starting from the QRS-wave onset, peak positive (x-wave), first peak negative (y-wave), and second negative peak (z-wave). The time from the QRS onset was measured to each wave peak.Adequate tracking quality was achieved in 64% of segments analyzed. Inter- and intraobserver variability coefficients of measurements ranged between 6% and 11%. Global PALS was 49 ± 13%, global TPLS was 363 ± 59 msec, x-wave was 2.12 ± 0.58 sec(-1) , y-wave was -1.91 ± 0.63 sec(-1) , and z-wave was -2.18 ± 0.78 sec(-1) .Speckle tracking is a feasible technique for the assessment of longitudinal myocardial RA deformation. Reference ranges of strain indices were reported.

Strain (injury)

Tracking (education)

P wave

Speckle tracking echocardiography

10.1111/j.1540-8175.2011.01564.x

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Citations (91)

Different aspects of coronary microvascular damage during reperfusion of ST-elevation acute myocardial infarction

Acta Cardiologica (2008)

Valerio Zacà Sergio Mondillo

The beneficial effects of a timely recanalisation of the infarct-related coronary artery in ST-elevation myocardial infarction may be limited at the microvascular level by reperfusion injury and distal microembolisation. These complications carry ominous consequences for both prognosis and survival. The importance of reperfusion injury and microembolisation has been progressively more recognized and many different preventive and therapeutic interventions have been developed to minimise these complications. In the present contribution some simple elements of value in the understanding, recognition and differential diagnosis of reperfusion injury and coronary microembolisation are provided.

Reperfusion Therapy

10.2143/ac.63.4.2033037

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Citations (0)

Morphological and Functional Adaptation of Left and Right Atria Induced by Training in Highly Trained Female Athletes

Circulation Cardiovascular Imaging (2014)

Flavio D’Ascenzi Antonio Pelliccia Benedetta Maria Natali Valerio Zacà Matteo Cameli

Background— Exercise is able to induce atrial remodeling in top-level athletes. However, evidence is mainly limited to men and based on cross-sectional studies. The aim of this prospective, longitudinal study was to investigate whether exercise is able to influence left and right atrial morphology and function also in female athletes. Methods and Results— Two-dimensional echocardiography was performed before season and after 16 weeks of intensive training in 24 top-level female athletes. Left and right atrial myocardial deformation was assessed by two-dimensional speckle-tracking echocardiography. Left atrial volume index (24.0±3.6 versus 26.7±6.9 mL/m 2 ; P <0.001) and right atrial volume index (15.66±3.09 versus 20.47±4.82 mL/m 2 ; P <0.001) significantly increased after training in female athletes. Left atrial global peak atrial longitudinal strain and peak atrial contraction strain significantly decreased after training in female athletes (43.9±9.5% versus 39.8±6.5%; P <0.05 and 15.5±4.0% versus 13.9±4.0%; P <0.05, respectively). Right atrial peak atrial longitudinal strain and peak atrial contraction strain showed a similar, although non-significant decrease (42.8±10.6% versus 39.3±8.3%; 15.6±5.6% versus 13.1±6.1%, respectively). Neither biventricular E / e ′ ratio nor biatrial stiffness changed after training, suggesting that biatrial remodeling occurs in a model of volume rather than pressure overload. Conclusions— Exercise is able to induce biatrial morphological and functional changes in female athletes. Biatrial enlargement, with normal filling pressures and low atrial stiffness, is a typical feature of the heart of female athletes. These findings should be interpreted as physiological adaptations to exercise and should be considered in the differential diagnosis with cardiomyopathies.

Left and right

10.1161/circimaging.113.001345

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Citations (105)

Electrical manipulation of the failing heart

Heart Failure Reviews (2018)

Valerio Zacà Theodore Murphy Mauro Biffi

10.1007/s10741-018-9732-x

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Citations (3)

Right Atrial Speckle Tracking Analysis as a Novel Noninvasive Method for Pulmonary Hemodynamics Assessment in Patients with Chronic Systolic Heart Failure

Echocardiography (2011)

Margherita Padeletti Matteo Cameli Matteo Lisi Valerio Zacà Charilos Tsioulpas

Background: The right atrium (RA) plays multiple roles in the cardiac cycle. The reservoir phase of the RA is a dynamic rather than a static phase of cardiac cycle and RA deformation is dependent on pulmonary pressures exerted on the right ventricle and, therefore, backwards on the RA. The purpose of this study was to assess the accuracy and the clinical applicability of the speckle tracking echocardiography (STE) evaluation of the RA in predicting the invasive systolic pulmonary artery pressure (SPAP) in patients with systolic heart failure (HF) undergoing right heart catheterization (RHC). Methods: Thirty-one hemodynamically stable, in-clinic HF patients who were undergoing RHC were included. Doppler echocardiography and RHC catheterization were simultaneously performed. Echocardiographic measures and STE where obtained as peak atrial longitudinal strain (PALS), RA strain rate, and time to peak longitudinal strain (TPLS). RA PALS was inversely correlated with invasively assessed SPAP (r =–0.81; P < 0.001) while RA strain directly correlated with SPAP (r = 0.82; P < 0.001). RA PALS and strain rate retained this correlation even after nitroprusside challenge test (r =–0.81; P < 0.001 and r = 0.91; P < 0.001, respectively). Area under the curve optimal cutoffs for predicting the SPAP > 50 mmHg were for RA PALS 10.3% (AUC:0.93, sensitivity: 100%, specificity: 78%). Conclusion: RA STE showed a significant correlation with pulmonary pressure. RA assessment with STE can predict pulmonary artery hypertension in HF patients. This result is consistent with nitroprusside challenge test. Although RA STE is not routinely used, its evaluation may implement right heart evaluation in HF patients. (Echocardiography 2011;28:658-664)

Speckle tracking echocardiography

10.1111/j.1540-8175.2011.01413.x

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Citations (61)

How should I treat pulmonary arteriovenous malformations in a patient with Rendu-Osler disease presenting with transient ischaemic attack

EuroIntervention (2011)

Flavio D’Ascenzi Valerio Zacà Alessandro Iadanza Sergio Mondillo Carlo Pierli

A 42-year-old man with no cardiovascular risk factors or history was admitted for evaluation of an episode of transient ischaemic attack (TIA). He had no cardiovascular risk factors and his physical examination was unremarkable.Physical examination, electrography, transesophageal echocardiogram, coronary angiogram.Intrapulmonary shunting, in the presence of arteriovenous malformations, possible hereditary haemorrhagic telangectasia.Transcatheter occlusion of multiple pulmonary arteriovenous malformations using an AMPLATZER vascular plug.

Transesophageal echocardiogram

Shunting

Medical History

Clinical history

10.4244/eijv7i7a137

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Citations (0)

Beneficial effect of post-procedural abciximab in patients undergoing primary coronary angioplasty and presenting with the no-reflow phenomenon

Acute Cardiac Care (2008)

Andrea Picchi Valerio Zacà Andrea Picchi Valerio Zacà Marta Focardi

We sought to investigate the effect of post-procedural abciximab on clinical outcome of patients presenting the no-reflow phenomenon after primary angioplasty. We retrospectively selected 38 patients who developed the no-reflow phenomenon after primary angioplasty: 18 received post-procedural abciximab, 20 age- and sex-matched patients who did not receive abciximab were considered as concurrent controls. At 6 months follow-up, the clinical course was uneventful in the abciximab group while the composite end-point of major adverse cardiac events occurred in 8 patients (40%) in the control group (P=0.009). 'Rescue' administration of abciximab is an effective option for the treatment of the no-reflow phenomenon determining significant prognostic improvements.

Abciximab

No reflow phenomenon

Clinical endpoint

10.1080/17482940701639401

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Citations (5)

Relationship Between Coronary Microcirculatory Dysfunction and Left Ventricular Long-Axis Function in Heart Transplant Recipients

The Journal of Heart and Lung Transplantation (2007)

Elisa Giacomin Stefano Gasperini Valerio Zacà Piercarlo Ballo Francesco Diciolla

Coronary flow reserve

Coronary circulation

Cardiac allograft vasculopathy

Ventricular Function

Fractional Flow Reserve

10.1016/j.healun.2007.09.004

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Citations (4)