1,721,031 research outputs found
Uncommon cause of ST-segment elevation in V1-V3: incremental value of cardiac magnetic resonance imaging
No full textAlthough ST-segment elevation in precordial leads is a
characteristic of anterior left ventricular infarction (LVI), it
may also be observed in patients with proximal right coronary
occlusion. An isolated right ventricular infarction
(RVI) accounts for only 3 % of all myocardial infarctions
(MI) [1]; in these cases, the ST-segment elevation in the
precordial leads V1–V3 also may occur in the absence of
inferior electrocardiographic changes [2], whereas the
combination of RVI with inferior LVI suppresses ST-segment
elevation in the precordial leads and yields an STsegment
elevation in leads DII, DIII, and aVF [3].
Although certain electrocardiographic features have been
suggested to help differentiate ST-segment elevation secondary
to isolated RVI from LVI [3], it may be impossible
to make a differential diagnosis on the basis of electrocardiography
alone because these features are not pathognomonic.
Furthermore, when a patient is admitted for
typical chest pain, slight ST-segment elevation in leads
V1–V3 and significant increase of cardiac troponin but
with normal coronary main vessels at the coronary angiography,
the diagnosis of a RVI is challenging; taking into
account the multiple causes of myocardial injury and
treatment consequences, there is great clinical need to
clarify the underlying reason for cardiac troponin release.
Although some studies report that echocardiography is a
valuable clinical tool for the evaluation of global RV
function [4], geometric assumptions in modeling the
complex RV shape restricts the ability of this technique in
accurate and precise quantification of RV function; furthermore,
RV function assessment can be difficult in
patients with poor acoustic window or when minor alterations
of RV function are present.
Cardiac magnetic resonance (CMR) provides a comprehensive,
multifaceted view of the heart and can be
useful to characterize an infarct site and size accurately [5].
CMR in this particular setting can confirm the presence of
a minor RVI and aid to exclude other potential causes of
troponin rise with normal coronary main vessels at the coronary
angiography, such as embolic myocardial infarction or
myocarditis [6]. Acute MI treatment [7–10] and traditional
predictors of long-term mortality after acute MI are well
characterized [11–14] but with introduction of CMR, new
predictors of cardiovascular events are emerging [15, 16] and
the evaluation of RV function using CMR can improve risk
stratification and potentially refine patient management after
MI [17]. Moreover, the extent of myocardial scar characterized
by CMR is significantly associated with the occurrence
of spontaneous ventricular arrhythmias [18].
There have been few reports of anterior ST-segment
elevation caused by isolated RVI due to right ventricle
branch occlusion [19–21]. Occlusion of the conus branch
has been described essentially as a complication of coronary
angioplasty or during cardiac surgery [19–21]. Only
one report described a spontaneous RVI with culprit lesion
in the conus branch [22]. Assessment of isolated RVI due
to a critical stenosis of the conus branch by magnetic resonance
is never been reported
The Pacemaker and Implantable Cardioverter-Defibrillator Registry of the Italian Association of Arrhythmology and Cardiac Pacing - Report 2021
No full textBackground: The Pacemaker (PM) and Implantable Cardioverter-Defibrillator (ICD) Registry of the Italian Association of Arrhythmology and Cardiac Pacing (AIAC) collects information about demographics, clinical characteristics, main indications for PM/ICD therapy and device types from the voluntary Italian collaborating centers. Methods: For the year 2021 main data about national PM and ICD implantation activity were obtained on the basis of European Cards and subsequently analyzed to create a standard report. Results: PM Registry: data about 18 631 PM implantations were collected (15879 first implants and 2752 replacements). The number of collaborating centers was 121. Median age of treated patients was 82 years (76 quartile I; 87 quartile III). Main ECG indications included atrioventricular conduction disorders in 26.8% of first PM implants, sick sinus syndrome in 12.2%, atrial fibrillation plus bradycardia in 9.6%, other unspecified ECG and electrophysiological abnormalities in 43.0%. For first PM implants, pacing in DDDR mode was reported in 46.5%, followed by DDD mode (20.6%), VVIR mode (15.0%), VVI mode (9.0%) and finally VDD-VDDR (5.8%). Median value of longevity of explanted PMs was 8.9 years. ICD Registry: data about 6878 ICD implantations were obtained (4708 first implants and 2170 replacements). The number of collaborating centers was 345. Median age of treated patients was 72 years (70 quartile I; 75 quartile III). Primary prevention indication was reported in 86.3% of first implants, secondary prevention in 13.7% (cardiac arrest in 4.4% of records). A single-chamber ICD was used in 32.1% of first implants, dual-chamber ICD in 30.3% and biventricular ICD in 37.6%. Median value of longevity of explanted ICDs was 6.9 years. Conclusions: In the calendar year 2021, the Italian PM Registry showed stable electrocardiographic and symptom indications, with an important prevalence of dual-chamber pacing. The ICD Registry documented a large use of prophylactic and biventricular ICDs, reflecting a favorable adherence in the clinical practice to trials and guidelines. The ICD longevity and the number of recalls demonstrated a favorable trend. In order to increase and optimize the cooperation of Italian PM and ICD implanting centers, the online data entry (https://www.aiac.it/riprid) should be adopted at large scale
The Pacemaker and Implantable Cardioverter-Defibrillator Registry of the Italian Association of Arrhythmology and Cardiac Pacing - Report 2022 [Registro Italiano Pacemaker e Defibrillatori Associazione Italiana di Aritmologia e Cardiostimolazione Report 2022]
No full textBackground: The Pacemaker (PM) and Implantable Cardioverter-Defibrillator (ICD) Registry of the Italian Association of Arrhythmology and Cardiac Pacing (AIAC) collects information about demographics, clinical characteristics, main indications for PM/ICD therapy and device types from the voluntary Italian collaborating centers. Methods: For the year 2022 main data about national PM and ICD implantation activity were obtained on the basis of European Cards and subsequently analyzed to create a standard report. Results: PM Registry: data about 17 800 PM implantations were collected (14 191 first implants and 3609 replacements). The number of collaborating centers was 152. Median age of treated patients was 81 years (75 quartile I; 86 quartile III). Main ECG indications included atrioventricular conduction disorders in 46.0% of first PM implants, sick sinus syndrome in 17.7%, atrial fibrillation plus bradycardia in 7.7%, other unspecified ECG and electrophysiological abnormalities in 43.0%. For first PM implants, pacing in DDDR mode was reported in 42.2%, followed by DDD mode (20.6%), VVIR mode (25.1%), VVI mode (11.1%) and finally VDD-VDDR (5.1%). Median value of longevity of explanted PMs was 8.3 years. ICD Registry: data about 5210 ICD implantations were obtained (3656 first implants and 1554 replacements). The number of collaborating centers was 301. Median age of treated patients was 72 years (63 quartile I; 79 quartile III). Primary prevention indication was reported in 72.4% of first implants, secondary prevention in 27.6% (cardiac arrest in 4.6% of records). A single-chamber ICD was used in 30.3% of first implants, dual-chamber ICD in 30.0% and biventricular ICD in 39.7%. Median value of longevity of explanted ICDs was 7.0 years. Conclusions: In the calendar year 2022, the Italian PM Registry showed stable electrocardiographic and symptom indications, with an important prevalence of dual-chamber pacing. The ICD Registry documented a large use of prophylactic and biventricular ICDs, reflecting a favorable adherence in clinical practice to trials and guidelines. The ICD longevity and the number of recalls demonstrated a favorable trend
Calcific degeneration and rupture of the aortic valve and ascending aorta: From cardiac auscultation to multimodality imaging
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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
Variations on the Author
Full text link“Variations on the Author” discusses two of Eduardo Coutinho’s recent films (Um Dia na Vida, from 2010, and Últimas Conversas, posthumously released in 2015) and their contribution to the general question of documentary authorship. The director’s filmography is characterized by a consistent yet self-effacing form of authorial self-inscription: Coutinho often features as an interviewer that rather than express opinions propels discourses; an interviewer that is good at listening. This mode of self-inscription characterizes him as an author who is not expressive but who is nonetheless markedly present on the screen. In Um Dia na Vida, however, Coutinho is completely absent form the image, while Últimas Conversas, on the contrary, includes a confessional prologue that moves the director from the margins to the center of his films. This article examines the ways in which these works stand out in the filmography of a director who offers new insights into the notion of cinematic authorship
Appropriate Similarity Measures for Author Cocitation Analysis
Full text linkWe provide a number of new insights into the methodological discussion about author cocitation analysis. We first argue that the use of the Pearson correlation for measuring the similarity between authors’ cocitation profiles is not very satisfactory. We then discuss what kind of similarity measures may be used as an alternative to the Pearson correlation. We consider three similarity measures in particular. One is the well-known cosine. The other two similarity measures have not been used before in the bibliometric literature. Finally, we show by means of an example that our findings have a high practical relevance.information science;Pearson correlation;cosine;similarity measure;author cocitation analysis
Acromegalic Cardiomyopathy With Malignant Arrhythmogenic Pattern Successfully Treated With Mechanical Circulatory Support and Heart Transplantation
Full text linkCardiovascular involvement is common in acromegaly and can lead to development of acromegalic cardiomyopathy, characterized by concentric biventricular hypertrophy with a progressive impairment of diastolic and systolic function. The onset of heart failure and arrhythmias are related to poor prognosis. We report on a case of a 48-year-old man with acromegalic cardiomyopathy caused by pituitary adenoma. Despite the successful trans-sphenoidal resection of the tumour, the patient was rehospitalized for ventricular arrhythmic storms that led to cardiogenic shock, which required mechanical hemodynamic support with intra-aortic balloon pump, venoarterial extracorporeal membrane oxygenation, and urgent heart transplantation
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