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J. Cardiovasc. Dev. Dis., Volume 9, Issue 11 (November 2022) – 45 articles

Cover Story (view full-size image): While individual 3D imaging methods can provide special types of micro-morphological and functional information about developing organs, a synthesis of different data types is necessary to understand normal and pathological development. We present a detailed workflow for specimen-specific correlation of dynamic in vivo optical coherence tomography (OCT) imaging of the developing chick heart with high-detail 3D X-ray microtomography (micro-CT) data. Our workflow allows for overview and dynamic imaging of the whole heart over the cardiac cycle and can provide 3D virtual histology information in intact specimens. This multimodal approach has the potential to provide new and valuable insights into cardiac morphogenesis by providing unique and complementary information only achievable through the correlation of these data. View this paper
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9 pages, 1260 KiB  
Article
Safety and Efficacy of Tirofiban in Severe Ischemic Stroke Patients Undergoing Mechanical Thrombectomy
by Lingxin Cai, Tingting Wang, Aiqing Chen, Chenhan Ling, Jing Xu, Cong Qian and Gao Chen
J. Cardiovasc. Dev. Dis. 2022, 9(11), 408; https://doi.org/10.3390/jcdd9110408 - 21 Nov 2022
Cited by 3 | Viewed by 1764
Abstract
Tirofiban has recently shown encouraging efficacy and safety among acute ischemic stroke (AIS) patients with mechanical thrombectomy (MT). However, the benefits of tirofiban varied among studies depending on the patient’s condition, which was often not well analyzed. This study aimed to identify the [...] Read more.
Tirofiban has recently shown encouraging efficacy and safety among acute ischemic stroke (AIS) patients with mechanical thrombectomy (MT). However, the benefits of tirofiban varied among studies depending on the patient’s condition, which was often not well analyzed. This study aimed to identify the characteristics of patients who may obtain the largest benefits from tirofiban. The efficacy endpoint was a favorable outcome defined as a modified Rankin Scale (mRS) score of 0~2 at 90 days. The safety endpoints were intracranial hemorrhage (ICH), symptomatic intracranial hemorrhage (sICH) and mortality at 90 days. Adjusted logistic regression analysis and subgroup analyses were utilized to investigate the factors associated with tirofiban and the outcome. All of 285 patients fit the inclusion criteria. Tirofiban was associated with a higher rate of favorable outcome (aOR 2.033, 95% CI, 1.002~4.123, p = 0.043) but not with an increased risk of ICH, sICH or mortality (p > 0.05). Moreover, subgroup analyses revealed that tirofiban was associated with favorable outcomes in patients with NIHSS > 14 (aOR 2.778, 95% CI 1.056~7.356, p = 0.038) but not in patients with NIHSS ≤ 14 (aOR 1.719, 95% CI 0.646~4.578, p = 0.278). No significant heterogeneity was found in the effect of tirofiban across the subgroups of age, sex, ASPECTS, time from onset to puncture, use of t-PA or stroke etiology (p for interaction > 0.05). The administration of tirofiban was associated with favorable outcomes in severe ischemic stroke patients, and further studies are needed to confirm this finding. Full article
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20 pages, 1545 KiB  
Review
Personalised Treatment in Aortic Stenosis: A Patient-Tailored Transcatheter Aortic Valve Implantation Approach
by Andreas Mitsis, Xun Yuan, Christos Eftychiou, Panayiotis Avraamides and Christoph A. Nienaber
J. Cardiovasc. Dev. Dis. 2022, 9(11), 407; https://doi.org/10.3390/jcdd9110407 - 21 Nov 2022
Cited by 1 | Viewed by 2454
Abstract
Transcatheter aortic valve replacement (TAVI) has become a game changer in the management of severe aortic stenosis shifting the concept from inoperable or high-risk patients to intermediate or low surgical-risk individuals. Among devices available nowadays, there is no clear evidence that one device [...] Read more.
Transcatheter aortic valve replacement (TAVI) has become a game changer in the management of severe aortic stenosis shifting the concept from inoperable or high-risk patients to intermediate or low surgical-risk individuals. Among devices available nowadays, there is no clear evidence that one device is better than the other or that one device is suitable for all patients. The selection of the optimal TAVI valve for every patient represents a challenging process for clinicians, given a large number of currently available devices. Consequently, understanding the advantages and disadvantages of each valve and personalising the valve selection based on patient-specific clinical and anatomical characteristics is paramount. This review article aims to both analyse the available devices in the presence of specific clinical and anatomic features and offer guidance to select the most suitable valve for a given patient. Full article
(This article belongs to the Special Issue Aortic Stenosis: Diagnosis, Treatment and Management)
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11 pages, 2138 KiB  
Systematic Review
AGTR1rs5186 Polymorphism Is Associated with the Risk of Restenosis after Percutaneous Coronary Intervention: A Meta-Analysis
by Feng Lv, Yufeng Jiang, Yebao Wang, Ting Zhang and Yafeng Zhou
J. Cardiovasc. Dev. Dis. 2022, 9(11), 406; https://doi.org/10.3390/jcdd9110406 - 21 Nov 2022
Viewed by 1150
Abstract
Background: Progress has been made in genetic investigations on restenosis for the past 20 years, many studies regarding AGTR1 rs5186 polymorphism and restenosis after percutaneous coronary intervention (PCI) have been published, but the result remains controversial. The study aimed to explore the relationship [...] Read more.
Background: Progress has been made in genetic investigations on restenosis for the past 20 years, many studies regarding AGTR1 rs5186 polymorphism and restenosis after percutaneous coronary intervention (PCI) have been published, but the result remains controversial. The study aimed to explore the relationship between rs5186 polymorphism and the risk of restenosis after PCI. Methods: We performed a systematic search on PubMed, Web of Science, Embase, CNKI, and Wan Fang databases up to December 2021. Two authors individually extracted all useful data of each study involved in this meta-analysis and assessed the study quality using the Newcastle-Ottawa scale. Odds ratios (ORs) and 95% confidence intervals (CIs) were combined in different genetic models for evaluation using a random-effects model or fixed-effect model. Results: There were eventually 8 studies of 1111 cases and 4097 controls eligible for this meta-analysis. Significant associations were found between rs5186 polymorphism and restenosis after PCI.allelic (OR: 1.31, 95% CI: 1.17–1.47, p < 0.001), homozygous (OR: 1.90, 95% CI: 1.50–2.44, p < 0.001), heterozygous (OR: 1.10, 95% CI: 0.93–1.29, p = 0.27), recessive (OR: 1.80, 95% CI: 1.37–2.36, p < 0.001), dominant genetic model (OR: 1.24, 95% CI: 1.06–1.44, p = 0.006). Subgroup analyses indicated a significant association in Asians. Conclusions: The rs5186 polymorphism in the AGTR1 gene increases the risk of restenosis after PCI in Asians significantly. Full article
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10 pages, 1615 KiB  
Article
New Wound Management of Driveline Infections with Cold Atmospheric Plasma
by Jamila Kremer, Étienne Fasolt Richard Corvin Meinert, Mina Farag, Florian Mueller, Jasmin Penelope Soethoff, Matthias Karck, Bastian Schmack, Anna Lassia Meyer and Gregor Warnecke
J. Cardiovasc. Dev. Dis. 2022, 9(11), 405; https://doi.org/10.3390/jcdd9110405 - 21 Nov 2022
Cited by 4 | Viewed by 2622
Abstract
The use of ventricular assist devices as a bridge to transplant or as destination therapy has increased. Wound complications increase morbidity in this cohort. Cold atmospheric plasma is a source of reactive oxygen and nitrogen species and can reduce the microbial load in [...] Read more.
The use of ventricular assist devices as a bridge to transplant or as destination therapy has increased. Wound complications increase morbidity in this cohort. Cold atmospheric plasma is a source of reactive oxygen and nitrogen species and can reduce the microbial load in skin wounds without negative effects on the surrounding tissue. We evaluated our cold atmospheric plasma treatment for LVAD driveline infections in a retrospective single-center study for peri- and postintervention outcome analysis. Between April 2019 and September 2019, 15 male patients were included (5 HVAD, 10 HeartMate III). The wounds were treated for a mean of 368.5 s with a reduction of bacterial load in treated wounds in 60% of patients, regardless of the pathogen. The most common pathogen was staphylococcus aureus (n = 8 patients). There was a significant reduction of the wound scale (scale 2.80 vs. 1.18; p < 0.001) plus a significant reduction in size (16.08 vs. 1.90 cm3; p = 0.047). Seven patients (46.6%) were free from any signs of local or systemic infection during 1-year follow-up. Five patients (33%) received a heart transplantation. Cold atmospheric plasma treatment is a potent, safe, and painless adjuvant technique for treating driveline infection without the need for repeating surgical interventions. Full article
(This article belongs to the Special Issue Current Challenges in Heart Failure and Cardiac Transplantation)
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11 pages, 3037 KiB  
Article
Optimizing Anastomoses Technique in Orthotopic Heart Transplantation: Comparison of Biatrial, Bicaval and Modified Bicaval Technique
by Moritz Benjamin Immohr, Udo Boeken, Raphael Romano Bruno, Yukiharu Sugimura, Arash Mehdiani, Hug Aubin, Ralf Westenfeld, Igor Tudorache, Artur Lichtenberg and Payam Akhyari
J. Cardiovasc. Dev. Dis. 2022, 9(11), 404; https://doi.org/10.3390/jcdd9110404 - 20 Nov 2022
Cited by 1 | Viewed by 3946
Abstract
Implantation techniques for orthotopic heart transplantation (HTx) have evolved over the centuries. Recently new approaches of modified bicaval techniques to minimize warm ischemia are gaining popularity in the literature. Between 2010 and 2022 n = 238 patients underwent HTx in our department. The [...] Read more.
Implantation techniques for orthotopic heart transplantation (HTx) have evolved over the centuries. Recently new approaches of modified bicaval techniques to minimize warm ischemia are gaining popularity in the literature. Between 2010 and 2022 n = 238 patients underwent HTx in our department. The recipients were retrospectively reviewed and divided regarding their anastomoses’ technique. Anastomoses were sutured either in biatrial (n = 37), bicaval (n = 191) or in a modified bicaval (n = 10) manner with suturing of the superior cava vein and A. pulmonalis anastomosis after removing the aortic cross-clamp during the reperfusion. Warm ischemia was 62 ± 11 min for biatrial, 66 ± 15 min for bicaval, but only 48 ± 10 min for modified bicaval technique (p < 0.001). The incidence of severe primary graft dysfunction (PGD) was comparable between biatrial (27.0%) and bicaval (28.8%) anastomoses. In contrast, in patients with modified bicaval technique PGD occurred only in a single patient (10.0%). The incidence of postoperative pacemaker implantation was 18.2% for biatrial compared to 3.0% for bicaval and 0.0% for modified bicaval technique (p = 0.01). The modified bicaval technique enables to decrease the crucial warm ischemia during HTx compared to both biatrial and regular bicaval techniques. Therefore, we strongly recommend bicaval anastomoses, ideally in a modified manner. Full article
(This article belongs to the Special Issue Current Challenges in Heart Failure and Cardiac Transplantation)
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12 pages, 533 KiB  
Review
Review of Recent Laboratory and Experimental Data on Cardiotoxicity of Statins
by Aleksey M. Chaulin
J. Cardiovasc. Dev. Dis. 2022, 9(11), 403; https://doi.org/10.3390/jcdd9110403 - 19 Nov 2022
Cited by 5 | Viewed by 1473
Abstract
Due to the fact that statins are among the most high-demand therapeutic agents used for the treatment and prevention of the most common cardiovascular diseases, a significant amount of research is focused on these drugs. As a result, the study and discovery of [...] Read more.
Due to the fact that statins are among the most high-demand therapeutic agents used for the treatment and prevention of the most common cardiovascular diseases, a significant amount of research is focused on these drugs. As a result, the study and discovery of new effects in statin drugs continues. Research methods are constantly being improved in terms of their sensitivity and specificity, which leads to a change in ideas. In addition to the main lipid-lowering effect, statins have a number of additional effects, which can be conditionally divided into positive (pleiotropic) and negative (side effects). Moreover, information about many of the pleiotropic effects of statins is controversial and may subsequently change as new data become available. To a large extent, this is due to the introduction of new and the improvement of old methods of study: clinical, laboratory and morphological ones. Recent studies report the possibility of statins having potential cardiotoxic properties, which is expressed by an increase in the concentration of highly sensitive cardiac troponins, as well as various adverse changes in cardiac myocytes at the ultrastructural and molecular levels. This paper discusses possible mechanisms of statin cardiotoxicity. This narrative review is based on an analysis of publications in the Medline, PubMed, PubMed Central and Embase databases. The terms “statins”, “troponin”, “troponin I”, “troponin T” in combination with “cardiotoxicity”, “false positive”, “mechanisms of increase”, “pathophysiological mechanisms”, “oxidative stress” and “cardiomyocyte apoptosis” were used to search publications. Full article
(This article belongs to the Special Issue Cellular Mechanisms of Cardiac Damage and Healing)
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18 pages, 2233 KiB  
Review
Novel Insights into the Sinoatrial Node in Single-Cell RNA Sequencing: From Developmental Biology to Physiological Function
by Wei Fan, Chao Yang, Xiaojie Hou, Juyi Wan and Bin Liao
J. Cardiovasc. Dev. Dis. 2022, 9(11), 402; https://doi.org/10.3390/jcdd9110402 - 18 Nov 2022
Cited by 1 | Viewed by 2734
Abstract
Normal cardiac automaticity is dependent on the pacemaker cells of the sinoatrial node (SAN). Insufficient cardiac pacemaking leads to the development of sick sinus syndrome (SSS). Since currently available pharmaceutical drugs and implantable pacemakers are only partially effective in managing SSS, there is [...] Read more.
Normal cardiac automaticity is dependent on the pacemaker cells of the sinoatrial node (SAN). Insufficient cardiac pacemaking leads to the development of sick sinus syndrome (SSS). Since currently available pharmaceutical drugs and implantable pacemakers are only partially effective in managing SSS, there is a critical need for developing targeted mechanism-based therapies to treat SSS. SAN-like pacemaker cells (SANLPCs) are difficult to regenerate in vivo or in vitro because the genes and signaling pathways that regulate SAN development and function have not been fully elucidated. The development of more effective treatments for SSS, including biological pacemakers, requires further understanding of these genes and signaling pathways. Compared with genetic models and bulk RNA sequencing, single-cell RNA sequencing (scRNA-seq) technology promises to advance our understanding of cellular phenotype heterogeneity and molecular regulation during SAN development. This review outlines the key transcriptional networks that control the structure, development, and function of the SAN, with particular attention to SAN markers and signaling pathways detected via scRNA-seq. This review offers insights into the process and transcriptional network of SAN morphogenesis at a single-cell level and discusses current challenges and potential future directions for generating SANLPCs for biological pacemakers. Full article
(This article belongs to the Section Cardiac Development and Regeneration)
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5 pages, 221 KiB  
Editorial
Towards a More Individually Tailored Exercise Prescription for Promoting Cardiovascular Health
by Giuseppe Caminiti and Ferdinando Iellamo
J. Cardiovasc. Dev. Dis. 2022, 9(11), 401; https://doi.org/10.3390/jcdd9110401 - 18 Nov 2022
Cited by 1 | Viewed by 1473
Abstract
The beneficial effects of exercise training (ET) in promoting cardiovascular health have been well established [...] Full article
(This article belongs to the Special Issue Cardiovascular Effects and Benefits of Exercise)
16 pages, 2551 KiB  
Article
Relationship between the Hemoglobin-to-Red Cell Distribution Width Ratio and All-Cause Mortality in Septic Patients with Atrial Fibrillation: Based on Propensity Score Matching Method
by Junhong Wang, Zirong Chen, Hongkuan Yang, Hua Li, Rudong Chen and Jiasheng Yu
J. Cardiovasc. Dev. Dis. 2022, 9(11), 400; https://doi.org/10.3390/jcdd9110400 - 18 Nov 2022
Cited by 8 | Viewed by 1788
Abstract
(1) Objective: To reveal the correlation between the hemoglobin-to-red cell distribution width ratio (HRR) and all-cause mortality (ACM) among the septic patients with atrial fibrillation. (2) Methods: Specific clinical information was collected from the Medical Information Mart for Intensive IV (MIMIC-IV) database. The [...] Read more.
(1) Objective: To reveal the correlation between the hemoglobin-to-red cell distribution width ratio (HRR) and all-cause mortality (ACM) among the septic patients with atrial fibrillation. (2) Methods: Specific clinical information was collected from the Medical Information Mart for Intensive IV (MIMIC-IV) database. The optimal cut-off value of HRR was calculated through ROC curve analysis conducted by using the maximum Youden index for the prediction of survival status. In addition, univariable and multivariable Cox regressive analyses were carried out to assess the prognostic significance of HRR and the Kaplan-Meier (K-M) analysis was conducted to draw the survival curves. Then, the 1:1 propensity score matching (PSM) method was adopted to improve the reliability of research result while balancing the unintended influence of underlying confounders. (3) Results: There were 9228 patients participating in this retrospective cohort study. The optimal cut-off value of the HRR was determined as 5.877 for in-hospital mortality. The PSM was performed to identify 2931 pairs of score-matched patients, with balanced differences exhibited by nearly all variables. According to the K-M analysis, those patients with a lower HRR than 5.877 showed a significantly higher level of in-hospital mortality, 28-day mortality, and 90-day mortality, compared to the patients with HRR ≥ 5.877 (p < 0.001). After the adjustment of possible confounders, those patients whose HRR was below 5.877 had a significantly higher level of in-hospital mortality than the patients with HRR ≥ 5.877, as revealed by the multivariable Cox regression analysis (HR = 1.142, 95%CI: 1.210–1.648, p < 0.001). Similarly, the ACM remained substantially higher in those patients with a lower HRR than in the patients with higher HRR after PSM. (4) Conclusion: A lower HRR (<5.877) was evidently associated with an increased risk of ACM, which made it applicable as a prognostic predictor of clinical outcomes for those septic patients with atrial fibrillation. Full article
(This article belongs to the Topic Biomarkers in Cardiovascular Disease—Chances and Risks)
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12 pages, 1428 KiB  
Review
The Role of Cardiovascular Magnetic Resonance in Patients with Mitral Regurgitation
by Anna Giulia Pavon, Marco Guglielmo, Pierpaolo Mattia Mennilli, Mariana B. L. Falcão, Luca Bergamaschi, David Filip Costantin, Michele Vivaldo, Laura Anna Leo, Susanne Schlossbauer, Christopher W. Roy, Matthias Stuber, Giovanni Pedrazzini and Francesco Faletra
J. Cardiovasc. Dev. Dis. 2022, 9(11), 399; https://doi.org/10.3390/jcdd9110399 - 18 Nov 2022
Cited by 4 | Viewed by 2585
Abstract
The 2019 Global Burden of Disease (GBD) study estimated that there were approximately 24.2 million people affected worldwide by degenerative mitral regurgitation (MR), resulting in 34,200 deaths. After aortic stenosis, MR is the most prevalent VHD in Europe and the second-most common VHD [...] Read more.
The 2019 Global Burden of Disease (GBD) study estimated that there were approximately 24.2 million people affected worldwide by degenerative mitral regurgitation (MR), resulting in 34,200 deaths. After aortic stenosis, MR is the most prevalent VHD in Europe and the second-most common VHD to pose indications for surgery in western countries. Current ESC and AHA/ACC guidelines for the management of VHD emphasize the importance of an integrative approach for the assessment of MR severity, which is of paramount importance in dictating the timing for surgery. Transthoracic echocardiography (TTE) and transesophageal echocardiography (TEE) are the first-line imaging modalities; however, despite the technological advancement, sometimes, the final diagnosis on the degree of the disease may still be challenging. In the last 20 years, CMR has emerged as a robust technique in the assessment of patients with cardiac disease, and, recently, its role is gaining more and more importance in the field of VHD. In fact, CMR is the gold standard in the assessment of cardiac volumes, and it is possible to accurately evaluate the regurgitant volume. The purpose of this review is to outline the current state-of-the-art management of MR by using Cardiac Magnetic Resonance (CMR). Full article
(This article belongs to the Special Issue Cardiac Imaging in Valvular Heart Disease)
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7 pages, 288 KiB  
Article
CPR Quality Assessment in Schoolchildren Training
by Katia M. G. Oliveira, Maria José C. Carmona, Antonio P. Mansur, Julio Y. Takada, Nino Fijačko, Federico Semeraro, Andrew Lockey, Bernd W. Böttiger and Naomi K. Nakagawa
J. Cardiovasc. Dev. Dis. 2022, 9(11), 398; https://doi.org/10.3390/jcdd9110398 - 17 Nov 2022
Cited by 6 | Viewed by 1570
Abstract
Whilst CPR training is widely recommended, quality of performance is infrequently explored. We evaluated whether a checklist can be an adequate tool for chest compression quality assessment in schoolchildren, compared with a real-time software. This observational study (March 2019–2020) included 104 schoolchildren with [...] Read more.
Whilst CPR training is widely recommended, quality of performance is infrequently explored. We evaluated whether a checklist can be an adequate tool for chest compression quality assessment in schoolchildren, compared with a real-time software. This observational study (March 2019–2020) included 104 schoolchildren with no previous CPR training (11–17 years old, 66 girls, 84 primary schoolchildren, 20 high schoolchildren). Simultaneous evaluations of CPR quality were performed using an observational checklist and real-time software. High-quality CPR was determined as a combination of 70% correct maneuvers in compression rate (100–120/min), depth (5–6 cm), and complete release, using a real-time software and three positive performance in skills using a checklist. We adjusted a multivariate logistic regression model for age, sex, and BMI. We found moderate to high agreement percentages in quality of CPR performance (rate: 68.3%, depth: 79.8%, and complete release: 91.3%) between a checklist and real-time software. Only 38.5% of schoolchildren (~14 years-old, ~54.4 kg, and ~22.1 kg/m2) showed high-quality CPR. High-quality CPR was more often performed by older schoolchildren (OR = 1.43, 95%IC:1.09–1.86), and sex was not an independent factor (OR = 1.26, 95%IC:0.52–3.07). For high-quality CPR in schoolchildren, a checklist showed moderate to high agreement with real-time software. Better performance was associated with age regardless of sex and BMI. Full article
21 pages, 1150 KiB  
Review
Novel Antithrombotic Agents in Ischemic Cardiovascular Disease: Progress in the Search for the Optimal Treatment
by Ignacio Barriuso, Fernando Worner and Gemma Vilahur
J. Cardiovasc. Dev. Dis. 2022, 9(11), 397; https://doi.org/10.3390/jcdd9110397 - 16 Nov 2022
Cited by 4 | Viewed by 3378
Abstract
Ischemic cardiovascular diseases have a high incidence and high mortality worldwide. Therapeutic advances in the last decades have reduced cardiovascular mortality, with antithrombotic therapy being the cornerstone of medical treatment. Yet, currently used antithrombotic agents carry an inherent risk of bleeding associated with [...] Read more.
Ischemic cardiovascular diseases have a high incidence and high mortality worldwide. Therapeutic advances in the last decades have reduced cardiovascular mortality, with antithrombotic therapy being the cornerstone of medical treatment. Yet, currently used antithrombotic agents carry an inherent risk of bleeding associated with adverse cardiovascular outcomes and mortality. Advances in understanding the pathophysiology of thrombus formation have led to the discovery of new targets and the development of new anticoagulants and antiplatelet agents aimed at preventing thrombus stabilization and growth while preserving hemostasis. In the following review, we will comment on the key limitation of the currently used antithrombotic regimes in ischemic heart disease and ischemic stroke and provide an in-depth and state-of-the-art overview of the emerging anticoagulant and antiplatelet agents in the pipeline with the potential to improve clinical outcomes. Full article
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8 pages, 579 KiB  
Article
Pre-Stroke Statin Use Is Associated with Mild Neurological Deficits at the Onset of Acute Ischemic Stroke
by Takahisa Mori, Kazuhiro Yoshioka and Yuichi Miyazaki
J. Cardiovasc. Dev. Dis. 2022, 9(11), 396; https://doi.org/10.3390/jcdd9110396 - 16 Nov 2022
Cited by 1 | Viewed by 1591
Abstract
Pre-stroke statin use reduces infarct size. Therefore, this retrospective study aimed to investigate whether pre-stroke statin use is associated with mild neurological deficits (mND) at the onset of acute ischemic stroke (AIS). We included patients with AIS admitted to our institution within 24 [...] Read more.
Pre-stroke statin use reduces infarct size. Therefore, this retrospective study aimed to investigate whether pre-stroke statin use is associated with mild neurological deficits (mND) at the onset of acute ischemic stroke (AIS). We included patients with AIS admitted to our institution within 24 h of stroke onset between 2011 and 2019. We collected data on age, sex, pre-stroke use of statins, the National Institutes of Health Stroke Scale (NIHSS) score, the serum biomarker levels, and stroke subtypes at admission. In addition, we defined mND as an NIHSS score ≤3 points. We conducted a logistic regression analysis using variables for pre-stroke statin initiation, calculated the propensity scores for pre-stroke statin use, and implemented propensity score matching (PSM). Finally, we used the McNemar test to evaluate whether pre-stroke statin administration significantly affected mND. Of 4370 patients, 2615 met our inclusion criteria. Among the 594 patients with pre-stroke statin use, 308 presented with mND. After PSM, 555 patients received pre-stroke statin treatment, while 286 patients with pre-stroke statin use presented with mND at admission (p = 0.0411). The binary matched pairs contingency table of mND was not symmetrical (p = 0.0385). Pre-stroke statin use is thus associated with mND at the onset of AIS. Full article
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12 pages, 2357 KiB  
Article
Dynamic of Circulating DNAM-1+ Monocytes and NK Cells in Patients with STEMI Following Primary Percutaneous Coronary Intervention
by Marko Kumric, Hrvoje Urlic, Admira Bilalic, Nikolina Rezic-Muzinic, Angela Mastelic, Anita Markotic, Doris Rusic, Josip A. Borovac, Darko Duplancic, Marina Luetic, Ivan Covic, Tina Ticinovic Kurir and Josko Bozic
J. Cardiovasc. Dev. Dis. 2022, 9(11), 395; https://doi.org/10.3390/jcdd9110395 - 15 Nov 2022
Viewed by 1614
Abstract
Although the role of inflammation and adverse cardiac remodeling in myocardial infarction (MI) have been extensively explored, gaps in knowledge on the complex interaction between these processes still exist. Data suggest that DNAX accessory molecule-1 (DNAM-1), an activating receptor implicated in NK cell [...] Read more.
Although the role of inflammation and adverse cardiac remodeling in myocardial infarction (MI) have been extensively explored, gaps in knowledge on the complex interaction between these processes still exist. Data suggest that DNAX accessory molecule-1 (DNAM-1), an activating receptor implicated in NK cell education, may be involved in cardiac remodeling following coronary artery occlusion. In the present study, we aimed to explore the dynamic of DNAM-1+ monocytes and NK cells in peripheral blood in the early phase following reperfusion in patients with ST-elevation MI (STEMI). The study enrolled 49 patients older than 18 years of age diagnosed with STEMI, referred to primary percutaneous coronary intervention (pPCI). Blood samples were obtained at three distinct points (at admission, 3 h, and 24 h after pPCI) and analyzed using flow cytometry. The number of circulating DNAM-1+ monocytes (CD16++ and CD14++) and CD56dimCD16++NK cells was significantly reduced 3 h after pPCI and subsequently returned to initial levels 24 h after procedure (p = 0.003, p < 0.001, and p = 0.002, respectively). Notably, such dynamic was dependent on age of patients. A positive correlation between high sensitivity troponin I levels and number of CD16++DNAM-1+ monocytes in peripheral blood 3 h after pPCI was observed (r = 0.431, p = 0.003). In conclusion, in the present study we delineated the post-reperfusion dynamic of DNAM-1-expresing leukocytes. Additionally, we demonstrated that the number of CD16++ DNAM-1+ monocytes correlate with the extent of myocardial injury. Full article
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11 pages, 762 KiB  
Article
Association between Abnormal Echocardiography and Adverse Obstetric Outcomes in Low-Risk Pregnant Women
by Kerrilynn C. Hennessey, Thara S. Ali, Eunjung Choi, Alexandra R. Ortengren, Leigh C. Hickerson, Jennifer May Lee and Cynthia C. Taub
J. Cardiovasc. Dev. Dis. 2022, 9(11), 394; https://doi.org/10.3390/jcdd9110394 - 15 Nov 2022
Cited by 2 | Viewed by 1909
Abstract
Maternal mortality in the United States is a public health crisis of preventable deaths among young women. The role of echocardiography in the evaluation of pregnant women with cardiovascular symptoms or risk factors without known heart disease is unclear. We retrospectively examined the [...] Read more.
Maternal mortality in the United States is a public health crisis of preventable deaths among young women. The role of echocardiography in the evaluation of pregnant women with cardiovascular symptoms or risk factors without known heart disease is unclear. We retrospectively examined the clinical characteristics of consecutive pregnant patients without established heart disease who underwent echocardiography and evaluated associations between abnormal exam findings and obstetric outcomes. Among low-risk women undergoing echocardiography during pregnancy, older age, higher parity and a history of chronic hypertension are associated with a higher likelihood of echocardiographic abnormalities, which in turn are associated with a higher likelihood of adverse obstetric outcomes including caesarean section and preterm delivery. Full article
(This article belongs to the Special Issue Heart Disease in Women)
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18 pages, 5523 KiB  
Article
Geometry Does Impact on the Plane Strain Directions of the Human Left Ventricle, Irrespective of Disease
by Paolo Piras, Ivan Colorado-Cervantes, Paola Nardinocchi, Stefano Gabriele, Valerio Varano, Giuseppe Esposito, Luciano Teresi, Concetta Torromeo and Paolo Emilio Puddu
J. Cardiovasc. Dev. Dis. 2022, 9(11), 393; https://doi.org/10.3390/jcdd9110393 - 15 Nov 2022
Cited by 1 | Viewed by 1612
Abstract
The directions of primary strain lines of local deformation in Epicardial and Endocardial layers have been the subject of debate in recent years. Different methods led to different conclusions and a complete assessment of strain direction patterns in large and variable (in terms [...] Read more.
The directions of primary strain lines of local deformation in Epicardial and Endocardial layers have been the subject of debate in recent years. Different methods led to different conclusions and a complete assessment of strain direction patterns in large and variable (in terms of pathology) cohorts of healthy and diseased patients is still lacking. Here, we use local deformation tensors in order to evaluate the angle of strain lines with respect to the horizontal circumferential direction in both Epi- and Endo-layers. We evaluated this on a large group of 193 subjects including 82 healthy control and 111 patients belonging to a great variety of pathological conditions. We found that Epicardial strain lines obliquely directed while those of Endocardium are almost circumferential. This result occurs irrespective of pathological condition. We propose that the geometric vinculum characterizing Endocardium and Epicardium in terms of different lever arm length and orientation of muscular fibers during contraction inescapably requires Endocardial strain lines to be circumferentially oriented and this is corroborated by experimental results. Further investigations on transmural structure of myocytes could couple results presented here in order to furnish additional experimental explanations. Full article
(This article belongs to the Special Issue Models and Methods for Computational Cardiology)
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10 pages, 2269 KiB  
Article
Income-Related Peripheral Artery Disease Treatment: A Nation-Wide Analysis from 2009–2018
by Daniel Messiha, Olga Petrikhovich, Julia Lortz, Amir Abbas Mahabadi, Ramona Hering, Mandy Schulz, Tienush Rassaf and Christos Rammos
J. Cardiovasc. Dev. Dis. 2022, 9(11), 392; https://doi.org/10.3390/jcdd9110392 - 14 Nov 2022
Cited by 4 | Viewed by 1684
Abstract
Economic status has a measurable and significant effect on cardiovascular health. Socioeconomic- and income-related disparities worsen cardiovascular risk factors. Peripheral artery disease (PAD) remains a major risk factor for morbidity and mortality. Not all patients benefit equally from recent advances in outpatient healthcare. [...] Read more.
Economic status has a measurable and significant effect on cardiovascular health. Socioeconomic- and income-related disparities worsen cardiovascular risk factors. Peripheral artery disease (PAD) remains a major risk factor for morbidity and mortality. Not all patients benefit equally from recent advances in outpatient healthcare. The implementation of guideline recommendations regarding treatment is inadequate. Income-related disparities for PAD treatment are unknown. We aimed to analyse income-stratified PAD prevalence, outpatient treatment and pharmacotherapy. Associations of statutory health insurance physicians at the regional level, income-stratified PAD prevalence and differences in outpatient care and pharmacotherapy were analysed in 70.1 million statutorily insured patients/year between 2009 and 2018. Analysis was based on claims data (§295 of the social code (SGB V)) and drug-prescription data (§300 SGB V). The diagnosis of PAD was defined by ICD I70.2-9. Regional income data were derived from the German Census Bureau. PAD prevalence was higher in low-income than in high-income areas. Low-income patients more often presented to angiology outpatient care and more frequently received guideline recommended pharmacotherapy. High-income patients more often presented to outpatient vascular surgery. This was true for statins, antiplatelets, intermittent claudication and critical limb ischemia alike. These data indicate that PAD and income are associated. Regional income is related to insufficiencies in guideline-recommended treatment and contact to vascular specialists. Our results aim to encourage medical professionals to implement PAD guideline recommendations, especially in high-income areas. Further studies on associations between spatial-level income and healthcare in PAD are needed. Full article
(This article belongs to the Special Issue Management and Challenges in Peripheral Arterial Disease)
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11 pages, 1725 KiB  
Article
Effect of Physical Training on the Morphology of Parasympathetic Atrial Ganglia after Unilateral Vagotomy in Rats
by Oleg V. Mamontov, Roman V. Grozov, Sarkis M. Minasian, Sergei G. Zhuravskii, Michael M. Galagudza and Alexei A. Kamshilin
J. Cardiovasc. Dev. Dis. 2022, 9(11), 391; https://doi.org/10.3390/jcdd9110391 - 13 Nov 2022
Cited by 1 | Viewed by 1252
Abstract
Cardiac denervation is a serious problem in a number of patients, including patients after heart transplantation. The status of the parasympathetic ganglia after crossing the preganglionic fibers of the vagus nerve has not been enough studied. The aim of our study was to [...] Read more.
Cardiac denervation is a serious problem in a number of patients, including patients after heart transplantation. The status of the parasympathetic ganglia after crossing the preganglionic fibers of the vagus nerve has not been enough studied. The aim of our study was to assess the effect of physical training on the morphological parameters of the parasympathetic atrial ganglia and autonomic regulation of heart rate after right- and left-sided vagotomy in rats. Morphometric characteristics of the right atrial ganglia were evaluated using an immunohistochemical method after a study that included a three-time assessment of heart rate variability. It was found that right-sided vagotomy leads to both an increase in the volume of ganglion and autonomic dysfunction. No significant change in the number of nerve cells was found in animals with false and left-sided vagotomy while maintaining preganglionic innervation after the physical training, whereas exercises led to a decrease in the volume of nerve tissue of rats with right-sided denervation. It was also found that in animals with preserved vagal innervation, the volume of atrial ganglion tissue correlates with overall heart rate variability and a normalized parasympathetic component. Therefore, a positive effect from regular physical activity on parasympathetic regulation can be expected only if preganglionic vagal influence is preserved. Full article
(This article belongs to the Section Basic and Translational Cardiovascular Research)
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11 pages, 1544 KiB  
Article
The Added Value of a High CT Coronary Artery Calcium Score in the Management of Patients Presenting with Acute Chest Pain vs. Stable Chest Pain
by Rafael Hitter, Amir Orlev, Itshak Amsalem, Nir Levi, Talya Wolak, Rivka Farkash, Naama Bogot, Michael Glikson and Arik Wolak
J. Cardiovasc. Dev. Dis. 2022, 9(11), 390; https://doi.org/10.3390/jcdd9110390 - 13 Nov 2022
Viewed by 1660
Abstract
Background: Contrast computerized tomography (CT) scan is occasionally aborted due to a high coronary artery calcium score (CACS). For the same CACS in our clinical practice, we observed a higher occurrence of severe coronary artery disease (CAD) in patients with acute chest pain [...] Read more.
Background: Contrast computerized tomography (CT) scan is occasionally aborted due to a high coronary artery calcium score (CACS). For the same CACS in our clinical practice, we observed a higher occurrence of severe coronary artery disease (CAD) in patients with acute chest pain (ACP) compared to patients with stable chest pain (SCP). Since it is known that ACP differs in many ways from SCP, the aim of this study was to compare the predictive value of a high CACS for the diagnosis of severe CAD between ACP and SCP patients. Methods: This single center observational retrospective study included consecutive patients who underwent cardiac CT for chest pain and were found to have a CACS of >200 Agatston units. Patients were divided into two groups, ACP and SCP. Severe CAD was defined as ≥70% stenosis on coronary CT angiography or invasive coronary angiography. Baseline characteristics and final diagnosis of severe CAD were compared. Results: The cohort included 220 patients, 106 with ACP and 114 with SCP. ACP patients had higher severe CAD rates (60.4% vs. 36.8%; p < 0.001). On multivariate analysis including cardiac risk factors, CACS > 400 au (OR = 2.34 95% CI [1.32–4.15]; p = 0.004) and ACP (OR = 2.54 95% CI [1.45–4.45]; p = 0.001) were independent predictors of severe CAD. The addition of the clinical setting of ACP added significant incremental predictive value for severe stenosis. Conclusion: A high CACS is more associated with severe CAD in patients presenting with ACP than SCP. The findings suggest that the CACS could impact the management of patients during the scan. Full article
(This article belongs to the Section Imaging)
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11 pages, 277 KiB  
Article
Left Ventricular Diastolic Response to Isometric Handgrip Exercise in Physically Active and Sedentary Individuals
by Dimitrios Rovithis, Maria Anifanti, Nikolaos Koutlianos, Andriana Teloudi, Evangelia Kouidi and Asterios Deligiannis
J. Cardiovasc. Dev. Dis. 2022, 9(11), 389; https://doi.org/10.3390/jcdd9110389 - 11 Nov 2022
Viewed by 1308
Abstract
Aims: This study aims to investigate the diastolic left ventricular (LV) response to isometric handgrip exercise among healthy middle-aged men with high physical activity levels, versus matched sedentary individuals. Methods: Two groups of 10 men aged 41–51 years were studied. Men in the [...] Read more.
Aims: This study aims to investigate the diastolic left ventricular (LV) response to isometric handgrip exercise among healthy middle-aged men with high physical activity levels, versus matched sedentary individuals. Methods: Two groups of 10 men aged 41–51 years were studied. Men in the first group had high weekly self-reported physical activity levels (>3000 METs × min/week). In comparison, men in the second group reported low physical activity levels (<300 METs × min/week). An isometric handgrip exercise (IHE) stress echocardiography test was performed in all of them. Results: Both groups showed a similar and statistically significant increase in heart rate, systolic, diastolic, and mean arterial pressure following IHE. The group of active men under study did not show a statistically significant change in the ratio of early diastolic mitral valve inflow velocity to early diastolic lateral wall tissue velocity (E/e’ ratio) in response to IHE. Conversely, the inactive participants’ E/e’ ratio was higher at peak activity in the isometric handgrip exercise. Conclusions: Apparently, healthy middle-aged men with high levels of physical activity seem to have an improved lusitropic cardiac function compared to men with low levels of physical activity, as observed by the different diastolic LV responses induced by isometric handgrip exercise. Full article
(This article belongs to the Special Issue Sports Cardiology: From Diagnosis to Clinical Management)
9 pages, 969 KiB  
Article
A New Definition of Thrombocytopenia Following Transcatheter Aortic Valve Implantation: Incidence, Outcome, and Predictors
by Francesco Pollari, Stine Horna, Magnus Rottmann, Christian Langhammer, Thomas Bertsch and Theodor Fischlein
J. Cardiovasc. Dev. Dis. 2022, 9(11), 388; https://doi.org/10.3390/jcdd9110388 - 9 Nov 2022
Cited by 1 | Viewed by 1894
Abstract
Background: The aim of this study was to assess the incidence, outcomes, and risk factors associated with thrombocytopenia following TAVI according to a corrected platelet count (CPC), to avoid the bias of hemodilution/concentration. Methods: We analyzed patients who underwent TAVI in our center [...] Read more.
Background: The aim of this study was to assess the incidence, outcomes, and risk factors associated with thrombocytopenia following TAVI according to a corrected platelet count (CPC), to avoid the bias of hemodilution/concentration. Methods: We analyzed patients who underwent TAVI in our center between 2009 and 2018. The study population were divided into three groups: none (NT), mild (MT), and severe (ST) postoperative thrombocytopenia. Primary outcomes were bleedings, length of hospital stay, and mortality. A multivariate logistic regression was performed to assess risk factors for ST. Results: A total of 907 patients were included in the analysis. MT was observed in 28.1% and ST in 2.6% of all patients. The following clinical outcomes were recorded: incidence of life-threatening and major bleeding (NT = 14.2%, MT = 20.8%, ST = 58.3%), the median length of hospital stay (NT = 8, MT = 10, ST = 14 days), in-hospital mortality (NT = 3.9%, MT = 6.3%, ST = 16.7%), and the overall significance in comparison with NT (p < 0.05). The logistic regression showed ST was associated with preoperative CPC, transapical access, diabetes mellitus, and the critical preoperative state. Conclusions: Worse clinical outcomes are associated with both MT and ST after TAVI. In particular, ST is associated with higher in-hospital and 30-day mortality. Management of modifiable baseline and procedural variables may improve this outcome. Full article
(This article belongs to the Special Issue Transcatheter Aortic Valve Implantation (TAVI))
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12 pages, 1496 KiB  
Article
Rate and Risk Factors of Acute Myocardial Infarction after Debut of Chronic Kidney Disease—Results from the KidDiCo
by Jan Dominik Kampmann, James Goya Heaf, Christian Backer Mogensen, Sofie Ronja Petersen, Donna Lykke Wolff, Hans Mickley and Frans Brandt
J. Cardiovasc. Dev. Dis. 2022, 9(11), 387; https://doi.org/10.3390/jcdd9110387 - 9 Nov 2022
Cited by 3 | Viewed by 1990
Abstract
Chronic kidney disease (CKD) is a known risk factor for cardiovascular disease, including acute myocardial infarction. However, whether this risk is only associated with severe kidney disease or is also related to mildly impaired kidney function is still under debate. The incidence rate [...] Read more.
Chronic kidney disease (CKD) is a known risk factor for cardiovascular disease, including acute myocardial infarction. However, whether this risk is only associated with severe kidney disease or is also related to mildly impaired kidney function is still under debate. The incidence rate and risk factors of incident acute myocardial infarction (AMI) in patients with CKD are sparse. Potential differences in risk factor profiles between CKD patients with incident AMI and CKD patients with a prior AMI have not been sufficiently investigated. Furthermore, important factors such as albuminuria and socio-economic factors are often not included. The primary aim of this study was to establish the incidence rate of AMI after CKD debut. Secondly, to evaluate the importance of different CKD stages and the risk of having an AMI. Finally, to identify individuals at risk for AMI after CKD debut adjusted for prevalent AMI. Based on data from the kidney disease cohort of Southern Denmark (KidDiCo), including 66,486 CKD patients, we established incidence rates and characteristics of incident AMI among patients within a 5-year follow-up period after CKD debut. A Cox regression was performed to compute the cause-specific hazard ratios for the different risk factors. The incidence rate for CKD stage G3–5 patients suffering acute myocardial infarction is 2.5 cases/1000 people/year. In patients without a previous myocardial infarction, the risk of suffering a myocardial infarction after CKD debut was only significant in CKD stage G4 (HR = 1.402; (95% CI: 1.08–1.81); p-value = 0.010) and stage G5 (HR = 1.491; (95% CI: 1.01–2.19); p-value = 0.042). This was not the case in patients who had suffered an acute myocardial infarction prior to their CKD debut. In this group, a previous myocardial infarction was the most critical risk factor for an additional myocardial infarction after CKD debut (HR = 2.615; (95% CI: 2.241–3.05); p-value < 0.001). Irrespective of a previous myocardial infarction, age, male sex, hypertension, and a low educational level were significant risk factors associated with an acute myocardial infarction after CKD debut. The incidence rate of AMI in patients with CKD stage G3–5 was 2.5 cases/1000 people/year. Risk factors associated with incident AMI in CKD stage G3–5 patients were CKD stage, age, and hypertension. Female sex and higher educational levels were associated with a lower risk for AMI. Prior AMI was the most significant risk factor in patients with and without previous AMI before fulfilling CKD stage G3–5 criteria. Only age, sex, and a medium-long educational level were significant risk factors in this group. Full article
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17 pages, 2778 KiB  
Review
A Meta-Analysis on the Impact of High BMI in Patients Undergoing Transcatheter Aortic Valve Replacement
by Jiyoung Seo, Weijia Li, Israel Safiriyu, Amrin Kharawala, Sanjana Nagraj, Arooj Tahir, Ioannis Doundoulakis, Leonidas Koliastasis, Saul Rios, Leonidas Palaiodimos and Damianos G. Kokkinidis
J. Cardiovasc. Dev. Dis. 2022, 9(11), 386; https://doi.org/10.3390/jcdd9110386 - 9 Nov 2022
Cited by 5 | Viewed by 2523
Abstract
Background: A paradoxical association of obesity with lower risk of transcatheter aortic valve replacement (TAVR) outcomes has been reported. We aimed to systematically review the literature and compare TAVR-related morbidity and mortality among individuals with overweight or obesity and their peers with normal [...] Read more.
Background: A paradoxical association of obesity with lower risk of transcatheter aortic valve replacement (TAVR) outcomes has been reported. We aimed to systematically review the literature and compare TAVR-related morbidity and mortality among individuals with overweight or obesity and their peers with normal body mass index (BMI). Methods: PubMed and Embase databases were systematically searched for studies reporting TAVR outcomes in different BMI groups. Separate meta-analyses were conducted for studies reporting hazard ratios (HR) and odds ratios/relative risks. Short- and mid-/long-term outcomes were examined. Results: 26 studies with a total of 74,163 patients were included in our study. Overweight was associated with lower risk of short-term mortality (HR: 0.77; 95% CI: 0.60–0.98) and mid-/long-term mortality (HR: 0.79; 95% CI: 0.70–0.89). Obesity was associated with lower risk for mid-/long-term mortality (HR: 0.79; 95% CI: 0.73–0.86), but no difference was observed in short-term mortality, although a trend was noted (HR: 0.87l 95% CI: 0.74–1.01). Individuals with obesity demonstrated an association with higher odds of major vascular complications (OR: 1.33; 95% CI: 1.05–1.68). Both overweight (OR: 1.16; 95% CI: 1.03–1.30) and obesity (OR: 1.26; 95% CI: 1.06–1.50) were associated with higher likelihood for receiving permanent pacemakers after TAVR. Conclusion: Individuals with overweight and obesity were associated with lower mortality risk compared to those with normal BMI but with higher likelihood of major vascular complications and permanent pacemaker implantation after TAVR. Full article
(This article belongs to the Special Issue Transcatheter Aortic Valve Implantation (TAVI))
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15 pages, 4329 KiB  
Article
P66Shc (Shc1) Zebrafish Mutant Line as a Platform for Testing Decreased Reactive Oxygen Species in Pathology
by Landon Haslem, Jennifer M. Hays, Xin A. Zhang and Franklin A. Hays
J. Cardiovasc. Dev. Dis. 2022, 9(11), 385; https://doi.org/10.3390/jcdd9110385 - 9 Nov 2022
Viewed by 1855
Abstract
Reactive oxygen species (ROS) dysregulation exacerbates many pathologies but must remain within normal ranges to maintain cell function. Since ROS-mediated pathology and routine cell function are coupled, in vivo models evaluating low-ROS background effects on pathology are limited. Some models alter enzymatic antioxidant [...] Read more.
Reactive oxygen species (ROS) dysregulation exacerbates many pathologies but must remain within normal ranges to maintain cell function. Since ROS-mediated pathology and routine cell function are coupled, in vivo models evaluating low-ROS background effects on pathology are limited. Some models alter enzymatic antioxidant expression/activity, while others involve small molecule antioxidant administration. These models cause non-specific ROS neutralization, decreasing both beneficial and detrimental ROS. This is detrimental in cardiovascular pathology, despite the negative effects excessive ROS has on these pathologies. Thus, current trends in ROS-mediated pathology have shifted toward selective inhibition of ROS producers that are dysregulated during pathological insults, such as p66Shc. In this study, we evaluated a zebrafish heterozygote p66Shc hypomorphic mutant line as a low-ROS myocardial infarction (MI) pathology model that mimics mammalian MI. Our findings suggest this zebrafish line does not have an associated negative phenotype, but has decreased body mass and tissue ROS levels that confer protection against ROS-mediated pathology. Therefore, this line may provide a low-ROS background leading to new insights into disease. Full article
(This article belongs to the Special Issue Cellular Mechanisms of Cardiac Damage and Healing)
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5 pages, 6117 KiB  
Case Report
A Rare Case of Haemophilus Influenzae Serotype F Endocarditis Complicated by Concurrent Cardiogenic and Septic Shock: A Case of Challenging Management
by Michael Kwok, Wasiq Sheikh, Fabio V. Lima and Raymond Russell
J. Cardiovasc. Dev. Dis. 2022, 9(11), 384; https://doi.org/10.3390/jcdd9110384 - 9 Nov 2022
Cited by 1 | Viewed by 1559
Abstract
H. Influenza is a rare cause of endocarditis. We report a case of H. Influenza endocarditis that was complicated by cardiogenic and septic shock, active myocardial ischemia and aortic insufficiency. The goal of this report is to help recognize the signs and symptoms [...] Read more.
H. Influenza is a rare cause of endocarditis. We report a case of H. Influenza endocarditis that was complicated by cardiogenic and septic shock, active myocardial ischemia and aortic insufficiency. The goal of this report is to help recognize the signs and symptoms of endocarditis and to discuss management strategies in patients with concomitant cardiogenic and septic shock complicated by aortic insufficiency. Full article
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7 pages, 922 KiB  
Case Report
Combined Methylprednisolone Pulse Therapy plus Rituximab for Treating a Rare Juvenile Steroid-Resistant Nephrotic Syndrome with Cerebral Venous Sinus Thrombosis: A Case Report
by Hader I. Sakr, Burhan Edrees, Hussein Omar Taher, Tuleen Talal Miliany, Raneem Yasser Gazzaz, Asma Omar AlRuwaithi, Mohammed Fouad Alamer and Mostafa E. Metawee
J. Cardiovasc. Dev. Dis. 2022, 9(11), 383; https://doi.org/10.3390/jcdd9110383 - 8 Nov 2022
Cited by 2 | Viewed by 1995
Abstract
Background: Cerebral venous sinus thrombosis (CVST) secondary to nephrotic syndrome (NS) is rarely reported. Additionally, treating steroid-sensitive nephrotic syndrome (SSNS) that changes to steroid resistance (SRNS) is difficult, with many relapses and side effects. Case presentation: A 32-month-old SSNS male child [...] Read more.
Background: Cerebral venous sinus thrombosis (CVST) secondary to nephrotic syndrome (NS) is rarely reported. Additionally, treating steroid-sensitive nephrotic syndrome (SSNS) that changes to steroid resistance (SRNS) is difficult, with many relapses and side effects. Case presentation: A 32-month-old SSNS male child turned into SRNS and developed cerebral venous sinus thrombosis (CVST), a rare complication of NS. As a result of the administration of combined pulse methylprednisolone and IV Rituximab (RTX) therapy, the patient showed marked improvement, the results of urine analysis were remarkably improved, and the child started to respond to treatment. Conclusions: Successful treatment of a rare case of juvenile SSNS behaving as SRNS with the development of CVST could be established using combined steroid pulse therapy, Enoxaparin, and the B lymphocytes monoclonal antibodies RTX. Full article
(This article belongs to the Section Stroke and Cerebrovascular Disease)
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16 pages, 934 KiB  
Review
The Athlete’s Heart and Machine Learning: A Review of Current Implementations and Gaps for Future Research
by Ryan A. A. Bellfield, Sandra Ortega-Martorell, Gregory Y. H. Lip, David Oxborough and Ivan Olier
J. Cardiovasc. Dev. Dis. 2022, 9(11), 382; https://doi.org/10.3390/jcdd9110382 - 8 Nov 2022
Cited by 5 | Viewed by 3169
Abstract
Background: Intense training exercise regimes cause physiological changes within the heart to help cope with the increased stress, known as the “athlete’s heart”. These changes can mask pathological changes, making them harder to diagnose and increasing the risk of an adverse cardiac outcome. [...] Read more.
Background: Intense training exercise regimes cause physiological changes within the heart to help cope with the increased stress, known as the “athlete’s heart”. These changes can mask pathological changes, making them harder to diagnose and increasing the risk of an adverse cardiac outcome. Aim: This paper reviews which machine learning techniques (ML) are being used within athlete’s heart research and how they are being implemented, as well as assesses the uptake of these techniques within this area of research. Methods: Searches were carried out on the Scopus and PubMed online datasets and a scoping review was conducted on the studies which were identified. Results: Twenty-eight studies were included within the review, with ML being directly referenced within 16 (57%). A total of 12 different techniques were used, with the most popular being artificial neural networks and the most common implementation being to perform classification tasks. The review also highlighted the subgroups of interest: predictive modelling, reviews, and wearables, with most of the studies being attributed to the predictive modelling subgroup. The most common type of data used was the electrocardiogram (ECG), with echocardiograms being used the second most often. Conclusion: The results show that over the last 11 years, there has been a growing desire of leveraging ML techniques to help further the understanding of the athlete’s heart, whether it be by expanding the knowledge of the physiological changes or by improving the accuracies of models to help improve the treatments and disease management. Full article
(This article belongs to the Special Issue Recent Advances in Sports Cardiology)
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9 pages, 2583 KiB  
Article
Mesenchymal Stem Cell Transplantation Increases Antioxidant Protein Expression and Ameliorates GP91/ROS/Inflammasome Signals in Diabetic Cardiomyopathy
by Wei-Syun Hu, Tung-Sheng Chen, Ka-Hung Cheang, Wei-Yu Liao and Chin-Hsien Chang
J. Cardiovasc. Dev. Dis. 2022, 9(11), 381; https://doi.org/10.3390/jcdd9110381 - 7 Nov 2022
Viewed by 1409
Abstract
Background: Cardiomyopathy is one of the complications associated with diabetes. Due to its high prevalence, diabetic cardiomyopathy has become an urgent issue for diabetic patients. Various pathological signals are related to diabetic cardiomyopathy progress, including inflammasome. Mesenchymal stem cell transplantation is full of [...] Read more.
Background: Cardiomyopathy is one of the complications associated with diabetes. Due to its high prevalence, diabetic cardiomyopathy has become an urgent issue for diabetic patients. Various pathological signals are related to diabetic cardiomyopathy progress, including inflammasome. Mesenchymal stem cell transplantation is full of potential for the treatment of diabetic cardiomyopathy because of stem cell cardiac regenerative capability. This study investigates whether mesenchymal stem cell transplantation shows therapeutic effects on diabetic cardiomyopathy through inflammasome signaling regulation. Methods: Wistar male rats were divided into three groups including Sham, T1DM (rats with type 1 diabetes) and T1DM + WJSC (T1DM rats receiving 1 × 106 stem cells per rat). Results: Compared to the Sham, experimental results indicated that several pathological conditions can be observed in heart tissues with T1DM, including structural change, fibrosis, oxidative stress elevation and inflammasome related protein expression. All of these pathological conditions were significantly improved in T1DM rats receiving mesenchymal stem cell transplantation (T1DM + WJSC). Furthermore, the experimental findings suggest that mesenchymal stem cell transplantation exerted antioxidant protein expression in diabetic heart tissues, resulting in a decrease in oxidative stress and inflammasome signaling blockage. Conclusion: These findings imply that mesenchymal stem cell transplantation shows therapeutic effects on diabetic cardiomyopathy through inflammasome regulation induced by oxidative stress. Full article
(This article belongs to the Section Cardiac Development and Regeneration)
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17 pages, 2263 KiB  
Article
Association between the Changes in Trimethylamine N-Oxide-Related Metabolites and Prognosis of Patients with Acute Myocardial Infarction: A Prospective Study
by Nan Li, Ying Wang, Jinying Zhou, Runzhen Chen, Jiannan Li, Xiaoxiao Zhao, Peng Zhou, Chen Liu, Yi Chen, Li Song, Hanjun Zhao, Hongbing Yan and Shaodi Yan
J. Cardiovasc. Dev. Dis. 2022, 9(11), 380; https://doi.org/10.3390/jcdd9110380 - 4 Nov 2022
Cited by 7 | Viewed by 1661
Abstract
This study aimed to investigate the association between changes in levels of trimethylamine N-oxide (TMAO) and its precursors and the prognosis of patients with acute myocardial infarction (AMI). Patients diagnosed with AMI were prospectively enrolled at Fuwai Hospital between March 2017 and January [...] Read more.
This study aimed to investigate the association between changes in levels of trimethylamine N-oxide (TMAO) and its precursors and the prognosis of patients with acute myocardial infarction (AMI). Patients diagnosed with AMI were prospectively enrolled at Fuwai Hospital between March 2017 and January 2020. TMAO, betaine, choline, and L-carnitine were measured in 1203 patients at their initial admission and 509 patients at their follow-up of one month. Major adverse cardiovascular events (MACE), a composite of all-cause death, recurrence of MI, rehospitalization caused by HF, ischemic stroke, and any revascularization, were followed up. A decision tree by TMAO levels implicated that compared to those with low levels at admission, patients with high TMAO levels at both time points showed an increased risk of MACE (adjusted hazard ratio (HR) 1.59, 95% confidence interval (CI): 1.03–2.46; p = 0.034), while patients with high TMAO levels at admission and low levels at follow-up exhibited a similar MACE risk (adjusted HR 1.20, 95% CI: 0.69–2.06; p = 0.520). Patients with high choline levels at admission and follow-up showed an elevated MACE risk compared to those with low levels at both time points (HR 1.55, 95% CI: 1.03–2.34; p = 0.034). Repeated assessment of TMAO and choline levels helps to identify the dynamic risk of cardiovascular events. Full article
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16 pages, 20381 KiB  
Article
OCT Meets micro-CT: A Subject-Specific Correlative Multimodal Imaging Workflow for Early Chick Heart Development Modeling
by Nina Kraus, Fabian Placzek and Brian Metscher
J. Cardiovasc. Dev. Dis. 2022, 9(11), 379; https://doi.org/10.3390/jcdd9110379 - 3 Nov 2022
Cited by 2 | Viewed by 2099
Abstract
Structural and Doppler velocity data collected from optical coherence tomography have already provided crucial insights into cardiac morphogenesis. X-ray microtomography and other ex vivo methods have elucidated structural details of developing hearts. However, by itself, no single imaging modality can provide comprehensive information [...] Read more.
Structural and Doppler velocity data collected from optical coherence tomography have already provided crucial insights into cardiac morphogenesis. X-ray microtomography and other ex vivo methods have elucidated structural details of developing hearts. However, by itself, no single imaging modality can provide comprehensive information allowing to fully decipher the inner workings of an entire developing organ. Hence, we introduce a specimen-specific correlative multimodal imaging workflow combining OCT and micro-CT imaging which is applicable for modeling of early chick heart development—a valuable model organism in cardiovascular development research. The image acquisition and processing employ common reagents, lab-based micro-CT imaging, and software that is free for academic use. Our goal is to provide a step-by-step guide on how to implement this workflow and to demonstrate why those two modalities together have the potential to provide new insight into normal cardiac development and heart malformations leading to congenital heart disease. Full article
(This article belongs to the Special Issue Models and Methods for Computational Cardiology)
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