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Topic Review
Link of Endothelin System and Ischemia-Induced Ventricular Tachyarrhythmias
Sympathetic activation has long been known to play a key role in the pathophysiology of ischemia-induced arrhythmias, but the regulating factors remain under investigation. The endothelin system is implicated as an important modulator of sympathetic activation in the setting of acute coronary syndromes. This system consists of a family of three endothelin isopeptides (ET-1, ET-2, and ET-3), produced by numerous cell types, and two specific receptors (ETA and ETB) that are widely expressed throughout the body. Endothelin is synthesized and released continuously, but it is also stored in intracellular endothelial storage pools and secreted by exocytosis. The main source of circulating endothelin in the setting of acute coronary syndromes appears to be the ischemic myocardium, with plasma levels correlating with the incidence of VTs. In addition to its vasoconstrictive effects in the coronary circulation, endothelin is implicated in ischemia-induced arrhythmogenesis, both directly and indirectly, the latter mode exerted by modulating sympathetic responses.
  • 407
  • 20 Jan 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.
  • 407
  • 21 Jul 2023
Topic Review
Arterial Stiffness Assessment by Pulse Wave Velocity
Metabolic syndrome (MS) is not a single disease but a cluster of metabolic disorders associated with increased risk for development of diabetes mellitus and its complications. Increased arterial stiffness (AS) can predict the development of cardiovascular disease both in the general population and in patients with MS. Pulse wave velocity (PWV), as a standard method to assess AS, may point out subclinical organ damage in patients with hypertension. The decrease in PWV level during antihypertensive therapy can identify a group of patients with better outcomes independently of their reduction in blood pressure. The adverse effect of metabolic disturbances on arterial function can be offset by an adequate program of exercises, which includes mainly aerobic physical training. Non-insulin-based insulin resistance index can predict AS due to a strong positive correlation with PWV. 
  • 404
  • 26 Sep 2022
Topic Review
Endothelial Dysfunction Due to Diabetes and/or Insulin Resistance
Endothelial dysfunction is not only involved in the development and progression of cardiovascular disease (CVD), but is also associated with the progression of CKD. In patients with type 2 diabetes, hyperglycemia, insulin resistance, hyperinsulinemia and dyslipidemia induce the development of endothelial dysfunction.
  • 404
  • 13 Jun 2023
Topic Review
Aging and Arterial Stiffness in End-Stage Renal Disease
Arterial dysfunction is major risk factor for cardiovascular complications, and arterial stiffness is an independent risk factor in end-stage renal disease patients. As the distance from the heart increases, arterial stiffness (pulse wave velocity) becomes progressively more marked. This generates a centrifugal stiffness gradient, which leads to partial, continuous local wave reflections, which in turn attenuate the transmission of pulsatile pressure into the microcirculation, thus limiting the potentially deleterious outcomes both upstream (on the heart: left-ventricular hypertrophy and coronary perfusion) and downstream (on the renal and cerebral microcirculation: reduced glomerular filtration and impaired cognitive functions). The impact of arterial aging is greater on the aorta and central capacitive arteries, and it is characterized by a loss or reversal of the physiological stiffness gradient between central and peripheral arteries.
  • 403
  • 31 Jan 2023
Topic Review
Etiopathogenesis of Takotsubo Syndrome
Broken Heart Syndrome, also known as Takotsubo Syndrome (TS), is sudden and transient dysfunction of the left and/or right ventricle which often mimics Acute Coronary Syndrome (ACS).
  • 403
  • 17 Feb 2023
Topic Review
Antithrombotic Therapy in Polyvascular Disease
Patients presenting with atherosclerosis involving more than one vascular bed, such as those with peripheral artery disease (PAD) and concomitant coronary artery disease (CAD), constitute a particularly vulnerable group characterized by enhanced residual long-term risk for major adverse cardiac events (MACE), as well as major adverse limb events (MALE). Antithrombotic therapy is the mainstay of secondary prevention in both patients with PAD or CAD; however, the optimal intensity of such therapy is still a topic of debate, particularly in the post-acute and long-term setting.
  • 402
  • 31 Aug 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.
  • 401
  • 28 Apr 2021
Topic Review
Molecular Mechanisms of Anthracycline-Induced Cardiotoxicity
Anthracycline is identified as one of the cancer treatments most likely to induce a significant decrease in left ventricular (LV) ejection fraction (LVEF), cardiomyopathy, and cardiac ischemia, ultimately leading to heart failure.
  • 401
  • 16 Oct 2023
Topic Review
State-of-the-Art Evaluation of Left Main Coronary Artery Disease
Due to its anatomical features, patients with an obstruction of the left main coronary artery (LMCA) have an increased risk of death. Knowing the unfavorable prognosis of untreated LMCAD, precise evaluation of atherosclerotic plaque is essential in further management. 
  • 399
  • 31 Oct 2022
Topic Review
miRNAs in Uremic Cardiomyopathy
Uremic Cardiomyopathy (UCM) is an irreversible cardiovascular complication that is highly pervasive among chronic kidney disease (CKD) patients, particularly in End-Stage Kidney Disease (ESKD) individuals undergoing chronic dialysis. Features of UCM are an abnormal myocardial fibrosis, an asymmetric ventricular hypertrophy with subsequent diastolic dysfunction and a complex and multifactorial pathogenesis where underlying biological mechanisms remain partly undefined.
  • 398
  • 24 Mar 2023
Topic Review
Coronary Artery Calcium Score and COVID-19 Prognosis
Coronary artery calcium score can aid in stratifying patients, thus allowing earlier interventions in rapidly developing illnesses.
  • 397
  • 13 Apr 2022
Topic Review
Gut Microbiota/Sex Hormone in Metabolic and Cardiovascular Disease
Cardiovascular disease (CVD) is responsible for a large incidence of death cases in both men and women worldwide. Even though age-adjusted CVD mortality rates are higher in men compared to premenopausal women, the midlife period, coincident with the menopause transition, leads to a significant increase of coronary heart disease (CHD) risk factors also in women. Many studies have demonstrated the association between specific gut microbiota (GM) signature and several CVD manifestations, highlighting the potential roles of bacteria in the pathogenesis of coronary heart disease, and cardiometabolic (CM) disorders. Unfortunately, most studies linking GM dysbiosis to CVD risk factors and focused on gender difference were performed in preclinical mouse models rather than in humans.
  • 397
  • 08 Jul 2022
Topic Review
Lipoprotein(a)
The treatment of patients with aortic valve calcification (AVC) and calcific aortic valve stenosis (CAVS) remains challenging as, until today, all non-invasive interventions have proven fruitless in preventing the disease’s onset and progression. Despite the similarities in the pathogenesis of AVC and atherosclerosis, statins failed to show a favorable effect in preventing AVC progression. The recognition of lipoprotein(a) [Lp(a)] as a strong and potentially modifiable risk factor for the development and, perhaps, the progression of AVC and CAVS and the evolution of novel agents leading in a robust Lp(a) reduction, have rekindled hope for a promising future in the treatment of those patients. Lp(a) seems to promote AVC via a ‘three hit’ mechanism including lipid deposition, inflammation and autotaxin transportation. All of these lead to valve interstitial cells transition into osteoblast-like cells and, thus, to parenchymal calcification. 
  • 397
  • 10 Mar 2023
Topic Review
Cardiac Rehabilitation Programs
Cardiac rehabilitation (CR) is an integral part of the management of various cardiovascular disease such as coronary artery disease (CAD), peripheral artery disease (PAD), or chronic heart failure (CHF), with proven morbidity and mortality benefits. Supervised exercise therapy has a positive impact on both functional capacity and also on the quality of life of such patients. The most effective manner to acquire this seems to be by combining revascularization therapy and supervised exercise.
  • 396
  • 28 Feb 2022
Topic Review
The Role of Buccal Mucosa for Arrhythmogenic Cardiomyopathy
Arrhythmogenic cardiomyopathy (ACM) is a heart muscle disease associated with ventricular arrhythmias and sudden cardiac death (SCD). Pathologically, it is characterized by the gradual degeneration of cardiac myocytes (CMs) and their subsequent replacement by fat and fibrous tissue. The buccal mucosa can aid the diagnosis and understanding of this deadly disease.
  • 396
  • 05 May 2023
Topic Review
Mediators Connecting Cardiovascular Disease and Cancer
Cardiovascular (CV) diseases and cancer are two of the most common causes of death worldwide.  The pathophysiological overlap between cancer and CV disease is expressed at different levels, including inflammation, oxidative stress, neuro-hormonal activation, clonal hematopoesis and circulating factors. Traditionally, the interest was to find predictors for CV toxicity associated with antineoplastic treatment and to identify these patients in whom chemotherapy would represent a heavy burden. The relationship between cancer and CV diseases is no longer unidirectional. Extracellular vesicles (EVs) could be among the most important biomarkers as they play a decisive role in early identification and determining the CV risk for cancer patients receiving specific treatment for this disease. The preclinical evidence on the bilateral connection between cancer and cardiovascular disease (especially early cardiac changes) through some specific mediators such as EVs  will be discussed here.
  • 395
  • 21 Feb 2023
Topic Review
Thromboembolic and Bleeding Events in Transthyretin Amyloidosis
Transthyretin amyloidosis (ATTR) is a group of diseases caused by the deposition of insoluble fibrils derived from misfolded transthyretin, which compromises the structure and function of various organs, including the heart. Thromboembolic events and increased bleeding risk are among the most important complications of ATTR, though the underlying mechanisms are not yet fully understood. Transthyretin plays a complex role in the coagulation cascade, contributing to the activation and regulation of the coagulation and fibrinolytic systems. The prevalence of atrial fibrillation, cardiac mechanical dysfunction, and atrial myopathy in patients with ATTR may contribute to thrombosis, though such events may also occur in patients with a normal sinus rhythm and rarely in properly anticoagulated patients. Haemorrhagic events are modest and mainly linked to perivascular amyloid deposits with consequent capillary fragility and coagulation anomalies, such as labile international-normalised ratio during anticoagulant therapy. 
  • 394
  • 06 Nov 2023
Topic Review
RA, OA, and IVL in Calcified Coronary Lesions
In order to improve the percutaneous treatment of coronary artery calcifications (CAC) before stent implantation, methods such as rotational atherectomy (RA), orbital atherectomy (OA), and coronary intravascular lithotripsy (IVL) were invented. These techniques use different mechanisms of action and therefore have various short- and long-term outcomes. IVL employs sonic waves to modify CAC, whereas RA and OA use a rapidly rotating burr or crown. These methods have specific advantages and limitations, regarding their cost-efficiency, the movement of the device, their usefulness given the individual anatomy of both the lesion and the vessel, and the risk of specified complications.
  • 394
  • 28 Feb 2024
Topic Review
Hydrogen Sulfide in Plaque Stability
Hydrogen sulfide (H2S) is an identified and recognized gasotransmitter after nitric oxide and carbon oxide. Atherosclerosis is one of most prevalent cardiovascular diseases worldwide, characterized as chronic inflammation and lipid accumulation in the large arteries. Atherosclerotic plaque rupture or erosion causes the formation of thrombosis or blood clot, resulting in acute events, such as myocardial infraction, or ischemic stroke, contributing to a major mortality rate in the case of human diseases.
  • 394
  • 23 Dec 2022
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