Usefulness of a Telemedicine Program in Refractory Older Congestive Heart Failure Patients.

Background: Home telemonitoring is a modern and effective disease management model that is able to improve medical care, quality of life, and prognosis of chronically ill patients, and to reduce expenditure. The objective of this study was to evaluate the efficacy, costs, and patients' and caregivers' acceptance of our model of telemedicine in a high-risk chronic heart failure (CHF) older population.

Methods: Patients with high risk/refractory CHF were included.

Infective endocarditis or myxoma? Description of a patient with new diagnosis of congestive heart failure.

Infective endocarditis (IE) is an inflammatory disease which interests heart endothelium and mostly heart valves. IE is not a uniform disease, but presents in a variety of different forms that makes the diagnosis difficult. Echocardiography is a crucial diagnostic tool for the diagnosis, especially in those patients who have no typical symptoms as in the case here presented, in which the possibility of a myxoma was also considered.

Prognostic factors of mid-term clinical outcome in congestive heart failure patients discharged after acute decompensation.

Introduction: Risk stratification in congestive heart failure (CHF) patients is based on a variety of clinical and laboratory variables. We analysed renal function, BNP, water composition, echocardiographic and functional determinations in predicting mid-term outcome in CHF patients discharged after decompensation.

Material And Methods: All subjects with NYHA class II-IV were enrolled at hospital discharge.

Effects of levosimendan/furosemide infusion on plasma brain natriuretic peptide, echocardiographic parameters and cardiac output in end-stage heart failure patients.

Background: Acute decompensation heart failure (ADHF) remains a cause of hospitalization in patients with end-stage congestive HF. The administration of levosimendan in comparison with a standard therapy in CHF patients admitted for ADHF was analysed.

Material/methods: Consecutive patients admitted for ADHF (NYHA class III-IV) were treated with levosimendan infusion 0.

[Antianginal efficacy of ivabradine in a very old patient with aortic stenosis: effects on cardiac output and transvalvular aortic gradients].

Ivabradine is a selective I(f) current inhibitor in the sinus node that decreases heart rate without negative inotropic effects. We report the case of an 88-year-old diabetic patient with arterial hypertension and peripheral arterial disease who experienced an antero-lateral non-ST-elevation myocardial infarction following post-surgical anemia. After admission, the patient complained of anginal pain at rest with ischemic alterations of ST-T at the ECG and mild increase in troponin T levels.

[Prevention of left ventricular remodeling after myocardial infarction: efficacy of physical training].

Post-myocardial infarction left ventricular remodelling should be considered an important therapeutic target in patients after an acute myocardial infarction, considering the heavy prognostic implication. The therapies used in these patients should reduce the progression of the left ventricular dysfunction to refractory heart failure. In order to prevent post-myocardial infarction cardiac remodelling, different therapies have been tested, and for ACE-inhibitors and beta-blockers a clear demonstration of efficacy has been obtained.