Severe Spontaneous Echo Contrast/Auricolar Thrombosis in "Nonvalvular" AF: Value of Thromboembolic Risk Scores.

Background: Patients with atrial fibrillation (AF) have an increased thromboembolic risk that can be estimated with risk scores and sometimes require oral anticoagulation therapy (OAT). Despite correct anticoagulation, some patients still develop left atrial spontaneous echo contrast (SEC) or thrombosis. The value of traditional risk scores (R CHADS , CHADS , and CHA DS -VASc) in predicting such events remains controversial.

Transthoracic Doppler ultrasound coronary flow reserve evaluation: preliminary insights into pathophysiology of Takotsubo cardiomyopathy.

Objective: The aim of this study was to elucidate the role of coronary microvascular function in the pathophysiological scenario of Takotsubo cardiomyopathy.

Methods: Noninvasive evaluations of coronary flow reserve through transthoracic Doppler ultrasound imaging of the left anterior descending coronary artery, a reliable marker of coronary microcirculation performance in the absence of epicardial coronary artery stenosis, were performed both in the acute and recovery phases of Takotsubo cardiomyopathy in consecutive patients strictly selected on the basis of absence of risk factors, concomitant diseases, or both impairing coronary microvascular function.

Results: Resting and hyperemic diastolic flow velocity tracings and corresponding velocity time integrals were obtained in seven consecutive patients, six of them women, aged 65-86 years (76 +/- 6.

Coronary microvascular function in Takotsubo cardiomyopathy: results of non-invasive evaluation.

The role of coronary microvascular function in Takotsubo cardiomyopathy remains to be elucidated. In this study it was evaluated through coronary flow reserve (CFR) by means of transthoracic Doppler ultrasound imaging of the left anterior descending (LAD) coronary artery in 5 consecutive patients without risk factors and/or concomitant diseases impairing, per se, coronary microcirculation. In each case CFR values were in the normal range and not significantly different from age and sex-matched control subjects.

The treatment of carotid artery bifurcation stenoses with systematic stenting: experience of first 100 consecutive cardiological procedures.

Carotid endarterectomy still represents the gold standard treatment of carotid artery bifurcation stenosis but percutaneous angioplasty with stenting is rapidly growing as a non-invasive alternative. In this paper we report the results of systematic application of carotid stenting performed in a cardiological setting, particularly as regards clinical management of patients and technical approach. One-hundred (100) procedures of carotid artery stenting (CAS) on 94 consecutive patients, both symptomatic and asymptomatic, with a carotid stenosis > 70%, were performed over a period of 30 months.

Acute filling pattern changes of the failing left ventricle after captopril as related to ventricular structure.

In congestive heart failure captopril modifies the left ventricular filling pattern mainly by unloading the heart. We investigated whether the structural characteristics of the left ventricle may influence the acute effects of captopril on this pattern in patients with untreated hypertensive (H group, 6 patients) or idiopathic (I group, 14 patients) cardiomyopathy. We evaluated changes of pulsed Doppler mitral flow, of systemic arterial and wedge pulmonary pressures 40 min after 25 mg captopril administered sublingually, and correlated these changes with the M-mode echocardiographic relative wall thickness index (h/r).