Giornale italiano di cardiologia最新文献

{"title":"[Application of artificial intelligence to pharmacological and interventional treatment].","authors":"Filippo Zilio, Gianluca Calogero Campo, Lodovica Videsott","doi":"10.1714/4663.46752","DOIUrl":"10.1714/4663.46752","url":null,"abstract":"<p><p>As in many other fields, artificial intelligence (AI) is transforming daily activities in cardiology. In pharmacological therapy, algorithms have been developed to prevent adverse reactions, improve therapeutic adherence, and optimize dosage. In the field of coronary intervention, AI has been studied primarily in the anatomical and functional assessment of coronary stenoses and in the characterization of atherosclerotic plaques, but also, for example, in predicting the efficacy of treatment for chronic total occlusions. In structural cardiac intervention, AI applications are currently focused on simplifying procedural planning and standardizing interventions, as well as post-interventional prognostic assessment. The purpose of this review is to explore the current or potential applications of AI in pharmacological and interventional cardiology, highlighting both its potential and its limitations and critical issues that must be addressed.</p>","PeriodicalId":12510,"journal":{"name":"Giornale italiano di cardiologia","volume":"27 4","pages":"249-256"},"PeriodicalIF":1.5,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147511200","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: e-Health management in cardiovascular care pathways].","authors":"Fabiana Lucà, Gian Franco Gensini, Francesco Gabbrielli, Daniela Aschieri, Michela Barisone, Ilaria Battistoni, Francesco Antonio Benedetto, Claudio Bilato, Giovanni Bisignani, Roberto Ceravolo, Vincenzo Ciconte, Silvana De Bonis, Leonardo De Luca, Stefania Angela Di Fusco, Andrea Di Lenarda, Sandro Gelsomino, Giovanna Geraci, Vered Gil Ad, Mauro Gori, Attilio Iacovoni, Barbara Maria Teresa Mabritto, Massimo Milli, Iris Parrini, Annarita Pilleri, Andrea Pozzi, Carmelo Massimiliano Rao, Carmine Riccio, Patrizia Rocca, Pietro Scicchitano, Marco Vatrano, Francesco Vigorito, Michele Massimo Gulizia, Furio Colivicchi, Domenico Gabrielli, Fabrizio Oliva, Federico Nardi, Massimo Grimaldi","doi":"10.1714/4663.46757","DOIUrl":"10.1714/4663.46757","url":null,"abstract":"<p><p>The ongoing digital transformation is reshaping organizational and care delivery models in cardiology, positioning telemedicine as a pivotal tool to address increasing clinical and demographic complexity. This ANMCO position paper presents a comprehensive and critical overview of telemedicine applications in cardiovascular care, with a focus on its role in strengthening hospital-community integration, its deployment within hospital-based healthcare systems, and the associated regulatory and operational frameworks. The analysis encompasses the management of chronic cardiovascular conditions, such as heart failure and atrial fibrillation, through telemonitoring, telecontrol, televisit, and teleconsultation. Additionally, it explores the use of digital technologies in post-myocardial infarction follow-up, oral anticoagulation management, preoperative assessment, and care for elderly patients. The position paper also highlights the challenges and opportunities linked to digital infrastructure, interoperability, data protection, and healthcare professional training.</p>","PeriodicalId":12510,"journal":{"name":"Giornale italiano di cardiologia","volume":"27 4","pages":"289-306"},"PeriodicalIF":1.5,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147511245","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":"[Ten questions about cardiac sarcoidosis].","authors":"Giuseppe Ciliberti, Stefano Cangemi, Francesca Musella, Federico Fortuni, Francesco Piroli, Enrica Vitale, Stefano Cornara, Daniela Zabbia, Antonella Spinelli, Serena Guasti, Stefania Marazia, Piero Gentile, Federico Nardi, Fabrizio Oliva, Massimo Grimaldi, Marco Metra, Massimo Imazio, Benedetta De Chiara","doi":"10.1714/4663.46751","DOIUrl":"10.1714/4663.46751","url":null,"abstract":"<p><p>Cardiac sarcoidosis is a rare but potentially life-threatening condition characterized by the formation of non-caseating granulomas in the myocardium. Clinical manifestations range from asymptomatic forms to atrioventricular blocks, ventricular arrhythmias, heart failure, and sudden cardiac death. Diagnostic work-up requires a multimodality approach combining advanced imaging, clinical criteria, and, when possible, histological confirmation. Immunosuppressive therapy remains the cornerstone of treatment, aimed at suppressing myocardial inflammation and preventing irreversible damage. Risk stratification for sudden cardiac death is crucial, and cardiac implantable electronic devices play a key role in selected patients. This review, structured in ten clinical questions, provides an overview of the epidemiology, clinical presentation, diagnostic criteria, differential diagnosis, therapeutic strategies, and risk stratification of cardiac sarcoidosis, in light of the most recent international guidelines and consensus documents.</p>","PeriodicalId":12510,"journal":{"name":"Giornale italiano di cardiologia","volume":"27 4","pages":"237-248"},"PeriodicalIF":1.5,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147511202","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":"[Best practice in nutrition in the cardiac intensive care unit (CICU): an operational flow chart to support the assessment of patients admitted to the CICU].","authors":"Sara Cignola, Michela Barisone, Francesco Cruciani, Consuelo Calderaro, Alice Sacco, Furio Colivicchi, Massimo Grimaldi, Fabrizio Oliva, Serafina Valente","doi":"10.1714/4663.46753","DOIUrl":"10.1714/4663.46753","url":null,"abstract":"<p><p>Managing patients in intensive care units involves special attention for complex patients with multiple comorbidities and multi-organ dysfunction, for whom continuous and advanced staff training is required. Recent evidence shows malnutrition negatively impacts cardiovascular outcomes but can be improved with targeted strategies. However, gaps remain in standardizing nutritional assessment and management in clinical practice. The aim of the Best Practice working group is to draw up an operational flow chart to support assessments in nutrition for patients admitted to the cardiac intensive care unit (CICU) and to evaluate their impact on clinical practice. After a thorough literature review, including Cochrane guidelines and reviews, available evidence on nutrition in CICU has been synthesized and decision-making algorithms have been developed for the following clinical conditions: acute heart failure, acute coronary syndrome, after cardiac arrest, cardiogenic shock, which have been synthesized into a single algorithm to facilitate consultation and use in clinical practice. This project aims to disseminate and standardize best practice-based decision-making in the CICU, serving as a structured first step toward greater awareness and more consistent, effective management of nutrition assessment.</p>","PeriodicalId":12510,"journal":{"name":"Giornale italiano di cardiologia","volume":"27 4","pages":"257-263"},"PeriodicalIF":1.5,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147511184","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":"[PONTE-HF/ACS registry: optimization of medical therapy in outpatient clinics in Apulia for patients with heart failure].","authors":"Massimo Iacoviello, Gaetano Citarelli, Gianpaolo Palmieri, Pietro Scicchitano, Luisa De Gennaro, Francesco Massari, Massimo Vincenzo Bonfantino, Michele Accogli, Francesco Bartolomucci, Natale Daniele Brunetti, Cosimo Campanella, Marco Matteo Ciccone, Giuseppe Colonna, Paolo Colonna, Giangiuseppe Dalena, Cosimo Angelo Greco, Giovanni Luzzi, Claudio Paolillo, Andrea Passantino, Giancarlo Piccinni, Ennio Pisanò, Domenico Potenza, Vito Sollazzo, Federico Nardi, Furio Colivicchi, Fabrizio Oliva, Domenico Gabrielli, Massimo Grimaldi, Pasquale Caldarola","doi":"10.1714/4663.46755","DOIUrl":"10.1714/4663.46755","url":null,"abstract":"<p><strong>Background: </strong>Despite advances in therapy, heart failure (HF) remains a syndrome characterized by high morbidity and mortality. The PONTE-HF/ACS registry aims to assess the outcomes of a structured outpatient follow-up between hospital and community care for patients with HF or recently hospitalized for acute coronary syndrome. The purpose of this study is to evaluate one of the main process indicators of the registry for patients with HF, namely the prescribed pharmacological therapy, with particular reference to therapy with angiotensin-converting enzyme inhibitors (ACEi) or angiotensin receptor blockers (ARB) or angiotensin receptor-neprilysin inhibitors (ARNi), beta-blockers, mineralocorticoid receptor antagonists (MRA), and sodium-glucose cotransporter 2 inhibitors (SGLT2i).</p><p><strong>Methods: </strong>Between January 2024 and September 2025, 1203 patients were enrolled: 496 with HF and reduced ejection fraction (HFrEF), 189 with HF and mildly reduced ejection fraction (HFmrEF), 302 with HF and preserved ejection fraction (HFpEF), and 216 with HF and improved ejection fraction.</p><p><strong>Results: </strong>In HFrEF patients, after enrollment, therapy was prescribed as follows: ACEi/ARB/ARNi in 89% of cases (64% ARNi), beta-blockers in 97%, MRA in 85%, and SGLT2i in 85%. Quadruple therapy with and without ARNi was prescribed in 69% and 51% of cases, respectively. The percentage of patients receiving at least 50% of the recommended dose was 63% for ARNi, 41% for ACEi/ARB, 70% for beta-blockers, and 98% for MRA.</p><p><strong>Conclusions: </strong>The PONTE-HF/ACS registry shows good optimization of therapy in enrolled patients with HFrEF. Achieving this important process indicator highlights the quality of care provided by the HF outpatient network in the Apulia region and confirms the relevance of the registry for the analysis and optimization of diagnostic-therapeutic pathways in patients with HF.</p>","PeriodicalId":12510,"journal":{"name":"Giornale italiano di cardiologia","volume":"27 4","pages":"276-286"},"PeriodicalIF":1.5,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147511243","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":"[Incidental finding of negative T waves: a case of endomyocardial fibrosis].","authors":"Matteo Nardin, Maria Lo Monaco, Rocco Mollace, Erika Bertella, Davide Cao","doi":"10.1714/4651.46658","DOIUrl":"10.1714/4651.46658","url":null,"abstract":"<p><p>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.</p>","PeriodicalId":12510,"journal":{"name":"Giornale italiano di cardiologia","volume":"27 3 Suppl. 1","pages":"15S-18S"},"PeriodicalIF":1.5,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147283271","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":"[Factor XI inhibition in atrial fibrillation: where do we stand?]","authors":"Simona Giubilato, Davide Capodanno","doi":"10.1714/4650.46649","DOIUrl":"10.1714/4650.46649","url":null,"abstract":"<p><p>Factor XI (FXI) has emerged as a promising target in the prevention and treatment of venous and arterial thromboembolism in several clinical settings. Its pharmacological inhibition, through small molecules, monoclonal antibodies, antisense oligonucleotides and small-interfering RNA, has been developed with the aim of achieving effective anticoagulation while reducing bleeding risk compared to conventional anticoagulants. Phase II studies have explored the role of FXI inhibitors in surgical thromboprophylaxis, in non-valvular atrial fibrillation (AF), and as an adjunctive strategy in acute atherothrombotic settings such as acute coronary syndromes and ischemic stroke. Although preliminary data on these compounds suggest an encouraging safety profile, the available evidence regarding efficacy remains less than convincing. The phase II AZALEA-TIMI 71 trial was terminated early after showing a significant reduction in the incidence of major bleeding with abelacimab compared with rivaroxaban. In contrast, the phase III OCEANIC-AF trial of asundexian was halted due to inferiority versus apixaban. Ongoing trials, such as LILAC-TIMI 76 and LIBREXIA-AF, will be crucial to further clarify the true efficacy and safety profile of this therapeutic class. While FXI inhibitors represent a potential innovation in the treatment of AF, additional evidence is required to clearly and definitively define their role in clinical practice. This review aims to examine the pathophysiological rationale underlying the use of FXI inhibitors, to describe the different molecular subclasses currently under development, and to summarize the results of both completed and ongoing clinical trials of this novel therapeutic class, with the goal of outlining future perspectives for thromboembolic prevention in patients with AF.</p>","PeriodicalId":12510,"journal":{"name":"Giornale italiano di cardiologia","volume":"27 3","pages":"198-205"},"PeriodicalIF":1.5,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147283259","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":"[Transgender individuals and cardiovascular risk: what should the cardiologist know].","authors":"Antonia Mannarini, Maria Teresa Manes, Giuseppe Ciliberti, Daniela Pavan, Georgette Khoury, Daniela Aschieri, Angela Beatrice Scardovi, Noemi Bruno, Sara Cocozza, Maura Francese, Claudio Bilato, Giovanna Geraci, Furio Colivicchi, Massimo Grimaldi, Fabrizio Oliva","doi":"10.1714/4650.46647","DOIUrl":"10.1714/4650.46647","url":null,"abstract":"<p><p>Cardiovascular risk estimation in transgender people is an emerging research area with significant clinical implications. Healthcare for transgender people is challenging, as it encompasses the impact of hormone therapies, social inequalities, and chronic stress associated with potential discrimination. In fact, these factors may differently influence cardiovascular risk as compared to the cisgender population, although current evidence is still limited. The aim of this paper was to provide an overview of current knowledge about cardiovascular disease in transgender individuals in order to promote an evidence-based approach for this population and, finally, health equality in cardiovascular disease management.</p>","PeriodicalId":12510,"journal":{"name":"Giornale italiano di cardiologia","volume":"27 3","pages":"182-190"},"PeriodicalIF":1.5,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147283214","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":"[Left ventricular thrombosis after anterior ST-elevation myocardial infarction: surgical management with a transmitral approach. A case report].","authors":"Enrica Fede, Francesca Fedeli, Andrea Broccatelli, Laura Sperandini, Maurizio Del Pinto, Davide Di Lazzaro","doi":"10.1714/4651.46657","DOIUrl":"10.1714/4651.46657","url":null,"abstract":"<p><p>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.</p>","PeriodicalId":12510,"journal":{"name":"Giornale italiano di cardiologia","volume":"27 3 Suppl. 1","pages":"11S-14S"},"PeriodicalIF":1.5,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147283303","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":"[Minimally invasive coronary surgery: new developments in myocardial revascularization].","authors":"Domenico Paparella, Vito Margari, Giuseppe Speziale","doi":"10.1714/4650.46650","DOIUrl":"10.1714/4650.46650","url":null,"abstract":"<p><p>Minimally invasive coronary revascularization has gained increasing interest as it represents a significant approach to reducing well-known complications of conventional sternotomy, such as bleeding, need for transfusions, postoperative atrial fibrillation, wound infections, and prolonged hospital stay. These potential benefits, described in numerous retrospective and observational studies, appear to be associated with faster functional recovery and improved quality of life, although prospective evidence remains limited at present. The harvesting of the internal mammary artery, initially performed under direct vision through a mini-thoracotomy, has been progressively refined through the introduction of thoracoscopy and, in highly specialized centers, with robotic assistance. The choice of the incision site and extent is now tailored to the patient's anatomy and the objectives of revascularization, resulting in an increasingly personalized approach. Among available techniques, the minimally invasive direct coronary artery bypass - in which the left internal mammary artery is anastomosed to the left anterior descending artery - represents a consolidated and effective option for isolated left anterior descending coronary artery lesions. Minimally invasive coronary surgery extends these possibilities to multivessel revascularization, performed with or without cardiopulmonary bypass, allowing accurate anastomoses even on lateral and inferior wall vessels. The totally endoscopic coronary artery bypass represents a further evolution, based on completely endoscopic access, whose clinical use remains limited to a few highly specialized centers, sometimes with robotic support, particularly during conduit harvesting. Overall, minimally invasive coronary surgery represents an evolving field, supported by a growing number of publications and clinical experiences in Europe, North America, and also in Italy, where centers such as the Santa Maria Hospital in Bari perform a significant proportion of minimally invasive revascularizations. According to the available literature, this approach is associated with reduced perioperative complications, shorter hospital stays, and faster return to daily activities, with greater patient acceptance. Thoracoscopy and robotics are promising innovations that may further enhance outcomes, while mini-invasiveness remains the cornerstone of an increasingly central evolution in coronary surgery.</p>","PeriodicalId":12510,"journal":{"name":"Giornale italiano di cardiologia","volume":"27 3","pages":"206-212"},"PeriodicalIF":1.5,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147283251","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}