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Aim To assess the prevalence and prognostic significance of NI-LGE in patients undergoing stress-CMR. Methods Stress-CMR with either dipyridamole or adenosine was performed in 283 patients (228 men, 81%) including perfusion imaging, wall motion evaluation and LGE. Follow-up was completed in all enrolled patients (median time: 1850 days; interquartile range: 1225-2705 days). Composite endpoint included cardiac death, ventricular tachycardia, myocardial infarction, stroke, hospitalization for cardiac cause and coronary revascularization performed beyond 90 days from stress-CMR scans. Results One hundred and twelve patients (40%) had negative LGE (no-LGE), 140 patients (49%) I-LGE and 31 patients (11%) NI-LGE. Twenty-five events occurred in the no-LGE group, 68 in I-LGE and 11 in the NI-LGE group. On survival curves, patients with NI-LGE had worse prognosis than patients with no-LGE regardless of the presence of inducible perfusion defects. No significant prognostic differences were found between I-LGE and NI-LGE. Conclusion NI-LGE can be detected in 11% of patients during stress-CMR providing a diagnosis of nonischemic cardiac disease. Patients with NI-LGE have worse prognosis than those with no-LGE.

Aims Recent reports evidenced gender differences in the knowledge, perception and awareness of cardiovascular risk factors (CVRFs) and cardiovascular diseases (CVDs). Despite the number of high-quality trials that attempted to establish the efficacy of different preventive interventions on CVDs, in the Italian scenario the differences by gender in awareness, knowledge and perception of CVD have not been addressed yet. So, the aims of this cross-sectional, observational and multicenter study will be to evaluate the gender differences in the awareness and perception of CVD risk, to assess the knowledge of CVD symptoms and preventive behaviors/barriers in men and women participating in this study, and to provide a national primary care approach for gender-oriented cardiovascular prevention strategies and therapy. Methods A self-administered questionnaire will be completed by 5000 consecutive Italian women and men aged 18-70 years. Moreover, a health questionnaire will be completed by the physicians. Results The present study will be the largest to be conducted in Italy, and probably in the European countries, to comprehensively demonstrate the current level of the knowledge, awareness and perception of CVRFs and CVD in both men and women. Conclusion The present project could shed new light on the knowledge, awareness and perception of CVRFs and CVDs. If substantial differences will be detected by gender, the findings of this study may contribute to ultimately provide a new gender-oriented primary care approach inside the Italian healthcare system related to cardiovascular prevention and therapy strategies.

Our aim was to evaluate the correlation between myocardial fibrosis detected using the late gadolinium enhancement (LGE) cardiovascular magnetic resonance (CMR) technique and chronic hepatitis C (CHC) in a large, retrospective, multicentre cohort of thalassemia major patients.LGE images were acquired in 434 thalassemia major patients (233 men, 31 ± 9 years) enrolled in the MIOT (Myocardial Iron Overload in Thalassemia) study. Hepatitis C virus (HCV)-RNA tests were sensitive to detect more than 50 copies/ml.No patient manifested moderate/severe adverse events associated with the use of Gadobutrol. Myocardial fibrosis was detected in 90 (21%) patients. Among the 312 patients tested for HCV-RNA, there was a significant correlation between the presence of myocardial fibrosis and CHC (P = 0.011). Among the 62 patients with myocardial fibrosis tested for HCV-RNA, we found a significantly higher prevalence of diabetes mellitus in CHC patients versus the no-CHC patients (P = 0.049).Our findings support the use of the LGE CMR approach well tolerated in the thalassemia major patients with CHC. HCV infection can be involved in the pathogenesis of myocardial fibrosis through both myocarditis directly and the pancreas and liver damage with the development of diabetes indirectly. These patients could therefore benefit from cardioactive drugs and therapeutic interventions directed towards the eradication of virus.