1,721,126 research outputs found
Black athletes' hearts
No full textAims Black athletes demonstrate an increased prevalence of repolarization anomalies and left ventricular hypertrophy compared to their white counterparts. Recent international recommendations for electrocardiogram (ECG) interpretation in athletes now account for some of these observations, but little attention is given to whether the heart of the black athlete is universal, or whether substantial differences exist according to geographic origin. Our aim was to examine the impact of geographical origin upon the electrical-and structural manifestations of the black athlete's heart.Methods and results A total of 1698 male competitive athletes participating in mixed sports presented at our organization for 12 lead-ECG led pre-participation screening, with 1222 athletes undergoing systematic echocardiography. Black athletes were categorized against United Nations defined geographical regions (North, East, Middle and West Africa, African American/Caribbean, South American, and West Asia) and compared with a cohort of non-black athletes who shared a close geographical boarder with Africa (South European White and Arabic North African). The prevalence of an abnormal ECG suggestive of cardiac pathology significantly varied by geographical origin. Repolarization abnormalities were significantly more common among West (6.4%) and Middle African (8.5%) athletes than East (1.5%) and North Africans (1.2%) (P < 0.05). Left ventricular hypertrophy was significantly more common among African-American/Caribbean (9.5%) and West African (5%) athletes than West Asian (0.8%), East African (0%), and North African (0%) athletes (P < 0.05). This result remained after accounting for body size.Conclusion The collective term 'black' should not imply that the hearts of all black athletes are universally comparable. There is considerable variability in the cardiac electrical and structural remodelling response to exercise that appears to be dependent on geographic origin
Atrial septal defect and training-induced changes in loading conditions: Clinical management and implications for competitive athletes
No full textAtrial septal defect (ASD) is the most common congenital heart disease in adults. When right heart dilation occurs, prompt closure should be considered. In the athletic population, however, the management of ASD can be challenging. Indeed, while the traininginduced haemodynamic effects on the right heart of an athlete with open ASD are not well known, possible device-related consequences may occur after percutaneous closure. We report the case of a competitive athlete with secundum ASD in which changes in the training regime significantly affected the right heart. Prompt normalisation of right ventricular size and of pulmonary artery pressures was demonstrated 2 months after percutaneous ASD closure
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The role of optical coherence tomography in clarifying the mechanisms for dobutamine stress echocardiography-induced takotsubo cardiomyopathy. [Echocardiography. 2013]
The role of optical coherence tomography in clarifying the mechanisms for dobutamine stress echocardiography-induced takotsubo cardiomyopathy.
Fineschi M, D'Ascenzi F, Sirbu V, Mondillo S, Pierli C.
Echocardiography. 2013 May; 30(5):E121-4. Epub 2013 Jan 11.Dobutamine stress echocardiography and Takotsubo syndrome: could milder forms of this pathology confound the diagnostic value of the test? [Echocardiography. 2013
Spontaneous coronary artery dissection in a middle-age woman: percutaneous treatment guided by intracoronary imaging techniques
No full textAngiographic diagnosis and treatment of spontaneous coronary artery dissection is challenging. Complementary use of intracoronary imaging can provide information to guide percutaneous treatments, particularly in these challenging settings. Here we report a case of a 52-year-old woman presenting with an anterior ST-segment elevation myocardial infarction caused by a spontaneous, long, and spiral dissection of the left anterior descending artery. Intracoronary imaging allowed us to visualize the entry port of the coronary dissection which was not sealed by the first angio-guided stenting. This case demonstrates that, beyond merely diagnostic information, the intracoronary imaging is able to provide information to guide percutaneous treatments, particularly in challenging settings in which coronary angiography reveals its limitations
Index of microcirculatory resistance to evaluate the efficacy of self-expanding stent and thrombectomy in acute myocardial infarction
No full textHow should I treat pulmonary arteriovenous malformations in a patient with Rendu-Osler disease presenting with transient ischaemic attack
No full textAbstract
BACKGROUND: A 42-year-old man with no cardiovascular risk factors or history was admitted for evaluation of an episode of transient ischaemic attack (TIA). He had no cardiovascular risk factors and his physical examination was unremarkable. INVESTIGATION: Physical examination, electrography, transesophageal echocardiogram, coronary angiogram. DIAGNOSIS: Intrapulmonary shunting, in the presence of arteriovenous malformations, possible hereditary haemorrhagic telangectasia. TREATMENT: Transcatheter occlusion of multiple pulmonary arteriovenous malformations using an AMPLATZER vascular plu
Cardiologia: È l'era dello smartphone? [Cardiology: is the smartphone era?]
No full textThe worldwide spread of smartphones has radically changed the habits of human life, allowing a 24/7 connection with other people. These changes have involved also Medicine with smartphones being able to simplify the clinical practice of physicians. The development of new external devices that can be connected to smartphones has further increased their use with mobile phones converted in portable electrocardiogram or echocardiogram machines. This extraordinary technological improvement seems to be partly in conflict with the classical tools available for the cardiologist, such as the "old" stethoscope that in 2016 had its 200th anniversary. This article focuses on the smartphone as a new tool available for the physicians, describing the most important potential uses and reporting an analysis of pros and cons of the smart-cardiology
Left ventricular non-compaction and hypertrabeculation in the athlete: Distinguishing between pathology and physiology
No full textTAPSE: An old but useful tool in different diseases
No full textRV function is an important component of overall heart function with prognostic value in predicting symptomatic limitation and outcome in different cardiovascular pathologies. RV longitudinal contraction accounts for the majority of total RV function, up to 80%, as compared to transverse shortening. Calculation of RV volume and RV ejection fraction (RVEF) remains hampered by the complex RV geometry and we lack a good geometric model allowing the calculation of right ventricular ejection fraction; secondly, the large apical trabeculations of the right ventricle make the endocardial delineation more difficult to obtain than for the left ventricle. To notice, the gold standard method for the assessment of the chamber (MRI) is resource intensive and cannot be employed in many settings. Considering these problems, multiple parameters have been developed for the evaluation of RV systolic function: tricuspid annular plane systolic excursion (TAPSE), systolic excursion velocity (S′), and longitudinal strain by speckle tracking
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