Enrico Cecchi's research while affiliated with Ospedale Maria Vittoria and other places

Publications (74)

Article
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Intravenous drug use is a predisposing condition for infective endocarditis (IE). We report the clinical features of IE, taken from the Italian Registry of IE, in people who inject drugs (PWIDs). The registry prospectively collected epidemiological, clinical, in-hospital, and follow-up data on patients with IE from 17 Italian centers. A total of 67...
Article
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Background Infective endocarditis (IE) is a common and serious complication in patients receiving chronic hemodialysis (HD). Objectives This study sought to investigate whether there are significant differences in complications, cardiac surgery, relapses, and mortality between IE cases in HD and non-HD patients. Methods Prospective cohort study (...
Article
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Patent foramen ovale (PFO) and cryptogenic stroke (CS) both have a high prevalence. The optimal treatment to reduce stroke recurrence after CS remains controversial. Results from clinical trials, meta-analyses, and position papers, support percutaneous PFO device closure and medical therapy compared to medical therapy alone. However, the procedure...
Article
: The 2015 European Society of Cardiology (ESC) guidelines for the management of infective endocarditis recommend the use of a multidisciplinary team in the care of patients with infective endocarditis. A standardized collaborative approach should be implemented in centres with immediate access to different imaging techniques, cardiac surgery and h...
Article
Objectives: Observational studies on early surgery in infective endocarditis have conflicting results. This study aims to compare the treatment strategies for early surgery (within 2 weeks of diagnosis) and late surgery/medical therapy in terms of survival among patients with the left-sided infective endocarditis. Methods: This study included pa...
Article
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Objectives: Minimal access mitral valve surgery (MVS) has already proved to be feasible and effective with low perioperative mortality and excellent long-term outcomes. However, experience in more complex valve diseases such as infective endocarditis (IE) still remains limited. The aim of this retrospective study was to evaluate early and long-ter...
Article
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Echocardiography is essential for the diagnosis and management of infective endocarditis (IE). However, the reproducibility for the echocardiographic assessment of variables relevant to IE is unknown. Objectives of this study were: (1) To define the reproducibility for IE echocardiographic variables and (2) to describe a methodology for assessing q...
Article
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Background: AtrioVentricular (AV) and InterVentricular (VV) delay optimization can improve ventricular function in Cardiac Resynchronization Therapy (CRT) and is usually performed by means of echocardiography. St Jude Medical has developed an automated algorhythm which calculates the optimal AV and VV delays (QuickOpt™) based on Intracardiac Electr...
Article
Unlabelled: Efficacy and safety of antibiotic prophylaxis (AP) for prevention of infective endocarditis (IE) in patients with predisposing cardiac condition (PCC) undergoing invasive procedures is still debated. We sought to assess the prevalence of PCC, the type of interventional procedures preceding the onset of symptoms, and the usefulness of A...
Article
The epidemiology of infective endocarditis (IE) is changing due to a number of factors, including aging and health related comorbidities and medical procedures. The aim of this study is to describe the main clinical, epidemiologic and etiologic changes of IE from a large database in Italy. We prospectively collected episodes of IE in 17 Italian cen...
Article
Background: Staphylococcus aureus left-sided native valve infective endocarditis (LNVIE) has higher complication and mortality rates compared with endocarditis from other pathogens. Whether echocardiographic variables can predict prognosis in S aureus LNVIE is unknown. Methods and Results: Consecutive patients with LNVIE, enrolled between January 2...
Article
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Background. The impact of early valve surgery (EVS) on the outcome of Staphylococcus aureus (SA) prosthetic valve infective endocarditis (PVIE) is unresolved. The objective of this study was to evaluate the association between EVS, performed within the first 60 days of hospitalization, and outcome of SA PVIE within the International Collaboration o...
Article
Staphylococcus aureus left-sided native valve infective endocarditis (LNVIE) has higher complication and mortality rates compared with endocarditis from other pathogens. Whether echocardiographic variables can predict prognosis in S aureus LNVIE is unknown. Consecutive patients with LNVIE, enrolled between January 2000 and September 2006, in the In...
Conference Paper
Background: There are limited prospective, controlled data evaluating survival in patients receiving early surgery versus medical therapy for prosthetic valve endocarditis (PVE). We sought to determine the in-hospital and 1-year mortality in patients with PVE who undergo valve replacement during index hospitalization compared with patients who rece...
Article
Aim: Takotsubo cardiomyopathy is a cardiac syndrome characterized by reversible left ventricular dysfunction, ischemic changes on electrocardiogram, elevation of cardiac biomarkers, absence of obstructive coronary artery disease in the setting of various stressing conditions. To date, little is known on best clinical management of this syndrome in...
Article
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Importance There are limited prospective, controlled data evaluating survival in patients receiving early surgery vs medical therapy for prosthetic valve endocarditis (PVE).Objective To determine the in-hospital and 1-year mortality in patients with PVE who undergo valve replacement during index hospitalization compared with patients who receive...
Article
The choice of the imaging modality (transthoracic [TTE] vs. transesophageal echocardiography [TEE]) for the diagnosis of infective endocarditis (IE) depends on different variables. Aim of the present study is to provide updated data on the diagnostic sensitivity and the clinical usefulness of TTE vs. TEE from the Italian Registry on IE (RIEI). The...
Article
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Infection of implantable cardiac devices is an emerging disease with significant morbidity, mortality, and health care costs. To describe the clinical characteristics and outcome of cardiac device infective endocarditis (CDIE) with attention to its health care association and to evaluate the association between device removal during index hospitali...
Article
We present the case of a 46 year-old male, HCV infected, treated with corrective surgery for tetralogy of Fallot (TOF) immediately after percutaneous closure of the Blalock Taussig shunt. Four months later, the patient had infective endocarditis by Staphylococcus capitis localised on the right side of the patch, treated by oxacillin and gentamycin....
Article
Referral bias occurs because of the clustering of patients at tertiary care centers. This may result in the distortion of observed clinical manifestations of rare diseases. This analysis evaluates the effect of referral bias on the epidemiology of infective endocarditis (IE) in the International Collaboration on Endocarditis-Prospective Cohort Stud...
Article
Full-text available
Prosthetic valve endocarditis (PVE) is associated with significant mortality and morbidity.1 Despite medical advances in surgical techniques, PVE continues to complicate cardiac valve surgery. The incidence is highest within the first 12 months following surgery and affecting 1–3% of patients.2 PVE can arise early or late after surgery. According t...
Article
Antibiotic prophylaxis of patients believed to be at a risk of developing infective endocarditis has been recently revisited with limited indications compared with the previous body of knowledge in use by the medical community. As a consequence, most of the healthcare specialists in cardiology and infectious diseases have doubts related to the enor...
Article
The cause of acute and recurrent pericarditis is often a major concern for the clinicians in clinical practice. Several possible causes of pericarditis can be listed, as the pericardium may be involved in a large number of systemic disorders or may be diseased, as an isolated process. The reported diagnostic yield of extensive laboratory evaluation...
Article
Corticosteroid use is widespread in recurrent pericarditis, even if rarely indicated, and high doses (eg, prednisone 1.0 to 1.5 mg . kg(-1) . d(-1)) are generally recommended, although only weak evidence supports their use with possible severe side effects. The aim of this work was to compare side effects, recurrences and other complications, and h...
Article
In the last 30 years, major improvements have been made in understanding the pathogenesis, diagnosis and treatment of infective endocarditis. Nevertheless, mortality still remains high, close to 30-40% at 1 year, and its reduction remains the main challenge. Moreover, important epidemiological changes have been recorded. Social changes in Western c...
Article
To investigate the relative incidence, clinical presentation and prognosis of myopericarditis among patients with idiopathic or viral acute pericarditis. Prospective observational clinical cohort study. Two general hospitals from an urban area of 220 000 inhabitants. 274 consecutive cases of idiopathic or viral acute pericarditis between January 20...
Article
Embolic events to the central nervous system are a major cause of morbidity and mortality in patients with infective endocarditis (IE). The appropriate role of valvular surgery in reducing such embolic events is unclear. The purpose of this study was to determine the relationship between the initiation of antimicrobial therapy and the temporal inci...
Article
Colchicine seems to be well tolerated and effective in the treatment and prevention of pericarditis. A preliminary clinical trial has shown that colchicine may be considered not only for the treatment of postpericardiotomy syndrome (PPS), but also for its primary prevention. The COPPS study is a multicentre, double-blind, randomised trial. On the t...
Article
Preliminary data have shown that colchicine may be considered for the prevention of the postpericardiotomy syndrome (PPS). The COlchicine for the Prevention of Post-pericardiotomy Syndrome (COPPS) study is a multicenter, double blind, placebo-controlled, randomized trial that will enroll 360 patients after cardiac surgery. The primary end point wil...
Article
Colchicine appears to be safe and effective in the treatment and prevention of recurrent pericarditis after failure of conventional therapies in case reports and non-randomized observational studies without control groups. On this basis, colchicine has been proposed as a therapeutic choice in the 2004 guidelines of the European Society of Cardiolog...
Article
After a systematic review of all publications on recurrent pericarditis from 1966 to 2006, we identified 8 major clinical series including a total of 230 patients with idiopathic recurrent pericarditis (mean age 46 years, men/women ratio: 0.9). After a mean follow-up of 61 months, the complication rate was 3.5% cardiac tamponade and 0% constrictive...
Article
We report a difficult case of a 45-year-old woman with refractory recurrent pericarditis, who was treated with several different medical therapies, pericardial window, and pericardiectomy. This case suggests that more invasive diagnostic and therapeutic choices, such as pericardial window and pericardiectomy, should be carefully considered for poss...
Article
Colchicine is safe and effective in the treatment and prevention of recurrent pericarditis after failure of conventional treatment. The recent guidelines of the European Society of Cardiology suggest that colchicine might be useful even in the treatment of the first episode. However, the use of the drug is not based on any strong evidence obtained...
Article
Intravenous drug users (IDUs) are at increased risk of infective endocarditis (IE). Episodes of IE in IDUs were retrospectively analyzed in this multicenter study. Cases were collected between 1986 and 1999. Only definite diagnosis according to the Duke criteria were analyzed. Two hundred and sixty-three cases, including 100 cases in HIV-positive p...
Article
We describe a 63-year-old man in sinus rhythm (SR) with an ischaemic stroke involving basal ganglia region on the right side. The patient was known to be heterozygous for factor V Leiden (FVL) mutation. On diagnostic work-up, no arterial sources of embolism were found. Transoesophageal echocardiography evidenced a left atrial (LA) thrombosis withou...
Article
The clinical search for indicators of poor prognosis of acute pericarditis may be useful for clinical triage of patients at high risk of specific causal conditions or complications. The aim of the present article is to assess the relationship between clinical features at presentation and specific causes or complications. A total of 453 patients age...
Article
Intravenous drug users (IVDUs) are at increased risk of infective endocarditis. Moreover, HIV infection is common in IVDUs, with a reported prevalence of 40-90%. The clinical features of IVDUs with infective endocarditis and HIV infection may be peculiar. Few data have been reported on the diagnostic accuracy of Duke criteria in IVDUs with or witho...
Article
Infective endocarditis is a disease that continues to evolve in response to changing host conditions and other factors.
Article
HIV infection is one of the leading causes of acquired heart disease. Because of its high diffusion, systematic echocardiographic monitoring has been proposed to exclude cardiovascular involvement in these patients. The aim of this study was to evaluate an alternative clinical approach by which echocardiographic screening is limited to patients wit...
Article
Full-text available
Colchicine is effective and safe for the treatment and prevention of recurrent pericarditis and might ultimately serve as the initial mode of treatment, especially in idiopathic cases. The aim of this work was to verify the safety and efficacy of colchicine as an adjunct to conventional therapy for the treatment of the first episode of acute perica...
Article
Colchicine seems to be a good drug for treating recurrences of pericarditis after conventional treatment failure, but no clinical trial has tested the effects of colchicine as first-line drug for the treatment of the first recurrence of pericarditis. A prospective, randomized, open-label design was used to investigate the safety and efficacy of col...
Article
Fifty-five of 294 consecutive patients with acute pericarditis had first attacks of recurrent pericarditis and were evaluated and treated according to a management protocol. Corticosteroids were restricted to aspirin contraindication or failure. Colchicine was added in cases of aspirin and prednisone failure and was the treatment of choice for the...
Article
Neoplastic etiology was found in 33 of 450 patients with acute pericardial disease (7.3%). Acute pericardial disease was the first manifestation of previously unknown malignancies in 18 of 450 patients (4.0%), and lung cancer was the most common malignancy (72.2%, p = 0.02). The following clinical characteristics were associated with a greater prob...
Article
To date, no studies have evaluated the usefulness of the Duke vs the modified Duke criteria for the early diagnosis of infective endocarditis (IE), nor is it known whether a probabilistic approach may be useful in establishing an early clinical diagnosis of IE. The aim of this study was (1) to assess and compare the clinical usefulness of the Duke...
Article
Recurrent pain without clinical evidence of acute pericarditis was recorded in 27 of 275 patients (9.8%; mean age 55.6 +/- 16.0 years, female/male ratio 20/7) with previous viral or idiopathic acute pericarditis. Female gender (odds ratio [OR] 4.3, 95% confidence interval [CI] 1.8 to 10.6), previous use of corticosteroids (OR 5.2, 95% CI 2.2 to 12....
Article
Echocardiography is currently considered one of the most important tools in the diagnosis and treatment of infective endocarditis (IE). However, its use leaves a number of issues open. Since transthoracic echocardiography (TTE) cannot define structures and vegetations < 4 mm, transesophageal echocardiography (TEE), though more costly and invasive,...
Article
Full-text available
Main pulmonary artery aneurysms are a rare entity with few available published data. As reported in the literature, operative treatment is commonly recommended but the relation between the size of the aneurysm, its localization, and the risk of rupture is not as well defined as for aortic aneurysms. Proximal lesions that involve the main branches o...
Article
The clinical and epidemiological profiles of infective endocarditis (IE) are continuously evolving. We report the results of a 2-year multicenter prospective survey that investigated new trends in the epidemiology, microbiological and clinical features and the prognosis of IE. From January 2000 through December 2001, a prospective multicenter surve...
Article
We sought to investigate the safety and efficacy of a protocol for acute pericarditis triage and outpatient management of low-risk cases. Acute pericarditis has generally a brief and benign course after empiric treatment by non-steroidal anti-inflammatory drugs, and routine hospitalization of most patients may be unnecessary. From January 1996 to D...
Article
This study was designed to investigate the prognostic value of cardiac troponin I (cTnI) in viral or idiopathic pericarditis. Idiopathic acute pericarditis has been recently reported as a possible cause of nonischemic release of cTnI. The prognostic value of this observation remains unknown. We enrolled 118 consecutive cases (age 49.2 +/- 18.4 year...
Article
Whether an invasive or a conservative strategy should form the basis of an optimal management strategy for non-Q wave myocardial infarction is at present still subject of debate. We reported our observational experience with the long-term follow-up of patients with a first uncomplicated non-Q wave myocardial infarction and submitted to a conservati...
Article
Full-text available
28-year-old man was admitted to the Emergency De- partment for syncope after several hours of violent vomiting and diarrhea. A few minutes after arrival, he complained of palpitations followed by a sudden loss of consciousness. An ECG showed a polymorphic ventricular tachycardia degenerating into ventricular fibrillation (Figure 1). Because of recu...
Article
The high sensitivity and specificity of echocardiography in the diagnosis of infective endocarditis have been well established for a number of years. However, little is known yet about the incremental value of this technique over the clinical and serological findings already available in subsets of patients presenting different initial probabilitie...
Article
Cardiological involvement in HIV infection is relatively rare but it presents important clinical aspects that are still open questions. We report our experience with HIV patients who underwent cardiological evaluation, Doppler echocardiography and follow-up. We selected 127 patients (9%) on the basis of clinical suspicion of heart disease, taking t...
Article
Full-text available
The purpose of this study was to determine the sensitivity and specificity of new criteria proposed by Duke University for case definition of infective endocarditis as compared to the previously accepted Von Reyn criteria. A total of 143 consecutive suspected cases of infective endocarditis in 137 febrile patients were included. Of these, 69 had in...
Article
A new diagnostic tool, transesophageal echocardiography (TEE), can detect potential cardioembolic sources, not identifiable before and seems to be useful in refining our understanding of a part of cerebrovascular diseases. 47 patients who presented cerebral ischemia, aged 32 to 65 yrs, underwent this examination and echocolordoppler of cerebral aff...
Article
In order to evaluate the transesophageal echocardiography (TEE) utility and relation of age with cardiac disease at risk for embolization, all the patients older than 75 years (group A, n=9) and all the patients younger than 45 years (group B, n=10) were selected from a group of 166 patients submitted to TEE after a TIA or ischemic stroke. All the...
Article
The transesophageal echocardiography (TEE) has a primary role in the research of cardiac conditions which are potentially cause of embolic ischemic strokes. It is useful, above all, in cases where: 1, there is limited echocardiographic vision with the transthoracic echocardiography (TTE); 2. in patients without clinical evidence of cardiac disease;...
Article
Isolated alterations of the left ventricular diastolic function have been described in diabetic insulin-dependent patients (IDDM), even in the absence of old age, hypertension, ischemic heart disease, left ventricular hypertrophy. Such alterations have been associated with microangiopathy but it is not known whether it is reversible or if there is...
Article
GISSI-3 is a multicentre randomised clinical trial to assess the efficacy of lisinopril, transdermal glyceryl trinitrate (GTN), and their combination in improving survival and ventricular function after acute myocardial infarction (AMI). Between June, 1991, and July, 1993, 19 394 patients were randomised from 200 coronary care units in Italy. Eligi...
Article
Two women suffered from aortic dissection during the third term of pregnancy. The first one, 37 years old, died from a sudden and intractable cardiovascular shock at the end of pregnancy, but the fetus was saved by cesarean. The diagnosis was made post mortem. In the second case a faster diagnosis and a slower development of the aortic dissection a...

Citations

... First, that the etiology of IE is not considered a relevant modifier of management strategy, with the exception of Staphylococcal or of non-HACEK, gram-negative infection of prosthetic valves, for which surgery is recommended [6]. Second, that even when indicated, the optimal timing for surgery is poorly defined [14][15][16]. Guidelines strongly recommend early surgery in patients with active IE and cardiac complications (e.g. acute heart failure or uncontrolled infection, defined as paravalvular extension or persistent bacteremia, or large vegetations after embolic events) [6]. ...
... Endo-aortic balloon occlusion is the alternative to the transthoracic external aortic cross-clamp (7,(19)(20)(21)(22)(23)(24)(25). The resulting absence of a cardioplegia puncture hole in the ascending aorta is a distinct advantage of the endo-aortic balloon occlusion technique. ...