I heard his heart stopped for far too long, so i believe like little-rich said that Piana is gone, just staying "alive" through machines... At this point it's better to let him go and pull the plug... It was probably an heart attack, if you check the last videos of his girlfriend Chanel, where they are in vacation, Piana was looking bad, bad skin, bad tone, massively hooked on stimulants... Piana and now McCarver, bodybuilding/fitness community taking big Ls, sad stuff...