Usefulness of Electrocardiographic Patterns at Presentation to Predict Long-term Risk of Cardiac Death in Patients With Hypertrophic Cardiomyopathy

The objective of this study was to investigate the prognostic significance of 12-lead electrocardiogram (ECG) patterns in a large multicenter cohort of patients with hypertrophic cardiomyopathy; 1,004 consecutive patients with hypertrophic cardiomyopathy and a recorded standard ECG (64% men, mean age 50 ± 16 years) were evaluated at 4 Italian centers. The study end points were sudden cardiac death (SCD) or surrogates, including appropriate implanted cardiac defibrillator discharge and resuscitated cardiac arrest and major cardiovascular events (including SCD or surrogates and death due to heart failure, cardioembolic stroke, or heart transplantation). Prevalence of baseline electrocardiographic characteristics was: normal ECG 4%, ST-segment depression 56%, pseudonecrosis waves 33%, "pseudo-ST-segment elevation myocardial infarction (STEMI)" pattern 17%, QRS duration ≥120 ms 17%, giant inverted T waves 6%, and low QRS voltages 3%. During a mean follow-up of 7.4 ± 6.8 years, 77 patients experienced SCD or surrogates and 154 patients experienced major cardiovascular events. Independent predictors of SCD or surrogates were unexplained syncope (hazard ratio [HR] 2.5, 95% confidence interval [CI] 1.4 to 4.5, p = 0.003), left ventricular ejection fraction <50% (HR 3.5, 95% CI 1.9 to 6.7, p = 0.0001), nonsustained ventricular tachycardia (HR 1.7, 95% CI 1.1 to 2.6, p = 0.027), pseudo-STEMI pattern (HR 2.3, 95% CI 1.4 to 3.8, p = 0.001), QRS duration ≥120 ms (HR 1.8, 95% CI 1.1 to 3.0, p = 0.033), and low QRS voltages (HR 2.3, 95% CI 1.01 to 5.1, p = 0.048). Independent predictors of major cardiovascular events were age (HR 1.02, 95% CI 1.01 to 1.03, p = 0.0001), LV ejection fraction <50% (HR 3.73, 95% CI 2.39 to 5.83, p = 0.0001), pseudo-STEMI pattern (HR 1.66, 95% CI 1.13 to 2.45, p = 0.010), QRS duration ≥120 ms (HR 1.69, 95% CI 1.16 to 2.47, p = 0.007), and prolonged QTc interval (HR 1.68, 95% CI 1.21 to 2.34, p = 0.002). In conclusion, a detailed qualitative and quantitative electrocardiographic analyses provide independent predictors of prognosis that could be integrated with the available score systems to improve the power of the current model

Piano della citta, e sobborghi di Cartagena

Plano de la Ciudad y suburbios de Cartagena, impreso en tinta negra sobre papel. Corresponde a la ilustración de la página 85 de “Il Gazzettiere Americano: Contenente, un distinto ragguaglio di tutte le parti del nuovo mondo della loro Situazione, Clima, Terreno, Prodotti, Stato antico e moderno, Merci, Manifatture e Commercio” Traducido del Inglés. Impreso en Livorno por Marco Coltellini en 1763. Contiene recuadro en la parte izquierda con los nombres de referencia 1) eclesiásticos: La catedral, Santo Domingo, la iglesia jesuita, Santa Teresa, Hospital de San Juan de Dios, San Agustín, Nuestra Señora de la Merced, Santa Clara, San Juan, San Francisco, La Trinidad, Capilla de San Roque. 2) Bastiones: Avanzado, de San José, Santa Isabell, Chambacú, San Francisco, San Pedro Martir, San Ignacio, San Lucas, San Francisco Saverio, Santa Catalina, San Diego y San Dominico. El norte está inclinado hacia la derecha.

Carta rappresentante la penisola della Florida.

Scale ca. 1:6,000,000.Relief shown pictorially.Shows southeastern United States, west to Pearl River, Louisiana and Mississippi, and north to latitude 34 degrees.LC Maps of North America, 1750-1789, 161

BMC 76--Carta Rappresentante i Cinque Laghi del Canada, 1763

This map was engraved by Andrea Scacciati and Giuseppe Pazzi for Il Gazzettiere Americano, published in Livorno in 1763. The map depicts all five of the Great Lakes although Lake Superior is only partially represented. It extends north and south beyond Lake Superior and Fort Duquesne, west to Green Bay, and east to include parts of New Jersey. The map identifies geographical features, various rivers, trading post, and fortifications. American Indian tribes are identified with Italianized names such as the “Irocchesi” and “Algonquini.” Niagara Falls is identified.https://digitalmaine.com/arc_baxter/1026/thumbnail.jp

BMC 76--Carta Rappresentante i Cinque Laghi del Canada, 1763

This map was engraved by Andrea Scacciati and Giuseppe Pazzi for Il Gazzettiere Americano, published in Livorno in 1763. The map depicts all five of the Great Lakes although Lake Superior is only partially represented. It extends north and south beyond Lake Superior and Fort Duquesne, west to Green Bay, and east to include parts of New Jersey. The map identifies geographical features, various rivers, trading post, and fortifications. American Indian tribes are identified with Italianized names such as the “Irocchesi” and “Algonquini.” Niagara Falls is identified.https://digitalmaine.com/arc_baxter/1026/thumbnail.jp

Piano della città e porto dell' Havana.

Scale ca. 1:24,000.Relief shown by hachures. Depths shown by soundings.LC Maps of North America, 1750-1789, 1815From Il gazzettiere americano. 1763. v. 2.Indexed

Piano del porto, e degli stabilimenti di Pensacola.

Scale ca. 1:42,000.Relief shown by hachures. Depths shown by soundings.LC Maps of North America, 1750-1789, 165