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Topic Review
Origins of Circulating Triglyceride-Rich Lipoproteins
The role of triglyceride-rich lipoproteins (TRLs) and their remnants in atherosclerosis has come to the forefront in the past decade. Triglycerides (TGs) stand as markers of the remnants of the catabolism of TRLs that tend to contain twice as much cholesterol as compared to LDL. The accumulation of circulating TRLs and their partially lipolyzed derivatives, known as “remnants”, is caused mainly by ineffective triglyceride catabolism. These cholesterol-enriched remnant particles are hypothesized to contribute to atherogenesis. 
  • 647
  • 10 Jul 2023
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.
  • 647
  • 21 Nov 2023
Topic Review
Pharmacological Approaches for Managing Hypercholesterolemia
Hypercholesterolemia plays a crucial role in the formation of lipid plaques, particularly with elevated low-density lipoprotein (LDL-C) levels, which are linked to increased risks of cardiovascular disease, cerebrovascular disease, and peripheral arterial disease. Controlling blood cholesterol values, specifically reducing LDL-C, is widely recognized as a key modifiable risk factor for decreasing the morbidity and mortality associated with cardiovascular diseases. Historically, statins, by inhibiting the enzyme β-hydroxy β-methylglutaryl-coenzyme A (HMG)-CoA reductase, have been among the most effective drugs.
  • 645
  • 26 Feb 2024
Topic Review
COVID-19 Diagnosis and Coronary Artery Thrombosis
Coronavirus disease 2019 is characterized by its severe respiratory effects. Data early on indicated an increased risk of mortality in patients with cardiovascular comorbidities. Early reports highlighted the multisystem inflammatory syndrome, cytokine storm, and thromboembolic events as part of the disease processes. The role of neutrophil extracellular traps (NETs) is explored in the pathogenesis of the disease. The structure and anatomy of the virus are pivotal to its virulence in comparison to other α and β Coronaviridae (HCoV-229E, HCoV-OC43, HCoV-229E, HCoV-NL63, HCoV-OC43, and HCoV-HKU1).  In particular, the host interaction and response may explain the variability of severity in patients. Angio tensin-converting enzyme 2 (ACE2) activation may be implicated in the cardiovascular and throm bogenic potential of the disease. The virus may also have direct effects on the endothelial lining affecting hemostasis and resulting in thrombosis through several mechanisms. 
  • 643
  • 18 Apr 2022
Topic Review
Technologies Used to Discover Immune Cell Heterogeneity
During homeostasis, immune cells perform daily housekeeping functions to maintain heart health by acting as sentinels for tissue damage and foreign particles.
  • 642
  • 30 Dec 2021
Topic Review
Prosthesis–Patient Mismatch
Prosthesis–patient mismatch (PPM) is defined as implanting a prosthetic that is insufficiently sized for the patient receiving it. PPM leads to high residual transvalvular gradients post-aortic valve replacement and consequently results in left ventricular dysfunction, morbidity and mortality in both the short and long term.
  • 641
  • 11 Sep 2023
Topic Review
Endothelial Progenitor Cells as Biomarkers of Cardiovascular Pathologies
Endothelial progenitor cells (EPC) may influence the integrity and stability of the vascular endothelium. Endothelial dysfunction is one of the key mechanisms in CVD. The assessment of endothelial dysfunction in vivo remains a major challenge, especially for a clinical evaluation of the need for therapeutic interventions or for primary prevention of CVD. Endothelial cells (EC) can become senescent, and the majority of circulating endothelial cells (CEC) show evidence of apoptosis or necrosis. There are a few viable CECs that have properties similar to those of an endothelial progenitor cell. To use EPC levels as a biomarker for vascular function and cumulative cardiovascular risk, a correct definition of their phenotype, as well as an update on the clinical application and practicability of current isolation methods, are an urgent priority. 
  • 640
  • 25 Jul 2022
Topic Review
Heart Transplant Surgeon Workforce between 2000 and 2020
Though diversity among cardiothoracic surgeons performing pediatric and adult heart transplantations (HTxs) has increased over the past years, the majority of the field remains male and White. This is particularly striking when compared with the composition of the United States population (49.2% male, 60.1% White in 2019). These findings are particularly important, given that prior studies have identified sex and racial disparities in access and outcomes following HTx among adult patients, and that racial concordance between physicians and patients improves patient outcomes in settings of known racial disparities. These results demonstrate the need for further research to analyze the causes of sex and racial disparities and initiate more effective efforts to increase diversity of the workforce.
  • 639
  • 07 Apr 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%.
  • 636
  • 13 Sep 2022
Topic Review
Pathophysiology of Inflammation in Peripheral Artery Disease
Inflammation has a critical role in the development and progression of atherosclerosis. On the molecular level, inflammatory pathways negatively impact endothelial barrier properties and thus, tissue homeostasis. Conformational changes and destruction of the glycocalyx further promote pro-inflammatory pathways also contributing to pro-coagulability and a prothrombotic state. In addition, changes in the extracellular matrix composition lead to (peri-)vascular remodelling and alterations of the vessel wall, e.g., aneurysm formation. Moreover, progressive fibrosis leads to reduced tissue perfusion due to loss of functional capillaries.
  • 636
  • 07 Sep 2023
Topic Review
Arrhythmogenic Cardiomyopathy across the Spectrum of Ventricular Involvement
Improved disease recognition through family screening and increased life expectancy with appropriate sudden cardiac death prevention has increased the burden of heart failure in arrhythmogenic cardiomyopathy (ACM). Heart failure management guidelines are well established but primarily focus on left ventricle function. A significant proportion of patients with ACM have predominant or isolated right ventricle (RV) dysfunction. Management of RV dysfunction in ACM lacks evidence but requires special considerations across the spectrum of heart failure regarding the initial diagnosis, subsequent management, monitoring for progression, and end-stage disease management. 
  • 635
  • 14 Dec 2023
Topic Review
Management of Hypertension in Diabetic Kidney Disease
Hypertension is a critical component of cardiovascular disease progression in patients with chronic kidney disease, and specifically diabetic kidney disease (DKD). Causation versus correlation remains up for debate, but what has been confirmed is the delay of DKD progression when hypertension is controlled or moved to guideline drive ranges.
  • 634
  • 13 Nov 2023
Topic Review
Temporary Right-Ventricular Assist Devices
Acute right-sided heart failure (RHF) is a complex clinical syndrome, with a wide range of clinical presentations, associated with increased mortality and morbidity, but about which there is a scarcity of evidence-based literature. A temporary right-ventricular assist device (t-RVAD) is a potential treatment option for selected patients with severe right-ventricular dysfunction as a bridge-to-recovery or as a permanent solution.
  • 633
  • 22 Feb 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.
  • 633
  • 20 Feb 2024
Topic Review
Epidemiology and Pathophysiology of Spontaneous Coronary Artery Dissection
Spontaneous Coronary Artery Dissection (SCAD) refers to the spontaneous separation of the layers of the vessel wall caused by intramural hemorrhage, with or without an intimal tear. This condition is not associated with trauma, atherosclerosis or iatrogenic causes and may be an expression of an underlying systemic arterial disease, namely, fibromuscular dysplasia. 
  • 632
  • 30 Dec 2022
Topic Review
Vital Echocardiographic Data Prior to Ventricular Arrhythmia Ablation
Ventricular arrhythmias (VA) are a major cause of sudden cardiac death (SCD). Echocardiography is the first widely available imaging tool which guides VA management strategies. Along with other invasive and noninvasive imaging techniques, it provides essential information for identification of VA substrate such as differentiation between ischemic and non-ischemic etiology and identification of structural heart disease. Both classic as well as novel echocardiographic techniques such as left ventricular strain measurement and mechanical dispersion assessment provide prognostic information and assist in risk stratification. Furthermore, intracardiac echocardiography may have an adjunctive role for the VA ablation by providing real-time visualization of cardiac structures, continuous monitoring of catheter location and early recognition of procedural complications.
  • 631
  • 21 Oct 2022
Topic Review
Obesity-Related Atrial Fibrillation
Atrial fibrillation (AF) is the most common arrhythmia worldwide and is associated with increased morbidity and mortality. The mechanisms underlying AF are complex and multifactorial. In addition to overall hemodynamic changes due to increased body weight, excess adiposity raises systemic inflammation and oxidative stress, which lead to adverse atrial remodeling. This remodeling includes atrial fibrosis, atrial dilation, decreased electrical conduction between atrial myocytes, and altered ionic currents, making atrial tissue more vulnerable to both the initiation and maintenance of AF. However, much remains to be learned about the mechanistic links between obesity and AF. 
  • 630
  • 06 Oct 2023
Topic Review
Human Hematopoietic Stem/Progenitor Cells in T1DM Treatment
Type 1 diabetes mellitus (T1DM) is a highly prevalent autoimmune disease causing the destruction of pancreatic islet β-cells. The resulting insulin production deficiency leads to a lifelong need for insulin re-placement therapy, systemic complications, and reduced life quality and expectancy. Cell therapy has been extensively attempted to restore insulin independence (IID), and autologous nonmyeloablative hematopoietic stem cell transplantation (AHST) has appeared to give the most promising results.
  • 628
  • 19 Apr 2023
Topic Review
Cardiovascular Health of People with Severe Mental Illness
In Australia and internationally, adults with SMI such as schizophrenia, schizoaffective disorder, and bipolar disorder are at increased risk of early death due to physical health problems. Cardiovascular diseases (CVD), type 2 diabetes, nutritional and metabolic diseases, and obesity and smoking-related cancers are some of these potentially preventable chronic conditions that are frequently observed and disproportionately found among people with SMI compared with non-SMI populations. This mental–physical health interface has multiple adverse impacts for the person in their daily life, and also appears to generate greater difficulty in the person’s healthcare management.
  • 627
  • 11 Feb 2022
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.
  • 627
  • 20 Jan 2023
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