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Topic Review
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Video Entry
Topic Review
Phenotypes of Arrhythmogenic Cardiomyopathy
Arrhythmogenic Cardiomyopathy (ACM) is a Mendelian disorder that can affect both left and right ventricles. It is most often associated with pathogenic desmosomal variants that can lead to fibrofatty replacement of the myocardium, a pathological hallmark of this disease.
437
11 Aug 2022
Topic Review
Management of Metabolic Syndrome
Metabolic syndrome (MS) is a growing disorder affecting thousands of people worldwide, especially in industrialised countries, increasing mortality. Oxidative stress, hyperglycaemia, insulin resistance, inflammation, dysbiosis, abdominal obesity, atherogenic dyslipidaemia and hypertension are important factors linked to MS clusters of different pathologies, such as diabesity, cardiovascular diseases and neurological disorders. All biochemical changes observed in MS, such as dysregulation in the glucose and lipid metabolism, immune response, endothelial cell function and intestinal microbiota, promote pathological bridges between metabolic syndrome, diabesity and cardiovascular and neurodegenerative disorders.
437
15 Dec 2023
Topic Review
Comorbid Sepsis and Cardiogenic Shock
Septic shock management in the cardiac intensive care unit (CICU) is challenging due to the complex interaction of pathophysiology between vasodilatory and cardiogenic shock, complicating how to optimally deploy fluid resuscitation, vasopressors, and mechanical circulatory support devices.
437
26 Oct 2023
Topic Review
Cardiovascular Magnetic Resonance Imaging in Hypertrophic Cardiomyopathy Evaluation
Hypertrophic cardiomyopathy (HCM) is the most common inherited cardiac disorder, affecting 1 out of 500 adults globally. It is a widely heterogeneous disorder characterized by a range of phenotypic expressions, and is most often identified by non-invasive imaging that includes echocardiography and cardiovascular magnetic resonance imaging (CMR). Within the last two decades, cardiac magnetic resonance imaging (MRI) has emerged as the defining tool for the characterization and prognostication of cardiomyopathies. With a higher image quality, spatial resolution, and the identification of morphological variants of HCM, CMR has become the gold standard imaging modality in the assessment of HCM. Moreover, it has been crucial in its management, as well as adding prognostic information that clinical history nor other imaging modalities may not provide.
436
09 Feb 2022
Topic Review
Temporary Right-Ventricular Assist Devices
Acute right-sided heart failure (RHF) is a complex clinical syndrome, with a wide range of clinical presentations, associated with increased mortality and morbidity, but about which there is a scarcity of evidence-based literature. A temporary right-ventricular assist device (t-RVAD) is a potential treatment option for selected patients with severe right-ventricular dysfunction as a bridge-to-recovery or as a permanent solution.
436
22 Feb 2022
Topic Review
Role of Epicardial Adipose Tissue in Cardiovascular Diseases
Cardiovascular diseases (CVDs) are the leading causes of death worldwide. Epicardial adipose tissue (EAT) is defined as a fat depot localized between the myocardial surface and the visceral layer of the pericardium and is a type of visceral fat. EAT is one of the most important risk factors for atherosclerosis and cardiovascular events and a promising new therapeutic target in CVDs. In health conditions, EAT has a protective function, including protection against hypothermia or mechanical stress, providing myocardial energy supply from free fatty acid and release of adiponectin. In patients with obesity, metabolic syndrome, or diabetes mellitus, EAT becomes a deleterious tissue promoting the development of CVDs.
436
08 Apr 2022
Topic Review
High-Density Lipoproteins-Based Nanomedicine in Cardiovascular Disease
High-density lipoproteins (HDL) are complex endogenous nanoparticles involved in important functions such as reverse cholesterol transport and immunomodulatory activities, ensuring metabolic homeostasis and vascular health. The ability of HDL to interact with a plethora of immune cells and structural cells places it in the centre of numerous disease pathophysiologies. With a better understanding of the properties of synthetic and reconstituted HDL formulations and an increase in preclinical research, several HDL based nanoformulations have been tested in clinical trials.
436
09 Jun 2023
Topic Review
Heart Transplant Surgeon Workforce between 2000 and 2020
Though diversity among cardiothoracic surgeons performing pediatric and adult heart transplantations (HTxs) has increased over the past years, the majority of the field remains male and White. This is particularly striking when compared with the composition of the United States population (49.2% male, 60.1% White in 2019). These findings are particularly important, given that prior studies have identified sex and racial disparities in access and outcomes following HTx among adult patients, and that racial concordance between physicians and patients improves patient outcomes in settings of known racial disparities. These results demonstrate the need for further research to analyze the causes of sex and racial disparities and initiate more effective efforts to increase diversity of the workforce.
434
07 Apr 2022
Topic Review
Veno-Arterial Extracorporeal Membrane Oxygenation
Mortality in infarct-related cardiogenic shock (CS) remains high, reaching 40–50%. In refractory CS, active mechanical circulatory support devices including veno-arterial extracorporeal membrane oxygenation (VA-ECMO) are rapidly evolving. However, supporting evidence of VAECMO therapy in infarct-related CS is low. The basics of VA-ECMO therapy, current evidence, ongoing trials, patient selection and potential complications warrant focus.
433
12 Apr 2022
Topic Review
Pulmonary Embolism Response Teams
Pulmonary embolism (PE) continues to represent a significant health care burden and its incidence is steadily increasing worldwide. Constantly evolving therapeutic options and the rarity of randomized controlled trial data to drive clinical guidelines impose challenges on physicians caring for patients with PE. PE response teams have been developed and recommended to help address these issues by facilitating a consensus among local experts while advocating the management of acute PE according to each individual patient profile.
433
21 Nov 2022
Topic Review
Cardiovascular Disease Complicating COVID-19
Cardiovascular disease (CVD) is the leading cause of death worldwide. Its incidence increases sharply with age, and the elderly bear a disproportionate burden of CVD morbidity and mortality. Coronavirus disease 2019 (COVID-19), caused by severe acute respiratory distress syndrome coronavirus 2 (SARS-CoV-2), has also caused significant mortality, specifically amongst the elderly, who are the most likely patient population to be hospitalized and die from the infection. Pre-existing CVD is a known risk factor for poor outcome in Covid-19 patients and, in our efforts to preserve life, attention must be paid to the adverse impact of the virus on the cardiovascular system. The emergence of novel SARS-CoV-2 pathogenic variants with greater transmissibility is prolonging the pandemic and sustaining the threat to life and health. An understanding of the pathogenic mechanisms that underlie the CVD-Covid-19 interaction can lead to improved treatment and reduced sequelae in the midst of this global health crisis.
432
23 Sep 2021
Topic Review
Dysregulated Calcium Handling in Cirrhotic Cardiomyopathy
Cirrhotic cardiomyopathy is a syndrome of blunted cardiac systolic and diastolic function in patients with cirrhosis. Since contractility and relaxation depend on cardiomyocyte calcium transients, any factors that impact cardiac contractile and relaxation functions act eventually through calcium transients. In addition, calcium transients play an important role in cardiac arrhythmias.
432
20 Jul 2023
Topic Review
Sestrin2 as a Potential Target in Hypertension
Hypertension is a highly complex, intricate condition affecting millions of individuals across the globe. Nearly half of adults in the United States are diagnosed with hypertension, with incident rates projected to rise over the next decade. Hypertension is a precursor to many cardiovascular diseases including atherosclerosis, stroke, myocardial infarction, heart failure, and peripheral artery disease. The Sestrin (SESN) family of proteins is comprised of three members Sesn1, Sens2, and Sesn3, and is expressed by three coding genes: SESN1, SESN2, and SESN3
431
31 Jul 2023
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.
430
17 Mar 2022
Topic Review
Finerenone on Cardiovascular and Chronic Kidney Diseases
Patients with cardiovascular disease (CVD) and chronic kidney disease (CKD) show high rates of cardiorenal outcomes. Several studies suggest that the activation of the mineralocorticoid receptor (MR) induces cardiac and renal injury, including inflammation and fibrosis. Finerenone is a novel non-steroidal selective mineralocorticoid receptor antagonist (MRA) with a stronger mineralocorticoid receptor binding potential than eplerenone and spironolactone. Finerenone has been shown to have anti-inflammatory and anti-fibrotic effects in preclinical studies.
430
08 Jun 2023
Topic Review
MINOCA Associated with a Myocardial Bridge
Myocardial bridging (MB) is the most frequent congenital coronary anomaly characterized by a segment of an epicardial coronary artery that passes through the myocardium. MB is an important cause of myocardial ischemia and is also emerging as a possible cause of myocardial infarction with non-obstructed coronary arteries (MINOCA). There are multiple mechanisms underlying MINOCA in patients with MB (i.e., MB-mediated increased risk of epicardial or microvascular coronary spasm, atherosclerotic plaque disruption and spontaneous coronary artery dissection).
430
13 Jun 2023
Topic Review
XBP1 Modulates the Aging Cardiorenal System
X-box binding protein 1 (XBP1) is a unique basic-region leucine zipper (bZIP) transcription factor. Over recent years, the powerful biological functions of XBP1 in oxidative stress have been gradually revealed. When the redox balance remains undisturbed, oxidative stress plays a role in physiological adaptations and signal transduction. However, during the aging process, increased cellular senescence and reduced levels of endogenous antioxidants cause an oxidative imbalance in the cardiorenal system.
429
15 Nov 2023
Topic Review
Pathophysiology of Cardiac Dysfunction in Aortic Stenosis
Aortic stenosis (AS) is a disease both of the valve and the myocardium, characterized by fibrosis and calcification of valve leaflets, progressive LV hypertrophy, and myocardial fibrosis. AS represents not only a valvular disease but a whole heart disease, often in patients with comorbidities.
429
11 Dec 2023
Topic Review
NLRP3 Inflammasome in Vascular Disease and Pharmacological Opportunities
The NLRP3 inflammasome is a multiprotein complex that assembles to engage the innate immune defense by processing the maturation of pro-inflammatory cytokines IL-1β and IL-18. Substantial evidence has positioned the NLRP3 inflammasome at the center of vascular disease progression, with a particular significance in the context of aging and the low-grade chronic inflammation associated (inflammaging). Therefore, pharmacological blockade of the NLRP3 inflammasome and its end products has arisen as an extremely promising tool to battle vascular disease.
429
16 Feb 2022
Topic Review
Blood-Based Biomarkers in Pulmonary Hypertension
Pulmonary hypertension (PH) is a serious hemodynamic condition, characterized by increased pulmonary vascular resistance (PVR), leading to right heart failure (HF) and death when not properly treated. The prognosis of PH depends on etiology, hemodynamic and biochemical parameters, as well as on response to specific treatment.
428
26 Jan 2022
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