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Topic Review
The Mitochondrial Dysfunction in Atherosclerosis
Atherosclerosis is a multifactorial inflammatory pathology that involves metabolic processes. Improvements in therapy have drastically reduced the prognosis of cardiovascular disease. Nevertheless, a significant residual risk is still relevant, and is related to unmet therapeutic targets. Endothelial dysfunction and lipid infiltration are the primary causes of atherosclerotic plaque progression. In this contest, mitochondrial dysfunction can affect arterial wall cells, in particular macrophages, smooth muscle cells, lymphocytes, and endothelial cells, causing an increase in reactive oxygen species (ROS), leading to oxidative stress, chronic inflammation, and intracellular lipid deposition. 
  • 722
  • 31 Jan 2023
Topic Review
Heart Failure in Patients with Chronic Kidney Disease
Patients with heart failure (HF) and associated chronic kidney disease (CKD) are a population less represented in clinical trials; additionally, subjects with more severe estimated glomerular filtration rate reduction are often excluded from large studies. In this setting, most of the data come from post hoc analyses and retrospective studies. Accordingly, in patients with advanced CKD, there are no specific studies evaluating the long-term effects of the traditional drugs commonly administered in HF. 
  • 720
  • 28 Apr 2023
Topic Review
Utility of Genetic Testing in Patients with ATTR-CM
Transthyretin amyloid cardiomyopathy (ATTR-CM) is an increasingly diagnosed condition. Although wild-type transthyretin amyloidosis (ATTRwt) is the most common ATTR-CM, hereditary transthyretin amyloidosis (ATTRv) may also occur. Genetic testing for transthyretin pathogenic variants is recommended for patients with a confirmed clinical diagnosis of ATTR-CM. In fact, confirmation of this autosomal dominant pathogenic variant prompts genetic counselling and allows early identification of affected relatives. Additionally, in the presence of an ATTR-CM-associated polyneuropathy, specific drugs targeting transthyretin can be used.
  • 720
  • 09 Jan 2024
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. 
  • 719
  • 10 Mar 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.
  • 719
  • 31 Aug 2023
Topic Review
Mechanisms of Relationship between NAFLD and Arterial Hypertension
Non-alcoholic fatty liver disease (NAFLD) and arterial hypertension (AH) are widespread noncommunicable diseases in the global population. Since hypertension and NAFLD are diseases associated with metabolic syndrome, they are often comorbid. In fact, many contemporary published studies confirm the association of these diseases with each other, regardless of whether other metabolic factors, such as obesity, dyslipidemia, and type 2 diabetes mellites, are present.
  • 719
  • 13 Sep 2023
Topic Review
Flow Mediated Skin Fluorescence for Vascular Dysfunction Identification
Arterial blood pressure monitoring plays an important role in preventive medicine, allowing, in selected cases, the identification of vascular dysfunction. Extensive research, encompassing both healthy subjects and patients with a range of vascular issues, has consistently demonstrated the efficacy of the Flow Mediated Skin Fluorescence (FMSF) technique in identifying cases of impaired vascular function, including many cases of silent vascular dysfunction that are not manifested by changes in blood pressure. 
  • 719
  • 15 Mar 2024
Topic Review
NLRP3 Inflammasome in Vascular Disease and Pharmacological Opportunities
The NLRP3 inflammasome is a multiprotein complex that assembles to engage the innate immune defense by processing the maturation of pro-inflammatory cytokines IL-1β and IL-18. Substantial evidence has positioned the NLRP3 inflammasome at the center of vascular disease progression, with a particular significance in the context of aging and the low-grade chronic inflammation associated (inflammaging). Therefore, pharmacological blockade of the NLRP3 inflammasome and its end products has arisen as an extremely promising tool to battle vascular disease. 
  • 717
  • 16 Feb 2022
Topic Review
Dapagliflozin and Heart Failure
Heart failure (HF) is associated with a high morbidity and mortality burden. In light of more recent evidence, SGLT2 inhibitors are currently recommended as first-line therapy in managing patients with HF, regardless of ejection fraction, to reduce HF burden. The DAPA-HF and DELIVER trials, and particularly, the pooled analysis of both studies, have shown that dapagliflozin significantly reduces the risk of cardiovascular death, all-cause death, total HF hospitalizations, and MACE in the whole spectrum of HF, with sustained benefits over time.
  • 716
  • 07 Nov 2023
Topic Review
Sestrin2 as a Potential Target in Hypertension
Hypertension is a highly complex, intricate condition affecting millions of individuals across the globe. Nearly half of adults in the United States are diagnosed with hypertension, with incident rates projected to rise over the next decade. Hypertension is a precursor to many cardiovascular diseases including atherosclerosis, stroke, myocardial infarction, heart failure, and peripheral artery disease. The Sestrin (SESN) family of proteins is comprised of three members Sesn1, Sens2, and Sesn3, and is expressed by three coding genes: SESN1, SESN2, and SESN3
  • 715
  • 31 Jul 2023
Topic Review
Cardiovascular Disease in T1DM
Cardiovascular disease (CVD) is a major cause of mortality in type 1 diabetes mellitus (T1DM) patients, and cardiovascular risk (CVR) remains high even in T1DM patients with good metabolic control.
  • 713
  • 22 Sep 2021
Topic Review
Ventricular Arrhythmias in Left Ventricular Assist Device Patient
Left ventricular assist devices (LVAD) are used in the treatment of advanced left ventricular heart failure. LVAD can serve as a bridge to orthotopic heart transplantation or as a destination therapy in cases where orthotopic heart transplantation is contraindicated. Ventricular arrhythmias are frequently observed in patients with LVAD. 
  • 713
  • 23 Feb 2024
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. 
  • 712
  • 02 Oct 2022
Topic Review
Renal Denervation in the Management of Heart Failure
Norepinephrine (NE) spillover in the kidneys is associated with a worse prognosis. Since the kidneys constitute an integral part of the sympathetic activation feedback loop between the brain, the heart, the vasculature, and the kidneys, the therapies targeting this afferent loop may provide a novel and promising target in the management of patients with heart failure. Renal denervation has evolved from surgical denervation to transcatheter-based technology. This latter technique is a minimally invasive, catheter-based procedure that ablates both the afferent and efferent renal sympathetic nerves. Various catheter-based technologies exist today, including radiofrequency ablation, ultrasound thermal ablation, and chemical ablation utilizing alcohol. Renal denervation has been predominantly studied as a tool for the management of resistant hypertension. 
  • 711
  • 01 Aug 2022
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.
  • 710
  • 28 Feb 2022
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.
  • 710
  • 19 Apr 2023
Topic Review
Cardiovascular Effects of Apelins
In-hospital mortality in patients with ST-segment elevation myocardial infarction (STEMI) is 5–6%. Consequently, it is necessary to develop fundamentally novel drugs capable of reducing mortality in patients with acute myocardial infarction. Apelins could be the prototype for such drugs. Chronic administration of apelins mitigates adverse myocardial remodeling in animals with myocardial infarction or pressure overload. The cardioprotective effect of apelins is accompanied by blockage of the MPT pore, GSK-3β, and the activation of PI3-kinase, Akt, ERK1/2, NO-synthase, superoxide dismutase, glutathione peroxidase, matrix metalloproteinase, the epidermal growth factor receptor, Src kinase, the mitoKATP channel, guanylyl cyclase, phospholipase C, protein kinase C, the Na+/H+ exchanger, and the Na+/Ca2+ exchanger. The cardioprotective effect of apelins is associated with the inhibition of apoptosis and ferroptosis.
  • 710
  • 05 May 2023
Topic Review
Cholesteryl Ester Transfer Protein Inhibition Reduces Cardiovascular Events
Cholesteryl ester transfer protein (CETP) is a glycoprotein synthesized in the liver that is present in all primates (including humans), rabbits and hamsters. The CETP molecule has a boomerang shape, with a tunnel that forms between spaces at each end for binding cholesteryl esters and triglycerides (TG). It is responsible for the exchange of TG from very low-density lipoprotein (VLDL) particles with cholesteryl esters from high-density lipoprotein (HDL) particles and low-density lipoprotein (LDL) particles. The net effect of this exchange is to enrich VLDL and LDL particles with cholesteryl esters and deplete them of TG while simultaneously enriching HDL particles with TG and depleting them of cholesteryl esters.
  • 709
  • 01 Sep 2022
Topic Review
Cardioplegic Solution with an Understanding of a Cardiochannelopathy
Cardiac surgeries have been improved by accompanying developing cardioplegia solutions. However, the cardioplegia application presents an ongoing challenge with a view of a sufficiently restored cardiac function.
  • 707
  • 15 Dec 2022
Topic Review
Cardiovascular Risk Prediction Parameters in Rheumatic Diseases
Multiple imaging techniques, such as ECG, ultrasound, and cIMT, as well as biomarkers like osteoprotegerin cytokine receptor and angiopoietin-2, can be beneficial in both CV risk prediction and in early subclinical diagnosis. Physical exercise is an essential non-pharmacological intervention that can maintain the health of the cardiovascular system and, additionally, influence the underlying disease. Lipid-lowering drugs (methotrexate from the non-biologic DMARDs family as well as biologic DMARDs such as anti-TNF) were all associated with a lower CV risk; however, anti-TNF medication can decrease cardiac compliance and promote heart failure in patients with previously diagnosed chronic HF. Although they achieved success rates in reducing inflammation, glucocorticoids, NSAIDs, and COX-2 inhibitors were correlated with an increased risk of CVD. When taking all of the aforementioned points into consideration, there appears to be a dire need to establish and implement CVD risk stratification models in rheumatic patients. 
  • 706
  • 07 Mar 2022
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