Sudden cardiac arrest, and in particular sudden out-of-hospital cardiac arrest (OHCA) remains a major public health concern in which survival statistics, and in particular neurologically intact survival statistics, have remained largely unimproved over many decades. Overall survival remains approximately 10%, being somewhat better in victims receiving bystander cardiopulmonary resuscitation (CPR), and those who are found to have a shockable rhythm (i.e., VT or VF). CPR and defibrillation (especially public-access defibrillation) remain the essential immediate management tools. However, recent research has introduced several novel adjunctive interventions (e.g., mechanical compression-decompression devices, 'head-up' CPR methodology, portable extra-corporeal circulatory assistance [ECPR]) that will hopefully impact survival positively. In any case, it is apparent that no single resuscitative tool will be sufficient to markedly improve OHCA survival; the combined application of a multi-faceted strategy is needed. This might comprise bystander CPR, combined use of 'head-up' CPR along with impedance threshold valve [ITD] and active compression-decompression mechanical chest compression devices. Application of mobile ECPR devices as early as possible during resuscitation appears to improve outcomes albeit expensive and complex to deploy broadly. Employed together, these novel steps, offer the possibility of moving the survival needle in a positive direction.

The primary aim of the study was to assess the relationship between epicardial adipose tissue (EAT) volume and Coronary Calcium Score (CCS), in addition to coronary artery stenosis severity and carotid intima-media thickness (CIMT).

In the morphology of coronary arteries, changes such as atherosclerosis and ectasia occur over time. The aim of this study is to identify the factors influencing changes in coronary artery morphology.

The no-reflow phenomenon (NRP) is associated with increased mortality and morbidity in patients with ST-segment elevation myocardial infarction (STEMI). Despite the lack of a definitive treatment for NRP, predicting procedural success remains a challenge. This study aims to evaluate the potential of intracoronary electrocardiography (ic-ECG) in predicting the success of the primary percutaneous coronary intervention (pPCI) in STEMI patients who develop NRP.

To assess how gender disparities impact major adverse cardiovascular events during hospitalization, as well as in the short and long term, among patients with ST-elevation myocardial infarction who undergo primary PCI.

Current evidence on the long-term outcome and its determinants in patients with unprotected left main trifurcation (LMT) treated with percutaneous coronary intervention (PCI) is based on small-sized studies. We aimed to assess the clinical, anatomical and procedural factors impacting long-term clinical outcomes of patients with LMT treated by PCI.

Vitamin D deficiency is a common clinical picture associated with poor cardiovascular prognosis. It is also associated with impaired diastolic dysfunction in stable coronary artery disease. We investigated the relationship between vitamin D levels and diastolic dysfunction in patients with acute coronary syndrome (ACS).

The relationship between Body Mass Index (BMI) and acute heart failure (HF) remains ill-defined. This study aimed to compare the influence of BMI on in-hospital mortality between patients with acute HF with preserved ejection fraction (HFpEF) and those with acute HF with reduced ejection fraction (HFrEF) and to examine the specific phenotypes of HFpEF/HFrEF according to BMI.

The assessment of myocardial function and its coupling with the arterial system, called ventricular-arterial coupling (VAC), is of paramount importance in many clinical fields, from arterial hypertension, which is the main cause of cardiovascular diseases and death, to heart failure. VAC has been the subject of studies for several decades both from an energetic cost and the impact it can exert on cardiovascular performance. Although more attention has been paid to the relationship between the left ventricle and the left arterial circuit in compromised hemodynamic stages, VAC has aroused interest in many other aspects of study, from its application in pathologies of the right sections of the heart to its clinical impact in prevention and cardiovascular risk factors. In this review we will focus on the importance of the hemodynamic data of the VAC in various clinical contexts and its possible applications in the future as a diagnostic and prognostic parameter in the cardiac clinic.

The current meta-analysis aimed to determine the efficacy of propolis supplementation on hypertension.

In clinical practice, ventricular ejection fraction (EF) and global longitudinal strain (GLS) are the most often used parameters for evaluating left ventricular systolic function, despite the impact that variable loading conditions have. Alternatively, the myocardial efficiency (ME) of the heart, encompassing cardiac energy formation and dissipation, along with myocardial oxygen consumption (MVO2), is a useful surrogate for assessing myocardial work (MW), a parameter correlated with the pressure-strain loop (PSL), arterial pressure, and cardiac output (CO). This refinement proves especially practical in defining cardiac work across various clinical contexts, including arterial hypertension and heart failure (HF), the primary conditions associated with cardiovascular mortality. In this review, we explore how many invasive and non-invasive studies have shown that MW and consequently ME are correlated with the state of cardiovascular wellbeing and myocardial performance, allowing it to be integrated with other parameters present in clinical practice.

Cardiac contractility modulation (CCM) signals are non-excitatory signals that are applied during the myocyte's absolute refractory period. These signals have been demonstrated to have an inotropic effect without increasing myocardial oxygen consumption. This has been observed in both preclinical animal studies and randomized clinical trials. CCM influences the expression of various genes that are abnormally expressed in heart failure: it reverses fetal myocyte gene programming associated with heart failure and regulates the expression of genes associated with calcium cycling and myocardial contractile machinery. Clinical investigations have primarily focused on patients with heart failure and normal QRS duration where CCM has demonstrated its safety and effectiveness in reducing heart failure-related hospitalizations, as well as improving symptoms, functional capacity, and overall quality of life. Currently, for individuals experiencing symptomatic heart failure with an ejection fraction ranging from 25% to 45% and a QRS duration of less than 130 ms, who are not suitable candidates for cardiac resynchronization therapy, CCM offers a viable treatment option. Even though promising results in specific HF subgroups have been published, further studies are needed to understand the role of CCM in tailored treatment for heart failure. Moreover, the role of multimodality imaging in lead placement and prognostic stratification in CCM patients should be further investigated. This review aims to summarize the main pathophysiological evidence related to the use of CCM and to highlight its role as a possible additional weapon in tailored treatment for specific subgroups of patients with heart failure.

Large-scale clinical outcome trials have demonstrated significant reductions in cardiovascular (CV) and renal outcomes with sodium-glucose cotransporter-2 inhibitors (SGLT2i). These benefits are sustained in patients with a range of left ventricular ejection fractions (LVEF), irrespective of diabetes status, and in a variety of clinical settings, prompting incorporation into clinical practice guidelines for patients with chronic kidney disease (CKD), heart failure (HF), and atherosclerotic cardiovascular disease (ASCVD). The clinical benefits are mediated by an interplay of cardio-metabolic-renal mechanisms, and they have a favorable safety profile. We provide a review of the proposed mechanisms of cardiorenal protection and the evidence supporting the clinical benefits of SGLT2i in CKD, acute and chronic HF treatment and prevention , and ASCVD, highlighting the uses of SGLT2i in clinical practice guidelines.

Complications of arrhythmia often occur in patients with acute myocardial infarction (AMI). This study mainly explored the expression and diagnostic significance of long non-coding RNA CYTOR (lncRNA CYTOR) in patients with AMI with arrhythmia, and analyzed the effects of CYTOR on inflammation and oxidative stress responses of cardiomyocytes.

Residual shunt (RS) after percutaneous patent foramen ovale (PFO) closure has classically been a question of debate for controversial results about its association with increased risk of recurrent ischemic events. Different underlying processes of neural tissue injury have to be taken into account evaluating clinical impact of residual shunt after PFO closure: clotting mechanisms and non-clotting, vasoactive or oxidative mechanisms. Some biochemical studies demonstrated the importance of effective PFO closure aimed to obtain significant reduction of several molecules involved in PFO related strokes. Blood levels of serotonin and homocysteine seem to significantly decrease after percutaneous procedures. A recent study on a pro-thrombotic phenotype of migraineurs with aura and PFO demonstrated that PFO closure reduce activated platelets and thrombin at the value of healthy subjects, underlining the importance of the correct sealing of the defect. The aim of this review is to examine currently available literature studies. Different and discordant results have been obtained due to heterogeneity of study population, instrumental assessment of RS and follow-up methods and length. In the 2021 American Guidelines for the prevention of stroke, RS was definitely considered a predictor of recurrence of ischemic events. Management of this subset of patients is still an unresolved issue and more studies are encouraged.

The aim of this study is to investigate the association between inflammation-related markers in COVID-19 infection and ST-segment elevation myocardial infarction (STEMI).

Contrast associated acute kidney injury (CA-AKI) is a major complication of contrast media (CM) exposure following percutaneous coronary intervention (PCI), associated with high rates of morbidity and mortality in both early and late phases. During the past years, several CA-AKI prevention strategies based on CM sparing have been proposed, which differ significantly in terms of methodological features and efficacy. In this review, we propose a new classification of these techniques based on their dependency on operators' management. Following, we summarize current evidence on the effectiveness in terms of CA-AKI reduction of each one of the currently available operator-dependent and -independent CM minimization strategies.