Topic Review
CMR Findings of Myocardial Inflammation and Pathological Correlations
Myocarditis comprises many clinical presentations ranging from asymptomatic to sudden cardiac death. The history, physical examination, cardiac biomarkers, inflammatory markers, and electrocardiogram are usually helpful in the initial assessment of suspected acute myocarditis. Echocardiography is the primary tool to detect ventricular wall motion abnormalities, pericardial effusion, valvular regurgitation, and impaired function. The advancement of cardiac magnetic resonance (CMR) imaging has been helpful in clinical practice for diagnosing myocarditis. 
  • 38
  • 19 Aug 2022
Topic Review
Nailfold Capillaroscopy
Nailfold capillaroscopy is a non-invasive imaging technique applied to an in vivo, dynamic, two-dimensional projection of the three-dimensional capillary network of the studied organ, typically the skin. 
  • 6
  • 19 Aug 2022
Topic Review
Natriuretic Peptides and Troponins for HFpEF
Heart failure (HF) is a significant cause of morbidity and mortality worldwide. HF with preserved ejection fraction (HFpEF) is a complex syndrome, often participated by several cardiac and extracardiac conditions, including chronic kidney disease, pulmonary disease, anaemia and advanced age. Circulating biomarkers reflecting pathophysiological pathways involved in HFpEF development and progression may assist clinicians in early diagnosis and management of this condition. Natriuretic peptides (NPs) are cardioprotective hormones released by cardiomyocytes in response to pressure or volume overload and in response to activation of neuro-endocrine-immune system. The relevance of B-type NP (BNP) and N-terminal pro-B-type NP (NT-proBNP) for diagnosis and risk stratification has been extensively demonstrated, and these biomarkers are emerging tools for population screening and as guides to the start of treatment in subclinical HF. On the contrary, conflicting evidence exists on the value of NPs to guide HF therapy. Among the other biomarkers, high-sensitivity troponins and soluble suppression of tumorigenesis-2 are the most promising biomarkers for risk stratification, predicting outcome independently from NPs. 
  • 13
  • 19 Aug 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 [2]. Assessing its morphology can reveal various normal and abnormal features, which can be associated with deteriorating clinical outcomes [3]. 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 [3].
  • 18
  • 18 Aug 2022
Topic Review
Iron Supplementation in Heart Failure
Iron deficiency is a significant comorbidity of heart failure (HF), defined as the inability of the myocardium to provide sufficient blood flow. However, iron deficiency remains insufficiently detected. Iron-deficiency anemia, defined as a decrease in hemoglobin caused by iron deficiency, is a late consequence of iron deficiency, and the symptoms of iron deficiency, which are not specific, are often confused with those of HF or comorbidities. HF patients with iron deficiency are often rehospitalized and present reduced survival. The correction of iron deficiency in HF patients is associated with improved functional capacity, quality of life, and rehospitalization rates. Because of the inflammation associated with chronic HF, which complicates the picture of nutritional deficiency, only the parenteral route can bypass the tissue sequestration of iron and the inhibition of intestinal iron absorption. Given the negative impact of iron deficiency on HF progression, the frequency and financial implications of rehospitalizations due to decompensation episodes, and the efficacy of this supplementation, screening for this frequent comorbidity should be part of routine testing in all HF patients.
  • 27
  • 18 Aug 2022
Topic Review
Genetic RyR2 Disease
The ryanodine receptor (RyR2) has a critical role in controlling Ca2+ release from the sarcoplasmic reticulum (SR) throughout the cardiac cycle. RyR2 protein has multiple functional domains with specific roles, and four of these RyR2 protomers are required to form the quaternary structure that comprises the functional channel. Numerous mutations in the gene encoding RyR2 protein have been identified and many are linked to a wide spectrum of arrhythmic heart disease. Gain of function mutations result in a hyperactive channel that causes excessive spontaneous SR Ca2+ release, but rare hypoactive loss of function mutations have also been described.
  • 15
  • 17 Aug 2022
Topic Review
Tetrahydrocurcumin-Related Vascular Protection
Tetrahydrocurcumin (THC), one of the major metabolites of Curcumin (CUR), possesses several CUR-like pharmacological effects; however, its mechanisms of action are largely unknown. The effects of THC on angiogenesis in CaSki xenografted mice and the expression of vascular endothelial growth factor (VEGF) are well documented. On the other hand, as an anti-inflammatory and antioxidant compound, THC is involved in enhancing homocysteine-induced mitochondrial remodeling in brain endothelial cells. The experimental evidence regarding the mechanism of mitochondrial dysfunction during cerebral ischemic/reperfusion injury and the therapeutic potential of THC to alleviate mitochondrial cerebral dysmorphic dysfunction patterns is also scrutinized and explored. Overall, the studies on different animal models of disease suggest that THC can be used as a dietary supplement to protect against cardiovascular changes caused by various factors (such as heavy metal overload, oxidative stress, and carcinogenesis). 
  • 29
  • 16 Aug 2022
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.
  • 26
  • 15 Aug 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.
  • 28
  • 11 Aug 2022
Topic Review
sST2 in Acute Heart Failure and COVID-19 Infection
As a member of the interleukin-1 receptor superfamily, the protein ST2 (alternative name for “interleukin-1 receptor-like 1”) presents with a transmembrane (ST2L) and soluble (sST2) isoforms. Since the discovery of interleukin-33 (IL-33) in 2005 as the ST2L ligand, the molecule has been deeply considered in inflammatory conditions, fibroproliferative diseases, autoimmune diseases, trauma, sepsis, and most recently and significantly in pulmonary and cardiovascular diseases. 
  • 27
  • 11 Aug 2022
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