One-year renal and cardiac effects of bisoprolol versus losartan in recently diagnosed hypertensive patients: a randomized, double-blind study.

BACKGROUND AND OBJECTIVES: Hypertension is a significant cause of chronic renal injury and its effective treatment is capable of reducing the rate of renal failure. beta-Adrenoceptor antagonists (beta-blockers) have been reported to induce a deterioration in renal function, while several data have indicated a renoprotective effect of treatment with the angiotensin II type 1 receptor antagonist losartan. Previous studies of the interaction between the selective beta(1)-blocker bisoprolol and kidney function were performed only for short- and medium-term periods. The aim of this study was to compare the antihypertensive efficacy and renal and cardiac haemodynamic effects of bisoprolol with th…

Short-term walking physical training and changes in body hydration status, B-type natriuretic peptide and C-reactive protein levels in compensated congestive heart failure.

BACKGROUND: Congestive heart failure (CHF) is associated with decreased exercise tolerance, alterations in body fluid balance and activation of neurohumoral and inflammatory pathways. Physical training, despite the contraindications of the past, is recommended for its beneficial effects on exercise capacity and quality of life. We investigate the effects of a short-term (ten weeks) walking physical training program (PT) on body hydration state (HS), B-type natriuretic peptide (BNP) and C-reactive protein (CRP) levels. METHODS AND RESULTS: 22 patients with CHF (mean age 62.7+/-4.8 years, 15 men, mean ejection fraction 38.9+/-3.6%, NYHA class II-III), were enrolled. Eleven patients were rando…

Usefulness of autopsy in the operated complex congenital Heart diseases

Early and personalized ambulatory follow-up to tailor furosemide and fluid intake according to congestion in post-discharge heart failure

Congestive heart failure (CHF) worsening is a worldwide cause of rehospitalization and mortality, specially during the early period after hospitalization. Fluid accumulation plays a key role in the pathophysiology of both acute heart decompensation and disease progression. The effective use of drugs to maintain restored clinical stabilization in recently discharged patients is a difficult task, and it relies on matching the most appropriately tailored therapy to specific clinical profiles. However, no successful treatment has been shown to reduce post-discharge readmission. We evaluated in a case-control study the effectiveness of an early and personalized congestion-guided ambulatory progr…

“TRANSMURAL CORONARY INFLAMMATION «TRIGGER» OF INSTABLE PLAQUES RUPTURE”

Embolizing inflammatory pseudotumor of the heart

A new option in measuring bioimpedance in congestive heart failure

We read with particular attention the interesting article of Tang and Tong1 concerning the measurement of impedance for assessing volume status in heart failure (HF). This technology is useful in detecting subclinical congestion and predicting future HF events.

Sudden severe abdominal pain after a single low dose of paracetamol/codein in a cholecystectomized patient: learning from a case report.

We report the case of an elderly patient with diastolic heart failure and renal insufficiency admitted to hospital as he complained of having a history of hypogastric pain and dysuria without fever due to renal lithiasis and urinary infection. Because the pain was persistence, and considering the presence of renal dysfunction, it was administered a single low dose of paracetamol/codein (500/30 mg). After about 1 hour of the administration, he suddenly complained of the onset of a lancinating epigastric pain radiating to the whole abdomen and retrosternum accompanied by nausea. The electrocardiogram (EKG) was negative for myocardial infarction and computed tomography excluded aortic dissecti…

Are BNP plasma levels useful in heart failure diagnosis each time? A dyspneic patient with anasarca.

Large hiatal hernia at chest radiography in a woman with cardiorespiratory symptoms

Hiatal hernia (HH) is a frequent entity. Rarely, it may exert a wide spectrum of clinical presentations mimicking acute cardiovascular events such as angina-like chest pain until manifestations of cardiac compression that can include postprandial syncope, exercise intolerance, respiratory function, recurrent acute heart failure, and hemodynamic collapse. A 69-year-old woman presented to the emergency department complaining of fatigue on exertion, cough, and episodes of restrosternal pain with less than 1 hour of duration. Her medical history only included some episodes of bronchitis and no history of hypertension. The 12-lead electrocardiogram demonstrated sinus rhythm with right bundle-bra…