Demographic and training variations across cardiology subspecialties in Italy: a national survey Federico Fortuni, Giuseppe Ciliberti, Pietro Scicchitano, Luca Franchin, Stefano Cangemi, et al. Journal of Cardiovascular Medicine, 2026 Background Advances in cardiovascular medicine and subspecialization have improved patient care but exposed persistent workforce disparities. Evidence on sex, age, and training mobility within cardiology is fragmented, and comprehensive analyses across subspecialties are lacking. Methods A nationwide survey was conducted by the Italian Association of Hospital Cardiologists (ANMCO) during its 2025 National Congress. The questionnaire included 17 multiple-choice items covering demographics, sex distribution, age, and training patterns across five subspecialties: interventional cardiology, clinical cardiology/acute care, cardiovascular imaging, heart failure, and electrophysiology. Responses were analyzed using descriptive statistics. Results A total of 355 cardiologists responded, 51% of whom were women, with 53% aged >45 years. Significant sex-based differences were observed across subspecialties ( P 50% in 51% of responses). Age distributions also differed significantly ( P < 0.001), with interventional cardiology, clinical cardiology, and electrophysiology dominated by the 40–50-years age range, whereas imaging showed a higher proportion of younger cardiologists. Training mobility varied but did not reach statistical significance ( P = 0.054), with greater local stability in electrophysiology and higher external training reported in imaging and clinical cardiology. Stratification by respondent sex confirmed similar perceptions of female underrepresentation. Conclusions This survey highlights persistent gender imbalances, mid-career clustering, and heterogeneous training mobility across Italian cardiology subspecialties. Targeted national and international strategies are needed to promote equity, strengthen training pathways, and support sustainable workforce development.
Percutaneous Mechanical Circulatory Support Devices in Cardiogenic Shock: A Narrative Review in Light of Recent Evidence Vincenzo Paragliola, Marco Gamardella, Luca Franchin, Maurizio Bertaina, Francesco Colombo, et al. Journal of Clinical Medicine, 2025 Cardiogenic shock (CS) is a complex, life-threatening syndrome characterized by inadequate tissue perfusion due to impaired cardiac function. Acute myocardial infarction (AMI) and acute decompensated heart failure are the leading causes, with mortality remaining high despite advances in revascularization and supportive care. The Society for Cardiovascular Angiography and Interventions (SCAI) classification allows risk stratification and guides clinical decision making by capturing the spectrum of shock severity. Percutaneous mechanical circulatory support (pMCS) devices, such as the intra-aortic balloon pump (IABP) and Impella, aim to stabilize hemodynamics by augmenting cardiac output and unloading the left ventricle. However, randomized trials and meta-analyses have not demonstrated a consistent survival advantage of Impella over IABP, while reporting higher rates of bleeding and vascular complications. Landmark trials, including ECLS-SHOCK and DanGer, have provided conflicting results, likely reflecting differences in baseline severity and timing of device implantation. Veno-arterial extracorporeal membrane oxygenator (VA-ECMO) offers full cardiopulmonary support but increases left ventricular afterload, potentially worsening myocardial injury. Combined strategies such as ECPELLA (Impella + VA-ECMO) or ECMO + IABP may mitigate left ventricle (LV) overload and improve bridging to recovery or advanced therapies, although evidence remains largely observational and complication rates are considerable. In right-sided or biventricular failure, tailored options (e.g., Impella RP, Bi-Pella) guided by invasive hemodynamics may be required. Current evidence suggests that pMCS benefits are limited to carefully selected subgroups, underscoring the importance of early diagnosis, prompt referral, and individualized intervention. Robust randomized data are still needed to define the optimal role of pMCS in AMI-related CS.
Colchicine and Atherosclerotic Coronary Artery Disease: An Updated Review Simona Giubilato, Giuseppe Ciliberti, Pietro Scicchitano, Antonio Di Monaco, Federico Fortuni, et al. Journal of Clinical Medicine, 2025 Atherosclerotic coronary artery disease remains a leading cause of morbidity and mortality worldwide, despite advances in lipid-lowering and antithrombotic therapies. Increasing evidence highlights the pivotal role of inflammation in all stages of atherosclerosis, from plaque formation to rupture. Colchicine, a well-known anti-inflammatory drug traditionally used in gout and pericarditis, has emerged as a promising agent in the secondary prevention of cardiovascular events. Recent clinical trials have demonstrated significant reductions in cardiovascular outcomes with low-dose colchicine, especially in patients with stable CAD and following myocardial infarction. This review provides an updated overview of the pathophysiological rationale for colchicine use in atherosclerosis, summarizes key clinical trial data, and discusses potential mechanisms, safety considerations, and future directions.
The role of simulation in medical education, clinical risk management, and enhancing patient care in cardiology F. Zilio, Simona Giubilato, P. Caldarola, Giuseppe Ciliberti, A. Di Monaco, et al. Giornale Italiano Di Cardiologia, 2025 In applied sciences, including medicine, simulation refers to a model of reality that employs a variety of techniques and technologies, along with diverse professional expertise, to facilitate the dynamic analysis and prediction of events or processes based on specific predefined conditions. Simulation is of paramount importance to improve the skills of medical staff, to speed up learning and to optimize clinical practice in different settings, including cardiology. Literature shows that simulation is more effective than other learning strategies, supporting both upgrading of staff's clinical skills and patients' safety, reducing the risk of medical error. Moreover, andragogical principles highlight the need for personalized training programs, in order to meet healthcare professionals' needs, while practicing in a safe environment, improving technical skills, clinical decision making, stress management, cooperation, and teamwork. This review written by the Management and Quality Working Group, by the Young Cardiologists Working Group, and by the Professional Responsibility and Safety of Care Study Group of the the Italian Association of Hospital Cardiologists (ANMCO) highlights the crucial role of simulation in managing high-risk situations commonly encountered in cardiology, emphasizing the importance of continuous high-quality training. It also describes how ANMCO is promoting simulation as a strategy for implementing quality in the field of cardiology.
Diagnosis and treatment of iron deficiency in heart failure Federico Fortuni, Giuseppe Ciliberti, Mauro Gori, Pietro Scicchitano, Michele Magnesa, et al. Giornale Italiano Di Cardiologia, 2025 I pazienti con scompenso cardiaco (SC) presentano frequentemente una carenza marziale, con una prevalenza di sideropenia stimata intorno al 50%. Nei pazienti affetti da SC, la carenza marziale è associata ad una riduzione della capacità funzionale, della qualità di vita e ad un aumento del rischio di ospedalizzazioni e mortalità. Pertanto, la diagnosi tempestiva e il trattamento della sideropenia sono essenziali per migliorare gli esiti clinici nei pazienti con SC a frazione di eiezione ridotta o lievemente ridotta, mentre i dati sui benefici della supplementazione di ferro nei pazienti con SC a frazione di eiezione preservata restano ancora limitati. Questa revisione della letteratura ha l’obiettivo di fornire una panoramica sulla prevalenza, i criteri diagnostici, le evidenze disponibili, le indicazioni, le formulazioni di ferro e i protocolli raccomandati per l’identificazione e il trattamento della carenza marziale nei pazienti con SC.
Ten questions about the athlete's heart: A guide for the clinical cardiologist Giornale Italiano Di Cardiologia, 2025
Ten questions about infective endocarditis Federico Fortuni, Giuseppe Ciliberti, N. Marsan, Victoria Delgado, Luca Franchin, et al. Giornale Italiano Di Cardiologia, 2024
