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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.
  • 632
  • 20 Jan 2023
Topic Review
Off-Target Effects of P2Y12 Receptor Inhibitors
Ischemic heart disease holds the foremost position as the primary contributor to mortality from cardiovascular disease (CVD). Furthermore, it constitutes the predominant underlying cause of heart failure on a global scale. Diverging from other tissues, the myocardium demonstrates a markedly limited ability to regenerate in the aftermath of injuries. Consequently, necrotic cardiomyocytes are replaced by fibrotic scar tissue in the cardiac repair process, which can lead to an adverse cardiac remodeling. Different cell types, including fibroblasts and macrophages, are involved in this process and play a pivotal role by releasing a wide array of mediators (i.e., cytokines) that regulate the activation of multiple molecular pathways, such as the Wnt/β-catenin pathway, involved in cardiac fibrosis. For this reason, the modulation of these pathways might be effective in promoting the replacement of fibrosis in reactive tissue. Dual antiplatelet therapy (DAPT), consisting of the combination of a platelet P2Y12 receptor inhibitor and aspirin, is the cornerstone of treatment for patients with acute coronary syndromes (ACS) requiring percutaneous coronary interventions (PCI). P2Y12 receptor activation, a platelet purinergic receptor for adenosine 5′-diphosphate (ADP), significantly contributes to the arterial thrombosis process. 
  • 632
  • 28 Feb 2024
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.
  • 631
  • 17 Apr 2023
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.
  • 631
  • 18 Apr 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.
  • 631
  • 19 Apr 2023
Topic Review
Diagnostic Performances of Nuclear Imaging in Infective Endocarditis
Infective endocarditis (IE) is a life-threatening disease with stable prevalence despite prophylactic, diagnostic, and therapeutic advances. While echocardiography remains the first line imaging technique, especially in native valve endocarditis, the incremental value of two nuclear imaging techniques, 18F-fluorodeoxyglucose positron emission tomography with computed tomography (18F-FDG-PET/CT) and white blood cells single photon emission tomography with computed tomography (WBC-SPECT), has emerged for the management of prosthetic valve and CIED IE.
  • 630
  • 05 Jan 2022
Topic Review
Myocardial Mechanics in Left Ventricular Noncompaction Cardiomyopathy
Left ventricular (LV) non-compaction (LVNC) is a rare genetic cardiomyopathy due to abnormal intra-uterine arrest of compaction of the myocardial fibers during endomyocardial embryogenesis. Due to the partial or complete absence of LV compaction, the structure of the LV wall shows characteristic abnormalities, including a thin compacted epicardium and a thick non-compacted endocardium with prominent trabeculations and deep intertrabecular recesses. LVNC is frequently associated with chronic heart failure, life-threatening ventricular arrhythmias, and systemic embolic events. 
  • 629
  • 01 Mar 2024
Topic Review
Facilitation of hERG Activation by Its Blocker
Modulation of the human Ether-à-go-go-Related Gene (hERG) channel, a crucial voltage-gated potassium channel in the repolarization of action potentials in ventricular myocytes of the heart, has significant implications on cardiac electrophysiology and can be either antiarrhythmic or proarrhythmic. For example, hERG channel blockade is a leading cause of long QT syndrome and potentially life-threatening arrhythmias, such as torsades de pointes. Conversely, hERG channel blockade is the mechanism of action of Class III antiarrhythmic agents in terminating ventricular tachycardia and fibrillation. In recent years, it has been recognized that less proarrhythmic hERG blockers with clinical potential or Class III antiarrhythmic agents exhibit, in addition to their hERG-blocking activity, a second action that facilitates the voltage-dependent activation of the hERG channel. This facilitation is believed to reduce the proarrhythmic potential by supporting the final repolarizing of action potentials.
  • 629
  • 27 Nov 2023
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.
  • 628
  • 24 Mar 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.
  • 627
  • 20 Mar 2023
Topic Review
Pharmacometabolomics of Lipid-Lowering Therapies
Lipid-lowering therapies are widely used to prevent the development of atherosclerotic cardiovascular disease (ASCVD) and related mortality worldwide. “Omics” technologies have been successfully applied to investigate the mechanisms of action of these drugs, their pleiotropic effects, and their side effects, aiming to identify novel targets for future personalized medicine with an improvement of the efficacy and safety associated with the treatment. Pharmacometabolomics is a branch of metabolomics that is focused on the study of drug effects on metabolic pathways that are implicated in the variation of response to the treatment considering also the influences from a specific disease, environment, and concomitant pharmacological therapies. The integration of pharmacometabolomics data with the information obtained from the other “omics” approaches could help in the comprehension of the biological mechanisms underlying the use of lipid-lowering drugs in view of defining a precision medicine to improve the efficacy and reduce the side effects associated with the treatment.
  • 626
  • 22 Feb 2023
Topic Review
POPDC Proteins in Cardiac Pacemaking and Conduction
The Popeye domain-containing (POPDC) gene family, consisting of Popdc1 (also known as Bves), Popdc2, and Popdc3, encodes transmembrane proteins abundantly expressed in striated muscle. POPDC proteins have recently been identified as cAMP effector proteins and have been proposed to be part of the protein network involved in cAMP signaling. However, their exact biochemical activity is presently poorly understood.
  • 625
  • 08 Dec 2021
Topic Review
Radiation-Induced Heart Disease
Cancer incidence and survivorship have had a rising tendency over the last two decades due to better treatment modalities. One of these is radiation therapy (RT). Radiation to the heart is a common complication of RT, especially in patients with lymphoma, breast, lung, and esophageal cancer. 
  • 625
  • 10 Jan 2022
Topic Review
Non-Invasive Diagnosis of Chronic Coronary Syndrome
Coronary artery disease is still a major cause of death and morbidity worldwide. In the setting of chronic coronary disease, demonstration of inducible ischemia is mandatory to address treatment. Consequently, scientific and technological efforts were made in response to the request for non-invasive diagnostic tools with better sensitivity and specificity. Clinicians have at their disposal a wide range of stress-imaging techniques. Among others, stress cardiac magnetic resonance (S-CMR) and computed tomography perfusion (CTP) techniques both demonstrated their diagnostic efficacy and prognostic value in clinical trials when compared to other non-invasive ischemia-assessing techniques and invasive fractional flow reserve measurement techniques. 
  • 625
  • 12 Jun 2023
Topic Review
Clinical Applications of 3D Printing in Cardiovascular Disease
3D printing has shown great promise in many medical applications covering a spectrum of areas, depending on the location, type and severity of pathologies. Whereas in the field of cardiovascular disease, in particular, congenital heart disease, the clinical value of 3D printing focuses on education of medical students or junior doctors or residents, improves physician-patient communication and increases confidence of cardiologists or cardiac surgeons in dealing with complex cardiac conditions. 3D printing is useful to develop medical devices in the treatment of aortic or valvular diseases.
  • 624
  • 22 Feb 2023
Topic Review
Ferroptosis in I/R Cardiac Injury
The hospital mortality in patients with ST-segment elevation myocardial infarction (STEMI) is about 6% and has not decreased in recent years. The leading cause of death of these patients is ischemia/reperfusion (I/R) cardiac injury. It is quite obvious that there is an urgent need to create new drugs for the treatment of STEMI based on knowledge about the pathogenesis of I/R cardiac injury, in particular, based on knowledge about the molecular mechanism of ferroptosis.
  • 624
  • 26 Jan 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.
  • 623
  • 16 Sep 2022
Topic Review
Paraoxonase 1 and Its Implications in Various Diseases
Paraoxonase enzymes have a protective role due to their ability to contribute to antioxidant and anti-inflammatory pathways, especially paraoxonase 1 (PON1). PON1 is diminished in infectious diseases, it can be used as a marker, and it can lead to lower protection against the microorganism; therefore, it can play a part in the development of antibiotic resistance.
  • 623
  • 21 Mar 2024
Topic Review
Current Knowledge of Enterococcal Endocarditis
Enterococci are a unique type of bacteria due to their ability to withstand a broad range of different environmental parameters such as pH, temperature, salinity, bile acids, and so on. They are resistant to many antibiotic compounds and have the flexibility to flourish as both common commensal and opportunistic pathogens in a broad range of clinical settings.
  • 621
  • 26 Mar 2024
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.
  • 620
  • 23 Jan 2022
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