{"id":26631,"date":"2026-03-08T19:43:28","date_gmt":"2026-03-08T18:43:28","guid":{"rendered":"https:\/\/www.bmscience.net\/blog\/?p=26631"},"modified":"2026-03-08T19:43:30","modified_gmt":"2026-03-08T18:43:30","slug":"linsufficienza-cardiaca-inquadramento-clinico-fisiopatologico-e-terapeutico","status":"publish","type":"post","link":"https:\/\/bmscience.net\/blog\/linsufficienza-cardiaca-inquadramento-clinico-fisiopatologico-e-terapeutico\/","title":{"rendered":"L&#8217;insufficienza cardiaca: inquadramento clinico, fisiopatologico e terapeutico"},"content":{"rendered":"\n<p>L\u2019<strong>insufficienza cardiaca<\/strong> non rappresenta una singola entit\u00e0 nosologica, bens\u00ec una <strong>sindrome clinica<\/strong> complessa e progressiva, caratterizzata da una costellazione di sintomi e segni derivanti da un\u2019anomalia strutturale o funzionale della pompa cardiaca.<sup data-fn=\"7edcea64-6f6d-4cf9-9bd3-2718cd33a30e\" class=\"fn\"><a href=\"#7edcea64-6f6d-4cf9-9bd3-2718cd33a30e\" id=\"7edcea64-6f6d-4cf9-9bd3-2718cd33a30e-link\">1<\/a><\/sup> Tale condizione determina l\u2019incapacit\u00e0 del cuore di espellere una quantit\u00e0 di sangue adeguata alle richieste metaboliche dei tessuti o, se ci\u00f2 avviene, solo a discapito di un aumento patologico delle pressioni di riempimento intraventricolari.<\/p>\n\n\n\n<p>La comprensione moderna di questa patologia ha subito un\u2019evoluzione paradigmatica, passando da una visione puramente <strong>emodinamica <\/strong>a una prospettiva <strong>neuro-ormonale<\/strong> e <strong>molecolare<\/strong>, dove il rimodellamento del ventricolo e l\u2019attivazione sistemica di vari assi endocrini giocano un ruolo determinante nella progressione del danno.<\/p>\n\n\n\n<p>Il presente articolo analizza in modo esaustivo ogni aspetto della sindrome, integrando le pi\u00f9 recenti evidenze delle linee guida internazionali per fornire un quadro accademico e professionale di riferimento.<\/p>\n\n\n\n<div id=\"rtoc-mokuji-wrapper\" class=\"rtoc-mokuji-content frame4 preset2 animation-slide rtoc_open default\" data-id=\"26631\" data-theme=\"eStar\">\n\t\t\t<div id=\"rtoc-mokuji-title\" class=\"rtoc_btn_none rtoc_center\">\n\t\t\t\n\t\t\t<span>Indice dei contenuti<\/span>\n\t\t\t<\/div><ol class=\"rtoc-mokuji decimal_ol level-1\"><li class=\"rtoc-item\"><a href=\"#indice-440381da-2ce5-4874-b195-6c4893163081\">Indice<\/a><\/li><li class=\"rtoc-item\"><a href=\"#definizione-ed-evoluzione-del-concetto-di-insufficienza-cardiaca-5d2d2d49-33ad-4e84-9ee5-8a4f639d4f30\">Definizione ed evoluzione del concetto di insufficienza cardiaca<\/a><\/li><li class=\"rtoc-item\"><a href=\"#classificazione-eziologica-e-determinanti-del-danno-miocardico-796d5ec9-d612-4ed8-9ea6-d18237b5c57a\">Classificazione eziologica e determinanti del danno miocardico<\/a><\/li><li class=\"rtoc-item\"><a href=\"#classificazione-e-forme-cliniche-82725317-8810-4f6b-a0a4-fbbba00bd946\">Classificazione e forme cliniche<\/a><ul class=\"rtoc-mokuji mokuji_none level-2\"><li class=\"rtoc-item\"><a href=\"#classificazione-in-base-alla-frazione-di-eiezione-lvef-93875098-28f3-48c1-9fb1-5c706429e035\">Classificazione in base alla frazione di eiezione (LVEF)<\/a><\/li><li class=\"rtoc-item\"><a href=\"#forme-cliniche-00964425-dfa1-4e73-8054-832759f0a950\">Forme cliniche<\/a><\/li><li class=\"rtoc-item\"><a href=\"#severita-e-tempistiche-nyha-e-stadiazione-68995f61-ffb7-4c65-9095-307de14215cc\">Severit\u00e0 e tempistiche: NYHA e stadiazione<\/a><\/li><li class=\"rtoc-item\"><a href=\"#cardiotossicita-e-cardiooncologia-a4dd744c-b008-49c9-a395-40bf06343ce0\">Cardiotossicit\u00e0 e cardio-oncologia<\/a><\/li><\/ul><\/li><li class=\"rtoc-item\"><a href=\"#fisiopatologia-meccanismi-di-adattamento-3bac7d23-e012-49a9-b837-af351f9b1861\">Fisiopatologia: meccanismi di adattamento<\/a><ul class=\"rtoc-mokuji mokuji_none level-2\"><li class=\"rtoc-item\"><a href=\"#meccanismo-di-frankstarling-e-ipertrofia-a6048e7b-8d1e-4ae0-8493-49f56b105a8c\">Meccanismo di Frank-Starling e ipertrofia<\/a><\/li><li class=\"rtoc-item\"><a href=\"#attivazione-neuroumorale-e6225e86-b1f0-485a-8a08-e93be79f6fc9\">Attivazione neuro-umorale<\/a><\/li><\/ul><\/li><li class=\"rtoc-item\"><a href=\"#manifestazioni-cliniche-ed-emodinamiche-558218b0-622d-42e8-a127-8711471d3bd6\">Manifestazioni cliniche ed emodinamiche<\/a><ul class=\"rtoc-mokuji mokuji_none level-2\"><li class=\"rtoc-item\"><a href=\"#scompenso-sinistro-e-sintomi-polmonari-ad63e899-2d2a-44c5-8a0e-646a54d17f4f\">Scompenso sinistro e sintomi polmonari<\/a><\/li><li class=\"rtoc-item\"><a href=\"#scompenso-destro-e-manifestazioni-sistemiche-677fe6cd-fe83-4dd0-ac65-5e661689fd1f\">Scompenso destro e manifestazioni sistemiche<\/a><\/li><li class=\"rtoc-item\"><a href=\"#manifestazioni-anterograde-e-alterazioni-del-ritmo-a656fdf0-efc8-4683-b51f-70cb9491e67f\">Manifestazioni anterograde e alterazioni del ritmo<\/a><\/li><li class=\"rtoc-item\"><a href=\"#la-sindrome-cardiorenale-crs-62347c46-3cf4-4ebd-8017-b0182787359f\">La sindrome cardiorenale (CRS)<\/a><\/li><\/ul><\/li><li class=\"rtoc-item\"><a href=\"#diagnostica-dellinsufficienza-cardiaca-837a4157-d283-462f-9e77-8615f9ccf072\">Diagnostica dell&#8217;insufficienza cardiaca<\/a><ul class=\"rtoc-mokuji mokuji_none level-2\"><li class=\"rtoc-item\"><a href=\"#criteri-di-framingham-7167e816-4606-4e9a-84ed-183e85f244fd\">Criteri di Framingham<\/a><\/li><li class=\"rtoc-item\"><a href=\"#laboratorio-e-imaging-5abd6313-9915-4381-aa91-7743d77b30ee\">Laboratorio e imaging<\/a><\/li><\/ul><\/li><li class=\"rtoc-item\"><a href=\"#terapia-dello-scompenso-cardiaco-cronico-e81a2cd9-d868-434e-96b0-9b5559b1f544\">Terapia dello scompenso cardiaco cronico<\/a><ul class=\"rtoc-mokuji mokuji_none level-2\"><li class=\"rtoc-item\"><a href=\"#trattamento-farmacologico-della-hfref-c35ae534-f6ed-4e69-a403-424c4ebcd275\">Trattamento farmacologico della HFrEF<\/a><\/li><li class=\"rtoc-item\"><a href=\"#terapia-per-hfmref-e-hfpef-4f7664e9-8c6d-4a68-86eb-cc97085fd376\">Terapia per HFmrEF e HFpEF<\/a><\/li><li class=\"rtoc-item\"><a href=\"#prevenzione-della-morte-improvvisa-e-crt-76e0f4ab-2a06-42e4-9c96-c0458783c067\">Prevenzione della morte improvvisa e CRT<\/a><\/li><\/ul><\/li><li class=\"rtoc-item\"><a href=\"#gestione-dellinsufficienza-cardiaca-acuta-grave-b34d57f0-9259-46b7-9261-f79c4ca5a0a3\">Gestione dell&#8217;insufficienza cardiaca acuta grave<\/a><ul class=\"rtoc-mokuji mokuji_none level-2\"><li class=\"rtoc-item\"><a href=\"#trattamento-delledema-polmonare-acuto-e-dello-shock-cardiogeno-d7d456ef-4884-44db-924b-f88a9893f0f9\">Trattamento dell&#8217;edema polmonare acuto e dello Shock Cardiogeno<\/a><\/li><li class=\"rtoc-item\"><a href=\"#supporto-meccanico-iabp-e-vad-e8ef7da2-0cc1-4fd5-96f6-619bd40b4169\">Supporto meccanico: IABP e VAD<\/a><\/li><\/ul><\/li><li class=\"rtoc-item\"><a href=\"#trapianto-cardiaco-786c4004-28ae-477b-809c-b651c1e6f6ee\">Trapianto cardiaco<\/a><\/li><\/ol><\/div><h2 class=\"wp-block-heading\" id=\"indice-440381da-2ce5-4874-b195-6c4893163081\"><span class=\"ez-toc-section\" id=\"Indice\"><\/span>Indice<span class=\"ez-toc-section-end\"><\/span><\/h2>\n\n\n<div id=\"bmscience1836080479\" style=\"margin-top: 15px;margin-left: 15px;float: right;\"><div style=\"\r\n  width: 200px;\r\n  margin: 0 auto;\r\n  text-align: center;\r\n\">\r\n<div data-id='24157' class='amazon-auto-links aal-js-loading'><p class='now-loading-placeholder'>Now loading&#8230;<\/p><\/div><\/div><\/div>\n\n\n<ul class=\"wp-block-advgb-summary advgb-toc alignnone\"><li class=\"toc-level-1\"><a href=\"#indice-440381da-2ce5-4874-b195-6c4893163081\">Indice<\/a><\/li><li class=\"toc-level-1\"><a href=\"#definizione-ed-evoluzione-del-concetto-di-insufficienza-cardiaca-5d2d2d49-33ad-4e84-9ee5-8a4f639d4f30\">Definizione ed evoluzione del concetto di insufficienza cardiaca<\/a><\/li><li class=\"toc-level-1\"><a href=\"#classificazione-eziologica-e-determinanti-del-danno-miocardico-796d5ec9-d612-4ed8-9ea6-d18237b5c57a\">Classificazione eziologica e determinanti del danno miocardico<\/a><\/li><li class=\"toc-level-1\"><a href=\"#classificazione-e-forme-cliniche-82725317-8810-4f6b-a0a4-fbbba00bd946\">Classificazione e forme cliniche<\/a><\/li><li class=\"toc-level-2\"><a href=\"#classificazione-in-base-alla-frazione-di-eiezione-lvef-93875098-28f3-48c1-9fb1-5c706429e035\">Classificazione in base alla frazione di eiezione (LVEF)<\/a><\/li><li class=\"toc-level-2\"><a href=\"#forme-cliniche-00964425-dfa1-4e73-8054-832759f0a950\">Forme cliniche<\/a><\/li><li class=\"toc-level-2\"><a href=\"#severita-e-tempistiche-nyha-e-stadiazione-68995f61-ffb7-4c65-9095-307de14215cc\">Severit\u00e0 e tempistiche: NYHA e stadiazione<\/a><\/li><li class=\"toc-level-2\"><a href=\"#cardiotossicita-e-cardiooncologia-a4dd744c-b008-49c9-a395-40bf06343ce0\">Cardiotossicit\u00e0 e cardio-oncologia<\/a><\/li><li class=\"toc-level-1\"><a href=\"#fisiopatologia-meccanismi-di-adattamento-3bac7d23-e012-49a9-b837-af351f9b1861\">Fisiopatologia: meccanismi di adattamento<\/a><\/li><li class=\"toc-level-2\"><a href=\"#meccanismo-di-frankstarling-e-ipertrofia-a6048e7b-8d1e-4ae0-8493-49f56b105a8c\">Meccanismo di Frank-Starling e ipertrofia<\/a><\/li><li class=\"toc-level-2\"><a href=\"#attivazione-neuroumorale-e6225e86-b1f0-485a-8a08-e93be79f6fc9\">Attivazione neuro-umorale<\/a><\/li><li class=\"toc-level-1\"><a href=\"#manifestazioni-cliniche-ed-emodinamiche-558218b0-622d-42e8-a127-8711471d3bd6\">Manifestazioni cliniche ed emodinamiche<\/a><\/li><li class=\"toc-level-2\"><a href=\"#scompenso-sinistro-e-sintomi-polmonari-ad63e899-2d2a-44c5-8a0e-646a54d17f4f\">Scompenso sinistro e sintomi polmonari<\/a><\/li><li class=\"toc-level-2\"><a href=\"#scompenso-destro-e-manifestazioni-sistemiche-677fe6cd-fe83-4dd0-ac65-5e661689fd1f\">Scompenso destro e manifestazioni sistemiche<\/a><\/li><li class=\"toc-level-2\"><a href=\"#manifestazioni-anterograde-e-alterazioni-del-ritmo-a656fdf0-efc8-4683-b51f-70cb9491e67f\">Manifestazioni anterograde e alterazioni del ritmo<\/a><\/li><li class=\"toc-level-2\"><a href=\"#la-sindrome-cardiorenale-crs-62347c46-3cf4-4ebd-8017-b0182787359f\">La sindrome cardiorenale (CRS)<\/a><\/li><li class=\"toc-level-1\"><a href=\"#diagnostica-dellinsufficienza-cardiaca-837a4157-d283-462f-9e77-8615f9ccf072\">Diagnostica dell&#8217;insufficienza cardiaca<\/a><\/li><li class=\"toc-level-2\"><a href=\"#criteri-di-framingham-7167e816-4606-4e9a-84ed-183e85f244fd\">Criteri di Framingham<\/a><\/li><li class=\"toc-level-2\"><a href=\"#laboratorio-e-imaging-5abd6313-9915-4381-aa91-7743d77b30ee\">Laboratorio e imaging<\/a><\/li><li class=\"toc-level-1\"><a href=\"#terapia-dello-scompenso-cardiaco-cronico-e81a2cd9-d868-434e-96b0-9b5559b1f544\">Terapia dello scompenso cardiaco cronico<\/a><\/li><li class=\"toc-level-2\"><a href=\"#trattamento-farmacologico-della-hfref-c35ae534-f6ed-4e69-a403-424c4ebcd275\">Trattamento farmacologico della HFrEF<\/a><\/li><li class=\"toc-level-2\"><a href=\"#terapia-per-hfmref-e-hfpef-4f7664e9-8c6d-4a68-86eb-cc97085fd376\">Terapia per HFmrEF e HFpEF<\/a><\/li><li class=\"toc-level-2\"><a href=\"#prevenzione-della-morte-improvvisa-e-crt-76e0f4ab-2a06-42e4-9c96-c0458783c067\">Prevenzione della morte improvvisa e CRT<\/a><\/li><li class=\"toc-level-1\"><a href=\"#gestione-dellinsufficienza-cardiaca-acuta-grave-b34d57f0-9259-46b7-9261-f79c4ca5a0a3\">Gestione dell&#8217;insufficienza cardiaca acuta grave<\/a><\/li><li class=\"toc-level-2\"><a href=\"#trattamento-delledema-polmonare-acuto-e-dello-shock-cardiogeno-d7d456ef-4884-44db-924b-f88a9893f0f9\">Trattamento dell&#8217;edema polmonare acuto e dello Shock Cardiogeno<\/a><\/li><li class=\"toc-level-2\"><a href=\"#supporto-meccanico-iabp-e-vad-e8ef7da2-0cc1-4fd5-96f6-619bd40b4169\">Supporto meccanico: IABP e VAD<\/a><\/li><li class=\"toc-level-1\"><a href=\"#trapianto-cardiaco-786c4004-28ae-477b-809c-b651c1e6f6ee\">Trapianto cardiaco<\/a><\/li><\/ul>\n\n\n<div id=\"bmscience747078380\" style=\"margin-top: 15px;margin-bottom: 15px;margin-left: auto;margin-right: auto;text-align: center;\"><a href=\"https:\/\/amzn.to\/4oEoTiW\" target=\"_blank\" aria-label=\"07ecff3c-2691-4fae-b229-957011848e28._CR0,0,3000,600_SX1920_\"><img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/bmscience.net\/blog\/wp-content\/uploads\/2025\/12\/07ecff3c-2691-4fae-b229-957011848e28._CR003000600_SX1920_.jpg\" alt=\"\"  srcset=\"https:\/\/bmscience.net\/blog\/wp-content\/uploads\/2025\/12\/07ecff3c-2691-4fae-b229-957011848e28._CR003000600_SX1920_.jpg 1920w, https:\/\/bmscience.net\/blog\/wp-content\/uploads\/2025\/12\/07ecff3c-2691-4fae-b229-957011848e28._CR003000600_SX1920_-300x60.jpg 300w, https:\/\/bmscience.net\/blog\/wp-content\/uploads\/2025\/12\/07ecff3c-2691-4fae-b229-957011848e28._CR003000600_SX1920_-1024x205.jpg 1024w, https:\/\/bmscience.net\/blog\/wp-content\/uploads\/2025\/12\/07ecff3c-2691-4fae-b229-957011848e28._CR003000600_SX1920_-768x154.jpg 768w, https:\/\/bmscience.net\/blog\/wp-content\/uploads\/2025\/12\/07ecff3c-2691-4fae-b229-957011848e28._CR003000600_SX1920_-1536x307.jpg 1536w\" sizes=\"auto, (max-width: 1920px) 100vw, 1920px\" width=\"1920\" height=\"384\"  style=\"display: inline-block;\" \/><\/a><\/div>\n\n\n<h2 class=\"wp-block-heading\" id=\"definizione-ed-evoluzione-del-concetto-di-insufficienza-cardiaca-5d2d2d49-33ad-4e84-9ee5-8a4f639d4f30\"><span class=\"ez-toc-section\" id=\"Definizione_ed_evoluzione_del_concetto_di_insufficienza_cardiaca\"><\/span>Definizione ed evoluzione del concetto di insufficienza cardiaca<span class=\"ez-toc-section-end\"><\/span><\/h2>\n\n\n\n<p>La definizione universale di insufficienza cardiaca, recepita dalle principali societ\u00e0 scientifiche globali, pone l&#8217;accento sulla correlazione tra evidenza oggettiva di <strong>disfunzione cardiaca <\/strong>e <strong>manifestazioni cliniche<\/strong>.<\/p>\n\n\n<div id=\"bmscience3651601769\" style=\"float: left;\"><script async src=\"\/\/pagead2.googlesyndication.com\/pagead\/js\/adsbygoogle.js?client=ca-pub-3495866718878812\" crossorigin=\"anonymous\"><\/script><ins class=\"adsbygoogle\" style=\"display:block;\" data-ad-client=\"ca-pub-3495866718878812\" \ndata-ad-slot=\"7361327101\" \ndata-ad-format=\"auto\" data-full-width-responsive=\"true\"><\/ins>\n<script> \n(adsbygoogle = window.adsbygoogle || []).push({}); \n<\/script>\n<\/div>\n\n\n<p>Una diagnosi formale richiede la presenza di <strong>sintomi tipici <\/strong>(dispnea, astenia, edemi) accompagnati da <strong>segni clinici<\/strong> (tachicardia, tachipnea, turgore giugulare) e la conferma di una sottostante <strong>causa cardiaca<\/strong>, identificata tramite imaging (ecocardiografia) o livelli elevati di peptidi natriuretici.<sup data-fn=\"3bba1f73-9944-4da3-a416-6238558666e8\" class=\"fn\"><a href=\"#3bba1f73-9944-4da3-a416-6238558666e8\" id=\"3bba1f73-9944-4da3-a416-6238558666e8-link\">2<\/a><\/sup><\/p>\n\n\n\n<p>La <strong>disfunzione <\/strong>pu\u00f2 essere di natura <span style=\"text-decoration: underline;\">strutturale<\/span>, coinvolgendo alterazioni macroscopiche come la <strong>dilatazione<\/strong> delle camere o l&#8217;<strong>ipertrofia<\/strong> delle pareti, oppure <span style=\"text-decoration: underline;\">funzionale<\/span>, riguardando anomalie nel ciclo contrattile (<strong>sistole<\/strong>) o nel rilassamento e riempimento (<strong>diastole<\/strong>).<sup data-fn=\"24033538-dce4-48ac-a21f-480593aa2d31\" class=\"fn\"><a href=\"#24033538-dce4-48ac-a21f-480593aa2d31\" id=\"24033538-dce4-48ac-a21f-480593aa2d31-link\">3<\/a><\/sup> <sup data-fn=\"fd0e75ab-589f-48ca-aecf-69b0a307b6b9\" class=\"fn\"><a href=\"#fd0e75ab-589f-48ca-aecf-69b0a307b6b9\" id=\"fd0e75ab-589f-48ca-aecf-69b0a307b6b9-link\">4<\/a><\/sup><\/p>\n\n\n\n<p>Un elemento cardine \u00e8 il <strong>ridotto output cardiaco<\/strong>, che in condizioni di riposo pu\u00f2 apparire inizialmente preservato grazie a meccanismi di compenso, ma che fallisce nel rispondere adeguatamente allo stress fisico, portando a una discrepanza tra offerta e domanda di ossigeno nei tessuti periferici.<sup data-fn=\"8d69f451-2f18-4f89-bcbc-f90a203cb0e8\" class=\"fn\"><a href=\"#8d69f451-2f18-4f89-bcbc-f90a203cb0e8\" id=\"8d69f451-2f18-4f89-bcbc-f90a203cb0e8-link\">5<\/a><\/sup><\/p>\n\n\n\n<h2 class=\"wp-block-heading\" id=\"classificazione-eziologica-e-determinanti-del-danno-miocardico-796d5ec9-d612-4ed8-9ea6-d18237b5c57a\"><span class=\"ez-toc-section\" id=\"Classificazione_eziologica_e_determinanti_del_danno_miocardico\"><\/span>Classificazione eziologica e determinanti del danno miocardico<span class=\"ez-toc-section-end\"><\/span><\/h2>\n\n\n\n<p>L&#8217;identificazione dell&#8217;eziologia \u00e8 il primo passo per un trattamento mirato, poich\u00e9 molte forme di insufficienza cardiaca possono essere <strong>reversibili <\/strong>se la causa sottostante viene corretta precocemente. Le cause possono essere raggruppate in categorie principali che riflettono il meccanismo primario del danno miocardico.<\/p>\n\n\n\n<figure class=\"wp-block-table\"><table><thead><tr><td><strong>Categoria eziologica<\/strong><\/td><td><strong>Esempi specifici<\/strong><\/td><td><strong>Meccanismo prevalente<\/strong><\/td><\/tr><\/thead><tbody><tr><td><strong>Miocardica primaria ischemica<\/strong><\/td><td>Infarto miocardico, coronaropatia cronica, danno ischemico acuto (<em>stunning<\/em>), cicatrice miocardica, patologia coronarica epicardica o microvascolare, disfunzione endoteliale<\/td><td>Perdita di miociti contrattili, fibrosi post-infartuale<\/td><\/tr><tr><td><strong>Miocardica primaria tossica<\/strong><\/td><td>Alcol, cocaina, anfetamine, farmaci citostatici\/chemioterapici (es. antracicline), FANS, antidepressivi, immunomodulanti (interferone, trastuzumab, cetuximab), radiazioni<\/td><td>Danno citotossico diretto, stress ossidativo<\/td><\/tr><tr><td><strong>Miocardica primaria metabolica<\/strong><\/td><td>Diabete, tireotossicosi e tireopatie, carenze vitaminiche, alterazioni ipofisarie (deficienza di GH), patologie surrenaliche<\/td><td>Alterazione energetica cellulare, disfunzione mitocondriale<\/td><\/tr><tr><td><strong>Infiltrativa e infiammatoria<\/strong><\/td><td>Amiloidosi, sarcoidosi, miocarditi da agenti infettivi (batteri, funghi, protozoi, parassiti), miocardite eosinofilica, miocarditi autoimmuni (da LES, artrite reumatoide)<\/td><td>Sostituzione del tessuto contrattile con materiale inerte o flogistico<\/td><\/tr><tr><td><strong>Sovraccarico emodinamico<\/strong><\/td><td>Ipertensione arteriosa, valvulopatie (difetti strutturali congeniti o acquisiti: mitralica, aortica, tricuspidalica, polmonare), stati ad alta gittata (anemia severa, sepsi, gravidanza), sovraccarico di volume (insufficienza renale)<\/td><td>Aumento cronico del postcarico o del precarico<\/td><\/tr><tr><td><strong>Inadeguato riempimento<\/strong><\/td><td>Pericardite costrittiva, cardiomiopatia restrittiva, versamento pericardico<\/td><td>Impedimento meccanico all&#8217;espansione diastolica<\/td><\/tr><tr><td><strong>Cardiopatie genetiche<\/strong><\/td><td>Cardiomiopatia ipertrofica, cardiomiopatia dilatativa, miocardio non compatto<\/td><td>Alterazioni strutturali su base genetica (proteine sarcomeriche o citoscheletriche)<\/td><\/tr><tr><td><strong>Aritmie<\/strong><\/td><td>Bradiaritmie (malattia del nodo del seno), tachiaritmie (fibrillazione atriale, aritmie ventricolari).<\/td><td>Alterazioni della genesi o della conduzione dell&#8217;impulso elettrico<\/td><\/tr><\/tbody><\/table><\/figure>\n\n\n\n<p>La <strong>cardiopatia ischemica<\/strong> resta la causa principale nei paesi sviluppati, dove la necrosi miocardica e il successivo rimodellamento portano alla <strong>dilatazione ventricolare<\/strong>.<sup data-fn=\"7858a89a-9d0d-4a3f-a465-38470a061394\" class=\"fn\"><a href=\"#7858a89a-9d0d-4a3f-a465-38470a061394\" id=\"7858a89a-9d0d-4a3f-a465-38470a061394-link\">6<\/a><\/sup><\/p>\n\n\n\n<p>Le cause tossiche, in particolare l\u2019alcol, inducono la cosiddetta <strong>cardiomiopatia alcolica<\/strong> (<strong>A-DCM<\/strong>), che si manifesta dopo un consumo eccessivo protratto (oltre 60-80 g\/die per 5 anni), portando a una riduzione della contrattilit\u00e0 e a dilatazione simile alla cardiomiopatia dilatativa idiopatica.<sup data-fn=\"55970946-624a-421c-a327-14f486f8e1ea\" class=\"fn\"><a href=\"#55970946-624a-421c-a327-14f486f8e1ea\" id=\"55970946-624a-421c-a327-14f486f8e1ea-link\">7<\/a><\/sup><br><strong>Sostanze simpaticomimetiche<\/strong> come la cocaina causano invece insufficienza cardiaca attraverso vasospasmo, ipertensione acuta e tossicit\u00e0 miocitaria diretta.<\/p>\n\n\n<div id=\"bmscience774180364\" style=\"margin-top: 15px;margin-bottom: 15px;margin-left: auto;margin-right: auto;text-align: center;\"><div data-id='24174' class='amazon-auto-links aal-js-loading'><p class='now-loading-placeholder'>Caricamento&#8230;.<\/p><\/div><\/div>\n\n\n<h2 class=\"wp-block-heading\" id=\"classificazione-e-forme-cliniche-82725317-8810-4f6b-a0a4-fbbba00bd946\"><span class=\"ez-toc-section\" id=\"Classificazione_e_forme_cliniche\"><\/span>Classificazione e forme cliniche<span class=\"ez-toc-section-end\"><\/span><\/h2>\n\n\n\n<p>La classificazione dell&#8217;insufficienza cardiaca \u00e8 stratificata secondo criteri emodinamici, temporali e sintomatologici per guidare la scelta terapeutica e definire la prognosi.<\/p>\n\n\n\n<h3 class=\"wp-block-heading\" id=\"classificazione-in-base-alla-frazione-di-eiezione-lvef-93875098-28f3-48c1-9fb1-5c706429e035\"><span class=\"ez-toc-section\" id=\"Classificazione_in_base_alla_frazione_di_eiezione_LVEF\"><\/span>Classificazione in base alla frazione di eiezione (LVEF)<span class=\"ez-toc-section-end\"><\/span><\/h3>\n\n\n\n<p>La<strong> frazione di eiezione <\/strong>del ventricolo sinistro rimane il parametro fondamentale per la fenotipizzazione dei pazienti:<\/p>\n\n\n<div id=\"bmscience1621129755\" style=\"margin-top: 15px;margin-left: 15px;float: right;\"><a href=\"https:\/\/amzn.to\/45LQEk0\" target=\"_blank\" aria-label=\"Version 1.0.0\"><img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/bmscience.net\/blog\/wp-content\/uploads\/2025\/07\/9727bdbc-b9a4-4a53-a53a-a03fe044d6be.jpg\" alt=\"\"  srcset=\"https:\/\/bmscience.net\/blog\/wp-content\/uploads\/2025\/07\/9727bdbc-b9a4-4a53-a53a-a03fe044d6be.jpg 300w, https:\/\/bmscience.net\/blog\/wp-content\/uploads\/2025\/07\/9727bdbc-b9a4-4a53-a53a-a03fe044d6be-180x150.jpg 180w\" sizes=\"auto, (max-width: 300px) 100vw, 300px\" width=\"300\" height=\"250\"   \/><\/a><\/div>\n\n\n<ul class=\"wp-block-list\">\n<li><strong>HFrEF (<em>HF with Reduced Ejection Fraction<\/em>)<\/strong>: LVEF&nbsp;\u226440%. In questi pazienti, il deficit contrattile \u00e8 il problema dominante. La maggior parte degli studi clinici ha dimostrato benefici di mortalit\u00e0 in questo sottogruppo;<\/li>\n\n\n\n<li><strong>HFmrEF (<em>HF with Mildly Reduced Ejection Fraction<\/em>)<\/strong>: LVEF&nbsp;41-49%. Rappresenta una zona grigia con caratteristiche cliniche sovrapponibili sia alla HFrEF che alla HFpEF;<\/li>\n\n\n\n<li><strong>HFpEF (<em>HF with Preserved Ejection Fraction<\/em>)<\/strong>: LVEF&nbsp;\u226550%. Spesso associata a pazienti anziani, ipertesi e obesi. La fisiopatologia \u00e8 legata principalmente all&#8217;irrigidimento ventricolare e all&#8217;aumento delle pressioni di riempimento diastolico;<\/li>\n\n\n\n<li><strong>HFimpEF (<em>HF with Improved Ejection Fraction<\/em>)<\/strong>: pazienti precedentemente HFrEF che, grazie alla terapia, presentano ora una LVEF&nbsp;&gt;40%. \u00c8 fondamentale che questi pazienti continuino il trattamento medico ottimale per evitare recidive.<\/li>\n<\/ul>\n\n\n\n<figure data-wp-context=\"{&quot;imageId&quot;:&quot;69ea937d9400c&quot;}\" data-wp-interactive=\"core\/image\" data-wp-key=\"69ea937d9400c\" class=\"wp-block-image alignwide size-large wp-lightbox-container\"><img loading=\"lazy\" decoding=\"async\" width=\"1024\" height=\"690\" data-wp-class--hide=\"state.isContentHidden\" data-wp-class--show=\"state.isContentVisible\" data-wp-init=\"callbacks.setButtonStyles\" data-wp-on--click=\"actions.showLightbox\" data-wp-on--load=\"callbacks.setButtonStyles\" data-wp-on-window--resize=\"callbacks.setButtonStyles\" src=\"https:\/\/www.bmscience.net\/blog\/wp-content\/uploads\/2026\/03\/insufficienza-cardiaca-classificazione-1024x690.png\" alt=\"\" class=\"wp-image-26646\" srcset=\"https:\/\/bmscience.net\/blog\/wp-content\/uploads\/2026\/03\/insufficienza-cardiaca-classificazione-1024x690.png 1024w, https:\/\/bmscience.net\/blog\/wp-content\/uploads\/2026\/03\/insufficienza-cardiaca-classificazione-300x202.png 300w, https:\/\/bmscience.net\/blog\/wp-content\/uploads\/2026\/03\/insufficienza-cardiaca-classificazione-768x517.png 768w, https:\/\/bmscience.net\/blog\/wp-content\/uploads\/2026\/03\/insufficienza-cardiaca-classificazione.png 1216w\" sizes=\"auto, (max-width: 1024px) 100vw, 1024px\" \/><button\n\t\t\tclass=\"lightbox-trigger\"\n\t\t\ttype=\"button\"\n\t\t\taria-haspopup=\"dialog\"\n\t\t\taria-label=\"Ingrandisci\"\n\t\t\tdata-wp-init=\"callbacks.initTriggerButton\"\n\t\t\tdata-wp-on--click=\"actions.showLightbox\"\n\t\t\tdata-wp-style--right=\"state.imageButtonRight\"\n\t\t\tdata-wp-style--top=\"state.imageButtonTop\"\n\t\t>\n\t\t\t<svg xmlns=\"http:\/\/www.w3.org\/2000\/svg\" width=\"12\" height=\"12\" fill=\"none\" viewBox=\"0 0 12 12\">\n\t\t\t\t<path fill=\"#fff\" d=\"M2 0a2 2 0 0 0-2 2v2h1.5V2a.5.5 0 0 1 .5-.5h2V0H2Zm2 10.5H2a.5.5 0 0 1-.5-.5V8H0v2a2 2 0 0 0 2 2h2v-1.5ZM8 12v-1.5h2a.5.5 0 0 0 .5-.5V8H12v2a2 2 0 0 1-2 2H8Zm2-12a2 2 0 0 1 2 2v2h-1.5V2a.5.5 0 0 0-.5-.5H8V0h2Z\" \/>\n\t\t\t<\/svg>\n\t\t<\/button><\/figure>\n\n\n\n<h3 class=\"wp-block-heading\" id=\"forme-cliniche-00964425-dfa1-4e73-8054-832759f0a950\"><span class=\"ez-toc-section\" id=\"Forme_cliniche\"><\/span>Forme cliniche<span class=\"ez-toc-section-end\"><\/span><\/h3>\n\n\n\n<p>In relazione alla <span style=\"text-decoration: underline;\">localizzazione <\/span>del deficit prevalente, si distingue tra insufficienza sinistra e destra. L&#8217;<strong>insufficienza sinistra<\/strong> \u00e8 dominata dalla congestione polmonare e dalla riduzione della perfusione sistemica, mentre quella <strong>destra <\/strong>si manifesta con segni di stasi nel circolo venoso sistemico.<sup data-fn=\"843fe78f-33f4-4a28-8b1a-84f383739baf\" class=\"fn\"><a href=\"#843fe78f-33f4-4a28-8b1a-84f383739baf\" id=\"843fe78f-33f4-4a28-8b1a-84f383739baf-link\">8<\/a><\/sup><\/p>\n\n\n\n<p>La distinzione tra insufficienza anterograda e retrograda \u00e8 di tipo <span style=\"text-decoration: underline;\">fisiopatologico<\/span>: l&#8217;<strong>anterograda<\/strong> (<em>forward failure<\/em>) \u00e8 legata all&#8217;incapacit\u00e0 di fornire sangue ossigenato alla periferia (causando astenia, pallore, ipotensione), mentre la <strong>retrograda <\/strong>(<em>backward failure<\/em>) riguarda l&#8217;accumulo di sangue &#8220;a monte&#8221; delle camere cardiache, portando a edema polmonare o periferico.<\/p>\n\n\n\n<p>Le forme ad alta portata sono meno comuni e derivano da stati ipercinetici dove il cuore non riesce a soddisfare richieste metaboliche patologicamente aumentate.<\/p>\n\n\n\n<h3 class=\"wp-block-heading\" id=\"severita-e-tempistiche-nyha-e-stadiazione-68995f61-ffb7-4c65-9095-307de14215cc\"><span class=\"ez-toc-section\" id=\"Severita_e_tempistiche_NYHA_e_stadiazione\"><\/span>Severit\u00e0 e tempistiche: NYHA e stadiazione<span class=\"ez-toc-section-end\"><\/span><\/h3>\n\n\n<div id=\"bmscience1828146223\" style=\"margin-top: 15px;margin-left: 15px;float: right;\"><a href=\"https:\/\/amzn.to\/4exVHa6\" target=\"_blank\" aria-label=\"Version 1.0.0\"><img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/bmscience.net\/blog\/wp-content\/uploads\/2025\/06\/ec79efd8-7b00-4f47-a66b-9a3b5fd0059f.jpg\" alt=\"\"  srcset=\"https:\/\/bmscience.net\/blog\/wp-content\/uploads\/2025\/06\/ec79efd8-7b00-4f47-a66b-9a3b5fd0059f.jpg 300w, https:\/\/bmscience.net\/blog\/wp-content\/uploads\/2025\/06\/ec79efd8-7b00-4f47-a66b-9a3b5fd0059f-180x150.jpg 180w\" sizes=\"auto, (max-width: 300px) 100vw, 300px\" width=\"300\" height=\"250\"   \/><\/a><\/div>\n\n\n<p>La classificazione NYHA (<em>New York Heart Association<\/em>) valuta la tolleranza allo sforzo del paziente<sup data-fn=\"278d6357-5117-434e-8684-22290d8aa34c\" class=\"fn\"><a href=\"#278d6357-5117-434e-8684-22290d8aa34c\" id=\"278d6357-5117-434e-8684-22290d8aa34c-link\">9<\/a><\/sup>:<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong>Classe I<\/strong>: attivit\u00e0 fisica ordinaria non causa sintomi;<\/li>\n\n\n\n<li><strong>Classe II<\/strong>: lieve limitazione; sintomi per sforzi ordinari;<\/li>\n\n\n\n<li><strong>Classe III<\/strong>: marcata limitazione; sintomi per sforzi minimi;<\/li>\n\n\n\n<li><strong>Classe IV<\/strong>: sintomi presenti a riposo.<\/li>\n<\/ul>\n\n\n\n<p>Le tempistiche di insorgenza definiscono la <strong>forma acuta<\/strong>, caratterizzata da un&#8217;emergenza medica improvvisa che richiede trattamento immediato, e la <strong>forma cronica<\/strong>, spesso intermezzata da episodi di riacutizzazione dovuti a cause scatenanti come infezioni, aritmie o mancata aderenza alla dieta.<\/p>\n\n\n\n<h3 class=\"wp-block-heading\" id=\"cardiotossicita-e-cardiooncologia-a4dd744c-b008-49c9-a395-40bf06343ce0\"><span class=\"ez-toc-section\" id=\"Cardiotossicita_e_cardio-oncologia\"><\/span>Cardiotossicit\u00e0 e cardio-oncologia<span class=\"ez-toc-section-end\"><\/span><\/h3>\n\n\n\n<p>Il legame tra oncologia e cardiologia \u00e8 diventato centrale con l&#8217;aumento della sopravvivenza dei pazienti oncologici. La <strong>tossicit\u00e0 cardiovascolare <\/strong>correlata alla terapia del cancro (<strong>CTR-CVT<\/strong>) pu\u00f2 manifestarsi con insufficienza cardiaca grave.<\/p>\n\n\n\n<p>Le <strong>antracicline <\/strong>inducono un danno dose-dipendente e irreversibile dovuto allo stress ossidativo e alla rottura dei legami nel DNA dei miociti.<sup data-fn=\"d396e279-4133-444b-99fa-92da61d53078\" class=\"fn\"><a href=\"#d396e279-4133-444b-99fa-92da61d53078\" id=\"d396e279-4133-444b-99fa-92da61d53078-link\">10<\/a><\/sup><br>Al contrario, gli <strong>inibitori di HER2 <\/strong>come il <strong>Trastuzumab <\/strong>causano spesso una disfunzione reversibile (Tipo II), che per\u00f2 richiede un monitoraggio ecocardiografico trimestrale.<\/p>\n\n\n\n<p>La prevenzione si basa sulla stratificazione del rischio tramite il <strong>punteggio HFA-ICOS <\/strong>e, nei pazienti ad alto rischio, sull&#8217;uso profilattico di<strong> beta-bloccanti <\/strong>e <strong>ACE-inibitori<\/strong>.<\/p>\n\n\n<div id=\"bmscience2662199761\" style=\"margin-left: auto;margin-right: auto;text-align: center;\"><script async src=\"\/\/pagead2.googlesyndication.com\/pagead\/js\/adsbygoogle.js?client=ca-pub-3495866718878812\" crossorigin=\"anonymous\"><\/script><ins class=\"adsbygoogle\" style=\"display:block;\" data-ad-client=\"ca-pub-3495866718878812\" \ndata-ad-slot=\"4682122636\" \ndata-ad-format=\"auto\" data-full-width-responsive=\"true\"><\/ins>\n<script> \n(adsbygoogle = window.adsbygoogle || []).push({}); \n<\/script>\n<\/div>\n\n\n<h2 class=\"wp-block-heading\" id=\"fisiopatologia-meccanismi-di-adattamento-3bac7d23-e012-49a9-b837-af351f9b1861\"><span class=\"ez-toc-section\" id=\"Fisiopatologia_meccanismi_di_adattamento\"><\/span>Fisiopatologia: meccanismi di adattamento<span class=\"ez-toc-section-end\"><\/span><\/h2>\n\n\n\n<p>Quando la funzione cardiaca declina, l&#8217;organismo attiva una serie di <strong>meccanismi di compenso <\/strong>per mantenere la pressione arteriosa e l&#8217;irrorazione degli organi vitali.<\/p>\n\n\n\n<h3 class=\"wp-block-heading\" id=\"meccanismo-di-frankstarling-e-ipertrofia-a6048e7b-8d1e-4ae0-8493-49f56b105a8c\"><span class=\"ez-toc-section\" id=\"Meccanismo_di_Frank-Starling_e_ipertrofia\"><\/span>Meccanismo di Frank-Starling e ipertrofia<span class=\"ez-toc-section-end\"><\/span><\/h3>\n\n\n<div class=\"wp-block-image\">\n<figure class=\"alignright size-full is-resized\"><img loading=\"lazy\" decoding=\"async\" width=\"602\" height=\"461\" src=\"https:\/\/www.bmscience.net\/blog\/wp-content\/uploads\/2026\/03\/image-50.png\" alt=\"\" class=\"wp-image-26633\" style=\"aspect-ratio:1.3058978620966355;width:331px;height:auto\" srcset=\"https:\/\/bmscience.net\/blog\/wp-content\/uploads\/2026\/03\/image-50.png 602w, https:\/\/bmscience.net\/blog\/wp-content\/uploads\/2026\/03\/image-50-300x230.png 300w\" sizes=\"auto, (max-width: 602px) 100vw, 602px\" \/><figcaption class=\"wp-element-caption\">Meccanismo di Frank-Starling.<\/figcaption><\/figure>\n<\/div>\n\n\n<p>Il cuore risponde all&#8217;aumento del volume telediastolico stirando le fibre miocardiche, il che aumenta la forza di contrazione secondo il <strong>meccanismo di Frank-Starling<\/strong>.<sup data-fn=\"7184c758-a3a7-467a-a402-a2cbb77d48c6\" class=\"fn\"><a href=\"#7184c758-a3a7-467a-a402-a2cbb77d48c6\" id=\"7184c758-a3a7-467a-a402-a2cbb77d48c6-link\">11<\/a><\/sup> Tuttavia, nel cuore insufficiente, la curva di prestazione \u00e8 piatta: l&#8217;ulteriore stiramento non produce pi\u00f9 un aumento della gittata, ma solo un aumento della pressione venosa polmonare o sistemica.<\/p>\n\n\n\n<p>Il rimodellamento strutturale segue la <strong>legge di Laplace<\/strong>. Per ridurre lo stress di parete dovuto all&#8217;aumento della pressione o del raggio della camera, il cuore aumenta lo spessore delle pareti (<strong>ipertrofia<\/strong>):<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong>ipertrofia eccentrica<\/strong>: causata da sovraccarico di volume. I sarcomeri si aggiungono in serie, portando a una dilatazione della camera con spessore di parete che pu\u00f2 rimanere normale o ridursi proporzionalmente;<\/li>\n\n\n\n<li><strong>ipertrofia concentrica<\/strong>: causata da sovraccarico di pressione. I sarcomeri si aggiungono in parallelo, le pareti si ispessiscono e il volume della camera diminuisce.<\/li>\n<\/ul>\n\n\n\n<div class=\"wp-block-columns are-vertically-aligned-center is-layout-flex wp-container-core-columns-is-layout-9d6595d7 wp-block-columns-is-layout-flex\">\n<div class=\"wp-block-column is-vertically-aligned-center is-layout-flow wp-block-column-is-layout-flow\" style=\"flex-basis:55%\">\n<figure data-wp-context=\"{&quot;imageId&quot;:&quot;69ea937daca08&quot;}\" data-wp-interactive=\"core\/image\" data-wp-key=\"69ea937daca08\" class=\"wp-block-image alignwide size-large wp-lightbox-container\"><img loading=\"lazy\" decoding=\"async\" width=\"1024\" height=\"576\" data-wp-class--hide=\"state.isContentHidden\" data-wp-class--show=\"state.isContentVisible\" data-wp-init=\"callbacks.setButtonStyles\" data-wp-on--click=\"actions.showLightbox\" data-wp-on--load=\"callbacks.setButtonStyles\" data-wp-on-window--resize=\"callbacks.setButtonStyles\" src=\"https:\/\/www.bmscience.net\/blog\/wp-content\/uploads\/2026\/03\/Right_side_heart_failure-1024x576.jpg\" alt=\"\" class=\"wp-image-26654\" srcset=\"https:\/\/bmscience.net\/blog\/wp-content\/uploads\/2026\/03\/Right_side_heart_failure-1024x576.jpg 1024w, https:\/\/bmscience.net\/blog\/wp-content\/uploads\/2026\/03\/Right_side_heart_failure-300x169.jpg 300w, https:\/\/bmscience.net\/blog\/wp-content\/uploads\/2026\/03\/Right_side_heart_failure-768x432.jpg 768w, https:\/\/bmscience.net\/blog\/wp-content\/uploads\/2026\/03\/Right_side_heart_failure-1536x864.jpg 1536w, https:\/\/bmscience.net\/blog\/wp-content\/uploads\/2026\/03\/Right_side_heart_failure-373x210.jpg 373w, https:\/\/bmscience.net\/blog\/wp-content\/uploads\/2026\/03\/Right_side_heart_failure.jpg 1920w\" sizes=\"auto, (max-width: 1024px) 100vw, 1024px\" \/><button\n\t\t\tclass=\"lightbox-trigger\"\n\t\t\ttype=\"button\"\n\t\t\taria-haspopup=\"dialog\"\n\t\t\taria-label=\"Ingrandisci\"\n\t\t\tdata-wp-init=\"callbacks.initTriggerButton\"\n\t\t\tdata-wp-on--click=\"actions.showLightbox\"\n\t\t\tdata-wp-style--right=\"state.imageButtonRight\"\n\t\t\tdata-wp-style--top=\"state.imageButtonTop\"\n\t\t>\n\t\t\t<svg xmlns=\"http:\/\/www.w3.org\/2000\/svg\" width=\"12\" height=\"12\" fill=\"none\" viewBox=\"0 0 12 12\">\n\t\t\t\t<path fill=\"#fff\" d=\"M2 0a2 2 0 0 0-2 2v2h1.5V2a.5.5 0 0 1 .5-.5h2V0H2Zm2 10.5H2a.5.5 0 0 1-.5-.5V8H0v2a2 2 0 0 0 2 2h2v-1.5ZM8 12v-1.5h2a.5.5 0 0 0 .5-.5V8H12v2a2 2 0 0 1-2 2H8Zm2-12a2 2 0 0 1 2 2v2h-1.5V2a.5.5 0 0 0-.5-.5H8V0h2Z\" \/>\n\t\t\t<\/svg>\n\t\t<\/button><figcaption class=\"wp-element-caption\">Modello di un cuore normale (a sinistra) e di un cuore indebolito, con muscolatura sovradistesa e dilatazione del ventricolo sinistro (a destra); entrambi in diastole.<\/figcaption><\/figure>\n<\/div>\n\n\n\n<div class=\"wp-block-column is-vertically-aligned-center is-layout-flow wp-block-column-is-layout-flow\" style=\"flex-basis:45%\">\n<figure data-wp-context=\"{&quot;imageId&quot;:&quot;69ea937dad170&quot;}\" data-wp-interactive=\"core\/image\" data-wp-key=\"69ea937dad170\" class=\"wp-block-image alignwide size-large wp-lightbox-container\"><img loading=\"lazy\" decoding=\"async\" width=\"1024\" height=\"935\" data-wp-class--hide=\"state.isContentHidden\" data-wp-class--show=\"state.isContentVisible\" data-wp-init=\"callbacks.setButtonStyles\" data-wp-on--click=\"actions.showLightbox\" data-wp-on--load=\"callbacks.setButtonStyles\" data-wp-on-window--resize=\"callbacks.setButtonStyles\" src=\"https:\/\/www.bmscience.net\/blog\/wp-content\/uploads\/2026\/03\/image-55-1024x935.png\" alt=\"\" class=\"wp-image-26647\" srcset=\"https:\/\/bmscience.net\/blog\/wp-content\/uploads\/2026\/03\/image-55-1024x935.png 1024w, https:\/\/bmscience.net\/blog\/wp-content\/uploads\/2026\/03\/image-55-300x274.png 300w, https:\/\/bmscience.net\/blog\/wp-content\/uploads\/2026\/03\/image-55-768x701.png 768w, https:\/\/bmscience.net\/blog\/wp-content\/uploads\/2026\/03\/image-55.png 1087w\" sizes=\"auto, (max-width: 1024px) 100vw, 1024px\" \/><button\n\t\t\tclass=\"lightbox-trigger\"\n\t\t\ttype=\"button\"\n\t\t\taria-haspopup=\"dialog\"\n\t\t\taria-label=\"Ingrandisci\"\n\t\t\tdata-wp-init=\"callbacks.initTriggerButton\"\n\t\t\tdata-wp-on--click=\"actions.showLightbox\"\n\t\t\tdata-wp-style--right=\"state.imageButtonRight\"\n\t\t\tdata-wp-style--top=\"state.imageButtonTop\"\n\t\t>\n\t\t\t<svg xmlns=\"http:\/\/www.w3.org\/2000\/svg\" width=\"12\" height=\"12\" fill=\"none\" viewBox=\"0 0 12 12\">\n\t\t\t\t<path fill=\"#fff\" d=\"M2 0a2 2 0 0 0-2 2v2h1.5V2a.5.5 0 0 1 .5-.5h2V0H2Zm2 10.5H2a.5.5 0 0 1-.5-.5V8H0v2a2 2 0 0 0 2 2h2v-1.5ZM8 12v-1.5h2a.5.5 0 0 0 .5-.5V8H12v2a2 2 0 0 1-2 2H8Zm2-12a2 2 0 0 1 2 2v2h-1.5V2a.5.5 0 0 0-.5-.5H8V0h2Z\" \/>\n\t\t\t<\/svg>\n\t\t<\/button><figcaption class=\"wp-element-caption\">Tipi di rimodellamento ventricolare.<\/figcaption><\/figure>\n<\/div>\n<\/div>\n\n\n\n<h3 class=\"wp-block-heading\" id=\"attivazione-neuroumorale-e6225e86-b1f0-485a-8a08-e93be79f6fc9\"><span class=\"ez-toc-section\" id=\"Attivazione_neuro-umorale\"><\/span>Attivazione neuro-umorale<span class=\"ez-toc-section-end\"><\/span><\/h3>\n\n\n\n<p>L&#8217;attivazione del <strong>Sistema Nervoso Simpatico<\/strong> (<strong>SNS<\/strong>) e del <strong>Sistema Renina-Angiotensina-Aldosterone<\/strong> (<strong>SRAA<\/strong>) \u00e8 il pilastro della fisiopatologia moderna.<sup data-fn=\"b4b698fc-1817-4c70-85c7-ea78b7dee721\" class=\"fn\"><a href=\"#b4b698fc-1817-4c70-85c7-ea78b7dee721\" id=\"b4b698fc-1817-4c70-85c7-ea78b7dee721-link\">12<\/a><\/sup><\/p>\n\n\n\n<figure class=\"wp-block-table\"><table><thead><tr><th>Sistema<\/th><th>Effetto acuto (compenso)<\/th><th>Effetto cronico (danno)<\/th><\/tr><\/thead><tbody><tr><td>SNS<\/td><td>Aumento frequenza e contrattilit\u00e0, vasocostrizione<\/td><td>Tossicit\u00e0 diretta da catecolamine, aritmie, aumento postcarico<\/td><\/tr><tr><td>SRAA<\/td><td>Ritenzione di sodio e acqua, aumento precarico<\/td><td>Edema, fibrosi miocardica, ipertrofia maladattativa<\/td><\/tr><tr><td>Peptidi natriuretici<\/td><td>Vasodilatazione, natriuresi<\/td><td>Meccanismo di contro-regolazione che fallisce nel tempo per sbilanciamento<\/td><\/tr><\/tbody><\/table><\/figure>\n\n\n\n<p>L&#8217;angiotensina II e l&#8217;aldosterone non solo aumentano il volume circolante, ma stimolano la sintesi di collagene, portando alla <strong>fibrosi<\/strong> che irrigidisce il cuore e ne compromette la funzione sia sistolica che diastolica.<\/p>\n\n\n\n<div class=\"wp-block-columns are-vertically-aligned-center is-layout-flex wp-container-core-columns-is-layout-9d6595d7 wp-block-columns-is-layout-flex\">\n<div class=\"wp-block-column is-vertically-aligned-center is-layout-flow wp-block-column-is-layout-flow\" style=\"flex-basis:70%\">\n<figure data-wp-context=\"{&quot;imageId&quot;:&quot;69ea937dae5b3&quot;}\" data-wp-interactive=\"core\/image\" data-wp-key=\"69ea937dae5b3\" class=\"wp-block-image alignwide size-full wp-lightbox-container\"><img loading=\"lazy\" decoding=\"async\" width=\"648\" height=\"488\" data-wp-class--hide=\"state.isContentHidden\" data-wp-class--show=\"state.isContentVisible\" data-wp-init=\"callbacks.setButtonStyles\" data-wp-on--click=\"actions.showLightbox\" data-wp-on--load=\"callbacks.setButtonStyles\" data-wp-on-window--resize=\"callbacks.setButtonStyles\" src=\"https:\/\/www.bmscience.net\/blog\/wp-content\/uploads\/2026\/03\/image-52.png\" alt=\"\" class=\"wp-image-26635\" srcset=\"https:\/\/bmscience.net\/blog\/wp-content\/uploads\/2026\/03\/image-52.png 648w, https:\/\/bmscience.net\/blog\/wp-content\/uploads\/2026\/03\/image-52-300x226.png 300w, https:\/\/bmscience.net\/blog\/wp-content\/uploads\/2026\/03\/image-52-373x280.png 373w\" sizes=\"auto, (max-width: 648px) 100vw, 648px\" \/><button\n\t\t\tclass=\"lightbox-trigger\"\n\t\t\ttype=\"button\"\n\t\t\taria-haspopup=\"dialog\"\n\t\t\taria-label=\"Ingrandisci\"\n\t\t\tdata-wp-init=\"callbacks.initTriggerButton\"\n\t\t\tdata-wp-on--click=\"actions.showLightbox\"\n\t\t\tdata-wp-style--right=\"state.imageButtonRight\"\n\t\t\tdata-wp-style--top=\"state.imageButtonTop\"\n\t\t>\n\t\t\t<svg xmlns=\"http:\/\/www.w3.org\/2000\/svg\" width=\"12\" height=\"12\" fill=\"none\" viewBox=\"0 0 12 12\">\n\t\t\t\t<path fill=\"#fff\" d=\"M2 0a2 2 0 0 0-2 2v2h1.5V2a.5.5 0 0 1 .5-.5h2V0H2Zm2 10.5H2a.5.5 0 0 1-.5-.5V8H0v2a2 2 0 0 0 2 2h2v-1.5ZM8 12v-1.5h2a.5.5 0 0 0 .5-.5V8H12v2a2 2 0 0 1-2 2H8Zm2-12a2 2 0 0 1 2 2v2h-1.5V2a.5.5 0 0 0-.5-.5H8V0h2Z\" \/>\n\t\t\t<\/svg>\n\t\t<\/button><figcaption class=\"wp-element-caption\">Lo schema illustra il circolo vizioso dello <strong>scompenso cardiaco<\/strong>. L&#8217;iniziale disfunzione ventricolare causa congestione e bassa portata, innescando due meccanismi compensatori: <strong>l&#8217;attivazione del SRAA <\/strong>(che aumenta il precarico tramite la ritenzione renale di sodio) e del <strong>sistema nervoso simpatico<\/strong> (che aumenta il postcarico tramite vasocostrizione e tachicardia). A lungo termine, questo continuo sovraccarico emodinamico promuove la <strong>fibrosi <\/strong>e il <strong>rimodellamento strutturale <\/strong>del cuore, portando a <strong>dilatazione <\/strong>e <strong>ipertrofia <\/strong>che aggravano ulteriormente la disfunzione di partenza.<\/figcaption><\/figure>\n<\/div>\n\n\n\n<div class=\"wp-block-column is-vertically-aligned-center is-layout-flow wp-block-column-is-layout-flow\" style=\"flex-basis:30%\"><div id=\"bmscience1954198484\" style=\"margin-top: 15px;margin-bottom: 15px;margin-left: auto;margin-right: auto;text-align: center;\"><div data-id='24174' class='amazon-auto-links aal-js-loading'><p class='now-loading-placeholder'>Caricamento....<\/p><\/div><\/div>\n<\/div>\n<\/div>\n\n\n<div id=\"bmscience2314309110\" style=\"margin-top: 15px;margin-bottom: 15px;margin-left: auto;margin-right: auto;text-align: center;\"><a href=\"https:\/\/amzn.to\/4kqcttm\" target=\"_blank\" aria-label=\"Screenshot 2025-05-19 151702\"><img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/bmscience.net\/blog\/wp-content\/uploads\/2025\/05\/Screenshot-2025-05-19-151702.png\" alt=\"\"  srcset=\"https:\/\/bmscience.net\/blog\/wp-content\/uploads\/2025\/05\/Screenshot-2025-05-19-151702.png 1186w, https:\/\/bmscience.net\/blog\/wp-content\/uploads\/2025\/05\/Screenshot-2025-05-19-151702-300x83.png 300w, https:\/\/bmscience.net\/blog\/wp-content\/uploads\/2025\/05\/Screenshot-2025-05-19-151702-1024x285.png 1024w, https:\/\/bmscience.net\/blog\/wp-content\/uploads\/2025\/05\/Screenshot-2025-05-19-151702-768x214.png 768w\" sizes=\"auto, (max-width: 1186px) 100vw, 1186px\" width=\"1186\" height=\"330\"  style=\"display: inline-block;\" \/><\/a><\/div>\n\n\n<h2 class=\"wp-block-heading\" id=\"manifestazioni-cliniche-ed-emodinamiche-558218b0-622d-42e8-a127-8711471d3bd6\"><span class=\"ez-toc-section\" id=\"Manifestazioni_cliniche_ed_emodinamiche\"><\/span>Manifestazioni cliniche ed emodinamiche<span class=\"ez-toc-section-end\"><\/span><\/h2>\n\n\n\n<h3 class=\"wp-block-heading\" id=\"scompenso-sinistro-e-sintomi-polmonari-ad63e899-2d2a-44c5-8a0e-646a54d17f4f\"><span class=\"ez-toc-section\" id=\"Scompenso_sinistro_e_sintomi_polmonari\"><\/span>Scompenso sinistro e sintomi polmonari<span class=\"ez-toc-section-end\"><\/span><\/h3>\n\n\n\n<p>La congestione retrograda del circolo polmonare causa la trasudazione di liquidi nell&#8217;interstizio e negli alveoli, generando sintomi quali:<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong>dispnea da sforzo<\/strong>: il sintomo pi\u00f9 precoce, causato dall&#8217;aumento delle pressioni capillari polmonari durante l&#8217;esercizio;<\/li>\n\n\n\n<li><strong>ortopnea<\/strong>: difficolt\u00e0 respiratoria in posizione supina, alleviata dai cuscini, dovuta alla ridistribuzione dei liquidi dagli arti al torace;<\/li>\n\n\n\n<li><strong>dispnea parossistica notturna (DPN)<\/strong>: attacchi improvvisi di dispnea che insorgono dopo alcune ore di sonno;<\/li>\n\n\n\n<li><strong>edema polmonare acuto<\/strong>: emergenza estrema con rantoli crepitanti diffusi, espettorato schiumoso e grave ipossia.<\/li>\n<\/ul>\n\n\n\n<div class=\"wp-block-columns are-vertically-aligned-center is-layout-flex wp-container-core-columns-is-layout-9d6595d7 wp-block-columns-is-layout-flex\">\n<div class=\"wp-block-column is-vertically-aligned-center is-layout-flow wp-block-column-is-layout-flow\">\n<figure data-wp-context=\"{&quot;imageId&quot;:&quot;69ea937db78ae&quot;}\" data-wp-interactive=\"core\/image\" data-wp-key=\"69ea937db78ae\" class=\"wp-block-image alignwide size-full wp-lightbox-container\"><img loading=\"lazy\" decoding=\"async\" width=\"1003\" height=\"833\" data-wp-class--hide=\"state.isContentHidden\" data-wp-class--show=\"state.isContentVisible\" data-wp-init=\"callbacks.setButtonStyles\" data-wp-on--click=\"actions.showLightbox\" data-wp-on--load=\"callbacks.setButtonStyles\" data-wp-on-window--resize=\"callbacks.setButtonStyles\" src=\"https:\/\/www.bmscience.net\/blog\/wp-content\/uploads\/2026\/03\/image-53.png\" alt=\"\" class=\"wp-image-26639\" srcset=\"https:\/\/bmscience.net\/blog\/wp-content\/uploads\/2026\/03\/image-53.png 1003w, https:\/\/bmscience.net\/blog\/wp-content\/uploads\/2026\/03\/image-53-300x249.png 300w, https:\/\/bmscience.net\/blog\/wp-content\/uploads\/2026\/03\/image-53-768x638.png 768w\" sizes=\"auto, (max-width: 1003px) 100vw, 1003px\" \/><button\n\t\t\tclass=\"lightbox-trigger\"\n\t\t\ttype=\"button\"\n\t\t\taria-haspopup=\"dialog\"\n\t\t\taria-label=\"Ingrandisci\"\n\t\t\tdata-wp-init=\"callbacks.initTriggerButton\"\n\t\t\tdata-wp-on--click=\"actions.showLightbox\"\n\t\t\tdata-wp-style--right=\"state.imageButtonRight\"\n\t\t\tdata-wp-style--top=\"state.imageButtonTop\"\n\t\t>\n\t\t\t<svg xmlns=\"http:\/\/www.w3.org\/2000\/svg\" width=\"12\" height=\"12\" fill=\"none\" viewBox=\"0 0 12 12\">\n\t\t\t\t<path fill=\"#fff\" d=\"M2 0a2 2 0 0 0-2 2v2h1.5V2a.5.5 0 0 1 .5-.5h2V0H2Zm2 10.5H2a.5.5 0 0 1-.5-.5V8H0v2a2 2 0 0 0 2 2h2v-1.5ZM8 12v-1.5h2a.5.5 0 0 0 .5-.5V8H12v2a2 2 0 0 1-2 2H8Zm2-12a2 2 0 0 1 2 2v2h-1.5V2a.5.5 0 0 0-.5-.5H8V0h2Z\" \/>\n\t\t\t<\/svg>\n\t\t<\/button><figcaption class=\"wp-element-caption\"><strong>Edema polmonare acuto<\/strong>.<br>Si notino i segni di ridistribuzione vascolare verso i campi superiori e l&#8217;ingrandimento secondario alla congestione di entrambi gli ili polmonari definito \u201cad ali di farfalla\u201d.<\/figcaption><\/figure>\n<\/div>\n\n\n\n<div class=\"wp-block-column is-vertically-aligned-center is-layout-flow wp-block-column-is-layout-flow\"><div id=\"bmscience909800047\" style=\"margin-top: 15px;margin-bottom: 15px;margin-left: auto;margin-right: auto;text-align: center;\"><div data-id='24174' class='amazon-auto-links aal-js-loading'><p class='now-loading-placeholder'>Caricamento....<\/p><\/div><\/div>\n<\/div>\n<\/div>\n\n\n\n<h3 class=\"wp-block-heading\" id=\"scompenso-destro-e-manifestazioni-sistemiche-677fe6cd-fe83-4dd0-ac65-5e661689fd1f\"><span class=\"ez-toc-section\" id=\"Scompenso_destro_e_manifestazioni_sistemiche\"><\/span>Scompenso destro e manifestazioni sistemiche<span class=\"ez-toc-section-end\"><\/span><\/h3>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong>Turgore giugulare<\/strong>: riflesso diretto dell&#8217;aumento della pressione in atrio destro;<\/li>\n\n\n\n<li><strong>epatomegalia e ascite<\/strong>: la stasi venosa nel circolo portale causa ingrossamento del fegato e accumulo di liquido peritoneale;<\/li>\n\n\n\n<li><strong>edemi periferici<\/strong>: tipicamente bilaterali, declivi (caviglie), con segno della fovea.<\/li>\n<\/ul>\n\n\n\n<h3 class=\"wp-block-heading\" id=\"manifestazioni-anterograde-e-alterazioni-del-ritmo-a656fdf0-efc8-4683-b51f-70cb9491e67f\"><span class=\"ez-toc-section\" id=\"Manifestazioni_anterograde_e_alterazioni_del_ritmo\"><\/span>Manifestazioni anterograde e alterazioni del ritmo<span class=\"ez-toc-section-end\"><\/span><\/h3>\n\n\n\n<p>La riduzione della portata causa <strong>oliguria diurna <\/strong>e <strong>nicturia notturna<\/strong> (quando il riposo migliora la perfusione renale).<sup data-fn=\"917c343b-5d3f-4eb0-bcbd-35a1917e2bfa\" class=\"fn\"><a href=\"#917c343b-5d3f-4eb0-bcbd-35a1917e2bfa\" id=\"917c343b-5d3f-4eb0-bcbd-35a1917e2bfa-link\">13<\/a><\/sup><\/p>\n\n\n\n<p>Possono comparire sintomi cerebrali come <strong>letargia <\/strong>o il <strong>respiro di Cheyne-Stokes<\/strong>, un pattern respiratorio periodico legato all&#8217;instabilit\u00e0 del centro del respiro e al ritardato tempo di circolo.<sup data-fn=\"6539cd9d-7835-4d6b-a5c7-5067c956e81e\" class=\"fn\"><a href=\"#6539cd9d-7835-4d6b-a5c7-5067c956e81e\" id=\"6539cd9d-7835-4d6b-a5c7-5067c956e81e-link\">14<\/a><\/sup><\/p>\n\n\n\n<figure data-wp-context=\"{&quot;imageId&quot;:&quot;69ea937db9314&quot;}\" data-wp-interactive=\"core\/image\" data-wp-key=\"69ea937db9314\" class=\"wp-block-image alignwide size-large wp-lightbox-container\"><img loading=\"lazy\" decoding=\"async\" width=\"1024\" height=\"326\" data-wp-class--hide=\"state.isContentHidden\" data-wp-class--show=\"state.isContentVisible\" data-wp-init=\"callbacks.setButtonStyles\" data-wp-on--click=\"actions.showLightbox\" data-wp-on--load=\"callbacks.setButtonStyles\" data-wp-on-window--resize=\"callbacks.setButtonStyles\" src=\"https:\/\/www.bmscience.net\/blog\/wp-content\/uploads\/2026\/03\/image-57-1024x326.png\" alt=\"\" class=\"wp-image-26664\" srcset=\"https:\/\/bmscience.net\/blog\/wp-content\/uploads\/2026\/03\/image-57-1024x326.png 1024w, https:\/\/bmscience.net\/blog\/wp-content\/uploads\/2026\/03\/image-57-300x95.png 300w, https:\/\/bmscience.net\/blog\/wp-content\/uploads\/2026\/03\/image-57-768x244.png 768w, https:\/\/bmscience.net\/blog\/wp-content\/uploads\/2026\/03\/image-57-1536x489.png 1536w, https:\/\/bmscience.net\/blog\/wp-content\/uploads\/2026\/03\/image-57.png 1600w\" sizes=\"auto, (max-width: 1024px) 100vw, 1024px\" \/><button\n\t\t\tclass=\"lightbox-trigger\"\n\t\t\ttype=\"button\"\n\t\t\taria-haspopup=\"dialog\"\n\t\t\taria-label=\"Ingrandisci\"\n\t\t\tdata-wp-init=\"callbacks.initTriggerButton\"\n\t\t\tdata-wp-on--click=\"actions.showLightbox\"\n\t\t\tdata-wp-style--right=\"state.imageButtonRight\"\n\t\t\tdata-wp-style--top=\"state.imageButtonTop\"\n\t\t>\n\t\t\t<svg xmlns=\"http:\/\/www.w3.org\/2000\/svg\" width=\"12\" height=\"12\" fill=\"none\" viewBox=\"0 0 12 12\">\n\t\t\t\t<path fill=\"#fff\" d=\"M2 0a2 2 0 0 0-2 2v2h1.5V2a.5.5 0 0 1 .5-.5h2V0H2Zm2 10.5H2a.5.5 0 0 1-.5-.5V8H0v2a2 2 0 0 0 2 2h2v-1.5ZM8 12v-1.5h2a.5.5 0 0 0 .5-.5V8H12v2a2 2 0 0 1-2 2H8Zm2-12a2 2 0 0 1 2 2v2h-1.5V2a.5.5 0 0 0-.5-.5H8V0h2Z\" \/>\n\t\t\t<\/svg>\n\t\t<\/button><\/figure>\n\n\n\n<p>All&#8217;auscultazione, il <strong>ritmo di galoppo<\/strong> (S3 o S4) \u00e8 un segno cardine di disfunzione ventricolare.<sup data-fn=\"d3d21180-feb5-4e0b-970b-d03db2faa3ab\" class=\"fn\"><a href=\"#d3d21180-feb5-4e0b-970b-d03db2faa3ab\" id=\"d3d21180-feb5-4e0b-970b-d03db2faa3ab-link\">15<\/a><\/sup><\/p>\n\n\n\n<p>Il <strong>polso alternante<\/strong>, caratterizzato da un&#8217;alternanza regolare di battiti forti e deboli, indica una grave compromissione della contrattilit\u00e0.<\/p>\n\n\n\n<div class=\"wp-block-cb-carousel-v2 cb-carousel-block cb-single-slide\" data-cb-slides-per-view=\"1\" data-cb-slides-per-group=\"1\" data-cb-space-between=\"15\" data-cb-speed=\"300\" data-cb-navigation=\"true\" data-cb-pagination=\"true\" data-cb-breakpoints=\"{&quot;768&quot;:{&quot;slidesPerView&quot;:1,&quot;slidesPerGroup&quot;:1}}\"><div class=\"swiper\"><div class=\"cb-wrapper swiper-wrapper\">\n<div class=\"wp-block-cb-slide-v2 cb-slide swiper-slide\">\n<div class=\"wp-block-columns are-vertically-aligned-center is-layout-flex wp-container-core-columns-is-layout-9d6595d7 wp-block-columns-is-layout-flex\">\n<div class=\"wp-block-column is-vertically-aligned-center is-layout-flow wp-block-column-is-layout-flow\" style=\"flex-basis:40%\">\n<figure data-wp-context=\"{&quot;imageId&quot;:&quot;69ea937dbb94a&quot;}\" data-wp-interactive=\"core\/image\" data-wp-key=\"69ea937dbb94a\" class=\"wp-block-image alignwide size-large wp-lightbox-container\"><img loading=\"lazy\" decoding=\"async\" width=\"783\" height=\"1024\" data-wp-class--hide=\"state.isContentHidden\" data-wp-class--show=\"state.isContentVisible\" data-wp-init=\"callbacks.setButtonStyles\" data-wp-on--click=\"actions.showLightbox\" data-wp-on--load=\"callbacks.setButtonStyles\" data-wp-on-window--resize=\"callbacks.setButtonStyles\" src=\"https:\/\/www.bmscience.net\/blog\/wp-content\/uploads\/2026\/03\/Elevated_JVP-783x1024.jpg\" alt=\"\" class=\"wp-image-26650\" srcset=\"https:\/\/bmscience.net\/blog\/wp-content\/uploads\/2026\/03\/Elevated_JVP-783x1024.jpg 783w, https:\/\/bmscience.net\/blog\/wp-content\/uploads\/2026\/03\/Elevated_JVP-229x300.jpg 229w, https:\/\/bmscience.net\/blog\/wp-content\/uploads\/2026\/03\/Elevated_JVP-768x1004.jpg 768w, https:\/\/bmscience.net\/blog\/wp-content\/uploads\/2026\/03\/Elevated_JVP-1174x1536.jpg 1174w, https:\/\/bmscience.net\/blog\/wp-content\/uploads\/2026\/03\/Elevated_JVP.jpg 1527w\" sizes=\"auto, (max-width: 783px) 100vw, 783px\" \/><button\n\t\t\tclass=\"lightbox-trigger\"\n\t\t\ttype=\"button\"\n\t\t\taria-haspopup=\"dialog\"\n\t\t\taria-label=\"Ingrandisci\"\n\t\t\tdata-wp-init=\"callbacks.initTriggerButton\"\n\t\t\tdata-wp-on--click=\"actions.showLightbox\"\n\t\t\tdata-wp-style--right=\"state.imageButtonRight\"\n\t\t\tdata-wp-style--top=\"state.imageButtonTop\"\n\t\t>\n\t\t\t<svg xmlns=\"http:\/\/www.w3.org\/2000\/svg\" width=\"12\" height=\"12\" fill=\"none\" viewBox=\"0 0 12 12\">\n\t\t\t\t<path fill=\"#fff\" d=\"M2 0a2 2 0 0 0-2 2v2h1.5V2a.5.5 0 0 1 .5-.5h2V0H2Zm2 10.5H2a.5.5 0 0 1-.5-.5V8H0v2a2 2 0 0 0 2 2h2v-1.5ZM8 12v-1.5h2a.5.5 0 0 0 .5-.5V8H12v2a2 2 0 0 1-2 2H8Zm2-12a2 2 0 0 1 2 2v2h-1.5V2a.5.5 0 0 0-.5-.5H8V0h2Z\" \/>\n\t\t\t<\/svg>\n\t\t<\/button><figcaption class=\"wp-element-caption\">Uomo con insufficienza cardiaca congestizia e marcato <strong>turgore giugulare<\/strong>. La vena giugulare esterna \u00e8 indicata da una freccia.<\/figcaption><\/figure>\n<\/div>\n\n\n\n<div class=\"wp-block-column is-vertically-aligned-center is-layout-flow wp-block-column-is-layout-flow\" style=\"flex-basis:60%\">\n<figure data-wp-context=\"{&quot;imageId&quot;:&quot;69ea937dbd547&quot;}\" data-wp-interactive=\"core\/image\" data-wp-key=\"69ea937dbd547\" class=\"wp-block-image alignwide size-large wp-lightbox-container\"><img loading=\"lazy\" decoding=\"async\" width=\"1024\" height=\"1005\" data-wp-class--hide=\"state.isContentHidden\" data-wp-class--show=\"state.isContentVisible\" data-wp-init=\"callbacks.setButtonStyles\" data-wp-on--click=\"actions.showLightbox\" data-wp-on--load=\"callbacks.setButtonStyles\" data-wp-on-window--resize=\"callbacks.setButtonStyles\" src=\"https:\/\/www.bmscience.net\/blog\/wp-content\/uploads\/2026\/03\/Combinpedal-1024x1005.jpg\" alt=\"\" class=\"wp-image-26652\" srcset=\"https:\/\/bmscience.net\/blog\/wp-content\/uploads\/2026\/03\/Combinpedal-1024x1005.jpg 1024w, https:\/\/bmscience.net\/blog\/wp-content\/uploads\/2026\/03\/Combinpedal-300x294.jpg 300w, https:\/\/bmscience.net\/blog\/wp-content\/uploads\/2026\/03\/Combinpedal-768x754.jpg 768w, https:\/\/bmscience.net\/blog\/wp-content\/uploads\/2026\/03\/Combinpedal-1536x1508.jpg 1536w, https:\/\/bmscience.net\/blog\/wp-content\/uploads\/2026\/03\/Combinpedal-2048x2010.jpg 2048w\" sizes=\"auto, (max-width: 1024px) 100vw, 1024px\" \/><button\n\t\t\tclass=\"lightbox-trigger\"\n\t\t\ttype=\"button\"\n\t\t\taria-haspopup=\"dialog\"\n\t\t\taria-label=\"Ingrandisci\"\n\t\t\tdata-wp-init=\"callbacks.initTriggerButton\"\n\t\t\tdata-wp-on--click=\"actions.showLightbox\"\n\t\t\tdata-wp-style--right=\"state.imageButtonRight\"\n\t\t\tdata-wp-style--top=\"state.imageButtonTop\"\n\t\t>\n\t\t\t<svg xmlns=\"http:\/\/www.w3.org\/2000\/svg\" width=\"12\" height=\"12\" fill=\"none\" viewBox=\"0 0 12 12\">\n\t\t\t\t<path fill=\"#fff\" d=\"M2 0a2 2 0 0 0-2 2v2h1.5V2a.5.5 0 0 1 .5-.5h2V0H2Zm2 10.5H2a.5.5 0 0 1-.5-.5V8H0v2a2 2 0 0 0 2 2h2v-1.5ZM8 12v-1.5h2a.5.5 0 0 0 .5-.5V8H12v2a2 2 0 0 1-2 2H8Zm2-12a2 2 0 0 1 2 2v2h-1.5V2a.5.5 0 0 0-.5-.5H8V0h2Z\" \/>\n\t\t\t<\/svg>\n\t\t<\/button><figcaption class=\"wp-element-caption\">Grave edema periferico foveolare.<\/figcaption><\/figure>\n<\/div>\n<\/div>\n<\/div>\n\n\n\n<div class=\"wp-block-cb-slide-v2 cb-slide swiper-slide\">\n<div class=\"wp-block-columns are-vertically-aligned-center is-layout-flex wp-container-core-columns-is-layout-9d6595d7 wp-block-columns-is-layout-flex\">\n<div class=\"wp-block-column is-vertically-aligned-center is-layout-flow wp-block-column-is-layout-flow\" style=\"flex-basis:45%\">\n<figure data-wp-context=\"{&quot;imageId&quot;:&quot;69ea937dbeb5e&quot;}\" data-wp-interactive=\"core\/image\" data-wp-key=\"69ea937dbeb5e\" class=\"wp-block-image alignwide size-full wp-lightbox-container\"><img loading=\"lazy\" decoding=\"async\" width=\"772\" height=\"1024\" data-wp-class--hide=\"state.isContentHidden\" data-wp-class--show=\"state.isContentVisible\" data-wp-init=\"callbacks.setButtonStyles\" data-wp-on--click=\"actions.showLightbox\" data-wp-on--load=\"callbacks.setButtonStyles\" data-wp-on-window--resize=\"callbacks.setButtonStyles\" src=\"https:\/\/www.bmscience.net\/blog\/wp-content\/uploads\/2026\/03\/image-56.png\" alt=\"\" class=\"wp-image-26651\" srcset=\"https:\/\/bmscience.net\/blog\/wp-content\/uploads\/2026\/03\/image-56.png 772w, https:\/\/bmscience.net\/blog\/wp-content\/uploads\/2026\/03\/image-56-226x300.png 226w, https:\/\/bmscience.net\/blog\/wp-content\/uploads\/2026\/03\/image-56-768x1019.png 768w\" sizes=\"auto, (max-width: 772px) 100vw, 772px\" \/><button\n\t\t\tclass=\"lightbox-trigger\"\n\t\t\ttype=\"button\"\n\t\t\taria-haspopup=\"dialog\"\n\t\t\taria-label=\"Ingrandisci\"\n\t\t\tdata-wp-init=\"callbacks.initTriggerButton\"\n\t\t\tdata-wp-on--click=\"actions.showLightbox\"\n\t\t\tdata-wp-style--right=\"state.imageButtonRight\"\n\t\t\tdata-wp-style--top=\"state.imageButtonTop\"\n\t\t>\n\t\t\t<svg xmlns=\"http:\/\/www.w3.org\/2000\/svg\" width=\"12\" height=\"12\" fill=\"none\" viewBox=\"0 0 12 12\">\n\t\t\t\t<path fill=\"#fff\" d=\"M2 0a2 2 0 0 0-2 2v2h1.5V2a.5.5 0 0 1 .5-.5h2V0H2Zm2 10.5H2a.5.5 0 0 1-.5-.5V8H0v2a2 2 0 0 0 2 2h2v-1.5ZM8 12v-1.5h2a.5.5 0 0 0 .5-.5V8H12v2a2 2 0 0 1-2 2H8Zm2-12a2 2 0 0 1 2 2v2h-1.5V2a.5.5 0 0 0-.5-.5H8V0h2Z\" \/>\n\t\t\t<\/svg>\n\t\t<\/button><figcaption class=\"wp-element-caption\">Segni e sintomi dell&#8217;insufficienza cardiaca grave.<\/figcaption><\/figure>\n<\/div>\n\n\n\n<div class=\"wp-block-column is-vertically-aligned-center is-layout-flow wp-block-column-is-layout-flow\"><div id=\"bmscience1023530435\" style=\"margin-top: 15px;margin-bottom: 15px;margin-left: auto;margin-right: auto;text-align: center;\"><div data-id='24174' class='amazon-auto-links aal-js-loading'><p class='now-loading-placeholder'>Caricamento....<\/p><\/div><\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div><\/div><div class=\"cb-pagination swiper-pagination\"><\/div><div class=\"cb-button-prev swiper-button-prev\"><\/div><div class=\"cb-button-next swiper-button-next\"><\/div><\/div>\n\n\n\n<h3 class=\"wp-block-heading\" id=\"la-sindrome-cardiorenale-crs-62347c46-3cf4-4ebd-8017-b0182787359f\"><span class=\"ez-toc-section\" id=\"La_sindrome_cardiorenale_CRS\"><\/span>La sindrome cardiorenale (CRS)<span class=\"ez-toc-section-end\"><\/span><\/h3>\n\n\n\n<p>La CRS descrive l&#8217;interazione patologica tra cuore e reni, classificata in cinque tipi<sup data-fn=\"ea0fe43a-ca72-4169-b30a-6738c0e91167\" class=\"fn\"><a href=\"#ea0fe43a-ca72-4169-b30a-6738c0e91167\" id=\"ea0fe43a-ca72-4169-b30a-6738c0e91167-link\">16<\/a><\/sup>:<\/p>\n\n\n<div id=\"bmscience3643759098\" style=\"margin-top: 15px;margin-left: 15px;float: right;\"><div style=\"\r\n  width: 300px;\r\n  margin: 0 auto;\r\n  text-align: center;\r\n\">\r\n<div data-id='24174' class='amazon-auto-links aal-js-loading'><p class='now-loading-placeholder'>Caricamento&#8230;.<\/p><\/div><\/div><\/div>\n\n\n<ol class=\"wp-block-list\">\n<li><strong>tipo 1 (acuta)<\/strong>: insufficienza cardiaca acuta che causa danno renale acuto (AKI). Il meccanismo principale \u00e8 la congestione venosa renale piuttosto che la bassa portata;<\/li>\n\n\n\n<li><strong>tipo 2 (cronica)<\/strong>: insufficienza cardiaca cronica che porta a malattia renale cronica progressiva;<\/li>\n\n\n\n<li><strong>tipo 3 (renocardiaca acuta)<\/strong>: un danno renale acuto (es. glomerulonefrite) induce insufficienza cardiaca acuta tramite sovraccarico di volume e ipertensione;<\/li>\n\n\n\n<li><strong>tipo 4 (renocardiaca cronica)<\/strong>: la nefropatia cronica induce ipertrofia e disfunzione cardiaca;<\/li>\n\n\n\n<li><strong>tipo 5 (secondaria)<\/strong>: condizioni sistemiche come sepsi, diabete o lupus che colpiscono contemporaneamente entrambi gli organi.<\/li>\n<\/ol>\n\n\n<div id=\"bmscience665464058\" style=\"margin-top: 15px;margin-bottom: 15px;margin-left: auto;margin-right: auto;text-align: center;\"><a href=\"https:\/\/amzn.to\/3Z1y57a\" target=\"_blank\" aria-label=\"51pUYGoTqgL._SX3000_\"><img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/bmscience.net\/blog\/wp-content\/uploads\/2025\/05\/51pUYGoTqgL._SX3000_.jpg\" alt=\"\"  srcset=\"https:\/\/bmscience.net\/blog\/wp-content\/uploads\/2025\/05\/51pUYGoTqgL._SX3000_.jpg 2006w, https:\/\/bmscience.net\/blog\/wp-content\/uploads\/2025\/05\/51pUYGoTqgL._SX3000_-300x79.jpg 300w, https:\/\/bmscience.net\/blog\/wp-content\/uploads\/2025\/05\/51pUYGoTqgL._SX3000_-1024x268.jpg 1024w, https:\/\/bmscience.net\/blog\/wp-content\/uploads\/2025\/05\/51pUYGoTqgL._SX3000_-768x201.jpg 768w, https:\/\/bmscience.net\/blog\/wp-content\/uploads\/2025\/05\/51pUYGoTqgL._SX3000_-1536x402.jpg 1536w\" sizes=\"auto, (max-width: 2006px) 100vw, 2006px\" width=\"2006\" height=\"525\"  style=\"display: inline-block;\" \/><\/a><\/div>\n\n\n<h2 class=\"wp-block-heading\" id=\"diagnostica-dellinsufficienza-cardiaca-837a4157-d283-462f-9e77-8615f9ccf072\"><span class=\"ez-toc-section\" id=\"Diagnostica_dellinsufficienza_cardiaca\"><\/span>Diagnostica dell&#8217;insufficienza cardiaca<span class=\"ez-toc-section-end\"><\/span><\/h2>\n\n\n\n<p>L&#8217;iter diagnostico deve essere rapido e preciso, basandosi su criteri clinici validati e test strumentali.<\/p>\n\n\n\n<h3 class=\"wp-block-heading\" id=\"criteri-di-framingham-7167e816-4606-4e9a-84ed-183e85f244fd\"><span class=\"ez-toc-section\" id=\"Criteri_di_Framingham\"><\/span>Criteri di Framingham<span class=\"ez-toc-section-end\"><\/span><\/h3>\n\n\n\n<p>La diagnosi richiede la presenza di 2 criteri maggiori o 1 maggiore e 2 minori.<sup data-fn=\"3841d17e-6378-4b93-be20-49919115aeeb\" class=\"fn\"><a href=\"#3841d17e-6378-4b93-be20-49919115aeeb\" id=\"3841d17e-6378-4b93-be20-49919115aeeb-link\">17<\/a><\/sup><\/p>\n\n\n\n<figure class=\"wp-block-table\"><table><thead><tr><td><strong>Criteri maggiori<\/strong><\/td><td><strong>Criteri minori<\/strong><\/td><\/tr><\/thead><tbody><tr><td>Dispnea parossistica notturna, ortopnea<\/td><td>Edemi declivi (edema malleolare)<\/td><\/tr><tr><td>Edema polmonare acuto<\/td><td>Dispnea da sforzo<\/td><\/tr><tr><td>Crepitii (rantoli polmonari)<\/td><td>Tosse notturna<\/td><\/tr><tr><td>Distensione della vena giugulare (turgore giugulare)<\/td><td>Versamento pleurico<\/td><\/tr><tr><td>Aumento della pressione venosa (&gt;16 cm H<sub>2<\/sub>O)<\/td><td>Capacit\u00e0 vitale ridotta di 1\/3<\/td><\/tr><tr><td>Reflusso (o riflesso) epato-giugulare positivo<\/td><td>Epatomegalia<\/td><\/tr><tr><td>Ritmo di galoppo (S3)<\/td><td>Tachicardia (&gt;120 bpm)<\/td><\/tr><tr><td>Cardiomegalia (Rx)<\/td><td>Perdita di peso (se usata come criterio minore)<\/td><\/tr><\/tbody><\/table><\/figure>\n\n\n\n<h3 class=\"wp-block-heading\" id=\"laboratorio-e-imaging-5abd6313-9915-4381-aa91-7743d77b30ee\"><span class=\"ez-toc-section\" id=\"Laboratorio_e_imaging\"><\/span>Laboratorio e imaging<span class=\"ez-toc-section-end\"><\/span><\/h3>\n\n\n\n<p>I <strong>peptidi natriuretici<\/strong> (<strong>BNP <\/strong>e <strong>NT-proBNP<\/strong>) sono fondamentali per lo screening. Un valore di <strong>NT-proBNP&nbsp;&lt;300&nbsp;pg\/ml <\/strong>in acuto o&nbsp;<strong>&lt;125&nbsp;pg\/ml<\/strong> in cronico ha un altissimo valore predittivo negativo per escludere l&#8217;insufficienza cardiaca.<\/p>\n\n\n\n<p>La radiografia del torace pu\u00f2 mostrare segni di congestione interstiziale (<strong>linee di Kerley B<\/strong>), l&#8217;<strong>edema alveolare ad &#8220;ali di farfalla&#8221;<\/strong> e quote di <strong>versamento pleurico bilaterale<\/strong>.<\/p>\n\n\n\n<div class=\"wp-block-cb-carousel-v2 cb-carousel-block cb-single-slide\" data-cb-slides-per-view=\"1\" data-cb-slides-per-group=\"1\" data-cb-space-between=\"15\" data-cb-speed=\"300\" data-cb-navigation=\"true\" data-cb-pagination=\"true\" data-cb-breakpoints=\"{&quot;768&quot;:{&quot;slidesPerView&quot;:1,&quot;slidesPerGroup&quot;:1}}\"><div class=\"swiper\"><div class=\"cb-wrapper swiper-wrapper\">\n<div class=\"wp-block-cb-slide-v2 cb-slide swiper-slide\">\n<div class=\"wp-block-columns are-vertically-aligned-center is-layout-flex wp-container-core-columns-is-layout-9d6595d7 wp-block-columns-is-layout-flex\">\n<div class=\"wp-block-column is-vertically-aligned-center is-layout-flow wp-block-column-is-layout-flow\">\n<figure data-wp-context=\"{&quot;imageId&quot;:&quot;69ea937dd75c1&quot;}\" data-wp-interactive=\"core\/image\" data-wp-key=\"69ea937dd75c1\" class=\"wp-block-image alignwide size-large wp-lightbox-container\"><img loading=\"lazy\" decoding=\"async\" width=\"1024\" height=\"919\" data-wp-class--hide=\"state.isContentHidden\" data-wp-class--show=\"state.isContentVisible\" data-wp-init=\"callbacks.setButtonStyles\" data-wp-on--click=\"actions.showLightbox\" data-wp-on--load=\"callbacks.setButtonStyles\" data-wp-on-window--resize=\"callbacks.setButtonStyles\" src=\"https:\/\/www.bmscience.net\/blog\/wp-content\/uploads\/2026\/03\/Chest_radiograph_with_signs_of_congestive_heart_failure_-_annotated-1024x919.jpg\" alt=\"\" class=\"wp-image-26662\" srcset=\"https:\/\/bmscience.net\/blog\/wp-content\/uploads\/2026\/03\/Chest_radiograph_with_signs_of_congestive_heart_failure_-_annotated-1024x919.jpg 1024w, https:\/\/bmscience.net\/blog\/wp-content\/uploads\/2026\/03\/Chest_radiograph_with_signs_of_congestive_heart_failure_-_annotated-300x269.jpg 300w, https:\/\/bmscience.net\/blog\/wp-content\/uploads\/2026\/03\/Chest_radiograph_with_signs_of_congestive_heart_failure_-_annotated-768x689.jpg 768w, https:\/\/bmscience.net\/blog\/wp-content\/uploads\/2026\/03\/Chest_radiograph_with_signs_of_congestive_heart_failure_-_annotated.jpg 1222w\" sizes=\"auto, (max-width: 1024px) 100vw, 1024px\" \/><button\n\t\t\tclass=\"lightbox-trigger\"\n\t\t\ttype=\"button\"\n\t\t\taria-haspopup=\"dialog\"\n\t\t\taria-label=\"Ingrandisci\"\n\t\t\tdata-wp-init=\"callbacks.initTriggerButton\"\n\t\t\tdata-wp-on--click=\"actions.showLightbox\"\n\t\t\tdata-wp-style--right=\"state.imageButtonRight\"\n\t\t\tdata-wp-style--top=\"state.imageButtonTop\"\n\t\t>\n\t\t\t<svg xmlns=\"http:\/\/www.w3.org\/2000\/svg\" width=\"12\" height=\"12\" fill=\"none\" viewBox=\"0 0 12 12\">\n\t\t\t\t<path fill=\"#fff\" d=\"M2 0a2 2 0 0 0-2 2v2h1.5V2a.5.5 0 0 1 .5-.5h2V0H2Zm2 10.5H2a.5.5 0 0 1-.5-.5V8H0v2a2 2 0 0 0 2 2h2v-1.5ZM8 12v-1.5h2a.5.5 0 0 0 .5-.5V8H12v2a2 2 0 0 1-2 2H8Zm2-12a2 2 0 0 1 2 2v2h-1.5V2a.5.5 0 0 0-.5-.5H8V0h2Z\" \/>\n\t\t\t<\/svg>\n\t\t<\/button><\/figure>\n<\/div>\n\n\n\n<div class=\"wp-block-column is-vertically-aligned-center is-layout-flow wp-block-column-is-layout-flow\">\n<pre class=\"wp-block-verse\">Radiografia del torace che mostra un polmone con distinte <strong>linee B di Kerley <\/strong>e <strong>cardiomegalia <\/strong>(evidenziata da un aumentato rapporto cardiotoracico), <strong>cefalizzazione delle vene polmonari<\/strong> e un lieve <strong>versamento pleurico<\/strong>, visibile ad esempio nella scissura orizzontale destra. Nonostante ci\u00f2, non si osserva un evidente edema polmonare. Nel complesso, il quadro indica un'insufficienza cardiaca di gravit\u00e0 intermedia (stadio II).<\/pre>\n<\/div>\n<\/div>\n<\/div>\n\n\n\n<div class=\"wp-block-cb-slide-v2 cb-slide swiper-slide\">\n<div class=\"wp-block-columns are-vertically-aligned-center is-layout-flex wp-container-core-columns-is-layout-9d6595d7 wp-block-columns-is-layout-flex\">\n<div class=\"wp-block-column is-vertically-aligned-center is-layout-flow wp-block-column-is-layout-flow\" style=\"flex-basis:40%\">\n<figure data-wp-context=\"{&quot;imageId&quot;:&quot;69ea937dd7e5b&quot;}\" data-wp-interactive=\"core\/image\" data-wp-key=\"69ea937dd7e5b\" class=\"wp-block-image alignwide size-large wp-lightbox-container\"><img loading=\"lazy\" decoding=\"async\" width=\"932\" height=\"1024\" data-wp-class--hide=\"state.isContentHidden\" data-wp-class--show=\"state.isContentVisible\" data-wp-init=\"callbacks.setButtonStyles\" data-wp-on--click=\"actions.showLightbox\" data-wp-on--load=\"callbacks.setButtonStyles\" data-wp-on-window--resize=\"callbacks.setButtonStyles\" src=\"https:\/\/www.bmscience.net\/blog\/wp-content\/uploads\/2026\/03\/Kerley-B-Linien-932x1024.jpg\" alt=\"\" class=\"wp-image-26653\" srcset=\"https:\/\/bmscience.net\/blog\/wp-content\/uploads\/2026\/03\/Kerley-B-Linien-932x1024.jpg 932w, https:\/\/bmscience.net\/blog\/wp-content\/uploads\/2026\/03\/Kerley-B-Linien-273x300.jpg 273w, https:\/\/bmscience.net\/blog\/wp-content\/uploads\/2026\/03\/Kerley-B-Linien-768x844.jpg 768w, https:\/\/bmscience.net\/blog\/wp-content\/uploads\/2026\/03\/Kerley-B-Linien.jpg 1000w\" sizes=\"auto, (max-width: 932px) 100vw, 932px\" \/><button\n\t\t\tclass=\"lightbox-trigger\"\n\t\t\ttype=\"button\"\n\t\t\taria-haspopup=\"dialog\"\n\t\t\taria-label=\"Ingrandisci\"\n\t\t\tdata-wp-init=\"callbacks.initTriggerButton\"\n\t\t\tdata-wp-on--click=\"actions.showLightbox\"\n\t\t\tdata-wp-style--right=\"state.imageButtonRight\"\n\t\t\tdata-wp-style--top=\"state.imageButtonTop\"\n\t\t>\n\t\t\t<svg xmlns=\"http:\/\/www.w3.org\/2000\/svg\" width=\"12\" height=\"12\" fill=\"none\" viewBox=\"0 0 12 12\">\n\t\t\t\t<path fill=\"#fff\" d=\"M2 0a2 2 0 0 0-2 2v2h1.5V2a.5.5 0 0 1 .5-.5h2V0H2Zm2 10.5H2a.5.5 0 0 1-.5-.5V8H0v2a2 2 0 0 0 2 2h2v-1.5ZM8 12v-1.5h2a.5.5 0 0 0 .5-.5V8H12v2a2 2 0 0 1-2 2H8Zm2-12a2 2 0 0 1 2 2v2h-1.5V2a.5.5 0 0 0-.5-.5H8V0h2Z\" \/>\n\t\t\t<\/svg>\n\t\t<\/button><figcaption class=\"wp-element-caption\"><strong>Linee B di Kerley <\/strong>in una radiografia di scompenso cardiaco acuto. Le linee corte e orizzontali sono visibili ovunque nel polmone destro.<\/figcaption><\/figure>\n<\/div>\n\n\n\n<div class=\"wp-block-column is-vertically-aligned-center is-layout-flow wp-block-column-is-layout-flow\" style=\"flex-basis:60%\">\n<figure class=\"wp-block-image alignwide size-full\"><img loading=\"lazy\" decoding=\"async\" width=\"991\" height=\"758\" src=\"https:\/\/www.bmscience.net\/blog\/wp-content\/uploads\/2026\/03\/CHF2016.png\" alt=\"\" class=\"wp-image-26661\" srcset=\"https:\/\/bmscience.net\/blog\/wp-content\/uploads\/2026\/03\/CHF2016.png 991w, https:\/\/bmscience.net\/blog\/wp-content\/uploads\/2026\/03\/CHF2016-300x229.png 300w, https:\/\/bmscience.net\/blog\/wp-content\/uploads\/2026\/03\/CHF2016-768x587.png 768w\" sizes=\"auto, (max-width: 991px) 100vw, 991px\" \/><figcaption class=\"wp-element-caption\">Insufficienza cardiaca congestizia con piccoli <strong>versamenti bilaterali<\/strong>.<\/figcaption><\/figure>\n<\/div>\n<\/div>\n<\/div>\n\n\n\n<div class=\"wp-block-cb-slide-v2 cb-slide swiper-slide\">\n<div class=\"wp-block-columns are-vertically-aligned-center is-layout-flex wp-container-core-columns-is-layout-9d6595d7 wp-block-columns-is-layout-flex\">\n<div class=\"wp-block-column is-vertically-aligned-center is-layout-flow wp-block-column-is-layout-flow\">\n<figure data-wp-context=\"{&quot;imageId&quot;:&quot;69ea937dda480&quot;}\" data-wp-interactive=\"core\/image\" data-wp-key=\"69ea937dda480\" class=\"wp-block-image alignwide size-large wp-lightbox-container\"><img loading=\"lazy\" decoding=\"async\" width=\"1021\" height=\"1024\" data-wp-class--hide=\"state.isContentHidden\" data-wp-class--show=\"state.isContentVisible\" data-wp-init=\"callbacks.setButtonStyles\" data-wp-on--click=\"actions.showLightbox\" data-wp-on--load=\"callbacks.setButtonStyles\" data-wp-on-window--resize=\"callbacks.setButtonStyles\" src=\"https:\/\/www.bmscience.net\/blog\/wp-content\/uploads\/2026\/03\/Kerley_b_lines-1021x1024.jpg\" alt=\"\" class=\"wp-image-26663\" srcset=\"https:\/\/bmscience.net\/blog\/wp-content\/uploads\/2026\/03\/Kerley_b_lines-1021x1024.jpg 1021w, https:\/\/bmscience.net\/blog\/wp-content\/uploads\/2026\/03\/Kerley_b_lines-300x300.jpg 300w, https:\/\/bmscience.net\/blog\/wp-content\/uploads\/2026\/03\/Kerley_b_lines-150x150.jpg 150w, https:\/\/bmscience.net\/blog\/wp-content\/uploads\/2026\/03\/Kerley_b_lines-768x770.jpg 768w, https:\/\/bmscience.net\/blog\/wp-content\/uploads\/2026\/03\/Kerley_b_lines-1531x1536.jpg 1531w, https:\/\/bmscience.net\/blog\/wp-content\/uploads\/2026\/03\/Kerley_b_lines-120x120.jpg 120w, https:\/\/bmscience.net\/blog\/wp-content\/uploads\/2026\/03\/Kerley_b_lines.jpg 1891w\" sizes=\"auto, (max-width: 1021px) 100vw, 1021px\" \/><button\n\t\t\tclass=\"lightbox-trigger\"\n\t\t\ttype=\"button\"\n\t\t\taria-haspopup=\"dialog\"\n\t\t\taria-label=\"Ingrandisci\"\n\t\t\tdata-wp-init=\"callbacks.initTriggerButton\"\n\t\t\tdata-wp-on--click=\"actions.showLightbox\"\n\t\t\tdata-wp-style--right=\"state.imageButtonRight\"\n\t\t\tdata-wp-style--top=\"state.imageButtonTop\"\n\t\t>\n\t\t\t<svg xmlns=\"http:\/\/www.w3.org\/2000\/svg\" width=\"12\" height=\"12\" fill=\"none\" viewBox=\"0 0 12 12\">\n\t\t\t\t<path fill=\"#fff\" d=\"M2 0a2 2 0 0 0-2 2v2h1.5V2a.5.5 0 0 1 .5-.5h2V0H2Zm2 10.5H2a.5.5 0 0 1-.5-.5V8H0v2a2 2 0 0 0 2 2h2v-1.5ZM8 12v-1.5h2a.5.5 0 0 0 .5-.5V8H12v2a2 2 0 0 1-2 2H8Zm2-12a2 2 0 0 1 2 2v2h-1.5V2a.5.5 0 0 0-.5-.5H8V0h2Z\" \/>\n\t\t\t<\/svg>\n\t\t<\/button><figcaption class=\"wp-element-caption\">Linee B di Kerley.<\/figcaption><\/figure>\n<\/div>\n\n\n\n<div class=\"wp-block-column is-vertically-aligned-center is-layout-flow wp-block-column-is-layout-flow\"><div id=\"bmscience3270795523\" style=\"margin-top: 15px;margin-bottom: 15px;margin-left: auto;margin-right: auto;text-align: center;\"><div data-id='24174' class='amazon-auto-links aal-js-loading'><p class='now-loading-placeholder'>Caricamento....<\/p><\/div><\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div><\/div><div class=\"cb-pagination swiper-pagination\"><\/div><div class=\"cb-button-prev swiper-button-prev\"><\/div><div class=\"cb-button-next swiper-button-next\"><\/div><\/div>\n\n\n\n<p>L&#8217;ecocardiografia colordoppler \u00e8 lo strumento principe per definire la <strong>frazione di eiezione<\/strong> e le alterazioni valvolari e cardiache.<\/p>\n\n\n\n<div class=\"wp-block-columns are-vertically-aligned-center is-layout-flex wp-container-core-columns-is-layout-9d6595d7 wp-block-columns-is-layout-flex\">\n<div class=\"wp-block-column is-vertically-aligned-center is-layout-flow wp-block-column-is-layout-flow\">\n<figure data-wp-context=\"{&quot;imageId&quot;:&quot;69ea937ddaef3&quot;}\" data-wp-interactive=\"core\/image\" data-wp-key=\"69ea937ddaef3\" class=\"wp-block-image alignwide size-full wp-lightbox-container\"><img loading=\"lazy\" decoding=\"async\" width=\"490\" height=\"617\" data-wp-class--hide=\"state.isContentHidden\" data-wp-class--show=\"state.isContentVisible\" data-wp-init=\"callbacks.setButtonStyles\" data-wp-on--click=\"actions.showLightbox\" data-wp-on--load=\"callbacks.setButtonStyles\" data-wp-on-window--resize=\"callbacks.setButtonStyles\" src=\"https:\/\/www.bmscience.net\/blog\/wp-content\/uploads\/2026\/03\/nhj1612902.jpg\" alt=\"\" class=\"wp-image-26648\" srcset=\"https:\/\/bmscience.net\/blog\/wp-content\/uploads\/2026\/03\/nhj1612902.jpg 490w, https:\/\/bmscience.net\/blog\/wp-content\/uploads\/2026\/03\/nhj1612902-238x300.jpg 238w\" sizes=\"auto, (max-width: 490px) 100vw, 490px\" \/><button\n\t\t\tclass=\"lightbox-trigger\"\n\t\t\ttype=\"button\"\n\t\t\taria-haspopup=\"dialog\"\n\t\t\taria-label=\"Ingrandisci\"\n\t\t\tdata-wp-init=\"callbacks.initTriggerButton\"\n\t\t\tdata-wp-on--click=\"actions.showLightbox\"\n\t\t\tdata-wp-style--right=\"state.imageButtonRight\"\n\t\t\tdata-wp-style--top=\"state.imageButtonTop\"\n\t\t>\n\t\t\t<svg xmlns=\"http:\/\/www.w3.org\/2000\/svg\" width=\"12\" height=\"12\" fill=\"none\" viewBox=\"0 0 12 12\">\n\t\t\t\t<path fill=\"#fff\" d=\"M2 0a2 2 0 0 0-2 2v2h1.5V2a.5.5 0 0 1 .5-.5h2V0H2Zm2 10.5H2a.5.5 0 0 1-.5-.5V8H0v2a2 2 0 0 0 2 2h2v-1.5ZM8 12v-1.5h2a.5.5 0 0 0 .5-.5V8H12v2a2 2 0 0 1-2 2H8Zm2-12a2 2 0 0 1 2 2v2h-1.5V2a.5.5 0 0 0-.5-.5H8V0h2Z\" \/>\n\t\t\t<\/svg>\n\t\t<\/button><figcaption class=\"wp-element-caption\">Ecografia che mostra un&#8217;ipertrofia concentrica del cuore.<\/figcaption><\/figure>\n<\/div>\n\n\n\n<div class=\"wp-block-column is-vertically-aligned-center is-layout-flow wp-block-column-is-layout-flow\">\n<figure data-wp-context=\"{&quot;imageId&quot;:&quot;69ea937ddb454&quot;}\" data-wp-interactive=\"core\/image\" data-wp-key=\"69ea937ddb454\" class=\"wp-block-image alignwide size-full wp-lightbox-container\"><img loading=\"lazy\" decoding=\"async\" width=\"489\" height=\"615\" data-wp-class--hide=\"state.isContentHidden\" data-wp-class--show=\"state.isContentVisible\" data-wp-init=\"callbacks.setButtonStyles\" data-wp-on--click=\"actions.showLightbox\" data-wp-on--load=\"callbacks.setButtonStyles\" data-wp-on-window--resize=\"callbacks.setButtonStyles\" src=\"https:\/\/www.bmscience.net\/blog\/wp-content\/uploads\/2026\/03\/nhj1612903.jpg\" alt=\"\" class=\"wp-image-26649\" srcset=\"https:\/\/bmscience.net\/blog\/wp-content\/uploads\/2026\/03\/nhj1612903.jpg 489w, https:\/\/bmscience.net\/blog\/wp-content\/uploads\/2026\/03\/nhj1612903-239x300.jpg 239w\" sizes=\"auto, (max-width: 489px) 100vw, 489px\" \/><button\n\t\t\tclass=\"lightbox-trigger\"\n\t\t\ttype=\"button\"\n\t\t\taria-haspopup=\"dialog\"\n\t\t\taria-label=\"Ingrandisci\"\n\t\t\tdata-wp-init=\"callbacks.initTriggerButton\"\n\t\t\tdata-wp-on--click=\"actions.showLightbox\"\n\t\t\tdata-wp-style--right=\"state.imageButtonRight\"\n\t\t\tdata-wp-style--top=\"state.imageButtonTop\"\n\t\t>\n\t\t\t<svg xmlns=\"http:\/\/www.w3.org\/2000\/svg\" width=\"12\" height=\"12\" fill=\"none\" viewBox=\"0 0 12 12\">\n\t\t\t\t<path fill=\"#fff\" d=\"M2 0a2 2 0 0 0-2 2v2h1.5V2a.5.5 0 0 1 .5-.5h2V0H2Zm2 10.5H2a.5.5 0 0 1-.5-.5V8H0v2a2 2 0 0 0 2 2h2v-1.5ZM8 12v-1.5h2a.5.5 0 0 0 .5-.5V8H12v2a2 2 0 0 1-2 2H8Zm2-12a2 2 0 0 1 2 2v2h-1.5V2a.5.5 0 0 0-.5-.5H8V0h2Z\" \/>\n\t\t\t<\/svg>\n\t\t<\/button><figcaption class=\"wp-element-caption\">Ecografia che mostra un&#8217;ipertrofia eccentrica del cuore.<\/figcaption><\/figure>\n<\/div>\n<\/div>\n\n\n\n<div class=\"wp-block-cb-carousel-v2 cb-carousel-block\" data-cb-slides-per-view=\"1\" data-cb-slides-per-group=\"1\" data-cb-space-between=\"15\" data-cb-speed=\"300\" data-cb-navigation=\"true\" data-cb-pagination=\"true\" data-cb-breakpoints=\"{&quot;768&quot;:{&quot;slidesPerView&quot;:2,&quot;slidesPerGroup&quot;:1}}\"><div class=\"swiper\"><div class=\"cb-wrapper swiper-wrapper\">\n<div class=\"wp-block-cb-slide-v2 cb-slide swiper-slide\">\n<figure class=\"wp-block-video alignwide\"><video height=\"360\" style=\"aspect-ratio: 606 \/ 360;\" width=\"606\" controls src=\"https:\/\/www.bmscience.net\/blog\/wp-content\/uploads\/2026\/03\/UOTW_48_-_Ultrasound_of_the_Week_1.webm.360p.webm\"><\/video><figcaption class=\"wp-element-caption\">Ecografia che mostra una grave insufficienza cardiaca sistolica.<\/figcaption><\/figure>\n<\/div>\n\n\n\n<div class=\"wp-block-cb-slide-v2 cb-slide swiper-slide\">\n<figure class=\"wp-block-video alignwide\"><video height=\"360\" style=\"aspect-ratio: 606 \/ 360;\" width=\"606\" controls src=\"https:\/\/www.bmscience.net\/blog\/wp-content\/uploads\/2026\/03\/UOTW_48_-_Ultrasound_of_the_Week_2.webm.360p.webm\"><\/video><figcaption class=\"wp-element-caption\">Ecografia che mostra una grave insufficienza cardiaca sistolica.<\/figcaption><\/figure>\n<\/div>\n\n\n\n<div class=\"wp-block-cb-slide-v2 cb-slide swiper-slide\">\n<figure class=\"wp-block-video alignwide\"><video height=\"360\" style=\"aspect-ratio: 606 \/ 360;\" width=\"606\" controls src=\"https:\/\/www.bmscience.net\/blog\/wp-content\/uploads\/2026\/03\/UOTW_48_-_Ultrasound_of_the_Week_3.webm.360p.webm\"><\/video><figcaption class=\"wp-element-caption\">Ecografia polmonare che mostra edema dovuto a grave insufficienza cardiaca sistolica.<\/figcaption><\/figure>\n<\/div>\n\n\n\n<div class=\"wp-block-cb-slide-v2 cb-slide swiper-slide\">\n<figure class=\"wp-block-video alignwide\"><video height=\"360\" style=\"aspect-ratio: 606 \/ 360;\" width=\"606\" controls src=\"https:\/\/www.bmscience.net\/blog\/wp-content\/uploads\/2026\/03\/UOTW_48_-_Ultrasound_of_the_Week_4.webm.360p.webm\"><\/video><figcaption class=\"wp-element-caption\">Ecocardiogramma con evidenza di grave insufficienza cardiaca sistolica.<\/figcaption><\/figure>\n<\/div>\n\n\n\n<div class=\"wp-block-cb-slide-v2 cb-slide swiper-slide\">\n<figure data-wp-context=\"{&quot;imageId&quot;:&quot;69ea937ddc48e&quot;}\" data-wp-interactive=\"core\/image\" data-wp-key=\"69ea937ddc48e\" class=\"wp-block-image alignwide size-full wp-lightbox-container\"><img loading=\"lazy\" decoding=\"async\" width=\"792\" height=\"470\" data-wp-class--hide=\"state.isContentHidden\" data-wp-class--show=\"state.isContentVisible\" data-wp-init=\"callbacks.setButtonStyles\" data-wp-on--click=\"actions.showLightbox\" data-wp-on--load=\"callbacks.setButtonStyles\" data-wp-on-window--resize=\"callbacks.setButtonStyles\" src=\"https:\/\/www.bmscience.net\/blog\/wp-content\/uploads\/2026\/03\/UOTW_48_-_Ultrasound_of_the_Week_5.jpg\" alt=\"\" class=\"wp-image-26659\" srcset=\"https:\/\/bmscience.net\/blog\/wp-content\/uploads\/2026\/03\/UOTW_48_-_Ultrasound_of_the_Week_5.jpg 792w, https:\/\/bmscience.net\/blog\/wp-content\/uploads\/2026\/03\/UOTW_48_-_Ultrasound_of_the_Week_5-300x178.jpg 300w, https:\/\/bmscience.net\/blog\/wp-content\/uploads\/2026\/03\/UOTW_48_-_Ultrasound_of_the_Week_5-768x456.jpg 768w\" sizes=\"auto, (max-width: 792px) 100vw, 792px\" \/><button\n\t\t\tclass=\"lightbox-trigger\"\n\t\t\ttype=\"button\"\n\t\t\taria-haspopup=\"dialog\"\n\t\t\taria-label=\"Ingrandisci\"\n\t\t\tdata-wp-init=\"callbacks.initTriggerButton\"\n\t\t\tdata-wp-on--click=\"actions.showLightbox\"\n\t\t\tdata-wp-style--right=\"state.imageButtonRight\"\n\t\t\tdata-wp-style--top=\"state.imageButtonTop\"\n\t\t>\n\t\t\t<svg xmlns=\"http:\/\/www.w3.org\/2000\/svg\" width=\"12\" height=\"12\" fill=\"none\" viewBox=\"0 0 12 12\">\n\t\t\t\t<path fill=\"#fff\" d=\"M2 0a2 2 0 0 0-2 2v2h1.5V2a.5.5 0 0 1 .5-.5h2V0H2Zm2 10.5H2a.5.5 0 0 1-.5-.5V8H0v2a2 2 0 0 0 2 2h2v-1.5ZM8 12v-1.5h2a.5.5 0 0 0 .5-.5V8H12v2a2 2 0 0 1-2 2H8Zm2-12a2 2 0 0 1 2 2v2h-1.5V2a.5.5 0 0 0-.5-.5H8V0h2Z\" \/>\n\t\t\t<\/svg>\n\t\t<\/button><figcaption class=\"wp-element-caption\">Ecocardiogramma con evidenza di grave insufficienza cardiaca sistolica.<\/figcaption><\/figure>\n<\/div>\n<\/div><\/div><div class=\"cb-pagination swiper-pagination\"><\/div><div class=\"cb-button-prev swiper-button-prev\"><\/div><div class=\"cb-button-next swiper-button-next\"><\/div><\/div>\n\n\n\n<p>L&#8217;elettrocardiogramma (ECG) \u00e8 utile per identificare cause scatenanti come <strong>fibrillazione atriale<\/strong> o pregresso <strong>infarto<\/strong>.<\/p>\n\n\n<div id=\"bmscience1785020685\" style=\"margin-top: 15px;margin-bottom: 15px;margin-left: auto;margin-right: auto;text-align: center;\"><a href=\"https:\/\/amzn.to\/3GHddMe\" target=\"_blank\" aria-label=\"71UL81bNiZL._SX3000_\"><img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/bmscience.net\/blog\/wp-content\/uploads\/2025\/05\/71UL81bNiZL._SX3000_.jpg\" alt=\"\"  srcset=\"https:\/\/bmscience.net\/blog\/wp-content\/uploads\/2025\/05\/71UL81bNiZL._SX3000_.jpg 2111w, https:\/\/bmscience.net\/blog\/wp-content\/uploads\/2025\/05\/71UL81bNiZL._SX3000_-300x72.jpg 300w, https:\/\/bmscience.net\/blog\/wp-content\/uploads\/2025\/05\/71UL81bNiZL._SX3000_-1024x245.jpg 1024w, https:\/\/bmscience.net\/blog\/wp-content\/uploads\/2025\/05\/71UL81bNiZL._SX3000_-768x184.jpg 768w, https:\/\/bmscience.net\/blog\/wp-content\/uploads\/2025\/05\/71UL81bNiZL._SX3000_-1536x368.jpg 1536w, https:\/\/bmscience.net\/blog\/wp-content\/uploads\/2025\/05\/71UL81bNiZL._SX3000_-2048x491.jpg 2048w\" sizes=\"auto, (max-width: 2111px) 100vw, 2111px\" width=\"2111\" height=\"506\"  style=\"display: inline-block;\" \/><\/a><\/div>\n\n\n<h2 class=\"wp-block-heading\" id=\"terapia-dello-scompenso-cardiaco-cronico-e81a2cd9-d868-434e-96b0-9b5559b1f544\"><span class=\"ez-toc-section\" id=\"Terapia_dello_scompenso_cardiaco_cronico\"><\/span>Terapia dello scompenso cardiaco cronico<span class=\"ez-toc-section-end\"><\/span><\/h2>\n\n\n\n<p>Il trattamento si \u00e8 evoluto verso una quadrupla terapia fondamentale per i pazienti HFrEF.<\/p>\n\n\n\n<h3 class=\"wp-block-heading\" id=\"trattamento-farmacologico-della-hfref-c35ae534-f6ed-4e69-a403-424c4ebcd275\"><span class=\"ez-toc-section\" id=\"Trattamento_farmacologico_della_HFrEF\"><\/span>Trattamento farmacologico della HFrEF<span class=\"ez-toc-section-end\"><\/span><\/h3>\n\n\n\n<p>Le linee guida ESC 2021 e l&#8217;aggiornamento 2023 pongono i seguenti farmaci come <span style=\"text-decoration: underline;\">Classe I<\/span>:<\/p>\n\n\n\n<ol class=\"wp-block-list\">\n<li><strong>ARNI (Sacubitril\/Valsartan)<\/strong>: raccomandato come sostituto di ACE-inibitori o sartani per ridurre ulteriormente mortalit\u00e0 e ospedalizzazioni;<\/li>\n\n\n\n<li><strong>beta-bloccanti<\/strong>: fondamentali per bloccare l&#8217;iperattivit\u00e0 simpatica. Devono essere iniziati a dosi basse e titolati lentamente;<\/li>\n\n\n\n<li><strong>antagonisti dei mineralocorticoidi (MRA)<\/strong>: spironolattone o eplerenone, essenziali per contrastare la fibrosi;<\/li>\n\n\n\n<li><strong>gliflozine (SGLT2i)<\/strong>: dapagliflozin o empagliflozin. Hanno rivoluzionato la terapia riducendo il rischio di morte cardiovascolare indipendentemente dalla presenza di diabete.<\/li>\n<\/ol>\n\n\n\n<p>Altri farmaci includono l&#8217;<strong>ivabradina<\/strong> (per frequenza&nbsp;&gt;70&nbsp;bpm), la <strong>digossina <\/strong>(per controllo della fibrillazione atriale o sintomi refrattari) e i <strong>diuretici <\/strong>per la gestione dei liquidi.<\/p>\n\n\n\n<h3 class=\"wp-block-heading\" id=\"terapia-per-hfmref-e-hfpef-4f7664e9-8c6d-4a68-86eb-cc97085fd376\"><span class=\"ez-toc-section\" id=\"Terapia_per_HFmrEF_e_HFpEF\"><\/span>Terapia per HFmrEF e HFpEF<span class=\"ez-toc-section-end\"><\/span><\/h3>\n\n\n\n<p>Recentemente, gli <strong>SGLT2i <\/strong>hanno ricevuto una raccomandazione di Classe I anche per HFmrEF e HFpEF, diventando la prima terapia a dimostrare un beneficio chiaro in queste popolazioni. Per le altre classi di farmaci, i dati sono meno robusti (<span style=\"text-decoration: underline;\">Classe IIb<\/span>).<\/p>\n\n\n\n<h3 class=\"wp-block-heading\" id=\"prevenzione-della-morte-improvvisa-e-crt-76e0f4ab-2a06-42e4-9c96-c0458783c067\"><span class=\"ez-toc-section\" id=\"Prevenzione_della_morte_improvvisa_e_CRT\"><\/span>Prevenzione della morte improvvisa e CRT<span class=\"ez-toc-section-end\"><\/span><\/h3>\n\n\n\n<p>L&#8217;impianto di un <strong>defibrillatore automatico<\/strong> (<strong>ICD<\/strong>) \u00e8 indicato in prevenzione primaria se LVEF&nbsp;\u226435%&nbsp;nonostante terapia medica ottimale.<\/p>\n\n\n\n<p>La terapia di <strong>resincronizzazione cardiaca <\/strong>(<strong>CRT<\/strong>) \u00e8 invece indicata in pazienti con LVEF ridotta e blocco di branca sinistra (QRS largo) per migliorare la coordinazione della contrazione ventricolare.<\/p>\n\n\n<div id=\"bmscience120225861\" style=\"margin-top: 15px;margin-bottom: 15px;margin-left: auto;margin-right: auto;text-align: center;\"><a href=\"https:\/\/amzn.to\/4kHiMcL\" target=\"_blank\" aria-label=\"IT_Main_Banner_FamilyFavourites\"><img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/bmscience.net\/blog\/wp-content\/uploads\/2025\/06\/IT_Main_Banner_FamilyFavourites-scaled.jpg\" alt=\"\"  srcset=\"https:\/\/bmscience.net\/blog\/wp-content\/uploads\/2025\/06\/IT_Main_Banner_FamilyFavourites-scaled.jpg 2560w, https:\/\/bmscience.net\/blog\/wp-content\/uploads\/2025\/06\/IT_Main_Banner_FamilyFavourites-300x40.jpg 300w, https:\/\/bmscience.net\/blog\/wp-content\/uploads\/2025\/06\/IT_Main_Banner_FamilyFavourites-1024x137.jpg 1024w, https:\/\/bmscience.net\/blog\/wp-content\/uploads\/2025\/06\/IT_Main_Banner_FamilyFavourites-768x102.jpg 768w, https:\/\/bmscience.net\/blog\/wp-content\/uploads\/2025\/06\/IT_Main_Banner_FamilyFavourites-1536x205.jpg 1536w, https:\/\/bmscience.net\/blog\/wp-content\/uploads\/2025\/06\/IT_Main_Banner_FamilyFavourites-2048x273.jpg 2048w\" sizes=\"auto, (max-width: 2560px) 100vw, 2560px\" width=\"2560\" height=\"341\"  style=\"display: inline-block;\" \/><\/a><\/div>\n\n\n<h2 class=\"wp-block-heading\" id=\"gestione-dellinsufficienza-cardiaca-acuta-grave-b34d57f0-9259-46b7-9261-f79c4ca5a0a3\"><span class=\"ez-toc-section\" id=\"Gestione_dellinsufficienza_cardiaca_acuta_grave\"><\/span>Gestione dell&#8217;insufficienza cardiaca acuta grave<span class=\"ez-toc-section-end\"><\/span><\/h2>\n\n\n\n<p>In fase acuta, l&#8217;obiettivo \u00e8 la stabilizzazione emodinamica e il sollievo dei sintomi.<\/p>\n\n\n\n<h3 class=\"wp-block-heading\" id=\"trattamento-delledema-polmonare-acuto-e-dello-shock-cardiogeno-d7d456ef-4884-44db-924b-f88a9893f0f9\"><span class=\"ez-toc-section\" id=\"Trattamento_delledema_polmonare_acuto_e_dello_Shock_Cardiogeno\"><\/span>Trattamento dell&#8217;edema polmonare acuto e dello Shock Cardiogeno<span class=\"ez-toc-section-end\"><\/span><\/h3>\n\n\n\n<p>Si basa sull&#8217;uso di <strong>ossigeno <\/strong>(anche tramite ventilazione non invasiva), <strong>furosemide <\/strong>endovena e <strong>vasodilatatori <\/strong>(nitroglicerina) se la pressione arteriosa \u00e8 preservata<sup data-fn=\"1bcd33ac-dd8c-41d8-acbe-0a2ee9bb0cf6\" class=\"fn\"><a href=\"#1bcd33ac-dd8c-41d8-acbe-0a2ee9bb0cf6\" id=\"1bcd33ac-dd8c-41d8-acbe-0a2ee9bb0cf6-link\">18<\/a><\/sup>. Nello shock cardiogeno, sono necessari farmaci inotropi:<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong>dobutamina<\/strong>: agonista beta-1, aumenta la portata ma anche il consumo di ossigeno;<\/li>\n\n\n\n<li><strong>milrinone<\/strong>: inibitore della fosfodiesterasi, utile in pazienti gi\u00e0 trattati con beta-bloccanti;<\/li>\n\n\n\n<li><strong>levosimendan<\/strong>: sensibilizzante al calcio, migliora la gittata senza aumentare il calcio intracellulare, riducendo il rischio di aritmie rispetto alle amine.<sup data-fn=\"fe40625a-fd4a-4588-8116-5ab15a0a3f40\" class=\"fn\"><a href=\"#fe40625a-fd4a-4588-8116-5ab15a0a3f40\" id=\"fe40625a-fd4a-4588-8116-5ab15a0a3f40-link\">19<\/a><\/sup><\/li>\n<\/ul>\n\n\n\n<h3 class=\"wp-block-heading\" id=\"supporto-meccanico-iabp-e-vad-e8ef7da2-0cc1-4fd5-96f6-619bd40b4169\"><span class=\"ez-toc-section\" id=\"Supporto_meccanico_IABP_e_VAD\"><\/span>Supporto meccanico: IABP e VAD<span class=\"ez-toc-section-end\"><\/span><\/h3>\n\n\n<div class=\"wp-block-image\">\n<figure class=\"alignright size-full is-resized\"><img loading=\"lazy\" decoding=\"async\" width=\"637\" height=\"418\" src=\"https:\/\/www.bmscience.net\/blog\/wp-content\/uploads\/2026\/03\/image-54.png\" alt=\"\" class=\"wp-image-26642\" style=\"aspect-ratio:1.5240168730439516;width:363px;height:auto\" srcset=\"https:\/\/bmscience.net\/blog\/wp-content\/uploads\/2026\/03\/image-54.png 637w, https:\/\/bmscience.net\/blog\/wp-content\/uploads\/2026\/03\/image-54-300x197.png 300w\" sizes=\"auto, (max-width: 637px) 100vw, 637px\" \/><figcaption class=\"wp-element-caption\">Dispositivo di assistenza ventricolare impiantato come terapia di destino.<\/figcaption><\/figure>\n<\/div>\n\n\n<p>Il <strong>contropulsatore aortico<\/strong> (IABP) \u00e8 un supporto temporaneo che riduce il postcarico e aumenta la perfusione coronarica. I <strong>dispositivi di assistenza ventricolare<\/strong> (<strong>VAD<\/strong>) sono invece pompe meccaniche a lungo termine utilizzate come<sup data-fn=\"ed214ce3-3dcb-490f-8601-65bc3d4a75ae\" class=\"fn\"><a href=\"#ed214ce3-3dcb-490f-8601-65bc3d4a75ae\" id=\"ed214ce3-3dcb-490f-8601-65bc3d4a75ae-link\">20<\/a><\/sup>:<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong><em>bridge to transplant<\/em> (BTT)<\/strong>: ponte al trapianto;<\/li>\n\n\n\n<li><strong><em>bridge to decision<\/em> (BTD)<\/strong>: ponte alla decisione terapeutica;<\/li>\n\n\n\n<li><strong><em>destination therapy<\/em> (DT)<\/strong>: terapia definitiva per chi non pu\u00f2 ricevere un trapianto.<sup data-fn=\"3f47439f-0e59-45ee-8b06-974da97426a7\" class=\"fn\"><a href=\"#3f47439f-0e59-45ee-8b06-974da97426a7\" id=\"3f47439f-0e59-45ee-8b06-974da97426a7-link\">21<\/a><\/sup><\/li>\n<\/ul>\n\n\n<div id=\"bmscience1618425796\" style=\"margin-left: auto;margin-right: auto;text-align: center;\"><div data-id='24153' class='amazon-auto-links aal-js-loading'><p class='now-loading-placeholder'>Caricamento&#8230;<\/p><\/div>\r\n\r\n<\/div>\n\n\n<h2 class=\"wp-block-heading\" id=\"trapianto-cardiaco-786c4004-28ae-477b-809c-b651c1e6f6ee\"><span class=\"ez-toc-section\" id=\"Trapianto_cardiaco\"><\/span>Trapianto cardiaco<span class=\"ez-toc-section-end\"><\/span><\/h2>\n\n\n<div class=\"wp-block-image\">\n<figure class=\"alignright size-full is-resized\"><a href=\"https:\/\/amzn.to\/3tRFEkx\" target=\"_blank\" rel=\"noreferrer noopener\"><img loading=\"lazy\" decoding=\"async\" width=\"564\" height=\"796\" src=\"https:\/\/www.bmscience.net\/blog\/wp-content\/uploads\/2024\/01\/51MPtNov9IL.jpg\" alt=\"\" class=\"wp-image-21732\" style=\"width:162px;height:auto\" srcset=\"https:\/\/bmscience.net\/blog\/wp-content\/uploads\/2024\/01\/51MPtNov9IL.jpg 564w, https:\/\/bmscience.net\/blog\/wp-content\/uploads\/2024\/01\/51MPtNov9IL-213x300.jpg 213w\" sizes=\"auto, (max-width: 564px) 100vw, 564px\" \/><\/a><figcaption class=\"wp-element-caption\"><strong><a href=\"https:\/\/amzn.to\/3tRFEkx\" target=\"_blank\" rel=\"noreferrer noopener\">Acquista ora<\/a><\/strong><\/figcaption><\/figure>\n<\/div>\n\n\n<p>Il trapianto rimane l&#8217;opzione definitiva per l&#8217;insufficienza terminale (<strong>Stadio D<\/strong>).<\/p>\n\n\n\n<p>Le <span style=\"text-decoration: underline;\">indicazioni<\/span> principali sono lo <strong>shock cardiogeno refrattario<\/strong>, la dipendenza da inotropi e un&nbsp;<em>VO<\/em><sub>2<\/sub>\u200b&nbsp;max&nbsp;&lt;12&nbsp;ml\/kg\/min.<br>Le <span style=\"text-decoration: underline;\">controindicazioni assolute<\/span> includono l&#8217;ipertensione polmonare fissa, neoplasie attive e infezioni sistemiche non controllate.<sup data-fn=\"f1335052-a639-4146-a76b-2dfa468d52ea\" class=\"fn\"><a href=\"#f1335052-a639-4146-a76b-2dfa468d52ea\" id=\"f1335052-a639-4146-a76b-2dfa468d52ea-link\">22<\/a><\/sup><\/p>\n\n\n\n<p>Le principali sfide includono il <strong>rigetto acuto e cronico<\/strong>, le <strong>infezioni <\/strong>(specialmente CMV) e la <strong>vasculopatia del <\/strong><em><strong>graft<\/strong> <\/em>(CAV).<sup data-fn=\"67e23e76-7c3a-4fbe-bf6e-30e4165037d3\" class=\"fn\"><a href=\"#67e23e76-7c3a-4fbe-bf6e-30e4165037d3\" id=\"67e23e76-7c3a-4fbe-bf6e-30e4165037d3-link\">23<\/a><\/sup><br>La CAV \u00e8 una forma accelerata di aterosclerosi che colpisce le coronarie del cuore trapiantato, rappresentando la principale causa di fallimento dell&#8217;organo a lungo termine.<\/p>\n\n\n\n<blockquote class=\"wp-block-quote is-layout-flow wp-block-quote-is-layout-flow\">\n<p>Fonte: <a href=\"https:\/\/amzn.to\/3tRFEkx\" target=\"_blank\" rel=\"noreferrer noopener\">Manuale di cardiologia, chirurgia vascolare e cardiochirurgia. Concorso Nazionale SSM<\/a>.<\/p>\n<\/blockquote>\n\n\n<div id=\"bmscience2320215486\" style=\"margin-top: 15px;margin-left: 15px;float: right;\"><div style=\"\r\n  width: 200px;\r\n  margin: 0 auto;\r\n  text-align: center;\r\n\">\r\n<div data-id='24153' class='amazon-auto-links aal-js-loading'><p class='now-loading-placeholder'>Caricamento&#8230;<\/p><\/div><\/div><\/div>\n\n\n<blockquote class=\"wp-block-quote is-layout-flow wp-block-quote-is-layout-flow\">\n<p>Altre fonti:<\/p>\n\n\n<ol class=\"wp-block-footnotes\"><li id=\"7edcea64-6f6d-4cf9-9bd3-2718cd33a30e\"><a href=\"https:\/\/pmc.ncbi.nlm.nih.gov\/articles\/PMC10192289\/\">ACC\/AHA\/HFSA 2022 and ESC 2021 guidelines on heart failure comparison &#8211; PMC<\/a> <a href=\"#7edcea64-6f6d-4cf9-9bd3-2718cd33a30e-link\" aria-label=\"Salta al riferimento nella nota a pi\u00e8 di pagina 1\">\u21a9\ufe0e<\/a><\/li><li id=\"3bba1f73-9944-4da3-a416-6238558666e8\"><a href=\"https:\/\/pmc.ncbi.nlm.nih.gov\/articles\/PMC11562572\/\">The 2023 ESC heart failure guideline update and its implications for clinical practice &#8211; PMC<\/a> <a href=\"#3bba1f73-9944-4da3-a416-6238558666e8-link\" aria-label=\"Salta al riferimento nella nota a pi\u00e8 di pagina 2\">\u21a9\ufe0e<\/a><\/li><li id=\"24033538-dce4-48ac-a21f-480593aa2d31\"><a href=\"https:\/\/www.cfrjournal.com\/articles\/history-heart-failure-definition?language_content_entity=en\">History of Heart Failure Definition &#8211; Cardiac Failure Review<\/a> <a href=\"#24033538-dce4-48ac-a21f-480593aa2d31-link\" aria-label=\"Salta al riferimento nella nota a pi\u00e8 di pagina 3\">\u21a9\ufe0e<\/a><\/li><li id=\"fd0e75ab-589f-48ca-aecf-69b0a307b6b9\"><a href=\"https:\/\/pressbooks.lib.vt.edu\/cardiovascularpathophysiology\/chapter\/chapter-2-heart-failure\/\">Heart Failure \u2013 Cardiovascular Pathophysiology for Pre-Clinical Students<\/a> <a href=\"#fd0e75ab-589f-48ca-aecf-69b0a307b6b9-link\" aria-label=\"Salta al riferimento nella nota a pi\u00e8 di pagina 4\">\u21a9\ufe0e<\/a><\/li><li id=\"8d69f451-2f18-4f89-bcbc-f90a203cb0e8\"><a href=\"https:\/\/pmc.ncbi.nlm.nih.gov\/articles\/PMC9553007\/\">Edema formation in congestive heart failure and the underlying mechanisms &#8211; PMC &#8211; NIH<\/a> <a href=\"#8d69f451-2f18-4f89-bcbc-f90a203cb0e8-link\" aria-label=\"Salta al riferimento nella nota a pi\u00e8 di pagina 5\">\u21a9\ufe0e<\/a><\/li><li id=\"7858a89a-9d0d-4a3f-a465-38470a061394\"><a href=\"https:\/\/pmc.ncbi.nlm.nih.gov\/articles\/PMC2300466\/\">Cardiac remodelling: concentric versus eccentric hypertrophy in strength and endurance athletes &#8211; PMC<\/a> <a href=\"#7858a89a-9d0d-4a3f-a465-38470a061394-link\" aria-label=\"Salta al riferimento nella nota a pi\u00e8 di pagina 6\">\u21a9\ufe0e<\/a><\/li><li id=\"55970946-624a-421c-a327-14f486f8e1ea\"><a href=\"https:\/\/www.ecrjournal.com\/articles\/alcohol-and-heart-failure?language_content_entity=en\">Alcohol and Heart Failure | ECR Journal &#8211; European Cardiology Review<\/a> <a href=\"#55970946-624a-421c-a327-14f486f8e1ea-link\" aria-label=\"Salta al riferimento nella nota a pi\u00e8 di pagina 7\">\u21a9\ufe0e<\/a><\/li><li id=\"843fe78f-33f4-4a28-8b1a-84f383739baf\"><a href=\"https:\/\/en.wikipedia.org\/wiki\/Heart_failure\">Heart failure &#8211; Wikipedia<\/a> <a href=\"#843fe78f-33f4-4a28-8b1a-84f383739baf-link\" aria-label=\"Salta al riferimento nella nota a pi\u00e8 di pagina 8\">\u21a9\ufe0e<\/a><\/li><li id=\"278d6357-5117-434e-8684-22290d8aa34c\"><a href=\"https:\/\/www.cms.gov\/medicare-coverage-database\/view\/ncacal-decision-memo.aspx?proposed=N&amp;NCAId=268%0A%0A\">Ventricular Assist Devices for Bridge-to-Transplant and Destination Therapy (CAG-00432R) &#8211; Decision Memo &#8211; CMS<\/a> <a href=\"#278d6357-5117-434e-8684-22290d8aa34c-link\" aria-label=\"Salta al riferimento nella nota a pi\u00e8 di pagina 9\">\u21a9\ufe0e<\/a><\/li><li id=\"d396e279-4133-444b-99fa-92da61d53078\"><a href=\"https:\/\/www.escardio.org\/communities\/councils\/cardiology-practice\/education\/cardiopractice\/strategies-for-risk-stratification-and-cardiovascular-toxicity-prevention-in-pat\/\">Strategies for risk stratification and cardiovascular toxicity prevention in patients with cancer<\/a> <a href=\"#d396e279-4133-444b-99fa-92da61d53078-link\" aria-label=\"Salta al riferimento nella nota a pi\u00e8 di pagina 10\">\u21a9\ufe0e<\/a><\/li><li id=\"7184c758-a3a7-467a-a402-a2cbb77d48c6\"><a href=\"https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK459390\/\">Physiology, Starling Relationships &#8211; StatPearls &#8211; NCBI Bookshelf<\/a> <a href=\"#7184c758-a3a7-467a-a402-a2cbb77d48c6-link\" aria-label=\"Salta al riferimento nella nota a pi\u00e8 di pagina 11\">\u21a9\ufe0e<\/a><\/li><li id=\"b4b698fc-1817-4c70-85c7-ea78b7dee721\"><a href=\"https:\/\/www.cfrjournal.com\/articles\/pathophysiology-congestion-heart-failure-contemporary-review?language_content_entity=en\">Pathophysiology of Congestion in Heart Failure: A Contemporary Review<\/a> <a href=\"#b4b698fc-1817-4c70-85c7-ea78b7dee721-link\" aria-label=\"Salta al riferimento nella nota a pi\u00e8 di pagina 12\">\u21a9\ufe0e<\/a><\/li><li id=\"917c343b-5d3f-4eb0-bcbd-35a1917e2bfa\"><a href=\"https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK560738\/\">Oliguria &#8211; StatPearls &#8211; NCBI Bookshelf &#8211; NIH<\/a> <a href=\"#917c343b-5d3f-4eb0-bcbd-35a1917e2bfa-link\" aria-label=\"Salta al riferimento nella nota a pi\u00e8 di pagina 13\">\u21a9\ufe0e<\/a><\/li><li id=\"6539cd9d-7835-4d6b-a5c7-5067c956e81e\"><a href=\"https:\/\/en.wikipedia.org\/wiki\/Cheyne%E2%80%93Stokes_respiration\">Cheyne\u2013Stokes respiration &#8211; Wikipedia<\/a> <a href=\"#6539cd9d-7835-4d6b-a5c7-5067c956e81e-link\" aria-label=\"Salta al riferimento nella nota a pi\u00e8 di pagina 14\">\u21a9\ufe0e<\/a><\/li><li id=\"d3d21180-feb5-4e0b-970b-d03db2faa3ab\"><a href=\"https:\/\/en.wikipedia.org\/wiki\/Fourth_heart_sound\">Fourth heart sound &#8211; Wikipedia<\/a> <a href=\"#d3d21180-feb5-4e0b-970b-d03db2faa3ab-link\" aria-label=\"Salta al riferimento nella nota a pi\u00e8 di pagina 15\">\u21a9\ufe0e<\/a><\/li><li id=\"ea0fe43a-ca72-4169-b30a-6738c0e91167\"><a href=\"https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK542305\/\">Cardiorenal Syndrome &#8211; StatPearls &#8211; NCBI Bookshelf<\/a> <a href=\"#ea0fe43a-ca72-4169-b30a-6738c0e91167-link\" aria-label=\"Salta al riferimento nella nota a pi\u00e8 di pagina 16\">\u21a9\ufe0e<\/a><\/li><li id=\"3841d17e-6378-4b93-be20-49919115aeeb\"><a href=\"https:\/\/pmc.ncbi.nlm.nih.gov\/articles\/PMC3756692\/\">The epidemiology of congestive heart failure: the Framingham Heart Study perspective &#8211; PMC<\/a> <a href=\"#3841d17e-6378-4b93-be20-49919115aeeb-link\" aria-label=\"Salta al riferimento nella nota a pi\u00e8 di pagina 17\">\u21a9\ufe0e<\/a><\/li><li id=\"1bcd33ac-dd8c-41d8-acbe-0a2ee9bb0cf6\"><a href=\"https:\/\/pmc.ncbi.nlm.nih.gov\/articles\/PMC6288642\/\">Use of levosimendan in acute heart failure &#8211; PMC &#8211; NIH<\/a> <a href=\"#1bcd33ac-dd8c-41d8-acbe-0a2ee9bb0cf6-link\" aria-label=\"Salta al riferimento nella nota a pi\u00e8 di pagina 18\">\u21a9\ufe0e<\/a><\/li><li id=\"fe40625a-fd4a-4588-8116-5ab15a0a3f40\"><a href=\"https:\/\/pmc.ncbi.nlm.nih.gov\/articles\/PMC12889367\/\">Comparative safety and efficacy of levosimendan versus dobutamine in acute heart failure: a systematic review, meta-analysis, and meta-regression &#8211; PMC<\/a> <a href=\"#fe40625a-fd4a-4588-8116-5ab15a0a3f40-link\" aria-label=\"Salta al riferimento nella nota a pi\u00e8 di pagina 19\">\u21a9\ufe0e<\/a><\/li><li id=\"ed214ce3-3dcb-490f-8601-65bc3d4a75ae\"><a href=\"https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK542233\/\">Intra-Aortic Balloon Pump &#8211; StatPearls &#8211; NCBI Bookshelf &#8211; NIH<\/a> <a href=\"#ed214ce3-3dcb-490f-8601-65bc3d4a75ae-link\" aria-label=\"Salta al riferimento nella nota a pi\u00e8 di pagina 20\">\u21a9\ufe0e<\/a><\/li><li id=\"3f47439f-0e59-45ee-8b06-974da97426a7\"><a href=\"https:\/\/pmc.ncbi.nlm.nih.gov\/articles\/PMC8503528\/\">Implantable ventricular assistance systems (VAD) as a bridge to transplant or as &#8216;destination therapy&#8217; &#8211; PMC<\/a> <a href=\"#3f47439f-0e59-45ee-8b06-974da97426a7-link\" aria-label=\"Salta al riferimento nella nota a pi\u00e8 di pagina 21\">\u21a9\ufe0e<\/a><\/li><li id=\"f1335052-a639-4146-a76b-2dfa468d52ea\"><a href=\"https:\/\/pmc.ncbi.nlm.nih.gov\/articles\/PMC2266869\/\">Guidelines for heart transplantation &#8211; PMC &#8211; NIH<\/a> <a href=\"#f1335052-a639-4146-a76b-2dfa468d52ea-link\" aria-label=\"Salta al riferimento nella nota a pi\u00e8 di pagina 22\">\u21a9\ufe0e<\/a><\/li><li id=\"67e23e76-7c3a-4fbe-bf6e-30e4165037d3\"><a href=\"https:\/\/pmc.ncbi.nlm.nih.gov\/articles\/PMC4735534\/\">Risk factors of cardiac allograft vasculopathy &#8211; PMC &#8211; NIH<\/a> <a href=\"#67e23e76-7c3a-4fbe-bf6e-30e4165037d3-link\" aria-label=\"Salta al riferimento nella nota a pi\u00e8 di pagina 23\">\u21a9\ufe0e<\/a><\/li><\/ol><\/blockquote>\n\n\n<div id=\"bmscience2798033185\" style=\"margin-top: 15px;margin-bottom: 15px;margin-left: auto;margin-right: auto;text-align: center;\"><a href=\"https:\/\/amzn.to\/3YYbWWZ\" target=\"_blank\" aria-label=\"Italian_Header_Banner_-_John._CB1751449782_\"><img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/bmscience.net\/blog\/wp-content\/uploads\/2026\/01\/Italian_Header_Banner_-_John._CB1751449782_.png\" alt=\"\"  srcset=\"https:\/\/bmscience.net\/blog\/wp-content\/uploads\/2026\/01\/Italian_Header_Banner_-_John._CB1751449782_.png 1782w, https:\/\/bmscience.net\/blog\/wp-content\/uploads\/2026\/01\/Italian_Header_Banner_-_John._CB1751449782_-300x41.png 300w, https:\/\/bmscience.net\/blog\/wp-content\/uploads\/2026\/01\/Italian_Header_Banner_-_John._CB1751449782_-1024x139.png 1024w, https:\/\/bmscience.net\/blog\/wp-content\/uploads\/2026\/01\/Italian_Header_Banner_-_John._CB1751449782_-768x104.png 768w, https:\/\/bmscience.net\/blog\/wp-content\/uploads\/2026\/01\/Italian_Header_Banner_-_John._CB1751449782_-1536x209.png 1536w\" sizes=\"auto, (max-width: 1782px) 100vw, 1782px\" width=\"1782\" height=\"242\"  style=\"display: inline-block;\" \/><\/a><\/div>","protected":false},"excerpt":{"rendered":"<p>L\u2019insufficienza cardiaca non rappresenta una singola entit\u00e0 nosologica, bens\u00ec una sindrome clinica complessa e progressiva, caratterizzata da una costellazione di sintomi e segni derivanti da un\u2019anomalia strutturale o funzionale della pompa cardiaca. Tale condizione determina l\u2019incapacit\u00e0 del cuore di espellere una quantit\u00e0 di sangue adeguata alle richieste metaboliche dei tessuti o, se ci\u00f2 avviene, solo&hellip;<\/p>\n<p class=\"more\"><a class=\"more-link\" href=\"https:\/\/bmscience.net\/blog\/linsufficienza-cardiaca-inquadramento-clinico-fisiopatologico-e-terapeutico\/\">Continue reading <span class=\"screen-reader-text\">L&#8217;insufficienza cardiaca: inquadramento clinico, fisiopatologico e terapeutico<\/span><\/a><\/p>\n","protected":false},"author":4,"featured_media":26644,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"advgb_blocks_editor_width":"","advgb_blocks_columns_visual_guide":"","footnotes":"[{\"content\":\"<a href=\\\"https:\/\/pmc.ncbi.nlm.nih.gov\/articles\/PMC10192289\/\\\">ACC\/AHA\/HFSA 2022 and ESC 2021 guidelines on heart failure comparison - PMC<\/a>\",\"id\":\"7edcea64-6f6d-4cf9-9bd3-2718cd33a30e\"},{\"content\":\"<a href=\\\"https:\/\/pmc.ncbi.nlm.nih.gov\/articles\/PMC11562572\/\\\">The 2023 ESC heart failure guideline update and its implications for clinical practice - PMC<\/a>\",\"id\":\"3bba1f73-9944-4da3-a416-6238558666e8\"},{\"content\":\"<a href=\\\"https:\/\/www.cfrjournal.com\/articles\/history-heart-failure-definition?language_content_entity=en\\\">History of Heart Failure Definition - Cardiac Failure Review<\/a>\",\"id\":\"24033538-dce4-48ac-a21f-480593aa2d31\"},{\"content\":\"<a href=\\\"https:\/\/pressbooks.lib.vt.edu\/cardiovascularpathophysiology\/chapter\/chapter-2-heart-failure\/\\\">Heart Failure \u2013 Cardiovascular Pathophysiology for Pre-Clinical Students<\/a>\",\"id\":\"fd0e75ab-589f-48ca-aecf-69b0a307b6b9\"},{\"content\":\"<a href=\\\"https:\/\/pmc.ncbi.nlm.nih.gov\/articles\/PMC9553007\/\\\">Edema formation in congestive heart failure and the underlying mechanisms - PMC - NIH<\/a>\",\"id\":\"8d69f451-2f18-4f89-bcbc-f90a203cb0e8\"},{\"content\":\"<a href=\\\"https:\/\/pmc.ncbi.nlm.nih.gov\/articles\/PMC2300466\/\\\">Cardiac remodelling: concentric versus eccentric hypertrophy in strength and endurance athletes - PMC<\/a>\",\"id\":\"7858a89a-9d0d-4a3f-a465-38470a061394\"},{\"content\":\"<a href=\\\"https:\/\/www.ecrjournal.com\/articles\/alcohol-and-heart-failure?language_content_entity=en\\\">Alcohol and Heart Failure | ECR Journal - European Cardiology Review<\/a>\",\"id\":\"55970946-624a-421c-a327-14f486f8e1ea\"},{\"content\":\"<a href=\\\"https:\/\/en.wikipedia.org\/wiki\/Heart_failure\\\">Heart failure - Wikipedia<\/a>\",\"id\":\"843fe78f-33f4-4a28-8b1a-84f383739baf\"},{\"content\":\"<a href=\\\"https:\/\/www.cms.gov\/medicare-coverage-database\/view\/ncacal-decision-memo.aspx?proposed=N&amp;NCAId=268%0A%0A\\\">Ventricular Assist Devices for Bridge-to-Transplant and Destination Therapy (CAG-00432R) - Decision Memo - CMS<\/a>\",\"id\":\"278d6357-5117-434e-8684-22290d8aa34c\"},{\"content\":\"<a href=\\\"https:\/\/www.escardio.org\/communities\/councils\/cardiology-practice\/education\/cardiopractice\/strategies-for-risk-stratification-and-cardiovascular-toxicity-prevention-in-pat\/\\\">Strategies for risk stratification and cardiovascular toxicity prevention in patients with cancer<\/a>\",\"id\":\"d396e279-4133-444b-99fa-92da61d53078\"},{\"content\":\"<a href=\\\"https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK459390\/\\\">Physiology, Starling Relationships - StatPearls - NCBI Bookshelf<\/a>\",\"id\":\"7184c758-a3a7-467a-a402-a2cbb77d48c6\"},{\"content\":\"<a href=\\\"https:\/\/www.cfrjournal.com\/articles\/pathophysiology-congestion-heart-failure-contemporary-review?language_content_entity=en\\\">Pathophysiology of Congestion in Heart Failure: A Contemporary Review<\/a>\",\"id\":\"b4b698fc-1817-4c70-85c7-ea78b7dee721\"},{\"content\":\"<a href=\\\"https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK560738\/\\\">Oliguria - StatPearls - NCBI Bookshelf - NIH<\/a>\",\"id\":\"917c343b-5d3f-4eb0-bcbd-35a1917e2bfa\"},{\"content\":\"<a href=\\\"https:\/\/en.wikipedia.org\/wiki\/Cheyne%E2%80%93Stokes_respiration\\\">Cheyne\u2013Stokes respiration - Wikipedia<\/a>\",\"id\":\"6539cd9d-7835-4d6b-a5c7-5067c956e81e\"},{\"content\":\"<a href=\\\"https:\/\/en.wikipedia.org\/wiki\/Fourth_heart_sound\\\">Fourth heart sound - Wikipedia<\/a>\",\"id\":\"d3d21180-feb5-4e0b-970b-d03db2faa3ab\"},{\"content\":\"<a href=\\\"https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK542305\/\\\">Cardiorenal Syndrome - StatPearls - NCBI Bookshelf<\/a>\",\"id\":\"ea0fe43a-ca72-4169-b30a-6738c0e91167\"},{\"content\":\"<a href=\\\"https:\/\/pmc.ncbi.nlm.nih.gov\/articles\/PMC3756692\/\\\">The epidemiology of congestive heart failure: the Framingham Heart Study perspective - PMC<\/a>\",\"id\":\"3841d17e-6378-4b93-be20-49919115aeeb\"},{\"content\":\"<a href=\\\"https:\/\/pmc.ncbi.nlm.nih.gov\/articles\/PMC6288642\/\\\">Use of levosimendan in acute heart failure - PMC - NIH<\/a>\",\"id\":\"1bcd33ac-dd8c-41d8-acbe-0a2ee9bb0cf6\"},{\"content\":\"<a href=\\\"https:\/\/pmc.ncbi.nlm.nih.gov\/articles\/PMC12889367\/\\\">Comparative safety and efficacy of levosimendan versus dobutamine in acute heart failure: a systematic review, meta-analysis, and meta-regression - PMC<\/a>\",\"id\":\"fe40625a-fd4a-4588-8116-5ab15a0a3f40\"},{\"content\":\"<a href=\\\"https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK542233\/\\\">Intra-Aortic Balloon Pump - StatPearls - NCBI Bookshelf - NIH<\/a>\",\"id\":\"ed214ce3-3dcb-490f-8601-65bc3d4a75ae\"},{\"content\":\"<a href=\\\"https:\/\/pmc.ncbi.nlm.nih.gov\/articles\/PMC8503528\/\\\">Implantable ventricular assistance systems (VAD) as a bridge to transplant or as 'destination therapy' - PMC<\/a>\",\"id\":\"3f47439f-0e59-45ee-8b06-974da97426a7\"},{\"content\":\"<a href=\\\"https:\/\/pmc.ncbi.nlm.nih.gov\/articles\/PMC2266869\/\\\">Guidelines for heart transplantation - PMC - NIH<\/a>\",\"id\":\"f1335052-a639-4146-a76b-2dfa468d52ea\"},{\"content\":\"<a href=\\\"https:\/\/pmc.ncbi.nlm.nih.gov\/articles\/PMC4735534\/\\\">Risk factors of cardiac allograft vasculopathy - PMC - NIH<\/a>\",\"id\":\"67e23e76-7c3a-4fbe-bf6e-30e4165037d3\"}]"},"categories":[48],"tags":[9334,12200,12205,11250,9012,11744,12193,9141,8488,10658,12221,12226,12204,12225,9137,9563,10584,12192,12211,2384,12227,2451,9568,12213,12215,2814,3148,12208,9139,12197,12195,12196,12194,12229,12202,3972,12203,12198,4114,12209,12210,9136,4369,12218,12223,12207,9567,12216,11745,12212,5434,12222,9216,12206,12219,12201,12199,12220,12224,12217,9138,7079,7621,12214,12228],"class_list":["post-26631","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-cardiologia","tag-ace-inibitori","tag-anterograda","tag-antracicline","tag-ascite","tag-beta-bloccanti","tag-bnp","tag-cardiomiopatia-alcolica","tag-cardiopatia-ischemica","tag-congestione-polmonare","tag-contropulsatore-aortico","tag-criteri-di-framingham","tag-crt","tag-ctr-cvt","tag-defibrillatore-automatico","tag-diastole","tag-digossina","tag-dilatazione-ventricolare","tag-disfunzione-cardiaca","tag-dispnea-da-sforzo","tag-dispnea-parossistica-notturna","tag-dispositivi-di-assistenza-ventricolare","tag-diuretici","tag-dobutamina","tag-edema-polmonare-acuto","tag-edemi-periferici","tag-epatomegalia","tag-fibrosi","tag-frank-starling","tag-frazione-di-eiezione","tag-hfimpef","tag-hfmref","tag-hfpef","tag-hfref","tag-iabp","tag-insufficienza-anterograda","tag-insufficienza-cardiaca","tag-insufficienza-retrograda","tag-insufficienza-sinistra","tag-ipertrofia","tag-ipertrofia-concentrica","tag-ipertrofia-eccentrica","tag-ivabradina","tag-legge-di-laplace","tag-letargia","tag-linee-di-kerley-b","tag-meccanismi-di-compenso","tag-milrinone","tag-nicturia-notturna","tag-nt-probnp","tag-ortopnea","tag-ossigeno","tag-peptidi-natriuretici","tag-polso-alternante","tag-punteggio-hfa-icos","tag-respiro-di-cheyne-stokes","tag-retrograda","tag-riduzione-della-perfusione-sistemica","tag-ritmo-di-galoppo","tag-sglt2i","tag-sindrome-cardiorenale","tag-sistole","tag-spironolattone","tag-trastuzumab","tag-turgore-giugulare","tag-vad","entry"],"author_meta":{"display_name":"Raffo Coco","author_link":"https:\/\/bmscience.net\/blog\/author\/raffo\/"},"featured_img":"https:\/\/bmscience.net\/blog\/wp-content\/uploads\/2026\/03\/insufficienza-cardiaca-300x167.png","coauthors":[],"tax_additional":{"categories":{"linked":["<a href=\"https:\/\/bmscience.net\/blog\/category\/medicina\/cardiologia\/\" class=\"advgb-post-tax-term\">Cardiologia<\/a>"],"unlinked":["<span class=\"advgb-post-tax-term\">Cardiologia<\/span>"]},"tags":{"linked":["<a href=\"https:\/\/bmscience.net\/blog\/category\/medicina\/cardiologia\/\" class=\"advgb-post-tax-term\">ACE-inibitori<\/a>","<a href=\"https:\/\/bmscience.net\/blog\/category\/medicina\/cardiologia\/\" class=\"advgb-post-tax-term\">anterograda<\/a>","<a href=\"https:\/\/bmscience.net\/blog\/category\/medicina\/cardiologia\/\" class=\"advgb-post-tax-term\">antracicline<\/a>","<a href=\"https:\/\/bmscience.net\/blog\/category\/medicina\/cardiologia\/\" class=\"advgb-post-tax-term\">Ascite<\/a>","<a href=\"https:\/\/bmscience.net\/blog\/category\/medicina\/cardiologia\/\" class=\"advgb-post-tax-term\">beta-bloccanti<\/a>","<a href=\"https:\/\/bmscience.net\/blog\/category\/medicina\/cardiologia\/\" class=\"advgb-post-tax-term\">BNP<\/a>","<a href=\"https:\/\/bmscience.net\/blog\/category\/medicina\/cardiologia\/\" class=\"advgb-post-tax-term\">cardiomiopatia alcolica<\/a>","<a href=\"https:\/\/bmscience.net\/blog\/category\/medicina\/cardiologia\/\" class=\"advgb-post-tax-term\">cardiopatia ischemica<\/a>","<a href=\"https:\/\/bmscience.net\/blog\/category\/medicina\/cardiologia\/\" class=\"advgb-post-tax-term\">congestione polmonare<\/a>","<a href=\"https:\/\/bmscience.net\/blog\/category\/medicina\/cardiologia\/\" class=\"advgb-post-tax-term\">Contropulsatore aortico<\/a>","<a href=\"https:\/\/bmscience.net\/blog\/category\/medicina\/cardiologia\/\" class=\"advgb-post-tax-term\">Criteri di Framingham<\/a>","<a href=\"https:\/\/bmscience.net\/blog\/category\/medicina\/cardiologia\/\" class=\"advgb-post-tax-term\">CRT<\/a>","<a href=\"https:\/\/bmscience.net\/blog\/category\/medicina\/cardiologia\/\" class=\"advgb-post-tax-term\">CTR-CVT<\/a>","<a href=\"https:\/\/bmscience.net\/blog\/category\/medicina\/cardiologia\/\" class=\"advgb-post-tax-term\">Defibrillatore Automatico<\/a>","<a href=\"https:\/\/bmscience.net\/blog\/category\/medicina\/cardiologia\/\" class=\"advgb-post-tax-term\">diastole<\/a>","<a href=\"https:\/\/bmscience.net\/blog\/category\/medicina\/cardiologia\/\" class=\"advgb-post-tax-term\">digossina<\/a>","<a href=\"https:\/\/bmscience.net\/blog\/category\/medicina\/cardiologia\/\" class=\"advgb-post-tax-term\">dilatazione ventricolare<\/a>","<a href=\"https:\/\/bmscience.net\/blog\/category\/medicina\/cardiologia\/\" class=\"advgb-post-tax-term\">disfunzione cardiaca<\/a>","<a href=\"https:\/\/bmscience.net\/blog\/category\/medicina\/cardiologia\/\" class=\"advgb-post-tax-term\">dispnea da sforzo<\/a>","<a href=\"https:\/\/bmscience.net\/blog\/category\/medicina\/cardiologia\/\" class=\"advgb-post-tax-term\">dispnea parossistica notturna<\/a>","<a href=\"https:\/\/bmscience.net\/blog\/category\/medicina\/cardiologia\/\" class=\"advgb-post-tax-term\">dispositivi di assistenza ventricolare<\/a>","<a href=\"https:\/\/bmscience.net\/blog\/category\/medicina\/cardiologia\/\" class=\"advgb-post-tax-term\">diuretici<\/a>","<a href=\"https:\/\/bmscience.net\/blog\/category\/medicina\/cardiologia\/\" class=\"advgb-post-tax-term\">dobutamina<\/a>","<a href=\"https:\/\/bmscience.net\/blog\/category\/medicina\/cardiologia\/\" class=\"advgb-post-tax-term\">edema polmonare acuto<\/a>","<a href=\"https:\/\/bmscience.net\/blog\/category\/medicina\/cardiologia\/\" class=\"advgb-post-tax-term\">edemi periferici<\/a>","<a href=\"https:\/\/bmscience.net\/blog\/category\/medicina\/cardiologia\/\" class=\"advgb-post-tax-term\">epatomegalia<\/a>","<a href=\"https:\/\/bmscience.net\/blog\/category\/medicina\/cardiologia\/\" class=\"advgb-post-tax-term\">fibrosi<\/a>","<a href=\"https:\/\/bmscience.net\/blog\/category\/medicina\/cardiologia\/\" class=\"advgb-post-tax-term\">Frank-Starling<\/a>","<a href=\"https:\/\/bmscience.net\/blog\/category\/medicina\/cardiologia\/\" class=\"advgb-post-tax-term\">frazione di eiezione<\/a>","<a href=\"https:\/\/bmscience.net\/blog\/category\/medicina\/cardiologia\/\" class=\"advgb-post-tax-term\">HFimpEF<\/a>","<a href=\"https:\/\/bmscience.net\/blog\/category\/medicina\/cardiologia\/\" class=\"advgb-post-tax-term\">HFmrEF<\/a>","<a href=\"https:\/\/bmscience.net\/blog\/category\/medicina\/cardiologia\/\" class=\"advgb-post-tax-term\">HFpEF<\/a>","<a href=\"https:\/\/bmscience.net\/blog\/category\/medicina\/cardiologia\/\" class=\"advgb-post-tax-term\">HFrEF<\/a>","<a href=\"https:\/\/bmscience.net\/blog\/category\/medicina\/cardiologia\/\" class=\"advgb-post-tax-term\">IABP<\/a>","<a href=\"https:\/\/bmscience.net\/blog\/category\/medicina\/cardiologia\/\" class=\"advgb-post-tax-term\">insufficienza anterograda<\/a>","<a href=\"https:\/\/bmscience.net\/blog\/category\/medicina\/cardiologia\/\" class=\"advgb-post-tax-term\">insufficienza cardiaca<\/a>","<a href=\"https:\/\/bmscience.net\/blog\/category\/medicina\/cardiologia\/\" class=\"advgb-post-tax-term\">insufficienza retrograda<\/a>","<a href=\"https:\/\/bmscience.net\/blog\/category\/medicina\/cardiologia\/\" class=\"advgb-post-tax-term\">insufficienza sinistra<\/a>","<a href=\"https:\/\/bmscience.net\/blog\/category\/medicina\/cardiologia\/\" class=\"advgb-post-tax-term\">ipertrofia<\/a>","<a href=\"https:\/\/bmscience.net\/blog\/category\/medicina\/cardiologia\/\" class=\"advgb-post-tax-term\">ipertrofia concentrica<\/a>","<a href=\"https:\/\/bmscience.net\/blog\/category\/medicina\/cardiologia\/\" class=\"advgb-post-tax-term\">ipertrofia eccentrica<\/a>","<a href=\"https:\/\/bmscience.net\/blog\/category\/medicina\/cardiologia\/\" class=\"advgb-post-tax-term\">ivabradina<\/a>","<a href=\"https:\/\/bmscience.net\/blog\/category\/medicina\/cardiologia\/\" class=\"advgb-post-tax-term\">legge di Laplace<\/a>","<a href=\"https:\/\/bmscience.net\/blog\/category\/medicina\/cardiologia\/\" class=\"advgb-post-tax-term\">letargia<\/a>","<a href=\"https:\/\/bmscience.net\/blog\/category\/medicina\/cardiologia\/\" class=\"advgb-post-tax-term\">linee di Kerley B<\/a>","<a href=\"https:\/\/bmscience.net\/blog\/category\/medicina\/cardiologia\/\" class=\"advgb-post-tax-term\">meccanismi di compenso<\/a>","<a href=\"https:\/\/bmscience.net\/blog\/category\/medicina\/cardiologia\/\" class=\"advgb-post-tax-term\">Milrinone<\/a>","<a href=\"https:\/\/bmscience.net\/blog\/category\/medicina\/cardiologia\/\" class=\"advgb-post-tax-term\">nicturia notturna<\/a>","<a href=\"https:\/\/bmscience.net\/blog\/category\/medicina\/cardiologia\/\" class=\"advgb-post-tax-term\">NT-proBNP<\/a>","<a href=\"https:\/\/bmscience.net\/blog\/category\/medicina\/cardiologia\/\" class=\"advgb-post-tax-term\">ortopnea<\/a>","<a href=\"https:\/\/bmscience.net\/blog\/category\/medicina\/cardiologia\/\" class=\"advgb-post-tax-term\">ossigeno<\/a>","<a href=\"https:\/\/bmscience.net\/blog\/category\/medicina\/cardiologia\/\" class=\"advgb-post-tax-term\">peptidi natriuretici<\/a>","<a href=\"https:\/\/bmscience.net\/blog\/category\/medicina\/cardiologia\/\" class=\"advgb-post-tax-term\">polso alternante<\/a>","<a href=\"https:\/\/bmscience.net\/blog\/category\/medicina\/cardiologia\/\" class=\"advgb-post-tax-term\">punteggio HFA-ICOS<\/a>","<a href=\"https:\/\/bmscience.net\/blog\/category\/medicina\/cardiologia\/\" class=\"advgb-post-tax-term\">respiro di Cheyne-Stokes<\/a>","<a href=\"https:\/\/bmscience.net\/blog\/category\/medicina\/cardiologia\/\" class=\"advgb-post-tax-term\">retrograda<\/a>","<a href=\"https:\/\/bmscience.net\/blog\/category\/medicina\/cardiologia\/\" class=\"advgb-post-tax-term\">riduzione della perfusione sistemica<\/a>","<a href=\"https:\/\/bmscience.net\/blog\/category\/medicina\/cardiologia\/\" class=\"advgb-post-tax-term\">ritmo di galoppo<\/a>","<a href=\"https:\/\/bmscience.net\/blog\/category\/medicina\/cardiologia\/\" class=\"advgb-post-tax-term\">SGLT2i<\/a>","<a href=\"https:\/\/bmscience.net\/blog\/category\/medicina\/cardiologia\/\" class=\"advgb-post-tax-term\">sindrome cardiorenale<\/a>","<a href=\"https:\/\/bmscience.net\/blog\/category\/medicina\/cardiologia\/\" class=\"advgb-post-tax-term\">sistole<\/a>","<a href=\"https:\/\/bmscience.net\/blog\/category\/medicina\/cardiologia\/\" class=\"advgb-post-tax-term\">spironolattone<\/a>","<a href=\"https:\/\/bmscience.net\/blog\/category\/medicina\/cardiologia\/\" class=\"advgb-post-tax-term\">trastuzumab<\/a>","<a href=\"https:\/\/bmscience.net\/blog\/category\/medicina\/cardiologia\/\" class=\"advgb-post-tax-term\">turgore giugulare<\/a>","<a href=\"https:\/\/bmscience.net\/blog\/category\/medicina\/cardiologia\/\" class=\"advgb-post-tax-term\">VAD<\/a>"],"unlinked":["<span class=\"advgb-post-tax-term\">ACE-inibitori<\/span>","<span class=\"advgb-post-tax-term\">anterograda<\/span>","<span class=\"advgb-post-tax-term\">antracicline<\/span>","<span class=\"advgb-post-tax-term\">Ascite<\/span>","<span class=\"advgb-post-tax-term\">beta-bloccanti<\/span>","<span class=\"advgb-post-tax-term\">BNP<\/span>","<span class=\"advgb-post-tax-term\">cardiomiopatia alcolica<\/span>","<span class=\"advgb-post-tax-term\">cardiopatia ischemica<\/span>","<span class=\"advgb-post-tax-term\">congestione polmonare<\/span>","<span class=\"advgb-post-tax-term\">Contropulsatore aortico<\/span>","<span class=\"advgb-post-tax-term\">Criteri di Framingham<\/span>","<span class=\"advgb-post-tax-term\">CRT<\/span>","<span class=\"advgb-post-tax-term\">CTR-CVT<\/span>","<span class=\"advgb-post-tax-term\">Defibrillatore Automatico<\/span>","<span class=\"advgb-post-tax-term\">diastole<\/span>","<span class=\"advgb-post-tax-term\">digossina<\/span>","<span class=\"advgb-post-tax-term\">dilatazione ventricolare<\/span>","<span class=\"advgb-post-tax-term\">disfunzione cardiaca<\/span>","<span class=\"advgb-post-tax-term\">dispnea da sforzo<\/span>","<span class=\"advgb-post-tax-term\">dispnea parossistica notturna<\/span>","<span class=\"advgb-post-tax-term\">dispositivi di assistenza ventricolare<\/span>","<span class=\"advgb-post-tax-term\">diuretici<\/span>","<span class=\"advgb-post-tax-term\">dobutamina<\/span>","<span class=\"advgb-post-tax-term\">edema polmonare acuto<\/span>","<span class=\"advgb-post-tax-term\">edemi periferici<\/span>","<span class=\"advgb-post-tax-term\">epatomegalia<\/span>","<span class=\"advgb-post-tax-term\">fibrosi<\/span>","<span class=\"advgb-post-tax-term\">Frank-Starling<\/span>","<span class=\"advgb-post-tax-term\">frazione di eiezione<\/span>","<span class=\"advgb-post-tax-term\">HFimpEF<\/span>","<span class=\"advgb-post-tax-term\">HFmrEF<\/span>","<span class=\"advgb-post-tax-term\">HFpEF<\/span>","<span class=\"advgb-post-tax-term\">HFrEF<\/span>","<span class=\"advgb-post-tax-term\">IABP<\/span>","<span class=\"advgb-post-tax-term\">insufficienza anterograda<\/span>","<span class=\"advgb-post-tax-term\">insufficienza cardiaca<\/span>","<span class=\"advgb-post-tax-term\">insufficienza retrograda<\/span>","<span class=\"advgb-post-tax-term\">insufficienza sinistra<\/span>","<span class=\"advgb-post-tax-term\">ipertrofia<\/span>","<span class=\"advgb-post-tax-term\">ipertrofia concentrica<\/span>","<span class=\"advgb-post-tax-term\">ipertrofia eccentrica<\/span>","<span class=\"advgb-post-tax-term\">ivabradina<\/span>","<span class=\"advgb-post-tax-term\">legge di Laplace<\/span>","<span class=\"advgb-post-tax-term\">letargia<\/span>","<span class=\"advgb-post-tax-term\">linee di Kerley B<\/span>","<span class=\"advgb-post-tax-term\">meccanismi di compenso<\/span>","<span class=\"advgb-post-tax-term\">Milrinone<\/span>","<span class=\"advgb-post-tax-term\">nicturia notturna<\/span>","<span class=\"advgb-post-tax-term\">NT-proBNP<\/span>","<span class=\"advgb-post-tax-term\">ortopnea<\/span>","<span class=\"advgb-post-tax-term\">ossigeno<\/span>","<span class=\"advgb-post-tax-term\">peptidi natriuretici<\/span>","<span class=\"advgb-post-tax-term\">polso alternante<\/span>","<span class=\"advgb-post-tax-term\">punteggio HFA-ICOS<\/span>","<span class=\"advgb-post-tax-term\">respiro di Cheyne-Stokes<\/span>","<span class=\"advgb-post-tax-term\">retrograda<\/span>","<span class=\"advgb-post-tax-term\">riduzione della perfusione sistemica<\/span>","<span class=\"advgb-post-tax-term\">ritmo di galoppo<\/span>","<span class=\"advgb-post-tax-term\">SGLT2i<\/span>","<span class=\"advgb-post-tax-term\">sindrome cardiorenale<\/span>","<span class=\"advgb-post-tax-term\">sistole<\/span>","<span class=\"advgb-post-tax-term\">spironolattone<\/span>","<span class=\"advgb-post-tax-term\">trastuzumab<\/span>","<span class=\"advgb-post-tax-term\">turgore giugulare<\/span>","<span class=\"advgb-post-tax-term\">VAD<\/span>"]}},"comment_count":"0","relative_dates":{"created":"Pubblicato 2 mesi fa","modified":"Aggiornato 2 mesi fa"},"absolute_dates":{"created":"Pubblicato il 08\/03\/2026","modified":"Aggiornato il 08\/03\/2026"},"absolute_dates_time":{"created":"Pubblicato il 08\/03\/2026 19:43","modified":"Aggiornato il 08\/03\/2026 19:43"},"featured_img_caption":"","series_order":"","_links":{"self":[{"href":"https:\/\/bmscience.net\/blog\/wp-json\/wp\/v2\/posts\/26631","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/bmscience.net\/blog\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/bmscience.net\/blog\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/bmscience.net\/blog\/wp-json\/wp\/v2\/users\/4"}],"replies":[{"embeddable":true,"href":"https:\/\/bmscience.net\/blog\/wp-json\/wp\/v2\/comments?post=26631"}],"version-history":[{"count":15,"href":"https:\/\/bmscience.net\/blog\/wp-json\/wp\/v2\/posts\/26631\/revisions"}],"predecessor-version":[{"id":26671,"href":"https:\/\/bmscience.net\/blog\/wp-json\/wp\/v2\/posts\/26631\/revisions\/26671"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/bmscience.net\/blog\/wp-json\/wp\/v2\/media\/26644"}],"wp:attachment":[{"href":"https:\/\/bmscience.net\/blog\/wp-json\/wp\/v2\/media?parent=26631"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/bmscience.net\/blog\/wp-json\/wp\/v2\/categories?post=26631"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/bmscience.net\/blog\/wp-json\/wp\/v2\/tags?post=26631"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}