[Outpatient cardiac rehabilitation in coronary artery disease: impact on cardiovascular outcomes].

Background: Cardiac rehabilitation (CR) is a model of care proven to reduce recurrent cardiovascular events, new hospitalizations and mortality in patients with coronary artery disease. The aim of this study was to describe ambulatory CR in Gualdo-Tadino, ASL1 of Perugia (Italy), analyzing the outcomes of this population at 1 year and in the medium-long term.

Methods: The clinical instrumental characteristics and the outcome of patients referred to CR after ST-elevation myocardial infarction (STEMI), non-ST-elevation myocardial infarction (NSTEMI), angina, coronary artery bypass graft (CABG), ischemic heart disease have been analyzed.

Educational pathway, competence, indication and quality process of the new classification of echocardiography according to the appropriateness of use and application.

In continuation of a previous publication, the present study will take into account for each application and profile the clinical use, the minimal data settings, the echo data findings, the indications, the quality process, the accreditation requirements, educational tailored pathway contents and modalities. The aim of the present document was to define the main applications of echocardiography and to tailor for each application-derived profile, according with the previous definitions, requirements that clearly identify the indication, objective, clinical situation in which echocardiography is used, educational pathway and training, quality process and accreditation.

[Appropriateness in echocardiography and clinical priority classification criteria: a proposal from the Italian Society of Cardiovascular Echography].

One of the main tasks of a scientific society is to define the theoretical bases and appropriate management strategies with the aim to maintain a high-quality diagnostic and therapeutic standard. As far as echocardiography is concerned, the task of the Italian Society of Cardiovascular Echography is to provide appropriate, complete, and useful echocardiographic tests for clinical application, as well as procedural, technological, organizational and economic indications to be adopted in clinical practice. In addition, there is an increasing need for regulating access to echocardiographic assessment according to clinical priority, because of the huge proportion of patients who should undergo a first or follow-up echocardiographic evaluation.

[Management of ST-elevation myocardial infarction in the Umbria region: results from the observational prospective Umbria-STEMI registry].

Background: In the last few years, advances have been made in the diagnosis and management of ST-segment elevation myocardial infarction (STEMI). Recent guidelines have been developed to improve outcome of STEMI patients by implementation of the recommendations into clinical practice. In order to assess the disease burden, the treatment modalities and the mid-term outcome of STEMI in the Umbria region, Italy, we performed a prospective observational study of all patients hospitalized with a diagnosis of STEMI from October 14, 2006 to April 14, 2008 (Umbria-STEMI registry).

[Evaluation of the appropriateness of prescribing echocardiography].

Background: We evaluated the appropriateness of indications to echocardiography for ambulatory patients performed during 4 weeks in 21 laboratories in Tuscany and Umbria, Italy.

Methods: We collected the following data: the appropriateness of the prescription (according to the guidelines of the Italian Federation of Cardiology), the prescribing physician (cardiologist vs non-cardiologist), the synthetic result (normal vs abnormal) and the clinical utility (useful vs useless) of each exam.

Results: We evaluated 2848 prescriptions (patients: 1450 males, 1398 females; mean age 62 years, range 15-90 years).