Subclinical cardiac involvement in Crohn's disease and ulcerative colitis: an echocardiographic case-control study.

Background: Cardiovascular manifestations of inflammatory bowel disease (IBD) are considered rare. The aim of the present study was to assess cardiac structure and function by means of traditional Doppler echocardiography and tissue Doppler imaging in order to better appreciate myocardial subclinical alterations and their future implications for these kind of patients.

Methods: Twenty-seven patients affected by Crohn's disease (CD) and 43 suffering from ulcerative colitis (UC) were enrolled.

Effects of oral administration of orodispersible levo-carnosine on quality of life and exercise performance in patients with chronic heart failure.

Objective: Chronic heart failure (CHF) is characterized by several micronutrient deficits. Amino acid supplementation may have a positive effect on nutritional and metabolic status in patients with CHF. Levo-carnosine (β-alanyl-L-histidine) is expressed at a high concentration in myocardium and muscle.

Separation of mediastinal shed blood during aortic valve surgery elicits a reduced inflammatory response.

Aims: The detrimental effects of inflammation following cardiopulmonary bypass (CPB) could negatively affect the postoperative outcome in a specific subset of high-risk patients. We therefore investigated the impact of a CPB circuit (Admiral, Eurosets, Italy) that allows separation of intracavitary and mediastinal blood on the release of biochemical markers and clinical outcome when compared with a conventional circuit.

Methods: Thirty patients undergoing aortic valve surgery were prospectively enrolled and assigned to Admiral group (Group 1, G1, n = 15) or conventional CPB group (Group 2, G2, n = 15).

Long-term prognostic value of longitudinal strain of right ventricle in patients with moderate heart failure.

Introduction: Right ventricular (RV) systolic dysfunction is a strong prognostic predictor in chronic heart failure (HF). However, assessment of RV function remains difficult. We investigated the prognostic value of different echocardiographic parameters for evaluating RV function in 60 patients with chronic HF and a low left ventricular ejection fraction (<40%) who were on optimal medical treatment.

Non-obstructive membranes of the left atrial appendage.

The left atrial appendage (LAA) is a blind-ending, complex structure distinct from the body of the left atrium and is sometimes regarded as a minor extension of the atrium. However, it should routinely be analysed as part of a transoesophageal echocardiographic examination. In this study we describe the presence of a non-obstructive membrane traversing the cavity of the LAA, found incidentally on transoesophageal echocardiography.

Hemodynamic progression and outcome of asymptomatic aortic stenosis in primary care.

The prognostic relevance of a rapid rate of hemodynamic progression of aortic stenosis (AS) has been predominantly investigated in tertiary centers. We reviewed the clinical and echocardiographic data from 153 asymptomatic patients with AS (age 77 ± 9 years; 65% men), with normal left ventricular function and paired echocardiograms ≥4 months apart (mean 2.9 ± 2.

Circulating tumor cells and cardiac metastasis from esophageal cancer: a case report.

We report the case of a 67-year-old man affected by metastatic esophageal cancer. The patient developed a symptomatic heart metastasis presenting as mimicking ST-segment elevation myocardial infarction. Cardiac magnetic resonance imaging (MRI) documented the presence of a mass in the apex and septum of the left ventriculum.

Effect of spironolactone on left ventricular ejection fraction and volumes in patients with class I or II heart failure.

The beneficial effects of spironolactone in chronic heart failure (HF) have been demonstrated in patients with New York Heart Association (NYHA) class III to IV HF. This study examined the effect of spironolactone on left ventricular (LV) function and functional capacity of patients with mild to moderate HF (NYHA class I to II). One hundred sixty-eight patients with NYHA class I to II HF and LV ejection fraction ≤40% were randomized to spironolactone or placebo and assessed by echocardiography, gated single-photon emission computed tomography, technetium-99m sestamibi single-photon emission computed tomographic radionuclide ventriculography, and cardiopulmonary exercise testing at baseline and after 6 months of treatment.

Measurement of the myocardial performance index in ambulatory patients with heart failure: correlation with other clinical and echocardiographic parameters and independent prognostic value.

Background: Many echocardiographic parameters have been proposed for the assessment of the patients with heart failure (HF). Recently, the myocardial performance index (MPI) has been shown to be an accurate index of myocardial function. We assessed the correlation with other clinical and echocardiographic measurements and the prognostic value of MPI in patients with HF.

[Usefulness of left atrial diametres and volumes for the evaluation of left ventricular diastolic function].

Introduction: The diastolic function of the left ventricle is a main point of the physiological adaptations of the cardiovascular system to the various situations.

Aim Of The Study: Evaluation of left atrium diameter change during diastole and left atrial volume and their possible correlation with different left ventricular diastolic filling pattern.

Material And Methods: Ninety patients with echocardiographically determined diastolic dysfunction and eighty healthy volunteers were included in the study.

Pneumonia in a cardiothoracic intensive care unit: incidence and risk factors.

Objective: The purpose of this study was to determine the incidence, risk factors, and pathogens causing pneumonia in a cardiothoracic intensive care unit (CTICU).

Design: A prospective study.

Setting: "Civili Hospital," Brescia, Italy.

[Acute heart failure: clinical profiles and pathophysiology].

Acute heart failure (HF) is the most common diagnosis at discharge in patients aged > 65 years. It carries a dismal prognosis with a high in-hospital mortality rate and very high post-discharge mortality and rehospitalization rates. It is a complex clinical syndrome that is challenging to define as it may vary widely with respect to underlying pathophysiological mechanisms and clinical presentations.

Bisoprolol in the treatment of chronic heart failure: from pathophysiology to clinical pharmacology and trial results.

Clinical trials have consistently shown the benefits of beta-blocker treatment in patients with chronic heart failure (HF). As a result, bisoprolol, carvedilol, and metoprolol succinate are now indicated for the treatment of all patients with chronic HF who do not have major contraindications. Bisoprolol is the first beta-blocker shown to improve survival in an outcome trial.

Worsening renal function in patients hospitalised for acute heart failure: clinical implications and prognostic significance.

Background: Renal function is a powerful prognostic variable in patients with heart failure (HF). Hospitalisations for acute HF (AHF) may be associated with further worsening of renal function (WRF).

Methods And Results: We analysed the clinical significance of WRF in 318 consecutive patients admitted at our institute for AHF.

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.

Clinical trials update from the World Congress of Cardiology 2006.

This article provides information on trials presented at the World Congress of Cardiology 2006 (WCC-2006). This was a joint meeting of the European Society of Cardiology and the World Heart Federation. Heart failure trials dealing with understudied patient populations (e.

Beta-blocker therapy of heart failure: an update.

The beneficial effects of beta-blocker therapy in patients with heart failure have been consistently shown by multi-center randomised trials. These agents are effective and also relatively well tolerated in the elderly and in patients with diabetes and advanced heart failure--traditionally considered as relative contraindications to their administration. However, the use of beta-blockers in clinical practice remains low.

Anemia and heart failure: a cause of progression or only a consequence?

Anemia is one of the most frequent co-morbidities in the patients with heart failure. Its prevalence increases from 4-7% in the subjects with asymptomatic left ventricular dysfunction to >30% in the patients with severe heart failure. Renal insufficiency, activation of inflammatory mediators, and treatment with renin-angiotensin antagonists seem to be its main determinants.

Prospective assessment of integrating the existing emergency medical system with automated external defibrillators fully operated by volunteers and laypersons for out-of-hospital cardiac arrest: the Brescia Early Defibrillation Study (BEDS).

Aims: There are few data on the outcomes of cardiac arrest (CA) victims when the defibrillation capability of broad rural and urban territories is fully operated by volunteers and laypersons.

Methods And Results: In this study, we investigated whether a programme based on diffuse deployment of automated external defibrillators (AEDs) operated by 2186 trained volunteers and laypersons across the County of Brescia, Italy (area: 4826 km(2); population: 1 112 628), would safely and effectively impact the current survival among victims of out-of-hospital CA. Forty-nine AEDs were added to the former emergency medical system that uses manual EDs in the emergency department of 10 county hospitals and in five medically equipped ambulances.

Secondary prevention of sudden cardiac death.

Sudden cardiac death is still the largest cause of natural death in western countries, especially in patients with coronary artery disease and in those who have already experienced an episode of resuscitated out-of-hospital cardiac arrest or ventricular tachycardia. Prevention of arrhythmia recurrences (i.e.

Serum cholesterol levels modulate long-term efficacy of cholinesterase inhibitors in Alzheimer disease.

The clinical, genetic or biological variables which regulate long-term efficacy of cholinesterase inhibitors (ChEIs) in Alzheimer disease (AD) are still unknown and it is not possible to predict who will benefit from the treatment. In this study we showed that high cholesterol levels correlated with faster decline at 1-year follow-up in AD patients on ChEIs. These findings suggest that serum cholesterol is a modulating factor of treatment response and additional therapies aimed at reducing treatable high cholesterol levels may represent an alternative strategy to improve ChEIs efficacy and slow down disease progression over time.

[Endocavitary electric cardioversion of atrial fibrillation in patients with persistent left superior vena cava].

The observation of a persistent left superior vena cava is a rare event during electrophysiological procedures. In the literature, many studies can be found describing permanent pacemaker implantation in patients with this congenital defect. We describe the case of a 70-year-old woman, referred to our centre for persistent atrial fibrillation, not converted to sinus rhythm with transthoracic electrical cardioversion in whom we decided to attempt an endocardial electrical cardioversion.