Patients with Subacute Bacterial Endocarditis (SBE) may present with multisystem disorders mimicking autoimmune diseases, such as An Antineutrophil Cytoplasmic Antibody (ANCA) - Associated Vasculitis (AAV). In this report, we present a 72-year-old female patient with streptococcal SBE who developed multiple inflammatory abnormalities, including ANCA positivity, which was complicated by the occurrence of leukocytoclastic vasculitis, glomerulonephritis, acute myocardial infarction, heart failure and subarachnoid hemorrhage. The patient had previously known mitral valve regurgitation. Repeated transthoracic echocardiography showed a floating lesion in the area of the mitral valve corresponding to chronic vegetation and confirmed the suspicion of SBE. Antibiotic treatment resulted in the decline of inflammatory parameters and complete recovery of renal function. Conservative treatment of acute myocardial infarction and neurorehabilitation were successful. Repeated ANCA tests were negative. Previously reported cases showed that ANCA-positive SBE can involve multiple organs. Distinguishing between AAV and SBE can sometimes be very difficult because of their clinical and serological similarities. Such a wide clinical presentation requires intensive monitoring of these patients. In conclusion, if systemic vasculitis is suspected, it is necessary to exclude diseases that mimic vasculitis, such as SBE.

The myocardial bridge is an intramural course of a coronary artery in which a more or less long section of a coronary branch, instead of running normally on the epicardial surface of the heart, deepens early in the myocardium, coming to be surrounded by a ring or sleeve of muscle fiber cells that, contracting in systole, can cause an ab-extrinsic “throttling” of the artery. The guidelines for granting eligibility for competitive sports have evolved over time: from 2009, when any case of myocardial bridging indicated exclusion of eligibility, to today, when only significant bridges, i.e. ‘long’ bridges > 1 cm and > 3 mm deep, place a restriction on competitive sports activity.

Background: Some studies have evaluated the role of QRS duration (QRSd) as predictor of response to Cardiac Resynchronization Therapy (CRT). However, their results are still not entirely clear. The goal of our study was to determine the correlation between the relative change in QRS narrowing index (QI) compared to clinical outcome and prognosis in patients who underwent CRT implantation. Methods: We collected clinical and echocardiographic data of 115 patients in whome a CRT device was implanted in accordance with current guidelines. QRS duration before and after CRT implantation and QI were measured. Results: After 6 months, a significant improvement in all echocardiographic parameters was detected. QI was correlated to reverse remodelling (r = +0.19; 95% CI: 0.006 to 0.35, p = 0,049). The value of QI that predicted best LV reverse remodelling after 6 months of CRT was 12.25% (sensitivity = 65,5%, specificity = 75%, area under the curve = 0.737, p = 0,001). Independent predictors of QI are sex, serum creatinine and eGFR measured at baseline and LVEF pre-CRT performed by echocardiography. We observed an betterment in their HF clinical composite score and NYHA class at 12 months. We have also investigated the clinical outcomes and the possible sex differences related to QI. Conclusions: Patients with a larger QI after CRT initiation showed greater echocardiographic reverse remodelling and better outcome from death or cardiovascular hospitalization. QI seems to be an easy-to- measure variable that could be used or evaluated to predict CRT response but further studies are needed.

In literature and clinical reports connections between a heart condition (blood properties) and emotional and mental states are documented [1,2]. It is well known that psychosocial risk factors may lead to the activation of mechanisms responsible for somatic dysfunction of the cardiovascular system.

Male gender and the marathon were shown to be independent and significant risk factors for cardiac arrest in United States road races in a 10-year registry beginning in 2000, during which events increased in frequency during the latter half of the study [1].

Background and objectives: Heart failure is a pathological condition characterized by the inability of the heart to pump (cardiac output) an adequate amount of blood to meet the metabolic needs of the body or, at any rate, to be able to do so only at the expense of increased filling pressures in one or more cardiac chambers and the upstream venous circulation. The research group states here the primary objective of expanding the indications contained in the ESC 2021 with the results of the last year on the subject of treatment profiles, to facilitate a better understanding of the overall clinical picture and contribute to the next edition of the guidelines. Materials and methods: Systematic literature review in the English language from January 1, 2021, to September 30, 2022, on PubMed/MedLine, Web on Science, and Cochrane archive. Our search strategy retrieved 8,317 articles. We excluded books and papers, meta-analyses, reviews, and systematic reviews and selected only 46 studies most significant about the clinical trial and randomized controlled trial. Results: The recent ESC 2021 guidelines are accurate and timely, and have confirmed their usefulness from a functional perspective, including concerning certain aspects that were represented as a “grey area”. Early risk prediction plays a key role in the subsequent management of patients, and to optimize risk prediction and intensity of management, one should take into account that: a) biomarkers have improved the understanding of the pathophysiology of heart failure and may therefore help to adjust the intensity of management in AHF; b) among the wide variety of biomarkers currently available, NT-proBNP and cTn seem the most promising in this indication; c) among the risk scores described, those combining demographic and clinical parameters with biomarkers in a model with routinely available rapid variables seem the most promising tools; d) in addition to biomarkers, age, systolic blood pressure, respiratory rate, oxygen saturation, creatinine, electrolytes, and blood urea nitrogen are the most commonly used predictor variables in the risk scores described; e) among the models selected, the MEESSI-AHF risk score appears to be currently the most promising tool for predicting the risk of AHF; f) during the management of decompensated patients (and in later stages), the psychological aspect is completely ignored, thus promoting the worsening of psychological symptoms (the need is as evident during the acute episode as it is in the daily management of chronic heart failure). Conclusions: The scientific literature search enriched the structure of ESC 2021, suggesting its implementation, with other findings related to new drug therapies such as Sotagliflozin, Hydrochlorothiazide Apabetalone, Alprostadil, Empagliflozin, Sacubitril/Valsartan, Dapagliflozin, Sodium-glucose co-transporter-2 inhibitors, and biomarkers such as Urinary sodium (UNa+), IL-6 levels and rh-brain natriuretic peptide (rhBNP), as well as the use of mindful breathing session, osteopathic manipulative treatment, electrical muscle stimulation, low-level tragus stimulation, venoarterial extracorporeal membrane oxygenation, oral nutritional supplements, and the correlative hypothesis between heart failure and intestinal dysbiosis, also concerning the psychological profile. However, these clinical studies suffer from some limitations that will necessarily have to be taken into account, such as the limited size of the population sample selected or the conflict of interest determined by the fact that some research is funded by the same pharmaceutical company producing the drug used that do not necessarily represent a negative limitation on the results obtained from studies.

Coronary Artery Disease (CAD) is one of the most important causes of mortality and morbidity in the world. Nevertheless, Myocardial Perfusion Scintigraphy (MPS) using Single-Photon Emission Computed Tomography (SPECT) with radiopharmaceuticals is still widely used for the non-invasive diagnosis of obstructive CAD and functional imaging of the myocardium at stress.

The immune system provides an intricate, balanced response to combat the effects of inflammatory stimuli. It incorporates both positive and negative feedback from multiple physiological systems such as the cardiovascular and endocrine systems including mechanisms functioning on a variety of time scales. They have been studied individually via scientific experiments and using mathematical modeling. However, more analysis is needed to study the interactions between these three systems during an inflammatory event. We present the first dynamical systems model studying immune, cardiovascular and endocrine responses to a 2 ng/kg bolus dose of endotoxin. The model is calibrated to experimental data from two endotoxin challenge studies and we use this model to investigate the effects of endotoxin dosage, administration timing and administration method. Our model shows that most repercussions of endotoxin administration clear the system within 24 hours, but effects can linger for up to 72 hours.

Lipid metabolism can experience different disorders resulting in changes in the function and concentrations of plasma lipoproteins. These changes affect alone or interact with other cardiovascular risk factors involved in the development of atherosclerosis. Therefore, dyslipidemias cover a wide spectrum of disorders lipids. Some of them have a genetic origin and very low prevalence. The main objective of this article is to report new cases of rare dislipemias of genetic origin in our population. Genetic analysis was performed by Next Generation Sequencing (NGS) using a customized panel of 436 genes in DNA samples of four patients. The results confirmed the genetic origin of the following dyslipidemias: fish-eye disease, primary hypoalphalipoproteinemia-2, familial hypercholesterolemia by a variant in STAP1 and Sitosterolemia. This approach allows us to confirm the genetic diagnosis of four patients with alterations in lipid metabolism, this will help to improve patient management, achieving early diagnosis in the study of family members

While peripheral artery occlusive disease (PAOD) by large is a clinical diagnosis, further characterization of the ischemic state, procedural planning, and longitudinal follow-up after revascularisation are mainly based on imaging that delineates the arterial vasculature. Although several potential techniques have been suggested [1], there is still no clearly established imaging technique that directly quantifies the crucial PAOD pathophysiological process-tissue perfusion in the lower limb.