No abstract

Nebivolol is as effective as carvedilol in patients with symptomatic chronic heart failure and reduced LV systolic function.

Background: Seasonal peaks in cardiovascular disease incidence have been widely reported, suggesting weather has a role. Design The aim of our study was to determine the influence of climatic variables on angina pectoris hospital admissions. Methods: We correlated the daily number of angina cases admitted to a western Sicilian hospital over a period of 12 years and local weather conditions (temperature, humidity, wind force and direction, precipitation, sunny hours and atmospheric pressure) on a day-to-day basis. A total of 2459 consecutive patients were admitted over the period 1987-1998 (1562 men, 867 women; M/F -1:8).Results: A seasonal variation was found with a noticeable winter peak. The results of Multivariate Poisson analysis showed a significant association between the daily number of angina hospital admission, temperature, and humidity. Significant incidence relative ratios (95% confidence intervals/measure unit) were, in males, 0.988 (0.980-0.996) (p ¼ 0.004) for minimal temperature, 0.990 (0.984-0.996) (p ¼ 0.001) for maximal humidity, and 1.002 (1.000-1.004) (p ¼ 0.045) for minimal humidity. The corresponding values in females were 0.973 (0.951-0.995) (p < 0.017) for maximal temperature and 1.024 (1.001-1.048) (p ¼ 0.037) for minimal temperature. Conclusions: Environmental temperature and humidity may play an important role in the pathogenesis of angina, although it seems different according to the gender. These data may help to understand the mechanisms that trigger ischemic events and to better organize hospital assistance throughout the year.

Hypertensive subjects with first AMI have a better in-hospital outcome than age- and gender-matched normotensive subjects, perhaps due to a less severe extension of the infarction area or to a different pathophysiologic mechanism.

IntroductIonAn excessive caloric intake and a low physical activity have as consequence the development of obesity, which, in turn, may lead to an increased risk of cardiovascular morbidity and mortality (1,2). In obese subjects, compared to normal weight subjects, it has been shown a lengthening of corrected QT (QTc) and QT dispersion (QTd) (3,4), parameters related to an increased incidence of ventricular tachyarrhythmias in various pathologies (5-10).Interest has grown, recently, in new electrocardiographic parameters, as indirect indexes of ventricular repolarization; in particular the Tpeak-Tend (Tpe) interval, its dispersion (Tpe-d), and the relationship between Tpe interval and QT interval (Tpe/QT ratio) showed to be valid markers of arrhythmic vulnerability in coronary heart disease, in Brugada syndrome, in hypertrophic cardiomyopathy, and in long QT syndrome (11)(12)(13)(14)(15).The aforementioned parameters have not yet been evaluated in overweight/obese subjects. The aim of this study was to verify their potential alteration in obesity without associated comorbid conditions. Methods and ProceduresA total of 120 subjects were studied, divided into two groups. The first group was composed of 60 healthy, athletic subjects with normal weight (BMI ≤24.9 kg/m 2 ). They worked out at the gym three times a week for more than 60 min, engaging in aerobic and anerobic activities. The second group was composed of 60 sedentary, overweight (BMI between 25 and 29.9 kg/m 2 ) and obese subjects (BMI ≥30 kg/m 2 ). The first group comprised 21 women and 39 men with the following characteristics: BMI between 19 and 24 kg/m 2 , mean BMI 22.0 ± 2.0 kg/m 2 , aged 14-64 years, mean age 32 ± 13.59 years. The second group comprised 22 women and 38 men, 34 overweight and 26 obese subjects with the following characteristics: BMI between 26 and 55 kg/m 2 , mean BMI 30.7 ± 5.7 kg/m 2 , aged 14-64 years, mean age 38 ± 14.49 years. The subjects with a normal weight were recruited from the Division of Sports Medicine at Palermo University Hospital, the overweight and obese subjects came from a primary prevention ambulatory clinic. Nobody had a personal history of heart disease, hypertension, impaired glucose tolerance, diabetes, renal failure, hepatic or thyroid diseases. No one had a family history of long QT syndrome, electrolyte disorders