Elisabetta Mariucci, Gabriele Bronzetti, Andrea Donti
Sudden cardiac arrest/death in pediatric patients is a rare but potentially preventable event. Cardiomyopathies and channelopathies are the most common causes which are detectable with ECG and transthoracic echocardiography in asymptomatic subjects. Coronary artery anomalies are a rare cause of sudden cardiac arrest/death, but these events suggest that ECG and echocardiography, focused on the site of origin of the coronary arteries, should be both part of the screening tool of young athletes. Finally, the rare cardiac arrest events in young patients with ventricular preexcitation without prior symptoms or markers of high risk suggest that transcatheter ablation should be considered in all pediatric patients with ventricular preexcitation because it can eliminate the small long-term risk of sudden cardiac arrest/death, but a careful consideration of the most appropriate timing is mandatory.
{"title":"[Sudden cardiac arrest in children and adolescents: diagnosis, clinical presentation and peculiarities].","authors":"Elisabetta Mariucci, Gabriele Bronzetti, Andrea Donti","doi":"10.1714/4318.43038","DOIUrl":"10.1714/4318.43038","url":null,"abstract":"<p><p>Sudden cardiac arrest/death in pediatric patients is a rare but potentially preventable event. Cardiomyopathies and channelopathies are the most common causes which are detectable with ECG and transthoracic echocardiography in asymptomatic subjects. Coronary artery anomalies are a rare cause of sudden cardiac arrest/death, but these events suggest that ECG and echocardiography, focused on the site of origin of the coronary arteries, should be both part of the screening tool of young athletes. Finally, the rare cardiac arrest events in young patients with ventricular preexcitation without prior symptoms or markers of high risk suggest that transcatheter ablation should be considered in all pediatric patients with ventricular preexcitation because it can eliminate the small long-term risk of sudden cardiac arrest/death, but a careful consideration of the most appropriate timing is mandatory.</p>","PeriodicalId":12510,"journal":{"name":"Giornale italiano di cardiologia","volume":"25 9","pages":"640-649"},"PeriodicalIF":0.7,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142139862","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Gabriella Bufano, Pietro Mazzeo, Maria Delia Corbo, Vincenzo Fioretti, Costantino Smaldone, Eugenio Stabile
Although mitral annular calcification is a common degenerative condition of the fibrous mitral annulus, tricuspid annular calcification, especially isolated, is rare. We report the case of a 73-year-old male, with a history of hypertension and severe kyphoscoliosis, referred to the emergency department for progressive dyspnea and leg swelling. Echocardiography revealed a dilated right heart with a homogeneous, hyperechoic, crescent shaped mass along the tricuspid annulus. Computed tomography confirmed the calcific nature of the lesion. Right heart catheterization revealed mild pre-capillary pulmonary hypertension and a mild spirometrically-defined restrictive ventilatory defect. Kyphoscoliosis has recently been associated with alterations in cardiac deformation and with an increased risk of restrictive lung disease. In our patient, we hypothesized that both these anomalies could have led to premature tricuspid annular degeneration resulting in a giant tricuspid calcification.
{"title":"[Giant tricuspid annular calcification and kyphoscoliosis: is there a link?]","authors":"Gabriella Bufano, Pietro Mazzeo, Maria Delia Corbo, Vincenzo Fioretti, Costantino Smaldone, Eugenio Stabile","doi":"10.1714/4318.43044","DOIUrl":"10.1714/4318.43044","url":null,"abstract":"<p><p>Although mitral annular calcification is a common degenerative condition of the fibrous mitral annulus, tricuspid annular calcification, especially isolated, is rare. We report the case of a 73-year-old male, with a history of hypertension and severe kyphoscoliosis, referred to the emergency department for progressive dyspnea and leg swelling. Echocardiography revealed a dilated right heart with a homogeneous, hyperechoic, crescent shaped mass along the tricuspid annulus. Computed tomography confirmed the calcific nature of the lesion. Right heart catheterization revealed mild pre-capillary pulmonary hypertension and a mild spirometrically-defined restrictive ventilatory defect. Kyphoscoliosis has recently been associated with alterations in cardiac deformation and with an increased risk of restrictive lung disease. In our patient, we hypothesized that both these anomalies could have led to premature tricuspid annular degeneration resulting in a giant tricuspid calcification.</p>","PeriodicalId":12510,"journal":{"name":"Giornale italiano di cardiologia","volume":"25 9","pages":"690-692"},"PeriodicalIF":0.7,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142139858","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"[An exotically and dangerous pattern].","authors":"Angelo Melpignano, Michele Trichilo, Alessandro Capecchi","doi":"10.1714/4318.43042","DOIUrl":"10.1714/4318.43042","url":null,"abstract":"","PeriodicalId":12510,"journal":{"name":"Giornale italiano di cardiologia","volume":"25 9","pages":"684"},"PeriodicalIF":0.7,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142139856","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Stefania Angela Di Fusco, Maurizio Giuseppe Abrignani, Giulia Bugani, Rita Myriam Cristina Intravaia, Marco Flori, Furio Colivicchi
Although there is substantial evidence on the harmful effects of air pollution on human health, these are scarcely considered in the general clinical practice and also in the context of cardiovascular disease prevention. In light of the numerous epidemiological and basic research studies that have demonstrated the unfavorable impact of air pollution on the cardiovascular system, this review aims to bring this aspect to the attention of clinicians. This work describes the main air polluting components that can contribute to the onset and progression of cardiovascular diseases. The pathophysiological mechanisms underlying the impact of pollutants on the cardiovascular system and the available evidence regarding their effect on cardiovascular risk factors are reported. This article also examines the evidence relating to the correlation between environmental pollutants and some specific cardiovascular diseases, including acute coronary syndromes, cerebrovascular diseases, heart failure, and arrhythmias. Finally, the possible strategies to be implemented to limit pollution-induced cardiovascular damage are analyzed.
{"title":"[Air pollution and cardiovascular disease].","authors":"Stefania Angela Di Fusco, Maurizio Giuseppe Abrignani, Giulia Bugani, Rita Myriam Cristina Intravaia, Marco Flori, Furio Colivicchi","doi":"10.1714/4318.43041","DOIUrl":"https://doi.org/10.1714/4318.43041","url":null,"abstract":"<p><p>Although there is substantial evidence on the harmful effects of air pollution on human health, these are scarcely considered in the general clinical practice and also in the context of cardiovascular disease prevention. In light of the numerous epidemiological and basic research studies that have demonstrated the unfavorable impact of air pollution on the cardiovascular system, this review aims to bring this aspect to the attention of clinicians. This work describes the main air polluting components that can contribute to the onset and progression of cardiovascular diseases. The pathophysiological mechanisms underlying the impact of pollutants on the cardiovascular system and the available evidence regarding their effect on cardiovascular risk factors are reported. This article also examines the evidence relating to the correlation between environmental pollutants and some specific cardiovascular diseases, including acute coronary syndromes, cerebrovascular diseases, heart failure, and arrhythmias. Finally, the possible strategies to be implemented to limit pollution-induced cardiovascular damage are analyzed.</p>","PeriodicalId":12510,"journal":{"name":"Giornale italiano di cardiologia","volume":"25 9","pages":"673-683"},"PeriodicalIF":0.7,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142139855","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"In questo numero.","authors":"","doi":"10.1714/4318.43035","DOIUrl":"https://doi.org/10.1714/4318.43035","url":null,"abstract":"","PeriodicalId":12510,"journal":{"name":"Giornale italiano di cardiologia","volume":"25 9","pages":"0"},"PeriodicalIF":0.7,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142139865","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Daniele Ronco, Matteo Matteucci, Giulio Massimi, Vittoria Lodo, Sara Garis, Arianna Scarantino, Corinne Messina, Alessandra Francica, Marco Russo, Roberto Lorusso, Fabio Barili, Alessandro Parolari
Left ventricular free wall rupture, ventricular pseudoaneurysm, papillary muscle rupture and ventricular septal rupture are life-threatening mechanical complications of acute myocardial infarction. Despite significant improvements over the last decades in overall mortality for patients with myocardial infarction, the outcome of subjects who develop post-infarction mechanical complications remains poor. Surgical treatment is considered the standard of care. However, percutaneous approaches (such as pericardial fibrin-glue injection for left ventricular free wall rupture, transcatheter edge-to-edge mitral repair for papillary muscle rupture and device closure for ventricular pseudoaneurysm or septal rupture) have been proposed in selected high-risk or inoperable patients, or in subjects with ideal characteristics for feasibility, as therapeutic alternatives to open surgery. The aim of the present review is to provide a comprehensive overview of the percutaneous strategies for the management of post-acute myocardial infarction mechanical complications.
{"title":"[Percutaneous treatment of post-acute myocardial infarction mechanical complications: state of the art].","authors":"Daniele Ronco, Matteo Matteucci, Giulio Massimi, Vittoria Lodo, Sara Garis, Arianna Scarantino, Corinne Messina, Alessandra Francica, Marco Russo, Roberto Lorusso, Fabio Barili, Alessandro Parolari","doi":"10.1714/4318.43036","DOIUrl":"https://doi.org/10.1714/4318.43036","url":null,"abstract":"<p><p>Left ventricular free wall rupture, ventricular pseudoaneurysm, papillary muscle rupture and ventricular septal rupture are life-threatening mechanical complications of acute myocardial infarction. Despite significant improvements over the last decades in overall mortality for patients with myocardial infarction, the outcome of subjects who develop post-infarction mechanical complications remains poor. Surgical treatment is considered the standard of care. However, percutaneous approaches (such as pericardial fibrin-glue injection for left ventricular free wall rupture, transcatheter edge-to-edge mitral repair for papillary muscle rupture and device closure for ventricular pseudoaneurysm or septal rupture) have been proposed in selected high-risk or inoperable patients, or in subjects with ideal characteristics for feasibility, as therapeutic alternatives to open surgery. The aim of the present review is to provide a comprehensive overview of the percutaneous strategies for the management of post-acute myocardial infarction mechanical complications.</p>","PeriodicalId":12510,"journal":{"name":"Giornale italiano di cardiologia","volume":"25 9","pages":"615-623"},"PeriodicalIF":0.7,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142139860","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pietro Mazzarotto, Greta Ghizzardi, Giovanni Monza, Giuseppina Granata, Greta Generati, Davide Randazzo, Marta Saronio, Anca Irina Corciu
Background: The Cardiology Complex Structure of the Azienda Socio Sanitaria Territoriale (ASST) of Lodi, Italy, assists patients with clinical conditions ranging from emergency to chronicity. The model of Homogeneous Waiting Groups should guide the appropriateness of prescriptions categorized as U (urgent), B (brief), D (deferrable), and P (programmable). This study aims to describe and analyze the characteristics of prescription and delivery of clinical and instrumental cardiology outpatient services with U and B priority during the November 2023-January 2024 quarter, paying particular attention to the clinical appropriateness of prescribing.
Methods: A prospective observational study was conducted. Computerized data were anonymously extracted from the company's Management Control and provided with the authorization of the Data Protection Officer.
Results: During the observed quarter, the Cardiology Complex Structure provided 7379 services for outpatients. Out of 123 U services, 94 (76.4%) were managed through SBC (Single Booking Center) and 29 (23.6%) were managed outside the SBC. From 529 services with B priority, 504 (95%) were managed through SBC and 25 (5%) outside the SBC. Requests with U priority mainly referred to ECG (n = 50; 40.6%) and first cardiological visit (n = 46; 37.4%). Fifty percent of U and B requests were prescribed by 4% and 8% of general practitioners, respectively. The prescribed priority was correct for 13% of requests (n = 64).
Conclusions: This study shows a vastly inappropriate use of resources allocated to urgent outpatient cardiological services. Actions aimed at promoting the adherence to the Homogeneous Waiting Groups Manual and enhancing telemedicine services, currently limited to heart failure, are necessary for resource optimization in cardiology within the ASST of Lodi.
背景:意大利洛迪 Azienda Socio Sanitaria Territoriale (ASST) 心脏病综合医院为临床症状从急诊到慢性病的患者提供帮助。同质候诊组模式应指导处方的合理性,处方可分为 U(紧急)、B(简短)、D(可推迟)和 P(可编程)四类。本研究旨在描述和分析 2023 年 11 月至 2024 年 1 月期间 U 和 B 优先级临床和器械心脏病学门诊服务的处方和交付特点,尤其关注处方的临床适宜性:进行了一项前瞻性观察研究。计算机数据以匿名方式从公司的管理控制中提取,并在数据保护官的授权下提供:在观察季度内,心脏科综合机构为门诊患者提供了 7379 次服务。在 123 项 U 级服务中,94 项(76.4%)通过 SBC(单一预约中心)管理,29 项(23.6%)在 SBC 之外管理。在 529 项 B 优先级服务中,504 项(95%)通过 SBC 管理,25 项(5%)在 SBC 以外管理。优先级为 U 的请求主要涉及心电图(50 人;40.6%)和首次心脏科就诊(46 人;37.4%)。50%的 U 级和 B 级请求分别由 4% 和 8% 的全科医生开具处方。13%的申请(64 人)的处方优先级是正确的:这项研究表明,分配给心脏科急诊门诊服务的资源使用极为不当。为了优化洛迪 ASST 的心脏病学资源,有必要采取旨在促进遵守《同质候诊群体手册》和加强远程医疗服务(目前仅限于心力衰竭)的行动。
{"title":"[Appropriateness of requests for urgent outpatient cardiological services and impact on waiting lists: the experience of the Azienda Socio-Sanitaria Territoriale of the Province of Lodi].","authors":"Pietro Mazzarotto, Greta Ghizzardi, Giovanni Monza, Giuseppina Granata, Greta Generati, Davide Randazzo, Marta Saronio, Anca Irina Corciu","doi":"10.1714/4318.43043","DOIUrl":"10.1714/4318.43043","url":null,"abstract":"<p><strong>Background: </strong>The Cardiology Complex Structure of the Azienda Socio Sanitaria Territoriale (ASST) of Lodi, Italy, assists patients with clinical conditions ranging from emergency to chronicity. The model of Homogeneous Waiting Groups should guide the appropriateness of prescriptions categorized as U (urgent), B (brief), D (deferrable), and P (programmable). This study aims to describe and analyze the characteristics of prescription and delivery of clinical and instrumental cardiology outpatient services with U and B priority during the November 2023-January 2024 quarter, paying particular attention to the clinical appropriateness of prescribing.</p><p><strong>Methods: </strong>A prospective observational study was conducted. Computerized data were anonymously extracted from the company's Management Control and provided with the authorization of the Data Protection Officer.</p><p><strong>Results: </strong>During the observed quarter, the Cardiology Complex Structure provided 7379 services for outpatients. Out of 123 U services, 94 (76.4%) were managed through SBC (Single Booking Center) and 29 (23.6%) were managed outside the SBC. From 529 services with B priority, 504 (95%) were managed through SBC and 25 (5%) outside the SBC. Requests with U priority mainly referred to ECG (n = 50; 40.6%) and first cardiological visit (n = 46; 37.4%). Fifty percent of U and B requests were prescribed by 4% and 8% of general practitioners, respectively. The prescribed priority was correct for 13% of requests (n = 64).</p><p><strong>Conclusions: </strong>This study shows a vastly inappropriate use of resources allocated to urgent outpatient cardiological services. Actions aimed at promoting the adherence to the Homogeneous Waiting Groups Manual and enhancing telemedicine services, currently limited to heart failure, are necessary for resource optimization in cardiology within the ASST of Lodi.</p>","PeriodicalId":12510,"journal":{"name":"Giornale italiano di cardiologia","volume":"25 9","pages":"685-689"},"PeriodicalIF":0.7,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142139857","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Andrea Pennacchioni, Maria Elena Nizzoli, Massimo Roncali, Alberto Bavieri, Durmo Rexhep, Alessandro Navazio, Stefano Luminari, Luigi Tarantini
Lymphoma patients are at high risk of cardiovascular events due to anthracycline cardiotoxicity and, in rare cases, related to heart infiltration. The presence of cardiac masses adds further complexity to the management of lymphoma patients beyond myocardial chemotherapy-related toxicity, given possible unpredictable acute complications such as arrhythmias, atrioventricular block, myocardial ischemia, pericardial effusion and cardiac tamponade. Here we describe the clinical presentation and successful multidisciplinary management of diffuse large B-cell lymphoma with multifocal cardiac involvement identified by total body 18FDG positron emission tomography performed at disease staging.
{"title":"[Diffuse large B-cell lymphoma with heart involvement: the relevance of the multidisciplinary and multiparameter approach].","authors":"Andrea Pennacchioni, Maria Elena Nizzoli, Massimo Roncali, Alberto Bavieri, Durmo Rexhep, Alessandro Navazio, Stefano Luminari, Luigi Tarantini","doi":"10.1714/4282.42640","DOIUrl":"10.1714/4282.42640","url":null,"abstract":"<p><p>Lymphoma patients are at high risk of cardiovascular events due to anthracycline cardiotoxicity and, in rare cases, related to heart infiltration. The presence of cardiac masses adds further complexity to the management of lymphoma patients beyond myocardial chemotherapy-related toxicity, given possible unpredictable acute complications such as arrhythmias, atrioventricular block, myocardial ischemia, pericardial effusion and cardiac tamponade. Here we describe the clinical presentation and successful multidisciplinary management of diffuse large B-cell lymphoma with multifocal cardiac involvement identified by total body 18FDG positron emission tomography performed at disease staging.</p>","PeriodicalId":12510,"journal":{"name":"Giornale italiano di cardiologia","volume":"25 7","pages":"526-529"},"PeriodicalIF":0.7,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141446006","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Matteo Arzenton, Renè Tezze, Alberto Sarti, Francesco Vitali
{"title":"[Right bundle branch block or ventricular preexcitation? Sometimes the solution lies in the middle].","authors":"Matteo Arzenton, Renè Tezze, Alberto Sarti, Francesco Vitali","doi":"10.1714/4282.42633","DOIUrl":"10.1714/4282.42633","url":null,"abstract":"","PeriodicalId":12510,"journal":{"name":"Giornale italiano di cardiologia","volume":"25 7","pages":"474"},"PeriodicalIF":0.7,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141446035","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Ailia Giubertoni, Luca Cumitini, Simone Fodra, Andrea Giordano, Davide Avenoso, Giuseppe Patti
In patients with cardiovascular, pulmonary, muscular and neurological diseases, cardiopulmonary exercise testing (CPET) is a valuable tool providing clinically-relevant diagnostic and prognostic information by evaluation of exercise response. CPET requires to be performed in dedicated centers able to correctly carry out the examination and to carefully evaluate the results. CPET analyzes functional capacity revealing both symptomatic and asymptomatic intolerance to exercise. One of the most important advantages for clinicians derived by the use of CPET, beyond standard exercise electrocardiography testing, is the capability not only to grade the severity of the disease, but also to distinguish between different causes of dyspnea and exercise impairment. Indications for CPET use in clinical practice are increasing in the last decades, evolving beyond the routine use as a training tool in athletes. In fact, CPET represents an important step in the management of patients with heart failure or pulmonary hypertension, as suggested by international guidelines. CPET role in helping for the selection of patients candidate to heart transplantation is also well known. Beyond its clinical usefulness, scientific interest in CPET is constantly expanding, mainly due to the safety of the exam and to the huge size of the pathophysiological information that it offers. The aim of this paper is to simply explain everyday applications and potential further purposes of CPET in clinical practice. Our review is intended both for physicians approaching CPET for the first time and for clinicians with an interest in expanding their knowledge in this field.
{"title":"[Ten questions about cardiopulmonary exercise testing: all that the cardiologist dares or dares not to ask].","authors":"Ailia Giubertoni, Luca Cumitini, Simone Fodra, Andrea Giordano, Davide Avenoso, Giuseppe Patti","doi":"10.1714/4269.42464","DOIUrl":"10.1714/4269.42464","url":null,"abstract":"<p><p>In patients with cardiovascular, pulmonary, muscular and neurological diseases, cardiopulmonary exercise testing (CPET) is a valuable tool providing clinically-relevant diagnostic and prognostic information by evaluation of exercise response. CPET requires to be performed in dedicated centers able to correctly carry out the examination and to carefully evaluate the results. CPET analyzes functional capacity revealing both symptomatic and asymptomatic intolerance to exercise. One of the most important advantages for clinicians derived by the use of CPET, beyond standard exercise electrocardiography testing, is the capability not only to grade the severity of the disease, but also to distinguish between different causes of dyspnea and exercise impairment. Indications for CPET use in clinical practice are increasing in the last decades, evolving beyond the routine use as a training tool in athletes. In fact, CPET represents an important step in the management of patients with heart failure or pulmonary hypertension, as suggested by international guidelines. CPET role in helping for the selection of patients candidate to heart transplantation is also well known. Beyond its clinical usefulness, scientific interest in CPET is constantly expanding, mainly due to the safety of the exam and to the huge size of the pathophysiological information that it offers. The aim of this paper is to simply explain everyday applications and potential further purposes of CPET in clinical practice. Our review is intended both for physicians approaching CPET for the first time and for clinicians with an interest in expanding their knowledge in this field.</p>","PeriodicalId":12510,"journal":{"name":"Giornale italiano di cardiologia","volume":"25 6","pages":"399-409"},"PeriodicalIF":0.5,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141161206","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}