Biomedical subjects

Paolo Ferrero

Publications and source records attributed to Paolo Ferrero.

3 recordsLinked to original sources

PubMed2006

Atrial fibrillation in heart failure patients: prevalence in daily practice and effect on the severity of symptoms. Data from the ALPHA study registry.

BACKGROUND: Estimates of the prevalence of atrial fibrillation (AF) in heart failure (HF) originate from patients enrolled in clinical trials. AIMS: To assess the prevalence and clinical correlates of AF among HF patients in everyday clinical practice from HF patients screened for the T-wave ALternans in Patients with Heart fAilure (ALPHA) study; to investigate the correlation between AF and functional status. METHODS AND RESULTS: Consecutive patients (N=3513) seen at nine Heart Failure Clinics were studied; 21.4% were in AF. AF prevalence was greater with increasing age (OR 1.04/year, p<0.001) in non-ischaemic cardiomyopathy (OR 2.34, p<0.001) and with increasing NYHA class (p<0.0001). Multiple logistic regression predictors of AF were age >70 years (OR 2.35), NYHA class II III or IV vs class I (OR 1.8, 4.4 and 3.1) and non-ischaemic cardiomyopathy (OR 3.2). A logistic model indicated that AF was associated with a 2.5 OR of being in NYHA class III-IV vs I-II while accounting for age, gender, left ventricular ejection fraction (LVEF), and aetiology of HF. CONCLUSIONS: The prevalence of AF in HF patients exceeds 20%, and increases with age and functional class. The presence of AF leads to a more severe NYHA class, indicating that AF contributes to the severity of heart failure.

Adolescent↗

PubMed2004

Myocardial infarction with normal coronary arteries: ten-year follow-up.

BACKGROUND: Patients with myocardial infarction without angiographically significant coronary artery lesions are considered, as a whole, to have a better prognosis. Different degrees of coronary involvement, within this wide group, may portend different degrees of risk. The aim of this study was to assess which clinical and angiographic covariates are more useful in defining the individual prognosis. METHLODS: We prospectively followed 53 consecutive patients admitted to our coronary care unit between 1985-1990 with myocardial infarction and a culprit lesion causing < or = 50% angiographic luminal narrowing. RESULTS: Patients with normal angiograms (group A) were compared to those with minor parietal irregularities (group B) or discrete (< or = 50%) stenosis (group C). Group A patients were younger, had a lower peak creatine kinase release, and a higher ejection fraction. After a median follow up of 125 +/- 32 months, group A patients had a 100% 10-year survival compared to 77 and 58% for group B and group C patients respectively (p = 0.01). At univariate analysis, ischemic events correlated with the severity of coronary lesions (while group A patients had no ischemic events at follow-up, events occurred in 46 and 50% of group B and C patients respectively; p = 0.003) and with ejection fraction, that was lower in patients with events (56.0 +/- 17 vs 67 +/- 11%, p = 0.006). Cardiac death, too, correlated with the type of coronary lesions (p = 0.03) and with lower ejection fraction (p = 0.004). By means of multivariate analysis, on the contrary, only the vessel morphology was predictive of ischemic events at follow-up (p = 0.02), while the only significant predictor of death was ejection fraction (p = 0.0012). CONCLUSIONS: Patients with myocardial infarction and strictly normal vessels have very few ischemic events at follow-up, and may be distinguished from both patients with non-significant lesions as well as those with minor angiographic irregularities. On the other hand, cardiac mortality correlates strongly and independently with a depressed ventricular function.

Adult↗

PubMed2003

Vasculitis mimicking bacterial endocarditis.

Fever of unknown origin is one of the most intriguing issues in clinical practice. One of the most feared diagnoses, especially in patients with known valvular disease, is endocarditis. The differential diagnosis of fever is often complicated by the clinical-pathological overlap between the systemic inflammatory response in different types of pathologies such as infectious, autoimmune or neoplastic disorders. We report a case of a patient presenting with fever, cutaneous nodules and malaise, with a known mitral valve prolapse and moderate regurgitation, in which the diagnosis of Wegener's granulomatosis was finally made.

Diagnosis, Differential↗