Francesco Paolo Perelli

@auxologico.it

istituto auxologico italiano

https://researchid.co/francescopaoloperelli

RESEARCH, TEACHING, or OTHER INTERESTS

Medicine, Cardiology and Cardiovascular Medicine

Scopus Publications

143

Scholar Citations

Scholar h-index

Scholar i10-index

Scopus Publications

Significant Disagreement Between Conventional Parameters and 3D Echocardiography-Derived Ejection Fraction in the Detection of Right Ventricular Systolic Dysfunction and Its Association With Outcomes
Máté Tolvaj, Attila Kovács, Noela Radu, Andrea Cascella, Denisa Muraru, Bálint Lakatos, Alexandra Fábián, Márton Tokodi, Michele Tomaselli, Mara Gavazzoni,et al.
Elsevier BV

Right Atrial Remodeling and Outcome in Patients with Secondary Tricuspid Regurgitation
Michele Tomaselli, Daniela N. Radu, Luigi P. Badano, Francesco P. Perelli, Francesca Heilbron, Andrea Cascella, Mara Gavazzoni, Diana R. Hădăreanu, Sorina Mihaila, Giorgio Oliverio,et al.
Elsevier BV

Clinical Value of a Novel Three-Dimensional Echocardiography–Derived Index of Right Ventricle–Pulmonary Artery Coupling in Tricuspid Regurgitation
Mara Gavazzoni, Luigi P. Badano, Andrea Cascella, Francesca Heilbron, Michele Tomaselli, Sergio Caravita, Claudia Baratto, Francesco Perelli, Noela Radu, Elisa Perger,et al.
Elsevier BV

Incremental Value of Right Atrial Strain Analysis to Predict Atrial Fibrillation Recurrence After Electrical Cardioversion
Michele Tomaselli, Luigi P. Badano, Vincenzo Cannone, Noela Radu, Emanuele Curti, Francesco Perelli, Francesca Heilbron, Mara Gavazzoni, Valeria Rella, Giorgio Oliverio,et al.
Elsevier BV

An accurate and time-efficient deep learning-based system for automated segmentation and reporting of cardiac magnetic resonance-detected ischemic scar
Daniele M Papetti, Kirsten Van Abeelen, Rhodri Davies, Roberto Menè, Francesca Heilbron, Francesco P Perelli, Jessica Artico, Andreas Seraphim, James C Moon, Gianfranco Parati,et al.
Elsevier BV

Corrigendum: The atrial secondary tricuspid regurgitation is associated to more favorable outcome than the ventricular phenotype (Front. Cardiovasc. Med., (2022), 9, 1022755, 10.3389/fcvm.2022.1022755)
Mara Gavazzoni, Francesca Heilbron, Luigi P. Badano, Noela Radu, Andrea Cascella, Michele Tomaselli, Francesco Perelli, Sergio Caravita, Claudia Baratto, Gianfranco Parati,et al.
Frontiers Media SA
[This corrects the article DOI: 10.3389/fcvm.2022.1022755.].

Impact of severe secondary tricuspid regurgitation on rest and exercise hemodynamics of patients with heart failure and a preserved left ventricular ejection fraction
Claudia Baratto, Sergio Caravita, Giorgia Corbetta, Davide Soranna, Antonella Zambon, Céline Dewachter, Mara Gavazzoni, Francesca Heilbron, Michele Tomaselli, Noela Radu,et al.
Frontiers Media SA
BackgroundBoth secondary tricuspid regurgitation (STR) and heart failure with preserved ejection fraction (HFpEF) are relevant public health problems in the elderly population, presenting with potential overlaps and sharing similar risk factors. However, the impact of severe STR on hemodynamics and cardiorespiratory adaptation to exercise in HFpEF remains to be clarified.AimTo explore the impact of STR on exercise hemodynamics and cardiorespiratory adaptation in HFpEF.MethodsWe analyzed invasive hemodynamics and gas-exchange data obtained at rest and during exercise from HFpEF patients with severe STR (HFpEF-STR), compared with 1:1 age-, sex-, and body mass index (BMI)- matched HFpEF patients with mild or no STR (HFpEF-controls).ResultsTwelve HFpEF with atrial-STR (mean age 72 years, 92% females, BMI 28 Kg/m2) and 12 HFpEF-controls patients were analyzed. HFpEF-STR had higher (p &lt; 0.01) right atrial pressure than HFpEF-controls both at rest (10 ± 1 vs. 5 ± 1 mmHg) and during exercise (23 ± 2 vs. 14 ± 2 mmHg). Despite higher pulmonary artery wedge pressure (PAWP) at rest in HFpEF-STR than in HFpEF-controls (17 ± 2 vs. 11 ± 2, p = 0.04), PAWP at peak exercise was no more different (28 ± 2 vs. 29 ± 2). Left ventricular transmural pressure and cardiac output (CO) increased less in HFpEF-STR than in HFpEF-controls (interaction p-value &lt; 0.05). This latter was due to lower stroke volume (SV) values both at rest (48 ± 9 vs. 77 ± 9 mL, p &lt; 0.05) and at peak exercise (54 ± 10 vs. 93 ± 10 mL, p &lt; 0.05). Despite these differences, the two groups of patients laid on the same oxygen consumption isophlets because of the increased peripheral oxygen extraction in HFpEF-STR (p &lt; 0.01). We found an inverse relationship between pulmonary vascular resistance and SV, both at rest and at peak exercise (R2 = 0.12 and 0.19, respectively).ConclusionsSevere STR complicating HFpEF impairs SV and CO reserve, leading to pulmonary vascular de-recruitment and relative left heart underfilling, undermining the typical HFpEF pathophysiology.

Association of outcome with left ventricular volumes and ejection fraction measured with two- and three-dimensional echocardiography in patients referred for routine, clinically indicated studies
Denisa Muraru, Sorina Mihaila Baldea, Davide Genovese, Michele Tomaselli, Francesca Heilbron, Mara Gavazzoni, Noela Radu, Caravita Sergio, Claudia Baratto, Francesco Perelli,et al.
Frontiers Media SA
ObjectivesWe sought to analyze if left ventricular (LV) volumes and ejection fraction (EF) measured by three-dimensional echocardiography (3DE) have incremental prognostic value over measurements obtained from two-dimensional echocardiography (2DE) in patients referred to a high-volume echocardiography laboratory for routine, clinically-indicated studies.MethodsWe measured LV volumes and EF using both 2DE and 3DE in 725 consecutive patients (67% men; 59 ± 18 years) with various clinical indications referred for a routine clinical study.ResultsLV volumes were significantly larger, and EF was lower when measured by 3DE than 2DE. During follow-up (3.6 ± 1.2 years), 111 (15.3%) all-cause deaths and 248 (34.2%) cardiac hospitalizations occurred. Larger LV volumes and lower EF were associated with worse outcome independent of age, creatinine, hemoglobin, atrial fibrillation, and ischemic heart diseases). In stepwise Cox regression analyses, the associations of both death and cardiac hospitalization with clinical data (CD: age, creatinine, hemoglobin, atrial fibrillation, and ischemic heart disease) whose Harrel’s C-index (HC) was 0.775, were augmented more by the LV volumes and EF obtained by 3DE than by 2DE parameters. The association of CD with death was not affected by LV end-diastolic volume (EDV) either measured by 2DE or 3DE. Conversely, it was incremented by 3DE LVEF (HC = 0.84, p &lt; 0.001) more than 2DE LVEF (HC = 0.814, p &lt; 0.001). The association of CD with the composite endpoint (HC = 0.64, p = 0.002) was augmented more by 3DE LV EDV (HC = 0.786, p &lt; 0.001), end-systolic volume (HC = 0.801, p &lt; 0.001), and EF (HC = 0.84, p &lt; 0.001) than by the correspondent 2DE parameters (HC = 0.786, HC = 0.796, and 0.84, all p &lt; 0.001) In addition, partition values for mild, moderate and severe reduction of the LVEF measured by 3DE showed a higher discriminative power than those measured by 2DE for cardiac death (Log-Rank: χ2 = 98.3 vs. χ2 = 77.1; p &lt; 0.001). Finally, LV dilation defined according to the 3DE threshold values showed higher discriminatory power and prognostic value for death than when using 2DE reference values (3DE LVEDV: χ2 = 15.9, p &lt; 0.001 vs. χ2 = 10.8, p = 0.001; 3DE LVESV: χ2 = 24.4, p &lt; 0.001 vs. χ2 = 17.4, p = 0.001).ConclusionIn patients who underwent routine, clinically-indicated echocardiography, 3DE LVEF and ESV showed stronger association with outcome than the corresponding 2DE parameters.

The atrial secondary tricuspid regurgitation is associated to more favorable outcome than the ventricular phenotype
Mara Gavazzoni, Francesca Heilbron, Luigi P. Badano, Noela Radu, Andrea Cascella, Michele Tomaselli, Francesco Perelli, Sergio Caravita, Claudia Baratto, Gianfranco Parati,et al.
Frontiers Media SA
AimWe sought to evaluate the differences in prognosis between the atrial (A-STR) and the ventricular (V-STR) phenotypes of secondary tricuspid regurgitation.Materials and methodsConsecutive patients with moderate or severe STR referred for echocardiography were enrolled. A-STR and V-STR were defined according to the last ACC/AHA guidelines criteria. The primary endpoint was the composite of all-cause death and heart failure (HF) hospitalizations.ResultsA total of 211 patients were enrolled. The prevalence of A-STR in our cohort was 26%. Patients with A- STR were significantly older and with lower NYHA functional class than V-STR patients. The prevalence of severe STR was similar (28% in A-STR vs. 37% in V-STR, p = 0.291). A-STR patients had smaller tenting height (TH) (10 ± 4 mm vs. 12 ± 7 mm, p = 0.023), larger end-diastolic tricuspid annulus area (9 ± 2 cm2 vs. 7 ± 6 cm2/m2, p = 0.007), smaller right ventricular (RV) end-diastolic volumes (72 ± 27 ml/m2 vs. 92 ± 38 ml/m2; p = 0.001), and better RV longitudinal function (18 ± 7 mm vs. 16 ± 6 mm; p = 0.126 for TAPSE, and −21 ± 5% vs. −18 ± 5%; p = 0.006, for RV free-wall longitudinal strain, RVFWLS) than V-STR patients. Conversely, RV ejection fraction (RVEF, 48 ± 10% vs. 46 ± 11%, p = 0.257) and maximal right atrial volumes (64 ± 38 ml/m2 vs. 55 ± 23 ml/m2, p = 0.327) were similar between the two groups. After a median follow-up of 10 months, patients with V-STR had a 2.7-fold higher risk (HR: 2.7, 95% CI 95% = 1.3–5.7) of experiencing the combined endpoint than A-STR patients. The factors related to outcomes resulted different between the two STR phenotypes: TR-severity (HR: 5.8, CI 95% = 1, 4–25, P = 0.019) in A-STR patients; TR severity (HR 2.9, 95% CI 1.4–6.3, p = 0.005), RVEF (HR: 0.97, 95% CI 0.94–0.99, p = 0.044), and RVFWLS (HR: 0.93, 95% CI 0.85–0.98, p = 0.009) in V-STR.ConclusionAlmost one-third of patients referred to the echocardiography laboratory for significant STR have A-STR. A-STR patients had a lower incidence of the combined endpoint than V-STR patients. Moreover, while TR severity was the only independent factor associated to outcome in A-STR patients, TR severity and RV function were independently associated with outcome in V-STR patients.

RECENT SCHOLAR PUBLICATIONS

Left atrial function and left atrioventricular coupling indices for atrial fibrillation prediction in hypertrophic cardiomyopathy
V Rella, C Delcea, A Clement, S Fisicaro, F Perelli, M Tomaselli, M Penso, ...
European Heart Journal-Cardiovascular Imaging 26 (Supplement_1), jeae333. 372 2025

Left ventricular mass by three-dimensional echocardiography is associated with myocardial replacement fibrosis and ventricular arrhythmias in hypertrophic cardiomyopathy
V Rella, C Delcea, A Clement, F Perelli, M Tomaselli, M Penso, A Buta, ...
European Heart Journal-Cardiovascular Imaging 26 (Supplement_1), jeae333. 355 2025

Significant disagreement between conventional parameters and 3D echocardiography-derived ejection fraction in the detection of right ventricular systolic dysfunction and its
M Tolvaj, A Kovcs, N Radu, A Cascella, D Muraru, B Lakatos, A Fbin, ...
Journal of the American Society of Echocardiography 37 (7), 677-686 2024

Right atrial remodeling and outcome in patients with secondary tricuspid regurgitation
M Tomaselli, DN Radu, LP Badano, FP Perelli, F Heilbron, A Cascella, ...
Journal of the American Society of Echocardiography 37 (5), 495-505 2024

OLD BUT NOT GOLD: DISAGREEMENT BETWEEN CONVENTIONAL PARAMETERS AND 3D ECHOCARDIOGRAPHY-DERIVED EJECTION FRACTION IN THE EVALUATION OF RIGHT VENTRICULAR SYSTOLIC DYSFUNCTION
M Tolvaj, DN Radu, A Cascella, D Muraru, BK Lakatos, A Fabian, ...
Journal of the American College of Cardiology 83 (13_Supplement), 1374-1374 2024

WAITING FOR A CONCERT IN SUMMER HEAT: A TRANSIENT ST ELEVATION IN A YOUNG MAN
G Benzoni, F Perelli, B Bilo, A Giuliano, G Parati, R Brambilla
European Heart Journal Supplements 26 (Supplement_2), ii184-ii185 2024

Significant disagreements between conventional functional metrics and 3D echocardiography-derived ejection fraction in the detection of right ventricular systolic dysfunction
M Tolvaj, N Radu, A Cascella, N Muraru, B Lakatos, A Fabian, M Tokodi, ...
European Heart Journal 44 (Supplement_2), ehad655. 021 2023

Clinical Value of a Novel Three-Dimensional Echocardiography–Derived Index of Right Ventricle–Pulmonary Artery Coupling in Tricuspid Regurgitation
M Gavazzoni, LP Badano, A Cascella, F Heilbron, M Tomaselli, ...
Journal of the American Society of Echocardiography 36 (11), 1154-1166. e3 2023

Incremental value of right atrial strain analysis to predict atrial fibrillation recurrence after electrical cardioversion
M Tomaselli, LP Badano, V Cannone, N Radu, E Curti, F Perelli, ...
Journal of the American Society of Echocardiography 36 (9), 945-955 2023

Discordance between conventional functional parameters and 3D echocardiography-derived ejection fraction in the detection of right ventricular systolic dysfunction
M Tolvaj, N Radu, A Cascella, D Muraru, B Lakatos, A Fabian, M Tokodi, ...
European Heart Journal-Cardiovascular Imaging 24 (Supplement_1), jead119. 265 2023

Mechanical adaptation of the right ventricle to increased volume overload associated with secondary tricuspid regurgitation
DN Radu, E Surkova, A Cascella, A Fabian, D Muraru, B Merkely, ...
European Heart Journal-Cardiovascular Imaging 24 (Supplement_1), jead119. 136 2023

Prognostic impact of disproportionate secondary tricuspid regurgitation
A Cascella, M Gavazzoni, D Muraru, F Perelli, M Tomaselli, N Radu, ...
European Heart Journal-Cardiovascular Imaging 24 (Supplement_1), jead119. 087 2023

The atrial secondary tricuspid regurgitation is associated to more favorable outcome than the ventricular phenotype (vol 9, 1022755, 2022)
M Gavazzoni, F Heilbron, LP Badano, N Radu, A Cascella, M Tomaselli, ...
FRONTIERS IN CARDIOVASCULAR MEDICINE 10 2023

Corrigendum: The atrial secondary tricuspid regurgitation is associated to more favorable outcome than the ventricular phenotype
M Gavazzoni, F Heilbron, LP Badano, N Radu, A Cascella, M Tomaselli, ...
Frontiers in Cardiovascular Medicine 10, 1169907 2023

Impact of severe secondary tricuspid regurgitation on rest and exercise hemodynamics of patients with heart failure and a preserved left ventricular ejection fraction
C Baratto, S Caravita, G Corbetta, D Soranna, A Zambon, C Dewachter, ...
Frontiers in Cardiovascular Medicine 10, 1061118 2023

An accurate and time-efficient deep learning-based system for automated segmentation and reporting of cardiac magnetic resonance-detected ischemic scar
DM Papetti, K Van Abeelen, R Davies, R Men, F Heilbron, FP Perelli, ...
Computer Methods and Programs in Biomedicine 229, 107321 2023

843 QUANTIFICATION OF VENTRICULAR FUNCTIONAL MITRAL REGURGITATION USING THE VOLUMETRIC METHOD BY 3D-ECHOCARDIOGRAPHY
M Tomaselli, E Curti, N Radu, F Perelli, A Cascella, D Stucchi, C Pece, ...
European Heart Journal Supplements 24 (Supplement_K), suac121. 241 2022

227 THE PROGNOSTIC VALUE OF RIGHT ATRIAL STRAIN IN PATIENTS WITH SECONDARY TRICUSPID REGURGITATION
M Tomaselli, L Paolo Badano, F Paolo Perelli, N Radu, G Oliverio, ...
European Heart Journal Supplements 24 (Supplement_K), suac121. 238 2022

MOST CITED SCHOLAR PUBLICATIONS

The atrial secondary tricuspid regurgitation is associated to more favorable outcome than the ventricular phenotype
M Gavazzoni, F Heilbron, LP Badano, N Radu, A Cascella, M Tomaselli, ...
Frontiers in Cardiovascular Medicine 9, 1022755 2022
Citations: 45