Alessandra Cinque

Prevalence and predictors of long corrected QT interval in HIV-positive patients: a multicenter study

Aims HIV and highly active antiretroviral therapy (HAART) may affect cardiac conduction, and a higher incidence of sudden death has been recognized in HIV-positive patients. Nevertheless, predictors of prolonged corrected QT interval (cQT) have been poorly described. The aim of the study was to investigate the prevalence and predictors of long cQT in a cohort of HIV-positive patients. Methods Consecutive HIV-positive patients followed in a primary prevention clinic at two Italian institutions were retrospectively enrolled. A 12-lead ECG was recorded in all patients; main clinical features were collected. Prevalence of long cQT (defined as cQT >470 ms in women and >450 ms in men) was the primary end-point. Secondary end-points were the identification of predictors of cQT prolongation, and the association between HAART and HIV-related features with long cQT. Results Three hundred and fifty-one HIV-positive patients were included, 26 (7.4%) with long cQT. Mean age was higher among those with long cQT (51.6 vs. 57.6 years; P = 0.007). A higher prevalence of long cQT was reported for patients with a CD4+ cell count below 200 cells/&mgr;l at the moment of ECG (60 vs. 24.2%; P = 0.002) and with a nadir of CD4+ cell count below 200 cells/&mgr;l (91.3 vs. 58.6%; P = 0.001). At multivariate analysis, only the nadir of CD4+ cell count below 200 cells/&mgr;l consistently related to the presence of long cQT (odds ratio 5.8, 95% confidence interval 1.3–26.4). Conclusion A low CD4+ cell count is associated with long cQT independently from HAART in HIV-positive patients and may be useful to correctly stratify arrhythmic risk in these patients.

Screening high school students in Italy for sudden cardiac death prevention by using a telecardiology device: a retrospective observational study

BACKGROUND In 2010, an Italian project was launched aimed at using a telecardiology device in order to perform early diagnosis of young students at risk of sudden cardiac death. METHODS Our retrospective observational study was conducted on a population of 13,016 students, aged between 16 and 19 years, in different Italian regions. It consisted of analysis of data recorded during a telecardiology pilot study. The recorded data were electrocardiograms and data concerning lifestyle habits and family history of cardiovascular diseases. In total, 14 alterations in the electrocardiogram signal have been considered in this study. Some of these alterations are as follows: ventricular ectopic beats, atrioventricular block, Brugada-like electrocardiogram pattern, left anterior/posterior fascicular block, left/right ventricular hypertrophy, long/short QT interval, left atrial enlargement, right atrial enlargement, short PQ interval, and ventricular pre-excitation Wolff-Parkinson-White syndrome. On the basis of the collected data, we implemented this retrospective observational study. RESULTS The analysed data showed that 13.60% of students had a family history for cardiovascular diseases, 22.43% reported smoking habits, 26.23% reported alcohol consumption, and 7.24% reported abuse of drugs. A total of 24% of students had at least one of the 14 electrocardiogram pathological alterations considered in our study and 32% had electrocardiogram values within the normal range. CONCLUSIONS This retrospective observational study analysed data registered during our telecardiology activity. This activity permitted to maximise data collection and minimise the costs for collecting such data. This activity of screening is being continued and in the next few years it will allow us to have a greater mass of data.

EKG ABNORMALITIES DISTRIBUTION BETWEEN COMPETITIVE ATHLETES, NON COMPETITIVE ATHLETES AND NON ATHLETES IN A POPULATION OF 12,000 YOUNG ITALIAN STUDENTS

Introduction: The European Society of Cardiology recommends cardiovascular screening to competitive athletes. In young population the execution of 12-lead ECG screening is still controversial. Hypothesis: The aim of our study is to evaluate the distribution of ECG abnormalities between competitive athletes, non competitive athletes and non athletes. Methods: From October 2010 to October 2015, we evaluated prospectively 11916 high school students (age 17.2 ± 2.4 years old; 45.9% male): 4533 (38.04 %) non athletes (G-A), 4936 (41.42 %) non competitive athletes (G-B) and 2447 (20.54%) competitive athletes (G-C). They were screened using 12-lead ECG. The statistical difference was considered significant only for p-value l this suggest that an ECG screening is recommended also in non athletes.

RISK STRATIFICATION FOR SUDDEN CARDIAC DEATH IN PATIENTS WITH HEART FAILURE: ROLE FOR 123-IODINE METAIODOBENZYLGUANIDINE IMAGING AND CARDIAC MAGNETIC RESONANCE IMAGING. A REAL WORLD SINGLE CENTRE EXPERIENCE

Implantable cardioverter defibrillator (ICD) is recommended for the prevention of sudden cardiac death (SCD) in patients with heart failure, basing mainly on ejection fraction (EF). However, the latter has low sensibility and specificity. 123-iodine metaiodobenzylguanidine (123-I MIBG) imaging,