From the laboratory to the bedside: a multidisciplinary program to reduce the impact of cardio-respiratory diseases /
Cardiology

Systemic hypertension
At the Inter-University Center for Clinical Physiology and Hypertension, specialized outpatient clinics for the diagnosis and treatment of arterial hypertension and for the study of cardiovascular risk factors are active, with daily cardiology examinations dedicated to the study of arterial hypertension, electrocardiography, 24-hour home pressure monitoring, as well as a color Doppler echocardiography and supra-aortic trunk ultrasound service, with the addition of non-mydriatic fundus oculi examination.
Current active research projects include evaluation of the neutrophil/lymphocyte ratio as a predictor of cardiovascular pathology.

Electrophysiology and Cardiostimulation
The research activity of the group focuses on the study of:

• Atrial fibrillation, typical and atypical atrial flutter (left atrium).
• Wolff-Parkinson-White syndrome (WPW).
• Circuit analysis of ventricular arrhythmias such as frequent ventricular extrasystole, ventricular tachycardia.

Ablative treatment of syncope for neuroreflexed bradycardia by Cardioneuroablation
Structural heart disease such as arrhythmogenic cardiomyopathy, hypertrophic cardiomyopathy, idiopathic dilated heart disease, myocarditis.
Optimization of cardiac resynchronization (CRT) through implantation of specific pacemaker and defibrillator devices.
Stimulation of the conduction system and implantation of leads in the Hissiana region and LBB pacing (left bundle branch pacing) to preserve the normal electrophysiological conduction pathway.

Heart failure
Research activity is directed toward the study of heart failure with reduced, preserved, or mild-range ejection fraction and the underlying physio-pathological mechanisms; it is closely linked to the initial and follow-up visits that take place regularly in the outpatient setting and to the various active experimental clinical trials. Currently, both interventional pharmacological and observational clinical protocols are active at recruitment in our H.C., aimed at evaluating efficacy and safety of drugs useful for managment and optimization of heart failure therapy.

Pulmonary hypertension and dyspnea
The program is aimed at exploring the etio-physio-pathological mechanisms associated with cardiac and cardiopulmonary diseases underlying the symptom of dyspnea in the context of pure cardiologic or internist diseases (mainly respiratory diseases, hemoglobinopathies, hepatopathies, and neoplasias). The various active research protocols, including experimental clinical trials, make use of high expertise and refined instrumentation, from advanced echocardiography to invasive diagnostics by right heart catheterization at rest and exercise.

Clinical cardiology and prevention
The Research Program in Clinical Cardiology and Prevention focuses on the study of innovative primary and secondary cardiovascular prevention strategies.

Ischemic Pathology
The research activity of the group focuses on:

• Molecular biology research on cardiomyocytes and histological studies for specific tissue responses with characterizations of cardiac tissues following Sars-Cov-2 infection.
• Registry on percutaneous treatment and follow-up of pediatric patients with nephrovascular hypertension;
• In-house protocol validation study of pre-hepatic transplant cardiology evaluation;
• Long-term evaluation of non-critical coronary artery stenosis studied with IVUS (Intravascular Ultrasound) and OCT (Optical Coherence Tomography) and coronary microcirculation dysfunction and correlation with genetics of lipid status.
• Cardiovascular involvement in systemic sclerosis
• Since 2016, we have been a cardiology referral center for the ScleroNet network, a project of the Gruppo Italiano Lotta alla Sclerodermia aimed at sharing specialist expertise. Research is aimed at early diagnosis of cardiac and cardiopulmonary damage as well as identification of the mechanisms underlying cardiac dysfunction and cardiorespiratory maladaptation, common alterations in patients with systemic sclerosis.

Basic research - Genetic characterization of cardiomyopathies
The group's research activity is focused on the genetic characterization of cardiomyopathies, with special emphasis on hypertrophic, dilated, channelopathy, and amyloidosis cardiomyopathy.
Hereditary forms of cardiomyopathy represent a challenge for personalized medicine. Indeed, for this subset of diseases the main risk factor is the family history of the disease, especially in cases of early onset, clearly suggesting a genetic predisposition to the development of the disease. For this reason, research and clinical trials have been directed toward the identification of new markers in order to identify genetic predisposition to the development of a given cardiovascular disease.
The aim of the study is to identify mutations related to known genes through a multi-method approach based on the use of different molecular biology techniques such as Next Generation Sequencing (NGS) and Clinical Exome (ES) and to identify at-risk individuals not yet affected by the disease in order to prevent sudden cardiac death and discover new genes and mutations involved in cardiomyopathies.