Topic Review
β-Blockers in Heart Failure
Cardiac β-receptor dysfunction in HFrEF is characterized by a reduced β1-receptor density and by the uncoupling of β1- and β2-receptors from the membrane G proteins, resulting in their functional desensitization. This mechanism is mediated by increased G protein-coupled receptor kinase 2 activity, resulting in reduced cardiac β-receptor density and reactivity, with consequent reduced cardiac inotropic reserve. In addition, catecholamines themselves are cardiotoxic, contributing to myocardial damage.
  • 94
  • 02 Sep 2021
Topic Review
Zinc Homeostasis
Research has indicated that zinc plays a consequential mechanistic role in the protection against oxidative stress as zinc is required for the proper functioning of the antioxidant system, the suppression of inflammatory mediators, and the modulation of zinc transporters. Recently, the mechanisms surrounding ZnT8, ZIP7, and metallothionein have shown to be of particular pathogenic importance and are considered as potential therapeutic targets in disease management. The literature has shown that zinc dysregulation is associated with diabetes and may be considered as a leading contributor to the deleterious vascular alterations exhibited by the disease. Although further investigation is required, studies have indicated the favorable use of zinc supplementation in the protection against and prevention of oxidative stress and its consequences over the course of the condition.
  • 110
  • 29 Mar 2022
Topic Review
Zero-Fluoroscopy Cardiac Ablation
Electrophysiological procedures are mainly performed using fluoroscopy, exposing both healthcare staff and patients to a non-negligible dose of radiation. To date, simple ablation procedures have often been approached with zero fluoroscopy. In complex ablation procedures, such as atrial fibrillation (AF) ablation, zero fluoroscopy is still challenging mainly because of transseptal puncture. We report a workflow to perform a complete zero-fluoroscopy AF ablation using a 3D electro-anatomical mapping system, intracardiac echocardiography and a novel steerable guiding sheath visible on the mapping system. We describe two cases, one with paroxysmal AF and the other with persistent AF during which this novel workflow was successfully applied with complete zero-fluoroscopy exposure and achieving pulmonary vein isolation.
  • 103
  • 16 Dec 2021
Topic Review
Zebrafish Models of Fibrotic Disease
Zebrafish models of fibrotic disease include, among others, cardiovascular disease models, liver disease models (categorized into Alcoholic Liver Diseases (ALD) and Non-Alcoholic Liver Disease (NALD)), and chronic pancreatitis models.
  • 85
  • 20 Jan 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. 
  • 137
  • 13 Jan 2022
Topic Review
Wearable Sensing Technologies
Standards for the fatigue testing of wearable sensing technologies are lacking. The majority of published fatigue tests for wearable sensors are performed on proof-of-concept stretch sensors fabricated from a variety of materials. Due to their flexibility and stretchability, polymers are often used in the fabrication of wearable sensors. Other materials, including textiles, carbon nanotubes, graphene, and conductive metals or inks, may be used in conjunction with polymers to fabricate wearable sensors.
  • 110
  • 10 Aug 2021
Topic Review
Warfarin has been utilized for decades as an effective anticoagulant in patients with a history of strong risk factors for venous thromboembolism (VTE).
  • 691
  • 05 May 2021
Topic Review
Viral Myocarditis - From Pathophysiology to Treatment
The pathophysiology of viral myocarditis and its sequelae leading to severe heart failure with a poor prognosis is not fully understood and represents a significant public health issue globally. Most likely, at a certain point, besides viral persistence, several etiological types merge into a common pathogenic autoimmune process leading to chronic inflammation and tissue remodeling, ultimately resulting in the clinical phenotype of dilated cardiomyopathy. 
  • 73
  • 05 Jan 2022
Topic Review
Veno-Arterial Extracorporeal Membrane Oxygenation
Mortality in infarct-related cardiogenic shock (CS) remains high, reaching 40–50%. In refractory CS, active mechanical circulatory support devices including veno-arterial extracorporeal membrane oxygenation (VA-ECMO) are rapidly evolving. However, supporting evidence of VAECMO therapy in infarct-related CS is low. The basics of VA-ECMO therapy, current evidence, ongoing trials, patient selection and potential complications warrant focus.
  • 74
  • 12 Apr 2022
Topic Review
Vasospasm in Fluoropyrimidine-Induced Ischemic Heart Disease
Cardiovascular diseases and cancer are the leading cause of morbidity and mortality globally. Cardiotoxicity from chemotherapeutic agents results in substantial morbidity and mortality in cancer survivors and patients with active cancer. Cardiotoxicity induced by 5-fluorouracil (5-FU) has been well established, yet its incidence, mechanisms, and manifestation remain poorly defined. Ischemia secondary to coronary artery vasospasm is thought to be the most frequent cardiotoxic effect of 5-FU. The available evidence of 5-FU-induced epicardial coronary artery spasm and coronary microvascular dysfunction suggests that endothelial dysfunction or primary vascular smooth muscle dysfunction (an endothelial-independent mechanism) are the possible contributing factors to this form of cardiotoxicity. In patients with 5-FU-related coronary artery vasospasm, termination of chemotherapy and administration of nitrates or calcium channel blockers may improve ischemic symptoms. However, there are variable results after administration of nitrates or calcium channel blockers in patients treated with 5-FU presumed to have myocardial ischemia, suggesting mechanisms other than impaired vasodilatory response. 
  • 74
  • 22 Apr 2022
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