Arrhythmogenic right ventricular cardiomyopathy or athlete's heart? Challenges in assessment of right heart morphology and function

The incidence of sudden cardiac death (SCD) in young athletes varies among studies, due to the disagreement in the definitions and the lack of information in this field

Tako-tsubo syndrome and hypovolemia

Tako-tsubo syndrome (TTS) is a rare disorder characterized by reversible apical left ventricular ballooning usually triggered by an emotional and/or physical stress and often mimicking an acute myocardial infarction. We describe a case of 78 year old woman with TTS associated with hypovolemia and hyponatraemia. The hypovolemic state could have activated the sympathetic system and in turn catecolamine overload with consequent myocardial stunning

Is there a role of statins in the prevention of aortic biological prostheses degeneration

It has been recently observed that statins might slow the progression of aortic stenosis or sclerosis. Preliminary reports suggested a similar positive effect in reducing the degeneration of aortic valve bioprostheses even though this hypothesis should be further proven and supported by new data. In this review the present evidences of the possible effects of statins in this field are discussed

Effect of uric acid serum levels on carotid arterial stiffness and intima-media thickness: A high resolution Echo-Tracking Study

Serum uric acid (UA) has been shown to be a predictor of cardiovascular (CV) morbidity and mortality, and it may play a role in the pathogenesis of CV disease affecting vascular structure and function. However, there is limited evidence of its specific association with carotid artery stiffness and structure. The aim of our study was to evaluate whether UA is associated with early signs of atherosclerosis, namely local carotid arterial stiffness and intima-media thickening. We evaluated 698 consecutive asymptomatic patients, referred to the Cardiovascular Department for risk factors evaluation and treatment. All patients underwent carotid artery ultrasonography with measurement of common carotid intima-media thickness (IMT) and echo-tracking carotid artery stiffness index Beta. Patients with hyperuricemia (defined as serum uric acid ≥7 mg/dL in men and ≥6 mg/dL in women) had higher IMT (0.97±0.22 vs 0.91±0.18, p<0.001) and stiffness index Beta (8.3±3.2 vs 7.5±2.7, p=0.005). UA levels correlated with both IMT (r=0.225; p<0.001) and stiffness index Beta (r=0.154; p<0.001); the correlations were statistically significant in males and females. In a multivariate model which included age, arterial pressure, serum glucose and LDL-cholesterol, serum UA emerged as an independent explanatory variable of IMT and stiffness index Beta. Carotid IMT and local arterial stiffness are related to UA independently of established CV risk factors; UA may play a role in the early development of atherosclerosis

Correction: Age-specific reference values for carotid arterial stiffness estimated by ultrasonic wall tracking

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A Large Ostium Secundum Atrial Septal Defect in an 88-Year-Old Asymptomatic Woman

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Epidemiology and cardiovascular risk factors of aortic stenosis

Abstract The abnormalities of aortic valve morphology and function represent the most common cardiac-valve lesion particularly in elderly. The etiology of aortic stenosis is degenerative-calcific in the majority of patients. Many risk factors seems to be linked to the calcification and the stenosis of the aortic valve but they must be confirmed. In this review the etiology and the possible physiopathology of the aortic valve stenosis is discussed.</p

Software integral de eco estrés para protocolo ABDCE de última generación

Background: Several specialized softwares are commercially available for the elective storage of stress echo (SE) data. State-of-theart SE is based upon novel parameters in addition to regional wall motion. Objective: To develop a novel software for SE data storage and reporting. Methods: We developed the prototype of a SE Comprehensive Software (SECS) with a minimum data set eventually allowing standardized collection of data. The software runs with medium-low performance computers as well as with the most popular operating systems (Windows, MAC OS and Linux). The export functions towards widely accepted formats allow easy data sharing. The software is able to generate a customized report which can be expanded in PDF and comma-separated values formats. Results: The program prototype data entry requires < 2 min per study. The main pages focus on the 5 steps of ABCDE-SE: step A (regional wall motion); step B (B-lines with 4-site simplified scan); step C (contractile reserve with force derived from systolic blood pressure and end-systolic volume); step D (Doppler-based coronary flow velocity reserve in left anterior descending coronary artery); step E (EKG-based chronotropic reserve measured as peak/rest heart rate). The final page graphically summarizes the ABCDE information in a risk prediction model (cardiac death rate per year, from low risk 3 %). Conclusion: SECS may provide a suitable infrastructure for an advanced clinical and research application, with simple graphic format and convenient reporting option. It may represent a trade-off between exhaustive information required by scientific standards and smooth workflow priority of busy, high volume, clinically-driven activities. Large scale validation and adaptation from users’ feedback is necessary prior to dissemination on demand.Introducción: Existen diversos softwares especializados en el mercado para el almacenamiento electivo de datos de eco estrés (EE). El EE de última generación incorpora nuevos parámetros además de la motilidad parietal. Objetivo: Desarrollar un nuevo software para el almacenamiento de datos e informe de EE. Métodos: Desarrollamos el prototipo de Software Integral de EE (SIEE) con un conjunto mínimo de datos que permite la eventual recolección estandarizada de datos. El software corre en computadoras con capacidad de trabajo mediana-baja y con los sistemas operativos más usados (Windows, MAC OS y Linux). Las funciones de exportación hacia formatos altamente aceptados permiten compartir los datos fácilmente. El software es capaz de generar un informe personalizado que se puede expandir en PDF y en formatos de valores separados por comas. Resultados: El ingreso de datos en el programa prototipo requiere menos de 2 minutos por estudio. Las páginas principales se concentran en las 5 fases ABCDE del EE: fase A (motilidad parietal regional); fase B (líneas B con escaneo simplificado de 4 sitios); fase C (reserva contráctil con fuerza derivada de la presión arterial sistólica y volumen de fin de sístole; fase D (Doppler de reserva coronaria de la arteria descendente anterior); y fase E (reserva cronotrópica derivada del electrocardiograma medida como la razón de frecuencia cardíaca pico/reposo). La última página resume la información ABCDE en un modelo de predicción de riesgo (tasa de muerte cardiovascular anual, abarcando desde riesgo bajo 3%. Conclusión: El SIEE puede proporcionar una infraestructura adecuada para una aplicación clínica y de investigación avanzada, con un formato gráfico simple y opción de informe satisfactoria. Puede representar una solución intermedia entre la información exhaustiva requerida por los estándares científicos y la prioridad de un flujo de trabajo fluido de actividades relacionadas a la clínica con gran volumen de pacientes. Su validación en gran escala y la adaptación de acuerdo a la opinión de los usuarios es necesaria antes de su difusión a demanda