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Topic Review
Basics of Coronary Bifurcation and Treatment in Brief
Coronary bifurcation percutaneous interventions (PCI) comprise a challenging subset of patients with coronary artery disease. PCI historically have a worse outcome compared to general revascularization procedures, but the advent of the third-generation drug-eluting stent (DES) has also drastically improved the results for patients with bifurcation disease. Beyond the discussion about beneficial effects on clinical outcomes of different strategies to fix coronary artery bifurcation disease, in order to improve the knowledge of technical complications, it is essential to understand the basics of bifurcation and the single versus double stent strategy.
  • 1.7K
  • 22 Nov 2022
Topic Review
Gla-Rich Protein in CKD
Chronic kidney disease (CKD) is estimated to affect more than 10% of the global population and represents an increasing health and economic burden for the society. Cardiovascular disease (CVD) is the most important complication of CKD and the primary cause of death in these patients. Chronic kidney disease-mineral and bone disorder (CKD-MBD), which is a common complication of CKD patients, involves changes in mineral ion homeostasis, bone quality and turnover, cardiovascular and soft tissue calcifications, highly contributing for cardiovascular outcomes. Vascular calcification (VC) is one of the strongest predictors of cardiovascular risk in chronic kidney disease (CKD) patients which is associated with significant morbidity and mortality. New diagnostic/prognostic tools are required for early detection of VC allowing interventional strategies. Gla-rich protein (GRP) is a cardiovascular calcification inhibitor, whose clinical utility still remained unknown. The present clinical study including a cohort of 80 diabetic patients with mild to moderate CKD (stages 2–4) explored, for the first time, correlations between levels of GRP in serum with CKD developmental stage, mineral metabolism markers, VC and pulse pressure (PP). The results shown an association between GRP, renal dysfunction and CKD-MBD. The relationship between low levels of GRP and vascular calcifications suggests a potential clinical utility for GRP as an early marker of vascular damage in CKD.
  • 1.7K
  • 02 Nov 2020
Topic Review
Atherosclerotic Cardiovascular Diseases
Atherosclerotic cardiovascular diseases (ASCVD) are the major cause of mortality worldwide. Despite the continuous progress in ASCVD therapy, the residual risk persists beyond the management of traditional risk factors. Several infections including Helicobacter pylori infection, periodontal disease, and viral infections are associated with the increased risk of ASCVD, both directly by damage to the heart muscle and vasculature, and indirectly by triggering a systemic proinflammatory state. Hence, beyond the optimal management of the traditional ASCVD risk factors, infections should be considered as an important non-classical risk factor to enable early diagnosis and appropriate treatment. 
  • 1.7K
  • 29 Jan 2022
Topic Review
Artificial Intelligence in Coronary Artery Disease
Clinically significant atherosclerosis of the coronary arteries, known as coronary artery disease (CAD), is an endemic condition that is associated with significant morbidity and mortality. The introduction of artificial intelligence (AI) and machine learning over the last two decades has unlocked new dimensions in the field of cardiovascular medicine. From automatic interpretations of heart rhythm disorders via smartwatches, to assisting in complex decision-making, AI has quickly expanded its realms in medicine and has demonstrated itself as a promising tool in helping clinicians guide treatment decisions. Understanding complex genetic interactions and developing clinical risk prediction models, advanced cardiac imaging, and improving mortality outcomes are just a few areas where AI has been applied in the domain of coronary artery disease. 
  • 1.7K
  • 13 Apr 2022
Topic Review
Pathophysiology of HFpEF
Heart failure (HF) with preserved ejection fraction (HFpEF) is an increasingly frequent form and is estimated to be the dominant form of HF. On the other hand, HFpEF is a syndrome with systemic involvement, and it is characterized by multiple cardiac and extracardiac pathophysiological alterations.
  • 1.7K
  • 22 Jan 2024
Topic Review
Polymeric Nanoparticles in Cardiovascular Diseases
Nanoparticles, including biodegradable polymeric nanoparticles, are able to increase the efficiency and reduce the degradability of natural polyphenols, thus increasing their beneficial abilities in the target tissues. Resveratrol-, quercetin-, or curcumin-loaded polymeric nanoparticles have been shown to markedly reduce reactive oxygen species formation, the inflammatory process, apoptosis, lipid peroxidation, cardiac hypertrophy, and even to delay myocardium injury due to ischemia/reperfusion. Thus, polymeric nanoparticles represent a promising tool for the delivery of natural polyphenols to target tissues and enhance their desirable effects in the cardiovascular system.
  • 1.7K
  • 27 Oct 2020
Topic Review
Effects of Finerenone’s Mechanism of Action
Finerenone is a novel, selective, nonsteroidal MRA that is efficacious in patients with type 2 diabetes (T2D) and chronic kidney disease (CKD). Steroidal MR antagonists (MRAs) are included in treatment paradigms for resistant hypertension and heart failure with reduced ejection fraction, while the nonsteroidal MRA finerenone was shown to reduce renal and cardiovascular outcomes in two large phase III trials (FIDELIO-DKD and FIGARO-DKD) in patients with chronic kidney disease and type 2 diabetes, respectively.
  • 1.7K
  • 02 Sep 2022
Topic Review
Mechanisms of Oxidative Stress in Metabolic Syndrome
Metabolic syndrome is characterized by abdominal obesity, high blood pressure, insulin resistance, a proinflammatory and prothrombotic state, atherogenic dyslipidemia , and low high-density lipoprotein cholesterol (HDL-C). Metabolic syndrom is mediated by oxidative stress and inflammation. Although the mechanisms are complicated and not very clear, this entry elucidates the mechanisms and pathways that drive oxidative stress in contributing to metabolic syndrome.
  • 1.7K
  • 09 May 2023
Topic Review
Interventional Management of Nutcracker and Wilkie Syndromes
Nutcracker and Wilkie syndromes are rare mesoaortic compression entities, and their association is even less common. Data on interventional treatment of these pathologies are still scarce, but results from limited case series are encouraging. 
  • 1.6K
  • 20 Sep 2022
Topic Review
Atrial Fibrillation Diagnosis Measurements
Atrial Fibrillation (AF) is a heart rhythm disorder. Hence, AF diagnosis is based on measurements which reflect the activity of the heart. Detectable symptoms of the disease might not be present all the time. Therefore, the measurement duration is positively correlated with the AF detection rate. Suitable measurements include photoplethysmogram, electrocardiogram, and heart rate. The data volume, produced through long term measurement, mandates computer support to automate the AF detection task.
  • 1.6K
  • 30 Oct 2020
Topic Review
Therapeutics: Atherosclerosis and Cardiovascular Diseases
Cardiovascular disease is the leading cause of death worldwide, and its prevalence is increasing due to the aging of societies. Atherosclerosis, a type of chronic inflammatory disease that occurs in arteries, is considered to be the main cause of cardiovascular diseases such as ischemic heart disease or stroke. In addition, the inflammatory response caused by atherosclerosis confers a significant effect on chronic inflammatory diseases such as psoriasis and rheumatic arthritis.
  • 1.6K
  • 18 Jun 2021
Topic Review
Cardiogenic Shock Complicating Acute Myocardial Infarction
Cardiogenic shock complicating acute myocardial infarction is a complex clinical condition associated with dismal prognosis. Routine early target vessel revascularization remains the most effective treatment to substantially improve outcomes, but mortality remains high. Temporary circulatory support devices have emerged with the aim to enhance cardiac unloading and improve end-organ perfusion.
  • 1.6K
  • 21 Sep 2022
Topic Review
The Interventricular Septum
Vertebrates developed pulmonary circulation and septated the heart into venous and arterial compartments, as the adaptation from aquatic to terrestrial life requires more oxygen and energy. The interventricular septum (IVS) accommodates the ventricular portion of the conduction system and contributes to the mechanical function of both ventricles. Conditions or diseases that affect IVS structure and function (e.g., hypertrophy, defects, other) may lead to ventricular pump failure and/or ventricular arrhythmias with grave consequences. IVS structure and function can be evaluated today using current imaging techniques. Effective therapies can be provided in most cases, although definitions of underlying etiologies may not always be easy, particularly in the elderly due to overlap between genetic and acquired causes of IVS hypertrophy, the most common being IVS abnormality.
  • 1.6K
  • 24 Jun 2022
Topic Review
Endothelial Nitric Oxide Synthase in Perivascular Adipose Tissue
Perivascular adipose tissue (PVAT) is a special type of ectopic fat depot that adheres to most vasculatures. PVAT has been shown to exert anticontractile effects on the blood vessels and confers protective effects against metabolic and cardiovascular diseases. PVAT plays a critical role in vascular homeostasis via secreting adipokine, hormones, and growth factors. Endothelial nitric oxide synthase (eNOS; also known as NOS3 or NOSIII) is well-known for its role in the generation of vasoprotective nitric oxide (NO). eNOS is primarily expressed, but not exclusively, in endothelial cells, while studies have identified its expression in both adipocytes and endothelial cells of PVAT. PVAT eNOS is an important player in the protective role of PVAT.
  • 1.6K
  • 08 Aug 2022
Topic Review
Capillary Leak Syndrome in COVID-19 and Cardiometabolic Disease
COVID-19 is a disease with multi-faceted clinical features, which vary from mild disease to fatal outcomes. The severity of the disease is associated with chronic low-grade inflammation and endothelial dysfunction underlying cardiometabolic diseases. Capillary leak, through endothelial hyperpermeability to proteins and the induction of pro-inflammatory, pro-coagulant pathways, has emerged as a pivotal pathogenetic factor of SARS-CoV-2 infection in cardiometabolic patients and as major etiology of hypoalbuminemia in severe COVID-19 cases. A great body of evidence supports the association of this condition with underlying metabolic derangement, and few remarkable indications regarding the role of metabolic disease in the incidence of systemic capillary leak syndrome flares have been noted. Further studies are needed to consolidate these findings and enlighten the pathophysiology behind them.
  • 1.6K
  • 17 Oct 2022
Topic Review
History of Automated Electrocardiogram Interpretation
The most recent development in the field of automated electrocardiogram (ECG) analysis has been the use of artificial intelligence (AI), including a variety of machine learning techniques to aid interpretation. One of the authors (PWM) was involved in the use of neural networks in the early 1990s but at that time, use of a simple neural network did not prove to be of any great advantage in ECG interpretation compared to the use of more basic, straightforward diagnostic criteria.  This entry describes the development of automated ECG interpretation since its beginnings in Washington DC around 1960 up until the present.
  • 1.6K
  • 15 Feb 2023
Topic Review
Antiphospholipid Syndrome (APS)
Antiphospholipid syndrome (APS) is considered an autoimmune, thrombo-inflammatory disease characterized by vascular thrombosis in the setting of one or more antiphospholipid antibodies (aPLs) such as lupus anticoagulant (AL), anticardiolipin antibodies (aCL) and anti-β2-glycoprotein1 antibodies (aβ2GPI).
  • 1.6K
  • 07 Dec 2021
Topic Review
Pathogenesis of COVID-19
The systemic manifestations commonly observed in COVID-19 patients include hypertension, arterial and venous thromboembolism, kidney disease, cerebrovascular disorders, and diabetes mellitus). These clinical findings strongly suggest that the virus is targeting the endothelium. Here we report a systematic and comprehensive evaluation of the evidence showing that the endothelium is a key target organ in COVID-19, playing a fundamental role in its pathogenesis.
  • 1.6K
  • 30 Oct 2020
Topic Review
Mechanical Heart Valve Patients with Intracranial Hemorrhage
The management of an intracranial hemorrhage in patients receiving anticoagulant therapy presents a significant challenge for medical professionals. Anticoagulant treatment is intended to prevent blood clotting, but it can worsen active brain bleeds. Despite this risk, avoiding the prothrombotic state caused by mechanical heart valves remains crucial. 
  • 1.6K
  • 17 May 2023
Topic Review
2D and 3D Echo in Mitral Stenosis
Mitral stenosis is an important cause of heart valve disease globally. Echocardiography is the main imaging modality used to diagnose and assess the severity and hemodynamic consequences of mitral stenosis as well as valve morphology. Transthoracic echocardiography (TTE) is sufficient for the management of most patients.
  • 1.6K
  • 15 Dec 2021
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