Exercise stress echocardiography with tissue Doppler imaging in risk stratification of mild to moderate aortic stenosis.

Background: Patients with mild to moderate aortic stenosis (AS) seem to have a worse outcome than commonly expected. Early identification of subjects who may develop a rapid disease progression or cardiovascular events is critical in order to apply adequate risk management.

Study Design: Observational prospective single-centre study.

Is There a Role for Tissue Doppler Imaging in Infective Endocarditis?

An 87-year-old woman was admitted to our Cardiology Department with symptoms and signs of acute congestive heart failure and fever. She had a long history of hypertension and chronic atrial fibrillation. Transthoracic echocardiography showed a large (>10 mm) and mobile mitral valve vegetation, prolapsing into the left ventricular inflow tract, with severe mitral regurgitation due to a perforation in the posterior leaflet, in a mitral valve with fibro-calcific degeneration.

[Giant left atrium in a patient with decompensated heart failure].

A 71-year-old woman was admitted to our institution with symptoms and signs of acute congestive heart failure. The patient had a long history of rheumatic heart disease and, in 1974, she had undergone mitral valve replacement with a single tilting-disk mechanical valve. Transthoracic echocardiography showed a giant left atrium, measuring 18.

Unusual CD4+CD28null T lymphocytes and recurrence of acute coronary events.

Objectives: We hypothesized that the expansion of unusual T lymphocytes, CD4+CD28null T cells, might represent a key pathogenetic mechanism of recurrent instability.

Background: Clinical presentation of acute coronary syndromes (ACS) is variable. Some patients have recurrent episodes of instability, despite optimal treatment, whereas others have a single acute event in their life.

Adjusted indirect meta-analysis of aspirin plus warfarin at international normalized ratios 2 to 3 versus aspirin plus clopidogrel after acute coronary syndromes.

After acute coronary syndromes, the beneficial effect of aspirin plus clopidogrel (A+C) or aspirin plus dose-adjusted warfarin (A+W) compared with aspirin alone is well established. However, these regimens were never compared. To compare the risk-benefit profile of A+C versus A+W after acute coronary syndromes, major medical databases for randomized controlled trials comparing 1 of these combined approaches versus aspirin alone after an acute coronary syndrome (updated June 2006) were searched.