17,244 research outputs found
Role of body mass index and the systolic and diastolic parameters of left venricular function in explaining the impairment of functional capacity in patients with dilated cardiomyopathy
No full textLong-Term prognostic stratification of dilated cardiomyopathy by functional capacity: relative role of NYHA Class vs VO2, PEAK
No full textIrreversible Dilated Cardiomyopathy After Abuse of Anabolic Androgenic Steroids: A Case Report and Literature Review
No full textIllicit usage in athletes of androgenic anabolic steroids, such as testosterone and its derivatives, can cause myocardial dysfunction, that is usually reversible after the end of the abuse. However, in some cases myocardial dysfunction can be severe and irreversible for reasons that are not clear. We report the case of a 31-year-old patient, bodybuilder, who came to our attention for acute heart failure secondary to a dilated cardiomyopathy, with severe and irreversible left ventricular systolic dysfunction (LVEF 23%). Instrumental and laboratory examinations excluded myocarditis and coronary artery disease as a possible etiology of the left ventricular systolic dysfunction. The patient had previously taken different types of androgenic anabolic steroids (testosterone and derivatives), for almost twelve years and also growth hormone (GH) for 1 year, and never stopped hard exercise training throughout in order to improve his performance as a bodybuilder. He had been diagnosed with left ventricular systolic dysfunction, symptomatic for heart failure (NYHA class II-III), about six months after cessation of the abuse and the severe LV dysfunction did not reverse. We believe that the abuse of steroids may be the cause of our patient’s left ventricular dysfunction, that became worse and irreversible due to many years of usage, in association with intense physical training and GH; our hypothesis is strengthened by experimental studies in animals and autopsy immunohistochemical studies demonstrating a direct cardiotoxicity of anabolic androg
Relantionship between OPG levels and ergometric test in the diagnosis of coronary heart disease
No full textCoronary flow, VO2 peak and anaerobic threshold in patients with dilated cardiomyopathy.
No full textBackground: Coronary flow is influenced by several determinants and may change according to external stimuli. In patients with dilated
cardiomyopathy (DC), adaptive mechanisms could induce alterations in coronary flow, possibly related to oxygen consumption.
Methods: In 67 consecutive patients with DC (mean age 52.06T13.84, 52 male gender, left ventricle ejection fraction (LVEF) 29.49%T8.68)
and normal coronary angiography findings, coronary flow in left anterior descending (LAD), right coronary artery (RC) and left circumflex
(LCx) was reported as TIMI frame count (TFC). All patients underwent a cardiopulmonary test with VO2 peak and anaerobic threshold (AT)
measurement, New York Heart Association (NYHA) class stratification, two-dimensional echocardiographic evaluation including LVEF and
left ventricle end-diastolic diameter (LVEDD) assessment. All patients were receiving optimal medical treatment.
Results: In a multivariate analysis, a statistically significant correlation was found between VO2 peak and TFC (B 7.61, p <0.001, R2 0.61
for LAD; B 3.42, p <0.001, R2 0.33 for RC); an inverse correlation was found between AT and TFC (B 9.77, p <0.001, R2 0.61 for LAD;
B 4.26, p <0.001, R2 0.33 for RC).
Conclusions: Coronary flow is related to VO2 peak and AT in patients with DC, suggesting a ‘‘compensatory’’ mechanism
Detection, location, and severity assessment of left anterior descending coronary artery stenoses by means of contrast-enhanced transthoracic harmonic echo Doppler
No full textAIMS: Contrast-enhanced second harmonic Doppler (ED) is a new ultrasound modality that increases the feasibility of recording blood flow velocity (BFV) in the left anterior descending coronary artery (LAD) using a transthoracic approach. Blood flow velocity convective acceleration is a reliable marker of coronary stenosis and can be used to assess the percentage area reduction at the stenosis site by applying the continuity equation. To detect, locate, and assess the severity of significant stenosis throughout the LAD by means of an ED recording of BFV acceleration at the stenosis site.
METHODS AND RESULTS: Fifty-three consecutive patients undergoing coronary angiography (CA) underwent a colour-guided pulsed-wave ED recording of BFV in the proximal/mid and distal portions of the LAD, and maximal and reference BFV was obtained in each of the two arterial segments. Maximal velocity was much higher in the diseased segments (>or=50% lumen narrowing) than in the normal segments (143 +/- 84 vs. 38 +/- 20 cm/s; P < 0.001); as the reference velocity was similar (37 +/- 13 vs. 31 +/- 12; P = 0.03), the percentage increase in velocity was also higher (290 +/- 233 vs. 20 +/- 37%; P < 0.001). Using a cut-off value of an 82% increase in velocity, sensitivity and specificity vs. CA was, respectively, 86 and 95%. The reduction in the percentage area of stenosis calculated using the continuity equation agreed with that determined by means of quantitative CA (r = 0.7).
CONCLUSION: Blood flow velocity evaluation in the LAD by means of transthoracic ED is feasible and reliable in detecting, locating, and assessing the severity of LAD stenosis
The Story of "Me" Contemporary American Autofiction
No full textCover -- Title Page -- Copyright Page -- Contents -- Acknowledgments -- Introduction -- 1. Masculinity, Whiteness, and Postmodern Self-Consciousness -- 2. Rage against the Dying of the Author -- 3. The New Journalism as the New Fiction -- 4. Trauma Autofiction, Dissociation, and the Authenticity of "Real" Experience -- 5. Memoir vs. Autofiction as the Story of Me vs. the Story of "Me" -- Coda -- Appendix -- Notes -- References -- IndexDescription based on publisher supplied metadata and other sources.Electronic reproduction. Ann Arbor, Michigan : ProQuest Ebook Central, YYYY. Available via World Wide Web. Access may be limited to ProQuest Ebook Central affiliated libraries
Pulmonary Venous Flows as Assessed by Transesophageal Echocardiography Indipendently Predicts Mortality in Patiens With Dilated Cardiomyopathy. A Thirteen Year Follow-up Study.
No full textPulmonary Venous Flow as Assessed by Transesophageal Echocardiography Independently Predicts Mortality in Patients With Dilated Cardiomyopathy. A Thirteen Year Follow-up Study
Background: Pulmonary venous flow (PVF), optimally studied during transesophageal echocardiography is a better index of diastolic restricted physiology in dilated cardiomyopathy (DCM) but it’s not known if it has an incremental value over the more established prognosticators such as LV ejection fraction (LVEF) and peak VO2 in the long term. Methods: This study included 122 patients (pts) with DCM (92 males, 58+/-11 years, LVEF= 28%+/-6), stable and in sinus rhythm. All pts underwent transesophageal echocardiography with color guided pulsed wave Doppler recording of PVF and transmitral flow; peak systolic and diastolic PVF wave ratio (S/D), E and A mitral wave ratio (E/A), mitral E deceleration time and the time difference between PVF atrial reversal (Ar) and mitral A wave duration (A) were measured. Others parameters attained were: LVEF, inspiratory collapse of the inferior vena cava, mitral regurgitation peak VO2, creatininemia. Cardiac events were defined as death or heart transplantation. Results: During the follow-up period (mean 13. 5+/- 0. 8 years) 81 pts (66%) had events; no pts were lost to follow-up. A 4-strata composite variable (high risk) attained by both LVEF (worse category= LVEF< 25%) and LV diastolic function (worse category= S/D ratio<1 or S/D>=1 and Ar-A >0) was the best predictor of hard events (see table). Other Doppler indices of diastolic function were not significant at the multivariate analysis. Conclusion: In the long term PVF and LVEF are the best predictors of outcome in pts with DCM
Remember Me A Novella about Finding Our Way to the Cross
No full textShades of Light.Cover -- Title Page -- Copyright -- Dedication Page -- Contents -- 1 The Word Became Flesh -- 2 The Gift of Myrrh -- 3 Taking the Cup -- 4 With a Kiss -- 5 Awakened -- 6 Accused -- 7 Bearing the Cross -- 8 Lament -- 9 Stripped -- 10 Pierced -- 11 It Is Finished -- 12 Into Your Hands -- 13 Buried -- 14 Risen -- Epilogue -- Journey to the Cross -- Acknowledgments -- Also Available -- Praise for Remember Me -- About the Author -- More Titles from InterVarsity PressShades of Light.Description based on publisher supplied metadata and other sources.Electronic reproduction. Ann Arbor, Michigan : ProQuest Ebook Central, YYYY. Available via World Wide Web. Access may be limited to ProQuest Ebook Central affiliated libraries
"Test me and treat me" - attitudes to vitamin D deficiency and supplementation: a qualitative study
No full text© 2015 BMJ Open, "Test me and treat me"-attitudes to vitamin D deficiency and supplementation: a qualitative study. This manuscript version is made available under the Creative Commons Attribution Licens
- …
