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Topic Review
Inflammation and Heart Failure
Inflammation is defined as the response of the immune system to a variety of stimuli that might be infectious or tissue harmful. Regardless of the initial insult, there is a series of programmed sequelae depending on the ability of the immune system to eliminate the ‘enemy’ and restore the tissues’ normal structure and function. The inflammatory process can be divided, without clearly defined and therefore overlapping borders, into three sequential phases, including the acute phase, the intermediate and the restore/repair phase. The pivotal role of inflammation in the pathophysiology of heart-failure (HF) development and progression has long been recognized. High blood levels of pro-inflammatory and inflammatory markers are present and associated with adverse outcomes in patients with HF. 
  • 874
  • 28 Jan 2023
Topic Review
Dual Antiplatelet Therapy after Coronary Stenting
Dual antiplatelet therapy (DAPT), comprising aspirin and a P2Y12 receptor inhibitor, is the cornerstone of post-percutaneous coronary intervention treatment to prevent stent thrombosis and reduce the risk of adverse cardiovascular events.
  • 874
  • 22 Nov 2023
Topic Review
Caval Valve Implantation for Tricuspid Regurgitation Treatment
Given the technical simplicity of the bicaval valve implantation (CAVI) technique compared to other transcatheter devices, CAVI is postulated as a suitable alternative for a wide variety of patients affected with severe+ tricuspid regurgitation.
  • 872
  • 15 Nov 2021
Topic Review
Inflammation in Coronary Microvascular Dysfunction
Chronic low-grade inflammation is involved in coronary atherosclerosis, presenting multiple clinical manifestations ranging from asymptomatic to stable angina, acute coronary syndrome, heart failure and sudden cardiac death. Coronary microvasculature consists of vessels with a diameter less than 500 μm, whose potential structural and functional abnormalities can lead to inappropriate dilatation and an inability to meet the required myocardium oxygen demands. 
  • 872
  • 10 Jan 2022
Topic Review
APJ in Myocardial Infarction- and Hypertension-Induced Heart Failure
The widely expressed G protein-coupled apelin receptor (APJ) is activated by two bioactive endogenous peptides, apelin and ELABELA (ELA). The apelin/ELA-APJ-related pathway has been found involved in the regulation of many physiological and pathological cardiovascular processes. Increasing studies are deepening the role of the APJ pathway in limiting hypertension and myocardial ischaemia, thus reducing cardiac fibrosis and adverse tissue remodelling, outlining APJ regulation as a potential therapeutic target for heart failure prevention.
  • 872
  • 10 May 2023
Topic Review
Mediators Connecting Cardiovascular Disease and Cancer
Cardiovascular (CV) diseases and cancer are two of the most common causes of death worldwide.  The pathophysiological overlap between cancer and CV disease is expressed at different levels, including inflammation, oxidative stress, neuro-hormonal activation, clonal hematopoesis and circulating factors. Traditionally, the interest was to find predictors for CV toxicity associated with antineoplastic treatment and to identify these patients in whom chemotherapy would represent a heavy burden. The relationship between cancer and CV diseases is no longer unidirectional. Extracellular vesicles (EVs) could be among the most important biomarkers as they play a decisive role in early identification and determining the CV risk for cancer patients receiving specific treatment for this disease. The preclinical evidence on the bilateral connection between cancer and cardiovascular disease (especially early cardiac changes) through some specific mediators such as EVs  will be discussed here.
  • 867
  • 21 Feb 2023
Topic Review
Tetrahydrocurcumin-Related Vascular Protection
Tetrahydrocurcumin (THC), one of the major metabolites of Curcumin (CUR), possesses several CUR-like pharmacological effects; however, its mechanisms of action are largely unknown. The effects of THC on angiogenesis in CaSki xenografted mice and the expression of vascular endothelial growth factor (VEGF) are well documented. On the other hand, as an anti-inflammatory and antioxidant compound, THC is involved in enhancing homocysteine-induced mitochondrial remodeling in brain endothelial cells. The experimental evidence regarding the mechanism of mitochondrial dysfunction during cerebral ischemic/reperfusion injury and the therapeutic potential of THC to alleviate mitochondrial cerebral dysmorphic dysfunction patterns is also scrutinized and explored. Overall, the studies on different animal models of disease suggest that THC can be used as a dietary supplement to protect against cardiovascular changes caused by various factors (such as heavy metal overload, oxidative stress, and carcinogenesis). 
  • 866
  • 16 Aug 2022
Topic Review
TXNIP
Thioredoxin interacting protein (TXNIP) is a metabolism- oxidative- and inflammation-related marker induced in cardiovascular diseases and is believed to represent a possible link between metabolism and cellular redox status. TXNIP is a potential biomarker in cardiovascular and ischemic diseases but also a novel identified target for preventive and curative medicine. 
  • 865
  • 12 Apr 2021
Topic Review
Physical Activity in Polluted Air and Cardiovascular Health
Both exposure to higher levels of polluted air and physical inactivity are crucial risk factors for the development and progression of major noncommunicable diseases and, in particular, of cardiovascular disease. While regular physical activity is well known to improve general health, it may also increase the uptake and deposit of air pollutants in the lungs/airways and circulation, due to increased breathing frequency and minute ventilation, thus increasing the risk of cardiovascular disease.
  • 865
  • 17 Nov 2021
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. 
  • 865
  • 26 Aug 2021
Topic Review
P2Y12 De-Escalation Strategies
Platelets play a vital role in hemostasis. They become activated upon encountering damaged blood vessels or tissues. Various mechanisms can initiate platelet activation, including pathways mediated by thrombin, collagen, and adenosine diphosphate (ADP). The P2Y1 receptor is responsible for inducing rapid calcium influx into the platelet, leading to shape change and granule secretion after it is linked to Gαq. The P2Y12 receptor is involved in platelet aggregation by activating the integrin alpha IIb beta 3 on the platelet surface and completing the ADP-dependent platelet aggregation response initiated by P2Y1 as well as the ADP-dependent amplification of platelet aggregation induced by other agents such as Gq-coupled serotonin receptors, Gq and G12/13-coupled TXA2 and PAR-1 receptors, immune complexes, or when platelets are activated by collagen through the GPVI/tyrosine kinase/PLCγ2 pathway.
  • 864
  • 14 Jun 2023
Topic Review
Smoking Cessation Pharmacotherapy and Obstructive Sleep Apnea
Tobacco smoking has been a recognized risk factor for cardiovascular diseases (CVD). Smoking is a chronic relapsing disease and pharmacotherapy is a main component of smoking cessation. Obstructive sleep apnea (OSA) and smoking both increase the risk of CVD and are associated with significant morbidity and mortality. There are few existing data examining how pharmacological treatment, such as nicotine replacement therapy (NRT), bupropion, and varenicline, affect smokers suffering with OSA and especially their cardiovascular effects.
  • 862
  • 21 Dec 2023
Topic Review
Monomeric C-Reactive Protein in Atherosclerotic Cardiovascular Disease
C-reactive protein (CRP) is the final product of the interleukin (IL)-1β/IL-6/CRP axis. Its monomeric form can be produced at sites of local inflammation through the dissociation of pentameric CRP and, to some extent, local synthesis. Monomeric CRP (mCRP) has a distinct proinflammatory profile. In vitro and animal-model studies have suggested a role for mCRP in: platelet activation, adhesion, and aggregation; endothelial activation; leukocyte recruitment and polarization; foam-cell formation; and neovascularization. mCRP has been shown to deposit in atherosclerotic plaques and damaged tissues.
  • 862
  • 01 Feb 2023
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.
  • 861
  • 16 Dec 2021
Topic Review
Endothelial Function Assessment by Flow-Mediated Dilation Method
Cardiovascular diseases (CVDs) in the course of atherosclerosis are one of the most critical public health problems in the world. Endothelial cells synthesize numerous biologically active substances involved in regulating the functions of the cardiovascular system. Endothelial dysfunction is an essential element in the pathogenesis of atherosclerosis. Thus, the assessment of endothelial function in people without overt CVD allows for a more accurate estimate of the risk of developing CVD and cardiovascular events. The assessment of endothelial function is primarily used in scientific research, and to a lesser extent in clinical practice. Among the tools for assessing endothelial function, the researchers can distinguish biochemical and physical methods, while physical methods can be divided into invasive and non-invasive methods. Flow-mediated dilation (FMD) is based on the ultrasound assessment of changes in the diameter of the brachial artery as a result of increased blood flow. FMD is a non-invasive, safe, and repeatable test, but it must be performed by qualified and experienced medical staff. 
  • 859
  • 10 Oct 2022
Topic Review
18F-Fluorodeoxyglucose (FDG) in Atherosclerosis
18F-Fluorodeoxyglucose (FDG) is a glucose analogue and the most-validated radiotracer for imaging high metabolically active inflammatory cells (e.g., macrophages) and tissues (e.g., atherosclerotic plaques) in animal models and humans [10]. The results have proven to be reproducible and modifiable via interventions that are anti-inflammatory [11]. FDG-PET imaging may mirror inflammatory activity in atherosclerosis due to the consumption of large amounts of glucose by inflammatory cells compared to other plaque cells.
  • 858
  • 28 Oct 2021
Topic Review
Genetics of Heritable Thoracic Aortic Disease
Genetic testing plays an increasing diagnostic and prognostic role in the management of patients with heritable thoracic aortic disease (HTAD). The identification of a specific variant can establish or confirm the diagnosis of syndromic HTAD, dictate extensive evaluation of the arterial tree in HTAD with known distal vasculature involvement and justify closer follow-up and earlier surgical intervention in HTAD with high risk of dissection of minimal or normal aortic size. Evolving phenotype–genotype correlations lead us towards more precise and individualized management and treatment of patients with HTAD. 
  • 858
  • 10 Feb 2022
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. 
  • 858
  • 02 Dec 2021
Topic Review
Clotting Dysfunction in Sepsis
Sepsis is regarded as one of the main causes of death among the critically ill. Pathogen infection results in a host-mediated pro-inflammatory response to fight infection; as part of this response, significant endogenous reactive oxygen (ROS) and nitrogen species (RNS) production occurs, instigated by a variety of sources, including activated inflammatory cells, such as neutrophils, platelets, and cells from the vascular endothelium. Inflammation can become an inappropriate self-sustaining and expansive process, resulting in sepsis. Patients with sepsis often exhibit loss of aspects for normal vascular homeostatic control, resulting in abnormal coagulation events and development of disseminated intravascular coagulation. Diagnosis and treatment of sepsis remains a significant challenge for health care providers globally. Targeting the drivers of excessive oxidative/nitrosative stress using antioxidant treatments might be a therapeutic option.
  • 855
  • 14 Jan 2022
Topic Review
Antithrombotic Therapy in Patients with AF Undergoing PCI
The antithrombotic management of patients with atrial fibrillation (AF) undergoing percutaneous coronary intervention (PCI) poses numerous challenges. Triple antithrombotic therapy (TAT), which combines dual antiplatelet therapy (DAPT) with oral anticoagulation (OAC), provides anti-ischemic protection but increases the risk of bleeding. Therefore, TAT is generally limited to a short phase (1 week) after PCI, followed by aspirin withdrawal and continuation of 6–12 months of dual antithrombotic therapy (DAT), comprising OAC plus clopidogrel, followed by OAC alone.
  • 855
  • 27 Dec 2023
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