Invasive Hemodynamic Monitoring in Acute Heart Failure and Cardiogenic Shock.

Invasive hemodynamic monitoring provides essential information for managing acute heart failure (AHF) and cardiogenic shock (CS) patients, aiding circulatory shock phenotyping and in individualized and hemodynamically-based therapeutic management. The hemodynamic trajectory after the initial care bundle has been provided refines prognostication and anticipates hospital outcomes. Invasive hemodynamic monitoring also tracks the clinical response to supportive measures, providing objective background for therapeutic escalation/de-escalation, facilitating titration of vasoactive/temporary mechanical circulatory support (tMCS) to achieve an optimal balance between native heart function and device assistance, and allowing for a repeated reassessment of hemodynamics during the support weaning phase.

Transcatheter Approaches to Atrial Functional Mitral Regurgitation: How Far Have We Come?

Functional mitral regurgitation (MR) is associated with increased cardiovascular morbidity and mortality and over the past decade, the diagnosis of atrial functional mitral regurgitation (aFMR) has been increasingly observed in the elderly, especially in those with atrial fibrillation (AF) and heart failure with preserved ejection fraction (HFpEF). Annular enlargement, perturbations of annular contraction, and atriogenic leaflet tethering distinguish the pathophysiology of aFMR from the one of ventricular origin. However, no consensus provides recommendations regarding the differential diagnosis and the subsequent management of aFMR.

A comprehensive and easy-to-use ECG algorithm to predict the coronary occlusion site in ST-segment elevation myocardial infarction.

Background: Several electrocardiogram (ECG) criteria have been proposed to predict the location of the culprit occlusion in specific subsets of patients presenting with ST-segment elevation myocardial infarction (STEMI). The aim of this study was to develop, through an independent validation of currently available criteria, a comprehensive and easy-to-use ECG algorithm, and to test its diagnostic performance in real-world clinical practice.

Methods: We analyzed ECG and angiographic data from 419 consecutive STEMI patients submitted to primary percutaneous coronary intervention over a one-year period, dividing the overall population into derivation (314 patients) and validation (105 patients) cohorts.