Minerva cardioangiologica
-
Minerva cardioangiologica · Feb 2010
Use of NaCl saline hydration and N-Acetyl Cysteine to prevent contrast induced nephropathy in different populations of patients at high and low risk undergoing coronary artery angiography.
Contrast-induced nephropathy (CIN) is most commonly defined as acute renal failure occurring within 48-72 h of exposure to intravascular radiographic contrast medium that is not attributable to other causes. In international literature a 25% increase in serum creatinine levels or an increase in absolute values of 0.5 mg/dL from baseline has been suggested to define CIN. The reported incidence of CIN varies widely, ranging from 2% to 50%. This variability results from differences in the presence or absence of risk factors. With a retrospective analysis authors evaluated the use of NaCl saline hydration and N-acetyl cysteine (NAC) to prevent CIN in different populations of patients at high and low risk undergoing coronary artery angiography. ⋯ The hydration with saline and NAC is an effective and low-cost tool in preventing CIN in patients undergoing coronary artery angiography and, according to the current guidelines, should be used in all high-risk patients. Present results show that even in patients at low risk for CIN, hydration could be useful: in fact, despite the Contrast Index was significantly lower in this population, the incidence of CIN was greater, thus suggesting a potential role for hydration also in the low-risk population.
-
Patients with aortic coarctation are prone to develop arterial hypertension at various stages throughout life. There are at least three different pathophysiologic pathways: re-stenosis at the aortic isthmus, paradoxical hypertension, and late hypertension at long-term follow-up. As the most common causes of death reported for coarctation patients are linked to hypertension, it is important to differentiate these pathways of hypertension carefully to provide optimal treatment for hypertensive coarctation patients. This review summarizes the actual data about those different pathologic pathways, about how to differentiate them from each other, and how to treat them adequately.
-
Minerva cardioangiologica · Aug 2009
Review Comparative StudyAdvanced applications of 3-dimensional echocardiography.
Over the last few decades, advancements in ultrasound, electronic and computing technologies have permitted current second generation 3-dimensional (3D) echocardiography to display on-line 3D rendered images of the heart. Since various studies demonstrated its superiority over 2-dimensional echocardiography, there is growing enthusiasm to embrace this new 3D echocardiographic technology. ⋯ However, as with any new emerging technologies, clinical applications of 3D echocardiography should be based on current evidence. This review will focus on the evidence from clinical studies that form the scientific basis for the advanced applications of 3D echocardiography, from cardiac chamber volume assessments, left ventricular dyssynchrony assessments, quantifications of valvular abnormalities, to the role of 3D echocardiography during cardiac interventions.
-
Minerva cardioangiologica · Apr 2009
Comparative StudyIn-hospital stay of patient with acute coronary syndrome with or without diabetes mellitus.
Type 2 diabetes is associated with an increase in the risk of coronary heart disease, by a factor of two to four. The scientific community has suggested that all patients with diabetes could be treated as if they had a prior coronary heart disease. ⋯ Diabetic patients with acute coronary syndrome had more clinical complications (41.1% vs 17.9%, P=0.0001) and a longer in-hospital stay period, resulting in an increased management costs, in comparison with non diabetic patients.