Italian heart journal : official journal of the Italian Federation of Cardiology最新文献

{"title":"Quadricuspid aortic valve: a rare cause of aortic insufficiency diagnosed by doppler echocardiography. Report of two cases and review of the literature.","authors":"Antonino Recupero,&nbsp;Pietro Pugliatti,&nbsp;Fabrizio Rizzo,&nbsp;Francesco Arrigo,&nbsp;Sebastiano Coglitore","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Quadricuspid aortic valve is an uncommon congenital valve disease mostly occurring as isolated lesion or sometimes in association with truncal anomalies. Approximately 50% of patients with quadricuspid aortic valve have aortic regurgitation. Before the advent of echocardiography most cases were diagnosed at the time of surgery or at post-mortem examination. We describe 2 cases of patients with quadricuspid aortic valve diagnosed by echocardiography. The first case, a quadricuspid aortic valve with four equal-sized cusps (type A, according to the classification of Hurwitz and Roberts), was identified in a 26-year-old man undergoing echocardiography because of a heart murmur. The second case, a quadricuspid aortic valve with three relatively equal cusps and one smaller cusp (type B, according to the classification of Hurwitz and Roberts), was identified in a 47-year-old man with a history of murmur. The identification and periodical non-invasive evaluation of a quadricuspid aortic valve is important, because such valves are more vulnerable to infection and need adequate prophylaxis against endocarditis.</p>","PeriodicalId":80289,"journal":{"name":"Italian heart journal : official journal of the Italian Federation of Cardiology","volume":"6 11","pages":"927-30"},"PeriodicalIF":0.0,"publicationDate":"2005-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25718507","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Illness understanding in adults with congenital heart disease.","authors":"Massimo Chessa,&nbsp;Gabriella De Rosa,&nbsp;Manuela Pardeo,&nbsp;Gabriela Diana Negura,&nbsp;Gianfranco Butera,&nbsp;Vlasta Feslova,&nbsp;Luciane Piazza,&nbsp;Alessandro Giamberti,&nbsp;Eduardo Bossone,&nbsp;Mario Carminati","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Adult patients with congenital heart disease need information regarding their clinical diagnosis, medications and side effects, endocarditis prophylaxis, reproductive issues, employment, future surveillance, treatments, and possible reoperations. Accurate understanding of chronic illness in these patients is associated with less distress, less confusion, improved satisfaction with medical care, better compliance with treatment, and a better emotional status, all key factors for good health-related quality of life. The aim of the present study was to assess the level of knowledge that adult patients with congenital heart disease followed in our Center have about their heart condition.</p><p><strong>Methods: </strong>A questionnaire on knowledge about congenital heart disease was sent by mail to 200 adults affected by a cardiac congenital disease chosen randomly from all patients regularly followed in our department.</p><p><strong>Results: </strong>Patients had good knowledge about the treatment received, the importance of follow-up, the prognosis of their condition, and the possibility of taking part in physical activities. The patients receiving drug treatment were moderately knowledgeable about their treatment. The anatomy of the heart defect, factors contributing to the onset of endocarditis, the impact of smoking and alcohol, and the possible inheritance of the heart condition were poorly understood by the patients. Most of female patients knew that the oral contraceptive pill was the most appropriate method of birth control; most of them were aware that pregnancy would cause additional risks to their health. Multiple logistic analysis showed that four correct answers were related to the age of the patient.</p><p><strong>Conclusions: </strong>Overall the results indicated that the educational efforts of all the staff (physicians and nurses) have given encouraging results, but there are still significant gaps in knowledge that need more educational work.</p>","PeriodicalId":80289,"journal":{"name":"Italian heart journal : official journal of the Italian Federation of Cardiology","volume":"6 11","pages":"895-9"},"PeriodicalIF":0.0,"publicationDate":"2005-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25719199","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[The long way of angiotensin-converting enzyme inhibitors in the fight against cardiovascular diseases].","authors":"Roberto Ferrari,&nbsp;Giuseppe Ambrosio,&nbsp;Massimo Chiariello","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":80289,"journal":{"name":"Italian heart journal : official journal of the Italian Federation of Cardiology","volume":"6 Suppl 7 ","pages":"3S-4S"},"PeriodicalIF":0.0,"publicationDate":"2005-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25861539","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Hypertension, heart failure, myocardial infarction, secondary prevention: the role of perindopril].","authors":"Claudio Rapezzi,&nbsp;Paolo Ciliberti,&nbsp;Maddalena Graziosi,&nbsp;Letizia Riva","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Perindopril is a long-acting, once-daily lipophilic angiotensin-converting enzyme inhibitor with high tissue angiotensin-converting enzyme affinity, lowering angiotensin II and potentiating bradykinin. Efficacy, safety, and tolerability of perindopril are well established in the treatment of hypertension and heart failure. Moreover, large morbidity-mortality trials, such as the EUROPA, PROGRESS, and PREAMI have shown that treatment with perindopril reduces morbidity and mortality and prevents cardiovascular disease in a large range of patients with vascular diseases, whether or not they are hypertensive. Thus, the outcomes of these and other trials support the concept of cardiovascular protective properties of angiotensin-converting enzyme inhibition with perindopril in addition to the obvious blood-pressure-lowering effect. Considering its properties and the clinical evidence on efficacy and tolerability that has been gathered, perindopril should be considered a first-line therapeutic agent in hypertension, heart failure and acute myocardial infarction and a tool of secondary prevention of coronary artery disease.</p>","PeriodicalId":80289,"journal":{"name":"Italian heart journal : official journal of the Italian Federation of Cardiology","volume":"6 Suppl 7 ","pages":"40S-47S"},"PeriodicalIF":0.0,"publicationDate":"2005-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25861544","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Can harvesting techniques modify postoperative results of the radial artery conduit?","authors":"Francesco Onorati,&nbsp;Marisa De Feo,&nbsp;Lucia Cristodoro,&nbsp;Antonio Esposito,&nbsp;Andrea Perrotti,&nbsp;Pasquale Mastroroberto,&nbsp;Attilio Renzulli,&nbsp;Maurizio Cotrufo","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Inappropriate harvesting of arterial conduits can lead to severe postoperative complications. We analyzed clinical and functional results of patients undergoing radial artery (RA) harvesting by means of three techniques.</p><p><strong>Methods: </strong>From January 2001 to January 2004 188 patients undergoing coronary artery bypass graft with RA were divided into three groups: harmonic scalpel was employed in 61 (RA1), electrocautery in 63 (RA2), Potts-scissors and clips in 64 (RA3) patients. Harvesting time, local complications, number of clips employed, graft flowmetry, postoperative troponin I, incidence of re-exploration for bleeding due to the graft were analyzed.</p><p><strong>Results: </strong>RA1 and RA2 showed a lower harvesting time (RA1 16.2 +/- 8.4 vs RA3 41.4 +/- 7.7 min, p = 0.0001; RA2 21.1 +/- 10.4 min, p = 0.001). Postoperative hand paresthesia was detected in RA1 (5/61; 8.2%) and RA2 (5/63; 7.9%), but not in RA3 (p = 0.048 and p = 0.05, respectively). More clips were necessary in RA3 compared to RA2 (p = 0.04) or RA1 (p = 0.0001 vs RA3; p = 0.001 vs RA2). RA1 showed significant higher values of maximum flow (RA1 59.4 +/- 37.5 vs RA2 22.1 +/- 7.7 ml/min, p = 0.0001; vs RA3 31.3 +/- 12.0 ml/min, p = 0.001), mean flow (RA1 23.4 +/- 17.3 vs RA2 10.2 +/- 5.7 mi/min, p = 0.001; vs RA3 11.6 +/- 8.9 ml/min, p = 0.001), minimum flow (RA1 11.6 +/- 6.5 vs RA2 4.2 +/- 3.7 ml/min, p = 0.01; vs RA3 4.7 +/- 3.3, p = 0.03), and pulsatility index (RA1 0.9 +/- 0.8 vs RA2 2.1 +/- 1.3, p = 0.03; vs RA3 1.7 +/- 2.1, p = 0.04). Troponin I was significantly lower in RA1, compared to RA2 and RA3 at 12 hours (p = 0.01 and p = 0.03, respectively) and 24 hours (p = 0.05 and p = 0.045, respectively). No RA1 patient underwent re-exploration for bleeding compared to RA2 (p = 0.011) and RA3 (p = 0.02).</p><p><strong>Conclusions: </strong>RA harvesting with ultrasounds is fast, determines high flowmetry values, low enzyme release and rarely causes local complications.</p>","PeriodicalId":80289,"journal":{"name":"Italian heart journal : official journal of the Italian Federation of Cardiology","volume":"6 11","pages":"911-6"},"PeriodicalIF":0.0,"publicationDate":"2005-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25718503","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A complete atrioventricular block secondary to myocardial metastases of lung cancer. A case report.","authors":"David Mocini,&nbsp;Raffaele Longo,&nbsp;Furio Colivicchi,&nbsp;Alessandro Morabito,&nbsp;Giampietro Gasparini,&nbsp;Massimo Santini","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>A metastatic involvement of the heart is an uncommon phenomenon in clinical practice; it is more frequent in patients with end-stage disease and a wide tumor spread. The clinical diagnosis is very difficult because there are no early symptoms and most often, the presence of metastases in other sites, such as lung and lymph nodes, may determine a misunderstanding of the clinical picture. We report the case of a young male (44 years old) with a complete atrioventricular block due to metastatic myocardial involvement from a primary occult lung cancer. The first symptom of the disease was a syncopal spell. In spite of permanent pacemaker implantation, the patient died suddenly and unexpectedly after 3 days. Autopsy revealed an anaplastic carcinoma of the right lung hilus. The myocardium was invaded by numerous metastatic nodules, particularly in the interventricular septum and in the left ventricular wall.</p>","PeriodicalId":80289,"journal":{"name":"Italian heart journal : official journal of the Italian Federation of Cardiology","volume":"6 11","pages":"931-2"},"PeriodicalIF":0.0,"publicationDate":"2005-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25718508","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Tako-tsubo: a transitory impairment of microcirculation? A case report.","authors":"Cristina Malafronte,&nbsp;Andrea Farina,&nbsp;Angela Tempesta,&nbsp;Elisabetta Lobiati,&nbsp;Roberto Galbiati,&nbsp;Edoardo Cantù,&nbsp;Luigi Piatti,&nbsp;Luigia Florimonte,&nbsp;Lorenzo Maffioli,&nbsp;Felice Achilli","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>The tako-tsubo syndrome, or transient left ventricular apical ballooning, has been widely described in Japan as a cardiomyopathy which resembles acute myocardial infarction on presentation, but characterized by a normal coronary tree and a favorable outcome. Conversely few series have been described in Europe and etiology and mechanism are still unknown. We describe the case of a 74-year-old Italian woman with tako-tsubo cardiomyopathy, one of the first Italian cases reported to our knowledge. In the acute phase, echocardiography and ventriculography showed the typical mid-apical systolic left ventricular dysfunction, with an angiographically normal coronary tree. A few days after, technetium-99m single-photon emission computed tomography disclosed a large mid-apical perfusion defect and dobutamine stress echocardiography showed a typical \"biphasic\" response. Three months later, all of these tests normalized with normal left ventricular function. In conclusion, the results of functional tests, during the acute and subacute phases, suggest that, in the absence of evident coronary spasm, a transitory reduction of the coronary reserve played a role in the pathogenesis. In the absence of epicardial coronary obstruction this could be due to a transient microcircle dysfunction, and may be attributed to a spasm followed by impaired vasodilation capability.</p>","PeriodicalId":80289,"journal":{"name":"Italian heart journal : official journal of the Italian Federation of Cardiology","volume":"6 11","pages":"933-8"},"PeriodicalIF":0.0,"publicationDate":"2005-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25718509","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Rationale, characteristics and study design of PREAMI (Perindopril and Remodelling in the Elderly with Acute Myocardial Infraction)].","authors":"Giulia Magrini,&nbsp;Gian Luigi Nicolosi,&nbsp;Massimo Chiariello,&nbsp;Roberto Ferrari,&nbsp;Pim Remme,&nbsp;Luigi Tavazzi","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Angiotensin-converting enzyme (ACE) inhibitors reduce mortality and morbidity in patients with heart failure and/or left ventricular systolic dysfunction and in patients with acute myocardial infarction (AMI), especially those with heart failure and/or evidence of left ventricular systolic dysfunction. ACE-inhibitors prevent cardiac events in patients at high cardiovascular risk and/or with documented coronary artery disease. There is a lack of data on the role of ACE-inhibitors in the elderly population with AMI and preserved left ventricular function. Nevertheless, the issue is of primary importance, considering the median age of patients with AMI and heart failure, the high risk of death, heart failure and left ventricular remodeling in the elderly, and the progressive aging of the general population. The multicenter and international (109 centers from five European countries), double-blind, randomized, parallel PREAMI (Perindopril and Remodelling in the Elderly with Acute Myocardial Infarction) trial evaluated the effects of the ACE-inhibitor perindopril in the elderly (aged > or =65 years) with AMI and preserved or mildly depressed left ventricular systolic function (ejection fraction > 40%). The combined primary endpoint was death, hospitalization for heart failure, and left ventricular remodeling (considered as an increase in left ventricular end-diastolic volume > or = 8%). Secondary endpoints included: each single primary endpoint, cardiovascular death, hospitalization for reinfarction or angina, and revascularization. The study involved 1252 patients, with an average age of 73 years, and AMI, treated with recommended usual therapy (antithrombotic drugs, beta-blockers, ACE-inhibitors). After 11 +/- 4 days from AMI, patients were randomized to receive either perindopril (4 mg/day for the first month and 8 mg/day for the remaining 11 months) or placebo, in addition to the recommended conventional therapy. Clinical assessment was performed at fixed times and included two-dimensional echocardiography (to evaluate left ventricular remodeling), Holter electrocardiographic monitoring (to assess heart rate variability and arrhythmias), and blood sampling (for safety evaluation). This review provides details on the background, rationale and study design of PREAMI.</p>","PeriodicalId":80289,"journal":{"name":"Italian heart journal : official journal of the Italian Federation of Cardiology","volume":"6 Suppl 7 ","pages":"14S-23S"},"PeriodicalIF":0.0,"publicationDate":"2005-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25861541","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Workshop II--Clinical and therapeutic pathways].","authors":"","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":80289,"journal":{"name":"Italian heart journal : official journal of the Italian Federation of Cardiology","volume":"6 Suppl 6 ","pages":"12S-26S"},"PeriodicalIF":0.0,"publicationDate":"2005-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25866187","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Current perspectives modern hemodynamic evaluation of the pulmonary circulation. Application to pulmonary arterial hypertension and embolic pulmonary hypertension.","authors":"Robert Naeije,&nbsp;Dario Vizza","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>The hemodynamic evaluation of the pulmonary circulation normally includes the measurements of mean pulmonary artery pressure and a calculation of pulmonary vascular resistance (PVR). The definition of PVR can be improved by the measurements of pulmonary vascular pressures at several levels of flow to derive a pressure-flow line, and the site of PVR can be identified by the analysis of pulmonary artery pressure decay curves after balloon occlusion. An analysis of the morphology of pulmonary artery pressure and flow waves informs about right ventricular (RV) hydraulic load. As pulmonary hypertension is clinically a right heart failure syndrome, it is important to measure the coupling of RV to pulmonary arterial function. This can be done using a single beat method with sampling and synchronization of instantaneous pulmonary artery flow and RV pressure to calculate a ratio of end-systolic to arterial elastances. The optimal value of this ratio is depressed in minimally symptomatic pulmonary arterial hypertension patients, indicating pending right heart failure.</p>","PeriodicalId":80289,"journal":{"name":"Italian heart journal : official journal of the Italian Federation of Cardiology","volume":"6 10","pages":"784-8"},"PeriodicalIF":0.0,"publicationDate":"2005-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25686553","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}