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Topic Review
Autonomic Nervous System Role in Coumel’s Triangle
Arrhythmogenic substrate, modulating factors, and triggering factors (the so-called Coumel’s triangle concept) play a primary role in atrial fibrillation (AF) pathophysiology. Several years have elapsed since the concept of the relevance of autonomic nervous system (ANS) influences on atrial cells’ electrophysiological characteristics was advanced.
  • 552
  • 25 May 2023
Topic Review
Cardiovascular Magnetic Resonance in Cardiac Amyloidosis
Cardiovascular magnetic resonance (CMR) has several advantages compared to TTE. In most centers, it is used for further investigation of subjects with suspected cardiac amyloidosis (CA) and in patients with confirmed systemic amyloidosis. On one hand, it offers unmatched precision when it comes to measurements, including the assessment of the right ventricle; on the other hand, there is a unique opportunity of tissue characterization. 
  • 551
  • 05 May 2022
Topic Review
Participation of KLF2 and KLF4 in in Atherogenesis
Atherosclerosis is an important problem in modern medicine, the keys to understanding many aspects of which are still not available to clinicians. Atherosclerosis develops as a result of a complex chain of events in which many cells of the vascular wall and peripheral blood flow are involved. Endothelial cells, which line the vascular wall in a monolayer, play an important role in vascular biology. A growing body of evidence strengthens the understanding of the multifaceted functions of endothelial cells, which not only organize the barrier between blood flow and tissues but also act as regulators of hemodynamics and play an important role in regulating the function of other cells in the vascular wall. Krüppel-like factors (KLFs) perform several biological functions in various cells of the vascular wall. The large family of KLFs in humans includes 18 members, among which KLF2 and KLF4 are at the crossroads between endothelial cell mechanobiology and immunometabolism, which play important roles in both the normal vascular wall and atherosclerosis.
  • 550
  • 07 Apr 2023
Topic Review
Imaging Techniques for Cardiac Function
Cardiac imaging techniques include a variety of distinct applications with which we can visualize cardiac function non-invasively. Through different applications of physical entities such as sound waves, X-rays, magnetic fields, and nuclear energy, along with highly sophisticated computer hardware and software, it is now possible to reconstruct the dynamic aspect of cardiac function in many forms, from static images to high-definition videos and real-time three-dimensional projections.
  • 549
  • 19 Nov 2021
Topic Review
Cardiac Natriuretic Peptides, Their Receptors and Metabolism
Cardiac natriuretic peptides (NPs), atrial NP (ANP) and B-type NP (BNP) are true hormones produced and released by cardiomyocytes, exerting several systemic effects. Together with C-type NP (CNP), mainly expressed by endothelial cells, they also exert several paracrine and autocrine activities on the heart itself, contributing to cardiovascular (CV) health. NPs prevent cardiac hypertrophy, fibrosis, arrhythmias and cardiomyopathies, counteracting the development and progression of heart failure (HF). Moreover, some studies revealed that a protein structurally similar to NPs mainly produced by skeletal muscles and osteoblasts called musclin/osteocrin is able to interact with the NPs clearance receptor, attenuating cardiac dysfunction and myocardial fibrosis and promoting heart protection during pathological overload. 
  • 549
  • 07 Dec 2022
Topic Review
Statins and Chemotherapy-induced Cardiotoxicity
Chemotherapy-induced cardiotoxicity (CIC) is a heterogenous term that describes cardiotoxic effects from cancer therapeutics and encompasses mild asymptomatic myocardial injury and symptomatic heart failure with a decline in left ventricular ejection fraction (LVEF). The term chemotherapy-induced cardiotoxicity is often interchangeably used with chemotherapy-induced cardiomyopathy. Some individual studies have suggested that statins may also play an important role in decreasing the risk of CIC. A significant reduction in the incidence of chemotherapy-induced cardiomyopathy and the degree of LVEF decline in patients in the statin group compared to those in the control group. 
  • 548
  • 26 Aug 2021
Topic Review
High-Density Lipoproteins as Bidirectional Lipid Vectors
The anti-atherogenic properties of high-density lipoproteins (HDL) have been explained mainly by reverse cholesterol transport (RCT) from peripheral tissues to the liver. The RCT seems to agree with most of the negative epidemiological correlations between HDL cholesterol levels and coronary artery disease. However, therapies designed to increase HDL cholesterol failed to reduce cardiovascular risk, despite their capacity to improve cholesterol efflux, the first stage of RCT. Therefore, the cardioprotective role of HDL may not be explained by RCT, and it is time for new paradigms about the physiological function of these lipoproteins. It should be considered that the main HDL apolipoprotein, apo AI, has been highly conserved throughout evolution. Consequently, these lipoproteins play an essential physiological role beyond their capacity to protect against atherosclerosis.
  • 548
  • 27 May 2022
Topic Review
Functional Mitral Regurgitation and Tricuspid Regurgitation
Functional mitral regurgitation (FMR) and tricuspid regurgitation (FTR) occur due to cardiac remodeling in the presence of structurally normal valve apparatus. Two main mechanisms are involved, distinguishing an atrial functional form (when annulus dilatation is predominant) and a ventricular form (when ventricular remodeling and dysfunction predominate). Both affect the prognosis of patients with heart failure (HF) across the entire spectrum of left ventricle ejection fraction (LVEF), including preserved (HFpEF), mildly reduced (HFmrEF), or reduced (HFrEF).
  • 548
  • 09 May 2023
Topic Review
Novel Therapeutic Strategies in IHD with Reduced EF
Ischemic heart disease (IHD) continues to be the most common cause of heart failure (HF). Traditional HFrEF therapies, which include beta-blockers, ACE inhibitors (ACEI), angiotensin II receptor blockers (ARB), and mineralocorticoid receptor antagonists (MRA), have extensive data from clinical trials to support their beneficial effect in patients with IHD and HFrEF, translated into improvements in survival and ventricular remodeling and function. The treatment of HF with reduced EF (HFrEF) has been innovated by the introduction of novel pharmacological therapies and device strategies which have been demonstrated to ameliorate the prognosis of HFrEF patients
  • 547
  • 04 May 2023
Topic Review
Cisd2 in Cardiac Ageing
CISD2 is an evolutionally conserved protein that is mainly located in the mitochondria, ER, and MAMs. The expression level of Cisd2 decreases during natural ageing in many tissues and organs, including the heart, skeletal muscles, liver, brain, and skin.
  • 546
  • 29 Dec 2020
Topic Review
Thrombocytopenia and impaired platelet function
Thrombocytopenia and impaired platelet function are known as intrinsic drawbacks of cardiac surgery and extracorporeal life supports (ECLS). A number of different factors influence platelet count and function including the inflammatory response to a cardiopulmonary bypass (CPB) or to ECLS, hemodilution, hypothermia, mechanical damage and preoperative treatment with platelet-inhibiting agents. Moreover, although underestimated, heparin-induced thrombocytopenia is still a hiccup in the perioperative management of cardiac surgical and, above all, ECLS patients. Moreover, recent investigations have highlighted how platelet disorders also affect patients undergoing biological prosthesis implantation. Though many hypotheses have been suggested, the mechanism underlying thrombocytopenia and platelet disorders is still to be cleared. This narrative review aims to offer clinicians a summary of their major causes in the cardiac surgery setting. 
  • 545
  • 08 Mar 2021
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.
  • 544
  • 14 Jan 2022
Topic Review
Technologies to Detect and Monitor Atrial Fibrillation
Up to 20% of patients with ischemic stroke or transient ischemic attack have a prior history of known atrial fibrillation (AF). Additionally, unknown AF can be detected by different monitoring strategies in up to 23% of patients with cryptogenic or non-cardioembolic stroke. However, most studies had substantial gaps in monitoring time, especially early after the index event. Following this, AF rates would be higher if patients underwent continuous monitoring early after stroke, avoiding any gaps in monitoring. The few existing randomized studies focused on patients with cryptogenic stroke but did not focus otherwise specifically on prevention strategies in patients at high risk for AF (patients at higher age or with high CHA2DS2-VASC scores). Besides invasive implantable loop recorders (ILRs), external loop recorders (ELRs) and mobile cardiac outpatient telemetry (MCOT) are non-invasive tools that are commonly used for long-term ECG monitoring in cryptogenic-stroke patients in the ambulatory setting. 
  • 544
  • 01 Aug 2023
Topic Review
Sympathetic–Vascular Interactions
Sympathetic–vascular interactions means that the sympathetic nervous system plays a pivotal role in the short- and long-term regulation of different cardiovascular functions. In recent decades, increasing evidence has demonstrated that sympathetic neural influences are involved not only in the vasomotor modulation of small resistance arteries but also in the control of large arteries. Sympathetic activity and vascular function, which are key factors in the pathophysiology and prognosis of cardiovascular disease, are linked by a close relationship. Evidence from experimental studies indicates that the sympathetic nervous system is critically influenced, at the central and also at the peripheral level, by the most relevant factors regulating vascular function, namely nitric oxide, reactive oxygen species and endothelin. Additionally, there is evidence of a reciprocal influence between endothelial function and sympathetic mechanisms. 
  • 542
  • 03 Sep 2021
Topic Review
Aftermath of the COVID-19 Crisis in Saudi Arabia
Since late 2019, the number of COVID-19 patients has gradually increased in certain regions as consecutive waves of infections hit countries. Whenever this wave hits the corresponding areas, the entire healthcare system must respond quickly to curb the diseases, morbidities, and mortalities in intensive care settings. The healthcare team involved in COVID-19 patients’ care must work tirelessly without having breaks. Our understanding of COVID-19 is limited as new challenges emerge with new COVID-19 variants appearing in different world regions. Though medical therapies are finding solutions to deal with the disease, there are few recommendations for respiratory rehabilitation therapies. A group of respiratory rehabilitation care professionals in Saudi Arabia and international experts have agreed with the World Health bodies such as the World Health Organization (WHO) on the treatment and rehabilitation of patients with COVID-19. Professionals participating in COVID-19 patient treatment, rehabilitation, and recovery formulated respiratory rehabilitation guidelines based on the DELPHI Method, combining scientific research and personal practical experience. As a result, it is envisaged that the number of individuals in the region suffering from respiratory ailments due to post-COVID-19 will decrease. 
  • 542
  • 02 Dec 2021
Topic Review
Coronary Microvascular Dysfunction and Atrial Cardiomyopathy
Ischemia with nonobstructive coronary artery disease (INOCA) is increasingly recognized as a significant cause of angina, myocardial remodeling, and eventually heart failure (HF). Coronary microvascular dysfunction (CMD) is a major endotype of INOCA, and it is caused by structural and functional alterations of the coronary microcirculation. At the same time, atrial cardiomyopathy (ACM) defined by structural, functional, and electrical atrial remodeling has a major clinical impact due to its manifestations: atrial fibrillation (AF), atrial thrombosis, stroke, and HF symptoms. Both these pathologies share similar risk factors and have a high comorbidity burden. CMD causing INOCA and ACM frequently coexist. 
  • 542
  • 04 May 2023
Biography
Jennie Han
Dr Jennie Han graduated from the University of Oxford with a Masters of Arts in Medical Sciences and a Bachelor of Medicine, Bachelor of Surgery. During the course, she was awarded the Brian Johnson Prize for Pathology for the best essay in pathology in Oxford University Clinical School. During her clinical placement, she was the Tutor in Anatomy for Christ Church, Oxford. She was also the Presi
  • 542
  • 17 May 2023
Topic Review
Patient-Specific 3D-Printed Models in Pediatric Congenital Heart Disease
Three-dimensional (3D) printing technology has become increasingly used in the medical field, with reports demonstrating its superior advantages in both educational and clinical value when compared with standard image visualizations or current diagnostic approaches. Patient-specific or personalized 3D printed models serve as a valuable tool in cardiovascular disease because of the difficulty associated with comprehending cardiovascular anatomy and pathology on 2D flat screens. Additionally, the added value of using 3D-printed models is especially apparent in congenital heart disease (CHD), due to its wide spectrum of anomalies and its complexity. 
  • 541
  • 15 Mar 2023
Topic Review
Cancer and Acute Coronary Syndrome
Among acute coronary syndrome (ACS) patients, 15% have concomitant cancer, especially in the first 6 months after their diagnosis, as well as in advanced metastatic stages. Lung, gastric, and pancreatic cancers are the most frequent malignancies associated with ACS.
  • 540
  • 29 Dec 2020
Topic Review
Pyrophosphate in Vascular Calcification
In vertebrates, plasma and other extracellular fluids are supersaturated with phosphate and calcium, causing a tendency for spontaneous calcium-phosphate precipitation. Therefore, the synthesis of calcium phosphate deposition inhibitors is essential for survival, including pyrophosphate and several proteins.
  • 539
  • 21 Dec 2021
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