1,721,020 research outputs found
Reply to: Is serum uric acid a pretty accurate prognostic predictor of ST elevated acute coronary syndrome? Author: Alexander E. Berezin
Ambulatory ECG monitoring for the detection of myocardial ischaemia. Technical implications and applications for clinical trials
[Psychological stress as precipitating factor of the acute manifestations of ischemic cardiopathy]. FT Lo stress psicologico come fattore scatenante nelle manifestazioni acute della cardiopatia ischemica.
Psychological stress may play an important role as a risk factor for coronary heart disease (CHD). Psychological stress consists of different components whose diverse role in the onset of the acute manifestations of CHD is still not clear. We studied 80 patients with acute CHD (56 with unheralded myocardial infarction, 24 with unstable angina, mean age 55 +/- 9 years, 55 men) vs 80 controls (mean age 50 +/- 9 years, 52 men) admitted for an acute traumatic event. We proposed to both groups these questionnaires: a retrospective self and etero-evaluation of the degree of psychological stress; the modified Maastricht questionnaire (MMQ) that evaluates psychic and physical manifestations of psychological stress in the period preceding admission; the social support questionnaire (SSQ); the life event assessment that evaluates frequency and importance of life events in the year preceding admission. Psychological stress index was greater in patients (self-evaluation = 7.1 +/- 2.4; etero-evaluation = 7.4 +/- 2.3; MMQ = 91 +/- 30.8) than controls (self-evaluation = 4.3 +/- 2.3; etero-evaluation = 4.3 +/- 2.4; MMQ = 58.6 +/- 32.5; p < 0.001 for all questionnaires). The perception of strong social isolation was greater in patients (SSQ = 29.8 +/- 11.8) than controls (SSQ = 23.8 +/- 9.6; p < 0.001). Painful life events were more numerous in patients (10.7 +/- 2.3) than controls (8.2 +/- 3.4; p < 0.05) and perceived in a more negative way (patients = 12.7 +/- 4.1 vs controls = 10.2 +/- 3.8; p < 0.01).(ABSTRACT TRUNCATED AT 250 WORDS
Racial differences in coronary vasomotor response or selection bias?
© 2001 American Heart Association, Inc.Pristipino, Christian; Finocchiaro, Maria L.; Mongiardo, Rocco; Cianflone, Domenico; Sanna, Tommaso; Maseri, Attilio; Beltrame, John F.; Hattori, Ryuichi; Fujita, Masatoshi; Sasayama, Shigetak
Cardiologist and Diabetologist crosstalk in the era of cardiovascular outcome trials of novel glucose-lowering drugs
The prevalence of type 2 diabetes continues to increase and cardiovascular (CV) diseases remain the leading cause of death in diabetic patients. Diabetologists and Cardiologists have to work together in order to provide the best management to these patients. After years of disappointing studies showing no reduction of CV events with strict glycaemic control, some of the novel glucose-lowering drugs (GLDs) seem to offer a new approach to tackle the problem, since the CV outcome trials (CVOTs-D) of liraglutide, semaglutide, empagliflozin and canagliflozin have demonstrated not only their CV safety but also their efficacy in the reduction of CV morbidity and mortality. Along with the initial enthusiasm, concerns have been raised about the economical sustainability of long-term therapies considering higher costs of new molecules relative to the traditional ones. As expenses in the medical field are on the rise, healthcare systems need to balance the positive impact of an intervention and its overall cost. This review is meant to offer the Cardiologists a different point of view on the positive influence of GLDs, in the light of the main trials in the CV fields they are familiar with. The purpose of this article is to critically review the magnitude of the CVOTs-D results by the analysis of their statistical determinants, to establish the extent of the GLDs positive impact on patients with both diabetes and CV disease. The analysis has been performed taking into account models and statistical determinants used in the main landmark cardiology trials. It is fundamental to translate the result of CVOTs-D in clinical practice: the interdisciplinary crosstalk between the Cardiologist and Diabetologist is of paramount importance in order to fully exploit the power of the new available pharmacological strategies. Keywords: Cardiovascular outcome trials, Glucose-lowering drugs, Type 2 diabetes, Crosstalk, Cardiovascular ris
A Critical Reappraisal of Differences in Cardiac Resynchronization Therapy Defibrillator Effectiveness Between Men and Women in the MADIT-CRT Trial
Postoperative Arrhythmias after Cardiac Surgery: Incidence, Risk Factors, and Therapeutic Management
Arrhythmias are a known complication after cardiac surgery and represent a major cause of morbidity, increased length of hospital stay, and economic costs. However, little is known about incidence, risk factors, and treatment of early postoperative arrhythmias. Both tachyarrhythmias and bradyarrhythmias can present in the postoperative period. In this setting, atrial fibrillation is the most common heart rhythm disorder. Postoperative atrial fibrillation is often self-limiting, but it may require anticoagulation therapy and either a rate or rhythm control strategy. However, ventricular arrhythmias and conduction disturbances can also occur. Sustained ventricular arrhythmias in the recovery period after cardiac surgery may warrant acute treatment and long-term preventive strategy in the absence of reversible causes. Transient bradyarrhythmias may be managed with temporary pacing wires placed at surgery, but significant and persistent atrioventricular block or sinus node dysfunction can occur with the need for permanent pacing. We provide a complete and updated review about mechanisms, risk factors, and treatment strategies for the main postoperative arrhythmias
Closing the gap between WHO projections and actual need for cardiac rehabilitation in Europe
Reduction of mitral valve regurgitation caused by acute papillary muscle ischemia
BACKGROUND: A 67-year-old man was admitted to a coronary care unit for non-ST-segment elevation myocardial infarction with complicating acute heart failure. Severe mitral regurgitation was detected by echocardiography at presentation. Repeat echocardiography carried out during another ischemic episode revealed a marked reduction in the patient's mitral regurgitation that was related to decreased apical traction of the valve leaflets.
INVESTIGATIONS: Physical examination, electrocardiography, laboratory tests, coronary angiography, chest radiography, echocardiography.
DIAGNOSIS: Mitral regurgitation associated with acute coronary syndrome.
MANAGEMENT: Early revascularization by percutaneous coronary intervention, supported by pharmacological therapy to decrease left ventricular filling pressure
Remote health monitoring with wearable non-invasive mobile system: The HealthWear project.
This paper focuses on the technical solutions enabling the monitoring of health conditions by means of ECG, HR, oxygen saturation, impedance pneumography and activity patterns. The Healthwear service is based on the Wealthy prototype system. A new design has been made to increase comfort in wearing of the system during daily patient activities. The cloth is connected to a patient portable electronic unit (PPU) that acquires and elaborates the signals from the sensors. The PPU transmits the signal to a central processing site through the use of GPRS wireless technology. This service is applied to three distinct clinical contexts: rehabilitation of cardiac patients, following an acute event; early discharge program in chronic respiration patients; promotion of physical activity in ambulatory stable cardio-respiratory patients
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