How the COAPT trial affected the selection of patients with secondary mitral regurgitation undergoing transcatheter edge-to-edge repair: insights from the GIOTTO Registry.

Background: The impact of the COAPT results on clinical practice has not yet been investigated in large real-world cohort study. The aim of the study is to evaluate the potential impact of the COAPT trial by analyzing the temporal trends of baseline characteristics and outcome of secondary mitral regurgitation (SMR) patients undergoing MitraClip (MC) included in the GIOTTO registry.

Methods: The study population was divided into two groups, considering the enrolment before or after the COAPT publication.

Informed Consent and Shared Decision-Making in Modern Medicine. Case-based Approach, Current Gaps and Practical Proposal.

Advances in personalized medicine and Systems Biology have introduced probabilistic models and error discovery to cardiovascular care, aiding disease prevention and procedural planning. However, clinical application faces cultural, technical, and methodological hurdles. Patient autonomy remains essential, with shared decision-making (SDM) gaining importance in managing complex cardiovascular treatment options.

BRAF-mutant melanoma management: a single center retrospective analysis of patients treated with sequential therapy.

Aims: In treating patients with melanoma, the order in which therapy is administered, choosing between targeted therapy and immune checkpoint inhibition, has garnered growing interest.

Patients And Methods: We conducted a retrospective, real-world analysis of patients with advanced melanoma undergoing immunotherapy or targeted therapy as first-line at a single center.

Results: A total of 88 patients diagnosed with melanoma were identified.

Left Ventricular Non-Compaction, Atrial Fibrillation and Mutation in a Young Athlete.

Left ventricular non-compaction (LVNC) is a rare primary cardiomyopathy with genetic etiology, resulting from an abnormality of myocardial development during embryogenesis. It carries an elevated risk of left ventricular dysfunction, thromboembolic events and malignant arrhythmias. We report the case of LVNC associated with paroxysmal atrial fibrillation and ankyrin 2 () mutation at the genetic test.

Patient reported outcome measures in cardiovascular research and care: PRO(M)s and CONS.

Patient-reported outcome measures (PROMs) are vital tools in cardiovascular disease (CVD) research and care, providing insights that complement traditional clinical outcomes like mortality and morbidity. PROMs capture patient experiences with CVD, such as quality of life, functional capacity, and emotional well-being, allowing clinicians to assess how interventions impact daily life. PROMs are integral to cardiovascular investigations as well as management, especially in chronic conditions and rehabilitation, where they inform on the impact of personalized care plans by tracking symptom progression and patient adherence.

Safety and efficacy of early initiation of sodium-glucose co-transporter inhibitors 2 in patients hospitalized for acute heart failure: A meta-analysis of randomized controlled trials.

Aims: Data on the early use of sodium-glucose co-transporter 2 inhibitors (SGLT2i) in patients with acute heart failure (HF) are conflicting, and mostly evaluating soft endpoints (i.e., indices of congestion, renal function, ejection fraction, and diuresis).

Clinical Characteristics and Outcomes of Patients Undergoing 3 Aortic Valve Interventions: The THIRD Multicenter Registry.

Background: Lifetime treatment of aortic valve disease is a matter of increasing debate. Although the risks of a second aortic valve intervention are recognized, little attention has been given to the challenges of a third.

Objectives: This study delves into the clinical characteristics, indications, and outcomes of patients undergoing 3 aortic valve interventions.

Special Issue "Effects of Dyslipidemia and Metabolic Syndrome on Cardiac and Vascular Dysfunction".

The global increase in dysmetabolic conditions such as hyperglycemia, insulin resistance, dyslipidemia, metabolic syndrome, and type 2 diabetes is becoming a significant healthcare concern [...

Gut Microbiome Implication and Modulation in the Management of Recurrent Urinary Tract Infection.

Urinary tract infections (UTIs) are one of the most common bacterial infections, affecting more than 150 million people each year in the world. UTIs have grown exponentially in the last few years. They represent a major load for both individuals and society.

Comparative Analysis of Irrigation Mist and CO vs. Direct CO Blower in On-Pump Coronary Artery Bypass Grafting Anastomosis: Efficacy, Efficiency, and Fibrillation upon De-Clamping and Micro-Embolic Gas Activity Incidence.

In coronary artery bypass grafting (CABG) on pump, achieving optimal visualization is critical for surgical precision and safety. The use of blowers to clear the CABG anastomosis poses risks, including the formation of micro-embolic gas bubbles, which can be insidious and increase the risk of cerebral or myocardial complications. This retrospective study compares the effectiveness of the use of irrigation mist and CO versus a direct CO blower without irrigation in terms of visualization, postoperative fibrillation, and micro-embolic gas activity.

The Saphenous Vein Graft: Can a Frog Become a Princess?

The saphenous vein graft (SVG) has been a cornerstone of coronary bypass surgery, but its long-term patency is limited by accelerated atherosclerosis. Recent advancements, including the no-touch technique and the use of SVG as a limb of the left internal thoracic artery (LITA), have shown promise in improving outcomes. Both approaches enhance nitric oxide (NO) availability, a key factor in promoting endothelial stability and arterial-like behavior in the SVG.

Post-myocardial infarction ventricular septal defects: incidence and treatment trends during and after the COVID-19 pandemic.

Ventricular septal defect (VSD) is a serious complication of myocardial infarction (MI), with its global incidence significantly reduced in recent years due to advances in coronary reperfusion techniques. However, during the COVID-19 pandemic, there was an unexpected rise in the incidence of post-MI VSD, likely driven by delays in seeking treatment. This study retrospectively analyzed 10 cases of post-MI VSD treated at our hospitals from March 2018 to August 2023, comparing incidence rates across pre-pandemic, pandemic, and post-pandemic periods.

Anatomic vs. Ischemia-Driven Strategies for Percutaneous Coronary Revascularization in Chronic Coronary Syndrome: A Network Meta-Analysis.

Introduction: In patients with chronic coronary syndromes (CCS), the benefit of percutaneous coronary intervention (PCI) added to optimal medical therapy (OMT) remains unclear. The indication to PCI may be driven either by angiographic evaluation or ischemia assessment, thus depicting different potential strategies which have not yet been thoroughly compared.

Methods: Randomized controlled trials (RCTs) comparing OMT versus PCI angio-guided or versus PCI non-invasive or invasive ischemia guided were identified and compared via network meta-analysis.

Impact of Inflammation After Cardiac Surgery on 30-Day Mortality and Machine Learning Risk Prediction.

Objectives: To investigate the impact of systemic inflammatory response syndrome (SIRS) on 30-day mortality following cardiac surgery and develop a machine learning model to predict SIRS.

Design: Retrospective cohort study.

Setting: Single tertiary care hospital.

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.

Antithrombotic therapy in patients with atrial high-rate episodes (AHREs): Current evidence and open questions.

With the increasing use of cardiac electronic implantable devices in recent years, the identification of asymptomatic atrial arrhythmias, including atrial high-rate episodes (AHREs) and device-detected subclinical atrial fibrillation (SCAF), has become common in clinical practice. AHREs have potentially important clinical implications because they are considered precursors of atrial fibrillation (AF). Although to a lesser extent than clinical AF, both AHREs and device-detected SCAF are associated with thromboembolic events, however routine use of anticoagulants in these conditions is not recommended.

Regional disparities in the management and outcomes of ST-elevation myocardial infarction: an Italian analysis focusing on time-dependent reperfusion networks and in-hospital logistics.

Background: Prompt reperfusion is critical for patients with ST-segment elevation myocardial infarction (STEMI) to improve outcomes. Yet, variability in regional healthcare delivery may influence treatment times and patient outcomes. We thus aimed at evaluating differences in management and outcomes of STEMI patients across Northern, Central, and Southern Italy, focusing on time-dependent reperfusion and in-hospital logistics.

Valvular and perivalvular thrombosis following self-expandable aortic valve replacement: analysis of 100 multi-detector computed tomography scans.

Aims: Subclinical thrombosis may represent an early stage of prosthesis structural disease. Most of the available evidence on the incidence, location, predictors, and consequences of thrombosis comes from studies that have employed balloon-expandable valves. We aimed to describe the different localisations of valvular and perivalvular thrombosis and analyse prosthesis-host multi-detector computed tomography predictors in the context of self-expandable prosthesis.

State of the Art in Rehabilitation Strategies After Hip Arthroscopy for Femoroacetabular Impingement Syndrome: A Systematic Review.

Femoroacetabular impingement (FAI) is a common cause of hip pain in athletes and active individuals, often requiring hip arthroscopy followed by a structured rehabilitation program. Effective rehabilitation is crucial for optimizing surgical outcomes and facilitating a return to sport. A systematic review following PRISMA guidelines was conducted to evaluate post-operative rehabilitation protocols after hip arthroscopy for FAI.