Previous experimental studies showed that increasing high-density lipoprotein cholesterol (HDL) cholesterol shortens cardiac ventricular repolarization and the QT interval corrected for heart rate (QTc). However, little is known about the epidemiological relationship between HDL and QTc. The potential antiarrhythmic effect of HDL cholesterol remains a speculative hypothesis. In this cross-sectional population based study in adults living in the Italian-speaking part of Switzerland, we aimed to explore the association between HDL cholesterol and the QTc interval in the general population. A total of 1202 subjects were screened. electrocardiogram (ECG) recordings, measurements of lipid parameters and other laboratory tests were performed. QTc was corrected using Bazett’s (QTcBaz) and Framingham (QTcFram) formulas. HDL was categorized according to percentile distributions: <25th (HDL-1; ≤1.39 mmol/L); 25th–<50th (HDL-2; 1.40–1.69 mmol/L); 50th–<75th (HDL-3; 1.69–1.99 mmol/L); and ≥75th (HDL-4; ≥2.0 mmol/L). After exclusion procedures, data of 1085 subjects were analyzed. Compared with the HDL reference group (HDL-1), HDL-2 and HDL-3 were associated with a reduction of QTcBaz and QTcFram duration in crude (HDL-2, QTcBaz/QTcFram: β-11.306/–10.186, SE 4.625/4.016; p = 0.016/0.012; HDL-3, β-12.347/–12.048, SE 4.875/4.233, p = 0.012/<0.001) and adjusted (HDL-2: β-11.697/–10.908, SE 4.333/4.151, p < 0.001/0.010; HDL-3 β-11.786/–11.002, SE 4.719/4.521, p = 0.014/0.016) linear regression models in women. In adjusted logistic regression models higher HDL, were also associated with lower risk of prolonged QTcBaz/QTcFram (HDL-2: OR 0.16/0.17, CI 0.03–0.83/0.47–0.65; HDL-3: OR 0.10/0.14, CI 0.10–0.64/0.03–0.63) in women. Restricted cubic spline analysis confirmed a non linear association (p < 0.001). The present findings indicate an epidemiological association between HDL cholesterol and QTc duration. To draw firm conclusions, further investigations in other populations and with a prospective cohort design are needed.

Others reported a significant reduction in the thinning rates of the left ventricular posterior wall and interventricular septum in 13 patients with Friedreich's ataxia.4The only scintigraphic studies of left ventricular function in patients with Friedreich's ataxia are those of Pentland and Fox5 and Therriault et al6 in which the ejection fraction was normal in most cases. We do not know of any radionuclide studies of the diastolic function of the left ventricle and the overall function ofthe right ventricle in this disease. We have assessed the function of both ventricles by radionuclide angiography in a group of patients with Friedreich's ataxia.Requests for reprints to Professor M Morpurgo, Via Boccaccio 24,

An 85-year-old patient presented to the emergency department because of orthopnoea and peripheral oedema. He was known for diabetes mellitus and coronary artery disease with severe chronic heart failure. Eighteen months earlier, he already showed biventricular dilatation and systolic dysfunction (20-25% left ventricular ejection fraction) with moderate mitral valve regurgitation at transthoracic echocardiography. On current physical examination, he showed moderate oedema of the legs. On chest X-ray, there was upper lobe pulmonary venous congestion and small bilateral pleural effusion. Laboratory testing revealed moderate creatinine elevation (150 μmol L −1 ; normal <107). Liver enzymes and creatine kinase levels were normal. The patient's daily therapy consisted of acetylsalicylic acid 100 mg, metoprolol 50 mg, sacubitril/valsartan 200 mg (97/103 mg), torasemide 10 mg,

Background There are several, even recent, basic research studies that have demonstrated the microbiota's cause for the predisposition and development of degenerative disorders and risk factors: cardiovascular diseases, obesity, metabolic syndrome and diabetes. Studies, knowledge and communication on probiotics have gone and are increasingly growing, so much so that almost a "trend" of the probiotic has developed. The importance of defining the "probiotic", developing knowledge and clinical research, or evaluating the results in real clinical practice, is essential for the appropriate use for the benefit of the person. The doctor has and must have a central and primary role. Purpose The study, which we conducted in clinical practice, is of an observational type, and has as its primary outcome that of evaluating the impact of nutriceutic integration with probiotics on risk factors of inflammatory and metabolic markers and as a secondary outcome the functional capacity and perception of psychophysical health. Methods Out of 70 patients followed, 50 patients were selected and evaluated for homogeneity and adherence characteristics. Eligibility characteristics below: risk profile, familiarity for cardiovascular diseases, dysendocrine disorders, overweight and obesity, hypertension, diabetes, hypercholesterolemia, hypertriglyceridemia, fatigue syndrome, neurovegetative dystonia. The evaluation of probiotic therapy was carried out in two stages on the basis of the following parameters: psychophysical perception of the state of health, using the SF-36 Questionnaire, functional capacity by means of the physical ability test (Six Minute Walking Test 6MWT or Walking Test), blood tests: PCR, Vitamins, lipid profile. The nutraceutical scheme consists of taking 2cps after breakfast and 2 cps after Enterelle's dinner, during the first week. Bifiselle, second week, Ramnoselle third week Serobrain 1 cps after breakfast fourth week. Serobioma, one tablet per day, for 3 months: maintenance phase. Results and Conclusions The observational study in real practice indicated an efficacy of the probiotic nutraceutical treatment on patients with regard to the reduction of the measurable risk profile, improvement of the perception of health including objective level of functional capacity, stabilization of the levels of vitamins (vit B and D).