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Topic Review
Cardiac Drugs in ACHD-Related Heart Failure
Pharmacotherapy in adult CHD (ACHD) is largely supportive and is used to manage complications such as arrhythmias, heart failure (HF), and pulmonary hypertension in addition to interventional or surgical procedures.
  • 232
  • 12 May 2023
Topic Review
Multimodality Imaging for Diagnosis for Fabry Disease
Fabry disease (FD) is a genetic lysosomal storage disease with frequent cardiovascular involvement, whose presence is a major determinant of adverse clinical outcomes. As a potentially treatable cause of left ventricular hypertrophy (LVH) and heart failure with preserved ejection fraction, the early recognition of FD is crucial to initiate enzyme replacement therapy and improve long-term prognosis. Multimodality imaging plays a central role in the evaluation of patients with FD and helps in the differential diagnosis of other conditions presenting with LVH.
  • 232
  • 30 Nov 2023
Topic Review
Four-Dimensional Flow Echocardiography in Congenital Heart Disease
Blood speckle tracking echocardiography (BSTE) is a new, promising 4D flow ultrafast non-focal plane imaging technique. BSTE is highly feasible, fast, and easy for visualization of normal/abnormal flow patterns in healthy children and in those with congenital heart disease (CHD). BSTE allows for visualization and basic 2D measures of normal/abnormal vortices forming the ventricles and in the main vessel. Left ventricular vortex characteristics and aortic flow patterns have been described both in healthy children and in those with CHD.
  • 232
  • 31 Jan 2024
Topic Review
Anderson–Fabry Disease
Anderson–Fabry disease (AFD) is a lysosome storage disorder resulting from an X-linked inheritance of a mutation in the galactosidase A (GLA) gene encoding for the enzyme alpha-galactosidase A (α-GAL A). This mutation results in a deficiency or absence of α-GAL A activity, with a progressive intracellular deposition of glycosphingolipids leading to organ dysfunction and failure. Cardiac damage starts early in life, often occurring sub-clinically before overt cardiac symptoms. Left ventricular hypertrophy represents a common cardiac manifestation, albeit conduction system impairment, arrhythmias, and valvular abnormalities may also characterize AFD. Even in consideration of pleiotropic manifestation, diagnosis is often challenging. Thus, knowledge of cardiac and extracardiac diagnostic “red flags” is needed to guide a timely diagnosis.
  • 231
  • 04 Feb 2024
Topic Review
Ventricular Arrhythmias in Left Ventricular Assist Device Patient
Left ventricular assist devices (LVAD) are used in the treatment of advanced left ventricular heart failure. LVAD can serve as a bridge to orthotopic heart transplantation or as a destination therapy in cases where orthotopic heart transplantation is contraindicated. Ventricular arrhythmias are frequently observed in patients with LVAD. 
  • 231
  • 23 Feb 2024
Topic Review
Diagnostics for Coronary Microvascular Dysfunction Patients with Hypertension
Coronary microvascular dysfunction (CMD) is a clinical entity linked with various risk factors that significantly affect cardiac morbidity and mortality. Hypertension, one of the most important, causes both functional and structural alterations in the microvasculature, promoting the occurrence and progression of microvascular angina. Endothelial dysfunction and capillary rarefaction play the most significant role in the development of CMD among patients with hypertension. CMD is also related to several hypertension-induced morphological and functional changes in the myocardium in the subclinical and early clinical stages, including left ventricular hypertrophy, interstitial myocardial fibrosis, and diastolic dysfunction. This indicates the fact that CMD, especially if associated with hypertension, is a subclinical marker of end-organ damage and heart failure, particularly that with preserved ejection fraction.
  • 230
  • 29 Dec 2023
Topic Review
Phenotypes and Symptoms of HFpEF and Sleep-Disordered Breathing
Heart failure with preserved ejection fraction (HFpEF) is emerging as a widespread disease with global socioeconomic impact. Patients with HFpEF show a dramatically increased morbidity and mortality, and, unfortunately, specific treatment options are limited. One such comorbidity is sleep-disordered breathing (SDB), which affects up to 58% (or up to 80% in certain cohorts) of HFpEF patients. SDB presents in HFpEF patients either as predominantly obstructive sleep apnea (OSA) or as predominantly central sleep apnea (CSA).
  • 226
  • 28 Nov 2023
Topic Review
Control of LDL Level with LDLR Pathway
Since the discovery of the LDL receptor in 1973 by Brown and Goldstein as a causative protein in hypercholesterolemia, tremendous amounts of effort have gone into finding ways to manage high LDL cholesterol in familial hypercholesterolemic (HoFH and HeFH) individuals with loss-of-function mutations in the LDL receptor (LDLR) gene. Statins proved to be the first blockbuster drug, helping both HoFH and HeFH individuals by inhibiting the cholesterol synthesis pathway rate-limiting enzyme HMG-CoA reductase and inducing the LDL receptor. However, statins could not achieve the therapeutic goal of LDL. Other therapies targeting LDLR include PCSK9, which lowers LDLR by promoting LDLR degradation. Inducible degrader of LDLR (IDOL) also controls the LDLR protein, but an IDOL-based therapy is yet to be developed. Among the LDLR-independent pathways, such as angiopoietin-like 3 (ANGPTL3), apolipoprotein (apo) B, apoC-III and CETP, only ANGPTL3 offers the advantage of treating both HoFH and HeFH patients and showing relatively better preclinical and clinical efficacy in animal models and hypercholesterolemic individuals, respectively.
  • 225
  • 03 Jul 2023
Topic Review
Global Cardiac Surgery
Cardiac surgery is a modern science in the history of medicine. The impact of cardiac disease, in terms of treatment and prognosis, has made this discipline indispensable to global health. Greatest investment has been dispensed to technological and material improvements to increase life expectancy. This surgery must address different epidemiological aspects dictated by the geography and economic–social conditions of the global populations. 
  • 223
  • 15 Nov 2023
Topic Review
Adverse Cardiovascular Effects of Radiation Therapy
Radiation therapy is a key part of treatment for many cancers. Vast advancements in the field of radiation oncology have led to a decrease in malignancy-related mortality, which has uncovered some of the long-term side effects of radiation therapy. Specifically, there has been an increase in research looking into the cardiovascular side effects of chest radiation therapy for cancers of the esophagus, breast, and lung tissue as well as lymphomas.
  • 222
  • 09 Nov 2023
Topic Review
Systemic Lupus Erythematosus and Arterial Hypertension
Systemic lupus erythematosus (SLE) is a multifactorial disorder with contributions from hormones, genetics, and the environment, predominantly affecting young women. Cardiovascular disease is the primary cause of mortality in SLE, and hypertension is more prevalent among SLE patients.
  • 222
  • 06 Dec 2023
Topic Review
Endothelial Senescence
Endothelial cells line at the most inner layer of blood vessels. They act to control hemostasis, arterial tone/reactivity, wound healing, tissue oxygen, and nutrient supply. With age, endothelial cells become senescent, characterized by reduced regeneration capacity, inflammation, and abnormal secretory profile. Endothelial senescence represents one of the earliest features of arterial ageing and contributes to many age-related diseases. Compared to those in arteries and veins, endothelial cells of the microcirculation exhibit a greater extent of heterogeneity. Microcirculatory endothelial senescence leads to a declined capillary density, reduced angiogenic potentials, decreased blood flow, impaired barrier properties, and hypoperfusion in a tissue or organ-dependent manner. The heterogeneous phenotypes of microvascular endothelial cells in a particular vascular bed and across different tissues remain largely unknown. Accordingly, the mechanisms underlying macro- and micro-vascular endothelial senescence vary in different pathophysiological conditions, thus offering specific target(s) for therapeutic development of senolytic drugs.
  • 222
  • 07 Mar 2024
Topic Review
Healthy Foods Choices for Cardiovascular Disease
Cardiovascular disease (CVD) remains the first cause of mortality globally. Diet plays a fundamental role in cardiovascular health and is closely linked to the development of CVD. Numerous human studies have provided evidence on the relationship between diet and CVD.
  • 221
  • 04 Dec 2023
Topic Review
Echocardiographic Assessment of Right Ventricular Function
Tricuspid regurgitation (TR) is a highly prevalent valvular heart disease that has been long overlooked, but lately its independent association with adverse cardiovascular outcomes was recognized. The time point to intervene and repair the tricuspid valve is defined by the right ventricular (RV) dilation and dysfunction that comes up at a later stage. While guidelines favor tricuspid valve repair before severe RV dysfunction ensues, the definition of RV dysfunction in a universal manner remains vague. As a result, the candidates for transcatheter or surgical TR procedures are often referred late, when advanced RV dysfunction is established, and any derived procedural survival benefit is attenuated.
  • 221
  • 04 Dec 2023
Topic Review
Glucagon-Like Peptide-1 Receptor Agonists in Atherosclerosis
Atherosclerosis is a chronic inflammatory disease characterized by lipid and inflammatory cell deposits in the inner layer of large- and medium-sized elastic and muscular arteries. Diabetes mellitus (DM) significantly increases the risk of cardiovascular diseases and the overall and cardiovascular mortality, and it is a pro-atherogenic factor that induces atherosclerosis development and/or accelerates its progression through a multifactorial process. Glucagon-like peptide-1 receptor agonists (GLP-1RAs) are a new class of drugs, belonging to the armamentarium to fight type 2 DM, that have shown robust reductions in atherosclerotic events and all-cause mortality in all studies.
  • 217
  • 04 Mar 2024
Topic Review
General Effects of Elevated Blood Pressure on Vasculature
Vascular dysfunction and vascular remodeling are caused by chronically elevated systemic arterial blood pressure (BP), and can be associated with changes in all vessel layers, from the endothelium to the perivascular adipose tissue (PVAT). In HHD, large artery alterations are characterized by increased proximal artery enlargement, arterial wall thickness, the elongation and widening of the aortic arch, and increased arterial stiffness. Small artery alterations are characterized by eutrophic remodeling (defined as increased media-to-lumen ratio with unchanged total wall tissue), increased arterial stiffness, and microvascular rarefaction. It is considered that the progressive course of HHD leads to a reduction in the microcirculatory network, and many bioactive molecules, such as angiotensin-II (Ang-II), endothelin-1 (ET-1), aldosterone, catecholamines, and metalloproteinases (MMP) have an impact on vascular remodeling, particularly because of their capacity to increase oxidative stress and to impair nitric oxide (NO) activity in the vascular wall.
  • 215
  • 31 Jan 2024
Topic Review
Novel MRI Tools for Hypertrophic Cardiomyopathy Risk Stratification
Hypertrophic cardiomyopathy (HCM) is a common genetic disorder with a well described risk of sudden cardiac death; however, risk stratification has remained a challenge. Recently, novel parameters in cardiac magnetic resonance imaging (CMR) have shown promise in helping to improve upon current risk stratification paradigms. 
  • 215
  • 28 Feb 2024
Topic Review
Natural Antioxidant in Myocardial Infarction/Ischemic Stroke Injury Treatment
Natural antioxidants are present in low concentrations within cells. They reduce free radicals to provide a protection system against vascular diseases. They have a strong potential to inhibit oxidative stress (OS), lipid peroxidation and the oxidation of breakdown products. Natural antioxidants can function either individually or synergistically to remove free radicals generated during oxidative metabolism, thus maintaining the redox balance.
  • 213
  • 23 Oct 2023
Topic Review
Myostatin and the Heart
Myostatin (growth differentiation factor 8) is a member of the transforming growth factor-β superfamily. It is secreted mostly by skeletal muscles, although small amounts of myostatin are produced by the myocardium and the adipose tissue as well. Myostatin binds to activin IIB membrane receptors to activate the downstream intracellular canonical Smad2/Smad3 pathway, and additionally acts on non-Smad (non-canonical) pathways. Studies on transgenic animals have shown that overexpression of myostatin reduces the heart mass, whereas removal of myostatin has an opposite effect. 
  • 212
  • 20 Dec 2023
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. 
  • 211
  • 19 Dec 2023
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