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Topic Review
BNT162b2 mRNA COVID-19 Vaccine
The coronavirus disease 2019 (COVID-19) pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has had a widespread impact on health, including a substantial mortality among patients with various pre-existing health conditions. Patients with cardiovascular disease (CVD) are more susceptible to the development of severe COVID-19 infection. The incidence of mechanical complications of acute coronary syndrome (ACS) increased fivefold after the declaration of a state of emergency in Japan. Therefore, vaccination against SARS-CoV-2 is generally recommended in patients with CVD, as is vaccination against other infectious agents. The BNT162b2 mRNA COVID-19 vaccine has shown promising efficacy and safety, mainly in people without apparent pre-existing comorbidities. A nationwide mass vaccination study focused on the estimated vaccine effectiveness of patients with various comorbidities such as heart disease. No data, however, are available regarding the vaccine effectiveness in patients with CVD alone. So it's necessary to investigate the humoral response of patients with CVD to the BNT162b2 mRNA COVID-19 vaccine compared to that in healthcare workers (HCWs).
  • 1.1K
  • 30 Nov 2021
Topic Review
Coronary Arteries Aneurysms
Coronary artery aneurysm (CAA) is an abnormal dilatation of a coronary artery segment, those coronary artery aneurysms that are very large in size are defined as giant. The reported prevalence of coronary aneurysms in the population who underwent coronary angiography ranges from 0.3% to 5%, and often CAAs are found in patient with aneurysms in other sites. Often, CAA is found in the context of acute coronary syndrome but CAA can be a found in sudden cardiac death patient. Currently, very few data exist about CAA treatment and often it is case-based. In this research, through two clinical cases, the current evidence regarding diagnostic tools and treatment options of CAAs will be described.
  • 1.1K
  • 14 Nov 2022
Topic Review
Syncope Management
Syncope is a highly prevalent clinical condition characterized by a rapid, complete, and brief loss of consciousness, followed by full recovery caused by cerebral hypoperfusion. This symptom carries significance, as its potential underlying causes may involve the heart, blood pressure, or brain, leading to a spectrum of consequences, from sudden death to compromised quality of life. Various factors contribute to syncope, and adhering to a precise diagnostic pathway can enhance diagnostic accuracy and treatment effectiveness.
  • 1.1K
  • 01 Feb 2024
Topic Review
Diagnostic Evaluation of Pulmonary Hypertension
Pulmonary hypertension (PH) is a disorder involving a heterogeneous group of medical conditions encompassing several cardiopulmonary illnesses.
  • 1.1K
  • 05 Dec 2023
Topic Review
SARS-CoV-2 and Acute Cerebrovascular Events
Since the coronavirus disease 2019 (COVID-19) pandemic, due to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, accumulating evidence indicates that SARS-CoV-2 infection may be associated with various neurological manifestations, including acute cerebrovascular events (i.e., stroke and cerebral venous thrombosis). These events can occur prior to, during and even after the onset of COVID-19's general symptoms. Although the mechanisms underlying the cerebrovascular complications in patients with COVID-19 are yet to be fully elucidated, the hypercoagulability state, inflammation and altered angiotensin-converting enzyme 2 (ACE-2) signaling in association with SARS-CoV-2 may play key roles. ACE-2 plays a critical role in preserving heart and brain homeostasis. As the number of published COVID-19 cases with cerebrovascular events is growing, prospective studies would help gather more valuable insights into the pathophysiology of cerebrovascular events, effective therapies, and the factors predicting poor functional outcomes related to such events in COVID-19 patients.
  • 1.1K
  • 26 Aug 2021
Topic Review
Oxidative Stress as a Target of Cardiac Remodeling
Cardiac remodeling is defined as a group of molecular, cellular, and interstitial changes that clinically manifest as changes in the heart’s size, mass, geometry, and function after different stimuli. It is important to emphasize that remodeling plays a pathophysiological role in the onset and progression of ventricular dysfunction and subsequent heart failure. Therefore, strategies to mitigate this process are critical. Different factors, including neurohormonal activation, can regulate the remodeling process and increase cell death, alterations in contractile and regulatory proteins, alterations in energy metabolism, changes in genomics, inflammation, changes in calcium transit, metalloproteases activation, fibrosis, alterations in matricellular proteins, and changes in left ventricular geometry, among other mechanisms.
  • 1.1K
  • 16 Dec 2022
Topic Review
Mechanism of Action and Effects of Sodium-Glucose Cotransporter
Heart failure (HF) is an extremely complex, multifactorial, progressive clinical condition, characterized by cardiac function impairment secondary to a structural and/or functional heart abnormality. Sodium-glucose cotransporter (SGLT2i) was the first class of glucose-lowering drugs able to reduce cardiovascular events in diabetic and non-diabetic patients with HF.
  • 1.0K
  • 12 Jan 2023
Topic Review
Links between Metabolic Syndrome and Hypertension
Hypertension is defined as repeated elevated office systolic blood pressure (SBP) values over 140 mmHg and/or diastolic BP (DBP) over 90 mmHg or average home BP over 135/85 mmHg. Metabolic syndrome (MetS) has serious outcomes regarding the individual’s health, with increasing prevalence nowadays and a significant impact on healthcare systems. Its definition varied over time. MetS consists of several conditions, such as hypertension, elevated fasting glucose (over 100 mg/dL) or type 2 diabetes mellitus (T2DM), decreased high-density lipoprotein cholesterol levels (less than 40 mg/dL in men or 50 mg/dL in women), high triglycerides concentrations (over 150 mg/dL) and waist circumference over 40 inches (men) or 35 inches (women).
  • 1.0K
  • 19 Jan 2023
Topic Review
Myocardial Perfusion and Flow Imaging with PET
Positron emission tomography (PET) is a non-invasive, functional imaging test utilizing ionizing radiation, the source of which is a radioactive isotope (radionuclide) administered to the patient. Myocardial perfusion imaging (MPI) with radionuclide PET is one of the non-invasive imaging methods that can provide rapid and accurate information about the extent of ischemia.
  • 1.0K
  • 12 Jun 2023
Topic Review
Human Monocyte Subsets and Cardiovascular Diseases
Monocytes are known for their very important role in tissue homeostasis and the innate immune system. The repartition of the circulating monocyte subsets has been identified as a predictive prognosis marker in various cardiovascular diseases caused by atherosclerosis.
  • 1.0K
  • 26 May 2022
Topic Review
Computed angiotomography for Preoperative TAVR Planning
Transcatheter aortic valve replacement (TAVR) is a well-established treatment option for patients with severe symptomatic aortic stenosis (AS) whose procedural efficacy and safety have been continuously improving. Appropriate preprocedural planning, including aortic valve annulus measurements, transcatheter heart valve choice, and possible procedural complication anticipation is mandatory for a successful procedure. The gold standard for preoperative planning is still to perform a multi-detector computed angiotomography (MDCT), which provides all the information required. The planning can be performed manually, using semi-automated and automated software.
  • 1.0K
  • 23 May 2022
Topic Review
Vascular Calcification in Chronic Kidney Disease
Chronic Kidney Disease (CKD) patients are at high risk of presenting with arterial calcification or stiffness, which confers increased cardiovascular mortality and morbidity. In recent years, it has become evident that VC is an active process regulated by various molecules that may act as inhibitors of vessel mineralization.
  • 1.0K
  • 09 Mar 2022
Topic Review
Treatment of Transthyretin Amyloid Cardiomyopathy
Transthyretin amyloid cardiomyopathy (ATTR-CM) is a progressively debilitating, rare disease associated with high mortality. ATTR-CM occurs when TTR amyloid protein builds up in the myocardium along with different organs, most commonly the peripheral and the autonomic nervous systems. Managing the cardiac complications with standard heart failure medications is difficult due to the challenge to maintain a balance between the high filling pressure associated with restricted ventricular volume and the low cardiac output. To date, tafamidis is the only agent approved for ATTR-CM treatment.
  • 1.0K
  • 06 May 2022
Topic Review
Natriuretic Peptides and Troponins for HFpEF
Heart failure (HF) is a significant cause of morbidity and mortality worldwide. HF with preserved ejection fraction (HFpEF) is a complex syndrome, often participated by several cardiac and extracardiac conditions, including chronic kidney disease, pulmonary disease, anaemia and advanced age. Circulating biomarkers reflecting pathophysiological pathways involved in HFpEF development and progression may assist clinicians in early diagnosis and management of this condition. Natriuretic peptides (NPs) are cardioprotective hormones released by cardiomyocytes in response to pressure or volume overload and in response to activation of neuro-endocrine-immune system. The relevance of B-type NP (BNP) and N-terminal pro-B-type NP (NT-proBNP) for diagnosis and risk stratification has been extensively demonstrated, and these biomarkers are emerging tools for population screening and as guides to the start of treatment in subclinical HF. On the contrary, conflicting evidence exists on the value of NPs to guide HF therapy. Among the other biomarkers, high-sensitivity troponins and soluble suppression of tumorigenesis-2 are the most promising biomarkers for risk stratification, predicting outcome independently from NPs. 
  • 1.0K
  • 25 Aug 2022
Topic Review
Epigenetics in LMNA-Related Cardiomyopathy
Mutations in the gene for lamin A/C (LMNA) cause a diverse range of diseases known as laminopathies. LMNA-related cardiomyopathy is a common inherited heart disease and is highly penetrant with a poor prognosis. Numerous investigations using mouse models, stem cell technologies, and patient samples have characterized the phenotypic diversity caused by specific LMNA variants and contributed to understanding the molecular mechanisms underlying the pathogenesis of heart disease. As a component of the nuclear envelope, LMNA regulates nuclear mechanostability and function, chromatin organization, and gene transcription.
  • 1.0K
  • 23 Mar 2023
Topic Review
Techniques to Assess the Size of KIV-2 CNV
Apolipoprotein(a) (apo(a)) is the protein component that defines lipoprotein(a) (Lp(a)) particles and is encoded by the LPA gene. The apo(a) is extremely heterogeneous in size due to the copy number variation (CNV) in the kringle IV type-2 (KIV-2) domains. Lp(a) concentrations in the blood vary by more than a thousand-fold between individuals, ranging from less than 0.1 to more than 300 mg/dL, depending on the size of apo(a) that is encoded by the LPA gene. The KIV-2 copy number ranges from 1 to >40, and the CNV of KIV-2 shows a >95% heterozygosity in most populations. Screening patients for elevated Lp(a) is strongly encouraged as an effective tool to identify individuals requiring more aggressive lipid-lowering therapy to reduce the CVD risk. Lp(a) levels above 50 mg/dL are correlated with an increased risk for the development of CVD.
  • 1.0K
  • 13 Sep 2023
Topic Review
Reentry Arrhythmia in Cardiac Tissue Models
Cardiac arrhythmias are a major cause of cardiovascular mortality worldwide. Many arrhythmias are caused by reentry, a phenomenon where excitation waves circulate in the heart. Optical mapping techniques have revealed the role of reentry in arrhythmia initiation and fibrillation transition, but the underlying biophysical mechanisms are still difficult to investigate in intact hearts.
  • 1.0K
  • 17 Oct 2023
Topic Review
Transcatheter Tricuspid Valve-in-Valve Procedure
Severe tricuspid commitment is no longer understood as merely a marker of disease but is now widely thought of as a significant contributor to cardiac morbidity and mortality. However, isolated tricuspid valve surgery remains rare and to this day continues to be associated with the highest surgical risk among all valve procedures and high operative mortality rates, especially in reoperations. Therefore, the development of tricuspid transcatheter procedures is as necessary as it was for the other valves a couple of years ago. Recently, multiple percutaneous therapies have been developed for the management of severe tricuspid disease, initially only repair and more recently replacement, thus creating a new branch for the management of patients who have already undergone surgery and who present with dysfunctional bioprostheses.
  • 1.0K
  • 20 Oct 2021
Topic Review Peer Reviewed
COVID-19 and Coronary Heart Disease
Coronary heart disease (CHD) is the leading cause of mortality worldwide. One of the main contributions of mortality and morbidity in CHD patients is acute myocardial infarction (AMI), which is the result of abrupt occlusion of an epicardial coronary artery due to a sudden rupture of atherosclerotic plaque, causing myocardial ischemia. In the initial stage of myocardial ischemia, lack of oxygen and nutrient supply results in biochemical and metabolic changes within the myocardium. Depletion of oxygen switches the aerobic cellular metabolism to anaerobic metabolism and impairs the oxidative phosphorylation pathway eventually leading to cardiomyocyte death. Several studies suggest an interlink between COVID-19 and ischemic heart disease. An increased ACE2 receptor expression in the myocardium may partly contribute to the myocardial injuries that are observed in patients affected by SARS-CoV-2. Furthermore, pre-existing cardiovascular disease, in conjunction with an aggravated inflammatory response which causes an up-regulation in pro-inflammatory cytokines. Moreover, patients with atherosclerosis are observed to be more prone to ischemic attacks when affected by COVID-19, due to hypercoagulation in the blood as well as elevated pro-inflammatory markers.
  • 1.0K
  • 13 Apr 2022
Topic Review
Iron Deficiency in Patients with Heart Failure
Iron deficiency (ID) is a comorbid condition frequently seen in patients with heart failure (HF). Iron has an important role in the transport of oxygen, and is also essential for skeletal and cardiac muscle, which depend on iron for oxygen storage and cellular energy production. Thus, ID per se, even without anaemia, can be harmful. In patients with HF, ID is associated with a poorer quality of life (QoL) and exercise capacity, and a higher risk of hospitalisations and mortality, even in the absence of anaemia.
  • 1.0K
  • 20 Jun 2022
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