Left atrial remodeling and response to valsartan in the prevention of recurrent atrial fibrillation: the GISSI-AF echocardiographic substudy.

Background: Left atrial (LA) dilation precedes or appears early after the onset of atrial fibrillation (AF) and factors in perpetuating the arrhythmia. Angiotensin receptor blockers were proposed for reversing LA remodeling. We evaluated the effect of valsartan on LA remodeling in patients with a recent episode of AF and the effect of LA size on AF recurrence (AFr).

The negative U wave: a pathogenetic enigma but a useful, often overlooked bedside diagnostic and prognostic clue in ischemic heart disease.

The pathogenesis of U-wave inversion and its clinical value are still not clear, although the U wave was described by Einthoven together with the other electrocardiographic (ECG) waves. Not considered a useful diagnostic clue, it is not usually mentioned in ECG reports. In recent years, stimulated by the long QT syndromes and by the discovery of U-wave changes in some pathologic, mostly cardiac states, this neglected wave has attracted new interest.

Electrocardiographic patterns in acute inferior myocardial infarction with and without right ventricle involvement: classification, diagnostic and prognostic value, masking effect.

Background: In acute inferior myocardial infarction (AIMI), the ST depression from V1 to V4 has been the subject of many papers, while the ST changes in other leads, their association, and the right ventricular (RV) involvement have been studied less.

Hypothesis: This study was performed to contribute to the meaning of the ST changes and RV involvement in AIMI.

Methods: Seventy-one patients, admitted within 6 h from symptom onset, all thrombolysed, were enrolled.

Pericardial involvement in acute myocardial infarction in the post-thrombolytic era: clinical meaning and value.

Pericardial involvement (PI) in acute myocardial infarction (AMI) is a complication usually considered benign and has therefore received less attention than those more severe. It may be easily missed because it presents few symptoms and signs, which in turn may be confused with those of AMI. Its pathophysiology, diagnosis, and pitfalls are discussed.

Cytokines in acute myocardial infarction: selective increase in circulating tumor necrosis factor, its soluble receptor, and interleukin-1 receptor antagonist.

Cytokines play a pathogenetic role in a variety of infective and inflammatory diseases. In the present study, we had two objectives: (a) to define the kinetics of tumor necrosis factor (TNF) in plasma after acute myocardial infarction (AMI) in patients treated with early thrombolysis, and (b) to measure other cytokines, interleukin-1 (IL-1) and TNF receptor antagonists, in plasma. TNF-alpha, but not IL-1 beta or IL-8, was present in plasma of 6 of 7 patients with severe AMI (Killip class 3 or 4).

Comparison of frequency, diagnostic and prognostic significance of pericardial involvement in acute myocardial infarction treated with and without thrombolytics. Gruppo Italiano per lo Studio della Sopravvivenza nell'Infarto Miocardico (GISSI).

Data from the Gruppo Italiano per lo Studio della Sopravvivenza nell'Infarto Miocardico (GISSI) trial were reviewed to describe the epidemiology of pericardial involvement in patients treated with or without thrombolysis, and to establish its role as a marker of the extent of myocardial infarction and its prognostic value. In both GISSI-1 (n = 11,806) and 2 (n = 12,381), a specific item regarding presence/absence of clinically detected pericardial involvement was included in the study forms. In GISSI-1, patients with ST elevation and depression at the onset of myocardial infarction were admitted, whereas GISSI-2 included only those with ST elevation.

[Pseudoaneurysm of the left ventricle: a clinical case].

A case of left ventricular pseudoaneurysm with a clinical onset of left ventricular failure, in absence of preceding signs or symptoms of coronary artery disease, is described. This case is particularly interesting because it shows how much time can pass (at least six months) from clinical onset without rupture of the pseudoaneurysm.

[Spontaneous grade I bundle of His block. Clinical, electrocardiographic and electrophysiological studies in 37 patients].

The clinical, ECG and electrophysiological data of 37 patients (28 males and 9 females) with spontaneous intra-hisian block are reported. Of these patients, 11 had hypertensive heart disease and 5 had ischemic heart disease with previous myocardial infarction; in 21 patients, clinical signs of heart disease were not evident. In 18 patients, a single or recurrent episode of syncope had occurred.

[A case of pheochromocytoma with atypical clinical presentation].

A case of pheochromocytoma that had undergone coronary arteriography because it stimulated coronary heart disease is presented. The correct diagnosis was suspected while checking the signs and symptoms during an episode of pulmonary edema and was definitely proved by computed tomography and scintigraphy with I 131 metaiodobenzylguanidine. The authors stress the importance of these new non invasive procedures in the diagnosis of site and nature of this disease.

[Clinical trial by perexiline maleate in treatment of angina pectoris (author's transl)].

A controlled double blind clinical trial has been conducted in 16 patients with "angina pectoris" in order to investigate the effect of Perexiline maleate as compared with prenilamine. Perexiline at the dose of 400 mg/die and prenilamine at the dose of 120 mg/die have been administered over a period of 4 weeks each. Between these periods placebo has been administered for two weeks.