The role of plasma biomarkers in acute heart failure. Serial changes and independent prognostic value of NT-proBNP and cardiac troponin-T.

Aims: Brain natriuretic peptide (BNP), NT-proBNP and troponins are useful for the assessment of patients with heart failure. Few data exist about their serial changes and their prognostic value in patients with acute heart failure (AHF).

Methods And Results: NT-proBNP and troponin-T plasma levels were measured at baseline, after 6, 12, 24, 48 h and at discharge in 116 consecutive patients with AHF and no evidence of acute coronary syndrome.

D-dimer serum levels in a case of type B aortic dissection. A rapid test for the early diagnosis of acute aortic disease?

This article reports on a case of acute type B aortic dissection presenting with electrocardiographic abnormalities mimicking an acute coronary syndrome, associated with high D-dimer levels in the acute phase and normalization in the chronic phase of the disease process. This case report is consistent with recent data from the literature suggesting that D-dimer levels might be a useful biochemical tool in the diagnostic work-up of patients with suspected acute aortic dissection.

Usefulness of cardiac calcification on two-dimensional echocardiography for distinguishing ischaemic from nonischaemic dilated cardiomyopathy: a preliminary report.

Background: Aortic valve calcification (AVC) and/or mitral annulus calcification (MAC) is considered to be a marker of atherosclerosis and has been demonstrated to predict cardiovascular morbidity and mortality.

Aim: We hypothesized that the presence of cardiac calcification by echocardiography can be used in the differential diagnosis between ischaemic (DCMI+) and nonischaemic dilated cardiomyopathy (DCMI-).

Methods: We evaluated 62 patients with DCM (38 males, mean age 66 +/- 10 years, LVEF < 40%), without any prior history of myocardial infarction or coronary intervention, who were undergoing coronary angiography for aetiological diagnosis.

A difficult diagnosis: right unilateral cardiogenic pulmonary edema. Usefulness of biochemical markers of heart failure for the correct diagnosis.

We describe a case of unilateral pulmonary edema occurring in a young woman affected by hypertrophic cardiomyopathy complicated by acute worsening of mitral regurgitation. The relevant role of biochemical markers of heart failure, such as brain natriuretic peptide and carbohydrate antigen 125, in clarifying the final diagnosis of cardiogenic pulmonary edema and modifying treatment accordingly is emphasized.

Sustained torsade de pointes occurring early during oral sotalol therapy for atrial fibrillation recurrence prophylaxis in a patient without heart disease.

This report describes a 64 year-old female patient admitted to our department for recurrent and symptomatic episodes of atrial fibrillation. Antiarrhythmic therapy with sotalol at 240 mg/day was started, and after 48 h the patient experienced several episodes of sustained torsade de pointes, dramatic marked QT interval prolongation and negative T wave, in absence of overt cardiac disease, renal failure, electrolyte abnormalities or baseline QT interval prolongation. This case emphasizes the importance of hospitalization at the starting of sotalol therapy, especially in female patients, even in absence of predisposing factors for drug-induced tachyarrhythmias.

[Pharmacological therapy of chronic heart failure in the elderly].

In the last years, the treatment of heart failure has radically changed, as did the knowledge of this complex and heterogeneous clinical syndrome. The comprehension of the pathophysiologic mechanisms involved in the progression of this disease highlighted the central role of various neurohormonal mechanisms. Antagonism of these systems was demonstrated to be the only strategy which favorably modifies the natural history of heart failure.

Serum levels of different tumour markers in patients with chronic heart failure.

Background: serum levels of carbohydratic antigen 125 (CA 125), a tumour marker related to ovarian cancer, are increased in patients with heart failure (CHF). To our knowledge there are no data concerning the levels of other tumour markers in CHF.

Methods: we measured serum levels of Alpha-Fetoprotein (AFP), Carcinoembrionic antigen (CEA), CA 19.