Field Of Cardiovascular Disease Research Articles

Circular RNAs and Cardiovascular Regeneration.

circular RNAs (circRNAs) are a type of non-coding RNAs that are widely present in eukaryotic cells. They have the characteristics of stable structure, high abundance, and cell or tissue specific expression. circRNAs are single-stranded RNAs that are covalently back spliced to form closed circular loops. They may participate in gene expression and regulation through a variety of action modes. circRNAs can encode proteins or function by acting as miRNA sponges for protein translation. Since 2016, a growing number of research studies have shown that circRNAs play important role in the pathogenesis of cardiovascular disease. With the construction of circRNA database, the differential expression of circRNAs in the heart tissue samples from different species and the gradual elucidation of its mode of action in disease may become an ideal diagnosis biomarker and an effective therapeutic target. What can be expected surely has a broader application prospect. In this review, we summarize recent publications on circRNA biogenesis, expression profiles, functions, and the most recent studies of circRNAs in the field of cardiovascular diseases with special emphasis on cardiac regeneration.

Graphene Coating Obtained in a Cold-Wall CVD Process on the Co-Cr Alloy (L-605) for Medical Applications.

Graphene coating on the cobalt-chromium alloy was optimized and successfully carried out by a cold-wall chemical vapor deposition (CW-CVD) method. A uniform layer of graphene for a large area of the Co-Cr alloy (discs of 10 mm diameter) was confirmed by Raman mapping coated area and analyzing specific G and 2D bands; in particular, the intensity ratio and the number of layers were calculated. The effect of the CW-CVD process on the microstructure and the morphology of the Co-Cr surface was investigated by scanning X-ray photoelectron microscope (SPEM), atomic force microscopy (AFM), scanning electron microscopy (SEM), and energy dispersive X-ray spectroscopy (EDS). Nanoindentation and scratch tests were performed to determine mechanical properties of Co-Cr disks. The results of microbiological tests indicate that the studied Co-Cr alloys covered with a graphene layer did not show a pro-coagulant effect. The obtained results confirm the possibility of using the developed coating method in medical applications, in particular in the field of cardiovascular diseases.

Polymers and Nanoparticles for Statin Delivery: Current Use and Future Perspectives in Cardiovascular Disease.

Atherosclerosis-related coronary artery disease (CAD) is one of the leading sources of mortality and morbidity in the world. Primary and secondary prevention appear crucial to reduce CAD-related complications. In this scenario, statin treatment was shown to be clinically effective in the reduction of adverse events, but systemic administration provides suboptimal results. As an attempt to improve bioavailability and effectiveness, polymers and nanoparticles for statin delivery were recently investigated. Polymers and nanoparticles can help statin delivery and their effects by increasing oral bioavailability or enhancing target-specific interaction, leading to reduced vascular endothelial dysfunction, reduced intimal hyperplasia, reduced ischemia-reperfusion injury, increased cardiac regeneration, positive remodeling in the extracellular matrix, reduced neointimal growth and increased re-endothelization. Moreover, some innovative aspects described in other cardiovascular fields could be translated into the CAD scenario. Recent preclinical studies are underlining the effect of statins in the stimulation and differentiation of endogenous cardiac stem cells, as well as in targeting of local adverse conditions implicated in atherosclerosis, and statin delivery through poly-lactic-co-glycolic acid (PLGA) appears the most promising aspect of current research to enhance drug activity. The present review intends to summarize the current evidence about polymers and nanoparticles for statin delivery in the field of cardiovascular disease, trying to shed light on this topic and identify new avenues for future studies.

Development of a New Detection Algorithm to Identify Acute Coronary Syndrome Using Electrochemical Biosensors for Real-World Long-Term Monitoring.

Electrochemically based technologies are rapidly moving from the laboratory to bedside applications and wearable devices, like in the field of cardiovascular disease. Major efforts have focused on the biosensor component in contrast with those employed in creating more suitable detection algorithms for long-term real-world monitoring solutions. The calibration curve procedure presents major limitations in this context. The objective is to propose a new algorithm, compliant with current clinical guidelines, which can overcome these limitations and contribute to the development of trustworthy wearable or telemonitoring solutions for home-based care. A total of 123 samples of phosphate buffer solution were spiked with different concentrations of troponin, the gold standard method for the diagnosis of the acute coronary syndrome. These were classified as normal or abnormal according to established clinical cut-off values. Off-the-shelf screen-printed electrochemical sensors and cyclic voltammetry measurements (sweep between −1 and 1 V in a 5 mV step) was performed to characterize the changes on the surface of the biosensor and to measure the concentration of troponin in each sample. A logistic regression model was developed to accurately classify these samples as normal or abnormal. The model presents high predictive performance according to specificity (94%), sensitivity (92%), precision (92%), recall (92%), negative predictive value (94%) and F-score (92%). The area under the curve of the precision-recall curve is 97% and the positive and negative likelihood ratios are 16.38 and 0.082, respectively. Moreover, high discriminative power is observed from the discriminate odd ratio (201) and the Youden index (0.866) values. The promising performance of the proposed algorithm suggests its capability to overcome the limitations of the calibration curve procedure and therefore its suitability for the development of trustworthy home-based care solutions.

MiRNA expression analysis emphasized the role of miR-424 in diabetic cardiovascular complications

The discovery of miRNAs as promising new biomarkers in the field of cardiovascular disease has caused great expectations. Stability in the bloodstream, specific regulation, and high sensitivity and specificity suggest that the feasibility of miRNAs as cardiovascular biomarkers can even displace protein-based biomarkers. The objective of our study was to determine the plasma expression profile of miRNAs, which are reported to have important correlations with cardiovascular diseases, in patients with type 2 diabetes mellitus in relation to cardiovascular complications. We isolated plasma miRNAs from 6 patients with type 2 diabetes mellitus without cardiovascular disease (control group) and 9 patients with type 2 diabetes mellitus and cardiovascular disease (target group). Following reverse transcription and subsequent real-time PCR analysis of the same amount of starting miRNAs, the following miRNAs were successfully analyzed: miR-16-5p, miR-155-3p, miR-155-5p, miR-210, miR-221-3p, and miR-424-5p. The relative expression analysis showed a statistically significant increase in the expression of all these miRNAs in the target group. The highest level of increase was established for miR-424-5p with an average relative quantification value of 10.5, followed by miR-155-5p with an average value of 7.5. Cardiovascular risk assessment, supported by emerging circulating biomarkers, such as miRNAs, is important for stratifying high-risk individuals, optimizing treatment strategies, and enhancing our understanding of basic biology. Our study showed the highest increase in expression levels of miR-424-5p in target group and emphasized its role as a biomarker for cardiovascular damage in patients with type 2 diabetes mellitus.

The role of myocardial innervation imaging in different clinical scenarios: an expert document of the European Association of Cardiovascular Imaging and Cardiovascular Committee of the European Association of Nuclear Medicine.

Cardiac sympathetic activity plays a key role in supporting cardiac function in both health and disease conditions, and nuclear cardiac imaging has always represented the only way for the non-invasive evaluation of the functional integrity of cardiac sympathetic terminals, mainly through the use of radiopharmaceuticals that are analogues of norepinephrine and, in particular, with the use of 123I-mIBG imaging. This technique demonstrates the presence of cardiac sympathetic dysfunction in different cardiac pathologies, linking the severity of sympathetic nervous system impairment to adverse patient's prognosis. This article will outline the state-of-the-art of cardiac 123I-mIBG imaging and define the value and clinical applications in the different fields of cardiovascular diseases.

Highlights from Studies Presented at the American Heart Association Scientific Session 2020: Navigating New Roads in Prevention.

Purpose of the ReviewThis review highlights late-breaking science presented at the American Heart Association Scientific Session 2020 that demonstrated advancements in preventative cardiology and introduced novel treatment approaches for the management of chronic kidney disease, type 2 diabetes, and/or heart failure.Recent FindingsThe studies reviewed include clinical trials that assessed the use of omecamtiv in the treatment of heart failure with reduced heart failure (GALACTIC-HF); effects of sotagliflozin in patients with diabetes and recent heart failure exacerbation; cardiovascular outcomes with the use of omega-3 carboxylic acids in patients with high vascular risk and atherogenic dyslipidemia (STRENGTH) and omega-3 fatty acids in elderly patients with recent myocardial infarction (OMEMI); efficacy and safety of evinacumab in patients with refractory hypercholesterolemia; and the use of coronary computed tomography angiography for the assessment of suspected acute coronary syndrome. In addition, we review the results of the International Polycaps Study (TIPS-3) on the use of a polypill for the primary prevention of cardiovascular disease in intermediate-risk people. Finally, we discuss the SAMSON trial—a three-arm-N-of-1 trial—to identify the root cause of the symptoms contributing to patient nonadherence to statin therapy.SummaryThe studies presented at the American Heart Association Scientific Session 2020 represent remarkable contributions in the field of cardiovascular disease and prevention.

Global research hot points on cardiovascular disease--bibliometric analysis based on the ESI hot papers

With the heavier burden of cardiovascular disease, an abundance of papers emerge every year in the research hotspots, which cover a wide range of types and content. In order to let readers interested in the cardiovascular field quickly understand the research hotspots and research frontier, it is necessary to sort out and summarize the research topic in time. According to the discipline classification, we screened papers in cardiovascular field from the Essential Science Indicators (ESI) hot papers published in 2019. Methods such as bibliometrics, statistical description, hierarchical induction, analysis and interpretation were used a step further to reveal the context and characteristics of research in the field of cardiovascular diseases, summarize the latest progress and development direction in this field, and provide information and hints for the expansion of future research directions. A total of 297 papers were finally included, which were mainly in the field of clinical medicine; The country with the most publications was the United States, while China ranked the fifth in terms of contribution; the research institution with the highest number of published papers was Harvard University; the New England Journal of Medicine (NEJM) has published the most papers, with contribution also from journals such as Circulation, Europe Heart Journal, JAMA, and Lancet. All the papers were categorized into disease burden, disease risk, drug treatment, device treatment and surgical treatment, clinical diagnosis, basic research and others, so as to review and summarize the research front in the field of cardiovascular diseases.

The role and molecular mechanism of FoxO1 in mediating cardiac hypertrophy.

Cardiac hypertrophy can lead to heart failure and cardiovascular events and has become a research hotspot in the field of cardiovascular disease. Despite extensive and in‐depth research, the pathogenesis of cardiac hypertrophy is far from being fully understood. Increasing evidence has shown that the transcription factor forkhead box protein O 1 (FoxO1) is closely related to the occurrence and development of cardiac hypertrophy. This review summarizes the current literature on the role and molecular mechanism of FoxO1 in cardiac hypertrophy. We searched the database MEDLINE via PubMed for available evidence on the effect of FoxO1 on cardiac hypertrophy. FoxO1 has many effects on multiple diseases, including cardiovascular diseases, diabetes, cancer, aging, and stem cell activity. Recent studies have shown that FoxO1 plays a critical role in the development of cardiac hypertrophy. Evidence for this relationship includes the following. (i) FoxO1 can regulate cardiac growth/protein synthesis, calcium homeostasis, cell apoptosis, and autophagy and (ii) is controlled by several upstream signalling molecules (e.g. phosphatidylinositol 3‐kinase/Akt, AMP‐activated protein kinase, and sirtuins) and regulates many downstream transcription proteins (e.g. ubiquitin ligases muscle RING finger 1/muscle atrophy F‐box, calcineurin/nuclear factor of activated T cells, and microRNAs). In response to stress or external stimulation (e.g. low energy, oxidative stress, or growth factor signalling), FoxO1 undergoes post‐translational modification and transfers from the cytoplasm to nucleus, thus regulating the expression of a series of target genes in myocardium that are involved in cardiac growth/protein synthesis, calcium homeostasis, cell apoptosis, and autophagy. (iii) Finally, targeted regulation of FoxO1 is an effective method of intervening in myocardial hypertrophy. The information reviewed here should be significant for understanding the roles of FoxO1 in cardiac hypertrophy and should contribute to the design of further studies related to FoxO1 and the hypertrophic response. It should also shed light on a potential treatment for cardiac hypertrophy.

Co-authorship network analysis in cardiovascular research utilizing machine learning (2009–2019)

BackgroundWith the recent advances in computational science, machine-learning methods have been increasingly used in medical research. Because such projects usually require both a clinician and a computational data scientist, there is a need for interdisciplinary research collaboration. However, there has been no published analysis of research collaboration networks in cardiovascular medicine using machine intelligence. MethodsCo-authorship network analysis was conducted on 2857 research articles published between 2009 and 2019. Bibliographic data were collected from the Web of Science, and the co-authorship networks were represented as undirected multigraphs. The network density, average degree, clustering coefficient, and number of communities were calculated, and the chronological changes were assessed. Thereafter, the leading authors were identified according to the centrality metrics. Finally, we investigated the significance of the characteristics of the co-authorship network in the largest component via a Monte Carlo simulation with the Barabasi–Albert model. ResultsThe co-authorship network of the entire period consisted of 13,979 nodes and 68,668 weighted edges. A time-series analysis revealed a linear correlation between the number of nodes and the number of edges (R2 = 0.9937, p < 0.001). Additionally, the number of communities was linearly correlated with the number of nodes (R2 = 0.9788, p < 0.001). The average shortest path increased by a greater degree than the logarithm of the number of nodes, indicating the scale-free structure of the network. We identified D. Berman as the most central author with regard to the degree centrality and closeness centrality. S. Neubauer was the top-ranking author with regard to the betweenness centrality. Among the 22 authors who were ranked in the top 10 for any centrality, 14 authors (63.6%) had a medical degree (medical doctor, MD). The remaining eight non-MD researchers had a PhD in computational science-related fields. The number of communities detected in the Barabasi–Albert model simulation was similar to that for the largest component of the real network (6.21 ± 0.07 vs. 6, p = 0.096). ConclusionsA co-authorship network analysis revealed a structure of collaboration networks in the application of machine learning in the field of cardiovascular disease, which can be useful for planning future scientific collaboration.

The preablation monocyte/ high density lipoprotein ratio predicts the late recurrence of paroxysmal atrial fibrillation after radiofrequency ablation

BackgroundThe monocyte/high-density lipoprotein ratio (MHR) has emerged as a promising alternative biomarker in the fields of cardiovascular disease and atrial fibrillation (AF). This retrospective study was aimed to explore the predictive value of the MHR for the late recurrence of AF after radiofrequency ablation.MethodsFrom April 2015 to October 2018, patients with paroxysmal AF who had undergone radiofrequency catheter ablation at Subei People’s Hospital of Jiangsu Province were enrolled in our study. All the participants were observed until November 2019 after the procedure. During the postoperative follow up, the patients were categorized into the recurrence group and maintenance of sinus rhythm group based on who had experienced AF recurrence.ResultsOne hundred twenty-five patients were diagnosed with paroxysmal AF, with an average age of 61.2 ± 9.3 years. Forty-seven patients had developed late recurrence during a mean follow up of 25.1 ± 12.0 months. The AF recurrence event rates were significantly increased in the highest MHR tertile compared with those in the lowest MHR tertile (22.0% vs. 57.1%; P < 0.05). On multivariate logistic regression analysis, the preablation MHR (OR = 1.34; 95% CI = 1.12 ~ 1.60; P = 0.001) and left atrial diameter (LAD) (OR = 1.21, 95% CI = 1.08 ~ 1.35; P = 0.001) were independent risk factors predicting the recurrence of AF after radiofrequency ablation. Furthermore, receiver operating characteristic (ROC) curve analysis revealed that the area under the curve (AUC) of the MHR was 0.712 (95% CI = 0.618 ~ 0.806; P = 0.000) and that of LAD was 0.739 (95% CI = 0.653 ~ 0.814; P = 0.000). Z-test found no significant difference between the MHR and LAD regarding the AUC (Z = 0.451; P = 0.652).ConclusionAn elevated preablation MHR was associated with an increased risk of the postoperative recurrence of AF. Additionally, the MHR independently predicted the late recurrence of paroxysmal AF after radiofrequency ablation, with the same predictive value as LAD.

Heart Score for Predicting in Hospital Major Cardiovascular Event in Patient with Non ST Segment Elevation Acute Coronary Syndrome

Background: Acute Coronary Syndrome (ACS) is one of the main problems in the field of cardiovascular diseases because of high hospitalization rate, high mortality and high medical cost. Rapid and accurate risk stratification is needed to calculate the risk of complication and right now exist two most used score which is GRACE and TIMI. Heart score has 5 simple variables that can be calculated easily and this score considered to have better predictive ability compared to other score. The aim of this study is to examine HEART score as a predictor for in hospital Major Cardiovascular Event (MACE) in patient diagnosed as Non ST Segment Elevation Acute Coronary Syndrome (NSTEACS) that hospitalized at Haji Adam Malik (HAM) General Hospital Medan.&#x0D; Methods: This is a prospective cohort study that includes 52 NSTEACS patient that hospitalized at HAM General Hospital since November 2018 until January 2019. Patient that diagnosed as NSTEACS were calculated for GRACE, TIMI, and HEART score then observed during hospitalization. Outcome of this study is MACE during hospitalization. Statistical analysis was performed to test HEART score as MACE predictor and then comparison was done with GRACE and TIMI&#x0D; Results: By using ROC curve analysis, the cut-off value of HEART score was 5 (AUC 0.947, 95% CI 0.883-0.997, p&lt;0.01). Study subject that experienced MACE with HEART score ≥5 was 21 patients (87.5%) compared to 2 patients (7.1%). HEART score ≥5 can predict MACE with sensitivity 87.5%, specificity 92.9%, negative predictive value (NPV) 89.7% and positive predictive value (PPV) 91.3%. ROC curve comparison was done between HEART with GRACE and TIMI then it was found that HEART score has better predictive ability compared to TIMI and GRACE (AUC 0.947 vs 0.829 vs 0.807, p &lt; 0.01).&#x0D; Conclusion: HEART score can be used as MACE predictor which is relatively simpler but have better predictive ability compared to GRACE and TIMI.

Impact of calculated plasma volume status on all-cause and cardiovascular mortality: 4-year nationwide community-based prospective cohort study.

Plasma volume status (PVS), a marker of plasma volume expansion and contraction, is gaining attention in the field of cardiovascular disease because of its role in the prevention and of the management of heart failure. However, it remains undetermined whether an abnormal PVS is a risk for all-cause and cardiovascular mortality in the general population. We used a nationwide database of 230,882 subjects (age 40-75 years) who participated in the annual "Specific Health Check and Guidance in Japan" check-up between 2008 and 2011. There were 586 cardiovascular deaths, 2,552 non-cardiovascular deaths, and 3,138 all-cause deaths during the follow-up period of four years. Abnormally high and low PVS were identified from the results of 80% of all subjects (high and low PVS ≥ 7 and < -13.3, respectively). Multivariate Cox proportional hazard regression analysis demonstrated that high PVS was an independent risk factor for all-cause, cardiovascular and non-cardiovascular deaths. Although low PVS was a positive risk factor for cardiovascular deaths as well, it was a negative risk factor for non-cardiovascular deaths. The addition of PVS to cardiovascular risk factors significantly improved the C-statistic, net reclassification, and integrated discrimination indexes. This is the first prospective report to reveal the impact of PVS on all-cause and cardiovascular mortality. PVS could be an additional risk factor for all-cause and cardiovascular mortality in the general population.

New Mechanisms of Vascular Dysfunction in Cardiometabolic Patients: Focus on Epigenetics.

Epigenetic processing takes centre stage in cardiometabolic diseases (obesity, metabolic syndrome, type 2 diabetes, hypertension), where it participates in adiposity, inflammation, endothelial dysfunction, vascular insulin resistance and atherosclerosis. Epigenetic modifications, defined as heritable changes in gene expression that do not entail mutation in the DNA sequence, are mainly induced by environmental stimuli (stress, pollution, cigarette smoking) and are gaining considerable interest due to their causal role in cardiovascular disease, and their amenability to pharmacological intervention. Importantly, epigenetic modifications acquired during life can be transmitted to the offspring and exert their biological effects across multiple generations. Indeed, such transgenerational transmission of epigenetic signals may contribute to anticipating cardiovascular and metabolic disease phenotypes already in children and young adults. A deeper understanding of environmental factors and their effects on the epigenetic machinery and transcriptional programs is warranted to develop effective mechanism-based therapeutic strategies. The clinical application of epigenetic drugs-also known as "epi-drugs"-is currently exploding in the field of cardiovascular disease. The present review describes the main epigenetic networks underlying cardiometabolic alterations and sheds light on specific points of intervention for pharmacological reprogramming in this setting.

Apabetalone -BET protein inhibition in cardiovascular disease and Type 2 diabetes.

Apabetalone is the first selectiveBET protein inhibitor in the field of cardiovascular diseases (CVD). BET proteins are epigenetic regulators that link upstream epigenetic modifications to downstream gene expression. Inhibition of BET proteins by apabetalone has been shown to modulate reverse cholesterol transport, coagulation, inflammation and vascular calcification. Furthermore, apabetalone reduces circulating markers of CVD risk and plaque vulnerability. Post-hoc pooled analyses suggest a potential reduction in risk of major adverse cardiac events (MACE) in patients with Type 2 diabetes (T2D) and stable CVD. However, the current cardiovascular outcomes trial BET-on-MACE failed to detect the assumed 30% reduction of MACE by apabetalone in patients with T2D after an acute coronary syndrome.

The State of Healthcare Facilities in the Field of Cardiovascular Diseases: Reflections from a Public Cardiac Hospital, Uttar Pradesh

Background: Literature suggest that majority of Indians belonging to lower socio-economic status (SES) are dependent on public health sector but still there is higher rate of deaths among them due to cardiac diseases. Objective: The aims of this paper are twofold: (i) To depict the ground realities of a public cardiac hospital, and (ii) To identify the key challenges for the effective policy implementation and control of CVD. Method: Using direct field based observation, experiences and field notes. Result and Conclusion: India’s public healthcare sector for cardiac patients suffers from problem of accessibility and affordability. Further, prevalence of prohibited practices makes things worse for the poor patients.

2019 Italian Society of Cardiology Census on telemedicine in cardiovascular disease: a report from the working group on telecardiology and informatics

BackgroundThe aim of this study was to assess by a census supported by the Italian Society of Cardiology (Società Italiana di Cardiologia, SIC) the present implementation of telemedicine in the...

Editorial Highlights on Treatment for Atrial Fibrillation

Journal of Cardiovascular Diseases & Diagnosis commemorates its 7 years long service to the scientific community by consistently publishing peer-reviewed articles and tracking the progress and significant advancements in the field of Cardiovascular Diseases. Ever since its inception in the year 2013, releasing its regular issue on a bimonthly basis, this transdisciplinary journal is also releases special issues and conference proceedings from time to time, thus comprehensively covering a wide range of topics and emerging challenges, enhancements, therapeutics towards Cardiovascular Diseases. The journal strives to publish the original research articles, epidemiological studies, new methodological clinical approaches, case reports, design and goals of clinical trials, review articles, points of view, editorial’s, and Images in cardiovascular medicine. In this issue some of the recent and impactful research articles that were published by the journal will be discussed.

Future Perspectives on the Role of Frailty in Cardiovascular Diseases.

Frailty is a clinical concept which is gaining increased momentum not only in geriatrics, but in all specialties treating adult patients. In these Future Perspectives, the following roles of frailty in the field of cardiovascular diseases (CVD) will be discussed as a narrative review: (1) Frailty as an adjunct to assess CVD patients in addition to traditional risk scores; (2) bidirectional relationship between frailty and CVD; (3) widening the scope of endpoints in CVD trials-inclusion of frailty; (4) finally, the relationship between geriatrics and cardiology will be shortly discussed.

Polyvascular Disease: Reappraisal of the Current Clinical Landscape.

Atherosclerosis within 2 or more arterial beds has been termed polyvascular disease. Although polyvascular disease has long been associated with heightened cardiovascular risk, much is still unknown regarding its pathophysiology and management. In this past decade, the field of cardiovascular disease has experienced exponential growth in terms of antithrombotic and lipid-lowering therapies aimed at mitigating ischemic events. This review describes the inherent risk associated with polyvascular disease in contemporary observational and clinical trial populations and summarizes novel therapies in this high-risk population.