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Topic Review
Direct Oral Anticoagulants
It is well established that direct oral anticoagulants (DOACs) are the cornerstone of anticoagulant strategy in atrial fibrillation (AF) and venous thromboembolism (VTE) and should be preferred over vitamin K antagonists (VKAs) since they are superior or non-inferior to VKAs in reducing thromboembolic risk and are associated with a lower risk of intracranial hemorrhage (IH).
  • 686
  • 27 Sep 2023
Topic Review
An Inherited Cardiomyopathy: Arrhythmogenic Right Ventricular Cardiomyopathy
Arrhythmogenic right ventricular cardiomyopathy (ARVC) is an inherited heart muscle disease, which is characterized by fibro-fatty replacement of predominantly the right ventricle (RV). The disease can result in ventricular tachyarrhythmias and sudden cardiac death.
  • 685
  • 10 Mar 2022
Topic Review
AngiomiRs in Cancer
Angiogenesis is the process of new blood vessel formation through the migration, growth, and differentiation of endothelial cells.
  • 685
  • 21 Nov 2022
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.
  • 685
  • 21 Nov 2023
Topic Review
Cardiovascular Disease Complicating COVID-19
Cardiovascular disease (CVD) is the leading cause of death worldwide. Its incidence increases sharply with age, and the elderly bear a disproportionate burden of CVD morbidity and mortality. Coronavirus disease 2019 (COVID-19), caused by severe acute respiratory distress syndrome coronavirus 2 (SARS-CoV-2), has also caused significant mortality, specifically amongst the elderly, who are the most likely patient population to be hospitalized and die from the infection. Pre-existing CVD is a known risk factor for poor outcome in Covid-19 patients and, in our efforts to preserve life, attention must be paid to the adverse impact of the virus on the cardiovascular system. The emergence of novel SARS-CoV-2 pathogenic variants with greater transmissibility is prolonging the pandemic and sustaining the threat to life and health. An understanding of the pathogenic mechanisms that underlie the CVD-Covid-19 interaction can lead to improved treatment and reduced sequelae in the midst of this global health crisis.
  • 683
  • 23 Sep 2021
Topic Review
Paediatric Restrictive Cardiomyopathy
Restrictive cardiomyopathy (RCM) is characterized by restrictive ventricular pathophysiology determined by increased myocardial stiffness. While suspicion of RCM is initially raised by clinical evaluation and supported by electrocardiographic and echocardiographic findings, invasive hemodynamic evaluation is often required for diagnosis and management of patients during follow-up. RCM is commonly associated with a poor prognosis and a high incidence of heart failure, and PH is reported in paediatric patients with RCM. Only a few therapies are available for specific RCM aetiologies. Early referral to centres for advanced heart failure treatment is often necessary.
  • 683
  • 02 Jan 2024
Topic Review
Aortic Stiffness as a Risk Factor for Multimorbidity
Multimorbidity, the coexistence of multiple health conditions in an individual, has emerged as one of the greatest challenges facing health services, and this crisis is partly driven by the aging population. Aging is associated with increased aortic stiffness (AoStiff), which in turn is linked with several morbidities frequently affecting and having disastrous consequences for the elderly. These include hypertension, ischemic heart disease, heart failure, atrial fibrillation, chronic kidney disease, anemia, ischemic stroke, and dementia. Two or more of these disorders (multimorbidity) often coexist in the same elderly patient and the specific multimorbidity pattern depends on several factors including sex, ethnicity, common morbidity routes, morbidity interactions, and genomics.
  • 682
  • 15 Jun 2023
Topic Review
The Endothelin System: Morphofunctional Considerations
Acute heart failure (AHF) is a life-threatening condition with high morbidity and mortality. Even though this pathology has been extensively researched, there are still challenges in establishing an accurate and early diagnosis, determining the long- and short-term prognosis and choosing a targeted therapeutic strategy. The use of reliable biomarkers to support clinical judgment has been shown to improve the management of AHF patients. Despite a large pool of interesting candidate biomarkers, endothelin-1 (ET-1) appears to be involved in multiple aspects of AHF pathogenesis that include neurohormonal activation, cardiac remodeling, endothelial dysfunction, inflammation, atherosclerosis and alteration of the renal function.
  • 682
  • 27 Jul 2023
Topic Review
Lipoprotein(a) as a Marker of Cardiovascular Health Risk
Lipoprotein(a) [Lp(a)] is made up of apoprotein(a) [apo(a)] and LDL-like particle. The proportion of Lp(a) in each individual is genetically determined and is only minimally modifiable by environment or diet. Lp(a) has important pro-atherosclerotic and pro-inflammatory effects. For these reasons, high Lp(a) values are an important independent risk factor for cardiovascular disease and calcific aortic valve stenosis. Numerous studies have been performed in adults about the pathophysiology and epidemiology of Lp(a), much less information is available regarding Lp(a) in children and adolescents. Gaining information on these points is particularly important for deciding whether Lp(a) assay may be useful for defining the cardiovascular risk in children, in order to plan a prevention program early.
  • 680
  • 03 Jul 2023
Topic Review
Pro-Inflammatory Cytokines in the Pathogenesis of Cardiovascular Disease
With cardiovascular disease (CVD) being a primary source of global morbidity and mortality, it is crucial that we understand the molecular pathophysiological mechanisms at play. Recently, numerous pro-inflammatory cytokines have been linked to several different CVDs, which are now often considered an adversely pro-inflammatory state. These cytokines most notably include interleukin-6 (IL-6),tumor necrosis factor (TNF)α, and the interleukin-1 (IL-1) family, amongst others. Not only does inflammation have intricate and complex interactions with pathophysiological processes such as oxidative stress and calcium mishandling, but it also plays a role in the balance between tissue repair and destruction.
  • 679
  • 26 Jan 2024
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).
  • 679
  • 17 Feb 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. 
  • 678
  • 31 Oct 2022
Topic Review
Gut Molecules and Cardiovascular Diseases
Atherosclerotic cardiovascular disease is the most common cause of morbidity and mortality worldwide. Diabetes mellitus increases cardiovascular risk. Heart failure and atrial fibrillation are associated comorbidities that share the main cardiovascular risk factors. The use of incretin-based therapies promoted the idea that activation of alternative signaling pathways is effective in reducing the risk of atherosclerosis and heart failure. Gut-derived molecules, gut hormones, and gut microbiota metabolites showed both positive and detrimental effects in cardiometabolic disorders. Although inflammation plays a key role in cardiometabolic disorders, additional intracellular signaling pathways are involved and could explain the observed effects. 
  • 675
  • 22 Feb 2023
Topic Review
Personalized Three-Dimensional Printed Models in Congenital Heart Disease
Patient-specific three-dimensional (3D) printed models have been increasingly used in cardiology and cardiac surgery, in particular, showing great value in the domain of congenital heart disease (CHD). CHD is characterized by complex cardiac anomalies with disease variations between individuals; thus, it is difficult to obtain comprehensive spatial conceptualization of the cardiac structures based on the current imaging visualizations. 3D printed models derived from patient’s cardiac imaging data overcome this limitation by creating personalized 3D heart models, which not only improve spatial visualization, but also assist preoperative planning and simulation of cardiac procedures, serve as a useful tool in medical education and training, and improve doctor–patient communication.
  • 674
  • 22 Feb 2023
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.
  • 671
  • 05 May 2023
Topic Review
Extracorporeal Mechanical Oxygenation and Drugs
There has been a substantial increase in the use of extracorporeal membrane oxygenation (ECMO) support in critically ill adults. Critically ill patients on ECMO represent a challenging clinical situation to manage pharmacotherapy. Thus, clinicians’ ability to predict PK and PD alterations within this complex clinical context is fundamental to ensure further optimal and, sometimes, individualized therapeutic plans that balance clinical outcomes with the minimum drug adverse events. 
  • 671
  • 16 Jun 2023
Topic Review
MINOCA Associated with a Myocardial Bridge
Myocardial bridging (MB) is the most frequent congenital coronary anomaly characterized by a segment of an epicardial coronary artery that passes through the myocardium. MB is an important cause of myocardial ischemia and is also emerging as a possible cause of myocardial infarction with non-obstructed coronary arteries (MINOCA). There are multiple mechanisms underlying MINOCA in patients with MB (i.e., MB-mediated increased risk of epicardial or microvascular coronary spasm, atherosclerotic plaque disruption and spontaneous coronary artery dissection). 
  • 671
  • 13 Jun 2023
Topic Review
Endomyocardial Biopsy in Pediatric Myocarditis and Cardiomyopathies
Endomyocardial biopsy is a well known diagnostic tool for the investigation and treatment of myocardial diseases and so far, remains the gold standard for the diagnosis of myocarditis. Due to its invasively with a complication rate ranging from 1% to 15%, its role in the diagnostic work-out of pediatric heart failure is not well established.
  • 668
  • 19 Apr 2022
Topic Review
Cardiovascular Magnetic Resonance Imaging in Hypertrophic Cardiomyopathy Evaluation
Hypertrophic cardiomyopathy (HCM) is the most common inherited cardiac disorder, affecting 1 out of 500 adults globally. It is a widely heterogeneous disorder characterized by a range of phenotypic expressions, and is most often identified by non-invasive imaging that includes echocardiography and cardiovascular magnetic resonance imaging (CMR). Within the last two decades, cardiac magnetic resonance imaging (MRI) has emerged as the defining tool for the characterization and prognostication of cardiomyopathies. With a higher image quality, spatial resolution, and the identification of morphological variants of HCM, CMR has become the gold standard imaging modality in the assessment of HCM. Moreover, it has been crucial in its management, as well as adding prognostic information that clinical history nor other imaging modalities may not provide. 
  • 668
  • 09 Feb 2022
Topic Review
Effects of COVID-19 on Arrhythmia
The World Health Organization announced that COVID-19, with SARS-CoV-2 as its pathogen, had become a pandemic on 11 March 2020. With the development of research, cardiovascular injury in patients with COVID-19, such as arrhythmia, myocardial injury, and heart failure, is the second major symptom in addition to respiratory symptoms, and cardiovascular injury is related to the prognosis and mortality of patients. The incidence of arrhythmia in COVID-19 patients ranges from 10% to 20%.
  • 667
  • 13 Sep 2022
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