BackgroundThe independent prognostic impact of diabetes mellitus (DM) and prediabetes mellitus (pre‐DM) on survival outcomes in patients with chronic heart failure has been investigated in observational registries and randomized, clinical trials, but the results have been often inconclusive or conflicting. We examined the independent prognostic impact of DM and pre‐DM on survival outcomes in the GISSI‐HF (Gruppo Italiano per lo Studio della Sopravvivenza nella Insufficienza Cardiaca‐Heart Failure) trial.Methods and ResultsWe assessed the risk of all‐cause death and the composite of all‐cause death or cardiovascular hospitalization over a median follow‐up period of 3.9 years among the 6935 chronic heart failure participants of the GISSI‐HF trial, who were stratified by presence of DM (n=2852), pre‐DM (n=2013), and non‐DM (n=2070) at baseline. Compared with non‐DM patients, those with DM had remarkably higher incidence rates of all‐cause death (34.5% versus 24.6%) and the composite end point (63.6% versus 54.7%). Conversely, both event rates were similar between non‐DM patients and those with pre‐DM. Cox regression analysis showed that DM, but not pre‐DM, was associated with an increased risk of all‐cause death (adjusted hazard ratio, 1.43; 95% CI, 1.28–1.60) and of the composite end point (adjusted hazard ratio, 1.23; 95% CI, 1.13–1.32), independently of established risk factors. In the DM subgroup, higher hemoglobin A1c was also independently associated with increased risk of both study outcomes (all‐cause death: adjusted hazard ratio, 1.21; 95% CI, 1.02–1.43; and composite end point: adjusted hazard ratio, 1.14; 95% CI, 1.01–1.29, respectively).ConclusionsPresence of DM was independently associated with poor long‐term survival outcomes in patients with chronic heart failure.Clinical Trial Registration URL: http://www.clinicaltrials.gov. Unique identifier: NCT00336336.

In this study a possible relationship between the presence of type 2 diabetes (DM2) and the Human Herpesvirus 8 infection (HHV-8) has been evaluated. The presence of HHV-8 DNA was monitored by nested PCR and Southern blotting in peripheral blood leucocytes of DM2 patients admitted to the Diabetology and Metabolic Disease Service of the “S. Giovanni di Dio” Hospital (Cagliari, Italy); healthy blood donor subjects were examined as controls. The results suggest that the frequency of HHV-8 DNA detection is more elevated in DM2 patients (23.7%) than in healthy control subjects (12%, p<0.05). The association of HHV-8 infection with some other frequent complicating pathologies of DM2 patients was also evaluated. The possible role of HHV-8 in DM2 disease and related intercurrent pathologies is critically discussed

The improvement in revascularization techniques and medicine treatment during infarction has substantially reduced mortality during the acute phase of this condition. Since the advent of kinetic sequences and the concomitant development of gadolinium chelates and delayed enhancement sequences, cardiac MRI has become the second-line reference examination for ischemic heart disease. The technique of delayed enhancement with the inversion recovery sequence performed after injection has been validated for numerous indications in ischemic disease. Delayed enhancement sequences make it possible in particular to look for "no-reflow" areas (microvascular obstructions), to quantify the infarction area, and to assess prognosis. MRI also allows us to define the area at risk, that is, the area with edema, and to look for and assess the mechanical complications of the infarction. The aim of this review is to summarize current knowledge about: the pharmacokinetic principles that regulate myocardial enhancement; the different sequences available to acquire delayed enhancement images, and; the value of cardiac MRI in the diagnosis of complications of myocardial infarction.

Problem statement: The possible contribution of viruses to vascular pathology is still a\ud controversial issue. Human herpesvirus type 8 (HHV-8) has been suggested to participate to the\ud pathogenetic events associated with atherosclerotic lesion establishment and progression. Recently, a\ud high incidence of infection of HHV-8 (11%) has been verified in the island of Sardinia. The aim of this\ud study was to evaluate a possible relationship between the HHV-8 infection and cardiovascular diseases in\ud the South of Sardinia. Approach: The presence of HHV-8 genome was detected in DNA extracted from\ud peripheral leucocytes, by nested-PCR and Southern blotting, in either acute or chronic cardiopathic\ud patients (n = 180); healthy blood donors were examined as controls (n = 108). Results: The results\ud demonstrated a significant increase (p = 0.035) in HHV-8 DNA isolation from cardiopathic patients\ud (22.8%) in comparison to healthy controls (12.0%). Conclusion: HHV8 infection can be considered,\ud among others, as an additional risk factor for cardiovascular disease development, although it was not\ud necessarily the starting cause. More extensive studies were needed to define the exact role of HHV-8\ud infection in cardiopathic patients