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Topic Review
Effects of Major Hypolipidemic Drugs on Platelet Function
Growing evidence supports the view that statins, ezetimibe, PCSK9 inhibitors, inclisiran, and icosapent ethyl also act as antithrombotics. The main effect of antidyslipidemic agents is mainly related to the reduction in low-density lipoprotein (LDL) levels (which are causally related to atherosclerosis) and triglycerides. Some studies suggested a potential role of these drugs also on platelet function. In particular, by interacting with specific platelet receptors, they reduce adhesion, aggregation, degranulation, in-flammation, vasoconstriction, and oxidative stress.
  • 706
  • 30 Aug 2023
Topic Review
Polyphenol Effects on Cardiovascular Disease
Several studies have demonstrated that polyphenol-enriched diets may have beneficial effects against the development of cardiovascular disease. This activity is exerted by multiple mechanisms, mainly described in in vitro studies. However, long-term studies on humans provided controversial results, making the prediction of polyphenol impact on health uncertain. This entry provides an overview and critical analysis of the literature related to the effects of the principal dietary polyphenols on cardiovascular disorders. We critically considered randomized controlled clinical trials involving subjects taking polyphenol-based supplements for at least two weeks.  Although pharmacological doses of polyphenols are likely to beneficially affect several CVD hallmarks, such as hypertension, dyslipidemia, endothelial dysfunction and inflammation, further studies aiming to fully characterize polyphenols pharmacokinetics and safety are necessary to unravel their potential preventive role in real life.
  • 705
  • 08 Mar 2022
Topic Review
Comorbid Sepsis and Cardiogenic Shock
Septic shock management in the cardiac intensive care unit (CICU) is challenging due to the complex interaction of pathophysiology between vasodilatory and cardiogenic shock, complicating how to optimally deploy fluid resuscitation, vasopressors, and mechanical circulatory support devices.
  • 704
  • 26 Oct 2023
Topic Review
Resveratrol in Relation to Cardiometabolic Risk and Disease
Resveratrol (RSV) is a phenolic compound with strong antioxidant activity, which is generally associated with the beneficial effects of wine on human health. All resveratrol-mediated benefits exerted on different systems and pathophysiological conditions are possible through resveratrol’s interactions with different biological targets, along with its involvement in several key cellular pathways affecting cardiometabolic (CM) health. With regard to its role in oxidative stress, RSV exerts its antioxidant activity not only as a free radical scavenger but also by increasing the activity of antioxidant enzymes and regulating redox genes, nitric oxide bioavailability and mitochondrial function. RSV effects are mediated by changes in sphingolipids, a class of biolipids emerging as critical determinants of CM risk and disease. 
  • 703
  • 26 May 2023
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.
  • 702
  • 23 Dec 2022
Topic Review
Impact of Iron Metabolism Disorders on Vascular Aging
Vascular aging is a physiological, multifactorial process that involves every type of vessel, from large arteries to microcirculation. This manifests itself as impaired vasomotor function, altered secretory phenotype, deteriorated intercellular transport function, structural remodeling, and aggravated barrier function between the blood and the vascular smooth muscle layer. Iron disorders, particularly iron overload, may lead to oxidative stress and, among other effects, vascular aging. The elevated transferrin saturation and serum iron levels observed in iron overload lead to the formation of a non-transferrin-bound iron (NTBI) fraction with high pro-oxidant activity. NTBI can induce the production of reactive oxygen species (ROS), which induce lipid peroxidation and mediate iron-related damage as the elements of oxidative stress in many tissues, including heart and vessels’ mitochondria. 
  • 700
  • 24 Nov 2022
Topic Review
Telomere Length and Coronary Artery Disease
Coronary artery disease (CAD) is a multifactorial disease with a high prevalence, particularly in developing countries. The investigation of telomeres as a potential tool for the early detection of the atherosclerotic disease seems to be a promising method. Telomeres are repetitive DNA sequences located at the extremities of chromosomes that maintain genetic stability. Telomere length (TL) has been associated with several human disorders and diseases while its attrition rate varies significantly in the population. The rate of TL shortening ranges between 20 and 50 bp and is affected by factors such as the end-replication phenomenon, oxidative stress, and other DNA-damaging agents.
  • 698
  • 27 Feb 2023
Topic Review
4D-Flow Imaging in Aortic Valve Disease
The development of abnormal blood flow has been demonstrated to be due to a variety of pathological causes, such as atherosclerotic plaque or valvular disease. Traditionally, cardiovascular magnetic resonance imaging (MRI) has provided high-quality imaging of the heart with its surrounding structures. 4D-flow imaging is an advanced cardiac MR imaging technique that allows fluid hemodynamics to be measured non-invasively in patients. As a growing field in radiology, its adaptation and clinical use remain underutilized. 
  • 698
  • 21 Jun 2023
Topic Review
Clinical Applications of Cardiac Scintigraphy with Bone Tracers
Radionuclide bone scintigraphy is the cornerstone of an imaging-based algorithm for accurate non-invasive diagnosis of transthyretin cardiac amyloidosis (ATTR-CA). In patients with heart failure and suggestive echocardiographic and/or cardiac magnetic resonance imaging findings, the positive predictive value of Perugini grade 2 or 3 myocardial uptake on a radionuclide bone scan approaches 100% for the diagnosis of ATTR-CA as long as there is no biochemical evidence of a clonal dyscrasia. The technetium-labelled tracers that are currently validated for non-invasive diagnosis of ATTR-CA include pyrophosphate (99mTc-PYP); hydroxymethylene diphosphonate (99mTc-HMDP); and 3,3-diphosphono-1,2-propanodicarboxylate (99mTc-DPD). Although nuclear scintigraphy has transformed the contemporary diagnostic approach to ATTR-CA, a number of grey areas remains, including the mechanism for binding tracers to the infiltrated heart, differences in the kinetics and distribution of these radiotracers, differences in protocols of image acquisition worldwide, the clinical significance of extra-cardiac uptake, and the use of this technique for prognostic stratification, monitoring disease progression and assessing the response to disease-modifying treatments.
  • 698
  • 21 Dec 2023
Topic Review
Cardiac Morphofunctional Characteristics of Individuals with ERP
Based on electrocardiographic (ECG), electrophysiological, epicardial, and non-invasive electroanatomical mapping studies, the inferior and/or lateral part of the left ventricle (LV) is involved in individuals with early repolarization pattern (ERP) . In  Brugada syndrome (BrS), which is also a form of J-wave syndrome, structural changes were described in the outflow tract of the right ventricle (mild fibrosis, decreased connexin-43 expression, increased collagen content, or fibro-adipose infiltration), while wall motion abnormalities and mild dilatation have been noted in imaging studies. These structural changes are more frequently observed in patients who have died of sudden cardiac death (SCD). It is reasonable to assume that morphological changes, presumably similar to BrS, are also present in individuals with ERP, in myocardial regions involved in pathomechanism.
  • 697
  • 17 Apr 2023
Topic Review
Metabolic Syndrome and Atrial Fibrillation
Obesity, hypertension, insulin resistance, and dyslipidemia are all clusters of an entity called “Metabolic Syndrome”. The global trends of this syndrome’s incidence/prevalence continue to increase reciprocally, converting it into a massive epidemic problem in the medical community.
  • 696
  • 19 Oct 2023
Topic Review
Decoys in Cardiovascular Diseases Therapeutic
Cardiovascular disease (CVD) is the main cause of global death, highlighting the fact that conventional therapeutic approaches for the treatment of CVD patients are insufficient, and there is a need to develop new therapeutic approaches. In recent years, decoy technology, decoy oligodeoxynucleotides (ODN), and decoy peptides show promising results for the future treatment of CVDs. Decoy ODN inhibits transcription by binding to the transcriptional factor, while decoy peptide neutralizes receptors by binding to the ligands.
  • 695
  • 25 Sep 2023
Topic Review
Cardiovascular Diseases and Exosomes
Cardiovascular diseases (CVDs) are widely recognized as the leading cause of mortality worldwide. Despite the advances in clinical management over the past decades, the underlying pathological mechanisms remain largely unknown. Exosomes have drawn the attention of researchers for their relevance in intercellular communication under both physiological and pathological conditions. These vesicles are suggested as complementary prospective biomarkers of CVDs; however, the role of exosomes in CVDs is still not fully elucidated.
  • 693
  • 25 Feb 2021
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.
  • 693
  • 26 Jan 2022
Topic Review
Clinical Impact of Anti-Arrhythmic Medications in Atrial Fibrillation
Atrial fibrillation has been described as a global epidemic with a three-fold increase in prevalence in the last 50 years. As the prevalence of atrial fibrillation continues to grow, multiple landmark trials have been designed to determine the best method to treat atrial fibrillation. Initial trials have stated that rate control was not inferior to rhythm control, however, as the efficacy of rhythm control of atrial fibrillation has improved, a benefit in rhythm control has been shown. Because of this trend towards increased rhythm control, more patients have been placed on anti-arrhythmic medications. 
  • 689
  • 20 Mar 2023
Topic Review
Infective Endocarditis
Infective endocarditis (IE) is a rare but potentially life-threatening disease, sometimes with longstanding sequels among surviving patients. The population at high risk of IE is represented by patients with underlying structural heart disease and/or intravascular prosthetic material. Taking into account the increasing number of intravascular and intracardiac procedures associated with device implantation, the number of patients at risk is growing too. If bacteremia develops, infected vegetation on the native/prosthetic valve or any intracardiac/intravascular device may occur as the final result of invading microorganisms/host immune system interaction. In the case of IE suspicion, all efforts must be focused on the diagnosis as IE can spread to almost any organ in the body. Unfortunately, the diagnosis of IE might be difficult and require a combination of clinical examination, microbiological assessment and echocardiographic evaluation. There is a need of novel microbiological and imaging techniques, especially in cases of blood culture-negative.
  • 688
  • 21 Apr 2023
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.
  • 687
  • 17 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. 
  • 687
  • 15 Jan 2024
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.
  • 686
  • 13 Apr 2022
Topic Review
Inflammation and Peripheral Artery Disease
Classical risk factors play a major role in the initiation and development of atherosclerosis. Efforts have been made to identify biomarkers that indicate ongoing atherosclerosis. Among important circulating biomarkers associated with peripheral arterial disease (PAD) are inflammatory markers which are determined by the expression of different genes and epigenetic processes. Among these proinflammatory molecules, interleukin-6, C-reactive protein, several adhesion molecules, CD40 ligand, osteoprotegerin and others are associated with the presence and progression of PAD.
  • 686
  • 01 Feb 2023
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