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3. Organization and Activity of Italian Echocardiographic Laboratories: A Survey of the Italian Society of Echocardiography and Cardiovascular Imaging

Author

Ciampi, Q, Pepi, M, Antonini-Canterin, F, Barbieri, A, Barchitta, A, Faganello, G, Miceli, S, Parato, V, Tota, A, Trocino, G, Abbate, M, Accadia, M, Alemanni, R, Angelini, A, Anglano, F, Anselmi, M, Aquila, I, Aramu, S, Avogadri, E, Azzaro, G, Badano, L, Balducci, A, Ballocca, F, Barbarossa, A, Barbati, G, Barletta, V, Barone, D, Becherini, F, Benfari, G, Beraldi, M, Bergandi, G, Bilardo, G, Binno, S, Bolognesi, M, Bongiovi, S, Bragato, R, Braggion, G, Brancaleoni, R, Bursi, F, Dessalvi, C, Cameli, M, Canu, A, Capitelli, M, Capra, A, Carbonara, R, Carbone, M, Carbonella, M, Carrabba, N, Casavecchia, G, Casula, M, Chesi, E, Cicco, S, Citro, R, Cocchia, R, Colombo, B, Colonna, P, Conte, M, Corrado, G, Cortesi, P, Cortigiani, L, Costantino, M, Cozza, F, Cucchini, U, D'Angelo, M, Ros, S, D'Andrea, F, D'Andrea, A, D'Auria, F, De Caridi, G, De Feo, S, De Matteis, G, De Vecchi, S, Del Giudice, C, Dell'Angela, L, Delli Paoli, L, Dentamaro, I, Destefanis, P, Di Fulvio, M, Di Gaetano, R, Di Giannuario, G, Di Gioia, A, Di Martino, L, Di Muro, C, Di Nora, C, Di Salvo, G, Dodi, C, Dogliani, S, Donati, F, Dottori, M, Epifani, G, Fabiani, I, Ferrara, F, Ferrara, L, Ferrua, S, Filice, G, Fiorino, M, Forno, D, Garini, A, Giarratana, G, Gigantino, G, Giorgi, M, Giubertoni, E, Greco, C, Grigolato, M, Marra, W, Holzl, A, Iaiza, A, Iannaccone, A, Ilardi, F, Imbalzano, E, Inciardi, R, Inserra, C, Iori, E, Izzo, A, La Rosa, G, Labanti, G, Lanzone, A, Lanzoni, L, Lapetina, O, Leiballi, E, Librera, M, Lo Conte, C, Lo Monaco, M, Lombardo, A, Luciani, M, Lusardi, P, Magnante, A, Malagoli, A, Malatesta, G, Mancusi, C, Manes, M, Manganelli, F, Mantovani, F, Manuppelli, V, Marchese, V, Marinacci, L, Mattioli, R, Maurizio, C, Mazza, G, Mazza, S, Melis, M, Meloni, G, Merli, E, Milan, A, Minardi, G, Monaco, A, Monte, I, Montresor, G, Moreo, A, Mori, F, Morini, S, Moro, C, Morrone, D, Negri, F, Nipote, C, Nisi, F, Nocco, S, Novello, L, Nunziata, L, Perini, A, Parodi, A, Pasanisi, E, Pastorini, G, Pavasini, R, Pavoni, D, Pedone, C, Pelliccia, F, Pelliciari, G, Pelloni, E, Pergola, V, Perillo, G, Petruccelli, E, Pezzullo, C, Piacentini, G, Picardi, E, Pinna, G, Pizzarelli, M, Pizzuti, A, Poggi, M, Posteraro, A, Privitera, C, Rampazzo, D, Ratti, C, Rettegno, S, Ricci, F, Ricci, C, Rolando, C, Rossi, S, Rovera, C, Ruggieri, R, Russo, M, Sacchi, N, Saladino, A, Sani, F, Sartori, C, Scarabeo, V, Sciacqua, A, Scillone, A, Scopelliti, P, Scorza, A, Scozzafava, A, Serafini, F, Serra, W, Severino, S, Simeone, B, Sirico, D, Solari, M, Spadaro, G, Stefani, L, Strangio, A, Surace, F, Tamborini, G, Tarquinio, N, Tassone, E, Tavarozzi, I, Tchana, B, Tedesco, G, Tinto, M, Torzillo, D, Totaro, A, Triolo, O, Troisi, F, Tusa, M, Vancheri, F, Varasano, V, Venezia, A, Vermi, A, Villari, B, Zampi, G, Zannoni, J, Zito, C, Zugaro, A, Di Bella, G, Carerj, S, Ciampi Q., Pepi M., Antonini-Canterin F., Barbieri A., Barchitta A., Faganello G., Miceli S., Parato V. M., Tota A., Trocino G., Abbate M., Accadia M., Alemanni R., Angelini A., Anglano F., Anselmi M., Aquila I., Aramu S., Avogadri E., Azzaro G., Badano L., Balducci A., Ballocca F., Barbarossa A., Barbati G., Barletta V., Barone D., Becherini F., Benfari G., Beraldi M., Bergandi G., Bilardo G., Binno S. M., Bolognesi M., Bongiovi S., Bragato R. M., Braggion G., Brancaleoni R., Bursi F., Dessalvi C. C., Cameli M., Canu A., Capitelli M., Capra A. C. M., Carbonara R., Carbone M., Carbonella M., Carrabba N., Casavecchia G., Casula M., Chesi E., Cicco S., Citro R., Cocchia R., Colombo B. M., Colonna P., Conte M., Corrado G., Cortesi P., Cortigiani L., Costantino M. F., Cozza F., Cucchini U., D'Angelo M., Ros S. D., D'Andrea F., D'Andrea A., D'Auria F., De Caridi G., De Feo S., De Matteis G. M., De Vecchi S., Del Giudice C., Dell'Angela L., Delli Paoli L., Dentamaro I., Destefanis P., Di Fulvio M., Di Gaetano R., Di Giannuario G., Di Gioia A., Di Martino L. F. M., Di Muro C., Di Nora C., Di Salvo G., Dodi C., Dogliani S., Donati F., Dottori M., Epifani G., Fabiani I., Ferrara F., Ferrara L., Ferrua S., Filice G., Fiorino M., Forno D., Garini A., Giarratana G. A., Gigantino G., Giorgi M., Giubertoni E., Greco C. A., Grigolato M., Marra W. G., Holzl A., Iaiza A., Iannaccone A., Ilardi F., Imbalzano E., Inciardi R., Inserra C. A., Iori E., Izzo A., La Rosa G., Labanti G., Lanzone A. M., Lanzoni L., Lapetina O., Leiballi E., Librera M., Lo Conte C., Lo Monaco M., Lombardo A., Luciani M., Lusardi P., Magnante A., Malagoli A., Malatesta G., Mancusi C., Manes M. T., Manganelli F., Mantovani F., Manuppelli V., Marchese V., Marinacci L., Mattioli R., Maurizio C., Mazza G. A., Mazza S., Melis M., Meloni G., Merli E., Milan A., Minardi G., Monaco A., Monte I., Montresor G., Moreo A., Mori F., Morini S., Moro C., Morrone D., Negri F., Nipote C., Nisi F., Nocco S., Novello L., Nunziata L., Perini A. P., Parodi A., Pasanisi E. M., Pastorini G., Pavasini R., Pavoni D., Pedone C., Pelliccia F., Pelliciari G., Pelloni E., Pergola V., Perillo G., Petruccelli E., Pezzullo C., Piacentini G., Picardi E., Pinna G., Pizzarelli M., Pizzuti A., Poggi M. M., Posteraro A., Privitera C., Rampazzo D., Ratti C., Rettegno S., Ricci F., Ricci C., Rolando C., Rossi S., Rovera C., Ruggieri R., Russo M. G., Sacchi N., Saladino A., Sani F., Sartori C., Scarabeo V., Sciacqua A., Scillone A., Scopelliti P. A., Scorza A., Scozzafava A., Serafini F., Serra W., Severino S., Simeone B., Sirico D., Solari M., Spadaro G. L., Stefani L., Strangio A., Surace F. C., Tamborini G., Tarquinio N., Tassone E. J., Tavarozzi I., Tchana B., Tedesco G., Tinto M., Torzillo D., Totaro A., Triolo O. F., Troisi F., Tusa M., Vancheri F., Varasano V., Venezia A., Vermi A. C., Villari B., Zampi G., Zannoni J., Zito C., Zugaro A., Di Bella G., Carerj S., Ciampi, Q, Pepi, M, Antonini-Canterin, F, Barbieri, A, Barchitta, A, Faganello, G, Miceli, S, Parato, V, Tota, A, Trocino, G, Abbate, M, Accadia, M, Alemanni, R, Angelini, A, Anglano, F, Anselmi, M, Aquila, I, Aramu, S, Avogadri, E, Azzaro, G, Badano, L, Balducci, A, Ballocca, F, Barbarossa, A, Barbati, G, Barletta, V, Barone, D, Becherini, F, Benfari, G, Beraldi, M, Bergandi, G, Bilardo, G, Binno, S, Bolognesi, M, Bongiovi, S, Bragato, R, Braggion, G, Brancaleoni, R, Bursi, F, Dessalvi, C, Cameli, M, Canu, A, Capitelli, M, Capra, A, Carbonara, R, Carbone, M, Carbonella, M, Carrabba, N, Casavecchia, G, Casula, M, Chesi, E, Cicco, S, Citro, R, Cocchia, R, Colombo, B, Colonna, P, Conte, M, Corrado, G, Cortesi, P, Cortigiani, L, Costantino, M, Cozza, F, Cucchini, U, D'Angelo, M, Ros, S, D'Andrea, F, D'Andrea, A, D'Auria, F, De Caridi, G, De Feo, S, De Matteis, G, De Vecchi, S, Del Giudice, C, Dell'Angela, L, Delli Paoli, L, Dentamaro, I, Destefanis, P, Di Fulvio, M, Di Gaetano, R, Di Giannuario, G, Di Gioia, A, Di Martino, L, Di Muro, C, Di Nora, C, Di Salvo, G, Dodi, C, Dogliani, S, Donati, F, Dottori, M, Epifani, G, Fabiani, I, Ferrara, F, Ferrara, L, Ferrua, S, Filice, G, Fiorino, M, Forno, D, Garini, A, Giarratana, G, Gigantino, G, Giorgi, M, Giubertoni, E, Greco, C, Grigolato, M, Marra, W, Holzl, A, Iaiza, A, Iannaccone, A, Ilardi, F, Imbalzano, E, Inciardi, R, Inserra, C, Iori, E, Izzo, A, La Rosa, G, Labanti, G, Lanzone, A, Lanzoni, L, Lapetina, O, Leiballi, E, Librera, M, Lo Conte, C, Lo Monaco, M, Lombardo, A, Luciani, M, Lusardi, P, Magnante, A, Malagoli, A, Malatesta, G, Mancusi, C, Manes, M, Manganelli, F, Mantovani, F, Manuppelli, V, Marchese, V, Marinacci, L, Mattioli, R, Maurizio, C, Mazza, G, Mazza, S, Melis, M, Meloni, G, Merli, E, Milan, A, Minardi, G, Monaco, A, Monte, I, Montresor, G, Moreo, A, Mori, F, Morini, S, Moro, C, Morrone, D, Negri, F, Nipote, C, Nisi, F, Nocco, S, Novello, L, Nunziata, L, Perini, A, Parodi, A, Pasanisi, E, Pastorini, G, Pavasini, R, Pavoni, D, Pedone, C, Pelliccia, F, Pelliciari, G, Pelloni, E, Pergola, V, Perillo, G, Petruccelli, E, Pezzullo, C, Piacentini, G, Picardi, E, Pinna, G, Pizzarelli, M, Pizzuti, A, Poggi, M, Posteraro, A, Privitera, C, Rampazzo, D, Ratti, C, Rettegno, S, Ricci, F, Ricci, C, Rolando, C, Rossi, S, Rovera, C, Ruggieri, R, Russo, M, Sacchi, N, Saladino, A, Sani, F, Sartori, C, Scarabeo, V, Sciacqua, A, Scillone, A, Scopelliti, P, Scorza, A, Scozzafava, A, Serafini, F, Serra, W, Severino, S, Simeone, B, Sirico, D, Solari, M, Spadaro, G, Stefani, L, Strangio, A, Surace, F, Tamborini, G, Tarquinio, N, Tassone, E, Tavarozzi, I, Tchana, B, Tedesco, G, Tinto, M, Torzillo, D, Totaro, A, Triolo, O, Troisi, F, Tusa, M, Vancheri, F, Varasano, V, Venezia, A, Vermi, A, Villari, B, Zampi, G, Zannoni, J, Zito, C, Zugaro, A, Di Bella, G, Carerj, S, Ciampi Q., Pepi M., Antonini-Canterin F., Barbieri A., Barchitta A., Faganello G., Miceli S., Parato V. M., Tota A., Trocino G., Abbate M., Accadia M., Alemanni R., Angelini A., Anglano F., Anselmi M., Aquila I., Aramu S., Avogadri E., Azzaro G., Badano L., Balducci A., Ballocca F., Barbarossa A., Barbati G., Barletta V., Barone D., Becherini F., Benfari G., Beraldi M., Bergandi G., Bilardo G., Binno S. M., Bolognesi M., Bongiovi S., Bragato R. M., Braggion G., Brancaleoni R., Bursi F., Dessalvi C. C., Cameli M., Canu A., Capitelli M., Capra A. C. M., Carbonara R., Carbone M., Carbonella M., Carrabba N., Casavecchia G., Casula M., Chesi E., Cicco S., Citro R., Cocchia R., Colombo B. M., Colonna P., Conte M., Corrado G., Cortesi P., Cortigiani L., Costantino M. F., Cozza F., Cucchini U., D'Angelo M., Ros S. D., D'Andrea F., D'Andrea A., D'Auria F., De Caridi G., De Feo S., De Matteis G. M., De Vecchi S., Del Giudice C., Dell'Angela L., Delli Paoli L., Dentamaro I., Destefanis P., Di Fulvio M., Di Gaetano R., Di Giannuario G., Di Gioia A., Di Martino L. F. M., Di Muro C., Di Nora C., Di Salvo G., Dodi C., Dogliani S., Donati F., Dottori M., Epifani G., Fabiani I., Ferrara F., Ferrara L., Ferrua S., Filice G., Fiorino M., Forno D., Garini A., Giarratana G. A., Gigantino G., Giorgi M., Giubertoni E., Greco C. A., Grigolato M., Marra W. G., Holzl A., Iaiza A., Iannaccone A., Ilardi F., Imbalzano E., Inciardi R., Inserra C. A., Iori E., Izzo A., La Rosa G., Labanti G., Lanzone A. M., Lanzoni L., Lapetina O., Leiballi E., Librera M., Lo Conte C., Lo Monaco M., Lombardo A., Luciani M., Lusardi P., Magnante A., Malagoli A., Malatesta G., Mancusi C., Manes M. T., Manganelli F., Mantovani F., Manuppelli V., Marchese V., Marinacci L., Mattioli R., Maurizio C., Mazza G. A., Mazza S., Melis M., Meloni G., Merli E., Milan A., Minardi G., Monaco A., Monte I., Montresor G., Moreo A., Mori F., Morini S., Moro C., Morrone D., Negri F., Nipote C., Nisi F., Nocco S., Novello L., Nunziata L., Perini A. P., Parodi A., Pasanisi E. M., Pastorini G., Pavasini R., Pavoni D., Pedone C., Pelliccia F., Pelliciari G., Pelloni E., Pergola V., Perillo G., Petruccelli E., Pezzullo C., Piacentini G., Picardi E., Pinna G., Pizzarelli M., Pizzuti A., Poggi M. M., Posteraro A., Privitera C., Rampazzo D., Ratti C., Rettegno S., Ricci F., Ricci C., Rolando C., Rossi S., Rovera C., Ruggieri R., Russo M. G., Sacchi N., Saladino A., Sani F., Sartori C., Scarabeo V., Sciacqua A., Scillone A., Scopelliti P. A., Scorza A., Scozzafava A., Serafini F., Serra W., Severino S., Simeone B., Sirico D., Solari M., Spadaro G. L., Stefani L., Strangio A., Surace F. C., Tamborini G., Tarquinio N., Tassone E. J., Tavarozzi I., Tchana B., Tedesco G., Tinto M., Torzillo D., Totaro A., Triolo O. F., Troisi F., Tusa M., Vancheri F., Varasano V., Venezia A., Vermi A. C., Villari B., Zampi G., Zannoni J., Zito C., Zugaro A., Di Bella G., and Carerj S.

Abstract

Background: The Italian Society of Echocardiography and Cardiovascular Imaging (SIECVI) conducted a national survey to understand better how different echocardiographic modalities are used and accessed in Italy. Methods: We analyzed echocardiography laboratory activities over a month (November 2022). Data were retrieved via an electronic survey based on a structured questionnaire, uploaded on the SIECVI website. Results: Data were obtained from 228 echocardiographic laboratories: 112 centers (49%) in the northern, 43 centers (19%) in the central, and 73 (32%) in the southern regions. During the month of observation, we collected 101,050 transthoracic echocardiography (TTE) examinations performed in all centers. As concern other modalities there were performed 5497 transesophageal echocardiography (TEE) examinations in 161/228 centers (71%); 4057 stress echocardiography (SE) examinations in 179/228 centers (79%); and examinations with ultrasound contrast agents (UCAs) in 151/228 centers (66%). We did not find significant regional variations between the different modalities. The usage of picture archiving and communication system (PACS) was significantly higher in the northern (84%) versus central (49%) and southern (45%) centers (P < 0.001). Lung ultrasound (LUS) was performed in 154 centers (66%), without difference between cardiology and noncardiology centers. The evaluation of left ventricular (LV) ejection fraction was evaluated mainly using the qualitative method in 223 centers (94%), occasionally with the Simpson method in 193 centers (85%), and with selective use of the three-dimensional (3D) method in only 23 centers (10%). 3D TTE was present in 137 centers (70%), and 3D TEE in all centers where TEE was done (71%). The assessment of LV diastolic function was done routinely in 80% of the centers. Right ventricular function was evaluated using tricuspid annular plane systolic excursion in all centers, using tricuspid valve annular systolic velocity by tissue

Published
2023

16. Cardiac arrhythmias.

Author

Lombardi, F., Sandrone, G., Porta, A., Torzillo, D., Terranova, G., Baselli, G., Cerutti, S., and Malliani, A.

Abstract

Analysis of heart rate variability has been proven useful in stratifying post myocardial patients at risk and in evaluating autonomic dysfunction. Recently augmented inter-lead variability of the QT interval has been associated with increased mortality as a result of arrhythmia and proposed as a marker of dispersion of ventricular repolarization. As the duration of the QT interval is largely dependent upon the length of the preceding cardiac cycle it is tempting to analyse whether neural mechanisms might also directly exert additional modulation.Using autoregressive algorithms we therefore analysed RR and R-Tapex interval variabilities in 15 normal subjects during sinus rhythm and in six patients with a fixed atrial rate. In controls mean R-Tapex interval and variance meas ured on the vector magnitude were, respectively, 245±6 ms and 5·1±0·7 ms2 Spectral analysis of R-Tapex indicated the presence of two spectral components which corresponded to the low and high frequency components of heart rate variability. In R-Tapex variability, high frequency (44±4 nu) was predominant over low frequency (29±4 nu). During controlled respiration, a manoeuvre associated with enhanced vagal modulation of sinus node, there was a further increase in high frequency (58±4 nu) whereas during tilt the low frequency component of R-Tapex variability became predominant (57±6 nu). In patients with a fixed atrial rate, variance was extremely low (3±0·9 ms2 and only a respiration-related high frequency component was recognizable in spectral analysis of RR and R-Tapex variabilities. This component was likely to depend upon mechanically induced changes in cardiac vector orientation.These data indicate that during sinus rhythm short-term R-Tapex interval variability is characterized by the same rhythmical components present in RR variability. However, the presence of a very low variance and of only a high frequency component in patients in whom the physiological variability of sinus node is abolished by atrial pacing, suggests that neural modulatory mechanisms do not exert a direct effect on the length of the R-Tapex interval. [ABSTRACT FROM PUBLISHER]

Published
1996
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24. Stress Echocardiography in Italian Echocardiographic Laboratories: A Survey of the Italian Society of Echocardiography and Cardiovascular Imaging.

Author

Ciampi Q, Pepi M, Antonini-Canterin F, Barbieri A, Barchitta A, Faganello G, Miceli S, Parato VM, Tota A, Trocino G, Abbate M, Accadia M, Alemanni R, Angelini A, Anglano F, Anselmi M, Aquila I, Aramu S, Avogadri E, Azzaro G, Badano L, Balducci A, Ballocca F, Barbarossa A, Barbati G, Barletta V, Barone D, Becherini F, Benfari G, Beraldi M, Bergandi G, Bilardo G, Binno SM, Bolognesi M, Bongiovi S, Bragato RM, Braggion G, Brancaleoni R, Bursi F, Dessalvi CC, Cameli M, Canu A, Capitelli M, Capra ACM, Carbonara R, Carbone M, Carbonella M, Carrabba N, Casavecchia G, Casula M, Chesi E, Cicco S, Citro R, Cocchia R, Colombo BM, Colonna P, Conte M, Corrado G, Cortesi P, Cortigiani L, Costantino MF, Cozza F, Cucchini U, D'Angelo M, Da Ros S, D'Andrea F, D'Andrea A, D'Auria F, De Caridi G, De Feo S, De Matteis GM, De Vecchi S, Del Giudice C, Dell'Angela L, Paoli LD, Dentamaro I, Destefanis P, Di Bella G, Di Fulvio M, Di Gaetano R, Di Giannuario G, Di Gioia A, Di Martino LFM, Di Muro C, Di Nora C, Di Salvo G, Dodi C, Dogliani S, Donati F, Dottori M, Epifani G, Fabiani I, Ferrara F, Ferrara L, Ferrua S, Filice G, Fiorino M, Forno D, Garini A, Giarratana GA, Gigantino G, Giorgi M, Giubertoni E, Greco CA, Grigolato M, Marra WG, Holzl A, Iaiza A, Iannaccone A, Ilardi F, Imbalzano E, Inciardi RM, Inserra CA, Iori E, Izzo A, La Rosa G, Labanti G, Lanzone AM, Lanzoni L, Lapetina O, Leiballi E, Librera M, Conte CL, Monaco ML, Lombardo A, Luciani M, Lusardi P, Magnante A, Malagoli A, Malatesta G, Mancusi C, Manes MT, Manganelli F, Mantovani F, Manuppelli V, Marchese V, Marinacci L, Mattioli R, Maurizio C, Mazza GA, Mazza S, Melis M, Meloni G, Merli E, Milan A, Minardi G, Monaco A, Monte I, Montresor G, Moreo A, Mori F, Morini S, Moro C, Morrone D, Negri F, Nipote C, Nisi F, Nocco S, Novello L, Nunziata L, Perini AP, Parodi A, Pasanisi EM, Pastorini G, Pavasini R, Pavoni D, Pedone C, Pelliccia F, Pelliciari G, Pelloni E, Pergola V, Perillo G, Petruccelli E, Pezzullo C, Piacentini G, Picardi E, Pinna G, Pizzarelli M, Pizzuti A, Poggi MM, Posteraro A, Privitera C, Rampazzo D, Ratti C, Rettegno S, Ricci F, Ricci C, Rolando C, Rossi S, Rovera C, Ruggieri R, Russo MG, Sacchi N, Saladino A, Sani F, Sartori C, Scarabeo V, Sciacqua A, Scillone A, Scopelliti PA, Scorza A, Scozzafava A, Serafini F, Serra W, Severino S, Simeone B, Sirico D, Solari M, Spadaro GL, Stefani L, Strangio A, Surace FC, Tamborini G, Tarquinio N, Tassone EJ, Tavarozzi I, Tchana B, Tedesco G, Tinto M, Torzillo D, Totaro A, Triolo OF, Troisi F, Tusa M, Vancheri F, Varasano V, Venezia A, Vermi AC, Villari B, Zampi G, Zannoni J, Zito C, Zugaro A, Picano E, and Carerj S

Abstract

Background: The Italian Society of Echography and Cardiovascular Imaging (SIECVI) conducted a national survey to understand the volumes of activity, modalities and stressors used during stress echocardiography (SE) in Italy., Methods: We analyzed echocardiography laboratory activities over a month (November 2022). Data were retrieved through an electronic survey based on a structured questionnaire, uploaded on the SIECVI website., Results: Data were obtained from 228 echocardiographic laboratories, and SE examinations were performed in 179 centers (80.6%): 87 centers (47.5%) were in the northern regions of Italy, 33 centers (18.4%) were in the central regions, and 61 (34.1%) in the southern regions. We annotated a total of 4057 SE. We divided the SE centers into three groups, according to the numbers of SE performed: <10 SE (low-volume activity, 40 centers), between 10 and 39 SE (moderate volume activity, 102 centers) and ≥40 SE (high volume activity, 37 centers). Dipyridamole was used in 139 centers (77.6%); exercise in 120 centers (67.0%); dobutamine in 153 centers (85.4%); pacing in 37 centers (21.1%); and adenosine in 7 centers (4.0%). We found a significant difference between the stressors used and volume of activity of the centers, with a progressive increase in the prevalence of number of stressors from low to high volume activity ( P = 0.033). The traditional evaluation of regional wall motion of the left ventricle was performed in all centers, with combined assessment of coronary flow velocity reserve (CFVR) in 90 centers (50.3%): there was a significant difference in the centers with different volume of SE activity: the incidence of analysis of CFVR was significantly higher in high volume centers compared to low - moderate - volume (32.5%, 41.0% and 73.0%, respectively, P < 0.001). The lung ultrasound (LUS) was assessed in 67 centers (37.4%). Furthermore for LUS, we found a significant difference in the centers with different volume of SE activity: significantly higher in high volume centers compared to low - moderate - volume (25.0%, 35.3% and 56.8%, respectively, P < 0.001)., Conclusions: This nationwide survey demonstrated that SE was significantly widespread and practiced throughout Italy. In addition to the traditional indication to coronary artery disease based on regional wall motion analysis, other indications are emerging with an increase in the use of LUS and CFVR, especially in high-volume centers., Competing Interests: There are no conflicts of interest., (Copyright: © 2023 Journal of Cardiovascular Echography.)

Published
2023
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25. Organization and Activity of Italian Echocardiographic Laboratories: A Survey of the Italian Society of Echocardiography and Cardiovascular Imaging.

Author

Ciampi Q, Pepi M, Antonini-Canterin F, Barbieri A, Barchitta A, Faganello G, Miceli S, Parato VM, Tota A, Trocino G, Abbate M, Accadia M, Alemanni R, Angelini A, Anglano F, Anselmi M, Aquila I, Aramu S, Avogadri E, Azzaro G, Badano L, Balducci A, Ballocca F, Barbarossa A, Barbati G, Barletta V, Barone D, Becherini F, Benfari G, Beraldi M, Bergandi G, Bilardo G, Binno SM, Bolognesi M, Bongiovi S, Bragato RM, Braggion G, Brancaleoni R, Bursi F, Dessalvi CC, Cameli M, Canu A, Capitelli M, Capra ACM, Carbonara R, Carbone M, Carbonella M, Carrabba N, Casavecchia G, Casula M, Chesi E, Cicco S, Citro R, Cocchia R, Colombo BM, Colonna P, Conte M, Corrado G, Cortesi P, Cortigiani L, Costantino MF, Cozza F, Cucchini U, D'Angelo M, Ros SD, D'Andrea F, D'Andrea A, D'Auria F, De Caridi G, De Feo S, De Matteis GM, De Vecchi S, Giudice CD, Dell'Angela L, Paoli LD, Dentamaro I, Destefanis P, Di Fulvio M, Di Gaetano R, Di Giannuario G, Di Gioia A, Di Martino LFM, Di Muro C, Di Nora C, Di Salvo G, Dodi C, Dogliani S, Donati F, Dottori M, Epifani G, Fabiani I, Ferrara F, Ferrara L, Ferrua S, Filice G, Fiorino M, Forno D, Garini A, Giarratana GA, Gigantino G, Giorgi M, Giubertoni E, Greco CA, Grigolato M, Marra WG, Holzl A, Iaiza A, Iannaccone A, Ilardi F, Imbalzano E, Inciardi R, Inserra CA, Iori E, Izzo A, Rosa G, Labanti G, Lanzone AM, Lanzoni L, Lapetina O, Leiballi E, Librera M, Conte CL, Monaco ML, Lombardo A, Luciani M, Lusardi P, Magnante A, Malagoli A, Malatesta G, Mancusi C, Manes MT, Manganelli F, Mantovani F, Manuppelli V, Marchese V, Marinacci L, Mattioli R, Maurizio C, Mazza GA, Mazza S, Melis M, Meloni G, Merli E, Milan A, Minardi G, Monaco A, Monte I, Montresor G, Moreo A, Mori F, Morini S, Moro C, Morrone D, Negri F, Nipote C, Nisi F, Nocco S, Novello L, Nunziata L, Perini AP, Parodi A, Pasanisi EM, Pastorini G, Pavasini R, Pavoni D, Pedone C, Pelliccia F, Pelliciari G, Pelloni E, Pergola V, Perillo G, Petruccelli E, Pezzullo C, Piacentini G, Picardi E, Pinna G, Pizzarelli M, Pizzuti A, Poggi MM, Posteraro A, Privitera C, Rampazzo D, Ratti C, Rettegno S, Ricci F, Ricci C, Rolando C, Rossi S, Rovera C, Ruggieri R, Russo MG, Sacchi N, Saladino A, Sani F, Sartori C, Scarabeo V, Sciacqua A, Scillone A, Scopelliti PA, Scorza A, Scozzafava A, Serafini F, Serra W, Severino S, Simeone B, Sirico D, Solari M, Spadaro GL, Stefani L, Strangio A, Surace FC, Tamborini G, Tarquinio N, Tassone EJ, Tavarozzi I, Tchana B, Tedesco G, Tinto M, Torzillo D, Totaro A, Triolo OF, Troisi F, Tusa M, Vancheri F, Varasano V, Venezia A, Vermi AC, Villari B, Zampi G, Zannoni J, Zito C, Zugaro A, Di Bella G, and Carerj S

Abstract

Background: The Italian Society of Echocardiography and Cardiovascular Imaging (SIECVI) conducted a national survey to understand better how different echocardiographic modalities are used and accessed in Italy., Methods: We analyzed echocardiography laboratory activities over a month (November 2022). Data were retrieved via an electronic survey based on a structured questionnaire, uploaded on the SIECVI website., Results: Data were obtained from 228 echocardiographic laboratories: 112 centers (49%) in the northern, 43 centers (19%) in the central, and 73 (32%) in the southern regions. During the month of observation, we collected 101,050 transthoracic echocardiography (TTE) examinations performed in all centers. As concern other modalities there were performed 5497 transesophageal echocardiography (TEE) examinations in 161/228 centers (71%); 4057 stress echocardiography (SE) examinations in 179/228 centers (79%); and examinations with ultrasound contrast agents (UCAs) in 151/228 centers (66%). We did not find significant regional variations between the different modalities. The usage of picture archiving and communication system (PACS) was significantly higher in the northern (84%) versus central (49%) and southern (45%) centers ( P < 0.001). Lung ultrasound (LUS) was performed in 154 centers (66%), without difference between cardiology and noncardiology centers. The evaluation of left ventricular (LV) ejection fraction was evaluated mainly using the qualitative method in 223 centers (94%), occasionally with the Simpson method in 193 centers (85%), and with selective use of the three-dimensional (3D) method in only 23 centers (10%). 3D TTE was present in 137 centers (70%), and 3D TEE in all centers where TEE was done (71%). The assessment of LV diastolic function was done routinely in 80% of the centers. Right ventricular function was evaluated using tricuspid annular plane systolic excursion in all centers, using tricuspid valve annular systolic velocity by tissue Doppler imaging in 53% of the centers, and using fractional area change in 33% of the centers. When we divided into cardiology (179, 78%) and noncardiology (49, 22%) centers, we found significant differences in the SE (93% vs. 26%, P < 0.001), TEE (85% vs. 18%), UCA (67% vs. 43%, P < 0001), and STE (87% vs. 20%, P < 0.001). The incidence of LUS evaluation was similar between the cardiology and noncardiology centers (69% vs. 61%, P = NS)., Conclusions: This nationwide survey demonstrated that digital infrastructures and advanced echocardiography modalities, such as 3D and STE, are widely available in Italy with a notable diffuse uptake of LUS in the core TTE examination, a suboptimal diffusion of PACS recording, and conservative use of UCA, 3D, and strain. There are significant differences between northern and central-southern regions and echocardiographic laboratories that pertain to the cardiac unit. This inhomogeneous distribution of technology represents one of the main issues that must be solved to standardize the practice of echocardiography., Competing Interests: There are no conflicts of interest., (Copyright: © 2023 Journal of Cardiovascular Echography.)

Published
2023
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26. Early echocardiographic findings in patients hospitalized for COVID-19 pneumonia: a prospective, single center study.

Author

Ceriani E, Marceca A, Lanfranchi A, De Vita S, Schiavon R, Casella F, Torzillo D, Del Medico M, Ruggiero D, Barosi A, and Cogliati C

Subjects
Adult, COVID-19 complications, Humans, Male, Middle Aged, Pneumonia, Viral virology, Prospective Studies, Risk Assessment, Risk Factors, COVID-19 diagnostic imaging, Echocardiography methods, Pneumonia, Viral diagnostic imaging
Abstract

Background: Cardiac dysfunction, mainly assessed by biomarker alterations, has been described in COVID-19 infection. However, there are still areas of uncertainty regarding its effective role in disease evolution. Aim of this study was to evaluate early echocardiographic parameters in COVID pneumonia and their association with severity disease and prognosis., Methods: An echocardiographic examination was performed within 72 h from admission in 64 consecutive patients hospitalized for COVID-19 pneumonia in our medium-intensity care unit, from March 30th to May 15th 2020. Six patients were excluded for inadequate acoustic window., Results: Fifty-eight consecutive patients were finally enrolled, with a median age of 58 years. Twenty-two (38%) were classifiable as severe COVID-19 disease. Eight out of 58 patients experienced adverse evolution (six died, two were admitted to ICU and received mechanical ventilation), all of them in the severe pneumonia group. Severe pneumonia patients showed higher troponin, IL-6 and D-Dimer values. No significant new onset alterations of left and right ventricular systolic function parameters were observed. Patients with severe pneumonia showed higher mean estimated systolic pulmonary artery pressure (sPAP) (30.7 ± 5.2 mmHg vs 26.2 ± 4.3 mmHg, p = 0.006), even if in the normality range values. No differences in echocardiographic parameters were retrieved in patients with adverse events with respect to those with favorable clinical course., Conclusion: A mild sPAP increase in severe pneumonia patients with respect to those with milder disease was the only significant finding at early echocardiographic examination, without other signs of new onset major cardiac dysfunction. Future studies are needed to deepen the knowledge regarding minor cardiac functional perturbation in the evolution of a complex systemic disorder, in which the respiratory involvement appears as the main character, at least in non-ICU patients., (© 2021. Società Italiana di Medicina Interna (SIMI).)

Published
2021
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27. Gastrointestinal Bleeding in Patients with SARS-CoV-2 Infection Managed by Interventional Radiology.

Author

Ierardi AM, Coppola A, Tortora S, Valconi E, Piacentino F, Fontana F, Stellato E, Cogliati CB, Torzillo D, Giampalma E, Renzulli M, Bargellini I, Cioni R, Scandiffio R, Spinazzola A, Foà RA, Del Giudice C, Venturini M, and Carrafiello G

Abstract

Background: This study was conducted to evaluate the technical and clinical success of trans-arterial embolization (TAE) as a treatment of gastrointestinal bleeding (GIB) in Coronavirus Disease 2019 (COVID-19) patients and to describe its safety; moreover, we describe the characteristics of these patients., Methods: Thirty-four COVID-19 hospitalized patients presented with GIB. Risk factors, drugs administered for COVID-19 infection, and clinical and biological parameters were evaluated. Furthermore, intraprocedural data and outcomes of embolization were analyzed., Results: GIB was more frequent in male. Overweight, hypertension, diabetes, previous cardiac disease, and anticoagulation preadmission (48.5%) were frequently found in our population. Previous or actual COVID Acute respiratory distress syndrome (ARDS) and a high level of D-dimer were encountered in most cases. Upper GIB was more frequent than lower GIB. Technical and clinical success rates of embolization were 88.2% and 94.1%, respectively. The complication rate was 5.9%., Conclusions: Our study highlights the most frequent characteristics of COVID-19 patients with GIB. Embolization is feasible, effective, and safe.

Published
2021
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29. Three-month mortality in permanently bedridden medical non-oncologic patients. The BECLAP study (permanently BEdridden, creatinine CLearance, albumin, previous hospital admissions study).

Author

Brucato A, Ferrari A, Tiraboschi M, Zucchi A, Cogliati C, Torzillo D, Dentali F, Tavecchia L, Gessi V, Squizzato A, Moretti S, Permunian ET, Carobbio A, Pasina L, De Stefano F, Tombetti E, Cumetti D, Tognoni G, and Barbui T

Subjects
Aged, Creatinine, Female, Hospital Mortality, Hospitals, Humans, Italy epidemiology, Albumins, Hospitalization
Abstract

Objective: To predict the 3-months mortality in permanently bedridden medical non-oncologic inpatients., Patients and Methods: 2788 consecutive patients admitted in 5 Italian Internal Medicine units from January 2016 through January 2017 were prospectively screened; 644 oncologic patients were excluded; 2144 non-oncologic patients (1021 female) were followed-up for mortality for 6 months. Main outcome was 3-months mortality in permanently bedridden inpatients with at least 2 of: creatinine clearance <35 ml/min; albumin < 2.5 g/dl; at least 2 hospital admissions in the previous 6 months. Advanced dementia and dysphagia were also recorded., Results: Mean age of the 2144 patients was 73.9 (SD, 14.9) years; 374 (17%) were permanently bedridden, 435 (20%) had a creatinine clearance <35 ml/min, 217 (10%) albumin <2,5 g/dl, 112 (5%) at least 2 hospital admissions in the previous 6 months. Seventy-seven (4%) patients were permanently bedridden with at least 2 of the above mentioned items, and 48 of them died within 3 months (62%) (p < 0.001;95% CI 51-73%). Regression coefficients of the variables associated with 3-months mortality in multivariate analysis in 998 patients of unit 1 (training cohort) were used to create a simple score, which was validated in the 1146 patients of the other units (validation cohort) and performed well in predicting the 3-months mortality (https://www.ejcrim.com/beclap/)., Conclusions: Approximately two out of three non-oncologic medical patients permanently bedridden having 2 of the abovementioned items are dead 3 months after index admission; a simple score including bedridden status, creatinine clearance, albumin, dysphagia, age and sex may help discuss management priorities., Competing Interests: Declaration of Competing Interest None., (Copyright © 2019 The Authors. Published by Elsevier B.V. All rights reserved.)

Published
2020
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31. Lung ultrasound and short-term prognosis in heart failure patients.

Author

Cogliati C, Casazza G, Ceriani E, Torzillo D, Furlotti S, Bossi I, Vago T, Costantino G, and Montano N

Subjects
Aged, Aged, 80 and over, Female, Follow-Up Studies, Heart Failure blood, Heart Failure mortality, Humans, Male, Natriuretic Peptide, Brain blood, Patient Readmission trends, Peptide Fragments blood, Prognosis, Time Factors, Heart Failure diagnostic imaging, Lung diagnostic imaging, Ultrasonography trends
Abstract

Background: Heart failure (HF) is the leading cause of hospitalization for patients older than 65years, with a 30-day readmission rate of 20-25%. Although several markers have been evaluated to stratify timing of follow-up after an acute decompensation is mostly based on clinical judgment. Lung ultrasound (LUS) has been demonstrated to be a valid tool for the assessment and monitoring of pulmonary congestion. Aim of our study was to evaluate if LUS performed in HF patients at discharge could predict 100-day hospital readmission or death., Methods: One-hundred fifty patients were enrolled. The anterolateral chest was scanned to evaluate the presence of B-lines. A sonographic score was calculated attributing 1 to each positive (≥3 B-lines) sector. Clinical, biochemical and echocardiographic data were recorded. A Cox proportional hazard regression analysis was performed to evaluate the association between variables and 100-day events., Results: Follow-up was obtained in 149 patients. Thirty-four events were recorded. Sonographic score was significantly associated with events (HR 1.19; CI 1.05 to 1.34; p=0.005). On average, the increase of 1 point in the sonographic score was associated with an increase of approximately 24% in the risk of event within 100days. At multivariate analysis NTproBNP remained the only independent prognostic factor., Conclusions: We confirmed that B-lines at discharge are a prognostic marker for hospital readmission and death at 100days in HF patients. Nevertheless, further randomized clinical studies are needed to definitely support the routine use of LUS in the clinical management of HF patients, in combination or not with NT-proBNP., (Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.)

Published
2016
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32. Lung ultrasonography for the assessment of rapid extravascular water variation: evidence from hemodialysis patients.

Author

Trezzi M, Torzillo D, Ceriani E, Costantino G, Caruso S, Damavandi PT, Genderini A, Cicardi M, Montano N, and Cogliati C

Subjects
Female, Heart Failure diagnostic imaging, Humans, Male, Middle Aged, Point-of-Care Systems, Pulmonary Edema diagnostic imaging, Ultrasonography, Vena Cava, Inferior diagnostic imaging, Extravascular Lung Water diagnostic imaging, Renal Dialysis
Abstract

Chest ultrasonography is a useful tool to assess extravascular lung water at bedside. In presence of interstitial-alveolar imbibition, vertical artifacts arising from the pleura are detected; these are called B-lines. Although a positive linear correlation between B-lines and extravascular lung water has been shown in symptomatic heart failure patients, the subclinical phase of pulmonary imbibition and the clearance of B-lines after rapid body fluid removal have been less investigated. The aim of this study was to assess if chest ultrasound could detect lung water imbibition and its variations induced by dialysis, an experimental model of controlled rapid fluid loss. Forty-one patients undergoing hemodialysis were studied. Total number of B-lines from ultrasound chest scanning and vena cava diameters were measured before and after treatment. Before dialysis, most of the patients presented ultrasound signs of pulmonary imbibition despite the absence of dyspnea; the number of B-lines was associated with the accumulated weight before treatment (p < 0.05) as well as with the residual weight after dialysis (p < 0.01); B-lines and end-inspiratory and end-expiratory vena cava diameters were also significantly reduced after dialysis. Moreover, B-lines reduction was significantly related to weight loss. Ultrasound performed at the bedside can detect lung water and intravascular overload and their reduction after dialysis in yet asymptomatic patients. These observations add further evidence regarding the use of lung ultrasound and inferior vena cava measurement in estimating volume overload and monitoring the response to therapy both in hemodialysis and congestive heart failure patients.

Published
2013
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33. Target organ damage in a population at intermediate cardiovascular risk, with adjunctive major risk factors: CArdiovascular PREvention Sacco Study (CAPRESS).

Author

Perego F, Renesto E, Arquati M, Scandiani L, Cogliati C, Torzillo D, Zocchi L, Casazza G, Duca P, Chirchiglia S, Lacaita G, Panteghini M, and Cortellaro M

Subjects
Adult, Aged, Algorithms, Body Mass Index, Cardiovascular Diseases pathology, Carotid Artery Diseases pathology, Confidence Intervals, Cross-Sectional Studies, Health Status Indicators, Humans, Italy epidemiology, Logistic Models, Male, Middle Aged, Multivariate Analysis, Odds Ratio, Prevalence, Risk Factors, Systole, Cardiovascular Diseases complications, Carotid Arteries pathology, Carotid Artery Diseases complications
Abstract

The objective of the study is to assess the prevalence of target organ damage (TOD) at carotid, cardiac, renal and peripheral vascular levels in a population at intermediate cardiovascular risk, with adjunctive major risk factors (AMRF). From March 2007 to July 2009 we examined 979 subjects at intermediate cardiovascular risk, as indicated by the Italian algorithm "Progetto Cuore"; the patients were aged 40-69 years, sensitized by one or more AMRF such as family history for cardiovascular disease (CVD), being overweight or obese, and smoking habit (more than 10 cigarettes/day). We measured common carotid intima-media thickness (cc-IMT) and plaque at any level, left ventricular mass index (LVMI), urine albumin/creatinine ratio (UACR), and ankle-brachial index (ABI). The prevalence of at least one TOD was 63% (617 subjects), cc-IMT was high in 48.2% (472), UACR abnormal in 14.1% (138), LVMI high in 12.6% (117) and ABI pathological in 9.1% (89). In those with carotid damage 423 had a plaque, amounting to 43.2% of the total population. Of note, carotid damage was present in all subjects with 3 TODs, and in 92% of subjects with 2 TODs. A multivariate logistic regression model including conventional factors and AMRF indicated that age 50-69 years, systolic blood pressure, relevant smoking and CV risk score ≥15 were independently and significantly associated with at least one TOD, and at least, with carotid damage. Among the AMRF, peripheral arterial disease was associated with relevant smoking, with an odds ratio (OR) of 3 [confidence interval (CI) 1.80-4.97, p < 0.0001]; overweight and obesity both had selective associations with cardiac damage with OR 2.75 (CI 1.2-6.3, p < 0.01) and OR 3.89 (CI 1.61-9.73, p < 0.01). A substantial proportion of people at intermediate risk, with at least one AMRF have at least one TOD, a major predictor of cardiovascular outcomes.

Published
2011
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34. Spectral analysis of short term R-Tapex interval variability during sinus rhythm and fixed atrial rate.

Author

Lombardi F, Sandrone G, Porta A, Torzillo D, Terranova G, Baselli G, Cerutti S, and Malliani A

Subjects
Adult, Algorithms, Cardiac Pacing, Artificial, Electrocardiography, Female, Head-Down Tilt, Humans, Male, Middle Aged, Reference Values, Respiration physiology, Rest, Time Factors, Atrial Function, Heart Rate
Abstract

Analysis of heart rate variability has been proven useful in stratifying post myocardial patients at risk and in evaluating autonomic dysfunction. Recently augmented inter-lead variability of the QT interval has been associated with increased mortality as a result of arrhythmia and proposed as a marker of dispersion of ventricular repolarization. As the duration of the QT interval is largely dependent upon the length of the preceding cardiac cycle it is tempting to analyse whether neural mechanisms might also directly exert additional modulation. Using autoregressive algorithms we therefore analysed RR and R-Tapex interval variabilities in 15 normal subjects during sinus rhythm and in six patients with a fixed atrial rate. In controls mean R-Tapex interval and variance measured on the vector magnitude were, respectively, 245 +/- 6 ms and 5.1 +/- 0.7 ms2. Spectral analysis of R-Tapex indicated the presence of two spectral components which corresponded to the low and high frequency components of heart rate variability. In R-Tapex variability, high frequency (44 +/- 4 nu) was predominant over low frequency (29 +/- 4 nu). During controlled respiration, a manoeuvre associated with enhanced vagal modulation of sinus node, there was a further increase in high frequency (58 +/- 4 nu) whereas during tilt the low frequency component of R-Tapex variability became predominant (57 +/- 6 nu). In patients with a fixed atrial rate, variance was extremely low (3 +/- 0.9 ms2) and only a respiration-related high frequency component was recognizable in spectral analysis of RR and R-Tapex variabilities. This component was likely to depend upon mechanically induced changes in cardiac vector orientation. These data indicate that during sinus rhythm short-term R-Tapex interval variability is characterized by the same rhythmical components present in RR variability. However, the presence of a very low variance and of only a high frequency component in patients in whom the physiological variability of sinus node is abolished by atrial pacing. suggests that neural modulatory mechanisms do not exert a direct effect on the length of the R-Tapex interval.

Published
1996
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35. Evidence of functional alterations in sympathetic activity after myocardial infarction.

Author

Spinnler MT, Lombardi F, Moretti C, Sandrone G, Podio V, Spandonari T, Torzillo D, Brusca A, and Malliani A

Subjects
3-Iodobenzylguanidine, Adult, Efferent Pathways diagnostic imaging, Efferent Pathways physiopathology, Electrocardiography, Ambulatory instrumentation, Exercise Test instrumentation, Heart Rate physiology, Humans, Image Processing, Computer-Assisted instrumentation, Iodine Radioisotopes, Iodobenzenes, Male, Middle Aged, Minicomputers, Myocardial Infarction diagnostic imaging, Radionuclide Imaging, Signal Processing, Computer-Assisted instrumentation, Sympathetic Nervous System diagnostic imaging, Sympatholytics, Thallium Radioisotopes, Vagus Nerve diagnostic imaging, Heart innervation, Myocardial Infarction physiopathology, Sympathetic Nervous System physiopathology, Vagus Nerve physiopathology
Abstract

To assess whether the presence of areas of efferent sympathetic denervation might contribute to alterations in sympathetic and vagal neural regulatory activities observed after myocardial infarction, we attempted to correlate the changes in the spectral components of RR variability with the I-123 MIBG and Thallium-201 uptake defects. Ten patients with first and uncomplicated myocardial infarction were studied. Thallium-201 and I-123 MIBG scintigraphy as well as spectral analysis of heart rate variability were performed 7 days, 4, 12 and 30 months after the acute event. Regional abnormalities in I-123 MIBG uptake were more extensive than the perfusion defects indicated by Thallium-201 images and remained constant throughout the entire period of observation. In the early post-infarction period, spectral analysis of RR variability was characterized by a predominant LF (74 +/- 6 nu) and a smaller HF (16 +/- 3 nu) component indicating a sympathetic predominance. Thereafter, we observed a progressive reduction in LF and a gradual increase in HF which were consistent with a normalization of sympatho-vagal balance. These data indicate that after a myocardial infarction, the presence and persistence of areas of sympathetic functional denervation do not seem to play a major role in determining the changes in sympathetic and vagal neural regulatory activities directed to the heart.

Published
1993
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