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

{"title":"[Sirolimus-eluting stent for in-stent restenosis treatment: single center results in an unselected study population].","authors":"Francesco Bellandi,&nbsp;Anna Toso,&nbsp;Mauro Maioli,&nbsp;Mario Leoncini,&nbsp;Roberto Piero Dabizzi","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Sirolimus-eluting stents have already proved to be efficient in the prevention of restenosis in de novo lesions and have been already proposed as a potential treatment of in-stent restenosis. In the present study, we evaluated the effectiveness of sirolimus-eluting stent implantation in unselected patients with in-stent restenosis.</p><p><strong>Methods: </strong>Fifty consecutive patients (59 lesions) were treated with sirolimus-eluting stents for instent restenosis. The incidence of major adverse cardiovascular events and restenosis was evaluated at 1-year clinical and angiographic follow-up.</p><p><strong>Results: </strong>At baseline, 54% of the lesions were complex (46% proliferative and 8% total occlusions). Small vessel size (< or = 2.5 mm) was present in 30%, a long lesion (> 20 mm) in 25%, and diabetes in 42% of the patients. The angiographic follow-up was obtained in 47 patients (55 lesions). Restenosis was observed in 13% of the lesions. At the 1-year follow-up, the incidence of major adverse cardiovascular events was 16% (4% acute myocardial infarction, 12% target lesion revascularization).</p><p><strong>Conclusions: </strong>This study confirms the efficacy of sirolimus-eluting stents for the treatment of instent restenosis in an unselected population of consecutive patients at high risk of restenosis and with a broad range of morphological lesion patterns.</p>","PeriodicalId":80290,"journal":{"name":"Italian heart journal. Supplement : official journal of the Italian Federation of Cardiology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2005-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25683613","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":"[Use of imaging in the evaluation of heart transplant recipients].","authors":"Benedetta De Chiara,&nbsp;Elèna Roubina,&nbsp;Maria Frigerio,&nbsp;Oberdan Parodi","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Common complications after heart transplantation include acute rejection and coronary allograft vasculopathy. In order to detect the presence of rejection, tissue Doppler imaging echocardiography provides high accuracy and allows to optimize the timing of endomyocardial biopsies, which remain the cornerstone in rejection diagnosis. Coronary allograft vasculopathy is often a diffuse disease so that it is difficult to recognize by imaging modalities, such as myocardial perfusion scintigraphy, which are based on intra-patient comparison of different areas. Quantitative assessment of the myocardial blood flow by positron emission tomography overcomes this issue. Dobutamine stress echocardiography provides accurate diagnosis as well as useful prognostic information. Nevertheless, intracoronary ultrasound is nowadays considered the gold standard for vasculopathy assessment, since it is able to detect a minimum intimal thickening which represents the early feature of disease. Magnetic resonance represents the most attractive approach, though it has not yet gained widespread clinical use.</p>","PeriodicalId":80290,"journal":{"name":"Italian heart journal. Supplement : official journal of the Italian Federation of Cardiology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2005-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25683100","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":"[Cardiological protocols on evaluation of fitness for competitive sports].","authors":"Pietro Delise,&nbsp;Umberto Guiducci,&nbsp;Paolo Zeppilli,&nbsp;Luigi D'Andrea,&nbsp;Cesare Proto,&nbsp;Roberto Bettini,&nbsp;Alessandro Villella,&nbsp;Giovanni Caselli,&nbsp;Franco Giada,&nbsp;Antonio Pelliccia,&nbsp;Maria Penco,&nbsp;Gaetano Thiene,&nbsp;Antonio Notaristefano,&nbsp;Antonio Spataro","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":80290,"journal":{"name":"Italian heart journal. Supplement : official journal of the Italian Federation of Cardiology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2005-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25008303","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":"[Atherosclerosis imaging to assess plaque progression].","authors":"Paolo Raggi,&nbsp;Antonio Bellasi","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Cardiovascular disease is the first cause of morbidity and mortality for both men and women in developed countries. Tracking the progression of the atherosclerotic plaque appears to be an effective way to predict modification of risk in individual patients. Quantitative coronary angiography was initially proposed as a method of choice to assess coronary disease progression. With this methodology it was possible to demonstrate a strong association of plaque regression with reduction in adverse cardiovascular outcomes. More recently, the focus of research has turned to the development of noninvasive modalities to image the atherosclerotic plaque in its preclinical stages and to evaluate the effectiveness of preventive therapies with sequential imaging. The ease of performance of these tests enabled their use as intermediate endpoints in clinical trials to test new strategies to treat atherosclerosis. If proven successful, these imaging tools may allow a reduction in size and duration of clinical trials with a substantial cost benefit for society.</p>","PeriodicalId":80290,"journal":{"name":"Italian heart journal. Supplement : official journal of the Italian Federation of Cardiology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2005-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25299843","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 early management of ST-elevation acute myocardial infarction in the Lombardy Region (GestIMA)].","authors":"Luigi Oltrona,&nbsp;Antonio Mafrici,&nbsp;Maurizio Marzegalli,&nbsp;Cesare Fiorentini,&nbsp;Roberto Pirola,&nbsp;Antonio Vincenti","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Recent international and national surveys on the management of ST-elevation myocardial infarction have described a number of crucial issues regarding the prehospital phase, the criteria to address patients to primary angioplasty, the organization of interhospital transfers. GestIMA is a perspective survey organized by the Lombardy Sections of the Italian Cardiology Societies (ANMCO and SIC) aimed to investigate the management of the acute phase of myocardial infarction in the Lombardy Region.</p><p><strong>Methods: </strong>Between October 15 and November 14, 2003, consecutive patients hospitalized for ST-elevation myocardial infarction in the coronary care units of 60 hospitals in Lombardy were enrolled into the study.</p><p><strong>Results: </strong>Among 612 patients (median age 67 years, interquartile range 56-76 years, 68% males, 43% with acute anterior myocardial infarction), 43% reached the hospital using the 118 emergency medical service, in 20% an ECG was recorded before arrival (reported in 47%), 1.5% were treated with thrombolysis and 1.0% with glycoprotein IIb/IIIa inhibitors before hospital admission. Sixty-eight percent of patients underwent a reperfusion treatment: 43% with primary angioplasty (6% facilitated), 25% with thrombolysis (18% of them had rescue angioplasty). Primary angioplasty was mainly performed in younger patients and in those directly admitted to centers equipped with interventional facilities. During the acute phase of myocardial infarction, 10% of patients arrived to the coronary care units from 39 peripheral hospitals without coronary care unit; 21% of patients had a secondary transport between hospitals with coronary care unit (47% for primary angioplasty).</p><p><strong>Conclusions: </strong>In the Lombardy Region, where a high rate of patients with ST-elevation myocardial infarction was treated with primary angioplasty in 2003, the 118 emergency medical service and the transmission of ECG by telephone are still underutilized. Moreover, the prehospital pharmacological treatment, the prehospital triage of patients to address to primary angioplasty and the organization of secondary transfer need to be improved.</p>","PeriodicalId":80290,"journal":{"name":"Italian heart journal. Supplement : official journal of the Italian Federation of Cardiology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2005-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25299844","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":"[Right ventricular cavernous hemangioma: a rare cardiac primary neoplasia].","authors":"Antonio Farinelli,&nbsp;Enrico Ferrara,&nbsp;Marco Cirillo,&nbsp;Fausto Zorzi","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Primary neoplasia of the heart is rare and often diagnosed postmortem (with a prevalence < 0.2% at postmortem examinations) due to the lack of specific clinical symptoms and signs. Among benign cardiac tumors, cavernous hemangioma has a prevalence of 2.8%. Less invasive diagnostic techniques such as transthoracic echocardiography allow for the diagnosis to be made during life with definitive surgical treatment. We report a representative case of right ventricular cavernous hemangioma, which mimicked right ventricular failure associated with systolic pulmonary flow tract obstruction. Surgical treatment was indicated for symptom severity and for the unpredictable behavior of the large neoplasm.</p>","PeriodicalId":80290,"journal":{"name":"Italian heart journal. Supplement : official journal of the Italian Federation of Cardiology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2005-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25008302","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":"[Guidelines for percutaneous coronary interventions].","authors":"Sigmund Silber,&nbsp;Per Albertsson,&nbsp;Francisco F Avilés,&nbsp;Paolo G Camici,&nbsp;Antonio Colombo,&nbsp;Christian Hamm,&nbsp;Erik Jørgensen,&nbsp;Jean Marco,&nbsp;Jan-Erik Nordrehaug,&nbsp;Witold Ruzyllo,&nbsp;Philip Urban,&nbsp;Gregg W Stone,&nbsp;William Wijns","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":80290,"journal":{"name":"Italian heart journal. Supplement : official journal of the Italian Federation of Cardiology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2005-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25233027","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 we prevent the progression of aortic valve sclerosis and stenosis? The need for a prospective, randomized trial].","authors":"Sabino Scardi,&nbsp;Antonella Cherubini","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Cardiologists long assumed that aortic valve sclerosis/stenosis is a wear-and-tear, degenerative process; recent studies suggested that lipoproteins can play a key role in the development of both sclerosis/stenosis in the aortic valve. Thus, sclerosis/stenosis cannot be considered as a simple degenerative process, but on the contrary it is complex and involves multiple pathogenetic mechanisms. Experimental, clinical and epidemiological data support the link between aortic valvulopathy and atherosclerosis: both are caused by inflammation, lipid deposition, and accumulation of extracellular bone matrix protein. In non-randomized clinical studies, hydroxy-methylglutaryl-coenzyme A reductase inhibitors minimized the progression of aortic valvulopathy. The major pharmacological effect, supposed to underlie the inferred (but still unproven) impact of statins on aortic sclerosis/stenosis is plasma cholesterol reduction. Lately, retrospective clinical studies supported this hypothesis and suggested a key role for statins in delaying the progression of aortic valvulopathy. However, the potential favorable effects of statins require confirmation. Prospective trials in Canada and Europe are now ongoing (ASTRONOMER--Aortic Stenosis Progression Observation Measuring Effects of Rosuvastatin; SEAS--Simvastatin and the Ezetimibe in Aortic Stenosis) and will address the use of cholesterol-lowering drugs in reducing the progression of aortic valve stenosis and in improving clinical outcomes.</p>","PeriodicalId":80290,"journal":{"name":"Italian heart journal. Supplement : official journal of the Italian Federation of Cardiology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2005-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25233024","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":"[Quantitative evaluation of regional myocardial function using strain and strain rate imaging: normal values in pediatric age].","authors":"Giovanni Di Salvo,&nbsp;Giuseppe Pacileo,&nbsp;Alessandra Rea,&nbsp;Simona Gala,&nbsp;Danila Faillace,&nbsp;Marina Verrengia,&nbsp;Tiziana Miele,&nbsp;Biagio Castaldi,&nbsp;Maria Giovanna Russo,&nbsp;Pio Caso,&nbsp;Raffaele Calabrò","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Based on color Doppler methodology, regional myocardial strain rate (SR) and strain (epsilon) can now be calculated by comparing local myocardial velocity profiles. These deformation data sets may be an important new approach to quantify regional function of the left or right ventricle in congenital heart disease. The aim of the present study was to provide normal value for epsilon and SR in pediatric age.</p><p><strong>Methods: </strong>We studied 45 healthy subjects (25 males, 20 females, mean age 11 +/- 6 years, range 4-16 years). For each subject we measured regional peak systolic, early and late diastolic E and SR.</p><p><strong>Results: </strong>Left ventricular (LV) longitudinal deformations were homogeneous for LV basal, mid and apical segments (peak systolic SR -1.9 +/- 0.7 s(-1), systolic epsilon -24 +/- 8%). Longitudinal SR and epsilon values were significantly higher in the right ventricle, compared with LV walls, and were maximal in the mid part of the right ventricle free wall (peak systolic SR -3.4 +/- 0.9 s(-1), systolic epsilon -35 +/- 5%). The LV systolic and diastolic SR and epsilon values were higher for deformations in the radial direction compared with the longitudinal direction [radial peak systolic epsilon 55 +/- 6% vs longitudinal peak systolic epsilon (-)24 +/- 8%, p < 0.0001; radial peak early diastolic epsilon (-)40 +/- 15% vs longitudinal peak early diastolic epsilon 17.22 +/- 7%, p < 0.0001; radial peak systolic SR 2.7 +/- 0.5 s(-1) vs longitudinal peak systolic SR (-)1.9 +/- 0.7 s(-1); radial peak early diastolic SR (-)6.2 +/- 1.5 s(-1) vs longitudinal peak early diastolic SR 2.24 +/- 1.2 s(-1), p < 0.0001].</p><p><strong>Conclusions: </strong>This study provides normal values for epsilon/SR in the largest published series of normal healthy children using a high frame rate (> or = 200 frames/s) and a commercially available software.</p>","PeriodicalId":80290,"journal":{"name":"Italian heart journal. Supplement : official journal of the Italian Federation of Cardiology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2005-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25233026","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 pacemaker current If: a novel pharmacological target for cardiologists].","authors":"Elisabetta Cerbai,&nbsp;Alessandro Mugelli","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>The pacemaker current contributes to endow some types of specialized cells (either cardiomyocytes, neurons, or smooth muscle cells) with an intrinsic rhythmic activity. In cardiac cells, this current has been named If for \"funny current\" by DiFrancesco, who first described it more than 20 years ago. The terminology points to the most peculiar If feature: pacemaker channels activate upon membrane hyperpolarization rather than depolarization, opposite to most voltage-gated channels. Recently, electrophysiological and molecular data demonstrated that f-channels are also present in ventricular cardiomyocytes, and become upregulated in cardiac hypertrophy and failure. Misplaced expression and/or overexpression of f-channels are a consequence of electrophysiological remodeling and, from a clinical point of view, may represent an arrhythmogenic mechanism in heart failure, a condition associated with high risk for sudden cardiac death. Due to its physiological (and pathophysiological) role and to the availability of selective f-channel blockers, If can be considered as a suitable therapeutic target for cardiologists.</p>","PeriodicalId":80290,"journal":{"name":"Italian heart journal. Supplement : official journal of the Italian Federation of Cardiology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2005-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25233025","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}