Pamela Gallo
University of Bologna
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Publication
Featured researches published by Pamela Gallo.
Journal of Geriatric Cardiology | 2016
Francesco Saia; Carolina Moretti; Gianni Dall'Ara; Cristina Ciuca; Nevio Taglieri; Alessandra Berardini; Pamela Gallo; Marina Cannizzo; Matteo Chiarabelli; Niccolò Ramponi; Linda Taffani; Maria Letizia Bacchi-Reggiani; Cinzia Marrozzini; Claudio Rapezzi; Antonio Marzocchi
Background Whilst the majority of the patients with severe aortic stenosis can be directly addressed to surgical aortic valve replacement (AVR) or transcatheter aortic valve implantation (TAVI), in some instances additional information may be needed to complete the diagnostic workout. We evaluated the role of balloon aortic valvuloplasty (BAV) as a bridge-to-decision (BTD) in selected high-risk patients. Methods Between 2007 and 2012, the heart team in our Institution required BTD BAV in 202 patients. Very low left ventricular ejection fraction, mitral regurgitation grade ≥ 3, frailty, hemodynamic instability, serious comorbidity, or a combination of these factors were the main drivers for this strategy. We evaluated how BAV influenced the final treatment strategy in the whole patient group and in each specific subgroup. Results Mean logistic European System for Cardiac Operative Risk Evaluation (EuroSCORE) was 23.5% ± 15.3%, age 81 ± 7 years. In-hospital mortality was 4.5%, cerebrovascular accident 1% and overall vascular complications 4% (0.5% major; 3.5% minor). Of the 193 patients with BTD BAV who survived and received a second heart team evaluation, 72.6% were finally deemed eligible for definitive treatment (25.4% for AVR; 47.2% for TAVI): 96.7% of patients with left ventricular ejection fraction recovery; 70.5% of patients with mitral regurgitation reduction; 75.7% of patients who underwent BAV in clinical hemodynamic instability; 69.2% of frail patients and 68% of patients who presented serious comorbidities. Conclusions Balloon aortic valvuloplasty can be considered as bridge-to-decision in high-risk patients with severe aortic stenosis who cannot be immediate candidates for definitive transcatheter or surgical treatment.
American Journal of Cardiology | 2014
Nevio Taglieri; Maria Letizia Bacchi Reggiani; Tullio Palmerini; Gabriele Ghetti; Francesco Saia; Pamela Gallo; Carolina Moretti; Gianni Dall'Ara; Cinzia Marrozzini; Antonio Marzocchi; Claudio Rapezzi
Several prospective studies have shown that high on-clopidogrel platelet reactivity (HPR) in patients undergoing percutaneous coronary intervention (PCI) is a risk factor for ischemic events. All studies were insufficiently powered to detect differences in stroke between patients with HPR and those without. Therefore, we performed a systematic review and meta-analysis of available publications aimed at determining whether patients undergoing PCI with HPR are also at increased risk of stroke. We searched for prospective studies enrolling patients undergoing PCI and treated with aspirin and clopidogrel that reported on clinical relevance of HPR to adenosine diphosphate. Study end point was the rate of stroke. We also investigated whether there was an interaction on the relative risk of stroke between HPR, clinical presentation, duration of follow-up, or laboratory methods. Fourteen studies including 11,959 patients were deemed eligible. On pooled analysis, the risk of stroke was higher in patients with HPR compared with patients with no HPR (1.2% vs 0.7%, relative risk on fixed effect 1.84, 95% confidence interval 1.21 to 2.80). There was no heterogeneity among the studies (I(2) = 0%, p = 0.5). Clinical presentation (p = 0.39 for interaction), duration of follow-up (p = 0.87 for interaction), and laboratory method for detection of HPR (p = 0.99 for interaction) did not affect the relative increase in the risk of stroke in patients with HPR compared with patients with no HPR. In conclusion, in patients with coronary artery disease undergoing PCI, the presence of HPR to adenosine diphosphate is a risk factor for stroke.
European heart journal. Acute cardiovascular care | 2014
Nevio Taglieri; Francesco Saia; Laura Alessi; Laura Cinti; Maria Letizia Bacchi Reggiani; Massimiliano Lorenzini; Cinzia Marrozzini; Tullio Palmerini; Paolo Ortolani; Stefania Rosmini; Gianni Dall’Ara; Pamela Gallo; Gabriele Ghetti; Angelo Branzi; Antonio Marzocchi; Claudio Rapezzi
Aims: To evaluate the relationship between ECG patterns and infarct related artery (IRA) in an all-comer population with ST-segment elevation myocardial infarction (STEMI) and validate current criteria for identifying IRA (right coronary artery (RCA) versus left circumflex artery (LCA)) in inferior STEMI and for diagnosing left main (LM) or left anterior descendent artery occlusion (LAD) in anterior STEMI. Methods and results: We retrospectively analysed ECGs at presentation and coronary angiogram in 885 consecutive patients undergoing primary percutaneous coronary intervention. Six ECG patterns were identified: anterior-STEMI (n=433; 49.0%), inferior-STEMI (i=365; 43.0%), lateral-STEMI (n=43; 5.0%), left bundle branch block (n=26; 3.0%), posterior-STEMI (n=7; 1.0%) and de Winter sign (n=7; 1.0%). The last two ECG patterns were univocally associated with LCA and proximal LAD occlusion respectively. In patients with inferior STEMI, predefined ECG algorithms showed high sensitivity(>90%) for RCA occlusion and high specificity(>90%) for LCA. The diagnostic performance was mainly determined by RCA dominance. In anterior STEMI the vectorial analysis of ST deviation in both frontal and horizontal planes could identify patients with LM/proximal LAD occlusion (adjusted-odds ratio for in-hospital mortality =2.45, 95% confidence interval: 1.31–4.56, p = 0.005) with low sensitivity (maximum 60%; using ST-depression in lead II, III, aVF + ΣSTE aVR + V1–ST depression V6≥0) and high specificity (maximum 95%; using ST-depression in inferior leads + ST-depression in V6). Conclusion: In STEMI undergoing primary percutaneous coronary intervention, six ECG patterns can be identified with a non-univocal relationship to the IRA. In inferior STEMI, vectorial analysis of ST deviation identifies IRA with a high appropriateness only when RCA is the dominant artery. In anterior STEMI, criteria derived from both frontal and horizontal planes identify LM/proximal LAD occlusion with high specificity but low sensitivity.
Acute Cardiac Care | 2011
Nevio Taglieri; Francesco Saia; Lanzillotti; Marrozzini; Faccioli R; Iarussi B; Paolo Ortolani; Tullio Palmerini; Cortesi P; Giovanni Gordini; Pamela Gallo; Angelo Branzi; Antonio Marzocchi
Introduction: We sought to assess the effect of a territorial system of care for ST-elevation myocardial infarction (STEMI) on the outcome of out-of-hospital cardiac arrest (OOHCA). Materials and Methods: We enrolled 720 patients who experienced a witnessed OOHCA of presumed cardiac origin during a four-year period in an area with a STEMI network and for whom resuscitation was attempted. Results: Overall, 242 (33.6%) patients had return of spontaneous circulation (ROSC), 645 (90%) died before discharge. We observed a trend toward decreased overall mortality for OOHCA between the years 2004 and 2007, both in the entire population and in patients with ROSC (2004=94%; 2005=89%; 2006=85%; 2007=89%; P=0.064; 2004=81%; 2005=69%; 2006=65%; 2007=60%; P=0.076, respectively). On multivariable analysis, age, crew-witnessed arrest and presence of shockable rhythm were independent predictors of mortality. Patients who experienced OOHCA in the year 2006 (OR=0.47; 95% CI: 0.21–1.05; P=0.07) and 2007 (OR=0.51; 95% CI: 0.23–1.12; P=0.09) showed a strong trend toward decreased risk of mortality compared to year 2004. In patients with ROSC, the year 2007 was associated with a significant lower risk of mortality compared to year 2004 (OR=0.38; 95% CI: 0.15–0.96; P=0.04). Conclusions: Implementation of a territorial network of care for STEMI appears to be associated with reduced mortality OOHCA patients.
Journal of the American College of Cardiology | 2012
Candida Cristina Quarta; Stefano Perlini; Simone Longhi; Alessandra Berardini; Francesco Musca; Francesco Salinaro; Laura Obici; Agnese Milandri; Pamela Gallo; Christian Gagliardi; Elena Biagini; Francesca Mingardi; Chiara Pazzi; Giampaolo Merlini; Claudio Rapezzi
Amyloidotic cardiomyopathy (AC) can mimic other diseases with left ventricular (LV) hypertrophy, including hypertrophic cardiomyopathy (HCM) and hypertensive heart disease (HHD). Low QRS voltage on ECG provides valuable clues for the non-invasive suspicion of AC. However its sensitivity is limited
PLOS ONE | 2016
Nevio Taglieri; Maria Letizia Bacchi Reggiani; Gabriele Ghetti; Francesco Saia; Gianni Dall’Ara; Pamela Gallo; Carolina Moretti; Tullio Palmerini; Cinzia Marrozzini; Antonio Marzocchi; Claudio Rapezzi
Background Stroke is a rare but serious adverse event associated with percutaneous coronary intervention (PCI). However, the relative risk of stroke between stable patients undergoing a direct PCI strategy and those undergoing an initial optimal medical therapy (OMT) strategy has not been established yet. This study sought to investigate if, in patients with stable coronary artery disease (SCAD), an initial strategy PCI is associated with a higher risk of stroke than a strategy based on OMT alone. Methods We performed a meta-analysis of 6 contemporary randomized control trials in which 5673 patients with SCAD were randomized to initial PCI or OMT. Only trials with stent utilization more than 50% were included. Study endpoint was the rate of stroke during follow up. Results Mean age of patients ranged from 60 to 65 years and stent utilization ranged from 72% to 100%. Rate of stroke was 2.0% at a weighted mean follow up of 55.3 months. On pooled analysis, the risk of stroke was similar between patients undergoing a PCI plus OMT and those receiving only OMT (2.2% vs. 1.8%, OR on fixed effect = 1.24 95%CI: 0.85–1.79). There was no heterogeneity among the studies (I2 = 0.0%, P = 0.15). On sensitivity analysis after removing each individual study the pooled effect estimate remains unchanged. Conclusions In patients with SCAD an initial strategy based on a direct PCI is not associated with an increased risk of stroke during long-term follow up compared to an initial strategy based on OMT alone.
Journal of the American College of Cardiology | 2012
Candida Cristina Quarta; Pier Luigi Guidalotti; Simone Longhi; Cinzia Pettinato; Ornella Leone; Fabrizio Salvi; Alessandra Ferlini; Agnese Milandri; Pamela Gallo; Christian Gagliardi; Elena Biagini; Claudio Rapezzi
Background: Senile systemic amyloidosis (SSA), due to intramyocardial deposition of wild-type transthyretin (TTR), is often mistaken as hypertensive heart disease (HHD) or hypertrophic cardiomyopathy (HCM). In patients with amyloidotic cardiomyopathy 99mTc-DPD scintigraphy can differentiate between TTR (mutant and wild-type) and primary amyloidosis. We assessed the diagnostic performance of 99mTc-DPD scintigraphy in the non-invasive identiication of SSA in a clinical context of elderly patients with unexplained concentric left ventricular (LV) “hypertrophy”.
Jacc-cardiovascular Imaging | 2011
Claudio Rapezzi; Candida Cristina Quarta; Pier Luigi Guidalotti; Cinzia Pettinato; Stefano Fanti; Ornella Leone; Alessandra Ferlini; Simone Longhi; Massimiliano Lorenzini; Letizia Bacchi Reggiani; Christian Gagliardi; Pamela Gallo; Caterina Villani; Fabrizio Salvi
European Journal of Nuclear Medicine and Molecular Imaging | 2011
Claudio Rapezzi; Candida Cristina Quarta; Pier Luigi Guidalotti; Simone Longhi; Cinzia Pettinato; Ornella Leone; Alessandra Ferlini; Fabrizio Salvi; Pamela Gallo; Christian Gagliardi; Angelo Branzi
International Journal of Cardiology | 2012
Antonio Marzocchi; Nevio Taglieri; Francesco Saia; Cinzia Marrozzini; Claudio Rapezzi; Pamela Gallo; Pietro Cortesi; Tullio Palmerini; Carolina Moretti; Giuseppe Di Pasquale; Pietro Sangiorgio; Rossana De Palma