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Topic Review
Multimodality Imaging in Detection Women's Ischemic Heart Disease
Cardiovascular disease is the leading cause of death and disability, accounting for approximately one in three deaths worldwide. It is the leading cause of death in the United States; coronary artery disease (CAD) and ischemic heart disease (IHD) remain the leading causes of death attributable to cardiovascular disease in men and women. The incidence of atherosclerotic cardiovascular disease is increasing due to an increase in cardiac risk factors such as obesity, diabetes, and hypercholesterolemia in addition to an aging population. However, age-adjusted mortality rates are decreasing, likely due to improved medical therapies allowing patients to live longer with IHD. Although cardiovascular disease is more common in men, women with CAD have a worse short and long-term prognosis. In addition, women with symptoms of angina or who have had an abnormal cardiac stress test are less likely to be referred for additional diagnostic testing and initiated on guideline directed medical therapies.
  • 1.3K
  • 31 Oct 2022
Topic Review
Vascular Aging
Vascular aging, i.e., the deterioration of the structure and function of the arteries over the life course, predicts cardiovascular events and mortality. Vascular degeneration can be recognized before becoming clinically symptomatic; therefore, its assessment allows the early identification of individuals at risk. This opens the possibility of minimizing disease progression. Vascular remodeling with advancing age is characterized by arterial stiffening and calcification. Arterial stiffening affects the macro- and micro-vasculature in unique ways. The main function of large arteries is to dampen the pulsatility of cardiac contraction by elastic recoiling after systolic expansion, so that constant, rather than pulsatile, blood flow is propelled to organs and tissues, including the coronary arteries.
  • 1.3K
  • 06 Sep 2023
Topic Review
RA, OA, and IVL in Calcified Coronary Lesions
In order to improve the percutaneous treatment of coronary artery calcifications (CAC) before stent implantation, methods such as rotational atherectomy (RA), orbital atherectomy (OA), and coronary intravascular lithotripsy (IVL) were invented. These techniques use different mechanisms of action and therefore have various short- and long-term outcomes. IVL employs sonic waves to modify CAC, whereas RA and OA use a rapidly rotating burr or crown. These methods have specific advantages and limitations, regarding their cost-efficiency, the movement of the device, their usefulness given the individual anatomy of both the lesion and the vessel, and the risk of specified complications.
  • 1.3K
  • 28 Feb 2024
Topic Review
Techniques to Preserve Endothelial Cells in Vein Grafts
Endothelial cells comprise the intimal layer of the vasculature, playing a crucial role in facilitating and regulating aspects such nutrient transport, vascular homeostasis, and inflammatory response. Endothelial dysfunction is believed to be a key driver for vein graft disease—a pathology in which vein grafts utilised in coronary artery bypass graft surgery develop intimal hyperplasia and accelerated atherosclerosis, resulting in poor long-term patency rates. Activation and denudation of the endothelium following surgical trauma and implantation of the graft encourage a host of immune, inflammatory, and cellular differentiation responses that risk driving the graft to failure. Several approaches have been developed to mitigate the onset and progression of this pathology both clincally and surgically, including optimisation of surgical technique, vein preservation conditions and pharma-modulation. Novel approaches are also under investigation in recent years, including the use of topical gene therapy and the utilisation of endothelial progenitor/colony-forming cells to regenerate vein grafts with the view to improving patient outcomes.
  • 1.3K
  • 10 Oct 2022
Topic Review
Phenotypes of Arrhythmogenic Cardiomyopathy
Arrhythmogenic Cardiomyopathy (ACM) is a Mendelian disorder that can affect both left and right ventricles. It is most often associated with pathogenic desmosomal variants that can lead to fibrofatty replacement of the myocardium, a pathological hallmark of this disease.
  • 1.3K
  • 11 Aug 2022
Topic Review
Macrophages as Potential Therapeutic Targets in Cardiovascular Disease
Cardiovascular disease (CVD) is one of the greatest public health concerns and is the leading cause of morbidity and mortality in the United States and worldwide. CVD is a broad yet complex term referring to numerous heart and vascular conditions, all with varying pathologies. Macrophages are one of the key factors in the development of these conditions. Macrophages play diverse roles in the maintenance of cardiovascular homeostasis, and an imbalance of these mechanisms contributes to the development of CVD.
  • 1.3K
  • 15 Jul 2022
Topic Review
Wearable Sensors and Machine Learning for Hypovolemia Problems
Hypovolemia is a physiological state of reduced blood volume that can exist as either (1) absolute hypovolemia because of a lower circulating blood (plasma) volume for a given vascular space (dehydration, hemorrhage) or (2) relative hypovolemia resulting from an expanded vascular space (vasodilation) for a given circulating blood volume (e.g., heat stress, hypoxia, sepsis). The external environment and the user's level of physical activity can exacerbate hypovolemic challenges to the body. Noninvasive, wearable sensing systems are being developed to track a user's ability to compensate for these challenges. 
  • 1.3K
  • 13 Jan 2022
Topic Review
Maternal Obesity: Shaping Future Generations' Well-Being
Maternal obesity (MO) results in short- and long-term adverse outcomes for the offspring, including an increased risk for cardiovascular disease (CVD) development. Maternal obesity can have profound implications for metabolic regulation during pregnancy due to changes in glucose metabolism to support fetal growth.
  • 1.2K
  • 28 Sep 2023
Topic Review
Perioperative Right Ventricular Dysfunction in Cardiac Surgery
Right ventricular (RV) dysfunction frequently occurs after cardiac surgery and is linked to adverse postoperative outcomes, including mortality, reintubation, stroke, and prolonged ICU stays. While various criteria using echocardiography and hemodynamic parameters have been proposed, a consensus remains elusive. Distinctive RV anatomical features include its thin wall, which presents a triangular shape in a lateral view and a crescent shape in a cross-sectional view. Principal causes of RV dysfunction after cardiac surgery encompass ischemic reperfusion injury, prolonged ischemic time, choice of cardioplegia and its administration, cardiopulmonary bypass weaning characteristics, and preoperative risk factors. Post-left ventricular assist device (LVAD) implantation RV dysfunction is common but often transient, with a favorable prognosis upon resolution. There is an ongoing debate regarding the benefits of concomitant surgical repair of the RV in the presence of regurgitation. According to the literature, the gold standard techniques for assessing RV function are cardiac magnetic resonance imaging and hemodynamic assessment using thermodilution. 
  • 1.2K
  • 04 Dec 2023
Topic Review
Unmet Needs in Transcatheter Aortic Valve Replacement
Transcatheter aortic valve replacement (TAVR) swiftly evolved from a disrupting technology towards mainstream therapy in the field of severe symptomatic aortic stenosis. A series of randomized evaluations established its role in treating severe aortic stenosis patients across all surgical risk categories, paving the way for an extension of its indications to younger low-risk patients with a longer life expectancy.
  • 1.2K
  • 21 Nov 2022
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. 
  • 1.2K
  • 18 Aug 2023
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.
  • 1.2K
  • 28 Apr 2021
Topic Review
Atrial Fibrillation and Heart Failure
Atrial Fibrillation (AF) and Heart Failure (HF) are closely linked to each other, as each can be either the cause of or the result of the other. Successfully treating one of the two entities means laying the basis for treating the other one as well. AF is the most common cardiac arrhythmia, It is predisposed by several risk factors such as HF, ischemic heart disease, high blood pressure, valvular heart disease, sleep apnea, and diabetes, and at the same time increases the risk of developing heart failure of any kind (heart failure with preserved ejection fraction, HFpEF; heart failure with mid-range ejection fraction, HFmrEF; heart failure with reduced ejection fraction, HFrEF). AF and heart failure co-exist in up to 30% of patients and are closely linked to each other, as each can be either the cause of or the result of the other (“Atrial Fibrillation Begets Heart Failure and Vice Versa”). When both conditions occur in the same patient, the prognosis is worse than with either condition alone. Pulmonary Vein Isolation (PVI) is a well established treatment option in patients with symptomatic atrial fibrillation. Studies investigating PVI in patients with AF and HF will be discussed in this paper.
  • 1.2K
  • 16 Sep 2021
Topic Review
Postoperative Myocardial Infarction after Non-Cardiac Surgery
In patients undergoing major non-cardiac surgery, perioperative myocardial infarction (PMI) is a threatened complication. Every year, not less than 300 million non-cardiac surgery interventions are performed in the world. Perioperative mortality after non-cardiac surgery is estimated at 2% in patients over 45 years of age. Cardiovascular events account for half of these deaths, and most are due to perioperative myocardial infarction (MINS). The diagnosis of postoperative myocardial infarction, before the introduction of cardiac biomarkers, was based on symptoms and electrocardiographic changes and its incidence was largely underestimated. The incidence of MINS when a standard troponin assay is used ranges between 8 and 19% but increases to 20–30% with high-sensitivity troponin assays. Higher troponin values suggesting myocardial injury, both with or without a definite diagnosis of myocardial infarction, are associated with an increase in 30-day and 1-year mortality. 
  • 1.2K
  • 20 Mar 2024
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.
  • 1.2K
  • 18 Apr 2022
Topic Review
Cardio- and Neurometabolic Adipobiology
Abstract: Studies over the past 30 years have revealed that adipose tissue is the major endocrine and paracrine organ of the human body. Arguably, adiopobiology has taken its reasonable place in studying obesity and related cardiometabolic diseases (CMDs), including Alzheimer’s disease (AD), which is viewed herein as a neurometabolic disorder. The pathogenesis and therapy of these diseases are multiplex at basic, clinical and translational levels. Our present goal is to describe new developments in cardiometabolic and neurometabolic adipobiology. Accordingly, we focus on adipose- and/or skeletal muscle-derived signaling proteins (adipsin, adiponectin, nerve growth factor, brain-derived neuroptrophic factor, neurotrophin-3, irisin, sirtuins, Klotho, neprilysin, follistatin-like protein-1, meteorin-like (metrnl), as well as growth differentiation factor 11) as examples of metabotrophic factors (MTFs) implicated in the pathogenesis and therapy of obesity and related CMDs. We argue that these pathologies are MTF-deficient diseases. In 1993 the “vascular hypothesis of AD” was published and in the present review we propose the “vasculometabolic hypothesis of AD.” We discuss how MTFs could bridge CMDs and neurodegenerative diseases, such as AD. Greater insights on how to manage the MTF network would provide benefits to the quality of human life.
  • 1.2K
  • 25 Apr 2021
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.
  • 1.2K
  • 09 Nov 2021
Topic Review
Pathophysiology of Vasoplegic Syndrome after Cardiopulmonary Bypass
Vasoplegic syndrome (VS) is a common complication following cardiovascular surgery with cardiopulmonary bypass (CPB), and its incidence varies from 5 to 44%. It is defined as a distributive form of shock due to a significant drop in vascular resistance after CPB. 
  • 1.2K
  • 28 Nov 2022
Topic Review
SARS-CoV-2 Infection and Cardioncology
The coronavirus disease-2019 (COVID-19) is a highly transmissible viral illness caused by SARS-CoV-2, which has been defined by the World Health Organization as a pandemic, considering its remarkable transmission speed worldwide. SARS-CoV-2 interacts with angiotensin-converting enzyme 2 and TMPRSS2, which is a serine protease both expressed in lungs, the gastro-intestinal tract, and cardiac myocytes. Patients with COVID-19 experienced adverse cardiac events (hypertension, venous thromboembolism, arrhythmia, myocardial injury, fulminant myocarditis), and patients with previous cardiovascular disease have a higher risk of death. Cancer patients are extremely vulnerable with a high risk of viral infection and more negative prognosis than healthy people, and the magnitude of effects depends on the type of cancer, recent chemotherapy, radiotherapy, or surgery and other concomitant comorbidities (diabetes, cardiovascular diseases, metabolic syndrome). Patients with active cancer or those treated with cardiotoxic therapies may have heart damages exacerbated by SARS-CoV-2 infection than non-cancer patients.
  • 1.2K
  • 20 Feb 2021
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.
  • 1.2K
  • 01 Jun 2022
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