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Topic Review
Cardiac Masses: Cardiovascular Imaging Diagnosis
Cardiac masses are space occupying lesions within the cardiac cavities or adjacent to the pericardium. They include frequently diagnosed clinical entities such as clots and vegetations, common benign tumors such as myxomas and papillary fibroelastomas and uncommon benign or malignant primary or metastatic tumors. Given their diversity, there are no guidelines or consensus statements regarding the best diagnostic or therapeutic approach. In the past, diagnosis used to be made by the histological specimens after surgery or during the post-mortem examination. Nevertheless, evolution and increased availability of cardiovascular imaging modalities has enabled better characterization of the masses and the surrounding tissue. Transthoracic echocardiography using contrast agents can evaluate the location, the morphology and the perfusion of the mass as well as its hemodynamic effect. Transesophageal echocardiography has increased spatial and temporal resolution; hence it is superior in depicting small highly mobile masses. Cardiac magnetic resonance and cardiac computed tomography are complementary providing tissue characterization. The scope of this review is to present the role of cardiovascular imaging in the differential diagnosis of cardiac masses and to propose a step-wise diagnostic algorithm, taking into account the epidemiology and clinical presentation of the cardiac masses, as well as the availability and the incremental value of each imaging modality.
  • 1.5K
  • 12 Jan 2021
Topic Review
Ferroptosis in Cardiovascular Diseases
Cardiovascular diseases (CVDs) are still a major cause of global mortality and disability, seriously affecting people’s lives. Due to the severity and complexity of these diseases, it is important to find new regulatory mechanisms to treat CVDs. Ferroptosis is a new kind of regulatory cell death currently being investigated. Increasing evidence showed that ferroptosis plays an important role in CVDs, such as in ischemia/reperfusion injury, heart failure, cardiomyopathy, and atherosclerosis. 
  • 1.5K
  • 17 Mar 2022
Topic Review
Left Ventricle Unloading in VA ECMO
Impressively increasing availability of mechanical circulatory/cardiac support systems (MCSs) worldwide, together with the deepening of the knowledge of critical care medical practitioners, has inevitably led to the discussion about further improvements of intensive care associated to MCS. An appealing topic of the left ventricle (LV) overload related to VA ECMO support endangering myocardial recovery is being widely discussed within the scientific community. Unloading of LV leads to the reduction in LV end-diastolic pressure, reduction in pressure in the left atrium, and decrease in the LV thrombus formation risk. Consequently, better conditions for myocardial recovery, with comfortable filling pressures and a better oxygen delivery/demand ratio, are achieved. The combination of VA ECMO and Impella device, also called ECPELLA, seems to be a promising strategy that may bring the improvement of CS mortality rates.
  • 1.5K
  • 07 Oct 2023
Topic Review
Osteopontin in Heart Failure
The matricellular protein osteopontin modulates cell–matrix interactions during tissue injury and healing. A complex multidomain structure of osteopontin enables it not only to bind diverse cell receptors but also to interact with various partners, including other extracellular matrix proteins, cytokines, and growth factors. Numerous studies have implicated osteopontin in the development and progression of myocardial remodeling in diverse cardiac diseases. Osteopontin influences myocardial remodeling by regulating extracellular matrix production, the activity of matrix metalloproteinases and various growth factors, inflammatory cell recruitment, myofibroblast differentiation, cardiomyocyte apoptosis, and myocardial vascularization. The exploitation of osteopontin loss- and gain-of-function approaches in rodent models provided an opportunity for assessment of the cell- and disease-specific contribution of osteopontin to myocardial remodeling.
  • 1.5K
  • 26 Aug 2022
Topic Review
Marfan Cardiomyopathy and Arrhythmia
Marfan syndrome (MFS) is a heritable systemic connective tissue disease with important cardiovascular involvement, including aortic root dilatation and mitral valve prolapse. Life expectancy in patients with MFS is mainly determined by cardiovascular complications, among which aortic dissection or rupture are most dreaded. In recent years, heart failure and ventricular arrhythmia have drawn attention as extra-aortic cardiovascular manifestations and as additional reported causes of death. Imaging studies have provided data supporting a primary myocardial impairment in the absence of valvular disease or cardiovascular surgery, while studies using ambulatory ECG have demonstrated an increased susceptibility to ventricular arrhythmia.
  • 1.5K
  • 22 Feb 2021
Topic Review
Ubiquitylation
Ubiquitylation is a post-translational modification that covalently conjugates the ubiquitin molecule through the C-terminus to a lysine residue on a substrate protein. Ubiquitylation results in the turnover of the ubiquitylated substrate protein by either the proteasome or lysosome, a change in subcellular localization of the substrate protein, or alteration of substrate protein function . Ubiquitylation is mediated by three enzymes and scaffolding proteins: E1, E2, and E3.
  • 1.5K
  • 22 Jun 2021
Topic Review
T-Type Calcium Channels
The role of T-type calcium channels is well established in excitable cells, where they preside over action potential generation, automaticity, and firing. They also contribute to intracellular calcium signaling, cell cycle progression, and cell fate; and, in this sense, they emerge as key regulators also in non-excitable cells. In particular, their expression may be considered a prognostic factor in cancer. Almost all cancer cells express T-type calcium channels to the point that it has been considered a pharmacological target; but, as the drugs used to reduce their expression are not completely selective, several complications develop, especially within the heart. T-type calcium channels are also involved in a specific side effect of several anticancer agents, that act on microtubule transport, increase the expression of the channel, and, thus, the excitability of sensory neurons, and make the patient more sensitive to pain.
  • 1.5K
  • 21 Nov 2022
Topic Review
Redox Regulation of Hypoxia-Inducible Factors
Oxidative stress and hypoxia-inducible factors (HIFs) have been implicated in the pathogenesis of diabetic cardiovascular and renal diseases. Reactive oxygen species (ROS) mediate physiological and pathophysiological processes, being involved in the modulation of cell signaling, differentiation, and survival, but also in cyto- and genotoxic damage. As master regulators of glycolytic metabolism and oxygen homeostasis, HIFs have been largely studied for their role in cell survival in hypoxic conditions.
  • 1.4K
  • 17 Nov 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.
  • 1.4K
  • 22 Jan 2024
Topic Review
Deep Hypothermia in Cardiac Surgery
While standard Deep Hypothermia (DH) is defined as a body core temperature below 28°C, this value is lower in cardiac surgery, below 20°C. DH is used not only to improve the technical aspect of surgery but primarily to prevent ischemic injury of the central nervous system and crucial organs. The protective effect of hypothermia is provided mainly by slowing the cellular metabolism and thus decreasing its oxygen consumption and energy demand.
  • 1.4K
  • 03 Aug 2021
Topic Review
Factor XI/XIa Inhibition in Cardio- and Cerebrovascular Disease
Factor XI (FXI) is one promising target. Existing direct oral anticoagulants (DOACs) have improved treatment options compared to the classic heparins and vitamin K antagonists (VKA), but the bleeding risks associated with their use are substantial enough to expand the focus onto the development of their antidotes. Early indications are that FXI-directed strategies could offer similar protection against thrombotic events as DOACs, but with the added benefit of lower bleeding risk. Furthermore, the spectrum of modalities for FXI inhibition presents a range of options in both types of administration and duration of effect. With the possibility of once- or twice-monthly injections, some FXI-directed agents could also improve treatment compliance compared to current therapies. Altogether, FXIa inhibitors could be a therapeutic option in a broad spectrum of clinical scenarios. 
  • 1.4K
  • 19 Dec 2022
Topic Review
Cardiovascular Risk Stratification and Cancer
Cancer patients receiving a potentially cardiotoxic oncologic therapy have an increased risk of cardiovascular adverse events (CVAEs), especially in presence of concomitant arterial hypertension (AH). Therefore, cancer patients should be evaluated before, during and after cardiotoxic treatments, to early identify new-onset or worsening AH or CVAEs. An expert panel of oncology networks from Piedmont and Aosta Valley (North-Western Italy) aimed to provide recommendations to support health professionals in selecting the best management strategies for patients, considering the impact on outcome and the risk–benefit ratio of diagnostic/therapeutic tools.
  • 1.4K
  • 28 Jan 2021
Topic Review
Erectile Dysfunction and Cardiovascular Disease Links
Erectile dysfunction (ED) is a multi-factorial illness that is characterized by the presence of vascular atherosclerosis and hormonal, lifestyle, age, neurological, and physiological factors, all occurring in a well-coordinated manner. Among all of the listed characteristics, vascular disease is the most common cause of ED. Testosterone levels, psychological concerns, such as performance anxiety, and iatrogenesis are all the variables that contribute to ED development.
  • 1.4K
  • 02 Aug 2022
Topic Review
Gut Microbiota and Sex Hormones
Gut microbiota (GM) is the set of microbe strains colonizing the intestinal tract. Through its genetic heritage, known as the gut microbiome, this complex ecosystem generates bioactive metabolites that impact various physiological processes, far beyond food digestion. Able to communicate with distal districts through multiple pathways, GM is therefore considered the largest endocrine organ of the body and one of the major determinants of humans’ health from infancy through adulthood. Indeed, while a balanced GM facilitates beneficial effects including digestion of macronutrients, synthesis of some vitamins, maintenance of immune homeostasis, and protection against pathogens, detrimental changes in GM composition lead to adverse remodeling of the host phenotype, which predispose to several pathological conditions, such as insulin resistance, atherosclerosis, obesity, and associated disorders, ultimately leading to cardiovascular disease (CVD). Dietary habit and sex hormones (SH) are considered major regulators of the GM variability (6, 7).
  • 1.4K
  • 07 Jul 2022
Topic Review
Development of Organ Specificity among Endothelial Cells
Endothelial cells have a mesodermal origin; during vasculogenesis, a “first draft” of the vascular system is laid down to support the growing embryo. Vascular endothelial cells line the entire circulatory system and show remarkable heterogeneity. Even though endothelial cells originate from the same progenitor cells during development, they eventually contribute to different subtypes of endothelia. Based on morphology, the microvasculature consists of three main phenotypes: discontinuous, fenestrated, and non-fenestrated endothelium.
  • 1.4K
  • 21 Feb 2022
Topic Review
NAFLD and Cardiovascular Diseases
Overwhelming evidence suggests an association of cardiovascular disease (CVD) with non-alcoholic fatty liver disease (NAFLD); however, the underlying mechanisms remain largely speculative.
  • 1.4K
  • 09 Feb 2021
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. 
  • 1.4K
  • 17 May 2023
Topic Review
Myocardial Injury Related to SARS-CoV-2 Pneumonia
The diagnosis of SARS-CoV-2 pneumonia is expected to worsen, and mortality will be higher when combined with myocardial injury (MI). The combination of novel coronavirus infections in patients with MI can cause confusion in diagnosis and assessment, with each condition exacerbating the other, and increasing the complexity and difficulty of treatment.
  • 1.4K
  • 08 Oct 2022
Topic Review
Dapagliflozin as a Drug in Heart Failure
Dapagliflozin is a selective SGLT-2 inhibitor that reduces renal glucose absorption by inhibiting the SGLT-2 receptors present in the S1 region of the proximal kidney tubules.
  • 1.4K
  • 22 Nov 2022
Topic Review
Consanguinity and Congenital Heart Disease Susceptibility
Congenital heart disease (CHD) encompasses a wide range of structural defects of the heart and, in many cases, the factors that predispose an individual to disease are not well understood, highlighting the remarkable complexity of CHD etiology. Evidence of familial aggregation of CHD has been demonstrated in different communities and for different cardiac lesions. Consanguinity, particularly among first cousins, is an added risk factor for these families, particularly in societies where it is considered a common cultural practice, as confirmed in previous studies conducted in Saudi Arabia and other countries.
  • 1.4K
  • 24 Feb 2022
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