Obesity and cardiovascular risk. Systematic intervention is the key for prevention

Obesity is a serious public health issue and associated with an increased risk of cardiovascular disease events and mortality. The risk of cardiovascular complications is directly related to excess body fat mass and ectopic fat deposition, but also other obesity-related complications such as pre-type 2 diabetes, obstructive sleep apnoea, and non-alcoholic fatty liver diseases. Body mass index and waist circumference are used to classify a patient as overweight or obese and to stratify cardiovascular risk. Physical activity and diet, despite being key points in preventing adverse events and reducing cardiovascular risk, are not always successful strategies. Pharmacological treatments for weight reduction are promising strategies, but are restricted by possible safety issues and cost. Nonetheless, these treatments are associated with improvements in cardiovascular risk factors, and studies are ongoing to better evaluate cardiovascular outcomes. Bariatric surgery is effective in reducing the incidence of death and cardiovascular events such as myocardial infarction and stroke. Cardiac rehabilitation programs in obese patients improve cardiovascular disease risk factors, quality of life, and exercise capacity. The aim of this review was to critically analyze the current role and future aspects of lifestyle changes, medical and surgical treatments, and cardiac rehabilitation in obese patients, to reduce cardiovascular disease risk and mortality, and to highlight the need for a multidisciplinary approach to improving cardiovascular outcomes

An overview of sport participation and exercise prescription in mitral valve disease

The incidence of heart valve disease (HVD) has been rising over the last few decades, mainly due to the increasing average age of the general population, and mitral valve (MV) disease is the second most prevalent HVD after calcific aortic stenosis, but MV disease is a heterogeneous group of different pathophysiological diseases. It is widely proven that regular physical activity reduces all-cause mortality rates, and exercise prescription is part of the medical recommendations for patients affected by cardiovascular diseases. However, changes in hemodynamic balance during physical exercise (including the increase in heart rate, preload, or afterload) could favor the progression of the MV disease and potentially trigger major cardiac events. In young patients with HVD, it is therefore important to define criteria for allowing competitive sport or exercise prescription, balancing the positive effects as well as the potential risks. This review focuses on mitral valve disease pathophysiology, diagnosis, risk stratification, exercise prescription, and competitive sport participation selection, and offers an overview of the principal mitral valve diseases with the aim of encouraging physicians to embody exercise in their daily practice when appropriate

Ruolo dei sistemi di monitoraggio elettrocardiografico in Cardiologia dello Sport

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Cuore d'atleta

Cuore d'atlet

Tricuspid leaflet flail after Micra™ leadless pacemaker implantation. A case report

We describe the first reported case of Micra™ leadless pacemaker implantation complicated by tricuspid posterior leaflet flail with severe regurgitation in a 29-year-old man affected by high degree atrio-ventricular block

Ruolo dei nuovi anticoagulanti orali nella prevenzione del cardioembolismo nel paziente con fibrillazione atriale non valvolare e del tromboembolismo venoso.

RUOLO DEI NUOVI ANTICOAGULANTI ORALI NELLA PREVENZIONE DEL CARDIOEMBOLISMO NEL PAZIENTE CON FIBRILLAZIONE ATRIALE NON VALVOLARE E DEL TROMBOEMBOLISMO VENOS

MULTIPLI EPISODI DI ENDOCARDITE INFETTIVA IN UN PAZIENTE TOSSICODIPENDENTE

MULTIPLI EPISODI DI ENDOCARDITE INFETTIVA RECIDIVANTE IN UN PAZIENTE TOSSICODIPENDENT

Anesthetic management of pregnant patients with cardiovascular disease: a commentary on the 2023 American Heart Association (AHA) scientific statement

The American Heart Association (AHA) has recently released a statement on cardiovascular management of pregnant women from an anesthesiological point of view. Although managing such situation is extremely frequent in clinical practice, poor attention is paid to the topic and many cardiologists and anesthesiologists in small centers have to cope with cardiovascular complications during pregnancy, being at the forefront as consultants. Consequently, we deem appropriate to dwell on this statement. The aim of the present commentary is to summarize the main practical indications provided by the AHA from a strictly cardiological point of view