Giornale italiano di cardiologia最新文献

Chronic coronary syndromes (CCS) are the most common clinical manifestation of coronary atherosclerosis. Coronary computed tomography angiography (CCTA) is a recent innovation in non-invasive cardiac imaging. It is the only anatomical imaging method that allows direct visualization of the coronary lumen, vessel walls, and atherosclerotic plaques, offering high sensitivity and a strong negative predictive value. CCTA is particularly useful in identifying or ruling out coronary atherosclerosis in the context of CCS and serves as an excellent filter for invasive coronary angiography. Compared to other non-invasive functional imaging tests (stress echocardiography, single photon emission computed tomography, magnetic resonance imaging, positron emission tomography), CCTA provides detailed characterization of both obstructive and non-obstructive plaques, enabling accurate risk stratification and guiding therapy. Recent advances in computed tomography technology and imaging techniques further extend the use of CCTA beyond plaque and stenosis evaluation, offering also functional lesion information. This consensus document aims to detail the technical aspects of CCTA and illustrate its role in optimizing CCS diagnostic and therapeutic management, enhancing precision medicine and personalized patient care.

Recently, cardiac intensive care units (CICUs) have undergone a significant transformation related to the evolution in management of acute coronary syndrome and influenced by other factors such as the epidemiological transition, the increasing complexity of clinical cases, the technological advancement, and the growth of clinical and scientific expertise of cardiologists. In the context of this evolution, a functional reorganization of CICUs in Italy has to be implemented in order to meet the changing needs of the population with cardiovascular disease requiring critical care. Therefore, the Italian Association of Hospital Cardiologists (ANMCO) proposes this position paper for the reorganization of CICUs into three levels with increasing functional complexity, based on the hospital characteristics, the available technology, and clinical cases treated. The system would be functionally integrated into a regional CICU organization modeled on a time-dependent care network. This proposed network aims to standardize diagnostic and therapeutic protocols and establish unified data collection registries to facilitate self-assessment and support clinical research. The document delineates specific requirements for each CICU level, including the management of clinical cases, the expertise of intensive care cardiologists, the technological facilities, and the medical and nursing staff needed to ensure optimal care delivery.

The growing number and complexity of procedures performed in interventional cardiology laboratories increases the risk of biological damage to personnel working in these settings. Given the radio sensitivity of the gonads and the product of conception, women have a risk related to radio exposure that has an impact on their private and working life. This review discusses the available evidence regarding the impact of ionizing radiation on fertility and pregnancy. Furthermore, the different preventive strategies and containment maneuvers of radio exposure in catheterization and electrophysiology/pacing laboratories are examined. Finally, the areas of uncertainty that require targeted research aimed at better defining risks and prevention possibilities are highlighted. Globally, greater information and a safe and inclusive work environment will ensure equal opportunities and fair professional growth in the cardiology field.