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Cardiac and Vascular Diseases: Pathogenesis, Pharmacological Treatments, Advances in Therapies...
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Cardiac and Vascular Diseases: Pathogenesis, Pharmacological Treatments, Advances in Therapies (3rd Edition)

A special issue of Biomedicines (ISSN 2227-9059). This special issue belongs to the section "Molecular and Translational Medicine".

Deadline for manuscript submissions: closed (31 January 2026) | Viewed by 9577

Special Issue Editors

Dr. Francesco Massari

E-Mail Website
Guest Editor
Cardiology Department, Perinei Hospital, Bari, Italy
Interests: heart failure; cardiomyopathies; cardiac physiology; cardiorenal syndrome; cardiovascular pharmacology
Special Issues, Collections and Topics in MDPI journals
Prof. Dr. Pietro Scicchitano

E-Mail Website
Guest Editor
Cardiology Department, Perinei Hospital, Bari, Italy
Interests: noninvasive assessment; heart failure; arrhythmias; preventive cardiology; cardiovascular pharmacology; cardio-oncology
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Cardiovascular diseases are the leading cause of death worldwide. The relationship between cardiac and vascular structures is not always considered, and these diseases are often underdiagnosed.

The focus of this Special Issue is to develop new insights into the pathogenesis of vascular alterations in cardiac diseases by outlining the complex genetic, biochemical, and molecular aspects at the center of these alterations.

Early identification of cardiac and vascular diseases as well as the correct evaluation of mechanisms and pathogenetic pathways will help to promote the development of targeted therapies.

This Special Issue also aims to cover the landscape of cardiovascular pharmacology. Authors are invited to contribute their research in the field of pharmacological approaches to cardiac and vascular diseases by outlining the most recent advances in therapies and treatments.

The combination of research in pathogenesis and pharmacology will give a comprehensive overview of cardiovascular diseases and the attempts to improve outcomes for patients.

Dr. Francesco Massari
Prof. Dr. Pietro Scicchitano
Guest Editors

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Keywords

  • endothelial function
  • cardiomyopathies
  • cardiovascular pharmacology
  • cardiac therapeutics
  • noninvasive vascular treatments
  • molecular cardiac biomarkers
  • molecular vascular biomarkers

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Published Papers (6 papers)

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16 pages, 895 KB  
Article
Alveolar and Bronchial Nitric Oxide Parameters in Pre-Capillary Pulmonary Hypertension
by Balázs Csoma, Gergő Szűcs, András Bikov, Zsolt Dezső Rozgonyi, Alexandra Nagy, Zsombor Matics, Veronika Müller, Kristóf Karlócai, Györgyi Csósza and Zsófia Lázár
Biomedicines 2025, 13(12), 2957; https://doi.org/10.3390/biomedicines13122957 - 1 Dec 2025
Viewed by 1050
Abstract
Background: Exhaled NO concentrations at different flow rates can be used to calculate pulmonary NO dynamics in the conductive and peripheral airways and can be described by the total bronchial flux of NO (JawNO) and alveolar NO concentration (CANO), [...] Read more.
Background: Exhaled NO concentrations at different flow rates can be used to calculate pulmonary NO dynamics in the conductive and peripheral airways and can be described by the total bronchial flux of NO (JawNO) and alveolar NO concentration (CANO), respectively. Changes in these parameters have been shown in pre-capillary pulmonary hypertension (PH); however, data from studies with low sample sizes are controversial and did not prospectively assess JawNO and CANO after adequate therapy. Methods: Patients with untreated pre-capillary PH (group 1: N = 23, group 3: N = 11, group 4: N = 18) and control subjects (N = 27) were recruited in a single-center observational study. Patients with group 1 (N = 15) and group 4 PH (N = 13) also attended a single follow-up visit when on pulmonary vasodilators or following interventions. Exhaled NO concentrations were measured at 50 mL/s and 100–250 mL/s expiratory flows and the two-compartment linear model was used for the calculation of JawNO and CANO. Results: CANO was higher in patients (median (interquartile range) 3.84 (2.64–7.29) ppb) than in control subjects (2.70 (1.85–4.29) ppb, p < 0.01; Mann–Whitney test) without a difference among PH groups or an association with survival. CANO showed moderate negative associations with the diffusion capacity of the lung for carbon monoxide (Spearman r = −0.41, p < 0.01) and a trend for mortality risk categories in groups 1 and 4 (r = −0.30, p = 0.06). Only JawNO changed at follow-up (0.69 (0.14–1.10) vs. 0.91 (0.40–1.68) nL/s, p = 0.02; Wilcoxon test), and there was a positive correlation between its increase and the improvement in 6 min walk distance (r = 0.40, p = 0.04). Conclusions: Alveolar NO concentration is increased in patients with pre-capillary PH, and the change in JawNO is related to the improvement in exercise capacity in PH groups 1 and 4. This is the first study implying that JawNO might be a non-invasive marker responsive to improved pulmonary hemodynamics in PH. Full article
(This article belongs to the Special Issue Cardiac and Vascular Diseases: Pathogenesis, Pharmacological Treatments, Advances in Therapies (3rd Edition))
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17 pages, 3747 KB  
Article
Drug Repurposing for AML: Structure-Based Virtual Screening and Molecular Simulations of FDA-Approved Compounds with Polypharmacological Potential
by Mena Abdelsayed and Yassir Boulaamane
Biomedicines 2025, 13(11), 2605; https://doi.org/10.3390/biomedicines13112605 - 24 Oct 2025
Cited by 3 | Viewed by 1583
Abstract
Background: Acute myeloid leukemia (AML) is a heterogeneous hematologic malignancy characterized by impaired differentiation, apoptosis resistance, and metabolic reprogramming, which collectively contribute to therapeutic resistance and poor clinical outcomes. While targeted agents—such as LSD1 inhibitors, the BCL-2 inhibitor venetoclax, and IDH1 inhibitors—have provided [...] Read more.
Background: Acute myeloid leukemia (AML) is a heterogeneous hematologic malignancy characterized by impaired differentiation, apoptosis resistance, and metabolic reprogramming, which collectively contribute to therapeutic resistance and poor clinical outcomes. While targeted agents—such as LSD1 inhibitors, the BCL-2 inhibitor venetoclax, and IDH1 inhibitors—have provided clinical benefit, their efficacy is often limited by compensatory signaling and clonal evolution. This study aimed to identify FDA-approved compounds with multitarget potential to simultaneously modulate key epigenetic, apoptotic, and metabolic pathways in AML. Methods: Structure-based virtual screening of 3957 FDA-approved molecules was performed against three AML-relevant targets: lysine-specific demethylase 1 (LSD1), BCL-2, and mutant IDH1 (R132H). Top-ranked hits were evaluated using ADMET prediction and molecular dynamics (MD) simulations to assess pharmacokinetic properties, toxicity, and ligand–protein complex stability over 100 ns trajectories. Results: Three compounds—DB16703, DB08512, and DB16047—exhibited high binding affinities across all three targets with favorable pharmacokinetic and safety profiles. MD simulations confirmed the structural stability of the ligand–protein complexes, revealing persistent hydrogen bonding and minimal conformational deviation. These findings suggest that these repurposed drugs possess a promising multitarget profile capable of addressing AML’s multifactorial pathophysiology. Conclusions: This computational study supports the feasibility of a polypharmacology-based strategy for AML therapy by integrating epigenetic modulation, apoptotic reactivation, and metabolic correction within single molecular scaffolds. However, the identified compounds (Belumosudil, DB08512, and Elraglusib) have not yet demonstrated efficacy in AML models; further preclinical validation is warranted to substantiate these predictions and advance translational development. Full article
(This article belongs to the Special Issue Cardiac and Vascular Diseases: Pathogenesis, Pharmacological Treatments, Advances in Therapies (3rd Edition))
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17 pages, 1005 KB  
Article
Hemodynamic and Clinical Predictors of Thrombolysis in Post-COVID Venous Thromboembolism: A Retrospective Cohort Study
by Giulia-Mihaela Cojocaru, Antoniu Octavian Petriş, Alin-Constantin Pînzariu, Tudor Cojocaru, Andreea Coca, Ruxandra Cojocaru, Catherine-Teodora Costan, Victorița Șorodoc and Elena Cojocaru
Biomedicines 2025, 13(9), 2232; https://doi.org/10.3390/biomedicines13092232 - 10 Sep 2025
Viewed by 1031
Abstract
Objectives: Post-acute venous thromboembolism (VTE) is a well-recognized complication of COVID-19, driven by persistent endothelial dysfunction and thromboinflammation. Identifying simple clinical predictors of VTE may optimize therapy and limit adverse outcomes. We propose a pragmatic risk-stratification approach, based on clinical and echocardiographic parameters. [...] Read more.
Objectives: Post-acute venous thromboembolism (VTE) is a well-recognized complication of COVID-19, driven by persistent endothelial dysfunction and thromboinflammation. Identifying simple clinical predictors of VTE may optimize therapy and limit adverse outcomes. We propose a pragmatic risk-stratification approach, based on clinical and echocardiographic parameters. Methods: We conducted a retrospective cohort study in a Romanian tertiary hospital (March 2020–April 2022) in 54 adults with laboratory-confirmed COVID-19 and imaging-confirmed VTE. Demographics, comorbidities, laboratory markers, and echocardiographic variables—particularly tricuspid annular plane systolic excursion (TAPSE), peripheral oxygen saturation (SpO2), and left-ventricular end-diastolic diameter (LVEDD)—were collected. The primary outcome was the percentage of patients receiving systemic thrombolysis. Statistical analyses included Mann–Whitney U tests, chi-square, Spearman correlations, and multivariable logistic regression. Results: The mean age was 61.2 ± 14.7 years, and 63% were men. Eleven patients (20.4%) underwent thrombolysis. Compared with conservatively managed patients, those receiving thrombolysis had lower TAPSE (13.0 vs. 20.8 mm), lower SpO2 (90.1 vs. 97.0%), and smaller LVEDD (24.4 vs. 46.1 mm); all differences were statistically significant. Each 1 mm decrease in TAPSE and 1% decrease in SpO2 increased the likelihood of thrombolysis (adjusted odds ratios 1.58 and 1.34, respectively). Inflammatory markers and right-ventricular diameter were not associated with treatment. Conclusions: Reduced TAPSE, lower SpO2, and decreased LVEDD identify post-COVID VTE patients at elevated risk of hemodynamic compromise requiring thrombolysis. A point-of-care assessment incorporating these variables may improve early risk stratification and guide therapeutic decisions. Full article
(This article belongs to the Special Issue Cardiac and Vascular Diseases: Pathogenesis, Pharmacological Treatments, Advances in Therapies (3rd Edition))
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14 pages, 3511 KB  
Article
CMR-Derived Strain and Torsion Reveal Subclinical Dysfunction in Hypertrophic Cardiomyopathy: A Prospective Case–Control Study
by Alexandru Zlibut, Ioana Danuta Muresan, Michael Bietenbeck, Andrei Dan Radu and Lucia Agoston-Coldea
Biomedicines 2025, 13(8), 1986; https://doi.org/10.3390/biomedicines13081986 - 15 Aug 2025
Cited by 1 | Viewed by 1199
Abstract
Background: Hypertrophic cardiomyopathy (HCM) is frequently associated with preserved left ventricular ejection fraction (LVEF), yet subclinical myocardial dysfunction often escapes detection using conventional imaging. Cardiac magnetic resonance (CMR) with feature tracking (FT) enables precise assessment of myocardial deformation and mechanics. Methods: [...] Read more.
Background: Hypertrophic cardiomyopathy (HCM) is frequently associated with preserved left ventricular ejection fraction (LVEF), yet subclinical myocardial dysfunction often escapes detection using conventional imaging. Cardiac magnetic resonance (CMR) with feature tracking (FT) enables precise assessment of myocardial deformation and mechanics. Methods: In this prospective case–control study, we evaluated 150 HCM patients and 100 age- and sex-matched healthy controls using standardized CMR protocols. Global longitudinal strain (GLS), circumferential strain (GCS), radial strain (GRS), and left ventricular (LV) torsion were quantified via FT-CMR. Myocardial fibrosis was assessed through late gadolinium enhancement (LGE), native T1 mapping, and extracellular volume (ECV). Results: HCM patients showed significantly impaired strain and torsion metrics compared with controls: GLS (−16% vs. −20%), GCS (−18% vs. −21%), GRS (29% vs. 38%), and global LV torsion (1.27°/cm vs. 1.95°/cm), all p < 0.001. These abnormalities were also observed in LGE-negative patients, suggesting early functional remodeling. Global LV torsion demonstrated the highest diagnostic performance for LGE detection (AUC = 0.995), surpassing those of GLS (0.877), native T1 (0.731), and ECV (0.657). A cut-off value of 0.7°/cm provided optimal sensitivity and specificity, and was associated with adverse prognosis in survival analysis. Conclusions: CMR-derived strain and torsion parameters detect early myocardial dysfunction in HCM beyond conventional markers. Global LV torsion, in particular, emerges as a sensitive and robust non-invasive marker with diagnostic and prognostic potential. Full article
(This article belongs to the Special Issue Cardiac and Vascular Diseases: Pathogenesis, Pharmacological Treatments, Advances in Therapies (3rd Edition))
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11 pages, 996 KB  
Article
The Prognostic Value of Non-Invasive Ventilation in Patients with Acute Heart Failure
by Pietro Scicchitano, Assunta Cinelli, Gaetano Citarelli, Anna Livrieri, Cosimo Campanella, Micaela De Palo, Pasquale Caldarola, Marco Matteo Ciccone and Francesco Massari
Biomedicines 2025, 13(8), 1844; https://doi.org/10.3390/biomedicines13081844 - 29 Jul 2025
Viewed by 2966
Abstract
Objectives: Patients with acute heart failure (AHF) often receive initial non-invasive ventilation (NIV). This study aimed to evaluate the prognostic role of NIV in patients hospitalized for AHF. Methods: This was a retrospective cohort study. We enrolled patients admitted to our cardiac intensive [...] Read more.
Objectives: Patients with acute heart failure (AHF) often receive initial non-invasive ventilation (NIV). This study aimed to evaluate the prognostic role of NIV in patients hospitalized for AHF. Methods: This was a retrospective cohort study. We enrolled patients admitted to our cardiac intensive care unit with a diagnosis of AHF. Anthropometric, clinical, pharmacological, and instrumental assessments were collected. Both in-hospital and 180-day post-discharge mortality were evaluated. Results: Among 200 patients (mean age 81 ± 9 years; 52% male), NIV was applied in 80 cases (40%). These patients had more severe NYHA functional class, a higher prevalence of de novo AHF, required higher diuretic doses, and had longer hospital stays. In multivariate analysis, NIV remained significantly associated with length of stay (LOS) (r = 0.26; p = 0.0004). In-hospital mortality was 5% overall and significantly higher in the NIV group compared to non-NIV patients (10% vs. 1.6%, p < 0.001). At 180 days, mortality was also significantly higher in the NIV group [hazard ratio (HR) 1.84; 95% confidence interval (CI): 1.18–2.85; p = 0.006]. After adjusting for age, BNP, CRP, arterial blood gas parameters, renal function, and LVEF, NIV remained an independent predictor of 180-day mortality (HR 1.61; 95% CI: 1.01–2.54; p = 0.04). Conclusions: Patients with AHF who required NIV exhibited more severe disease and longer hospital stays. NIV use was independently associated with both in-hospital and post-discharge mortality, suggesting its potential role as a prognostic marker in AHF. Full article
(This article belongs to the Special Issue Cardiac and Vascular Diseases: Pathogenesis, Pharmacological Treatments, Advances in Therapies (3rd Edition))
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20 pages, 1803 KB  
Systematic Review
Dedicated Bifurcation Stents vs. Regular Drug-Eluting Stents in Coronary Bifurcation Treatment: A Systematic Review and Meta-Analysis of 1-Year and 4-Year Outcomes, Including Left Main and Non-Left Main Subgroup Comparisons
by Jacek Bil, Adam Kern, Aneta I. Gziut-Rudkowska, Jarosław Zalewski, Krystian Bojko and Robert J. Gil
Biomedicines 2025, 13(11), 2763; https://doi.org/10.3390/biomedicines13112763 - 12 Nov 2025
Viewed by 1001
Abstract
Background: Dedicated bifurcation stents (DBS) were developed to overcome the limitations of conventional drug-eluting stents (DES) in percutaneous coronary intervention (PCI) for bifurcation lesions, but their clinical benefit remains uncertain. Methods: We conducted a systematic review and meta-analysis of randomized trials [...] Read more.
Background: Dedicated bifurcation stents (DBS) were developed to overcome the limitations of conventional drug-eluting stents (DES) in percutaneous coronary intervention (PCI) for bifurcation lesions, but their clinical benefit remains uncertain. Methods: We conducted a systematic review and meta-analysis of randomized trials comparing DBS with contemporary DES in bifurcation PCI. Primary outcomes included all-cause death, myocardial infarction (MI), and target lesion revascularization (TLR) at 1 and 4 years. Subgroup analyses were performed for left main (LM) and non-LM bifurcations. Results: Ten trials involving approximately 2500 patients were analyzed. At 1 year, DBS and DES demonstrated similar rates of all-cause death (RR 1.12, 95% CI 0.81–1.55), MI (RR 0.80, 95% CI 0.38–1.69), and TLR (RR 1.23, 95% CI 0.79–1.90). At 4 years, results remained consistent: all-cause death (RR 1.10, 95% CI 0.75–1.60), MI (RR 0.66, 95% CI 0.29–1.49), and TLR (RR 1.29, 95% CI 0.86–1.94). No significant differences were observed between LM and non-LM subgroups, and no excess in late stent thrombosis was detected. Conclusions: DBS are safe and provide outcomes comparable to DES in bifurcation PCI. Their use may be reasonable in selected anatomies, but larger trials are needed to define their clinical advantage. Full article
(This article belongs to the Special Issue Cardiac and Vascular Diseases: Pathogenesis, Pharmacological Treatments, Advances in Therapies (3rd Edition))
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