Adherence to the Mediterranean lifestyle—as captured by the Medlife Index Questionnaire (i.e., encompassing a Mediterranean diet as well as other aspects of healthy living, such as food preparation, physical activity, and socializing)—has been associated with reduced cardiovascular events in healthy individuals. In the present study, we sought to determine the adherence to, and the effect of comprehensive cardiac rehabilitation on, Mediterranean lifestyle adherence in patients after myocardial infarction. We included 121 patients (mean age, 55 years; women, 37%) undergoing comprehensive cardiac rehabilitation—i.e., exercise training 3 times per week for 12 weeks plus dedicated workshops promoting the Mediterranean lifestyle. Before and after cardiac rehabilitation, patients completed the Medlife Index Questionnaire. High baseline adherence was associated with favourable glucose (5.39 vs. 6.1 mmol/L; p < 0.001), triglycerides (1.1 vs. 1.5 mmol/L; p = 0.002), and HDL cholesterol levels (1.32 vs. 1.12 mmol/L; p = 0.032). More importantly, the Medlife Score significantly improved following comprehensive cardiac rehabilitation in patients with low baseline adherence (from 13.8 to 16.7 points; p < 0.001), but not in patients with high baseline adherence (from 19.4 to 18.8 points; p = 0.205). Our findings suggested that Mediterranean lifestyle promotion during cardiac rehabilitation improved adherence to the Mediterranean lifestyle, especially in low-adherence patients.

(1) Background and Objectives: Atrial fibrillation (AF) is the most common cardiac arrhythmia and is associated with increased morbidity and mortality both in the general population and heart failure patients. Inflammation may promote the initiation, maintenance and perpetuation of AF, but the impact of inflammatory molecular signaling on the association between AF and heart failure remains elusive. (2) Materials and Methods: In 111 patients with chronic stable heart failure, baseline values of conventional (IL-6 and hsCRP) and selected novel inflammatory biomarkers (IL-10, IL-6/IL-10 ratio, orosomucoid and endocan) were determined. Inflammatory biomarkers were compared with respect to the presenting cardiac rhythm. (3) Results: Patients aged below 75 years with AF had significantly higher values of IL-6 and IL-6/IL-10 ratio; IL-6 levels were a significant predictor of AF in both univariate (OR 1.175; 95%CI 1.013–1.363; p = 0.034) and multivariate logistic regression analysis when accounting for other inflammatory biomarkers (OR 1.327; 95% CI 1.068–1.650; p = 0.011). Conversely, there was no association between other novel inflammatory biomarkers and AF. (4) Conclusions: IL-6 levels and the IL-6/IL-10 ratio are associated with AF in patients with chronic stable heart failure under the age of 75 years, suggesting that inflammatory molecular signaling may play a role in the development of AF in the heart failure population.

Background and aims: Coronary artery disease (CAD) is a leading cause of mortality. Depression and anxiety are common in CAD patients and negatively affect quality of life, physical functioning, and adherence to cardiac rehabilitation (CR) programs. This study aimed to identify possible associations with clinically relevant parameters, vascular function and blood biomarkers.Methods: Participants were consecutively recruited during cardiac rehabilitation intake visits at the University Medical Centre Ljubljana within 4 months of myocardial infarction (MI). Hospital Anxiety and Depression Scale (HADS) scores were analyzed in relation to endothelial function (assessed with flow-mediated dilation), arterial stiffness, and blood biomarkers (fibrinogen, endocan, and brain-derived neurotrophic factor [BDNF]) in post-MI patients. All vascular and biomarker assessments were performed within 5 days of questionnaire completion and prior to the start of rehabilitation.Results: There were 105 patients included in the study. The median age was 56 years (49–62), and 80.0% of participants were male. Clinically relevant anxiety and depression were present in 29.5% and 21.9% of participants, respectively. Anxiety was significantly associated with younger age, higher body mass index, and increased arterial stiffness, with total HADS scores negatively correlated with age. Endothelial function showed no significant associations with HADS scores. Vital signs showed no significant differences, except for slightly higher systolic blood pressure in those with clinically relevant depression. Fibrinogen levels were significantly higher in participants with anxiety and depression, while endocan and BDNF levels were lower in those with anxiety.Conclusion: Depression and especially anxiety are significantly associated with endothelial function and relevant biomarkers in post-MI patients. However, as HADS is a screening tool and not a diagnostic instrument, and given the study’s observational design, findings reflect associations rather than causality. Routine screening and targeted mental health support within CR programs might improve participation, enhance cardiovascular recovery, and optimize long-term outcomes. These findings underscore the clinical importance of psychological assessment in the early post-MI period and support the integration of mental health evaluation into cardiovascular care.

Exercise capacity and endothelial function are impaired in adults with repaired tetralogy of Fallot (ToF). This may be related to pathophysiological determinants, such as cardiac and endothelial impairment, or to a more sedentary lifestyle. Therefore, we sought to assess if cardiac and endothelial function are associated with exercise capacity in adults with repaired ToF. In a case-control study, we compared adults with repaired ToF and controls in terms of exercise workload, peak oxygen consumption (VO2peak) and flow-mediated dilation (FMD). Additionally, we determined associations of natriuretic peptide levels, echocardiographic parameters of size, function and systolic pressure with exercise capacity. A total of 26 patients (mean age 38 ​± ​10 years, 46% males) and 10 controls were included. Patients with repaired ToF had reduced VO2peak (25.0 vs. 36.3 ​ml/kg/min, p ​< ​0.001) and FMD (7.6 vs. 10.8%, p ​= ​0.007) compared to controls. Exercise workload was moderately associated with FMD (r ​= ​0.428, p ​= ​0.029) and right ventricular parameters, while VO2peak was moderately associated with natriuretic peptide levels (r ​= ​−0.523, p ​= ​0.006). Adults with repaired ToF have impaired exercise capacity and endothelial function as compared to healthy controls. Natriuretic peptide levels and FMD are moderately associated with exercise capacity in adults with repaired ToF.