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Cardiomyopathies (CMPs) are a group of myocardial disorders that are characterized by structural and functional abnormalities of the heart muscle. These abnormalities occur in the absence of coronary artery disease (CAD), hypertension, valvular disease, and congenital heart disease. CMPs are an increasingly important topic in the field of cardiovascular diseases due to the complexity of their diagnosis and management. In 2023, the ESC guidelines on cardiomyopathies were first published, marking significant progress in the field. The growth of techniques such as cardiac magnetic resonance imaging (CMR) and genetics has been fueled by the development of multimodal imaging approaches. For the diagnosis of CMPs, a multimodal imaging approach, including CMR, is recommended. CMR has become the standard for non-invasive analysis of cardiac morphology and myocardial function. This document provides an overview of the role of CMR in CMPs, with a focus on tissue mapping. CMR enables the characterization of myocardial tissues and the assessment of cardiac functions. CMR sequences and techniques, such as late gadolinium enhancement (LGE) and parametric mapping, provide detailed information on tissue composition, fibrosis, edema, and myocardial perfusion. These techniques offer valuable insights for early diagnosis, prognostic evaluation, and therapeutic guidance of CMPs. The use of quantitative CMR markers enables personalized treatment plans, improving overall patient outcomes. This review aims to serve as a guide for the use of these new tools in clinical practice. [ABSTRACT FROM AUTHOR]

Telemedicine and remote monitoring devices, including implantable loop recorders (ILR), are increasingly adopted in the cardiologic setting. These are valuable tools in the arrhythmic stratification of patients at risk of sudden cardiac death, providing a tailored therapeutic management to prevent lethal arrhythmias. We report a case of an asymptomatic 18-year-old boy with a family history of syncope and cardiac arrest, who had a diagnosis of Brugada syndrome with an inducible type 1 pattern and carrier of a missense mutation of the SCN5A gene. In light of the risk factors, although not recommended by current guidelines, we decided to proceed with the implantation of an ILR with remote monitoring service. A few months later, an episode of asymptomatic sustained polymorphic ventricular tachycardia was promptly observed by the remote monitoring, leading to a timely implantation of a subcutaneous cardiac implantable defibrillator. [ABSTRACT FROM AUTHOR]

Non-ischemic dilated cardiomyopathy (DCM) is a disease characterized by left ventricular dilation and systolic dysfunction. Patients with DCM are at higher risk for ventricular arrhythmias and sudden cardiac death (SCD). According to current international guidelines, left ventricular ejection fraction (LVEF) ≤ 35% represents the main indication for prophylactic implantable cardioverter defibrillator (ICD) implantation in patients with DCM. However, LVEF lacks sensitivity and specificity as a risk marker for SCD. It has been seen that the majority of patients with DCM do not actually benefit from the ICD implantation and, on the contrary, that many patients at risk of SCD are not identified as they have preserved or mildly depressed LVEF. Therefore, the use of LVEF as unique decision parameter does not maximize the benefit of ICD therapy. Multiple risk factors used in combination could likely predict SCD risk better than any single risk parameter. Several predictors have been proposed including genetic variants, electric indexes, and volumetric parameters of LV. Cardiac magnetic resonance (CMR) can improve risk stratification thanks to tissue characterization sequences such as LGE sequence, parametric mapping, and feature tracking. This review evaluates the role of CMR as a risk stratification tool in DCM patients referred for ICD. [ABSTRACT FROM AUTHOR]

International literature has shown that demographic characteristics, socioeconomic status, social ties and supports in the host country play an important role on migrants' subjective wellbeing. The influence of such characteristics has been widely studied so far, especially on immigrants' levels of life satisfaction, but how living transnational partnerships and parenthoods might affect the subjective wellbeing of migrants and how this situation might be reflecting social integration issues still remains poorly understood. This paper is aimed at covering this gap by analyzing each one of the components of subjective well-being: own assessment of life satisfaction (cognitive component), feelings of loneliness (emotional component) and sense of belonging (affective component). Ordinal logistic regressions were run on a selected sample of the Survey on Social Conditions and Integration of Foreign citizens carried out by ISTAT in 2011/2012. Results have shown that living in transnational families differently affect subjective wellbeing, being particularly important for the cognitive and emotional components among married immigrants. Self-perceived social integration has been found to be a protective factor of immigrants' levels of subjective wellbeing, having a preventive role on their levels of life satisfaction and feelings of loneliness. [ABSTRACT FROM AUTHOR]

In France and Italy – like all the countries of the European Union – the proportion of higher education graduates in the working population has continued to increase. At the same time, the number of jobs requiring this level of education has not grown as quickly. In France and Italy, this has meant a decrease in the proportion of tertiary graduates who occupy managerial positions, and a growing share of these graduates hold jobs as middle and low ranking employees. Several studies have investigated the phenomenon of professional downgrading, focusing on its structural determinants and socio-economic implications at the national level and examining international differences. Nevertheless, only a few studies explore disparities in over-education and compare nations at the regional level. By addressing the need for a spatial approach to this subject, which is so far lacking in the scientific literature, this paper examines the downgrading of higher education graduates in Italy and France at the regional level and discusses the real occupational returns for high levels of education. Using data from the Italian and French censuses, the findings of this analysis show significant sub-regional heterogeneities regarding access to managerial positions for graduates according to the territorial unit observed. [ABSTRACT FROM AUTHOR]

Migration is an obvious response to political, economic, socio-demographic, and ecological crises. In recent decades, several crises have occurred in the Mediterranean region; consequently, migration has intensified, the geography of flows has been altered, and the roles of some countries within the Mediterranean migration system have rapidly changed. This paper aims to delineate an overview of migration flows in this region over the last 20 years, focusing on the new migration flows related to humanitarian crises. In doing so, the present study also examines similarities and differences between past and current migration factors that shape the decisions of individuals. Migration flows are closely linked to the needs and fears of European societies. Following this logic, and by analysing challenges related to demographic and geopolitical dimensions in the future scenario, this study discusses the necessity of new policy responses. [ABSTRACT FROM AUTHOR]

The interventricular septum (IVS) is a core myocardial structure involved in biventricular coupling and performance. Physiologically, during systole, it moves symmetrically toward the center of the left ventricle (LV) and opposite during diastole. Several pathological conditions produce a reversal or paradoxical septal motion, such as after uncomplicated cardiac surgery (CS). The postoperative paradoxical septum (POPS) was observed in a high rate of cases, representing a unicum in the panorama of paradoxical septa as it does not induce significant ventricular morpho-functional alterations nor negative clinical impact. Although it was previously considered a postoperative event, evidence suggests that it might also appear during surgery and gradually resolve over time. The mechanism behind this phenomenon is still debated. In this article, we will provide a comprehensive review of the various theories generated over the past fifty years to explain its pathological basis. Finally, we will attempt to give a heuristic interpretation of the biventricular postoperative motion pattern based on the switch of the ventricular anchor points. [ABSTRACT FROM AUTHOR]

Introduction: Micra AV Transcatheter Pacing System (TPS) represents an innovative second‐generation leadless pacemaker which represents an effective alternative to conventional devices in selected cases. Intrinsic malfunctions of these devices are rare, requiring sometimes their retrieval. When performed in experienced centers, this procedure is safe. Case Presentation: We describe a case of sudden battery malfunction of a Micra AV TPS, which required the extraction and the placement of a new pacing system in the right ventricle. Discussion: This case, which has never been reported, highlights the need to a careful fluoroscopic evaluation and the usefulness of remote monitoring. [ABSTRACT FROM AUTHOR]

Highlights: What are the main findings? We presented a case of new onset dilated cardiomyopathy (DCM) with renal infarction in a young man on a treatment with high-dose isotretinoin. Possible known causes of DCM using a complete cardiac imaging assessment, genetic testing, and laboratory analysis have been ruled out. What is the implication of the main finding? The possible association of DCM with isotretinoin assumption is, to the authors' opinion, deserving of further investigations. Isotretinoin or 13-cis-retinoic acid (RA) is one of the most effective and widely used drugs for the treatment of severe acne vulgaris. Despite being deemed safe, no definite consensus has been reached on the cardiovascular risk of RA derivatives. We report a case of heart failure due to dilated cardiomyopathy (DCM) and concomitant renal infarction occurring after 5 months of isotretinoin use in a previously healthy 18-year-old male. The patient, with a history of acne vulgaris, presented to our emergency department with left iliac fossa pain and effort dyspnea. A trans-thoracic echocardiogram showed DCM and severely reduced left ventricle ejection fraction (LVEF: 29%). During hospitalization, a total body computed tomography (CT) showed an ischemic lesion in the left kidney. Ischemic, autoimmune, infective, and heritable causes of DCM were ruled out. Cardiac magnetic resonance (CMR) evidenced LV circumferential mid-wall late gadolinium enhancement. Heart failure therapy was promptly started and up-titrated, but only poor LVEF improvement was detected overtime. Our case aims to raise awareness on rare life-threatening cardiovascular events possibly associated with isotretinoin use. To the best of our knowledge, this is the first described case of renal thromboembolism and severe DCM leading to implantable cardioverter-defibrillator (ICD) implantation occurring during isotretinoin treatment. [ABSTRACT FROM AUTHOR]

In the original publication of the article the Acknowledgement section has been missed to include and now the same has been updated in this correction. [ABSTRACT FROM AUTHOR]

Abstract: The aim of the paper is to investigate the relation between Non-Profit Organizations (NP) and immigration. In particular, we examine the services offered to immigrants in Italy and Spain, both noted for their similar patterns of migration. In these countries immigration is characterised by a lack of the so-called “real” (not just legislative) measures that take the needs of immigrants into consideration. Even though emergency policies exist to meet various contingencies, lack of awareness of population movements is probably behind the “absence” of the state. The hypothetic and causal connection between the NP sector and immigration will be studied using selected data. The positive results of the analysis are the first stage in considering the possible substitution of state institutions by the NP sector, with regard to immigrants. [Copyright &y& Elsevier]

Cardiac magnetic resonance (CMR) imaging has witnessed substantial progress with the advent of parametric mapping techniques, most notably T1 and T2 mapping. These advanced techniques provide valuable insights into a wide range of cardiac conditions, including ischemic heart disease, cardiomyopathies, inflammatory cardiomyopathies, heart valve disease, and athlete's heart. Mapping could be the first sign of myocardial injury and oftentimes precedes symptoms, changes in ejection fraction, and irreversible myocardial remodeling. The ability of parametric mapping to offer a quantitative assessment of myocardial tissue properties addresses the limitations of conventional CMR methods, which often rely on qualitative or semiquantitative data. However, challenges persist, especially in terms of standardization and reference value establishment, hindering the wider clinical adoption of parametric mapping. Future developments should prioritize the standardization of techniques to enhance their clinical applicability, ultimately optimizing patient care pathways and outcomes. In this review, we endeavor to provide insights into the potential contributions of CMR mapping techniques in enhancing the diagnostic processes across a range of cardiac conditions. [ABSTRACT FROM AUTHOR]

Background and aim: Our aim was to evaluate the fluoroscopy time (FT), procedure time (PT) safety and efficacy when using intracardiac echocardiography (ICE) in comparison to transesophageal echocardiography (TEE) guidance for transcatheter closure of Ostium Secundum Atrial Septal Defect (OS‐ASD). Method: Ninety patients (n = 90) diagnosed with OS‐ASD underwent transcatheter closure between March 2006 and October 2021. Fifty‐seven patients were treated under ICE guidance, while 33 patients were treated under TEE guidance. Results: Mean age was 43 ± 15 years and 42 ± 10 years in the ICE and TEE groups, respectively. The majority of patients had a centrally placed defect. Median FT was 8.40 min versus 11.70 min (p <.001) in the ICE group compared to the TEE group, respectively. Median PT was 43 min versus 94 min (p <.001) in the ICE group compared to the TEE group, respectively. Both ICE and TEE provided high quality images. All interventions were completed successfully, except for one patient in the ICE group who experienced a device migration, the development of atrial tachycardia in one patient and atrial fibrillation in two patients in the ICE group which spontaneously cardioverted. There were no other complications. Conclusion: This study on a consistent cohort of patients with OS‐ASD undergoing percutaneous closure suggests that use of ICE is safe and efficacious. Compared to TEE, ICE demonstrated significantly shorter FT and PT, decreasing the entire duration of the procedure and x‐ray exposure. No relevant differences were observed in terms of success rate and complications. [ABSTRACT FROM AUTHOR]

Introduction: The importance of atrio‐ventricular synchrony pacing in sinus rhythm patients is known. To identify patients in whom leadless pacemakers are able to guarantee this atrio‐ventricular synchrony, we explored correlations among echocardiographic measures of left atrial (LA) size and function (doppler parameter and strain) with A4 amplitude in patients implanted with new generation Micra‐AV device. Methods: After implantation with Micra‐AV system, patients underwent device interrogation to evaluate AV synchrony based on the sensing of atrial mechanics and echocardiographic exam to assess LA morphology and LA function. Results: In the 21 studied patients (14 males, 72 ± 13 years), the A4 wave amplitude values inversely correlated with LA antero‐posterior diameter, LA volume, LA contraction strain and LA conduit strain, while they were positively related with LA reservoir strain. Discussion: Our results indicate a statistically significant relationship between morphological echocardiographic LA parameters and atrial contraction signal (A4), detected by leadless pacemakers and used to synchronize ventricular pacing with the atrium. Instantaneous LA function assessment obtained with LA strain provides incremental information over morphological parameters. LA strain evaluates atrial myocardial deformation during the whole cardiac cycle. We found higher value of A4 in patients that have grater absolute value of LAsr, LAscd and LAsct, that are simple and measurable parameters of LA functional capacity. Conclusion: Preimplant echocardiographic evaluation of the atrial contractility may be useful in predicting adequate A4 sensing and consequently a good atrio‐ventricular synchrony pacing. Echocardiography LA strain study seems promising in Micra‐AV patient selection. [ABSTRACT FROM AUTHOR]

Cangrelor, the first intravenous P2Y12 inhibitor (P2Y12-I), has been approved on the basis of three large RCTs from the CHAMPION program which nevertheless have been criticized for the low bleeding risk of the enrolled patients, the large quote of chronic coronary syndromes, and the use of Clopidogrel as control arm even in the setting of acute coronary syndromes (ACS). We sought to investigate, in the setting of ACS, the comparative performance of Cangrelor in terms of in-hospital ischemic and haemorrhagic outcomes compared with the current gold-standard of oral P2Y12-I. The study retrospectively enrolled 686 consecutive patients admitted to the Divisions of Cardiology of Policlinico of Bari and L. Bonomo Hospital of Andria for ACS and treated with percutaneous coronary intervention. The study population was divided according to the P2Y12-I treatment strategy in two groups: patients given an oral P2Y12-I and patients receiving Cangrelor in the cath lab followed by an oral P2Y12-I. Clinical endpoints included death, ischemic and bleeding events occurring during hospital stay. Cangrelor treated patients presented higher clinical risk profile at presentation and faced higher death rate. However, after PS matching, in-hospital mortality resulted comparable between the groups and Cangrelor use was associated with reduced in-hospital definite stent thrombosis (p = 0.03). Data from our real-world registry highlight that, in the setting of ACS, Cangrelor is prevalently used in patients with very challenging clinical presentations. The adjusted analysis provides for the first time promising data on stent thrombosis reduction associated with Cangrelor use. [ABSTRACT FROM AUTHOR]

(1) Background: Glucagone-Like Peptide-1 Receptor Agonists (GLP-1 RAs) (GLP-1 RAs) are incretine-based medications recommended in the treatment of type 2 Diabetes Mellitus (DM2) with atherosclerotic cardiovascular disease (ASCVD) or high or very high cardiovascular (CV) risk. However, knowledge of the direct mechanism of GLP-1 RAs on cardiac function is modest and not yet fully elucidated. Left ventricular (LV) Global Longitudinal Strain (GLS) with Speckle Tracking Echocardiography (STE) represents an innovative technique for the evaluation of myocardial contractility. (2) Methods: an observational, perspective, monocentric study was conducted in a cohort of 22 consecutive patients with DM2 and ASCVD or high/very high CV risk, enrolled between December 2019 and March 2020 and treated with GLP-1 RAs dulaglutide or semaglutide. The echocardiographic parameters of diastolic and systolic function were recorded at baseline and after six months of treatment. (3) Results: the mean age of the sample was 65 ± 10 years with a prevalence of the male sex (64%). A significant improvement in the LV GLS (mean difference: −1.4 ± 1.1%; p value < 0.001) was observed after six months of treatment with GLP-1 RAs dulaglutide or semaglutide. No relevant changes were seen in the other echocardiographic parameters. (4) Conclusions: six months of treatment with GLP-1 RAs dulaglutide or semaglutide leads to an improvement in the LV GLS in subjects with DM2 with and high/very high risk for ASCVD or with ASCVD. Further studies on larger populations and with a longer follow-up are warranted to confirm these preliminary results. [ABSTRACT FROM AUTHOR]

This article examines the magnitude and determinants of migration from east to west (Europe) following the collapse of communism, and from south (Africa) to north (Europe). Special attention is given to assessing numbers and characteristics (including illegal) of the flows, and also to reasons for and success of bilateral agreements and cooperative projects by the governments of Italy and Spain designed to check and control the flows. Notwithstanding tighter controls on visas for Third World nationals, migration to western Europe does not seem to have abated. In Italy, illegal migration from the east (Albania in particular) is connected, directly or indirectly, with the criminal underworld. The inventory of legal texts and agreement protocols between Spain and Morocco designed to resolve many issues relating to migration, reflect long-standing relations between the two countries. Political and economic relations between Italy and Albania, on the other hand, have developed only within the framework of recent policies. While the presence of Moroccans in Spain and Albanians in Italy is not yet demographically significant, the authors predict that, in the absence of further appropriate political and economic measures, numbers will increase. [ABSTRACT FROM AUTHOR]

In Spain cohabitation the prevalence of cohabiting couples is no longer marginal. Not only the incidence but also the nature of cohabiting couples is diverse: in Spain cohabitation is considered a temporal alternative that generally ends with the legalization of the union (marriage). The main purpose of this paper is to examine the incidence, duration and development of cohabitation using a life course comparative approach, identifying also the profiles of women who split up against those who decide to marry. Results show the prevalence of the transition from cohabitation to marriage in Spain, establishing this type of union as a prelude and not as a definitive alternative to marriage. [ABSTRACT FROM AUTHOR]

In Spain cohabitation the prevalence of cohabiting couples is no longer marginal. Not only the incidence but also the nature of cohabiting couples is diverse: in Spain cohabitation is considered a temporal alternative that generally ends with the legalization of the union (marriage). The main purpose of this paper is to examine the incidence, duration and development of cohabitation using a life course comparative approach, identifying also the profiles of women who split up against those who decide to marry. Results show the prevalence of the transition from cohabitation to marriage in Spain, establishing this type of union as a prelude and not as a definitive alternative to marriage. [ABSTRACT FROM AUTHOR]