Short-term effects of DAPAgliflozin on Lung fUNction, sleep apneas, and circulatinG surfactant protein B in Heart Failure with reduced ejection fraction (DAPA-LUNG-HF).

The mechanisms underlying the effects of dapagliflozin in heart failure with reduced ejection fraction (HFrEF) are not yet fully understood. This study aims to evaluate the effect of the drug on cardiorespiratory function by assessing alveolar-capillary membrane characteristics, sleep apnea, pulmonary and cardiac performance in stable HFrEF patients. Seventy-three patients with stable HFrEF were enrolled, with 66 completing the six-month follow-up.

Impact of GFR Estimation Formulas on MECKI Score Performance and Prognostic Accuracy in Heart Failure: The MECKI-RENAL Study.

Background: Appropriate interpretation of kidney function is essential for clinical and therapeutic management of heart failure (HF). We evaluated the prognostic accuracy of 6 glomerular filtration rate estimation (eGFR) formulas in HF patients with reduced ejection fraction (HFrEF) and their impact on the Metabolic Exercise test data combined with Cardiac and Kidney Indexes (MECKI) score prognostic accuracy.

Methods: We retrospectively analyzed 6,933 patients enrolled in the MECKI score database.

Cardiopulmonary exercise testing in hypertrophic cardiomyopathy: the role of reduced O2 pulse and chronotropic incompetence in myocardial adaptation.

Aims: Hypertrophic cardiomyopathy (HCM) is associated with functional limitations during exercise. We aimed to evaluate oxygen pulse (O2p) as a stroke volume (SV) surrogate and to propose a new HCM classification (RoMa) based on haemodynamic profiles during exercise: predicted peak O2p (O2pp) and peak heart rate (HRpp).

Methods And Results: This multicentre, prospective study included 90 clinically stable HCM patients who underwent cardiopulmonary exercise testing with simultaneous impedance cardiography (PhysioFlow®).

Pharmacological Therapy of HFrEF in 2025: Navigating New Advances and Old Unmet Needs in An Eternal Balance Between Progress and Perplexities.

Recent advances in medical therapy have significantly improved the prognosis of patients with heart failure and reduced ejection fraction (HFrEF). The established four pillars of HFrEF treatment - β-blockers, angiotensin-converting enzyme inhibitors or angiotensin receptor- neprilysin inhibitors, mineralocorticoid receptor antagonists and sodium-glucose cotransporter 2 inhibitors - serve as the foundation for ongoing innovations in this domain. However, these represent only the starting point for the therapy and management of heart failure.

Nasal vs. oral BREATHing WIn Strategies in healthy individuals during cardiorespiratory Exercise testing (BreathWISE).

Background: Nasal and oral exclusive breathing modes have benefits and drawbacks during submaximal exercise. It is less known whether these responses would extend to anaerobic work performed at high intensity. The purpose of this study is to find the most efficient mode of breathing during different phases of a maximal exercise at cardiopulmonary exercise test (CPET).

Myosin-ATPase inhibitor in real-world patients with obstructive HCM: a report by the Cardiomyopathies and Pericardial Diseases WG of the Italian Society of Cardiology.

Introduction: Approximately two-thirds of patients suffering from hypertrophic cardiomyopathy present with an obstructive (HOCM) physiology. For years, medical therapy has been limited to beta blockers, verapamil and/or disopyramide. Recently, a novel class of drugs, the allosteric inhibitors of the cardiac-specific myosin head adenosine triphosphatase (ATPase), have been demonstrated to be effective in relieving the dynamic obstruction and related clinical condition.

Prognostic significance of early stage aortic valve disease development in heart failure: insights from the MECKI score cohort.

Aims: Heart failure (HF) continues to pose a major clinical challenge, making the identification of high-risk HF patients crucial for improving patient care, optimizing resource allocation, and streamlining healthcare processes. Among various risk models, the metabolic exercise test data combined with cardiac and kidney indexes score stands out as a strong predictor of HF prognosis. However, the relationship between aortic valve (AV) sclerosis, an emerging marker of cardiovascular disease, and HF prognosis are currently poorly studied.

Temporal behavior of exercise oscillatory ventilation and respiratory muscle performance in patients with heart failure.

Background: Exercise oscillatory ventilation (EOV) is a negative prognostic marker in patients with heart failure (HF). EOV can either disappear (D-EOV) or persist (P-EOV) during exercise, with each showing different clinical implications. The relationship between respiratory muscle weakness and EOV persistence is not well understood, and its impact on exercise performance and muscle function in HF patients needs further exploration.

The role of impaired iron transport on exercise performance and prognosis in patients with chronic heart failure.

Background: Iron deficiency (ID) is frequent in chronic heart failure (HF). Among HF-ID patients those with impaired iron transport (IIT) (Transferrin saturation (TSAT) < 20 %) have the worst prognosis. In HF survival is strictly related to exercise limitation but the link between IIT, exercise limitation and survival is at present undefined.

Integrating pulmonary function testing with cardiopulmonary exercise testing for enhanced stratification in hypertrophic cardiomyopathy.

Background: Cardiopulmonary exercise testing (CPET) is essential for assessing patients with hypertrophic cardiomyopathy (HCM), but the role of pulmonary function testing (PFT) in refining patient stratification remains underexplored. This study investigates the relationship between PFT and CPET parameters in patients with HCM.

Methods: In this prospective two-centre study, 102 clinically stable patients with HCM underwent PFT and CPET.

Dapagliflozin effects on exercise, cardiac remodeling, biomarkers, and renal and pulmonary function in heart failure patients: not as good as expected?

Background: Sodium-glucose cotransporter-2 inhibitors (SGLT2-i) are standard therapy for heart failure (HF). We performed a holistic evaluation of dapagliflozin, including its effects on exercise performance, left ventricle (LV) reverse remodeling, cardiac biomarkers, fluid retention, and renal and pulmonary function.

Methods: We enrolled HF reduced ejection fraction (LVEF) outpatients (EF <40%) eligible for SGLT2-i and performed cardiopulmonary exercise tests (CPET), pulmonary function tests, bioelectrical impedance vector analysis, and laboratory and echocardiographic assessments at baseline ( = 0), after 2-4 weeks (T1), and after 6 months of treatment (T2).

Periodic breathing during exercise in heart failure: beyond the classic risk factors.

Periodic breathing is a peculiar ventilatory pattern in patients with heart failure (HF), characterized by cyclic oscillations in minute ventilation. This phenomenon has been observed in awake patients, during sleep, and during exercise. Periodic breathing during exercise, also known as exercise oscillatory ventilation (EOV), is an important marker of clinical and functional status, morbidity, and mortality in HF patients.

Incidental Diagnosis of Massive Mobile Left Ventricle Thrombi Following COVID-19 in a Heart Failure Patient.

A 71-year-old woman with dilated cardiomyopathy underwent an echocardiogram showing new onset of multiple mobile left ventricular masses. She experienced a mild COVID-19 infection 1 month before. After a multimodality imaging evaluation, vitamin K antagonist treatment was started, with progressive reduction of the masses without clinical events.

Connected health: Ventricular tachycardia detection with Apple Watch-A case report.

Background: Traditional screening methods, such as 12-lead electrocardiograms (ECGs) and Holter monitors, often fall short in detecting transient arrhythmias. However, advancements in wearable technology, like the Apple Watch®, enable real-time rhythm monitoring and specific arrhythmia detection through dedicated algorithms.

Case Description: A 60-year-old man with a history of arrhythmogenic cardiomyopathy and an implanted cardioverter-defibrillator (ICD), during a walk, experienced palpitations and dizziness; the Apple Watch® alerted him of an elevated heart rate.

Surfactant-derived protein type B: a new biomarker linked to respiratory failure and lung damage in mild to moderate SARS-CoV-2 pneumonia.

Background: The COVID-19 pandemic has led to significant concern due to its impact on human health, particularly through pneumonia-induced lung damage. Surfactant proteins A and D (SP-A and SP-D) are implicated in COVID-19 lung damage, but the role of surfactant protein B (SP-B) remains unclear.

Methods: We conducted a single-centre, prospective observational study involving 73 hospitalised COVID-19 pneumonia patients.

A matter of sex-persistent predictive value of MECKI score prognostic power in men and women with heart failure and reduced ejection fraction: a multicenter study.

Background: A sex-based evaluation of prognosis in heart failure (HF) is lacking.

Methods And Results: We analyzed the Metabolic Exercise test data combined with Cardiac and Kidney Indexes (MECKI) score registry, which includes HF with reduced ejection fraction (HFrEF) patients. A cross-validation procedure was performed to estimate weights separately for men and women of all MECKI score parameters: left ventricular ejection fraction (LVEF), hemoglobin, kidney function assessed by Modification of Diet in Renal Disease, blood sodium level, ventilation vs.