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Topic Review
Vasospasm in Fluoropyrimidine-Induced Ischemic Heart Disease
Cardiovascular diseases and cancer are the leading cause of morbidity and mortality globally. Cardiotoxicity from chemotherapeutic agents results in substantial morbidity and mortality in cancer survivors and patients with active cancer. Cardiotoxicity induced by 5-fluorouracil (5-FU) has been well established, yet its incidence, mechanisms, and manifestation remain poorly defined. Ischemia secondary to coronary artery vasospasm is thought to be the most frequent cardiotoxic effect of 5-FU. The available evidence of 5-FU-induced epicardial coronary artery spasm and coronary microvascular dysfunction suggests that endothelial dysfunction or primary vascular smooth muscle dysfunction (an endothelial-independent mechanism) are the possible contributing factors to this form of cardiotoxicity. In patients with 5-FU-related coronary artery vasospasm, termination of chemotherapy and administration of nitrates or calcium channel blockers may improve ischemic symptoms. However, there are variable results after administration of nitrates or calcium channel blockers in patients treated with 5-FU presumed to have myocardial ischemia, suggesting mechanisms other than impaired vasodilatory response. 
  • 876
  • 22 Apr 2022
Topic Review
Experimental Models of Takotsubo Syndrome
Takotsubo syndrome (TTS) is identified as an acute severe ventricular systolic dysfunction, which is usually characterized by reversible and transient akinesia of walls of the ventricle in the absence of a significant obstructive coronary artery disease (CAD). Patients present with chest pain, ST-segment elevation or ischemia signs on ECG and increased troponin, similar to myocardial infarction. Currently, the known mechanisms associated with the development of TTS include elevated levels of circulating plasma catecholamines and their metabolites, coronary microvascular dysfunction, sympathetic hyperexcitability, inflammation, estrogen deficiency, spasm of the epicardial coronary vessels, genetic predisposition and thyroidal dysfunction. 
  • 874
  • 17 Mar 2022
Topic Review
Stroke Genomics
The pathophysiology of stroke involves many complex pathways and risk factors. Though there are several ongoing studies on stroke, treatment options are limited, and the prevalence of stroke is continuing to increase. Understanding the genomic variants and biological pathways associated with stroke could offer novel therapeutic alternatives in terms of drug targets and receptor modulations for newer treatment methods.
  • 872
  • 09 Mar 2022
Topic Review
Lp(a) Paradox in Diabetes Mellitus
Lipoprotein(a) (Lp(a)) is one of the strongest causal risk factors of atherosclerotic disease. It is rich in cholesteryl ester and composed of apolipoprotein B and apo(a). Plasma Lp(a) levels are determined by apo(a) transcriptional activity driven by a direct repeat (DR) response element in the apo(a) promoter under the control of (HNF)4α Farnesoid-X receptor (FXR) ligands play a key role in the downregulation of APOA expression. In vitro studies on the catabolism of Lp(a) have revealed that Lp(a) binds to several specific lipoprotein receptors; however, their in vivo role remains elusive. In patients suffering from Type-I diabetes mellitus (T1DM), provided they are metabolically well-controlled, Lp(a) plasma concentrations are directly comparable to healthy individuals. In contrast, there exists a paradox in T2DM patients, as many of these patients have reduced Lp(a) levels; however, they are still at an increased cardiovascular risk. The Lp(a) lowering mechanism observed in T2DM patients is most probably caused by mutations in the mature-onset diabetes of the young (MODY) gene and possibly other polymorphisms in key transcription factors of the apolipoprotein (a) gene (APOA).
  • 872
  • 19 Jun 2022
Topic Review
Angiotensin Receptor Blockers in Diabetic Neuropathy
Type 2 diabetes mellitus (T2DM) is becoming increasingly prevalent and currently affects approximately 14.3% of the adult US population. Moreover, a further 38.0% of the adult US population has prediabetes, i.e., impaired fasting glucose or impaired glucose tolerance. Diabetic neuropathy is a frequent complication of both T2DM and type 1 diabetes mellitus (T1DM), and it is present in approximately 3.5–9.4% of patients who havehad T1DM for 1–5 years and in 28% of patients who havehad T2DM for > 4 –7 years. Angiotensin receptor blockers (ARBs) are the antihypertensive agents of choice for hypertensive patients with diabetes mellitus (along with angiotensin-converting enzyme inhibitors, ACE-I). ARBs act by inhibiting the binding of angiotensin II (which is produced by the cleavage of angiotensin I by the angiotensin-converting enzyme) to angiotensin receptor I, thereby promoting vasodilation and inhibiting aldosterone secretion.
  • 871
  • 03 Aug 2022
Topic Review
microRNAs in Acute Coronary Syndromes
microRNAs (miRs) are endogenous non-coding single-stranded RNAs of approximately 20 nucleotides in length that negatively regulate post-transcriptional gene functions. Acute coronary syndromes (ACS) is a result of the interplay between coronary artery in situ thrombus formation, vulnerable plaque features such as a lipid or a necrotic core, myocardial necrosis followed by fibrosis. 
  • 871
  • 29 Nov 2022
Topic Review
Fatty Acids for Cardiovascular Disorders
Data are discussed regarding the roles of the most relevant fatty acids, such as myristic (C14:0), palmitic (C16:0), stearic (C18:0), palmitoleic (C16:1), oleic (C18:1), linoleic (C18:2), α-linolenic (C18:3, ω-3), γ-linolenic (C18:3, ω-6), arachidonic (C20:4), eicosapentaenoic (C20:5), docosahexaenoic (C22:6), and docosapentaenoic (C22:5) acid. The accumulated knowledge has expanded the understanding of the involvement of fatty acids in metabolic processes, thereby enabling the transition from basic exploratory studies to practical issues of application of these biomolecules to CVD treatment. In the future, these findings are expected to facilitate the interpretation and prognosis of changes in metabolic lipid aberrations in CVD.
  • 869
  • 31 Aug 2020
Topic Review
Management of Dyslipidemia
Dyslipidemia, especially a circulating non-optimal level of cholesterol, is one of the most important risk factors for atherosclerotic cardiovascular disease (ASCVD), which accounts for the most deaths worldwide. Maintaining a healthy level of blood cholesterol is an important prevention strategy for ASCVD, through lifestyle intervention or cholesterol-lowering therapy. 
  • 869
  • 14 Nov 2022
Topic Review
Artificial Intelligence in Identifying Disease States
Echocardiography is an integral part of the diagnosis and management of cardiovascular disease. The use and application of artificial intelligence (AI) is a rapidly expanding field in medicine to improve consistency and reduce interobserver variability. AI can be successfully applied to echocardiography in addressing variance during image acquisition and interpretation. Furthermore, AI and machine learning can aid in the diagnosis and management of cardiovascular disease. In the realm of echocardiography, accurate interpretation is largely dependent on the subjective knowledge of the operator. Echocardiography is burdened by the high dependence on the level of experience of the operator, to a greater extent than other imaging modalities like computed tomography, nuclear imaging, and magnetic resonance imaging. AI technologies offer new opportunities for echocardiography to produce accurate, automated, and more consistent interpretations. 
  • 869
  • 01 Mar 2023
Topic Review
Stroke in Patients with Atrial Fibrillation
Atrial fibrillation (AF) is the most common sustained arrythmia and one of the strongest risk factors and causal mechanisms of ischemic stroke (IS). Acute IS due to AF tends to be more severe than with other etiology of IS and patients with treated AF have reported to experience worse outcomes after endovascular treatment compared with patients without AF. As cardioembolism accounts for more than a fifth of ISs and the risk of future stroke can be mitigated with effective anticoagulation, which has been shown to be effective and safe in patients with paroxysmal or sustained AF, the screening of patients with cryptogenic IS (CIS) for AF is paramount.
  • 868
  • 05 Jan 2024
Topic Review
Sphingolipids in Cardiovascular Diseases
Cardiovascular diseases (CVDs) are the leading cause of death and illness in Europe and worldwide, responsible for a staggering 47% of deaths in Europe. There has been increasing evidence pointing to bioactive sphingolipids as drivers of CVDs. Among them, most studies place emphasis on the cardiovascular effect of ceramides and sphingosine-1-phosphate (S1P), reporting correlation between their aberrant expression and CVD risk factors. 
  • 867
  • 16 Jan 2023
Topic Review
Drug Coated Balloons Characteristics according to Antiproliferative Drugs
Drug coated balloons (DCBs) are indicated in guidelines as a first choice option in the management of instant restenosis, whereas their use in de novo lesions is still debated. The concerns raised after the contrasting results of the initial trials with DCBs in de novo lesions have been overcome by a larger amount of data confirming their safety and effectiveness as compared to drug-eluting stents (DES), with potentially greater benefits being achieved, especially in particular anatomical settings, as in very small or large vessels and bifurcations, but also in selected subsets of higher-risk patients, where a ‘leave nothing behind’ strategy could offer a reduction of the inflammatory stimulus and thrombotic risk.
  • 867
  • 12 Jun 2023
Topic Review
IR and Atherosclerosis in T2DM with CAD
Type 2 diabetes mellitus (T2DM) is characterized by impaired insulin secretion on a background of insulin resistance (IR). IR and T2DM are associated with atherosclerotic coronary artery disease (CAD). The mechanisms of IR and atherosclerosis are known to share similar genetic and environmental roots.
  • 866
  • 29 Mar 2023
Topic Review
Different Cardiac Clinical Scenarios in Long COVID
Long COVID-19 or ‘post-acute COVID-19 syndrome’ emerged as the new pandemic, being characterized by a high variability of clinical manifestations ranging from cardiorespiratory and neurological symptoms such as chest pain, exertional dyspnoea or cognitive disturbance to psychological disturbances, e.g., depression, anxiety or sleep disturbance with a crucial impact on patients’ quality of life. Moreover, Long COVID is viewed as a new cardiovascular risk factor capable of modifying the trajectory of current and future cardiovascular diseases, altering the patients’ prognosis. 
  • 866
  • 19 Dec 2023
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. 
  • 865
  • 02 Dec 2021
Topic Review
Obstructive Sleep Apnea and Atrial Fibrillation
Atrial fibrillation (AF) is the most common arrhythmia, increasing with age and comorbidities. Obstructive sleep apnea (OSA) is a chronic sleep disorder more common in older men. It has been shown that OSA is linked to AF. Nonetheless, the prevalence of OSA in patients with AF remains unknown because OSA is significantly underdiagnosed. 
  • 864
  • 24 Mar 2022
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.
  • 863
  • 29 Dec 2020
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
  • 863
  • 17 Nov 2022
Topic Review
Molecular Determinants of Chronic Venous Disease
Chronic Venous Disease (CVD) refers to several pathological and hemodynamic alterations of the veins of lower limbs causing a wide range of symptoms and signs with a high prevalence in the general population and with disabling consequences in the most severe forms. The etiology and pathophysiology of CVD is complex and multifactorial, involving genetic, proteomic, and cellular mechanisms that result in changes to the venous structure and functions. Expressions of several genes associated with angiogenesis, vascular development, and the regulation of veins are responsible for the susceptibility to CVD. Evidence shows that several extracellular matrix alterations (ECM) could be identified and in some cases pharmacologically targeted. 
  • 863
  • 07 Feb 2023
Topic Review
Cardiac Remodeling and Dysfunction in Primary Aldosteronism
Speckle tracking echocardiography is a novel technique to quantify cardiac function and deformation. It has been applied in a series of cardiovascular diseases for the evaluation of early cardiac impairment. Cardiac damage usually occurs earlier in patients with primary aldosteronism than those with primary hypertension, probably because aldosterone hypersecretion is more commonly observed in the former than the latter patients.
  • 862
  • 02 Mar 2022
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