139 research outputs found
Nutrition and prevention of venous thromboembolism
Prophylaxis of venous thromboembolism is a major health problem in everyday clinical practice. The therapeutic anticoagulants available to clinicians for prophylaxis of VTE is mainly composed by parenteral anticoagulants and oral vitamin K antagonists, warfarin. Oral vitamin K antagonists have several limitations, including a narrow therapeutic window and a metabolism that is affected by multiple drug and herbal interactions, vitamin K intake and genetic polymorphisms. The present review explore causes of poor prevention of thromboembolism and evaluated some new anticoagulants. The main target of new anticoagulants is to replace oral vitamin K antagonists for long-term anticoagulation. Moreover the role of genetics and the novel concept of cell therapy is evaluated. The hypothesis is that the patho-physiology of thrombosis may involve a "physiologic" cell that provides the same repair molecules that are used for treatment of thrombotic disorders
Bacteremia in Cardiac Surgery Patients with Heparin-Induced Thrombocytopenia
We have read with great interest the paper "Characterization of hospitalized cardiovascular patients with suspected heparin-induced thrombocytopenia" by Stoll and co-workers [1] and we found it very important with a view to clinical prevention
Fruit and vegetables in hypertensive women with asymptomatic peripheral arterial disease
Background and aims: Fruit and vegetables are considered a very healthy diet useful in the prevention of cardiovascular disease. The present study aims to evaluate intake of fruit and vegetables in hypertensive women and its correlation with asymptomatic atherosclerosis. Methods and results: A group of 237 women with hypertension was evaluated. Fruit and vegetables consumption were assessed by a self-administered food frequency validated questionnaire completed by an interviewer administered 24 h diet recall. They all underwent ABI. ABI measurement observed that fruit consumption was inversely associated with pre-clinical atherosclerosis suggesting a protective effect, moreover this association was stronger for vegetables. Increasing intake of vegetables was associated with a lower risk of asymptomatic PAD. Conclusions: Women with a high intake of fruit and vegetables showed less instrumental sign of preclinical peripheral atherosclerosis. Can be suggests that fruit and vegetables play an important role in prevention of atherosclerosis in pre-menopausal women
AB0611 STRAIN ANALYSIS OF THE RIGHT VENTRICLE USING 2D-SPECKLE TRACKING ECHOCARDIOGRAPHY IN A COHORT OF PATIENTS WITH SYSTEMIC SCLEROSIS
Background:
Systemic Sclerosis (SSc) is a rare and life-threatening connective tissue disease with multiple organ impairment. Cardio-pulmonary involvement is common: pulmonary fibrosis, pulmonary hypertension (PH), and electrical disorders are the most serious complications and causes of increased mortality.
Objectives:
We evaluated features related with the onset and development of PH in a cohort of SSc patients. We further studied ecocardiographic abnormalities, by means of 2D-speckle tracking echocardiography (STE) with specific reference to the right ventricular strain measure (RV-strain).
Methods:
We analyzed data from 50 SSc patients (pts) referred to our University-based Rheumatology Centre and SSc Unit from January 2007 to June 2019 (F/M 45/5; lc/dcSSc 45/5; mean age 59.20±14.357 years; mean disease duration 12.08±8.75 years). All pts underwent general and cardio-pulmonary
Labile plasma iron and echocardiographic parameters are associated to cardiac events in beta-thalassemic patients
Background and aim: Notwithstanding the improvement in therapies, patients
affected by thalassemia major (TM) and intermedia (TI) are still at
high risk of cardiac complications. This study aimed at evaluating the incidence
and predictive factors for developing cardiac events in adult β-TM
and TI patients.
Population andmethods: Data on diagnosis and clinical historywere
collected retrospectively; prospective data on new-onset cardiac failure
and arrhythmias, echocardiographic parameters, biochemical variables
including non-transferrin-bound iron (NTBI) and labile plasma iron (LPI),
magnetic resonance imaging (MRI) T2* measurement of hepatic and cardiac
iron deposits, and iron chelation therapy were recorded during a 6
year follow-up.
Results: Thirty-seven patients, 29 TM and 8 TI, were included. At
baseline, 8 TM patients and 1 TI patient had previously experienced a
cardiac event (mainly heart failure). All patients were on chelation therapy
and only 3 TM patients had mild-to-severe cardiac siderosis. During
follow-up, 11 patients (29.7%) experienced a new cardiac event. The occurrence
of cardiac events was correlated to high LPI levels (OR 12.0,
95% CI 1.56-92.3, p 0.017), low mean pre-transfusion hemoglobin (OR
0.21, 95% C.I. 0.051-0.761, p 0.21), and echocardiographic parameters
suggestive of myocardial hypertrophy. Multivariate analysis disclosed
high LPI and left ventricle mass index (LVMI) as independent variables
significantly associated with cardiac events. Cardiac iron deposits measured
by MRI T2* failed to predict cardiac events.
Conclusion: LPI, Hb levels, and echocardiographic parameters assessing
cardiac remodeling are associated to cardiac events in adult TM
and TI patients. LPI might represent both a prognostic marker and a
potential target for novel treatment strategies. Further studies are warranted to confirm our findings on larger population
Do the Current Guidelines for Heart Failure Diagnosis and Treatment Fit with Clinical Complexity?
Heart failure (HF) is a clinical syndrome defined by specific symptoms and signs due to structural and/or functional heart abnormalities, which lead to inadequate cardiac output and/or increased intraventricular filling pressure. Importantly, HF becomes progressively a multisystemic disease. However, in August 2021, the European Society of Cardiology published the new Guidelines for the diagnosis and treatment of acute and chronic HF, according to which the left ventricular ejection fraction (LVEF) continues to represent the pivotal parameter for HF patients’ evaluation, risk stratification and therapeutic management despite its limitations are well known. Indeed, HF has a complex pathophysiology because it first involves the heart, progressively becoming a multisystemic disease, leading to multiorgan failure and death. In these terms, HF is comparable to cancer. As for cancer, surviving, morbidity and hospitalisation are related not only to the primary neoplastic mass but mainly to the metastatic involvement. In HF, multiorgan involvement has a great impact on prognosis, and multiorgan protective therapies are equally important as conventional cardioprotective therapies. In the light of these considerations, a revision of the HF concept is needed, starting from its definition up to its therapy, to overcome the old and simplistic HF perspective
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