0000000000020721

AUTHOR

P. Assennato

Functional Evaluation of Patients with Implanted Pacemakers

Because of the knowledge that his life is dependent on the pacemaker and due to the uncertainty of some clinical results, the paced patient needs a guide to return to society.

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Comparison of coronary artery flow impairment in diabetic and ipertensive patients with stable microvascular angina

OBJECTIVE: Stable microvascular angina (SMVA) describes patients with angina, findings compatible with myocardial ischemia and normal coronary angiograms. The aim of this study was to evaluate the impact of diabetes on the coronary microcirculation troughs angiography indexes (TIMI Frame Count, Myocardial Blush Grade, Total Myocardial Blush Score) and a new index:TotalTIMI Frame Count (TTFC). PATIENTS AND METHODS: The study population included 310 patients with SMVA that we split into two populations: diabetic-non hypertensive (164 patients) and non-diabetichypertensive (146 patients). We calculated, on angiographic images of each patient, TIMI Frame Count (TFC), Myocardial Blush Grade (MBG…

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Carotid intimal-media thickness and endothelial function in young patients with history of myocardial infarction

AIM: The aim of the study was to evaluate the prevalence of carotid atherosclerosis and endothelial dysfunction in 45 young patients (38 mens and 7 females) with myocardial infarction (MI), age 29-45, mean age 42+/-3 years, to verify its possible role as a marker of coronary atherosclerosis. METHODS: Vascular echography was performed to verify the presence of carotid atherosclerosis and/or endothelial dysfunction in 45 young patients with MI and in 45 healthy control subjects well matched for age and sex. RESULTS: We observed a normal intima media thickness (IMT) only in 30% of patients with juvenile myocardial infarction (JMI) compared with 66% in the control group (P<0.0001) and 34% of pa…

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Anatomical features and clinical correlations in Caucasian patients with definite arrhythmogenic right ventricular dysplasia/cardiomyopathy.

AIM: Arrhythmogenic right ventrticular dysplasia/cardiomyopathy (ARVD/C) is an inherited cardiomyopathy characterized by fibrofatty replacement and a high risk of ventricular arrhythmias (VA) and sudden cardiac death (SCD). The aim of the present investigation is to examine the pathological profile and the clinical correlations in a group of ARVD/C patients. METHODS: We conducted a multicenter study evaluating 47 patients (31 men; mean age 37±14 years) with definite ARVD/C. Diagnosis was established according to the actual clinicomorphologic criteria at autopsy or clinically. We divided the study population in 2 different groups. First group included 28 alive patients and the second 19 pati…

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Screening for Early Detection of Asymptomatic Coronary Artery Disease (Secondary Prevention): An Approach to Cost/Benefit and Cost/Effectiveness Analysis

Classification of different types of preventive measures for ischemic heart disease (IHD) has been much debated. In the classical use of terms “primary prevention” (prevention of occurrence) includes removal of risk factors in otherwise healthy individuals, while the attempts to change diet and life style in the very early age, in order to avoid the acquisition of risk factors, has been called “preprimary prevention” or “early prevention.”

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In-hospital stay of patient with acute coronary syndrome with or without diabetes mellitus

Aim. Type 2 diabetes is associated with an increase in the risk of coronary heart disease, by a factor of two to four. The scientific community has suggested that all patients with diabetes could be treated as if they had a prior coronary heart disease. Methods. A computer review of 11-year prevalence (from 1991 to 2002) of type 2 diabetes among 3 242 patients admitted to the Intensive Coronary Care Unit of the Division of Cardiology of the University Hospital "Paolo Giaccone", Palermo, was carried out, with the diagnosis of ST elevation myocardial infarction (STEMI) (51%), non ST elevation myocardial infarction (NSTEMI) (6%) or unstable angina (UA) (43%). Results. Prevalence of type 2 diab…

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Vasospastic angina and scombroid syndrome: a case report

Scombroid syndrome is a fish poisoning characterised by the onset of symptoms compatible with a pseudoallergic reaction; it is rarely also responsible of signs and symptoms of acute coronary syndromes, as demonstrated in this case report.

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Prognostic role of endothelial dysfunction and carotid intima-media thickness in patients undergoing coronary stent implantation

Aim. Impaired endothelial function and increased carotid intima-media thickness are key events in the atherosclerotic process and predict future cardiovascular events in subjects with and without coronary artery disease. The purpose of this study was to investigate whether the vasodilator response to increased flow in the brachial artery and the presence of carotid lesions may have a prognostic significance for in-stent restenosis in patients undergoing coronary angioplasty. Methods. The study population included 58 patients undergoing percutaneous coronary intervention (PCI) with stenting and at least 10 months of follow-up. All patients underwent ultrasound detection of brachial artery re…

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A risk score derived from the analysis of a cluster of 27 serum inflammatory cytokines to predict long term outcome in patients with acute myocardial infarction: A pilot study

Objective. The aim of our study was to evaluate the clinical utility and prognostic significance of a cluster of 27 serum cytokines for risk stratification after myocardial infarction. Materials and Methods. We enrolled 33 consecutive patients admitted to our institution for acute myocardial infarction and prospectively followed. We evaluated traditional cardiovascular risk factors and assayed, during the acute phase, 27 serum cytokines (IL-1, IL-1ra, IL-2, IL-4, IL-5, IL-6, IL -7, IL-8, IL-9, IL-10, IL-12, IL-13, IL-15, IL-17, EOTAXIN, FGF, G-CSF, GM-CSF, IFN-γ, IP-10, MCP-1, MIP-1α, MIP-1ß, PDGF, RANTES, TNF-α, VEGF) potentially associated with cardiovascular risk. Patients were divided i…

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Short term prognostic role of NT-proBNP in patients after myocardial infarction

Aim. The clinical and prognostic role of cardiac natriuretic peptides (CNP) in patients with heart failure is well known; recently, several studies have evaluated the possibility of using CNP to evaluate their potential prognostic role in patients with acute coronary syndromes (ACS). The aim of this study was to evaluate the short term prognostic value of NT-proBNP in 70 patients admitted for ACS. Methods. The authors studied 70 patients with ACS, evaluating, at admission, clinical-anamnestic, instrumental and laboratory characteristics including NT-proBNP plasma levels. Patients were monitored in a 6-month-follow-up to record adverse fatal events and their possible correlation with baselin…

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Implantation of a biventricular defibrillator in a borderline case of arrhythmogenic right ventricular dysplasia/cardiomyopathy

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