Abstract:
:In recent years, it has become increasingly recognised that a central feature of the disease progression associated with heart failure is the process of left ventricular remodeling. The remodeling process manifests as an increase in left ventricular volumes, leading to a rise in wall stress and a compensatory increase in myocardial mass. The left ventricle also gradually assumes a more spherical shape, resulting in functional mitral regurgitation leading to further haemodynamic overload, worsening myocardial function and an unfavourable clinical course. Accumulating clinical data support the hypothesis that the benefits in clinical outcome with ACE-inhibitors and beta-blockers may relate to modification of the remodeling process resulting in slowing of disease progression and preservation of contractile function. The general trend from a number of clinical studies indicates that whereas ACE-inhibitors seem to prevent progressive left ventricular dilatation, the third generation beta-blocker, carvedilol, may actually reverse the remodelling process by reducing left ventricular volumes and improving systolic function. Direct comparisons indicate that carvedilol has a similar safety and tolerability profile to ACE-inhibitors and thereby support the feasibility of administering this drug as first-line therapy in selected patients with mild to moderate chronic heart failure. Therefore, the decision to initiate treatment with carvedilol or an ACE-inhibitor might in future be tailored on an individual basis and followed thereafter by combination therapy at the earliest and safest opportunity. Finally, the possible development of treatment strategies addressing the cellular and molecular mechanisms responsible for the remodeling process and the recently published benefits of device therapies herald a combined, synergistic approach to the future management of heart failure.
journal_name
Minerva Cardioangioljournal_title
Minerva cardioangiologicaauthors
Khattar RSkeywords:
subject
Has Abstractpub_date
2003-04-01 00:00:00pages
143-54issue
2eissn
0026-4725issn
1827-1618journal_volume
51pub_type
杂志文章,评审abstract::Percutaneous coronary artery revascularization has now evolved to a status where angioplasty and stenting have become routine practice for the treatment of significant obstructive atherosclerotic vascular disease. Angioplasty and stenting have become routine practice for the treatment of significant obstructive athero...
journal_title:Minerva cardioangiologica
pub_type: 杂志文章,评审
doi:
更新日期:2009-02-01 00:00:00
abstract::As echocardiography is being used more often, its value and accuracy are becoming more fully appreciated, especially for identifying normal anatomic variants and their possible erroneous interpretation as pathologic states. We report the echocardiographic and clinical findings observed in sixteen subjects examined at ...
journal_title:Minerva cardioangiologica
pub_type: 杂志文章
doi:
更新日期:1989-07-01 00:00:00
abstract:BACKGROUND:Aim of this registry study was the evaluation of the stability of carotid plaques by ultrasound in asymptomatic subjects with high oxidative stress following supplementation with a combination of the extract from bark of Pinus pinaster, Pycnogenol®, with an extract from Centella asiatica leaves, Centellicum®...
journal_title:Minerva cardioangiologica
pub_type: 杂志文章
doi:
更新日期:2016-12-01 00:00:00
abstract::Acute mesenteric ischemia is a severe complication after aortic reconstructive surgery for AAA repair. This ischemic event, due to a poor intestinal perfusion especially in ruptured AAA in consequence of the hypotension and the hypovolemic shock, shows different clinical manifestations such as delayed canalization, is...
journal_title:Minerva cardioangiologica
pub_type: 杂志文章
doi:
更新日期:1995-10-01 00:00:00
abstract::An aortic thrombus may be detected by using transesophageal echocardiography after an embolic event. Clinical features are variable and may include cardiac and neurologic symptoms, such as the stroke. We report a case of a woman with an acute ischemic stroke, a myocardial infarction and a free floating aortic thrombus...
journal_title:Minerva cardioangiologica
pub_type: 杂志文章
doi:
更新日期:2006-12-01 00:00:00
abstract:BACKGROUND:Galectin-3 is a recently developed biomarker of fibrosis, which may play a role in cardiac remodeling and associated with both the progression and severity of heart failure (HF). METHODS:A prospective cohort study of 190 patients with documented prior myocardial infarction and chronic HF (NYHA class II-IV) ...
journal_title:Minerva cardioangiologica
pub_type: 杂志文章
doi:
更新日期:2016-12-01 00:00:00
abstract::The aneurysm of the interatrial septum (ASA) is a rare congenital heart disease, easily recognizable by real time cross sectional two dimensional echocardiography. The ASA occurs as an isolated entity or may be associated with congenital heart disease. Usually ASA may cause serious complications such as embolic phenom...
journal_title:Minerva cardioangiologica
pub_type: 杂志文章
doi:
更新日期:1992-04-01 00:00:00
abstract::Coronary artery disease and atherothrombosis are complex pathologic entities. The intricate interplay between anatomical, cellular and molecular factors characterizes their pathogenesis and determines their clinical manifestations. Coronary artery revascularization strategies, by restoring myocardial blood perfusion, ...
journal_title:Minerva cardioangiologica
pub_type: 杂志文章,评审
doi:
更新日期:2015-08-01 00:00:00
abstract:AIM:The purpose of this paper was to verify whether there is any sign of involvement of the cardiovascular system in the early stages of collagen diseases. METHODS:Seventeen patients (10 female and 7 male, average age 41.35 +/- 9.85 years) (group A) recruited at the Ambulatory of Internal Medicine for suspected collag...
journal_title:Minerva cardioangiologica
pub_type: 杂志文章
doi:
更新日期:2006-02-01 00:00:00
abstract::Left main coronary artery (LMCA) disease has been reported in up to 10% of all patients with coronary artery disease (CAD) and in the majority of cases are associated with severe three-vessel CAD. Among patients with chronic coronary syndrome revascularization of significant LMCA disease improves prognosis, while ther...
journal_title:Minerva cardioangiologica
pub_type: 杂志文章
doi:10.23736/S0026-4725.20.05198-1
更新日期:2020-10-01 00:00:00
abstract::The worldwide prevalence of heart failure is increasing in part due to an ageing population. In the developed world, heart failure affects 1-2% of the general population, accounting for 5% of adult hospital admissions. There is now convincing evidence supporting the beneficial effects of cardiac resynchronization ther...
journal_title:Minerva cardioangiologica
pub_type: 杂志文章,评审
doi:
更新日期:2005-08-01 00:00:00
abstract::Syncope is a common symptom and accounts for approximately 1% of all emergency visits. There are four main causes of syncope: reflex, neurally mediated syncope, orthostatic hypotension and cardiac syncope. The prognosis of patients with reflex syncopes is good, whereas patients with cardiac syncope are at increased ri...
journal_title:Minerva cardioangiologica
pub_type: 杂志文章,评审
doi:
更新日期:2010-12-01 00:00:00
abstract::Inflammatory mechanisms play a pivotal role in the atherosclerotic process. At the base of atherogenesis there are complex interactions between macrophages, T lymphocytes and smooth muscle cells. A growing body of experimental evidences suggest that inflammation is involved in the pathogenesis of acute coronary syndro...
journal_title:Minerva cardioangiologica
pub_type: 杂志文章
doi:
更新日期:2002-10-01 00:00:00
abstract::The Authors describe a case of uniatrial univentricular heart with a right transposition and atresia of the aorta. This case forms part of an autoptic series of 74 congenital cardiopathies with defects of the septal system: monometameric (52 cases), polymetameric (22 cases), and limited (66 cases) or broad DIA, DIV or...
journal_title:Minerva cardioangiologica
pub_type: 杂志文章
doi:
更新日期:1991-01-01 00:00:00
abstract::Segmentary isolated stenosis or obstructions of the superficial femoral artery in young people are rarely reported. In patients, most of them women, affected by chronic symptomatology of the lower limbs, the aetiology has been referred to fibromuscular dysplasia with unusual localization. We report a case of acute low...
journal_title:Minerva cardioangiologica
pub_type: 杂志文章
doi:
更新日期:2001-04-01 00:00:00
abstract::A patent ductus arteriosus in adults is a rare eventuality. After correct diagnosis, an accurate evaluation of pulmonary vascular resistances is necessary with, in case of normality, a straightforward indication to surgery, because the evolution of the disease cannot be predicted. In case of pulmonary hypertension irr...
journal_title:Minerva cardioangiologica
pub_type: 杂志文章
doi:
更新日期:1991-09-01 00:00:00
abstract::A case is reported of pseudoaneurysm of the right iliac artery secondary to an endarterectomy with dacron patch due to atherosclerosis performed 4 years ago. The case presented acute anemia and massive enteric hemorrhage subsequent to arterial rupture into the cecum. Because of the dramatic onset, the patient was imme...
journal_title:Minerva cardioangiologica
pub_type: 杂志文章
doi:
更新日期:1990-01-01 00:00:00
abstract::Vasodilators represent one of the main steps for the medical treatment of pulmonary hypertension; the rationale for their use is the reversibility of the pulmonary vasoconstriction, to be tested with a correct pharmacological trial. In this report the authors consider the use of calcium-channel blockers, prostaglandin...
journal_title:Minerva cardioangiologica
pub_type: 杂志文章
doi:
更新日期:1995-06-01 00:00:00
abstract::Pathophysiological remodeling of cardiac function occurs at multiple levels, spanning the spectrum from molecular and sub-cellular changes to those occurring at the organ-system levels. Of key importance to arrhythmias are changes in the electrophysiological substrate at the tissue level. In this manuscript, we provid...
journal_title:Minerva cardioangiologica
pub_type: 杂志文章,评审
doi:
更新日期:2010-04-01 00:00:00
abstract::Diabetes is associated with significant morbidity and mortality in the setting of acute coronary syndromes. Exists a progressive relationship between glucose levels and cardiovascular risk. Hyperglycemy in fact produces endothelial dysfunction recognised to be a key accessory to diabetic microangiopathy and macroangio...
journal_title:Minerva cardioangiologica
pub_type: 杂志文章,评审
doi:
更新日期:2002-02-01 00:00:00
abstract:OBJECTIVES:To examine the relationship between patients gender, age and the development of different types of internal carotid artery plaque. DESIGN:Prospective open clinical study. METHODS:455 carotid duplex scans with a greater than 50% stenosis were analysed in terms of gender, age, degree of stenosis symptoms and...
journal_title:Minerva cardioangiologica
pub_type: 杂志文章
doi:
更新日期:1997-07-01 00:00:00
abstract:AIM:It is not known whether therapy assisted by determinations of serum B-type natriuretic peptide (BNP) may improve the outcome for outpatients with chronic heart failure (CHF). METHODS:A retrospective case-control study was carried out, enrolling patients with acutely decompensated heart failure (ADHF) who were foll...
journal_title:Minerva cardioangiologica
pub_type: 杂志文章
doi:
更新日期:2013-08-01 00:00:00
abstract::With radioisotopes it is possible to study the heart obtaining complementary or substitutive informations to those provided by the most common noninvasive methods of myocardial assessment and by coronarography. This paper aim is to report experience with thallium 201 and 99mTc isonitrile in the diagnosis and followup ...
journal_title:Minerva cardioangiologica
pub_type: 杂志文章
doi:
更新日期:1994-01-01 00:00:00
abstract::Despite advances in clinical interventions, drug therapy and preventative strategies for cardiovascular disease, heart disease remains the number one cause of death in the United States. A major cause of heart failure leading to death is myocardial ischemic disease. Terminal heart failure can be salvaged in some cases...
journal_title:Minerva cardioangiologica
pub_type: 杂志文章,评审
doi:
更新日期:2010-02-01 00:00:00
abstract::Three hundred carotid plaques (stenosis 45 to 65%) in 300 asymptomatic patients were included into a follow-up study considering three ultrasound types of plaques: type 1, non echogenic; type 2 intermediate, partially echogenic and type 3 highly echogenic. Types 1 and 2 had regular contour/surface while type 3 was irr...
journal_title:Minerva cardioangiologica
pub_type: 临床试验,杂志文章,随机对照试验
doi:
更新日期:1992-07-01 00:00:00
abstract::Two hundred and one patients admitted to Coronary Care Unit with documented acute myocardial infarction, whose chest pain had occurred within 12 hours of hospital admission non thrombolised, were studied. The peak of creatine kinase (CK) was examined and compared between patients without previous manifestations of myo...
journal_title:Minerva cardioangiologica
pub_type: 杂志文章
doi:
更新日期:1995-03-01 00:00:00
abstract:AIM:To evaluate any differences in ventricular pre-excitation secondary to Wolff Parkinson White syndrome in the aged compared to young and adult patients. METHODS: EXPERIMENTAL DESIGN:a clinical study was performed using a comparative prospective criterion with retrospective analysis. The duration of follow-up range...
journal_title:Minerva cardioangiologica
pub_type: 杂志文章
doi:
更新日期:1998-12-01 00:00:00
abstract:BACKGROUND:Of the main aspects of hypertension, left ventricular hypertrophy and appearance of cardiac dysfunction seem to be the most common and to produce an early and severe cardiac deterioration. Even in the presence of normal systolic function diastolic filling abnormalities are described. The efficacy of many ant...
journal_title:Minerva cardioangiologica
pub_type: 杂志文章
doi:
更新日期:1993-05-01 00:00:00
abstract::Atrial fibrillation (AF) is the most common observed cardiac arrhythmia and is the most frequent condition associated with thromboembolic events in patients with or without mitral valve disease. The source of cardiac emboli is the left atrium, the left atrial appendage or, less frequently, the left ventricle. Emboli m...
journal_title:Minerva cardioangiologica
pub_type: 杂志文章,评审
doi:
更新日期:2003-06-01 00:00:00
abstract::Coronary artery disease among women presents differences in terms of clinical presentation and pathophysiology. To date, women present worse prognoses with more events and higher mortality rate. One the one hand, they are less likely addressed for invasive therapy. One the other hand, revascularization procedures, whe...
journal_title:Minerva cardioangiologica
pub_type: 杂志文章
doi:10.23736/S0026-4725.20.05203-2
更新日期:2020-10-01 00:00:00