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Topic Review
Transcatheter Mitral Valve Replacement
The transcatheter mitral valve replacement (TMVR) is performed through the implantation of either an aortic or mitral transcatheter heart valve (THV) in the mitral position. Although not specifically designed for the mitral position, the aortic THV has been successfully employed in patients with failed bioprostheses (mitral valve-in-valve (MViV)), failed prosthetic rings and bands (mitral valve-in-ring (MViR)) and native calcified valves (valve in mitral annular calcification (ViMAC)). On the other hand, newer TMVR devices with mitral THVs have primarily been used for native noncalcified mitral valves. 
  • 745
  • 26 Jul 2023
Topic Review
Molecular Therapies in Cardiovascular Diseases
Small interfering RNA (siRNA) represents a novel, fascinating therapeutic strategy that allows for selective reduction in the production of a specific protein through RNA interference. In the cardiovascular (CV) field, several siRNAs have been developed in the last decade. Inclisiran has been shown to significantly reduce low-density lipoprotein cholesterol (LDL-C) circulating levels with a reassuring safety profile, also in older patients, by hampering proprotein convertase subtilisin/kexin type 9 (PCSK9) production. Olpasiran, directed against apolipoprotein(a) mRNA, prevents the assembly of lipoprotein(a) [Lp(a)] particles, a lipoprotein linked to an increased risk of ischemic CV disease and heart valve damage. Patisiran, binding transthyretin (TTR) mRNA, has demonstrated an ability to improve heart failure and polyneuropathy in patients with TTR amyloidosis, even in older patients with wild-type form. Zilebesiran, designed to reduce angiotensinogen secretion, significantly decreases systolic and diastolic blood pressure (BP).
  • 744
  • 15 Jan 2024
Topic Review
Moderator Band-Related Arrhythmias
The moderator band (MB) is an intracavitary structure of the right ventricle composed of muscular fibers encompassing specialized Purkinje fibers, separated each other by collagen and adipose tissue. Premature ventricular complexes originating within the Purkinje network have been implicated in the genesis of life-threatening arrhythmias. However, right Purkinje network arrhythmias have been much less reported in the literature compared to the left counterpart. The MB has unique anatomical and electrophysiological properties, which may account for its arrhythmogenicity and may be responsible for a significant portion of idiopathic ventricular fibrillation.
  • 742
  • 25 Apr 2023
Topic Review
Influence of Vitamin D Levels on Atrial Fibrillation
Atrial fibrillation (AF) is a severe and most common supraventricular arrhythmia in humans, which, if left untreated or treated ineffectively, can lead to ischemic stroke or heart failure. It has been suggested that serum vitamin D (VitD) deficiency may be one of the critical factors influencing the onset of AF, especially in the period after cardiac surgery, such as coronary artery bypass grafting. Several papers have indicated that VitD supplementation reduces the risk of AF, significantly reducing the proportion of patients between the control and study groups in both the pre- and postoperative periods. Factors that increase the risk of AF from VitD deficiency are also further indicated, and these are age, gender, weight, season or comorbidities.
  • 742
  • 21 Jul 2023
Topic Review
Artery Stenosis and Vasospastic Angina
Vasospastic angina (VA) is caused by focal or diffuse spasm of an epicardial coronary artery, resulting in severe obstruction of the coronary artery lumen and myocardial ischemia. Vasospasm can occur in an angiographically normal coronary artery, but may also occur at the site of an existing organic atherosclerotic stenosis. Stable atherosclerotic plaques are rarely fatal, but can interfere with coronary blood flow and lead to stable angina. However, it has been suggested that vasospasm is associated with endothelial damage and subsequent atheroma rupture. Considering that acute coronary syndrome (ACS) is almost always caused by luminal thrombus or sudden plaque rupture applied to organic atherosclerotic plaques, coronary vasospasm can induce the rupture of a stable atheroma, which could lead to myocardial infarction and sudden cardiac death.
  • 740
  • 08 Nov 2021
Topic Review
Sirtuin-Induced Autophagy in Cardiovascular Diseases
Sirtuins belong to the class III histone deacetylases and possess nicotinamide adenine dinucleotide-dependent deacetylase activity. They are involved in the regulation of multiple signaling pathways implicated in cardiovascular diseases. Autophagy is a crucial adaptive cellular response to stress stimuli. Mounting evidence suggests a strong correlation between Sirtuins and autophagy, potentially involving cross-regulation and crosstalk. Sirtuin-mediated autophagy plays a crucial regulatory role in some cardiovascular diseases, including atherosclerosis, ischemia/reperfusion injury, hypertension, heart failure, diabetic cardiomyopathy, and drug-induced myocardial damage.
  • 738
  • 20 Sep 2023
Topic Review
Calcium in Arrhythmogenic Cardiomyopathy
Arrhythmogenic cardiomyopathy (ACM) is an inherited heart disease characterized by sudden death in young people and featured by fibro-adipose myocardium replacement, malignant arrhythmias, and heart failure. The Ca2+ toolkit is heavily remodeled in cardiomyocytes derived from a mouse model of ACM defective of the desmosomal protein plakophilin-2. Furthermore, ACM-related mutations were found in genes encoding for proteins involved in excitation‒contraction coupling, e.g., type 2 ryanodine receptor and phospholamban. 
  • 737
  • 15 Nov 2021
Topic Review
Cardioprotective Strategies from Cardiotoxicity in Cancer Patients
Cardiotoxicity is a significant complication of chemotherapeutic agents in cancer patients. Cardiovascular incidents including LV dysfunction, heart failure (HF), severe arrhythmias, arterial hypertension, and death are associated with high morbidity and mortality. Risk stratification of cancer patients prior to initiation of chemotherapy is crucial, especially in high-risk patients for cardiotoxicity. The early identification and management of potential risk factors for cardiovascular side effects seems to contribute to the prevention or minimization of cardiotoxicity. Screening of cancer patients includes biomarkers such as cTnI and natriuretic peptide and imaging measurements such as LV function, global longitudinal strain, and cardiac MRI. Cardioprotective strategies for either primary or secondary prevention include medical therapy such as ACE inhibitors, ARBs, b-blockers, aldosterone antagonists, statins and dexrazoxane, physical therapy, and reduction of chemotherapeutic dosages. However, data regarding dosages, duration of medical therapy, and potential interactions with chemotherapeutic agents are still limited. Collaboration among oncologists, cardiologists, and cardio-oncologists could establish management cardioprotective strategies and approved follow-up protocols in patients with cancer receiving chemotherapy.
  • 737
  • 25 Aug 2022
Topic Review
Long Non-Coding Ribonucleic Acids Implicated in Plaque Instability
Long non-coding RNAs (lncRNAs) represent an important class of molecules that are implicated in epigenetic control of numerous cellular processes. Atherosclerotic plaque represents a dynamic environment where the interplay between various cell types, including endothelial cells, immune cells, and VSMCs, governs the plaque phenotype and its vulnerability. The specific roles of nuclear lncRNAs in regulating gene expression and cellular processes associated with plaque instability, providing a comprehensive understanding of their contributions to the pathogenesis of atherosclerosis.
  • 735
  • 26 Jul 2023
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. 
  • 734
  • 20 Jul 2023
Topic Review
Glucagon and Its Receptors in the Mammalian Heart
Glucagon exerts effects on the mammalian heart. These effects include alterations in the force of contraction, beating rate, and changes in the cardiac conduction system axis. The cardiac effects of glucagon vary according to species, region, age, and concomitant disease. Depending on the species and region studied, the contractile effects of glucagon can be robust, modest, or even absent. Glucagon is detected in the mammalian heart and might act with an autocrine or paracrine effect on the cardiac glucagon receptors. The glucagon levels in the blood and glucagon receptor levels in the heart can change with disease or simultaneous drug application. 
  • 733
  • 06 Sep 2023
Topic Review
Aortic and Visceral Aneurysms
Aortic and visceral aneurysms affect large arterial vessels, including the thoracic and abdominal aorta, as well as visceral arterial branches, such as the splenic, hepatic, and mesenteric arteries, respectively. 
  • 732
  • 20 Sep 2023
Topic Review
Heart Failure after Aortic Valve Replacement
Severe aortic stenosis (AS) carries a poor prognosis with the onset of heart failure (HF) symptoms, and surgical or transcatheter aortic valve replacement (AVR) is its only definitive treatment. The management of AS has seen a paradigm shift with the adoption of transcatheter aortic valve replacement (TAVR), allowing for the treatment of AS in patients who would not otherwise be candidates for surgical AVR.
  • 731
  • 12 Oct 2023
Topic Review
Physiopathology of Post-Cardiac Arrest
Cardiac arrest is an important public health issue, with a survival rate of approximately 15 to 22%. A great proportion of these deaths occur after resuscitation due to post-cardiac arrest syndrome, which is characterized by the ischemia-reperfusion injury that affects the role body. post-cardiac arrest syndrome (PCAS) is a complex and critical issue that was first described in the 1950s. Understanding the pathophysiology of the ischemia-reperfusion (IR) injury that occurs in PCAS may elucidate therapeutic targets.
  • 729
  • 11 Jan 2023
Topic Review
Aetiology of Bicuspid Aortic Valve
BAV (Bicuspid Aortic Valve) stands as the most prevalent congenital heart condition closely linked to critical and potentially life-threatening cardiac and aortic ailments, including aortic stenosis, aortic insufficiency, aortic aneurysms, and aortic dissection. It is believed that both genetic and epigenetic factors influence the etiology of BAV. Gaining insight into this underlying causative framework is paramount in guiding treatment strategies for BAV and its associated pathologies.
  • 729
  • 12 Oct 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.
  • 729
  • 23 Oct 2023
Topic Review
Cardiotoxicity of Cancer Chemotherapy Agents
Cardiotoxicity is defined as every cardiovascular (CV) event related to the use of cancer medication. 
  • 726
  • 18 Mar 2022
Topic Review
Microbial Modulation of Bile Acid in Cardiovascular Disease
Bile acids represent a class of cholesterol derivatives that is essential for intestinal absorption of lipids and fat-soluble vitamins, plays an important role in cholesterol turnover and, as more recently discovered, acts as a group of signaling molecules that exerts hormonal functions throughout the body.
  • 726
  • 28 Apr 2023
Topic Review
Myocardial Restoration Therapy
Myocardial restoration approaches so far have encompassed various types of cells, cell products or derivatives, scaffolds of various physical conditions, as well as multiple administration routes. 
  • 725
  • 08 Jun 2021
Topic Review
Mechanisms of Hyperglycaemia-Induced Vascular Damage
Coronary artery disease (CAD) remains one of the most important causes of morbidity and mortality worldwide, and revascularization through percutaneous coronary interventions (PCI) significantly improves survival. In this setting, poor glycaemic control, regardless of diabetes, has been associated with increased incidence of peri-procedural and long-term complications and worse prognosis. Novel antidiabetic agents have represented a paradigm shift in managing patients with diabetes and cardiovascular diseases.
  • 725
  • 15 Jul 2022
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