Giornale italiano di cardiologia最新文献

{"title":"[ANMCO Position paper: ANMCO States General 2024 - The new organization of scientific research: ANMCO proposal].","authors":"Stefania Angela Di Fusco, Francesco Orso, Aldo Pietro Maggioni, Claudio Bilato, Marco Corda, Leonardo De Luca, Massimo Di Marco, Giovanna Geraci, Attilio Iacovoni, Massimo Milli, Alessandro Navazio, Vittorio Pascale, Carmine Riccio, Pietro Scicchitano, Emanuele Tizzani, Federico Nardi, Domenico Gabrielli, Furio Colivicchi, Massimo Grimaldi, Fabrizio Oliva","doi":"10.1714/4542.45435","DOIUrl":"https://doi.org/10.1714/4542.45435","url":null,"abstract":"<p><p>Since 2021, the Research Center of the Italian Association of Hospital Cardiologists (ANMCO)/Heart Care Foundation, which boasts a long tradition of research with significant impact on clinical practice, has implemented a training project to promote knowledge of the basic methodologies for clinical research and the creation of a network of young researchers currently active in numerous research studies coordinated by the same Study Center and illustrated during the ANMCO General States 2024. Among these, the EYESHOT-2 study, together with the first phase of the BRING-UP Prevention and BRING-UP3 Heart Failure studies, enrolled almost 13 000 patients with, for the last two, 97% completeness of data at the 6-month follow-up, which is expression of the high quality of observational research work. Furthermore, in collaboration with international scientific societies and research centers, the same Study Center coordinates the activities in Italy of several international multicenter studies including EuroHeart, COLT-HF, and AFFIRMO. The States General was also an opportunity to discuss the main challenges that clinical research must face in the near future, from new research methodologies, such as the use of machine learning and registry-based randomized clinical trials, to new lines of research, such as mechanistic and pathophysiological clinical studies and decentralized clinical trials for rare diseases.</p>","PeriodicalId":12510,"journal":{"name":"Giornale italiano di cardiologia","volume":"26 9","pages":"701-705"},"PeriodicalIF":0.7,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144949977","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":"[A heart-pounding match].","authors":"Maria Mele, Elisabetta Tonet","doi":"10.1714/4542.45437","DOIUrl":"https://doi.org/10.1714/4542.45437","url":null,"abstract":"","PeriodicalId":12510,"journal":{"name":"Giornale italiano di cardiologia","volume":"26 9","pages":"e9"},"PeriodicalIF":0.7,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144949894","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":"[Recommendations for the prevention of infective endocarditis in patients undergoing cardiovascular interventions].","authors":"Caterina Chiara De Carlini, Maria Grazia Castelli, Chiara Roberta Vecchio, Annalisa Turco, Annamaria Iorio, Filippo Russo, Anna Frisinghelli, Niccolò Brenno Grieco, Paolo Bonfanti, Ilaria Chiara Caramma, Alfredo Corticelli, Edvige Rendina, Marzia Cecchini, Elena Farina, Diana Borriello, Dario D'Amata, Luca Ferri, Lucia Barbieri, Simona Pierini, Federico De Marco, Alessandra Bandera, Elena Seminari, Samuele Bichi, Giovanni Marchetto, Antonello Martino, Valerio Stefano Tolva, Alberto Froio, Antonella Loffreno, Giuseppe Uccello, Giosuè Mascioli, Giovanni Rovaris, Roberto Rordorf, Stefania Piconi, Giuseppe Di Tano, Fabrizio Oliva, Felice Achilli","doi":"10.1714/4542.45432","DOIUrl":"https://doi.org/10.1714/4542.45432","url":null,"abstract":"<p><p>Infective endocarditis is a pathology that still presents a high burden of morbidity and mortality. Several observational studies and national and international registries showed that patients undergoing invasive cardiovascular procedures (surgical or percutaneous) are at higher risk of developing infective endocarditis, resulting in increased morbidity, length of hospital stay and mortality related to these procedures. The role of antibiotic prophylaxis is therefore crucial in the prevention of postoperative infections. This is accompanied by new emerging strategies in the pre- and postoperative nursing management of patients.</p>","PeriodicalId":12510,"journal":{"name":"Giornale italiano di cardiologia","volume":"26 9","pages":"677-686"},"PeriodicalIF":0.7,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144949897","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":"[Telemonitoring in heart failure: methodology and results of ASL Nuoro's 2-year experience].","authors":"Mauro Pisano, Manuela Bocchino, Eleonora Moccia, Enrico Mura, Gianluca Doa, Serafino Ponti, Fabio De Paolis, Marco Silano, Paolo Cannas","doi":"10.1714/4542.45433","DOIUrl":"https://doi.org/10.1714/4542.45433","url":null,"abstract":"<p><strong>Background: </strong>Heart failure (HF) significantly impacts on morbidity, mortality, and healthcare use, particularly in elderly populations and underserved areas. Remote monitoring can anticipate clinical deterioration and improve care. The aim of this study was to describe the ASL Nuoro's integrated model for proactive HF management via telemonitoring.</p><p><strong>Methods: </strong>A prospective observational study enrolled HF patients stratified by the 3C-HF score and monitored using non-invasive home devices linked to the CARE MAP platform.</p><p><strong>Results: </strong>From April 2023 to March 2025, 499 patients were enrolled; 354 were active at follow-up (mean age 80 ± 11 years, 61% men). Therapeutic adherence was high (sodium-glucose cotransporter 2 inhibitors 85%, angiotensin receptor-neprilysin inhibitors 56%). Monthly clinical alerts averaged 1740 (60% clinical relevant), leading to 413 contacts/month. HF hospitalizations dropped by 71% (June-December 2023 vs. 2022).</p><p><strong>Conclusions: </strong>The integrated model proves to be feasible, effective, and sustainable, even in settings characterized by high organizational complexity. From a social perspective, it ensures equitable access to care and is applicable in geographically disadvantaged areas. The inherent limitations of the 3C-HF score highlight the need for more advanced and dynamic prognostic tools. The intervention also demonstrates economic advantage through the reduction of hospitalizations and the optimization of resource utilization.</p>","PeriodicalId":12510,"journal":{"name":"Giornale italiano di cardiologia","volume":"26 9","pages":"687-697"},"PeriodicalIF":0.7,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144950042","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":"[From anatomy to echocardiography in secondary tricuspid regurgitation. Controversial issues].","authors":"Francesco Fulvio Faletra, Eluisa La Franca, Michele Pilato, Manlio Cipriani","doi":"10.1714/4542.45429","DOIUrl":"https://doi.org/10.1714/4542.45429","url":null,"abstract":"<p><p>This review article describes two controversial aspects of secondary tricuspid regurgitation: the still poorly understood anatomy of the tricuspid valve and the advantages and limitations of color Doppler echocardiography in evaluating tricuspid regurgitation. The tricuspid apparatus is characterized by a complex anatomical structure that includes a saddle-shaped ring, three leaflets (or more), and a subvalvular apparatus. An in-depth knowledge of the anatomy is essential for understanding the various pathophysiological mechanisms of secondary (atriogenic and ventriculogenic) tricuspid regurgitation. Two-dimensional and three-dimensional echocardiography and color Doppler analysis play a key role in correct morphological and functional evaluation and in defining the etiology and extent of tricuspid regurgitation. A multiparametric approach that considers qualitative, semiquantitative, and quantitative parameters is recommended.</p>","PeriodicalId":12510,"journal":{"name":"Giornale italiano di cardiologia","volume":"26 9","pages":"648-655"},"PeriodicalIF":0.7,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144949900","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":"[Secondary atrial tricuspid regurgitation: an underestimated but increasingly clinically relevant valve disorder].","authors":"Luigi P Badano, Michele Tomaselli, Chiara Fraccaro, Anna Sannino, Federico Fortuni, Marianna Adamo, Francesco Ancona, Alessandro Sticchi, Valeria Camalleri, Annalisa Pasquini, Francesco Cannata, Giulia Masiero, Paolo Golino, Pasquale Perrone Filardi, Ciro Indolfi, Carmine Dario Vizza, Denisa Muraru","doi":"10.1714/4542.45430","DOIUrl":"https://doi.org/10.1714/4542.45430","url":null,"abstract":"<p><p>Atrial secondary tricuspid regurgitation (A-STR) is a complex and increasingly recognized form of valvular heart disease that arises primarily due to right atrial and tricuspid annular dilation in the absence of intrinsic leaflet pathology. Unlike ventricular secondary tricuspid regurgitation, which is driven by right ventricular remodeling, A-STR is predominantly associated with atrial fibrillation, heart failure with preserved ejection fraction, and other conditions that lead to chronic right atrial remodeling. This condition has been underappreciated despite its significant prevalence and impact on patient morbidity and mortality. Echocardiography is the primary diagnostic tool for diagnosing and assessing patients with A-STR. The natural history of A-STR is unfavorable, with potential worsening over time, particularly if the underlying conditions are not properly treated. Treatment options include cardioversion of atrial fibrillation and medical treatment of heart failure with preserved ejection fraction, which may promote reverse remodeling of the right heart structures and reduce STR severity in some cases. Surgical tricuspid valve annuloplasty remains the gold standard for severe cases, but transcatheter interventions are emerging as potential alternatives. This review provides a comprehensive overview of A-STR, encompassing its epidemiology, pathophysiology, diagnostic approaches, and treatment strategies. By synthesizing current evidence and highlighting gaps in knowledge, this paper aims to guide clinicians in the management of this challenging condition and to inspire future research.</p>","PeriodicalId":12510,"journal":{"name":"Giornale italiano di cardiologia","volume":"26 9","pages":"656-665"},"PeriodicalIF":0.7,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144949935","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":"[Artificial intelligence-enhanced ECG interpretation: a new era for electrocardiography?]","authors":"Fabrizio Ricci, Maria Luana Rizzuto, Giandomenico Bisaccia, Davide Mansour, Sabina Gallina, Luigi Sciarra, Giuseppe Bagliani, Antonio Dello Russo, Andrea Mortara, Giuseppe Ciliberti","doi":"10.1714/4542.45427","DOIUrl":"10.1714/4542.45427","url":null,"abstract":"<p><p>Artificial intelligence (AI) is redefining ECG interpretation, transforming it from a static diagnostic tool into a dynamic, predictive, and integrative instrument. Although widespread, traditional rule-based ECG analysis has limitations in accuracy and adaptability, especially in complex clinical settings. In contrast, AI-driven models, particularly those employing machine learning and deep learning architectures, have demonstrated improved diagnostic performance across a broad spectrum of cardiovascular diseases, including atrial fibrillation, acute myocardial infarction, hypertrophic cardiomyopathy, and valvular heart disease. Notably, AI-ECG is now able to detect subclinical ventricular dysfunction, stratify long-term risk, and anticipate major adverse events before overt clinical manifestations occur. In addition to diagnosis, AI-ECG is emerging as a decision support tool in scenarios characterized by diagnostic uncertainty, such as syncope and cardio-oncology, and may significantly optimize triage and resource allocation. Multiparametric approaches further extend its utility, enabling simultaneous prediction of structural, functional, and electrical cardiac parameters. Wearable devices integrated with AI improve continuous monitoring and may decentralize arrhythmia detection and sudden cardiac death prevention. Despite these advances, critical challenges remain. Poorly explainable AI models, algorithmic bias, overfitting, data governance, and regulatory uncertainty demand rigorous methodological scrutiny. In this framework, federated learning architectures may enable continuous multicenter model refinement and enhance methodological robustness while safeguarding data privacy. The European AI Act and methodological checklists promoted by scientific societies offer a framework to address these issues, fostering transparency, equity, and clinical validity. If validated and implemented responsibly, AI-enhanced ECG has the potential to enhance - not replace - clinical reasoning, advancing a precision medicine paradigm based on both technological innovation and human expertise.</p>","PeriodicalId":12510,"journal":{"name":"Giornale italiano di cardiologia","volume":"26 9","pages":"635-646"},"PeriodicalIF":0.7,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144949912","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":"[When the STEMI pattern is a cardiomyopathy scar].","authors":"Nicola Gonano, Rosa Pecoraro, Gianfranco Sinagra","doi":"10.1714/4542.45428","DOIUrl":"https://doi.org/10.1714/4542.45428","url":null,"abstract":"","PeriodicalId":12510,"journal":{"name":"Giornale italiano di cardiologia","volume":"26 9","pages":"647"},"PeriodicalIF":0.7,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144949987","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":"[ANMCO Position paper: ANMCO States General 2024 - In the era of precision cardiology, a reflection on the balance between cost containment and innovation].","authors":"Giovanna Geraci, Attilio Iacovoni, Fabiana Lucà, Claudio Bilato, Marco Corda, Leonardo De Luca, Massimo Di Marco, Massimo Milli, Alessandro Navazio, Vittorio Pascale, Carmine Riccio, Pietro Scicchitano, Emanuele Tizzani, Federico Nardi, Domenico Gabrielli, Furio Colivicchi, Masssimo Grimaldi, Fabrizio Oliva","doi":"10.1714/4542.45436","DOIUrl":"https://doi.org/10.1714/4542.45436","url":null,"abstract":"<p><p>Cardiovascular diseases continue to be the leading cause of death worldwide, with ischemic heart disease remaining the primary cause among cardiovascular conditions; as is well known, it is closely linked to LDL cholesterol levels, now identified as the \"cause\" of atherosclerotic plaque development and not just a risk factor. The recent introduction of increasingly powerful lipid-lowering drugs makes it more realistic today to achieve the desired LDL targets, and the evolution of therapeutic strategies allows for more personalized care by tailoring treatments to the specific profile of each patient. There are also high expectations for therapies, currently under evaluation, aimed at other potential targets contributing to atherosclerotic disease, such as lipoprotein(a) and interleukin-6. However, these new and potent therapies also have a significant economic impact, making it essential for scientific societies to thoughtfully consider how to manage resources to ensure equitable care. Likely, the use of digital tools can support a balanced and cost-effective management approach.</p>","PeriodicalId":12510,"journal":{"name":"Giornale italiano di cardiologia","volume":"26 9","pages":"706-708"},"PeriodicalIF":0.7,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144949915","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":"[Surgical and percutaneous treatment of hypertrophic obstructive cardiomyopathy: state-of-the-art review].","authors":"Maria Sabrina Ferrante, Calogera Pisano, Giuseppe Maria Raffa, Arianna Scarantino, Carlo Lachina, Vincenzo Nuzzi, Paolo Manca, Stefano Cannata, Maria Scarlata, Michele Pilato","doi":"10.1714/4531.45334","DOIUrl":"10.1714/4531.45334","url":null,"abstract":"<p><p>Hypertrophic cardiomyopathy is a heterogeneous and complex disease. It is an autosomal dominant genetic disease caused by a missense mutation in one of at least 12 genes that code for cardiac sarcomere proteins. There are various approaches used today for the treatment of this pathology, but the \"gold standard\" remains the surgical treatment of septal myectomy according to Morrow, in which the hypertrophic septum is surgically excised. However, further less invasive approaches have been proposed, such as alcohol septal ablation and edge-to-edge repair of the systolic anterior motion of the mitral valve in patients who are not candidates for surgery, but the superiority of surgery in resolution of left ventricular outflow tract obstruction and its recurrence has been widely demonstrated. Moreover, the surgical approach is correlated with low mortality and morbidity rates in expert centers for the treatment of this pathology.</p>","PeriodicalId":12510,"journal":{"name":"Giornale italiano di cardiologia","volume":"26 8","pages":"585-596"},"PeriodicalIF":0.7,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144729537","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}