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Updated time: 15 Apr 2021
Definition: Aging is a multifactorial dynamic process that is influenced by a variety of external and internal variables, including environmental, demographic, and biopsychosocial factors, to determine the development and progression of age-related diseases, rather than being a solely static intrinsic process of cellular alterations.
Updated time: 12 May 2021
Definition: The cardiac conduction system is an extended network of excitable tissue tasked with generation and propagation of electrical impulses to signal coordinated contraction of the heart. The fidelity of this system depends on the proper spatio-temporal regulation of ion channels in myocytes throughout the conduction system. Importantly, inherited or acquired defects in a wide class of ion channels has been linked to dysfunction at various stages of the conduction system resulting in life-threatening cardiac arrhythmia. Members of the ankyrin and spectrin families have emerged as important nodes for normal expression and regulation of ion channels in myocytes throughout the conduction system. Human variants impacting ankyrin/spectrin function give rise to a broad constellation of cardiac arrhythmias. Furthermore, chronic neurohumoral and biomechanical stress promotes ankyrin/spectrin loss of function that likely contributes to conduction disturbances in the setting of acquired cardiac disease.
Updated time: 12 Aug 2021
Definition: Atrial fibrillation (AF) patient care encompasses different possible management strategies which are classified as rhythm-control therapies, aimed at restoring and maintaining the sinus rhythm, and rate-control therapies, aimed at ensuring an appropriate control of heart rate during AF.
Updated time: 08 Mar 2021
Definition: 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.
Updated time: 07 Jul 2021
Definition: Targeted cellular ablation is being increasingly used in the treatment of arrhythmias and structural heart disease. Catheter-based ablation for atrial fibrillation (AF) is considered a safe and effective approach for patients who are medication refractory. Electroporation (EPo) employs electrical energy to disrupt cell membranes which has a minimally thermal effect. The nanopores that arise from EPo can be temporary or permanent. Reversible electroporation is transitory in nature and cell viability is maintained, whereas irreversible electroporation causes permanent pore formation, leading to loss of cellular homeostasis and cell death. Several studies report that EPo displays a degree of specificity in terms of the lethal threshold required to induce cell death in different tissues. However, significantly more research is required to scope the profile of EPo thresholds for specific cell types within complex tissues. Irreversible electroporation (IRE) as an ablative approach appears to overcome the significant negative effects associated with thermal based techniques, particularly collateral damage to surrounding structures. With further fine-tuning of parameters and longer and larger clinical trials, EPo
Updated time: 03 Aug 2021
Definition: Vasospastic angina (VA) is caused by focal or diffuse spasm of an epicardial coronary artery, resulting in severe obstruction of the coronary artery lumen and myocardial ischemia. Vasospasm can occur in an angiographically normal coronary artery, but may also occur at the site of an existing organic atherosclerotic stenosis. Stable atherosclerotic plaques are rarely fatal, but can interfere with coronary blood flow and lead to stable angina. However, it has been suggested that vasospasm is associated with endothelial damage and subsequent atheroma rupture. Considering that acute coronary syndrome (ACS) is almost always caused by luminal thrombus or sudden plaque rupture applied to organic atherosclerotic plaques, coronary vasospasm can induce the rupture of a stable atheroma, which could lead to myocardial infarction and sudden cardiac death.
Updated time: 28 Apr 2021
Definition: 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.
Updated time: 05 Jul 2021
Definition: Ang II is known as the main effector of the RAS. Ang II binds with a similar affinity to two receptors: the Ang II type 1 receptor (AT1) and type 2 receptor (AT2), both belonging to the G protein-coupled receptor (GPCR) family and sharing 50% homology and 34% identity in their amino acid sequence. Ang II activation of AT1 is acknowledged as triggering most of the known effects of RAS stimulation, such as vasoconstriction, water and sodium retention and aldosterone release by the adrenal glands. This leads to increases in blood pressure, cardiovascular remodeling and fibrosis. Due to its wide physiological effects, AT1 plays a critical role in many pathological conditions and cardiovascular diseases, like cardiac hypertrophy, hypertension and heart failure.
Updated time: 30 Jun 2021
Definition: Atherosclerotic cardiovascular diseases (ASCVD) are the major cause of mortality worldwide. Despite the continuous progress in ASCVD therapy, the residual risk persists beyond the management of traditional risk factors. Several infections including Helicobacter pylori infection, periodontal disease, and viral infections are associated with the increased risk of ASCVD, both directly by damage to the heart muscle and vasculature, and indirectly by triggering a systemic proinflammatory state. Hence, beyond the optimal management of the traditional ASCVD risk factors, infections should be considered as an important non-classical risk factor to enable early diagnosis and appropriate treatment.
Updated time: 16 Sep 2021
Definition: 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.