Exercise training improves erectile dysfunction (ED) in patients with metabolic syndrome on phosphodiesterase-5 (PDE-5) inhibitors.

Introduction: Erectile dysfunction (ED) affects about 50% of males aged 40-70 years old. ED shares with atherosclerotic disease several common risk factors; therefore, it may be considered a surrogate marker of atherosclerosis. Since phosphodiesterase-5 inhibitors are well known pharmacologic agents capable of significant improvement in ED, we designed this study to evaluate whether exercise training is of added value in patients with ED who are already on PDE-5 inhibitors.

Post-traumatic stress disorder, emotional processing and inappropriate implantable cardioverter-defibrillator shocks: clinical consideration by a single case report.

Introduction: Even though an overwhelming amount of evidence supports the clinical efficacy and safety of the implantable cardioverter defibrillator (ICD), inappropriate shocks for atrial arrhythmias with rapid ventricular conduction or for abnormal sensing results in multiple adverse effects

Presentation: In this study we present the case of a 59-year-old woman who was admitted to hospital for ICD implantation with a past medical history that was positive for non-ischemic dilated cardiomyopathy, congestive heart failure (NYHA class III), atrial fibrillation, essential hypertension and a recent episode of syncope. Since in the 18 months follow-up the patient suffered many inappropriate shocks, we investigated the association of the presence of a PTSD (PostTraumatic-Stress-Disorder) prior to implantation and a specific profile of cognitive processing emotions, with the effec-tiveness of the ICD. Emotional distress states and cognitive thoughts preceding ICD shock inappropriate episode were recorded by structured mobile diary (eMotional-ICDiary).

Vulnerable personality and Takotsubo cardiomyopathy consequent to emotional stressful events: a clinical case report.

Introduction: Although the onset of Takotsubo cardiomyopathy (TTC) can be triggered by an acute, intense emotional stress, the exact pathogenic mechanisms still remain undefined.

Presentation: A 58-year-old female was sent by ambulance to the Emergency Department (ED) for chest pain and ST elevations on ECG. Her chest pain began 3 hours before on admission after a domestic argument.

[Takotsubo syndrome in a young woman during puerperium: case report].

Introduction: Takotsubo syndrome is a reversibile cardiomyopathy that often occurs during an emotional stress and is more frequent in post-menopausal women.

Case Presentation: We describe a clinic case of a 42 years old woman, admitted to our emergency unit because of a thoracic pain. The ECG showed ST-T elevation in V1-V4, the echocardiography revealed akinesia of apical segment of left ventricle.

Growth hormone deficiency in patients with chronic heart failure and beneficial effects of its correction.

Context: A reduced activity of the GH/IGF-I axis in chronic heart failure (CHF) has been described by several independent groups and is associated with poor clinical status and outcome.

Objective: The aim of the current study was to investigate the prevalence of GH deficiency in a patient population with CHF and evaluate the cardiovascular effects of GH replacement therapy.

Design And Setting: The randomized, single-blind, controlled trial was conducted at the Federico II University.

Two-year multicomprehensive secondary prevention program: favorable effects on cardiovascular functional capacity and coronary risk profile after acute myocardial infarction.

Background: Cardiac rehabilitation includes interventions aimed at facilitating physical, psychological and emotional recovery following the acute phase of myocardial infarction (AMI). To date, optimal cardiac rehabilitation program duration and frequency of patient contact has yet to be identified.

Objective: The present study was performed to evaluate the effects of two different strategies of secondary prevention (2 years, multifactorial continued educational and behavioral intervention versus usual care) implemented into a cardiac rehabilitation setting on several cardiovascular endpoints indicating cardiovascular functional exercise capacity and coronary risk profile in patients with recent AMI.

Left ventricular remodelling in patients with moderate systolic dysfunction after myocardial infarction: favourable effects of exercise training and predictive role of N-terminal pro-brain natriuretic peptide.

Aims: To investigate the effects of exercise training (ET) on left ventricular (LV) volumes, cardiopulmonary functional capacity and N-terminal pro-brain natriuretic peptide (NT-proBNP) levels in postinfarction patients with moderate LV dysfunction.

Methods: Sixty-one postinfarction patients were randomized into two groups: group T [n=30, LV ejection fraction (EF) 41.6+/-11.

[Psychosocial risk factors in cardiac practice].

A large number of studies investigated the link between psychosocial risk factors and atherosclerosis or cardiac events. They found that emotional factors and chronic stressors strongly influence the course of coronary artery disease, by promoting the same pathophysiological mechanisms responsible for atherosclerosis. Thus, cardiologists often find in cardiac practice patients that presents psychosocial risk factors, needing the development of interventions aimed to management of these factors.

Efficacy of telecardiology in improving the results of cardiac rehabilitation after acute myocardial infarction.

Background: This study was addressed to verify if Telecardiology (TC) improves the results of Cardiac Rehabilitation in patients following a home-based Cardiac Rehabilitation Program (CRP) after acute myocardial infarction (AMI).

Materials And Methods: We studied three groups of patients after AMI: Group A (control group): 15 patients, who followed a standard in-hospital CRP of 3 weekly sessions of 2 months duration; Group B (study group): 15 patients, who were enrolled in a home-based CRP of similar duration and were monitored by TC with the aid of an ecg-device (Sorin Life Watch CG 6106); Group C (second control group): 15 patients, who followed a home-based CRP without ecg-monitoring by TC. All patients performed a symptom-limited exercise testing at the beginning of the CRP.

Favourable effects of exercise training on N-terminal pro-brain natriuretic peptide plasma levels in elderly patients after acute myocardial infarction.

Background: regional or global impairment of left ventricular (LV) systolic or diastolic function leading to increased LV wall stress results in increased circulating levels of N-terminal pro-brain natriuretic peptide (NT-pro-BNP).

Objective: this study aims at evaluating the effect of exercise training (ET) on NT-pro-BNP plasma levels in older patients recovering from acute myocardial infarction (AMI).

Design: prospective randomised study.

Reduction of N terminal-pro-brain (B-type) natriuretic peptide levels with exercise-based cardiac rehabilitation in patients with left ventricular dysfunction after myocardial infarction.

Introduction: N-terminal-pro-brain (B-type) natriuretic peptide (NT-pro-BNP) is a peptide hormone released from ventricles in response to myocyte stretch. The aim of the study was to investigate the influence of exercise training on plasma NT-pro-BNP to verify if this parameter could be used as a biological marker of left ventricular remodelling in myocardial infarction patients undergoing an exercise training programme.

Methods: Forty-four patients after myocardial infarction were enrolled into a cardiac rehabilitation programme, and were randomized in two groups of 22 patients each.

Long-term effects of cardiac rehabilitation on end-exercise heart rate recovery after myocardial infarction.

Background: Heart rate recovery (HRR) is a marker of vagal tone that is a powerful predictor of mortality in patients with coronary artery disease.

Design: This study aims at evaluating the effects of long-term exercise training on HRR after acute myocardial infarction (AMI), in order to clarify whether prolonged exercise training could maintain a long-term improvement of HRR.

Methods: Forty-four patients after AMI were enrolled in a 3-month hospital-based exercise training programme.

Role of smokers in the household and of cardiac rehabilitation in smoking behaviour after acute myocardial infarction.

Objects: This study aims to evaluate the influence of household smokers and of a prolonged, comprehensive home-based Cardiac Rehabilitation Program (CRP) on patient's long term smoking behaviour after AMI.

Methods: 164 male post-AMI patients, all smokers until the day of AMI, were subdivided into three groups: Group A (n=54): patients with recent AMI, discharged from hospital without enrolment in CRP; Group B (n=55): similar to Group A but enrolled in an 8 weeks hospital-based CRP and then discharged home with routine care; Group C (n=55) enrolled in an 8 weeks hospital-based CRP followed by a further 10 months of formal home-based CRP, with scheduled hospital follow-up visits.

Results: Smoking resumption at 12 months was influenced by the presence of household smokers (HS): 38% of patients with HS resumed smoking compared to 27% of patients without HS (p <0.

[Inflammatory syndrome after thoracic aortic endoprosthesis implantation associated with cortico-suprarenal adenoma].

We report a case of a 68-year-old patient, admitted with diagnosis of aneurysm of the descending thoracic aorta to the Department of Cardiac Surgery, where he underwent percutaneous endovascular application of 4 endoprostheses in the descending thoracic aorta. After antibiotic prophylaxis and hemodynamic stabilization, the patient was admitted to the Cardiac Rehabilitation Unit for the management of the of postoperative course and undergo a program of cardiac rehabilitation. Five days following admission and before starting physical training, the patient developed fever associated with neutrophil leukocytosis, strong activation of inflammatory markers and sideropenic anemia, compatible with post-implantation inflammatory syndrome.

[Cardiac rehabilitation in a HIV-patient treated with protease inhibitors].

We report a case of a 38-years-old HIV-positive patient, undergoing in the last 18 months therapy with three antiretroviral drugs including a protease inhibitor (nelfinavir). The patient was admitted in our Department with acute anterior myocardial infarction and was submitted to PTCA on the left anterior descending coronary artery. The patient, a 30 cigarettes/day smoker, with family history of hypertension and high levels of trygliceride and cholesterol, was subsequently admitted to our Cardiac Rehabilitation Unit.