Summary

Hypertension is a major public health concern worldwide because of its rising prevalence and concomitant risks of cardiovascular diseases. Coping strategies may encompass a full spectrum of clinical, epidemiological, experimental, and technological factors to inspire front-line practices and shape critical thinking. This entry collection aims to assemble entries of wealthy topics related to clinical, therapeutic, and population sciences of hypertension and cardiovascular diseases that could inform research scientists and healthcare professionals.

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Entries
Topic Review
Pathogenesis and Management of Brugada Syndrome
Brugada syndrome (BrS) is a primary electrical disease associated with arrhythmias and an elevated risk of sudden cardiac death (SCD). It was described by Pedro and Josep Brugada in 1992 as a syndrome comprised of “right bundle branch block, persistent ST segment elevation and SCD”. The prevalence of BrS electrocardiogram (ECG) patterns differs largely among various regions and populations of the world. Patients with BrS are considered symptomatic if they have history of aborted SCD, ventricular fibrillation (VF), sustained ventricular tachycardia (VT), or syncope. BrS usually presents during the third or fourth decade of life, and about 63% of patients are asymptomatic at diagnosis. However, syncope or major arrhythmic events (MAE) can occur at any age, or SCD may even present as the first event. BrS contributes towards sudden infant death syndrome, SCD in children, and is estimated to cause about 20% of all SCDs in individuals with anatomically normal cardiac structures.
  • 715
  • 18 Apr 2022
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.
  • 596
  • 18 Apr 2022
Topic Review
Analyzing Heart Failure Care by Actor-Partner Interdependence Model
Heart failure (HF) is a complex, heterogeneous, increasingly prevalent cardiovascular disorder with high morbidity and mortality. Self-care behaviors are essential for the effective treatment of heart failure, and poor self-care may lead to adverse clinical events in patients with HF, including repeated hospitalizations, poor quality of life, and increased mortality. One of the most common approaches for analyzing data on HF self-care dyads is the Actor–Partner Interdependence Model (APIM). Studies using the APIM approach revealed interrelated patient and caregiver characteristics that influence self-care and explain many complex dyadic behaviors. 
  • 366
  • 15 Apr 2022
Topic Review
Artificial Intelligence in Coronary Artery Disease
Clinically significant atherosclerosis of the coronary arteries, known as coronary artery disease (CAD), is an endemic condition that is associated with significant morbidity and mortality. The introduction of artificial intelligence (AI) and machine learning over the last two decades has unlocked new dimensions in the field of cardiovascular medicine. From automatic interpretations of heart rhythm disorders via smartwatches, to assisting in complex decision-making, AI has quickly expanded its realms in medicine and has demonstrated itself as a promising tool in helping clinicians guide treatment decisions. Understanding complex genetic interactions and developing clinical risk prediction models, advanced cardiac imaging, and improving mortality outcomes are just a few areas where AI has been applied in the domain of coronary artery disease. 
  • 791
  • 13 Apr 2022
Topic Review
Pulmonary Atresia with Ventricular Septal Defect
Pulmonary atresia with ventricular septal defect (PA/VSD) is the extreme form of Fallot's tetralogy in which pulmonary blood flow is ensured from systemic blood flow sources. In the presence of Major Aorto-Pulmonary Collateral Arteries (MAPCAs), the disease assumes the greatest complexity due to the variable pulmonary perfusion patterns, of which MAPCAs are an important, although not the only source. True pulmonary arteries may have varying degrees of hypoplasia, be absent and, more rarely, discontinuous, with unilateral pulmonary perfusion provided by the arterial duct and contralateral by MAPCAs. The variability of the pulmonary perfusion pattern is a determining factor in the complexity of patients with PA/VSD/MAPCAs and the consequent diversity of their surgical management.
  • 487
  • 12 Apr 2022
Topic Review
Gap Junctions in Atrial Fibrillation
Atrial fibrillation (AF) represents the most common type of clinical cardiac arrhythmia worldwide and contributes to substantial morbidity, mortality and socioeconomic burden. Aggregating evidence highlights the strong genetic basis of AF. In addition to chromosomal abnormalities, pathogenic mutations in over 50 genes have been causally linked to AF, of which the majority encode ion channels, cardiac structural proteins, transcription factors and gap junction channels. In the heart, gap junctions comprised of connexins (Cxs) form intercellular pathways responsible for electrical coupling and rapid coordinated action potential propagation between adjacent cardiomyocytes. Among the 21 isoforms of connexins already identified in the mammal genomes, 5 isoforms (Cx37, Cx40, Cx43, Cx45 and Cx46) are expressed in human heart. Abnormal electrical coupling between cardiomyocytes caused by structural remodeling of gap junction channels (alterations in connexin distribution and protein levels) has been associated with enhanced susceptibility to AF and recent studies have revealed multiple causative mutations or polymorphisms in 4 isoforms of connexins predisposing to AF.
  • 493
  • 11 Apr 2022
Topic Review
Mitral Paravalvular Leak
Paravalvular leak incidence after mitral surgical replacement ranges from 7% to 17%. Between 1% and 5% of these are clinically significant. Large PVLs can cause important clinical manifestations such as heart failure or haemolysis. Current guidelines consider that surgical reparation is the gold-standard therapy in symptomatic patients with paravalvular leak. However, these recommendations are based in non-randomized observational registries. On the other hand, transcatheter paravalvular leak closure has shown excellent results with a low rate of complications, and nowadays it is considered the first option in selected patients in some experienced centres.
  • 585
  • 11 Apr 2022
Topic Review
Endothelial Ion Channel Therapy-Targets for Pulmonary Arterial Hypertension
Endothelial cells (ECs) form a multifunctional signal-transducing surface that performs diverse tasks depending on its localization in the vessel tree. A diverse variety of ion channels is expressed in the plasma and organelle membranes that control the function of these cells. Pulmonary arterial hypertension (PAH) is a severe disease characterized by vascular remodeling in pulmonary arteries attributable to persistent vasoconstriction, proliferation, inflammation, and in situ thrombosis.  Ion channels play a crucial role in the pathophysiology of the disease and can be carefully considered as new therapeutic targets relevant for PAH.
  • 453
  • 08 Apr 2022
Topic Review
Cross-Sectional Imaging in Pediatric Interventional Cardiac Catheterization
Computed tomography (CT)  and Cardiac magnetic resonance (CMR) continue to advance the field of congenital cardiology by allowing for new and unique procedures not previously imagined. Enabling the interventionalist to enter the catheterization lab with a plan of attack expedites the procedure and has been shown to reduce procedural times and improve outcomes. Substantial advances in cross-sectional image resolution with a significant decrease in radiation exposure for cardiac CTs have led to more mainstream utilization. CMR has a unique ability to deliver real-time functional imaging in several views without exposing the patient to the detrimental effects of ionizing radiation. This can reduce procedural times in the interventional fluoroscopic suite to allow for more directed procedures.
  • 423
  • 08 Apr 2022
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. 
  • 622
  • 06 Apr 2022
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