A case of Multiple Unilateral Pulmonary arteriovenous Malformation Relapse: Efficacy of embolization treatment.

Pulmonary arteriovenous Malformations (PAVMs) are a rare vascular alteration characterized by abnormal communications between the pulmonary arteries and veins resulting in an extracardiac right-to-left (R-L) shunt. The majority of PAVMs are associated with an autosomal dominant vascular disorder also known as Osler-Weber-Rendu Syndrome. PAVMs appearance can be both single and multiple.

The Role of the Atrial Electromechanical Delay in Predicting Atrial Fibrillation in Myotonic Dystrophy Type 1 Patients.

Background: Paroxysmal atrial tachyarrhythmias frequently occur in myotonic dystrophy type 1 (DM1) patients. The aim of the current study was to evaluate the atrial electromechanical-delay (AEMD) in a DM1-population with normal cardiac function and its relationship to atrial fibrillation (AF) onset.

Methods And Results: Fifty DM1 patients (28 male; mean age 34.

Echocardiographic prediction of pre- versus postcapillary pulmonary hypertension.

Background: The differential diagnosis between pre- and postcapillary pulmonary hypertension (PH) is of major therapeutic relevance and thus requires optimal clinical probability assessment with echocardiography.

Methods: We prospectively analyzed 152 consecutive patients referred to a PH center over a 1-year period undergoing quasi-simultaneous (within 1 hour) echocardiography and right heart catheterization. Echocardiography was performed as usually recommended for the assessment of PH and left heart conditions.

Pulmonary arterial hypertension: the key role of echocardiography.

Echocardiography is a key screening tool in the diagnostic algorithm of pulmonary arterial hypertension (PAH). It provides an estimate of right ventricular function and pulmonary artery pressure, either at rest or during exercise, and is useful in ruling out secondary causes of pulmonary hypertension (PH) such as left heart disease or congenital heart disease. Several studies have showed that echocardiography is insufficiently precise as single tool for the ultimate diagnosis of PH respect to the right heart catheterization, considered the gold standard technique.

The effect of atrial preference pacing on paroxysmal atrial fibrillation incidence in myotonic dystrophy type 1 patients: a prospective, randomized, single-bind cross-over study.

Aims: Atrial Preference Pacing (APP) is a pacemaker (PM) algorithm that supports a continuous atrial stimulation instead of a spontaneous atrial rhythm to prevent supraventricular tachyarrhythmias. The role of the APP in the prevention of atrial fibrillation (AF) is still controversial. The aim of our study was to evaluate the effect of preventive atrial pacing on AF incidence in myotonic dystrophy type I patients during a 12-month follow-up period.

P-wave duration and dispersion in patients with Emery-Dreifuss muscular dystrophy.

Background: Paroxysmal episodes of atrial fibrillation frequently occur in Emery-Dreifuss muscular dystrophy (EDMD). Although previous studies have documented a variety of electrocardiographic abnormalities in EDMD, little is still known about P-wave dispersion (PD), an independent risk factor for the development of atrial fibrillation. The aim of our study was to evaluate the P-wave duration and PD in patients with EDMD with conserved systolic and diastolic cardiac function.

Inappropriate exercise-induced increase in pulmonary artery pressure in patients with systemic sclerosis.

Background: Recent data show that there is an unexpectedly high prevalence of 'inappropriate' pulmonary responses to exercise among patients with systemic sclerosis (SS). However, no consensus exists as to which threshold of pulmonary artery systolic pressure (PASP) can be considered diagnostically relevant.

Aim: To evaluate pulmonary vascular reserve and right ventricular function changes induced by exercise in SS patients without overt pulmonary arterial hypertension.

Optimal site for atrial lead implantation in myotonic dystrophy patients: the role of Bachmann's Bundle stimulation.

Aim: The aim of this study was to identify the optimal site for atrial lead implantation in myotonic dystrophy type 1 (MD1) patients.

Methods: The atrial pacing lead was positioned in the high-lateral right atrial wall (site A), then in the right atrial appendage (site B), and finally on the interatrial septum (site C) in 22 patients. Pacing and sensing thresholds were obtained for all sites.

Two-dimensional strain and atrial function: a study on patients after percutaneous closure of atrial septal defect.

Aims: To assess the value of two-dimensional (2D) strain in assessing regional myocardial function along the atrial wall.

Methods And Results: We studied 20 patients late after successful percutaneous atrial septal defect (ASD) closure. The analysis was performed for atrial longitudinal peak systolic strain on the interatrial septum, in correspondence of the device, and on the lateral wall of the left atrium.

Strain rate imaging is a superior method for the assessment of regional myocardial function compared with Doppler tissue imaging: a study on patients with transcatheter device closure of atrial septal defect.

To compare the value of strain and strain rate imaging in assessing regional myocardial function to that of myocardial velocities, we studied 10 patients late after successful percutaneous atrial septal defect closure. Analysis was performed for atrial longitudinal peak systolic velocity, strain, and strain rate from the midsegment of interatrial septum, in correspondence of the device, and from the lateral left atrial wall. Placing the sample volume in the middle part of the atrial septal defect occluder, a bulky noncontractile element, passively moved by global heart motion, the new ultrasonic-derived myocardial deformation indexes demonstrated almost the absence of any deformations, whereas myocardial velocities failed to significantly discriminate between this noncontracting structure and the normal atrial wall.

Improved outcome of pulmonary aspergillosis in heart transplant recipients with early diagnosis and itraconazole treatment.

Pulmonary aspergillosis is a severe complication in heart transplant recipients. The drug of choice for this infection is amphotericin B, but its use is limited because of its side effects. We observed six cases of pulmonary aspergillosis in a group of 200 patients who had received heart transplants from January 1988 to January 1999.