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Topic Review
Pathogenesis of COVID-19
The systemic manifestations commonly observed in COVID-19 patients include hypertension, arterial and venous thromboembolism, kidney disease, cerebrovascular disorders, and diabetes mellitus). These clinical findings strongly suggest that the virus is targeting the endothelium. Here we report a systematic and comprehensive evaluation of the evidence showing that the endothelium is a key target organ in COVID-19, playing a fundamental role in its pathogenesis.
  • 1.2K
  • 30 Oct 2020
Topic Review
Cardiovascular Effects of Vasopressin and Oxytocin
Oxytocin (Cys-Tyr-Ile-Gln-Asn-Cys-Pro-Leu-Gly-NH2; OXY) and arginine vasopressin (Cys-Tyr-Phe-Gln-Asn-Cys-Pro-Arg-Gly-NH2; AVP) are nonapeptides, differing only in two aminoacids.  The secretion of OXY and AVP is influenced by changes in body fluid osmolality, blood volume, blood pressure, hypoxia, and stress. AVP and OXY receptors are present in several regions of the brain (cortex, hypothalamus, pons, medulla, and cerebellum) and in the peripheral organs (heart, lungs, carotid bodies, kidneys, adrenal glands, pancreas, gastrointestinal tract, ovaries, uterus, thymus). Hypertension, myocardial infarction, and coexisting factors, such as pain and stress, have a significant impact on the secretion of oxytocin and vasopressin and on the expression of their receptors.
  • 1.2K
  • 10 Nov 2021
Topic Review
Honey
Honey is one of the most prized medicinal remedies used since ancient times. There is evidence that indicates honey can function as a cardioprotective agent in cardiovascular diseases.
  • 1.1K
  • 02 Nov 2020
Topic Review
Atrial Fibrillation Diagnosis Measurements
Atrial Fibrillation (AF) is a heart rhythm disorder. Hence, AF diagnosis is based on measurements which reflect the activity of the heart. Detectable symptoms of the disease might not be present all the time. Therefore, the measurement duration is positively correlated with the AF detection rate. Suitable measurements include photoplethysmogram, electrocardiogram, and heart rate. The data volume, produced through long term measurement, mandates computer support to automate the AF detection task.
  • 1.1K
  • 30 Oct 2020
Topic Review
Standard for Automated ECG Interpretation
Diagnostic statements for automated ECG interpretation algorithms are the fundamental output, and the accuracy of these statements should be well characterized by algorithm testing, including both ECG contour and ECG rhythm diagnostic statements. The methods for measuring accuracy have been consistently and well defined, and previously included in ECG standards. However, the current industry ECG standards have omitted these historical requirements to test the accuracy of diagnostic statements, which is a gap that is being addressed in 80601-2-86.
  • 1.1K
  • 17 Sep 2021
Topic Review
Antiphospholipid Syndrome (APS)
Antiphospholipid syndrome (APS) is considered an autoimmune, thrombo-inflammatory disease characterized by vascular thrombosis in the setting of one or more antiphospholipid antibodies (aPLs) such as lupus anticoagulant (AL), anticardiolipin antibodies (aCL) and anti-β2-glycoprotein1 antibodies (aβ2GPI).
  • 1.1K
  • 07 Dec 2021
Topic Review
Non-Pharmacological Options in Atherosclerosis
Atherosclerosis remains the leading cause of mortality and morbidity worldwide characterized by the deposition of lipids and fibrous elements in the form of atheroma plaques in vascular areas which are hemodynamically overloaded. Atherosclerotic cardiovascular disease is the leading cause of death and disability. Prolonged survival with chronic disease explains why the prevalence, burden, and costs of the disease remain high. Given these issues, aggressive treatment should be started at the first indication and continued over several years, along with the reduction in disease risk factors such as visceral adiposity, dyslipidemia, hypertension, and diabetes.
  • 1.1K
  • 04 Oct 2022
Topic Review
Polymeric Nanoparticles in Cardiovascular Diseases
Nanoparticles, including biodegradable polymeric nanoparticles, are able to increase the efficiency and reduce the degradability of natural polyphenols, thus increasing their beneficial abilities in the target tissues. Resveratrol-, quercetin-, or curcumin-loaded polymeric nanoparticles have been shown to markedly reduce reactive oxygen species formation, the inflammatory process, apoptosis, lipid peroxidation, cardiac hypertrophy, and even to delay myocardium injury due to ischemia/reperfusion. Thus, polymeric nanoparticles represent a promising tool for the delivery of natural polyphenols to target tissues and enhance their desirable effects in the cardiovascular system.
  • 1.1K
  • 27 Oct 2020
Topic Review
Techniques for Ventricular Tachycardia Functional Substrate Mapping
Conventional mapping techniques used to define the critical isthmus, such as activation mapping and entrainment, are limited by the non-inducibility of the clinical tachycardia or its poor hemodynamic tolerance. To overcome these limitations, a voltage mapping strategy based on bipolar electrograms peak to peak analysis was developed, but a low specificity (30%) for VT isthmus has been described with this approach. Functional mapping strategy relies on the analysis of the characteristics of the electrograms but also their propagation patterns and their response to extra-stimulus or alternative pacing wavefronts to define the targets for ablation.
  • 1.1K
  • 19 Sep 2022
Topic Review
C-reactive protein (CRP) apheresis
Almost every kind of inflammation in the human body is accompanied by rising C-reactive protein (CRP) concentrations. This can include bacterial and viral infection, chronic inflammation and so-called sterile inflammation triggered by (internal) acute tissue injury. CRP is part of the ancient humoral immune response and secreted into the circulation by the liver upon respective stimuli. Its main immunological functions are the opsonization of biological particles (bacteria and dead or dying cells) for their clearance by macrophages and the activation of the classical complement pathway. This not only helps to eliminate pathogens and dead cells, which is very useful in any case, but unfortunately also to remove only slightly damaged or inactive human cells that may potentially regenerate with more CRP-free time. CRP action severely aggravates the extent of tissue damage during the acute phase response after an acute injury and therefore negatively affects clinical outcome. CRP is therefore a promising therapeutic target to rescue energy-deprived tissue either caused by ischemic injury (e.g., myocardial infarction and stroke) or by an overcompensating immune reaction occurring in acute inflammation (e.g., pancreatitis) or systemic inflammatory response syndrome (SIRS; e.g., after transplantation or surgery). Selective CRP apheresis can remove circulating CRP safely and efficiently. We explain the pathophysiological reasoning behind therapeutic CRP apheresis and summarize the broad span of indications in which its application could be beneficial with a focus on ischemic stroke as well as the results of this therapeutic approach after myocardial infarction.
  • 1.1K
  • 17 Sep 2020
Topic Review
Age-Related Diseases
Aging is a multifactorial dynamic process that is influenced by a variety of external and internal variables, including environmental, demographic, and biopsychosocial factors, to determine the development and progression of age-related diseases, rather than being a solely static intrinsic process of cellular alterations.
  • 1.1K
  • 15 Apr 2021
Topic Review
Marfan Cardiomyopathy and Arrhythmia
Marfan syndrome (MFS) is a heritable systemic connective tissue disease with important cardiovascular involvement, including aortic root dilatation and mitral valve prolapse. Life expectancy in patients with MFS is mainly determined by cardiovascular complications, among which aortic dissection or rupture are most dreaded. In recent years, heart failure and ventricular arrhythmia have drawn attention as extra-aortic cardiovascular manifestations and as additional reported causes of death. Imaging studies have provided data supporting a primary myocardial impairment in the absence of valvular disease or cardiovascular surgery, while studies using ambulatory ECG have demonstrated an increased susceptibility to ventricular arrhythmia.
  • 1.1K
  • 22 Feb 2021
Topic Review
Gla-Rich Protein in CKD
Chronic kidney disease (CKD) is estimated to affect more than 10% of the global population and represents an increasing health and economic burden for the society. Cardiovascular disease (CVD) is the most important complication of CKD and the primary cause of death in these patients. Chronic kidney disease-mineral and bone disorder (CKD-MBD), which is a common complication of CKD patients, involves changes in mineral ion homeostasis, bone quality and turnover, cardiovascular and soft tissue calcifications, highly contributing for cardiovascular outcomes. Vascular calcification (VC) is one of the strongest predictors of cardiovascular risk in chronic kidney disease (CKD) patients which is associated with significant morbidity and mortality. New diagnostic/prognostic tools are required for early detection of VC allowing interventional strategies. Gla-rich protein (GRP) is a cardiovascular calcification inhibitor, whose clinical utility still remained unknown. The present clinical study including a cohort of 80 diabetic patients with mild to moderate CKD (stages 2–4) explored, for the first time, correlations between levels of GRP in serum with CKD developmental stage, mineral metabolism markers, VC and pulse pressure (PP). The results shown an association between GRP, renal dysfunction and CKD-MBD. The relationship between low levels of GRP and vascular calcifications suggests a potential clinical utility for GRP as an early marker of vascular damage in CKD.
  • 1.1K
  • 02 Nov 2020
Topic Review
The Endothelin System
Endothelin was first discovered more than 30 years ago as a potent vasoconstrictor. In subsequent years, three isoforms, two canonical receptors, and two converting enzymes were identified, and their basic functions were elucidated by numerous preclinical and clinical studies. The endothelin system has been found to be critical in the pathogenesis of several cardiovascular diseases, including hypertension, pulmonary arterial hypertension, heart failure, and coronary artery disease.
  • 1.1K
  • 01 Jun 2022
Topic Review
Desmosomal Genes
Desmosomes are mirroring, transmembrane protein chains that connect the intermediate filament networks of neighbouring cells. Each chain continuously (dis)assembles due to the turnover of five desmosomal protein types: desmoplakin, plakoglobin, plakophilins, desmocollins and desmogleins. The expression of two genes is critical to the formation of all desmosomes: namely DSP, encoding two differently spliced desmoplakin proteins (DPI and DPII) and JUP, encoding plakoglobin (PG). Meanwhile, plakophilins, desmocollins and desmogleins are expressed in a tissue-specific manner and are therefore encoded by multiple genes.
  • 1.0K
  • 20 Oct 2022
Topic Review
Oxidative Stress and Aging Heart-Diseases
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
  • 20 Jan 2021
Topic Review
Endothelial Nitric Oxide Synthase
Endothelial function is largely based on endothelial nitric oxide synthase (eNOS) function and activity. Likewise, oxidative stress can lead to the loss of eNOS activity or even “uncoupling” of the enzyme by adverse regulation of well-defined “redox switches” in eNOS itself or up-/down-stream signaling molecules. 
  • 1.0K
  • 01 Dec 2021
Topic Review
Artificial Intelligence in Coronary Artery Disease
Clinically significant atherosclerosis of the coronary arteries, known as coronary artery disease (CAD), is an endemic condition that is associated with significant morbidity and mortality. The introduction of artificial intelligence (AI) and machine learning over the last two decades has unlocked new dimensions in the field of cardiovascular medicine. From automatic interpretations of heart rhythm disorders via smartwatches, to assisting in complex decision-making, AI has quickly expanded its realms in medicine and has demonstrated itself as a promising tool in helping clinicians guide treatment decisions. Understanding complex genetic interactions and developing clinical risk prediction models, advanced cardiac imaging, and improving mortality outcomes are just a few areas where AI has been applied in the domain of coronary artery disease. 
  • 1.0K
  • 13 Apr 2022
Topic Review
Basics of Coronary Bifurcation and Treatment in Brief
Coronary bifurcation percutaneous interventions (PCI) comprise a challenging subset of patients with coronary artery disease. PCI historically have a worse outcome compared to general revascularization procedures, but the advent of the third-generation drug-eluting stent (DES) has also drastically improved the results for patients with bifurcation disease. Beyond the discussion about beneficial effects on clinical outcomes of different strategies to fix coronary artery bifurcation disease, in order to improve the knowledge of technical complications, it is essential to understand the basics of bifurcation and the single versus double stent strategy.
  • 1.0K
  • 22 Nov 2022
Topic Review
2D and 3D Echo in Mitral Stenosis
Mitral stenosis is an important cause of heart valve disease globally. Echocardiography is the main imaging modality used to diagnose and assess the severity and hemodynamic consequences of mitral stenosis as well as valve morphology. Transthoracic echocardiography (TTE) is sufficient for the management of most patients.
  • 1.0K
  • 15 Dec 2021
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