Improving Outcomes in Peripartum Cardiomyopathy with Vericiguat: A Clinical Case.

Peripartum cardiomyopathy (PPCM) is a specific form of cardiomyopathy that manifests toward the end of pregnancy or within 5 months postpartum, characterized by a decrease in cardiac output due to impaired myocardial function. This condition has a multifactorial origin, influenced by genetic predispositions, inflammatory processes, autoimmunity, hormonal variations, and nutritional deficiencies. Prognosis varies among patients: while some recover completely within 6 months, others may develop chronic cardiac dysfunction requiring long-term treatment.

The Role of Vericiguat in Early Phases of Anterior Myocardial Infarction: A Potential Game-Changer?

Anterior myocardial infarction is a critical condition with significant implications for cardiac function and patient prognosis. Despite advancements in reperfusion therapies, optimizing recovery during the early phases of myocardial infarction remains challenging. Anterior myocardial infarction can lead to substantial long-term effects on a patient's health due to extensive damage to the heart muscle, particularly the left ventricle, impacting both quality of life and overall prognosis.

Sleep-disordered breathing and heart failure: a vicious cycle of cardiovascular risk.

Sleep-disordered breathing (SDB) represents an important cardiovascular risk factor that is still often underestimated and not always optimally treated. Such breathing disorders can induce several harmful effects on the heart, also favoring the development of arrhythmias, ischemic heart disease, and left ventricular remodeling. Obstructive sleep apnea syndrome (OSA) is more frequent in heart failure patients than in the general population, promoting the worsening of left ventricular dysfunction.

An unexpected cause of chest pain, dyspnea and palpitations in a young patient during a post-COVID syndrome.

A 31-year-old male presented with sudden onset of chest pain and dyspnea after a COVID-19 infection. Initially labeled as a myopericarditis related to COVID-19, because of the young age and low risk profile, after a multiparametric evaluation was possible to diagnose and treat an unstable lesion on an intermediate branch of left coronary.

[Endocarditis complicated by anterior myocardial infarction: a case report. What the guidelines do not say].

Acute myocardial infarction is an uncommon complication of infective endocarditis, burdened by high mortality and often underdiagnosed. Due to its reduced frequency, current guidelines do not always highlight this condition or provide clear indications regarding treatment. We present a case of acute coronary syndrome induced by the occlusion of the anterior descending artery, due to a septic embolus and treated by aspiration of the embolic material.

Left atrial invasion of a lung cancer: a case report.

Lung cancer is the leading neoplastic form worldwide for both incidence and mortality and represents the largest contributor to new cancer diagnosis. Cardiac extensions of a pulmonary neoplasm are rare and dramatically under-diagnosed because of the extreme variability of clinical presentation and frequently are expression of an advanced-stage primary lung cancer. The invasion often happens through pulmonary veins in absence of a clear respiratory impairment.

Could Low Doses Acetylsalicylic Acid Prevent Thrombotic Complications in COVID-19 Patients?

Severe Acute Respiratory Syndrome-Coronavirus-2 (SARS-CoV-2) can induce inflammatory and thrombotic complications of pulmonary district (interstitial pneumonia), sometimes evolving toward acute respiratory failure. In adults, Acetylsalicylic Acid (ASA) is widely employed at low doses for primary and secondary prevention of cardiovascular diseases (CVD). Apart their anti-thrombotic effect, low ASA doses also exert an anti-inflammatory action.

The role of Ivabradine in Diastolic Heart Failure with preserved Ejection Fraction. A Doppler-Echocardiographic study.

Background: Ivabradine (IVA) is effective in patients with coronary artery disease (CAD) or systolic heart failure in sinus rhythm. Its action consists in reducing heart rate (HR) and improving the time of left ventricular (LV) diastolic filling. The aim of this study was to evaluate the effects of IVA added to conventional therapy on patients with diastolic heart failure (DHF) and preserved ejection fraction (HFpEF).

Left Ventricular Postinfarction Pseudoaneurysm: Diagnostic Advantages of Three-Dimensional Echocardiography.

We present a case of posterior left ventricular pseudoaneurysm, a rare but potentially lethal complication of inferior acute myocardial infarction. The clinical findings and the customary, noninvasive diagnostic methods used are illustrated. Particularly, the most evident display obtained by the employment of three-dimensional echocardiography in comparison to those supplied by two-dimensional ultrasonic method was illustrated.

Two-dimensional Speckle Tracking Echocardiography and Three-dimensional Echocardiography Characterization of Left Atrial Giant Myxoma.

Myxomas are the most common cancerous nonneoplasms among the rare heart's tumors. Usually, they are located in the left atrium (LA). They are more frequent in women than in men and ranged in age from 30 to 50 years.

Ranolazine and Ivabradine: two different modalities to act against ischemic heart disease.

Among the innovative drugs recently introduced for the management of chronic stable angina, Ranolazine and ivabradine represent two most true innovations. In fact, even if both drugs act by reducing myocardial work and thus oxygen consumption, this happens by a peculiar mechanism unlike that of conventional antischemic drugs. Ranolazine mediates its antianginal effects by the inhibition of cardiac late sodium current.

The role of echocardiography in the non-invasive diagnosis of cardiac amyloidosis.

Introduction: The diagnosis of cardiac amyloidosis (CA) is usually performed by endomyocardial biopsy; however, possible sampling errors and procedural risks such as cardiac tamponade, malignant arrhythmias and bleeding risk, limit its use. Therefore, a non-invasive diagnostic method appears to be necessary.

Materials And Methods: Echocardiography plays an important role in this need.

Left Atrial Longitudinal Speckle Tracking Echocardiography in Healthy Aging Heart.

Background: Left atrial volume (LAV) and function are connected to the left ventricular (LV) haemodynamic patterns. To define the changes of LAV and functions to counterbalance age-related LV diastolic impairment, this study was undertaken.

Methods: 2D-Left Atrial Speckle Tracking Echocardiography (2D-LASTE) was used to define both LAV and functions in an aged healthy population (group II) respect to adult healthy controls (group I).

Three-Dimensional Trans-Thoracic Echocardiography of Esophageal Achalasia: Description of a Case.

Esophageal achalasia is a motility disorder characterized by impaired relaxation of the lower esophageal sphincter and dilatation of the distal two-thirds of the esophagus. This condition may be a non-frequent reason of extrinsic compression of left atrium. In turn, this can be a cause of some hemodynamic changes such as chest discomfort, dyspnea or reduced exercise tolerance, systemic hypotension and tachycardia.

Role of ubiquitin-proteasome system (UPS) in left ventricular hypertrophy (LVH).

Cardiac hypertrophy is a key compensatory mechanism acting in response to pressure or volume overload, involving some alterations in signaling transduction pathways and transcription factors-regulation. These changes result in enhanced proteins' synthesis leading to Left Ventricular Hypertrophy (LVH). It is known that the main function of Ubiquitin-Proteasome System (UPS) is to prevent accumulation of damaged, misfolded and mutant proteins by proteolysis.

Silymarin in non alcoholic fatty liver disease.

Aim: This study was undertaken to evaluate the hepatic effects of silybum marianum on non alcoholic fatty liver disease (NAFLD).

Methods: In 72 patients affected by NAFLD, main metabolic, hepatic and anti-inflammatory parameters were assayed after 3 mo of a restricted diet and before silymarin treatment (twice a day orally). The brightness of liver echography texture (hepatorenal ratio brightness) was also defined at same time.

Lowering homocysteine levels with folic acid and B-vitamins do not reduce early atherosclerosis, but could interfere with cognitive decline and Alzheimer's disease.

Inheired or acquired hyperhomocysteinemia (HHcy) is associated with several impairments, as certain tumors, deep venous thrombosis, tube neural defects, osteoporosis, early atherosclerosis and vascular acute events (IMA, stroke, PVD), mild cognitive impairments till Alzheimer's disease (AD). But, vascular and neuronal derangements are the most frequent HHcy-manifestations. As far as early atherosclerosis, some clinical trials demonstrated that folates and B6-12 vitamins supplementation is unable to reduce atherosclerotic lesions and cardiovascular events, even if it lowers HHcy levels.

Lowering homocysteine levels may prevent cardiovascular impairments? Possible therapeutic behaviors.

Homocysteine (Hcy) is metabolized through two pathways, requiring folates and B6-12 vitamins as cofactors. Increased Hcy concentration is responsible for early atherosclerosis with possible acute cardiovascular events. Ample evidence has demonstrated that Hcy lowering with folic acid and B vitamin supplementation, even if reduces Hcy serum levels, is unable to lower cardiovascular risk.

Left Atrial Volume Index as Indicator of Left Ventricular Diastolic Dysfunction: Comparation between Left Atrial Volume Index and Tissue Myocardial Performance Index.

Background: To point out a possible correlation between left atrial volume index (LAVI) and left ventricular (LV) diastolic time interval to better define LV diastolic dysfunction, this study was performed.

Methods: In 62 hypertensive-hypertrophic patients without LV systolic dysfunction, LV volumes, myocardial mass index, ejection fraction% (EF%) and LAVI were measured by two-dimensional echocardiography. Instead, tissue Doppler echocardiography (TDE) was used to measure myocardial performance index (MPI) and its systo-diastolic time intervals, such as: iso-volumetric contraction time (IVCT); iso-volumetric relaxation time (IVRT); ejection time.

Tight glycemic control may increase regenerative potential of myocardium during acute infarction.

Aims: We analyzed the effects of tight glycemic control on regenerative potential of myocardium during acute myocardial infarction.

Patients And Methods: Seventy-five patients with their first acute myocardial infarction undergoing coronary bypass surgery were studied: 25 patients with glycemia below 140 mg/dl served as the control group; hyperglycemic patients (glucose>140 mg/dl) were randomized to intensive glycemic control (IGC; n=20; glucose goal, 80-140 mg/dl), conventional glycemic control (CGC; n=20; glucose goal, 180-200 mg/dl), or glucose-insulin-potassium (GIK; n=10; glucose goal, 180-200 mg/dl) for almost 3 d before surgery, using insulin infusion followed by sc insulin treatment. During surgery, myocyte precursor cells (MPC) (c-kit/MEFC2/GATA4-positive cells), oxidation of MPC DNA (c-kit/8-hydroxydeoxyguanosine-positive cells), senescent MPC (c-kit/p16INK4a-positive cells), and cycling cardiomyocytes (Ki-67-positive cells) were analyzed in biopsy specimens taken from the peri-infarcted area.

Molecular mechanisms of left ventricular hypertrophy (LVH) in systemic hypertension (SH)-possible therapeutic perspectives.

Left ventricular hypertrophy (LVH) induced by systemic hypertension (SH) represents a maladaptive response to the increased overload. It is known that the LV pathological remodeling is associated with an increased risk of cardiovascular morbidity and mortality. Secretion and production of vasoactive peptides, such as angiotensin II, endothelin-1, norepinephrine, and Rho and Ras proteins, are increased during the process and play critical roles in the hypertrophic response to systemic hypertension.