Myocardial deformation and volume of exercise: a new overlap between pathology and athlete's heart?

Regular physical exercise induces cardiac adaptations that can overlap pathological conditions. Controversy still persists about the variability of myocardial deformation in different types and intensity of exercise. The aim of this study was to assess myocardial longitudinal deformation in athletes with different level of exercise.

Variability in interpretation of the electrocardiogram in athletes: Another limitation in pre-competitive screening.

Introduction: Assessment of the electrocardiogram (ECG) in athletes remains controversial, with lack of standardization and difficulty in applying specific criteria in its interpretation. The purpose of this study was to assess variability in the interpretation of the ECG in athletes.

Methods: Twenty ECGs of competitive athletes were assessed by cardiologists and cardiology residents, 11 of them normal or with isolated physiological changes and nine pathological.

Compliance of pharmacological treatment for non-ST-elevation acute coronary syndromes with contemporary guidelines: influence on outcomes.

Background: Although the proven efficacy of evidence-based therapy in patients with cardiovascular diseases, the recommendations are not always instituted. We aimed to analyse the compliance of non-ST-elevation acute coronary syndrome (NSTE-ACS) patients with treatment guidelines and to assess the impact of these measures in hospital death during the index hospitalization.

Population And Methods: All consecutive patients (pts) included in the Portuguese Registry on Acute Coronary Syndromes (ProACS) between January 1, 2002 and August 31, 2011 were analysed.

[Impact of red blood cell distribution width on risk for bleeding events in patients with non-ST elevation acute coronary syndromes].

Introduction: Higher values of red blood cell distribution width (RDW) have recently been associated with worse outcome in patients with cardiovascular disease. However, its relation to bleeding events in patients with non-ST elevation acute coronary syndromes has not been established.

Aim: To determine the prognostic value of RDW in patients with non-ST segment elevation acute coronary syndromes, particularly regarding the risk of major bleeding.

[Carcinoid tumors: echocardiographic contribution to the diagnosis].

Introduction: Carcinoid tumors are rare, most commonly originating from the neuroendocrine cells in the gastrointestinal tract. Carcinoid syndrome is characterized by flushing, diarrhea, and bronchospasm. Half of these patients have carcinoid heart disease, affecting the right side of the heart, causing tricuspid and pulmonary regurgitation and stenosis and subsequently right heart failure.

Comparison of ischemic and bleeding risk scores in non-ST elevation acute coronary syndromes.

Objectives: Compare the discriminatory performance of two validated ischemic risk scores and a bleeding risk score for in-hospital adverse events across the spectrum of non-ST elevation acute coronary syndromes (NSTE-ACS).

Material And Methods: Single center, 516 consecutive patients admitted with the diagnosis of NSTE-ACS. The following risk scores were calculated for each patient: TIMI, GRACE and CRUSADE.

Chronic medical comorbidities in patients with acute coronary syndrome.

Background: Patients with acute coronary syndrome (ACS) frequently present chronic noncardiovascular medical comorbidities that can influence treatment and prognosis. Compliance with therapeutic guidelines in ACS is crucial to event reduction and the presence of these comorbidities may be a determining factor in guideline adherence.

Objective: To assess the prevalence of chronic noncardiovascular medical comorbidities in patients with ACS and their impact on guideline adherence.

Portuguese Registry of Acute Coronary Syndromes: seven years of activity.

Background: The Portuguese Registry of Acute Coronary Syndromes was established in 2002, with the goal of gathering data on the clinical characteristics, treatment and prognosis of Portuguese patients with acute coronary syndromes (ACS).

Objective: To report the information collected during the seven years of activity of the Portuguese Registry of ACS (from January 1, 2002 to December 31, 2008).

Methods: The Portuguese Registry of ACS is an observational, prospective and continuous registry, which started on January 1, 2002 and involved 45 Portuguese hospitals.

Bovine papillomavirus type 4 L1 gene transfection in a Drosophila S2 cell expression system: absence of L1 protein expression.

The development of a bovine papillomavirus (BPV) vaccine is an outstanding challenge. BPV protein L1 gene transfection in the Drosophila melanogaster S2 cell expression system failed to produce L1 protein notwithstanding correct L1 gene insertion. Severe genetic inbalance in the host cell line, including cytogenetic alterations, may account for the lack of protein expression.

Predictors of response to cardiac resynchronization therapy--importance of left ventricular dyssynchrony.

Background: Cardiac resynchronization therapy (CRT) is currently used in selected patients with dilated cardiomyopathy and heart failure. However, 30% of patients do not respond to CRT when selection is based on clinical and electrocardiographic criteria. Left ventricular dyssynchrony can be evaluated by tissue Doppler imaging and it has been described as a useful precdictor of response to CRT.

Glucose metabolism in non-diabetic patients with stable coronary artery disease.

Background: Diabetes and other forms of impaired glucose metabolism (IGM) can be present in patients with coronary artery disease (CAD), despite normal fasting glycemia and no prior evidence of diabetes. Undiagnosed IGM can be associated with increased risk of cardiovascular events.

Objective: To assess the prevalence of IGM in patients with CAD and without diabetes and to identify its repercussions on their cardiovascular risk profile.

Cardiac resynchronization therapy with sequential biventricular pacing: impact of echocardiography guided VV delay optimization on acute results.

Background: Cardiac resynchronization therapy (CRT) improves left ventricular synchrony as evaluated by tissue Doppler imaging (TDI), leading to improved left ventricular performance and reverse remodeling. New CRT devices enable programming of left and right VV delay. The aim of this study was to determine whether sequential biventricular (BiV) pacing by echo-guided programming of VV delay would enhance the response to CRT.

Prognosis of non-ST-segment elevation acute coronary syndrome in patients with prior percutaneous coronary intervention.

Background: There is disagreement concerning the prognostic value of a prior history of percutaneous coronary intervention (PCI) in patients with non-ST-segment elevation acute coronary syndromes (ACS). This study characterizes these patients and investigates the impact of prior PCI on their prognosis.

Methods: 448 consecutive patients admitted due to ACS between 1998 and 2000 were evaluated.

Tissue Doppler echocardiography for evaluation of patients with ventricular resynchronization therapy.

Introduction And Objective: Ventricular resynchronization therapy optimizes cardiac function and induces reverse remodeling of the left ventricle (LV) in patients (pts) with dilated cardiomyopathy and intraventricular conduction disturbances. Improvement of LV mechanical synchrony seems to be the predominant mechanism. There is a growing interest in objective quantification of desynchronization.

Effects of cardiac resynchronization therapy on right ventricular function--evaluation with tissue Doppler echocardiography.

Introduction And Objective: Ventricular resynchronization therapy improves cardiac function in patients (pts) with dilated cardiomyopathy and intraventricular conduction disturbances. The effects of ventricular resynchronization on right ventricular function have been poorly studied. Tricuspid annular motion can be studied with tissue Doppler echocardiography, which enables quantitative assessment of right ventricular function.

Non invasive hemodynamic monitorization for AV interval optimization in patients with ventricular resynchronization therapy.

Introduction And Objective: In patients (pts) with dilated cardiomyopathy and intraventricular conduction disturbances, resynchronization therapy improves cardiac function and functional capacity. Determination of the optimal AV interval is essential to optimize the therapy results and various methods have been used in daily practice to obtain such an interval. The aim of this work is to assess optimal AV determined by impedance cardiography and compare it to the interval previously obtained by transmitral flow Doppler echocardiography.