[State of the art and projects of the Italian Fabry Disease Cardiovascular Registry].

Anderson-Fabry disease is a panethnic, rare disease caused by α-galactosidase A deficiency, with subsequent systemic intracellular accumulation of glycosphingolipids. Confined as a nephrological disease for many decades, the widespread use of multimodality imaging techniques over the last 20 years (like cardiac magnetic resonance) has allowed to highlight the frequent and heterogeneous cardiovascular involvement, with important impact on therapeutic strategies and prognosis. However, many grey zones and knowledge gaps remain, both in diagnostic and management approaches.

[Secondary atrial tricuspid regurgitation: an underestimated but increasingly clinically relevant valve disorder].

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.

Non cardiovascular comorbidities in Heart Failure. An updated position paper from the Heart Failure Working Group of the Italian Society of Cardiology (SIC).

Heart Failure (HF) is frequently associated with various non cardiovascular (CV) comorbidities significantly impacting HF prognosis. Indeed, the simultaneous presence of multiple diseases leads to an increased vulnerability, with frailty occurrence. This status implies poor quality of life and increased adverse events rate in terms of hospitalization and mortality.

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.

Addressing the unmet needs of cardiovascular evaluation in athletes: A national survey of the Italian Society of Cardiology (SIC) and the Regional Associations of Ambulatory Cardiologists (ARCA).

Introduction: Cardiovascular screening of athletes is of paramount importance in identifying individuals at risk for sudden cardiac death. Performing such evaluations requires specific knowledge and expertise. The educational needs of cardiology community and the perception of sports cardiology as a specific subspecialty needing a dedicated approach have never been explored.

Pregnancy in patients with inherited myocardial disorders - A consensus document on preconception counseling and pregnancy management by the working group on myocardial and pericardial disorders of the Italian Society of Cardiology.

Cardiomyopathies are inherited cardiac disorders characterized by increased risk of heart failure and life-threatening arrhythmias leading to sudden cardiac death. The comprehension of the genetic foundation and the accessibility of genetic testing have significantly enhanced the identification of patients harbouring mutations linked to cardiomyopathy, even in the absence of a distinct phenotype, facilitating early diagnosis. However, the diagnosis at a young age carries the intrinsic problem of the possible disease transmission.

Cardiac mechanical synchrony couples with myocardial sympathetic innervation. A retrospective study with novel echocardiographic assessment in patients with I-mIBG imaging.

Purpose: Left ventricular (LV) mechanical synchrony is essential for efficient cardiac function, and its disruption (dyssynchrony) negatively impacts outcomes, particularly in heart failure. Although sympathetic innervation modulates electrical activation and contraction timing, its relationship with mechanical synchrony is underexplored. This study aimed to assess their association using echocardiographic synchrony indices and I-mIBG scintigraphy, introducing a novel index (AMP-sync).

Gender and Sex-related differences in Type 2 Myocardial Infarction: the undervalued side of a neglected disease.

Type 2 myocardial infarction (T2MI) occurs due to an imbalance between coronary blood supply and myocardial oxygen demand, leading to ischemia without the rupture of an atherosclerotic plaque, distinguishing it from Type 1 myocardial infarction (T1MI). Although T2MI is frequently diagnosed in clinical practice and associated with a poor prognosis, there is limited understanding of the sex differences in this condition, despite women representing a higher proportion of T2MI cases compared to T1MI. This review explores the definitions, epidemiological aspects, and clinical scenarios that reveal significant differences in T2MI between men and women that contribute to disparities in outcomes.

Therapeutic tailored approach in patients with diabetes, cardiovascular and renal comorbidities: A cardiologist's view.

Aims: The aim of this narrative review is to explore the management of hypoglycemic drugs in patients with type 2 diabetes mellitus (T2DM) and cardiovascular (CV) or renal disease using the most recent strategies.

Data Synthesis: Cardiovascular diseases (CVD) are the principal source of sickness and mortality in patients with T2DM. The importance of CVD risk factors among individuals with diabetes has been the object of recent investigation and several recommendations have been updated thanks to studies focused on CV outcomes.

Prognostic significance of severe mitral annular calcification in aortic stenosis: implications for aortic valve replacement outcome.

Background: Mitral annulus calcification (MAC) is no longer seen as merely age-related. Recent evidence links MAC to calcific aortic stenosis (AS), but its prognostic value in AS patients undergoing aortic valve replacement (AVR) remains unclear. This study aims to assess the impact of cardiac CT-derived MAC on cardiovascular outcomes in this population.

Comprehensive insights into peripheral artery disease: an overview from the working groups of pathogenesis of atherosclerosis and thrombosis of the Italian Society of Cardiology.

Peripheral artery disease (PAD) is a global health burden due to its high prevalence, morbidity, and mortality. It affects more than 200 million people worldwide. PAD is a manifestation of systemic atherosclerosis that is often associated with coronary and cerebrovascular disease, underscoring its crucial role as an indicator of advanced vascular pathology.

Exploring the Benefits of Extra Virgin Olive Oil on Cardiovascular Health Enhancement and Disease Prevention: A Systematic Review.

Olive oil's health benefits are widely known and extensively documented; its advantages are widespread, covering numerous areas of human health. Clinical and experimental data indicate that a Mediterranean Diet (MedDiet) with Extra Virgin Olive Oil (EVOO) lowers the risk of illnesses associated with oxidative stress, chronic inflammation, and weakened immunity, including cancer and cardiovascular disease (CVD). The European Food Safety Authority (EFSA) confirms that olive oil's polyphenols help protect blood lipids against oxidative damage; thus, EVOO, crucial in the MedDiet, could be a functional food component.

Current trends and challenges in the clinical use of cardiovascular magnetic resonance: a survey from the Italian Society of Cardiology.

Aims: Challenges related to the use of cardiovascular magnetic resonance (CMR) remain a key issue to secure its full clinical impact. This survey aimed to assess the awareness of CMR clinical utility and to collect data on its local usage levels, operational barriers, and report efficacy, with the goal of identifying key obstacles to its effective implementation across Italy.

Methods And Results: The CMR Working Group of the Italian Society of Cardiology promoted an online survey targeting Italian physicians involved in direct care of patients with cardiovascular disease.

Expert consensus document on artificial intelligence of the Italian Society of Cardiology.

Artificial intelligence (AI), a branch of computer science focused on developing algorithms that replicate intelligent behaviour, has recently been used in patients management by enhancing diagnostic and prognostic capabilities of various resources such as hospital datasets, electrocardiograms and echocardiographic acquisitions. Machine learning (ML) and deep learning (DL) models, both key subsets of AI, have demonstrated robust applications across several cardiovascular diseases, from the most diffuse like hypertension and ischemic heart disease to the rare infiltrative cardiomyopathies, as well as to estimation of LDL cholesterol which can be achieved with better accuracy through AI. Additional emerging applications are encountered when unsupervised ML methodology shows promising results in identifying distinct clusters or phenotypes of patients with atrial fibrillation that may have different risks of stroke and response to therapy.

[Management of cardiac amyloidosis in Italy: a national survey of the Italian Cardiac Amyloidosis Network (RIAC)].

Background: The national survey of the SIC-ANMCO Amyloidosis Centers was designed to create a geographical mapping of the centers that identify and follow patients with cardiac amyloidosis in Italy and to describe their diagnostic capabilities and multidisciplinary organization.

Methods: The survey was administered to 212 centers in Italy. Among them, 153 centers responded (72%), 31/35 (89%) of which were academic medical centers and 122/177 (69%) hospitals.

Resource and OUTcome Impact of routiNE availability of Computed Tomography Perfusion.

Aims: Stress computed tomography perfusion (Stress-CTP) is a functional technique added on top of coronary computed tomography angiography (cCTA) to improve the management of subjects with coronary artery disease (CAD). The ROUTINE-CTP Registry is a prospective study aimed at evaluating the impact of routine implementation of combined cCTA plus Stress-CTP for the assessment of patients with intermediate to high CAD risk or known CAD symptomatic for chest pain in a real-world setting.

Methods And Results: Data collected during follow-up included radiation exposure, reclassification rates between cCTA alone and cCTA with Stress-CTP, subsequent non-invasive testing, referral rates for invasive coronary angiography (ICA), prevalence of non-obstructive CAD at ICA, rates of revascularization, and major adverse cardiac events (MACE).

Epigenetic mechanisms underlying the beneficial effects of cardiac rehabilitation. An overview from the working groups of "cellular and molecular biology of the heart" and "cardiac rehabilitation and cardiovascular prevention" of the Italian Society of Cardiology (SIC).

The benefits of cardiac rehabilitation (CR) have been demonstrated in patients after myocardial infarction (MI), and in patients with chronic heart failure (HF). The core components of the CR program include improvement in exercise tolerance and optimization of coronary risk factors (i.e.

Quality of life in heart failure. The heart of the matter. A scientific statement of the Heart Failure Association and the European Association of Preventive Cardiology of the European Society of Cardiology.

For most patients with chronic, progressive illnesses, maintaining good quality of life (QoL), with preserved functional capacity, is just as crucial as prolonging survival. Patients with heart failure (HF) experience much worse QoL and effort intolerance than both the general population and people with other chronic conditions, since they present a range of physical and psychological symptoms, including shortness of breath, chest discomfort, fatigue, fluid congestion, trouble with sleeping, and depression. These symptoms reduce patients' capacity for daily social and physical activity.

Quality of life in heart failure. The heart of the matter. A scientific statement of the Heart Failure Association and the European Association of Preventive Cardiology of the European Society of Cardiology.

For most patients with chronic, progressive illnesses, maintaining good quality of life (QoL), with preserved functional capacity, is just as crucial as prolonging survival. Patients with heart failure (HF) experience much worse QoL and effort intolerance than both the general population and people with other chronic conditions, since they present a range of physical and psychological symptoms, including shortness of breath, chest discomfort, fatigue, fluid congestion, trouble with sleeping, and depression. These symptoms reduce patients' capacity for daily social and physical activity.

Growth Hormone Replacement Therapy in Heart Failure With Reduced Ejection Fraction: A Randomized, Double-Blind, Placebo-Controlled Trial.

Background: Growing evidence suggests that reduced activity of the growth hormone (GH)/insulin-like growth factor (IGF)-1 axis is common and associated with poor clinical status and outcome in heart failure (HF). In addition, preliminary results of growth hormone deficiency (GHD) correction in HF showed an improvement in quality of life, cardiac structure and function, and cardiovascular performance.

Objectives: The aim of the present double-blind, randomized, placebo-controlled trial was to evaluate the cardiovascular effects of 1 year of GH replacement therapy in a cohort of patients with heart failure and reduced ejection fraction (HFrEF).

Non-invasive imaging assessment in angina with non-obstructive coronary arteries (ANOCA).

Due to its significant prevalence and clinical implications, angina with non-obstructive coronary arteries (ANOCA) has become a major focus in modern cardiology. In fact, diagnosing ANOCA presents a significant challenge. The final diagnosis is often difficult, delayed, and frequently necessitates an invasive assessment through coronary angiography.

The European Society of Cardiology 2024 Guidelines on Chronic Coronary Syndromes: A Critical Appraisal.

: During the 2024 annual meeting in London, The European Society of Cardiology released new guidelines () on chronic coronary syndromes () and simultaneously published them in the European Heart Journal. : A few experts on the topic from Europe, South America, India, and Asia, who attended the presentation and the Question and Answer sections, met virtually to comment on the GLs after carefully reading the 123-page document. : There is a consensus that the presented GLs are a comprehensive, up-to-date, clear document of the available data on how to diagnose and treat CCSs and a definite step forward compared to all previous GLs.

ANOCA, INOCA, MINOCA: The New Frontier of Coronary Syndromes.

The growing prevalence in the diagnosis of INOCA (Ischemia with Non-Obstructive Coronary Arteries), ANOCA (Angina with Non-Obstructive Coronary Arteries), and MINOCA (Myocardial Infarction with Non-Obstructive Coronary Arteries) highlights the need to reassess their clinical relevance. Historically regarded as benign syndromes, emerging evidence suggests that these conditions may cause serious cardiovascular events and considerable long-term disability. Additionally, emerging studies suggest that non-obstructive coronary artery disease (CAD) may have a higher prevalence compared to traditional obstructive forms of CAD.

Biomarkers for Congestion in Heart Failure: State-of-the-art and Future Directions.

Congestion in patients with heart failure (HF) predicts adverse outcomes and is a leading cause of hospitalisation. Understanding congestion mechanisms helps in HF management and underscores the importance of tailored therapies to treat vascular and tissue congestion, improving patient outcomes. In this setting, several tools are available to detect congestion.

Myocarditis and pericarditis during COVID-19 pandemic: a study of the Italian Society of Cardiology.

Aims: Some studies about myocarditis and pericarditis following COVID-19 vaccination raised concerns worldwide. However, the heterogeneous diagnostic criteria for postvaccination inflammatory heart diseases may result in overestimating incidence rates. The aim of this multicentre Italian registry is to evaluate the impact of COVID-19 vaccines on the incidence of myocarditis and pericarditis in the Italian population.