Interdisciplinarity in Cardiovascular Diseases: From Pathophysiology to Diagnosis and Treatment—2nd Edition

A special issue of Life (ISSN 2075-1729). This special issue belongs to the section "Physiology and Pathology".

Deadline for manuscript submissions: 30 June 2024 | Viewed by 5708

Special Issue Editors


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Guest Editor
1. Department of Gastroenterology, “Grigore T. Popa” University of Medicine and Pharmacy, Iasi, Romania
2. Institute of Gastroenterology and Hepatology, "St. Spiridon" University Hospital, Iasi, Romania
Interests: acute and chronic liver disease; steatohepatitis; liver transplantation; inflammatory bowel disease; celiac disease; endomicroscopy
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Guest Editor
Department of Internal Medicine, University of Medicine and Pharmacy “Grigore T. Popa”, 16 University Street, Iasi, Romania
Interests: arrhythmias; atrial fibrillation; left atrium; cardiovascular disease; cardiovascular risk factor; echocardiography; gastroesophageal reflux disease; metabolic-associated steato-hepatitis; heart–liver axis
Special Issues, Collections and Topics in MDPI journals

E-Mail Website
Guest Editor
Department of Internal Medicine, University of Medicine and Pharmacy “Grigore T. Popa”, 16 University Street, Iasi, Romania
Interests: cardiovascular diseases; cardiovascular complications; atherosclerosis; oxidative stress; inflammatory bowel disease; nonalcoholic fatty liver disease; gut microbiota; dysbiosis; type 2 diabetes
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

The first volume of this Special Issue was completed successfully. We intend to publish a second volume, so we invite you to submit your research for publication.

https://www.mdpi.com/journal/life/special_issues/56Z399BE63

Cardiovascular diseases are an important cause of death worldwide. Interdisciplinarity has become mandatory in many cardiovascular diseases like hypertension, ischemic heart disease, arrhythmias, congenital heart disease, pericarditis, arrhythmias or valvular heart disease. The heart team decision has become a common recommendation in cardiology guidelines. Diagnosis and treatment algorithms in cardiovascular disease imply, therefore, interdisciplinary collaboration with gastroenterologists, nephrologists, pulmonologists, neurologists, rheumatologists, hematologists, etc.

Gastroesophageal reflux disease, inflammatory bowel diseases, and metabolic-associated steatohepatitis are some of the digestive diseases that require a mixed team: cardiologist–gastroenterologist. These diseases share common physiopathological mechanisms or substrates and therefore there are diagnostic and therapeutic interferences.

Despite the importance of cardiorenal syndrome and cardiac complications of chronic kidney disease or kidney transplantation, the interaction between nephrology and cardiovascular medicine is much broader. Nowadays, there are many advancements in nephrology and cardiovascular medicine, which merge new diagnostic, monitoring and therapeutic modalities. Patients with acute or chronic kidney disease have pathologies like ischemia, dyslipidemia or hypertension, and need interdisciplinary collaboration with the cardiologist. Nephrocardiology or cardionephrology, defined as the interaction between nephrology and cardiovascular medicine, is the multidirectional interplay of cardiovascular diseases and nephrology-related conditions.

Respiratory medicine and cardiac pathology share multiple comorbidities such as pulmonary hypertension, pulmonary embolism and COPD. The cardiovascular and respiratory systems share common physiological and pathophysiological mechanisms and complications. The recent COVID-19 pandemic is the best example of the interdisciplinarity between cardiologists and pulmonologists.

Beyond the frequent interactions of cardiology with gastroenterohepatology, nephrology or respiratory medicine, there are many others like metabolic, endocrinology or hematology diseases, which share common risk factors, comorbidities and complications.

To conclude, the heart team concept brings to the fore the need for interdisciplinary collaboration in cardiology. The liver–heart, bowel–heart, brain–heart or kidney–heart axes might explain the pathophysiologic interferences and the multiples clinical consequences. Therefore, prevention, diagnosis and therapy of cardiovascular diseases increasingly involve collaboration with other specialties for the best decisions for our patients. In addition, interdisciplinarity in cardiovascular disease might create new algorithms from diagnostic or therapeutic points of view in some cardiovascular diseases.

Prof. Dr. Anca Trifan
Prof. Dr. Mariana Floria
Dr. Daniela Maria Tanase
Guest Editors

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Keywords

  • interdisciplinary team
  • cardiovascular diseases
  • cardiovascular complications
  • gastro-esophago-enterology and hepatology
  • metabolic associated steato-hepatitis
  • gut microbiota
  • nephrocardiology
  • pulmonary diseases
  • rheumatology diseases
  • endocrinology diseases

Published Papers (3 papers)

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Review

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17 pages, 734 KiB  
Review
Vascular Alterations Following COVID-19 Infection: A Comprehensive Literature Review
by Paschalis Karakasis, Athina Nasoufidou, Marios Sagris, Nikolaos Fragakis and Konstantinos Tsioufis
Life 2024, 14(5), 545; https://doi.org/10.3390/life14050545 - 24 Apr 2024
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Abstract
SARS-CoV-2, the causative agent of the ongoing COVID-19 pandemic, has revealed a broader impact beyond the respiratory system, predominantly affecting the vascular system with various adverse manifestations. The infection induces endothelial dysfunction and immune system dysregulation, creating an inflammatory and hypercoagulable state. It [...] Read more.
SARS-CoV-2, the causative agent of the ongoing COVID-19 pandemic, has revealed a broader impact beyond the respiratory system, predominantly affecting the vascular system with various adverse manifestations. The infection induces endothelial dysfunction and immune system dysregulation, creating an inflammatory and hypercoagulable state. It affects both microvasculature and macrovasculature, leading to thromboembolic events, cardiovascular manifestations, impaired arterial stiffness, cerebrovascular complications, and nephropathy, as well as retinopathy—frequently observed in cases of severe illness. Evidence suggests that SARS-CoV-2 infection may result in persistent effects on the vascular system, identified as long-term COVID-19. This is characterized by prolonged inflammation, endotheliopathy, and an increased risk of vascular complications. Various imaging modalities, histopathological studies, and diagnostic tools such as video capillaroscopy and magnetic resonance imaging have been employed to visualize vascular alterations. This review aims to comprehensively summarize the evidence concerning short and long-term vascular alterations following COVID-19 infection, investigating their impact on patients’ prognosis, and providing an overview of preventive strategies to mitigate associated vascular complications. Full article
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17 pages, 1108 KiB  
Review
Interleukin-1 Blockers: A Paradigm Shift in the Treatment of Recurrent Pericarditis
by Emilia Lazarou, Christos Koutsianas, Panagiotis Theofilis, George Lazaros, Dimitrios Vassilopoulos, Charalambos Vlachopoulos, Costas Tsioufis, Massimo Imazio, Antonio Brucato and Dimitris Tousoulis
Life 2024, 14(3), 305; https://doi.org/10.3390/life14030305 - 26 Feb 2024
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Abstract
Recurrent pericarditis is a problematic clinical condition that impairs the quality of life of the affected patients due to the need for repeated hospital admissions, emergency department visits, and complications from medications, especially glucocorticoids. Unfortunately, available treatments for recurrent pericarditis are very limited, [...] Read more.
Recurrent pericarditis is a problematic clinical condition that impairs the quality of life of the affected patients due to the need for repeated hospital admissions, emergency department visits, and complications from medications, especially glucocorticoids. Unfortunately, available treatments for recurrent pericarditis are very limited, including only a handful of medications such as aspirin/NSAIDs, glucocorticoids, colchicine, and immunosuppressants (such as interleukin-1 (IL-1) blockers, azathioprine, and intravenous human immunoglobulins). Until recently, the clinical experience with the latter class of medications was very limited. Nevertheless, in the last decade, experience with IL-1 blockers has consistently grown, and valid clinical data have emerged from randomized clinical trials. Accordingly, IL-1 blockers are a typical paradigm shift in the treatment of refractory recurrent pericarditis with a clearly positive cost/benefit ratio for those unfortunate patients with multiple recurrences. A drawback related to the above-mentioned medications is the absence of universally accepted and established treatment protocols regarding the full dose administration period and the need for a tapering protocol for individual medications. Another concern is the need for long-standing treatments, which should be discussed with the patients. The above-mentioned unmet needs are expected to be addressed in the near future, such as further insights into pathophysiology and an individualized approach to affected patients. Full article
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14 pages, 1655 KiB  
Systematic Review
Retinal Structural and Vascular Changes in Patients with Coronary Artery Disease: A Systematic Review and Meta-Analysis
by Alexandra Cristina Rusu, Karin Ursula Horvath, Grigore Tinica, Raluca Ozana Chistol, Andra-Irina Bulgaru-Iliescu, Ecaterina Tomaziu Todosia and Klara Brînzaniuc
Life 2024, 14(4), 448; https://doi.org/10.3390/life14040448 - 28 Mar 2024
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Abstract
Background: Retinal microvascular anomalies have been identified in patients with cardiovascular conditions such as arterial hypertension, diabetes mellitus, and carotid artery disease. We conducted a systematic review and meta-analysis (PROSPERO registration number CRD42024506589) to explore the potential of retinal vasculature as a biomarker [...] Read more.
Background: Retinal microvascular anomalies have been identified in patients with cardiovascular conditions such as arterial hypertension, diabetes mellitus, and carotid artery disease. We conducted a systematic review and meta-analysis (PROSPERO registration number CRD42024506589) to explore the potential of retinal vasculature as a biomarker for diagnosis and monitoring of patients with coronary artery disease (CAD) through optical coherence tomography (OCT) and optical coherence tomography angiography (OCTA). Methods: We systematically examined original articles in the Pubmed, Embase, and Web of Science databases from their inception up to November 2023, comparing retinal microvascular features between patients with CAD and control groups. Studies were included if they reported sample mean with standard deviation or median with range and/or interquartile range (which were computed into mean and standard deviation). Review Manager 5.4 (The Cochrane Collaboration, 2020) software was used to calculate the pooled effect size with weighted mean difference and 95% confidence intervals (CI) by random-effects inverse variance method. Results: Eleven studies meeting the inclusion criteria were incorporated into the meta-analysis. The findings indicated a significant decrease in the retinal nerve fiber layer (WMD −3.11 [−6.06, −0.16]), subfoveal choroid (WMD −58.79 [−64.65, −52.93]), and overall retinal thickness (WMD −4.61 [−7.05, −2.17]) among patients with CAD compared to controls (p < 0.05). Furthermore, vascular macular density was notably lower in CAD patients, particularly in the superficial capillary plexus (foveal vessel density WMD −2.19 [−3.02, −1.135], p < 0.0001). Additionally, the foveal avascular zone area was statistically larger in CAD patients compared to the control group (WMD 52.73 [8.79, 96.67], p = 0.02). Heterogeneity was significant (I2 > 50%) for most features except for subfoveal choroid thickness, retina thickness, and superficial foveal vessel density. Conclusion: The current meta-analysis suggests that retinal vascularization could function as a noninvasive biomarker, providing additional insights beyond standard routine examinations for assessing dysfunction in coronary arteries. Full article
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