Large left ventricular metastatis in patient with liposarcoma.

Abstract Metastasis to the heart and pericardium are rare. We present a 44-year-old male with pleural dedifferentiated liposarcoma and multiple metastases, with no previous cardiological history and/or cardiac symptoms. A transthoracic echocardiogram during the advanced stage of disease showed a lobulated, large and mobile mass, with homogeneous echogenicity, attached to the basal posterior wall of the left ventricle via a broad base and with intracavitary growth. This mass extends to inferolateral and inferoseptal wall of the left ventricle.

ATEROSCLEROSI CAROTIDEA E PERIFERICA E RESTENOSI CORONARICA DOPO ANGIOPLASTICA PERCUTANEA.

RISK FACTORS, VASCULAR AGING AND ATHEROSCLEROSIS: 3rd ANTONIO STRANO LECTURE

RISK FACTORS, VASCULAR AGING AND ATHEROSCLEROSIS: 3rd ANTONIO STRANO LECTURE

Cardiovascular risk assessment beyond Systemic Coronary Risk Estimation: A role for organ damage markers

BACKGROUND: Cardiovascular risk assessment in the clinical practice is mostly based on risk charts, such as Framingham risk score and Systemic Coronary Risk Estimation (SCORE). These enable clinicians to estimate the impact of cardiovascular risk factors and assess individual cardiovascular risk profile. Risk charts, however, do not take into account subclinical organ damage, which exerts independent influence on risk and may amplify the estimated risk profile. Inclusion of organ damage markers in the assessment may thus contribute to improve this process. OBJECTIVE: Our aim was to evaluate the influence of implementation of SCORE charts with widely available indexes of organ damage, with t…

PERIPHERAL ATHEROSCLEROSIS AS MARKER OF CORONARY ARTERY DISEASE

Left bundle branch block and myocardial infarction, a diagnosis not always easy: Our experience and review of literature

The occurrence of left bundle branch block (LBBB) is quite common in clinical practice. The changes in cardiac repolarization, caused by this disorder of electric conduction, may mask the presence of an acute myocardial infarction (AMI), delaying the diagnostic-therapeutic iter, with an important impact on prognosis. We describe the case of a woman of 59 years with LBBB, came to our observation for a constrictive chest pain associated with dyspnea. The diagnostic workup for suspected acute coronary syndrome (ACS), initially conducted only on the analysis of the electrocardiogram (negative TnI at entry), showed the presence of coronary arteries free of stenosis. However, the diagnostic confi…

VALUTAZIONE DELLA PROTEINA C-REATTIVA AD ELEVATA SENSIBILITÀ IN PREVENZIONE PRIMARIA

In an attempt to improve global cardiovascular risk prediction, considerable interest has focused on C-reactive protein (CRP), that has been shown in multiple prospective epidemiological studies to predict incident myocardial infarction, stroke, peripheral arterial disease, and sudden cardiac death. CRP is a hepatically-derived pentraxin that plays a key role in the innate immune response. Standard CRP tests determine levels which are increased up to 1000-fold in response to infection or tissue destruction, but cannot adequately assess the normal range. High-sensitive CRP detects levels of CRP within the normal range as well as higher levels proven to predict future cardiovascular events. T…

L’ISCHEMIA MIOCARDICA NEL SOGGETTO IPERTESO: IL RUOLO DELLE ALTERAZIONI DEL MICROCIRCOLO CORONARICO

SYNCOPE AND ARRHYTHMIAS IN PAEDIATRIC AGE

SYNCOPE AND ARRHYTHMIAS IN PAEDIATRIC AGE

Long-term treatment with the ace inhibitor captopril, alone or in combination with hydrochlorothiazide, in elderly hypertensives: Effects on blood pressure and quality of life

Abstract The efficacy and tolerability of long-term treatment with the angiotensin converting enzyme inhibitor captopril was evaluated in elderly hypertensive subjects. One hundred thirty patients were studied (61 men and 69 women; mean age, 68.33 ± 5.49 years), all with mild to moderate arterial hypertension (mild = 90–105 mmHg; moderate = 105–115 mmHg). Patients with secondary hypertension were excluded from the study. After a 2-week drug washout, patients were given captopril 25 to 100 mg/day alone or in combination with hydrochlorothiazide (HCTZ) 25 mg/day for 15 weeks. After 2 weeks of treatment, significant decreases in systolic and diastolic blood pressures were observed (P

Coronary artery fistulas as a cause of angina: How to manage these patients?

Abstract Coronary artery fistulas represent the most common hemodynamically significant congenital defect of the coronary arteries and the clinical presentation is mainly dependent on the severity of the left-to-right shunt. We describe a case of a 55-year-old man with history of chest pain and without history of previous significant chest wall trauma or any invasive cardiac procedures. A coronary multislice computed tomography showed two large coronary fistulas arising from the left anterior descending coronary artery and ending in an angiomatous plexus draining into the common pulmonary trunk. Coronary angiography confirmed the CT finding and showed a third fistulous communication arising…

Infection and inflammation influence the outcome of patient with asymptomatic carotid lesions

BACKGROUND AND PURPOSE: It is still in debate whether the evaluation of markers of infection and inflammation may be of importance for cerebrovascular and cardiovascular prevention, and we aimed to investigate this field in a prospective 5-year clinical follow-up study in patients with early stages of atherosclerosis. METHODS: We studied 668 subjects divided in 3 groups according to the results of carotid ultrasound examination: (1) normal subjects, if intima-media thickness (IMT) was 1.5 mm. Traditional cardiovascular risk factors were investigated, and laboratory analysis included measurement of plasma lipids, fibrinogen, C-reactive protein, IgG antibodies for helicobacter pylori (HP), cy…

EVALUATION OF DIASTOLIC FUNCTION BY THE TISSUE DOPPLER IN CHILDREN AFFECTED BY NON COMPACTION.

INFLAMMATION ET INFECTION IN ANGEIOLOGIE.

INFLAMMATION ET INFECTION IN ANGEIOLOGIE

Preclinical carotid atherosclerosis enhances the global cardiovascular risk and increases the rate of cerebro- and cardiovascular events in a five-year follow-up

AIM: To evaluate if the intima-media thickening (IMT) and asymptomatic carotid plaque (ACP), as expression of carotid preclinical atherosclerosis (pre-ATS), can provide further information on the global cardiovascular risk (GCVR). METHODS: We studied 454 asymptomatic subjects, with a cluster of risk factors (RF), and evaluated the incidence of a first cardiovascular (CV) event in a five-year follow-up. The subjects at admission were subdivided in three groups of risk. RESULTS: Events occurred in 38% of subjects at high risk, in 13% and 6% of subjects at intermediate and low risk (p<0.003). Among evaluated parameters, carotid pre-ATS was a predictive marker of CV events (OR 2.7, 95% IC 1.4-5…

Isolated non-compaction, stroke and trabecular meshwork fibrosis

MULTIFOCAL ATHEROSCLEROSIS INFLUENCING THE OUTCOME OF PATIENTS WITH ACUTE AND CHRONIC CORONARY HEART DISEASE

MULTIFOCAL ATHEROSCLEROSIS INFLUENCING THE OUTCOME OF PATIENTS WITH ACUTE AND CHRONIC CORONARY HEART DISEASE

Behavior of patients at high risk of developing contrast induced nephropathy after coronary procedures

2017 ESC Guidelines on the Diagnosis and Treatment of Peripheral Arterial Diseases, in collaboration with the European Society for Vascular Surgery (ESVS)

2017 ESC Guidelines on the Diagnosis and Treatment of Peripheral Arterial Diseases, in collaboration with the European Society for Vascular Surgery (ESVS) : Document covering atherosclerotic disease of extracranial carotid and vertebral, mesenteric, renal, upper and lower extremity arteries

A coronary right fistula canalized in a small accessory right atrial chamber.

The coronary artery fistulas are rare congenital anomalies with a very low incidence. These can be symptomatic or asymptomatic because the hemodynamic consequences of the fistula vary and depend on the shunt dimensions. Discordant opinions instead are present in the literature for the defect closing in asymptomatic patients. Here, we describe a patient affected by a coronary right fistula canalized in a small accessory right atrial chamber. During follow-up, we observed a progressive dilatation of the right coronary artery (maximum diameter 10.3 mm) with hemodynamic overload of the right sections.

Patent foramen ovale (PFO): long-term impact of percutaneous treatment

Although in our center the percutaneous procedure is performed from a few years, our results are encouraging, also not understimate improve in quality of live and psychological aspects.

Calf veins thrombosis: optimal duration of treatment

Early Treatment With Zofenopril and Ramipril in Combination With Acetyl Salicylic Acid in Patients With Left Ventricular Systolic Dysfunction After Acute Myocardial Infarction: Results of a 5-Year Follow-up of Patients of the SMILE-4 Study

Abstract: The SMILE-4 study showed that in patients with left ventricular dysfunction (LVD) after acute myocardial infarction, early treatment with zofenopril plus acetyl salicylic acid is associated with an improved 1-year survival, free from death or hospitalization for cardiovascular (CV) causes, as compared to ramipril plus acetyl salicylic acid. We now report CV outcomes during a 5-year follow-up of the patients of the SMILE-4 study. Three hundred eighty-six of the 518 patients completing the study (51.2%) could be tracked after the study end and 265 could be included in the analysis. During the 5.5 (±2.1) years of follow-up, the primary endpoint occurred in 27.8% of patients originall…

Older age and markers of inflammation are strong predictors of clinical events in women with asymptomatic carotid lesions.

PREDICTION OF CEREBROVASCULAR AND CARDIOVASCULAR EVENTS IN PATIENTS WITH SUBLINICAL CAROTID ATHEROSCLEROSIS: THE ROLE OF C-REACTIVE PROTEIN

Background Several studies have suggested that inflammation and infection may be important for accelerated progression of atherosclerosis, but few data are available on subjects with early stages of atherosclerosis. Methods and Results We included, in a prospective 5-year follow-up study, 150 patients with subclinical carotid atherosclerosis, evaluating at baseline all established traditional cardiovascular risk factors (eg, older age, male sex, obesity, hypertension, diabetes, smoking, family history of coronary artery disease, and dyslipidemia); 2 markers of inflammation, fibrinogen, and high-sensitivity C-reactive protein (CRP); and the seropositivity to Helicobacter pylori, Chlamydia pn…

RISK FACTORS, MULTIFOCAL ATHEROSCLEROSIS AND RESTENOSIS POST-PTCA

Low HDL-cholesterol concentrations cause atherosclerotic disease to develop

Relationship between endothelial dysfunction, intima media thickness, hypertension and other cardiovascular risk factors in asymptomatic subjects

Troponin I/ejection fraction ratio: A new index to differentiate Takotsubo cardiomyopathy from myocardial infarction

– Transient hypokinesis, akinesis, or dyskinesis of the left ventricular mid-segments with or without apical involvement; the regional wall motion abnormalities extend beyond a single epicardial vascular distribution; a stressful trigger is often, but not always, present; – Absence of obstructive coronary disease or angiographic evidence of acute plaque rupture; – New ECG abnormalities (either ST-segment elevation and/or T wave inversion) or modest elevation in cardiac troponin; and – Absence of pheochromocytoma or myocarditis.

ARRYTHMOGENIC RIGHT VENTRICULAR CARDIOMYOPATHY: MULTISLICE COMPUTED TOMOGRAPHY FEATURES

Infection and inflammation influence the outcome of patients with asymptomatic carotid lesions. Int Angiol. 2004. 23(suppl.1)

Asymptomatic carotid lesions add to cardiovascular risk prediction.

AIM To show that subclinical atherosclerosis (subclinical-ATS) of carotid arteries [intima-media thickness (IMT) or asymptomatic carotid plaque (ACP)], may provide additional information for risk stratification, in asymptomatic patients, aged greater than 45 years, with a cluster of risk factors (RFs). METHODS AND RESULTS We studied 558 asymptomatic patients (235 males). RFs for atherosclerosis were assessed and the 10-year-risk was calculated according to the Italian risk score. Doppler ultrasound of carotid arteries identified the presence of IMT greater than 0.9 mm in 183 patients and ACP in 147 patients. One hundred and fifty-three patients developed cerebrovascular or cardiovascular (C…

Trattamento delle manifestazioni vascolari nella Sclerosi Sistemica e qualità della vita: nuovo protocollo

Chronic pharmacological treatment in takotsubo cardiomyopathy.

Abstract Background Takotsubo cardiomyopathy is a disorder that has been appreciated only recently. In most of reported cases, this syndrome mimes an acute myocardial infarction. Till this moment no data are available from literature about the treatment in the acute phase of this disease. Aim of the study In our multicentric experience we have retrospectively looked at the benefits of a treatment with ACE-inhibitors, beta-blockers, Aspirin and calcium channels blockers, started until the early phases of the disease and continued for 30 days, in 36 patients affected by Takotsubo cardiomyopathy. We chose as endpoint of the study the efficacy of the used drug in improving left ventricular myoc…

ATHEROSCLEROSIS AND MARKERS OF INFLAMMATION IN PATIENTS WITH METABOLIC SYNDROME

How to manage patients with polyvascular atherosclerotic disease. Position paper of the International Union of Angiology

Atherosclerosis is a systemic disease affecting multiple arterial territories. Patients with clinical atherosclerotic disease in one vascular bed are likely to have asymptomatic or symptomatic atherosclerotic lesions in other vascular beds. Specifically, peripheral arterial disease (PAD) often coexists with coronary and carotid disease. With progression of atherosclerotic disease in one vascular bed, the risk of clinical manifestations in other territories increases and the incidence of adverse cardiovascular events increases substantially with the number of affected vascular beds. Classical risk factors are associated with the development of polyvascular atherosclerotic disease (PVD) in di…

RUOLO DELL’ECOCOLOR DOPPLER TISSUTALE NELLA VALUTAZIONE DELLA CARDIOTOSSICITÀ DA CHEMIOTERAPICI

Livelli plasmatici di fibrinogeno in soggetti con infarto miocardico acuto: relazione con gli eventi nel follow-up a 42 mesi

The Effects of Prostaglandin E-1 in Patients with Intermittent Claudication

Aim of the study is to evaluate the effects of Prostaglandin E-1 (PGE-1) in patients with peripheral arterial disease (PAD) at the 2nd b stage Fontaines classification. The study, controlled, single blinded, enrolled 123 patients with intermittent claudication that were randomised in two groups; the first group received a treatment with PGE-1 while the second one received a pentoxifylline-buflomedil association by venous infusion. We evaluated: Pain Free Walking Distance (PFWD), Maximum Walking Distance (MWD), Rest Flow (RF), Peak Flow (PF), Basal (BVR) and Minimal Vascular Resistance (MVR) with a strain gauge plethysmograph, Resting Flow (RF), Peak Flow (PF), time to reach the Peak Flow (t…

TDI and myocardial blush: good indicators of myocardial reperfusion

The TDI at follow-up confirms the reliability's value of Blush is predicting anatomical and functional recovery of the myocardium and microcirculation.

CORONARY ARTERY BYPASS GRAFT (CABG) PATENCY: ASSESSMENT WITH 40-ROW MULTISLICE COMPUTED TOMOGRAPHY (MSCT) CERSUS CORONARY ANGIOGRAPHY

TERAPIA IPOLIPIDEMIZZANTE NELLA SINDROME CORONARICA ACUTA

The effect of two low doses of aspirin on whole blood thromboxane and prostacyclin generation in healthy subjects

SummaryThe effects of two low doses of aspirin (20 mg and 100 mg) on prostacyclin and thromboxane formation during whole blood clotting were studied in 8 healthy volunteers.A single 100 mg aspirin dose caused more than 90% reduction of both serum TXB2 and 6-keto-PGF1α; a single 20 mg dose of aspirin inhibited serum TXB2 more than 6-keto-PGF1α but effects on these two products could not be completely dissociated.However, the effect of a single 20 mg aspirin dose on serum TXB2, was of much longer duration than its inhibitory effect on PGI2 synthesis during whole blood clotting.

TAKOTSUBO CARDIOMYOPATHY

Clinical significance of macrophage colony stimulating factor levels in acute coronary syndrome.

Aim. The aim of this paper was to ascertain whether macrophage colony stimulating factor (MCSF) serum levels, measured during the acute phase of coronary syndromes (ACS), are useful to predict short term outcomes. Methods. Seventy-four consecutive patients (mean age: 66±12), admitted to the Intensive Coronary Care Unit of Palermo University Hospital (Italy) affected by ACS were observed; 39 patients showed a non ST elevation (NSTEMI) and 35 showed a ST elevation myocardial infarction (STEMI). During the hospital stay, all patients underwent echocardiography and 84% of patients received coronary angiography. Peripheral venous blood samples were collected for the determination of serum levels…

Metabolic therapy in the treatment of chronic critical limbs ischemia: the L-propionyl-carnitine enhances the effects of PGE-1

Impact of anemia on long term prognosis of patients with STEMI treated with PCI and dual antiplatelet therapy

Anemia on admission and Hb drop % are associated with worse long term prognosis and they are independent risk factor for adverse events in patient with STEMI treated with PCI and dual antiplatelet therapy.

[Metabolic syndrome in children and in adults: is it an autonomous nosological entity?].

The term metabolic syndrome defines a cluster of risk factors for cardiovascular diseases and diabetes. This syndrome is very frequent in general population. However, despite the efforts to define the diagnostic criteria, nowadays its clinical utility is object of a lively debate.

Influence of climatic variables on acute myocardial infarction hospital admissions

BACKGROUND: Seasonal peaks in acute myocardial infarction (AMI) incidence have been widely reported. Weather has been postulated to be one of the elements at the basis of this association. The aim of our study was to determine the influence of seasonal variations and weather on AMI hospital admissions. METHODS: We correlated the daily number of AMI cases admitted to a western Sicily hospital over twelve years and weather conditions on a day-to-day basis. Information on temperature, humidity, wind force and direction, precipitation, sunny hours and atmospheric pressure was obtained from the local Birgi Air Force base. A total of 3918 consecutive patients were admitted with AMI over the perio…

Biomarkers in heart failure

Nowadays, heart failure (HF) has an increasing prevalence, particularly in the elderly, and is becoming a clinical problem of epidemic proportion in terms of morbidity and mortality. Developing biological markers, that can aid in the diagnosis of HF and in the differentiation of congestive heart failure (CHF) from other causes of dyspnoea, will reduce the cost of health care. However, an ideal biomarker has not yet been identified. Potential markers of HF include neuro-hormonal mediators, markers of myocyte injury, and indicators of systemic inflammation. Among these, the BNP and NT-pro-BNP are the most widely studied and appear to be useful in patients with dyspnoea of unknown aetiology, a…

Tissue Doppler analysis: does the false negative exist?

LA TERAPIA FARMACOLOGICA DELLA DEPRESSIONE POST-IMA

An unusual cause of cerebral cardioembolism in a 33-year-old man due to ventricular noncompaction

N.A.

[Pharmacological treatment of depression after acute myocardial infarction].

Depressed mood and other depressive symptoms frequently appear after acute myocardial infarction and it is known how these patients have an increased risk for morbidity and mortality compared to patients without depression. Many risk factors promote the development of clinical depression in patients with recent myocardial infarction. Although a large number of studies underline the negative prognostic impact of depression on the infarcted patient, only rarely depressed patients are appropriately diagnosed and treated. Furthermore it should be borne in mind that the use of psychotropics in medically ill patients requires attention. These compounds, in fact, may interact with the disease caus…

Statin therapy in patients with aortic stenosis after the ASTRONOMER trial: is there still any space?

APPROCCIO NON INVASIVO PER LO STUDIO DEL CIRCOLO CORONARICO CON TC MULTISLICE

DEEP VEIN THROMBOSIS IN A LEFT-PLACED INFERIOR VENA CAVA

L’eta’ e gli elevati livelli di proteina C-reattiva e fibrinogeno sono forti predittori di eventi clinici in una popolazione di donne con aterosclerosi carotidea.

UTILITA’ DELLA ANGIOGRAFIA CORONARICA ESEGUITA MEDIANTE TOMOGRAFIA COMPUTERIZZATA MULTIDETETTORE NEL CONTROLLO DELLA PERVIETA’ DEL BYPASS AORTO-CORONARICO

INFLAMMATION, INFECTIONS AND VASCULAR DISEASES

INFLUENCE OF CAROTID AND PERIPHERAL ATHEROSCLEROSIS ON THE OUTCOME OF PATIENTS WITH ACUTE CORONARY SYNDROME

Heart rate turbulence for guiding electric therapy in patients with cardiac failure

It is well-known that a reduction of the cardiac frequency variability, measurable with the Heart Rate Variability (HRV) system, is an indirect expression of the sympathetic-autonomic tone. Another index, Heart Rate Turbulence (HRT), has been recently suggested as a possible unit of measurement for the sympathetic-autonomic tone: this system allows to estimate the baro-reflex response of the carotid arteries to an early ventricular extra-systole by analysing heart rate variations induced by a premature beat.In our research we have analyzed this phenomenon in patients affected by moderate or severe cardiac failure. In particular, we divided 110 patients into two arms: subjects with or withou…

Sulfinpyrazone and platelet function in hypertensive patients

Medical management of patients with peripheral arterial disease.

Peripheral arterial disease (PAD) is one of the most frequent manifestations of atherosclerosis and is associated with atherosclerosis in the coronary and carotid arteries, leading to a highly increased incidence of cardiovascular events. Major risk factors of PAD are similar to those that lead to atherosclerosis in other vascular beds. However, there are differences in the power of individual risk factors in the different vascular territories. Cigarette smoking and diabetes mellitus represent the greatest risks of PAD. For prevention of the progression of PAD and accompanying cardiovascular events similar preventative measures are used as in coronary artery disease (CAD). However, recent d…

Troponina e infarto periprocedurale: filo di Arianna o folle volo di Icaro?

Percutaneous coronary interventions cause frequently an increase in myocardial necrosis markers. Is troponin elevation after percutaneous coronary intervention a predictor of events at follow-up or a consequence of the procedure with no cause-effect relationship with prognosis? The debate is still open

Impact of ''off-label'' use of ivabradine on exercise capacity, gas exchange, functional class, quality of life, and neurohormonal modulation in patients with ischemic chronic heart failure.

Background: Epidemiologic studies indicate that elevated heart rate (HR) is an independent risk factor for mortality and morbidity in patients (pts) with chronic heart failure (CHF). Clinical trials with b-blockers suggest that HR reduction is an important mechanism of their benefit in pts with stable CHF. Pharmacologic inhibition of the If current now provides the opportunity of pure HR reduction. The purpose of this study was to evaluate the impact of ‘‘Off-Label’’ use of ivabradine on exercise capacity, gas exchange, functional class, quality of life, and neurohormonal modulation in pts with ischemic CHF. Methods: Between January 2008 and June 2008, a graded maximal exercise test with re…

Right atrium compression by a renal cyst: a tomographic diagnosis.

Impatto dell'anemia sulla prognosi dei pazienti sottoposti a PCI

RITMO SINUSALE VERSUS FIBRILLAZIONE ATRIALE: UNO STUDIO OSSERVAZIONE SU 150 PAZIENTI

A rare case of Prinzmetal angina 3 days after coronary artery stenting with a second-generation drug-eluting stent

Non previsto.

Contractile Reserve in Heart Failure with Preserved Ejection Fraction.

Background: Diastolic stress echocardiography (SE) is useful for confirming the diagnosis of heart failure with preserved left ventricular ejection fraction (HFpEF) when it is uncertain. The aim of this study was to assess the value of new echocardiographic parameters during diastolic SE in patients with dyspnea and suspected HFpEF. Methods: Sixty-two patients with exertional dyspnea and inconclusive rest echocardiography for a diagnosis of HFpEF were enrolled. Exercise SE was performed in all patients. Contractile reserve (LVCR) was assessed by measuring: 1. changes in the left ventricular ejection fraction (LVEF) between rest and peak stress; 2. stress-to-rest ratio of force (force was de…

Inefficiency of renin-angiotensin inhibitors to prevent the Atrial Fibrillation in patient with normal heart

Right lobar pulmonitis: a possible cause of lone atrial fibrillation

Optimal duration of treatment in surgical patients with calf venous thrombosis involving one or more veins.

The aim of this study was to evaluate different durations of treatment in patients with calf venous thrombosis (CVT) involving 1 or more deep veins. The authors studied 2 groups of patients with postsurgical CVT diagnosed by echo-color Doppler. The first group consisted of 68 patients with CVT involving a single vein, and the second group consisted of 124 patients with CVT involving 2 or more veins. Immediately after diagnosis, all patients were treated with nadroparin calcium and sodium warfarin. Heparin treatment was withdrawn after 5–6 days of treatment, when the international normalized ratio (INR) was stabilized between 2 and 3. Each group was divided into 2 subgroups receiving antico…

Zofenopril and Ramipril in Combination with Acetyl Salicylic Acid in Postmyocardial Infarction Patients with Left Ventricular Systolic Dysfunction: A Retrospective Analysis of the SMILE-4 Randomized, Double-Blind Study in Diabetic Patients

Summary Objective In the SMILE-4 study, zofenopril + acetyl salicylic acid (ASA) was more effective than ramipril + ASA on 1-year prevention of major cardiovascular events (MACE) in patients with acute myocardial infarction complicated by left ventricular dysfunction. In this retrospective analysis, we evaluated drug efficacy in subgroups of patients, according to a history of diabetes mellitus. Methods The primary study endpoint was 1-year combined occurrence of death or hospitalization for cardiovascular causes. Diabetes was defined according to medical history (previous known diagnosis). Results A total of 562 of 693 (81.0%) patients were classified as nondiabetics and 131 (18.9%) as dia…

Markers of Inflammation and Infection Influence the Outcome of Patients With Baseline Asymptomatic Carotid Lesions

Background and Purpose— It is still in debate whether the evaluation of markers of infection and inflammation may be of importance for cerebrovascular and cardiovascular prevention, and we aimed to investigate this field in a prospective 5-year clinical follow-up study in patients with early stages of atherosclerosis. Methods— We studied 668 subjects divided in 3 groups according to the results of carotid ultrasound examination: (1) normal subjects, if intima-media thickness (IMT) was &lt;0.9 mm; (2) with IMT, if IMT was between 0.9 and 1.5 mm; and (3) with asymptomatic carotid plaque, if IMT was &gt;1.5 mm. Traditional cardiovascular risk factors were investigated, and laboratory analysis…

CAROTID INTMAL-MEDIAL THICKNESS ANS ENDOTHELIAL FUNCTION IN YOUNG ADULTS PATIENTS WITH MYOCARDIAL INFARCTION

Un caso di endoplastite in portatore di ICD: ruolo Dell'ecografia cardiaca nell'iter diagnostico

IL PROCESSO INFIAMMATORIO E LA FIBRILLAZIONE ATRIALE: RELAZIONE FRA I LIVELLI EMATICI DI PCR, FIBRINOGENO C E MMP-9 E DIFFERENTI PATTERN CLINICI DELL’ARITMIA

DETECTION OF IMPAIRMENT OF LEFT VENTRICULAR DISTOLIC FUNCTION IN PATIENTS WITH CARDIAC AMYLOIDOSIS USING STRAIN RATE ECHOCARDIOGRAPHY.

Hsp60 and heme oxygenase-1 (Hsp32) in acute myocardial infarction

Heat shock proteins (Hsps) are produced in response to various stressors, including ischemia-reperfusion, and they can exit cells and reach the blood. In this pilot study, we determined serum levels of Hsp60 and heme-oxygenase-1 (HO-1; also named Hsp32) in subjects with acute myocardial infarction (AMI) to assess their clinical significance and potential prognostic value. We also performed a bioinformatics analysis of the 2 molecules in search of structural clues on the mechanism of their release from cells. We studied 40 patients consecutively admitted for AMI (male:female patient ratio = 20:20, mean age: 64 ± 13 years) and 40 matched controls. A blood sample was drawn for biochemical anal…

Integrated non-invasive approach to atherosclerosis with cardiac CT and carotid ultrasound in patients with suspected coronary artery disease

The aim of the study was to compare the atherosclerotic disease in the coronary and carotid arteries in patients who underwent non-invasive imaging for suspected stable coronary artery disease (CAD). 107 patients (64 men, age 59 ± 12) with atypical chest pain underwent cardiac CT (CCT) and carotid ultrasound (US) on the same day. Severity (obstructive or not-obstructive disease), location, shape, and composition of atherosclerotic plaques in the two districts were evaluated. Patients presented normal coronary arteries in 36 % (n = 38), not-obstructive CAD in 36 % (n = 39), and obstructive CAD in 28 % (n = 30), while had normal carotid arteries in 53 % (n = 57), not-obstructive disease in 44…

SILENT EMBOLIC INFARCTS ON COMPUTED TOMOGRAPHY BRAIN SCANS AND RISK OF IPSILATERAL HEMISPHERIC EVENTS IN PATIENTS WITH ASYMPTOMATIC INTERNAL CAROTID ARTERY STENOSIS.

OBJECTIVES: This study tested the hypothesis that silent embolic infarcts on computed tomography (CT) brain scans can predict ipsilateral neurologic hemispheric events and stroke in patients with asymptomatic internal carotid artery stenosis. METHODS: In a prospective multicenter natural history study, 821 patients with asymptomatic carotid stenosis graded with duplex scanning who had CT brain scans were monitored every 6 months for a maximum of 8 years. Duplex scans were reported centrally, and stenosis was expressed as a percentage in relation to the normal distal internal carotid criteria used by the North American Symptomatic Carotid Endarterectomy Trialists. CT brain scans were reporte…

Infection and inflammation influence the outcome of patients with asymptomatic carotid lesions

Non-responders to cardiac resynchronization therapy: Insights from multimodality imaging and electrocardiography. A brief review

Background Cardiac resynchronization therapy (CRT) is a successful strategy for heart failure (HF) patients. The pre-requisite for the response is the evidence of electrical dyssynchrony on the surface electrocardiogram usually as left bundle branch block (LBBB). Non-response to CRT is a significant problem in clinical practice. Patient selection, inadequate delivery and sub-optimal left ventricle lead position may be important causes. Objectives In an effort to improve CRT response multimodality imaging (especially echocardiography, computed tomography and cardiac magnetic resonance) could play a decisive role and extensive literature has been published on the matter. However, we are so fa…

Carotid and periferal atherosclerosis in patients underwent to primary PCI and outcome associated with multifocal atherosclerosis

Preclinical atherosclerosis and metabolic syndrome increase cardio- and cerebrovascular events rate: a 20-year follow up

BACKGROUND: Intima-media thickness (IMT) is a validated marker of preclinical atherosclerosis and a predictor of cardiovascular events. PATIENTS: We studied a population of 529 asymptomatic patients (age 62 ± 12.8 years), divided into two groups of subjects with and without Metabolic Syndrome (MetS). METHODS: All patients, at baseline, have had a carotid ultrasound evaluation and classified in two subgroups: the first one without atherosclerotic lesions and the second one with preclinical atherosclerosis (increased IMT or asymptomatic carotid plaque). Cardiovascular endpoints were investigated in a 20-years follow-up. RESULTS: There were 242 cardiovascular events: 144 among patients with Me…

Acidi grassi ematici e infarto miocardico

Impact of insulin resistance on cardiac and vascular function.

Background Insulin resistance (IR), constitutes an important cardiovascular risk factor and can cause ischemic heart disease. It can lead to left ventricular dysfunction with a mechanism independent of ischemic heart disease and it is closely associated with impaired vascular function. The aim of our study was to explore the impact of IR on cardiac and vascular function, in patients with cardiovascular risk factors but angiographically undamaged coronary arteries. Methods We studied 32 patients (62.06 ± 11.19 years) with cardiovascular risk factors. All patients underwent coronary angiography, echocardiography, Doppler ultrasound of carotid arteries and laboratory tests. Exclusion criteria …

Effects of ambient temperature, humidity, and other meteorological variables on hospital admissions for angina pectoris.

Background: Seasonal peaks in cardiovascular disease incidence have been widely reported, suggesting weather has a role. Design The aim of our study was to determine the influence of climatic variables on angina pectoris hospital admissions. Methods: We correlated the daily number of angina cases admitted to a western Sicilian hospital over a period of 12 years and local weather conditions (temperature, humidity, wind force and direction, precipitation, sunny hours and atmospheric pressure) on a day-to-day basis. A total of 2459 consecutive patients were admitted over the period 1987–1998 (1562 men, 867 women; M/F – 1:8). Results: A seasonal variation was found with a noticeable winter pea…

Asymptomatic carotid lesions and aging: role of hypertension and other traditional and emerging risk factors

ASYMPTOMATIC CAROTID LESIONS AND AGING: ROLE OF HYPERTENSION AND OTHER TRADITIONAL AND EMERGING RISK FACTORS BACKGROUND: We evaluated the prevalence of intima-media thickening (IMT) and asymptomatic carotid plaque (ACP) in a group of subjects with or without traditional and/or emerging risk factors (RF). METHODS: There were 631 subjects (313 male and 318 female) aged between 19 and 97 years, asymptomatic for cerebro- and cardiovascular diseases. The following measurements were used: anamnesis, physical examination, height and sitting blood pressure. Biochemistry variables were also considered: total cholesterol, HDL-C, LDL-C, triglycerides, fibrinogen, high sensitive C-reactive protein, IgG…

L’ATEROSCLEROSI PERIFERICA COME MARKER DI MALATTIA CORONARICA

OBESITY: A NEW PATHOLOGY TO PAY ATTENTION TO IN YOUNG PEOPLE

Obesity in young people is a form of malnutrition that is found more and more in industrialized countries known both for its association with obesity in adult age and the chronic-degenerate pathologies correlated to it. In 1998 in the United States the prevalence of obesity in 4-12 year olds was 22% for the Hispanics and Afro-Americans and 12.3% for the non Hispanic Caucasians Also in children as in adults, the consequence of obesity is hyperinsulinemia, in direct proportion to the body weight. In this review we discuss the effects of hyperinsulinemia and obesity in young people, and evaluated the difference of cardiovascular complication in young and in adults.

Effects of drug therapy on cardiac arrhythmias and ischemia in hypertensives with LVH.

Left ventricular hypertrophy (LVH) in hypertensive subjects is associated with an increased prevalence of ventricular arrhythmias. To evaluate the effect of antihypertensive treatment on cardiac arrhythmias (CA) and transient episodes of myocardial ischemia (TEMI), we studied 46 hypertensive patients with LVH, divided into four groups randomly treated with enalapril, hydrochlorothiazide (HCTZ), atenolol, or verapamil (SR-V) for 6 months. Office blood pressure and office heart rate values were recorded, in basal conditions, after 1 and 6 months of treatment, and all patients underwent echocardiography, electrocardiographic Holter monitoring, and stress testing. All drugs significantly lowere…

SIGNIFICATO PROGNOSTICO DELL’MMP-9 IN PAZIENTI CON SINDROME CORONARICA ACUTA

COMPORTAMENTO DEI PAZIENTI AD ALTO RISCHIO DI SVILUPPARE NEFROPATIA INDOTTA DA MEZZO DI CONTRASTO DOPO CORONAROGRAFIA/ANGIOPLASTICA PERCUTANEA

Role of curcumin in idiopathic pulmonary arterial hypertension treatment: A new therapeutic possibility

The idiopathic pulmonary arterial hypertension is a complex disease that mainly affects pulmonary arterial circulation. This undergoes a remodeling with subsequent reduction of flow in the small pulmonary arteries. Because of this damage an increased vascular resistance gradually develops, and over time it carries out in heart failure. The inflammatory process is a key element in this condition, mediated by various cytokines. The inflammatory signal induces activation of NF-κB, and prompts TGF-β-related signaling pathway. Clinical evolution leads to progressive debilitation, greatly affecting the patient quality of life. The actual therapeutic approaches, are few and expensive, and include …

Analysis of N-terminal pro-B-type natriuretic peptide in patients with acute coronary syndromes

Background The N-terminal portion of brain natriuretic peptide (NT-proBNP) has been identified as an indicator of prognosis in different cardiovascular diseases. The objective of this study was to determine the utility of measuring plasma NT-proBNP levels in patients with acute coronary syndromes. Methods and results We studied 66 patients admitted in our division for acute coronary syndromes. Patients underwent a venous blood sample within 24 h from the admission to determine NT-proBNP levels. Increasing plasma levels of NT-proBNP (in tertiles) was associated with a greater history of hypertension and current smoking, whereas biochemical parameters were associated with higher level of crea…

Task force on 'Early markers of atherosclerosis: influence of age and sex'

Atherosclerosis and its complications are the most important causes of death all over the world, especially in Western countries. Diet habits, modern stress life, smoking, sedentary way of life and an involvement of genetic pattern of individuals lead to a sure degeneration of quality of life increasing the risk of atherosclerosis development. For this reason, the main purpose of actual medicine is to identify all the markers that could allow the physicians to evaluate the first moments of the development of this dangerous pathological process. The aim is to reduce the speed of its evolution, trying to delay indefinitely the risk coming from the morphological alterations of the vessels. 'En…

Papillary muscle relocation in conjunction with valve annuloplasty improve repair results in severe ischemic mitral regurgitation

OBJECTIVE: The incidence of recurrent mitral regurgitation (MR) after restrictive annuloplasty (RA) was 5% to 20% in several reports. There are many opinions in favor of adding subvalvular procedures to RA to reduce the tenting forces and improve the repair results. METHODS: From March 2003 to May 2010, 55 patients with severe ischemic MR who had undergone papillary muscle (PPM) relocation in conjunction with mitral annuloplasty in our institutions were enrolled. The patients were matched 1:1 with those who underwent isolated RA using the propensity score. The mean left ventricular ejection fraction was 42% ± 6%. The mean tenting area and coaptation depth was 3.2 ± 0.6 cm(2) and 1.3 ± 0.2 c…

GLI INIBITORI DIRETTI DELLA TROMBINA

The risk of noncardiac surgery in patients with heart disease: a new way for an easy approach to a right preoperative assessment

Reduced regional systolic function evolved compacted segments in noncompaction

Abstract In a recent report about noncompaction Nemes et al. reported that systolic left ventricular (LV) dysfunction assessed using the wall motion score during 2D echocardiography in noncompaction is not confined to noncompacted LV segments. These results confirmed some published reports of our group. Recently we analyzed a population of 238 patients affected by noncompaction, and demonstrated that the number of noncompacted segment is uncorrelated with the degree of systolic dysfunction. It is an attractive hypothesis that the systolic dysfunction could be depend on the fibrosis of the left ventricle, itself a consequence of microcirculatory dysfunction, which has been confirmed by repor…

TOMOGRAFIA COMPUTERIZZATA MULTISTRATO E VALUTAZIONE CORONARICA NON INVASIVA

Use of direct oral anticoagulants in very elderly patients: a case report of apixaban in an ultracentenary patient.

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Electrocardiographic abnormalities, preclinical carotid atherosclerosis and cardiovascular risk in an apparently healthy real-world population. Data from the "No Stroke, No Infarction" project of the Rotary International - district 2110 (Sicily and Malta)

Background: Cardiovascular diseases (CVDs) represent important causes of morbidity and mortality. Our study aimed to evaluate cardiovascular risk using the EuroSCORE, ECG and carotid ultrasound for prevention purpose in a population of companions aged 50-70 years, asymptomatic and without CVD. Methods: History of CVD, risk factors (RF), ECG and carotid ultrasound were evaluated. Intima-media thickness (IMT) was defined as wall thickness &gt;0.9 mm, while focal thickening ≥1.5 mm protruding into the lumen as asymptomatic carotid plaque (ACP). Results: Totally, 1860 subjects were screened. 393 (21.1%) had no RF, 780 (42%) hypertension, 571 (30.7%) hypercholesterolemia, 557 (29.9%) diabetes, 4…

Subclinical cardiovascular damage in patients with HCV cirrhosis before and after treatment with direct antiviral agents: a prospective study

BACKGROUND Cirrhosis is associated with morpho-functional cardiovascular alterations. AIMS To detect early features of cardiovascular damage in HCV-compensated cirrhotic patients using myocardial deformation indices and carotid arterial stiffness, and, further, to evaluate their short-term behaviour after HCV eradication with direct antiviral agents (DAAs). METHODS Thirty-nine consecutive patients with HCV cirrhosis, without previous cardiovascular events, were studied and matched for age, gender and cardiovascular risk factors to 39 controls without liver or cardiovascular disease. Patients and controls underwent a baseline echocardiographic evaluation including global longitudinal strain …

VALUTAZIONE ANGIOGRAFICA DELLA RIPERFUSIONE MIOCARDICA IN PAZIENTI CON INFARTO MIOCARDICO ACUTO TRATTATI CON ANGIOPLASTICA PRIMARIA

Scopo L'obiettivo del presente studio è quello di valutare se, nella popolazione in esame, il Myocardial Blush Grade e gli altri parametri angiografici siano correlati ad altri indici clinici dopo la riapertura dell'arteria epicardica. Materiali e metodi Il presente studio consiste in una valutazione retrospettiva dei parametri angiografici, in relazione a dati ecocardiografici ed elettrocardiografici, di una popolazione osservata comprendente 118 pazienti, tra Febbraio 2003 e Giugno 2007, con sopraslivellamento del tratto ST > 1 mm in almeno due derivazioni elettrocardiografiche vicine, sottoposti ad angioplastica primaria nel nostro Dipartimento. Risultati Dopo PCI, un flusso TIMI 3 è sta…

Giant left atrium: a condition that is rarely seen today.

Today, giant left atrium is a condition that is rarely observed in clinical practice and diagnosis can be missed. It is prevalent in patients with rheumatic heart disease that has decreased considerably in industrialized countries in the last two decades. However, the immigration flow in the current era can revive its incidence.

Alteration of Heart Rate Variability as an Early Predictor of Cardiovascular Events: A Look at Current Evidence

Evidence suggests an association between autonomic nervous system (ANS) function and atrial fibrillation (AF) development. We sought to examine the association of baseline resting heart rate (RHR) and short-term heart rate variability (HRV) as surrogates of (ANS) with incident AF in individuals without prior cardiovascular disease. A total of 6261 participants of the Multi Ethnic Study of Atherosclerosis (MESA) who were free of AF and diagnosed cardiovascular disease were enrolled. Three standard 10-second, 12-lead electrocardiograms were used to measure RHR, the standard deviation of normal-to-normal intervals (SDNN) and the root mean square of successive differences in RR intervals (RMSSD…

MULTIFOCAL ATHEROSCLEROSIS INFLUENCE THE OUTCOME OF PATIENTS UNDERWENT TO PRIMARY PTCA

Total occlusion of aortic arch in a 62-year-old man presenting with acute myocardial infarction

Not available

Nutraceuticals and dyslipidaemia: Beyond the common therapeutics

Dyslipidaemia accelerates the atherosclerotic process and its morbid consequences; statins represent the evidence-based treatment of choice for reducing low-density lipoprotein cholesterol levels and decreasing cardiovascular events. Unfortunately, statins are frequently not available for several reasons, including intolerance, side effects or, simply, patient preference. Nutraceuticals and functional food ingredients that are beneficial to vascular health may represent useful compounds that are able to reduce the overall cardiovascular risk induced by dyslipidaemia by acting parallel to statins or as adjuvants in case of failure or in situations where statins cannot be used. The mechanisms…

Impact of Metabolic Syndrome on Coronary Microvascular Dysfunction: A Single Center Experience

Coronary microvascular dysfunction (CMD) represents a widespread condition and a prevalent cause of ischemic heart disease. Total TIMI frame count (TTFC) can be a good indicator of CMD in different populations. The aim of our study was to evaluate the incidence of CMD in different populations such as METS patients compared with diabetic and hypertensive patients. The study was carried out on patients with chest pain and/or positive stress test and angiographically undamaged coronary arteries. Our CMD population was divided into three subgroups; patients with arterial hypertension, patients with type II diabetes mellitus and patients with metabolic syndrome. TIMI Frame Count (TFC) and Myocar…

Aortic aneurysm rupture into right atrium in patient with previous aortic valve replacement

Timely recognition of cardiovascular toxicity by anticancer agents: a common objective of the pharmacologist, oncologist and cardiologist.

Both conventional and new anticancer drugs can frequently cause adverse cardiovascular effects, which can span from subclinical abnormalities to serious life-threatening and sometimes fatal events. This review examines the principal basic and clinical elements that may be of profit to identify, prevent and treat such toxicities. Clearly, the accomplishment of such objectives requires the strong commitment and cooperation of different professional figures including, but not limited to, pharmacologists, oncologists and cardiologists. The aspect of anticancer drug cardiotoxicity seems to be somehow underestimated, mainly due to inadequate reporting of adverse reactions from oncology drugs in t…

Association of elevated fibrinogen and C-reactive protein levels with carotid lesions in patients with newly diagnosed hypertension or type II diabetes.

BACKGROUND: Inflammation may be important for accelerated progression of atherosclerosis in patients with hypertension or diabetes, but few studies included subjects with early stages of atherosclerosis such as those with asymptomatic carotid lesions. METHODS: We studied 100 patients with newly diagnosed hypertension and another 100 patients with newly diagnosed type II diabetes to evaluate in such groups the association of two markers of inflammation, fibrinogen and C-reactive protein (CRP), with carotid atherosclerosis, beyond traditional cardiovascular risk factors (e.g., older age, male gender, obesity, smoking, family history of CAD, dyslipidemia). RESULTS: We found positive correlatio…

THE ITALIAN CUORE PROJECT: AN ALLIANCE AMONG INSTITUTIONS, CARDIOLOGISTS AND GENERAL PRACTITIONERS TO ESTIMATE THE GLOBAL ABSOLUTE CARDIOVASCULAR RISK ASSESSMENT AND IMPROVE HEART HEALTH IN THE ITALIAN POPULATION

MARKERS OF INFLAMMATION AND RISK OF VASCULAR EVENTS IN PATIENTS WITH NON-INSULIN DEPENDANT DIABETES

TAVI nel trattamento della stenosi aortica degenerativa: stato dell’arte e prospettive

Degenerative aortic stenosis is the most common form of heart valve disease in developed countries and predominantly affects the elderly. Aortic valve replacement (AVR) has been the gold standard, but recently, transcatheter aortic valve implantation has emerged as an effective therapeutic alternative to conventional AVR for high-risk patients. This review analyzed the literature about AVR, with the objective of evaluating the outcomes of transcatheter aortic valve implantation in patients who are not eligible for surgery showing an improvement in quality of life and middle-term outcomes. The crucial point is the lack of studies with long-term follow-up that could give therapeutic importanc…

Acute myopericarditis in a young with autoimmune disorders

Cardiovascular magnetic resonance characterization of a hamartoma in an asyntomatic child

Abstract Background The prevalence of primary cardiac neoplasms is approximately 0.3% and these masses should be distinguished from many of other primary and secondary processes that can occur in the heart. Further assessment of the left ventricular mass presents important clinical implications. Cardiovascular magnetic resonance was used. Clinical case An asyntomatic 12-year-old child was referred for cardiovascular magnetic resonance imaging to further assess a left ventricular mass found after an echocardiography, executed for assessment for sport activity. His past medical history was absolutely negative. The patient was in optimal state of health. The EKG showed an aspecific ST elevatio…

Lower plasma testosterone levels enhance the predictive value of endothelial dysfunction for future cardiovascular events: A 5-year prospective study.

LETTER TO EDITOR

EFFECT OF IMAGE NORMALIZATION ON CAROTID PLAQUE CLASSIFICATION AND THE RISK OF IPSILATERAL HEMISFERIC ISCHEMIC EVENTS. RESULTS FROM THE ASYMPTOMATIC CAROTID STENOSIS AND RISK OF STROKE STUDY

The aim of this study was to determine the effect of image normalization on plaque classification and the risk of ipsilateral ischemic neurologic events in patients with asymptomatic carotid stenosis. The first 1,115 patients recruited to the Asymptomatic Carotid Stenosis and Risk of Stroke (ACSRS) study with a follow-up of 6 to 84 months (mean 37.1 months) were included in this study. Duplex ultrasonography was used for grading the degree of internal carotid artery stenosis and for plaque characterization (types 1-5), which was performed before and after image normalization. One hundred sixteen ipsilateral ischemic hemispheric events occurred. Image normalization resulted in 60% of plaques…

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…

Markers of inflammation are strong predictors of subclinical and clinical atherosclerosis in women with hypertension

Cardiovascular diseases in women still rises and remains their leading cause of death in most developed countries; yet we have less sex-specific data in women than in men as a result of lower enrollment in clinical trials and low rates of sex-specific reporting. The aim of our study was to evaluate in hypertensive postmenopausal women the potential predictive role of markers of inflammation, for example, fibrinogen and C-reactive protein (CRP), on subclinical and clinical atherosclerosis, beyond that of the other established cardiovascular risk factors. We studied 127 asymptomatic hypertensive postmenopausal women with different degrees of carotid intima–media thickness, as examined by the …

G-protein-coupled receptor kinase 5 polymorphism and Takotsubo cardiomyopathy.

BACKGROUND: Takotsubo cardiomyopathy (TTC) is an increasingly reported clinical syndrome that mimics acute myocardial infarction without obstructive coronary artery disease and is characterized by transient systolic dysfunction of the apical and/or mid-segments of the left ventricle. The syndrome mainly occurs in postmenopausal women with high adrenergic state conditions. Nowadays, the pathophysiology of TTC is not yet known and the possibility of a genetic predisposition is controversial. AIMS: The purpose of this study was to assess the genetic susceptibility to TTC through analysis of the L41Q polymorphism of the G-protein-coupled receptor kinase 5 (GRK5). METHODS AND RESULTS: In a cohor…

Reply to letter by Parodi et al. regarding article: Revised clinical diagnostic criteria for Takotsubo syndrome: The Takotsubo Italian Network proposal.

Non-compact myocardium assessment by cardiac magnetic resonance: dependence on image analysis method

To compare image analysis methods for the assessment of left ventricle non-compaction from cardiac magnetic resonance (CMR) imaging. CMR images were analyzed in 20 patients and 10 normal subjects. A reference model of the MR signal was introduced and validated based on image data. Non-compact (NC) myocardium size and distribution were assessed by tracing a single, continuous contour delimiting trabeculated region (Jacquier) or by one-by-one selection of trabeculae (Grothoff). The global non-compact/compact (NC/C) ratio, the NC mass, and the segmental NC/C ratio were assessed. Results were compared with the reference model. A significant difference between Grothoff and Jacquier approaches in…

Utility of Multi-Slice Computed Tomography Coronary Angiography to Evaluate Coronary Artery Bypass Graft Patency

Association between asymptomatic carotid atherosclerosis and degenerative aortic stenosis.

OBJECTIVE: Degenerative aortic stenosis shows similarities with atherosclerosis. To confirm the hypothesis that aortic stenosis is an "atherosclerosis-like" disease, we investigated the association between degenerative aortic stenosis and atherosclerosis of carotid arteries. METHODS: We studied 270 consecutive patients, 135 with degenerative aortic stenosis (trans-aortic peak velocity ≥ 2 m/sec) and other 135 subjects without aortic valve disease. All patients underwent echocardiography and ultrasound scan of the supra-aortic trunks to assess the presence of plaque and/or intima-media thickening (IMT). RESULTS: Atherosclerosis of carotid arteries (IMT and plaque) was significantly more freq…

RUPTURE OF A LEFT SINUS OF VALSALVA ANEURYSM INTO THE PULMONARY ARTERY: A CASE REPORT

Calf vein thrombosis: optimal duration of tretment

Subclinical atherosclerosis: independent predictor of cardiovascular events in a 20-years follow up of patients with or without metabolic syndrome

Purpose: To evaluate the influence of carotid atherosclerosis and metabolic syndrome (MetS) on the prediction of cardiovascular events during a 20-years follow-up. Methods: We studied a population of 529 asymptomatic patients, divided into 2 groups according to the results of the carotid ultrasound evaluation: one without atherosclerotic lesions (198 patients) and a second one with an increased carotid IMT or asymptomatic carotid plaque (331 patients). In each of these groups, we identified two subgroups of subjects with and without MetS. Cardiovascular endpoints were investigated in a 20-years follow-up: acute myocardial infarction, angina, transient ischemic attack, ischemic stroke, abdom…

Asymptomatic Carotid Lesion as a Marker of Future Cerebrovascular and Cardiovascular Events

ROLE AND CLINICAL RELEVANCE OF NEW RISK FACTORS OF ATS

MULTIFOCAL ATHEROSCLEROSIS INFLUENCE THE UTCOME OF PATIENTS UNDERWENT TO PRIMARY PTCA

ACCURATEZZA DIAGNOSTICA DELLA TC 40 STRATI IN PAZIENTI CON DOLORE TORACICO

SYMPTOMATIC ACUTE MYOCARDIAL INFARCTION IN A PATIENT BEARER OF HEART TRANSPLANTATION FOLLOWING ISCHEMIC HEART DISEASE

In 2005 Syeda et al. reported that the major factor limiting the long term of cardiac transplantation is the development of accelerated arteriosclerosis that occurs in the coronary arteries of the cardiac allograft. Transplant arteriosclerosis is characterized by diffuse, uniform, concentric narrowing of the artery by a fibrous proliferation of sub-intima cells. This atherosclerosis was estimate to occur in approximately 50% of patients by 5 years after transplantation. Unfortunately, as a consequence of cardiac denervation, symptoms are often atypical or completely absent. When these are present, the symptoms are those typical of effort angina. Very uncommon is the acute coronary syndrome.…

Zofenopril and ramipril in patients with left ventricular systolic dysfunction after acute myocardial infarction: A propensity analysis of the Survival of Myocardial Infarction Long-term Evaluation (SMILE) 4 study

Introduction: This was a propensity score analysis of the prospective, randomized, double-blind Survival of Myocardial Infarction Long-term Evaluation (SMILE) 4 study in which one-year treatment with zofenopril 60 mg plus acetylsalicylic acid (ASA) 100 mg gave superior results compared to ramipril 10 mg plus ASA in terms of death or hospitalization for cardiovascular causes in patients with acute myocardial infarction (AMI) complicated by left ventricular dysfunction (LVD). Materials and methods: A total of 716 patients of the intention-to-treat population were divided into homogeneous propensity quintiles (Q) using a logistic regression model (QI: best risk profile; QV: worst risk profile)…

Stable microvascular angina: instrumental evaluation of coronary microvascular dysfunction with coronary angiography and myocardial scintigraphy

Graft patency and late outcomes for patients with ST-segment elevation myocardial infarction who underwent coronary surgery

Objective: The aim of our study was to assess the long-term clinical outcomes and the grafts patency rates of patients with ST-segment elevation myocardial infarction (STEMI) who underwent urgent or emergency coronary artery bypass grafting (CABG). Materials: Participants in two previous studies comprising 207 STEMI patients undergoing on-pump (145 patients) or off-pump (62 patients) coronary artery bypass graft (CABG) surgery in our institution were prospectively followed to assess late mortality, graft patency, and major adverse cardiac-related event (MACE) rates. Graft patency was evaluated by multi-detector computed tomography angiography 64-slice scan. Mean times of graft implantation…

SUPERFICIAL VENOUS THROMBOSIS: ROLE OF GENETIC RISK FACTORS ON SPREADING TO DEEP VEINS

PREVALENZA DELLE LESIONI CAROTIDEE IN UNA POPOLAZIONE MEDITERRANEA DI IPERTESI

Peripheral atherosclerosis is associated with the occurrence of restenosis after percutaneous coronary intervention

INTRODUCTION: The aim of our study was to evaluate, in patients with proven coronary artery disease (CAD) and treated with elective percutaneous coronary intervention (PCI), whether the coexistence of asymptomatic carotid and femoral atherosclerotic lesions would provide prognostic information in terms of occurrence of restenosis. METHODS: We studied 104 patients with CAD (M/F=77/27), mean age 60.5+/-9 years. All patients were treated with elective PCI. After PCI the suspicion of restenosis was confirmed by coronary angiography. All patients underwent ultrasound duplex scan of carotid and femoral-popliteal-tibial axis to detect atherosclerotic lesions. According to ultrasound results, patie…

Platelet Aggregation, Coagulation and Fibrinolysis at Rest and after Bicycle Ergometer Test in CHD

Several observers have suggested that a dysfunction of dynamic balance between platelet aggregation, coagulation and fibrinolysis may be a factor in the pathogenesis of atherosclerosis. This dysfunction, presumably, is correlated with the atherosclerotic vascular lesions, that could reduce the parietal synthesis of heparan-sulphase, prostacyclin and plas minogen activator.

Ventricular dysfunction and number of non compacted segments in non compaction: Non-independent predictors.

Abstract Background Isolated ventricular noncompaction (IVNC) is characterized by multiple prominent trabeculations and deep intertrabecular recesses. Some reports prove that the chronic heart failure may occur in approximately half of the patients. In this report we investigate the correlation between the number of non compacted segments and entity of systolic dysfunction from the registry and subregistries of the SIEC. Method To identify the correlation between ventricular dysfunction and number of segments involved in non compaction we evaluated a consecutive series of 238 patients affected by non compaction, from the SIEC (Societa Italiana di Ecografia Cardiovascolare) registry. The ave…

A strange pneumonia

We report the case of a 62-year-old man with non-ST elevation myocardial infarction complicated by partial rupture of the antero-lateral papillary muscle in which severe mitral regurgitation with lateralized direction towards the right pulmonary veins gave unilateral pulmonary oedema, resembling an acute pneumonia.Unilateral pulmonary oedema is a rare entity, more frequently appearing as opacity of the right lung and always associated with severe mitral regurgitation. It is very important to suspect and promptly recognize unilateral pulmonary oedema because initial misdiagnosis leads to a delay in the initiation of appropriate treatment and to an increased risk of mortality.

PREVALENZA DELLA SINDROME METABOLICA IN PAZIENTI CON CARDIOPATIA ICSHEMICA CRONICA Ital. Heart J. 2005; 6 (Suppl. 8): 170S

STUDIO ADVANCE: QUALI RISPOSTE PER LA NOSTRA PRATICA CLINICA?

Agenesis of the renal segment of inferior vena cava associated with venous stasis.

Congenital anomalies of the inferior vena cava is an extremely rare vascular anomaly with controversial pathogenesis. Anomalies of the inferior vena cava (IVC) are present in 0.3% to 0.5% of otherwise healthy individual and in 0.6% to 2% of patients with other cardiovascular defects. The phenomenon of absence of the IVC has been described in a variety of ways such as absence, agenesis, anomalous, and interruption of a particular segment ([infra] hepatic, pre-renal, renal, or infrarenal) of the IVC. We describe a 42-year-old man with chronic venous insufficiency, without DVT, caused by congenital absence of renal segment of the IVC

Five-year prospective study on cardiovascular events, in patients with erectile dysfunction and hypotestosterone.

Objective: Testosterone levels play a role in cardiac and vascular pathology. In the present study we investigated the prognostic significance of this hormone for cardiovascular outcome, in a 5-year follow-up. Materials and methods: Our cohort included 802 adult subjects, from 40 to 80 years. Patients were excluded if they had a past history of peripheral or coronary artery disease, and revascularization. A blood sample was drawn to valuate testosterone level, and we considered normal testosterone levels 300 ng/dl. FMD (flow mediated dilatation) of the brachial artery was assessed by measuring the increase of the brachial artery diameter during reactive hyperemia after transient forearm isc…

Statins and peripheral arterial disease: effects on claudication, disease progression, and prevention of cardiovascular events.

Peripheral arterial disease (PAD) of the lower limbs is the third most important site of atherosclerotic disease alongside coronary heart disease (CHD) and cerebrovascular disease (CVD). Best medical treatment is beneficial even in patients who eventually need invasive treatment, as the safety, immediate success, and durability of intervention is greatly improved in patients who adhere to best medical treatment. In recent years, a number of studies have suggested that the ACE-inhibitor ramipril and different statins, together with antiplatelet drugs, reduce cardiovascular morbidity and mortality in PAD. Patients with PAD are really a category of patients with a very high cardiovascular risk…

La terapia metabolica nel trattamento dell'ischemia critica cronica degli arti inferiori: la L-propionilcarnetina potenzia gli effetti della PGE-1

LA CARDIOPATIA “TAKOTSUBO”: DOCUMENTO DI CONSENSO

INFLUENCE OF CAROTID AND PERIPHERAL ATHERLSCLEROSIS IN THE OUTCOME OF PATIENTS WITH ACUTE CORONARY SYNDROME

INFLUENCE OF CAROTID AND PERIPHERAL ATHERLSCLEROSIS IN THE OUTCOME OF PATIENTS WITH ACUTE CORONARY SYNDROME

[Cardiac arrhythmias in hypertensive subjects with and without left ventricular hypertrophy compared to the circadian profile of the blood pressure].

To evaluate possible correlations between cardiac arrhythmias and circadian pattern of blood pressure (BP) and of heart rate (HR), we studied 2 groups of 20 males with stable arterial hypertension of mild to moderate entity, with (Group I) or without (Group II) left ventricular hypertrophy (LVH). In patients with LVH the mean age (56 vs 46 years), the duration of the hypertensive state (48.1 vs 15.7 months), the thickening of interventricular septum (IVS; 13.7 vs 9.6 mm) and of the posterior wall of the left ventricle (13.2 vs 9.2 mm) and the mass of LV (149.8 vs 99.7 g/m2) were significantly greater (p less than 0.01). On the contrary, the 2 groups did not show significant differences conc…

Trombosi venosa superficiale ed estensione al circolo profondo: ruolo dei fattori di rischio genetici

CAROTID AND PERIPHERAL ATHEROSCLEROSIS IN PATIENTS UNDERWENT TO PRIMARY PCI AND OUTCOME ASSOCIATED WITH MULTIFOCAL ATHEROSCLEROSIS

INFLUENZA DELL’ATEROSCLEROSI MULTIFOCALE NELL’OUTCOME DI PAZIENTI CHE HANNO EFFETTUATO PTCA PRIMARIA

Association of carotid atherosclerosis with coronary artery disease: comparison between carotid ultrasonography and coronary angiography in patients with chest pain].

Endothelial dysfunction and carotid lesions are strong predictors of clinical events in patients with early stages of atherosclerosis: a 24-month follow-up study

Background The purpose of this study was to investigate whether the vasodilator response to brachial artery and the presence of carotid lesions may have a prognostic significance in patients with early stages of atherosclerosis. Methods and results Vascular echography was performed to analyze flow-mediated vasodilatation (FMD) at the brachial artery and intima–media thickness (IMT) of carotid arteries in 84 asymptomatic patients. At baseline, we evaluated all the established traditional cardiovascular risk factors. Transient ischemic attack, stroke, effort or unstable angina, acute myocardial infarction, peripheral arterial disease and cerebrovascular and cardiovascular death served as outc…

RUOLO DEI FATTORI DI RISCHIO TRADIZIONALI E DELLA PROTEINA-C REATTIVA NELLA PATOGENESI DELLA DISFUNZIONE ENDOTELIALE

COLESTEROLO HDL E PROGRESSIONE DELLA MALATTIA ATEROSCLEROTICA

Left ventricular non-compaction cardiomyopathy in children: Is segmental fibrosis the cause of tissue Doppler alterations and of EF reduction?

Noncompaction of the ventricular myocardium (LVNC) is a rare congenital cardiomyopathy resulting from an arrest in normal endomyocardial embryogenesis. In 2002 Jenni et al. [Jenni R, Wyss CA, Oechslin EN, Kaufmann PA. Isolated ventricular noncompaction is associated with coronary microcirculatory dysfunction. J Am Coll Cardiol 2002; 39:450-454.] reported a microvascular dysfunction in 12 patients affected by non compaction: areas of restricted myocardial perfusion have been documented by scintigraphy, suggesting a reduction of Coronary flow reserve. McMahon et al reported in a recent article a reduction of TD velocities in children with noncompaction of the left ventricle, compared with nor…

Cost-effectiveness of zofenopril in patients with left ventricular systolic dysfunction after acute myocardial infarction: a post hoc analysis of SMILE-4.

Claudio Borghi,1 Ettore Ambrosioni,1 Stefano Omboni,2 Arrigo FG Cicero,1 Stefano Bacchelli,1 Daniela Degli Esposti,1 Salvatore Novo,3 Dragos Vinereanu,4 Giuseppe Ambrosio,5 Giorgio Reggiardo,6 Dario Zava7 1Unit of Internal Medicine, Policlinico S Orsola, University of Bologna, Bologna, Italy; 2Italian Institute of Telemedicine, Varese, Italy; 3Division of Cardiology, University of Palermo, Palermo, Italy; 4University and Emergency Hospital, Bucharest, Romania; 5Division of Cardiology, University of Perugia, Perugia, Italy; 6Mediservice, Milano, Italy; 7Istituto Lusofarmaco d&amp;#39;Italia SpA, Peschiera Borromeo, Italy Background: In SMILE-4 (the Survival of Myocardial Infarction Long-term…

Calf vein thrombosis: optimal duration of treatment

Impact of moderate ischemic mitral regurgitation after isolated coronary artery bypass grafting

The aim of the study was to evaluate the clinical and echocardiographic outcomes, at rest and under exercise testing, of patients with moderate ischemic mitral regurgitation (IMR) undergoing isolated coronary artery bypass graft surgery (CABG).Between February 2003 and March 2008, 180 patients with moderate IMR who had isolated CABG were enrolled. Patients were matched 1:2 (n = 360) with patients who underwent isolated CABG without IMR (by propensity score). The study endpoints were freedom from all death, cardiac related-death, late events, and cardiac-related events. Late outcomes and left ventricular remodeling were evaluated according to preoperative percent of ejection fraction. Sympto…

DIABETE

Growth hormone deficiency and increased coronary risk.

PRIMARY PTCA: THE BEST CHOICE FOR ALL PATIENTS WITH ACUTE CORONARY SYNDROMES?

PRIMARY PTCA: THE BEST CHOICE FOR ALL PATIENTS WITH ACUTE CORONARY SYNDROMES?

Rate vs. rhythm control and adverse outcomes among European patients with atrial fibrillation

Aim The impact of rate and rhythm control strategies on outcomes in patients with atrial fibrillation (AF) remains controversial. Our aims were: to report use of rate and rhythm control strategies in European patients from the EURObservational Research Program AF General Pilot Registry. Secondly, to evaluate outcomes according to assigned strategies. ........................................................................................................................................................... Methods and results Use of pure rate and rhythm control agents was described according to European regions. 1-year follow-up data were reported. Among rate control strategies, beta-blockers …

THE INTERNATIONAL UNION OF ANGIOLOGY: AN INTERNATIONAL AND MULTINATIONAL SOCIETY BETWEEN TRADITION AND INNOVATION

THE INTERNATIONAL UNION OF ANGIOLOGY: AN INTERNATIONAL AND MULTINATIONAL SOCIETY BETWEEN TRADITION AND INNOVATION

FIBRINOGEN AS PREDICTOR OF MORTALITY AFTER ACUTE MYOCARDIAL INFARCTION: A 42-MONTHS FOLLOW-UP STUDY

Background. Several studies suggest that fibrinogen may be considered an independent risk factor for coronary artery disease, but it is still on debate if we need its evaluation during an acute myocardial infarction (AMI) to prevent future fatal or non-fatal cardiovascular events. Therefore, we decided to investigate this field. Methods: We studied 92 male patients with AMI, evaluating at admission age, body mass index, systolic blood pressure, cigarette smoking, ejection fraction, plasma levels of total cholesterol, triglycerides, fibrinogen, glycemia, and white blood cell count. All patients were followed up for 42 months to evaluate total mortality and cardiovascular morbidity. Results: …

RUOLO DELLA SINDROME METABOLICA NELLA FIBRILLAZIONE ATRIALE

DIAGNOSTIC APPROACH TO THE PATIENT WITH SUSPICION OF MULTIFOCAL DISEASE

Evaluation of atrial function by 2D strain echocardiography in patients with atrial fibrillation

Abstract Objectives To evaluate atrial function by 2D strain in patients with atrial fibrillation (AF) and normal or slightly increased atrial size and to verify whether lower atrial strain is associated with more frequent AF recurrences. Materials and methods We studied 50 patients with AF, mean age 59.6 ± 13 years and 50 age-and gender-matched controls. We analyzed left atrial function through 2Dstrain imaging, after the re-establishment of sinus rhythm (SR) and we investigated about the recurrences of the arrhythmia. Results Atrial strain (AS) was lower in AF patients vs controls (LA p Conclusions The assessment of atrial function by strain imaging might help to identify patients who nee…

Thromboxane formation by platelets and platelet sensitivity to prostacyclin in patients with acute myocardial infarction

Iloprost treatment in patients with Raynaud's phenomenon secondary to systemic sclerosis and the quality of life: a new therapeutic protocol

Objectives: to evaluate the clinical efficacy and the effects on the quality of life of Iloprost, a prostacyclin analogue, used, according to a new protocol, in patients with Raynaud’s phenomenon secondary to Systemic Sclerosis. Methods: in this randomized study we treated 30 patients with Iloprost given by intravenous infusion, at progressively increasing doses (starting from 0.5 ng/Kg/min up 2 ng/Kg/min) over a period of 6 hours a day for ten days in two consecutive weeks, with repeated cycles at regular intervals of three months for 18 months. The results were compared with those obtained in 30 other patients, who had received the same drug but with different posologic schemes. Results: …

Myocardial infarction marker levels are influenced by prothrombin and tumor necrosis factor-α gene polymorphisms in young patients.

Polymorphisms of genes encoding key factors for the control and activation of inflammatory response and coagulation cascade regulation may play a role in genetic susceptibility to acute myocardial infarction (AMI). This study sought to analyze the effect of TNF - 308G/A and pro-thrombin (FII) 20210G/A polymorphisms on the laboratory parameters of young patients affected by AMI. Results indicated that TNF - 308A positive genotype frequencies were increased in these patients and that a genetically determined higher production of TNF-alpha is associated in young subjects to a more severe cardiac damage as depicted by higher levels of troponin, Creatine kinase-MB Isoenzyme (mCK-MB) and a signif…

METABOLIC SYNDROME IN CHILDHOOD AND CARDIOVASCULAR RISK

Prediction of vascular events in subjects with subclinical atherosclerosis and the metabolic syndrome: the role of markers of inflammation.

Response to letter by Drs. Mohammed Abbas, Maria Sessa, and Francesco Corea

Mediterranean diet impact on cardiovascular diseases: a narrative review

Cardiovascular disease (CVD) accounts for more than 17 million deaths per year worldwide. It has been estimated that the influence of lifestyle on CVD mortality amounts to 13.7% for smoking, 13.2% for poor diet, and 12% for inactive lifestyle. These results deeply impact both the healthy status of individuals and their skills in working. The impact of CVD on productivity loss accounts for the 24% in total costs for CVD management. Mediterranean diet (MedD) can positively impact on natural history of CVD. It is characterized by a relatively high consumption of inexpensive and genuine food such as cereals, vegetables, legumes, nuts, fish, fresh fruits, and olive oil as the principal source of…

Coronary microvascular dysfunction in patients with diabetes, hypertension and metabolic syndrome

MTHFR allele 677T and risk of abdominal aortic aneurysm

In-hospital complications of acute myocardial infarction in hypertensive subjects

Recent studies have shown a worse in-hospital outcome in hypertensive than in normotensive patients with acute myocardial infarction (AMI), which has been attributed to more frequent complications. The aim of this study was to investigate clinical patterns, risk factors, and in-hospital complications in hypertensive and normotensive patients with AMI.Of 4994 consecutive patients with AMI admitted to the intensive care unit, hypertensive patients with first infarction (n = 915; mean age 68.8 +/- 11.4 years) and 915 gender- and age-matched normotensive subjects were retrospectively studied.In the univariate analysis, hypertensive subjects presented more frequently non-Q-wave infarction and ST…

ABI – MARKER OF MULTIFOCAL DISEASES AND INDICATOR OF CARDIOVASCULAR EVENT

The treatment of venous leg ulcers: a new therapeutic use of iloprost. In:

Takotsubo cardiomyopathy features at cardiac magnetic resonance

Abstract Diagnosis of Takotsubo cardiomyopathy is based on clinical symptoms, electrocardiographic changes, absence of angiographic significant coronary lesions and presence of suggestive wall motion abnormalities. CardioMRI is an useful complementary tool especially to role out the diagnosis of myocarditis and of myocardial infarction with angiographically normal coronary artery and to document complications of the disease.

An update on the role of markers of inflammation in atherosclerosis

In recent years, several studies have used the measurement of carotid intima-media thickness (IMT) as a marker of early atherosclerosis: IMT has been shown to correlate significantly with the presence of coronary artery disease (CAD) and to predict fatal and not fatal cerebro- and cardio-vascular events. These findings highlight the importance of recognizing and managing early stages of atherosclerosis for effective cardiovascular prevention. Beyond traditional established cardiovascular risk factors, inflammation has been shown to be crucial throughout atherosclerosis from endothelial dysfunction to plaque rupture and thrombosis. Several studies have shown the existence of a strong relatio…

Incidence and Clinical Impact of Recurrent Takotsubo Syndrome: Results From the GEIST Registry

Background Current literature only reports variable information from single‐center studies on the recurrence rate, the complications, and the outcome of patients with Takotsubo syndrome ( TTS) experiencing recurrent TTS . Therefore, a detailed description of clinical characteristics, predictors, and the prognostic impact of patients with TTS and recurrences in a multicenter registry is needed. Methods and Results We analyzed 749 patients with TTS from 9 European centers being part of the international, multicenter GEIST (German Italian Stress Cardiomyopathy) Registry. Patients were divided into the recurrence group and the nonrecurrence group. The recurrence rate at a median follow‐up of 8…

PROPIONIL-L-CARNITINA E ARTERIOPATIA OBLITERANTE PERIFERICA

Fetuin-A is Associated to Serum Calcium and AHSG T256S Genotype but Not to Coronary Artery Calcification

Vascular calcification has been recently associated to an increased cardiovascular risk and mortality. In few studies, Fetuin-A showed an association to coronary artery calcification (CAC), although the physiopathological mechanism underlying this association has not been fully established yet. Seventy-four patients with one or more cardiovascular risk factor and asymptomatic for coronary vasculopathy were included in the study. CAC was evaluated by Agatston score. Serum Fetuin-A levels were determined by ELISA. Molecular analysis of AHSG T256S gene variant (rs4918) was performed by PCR-RFLP. Serum Fetuin-A was correlated to serum calcium (r = 0,321; P = 0,018), but not to serum phosphorous…

Three-dimensional transesophageal echocardiography in the guide of cardiac mass biopsy

Cardiac tumors are rare. Cardiovascular imaging is more important in the differential diagnosis of cardiac masses but no current noninvasive diagnostic tool has the ability to absolutely diagnose cardiac tumors. In effect cardiac biopsy remains the gold standard in the differential diagnosis. In our case we show the advantages of three-dimensional (3D) transesophageal echocardiography as a guide for cardiac biopsy. We believe that 3D TEE is ready to be used in the guide of cardiac mass biopsy. Once interventionalists become confident with 3D imaging, this technique should be used routinely during these procedures.

Segmental dyskinesia in Wolff-Parkinson-White syndrome: A possible cause of dilatative cardiomyopathy.

Wolff-Parkinson-White (WPW) is a syndrome characterized by the presence of an accessory pathway that skipping A-V node may lead the electrical stimulus from the atrium directly to the ventricle. Some studies reported the finding of myocardial dyskinesia in the segments precociously activated by the accessory pathway, at echocardiogram and at nuclear cardiac study. Soria et al. reported, in 1985, an increased incidence of dilative cardiomyopathy in patients with WPW. The pathophysiological pathway that leads to ventricular dilation may be due to the increase of end-diastolic pressure secondary to a tachycardia-induced cardiomyopathy. Tachycardia-induced cardiomyopathy is usually secondary to…

Platelet Activity and Blood Lipid Changes in Diabetes Mellitus

An altered platelet function can often be found in diabetes mellitus (2, 3, 4, 10, 13, 16, 17, 23, 24). Several studies have pointed towards an increased sensitivity of platelets to ADP induced aggregation (3, 6, 23) in diabetic patients; this phenomenon can also be found in diabetics without apparent vasculopathy and in subjects with altered glucose tolerance (3, 23).

A late diagnosis of aortic coarctation began as an acute coronary syndrome

Abstract Aortic coarctation accounts the 5%–10% of congenital heart disease. It is usually diagnosed during childhood but the postductal form is most common in adults and may be diagnosed incidentally in the context of investigation for hypertension. The age of correction is the most important factor for the relief of hypertension and long-term survival. We describe a case of a 63-year-old man, came to our emergency room for acute coronary syndrome. Cardiac catheterization with right femoral artery access was performed but for many difficulties during the introduction of catheters was therefore performed aortography that showed an interruption "a cul de sac" at the level of the descending t…

P776 Stress ecocardiography and speckle tracking analysis in patients with heart failure and preserved ejection fraction

Abstract BACKGROUND Heart failure with preserved ejection fraction (HFpEF) is characterized by heart failure symptoms despite preserved LV systolic function together with at least one among left ventricle hypertrophy/left atrial enlargement plus diastolic dysfunction (DD) and increased brain natriuretic peptide levels. Rest echocardiography could still be normal despite patients experience HF symptoms. Speckle tracking analysis (STE) analyzes myocardial deformation and is able to identify subtle left ventricular dysfunction. PURPOSE to analyze the added value of stress echocardiography to improve diagnostic accuracy in patients with normal ejection fraction and unexplained dyspnoea by evalu…

LA TERAPIA MEDICA NELLA TASC II

CARDIOVASCULAR MAGNETIC RESONANCE IN CHILDREN WITH IDIOPATHIC MONOMORPHIC VENTRICULAR TACHYCARDIA OR COMPLEX VENTRICULAR EXTRASYSTOLES

Rupture of the atherosclerosis plaque: is chlamydia pneumonie a possible agent

FIBRILLAZIONE ATRIALE E DETERIORAMENTO COGNITIVO CEREBRALE

A rare case of a coronary artery anomaly detected on multidetector computed tomography

An anomalous aortic origin of the coronary artery arising from the opposite sinus with an interarterial course is a rare condition that is associated with a high risk of sudden cardiac death during or after strenuous exertion. We herein report the case of a 47-year-old woman presenting with chest pain, syncope and palpitations who presented with a rare coronary artery anomaly on multidetector computed tomography coronary artery (MDCT-CA) with prospective electrocardiogram (ECG) gating.

Atherosclerosis, degenerative aortic stenosis and statins

Aortic stenosis is the most common valvular heart disease among adult subjects in western countries The current treatment for aortic stenosis is aortic valve replacement. The possibility of a medical treatment that can slow the progression of aortic stenosis is very fascinating and statins have been tested to reduce the progression of degenerative aortic stenosis (DAS). The rationale for statin treatment in DAS has a deep pathophysiological substrate, in fact inflammation and lipid infiltration constitute the same histopathological pattern of both aortic stenosis and atherosclerosis and these two conditions have the same risk factors. Whether retrospective studies have shown some efficacy o…

RIGHT VENTRICULAR PACING: IS IT REALLY THAT BAD? In: Cardiac Arrhythmias 2005

Quando e come valutare la presenza di trombofilia?

Disfunzione endoteliale e malattia carotidea in pazienti con bright liver echopattern

LOW EF: THE BEST MARKER OF POOR PROGNOSIS IN PATIENTS AFFECTED BY NON COMPACTION.

N.A.

PREVALENCE OF METABOLIC SYNDROME IN CHRONIC ISCHEMIC HEART DISEASE

PREVALENCE OF METABOLIC SYNDROME IN CHRONIC ISCHEMIC HEART DISEASE

High plasma levels of endothelin-1 enhance the predictive value of preclinical atherosclerosis for future cerebrovascular and cardiovascular events: a 20-year prospective study

BACKGROUND AND PURPOSE: Clinical and experimental evidence suggests that endothelin-1 (Et-1) plays a role in cardiac and vascular disease. In the present study, we investigated the prognostic significance of Et-1 for cerebrovascular and cardiovascular outcome, in a 20-year follow-up. METHODS: We studied 82 originally healthy individuals, referred to our Unit of Cardiovascular Prevention, to evaluate the presence of asymptomatic carotid lesions. We subdivided these individuals into two groups, according to the plasma values of Et-1 (respectively ≤ or >2.7 pg/ml). Traditional cardiovascular risk factors were investigated, and by carotid ultrasound examination, we distinguished between normal …

Carotid atherosclerosis in renal transplant recipients: Relationships with cardiovascular risk factors and plasma lipoproteins

BACKGROUND: Renal transplant recipients have an increased incidence of cardiovascular disease, but less data exist about cerebrovascular atherosclerosis. In this study, we assessed the prevalence of carotid lesions as evaluated by B-mode ultrasonography in a group of renal transplant recipients, and we evaluated univariate and multivariate relationships between common risk factors and plasma lipoproteins and carotid lesions. METHODS: Fifty-seven renal transplant recipients and 113 age- and gender-matched controls underwent a complete clinical visit for the evaluation of risk factors present. In all subjects, a blood sample was collected for lipoprotein determination, and an ultrasound high-…

MIOCARDIO NON COMPATTATO

Climatic variables in Takotsubo cardiomyopathy: role of temperature

Background Recent studies documented a seasonal (summer) and circadian (morning) temporal distribution of takotsubo cardiomyopathy (TTC). Aim The aim of our study was to investigate whether there is a relationship among season, temperature and the occurrence of TTC. A second aim of our study was the comparison of climatic variables in Takotsubo cardiomyopathy versus acute myocardial infarction (AMI). Methods We enrolled consecutive patients with TTC in three Italian centres and, for comparison consecutive patients with AMI. The frequency of TTC and AMI patients according to month, season and quartiles of temperature (I quartile: 9.8–15-, II quartile: 15–19-, III quartile: 19–25- and IV quar…

Diagnosis and definition of biventricular non-compaction associated to Ebstein's anomaly

Abstract Background Non-compaction of ventricular myocardium is a rare congenital cardiomyopathy characterized by the presence of an extremely thickened endocardial layer with prominent trabeculations and deep recesses in communication with ventricular chamber and determining the typical spongeous aspect. The diagnosis of non-compaction of ventricular myocardium is possible through the identification of morphological alterations by echocardiographic evaluation. Ebstein's anomaly is a rare congenital cardiac disease, defined as the significant apical displacement of the part of the tricuspid valve causing significant tricuspid regurgitation and reduction of the functional right ventricle, ri…

Cost effectiveness of zofenopril in patients with left ventricular systolic dysfunction after acute myocardial infarction: a post- hoc analysis of the smile-4 study

BACKGROUND: In SMILE-4 (the Survival of Myocardial Infarction Long-term Evaluation 4 study), zofenopril + acetylsalicylic acid (ASA) was superior to ramipril + ASA in reducing the occurrence of major cardiovascular events in patients with left ventricular dysfunction following acute myocardial infarction. The present post hoc analysis was performed to compare the cost-effectiveness of zofenopril and ramipril. METHODS: In total, 771 patients with left ventricular dysfunction and acute myocardial infarction were randomized in a double-blind manner to receive zofenopril 60 mg/day (n = 389) or ramipril 10 mg/day (n = 382) + ASA 100 mg/day and were followed up for one year. The primary study end…

RUPTURE OF THE ATHEROSCLEROTIC PLAQUE: IS CHLAMYDIA PNEUMONIAE A POSSIBLE AGENT?

BACKGROUND: The natural history of atherosclerosis has not clearly been elucidated yet. Some works reported that flogosis plays a role in plaque instability. Why does this inflammatory process start? We investigated the correlation between Chlamydia pneumoniae acute infection and plaque rupture. METHODS: We compared blood concentrations of IgM anti-Chlamydia pneumoniae in patients affected by acute myocardial infarction (AMI) and in patients affected by stable angina. RESULTS: Our results showed a minimal statistical difference, with a more positive value in patients with AMI. Subsequently, the group affected by AMI was divided into two subgroups with and without plaque rupture: the subgrou…

Treatment decision making in patients with arrhythmogenic right ventricular dysplasia/cardiomyopathy: State of the art

No abstract available

Low levels of testosterone levels increase the risk of major cardiovascular events in a follow-up to 5 years

Materials and Methods. We evaluated a series of 802 patients with intermediate cardiovascular risk according to the Framingham Risk Score (FRS). The endothelial function through flow-mediated vasodilatation (FMD), the erectile function (EF), and the total serum testosterone levels were assessed. Patients were followed for up to 5 years and the prevalence and predictors of MACEs were evaluated. Results. The levels of serum testosterone are related with both endothelial function (FMD) (t=9,4080, 95% CI= 0,9318 to 1,4234, p<0,0001) and erectile function (FMD) (t=8,9584, 95% CI= 0,7642 to 1,1932, p<0,0001). Analysis of variance (ANOVA) of serum testosterone levels are related with the MACEs (F-…

RUOLO DELLA SINDROME METABOLICA NELLE SINDROMI CORONARICHE ACUTE

RISK FACTORS AND MULTIFOCAL ATHEROSCLEROSIS INFLUENCE THE RATE OF RESTENOSIS POST-PTCA

MYOCARDIAL ISCHEMIA IN THE HYPERTENSIVE PATIENT: THE ROLE OF CORONARY MICROCIRCULATION

The role of the renin-angiotensin system in atrial fibrillation and the therapeutic effects of ACE-Is and ARBS

Atrial fibrillation (AF) is the most common rhythm disturbance in medical practice and represents a very expensive health problem. AF can be managed with the prevention of thromboembolism and either a rate control of rhythm strategy. As both strategies have important limitations, probably a preventative strategy in patients at risk of developing arrhythmia can be a more attractive option. The renin-angiotensin system (RAS) seems to be involved in the genesis of arrhythmia by the following two mechanisms: 1. the induction of atrial fibrosis and structural remodelling by mitogen-activated protein kinase (MAPK) expression and reduction of collagenase activity; 2. the induction of electrical re…

What links BRAF to the heart function? new insights from the cardiotoxicity of BRAF inhibitors in cancer treatment

The RAS-related signalling cascade has a fundamental role in cell. It activates differentiation and survival. It is particularly important one of its molecules, B-RAF. B-RAF has been a central point for research, especially in melanoma. Indeed, it lacked effective therapeutic weapons since the early years of its study. Molecules targeting B-RAF have been developed. Nowadays, two classes of molecules are approved by FDA. Multi-target molecules, such as Sorafenib and Regorafenib, and selective molecules, such as Vemurafenib and Dabrafenib. Many other molecules are still under investigation. Most of them are studied in phase 1 trials. Clinical studies correlate B-RAF inhibitors and QT prolonga…

Editorial: Current trends in the treatment of supraventricular tachycardia in pediatric age

In pediatric age supraventricular tachiarrhythmias represent one of the most common cause of admission in cardiology units. Supraventricular arrhythmias may significantly influence the normal growth of a child with significant psycho-social implications. Pediatric cardiologists should be aware about the arrhythmias they face in their clinical practice. Moreover, they should know the possible risks related to specific arrhythmias and use the most efficacious therapeutic strategy with a correct knowledge of antiarrhythmic drugs. In this issue of Current Pharmacological Design the most recent knowledges on pathophysiology, diagnosis and treatment of supraventricular tachyarrhythmias in pediatr…

Cytokine Polymorphism in Takotsubo Cardiomyopathy

IMIN11. Cytokine Polymorphism in Takotsubo Cardiomyopathy P. Di Gangi1, L. Scola1, S. Giambanco1, M. Bova1, G. Santini1, L. Vaccarino1, C. R. Balistreri1, D. Lio1, P. Assennato1, S. Novo1, G. Novo1 1University of Palermo, Palermo, Italy Background: Takotsubo (TT) cardiomyopathy is characterised by an acute left ventricular dysfunction triggered by emotional or physical stresses. Clinically, the syndrome is characterised by acute symptoms mimicking acute infarction without relevant electrocardiographic and biochemical markers of myocardial damage changes. Stressful events inducing an excess catecholamine release and myocardial β-adrenergic receptors (β-AR) seem to play a major role in TT. Ac…

Lipid ratios as predictors of subclinical atherosclerosis

Midventricular dyskinesia during clozapine treatment?

This is the case of a young man suffering from schizophrenia and treated with clozapine. He developed acute heart failure associated with pericardial effusion and midventricular dyskinesia with severe systolic dysfunction and left ventricular dilatation at echocardiogram, readily resolved after the suspension of clozapine therapy. The segmental wall motion abnormalities observed at echocardiogram in this case are peculiar and have never been described before. The possible cardiotoxic effects of clozapine have been reported previously in the literature. Because of its serious potential side effects this drug is not considered the first choice for treatment of schizophrenia. Before beginning …

Iatrogenic pulmonary artery dissection in patient with ostium secundum interatrial septum defect

Pulmonary artery dissection is a rare and lethal condition. Few cases are reported in the literature, and most are derived from autopsies. In most cases, pulmonary artery dissection is a complication of chronic pulmonary hypertension leading to pulmonary artery aneurysm but there are other causes. We describe a case of iatrogenic pulmonary artery dissection in an elderly patient with ostium secundum defect. In particular, we describe the role of cardiac magnetic resonance in making this diagnosis and guiding future therapeutic decisions.

Evaluation of C-Reactive Protein in Primary and Secondary Prevention

Inflammation is pivotal in atherosclerosis, and C-reactive protein (CRP) is an inflammatory marker that predicts cardiovascular events. Several population-based studies have demonstrated that baseline CRP levels predict future cardiovascular events. CRP testing may thus have a major adjunctive role in the global assessment of cardiovascular risk. Recently, the National Cholesterol Education Program, through the Adult Treatment Panel III guidelines, identified CRP and another marker of inflammation, the fibrinogen, as “emerging risk factors,” suggesting that their measurement may improve the estimations of absolute risk obtained using the traditional cardiovascular risk factors. In terms of…

The percutaneous treatment of Patent Foramen Ovale, an effective and safe therapeutic choice

Introduction: The aim of our study is to evaluate the feasibility, safety and efficacy of the percutaneous closure of PFO (abnormal communication between the right and left atrium). Methods: Between July 2009 and October 2012 percutaneous closure was performed in 37 patients. The presence of PFO was diagnosed through the use of ultrasound techniques: transcranial doppler with contrast (cTCD), transthoracic echocardiography(TTE) and transesophageal echocardiography (TEE). Follow-up was composed consisted of a Holter ECG 7 days after the closure with a 24 hour heart rhythm monitoring, to evaluate eventual arrhythmia cases and programmed controls which included a TTE at 1-3 months, TTE+ cTCD a…

Two cases of tako-tsubo cardiomyophaty in Caucasians

Tako-tsubo cardiomyopathy is a recently described disease characterized by chest pain, transient left ventricular dysfunction and specific electrocardiographic changes. The disease takes its name from the typical left apical ballooning observed at left ventriculogram. Tako-tsubo cardiomyopathy was first described by Sato in 1990. Since then sporadic cases were reported by Japanese authors, and only a few European publications are available. We describe 2 cases of patients affected by this syndrome.

Troponin levels after elective percutaneous coronay intervention: outcome and follow-up

Troponin is a diagnostic factor for cardiovascular disease for its specificity and myocardial tissue high sensitivy.

CAROTIDOPATIA E INFIAMMAZIONE

MULTIFOCAL ATHEROSCLEROSIS AND MARKERS OF INFLAMMATION INFLUENCE THE OUTCOME OF THE VASCULAR PATIENTS

ALIMENTAZIONE NELLA PREVENZIONE DELLE MALATTIE VASCOLARI

UTILITA’ DELL’ANGIOGRAFIA CORONARICA ESEGUITA MEDIANTE TOMOGRAFIA COMPUTERIZZATA MULTISTRATO NEL CONTROLLO DELLA PERVIETA’ DEL BYPASS AORTO-CORONARICO

Neuromuscular disorders and non compaction

Abstract For neurological disorders we consider every possible affection of the central nervous system or neuro-muscular junction, in the presence of complex syndromes as well, such as Cornelia De Lange syndrome or any other. In our experience the incidence of neurological or neuromuscular envolment in patients affected by noncompaction is low. An incidence of comorbidities higher than 20% is not recorded in any centre, in published experiences. Data of the Vienna group could be likely influenced by selection bias (second level centre) or territorial genetic factors, or could depend on higher sensibility of used diagnostic techniques of neurological disease. But, if it was so, in our opinio…

The predictive role of C-reactive protein in patients with hypertension and subclinical atherosclerosis.

Recent guidelines published by the joint European Society of Hypertension/European Society of Cardiology have suggested the inclusion of C-reactive protein (CRP) in the standard assessment of cardiovascular risk in hypertensive patients, but little data is available on the role of CRP in patients with carotid lesions. We studied in 472 subjects, 236 with and 236 without hypertension, gender- and age-matched, with and without early stages of atherosclerosis (e.g. those with asymptomatic intima-media thickness >0.9 mm), the influence of all the other traditional cardiovascular risk factors (e.g. older age, male gender, obesity, diabetes, smoking habit, family history of coronary artery diseas…

LIVELLI PLASMATICI DI MCSF IN PAZIENTI CON SINDROMI CORONARICHE ACUTE.

Impact of anemia on long-term prognosis of patients with NSTEMI treated with PCI and dual antiplatelet therapy

Anemia; NSTEMI;

Early detection of coronary artery flow and myocardial perfusion impairment in hypertensive patients evidenced by myocardial blush grade (MBG) and thrombolysis in myocardial infarction (TIMI) frame count (TFC).

OBJECTIVE: In hypertensive patients with typical chest pain but absence of coronary stenosis the coronary microcirculation may be impaired, thus, our study aimed to appraise, in these subjects, the role of the coronary microcirculation, assessed by Myocardial Blush Grade (MBG) and Thrombolysis in Myocardial Infarction (TIMI) Frame Count (TFC). METHODS: A total of 95 subjects with chest pain and uninjured coronary arteries were recruited into the study: 80 subjects were hypertensive while 15 subjects were normotensive. The hypertensive subjects were divided into two subgroups: hypertensive subjects with positive scintigraphy and hypertensive subjects with negative scintigraphy. The TFC, a qu…

Cardiovascular Health in Migrants. Current status and issues for prevention. A Collaborative Multidisciplinary Task Force Report

OBJECTIVES: To review information on cardiovascular health and migration, to stress the attention of researchers that much needs to be done in the collection of sound data in Italy and to allow policy makers identifying this issue as an important public health concern. BACKGROUND: In Italy, the rate of immigrants in the total number of residents increased from 2.5% in 1990 to 7.4% in 2010, and currently exceeds 10% in regions such as Lombardia, Emilia Romagna and Toscana. METHODS: A consensus statement was developed by approaching relevant Italian national scientific societies involved in cardiovascular prevention. Task force members were identified by the president and/or the boards of eac…

Marker of inlammation and prevalance of vascular disease in patients with metabolic syndrome

[Diagnosis of coronary microvascualar dysfunction in diabetic patients with cardiac syndrome X: comparison by current methods].

The study population included 208 patients with chest pain and uninjured coronary arteries that we split into two populations: diabetics (72 patients) and non-diabetics (136 patients). We split patients with chest pain and uninjured coronary arteries that had a myocardial scintigraphy into two populations: patients with positive scintigraphy and negative. We calculated, on angiographic images of each patient, stored on suitable digital supports, Timi Frame Count (TFC), Myocardial Blush Grade (MBG) and Total Myocardial Blush Score (TMBS) using the protocol described by Gibson and Yusuf. On the basis of Yusuf's experience we imagined a new index: the Total Timi Frame Count as the sum of the t…

Focus sui non responder alla terapia di resincronizzazione cardiaca: orizzonti e prospettive

Cardiac resynchronization therapy (CRT) has been shown as a successful strategy in the treatment of patients with heart failure and electrical dyssincrony. However, a significant proportion of implanted patients fails to respond sufficiently or in a predictable manner. Consequently, non response to CRT remains a valuable problem in clinical practice. In order to improve CRT response and long-term clinical benefits, the proper evaluation of patient's global frialty, the technology improvement, the multimodality imaging approach and the use of simple and low cost electrographic parameters (to verify effective biventricular capture and QRS narrowing) could play a important role. Therefore, the…

RUPTURE OF A LEFT SINUS OF VALSALVA ANEURYSM INTO THE PULMONARY ARTERY.

Sinus of Valsalva aneurysm is a rare congenital defect and the diagnosis is usually made after it ruptures. Very few cases of non-complicated sinus of Valsalva aneurysm have been published. The anomaly most often involves the right coronary sinus and less frequently the non-coronary sinus. A case with left sinus of Valsalva has not been reported. Since the aortic valve occupies a central position in the base of the heart, rupture of a sinus of Valsalva aneurysm can occur in any of the four heart chambers. Rupture into the pulmonary artery is very rare and is mostly associated with other congenital cardiopathies. ª 2005 The European Society of Cardiology. Published by Elsevier Ltd. All right…

NUOVI FATTORI DI RISCHIO CARDIOVASCOLARE E ALIMENTAZIONE

Chemotherapy-induced cardiotoxicity: role of the tissue Doppler in the early diagnosis of left ventricular dysfunction.

Cardiotoxicity is a common complication of chemotherapy. The aim of this study was to assess the cardiotoxicity of anticancer drugs using tissue Doppler imaging. A prospective study was carried out using patients with early breast cancer (72 women, median age: 57 ± 12 year) and other inclusion and exclusion criteria. Inclusion criteria were treatment with epirubicin, trastuzumab, fluorouracil, cyclophosphamide, taxotere, and taxolo; left ventricular ejection fraction (LVEF) of more than 50%; and absence of important pathologies. Exclusion criteria were presence of known heart disease, earlier exposure to mediastinal irradiation, and earlier chemotherapy. On the basis of treatment, patients …

LESIONI CAROTIDEE ASINTOMATICHE, INCIDENZA DI EVENTI VASCOLARI FATALI E NON IN UNA POPOLAZIONE DI DIABETICI DI TIPO II: RUOLO DELLA PROTEINA C REATTIVA AD ALTA SENSIBILITA’

Decision making in a presumptive case of STEMI-like myocarditis

In youngmales, differential diagnosis during chest pain is not always easy. When ECG findings suggest a cardiac origin of such symptoms, myo-pericarditis is usually themost likely hypothesis, beingmore common than Acute Coronary Syndromes (ACS) in the first decades of life [1]. In the presence of ST segment elevation, Troponin release and ventricular wall motion abnormalities, the diagnosis can be challenging, though. In the young a lowcoronary risk profile and atypical symptoms seldom support a working diagnosis of Coronary Heart Disease (CHD), and, therefore, urgent coronary angiography is not recommended routinely, although cases of early ACS are not so rare. In October 2014 a 26-year-ol…

Atherosclerosis, inflammation and Chlamydia pneumoniae

Coronary heart disease is the single most common cause of illness and death in the developed world. Coronary atherosclerosis is by far the most frequent cause of ischemic heart disease, and plaque disruption with superimposed thrombosis is the main cause of the acute coronary syndromes of unstable angina, myocardial infarction, and sudden death. Atherosclerosis is the result of a complex interaction between blood elements, disturbed flow, and vessel wall abnormality, involving several pathological processes: inflammation, with increased endothelial permeability, endothelial activation, and monocyte recruitment; growth, with smooth muscle cell proliferation, migration, and matrix synthesis; …

ATRIAL FIBRILLATION AND MILD COGNITIVE IMPAIRMENT: WHAT CORRELATION?

ATRIAL FIBRILLATION AND MILD COGNITIVE IMPAIRMENT: WHAT CORRELATION? Aim. Atrial fibrillation (AF), in addition to macroembolic complications, may also produce multiple cerebral ischemic areas due to microembolic phenomena and transient hypoperfusion, eventually leading to a progressive cognitive impairment and even to acclaimed vascular dementia. The aim of this study was to evaluate the prevalence of cognitive impairment in patients with AF. The reported results concern data obtained at the moment of recruitment. Methods. The authors studied 42 patients with a history of non valvular AF (paroxysmal, persistent, recurrent or permanent) and 40 homogenous controls in sinus rhythm without pre…

Pharmacological Therapy in Children with Atrial Fibrillation and Atrial Flutter

Heart rhythm disorders in children are not different, on electrocardiographic trace, from heart rhythm disorders in adults with the exception of incidence which is different according to the age. Paticularly, atrial flutter (FlA) and fibrillation (FA) are very uncommon arrhythmias in the general pediatric population. Generally atrial fibrillation and atrial flutter, in our experience, is a temporary heart rhythm disturbance connected to specifical and resovable reasons with the exception of Fontains surgical correction of congenital heart diseases or cardiopathies with dilatation of both atria. Presenting symptoms, symptom history (e.g., frequency, duration, and severity), risk assessment, …

ATHEROGENETIC MECHANISMS AND MORPHOLOGIC CHARACTERISTICS OF ATHEROSCLEROTIC LESIONS IN DIFFERENT LOCATIONS: ARE THEY IDENTICAL?

ARTERIOPATIA PERIFERICA E DIABETE

Rupture of the atherosclerotic plaque: is Chlamydia pneumoniae a possible agent?

PREVALENCE OF METABOLIC SYNDROME IN PATIENTS WITH ACUTE CORONARY SYNDROME

PREVALENCE OF METABOLIC SYNDROME IN PATIENTS WITH ACUTE CORONARY SYNDROME

Cardiopulmonary Exercise Testing in Patients with Chronic Heart Failure: Prognostic Comparison from Peak VO2 and VE/VCO2 Slope

Background: Cardiopulmonary exercise testing with ventilatory expired gas analysis (CPET) has proven to be a valuable tool for assessing patients with chronic heart failure (CHF). The maximal oxygen uptake (peak V02) is used in risk stratification of patients with CHF. The minute ventilation-carbon dioxide production relationship (VE/VCO2 slope) has recently demonstrated prognostic significance in patients with CHF. Methods: Between January 2006 and December 2007 we performed CPET in 184 pts (146 M, 38 F, mean age 59.8 ± 12.9 years), with stable CHF (96 coronary artery disease, 88 dilated cardiomyopathy), in NYHA functional class II (n.107) - III (n.77), with left ventricular ejection frac…

Tako-tsubo cardiomyopathy and microcirculation.

Takotsubo cardiomyopathy was described for the first time in Japan in the 1990s. It is very similar to the ischemic cardiopathy both for clinical and instrumental characteristics. His peculiarity is an alteration of the ventricular contraction mechanism with hypo-akinesis of the apex and lateral segments of the left ventricle, associated with hyper-kinesis of the heart base which is responsible for the typical echocardiographic aspect of a cruet during the systole. However, the etiology of this cardiomyopathy is still unknown despite the fact that numerous hypothesis have been made. A single study of 16 patients proved multivasal damage by a BLASH SCORE analysis of the coronary radiography.…

Effetto di due vini rossi siciliani su alcuni fattori di rischio cardiovascolare

Background. The aim of this study was to evaluate whether Sicilian red wine consumption is associated with a lower cardiovascular risk. Methods. Forty-eight subjects of both sexes (age range 35-65 years) nondrinkers or rarely drinkers of moderate red wine intake were selected. Subjects were divided into two groups (group A and group B), assigned to receive with a crossover design 250 ml/die (during the meals) of one of two types of Sicilian red wines (Nero d’Avola and Etna Torrepalino respectively). At all visits (-15 days, basal, +4 and +8 weeks) the following parameters were measured: blood glucose, total cholesterol and triglycerides (by enzyme kit methods, Boehringer Mannheim, Milan, It…

CORRELAZIONE TRA ATEROSCLEROSI EPERIFERICA E CORONARICA IN PAZIENTI CON CARDIOPATIA ISCHEMICA CRONICA

Neuromuscolar disorders and non compaction reply

Asymptomatic ventricular pre-excitation in children.

ASYMPTOMATIC VENTRICULAR PREEXCITATION IN CHILDREN OBJECTIVE: This retrospective study was planned for a good risk assessment of asymptomatic patients affected by ventricular pre-excitation. METHODS: From 1985 to 2007, 124 patients with an atrioventricular pathway (electrocardiographic signs of ventricular pre-excitation) were admitted to our cardiology division. The average age was 7 years (range 1 month to 18 years). The mean follow-up period in the whole population of patients was 4.2 years (range 1-13 years). Four patients were lost during the follow-up. During this period, all patients remained in good health. In all of them, we performed a Holter evaluation every year. An intermittent…

The controversial relationship between exercise and atrial fibrillation: clinical studies and pathophysiological mechanisms

Atrial fibrillation is the most common clinically significant arrhythmia observed both in the general population and in competitive athletes. The most important risk factors are all preventable by regular physical activity. However, although the benefits of moderate physical activity in controlling cardiovascular risk factors and decreasing the risk of atrial fibrillation have been extensively proved, concerns have arisen about the potential negative effects of vigorous exercise, particularly in endurance athletes. Furthermore, in a subset of patients with atrial fibrillation younger than 60 years, routine evaluation does not reveal any cardiovascular disease or any other known causal facto…

Randomised comparison of zofenopril and ramipril plus acetylsalicylic acid in postmyocardial infarction patients with left ventricular systolic dysfunction: a post hoc analysis of the SMILE-4 Study in patients according to levels of left ventricular ejection fraction at entry

Objective Conflicting evidence exists on the benefits of treating patients with coronary artery disease and preserved left ventricular ejection fraction (LVEF) with an ACE inhibitor. This retrospective analysis of the SMILE-4 Study sought to compare the efficacy of zofenopril 60 mg plus acetylsalicylic acid (ASA) versus ramipril 10 mg plus ASA 100 mg in patients with acute myocardial infarction (AMI) and heart failure, according to an impaired or preserved LVEF. Methods The primary study end point was 1-year combined occurrence of death or hospitalisation for cardiovascular causes. A preserved LVEF was defined by a baseline LVEF >40% and an impaired one by an LVEF ≤40%. Results 448 patients…

L’IMPIEGO CLINICO DI UNA NUOVA CLASSE DI FARMACI ANTICOAGULANTI: GLI INIBITORI DIRETTI DELLA TROMBINA

The coagulation cascade, and particularly thrombin, plays a very important role in arterial and venous thrombosis. Thereby, it is clear that thrombin inactivation is an optimal strategy for thrombotic disease prevention and treatment. The direct thrombin inhibitors are a new class of anticoagulant drugs directly binding thrombin and blocking its interaction with fibrinogen. The group of direct thrombin inhibitors includes recombinant hirudin (lepirudin and desirudin), bivalirudin, melagatran and its oral precursor, ximelagatran, argotraban and dabigatran. These drugs have several advantages compared to other anticoagulant drugs, and the particular pharmacokinetic properties of some of them …

ASYMPTOMATIC CAROTID LESIONS AND AGING: ROLE OF HYPERTENSION AND OTHER RISK FACTORS

Selective pacing sites

The right ventricular apex (RVA) has always been the most used pacing site, because it is easily accessible and provides a stable lead position with a low dislodgment rate. However, it is well-known that long-term right ventricular apical pacing may have deleterious effects on left ventricular function by inducing a iatrogenic left bundle branch block, which can have strong influences on the left ventricle hemodynamic performances. More specifically, RVA pacing causes abnormal contraction patterns and the consequent dyssynchrony may cause myocardial perfusion defects, histopathological alterations, left ventricular dilation and both systolic and diastolic left ventricular dysfunction. All t…

PERIPHERAL ATEROSCLEROSIS AND RESTENOSIS AFTER PCI

Aortic valve disease: follow-up of a group of patients undergone to aortic valve replacement.

Vascular Changes and Aging

The progress of cardiovascular prevention and the large use of antibiotics have determined in the last fifty years a progressive increase of life duration, especially in the western countries, and so, a noticeable increase of elderly subjects in the population (1,2).

Angiographic Evaluation of Coronary Microvascular Dysfunction in Patients with Heart Failure and Preserved Ejection Fraction

Background The aim of this study was to evaluate myocardial perfusion and coronary blood flow through validated angiography indices to assess whether there is greater MVD in patients with microvascular angina and HFPEF compared to those who do not have. Methods Our study was performed on a population of 286 patients with stable angina that underwent coronary angiography and echocardiography. They showed epicardial coronary arteries free from stenosis. We divided the sample into two categories: patients with HFPEF and those without. We calculated indices for each patient based on angiographic images, including TFC, MBG, and TMBS. Results Our sample compared two groups: HFPEF (n = 155) and no…

Ventricular tachycardia in non-compaction of left ventricle: Is this a frequent complication?

Background: Isolated left ventricular non-compaction is the result of incomplete myocardial morphogenesis, leading to persistence of the embryonic myocardium. The condition is recognized by an excessively prominent trabecular meshwork and deep intertrabecular recesses of the left ventricle. Whether these intertrabecular recesses are a favorable substrate for ventricular arrhythmias is unclear. Some reports have found that the fatal ventricular arrhythmias may occur in approximately half of the patients. In this report we investigated about this association. Methods and Results: In total we evaluated a continuous series of 238 patients affected by non-compaction. Periodic Holter monitoring w…

Clinical outcomes of aortic valve repair in asymptomatic patients with chronic severe aortic valve regurgitation.

Platelet Function Changes In Acute Myocardial Infarction

Whether the thrombotic component of myocardial infarction is primary or secondary in a given patient, platelet function alterations can influence many mechanism from which depends if the thrombotic lesion grows or sends platelet emboli to the smaller myocardial vessels. Recently in some cases of infarction, coronary artery spasm has been demonstrated angiographically; thromboxanes, vasoconstrictive and platelet-aggregating substances, are released by platelets during myocardial ischemia. The local release of these substances may modify the myocardial cell viability and regional blood flow.The aim of the present study was to investigate changes in platelet function in relation to the time in…

Anticoagulant drugs in noncompaction: A mandatory therapy?

BACKGROUND: Noncompaction of left ventricular myocardium is a rare congenital cardiomyopathy resulting from an incomplete myocardial morphogenesis that leads to the persistence of the embryonic myocardium. This condition is characterized by a thin compacted epicardial and an extremely thickened endocardial layer with prominent trabeculations and deep intertrabecular recesses. It is not clear, in noncompaction of myocardium, whether intertrabecular recesses could be responsible for thrombi formation and thromboembolic complications. METHODS: The prevalence of stroke and echocardiographic finding of thrombus was evaluated in a continuous series of 229 patients (men and women) affected by nonc…

PREVENTION AND TREATMENT OF VENOUS THROMBOEMBOLISM.International Consensus Statement. Guidelines compiled in accordance with the scientific evidence

Early subclinical ventricular dysfunction in patients with insulin resistance

AIMS: The aim of our study was to evaluate the relationship between insulin resistance and the detection of precocious echocardiographic signs of heart failure in patients with cardiovascular risk factors. METHODS: We enrolled 34 consecutive patients with cardiovascular risk factors. All patients underwent coronary angiography, echocardiography, and laboratory tests. Exclusion criteria were diabetes (fasting glucose greater than 126 mg/dl or treatment with insulin or oral hypoglycemic agents), coronary artery disease, creatinine above 1.5 mg/dl, left-ventricular hypertrophy, valvular heart disease, ejection fraction below 50%, atrial fibrillation, or other severe arrhythmia. The presence of…

Real-world use of ticagrelor and prasugrel in patients with NSTEMI undergoing percutaneous coronary intervention.

Usefulness of longitudinal systolic strain and delayed enhancement cardiac magnetic resonance in depicting risk of supraventricular arrythmias in patients with acute myocarditis and preserved left ventricular function

Background: Myocarditis have variable clinical presentation, evolution and prognosis. Aim of our study was to evaluate the value of speckle tracking echocardiography and cardiac magnetic resonance (CMR) in the short-term prediction of supraventricular arrhythmias (SVA) in patients with acute myocarditis. Methods: Seventy patients (mean age 31±14 years old) with acute myocarditis and preserved left ventricular ejection fraction (LVEF) were enrolled. Longitudinal systolic strain (LS) of the left ventricle (LV), mechanical dispersion (MD) and CMR with quantitative measurement of delayed enhancement (DE) were performed in a subset of 43 patients. Logistic regression and ROC analysis were used t…

THE NONCOMPACTION OF THE LEFT VENTRICULAR MYOCARDIUM: OUR PEDIATRIC EXPERIENCE

OBJECTIVES: The noncompaction of the left ventricular myocardium is a rare congenital heart disease, characterized by an excessive prominence of trabecular meshwork, spaced out by deep intertrabecular recesses, consequent to the arrest of the normal myocardium embryogenesis. Although there are numerous descriptions, the physiopathological effects of the structural alterations, just like the clinical spectrum and the evolution of the disease, are not totally clarified. In the present study, we have evaluated the natural history of the disease, the familial incidence and the alterations of the systolic and diastolic function. METHODS: We collected a series of 21 young patients who were affect…

INFLAMMATION, INFECTION AND VASCULAR PATHOLOGY

Long-term parameters of heart rate variability in patients with insulin-resistance.

Heart rate variability (HRV) is defined as the oscillation in both the interval between consecutive heartbeats (considered RR intervals) and consecutives measures of instantaneous heart rates.1 HRV measures the cardiac autonomic function noninvasively1,2 and its reduction is an independent risk factor for cardiovascular events.3 Insulin-resistance is a pathological condition, in which the body’s cells become resistant to insulin effects.4 The aim of our study was to evaluate the relationship between insulin-resistance and the reduction of HRV parameters.

Chronic Administration of Slow-Release Nifedipine Improves Arterial Compliance in Elderly Hypertensives with Systolic Hypertension

ROLE OF ARTERIAL STIFFNESS IN HEART FAILURE DUE TO PRIMARY DILATED CARDIOMIOPATHY

ASSOCIAZIONE TRA ATEROSCLEROSI CAROTIDEA, DISFUNZIONE ENDOTELIALE E STEATOSI EPATICA IN UNA POPOLAZIONE CON SINDROME METABOLICA.

Noninvasive blood pressure monitoring evaluation of verapamil slow-release 240-mg antihypertensive effectiveness

The aim of our study was to evaluate the antihypertensive effectiveness of verapamil slow-release (SR), administered once a day. We studied 11 patients, 7 male and 4 female, with an average age of 53.6 +/- 12.86 years, who had essential hypertension. After a drug washout period of at least 15 days, placebo was administered (one tablet per day), and then patients received verapamil SR 240 mg/day at 8:00 a.m. for at least 2 weeks. At the end of the washout, placebo, and active drug treatment periods we performed ambulatory intermittent blood pressure monitoring for 24 h using a Squibb Spacelabs pressurometer. After verapamil treatment, in comparison to placebo, a significant reduction of syst…

Prevalence, management, and outcome of adverse rhythm disorders in takotsubo syndrome: insights from the international multicenter GEIST registry

One important complication related to takotsubo syndrome (TTS) is adverse rhythm disorders. Our study was conducted to determine the incidence and management of adverse rhythm disorders in TTS and its long-term prognostic impact. We analyzed 906 TTS patients from 9 European centers. Patients were divided into the adverse rhythm disorders group (encompassing ventricular tachycardia, ventricular fibrillation, torsade de pointes, and asystole or complete atrioventricular block) and non-adverse rhythm disorders group. In our study cohort, we identified 67 (7.4%) patients with presence of adverse rhythm disorders. TTS patients were followed up over a period of 2.8 years. In the adverse rhythm di…

Ventricular arrhythmias in children : the usefulness of MRI

NON INVASIVE VALUATION OF ENDOTHELIAL FUNCTION IN THE PATIENTS WITH ANDERSON- FABRY DISEASE

MULTIFOCAL ATHEROSCLEROTIC DISEASE: A CASE –REPORT

Pacing ventricolare destro: una risorsa o una minaccia?

Early after the beginning of the pacemaker era, endocardial right ventricular apex has been the most extensively used site for cardiac pacing because it was easily accessible and reliable in a long-term perspective. However many data have demonstrated that this kind of pacing is suboptimal from a physiologic point of view because it causes several adverse effects such as altered ventricular contraction geometry, mitral regurgitation, perfusion alterations and interference with myocardial ion channels which determine a worsening of left ventricular function. Several strategies have been proposed to solve these problems (alternative pacing sites, specific algorithms able to reduce the percent…

FIBRILLAZIONE ATRIALE E MILD COGNITIVE IMPAIRMENT: QUALE RELAZIONE.

EFFECTS OF DEFIBROTIDE IN PATIENTS WITH CHRONIC DEEP INSUFFICIENCY. THE PROVEDIS STUDY

Aim. In the ­present study the ­effect of defi­bro­tide, an anti­throm­bot­ic and prof­i­brin­o­lyt­ic agent, was inves­ti­gat­ed in ­patients with chron­ic ­venous insuf­fi­cien­cy (CVI) due to deep vein obstruc­tion and/or ­reflux (chron­ic deep vein insuf­fi­cien­cy, CDVI). Meth­ods. The study was a mul­ti­cen­ter, ran­dom­ized, dou­ble blind pla­ce­bo con­trolled trial in which only ­patients with CDVI con­firmed by ultra­sound were ­enrolled. All ­patients were treat­ed with ade­quate elas­tic com­pres­sion and ran­dom­ized to ­receive ­either oral defi­bro­tide (800 mg/die) or match­ing pla­ce­bo for 1 year. ­Patients with ­active or pre­vi­ous leg ulcer were exclud­ed. ­Results. A to…

Assessment of no-reflow phenomenon by myocardial blush grade and pulsed wave tissue doppler imaging in patients with acute coronary syndrome

Background: No-reflow phenomenon is a complication of myocardial revascularization and it is associated with a worse prognosis. Materials and Methods: A prospective study was carried out enrolling patients with acute myocardial infarction (64 patients, 49 male and 15 female, median age 64.9 ± 10.61 years), both STEMI and NSTEMI, who underwent myocardial revascularization with percutaneous coronary intervention (PCI). TIMI flow and Myocardial Blush Grade (MBG) were assessed at baseline (T0), in addition to tissue Doppler imaging (TDI) and electrocardiogram. Cardiological evaluation was also performed at T1 (one month after PCI) and T2 (every year after revascularization for a mean follow-up …

MTHFR allele 677T band risk of abdominal aortic aneurysm

Effects of sorbinicate and nicotinic acid on blood viscosity, red cell deformation and platelet function

Summary Nicotinic acid (NA) and a retard derivative, sorbinicate, were investigated for their effects on blood rheology and platelet function, after oral administration, in two groups of patients with lower limb atherosclerosis obliterans — the second group having diabetes also. Red cell deformation and blood plasma viscosity were studied in the nondiabetic group (single dose of NA, 100 mg, and sorbinicate, 400 mg); release of platelet malondialdehyde (MDA) (single dose of NA, 100 mg, and sorbinicate, 800 mg), and the platelet regeneration time (before and after sorbinicate 400 mg × 3/die for 7 days) were studied in the diabetic group. Both drugs induced a significant improvement in red cel…

Peripheral artery disease: potential role of ACE-inhibitor therapy

Giuseppe Coppola, Giuseppe Romano, Egle Corrado, Rosa Maria Grisanti, Salvatore NovoDepartment of Internal Medicine, Cardiovascular and Nephro-Urological Diseases, Chair of Cardiovascular Disease, University of Palermo, Palermo, ItalyAbstract: Subjects with peripheral arterial disease (PAD) of the lower limbs are at high risk for cardiovascular and cerebrovascular events and the prevalence of coronary artery disease in such patients is elevated. Recent studies have shown that regular use of cardiovascular medications, such as therapeutic and preventive agents for PAD patients, seems to be promising in reducing long-term mortality and morbidity. The angiotensin-converting-enzyme (ACE) system…

Morbillo e fenomeno di Brugada: un caso clinico

A CLINICAL CASE OF CORONARY FISTULA CANALIZED IN ACCESSORY CHAMBER COMMUNICATING WITH RIGHT ATRIUM

The PFO anatomy evaluation as possible tool to stratify the associated risks and the benefits arising from the closure

Aims According to the current guidelines, the patent foramen ovale (PFO) is still considered a qualitative factor and, as a consequence, its closure is recommended just on the basis of its ‘presence’. Methods and results In the year 2008, we evaluated 25 patients (mean age 62.7) with acute cerebrovascular event and 92 patients (mean age 27.3) suffering from migraine with aura. No PFO was reported in 79 patients. A venous-to-arterial circulation shunt had been shown in 38 patients (29 subjects with migraine and 9 subjects with prior stroke). According to the number of microbubbles arrived during the Valsava manoeuvre, we found: 25 small PFO, 6 moderate PFO, and 6 severe PFO. In the baseline …

Role of cardiac computed tomography in the evaluation of coronary artery stenosis in patients with ascending aorta aneurysm detected at transthoracic echocardiography

OBJECTIVE The aim of our study was to evaluate the diagnostic performance of cardiac computed tomography (CCT) in the evaluation of coronary artery stenosis in patients with ascending aorta aneurysm detected at transthoracic echocardiography. METHODS We conducted a retrospective analysis of patients with an aneurysm 45 mm or greater at transthoracic echocardiography who underwent CCT from 2012 to 2014 in our hospital. We calculated the sensitivity, specificity, and positive and negative predictive values of CCT for the assessment of coronary artery stenosis (<50% or ≥50% stenosis) in patients who underwent conventional coronary angiography. RESULTS We included 104 patients (73 men, aged 64 …

Chest pain due to late huge coronary pseudoaneurysm following stent implantation

A 50-year-old man was referred to our hospital because of persistent atypical chest pain. His past medical history was remarkable for a non ST elevation myocardial infarction, treated five months previously with PCI on the right coronary artery. Two months later, for chest pain, he underwent coronary angiography that showed a right coronary artery with slight ectasia near the stent. Five months later for the persistence of atypical chest pain he came to our clinic. Chest CT showed a 31.5 mm hematoma of the right coronary artery. Coronary angiography revealed a giant aneurysm, proximal to the stent. In the light of rapid growth of aneurysm, the risk of rupture and symptoms, we decided to tre…

DIAGNOSTIC ACCURACY OF MDCT 40 SLICES IN PATIENTS WITH CHEST PAIN

DUE CASI DI DISFUNZIONE VENTRICOLARE SINISTRA REVERSIBILI: ERA CARDIOMIOPATIA DI TAKOTSUBO?

Detection of Left Ventricular Systolic Dysfunction in Cardiac Amyloidosis with Strain Rate Echocardiography .

Background We examined the potential role of Doppler myocardial imaging including tissue velocity imaging, strain imaging, and strain rate imaging for detection of left ventricular systolic dysfunction in cardiac amyloidosis (CA) and determined the minimum dataset required to make the diagnosis. Methods and Results Doppler myocardial imaging was performed in 103 patients with amyloidosis (AL). Peak longitudinal systolic tissue velocity, systolic strain rate (sSR), and systolic strain (sS) were determined for 16 left ventricular segments. Radial and circumferential sSR and sS were also measured. Patients with increased left ventricular wall thickness were classified with advanced-CA, and the…

Cardiovascular magnetic resonance characterization of a hamartoma in an asymptomatic child

Scrotal swelling in a patient with paroxysmal supraventricular tachycardia

We present a case of a patient with paroxysmal supraventricular tachycardia and a history of chronic ischemic disease evolved into dilated cardiomyopathy. During hospitalization, the occurrence of arrhythmic crisis, our patient felt sporadic palpitations associated with dyspnea, distended jugular veins and scrotal swelling, quite unexpected clinical sign that caught our attention. Echocardiography showed dilated left ventricle, severely reduced systolic function, dilated right-sided, dilated inferior vena cava with reduced respiratory excursions. Echography of both testicles showed bilateral expansion of pampiniform plexus with reflux to the functional maneuvers, such as varicocele of grade…

Impact of dual antiplatelet therapy with proton pump inhibitors on the outcome of patients with acute coronary syndrome undergoing drug-eluting stent implantation.

This study aimed to assess if proton pump inhibitors (PPIs) may reduce the effectiveness of clopidogrel, than H2 antagonist (anti-H2) in order to determine rehospitalization for acute coronary syndrome (re-ACS), target vessel revascularization (TVR) and cardiac death. This case-control study included 176 patients with ACS undergoing angioplasty (PCI) with drug-eluting stent implantation. The population was divided into two groups: PPI group (n=121) consisting of patients receiving at discharge dual antiplatelet therapy (DAT) plus PPI and anti-H2 group (n=55), consisting of patients receiving at discharge DAT + H2 receptor antagonist (H2RA). In a followup of 36 months the prevalence of ACS e…

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.

Methylenetetrahydrofolate reductase mutation in subjects with abdominal aortic aneurysm subdivided for age.

RISCHIO VASCOLARE O RISCHIO CARDIOVASCOLARE?

Prevalence of metabolic syndrome in patients with acute coronary syndrome

The spectrum of risk factors for contrast induced nephropathy in patients undergoing coronary angiography or intervention

Abstract Introduction Contrast induced nephropathy is an unfavorable acute event which can complicate the clinical course of patients undergoing coronary angiography. Clinical characteristics predisposing to its occurrence are still rather obscure. Methods We enrolled 591 patients (mean age 64.2 ± 10.98; 449 male and 142 female) who underwent emergency or elective Coronary angiography/Angioplastic in our Cardiologic Division between 10/2006 and 06/2008, paying attention to their Cardiovascular risk factors, dose and type of contrast medium, type and number of affected coronary arteries, pharmacological therapies, baseline renal function and extracoronary atherosclerosis. We performed a univ…

Carotid atherosclerosis and chronic hepatitis C: A prospective study of risk associations

BACKGROUND AND AIMS: There are contrasting results in studies of cardiovascular risk in patients with genotype 1 chronic hepatitis C (G1 CHC). We evaluated the prevalence of carotid atherosclerosis compared with a control population in order to assess the potential association between atherosclerosis, host and viral factors, and liver histological features. MATERIALS AND METHODS: One hundred seventy-four consecutive biopsy-proven G1 CHC patients were evaluated by anthropometric and metabolic measurements. One hundred seventy-four patients attending an outpatient cardiology unit were used as controls. Intima-media thickness (IMT) and carotid plaques, defined as focal thickening of > 1.3 mm a…

Platelet Activity in Relation to Smoke and Exercise in Patients with Chronic Obstructive Lung Disease: Effects of Platelet Antiaggregating Drugs

Lung tissue is involved in the synthesis and/or metabolism of many vasoactive substances such as histamine, serotonin, dopamine, norepinephrine, bradikinin, angiotensin II and prostaglandins (1).

The role of statins in preventing the progression of congestive heart failure in patients with metabolic syndrome.

Heart Failure (CHF) is a very important public health problem in the world and certainly one of the most common debilitating diseases and cause of mortality. Current knowledge underlines that incidence rates are also influenced by the coexisting pathologic conditions that accelerate the development of disease or increase its severity. Important scientific evidence is emerging to demonstrate a strong correlation between HF and the metabolic syndrome (MetS). Hypolipemia- inducing medication offers the opportunity to discuss the possible existence of pharmacological substances that in addition to their specific targets have several demonstrated pleiotropic effects that could be beneficial in H…

ANGIOPLASTICA CORONARICA NELLA STENOSI DEL TRONCO COMUNE DELLA CORONARIA SINISTRA: NOSTRA ESPERIENZA

MDCT-CA VERSUS MYOCARDIAL SCINTIGRAPHY TO DETECT SIGNIFICANT CORONARY ARTERY DISEASE

RISULTATI DEI TRIALS DI INTERVENTO PER LA MALATTIA VASCOLARE PERIFERICA E SUA COMORBILITÀ

IL TRATTAMENTO FARMACOLOGICO NELLA CARDIOMIOPATIA DI TASKOTSUBO: IL RUOLO DEI BETABLOCCANTI, DEGLI ACE INIBITORI, DEI CALCIOANTAGONISTI E DELL’ASPIRINA.

Il ruolo del microcircolo nell’eziopatogenesi della Cardiopatia di Takotsubo

Platelet Function Changes in Acute Myocardial Infarction

Whether the thrombotic component of myocardial infarction is primary or secondary in a given patient, platelet function alterations can influence many mechanisms — operating at the microenvi-ronmental level — from which it depends if the thrombotic lesion grows or sends platelet emboli to the smaller myocardial vessels.

RUOLO DELL’ANGIOGRAFIA CORONARICA IN TOMOGRAFIA

ATRIAL FLUTTER AND MULTIFOCAL ATRIAL TACHYCARDIA IN CHILD

Efficacy, tolerability and influence on "quality of life" of nifedipine GITS versus amlodipine in elderly patients with mild-moderate hypertension.

The main purpose of this study was to compare efficacy, tolerability and influence on quality of life (QOL) of nifedipine gastrointestinal therapeutic system (NI) 30-60 mg once a day vs amlodipine (AM) 5-10 mg once a day in elderly patients with mild-moderate hypertension.This was a randomized, double-blind, parallel-group, multicenter study. After a 2-week single-blind placebo run-in, patients were randomized to either NI 30 mg or AM 5 mg. Responders continued on the same dosage for 16 additional weeks, while non-responders were titrated to 60 mg NI or 10 mg AM.Blood pressure was measured by mercury sphygmomanometer and efficacy equivalence of NI and AM tested by covariance analysis. Diast…

METABOLIC THERAPY IN THE TREATMENT OF CHRONIC CRITICAL LIMBS ISCHEMIA OF THE LOWER LIMBS. THE L-PROPIONYL-CARNITINE ENHANCES THE EFFECTS OF PGE-1

ROTTURA DI UNA DISSEZIONE AORTICA IN ATRIO DESTRO IN PAZIENTE CON PREGRESSA SOSTITUZIONE VALVOLARE AORTICA

Retrospective comparison of MDCT-CA and SPECT to detect significant coronary artery disease

Cardiovascular Toxicity in Cancer Patients Treated with Tyrosine Kinase Inhibitors: A Real-World Single-Center Experience

&lt;b&gt;&lt;i&gt;Background:&lt;/i&gt;&lt;/b&gt; Target therapy can cause various cardiovascular complications. The aim of this study was to evaluate the burden of cardiovascular complications related to treatment with anti-BCR-ABL tyrosine kinase inhibitors (TKIs) and to determine if there are differences between the latest- and first-generation TKIs. &lt;b&gt;&lt;i&gt;Methods:&lt;/i&gt;&lt;/b&gt; A retrospective observational study was carried out on 55 patients (39 men, 16 women; mean age ± SD: 58 ± 11 years) treated with TKIs targeting Bcr-Abl for a median period of 3.5 years. Patients were divided in two groups according to the type of treatment. Group A included patients treated with…

Aterosclerosi Preclinica e Rischio Cardiovascolare Globale

Treatment of Tako-tsubo cardiomyopathy

N.A.

PePERCUTANEOUS ANGIOPLASTY AND STENTING OF LEFT SUBCLAVIAN ARTERY LESIONS FOR THE TREATMENT OF PATIENTS WITH SIMULTANEOUS VERTEBRAL AND CORONARY SUBCLAVIAN STEAL SYNDROMES

CLINICAL APPROPRIATENESS OF CORONARY ANGIOGRAPHY EXAMINATION IN PATIENTS OBSERVED IN A DIVISION OF CARDIOLOGY

Hyperuricemia in patients with left ventricular dysfunction

Introduction: Hyperuricemia is a cardiovascular risk factor associated with oxidative stress and inflammation, conditions that are involved in the genesis of atherosclerotic disease and in the progression of ischemic heart disease to heart failure. The aim of our retrospective study is to evaluate the variations of serum uric acid level in patients with ventricular dysfunction, in order to highlight any correlations. Methods: We enrolled 118 patients. In our population we identified three groups: patients with systolic and diastolic dysfunction (ejection fraction &lt;50% and E wave 50% and E wave50% and E wave&gt; A wave, n = 54). All patients underwent echocardiography and laboratory test …

Classification, epidemiology, risk factors, and natural history of peripheral arterial disease.

Peripheral arterial disease (PAD) is a clinical condition that has often been neglected. The clinical diagnosis of PAD may be made on the basis of an accurate history by using the WHO/Rose Questionnaire or the Edinburgh Questionnaire. From a clinical point of view, PAD may be classified into four stages. The PARTNERS Programme (PAD Awareness, Risk and Treatment: NEw Resources for Survival) is a recent study based on a partnership to improve PAD care. In this population, the prevalence of patients who were PAD+/CVD- was approximately 12% in males and 15% in females; PAD+/CVD+ approximately 18% in males and 14% in females; PAD-/CVD+ 28% in males and 17% in females; and finally, patients witho…

Measles and Brugada pattern: A case report

No abstract available

Large Mediastinal mass in pregnancy: utility of echocardiography and cardiac MRI. A case report

PREVALENCE OF CAROTID LESIONS IN A MEDITERRANEAN POPULTION OF HYPERTENSIVES

LA CHLAMYDIA PNEUMONIAE È CORRELABILE CON LA ROTTURA DELLA PLACCA ATEROSCLEROTICA? RUPTURE OF THE ATHEROSCLEROTIC PLAQUE: IS CHLAMYDIA PNEUMONIAE A POSSIBLE AGENT?

Background. The natural history of atherosclerosis has not clearly been elucidated yet. Some works reported that flogosis plays a role in plaque instability. Why does this inflammatory process start? We investigated the correlation between Chlamydia pneumoniae acute infection and plaque rupture. Methods. We compared blood concentrations of IgM anti-Chlamydia pneumoniae in patients affected by acute myocardial infarction (AMI) and in patients affected by stable angina. Results. Our results showed a minimal statistical difference, with a more positive value in patients with AMI. Subsequently, the group affected by AMI was divided into two subgroups with and without plaque rupture: the subgrou…

SYNCOPE IN PAEDIATRIC AGE: THE RULE OF MOST COMMON RESEARCH METHODS USED IN CARDIOLOGY TO THE DIAGNOSTIC AND PROGNOSTIC STRATIFICATION

Superficial venous thrombosis and spreading to deep veins: role of genetic risk factors for venous thromboembolism

P1687Microvascular function detected by timi frame count (TFC) and myocardial blush grade (MBG) in patients with takostubo syndrome

Unusual case of left ventricular pseudoaneurysm.

A 71 year-old man with a history of previous anterior myocardial infarction, triple coronary artery bypass graft and left ventricular (LV) aneurysmectomy was admitted to the cardiology unit for chest pain. Physical examination showed a pulsing mass in the left chest wall. Cardiac multislice computed tomography showed a rare case of LV pseudoaneurysm (6.3 x 6 x 10 cm) communicating by a fistulous trait (1 cm) with the left anterior chest wall (C7-C8), creating a subfascial mass (7.1 x 3.6 cm).

Role of inflammation and infection in vascular disease

Relationship of infection, inflammation, and atherosclerosis has been a subject of intensive investigation in recent years. Potential mechanisms whereby chronic infections may play a role in atherogenesis are myriad. Chlamydia pneumoniae (Cp) infection in early life may accelerate atherosclerosis, leading to cardiovascular complications. Other infections, simultaneously occurring with Cp, may result in a synergistic effect to promote atherosclerosis. Chronic Helicobacter pylori infection is known to increase the pH level of the gastric juice and to decrease ascorbic acid levels, both of which will lead to a reduced folate absorption. Low folate hampers the methionine synthase reaction. This…

Echocardiographic Assessment of Ventricular Septal Rupture and Left Ventricular Aneurysm after Inferior and Posterior Myocardial Infarction

We present a case of posterior ventricular septal rupture associated to left ventricular aneurysm manged, during peri-operative period, by transthoracic and transesophageal echocardiography. Three-dimensional transesophageal echocardiography findings add adjunctive and more accurate information regarding morphological details of the ventricular septal rupture rather than two-dimensional echocardiography, allowing, meanwhile, the detection of the outcome of the surgical repair.

Erectile dysfunction is associated with low total serum testosterone levels and impaired flow-mediated vasodilation in intermediate risk men according to the framingham risk score

Background: The role erectile dysfunction (ED) coupled with low testosterone levels as early markers of atherosclerosis is not well understood. Objectives: To analyze the relationship between serum testosterone levels with both ED and brachial artery flow-mediated vasodilation (FMD), in a primary prevention sample of men. Methods: We enrolled 802 asymptomatic, intermediate CV risk patients, according to the Framingham Risk Score, aged 40e80 years, who underwent the ultrasound examination of FMD, the evaluation of ED and the assessment of total serum testosterone levels. Results: Testosterone levels correlated both with FMD (r ¼ 0.85; p &lt; 0.0001) and IIEF-5 score (rs ¼ 0.65; p &lt; 0.0001…

Neuromuscular disorders and non compaction: How much is the strength of the association and how can it be suspected?

In many reports Finsterer and Stöllberger reported a strong association between non compaction of the left ventricle and neuromuscular disorders. In the same report the authors described a neurological involvement in more than 50%. Recently we published our personal experience, about 21 paediatric patients: only 4 patients (19%) showed a neuromuscular disorder, and only 1 of them showed an increased plasmatic level of CK, and in particular of MM isoform, with a normal level of CK-MB. None presented high levels of troponine. Through the experience of 3 centres we collected 61 patients affected by non compaction that performed a neurological control, and only 14 (21%) were affected by neuromu…

STATINE E ARTERIOPATIA PERIFERICA: NECESSITA’ DI UN APPROCCIO VASCOLARE GLOBALE.

A case of Takotsubo syndrome

Reply to letter by Parodi et al. regarding article: Revised clinical diagnostic criteria for Tako-tsubo syndrome: The Tako-tsubo Italian Network proposal.

Carotid artery intima-media thickness: normal and percentile values in the Italian population (camp study)

AIMS: Carotid intima-media thickness (IMT) is one of the best non-invasive parameters for evaluating previous vascular lesions and could be used to identify a preclinical stage of the atherosclerotic process. The aim of our research was to develop an epidemiological study of the normal mean values of IMT of the common carotid artery, adjusted for age and sex, in the Italian population. METHODS AND RESULTS: In this multicenter study, a total of 1017 patients (596 males, mean age: 58.5 + 13.2 years) were enrolled at four different Italian centers. Inclusion criteria were the absence of cardiovascular risk factors or presence of not more than one. Patients underwent two-dimensional echo-color …

INIBITORI DEL SISTEMA RENINA-ANGIOTENSINA E FIBRILLAZIONE ATRIALE: UNO STUDIO RETROSPETTIVO SU 187 PAZIENTI

INFLUENZA DELL’ATEROSCLEROSI CAROTIDEA PRECLINICA SUGLI EVENTI CEREBRO- E CARDIOVASCOLARI IN 5 ANNI DI FOLLOW-UP. INFLUENCE OF PRECLINICAL CAROTID ATHEROSCLEROSIS ON CEREBRO- AND CARDIOVASCULAR EVENTS IN A FIVE YEARS FOLLOW-UP

Introduzione: numerosi studi hanno utilizzato la valutazione dello spessore intima-media carotideo (IMT) come marker di aterosclerosi (ATS) preclinica ed è stato ampiamente dimostrato che l’IMT correla con la presenza di ATS coronarica ed è predittivo di eventi sia cardio- che cerebrovascolari. Scopo dello studio: valutare se in soggetti asintomatici la presenza di ATS carotidea preclinica, ispessimento medio intimale carotideo (IMT) e placca carotidea asintomatica (PCA), aggiunga ulteriori informazioni nella stratificazione del rischio permettendo di individuare soggetti che potrebbero beneficiare di un trattamento più aggressivo, anche farmacologico, dei fattori di rischio presenti. Mater…

Decision making and devices approach in a case of left main coronary artery thrombus.

☆ This statement is to certify that all authors have seen being submitted, have contributed significantly to the w legitimacy of the data and its interpretation, and ag International Journal of Cardiology. We attest that the artic has not received prior publication and is not under elsewhere. We adhere to the statement of ethical pub (Shewan LG et al 2013 in press). ☆☆ On behalf of all co-authors, the corresponding author the submission. ⁎ Corresponding author at: Division of Cardiology II, D and Cardiovascular Diseases, University Hospital Paolo Gi 90127 Palermo, Italy. Tel.: +39 1 6554303; fax: +39 1 65 E-mail address: odisseos86@alice.it (V. Sucato).

4G/5G polymorphism on the promoter of the plasminogen activator inhibitor-1 gene and post-surgical calf vein thrombosis

IN MEMORIAM OF PROFESSOR ANTONIO STRANO 1920 – 1988

LA TERAPIA FARMACOLOGICA DELLA DEPRESSIONE DOPO UN INFARTO ACUTO DEL MIOCARDIO

Delayed MRI Hyperenhancement in Noncompaction: Sign of Fibrosis Correlated with Clinical Severity

N.A.

LA PREVENZIONE DELLA CARDIOPATIA ISCHEMICA

PREVALENCE OF CAROTID LESIONS ACCORDING TO TRADITIONAL RISK FACTORS IN A POPULATION ASYMPTOMATIC FOR CARDIOVASCULAR DISEASE

CONSENSUS SU “RUOLO DEL CONTROLLO DELLA COLESTEROLEMIA NELLA PREVENZIONE PRIMARIA E SECONDARIA DELLE MALATTIE CARDIOVASCOLARI C.

Transesophageal contrast echocardiography is not always the gold standard method in the identification of a patent foramen ovale: A clinical case

In the embryo, Eustachian valve is a crescent-shaped membrane extending from the lower margin of the inferior vena cava and the ostium of the coronary sinus into the right atrium toward fossa ovalis and tricuspid valve. At birth, after the functional closure of the foramen ovale, the Eustachian valve loses its function, reducing to an embryo remnant. According to growing evidence, a persistent Eustachian valve is a frequent finding in patients with a patent foramen ovale (PFO). By directing the blood from the inferior cava to the interatrial septum, it may prevent the spontaneous closure of PFO after birth and indirectly predispose to paradoxical embolism. Transesophageal contrast enhanced …

INSUFFICIENZA CARDIACA ACUTA E CARDIOMIOPATIE: UN CASO CLINICO

Isolated noncompaction of left ventricular myocardium is a rare congenital heart disease, characterized by an excessive prominence of trabecular meshwork, spaced out by deep intertrabecular recesses, consequent to the arrest of the normal myocardial embryogenesis. Although there are numerous descriptions, the pathophysiological effects of the structural alterations, like the clinical spectrum and the evolution of the disease, are not fully clarified. In this paper we evaluated the natural history of the disease, the family incidence and the alterations of the systolic and diastolic function. An interesting case report is described concerning a patient affected by noncompaction and atrial fi…

IL RISCHIO CARDIOVASCOLARE GLOBALE NELLA SINDROME METABOLICA DEL BAMBINO

Microvascular angina in diabetic patients with uninjured coronary arteries

Received 14 March 2012; Accepted 26 July 2012 Abstract: Aims: The study aims at the evaluation, of patients with chest pain and uninjured coronary arteries, and the impact of diabetes mellitus on coronary microcirculation. Moreover we want to verify whether a correlation between myocardial scintigraphy results and coronary angiography or not. Methods: The study population included 316 patients (173 males,143 females) with uninjured coronary arteries. Patients with chest pain (208) were divided into two populations: diabetics (72) and non-diabetics (136).We compared 66 patients with a myocardial scintigraphy with results of angiographic indexes. On angiographic images we evaluated, on the th…

Quantitative criteria for the diagnosis of the congenital absence of pericardium by cardiac magnetic resonance

Congenital absence of the left ventricular pericardium (LCAP) is a rare and poorly known cardiac malformation. Cardiac Magnetic Resonance (CMR) is generally used for the diagnosis of LCAP because of its high soft tissue contrast, multiplanarity and cine capability, but the diagnosis is usually made by only qualitative criteria. The aim of the present study was to establish quantitative criteria for the accurate diagnosis of LCAP on CMR.We enrolled nine consecutive patients affected by LCAP (mean age 26±8years, 7 males), 13 healthy controls, 13 patients with dilated cardiomyopathy (DCM), 12 patients with hypertrophic cardiomyopathy (HCM) and 13 patients with right ventricular overload (RVO).…

LA CARDIOMIOPATIA DI TAKOTSUBO: UNO STUDIO MULTICENTRICO INTERNAZIONALE SU 39 PAZIENTI

LA CHLAMYDIA PNEUMONIAE E’ CORRELABILE CON LA ROTTURA DELLA PLACCA ATEROSCLEROTICA?

Factors associated with mortality in patients with asymptomatic carotid stenosis: results from the ACSRS Study.

AIM: This study determines the factors associated with mortality in patients with asymptomatic carotid stenosis. METHODS: Patients (n=1,101) with asymptomatic internal carotid artery stenosis greater than 50% in relation to the bulb diameter were followed up for a period of 6 to 84 (median 38) months. Stenosis was graded using duplex scanning and expressed as a percentage of the carotid bulb diameter. Clinical and biochemical risk factors were recorded. The end-points were ipsilateral ischemic stroke, cardiovascular death and all cause mortality. RESULTS: In a Cox multivariate analysis 6 factors emerged as independent predictors of risk. Age, male gender, cardiac failure, left ventricular h…

Metabolic syndrome and peripheral arterial disease.

The relationship between endothlial ABD erectile dysfunction, levels of testosterone and cardiovascular events in the follow-up

Background: Clinical and experimental evidence suggest that testosterone levels play a role in cardiac and vascular pathology. A long history of observational studies investigating serum testosterone level and cardiovascular risks, specifically mortality, reveals important associations between low testosterone and mortality, while higher serum testosterone level appear to be predictive in the majority of studies. On the other hand, it is well documented and accepted that endothelial dysfunction is expression of preclinical atherosclerosis and it is associated with an increased amount of CV events in the follow-up. Erectile dysfunction is also an early manifestation of arteriosclerosis assoc…

STATINS AND PERIPHERAL ARTERIAL DISEASE: EFFECTS ON DISEASE PROGRESSION, CLAUDICATION AND PREVENTION OF CARDIOVASCULAR EVENTS.

Peripheral arterial disease (PAD) of the lower limbs is the third most important site of atherosclerotic disease alongside coronary heart disease (CHD) and cerebrovascular disease (CVD). Best medical treatment is beneficial even in patients who eventually need invasive treatment, as the safety, immediate success, and durability of intervention is greatly improved in patients who adhere to best medical treatment. In recent years, a number of studies have suggested that the ACE-inhibitor ramipril and different statins, together with antiplatelet drugs, reduce cardiovascular morbidity and mortality in PAD. Patients with PAD are really a category of patients with a very high cardiovascular risk…

Effects of alirocumab on types of myocardial infarction : insights from the ODYSSEY OUTCOMES trial

Gislason, Gunnar H/0000-0002-0548-402X; Malynovsky, Yaroslav V/0000-0002-9118-1104; Bhatt, Deepak L./0000-0002-1278-6245; Nikolaev, Konstantin/0000-0003-4601-6203; Sherwood, Matthew/0000-0002-4305-5883; Chumakova, Galina A/0000-0002-2810-6531; Raffel, Owen C/0000-0001-5470-7050; Leonardi, Sergio/0000-0002-4800-6132; Tse, Hung Fat/0000-0002-9578-7808; Reshetko, Olga/0000-0003-3107-7636; Pereira, Helder/0000-0001-8656-4883; Racca, Vittorio/0000-0002-4465-3789; Podoleanu, Cristian/0000-0001-9987-2519; Ersanli, Murat/0000-0003-1847-3087; Muenzel, Thomas/0000-0001-5503-4150; Sandhu, Manjinder/0000-0003-2538-2079; Taskinen, Marja-Riitta/0000-0002-6229-3588; bastos, jose/0000-0002-9526-3123; Manak…

Metabolic syndrome (MetS) predicts cardio and cerebrovascular events in a twenty years follow-up. A prospective study.

BACKGROUND AND PURPOSE: Metabolic syndrome (MetS) is a cluster of cardiovascular risk factors, considered as emerging and promoting atherosclerosis. This study aimed at the evaluation of the influence of MetS on the prediction of cerebro and cardiovascular events during a 20 years follow-up period in an asymptomatic population of middle-aged subjects. METHODS: We evaluated 529 asymptomatic persons through a prospective study. Study population was divided into two subgroups: patients with and without MetS. Echo-color-Doppler was used in order to assess the presence of subclinical atherosclerosis. A 20 years follow-up study was carried out in order to estimate the incidence of cerebro and car…

Supraventricular arrhythmias in noncompaction of left ventricle: Is this a frequent complication?

Background: Isolated left ventricular noncompaction is the result of incomplete myocardial morphogenesis, leading to persistence of the embryonic myocardium. The condition is recognised by an excessively prominent trabecular meshwork and deep intertrabecular recesses of the left ventricle. Whether these intertrabecular recesses are a favorable substrate for supraventricular arrhythmias is unclear, even if the incidence of chronic heart failure seems to be high. Results: We evaluated a continuous series of 238 patients affected by noncompaction. In 4 cases the patients reported palpitations and in 4 an episode of syncope. Periodic holter monitoring was performed every 6 months for 4 years. O…

The role of macrophage colony-stimulating factor in patients with acute myocardial infarction: a pilot study.

We assessed whether macrophage colony-stimulating factor (M-CSF) levels are associated with left ventricular systolic dysfunction (LVSD) in patients with acute myocardial infarction (AMI). We studied 56 patients with AMI (mean age: 67 ± 12 years) and identified those with clinical (Killip class &gt;II) or echocardiographic signs (ejection fraction ≤45%) of LVSD. We evaluated the established cardiovascular risk factors and measured several cardiovascular biomarkers, including M-CSF. Serum M-CSF concentrations (pg/mL) were significantly increased in patients with both clinical and echocardiographic signs of LVSD (460 ± 265 vs 290 ± 210, P = .0103 and 493 ± 299 vs 287 ± 174, P = .0028, respec…

Multimodality imaging in cardiac echinococcosis for diagnosis and follow-up of an untreatable cyst

RIGHT LOBAR PULMONITIS A POSSIBLE CAUSE OF LONE ATRIAL FIBRILLATION

RIGHT LOBAR PULMONITIS A POSSIBLE CAUSE OF LONE ATRIAL FIBRILLATION

INCREASED MACROPHAGE COLONY STIMULATING FACTOR CONCENTRATIONS ARE ASSOCIATED WITH LEFT VENTRICLE SYSTOLIC DYSFUNCTION IN PATIENTS WITH ACUTE CORONARY SYNDROMES

INCREASED MACROPHAGE COLONY STIMULATING FACTOR CONCENTRATIONS ARE ASSOCIATED WITH LEFT VENTRICLE SYSTOLIC DYSFUNCTION IN PATIENTS WITH ACUTE CORONARY SYNDROMES

Amyloidosis and device therapy: an open debate

Cardiac involvement represents a critical prognostic factor in amyloidosis, as it represents a leading cause of morbidity and mortality, in primary light chain amyloidosis, in hereditary and also in wild-type transthyretin amyloidosis. A 54-year-old male was admitted to Emergency Room with complaints of dyspnea, palpitations and diaphoresis.

Left ventricular noncompaction presenting like a double-chambered left ventricle

Approccio diagnostico non invasivo con tomografia computerizzata multidetettore a 40 strati per lo studio della malattia aterosclerotica coronarica

Background. Multidetector computed tomography coronary angiography (MDCT-CA) is a non-invasive technique that clearly shows coronary anatomy and correctly identifies plaque location and morphology. In this study we assessed diagnostic accuracy of MDCT-CA in detectiong significant stenosis in patients with clinically relevant coronary tree disease. Methods. Fifty patients (38 males, 12 females, mean age 60.9 ± 9.2 years) with atypical chest pain, stable or unstable angina pectoris, or non-ST-elevation myocardial infarction underwent MDCT-CA (Brilliance 40, Philips Medical Systems, Cleveland, OH, USA) within 3 days before diagnostic conventional coronary angiography. Inclusion criteria were s…

Protrhombotic Effects of Contraceptives

The use of oral contraceptives first became widespread some 40 years ago, and reports of an excess risk of cardiovascular disease among women who used these agents soon followed. Few drugs have been the object of such intensive epidemiological research, the outcome of which has provided clinicians with detailed information about risks not only of specific thrombotic diseases but also important non-contraceptive benefits from the pill. Recently, oral contraceptives have been classified by some according to "generation" (first, second, third, and most recently, fourth generation): first-generation formulations containing lynestrenol or norethindrone, second-generation formulations containing …

Asymptomatic Carotid Lesions and Aging: Role of Hypertension and Other Traditional and Emerging Risk Factors

Background We evaluated the prevalence of intima-media thickening (IMT) and asymptomatic carotid plaque (ACP) in a group of subjects with or without traditional and/or emerging risk factors (RF). Methods There were 631 subjects (313 male and 318 female) aged between 19 and 97 years, asymptomatic for cerebro- and cardiovascular diseases. The following measurements were used: anamnesis, physical examination, height and sitting blood pressure. Biochemistry variables were also considered: total cholesterol, HDL-C, LDL-C, triglycerides, fibrinogen, high sensitive C-reactive protein, IgG antibodies for Helicobacter pylori (HP), cytotoxic HP, cytomegalovirus and Chlamydia pneumoniae . Finally, an …

Soluble CD40L and Cardiovascular Risk in Asymptomatic Low-Grade Carotid Stenosis

Background and Purpose— We investigated whether soluble CD40L (sCD40L) may predict the risk of cardiovascular (CV) events in patients with asymptomatic carotid plaques. Methods— Forty-two patients with asymptomatic low-grade carotid stenosis (ALCS) and 21 controls without any carotid stenosis were enrolled. All subjects had at least a major cardiovascular risk factor (CRF). Plasma levels of C-reactive protein (CRP), IL-6, and sCD40L were measured. Subjects were reviewed every 12 months (median follow-up, 8 years). Results— ALCS patients had higher ( P &lt;0.0001) CRP, IL-6, and sCD40L than controls. Fourteen patients experienced a CV event. Cox regression analysis showed that only high sCD…

Prediction of cardio- and cerebro-vascular events in patients with subclinical carotid atherosclerosis and the metabolic syndrome.

CHLAMIDYA PNEUMONIAE AND VULNERABLE PLAQUE: DOES EXIST A CORRELATION?

ST segment elevations: Always a marker of acute myocardial infarction?

AbstractChest pain is one of the chief presenting complaints among patients attending Emergency department. The diagnosis of acute myocardial infarction may be a challenge. Various tools such as anamnesis, blood sample (with evaluation of markers of myocardial necrosis), ultrasound techniques and coronary computed tomography could be useful. However, the interpretation of electrocardiograms of these patients may be a real concern. The earliest manifestations of myocardial ischemia typically interest T waves and ST segment. Despite the high sensitivity, ST segment deviation has however poor specificity since it may be observed in many other cardiac and non-cardiac conditions. Therefore, when…

Alteraziioni morfofunzionali vascolari in una popolazione con sindrome metabolica e steatosi epatica ecografica

A cardiac fibroma in a 7-year-old asymptomatic girl admitted for ECG anomalies

PREVALENCE OF A MILD COGNITIVE IMPAIRMENT IN PATIENTS WITH ATRIAL FIBRILLATION

Polycythemia Vera as a Predisposing Factor for Aortic Stenosis: Prevalence and Correlation with Blood Cells Count and Mutational Status

Abstract The association between Polycythemia Vera (PV) and thrombosis is multi-factorial involving the complex interaction between activated leukocytes, platelets and endothelium. Recent reports have postulated that PV patients may over express adhesive molecules on red cell surface, likely by JAK2 mutation (Wautier M et al. Blood.2007;110(3):894–901). This process activates endothelium with production of vascular growth factors and other mechanisms leading to atherosclerosis. Aortic Stenosis (AS) is the commonest valvular heart disease in western countries; its pathogenesis is mainly related to a degenerative process sharing many characteristics with atherosclerosis. At the present is not…

Prediction of cardio- and cerebro-vascular events in patients with subclinical carotid atherosclerosis and low HDL-cholesterol.

Low HDL-cholesterol concentrations are associated with increased cardiovascular risk and recent evidences suggest that HDL may aggravate the atherosclerotic process promoting inflammation: HDL are anti-inflammatory in the absence of inflammation but can become proinflammatory in the presence of atherosclerosis. Yet, no data is available on the cardiovascular outcome in subjects with low HDL-cholesterol and early stages of atherosclerosis. Therefore, we included in a prospective 5-year follow-up study 150 subjects with low HDL-cholesterol concentrations and subclinical carotid atherosclerosis, as assessed by carotid colour doppler, evaluating at baseline all the established traditional cardi…

EFFICACIA DEI TIROFIBAN AD ALTE DOSI NELLA LISI DEI TROMBI INTRACORONARICI

Impact of Diabetes and Impaired Glucose Tolerance (IGT) on Complications and Hospitalisation in Patients with Acute Coronary Syndrome

The percutaneous closure of patent foramen ovale (PFO): Impact on the quality of life

ELEVATED C-REACTIVE PROTEIN LEVELS ARE A STRONG PREDICTOR OF CLINICAL EVENTS IN HYPERTENSIVE PATIENTS WITH EARLY STAGE OF ATHEROSCLEROSIS

High dose of trimethoprim-sulfamethoxazole and daptomycin as a therapeutic option for MRSA endocarditis with large vegetation complicated by embolic stroke: a case report and literature review.

A multidisciplinary approach to cardiovascular diseases

It is a great honor for me to present a selection of papers discussed on the occasion of the 1st Congress organized by the Multinational Chapter of the International Union of Angiology (IUA) in conjunction with the XXIV Congress of the Mediterranean League of Angiology and Vascular Surgery (MLAVS), that was held on October 2-5, 2014 at the Didactic Centre of the Campus of the University of Palermo, with the aim of being an opportunity for scientific dialogue and communication at the highest levels.The subtitle of the meeting “A multidisciplinary approach to cardiovascular diseases” is in agreement with the mission of the IUA and MLAVS, both characterized by a multidisciplinary approach, aim…

IVABRADINE VERSUS BISOPROLOL

IVABRADINE VERSUS BISOPROLOL

ICD implantation in noncompaction of the left ventricular myocardium: a case report

Isolated noncompaction of the ventricular myocardium (INVM) is an uncommon cardiomyopathy characterized by the persistence of fetal myocardium with prominent trabecular meshwork and deep intertrabecular recesses, often associated with systolic dysfunction and ventricular dilatation. A 23-year-old man from Burkina Faso was referred to our operative unit with a diagnosis of INVM, made with echocardiogram and magnetic resonance imaging and nonsustained ventricular tachycardia. The literature reports the incidence of malignant ventricular arrhythmias in as many as 47% of the patients and sudden cardiac death in almost 50% of them and this supported our decision to perform implantable cardiovert…

The association between the 4G/5G polymorphism in the promoter of the plasminogen activator inhibitor-1 gene and extension of postsurgical calf vein thrombosis.

The objective of this study was to evaluate whether the presence of a plasminogen activator inhibitor type 1 (PAI-1) promoter polymorphism 4G/5G could significantly influence the proximal extension of vein thrombosis in spite of anticoagulant treatment in patients with calf vein thrombosis (CVT) following orthopaedic, urological and abdominal surgery. We studied 168 patients with CVT, who had undergone orthopaedic, urological and abdominal surgery, subdivided as follows: first, 50 patients with thrombosis progression; second, 118 patients without thrombosis progression. The 4G/5G polymorphism of the plasminogen activator inhibitor 1 was evaluated in all patients and in 70 healthy matched co…

Isolated left ventricular non-compaction: A larger part of submerged iceberg with criteria for diagnosis to the limits of standard

Circulating transforming growth factor-beta1 levels in asymptomatic carotid plaques

takotsubo cardiomiopathy after acute diarrhea

Takotsubo cardiomyopaty is a recently described syndrome characterized by transient left ventricular dysfunction, mimicking an acute coronary syndrome and usually precipitated by a physical or emotional stress. We report the first case of Takotsubo cardiomyopathy after acute diarrhea in a man. It may be argued that severe diarrhea in predisposed individuals may cause an acute stress resulting in increased sympathetic activity leading to this syndrome. Probably the relationship between the adrenergic system and the heart is more complex than general thought and the stimuli which favor an autonomic imbalance and precipitate the syndrome are very disparate in clinical practice.

Thrombotic complications during overt hyperthyroidism

Novo, S. et al. Aliskiren: Just a New Drug for Few Selected Patients or an Innovative Molecule Predestinated to Replace Arbs and Ace-Inhibitors? Pharmaceuticals 2009, 2, 118-124

The renin-angiotensin-aldosterone system (RAAS) plays a dominant role in the pathophysiology of hypertension, diabetes mellitus, chronic kidney disease and chronic heart failure. Therefore, drugs that block key components of the RAAS such as ACE inhibitors (ACEI) and angiotensin receptor blockers (ARBs) have gained wide clinical use for these indications. Despite progress, the morbidity and mortality of patients treated with ACEI or ARBs remain high. Aliskiren (Tekturna, Rasilez) is the first orally active inhibitor of renin approved for clinical use as an antihypertensive agent. The development program has established that at the licensed doses of 150 mg and 300 mg. Aliskiren is effective …

Relazione tra disfunzione erettile, livelli di testosterone e funzione endoteliale in pazienti a rischio cardiovascolare intermedio secondo le stime della Carta di Framingham” – P259

Scopo del lavoro Il ruolo dei livelli di testosterone plasmatico e della disfunzione erettile come marcatori precoci di disfunzione endoteliale non è ben definito. Pertanto, abbiamo cercato di analizzare la relazione tra testosterone plasmatico e disfunzione erettile, in rapporto alla funzione endoteliale. Materiali e metodi Abbiamo quindi arruolato 802 pazienti in prevenzione primaria, con una stima di rischio cardiovascolare (CV) intermedio secondo la carta del rischio di Framingham, di età compresa fra 40 e 80 anni, che si sono sottoposti all’esame ecografico della dilatazione flusso mediata dell’arteria brachiale destra, alla valutazione della disfunzione erettile attraverso il question…

PREVALENCE OF METABOLIC SYNDROME IN PATIENTS WITH ACUTE CORONARY SYNDROMES

PROGNOSTIC IMPACT OF HYPERTENSION AND CAROTIID LESIONS N A FIVE YEARS FOLLOW UP

Incidence and Clinical Impact of Right Ventricular Involvement (Biventricular Ballooning) in Takotsubo Syndrome

Background The short- and long-term prognosis of Takotsubo syndrome (TTS) presenting with right ventricular (RV) involvement remains poorly understood. Research Question What is the incidence and clinical outcome of RV involvement in TTS? Study Design and Methods This study analyzed 839 consecutive patients with TTS (758 female subjects and 81 male subjects) in a multicenter registry. RV involvement was defined as wall motion abnormality of the RV free wall, with or without apical involvement. The median long-term follow-up was 2.1 years (interquartile range, 0.3-4.5 years). The primary outcome was in-hospital and out-of-hospital all-cause mortality. The secondary end point was a composite …

Dietary strategy for prevention and management of dyslipidemia: international guidelines

Primary prevention of cardiovascular disease should begin with a detailed metabolic study of our patients who must follow a nutritional therapy. Recently, new guidelines ESC/EAS 2011 on the treatment of dyslipidemia have been drawn up, according to which it is possible to arrive at desirable values of cholesterol and triglycerides with a synergy between drug treatment and adequate diet therapy. At this time, Mediterranean diet has been undergoing a radical transformation: there is hyperalimentation of the Mediterranean diet in all its components. The effectiveness of the Mediterranean diet on the reduction of lipids has been demonstrated, and the problem is how to implement this diet in the…

Thrombus-like small apical fibroma in patient with left ventricular dysfunction and thrombophilia: an unusual presentation.

STRAIN RATE ECHOCARDIOGRAPHYTO DETECT EARLY IMPAIRMENT OF LEFT VENTRICULAR SYSTOLIC FUNCTION IN PATIENTS WITH ASYMPTOMATIC CARDIAC AMYLOIDOSIS

Older age and markers of inflammation are strong predictors of clinical events in women with asymptomatic carotid lesions

OBJECTIVE: Limited information exists regarding the association between markers of inflammation, such as high-sensitivity C-reactive protein (hs-CRP) and fibrinogen, and adverse events in postmenopausal women with subclinical atherosclerosis. Therefore, we investigated the prognostic impact of traditional risk factors and inflammation on adverse cardiac events in women with asymptomatic carotid lesions. DESIGN: We studied 250 postmenopausal women who were free of cardiovascular disease. Traditional cardiovascular risk factors were investigated, and laboratory analysis included measurement of plasma lipids, fibrinogen, and hs-CRP. The early phases of carotid atherosclerosis were assessed by …

Prognostic value of LDL/HDL cholesterol ratio in patients undergoing coronary stenting

P1319 Speckle tracking echocardiography in patients with acute coronary syndrome: the added value

Abstract Background Speckle tracking echocardiography with assessment of left ventricular global longitudinal strain (GLS) allows to identify early signs of cardiac dysfunction. The superiority of GLS in the prediction of all-cause mortality in the general population compared with LVEF is well known; in addiction GLS improves risk stratification and recognize early left ventricular dysfunction in several clinical setting. Purpose the aim of this study was to assess the diagnostic and prognostic role of global and segmental strain in the early identification of cardiac dysfunction in patients with myocardial infarction without persistent ST segment elevation (NSTEMI) and without obvious wall…

Endothelial dysfunction and carotid lesions are strong predictors of clinical events in patients with early stages of atherosclerosis: a 24 months follow-up study.

Update on the use of anti-thrombotic therapy in acute coronary syndromes

coronary syndromes; anti-thrombotic therapy

[Coronary artery ectasia: etiopathogenesis, diagnosis and treatment].

Coronary ectasia is a dilation of coronary arteries, angiographically defined if the diameter of the artery is ≥ 1.5 times greater than that of the intact adjacent vascular segment. An association has been found between coronary artery ectasia and a broad spectrum of different diseases, first of all atherosclerotic coronary artery disease. The mechanisms that determine the abnormal dilatation of the vascular lumen and the etiology of coronary artery ectasia are still poorly understood. Various hypotheses have been formulated over the time, the most accredited between these recognizes as main responsible an uncontrolled activity of a particular family of enzymes that degrade the extracellula…

The effects Prostaglandine E-1 in patients with intermittent claudication

ASSOCIATION OF ELEVATED FIBRINOGEN AND C-REACTIVE PROTEIN LEVELS WITH CAROTID LESIONS IN PATIENTS WITH EARLY ONSET OF HYPERTENSION OR TYPE II DIABETES.

EXTRACORONARY ATHEROSCLEROSIS IN PATIENTS WITH CHRONIC ISCHEMIC HEART DISEASE

Superficial venous thrombosis: role of genetic risk factors on spreeding to deep veins

Therapeutic management in Sicilian patients with definite arrhythmogenic right ventricular dysplasia/cardiomyopathy and focus on the role of implantable cardioverter-defibrillator therapy

Arrhythmogenic Right Ventrticular Dysplasia/Cardiomyopathy(ARVD/C) is an inherited cardiomyopathy characterized by right ven-tricularmyocytelosswithfibrofattyreplacement,ahighriskofventric-ular arrhythmias (VA) and sudden cardiac death (SCD) [1]. Preventionof SCD represents the most important management strategy and theachievement of this target can be reached by different therapeuticstrategies including implantable cardioverter-defibrillator (ICD)implantation, pharmacologic therapy, catheter ablation of ventriculartachycardia (VT) and cardiac transplantation [2,3]. The aim of thisstudy is to examine the outcome of the different therapies adopted ina group of affected patients, focusing on th…

EFFICACIA DELL’ATP IN PAZIENTI CON ICD E TV RAPIDE: UN CASO CLINICO

Markers of inflammation are strong predictors of subclinical and clinical atherosclerosis in women with hypertension

DANNO VASCOLARE E TERAPIA

IN HOSPITAL STAY OF PATIENTS WITH ACUTE CORONARY SYNDROME WITHOUT OR WITH DIABETES MELLITUS

The significance of low-density lipoproteins size in vascular diseases

Low density lipoproteins (LDL) comprise in humans two different main fractions: large, buoyant and small, dense particles. Small, dense LDL particles correlate negatively with plasma HDL levels and positively with plasma triglyceride concentrations and are associated with the metabolic syndrome and increased risk for cardiovascular disease. LDL size seems to be an important predictor of cardiovascular events and progression of coronary heart disease (CHD). In addition, several studies have suggested that therapeutic modulation of specific LDL subclasses may be of great benefit in reducing the atherosclerotic risk. Therefore, LDL size measurement may be of potential value in the clinical ass…

INTER-SOCIETY CONSENSUS FOR THE MANAGEMENT OF PERIPHERAL ARTERIAL DISEASE (TASC II)

SINDROME METABOLICA ED ATEROSCLEROSI PRECLINICA CAROTIDEA IN UNA POPOLAZIONE GIOVANE CON ALTERATO STILE DI VITA

Intrahospital complications of acute myocardial infarction in hypertensive patients. A retrospective case-control study

Segmental dyskinesia in Wolff–Parkinson–White syndrome: A possible cause of dilatative cardiomyopathy

Wolff-Parkinson-White (WPW) is a syndrome characterized by the presence of an accessory pathway that skipping A-V node may lead the electrical stimulus from the atrium directly to the ventricle. Some studies reported the finding of myocardial dyskinesia in the segments precociously activated by the accessory pathway, at echocardiogram and at nuclear cardiac study. Soria et al. reported, in 1985, an increased incidence of dilative cardiomyopathy in patients with WPW. The pathophysiological pathway that leads to ventricular dilation may be due to the increase of end-diastolic pressure secondary to a tachycardia-induced cardiomyopathy. Tachycardia-induced cardiomyopathy is usually secondary to…

The prognostic role of CMR using global planimetric criteria in patients with excessive left ventricular trabeculation.

Objectives: Although cardiovascular magnetic resonance (CMR) is widely used in the assessment of left ventricular non-compaction (LVNC), there are no universally accepted diagnostic criteria and limited data regarding their prognostic value. We assessed the long-term prognostic role of the planimetric global Grothoff’s criteria and of the CMR findings in predicting adverse cardiovascular events (CE). Methods: We prospectively enrolled 78 patients (46.7 ± 18.7 years, 33.3% females) with documented positive Jenni’s echocardiographic criteria for LVNC. Cine images were used to quantify function parameters and to assess for the presence of all four quantitative Grothoff’s criteria (global Groth…

In Hospital stay of patients with acute coronary syndrome without or with diatetes mellitus

Correlation between longitudinal strain analysis and coronary microvascular dysfunction in patients with heart failure with preserved ejection fraction

Objective: The aim of this study was to evaluate in patients with microvascular angina and heart failure with preserved ejection fraction, the speckle-tracking echocardiography, and longitudinal myocardial strain to evaluate the possible presence of alterations in heart failure with preserved ejection fraction patients compared with a control population. We also investigated the correlation between the longitudinal strain analysis and the TIMI frame count after coronary angiography. Methods: Our study was performed on a population 41 patients with microvascular angina that underwent coronary angiography and speckle-tracking echocardiography. We divided the sample into two categories: patien…

Chronic atrial fibrillation in presence of aortic stenosis in a patient with polysplenia syndrome.

We report a rare case of “situs viscerum ambiguous” with polysplenia syndrome, in a 69 year old female patient with aortic stenosis and chronic atrial fibrillation. The presenting symptom was dyspnoea on moderate exertion and an ECG showed supra ventricular arrhythmia. Patients trans-thoracic echocardiogram revealed a dilated left atrium, reduced ejection fraction, mild tricuspid regurgitation, moderate-severe pulmonary hypertension and severe aortic stenosis. The patient was successfully treated with a replacement of her aortic valve and ascending aorta.

INFECTION, INFLAMMATION AND VASCULAR COMPLICATIONS: AN EMERGING SCENARIO

Ischemia in patients with no obstructive coronary artery disease: classification, diagnosis and treatment of coronary microvascular dysfunction

Patients with coronary microvascular dysfunction represent a widespread population, and despite the good prognosis, many of them, because of the angina symptoms, have a poor quality of life with strong limitations in their daily activities. In 2017, a new classification of microvascular dysfunction as well as a new definition of ischemia in patients with no obstructive coronary artery disease became available. This new definition improves Kemp's initial work, where cardiac X syndrome was initially described. This work summarizes the last updates on the subject with particular attention to the new classification of microvascular dysfunction, with particular attention to microvascular and vas…

ISOLATED SHORT PR IN CHILDREN WITH PALPITATION: AN ELECTROCARDIOGRAPHIC FINDING OF FAST-SLOW NODAL TACHYCARDIA?

ISOLATED SHORT PR IN CHILDREN WITH PALPITATION: AN ELECTROCARDIOGRAPHIC FINDING OF FAST-SLOW NODAL TACHYCARDIA?

LA TERAPIA DI RESINCRONIZZAZIONE CARDIACA (TRC) COME PONTE AL TRAPIANTO CARDIACO. UN CASO CLINICO

INCIDENZA DELL’ATEROSCLEROSI CORONARICA E PERIFERICA IN RELAZIONE ALLA PRESENZA DELLA SINDROME METABOLICA IN UNA POPOLAZIONE AMBULATORIALE NON SELEZIONATA: RUOLO DELLA PCR E DEL FIBRINOGENO

Superficial venous thrombosis: Prevalence of common genetic risk factors and their role on spreading to deep veins

Introduction. Superficial venous thrombosis (SVT) has been considered for a long time a limited clinical condition with a low importance, but this approach has changed in recent years, when several studies demonstrated spreading to deep veins occurring from 7.3 to 44%, with high prevalence of pulmonary embolism . Materials and Methods. To evaluate the prevalence of genetic risk factors for VTE in patients suffering from SVT on both normal and varicose vein, and to evaluate their role on spreading to deep veins, we studied 107 consecutive outpatients with symptomatic SVT. Ultrasound examination was performed, and the presence of FV Leiden, Prothrombin G20210A mutation, MTHFR C677T mutation w…

Transient mid-ventricular dyskinesia: a variant of Takotsubo syndrome

Takotsubo Cardiomyopathy is characterized by a reversible systolic left ventricular apical ballooning. A new pattern of dyskinesia in the absence of angiographic evidence of coronary artery stenosis has been indicated like a variant of takotsubo cardiomiopathy: mid-ventricular akinesis with preservation of apical and basal contractilities revealed at echocardiograms and ventriculographies. We report the case of a 65 years old patient with this pattern, reverted in 4 weeks.

Effects of Essential Hypertension on coronary Microcirculation: Focus on a Population of Hypertensives Affected by Microvascular Angina

A correlation between essential hypertension and the establishmentof myocardial ischemia is nowadays universally accepted. Coronary atherosclerosis is deemed to be the most important process through which the capability of coronary district to supply a blood flow consistent with myocardial needs can be impaired, until the onset of an anginal syndrome. In this study, we verified whether hypertensives’ coronaries, seen by performing an angiographic study, are properly definable as normal, even in presence of an overt exertional angina, or if they should rather be barely defined as “macroscopically unharmed”, through the clues of a microvascular alteration

Contrast-induced Nephropathy after Percutaneous Coronary Intervention in Simple Lesions: Risk Factors and Incidence are Affected by the Definition Utilized

Aim To compare the incidence, and risk factors, in-hospital and at the 18-month prognosis of contrast-induced nephropathy (CIN) according to the definition utilized: as an increase in serum creatinine (Scr) ≥0.5 mg/dL (CIN 1) or as an increase in Scr ≥25% above baseline values (CIN 2). Methods and Results We prospectively evaluated CIN according to two different definitions in 150 patients who underwent percutaneous coronary intervention (PCI) in simple lesions employing a low-medium dose of contrast media. Incidence of CIN was higher using the CIN 2 definition than CIN 1 (9.3% vs. 4%; p=0.0133). Patients with CIN 1 had a higher incidence of chronic kidney disease (CKD) (66.7% vs. 13.9%; p=…

Effects of Middle-Term Treatment with Nifedipine on Hemodynamic Parameters and on Left Ventricular Function in Hypertensive Patients

NONCOMPACTION OF THE LEFT VENTRICULAR MYOCARDIUM IN CHILDREN: CLINICAL AND PHYSIOPATHOLOGIC FEATURES

Multiplane Two-Dimensional versus Real Time Three-Dimensional Transesophageal Echocardiography in Ischemic Mitral Regurgitation

Objectives: Intraoperative three-dimensional (3D) transesophageal echocardiography (TEE) has been suggested to be a valuable technique for the evaluation of the mechanisms of ischemic mitral regurgitation (IMR). Studies comparing multiplane two-dimensional (2D) with 3D TEE reconstruction of the mitral valve using the new mitral valve quantification (MVQ) software are lacking. We undertook a prospective comparison between multiplane 2D and 3D TEE for the assessment of IMR. Methods: We evaluated echocardiographically 45 patients with IMR who underwent mitral valve surgery in our institution. 2D and 3D TEE examinations followed by a 3D offline assessment of the mitral valve apparatus were perf…

Multiplane two-dimensional versus real time three-dimensional transesophageal echocardiography in ischemic mitral regurgitation

OBJECTIVES: Intraoperative three-dimensional (3D) transesophageal echocardiography (TEE) has been suggested to be a valuable technique for the evaluation of the mechanisms of ischemic mitral regurgitation (IMR). Studies comparing multiplane two-dimensional (2D) with 3D TEE reconstruction of the mitral valve using the new mitral valve quantification (MVQ) software are lacking. We undertook a prospective comparison between multiplane 2D and 3D TEE for the assessment of IMR. METHODS: We evaluated echocardiographically 45 patients with IMR who underwent mitral valve surgery in our institution. 2D and 3D TEE examinations followed by a 3D offline assessment of the mitral valve apparatus were perf…

RELAZIONE FRA I LIVELLI EMATICI DI PCR, FIBRINOGENO C E MMP-9 E DIFFERENTI PATTERN CLINICI DELL'ARITMIA

1232 Acute myocarditis: prognostic role of speckle tracking echocardiography and cardiac magnetic resonance

Abstract Background Myocarditis is an inflammatory disease of the myocardium predominantly caused by infection with subsequent immunological response. Cardiac magnetic resonance (CMR) is the currently best imaging modality to confirm a suspected diagnosis of myocarditis. Conventional echocardiography can detect regional or global wall motion abnormalities but it could also be negative. Speckle tracking echocardiography can help to identify subtle systolic dysfunction, in patients with myocardits and apparently negative echocardiogram. Purpose the aim of this study was to identify cardiac imaging parameters predictive of cardiovascular events in patients with acute myocarditis. Methods a pro…

Role of ARBs in the blood hypertension therapy and prevention of cardiovascular events

Hypertension has a worldwide high incidence in the general population and undoubtedly it is the most important risk factor for cardiovascular morbidity and mortality, in industrialized countries. In this Review we investigated the role of angiotensin II receptor antagonists (ARBs) therapy in the treatment of essential hypertension. We selected in the PubMed and in a list of selected sources the most significant clinical trials and meta-analysis carried out from 1999 to now, to assess, in adult patients populations, ARBs efficacy, safety and tolerability profile, in comparison with the efficacy of the other common antihypertensive drugs, with particular regard to both the prevention of disab…

ASSOCIATION OF ELEVATED FIBRINOGEN AND C-REACTIVE PROTEIN LEVELS WITH CAROTID LESIONS IN PATIENTS WITH EARLY ONSET OF HYPERTENSION OR TYPE-II DIABETES

La terapia di resincronizzazione cardiaca (TRC) come ponte al trapianto cardiaco. Un caso clinico

L’eta’ e gli elevati livelli di proteina C-reattiva e fibrinogeno sono forti predittori di eventi clinici in una popolazione di donne con aterosclerosi carotidea.

Impatto dell’insufficienza mitralica ischemica moderata in pazienti sottoposti a sola rivascolarizzazione miocardica chirurgica: Follow-up clinico ed ecocardiografico.

RUPTURE OF AN AORTIC DISSECTION INTO THE RIGHT ATRIUM IN A PATIENT WITH PREVIOUS AORTIC VALVE REPLACEMENT: A CASE REPORT

We report the case of a 73-year-old man with a history of previous aortic valve replacement in 1990 and rupture of an aortic dissection into the right atrium. The patient was admitted to the emergency room because of chest pain, stopped not long after. The electrocardiogram did not show any signs of ischemia and myocardial enzymes were not increased. Transthoracic echocardiography revealed aortic root dilation (maximum diameter 60 mm) extended to the aortic arch, and the presence of a flow from the ascending aorta to the right atrium (evocative of a fistula between the two chambers). The aortic valvular prosthesis function was good. Transesophageal echocardiography confirmed an aorta-right …

Evaluation of diastolic function by the Tissue doppler in children affected by non- compaction

The Tissue doppler analysis is a new echocardiographic approach to evaluate the diastolic function. In this report we performed a Tissue doppler analysis in a series of 15 children affected by non-compaction. The bidimensional echo-cardiogram showed a systolic function which was reduced only in 8 patients. Alterations of the diastolic function were founded in 7 patients: in 2 cases, a reduction of the E tissue wave was present in all segments. In 3 patients the diastolic dysfunction was limited to apical and lateral segments. In the last 2 children a reduction of the E wave interested only the apical segments. There was a strong correlation between systolic and diastolic dysfunction: in fac…

Optimal duration of treatment in surgical patients with calf venous thrombosis localized only in one or two leg.

OBJECTIVE: This retrospective study was planned for a good risk assessment of asymptomatic patients affected by ventricular pre-excitation. METHODS: From 1985 to 2007, 124 patients with an atrioventricular pathway (electrocardiographic signs of ventricular pre-excitation) were admitted to our cardiology division. The average age was 7 years (range 1 month to 18 years). The mean follow-up period in the whole population of patients was 4.2 years (range 1-13 years). Four patients were lost during the follow-up. During this period, all patients remained in good health. In all of them, we performed a Holter evaluation every year. An intermittent pathway was detected in 18 patients (15%), and fou…

Chronic inflammation: A key role in degeneration of bicuspid aortic valve.

Abstract Introduction Bicuspid aortic valve (BAV) is the most common congenital valvular heart defect resulting from abnormal aortic cusp formation during heart development, where two of the three normal and equal sized cusps fuse into a single large cusp resulting in a two cusps aortic valve. Over the past years, much interest has been given in understanding the pathogenesis of BAV and its complications. In this review, we focused on the role of inflammation, involved in the degeneration of BAV and the development of its complications. Role of inflammation From a pathophysiological point of view, BAV may rapidly progress into aortic stenosis (AS) and is related to aortopathy. Several histo…

Association Between Carotid Atherosclerosis and Metabolic Syndrome: Results From the ISMIR Study

The metabolic syndrome (MetS) has previously been associated with an early marker of atherosclerosis, the carotid intima-media thickness (IMT). From the ISMIR (Ispessimento Medio Intimale e Rischio cardiovascolare [media-intima thickness and cardiovascular risk]) study population of 479 asymptomatic participants, we identified 80 participants with MetS. Carotid IMT and plaques were evaluated by ultrasonography. Blood samples were obtained from all participants. Participants with MetS had a significantly higher prevalence of a carotid IMT &gt; 0.80 mm (P = .004) and of carotid plaques (P &lt; .001) as compared with participants without MetS. Carotid IMT was significantly correlated with fas…

Subclavian Stenosis/Occlusion in Patients with Subclavian Steal and Previous Bypass of Internal Mammary Interventricular Anterior Artery: Medical or Surgical Treatment?

There are only a few published studies on the association between subclavian steal syndrome and ischemic heart disease. The objective of this report is to evaluate the efficacy of subclavian stenoocclusion treatment in patients with subclavian steal syndrome (SSS) and previous cor- onary bypass. Over the last 8 years we observed 207 patients who underwent left internal mammary artery–intraventricular artery (LIMA–IVA) bypass graft. Of these, 31 patients were affected by steno-occlusion of the homolateral subclavian artery. Ten patients (group 1) showed latent vertebral-SSS and were pharmacologically treated. Seven patients (group 2) had an intermittent vertebral-SSS; four patients were trea…

RUOLO DELLA TOMOGRAFIA COMPUTERIZZATA MULTISLICE NELLA DIAGNOSTICA NON INVASIVA DELLA MALATTIA ATEROSCLEROTICA CORONARICA

ELEVATED C-REATIVE PROTEIN LEVELS ARE STRONG PREDICTOR OF CLINICAL EVENTS IN HYPERTENSIVE PATIENTS WITH EARLY STAGES OF ATHEROSCLEROSIS

P1462 Additive value of global longitudinal strain measurement in patients with known or suspected ischaemic heart disease undergoing stress echo

Abstract BACKGROUND Speckle-tracking echocardiography (STE) can be applied in a large variety of clinical conditions. Global longitudinal strain (GLS) shows high diagnostic accuracy for the detection of myocardial ischemia as it reflects changes in subendocardial fibers deformation that are more exposed to ischemic damage, even before alterations in segmental kinetics are revealed. PURPOSE Aim of our study was to assess whether the measurement of global longitudinal strain during stress-echo can provide additional information compared to the assessment of conventional parameters such as left ventricular ejection fraction (LVEF) and wall motion abnormalities. We also evaluated the added valu…

Testosterone levels are directly related with erectile function and endothelial function in men with intermediate risk according to the Framingham score

Background. The value of testosterone levels and erectile dysfunction (ED) as early markers of atherosclerosis is not well understood. Objectives. To analyze the relationship between plasma testosterone levels in men with both endothelial function (F) and ED. Methods. We enrolled 802 asymptomatic, intermediate cardiovascular risk patients, according to the Framingham Risk Score, aged 40 to 80 years, who underwent the study of EF, evaluation of ED and dosage of plasma testosterone. Results. At linear regression, EF (t=9.40; 95% CI from 0.9318 to 1.4234; p<0.0001) and erectile function (t=8.96; 95% CI from 0.7642 to 1.1932; p<0.0001) statistically increased with increasing levels of testoster…

Aliskiren: Just a New Drug for Few Selected Patients or an Innovative Molecule Predestinated to Replace Arbs and Ace-Inhibitors?

The renin-angiotensin-aldosterone system (RAAS) plays a dominant role in the pathophysiology of hypertension, diabetes mellitus, chronic kidney disease and chronic heart failure. Therefore, drugs that block key components of the RAAS such as ACE inhibitors (ACEI) and angiotensin receptor blockers (ARBs) have gained wide clinical use for these indications. Despite progress, the morbidity and mortality of patients treated with ACEI or ARBs remain high. Aliskiren (Tekturna, Rasilez) is the first orally active inhibitor of renin approved for clinical use as an antihypertensive agent. The development program has established that at the licensed doses of 150 mg and 300 mg. Aliskiren is effective …

Conquests and perspectives of cardio-oncology in the field of tumor angiogenesis-targeting tyrosine kinase inhibitor-based therapy

Abstract: Introduction: Angiogenesis is fundamental for tumor development and progression. Hence, anti-angiogenic drugs have been developed to target VEGF and its receptors (VEGFRs). Several tyrosine kinase inhibitors (TKIs) have been developed over the years and others are still under investigation, each anti-VEGFR TKI showing a different cardiotoxic profile. Knowledge of the cardiac side-effects of each drug and the magnitude of their expression and frequency can lead to a specific approach. Areas covered: This work reviews the mechanism of action of anti-VEGFR TKIs and the pathophysiological mechanisms leading to cardiotoxicity, followed by close examination of the most important drugs i…

Impact of preclinical carotid atherosclerosis on global cardiovascular risk stratification and events in a 10-year follow-up: comparison between the algorithms of the Framingham Heart Study, the European SCORE and the Italian 'Progetto Cuore'

Background The aim of the study was to compare three widely used algorithms for stratification of the global cardiovascular risk (GCVR): the Framingham Heart Study (FHS) score, the European systemic coronary risk estimation (SCORE) and the Italian 'Progetto Cuore' (heart project) score. It was also investigated how preclinical carotid atherosclerosis (pre-ATS) might influence the incidence and improve the risk prediction of cerebrovascular and cardiovascular events. Methods Subjects (n = 358) without previous history of cardiovascular disease (CVD) were recruited and the GCVR was calculated for each patient. An ultrasound evaluation of the carotid arteries was also performed. Results Accord…

Effects of four different anti-hypertensive treatments on cardiac arrhythmias and transient episodes of myocardial ischemia in hypertensives with left ventricular hypertrophy

Platelet sensitivity to prostacyclin and thromboxane production in hyperlipidemic patients

SummaryIn 13 type II hyperlipidemics (10 males and 3 females; mean age 50.2 ± 10.6 years), in 10 type IV hyperlipidemics (7 males and 3 females; mean age 51 ± 13.3 years) and in 23 healthy age-and sex-matched controls, the following parameters were measured: plasma cholesterol; plasma TG; plasma C-HDL; VLDL, separated in a preparative ultracentrifuge; C-LDL; Apo B, with immunoelectrophoretic method; platelet sensitivity to prostacyclin; TXB2 formation in PRP; TXB2 in serum.This study provides evidence for: 1. Reduced platelet sensitivity to prostacyclin, more evident in type II hyperlipidemia that provides an additional mechanism involved in increased platelet aggregation found in type II h…

CONSENSUS ON INTERMITTENT CLAUDICATION

Sympathetic tone and ventricular tachycardia

Background The pathogenesis of idiopathic monomorphic ventricular tachycardia is not clear. We suppose that a lack of balance of the sympathetic system could be involved. Frequency domain analyses of the heart rate can be useful to understand autonomic system balance. Therefore we performed this evaluation on a sample of seven children affected by idiopathic monomorphic ventricular tachycardia. Methods and results We performed a Holter recording for palpitations on all the children, with an average age of 12 (range: 7-18 years). In all the patients many episodes of repeated sustained or nonsustained ventricular tachycardia were demonstrated, with an average heart rate of 170 bpm. We exclude…

LA PROTEINA C REATTIVA ED IL FIBRINOGENO NELLA VALUTAZIONE DEL RISCHIO REALE DI EVENTI VASCOLARI IN PAZIENTI CON DIABETE MELLITO TIPO II.

Patent Foramen Ovale and Thromboembolic Complications

The foramen ovale, an atrial septal defect which is essential in the fetal circulation, remains patent through adulthood in approximately 25% of the general population and so it represents the most common persistent abnormality of fetal origin. Patent foramen ovale (PFO) allows interatrial right-to-left blood shunting during those periods of the cardiac cycle in which the right atrial pressure exceeds the left one. An increasing number of pathological manifestations of PFO has been recently identified; among these, paradoxical systemic embolism, refractory hypoxemia in patients with right ventricular myocardium infarction or severe pulmonary disease, orthostatic oxygen desaturation in the r…

Efficacy and Safety of Zofenopril Versus Ramipril in the Treatment of Myocardial Infarction and Heart Failure: A Review of the Published and Unpublished Data of the Randomized Double-Blind SMILE-4 Study

Zofenopril is a lipophilic, sulfhydryl group-containing angiotensin-converting enzyme (ACE)-inhibitor, characterized by wide tissue distribution, long duration of action, and pleiotropic effects on endothelial dysfunction. Its clinical efficacy and safety have been described in the four randomized controlled trials of the SMILE program, which globally enrolled more than 3600 patients in post-acute myocardial infarction (AMI) setting. The SMILE-4 study specifically selected patients with left ventricular dysfunction at admission, and compared the effects of zofenopril or ramipril in combination with acetylsalicylic acid (ASA). Zofenopril demonstrated its superiority over ramipril in reducing…

Ankle-Brachial Index as a Predictor of Cardiovascular Risk in Atrial Fibrillation

Objectives: Atrial Fibrillation (AF), the most frequent sustained arrhythmia, is associated with a high rate of morbidity and mortality. The clinical course of AF is often complicated by cardiovascular and cerebrovascular adverse events that usually have a dual origin: cardio embolic and atherothrombotic. The aim of our study is to demonstrate the existence of a relationship between Systemic Atherosclerosis and AF. More specifically, we have analysed the prevalence of lower limb Peripheral Artery Disease (PAD) in a population of fibrillating patients, and we have assessed whether the coexistence of AF and PAD might result in increased cardiovascular risks. Methods: The study has been conduc…

MYOCARDIAL ISCHEMIA IN THE HYPERTENSIVE PATIENT: THE ROLE OF CORONARY MICROCIRCULATION

LA PRESENZA DI ELEVATI LIVELLI DI FIBRINOGENO E PROTEINA C-REATTIVA SONO SIGNIFICATIVAMENTE ASSOCIATI ALLA PRESENZA DI ATEROSCLEROSI CAROTIDEA NEI PAZIENTI IPERTESI O DIABETICI.

Panic disorder, anxiety, and cardiovascular diseases

Different data indicate that psychological and/or emotional disorders may play an important role in the natural history of heart diseases. Although the major evidence is that related to depression, epidemiological data would indicate that anxiety and panic disorders are highly represented in cardiac patient, thus influencing mortality and morbidity. The diagnosis of panic disorder in patients with chest pain is crucial to a correct therapeutic approach, as well as to reduce the risks and costs of inappropriate treatments. Anxiety and panic may accelerate different direct and indirect processes involved in the pathogenesis of cardiovascular diseases: lifestyle risk factors, arterial hyperten…

Characteristics of coronary microcirculatory function in patients with Takotsubo syndrome.

Background: Takotsubo syndrome (TS) is a recently described cardiac syndrome whose pathogenesis is still unclear. We investigated the characteristics of coronary microcirculatory function in patients with TS through the analysis of the TIMI frame count (TFC) compared to normal subjects and with to subjects with microvascular angina (MA). Methods: We enrolled 71 TS patients (F:M =69:2, mean age of 65.27±9.53 years), 70 controls (F:M =34:36, mean age of 56.63±13.5 years) and 71 patients with MA, (F:M =69:2, mean age of 65.9±9.2 years). The assessment of the microcirculation was carried out through the TFC. Results: microcirculation was significantly altered in patients with TS compared with h…

Critical limb ischaemia: definition and natural hystory

The term critical limb ischemia refers to a condition characterized by chronic ischemic at-rest pain, ulcers, or gangrene in one or both legs attributable to objectively proven arterial occlusive disease. Critical limb ischemia implies chronicity and is to be distinguished from acute limb ischemia. Its incidence is approximately 500 to 1000 per million year, with the highest rates among older subjects, smokers and diabetics. The rate of primary amputation ranges from 10% to 40%, and was performed only when no graftable distal vessels were present, or in neurologically impaired or hopelessly nonambulatory patients. Contrarily, in some highly specialized and aggressive centres about 90% of pa…

rs629301 CELSR2 polymorphism confers a ten-year equivalent risk of critical stenosis assessed by coronary angiography

Abstract Background and aims Novel genetic determinants associated with coronary artery disease (CAD) have been discovered by genome wide association studies. Variants encompassing the CELSR2- PSRC1-SORT1 gene cluster have been associated with CAD. This study is aimed to investigate the rs629301 polymorphism association with the extent of CAD evaluated by coronary angiography (CAG), and to evaluate its associations with an extensive panel of lipid and lipoprotein measurements in a large Italian cohort of 2429 patients. Methods and results The patients were collected by four Intensive Care Units located in Palermo and Verona (Italy). Clinical Records were filed, blood samples were collected,…

Genetic susceptibility to the coronary artery diseases

The origin of coronary arterydisease is the interaction between genetic predisposition and environmental influences.

INFLUENZA PROGNOSTICA DELL’ATEROSCLEROSI CAROTIDEA O PERIFERICA IN PAZIENTI CON SINDROMI CORONARICHE ACUTE.

THE ASSOCIATION BETWEEN PROGRESSION OF POST-SURGICAL CALF VEIN THROMBOSIS AND 4G/5G POLYMORPHSM IN THE PROMOTER OF THE PLASMINOGEN ACTIVATOR INHIBITOR

A case of neurogenic heart disease: is there a elationship between heart and brain?

VALVULOPATIA AORTICA: FOLLOW-UP IN UN GRUPPO DI PAZIENTI SOTTOPOSTI AD INTERVENTO DI SOSTITUZIONE VALVOLARE

Preliminary Short-term Results of a Population of Patients Treated with MitraClip therapy: one Center Experience

&lt;p&gt;&lt;span&gt;Objectives: This retrospective analysis sought to evaluate 1-month outcomes and therapy effectiveness of a population of patients treated with MitraClip therapy. We describe in this article the preliminary results of primary effictiveness endpoint.&lt;/span&gt;&lt;/p&gt;&lt;p&gt;&lt;span&gt;Background: Percutaneous Mitral Repair is being developed to treat severe mitral regurgitation (MR),with increasing real-world cases of functional MR(FMR). In the EVEREST(Endovascular Valve Edge-to-Edge Repair Study)II trial,percutaneous device showed superior safety but less reduction in MR at 1year. 4-year outcomes from EVEREST II trial showed no difference in the prevalence of mod…

NON COMPATTAZIONE DEL VENTRICOLO SINISTRO E ARITMIE VENTRICOLARI: UN CASO CLINICO

RELATIONSHIP BETWEEN PERIPHERAL AND CORONARY ATHEROSCLEROSIS IN PATIENTS WITH CHRONIC ISCHEMIC HEART DISEASE

TROMBOSI PROFONDA SUPERFICIALE ED ESTENSIONE AL CIRCOLO PROFONDO: RUOLO DEI FATTORI DI RISCHIO GENETICI

Letters to the Editor

Moderate alcohol use and health: a consensus document

Abstract Aims The aim of this consensus paper is to review the available evidence on the association between moderate alcohol use, health and disease and to provide a working document to the scientific and health professional communities. Data synthesis In healthy adults and in the elderly, spontaneous consumption of alcoholic beverages within 30 g ethanol/d for men and 15 g/d for women is to be considered acceptable and do not deserve intervention by the primary care physician or the health professional in charge. Patients with increased risk for specific diseases, for example, women with familiar history of breast cancer, or subjects with familiar history of early cardiovascular disease, …

Correction of cardiovascular risks factor after an acute coronary syndrome: impact of pharmacological therapies on a two-years follow-up

Not available

Optimal duration of treatment in surgical patients with calf venous thrombosis involving one more veins

A CASE REPORT OF ABNORMAL ORIGIN OF THE LEFT CORONARY ARTERY FROM THE RIGH CORONARY SINUS

LA PLACCA ATEROSCLEROTICA: UN COMUNE MECCANISMO FISIOPATOLOGICO?

DYSLIPIDEMIA AND CARDIOVASCULAR RISK: FOCUS ON THE ROLE OF LOW HDL-CHOLESTEROL CONCENTRATIONS IN DEVELOPING ATHEROSCLEROTIC DISEASE AND IN ACCELERATING ITS PROGRESSION FROM SUBCLINICAL LESIONS TO CLINICAL EVENTS. EVIDENCES AND THERAPEUTICAL IMPLICATIONS.

Assessment of the German and Italian Stress Cardiomyopathy Score for Risk Stratification for In-hospital Complications in Patients With Takotsubo Syndrome.

IMPORTANCE Takotsubo syndrome (TTS) is an acute, reversible heart failure syndrome featured by significant rates of in-hospital complications. There is a lack of data for risk stratification during hospitalization. OBJECTIVE To derive a simple clinical score for risk prediction of in-hospital complications among patients with TTS. DESIGN, SETTING, AND PARTICIPANTS In this prognostic study, 1007 consecutive patients were enrolled in the German and Italian Stress Cardiomyopathy (GEIST) registry from July 1, 2007, through December 31, 2017, and identified as the derivation cohort; 946 patients were enrolled in the Spanish Registry for Takotsubo Cardiomyopathy (RETAKO) as the external score val…

ATHEROSCLEROSIS ACUTE CORONARY SYNDROMES AND HEART TRANSPLANTATION

Disfunzione endoteliale e malattia carotidea in pazienti con bright liver echopattern

The metabolic syndrome: Definition, diagnosis and management

The metabolic syndrome (MetS) constitutes a major public health problem in the developed countries.(1) It is cited with different names, such as syndrome X, insulin resistance syndrome, Reaven's syndrome or CHAOS (Australia). MetS increases the cardiovascular risk, but with specific lifestyle changes and individualized drug treatment the development of serious vascular complications can be avoided. In the last years, MetS has become a prevalent clinical condition. Therefore, it is necessary to create a complete document on the diagnosis and clinical management of MetS to avoid the confusion that derives from the vast amount of scientific papers, different revisions and definitions of the sy…

Subclinical atherosclerosis inflammation and events

UN CASO CLINICO DI ATEROSCLEROSI POLIDISTRETTUALE

high sensitivity of c-reactive protein in primary prevention

In an attempt to improve global cardiovascular risk prediction, considerable interest has focused on C-reactive protein (CRP), that has been shown in multiple prospective epidemiological studies to predict incident myocardial infarction, stroke, peripheral arterial disease, and sudden cardiac death. CRP is a hepatically-derived pentraxin that plays a key role in the innate immune response. Standard CRP tests determine levels which are increased up to 1000-fold in response to infection or tissue destruction, but cannot adequately assess the normal range. High-sensitive CRP detects levels of CRP within the normal range as well as higher levels proven to predict future cardiovascular events. T…

Efficacy of the treatment with prostaglandin E-1 in venous ulcers of the lower limbs.

Background. Venous ulcers represent an important medical problem due to their high prevalence and consequent sanitary costs. In this study we evaluated the effect of Prostaglandin E-1 (PGE-1), a drug that improves district ischemia, on the healing of venous ulcers. Methods. We performed a randomized, placebo-controlled, single blind study, in which 87 patients, carriers of venous leg ulcers, homogeneous for dimensions and characteristics, were treated for 20 days an with infusion of Prostaglandin E-1 or placebo, in association with a topic therapy. The dimension and the number of the ulcers were determined at the beginning of the treatment and then every 20 days up to 4 months or until tota…

Increased prevalence of cardiac arrhythmias and transient episodes of myocardial ischemia in hypertensives with left ventricular hypertrophy but without clinical history of coronary heart disease.

To evaluate the behavior of cardiac arrhythmias (CA) and transient episodes of myocardial ischemia (TEMI), in relation to the circadian pattern of blood pressure in patients suffering from arterial hypertension, with or without echocardiographically ascertained left ventricular hypertrophy (LVH), we studied 128 patients, 87 men (M) and 41 women (F), aging from 21 to 76 years, subdivided into two groups: Group I, including 66 patients with LVH (45 M and 21 F; mean age of 53.7 ± 9.1 years; Group II, including 62 patients without LVH ( 42 M and 20 F; mean age of 49.7 ± 9.5 years). Office blood pressure (OBP) as well as nighttime ambulatory blood pressure (ABP) were higher in patients with LVH …

CONTROLLO DELLA PERVIETA’ DEI VASI CORONARICI IN PAZIENTI CON CARDIOPATIA ISCHEMICA MEDIANTE TAC MULTISTRATO

UN CASO CLINICO DI ATEROSCLEROSI POLIDISTRETTUALE

Prediction of cerebrovascular and cardiovascular events in patients with subclinical carotid atherosclerosis: the role of C-reactive protein.

Increased levels of C-reactive protein and fibrinogen influence the risk of vascular events in patients with NIDDM

AIM: To evaluate the predictive role of hs-CRP and fibrinogen for cardio- and cerebrovascular events in a population of patients with type 2 diabetes. METHODS: We studied 156 patients with type 2 diabetes, mean age 66+10 years, and 156 sex and age matched control subjects. Patients underwent physical examination, EKG, measurement of body mass index and blood pressure. A blood sample was drawn to evaluate glycaemia, total and HDL/LDL cholesterol, triglycerides, high sensitive C-reactive protein (hs-CRP), fibrinogen. Finally, patients underwent an ecocolordoppler examination of the common carotid arteries until the bifurcation. In a follow-up of 5+/-1.2 years we evaluated the following events…

RUOLO DEL NT-proBNP NELLA PROGNOSI A BREVE TERMINE DOPO INFARTO MIOCARDICO ACUTO

CLINICAL FEATURES OF PATIENTS WITH ACUTE CORONARY SYNDROME WITHOUT OR WITH DIABETES MELLITUS

CAROTID ATHEROSCLEROTIC LESIONS AS INDICATOR OF SYSTEMIC ATHEROSCLEROSIS

Aortic stenosis: insights on pathogenesis and clinical implications

Aortic stenosis (AS) is a common valvular heart disease in the Western populations, with an estimated overall prevalence of 3% in adults over 75 years. To understand its patho-biological processes represents a priority. In elderly patients, AS usually involves trileaflet valves and is referred to as degenerative calcific processes. Scientific evidence suggests the involvement of an active "atherosclerosis-like" pathogenesis in the initiation phase of degenerative AS. To the contrary, the progression could be driven by different forces (such as mechanical stress, genetic factors and interaction between inflammation and calcification). The improved understanding presents potentially new thera…

Changes of Angiotensin Converting Enzyme (Ace) Levels During Activation of the Renin-Angiotensin-Aldosterone System (RAAs)

The aim of this study was to evaluate the changes of ACE levels during RAAs activation induced by: 1) a continuous graded bicycle ergometer test performed in a group of 15 males health youths aged between 21 and 30 years, with average age of 25.8 +/- 2.85 years; 2) i.m. injection of 20 mg of frusemide in 11 health youths (10 males and 1 female), aged between 20 and 30 years, with average age of 24.09 +/- 2.77 years; 3) dialytic treatment in 25 patients (12 males and 13 females), suffering from chronic renal failure, aged between 26 and 68 years, with average age of 54 +/- 15.42 years. Plasmatic renin activity (PRA), aldosterone (ALD) and ACE levels were determined by RIA in basal conditions…

Pharmacological treatment of patients with chronic critical limb ischemia: L-propionyl-carnitine enhances the short-term effects of PGE-1.

Purpose. To evaluate the therapeutic effects of L-propionyl-carnitine (LPC) in patients with critical limb ischemia (CLI), as defined by the TASC guidelines. Methods. The study, double-blinded, randomised, assessed intravenous infusion of LPC 1.2 g/day in combination with PGE-1, 60 mg/day (LPC group: 37 patients), or PGE-1 only (control group: 38 patients) in a total of 75 patients suffering from CLI. Treatment duration was 20 days. We evaluated rest pain, maximum walking distance (MWD) and skin ulcer size. Results. In both groups we observed a significant reduction in pain score and ulcer size and an increase in MWD. In the patients treated with the combination, the improvement was greater…

Noncompaction of the Right Ventricle

Noncompaction of the ventricular myocardium is a disease characterized by an increase of the ventricular trabecular meshwork caused by arrest of the normal endomyocardial morphogenesis (Figs. 1, 2, 3). In accordance with the normal human anatomy, the left ventricular wall is well compacted with a few thin trabeculae; on the contrary, the normal right ventricular wall is furrowed by many trabeculae (the trabecula of the marginal septum as well as other ones). For this reason, the term ‘‘noncompaction’’ usually refers to an exclusive or prevalent disease of the left ventricle [1–16]. Recently Song and Aragona et al. [1–3] reported two cases of isolated right-ventricular noncompaction. Accordi…

[Cardiovascular risk profile of patients with psoriasis].

The aim of this study was to assess the cardiovascular risk profile of patients with psoriasis compared to patients without psoriasis. A case-control assay was performed using 143 cases (psoriasis patients) and 104 controls (patients without psoriasis). We assessed the presence of hypertension, lipid profile (HDL, triglycerides), diabetes, and body mass index in both cases and controls. Psoriasis patients showed an unfavorable cardiovascular risk profile and a higher risk of cardiovascular events and metabolic syndrome than patients without psoriasis.

RISOLUZIONE DI UN’ENDOCARDITE DA MRSA CON VEGETAZIONE LARGA, MOBILE E COMPLICATA DA STROKE EMBOLICO TRATTATA CON SOLA TERAPIA ANTIBIOTICA COMBINATA

Factor VIII and Antithrombin III in Atherosclerosis Obliterans of the Lower Limbs

In the multifactorial pathogenesis of atherosclerosis (the W.H.O. gives a list of about forty risk factors) recent acquisitions have allowed to determine in part the role carried out by the term “haemocoagulative disorders” (90) showing the possible connections between haematic components of haemocoagulation and vascular wall that up to now have been only hypothesised.

Effects of drug therapy on cardiac arrhythmias and ischemia in hypertensives with LVH.

Left ventricular hypertrophy (LVH) in hypertensive subjects is associated with an increased prevalence of ventricular arrhythmias. To evaluate the effect of antihypertensive treatment on cardiac arrhythmias (CA) and transient episodes of myocardial ischemia (TEMI), we studied 46 hypertensive patients with LVH, divided into four groups randomly treated with enalapril, hydrochlorothiazide (HCTZ), atenolol, or verapamil (SR-V) for 6 months. Office blood pressure and office heart rate values were recorded, in basal conditions, after 1 and 6 months of treatment, and all patients underwent echocardiography, electrocardiographic Holter monitoring, and stress testing. All drugs significantly lowere…

Risk factors for contrast induced nephropathy: A study among Italian patients

This study aimed to make a profile of patients at highest risk of developing contrast induced nephropathy (CIN) in order to take appropriate prevention measures. 591 patients undergoing coronary procedures were divided into two groups: patients with (CIN-group) and without (no-CIN) an increase in creatinine level equal or more than 25% from baseline values within 24-48 h after the coronary procedure. All patients underwent an accurate anamnesis, objective exam, hematochemical measurements, and diagnostic exams. The results of this study while confirming that, average age (p = 0.01), diabetes mellitus (p < 0.0001), base line renal insufficiency (p = 0.0001), diuretic therapy (p = 0.002), hig…

VALUTAZIONE NON INVASIVA DELLA FUNZIONE ENDOTELIALE IN PAZIENTI AFFETTI DALLA MALATTIA DI ANDERSON-FABRY

Prognostic role of aldosterone in patients with acute coronary syndrome: short and medium term follow-up.

AIMS: Different studies have shown a correlation between aldosterone, atherosclerosis and ischemia in the past decade. Evidence exists for the relationship between high levels of aldosterone and augmented risk of cardiovascular diseases, such as hypertension, cardiac failure, coronary artery disease and stroke. The objective of this study was to determine the prognostic role of aldosterone in patients with myocardial infarction. METHODS: The study population included 96 consecutive patients admitted to our department for ST-elevated and non-ST-elevated myocardial infarction from June 2009 to March 2012. Plasma aldosterone levels were measured at admission to hospital in all patients. A 2-ye…

The association between coronary microvascular dysfunction and carotid intima media thickness in patients with cardiac syndrome X

Abstract Objective The aim of this study was to evaluate in patients with cardiac syndrome X (CSX), using validated angiography indices, coronary blood flow and myocardial perfusion of the microcirculation to assess whether there is greater microvascular dysfunction in patients with increase of carotid intima media thickness (C-IMT), compared to those who do not have. Methods Our study was performed on a population 124 patients with CSX that underwent coronary angiography and carotid ultrasound. We divided the sample into two categories: patients with increase of C-IMT and those without increase. We calculated Gibson and Yusuf indices for each patient based on angiographic images, including…

Peripheral atherosclerosis is associated with the occurrence of restenosis after percutaneous coronary intervention

The aim of our study was to evaluate, in patients with proven coronary artery disease (CAD) and treated with elective percutaneous coronary intervention (PCI), whether the coexistence of asymptomatic carotid and femoral atherosclerotic lesions would provide prognostic information in terms of occurrence of restenosis.We studied 104 patients with CAD (M/F=77/27), mean age 60.5+/-9 years. All patients were treated with elective PCI. After PCI the suspicion of restenosis was confirmed by coronary angiography. All patients underwent ultrasound duplex scan of carotid and femoral-popliteal-tibial axis to detect atherosclerotic lesions. According to ultrasound results, patients were classified as n…

A case of ovarian hyperstimulation syndrome (OHSS) associated with the methylenetetrahydrofolate reductase (MTHFR) mutation gene

Influence of carotid peripheral atherosclerosis on the outcome of patients with acute coronary syndrome

ARTERIOSCLEROSI

Zofenopril is a cost-effective treatment for patients with left ventricular systolic dysfunction following acute myocardial infarction: a pharmacoeconomic analysis of the SMILE-4 study

Objective: The Survival of Myocardial Infarction Long-term Evaluation 4 Study (SMILE-4) showed the superiority of Zofenopril (Z) associated with Acetylsalicylic Acid (ASA) as respect to Ramipril (R) plus ASA in reducing the occurrence of major cardiovascular events, in patients with left ventricular dysfunction (LVD) following Acute Myocardial Infarction (AMI). The objective of this retrospective analysis was the evaluation of cost-effectiveness of Z compared to R. Methods: 771 patients with LVD and AMI were randomized, double-blind to Z 60 mg/day (n=389) or R 10 mg/day (n=382) plus ASA 100 mg/day and followed-up for 1 year. The primary study end-point was 1-year combined occurrence of deat…

Hemostatic Alterations in Peripheral Arteriopathies

The most common cause of obliterative disease in limb arteries is slowly progressive arteriosclerosis which is eventually superimposed by thrombosis.

Double-blind, crossover study of the clinical efficacy and the hemorheological effects of pentoxifylline in patients with occlusive arterial disease of the lower limbs.

The effect of a 3 month daily administration of 800 mg pentoxifylline (Trental 400 bds) or placebo was assessed under double blind crossover design in 18 patients (12 males and 6 females) with peripheral occlusive arterial disease in respect of painfree walking distance and various hemorheological and hemostasiological variables, platelet aggregation, serum cholesterol and triglycerides. In first treatment period walking distance significantly increased with pentoxifylline by 46% from baseline 121 ± 15 m and by 4% with placebo from baseline 134 ± 18 m. Pentoxifylline administration furthermore yielded significant decrease in whole blood and plasma viscosity and significant increase in eryt…

IN-HOSPITAL COMPLICATIONS OF ACUTE MYOCARDIAL INFARCTION IN HYPERTENSIVE SUBJECTS

BACKGROUND: Recent studies have shown a worse in-hospital outcome in hypertensive than in normotensive patients with acute myocardial infarction (AMI), which has been attributed to more frequent complications. The aim of this study was to investigate clinical patterns, risk factors, and in-hospital complications in hypertensive and normotensive patients with AMI. METHODS: Of 4994 consecutive patients with AMI admitted to the intensive care unit, hypertensive patients with first infarction (n = 915; mean age 68.8 +/- 11.4 years) and 915 gender- and age-matched normotensive subjects were retrospectively studied. RESULTS: In the univariate analysis, hypertensive subjects presented more frequen…

Clinical findings of Takotsubo cardiomyopathy: results from a multicenter international study

BACKGROUND: Takotsubo cardiomyopathy consists of reversible systolic left ventricular apical ballooning associated with chest pain. Electrocardiographic abnormalities and the minimal rise of serum cardiac markers are similar to those in acute myocardial infarction, but without evidence of myocardial ischemia or injury. To date, many reports concerning this kind of acute reversible heart failure have been published, but the information available about the management of affected patients is scarce and the clinical data are incomplete. AIMS: In the present study, we report a collection of 40 patients who were affected by Takotsubo cardiomyopathy obtained in a multicentric international study, …

Women and peripheral arterial disease: same disease, different issues

Objectives Atherosclerosis is a multifactorial disease and, thus, its clinical manifestations are likely to present gender-specific differences with respect to their development, course, symptom complexes and prognosis. The present study aimed to examine sex differences in peripheral arterial disease (PAD) and its clinical correlates. Methods PAD severity, quality of life (assessed by ST-22), cardiovascular risk factors, inflammatory profile and comorbidity were assessed in 163 men and 68 women who were consecutively diagnosed with PAD at three Italian University vascular centres. Results Compared to men, women showed a higher prevalence of critical limb ischemia (P = 0.018), but had a less…

ATTUALITA’ SUL TRATTAMENTO CON STATINE

LETTER TO THE EDITOR.

RISCHIO CARDIOVASCOLARE GLOBALE E VASCULOPATIE PERIFERICHE

THE CHRONIC HEART FAILURE IS NOT SO FREQUENT IN NON-COMPACTATION

40 Slices MDCT Non-Invasive Diagnostic Approach to Coronary Artery Disease

CAROTID INTIMAL-MEDIAL THICKNESS AND ENDOTHELIAL FUNCTION IN YOUNG ADULT PATIENTS WITH MYOCARDIAL INFARCTION.

The treatment of venous leg ulcers: a new therapeutic use of iloprost

Background: We conducted a study using an intravenous (i.v.) infusion of iloprost in the treatment of venous ulcers to verify whether the association of i.v. iloprost + local therapy + elastic compression has a favorable effect when compared with traditional treatment with local therapy and elastic compression. Study Design: We evaluated the effects of iloprost in 98 consecutive patients with noncomplicated venous ulcers of lower limbs subdivided into 2 groups: the first group (48 patients) received iloprost in saline solution for 3 weeks and the second group (50 patients) received a venous infusion of a saline solution. The patients were examined at baseline time 0 (first visit) and then a…

Bifocal stimulation in patient with congenitally corrected transposition of great vessels

Congenitally corrected transposition of the great vessels (CCTGV) is a rare congenital heart defect associated with multiple cardiac morphological abnormalities and conduction defects. Complete atrioventricular (AV) block occurs in 30% of patients and it may be present at birth or develop later with a rate of 2% per year; moreover, a systemic right ventricle is frequently characterized by heart failure in adult life. We used a bifocal cardiac stimulation for a young woman affected by CCTGV and atrioventricular Mobitz 2 and 2:1 block, considering structural, anatomic condition, and the high rate of pacing she underwent

Patients with acute chest pain, elevated troponin and normal coronary arteries, could be the Cardiovascular Magnetic Resonance advantageous?

RUOLO DEI FATTORI DI RISCHIO TRADIZIONALI E DELLA PROTEINA-C REATTIVA NELLA PATOGENESI DELLA DISFUNZIONE ENDOTELIALE

Relationship between epicardial fat and diastolic dysfunction in obese subjects: an echocardiographic study

Cardiovascular prevention for our time

No abstract available

LA PREVENZIONE DELLA CARDIOPATIA ISCHEMICA

The planimetric Grothoff's criteria by cardiac magnetic resonance can improve the specificity of left ventricular non-compaction diagnosis in thalassemia intermedia

We differentiated the left ventricle non-compaction (LVNC) from hypertrabeculated myocardium due to a negative remodeling in thalassemia intermedia (TI) patients applying linear and planimetric criteria and comparing the cardiovascular magnetic resonance (CMR) findings. CMR images were analyzed in 181 TI patients enrolled in the Myocardial Iron Overload in Thalassemia Network and 27 patients with proved LVNC diagnosis. The CMR diagnostic criteria applied in TI patients were: a modified linear CMR Petersen’s criterion based on a more restrictive ratio of diastolic NC/C &gt; 2.5 at segmental level and the combination of planimetric Grothoff’s criteria (percentage of trabeculated LV myocardial…

PREVALENCE OF INTIMAL MEDIA THICKNESS AND PLAQUE IN CAROTID ARTERIES ACCORDING TO TRADITIONAL CARDIOVASCULAR RISK FACTORS IN A MEDITERRANEAN POPULATION ASYMPTOMATIC FOR CARDIOVASCULAR DISEASE

Usefulness of coronary angiography with multidetector computed tomography in the evaluation of aorto-coronary bypass patency

Angioplastica percutanea con stent in pazienti con concomitante sindrome da fdurto vertebro-succlaveare e coronario-succlaveare

Angioplastica percutanea e stent nel trattamento delle lesioni steno-obliteranti della succlavia sinistra in sogetti conm furto coronarop e vertebro-succlaveare.

[Forty-slice multidetector computed tomography for non-invasive diagnostic approach to coronary artery disease]

IL MIOCARDIO NON COMPATTATO: UNA SERIE DI 177 CASI DEL REGISTRO ITALIANO DELLA SOCIETA’ ITALIANA DI ECOGRAFIA CARDIOVASCOLARE

Infarto miocardico acuto e contraccezione orale.: un caso clinico

Prognostic impact of hypertension and carotid lesions in a five years follow-up

Bicuspid aortic valve and unruptured sinus of Valsalva aneurysm, a rare association

Bicuspid aortic valve (BAV) is one of the most common forms of congenital heart defect and is associated with other congenital vascular and cardiac defects. The most common comorbidity is dilation of thoracic aorta and clinical manifestations are usually related to function of the aortic valve and to other cardiovascular acquired complications. Sinus of Valsalva aneurysm (SVA) is an uncommon congenital cardiovascular anomaly and the combination of these two anomalies is very rare. Common complications are rupture and obstruction of the termination chamber due to space-occupying effect of large unruptured aneurysms. Early cardiac imaging can help limiting morbidity and mortality in these pat…

ASSOCIAZIONE TRA ATEROSCLEROSI CAROTIDEA E MALATTIA CORONARICA: ECO-COLORDOPPLER DEI TRONCHI SOVRAORTICI E CORONAROGRAFIA A CONFRONTO IN PAZIENTI CON DOLORE TORACICO

Magnetic resonance in isolated noncompaction of the ventricular myocardium

Abstract Non-compaction of the ventricular myocardium (LCVM) is a rare disorder of myocardial morphogenesis usually diagnosed in paediatric age. The diagnosis was echocardiographically made on the basis of a reported spongeous/compacted ratio >2 in one or more segments of the left ventricle during the diastolic period. We aimed to test the diagnostic accuracy of cardiovascular magnetic resonance (CMR) imaging in distinguishing pathological left ventricular non-compaction. Methods We collected a consecutive series of 8 patients, 5 males and 3 females, with a mean age of 14.9 years with non-compaction of left ventricular myocardium. All patients were admitted in our divisions of cardiology. I…

Significato clinico e prognostico dell'aterosclerosi carotidea nella valutazione del rischio cardiovascolare globale

TRIAL FIBRILLATION AND COGNITIVE IMPAIRMENT

Chemotherapy cardiotoxicity: cardioprotective drugs and early identification of cardiac dysfunction.

Background: Chemotherapy cardiotoxicity is an emerging problem and it is very important to prevent cardiac dysfunction caused by anticancer drugs. The aim of this study was to assess the alterations of the cardiac function induced by chemotherapy in a follow-up of 2 years and to evaluate the cardioprotective role of angiotensin-converting enzyme inhibitors (ACEIs) in the prevention of cardiac dysfunction. Methods: A prospective study was carried out using patients with breast cancer (85 women; median age 57W12years) and other inclusion and exclusion criteria. On the basis of treatment, patients were divided into six groups: fluorouracil-epirubicincyclophosphamide, FEC (group A); FEC and tra…

DO MARKERS OF PRECLINICAL ATHEROSCLEROSIS INFLUENCE GLOBAL CARDIOVASCULAR RISK?

DO MARKERS OF PRECLINICAL ATHEROSCLEROSIS INFLUENCE GLOBAL CARDIOVASCULAR RISK?

Prognosis in patients with microvascular angina: A clinical follow-up

A new clinical classification (V.I.A.) of hypertensive heart disease: our experience

VENTRICULAR DYSFUNCTION AND NUMBER OF NON COMPACTED SEGMENTS IN NON COMPACTION: NON-INDEPENDENT PREDICTORS

VENTRICULAR DYSFUNCTION AND NUMBER OF NON COMPACTED SEGMENTS IN NON COMPACTION: NON-INDEPENDENT PREDICTORS BACKGROUND: Isolated ventricular noncompaction (IVNC) is characterized by multiple prominent trabeculations and deep intertrabecular recesses. Some reports prove that the chronic heart failure may occur in approximately half of the patients. In this report we investigate the correlation between the number of non compacted segments and entity of systolic dysfunction from the registry and subregistries of the SIEC. METHOD: To identify the correlation between ventricular dysfunction and number of segments involved in non compaction we evaluated a consecutive series of 238 patients affecte…

ROLE OF INFLAMMATION OF PATIENTS WITH SUBCLINICAL ATHEROSCLEROSIS

IDIOPHATIC MONOMORPHIC VENTRICULAR TACHYCARDIA AND SYMPATHETIC IMBALANCE

IDIOPHATIC MONOMORPHIC VENTRICULAR TACHYCARDIA AND SYMPATHETIC IMBALANCE

Dangerous ratio modification of plasma and erythrocyte S-adenosylmethionine/S-adenosylhomocysteine in cardiovascular disease

MANAGEMENT OF CHILDREN AFFECTED BY ATRIOVENTRICULAR NODAL RE-ENTRANT TACHICARDIA

MANAGEMENT OF CHILDREN AFFECTED BY ATRIOVENTRICULAR NODAL RE-ENTRANT TACHICARDIA

TASC II - DOCUMENTO DI CONSENSO INTERSOCIETARIO TRANSATLANTICO PER IL TRATTAMENTO DELLA MALATTIA VASCOLARE PERIFERICA

NONCOMPACTION OF THE LEFT VENTRICULAR MYOCARDIUM IN CHILDREN: CLINICAL AND PHYSIOPATHOLOGIC FEATURES

Fazio, G; Novo, S; Zito, R; Icona, MA; Marchì, S; Mongiovì, S; Gagliano, S; Pipitone, S

INTIMA-MEDIA THICKENING AND ASYMPTOMATIC CAROTID PLAQUE AS MARKER OF FUTURE CEREBRO- AND CARDIOVASCULAR EVENTS