Quattrocchi Dott.ssa Giuseppina
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Long-term prognostic performance of cardiac magnetic resonance imaging markers versus complicated clinical presentation after an acute myocarditis.
Int J Cardiol2024 Dec;417():132567. doi: 10.1016/j.ijcard.2024.132567.
Ammirati Enrico, Varrenti Marisa, Sormani Paola, Bernasconi Davide, Moro Claudio, Grosu Aurelia, D'Elia Saverio, Raineri Claudia, Quattrocchi Giuseppina, Milazzo Angela, Turco Annalisa, Maestroni Alberto, Valsecchi Maria Grazia, Oliva Fabrizio, Garascia Andrea, Giannattasio Cristina, Camici Paolo G, Pedrotti Patrizia
Abstract
BACKGROUND:
Identifying markers associated with adverse events after acute myocarditis (AM) is relevant to plan follow-up. We assessed the prognostic performance of previously described cardiac magnetic resonance imaging (CMRI) markers and their combination: septal late gadolinium enhancement (LGE) localization and left ventricular ejection fraction (LVEF)
METHODS:
We retrospectively assessed 248 AM patients (median age of 34 years, 87.1 % male) from 6 hospitals with onset of cardiac symptoms
RESULTS:
Thirteen patients (5.2 %) experienced at least one major cardiac event after a median follow-up of 4.7 years with a significant hazard ratio of 35.8 for CCP vs. 9.2 for septal LGE vs. 12.4 for LVEF
CONCLUSIONS:
Major cardiac events after an AM are relatively low, and CCP, septal LGE, and LVEF
Copyright © 2024. Published by Elsevier B.V.
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Arrhythmic Mitral Valve Prolapse Phenotype: An Unsupervised Machine Learning Analysis Using a Multicenter Cardiac MRI Registry.
Radiol Cardiothorac Imaging2024 Jun;6(3):e230247. doi: e230247.
Akyea Ralph Kwame, Figliozzi Stefano, Lopes Pedro M, Bauer Klemens B, Moura-Ferreira Sara, Tondi Lara, Mushtaq Saima, Censi Stefano, Pavon Anna Giulia, Bassi Ilaria, Galian-Gay Laura, Teske Arco J, Biondi Federico, Filomena Domenico, Stylianidis Vasileios, Torlasco Camilla, Muraru Denisa, Monney Pierre, Quattrocchi Giuseppina, Maestrini Viviana, Agati Luciano, Monti Lorenzo, Pedrotti Patrizia, Vandenberk Bert, Squeri Angelo, Lombardi Massimo, Ferreira António M, Schwitter Juerg, Aquaro Giovanni Donato, Pontone Gianluca, Chiribiri Amedeo, Rodríguez Palomares José F, Yilmaz Ali, Andreini Daniele, Florian Anca-Rezeda, Francone Marco, Leiner Tim, Abecasis João, Badano Luigi Paolo, Bogaert Jan, Georgiopoulos Georgios, Masci Pier-Giorgio
Abstract
Purpose To use unsupervised machine learning to identify phenotypic clusters with increased risk of arrhythmic mitral valve prolapse (MVP). Materials and Methods This retrospective study included patients with MVP without hemodynamically significant mitral regurgitation or left ventricular (LV) dysfunction undergoing late gadolinium enhancement (LGE) cardiac MRI between October 2007 and June 2020 in 15 European tertiary centers. The study end point was a composite of sustained ventricular tachycardia, (aborted) sudden cardiac death, or unexplained syncope. Unsupervised data-driven hierarchical -mean algorithm was utilized to identify phenotypic clusters. The association between clusters and the study end point was assessed by Cox proportional hazards model. Results A total of 474 patients (mean age, 47 years ± 16 [SD]; 244 female, 230 male) with two phenotypic clusters were identified. Patients in cluster 2 (199 of 474, 42%) had more severe mitral valve degeneration (ie, bileaflet MVP and leaflet displacement), left and right heart chamber remodeling, and myocardial fibrosis as assessed with LGE cardiac MRI than those in cluster 1. Demographic and clinical features (ie, symptoms, arrhythmias at Holter monitoring) had negligible contribution in differentiating the two clusters. Compared with cluster 1, the risk of developing the study end point over a median follow-up of 39 months was significantly higher in cluster 2 patients (hazard ratio: 3.79 [95% CI: 1.19, 12.12], = .02) after adjustment for LGE extent. Conclusion Among patients with MVP without significant mitral regurgitation or LV dysfunction, unsupervised machine learning enabled the identification of two phenotypic clusters with distinct arrhythmic outcomes based primarily on cardiac MRI features. These results encourage the use of in-depth imaging-based phenotyping for implementing arrhythmic risk prediction in MVP. MR Imaging, Cardiac, Cardiac MRI, Mitral Valve Prolapse, Cluster Analysis, Ventricular Arrhythmia, Sudden Cardiac Death, Unsupervised Machine Learning © RSNA, 2024.
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Outcome and Morphofunctional Changes on Cardiac Magnetic Resonance in Patients With Acute Myocarditis Following mRNA COVID-19 Vaccination.
Circ Heart Fail2023 Jun;16(6):e010315. doi: 10.1161/CIRCHEARTFAILURE.122.010315.
Ammirati Enrico, Lupi Laura, Palazzini Matteo, Ciabatti Michele, Rossi Valentina A, Gentile Piero, Uribarri Aitor, Vecchio Chiara R, Nassiacos Daniele, Cereda Alberto, Conca Cristina, Tumminello Gabriele, Piriou Nicolas, Lelarge Coline, Pedrotti Patrizia, Stucchi Miriam, Peretto Giovanni, Galasso Michele, Huang Florent, Ianni Umberto, Procopio Antonio, Saponara Gianluigi, Cimaglia Paolo, Tomasoni Daniela, Moroni Francesco, Turco Annalisa, Sala Simone, Di Tano Giuseppe, Bollano Entela, Moro Claudio, Abbate Antonio, Della Bona Roberta, Porto Italo, Carugo Stefano, Campodonico Jeness, Pontone Gianluca, Grosu Aurelia, Bolognese Leonardo, Salamanca Jorge, Diez-Villanueva Pablo, Ozieranski Krzysztof, Tyminska Agata, Sardo Infirri Loren, Bromage Daniel, Cannatà Antonio, Hong Kimberly N, Adamo Marianna, Quattrocchi Giuseppina, Foà Alberto, Potena Luciano, Garascia Andrea, Giannattasio Cristina, Adler Eric D, Sinagra Gianfranco, Ruschitzka Frank, Camici Paolo G, Metra Marco, Pieroni Maurizio
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Fulminant Lymphocytic Myocarditis During Pregnancy Treated With Temporary Mechanical Circulatory Supports and Aggressive Immunosuppression.
Circ Heart Fail2022 Dec;15(12):e009810. doi: 10.1161/CIRCHEARTFAILURE.122.009810.
Veronese Giacomo, Nonini Sandra, Cannata Aldo, Aresta Francesca, Olivieri Guido, Montrasio Elisa, De Caria Daniele, Perna Enrico, Calini Angelo, Bottiroli Maurizio, Cislaghi Francesca, Pedrazzini Giovanna, Baltaro Federica, Quattrocchi Giuseppina, Pedrotti Patrizia, Russo Claudio F, Garascia Andrea, Mondino Michele, Ammirati Enrico
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Myocardial Fibrosis at Cardiac MRI Helps Predict Adverse Clinical Outcome in Patients with Mitral Valve Prolapse.
Radiology2023 Jan;306(1):112-121. doi: 10.1148/radiol.220454.
Figliozzi Stefano, Georgiopoulos Georgios, Lopes Pedro M, Bauer Klemens B, Moura-Ferreira Sara, Tondi Lara, Mushtaq Saima, Censi Stefano, Pavon Anna Giulia, Bassi Ilaria, Servato Maria Luz, Teske Arco J, Biondi Federico, Filomena Domenico, Pica Silvia, Torlasco Camilla, Muraru Denisa, Monney Pierre, Quattrocchi Giuseppina, Maestrini Viviana, Agati Luciano, Monti Lorenzo, Pedrotti Patrizia, Vandenberk Bert, Squeri Angelo, Lombardi Massimo, Ferreira António M, Schwitter Juerg, Aquaro Giovanni Donato, Chiribiri Amedeo, Rodríguez Palomares José F, Yilmaz Ali, Andreini Daniele, Florian Anca, Leiner Tim, Abecasis João, Badano Luigi Paolo, Bogaert Jan, Masci Pier-Giorgio
Abstract
Background Patients with mitral valve prolapse (MVP) may develop adverse outcomes even in the absence of mitral regurgitation or left ventricular (LV) dysfunction. Purpose To investigate the prognostic value of mitral annulus disjunction (MAD) and myocardial fibrosis at late gadolinium enhancement (LGE) cardiac MRI in patients with MVP without moderate-to-severe mitral regurgitation or LV dysfunction. Materials and Methods In this longitudinal retrospective study, 118?144 cardiac MRI studies were evaluated between October 2007 and June 2020 at 15 European tertiary medical centers. Follow-up was from the date of cardiac MRI examination to June 2020; the minimum and maximum follow-up intervals were 6 months and 156 months, respectively. Patients were excluded if at least one of the following conditions was present: cardiomyopathy, LV ejection fraction less than 40%, ischemic heart disease, congenital heart disease, inflammatory heart disease, moderate or worse mitral regurgitation, participation in competitive sport, or electrocardiogram suggestive of channelopathies. In the remainder, cardiac MRI studies were reanalyzed, and patients were included if they were aged 18 years or older, MVP was diagnosed at cardiac MRI, and clinical information and electrocardiogram monitoring were available within 3 months from cardiac MRI examination. The end point was a composite of adverse outcomes: sustained ventricular tachycardia (VT), sudden cardiac death (SCD), or unexplained syncope. Multivariable Cox regression analysis was performed. Results A total of 474 patients (mean age, 47 years ± 16 [SD]; 244 women) were included. Over a median follow-up of 3.3 years, 18 patients (4%) reached the study end point. LGE presence (hazard ratio, 4.2 [95% CI: 1.5, 11.9]; = .006) and extent (hazard ratio, 1.2 per 1% increase [95% CI: 1.1, 1.4]; = .006), but not MAD presence ( = .89), were associated with clinical outcome. LGE presence had incremental prognostic value over MVP severity and sustained VT and aborted SCD at baseline (area under the receiver operating characteristic curve, 0.70 vs 0.62; = .03). Conclusion In contrast to mitral annulus disjunction, myocardial fibrosis determined according to late gadolinium enhancement at cardiac MRI was associated with adverse outcome in patients with mitral valve prolapse without moderate-to-severe mitral regurgitation or left ventricular dysfunction. © RSNA, 2022 See also the editorial by Gerber in this issue.
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A heart of iron: juvenile haemochromatosis presents with cardiac failure.
Lancet2022 Aug;400(10352):616. doi: 10.1016/S0140-6736(22)01285-5.
Cartella Iside, Tavecchia Giovanni A, Quattrocchi Giuseppina, Giannattasio Cristina, Volpato Elisabetta, Palazzini Matteo, Garascia Andrea, Cipriani Manlio, Frigerio Maria, Ammirati Enrico, Pedrotti Patrizia
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Takotsubo syndrome after BNT162b2 mRNA Covid-19 vaccine: Emotional or causative relationship with vaccination?
Int J Cardiol Heart Vasc2022 Jun;40():101002. doi: 101002.
Tedeschi Andrea, Camilli Massimiliano, Ianni Umberto, Tavecchia Giovanni, Palazzini Matteo, Cartella Iside, Gentile Piero, Quattrocchi Giuseppina, Maria Spanò Francesca, Cipriani Manlio, Garascia Andrea, Ammirati Enrico
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Primary mediastinal large B-cell lymphoma and pregnancy: a challenging clinical scenario.
Monaldi Arch Chest Dis2022 Feb;92(4):. doi: 10.4081/monaldi.2022.2198.
Intravaia Rita, De Chiara Benedetta, Musca Francesco, Casadei Francesca, Santambrogio Gloria, Spanò Francesca, Belli Oriana, Quattrocchi Giuseppina, Giannattasio Cristina, Moreo Antonella
Abstract
A 26-weeks pregnant woman presented with progressively worsening dyspnoea and poor general conditions. Using low-dose radiation multi-imaging techniques and thoracic biopsy a primary mediastinal large B cell was diagnosed. A multidisciplinary approach identified the correct hemodynamic management, the best therapeutic strategy and the timing for delivery.
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Usefulness of Cardiac Magnetic Resonance for Recurrent Pericarditis.
Am J Cardiol2020 Jan;125(1):146-151. doi: 10.1016/j.amjcard.2019.09.026.
Imazio Massimo, Pivetta Emanuele, Palacio Restrepo Sara, Sormani Paola, Pedrotti Patrizia, Quarta Giovanni, Brucato Antonio, Bubbico Elisa, Dal Corso Maria, Milazzo Angela, Quattrocchi Giuseppina, Andriani Monica, Lobetti Bodoni Luisa, Davini Ottavio, Sironi Sandro, Giannattasio Cristina, Giustetto Carla, Bogaert Jan, Adler Yehuda, Bucciarelli Ducci Chiara, De Ferrari Gaetano Maria
Abstract
Cardiac magnetic resonance (CMR) offers the capability to objectively detect pericarditis by identifying pericardial thickening, edema/inflammation by Short-TI Inversion Recovery-T2 weighted (STIR-T2w) imaging, edema/inflammation or fibrosis by late gadolinium enhancement (LGE), and presence of pericardial effusion. This is especially helpful for the diagnosis of recurrent pericarditis. Aim of the present paper is to assess the diagnostic accuracy of CMR findings as well as their potential prognostic value for the diagnosis of recurrent pericarditis. Multicenter cohort study of consecutive patients with recurrent pericarditis evaluated by CMR. We included 128 consecutive cases (60 males, 47%; mean age 48 ± 14 years). CMR was performed at a mean time of 12 days (95% confidence interval 15 to 21) after the clinical diagnosis. We evaluated the diagnostic accuracy and areas under the receiver operating characteristic (ROC) curve for CMR diagnostic criteria and complications (additional recurrences, cardiac tamponade, and constrictive pericarditis). Areas under the ROC curve were respectively 64% for pericardial thickening, 84% for pericardial edema, 82% for pericardial LGE, and 71% for pericardial effusion. After a mean follow-up of 34 months, recurrences occurred in 52% of patients, tamponade in 6%, and constrictive pericarditis in 11%. Using a multivariable Cox model, elevation of CRP and presence of CMR pericardial thickening were predictors of adverse events, whereas the presence of CMR LGE was associated with a lower risk. The prognostic model for adverse events using gender, age, CRP level, and all CMR variables showed a C-index of 0.84. In conclusion, CMR findings show high diagnostic accuracy and may help identifying patients at higher risk of complications.
Copyright © 2019 Elsevier Inc. All rights reserved.
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[Clinical applications of cardiac magnetic resonance imaging: coronary heart disease, myocarditis, pericardial diseases, arrhythmias, valvular heart disease, congenital heart disease and cardiac masses].
G Ital Cardiol (Rome)2019 Jan;20(1):8-19. doi: 10.1714/3079.30716.
Pedrotti Patrizia, Pedretti Stefano, Imazio Massimo, Quattrocchi Giuseppina, Sormani Paola, Milazzo Angela, Quarta Giovanni
Abstract
Cardiac magnetic resonance is an accurate and versatile tool for multiparametric morphologic and functional evaluation of the heart and great vessels, with a wide range of clinical applications: from acute and chronic ischemic heart disease to the assessment of the substrate of complex ventricular arrhythmias and the follow-up of patients with valvular and congenital heart disease. The accuracy in cardiac volume and ejection fraction quantification, tissue characterization, valvular regurgitant fraction and cardiac shunt assessment, pharmachologic stress myocardial perfusion and three-dimensional reconstruction of great vessels are the points of strength that have made Cardiac magnetic resonance an invaluable tool for diagnostic, classification and follow-up of patients with various cardiac diseases.
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[Clinical applications of cardiac magnetic resonance imaging: heart failure and cardiomyopathies].
G Ital Cardiol (Rome)2018 Dec;19(12):679-691. doi: 10.1714/3027.30252.
Pedrotti Patrizia, Pedretti Stefano, Imazio Massimo, Quattrocchi Giuseppina, Sormani Paola, Quarta Giovanni
Abstract
Cardiac magnetic resonance (CMR) has proved to be a powerful tool in the assessment of several cardiac diseases, thanks to its capability to offer multiparametric morphologic and functional evaluation of the heart and great vessels, using neither ionizing radiations nor nephrotoxic contrast medium. The accuracy in quantification of cardiac volumes and ejection fraction (gold standard) together with native and post-contrast myocardial tissue characterization have made CMR an invaluable tool for the diagnosis, prognosis and therapeutic planning in patients with heart failure and cardiomyopathy.
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Complexity of scar and ventricular arrhythmias in dilated cardiomyopathy of any etiology: Long-term data from the SCARFEAR (Cardiovascular Magnetic Resonance Predictors of Appropriate Implantable Cardioverter-Defibrillator Therapy Delivery) Registry.
Clin Cardiol2018 Apr;41(4):494-501. doi: 10.1002/clc.22911.
Pedretti Stefano, Vargiu Sara, Baroni Matteo, Dellegrottaglie Santo, Lanzarin Barbara, Roghi Alberto, Milazzo Angela, Quattrocchi Giuseppina, Lunati Maurizio, Pedrotti Patrizia
Abstract
BACKGROUND:
Late gadolinium enhancement (LGE) assessed with cardiovascular magnetic resonance (CMR) correlates with ventricular arrhythmias and survival in patients with structural heart disease. Whether some LGE characteristics may specifically improve prediction of arrhythmic outcomes is unknown.
HYPOTHESIS:
We sought to evaluate scar characteristics assessed with CMR to predict implantable cardioverter-defibrillator (ICD) interventions in dilated cardiomyopathy of different etiology.
METHODS:
96 consecutive patients evaluated with CMR received an ICD. Biventricular volumes, ejection fraction, and myocardial LGE were evaluated. LGE was defined as "complex" (Cx-LGE) in presence of ?1 of the following: ischemic pattern, involving ?2 different coronary territories; epicardial pattern; global endocardial pattern; and presence of ?2 different patterns. The primary endpoint was occurrence of any appropriate ICD intervention. A composite secondary endpoint of cardiovascular death, cardiac transplantation, or ventricular assist device implantation was also considered.
RESULTS:
During a median follow-up of 75 months, 30 and 25 patients reached the primary and secondary endpoints, respectively. Cx-LGE was correlated with a worse primary endpoint survival (log-rank P
CONCLUSIONS:
Cx-LGE identified at CMR imaging seems promising as an independent and specific prognostic factor of ventricular arrhythmias requiring ICD therapy in dilated cardiomyopathy of different etiologies.
© 2018 Wiley Periodicals, Inc.
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[Catecholamine-induced myocarditis in pheochromocytoma].
G Ital Cardiol (Rome)2017 Feb;18(2):164-168. doi: 10.1714/2663.27302.
Muratori Davide, Pedrotti Patrizia, Baroni Matteo, Belloni Armando, Quattrocchi Giuseppina, Milazzo Angela, Giannattasio Cristina, Roghi Alberto
Abstract
Pheochromocytoma is a rare tumor, usually benign, potentially lethal in case of crisis with acute release of catecholamines. The heart is a target and the clinical presentation can mimic various cardiac conditions, thus rendering diagnosis elusive. Cardiac magnetic resonance is a valuable non-invasive diagnostic tool for the evaluation of cardiomyopathies; it allows the identification of catecholamine-induced myocarditis pattern and, in some cases, it can detect the primary tumor. The definitive treatment of pheochromocytoma is surgical, while the acute crisis may require mechanical support to circulation. We here report a case of pheochromocytoma in a 25-year-old man complicated by catecholamine-induced myocarditis and heart failure.
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Quantitative changes in late gadolinium enhancement at cardiac magnetic resonance in the early phase of acute myocarditis.
Int J Cardiol2017 Mar;231():216-221. doi: 10.1016/j.ijcard.2016.11.282.
Ammirati Enrico, Moroni Francesco, Sormani Paola, Peritore Angelica, Milazzo Angela, Quattrocchi Giuseppina, Cipriani Manlio, Oliva Fabrizio, Giannattasio Cristina, Frigerio Maria, Roghi Alberto, Camici Paolo G, Pedrotti Patrizia
Abstract
BACKGROUND:
The presence of late gadolinium enhancement (LGE) at cardiac magnetic resonance (CMR) has diagnostic and prognostic value in patients with acute myocarditis (AM). Aim of our study was to quantify the changes in LGE extension (LGE%) early after AM and evaluate its relations with biventricular function and morphology.
METHODS:
We investigated 76 consecutive patients with AM (acute onset of chest pain/heart failure/ventricular arrhythmias not explained by other causes, and raised troponin) that met CMR criteria based on myocardial oedema at T2-weighted images and LGE on post-contrast images at median time of 6days from onset of symptoms. We quantified LGE% at baseline and after 148days in 49 patients.
RESULTS:
Median left ventricular (LV)-ejection fraction (EF) was 64% (interquartile range [Q1-Q3]: 56-67%), and LGE% 9.4% (Q1-Q3: 7.5-13.2%). LGE% was correlated with LV end-systolic volume index (LV-ESVi; r=+0.34; p=0.003). LGE% was inversely correlated with LV-EF (r=-0.31; p=0.009) and time to CMR scan (r=-0.25; p=0.028). In the 49 patients with a second CMR scan, despite no significant variations in LV-EF, a significant decrease of LGE% was observed (p
CONCLUSIONS:
In the acute phase of AM the LGE extension is a dynamic process that reflects impairment of LV function and is time dependent. LGE% appears one of the CMR parameters with the largest relative variations in the first months after AM.
Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.
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Multimodality imaging of pericardial diseases.
J Cardiovasc Med (Hagerstown)2016 Nov;17(11):774-82. doi: 10.2459/JCM.0000000000000427.
Imazio Massimo, Pedrotti Patrizia, Quattrocchi Giuseppina, Roghi Alberto, Badano Luigi, Faletti Riccardo, Bogaert Jan, Gaita Fiorenzo
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Partial Anomalous Pulmonary Venous Return as Rare Cause of Right Ventricular Dilation: A Retrospective Analysis.
Congenit Heart Dis2016 Jul;11(4):365-8. doi: 10.1111/chd.12382.
Sormani Paola, Roghi Alberto, Cereda Alberto, Peritore Angelica, Milazzo Angela, Quattrocchi Giuseppina, Giannattasio Cristina, Pedrotti Patrizia
Abstract
INTRODUCTION:
Partial anomalous pulmonary venous return (PAPVR) is an uncommon cause of right ventricular dilation. It may be difficult to identify and often remains undiagnosed.
METHODS:
We reviewed the database of the Cardiac Magnetic Resonance (CMR) Laboratory of Niguarda Hospital, in order to identify the cases of PAPVR between 2008 and 2014.
RESULTS:
On a total number of 7832 CMR scans, we identified 24 patients with PAPVR (14 male, age 41?±?18 y) corresponding to 0.31% of the total population. Only 30% of patients had been referred for known or suspected PAPVR, 33% of patients had been referred for suspected right ventricular arrhythmogenic dysplasia and 37% had been referred for other cardiac disease. PAPVR involved mainly the right pulmonary veins (18 patients, 75%) and in 62% of our cases was associated with an atrial septal defect. Eight patients underwent corrective surgery in our institution, which confirmed and successfully repaired the anomalies.
CONCLUSIONS:
PAPVR is a rare congenital cardiac pathology which should be suspected in case of unexplained right chambers enlargement. CMR imaging allows an accurate anatomic and functional definition of this pathology and associated abnormalities. Early correction has an excellent prognosis and prevents long term complications like pulmonary hypertension, right ventricular failure and atrial fibrillation.
© 2016 Wiley Periodicals, Inc.
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Allogeneic peripheral blood stem cell transplantation and accelerated atherosclerosis: An intriguing association needing targeted surveillance. Lessons from a rare case of acute anterior myocardial infarction.
Eur Heart J Acute Cardiovasc Care2020 Oct;9(7):NP3-NP7. doi: 10.1177/2048872616652311.
Scudiero Laura, Soriano Francesco, Morici Nuccia, Grillo Giovanni, Belli Oriana, Sacco Alice, Cipriani Manlio, Pedrotti Patrizia, Quattrocchi Giuseppina, Klugmann Silvio, Oliva Fabrizio
Abstract
We report the case of a 23-year-old man who developed an acute ST-elevation myocardial infarction secondary to acute thrombotic occlusion of the proximal left anterior descending coronary artery five years after undergoing chemotherapy, radiotherapy, haematopoietic stem cell transplantation for acute lymphoblastic leukaemia and bulky mediastinal mass involving the pleura and pericardium. His medical history also included Graft versus Host Disease developed 13 months after transplantation and acute myocarditis three months before the actual hospital admission. To the best of our knowledge, coronary artery disease as a complication of haematopoietic stem cell transplantation and low-dose mediastinal radiation therapy in young patients has been rarely reported in the medical literature. Clinicians should have a high degree of suspicion of coronary artery disease in patients treated with allogeneic haematopoietic stem cell transplantation, especially in patients previously treated with target mediastinal radiotherapy, as a group at risk of premature and significantly accelerated atherosclerosis, in order to make a timely and correct diagnosis.
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The role of cardiac magnetic resonance in assessing the cardiac involvement in Gaucher type 1 patients: morphological and functional evaluations.
J Cardiovasc Med (Hagerstown)2017 Apr;18(4):244-248. doi: 10.2459/JCM.0000000000000326.
Roghi Alberto, Poggiali Erika, Cassinerio Elena, Pedrotti Patrizia, Giuditta Marianna, Milazzo Angela, Quattrocchi Giuseppina, Cappellini Maria Domenica
Abstract
BACKGROUND:
Type 1 Gaucher disease (GD1) is the most common lysosomal disorder, characterized by the accumulation of beta-glucocerebroside into the macrophages of several organs. Cardiac involvement is rare and referred to as restrictive cardiomyopathy, pulmonary hypertension, and calcifications of the valves and the aortic arch.
AIM:
To assess the cardiovascular status by cardiac magnetic resonance, including evaluation of tissue characterization, in GD1 patients.
METHODS:
Nine GD1 patients were recruited at the Tertiary Care Centre for Rare Diseases at Ca' Granda Foundation IRCCS Hospital, Milan. The patients' records were available for a mean time of 6?±?3 years. Medical history of cardiac disease and cardiovascular risk factors were surveyed by direct interview. Patients were scanned with a 1.5 Avanto Siemens using a comprehensive cardiovascular evaluation protocol, including morphologic and functional sequences with gadolinium contrast media, to assess early and late enhancement (late gadolinium enhancement). Echocardiography was performed to study the cardiac morphology and function, including the measurement of pulmonary pressure.
RESULTS:
Three patients showed left atrial enlargement, one patient showed moderate aortic stenosis in bicuspid valve with mild aortic dilatation, and one patient showed moderate mitral regurgitation. No evidence of myocardial late gadolinium enhancement was detected after gadolinium contrast media. Seven patients received enzyme replacement therapy for a median of 1 year, and two patients were evaluated at diagnosis.
CONCLUSION:
Although cardiac disease in Gaucher disease is considered rare and associated with particular genotypes, we have found two valvular diseases and mild left atrial enlargement in three out of nine patients. Further studies to evaluate the prognostic value of these findings are warranted.
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Cardiac metastatic melanoma: Imaging diagnostic clues.
J Cardiol Cases2015 Aug;12(2):33-36. doi: 10.1016/j.jccase.2015.03.001.
Pedrotti Patrizia, Musca Francesco, Torre Massimo, Pirola Roberto, De Biase Anna Maria, Fieschi Stefano, Quattrocchi Giuseppina, Roghi Alberto, Giannattasio Cristina
Abstract
A 47-year-old male was admitted to hospital for severe pericardial effusion; he had undergone surgical removal of cutaneous melanoma 10 years before. Echocardiography-guided pericardiocentesis revealed the presence of intramyocardial masses, which were better defined and characterized, together with pericardial involvement, by cardiac magnetic resonance. Pericardial fluid drained was negative for malignant cells, so video-assisted thoracoscopy was performed and pathologic tissue was biopsied, leading to the diagnosis of metastatic melanoma. Multidisciplinary approach and multimodality imaging played a key role in allowing the diagnostic workup in this complex case. .
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Myocardial and hepatic iron overload assessment by region-based and pixel-wise T2* mapping analysis: technical pitfalls and clinical warnings.
J Comput Assist Tomogr2015 ;39(1):128-33. doi: 10.1097/RCT.0000000000000159.
Roghi Alberto, Poggiali Erika, Pedrotti Patrizia, Milazzo Angela, Quattrocchi Giuseppina, Cassinerio Elena, Cappellini Maria Domenica
Abstract
OBJECTIVE:
The aim of this study was to compare myocardial T2* assessment with region-based (RB) T2* multiecho technique (CMRtools) with the pixel-wise (PW) inline myocardial T2* mapping (Siemens) in patients with thalassemia major for myocardial iron characterization.
MATERIALS AND METHODS:
Forty-three thalassemia major patients were examined on a 1.5-T scanner using conventional gradient multiecho sequence. All the images were analyzed using both RB and PW T2* mapping. Coefficients of reproducibility (CRs) were used to assess the interoperator and intraobserver variability of each software.
RESULTS:
The mean (SD) myocardial T2* values using RB and PW software resulted significantly different (30.7 [15] milliseconds [range, 4.8-52.6 milliseconds] vs 24.3 [10.5] milliseconds [range 4.6-38.2 milliseconds]; P
CONCLUSIONS:
Our data show that RB and PW T2* mapping can be used interchangeably to measure severe myocardial and hepatic iron overload, whereas for borderline T2* values, we observed differences among the 2 methods causing different categorization.
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