Obesity is a growing public health epidemic worldwide and is implicated in slowing improved life expectancy and increasing cardiovascular (CV) risk; indeed, several obesity-related mechanisms drive structural, functional, humoral, and hemodynamic heart alterations. On the other hand, obesity may indirectly cause CV disease, mediated through different obesity-associated comorbidities. Diet and physical activity are key points in preventing CV disease and reducing CV risk; however, these strategies alone are not always sufficient, so other approaches, such as pharmacological treatments and bariatric surgery, must support them. Moreover, these strategies are associated with improved CV risk factors and effectively reduce the incidence of death and CV events such as myocardial infarction and stroke; consequently, an individualized care plan with a multidisciplinary approach is recommended. More precisely, this review explores several interventions (diet, physical activity, pharmacological and surgical treatments) to address CV risk in obese patients and emphasizes the importance of adherence to treatments.

(1) Background: Chronic pulmonary diseases (CPDs), such as COPD, asthma, and interstitial lung disease, are often accompanied by psychological distress and reduced quality of life. Mindfulness-Based Interventions (MBIs), including digital and virtual reality (VR) formats, have emerged as promising non-pharmacological approaches to improve symptom management and well-being. This systematic review aimed to evaluate the effectiveness of MBIs—delivered in-person or digitally—on anxiety, depression, disease-related stress, dyspnea, and health-related quality of life in individuals with CPDs. (2) Methods: A systematic review was conducted following PRISMA guidelines across PubMed, Scopus, and Web of Science (2005–2025). Thirteen studies (8 randomized controlled trials, 5 non-randomized) met inclusion criteria. Outcomes assessed included psychological distress, physical symptoms, and health-related quality of life (HRQoL). Risk of bias was evaluated using RoB 2 and ROBINS-I tools. (3) Results: MBIs were associated with improvements in anxiety, depression, stress, and HRQoL in several studies. Interventions were generally well-tolerated and effective across various delivery methods, including digital and VR-based formats. Improvements were especially notable when interventions were tailored and sustained. (4) Conclusions: MBIs, including digital and VR-delivered formats, show promise in supporting psychological and physical outcomes in CPD populations. They represent a feasible and complementary tool in modern respiratory care.

Severe obesity is closely associated with an increased risk of comorbidities and alterations in cardiac structure and function. The primary objective of this study was to investigate cardiovascular (CV) risk factors and ventricular remodeling in individuals from an obese population eligible for bariatric surgery. The secondary objective was to evaluate changes in anthropometric, clinical laboratory, and echocardiographic measurements 12 weeks after surgery compared to baseline values. This retrospective observational cohort study involved patients from a single specialized bariatric surgery center. A total of 35 patients were included (mean age 41.5 ± 10.3 years; BMI 43.4 ± 6.6 kg/m²), of whom 34.2% had a family history of coronary artery disease (CAD), 5.7% had a prior history of CAD, 8 had essential hypertension, 11.4% had dyslipidemia, 20% were smokers, and 8.6% were former smokers. Approximately 57% of the patients exhibited concentric left ventricular remodeling, and 14% had grade I diastolic dysfunction. At 12 weeks post-surgery, with an average weight loss of 25 kg and a mean BMI reduction of 8.5 kg/m², 14% of the patients still exhibited concentric left ventricular remodeling, and about 11% had grade I diastolic dysfunction. Bariatric surgery contributes to the improvement of cardiac function and structure over time as a result of significant weight loss.

Background: Cardiac rehabilitation (CR) is a fundamental pillar in the therapeutic pathway of patients with cardiovascular disease, contributing significantly to improving quality of life and reducing the risk of cardiovascular event recurrence. Over the past decades, this approach has progressively evolved, integrating multidisciplinary strategies based on scientific evidence. This study aimed to conduct a detailed analysis of the anthropometric, clinical, and functional characteristics of patients enrolled in the CR Unit of the San Giovanni di Dio and Ruggi D’Aragona University Hospital in Salerno, with particular attention to therapeutic changes, drug titration, and cognitive assessment. Methods: Specifically, the anthropometric, clinical, laboratory, and instrumental data of 95 patients (age 66.56 ± 0.99 years, 75% male) who underwent the CR program between 2023 and 2025 were analyzed. Results: Patients with various diagnoses were enrolled in the CR program: 17% heart failure, 18% cardiac surgery, 20% acute coronary syndrome, 16% chronic coronary syndrome, 29% dyspnea. The patients had numerous comorbidities and risk factors: 73% arterial hypertension, 77% dyslipidemia, 35% diabetes mellitus, 33% smoking, 13% thyroid dysfunction, 47% CAD, 18% CKD, 16% COPD. At baseline, Cardiopulmonary exercise test (CPET) showed a moderately reduced functional capacity (VO₂ peak pre-CR: 14.29 ± 0.53 mL/min/kg; VO₂% predicted pre-CR: 62.19 ± 2.43%), and a significant improvement was recorded in meters at 6 min walk test (6MWT) post-CR (pre-CR: 306.02 ± 9.93 m vs. post-CR: 378.88 ± 13.37 m; p < 0.05). Notably, 22% of patients had a Qmci score < 49.4 points, indicating an MCI. Finally, the cardiovascular therapy was titrated and adapted; specifically, we recorded a significant increase in the use of SGLT2i therapy (pre-RC 22.00% vs. post-RC 34.00%; p < 0.05). Conclusions: In conclusion, CR proved to be safe and effective in enrolled patients; further studies will be needed to investigate the therapeutic modifications implemented during CR programs in more detail.

Cardiac rehabilitation (CR) is strongly recommended in secondary cardiovascular prevention; indeed, in patients after cardiac surgery or with coronary artery disease or heart failure, this intervention is recommended to decrease mortality, morbidity, and disability, and to improve quality of life and cardiorespiratory fitness. Moreover, each step of the cardiovascular continuum denotes a potential risk factor for the progression of cognitive frailty; this interaction is highly prevalent, affecting approximately one-third of all patients in cardiology settings. For these reasons, CR should consider the patient’s cognitive domain; however, cognitive assessment is still rarely integrated into standard CR protocols. Therefore, this comprehensive review presents current evidence and recent updates on the interaction between CR and cognitive impairment, focusing on physiological mechanisms, core components, benefits, and strategies for implementing CR in patients with cognitive frailty to optimize recovery and prognosis.

None Aims. To evaluate the effects of Sacubitril/Valsartan (S/V) on clinical, laboratory and echocardiographic parameters and outcomes in a real-world population with heart failure with reduced ejection fraction (HFrEF). Methods and results. Prospective study enrolling consecutive patients with HFrEF treated with S/V.The primary outcome was HF rehospitalization;secondary outcomes were all-cause death, cardiac death and the composite of cardiac death and HF rehospitalization at 12 months follow up.The clinical outcome was compared with a retrospective cohort of 90 HFrEF patients treated with standard medical therapy by using propensity score weighting. At 6 months follow-up, changes in symptoms, echocardiographic parameters, eGFR and furosemide dose were also evaluated. The study population consisted of 90 patients (66.1 ± 11.7 years). At 6 months FU, a significant improvement in NYHA class, LVEF (from 31.0% to 34.0%; p = 0.001), LVESV (from 115.0 to 101.0 mL; p = 0.033) and sPAP (from 31.0 to 25.0 mmHg; p = 0.024) was observed. Moreover, S/V did not affect negatively eGFR and was associated with a significantly lower dose of furosemide prescribed. The propensity score weighting adjusted regression analysis showed a significantly lower risk for HF rehospitalization (HR, 0.131; 95% CI, 0.034-0.503; p = 0.003) and the composite outcome (HR, 0.162; 95% CI, 0.053-0.492; p = 0.001) among patients treated with S/V as compared to the standard therapy group. In this real-world HFrEF population, S/V reduced HF rehospitalization and cardiac death at 1 year. Moreover, S/V improved significantly NYHA class, LVEF, LVESV and sPAP at 6 months, preserving renal function and reducing the need of furosemide. Table Adjusted and unadjusted HR for the study outcomes. Table Adjusted and unadjusted HR for the study outcomes. Abstract 412 Figure. Abstract 412 Figure.