Yehuda Adler

Tel Aviv University

Author Statistics

Papers

Citation

H-Index

i-10 index

Research Trends

Author Order

Document Type

Co-Authors

Massimo Imazio

Ospedale Santa Maria della Misericordia di Udine

Antonio Brucato

Fatebenefratelli Hospital

Michael Motro

Sheba Medical Center

Enrique Z. Fisman

Tel Aviv University

David Tanné

Rambam Health Care Campus

David H. Spodick

Saint Vincent Hospital

Ehud Schwammenthal

Sheba Medical Center

Rita Trinchero

Associazione Nazionale Medici Cardiologi Ospedalieri

Alexander Tenenbaum

Sapienza University of Rome

Philippe Charron

Fondation pour l’innovation en Cadiométabolisme et Nutrition

Cooperative Institutions

Tel Aviv University

227

Sheba Medical Center

182

Rabin Medical Center

120

Hippocration General Hospital

Cardiovascular Research Center

Jewish General Hospital

University Clinic of Traumatology

Ospedale di Rivoli

University of Turin

Istituti di Ricovero e Cura a Carattere Scientifico

Author Statistics

Papers

Citation

H-Index

i-10 index

Research Field

Management of pericardial effusion

European Heart Journal (2012)

Massimo Imazio Yehuda Adler

Pericardial effusion is a common finding in clinical practice either as incidental finding or manifestation of a systemic or cardiac disease. The spectrum of pericardial effusions ranges from mild asymptomatic effusions to cardiac tamponade. The aetiology is varied (infectious, neoplastic, autoimmune, metabolic, and drug-related), being tuberculosis the leading cause of pericardial effusions in developing countries and all over the world, while concurrent HIV infection may have an important promoting role in this setting. Management is guided by the haemodynamic impact, size, presence of inflammation (i.e. pericarditis), associated medical conditions, and the aetiology whenever possible. Pericardiocentesis is mandatory for cardiac tamponade and when a bacterial or neoplastic aetiology is suspected. Pericardial biopsy is generally reserved for cases with recurrent cardiac tamponade or persistence without a defined aetiology, especially when a bacterial or neoplastic aetiology is suspected and cannot be assessed by other conventional and less invasive means. A true isolated effusion may not require a specific treatment if the patient is asymptomatic, but large ones are at risk of progression to cardiac tamponade (up to one third). Pericardiocentesis alone may be curative for large effusions, but recurrences are also common and pericardiectomy or less invasive options (i.e. pericardial window) should be considered with recurrent cardiac tamponade or symptomatic pericardial effusion (either circumferential or loculated). The aim of this paper was to summarize and critically evaluate current knowledge on the management of pericardial effusion.

Pericardiocentesis

Pericardial window

Etiology

Pericardiectomy

Pericardial fluid

Tuberculous Pericarditis

10.1093/eurheartj/ehs372

Cite

Citations (353)

THU0376 Cardiovascular and Metabolic Risk Factors in Inherited Auto-Inflammation

Annals of the Rheumatic Diseases (2014)

Gilad Twig Avi Livneh Asaf Vivante Arnon Afek Estela Derazne

Background

Low-grade inflammation is a risk factor for coronary artery disease. Yet, clinical data on patients with inherited auto-inflammation are limited.

Objectives

To assess the natural progression of cardiovascular and metabolic risk among participants with familial Mediterranean Fever (FMF).

Methods

We performed a cross-sectional study of the prevalence of components of the metabolic syndrome at age 17, from the medical database of the Israeli Defense Force from 1973 through 1997.Included were 745 males with FMF, 902 healthy male siblings and a control group of 787,714 participants. A prospective follow-up (mean follow-up >19 years) study traced the incidence of components of the metabolic syndrome and angiography-proven coronary artery disease (CAD) to age 45 years among 57 FMF and 1,568 control army personnel participants.

Results

In multivariable multinomial regression analysis adjusted for known confounders of obesity, FMF participants had an odds ratio of 0.65 for occurrence of overweight (95%CI=0.44-0.96,p=0.03) and 0.66 (95%CI=0.48-0.92,p=0.012) for hypertension-range blood pressure; their siblings tended to obesity (OR=1.48;95%CI=1.04-2.11,p=0.008). In the follow-up arm, Cox-regression multivariable models adjusted for age, birth year, BMI, education, socioeconomic status, country of origin and physical activity yielded hazard ratios of 0.32 (95%CI=0.10-0.82,p=0.002) for incident obesity, 0.49 (95%CI=0.25-0.95,p=0.037) for incident TG≥150mg/dL, 0.56 (95%CI=0.31-0.98,p=0.048) for LDL≥130mg/dL and 2.14 (1.368-3.359,p=0.001) for HDL<40mg/dL for FMF participants compared to controls. In univariate analysis, incident elevated blood pressure was lower among FMF participants (HR=0.49;95%CI=0.23-1.00,p=0.05), while dysglycemia incidence was comparable. There was no evidence for accelarated CAD among FMF patients.

Conclusions

FMF was associated with lower rates of most components of the metabolic syndrome compared to normal subjects, with no evidence for accelerated CAD.

Disclosure of Interest

: None declared

DOI

10.1136/annrheumdis-2014-eular.4242

Cite

Citations (0)

Therapy for recurrent acute pericarditis: a rheumatological solution?

PubMed (2006)

Antonio Brucato Giovanni Brambilla Yehuda Adler David H. Spodick B Canesi

To assess the efficacy of a multidrug protocol in recurrent acute pericarditis. We tried also to assess the specific role of colchicine.We studied 58 patients (34 males) in the largest monocentric observational study. All patients received prolonged courses of non-steroidal anti-inflammatory drugs; generally we do not start a corticosteroid in recurrent acute pericarditis, but if a steroid had already been started, we planned a very slow tapering; if necessary azathioprine, hydroxychloroquine, and other immunosuppressive drugs were used; 44 patients (27 males, 61.4%) were treated also with colchicine and 14 patients (7 males, 50%) were not given this drug.After starting our protocol recurrences dropped from 0.48 to 0.03 attacks/patient/month (p < 0.00001) within 12 months and remained at the same level till the end of the follow-up (mean 8.1 years) in the whole cohort. In the 44 patients treated with colchicine recurrences dropped from 0.54 to 0.03 attacks/patient/month (p < 0.00001) within 12 months, and in 14 patients not given colchicine recurrences decreased from 0.31 to 0.06 attacks/patient/month (p = 0.002). In patients treated with colchicine the decrease was significantly higher (0.51) than in patients not taking this drug (0.25) (p = 0.006). Colchicine was discontinued by 16.3% of patients because of side effects.A multidrug protocol including non-steroidal anti-inflammatory drugs at high dosage, slow tapering of corticosteroid, colchicine, reassurance and close clinical monitoring is very effective in recurrent pericarditis; this improvement is more dramatic in colchicine treated patients, but also patients who do not tolerate it can achieve good control of the disease.

Colchicine

Acute pericarditis

Source

Cite

Citations (56)

Myocarditis and pericarditis

Oxford University Press eBooks (2023)

Stéphane Heymans Arsen Ristić Yehuda Adler Massimo Imazio

Abstract Myocarditis can cause atrial and ventricular arrhythmias, and transient or chronic and progressive heart failure. Viruses are the most frequent infectious triggers. Systemic diseases and toxic agents are important non-infectious causes of myocarditis. As viral triggers in peri- and myocarditis are common cough viruses, with only a minority of infected persons developing peri- or myocarditis, a certain immune–genetic susceptibility—including coding and non-coding genes—of the affected person is key. Endomyocardial biopsies are indicated in acute myocarditis if progressive or persistent severe cardiac dysfunction and/or life-threatening ventricular arrhythmias with a lack of short-term response to usual medical treatment are present. Cardiac magnetic resonance is essential in all patients with a high suspicion of myocarditis, after significant coronary artery disease has been excluded or considered to be unlikely. This chapter will discuss the pathophysiology of (peri-)myocarditis and its heterogeneous disease presentation, as well as its diagnosis and treatment in more detail.

Viral Myocarditis

10.1093/med/9780198891628.003.0013

Cite

Citations (3)

Calcification of the thoracic aorta by spiral computed tomography among hypertensive patients: Associations and risk of ischemic cerebrovascular events

International Journal of Cardiology (2006)

David Tanné Alexander Tenenbaum Joseph Shemesh Yvonne Schwammenthal Enrique Z. Fisman

Thoracic aorta

Descending aorta

10.1016/j.ijcard.2006.08.010

Cite

Citations (37)

Usefulness of Cardiac Magnetic Resonance for Recurrent Pericarditis

The American Journal of Cardiology (2019)

Massimo Imazio Emanuele Pivetta Sara Palacio Restrepo Paola Sormani Patrizia Pedrotti

Cardiac magnetic resonance

10.1016/j.amjcard.2019.09.026

Cite

Citations (49)

Interleukin-6 and the Risk of Future Cardiovascular Events in Patients With Angina Pectoris and/or Healed Myocardial Infarction

The American Journal of Cardiology (2006)

Enrique Z. Fisman Michal Benderly Ricardo J. Esper Solomon Behar Valentina Boyko

Unstable angina

Sudden Death

Proinflammatory cytokine

10.1016/j.amjcard.2006.01.045

Cite

Citations (121)

Recurrent pericarditis: Infectious or autoimmune?

Autoimmunity Reviews (2008)

Antonio Brucato Silvia Maestroni Davide Cumetti Giuseppe Thiella Gabriella Alari

Erythrocyte sedimentation rate

Pathogenesis

Etiology

Coxiella burnetii

Acute pericarditis

10.1016/j.autrev.2008.07.024

Cite

Citations (53)

Anti-Fc Gamma Receptor III Autoantibody is Associated with Soluble Receptor in Rheumatoid Arthritis Serum and Synovial Fluid

Journal of Autoimmunity (1995)

A. Lamour D. Baron Claude Soubrane J Cartron David Khayat

CD16

10.1006/jaut.1995.0019

Cite

Citations (19)

Colchicine for acute pericarditis. Results from the Investigation on Colchicine in Acute Pericarditis (ICAP). A prospective, randomized, double-blind, placebo-controlled, multicenter trial

European Heart Journal (2013)

Massimo Imazio Antonio Brucato Roberto Cemin Stefania Ferrua Stefano Maggiolini

Risk stratification in cardiomyopathies: what's new? / Net clinical benefit of cardiovascular drugs: focus on safety 167Purpose: To assess the incidence of SCD, ICD therapies and device-related complications in patients (pts) with HCM who received an ICD for primary or secondary prevention of SCD during a long term follow-up.Methods: A retrospective, observational cohort study analysis was performed.Between 1995 and 2012, from 636 pts with HCM, 88 pts who received an ICD were followed.Indications for secondary prevention were sustained ventricular tachycardia (VT) or cardiac arrest in 14 pts (15.9%) and the traditional 5 risk factors (RF) of the 2003 ACC/ESC risk stratification algorithm for primary prevention of SCD (non-sustained VT, severe left ventricular hypertrophy, family history of SCD, unexplained syncope and abnormal blood pressure response to exercise) in 74 pts (84.1%).A combined endpoint of SCD or appropriate ICD therapy (AT), incidence of inappropriate ICD therapy (IT) and device-related complications were assessed.Variables were analyzed with chi 2 test and survival curves with Kaplan-Meier method.Median follow-up was 54.5 months.Results: Mean age was 38.4±18 years, (59% male).1. ICD implanted for secondary prevention: a) the incidence of SCD/AT was 35.7% (5/14 pts); b) the rate of IT was 14.2% (2/14 pts) both due to atrial fibrillation; c) there was no ICD related-complications.2. ICD implanted for primary prevention: a) the incidence of SCD/AT was 8.1% (6/74): 1 pt with 1 RF, 2 pts with 2 RF and 3 pts with 3 RF for SCD; b) the rate of IT was 20.2% (15/74 pts), 5 atrial fibrillation, 3 noise oversensing, 6 sinus tachycardia and 1 atrial tachycardia; c) 13 pts (14.7%) had ICD related-complications: infection 5 pts, lead displacement 4 pts, pericardial effusion 2 pts and lead fracture 2 pts.The incidence of SCD/AT was 8.1% vs 35.7% in primary vs secondary prevention (p: 0.004).Survival free of SCD/AT in pts implanted for primary prevention at 72 months was 86.1%.Conclusions: In this study population ICDs were highly effective in the setting of secondary prevention.Pts with ICD for primary prevention had a significantly lower incidence of SCD/AT and a high rate of IT and ICD-related complications.These findings suggests that the current risk algorithm for primary prevention needs to be improved to distinguish high from low risk pts.

Colchicine

Acute pericarditis

10.1093/eurheartj/eht308.877

Cite

Citations (9)