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Topic Review
Computer Modeling of the Heart
Computer modeling of the electrophysiology of the heart has undergone significant progress. A healthy heart can be modeled starting from the ion channels via the spread of a depolarization wave on a realistic geometry of the human heart up to the potentials on the body surface and the ECG.
  • 742
  • 25 Aug 2021
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.
  • 740
  • 09 May 2023
Topic Review
Saliva biomarkers for Heart Failure
Heart Failure (HF) is a clinical syndrome characterized by symptoms such as dyspnoea or fatigue on exertion or at rest, and clinical signs (i.e. lower extremity oedema, elevated jugular venous pressure, pulmonary crackles, etc.) caused by a structural and/or functional cardiac abnormality, ultimately leading to reduced cardiac output. Despite advances in the knowledge on HF, decisions on diagnosis and treatment of HF remain challenging. In everyday clinical practice, biomarkers such as plasma natriuretic peptides such as brain natriuretic peptide (BNP) and N-terminal fragment BNP (NT-proBNP), play an important role in HF diagnosis, therapy monitoring and risk stratification, while many other serum biomarkers have also been studied without definite evidence on how to use them in clinical practice. Biomarkers that could be measured in other biological fluids other than blood, easily and non-invasively, and outside the hospital setting, have attracted research interest. During the last years, saliva has emerged as a body fluid for this purpose.  This review assessed the potential role of salivary biomarkers in diagnosis and progression monitoring of patients with HF. 18 salivary biomarkers were analyzed and the levels of all biomarkers studied were found to be higher in HF patients compared to controls, except for amylase, sodium, and chloride that had smaller saliva concentrations in HF patients. Natriuretic peptides are the most commonly used plasma biomarkers in the management of HF. Their saliva levels show promising results, although the correlation of saliva to plasma values is weakened in higher plasma values. In most of the publications, differences in biomarker levels between HF patients and controls were found to be statistically significant. Due to small number of patients included, larger studies need to be conducted in order to facilitate the use of saliva biomarkers in clinical practice.
  • 739
  • 19 May 2021
Topic Review
Cardioprotective Effects of Metformin on Myocardial Ischemia/Reperfusion
The most common is coronary artery disease, which causes the death of cardiomyocytes, the cells responsible for cardiac contractility, through ischemia and subsequent reperfusion, which leads to heart failure in the medium and short term. Metformin is one of the most-used drugs for the control of diabetes, which has shown effects beyond the control of hyperglycemia. Some of these effects are mediated by the regulation of cellular energy metabolism, inhibiting apoptosis, reduction of cell death through regulation of autophagy and reduction of mitochondrial dysfunction with further reduction of oxidative stress. This suggests that metformin may attenuate left ventricular dysfunction induced by myocardial ischemia; preclinical and clinical trials have shown promising results, particularly in the setting of acute myocardial infarction. 
  • 737
  • 18 Aug 2023
Topic Review
Left Ventricular Non-Compaction
Left ventricular non-compaction (LVNC) is a complex clinical condition with no diagnostic gold standard. At present, there is trepidation about the accuracy of the diagnosis, the correlation to clinical outcomes and the long-term medical management. This article reviews the current imaging criteria, the limitations of echocardiography and cardiac magnetic resonance and the consequences of LV hypertrabeculation in athletes.
  • 736
  • 25 Dec 2020
Topic Review
Heart Failure and Diabetes Mellitus
Heart failure (HF) and type 2 diabetes mellitus (T2DM) have a synergistic effect on cardiovascular (CV) morbidity and mortality in patients with established CV disease (CVD). 
  • 733
  • 01 Jun 2021
Topic Review
Statin Residual Cardiovascular Disease Risk
Several randomized, double blind, placebo-controlled trials (RCTs) have demonstrated that low-density lipoprotein cholesterol (LDL-C) lowering by using statins, including high-doses of strong statins, reduced the development of cardiovascular disease (CVD). However, among the eight RCTs which investigated the effect of statins vs. placebos on the development of CVD, 56–79% of patients had the residual CVD risk after the trials. In three RCTs which investigated the effect of a high dose vs. a usual dose of statins on the development of CVD, 78–87% of patients in the high-dose statin arms still had the CVD residual risk after the trials. An analysis of the characteristics of patients in the RCTs suggests that elevated triglyceride (TG) and reduced high-density lipoprotein cholesterol (HDL-C), the existence of obesity/insulin resistance, and diabetes may be important metabolic factors which determine the statin residual CVD risk. 
  • 733
  • 06 Apr 2022
Topic Review
Current Management Strategies for Neurogenic Hypertension
Hypertension is a significant risk factor for renal impairment, other cardiovascular diseases, diabetes mellitus, and multiple end-organ damages. Nevertheless, a large pool of recent studies affirms a relatively higher incidence of sympathetic nerve activity (SNA) (as indicated by high levels of norepinephrine and plasma catecholamines) in hypertension unresponsive to conventional treatment, which is also referred to as resistance hypertension or neurogenic hypertension (NH). This strong association between an increase in SNA and elevated blood pressure (BP) forms the basis of NH: a form of hypertension mainly driven by a sympathetic mechanism. The complex nature of NH makes curative treatment difficult. Therefore, the current therapeutic approach to tackling NH aims at bringing BP under control to prevent any cardiovascular events and associated end-organ damage. In addition, surgical procedures that have been explored for NH management interfere with the sympathetic influence on cardiac function. Although several surgical approaches were adopted, only a few progresses toward preclinical stages and still lead to inconclusive outcomes. Both therapeutic and surgical approaches that have been implemented for the management of NH will be briefly discussed.
  • 733
  • 20 Feb 2023
Topic Review
Oxidative Stress as a Target of Cardiac Remodeling
Cardiac remodeling is defined as a group of molecular, cellular, and interstitial changes that clinically manifest as changes in the heart’s size, mass, geometry, and function after different stimuli. It is important to emphasize that remodeling plays a pathophysiological role in the onset and progression of ventricular dysfunction and subsequent heart failure. Therefore, strategies to mitigate this process are critical. Different factors, including neurohormonal activation, can regulate the remodeling process and increase cell death, alterations in contractile and regulatory proteins, alterations in energy metabolism, changes in genomics, inflammation, changes in calcium transit, metalloproteases activation, fibrosis, alterations in matricellular proteins, and changes in left ventricular geometry, among other mechanisms.
  • 732
  • 16 Dec 2022
Topic Review
Restenosis
Restenosis is defined as the reduction in lumen size of an artery after intra-arterial intervention.
  • 731
  • 05 Feb 2021
Topic Review
RDW Change in Heart Failure
Red blood cell distribution width (RDW) is an integral parameter of the complete blood count (CBC), which has been traditionally used for the classification of several types of anemia. It has been defined either as the standard deviation (SD) of erythrocyte volumes (RDW-SD), which is measured by calculating the width at the 20% height level of the red blood cell (RBC) size distribution histogram; or, as the coefficient of variation (RDW-CV) of erythrocyte volumes by dividing the standard deviation (SD) of the red blood cell volume (RBCs) by the mean corpuscular volume (MCV) multiplied by 100 (SD/MCV × 100), and expressing the variability in size of circulating erythrocytes (anisocytosis). The normal reference ranges of RDW-SD and RDW-CV are typically 39–46 fL and 11.5–15%, respectively, but often vary depending on the method of RDW calculation and the available hematological analyzers used.
  • 731
  • 18 Apr 2022
Topic Review
Transient Receptor Potential Melastatin 2 in Ischemic Stroke
Ischemic stroke causes a heavy health burden worldwide, with over 10 million new cases every year. Despite the high prevalence and mortality rate of ischemic stroke, the underlying molecular mechanisms for the common etiological factors of ischemic stroke and ischemic stroke itself remain unclear, which results in insufficient preventive strategies and ineffective treatments for this devastating disease. The transient receptor potential cation channel, subfamily M, member 2 (TRPM2), a non-selective ion channel activated by oxidative stress, is actively involved in all the important steps in the etiology and pathology of ischemic stroke. 
  • 730
  • 11 Mar 2022
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.
  • 729
  • 21 Sep 2022
Topic Review
Sympathetic Activation after Myocardial Infarction
Myocardial infarction often leads to progressive structural and electrophysiologic remodeling of the left ventricle. Histological and functional studies have demonstrated extensive alterations of sympathetic nerve endings at the peri-infarct area and flow-innervation mismatches that create a highly arrhythmogenic milieu.
  • 728
  • 26 Jun 2021
Topic Review
Heart Failure with Preserved Ejection Fraction
Heart failure with preserved ejection fraction (HFpEF) remains a poorly characterized syndrome with many unknown aspects related to different patient profiles, various associated risk factors and a wide range of aetiologies. It comprises several pathophysiological pathways, such as endothelial dysfunction, myocardial fibrosis, extracellular matrix deposition and intense inflammatory system activation.
  • 726
  • 18 Jan 2023
Topic Review
Human Embryonic Heart Start Beating
The onset of embryonic heart beating may be regarded as the defining feature for the beginning of personal human life. Clarifying the timing of the first human heartbeat, therefore, has religious, philosophical, ethical, and medicolegal implications.
  • 726
  • 20 Jun 2022
Topic Review
Artificial Intelligence (AI)-Empowered Echocardiography Interpretation
Echocardiography (Echo), a widely available, noninvasive, and portable bedside imaging tool, is the most frequently used imaging modality in assessing cardiac anatomy and function in clinical practice. Artificial-intelligence-empowered echo (AI-Echo) can potentially reduce inter-interpreter variability and indeterminate assessment and improve the detection of unique conditions as well as the management of various cardiac disorders.
  • 724
  • 28 Apr 2021
Topic Review
Extracellular Vesicles and COVID-19-Related Thrombosis
Extracellular vesicles (EVs) is a term used to describe a heterogeneous group of vesicles located in different types of tissues or biological fluids such as blood, urine, saliva, breast milk and the amniotic, cerebrospinal, synovial, seminal fluid and bronchial lavage. The role of EVs in infectious diseases has been particularly controversial over the last years. It has been shown that they can influence the recipient cell activities by transporting viral proteins, RNA, DNA and receptors from infected cells to healthy cells and thus increasing the spread of virus infection. Thus, EVs may serve as potential predictors of COVID-19 severity.  Importantly, due to their stability in the circulation, low immunogenicity, biocompatibility and biodegradation, the EVs are considered suitable for designing new therapeutic strategies or delivery systems for a vaccine against the SARS CoV-2 infection 
  • 724
  • 02 Jul 2021
Topic Review
No-Reflow Phenomenon
Primary percutaneous angioplasty (pPCI), represents the reperfusion strategy of choice for patients with STEMI according to current international guidelines of the European Society of Cardiology. Coronary no-reflow is characterized by angiographic evidence of slow or no anterograde epicardial flow, resulting in inadequate myocardial perfusion in the absence of evidence of mechanical vessel obstruction. No reflow (NR) is related to a functional and structural alteration of the coronary microcirculation.
  • 724
  • 29 Apr 2022
Topic Review
Outflow Tract Valves of the Vertebrate Heart
The anatomical elements that in humans guard the unidirectional blood flow from the cardiac ventricles to the aortic and pulmonary arteries are the arterial (semilunar) valves. The valve that prevents blood backflow from the aorta to the left ventricle is the aortic valve, while that which performs this function between the pulmonary artery and the right ventricle is the pulmonary or pulmonic valve. The main medical interest in arterial valves is that their congenital malformations and diseases over a lifetime are clinically relevant. Although both valves are subject to similar complications, those affecting the aortic valve cause the most severe effects.
  • 724
  • 04 Oct 2022
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