Management of Atrial Fibrillation Suppression in AF-HF Comorbidity Therapy (MASCOT) Trial

Inter- [1,2], intra- [3,4], and atrioventricular [51(AV) dyssynchrony are not new concepts, but only recently have attempts been made to correct these disorders in an effort to treat heart failure (HF). A series of trials [6] has addressed partial or comprehensive cardiac resynchronization in patients with severe HF and evidence of cardiac dyssynchrony. Cardiac resynchronization should improve left ventricular (LV) performance; several trials [7-10] have demonstrated improvement in many hemodynamic parameters (LV and aortic pressure, shortening of mitral diastolic regurgitation, synchronized LV and atrial systole, LV volume, reduced myocardial oxygen consumption) and clinical end-points (qu…

Elastase in young subjects with acute myocardial infarction: Evaluation at the initial stage and after 12 months

P-364 Effectiveness and safety of transvenous ICD leads extraction

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

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

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

Carotid and peripheral atherosclerosis in patients who underwent primary percutaneous coronary intervention and outcome associated with multifocal atherosclerosis.

AIM: The aim of our study was to determine if patients with multifocal atherosclerosis have a worse prognosis than patients with atherosclerosis only in the coronary bed. METHODS: We studied 45 subjects admitted to intensive coronary care unit of the Division of Cardiology with the diagnosis of acute myocardial infarction (AMI). Traditional cardiovascular risk factors were investigated and laboratory analysis included measurement of plasma lipids, glycemia, fibrinogen and high-sensitivity-C-reactive protein (hs-CRP). Each patient underwent coronary-angiography as well as carotid and peripheral arterial ultrasound examination. A follow-up of 13+/-2 months was performed. RESULTS: We found tha…

Polymorphonuclear leukocyte membrane fluidity and cytosolic Ca2+ content in young adults with acute myocardial infarction. Evaluation at the initial stage and after 12 months

Our aim was to examine two aspects of polymorphonuclear leukocyte (PMN) rheology (membrane fluidity and cytosolic Ca2+ content), at baseline and after in vitro activation, in a group of young adults with acute myocardial infarction (AMI) at the initial stage and after 12 months. We enrolled 21 AMI subjects aged < or = 45 years (mean age 41.1 +/- 3.5 years) and evaluated PMN membrane fluidity, labelling intact PMN cells with the fluorescent probe 1,4-(trimethylamino)-phenyl-4-phenylhexatriene and the PMN cytosolic Ca2+ content marking PMN cells with the fluorescent probe Fura 2-AM, at baseline and after in vitro activation with 4-phorbol 12-myristate 13-acetate (PMA) and N-formyl-methionyl-l…

Can Ventricular Resynchronization Reduce Atrial Fibrillation Recurrences?

In recent years a new pacing therapy has been proposed for patients affected by heart failure (HF) in order to reduce inter- [1,2], intra- [3,4], and atrioventricular [5] (AV) dyssynchrony. Cardiac resynchronization therapy (CRT) has the goal of correcting these hemodynamic disorders, thus improving left ventricular (LV) performance. The benefits of CRT have been evaluated in a series of clinical trials [6-10].

Sleep Apnea: New Insights

Sleep apnea is the most common disorder of breathing during sleep. It is defined as repeated episodes of obstructive apnea and hypopnea during sleep, together with daytime sleepiness or altered cardiopulmonary function [1]. There are three syndromes of upper airway closure during sleep: obstructive sleep apnea (OSA), obstructive sleep hypopnea, and upper airway resistance. These three syndromes share two features: excessive daytime sleepiness and arousal associated with increased ventilatory effort in response to upper airway closure. The specific sites of narrowing or closure and upper airway dysfunction are influenced by the underlying neuromuscular tone, upper airway muscle synchrony, an…

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

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

Extracoronary atherosclerosis in patients with chronic ischemic heart disease: Relationship with risk factors and the severity of coronary artery disease

AIM: The aim of the present study was to investigate the prevalence of carotid and/or peripheral atherosclerotic lesions in patients with chronic ischemic heart disease (previous acute myocardial infarction [AMI] or stable angina). METHODS: We studied 248 patients (168 male and 80 female), mean age 63+/-10 years, which were investigated for traditional risk factors. Systolic blood pressure, body mass index, lipid profile, fasting glucose and plasma fibrinogen were also measured. We assessed the prevalence of atherosclerotic lesions in carotid and lower limb arteries, by ultrasound duplex scanning (UDS). RESULTS: Angina was present in 33% of the patients, a previous AMI in 67%, a previous tr…

Plasma markers of platelet and polymorphonuclear leukocyte activation in young adults with acute myocardial infarction

Our goal was to evaluate some plasma markers of platelet and polymorphonuclear leukocyte (PMN) activation in a group of young adults with acute myocardial infarction (AMI) at the initial stage and after three months. We enrolled 49 AMI subjects aged<45 years and examined plasmatic levels of platelet factor 4 (PF4), β-thromboglobulin (β-TG), elastase and myeloperoxidase (MPO) using ELISA methods. PF4 and β-TG were increased, compared to control subjects, both at the initial stage and after 3 months. In control subjects and in AMI patients, at both times of observation, there was a significant and positive correlation between the two platelet parameters, while no correlation was present betwe…

Radiäre Optikusneurotomie (RON) bei retinalen Zentralvenenverschlüssen

Background Compression in the lamina cribrosa is discussed as a reason for central retinal vein occlusion. Radial optic neurotomy should release the pressure and increase venous blood outflow. Patients and methods In a clinical trial 27 eyes with central retinal vein occlusion (22 eyes with clinical ischaemia, 5 eyes with continuous disc oedema and visual acuity below 4/10) underwent surgical decompression by vitrectomy and radial optic neurotomy. During surgery the intravenous pressure in the central vein was tested by infusion dynamometry before and right next to the incision. Follow up-time minimally was 1.5 years. Results Infusion dynamometry demonstrated a decrease of the central vein …

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

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

Ruolo del recettore TLR4 nell’infarto e nella longevità