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Publications

English Abstract Journal Article Ppublish

PubMed: 42345057 DOI: 10.1714/4722.47390

[Green paper ANMCO: Environmental sustainability in cardiology: a shared commitment of healthcare professionals].

G Ital Cardiol (Rome) 27(7):505-517

Authors: Simona Giubilato, Stefania Angela Di Fusco, Simone Cappannelli, Vered Gil Ad, Roberta Rossini, Sara Doimo, Roberta Della Bona, Carlotta Sorini-Dini, Antonio Di Monaco, Filippo Zilio, Nicola Gasparetto, Laura Gatto, Francesco Amico, Maurizio Giuseppe Abrignani, Attilio Iacovoni, Carmine Riccio, Claudio Bilato, Fabiana Lucà, Pietro Scicchitano, Andrea Di Lenarda, Eugenio Picano, Giovanna Geraci, Leonardo De Luca, Michele Massimo Gulizia, Furio Colivicchi, Domenico Gabrielli, Fabrizio Oliva, Federico Nardi, Massimo Grimaldi

Affiliations

  • U.O.C. di UTIC con Cardiologia ed Emodinamica, AOE Cannizzaro, Catania.
  • U.O.C. Cardiologia Clinica e Riabilitativa, Presidio Ospedaliero San Filippo Neri - ASL Roma 1, Roma.
  • U.O. di UTIC e Cardiologia, Ospedale Gubbio-Gualdo Tadino, Gubbio (PG).
  • U.O. Cardiologia, Dipartimento Cardio-Toraco-Vascolare (DICATOV), Ospedale Policlinico San Martino IRCCS - IRCCS Cardiovascular Network, Genova.
  • U.O.C. Cardiologia, Azienda Ospedaliera Santa Croce e Carle, Cuneo.
  • S.O.C. Cardiologia, Ospedale di Pordenone, Pordenone.
  • U.O.C. Cardiologia Clinico-Chirurgica-UTIC, Azienda Ospedaliero-Universitaria Senese - Ospedale Santa Maria alle Scotte, Siena.
  • U.O.C. Cardiologia, Ospedale Miulli, Acquaviva delle Fonti (BA).
  • U.O. Cardiologia, Ospedale Santa Chiara, APSS Trento.
  • U.O.C. Cardiologia, Ospedale Ca' Foncello, Treviso.
  • Dipartimento Cardiovascolare, Azienda Ospedaliera San Giovanni Addolorata, Roma.
  • U.O.C. Cardiologia e UTIC, Presidio Ospedaliero P. Borsellino, Marsala, ASP Trapani.
  • SSD Chirurgia dei Trapianti e del Trattamento Chirurgico dello Scompenso, Dipartimento Cardiovascolare, ASST Papa Giovanni XXIII, Bergamo.
  • U.O.S.D. Follow-up del Paziente Post-Acuto, Dipartimento Cardio-Vascolare, AORN Sant'Anna e San Sebastiano, Caserta.
  • U.O.C. Cardiologia, Ospedali dell'Ovest Vicentino, Azienda ULSS 8 Berica, Vicenza.
  • U.O.C. Cardiologia-UTIC, Grande Ospedale Metropolitano GOM, Reggio Calabria.
  • U.O. Cardiologia-UTIC, Ospedale "F. Perinei", Altamura (BA).
  • S.C. Patologie Cardiovascolari, Dipartimento Specialistico Territoriale, Azienda Sanitaria Universitaria Giuliano Isontina-ASUGI, Trieste.
  • Cardiology Clinic, University Center Serbia, Medical School, University Clinical Center Serbia, University of Belgrade, Belgrado, Serbia.
  • U.O. Cardiologia, Ospedale San Antonio Abate, ASP Trapani, Erice (TP).
  • S.C. Cardiologia, Dipartimento Cardio-Toraco-Vascolare, Fondazione IRCCS Policlinico San Matteo, Pavia.
  • U.O.C. Cardiologia, Ospedale Garibaldi-Nesima, Azienda di Rilievo Nazionale e Alta Specializzazione "Garibaldi", Catania.
  • U.O.C. Cardiologia, Dipartimento di Scienze Cardio-Toraco-Vascolari, Azienda Ospedaliera San Camillo Forlanini, Roma - Fondazione per il Tuo cuore - Heart Care Foundation, Firenze.
  • Cardiologia 1-Emodinamica, Dipartimento Cardiotoracovascolare "A. De Gasperis", ASST Grande Ospedale Metropolitano Niguarda, Milano.
  • Dipartimento di Cardiologia, Ospedale Santo Spirito, Casale Monferrato (AL).
  • U.O.C. Cardiologia, Ospedale Miulli, Acquaviva delle Fonti (BA) - Associazione Nazionale Medici Cardiologi Ospedalieri (ANMCO), Firenze.

Abstract

Environmental sustainability represents an emerging priority for cardiology, owing to the close interconnection between planetary health and human health, with cardiovascular diseases constituting the main clinical outcome. The global healthcare sector accounts for approximately 4-5% of total greenhouse gas emissions, and cardiology contributes substantially to this burden because of its high resource intensity in diagnostic testing, interventional procedures, and energy consumption. At the same time, environmental factors such as air pollution, extreme temperatures, defined as values significantly above or below the regional average caused by climate change, and exposure to emerging contaminants, including heavy metals (lead, cadmium, arsenic) and micro- and nanoplastics are increasingly recognized as major determinants of cardiovascular risk. Chronic exposure to these pollutants is associated with oxidative stress, systemic inflammation, and accelerated progression of atherosclerosis. Strategies for sustainable cardiology primarily aim to reduce emissions related to energy use and supply chains. Priority actions include adopting circular economy principles (reduce, reuse, recycle), improving the appropriateness and optimization of diagnostic testing favoring lower environmental impact modalities, such as echocardiography, over carbon-intensive techniques and implementing telemedicine to reduce patient and provider travel. Furthermore, primary cardiovascular prevention can be considered an effective "double-benefit strategy", capable of simultaneously reducing disease burden and the demand for emission-intensive healthcare. In this context, healthcare professionals and scientific societies, including ANMCO, are called upon to lead a cultural shift by integrating environmental sustainability as a core ethical principle of contemporary cardiology practice.

MeSH

Research Design, Diagnostic Techniques And Procedures, Cardiovascular Diseases, Cardiology