Giornale italiano di cardiologia最新文献

{"title":"[The Pacemaker and Implantable Cardioverter-Defibrillator Registry of the Italian Association of Arrhythmology and Cardiac Pacing - Report 2022].","authors":"Alessandro Proclemer,&nbsp;Massimo Zecchin,&nbsp;Gabriele Zanotto,&nbsp;Dario Gregori,&nbsp;Roberto De Ponti,&nbsp;Antonio D'Onofrio","doi":"10.1714/4100.40986","DOIUrl":"https://doi.org/10.1714/4100.40986","url":null,"abstract":"<p><strong>Background: </strong>The Pacemaker (PM) and Implantable Cardioverter-Defibrillator (ICD) Registry of the Italian Association of Arrhythmology and Cardiac Pacing (AIAC) collects information about demographics, clinical characteristics, main indications for PM/ICD therapy and device types from the voluntary Italian collaborating centers.</p><p><strong>Methods: </strong>For the year 2022 main data about national PM and ICD implantation activity were obtained on the basis of European Cards and subsequently analyzed to create a standard report.</p><p><strong>Results: </strong>PM Registry: data about 17 800 PM implantations were collected (14 191 first implants and 3609 replacements). The number of collaborating centers was 152. Median age of treated patients was 81 years (75 quartile I; 86 quartile III). Main ECG indications included atrioventricular conduction disorders in 46.0% of first PM implants, sick sinus syndrome in 17.7%, atrial fibrillation plus bradycardia in 7.7%, other unspecified ECG and electrophysiological abnormalities in 43.0%. For first PM implants, pacing in DDDR mode was reported in 42.2%, followed by DDD mode (20.6%), VVIR mode (25.1%), VVI mode (11.1%) and finally VDD-VDDR (5.1%). Median value of longevity of explanted PMs was 8.3 years. ICD Registry: data about 5210 ICD implantations were obtained (3656 first implants and 1554 replacements). The number of collaborating centers was 301. Median age of treated patients was 72 years (63 quartile I; 79 quartile III). Primary prevention indication was reported in 72.4% of first implants, secondary prevention in 27.6% (cardiac arrest in 4.6% of records). A single-chamber ICD was used in 30.3% of first implants, dual-chamber ICD in 30.0% and biventricular ICD in 39.7%. Median value of longevity of explanted ICDs was 7.0 years.</p><p><strong>Conclusions: </strong>In the calendar year 2022, the Italian PM Registry showed stable electrocardiographic and symptom indications, with an important prevalence of dual-chamber pacing. The ICD Registry documented a large use of prophylactic and biventricular ICDs, reflecting a favorable adherence in clinical practice to trials and guidelines. The ICD longevity and the number of recalls demonstrated a favorable trend.</p>","PeriodicalId":12510,"journal":{"name":"Giornale italiano di cardiologia","volume":null,"pages":null},"PeriodicalIF":0.5,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41122714","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Management of patients with type 2 diabetes during cardiac prevention and rehabilitation. An expert opinion from the Italian Alliance for Cardiovascular Rehabilitation and Prevention (ITACARE-P)].","authors":"Marco Ambrosetti,&nbsp;Francesco Fattirolli,&nbsp;Francesco Maranta,&nbsp;Matteo Ruzzolini,&nbsp;Manfredi Rizzo,&nbsp;Gian Francesco Mureddu,&nbsp;Raffaele Griffo,&nbsp;Elio Venturini,&nbsp;Francesco Giallauria,&nbsp;Francesco Orso,&nbsp;Alessandra Pratesi,&nbsp;Angelo Patti,&nbsp;Francesco Perone","doi":"10.1714/4100.40985","DOIUrl":"https://doi.org/10.1714/4100.40985","url":null,"abstract":"<p><p>Patients with diabetes, regardless of their cardiovascular disease and their index event, are more and more often referred to Cardiac Rehabilitation Units. These patients usually show high or very high cardiovascular risk, marked disability and poor quality of life. Furthermore, those with older age, frailty, and female sex have even more rehabilitative needs, thus requiring fine individualized approaches. Consequently, in order to identify their therapeutic goals, the glycemic target should be pursued together with the effective reduction of the global cardiovascular risk. Modern exercise protocols are based on the synergic effect of both aerobic and strength training of moderate and high effort intensities, in order to achieve improvements of cardiorespiratory fitness and glycemic values as well. Exercise training and nutritional intervention are strictly related during the rehabilitation program, thus promoting better lifestyle in the long term too. New antidiabetic drugs (such as sodium-glucose cotransporter 2 inhibitors and glucagon-like peptide-1 receptor agonists) should be included into a specific \"patient journey\" along with other core components of the rehabilitation program. Therefore, the active role of all allied professionals (namely nurses, physiotherapists, dietitians and psychologists) is essential to the success of the cardiometabolic team. Diabetes should be routinely included in the outcome evaluation of cardiac rehabilitation programs and in every follow-up plan through a successful crosstalk among cardiologists, diabetologists and patients.</p>","PeriodicalId":12510,"journal":{"name":"Giornale italiano di cardiologia","volume":null,"pages":null},"PeriodicalIF":0.5,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41105603","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[How to overcome barriers to implementation of prevention and management strategies of atherosclerotic cardiovascular disease through lipid-lowering therapy].","authors":"Marcello Arca,&nbsp;Maurizio Averna,&nbsp;Claudio Borghi,&nbsp;Maddalena Lettino,&nbsp;Pasquale Perrone Filardi,&nbsp;Antonia Alberti,&nbsp;Claudio Bilato,&nbsp;Paolo Calabrò,&nbsp;Francesca Carubbi,&nbsp;Marco Matteo Ciccone,&nbsp;Francesco Cipollone,&nbsp;Nadia Citroni,&nbsp;Leonardo De Luca,&nbsp;Andrea Giaccari,&nbsp;Gabriella Iannuzzo,&nbsp;Alessandro Maloberti,&nbsp;Rossella Marcucci,&nbsp;Pasquale Pignatelli Spinazzola,&nbsp;Matteo Pirro,&nbsp;Livia Pisciotta,&nbsp;Filippo Sarullo,&nbsp;Angela Sciacqua,&nbsp;Patrizia Suppressa,&nbsp;Ferdinando Varbella,&nbsp;José Pablo Werba,&nbsp;Alberto Zambon","doi":"10.1714/4100.40977","DOIUrl":"10.1714/4100.40977","url":null,"abstract":"<p><p>Atherosclerotic cardiovascular diseases remain the main cause of mortality worldwide, due to a poor control of modifiable risk factors for atherosclerosis. High levels of low-density lipoprotein cholesterol represent the most relevant actor in the development of atherosclerotic cardiovascular diseases, as well as the main target of prevention strategies. Although lipid-lowering treatments were shown to be effective for cardiovascular prevention, several barriers (e.g. clinician reluctance to prescribe an intensive treatment, poor adherence of patients to therapy, high pharmacotherapy burden of high-risk patients and the fear for adverse events potentially associated with statins) still prevent therapy optimization. Such issues will be addressed in this review article, taking into account possible strategies for their solution, through an integrated approach including both management interventions and a larger use of the available pharmacologic options.</p>","PeriodicalId":12510,"journal":{"name":"Giornale italiano di cardiologia","volume":null,"pages":null},"PeriodicalIF":0.5,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41110089","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Italian Society of Interventional Cardiology (GISE) and Italian Society of Arterial Hypertension (SIIA) Consensus document on the role of renal denervation in the management of the difficult to treat hypertension].","authors":"Eugenio Stabile, Maria Lorenza Muiesan, Flavio Luciano Ribichini, Giuseppe Sangiorgi, Stefano Taddei, Francesco Versaci, Bruno Villari, Alessandra Bacca, Daniela Benedetto, Vincenzo Fioretti, Gaetano Liccardo, Eugenio Laurenzano, Massimiliano Scappaticci, Francesco Saia, Giuseppe Tarantini, Guido Grassi, Giovanni Esposito","doi":"10.1714/4101.40995","DOIUrl":"10.1714/4101.40995","url":null,"abstract":"<p><p>Arterial hypertension is the most prevalent cardiovascular risk factor worldwide. Despite the availability of many and effective antihypertensive medications, the prevalence of uncontrolled blood pressure (BP) remains high. As sympathetic hyperactivity has long been recognized as a major contributor to resistant hypertension, catheter-based renal denervation (RDN) has emerged as a new strategy to reduce BP. RDN aims to interrupt the activity of renal sympathetic nerves by applying radiofrequency (RF) energy, ultrasound (US) energy, or injection of alcohol in the perivascular space. The Symplicity HTN-3 trial, the largest sham-controlled trial using the first-generation RF-based RDN device, failed to significantly reduce BP. Since then, new devices and techniques have been developed and consequently many sham-controlled trials using second-generation RF or US-based RDN devices have demonstrated the BP lowering efficacy and safety of the procedure. A multidisciplinary team involving hypertension experts, interventionalists with expertise in renal interventions and anesthesiologists, plays a pivotal role from the selection of the patient candidate for the procedure to the post-procedural care. The aim of this consensus document is to summarize the current evidence about the use of RDN in difficult to treat hypertension and to propose a management strategy from the selection of the patient candidate for the procedure to the post-procedural care.</p>","PeriodicalId":12510,"journal":{"name":"Giornale italiano di cardiologia","volume":null,"pages":null},"PeriodicalIF":0.5,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41113789","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Ischemia with non-obstructive coronary artery disease: state-of-the-art review].","authors":"Giulia Ghizzoni, Luigi Di Serafino, Giulia Botti, Domenico Galante, Domenico D'Amario, Stefano Benenati, Filippo Luca Gurgoglione, Renzo Laborante, Graziella Pompei, Italo Porto, Gianluca Calogero Campo, Giampaolo Niccoli, Giovanni Esposito, Antonio Maria Leone, Alaide Chieffo","doi":"10.1714/4101.40990","DOIUrl":"10.1714/4101.40990","url":null,"abstract":"<p><p>Chest pain affects more than 100 million people globally, however up to 70% of patients undergoing invasive angiography do not have obstructive coronary artery disease and ischemia with non-obstructive coronary artery disease (INOCA) is often a cause of the clinical picture. The symptoms reported by INOCA patients are very heterogeneous and often misdiagnosed as non-cardiac leading to under-diagnosis/investigation and under-treatment. The underlying pathophysiological mechanisms of INOCA are multiple and include coronary vasospasm and microvascular dysfunction. Most importantly, this condition must not be considered benign: compared to asymptomatic individuals, INOCA patients present an increased incidence of cardiovascular events, rehospitalizations, as well as impaired quality of life, with increasing costs for healthcare systems. The aims of this review are to describe the pathophysiological and clinical characteristics of INOCA and to provide guidance to the medical community on the diagnostic approaches and management of INOCA, also via a series of clinical case reports.</p>","PeriodicalId":12510,"journal":{"name":"Giornale italiano di cardiologia","volume":null,"pages":null},"PeriodicalIF":0.5,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41096743","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Critical reading of cardiovascular trials with neutral or negative findings].","authors":"Alberto Aimo,&nbsp;Vincenzo Castiglione,&nbsp;Iacopo Fabiani,&nbsp;Paolo Morfino,&nbsp;Michele Emdin,&nbsp;Roberto Ferrari,&nbsp;Luigi Tavazzi,&nbsp;Aldo Pietro Maggioni,&nbsp;Claudio Rapezzi","doi":"10.1714/4100.40982","DOIUrl":"https://doi.org/10.1714/4100.40982","url":null,"abstract":"<p><p>Randomized controlled trials showing a significant benefit are met with enthusiasm because they may change the standard of care for patients who share the clinical and pathophysiologic characteristics of trial participants. Nonetheless, a well-designed and fully executed trial with neutral or negative findings also represents a critically important investigation deserving careful scientific scrutiny. In this paper we propose a 10-step approach to the interpretation of neutral or negative trials to exclude important methodological issues before concluding that the treatment really does not work. We will discuss this approach using the most classic trials of the past and some notable examples among superiority trials (mostly phase 3 trials) published over the last years.</p>","PeriodicalId":12510,"journal":{"name":"Giornale italiano di cardiologia","volume":null,"pages":null},"PeriodicalIF":0.5,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41107500","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[ST-segment elevation and beyond...]","authors":"Michele Trichilo,&nbsp;Assunta Di Domenico,&nbsp;Silvia Zagnoni","doi":"10.1714/4100.40976","DOIUrl":"https://doi.org/10.1714/4100.40976","url":null,"abstract":"","PeriodicalId":12510,"journal":{"name":"Giornale italiano di cardiologia","volume":null,"pages":null},"PeriodicalIF":0.5,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41094929","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Hormone therapy, cardio-metabolic profile, and cardiotoxicity. Still a dark side of cardio-oncology - Part 2: Prostate cancer].","authors":"Luigi Tarantini,&nbsp;Stefania Di Girolamo,&nbsp;Cristina Masini,&nbsp;Giovanni Cioffi,&nbsp;Jennifer Foglietta,&nbsp;Sergio Bracarda,&nbsp;Carmine Pinto,&nbsp;Alessandro Navazio","doi":"10.1714/4100.40978","DOIUrl":"10.1714/4100.40978","url":null,"abstract":"<p><p>Hormone therapies (HTs) with anti-androgenic properties are a cornerstone for the treatment of prostate cancer (PC) and have significantly improved the survival of patients, though exposing them to a higher risk of cardiovascular diseases (CVDs), which represent a major cause of morbidity and mortality. This occurs due to the high average age of patients undergoing HT for PC, an age group in which CVDs have a high prevalence and incidence, and due to the type and duration of HTs that are increasingly effective but at the same time more aggressive towards cardiovascular health. Recent evidence from the real world suggests, however, that the cardiometabolic risk is widely underestimated and undertreated with significant impact also on the oncological prognosis. In the light of the results of the PRONOUNCE study, in this review it is emphasized the need for a multidisciplinary management of patients with PC who are candidate for or treated with HT by implementing a personalized treatment program in accordance with the current European guidelines on CVD prevention.</p>","PeriodicalId":12510,"journal":{"name":"Giornale italiano di cardiologia","volume":null,"pages":null},"PeriodicalIF":0.5,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41111906","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[West Nile virus and myocarditis, a rare event: case report].","authors":"Andrea Laurito,&nbsp;Luca Rodella,&nbsp;Enrico Vizzardi,&nbsp;Marco Metra","doi":"10.1714/4100.40983","DOIUrl":"https://doi.org/10.1714/4100.40983","url":null,"abstract":"<p><p>We present a rare case of a 77-year-old Italian woman, admitted to the neurology unit with the diagnosis of West Nile virus encephalitis. Twenty days after the onset of the neurological symptoms, new negative T-waves appeared on the ECG in association with serum elevation of myocardial necrosis enzymes and regional cardiac wall motion abnormalities on echocardiography, so that a coronary angiography was performed. The exam showed significant stenosis on the left circumflex artery, treated with percutaneous coronary intervention. In addition, a cardiovascular magnetic resonance was performed for further investigation: the T2-weighted images revealed edema in the anterior wall and mid-wall late gadolinium enhancement, significant findings of acute myocardial inflammation. Because of the recent diagnosis of West Nile virus encephalitis and the high serum level of specific IgM antibody, the clinical presentation was suggestive of West Nile myocarditis.</p>","PeriodicalId":12510,"journal":{"name":"Giornale italiano di cardiologia","volume":null,"pages":null},"PeriodicalIF":0.5,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41121315","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Temporary cardiac pacing: 50 years old and still young].","authors":"Raimondo Calvanese,&nbsp;Manuel Antonio Conti,&nbsp;Amir Kol,&nbsp;Carlo Pignalberi","doi":"10.1714/4100.40981","DOIUrl":"https://doi.org/10.1714/4100.40981","url":null,"abstract":"<p><p>Temporary cardiac pacing (TCP) is a 50-year-old technique but it is still young. It is used in all cardiology departments for saving lives of patients with bradycardia and hemodynamic instability. The know-how of TCP cannot miss in clinical competence of cardiologists that work in the cardiac intensive care unit. However, despite its wide diffusion, the scientific evidence supporting TCP is not so strong and in Italian hospitals the management of some aspects of TCP is highly variable, including indications as well as antibiotic and anticoagulant prophylaxis. Due to the high risk of TCP-related complications, the 2021 European guidelines on cardiac pacing recommend whenever possible to avoid TCP before cardiac implantable electronic device implantation and, in all cases, TCP duration should be as short as possible. In the last years, if on the one hand, TCP indications have gradually decreased, on the other hand high-frequency TCP during aortic valvuloplasty or transcatheter aortic valve implantation procedures have progressively increased.</p>","PeriodicalId":12510,"journal":{"name":"Giornale italiano di cardiologia","volume":null,"pages":null},"PeriodicalIF":0.5,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41111907","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}