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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.
  • 839
  • 18 Jun 2021
Topic Review
Coronary Heart Disease
Coronary heart disease is a public health problem and is one of the leading causes of loss of quality of life, disability, and death worldwide. A widely used therapeutic option for the treatment of coronary disease worldwide is coronary artery bypass grafting (CABG). A CABG seems to be very beneficial for patients, since in addition to the positive quality of life results, other studies indicate that it positively influences the occurrence of depression [30], can lead to the disappearance of symptoms for around 15 years, decreases death resulting from other causes, reduces hospital admission, and reduces death due to cardiovascular factors.
  • 837
  • 20 Nov 2020
Topic Review
Novel Biomarkers of Heart Failure in Pediatrics
Novel biomarkers of heart failure are the subject of numerous studies. Biomarkers of heart failure can be determined in the blood and in the urine. The future of biomarker use is in multimarker panels that include a combination of biomarkers with different pathophysiological mechanisms in order to improve their diagnostic and prognostic predictive value.
  • 834
  • 01 Jun 2022
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. 
  • 832
  • 17 Mar 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).
  • 828
  • 07 Jul 2022
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.
  • 822
  • 21 Nov 2022
Topic Review
Macrophages in Atherosclerosis Development
Atherosclerosis is a multifactorial chronic disease that has a prominent inflammatory component. Currently, atherosclerosis is regarded as an active autoimmune process that involves both innate and adaptive immune pathways. One of the drivers of this process is the presence of modified low-density lipoprotein (LDL). For instance, lipoprotein oxidation leads to the formation of oxidation-specific epitopes (OSE) that can be recognized by the immune cells. Macrophage response to OSEs is recognized as a key trigger for initiation and a stimulator of progression of the inflammatory process in the arteries. At the same time, the role of oxidized LDL components is not limited to pro-inflammatory stimulation, but includes immunoregulatory effects that can have protective functions. 
  • 819
  • 28 Sep 2021
Topic Review
Statin Treatment in the Elderly
Ample evidence supports the use of statin therapy for secondary prevention in patients with a history of atherosclerotic cardiovascular disease (ASCVD), but evidence is wanting in the case of primary prevention, low-risk individuals, and elderly adults 65+. The efficacy of statins can be contrasted for distinct subsets of patients based on age, diabetes, ASCVD, and coronary artery calcium (CAC) status. Most cardiovascular risk calculators heavily weight age and overestimate one’s absolute risk of ASCVD, particularly in very old adults. Improvements in risk assessment will enable the identification of specific patient populations that benefit most from statin treatment. Derisking is particularly important for adults over 75, in whom treatment benefits are reduced and adverse musculoskeletal effects are amplified. The CAC score stratifies the benefit effect size obtainable with statins, and CAC > 100 can be regarded as a significant patient benefit group. Robust biomarkers, improved risk estimator tools, and personalized, evidence-based approaches are needed to optimally reduce cardiovascular events and mortality rates through administration of cholesterol-lowering medications.
  • 816
  • 26 Nov 2020
Topic Review
The Role of ALDH2 in Cardiovascular Disease Management
Mitochondrial aldehyde dehydrogenase 2 (ALDH2) is a cardioprotective enzyme that catalyzes the bio-activation of GTN to NO. Nitrate tolerance is accompanied by an increase in oxidative stress, endothelial dysfunction, and sympathetic activation, as well as a loss of the catalytic activity of ALDH2 itself. On the basis of current knowledge, nitrate intake in the diet would guarantee a concentration of NO such as to avoid (or at least reduce) treatment with GTN and the consequent onset of nitrate tolerance in the course of cardiovascular diseases, so as not to make necessary the increase in GTN concentrations and the possible inhibition/alteration of ALDH2, which aggravates the problem of a positive feedback mechanism. 
  • 816
  • 29 Dec 2022
Topic Review
Nanodiagnosis and Nanotreatment of CVDs
Cardiovascular diseases (CVDs) are the world’s leading cause of mortality and represent a large contributor to the costs of medical care. Although tremendous progress has been made for the diagnosis of CVDs, there is an important need for more effective early diagnosis and the design of novel diagnostic methods. The diagnosis of CVDs generally relies on signs and symptoms depending on molecular imaging (MI) or on CVD-associated biomarkers. For early-stage CVDs, however, the reliability, specificity, and accuracy of the analysis is still problematic. Because of their unique chemical and physical properties, nanomaterial systems have been recognized as potential candidates to enhance the functional use of diagnostic instruments. Nanomaterials such as gold nanoparticles, carbon nanotubes, quantum dots, lipids, and polymeric nanoparticles represent novel sources to target CVDs. The special properties of nanomaterials including surface energy and topographies actively enhance the cellular response within CVDs. The availability of newly advanced techniques in nanomaterial science opens new avenues for the targeting of CVDs. 
  • 815
  • 13 Apr 2021
Topic Review
Individualized Risk Assessment in Cardiovascular Disease
Cardiovascular disease is a major global cause of death, with an estimated 17.9 million cardiovascular disease-related deaths in 2019, representing nearly one third of global deaths. Atherosclerosis, which can begin in childhood, is a multifactorial, chronic condition that contributes to cardiovascular disease. Characterized by lipid deposition in the blood vessel intima, atherosclerosis is associated with inflammation and calcification and can cause vessel stenosis with thrombotic occlusion and/or embolism. A more precise and sophisticated tool that can reliably predict the thrombosis and bleeding risks at an individual level is required in order for clinicians to confidently recommend early interventions with a favorable risk–benefit profile. Critical to the development of this tool is the assessment and understanding of Virchow’s triad and its complex interactions between hypercoagulability, endothelial dysfunction and vessel flow, a fundamental concept to the development of thrombosis. 
  • 814
  • 19 Jul 2022
Topic Review
Extracellular Vesicles in Atherothrombosis
Atherosclerotic cardiovascular disease (ASCVD) is the leading cause of morbidity and mortality all over the world. Extracellular vesicles (EVs), small lipid-bilayer membrane vesicles released by most cellular types, exert pivotal and multifaceted roles in physiology and disease. Emerging evidence emphasizes the importance of EVs in intercellular communication processes with key effects on cell survival, endothelial homeostasis, inflammation, neoangiogenesis, and thrombosis. The following content focuses on EVs as effective signaling molecules able to both derail vascular homeostasis and induce vascular dysfunction, inflammation, plaque progression, and thrombus formation as well as drive anti-inflammation, vascular repair, and atheroprotection.
  • 812
  • 24 Jun 2022
Topic Review
Practical Echocardiographic Approach of Regurgitant Mitral Valve Assessment
Mitral regurgitation is the second-most frequent valvular heart disease in Europe after degenerative aortic stenosis. The mitral valve is a complex anatomical structure whose physiological functioning relies on the biomechanical properties and structural integrity of its components. Their compromise can lead to mitral valve dysfunction. Assessing its morphology can reveal various normal and abnormal features, which can be associated with deteriorating clinical outcomes. Transthoracic echocardiography is the first diagnosis approach that should be performed to assess the valve disfunction, giving a complete morphological description of the structures, the regurgitant mechanism, and etiology.
  • 809
  • 22 Aug 2022
Topic Review
Cardiorenal Syndrome
Cardiorenal syndrome (CRS) is a multi-organ disease characterized by the complex interaction between heart and kidney during acute or chronic injury. The pathogenesis of CRS involves metabolic, hemodynamic, neurohormonal, and inflammatory mechanisms, and atherosclerotic degeneration. In the process of better understanding the bi-directional pathophysiological aspects of CRS, the need to find precise and easy-to-use markers has also evolved.
  • 808
  • 09 Nov 2021
Topic Review
Aortic Dissection
Acute aortic syndromes (AAS) represent a spectrum of interrelated disorders characterized by the disruption of the aortic integrity, and are associated with high morbidity and mortality. These conditions include aortic dissection (AD), accounting for the majority of AAS (80%), intramural hematoma (IMH, ~15%), and penetrating aortic ulcer (PAU, ~5%).
  • 808
  • 21 Feb 2023
Topic Review
Role of NADPH Oxidases in Pathologies
Nicotinamide adenine dinucleotide phosphate oxidases (NADPH oxidases, NOX), were discovered in immune cells, such as neutrophils and macrophages, in the 1970s. Upon phagocytosis of pathogens, the enzymatic complex is activated and triggers O2− production in an “oxidative burst” that acts to kill pathogens. Over time, enzymes with a similar function located in various tissues have been identified and subsequently grouped into the NOX family of enzymes. The mitochondrial electron transport chain was soon demonstrated as another source of O2− due to a “leaky” electron transport system, its O2− scavenged by superoxide dismutase (SOD) into H2O2.
  • 796
  • 29 Jun 2022
Topic Review
Evolution of an Atherosclerotic Plaque
Atherosclerosis is a condition mediated by immune mechanisms, which is realized by the accumulation of lipoproteins in the wall of arterial vessels, leading to its focal thickening and the formation of atherosclerotic plaques in medium- and large-caliber arteries. Lipids, inflammatory infiltrates, smooth muscle cells, and connective tissue composes an atherosclerotic plaque, and a fibrous cap covers it. Damage to the latter leads to the fact that the internal contents of the plaque interact directly with the blood, which can cause thrombosis, and in the case of fragmentation of both the plaque and the blood clot on its surface—embolism in the distal vascular bed.
  • 794
  • 20 Oct 2022
Topic Review
Antivirals on the Cardiovascular Conditions
The COVID-19 pandemic has resulted in a complex clinical challenge, caused by a novel coronavirus, partially similar to previously known coronaviruses but with a different pattern of contagiousness, complications, and mortality. Safety profiles of antivirals are largely questioned and addressed by health agencies, in consideration of COVID-19 cardiac and pro-thrombotic complications generally experienced by predisposed subjects.
  • 792
  • 25 Feb 2022
Topic Review
Management of Coronary Artery Disease in Older Adults
Coronary artery disease (CAD) is highly prevalent in older adults, yet its management remains challenging. Treatment choices are made complex by the frailty burden of older patients, a high prevalence of comorbidities and body composition abnormalities (e.g., sarcopenia), the complexity of coronary anatomy, and the frequent presence of multivessel disease, as well as the coexistence of major ischemic and bleeding risk factors.
  • 791
  • 16 Aug 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.
  • 785
  • 08 Oct 2022
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