Comparazione di metodi per l'elaborazione di mappe di vulnerabilità degli acquiferi

Lo scopo di questa tesi di dottorato è la comparazione di metodi per redarre mappe della vulnerabilità degli acquiferi all’inquinamento. Sono state redatte le mappe di vulnerabilità dell’acquifero della conoide del Reno utilizzando i metodi parametrici SINTACS (Civita e De Maio, 1997) e DRASTIC (Aller et al., 1987). E' stato elaborato un modello tridimensionale del flusso tramite l'utilizzo del software di modellistica numerica FEFLOW. I risultati ottenuti sono stati confrontati con le mappe derivanti dall'appllicazione dei PCSM. E’ stato, inoltre, approfondito lo sviluppo di un modello inverso, che, partendo dalla distruzione del carico piezometrico, fornisce la distribuzione della conducibilità idraulica dell’acquifero.La conoscenza di questo parametro è, infatti, il punto di partenza per lo sviluppo di un nuovo metodo per la definizione della vulnerabilità basato sulla caratterizzazione dell'area di acquifero potenzialmente inquinabile rispetto ad uno sversamento in superficie di un inquinante.L’indice di vulnerabilità viene definito sulla lunghezza del cammino che un inquinante percorrere nell’arco di un anno.

Studio dell'intrusione salina all'interno di un acquifero freatico costiero (Ravenna; Italia)

L’acquifero freatico costiero ravennate è intensamente salinizzato fino a diversi km nell’entroterra. Il corpo dell’acquifero è formato da sabbie che poggiano su un substrato argilloso ad una profondità media di 25 m, i depositi affioranti sono sabbie e argille. Il lavoro svolto consiste in una caratterizzazione dello stato di salinizzazione con metodologie indirette (geoelettrica) e metodologie dirette (letture dei parametri fisici delle acque in pozzo). I sondaggi elettrici verticali (V.E.S.) mostrano stagionalità dovuta alle differenti quantità di pioggia e quindi di ricarica, le aree con depositi superficiali ad alta conducibilità idraulica (sabbie) hanno una lente d’acqua dolce compresa tra 0,1 e 2,25 m di spessore, al di sotto della quale troviamo una zona di mescolamento con spessori che vanno da 1,00 a 12,00 m, mentre quando in superficie abbiamo depositi a bassa conducibilità idraulica (limi sabbiosi e argille sabbiose) la lente d’acqua dolce scompare e la zona di mescolamento è sottile. Le misure dirette in pozzo mostrano una profondità della tavola d’acqua quasi ovunque sotto il livello del mare in entrambi i mesi monitorati, Giugno e Dicembre 2010, presentando una profondità leggermente maggiore nel mese di Dicembre. Dalla ricostruzione litologica risulta un acquifero composto da 4×109 m3 di sabbia, per cui ipotizzando una porosità media del 30% sono presenti 1,2×109 m3 di acqua. Dalla modellazione numerica (Modflow-SEAWAT 2000) risulta che l’origine dell’acqua salata che si trova in falda trova più facilmente spiegazione ipotizzando la sua presenza fin dalla formazione dell’acquifero, residuo delle acque marine che regredivano. Un’altra problematica analizzata è valutare l’applicazione della metodologia a minifiltri in uno studio sulla salinizzazione delle acque di falda. É stata implementata la costruzione di un transetto sperimentale, che ha permesso la mappatura dell’interfaccia acqua dolce/salmastra/salata con una precisione finora non raggiungibile.

Modelli affidabilistico-diagnostici per i componenti delle reti elettriche

L’oggetto della presente dissertazione è inerente aspetti affidabilistici e diagnostici dei componenti delle reti elettriche. Sono stati condotti studi sul ruolo svolto dai parametri presenti nei modelli affidabilistici utilizzati in presenza di regimi distorti. I risultati ottenuti nel corso della ricerca, indicano chiaramente come anche il fattore efficace Krms e, soprattutto, il fattore di forma, Kf, sotto certe condizioni, possano avere effetti considerevoli sulla degradazione degli isolanti (a volte con contributi perfino maggiori di quello dato dal ben noto fattore di picco, Kp, considerato predominante). Viene inoltre riportata un’indagine sviluppata sui principali Dispositivi Automatizzati per il Controllo degli Isolamenti (AIMS), attualmente disponibili sul mercato. Sono illustrati e discussi innovativi modelli di rischio integrati, sviluppati per integrare informazioni fornite dall’analisi affidabilistica tradizionale con misure di proprietà diagnostiche, acquisite grazie ad un monitoraggio costante dei componenti in servizio. L’impiego di tali modelli permetterebbe di ottenere una manutenzione di tipo affidabilistico-diagnostico, basata sull’effettiva condizione del componente in esame (manutenzione tipo CBM), piuttosto che su scadenze temporali fissate a priori (manutenzione di tipo TBM).

Controllo Vettoriale generalizzato per Macchine Elettriche Trifase

Nell’ambito della presente tesi verrà descritto un approccio generalizzato per il controllo delle macchine elettriche trifasi; la prima parte è incentrata nello sviluppo di una metodologia di modellizzazione generale, ossia in grado di descrivere, da un punto di vista matematico, il comportamento di una generica macchina elettrica, che possa quindi includere in sé stessa tutte le caratteristiche salienti che possano caratterizzare ogni specifica tipologia di macchina elettrica. Il passo successivo è quello di realizzare un algoritmo di controllo per macchine elettriche che si poggi sulla teoria generalizzata e che utilizzi per il proprio funzionamento quelle grandezze offerte dal modello unico delle macchine elettriche. La tipologia di controllo che è stata utilizzata è quella che comunemente viene definita come controllo ad orientamento di campo (FOC), per la quale sono stati individuati degli accorgimenti atti a migliorarne le prestazioni dinamiche e di controllo della coppia erogata. Per concludere verrà presentata una serie di prove sperimentali con lo scopo di mettere in risalto alcuni aspetti cruciali nel controllo delle macchine elettriche mediante un algoritmo ad orientamento di campo e soprattutto di verificare l’attendibilità dell’approccio generalizzato alle macchine elettriche trifasi. I risultati sperimentali confermano quindi l’applicabilità del metodo a diverse tipologie di macchine (asincrone e sincrone) e sono stati verificate nelle condizioni operative più critiche: bassa velocità, alta velocità bassi carichi, dinamica lenta e dinamica veloce.

Asset management of wastewater networks

Asset Management (AM) is a set of procedures operable at the strategic-tacticaloperational level, for the management of the physical asset’s performance, associated risks and costs within its whole life-cycle. AM combines the engineering, managerial and informatics points of view. In addition to internal drivers, AM is driven by the demands of customers (social pull) and regulators (environmental mandates and economic considerations). AM can follow either a top-down or a bottom-up approach. Considering rehabilitation planning at the bottom-up level, the main issue would be to rehabilitate the right pipe at the right time with the right technique. Finding the right pipe may be possible and practicable, but determining the timeliness of the rehabilitation and the choice of the techniques adopted to rehabilitate is a bit abstruse. It is a truism that rehabilitating an asset too early is unwise, just as doing it late may have entailed extra expenses en route, in addition to the cost of the exercise of rehabilitation per se. One is confronted with a typical ‘Hamlet-isque dilemma’ – ‘to repair or not to repair’; or put in another way, ‘to replace or not to replace’. The decision in this case is governed by three factors, not necessarily interrelated – quality of customer service, costs and budget in the life cycle of the asset in question. The goal of replacement planning is to find the juncture in the asset’s life cycle where the cost of replacement is balanced by the rising maintenance costs and the declining level of service. System maintenance aims at improving performance and maintaining the asset in good working condition for as long as possible. Effective planning is used to target maintenance activities to meet these goals and minimize costly exigencies. The main objective of this dissertation is to develop a process-model for asset replacement planning. The aim of the model is to determine the optimal pipe replacement year by comparing, temporally, the annual operating and maintenance costs of the existing asset and the annuity of the investment in a new equivalent pipe, at the best market price. It is proposed that risk cost provide an appropriate framework to decide the balance between investment for replacing or operational expenditures for maintaining an asset. The model describes a practical approach to estimate when an asset should be replaced. A comprehensive list of criteria to be considered is outlined, the main criteria being a visà- vis between maintenance and replacement expenditures. The costs to maintain the assets should be described by a cost function related to the asset type, the risks to the safety of people and property owing to declining condition of asset, and the predicted frequency of failures. The cost functions reflect the condition of the existing asset at the time the decision to maintain or replace is taken: age, level of deterioration, risk of failure. The process model is applied in the wastewater network of Oslo, the capital city of Norway, and uses available real-world information to forecast life-cycle costs of maintenance and rehabilitation strategies and support infrastructure management decisions. The case study provides an insight into the various definitions of ‘asset lifetime’ – service life, economic life and physical life. The results recommend that one common value for lifetime should not be applied to the all the pipelines in the stock for investment planning in the long-term period; rather it would be wiser to define different values for different cohorts of pipelines to reduce the uncertainties associated with generalisations for simplification. It is envisaged that more criteria the municipality is able to include, to estimate maintenance costs for the existing assets, the more precise will the estimation of the expected service life be. The ability to include social costs enables to compute the asset life, not only based on its physical characterisation, but also on the sensitivity of network areas to social impact of failures. The type of economic analysis is very sensitive to model parameters that are difficult to determine accurately. The main value of this approach is the effort to demonstrate that it is possible to include, in decision-making, factors as the cost of the risk associated with a decline in level of performance, the level of this deterioration and the asset’s depreciation rate, without looking at age as the sole criterion for making decisions regarding replacements.

Analisi degli aspetti di qualità nella gestione dei sistemi di drenaggio urbano attraverso modellazione numerica e indagini di campo

In order to protect river water quality, highly affected in urban areas by continuos as intermittent immissions, it is necessary to adopt measures to intercept and treat these polluted flows. In particular during rain events, river water quality is affected by CSOs activation. Built in order to protect the sewer system and the WWTP by increased flows due to heavy rains, CSOs divert excess flows to the receiving water body. On the basis of several scientific papers, and of direct evidences as well, that demonstrate the detrimental effect of CSOs discharges, also the legislative framework moved towards a stream standard point of view. The WFD (EU/69/2000) sets new goals for receiving water quality, and groundwater as well, through an integrated immission/emissions phylosophy, in which emission limits are associated with effluent standards, based on the receiving water characteristics and their specific use. For surface waters the objective is that of a “good” ecological and chemical quality status. A surface water is defined as of good ecological quality if there is only slight departure from the biological community that would be expected in conditions of minimal anthropogenic impact. Each Member State authority is responsible for preparing and implementing a River Basin Management Plan to achieve the good ecological quality, and comply with WFD requirements. In order to cope with WFD targets, and thus to improve urban receiving water quality, a CSOs control strategy need to be implemented. Temporarily storing the overflow (or at least part of it) into tanks and treating it in the WWTP, after the end of the storm, showed good results in reducing total pollutant mass spilled into the receiving river. Italian State Authority, in order to comply with WFD statements, sets general framework, and each Region has to adopt a Water Remediation Plan (PTA, Piano Tutela Acque), setting goals, methods, and terms, to improve river water quality. Emilia Romagna PTA sets 25% reduction up to 2008, and 50% reduction up to 2015 fo total pollutants masses delivered by CSOs spills. In order to plan remediation actions, a deep insight into spills dynamics is thus of great importance. The present thesis tries to understand spills dynamics through a numerical and an experimental approach. A four months monitoring and sampling campaign was set on the Bologna sewer network, and on the Navile Channel, that is the WWTP receiving water , and that receives flows from up to 28 CSOs during rain events. On the other hand, the full model of the sewer network, was build with the commercial software InfoWorks CS. The model was either calibrated with the data from the monitoring and sampling campaign. Through further model simulations interdependencies among masses spilled, rain characteristics and basin characteristics are looked for. The thesis can be seen as a basis for further insighs and for planning remediation actions.

Development and characterization of a distributed measurement system for the evaluation of voltage quality in electric power networks

The research activity carried out during the PhD course in Electrical Engineering belongs to the branch of electric and electronic measurements. The main subject of the present thesis is a distributed measurement system to be installed in Medium Voltage power networks, as well as the method developed to analyze data acquired by the measurement system itself and to monitor power quality. In chapter 2 the increasing interest towards power quality in electrical systems is illustrated, by reporting the international research activity inherent to the problem and the relevant standards and guidelines emitted. The aspect of the quality of voltage provided by utilities and influenced by customers in the various points of a network came out only in recent years, in particular as a consequence of the energy market liberalization. Usually, the concept of quality of the delivered energy has been associated mostly to its continuity. Hence the reliability was the main characteristic to be ensured for power systems. Nowadays, the number and duration of interruptions are the “quality indicators” commonly perceived by most customers; for this reason, a short section is dedicated also to network reliability and its regulation. In this contest it should be noted that although the measurement system developed during the research activity belongs to the field of power quality evaluation systems, the information registered in real time by its remote stations can be used to improve the system reliability too. Given the vast scenario of power quality degrading phenomena that usually can occur in distribution networks, the study has been focused on electromagnetic transients affecting line voltages. The outcome of such a study has been the design and realization of a distributed measurement system which continuously monitor the phase signals in different points of a network, detect the occurrence of transients superposed to the fundamental steady state component and register the time of occurrence of such events. The data set is finally used to locate the source of the transient disturbance propagating along the network lines. Most of the oscillatory transients affecting line voltages are due to faults occurring in any point of the distribution system and have to be seen before protection equipment intervention. An important conclusion is that the method can improve the monitored network reliability, since the knowledge of the location of a fault allows the energy manager to reduce as much as possible both the area of the network to be disconnected for protection purposes and the time spent by technical staff to recover the abnormal condition and/or the damage. The part of the thesis presenting the results of such a study and activity is structured as follows: chapter 3 deals with the propagation of electromagnetic transients in power systems by defining characteristics and causes of the phenomena and briefly reporting the theory and approaches used to study transients propagation. Then the state of the art concerning methods to detect and locate faults in distribution networks is presented. Finally the attention is paid on the particular technique adopted for the same purpose during the thesis, and the methods developed on the basis of such approach. Chapter 4 reports the configuration of the distribution networks on which the fault location method has been applied by means of simulations as well as the results obtained case by case. In this way the performance featured by the location procedure firstly in ideal then in realistic operating conditions are tested. In chapter 5 the measurement system designed to implement the transients detection and fault location method is presented. The hardware belonging to the measurement chain of every acquisition channel in remote stations is described. Then, the global measurement system is characterized by considering the non ideal aspects of each device that can concur to the final combined uncertainty on the estimated position of the fault in the network under test. Finally, such parameter is computed according to the Guide to the Expression of Uncertainty in Measurements, by means of a numeric procedure. In the last chapter a device is described that has been designed and realized during the PhD activity aiming at substituting the commercial capacitive voltage divider belonging to the conditioning block of the measurement chain. Such a study has been carried out aiming at providing an alternative to the used transducer that could feature equivalent performance and lower cost. In this way, the economical impact of the investment associated to the whole measurement system would be significantly reduced, making the method application much more feasible.

Validazione in torrenti appenninici monitorati di un modello fisicamente basato per la stima del deflusso solido sospeso

Il modello afflussi-deflussi e di erosione Kineros2, fisicamente basato, distribuito e a scala di evento, è stato applicato a due bacini idrografici montani della provincia di Bologna (Italia) al fine di testare e valutare il suo funzionamento in ambiente appenninico. Dopo la parametrizzazione dei due bacini, Kineros2 è stato calibrato e validato utilizzando dati sperimentali di portata e di concentrazione dei solidi sospesi, collezionati alla chiusura dei bacini grazie alla presenza di due stazioni di monitoraggio idrotorbidimetrico. La modellazione ha consentito di valutare la capacità del modello di riprodurre correttamente le dinamiche idrologiche osservate, nonchè di trarre conclusioni sulle sue potenzialità e limitazioni.

Abbandono del territorio e dissesto idrogeologico in Appennino bolognese: analisi delle dinamiche e degli interventi di gestione idraulico-forestale

The abandonment of less productive fields and agro-forest activities has occured in the last decades, interesting large mountain areas in all mediterranean basin. Until the fifties, agricultural practices dealt mainly with soil surface and surface runoff control systems. However, the apparent sustainability of soil use results often in contrast with historical documents, witnessing heavy hydrogeological instability, in naturally fragile areas. The research focused on the dynamics and effects of post-coltural land abandonment in a critical mountain area of the Reno River. The Reno River rappresents a typical Tuscan-Emilian Apennines Watershed where soil erosion occurs under very different conditions depending on interactions between land use, climate, geomorphology and lithology. Landslides are largely rappresented, due to the diffusion of clay hill slopes. Recent researches suggest that climatic variability will increase as a consequence of global climate change, resulting in greater frequency and intensity of extreme weather events, which could increase rates of erosion, landslides reactivations and diffusion of calanchive basins. As far as hill slopes are concerned, instability is today basically due to intrinsic factors, as the Apennine range is a rather young formation, in geological terms, and is mainly formed by sedimentary rocks with high occurrence of clays. Therefore landslides and rockfalls are very frequent, while surface soil erosion is generally low and anyway concentrated in the low Apennine, where intensive farming is still economically worth. The study, supported by GIS use, analyses the main fisical characteristics of the area and the historical changes of land use, and focalizes the dynamics of spontaneous reafforestation. Futhermore, the research studies the results of soil bioengineering and surface water control solutions for the restablishment of landslides occured in the last period. Infact soil bioengineering has been recently used in different situations in order to consolidate slopes and hillsides and prevent erosion; when applied, it gave good results, both in terms of engineering efficiency and vegetational development, expecially if combined with a good hydraulic control, thus proving to be an actual alternative to other techniques with heavier environmental impacts. Research into the specific site features and the use of proper plant species is vital to the success of bioengineering works.

Ottimizzazione delle reti di distribuzione idrica tramite algoritmi genetici multi-obiettivo

Water distribution networks optimization is a challenging problem due to the dimension and the complexity of these systems. Since the last half of the twentieth century this field has been investigated by many authors. Recently, to overcome discrete nature of variables and non linearity of equations, the research has been focused on the development of heuristic algorithms. This algorithms do not require continuity and linearity of the problem functions because they are linked to an external hydraulic simulator that solve equations of mass continuity and of energy conservation of the network. In this work, a NSGA-II (Non-dominating Sorting Genetic Algorithm) has been used. This is a heuristic multi-objective genetic algorithm based on the analogy of evolution in nature. Starting from an initial random set of solutions, called population, it evolves them towards a front of solutions that minimize, separately and contemporaneously, all the objectives. This can be very useful in practical problems where multiple and discordant goals are common. Usually, one of the main drawback of these algorithms is related to time consuming: being a stochastic research, a lot of solutions must be analized before good ones are found. Results of this thesis about the classical optimal design problem shows that is possible to improve results modifying the mathematical definition of objective functions and the survival criterion, inserting good solutions created by a Cellular Automata and using rules created by classifier algorithm (C4.5). This part has been tested using the version of NSGA-II supplied by Centre for Water Systems (University of Exeter, UK) in MATLAB® environment. Even if orientating the research can constrain the algorithm with the risk of not finding the optimal set of solutions, it can greatly improve the results. Subsequently, thanks to CINECA help, a version of NSGA-II has been implemented in C language and parallelized: results about the global parallelization show the speed up, while results about the island parallelization show that communication among islands can improve the optimization. Finally, some tests about the optimization of pump scheduling have been carried out. In this case, good results are found for a small network, while the solutions of a big problem are affected by the lack of constraints on the number of pump switches. Possible future research is about the insertion of further constraints and the evolution guide. In the end, the optimization of water distribution systems is still far from a definitive solution, but the improvement in this field can be very useful in reducing the solutions cost of practical problems, where the high number of variables makes their management very difficult from human point of view.

Two fluid numerical model for coastal applications

Wave breaking is an important coastal process, influencing hydro-morphodynamic processes such as turbulence generation and wave energy dissipation, run-up on the beach and overtopping of coastal defence structures. During breaking, waves are complex mixtures of air and water (“white water”) whose properties affect velocity and pressure fields in the vicinity of the free surface and, depending on the breaker characteristics, different mechanisms for air entrainment are usually observed. Several laboratory experiments have been performed to investigate the role of air bubbles in the wave breaking process (Chanson & Cummings, 1994, among others) and in wave loading on vertical wall (Oumeraci et al., 2001; Peregrine et al., 2006, among others), showing that the air phase is not negligible since the turbulent energy dissipation involves air-water mixture. The recent advancement of numerical models has given valuable insights in the knowledge of wave transformation and interaction with coastal structures. Among these models, some solve the RANS equations coupled with a free-surface tracking algorithm and describe velocity, pressure, turbulence and vorticity fields (Lara et al. 2006 a-b, Clementi et al., 2007). The single-phase numerical model, in which the constitutive equations are solved only for the liquid phase, neglects effects induced by air movement and trapped air bubbles in water. Numerical approximations at the free surface may induce errors in predicting breaking point and wave height and moreover, entrapped air bubbles and water splash in air are not properly represented. The aim of the present thesis is to develop a new two-phase model called COBRAS2 (stands for Cornell Breaking waves And Structures 2 phases), that is the enhancement of the single-phase code COBRAS0, originally developed at Cornell University (Lin & Liu, 1998). In the first part of the work, both fluids are considered as incompressible, while the second part will treat air compressibility modelling. The mathematical formulation and the numerical resolution of the governing equations of COBRAS2 are derived and some model-experiment comparisons are shown. In particular, validation tests are performed in order to prove model stability and accuracy. The simulation of the rising of a large air bubble in an otherwise quiescent water pool reveals the model capability to reproduce the process physics in a realistic way. Analytical solutions for stationary and internal waves are compared with corresponding numerical results, in order to test processes involving wide range of density difference. Waves induced by dam-break in different scenarios (on dry and wet beds, as well as on a ramp) are studied, focusing on the role of air as the medium in which the water wave propagates and on the numerical representation of bubble dynamics. Simulations of solitary and regular waves, characterized by both spilling and plunging breakers, are analyzed with comparisons with experimental data and other numerical model in order to investigate air influence on wave breaking mechanisms and underline model capability and accuracy. Finally, modelling of air compressibility is included in the new developed model and is validated, revealing an accurate reproduction of processes. Some preliminary tests on wave impact on vertical walls are performed: since air flow modelling allows to have a more realistic reproduction of breaking wave propagation, the dependence of wave breaker shapes and aeration characteristics on impact pressure values is studied and, on the basis of a qualitative comparison with experimental observations, the numerical simulations achieve good results.

Dimensionamento di invasi per il controllo dei deflussi nei bacini urbanizzati

Urbanization is a continuing phenomenon in all the world. Grasslands, forests, etc. are being continually changed to residential, commercial and industrial complexes, roads and streets, and so on. One of the side effects of urbanization with which engineers and planners must deal with, is the increase of peak flows and volumes of runoff from rainfall events. As a result, the urban drainage and flood control systems must be designed to accommodate the peak flows from a variety of storms that may occur. Usually the peak flow, after development, is required not to exceed what would have occurred from the same storm under conditions existing prior to development. In order to do this it is necessary to design detention storage to hold back runoff and to release it downstream at controlled rates. In the first part of the work have been developed various simplified formulations that can be adopted for the design of stormwater detention facilities. In order to obtain a simplified hydrograph were adopted two approaches: the kinematic routing technique and the linear reservoir schematization. For the two approaches have been also obtained other two formulations depending if the IDF (intensity-duration-frequency) curve is described with two or three parameters. Other formulations have been developed taking into account if the outlet have a constant discharge or it depends on the water level in the pond. All these formulations can be easily applied when are known the characteristics of the drainage system and maximum discharge that these is in the outlet and has been defined a Return Period which characterize the IDF curve. In this way the volume of the detention pond can be calculated. In the second part of the work have been analyzed the design of detention ponds adopting continuous simulation models. The drainage systems adopted for the simulations, performed with SWMM5, are fictitious systems characterized by different sizes, and different shapes of the catchments and with a rainfall historical time series of 16 years recorded in Bologna. This approach suffers from the fact that continuous record of rainfall is often not available and when it is, the cost of such modelling can be very expensive, and that the majority of design practitioners are not prepared to use continuous long term modelling in the design of stormwater detention facilities. In the third part of the work have been analyzed statistical and stochastic methodologies in order to define the volume of the detention pond. In particular have been adopted the results of the long term simulation, performed with SWMM, to obtain the data to apply statistic and stochastic formulation. All these methodologies have been compared and correction coefficient have been proposed on the basis of the statistic and stochastic form. In this way engineers which have to design a detention pond can apply a simplified procedure appropriately corrected with the proposed coefficient.

Stategie di trattamento elettrico nei pazienti con insufficienza cardiaca: valutazione dei risultati a distanza

Lo scompenso cardiaco è una sindrome clinica complessa di notevole prevalenza ed incidenza nella popolazione generale, con elevata mortalità e morbidità. Le numerose alterazioni strutturali e funzionali che lo caratterizzano sono in grado di generare contemporaneamente diversi tipi di alterazioni del ritmo: dalle tachiaritmie ventricolari/sopraventricolari alle turbe della conduzione dell’impulso con bradi-aritmie e dissincronie di contrazione. La cardioversione della fibrillazione atriale e la resincronizzazione cardiaca rappresentano due terapie elettriche molto importanti in tale contesto. Le modificazioni emodinamiche, funzionali e neuro-ormonali indotte da tali trattamenti, tanto in acuto che a medio/lungo termine, possono generare numerose informazioni sulla fisio-patologia di questa sindrome. Il progetto scientifico alla base del presente manoscritto è costituito da due studi volti ad affrontare separatamente le tematiche accennate. Il primo studio è stato focalizzato sulle modificazioni indotte in 38 pazienti dalla terapia di resincronizzazione cardiaca sui parametri di circolazione periferica. I risultati ottenuti evidenziano come il trattamento consenta un incremento del flusso muscolare, soprattutto in chi presenterà un rimodellamento ventricolare inverso. La diversa eziologia sottostante (ischemica vs. non ischemica) appare influenzare i parametri relativi alla circolazione periferica tanto in acuto, quanto in cronico. Il diverso comportamento in merito alle variabili della circolazione periferica nelle valutazioni seriate suggerisce che la terapia di resincronizzazione cardiaca abbia, principalmente nei pazienti responders, effetti non solo “centrali”, e che essi non siano puramente meccanici ma mediati da fattori probabilmente di natura neuro-ormonale. Il secondo studio si è occupato della cardioversione elettrica esterna di fibrillazione atriale, un’aritmia che presenta strette relazioni con l’insufficienza cardiaca. 242 pazienti sono stati sottoposti a cardioversione elettrica esterna con onda bifasica, utilizzando due 1 diverse configurazioni di erogazione dell’energia: antero-posteriore con patch adesivi e antero-apicale con piastre standard. Il ripristino del ritmo sinusale è stato ottenuto in oltre l’80% dei pazienti già col primo shock a 120J. Sebbene fra le due metodiche non si evidenzi una significatività in termini di efficacia, i risultati ottenuti suggeriscono che la scelta della specifica configurazione di shock dovrebbe prendere in considerazione anche alcune variabili biometriche: peso, altezza e superficie corporea del paziente. Il ripristino ed il mantenimento del ritmo sinusale inducono un’importante modificazione della concentrazione di NT-pro-BNP. Un’elevata attivazione neuro-ormonale pre-procedura predispone alle recidive a medio-lungo termine, mentre le recidive nel breve-medio periodo appaiono influenzate da tale fattore solo in corso di profilassi anti-aritmica per il mantenimento del ritmo sinusale. In conclusione i risultati del progetto di ricerca sottolineano come trattamenti mirati a parametri strettamente cardiaci (ritmo e conduzione dell’impulso) siano in grado di determinare importanti modificazioni sugli equilibri emodinamici e neuro-ormonali dell’intero organismo, confermando la stretta relazione tra questi parametri e l’evoluzione del quadro clinico.