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Life
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Management of Ischemia and Heart Failure—3rd Edition
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Management of Ischemia and Heart Failure—3rd Edition

A special issue of Life (ISSN 2075-1729). This special issue belongs to the section "Medical Research".

Deadline for manuscript submissions: closed (31 October 2025) | Viewed by 2468

Special Issue Editor

Dr. Cristian Mornoş

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Guest Editor
Cardiology Department, “Victor Babes” University of Medicine and Pharmacy, 2 Eftimie Murgu Square, 300041 Timisoara, Romania
Interests: heart failure; acute coronary syndrome; speckle tracking; tissue Doppler imaging
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

We are grateful to the researchers who contributed to the first and second editions of this Special Issue, linked below:

Management of Ischemia and Heart Failure: https://www.mdpi.com/journal/life/special_issues/ischemia_heart

Management of Ischemia and Heart Failure—2nd Edition: https://www.mdpi.com/journal/life/special_issues/74677OH137

We are pleased to announce the upcoming publication of the latest edition of our Special Issue, entitled “Management of Ischemia and Heart Failure—3rd Edition”.

Heart disease is the number one cause of death worldwide, within which myocardial ischemia and heart failure are some of the most important entities. Heart failure is a complex syndrome responsible for high rates of death and hospitalization. Ischemic heart disease is one of the most frequent causes of heart failure, and is normally attributed to coronary artery disease, defined by the presence of one or more obstructive plaques, which restrict coronary blood flow, causing myocardial ischemia and consequent heart failure. Coronary microvascular dysfunction results in an inability of coronary circulation to satisfy myocardial metabolic demands due to the imbalance of coronary blood flow regulatory mechanisms, including in ion channels, leading to the development of hypoxia, fibrosis and tissue death, which may determine a loss of myocardial function, even beyond the presence of atherosclerotic epicardial plaques. 

The aim of this Special Issue is to analyze and discuss major unsolved issues, from basic research to new medical and interventional options, to provide the best management strategies. Invited papers will focus on left ventricular remodeling, reperfusion injury (potential targets for treatment), prognostic markers, timing and tools to achieve optimal management in patients with ischemia and heart failure, and concepts to improve heart failure networks.

Dr. Cristian Mornoş
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. Life 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 2600 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 failure
  • myocardial ischemia
  • left ventricular remodeling
  • prognosis

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Published Papers (4 papers)

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Research

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19 pages, 3373 KB  
Article
Beyond the Heart: The Neuroprotective Potential of Nebivolol in Acute Myocardial Infarction
by Guldem Mercanoglu, Ozge E. Bamac, Gulbin Sennazlı, Rivaze Kalaycı and Fehmi Mercanoglu
Life 2025, 15(12), 1880; https://doi.org/10.3390/life15121880 - 9 Dec 2025
Viewed by 299
Abstract
Myocardial infarction (MI) triggers complex heart–brain interactions that increase the risk of stroke, cognitive decline, and mortality. Neuroinflammation and oxidative stress serve as critical mediators of these complications. We evaluated the neuroprotective effects of nebivolol, a β-blocker with nitric oxide-releasing properties, during acute [...] Read more.
Myocardial infarction (MI) triggers complex heart–brain interactions that increase the risk of stroke, cognitive decline, and mortality. Neuroinflammation and oxidative stress serve as critical mediators of these complications. We evaluated the neuroprotective effects of nebivolol, a β-blocker with nitric oxide-releasing properties, during acute MI. Male Sprague-Dawley rats were divided into sham-operated controls, MI-induced controls, and MI groups treated with oral nebivolol or intravenous loading followed by oral nebivolol. MI was induced by left anterior descending coronary artery ligation. Cardiac function was assessed by echocardiography and hemodynamic measurements. Brain tissues were analyzed for proinflammatory cytokines, oxidative stress markers, and histopathological changes. Nitric oxide synthase (NOS) isoform expression was evaluated by immunohistochemistry. MI induced significant neuroinflammation in the cerebral cortex and hippocampus, characterized by elevated cytokines, increased oxidative stress, upregulated iNOS expression, and altered histological patterns (necrosis, astrocytosis, gliosis, demyelination). Intravenous nebivolol significantly reduced these neuroinflammatory markers, normalized cytokine levels, prevented structural brain changes, and attenuated iNOS expression, while oral administration showed minimal effects. Both routes preserved cardiac function without affecting infarct size. These findings demonstrate that nebivolol, particularly via intravenous administration, provides significant NO-dependent neuroprotection during acute MI, supporting its potential as a dual-action therapeutic strategy targeting both cardiac and neurological complications. Full article
(This article belongs to the Special Issue Management of Ischemia and Heart Failure—3rd Edition)
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14 pages, 1208 KB  
Article
The Neutrophil-to-Albumin Ratio (NAR) Reflects the Severity of the Post-CABG Inflammatory Response and Is Associated with a Pre-Existing Pro-Inflammatory Monocyte Profile
by Mikhail A. Popov, Siarhei A. Dabravolski, Vladislav V. Dontsov, Sergei A. Vzvarov, Evgeniy G. Agafonov, Dmitriy I. Zybin, Alexandra K. Kharabet, Olga V. Radchenkova, Dmitriy R. Saveliev, Victoria P. Pronina, Svetlana S. Verkhova, Nikita G. Nikiforov, Yegor S. Chegodaev, Alexander D. Zhuravlev, Daiana B. Erdyneeva, Yegor E. Yegorov, Elena E. Sigaleva, Milena I. Koloteva, Ekaterina V. Silina, Victor A. Stupin, Alexander V. Ivanov and Dmitriy V. Shumakovadd Show full author list remove Hide full author list
Life 2025, 15(12), 1790; https://doi.org/10.3390/life15121790 - 21 Nov 2025
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Abstract
Background: The systemic inflammatory response to coronary artery bypass grafting (CABG) is highly variable and a key driver of complications. We hypothesised that a pre-existing pro-inflammatory immune state, characterised by a skewed monocyte profile, ‘primes’ patients for an exaggerated response. This pilot prospective [...] Read more.
Background: The systemic inflammatory response to coronary artery bypass grafting (CABG) is highly variable and a key driver of complications. We hypothesised that a pre-existing pro-inflammatory immune state, characterised by a skewed monocyte profile, ‘primes’ patients for an exaggerated response. This pilot prospective study aimed to test this hypothesis and to evaluate the Neutrophil-to-Albumin Ratio (NAR) as an integrated biomarker of this response, comparing it against the established Neutrophil-to-Lymphocyte Ratio (NLR). Methods: In this pilot prospective, single-centre pilot study, we enrolled 34 patients with multivessel coronary artery disease (CAD) scheduled for off-pump CABG and 20 control subjects. Preoperatively, peripheral blood monocyte subsets were quantified by flow cytometry. Neutrophil, lymphocyte, and albumin levels were measured before and after surgery to calculate NAR and NLR. Multivariable linear regression was used to test for independent predictors of the inflammatory response. Results: Preoperatively, CAD patients exhibited a reduced percentage of the classical monocyte subpopulation (p < 0.001), with a skew toward intermediate and non-classical subpopulations. Postoperatively, both NAR and NLR increased significantly (p < 0.001) and performed comparably in discriminating the postoperative state (AUC: 0.89 vs. 0.86, p > 0.05). Critically, in multivariable linear regression analysis, the preoperative percentage of classical monocytes remained a significant and independent predictor of the magnitude of the postoperative NAR surge (β = −0.028, p = 0.007), after adjusting for clinical confounders including atherosclerotic burden. Conclusion: A patient’s preoperative immune profile, specifically the degree of monocyte skew, is an independent predictor of the acute inflammatory response to CABG. This finding supports a ‘priming’ mechanism in high-risk patients. While NAR and NLR perform similarly as monitoring tools, the independent link between the underlying immunology and the postoperative outcome suggests that combining preoperative immunophenotyping with simple biomarker monitoring could offer a powerful new strategy for personalised risk stratification in cardiac surgery. Full article
(This article belongs to the Special Issue Management of Ischemia and Heart Failure—3rd Edition)
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13 pages, 834 KB  
Article
Retrospective Analysis of Angiographic Radial Artery Spasm Predictors
by Adrian Sebastian Zus, Simina Crișan, Silvia Luca, Daniel Nișulescu, Mihaela-Daniela Valcovici, Oana Pătru, Mihai-Andrei Lazăr, Cristina Văcărescu, Dan Gaiță and Constantin-Tudor Luca
Life 2025, 15(11), 1759; https://doi.org/10.3390/life15111759 - 16 Nov 2025
Viewed by 345
Abstract
Background: Radial artery spasm remains a frequent complication during transradial coronary and peripheral angiography. Despite its impact on procedural success and patient discomfort, consistent predictors remain elusive, as does a standard definition. Objectives: This study aimed to identify independent clinical, hemodynamic, and anatomical [...] Read more.
Background: Radial artery spasm remains a frequent complication during transradial coronary and peripheral angiography. Despite its impact on procedural success and patient discomfort, consistent predictors remain elusive, as does a standard definition. Objectives: This study aimed to identify independent clinical, hemodynamic, and anatomical predictors of radial artery spasm using data from a single-operator, real-world cohort of patients undergoing both elective and emergency procedures, utilizing an angiographic definition of radial artery spasm. Methods: A retrospective observational analysis was conducted on 96 patients with successful radial artery access. Radial artery spasm was objectively defined as >50% luminal narrowing on radial angiography. Patient demographics, procedural characteristics, comorbidities, and arterial parameters were analyzed. Univariate and multivariate logistic regression models were used to identify significant predictors. Results: Radial artery spasm occurred in 62.5% of patients. Univariate analysis identified lower height, weight, smaller radial artery diameter, higher pain scores, and lower diastolic blood pressure as associated with radial artery spasm. In multivariate analysis, only lower body weight (β = −0.043, p = 0.0307) and smaller radial artery diameter (β = −1.352, p = 0.0200) remained independent predictors. Age, sex, and most comorbidities, including diabetes, chronic kidney disease, and peripheral artery disease, showed no significant association. Clinically, these findings suggest that simple pre-procedural assessment of patient weight and radial artery diameter may help operators identify individuals at higher risk of radial spasm, allowing for tailored preventive strategies and potentially improving procedural comfort and success. Conclusions: Our findings suggest that low body weight and small radial artery diameter are significant independent predictors of angiographic radial artery spasm, highlighting the importance of anatomical considerations over demographic or clinical factors. Preprocedural assessment of radial artery size may enhance risk stratification and guide preventive strategies. Further multicenter validation is warranted. Incorporating routine evaluation of radial artery size and body habitus into pre-procedural assessment may help identify patients who could benefit from tailored preventive approaches—such as smaller sheath sizes, increased vasodilator use, or ultrasound-guided puncture—to optimize procedural success and patient comfort. Full article
(This article belongs to the Special Issue Management of Ischemia and Heart Failure—3rd Edition)
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Review

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24 pages, 2060 KB  
Review
Longitudinal Myocardial Deformation as an Emerging Biomarker for Post-Traumatic Cardiac Dysfunction
by Makhabbat Bekbossynova, Timur Saliev, Murat Mukarov, Madina Sugralimova, Arman Batpen, Anar Kozhakhmetova and Zhumagul Sholdanova
Life 2025, 15(7), 1052; https://doi.org/10.3390/life15071052 - 30 Jun 2025
Viewed by 1116
Abstract
Post-traumatic cardiac dysfunction is a clinically under-recognized complication of polytrauma, often occurring in the absence of overt structural injury. Traditional diagnostic tools frequently fail to detect early or subclinical myocardial impairment, underscoring the need for more sensitive assessment methods. This review explores the [...] Read more.
Post-traumatic cardiac dysfunction is a clinically under-recognized complication of polytrauma, often occurring in the absence of overt structural injury. Traditional diagnostic tools frequently fail to detect early or subclinical myocardial impairment, underscoring the need for more sensitive assessment methods. This review explores the utility of global longitudinal strain (GLS), derived from speckle-tracking echocardiography (STE), as a sensitive biomarker for identifying and managing cardiac dysfunction following traumatic injury. It outlines the complex pathophysiology of trauma-induced myocardial impairment, including mechanical injury, systemic inflammation, oxidative stress, and neuro-hormonal activation. The limitations of conventional diagnostic approaches, such as electrocardiography, left ventricular ejection fraction (LVEF), and cardiac biomarkers, are critically assessed and contrasted with the enhanced diagnostic performance of GLS. GLS has demonstrated superior sensitivity in detecting subclinical myocardial dysfunction even when LVEF remains preserved and is associated with increased risk of long-term cardiovascular complications, including arrhythmias and heart failure. The manuscript highlights the clinical utility of GLS in early diagnosis, risk stratification, treatment monitoring, and long-term follow-up. Integration of GLS with inflammatory and oxidative biomarkers (e.g., IL-6, TNF-α, and MPO) and artificial intelligence-based diagnostic models offers potential for improved precision in trauma cardiology. Full article
(This article belongs to the Special Issue Management of Ischemia and Heart Failure—3rd Edition)
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