Characterizing the spectrum of right ventricular remodelling in response to chronic training.

The significance and spectrum of reduced right ventricular (RV) deformation, reported in endurance athletes, is unclear. To comprehensively analyze the cardiac performance at rest of athletes, especially focusing on integrating RV size and deformation to unravel the underlying triggers of this ventricular remodelling. Hundred professional male athletes and 50 sedentary healthy males of similar age were prospectively studied.

Exercise echocardiography and multidetector computed tomography for the evaluation of acute chest pain.

Introduction And Objectives: Up to 4% of patients with acute chest pain, normal electrocardiogram, and negative troponins present major adverse cardiac events as a result of undiagnosed acute coronary syndrome. Our aim was to compare the diagnostic performance of multidetector computed tomography and exercise echocardiography in patients with a low-to-intermediate probability of coronary artery disease.

Methods: We prospectively included 69 patients with acute chest pain, normal electrocardiogram, and negative troponins who underwent coronary tomography angiography and exercise echocardiography.

Atrial functional and geometrical remodeling in highly trained male athletes: for better or worse?

Purpose: Highly trained athletes have an increased risk of atrial arrhythmias. Atrial geometrical and functional remodeling may be the underlying substrate. We analyze and relate atrial size, deformation and performance in professional handball players compared with non-sportive subjects.

Echocardiographic abnormalities in patients with COPD at their first hospital admission.

Cardiovascular disease accounts for significant morbidity and mortality in chronic obstructive pulmonary disease (COPD). Its prevalence and mechanisms of association have not been elucidated. The study aimed to assess the prevalence of echocardiographic abnormalities and potential risk factors in patients with COPD at their first exacerbation requiring hospital admission.

Ischaemic postconditioning revisited: lack of effects on infarct size following primary percutaneous coronary intervention.

Aims: To assess the short- and long-term effects of postconditioning (p-cond) on infarct size, extent of myocardial salvage, and left ventricular ejection fraction (LVEF) in a series of patients presenting with evolving ST-elevation myocardial infarction (STEMI). Previous studies have shown that p-cond during primary percutaneous coronary intervention (PCI) confers protection against ischaemia-reperfusion injury and thus might reduce myocardial infarct size.

Methods And Results: Seventy-nine patients undergoing PCI for a first STEMI with TIMI grade flow 0-1 and no collaterals were randomized to p-cond (n= 39) or controls (n= 40).

Identification and prospective validation of clinically relevant chronic obstructive pulmonary disease (COPD) subtypes.

Background: Chronic obstructive pulmonary disease (COPD) is increasingly considered a heterogeneous condition. It was hypothesised that COPD, as currently defined, includes different clinically relevant subtypes.

Methods: To identify and validate COPD subtypes, 342 subjects hospitalised for the first time because of a COPD exacerbation were recruited.

Repeated episodes of hypoglycemia as a potential aggravating factor for preclinical atherosclerosis in subjects with type 1 diabetes.

Objective: To evaluate through early preclinical atherosclerosis assessment whether repeated episodes of hypoglycemia represent an aggravating factor for macrovascular disease in type 1 diabetes.

Research Design And Methods: After sample-size calculation, a case-control study of 25 patients with type 1 diabetes and repeated severe/nonsevere hypoglycemia (H-group) compared with 20 age- and sex-matched type 1 diabetes control subjects (C-group) was designed. Assessment of preclinical atherosclerosis consisted of flow-mediated brachial dilatation (FMD) and carotid and femoral intima-media thickness (IMT) studies.

[Study of the BMPR2 gene in patients with pulmonary arterial hypertension].

Introduction: Mutations of the gene that code bone morphogenic protein type 2 receptor (BMPR2) are involved in the pathogenesis of pulmonary arterial hypertension (PAH), both in its familial (FPAH) and its idiopathic (IPAH) forms.

Method: With the aim of increasing the knowledge of these genetic factors in our area, the BMPR2 gene was studied in 17 patients with PAH, 8 with FPAH and 9 with sporadic IPAH. Additionally, a study was made to see whether the presence of BMPR2 mutations was associated with changes in the CO diffusing CO (DL(CO)) with the aim of evaluating the interest in this measurement in the pre-clinical diagnosis.

Relation of plasma brain natriuretic peptide levels on admission for ST-elevation myocardial infarction to left ventricular end-diastolic volume six months later measured by both echocardiography and cardiac magnetic resonance.

The main objective of this study was to investigate the relation between brain natriuretic peptide (BNP) levels within the first 96 hours after ST-segment elevation acute myocardial infarction (STEMI) and the development of left ventricular (LV) dilatation at 6-month follow-up. Eighty-two patients with first STEMIs, reperfused within 12 hours of symptom onset, were prospectively included. Plasma BNP was determined on admission and at 1- and 6-month follow-up.

Long-term effect of cardiac resynchronization therapy on functional mitral valve regurgitation.

Cardiac resynchronization therapy (CRT) has been shown to reduce functional mitral regurgitation (MR). The aims of this study were to analyze the underlying mechanisms leading to this reduction and to identify the best candidates with functional MR for this therapy. Changes in mitral geometry, left ventricular (LV) remodeling, and LV synchrony were studied in patients who underwent CRT acutely and at 6- and 12-month follow-up.

Magnetic resonance reveals long-term sequelae of apical ballooning syndrome.

Background: The presence of small areas of necrosis has been occasionally reported immediately following apical ballooning syndrome (ABS). However, their persistence at later stages and impact on long-term prognosis are currently unknown.

Methods: Twenty consecutive patients admitted for ABS between 2004 and 2007 were prospectively evaluated.

Assessment of left ventricular dyssynchrony by real-time three-dimensional echocardiography.

Introduction And Objectives: A number of different imaging methods have been proposed as possible tools for assessing left ventricular (LV) mechanical dyssynchrony. The aim of this study was to evaluate the usefulness of real-time three-dimensional echocardiography (RT3DE) for studying LV mechanical dyssynchrony.

Methods: In total, 60 individuals underwent RT3DE, including 10 healthy volunteers, 23 patients with acute ST-segment elevation myocardial infarction and 27 patients with dilated cardiomyopathy.

Fate of left atrial function as determined by real-time three-dimensional echocardiography study after radiofrequency catheter ablation for the treatment of atrial fibrillation.

Radiofrequency catheter ablation has been demonstrated to be effective in the treatment of patients with atrial fibrillation. However, its impact on left atrial (LA) function has not been widely studied. The purpose of the present study was to evaluate the impact of radiofrequency catheter ablation on LA function in patients with atrial fibrillation.

[Influence of cardiopathy etiology on responses to cardiac resynchronization therapy].

Introduction And Objectives: Little is known about how responses to cardiac resynchronization therapy (CRT) are affected by the nature of the underlying cardiopathy. The aim of this study was to investigate how cardiopathy etiology influences the effect of CRT on reverse left ventricular remodeling.

Methods: The study included 106 patients with left ventricular systolic dysfunction and left bundle branch block (LBBB) who were receiving CRT.

Electrocardiographic optimization of interventricular delay in cardiac resynchronization therapy: a simple method to optimize the device.

Introduction: Echocardiography is widely used to optimize CRT programming, but it is time-consuming. This study aimed to correlate the optimal interventricular pacing (V-V) interval obtained by echo with the optimal V-V interval obtained by a simpler method based on the surface ECG.

Methods And Results: Three V-V intervals were tested: LV preactivation at -30 ms, simultaneous biventricular pacing (0 ms), and RV preactivation at +30 ms.

Optimizing the programation of cardiac resynchronization therapy devices in patients with heart failure and left bundle branch block.

This study was conducted to investigate the clinical impact of cardiac resynchronization device optimization. A series of 100 consecutive patients received cardiac resynchronization therapy. In the first 49 patients, an empirical atrioventricular delay of 120 ms was set, with simultaneous biventricular stimulation (interventricular [VV] interval=0 ms).

Usefulness of ventricular dyssynchrony measured using M-mode echocardiography to predict response to resynchronization therapy.

There are discordant data about the utility of septal-to-posterior wall motion delay (SPWMD) assessed using M-mode echocardiography to predict an improvement with cardiac resynchronization therapy (CRT). Baseline SPWMD was measured using M-mode in a parasternal short-axis view in a series of 67 patients undergoing CRT and followed up after 6 months. Heart failure was caused by coronary artery disease in 27 patients.

Is there an anatomical substrate for idiopathic paroxysmal atrial fibrillation? A case-control echocardiographic study.

Aim: Idiopathic paroxysmal atrial fibrillation (AF) occurs in patients with apparently normal heart. Its mechanisms may be complex and are poorly understood. The aim of the study was to evaluate whether patients with idiopathic AF have any structural abnormality that may explain the occurrence of AF.

A rare association of pheochromocytoma and thoracic paraganglioma: utility of 2D contrast enhanced echocardiography.

Pheochromocytomas with concomitant paragangliomas are very rare, particularly when the latter is located close to cardiac structures. We report a pheochromocytoma with an associated paraganglioma located adjacent to the left atrium as demonstrated by echocardiography.

[Clinical and echocardiographic follow-up of patients with hypertrophic obstructive cardiomyopathy treated by percutaneous septal ablation].

Introduction And Objectives: Alcohol septal ablation is a therapeutic option for patients with hypertrophic obstructive cardiomyopathy who remain symptomatic despite medical treatment. Our aim was to monitor clinical and echocardiographic progression in patients with hypertrophic obstructive cardiomyopathy treated by septal ablation at our center.

Methods: Thirty-five septal ablations were performed in 34 patients (79% male) who had symptomatic hypertrophic obstructive cardiomyopathy despite optimum medical treatment.