Journal of cardiovascular medicine
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J Cardiovasc Med (Hagerstown) · Jan 2009
Hormone replacement therapy and cardioprotection: a new dawn? A statement of the Study Group on Cardiovascular Disease in Women of the Italian Society of Cardiology on hormone replacement therapy in postmenopausal women.
Cardiovascular disease is the leading cause of death in women in Western countries. Despite preventive strategies, in the past decades the incidence of cardiovascular events has shown a decline in men but a rise in women, matching the growth of the population of postmenopausal women. Several epidemiological findings suggest the causative pathophysiological role of ovarian hormone deficiency in the development of cardiovascular disease in women. ⋯ Conversely, aging, time since menopause and presence of cardiovascular risk factors or cardiovascular disease may decrease its efficacy and increase the risk of cardiovascular events. It is plausible that the unfavorable effects of the estrogen/progestin combination used in the randomized studies are not related to the hormone preparation per se but rather to the use of hormones in the less receptive group of women, older and with cardiovascular risk factors. Clinical judgment, choice of the right dose and estrogen/progestin combination are of pivotal importance to maximize the beneficial effect of estrogen replacement therapy/hormone replacement therapy, especially if given within a reasonable time after the menopause to women who need the therapy for the relief of menopausal symptoms.
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J Cardiovasc Med (Hagerstown) · Jan 2009
Natriuretic peptide system is not exhausted in severe heart failure.
We aimed to investigate the prognostic value of amino-terminal B-type natriuretic peptide (NT-pro-BNP) in severe heart failure. ⋯ We conclude that in patients with severe heart failure, NT-pro-BNP has a powerful prognostic value. Patients with high NT-pro-BNP had more than five-fold increase in the 6-month risk of death. Our results do not support the hypothesis that ventricular exhaustion with inability to synthesize and secrete natriuretic peptides is the mechanism underlying decompensation. Attenuation mechanisms of compensatory systems ought to be further studied.
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J Cardiovasc Med (Hagerstown) · Jan 2009
Case ReportsGiant left ventricular pseudoaneurysm complicating an acute myocardial infarction in patient with previous cardiac surgery: a case report.
Left ventricular pseudoaneurysm is a nonfrequent complication of acute myocardial infarction. We describe a case of a patient with previous cardiac surgery and recent inferior myocardial infarction, who developed severe congestive heart failure due to a giant pseudoaneurysm of the inferoposterior wall.