[Non ST ergometric variables in the diabetic patient and their prognostic significance].

Background: Recent research based on large number of patients has demonstrated that there are strong exercise predictors of cardiovascular events other than ST-segment behaviour. Studies focused on non-ST segment variables in exercise testing (exercise capacity, chronotropic and pressure response, heart rate recovery) in diabetics are lacking. The aim of our study is to find out differences in the exercise-testing variables between diabetics and non and to evaluate their prognostic role.

[Exercise training parameters and pre- and post-test scores in the light of the most recent studies: review of the literature].

Exercise test is the simplest, most thorough and cost-effective tool capable of providing diagnostic and prognostic evaluation of patients with known or suspected coronary heart disease. Imaging tests have been lately utilized with increasing frequency: while quite useful to define the presence and extent of ischemia, these tests do not have the prognostic insight offered by data derived from exercise parameters like effort duration, behavior of heart rate, blood pressure and occurrence of arrhythmias. The diagnostic and prognostic value of exercise test-derived data may be further enhanced by the utilization of scores.

[Pseudoischemic ST-segment due to atrial repolarization during exercise test. Review of the literature, diagnostic criteria and personal experience].

Atrial repolarization wave has been known since many years: it is opposite in direction to P wave, may have a magnitude of 100 to 200 microV and may extent into the ST segment (usually it is hidden in the QRS complex). It was hypothesized that this wave could cause ST-segment depression mimicking myocardial ischemia. The false positive response is characterized by marked downsloping of the PR segment at peak exercise, longer exercise time (> 6 min), peak exercise heart rate > 125 bpm, absence of chest pain and ST-segment normalization in the first minute of recovery.

[Cardiac rehabilitation and resuming sexual activity].

Sexual function is an important component of cardiac patients' quality of life and subjective well being. Patients, however, are often uninformed regarding the question of resuming sexual activity after a cardiac event. Recent epidemiologic data reveal that sexual problems are widespread and adversely affect mood, well-being, and interpersonal functioning Erectile dysfunction (ED) is the most commonly recognized and treated sexual dysfunction.

[The appropriateness of diagnostic angiography in cardiology].

Coronary angiography is the most frequently performed invasive diagnostic test in the western world, but regional differences are common and have been outlined in both observational and randomized studies. Appropriateness evaluation is hence fundamental, as the use of invasive cardiac procedures is strongly associated with the population-based availability of catheterization facilities. A procedure is judged appropriate if the expected health benefit exceeds the possible negative consequences by a sufficiently wide margin; it is necessary when not performing it could result in harm for the patient.