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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
Premature Ventricular Complexes
Premature ventricular complexes (PVCs) are frequently encountered in clinical practice. The association of PVCs with adverse cardiovascular outcomes is well established in the context of structural heart disease, yet not so much in the absence of structural heart disease.
  • 1.3K
  • 08 Oct 2023
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
Antioxidants supplementation in cardiovascular diseases
Oxidative stress may be defined as an imbalance between reactive oxygen species (ROS) and the antioxidant system to counteract or detoxify these potentially damaging molecules. This phenomenon is a common feature of many human disorders such as cardiovascular disease. Many of the risk factors, including smoking, hypertension, hypercholesterolemia, diabetes, and obesity are associated with an increased risk of developing cardiovascular disease involving an elevated oxidative stress burden, either due to enhanced ROS production or decreased antioxidant protection. There is a number of therapeutic options to treat oxidative stress-associated cardiovascular diseases. Numerous studies have focused on the utility of antioxidant supplementation. However, whether antioxidant supplementation has any preventive and/or therapeutic value in cardiovascular pathology is still a matter of debate. 
  • 1.3K
  • 08 Mar 2021
Topic Review
Electrocardiographic Changes in Myocardial Ischemia in COVID-19 Patients
Given the possible pathophysiological links between myocardial ischemia and SARS-CoV-2 infection, several studies have focused attention on acute coronary syndromes in order to improve patients’ morbidity and mortality. Understanding the pathophysiological aspects of myocardial ischemia in patients infected with SARS-CoV-2 can open a broad perspective on the proper management for each patient. The electrocardiogram (ECG) remains the easiest assessment of cardiac involvement in COVID-19 patients, due to its non-invasive profile, accessibility, low cost, and lack of radiation. The ECG changes provide insight into the patient’s prognosis, indicating either the worsening of an underlying cardiac illnesses or the acute direct injury by the virus. This indicates that the ECG is an important prognostic tool that can affect the outcome of COVID-19 patients, which important to correlate its aspects with the clinical characteristics and patient’s medical history. The ECG changes in myocardial ischemia include a broad spectrum in patients with COVID-19 with different cases reported of ST-segment elevation, ST-segment depression, and T wave inversion, which are associated with severe COVID-19 disease.
  • 1.3K
  • 15 Aug 2022
Topic Review
Definition of Hypertension and Establishment of Treatment Targets
Hypertension is the most frequent chronic and non-communicable disease all over the world, with about 1.5 billion affected individuals worldwide. Its impact is currently growing, particularly in low-income countries. Even in high-income countries, hypertension remains largely underdiagnosed and undertreated, with consequent low rates of blood pressure (BP) control.
  • 1.3K
  • 21 Mar 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. 
  • 1.3K
  • 18 Aug 2023
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. 
  • 1.3K
  • 20 Mar 2024
Topic Review
Specialized Pro-resolving Mediators in Atherosclerosis
Atherosclerosis is one of the most important problems of modern medicine as it is the leading cause of hospitalizations, disability, and mortality. The key role in the development and progression of atherosclerosis is the imbalance between the activation of inflammation in the vascular wall and the mechanisms of its control. The resolution of inflammation is the most important physiological mechanism that is impaired in atherosclerosis. The resolution of inflammation has complex, not fully known mechanisms, in which lipid mediators derived from polyunsaturated fatty acids (PUFAs) play an important role. Specialized pro-resolving mediators (SPMs) represent a group of substances that carry out inflammation resolution and may play an important role in the pathogenesis of atherosclerosis. SPMs include lipoxins, resolvins, maresins, and protectins, which are formed from PUFAs and regulate many processes related to the active resolution of inflammation. 
  • 1.3K
  • 16 May 2022
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
Autonomic Nervous System Role in Coumel’s Triangle
Arrhythmogenic substrate, modulating factors, and triggering factors (the so-called Coumel’s triangle concept) play a primary role in atrial fibrillation (AF) pathophysiology. Several years have elapsed since the concept of the relevance of autonomic nervous system (ANS) influences on atrial cells’ electrophysiological characteristics was advanced.
  • 1.3K
  • 25 May 2023
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. 
  • 1.3K
  • 28 Nov 2022
Topic Review
Functional Mitral Regurgitation and Tricuspid Regurgitation
Functional mitral regurgitation (FMR) and tricuspid regurgitation (FTR) occur due to cardiac remodeling in the presence of structurally normal valve apparatus. Two main mechanisms are involved, distinguishing an atrial functional form (when annulus dilatation is predominant) and a ventricular form (when ventricular remodeling and dysfunction predominate). Both affect the prognosis of patients with heart failure (HF) across the entire spectrum of left ventricle ejection fraction (LVEF), including preserved (HFpEF), mildly reduced (HFmrEF), or reduced (HFrEF).
  • 1.3K
  • 09 May 2023
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.
  • 1.3K
  • 09 Nov 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.
  • 1.3K
  • 18 Apr 2022
Topic Review
ECG Signs in Cardiac Resynchronization Therapy Response Prediction
Cardiac resynchronization therapy (CRT) is a cornerstone therapeutic opportunity for selected patients with heart failure. For optimal patient selection, no other method has been proven to be more effective than the 12-lead ECG, and hence ECG characteristics are extensively researched. The evaluation of particular ECG signs before the implantation may improve selection and, consequently, clinical outcomes. The definition of a true left bundle branch block (LBBB) seems to be the best starting point with which to select patients for CRT. Although there are no universally accepted definitions of LBBB, using the classical LBBB criteria, some ECG parameters are associated with CRT response. In patients with non-true LBBB or non-LBBB, further ECG predictors of response and non-response could be analyzed, such as QRS fractionation, signs of residual left bundle branch conduction, S-waves in V6, intrinsicoid deflection, or non-invasive estimates of Q-LV which are described in newer publications. 
  • 1.3K
  • 20 Nov 2023
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
Factors Affecting the Lipoprotein(a) Levels
Lipoprotein(a) is a variant of LDL-C, distinguished by the covalent binding of ApoB100 to a unique glycoprotein called apolipoprotein(a) via a disulfide thioester bond.
  • 1.3K
  • 01 Apr 2024
Topic Review
Coronary Vascular Function and Invasive Physiology Assessment
A considerable number of patients with angina or myocardial ischemia have no significant coronary artery disease on invasive angiography. Several steps towards a better comprehension of the pathophysiology of these conditions, angina or ischemia with non-obstructive coronary arteries (ANOCA/INOCA), have been made.
  • 1.3K
  • 07 Aug 2023
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