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Topic Review
Soluble ST2 Biology
ST2 is a member of the interleukin (IL)-1 receptor family, whose gene is located on human chromosome 2q12. Alternative promoter splicing and 3′ processing of the mRNA are responsible for the production of two different forms: a soluble receptor, named sST2; or a transmembrane receptor, named ST2L. ST2 was first described in 1989.
  • 381
  • 21 Nov 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.
  • 380
  • 08 Mar 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.
  • 380
  • 01 Feb 2023
Topic Review
Physiologic Effects of Natriuretic Peptides
Natriuretic peptides are a complex and interesting network of molecules playing pleiotropic effects on many organs and tissues, ensuring the maintenance of homeostasis mainly in the cardiovascular system and regulating the water–salt balance. Natriuretic peptides (NPs) and their receptors play several physiological roles in maintaining and ensuring homeostasis in the human body by performing pleiotropic actions on multiple organs and target sites. Various other mechanisms have been characterized in other organs, which were made possible by the specific and individual interactions between each natriuretic peptide and the corresponding receptor in a particular site of action.
  • 380
  • 08 Jun 2023
Topic Review
General Considerations Regarding Heart Failure Treatment and Strategies
Since the prevalence of heart failure (HF) increases with age, HF is now one of the most common reasons for the hospitalization of elderly people. Although the treatment strategies and overall outcomes of HF patients have improved over time, hospitalization and mortality rates remain elevated, especially in developed countries where populations are aging.
  • 378
  • 27 May 2022
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.
  • 378
  • 20 Sep 2023
Topic Review
Drug Coated Balloons Characteristics according to Antiproliferative Drugs
Drug coated balloons (DCBs) are indicated in guidelines as a first choice option in the management of instant restenosis, whereas their use in de novo lesions is still debated. The concerns raised after the contrasting results of the initial trials with DCBs in de novo lesions have been overcome by a larger amount of data confirming their safety and effectiveness as compared to drug-eluting stents (DES), with potentially greater benefits being achieved, especially in particular anatomical settings, as in very small or large vessels and bifurcations, but also in selected subsets of higher-risk patients, where a ‘leave nothing behind’ strategy could offer a reduction of the inflammatory stimulus and thrombotic risk.
  • 377
  • 12 Jun 2023
Topic Review
Role of Chemerin in Metabolic and Cardiovascular Disease
Chemerin is a novel adipokine that plays a major role in adipogenesis and lipid metabolism. It also induces inflammation and affects insulin signaling, steroidogenesis and thermogenesis. Consequently, it likely contributes to a variety of metabolic and cardiovascular diseases, including atherosclerosis, diabetes, hypertension and pre-eclampsia.
  • 375
  • 29 Jun 2023
Topic Review
LVAD as Bridge to Remission from Advanced HF
Left ventricular assist devices (LVADs) are an established treatment modality for advanced heart failure (HF). It has been shown that through volume and pressure unloading they can lead to significant functional and structural cardiac improvement, allowing LVAD support withdrawal in a subset of patients. 
  • 374
  • 27 Jul 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. 
  • 374
  • 20 Mar 2023
Topic Review
Prostaglandin E2 Signaling in Pulmonary Hypertension
Mild-to-moderate pulmonary hypertension (PH) is a common complication of chronic obstructive pulmonary disease (COPD). As another well-known and extensively researched prostaglandins, prostaglandin E2 (PGE2) and its downstream signaling have been found to play an important role in various biological processes. Emerging evidence has revealed that PGE2 and its receptors (i.e., EP1–4) are involved in the regulation of pulmonary vascular homeostasis and remodeling. 
  • 374
  • 01 Dec 2023
Topic Review
sST2 in Acute Heart Failure and COVID-19 Infection
As a member of the interleukin-1 receptor superfamily, the protein ST2 (alternative name for “interleukin-1 receptor-like 1”) presents with a transmembrane (ST2L) and soluble (sST2) isoforms. Since the discovery of interleukin-33 (IL-33) in 2005 as the ST2L ligand, the molecule has been deeply considered in inflammatory conditions, fibroproliferative diseases, autoimmune diseases, trauma, sepsis, and most recently and significantly in pulmonary and cardiovascular diseases. 
  • 373
  • 11 Aug 2022
Topic Review
Invasive Techniques for Intermediate Coronary Lesions Assessment
Intravascular ultrasound has been used for many years in the assessment of intermediate coronary lesions. This technique uses a piezoelectric transducer that produces ultrasound signals allowing the assessment of the vessel wall and characterizing the atherosclerotic lesions, eliminating the disadvantages of angiography and FFR/iFR. Its main indications in the American College of Cardiology guideline as class IIa recommendation are the assessment of angiographically intermediate stenosis of the LMCA or the mechanisms of stent failure (thrombosis or restenosis) as well as guidance of coronary stent implantation, especially in LMCA or complex coronary artery disease.
  • 373
  • 30 Jun 2022
Topic Review
Stem Cell Studies in Cardiovascular Biology and Medicine
Resident macrophages can trigger cell regeneration. As macrophages express chemokine receptors, chemokines are also important in the regulation of macrophages. Exosomes are used for cell-cell communication in macrophages and the surrounding cells. Therefore, macrophages may play a key role in regenerative medicine in the future.
  • 372
  • 23 Jan 2022
Topic Review
Diagnosing Atrial Fibrillation by Artificial Intelligence
Atrial fibrillation (AF) is a common arrhythmia affecting 8–10% of the population older than 80 years old. The importance of early diagnosis of atrial fibrillation has been broadly recognized since arrhythmias significantly increase the risk of stroke, heart failure and tachycardia-induced cardiomyopathy with reduced cardiac function. The development of wearable devices has provided a reliable way for healthcare providers to uncover undiagnosed atrial fibrillation in the population, especially those most at risk. Furthermore, with the advancement of artificial intelligence and machine learning, the technology is now able to utilize the database in assisting detection of arrhythmias from the data collected by the devices.
  • 372
  • 29 Apr 2022
Topic Review
Surgical Challenges in Infective Endocarditis
Infective endocarditis (IE) is still a life-threatening disease with frequent lethal outcomes despite the profound changes in its clinical, microbiological, imaging, and therapeutic profiles. Nowadays, the scenario for IE has changed since rheumatic fever has declined, but on the other hand, multiple aspects, such as elderly populations, cardiovascular device implantation procedures, and better use of multiple imaging modalities and multidisciplinary care, have increased, leading to escalations in diagnosis. Mainly, guidelines put emphasis on the importance of an endocarditis team in the handling of systemic complications and how they affect the timing of surgery and perioperative management. Neurological complications, acute renal failure, splenic or musculoskeletal manifestations, or infections determined by multiresistant microorganisms or fungi can affect long-term prognosis and survival. Not to be outdone, anatomical and surgical factors, such as the presence of native or prosthetic valve endocarditis, a repair strategy when feasible, anatomical extension and disruption in the case of an annular abscess (mitral valve annulus, aortic mitral curtain, aortic root, and annulus), and the choice of prosthesis and conduits, can be equally crucial.
  • 372
  • 20 Feb 2024
Topic Review
Postoperative Intensive Care Management of Aortic Repair
Vascular surgery patients have multiple comorbidities and are at high risk for perioperative complications. Aortic repair surgery has greatly evolved, with an increasing predominance of endovascular techniques (EVAR). The incidence of cardiac complications is significantly reduced with endovascular repair, but high-risk patients require postoperative ST-segment monitoring. Open aortic repair may portend a prohibitive risk of respiratory complications that could be a contraindication for surgery. This risk is greatly reduced in the case of an endovascular approach, and general anesthesia should be avoided whenever possible in the case of endovascular repair. Preoperative renal function and postoperative kidney injury are powerful determinants of short- and long-term outcome, so that preoperative risk stratification and secondary prevention are critical tasks. Intraoperative renal protection with selective renal and distal aortic perfusion is essential during open repair. EVAR has lower rates of postoperative renal failure compared to open repair, with approximately half the risk for acute kidney injury (AKI) and one-third of the risk of hemodialysis requirement. Spinal cord ischemia used to be the most distinctive and feared complication of aortic repair. The risk has significantly decreased since the beginning of aortic surgery, with advances in surgical technique and spinal protection protocols, and is lower with endovascular repair. Endovascular repair avoids extensive aortic dissection and aortic cross-clamping and is generally associated with reduced blood loss and less coagulopathy.
  • 371
  • 16 Sep 2022
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.
  • 371
  • 21 Dec 2023
Topic Review
Smooth Muscle Heterogeneity and Plasticity in Aortic Aneurysm
Vascular smooth muscle cells (VSMCs) are the predominant cell type in the medial layer of the aorta, which plays a critical role in the maintenance of aortic wall integrity. VSMCs have been suggested to have contractile and synthetic phenotypes and undergo phenotypic switching to contribute to the deteriorating aortic wall structure. The unprecedented heterogeneity and diversity of VSMCs and their complex relationship to aortic aneurysms (AAs) have been revealed by high-resolution research methods, such as lineage tracing and single-cell RNA sequencing. The aortic wall consists of VSMCs from different embryonic origins that respond unevenly to genetic defects that directly or indirectly regulate VSMC contractile phenotype. This difference predisposes to hereditary AAs in the aortic root and ascending aorta. 
  • 370
  • 25 Jul 2023
Topic Review
Types of Dysrhythmias
Dysrhythmia is a term referring to the occurrence of spontaneous and repetitive changes in potentials with parameters deviating from those considered normal. The term refers to heart anomalies but has a broader meaning. Dysrhythmias may concern the heart, neurological system, digestive system, and sensory organs. Ion currents conducted through ion channels are a universal phenomenon. The occurrence of channel abnormalities will therefore result in disorders with clinical manifestations depending on the affected tissue, but phenomena from other tissues and organs may also manifest themselves. 
  • 369
  • 04 Jan 2024
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