1,721,006 research outputs found
Cardiologia riabilitativa e prevenzione secondaria durante la pandemia COVID-19: stato dell'arte e prospettive
No full textRelations of left ventricular geometry and function to body composition in children with high casual blood pressure.
No full textABSTRACT To determine whether abnormal casual blood pressure (BP) is associated with left ventricular (LV) abnormalities in children, 190 6- to 11-year-old children (77 girls, 113 boys) were studied at a school site in Naples, Italy, by limited echocardiography and bioelectric impedance to calculate fat-free body mass FFM).Single-visit BP measurements (defined as casual BP) were high (based on the Italian tables of BP) in 34 children (18%; 9 girls, 25 boys; 133+/-8/81+/-10 mm Hg) and obesity was present in 44 (23%; 15 girls, 29 boys). Sex- and age-independent risk of high casual BP value was 2.9-fold (odds ratio) greater in obese than in normal-weight children (95% confidence interval, 1.3 to 6.5; P<.01). LV mass (as both absolute value and normalized for height or FFM) was higher and relative wall thickness increased in children with high casual BP (all P<.01). Prevalence of LV hypertrophy was 21% among children with high casual BP(P<.004 versus 4.3% in normal group). Risk of LV hypertrophy was 5.5-fold higher in the presence of high casual BP (P<.004), whereas obesity, age, and sex did not have independent effects. Endocardial shortening was slightly higher in children with high casual BP (36.8+/-8.2%) than in children with normal BP (34.3+/-4.8%,P<.02), whereas midwall shortening was identical in the two groups (20%). Both endocardial shortening and midwall shortening were negatively related to end-systolic stress (r=-.62, SEE=3.8% and r=-.32, SEE=2.4% in normal children). Shortening as a percentage of predicted from wall stress was increased in children with high casual BP at the endocardial level (P<.001), whereas it was normal at the midwall. Therefore, (1) casual detection of high BP in school children is associated with LV geometric abnormalities similar to those found in adults with sustained hypertension (LV hypertrophy, concentric pattern); (2)similar to in adult hypertension, endocardial chamber function in children is supranormal; and (3) in contrast to findings in adults, midwall shortening is normal in children with high casual BP
ANMCO Position paper: Clinical management of hypercholesterolemia in patients with acute coronary syndrome
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Elettrocardiografia di base nella pratica clinica: rischio cardiovascolare e danno d'organo
No full textANMCO Scientific Statement: clinical management of hypercholesterolaemia in patients with acute coronary syndromes
Full text linkLDL cholesterol (LDL-C) reduction after Acute Coronary Syndromes (ACS) is associated with a significant decrease in subsequent atherosclerotic cardiovascular events. Accordingly, international guidelines recommend a reduction of LDL-C below 70 mg/dL in ACS patients. Such a result can be effectively accomplished in most cases by using high intensity statins. In selected cases, the association with ezetimibe may be necessary in order to achieve recommended LDL-C targets. This document outlines management strategies that can be consistently implemented in clinical practice in order to achieve and maintain guidelines recommended therapeutic goals
Slow-release isradipine in mild to moderate hypertension: hemodynamic and antihypertensive effects.
No full textIn this study we used casual and 24-h blood pressure (BP) monitoring and Doppler echocardiographic data to investigate the antihypertensive and hemodynamic effects of isradipine 5 mg in the new slow-release oral (SRO) formulation administered once daily for 12 weeks to 10 patients with mild to moderate hypertension. The antihypertensive action of SR isradipine was revealed by the normalized values of casual BP in 60 patients and by the significant reduction of 24-h BP variability as assessed by mean standard variation, coefficient of variation and the percent incidence of abnormal levels of both systolic and diastolic BP during 24 h (p less than .001). The echocardiographic data showed some beneficial hemodynamic effects (improvement of systolic and diastolic indices) without significant variation of left ventricular structure. The drug was well tolerated, with a low incidence of side effects. In conclusion, SR isradipine can be considered a safe and effective first-choice drug for the treatment of mild to moderate hypertension
Compensatory or inappropriate left ventricular mass in different models of left ventricular pressure overload: comparison between patients with aortic stenosis and atrial hypertension
No full textEstimation of left ventricular chamber and stroke volume by limited M-mode echocardiography and validation by two-dimensional and Doppler echocardiography
No full textThis study has been designed to improve estimation of stroke volume from linear left ventricular (LV) dimensions measured by M-mode echocardiography, in symmetrically contracting ventricles. In experimental studies, the ratio of LV epicardial long/short axes ''Z'' is about 1.3. We measured systolic and diastolic epicardial long and short axes by 2-dimensional echocardiography in 115 adults with widely varying LV short-axis dimensions (LV end-diastolic dimension = 3.95 to 8.3 cm). In a learning series of 23 normotensive and 27 hypertensive subjects, Z(diastole) was 1.3 +/- 0.1 and Z(systole) = 1.2 +/- 0.1, similar to findings in experimental animals. Regression equations were developed by comparing LV volumes by M-mode and 2-dimensional echocardiography. In a test series (65 subjects), LV volumes were calculated using separate regression equations for end-diastolic volume ([LV end-diastolic dimension](2) 4.765 - 0.288 x posterior wall thickness]) and for end-systolic volume ([LV end-systolic dimension](2)[4.136 - 0.288 x posterior wall thickness]). Because the term 0.288 x wall thickness was only about 8% of the first term between brackets, the average wall thickness in the learning series was substituted in the Z-volume formulas applied to the test series: end-diastolic volume = (4.5 x [LV end-diastolic dimensions](2)) and end-systolic volume = (3.72 x [LV end-diastolic dimension](2)). The mean relative error produced with this simplified method was 0.9% in diastole and 1.4% in systole. Compared with Teichholz' M-mode volume method, Z-derived end-diastolic volume in the test series was equally well related to 2-dimensional volumes (both r = 0.88),with a better intercept (1.5 vs -23 ml, p < 0.001) and a slope closer to the identity line (1.1 vs 1.4). Similar results were found for systolic volumes. In a second test series of 1,721 American Indian participants in the Strong Heart Study without mitral regurgitation or segmental LV wall motion abnormalities, Doppler-derived LV stroke volume (70 +/- 14 ml/beat) was similarly predicted by the Z-derived method (r = 0.65, 70 +/- 11 ml/beat) and Teichholz formulas (r = 0.64, 72 +/- 13 ml/beat), but Z-derived volumes had a regression line significantly closer to the identity line (p < 0.005). Thus, LV chamber and stroke volumes can be determined from M-mode LV diameters over a wide range of LV sizes and in epidemiologic as well as clinical populations. The performance of this new method appears better than that obtained using the Teichholz formula, with a formula that is easy to handle and makes calculation of LV volumes by pocket calculator possible, even from limited echocardiographic studies
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