ATEROSCLEROSI CAROTIDEA E PERIFERICA E RESTENOSI CORONARICA DOPO ANGIOPLASTICA PERCUTANEA.

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

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

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.

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.

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

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

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.

Carotid Artery Disease in the Era of Biomarkers: A Pilot Study

The intima-media thickness (IMT) and its irregularities or ulcerations in the common carotid artery (CCA) are useful tools as sentinel biomarkers for the integrity of the cardiovascular system. Total homocysteine and lipoprotein levels are the most commonly used elements in cardiovascular risk stratification. Duplex ultrasound (DUS), associated with serum biomarkers, can be used simply to assess the degree of atherosclerotic disease and cardiovascular risk. This study highlights the role of different kinds of biomarkers, showing their usefulness and potentiality in multi-district atherosclerotic patients, especially for early diagnosis and therapy effectiveness monitoring. A retrospective a…

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

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

Clinical value of Multislice CT Coronary Angiography in a cohort of asymptomatic high risk patients with dysmetabolic syndrome

Impatto dell'anemia sulla prognosi dei pazienti sottoposti a PCI

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

Non previsto.

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

Comprehensive cardiovascular ECG-gated MDCT as a standard diagnostic tool in patients with acute chest pain

Acute myocardial infarction, pulmonary embolism, and aortic dissection are diseases associated with acute chest pain and may lead to severe morbidity and mortality. These diseases may not be trivial to diagnose in the settings of emergency room. ECG-gated multi-detector computed tomography (MDCT), already established for the assessment of pulmonary embolism and aortic dissection, provides reliable information regarding the triage of patients with acute coronary syndrome in the emergency room. MDCT recently appeared to be logistically feasible and a promising comprehensive method for the evaluation of cardiac and non-cardiac chest pain in emergency department patients. The possibility to sca…

MULTIFOCAL ATHEROSCLEROSIS INFLUENCE THE OUTCOME OF PATIENTS UNDERWENT TO PRIMARY PTCA

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…

Myocardial infarction with non-obstructive coronary arteries (MINOCA): Intracoronary imaging-based diagnosis and management.

Myocardial infarction with non-obstructive coronary arteries (MINOCA) is defined by clinical evidence of myocardial infarction (MI) with normal or near-normal coronary arteries on angiography. This condition is present in about 5% to 25% of patients presenting with acute coronary syndromes. MINOCA is a working diagnosis. Current guidelines and consensus recommend identification of underlying causes of MINOCA in order to optimize treatment, improve prognosis, and promote prevention of recurrent myocardial infarction. An accurate evaluation of patient history, symptoms and use of invasive and non-invasive imaging should lead to identification of epicardial or microvascular causes of MINOCA an…

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…

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

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…

MULTIFOCAL ATHEROSCLEROSIS INFLUENCE THE UTCOME OF PATIENTS UNDERWENT TO PRIMARY PTCA

ACCURATEZZA DIAGNOSTICA DELLA TC 40 STRATI IN PAZIENTI CON DOLORE TORACICO

[Cardiovascular health in Asian immigrants to Italy: risk factors, pathogenesis and pharmacological treatment].

In the last decades a significant increase of the migratory phenomenon from South Asian countries to the western world has occurred due to several factors, such as economic crisis, political instabilities, persecutions and wars. It is well established that South Asians (SA) have a higher prevalence of coronary artery disease (CAD) and premature onset of myocardial infarction episodes than other populations. This higher predisposition might be caused by genetic factors, common in both SA residing in their birth country and in those residing abroad, but it may also be due to the new spatial environment in which they live. We have found a higher prevalence of traditional cardiovascular risk fa…

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

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…

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.

Giant unruptured circumflex coronary artery aneurysms presenting as acute coronary syndrome

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

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.

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…

CT anatomy of the heart and classification in coronary segments.

Anatomia TC del cuore e classificazione in segmenti coronarici

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

Catheter-based closure of a large atrial septal defect with inferior rim deficiency using pulmonary vein slide-out assisted implantation technique: a case report

Abstract Background Transcatheter approach for large and complex atrial septal defects may represent a therapeutic challenge, particularly when the postero-inferior rim is deficient and floppy. Case summary Here, we describe a successful catheter-based closure of a large (>30 mm) secundum atrial septal defect associated with postero-inferior rim deficiency in a 35-year-old female with congestive heart failure using pulmonary vein slide-out assisted implantation technique. Discussion Inferior–posterior rim deficiency is a well-known risk factor for device instability or embolization. Transcatheter closure may represent a safe and effective alternative to the traditional surgical appro…

Lipid ratios as predictors of subclinical atherosclerosis

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…

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.

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

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…

PREVALENCE OF METABOLIC SYNDROME IN PATIENTS WITH ACUTE CORONARY SYNDROME

PREVALENCE OF METABOLIC SYNDROME IN PATIENTS WITH ACUTE CORONARY SYNDROME

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.…

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

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

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…

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

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.

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 …

Atrial fibrillation and cognitive disorders: An overview on possible correlation

Atrial Fibrillation is the most common cardiac arrhythmia affecting people of all ages, principally the elderly. Cognitive decline and dementia are also prevalent diseases in elderly. The scientific community always showed interest in the possible association between these two pathological entities, both implicating social and economic burden. This has been confirmed by several longitudinal population-based studies. Some studies also revealed that the association between atrial fibrillation and dementia may be not related to history of stroke. Therefore, other pathophysiological mechanisms are likely implicated, so far unclear or undefined. The aim of the present review is to analyse the po…

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

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…

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…

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

Il ruolo del microcircolo nell’eziopatogenesi della Cardiopatia di Takotsubo

RUOLO DELL’ANGIOGRAFIA CORONARICA IN TOMOGRAFIA

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

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

PREVALENCE OF CAROTID LESIONS IN A MEDITERRANEAN POPULTION OF HYPERTENSIVES

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).

Performance diagnostica della TCMD a 64 strati ECG-GATED vs. GATED-SPECT in pazienti a rischio di malattia coronarica intermedio-alto con dolore toracico atipico

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…

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…

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…

Longitudinal Strain Analysis and Correlation with TIMI Frame Count in Patients with Ischemia with No Obstructive Coronary Artery (INOCA) and Microvascular Angina (MVA)

Background: The aim of the study is to evaluate the subclinical alterations of cardiac mechanics detected using speckle-tracking echocardiography and compare these data with the coronary angiography indices used during coronary angiography in a population of patients diagnosed with ischemia with no obstructive coronary artery (INOCA) and microvascular angina (MVA). Methods: The study included 85 patients admitted to our center between November 2019 and January 2022 who were diagnosed with INOCA compared with a control group of 70 healthy patients. A collection of anamnestic data and a complete cardiovascular physical examination, and echocardiogram at rest with longitudinal strain were perf…

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

PREVALENCE OF METABOLIC SYNDROME IN PATIENTS WITH ACUTE CORONARY SYNDROMES

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

EXTRACORONARY ATHEROSCLEROSIS IN PATIENTS WITH CHRONIC ISCHEMIC HEART DISEASE

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…

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…

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=…

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

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…

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

The Role of Early Revascularization and Biomarkers in the Management of Diabetic Foot Ulcers: A Single Center Experience

Diabetic neuropathy and Peripheral Arterial Disease (PAD) are the main etiological factors in foot ulceration. Herein, we report our experience of diabetic foot ulceration (DFU) management, with an analysis of the relationship between the rate of lower extremity amputation, in persons with infected DFU, after revascularization procedures performed to prevent major amputation. This study highlights the role of different biomarkers, showing their usefulness and potentiality in diabetic foot ulcer management, especially for the early diagnosis and therapy effectiveness monitoring. A retrospective analysis, from September 2016 to January 2021, of diabetic patients presenting diabetic foot with …

La preparazione in angiografia coronarica mediante TC a 64 strati nelle donne: una “sfida” per il radiologo?

Coronary embolism in a young patient with nonbacterial thrombotic endocarditis related to antiphospholipid syndrome

myocardial infarction

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

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…

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

Coronary microvascular dysfunction

Patients with coronary microvascular dysfunction (CMVD) represent a widespread population and despite the good prognosis, many of them have a poor quality of life with strong limitations in their daily activities because of the angina symptoms. This article summarizes the most frequent clinical presentation pictures like stable and unstable microvascular angina. Main risk factors are discussed, followed by the latest updates on the subject about different pathogenic hypotheses, diagnosis and treatment. Not very well understood microvascular alterations, like slow flow phenomenon and no reflow are discussed and both prognosis and the impact of the disease in the quality of life are analyzed.

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

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…

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…

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

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

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

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