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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
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. 
  • 428
  • 10 Oct 2022
Topic Review
Physiological Mechanisms of Incretins
Atherosclerosis is a multifactorial process characterized by forming fibrofatty lesions within the arterial wall and is considered the leading cause of death worldwide. Improvement in treatment and prevention is crucial, especially in patients with type 2 diabetes (T2D), a clinical syndrome expected to affect 783.2 million people by 2045. Therefore, the treatment guidelines for T2D patients recommend a patient-tailored approach based on lifestyle modifications and the choice of optimal therapeutic option. An ideal anti-diabetic drug should have the following characteristics: significant impact on weight and cardiovascular comorbidities, low risk of hypoglycemia and adverse events, and, last but not least, low costs. Even if no optimal medication exists, incretins represent one of the most attractive and promising options. The “incretin effect” indicates the amplification of pancreatic insulin secretion induced by these gastrointestinal tract-released hormones.
  • 428
  • 17 Jul 2023
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.
  • 427
  • 14 Jun 2023
Topic Review
Metabolic Exercise Testing in Heart Failure
Heart Failure (HF) is a clinical syndrome that is caused by a structural and/or functional cardiac abnormality and corroborated by elevated natriuretic peptide levels and/or objective evidence of pulmonary or systemic congestion. Metabolic exercise testing, also known as cardiopulmonary exercise testing, provides a comprehensive evaluation of the multisystem (i.e., neurological, respiratory, circulatory, and musculoskeletal) response to exercise performance.
  • 426
  • 10 Jul 2023
Topic Review
Telemedicine and Emerging Trends in Heart Failure Management
Heart failure is a cardiovascular condition, leading to fatigue, breathlessness, and fluid retention. It affects around 56 million people globally and is a leading cause of hospitalization and mortality. Its prevalence is rising due to aging populations and lifestyle factors. Managing heart failure demands a multidisciplinary approach, encompassing medications, lifestyle modifications, and often medical devices or surgeries. The treatment burden is substantial, impacting patients’ daily lives and straining healthcare systems. Improving early detection, novel therapies, and patient education are crucial for alleviating the burden and enhancing the quality of life. There are notable advancements in the field of heart failure treatment and prevention. 
  • 426
  • 15 Jan 2024
Topic Review
Prediabetes and Microcirculation
Prediabetes is a significant metabolic status since there is high potential for future progression of diabetes mellitus (DM). People with prediabetes are at increased risk of cardiovascular disease (CVD) and mortality. Endothelial and microvascular dysfunction is considered a key step towards the development and progression of CVD. The term microcirculation refers to the circulation in vessels with diameter <150 μm, including the small arteries and veins, as well as the capillaries. The main function of microcirculation is to ensure the provision of nutrients and oxygen to tissues. It also regulates hydrostatic pressure at the level of capillaries and blood flow, and consequently, it helps in the regulation of blood pressure through the increase of peripheral resistance.
  • 425
  • 19 Apr 2023
Topic Review
Revascularization and Left Ventricular Dysfunction for ICD Eligibility
Common triggers for sudden cardiac death (SCD) are transient ischemia, hemodynamic fluctuations, neurocardiovascular influences, and environmental factors. SCD occurs rapidly when sinus rhythm degenerates into ventricular tachycardia (VT) and/or ventricular fibrillation (VF), followed by asystole. Such progressive worsening of the cardiac rhythm is in most cases observed in the setting of ischemic heart disease and often associated with advanced left ventricular (LV) impairment. Revascularization prevents negative outcomes including SCD and heart failure (HF) due to LV dysfunction (LVD). The implantable cardioverter–defibrillator (ICD) on top of medical therapy is superior to antiarrhythmic drugs for patients with LVD and VT/VF. The beneficial effects of ICD have been demonstrated in primary prevention of SCD as well.
  • 425
  • 23 Oct 2023
Topic Review
Mechanical Unloading of Failing Heart
Ventricular assist devices (VADs) have been considered a reasonable alternative strategy in advanced heart failure (HF), widely used as a bridge to heart transplantation or candidacy. Mechanical unloading supports the function of a failing heart and the perfusion of vital organs through reduced workload placed on the ventricles. In clinical practice, it might initiate a healing response with even myocardial recovery, making heart transplantation and mechanical support no longer required. 
  • 424
  • 02 Oct 2022
Topic Review
Gender Differences and Cardiometabolic Risk
Metabolic syndrome (Mets) is a clinical condition characterized by a cluster of major risk factors for cardiovascular disease (CVD) and type 2 diabetes: proatherogenic dyslipidemia, elevated blood pressure, dysglycemia, and abdominal obesity. Each risk factor has an independent effect, but, when aggregated, they become synergistic, doubling the risk of developing cardiovascular diseases and causing a 1.5-fold increase in all-cause mortality.
  • 424
  • 27 Feb 2023
Topic Review
Intra and Post-Operative Graft Quality Assessment
Coronary artery bypass grafting (CABG) is the gold standard procedure for multi vessels and left main coronary artery disease. The prognosis and survival outcomes of CABG surgery are highly dependent on the patency of the bypass graft. Early graft failure which can occur during or soon after CABG remains a significant issue, with reported incidences of 3–10%. Graft failure can lead to refractory angina, myocardial ischemia, arrhythmias, low cardiac output, and fatal cardiac failure, emphasizing the importance of ensuring graft patency during and after surgery to prevent such complications. Technical errors during anastomosis are among the leading causes of early graft failure.
  • 424
  • 25 Jun 2023
Topic Review
Diagnostic Performances of Nuclear Imaging in Infective Endocarditis
Infective endocarditis (IE) is a life-threatening disease with stable prevalence despite prophylactic, diagnostic, and therapeutic advances. While echocardiography remains the first line imaging technique, especially in native valve endocarditis, the incremental value of two nuclear imaging techniques, 18F-fluorodeoxyglucose positron emission tomography with computed tomography (18F-FDG-PET/CT) and white blood cells single photon emission tomography with computed tomography (WBC-SPECT), has emerged for the management of prosthetic valve and CIED IE.
  • 423
  • 05 Jan 2022
Topic Review
Genetic Predisposition and Inflammatory Inhibitors in COVID-19
Genetic predisposition, as in other inflammatory diseases, might be responsible for alterations in the clinical course of COVID-19 patients through polymorphisms in crucial genes such as ACE2 and MHC class I. Components of the immune response to the virus appear to be primarily related to disease severity, whereas genes related to the binding of the ACE2 cell surface—the entry point for SARS-CoV-2—during the early stages of infection appear to be largely responsible for the varying susceptibility to SARS-CoV-2. Inflammatory inhibitors are at the forefront of pharmacological management in COVID-19, although their potential has not been fully elucidated till now. The above mentioned would have a potentially large impact on targeted medicines and, more critically, vaccine development.
  • 422
  • 17 Feb 2022
Topic Review
Transcatheter Mitral Valve Repair or Replacement
Transcatheter devices have been developed to repair or replace diseased mitral valves (MV). Transcatheter mitral valve repair (TMVr) devices have been proven to be efficient and safe, but many anatomical structures are not compatible with these technologies.
  • 422
  • 29 Jun 2022
Topic Review
The Right Ventricle in COVID-19 Patients
Cardiac involvement has been described during the course of SARS-CoV-2 disease (COVID-19), with different manifestations. Several series have reported only increased cardiac troponin without ventricular dysfunction, others the acute development of left or right ventricular dysfunction, and others myocarditis. 
  • 421
  • 11 May 2022
Topic Review
Fontan System in Univentricular Hearts in Heart Transplantation
The Fontan procedure (FP) is the standard surgical treatment for Univentricular heart diseases. Over time, the Fontan system fails, leading to pathologies such as protein-losing enteropathy (PLE), plastic bronchitis (PB), and heart failure (HF). FP should be considered as a transitional step to the final treatment: heart transplantation (HT). 
  • 420
  • 13 Dec 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. 
  • 420
  • 10 Jan 2022
Topic Review
CFD Analysis in LAA Thrombus Formation Risk
Atrial fibrillation (AF) is a common cardiac arrhythmia characterized by irregular and rapid electrical activity in the atria, leading to ineffective contraction and poor blood flow. More than 90% of the left atrial (LA) thrombi that cause thromboembolic events during atrial fibrillation (AF) develop in the left atrial appendage (LAA). Computational fluid dynamics (CFD) analysis can be used to better understand the risk of thrombus formation and subsequent embolic events. 
  • 420
  • 20 Jul 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.
  • 420
  • 21 Dec 2023
Topic Review
Cardiovascular Health of People with Severe Mental Illness
In Australia and internationally, adults with SMI such as schizophrenia, schizoaffective disorder, and bipolar disorder are at increased risk of early death due to physical health problems. Cardiovascular diseases (CVD), type 2 diabetes, nutritional and metabolic diseases, and obesity and smoking-related cancers are some of these potentially preventable chronic conditions that are frequently observed and disproportionately found among people with SMI compared with non-SMI populations. This mental–physical health interface has multiple adverse impacts for the person in their daily life, and also appears to generate greater difficulty in the person’s healthcare management.
  • 419
  • 11 Feb 2022
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