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Diagnostics
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Clinical Diagnosis and Management in Cardiology
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Clinical Diagnosis and Management in Cardiology

A special issue of Diagnostics (ISSN 2075-4418). This special issue belongs to the section "Clinical Diagnosis and Prognosis".

Deadline for manuscript submissions: 30 June 2025 | Viewed by 6729

Special Issue Editor

Dr. Oskars Kalejs

E-Mail Website
Guest Editor
1. Department of Internal Diseases, Pauls Stradins Clinical University Hospital, 13 Pilsoņu Str., LV-1002 Rīga, Latvia
2. Department of Internal Diseases, Faculty of Medicine, Rīga Stradins University, 16 Dzirciema Str., LV-1007 Rīga, Latvia
Interests: atrial fibrillation; cardiac surgery; cardiovascular surgery; pacemakers; heart valve diseases

Special Issue Information

Dear Colleagues,

The clinical diagnosis and management of cardiology play a crucial role in the field of medicine, involving the accurate identification and assessment of heart diseases, as well as the formulation and implementation of effective treatment plans.

The clinical diagnosis of cardiology typically relies on a series of detailed examinations and tests. Firstly, doctors collect patients’ medical history information and symptom descriptions to obtain initial diagnostic clues. Subsequently, through physical examination, doctors can observe certain signs of heart disease, such as heart murmurs and arrhythmias. Further diagnostic tools include electrocardiogram (ECG) testing, a non-invasive method that records the electrical activity of the heart, aiding in the diagnosis of arrhythmias, myocardial ischemia, and other issues. Additionally, imaging techniques such as echocardiography, radionuclide testing, magnetic resonance imaging (MRI), and computed tomography (CT) provide visual representations of the heart's structure and function, crucial for diagnosing valvular heart disease, cardiomyopathy, coronary heart disease, and other conditions. In some cases, doctors may also perform blood tests to detect markers of myocardial injury, lipid levels, and other biochemical indicators that help with making diagnoses.

This Special Issue aims to improve our knowledge on the latest advances in the diagnosis and management of cardiology, providing valuable insights for medical professionals and researchers.

Dr. Oskars Kalejs
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Diagnostics is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • cardiology
  • heart disease
  • arrhythmia
  • myocardial infarction
  • angina pectoris
  • coronary artery disease
  • echocardiography

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Published Papers (7 papers)

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11 pages, 2225 KiB  
Article
The Potential Morphological Stenosis Pattern of the Arcuate Foramen
by Ioannis Paschopoulos, Maria Piagkou, George Triantafyllou, Panagiotis Papadopoulos-Manolarakis, Fabrice Duparc, Fotis Demetriou, George Tsakotos, Rǎzvan-Costin Tudose, Mugurel Constantin Rusu and Oana Daniela Toader
Diagnostics 2025, 15(10), 1203; https://doi.org/10.3390/diagnostics15101203 - 9 May 2025
Viewed by 192
Abstract
Background: The arcuate foramen (AF), an osseous foramen, is probably formatted from the ossification of the posterior atlanto-occipital membrane. When this morphologically ossified variant exists, it encloses the vertebral artery (VA) third segment (V3). This close relationship may cause compression to the [...] Read more.
Background: The arcuate foramen (AF), an osseous foramen, is probably formatted from the ossification of the posterior atlanto-occipital membrane. When this morphologically ossified variant exists, it encloses the vertebral artery (VA) third segment (V3). This close relationship may cause compression to the VA with concomitant vertebrobasilar insufficiency, vertigo, headaches, or neck pain. In the published literature, no studies investigate the abovementioned potential compression pattern. The present study examines the AF ossification pattern (complete or partial type) and the variable VA diameter at the atlantal part (V3), concluding a potential risk for VA compression after correlating the relative diameters (AF and VA diameters). Materials and Methods: One hundred and fifty dried first cervical vertebrae (atlases) and one hundred fifty computed tomography (CT) scans were obtained for the present study. The presence of a complete or incomplete AF was evaluated, and when present, its diameter was measured. To correlate these findings with the vessel, 50 computed tomography angiographies (without AF presence) were obtained to measure the V3 segment diameter. Results: Out of the total 600 (N = 600) sides, 111 sides had incomplete AF (18.2%), and 67 sides had complete AF (11.1%). The AF mean diameter was 6.41 (1.12) mm. The diameter of the V3 segment ranged between 5.0 and 6.0 mm; therefore, three morphological stenosis patterns were identified. A low risk of compression (over 6.0 mm) was identified in 61.2% (N = 109 sides), a moderate risk (between 5.0–6.0 mm) was observed in 29.2% (N = 52 sides), and a high risk (under 5.0 mm) was recorded in 9.6% (N = 17 sides). There was no statistically significant correlation regarding sexes and age for the potential compression patterns. Conclusions: The present study revealed the morphological stenosis pattern of the AF to the V3 segment. The variation had a high risk of compression to the vessel in 9.6% of sides, indicating that it is not infrequent. Knowledge of these details is essential for clinicians when investigating vertebrobasilar insufficiency. Full article
(This article belongs to the Special Issue Clinical Diagnosis and Management in Cardiology)
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11 pages, 819 KiB  
Article
Lipoprotein(a) as a Risk Factor for Recurrent Acute Myocardial Infarction and Mortality: Insights from Routine Clinical Practice
by David Šuran, Vojko Kanič, Peter Kokol, Tadej Završnik, Florjan Verhnjak, Bojan Žlahtič, Andreja Sinkovič and Franjo Husam Naji
Diagnostics 2024, 14(23), 2757; https://doi.org/10.3390/diagnostics14232757 - 7 Dec 2024
Viewed by 1140
Abstract
Background: Lipoprotein(a) [Lp(a)] is a well-established risk factor for incident atherosclerotic cardiovascular (CV) disease. However, evidence regarding its association with recurrent events is limited. To address this gap, we conducted a retrospective analysis of routine clinical data, focusing on patients hospitalized for acute [...] Read more.
Background: Lipoprotein(a) [Lp(a)] is a well-established risk factor for incident atherosclerotic cardiovascular (CV) disease. However, evidence regarding its association with recurrent events is limited. To address this gap, we conducted a retrospective analysis of routine clinical data, focusing on patients hospitalized for acute myocardial infarction (AMI) between 2000 and 2022 with available admission Lp(a) results. Methods: Patients were stratified into three groups based on their Lp(a) level (≤50 mg/dL, 51–90 mg/dL, and >90 mg/dL). A multivariable-adjusted Cox regression analysis was performed to assess the associations of Lp(a) with recurrent AMI, CV mortality, and all-cause mortality. Results: A total of 2248 patients (31.5% women), with a mean age of 64.7 ± 12.2 years, were retrospectively followed until 31 December 2022, or death. The multivariable-adjusted hazard ratios (HRs) for recurrent AMI were 1.01 (p = 0.921) for levels 51–90 mg/dL and 1.51 (p = 0.013) for levels > 90 mg/dL, compared with levels ≤ 50 mg/dL. The corresponding HRs for CV mortality were 1.13 (p = 0.300) and 1.14 (p = 0.348), and those for all-cause mortality were 1.09 (p = 0.310) and 1.20 (p = 0.090), respectively. Stratification by sex and age revealed a significant association of Lp(a) with recurrent AMI only in women aged > 65 years, with adjusted HRs of 2.34 (p = 0.013) for levels 51–90 mg/dL and 3.94 (p < 0.001) for levels > 90 mg/dL, compared with levels ≤ 50 mg/dL. Conclusions: In the presented study, Lp(a) was associated with a significantly higher risk of recurrent AMI only in women aged > 65 years with Lp(a) levels > 50 mg/dL. We found no significant associations between Lp(a) and CV or all-cause mortality. Full article
(This article belongs to the Special Issue Clinical Diagnosis and Management in Cardiology)
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13 pages, 791 KiB  
Article
Thoracic Lymphatic Perfusion Patterns Assessed by Magnetic Resonance Imaging and Late Fontan Failure
by Diego B. Ortega-Zhindón, Gabriela Meléndez-Ramírez, Sergio A. Patrón-Chi, Frida Rivera-Buendía, Juan Calderón-Colmenero, José A. García-Montes, Nonanzit Pérez-Hernández, José Manuel Rodríguez-Pérez and Jorge L. Cervantes-Salazar
Diagnostics 2024, 14(23), 2611; https://doi.org/10.3390/diagnostics14232611 - 21 Nov 2024
Cited by 1 | Viewed by 740
Abstract
Background: Fontan circulation maintains an elevated venous pressure; this promotes venous and lymphatic congestion and may lead to late circuit failure. Our objective was to determine the association between thoracic lymphatic perfusion patterns assessed by magnetic resonance imaging and late Fontan failure. Methodology: [...] Read more.
Background: Fontan circulation maintains an elevated venous pressure; this promotes venous and lymphatic congestion and may lead to late circuit failure. Our objective was to determine the association between thoracic lymphatic perfusion patterns assessed by magnetic resonance imaging and late Fontan failure. Methodology: A retrospective study was performed. We included patients who underwent the Fontan procedure between January 2005 and December 2019 and who were evaluated with lymphatic mapping using magnetic resonance imaging. Lymphatic abnormalities were classified into four types. The prevalence of late failure was determined, and logistic regression analysis was performed to establish the association between the variables of interest and the outcome. Results: Fifty-four patients were included with a mean age at surgery of 8.8 years ± 3.5 years; 42.6% (n = 23) were men. The most frequent diagnosis was tricuspid atresia (50%, n = 27), and the Fontan procedures were mainly performed using an extracardiac conduit (96.3%, n = 52). The prevalence of late Fontan failure was 35.2%. The lymphatic perfusion patterns observed were Type 1 in 25.9% (n = 14), Type 2 in 46.3% (n = 25), Type 3 in 25.9% (n = 14), and Type 4 in 1.8% (n = 1), with no differences in relation to late failure. (p = 0.42). The age at surgery was found to be a factor associated with the late Fontan failure (OR: 1.23; 95% CI: 1.02–1.48; p = 0.02). Conclusions: One-third of patients with Fontan circulation may experience late failure, not significantly associated with lymphatic changes, but when the total cavopulmonary connection is completed at an older age. Full article
(This article belongs to the Special Issue Clinical Diagnosis and Management in Cardiology)
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10 pages, 2293 KiB  
Article
Normal Values for Echocardiographic Myocardial Work in a Large Pediatric Population
by Pietro Marchese, Marco Scalese, Nadia Assanta, Eliana Franchi, Cecilia Viacava, Giuseppe Santoro, Giulia Corana, Alessandra Pizzuto, Francesca Valeria Contini, Shelby Kutty and Massimiliano Cantinotti
Diagnostics 2024, 14(10), 1022; https://doi.org/10.3390/diagnostics14101022 - 15 May 2024
Viewed by 1290
Abstract
Background: Echocardiographic myocardial work is a new load-independent echocardiographic technique to quantify left ventricle (LV) systolic performance. Our aim was to establish normal values for echocardiographic myocardial work in a large population of healthy children. Methods: For all the subjects 4-, 2-, and [...] Read more.
Background: Echocardiographic myocardial work is a new load-independent echocardiographic technique to quantify left ventricle (LV) systolic performance. Our aim was to establish normal values for echocardiographic myocardial work in a large population of healthy children. Methods: For all the subjects 4-, 2-, and 3-chamber-view videos were stored. The following parameters were obtained by offline analysis: the global myocardial work (GMW), the global myocardial constructive work (GCW), the global myocardial wasted work (GWW), and the global myocardial work efficiency (GWE). Age, weight, height, heart rate, and body surface area (BSA) were used as independent variables in the statistical analysis. Results: In all, 516 healthy subjects (age range, 1 day—18 years; median age, 8.2 ± 5.3 years; 55.8% male; body surface area (BSA) range, 0.16 to 2.12 m2) were included. GWI, GCW, and GWW increased with weight, height, and BSA (ρ ranging from 0.635 to 0.226, p all < 0.01); GWI and GCW positively correlated with age (ρ 0.653 and 0.507). After adjusting for BSA differences, females showed higher mean GWI (p = 0.002) and GCW values (p < 0.001), thus Z-score equations for gender have been presented. Conclusions: We provided MW values in a large population of healthy pediatric subjects including lower ages. MW values increased with age and body size and, interestingly, were higher in females than in men. These data cover a gap in current nomograms and may serve as a baseline for the evaluation of MW analysis in children with congenital and acquired heart diseases. Full article
(This article belongs to the Special Issue Clinical Diagnosis and Management in Cardiology)
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3 pages, 1684 KiB  
Interesting Images
Computed Tomography, Coronary Angiography, and Intravascular Ultrasound in the Diagnosis of Left Anterior Descending Stenosis in a 38-Year-Old Woman with a Calcium Score of Zero
by Malgorzata Zalewska-Adamiec and Slawomir Dobrzycki
Diagnostics 2025, 15(9), 1169; https://doi.org/10.3390/diagnostics15091169 - 4 May 2025
Viewed by 284
Abstract
Cardiovascular diseases, including coronary artery disease, are the leading cause of mortality in the general population. The likelihood of significant coronary artery disease occurring in young women (<40 years of age) is very low. Diagnosis is challenging and often delayed, treatment tends to [...] Read more.
Cardiovascular diseases, including coronary artery disease, are the leading cause of mortality in the general population. The likelihood of significant coronary artery disease occurring in young women (<40 years of age) is very low. Diagnosis is challenging and often delayed, treatment tends to be suboptimal, and the long-term prognosis is poor. We present the case of a 38-year-old woman with typical anginal chest pain whose coronary computed tomography angiography (CCTA) revealed significant narrowing in the left anterior descending artery (LAD) despite a coronary artery calcium score (CACS) of zero. To assess the significance of the lesion, coronary angiography and intravascular ultrasound (IVUS) were performed, which revealed borderline narrowing. Conservative treatment was recommended. Full article
(This article belongs to the Special Issue Clinical Diagnosis and Management in Cardiology)
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6 pages, 10417 KiB  
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Spontaneous Coronary Artery Dissection Involving the Left Main with Extension to Left Anterior Descending Artery and Left Circumflex Artery: Diagnostic and Management Challenges
by Constantin Andrei Rusali, Lucia Cojocaru, Ioana Caterina Lupu, Cezar-Dan Uzea and Maria Lavinia Rusali
Diagnostics 2025, 15(1), 61; https://doi.org/10.3390/diagnostics15010061 - 29 Dec 2024
Viewed by 646
Abstract
Spontaneous coronary artery dissection is a rare cause of unstable angina, myocardial infarction, and sudden cardiac death, particularly among young women and individuals without conventional atherosclerotic risk factors. We present the case of a 43-year-old woman who had spontaneous coronary artery dissection involving [...] Read more.
Spontaneous coronary artery dissection is a rare cause of unstable angina, myocardial infarction, and sudden cardiac death, particularly among young women and individuals without conventional atherosclerotic risk factors. We present the case of a 43-year-old woman who had spontaneous coronary artery dissection involving the left main with extension to left anterior descending artery and left circumflex artery. She was ultimately managed medically, with a good outcome. Spontaneous coronary artery dissection is a unique and intricate condition that demands advanced diagnostic techniques and tailored management strategies. Greater awareness and advancements in imaging technologies have enhanced the detection and understanding of spontaneous coronary artery dissection. However, continued research is crucial to resolving outstanding uncertainties and optimizing patient outcomes. Full article
(This article belongs to the Special Issue Clinical Diagnosis and Management in Cardiology)
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26 pages, 2500 KiB  
Systematic Review
Anatomical Variants of the Origin of the Coronary Arteries: A Systematic Review and Meta-Analysis of Prevalence
by Juan José Valenzuela Fuenzalida, Emelyn Sofia Becerra-Rodriguez, Alonso Sebastián Quivira Muñoz, Belén Baez Flores, Catalina Escalona Manzo, Mathias Orellana-Donoso, Pablo Nova-Baeza, Alejandra Suazo-Santibañez, Alejandro Bruna-Mejias, Juan Sanchis-Gimeno, Héctor Gutiérrez-Espinoza and Guinevere Granite
Diagnostics 2024, 14(13), 1458; https://doi.org/10.3390/diagnostics14131458 - 8 Jul 2024
Cited by 1 | Viewed by 1768
Abstract
Purpose: The most common anomaly is an anomalous left coronary artery originating from the pulmonary artery. These variants can be different and depend on the location as well as how they present themselves in their anatomical distribution and their symptomatological relationship. For these [...] Read more.
Purpose: The most common anomaly is an anomalous left coronary artery originating from the pulmonary artery. These variants can be different and depend on the location as well as how they present themselves in their anatomical distribution and their symptomatological relationship. For these reasons, this review aims to identify the variants of the coronary artery and how they are associated with different clinical conditions. Methods: The databases Medline, Scopus, Web of Science, Google Scholar, CINAHL, and LILACS were researched until January 2024. Two authors independently performed the search, study selection, and data extraction. Methodological quality was evaluated using an assurance tool for anatomical studies (AQUA). Pooled prevalence was estimated using a random effects model. Results: A total of 39 studies met the established selection criteria. In this study, 21 articles with a total of 578,868 subjects were included in the meta-analysis. The coronary artery origin variant was 1% (CI = 0.8–1.2%). For this third sample, the funnel plot graph showed an important asymmetry, with a p-value of 0.162, which is directly associated with this asymmetry. Conclusions: It is recommended that patients whose diagnosis was made incidentally and in the absence of symptoms undergo periodic controls to prevent future complications, including death. Finally, we believe that further studies could improve the anatomical, embryological, and physiological understanding of this variant in the heart. Full article
(This article belongs to the Special Issue Clinical Diagnosis and Management in Cardiology)
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