Stress Echo 2030 Study: A Flagship Project of the Italian Society of Echocardiography and Cardiovascular Imaging.

Over the past decade, stress echocardiography has evolved from a test for assessing epicardial artery stenosis to a comprehensive functional test, targeting multiple cardiovascular parameters. The new approach includes several structured steps: (a) evaluating regional wall motion abnormalities to detect epicardial artery stenosis or vasospasm; (b) assessing pulmonary congestion and diastolic function via B-lines with lung ultrasound; (c) gauging preload and contractile reserve with volumetric echocardiography; (d) measuring coronary microvascular reserve using Doppler-based coronary flow velocity in the middistal left anterior descending artery; and (e) determining cardiac sympathetic reserve by tracking heart rate reserve on an ECG. This evolution was supported extensively by the Italian Society of Echocardiography and Cardiovascular Imaging (SIECVI), which played a key role in five areas: (1) developing the initial, curiosity-driven project; (2) disseminating protocols and results at national and international conferences, supporting logistic infrastructure and publication expenses; (3) establishing a digital platform (customized Redcap) for data entry and storage; (4) facilitating patient recruitment across 19 Italian centers; and (5) offering formal endorsement through six presidencies, adding credibility and reach beyond any single institution.

Resolution of left ventricular thrombus assessed by echocardiography: insights from a contemporary multicentre prospective registry.

Aims: How to detect and monitor left ventricular thrombus (LVT) remains complex since clinicians can rely only on retrospective, single-centre data. To characterize the incidence and independent associates of LVT resolution (assessed with echocardiography) and its clinical implications on long-term follow-up in a contemporary cohort of consecutive patients with LVT.

Methods And Results: Ten centres were involved in this observational prospective multicentre study.

Prevalence of low-flow state by automated machine-learning 3D echocardiography in patients with moderate-to-severe aortic stenosis and normal ejection-fraction.

Background: In aortic valve stenosis (AS), measurement of stroke volume index (SVi) by the 2D Doppler- technique is required to calculate the aortic valve area (AVA) and determine flow status but is prone to systematic errors.

Purpose: To investigate the prevalence of low-flow (LF) state (SVi ≤ 35 ml/m) in patients with AS and concurrent SVi quantification by a validated 3D left ventricular volumetric method and standard 2D Doppler methods and its potential repercussions on flow status reclassification.

Methods: Consecutive patients with moderate or severe AS (≤1.

Left and right atrial echocardiographic parameters and outcomes in patients with atrial fibrillation.

Background: This study evaluates the association between left atrial and right atrial (LA, RA) parameters and a composite endpoint (CEP) of all-cause death, thromboembolism, acute coronary syndrome, and heart failure hospitalization in atrial fibrillation (AF) patients.

Material And Methods: Patients were prospectively enrolled. At baseline, the following echocardiogram parameters were measured: LA and RA antero-posterior diameter index (iLAAPD, iRAAPD), LA and RA volume index (LAVi, RAVi), LA and RA sphericity index (LASI, RASI), LA and RA emptying fraction.

Photoinduced energy and electron transfer processes in a supramolecular system combining a tetrapyrenylporphyrin derivative and arene-ruthenium metalla-prisms.

A supramolecular system, consisting of a tetrapyrenylporphyrinic core surrounded by arene-ruthenium prisms, has been assembled and characterized by means of electrochemical and photophysical techniques. The photophysical study shows that quantitative energy transfer from the peripheral pyrenyl units towards the central porphyrin core is operative in the tetrapyrenylporphyrinic system. Interestingly, encapsulation of the pyrenyl units into the ruthenium cages affects the photophysics of the central porphyrin component, since its emission quantum yield is reduced in the supramolecular array.

Predictors of hypercontractile heart phenotype in patients with chronic coronary syndromes or heart failure.

Hypercontractile phenotype (HP) of the left ventricle (LV) is an actionable therapeutic target in patients with chronic coronary syndromes (CCS) or heart failure (HF), but its clinical recognition remains difficult. To assess the clinical variables associated with the HP. In a prospective, observational, multicenter study, we recruited 5122 patients (age 65 ± 11 years, 2974 males, 58%) with CCS and/or HF with preserved ejection fraction (EF).

Temporal implementation of a regional referral pathway in transthyretin cardiac amyloidosis: Emilia-Romagna experience.

Aims: Transthyretin cardiac amyloidosis (ATTR-CA) is a rare and progressive cardiomyopathy caused by amyloid fibril deposition in myocardial tissue. Diagnostic challenges have historically hampered timely detection. Recent advances in noninvasive diagnostic techniques have facilitated ATTR-CA diagnosis.

Indexing left ventricular end-systolic dimension to body size: Association with mortality in patients with degenerative mitral regurgitation.

Aims: In patients with degenerative mitral regurgitation (DMR), left ventricular (LV) dysfunction is associated with increased risk of heart failure and excess mortality. LV end-systolic diameter (LVESD) is an established trigger for intervention, yet recommended LVESD thresholds apply poorly to patients with small body size. Whether LV normalization to body surface area (BSA) may be used as a trigger for DMR correction is unknown.

Degenerative mitral regurgitation due to flail leaflet: sex-related differences in presentation, management, and outcomes.

Background And Aims: Presentation, outcome, and management of females with degenerative mitral regurgitation (DMR) are undefined. We analysed sex-specific baseline clinical and echocardiographic characteristics at referral for DMR due to flail leaflets and subsequent management and outcomes.

Methods: In the Mitral Regurgitation International Database (MIDA) international registry, females were compared with males regarding presentation at referral, management, and outcome (survival/heart failure), under medical treatment, post-operatively, and encompassing all follow-up.

Echocardiographic functional determinants of survival in heart failure with abnormal ejection fraction.

Background And Aims: Patients with heart failure (HF) with reduced left ventricular (LV) ejection fraction (EF) have a heterogeneous prognosis, and assessment of coronary physiology with coronary flow velocity (CFV) and coronary flow velocity reserve (CFVR) may complement established predictors based on wall motion and EF.

Methods And Results: In a prospective multicenter study design, we enrolled 1,408 HF patients (age 66 ± 12 years, 1,035 men), with EF <50%, 743 (53%) with coronary artery disease, and 665 (47%) with normal coronary arteries. Recruitment (years 2004-2022) involved 8 accredited laboratories, with inter-observer variability <10% for CFV measurement.

"It is like post-traumatic stress disorder, but in a positive sense!": New territories of the self as inner therapeutic landscapes for youth experiencing mental ill-health.

The manuscript reports on a study conducted on a youth mental health intervention, proposing a novel framework to look at the therapeutic potential of viticultural landscapes. Drawing on care studies applied to agricultural contexts, the work explores how the attention-based practice of manual grape harvest in a specific natural and social environment can produce a "therapeutic landscape of the mind". Through ethnographic research, we investigate how the spatial and social context of the viticultural environment influences the experience of a group of young people with mental-ill health, eventually supporting their process of recovery.

Quantification of Myocardial Contraction Fraction with Three-Dimensional Automated, Machine-Learning-Based Left-Heart-Chamber Metrics: Diagnostic Utility in Hypertrophic Phenotypes and Normal Ejection Fraction.

The differentiation of left ventricular (LV) hypertrophic phenotypes is challenging in patients with normal ejection fraction (EF). The myocardial contraction fraction (MCF) is a simple dimensionless index useful for specifically identifying cardiac amyloidosis (CA) and hypertrophic cardiomyopathy (HCM) when calculated by cardiac magnetic resonance. The purpose of this study was to evaluate the value of MCF measured by three-dimensional automated, machine-learning-based LV chamber metrics (dynamic heart model [DHM]) for the discrimination of different forms of hypertrophic phenotypes.

Organization and Activity of Italian Echocardiographic Laboratories: A Survey of the Italian Society of Echocardiography and Cardiovascular Imaging.

Background: The Italian Society of Echocardiography and Cardiovascular Imaging (SIECVI) conducted a national survey to understand better how different echocardiographic modalities are used and accessed in Italy.

Methods: We analyzed echocardiography laboratory activities over a month (November 2022). Data were retrieved via an electronic survey based on a structured questionnaire, uploaded on the SIECVI website.