1,721,093 research outputs found
Pulmonary arterial hypertension
Full text linkPulmonary arterial hypertension: correlation between severity of pathology and new markers of endothelail damage and repai
[Atherothrombosis in patients with type 2 diabetes mellitus: an overview of pathophysiology]
No full textType 2 diabetes mellitus is a well known condition characterized by a functional and metabolic milieu that promotes the development of the atherosclerotic process and its macrovascular complications (e.g., acute myocardial infarction, stroke, peripheral arterial disease). In diabetic patients, several negative alterations lead to the progression of the atherosclerotic disease. These alterations involve the coagulation cascade, the endothelial function, platelet and monocyte adhesiveness, macrophage function, and fibrinolysis: all these processes are adversely affected by hyperglycemia and insulin resistance. In diabetic patients, the fluid and the cellular phases are modified to generate a prothrombotic phenotype. In this review we will discuss about the main pathophysiological mechanisms involved in diabetic atherotrombosis in order to look beyond the usual "hydraulic-rheologic" picture of macrovascular diabetic disease, and to better understand the importance of the adverse interactions that occur between the endothelial wall and the circulating cells
Electrical storm: Incidence, Prognosis and Therapy
No full textImplantable defibrillators are lifesavers and have improved mortality rates in patients at risk of sudden death, both in primary and secondary prevention. However, they are unable to modify the myocardial substrate, which remains susceptible to life-threatening ventricular arrhythmias. Electrical storm is a clinical entity characterized the recurrence of hemodynamically unstable ventricular tachycardia and/or ventricular fibrillation, twice or more in 24 hours, requiring electrical cardioversion or defibrillation. With the arrival of the implantable cardioverter-defibrillator, this definition was broadened, and electrical storm is now defined as the occurrence of three or more distinct episodes of ventricular tachycardia or ventricular fibrillation in 24 hours, requiring the intervention of the defibrillator (anti-tachycardia pacing or shock). Clinical presentation can be very dramatic, with multiple defibrillator shocks and hemodynamic instability. Managing its acute presentation is a challenge, and mortality is high both in the acute phase and in the long term. In large clinical trials involving patients implanted with a defibrillator both for primary and secondary prevention, electrical storm appears to be a harbinger of cardiac death, with notably high mortality soon after the event. In most cases, the storm can be interrupted by medical therapy, though transcatheter radiofrequency ablation of ventricular arrhythmias may be an effective treatment for refractory cases.This narrative literature review outlines the main clinical characteristics of electrical storm and emphasises critical points in approaching and managing this peculiar clinical entity. Finally focus is given to studies that consider transcatheter ablation therapy in cases refractory to medical treatment
Asymptomatic atrial fibrillation: improving its detection, characterization and management
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Recent advances in ablation of ventricular tachycardia associated with structural heart disease: Overcoming the challenges of functional and fixed barriers
No full text[Air pollution exposure as an emerging risk factor for cardiovascular disease: a literature review]
No full textSeveral epidemiological studies have demonstrated a consistent statistical association between cardiovascular disease and air pollution exposure. In this review we describe the nature of the most common ambient-air pollutants (either gaseous or particulate of different size); then, we examine the pathophysiological pathways linking the air pollutants with their cardiovascular effects (arterial vasoconstriction, systemic inflammatory response, enhanced thrombosis, a propensity for arrhythmia). A comprehensive review of the literature on air pollution and the rate of hospital admission, morbidity, and mortality due to cardiovascular reasons are also provided. In the last section, we review the most recent studies that have outlined the correlation between the onset of acute myocardial infarction and the level of outdoor air pollution. In conclusion, scientific evidence is growing in support of the hypothesis that ambient air pollution acts as a risk factor for cardiovascular disease, and may trigger the onset of acute myocardial infarction
Letter by Proietti et al Regarding Article, "Stroke or Transient Ischemic Attack in Patients with Transvenous Pacemaker or Defibrillator and Echocardiographically Detected Patent Foramen Ovale"
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