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Heart failure (HF) and atrial fibrillation (AF) are prevalent cardiovascular diseases that contribute significantly to morbidity, mortality, hospitalisation, and healthcare costs. It is not uncommon for these conditions to coexist and have mutually reinforcing effects. A critical factor in the aetiology of these conditions is oxidative stress, driven by reactive oxygen species (ROS), which contributes to atrial remodelling and fibrosis. The recent introduction of new drugs for the treatment of heart failure has also had an impact on the management of atrial fibrillation due to their influence on oxidative stress. The objective of this review is to analyse the effects of these therapies, including their role in mitigating ROS, on the prevention and treatment of AF in HF patients. [ABSTRACT FROM AUTHOR]

Purpose of Review: Left ventricular arrhythmogenic cardiomyopathy (ALVC) is a rare and poorly characterized cardiomyopathy that has recently been reclassified in the group of non-dilated left ventricular cardiomyopathies. This review aims to summarize the background, diagnosis, and sudden cardiac death risk in patients presenting this cardiomyopathy. Recent Findings: Although there is currently a lack of data on this condition, arrhythmogenic left ventricular dysplasia can be considered a specific disease of the left ventricle (LV). We have collected the latest evidence about the management and the risks associated with this cardiomyopathy. Summary: Left ventricular arrhythmogenic cardiomyopathy is still poorly characterized. ALVC is characterized by fibrofatty replacement in the left ventricular myocardium, with variable phenotypic expression. Diagnosis is based on a multiparametric approach, including cardiac magnetic resonance (CMR) and genetic testing, and is important for sudden cardiac death (SCD) risk stratification and management. Recent guidelines have improved the management of left ventricular arrhythmogenic cardiomyopathy. Further studies are necessary to improve knowledge of this cardiomyopathy. [ABSTRACT FROM AUTHOR]

The article discusses a case of transient global amnesia (TGA) in a 42-year-old woman with painless spontaneous internal carotid artery dissection. TGA is a neurological condition characterized by sudden memory loss that resolves within 24 hours. The patient's anterograde amnesia was linked to reduced cerebral perfusion due to the carotid artery dissection, which was confirmed by Doppler ultrasound. The article highlights the importance of considering rare underlying causes like carotid artery dissection in TGA cases and emphasizes the need for appropriate diagnostic tools and follow-up care for such patients. [Extracted from the article]

Purpose of Review: Advances in pharmacogenomics have paved the way for personalized medicine. Cardiovascular diseases still represent the leading cause of mortality in the world. The aim of this review is to summarize the background, rationale, and evidence of pharmacogenomics in cardiovascular medicine, in particular, the use of antiplatelet drugs, anticoagulants, and drugs used for the treatment of dyslipidemia. Recent findings: Randomized clinical trials have supported the role of a genotype-guided approach for antiplatelet therapy in patients with coronary heart disease undergoing percutaneous coronary interventions. Numerous studies demonstrate how the risk of ineffectiveness of new oral anticoagulants and vitamin K anticoagulants is linked to various genetic polymorphisms. Furthermore, there is growing evidence to support the association of some genetic variants and poor adherence to statin therapy, for example, due to the appearance of muscular symptoms. There is evidence for resistance to some drugs for the treatment of dyslipidemia, such as anti-PCSK9. Summary: Pharmacogenomics has the potential to improve patient care by providing the right drug to the right patient and could guide the identification of new drug therapies for cardiovascular disease. This is very important in cardiovascular diseases, which have high morbidity and mortality. The improvement in therapy could be reflected in the reduction of healthcare costs and patient mortality. [ABSTRACT FROM AUTHOR]

Background: Arterial stiffness measurement still plays a role in prediction of future cardiovascular events, thus helping for quantification of patients' cardiovascular (CV) risk level. However, significant measurement difficulties still exist, making its widespread evaluation not routinary. At present indices of arterial stiffness have not been associated with qualitative morphological characteristics of intima-media complex. The intima-media thickness (IMT) measurement is no longer recommended in the cardiovascular disease (CVD) risk assessment due to lack of a standard acquisition protocol. The intima media gray scale median (IM-GSM) is a relatively simple measurement, acquirable during a conventional carotid color-Doppler ultrasound examination. This study aims at investigating the possible relationship between arterial stiffness and echogenicity of IM-GSM of the common carotid arteries, in patients already diagnosed with arterial hypertension. Material and methods: A total of 421 hypertensive patients were retrospectively selected from our database of hypertension outpatients ambulatory. They were divided into two groups according to IM-GSM values (cutoff value: 30) and then subsequently compared. Results: In our study population, subjects with IM-GSM > 30 showed a statistically increased arterial stiffness and left ventricle mass index. A weak positive correlation was also found between IM-GSM, systolic blood pressure and duration of hypertension. Conclusion: The data presented here indicated that the variation of arterial stiffness observed in hypertensive patients is associated with structural modifications in carotid arterial wall. [ABSTRACT FROM AUTHOR]

Cardiovascular diseases (CVDs), such as arterial hypertension, myocardial infarction, stroke, heart failure, atrial fibrillation, etc., still represent the main cause of morbidity and mortality worldwide. They significantly modify the patients' quality of life with a tremendous economic impact. It is well established that cardiovascular risk factors increase the probability of fatal and non-fatal cardiac events. These risk factors are classified into modifiable (smoking, arterial hypertension, hypercholesterolemia, low HDL cholesterol, diabetes, excessive alcohol consumption, high-fat and high-calorie diet, reduced physical activity) and non-modifiable (sex, age, family history, of previous cardiovascular disease). Hence, CVD prevention is based on early identification and management of modifiable risk factors whose impact on the CV outcome is now performed by the use of CV risk assessment models, such as the Framingham Risk Score, Pooled Cohort Equations, or the SCORE2. However, in recent years, emerging, non-traditional factors (metabolic and non-metabolic) seem to significantly affect this assessment. In this article, we aim at defining these emerging factors and describe the potential mechanisms by which they might contribute to the development of CVD. [ABSTRACT FROM AUTHOR]

The abdominal aortic aneurysm (AAA) is a potentially fatal asymptomatic disease. It progresses silently with clinical complications that, when they occur, constitute a very serious event, frequently resulting in the patient's exitus. As a result, early detection and treatment are critical because the right therapeutic strategy can halt the disease's natural progression. AAA is frequently discovered as an incidental finding during an abdominal ultrasound or a plain X-ray of the abdomen, which is required for other pathologies. The primary diagnostic tool for AAA identification is abdominal B-mode ultrasound. It is cheap, widely available, non-invasive, and has high diagnostic sensitivity. However, this diagnostic tool may fail in rare cases due to misleading anatomical findings. We present an unusual flaw in the echographic AAA evaluation that should be considered during the diagnostic work-up. [ABSTRACT FROM AUTHOR]

The goal in cardiovascular prevention is the reduction of morbidity and mortality through the promotion of healthy lifestyles in the general population. The management of modifiable risk factors with pharmacological and non-pharmacological interventions, based on the individual risk is the first strategy suggested by the current guidelines. Several epidemiological studies have clearly shown the direct correlation between high levels of low-density lipoprotein cholesterol (LDL-C) and incidence of cardiovascular diseases. On the other hand, numerous randomized clinical studies have reported a huge benefit in terms of major cardiovascular events achievable by the reduction of LDL-C, thus supporting the notion that "the lower is better". Among the lipid-lowering strategies, statins are the drugs of choice in cardiovascular prevention, at both primary and secondary level. To achieve the ambitious targets suggested by the current guidelines, other lipid-lowering therapies are currently available in addition to statins, such as ezetimibe the inhibitors of the PCSK9. Pharmacological research has recently led to the development of a new drug, the bempedoic acid, which further enrich the available therapies. This drug also acts on the biosynthesis of cholesterol but at upstream level than statins. From the biochemical point of view, it has the potential to be considered before the statin with consequent titration of statins to achieve the desirable LDL-C target. In the present review, the biochemical and pharmacological characteristics of bempedoic acid are discussed. An overview of the clinical data that support its use in the management of the cardiovascular patient and its allocation in the lipid-lowering scenario will be also provided. [ABSTRACT FROM AUTHOR]

Sudden cardiac death (SCD) is one of the leading causes of cardiovascular death in general population. SCD primary prevention requires the correct selection of patients at increased risk who may benefit from implantable cardioverter-defibrillator (ICD). Despite several noninvasive arrhythmic risk indexes are available, their ability to stratify the SCD risk among asymptomatic patients with cardiac disease at increased arrhythmic risk is debated. The programmed ventricular stimulation (PVS) is an invasive approach historically used for SCD risk stratification in patients with acquired or inherited cardiac disease and is currently included in international guidelines. Aim of this review is to summarize all available data about the role of PVS for the SCD risk stratification in different clinical settings. [ABSTRACT FROM AUTHOR]

In the last few years, a tremendous advancement has been made in the therapeutical management of several diseases with an increasing need for parental drug administration. To avoid repeated venous insertions and the patient's anxiety related to these procedures, it is now common practice to insert a catheter to leave it in place for a longer time. However, these procedures may generate some complications, such as failure of insertion, embolization, and infection. Different noninvasive techniques have been proposed and used for the retrieval of lost or misplaced foreign objects. Here, we presented a case of the lost fragmented catheter in a young female who underwent a central venous catheter insertion 10 years ago, incidentally detected during an echocardiographic examination. Here, we presented a case of a lost fragmented catheter in a young female who underwent a central venous catheter insertion 10 years before. [ABSTRACT FROM AUTHOR]

Background: Irritable bowel syndrome (IBS) is a functional bowel disorder characterized by abdominal pain or discomfort and an irregular bowel habit. The prevalence is up to 20% in Western adults, which makes IBS the most common diagnosis in gastroenterology. Despite extensive interest and investigation, IBS's precise aetiology and pathophysiology are poorly understood. Current knowledge suggests that an altered gut microbiota, altered motility, visceral hyperalgesia, and dysregulation of the brain-gut axis are central to IBS. This is also significantly related to a higher prevalence of metabolic syndrome and elevated triglycerides among the adult population. This retrospective study examines the effect of a novel nutraceutical compound, Triobiotix, on gastrointestinal symptoms in IBS patients. Effects on lipid profiles have also been recorded. Objectives: The focus of this study is to evaluate the effectiveness of Triobiotix, a nutraceutical compound composed of prebiotics and probiotics. Methods: Triobiotix is a nutraceutical consisting of Maltodextrin; mineralized extract of Lithothamnion (Lithothamnion calcareum (Pallas) Areschoug, thallus dry extract); Bioecolians® gluco-oligosaccharides; Ferment mix (corn starch, Bifidobacterium animalis ssp. Lactis BLC1 (DSM 17741), Lactobacillus acidophilus LA3 (DSM 17742), Lactobacillus rhamnosus IMC 501 (DSM 16104), Lactobacillus paracasei Streptococcus 501 IMC102 SP4 (DSM 19385); short-chain fructo-oligosaccharides powder. The database of 40 Italian General Practitioners (GPs) was analyzed. A total of 587 patients with IBS treated with Triobiotix were identified. Among them, 535/587 (91.1%) completed the first (T0) and second (T1) visits and their data were available. The primary endpoint of this analysis was to assess if Triobiotix, at a dosage of 1 sachet per day for 30 days, could reduce abdominal pain and bloating, thus resulting in a lower intensity of the main gastrointestinal symptoms. Secondary endpoints were to evaluate presence of any significant changes in triglycerides blood levels and glycaemia. Results: Treatment with this nutraceutical for one month resulted in a reduction in the frequency and intensity of bloating, abdominal pain, flatulence, and tenesmus. In the 85 patients who reported evacuative urgency, the frequency of the episodes didn't significantly change while their intensity was statistically reduced. Unexpectedly, triglyceride levels also significantly decreased. Conclusions: Our analysis demonstrates this formulation is effective in the relief of the main symptoms associated with IBS. Moreover, an unexpected effect of this combination of micronutrients on tryglicerides, beyond IBS symptoms, was also found. However, further studies are needed to confirm this evidence and to evaluate the particular compound responsible of this effect. [ABSTRACT FROM AUTHOR]

Purpose: Increasing evidence reinforces the benefits of reduction of low-density lipoprotein (LDL-C) levels on cardiovascular outcomes. Different targets are suggested based on cardiovascular risk (CVR). According to the current European guidelines, a goal of LDL-C≤ 115mg/dL is desirable for patients with low-moderate CVR. However, a high percentage of these patients are far from this target. Nutraceuticals are "food supplements" that may help to achieve this goal in this population. In this retrospective analysis, we evaluate the effects of dietary supplementation with a novel monacolin/berberine/bergamot nutraceutical formulation on plasma lipid levels of subjects with low-moderate hypercholesterolemia who are not treated with conventional drug or other dietary supplements. Patients and Methods: 526 adult patients with hypercholesterolemia were retrospectively selected from the database of participant family practitioners according to prespecified criteria. All selected patients had a baseline and 30-day value of total cholesterol (TC), LDL-C, high-density lipoprotein cholesterol, triglycerides, C-reactive protein, and transaminases and have started a dietary supplementation with this novel nutraceutical. Similarly, 104 subjects with comparable clinical features but not treated with any supplements were also selected. Results: At 30-day, the administration of nutraceuticals was associated with a significant reduction of LDL-C (124 ± 14 vs. 100 ± 13 mg/dL, Δ 24.5mg, p-value <0.0001) and TC levels (210 ± 56 vs. 187 ± 60, p-value < 0.0001), in the absence of a significant change of transaminase levels. No side effects were reported in the database during the observation period. Conclusion: This novel nutraceutical is an effective dietary supplement to achieve a significant and early LDL-C reduction in patients with hypercholesterolemia at low-moderate CVR. [ABSTRACT FROM AUTHOR]

Thanks to an unusual reversible cause of reflex syncope, a young physician avoided pacemaker implantation. We present the treatment of a bizarre case of gastro-cardiac syndrome, an oftenoverlooked clinical entity. [ABSTRACT FROM AUTHOR]

Incremental tests are widely used in cardiopulmonary exercise testing, both in the clinical domain and in sport sciences. The highest workload (denoted W[sub peak]) reached in the test is key information for assessing the individual body response to the test and for analyzing possible cardiac failures and planning rehabilitation, and training sessions. Being physically very demanding, incremental tests can significantly increase the body stress on monitored individuals and may cause cardiopulmonary overload. This article presents a new approach to cardiopulmonary testing that addresses these drawbacks. During the test, our approach analyzes the individual body response to the exercise and predicts the W[sub peak ]value that will be reached in the test and an evaluation of its accuracy. When the accuracy of the prediction becomes satisfactory, the test can be prematurely stopped, thus avoiding its entire execution. To predict W[sub peak], we introduce a new index, the Cardiopulmonary Efficiency Index (CPE), summarizing the cardiopulmonary response of the individual to the test. Our approach analyzes the CPE trend during the test, together with the characteristics of the individual, and predicts W[sub peak]. A K-nearest-neighbor-based classifier and an ANN-based classier are exploited for the prediction. The experimental evaluation showed that the W[sub peak] value can be predicted with a limited error from the first steps of the test. Categories and Subject Descriptors: J.3 [Computer Applications]: Life and Medical Sciences -- Medical information systems; H.2.8 [Database Management]: Database Applications -- Data mining General Terms: Measurement, Design [ABSTRACT FROM AUTHOR]