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Topic Review
Aging and Arterial Stiffness in End-Stage Renal Disease
Arterial dysfunction is major risk factor for cardiovascular complications, and arterial stiffness is an independent risk factor in end-stage renal disease patients. As the distance from the heart increases, arterial stiffness (pulse wave velocity) becomes progressively more marked. This generates a centrifugal stiffness gradient, which leads to partial, continuous local wave reflections, which in turn attenuate the transmission of pulsatile pressure into the microcirculation, thus limiting the potentially deleterious outcomes both upstream (on the heart: left-ventricular hypertrophy and coronary perfusion) and downstream (on the renal and cerebral microcirculation: reduced glomerular filtration and impaired cognitive functions). The impact of arterial aging is greater on the aorta and central capacitive arteries, and it is characterized by a loss or reversal of the physiological stiffness gradient between central and peripheral arteries.
  • 1.0K
  • 31 Jan 2023
Topic Review
Mechanical Circulatory Support Systems in Fulminant Myocarditis
Fulminant myocarditis (FM) constitutes a severe and life-threatening form of acute cardiac injury associated with cardiogenic shock. The condition is characterised by rapidly progressing myocardial inflammation, leading to significant impairment of cardiac function. Due to the acute and severe nature of the disease, affected patients require urgent medical attention to mitigate adverse outcomes. Besides symptom-oriented treatment in specialised intensive care units (ICUs), the necessity for temporary mechanical cardiac support (MCS) may arise. Numerous patients depend on these treatment methods as a bridge to recovery or heart transplantation, while, in certain situations, permanent MCS systems can also be utilised as a long-term treatment option. 
  • 1.0K
  • 11 Mar 2024
Topic Review
Heart Failure and Diabetes Mellitus
Heart failure (HF) and type 2 diabetes mellitus (T2DM) have a synergistic effect on cardiovascular (CV) morbidity and mortality in patients with established CV disease (CVD). 
  • 1.0K
  • 01 Jun 2021
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.
  • 1.0K
  • 27 Aug 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.
  • 1.0K
  • 17 Jun 2021
Topic Review
Cyclic Nucleotides Regulate Vascular Tone
Several mediators and drugs regulate blood flow and blood pressure. The cyclic nucleotides cAMP and cGMP are the key messengers mediating vasodilation under physiological conditions and are therefore involved in the physiological regulation of vascular tone. Their function is due to the existence of several mechanisms that include the reduction of [Ca2+]i and a decrease in the sensitivity of the contractile machinery; both mechanisms may occur together and decrease MLC phosphorylation. On the other hand, these mechanisms are regulated by several cellular effectors, including ion channels that regulate the membrane potential and Ca2+ influx. All these mechanisms promote vessel relaxation by reducing vascular contractility and tone. 
  • 1.0K
  • 04 Jan 2022
Topic Review
Dysuricemia
The importance of uric acid, the final metabolite of purines excreted by the kidneys and intestines, was not previously recognized, except for its role in forming crystals in the joints and causing gout. Uric acid is not a biologically inactive substance and may exert a wide range of effects, including antioxidant, neurostimulatory, proinflammatory, and innate immune activities. 
  • 1.0K
  • 08 Jun 2023
Topic Review
Myocardium Infarction
Myocardium Infarction (MI) is one of the foremost cardiovascular diseases (CVDs) causing death worldwide, and its case numbers are expected to continuously increase in the coming years. Pharmacological interventions have not been at the forefront in ameliorating MI-related morbidity and mortality. Stem cell-based tissue engineering approaches have been extensively explored for their regenerative potential in the infarcted myocardium. Recent studies on microfluidic devices employing stem cells under laboratory set-up have revealed meticulous events pertaining to the pathophysiology of MI occurring at the infarcted site. This discovery also underpins the appropriate conditions in the niche for differentiating stem cells into mature cardiomyocyte-like cells and leads to engineering of the scaffold via mimicking of native cardiac physiological conditions. However, the mode of stem cell-loaded engineered scaffolds delivered to the site of infarction is still a challenging mission, and yet to be translated to the clinical setting.
  • 1.0K
  • 23 Oct 2021
Topic Review
Ox-Stress, Genetics-Epigenetic and Aging CVD
Aging can be seen as process characterized by accumulation of oxidative stress induced damage. Oxidative stress derives from different endogenous and exogenous processes, all of which ultimately lead to progressive loss in tissue and organ structure and functions. The oxidative stress theory of aging expresses itself in age-related diseases. Aging is in fact a primary risk factor for many diseases and in particular for cardiovascular diseases and its derived morbidity and mortality. Here we highlight the role of oxidative stress in age-related cardiovascular aging and diseases. We take into consideration the molecular mechanisms, the structural and functional alterations, and the diseases accompanied to the cardiovascular aging process.
  • 1.0K
  • 19 Jan 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.
  • 1.0K
  • 11 May 2022
Topic Review
Cardiopulmonary Exercise Testing in Hypertrophic Cardiomyopathy
In contrast to standard exercise testing and stress echoes, which are limited due to the ECG changes and wall motion abnormalities that characterize this condition, CPET allows for the assessment of the complex pathophysiology and severity of the disease, its mechanisms of functional limitation, and its risk stratification. It is useful tool to evaluate the risk for sudden cardiac death and select patients for cardiac resynchronization therapy (CRT), cardiac transplantation, or mechanical circulatory support, especially when symptomatology and functional status are uncertain. It may help in differentiating HCM from other forms of cardiac hypertrophy, such as athletes’ heart. Finally, it is used to guide and monitor therapy as well as for exercise prescription. It may be considered every 2 years in clinically stable patients or every year in patients with worsening symptoms. Although performed only in specialized centers, CPET combined with echocardiography (i.e., CPET imaging) and invasive CPET are more informative and provide a better assessment of cardiac functional status, left ventricular outflow tract obstruction, and diastolic dysfunction during exercise in patients with HCM.
  • 1.0K
  • 27 Jul 2023
Topic Review
Sudden Unexplained Death
Sudden unexplained death (SUD) is a fatal event that encompasses several heart disorders which lead to abrupt and unpredicted death. Normally, the victim has no known history of heart disease. In adult population (16–64 years) the SUD rate is 11/100,000 per year, while, in the young population (<16 years of age), it is 7.5/100,000. Please note that sudden unexplained death is sometimes used as a synonym of sudden unexpected death but some authors use this term to specifically indicate sudden deaths in which both autopsy and toxicology testing are negative. 
  • 1.0K
  • 05 May 2021
Topic Review
iPSC in Cardiovascular Diseases
Since their discovery in 2006, induced pluripotent stem cells (iPSCs) immediately stand out for their potential. While their differentiation capabilities are similar to those of ESCs, their somatic origin does not raise the same ethical questions as ESCs. In the cardiovascular field, methodological and intellectual progresses led to the development of highly sophisticated systems, such as patient-implantable cardiopatches, giving an enormous impulse to the regenerative medicine field.
  • 1.0K
  • 23 Jun 2021
Topic Review
Marine-Derived Omega-3 Polyunsaturated Fatty Acids and Heart Failure
Heart failure (HF) is a rapidly growing global public health problem. Since HF results in high mortality and re-hospitalization, new effective treatments are desired. Although it remains controversial, omega 3 polyunsaturated fatty acids (n-3 PUFAs), such as the eicosapentaenoic acid and docosahexaenoic acid, have been widely recognized to have benefits for HF.
  • 1.0K
  • 11 Nov 2021
Topic Review
Broad Electrocardiogram Syndromes Spectrum
Electrocardiogram (ECG) still remains a very useful diagnostic method in modern cardiology. Its broad availability, noninvasiveness and good sensitivity explain why it plays a capital role in the very beginning of the process of diagnosis for every patient, with or without cardiac-related complaints. For the practitioner, good training in ECG interpretation is mandatory. Sometimes, the ECG trace reveals particular aspects that may cause confusion and complicate decision-making. Several less common situations underlying the general context and ECG features are presented. The syndromes studied have a high pathological significance and may range from acute emergencies that call for a rapid therapeutical response to chronic syndromes that require prolonged observation, monitoring and risk stratification.
  • 1.0K
  • 30 Dec 2022
Topic Review
Temporal Artery Vascular Diseases
The term “temporal arteritis” is sometimes used to refer to giant cell arteritis (GCA) but this term is not appropriate. In fact, GCA does not consistently affect the temporal artery (TA) and other types of vasculitis or non-inflammatory diseases may affect TA.
  • 1.0K
  • 14 Jan 2022
Topic Review
Diagnostic Method for Cardiac Malposition
A significant number of patients with dextrocardia and other cardiac malpositions have other congenital heart defects (CHDs). The incidence of CHDs in subjects with cardiac malpositions is significantly greater than that in normal children, and the prevalence varies with the associated visceroatrial situs. The most useful approach to diagnosis is segmental analysis. Firstly, dextroposition should be excluded. In segmental analysis, the visceroatrial situs, ventricular location, status of atrioventricular connections, the great artery relationship, and conotruncal relationship are determined with the use of electrocardiogram (ECG), chest X-ray, and echocardiographic studies, and, when necessary, other imaging studies, including angiography. Following identification of the afore-mentioned segments, the associated defects in the atrial and ventricular septae, valvar and vascular stenosis or atresia may be determined by a review of the historical information, physical examination, and analysis of chest roentgenogram, ECG, and echocardiographic studies. Along the way, a pictorial rendition of the terminology and diagnosis of cardiac malpositions is undertaken.
  • 999
  • 30 Dec 2022
Topic Review
Antiplatelet for Older Patients with Acute Coronary Syndromes
Patients ≥ 75 years of age account for about one third of hospitalizations for acute coronary syndromes (ACS). Since the European Society of Cardiology guidelines recommend that older ACS patients use the same diagnostic and interventional strategies used by the younger ones, most elderly patients are currently treated invasively. Therefore, an appropriate dual antiplatelet therapy (DAPT) is indicated as part of the secondary prevention strategy to be implemented in such patients. The choice of the composition and duration of DAPT should be tailored on an individual basis, after careful assessment of the thrombotic and bleeding risk of each patient. Advanced age is a main risk factor for bleeding. Data show that in patients of high bleeding risk short DAPT (1 to 3 months) is associated with decreased bleeding complications and similar thrombotic events, as compared to standard 12-month DAPT. Clopidogrel seems the preferable P2Y12 inhibitor, due to a better safety profile than ticagrelor. When the bleeding risk is associated with a high thrombotic risk (a circumstance present in about two thirds of older ACS patients) it is important to tailor the treatment by taking into account the fact that the thrombotic risk is high during the first months after the index event and then wanes gradually over time, whereas the bleeding risk remains constant. 
  • 999
  • 21 Apr 2023
Topic Review
Fractalkine in Cardiovascular Disease
Fractalkine (FKN, CX3CL1) is a unique chemokine, present as a transmembrane protein on the endothelium, or following cleavage as a soluble ligand, attracting leukocyte subsets expressing the corresponding receptor CX3CR1.  Fractalkine receptor CX3CR1 is associated with microvascular obstruction (MVO) in patients undergoing primary PCI. Moreover, inhibition of CX3CR1 with an allosteric small molecule antagonist (KAND567) in the rat MI model reduces acute infarct size, inflammation, and intramyocardial haemorrhage (IMH). 
  • 998
  • 03 Aug 2023
Topic Review
Endocarditis
Prosthetic valve infective endocarditis (PVE) is the most worrisome complication after valve replacement, as it still carries high mortality and morbidity rate.
  • 997
  • 02 Feb 2021
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