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Background: Repeat coronary artery bypass grafting (redo-CABG) in patients with ischaemic cardiomyopathy is associated with high perioperative risk and worse long-term outcome compared with patients undergoing their first CABG. Objective: To assess whether patients with viable myocardium undergoing redo-CABG have a better outcome. Methods: 18 patients with ischaemic cardiomyopathy underwent redo-CABG and 34 underwent their first CABG; all had substantial viability (> or =25% of the left ventricle) on dobutamine stress echocardiography (DSE). Left ventricular ejection fraction (LVEF) and heart failure symptoms were assessed before and 9-12 months after revascularisation. Cardiac event rate was assessed during the follow-up period (median 4 years, 25-75th centile 2.8-4.9 years). Results: The extent of viable myocardium on DSE was comparable in the two groups (11.3 (3.9) segments in patients who underwent redo-CABG v 12.8 (3.0) in patients who underwent their first CABG; p = NS). LVEF improved from 32% (9%) to 39% (12%); p = 0.01, in patients who underwent redo-CABG and from 30% (7%) to 36% (7%); p<0.01, in those who underwent their first CABG; New York Heart Association class improved from 2.5 (1.1) to 1.9 (0.8); p = 0.03, and from 2.7 (1.0) to 1.8 (0.70); p<0.01, respectively. In patients who underwent redo-CABG, the perioperative mortality was 0, post-surgery inotropic support was needed in 11% of the patients and mid-term (4-year) survival was 100%, with a total event rate of 28%. All these variables were not statistically different from patients who underwent their first CABG (p = 0.50, 0.90, 0.08 and 0.81, respectively). Conclusion: Patients with ischaemic cardiomyopathy and substantial viability undergoing redo-CABG benefit from revascularisation in terms of improvement in LVEF, heart failure symptoms, angina and mid-term prognosis. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the relative merits of viability and ischaemia for prognosis after revascularisation. Methods: Low-high dose dobutamine stress echocardiography (DSE) was performed before revascularisation in 128 consecutive patients with ischaemic cardiomyopathy (mean (SD) left ventricular ejection fraction (LVEF) 31 (8)%). Viability (defined as contractile reserve (CR)) and ischaemia were assessed during low and high dose dobutamine infusion, respectively. Cardiac death was evaluated during a five year follow up. Clinical, angiographic, and echocardiographic data were analysed to identify predictors of events. Results: Univariable predictors of cardiac death were the presence of multivessel disease (hazard ratio (HR) 0.21, p < 0.001), baseline LVEF (HR 0.90, p < 0.0001), wall motion score index (WMSI) at rest (HR 4.02, p = 0.0006), low dose DSE (HR 7.01, p < 0.0001), peak dose DSE (HR 4.62, p < 0.0001), the extent of scar (HR 1.39, p < 0.0001), and the presence of CR in > or = 25% of dysfunctional segments (HR 0.34, p = 0.02). The best multivariable model to predict cardiac death included the presence of multivessel disease, WMSI at low dose DSE, and the presence of CR in > or = 25% of the severely dysfunctional segments (HR 9.62, p < 0.0001). Inclusion of ischaemia in the model did not provide additional predictive value. Conclusion: The findings of the present study illustrate that in patients with ischaemic cardiomyopathy, the extent of viability (CR) is a strong predictor of long term prognosis after revascularisation. Ischaemia did not add significantly in predicting outcome. [ABSTRACT FROM AUTHOR]

BACKGROUND: In patients with ischaemic cardiomyopathy and viable myocardium, left ventricular ejection fraction (LVEF) does not always improve after revascularisation. Whether this may affect prognosis is unclear. OBJECTIVE: To evaluate the prognosis of viable patients with and without improvement of LVEF after coronary revascularisation. METHODS: Before revascularisation, radionuclide ventriculography (RNV) and dobutamine stress echocardiography were performed to assess LVEF and myocardial viability, respectively. Nine to 12 months after revascularisation, LVEF improvement was assessed by RNV. Patients were divided into three groups: group 1, viable patients with LVEF improvement (n = 27); group 2, viable patients without LVEF improvement (n = 15), group 3, non-viable patients (n = 48). Cardiac events were evaluated during a 4-year follow-up. RESULTS: After revascularisation, the mean (SD) LVEF improved from 32 (9)% to 42 (10)% in group 1, but did not change significantly in group 2 and in group 3, p<0.001 by analysis of variance (ANOVA). Heart failure symptoms improved in both groups 1 (mean (SD) NYHA class from 3.1 (0.9) to 1.7 (0.7)) and 2 (from 3.2 (0.7) to 1.7 (0.9)), but not in group 3 (from 2.8 (1.0) to 2.7 (0.5)), p<0.001 by ANOVA. During follow-up, the cardiac event rate was low (4%) in group 1, intermediate (21%) in group 2 and high (33%) in group 3 (p = 0.01). CONCLUSION: The best prognosis after revascularisation may be expected in those viable patients whose LVEF improves. Conversely, viable patients without functional improvement have an intermediate prognosis. [ABSTRACT FROM AUTHOR]

AIMS: Despite its relatively high intra- and inter-observer variability for left ventricular ejection fraction (LV-EF) echocardiography is clinically still the most used modality to assess LV-EF. We studied whether adding a second-generation microbubble contrast agent could decrease this variability. METHODS AND RESULTS: Forty-eight patients underwent transthoracic echocardiography in second-harmonic mode (SHI) with and without contrast within 5 days after an acute myocardial infarction. LV-EF was determined using the Simpson's biplane method. With contrast intra-observer variability decreased from 12.5 +/- 11.5% to 7.0 +/- 7.0% (P < 0.001) and inter-observer variability decreased from 16.9 +/- 9.9% to 7.0 +/- 6.2% (P < 0.001). Bland-Altman analysis confirmed these findings by demonstrating smaller 95% limits of agreement for both the intra- and inter-observer variability when contrast was used. This improvement in intra- and inter-observer variability was seen to a comparable extent in patients with moderate-to-poor and good quality SHI echocardiograms. CONCLUSION: Echo contrast significantly improves intra- and inter-observer variability for LV-EF, both in patients with moderate-to-poor and good quality SHI echocardiograms. [ABSTRACT FROM AUTHOR]

Background: Although left ventricular (LV) pacing has been proposed as an alternative to biventricular (BIV) pacing for heart failure (HF) patients, few comparative data are available on the electromechanical effects of these pacing modalities at mid-term follow-up. Aim: To investigate the clinical and echocardiographic effects of LV versus BIV pacing in a mid-term randomized study. Methods: After implantation of a device with LV/BIV pacing capabilities, 22 patients with chronic HF and left bundle branch block were randomized to LV or BIV pacing. Patients were assessed both preimplantation and after 3 months by clinical examination, ECG and echocardiography with pulsed tissue Doppler imaging. Results: At 3 months LV pacing improved clinical parameters, LV ejection fraction (+5%, range 5-8%, P = 0.007) and intraventricular dyssynchrony (-40 ms, range -50 to -15 ms, in septal to lateral delay, P = 0.008) to a similar extent to BIV pacing. A decrease in interventricular mechanical delay (-25 ms, range -40 to -5 ms, P = 0.008) and QRS duration (-28 ms, range -40 to -5 ms, P = 0.008) was observed in BIV, but not in LV patients. Conclusion: In this pilot evaluation, LV pacing appeared to be associated with clinical benefits similar to BIV pacing at mid-term follow-up, and this was combined with an improvement in intraventricular dyssynchrony, regardless of variations in interventricular dyssynchrony and QRS duration. Echocardiographic evaluation of intraventricular dyssynchrony seems to be an appropriate method for assessing the chronic response to LV pacing. [ABSTRACT FROM AUTHOR]

Background: Repeat coronary artery bypass grafting (redo-CABG) in patients with ischaemic cardiomyopathy is associated with high perioperative risk and worse long-term outcome compared with patients undergoing their first CABG. Objective: To assess whether patients with viable myocardium undergoing redo-CABG have a better outcome. Methods: 18 patients with ischaemic cardiomyopathy underwent redo-CABG and 34 underwent their first CABG; all had substantial viability (⩾25% of the left ventricle) on dobutamine stress echocardiography (DSE). Left ventricular ejection fraction (LVEF) and heart failure symptoms were assessed before and 9–12 months after revascularisation. Cardiac event rate was assessed during the follow-up period (median 4 years, 25–75th centile 2.8–4.9 years). Results: The extent of viable myocardium on DSE was comparable in the two groups (11.3 (3.9) segments in patients who underwent redo-CABG v 12.8 (3.0) in patients who underwent their first CABG; p = NS). LVEF improved from 32% (9%) to 39% (12%); p=0.01, in patients who underwent redo-CABG and from 30% (7%) to 36% (7%); p<0.01, in those who underwent their first CABG; New York Heart Association class improved from 2.5 (1.1) to 1.9 (0.8); p=0.03, and from 2.7 (1.0) to 1.8 (0.70); p<0.01, respectively. In patients who underwent redo-CABG, the perioperative mortality was 0, post-surgery inotropic support was needed in 11% of the patients and mid-term (4-year) survival was 100%, with a total event rate of 28%. All these variables were not statistically different from patients who underwent their first CABG (p = 0.50, 0.90, 0.08 and 0.81, respectively). Conclusion: Patients with ischaemic cardiomyopathy and substantial viability undergoing redo-CABG benefit from revascularisation in terms of improvement in LVEF, heart failure symptoms, angina and mid-term prognosis. [ABSTRACT FROM AUTHOR]

Objectives: To investigate diagnostic routes, echocardiographic substrates, outcomes and prognostic factors in patients with isolated ventricular non-compaction (IVNC) identified by echocardiographic laboratories with referral from specialists and primary care physicians. Patients and design: Since 1991, all patients with suspected IVNC were flagged and followed up on dedicated databases. Patients were divided into symptom-based and non-symptom-based diagnostic subgroups. Results: 65 eligible patients were followed up for 6-193 months (mean 46 (SD 44). In 53 (82%) patients, IVNC was associated with variable degrees of left ventricular (LV) dilatation and hypokinesia, and in the remaining 1 2 (18%) LV volumes were normal. Diagnosis was symptom based in 48 (74%) and non-symptom based in 17 (26%) (familial referral in 10). The non-symptom-based subgroup was characterised by younger age, lower prevalence of ECG abnormalities, better systolic function and lower left atrial size, whereas the extent of non-compaction was not different. No major cardiovascular events occurred in the non-symptom- based group, whereas 15 of 48 (3 1%) symptomatically diagnosed patients experienced cardiovascular death or heart transplantation (p = 0.01, Kaplan-Meier analysis). Independent predictors of cardiovascular death or heart transplantation were New York Heart Association class III-IV, sustained ventricular arrhythmias and left atrial size. Conclusions: IVNC is associated with a broad spectrum of clinical and pathophysiological findings, and the overall natural history and prognosis may be better than previously thought. Adult patients with incidental or familial discovery of IVNC have an encouraging outlook, whereas those who have symptoms of heart failure, a history of sustained ventricular tachycardia or an enlarged left atrium have an unstable course and more severe prognosis. [ABSTRACT FROM AUTHOR]

Objectives: To compare the long term prognosis of patients having silent versus symptomatic ischaemia during dobutamine stress echocardiography (DSE). Design: Observational study. Setting: Tertiary referral centre. Patients: 931 patients who experienced stress induced myocardial ischaemia during DSE. Results: Silent ischaemia was present in 643 of 931 patients (69%). The number of dysfunctional segments at rest (mean (SD) 9.6 (5.1) v 8.8 (5.0), p = 0.1) and of ischaemic segments (3.5 (2.2) v 3.8 (2.1), p = 0.2) was comparable in both groups. During a mean (SD) follow up of 5.5 (3.3) years, there were 169 (18%) cardiac deaths and 86 (9%) non-fatal infarctions. Multivariable Cox regression analysis showed age (hazard ratio (FIR) 1.1, 95% confidence interval (Cl) 1.02 to 1.05), previous myocardial infarction (HR 1.4, 95% CI 1.1 to 2.0), and number of ischaemic segments during the test (HR 2.0, 95% CI 1.0 to 3.7) as independent predictors of cardiac death and myocardial infarction. For every additional ischaemic segment there was a twofold increment in risk of late cardiac events. The annual cardiac death or myocardial infarction rate was 3.0% in patients with symptomatic ischaemia and 4.6% in patients with silent ischaemia (p <0.01). Silent induced ischaemia was an independent predictor of cardiac death and myocardial infarction (HR 1.7, 95% CI 1.1 to 2.0). During follow up symptomatic patients were treated more often with cardioprotective therapy (p <0.01) and coronary revascularisation (145 of 288 (50%) v 174 of 643 (27%), p <0.001). Conclusions: Patients with silent ischaemia had a similar extent of myocardial ischaemia during DSE compared to patients with symptomatic ischaemia but received less cardioprotective treatment and coronary revascularisation and experienced a higher cardiac event rate. [ABSTRACT FROM AUTHOR]

Objective: To evaluate prospectively the response of left ventricular ejection fraction (LVEF) to high dose dobutamine infusion in patients showing substantial viability, with and without improved resting IVEF after revascularisation. Methods: Before and 9-12 months after revascularisation, 50 patients with ischaemic cardiomyopathy (LVEF 32 (8)%) and substantial myocardial viability (≥4 viable segments) underwent radionuclide ventriculography and dobutamine stress echocardiography. Patients were divided into group 1, patients with, and group 2, patients without significant improvement in resting IVEF (≥5% by radionuclide ventriculography) after revascularisation. The response of IVEF during dobutamine stress echocardiography was compared in these two groups. Results: Groups 1 and 2 were comparable in baseline characteristics, resting IVEF, and number of viable segments (mean (SD) 7 (4) v 6 (2), not significant). After revascularisation, the LVEF response during dobutamine stress echocardiography improved significantly in both groups (group 1,34(10)% to 56 (8)%; group 2, 32 (10)% to 46 (11)%; both p < 0.001). Interestingly, although resting IVEF did not improve in group 2, peak stress LVEF after revascularisation did (p < 0.001). Group 1 patients had, however, a greater increase in peak stress LVEF (group 1, 22 (10)%; group 2, 13 (9)%; p <0.01). New York Heart Association and Canadian Cardiovascular Society classes decreased in both groups. Conclusions: Although patients with viable myocardium did not always have improved rest IVEF after revascularisation, peak stress LVEF improved. Assessment of improvement of resting function may not be the ideal end point to evaluate successful revascularisation. [ABSTRACT FROM AUTHOR]

Objective: To assess the prognostic value of dobutamine stress echocardiography (DSE) in patients with previous myocardial revascularisation. Design: Prospective study. Setting: Tertiary referral centre in Rolterdam, the Netherlands. Patients: 332 consecutive patients with previous percutaneous or surgical coronary revascularisation underwent DSE. Follow up was successful for 331 (99.7%) patients. Thirty eight patients who underwent early revasculorisation (&les; 3 months) after the test were excluded from analysis. Main outcome measures: Cox proportional hazards regression models were used to identify independent predictors of the composite of cardiac events (cardiac death, non-Fatal myocardial infarction, and late revascularisation). Results: During a mean (SD) of 24 (20) months, 37 (13%) patients died and 89 (30%) had at least one cardiac event (21 (7%) cardiac deaths, 11(4%) non-fatal myocardial infarctions, and 68 (23%) late revascularisations). In multivariate analysis of clinical data, independent predictors of late cardiac events were hypertension (hazard ratio (HR) 1.7, 95% confidence interval (Cl) 1.1 to 2.6) and congestive heart failure (HR 2.1, 95% Cl 1.3 to 3.2). Reversible wall motion abnormalities (ischaemia) on DSE were incrementally predictive of cardiac events (HR 2.1, 95% Cl 1.3 to 3.2). Conclusions: Myocarcllal ischaemio during DSE is independently predictive of cardiac events among patients with previous myocardial revascularisation, after controlling for clinical data. [ABSTRACT FROM AUTHOR]

The applicability of secondary fuels in practical plants (combustion, pyrolysis, gasification) requires a detailed characterization, mainly in severe thermal conditions, to provide optimized parameters for design and modeling purposes. Devolatilization is the basic step in all thermal treatments of materials. An experimental procedure is developed, described, and applied to the devolatilization of biomass (lignin-cellulosic materials), wastes (paper and sewage sludges), and low-quality coals. It consists of a preliminary characterization followed by further investigation (TG-FTIR analysis, kinetic abstraction, analysis on solid residue) to shed light on the effects of different operating conditions. The volatile matter released is found to strongly depend on the conditions used during the thermal treatment. Kinetics of devolatilization are obtained as functions of the heating rate in a wide range of conditions using different facilities on a laboratory scale (TG balance, wire mesh reactor, electrodynamic balance). This methodological approach provides important information and valuable parameters for practical applications and comprehensive modeling. [ABSTRACT FROM AUTHOR]

Objectives: To assess whether quantification of myocardial systolic velocities by pulsed wave tissue Doppler imaging can differentiate between stunned, hibernating, and scarred myocardium.Design: Observational study.Setting: Tertiary referral centre.Patients: 70 patients with reduced left ventricular function caused by chronic coronary artery disease.Methods: Pulsed wave tissue Doppler imaging was done close to the mitral annulus at rest and during low dose dobutamine; systolic ejection velocity (Vs) and the difference in Vs between low dose dobutamine and the resting value (DeltaVs) were assessed using a six segment model. Assessment of perfusion (with Tc-99m-tetrofosmin SPECT) and glucose utilisation (by 18F-fluorodeoxyglucose SPECT) was used to classify dysfunctional regions (by resting cross sectional echocardiography) as stunned, hibernating, or scarred.Results: 253 of 420 regions (60%) were dysfunctional. Of these, 132 (52%) were classified as stunned, 25 (10%) as hibernating, and 96 (38%) as scarred. At rest, Vs in stunned, hibernating, and scar tissue was, respectively, 6.3 (1.8), 6.6 (2.2), and 5.5 (1.5) cm/s (p = 0.001 by ANOVA). There was a gradual decline in Vs during low dose dobutamine infusion between stunned, hibernating, and scar tissue (8.3 (2.6) v 7.8 (1.5) v 6.8 (1.9) cm/s, p < 0.001 by ANOVA). DeltaVs was higher in stunned (2.1 (1.9) cm/s) than in hibernating (1.2 (1.4) cm/s, p < 0.05) or scarred regions (1.3 (1.2) cm/s, p = 0.001).Conclusions: Quantitative tissue Doppler imaging showed a gradual reduction in regional velocities between stunned, hibernating, and scarred myocardium. Dobutamine induced contractile reserve was higher in stunned regions than in hibernating and scarred myocardium, reflecting different severities of myocardial damage. [ABSTRACT FROM AUTHOR]

Background: In ischaemic cardiomyopathy, raised plasma concentrations of natriuretic peptides are associated with a poor long term prognosis, while the presence of contractile reserve is a favourable sign.Objective: To assess the relation between plasma natriuretic peptides and contractile reserve.Design: Prospective observational study.Setting: Tertiary referral centre.Patients: 66 consecutive patients undergoing low dose dobutamine stress echocardiography to evaluate contractile reserve in regions with contractile dysfunction at rest, divided into two groups: group 1, 31 patients with ischaemic cardiomyopathy (left ventricular ejection fraction < or = 40%) and heart failure symptoms; group 2, 35 patients with normal left ventricular function.Main Outcome Measures: Plasma atrial natriuretic peptide (ANP) and brain natriuretic peptide (BNP), measured using immunoradiometric assays. Contractile reserve was defined as an improvement in segmental wall motion score during infusion of low dose dobutamine.Results: Plasma ANP and BNP concentrations were higher in group 1 than in group 2 (mean (SD): ANP, 17.8 (32.8) v 7.2 (9.7), p < 0.005; BNP, 24.4 (69.0) v 5.0 (14.3) pmol/l, respectively; p < 0.001). In group 1, the presence of contractile reserve was inversely related to ANP and BNP levels; however, patients with contractile reserve had lower ANP and BNP concentrations than patients without contractile reserve (ANP, 14.2 (9.1) v 24.2 (44.2), p < 0.05; BNP, 20.2 (25.5) v 37.5 (93.8) pmol/l, respectively; p < 0.05).Conclusions: Plasma natriuretic peptide concentrations are raised in patients with left ventricular dysfunction, but in the presence of preserved myocardial contractile reserve, relatively low levels of ANP and BNP are present. [ABSTRACT FROM AUTHOR]

Experimental and modeling investigations have been performed on the co-combustion of a traditional fossil fuel and a tire residue. The experimental runs have been carried out using a pilot-scale vertical furnace (0.5 MW) with a burner for pulverized solid fuels. Different conditions have been set up for the co-combustion of a medium volatile bituminous coal and a tire residue. The scope was to test the feasibility of burning secondary fuels (biomasses and residues) with coals using a low NO x burner developed for pulverized coal in the ENEL Research Centre. A co-combustion model was developed for interpreting the results and extrapolating kinetic parameters to practical conditions. It considers the effect of the particle size distribution, the different reactivity, and, in general, the different combustion behavior of each fuel fed to the furnace. The kinetic scheme adopted is simple and the introduced assumptions allow easy coupling with computational reactive fluid dynamic codes. Fuel conversion, oxygen concentration and carbon-in-ash profiles have been computed and compared with the experimental results. Quite good agreement has been obtained, allowing kinetic information to be used in more comprehensive descriptions of full-scale systems. [ABSTRACT FROM AUTHOR]

Background: In patients with ischaemic cardiomyopathy and viable myocardium, left ventricular ejection fraction (LVEF) does not always improve after revascularisation. Whether this may affect prognosis is unclear. Objective: To evaluate the prognosis of viable patients with and without improvement of LVEF after coronary revascularisation. Methods: Before revascularisation, radionuclide ventriculography (RNV) and dobutamine stress echocardiography were performed to assess LVEF and myocardial viability, respectively. Nine to 12 months after revascularisation, LVEF improvement was assessed by RNV. Patients were divided into three groups: group 1, viable patients with LVEF improvement (n = 27); group 2, viable patients without LVEF improvement (n = 15), group 3, non-viable patients (n = 48). Cardiac events were evaluated during a 4-year follow-up. Results: After revascularisation, the mean (SD) LVEF improved from 32 (9)% to 42 (10)% in group 1, but did not change significantly in group 2 and in group 3, p<0.001 by analysis of variance (ANOVA). Heart failure symptoms improved in both groups 1 (mean (SD) NYHA class from 3.1 (0.9) to 1.7 (0.7)) and 2 (from 3.2 (0.7) to 1.7 (0.9)), but not in group 3 (from 2.8 (1.0) to 2.7 (0.5)), p<0.001 by ANOVA. During follow-up, the cardiac event rate was low (4%) in group 1, intermediate (21%) in group 2 and high (33%) in group 3 (p = 0.01). Conclusion: The best prognosis after revascularisation may be expected in those viable patients whose LVEF improves. Conversely, viable patients without functional improvement have an intermediate prognosis. [ABSTRACT FROM AUTHOR]

The article presents a case study on echocardiagraphic clues to diagnosis of dystrophin related dilated cardiomyopathy. A 32-year-old man with a four-year history of congestive heart failure is under study. A diagnosis of idiopathic dilated cardiomyopathy with severe secondary mitral insufficiency was received by the patient two years ago.

An abstract of the article "Does the Presence of Angina During Stress Testing Influence Prognosis in Patients With Ischemia During Stress Echocardiography" by E. Biagini and colleagues is presented.

An abstract of the article "Can We Predict Better Functional Recovery After Coronary Revascularization in Mildly Hypokinetic Segments?" by V. Rizzello and colleagues is presented.

An abstract of the article "Can resting 2D echocardiography identify patients with ischemic cardiomyopathy and low likelihood of functional improvement after revascularization?" by V. Rizzello and colleagues is presented.

An abstract of the article "How many patients develop end-stage hypertrophic cardiomyopathy in a non tertiary center?" by E. Biagini, F. Coccolo, C. Pedone, C. Rapezzi, E. Perugini, A. Donti, M. F. Picchio, A. Branzi and S. Orsola is presented.

An abstract of the article "How many patients with ischemic left ventricular dysfunction do recover in contractile function following revascularization?" by A. F. L. Schinkel and colleagues is presented.

An abstract of the article "The Assessment of Left Ventricular Volumes and Ejection Fraction by Experienced and Low-Experienced Observers Is Improved by the Use of a Contrast Agent" by V. Rizzello and colleagues is presented.

An abstract of the article "Do All Patients with Ischemic Heart Failure and a Substantial Amount of Viable Myocardium Recover in Function After Myocardial Revascularization" by A. F. L. Schinkel and colleagues is presented.

An abstract of the article "Myocardial contrast echocardiography and contrast magnetic resonance imaging to assess reversible myocardial dysfunction after percutaneous coronary intervention in acute myocardial infarction" by E. Biagin is presented.

An abstract of the article "What test should we use to assess prognosis: dobutamine stress echocardiography or nuclear imaging?" by A.F.L. Schinkel, J.J. Bax, A. Elhendy, M. Bountioukos, E. Biagini, E. Vourvouri, V. Rizzello, B. Krenning, J.R.T.C. Roelandt, and D. Poldermans is presented.

An abstract of the article "The performance of hand-carried ultrasound devices for assessment of global and segmental left ventricular function is improved with the use of echocontrast," by V. Rizzello and colleagues is presented.

An abstract of the article "Aortic valve sclerosis screening using a hand-held ultrasound device," by E. Biagini, V. Rizzello, E.C. Vourvouri, A.F.L. Schinkel, M. Bountioukos, G. Rocchi, C. Rapezzi, D. Poldermans, and J.R.T.C. Roelandt is presented.

An abstract of the article "A hand-carried cardiac ultrasound device in the diagnosis of cardiac abnormalities. A comparison to physical examination," by E.C. Vourvouri, V. Rizzello, A.F.L. Schinkel, M. Bountioukos, E. Biagini, F. J. Ten Cate, H.I. Karvounis, and J.R.T.C. Roelandt is presented.

An abstract of the article "Safety of dobutamine stress echocardiography in patients with aortic stenosis" by M. Bountioukos, M. D. Kertai, E. C. Vourvouri, V. Rizzello, E. Biagini, and B. J. Krenning is presented.