Impact of heart rate on myocardial salvage in timely reperfused patients with STSegment elevation myocardial infarction. new insights from cardiovascular magnetic resonance

BACKGROUND: Previous studies evaluating the progression of the necrotic wave in relation to heart rate were carried out only in animal models of ST-elevated myocardial infarction (STEMI). Aim of the study was to investigate changes of myocardial salvage in relation to different heart rates at hospital admission in timely reperfused patients with STEMI by using cardiovascular magnetic resonance (CMR). METHODS: One hundred-eighty-seven patients with STEMI successfully and timely treated with primary coronary angioplasty underwent CMR five days after hospital admission. According to the heart rate at presentation, patients were subcategorized into 5 quintiles: <55 bpm (group I, n = 44), 55-64 bpm (group II, n = 35), 65-74 bpm (group III, n = 35), 75-84 bpm (group IV, n = 37), ≥85 bpm (group V, n = 36). Area at risk, infarct size, microvascular obstruction (MVO) and myocardium salvaged index (MSI) were assessed by CMR using standard sequences. RESULTS: Lower heart rates at presentation were associated with a bigger amount of myocardial salvage after reperfusion. MSI progressively decreased as the heart rates increased (0.54 group I, 0.46 group II, 0.38 group III, 0.34 group IV, 0.32 group V, p<0.001). Stepwise multivariable analysis showed heart rate, peak troponin and the presence of MVO were independent predictor of myocardial salvage. No changes related to heart rate were observed in relation to area at risk and infarct size. CONCLUSIONS: High heart rates registered before performing coronary angioplasty in timely reperfused patients with STEMI are associated with a reduction in salvaged myocardium. In particular, salvaged myocardium significantly reduced when heart rate at presentation is ≥85 bpm

The History of a Sixteenth-century Greek Type Revised

This article attempts to study the history of a sixteenth-century Greek type in Italy. The type was produced under the auspices of Cardinal Marcello Cervini who wished to publish some of the manuscripts from the Vatican Collections. Cervini commissioned the Roman printer Antonio Blado to be in charge of the project. Since Blado did not own Greek type and had no experience with Greek he invited Stefano Nicolini da Sabbio, the noted printer of Greek in Venice, to come to Rome and take charge of the cardinal's project. The scholar-scribe Nikolaos Sophianos also joined the project along with Benedetto Giunta, a bookseller in Rome who represented the cardinal. The Greek font designed and cut for this project appeared in several works in Rome and was designated by scholars as Greek 1. To this day nobody has been able to match Greek 1 with the handwriting of any of the scribes working in Italy during this period. When the association of Sophianos with the cardinal's project came to an end, Greek 1 became very much in demand and was used by a number of well-known printers in Rome, Florence and Venice. It required a series of legal actions to prove that Greek 1 belonged to Sophianos who finally took possession of his type and other equipment. He used it to print a number of publications. The type later passed into the hands of Vasileios and Hippolitos Valeris and later to some other minor publishers of Greek liturgical books. It was still in use as late as the mid-1580s

The History of a Sixteenth-century Greek Type Revised

This article attempts to study the history of a sixteenth-century Greek type in Italy. The type was produced under the auspices of Cardinal Marcello Cervini who wished to publish some of the manuscripts from the Vatican Collections. Cervini commissioned the Roman printer Antonio Blado to be in charge of the project. Since Blado did not own Greek type and had no experience with Greek he invited Stefano Nicolini da Sabbio, the noted printer of Greek in Venice, to come to Rome and take charge of the cardinal's project. The scholar-scribe Nikolaos Sophianos also joined the project along with Benedetto Giunta, a bookseller in Rome who represented the cardinal. The Greek font designed and cut for this project appeared in several works in Rome and was designated by scholars as Greek 1. To this day nobody has been able to match Greek 1 with the handwriting of any of the scribes working in Italy during this period. When the association of Sophianos with the cardinal's project came to an end, Greek 1 became very much in demand and was used by a number of well-known printers in Rome, Florence and Venice. It required a series of legal actions to prove that Greek 1 belonged to Sophianos who finally took possession of his type and other equipment. He used it to print a number of publications. The type later passed into the hands of Vasileios and Hippolitos Valeris and later to some other minor publishers of Greek liturgical books. It was still in use as late as the mid-1580s

Frequency of vitamin d deficiency in multiple sclerosis patients: a cross sectional study.

Vitamin D deficiency is linked to poor treatment response in patients with Multiple S clerosis. The aim of this study is to define the frequency of Vitamin D deficiency for early detection and timely intervention leading to improved morbidity rates

Clinical application of exercise stress echocardiography: Supine bicycle or treadmill?

Although exercise stress echocardiography is currently used to evaluate coronary artery disease (CAD) patients, the best exercise methodology is still undefined. The objectives of the study were: (1) to compare supine bicycle stress echocardiography (SBSE) and treadmill in the evaluation of CAD; and (2) to define, in normal subjects, the different behavior of factors determining MVO2 wish treadmill and SBSE. We selected 10 male patients with CAD (group A), and 10 male control subjects (group B). Each patient underwent SBSE and tread-mill testing in random order. We studied heart sate, systolic blood pressure, heart rate x systolic blood pressure, and end-diastolic and end-systolic volume indexes. in group A, we also studied wall motion score index (according to the American Society of Echocardiography) and in group B, systolic blood pressure/end-systolic volume index. The results were as follows: Group A: SBSE resulted in significantly lower work load, heart rate, and significantly higher systolic blood pressure, heart hate x systolic blood pressure, end-diastolic volume index, end-systolic volume index, and wall motion score index. SBSE showed wall motion abnormalities in each patient, whereas treadmill did not detect wail motion abnormalities in 4 patients (3 single-vessel; 1 multivessel); of the other 6 patients, 2 showed a lower wall motion score index and 4 did not show any difference in left ventricle kinetics with the 2 methodologies of exercise. Mean acquisition time for postexercise images was 72 +/- 6 seconds. Group B: SBSE resulted in lower work load, heart rate, heart rate x systolic blood pressure, systolic blood pressure/end-systolic volume index, and higher end-diastolic volume index and end-systolic volume index. Systolic blood pressure was similar with SBSE and treadmill testing. In conclusion, our experience suggests SBSE is a highly accurate diagnostic fool for evaluating CAD compared with treadmill testing; the maximum cardiovascular performance can be achieved With lower values of heart rate, suggesting the echo test is more feasible. Treadmill testing could lose important information about the existence, extension, and location of CAD; ire contrast, SBSE detects even small, quickly reversible wall motion abnormalities. (C) 1998 by Excerpta Medica, Inc

High frame rate contrast enhanced echocardiography: microbubbles stability and contrast evaluation

Contrast Echocardiography (CE) with microbubble contrast agents have significantly advanced our capability in assessing cardiac function, including myocardium perfusion imaging and quantification. However in conventional CE techniques with line by line scanning, the frame rate is limited to tens of frames per second and image quality is low. Recent works in high frame-rate (HFR) ultrasound have shown significant improvement of the frame rate. The aim of this work is to investigate the MBs stability and the contrast improvement using HFR CE compared to CE transmission at an echocardiography relevant frequency for different mechanical indices (MIs). Our results show that the contrast and bubble destruction of HFR CE and standard CEUS varies differently as a function of space and MIs. At low MIs, HFR CE shows a similar behavior as focused CE with little MB destruction, and generates better CTR (up to 3 folds). As MI increases, the MB destruction is more significant for HFR CE with a reduction of the CTR

La tradition manuscrite du Physiologus grec au miroir de témoins conservés en France et en Italie : réflexions pour une étude comparée

Une nouvelle analyse codicologique et paléographique de quatre manuscrits italiens du Physiologus grec (deuxième recension, troisième type, de la nomenclature de Sbordone), composés dans les années 1550-1560 permet de préciser les modalités de leur fabrication. Ces copies de luxe commandées par la Curie romaine ont été en effet réalisées en collaboration par divers membres, plus ou moins identifiés, de l’entourage du scriptor Emmanuel Provataris et de Manuel Malaxos. Bien connus pour leur illustration, ces exemplaires témoignent aussi de la faveur persistante pour le manuscrit, alors même que se prépare, sur leur base, réduite, la première impression de l’ouvrage (1587).A new codicological and paleographic analysis of four Italian manuscripts of the Greek Physiologus (third type of the second version in Sbordone's nomenclature), compiled in the 1550s-1560s, enables to determine the conditions of their production. These luxurious copies commissioned by the Roman Curia were done in collaboration by various, more or less identified members of the entourage of the scriptor Emmanuel Provataris and of Manuel Malaxos. These copies are well known for their illustrations and demonstrate the persistence of preference for the manuscript book, even though the first printing of the work is based on them (1587)