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Topic Review
Antiplatelet Therapies in Current Clinical Practice
Antiplatelet therapy plays a crucial role in a number of cardiovascular disorders.
  • 210
  • 21 Jul 2023
Topic Review
Multimodality Imaging Diagnosis in Infective Endocarditis
Imaging is an important tool in the diagnosis and management of infective endocarditis (IE). Echocardiography is an essential examination, especially in native valve endocarditis (NVE), but its diagnostic accuracy is reduced in prosthetic valve endocarditis (PVE). The diagnostic ability is superior for transoesophageal echocardiography (TEE), but a negative test cannot exclude PVE. Both transthoracic echocardiography (TTE) and TEE can provide normal or inconclusive findings in up to 30% of cases, especially in patients with prosthetic devices.
  • 210
  • 11 Jan 2024
Topic Review
Anti-Inflammation Strategies in Ischemic Heart Disease
Cardiovascular (CV) diseases remain a global health challenge, with ischemic heart disease (IHD) being the primary cause of both morbidity and mortality. Despite optimal pharmacological therapy, older patients with IHD exhibit an increased susceptibility to recurrent ischemic events, significantly impacting their prognosis. Inflammation is intricately linked with the aging process and plays a pivotal role in the evolution of atherosclerosis. Emerging anti-inflammatory therapies have shown promise in reducing ischemic events among high-risk populations.
  • 208
  • 17 Jan 2024
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. 
  • 207
  • 01 Mar 2024
Topic Review
Radiofrequency Ablation Versus Cryoablation as First-Line Treatment
Catheter ablation has been shown to be more effective at maintaining sinus rhythm and improving quality of life when compared to antiarrhythmic drugs. Radiofrequency and cryoablation are two effective methods. 
  • 199
  • 30 Aug 2023
Topic Review
Blood Flow Imaging Technology Based on Fluid Dynamics
Vascular calcification is the abnormal deposition of calcium phosphate complexes in blood vessels, regarded as the pathological basis of multiple cardiovascular diseases. The flowing blood exerts a frictional force called shear stress on the vascular wall. Blood vessels have different hydrodynamic properties due to discrepancies in geometric and mechanical properties. The disturbance of the blood flow in the bending area and the branch point of the arterial tree produces shear stress lower than the physiological magnitude of the laminar shear stress, which can induce the occurrence of vascular calcification. Endothelial cells sense the fluid dynamics of blood and transmit electrical and chemical signals to the full thickness of blood vessels. Through crosstalk with endothelial cells, smooth muscle cells trigger osteogenic transformation, involved in mediating vascular intima and media calcification. In addition, based on the detection of fluid dynamics parameters, emerging imaging technologies such as 4D Flow MRI and computational fluid dynamics have greatly improved the early diagnosis ability of cardiovascular diseases, showing extremely high clinical application prospects.
  • 194
  • 23 Aug 2023
Topic Review
Mitral Annular Calcification and Its Management
The mitral valve annulus serves as a boundary between the left atrium (LA) and the left ventricular (LV). The mitral annulus has an anterior and posterior segment. The anterior segment connects the aortic root to the anterior leaflet of the mitral valve and thereby forms the aorto-mitral curtain. The anterior and posterior segments act as anchoring points for the respective mitral valve (MV) leaflets. Mitral valve annular calcification-related valvular disease is increasingly common due to the rising prevalence of age-related mitral annular calcifications. Mitral annular calcification alters the structure and function of the mitral valve annulus, which in turn causes mitral valve regurgitation, stenosis, or both. As it frequently coexists with comorbid conditions and overlapping symptoms, mitral annular calcification-related valvular disease poses significant diagnostic and therapeutic challenges.
  • 193
  • 08 Feb 2024
Topic Review
Targeting Collagen Pathways as an HFpEF Therapeutic Strategy
Heart failure with preserved ejection fraction (HFpEF) is a complex and heterogeneous clinical syndrome, and the prevalence is expected to increase in the coming years. This condition poses a burden to the global health care system as the number of patients affected by this condition is constantly increasing due to a rising average lifespan. The absence of validated drugs effective in reducing hospitalization rates and mortality may reflect the impossibility of applying a one size fits all approach as in HFrEF, heading for a personalized approach. Available evidence demonstrated the link between collagen quantity and quality alterations, and cardiac remodeling. In the context of fibrosis, collagen cross-linking is strictly involved, displaying two types of mechanisms: enzymatic and non-enzymatic. In the murine model, enzymatic inhibition of fibrosis-inducing protease-activated receptor-1 (PAR1) and transforming growth factor (TGF)-β signaling appeared to reduce cardiac fibrosis. On the other hand, in the case of non-enzymatic cross-linking, sodium glucose co-transporter type 2 inhibitors (SGLT2is), appeared to counteract the deposition of advanced glycation end-products (AGEs), which in turn contributed to ventricular remodeling.
  • 191
  • 04 Jan 2024
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.
  • 187
  • 24 Jan 2024
Topic Review
Cardiovascular Computed Tomography in Cardiovascular Disease Diagnosis
The recent emergence of photon-counting computed tomography (CT) has further enhanced CT performance in clinical applications, providing improved spatial and contrast resolution. CT-derived fractional flow reserve is superior to standard CT-based anatomical assessment for the detection of lesion-specific myocardial ischemia. CT-derived 3D-printed patient-specific models are also superior to standard CT, offering advantages in terms of educational value, surgical planning, and the simulation of cardiovascular disease treatment, as well as enhancing doctor–patient communication. Three-dimensional visualization tools including virtual reality, augmented reality, and mixed reality are further advancing the clinical value of cardiovascular CT in cardiovascular disease.
  • 187
  • 24 Jan 2024
Topic Review
Risk Factors and Cellular Differences in Heart Failure
Patients with heart failure are conventionally stratified into phenotypic groups based on their ejection fraction. The aim of this stratification is to improve disease management with a more targeted therapeutic approach. A further subdivision based on patient gender is justified. It is recognized that women are underrepresented in randomized controlled clinical trials, resulting in limited clinical and molecular differentiation between males and females. However, many observational studies show that the onset, development, and clinical course of the disease may substantially differ between the two sexes. 
  • 185
  • 27 Nov 2023
Topic Review
New-Onset Atrial Fibrillation in Severe COVID-19 Patients
New-onset atrial fibrillation (NOAF) is the most frequently encountered cardiac arrhythmia observed in patients with COVID-19 infection, particularly in Intensive Care Unit (ICU) patients. The proposed mechanisms that could contribute to the development of Atrial fibrillation (AF) in these patients include myocardial damage resulting from direct virus-induced cardiac injury, potentially leading to perimyocarditis; a cytokine crisis and heightened inflammatory response; hypoxemia due to acute respiratory distress; disturbances in acid-base and electrolyte levels; as well as the frequent use of adrenergic drugs in critically ill patients.
  • 184
  • 21 Nov 2023
Topic Review
Heart Transplantation
Heart transplantation (HTx) remains the last therapeutic resort for patients with advanced heart failure. Several factors have been associated with the outcome of HTx, such as ABO and HLA compatibility, graft size, ischemic time, age, infections, and the cause of death, as well as imaging and laboratory tests. 
  • 184
  • 07 Feb 2024
Topic Review
Transcriptomic Analysis in Heart Failure
Heart failure constitutes a clinical complex syndrome with different symptomatic characteristics depending on age, sex, race and ethnicity, among others, which has become a major public health issue with an increasing prevalence. One of the most interesting tools seeking to improve prevention, diagnosis, treatment and prognosis of this pathology has focused on finding new molecular biomarkers since heart failure relies on deficient cardiac homeostasis, which is regulated by a strict gene expression. Therefore, currently, analyses of non-coding RNA transcriptomics have been oriented towards human samples. 
  • 183
  • 13 Oct 2023
Topic Review
Conduction Abnormalities Post Transcatheter Aortic Valve Implantation
Transcatheter aortic valve implantation (TAVI) is an established alternative to surgery in patients with symptomatic severe aortic stenosis and has expanded its indications to even low-surgical-risk patients. Conduction abnormalities (CA) and permanent pacemaker (PPM) implantations remain a relatively common finding post TAVI due to the close proximity of the conduction system to the aortic root. New onset left bundle branch block (LBBB) and high-grade atrioventricular block are the most commonly reported CA post TAVI. The overall rate of PPM implantation post TAVI varies and is related to pre- and intra-procedural factors. Therefore, when screening patients for TAVI, Heart Teams should take under consideration the various anatomical, pathophysiological and procedural conditions that predispose to CA and PPM requirement after the procedure. This is particularly important as TAVI is being offered to younger patients with longer life-expectancy. 
  • 183
  • 30 Nov 2023
Topic Review
Vascular Diseases in Women
According to the World Health Organization, cardiovascular disease (CVD) is the leading cause of death among women worldwide, yet its magnitude is often underestimated. Biological and gender differences affect health, diagnosis, and healthcare in numerous ways. The lack of sex and gender awareness in health research and healthcare is an ongoing issue that affects not only research but also treatment and outcomes. The importance of recognizing the impacts of both sex and gender on health and of knowing the differences between the two in healthcare is beginning to gain ground. There is more appreciation of the roles that biological differences (sex) and sociocultural power structures (gender) have, and both sex and gender affect health behavior, the development of diseases, their diagnosis, management, and the long-term effects of an illness. 
  • 181
  • 28 Feb 2024
Topic Review
Drug-Coated Balloons
Drug-coated balloons (DCB) are a well-established option for treating in-stent restenosis endorsed by European Guidelines on myocardial revascularization. However, in recent years, a strategy of “leaving nothing behind” with DCB in de novo coronary stenosis has emerged as an appealing approach.
  • 181
  • 12 Mar 2024
Topic Review
Cardiac Masses and Pseudomasses
A cardiac lesion detected at ultrasonography might turn out to be a normal structure, a benign tumor or rarely a malignancy, and lesion characterization is very important to appropriately manage the lesion itself. The exact relationship of the mass with coronary arteries and the knowledge of possible concomitant coronary artery disease are necessary preoperative information.
  • 178
  • 09 Jan 2024
Topic Review
Possible Molecular Mechanisms of Hypertension in SAS
Intermittent hypoxia (IH) is a central characteristic of sleep apnea syndrome (SAS), and it subjects cells in the body to repetitive apnea, chronic hypoxia, oxygen desaturation, and hypercapnia. Since SAS is linked to various serious cardiovascular complications, especially hypertension, many studies have been conducted to elucidate the mechanism of hypertension induced by SAS/IH. Hypertension in SAS is associated with numerous cardiovascular disorders. As hypertension is the most common complication of SAS, cell and animal models to study SAS/IH have developed and provided lots of hints for elucidating the molecular mechanisms of hypertension induced by IH. However, the detailed mechanisms are obscure and under investigation.
  • 167
  • 01 Feb 2024
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.
  • 165
  • 26 Jan 2024
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