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.

Thrombotic Risk in Cancer Patients: Diagnosis and Management of Venous Thromboembolism.

Venous thromboembolism (VTE) represents a major health problem, especially in cancer patients, who experience a significantly higher incidence of both deep vein thrombosis and pulmonary embolism compared to the general population. Indeed, patients with cancer have a prothrombotic state resulting in both increased expression of procoagulants and suppression of fibrinolytic activity. In addition, VTE increases the morbidity and mortality of these patients.

Update on the Organizational Aspects of Echocardiography in Italy (From Operator Training to the Report: 2007-2019): A Consensus Document by the "Società Italiana di Ecocardiografia e CardioVascular Imaging" Accreditation Area and Board 2017-2019.

In 2007, Società Italiana di Ecocardiografia e CardioVascular Imaging (SIECVI) already SIEC, published the document on the organization of echocardiography in Italy. In the years following the technological evolution, cultural and health factors have changed "the way, we do echo" as a tool for the different clinical pathways. The SIECVI Accreditation Area and Board 2017-2019 considered necessary to review and update the document in the light of innovation in the application of ultrasound for the heart disease assessment.

Bicuspid Aortic Valve Registry of the Italian Society of Echocardiography and Cardiovascular Imaging (REgistro della valvola aortica bicuspide della società italiana di ECocardiografia e CArdiovascular imaging): Rationale and Study Design.

Background: Bicuspid aortic valve (BAV) is the most common congenital heart disease, affecting 0.5%-2% of the general population. It is associated not only with notable valvular risk (aortic stenosis and/or regurgitation, endocarditis) but also with aortopathy with a wide spectrum of unpredictable clinical presentations, including aneurysmal dilation of the aortic root and/or ascending thoracic aorta, isthmic coarctation, aortic dissection, or wall rupture.

Acute heart failure related to a large left atrial myxoma.

An association between atrial myxoma and left ventricular failure is rarely described, is not completely understood, and may have multiple etiologies. We present a 49-year-old man with no history of cardiovascular disease who was admitted to our hospital with pulmonary edema. He was in atrial fibrillation with rapid ventricular response.

Incremental Value of Pocket-Sized Echocardiography in Addition to Physical Examination during Inpatient Cardiology Evaluation: A Multicenter Italian Study (SIEC).

Background: We prospectively assessed the incremental value of a pocket-sized echocardiography (PSE) device during cardiology consultations, in addition to physical examination, ECG reading, and chest x-ray.

Methods: A total of 443 consecutive patients (53% men), referred for bedside consultations, underwent physical examination, ECG, and CXR, followed by PSE examination. The physician completed a detailed questionnaire (clinical and echocardiographic data, scanning time, abnormal results).

[Information and Communication Technology in medicine in Italy: problems and perspectives. A document by the "e-cardio" area of the Italian Association of Hospital Cardiologists (ANMCO)].

In Italy, health protection is an individual right protected by the article 32 of the Constitution, granted to everyone since 1978 by the foundation of the National Health Service. However, regionalization of the healthcare system has caused noticeable discrepancies among the different areas of the country. The use of the Information and Communication Technology (ICT) may be useful to solve them.

Relationship between B-type natriuretic peptide levels and echocardiographic indices of left ventricular filling pressures in post-cardiac surgery patients.

Background: B-type natriuretic peptide (BNP) is increased in post-cardiac surgery patients, however the mechanisms underlying BNP release are still unclear. In the current study, we aimed to assess the relationship between postoperative BNP levels and left ventricular filling pressures in post-cardiac surgery patients.

Methods: We prospectively enrolled 134 consecutive patients referred to our Center 8 +/- 5 days after cardiac surgery.

'Lone' increase in C-reactive protein after cardiac surgery: prevalence, clinical characteristics, in-hospital course, and prognostic value.

Background: Serum C-reactive protein (CRP) is involved in the acute phase reaction after surgery, even though its clinical significance remains a matter of debate. We evaluated CRP levels in cardiac surgery patients without clinical or laboratory signs of infection.

Methods: We screened 737 consecutive patients referred to our center 8+/-5 days after cardiac surgery.

Echocardiographic estimation of pulmonary pressures.

Cardiac ultrasound plays a pivotal role in assessing pulmonary artery pressures. Estimation of right atrial pressure can be derived from the dimensions and respiratory variation of the inferior vena cava and Doppler modalities provide an accurate and comprehensive evaluation of right ventricular and pulmonary artery pressures. Peak pulmonary artery pressure can be calculated from continuous wave Doppler sampling of the tricuspid regurgitant jet, while pulsed wave Doppler sampling of the pulmonary regurgitant jet allows evaluation of mean and diastolic pulmonary artery pressures.

[Mitral valve prolapse].

Mitral valve prolapse (MVP) is still a clinical challenging problem. In this report, we review the main characteristics of this entity. Epidemiology of MVP, which relies on the diagnostic criteria adopted, and the incidence of complications, both arrhythmic and structural, are influenced by the characteristics of the population studied, which may lead to bias in data interpretation.

Bedside diagnosis and follow-up of patients with pleural effusion by a hand-carried ultrasound device early after cardiac surgery.

Objectives: The aim of this study was to assess the potential value of hand-carried ultrasound (HCU) devices in the diagnosis and follow-up of patients with pleural effusion (PE) after cardiac surgery.

Methods: Seventy consecutive patients were evaluated at bedside early after cardiac surgery, in the upright sitting position, using an HCU device on hospital admission and every 3 days until hospital discharge. The posterior chest wall was scanned along the paravertebral, scapular, and posterior axillary lines.

[Digital echocardiography laboratory].

The implementation of a digital echocardiography laboratory exists today using the DICOM (Digital Imaging Communication in Medicine) standard to acquire, store and transfer echocardiographic digital images. The components of a laboratory include: 1) digital echocardiography machines with DICOM output, 2) a switched high-speed local area network, 3) a DICOM server with abundant local storage, and 4) a software to manage image and measurement information. The aim of this article was to describe the critical components of a digital echocardiography laboratory, discuss strategies for implementation, and describe some of the pitfalls that we encountered in our own implementation of the digital third level echocardiography laboratory.