[Longitudinal echocardiographic study of HIV positive patients]

BACKGROUND

From May 1992 to June 1996 the authors have studied a group of 39 subjects with positive anti-HIV, with echo 2D color Doppler examination, to evaluate with semi-annual controls, the wide variety of cardiac complications in the various phases of clinical evolution of the illness.

METHODS

At the moment of recruiting, all the subjects with HIV infection were asymptomatic A1 (HIV + As). The patients whose average age was 29 +/- 5, were composed of 60% drug addicts, 17% homosexuals, 8% haemophiliacs and for the 15% heterosexual.

RESULTS

The most frequent cardiac complications are represented by hypokinesia of the left ventricle (h-aLV) and by pericardial effusion (PE); more rarely of endocardial vegetations (EV), dilatation of the left ventricle (dLV) and tricuspid insufficiency (TI). The entity of damage and the number of cases observed, are correlated with the grade of clinical severity of the illness.

CONCLUSIONS

In accordance with the literature data, cardiac pathologies, particularly in the first phases of the illness, are asymptomatic or paucisymptomatic, making the clinical-instrumental observation of the patient useful also in cardiology.

The effects of muscle-building exercise on forearm bone mineral content and osteoblast activity in drug-free and anabolic steroids self-administering young men

We measured bone mineral content (BMC) and bone density (BD) at appendicular sites by single photon absorptiometry in 18 men engaged in body-building exercises for at least 2 years, and in 14 age- and weight-matched controls. Eight exercises were using anabolic steroids by self-administration. Serum levels of bone Gla-protein (BGP), a reliable index of bone formation were also measured in all subjects. It was observed that muscle-building exercise was associated with increased BMC and BD at the distal radius, which contains both cortical and trabecular (more than 50%) bone. Previous authors have failed to detect any increase in BMC at mid radius, a site consisting almost entirely of cortical bone. Serum BGP levels were significantly higher in exercisers than in controls. If compared to drug-free exercisers, subjects taking steroids showed no significant increase of BMC, BD and serum levels of BGP. This study shows that muscle-building exercise is associated with increase in BMC and BD also at non-weight bearing sites, and that anabolic steroids did not provide, at the time of the observation, any further stimulus for osteoblast activity and bone formation.

[Validity of electrocardiographic indices of left ventricular hypertrophy in athletes]

The Authors have evaluated the reliability of the most important electrocardiographic criteria for left ventricular hypertrophy in a group of 95 athletes. An ECG and a M- and B-mode echocardiogram have been performed in each subject; the criteria by Sokolow and Lyon, by Cornell, by Gubner, by Romhilt and Estes and by Casale have been employed to evaluate left ventricular hypertrophy. Left ventricular mass has been evaluated by the echocardiogram according to Devereux and coll. The electrocardiographic method by Casale and coll., proposed only for a few years, is based on the valuation of R wave and on the study of ventricular repolarization depending on sex and age. By this method, still now not much used in the study of athletes, a good correlation with the echocardiographic data was expected, in relation to the young age of the population. The athletes have been divided into three groups, practising aerobic sports, aerobic-anaerobic sports and power sports, according to the physiologic classification of the sports activities of Dal Monte. Using the chi-squared test, for the whole population and separately for the three groups, no significant statistical correlation has been observed. In conclusion, the results demonstrate that not only the "classic" criteria, but also the most recent ECG criteria of left ventricular hypertrophy are not reliable in evaluating left ventricular hypertrophy in trained athletes, leaving the final assessment of the real state of the cardiac chambers to echocardiography.