An early stage of diabetic cardiomyopathy can be evidenced by TDI in Type 2 diabetic subjects even in the presence of a normal cardiac function with CE. This abnormality is associated with insulin resistance.

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Objectives: Coronary heart disease is frequent in the working-age population. Traditional outcomes, such as mortality and hospital readmission, are useful for evaluating prognosis. Fit-for-work is an emerging outcome with clinical as well as socioeconomic significance. We describe the possible benefit of a cardiac rehabilitation (CR) program for return to work (RTW) after acute coronary syndrome (ACS). Material and Methods: We evaluated 204 patients with recent ACS. They were divided into 4 groups on the basis of their occupational work load: very light (VL), light (L), moderate (M), and heavy (H). Work-related outcomes were assessed with the Work Performance Scale (WPS) of the Functional Status Questionnaire and as "days missed from work" (DMW) in the previous 4 weeks. The variables considered for outcomes were percent ejection fraction, functional capacity expressed in metabolic equivalents (METs), and participation or non-participation in the CR program (CR+ and CR-). Results: One hundred thirty (66%) patients took part in the CR program. Total WPS scores for CR+ and CR-subgroups were VL group: 18±4 vs. 14±4 (p < 0.001), L group: 18±3 vs. 14±3 (p < 0.0001), M group: 19±3 vs. 16±3 (p < 0.003), and H group: 20±4 vs. 17±3 (p < 0.006). Fewer DMW were reported by the CR+ group. Conclusions: Non-participation in CR was a consistent cause of poorer work-related outcomes. Our findings indicate that CR and occupational counseling play a very important role in worker recovery and subsequent reintegration in the workplace, in particular among clerical workers. resistance training, and aerobic exercise. The education and counseling session (four 50-min counseling sessions for 1 month) consisted of advice on healthy nutrition, physical activity, maintaining a healthy body weight, and issues related to quitting smoking and alcohol consumption. Exclusion criteria were age > 65 years, severe concomitant non-cardiac diseases such as cancer, renal dysfunction (serum creatinine > 3 mg/dl), liver dysfunction (alanine aminotransferase/aspartate aminotransferase > 1.5 times the upper normal limit), and dementia, any systemic disease limiting exercise, and inability to participate in a prospective study for logistical reasons. The average energy requirement for the patients' work activities was estimated with the aid of pre-existing, specific tables [13] that classify the various tasks on the basis of metabolic equivalents (METs): < 3 METs -very INTRODUCTIONCoronary heart disease (CHD) is the main cause of death worldwide, accounting for 31% of mortality [1]. In fact, in the working population (aged < 65), CHD is the single most important cause of death in men, and in women it is preceded only by breast cancer [2][3]. It is both a medical and a socio-economic problem. Returning to work after a coronary event produces economic benefits for the community and patients alike, improving the quality of life of their families too [4][5]. It is generally recognized that the return to work is not a simple function of clinical status...

Aims  Following coronavirus disease (COVID-19) outbreak, the Italian government adopted strict rules of lockdown and social distancing. The aim of our study was to assess the admission rate for cardiac implantable electronic devices (CIEDs) replacement procedures in Campania, the 3rd-most-populous region of Italy, during COVID-19 lockdown. Methods and results  Data were sourced from 16 referral hospitals in Campania from 10 March to 4 May 2020 (lockdown period) and during the same period in 2019. We retrospectively evaluated consecutive patients hospitalized for CIEDs replacement procedures during the two observational periods. The number and type of CIEDs replacement procedures among patients followed by remote monitoring (RM), the admission rate, and the type of hospital admission between the two observational periods were compared. In total, 270 consecutive patients were hospitalized for CIEDs replacement procedures over the two observation periods. Overall CIEDs replacement procedures showed a reduction rate of 41.2% during COVID-19 lockdown. Patients were equally distributed for sex (P = 0.581), and both age [median 76 years (IQR: 68–83) vs. 79 years (IQR: 68–83); P = 0.497]. Cardiac implantable electronic devices replacement procedures in patients followed by RM significantly increased (IR: +211%; P &lt; 0.001), mainly driven by the remarkable increase rate trend of both PM (IR: +475%; P &lt; 0.001) and implantable cardiac defibrillator replacement procedures (IR: +67%, P = 0.01), during COVID-19 lockdown compared with 2019 timeframe. Conclusions  We showed a significant increase trend rate of replacement procedures among CIEDs patients followed by RM, suggesting the hypothesis of its increased use to closely monitoring and to optimize the hospital admission time during COVID-19 lockdown.

Introduction: Early evidence suggests that multipoint left ventricular pacing (MPP)