Transthoracic Doppler echocardiography for the assessment of left atrial appendage size and blood flow velocity: a multicentre study.

Objective: The aim of this study was to evaluate the reliability of transthoracic Doppler echocardiography (TTE) in the assessment of left atrial appendage (LAA) size and function.

Methods: We considered 86 consecutive patients [56 male, 30 female; mean age 64 +/- 13 years, sinus rhythm 36 patients (42%); atrial flutter/fibrillation 50 patients (58%)] referred for transoesophageal echocardiography (TEE) and TTE. Maximum LAA transverse diameters and LAA peak flow velocities were calculated by two-dimensional and pulsed-wave Doppler analysis at TEE and TTE.

A protective role of a cholesteryl ester transfer protein gene variant towards ischaemic stroke in Sardinians.

Objectives: Cholesteryl ester transfer protein (CETP) plays a key role in the metabolism of high-density lipoprotein (HDL), a strong, inverse, independent risk factor for cardiovascular disease. We sought to investigate the relationship between a common variant of CETP gene, the Taq1 B polymorphism, that has been previously associated with CETP blood concentrations, and the risk of ischaemic stroke in a genetically homogenous population from the Sardinia island, Italy. This population has been previously shown to be a highly conservative sample.

Multivariate risk assessment and risk score cards in hypertension.

Cardiovascular disease represents the leading cause of morbidity and mortality in Western countries, and hypertension-related cardiovascular events affect about 37 million people per year, worldwide. In this perspective, hypertensive patients are at increased risk to experience cardiovascular events during life-long period, and treatment of high blood pressure represents one of the most effective strategies to reduce global cardiovascular risk. However, due to its multifactorial pathophysiology and its frequent association with other relevant risk factors and clinical conditions, treatment of hypertension requires an integrated approach, including life-style measures, antihypertensive drugs and other therapies.

Antihypertensive strategy based on angiotensin II receptor blockers: a new gateway to reduce risk in hypertension.

Effective treatment of high blood pressure levels represents a key strategy for reducing global cardiovascular risk. Other factors, beyond blood pressure control, however, appear to be of potential relevance in reducing the risk related to hypertension. Recent clinical trials have demonstrated that those pharmacological agents that counteract the renin-angiotensin system may confer additional clinical benefits across the spectrum of cardiovascular disease, beyond their blood pressure-lowering properties.

Markers of inflammation and fibrosis are related to cardiovascular damage in hypertensive patients with metabolic syndrome.

Background: Previous studies have shown that metabolic syndrome (MS) is associated with an increased susceptibility to develop cardiovascular damage (CD). Experimental evidence indicates that inflammation and fibrosis could play a critical role in the development of CD in hypertension. This issue has not been clarified yet in patients with MS.

Reduced levels of N-terminal-proatrial natriuretic peptide in hypertensive patients with metabolic syndrome and their relationship with left ventricular mass.

Objectives: The metabolic syndrome (MS) is associated with left ventricular hypertrophy (LVH). Previous evidence has shown that LVH is favoured by low levels of atrial natriuretic peptide (ANP), independently from blood pressure (BP), in hypertension. Although levels of natriuretic peptides are known to be lower in obesity, plasma ANP levels have not yet been assessed in MS.

Adverse effects of statins : how should cardiologists and general physicians manage them in clinical practice?

A key role in the pathogenesis of atherosclerotic lesions is represented by cholesterol deposition in the arterial vessel wall, and a large body of international, randomised, controlled clinical trials have shown that the clinical use of drugs that are active in lowering serum cholesterol concentrations, such as competitive inhibitors of hydroxymethylglutaryl coenzyme A (HMG-CoA) reductase (collectively defined as 'statins'), produces significant reductions of cardiovascular mortality and morbidity through different and sometimes not fully elucidated mechanisms. However, it is important to consider that the patients who get the largest benefit from taking statins (frequently at high doses) are at the same time those with the highest risk of presenting adverse effects related to the use of these drugs. These patients are usually elderly, hypertensive and diabetic, often have renal function impairment or other associated clinical conditions and are usually receiving multiple therapies.