Cardiovascular diseases (CVDs) remain a major global health challenge, leading to significant morbidity and mortality while straining healthcare systems. Despite progress in medical treatments for CVDs, their increasing prevalence calls for a shift towards more effective prevention strategies. Traditional preventive approaches have centered around lifestyle changes, risk factors management, and medication. However, the integration of imaging methods offers a novel dimension in early disease detection, risk assessment, and ongoing monitoring of at-risk individuals. Imaging techniques such as supra-aortic trunks ultrasound, echocardiography, cardiac magnetic resonance, and coronary computed tomography angiography have broadened our understanding of the anatomical and functional aspects of cardiovascular health. These techniques enable personalized prevention strategies by providing detailed insights into the cardiac and vascular states, significantly enhancing our ability to combat the progression of CVDs. This review focuses on amalgamating current findings, technological innovations, and the impact of integrating advanced imaging modalities into cardiovascular risk prevention, aiming to offer a comprehensive perspective on their potential to transform preventive cardiology.

Heart failure (HF) is a leading cause of morbidity worldwide, imposing a significant burden on deaths, hospitalizations, and health costs. Anticipating patients’ deterioration is a cornerstone of HF treatment: preventing congestion and end organ damage while titrating HF therapies is the aim of the majority of clinical trials. Anyway, real-life medicine struggles with resource optimization, often reducing the chances of providing a patient-tailored follow-up. Telehealth holds the potential to drive substantial qualitative improvement in clinical practice through the development of patient-centered care, facilitating resource optimization, leading to decreased outpatient visits, hospitalizations, and lengths of hospital stays. Different technologies are rising to offer the best possible care to many subsets of patients, facing any stage of HF, and challenging extreme scenarios such as heart transplantation and ventricular assist devices. This article aims to thoroughly examine the potential advantages and obstacles presented by both existing and emerging telehealth technologies, including artificial intelligence.

Cardiac amyloidosis, encompassing both transthyretin (ATTR) and light-chain (AL) types, poses considerable challenges in patient management due to its intricate pathophysiology and progressive course. This narrative review elucidates the pivotal role of cardiopulmonary exercise testing (CPET) in the assessment of these patients. CPET is essential for evaluating disease progression by measuring cardio-respiratory performance and providing prognostic insights. This functional test is crucial not only for tracking the disease trajectory, but also for assessing the effectiveness of disease-modifying therapies. Moreover, CPET facilitates the customization of therapeutic strategies based on individual patient performance, enhancing personalized care. By objectively measuring parameters such as peak oxygen uptake (VO₂ peak), ventilatory efficiency, and exercise capacity, clinicians can gain a deeper understanding of the degree of functional impairment and make informed decisions regarding treatment initiation, adjustment, and anticipated outcomes. This review emphasizes the importance of CPET in advancing personalized medicine approaches, ultimately striving to improve the quality of life and clinical outcomes for patients with cardiac amyloidosis.

Background: Heart failure with preserved ejection fraction (HFpEF) is a complex and heterogeneous clinical syndrome that represents an increasing global health challenge due to its high rates of morbidity, hospitalization, and mortality. In this context, cardiopulmonary exercise testing (CPET) has emerged as a valuable diagnostic modality, particularly in patients presenting with unexplained exertional dyspnea and inconclusive resting imaging results. Objectives and Clinical Implications: This narrative review examines current evidence on the clinical relevance and prognostic value of CPET parameters in HFpEF. Peak VO₂, a marker of aerobic capacity and cardiovascular fitness, has established prognostic value in heart failure with reduced ejection fraction (HFrEF). However, its prognostic significance in HFpEF remains less well defined. Oxygen pulse has emerged as another important measure for evaluating functional capacity and predicting response to exercise-based interventions, offering potential prognostic insight into adverse outcomes in HFpEF. Finally, the VE/VCO₂ slope, an index of ventilatory efficiency during exercise, also holds clinical relevance in HFpEF, particularly with concomitant pulmonary hypertension, though evidence remains heterogeneous. Conclusions: CPET-derived variables are valuable parameters for HFpEF assessment. Their systematic integration into clinical evaluation of HFpEF patients could guide individualized management strategies and inform clinicians for improving outcomes in this challenging condition.

Heart failure represents a complex clinical syndrome characterized by progressive ventricular dysfunction, systemic congestion, and high mortality despite significant advances in pharmacological and device-based therapy. This review explores recent developments across the heart failure continuum, with a focus on therapeutic advances across the continuum of care, with emphasis on both established and emerging strategies. In patients with reduced ejection fraction, early initiation of the four pillars markedly lowers cardiovascular events, yet real-world implementation remains limited by therapeutic inertia and underdosing. Novel agents such as finerenone provide cardiorenal benefits in patients with diabetes and chronic kidney disease, while glucagon-like peptide-1 receptor agonists show promise in preserved or mildly reduced ejection fraction, particularly with obesity. Tricuspid regurgitation, once considered a secondary phenomenon, is now recognized as a modifiable contributor to disease progression, with transcatheter interventions offering new therapeutic avenues. In advanced disease, innovations including donation after circulatory death and the development of total artificial heart systems offer promising solutions to overcome organ shortages and improve access to transplantation. Together, these advances highlight a shift toward precision-guided, multidisciplinary heart failure care.

Bruton tyrosine kinase inhibitors have transformed the management of chronic lymphocytic leukemia and other B-cell malignancies, but their clinical use is increasingly influenced by cardiovascular safety. In contemporary practice, patients receiving these therapies are typically older and characterized by a high burden of comorbidities, including cardiovascular disease, metabolic disorders, and renal impairment. In this setting, cardiovascular complications should not be interpreted as isolated adverse events, but rather as clinical expressions of underlying patient vulnerability and frailty. Atrial fibrillation and arterial hypertension represent the most frequent complications, while heart failure, ventricular arrhythmias, and bleeding, although less common, may carry significant prognostic implications. Importantly, these events often arise from the interaction between drug exposure and pre-existing comorbidities, and may lead to treatment interruption, dose reduction, or discontinuation, ultimately compromising the long-term benefit of otherwise highly effective therapies. This review provides a comprehensive overview of the clinical burden, mechanisms, and management of cardiovascular complications associated with these agents, and proposes a practical, patient-centered framework to guide clinical decision-making. A structured approach based on risk assessment, early detection, and proactive management is essential to prevent complications, optimize treatment continuity, and preserve the long-term benefit of therapy in a complex and vulnerable population.