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Topic Review
Three-Dimensional Bioprinting in Cardiovascular Disease
Three-dimensional (3D) printing plays an important role in cardiovascular disease through the use of personalised models that replicate the normal anatomy and its pathology with high accuracy and reliability. 3D bioprinting represents a promising field that could revolutionise the future of cardiovascular disease treatment. Three-dimensional bioprinting uses mostly the same additive manufacturing technologies but prints functional living structures from biological components such as living cells, biomaterials and growth factors.
  • 617
  • 01 Aug 2023
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.
  • 616
  • 21 Mar 2024
Topic Review
Cardiac Imaging
Cardiac magnetic resonance imaging emerged as the most definitive modality, offering real-time detection, comprehensive assessment of cardiac function, the ability to detect early myocardial changes, and superior detection of cardiotoxicity when compared to the other imaging modalities. 
  • 615
  • 19 Dec 2023
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.
  • 614
  • 29 Apr 2022
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.
  • 614
  • 16 Sep 2022
Topic Review
Transcatheter Aortic Valve Intervention Complications and Challenges
Since the first in man transcatheter aortic valve intervention (TAVI) performed by Dr. Alain Cribier in 2002 in a non-operable aortic stenosis (AS) patient, TAVI has changed the lives of so many patients for whom medical treatment was, up to then, the only option.
  • 614
  • 12 Oct 2023
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.
  • 613
  • 25 Apr 2022
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.
  • 613
  • 25 Apr 2023
Topic Review
Soluble Suppression of Tumorigenicity-2 in Heart Failure
There has been growing interest in the risk stratification for heart failure, and the use of multiple biomarkers to identify different pathophysiological processes associated with this condition. One such biomarker is soluble suppression of tumorigenicity-2 (sST2), which has shown some potential for integration into clinical practice. sST2 is produced by both cardiac fibroblasts and cardiomyocytes in response to myocardial stress. Other sources of sST2 are endothelial cells of the aorta and coronary arteries and immune cells such as T cells.
  • 611
  • 14 Jun 2023
Topic Review
Surgical Left Atrial Appendage Occlusion
Atrial fibrillation (AF) is the most common arrhythmia worldwide. It is estimated to affect 2–4% of the adult population, and its prevalence increases with advancing age. Given the aging population, AF is expected to become even more prevalent in the coming years. Ischemic stroke and systemic embolism are the most significant risks associated with AF, leading to increased morbidity and mortality. Therefore, thromboembolism prevention is the cornerstone of managing AF.
  • 610
  • 06 Sep 2023
Topic Review
Leadless Ventricular Pacemaker
Conventional transvenous pacemakers (TPMs) have been the cornerstone of the treatment of bradyarrhythmias. With technological advances in device miniaturization, communication, and battery longevity, leadless pacemakers (LPMs) have emerged as an alternative to TPMs to eliminate the complications associated with leads and subcutaneous pockets.
  • 610
  • 16 Jun 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. 
  • 609
  • 07 Sep 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.
  • 608
  • 28 Dec 2022
Topic Review
High-Density Lipoproteins, the NLRP3 Inflammasome and Myocardial Infarction
The NLRP3 inflammasome is an intracellular defender that acts against the cellular fragments and cytoplasmic contents of injured and/or dead cells, called damage-associated molecular patterns (DAMPs) (also known as alarmins). The ultimate consequence of prolonged cardiac ischemia is myocardial infarction (MI), a condition accountable for one-third of global fatalities. The extent of MI is a potent predictor of various adverse cardiovascular events, encompassing mortality, recurrent MI, arrhythmias, congestive heart failure, angina, and the need for revascularization, as substantiated by several studies.
  • 608
  • 24 Jan 2024
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. 
  • 607
  • 17 May 2021
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.
  • 606
  • 25 Oct 2023
Topic Review
Lipid-Lowering Therapy of Post-Acute Coronary Syndrome
It has been consistently demonstrated that circulating lipids and particularly low-density lipoprotein cholesterol (LDL-C) play a significant role in the development of coronary artery disease (CAD). Several trials have been focused on the reduction of LDL-C values in order to interfere with atherothrombotic progression. Importantly, for patients who experience acute coronary syndrome (ACS), there is a 20% likelihood of cardiovascular (CV) event recurrence within the two years following the index event. 
  • 596
  • 21 Aug 2023
Topic Review
The Role of Nutrition in Cardiovascular Damage
The cardiovascular system is a well-known target of antineoplastic treatments, including anthracyclines, chest radiotherapy and new molecules, such as tyrosine kinase inhibitors. Researchers investigated nutritional changes in children with cancer from the diagnosis to the end of treatment and dietary habits in cancer survivors. At diagnosis, children with cancer may present variable degrees of malnutrition, potentially affecting drug tolerability and prognosis. 
  • 594
  • 31 Aug 2023
Topic Review
Treatment of Obstructive Hypertrophic Cardiomyopathy
Left ventricular outflow obstruction (LVOTO) and diastolic dysfunction are the main pathophysiological characteristics of hypertrophic cardiomyopathy (HCM)LVOTO, may be identified in more than half of HCM patients and represents an important determinant of symptoms and a predictor of worse prognosis.  Treatment of LVOTO is indicated in patients with lifestyle-limiting symptoms only. Negative inotropic and chronotropic medications are indicated as the first-line therapy. If patients remain symptomatic, or remain in the presence of side effects, surgery is suggested only when performed in experienced centers.
  • 593
  • 30 May 2023
Topic Review
mTORC1 and SGLT2 Inhibitors for Diabetic Cardiomyopathy
Diabetic cardiomyopathy is a critical diabetes-mediated co-morbidity characterized by cardiac dysfunction and heart failure, without predisposing hypertensive or atherosclerotic conditions. Metabolic insulin resistance, promoting hyperglycemia and hyperlipidemia, is the primary cause of diabetes-related disorders, but ambiguous tissue-specific insulin sensitivity has shed light on the importance of identifying a unified target paradigm for both the glycemic and non-glycemic context of type 2 diabetes (T2D). Several studies have indicated hyperactivation of the mammalian target of rapamycin (mTOR), specifically complex 1 (mTORC1), as a critical mediator of T2D pathophysiology by promoting insulin resistance, hyperlipidemia, inflammation, vasoconstriction, and stress. Moreover, mTORC1 inhibitors like rapamycin and their analogs have shown significant benefits in diabetes and related cardiac dysfunction. Recently, FDA-approved anti-hyperglycemic sodium–glucose co-transporter 2 inhibitors (SGLT2is) have gained therapeutic popularity for T2D and diabetic cardiomyopathy, even acknowledging the absence of SGLT2 channels in the heart. Recent studies have proposed SGLT2-independent drug mechanisms to ascertain their cardioprotective benefits by regulating sodium homeostasis and mimicking energy deprivation.
  • 593
  • 24 Oct 2023
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