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Topic Review
Coronary Syndromes and High-Altitude Exposure
High-altitude (HA) locations (more than 2500 m above sea level) are reached by millions of people on a daily basis, aspect largely due to the ease of transport in recent years, mainly by air travel. Mountain areas cover 24% of Earth’s surface: 33% of Eurasia, 19% of South America, 24% of North America, and 14% of Africa.
  • 604
  • 06 Apr 2023
Topic Review
Theranostic Nanomedicines for Cardiovascular and Related Diseases
Cardiovascular and related diseases (CVRDs) are among the most prevalent chronic diseases in the 21st century, with a high mortality rate. Theranostic nanomedicines can prolong systemic circulation, escape from the host defense system, and deliver theranostic agents to the targeted site for imaging and therapy at a cellular and molecular level. The various nanomedicines for diagnostic and therapeutic applications in CVRDs, including nanomedicine for angina pectoris, myocarditis, myocardial infarction, pericardial disorder, thrombosis, atherosclerosis, hyperlipidemia, hypertension, pulmonary arterial hypertension and stroke are summarized. Presently, discrete non-invasive and non-surgical theranostic methodologies are such an advancement modality capable of targeted diagnosis and therapy and have better efficacy with fewer side effects than conventional medicine.
  • 603
  • 25 Apr 2022
Topic Review
Cardiovascular Morbidities in Adults Born Preterm
Advances in perinatal and neonatal care have led to improved survival of preterm infants into adulthood. However, the shift in focus to long-term health in adults born preterm requires a clear understanding of the impact of prematurity on developing organ systems and the development of adult-oriented disease. A less well-recognized area of risk for surviving preterm infants is their cardiometabolic health. Epidemiologic evidence has linked preterm birth to the development of systemic hypertension, type 2 diabetes, metabolic syndrome, heart failure, and ischemic heart disease. Of more significant concern is that the risk of cardiometabolic disorders is higher in adults born preterm compared to full-term infants. 
  • 603
  • 20 Dec 2022
Topic Review
Cardiometabolic Care
The mechanisms leading to the development of heart failure (HF) in diabetes mellitus (DM) patients are multifactorial. Assessing the risk of HF development in patients with DM is valuable not only for the identification of a high-risk subgroup, but also equally important for defining low-risk subpopulations. DM and HF have been recognized as sharing similar metabolic pathways. Moreover, the clinical manifestation of HF can be independent of left ventricular ejection fraction (LVEF) classification. Consequently, approaching HF should be through structural, hemodynamic and functional evaluation. 
  • 603
  • 27 Mar 2023
Topic Review
Coronary Artery Disease
Coronary artery disease (CAD) is a significant cause of illness and death amongst women. The pathophysiology, manifestations, and outcomes of Cardiovascular disease (CVD) and CAD differ between sexes. These sex differences remain under-recognized.
  • 603
  • 01 Nov 2021
Topic Review
SGLT2 Inhibitors in Treatment of Type 2 Diabetes
Sodium-glucose cotransporter 2 (SGLT2) inhibitors are a novel class of oral hypoglycemic agents which increase urinary glucose excretion by suppressing glucose reabsorption at the proximal tubule in the kidney. SGLT2 inhibitors lower glycated hemoglobin (HbA1c) by 0.6–0.8% (6–8 mmol/mol) without increasing the risk of hypoglycemia and induce weight loss and improve various metabolic parameters including blood pressure, lipid profile and hyperuricemia.
  • 602
  • 15 Jun 2022
Topic Review
Iron Supplementation in Heart Failure
Iron deficiency is a significant comorbidity of heart failure (HF), defined as the inability of the myocardium to provide sufficient blood flow. However, iron deficiency remains insufficiently detected. Iron-deficiency anemia, defined as a decrease in hemoglobin caused by iron deficiency, is a late consequence of iron deficiency, and the symptoms of iron deficiency, which are not specific, are often confused with those of HF or comorbidities. HF patients with iron deficiency are often rehospitalized and present reduced survival. The correction of iron deficiency in HF patients is associated with improved functional capacity, quality of life, and rehospitalization rates. Because of the inflammation associated with chronic HF, which complicates the picture of nutritional deficiency, only the parenteral route can bypass the tissue sequestration of iron and the inhibition of intestinal iron absorption. Given the negative impact of iron deficiency on HF progression, the frequency and financial implications of rehospitalizations due to decompensation episodes, and the efficacy of this supplementation, screening for this frequent comorbidity should be part of routine testing in all HF patients.
  • 601
  • 18 Aug 2022
Topic Review
Pathophysiology of Vasoplegic Syndrome after Cardiopulmonary Bypass
Vasoplegic syndrome (VS) is a common complication following cardiovascular surgery with cardiopulmonary bypass (CPB), and its incidence varies from 5 to 44%. It is defined as a distributive form of shock due to a significant drop in vascular resistance after CPB. 
  • 601
  • 28 Nov 2022
Topic Review
Cardiac Connexin-43
Cardiac connexin-43 (Cx43) creates gap junction channels (GJCs) at intercellular contacts and hemi-channels (HCs) at the peri-junctional plasma membrane and sarcolemmal caveolae/rafts compartments.
  • 599
  • 20 Jan 2021
Topic Review
Congenital Heart Defects
Congenital heart defects (CHD) are malformations present at birth that occur during heart development. Increasing evidence supports a genetic origin of CHD.
  • 599
  • 16 Jun 2021
Topic Review
Antithrombotic Therapy Following Transcatheter Aortic Valve Replacement
Transcatheter aortic valve replacement (TAVR) is expanding towards a low-risk patient category as a result of technical advances and operators’ improved skills. However, the post-TAVR antithrombotic regimen remains challenging. Single antiplatelet therapy appears to be the best compromise when there is no compelling indication for chronic oral anticoagulation. Whether it should be aspirin or clopidogrel is not established. There is no supportive evidence to use oral anticoagulation when there is no established indication for oral anticoagulation other than the TAVR procedure. The gap in evidence as to whether DOACs should be preferred over VKA remains when there is an indication for oral anticoagulation (OAC) use. It seems that DOACs are not the same and randomized trials are awaited. Likewise, whether oral anticoagulant therapy should be continued or interrupted during the procedure remains unclear.
  • 599
  • 17 Jun 2022
Topic Review
AT1 Receptor in Cerebrovascular Diseases
Ang II is known as the main effector of the RAS. Ang II binds with a similar affinity to two receptors: the Ang II type 1 receptor (AT1) and type 2 receptor (AT2), both belonging to the G protein-coupled receptor (GPCR) family and sharing 50% homology and 34% identity in their amino acid sequence. Ang II activation of AT1 is acknowledged as triggering most of the known effects of RAS stimulation, such as vasoconstriction, water and sodium retention and aldosterone release by the adrenal glands. This leads to increases in blood pressure, cardiovascular remodeling and fibrosis. Due to its wide physiological effects, AT1 plays a critical role in many pathological conditions and cardiovascular diseases, like cardiac hypertrophy, hypertension and heart failure.
  • 596
  • 05 Jul 2021
Topic Review
Arrhythmia-Related Cardiovascular Disease
Targeted cellular ablation is being increasingly used in the treatment of arrhythmias and structural heart disease. Catheter-based ablation for atrial fibrillation (AF) is considered a safe and effective approach for patients who are medication refractory. Electroporation (EPo) employs electrical energy to disrupt cell membranes which has a minimally thermal effect. The nanopores that arise from EPo can be temporary or permanent. Reversible electroporation is transitory in nature and cell viability is maintained, whereas irreversible electroporation causes permanent pore formation, leading to loss of cellular homeostasis and cell death. Several studies report that EPo displays a degree of specificity in terms of the lethal threshold required to induce cell death in different tissues. However, significantly more research is required to scope the profile of EPo thresholds for specific cell types within complex tissues. Irreversible electroporation (IRE) as an ablative approach appears to overcome the significant negative effects associated with thermal based techniques, particularly collateral damage to surrounding structures. With further fine-tuning of parameters and longer and larger clinical trials, EPo 
  • 596
  • 07 Jul 2021
Topic Review
Exercise Training Effects on Heart Failure
Heart failure (HF) is a major public health issue worldwide with increased prevalence and a high number of hospitalizations. Patients with chronic HF and either reduced ejection fraction (HFrEF) or mildly reduced ejection fraction (HFmrEF) present vascular endothelial dysfunction and significantly decreased circulating levels of endothelial progenitor cells (EPCs).
  • 595
  • 25 Jul 2022
Topic Review
Gut Microbiota Interacts with HFpEF
Heart failure with preserved ejection fraction (HFpEF) is a disease for which there is no definite and effective treatment, and the number of patients is more than 50% of heart failure (HF) patients. Gut microbiota (GMB) is a general term for a group of microbiota living in humans’ intestinal tracts, which has been proved to be related to cardiovascular diseases, including HFpEF. In HFpEF patients, the composition of GMB is significantly changed, and there has been a tendency toward dysbacteriosis. Metabolites of GMB, such as trimethylamine N-oxide (TMAO), short-chain fatty acids (SCFAs) and bile acids (BAs) mediate various pathophysiological mechanisms of HFpEF. GMB is a crucial influential factor in inflammation, which is considered to be one of the main causes of HFpEF. The role of GMB in its important comorbidity—metabolic syndrome—also mediates HFpEF. Moreover, HF would aggravate intestinal barrier impairment and microbial translocation, further promoting the disease progression. In view of these mechanisms, drugs targeting GMB may be one of the effective ways to treat HFpEF. 
  • 595
  • 20 Feb 2023
Topic Review
Advanced Monitoring Technologies
Heart failure (HF) is characterized by a progressive course of disease accompanied by recurrent exacerbations leading to high hospitalization and rehospitalization rates, which account for a substantial part of the disease load. Among the elderly, acute decompensated heart failure (ADHF) is the leading cause of hospitalization. The 30-day rehospitalization rate following the first admission to the hospital for HF exacerbation is 22–29.4%, which is the most common amongst all other etiologies.
  • 594
  • 29 Oct 2021
Topic Review
P2Y12 Inhibitor Monotherapy and Dual Antiplatelet Therapy
Dual antiplatelet therapy (DAPT) with aspirin plus a P2Y12 inhibitor is the standard treatment for patients undergoing percutaneous coronary intervention (PCI) with stent implantation. Although it is an effective treatment to reduce the risk of ischemic events and stent thrombosis, it increases the risk of bleeding. Newer-generations of drug-eluting stents (DES) have thinner stent struts and better design to lower the risk of stent thrombosis and have more rapid endothelialization. The role of DAPT was challenged by many clinical trials in recent years. Increasing evidence is showing P2Y12 inhibitor monotherapy is a feasible alternative treatment for patients after PCI with stent implantation in the modern era, as it could lower the risk of bleeding complications and still has enough antiplatelet effect to avoid recurrent ischemic events.
  • 594
  • 11 May 2022
Topic Review
Hypertrophic Cardiomyopathy
Hypertrophic cardiomyopathy (HCM) is a genetic cardiac disease that presents with cardiac hypertrophy. HCM phenocopies are clinical conditions that are phenotypically undistinguishable from HCM, but with a different underlying etiology. Cardiac tumors are rare entities that can sometimes mimic HCM in their echocardiographic appearance, thus representing an example of HCM phenocopy. At present, only case reports of tumoral HCM phenocopies can be found in literature.
  • 593
  • 07 May 2021
Topic Review
Thromboembolic complications of SARS-CoV-2
Covid-19 has the potential to cause severe damage to many tissues, including systemic inflammatory response syndrome (SIRS), acute respiratory disease syndrome (ARDS), multiorgan involvement, and shock. One of the most feared complications are thromboembolic events which lead to severe clinical phenotypes: worsening of pulmonary conditions, oxygen desaturation, and acute respiratory distress. Management choices should be considered according to the critical or chronic setting.                             Main pathophysiological mechanisms underlying thrombosis from Covid-19 are discussed, including metabolic derangements and hormonal factors.
  • 593
  • 17 Jun 2021
Topic Review
Dissecting Polygenic Etiology of Ischemic Stroke
Ischemic stroke (IS), the leading cause of death and disability worldwide, is caused by many modifiable and non-modifiable risk factors. This complex disease is also known for its multiple etiologies with moderate heritability. Polygenic risk scores (PRSs), which have been used to establish a common genetic basis for IS, may contribute to IS risk stratification for disease/outcome prediction and personalized management. Statistical modeling and machine learning algorithms have contributed significantly to this field. For instance, multiple algorithms have been successfully applied to PRS construction and integration of genetic and non-genetic features for outcome prediction to aid in risk stratification for personalized management and prevention measures. PRS derived from variants with effect size estimated based on the summary statistics of a specific subtype shows a stronger association with the matched subtype. The disruption of the extracellular matrix and amyloidosis account for the pathogenesis of cerebral small vessel disease (CSVD). Pathway-specific PRS analyses confirm known and identify novel etiologies related to IS.
  • 593
  • 20 Oct 2022
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