Pub Date : 2024-06-01DOI: 10.1016/j.ijcrp.2024.200275
Marco Ambrosetti , Francesco Fattirolli , Paola Gnerre , Franco Mastroianni , Gian Francesco Mureddu , Francesco Dentali , Francesco Giallauria , Michele Meschi , Alessandra Pratesi , Matteo Ruzzolini , Elio Venturini
The Italian Association for Cardiovascular Rehabilitation and Prevention (ITACARE-P) and the Italian Federation of Associations of Hospital Doctors on Internal Medicine (FADOI) released a joint position paper to guide referrals of cardiovascular patients discharged from Internal Medicine (IM) wards to Cardiac Rehabilitation (CR) facilities. The document provides rationale and operative recommendations for appropriateness (i.e. qualifying diagnoses) and priority criteria to overcome the mismatch between potential demand and effective supply of CR programmes. In case of no-referral due to logistic barriers, the document recommends the adoption of best alternatives to CR for disability reduction, better prognosis, and improvement of quality of life. The joint position paper is also aimed to promote the consideration of IM as a potential stakeholder of CR.
意大利心血管康复与预防协会(ITACARE-P)和意大利医院内科医生协会联合会(FADOI)发布了一份联合立场文件,旨在指导从内科(IM)病房出院的心血管病人转诊至心脏康复(CR)机构。该文件就适当性(即合格诊断)和优先标准提供了理论依据和操作建议,以克服 CR 项目潜在需求与有效供应之间的不匹配。在因后勤障碍而无法转诊的情况下,文件建议采用 CR 的最佳替代方案,以减少残疾、改善预后和提高生活质量。联合立场文件还旨在促进将 IM 视为 CR 的潜在利益攸关方。
{"title":"Position paper ITACARE-P/FADOI on the referral from internal medicine to cardiac rehabilitation: Executive summary and factsheet","authors":"Marco Ambrosetti , Francesco Fattirolli , Paola Gnerre , Franco Mastroianni , Gian Francesco Mureddu , Francesco Dentali , Francesco Giallauria , Michele Meschi , Alessandra Pratesi , Matteo Ruzzolini , Elio Venturini","doi":"10.1016/j.ijcrp.2024.200275","DOIUrl":"https://doi.org/10.1016/j.ijcrp.2024.200275","url":null,"abstract":"<div><p>The Italian Association for Cardiovascular Rehabilitation and Prevention (ITACARE-P) and the Italian Federation of Associations of Hospital Doctors on Internal Medicine (FADOI) released a joint position paper to guide referrals of cardiovascular patients discharged from Internal Medicine (IM) wards to Cardiac Rehabilitation (CR) facilities. The document provides rationale and operative recommendations for appropriateness (i.e. qualifying diagnoses) and priority criteria to overcome the mismatch between potential demand and effective supply of CR programmes. In case of no-referral due to logistic barriers, the document recommends the adoption of best alternatives to CR for disability reduction, better prognosis, and improvement of quality of life. The joint position paper is also aimed to promote the consideration of IM as a potential stakeholder of CR.</p></div>","PeriodicalId":29726,"journal":{"name":"International Journal of Cardiology Cardiovascular Risk and Prevention","volume":"21 ","pages":"Article 200275"},"PeriodicalIF":2.3,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2772487524000400/pdfft?md5=547cac32d2f40a66c7d6662f3454beb0&pid=1-s2.0-S2772487524000400-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141249813","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-06-01DOI: 10.1016/j.ijcrp.2024.200268
Elisabetta Angelino
Women receive similar or greater benefits than men from Cardiac Rehabilitation (CR). However, they are less likely to participate. An integrated and gender-sensitive approach to cardiovascular disease is required to enhance the quality and experience of care for women with different cardiovascular issues throughout their lives.
The Italian Alliance for Cardiovascular Rehabilitation and Prevention (ITACARE-P) is committed to developing a gender-specific approach to CR that will more effectively meet the needs of both women and men.
{"title":"41Bridging the gender gap in Cardiac Rehabilitation. The first step: The equal opportunities project","authors":"Elisabetta Angelino","doi":"10.1016/j.ijcrp.2024.200268","DOIUrl":"https://doi.org/10.1016/j.ijcrp.2024.200268","url":null,"abstract":"<div><p>Women receive similar or greater benefits than men from Cardiac Rehabilitation (CR). However, they are less likely to participate. An integrated and gender-sensitive approach to cardiovascular disease is required to enhance the quality and experience of care for women with different cardiovascular issues throughout their lives.</p><p>The Italian Alliance for Cardiovascular Rehabilitation and Prevention (ITACARE-P) is committed to developing a gender-specific approach to CR that will more effectively meet the needs of both women and men.</p></div>","PeriodicalId":29726,"journal":{"name":"International Journal of Cardiology Cardiovascular Risk and Prevention","volume":"21 ","pages":"Article 200268"},"PeriodicalIF":2.3,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2772487524000333/pdfft?md5=6cc1d0225a067fede5e8f931a690a21f&pid=1-s2.0-S2772487524000333-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141249814","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-06-01DOI: 10.1016/j.ijcrp.2024.200270
Letizia da Vico
Background
The prevalence and incidence of cardiovascular diseases significantly increase with age, and it is well-known that nutritional status affects the prognosis and treatment of these diseases. Therefore, evaluating nutritional status is essential for maintaining/regaining health. It is crucial to identify nutritional risk early, prevent and/or treat protein-energy malnutrition, and promote the modification of inappropriate dietary habits.
Methods
Nutritional screening represents the first step of access to the Nutrition Care Process (NCP) adopted and managed by the dietitian; this tool must be simple, inexpensive, accessible, accurate, efficient, and validated. A globally accepted standardized definition of malnutrition is necessary, and for this reason, the Global Leadership Initiative on Malnutrition (GLIM) criteria have been recently introduced.
The GLIM criteria, after confirming nutritional risk through screening, include both phenotypic and etiological criteria: to diagnose malnutrition, at least one of these must be present.
A less commonly performed phenotypic criterion is the assessment of muscle mass, which should be studied as a significant component of sarcopenia.
Conclusion
Greater attention to the identification and treatment of malnutrition would bring benefits to patients and ensure a saving in healthcare expenditure, but for this purpose, an implementation of clinical nutrition services is necessary.
{"title":"Indicators of nutritional status and patient needs in cardiac rehabilitation","authors":"Letizia da Vico","doi":"10.1016/j.ijcrp.2024.200270","DOIUrl":"https://doi.org/10.1016/j.ijcrp.2024.200270","url":null,"abstract":"<div><h3>Background</h3><p>The prevalence and incidence of cardiovascular diseases significantly increase with age, and it is well-known that nutritional status affects the prognosis and treatment of these diseases. Therefore, evaluating nutritional status is essential for maintaining/regaining health. It is crucial to identify nutritional risk early, prevent and/or treat protein-energy malnutrition, and promote the modification of inappropriate dietary habits.</p></div><div><h3>Methods</h3><p>Nutritional screening represents the first step of access to the Nutrition Care Process (NCP) adopted and managed by the dietitian; this tool must be simple, inexpensive, accessible, accurate, efficient, and validated. A globally accepted standardized definition of malnutrition is necessary, and for this reason, the Global Leadership Initiative on Malnutrition (GLIM) criteria have been recently introduced.</p><p>The GLIM criteria, after confirming nutritional risk through screening, include both phenotypic and etiological criteria: to diagnose malnutrition, at least one of these must be present.</p><p>A less commonly performed phenotypic criterion is the assessment of muscle mass, which should be studied as a significant component of sarcopenia.</p></div><div><h3>Conclusion</h3><p>Greater attention to the identification and treatment of malnutrition would bring benefits to patients and ensure a saving in healthcare expenditure, but for this purpose, an implementation of clinical nutrition services is necessary.</p></div>","PeriodicalId":29726,"journal":{"name":"International Journal of Cardiology Cardiovascular Risk and Prevention","volume":"21 ","pages":"Article 200270"},"PeriodicalIF":2.3,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2772487524000357/pdfft?md5=9b643f5c811d8c8904d2450799e9d61a&pid=1-s2.0-S2772487524000357-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141249845","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-06-01DOI: 10.1016/j.ijcrp.2024.200271
Alessandro Maloberti , Claudio Ciampi , Francesco Politi , Saverio Fabbri , Francesco Musca , Cristina Giannattasio
Cardiac amyloidosis is becoming increasingly important among cardiologist and an early diagnosis is very important. Amyloidosis is a systemic disease and many cardiac and extracardiac elements (red flags) should raise the suspicion of the disease. Electrocardiographic and imaging techniques (such as echocardiography, cardiac magnetic resonance and scintigraphy) are useful tools to make a diagnosis together with the presence of orthopedic issues, peripheral neuropathy or plasma cell dyscrasia. Cardiac amyloidosis is also often associated with valvular disorder, heart failure or cardiomyopathy. Red flags are crucial to raise suspicion and reach an early diagnosis, in order to start a targeted treatment strategy that could change the patient's outcome. Indeed, in the last years four new drugs were approved to treat transthyretin amyloidosis.
{"title":"Cardiac amyloidosis red flags: What all the cardiologist have to know","authors":"Alessandro Maloberti , Claudio Ciampi , Francesco Politi , Saverio Fabbri , Francesco Musca , Cristina Giannattasio","doi":"10.1016/j.ijcrp.2024.200271","DOIUrl":"https://doi.org/10.1016/j.ijcrp.2024.200271","url":null,"abstract":"<div><p>Cardiac amyloidosis is becoming increasingly important among cardiologist and an early diagnosis is very important. Amyloidosis is a systemic disease and many cardiac and extracardiac elements (red flags) should raise the suspicion of the disease. Electrocardiographic and imaging techniques (such as echocardiography, cardiac magnetic resonance and scintigraphy) are useful tools to make a diagnosis together with the presence of orthopedic issues, peripheral neuropathy or plasma cell dyscrasia. Cardiac amyloidosis is also often associated with valvular disorder, heart failure or cardiomyopathy. Red flags are crucial to raise suspicion and reach an early diagnosis, in order to start a targeted treatment strategy that could change the patient's outcome. Indeed, in the last years four new drugs were approved to treat transthyretin amyloidosis.</p></div>","PeriodicalId":29726,"journal":{"name":"International Journal of Cardiology Cardiovascular Risk and Prevention","volume":"21 ","pages":"Article 200271"},"PeriodicalIF":2.3,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2772487524000369/pdfft?md5=82695930583ce0e9b5824df165f8db8f&pid=1-s2.0-S2772487524000369-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141249846","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-06-01DOI: 10.1016/j.ijcrp.2024.200280
Zeeshan Afzal, Abdul Basit, Usama Habib, Mateen Aman, Muhammad Azim, Huili Cao
{"title":"Emerging risks of microplastics and nanoplastics (MNPs): Is a silent threat for cardiovascular disease?","authors":"Zeeshan Afzal, Abdul Basit, Usama Habib, Mateen Aman, Muhammad Azim, Huili Cao","doi":"10.1016/j.ijcrp.2024.200280","DOIUrl":"10.1016/j.ijcrp.2024.200280","url":null,"abstract":"","PeriodicalId":29726,"journal":{"name":"International Journal of Cardiology Cardiovascular Risk and Prevention","volume":"21 ","pages":"Article 200280"},"PeriodicalIF":2.3,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S277248752400045X/pdfft?md5=a163542ae81fcc5ef1bc68ad77f4cfd5&pid=1-s2.0-S277248752400045X-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141030184","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-05-31DOI: 10.1016/j.ijcrp.2024.200292
H.A. Nati-Castillo , David Aristizabal-Colorado , Carolina López Ordoñez , Diego Egas Proaño , Esteban Ortiz-Prado , Juan S. Izquierdo-Condoy
Background
Acute cardiac complications post-chemotherapy is rare. Stress cardiomyopathy, one of these complications, should be considered in differential diagnoses as its symptoms closely resemble those of acute myocardial infarction and can lead to mortality.
Objective
The objective of this paper is to describe Takotsubo syndrome (TTS) as an acute complication following combined chemotherapy in a patient with significant thromboembolic burden and metastatic cervical cancer.
Case
A 61-year-old female patient with a diagnosis of metastatic cervical cancer experienced acute chest pain. Elevated troponin levels and abnormalities in the electrocardiogram initially suggested an acute myocardial infarction, occurring after a chemotherapy session involving Carboplatin and Paclitaxel infusion. Although initial treatment targeted myocardial infarction, further diagnostic evaluations including coronary angiography and cardiac magnetic resonance imaging revealed no coronary artery disease but identified features consistent with stress cardiomyopathy, indicative of Takotsubo syndrome (TTS). This diagnosis led to an improvement in symptoms and a resolution of the acute changes observed.
Conclusion
Stress cardiomyopathy, particularly TTS, is being increasingly recognized as an acute complication associated with combined chemotherapy regimens. The potential cardiotoxic effects of these chemotherapy agents demand careful monitoring and evaluation in patients undergoing oncological treatment, underscoring the importance of integrating cardioprotective strategies into the management of these patients.
{"title":"Takotsubo syndrome as an acute cardiac complication following combined chemotherapy","authors":"H.A. Nati-Castillo , David Aristizabal-Colorado , Carolina López Ordoñez , Diego Egas Proaño , Esteban Ortiz-Prado , Juan S. Izquierdo-Condoy","doi":"10.1016/j.ijcrp.2024.200292","DOIUrl":"https://doi.org/10.1016/j.ijcrp.2024.200292","url":null,"abstract":"<div><h3>Background</h3><p>Acute cardiac complications post-chemotherapy is rare. Stress cardiomyopathy, one of these complications, should be considered in differential diagnoses as its symptoms closely resemble those of acute myocardial infarction and can lead to mortality.</p></div><div><h3>Objective</h3><p>The objective of this paper is to describe Takotsubo syndrome (TTS) as an acute complication following combined chemotherapy in a patient with significant thromboembolic burden and metastatic cervical cancer.</p></div><div><h3>Case</h3><p>A 61-year-old female patient with a diagnosis of metastatic cervical cancer experienced acute chest pain. Elevated troponin levels and abnormalities in the electrocardiogram initially suggested an acute myocardial infarction, occurring after a chemotherapy session involving Carboplatin and Paclitaxel infusion. Although initial treatment targeted myocardial infarction, further diagnostic evaluations including coronary angiography and cardiac magnetic resonance imaging revealed no coronary artery disease but identified features consistent with stress cardiomyopathy, indicative of Takotsubo syndrome (TTS). This diagnosis led to an improvement in symptoms and a resolution of the acute changes observed.</p></div><div><h3>Conclusion</h3><p>Stress cardiomyopathy, particularly TTS, is being increasingly recognized as an acute complication associated with combined chemotherapy regimens. The potential cardiotoxic effects of these chemotherapy agents demand careful monitoring and evaluation in patients undergoing oncological treatment, underscoring the importance of integrating cardioprotective strategies into the management of these patients.</p></div>","PeriodicalId":29726,"journal":{"name":"International Journal of Cardiology Cardiovascular Risk and Prevention","volume":"22 ","pages":"Article 200292"},"PeriodicalIF":2.3,"publicationDate":"2024-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2772487524000576/pdfft?md5=bb7fbb4891a2536b1f96af8c86c64fdc&pid=1-s2.0-S2772487524000576-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141239743","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Limited data exists on upfront combination therapy for portopulmonary hypertension. We evaluated the clinical efficacy, long-term outcomes, and safety of upfront combination therapy in patients with portopulmonary hypertension.
Methods
We performed a retrospective, single-center cohort study involving a final analysis of 33 consecutive patients diagnosed with portopulmonary hypertension who were taking pulmonary arterial hypertension-specific medication. We compared hemodynamic parameters, risk profiles, composite clinical worsening events, and safety between monotherapy (n = 23) and upfront combination therapy (n = 10).
Results
Twenty-seven patients (82 %) were classified into the Child–Pugh A stage. The change ratios of pulmonary vascular resistance (−32 % vs. −57 %, P = 0.006) were significantly better with upfront combination therapy. Upfront combination therapy also showed significant improvement in risk profiles. Kaplan–Meier analysis showed that the composite event-free rate was significantly lower in patients who received upfront combination therapy than in those who received monotherapy (P = 0.016), although no statistical differences were observed in all-cause death. In the univariate Cox proportional hazards analysis, upfront combination therapy was a factor for decreasing composite clinical worsening outcomes (hazard ratio 0.190, 95 % confidence interval 0.042–0.854; P = 0.030). No significant hepatic impairments were observed over 2 years of follow-up in the upfront combination group.
Conclusions
In patients with portopulmonary hypertension, upfront combination therapy significantly improved symptoms and short-term hemodynamics, and reduced long-term clinical worsening events without serious adverse effects. This study's findings suggest that patients with portopulmonary hypertension presenting with mild hepatic impairment benefit from upfront combination therapy.
{"title":"Clinical outcomes of upfront combination therapy for portopulmonary hypertension","authors":"Takatoyo Kiko , Ryotaro Asano , Hiroyuki Endo , Naruhiro Nishi , Hiroya Hayashi , Jin Ueda , Tatsuo Aoki , Akihiro Tsuji , Takeshi Ogo","doi":"10.1016/j.ijcrp.2024.200294","DOIUrl":"https://doi.org/10.1016/j.ijcrp.2024.200294","url":null,"abstract":"<div><h3>Background</h3><p>Limited data exists on upfront combination therapy for portopulmonary hypertension. We evaluated the clinical efficacy, long-term outcomes, and safety of upfront combination therapy in patients with portopulmonary hypertension.</p></div><div><h3>Methods</h3><p>We performed a retrospective, single-center cohort study involving a final analysis of 33 consecutive patients diagnosed with portopulmonary hypertension who were taking pulmonary arterial hypertension-specific medication. We compared hemodynamic parameters, risk profiles, composite clinical worsening events, and safety between monotherapy (n = 23) and upfront combination therapy (n = 10).</p></div><div><h3>Results</h3><p>Twenty-seven patients (82 %) were classified into the Child–Pugh A stage. The change ratios of pulmonary vascular resistance (−32 % vs. −57 %, P = 0.006) were significantly better with upfront combination therapy. Upfront combination therapy also showed significant improvement in risk profiles. Kaplan–Meier analysis showed that the composite event-free rate was significantly lower in patients who received upfront combination therapy than in those who received monotherapy (P = 0.016), although no statistical differences were observed in all-cause death. In the univariate Cox proportional hazards analysis, upfront combination therapy was a factor for decreasing composite clinical worsening outcomes (hazard ratio 0.190, 95 % confidence interval 0.042–0.854; P = 0.030). No significant hepatic impairments were observed over 2 years of follow-up in the upfront combination group.</p></div><div><h3>Conclusions</h3><p>In patients with portopulmonary hypertension, upfront combination therapy significantly improved symptoms and short-term hemodynamics, and reduced long-term clinical worsening events without serious adverse effects. This study's findings suggest that patients with portopulmonary hypertension presenting with mild hepatic impairment benefit from upfront combination therapy.</p></div>","PeriodicalId":29726,"journal":{"name":"International Journal of Cardiology Cardiovascular Risk and Prevention","volume":"22 ","pages":"Article 200294"},"PeriodicalIF":2.3,"publicationDate":"2024-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S277248752400059X/pdfft?md5=05e38f9b9c971dcf588cf7bd1f11bc24&pid=1-s2.0-S277248752400059X-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141239737","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}