Anatomical features and clinical correlations in Caucasian patients with definite arrhythmogenic right ventricular dysplasia/cardiomyopathy.

AIM: Arrhythmogenic right ventrticular dysplasia/cardiomyopathy (ARVD/C) is an inherited cardiomyopathy characterized by fibrofatty replacement and a high risk of ventricular arrhythmias (VA) and sudden cardiac death (SCD). The aim of the present investigation is to examine the pathological profile and the clinical correlations in a group of ARVD/C patients. METHODS: We conducted a multicenter study evaluating 47 patients (31 men; mean age 37±14 years) with definite ARVD/C. Diagnosis was established according to the actual clinicomorphologic criteria at autopsy or clinically. We divided the study population in 2 different groups. First group included 28 alive patients and the second 19 patients dead suddenly. RESULTS: Age at presentation was different in the two groups (P=0.0015). We observed an important association regarding the risk of sudden death and the history of physical exercise (P=0.0017). Moreover patients with negative outcome (i.e., SCD, cardiac transplantation, congestive heart failure) had a significantly association with biventricular form of ARVD/C (P=0.0034) and age presentation (P=0.003). Left ventricular (LV) involvement was frequently observed in the two groups (17% and 32% respectively). Post-mortem examination revealed frequent inflammatory infiltrates (26%) indicating active myocarditis, which probably justify the fatal arrhythmic events occurred in these patients. CONCLUSION: Frequent LV involvement justifies the recent adoption of the broad term Arrhythmogenic Cardiomyopathy. Early age presentation, sport activity and the biventricular form of ARVD/C represent important predictors of adverse outcome that can be useful to early identify patients at high risk.

Carotid and peripheral atherosclerosis in patients who underwent primary percutaneous coronary intervention and outcome associated with multifocal atherosclerosis.

AIM: The aim of our study was to determine if patients with multifocal atherosclerosis have a worse prognosis than patients with atherosclerosis only in the coronary bed. METHODS: We studied 45 subjects admitted to intensive coronary care unit of the Division of Cardiology with the diagnosis of acute myocardial infarction (AMI). Traditional cardiovascular risk factors were investigated and laboratory analysis included measurement of plasma lipids, glycemia, fibrinogen and high-sensitivity-C-reactive protein (hs-CRP). Each patient underwent coronary-angiography as well as carotid and peripheral arterial ultrasound examination. A follow-up of 13+/-2 months was performed. RESULTS: We found that the severity of coronary atherosclerosis is significantly associated with the presence of carotid (P<0.05) and peripheral atherosclerosis (P<0.005). Markers of inflammation, hs-CRP (P<0.005) and fibrinogen (P<0.05), were significantly associated with multifocal atherosclerosis. We have shown that an increased number of coronary vessels with atherosclerotic stenosis is associated with a higher value of carotid (P<0.0001) and peripheral intima media thickness (P<0.0001). During 13 months of follow-up the incidence of fatal or non fatal events was 18%. The multivariate analysis showed that the variables independently associated with fatal and non fatal events were: male sex (P<0.001), family history of cardiovascular disease (P<0.005), hypertension (P<0.01), diabetes mellitus (P<0.05), higher levels of total cholesterol (P<0.05), smoking habit (P<0.05), and multifocal atherosclerosis (P<0.05). CONCLUSIONS: The ultrasound examination of carotid and peripheral atherosclerotic lesions may be useful in placing patients with AMI in a category of higher risk of cerebrovascular and cardiovascular events. Moreover, the precocious identification of patients at risk can suggest a more aggressive pharmacological treatment and a more accurate follow-up in order to avoid future events.

Exercise test: trend of the leukocyte flow properties, polymorphonuclear membrane fluidity and cytosolic Ca2+ content in normals, in subjects with previous acute myocardial infarction and in subjects with aortocoronary by-pass.

We evaluated, during an exercise test, the leukocyte flow properties, the polymorphonuclear leukocyte (PMN) membrane fluidity and PMN cytosolic Ca2+ content in normals, in subjects with previous acute myocardial infarction (AMI) and in subjects previously submitted to a aortocoronary by-pass. Leukocyte flow properties were evaluated using the St. George filtrometer. Examination of the PMN membrane fluidity was effected employing the probe TMA-DPH; while evaluation of the PMN cytosolic Ca2+ content was carried out using the probe Fura 2-AM. At baseline, in both cardiopathic groups a significant difference in PMN filtration parameters and in PMN cytosolic Ca2+ content was evident compared to normals. In normals, at peak of exercise, there was an evident reduction of mononuclear filtration parameters, while during recovery a slight increase of the PMN cytosolic Ca2+ content was observed. In subjects with previous AMI and in subjects with aortocoronary by-pass, however, we observed, at peak of exercise, a decrease of the mononuclear filtration parameters, a reduction of the PMN membrane fluidity and an increase of the PMN cytosolic Ca2+ content. In both groups, the changes in PMN membrane fluidity and cytosolic Ca2+ content remained during recovery. The trend of the PMN membrane fluidity and cytosolic Ca2+ content found in the cardiopathic subjects during the exercise test suggest the PMN activation may be more evident in these subjects.

[Magnetic fields in physical medicine. General and special criteria of application]. / I campi magnetici in medicina fisica. Criteri di applicazione generali e particolari.

The influence of magnetic fields on living creatures has been studied, and the physical characteristics, biological effects (stimulating and analgesic) as well as therapeutic applications are described. In particular, the authors discuss: traumatic bone lesions, bone grafting and internal prostheses in orthopedic surgery, neurodystrophic lesions, painful musculo-articular syndromes, osteomyelitis, sluggish wounds, and peripheral nerve lesions.