Colivicchi F, Orso F, Oliva F
… +21 more, Abrignani MG, Arca M, Averna M, Catapano AL, Ceseri M, Di Fusco SA, Di Lenarda A, Fattirolli F, Lucci D, Gonzini L, Gulizia MM, Riccio C, Temporelli PL, Bertaina M, Cortese F, Nuzzi V, Poli S, Reccia M, Maggioni AP, Gabrielli D, a nome dei Ricercatori dello Studio BRING-UP Prevenzione
Ribeiro Carvalho C, Bernardo MC, Martins Moreira I
… +3 more, Moz M, Baptista A, Moreira I
G Ital Cardiol (Rome)
· 2025 Jun · PMID 40432468
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Thyrotoxic cardiomyopathy is a rare but dreaded form of dilated cardiomyopathy. Its prompt diagnosis is crucial, not only due to the elevated risk of cardiovascular events and mortality, but also because cardiac function...Thyrotoxic cardiomyopathy is a rare but dreaded form of dilated cardiomyopathy. Its prompt diagnosis is crucial, not only due to the elevated risk of cardiovascular events and mortality, but also because cardiac function may fully recover once a euthyroid state is achieved. Furthermore, thyrotoxicosis is associated with a hypercoagulable state, known to increase the risk of thrombotic events regardless of the CHA2DS2-VA score. However, identification of intracardiac biventricular thrombi is an exceedingly rare presentation. We report the case of a 50-year-old woman, who had previously undergone total thyroidectomy, who presented to the emergency department with acute heart failure (INTERMACS 3). Echocardiography revealed a severely dilated left ventricle and a reduced ejection fraction with biventricular thrombi, further complicated by pulmonary thromboembolism. Investigation revealed an undiagnosed recurrence of intrathoracic goiter which, in addition to ongoing levothyroxine supplementation, led to the development of a thyrotoxic cardiomyopathy. Following the excision of the remaining thyroid tissue, she evolved with complete recovery of cardiac function. This case illustrates a unique presentation of a rare disease, highlighting the importance of keeping in mind etiologic causes that might initially be ruled out.
Nuzzi V, Sciacca S, Lucchino A
… +19 more, Manca P, Panarello G, Rossetti M, Fontana A, Leone S, Scarlata M, Bonicolini E, Mulè M, Raffa G, Morsolini M, Parisi F, Cannata S, Gandolfo C, Burgio G, Musumeci F, Faletra FF, Arcadipane A, Pilato M, Cipriani MG
G Ital Cardiol (Rome)
· 2025 Jun · PMID 40432466
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BACKGROUND: Advanced heart failure is a condition where pharmacological therapies have a limited impact on prognosis. Left ventricular assist devices (LVAD) have been shown to improve survival and quality of life in well...BACKGROUND: Advanced heart failure is a condition where pharmacological therapies have a limited impact on prognosis. Left ventricular assist devices (LVAD) have been shown to improve survival and quality of life in well-selected patients in this setting. LVAD technology has evolved over time, leading to more efficient devices with fewer complications. METHODS: This retrospective, single-center study analyzes outcomes of LVAD implants at ISMETT, comparing two devices: HeartWare (HVAD) and HeartMate 3 (HM3). Event analyses were conducted over the first year of follow-up. The primary endpoint was mortality, while secondary endpoints included adverse events such as stroke, driveline infections, heart failure, and pump thrombosis. RESULTS: Between 2010 and 2024, a total of 109 LVAD were implanted (10.75 implants/year). One-year survival was higher in HM3 patients (84.6%) compared to HVAD patients (78.6%). Cerebrovascular events were significantly less frequent in the HM3 group. Driveline infections were comparable between the two devices. Pump thrombosis occurred in 15.7% of HVAD patients and in none of HM3 patients. Gastrointestinal bleeding risk was significantly higher in the HVAD group, whereas the risk of right ventricular failure was similar between groups. CONCLUSIONS: HM3 LVADs offer a superior safety profile, with reduced mortality and fewer complications compared to HVADs, reflecting technological advancements in mechanical support for advanced heart failure. This study provides new insights into LVAD patient outcomes in Italy, contributing to improved treatment strategies for this high-risk population.
Di Fusco SA, Castelletti S, Chimenti C
… +16 more, Nesti M, Pignalberi C, Grego S, Costantino J, Matteucci A, Gil Ad V, Lucà F, Bilato C, Riccio C, Nardi F, Geraci G, Gabrielli D, Grimaldi M, Oliva F, Colivicchi F, Area Prevenzione Cardiovascolare, Area Aritmie, Area Malattie Rare, e Gruppo di Studio Approccio Multi-specialistico e Multi-integrato del paziente cardiologico dell’Associazione Nazionale Medici Cardiologi Ospedalieri (ANMCO)
G Ital Cardiol (Rome)
· 2025 Jun · PMID 40432465
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Genetic tests are useful in the, even early, diagnosis and management of various hereditary pathologies with cardiovascular involvement such as cardiomyopathies, arrhythmic diseases, and aortic diseases. The diagnosis of...Genetic tests are useful in the, even early, diagnosis and management of various hereditary pathologies with cardiovascular involvement such as cardiomyopathies, arrhythmic diseases, and aortic diseases. The diagnosis of these diseases can be challenging in athletes where the ECG and echocardiogram show physiological alterations due to intense physical activity. However, if performed inappropriately and if not interpreted by a team of professionals with multidisciplinary skills, genetic tests can lead to unnecessary disqualifications from sports activity with important psychological repercussions as well as on the athlete's career. This review analyzes the potential role of genetic tests in the presence of clinical/instrumental findings (ECG, imaging) that require a precise distinction between adaptive changes in the athlete's heart and hereditary pathologies. Furthermore, the impact of test results in prognostic stratification in athletes with a defined diagnosis is discussed. The objective is to provide clinicians, who in their work find dubious clinical pictures or previous diagnoses of dubious prognostic significance, with the basic tools to decide when to recommend genetic testing. The review examines the role of genetic tests in athletes in three specific cardiological contexts: cardiomyopathies, channelopathies, and aortic diseases.
Abrignani MG, Di Fusco SA, Bugani G
… +3 more, Intravaia RCM, Abrignani V, Colivicchi F
G Ital Cardiol (Rome)
· 2025 Jun · PMID 40432464
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Several epidemiological studies have found that noise, particularly that related to means of transport, can increase the risk of cardiovascular morbidity and mortality, with high-quality evidence for ischemic heart disea...Several epidemiological studies have found that noise, particularly that related to means of transport, can increase the risk of cardiovascular morbidity and mortality, with high-quality evidence for ischemic heart disease. According to the World Health Organization, over 1.6 million years of healthy life are lost every year in Western Europe due to traffic-related noise. Noise, especially at night, causes fragmentation and shortening of sleep, increased levels of stress hormones and oxidative stress, with adverse effects on the cardio-cerebrovascular system. These factors can promote the appearance of vascular dysfunction, inflammation and hypertension, thus increasing the risk of cardiovascular disease. In this review, we address the indirect effects of noise on cardiovascular health. In particular, we provide an up-to-date overview of current epidemiological research on the effects of noise on risk factors and cardiovascular diseases, discussing the pathophysiological hypotheses proposed by the most recent clinical and experimental studies, aimed at providing a reliable explanation of this relationship. Finally, we describe current and future noise mitigation strategies.
Carluccio M, Tamborrino PP, Favilli S
… +18 more, Mecacci F, Pacifici M, Voller F, Spaziani G, Casolo G, Talini E, Misuraca L, Magnaghi GS, Del Meglio J, Biagini D, Cesareo F, Padeletti M, Colivicchi F, Geraci G, Grimaldi M, Milli M, Oliva F, Zucchelli G
G Ital Cardiol (Rome)
· 2025 Jun · PMID 40432463
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Maternal mortality represents a crucial indicator of the quality of care, as stated by the World Health Organization. Non-obstetric mortality in Italy is equally derived from cardiovascular and hypertensive problems with...Maternal mortality represents a crucial indicator of the quality of care, as stated by the World Health Organization. Non-obstetric mortality in Italy is equally derived from cardiovascular and hypertensive problems with an upward trend. The increased incidence of cardiovascular risk factors, the rise in maternal age, and the use of assisted reproduction suggest a growing impact of arrhythmias on maternal morbidity and mortality. This review article outlines the management of the most common arrhythmias during pregnancy, following the Heart Rhythm Society consensus document. The general principle is that any treatment should not be delayed in urgent situations due to concerns about fetal risk, as restoring sinus rhythm and adequate maternal hemodynamics is the primary objective of therapy. Despite limitations associated with data from non-randomized studies, key antiarrhythmic drugs are relatively safe. Electrical cardioversion is risk-free with certain management peculiarities. When required, ablation therapy or the implantation of intracardiac devices with zero or minimal fluoroscopy can be considered. Clinically significant arrhythmias and the management of patients with structural heart disease or channelopathies require multidisciplinary care in a cardio-obstetric team, with particular attention to delivery setting and timing.
G Ital Cardiol (Rome)
· 2025 Jun · PMID 40432461
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The long QT syndrome (LQTS) is a cardiac disease of genetic origin which, unless properly diagnosed and managed, carries a high risk for sudden cardiac death, especially among youngsters. At the same time, the available...The long QT syndrome (LQTS) is a cardiac disease of genetic origin which, unless properly diagnosed and managed, carries a high risk for sudden cardiac death, especially among youngsters. At the same time, the available therapies are quite effective. Most lethal episodes occur as the sentinel event, stressing the fact that most of the time there is no room for error in diagnosis or management. Here, we endeavored to share the 50-year specific experience of our group, by critically discussing both the approach and management of LQTS. Following an analysis of the clinical impact of the genetic findings, essential for personalized management, we focused on diagnosis and especially on management by analyzing the therapies currently available (beta-blockers, left cardiac sympathetic denervation, mexiletine and the implantable cardioverter-defibrillator) and those which are still experimental. We thought it appropriate to show examples of major clinical errors which unfortunately keep recurring. LQTS is a moving target, because the arrhythmic risk can decrease in response to therapy or increase for still unknown reasons: this forces the need for a constant reassessment of the arrhythmic risk of these patients. This regular reassessment, which we deem essential to protect the patients' life, represents an integral part of our management strategy because it allows yearly therapeutic optimization, key to our patients' survival. Practically, almost all patients with LQTS could have an essentially normal life, if they are correctly managed.
Buttiglione G, Francica A, Comisso M
… +11 more, Russo M, Santoro G, Lodo V, Matteucci M, Di Mauro M, Pollari F, Onorati F, Barili F, Parolari A, Pilato M, a nome della Task Force SICCH Young della Società Italiana di Chirurgia Cardiaca
G Ital Cardiol (Rome)
· 2025 Jun · PMID 40432460
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The Impella 5.5® (Abiomed Inc., Danvers, MA, USA) is a temporary mechanical circulatory support device utilized for the management of cardiogenic shock. In this review, we outline the device's key features, paying partic...The Impella 5.5® (Abiomed Inc., Danvers, MA, USA) is a temporary mechanical circulatory support device utilized for the management of cardiogenic shock. In this review, we outline the device's key features, paying particular attention to its indications and contraindications, the surgical technique for implantation, and potential complications. Additionally, we emphasize the potential benefits of using the Impella as a bridge to left ventricular assistance device implantation, a safe strategy to mitigate the risk of right heart failure.
G Ital Cardiol (Rome)
· 2025 Jun · PMID 40432458
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Artificial intelligence (AI) is rapidly transforming cardiovascular imaging, offering innovative solutions to enhance diagnostic precision, prognostic accuracy, and therapeutic decision-making. This review explores the r...Artificial intelligence (AI) is rapidly transforming cardiovascular imaging, offering innovative solutions to enhance diagnostic precision, prognostic accuracy, and therapeutic decision-making. This review explores the role of AI in cardiovascular imaging, highlighting its applications, advantages, limitations, and future challenges. The discussion is structured by imaging modalities, including echocardiography, cardiac and coronary computed tomography, cardiac magnetic resonance, and nuclear cardiology. For each modality, we examine AI's contributions across the patient care continuum: from patient selection and image acquisition to quantitative and qualitative analysis, interpretation support, prognostic stratification, therapeutic guidance, and integration with other clinical data. AI applications demonstrate significant potential to streamline workflows, improve diagnostic accuracy, and provide advanced insights for complex clinical scenarios. However, several limitations must be addressed. Many AI algorithms are developed using data from single, high-expertise centers, raising concerns about their generalizability to routine clinical practice. In some cases, these algorithms may even produce misleading results. Additionally, the "black box" nature of certain AI systems poses challenges for cardiologists, making discrepancies difficult to interpret or rectify. Importantly, AI should be seen as a complementary tool rather than a replacement for cardiologists, designed to expedite routine tasks and allow clinicians to focus on complex cases. Future challenges include fostering clinician involvement in algorithm development and extending AI implementation to peripheral healthcare centers. This approach aims to enhance accessibility, understanding, and applicability of AI in everyday clinical practice, ultimately democratizing its benefits and ensuring equitable integration into healthcare systems.
Chimenti C, Iacovoni A, Montalto A
… +41 more, Emdin M, Olivotto I, Basso C, De Chiara BC, Bottillo I, Ciampi CM, Dellegrottaglie S, Di Marco M, Gentile P, Girolami F, Grammatico P, Iascone M, La Franca E, Lofiego C, Matteucci A, Pasqualucci D, Pentiricci S, Perugini E, Pieroni M, Quarta G, Re F, Scelsi L, Todiere G, Alfarano M, De Gaspari M, Bilato C, Corda M, De Luca L, Geraci G, Milli M, Navazio A, Pascale V, Riccio C, Scicchitano P, Tizzani E, Gulizia MM, Nardi F, Gabrielli D, Colivicchi F, Grimaldi M, Oliva F
G Ital Cardiol (Rome)
· 2025 May · PMID 40292507
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Hypertrophic cardiomyopathy (HCM) is a non-rare genetic cardiomyopathy, with an estimated prevalence of 1:500, characterized by an increase in the left ventricular wall thickness in absence of increased loading condition...Hypertrophic cardiomyopathy (HCM) is a non-rare genetic cardiomyopathy, with an estimated prevalence of 1:500, characterized by an increase in the left ventricular wall thickness in absence of increased loading conditions. The hypertrophy is mostly asymmetric and predominantly affects the basal septum and anterior wall. Left ventricular outflow tract obstruction, at rest or after provocative tests, is detected in many patients and represents the primary cause of reduced functional capacity, as well as an independent predictor of sudden cardiac death and advanced heart failure. Until about 1 year ago, symptomatic patients despite maximal therapy with beta-blockers or calcium channel blockers, with or without disopyramide, had only basal septal reduction therapy via myectomy or alcohol septal ablation as additional therapeutic options. Today, a new class of drugs that inhibit cardiac myosin activity is available for patients with obstructive HCM.In light of the new treatment perspectives, the correct clinical-therapeutic classification of affected patients becomes of fundamental importance for the cardiologist. The aim of this position paper is to increase the knowledge of cardiologists in the field of HCM, defining its epidemiological, genetic and pathological characteristics, identifying the diagnostic criteria and instrumental methods capable of stratifying the risk profile, with the aim of an optimal therapy tailored on the single patient.
Chimenti C, Porcari A, Cittar M
… +15 more, Aimo A, Musca F, Cipriani A, Zuin M, Longhi S, Di Lenarda A, Merlo M, Iacoviello M, Canepa M, Limongelli G, Emdin M, Colivicchi F, Perrone Filardi P, Oliva F, Sinagra G
G Ital Cardiol (Rome)
· 2025 May · PMID 40292506
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BACKGROUND: The national survey of the SIC-ANMCO Amyloidosis Centers was designed to create a geographical mapping of the centers that identify and follow patients with cardiac amyloidosis in Italy and to describe their...BACKGROUND: The national survey of the SIC-ANMCO Amyloidosis Centers was designed to create a geographical mapping of the centers that identify and follow patients with cardiac amyloidosis in Italy and to describe their diagnostic capabilities and multidisciplinary organization. METHODS: The survey was administered to 212 centers in Italy. Among them, 153 centers responded (72%), 31/35 (89%) of which were academic medical centers and 122/177 (69%) hospitals. RESULTS: The results revealed a prevalence of centers in the North and Center of Italy compared to the South and the Islands, highlighting a greater number of patients in heart failure/cardiomyopathy clinics in hospitals (53%) and in clinics dedicated to amyloidosis in academic medical centers (71%). Most centers have an internal multidisciplinary collaboration network with the neurologist (82% in total, 97% in academic medical centers and 78% in hospitals) and the hematologist (69% in total, in 94% and 63%, respectively) and have the possibility of performing on-site cardiac magnetic resonance imaging (74%, in 94% and 68%, respectively) and scintigraphy with bone tracers (52%, in 91% and 44%, respectively), or alternatively to refer patients to other centers thanks to well-structured or occasional collaborations. Conversely, only a minority of centers perform endomyocardial biopsy (31%, in 71% of academic medical centers and in 20% of hospitals) and a smaller number of academic medical centers perform sophisticated amyloid tissue typing techniques such as immunogold labeling (11%) and mass spectrometry (4%). CONCLUSIONS: The survey provided important information on the current Italian situation, underlining the importance of collaboration between the various levels of the network, to guarantee the best possible pathways and treatments for all patients with amyloidosis.
G Ital Cardiol (Rome)
· 2025 May · PMID 40292505
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In the past few years, computed tomography coronary angiography (CTCA) has rapidly become a widely used diagnostic tool in several clinical settings and is recommended by the European guidelines with a high degree of rec...In the past few years, computed tomography coronary angiography (CTCA) has rapidly become a widely used diagnostic tool in several clinical settings and is recommended by the European guidelines with a high degree of recommendation in patients with suspected coronary artery disease. The rapid accumulation of evidence is tumultuous and clinical use has grown in parallel with the possibility of offering significant advantages in many areas. Today, CTCA is used both in the diagnosis of low-risk chest pain in emergency departments and in the recognition and prognostic assessment of stable coronary artery disease. By identifying the presence, extent, and quality of atherosclerotic disease, CTCA today offers an important tool for the identification of the disease, promoting the best therapeutic choices with significant prognostic implications, a high safety profile and potentially significant savings in resources. New applications and evidence are accumulating thanks to the marriage of CTCA with artificial intelligence. Alongside increasing accuracy, new risk markers have been identified that enrich the informative content of this method. This review reports the most significant studies that have marked this path so far.
Fortuni F, Ciliberti G, Gori M
… +13 more, Scicchitano P, Magnesa M, Spinelli A, Vitale E, Di Nora C, Franchin L, Cornara S, Manca P, Cangemi S, Carigi S, Colivicchi F, Grimaldi M, Oliva F
G Ital Cardiol (Rome)
· 2025 May · PMID 40292504
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Patients with heart failure (HF) frequently experience iron deficiency, with an estimated prevalence of sideropenia around 50%. In HF patients, iron deficiency is associated with reduced functional capacity, lower qualit...Patients with heart failure (HF) frequently experience iron deficiency, with an estimated prevalence of sideropenia around 50%. In HF patients, iron deficiency is associated with reduced functional capacity, lower quality of life, and an increased risk of hospitalizations and mortality. Therefore, timely diagnosis and treatment of sideropenia are essential to improve clinical outcomes in HF patients with reduced or mildly reduced ejection fraction, while data on the benefits of iron supplementation in HF patients with preserved ejection fraction remain limited. This review aims to provide an overview of the prevalence, diagnostic criteria, available evidence, indications, iron formulations, and recommended protocols for identifying and treating iron deficiency in HF patients.
Zuin M, Pavan D, Francese GM
… +6 more, Scagnetto A, Radesich C, Ranzato K, Valente S, Gensini GF, Di Lenarda A
G Ital Cardiol (Rome)
· 2025 May · PMID 40292503
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Artificial intelligence (AI) is revolutionizing cardiology, offering new opportunities to improve diagnosis, therapy, and prevention of cardiovascular diseases. By analyzing large amounts of data and supporting clinical...Artificial intelligence (AI) is revolutionizing cardiology, offering new opportunities to improve diagnosis, therapy, and prevention of cardiovascular diseases. By analyzing large amounts of data and supporting clinical decisions, AI can simplify modern medical complexities. However, its development is limited by methodological, ethical, and organizational obstacles. This review aims to present the potential applications of AI in cardiology in a practical and accessible manner, exploring key algorithms, opportunities, and limitations. It is crucial to address the challenges associated with AI to ensure its ethical and responsible use in support of clinical expertise while actively promoting collaboration between clinicians and information technology specialists to fully realize the potential of AI in daily cardiological practice.