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Topic Review
Viral Myocarditis - From Pathophysiology to Treatment
The pathophysiology of viral myocarditis and its sequelae leading to severe heart failure with a poor prognosis is not fully understood and represents a significant public health issue globally. Most likely, at a certain point, besides viral persistence, several etiological types merge into a common pathogenic autoimmune process leading to chronic inflammation and tissue remodeling, ultimately resulting in the clinical phenotype of dilated cardiomyopathy. 
  • 592
  • 05 Jan 2022
Topic Review
Zero-Fluoroscopy Cardiac Ablation
Electrophysiological procedures are mainly performed using fluoroscopy, exposing both healthcare staff and patients to a non-negligible dose of radiation. To date, simple ablation procedures have often been approached with zero fluoroscopy. In complex ablation procedures, such as atrial fibrillation (AF) ablation, zero fluoroscopy is still challenging mainly because of transseptal puncture. We report a workflow to perform a complete zero-fluoroscopy AF ablation using a 3D electro-anatomical mapping system, intracardiac echocardiography and a novel steerable guiding sheath visible on the mapping system. We describe two cases, one with paroxysmal AF and the other with persistent AF during which this novel workflow was successfully applied with complete zero-fluoroscopy exposure and achieving pulmonary vein isolation.
  • 591
  • 16 Dec 2021
Topic Review
Bioavailability of Thymol in Humans and Animals
Herbal additives may have possible health benefits in animals and humans, particularly thymol, whose phenolic group is responsiblefor the neutralisation of free radicals, and information concerning its detection through body action,bioavailability and mechanisms in rabbits. Plants containing thymol have been used in traditional medicine for the treatment of various diseases, such as cardiovascular diseases, cancer and diabetes. Although a great number of in vitro studies of cardiovascular and cancer diseases are available, in vivo studies that confirm these findings have not been sufficiently reported. To determine the beneficial dose, further clinical studies are necessary, with preclinical comprehensive research on animal models.
  • 591
  • 22 Jun 2022
Topic Review
Redox Regulation of Hypoxia-Inducible Factors
Oxidative stress and hypoxia-inducible factors (HIFs) have been implicated in the pathogenesis of diabetic cardiovascular and renal diseases. Reactive oxygen species (ROS) mediate physiological and pathophysiological processes, being involved in the modulation of cell signaling, differentiation, and survival, but also in cyto- and genotoxic damage. As master regulators of glycolytic metabolism and oxygen homeostasis, HIFs have been largely studied for their role in cell survival in hypoxic conditions.
  • 590
  • 17 Nov 2022
Topic Review
Pathophysiology of Exercise-Induced Pulmonary Hypertension
Exercise-induced pulmonary hypertension (EIPH) has been defined as an increase in mean pulmonary arterial pressure (mPAP) during exercise in otherwise normal values at rest. EIPH reflects heart and/or lung dysfunction and may precede the development of manifest pulmonary hypertension (PH) in a proportion of patients. It is also associated with decreased life expectancy in patients with heart failure with reduced ejection fraction (HFrEF) or left ventricle (LV) valvular diseases. Diastolic dysfunction exacerbated during exercise relates to increased LV filling pressure and left atrial pressure (LAP). In this context backward, transmitted pressure alone or accompanied with backward blood flow promotes EIPH. 
  • 589
  • 18 Jan 2023
Topic Review
Exosomes in Ischemic Heart Disease
Exosomes are a subgroup of extracellular vesicles that can be secreted by virtually all types of cells, including cardiomyocytes, cardiac fibroblasts, endothelial cells, and stem and progenitor cells.
  • 587
  • 01 Jul 2021
Topic Review
Cross-Sectional Imaging in Pediatric Interventional Cardiac Catheterization
Computed tomography (CT)  and Cardiac magnetic resonance (CMR) continue to advance the field of congenital cardiology by allowing for new and unique procedures not previously imagined. Enabling the interventionalist to enter the catheterization lab with a plan of attack expedites the procedure and has been shown to reduce procedural times and improve outcomes. Substantial advances in cross-sectional image resolution with a significant decrease in radiation exposure for cardiac CTs have led to more mainstream utilization. CMR has a unique ability to deliver real-time functional imaging in several views without exposing the patient to the detrimental effects of ionizing radiation. This can reduce procedural times in the interventional fluoroscopic suite to allow for more directed procedures.
  • 587
  • 08 Apr 2022
Topic Review
Fibrinolysis for Patients with COVID-19
An impaired fibrinolytic process has been demonstrated in patients infected with SARS-CoV-2, including those in severe or critical condition. Disruption of fibrinolysis leads to fibrin deposition, which exacerbates inflammation and fibrosis and damages the pulmonary surfactant. Numerous authors point out the different course of coagulopathy in patients with COVID-19. It is reported that they may have a state of secondary hyperfibrinolysis, which may explain, at least in part, the increased incidence of venous thromboembolism, even among those patients already receiving appropriate anticoagulant treatment. This raises the question of whether current guidelines for the prevention and treatment of embolic–thrombotic complications, among patients with severe COVID-19, are sufficient. Some studies show evidence of clinical improvement in patients who have received fibrinolytic therapy, beyond the current indications for its implementation. 
  • 587
  • 07 Nov 2022
Biography
Fotios Barkas
Nationality: Greek (+30) 6936636376 (+30) 2651099846 Date of birth: 16/10/1986 Email addresses: fotisbarkas@windowslive.com; f.barkas@ic.ac.uk; f.barkas@uoi.gr Facebook: https://www.facebook.com/fotis.barkas.3 Twitter: https://twitter.com/fotisbarkas LinkedIn: www.linkedin.com/in/fotisbarkas Home address: Aoou 21, 45221 Ioannina (Greece) Consultant in Internal Medicine University Hospital
  • 587
  • 17 Nov 2022
Topic Review
Cytoskeletal Protein
Cytoskeletal protein variants include variants in desmin, lamin A/C, titin, myosin heavy and light chain, junctophilin, nucleoporin, nesprin, and filamin C.
  • 586
  • 11 Feb 2022
Topic Review
RhoA Signaling in Immune Cell/Cardiac
One of the key proteins involved in stress-mediated cardiomyocyte signal transduction is a small GTPase RhoA. Importantly, the regulation of RhoA activation is critical for effective immune cell response and is being considered as one of the potential therapeutic targets in many immune-cell-mediated inflammatory diseases.
  • 585
  • 27 Jul 2021
Topic Review
Multimodality Imaging
Multimodality imaging is the basis of the diagnosis, follow-up, and surgical management of bicuspid aortic valve (BAV) patients.
  • 583
  • 09 Feb 2022
Topic Review
MicroRNAs in Valvular Heart Diseases
microRNAs (miRNAs) have been documented to be regulators of valvular diseases pathogenesis, diagnostic biomarkers, and therapeutical targets. They in fact play stimulatory or inhibitory roles in mitral valve prolapse development, aortic leaflet fusion, and calcification pathways. Tissue expression assessment and comparison between physiological and pathological phenotypes of different disease entities, including mitral valve prolapse and mitral chordae tendineae rupture, emerged as the best strategies to address miRNAs over or under-representation and thus, their impact on pathogeneses. miRNAs can also be targeted by several molecules. Inhibitors such as antisense oligonucleotides and sponge vectors are under investigation. Furthermore, to increase miRNAs activity miRNA mimics, miRNA expression vectors, and small molecules have been developed.
  • 582
  • 23 Nov 2021
Topic Review
Impact of Dietary Fats on Cardiovascular Disease
Dietary habits have major implications as causes of death globally, particularly in terms of cardiovascular disease, but to precisely define the role of the single components of diet in terms of cardiovascular risk is not an easy task. As an example, complex and multifactorial are the possible nutritional or detrimental effects of dietary fats, due to the huge variety of lipid metabolites originating from either the enzymatic or non-enzymatic oxidation of polyunsaturated fatty acids, cholesterol and phospholipids. The area of research that has allowed the benefit/risk profile of a dietary supplement to be tested with controlled studies is that of omega-3 fatty acids. Omega-3 fatty acids have showed a potential therapeutic role only in secondary cardiovascular prevention, while controlled studies in primary prevention have consistently produced neutral results.
  • 582
  • 28 Nov 2022
Topic Review
Segmental Disharmony
In very rare circumstances, individuals can be found in whom, when the atrial chambers are in their expected position, and the cavities of the atrial chambers are in continuity with their morphologically appropriate or inappropriate ventricles, the ventricular topology is incongruent with the connections present.
  • 581
  • 27 May 2022
Topic Review
Marathon-Induced Cardiac Fatigue
There is a clear impact of marathon on skeletal muscle and myocardium structure. 
  • 580
  • 02 Sep 2021
Topic Review
Techniques to Preserve Endothelial Cells in Vein Grafts
Endothelial cells comprise the intimal layer of the vasculature, playing a crucial role in facilitating and regulating aspects such nutrient transport, vascular homeostasis, and inflammatory response. Endothelial dysfunction is believed to be a key driver for vein graft disease—a pathology in which vein grafts utilised in coronary artery bypass graft surgery develop intimal hyperplasia and accelerated atherosclerosis, resulting in poor long-term patency rates. Activation and denudation of the endothelium following surgical trauma and implantation of the graft encourage a host of immune, inflammatory, and cellular differentiation responses that risk driving the graft to failure. Several approaches have been developed to mitigate the onset and progression of this pathology both clincally and surgically, including optimisation of surgical technique, vein preservation conditions and pharma-modulation. Novel approaches are also under investigation in recent years, including the use of topical gene therapy and the utilisation of endothelial progenitor/colony-forming cells to regenerate vein grafts with the view to improving patient outcomes.
  • 580
  • 10 Oct 2022
Topic Review
Traditional and Novel Biomarkers for Coronary Microvascular Dysfunction
Coronary microvascular dysfunction (CMD) is related to a broad variety of clinical scenarios in which cardiac microvasculature is morphologically and functionally affected, and it is associated with impaired responses to vasoactive stimuli. Although the prevalence of CMD involves about half of all patients with chronic coronary syndromes and more than 20% of those with acute coronary syndrome, the diagnosis of CMD is often missed, leading to the underestimation of its clinical importance. The established and validated techniques for the measurement of coronary microvascular function are invasive and expensive. An ideal method to assess endothelial dysfunction should be accurate, non-invasive, cost-effective and accessible. There are varieties of biomarkers available, potentially involved in microvascular disease, but none have been extensively validated in this heterogeneous clinical population. The investigation of potential biomarkers linked to microvascular dysfunction might improve the assessment of the diagnosis, risk stratification, disease progression and therapy response. 
  • 580
  • 26 Apr 2022
Topic Review
Approaches to Cardiovascular Disease Intervention
Interventions aimed at the cellular origin of the pathology would have a better chance of preventing and treating cardiovascular disease, lowering healthcare costs, and incurring less risk.
  • 579
  • 20 Dec 2022
Topic Review
Transcription Control of Liver Development
During liver organogenesis, cellular transcriptional profiles are constantly reshaped by the action of hepatic transcriptional regulators, including FoxA1-3, GATA4/6, HNF1α/β, HNF4α, HNF6, OC-2, C/EBPα/β, Hex, and Prox1. These factors are crucial for the activation of hepatic genes. The initial opening of highly condensed chromatin is executed by a special class of transcription factors known as pioneer factors. This is followed by the progressive recruitment of chromatin modifiers and the stable or transient binding of other transcription factors, which lead to the gradual deposition of activating histone modifications and the broadening of active chromatin domains. The resulting permissive chromatin state facilitates the assembly of the pre-initiation complex (PIC) and promotes transcriptional initiation.
  • 578
  • 27 Aug 2021
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