Journal Description
Journal of Cardiovascular Development and Disease
Journal of Cardiovascular Development and Disease
is an international, scientific, peer-reviewed, open access journal on Cardiovascular medicine published monthly online by MDPI.
- Open Access— free for readers, with article processing charges (APC) paid by authors or their institutions.
- High Visibility: indexed within Scopus, SCIE (Web of Science), PubMed, PMC, Embase, CAPlus / SciFinder, and many other databases.
- Journal Rank: JCR - Q2 (Cardiac & Cardiovascular Systems)
- Rapid Publication: manuscripts are peer-reviewed and a first decision provided to authors approximately 16.5 days after submission; acceptance to publication is undertaken in 2.9 days (median values for papers published in this journal in the first half of 2021).
- Recognition of Reviewers: reviewers who provide timely, thorough peer-review reports receive vouchers entitling them to a discount on the APC of their next publication in any MDPI journal, in appreciation of the work done.
Impact Factor:
3.948 (2020)
;
5-Year Impact Factor:
3.84 (2020)
Latest Articles
Antiphospholipid Syndrome-Induced Leriche Syndrome in a Man with Lower Limbs Sensory and Motor Defect
J. Cardiovasc. Dev. Dis. 2021, 8(9), 104; https://doi.org/10.3390/jcdd8090104 (registering DOI) - 29 Aug 2021
Abstract
Antiphospholipid syndrome (APS) is an autoimmune disorder with characteristics of arterial and/or venous thrombosis due to hypercoagulation status. Although deep vein thrombosis is common, the involvement of arterial thrombosis is more dangerous and poses a high risk of complications. Acute aorto-iliac occlusive disease
[...] Read more.
Antiphospholipid syndrome (APS) is an autoimmune disorder with characteristics of arterial and/or venous thrombosis due to hypercoagulation status. Although deep vein thrombosis is common, the involvement of arterial thrombosis is more dangerous and poses a high risk of complications. Acute aorto-iliac occlusive disease (AIOD, known as Leriche syndrome) is severe arterial thrombosis that is associated with high morbidity and mortality rates. Severe acute occlusion may cause spinal cord ischemia, leading to neurological defects, such as acute onset of paraplegia. Co-occurrence of acute aorto-iliac occlusive disease and antiphospholipid syndrome is rare and may present with atypical symptoms mimicking other diseases, including chronic ulcers, musculoskeletal events, and pulmonary diseases. In patients with weak femoral pulses and recurrent thrombotic events, co-occurrence of APS and AIOD should be taken into consideration. Here, we describe a rare case of co-occurrence of APS and AIOD presenting with acute lower leg weakness and numbness. Timely thrombectomies and bilateral common iliac artery stentings rescued distal blood flow. We highlight the clinical features and early diagnosis of co-occurrence of APS and AIOD in order to prevent catastrophic complications. The detailed mechanism and pathogenesis of antiphospholipid syndrome-induced acute aorto-iliac occlusive disease are also discussed.
Full article
(This article belongs to the Special Issue Atherosclerosis:Current Concepts of Genetic, Epigenetic and Environmental Risk Factors)
Open AccessReview
Harnessing the Therapeutic Potential of Decoys in Non-Atherosclerotic Cardiovascular Diseases: State of the Art
by
, , , and
J. Cardiovasc. Dev. Dis. 2021, 8(9), 103; https://doi.org/10.3390/jcdd8090103 - 27 Aug 2021
Abstract
►▼
Show Figures
Cardiovascular disease (CVD) is the main cause of global death, highlighting the fact that conventional therapeutic approaches for the treatment of CVD patients are insufficient, and there is a need to develop new therapeutic approaches. In recent years, decoy technology, decoy oligodeoxynucleotides (ODN),
[...] Read more.
Cardiovascular disease (CVD) is the main cause of global death, highlighting the fact that conventional therapeutic approaches for the treatment of CVD patients are insufficient, and there is a need to develop new therapeutic approaches. In recent years, decoy technology, decoy oligodeoxynucleotides (ODN), and decoy peptides show promising results for the future treatment of CVDs. Decoy ODN inhibits transcription by binding to the transcriptional factor, while decoy peptide neutralizes receptors by binding to the ligands. This review focused on studies that have investigated the effects of decoy ODN and decoy peptides on non-atherosclerotic CVD.
Full article

Figure 1
Open AccessSystematic Review
The Coronary Arteries in Adults after the Arterial Switch Operation: A Systematic Review
by
, , , , , , , and
J. Cardiovasc. Dev. Dis. 2021, 8(9), 102; https://doi.org/10.3390/jcdd8090102 - 26 Aug 2021
Abstract
Coronary artery status in adults long after the arterial switch operation (ASO) is unclear. We conducted a systematic review to provide an overview of coronary complications during adulthood and to evaluate the value of routine coronary imaging in adults after ASO, in light
[...] Read more.
Coronary artery status in adults long after the arterial switch operation (ASO) is unclear. We conducted a systematic review to provide an overview of coronary complications during adulthood and to evaluate the value of routine coronary imaging in adults after ASO, in light of current guidelines. Articles were screened for the inclusion of adult ASO patients and data on coronary complications and findings of coronary imaging were collected. A total of 993 adults were followed with a median available follow-up of only 2.0 years after reaching adulthood. Myocardial ischemia was suspected in 17/192 patients (8.9%). The number of coronary interventions was four (0.4%), and coronary death was reported in four (0.4%) patients. A lack of ischemia-related symptoms cannot be excluded because innervation studies indicated deficient cardiac innervation after ASO, although data is limited. Anatomical high-risk features found by routine coronary computed tomography (cCT) included stenosis (4%), acute angle (40%), kinking (24%) and inter-arterial course (11%). No coronary complications were reported during pregnancy (n = 45), although, remarkably, four (9%) patients developed heart failure. The 2020 European Society of Cardiology (ESC) guidelines state that routine screening for coronary pathologies is questionable. Based on current findings and in line with the 2018 American ACC/AHA guidelines a baseline assessment of the coronary arteries in all ASO adults seems justifiable. Thereafter, an individualized coronary follow-up strategy is advisable at least until significant duration of follow-up is available.
Full article
(This article belongs to the Special Issue Leaders in Cardiovascular Research: A Special Issue Dedicated to Professor Adriana Gittenberger-De Groot)
►▼
Show Figures

Graphical abstract
Open AccessReview
The Use of β-Blockers in Heart Failure with Reduced Ejection Fraction
J. Cardiovasc. Dev. Dis. 2021, 8(9), 101; https://doi.org/10.3390/jcdd8090101 - 24 Aug 2021
Abstract
►▼
Show Figures
Treatment with β-blockers is the main strategy for managing patients with heart failure and reduced ejection fraction because of their ability to reverse the neurohumoral effects of the sympathetic nervous system, with consequent prognostic and symptomatic benefits. However, to date, they are underused,
[...] Read more.
Treatment with β-blockers is the main strategy for managing patients with heart failure and reduced ejection fraction because of their ability to reverse the neurohumoral effects of the sympathetic nervous system, with consequent prognostic and symptomatic benefits. However, to date, they are underused, mainly because of the misconception that hypotension and bradycardia may worsen the haemodynamic status of patients with HFrEF and because of the presence of comorbidities falsely believed to be absolute contraindications to their use. To promote proper use of β-blockers in this article, we review the clinical pharmacology of β-blockers, the evidence of the beneficial effects of these drugs in heart failure with reduced ejection fraction, and the current guidelines for their use in clinical practice and in the presence of comorbidities (e.g., pulmonary disease, diabetes, atrial fibrillation, peripheral arterial disease, etc.). It is hoped that the practical approach discussed in this review will allow for a proper diffusion of knowledge about the correct use of β-blockers and the drug-disease interactions to achieve their increased use and titration, as well as for the selection of a specific agent with a view to a properly tailored approach for HFrEF patients.
Full article

Graphical abstract
Open AccessReview
New Interventional Therapies beyond Stenting to Treat ST-Segment Elevation Acute Myocardial Infarction
J. Cardiovasc. Dev. Dis. 2021, 8(9), 100; https://doi.org/10.3390/jcdd8090100 - 24 Aug 2021
Abstract
Myocardial infarction remains the principal cause of death in Europe. In patients with ST-segment-elevation myocardial infarction (STEMI), a promptly revascularization with primary percutaneous intervention (PCI) has transformed prognosis in the last decades. However, despite increasing successful PCI procedures, mortality has remained unchanged in
[...] Read more.
Myocardial infarction remains the principal cause of death in Europe. In patients with ST-segment-elevation myocardial infarction (STEMI), a promptly revascularization with primary percutaneous intervention (PCI) has transformed prognosis in the last decades. However, despite increasing successful PCI procedures, mortality has remained unchanged in recent years. Also, due to an unsatisfactory reperfusion, some patients have significant myocardial damage and suffer left ventricular adverse remodeling with reduced function—all that resulting in the onset of heart failure with all its inherent clinical and socioeconomic burden. As a consequence of longer ischemic times, distal thrombotic embolization, ischemia-reperfusion injury and microvascular dysfunction, the resultant myocardial infarct size is the major prognostic determinant in STEMI patients. The improved understanding of all the pathophysiology underlying these events has derived to the development of several novel therapies aiming to reduce infarct size and to improve clinical outcomes in these patients. In this article, based on the mechanisms involved in myocardial infarction prognosis, we review the new interventional strategies beyond stenting that may solve the suboptimal results that STEMI patients still experience.
Full article
(This article belongs to the Section Acquired Heart Disease)
►▼
Show Figures

Figure 1
Open AccessArticle
Radiation Reduction and Protection for Radiosensitive Organs (Lens, Thyroid, and Genital Organs) of Patients Receiving Percutaneous Coronary Intervention—Real-World Measurement of Radiation Dose in a Single Center
J. Cardiovasc. Dev. Dis. 2021, 8(8), 99; https://doi.org/10.3390/jcdd8080099 - 20 Aug 2021
Abstract
Backgrounds: Reducing radiation exposure is the basic principle for performing percutaneous coronary intervention (PCI). Many studies have confirmed the effect of radiation protection for medical staff, but studies about the effectiveness of protection for patients and real measurement of radiation dose in patients’
[...] Read more.
Backgrounds: Reducing radiation exposure is the basic principle for performing percutaneous coronary intervention (PCI). Many studies have confirmed the effect of radiation protection for medical staff, but studies about the effectiveness of protection for patients and real measurement of radiation dose in patients’ specific organs are lacking. Aim: To measure the radiation doses absorbed by patients’ radiosensitive organs during PCI and the effectiveness of radiation protection. Methods: A total of 120 patients were included and allocated into three groups as the ratio of 1:1:2. A total of 30 patients received PCI at 15 frames rate per second (fps), 30 patients at 7.5 fps, and 60 patients wore radiation protective hat and glasses during PCI at 7.5 fps. The radiation doses were measured at right eyebrow (lens), neck (thyroid), back (skin), and inguinal area (genital organs) by using thermoluminescent dosimeters (TLDs). Results: Dose-area product (DAP) reduced by 58.8% (from 534,454 ± 344,660 to 220,352 ± 164,101 mGy·cm2, p < 0.001) after reducing the frame rate, without affecting successful rate of PCI. Radiation doses measured on skin, lens, genital organs, and thyroid decreased by 73.3%, 40.0%, 40.0%, and 35.3%, respectively (from 192.58 ± 349.45 to 51.10 ± 59.21; 5.29 ± 4.27 to 3.16 ± 2.73; 0.25 ± 0.15 to 0.15 ± 0.15; and 17.42 ± 12.11 to 11.27 ± 8.52 μSv, p < 0.05). By providing radiation protective equipment, radiation doses at lens and thyroid decreased further by 71.8% and 65.9% (from 3.16 ± 2.73 to 0.89 ± 0.79; 11.27 ± 8.52 to 3.84 ± 3.49 μSv, p < 0.05). Conclusions: By lowering the frame rate and providing protective equipment, radiation exposure in radiosensitive organs can be effectively reduced in patients.
Full article
(This article belongs to the Section Epidemiology, Lifestyle, and Cardiovascular Health)
►▼
Show Figures

Graphical abstract
Open AccessReview
Collagen Fibrillogenesis in the Mitral Valve: It’s a Matter of Compliance
J. Cardiovasc. Dev. Dis. 2021, 8(8), 98; https://doi.org/10.3390/jcdd8080098 - 20 Aug 2021
Abstract
Collagen fibers are essential structural components of mitral valve leaflets, their tension apparatus (chordae tendineae), and the associated papillary muscles. Excess or lack of collagen fibers in the extracellular matrix (ECM) in any of these structures can adversely affect mitral valve function. The
[...] Read more.
Collagen fibers are essential structural components of mitral valve leaflets, their tension apparatus (chordae tendineae), and the associated papillary muscles. Excess or lack of collagen fibers in the extracellular matrix (ECM) in any of these structures can adversely affect mitral valve function. The organization of collagen fibers provides a sophisticated framework that allows for unidirectional blood flow during the precise opening and closing of this vital heart valve. Although numerous ECM molecules are essential for the differentiation, growth, and homeostasis of the mitral valve (e.g., elastic fibers, glycoproteins, and glycans), collagen fibers are key to mitral valve integrity. Besides the inert structural components of the tissues, collagen fibers are dynamic structures that drive outside-to-inside cell signaling, which informs valvular interstitial cells (VICs) present within the tissue environment. Diversity of collagen family members and the closely related collagen-like triple helix-containing proteins found in the mitral valve, will be discussed in addition to how defects in these proteins may lead to valve disease.
Full article
(This article belongs to the Special Issue Mitral Valve Development and Disease)
►▼
Show Figures

Figure 1
Open AccessArticle
Diagnostic Performance of Serial High-Sensitivity Cardiac Troponin Measurements in the Emergency Setting
by
, , , , , , , , , , , and
J. Cardiovasc. Dev. Dis. 2021, 8(8), 97; https://doi.org/10.3390/jcdd8080097 - 13 Aug 2021
Abstract
►▼
Show Figures
Serial high-sensitivity cardiac troponin (hsTn) testing in the emergency department (ED) and the intensive cardiac care unit may assist physicians in ruling out or ruling in acute myocardial infarction (MI). There are three major algorithms proposed for high-sensitivity cardiac troponin I (hsTnI) using
[...] Read more.
Serial high-sensitivity cardiac troponin (hsTn) testing in the emergency department (ED) and the intensive cardiac care unit may assist physicians in ruling out or ruling in acute myocardial infarction (MI). There are three major algorithms proposed for high-sensitivity cardiac troponin I (hsTnI) using serial measurements while incorporating absolute concentration changes for MI or death following ED presentation. We sought to determine the diagnostic estimates of these three algorithms and if one was superior in two different Canadian ED patient cohorts with serial hsTnI measurements. An undifferentiated ED population (Cohort-1) and an ED population with symptoms suggestive of acute coronary syndrome (ACS; Cohort-2) were clinically managed with non-hsTn testing with the hsTnI testing performed in real-time with physicians blinded to these results (i.e., hsTnI not reported). The three algorithms evaluated were the European Society of Cardiology (ESC), the High-STEACS pathway, and the COMPASS-MI algorithm. The diagnostic estimates were derived for each algorithm for the 30-day MI/death outcome for the rule-out and rule-in arm in each cohort and compared to proposed diagnostic benchmarks (i.e., sensitivity ≥ 99.0% and specificity ≥ 90.0%) with 95% confidence intervals (CI). In Cohort-1 (n = 2966 patients, 15.3% had outcome) and Cohort-2 (n = 935 patients, 15.6% had outcome), the algorithm that obtained the highest sensitivity (97.8%; 95% CI: 96.0–98.9 and 98.6%; 95% CI: 95.1–99.8, respectively) in both cohorts was COMPASS-MI. Only Cohort-2 with both the ESC and COMPASS-MI algorithms exceeded the specificity benchmark (97.0%; 95% CI: 95.5–98.0 and 96.7%; 95% CI: 95.2–97.8, respectively). Patient selection for serial hsTnI testing will affect specificity estimates, with no algorithm achieving a sensitivity ≥ 99% for 30-day MI or death.
Full article

Figure 1
Open AccessArticle
Fat-to-Muscle Ratios and the Non-Achievement of LDL Cholesterol Targets: Analysis of the Korean Genome and Epidemiology Study
J. Cardiovasc. Dev. Dis. 2021, 8(8), 96; https://doi.org/10.3390/jcdd8080096 - 12 Aug 2021
Abstract
►▼
Show Figures
Maintaining optimal low-density lipoprotein (LDL) cholesterol levels is necessary to prevent cardiovascular disease (CVD). Excessive fat mass and decreased muscle mass are both associated with increased risks of developing dyslipidemia. Thus, we investigated the longitudinal relationship between the fat-to-muscle ratio (FMR) and the
[...] Read more.
Maintaining optimal low-density lipoprotein (LDL) cholesterol levels is necessary to prevent cardiovascular disease (CVD). Excessive fat mass and decreased muscle mass are both associated with increased risks of developing dyslipidemia. Thus, we investigated the longitudinal relationship between the fat-to-muscle ratio (FMR) and the non-achievement of LDL cholesterol targets. We analyzed a total of 4386 participants aged 40–69 years from the Korean Genome and Epidemiology Study. FMR was defined as the ratio of total fat mass to total muscle mass, measured by bioelectrical impedance. The non-achievement of an LDL cholesterol target was defined as an LDL cholesterol level higher than the established target level according to individual CVD risk. The adjusted hazard ratios and 95% confidence interval for the incidence of non-achievement of LDL cholesterol targets for the sex-specific middle and highest tertiles vs. the referent lowest tertile of FMR were 1.56 (1.29–1.90) and 1.86 (1.47–2.31) in men and 1.40 (1.18–1.66) and 1.31 (1.06–1.62) in women after adjusting confounders. Our findings suggest that FMR, a novel indicator of the combined effects of fat and muscle mass, is useful for predicting non-achievement of LDL cholesterol targets.
Full article

Figure 1
Open AccessReview
New Insights into the Development and Morphogenesis of the Cardiac Purkinje Fiber Network: Linking Architecture and Function
J. Cardiovasc. Dev. Dis. 2021, 8(8), 95; https://doi.org/10.3390/jcdd8080095 - 07 Aug 2021
Abstract
The rapid propagation of electrical activity through the ventricular conduction system (VCS) controls spatiotemporal contraction of the ventricles. Cardiac conduction defects or arrhythmias in humans are often associated with mutations in key cardiac transcription factors that have been shown to play important roles
[...] Read more.
The rapid propagation of electrical activity through the ventricular conduction system (VCS) controls spatiotemporal contraction of the ventricles. Cardiac conduction defects or arrhythmias in humans are often associated with mutations in key cardiac transcription factors that have been shown to play important roles in VCS morphogenesis in mice. Understanding of the mechanisms of VCS development is thus crucial to decipher the etiology of conduction disturbances in adults. During embryogenesis, the VCS, consisting of the His bundle, bundle branches, and the distal Purkinje network, originates from two independent progenitor populations in the primary ring and the ventricular trabeculae. Differentiation into fast-conducting cardiomyocytes occurs progressively as ventricles develop to form a unique electrical pathway at late fetal stages. The objectives of this review are to highlight the structure–function relationship between VCS morphogenesis and conduction defects and to discuss recent data on the origin and development of the VCS with a focus on the distal Purkinje fiber network.
Full article
(This article belongs to the Special Issue Molecular Control of Development and Function of the Cardiac Conduction System)
►▼
Show Figures

Figure 1
Open AccessSystematic Review
Effects of Different Exercise Interventions on Cardiac Autonomic Control and Secondary Health Factors in Middle-Aged Adults: A Systematic Review
J. Cardiovasc. Dev. Dis. 2021, 8(8), 94; https://doi.org/10.3390/jcdd8080094 - 05 Aug 2021
Abstract
This systematic review was conducted in accordance with the PRISMA guidelines to summarize the existing literature on the effects of different exercise interventions on cardiac autonomic control and secondary health factors. Resting heart rate variability (HRV) was used as indicator of cardiac autonomic
[...] Read more.
This systematic review was conducted in accordance with the PRISMA guidelines to summarize the existing literature on the effects of different exercise interventions on cardiac autonomic control and secondary health factors. Resting heart rate variability (HRV) was used as indicator of cardiac autonomic control. Secondary factors were related to factors that contribute to cardiovascular health. Studies examining the effects of endurance, resistance, multimodal, or coordinative training interventions in healthy participants aged between 45 and 60 years old on average were considered. The methodological quality of the studies was examined using two assessment scales (TESTEX and STARDHRV). PROSPERO registration number: CRD42020206606. The literature review retrieved eight studies fulfilling all inclusion criteria. Cardiac autonomic control and cardiovascular health improved after endurance and multimodal interventions. Resistance training had no significant impact on HRV or any secondary health factor. Coordinative exercise interventions showed inconclusive results regarding HRV but showed significant improvements in secondary health factors. The quality assessment tools revealed some methodological and reporting deficits. Despite the small number of studies, we suggest endurance and multimodal interventions including aerobic exercises for the enhancement of cardiac autonomic control and the reduction of cardiovascular risk in middle-aged adults. Further studies need to be conducted to examine the long-term effects of exercise in the midlife period.
Full article
(This article belongs to the Section Epidemiology, Lifestyle, and Cardiovascular Health)
►▼
Show Figures

Figure 1
Open AccessArticle
Applicability of the Leiden Convention and the Lipton Classification in Patients with a Single Coronary Artery in the Setting of Congenital Heart Disease
by
, , , , , , and
J. Cardiovasc. Dev. Dis. 2021, 8(8), 93; https://doi.org/10.3390/jcdd8080093 - 04 Aug 2021
Abstract
In single coronary artery (SCA) anatomy, all coronary tributaries arise from a single ostium, providing perfusion to the entire myocardium. Coronary classification systems can facilitate the description of SCA anatomy. Aim: Evaluation of the applicability of Lipton classification and the Leiden Convention coronary
[...] Read more.
In single coronary artery (SCA) anatomy, all coronary tributaries arise from a single ostium, providing perfusion to the entire myocardium. Coronary classification systems can facilitate the description of SCA anatomy. Aim: Evaluation of the applicability of Lipton classification and the Leiden Convention coronary coding system in SCA. Methods: All patients (n = 6209) who underwent computed tomography (CT) scanning between 2014 and 2018 were retrospectively examined for the presence of SCA and classified, according to Lipton classification and the Leiden Convention coronary coding system. Results: The prevalence of SCA was 0.51% (32/6209). Twenty-eight patients (87.5%) had coexisting congenital heart disease (CHD), most frequently pulmonary atresia (9/32, 28.1%). Ten patients (10/32, 31.25%) could not be classified with either the Leiden Convention or Lipton classification (pulmonary atresia n = 9, common arterial trunk (CAT) n = 1). In one case with CAT, Lipton classification, but not the Leiden Convention, could be applied. In two cases with the transposition of the great arteries and in two cases of double outlet right ventricle, the Leiden Convention, but not the Lipton classification, could be applied. Conclusions: Both classifications are useful to detail information about SCA. As Lipton classification was not developed for structural heart disease cases, in complex CHD with abnormal position of the great arteries, the Leiden Convention is better applicable. The use of both systems is limited in pulmonary atresia. In this scenario, it is better to provide a precise description of the coronary origin and associated characteristics that might affect treatment and prognosis.
Full article
(This article belongs to the Special Issue Leaders in Cardiovascular Research: A Special Issue Dedicated to Professor Adriana Gittenberger-De Groot)
►▼
Show Figures

Figure 1
Open AccessReview
Excess Provisional Extracellular Matrix: A Common Factor in Bicuspid Aortic Valve Formation
J. Cardiovasc. Dev. Dis. 2021, 8(8), 92; https://doi.org/10.3390/jcdd8080092 - 04 Aug 2021
Abstract
A bicuspid aortic valve (BAV) is the most common cardiac malformation, found in 0.5% to 2% of the population. BAVs are present in approximately 50% of patients with severe aortic stenosis and are an independent risk factor for aortic aneurysms. Currently, there are
[...] Read more.
A bicuspid aortic valve (BAV) is the most common cardiac malformation, found in 0.5% to 2% of the population. BAVs are present in approximately 50% of patients with severe aortic stenosis and are an independent risk factor for aortic aneurysms. Currently, there are no therapeutics to treat BAV, and the human mutations identified to date represent a relatively small number of BAV patients. However, the discovery of BAV in an increasing number of genetically modified mice is advancing our understanding of molecular pathways that contribute to BAV formation. In this study, we utilized the comparison of BAV phenotypic characteristics between murine models as a tool to advance our understanding of BAV formation. The collation of murine BAV data indicated that excess versican within the provisional extracellular matrix (P-ECM) is a common factor in BAV development. While the percentage of BAVs is low in many of the murine BAV models, the remaining mutant mice exhibit larger and more amorphous tricuspid AoVs, also with excess P-ECM compared to littermates. The identification of common molecular characteristics among murine BAV models may lead to BAV therapeutic targets and biomarkers of disease progression for this highly prevalent and heterogeneous cardiovascular malformation.
Full article
(This article belongs to the Section Basic Cardiovascular Research)
►▼
Show Figures

Figure 1
Open AccessArticle
Isolated Dissection of the Ductus Arteriosus Associated with Sudden Unexpected Intrauterine Death
by
, , , , , , , , and
J. Cardiovasc. Dev. Dis. 2021, 8(8), 91; https://doi.org/10.3390/jcdd8080091 - 31 Jul 2021
Abstract
We report five cases of sudden intrauterine death due to premature closure of the ductus arteriosus. In four cases, this was caused by dissecting the hematoma of the ductus arteriosus with intimal flap and obliteration of the lumen. In one case, the ductus
[...] Read more.
We report five cases of sudden intrauterine death due to premature closure of the ductus arteriosus. In four cases, this was caused by dissecting the hematoma of the ductus arteriosus with intimal flap and obliteration of the lumen. In one case, the ductus arteriosus was aneurysmatic, with lumen occlusion caused by thrombus stratification. No drug therapy or free medication consumption were reported during pregnancy. The time of stillbirth ranged between 26 and 33 gestational weeks. We performed TUNEL analysis for apoptosis quantification. The dissecting features were intimal tears with flap formation in four of the cases, just above the origin of the ductus arteriosus from the pulmonary artery. The dissecting hematoma of the ductus arteriosus extended downward to the descending aorta and backward to the aortic arch with involvement of the left carotid and left subclavian arteries. TUNEL analysis showed a high number of apoptotic smooth muscle cells in the media in two cases. Abnormal ductal remodeling with absence of subintimal cushions, lacunar spaces rich in glycosaminoglycans (cystic medial necrosis), and smooth muscle cell apoptosis were the pathological substrates accounting for failure of remodeling process and dissection.
Full article
(This article belongs to the Special Issue Leaders in Cardiovascular Research: A Special Issue Dedicated to Professor Adriana Gittenberger-De Groot)
►▼
Show Figures

Figure 1
Open AccessReview
Fetal Blood Flow and Genetic Mutations in Conotruncal Congenital Heart Disease
by
and
J. Cardiovasc. Dev. Dis. 2021, 8(8), 90; https://doi.org/10.3390/jcdd8080090 - 30 Jul 2021
Abstract
►▼
Show Figures
In congenital heart disease, the presence of structural defects affects blood flow in the heart and circulation. However, because the fetal circulation bypasses the lungs, fetuses with cyanotic heart defects can survive in utero but need prompt intervention to survive after birth. Tetralogy
[...] Read more.
In congenital heart disease, the presence of structural defects affects blood flow in the heart and circulation. However, because the fetal circulation bypasses the lungs, fetuses with cyanotic heart defects can survive in utero but need prompt intervention to survive after birth. Tetralogy of Fallot and persistent truncus arteriosus are two of the most significant conotruncal heart defects. In both defects, blood access to the lungs is restricted or non-existent, and babies with these critical conditions need intervention right after birth. While there are known genetic mutations that lead to these critical heart defects, early perturbations in blood flow can independently lead to critical heart defects. In this paper, we start by comparing the fetal circulation with the neonatal and adult circulation, and reviewing how altered fetal blood flow can be used as a diagnostic tool to plan interventions. We then look at known factors that lead to tetralogy of Fallot and persistent truncus arteriosus: namely early perturbations in blood flow and mutations within VEGF-related pathways. The interplay between physical and genetic factors means that any one alteration can cause significant disruptions during development and underscore our need to better understand the effects of both blood flow and flow-responsive genes.
Full article

Figure 1
Open AccessReview
The Cardiac Neural Crest Cells in Heart Development and Congenital Heart Defects
J. Cardiovasc. Dev. Dis. 2021, 8(8), 89; https://doi.org/10.3390/jcdd8080089 - 30 Jul 2021
Abstract
The neural crest (NC) is a multipotent and temporarily migratory cell population stemming from the dorsal neural tube during vertebrate embryogenesis. Cardiac neural crest cells (NCCs), a specified subpopulation of the NC, are vital for normal cardiovascular development, as they significantly contribute to
[...] Read more.
The neural crest (NC) is a multipotent and temporarily migratory cell population stemming from the dorsal neural tube during vertebrate embryogenesis. Cardiac neural crest cells (NCCs), a specified subpopulation of the NC, are vital for normal cardiovascular development, as they significantly contribute to the pharyngeal arch arteries, the developing cardiac outflow tract (OFT), cardiac valves, and interventricular septum. Various signaling pathways are shown to orchestrate the proper migration, compaction, and differentiation of cardiac NCCs during cardiovascular development. Any loss or dysregulation of signaling pathways in cardiac NCCs can lead to abnormal cardiovascular development during embryogenesis, resulting in abnormalities categorized as congenital heart defects (CHDs). This review focuses on the contributions of cardiac NCCs to cardiovascular formation, discusses cardiac defects caused by a disruption of various regulatory factors, and summarizes the role of multiple signaling pathways during embryonic development. A better understanding of the cardiac NC and its vast regulatory network will provide a deeper insight into the mechanisms of the associated abnormalities, leading to potential therapeutic advancements.
Full article
(This article belongs to the Section Cardiac Development and Regeneration)
►▼
Show Figures

Figure 1
Open AccessReview
Acute Kidney Injury in Cardiogenic Shock: An Updated Narrative Review
by
, , , , , , and
J. Cardiovasc. Dev. Dis. 2021, 8(8), 88; https://doi.org/10.3390/jcdd8080088 - 28 Jul 2021
Abstract
►▼
Show Figures
Acute myocardial infarction with cardiogenic shock (AMI-CS) is associated with high mortality and morbidity despite advancements in cardiovascular care. AMI-CS is associated with multiorgan failure of non-cardiac organ systems. Acute kidney injury (AKI) is frequently seen in patients with AMI-CS and is associated
[...] Read more.
Acute myocardial infarction with cardiogenic shock (AMI-CS) is associated with high mortality and morbidity despite advancements in cardiovascular care. AMI-CS is associated with multiorgan failure of non-cardiac organ systems. Acute kidney injury (AKI) is frequently seen in patients with AMI-CS and is associated with worse mortality and outcomes compared to those without. The pathogenesis of AMI-CS associated with AKI may involve more factors than previously understood. Early use of renal replacement therapies, management of comorbid conditions and judicious fluid administration may help improve outcomes. In this review, we seek to address the etiology, pathophysiology, management, and outcomes of AKI complicating AMI-CS.
Full article

Figure 1
Open AccessArticle
Alternative Splicing of Pericentrin Contributes to Cell Cycle Control in Cardiomyocytes
J. Cardiovasc. Dev. Dis. 2021, 8(8), 87; https://doi.org/10.3390/jcdd8080087 - 27 Jul 2021
Abstract
Induction of cardiomyocyte proliferation is a promising option to regenerate the heart. Thus, it is important to elucidate mechanisms that contribute to the cell cycle arrest of mammalian cardiomyocytes. Here, we assessed the contribution of the pericentrin (Pcnt) S isoform to cell cycle
[...] Read more.
Induction of cardiomyocyte proliferation is a promising option to regenerate the heart. Thus, it is important to elucidate mechanisms that contribute to the cell cycle arrest of mammalian cardiomyocytes. Here, we assessed the contribution of the pericentrin (Pcnt) S isoform to cell cycle arrest in postnatal cardiomyocytes. Immunofluorescence staining of Pcnt isoforms combined with SiRNA-mediated depletion indicates that Pcnt S preferentially localizes to the nuclear envelope, while the Pcnt B isoform is enriched at centrosomes. This is further supported by the localization of ectopically expressed FLAG-tagged Pcnt S and Pcnt B in postnatal cardiomyocytes. Analysis of centriole configuration upon Pcnt depletion revealed that Pcnt B but not Pcnt S is required for centriole cohesion. Importantly, ectopic expression of Pcnt S induced centriole splitting in a heterologous system, ARPE-19 cells, and was sufficient to impair DNA synthesis in C2C12 myoblasts. Moreover, Pcnt S depletion enhanced serum-induced cell cycle re-entry in postnatal cardiomyocytes. Analysis of mitosis, binucleation rate, and cell number suggests that Pcnt S depletion enhances serum-induced progression of postnatal cardiomyocytes through the cell cycle resulting in cell division. Collectively, our data indicate that alternative splicing of Pcnt contributes to the establishment of cardiomyocyte cell cycle arrest shortly after birth.
Full article
(This article belongs to the Section Basic Cardiovascular Research)
►▼
Show Figures

Figure 1
Open AccessArticle
Alternative Approach for Cerebral Protection during Complex Aortic Arch and Redo Surgery
by
, , , , , and
J. Cardiovasc. Dev. Dis. 2021, 8(8), 86; https://doi.org/10.3390/jcdd8080086 - 27 Jul 2021
Abstract
►▼
Show Figures
Total arch replacement remains a very demanding surgical procedure. It can be associated with reasonable long-term outcomes but carries serious perioperative complications. Aortic arch surgery has progressed in recent years to a wider adoption of reproducible and reliable techniques. Conventional open, surgical aortic
[...] Read more.
Total arch replacement remains a very demanding surgical procedure. It can be associated with reasonable long-term outcomes but carries serious perioperative complications. Aortic arch surgery has progressed in recent years to a wider adoption of reproducible and reliable techniques. Conventional open, surgical aortic arch replacement is currently offered to the majority of patients, although hybrid and wholly endovascular techniques are gaining popularity. With regards to open arch replacement, the nuances of surgical technique, the mode of cannulation and the optimal cerebral protection protocols remain a matter of debate. We propose an alternative cannulation approach facilitated by the cooperation between cardiac and vascular surgeons. A three-way arterial cannulation including both carotid arteries and the femoral artery (or ascending aorta) is the key feature of this approach. A case series of complex patients is presented to show both the feasibility and relative safety of a standardised new approach with a 100% technical success rate and a 16% 30-day mortality. The three-way cannulation approach may have a role to play for complex and extensive procedures requiring prolonged cerebral protection. We believe that a shared skill set from cardiac and vascular specialists is essential for the safe management and successful outcomes using this adaptive technique.
Full article

Figure 1
Open AccessArticle
The Effect of Vitamin D on Coronary Atherosclerosis: A Propensity Score Matched Case–Control Coronary CTA Study
by
, , , , , , , , , and
J. Cardiovasc. Dev. Dis. 2021, 8(8), 85; https://doi.org/10.3390/jcdd8080085 - 25 Jul 2021
Abstract
Background: Vitamin D supplementation may be associated with lower cardiovascular (CV) events, but the data are controversial. It remains speculative whether vitamin D supplementation has a direct effect on coronary atherosclerosis. We therefore set out to assess the influence of vitamin D supplementation
[...] Read more.
Background: Vitamin D supplementation may be associated with lower cardiovascular (CV) events, but the data are controversial. It remains speculative whether vitamin D supplementation has a direct effect on coronary atherosclerosis. We therefore set out to assess the influence of vitamin D supplementation on the coronary atherosclerosis profile quantified by coronary computed tomography angiography (CTA) in a retrospective case–control cohort study. Methods: 176 patients (age: 62.4 ± 10.4) referred to coronary CTA for clinical indications were included. A total of 88 patients receiving vitamin D supplementation (mean duration 65.3 ± 81 months) were 1:1 propensity score matched with 88 controls for age, gender, smoking, arterial hypertension, positive family history, dyslipidemia, and diabetes. Coronary stenosis severity (CAD-RADSTM), mixed plaque burden (weighted for non-calcified), high-risk-plaque (HRP) features, and plaque density (HU) were quantified by CTA. Serum 25-hydroxyvitamin D (OH)-levels were measured in 138 patients and categorized into four groups (0: <20 ng/mL; 1: 20–40 ng/mL; 2: 40–60 ng/mL; and 3: >60 ng/mL) and compared with CTA. Results: The prevalence of atherosclerosis by CTA was similar in both groups (75.6% versus 74.3%, p = 0.999), >50% coronary stenosis was slightly higher in controls (p = 0.046), but stenosis severity score (CAD-RADS) was not different (p = 0.106). Mixed plaque burden (weighted for non-calcified) was lower in patients receiving vitamin D supplementation (p = 0.002) and high-risk-plaque prevalence was markedly lower (3.8% versus 32%, p < 0.001). CT plaque density (HU) was higher (p < 0.001) in the vitamin D group. Patients with serum vitamin D (OH) levels >60 ng/mL had higher plaque density (p = 0.04), indicating more calcified and less vulnerable plaque. Conclusions: In this retrospective case–control cohort study, vitamin D supplementation was associated with less high-risk plaque, less non-calcified plaque burden, and a higher calcified plaque independent of CV risk factors.
Full article
(This article belongs to the Section Cardiac Imaging)
►▼
Show Figures

Figure 1
Highly Accessed Articles
Latest Books
E-Mail Alert
News
Conferences
Special Issues
Special Issue in
JCDD
Cardiovascular Tissue Engineering
Guest Editors: Sean M. Wu, Vahid SerpooshanDeadline: 31 August 2021
Special Issue in
JCDD
Zebrafish Heart Development, Regeneration, and Disease Modelling
Guest Editors: Mathilda Mommersteeg, Juan Manuel González-RosaDeadline: 31 December 2021
Special Issue in
JCDD
Echocardiography in Cardiovascular Disease
Guest Editor: Kenya KusunoseDeadline: 31 January 2022
Special Issue in
JCDD
Endothelial Regulation of Cardiac Development, Homeostasis, and Pathology
Guest Editors: Rubén Marín-Juez, Gonzalo del Monte-NietoDeadline: 31 May 2022
