Publications by authors named "Simone Pasquale Crispino"
Coronary artery disease (CAD) remains a leading cause of morbidity and mortality worldwide, accounting for over 9 million deaths annually. The prevalence of CAD continues to rise, driven by ageing and the increasing prevalence of risk factors such as hypertension, diabetes, and obesity. Current clinical guidelines emphasize the importance of functional tests in the diagnostic pathway, particularly for assessing the presence and severity of ischemia.
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- Athletes often show changes in their electrocardiograms (ECGs) due to heart adaptations from regular training, known as the athlete's heart, but these changes can sometimes mimic heart disease signs.
- Misdiagnosis can lead to serious consequences, including sudden cardiac death, which is a major risk for young athletes.
- This review aims to help cardiologists and sports doctors differentiate between normal exercise-related ECG changes and those indicating potential heart problems, guiding further investigations when needed.
Environmental factors such as extreme temperatures, humidity, wind, pollution, altitude, and diving can significantly impact athletes' cardiovascular systems, potentially hindering their performance, particularly in outdoor sports. The urgency of this issue is heightened by the increasing prevalence of climate change and its associated conditions, including fluctuating pollution levels, temperature variations, and the spread of infectious diseases. Despite its critical importance, this topic is often overlooked in sports medicine.
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- The study explored the presence of cardiac remodelling, specifically eccentric hypertrophy (EH), in 309 endurance athletes and sought to identify those without this adaptation, known as normal geometry (NG).
- Among athletes studied, 67% of males and 68.5% of females exhibited EH, while a notable number (31.3% of males and 31.4% of females) showed NG characteristics.
- Athletes with NG demonstrated lower peak power outputs and higher resting heart rates compared to those with EH; however, both groups did not show significant differences in their athletic achievements.
Introduction: Left ventricular (LV) trabeculations (LVTs) are common findings in athletes. Limited information exists regarding clinical significance, management, and outcome.
Objectives: The purpose of this study is to examine the prevalence and morphologic characteristics of LVTs in elite athletes, with a focus on clinical correlates and prognostic significance.
Article Synopsis
- Uricemia is linked to cardiovascular disease and is elevated in 4.4% of Olympic athletes, lower than the general population; males show higher levels than females.
- The study categorizes athletes into four disciplines and measures various health indicators, finding correlations between hyperuricemia and factors like hypertension and body fat.
- Despite being generally healthy, the presence of multiple cardiovascular risk factors in athletes suggests that monitoring uric acid levels is important for assessing their overall cardiovascular health.
Article Synopsis
- The study examined right ventricular (RV) changes in 370 elite athletes during the Tokyo and Beijing Olympics, focusing on differences based on gender and type of exercise (isometric vs. isotonic).
- Isotonic athletes displayed greater RV remodeling with notable differences in size measurements compared to isometric athletes, while males generally had larger RV and right atrium sizes but with lower RV TDI velocities.
- Although RV morphological changes varied by exercise type, functional differences were minimal, with female athletes showing unique RV profiles in terms of specific velocity measurements.
Female physiology is regulated after puberty by the menstrual cycle, whose hormonal fluctuations create a multitude of effects on several systems, including the cardiovascular one. The use of hormone therapy (HT) is quite common in female athletes, and data on cardiovascular effects in this population are lacking. We sought to investigate the effects of HT in highly trained athletes to assess any difference associated with HT on cardiac remodeling, exercise capacity, and clinical correlates.
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- Bilirubin is thought to have protective effects on cardiovascular and metabolic health, with mild hyperbilirubinemia potentially providing benefits against diseases related to oxidative stress, particularly in individuals with Gilbert syndrome (GS).
- A study involving 1,492 elite Italian athletes revealed that GS was present in 6% of participants, predominantly males, and athletes with GS showed specific hematological differences such as lower platelet counts and higher iron levels compared to those without GS.
- No significant differences were noted in cardiac health or exercise capacity among GS athletes, although endurance athletes exhibited higher levels of total and indirect bilirubin.
Practical Guidance for the Use of SGLT2 Inhibitors in Heart Failure.
Am J Cardiovasc Drugs
November 2023
Article Synopsis
- Heart failure (HF) remains a significant global health challenge despite improvements in diagnosis and treatment options.
- Sodium-glucose co-transporter 2 inhibitors (SGLT2i), like dapagliflozin and empagliflozin, are now recommended as foundational therapy for HF, shown to reduce cardiovascular death and hospitalizations.
- Barriers to their use include low prescription rates, awareness gaps, and concerns about safety, highlighting the need for better education and practical guidance for clinicians.
Observing mitral or tricuspid valve disease in an athlete raises many considerations for the clinician. Initially, the etiology must be clarified, with causes differing depending on whether the athlete is young or a master. Notably, vigorous training in competitive athletes leads to a constellation of structural and functional adaptations involving cardiac chambers and atrioventricular valve systems.
View Article and Find Full Text PDFIn the present article, we describe the case of a 21-year-old male presenting to the emergency department following a syncopal episode. Physical examination revealed a distinctive facial appearance in the context of an overgrowth syndrome. Also, an ajmaline test was performed because of the evidence of an incomplete right bundle branch block with ST-T segment elevation in the right precordial derivations, revealing a type-1 Brugada electrocardiographic pattern.
View Article and Find Full Text PDFHeart failure (HF) affects many patients worldwide every year. It represents a leading cause of hospitalization and still, today, mortality remains high, albeit the progress in treatment strategies. Several factors contribute to the development and progression of HF.
View Article and Find Full Text PDFA 55-year-old male affected by heart failure with reduced ejection fraction and a history of a transient cerebrovascular accident was accepted to the Cardiology Department for worsening dyspnea. A cardiopulmonary exercise test was performed after therapy optimization to further evaluate exercise intolerance. A rapid increase in the minute ventilation/carbon dioxide production slope, end-tidal oxygen pressure, and respiratory exchange ratio, with a concomitant decrease in end-tidal carbon dioxide pressure and oxygen saturation, were observed during the test.
View Article and Find Full Text PDFPatients with advanced heart failure (AdHF) have a reduced quality of life and poor prognosis. A heart transplant (HT) is an effective treatment for such patients. Still, because of a shortage of donor organs, the final decision to place a patient without contraindications on the HT waiting list is based on detailed risk-benefit analysis.
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