Crosstalk between Cardiovascular Disease and Its Comorbidities

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

Deadline for manuscript submissions: closed (14 June 2024) | Viewed by 8593

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Department of Internal Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iași, Romania
Interests: ischemic heart disease; arterial hypertension; pulmonary embolism; heart failure; biomarkers
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Special Issue Information

Dear Colleagues,

As our knowledge of the physiological and pathophysiological processes that take place in the human body deepens, we are also gaining a deeper awareness of their complexity. We now know that the activation and/or inactivation of multiple mechanisms and the chains of biological events that take place in an organ can have impacts of variable intensity on other organs and systems.

This interdependence is especially evident in diseases of the cardiovascular system. Metabolic disorders, such as dyslipidemia and diabetes; conditions associated with vascular injuries, such as chronic kidney disease; or chemotherapy and chest radiotherapy for patients with various neoplasms are just a few triggers of cardiovascular disease. Moreover, the presence of cardiovascular disease, especially in its most severe form—heart failure—has major consequences for all organs and systems, such as the kidneys, liver and brain, leading to their rapid dysfunction. This interplay causes a downward spiral of progressive and reciprocal aggravation that leads inexorably to early death.

Thus, the diagnosis and treatment of cardiovascular disease, aside from targeting the primary disease, must also seek to actively manage its comorbidities. This is sometimes difficult to achieve, because early dysfunction is subclinical, reflected in adaptive structural or humoral changes that can only be highlighted by imaging or laboratory methods. Moreover, these adaptive changes are the expression of long-term disturbances at the infracellular level. Their identification is becoming an essential pillar of modern medicine, as it could lead to early treatment before irreversible structural and functional changes occur, especially symptomatic ones.

This Special Issue invites you to share research on the diagnosis and treatment of cardiovascular diseases in patients with comorbidities, where the accumulation of disturbances requires diagnostic and therapeutic management on multiple levels. We are interested in both original articles and reviews, with the aim of improving the management of patients with cardiovascular disease and its comorbidities, which are both difficult to treat and frequently encountered in current practice.

Prof. Dr. Irina Iuliana Costache
Dr. Minerva Codruta Badescu
Guest Editors

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Keywords

  • cardiovascular
  • comorbidities
  • diabetes
  • obesity
  • dyslipidemia
  • chronic kidney disease
  • cancer
  • lung disease
  • liver disease

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Published Papers (6 papers)

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Research

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15 pages, 1900 KiB  
Article
The Prevalence of Arrhythmias, Including Premature Supraventricular and Ventricular Beats and Other Electrocardiographic Patterns, in 24-Hour Holter Monitoring in Patients with Overweight and Obesity
by Irena Anna Dykiert, Krzysztof Kraik, Lidia Jurczenko, Paweł Gać, Rafał Poręba and Małgorzata Poręba
Life 2024, 14(9), 1140; https://doi.org/10.3390/life14091140 - 9 Sep 2024
Viewed by 684
Abstract
Objectives: this study aims to evaluate the prevalence of various arrhythmias and other electrocardiographic patterns within the group of individuals with overweight and obesity. Methods: One hundred eighty-one adults (90 females and 91 males) were qualified for inclusion in the experimental group. All [...] Read more.
Objectives: this study aims to evaluate the prevalence of various arrhythmias and other electrocardiographic patterns within the group of individuals with overweight and obesity. Methods: One hundred eighty-one adults (90 females and 91 males) were qualified for inclusion in the experimental group. All participants had a body mass index (BMI) exceeding 25 kg/m2 (98 patients with obesity and 83 with overweight). The mean BMI in the obesity group was 33.6 kg/m2, and all participants had class 1 obesity. The control group comprised 69 individuals (56 females and 13 males) with normal BMI. The basic measurements were performed, and the participants filled out questionnaires describing their health conditions and lifestyles. Each participant underwent an electrocardiographic (ECG) examination and a 24 h Holter ECG examination. Results: In patients with class 1 obesity compared to the control patients, the average numbers of premature ventricular beats (PVBs) and premature supraventricular beats (SPBs) were statistically significantly higher (p = 0.030 and p = 0.042). There was a positive correlation between body weight and PVB (p = 0.028) and between body weight and SPB (p = 0.028). Moreover, BMI and waist circumference were correlated with SPB (p = 0.043 and p = 0.031). In the backward stepwise multivariate regression model considering 24 h Holter ECG monitoring, concerning SPB as the dependent variable, it was observed that BMI (especially obesity class 1), type 2 diabetes, and thyroid disease exhibited the highest regression coefficients. Conclusions: obesity, even in class 1, might be a factor in a more frequent occurrence of abnormalities in electrocardiographic tests. Full article
(This article belongs to the Special Issue Crosstalk between Cardiovascular Disease and Its Comorbidities)
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13 pages, 928 KiB  
Article
Von Willebrand Factor Dynamics in Patients with Aortic Stenosis Undergoing Surgical and Transcatheter Valve Replacement
by Andrei Emanuel Grigorescu, Andrei Anghel, Claudia Koch, Florin George Horhat, Delia Savescu and Horea Feier
Life 2024, 14(8), 934; https://doi.org/10.3390/life14080934 - 25 Jul 2024
Viewed by 508
Abstract
Aortic stenosis (AS) is a prevalent valvular disorder that poses a significant burden on healthcare systems due to its debilitating symptoms and high mortality rates if left untreated. Surgical aortic valve replacement (SAVR) and transcatheter aortic valve replacement (TAVR) are the primary interventions [...] Read more.
Aortic stenosis (AS) is a prevalent valvular disorder that poses a significant burden on healthcare systems due to its debilitating symptoms and high mortality rates if left untreated. Surgical aortic valve replacement (SAVR) and transcatheter aortic valve replacement (TAVR) are the primary interventions for severe AS, but perioperative complications such as bleeding remain a concern. Von Willebrand factor (VWF), a crucial player in hemostasis, is known to be altered in AS and may contribute to the hemostatic imbalance observed in these patients. This prospective study aimed to investigate the association between prosthetic valve type, size, and postprocedural VWF levels in patients undergoing aortic valve replacement (AVR) for severe AS. This study involved 39 consecutive patients diagnosed with severe AS who underwent SAVR or TAVR. By elucidating the VWF dynamics associated with different prosthetic valves, this study sought to provide valuable insights into personalized valve selection and perioperative management strategies. Full article
(This article belongs to the Special Issue Crosstalk between Cardiovascular Disease and Its Comorbidities)
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12 pages, 274 KiB  
Article
Cardiovascular Outcome in Patients with Major Depression: Role of Obstructive Sleep Apnea Syndrome, Insomnia Disorder, and COMISA
by Matthieu Hein, Benjamin Wacquier, Matteo Conenna, Jean-Pol Lanquart and Camille Point
Life 2024, 14(5), 644; https://doi.org/10.3390/life14050644 - 19 May 2024
Cited by 3 | Viewed by 1056
Abstract
In this study, the 10-year cardiovascular risk associated with comorbid sleep disorders (insomnia disorder, obstructive sleep apnea syndrome, and COMISA [comorbid insomnia and sleep apnea]) was investigated for patients with major depression. To enable our analysis, 607 patients with major depression were selected [...] Read more.
In this study, the 10-year cardiovascular risk associated with comorbid sleep disorders (insomnia disorder, obstructive sleep apnea syndrome, and COMISA [comorbid insomnia and sleep apnea]) was investigated for patients with major depression. To enable our analysis, 607 patients with major depression were selected from the data register of the Sleep Unit. High 10-year cardiovascular risk was considered present when the Framingham Risk Score was ≥10%. The 10-year cardiovascular risk associated with comorbid sleep disorders has been assessed using logistic regression analyzes. High 10-year cardiovascular risk is significant (40.4%) in patients with major depression. After successive introduction of the different confounders, multivariate logistic regressions showed that for patients with major depression high 10-year cardiovascular risk was significantly associated with COMISA but was not significantly associated with insomnia disorder or obstructive sleep apnea syndrome alone. Thus, these results highlight the existence of a negative synergistic action between insomnia disorder and obstructive sleep apnea syndrome on the 10-year cardiovascular risk in patients with major depression, which demonstrates the importance of researching and treating COMISA to improve the prognosis of this specific population subgroup characterized by higher cardiovascular morbidity and mortality. Full article
(This article belongs to the Special Issue Crosstalk between Cardiovascular Disease and Its Comorbidities)
14 pages, 3457 KiB  
Article
Association of Platelet-Monocyte Ratio with Dyslipidemia in Saudi Arabia: A Large, Population-Based Study
by Mohammad A. Alfhili, Ghada A. Alotaibi, Mohammed Alfaifi, Yousef Almoghrabi and Jawaher Alsughayyir
Life 2023, 13(8), 1685; https://doi.org/10.3390/life13081685 - 4 Aug 2023
Cited by 3 | Viewed by 1312
Abstract
Background: Abnormal lipid metabolism predisposes to cardiovascular disease. However, dyslipidemia is often asymptomatic leading to its underdiagnosis. Therefore, it is of utmost importance to identify biomarkers that reflect an abnormal lipid profile and trigger the specific investigation of lipid metabolism. The platelet–monocyte ratio [...] Read more.
Background: Abnormal lipid metabolism predisposes to cardiovascular disease. However, dyslipidemia is often asymptomatic leading to its underdiagnosis. Therefore, it is of utmost importance to identify biomarkers that reflect an abnormal lipid profile and trigger the specific investigation of lipid metabolism. The platelet–monocyte ratio (PMR) is a severely understudied index whose association with disturbed lipid markers remains unknown. Methods: A cross-sectional study of the association between PMR and comprehensive lipid profile including total cholesterol (TC), low-density lipoprotein (LDL), high-density lipoprotein (HDL), triglycerides (TG), TC/HDL, LDL/HDL, and TG/HDL in 14,269 Saudi subjects was designed. Prevalence, risk measures, association, and the diagnostic performance (i.e., area under the curve (AUC)) were evaluated. Results: Median PMR was significantly elevated in subjects with high TC (p < 0.01), TG, TC/HDL, LDL/HDL, TG/HDL, and LDL and reduced in those with low HDL (all p < 0.0001) compared to normal subjects. The increase in PMR was abolished when only males with high TC were considered. Except for TC and LDL, all other abnormal markers were significantly more prevalent when PMR was lower (higher for HDL) than a certain cutoff specific for each parameter. Moreover, the odds of having PMR readings above or below the selected cutoffs are significantly higher with all lipid abnormalities. PMR was also weakly but significantly and differentially correlated with all forms of dyslipidemia (p < 0.0001). Notably, the highest diagnostic accuracy of PMR was observed for reduced HDL (AUC = 0.608, p < 0.0001) and elevated TG/HDL (AUC = 0.596, p < 0.0001). Conclusions: PMR is a novel, inexpensive, and readily available index that is associated with all forms of dyslipidemia, suggesting its potential use in related disorders. Full article
(This article belongs to the Special Issue Crosstalk between Cardiovascular Disease and Its Comorbidities)
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Review

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14 pages, 1769 KiB  
Review
Novel Therapeutic Approaches for the Management of Elevated Lipoprotein(a): From Traditional Agents to Future Treatment Options
by György Paragh, Péter Zilahi, László Róbert Kolozsvári, Hajnalka Lőrincz, Péter Fülöp and Mariann Harangi
Life 2024, 14(3), 374; https://doi.org/10.3390/life14030374 - 12 Mar 2024
Cited by 1 | Viewed by 2255
Abstract
Cardiovascular disease is the leading cause of mortality worldwide. Despite the availability of effective low-density lipoprotein cholesterol (LDL-C) lowering agents, an increased cardiovascular risk is still observed in individuals with therapeutic LDL-C levels. One of these cardiovascular risk factors is elevated plasma lipoprotein(a) [...] Read more.
Cardiovascular disease is the leading cause of mortality worldwide. Despite the availability of effective low-density lipoprotein cholesterol (LDL-C) lowering agents, an increased cardiovascular risk is still observed in individuals with therapeutic LDL-C levels. One of these cardiovascular risk factors is elevated plasma lipoprotein(a) (Lp(a)) concentration, which maintains chronic inflammation through the increased presence of oxidized phospholipids on its surface. In addition, due to its 90 percent homology with the fibrinolytic proenzyme plasminogen, Lp(a) exhibits atherothrombotic effects. These may also contribute to the increased cardiovascular risk in individuals with high Lp(a) levels that previous epidemiological studies have shown to exist independently of LDL-C and other lipid parameters. In this review, the authors overview the novel therapeutic options to achieve effective Lp(a) lowering treatment, which may help to define tailored personalized medicine and reduce the residual cardiovascular risk in high-risk patients. Agents that increase LDL receptor expression, including statins, proprotein convertase subtilisin kexin type 9 inhibitors, and LDL production inhibitors, are also discussed. Other treatment options, e.g., cholesterolester transfer protein inhibitors, nicotinic acid derivatives, thyroid hormone mimetics, lipoprotein apheresis, as well as apolipoprotein(a) reducing antisense oligonucleotides and small interfering RNAs, are also evaluated. Full article
(This article belongs to the Special Issue Crosstalk between Cardiovascular Disease and Its Comorbidities)
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21 pages, 1041 KiB  
Review
Novel Biomarkers for Atherosclerotic Disease: Advances in Cardiovascular Risk Assessment
by Raul-Alexandru Jigoranu, Mihai Roca, Alexandru-Dan Costache, Ovidiu Mitu, Alexandru-Florinel Oancea, Radu-Stefan Miftode, Mihai Ștefan Cristian Haba, Eosefina Gina Botnariu, Alexandra Maștaleru, Radu-Sebastian Gavril, Bogdan-Andrei Trandabat, Sabina Ioana Chirica, Raluca Maria Haba, Maria Magdalena Leon, Irina-Iuliana Costache and Florin Mitu
Life 2023, 13(8), 1639; https://doi.org/10.3390/life13081639 - 27 Jul 2023
Cited by 2 | Viewed by 1852
Abstract
Atherosclerosis is a significant health concern with a growing incidence worldwide. It is directly linked to an increased cardiovascular risk and to major adverse cardiovascular events, such as acute coronary syndromes. In this review, we try to assess the potential diagnostic role of [...] Read more.
Atherosclerosis is a significant health concern with a growing incidence worldwide. It is directly linked to an increased cardiovascular risk and to major adverse cardiovascular events, such as acute coronary syndromes. In this review, we try to assess the potential diagnostic role of biomarkers in the early identification of patients susceptible to the development of atherosclerosis and other adverse cardiovascular events. We have collected publications concerning already established parameters, such as low-density lipoprotein cholesterol (LDL-C), as well as newer markers, e.g., apolipoprotein B (apoB) and the ratio between apoB and apoA. Additionally, given the inflammatory nature of the development of atherosclerosis, high-sensitivity c-reactive protein (hs-CRP) or interleukin-6 (IL-6) are also discussed. Additionally, newer publications on other emerging components linked to atherosclerosis were considered in the context of patient evaluation. Apart from the already in-use markers (e.g., LDL-C), emerging research highlights the potential of newer molecules in optimizing the diagnosis of atherosclerotic disease in earlier stages. After further studies, they might be fully implemented in the screening protocols. Full article
(This article belongs to the Special Issue Crosstalk between Cardiovascular Disease and Its Comorbidities)
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