Biffi A, Fernando F, Messina M
… +2 more, De Martino L, Palermi S
G Ital Cardiol (Rome)
· 2026 Mar · PMID 41738419
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Cardiovascular diseases remain the leading cause of death and disability in industrialized countries. The workplace represents an ideal setting for primary prevention, allowing for the early identification of individuals...Cardiovascular diseases remain the leading cause of death and disability in industrialized countries. The workplace represents an ideal setting for primary prevention, allowing for the early identification of individuals at cardiovascular risk who are often not reached by traditional screening pathways. In this context, Occupational Cardiology has emerged as a new branch of preventive cardiology, focused on population health within occupational settings. The aim of this review article is to describe the role, fields of application, and clinical, organizational, and economic potential of Occupational Cardiology, with particular reference to Corporate Wellness programs and high-risk occupational groups. Corporate Wellness programs encompass clinical and instrumental screenings, promotion of physical activity, health education, stress management, and the utilization of digital health technologies. The "Formula Benessere" project implemented at Ferrari has demonstrated significant benefits in terms of health outcomes, participation rates, and economic return. In parallel, numerous professional categories, such as firefighters, military personnel, pilots, and high-altitude workers, are exposed to specific cardiovascular risk factors that require tailored, innovative, and standardized assessment protocols. Personalized strategies enable better risk stratification and more effective management of cardiovascular health in the workplace. Occupational Cardiology represents a new opportunity for large-scale cardiovascular prevention at the community level. Its broader implementation at the national level, the development of dedicated clinical guidelines, and the integration of Digital Health tools are key elements in establishing this discipline as a new frontier in preventive cardiology.
Patrizi G, Casasco M, Oliva F
… +1 more, Perrone Filardi P
G Ital Cardiol (Rome)
· 2026 Mar · PMID 41738418
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The benefits of physical exercise are well established and universally recognized, but, at the same time, in our nation we are forced to face extremely annoying data about sedentary habits that directly correlate with th...The benefits of physical exercise are well established and universally recognized, but, at the same time, in our nation we are forced to face extremely annoying data about sedentary habits that directly correlate with the outbreak of many cardiovascular risk factors or with the worsening of pre-existing cardiovascular diseases. For these reasons, the Italian Society of Sports Cardiology (SIC Sport) and the Italian Federation of Sport Medicine (FMSI), in collaboration with the Italian Society of Cardiology (SIC) and the Italian Association of Hospital Cardiologists (ANMCO), have decided to update the only previous edition, dating back to 2007, of the "Document on physical exercise prescription in a cardiological setting". Our aim is to provide physicians and other professional subjects directly involved (i.e. kinesiologists) with, at the same time, updated scientific knowledge and clear and precise indications in order to arrive to a really tailored prescription of "physical exercise-drug". The aim of this review is to summarize this new version and underline its innovations when compared to the previous edition.
Bernardi M, Spadafora L, Dalla Vecchia LA
… +4 more, Pedretti RFE, Cenciarelli S, Zoccai GB, Versaci F
G Ital Cardiol (Rome)
· 2026 Mar · PMID 41738417
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Artificial intelligence (AI) is rapidly transforming the world, and medicine is at the forefront of this revolution. In cardiology, AI is increasingly providing innovative tools for diagnosis, risk stratification, interv...Artificial intelligence (AI) is rapidly transforming the world, and medicine is at the forefront of this revolution. In cardiology, AI is increasingly providing innovative tools for diagnosis, risk stratification, interventional planning, and personalized care. From automated interpretation of ECGs and cardiovascular imaging to integration into interventional workflows and predictive models, AI is emerging as a powerful ally for both clinicians and researchers. However, its implementation also raises critical ethical, legal, and regulatory challenges that require transparency, independent validation, and multidisciplinary governance. This review explores the potential and limitations of AI in cardiovascular medicine, with a focus on emerging technologies, their clinical implications, and the growing role of generative tools such as ChatGPT in scientific research. Much like HAL 9000, AI can enhance human capabilities - but only under vigilant oversight to prevent uncontrolled drifts. The future of cardiology will undoubtedly be more digital, but must remain fundamentally human.
Nardin M, Lo Monaco M, Mollace R
… +2 more, Bertella E, Cao D
G Ital Cardiol (Rome)
· 2026 Mar · PMID 41738410
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We present the case of a 58-year-old man with negative T waves in the inferior and lateral leads observed on a routine ECG in the context of persistent peripheral eosinophilia, 6 months after an intestinal parasitic infe...We present the case of a 58-year-old man with negative T waves in the inferior and lateral leads observed on a routine ECG in the context of persistent peripheral eosinophilia, 6 months after an intestinal parasitic infection. The diagnostic workup excluded coronary artery disease and led to a diagnosis of endomyocardial fibrosis with apical thrombosis. Endomyocardial fibrosis, also known as Loeffler endocarditis, represents the cardiac involvement of the hypereosinophilic syndrome, resulting in a cardiomyopathy with a restrictive phenotype. After initiating specific therapy, further investigations identified chronic eosinophilic leukemia as the underlying cause of hypereosinophilia. The patient remained asymptomatic regarding heart failure manifestations. Additionally, diastolic function was pseudo normal on transthoracic echocardiography, with no restrictive pattern, and troponin and natriuretic peptide levels were only mildly elevated. The moderate peripheral eosinophilia was firstly attributed to the recent parasitic infection, supported by the decrease in eosinophil count following treatment with metronidazole. Cardiac involvement occurred relatively shortly after the onset of peripheral eosinophilia (approximately 6 months). Early diagnosis through advanced cardiac imaging allowed the detection of this condition before irreversible myocardial damage occurred and facilitated the initiation of targeted therapy for both ventricular thrombosis and cardiomyopathy.
Fede E, Fedeli F, Broccatelli A
… +3 more, Sperandini L, Del Pinto M, Di Lazzaro D
G Ital Cardiol (Rome)
· 2026 Mar · PMID 41738409
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A 66-year-old patient with an anterior ST-elevation myocardial infarction (STEMI), treated with primary angioplasty and stenting of the proximal left anterior descending artery, developed an extensive left ventricular th...A 66-year-old patient with an anterior ST-elevation myocardial infarction (STEMI), treated with primary angioplasty and stenting of the proximal left anterior descending artery, developed an extensive left ventricular thrombosis that was initially sessile but later, after the introduction of anticoagulant therapy, became pedunculated and mobile. Given the high cardioembolic risk, the case was extensively discussed by the Heart Team, which recommended surgical thrombectomy through a transmitral approach. The procedure, performed with fibroscopic assistance, allowed complete removal of the thrombus using an unprotected aspirator. The postoperative course was complicated by hemopericardium, which required surgical resolution, followed by favorable clinical evolution. Left ventricular thrombosis is a not uncommon complication of acute myocardial infarction, particularly in anterior infarctions, and is associated with a high risk of systemic embolization. Optimal management remains controversial: anticoagulant therapy is the first-line treatment, but in cases of large and mobile thrombi, surgical removal may be necessary - an option rarely reported in the literature. Our case highlights the importance of early echocardiographic monitoring in patients with anterior STEMI and of multidisciplinary evaluation for the management of high-risk thrombotic complications.
Scherillo G, Cerrato E, Ferrua S
… +5 more, Meynet I, Lococo M, Calabrò P, Rinaldi M, Varbella F
G Ital Cardiol (Rome)
· 2026 Mar · PMID 41738408
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A 44-year-old man with no known cardiovascular history or risk factors experienced chest pain after a volleyball match. ECG showed ST-segment elevation in the inferior leads, a finding consistent with ST-elevation myocar...A 44-year-old man with no known cardiovascular history or risk factors experienced chest pain after a volleyball match. ECG showed ST-segment elevation in the inferior leads, a finding consistent with ST-elevation myocardial infarction (STEMI). The patient was urgently taken to the cath lab, where coronary angiography revealed complete occlusion of the distal left anterior descending artery and of an obtuse marginal branch. Plain old balloon angioplasty was attempted but unsuccessful. During the procedure, an abnormal vascular network originating from the right coronary artery and the circumflex artery and directed toward the left atrium was observed. Transthoracic echocardiography revealed a 30 x 32 mm ovoid, pedunculated mass attached to the atrial roof. Transesophageal echocardiography confirmed the finding, very suggestive of an atrial myxoma. Upon deeper anamnesis, the patient reported transient episodes of visual loss. Brain magnetic resonance imaging revealed multiple small gliotic lesions, indicative of systemic embolization. The patient underwent surgical resection of the mass via right mini-thoracotomy. Histological analysis confirmed the diagnosis of atrial myxoma. This case highlights the importance of considering an embolic etiology in STEMI, especially in young patients without traditional cardiovascular risk factors.
Maffè S, Paffoni P, Bergamasco L
… +8 more, Arrondini M, Prenna E, Leva L, Ariotti S, Facchini E, Paino AM, Ticozzi S, Dellavesa P
G Ital Cardiol (Rome)
· 2026 Mar · PMID 41738407
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Primary mediastinal B-cell lymphoma is a rare subtype of non-Hodgkin lymphoma. Typical symptoms include cough, chest pain, and dyspnea; however, cardiac tamponade as the primary manifestation is exceedingly rare. We here...Primary mediastinal B-cell lymphoma is a rare subtype of non-Hodgkin lymphoma. Typical symptoms include cough, chest pain, and dyspnea; however, cardiac tamponade as the primary manifestation is exceedingly rare. We hereby present a case of a 83-year-old woman, who presented to our emergency department with dyspnea, cough and hypotension. On admission, echocardiography (transthoracic and transesophageal), computed tomography and cardiac magnetic resonance demonstrated a large 70 x 38 mm pericardial mass, with pericardial effusion and signs of cardiac tamponade. Positron emission tomography highlighted a marked hyperaccumulation of the tracer at the mass level, compatible with high metabolic activity. The patient underwent further workup with diagnostic and therapeutic pericardiocentesis, which demonstrated histopathology consistent with primary mediastinal B-cell lymphoma. This precise and complete diagnosis allowed the start of chemotherapy treatment with complete remission of the disease and regression of the mass in a few months. Our case highlights the importance of a complete and thorough workup for patients with chronic untraditional symptoms, like tamponade as the primary clinical presentation. Advanced multimodality imaging is crucial for early non-invasive assessment of primary cardiac tumors, helps guiding further investigations, treatment decision, assessing for potential complications, and allows documentation of therapeutic success.
De Backer J, Haugaa KH, Hasselberg NE
… +23 more, de Hosson M, Brida M, Castelletti S, Cauldwell M, Cerbai E, Crotti L, de Groot NMS, Estensen ME, Goossens ES, Haring B, Kurpas D, McEniery CM, Peters SAE, Rakisheva A, Sambola A, Schlager O, Schoenhoff FS, Simoncini T, Steinbach F, Sudano I, Swan L, Valente AM, ESC Scientific Document Group
G Ital Cardiol (Rome)
· 2026 Feb · PMID 41631363
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Aimo A, Vergaro G, Castiglione V
… +21 more, Ferrari Chen YF, Porcari A, Canepa M, Chimenti C, Di Lenarda A, Oliva F, Colivicchi F, Indolfi C, Perrone Filardi P, Cipriani A, Longhi S, Cappelli F, Musca F, Iacoviello M, Limongelli G, Perfetto F, Merlini G, Merlo M, Sinagra G, Buda G, Emdin M
G Ital Cardiol (Rome)
· 2026 Feb · PMID 41631334
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Light chain (AL) amyloidosis is a rare systemic disease caused by monoclonal immunoglobulin light chains with abnormal folding that aggregate into fibrils, which deposit in extracellular tissues. This process leads to cy...Light chain (AL) amyloidosis is a rare systemic disease caused by monoclonal immunoglobulin light chains with abnormal folding that aggregate into fibrils, which deposit in extracellular tissues. This process leads to cytotoxicity and organ dysfunction. Cardiac involvement is the main prognostic determinant and requires a multidisciplinary management approach. In recent years, the treatment of AL amyloidosis has significantly evolved with the introduction of innovative agents such as proteasome inhibitors, immunomodulators, and monoclonal antibodies like daratumumab, which has shown a favorable impact on hematological outcomes and organ function. The daratumumab-CyBorD regimen is currently the standard first-line therapeutic option. The therapy is tailored based on the stage of cardiac and renal damage, aiming for a complete hematological and organ response. The management of cardiac involvement, including aortic stenosis, atrial fibrillation, thromboembolic risk, conduction disorders, arrhythmias, and heart failure, plays a crucial role in prognosis. An integrated multidisciplinary approach in specialized centers experienced in the disease is essential to optimize clinical outcomes.
Nardi F, Patti G, Quadri G
… +40 more, Pollarolo L, Alunni G, Andriani M, Angelini A, Bertolazzi M, Boccuzzi G, Capriolo M, Chinaglia A, de Benedictis M, De Filippo O, Dellavesa P, Delnevo F, Ferrillo S, Giammaria M, Lanfranchi A, Greco Lucchina P, Maffè S, Pavani M, Pelloni E, Presutti D, Rovere ME, Scacciatella P, Senatore G, Taravelli E, Viola O, Zanda G, D'Amico M, De Ferrari GM, Della Valle A, Feola M, Grosso Marra W, Lupi A, Moretti C, Pistis G, Rametta F, Rognoni A, Rossini R, Scaglione M, Varbella F, Musumeci G
G Ital Cardiol (Rome)
· 2026 Feb · PMID 41631333
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BACKGROUND: Although international guidelines recommend increasingly lower thresholds for low-density lipoprotein cholesterol (LDL-C), everyday clinical experience shows that many patients fail to reach these targets, ex...BACKGROUND: Although international guidelines recommend increasingly lower thresholds for low-density lipoprotein cholesterol (LDL-C), everyday clinical experience shows that many patients fail to reach these targets, exposing themselves to a significant residual cardiovascular risk. Clear Pathway - a patient-centered approach to dyslipidemia - was developed to bridge this gap by promoting an integrated use of oral lipid-lowering therapies. METHODS: In the Clear Pathway project, a panel of hospital cardiologists applied a mini-Delphi methodology in two rounds to evaluate 20 statements related to lipid-lowering therapy, divided into three thematic areas: oral combination and fixed-dose strategies; use of LDL-C target distance as a guide to treatment decisions; and personalization based on patient's clinical profile. Each statement was rated on a 1-5 Likert scale and approved if the average score was ≥4.0. Statements not approved in the first round were reformulated and resubmitted. RESULTS: In the first round, 17 out of 20 statements met the consensus threshold and were approved without any modification. The three statements not approved (early intensification in post-acute coronary syndrome patients with LDL-C <140 mg/dl, use of bempedoic acid in patients undergoing elective angioplasty, and in those one with stroke) were reformulated and resubmitted during a second round, where they also reached the approval threshold. CONCLUSIONS: The Clear Pathway recommendations outline a model for dyslipidemia management based on integrated oral therapies, with a key role for bempedoic acid. Adopting these guidelines is expected to improve adherence, optimize achievement of LDL-C targets, and reduce the incidence of cardiovascular events in routine clinical practice.
G Ital Cardiol (Rome)
· 2026 Feb · PMID 41631332
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Despite the widespread use of lipid-lowering therapies, a significant proportion of patients with atherosclerotic cardiovascular disease fail to achieve the recommended LDL-cholesterol targets, thus remaining at high res...Despite the widespread use of lipid-lowering therapies, a significant proportion of patients with atherosclerotic cardiovascular disease fail to achieve the recommended LDL-cholesterol targets, thus remaining at high residual risk. Inhibition of cholesteryl ester transfer protein (CETP) has long been considered a pharmacological strategy, but has historically been hindered by clinical failures. Obicetrapib, a next-generation CETP inhibitor, has recently shown promising results in terms of efficacy and safety. This review critically examines the physiology of CETP, the negative outcomes of earlier CETP inhibitors, and the emerging evidence on obicetrapib, highlighting the potential role of this molecule in the treatment of hypercholesterolemia and in the secondary prevention of atherosclerotic cardiovascular disease.
G Ital Cardiol (Rome)
· 2026 Feb · PMID 41631331
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Angina in non-obstructive coronary artery disease (ANOCA) is a common clinical condition affecting 20-50% of patients undergoing coronary angiography for suspected angina. Despite recent 2024 European guidelines on chron...Angina in non-obstructive coronary artery disease (ANOCA) is a common clinical condition affecting 20-50% of patients undergoing coronary angiography for suspected angina. Despite recent 2024 European guidelines on chronic coronary syndrome emphasizing its significance and clinical implications, ANOCA remains often underdiagnosed and undertreated. The management of ANOCA differs from obstructive coronary artery disease and requires careful interpretation of diagnostic tests and tailored treatment based on accurate clinical assessment. ANOCA diagnosis may involve microvascular dysfunction or vasospasm (epicardial or microvascular), and treatment should be individualized. The impact on patients' quality of life is considerable, with symptom regression due to correct diagnosis. A timely diagnostic and therapeutic approach is crucial to improving patient's quality of life. This review aims to provide a practical guide in managing ANOCA patients, emphasizing the need for comprehensive coronary functional evaluation and optimal risk factor management.
Del Sindaco D, Pulignano G, Ingianni N
… +10 more, Ammendolea C, Chimenti C, Di Lenarda A, Emdin M, Pezzi L, Rao CM, Sciacqua A, Zuccalà G, Armentaro G, Parrini I
G Ital Cardiol (Rome)
· 2026 Feb · PMID 41631330
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Cardiac amyloidosis is considered a rare disease but is increasingly frequent in elderly patients. In these patients, heterogeneous and peculiar clinical manifestations require specific approaches and dedicated diagnosti...Cardiac amyloidosis is considered a rare disease but is increasingly frequent in elderly patients. In these patients, heterogeneous and peculiar clinical manifestations require specific approaches and dedicated diagnostic-therapeutic pathways. Early diagnosis is important because mortality is high, and the disease is often latent and underdiagnosed. In particular, the light chain form represents a real emergency, due to the rapidly fatal course in the absence of treatment. Specific programs based on a multispecialist approach should be implemented to reduce delays in diagnosis. Thanks to these programs, in recent years patients are often diagnosed at an early stage with a reduction in mortality. In the elderly, health status does not only depend on the disease or age, but also on factors such as frailty, comorbidity, living conditions and psychological factors. In these patients, a pragmatic approach should include a frailty screening using simple and easy-to-use tools. The therapeutic approach in the elderly has the dual objective of treating symptoms and complications of the disease and modifying the course of the disease and slowing its progression with specific therapies. In the context of a universalistic health system such as the Italian one, the introduction of highly innovative, but also expensive, therapies raises significant questions in terms of economic sustainability, accessibility of care and protection of patients' dignity.
Buia F, Bergamaschi L, Franceschi P
… +2 more, Russo V, Lovato L
G Ital Cardiol (Rome)
· 2026 Feb · PMID 41631329
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Artificial intelligence (AI) is rapidly transforming the field of aortic imaging, enhancing diagnostic accuracy, risk stratification, and treatment planning. This review provides a comprehensive overview of AI applicatio...Artificial intelligence (AI) is rapidly transforming the field of aortic imaging, enhancing diagnostic accuracy, risk stratification, and treatment planning. This review provides a comprehensive overview of AI applications in measuring aortic dimensions, detecting and characterizing aneurysms, dissections, and atherosclerotic disease, as well as predicting clinical outcomes. Automated measurement and segmentation tools, powered by deep learning algorithms, offer reproducible and time-efficient assessments, reducing inter- and intraobserver variability. In atherosclerotic disease, AI enables objective quantification of calcification burden and advanced radiomic analysis for prognostic stratification. In acute aortic syndromes, AI-based models improve diagnostic sensitivity, assist in differentiating true from false lumens, and predict complications or surgical outcomes. The integration of emerging technologies such as radiomics, dual-energy computed tomography, photon-counting computed tomography, and computational fluid dynamics further expands predictive capabilities, potentially leading to personalized "digital twin" models for therapeutic decision-making. Despite promising results, challenges remain in software availability, cost, data integration, and defining the radiologist's evolving role. AI holds the potential to become an indispensable tool in aortic disease management, bridging imaging, clinical, and computational domains to improve patient outcomes.