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Topic Review
Porcine Bioprostheses In Situ “Humanization”
This entry describes bioprostheses conversion into viable permanently functional tissue in humans. This process includes gradual degradation of the porcine tissue, with concomitant neo-vascularization and reconstruction of the implanted bioprosthesis with human cells and extracellular matrix. Such a reconstruction process is referred to in this review as “humanization”. Humanization was achieved with porcine bone-patellar-tendon-bone (BTB), replacing torn anterior-cruciate-ligament (ACL) in patients. In addition to its possible use in orthopedic surgery, it is suggested that this humanization method should be studied as a possible mechanism for converting implanted porcine bioprosthetic heart-valves (BHV) into viable tissue valves in young patients. Presently, these patients are only implanted with mechanical heart-valves, which require constant anticoagulation therapy. The processing of porcine bioprostheses, which enables humanization, includes elimination of α-gal epitopes and partial (incomplete) crosslinking with glutaraldehyde. Studies on implantation of porcine BTB bioprostheses indicated that enzymatic elimination of α-gal epitopes prevents subsequent accelerated destruction of implanted tissues by the natural anti-Gal antibody, whereas the partial crosslinking by glutaraldehyde molecules results in their function as “speed bumps” that slow the infiltration of macrophages, enabling gradual degradation of the bioprosthesis and replacement of the porcine tissue with human fibroblasts and the collagen fibers and matrix components they produce.
  • 767
  • 09 Feb 2021
Topic Review
Natural Monoterpenes against Atherosclerosis
Traditional herbal medicines based on natural products play a pivotal role in preventing and managing atherosclerotic diseases, which are among the leading causes of death globally. Monoterpenes are a large class of naturally occurring compounds commonly found in many aromatic and medicinal plants. Emerging evidence has shown that monoterpenes have many biological properties, including cardioprotective effects.
  • 767
  • 05 May 2023
Topic Review
Myocarditis Following mRNA COVID-19 Vaccination
The development of the mRNA vaccine against SARS-CoV-2 is unprecedented in the history of Vaccinology. The prototypes of the mRNA vaccine are BNT162b2 (Pfizer-BioNTech) and mRNA-1273 (Moderna), which gained widespread use to prevent severe SARS-CoV-2 infection. As per CDC guidelines, these vaccines have undergone extensive testing and trials, and myocarditis and pericarditis occurred after the mRNA vaccines were not reported in trials.
  • 765
  • 17 Aug 2021
Topic Review
Endothelial Dysfunction in COVID-19
The endothelium is considered a real organ, with its own defined structure capable of guaranteeing vascular homeostasis through several functions.
  • 764
  • 29 Apr 2022
Topic Review
Coronary Computed Tomography Angiography
The use of coronary computed tomography angiography (CCTA) in the setting of stable coronary artery disease is highly recommended for low-risk patients. High-risk patients, such as symptomatic subjects with prior revascularization, are suggested to be investigated with noninvasive functional tests or invasive coronary angiography.
  • 761
  • 31 Jan 2024
Topic Review
Effects of Interleukins on CMs in Heart Disease
Myocardial infarction (MI), heart failure, cardiomyopathy, myocarditis, and myocardial ischemia-reperfusion injury (I/R) are the most common heart diseases, yet there is currently no effective therapy due to their complex pathogenesis. Cardiomyocytes (CMs), fibroblasts (FBs), endothelial cells (ECs), and immune cells are the primary cell types involved in heart disorders, and, thus, targeting a specific cell type for the treatment of heart disease may be more effective. The same interleukin may have various effects on different kinds of cell types in heart disease. CMs are the beating muscle cells that make up the atria and ventricles and are being targeted primarily in heart disease therapy.
  • 760
  • 19 Apr 2023
Topic Review
Imaging Cardiovascular in Chronic Kidney Disease
Chronic kidney disease (CKD) patients have a higher risk of developing early cardiovascular disease (CVD). Although vascular calcification (VC) is one of the strongest predictors of CVD risk, its diagnosis among the CKD population remains a serious clinical challenge. Imaging methods, henceforward referred to as imaging biomarkers, have played a crucial role in the diagnosis of VC, with important insights into cardiovascular risk. One of the reasons that may explain the struggle for accurate VC diagnosis in CKD patients is that the calcification characteristics change alongside renal deterioration and CKD progression. Novel circulating biomarkers like Fetuin-a, Matrix Gla Protein (MGP) and Gla Rich Protein (GRP), representing a more direct and unique reflection of the molecular dynamics involved in VC mechanisms, could complement VC clinical diagnostic and add value to patient care.
  • 759
  • 30 Dec 2022
Topic Review
Gut Microbiota for Atherosclerosis Disease
The increasing number of studies on the relationship between the gut microbiota and atherosclerosis have led to significant interest in this subject. The gut microbiota, its metabolites (metabolome), such as TMAO, and gut dysbiosis play an important role in the development of atherosclerosis. Furthermore, inflammation, originating from the intestinal tract, adds yet another mechanism by which the human ecosystem is disrupted, resulting in the manifestation of metabolic diseases and, by extension, cardiovascular diseases. 
  • 758
  • 22 Sep 2023
Topic Review
High-Density Lipoproteins as Bidirectional Lipid Vectors
The anti-atherogenic properties of high-density lipoproteins (HDL) have been explained mainly by reverse cholesterol transport (RCT) from peripheral tissues to the liver. The RCT seems to agree with most of the negative epidemiological correlations between HDL cholesterol levels and coronary artery disease. However, therapies designed to increase HDL cholesterol failed to reduce cardiovascular risk, despite their capacity to improve cholesterol efflux, the first stage of RCT. Therefore, the cardioprotective role of HDL may not be explained by RCT, and it is time for new paradigms about the physiological function of these lipoproteins. It should be considered that the main HDL apolipoprotein, apo AI, has been highly conserved throughout evolution. Consequently, these lipoproteins play an essential physiological role beyond their capacity to protect against atherosclerosis.
  • 757
  • 27 May 2022
Topic Review
Inflammation in Heart Failure
Chronic heart failure is a terminal point of a vast majority of cardiac or extracardiac causes affecting around 1–2% of the global population and more than 10% of the people above the age of 65. Inflammation is persistently associated with chronic diseases, contributing in many cases to the progression of disease. Even in a low inflammatory state, past studies raised the question of whether inflammation is a constant condition, or if it is, rather, triggered in different amounts, according to the phenotype of heart failure. 
  • 757
  • 20 Dec 2023
Topic Review
Therapy of Cardiac-Atrial-Appendage-Stem-Cells and Pyridoxamine
Myocardial infarction (MI) occurs when the coronary blood supply is interrupted. As a consequence, cardiomyocytes are irreversibly damaged and lost. Unfortunately, current therapies for MI are unable to prevent progression towards heart failure. As the renewal rate of cardiomyocytes is minimal, the optimal treatment should achieve effective cardiac regeneration, possibly with stem cells transplantation. In that context, our research group identified the cardiac atrial appendage stem cells (CASCs) as a new cellular therapy. However, CASCs are transplanted into a hostile environment, with elevated levels of advanced glycation end products (AGEs), which may affect their regenerative potential. In this study, we hypothesize that pyridoxamine (PM), a vitamin B6 derivative, could further enhance the regenerative capacities of CASCs transplanted after MI by reducing AGEs’ formation. Methods and Results: MI was induced in rats by ligation of the left anterior descending artery. Animals were assigned to either no therapy (MI), CASCs transplantation (MI + CASCs), or CASCs transplantation supplemented with PM treatment (MI + CASCs + PM). Four weeks post-surgery, global cardiac function and infarct size were improved upon CASCs transplantation. Interstitial collagen deposition, evaluated on cryosections, was decreased in the MI animals transplanted with CASCs. Contractile properties of resident left ventricular cardiomyocytes were assessed by unloaded cell shortening. CASCs transplantation prevented cardiomyocyte shortening deterioration. Even if PM significantly reduced cardiac levels of AGEs, cardiac outcome was not further improved. Conclusion: Limiting AGEs’ formation with PM during an ischemic injury in vivo did not further enhance the improved cardiac phenotype obtained with CASCs transplantation. Whether AGEs play an important deleterious role in the setting of stem cell therapy after MI warrants further examination. 
  • 754
  • 04 Sep 2021
Topic Review
SGLT2i in Diabetes, Cardiovascular Disease, and Kidney Disease
Sodium glucose cotransporter 2 inhibitor (SGLT2i) is a class of drugs that were originally intended for decreasing blood glucose in diabetes. However, recent trials have shown that there are other beneficial effects. Recent major SGLT2i landmark trials have demonstrated benefits for cardiovascular disease (reduce major adverse cardiovascular events (heart attack, stroke, cardiovascular death), hospitalization for heart failure, all-cause death), and renal disease (delay the onset of dialysis) regardless of diabetic status. 
  • 753
  • 17 Mar 2023
Topic Review
Cognitive Impairment in Heart Failure
Cognitive impairment (CI) is common in heart failure (HF). Patients with HF demonstrate reduced global cognition as well as deficits in multiple cognitive domains compared to controls. Degree of CI may be related to HF severity. HF has also been associated with an increased risk of dementia. Anatomical brain changes have been observed in patients with HF, including grey matter atrophy and increased white matter lesions. Patients with HF and CI have poorer functional independence and self-care, more frequent rehospitalisations as well as increased mortality. Pathophysiological pathways linking HF and CI have been proposed, including cerebral hypoperfusion and impaired cerebrovascular autoregulation, systemic inflammation, proteotoxicity and thromboembolic disease.
  • 751
  • 27 Jan 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. 
  • 751
  • 11 May 2022
Topic Review
Management of Heart Failure with Preserved Ejection Fraction
Heart failure with preserved ejection fraction (HFpEF) is a heterogeneous clinical syndrome with multiple underlying mechanisms and comorbidities that leads to a variety of clinical phenotypes. The identification and characterization of these phenotypes are essential for better understanding the precise pathophysiology of HFpEF, identifying appropriate treatment strategies, and improving patient outcomes.
  • 751
  • 13 Jul 2023
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.
  • 749
  • 17 Feb 2022
Topic Review
Dipeptidyl Amino-Peptidase 3 (DPP3) in Cardiogenic Shock
Dipeptidyl amino-peptidase 3 (DPP3) is an aminopeptidase that is released into circulation upon cell death. DPP3 is involved in the degradation of angiotensins, enkephalines, and endomorphines. It has been shown that circulating DPP3 (cDPP3) plasma concentration increases in cardiogenic shock (CS) patients and correlates with high mortality risk. Cardiogenic shock is a life-threatening syndrome associated with organ hypoperfusion. One of the common causes of CS is acute myocardial infarction (AMI).
  • 748
  • 10 Nov 2023
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. 
  • 748
  • 15 Dec 2023
Topic Review
Cardiovascular Calcification
Cardiac calcifications are generally asymptomatic findings frequently encountered on routine echocardiographic examination or CT scanning. The sites affected most often are the aortic valve (prevalence about 24%) and the mitral annulus (prevalence 8- 15%). The recognition of even small calcium deposits on valves and other cardiac structures is clinically relevant, both as a marker of systemic atherosclerosis and as a predictor of future cardiovascular events. The detection of cardiac calcifications by ultrasound is a promising tool for identifying subclinical atherosclerosis and thus improving risk stratification in asymptomatic subjects.
  • 746
  • 28 Apr 2021
Topic Review
Use of Cardioprotective Devices and Strategies
Cardioprotective devices such as TandemHeart, Impella family devices, and venoarterial extracorporeal membrane oxygenation (VA-ECMO) have been proven to show significant cardioprotection through mechanical support. However, their use as interventional agents in the prevention of hemodynamic changes due to cardiac surgery or percutaneous interventions has been correlated with adverse effects. This can lead to a rebound increased risk of mortality in high-risk patients who undergo cardiac surgery. 
  • 746
  • 21 Apr 2023
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