Di Fusco SA, Alaimo C, Matteucci A
… +2 more, Bernelli C, Colivicchi F
G Ital Cardiol (Rome)
· 2025 Dec · PMID 41287612
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BACKGROUND: Over the last decades the proportion of women working in cardiology has progressively increased. This study aims to evaluate overtime changes in women's contribution to authorship in articles published in the...BACKGROUND: Over the last decades the proportion of women working in cardiology has progressively increased. This study aims to evaluate overtime changes in women's contribution to authorship in articles published in the Giornale Italiano di Cardiologia (GIC). METHODS: We collected data on article authorship from 2004 to 2024. Our objective was to assess temporal trends in women's authorship, including the number of articles with a woman as first or last author. Further analyses focused on women representation in editorial bodies of GIC. RESULTS: In the time interval analyzed, a significant increase was observed in the number of total authors per year (Pearson r=0.798, p<0.001), and the number of female authors per year (Pearson r=0.758, p<0.001). The percentage of female authors showed a non-significant increasing trend over time (Pearson r=0.313, p=0.166). However, the percentage of articles with a female first author (Pearson r=0.569, p=0.007) and last author (Pearson r=0.603, p=0.004) increased significantly. Female representation on the GIC editorial board increased over time, but leadership roles were held almost exclusively by men. CONCLUSIONS: Over the past two decades, there has been an increase in women's authorship in the GIC. Nevertheless, this increase does not reflect their growing representation in the cardiology field. Greater efforts are needed to enhance women's involvement in scientific publishing to promote diversity and improve scientific research quality.
Bennati E, Oreto L, Adorisio R
… +7 more, Di Salvo G, Domenicucci S, Giugno L, Marzullo R, Russo MG, Egidy Assenza G, a nome dell’Area di Cardiologia Pediatrica e del Congenito Adulto (ACHD) dell’Associazione Nazionale Medici Cardiologi Ospedalieri (ANMCO)
G Ital Cardiol (Rome)
· 2025 Dec · PMID 41287611
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Thanks to the improvement of surgical, interventional techniques and medical care, the survival of the adult population with congenital heart disease is constantly increasing with more frequent access to the emergency de...Thanks to the improvement of surgical, interventional techniques and medical care, the survival of the adult population with congenital heart disease is constantly increasing with more frequent access to the emergency department because of residual defects and cardiovascular sequelae. This review article examines in alphabetical order the main clinical conditions for which an urgent cardiological evaluation may be required, providing some indications about diagnosis, acute management and possible transfer to dedicated centers.
Mantovani F, Malaguti M, Bursi F
… +2 more, Benfari G, Barbieri A
G Ital Cardiol (Rome)
· 2025 Dec · PMID 41287610
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Severe aortic stenosis and mitral regurgitation frequently coexist and pose significant diagnostic and therapeutic challenges. The hemodynamic interplay between these two valvular diseases can obscure the accurate assess...Severe aortic stenosis and mitral regurgitation frequently coexist and pose significant diagnostic and therapeutic challenges. The hemodynamic interplay between these two valvular diseases can obscure the accurate assessment of each lesion, necessitating an advanced understanding of flow dynamics and cardiac remodeling. This review explores the complex relationship between aortic stenosis and mitral regurgitation, highlighting pathophysiological mechanisms, diagnostic pitfalls, and contemporary management strategies. By synthesizing current evidence, we aim to provide clinicians with practical insights to guide decision-making in the era of advanced cardiac imaging and percutaneous interventions.
Indolfi C, Spaccarotella C, Curcio A
… +3 more, Polimeni A, Castiello DS, Esposito G
G Ital Cardiol (Rome)
· 2025 Dec · PMID 41287609
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Artificial intelligence (AI) is assuming an increasingly prominent role in the diagnosis and management of acute myocardial infarction. Its main objective is to enable earlier and more accurate diagnosis, enhance the int...Artificial intelligence (AI) is assuming an increasingly prominent role in the diagnosis and management of acute myocardial infarction. Its main objective is to enable earlier and more accurate diagnosis, enhance the interpretation of the ECG, accelerate reperfusion times, and ultimately improve patient outcomes. The ECG represents an ideal substrate for the application of deep learning, owing to the vast availability of digital tracings, the association with confirmed diagnoses, and the inclusion of numerous clinical variables. Several systems even allow the automated analysis of photographs of paper-based ECGs, processed through deep learning algorithms. Current evidence indicates that: (i) in ST-elevation myocardial infarction, AI achieves sensitivity and specificity superior to those of experienced cardiologists, with an accuracy approaching clinical applicability; (ii) in non-ST-elevation myocardial infarction, clinical heterogeneity reduces diagnostic precision, yet AI still demonstrates significant discriminative power, serving as a valuable support tool for clinicians; (iii) emerging applications include the prediction of complete vessel occlusion and identification of the culprit coronary artery; and (iv) advanced algorithms may also estimate functional parameters such as ejection fraction and global longitudinal strain, thereby enriching prognostic stratification. In conclusion, AI applied to the ECG represents an innovative tool for the timely diagnosis of acute coronary syndromes. Its integration into clinical practice has the potential to support cardiologists both in confirming uncertain diagnoses and in rapidly selecting patients who should undergo revascularization.
G Ital Cardiol (Rome)
· 2025 Dec · PMID 41287603
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Cinema and medicine repair biographies and wounds by raising plots, naming things, seeking a solution even to the most unthinkable enigma. Even before entering a movie theater, we should sign a consent form: are we ready...Cinema and medicine repair biographies and wounds by raising plots, naming things, seeking a solution even to the most unthinkable enigma. Even before entering a movie theater, we should sign a consent form: are we ready to be paralyzed for two hours, without curare, to cure?If we're prepared to remain quadriplegic for hours in a theater, why shouldn't we listen and watch the patient in front of us? After all, he brings us symptoms and signs, a script that leaves the movie's direction up to us. No matter if it's crude. When the dance of life turns tragic, the doctor must act with the apparent playfulness of an actor, without ever losing focus and a steady hand. Like literature, cinema is a medicine that helps us to enter into other's lives, especially if they are suffering.
Praz F, Borger MA, Lanz J
… +23 more, Marin-Cuartas M, Abreu A, Adamo M, Ajmone Marsan N, Barili F, Bonaros N, Cosyns B, De Paulis R, Gamra H, Jahangiri M, Jeppsson A, Klautz RJM, Mores B, Pérez-David E, Pöss J, Prendergast BD, Rocca B, Rossello X, Suzuki M, Thiele H, Tribouilloy CM, Wojakowski W, ESC/EACTS Scientific Document Group
G Ital Cardiol (Rome)
· 2025 Dec · PMID 41287601
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Giubilato S, Scicchitano P, Bilato C
… +17 more, Corda M, De Luca L, Di Marco M, Geraci G, Iacovoni A, Milli M, Navazio A, Pascale V, Riccio C, Tizzani E, Zilio F, Di Monaco A, Nardi F, Gabrielli D, Colivicchi F, Grimaldi M, Oliva F
G Ital Cardiol (Rome)
· 2025 Nov · PMID 41143314
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Cardiovascular diseases remain the leading cause of mortality globally and in Italy, with a growing burden exacerbated by aging populations and underdeveloped strategies for managing chronic cardiovascular conditions. Th...Cardiovascular diseases remain the leading cause of mortality globally and in Italy, with a growing burden exacerbated by aging populations and underdeveloped strategies for managing chronic cardiovascular conditions. This position paper, resulting from the 2024 ANMCO General Assembly, addresses the current state of cardiovascular chronicity management in Italy, highlighting critical gaps and proposing sustainable, integrative solutions. Despite improvements in acute cardiovascular care, the lack of structured post-acute management, insufficient adoption of secondary prevention protocols, limited access to innovative therapies, and a slow digital transition continue to hinder effective chronic care. The document stresses the pivotal role of cardiologists, not only in acute intervention but also in long-term care and secondary prevention, emphasizing the need for a multidisciplinary, multichannel healthcare model. The paper explores the potential of e-Health and artificial intelligence to revolutionize chronic disease management. It advocates for the widespread implementation of integrated care pathways, digital tools like electronic health records and telemedicine platforms, which together could enhance early detection, patient monitoring, and therapeutic adherence while reducing unnecessary hospitalizations. It also underscores the necessity of updating national and regional pharmaceutical policies to improve equitable access to disease-modifying therapies. Furthermore, the integration of palliative care in end-stage cardiovascular disease and the enhancement of post-acute care networks are deemed essential. Ultimately, the document advocates for a comprehensive systemic and cultural transformation - spearheaded by scientific societies such as ANMCO - where technological innovation, organizational reform, and patient-centered care align to ensure a sustainable and universally accessible healthcare system. This vision is consistent with the objectives of the PNRR, the 2030 Agenda, and, most importantly, the foundational principles of the Italian Constitution.
Abrignani MG, Barisone M, Usmiani T
… +31 more, Zuccalà G, Cappannelli S, Doimo S, Parrini I, Temporelli PL, Bilato C, Del Sindaco D, De Luca G, Gorini A, Laudisio A, Lucà F, Maloberti A, Pulignano G, Zuin M, Corda M, De Luca L, Di Marco M, Iacovoni A, Milli M, Navazio A, Pascale V, Riccio C, Scicchitano P, Tizzani E, Gulizia MM, Nardi F, Gabrielli D, Geraci G, Colivicchi F, Grimaldi M, Oliva F
G Ital Cardiol (Rome)
· 2025 Nov · PMID 41143313
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The epidemiological transition has led to an increase in life expectancy and to a growing population of chronic patients, often with heart failure. These patients are frequently affected by comorbidities and frailty, whi...The epidemiological transition has led to an increase in life expectancy and to a growing population of chronic patients, often with heart failure. These patients are frequently affected by comorbidities and frailty, which in turn increase the risk of disability and worsening quality of life, requiring an accurate multidimensional assessment (MDA). In this context, MDA is crucial for integrated and holistic management of elderly patients, considering not only the pathology but the patient in his complexity. MDA requires a multidisciplinary team to ensure a comprehensive and integrated assessment of the elderly patient. MDA tools assess various domains of health, using scales and validated tools to explore physical, functional, mental and socio-economic status. MDA is applied in two phases: an initial screening procedure and an in-depth analysis of individual problems for targeted interventions. MDA can be performed in various care settings, including outpatient clinics, hospitals, nursing homes, home care, and rehabilitation centers. Several studies show that MDA improves survival as well as functional and mental status, reducing hospitalization times and the frequency of institutionalization. This ANMCO position paper discusses MDA tools of older adults with chronic heart disease, highlighting the need for a holistic approach to address comorbidities and frailty in a growing population.
Rubbo FM, Bianco E, Zecchin M
… +4 more, Mazzaro E, Monica F, de Manzini N, Sinagra G
G Ital Cardiol (Rome)
· 2025 Nov · PMID 41143312
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In 2021, a 64-year-old patient with paroxysmal atrial fibrillation underwent radiofrequency catheter ablation at our center. Several days later, he initially developed pericarditis, followed by a septic state, which was...In 2021, a 64-year-old patient with paroxysmal atrial fibrillation underwent radiofrequency catheter ablation at our center. Several days later, he initially developed pericarditis, followed by a septic state, which was subsequently identified as an epiphenomenon of an atrio-esophageal fistula. The patient underwent combined surgical and endoscopic repair, and despite a complicated postoperative course, he returned to leading a normal life. The atrio-esophageal fistula is one of the most feared complications of atrial fibrillation ablation, associated with high mortality and morbidity. Its severity is exacerbated by diagnostic challenges, which may delay intervention, as well as the high surgical risk associated with repair techniques, and the limited evidence on prevention during the ablation procedure.
Manzi G, Badagliacca R, D'Alto M
… +7 more, Ghio S, Manes A, Palazzini M, Romeo E, Scelsi L, Vitulo P, Vizza CD
G Ital Cardiol (Rome)
· 2025 Nov · PMID 41143311
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BACKGROUND: Pulmonary arterial hypertension (PAH) is a rare syndrome characterized by remodeling of the small pulmonary arterial vessels and increased pulmonary vascular resistance, which in the later stages can lead to...BACKGROUND: Pulmonary arterial hypertension (PAH) is a rare syndrome characterized by remodeling of the small pulmonary arterial vessels and increased pulmonary vascular resistance, which in the later stages can lead to right-sided heart failure and death. The therapeutic approach is evolving, but differences remain between countries. METHODS: An Italian survey was designed to evaluate differences in the diagnosis, management and treatment of PAH patients across Italian centers. The survey was administered to 32 PAH Centers in Italy via an online questionnaire. A panel of 9 PAH experts analyzed and discussed the results. RESULTS: Thirty Centers from 15 regions responded, thus representing the entire Italian reality. The results showed that all participating Centers perform right heart catheterization at PAH diagnosis (100%), while genetic testing is available in 73% of cases. Centers with a high patient volume have 10.4% of patients on oral monotherapy, while Centers with a low patient volume have a low percentage of patients on triple oral therapy (15%) or parenteral prostanoids (11.3%). Many Centers (70%) use parenteral prostanoids in up-front approach in incident high-risk PAH patients. Nine Centers (30%) achieve the low risk profile in more than 60% of the population followed. In line with the literature, an upfront strategy including parenteral prostanoids was associated with a high likelihood of achieving a low-risk profile. Overall, 70% of Centers have patients on the list for lung transplant. CONCLUSIONS: Italian PAH Centers have excellent adherence to the diagnostic standards recommended by European guidelines and good uniformity in therapeutic management, with some divergences related to differences in the phenotype of PAH patients. The survey also revealed a good awareness of the efficacy of parenteral prostanoids, especially if started early. Collaboration and referral of selected PAH patients to Centers with greater experience in the management of complex infusion therapies is the key to success.
Martin-Suarez S, Botta L, Barberio G
… +6 more, Londi F, Snaidero S, Careddu M, Scuppa MF, Cordella E, Pacini D
G Ital Cardiol (Rome)
· 2025 Nov · PMID 41143310
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In the treatment of end-stage heart disease, heart transplantation often represents the only viable option, particularly in terms of survival and quality of life. The evolution and refinement of medical therapy have subs...In the treatment of end-stage heart disease, heart transplantation often represents the only viable option, particularly in terms of survival and quality of life. The evolution and refinement of medical therapy have substantially decreased mortality rates in cardiac patients, enabling them to progress to advanced stages of heart disease and consequently expanding the pool of eligible transplant candidates. A partial response to this growing demand has come from technological advancements in the development of devices designed to replace cardiac function. Meanwhile, the donor pool remains insufficient to cover the transplant demand, though expanded through multiple strategies, including increasing donor age, public awareness campaigns, research into xenotransplantation, and the use of hearts from donors who meet circulatory death criteria. Conventionally, since 1968, donors' death has been ascertained with brain death criteria; the use of cardiocirculatory death criteria, a recent rediscovery, has long been limited to organs other than the heart, considering also the significant differences among various countries' regulations. In Italy, the law requires 20 min of electrical asystole to ascertain death, a longer time than in other countries, raising doubts about the resumption of cardiac activity, thus limiting the use of such donors for heart donation in our country. However, as a result of the collaboration of experts, since May 2023 protocols have been developed to successfully include donors with circulatory death criteria in the heart donor pool. This review aims to provide the medical community with a detailed analysis of the ethical, legislative, technical, clinical, and scientific aspects that have enabled the opening of a new era in transplantation, with specific reference to heart transplantation. This innovation assumes a historical significance comparable to the first heart transplant performed in 1967, marking a fundamental turning point in the treatment of end-stage heart disease.
G Ital Cardiol (Rome)
· 2025 Nov · PMID 41143309
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Forty years after the first heart transplant in Italy, this paper offers some considerations about those aspects that may be of interest for a wider community than that represented by those (healthcare professionals, pat...Forty years after the first heart transplant in Italy, this paper offers some considerations about those aspects that may be of interest for a wider community than that represented by those (healthcare professionals, patients and families) that are directly involved. In the process of organ donation and transplantation (especially regarding the heart, that has strong anthropological and cultural implications), there is an interplay of medicine and surgery with ethical and social issues. The authors describe these interactions from their point of view, being aware that they may not find universal agreement. Anyway, they hope to contribute to increase the willingness of the medical and cardiological community to analyze more in-depth the open questions regarding organ donation and heart transplantation: a larger number of participants to the discussion will undoubtedly help in finding better solutions for the present and the future.
G Ital Cardiol (Rome)
· 2025 Nov · PMID 41143308
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Synthetic artificial intelligence (AI) represents a paradigm shift in cardiovascular medicine: from prediction to creation. Unlike conventional AI, which analyzes existing data, synthetic AI generates new, patient-like c...Synthetic artificial intelligence (AI) represents a paradigm shift in cardiovascular medicine: from prediction to creation. Unlike conventional AI, which analyzes existing data, synthetic AI generates new, patient-like clinical content, signals, images, virtual populations, and personalized treatment simulations, based on learned patterns. This review provides clinicians with a clear and practical overview of core generative technologies, including generative adversarial networks, variational autoencoders, transformers, diffusion models, autoregressive architectures, digital twins, and synthetic cohort simulators. Each method is illustrated through real-world cardiovascular use cases, from ECG generation to risk stratification, virtual trial design, and procedural planning. Beyond technical explanation, the article explores current regulatory, ethical, and validation challenges, highlighting how synthetic AI can enhance diagnostics, training, and clinical decision-making, particularly in data-limited settings. Far from replacing physicians, these tools extend clinical reach and invite the medical community to take an active role in shaping their responsible use. Synthetic AI is no longer a theoretical innovation, it is a growing infrastructure. Understanding its capabilities, limitations, and clinical relevance will be essential for the cardiologist of tomorrow.