Nicola Riccardo Pugliese
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View article: Advancing Cardiovascular Risk Stratification and Functional Assessment: A Narrative Review of CPET and ESE Applications
Advancing Cardiovascular Risk Stratification and Functional Assessment: A Narrative Review of CPET and ESE Applications Open
Cardiopulmonary exercise testing combined with exercise stress Echocardiography (CPET-ESE) is an advanced diagnostic modality for evaluating cardiovascular disease and tailoring patient-specific treatment strategies. By integrating metabol…
View article: Refining the link between obesity and heart failure: insights from GLP-1 receptor agonist trials and studies adopting direct adiposity measures
Refining the link between obesity and heart failure: insights from GLP-1 receptor agonist trials and studies adopting direct adiposity measures Open
Overweight and obesity are major risk factors for heart failure (HF), contributing to its development through metabolic, neurohormonal, haemodynamic, and inflammatory alterations. While overweight/obesity increases the risk of developing H…
View article: Right Ventricular–Pulmonary Artery Uncoupling and Strain in Acute Heart Failure
Right Ventricular–Pulmonary Artery Uncoupling and Strain in Acute Heart Failure Open
Background Assessment of right ventricular–pulmonary artery coupling plays a crucial role in risk stratification, monitoring efficacy, and predicting outcomes in chronic heart failure patients. However, data in acute heart failure (AHF) ar…
View article: Unsupervised machine learning applied to CPETecho for subclassifying heart failure with preserved ejection fraction: a pathophysiological approach
Unsupervised machine learning applied to CPETecho for subclassifying heart failure with preserved ejection fraction: a pathophysiological approach Open
Background Heart failure with preserved ejection fraction (HFpEF) is a heterogeneous disease, and not all patients respond well to current treatment. Identifying subgroups of HFpEF patients may support more personalised and effective thera…
View article: Intolleranza allo sforzo nel diabete di tipo 2: diagnosi, rilevanza clinica, fisiopatologia e sviluppi futuri di un sintomo “trascurato”
Intolleranza allo sforzo nel diabete di tipo 2: diagnosi, rilevanza clinica, fisiopatologia e sviluppi futuri di un sintomo “trascurato” Open
Effort intolerance is common among patients with type 2 diabetes, wherein it predicts the development of heart failure. Difficult to assess subjectively, it can be confirmed and quantified with cardiopulmonary exercise testing (CPET), in w…
View article: Imaging of Congestion in Cardio-renal Syndrome
Imaging of Congestion in Cardio-renal Syndrome Open
View article: AI-driven Classification of Heart Failure Preserved and Reduced Ejection Fraction Patients Using the Total Protein Approach
AI-driven Classification of Heart Failure Preserved and Reduced Ejection Fraction Patients Using the Total Protein Approach Open
Heart failure (HF) presents two major subtypes: HF with preserved ejection fraction (HFpEF) and HF with reduced ejection fraction (HFrEF), each one with distinct metabolic characteristics. This study utilized artificial intelligence, high-…
View article: Exercise Echocardiography of Left Ventricular Diastolic Function in Healthy Subjects: Insights From the RIGHT-NET
Exercise Echocardiography of Left Ventricular Diastolic Function in Healthy Subjects: Insights From the RIGHT-NET Open
In healthy adult subjects, E/e' slightly increased during midlevel exercise. Both E/e' and TRV are exercise intensity-dependent and would therefore be better expressed as a function of CO for the diagnosis of normal vs abnormal LV diastoli…
View article: Circadian heart rate fluctuations predict cardiovascular and all-cause mortality in type 2 and type 1 diabetes: a 21-year retrospective longitudinal study
Circadian heart rate fluctuations predict cardiovascular and all-cause mortality in type 2 and type 1 diabetes: a 21-year retrospective longitudinal study Open
Aims Circadian heart rate (HR) fluctuations are associated with cardiovascular health. We examined their relationship with microvascular disease and long-term survival in patients with diabetes. Methods and results In this secondary analys…
View article: Integrative assessment of congestion in heart failure using ultrasound imaging
Integrative assessment of congestion in heart failure using ultrasound imaging Open
View article: Sex-Related Determinants of Exercise Intolerance in HFpEF
Sex-Related Determinants of Exercise Intolerance in HFpEF Open
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View article: Novel Techniques, Biomarkers and Molecular Targets to Address Cardiometabolic Diseases
Novel Techniques, Biomarkers and Molecular Targets to Address Cardiometabolic Diseases Open
Cardiometabolic diseases (CMDs) are interrelated and multifactorial conditions, including arterial hypertension, type 2 diabetes, heart failure, coronary artery disease, and stroke. Due to the burden of cardiovascular morbidity and mortali…
View article: Lean body mass and the cardiorespiratory phenotype: An ethnic‐specific relationship in Hans Chinese women and men
Lean body mass and the cardiorespiratory phenotype: An ethnic‐specific relationship in Hans Chinese women and men Open
Background Lean body mass (LBM) and the functional capacity of cardiovascular (CV) and respiratory systems constitute a female‐specific relationship in European–American individuals. Whether this recent finding be extrapolated to the world…
View article: Development of a high-throughput liquid chromatography-tandem mass spectrometry platform for the determination of intact natriuretic peptides in human plasma
Development of a high-throughput liquid chromatography-tandem mass spectrometry platform for the determination of intact natriuretic peptides in human plasma Open
View article: Prognostic implication of lung ultrasound in heart failure: a pooled analysis of international cohorts
Prognostic implication of lung ultrasound in heart failure: a pooled analysis of international cohorts Open
Aims Lung ultrasound (LUS) is often used to assess congestion in heart failure (HF). In this study, we assessed the prognostic role of LUS in patients with HF at admission and hospital discharge, and in an outpatient setting, and explored …
View article: THE IMPACT OF HEART FAILURE ON QUALITY OF LIFE: A MIXED METHOD STUDY
THE IMPACT OF HEART FAILURE ON QUALITY OF LIFE: A MIXED METHOD STUDY Open
Introduction Heart failure (HF) is a significant global health problem, affecting over 64,000 people annually and resulting in high mortality rates (Savarese et al., 2023). However, for those receiving follow–up care, there is a 20% increa…
View article: Transthoracic and transoesophageal echocardiography for tricuspid transcatheter edge-to-edge repair: a step-by-step protocol
Transthoracic and transoesophageal echocardiography for tricuspid transcatheter edge-to-edge repair: a step-by-step protocol Open
Tricuspid regurgitation (TR) carries an unfavourable prognosis and often leads to progressive right ventricular (RV) failure. Secondary TR accounts for over 90% of cases and is caused by RV and/or tricuspid annulus dilation, in the setting…
View article: mPAP/CO Slope and Oxygen Uptake Add Prognostic Value in Aortic Stenosis
mPAP/CO Slope and Oxygen Uptake Add Prognostic Value in Aortic Stenosis Open
BACKGROUND: Recent guidelines redefined exercise pulmonary hypertension as a mean pulmonary artery pressure/cardiac output (mPAP/CO) slope >3 mm Hg·L −1 ·min −1 . A peak systolic pulmonary artery pressure >60 mm Hg during exercise has been…
View article: Digital Ulcers and Ventricular Arrhythmias as Red Flags to Predict Replacement Myocardial Fibrosis in Systemic Sclerosis
Digital Ulcers and Ventricular Arrhythmias as Red Flags to Predict Replacement Myocardial Fibrosis in Systemic Sclerosis Open
Background: Cardiac involvement in systemic sclerosis (SSc) affects the prognosis of the disease. Echocardiography is the first line imaging tool to detect cardiac involvement, but it is not able to routinely detect myocardial fibrosis. La…
View article: Treatment with recombinant Sirt1 rewires the cardiac lipidome and rescues diabetes-related metabolic cardiomyopathy
Treatment with recombinant Sirt1 rewires the cardiac lipidome and rescues diabetes-related metabolic cardiomyopathy Open
View article: Abnormal workload-indexed blood pressure response to exercise in patients at risk of or with overt heart failure
Abnormal workload-indexed blood pressure response to exercise in patients at risk of or with overt heart failure Open
Background Conflicting evidence exists regarding the functional and prognostic significance of hypertensive response to exercise (HRE), commonly defined as peak systolic blood pressure (SBP) >210 mmHg in males and >190 mmHg in female…
View article: Distinct effects of type 2 diabetes and obesity on cardiopulmonary performance
Distinct effects of type 2 diabetes and obesity on cardiopulmonary performance Open
Aim Effort intolerance is frequent in patients with overweight/obesity and/or type 2 diabetes (T2D) free from cardiac and respiratory disease. We sought to quantify the independent effects of T2D and body mass index (BMI) on cardiopulmonar…
View article: The Results of the URRAH (Uric Acid Right for Heart Health) Project: A Focus on Hyperuricemia in Relation to Cardiovascular and Kidney Disease and its Role in Metabolic Dysregulation
The Results of the URRAH (Uric Acid Right for Heart Health) Project: A Focus on Hyperuricemia in Relation to Cardiovascular and Kidney Disease and its Role in Metabolic Dysregulation Open
View article: Bio-Humoral and Non-Invasive Haemodynamic Correlates of Renal Venous Flow Patterns across the Heart Failure Spectrum
Bio-Humoral and Non-Invasive Haemodynamic Correlates of Renal Venous Flow Patterns across the Heart Failure Spectrum Open
Background: We evaluated the bio-humoral and non-invasive haemodynamic correlates of renal congestion evaluated by Doppler renal venous flow (RVF) across the heart failure (HF) spectrum, from asymptomatic subjects with cardiovascular risk …
View article: Breath analysis combined with cardiopulmonary exercise testing and echocardiography for monitoring heart failure patients: the AEOLUS protocol
Breath analysis combined with cardiopulmonary exercise testing and echocardiography for monitoring heart failure patients: the AEOLUS protocol Open
This paper describes the AEOLUS pilot study which combines breath analysis with cardiopulmonary exercise testing (CPET) and an echocardiographic examination for monitoring heart failure (HF) patients. Ten consecutive patients with a prior …
View article: Haemodynamic forces predicting remodelling and outcome in patients with heart failure treated with sacubitril/valsartan
Haemodynamic forces predicting remodelling and outcome in patients with heart failure treated with sacubitril/valsartan Open
Aims A novel tool for the evaluation of left ventricular (LV) systo‐diastolic function through echo‐derived haemodynamic forces (HDFs) has been recently proposed. The present study aimed to assess the predictive value of HDFs on (i) 6 mont…
View article: Functional and prognostic impact of hypertensive response to exercise across the heart failure spectrum
Functional and prognostic impact of hypertensive response to exercise across the heart failure spectrum Open
Funding Acknowledgements Type of funding sources: None. Background Conflicting data exist regarding the prognostic significance of hypertensive response to exercise (HRE), commonly defined according to absolute peak systolic blood pressure…
View article: Multi-organ sonographic assessment of congestion has incremental prognostic value in outpatients with heart failure irrespective of left ventricular ejection fraction
Multi-organ sonographic assessment of congestion has incremental prognostic value in outpatients with heart failure irrespective of left ventricular ejection fraction Open
Funding Acknowledgements Type of funding sources: None. Background Congestion is a key driver of symptoms, disease progression and prognosis for patients with heart failure (HF), irrespective of left ventricular ejection fraction (LVEF). H…
View article: Combining cardiopulmonary exercise testing with echocardiography: a multiparametric approach to the cardiovascular and cardiopulmonary systems
Combining cardiopulmonary exercise testing with echocardiography: a multiparametric approach to the cardiovascular and cardiopulmonary systems Open
Exercise intolerance is a prominent feature of several cardiovascular conditions. However, the physical effort requires the intertwined adaptation of several factors, namely the cardiovascular system, the lungs, and peripheral muscles. Sev…
View article: P446 INDEPENDENT EFFECTS OF TYPE 2 DIABETES AND OBESITY ON CARDIOPULMONARY PERFORMANCE IN SUBJECTS AT HIGH CARDIOVASCULAR RISK
P446 INDEPENDENT EFFECTS OF TYPE 2 DIABETES AND OBESITY ON CARDIOPULMONARY PERFORMANCE IN SUBJECTS AT HIGH CARDIOVASCULAR RISK Open
Background Both obesity and type 2 diabetes (T2D) are associated with effort intolerance and heart failure. Since the two conditions often coexist and overlap, their distinct effect on cardiopulmonary performance remains to be elucidated. …