Search Results (9,118)

Cardiovascular diseases remain the leading cause of global mortality, and environmental toxic metals and metalloids (TMMs) exposure has emerged as an important and potentially modifiable cardiovascular (CV) risk factor. Due to their persistence, bioaccumulation, and widespread distribution, represent a significant public health concern and have been associated with adverse CV outcomes. Mechanistically, TMM-induced cardiotoxicity is primarily mediated through oxidative stress (OS) and inflammatory pathways. Accordingly, related biomarkers, may be considered markers of biological effect and potential pathophysiological mediators associated with TMM exposure. This narrative review summarizes epidemiological evidence linking environmental TMMs exposure with OS and inflammatory biomarkers to CV outcomes. A structured literature search identified 1915 records in PubMed, of which 42 epidemiological studies met the inclusion criteria. The reviewed evidence consistently indicates that environmental and occupational TMMs exposure is associated with significant alterations in biomarkers of lipid peroxidation, antioxidant defense, systemic inflammation, and endothelial dysfunction, all of which reflect early biological CV effects associated with exposure. However, substantial heterogeneity across studies and the predominance of cross-sectional designs limit causal inference and the evaluation of their predictive capacity for future CV events. Future prospective studies integrating mixture-based exposure assessment, standardized biomarker measurements, and multi-omics approaches are needed to clarify whether these biomarkers can serve as markers of biological effect or subclinical CV toxicity and as potential mediators of CV risk, while also assessing their potential contribution to cardiovascular risk stratification in exposed populations. Full article

Heart failure with preserved ejection fraction (HFpEF) is a substantial global health burden and the greatest unmet medical need for cardiovascular diseases. It is marked by pronounced clinical heterogeneity and complex multi-system pathophysiology with limited therapeutic options. Progress in developing effective therapeutics is constrained by the inadequacy of experimental models to fully recapitulate the multifactorial nature of the disease. Recent evidence underscores the significant involvement of inflammatory, oxidative, and mitochondrial pathways in the pathogenesis of HFpEF, with non-coding RNAs and epigenetic regulation serving as crucial modulators and prospective therapeutic targets. This review maps the HFpEF target landscape, while critically assessing the mechanistic contributions, translational fidelity, and limitations of existing in vivo and in vitro models. Further, advances are noted among the in vitro technologies, including human cardiac organoids and engineered heart tissues integrated with high-throughput multi-omics and computational modeling, enabling in-depth examination of HFpEF mechanisms. Finally, we underscore the necessity of integrative, systems-level approaches and multi-marker strategies to enhance translational relevance, improve risk stratification, and accelerate development of mechanism-based therapies. Collectively, this review supports phenotypic-guided and mechanism-informed therapeutic development for HFpEF, and provides a roadmap for next generation model development and therapeutic innovation. Full article

Background/Objectives: Patients with hypertension or diabetes often share common risk factors for both cardiovascular diseases and cancer. Although health knowledge is associated with preventive health behaviors, the association between knowledge of stroke and myocardial infarction (MI) symptoms and cancer screening participation remains poorly understood. Methods: This cross-sectional study analyzed data from the 2023 Community Health Survey, including 45,949 adults with hypertension and 20,357 with diabetes aged ≥40 years. Multivariate logistic regression was used to examine the association between knowledge of stroke and MI symptoms and cancer screening participation. Subgroup analyses were conducted according to age and sex. Results: Among patients with hypertension, knowledge of stroke and MI symptoms was significantly associated with higher odds of undergoing cancer screening. Similar associations were observed among patients with diabetes for stroke and MI symptom knowledge. Subgroup analysis revealed that the association for stroke knowledge was significantly more pronounced among adults aged 40–59 years with hypertension, while remaining age and sex subgroup variations were exploratory. Conclusions: Knowledge of stroke and MI symptoms was associated with participation in cancer screening among adults with hypertension and diabetes. These findings suggest that knowledge of cardiovascular symptoms may reflect overall engagement in preventive health behaviors, including cancer screening. Full article

Metabolic dysfunction-associated steatotic liver disease (MASLD), formerly known as non-alcoholic fatty liver disease (NAFLD), has become one of the most common chronic liver diseases worldwide, representing a major global health challenge closely linked to metabolic syndrome, obesity, and type 2 diabetes mellitus (TD2M). The condition is characterized by a multisystem nature driven by complex multifactorial mechanisms, including insulin resistance, lipotoxicity, mitochondrial dysfunction, genetic predispositions, and gut-liver axis alterations. Although liver biopsy remains the gold standard, non-invasive markers and advanced imaging methods are of key importance for early risk stratification. Furthermore, while liver-related complications such as fibrosis, cirrhosis, and hepatocellular carcinoma (HCC) are significant, cardiovascular disease remains the leading cause of mortality in patients with MASLD. Current management relies primarily on lifestyle modifications, targeted pharmacotherapy (such as pioglitazone, GLP-1 receptor agonists, SGLT-2 inhibitors), and novel experimental therapies. Consequently, MASLD requires a multidisciplinary approach emphasizing early diagnosis, risk stratification, and comprehensive treatment of both hepatic and extrahepatic manifestations. Full article

Fish is a food of high nutritional value, being an important source of proteins, fat, vitamins, and essential minerals. Atlantic horse mackerel is also rich in omega-3 polyunsaturated fatty acids (n3-PUFAs), recognized for their benefits to cardiovascular and neurological health. However, this composition also makes it highly susceptible to lipid oxidation, reducing its shelf life. Oxidation is accelerated by high water activity and near-neutral pH, conditions common in fish and processed products such as fish burgers. This work aimed to develop fish burgers incorporated with bioactive extracts (protein hydrolysates from cod fish processing by-product—PH, or green tea extract—GTE) and study their shelf life. The PH was recovered from cod frames using subcritical water extraction, and GTE with hydro-alcoholic extraction. The fish burgers were prepared using minced fish meat incorporated with 1% (w/w) of extracts, in four formulations: (i) 1% (w/w) of PH; (ii) 1% (w/w) of GTE; (iii) a combination of both extracts at 0.5% (w/w) each; and (iv) control without extracts. Physical–chemical, antioxidant and microbiological analysis of the burgers was performed to evaluate their preservation over 6 days of refrigerated storage. Compared to the control, samples with only GTE or the combined GTE + PH presented a delay in oxidation (50% less in TBARS) and microbiological deterioration (reduction of 0.5–1.8 Log CFU/g in total psychrotropic microorganisms). No significant changes were observed in the fish burgers incorporated with only PH. The results demonstrate that the incorporation of bioactive extracts has potential in reducing oxidative degradation and improving microbiological stability in fish-based products; however, superior doses must be used. Moreover, the use of natural extracts aligns with current consumer demand for clean-label and functional foods. Full article

Chili pepper consumption has been linked to lower cardiovascular disease (CVD) risk, although underlying mechanisms remain unclear. We investigated the association between long-term changes in chili pepper consumption and changes in circulating inflammatory markers. This longitudinal analysis included 573 adults (≥35 years) from the Italian Moli-sani Study with dietary, health, and biological data collected at baseline (2005–2010) and follow-up (2017–2020). The exposure was the 12.7-year change in chili pepper consumption frequency. Outcomes included changes in serum concentrations of C-reactive protein, eight other inflammatory factors (IL-6, IL8, IL-10, TNF-α, IFN-γ, MCP-1, IP-10, and VEGF), and the INFLA-score. Multivariable-adjusted linear regression models accounted for changes in dietary and lifestyle factors. Overall, 41.2%, 20.6%, and 38.2% of participants reduced, increased, or maintained their chili pepper consumption, respectively. A 1-unit increase in the delta of chili pepper consumption was associated with lower serum TNF-α concentrations (β = −0.85; 95% CI: −1.67, −0.03; p = 0.041). No associations were observed with the other inflammatory markers, although most showed downward trends. Among women, increased consumption was associated with different MCP-1 and IP-10 levels. An increase in chili pepper consumption over 12.7 years was associated with lower circulating TNF-α concentrations in this population. Although no consistent associations were observed across the inflammatory markers evaluated, these findings suggest a potential modulation of selected inflammatory pathways by sustained chili pepper consumption and warrant confirmation in larger prospective studies. Full article

Introduction: The Roma, historically referred to as “Gypsies” (a term now widely considered pejorative in many contexts), appear to have originated in northern India and settled in Europe in the 14th century, spreading mainly to Eastern and Southern Europe. In Greece, they make up 1.13% of the total population and live in all geographical areas of the country. Aim: The aim of this article is to investigate and study the dietary habits of Roma and their health consequences. Methodology: A literature review was conducted in Medline, PubMed and Scopus databases, using the keywords “nutrition”, “health”, “outcomes”, and “Roma”. Results: In Europe, as well as in Greece, Roma continue to experience poverty, unemployment, socioeconomic inequalities, limited access to health services, and phenomena of racism, despite the efforts of states. These conditions negatively affect their dietary choices, leading to an unhealthy and unbalanced diet, with consequences such as obesity, cardiovascular diseases and diabetes mellitus. Conclusions: The profound gap between Roma and non-Roma populations in Europe requires not only targeted policies but also active interventions by health professionals. These interventions should aim at improving the nutritional status and general healthcare of Roma. Full article

Background: Cardiovascular complications of cancer therapy may affect patients far beyond conventional measures of cardiac function, yet their relationship with health-related quality of life (HRQoL) remains incompletely defined. This review examined how cardiovascular status and cardiotoxicity-related interventions relate to HRQoL across cancer treatment and survivorship. Methods: Twenty-one studies were reviewed and reassessed according to four research questions: established cardiovascular disease or cardiac dysfunction and HRQoL; subclinical cardiovascular abnormalities and subsequent HRQoL; interventions targeting cardiotoxicity with HRQoL assessment; and supportive interventions improving HRQoL without demonstrated cardioprotection. Evidence was additionally considered across diagnostic, pharmacological/cardioprotective, exercise, and supportive-care domains. Results: The available evidence revealed a clinically relevant pattern. Established cardiovascular disease or cardiac dysfunction showed the clearest association with poorer HRQoL, particularly in physical domains, whereas evidence linking subclinical abnormalities to subsequent patient-reported deterioration was sparse. Most studies evaluated interventions, including cardioprotective pharmacological strategies and exercise-based approaches, but improvements in HRQoL were not consistently accompanied by, or attributable to, demonstrated cardioprotection. Exercise and supportive interventions were also associated with improvements in functional or patient-reported outcomes in some studies, independently of demonstrable cardiovascular benefit. Across domains, substantial heterogeneity in populations, cardiovascular measures, interventions, HRQoL instruments, and study designs limited direct comparison and causal interpretation. Conclusions: Cardiovascular health and HRQoL appear closely interconnected, but the available evidence does not establish a consistent link between cardiovascular injury and subsequent changes in HRQoL. The literature is richer in prevention and intervention studies than in longitudinal assessment of the patient-reported consequences of cardiovascular injury. Larger prospective studies incorporating standardized serial cardiovascular assessment and HRQoL as a predefined primary endpoint are needed to establish temporal relationships and clinically meaningful cardiovascular determinants of HRQoL. Full article

Background: Psychological distress is common among patients with cardiovascular disease and adversely affects secondary prevention. We investigated whether depressive and anxiety symptoms, identified by guideline-recommended ultra-brief screening instruments, were associated with blood pressure (BP) control after hospital discharge, with particular attention to sex. Data in very high-risk populations remain limited. Methods: In this prospective observational single-center study, 305 consecutive hospitalized cardiovascular patients (mean age 63.9 years, 62.6% men, 79.3% at very high cardiovascular risk) underwent screening for depressive and anxiety symptoms using the Patient Health Questionnaire-2 (PHQ-2) and Generalized Anxiety Disorder-2 (GAD-2). BP control was assessed at discharge and at routine follow-up after a median of 36.0 (32.5–39.5) days using ambulatory or home BP monitoring. Clinical, echocardiographic and psychosocial characteristics were analyzed. Results: Depressive and anxiety symptoms were identified in 31.1% and 29.2% of patients, respectively. Depressive symptoms were more prevalent in women. BP target achievement declined from 78.4% at discharge to 49.5% during follow-up. PHQ-2 ≥ 3 was independently associated with lower odds of achieving BP targets (OR 0.12, 95% CI 0.06–0.23; p < 0.001), together with overweight/obesity (OR 0.20, 95% CI 0.09–0.42; p < 0.001), while male sex was independently associated with better BP control (OR 2.06, 95% CI 1.12–3.77; p = 0.02). Female sex, overweight/obesity, chronic kidney disease, loneliness, and poor sleep quality were associated with PHQ-2 ≥ 3. Conclusions: Female sex and depressive symptoms were independently associated with a lower likelihood of achieving guideline-recommended BP targets during early post-discharge follow-up. These findings highlight the potential utility of brief psychological screening to identify patients at increased risk after discharge. Full article

Background: A functional balance between angiotensin II receptors (AT1R/AT2R) is associated with the regulation of cardiovascular, inflammatory, and tissue remodeling processes. Interventions that promote this balance have a significant impact on quality of life. Physical exercise stands out among these interventions, as the literature extensively identifies it as a therapeutic tool for managing conditions linked to the main axis of the renin–angiotensin system (RAS). Despite its beneficial role regarding the RAS, its effects on AT1R and AT2R receptor expression have not yet been systematically synthesized. Objective: To review the literature and systematically compile existing knowledge regarding the effect of physical exercise on the expression of angiotensin II receptors (AT1R and AT2R) within the RAS. Methods: This is a systematic review registered in PROSPERO (CRD420251267388). Searches were conducted in the PubMed/MEDLINE, PEDro, Cochrane Central Register of Controlled Trials, Scientific Electronic Library Online, Latin American and Caribbean Health Sciences Literature (LILACS), Web of Science, and Scopus databases. Risk of bias was assessed using the RoB 2 and SYRCLE tools. A total of 724 studies were identified, of which 11 met the eligibility criteria: 10 conducted using experimental animal models and 1 involving humans. Results: Eleven studies were included, predominantly animal experimental models. The findings indicate that chronic cyclic physical exercise is associated with reduced AT1R expression and increased AT2R expression in different tissues. In contrast, the only study that evaluated resistance exercise showed a distinct physiological response, with increased AT1R expression. Conclusions: The results suggest that chronic cyclical physical exercise promotes an increase in AT2R receptor expression and a reduction in AT1R expression in various body tissues, although the evidence is derived primarily from animal studies. Full article

Polycyclic aromatic hydrocarbons (PAHs) are produced primarily by incomplete combustion of organic materials, including biomass burning, vehicle exhaust, and forest fires. Exposure to PAHs can induce reactive oxygen species (ROS) and oxidative stress, leading to lipid peroxidation and DNA damage. Biomass burning is a major environmental and public health problem in Chiang Mai province, containing particulate matter linked with respiratory and cardiovascular diseases. This prospective observational study aimed to evaluate the association between oxidative stress biomarkers and PAH exposure. A total of 152 participants comprised healthy controls (88), diabetes patients (35), hypertension patients (15) and diabetes + hypertension patients (14). Only participants aged more than 18 years were included. Participants who had acute respiratory infection or malignancies were excluded. This study was conducted in the pre-burning (December) and post-burning (May) periods by measuring biomarkers such as 1-OHP, MDA and 8-OHdG. Urinary 1-OHP increased significantly in the post-burning period from 0.21 ± 0.50 to 0.87 ± 1.25 μmol/mol creatinine (p < 0.001). Serum 8-OHdG increased significantly in all participants from 51.04 ± 24.90 to 66.08 ± 27.82 pg/mL (p < 0.001) and increased significantly in the diabetic and hypertension group. Serum MDA did not show any significant change post-burning (6.09 ± 3.71 to 6.00 ± 3.71 nmol/mL; p = 0.825), but MDA significantly decreased in the diabetic group (p = 0.017). 8-OHdG tended to increase in all clinical groups in the post-burning season compared to the pre-burning season, indicating oxidative DNA damage. 8-OHdG was found to be a sensitive biomarker of oxidative stress, suggesting its potential as an early indicator in haze season in vulnerable populations. Full article

Background/Objectives: The comparative efficacy of off-pump and on-pump coronary bypass grafting (CABG) for patients with acute and subacute myocardial infarction (AMI) remains controversial. We compared the outcomes of on-pump versus off-pump coronary artery bypass grafting in Korean patients with acute and subacute myocardial infarction. Methods: This nationwide retrospective cohort study included 14,578 propensity score-matched patients undergoing on-pump or off-pump CABG between 2007 and 2022 using the Korean National Health Insurance Service database. The primary outcomes were recurrent myocardial infarction, repeat revascularization, stroke, all-cause mortality, and major adverse cardiovascular and cerebrovascular events. Chi-square, Kaplan–Meier, and log-rank tests and Cox regression analysis were used. Results: Compared with on-pump CABG, off-pump CABG was associated with significantly lower risks of major adverse cardiovascular and cerebrovascular events (MACCEs), all-cause mortality, and recurrent myocardial infarction in the cause-specific Cox analysis, whereas repeat revascularization and stroke rates were comparable between groups. However, the association with recurrent myocardial infarction was not statistically significant in the Fine–Gray competing-risk analysis. Conclusions: Off-pump CABG was associated with lower risks of all-cause mortality and MACCEs in patients with acute and subacute myocardial infarction. The association with recurrent myocardial infarction was less consistent across analytical approaches and should be interpreted cautiously. Full article

Background/Objectives: The oxidation of low-density lipoprotein (LDL) is a crucial step in atherogenesis. Beta-Caryophyllene (BCP) is a natural compound with established anti-oxidative and anti-inflammatory properties as shown in animal and cell culture studies. We examined whether BCP can impede LDL oxidation in an in vitro model. Methods: The anti-oxidative effect of BCP was evaluated in different concentrations (0, 25, 50, 100, and 150 µg/mL) with regard to scavenging reactive oxygen species (ROS) during LDL oxidation, which was initiated by the addition of copper chloride (CuCl₂) in a concentration of 10 µmol/L. Lipid hydroperoxides (LPO), malondialdehyde (MDA), dienes, cell viability, and reactions of BCP with ROS according to Gibbs free energies were applied to determine the oxidation state of LDL. Results: Our findings indicated that BCP is highly efficient in inhibiting LDL oxidation in a dose-dependent manner in this in vitro model. The lipid hydroperoxide content in oxLDL was significantly lower in the presence of 100 µg/mL BCP compared to oxLDL without BCP (p < 0.0001). This corresponds to the MDA levels, which were significantly lower in the presence of 100 µg/mL BCP compared to oxLDL without BCP (p = 0.0393). Furthermore, a dose-dependent inhibition of diene formation in the LDL particle was observed in the presence of ascending BCP concentrations which corresponds to a decrease in the cytotoxicity of oxLDL in EA.hy926 cells in the presence of increasing concentrations of BCP. Moreover, BCP’s anti-oxidant effectiveness exceeds that of the widely recognized anti-oxidant spermidine at equivalent concentrations. Our quantum chemical calculations showed that the reactions between BCP and hydroxyl radicals, hydroperoxyl radicals, or hydrogen peroxide are exergonic. We therefore conclude that BCP impedes the oxidation of LDL by its capability to scavenge (at least) these three reactive oxygen species. Conclusions: Our results indicate that BCP impedes the oxidation of LDL in vitro and therefore presumably has the potential to serve as an appropriate therapeutic agent to prevent atherogenesis and related (cardio)vascular diseases by balancing vascular oxidative stress. For this purpose, more prospective clinical studies in humans are required to assess the potential atheroprotective and health-promoting effects of BCP. Full article

Telemedicine is increasingly transforming pediatric cardiology by expanding access to specialized care, supporting early diagnosis, and improving longitudinal monitoring of children with cardiovascular disease. This narrative review summarizes current applications of digital health in pediatric cardiology, with emphasis on congenital heart disease, pediatric hypertension, and arrhythmia management. Tele-echocardiography represents one of the most established telehealth tools, enabling remote interpretation of fetal, neonatal, and pediatric echocardiographic images and improving referral appropriateness, particularly in peripheral or resource-limited settings. In infants with complex congenital heart disease, especially those with single-ventricle physiology during the interstage period, home monitoring programs using mobile applications, pulse oximeters, digital scales, and structured caregiver reporting may facilitate early recognition of clinical deterioration and reduce avoidable transfers. In non-congenital cardiovascular disease, home blood pressure monitoring can improve diagnostic accuracy by reducing white-coat effects and supporting repeated measurements in real-life settings. Smartphone-enabled electrocardiographic devices and wearable technologies may enhance detection of intermittent arrhythmias and strengthen outpatient management. Despite these advantages, challenges remain, including data fragmentation, limited pediatric validation of consumer devices, interoperability issues, privacy concerns, and socioeconomic disparities in technology access. Properly integrated telemedicine may promote more timely, equitable, and patient-centered pediatric cardiovascular care. Full article

Background/Objectives: Metabolic syndrome (MetS) is a major global public health concern associated with an increased risk of cardiovascular disease and type 2 diabetes mellitus. Iron metabolism has been implicated, but the storage (ferritin) and functional (soluble transferrin receptor, sTfR) axes are rarely assessed within a single model. We aimed to determine whether both axes are independently associated with glycaemia and MetS and to evaluate their diagnostic value. Materials and Methods: A cross-sectional study was conducted in 297 adults (72.8% women) from Turkestan, Kazakhstan. Hierarchical regression models with sequential adjustment were applied for age, sex, body mass index (BMI), high-sensitivity C-reactive protein (hs-CRP), dietary inflammatory index (DII), HFE H63D genotype, and gamma-glutamyl transferase (GGT). Path analysis and receiver operating characteristic (ROC) analysis were also performed. Results: Ferritin and sTfR were independently associated with fasting glucose (β = 0.27 and 0.73, respectively) and metabolic syndrome (OR = 1.52 and 4.53, respectively). When analyzed separately, neither biomarker reached statistical significance for MetS (ferritin: OR = 1.20, p = 0.140; sTfR: OR = 1.93, p = 0.072). Ferritin demonstrated no discriminatory ability in men (AUC = 0.500, 95% CI 0.370–0.630) and modest discrimination in women (AUC = 0.652, 95% CI 0.571–0.732). GGT accounted for approximately 28% of the ferritin–glucose association in a path-analytic model. Ferritin, GGT, and HbA1c levels increased progressively even among individuals with 0–2 MetS components. Conclusions: Both the storage and functional axes of iron metabolism provide independent information on glycaemic status, but their associations become apparent only when assessed simultaneously. Ferritin alone is not suitable as a diagnostic marker for metabolic syndrome. Full article