1,721,020 research outputs found
Echocardiographic tools for prognostic stratification in transthyretin cardiac amyloidosis: a new arrow in the quiver
Ventricular Septal Defect Complicating Inferior Acute Myocardial Infarction: A Case of Percutaneous Closure
Ventricular septal defect (VSD) is one of the most serious mechanical complications of acute myocardial infarction (AMI). Despite the incidence of post-AMI VSD in reperfusion era has reduced from 1%-2% to 0.17%-0.31%, it is a still life-threatening condition with poor prognosis. Surgical VSD closure is considered the best treatment approach since conservative management carries an extremely high mortality rate. Over the last decade, percutaneous transcatheter closure has emerged as an alternative therapeutic strategy for a patient with post-AMI VSD, with outcomes similar to cardiac surgery (30-day mortality 14%-66%). We present a case of inferior AMI complicated by posterobasal VSD and cardiogenic shock successfully treated with percutaneous closure. The role of echocardiography in diagnosis, management, and percutaneous procedure guiding has been emphasized
La diagnosi scientifica a servizio delle opere d'arte: il busto di San Donato della cattedrale di Bari
[Cardiovascular management of patients with chronic myeloid leukemia treated with BCR-ABL tyrosine kinase inhibitors: it is time for a shared management]
: Chronic myeloid leukemia is a rare myeloproliferative disease, characterized by a chromosomal translocation detected in 95% of cases, defined as "Philadelphia chromosome", encoding for the BCR-ABL fusion protein with continuous activation of the tyrosine kinase domain. Over the last 20 years, treatment has been revolutionized by the use of BCR-ABL tyrosine kinase inhibitors (TKI). Imatinib is the first TKI approved with a good cardiovascular safety profile, while some second-generation (nilotinib and dasatinib) and third-generation (ponatinib) drugs, developed to overcame drug resistance, can be associated with cardiovascular adverse events. The major adverse effect of dasatinib is pulmonary hypertension, reversible after treatment discontinuation. Conversely, nilotinib or ponatinib assumption is associated with a higher incidence of ischemic events, including coronary artery disease, cerebral stroke and peripheral arterial disease. Therefore, the management of patients receiving TKI therapy should include an integrated multidisciplinary evaluation and follow-up, involving highly specialized figures such as a cardiologist, hematologist and/or oncologist and the application of dedicated pathways, in order to prevent the onset or manage cardiovascular complications associated with these drugs
The “Exultet 1” of Bari: multi-methodological approach for the study of a rare medieval parchment roll
A rare medieval parchment roll, called Exultet 1 (first half of XI Century), preserved in the Diocesan Museum of Capitolo Metropolitano of Bari (Italy) has been studied. Certainly, it is one of the highest literary and artistic expressions ever produced in Bari, one of a kind. It is also the very first among medieval European liturgical rolls, in which miniatures are painted upside-down in respect to the text. To analyse inorganic pigments, a mobile laboratory has been set up at the museum. The techniques used, for a non-invasive and non-destructive in situ analysis, were: VIS-NIR spectrophotometry in reflectance mode with optic fibres (FORS), X-Ray fluorescence spectrometry (XRF) and finally μ-Raman spectroscopy. Such multi-methodological approach allowed to acquire many data without causing any stress to the artwork. The mineral pigments have been identified mainly by FORS and they are: red earth and minium, lapis lazuli and azurite, green earth and copper resinate, orpiment and yellow earth. In some areas, traces of a residual gold leaf have been identified by XRF. The presence of rare and precious pigments as lapis lazuli and gold leaf underlines the sacredness and the importance of the parchment. This is the first scientific investigation performed on the Exultet 1 of Bari
The Role of Stress Echocardiography in Valvular Heart Disease
PURPOSE OF REVIEW: Stress echocardiography is recommended in valvular heart disease when there is a mismatch between resting transthoracic echocardiography findings and symptoms during activities of daily living. We describe the current methodology and the evidence supporting these applications. RECENT FINDINGS: The comprehensive stress echo assessment includes valve function (gradients and regurgitation), left ventricular global systolic and diastolic function, left atrial volume, pulmonary congestion, pulmonary arterial pressure, and right ventricular function, integrated with blood pressure response with cuff sphygmomanometer, chronotropic reserve with heart rate, and symptoms. SUMMARY: Recent guidelines recommend the evaluation of asymptomatic severe or symptomatic non-severe mitral regurgitation or stenosis with exercise stress and suspected low-flow, low-gradient severe aortic stenosis with reduced ejection fraction with low dose (up to 20 mcg, without atropine) dobutamine stress. Prospective, large-scale studies based on a comprehensive protocol (ABCDE +) capturing the multiplicity of clinical phenotypes are needed to support stress echo-driven treatment strategies
Response to: Correspondence on 'Beta-blockers are associated with better long-term survival in patients with Takotsubo syndrome' by Chang et al
Response to: Correspondence on ‘Beta-blockers are associated with better long-term survival in patients with Takotsubo syndrome’ by John E Madias
Comparison of mortality in primary and secondary Takotsubo cardiomyopathy with severe left ventricular dysfunction: reply
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