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Clinical Burden of Comorbidities on Cardiovascular System and Beyond: 2nd...
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Clinical Burden of Comorbidities on Cardiovascular System and Beyond: 2nd Edition

A special issue of Journal of Cardiovascular Development and Disease (ISSN 2308-3425). This special issue belongs to the section "Cardiovascular Clinical Research".

Deadline for manuscript submissions: 31 May 2026 | Viewed by 6718

Special Issue Editor

Prof. Dr. Zbigniew Siudak

E-Mail Website
Guest Editor
Medical College, Jan Kochanowski University, 25-317 Kielce, Poland
Interests: epidemiology; co-morbidities; acute coronary syndromes; diabetes; inflammation; platelets; PCI; statistics
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

The scope of this JCDD Special Issue is to promote a multidisciplinary approach to cardiovascular disease and its burden. Atherosclerosis is a generalized inflammatory process that almost never impacts solely on the heart and coronary system. Recent decades, but also the COVID-19 pandemic, have underlined the importance of comorbidities on cardiovascular disease and outcomes. We seek novel and bold analyses of known and hypothetical but currently untested markers, imaging methods and co-morbidities on the heart and vessels.

This Special Issue will provide a platform for the presentation of recent advances in knowledge on the development of cardiovascular disease from diverse scientific disciplines including internal medicine and cardiac surgery, as well as basic sciences and dentistry. The broad focus of the Special Issue will enhance our understanding of the range of cardiovascular disease burden.

Prof. Dr. Zbigniew Siudak
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 250 words) can be sent to the Editorial Office for assessment.

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. Journal of Cardiovascular Development and Disease is an international peer-reviewed open access monthly 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 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

  • co-morbidity
  • inflammation
  • valves
  • stents
  • epidemiology
  • coronary
  • diabetes
  • gender
  • age
  • markers

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Related Special Issue

Published Papers (5 papers)

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Research

12 pages, 735 KB  
Article
Long-Term Mortality and Survival in Patients with Acute Heart Failure Assessed by Emergency Medical Services
by Enrique Castro-Portillo, Ana Ramos-Rodríguez, Raúl López-Izquierdo, Irene Bermudez-Castellanos, Miguel Á. Castro Villamor, Santiago Otero de la Torre, Francisco T. Martínez Fernández, Irene Sánchez Soberon, Ancor Sanz-García and Francisco Martín-Rodríguez
J. Cardiovasc. Dev. Dis. 2025, 12(12), 485; https://doi.org/10.3390/jcdd12120485 - 10 Dec 2025
Viewed by 641
Abstract
Background: Acute heart failure (AHF) is a common reason for emergency care, yet data on its epidemiology and prognosis in the prehospital setting remain limited. This study aims to analyze the characteristics and long-term survival outcomes of patients with AHF managed by emergency [...] Read more.
Background: Acute heart failure (AHF) is a common reason for emergency care, yet data on its epidemiology and prognosis in the prehospital setting remain limited. This study aims to analyze the characteristics and long-term survival outcomes of patients with AHF managed by emergency medical services (EMSs). Methods: A multicenter, prospective, observational study was conducted in adult patients attended by EMSs and transferred to emergency departments (EDs). Collected data included demographics, vital signs, laboratory parameters, chronic obstructive pulmonary disease (COPD) history, comorbidity burden assessed using the Age-adjusted Charlson Comorbidity Index (aCCI), and clinical outcomes. The primary endpoint was 2-year mortality (M2Y). Survival analysis was performed using Cox regression and Kaplan–Meier analysis. Results: A total of 417 patients were included. Their median age was 84 years, and 48.2% were women. A total of 92.3% of the patients had an elevated aCCI. Overall, M2Y was 57.6%, rising to 74.4% among COPD patients. aCCI range and elevated plasma potassium and lactate levels were independently associated with reduced survival (HR 2.86, 1.45 and 1.15, respectively). Overall, 50% of all deaths occurred within the first 49 days. Conclusions: AHF patients attended by EMSs exhibited high 2-year mortality, likely due to advanced age and comorbidities. High comorbidity burden and abnormal potassium and lactate levels were linked to worse outcomes. Full article
(This article belongs to the Special Issue Clinical Burden of Comorbidities on Cardiovascular System and Beyond: 2nd Edition)
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11 pages, 245 KB  
Article
Prescription Trends and the Role of Cardiologists in the Diagnosis and Treatment of Erectile Dysfunction
by Filip Tkaczyk, Michal Chudzik, Aleksandra M. Piotrowska, Tim Stolpe, Julia Zurawska and Zbigniew Siudak
J. Cardiovasc. Dev. Dis. 2025, 12(10), 414; https://doi.org/10.3390/jcdd12100414 - 21 Oct 2025
Viewed by 1281
Abstract
Introduction: Erectile dysfunction (ED) is strongly associated with metabolic and cardiovascular diseases and may serve as a marker of vascular pathology. Phosphodiesterase type 5 (PDE-5) inhibitors are the mainstay of treatment. Considering this link, cardiologists and internists might be expected to play a [...] Read more.
Introduction: Erectile dysfunction (ED) is strongly associated with metabolic and cardiovascular diseases and may serve as a marker of vascular pathology. Phosphodiesterase type 5 (PDE-5) inhibitors are the mainstay of treatment. Considering this link, cardiologists and internists might be expected to play a key role in therapy initiation. Purpose: This study evaluated prescription patterns of PDE-5 inhibitors in Poland, focusing on physician specialization and consultation type. Methods: We performed a retrospective analysis of electronic health records from over 300 outpatient clinics (2014–2024). Men >18 years with newly diagnosed ED were included. Data on the first prescriptions of sildenafil and tadalafil were assessed. Ethical approval was obtained. Results: A total of 11,998 patients were identified (mean age 42 years; mean BMI 26.54 kg/m2). Common comorbidities included hypercholesterolemia (67.0%), hypertension (58.5%), obesity (31.5%), and diabetes (12.4%). PDE-5 inhibitors (predominantly tadalafil (≈67%)) were prescribed in 71.5% of cases. Urologists accounted for 51.0% of prescriptions, sexologists 14.9%, internists 20.4%, and cardiologists only 0.10%. Treated patients were younger and had a lower BMI, fewer comorbidities, and more favorable metabolic profiles (all p < 0.05). Conclusions: Contrary to expectations, cardiologists and internists rarely initiate PDE-5 therapy. Prescribing is dominated by urologists despite high rates of cardiovascular comorbidities. A multidisciplinary approach incorporating metabolic and cardiovascular risk assessment is warranted. Full article
(This article belongs to the Special Issue Clinical Burden of Comorbidities on Cardiovascular System and Beyond: 2nd Edition)
13 pages, 738 KB  
Article
Impaired Left Atrial Strain as an Early Marker of Cardiac Involvement in Type 2 Diabetes Mellitus: A Cross-Sectional Study
by Laura-Cătălina Benchea, Larisa Anghel, Nicoleta Dubei, Răzvan-Liviu Zanfirescu, Gavril-Silviu Bîrgoan, Radu Andy Sascău and Cristian Stătescu
J. Cardiovasc. Dev. Dis. 2025, 12(9), 369; https://doi.org/10.3390/jcdd12090369 - 19 Sep 2025
Cited by 1 | Viewed by 1098
Abstract
Background: Diabetic cardiomyopathy is a major contributor to cardiovascular morbidity, often progressing silently before overt heart failure. Left atrial (LA) strain, assessed via speckle-tracking echocardiography, could serve as an early indicator of subclinical myocardial dysfunction in patients with type 2 diabetes mellitus (T2DM). [...] Read more.
Background: Diabetic cardiomyopathy is a major contributor to cardiovascular morbidity, often progressing silently before overt heart failure. Left atrial (LA) strain, assessed via speckle-tracking echocardiography, could serve as an early indicator of subclinical myocardial dysfunction in patients with type 2 diabetes mellitus (T2DM). Objectives: The objectives of this study were to evaluate LA strain parameters in patients with T2DM versus non-diabetic controls and investigate their association with glycemic control and diabetes duration. Methods: This cross-sectional study, designed according to STROBE reporting guidelines, included 47 participants (25 with T2DM and 22 controls) undergoing comprehensive echocardiographic and biochemical evaluation. LA reservoir (LASr), conduit (LAScd), and booster-pump (LASbp) strain values were measured. Associations with glycosylated hemoglobin (HbA1c) and diabetes duration were assessed via multivariate analysis. ROC curves were used to evaluate predictive performance. Results: Diabetic patients had significantly lower LASr (20.4 ± 7.25% vs. 26.7 ± 8.0%, p = 0.007), LAScd (−10.9 ± 5.4% vs. −15.6 ± 6.5%, p = 0.010), and LASbp (−9.9 ± 4.2% vs. −12.9 ± 5.0%, p = 0.034). LASr and LAScd remained independent predictors in multivariate models. ROC analysis showed good discrimination (AUC: LAScd = 0.78; LASr = 0.73). Conclusions: This study demonstrates that LASr and LAScd are independently associated with type 2 diabetes mellitus and can reliably identify subclinical atrial dysfunction before the onset of structural or symptomatic heart disease. Full article
(This article belongs to the Special Issue Clinical Burden of Comorbidities on Cardiovascular System and Beyond: 2nd Edition)
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13 pages, 1602 KB  
Article
Implications of Myocardial Fibrosis Burden on Left Ventricular Systolic Function in Sepsis Survivors: Insights from a Retrospective Cohort Study Using Quantitative Late Gadolinium Enhancement Cardiovascular Magnetic Resonance
by Shayan Datta, Samuel Malomo, Thomas Oswald, Claire Phillips, Barbara Philips, Joon Lee, David Hildick-Smith, Victoria Parish and Alexander Liu
J. Cardiovasc. Dev. Dis. 2025, 12(8), 306; https://doi.org/10.3390/jcdd12080306 - 13 Aug 2025
Viewed by 1184
Abstract
Background: After recovery from acute sepsis, patients can exhibit left ventricular systolic dysfunction (LVSD) and non-ischaemic myocardial fibrosis. The relationship between myocardial fibrosis and LVSD remains poorly defined. This study sought to fill this knowledge gap using quantitative late gadolinium enhancement (LGE) cardiovascular [...] Read more.
Background: After recovery from acute sepsis, patients can exhibit left ventricular systolic dysfunction (LVSD) and non-ischaemic myocardial fibrosis. The relationship between myocardial fibrosis and LVSD remains poorly defined. This study sought to fill this knowledge gap using quantitative late gadolinium enhancement (LGE) cardiovascular magnetic resonance (CMR). Methods: Twenty-eight sepsis survivors underwent CMR at 1.5-Tesla for the assessment of cardiac volumes, systolic function and LGE. Myocardial fibrosis burden was derived quantitatively by LGE, expressed as a percentage of LV mass. Results: Study patients (age 51 ± 16 years; 57% males) had a median LVEF of 59% (IQR: 43–64) of whom 43% had LVSD (LV ejection fraction [LVEF] < 50%). LGE was found in 64% of the study patients by visual assessment, mostly in non-ischaemic patterns. The overall myocardial fibrosis burden was 3.3% (IQR: 0.9–7.1) of LV mass. Myocardial fibrosis burden was inversely correlated to LVEF in sepsis survivors (Rho = -0.385; p = 0.043). Patients with LVSD had greater myocardial fibrosis burden than patients without LVSD (7.3 ± 6.0% vs. 3.1 ± 2.5%; p = 0.041). Myocardial fibrosis burden was not significantly influenced by the presence of major co-morbidities. Conclusions: Myocardial fibrosis burden may play a role in LV dysfunction in sepsis survivors. Further work is needed to better understand its prognostic value. Full article
(This article belongs to the Special Issue Clinical Burden of Comorbidities on Cardiovascular System and Beyond: 2nd Edition)
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13 pages, 239 KB  
Article
In-Hospital Mortality and Costs of Added Morbidity in Heart Failure Patients at a University Hospital: A Retrospective Cross-Sectional Study
by Lourdes Raya Ortega, Jesús Martínez Tapias, María José Ferreras Fernández, Manuel Jiménez-Navarro, Almudena Ortega-Gómez, Miguel Romero-Cuevas and Juan José Gómez-Doblas
J. Cardiovasc. Dev. Dis. 2025, 12(5), 185; https://doi.org/10.3390/jcdd12050185 - 15 May 2025
Cited by 1 | Viewed by 1774
Abstract
Background: Heart failure (HF) is a leading cause of hospital admissions and in-hospital mortality among the elderly. This study aims to characterize HF patients admitted to Virgen de la Victoria University Hospital (HUVV), identify factors associated with in-hospital mortality and analyze the impact [...] Read more.
Background: Heart failure (HF) is a leading cause of hospital admissions and in-hospital mortality among the elderly. This study aims to characterize HF patients admitted to Virgen de la Victoria University Hospital (HUVV), identify factors associated with in-hospital mortality and analyze the impact of added morbidity on healthcare costs. Methods: A cross-sectional study was conducted using data from the Minimum Basic Data Set (MBDS) at HUVV. We included all discharges with a primary diagnosis of HF in 2021. Logistic regression analysis was employed to identify factors associated with mortality, and cost analysis was performed to assess the economic impact of added morbidity. Results: A total of 731 hospital discharges for HF were analyzed, with a mortality rate of 14.77%. Mortality was significantly associated with age ≥ 75 years (OR = 4.12; p < 0.001), high or extreme severity (OR = 2.26 and 8.10, respectively; p < 0.001), and more than 10 diagnoses at discharge (OR = 2.95; p < 0.01). Treatment with angiotensin-converting enzyme inhibitors (ACEIs) or angiotensin II receptor blockers (ARBs) was associated with a reduced risk of death (OR = 0.29; p < 0.001). Hospital-acquired morbidity occurred in 27.22% of patients, resulting in an additional cost of EUR 152,780.61, representing a 3.8% increase over the total hospitalization costs. Conclusions: In-hospital mortality in HF patients at HUVV is strongly associated with advanced age, disease severity, and multiple comorbidities. Treatment with ACEIs or ARBs was associated with a lower likelihood of in-hospital mortality. Preventable added morbidity was associated with increased healthcare costs, highlighting the importance of infection control measures and multidisciplinary management to potentially improve outcomes and reduce costs. Full article
(This article belongs to the Special Issue Clinical Burden of Comorbidities on Cardiovascular System and Beyond: 2nd Edition)
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