Cardiovascular Diseases: From Pathophysiology to Novel Therapeutic Approaches

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

Deadline for manuscript submissions: 30 June 2025 | Viewed by 2032

Special Issue Editors


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Guest Editor
Department of Internal Medicine, School of Medicine, Federico II University, Via Sergio Pansini 5, 80135 Naples, Italy
Interests: hormones and heart; cardiac failure; insulin resistance; hyperinsulinism; metabolic syndrome; nutraceuticals; pulmonary arterial hypertension; COVID-19
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Guest Editor
Department of Translational Medical Sciences, Federico II University, Naples, Italy
Interests: heart failure; echocardiography; right ventricular function; pulmonary vascular disease; pulmonary arterial hypertension; cardio-oncology
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Despite the considerable progress made over recent decades in the treatment and prevention of cardiovascular diseases, they still remain the leading cause of hospitalizations and deaths in developed and developing countries. It is likely that we are missing something! We have therefore developed a Special Issue, entitled "Cardiovascular Diseases: From Pathophysiology to Novel Therapeutic Approaches", which addresses this problem in depth, collecting manuscripts that can contribute to the in-depth study of the topic and try to clarify what has been done and what can still be done to reduce the risks related to cardiovascular diseases, from both therapeutic and preventive point of views. For example, a condition that has considerable scientific literature to support it, but which is still rather neglected, is insulin resistance with associated hyperinsulinemia. This condition, which in itself should already be considered an independent risk factor for the development of cardiovascular diseases, when elevated to a risk factor is often treated only too late, namely when it transforms into type 2 diabetes mellitus. It is very likely that if we intervened earlier with screening and therapy, we could obtain a notable prognostic improvement.

Dr. Serafino Fazio
Dr. Valentina Mercurio
Guest Editors

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Keywords

  • cardiovascular diseases
  • heart failure
  • cardiac arrhythmias
  • metabolic syndrome
  • stroke
  • pulmonary hypertension
  • peripheral artery disease (PAD)
  • acute coronary syndrome
  • myocarditis
  • pericarditis
  • valvulopathies

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Published Papers (3 papers)

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Research

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17 pages, 2157 KiB  
Article
Different Effects of Riociguat and Vericiguat on Pulmonary Vessels and Airways
by Katharina Nubbemeyer, Julia Krabbe, Svenja Böll, Anna Michely, Sebastian Kalverkamp, Jan Spillner and Christian Martin
Biomedicines 2025, 13(4), 856; https://doi.org/10.3390/biomedicines13040856 - 2 Apr 2025
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Abstract
Background/Objectives: Pulmonary hypertension is a progressive disease leading to right heart failure. One treatment strategy is to induce vasodilation via the nitric oxide–soluble guanylate cyclase–cyclic guanosine monophosphate (NO–sGC–cGMP) signaling pathway. There are currently two soluble guanylate cyclase stimulators on the market: Riociguat [...] Read more.
Background/Objectives: Pulmonary hypertension is a progressive disease leading to right heart failure. One treatment strategy is to induce vasodilation via the nitric oxide–soluble guanylate cyclase–cyclic guanosine monophosphate (NO–sGC–cGMP) signaling pathway. There are currently two soluble guanylate cyclase stimulators on the market: Riociguat and vericiguat, with vericiguat having a longer half-life and needing to be taken only once a day. This study investigated whether the pharmacological differences between the drugs affect pulmonary vessels and airways. Methods: The effects of vericiguat and riociguat on pulmonary arteries, veins, and airways were studied using rat precision-cut lung slices (PCLS). Vessels were pretreated with endothelin-1 and airways with serotonin. In isolated perfused lungs (IPL), the effects of sGC stimulation on pulmonary artery pressure (PAP), airway resistance, inflammatory cytokine, and chemokine release were quantified. Results: Riociguat and vericiguat caused pulmonary artery dilation in PCLS. During IPL, riociguat was more effective than vericiguat in reducing PAP with a statistically significant reduction of 10%. Both drugs were potent bronchodilators in preconstricted airways (p < 0.001). Only vericiguat reduced airway resistance during IPL, as shown here for the first time. Both drugs significantly reduced IL-6 and IL-1ß levels, while riociguat also reduced VEGF-A and KC-GRO levels. Conclusions: Riociguat and vericiguat had three main effects in the two rat ex-vivo models: They dilated the pulmonary arteries, induced bronchodilation, and reduced inflammation. These properties could make sGC stimulators useful for treating diseases associated with endothelial dysfunction. In the future, vericiguat may provide an alternative treatment to induce bronchodilation in respiratory diseases. Full article
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11 pages, 1196 KiB  
Article
Circulating Microvesicles Enriched in miR–126–5p and miR–223–3p: Potential Biomarkers in Acute Coronary Syndrome
by José Rubicel Hernández-López, Mirthala Flores-García, Esbeidy García-Flores, Benny Giovanni Cazarín-Santos, Marco Antonio Peña-Duque, Fausto Sánchez-Muñoz, Martha Alicia Ballinas-Verdugo, Hilda Delgadillo-Rodríguez, Marco Antonio Martínez-Ríos, Eduardo Angles-Cano and Aurora de la Peña-Díaz
Biomedicines 2025, 13(2), 510; https://doi.org/10.3390/biomedicines13020510 - 18 Feb 2025
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Abstract
Background. The molecular mechanisms underlying acute coronary syndrome (ACS) have been extensively investigated, with a particular focus on the role of circulating microvesicles (MVs) as carriers of regulatory elements that influence hemodynamic changes and coronary flow. Endothelial and platelet dysfunction during ACS alters [...] Read more.
Background. The molecular mechanisms underlying acute coronary syndrome (ACS) have been extensively investigated, with a particular focus on the role of circulating microvesicles (MVs) as carriers of regulatory elements that influence hemodynamic changes and coronary flow. Endothelial and platelet dysfunction during ACS alters MV composition, impacting clinical outcomes. This study explores the levels of miR–126–5p and miR–223–3p in circulating MVs and their association with the Thrombolysis in Myocardial Infarction (TIMI) coronary flow classification scale, proposing their potential as biomarkers. Methods. Bioinformatic tools identified miRNAs linked to ACS. Plasma MVs were isolated from ACS patients and healthy controls through high-speed centrifugation. miRNA levels were quantified using quantitative reverse transcription polymerase chain reaction (qRT-PCR) and compared across TIMI 0 and TIMI 3 groups. Diagnostic efficacy was assessed via receiver operating characteristic (ROC) curve analysis. Results. The bioinformatic analysis identified miR–126 and miR–223 present in ACS. miR–126–5p and miR–223–3p were significantly reduced in MVs from TIMI 0 patients compared to TIMI 3. ROC analysis showed high diagnostic accuracy for miR–126–5p (AUC = 0.918; 95% CI: 0.818–1.00; p = 0.001) and miR–223–3p (AUC = 1.00; 95% CI: 1.00–1.00; p < 0.001). Conclusions. Reduced levels of miR–126–5p and miR–223–3p in circulating MVs are strongly associated with impaired coronary flow, positioning these miRNAs as potential biomarkers for ACS risk stratification and therapeutic targeting. Full article
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9 pages, 1015 KiB  
Case Report
Renal Abscess Associated with SGLT2 Inhibitors Administration in Heart Failure Without Other Previous Risk Factors: A Case Report
by Madalina Andreea Munteanu, Camelia Nicolae, Razvan Ionut Popescu, Andreea Rusescu, Nicolae Paun and Tiberiu Ioan Nanea
Biomedicines 2025, 13(2), 389; https://doi.org/10.3390/biomedicines13020389 - 6 Feb 2025
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Abstract
Background and Clinical Significance: Renal abscess represents one infectious urological complication with lethal potential. The treatment of this pathology may differ depending on the severity of the symptoms and the size of the infectious collection. Diabetes, immunosuppression, and associated urinary pathologies are most [...] Read more.
Background and Clinical Significance: Renal abscess represents one infectious urological complication with lethal potential. The treatment of this pathology may differ depending on the severity of the symptoms and the size of the infectious collection. Diabetes, immunosuppression, and associated urinary pathologies are most frequently responsible for the development of abscesses. This case report presents the first documented case of a renal abscess associated with Sodium-glucose cotransporter 2 (SGLT2) inhibitors in a person without previous predisposing pathologies. Case Presentation: A 62-year-old patient presented to the emergency department for pain in the right flank, vomiting, and dysuria. The patient’s medical history revealed Heart Failure New York Heart Association (NYHA) Class II, Coronary Artery Disease (CAD) with prior angioplasty, and permanent Atrial Fibrillation. No prior urological or immunosuppressive conditions were detected. The Computed Tomography (CT) evaluation confirmed the ultrasound suspicion of a right renal abscess performed in the emergency room. The only risk factor identified was the initiation of SGLT2 inhibitor therapy for cardiac pathology approximately 2 months before. According to the small dimensions and urine culture, the abscess was successfully treated with antibiotic administration in collaboration with the urology department. The infectious process was remitted within 2 weeks. Conclusions: To our knowledge this is the first documented case of a renal abscess associated with SGLT2 inhibitor administration in a person without previous predisposing risk factors. Despite the relatively low incidence of urinary tract infections (UTIs) associated with SGLT2 inhibitors, their widespread use in the treatment of various socially significant conditions highlights the need for both patients and medical specialists to be aware of all potential risks and pay increased attention to these cases. Full article
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