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51. Variable threshold of exertional ischaemia in patients with positive exercise test at low workload.

Author

OPASICH, C., FALCONE, C., COBELLI, F., ASSANDRI, J., LA ROVERE, M. T., RICCARDI, G., TRAMARIN, R., ARDISSINO, D., and SPECCHIA, G.

Abstract

In order to determine individual variability of ischaemic threshold on different days, 18 patients with exertional ischaemia at low workload were studied. All patients performed two exercise tests during different days in the morning and three on the same day at 9 am, 2 pm and 5 pm. The test performed in the morning on different days resulted in a significant difference in the mean values of rate pressure product at the ischaemic threshold as a consequence of individual variability observed in 10 patients. In 8 of these patients the differences were greater than 4000 mmHg beats min. Two patients showed respectively, 1 and 5 negative exercise tests despite the greater values of rate pressure product reached. Only 3 patients showed circadian variation of the ischaemic threshold; in these 3 patients variations of rate pressure product at the ischaemic threshold were also observed between different days. These data indicate that in patients with exertional ischaemia at low workload the rate pressure product at the ischaemic threshold shows considerable variability between tests performed on different days. [ABSTRACT FROM PUBLISHER]

Published
1987
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52. Two-dimensional echocardiographic assessment of anticoagulant therapy in left ventricular thrombosis early after acute myocardial infarction.

Author

TRAMARIN, R., POZZOLI, M., FEBO, O., OPASICH, C., COLOMBO, E., COBELLI, F., and SPECCHIA, G.

Abstract

This study was designed to assess, by two-dimensional echocardiography, the effects of anticoagulant therapy on left ventricular thrombosis detected after acute myocardial infarction. Thirty-eight patients with left ventricular thrombi detected by two-dimensional echocardiology within 5 weeks (mean 4) of the onset of infarction were randomly assigned to the following groups: group A consisted of 19 patients who received oral anticoagulants (acenocoumarin 1.6 mg daily regulated to keep prothrombin time within the range of 25 to 35%) and group B which consisted of 19 non-treated control patients. Seventeen patients from both groups were restudied 15 days, 3 months and one year later to evaluate the changes in size of thrombi. Echocardiographic examinations were read blindly; a significant decrease in ventricular thrombus size was taken as a ≥ 5 mm reduction of thickness in the apical views. In Group A, 9 patients showed a complete resolution of thrombus at the 15 day study; at one year, thrombus had resolved in 15 and persisted unchanged in size in 2 patients. The mean dimension of thrombi in patients of group A was 18±6.6 mm at the screening examination and decreased to 6.6mm, 3.8mm and 2.2mm, respectively, at 15 days, 3 months and one year follow-up studies. Among 17 patients of group B at the 15 day study, two had resolution of thrombus and 15 were unchanged; at the one year examination thrombus was resolved in 4, decreased in size in 4 and persisted unchanged in 9 patients. Analysis of variance of the dimensional changes of thrombi in the two groups of patients confirmed a significant efficacy of anticoagulant therapy (P<0.001). On the basis of our results we conclude that full-dose anticoagulant therapy, started early (within 5 weeks) after acute myocardial infarction, is effective in the resolution of left ventricular thrombosis. [ABSTRACT FROM PUBLISHER]

Published
1986
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53. Echocardiographic evaluation of verapamil in Friedreich's ataxia.

Author

Casazza, F, Ferrari, F, Finocchiaro, G, Hartwig, J, Piccone, U, Tramarin, R, and Morpurgo, M

Abstract

Nine patients with hypertrophic cardiomyopathy associated with Friedreich's ataxia were treated with the calcium antagonist verapamil, which is known to reduce myocardial hypertrophy and improve diastolic function in patients with idiopathic hypertrophic cardiomyopathy. Daily oral doses of 7 mg/kg were given for a mean (SD) of 24 (8) months. M mode echocardiography performed at the start of the study and at the end of follow up showed no significant difference between the treated group and an untreated control group of nine patients. Verapamil produced no changes in left ventricular wall thickness, mass index, left ventricular internal diameter, fractional shortening, peak normalised lengthening rate, peak rate of septal and posterior wall thinning, and time from minimum ventricular cavity dimension to mitral valve opening. Myocardial calcium overload has been suggested as a cause of cardiac disease in Friedreich's ataxia; however, verapamil had no beneficial effect on these patients with established myocardial hypertrophy. [ABSTRACT FROM PUBLISHER]

Published
1986
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54. Despite good compliance, very low fat diet alone does not achieve recommended cholesterol goals in outpatients with coronary heart disease.

Author

Aquilani, R., Tramarin, R, Pedretti, R.F.E., Bertolotti, G., Sommaruga, M., Mariani, P., Ruffato, L., Catapano, M., Boschi, F., Dossena, M., and Pastoris, O.

Abstract

Aim A low-saturated, low-cholesterol diet is important in the treatment of hypercholesterolaemia in patients with coronary heart disease. The aim of this study was to investigate the efficacy of a very low fat diet to achieve a targeted serum low density lipoprotein (LDL) cholesterol level (⩽2·59mmol.l−1) in outpatients with coronary heart disease.Methods One hundred and twenty-six male patients (all ex-smokers) with coronary heart disease and a serum LDL cholesterol >3·37mmol.l−1were investigated 12–14 weeks after an acute coronary event. After overnight fasting each patient had (a) his resting energy expenditure measured (indirect calorimetry using standard protocol) and (b) venous blood sampled from a forearm vein to determine lipid profile. All the patients were randomly allocated to four groups of treatment:Group Aon a very low fat diet (resting energy expenditure-fat diet, where fat intake was ⩽20% resting energy expenditure);Group Bon a low fat diet from the National Cholesterol Education program (National Cholesterol Education Program step 2 diet);Group Con resting energy expenditure-fat diet+simvastatin 10mg daily;Group Don National Cholesterol Education Program step 2 diet+simvastatin 10mg daily. For all patients the prescribed energy intakes were equal to their respective resting energy expenditures.Results At 6 months, the average decrease in serum LDL cholesterol was not different between Group A and Group B, but the increase in high density lipoprotein cholesterol (HDL) (+29%) observed in Group A led to a reduced LDL cholesterol/HDL cholesterol ratio (P<0·001). As expected, a more important serum lipid improvement was found in the groups supplemented with diet+drug association, but the decrease in LDL cholesterol was higher in Group C than in Group D (−37±9·7% vs −24·5±15%;P<0·00001) as well as LDL cholesterol/HDL cholesterol ratio (P<0·001). No patient on diet alone achieved the recommended LDL cholesterol level ⩽2·59mmol.l−1.Conclusion Diet alone does not allow patients with coronary heart disease to achieve the recommended blood cholesterol levels, even if its fat content is highly reduced. [ABSTRACT FROM PUBLISHER]

Published
1999
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56. The Italian survey on cardiac rehabilitation - 2008 (ISYDE-2008). Part 3. National availability and organization of cardiac rehabilitation facilities. Official report of the Italian association for cardiovascular prevention, rehabilitation and epidemiology (IACPR-GICR)

Author

Tramarin R., Ambrosetti M., De Feo S., Piepoli M., Riccio C., Griffo R., Carlon R., Castello A., Ferratini M., Schweiger C., Chieffo C., Diaco T., Ciglia C., Lapolla A., Pietropaolo F., Furgi G., Martin G., Semprini P., Avallone A., Bertoli D., Belardinelli R., Soffiantino F., Scrutinio D., Maxia P., Coco R., Giustarini C., Anniboletti P., Favretto G., Vaghi P., Calisi P., Chiavetta C., VIGORITO, CARLO, Tramarin, R., Ambrosetti, M., De Feo, S., Piepoli, M., Riccio, C., Griffo, R., Carlon, R., Castello, A., Ferratini, M., Schweiger, C., Chieffo, C., Vigorito, Carlo, Diaco, T., Ciglia, C., Lapolla, A., Pietropaolo, F., Furgi, G., Martin, G., Semprini, P., Avallone, A., Bertoli, D., Belardinelli, R., Soffiantino, F., Scrutinio, D., Maxia, P., Coco, R., Giustarini, C., Anniboletti, P., Favretto, G., Vaghi, P., Calisi, P., and Chiavetta, C.

Subjects
Pulmonary and Respiratory Medicine, medicine.medical_specialty, Heart Diseases, Cardiologia Riabilitativa, medicine.medical_treatment, attrezzature, Staffing, lcsh:Medicine, Ambulatory Care Facilities, Rehabilitation Centers, Health Services Accessibility, Age Distribution, Ambulatory care, Health care, Epidemiology, medicine, Humans, ISYDE 2008, strutture, Geriatrics, Rehabilitation, Cardiac Rehabilitation, business.industry, lcsh:R, Coronary Care Units, organization, medicine.disease, Long-term care, Italy, Cardiovascular Diseases, staffing, Health Care Surveys, Workforce, Physical therapy, program, Medical emergency, provision, Cardiology and Cardiovascular Medicine, business
Abstract

From January 28th to February 10th 2008, the Italian Association for Cardiovascular Prevention, Rehabilitation and Epidemiology (IACPR-GICR) conducted the ISYDE- 2008 study, the primary aim of which was to take a detailed snapshot of cardiac rehabilitation (CR) provision in Italy – in terms of number and distribution of facilities, staffing levels, organization and setting – and compare the actual CR provision with the recommendations of national guidelines for CR and secondary prevention. The secondary aim was to describe the patient population currently being referred to CR and the components of the programs offered. Out of 190 cardiac rehabilitation centers existing in Italy in 2008, 165 (87%) took part in the study. On a national basis, there is one CR unit every 299,977 inhabitants: in northern Italy there is one CR unit every 263,578 inhabitants, while in central and southern Italy there is one every 384,034 and 434,170 inhabitants, respectively. The majority of CR units are located in public hospitals (59%), the remainder in privately owned health care organizations (41%). Fifty-nine percent are located in hospitals providing both acute and rehabilitation care, 32% are in specifically dedicated rehabilitation structures, while 8% operate in the context of residential long term care for chronic conditions. Almost three-quarters of CR units currently operating are linked to dedicated cardiology divisions (74%), 5% are linked to physical medicine and rehabilitation divisions, 2% to internal medicine, and 19% to cardiac surgery and other divisions. Inhospital care is provided by 62.4% of the centers; outpatient care is provided on a day-hospital basis by 10.9% of facilities and on an ambulatory basis by 20%. The CR units are led in 86% of cases by a cardiologist and in only 14% of cases by specialists in internal medicine, geriatrics, physical medicine and rehabilitation, pneumology or other disciplines. In terms of staffing, each cardiac rehabilitation unit has 4.0±2.7 dedicated physicians (range 1-16, mode 2), 10.1±8.0 nurses, 3.3±2.5 physiotherapists (range 0 – 20; 16% of services have no physiotherapist in the rehabilitation team), 1.5±0.8 psychologists, and a dietitian (present in 62% of CR units). Phase II CR programs are available in 67.9% of cases in residential (inpatient) and in 30.9% of cases in outpatient (day-hospital and ambulatory) settings. Phase III programs are offered by 56.4% of the centers in ambulatory outpatient regime, and on an at home basis by 4.8% with telecare supervision, 7.3% without. Long term secondary prevention follow up programs are provided by 42.4% of CR services.

57. Is old age a contraindication to cardiac rehabilitation after acute myocardial infarction?

Author

Opasich, C., Cobelli, F., Assandri, J., Calsamiglia, G., Febo, O., Larovere, M. T., Pozzoli, M., Tramarin, R., Traversi, E., and Specchia, G.

Abstract

Fifty male patients older than 65 years of age (mean 66·3) underwent a symptom-limited exercise test on an average of 34 days after acute myocardial infarction. After 4 weeks of supervised rehabilitation training and after one-year follow-up, the patients underwent controlled exercise tests. The ergometric parameters were compared with respective values in 10 healthy males (mean age 66·4, range 65–75). The rehabilitation training induced a substantial improvement in physical capacity (total work from 3149±1326 to 4791 ± 1403 kg; P<0·001) with a better cardiovascular response: increased maximum oxygen pulse (from 8·97±2 to 10·7±2; P<0·001), decreased heart rate (from 120·5±16·1 to 111·3±14·7beats min−1; P < 0·05) and a decreased double product at a 75 W work load (from 22 866 ± 4005 to 20 472 ± 3982 beats min−1 mmHg; P<0·05). The recovery of physical capacity and cardiovascular tolerance in the physical exercise was nearly complete as compared with healthy subjects of the same age. During the training period one patient died from heart failure. In all the other patients the same improvement was still maintained one-year later.In conclusion, old age does not seem to be per se a contraindication to cardiac rehabilitation. Physiological beneficial effects from cardiac rehabilitation can also be received by patients older than 65 years of age. [ABSTRACT FROM PUBLISHER]

Published
1984
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59. ICAROS (Italian survey on CardiAc RehabilitatiOn and Secondary prevention after cardiac revascularization): Temporary report of the first prospective, longitudinal registry of the cardiac rehabilitation network GICR/IACPR,ICAROS (Italian survey on CardiAc RehabilitatiOn and Secondary prevention after cardiac revascularization): Primo bilancio di una grande esperienza scientifica del network riabilitativo GICR/IACPR

Author

Griffo, R., Temporelli, P. L., Fattirolli, F., Ambrosetti, M., Tramarin, R., Vestri, A. R., Feo, S., Tavazzi, L., Giannuzzi, P., Riccio, C., Ferratini, M., Belardinelli, R., Favretto, G., Scrutinio, D., Castello, A., Urbinati, S., Piepoli, M., Carlon, R., Schweiger, C., Volterrani, M., Vigorito, C., Chieffo, C., Majani, G., Ciglia, C., Mantini, L., Borrello, G., Mazza, M. L., Scaglione, A., Furgi, G., Nicolino, A., Golino, P., Parrilli, G., Giallauria, F., Coruzzi, P., Gualerzi, M., D Cruz, S., Violi, D., Burgisser, C., Giustarini, C., Macchi, C., Zipoli, R., Provvidenza, M., Scalzini, A., Ferrario, G., Eleas, A., Sarno, C., Anniboletti, F., Filippucci, L., Mandorla, S., Baroni, P. L., Bellotto, F., Setzu, T., Bordin, F., Mantovani, E., Mosele, G. M., Semprini, P., Di Mario, F., Galati, A., Rossetti, A., Salustri, A., Cerquetani, E., Tassoni, G., Corsiglia, L., Acquistapace, F., Reggiani, R., Passera, M., Anzà, C., Baravelli, M., Cobelli, F., Diaco, T., Febo, O., Riccardi, G., Frizzelli, R., Gei, P., Proto, A., Giordano, A., Zanelli, E., Jones, N., Malfatto, G., Malinverni, C., Rocca, P., Roberto Pedretti, Vanitetti, R., Palvarini, M., Schizzarotto, A., Abello, P., Calisi, P., Pianese, M., Bosimini, E., Tidu, M., Mazzucco, G., Delpero, P., Soffiantino, F., Ingignoli, B., Polimeni, G., Sannia, L., and Sarullo, F.

70. Clinical validation of an anxiety and depression screening test for intensive in-hospital rehabilitation

Author

Vedana, L., Paola Baiardi, Sommaruga, M., Gallì, M., Neri, M., Pedretti, R. F. E., Tramarin, R., and Bertolotti, G.

Subjects
Adult, Hospitalization, Male, Psychological Tests, Critical Care, Depression, Humans, Female, Anxiety, Middle Aged, Aged
Abstract

Routine hospital psychological care must necessarily make use of a clinically reliable screening instrument for the identification of the patients to be referred for a clinical interview with a psychologist. This study compared two tests for the evaluation of anxiety and depression that are widely used in the hospital setting: the Hospital Anxiety and Depression Scale (HADS) and Form A-D, consisting of the State-Trait Anxiety Inventory (STAI-X1) for the evaluation of anxiety, and the Depression Questionnaire (DQ) for measuring depression. The aim of the study was to identify which of these instruments is the most suitable for screening a population admitted at in-hospital intensive rehabilitation using the clinical interview-based psychological evaluation as the gold standard. Both of the tests showed a concordance with the clinical opinion expressed by the psychologist, whose judgement was guided by the use of the validation study evaluation form. The analyses confirmed the good correlation of the two instruments in measuring anxiety and depression. The sensitivity of the STAI-X1 (52%) was less than that of HADS section A (72%), but its specificity (99%) was greater than that observed with the application of the HADS Anxiety subscale (84%). Analysis of the ROC curves showed that the STAI-X1 percentages of sensitivity and specificity tended to balance at higher level with a cut-off point equal to the 80th percentile. The results of the analysis of the DQ demonstrated equivalence with the results obtained using HADS section D, with a cut-off point of the 90th percentile. On the basis of these results, and given that both the STAI-X1 and the DQ have a broadly based Italian normative population, we feel that they can be recommended for psychological screening of patients in an in-hospital intensive rehabilitation.

72. Embolizing fibroelastoma of the aortic valve

Author

Ragni T, Am, Grande, Cappuccio G, Eloisa Arbustini, Grasso M, Tramarin R, and Vigano M

Subjects
Heart Neoplasms, Male, Echocardiography, Ischemic Attack, Transient, Aortic Valve, Embolism, Heart Valve Diseases, Humans, Fibroma, Middle Aged, Echocardiography, Transesophageal
Abstract

Papillary fibroelastomas are very rare cardiac tumours that can present with embolization of coronary and peripheral arteries and sudden death. The diagnosis can be made by two-dimensional or transoesophageal echocardiography. A 53-year-old man with an aortic valve papillary fibroelastoma who presented with several transient ischaemic attacks is reported.

76. Summary Statement on Cardiopulmonary Exercise Testing in Chronic Heart Failure due to Left Ventricular Dysfunction: Recommendations for performance and interpretation

Author

Piepoli, M. F., Fattirolli, F., Chieffo, C., Griffo, R., Pirelli, S., Temporelli, P., Tramarin, R., Urbinati, S., Vigorito, C., Vona, M., Bjornstad, H., Adamopoulos, S., Dugmore, L., Fioretti, P., Gaita, D., Mendes, M., Bjarnason-Wehrens, B., Helleman, I., Mcgee, H., Perk, J., Ugo Corrà, Agostoni, P. G., Belardinelli, R., Cohen-Solal, A., Hambrecht, R., Vanhees, L., Coats, A. J. S., Francis, D. P., Giannuzzi, P., Guazzi, M., Metra, M., Mezzani, A., Ponikowski, P., and Saner, H.

79. Summary Statement on Cardiopulmonary Exercise Testing in Chronic Heart Failure due to Left Ventricular Dysfunction: Recommendations for performance and interpretation

Author

Piepoli, M. F., Fattirolli, F., Chieffo, C., Griffo, R., Pirelli, S., Temporelli, P., Tramarin, R., Urbinati, S., Vigorito, C., Vona, M., Bjornstad, H., Adamopoulos, S., Dugmore, L., Fioretti, P., Gaita, D., Mendes, M., Bjarnason-Wehrens, B., Helleman, I., Mcgee, H., Perk, J., Ugo Corrà, Agostoni, P. G., Belardinelli, R., Cohen-Solal, A., Hambrecht, R., Vanhees, L., Coats, A. J. S., Francis, D. P., Giannuzzi, P., Guazzi, M., Metra, M., Mezzani, A., Ponikowski, P., and Saner, H.

80. The Italian SurveY on carDiac rEhabilitation 2008 (ISYDE 2008): Study presentation,Il progetto ISYDE 2008 (Italian SurveY on carDiac rEhabilitation): Strutture, rete, organizzazione e programmi di cardiologia riabilitativa in Italia

Author

Tramarin, R., Ambrosetti, M., Feo, S., Griffo, R., Maslowsky, F., Diaco, T., Riccio, C., Carlon, R., Castello, A., Ferratini, M., Schweiger, C., Chieffo, C., Vigorito, C., Piepoli, M., Ciglia, C., Lapolla, A., Pietropaolo, F., Furgi, G., Martin, G., Semprini, P., Avallone, A., Bertoli, D., Belardinelli, R., Soffiantino, F., Scrutinio, D., Maxia, P., Coco, R., Giustarini, C., Anniboletti, P., Favretto, G., Vaghi, P., Calisi, P., Chiavetta, C., Guarracini, L., Marcellini, G., Iannopollo, M., Borrello, G., Matta, M., Peccerillo, N., Boncompagni, F., Amici, A., Feraco, E., Pulitanò, G., Tripodi, E., Capomolla, S., Golino, P., Parrilli, G., Di Patria, A., Di Gioia, C., Micieli, D., Perrotta, S., Rubino, A., Aulitto, V., Riccio, G., Codec, L., Coruzzi, P., Violi, E., Nardini, M., Urbinati, S., Dcruz, S., Fucili, A., Cerulli, M., Roberto, B., Balestra, G., Tuniz, D., Gori, P., Marini, R., Morgera, T., Di Mario, F., Volterrani, M., Galati, A., Salustri, A., Jesi, A. P., Lacch, A., Loperfido, F., Corsiglia, L., Pantaleo, P., Gigli, G., Marchesi, D., Febo, O., Cobelli, F., Malinverni, C., Jones, N., Anzà, C., Frizzelli, R., Gei, P., Acquistapace, F., Pedretti, R., STEFANO CARUGO, Malfatto, G., Meloni, C., Giordano, A., Schizzarotto, A., Zanettini, R., Bosco, R., Occhi, G., Aglieri, S., Caprioli, G., Cuocina, N., Lazzaroni, L., Lorenzi, A., Savonelli, C., Veniani, M., Corda, G., Meinecke, C., Castiglioni, G., Ravizza, P., Giani, P., Robustelli, F., Gullace, G., Passoni, F., Barelli, M. V., Richichi, I., Rossi, A., Politi, A., Persico, M., Giannuzzi, P., Mazzucco, G., Bosimini, E., Riva, G., Massobrio, N., Gondoni, L., Aina, F., Ingignoli, B., Cal, M. V., Costante, A., Villella, M., La Rosa, C., Sannia, L., Barbanto, P., Rametta, R., Albanese, D., Circo, A., Raciti, R., Scarnato, L., Dispensa, F., La Spina, L., Stuto, A., Vasco, C., Gibiino, S., Gabriele, M., Dispensieri, C., Carini, V., Provvidenza, M., Scalzini, A., Macchi, C., Fattirolli, F., Vannucci, M., Iacopetti, L., Cordoni, M., Gabriele, F., Santoni, R., Pitscheider, W., Bettini, R., Girardini, D., Mandorla, S., Anniboletti, F., Patriarchi, F., Baroni, P. L., Bordin, F., Biondi, P., Bellotto, F., Zanocco, A., Ponchia, A., Mantovani, E., Li Greci, E., Celegon, L., Baracchi, S., Pizzolato, G., Peroni, L., Apolloni, E., Mosele, G., Guarniero, M., and Roncon, L.

84. 417 First step towards the definition of a multidisciplinary tool for guidance to work eligibility in patients with left ventricular dysfunction

Author

De Feo, S., Cazzaniga, E., Capietti, M., De Salvo, M., Tramarin, R., Cavalleri, A., and Opasich, C.

Subjects
HEART ventricle diseases, HEART disease diagnosis
Abstract

An abstract of the article "First Step Towards the Definition of a Multidisciplinary Tool for Guidance to Work Eligibility in Patients With Left Ventricular Dysfunction," by S. De Feo and colleagues, is presented.

Published
2004

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