1,721,045 research outputs found
Unusual intracardiac thrombosis in two patients with coronavirus disease 2019 (COVID-19): case series
No full textCOVID-19 may induce a coagulation dysregulation resulting in a prothrombotic state with a higher risk of arterial and venous thrombosis. This abnormal thrombotic diathesis can lead to pulmonary embolism, stroke, and intracardiac thrombosis
Prognostic effect of inappropriately high left ventricular mass in asymptomatic severe aortic stenosis
No full text[The serotonin syndrome: why should cardiologists be aware and scared of it]
No full textThe serotonin syndrome (SS) represents a life-threatening adverse drug reaction, caused by serotonin overload in the central and peripheral nervous system, producing autonomic instability, neuromuscular and cardiovascular abnormalities, and cognitive alterations. The incidence of SS has been growing over the last few years, as a consequence of population aging and the steadily increasing use of pro-serotoninergic agents in clinical practice, in the presence of various comorbidities, mainly cardiovascular. Cardiologists often use combination therapies including serotoninergic agents, and should therefore consider the risk of serotoninergic adverse events caused by inappropriate drug interactions. SS is often difficult to diagnose and may be life-threatening if not adequately managed. Considering the several published case reports of overdose or not recommended associations, a greater awareness by clinicians about the potential risks associated with inappropriate use of these drugs is needed, as well as better information on the clinical features and therapeutic approaches to SS
Frequent coexistence of chronic heart failure and chronic obstructive pulmonary disease in respiratory and cardiac outpatients: Evidence from SUSPIRIUM, a multicentre Italian survey
No full textBackground: Chronic heart failure (CHF) and chronic obstructive pulmonary disease (COPD) frequently coexist but concurrent COPD+CHF has been little investigated. Design: This multicentre survey (SUSPIRIUM) was designed to evaluate: the prevalence of COPD in stable CHF and CHF in stable COPD; diagnostic/therapeutic work-up for concurrent COPD+CHF; clinical profile of patients with COPD+CHF; predictors of COPD in CHF and CHF in COPD. Methods: A 5-month-long cross-sectional prospective observational survey was conducted in 10 cardiac and 10 respiratory connected outpatient units. Results: The prevalence of CHF in the 378 surveyed COPD patients was 11.9% (95% confidence interval 8.8-16.6) and the prevalence of COPD in 375 CHF patients was 31.5% (95% confidence interval 26.8-36.4). Diagnostic tests for suspected comorbidity were prescribed in 21.6% and 22.9% of COPD and CHF patients, respectively. Patients with coexisting CHF+COPD had a higher incidence of hypertension, physical inactivity and more frequently a GOLD score of 3 or greater. Compared to CHF only, CHF+COPD patients were significantly older, more frequently smokers, at worse respiratory risk and in a higher New York Heart Association class. Conversely, hypercholesterolaemia, a family history of ischaemic heart disease, fluid retention and comorbidities were more frequent in COPD+CHF than COPDonly patients. At multivariate analysis, a GOLD score of 3 or greater in CHF strongly predicted coexistent COPD (odds ratio 8.985, P<0.0001) as did a history of other respiratory diseases (5.184, P<0.0001). A history of ischaemic heart disease (4.868, P<0.0001), atrial fibrillation (3.302, P<0.0001) and sedentary lifestyle (2.814, P<0.004) predicted coexistent CHF in COPD. Conclusion: The high prevalence of COPD+CHF calls for integrated disease management between cardiologists and pulmonologists. SUSPIRIUM identifies which cardiac/pulmonary outpatients should be screened for the respective comorbidity
Beta-blockers can improve survival in medically-treated patients with severe symptomatic aortic stenosis
No full textIn patients with symptomatic severe aortic stenosis (AS), surgical or percutaneous aortic valve replacement (AVR) is the only treatment with proven ability to improve survival [1]. Nonetheless, a consistent proportionof symptomatic patients with severe AS remain un-operated [2]. This patient group has an extremely unfavorable prognosis with no available medical therapy of proven efficacy. Although the majority ofthese patients are also affected by heart failure, the recommended drugs able to counteract the negative effects of heart failure are generally precluded due to the fear that they could worsen flow obstruction atthe valve level. In particular, AS is traditionally considered a contraindication for beta-blockers (BBs) although, in asymptomatic patients with AS, BB use has been associatedwith improved survival [3]. We aimed toassess whether BBs could have a protective effect also on patients with symptomatic medically treated AS
Preoperative cardiac risks in noncardiac surgery: The role of coronary angiography
Full text linkThe preoperative evaluation of patients candidates to noncardiac surgery requires a knowledge of factors related both to type of surgery and to features of the single patient, potentially responsible for perioperative cardiovascular complications , fatal and nonfatal. The assessment of symptoms and/or noninvasive testing indicating the presence of coronary artery disease may suggest the need for medical therapy optimization and, eventually, coronary arteriography before the scheduled timing of noncardiac surgery. There is no evidence favoring a prophylactic myocardial revascularization (percutaneous or surgical) and more studies are needed to define the role of coronary artery disease diagnosis and treatment before high-risk non cardiac surgery
Going Beyond Counting First Authors in Author Co-citation Analysis
Full text linkThe present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation
counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings
are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that
only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into
account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed
Cardiac calcium score on 2D echo: correlations with cardiac and coronary calcium at multi-detector computed tomography
No full textBackground: To test the hypothesis that a semi-quantitative echocardiographic calcium score (eCS) significantly correlates with cardiac calcium measured by coronary computed tomography angiography (CCTA) and, secondarily, severe coronary artery calcifications and stenosis. Methods: This is a retrospective, observational study, conducted in a tertiary centre. eCS was compared with CCTA scores of non-coronary cardiac calcium (nCACS), coronary cardiac calcium (CACS) and number of diseased coronary vessels, in 141 subjects without known coronary artery disease (CAD), who underwent both echocardiography and CCTA for clinical reasons. Results: Age, prevalence of hypertension and all measures of calcium (eCS, nCACS and CACS) differed significantly between the no-CAD and CAD subgroups. eCS was positively correlated with nCACS (Spearman rho = 0.64, p 400), a known predictor of cardiovascular morbidity and mortality. The eCS also predicts obstructive CAD, incrementally to age and clinical variables, although for this purpose CACS remains the most accurate score
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