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Topic Review
Radiotherapy in Breast Cancer-Induced Cardiovascular Toxicity
The number of patients diagnosed with breast cancer and cardiovascular disease is continuously rising. Treatment options for breast cancer have greatly evolved, but radiotherapy (RT) still has a key role in it. Despite many advances in RT techniques, cardiotoxicity is one of the most important side effects. 
  • 606
  • 09 Aug 2023
Topic Review
Atherothrombosis in Progression of Non-Coronary Artery Disease
Peripheral artery disease (PAD) encompasses a variety of non-coronary artery diseases, and its prevalence varies based on screening approaches and clinical features. Recent data reveal a global prevalence of 80 million strokes, the majority (87%) of which are ischemic.
  • 605
  • 25 Apr 2023
Topic Review
Cardioprotective Mechanisms against Reperfusion Injury in AMI
Ischemia/reperfusion injury is a process associated with cardiologic interventions, such as percutaneous coronary angioplasty after an acute myocardial infarction. Blood flow restoration causes a quick burst of reactive oxygen species (ROS), which generates multiple organelle damage, leading to the activation of cell death pathways. Therefore, the intervention contributes to a greater necrotic zone, thus increasing the risk of cardiovascular complications. A major cardiovascular ROS source in this setting is the activation of multiple NADPH oxidases, which could result via the occupancy of type 1 angiotensin II receptors (AT1R); hence, the renin angiotensin system (RAS) is associated with the generation of ROS during reperfusion.
  • 604
  • 28 Dec 2022
Topic Review
Propranolol in Rare Vascular Diseases
Rare Diseases (RD) are defined by their prevalence in less than 5 in 10,000 of the general population. Considered individually, each RD may seem insignificant, but together they add up to more than 7000 different diseases. Research in RD is not attractive for pharmaceutical companies since it is unlikely to recover development costs for medicines aimed to small numbers of patients. Since most of these diseases are life threatening, this fact underscores the urgent need for treatments. Drug repurposing consists of identifying new uses for approved drugs outside the scope of the original medical indication. It is an alternative option in drug development and represents a viable and risk-managed strategy to develop for RDs. In 2008, the “off label” therapeutic benefits of propranolol were described in the benign tumor Infantile Hemangioma. Propranolol, initially prescribed for high blood pressure, irregular heart rate, essential tremor, and anxiety, has shown increasing evidence of its antiangiogenic, pro-apoptotic, vasoconstrictor and anti-inflammatory properties in different RDs, including vascular or oncological pathologies.
  • 603
  • 25 Apr 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.
  • 603
  • 30 Jun 2022
Topic Review
Arterial Stiffness Assessment by Pulse Wave Velocity
Metabolic syndrome (MS) is not a single disease but a cluster of metabolic disorders associated with increased risk for development of diabetes mellitus and its complications. Increased arterial stiffness (AS) can predict the development of cardiovascular disease both in the general population and in patients with MS. Pulse wave velocity (PWV), as a standard method to assess AS, may point out subclinical organ damage in patients with hypertension. The decrease in PWV level during antihypertensive therapy can identify a group of patients with better outcomes independently of their reduction in blood pressure. The adverse effect of metabolic disturbances on arterial function can be offset by an adequate program of exercises, which includes mainly aerobic physical training. Non-insulin-based insulin resistance index can predict AS due to a strong positive correlation with PWV. 
  • 603
  • 26 Sep 2022
Topic Review
Systemic Sclerosis-Related Pulmonary Arterial Hypertension
Systemic sclerosis (SSc)-related pulmonary arterial hypertension (SSc-PAH) is a leading cause of mortality in SSc. The extent of peripheral microvasculopathy assessed through nailfold capillaroscopy might correlate with the presence of PAH in SSc patients. 
  • 601
  • 17 May 2021
Topic Review
Arterial Stiffness among Overweight and Obese Subjects
It is known that arterial stiffness increases among obese and overweight individuals, especially with excess abdominal fat. Increased arterial stiffness contributes to the development of hypertension, due to structural modifications in the vessels and changes in their elasticity, capacity, and resistance, with a consequent loss of vascular compliance.
  • 599
  • 18 Apr 2023
Topic Review
Cellular Mechanisms Mediating Exercise-Induced Protection
Anthracyclines such as doxorubicin are widely used chemotherapy drugs. A common side effect of anthracycline therapy is cardiotoxicity, which can compromise heart function and lead to dilated cardiomyopathy and heart failure. Dexrazoxane and heart failure medications (i.e., beta blockers and drugs targeting the renin–angiotensin system) are prescribed for the primary prevention of cancer therapy-related cardiotoxicity and for the management of cardiac dysfunction and symptoms if they arise during chemotherapy. Exercise is a cardioprotective stimulus that has recently been shown to improve heart function and prevent functional disability in breast cancer patients undergoing anthracycline chemotherapy. Evidence from preclinical studies supports the use of exercise training to prevent or attenuate the damaging effects of anthracyclines on the cardiovascular system.
  • 599
  • 25 May 2023
Topic Review
Stable Coronary Artery Disease
Coronary revascularization is one of the most studied treatment modalities in cardiology; however, there is no consensus among experts about its indications in patients with stable coronary artery disease (SCAD). 
  • 597
  • 12 Jul 2023
Topic Review
Effects of Dietary Fat on Cardiovascular Disease
Cardiovascular disease (CVD) is a leading cause of global mortality, and is considered one of diseases with the most rapid growth rate in China. Dietary fat is one of the three primary nutrients of consumption; however, high fat dietary in causing CVD has been neglected in some official dietary guidelines.
  • 596
  • 25 Oct 2023
Topic Review
Non-Steroidal Mineralocorticoid Receptor Antagonists in Cardiovascular Disease
Inappropriate mineralocorticoid receptor (MR) activation in different cardiovascular cell types has deleterious effects on cardiac remodeling and function. Therefore, MR inhibition is a crucial pharmacological strategy to overcome cardiovascular dysfunction. Despite efficient blockade of MR with steroidal MR antagonists (MRAs), their clinical application is unsatisfactory due to the adverse effects. Novel non-steroidal MRAs with greater potency could be suitable for clinical application, especially in patients with type 2 diabetes mellitus and chronic kidney disease. Although clinical evidence has shown the beneficial effects of non-steroidal MRAs on cardiovascular outcomes in patients with heart failure with reduced ejection fraction, clinical trials are ongoing to evaluate the efficacy of heart failure with preserved ejection fraction. Therefore, comparative pharmacological characterization of non-steroidal MRAs over classical steroidal MRAs is crucial.
  • 595
  • 17 Apr 2023
Topic Review
Viral Myocarditis
Viral infections are the most frequently reported etiological factors of acute myocarditis, presumed even in cases where the viral pathogen cannot be detected, or when it could act as a trigger for a secondary reaction. No consensus exists regarding the necessary investigations to confirm infectious causes. Coronary artery disease and congenital or acquired structural deformities are routinely investigated, but dysfunction induced by toxic substances, collagen vascular diseases, postpartum cardiomyopathy and myocardial infarction with non-obstructed coronary arteries are just a few of the examples that occasionally can cause misdiagnosis, especially in patients having a coincidental history of a recent viral illness. The COVID-19 pandemic brought attention to viral myocarditis and problems with its diagnostics.
  • 594
  • 16 Sep 2022
Topic Review
Kounis Syndrome
Kounis syndrome (KS) is an acute coronary syndrome triggered by allergic or hypersensitivity reactions. Incidence rates vary, with studies reporting 19.4 per 100.000 among all admissions and 3.4% among allergy patients. The pathophysiology of this syndrome involves a complex interplay between allergic reactions and the cardiovascular system. Mast cell activation, histamine release, leukotrienes, cytokines, and platelet activation can contribute to coronary events. Three types of classification systems (allergic angina, allergic myocardial infarction, allergic stent thrombosis) aid in categorizing presentations. The diagnosis of KS relies on clinical presentation, laboratory findings, and imaging. Postmortem assessment of KS is based on the integration of circumstantial data, autopsy, and histological findings. Biochemical and immunohistochemical analyses also contribute to postmortem diagnosis. In conclusion, a combined, multidisciplinary approach should be used to ease the diagnostic process, which is crucial for forensic practitioners in confirming KS occurrence.
  • 594
  • 09 Jan 2024
Topic Review
miRNAs in Uremic Cardiomyopathy
Uremic Cardiomyopathy (UCM) is an irreversible cardiovascular complication that is highly pervasive among chronic kidney disease (CKD) patients, particularly in End-Stage Kidney Disease (ESKD) individuals undergoing chronic dialysis. Features of UCM are an abnormal myocardial fibrosis, an asymmetric ventricular hypertrophy with subsequent diastolic dysfunction and a complex and multifactorial pathogenesis where underlying biological mechanisms remain partly undefined.
  • 593
  • 24 Mar 2023
Topic Review
Current Management for PAH-CHD
Current management of patients with congenital heart disease has increased their survival into adulthood. This is accompanied by potential cardiac complications, including pulmonary hypertension associated with congenital heart disease (PAH-CHD). PAH-CHD constitutes a challenging subgroup of pulmonary hypertension and requires expert management to improve quality of life and prognosis. Novel agents have shown a significant improvement in morbidity and mortality in patients with pulmonary arterial hypertension.
  • 592
  • 03 Jan 2024
Topic Review
Infective Endocarditis during Pregnancy
The diagnosis of infective endocarditis (IE) during pregnancy is accompanied by a poor prognosis for both mother and fetus in the absence of prompt management by multidisciplinary teams.
  • 589
  • 16 May 2023
Topic Review
Cerebral Protection Devices in Transcatheter Procedures
Intraprocedural stroke is a well-documented and feared potential risk of cardiovascular transcatheter procedures (TPs). Moreover, subclinical neurological events or covert central nervous system infarctions are concerns related to the development of dementia, future stroke, cognitive decline, and increased risk of mortality. Cerebral protection devices (CPDs) were developed to mitigate the risk of cardioembolic embolism during TPs. They are mechanical barriers designed to cover the ostium of the supra-aortic branches in the aortic arch, but newer devices are able to protect the descending aorta. CPDs have been mainly designed and tested to provide cerebral protection during transcatheter aortic valve replacement (TAVR), but their use in both Catheterization and Electrophysiology laboratories is rapidly increasing. 
  • 588
  • 07 Sep 2023
Topic Review
Relationship between Inflammation and Vasospastic Angina
Coronary artery spasm (CAS) is a dynamic coronary stenosis causing vasospastic angina (VSA). However, VSA is a potentially lethal medical condition with multiple presentations, including sudden cardiac death. Mounting evidence supports the relation of local or systemic inflammation to VSA.
  • 586
  • 20 Mar 2023
Topic Review
Biomechanics of Transcatheter Aortic Valve Implant
Transcatheter aortic valve implantation (TAVI) has grown exponentially within the cardiology and cardiac surgical spheres. It has now become a routine approach for treating aortic stenosis. Several concerns have been raised about TAVI in comparison to conventional surgical aortic valve replacement (SAVR). The primary concerns regard the longevity of the valves. Several factors have been identified which may predict poor outcomes following TAVI. To this end, the lesser-used finite element analysis (FEA) was used to quantify the properties of calcifications which affect TAVI valves. This method can also be used in conjunction with other integrated software to ascertain the functionality of these valves. Other imaging modalities such as multi-detector row computed tomography (MDCT) are now widely available, which can accurately size aortic valve annuli. This may help reduce the incidence of paravalvular leaks and regurgitation which may necessitate further intervention.
  • 585
  • 26 Sep 2022
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