Giornale italiano di cardiologia : organo ufficiale della Federazione italiana di cardiologia : organo ufficiale della Società italiana di chirurgia cardiaca
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G Ital Cardiol (Rome) · Apr 2012
Review[Continuous infusion versus bolus injection of loop diuretics in acute heart failure: a literature review].
Intravenous loop diuretics are increasingly used to treat symptoms and signs of fluid overload in acute heart failure, a clinical condition associated with high morbidity and mortality rates. Although diuretic therapy is widely used and strongly recommended by most recent clinical guidelines, prospective studies and randomized clinical trials are lacking and hence there is no reliable evidence regarding the best therapy in terms of doses, ways and methods of administration. With heart failure progression, the efficacy of loop diuretics is impaired by diuretic resistance characterized by a decreased diuretic and natriuretic effect of drugs. ⋯ Several available studies comparing bolus injection to continuous infusion of loop diuretics proved the latter to be an effective and safe method of administration. Continuous infusion seems to produce a constant plasma drug concentration with a more uniform daily diuretic and natriuretic effect and a greater safety profile (fewer adverse events such as worsening renal failure, electrolyte imbalance, ototoxicity). In addition, the analysis of available literature data did not provide conclusive evidence about the effects on clinical outcomes (mortality, rehospitalization rates, adverse events).
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G Ital Cardiol (Rome) · Apr 2012
[Conflict of interest policies and disclosure requirements among European Society of Cardiology National Cardiovascular Journals].
Disclosure of potential conflicts of interest (COI) is used by biomedical journals to guarantee credibility and transparency of the scientific process. COI disclosure, however, is not systematically nor consistently dealt with by journals. ⋯ This paper provides a comprehensive editorial perspective on classical COI-related issues. New insights into current COI policies and practices among European Society of Cardiology national cardiovascular journals, as derived from a cross-sectional survey using a standardised questionnaire, are discussed.
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G Ital Cardiol (Rome) · Apr 2012
Review[Physiological versus pathological left ventricular remodeling in athletes].
Intense and chronic athletic training is associated with left ventricular remodeling, including an increase in wall thickness, cavity size and mass. The extent of morphological cardiac changes depends on a variety of factors, namely body size, gender, type of sport, ethnicity and, likely, genetic factors. ⋯ A common clinical challenge in sports cardiology is the differential diagnosis between physiological left ventricular hypertrophy (i.e., "athlete's heart") and hypertrophic cardiomyopathy, which is one of the most common causes of sudden cardiac death in young athletes. This review describes the physiological determinants, characteristics and upper limits of left ventricular hypertrophy in athletes, and analyzes the criteria that can be useful in the differential diagnosis between "athlete's heart" and hypertrophic cardiomyopathy.
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G Ital Cardiol (Rome) · Apr 2012
Letter Historical Article[A tribute to the New England Journal of Medicine].