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Diagnostics
Special Issues
Innovative Solutions to Cardiovascular Dilemmas: From Diagnosis to Therapy
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Innovative Solutions to Cardiovascular Dilemmas: From Diagnosis to Therapy

A special issue of Diagnostics (ISSN 2075-4418). This special issue belongs to the section "Pathology and Molecular Diagnostics".

Deadline for manuscript submissions: 30 June 2025 | Viewed by 2532

Special Issue Editors

Dr. Thach N. Nguyen

E-Mail Website
Guest Editor
1. Director of Cardiovascular Research, Methodist Hospital, Merrillville, IN 46410, USA
2. Academic Dean, School of Medicine, Tan Tao University, Duc Hoa 82000, Long An, Vietnam
Interests: interventional cardiology; heart failure; coronary artery disease; cardiogenic shock
Dr. C Michael Gibson

E-Mail Website
Guest Editor
Harvard Medical School, Boston, MA 02115, USA
Interests: coronary artery disease; angiography; atherosclerosis; cardiovascular imaging

Special Issue Information

Dear Colleagues,

For the care of cardiovascular (CV) patients, there have been many guidelines, issued by the American College of Cardiology (ACC), American Heart Association (AHA), European Society of Cardiology (ESC), Heart Failure Society (HFS) and Heart Rhythm Society (HRS), etc. From these guideline-directed medical therapies (GDMTs), physicians at the bedside or in the clinic can select the most suitable diagnostic strategy, a choice of time-proven prevention tactics or evidence-based management protocols. However, in many instances, even after applying the gold-standard GDMTs, physicians encounter clinical failures, which are highlighted below.

In the prevention of coronary artery disease (CAD), why do patients still develop this condition even after all risk factors are controlled (blood pressure <120 mmHg, low-density lipoprotein (LDL) <50 mg, no smoking)? Of the CAD patients with moderate (50%) stenotic lesion, which could undergo medical treatment without developing acute coronary syndrome (ACS)? What is the pathophysiological mechanism of the benefits for these patients on medications? For CAD patients who undergo percutaneous coronary interventions (PCIs) (balloon angioplasty or stenting), what are the flow dynamic features that the PCI rectifies so that no new lesion will develop? In patients with new dilated cardiomyopathy and a reduced ejection fraction (EF), which test could identify the patients whose EF returns to a normal level with GDMT? Many patients with aortic stenosis (AS), dilated cardiomyopathy, and anomalous origin of coronary artery from the opposite aortic sinus of Valsalva (ACAOS) have patent coronary arteries. Why do they all present with chest pain (CP) and sudden death (SCD)? What is the common pathophysiological mechanism of CP and SCD in these patients?  

As physicians at the front line, could we offer any new breakthrough solutions in the diagnosis and management of the patients who fail GDMT? Could any new clinical, imaging, laboratory methodology, computational fluid dynamic or big data analysis, artificial intelligence (AI) or machine learning (ML) algorithms identify the root cause of these failures? To solve these problems, the best management strategy is to rectify or to reverse the disease mechanism. If so, what is the most cost- and time-effective treatment plan?

This Special Issue focuses on the new, innovative, breakthrough strategies and tactics in the diagnosis, prevention, and management of common CV problems seen by clinicians, such as stable CAD, ACS, dilated cardiomyopathy, heart failure, valvular disease, atrial fibrillation, ventricular arrythmia, sudden cardiac death, etc. The common denominator of these patients is that they all fail GDMT. This Special Issue covers topics including risk stratification tools, diagnostic modalities, and personalized short- and long-term preventive and therapeutic strategies. By highlighting the mechanism of disease and its reversal as a management tactic, this Special Issue will enable clinicians at the frontline to present their new, innovative clinical decision-making processes and cutting-edge treatment modalities for CV patients beyond GDMT

Dr. Thach N. Nguyen
Dr. C Michael Gibson
Guest Editors

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

  • coronary artery disease
  • acute coronary syndrome
  • heart failure
  • hemodynamics in heart failure
  • coronary flow dynamic
  • dilated cardiomyopathy
  • valvular disease
  • atrial fibrillation
  • sudden cardiac death
  • syncope
  • individualized treatment
  • clinical decision-making
  • computational fluid dynamic
  • big data analysis
  • artificial intelligence
  • machine learning

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Published Papers (2 papers)

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Review

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19 pages, 1583 KiB  
Review
Definitional Challenges in Understanding Hypertrophic Cardiomyopathy
by Jan M. Federspiel, Jochen Pfeifer, Frank Ramsthaler, Jan-Christian Reil, Peter H. Schmidt and Vasco Sequeira
Diagnostics 2024, 14(22), 2534; https://doi.org/10.3390/diagnostics14222534 - 13 Nov 2024
Viewed by 1284
Abstract
Hypertrophic cardiomyopathy (HCM) is the most common hereditary cardiomyopathy. It is often caused by mutations of genes encoding for sarcomeric or sarcomere-associated proteins. Despite its clinical importance, divergent definitions are published by major cardiology societies. Some regard HCM as a specific genetic disease, [...] Read more.
Hypertrophic cardiomyopathy (HCM) is the most common hereditary cardiomyopathy. It is often caused by mutations of genes encoding for sarcomeric or sarcomere-associated proteins. Despite its clinical importance, divergent definitions are published by major cardiology societies. Some regard HCM as a specific genetic disease, whereas others define it as a broad ‘spectrum of the thick heart’. The present narrative review aimed to assess both definitions from a pathoanatomical perspective. As a conjoint interdisciplinary and translational approach is needed to further increase knowledge and improve the understanding of HCM, the PubMed database was searched using several advanced search algorithms to explore the perspectives of the (forensic) pathologist, clinician, and basic researcher regarding the difference between the definitions of HCM. This discrepancy between definitions can impact critical data, such as prevalence and mortality rate, and complicate the understanding of the disease. For example, due to the different definitions, research findings regarding molecular changes from studies applying the narrow definition cannot be simply extended to the ‘spectrum’ of HCM. Full article
(This article belongs to the Special Issue Innovative Solutions to Cardiovascular Dilemmas: From Diagnosis to Therapy)
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Other

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20 pages, 4870 KiB  
Case Report
Minimally Invasive Surgical Approach in Granulomatosis with Polyangiitis Complicated with Intramural Descending Aorta Hematoma Followed by Aortic Wall Rupture
by Mihai-Lucian Ciobica, Alexandru-Sebastian Botezatu, Zoltan Galajda, Mara Carsote, Claudiu Nistor and Bianca-Andreea Sandulescu
Diagnostics 2025, 15(2), 144; https://doi.org/10.3390/diagnostics15020144 - 9 Jan 2025
Viewed by 792
Abstract
Background and Clinical Significance: Granulomatosis with polyangiitis (GPA) represents a rare autoimmune disease with granulomatous inflammation, tissue necrosis, and systemic vasculitis of the small and medium blood vessels. Although the clinical elements vary, aortic involvement is exceptional and it represents a challenge [...] Read more.
Background and Clinical Significance: Granulomatosis with polyangiitis (GPA) represents a rare autoimmune disease with granulomatous inflammation, tissue necrosis, and systemic vasculitis of the small and medium blood vessels. Although the clinical elements vary, aortic involvement is exceptional and it represents a challenge that requires a rapid intervention with the potential of displaying a fulminant evolution. Case Presentation: We report a 64-year-old male with an 18-year history of GPA who presented atypical low back pain. Following ultrasound and computed tomography exams, the initial suspicion was an intramural descending aorta hematoma, surrounded by a peri-aortic sleeve suggesting a chronic inflammation. Serial non-invasive assessments revealed a progressive lesion within the next 10 to 12 days to an aortic wall rupture, despite the absence of previous aneurysmal changes. The peri-aortic fibrous inflammatory sleeve was life-saving, and emergency minimally invasive surgery was successful, including the massive improvement in back pain. Conclusions: To our knowledge, this is a very rare scenario in GPA; we found only 18 other cases (the oldest report being from 1994). An interventional approach was mentioned in a few cases as seen in this instance. Glucocorticoid medication for GPA might act as a potential contributor to symptomatic osteoporotic fractures which require a prompt differential diagnosis. Unusual aortic manifestations (such as intramural aortic hematoma or aortic wall rupture) are difficult to recognize since the index of clinical suspicion is rather low. A prompt intervention may be life-saving and a multidisciplinary team is mandatory. Minimally invasive surgical correction of the aortic event represents an optimum management in the modern era. Such cases add to the limited data we have so far with respect to unusual outcomes in long-standing GPAs. Full article
(This article belongs to the Special Issue Innovative Solutions to Cardiovascular Dilemmas: From Diagnosis to Therapy)
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