From Heart to Brain: Innovations in Cardiovascular and Stroke Research

A special issue of Healthcare (ISSN 2227-9032).

Deadline for manuscript submissions: closed (30 November 2024) | Viewed by 16076

Special Issue Editor


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Guest Editor
Discipline of Pharmacy, School of Health Sciences, Faculty of Health, University of Canberra, Canberra 2617, Australia
Interests: venous thromboembolism; stroke; thrombosis; coagulation; platelets; diabetes
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Special Issue Information

Dear Colleagues,

Welcome to our Special Issue of “From Heart to Brain: Innovations in Cardiovascular and Stroke Research”. We seek to assess and publish groundbreaking research that explores cardiovascular and/or cerebrovascular disease from prevention, screening, diagnosis, or patient management perspectives. We are inviting researchers from diverse backgrounds to submit their quantitative, qualitative, or mixed-method research for publication (in open access). Studies using cutting-edge technologies and artificial intelligence are highly sought after. With your support, we aim to pave the way for groundbreaking advances in this field; this being the case, please join us in this exciting journey. Submissions of all types of manuscripts (clinical trials, cohort studies, case-control studies, case reports, review articles, etc.) will be received for peer review. The following are some topics of interest:

  • Precision medicine in cardiovascular disease/stroke.
  • Risk factors and risk assessment for cardiovascular disease/stroke.
  • Role of inflammation in cardiovascular disease/stroke.
  • Atherosclerosis.
  • Thromboembolism.
  • Coronary artery disease.
  • Atrial fibrillation.
  • Heart failure.
  • Hypertension.
  • Endovascular treatments.
  • Imaging or non-imaging techniques.
  • Psychosocial and emotional aspects of cardiovascular as well as stroke recovery and care.
  • Innovations in stroke rehabilitation.
  • Malignancies of the heart or brain.

For enquires, please contact the Guest Editor, Dr. Reza Mortazavi, at Reza.Mortazavi@canberra.edu.au.

Dr. Reza Mortazavi
Guest Editor

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Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2700 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

  • heart disease
  • cardiovascular
  • cerebrovascular accident
  • diagnostic imaging
  • prevention and control
  • risk factors
  • atrial fibrillation
  • stroke
  • ischemic, hemorrhagic, and precision medicine
  • anticoagulation
  • fibrinolysis

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Published Papers (6 papers)

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Research

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12 pages, 1445 KiB  
Article
Regulation of Cerebral Blood Flow Velocity by Transcutaneous Electrical Nerve Stimulation: A Preliminary Study
by Eun-Seon Yang, Ju-Yeon Jung and Chang-Ki Kang
Healthcare 2024, 12(19), 1908; https://doi.org/10.3390/healthcare12191908 - 24 Sep 2024
Viewed by 1388
Abstract
Objectives: An excessive and abrupt increase in cerebral blood flow may cause blood vessel damage, leading to stroke. Therefore, appropriate methods to immediately regulate blood flow velocity are important. Through an analysis of 31 healthy adults, we therefore investigated whether stimulating the common [...] Read more.
Objectives: An excessive and abrupt increase in cerebral blood flow may cause blood vessel damage, leading to stroke. Therefore, appropriate methods to immediately regulate blood flow velocity are important. Through an analysis of 31 healthy adults, we therefore investigated whether stimulating the common carotid artery (CCA) using transcutaneous electrical nerve stimulation (TENS) could modulate blood flow velocity in the CCA. Methods: Three stimulation intensities (below-threshold, threshold, and above-threshold) were applied in a random order. Blood velocity changes were examined by the measurement of peak systolic velocity (PSV) with Doppler ultrasound before, during, and after TENS stimulation. To evaluate arterial stiffness, pulse wave velocity (PWV) was calculated using CCA diameter, and blood pressure was measured before and after stimulation. Results: PSV changes in the below-threshold level were significant (p = 0.028). The PSV after below-threshold stimulation was significantly decreased by 2.23% compared to that before stimulation (p = 0.031). PWV showed no significant differences; however, a nonsignificant increase was observed immediately after stimulation only in the above-threshold condition. Above-threshold stimulation can increase vascular tone by activating the sympathetic nerve, possibly triggering vasoconstriction. Conclusions: A decrease in blood flow velocity may not be expected upon the above-threshold stimulation. In contrast, the below-threshold stimulation immediately reduces blood flow velocity, without significantly affecting hemodynamic function, such as arterial flexibility. Therefore, this short-term and low electrical stimulation technique can help to lower vascular resistance and prevent vascular damage from rapid blood flow velocity. Full article
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8 pages, 484 KiB  
Article
Emergence of Atrial Fibrillation and Flutter in COVID-19 Patients: A Retrospective Cohort Study
by Tanzim Bhuiya, Paras P. Shah, Wing Hang Lau, Timothy Park, Rezwan F. Munshi, Ofek Hai, Roman Zeltser and Amgad N. Makaryus
Healthcare 2024, 12(17), 1682; https://doi.org/10.3390/healthcare12171682 - 23 Aug 2024
Viewed by 2592
Abstract
COVID-19 is associated with various cardiovascular complications, including arrhythmias. This study investigated the incidence of new-onset atrial fibrillation (AFB) and atrial flutter (AFL) in COVID-19 patients and identified potential risk factors. We conducted a retrospective cohort study at a tertiary-care safety-net community hospital [...] Read more.
COVID-19 is associated with various cardiovascular complications, including arrhythmias. This study investigated the incidence of new-onset atrial fibrillation (AFB) and atrial flutter (AFL) in COVID-19 patients and identified potential risk factors. We conducted a retrospective cohort study at a tertiary-care safety-net community hospital including 647 patients diagnosed with COVID-19 from March 2020 to March 2021. Patients with a prior history of AFB or AFL were excluded. Data on demographics, clinical characteristics, and outcomes were collected and analyzed using chi-square tests, t-tests, and binary logistic regression. We found that 69 patients (10.66%) developed AFB or AFL, with 41 patients (6.34%) experiencing new-onset arrhythmias. The incidence rates for new-onset AFB and AFL were 5.4% and 0.9%, respectively. Older age (≥65 years) was significantly associated with new-onset AFB/AFL (OR: 5.43; 95% CI: 2.31–12.77; p < 0.001), as was the development of sepsis (OR: 2.73; 95% CI: 1.31–5.70; p = 0.008). No significant association was found with patient sex. Our findings indicate that new-onset atrial arrhythmias are a significant complication in COVID-19 patients, particularly among the elderly and those with sepsis. This highlights the need for targeted monitoring and management strategies to mitigate the burden of atrial arrhythmias in high-risk populations during COVID-19 infection. Full article
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11 pages, 743 KiB  
Article
Mid-Term Results of an Italian Multicentric Experience with the RoadsaverTM Dual-Layer Carotid Stent System
by Olga Silvestri, Giulio Accarino, Davide Turchino, Francesco Squizzato, Michele Piazza, Martina Bastianon, Sara Di Gregorio, Giovanni Pratesi, Michele Antonello, Davide Costa, Raffaele Serra and Umberto Marcello Bracale
Healthcare 2024, 12(1), 120; https://doi.org/10.3390/healthcare12010120 - 4 Jan 2024
Cited by 1 | Viewed by 1733
Abstract
Background: Carotid artery stenting (CAS) using first-generation single-layer stents is widely accepted as a good alternative to standard carotid endarterectomy (CEA) but it is associated with worse outcomes in terms of both plaque prolapse and cerebral embolization. Aim: To evaluate the perioperative and [...] Read more.
Background: Carotid artery stenting (CAS) using first-generation single-layer stents is widely accepted as a good alternative to standard carotid endarterectomy (CEA) but it is associated with worse outcomes in terms of both plaque prolapse and cerebral embolization. Aim: To evaluate the perioperative and midterm outcomes of CAS using the new-generation RoadsaverTM dual-layer micromesh-covered carotid stent. Methods: Herein, we present the results of an observational, retrospective, multicentric study on non-consecutive patients who underwent the CAS procedure between January 2017 and December 2022 at three Italian, high-volume vascular surgery centers. The inclusion criteria were the patients’ eligibility for the CAS procedure in accordance with the current Italian guidelines, and the implantation of a Roadsaver stent. Both symptomatic and asymptomatic patients were included in the study. The patients requiring reintervention for carotid restenosis following CEA were also included. Perioperative data regarding procedural success was defined as the successful implantation of the device in the desired position, less than 30% residual stenosis, and the absence of intraoperative neurological complications. The primary outcome was any adverse cerebrovascular event such as stroke or transient ischemic attack (TIA) during the procedure and/or after discharge. The secondary outcomes were the need for further intervention, and all-cause death following procedure. Results: Three-hundred-fifty-three (353) patients were included in our study; the mean age was 74.3 years. A total of 5.9% of the patients were symptomatic on their operated side, while 7.3% had contralateral carotid occlusion. A cerebral embolic protection device (CPD) was employed in all patients. A total of 13.3% of the patients were operated on for restenosis after CEA Technical success was achieved in 96.9% of the cases with an intraoperative report of six TIAs (1.7%) and six ipsilateral strokes (1.7%). The mean hospital stay was 1.8 days. The thirty-day follow up showed one TIA and one more stroke. At the mean 35-month follow-up time, the primary outcome was present in six patients (1.7%), where four TIAs (1.1%) and two strokes (0.5%) were reported. Restenosis occurred in five patients (1.4%). Death for any cause was reported in 11 patients (3.1%). Conclusions: As most recent, high-quality studies show, the CAS procedure with second-generation devices such as the Roadsaver stent is safe and effective in preventing carotid-related cerebrovascular events in both symptomatic and asymptomatic patients. The intraoperative and postoperative cerebrovascular complication rate in high volume centers is very low, ensuring confidence in its employment for the CAS procedure along with a CPD as a valid alternative to CEA. Full article
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9 pages, 561 KiB  
Article
Seasonal Pattern of Cerebrovascular Fatalities in Cancer Patients
by Velizar Shivarov, Hristo Shivarov and Angel Yordanov
Healthcare 2023, 11(4), 456; https://doi.org/10.3390/healthcare11040456 - 4 Feb 2023
Cited by 2 | Viewed by 1439
Abstract
Cancer patients are at increased risk of cerebrovascular events. The incidence of those events and the associated mortality are known to follow a seasonal pattern in the general population. However, it is unclear whether cerebrovascular mortality in cancer patients has seasonal variation. To [...] Read more.
Cancer patients are at increased risk of cerebrovascular events. The incidence of those events and the associated mortality are known to follow a seasonal pattern in the general population. However, it is unclear whether cerebrovascular mortality in cancer patients has seasonal variation. To address this question, we performed a retrospective analysis of the seasonality of deaths due to the fact of cerebrovascular diseases among patients with first primary malignancy registered between 1975 and 2016 in the SEER database. The presence of seasonality in death rates was modeled using the cosinor approach assuming a circa-annual pattern. A significant seasonal pattern with a peak in the first half of November was identified in all patient groups. The same peak was observed in almost all subgroups of patients defined based on demographic characteristics. However, not all entity-defined subgroups showed a seasonal pattern, which might be explained by the different pathologic processes affecting the circulatory system in each cancer type. Based on our findings, one can propose that the active monitoring of cancer patients for cerebrovascular events from the late autumn and during the winter can help in the reduction of mortality in this patient population. Full article
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Review

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21 pages, 2418 KiB  
Review
Infective Endocarditis in Patients with End-Stage Renal Disease on Dialysis: Epidemiology, Risk Factors, Diagnostic Challenges, and Management Approaches
by Rochell Issa, Nourhan Chaaban, Abdullah Salahie, Bianca Honnekeri, Gary Parizher and Bo Xu
Healthcare 2024, 12(16), 1631; https://doi.org/10.3390/healthcare12161631 - 16 Aug 2024
Cited by 1 | Viewed by 2370
Abstract
Infective endocarditis (IE) poses a significant clinical challenge, especially among patients with end-stage renal disease (ESRD) undergoing dialysis, and is associated with high morbidity and mortality rates. This review provides a contemporary discussion of the epidemiology, risk factors, diagnostic challenges, and management strategies [...] Read more.
Infective endocarditis (IE) poses a significant clinical challenge, especially among patients with end-stage renal disease (ESRD) undergoing dialysis, and is associated with high morbidity and mortality rates. This review provides a contemporary discussion of the epidemiology, risk factors, diagnostic challenges, and management strategies for IE among ESRD patients, including a literature review of recent studies focused on this vulnerable population. The review highlights the multifactorial nature of IE risk in ESRD patients, emphasizing the roles of vascular access type, dialysis modality, and comorbid conditions. It also explores the diagnostic utility of different imaging modalities and the importance of a multidisciplinary approach in managing IE, including both medical and surgical interventions. The insights from this review aim to contribute to the improvement of patient outcomes through early recognition, appropriate antimicrobial therapy, and timely surgical intervention when necessary. Full article
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17 pages, 427 KiB  
Review
Potential Benefits of Continuous Glucose Monitoring for Predicting Vascular Outcomes in Type 2 Diabetes: A Rapid Review of Primary Research
by Radhika Kiritsinh Jadav, Kwang Choon Yee, Murray Turner and Reza Mortazavi
Healthcare 2024, 12(15), 1542; https://doi.org/10.3390/healthcare12151542 - 4 Aug 2024
Cited by 1 | Viewed by 2667
Abstract
(1) Background: Chronic hyperglycaemia is a cause of vascular damage and other adverse clinical outcomes in type 2 diabetes mellitus (T2DM). Emerging evidence suggests a significant and independent role for glycaemic variability (GV) in contributing to those outcomes. Continuous glucose monitoring (CGM) provides [...] Read more.
(1) Background: Chronic hyperglycaemia is a cause of vascular damage and other adverse clinical outcomes in type 2 diabetes mellitus (T2DM). Emerging evidence suggests a significant and independent role for glycaemic variability (GV) in contributing to those outcomes. Continuous glucose monitoring (CGM) provides valuable insights into GV. Unlike in type 1 diabetes mellitus, the use of CGM-derived GV indices has not been widely adopted in the management of T2DM due to the limited evidence of their effectiveness in predicting clinical outcomes. This study aimed to explore the associations between GV metrics and short- or long-term vascular and clinical complications in T2DM. (2) Methods: A rapid literature review was conducted using the Cochrane Library, MEDLINE, and Scopus databases to seek high-level evidence. Lower-quality studies such as cross-sectional studies were excluded, but their content was reviewed. (3) Results: Six studies (five prospective cohort studies and one clinical trial) reported associations between GV indices (coefficient of variation (CV), standard deviation (SD), Mean Amplitude of Glycaemic Excursions (MAGE), Time in Range (TIR), Time Above Range (TAR), and Time Below Range (TBR)), and clinical complications. However, since most evidence came from moderate to low-quality studies, the results should be interpreted with caution. (4) Conclusions: Limited but significant evidence suggests that GV indices may predict clinical compilations in T2DM both in the short term and long term. There is a need for longitudinal studies in larger and more diverse populations, longer follow-ups, and the use of numerous CGM-derived GV indices while collecting information about all microvascular and macrovascular complications. Full article
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