Ventricular mechanical asynchrony in patients with different degrees of systolic dysfunction: results from AVE Registry by the Italian Society of Cardiovascular Echography (SIEC).

OBJECTIVE: The aim of the study was to compare the prevalence of interventricular and intraventricular asynchrony in patients with different degrees of left ventricular (LV) dysfunction. METHODS: We enrolled 182 patients (male 79%, mean age 64 +/- 11 years) with LV ejection fraction (EF) < 50% and identified two groups: Group A (n = 79) with mild-to-moderate LV dysfunction (EF between 36% and 49%) and Group B (n = 103) with severe dysfunction (EF 102 msec) did not differ between groups either (29.9% vs. 35.9%; P = 0.39). CONCLUSIONS: The prevalence of intraventricular asynchrony is independent of the LV systolic dysfunction severity. This could indicate the potential role of cardiac resynchronization therapy in patients with mild-moderate systolic dysfunction.

[Pharmacologic therapy in failed thrombolysis: sequential infusion of tirofiban. Pilot study with 47 patients]. / La terapia farmacologica nella trombolisi fallita: infusione sequenziale di tirofiban. Studio pilota in 47 pazienti.

Glycoprotein IIb/IIIa inhibitors have been recently proposed as a bridge to rescue transluminal coronary angioplasty in ST elevation myocardial infarction patients in whom thrombolysis fails; but data in its feasibility, safety and efficacy are still limited. In 47 consecutive acute myocardial infarction patients in whom thrombolysis failed to achieve 90 minute reperfusion, tirofiban was given at full regimen. Our results have been compared with those obtained in a control group of 48 consecutive acute myocardial infarction patients admitted two years before, period in which tirofiban and rescue angioplasty were not available in our hospital. Our preliminary data suggest this approach is feasible and safe, with possible clinical benefit in this high-risk subgroup of patients.