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Special Issue Editor

Dr. Thomas Stiermaier

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Guest Editor

1. Department of Cardiology, Angiology and Intensive Care Medicine, Medical Clinic II, University Heart Center Lübeck, 23538 Lübeck, Germany
2. German Center for Cardiovascular Research (DZHK), Partner Site Hamburg/Kiel/Lübeck, 23538 Lübeck, Germany
Interests: acute coronary syndrome; takotsubo syndrome; interventional cardiology; cardiac magnetic resonance
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Myocardial diseases are abnormalities of the cardiac muscle and can be divided into primary and secondary types. Primary myocardial diseases are mainly related to genetic causes and include different cardiomyopathies (hypertrophic, dilated, restrictive, infiltrative, etc.) and storage diseases. Secondary types of myocardial diseases are mostly acquired (with a potential genetic background) and can be caused by hypertension, valvular heart disease, ischemia, or heart rhythm disease, among other conditions. In addition, some rare diseases such as Takotsubo syndrome or peripartum cardiomyopathy belong to the secondary forms of myocardial diseases. The underlying pathophysiology of the primary and secondary types of myocardial diseases are to some extent considerably different, which has immediate implications in terms of treatment approaches. While symptomatic therapy is quite similar in some myocardial diseases, specific causal treatment requires accurate knowledge of the underlying disease mechanisms and differs between the respective types. This Special Issue aims to provide an overview of the latest evidence and close the gaps in the current understanding of myocardial diseases to improve treatment options. Therefore, I welcome the submission of in-depth review articles and innovative original research papers in the important field of myocardial diseases.

Dr. Thomas Stiermaier
Guest Editor

Manuscript Submission Information

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Keywords

myocardial diseases
cardiomyopathies
pathophysiology
treatment

Published Papers (2 papers)

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Research

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13 pages, 472 KiB

Open AccessArticle

Subclinical Myocardial Injury in Patients Recovered from COVID-19 Pneumonia: Predictors and Longitudinal Assessment

by Antonella Cecchetto, Gianpaolo Torreggiani, Gabriella Guarnieri, Andrea Vianello, Giulia Baroni, Chiara Palermo, Leonardo Bertagna De Marchi, Giulia Lorenzoni, Patrizia Bartolotta, Emanuele Bertaglia, Filippo Donato, Patrizia Aruta, Sabino Iliceto and Donato Mele

J. Cardiovasc. Dev. Dis. 2023, 10(4), 179; https://doi.org/10.3390/jcdd10040179 - 19 Apr 2023

Cited by 3 | Viewed by 1034

Abstract

(1) Background: Emerging data regarding patients recovered from COVID-19 are reported in the literature, but cardiac sequelae have not yet been clarified. To quickly detect any cardiac involvement at follow-up, the aims of the research were to identify: elements at admission predisposing subclinical myocardial injury at follow up; the relationship between subclinical myocardial injury and multiparametric evaluation at follow-up; and subclinical myocardial injury longitudinal evolution. (2) Methods and Results: A total of 229 consecutive patients hospitalised for moderate to severe COVID-19 pneumonia were initially enrolled, of which 225 were available for follow-up. All patients underwent a first follow-up visit, which included a clinical evaluation, a laboratory test, echocardiography, a six-minute walking test (6MWT), and a pulmonary functional test. Of the 225 patients, 43 (19%) underwent a second follow-up visit. The median time to the first follow-up after discharge was 5 months, and the median time to the second follow-up after discharge was 12 months. Left ventricular global longitudinal strain (LVGLS) and right ventricular free wall strain (RVFWS) were reduced in 36% (n = 81) and 7.2% (n = 16) of the patients, respectively, at first the follow-up visit. LVGLS impairment showed correlations with patients of male gender (p 0.008, OR 2.32 (95% CI 1.24–4.42)), the presence of at least one cardiovascular risk factor (p < 0.001, OR 6.44 (95% CI 3.07–14.9)), and final oxygen saturation (p 0.002, OR 0.99 (95% CI 0.98–1)) for the 6MWTs. Subclinical myocardial dysfunction had not significantly improved at the 12-month follow-ups. (3) Conclusions: in patients recovered from COVID-19 pneumonia, left ventricular subclinical myocardial injury was related to cardiovascular risk factors and appeared stable during follow-up. Full article

(This article belongs to the Special Issue Further Understanding of Myocardial Diseases: From Mechanisms to Treatment)

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Review

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20 pages, 929 KiB

Open AccessReview

Metabolic Approaches for the Treatment of Dilated Cardiomyopathy

by Roberto Spoladore, Giuseppe Pinto, Francesca Daus, Sara Pezzini, Damianos Kolios and Gabriele Fragasso

J. Cardiovasc. Dev. Dis. 2023, 10(7), 287; https://doi.org/10.3390/jcdd10070287 - 05 Jul 2023

Cited by 1 | Viewed by 1963

Abstract

In dilated cardiomyopathy (DCM), where the heart muscle becomes stretched and thin, heart failure (HF) occurs, and the cardiomyocytes suffer from an energetic inefficiency caused by an abnormal cardiac metabolism. Although underappreciated as a potential therapeutic target, the optimal metabolic milieu of a failing heart is still largely unknown and subject to debate. Because glucose naturally has a lower P/O ratio (the ATP yield per oxygen atom), the previous studies using this strategy to increase glucose oxidation have produced some intriguing findings. In reality, the vast majority of small-scale pilot trials using trimetazidine, ranolazine, perhexiline, and etomoxir have demonstrated enhanced left ventricular (LV) function and, in some circumstances, myocardial energetics in chronic ischemic and non-ischemic HF with a reduced ejection fraction (EF). However, for unidentified reasons, none of these drugs has ever been tested in a clinical trial of sufficient size. Other pilot studies came to the conclusion that because the heart in severe dilated cardiomyopathy appears to be metabolically flexible and not limited by oxygen, the current rationale for increasing glucose oxidation as a therapeutic target is contradicted and increasing fatty acid oxidation is supported. As a result, treating metabolic dysfunction in HF may benefit from raising ketone body levels. Interestingly, treatment with sodium-glucose cotransporter-2 inhibitors (SGLT2i) improves cardiac function and outcomes in HF patients with or without type 2 diabetes mellitus (T2DM) through a variety of pleiotropic effects, such as elevated ketone body levels. The improvement in overall cardiac function seen in patients receiving SGLT2i could be explained by this increase, which appears to be a reflection of an adaptive process that optimizes cardiac energy metabolism. This review aims to identify the best metabolic therapeutic approach for DCM patients, to examine the drugs that directly affect cardiac metabolism, and to outline all the potential ancillary metabolic effects of the guideline-directed medical therapy. In addition, a special focus is placed on SGLT2i, which were first studied and prescribed to diabetic patients before being successfully incorporated into the pharmacological arsenal for HF patients. Full article

(This article belongs to the Special Issue Further Understanding of Myocardial Diseases: From Mechanisms to Treatment)

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