Environmental factors such as extreme temperatures, humidity, wind, pollution, altitude, and diving can significantly impact athletes’ cardiovascular systems, potentially hindering their performance, particularly in outdoor sports. The urgency of this issue is heightened by the increasing prevalence of climate change and its associated conditions, including fluctuating pollution levels, temperature variations, and the spread of infectious diseases. Despite its critical importance, this topic is often overlooked in sports medicine. This narrative review seeks to address this gap by providing a comprehensive, evidence-based evaluation of how athletes respond to environmental stresses. A thorough assessment of current knowledge is essential to better prepare athletes for competition under environmental stress and to minimize the harmful effects of these factors. Specifically, adaptative strategies and preventative measures are vital to mitigating these environmental influences and ensuring athletes’ safety.

Background: The foot racing disciplines include sprints, middle distances, and long distances, which vary in terms of intensities, duration of training, and metabolic demands. The aim of our study was to evaluate the differences in morpho-functional parameters describing cardiac remodeling in a large cohort of Olympic athletes practicing the different track subspecialties. Methods: We evaluated 140 track and field (52.1% males, mean age 26.3 ± 4.3 years) Olympic athletes divided into four groups according to the distance performed: Group A (46, 32.9%): 100 and 200 mt; Group B (34, 24.3%): 400 mt; Group C (25, 17.9%): 800, 1500, and 3000 mt; Group D (35, 24.9%): 5000, 10,000 mt, and marathon distance. The athletes underwent a pre-participation screening, which included transthoracic echocardiography and exercise stress testing. Results: In Group A and in Group B, most athletes presented normal cardiac geometry (41/46, 89.1% in Group A and 31/34, 91.2% in Group B, p < 0.0001). Instead, in Groups C and D, more than half presented eccentric cardiac remodeling (13\25, 52% in Group C and 23\35, 65.7% in Group D). No significant differences were found between subspecialties in LVEF (p = 0.587), diastolic function (p = 0.431), and training hours/week (p = 0.078). Conclusions: In conclusion, the presence and extent of cardiac remodeling vary according to the distance of the discipline practiced, with the largest dimensional increase in both left and right ventricles and atria in mid- and long-distance runners and the lowest in sprinters.

Atherosclerosis is the leading cause of death worldwide, especially in patients with type 2 diabetes mellitus (T2D). GLP-1 receptor agonists and DPP-4 inhibitors were demonstrated to play a markedly protective role for the cardiovascular system beyond their glycemic control. Several cardiovascular outcome trials (CVOT) reported the association between using these agents and a significant reduction in cardiovascular events in patients with T2D and a high cardiovascular risk profile. Moreover, recent evidence highlights a favorable benefit/risk profile in myocardial infarction and percutaneous coronary revascularization settings. These clinical effects result from their actions on multiple molecular mechanisms involving the immune system, platelets, and endothelial and vascular smooth muscle cells. This comprehensive review specifically concentrates on these cellular and molecular processes mediating the cardiovascular effects of incretins-like molecules, aiming to improve clinicians’ knowledge and stimulate a more extensive use of these drugs in clinical practice as helpful cardiovascular preventive strategies.

Background: Intraductal papillary mucinous neoplasms (IPMNs) display four histological subtypes: gastric foveolar, pancreaticobiliary, intestinal, and oncocytic. All of these subtypes harbor a different risk of cancer development. The clinical impact of these subtypes concerning the occurrence of high-grade dysplasia (HGD)/cancer (C) in specific morphological types, such as branch-duct (BD), main-duct (MD), and mixed-type (MT) IPMNs, has been less investigated. Hence, our aim was to investigate the prevalence of histological subtypes and their possible association with HGD/C concerning morphologically different IPMNs. Methods: This was a retrospective review of demographics, risk factors, and histological features in a surgical cohort of patients having undergone resection for suspect malignant IPMNs at a high-volume tertiary center from 2007 to 2017. Results: A total of 273 patients were resected for IPMNs from during the study period, of which 188 were included in the final analysis. With sex- and age-adjusted multivariable logistic regression analysis across the entire cohort, gastric foveolar subtypes were associated with a reduced prevalence of HGD/C (OR = 0.30; 0.11–0.81, 95% CI, 95%CI; p = 0.01). With univariable logistic regression analysis, in the BD-IPMN subgroup, the pancreaticobiliary subtype was associated with an increased prevalence of HGD/C (OR = 18.50, 1.03–329.65, 95% CI; p = 0.04). In MD- and MT-IPMNs, the gastric foveolar subtype was associated with a decreased prevalence of HGD/cancer (OR = 0.30, 0.13–0.69, 95% CI; p = 0.004). Conclusions: In MD and MT-IPMNs, the gastric-foveolar subtype is associated with a lower prevalence of HGD/C, possibly identifying in such a high-risk group, a subgroup with more indolent behavior. In BD-IPMNs, the pancreaticobiliary subtype is associated with a higher prevalence of HGD/C, conversely identifying among those patients, a subgroup deserving special attention.

Background: For years, the left atrial appendage (LAA) was considered a simple recess of the atrial wall, but recently it has gained its own respectability in the cardiovascular field, therefore its accurate assessment cannot be overlooked in clinical practice. Percutaneous or surgical closure of the LAA has become a valid and safe alternative to reduce the risk of stroke in patients with non-valvular atrial fibrillation (AF), who have long-term contraindications to anticoagulant therapy. Results: This progression was feasible thanks to the developments and the improvements of devices, surgical and imaging techniques. Objectives: This review explores the essential role of multimodality imaging in LAA, including new imaging tools, and its impact on the optimization of closure techniques and outcomes. Conclusions: Multimodality imaging is mandatory for each step along the therapeutic path: patient selection, pre-procedural planning, procedural monitoring, and follow-up.