Field Of Cardiovascular Medicine Research Articles

Dynamically reshaping high density hydrogen bonds enhanced polyurethane used as artificial heart valves with enhanced fatigue resistance, anti-calcification and blood compatibility

Injury to cardiac valves is a major contributor to mortality associated with cardiovascular diseases. Artificial valves are preferred for their mimicry of natural valve efficiency in optimizing hemodynamics and minimizing associated complications. To endure the substantial pressures of the cardiovascular system, these valves require exceptional fatigue resistance, calcification resistance, and blood compatibility. To address these demands, we have designed and synthesized a silane uniformly integrated polyurea-polyurethane elastomer (PSCU). The PSCU features a highly responsive hydrogen bond network, conferred by the integration of oxygen-containing spirochemical rings and polyurethane urea segments, which forms orientation to prevent material fatigue damage. Concurrently, PSCU has almost no adverse effects on the blood due to the uniform integration of silane, and long-term use will not cause calcification. In vivo evaluations have confirmed PSCU’s exceptional biocompatibility and stability, with no observable tissue inflammation or material accumulation. Moreover, fluid dynamics studies have demonstrated PSCU’s superior mechanical attributes, maintaining effective unidirectional blood flow under a sustained 60 mmHg pressure gradient. This breakthrough material represents a significant advancement in the field of cardiovascular medicine, offering enhanced durability and reliability for artificial heart valves.

Evaluation of anti-hypertensive activity of Quercus leucotrichophora A. camus methanolic extract on DOCA-salt induced hypertensive rats

Quercus leucotrichophora A. camus, commonly known as Banj oak or Ban tree, belongs to the Fagaceae family and is abundantly found in the regions of Shimla, Kullu-Manali, and upper Mandi in Himachal Pradesh. This study explores the medicinal properties of plant seeds, known for their antioxidant and diuretic activity, traditionally utilized in the treatment of hypertension and hypolipidemic, hepatoprotective conditions. PurposeTo investigate the antihypertensive effect of methanolic extract of Quercus leucotrichophora A. camus seeds in DOCA sat induced rats. Material and methodsGround seeds of Quercus leucotrichophora A. camus were stored in an airtight container. A total of 100 gs of dried seed powder were subjected to extraction using 250 ml of methanol and a Soxhlet extractor maintained at 60–65 °C for five hours. The resulting dried extract (5 gs) was stored in an airtight container in a refrigerator at low temperature and administered by rats to test its antihypertensive impact. The assessment of obtained extract impact on hypertension induced by DOCA-salt was conducted through blood pressure measurement and biochemical analysis. ResultsOur study revealed that the methanolic extract of Quercus leucotrichophora A. camus seeds exerted blood pressure-lowering effects, associated with an increase in serum Nitric Oxide (NO) levels. The attenuation of hypertension by extract was further linked to the normalization of serum Na+ and K+concentrations, indicating an improvement in electrolyte imbalance. Additionally, the antioxidant properties of Quercus leucotrichophora A. camus were evident through increased activities of Glutathione (GSH), Glutathione Peroxidase (GHPx), Superoxide Dismutase (SOD), and decrease activity of Thiobarbituric acid reactive substances (TBARS). ConclusionThe findings of our investigation suggest that the antihypertensive action of Quercus leucotrichophora A. camus is correlated with enhanced endothelial nitric oxide synthase (eNOS) activation and an augmented antioxidant defense system. This sheds light on the potential therapeutic benefits of plant under investigation in managing hypertension, emphasizing its role in promoting cardiovascular health. Further research is warranted to elucidate the underlying mechanisms and to explore the full pharmacological potential of Quercus leucotrichophora A. camus in the field of cardiovascular medicine.

Enhancing Cardiovascular Health with the Implementation of Digitalis

Cardiovascular diseases (CVDs) are a major global health problem that cause a lot of illness, death, and high healthcare costs. As medical science advances, the number of people with CVDs continues to rise, necessitating the development of new methods for their prevention, diagnosis, and treatment. In recent years, using digital health technologies in cardiovascular care has become an excellent way to improve patient outcomes and make disease management better. It is possible for digitalis medicines, which come from the foxglove plant (Digitalis purpurea), to improve heart health in the digital age. In the field of cardiovascular medicine, this in-depth review looks at digitalis's historical importance, pharmacology, clinical uses, safety concerns, and digital transformation. The review starts with an overview of the epidemiological setting and the problems that CVDs cause, emphasizing the urgent need for creative solutions to deal with this worldwide health event. This article deals with how it has changed over time, from herbal remedies to modern drug therapy. It informs about the pharmacology of digitalis, mostly the way it works, its pharmacokinetics, and its pharmacodynamics. Pharmaceuticals that contain digitalis mainly work by stopping the Na+/K+ ATPase pump. The medication can help with heart failure, atrial fibrillation, and some types of arrhythmias. Digitalis's digital transformation is looked at with a focus on the way digital health technologies are used in its management, monitoring, and effectiveness. The review highlights that digitalis-based interventions could change the way cardiovascular medicine is done in the modern era.

Risk Stratification in People with Diabetes for Fasting During Ramadan: Consensus from Arabic Association for the Study of Diabetes and Metabolism.

Current international guidelines recommend a pre-Ramadan risk assessment for people with diabetes (PwDM) who plan on fasting during the Holy month. However, a comprehensive risk assessment-based recommendation for the management of PwDM intending to fast is still controversial. Therefore, the Arabic Association for the Study of Diabetes and Metabolism (AASD) developed this consensus to provide further insights into risk stratification in PwDM intending to fast during Ramadan. The present consensus was based on the three-step modified Delphi method. The modified Delphi method is based on a series of voting rounds and in-between meetings of the expert panel to reach agreements on the statements that did not reach the consensus level during voting. The panel group comprised professors and consultants in endocrinology (both adult and pediatric). Other members included experts in the fields of cardiovascular medicine, nephrology, ophthalmology, and vascular surgery, affiliated with academic institutions in Egypt. In PwDM who intend to fast during Ramadan, risk stratification is crucial to optimize patient outcomes and prevent serious complications. The present consensus provides risk assessment of those living with diabetes according to several factors, including the type of diabetes, presence, and severity of complications, number of fasting hours, and other socioeconomic factors. According to their risk factors, patients were classified into four categories (very high, high, moderate, and low risk). Future research is warranted due to the controversial literature regarding the impact of fasting on certain comorbidities.

The frozen elephant trunk technique in acute aortic dissection: the ultimate solution? An institutional experience.

Acute aortic dissection remains a serious emergency in the field of cardiovascular medicine and a challenge for cardiothoracic surgeons. In the present study, we seek to compare the outcomes of different surgical techniques in the repair of type A acute aortic dissection. Between April 2015 and May 2023, 213 patients (82 women, aged: 63.9 ± 13.3 years) with acute aortic dissection (205 type A and 8 non-A-non-B dissections) underwent surgical treatment in our department. A total of 45 patients were treated with the frozen elephant trunk (FET) technique supported by the Thoraflex™ Hybrid prosthesis, 33 received total aortic arch replacement (TAR)-standard or conventional elephant trunk-treatment, and 135 were treated with hemiarch replacement (HR). Aortic arch surgery was performed in most patients under moderate hypothermic (28°C on average) circulatory arrest, with selective antegrade cerebral perfusion through the right axillary artery. The rates of early mortality were 17.8% (38 perioperative deaths) in the whole population, 8.9% in the FET group of patients, and 33% and 17% in the TAR and HR group of patients, respectively (P-value 0.025). The rate of spinal cord injury was 2.3% (five patients), and a paresis of recurrent laryngeal occurred in 3.7% of patients (seven patients, four were treated with FET). Permanent neurological dysfunction occurred in 27 patients (12.7%). After a mean follow-up of 3 years, the rate of mid-term mortality of discharged patients was 19.4% (34 deaths: 7 FET, 4 TAR, and 23 HR) and the overall mortality rate was 33.8% [72 deaths: 11 FET (24.4%); 15 TAR (45.4%); 46 HR (34.1%)]. A total of 8 patients (17.8%) in whom FET was applied received additional endovascular treatment in the descending aorta. In our institutional experience, we found that the frozen elephant trunk technique with a high-end Thoraflex Hybrid prosthesis proved its surgical suitability in the treatment of acute aortic dissection with favorable outcomes. The FET technique and our perioperative management led to comparable neurological outcomes and reduced mortality rates in these emergency cases.

Molecular basis of hereditary cardiomyopathy: A systematic review

Hereditary cardiomyopathies include a diverse spectrum of myocardial disorders characterized by mechanical and electrical abnormalities, among which hypertrophic cardiomyopathy (HCM) and dilated cardiomyopathy (DCM) are distinguished. This paper dives into the genetic foundations of these conditions, with a focus on mutations in genes encoding sarcomere proteins, thin filament proteins, and calcium homeostasis regulators. The familial aggregation of cardiomyopathies underscores the substantial genetic component, with autosomal dominant inheritance patterns predominant in some cases. Genetic testing and counseling emerge as pivotal tools for early diagnosis, risk assessment, and the formulation of personalized treatment strategies. The integration of genetic insights into clinical management holds promise for improving patient outcomes and reducing disease burden. Further analysis of the molecular mechanisms underlying hereditary cardiomyopathies is critical for identifying novel therapeutic targets and advancing precision medicine approaches. By comprehensively exploring the genetic underpinnings of cardiomyopathies, this paper contributes to our understanding of these complex diseases and highlights the potential for innovative interventions to enhance patient care in the field of cardiovascular medicine.

Application of computational fluid dynamics in the evaluation of left ventricular function in cardiomyopathies and coronary disease

Computational fluid dynamics (CFD) is an emerging technology applied in the field of cardiovascular medicine, which can obtain hemodynamic data by simulating the blood flow in the patient's heart for cardiac function assessment and disease diagnosis. Left ventricular function plays a key role in the occurrence and development of cardiomyopathies and coronary disease. CFD can reconstruct the left ventricular anatomic structures of patients to clarify pathophysiologic mechanisms and analyze hemodynamic parameters to evaluate left ventricular function, verify surgical efficacy, and guide surgical strategy, which has a positive effect on achieving early diagnosis and reducing mortality from cardiomyopathies and coronary disease. At present, there are still technical limitations in the large-scale clinical application of CFD, and various solutions are being developed and tested, and further improvement and refinement are needed.

The emergence and clinical significance of artificial intelligence–enhanced electrocardiography

The integration of artificial intelligence (AI) with electrocardiography (ECG), a technology known as AI-ECG, represents a transformative leap in the field of cardiovascular medicine. This innovative approach has significantly advanced the capabilities of ECG, traditionally used for diagnosing heart diseases. AI-ECG excels in detecting subtle changes and interconnected patterns in cardiac waveforms, offering a level of precision and sensitivity that was previously unattainable with conventional methods. The scope of AI-ECG extends beyond the realm of heart diseases. It has shown remarkable potential in predicting and identifying the impacts of noncardiac conditions on heart health, thereby broadening the diagnostic capabilities of ECG. This is especially valuable given the complex nature of cardiovascular diseases and their interactions with other health conditions. Despite its groundbreaking potential, AI-ECG faces several challenges. One of the primary concerns is the "black box" nature of AI algorithms, which can make the decision-making process opaque and difficult to interpret. This poses a challenge in medical settings where understanding the rationale behind a diagnosis is crucial. Additionally, the effectiveness of AI-ECG is dependent on the quality and diversity of the datasets used to train the algorithms. Limited or biased datasets can lead to inaccuracies and diminish the reliability of the technology. However, the benefits of AI-ECG are significant. It enables faster, more accurate diagnoses and has the potential to greatly enhance the efficiency of cardiovascular care. As research and technology continue to evolve, AI-ECG is poised to become an indispensable tool in the diagnosis and management of heart diseases.

Cancer and Cardiovascular Disease: The Conjoined Twins.

Cancer and cardiovascular disease are the two most common causes of death worldwide. As the fields of cardiovascular medicine and oncology continue to expand, the area of overlap is becoming more prominent demanding dedicated attention and individualized patient care. We have come to realize that both fields are inextricably intertwined in several aspects, so much so that the mere presence of one, with its resultant downstream implications, has an impact on the other. Nonetheless, cardiovascular disease and cancer are generally approached independently. The focus that is granted to the predominant pathological entity (either cardiovascular disease or cancer), does not allow for optimal medical care for the other. As a result, ample opportunities for improvement in overall health care are being overlooked. Herein, we hope to shed light on the interconnected relationship between cardiovascular disease and cancer and uncover some of the unintentionally neglected intricacies of common cardiovascular therapeutics from an oncologic standpoint.

Crafting a Rigorous, Clinically Relevant Large Animal Model of Chronic Myocardial Ischemia: What Have We Learned in 20 Years?

The past several decades have borne witness to several breakthroughs and paradigm shifts within the field of cardiovascular medicine, but one component that has remained constant throughout this time is the need for accurate animal models for the refinement and elaboration of the hypotheses and therapies crucial to our capacity to combat human disease. Numerous sophisticated and high-throughput molecular strategies have emerged, including rational drug design and the multi-omics approaches that allow extensive characterization of the host response to disease states and their prospective resolutions, but these technologies all require grounding within a faithful representation of their clinical context. Over this period, our lab has exhaustively tested, progressively refined, and extensively contributed to cardiovascular discovery on the basis of one such faithful representation. It is the purpose of this paper to review our porcine model of chronic myocardial ischemia using ameroid constriction and the subsequent myriad of physiological and molecular-biological insights it has allowed our lab to attain and describe. We hope that, by depicting our methods and the insight they have yielded clearly and completely-drawing for this purpose on comprehensive videographic illustration-other research teams will be empowered to carry our work forward, drawing on our experience to refine their own investigations into the pathogenesis and eradication of cardiovascular disease.

Global Research Trends on Exosome in Cardiovascular Diseases: A Bibliometric-Based Visual Analysis.

Exosomes in cardiovascular diseases (CVDs) have attracted huge attention with substantial value and potential. Our bibliometrics is based on literature from the field of cardiovascular exosomes over the past 30 years, which has been visualized to display the development process, research hotspots, and cutting-edge trends of clinical practices, mechanisms, and management strategies related to psych cardiology. We selected articles and reviews on exosomes in CVDs from the core collection of Web of Science, and generated visual charts by using CiteSpace and VOSviewer software. Our research included 1613 publications. The number of exosome articles in CVD fluctuates slightly, but overall shows an increasing trend. The main research institutions were Tongji University and Nanjing Medical University. The International Journal of Molecular Sciences has the highest publication volume, while the Journal of Cellular and Molecular Medicine has the highest citation count. Among all the authors, Eduardo Marban ranks first in terms of publication volume and H-index. The most common keywords are exosome, extracellular vesicles, and angiogenesis. This is a bibliometric study on the research hotspots and trends of exosomes in CVD. Exosome research in the field of cardiovascular medicine is on the rise. Some exosome treatment methods may become the focus of future research.

Fetuin-A levels in association with calcific aortic valve disease: A meta-analysis

Background and aimsCalcific aortic valve disease (CAVD) is a common valvular disease, prevalent particularly within the older age groups. The potential use of biomarkers in diagnosing and assessing the severity of CAVD, in supplementation with imaging techniques, has recently gained momentum within the field of cardiovascular medicine. Therefore, a meta-analysis was performed that assessed the association between the fetuin-A levels, and the presence of CAVD. MethodsPubMed and Cochrane were searched from inception to April 2023. Risk of bias was assessed using the Newcastle-Ottawa scale for cohort studies. ResultsThis analysis includes a total of 3,280 patients with CAVD, and 7,505 patients as control, resulting in the pooling of 10,785 patients in this meta-analysis. It was observed that the circulating levels of fetuin-A were significantly lowered in patients with CAVD (SMD: -0.20; 95% CI: -0.39, -0.02; P = 0.03). Moreover, the analysis revealed that fetuin-A levels had no significant association with CAVD in patients suffering from kidney disease (SMD: 0.20; 95% CI: -0.46, 0.85; P = 0.56). ConclusionWhile initial results demonstrate the potential effectiveness, further research is essential in order to arrive at a robust conclusion regarding the use of fetuin-A as a diagnostic biomarker for calcific aortic valve disease.

Robotic-Assisted Solutions for Invasive Cardiology, Cardiac Surgery and Routine On-Ward Tasks: A Narrative Review.

Robots are defined as programmable machines that can perform specified tasks. Medical robots are emerging solutions in the field of cardiology leveraging recent technological innovations of control systems, sensors, actuators, and imaging modalities. Robotic platforms are successfully applied for percutaneous coronary intervention, invasive cardiac electrophysiology procedures as well as surgical operations including minimally invasive aortic and mitral valve repair, coronary artery bypass procedures, and structural heart diseases. Furthermore, machines are used as staff-assisting tools to support nurses with repetitive clinical duties i.e., food delivery. High precision and resolution allow for excellent maneuverability, enabling the performance of medical procedures in challenging anatomies that are difficult or impossible using conventional approaches. Moreover, robot-assisted techniques protect operators from occupational hazards, reducing exposure to ionizing radiation, and limiting risk of orthopedic injuries. Novel automatic systems provide advantages for patients, ensuring device stability with optimized utilization of fluoroscopy. The acceptance of robotic technology among healthcare providers as well as patients paves the way for widespread clinical application in the field of cardiovascular medicine. However, incorporation of robotic systems is associated with some disadvantages including high costs of installation and expensive disposable instrumentations, the need for large operating room space, and the necessity of dedicated training for operators due to the challenging learning curve of robotic-assisted interventional systems.

Individualizing Medicinal Therapy Post Heart Stent Implantation: Tailoring for Patient Factors.

The field of cardiovascular medicine is undergoing a transformative shift towards personalized medicinal therapy, particularly in the context of post stent implantation. This narrative review explores the significance, challenges, and future directions of individualized treatment strategies for patients with coronary stents. The review highlights the pivotal role of personalized approaches in optimizing treatment efficacy and minimizing adverse events. Real-world clinical studies and trials underscore the importance of tailoring antiplatelet therapy based on platelet function testing, genetic testing, and risk scoring. These studies reveal that personalized medicinal treatment improves clinical outcomes by balancing preventing thrombotic events and mitigating bleeding risks. Challenges, including cost, test availability, patient adherence, and ethical considerations, are discussed in depth, shedding light on the complexities of implementing personalized approaches. Technological advancements, including omics data integration, artificial intelligence, and big data analytics, shape the future of personalized medicinal therapy. These tools enable precise pharmacogenomic selection of medications and the development of integrated risk-scoring systems. Patient engagement and education are also central, with empowered patients and remote monitoring contributing to collaborative decision-making. In conclusion, the narrative review underscores that personalized medicinal therapy post stent implantation holds immense promise for revolutionizing cardiovascular care. By embracing a comprehensive approach that considers genetics, clinical factors, and patient preferences, healthcare providers can optimize treatment outcomes and improve patient quality of life. The evolving landscape of personalized medicine offers a glimpse into a future where tailored treatment strategies become the cornerstone of precision cardiovascular care.

Abstract P2145: A Review Of Trends In Cardiovascular Medicine Clinical Trials; 2012-2021

Introduction: We examine cardiovascular medicine clinical trials (CTs) from the United States over the past decade focusing on characteristics that are important for assessing the reliability of evidence derived from them. Methods: The Clinicaltrials.gov API interface was queried with a comprehensive search strategy to identify trials in the field of cardiovascular medicine from the US registered from 1/1/2012 till the 12/31/2021. We extracted data on the presence of data monitoring committees (DMC), masking status and allocation methods used in the CTs. Results: Our initial query identified 1299 CTs. After reviewing and excluding unrelated trials, 536 were found to be cardiovascular medicine CTs. Of these, 507 (95%) reported if they had a DMC or not, 261 (49%) reported having a DMC while 246 (46%) reported not having one. 471 (88%) CTs reported on their design allocation method, most common being randomized as reported by 312 (58%) of the trials, 43 (8%) were non-randomized and 116 (22%) reported that a design allocation was not applicable to them. 471 (88%) CTs reported on their masking status, most common being open label as seen in 247 (46%) of the trials followed by double masking seen in 71 (13%) of the trials. On performing a Cox and Stuart trend test, no trend was seen in the annual proportion of trials with randomization, a DMC or masking over the past decade [P > 0.05 for all three]. Conclusions: In these analyses of 536 CTs, we found that > 50% did not have a DMC or any masking and no favorable trend was seen in the annual proportion of same over the past decade. Additionally, majority of the trials reported randomization as the design allocation method.

The Emergence of Nanotechnology in the Prognosis and Treatment of Myocardial Infarctions.

Myocardial infarction (MI), commonly known as a heart attack, is a critical cardiovascular condition associated with high morbidity and mortality rates worldwide. Despite significant advancements in traditional treatment modalities, there remains a need for innovative approaches to improve the prognosis and treatment outcomes of MI. The emergence of nanotechnology has provided a promising avenue for revolutionizing the management of this life-threatening condition. This manuscript aims to explore the role of nanotechnology in the prognosis and treatment of myocardial infarctions. Nanotechnology offers unique advantages in the field of cardiovascular medicine, including targeted drug delivery, precise imaging and diagnosis, regenerative medicine approaches, biosensors and monitoring, and the integration of therapy and diagnostics (theragnostic). One of the key advantages of nanotechnology is the ability to deliver therapeutic agents directly to the affected site. Nanoparticles can be engineered to carry drugs specifically to damaged heart tissue, enhancing their efficacy while minimizing off-target effects. Additionally, nanoparticles can serve as contrast agents, facilitating high-resolution imaging and accurate diagnosis of infarcted heart tissue. Furthermore, nanotechnology-based regenerative approaches show promise in promoting tissue healing and regeneration after MI. Nanomaterials can provide scaffolding structures or release growth factors to stimulate the growth of new blood vessels and support tissue repair. This regenerative potential holds significant implications for restoring cardiac function and minimizing long-term complications. Nanotechnology also enables real-time monitoring of critical parameters within the heart, such as oxygen levels, pH, and electrical activity, through the utilization of nanoscale devices and sensors. This capability allows for the early detection of complications and facilitates timely interventions. Moreover, the integration of therapy and diagnostics through nanotechnology-based platforms, known as theragnostic, holds tremendous potential. Nanoparticles can simultaneously deliver therapeutic agents while providing imaging capabilities, enabling personalized treatment strategies tailored to individual patients. This manuscript will review the recent advancements, clinical trials, and patents in nanotechnology for the prognosis and treatment of myocardial infarctions. By leveraging nanotechnology's unique properties and applications, researchers and clinicians can develop innovative therapeutic approaches that enhance patient outcomes, improve prognosis, and ultimately revolutionize the management of myocardial infarctions.

STEM CELLS IN REGENERATIVE MEDICINE AND THERAPEUTIC POTENTIAL

Stem cells are a form of undifferentiated cell that has the potential to proliferate (self-renew), emerge from a single cell (clonal), and develop into different types of cells and tissues (potent). There are several sources of stem cells of varied potency.Although stem cell research has grown at an exponential rate, medicinal applications have moved considerably more slowly. The study is currently focused on understanding embryonic, adult, and inducible pluripotent stem cells. Adult stem cell research translation has demonstrated a decisive benefit that is larger than the present standard of care in the field of cardiovascular medicine. The future of stem cell research and therapy will continue to open up new diagnostic, therapeutic, and tissue regeneration pathways.In cellular treatment, stem cells can be employed to repair damaged cells or rebuild tissues. Furthermore, stem cells have advanced our understanding of development as well as disease causation. Cell lines that are particular to a disease can also be grown and employed in medication research.Despite considerable improvements in stem cell biology, ethical concerns about embryonic stem cells, tumour growth, and rejection restrict their applicability. However, several of these constraints are being overcome, which might lead to significant advancements in illness management. This article provides an introduction to the world of stem cells, including its definition, origin, and categorization, as well as their uses in regenerative medicine.

Philippine Learning Framework for Specialty Fellows in General Adult Cardiology

For a long time, the training of fellows for the specialty of cardiology has not been looked into in greater detail. The first local guideline devoted to a discussion of cardiology training in the country was released by the Philippine Heart Association-Philippine College of Cardiology in 2007. Since then, no update has been formally released regarding the document. Such an update is undeniably necessary, especially since the field of cardiovascular medicine is dynamic and ever-changing.

Three-Dimensional Echocardiography Derived Printing: A Review of Workflow, Current, and Future Applications

While most of the work pertaining to 3D printing in cardiology has been based on 3D CT and MRI datasets, due to the recent advents in 3D printing and 3D echocardiography, 3D printing from echocardiography has now become feasible. In this review, we discuss the workflow, applications, limitations, and potential future directions of 3D echocardiography-based 3D printing. 3D printing using 3D echocardiographic datasets has been successfully deployed in the field of cardiovascular medicine in the twenty-first century. It was shown to provide a significant additive value particularly with regards to visualization of valves and subvalvar apparatus. Given its limitations of limited field of view and somewhat lower spatial resolution, this approach is likely ideally suited for a combined multi-modality-based printing. Patient-specific, 3D echocardiography-derived 3D-printed models are now quite feasible. This can be used for surgical/procedural planning and training for optimal outcomes.

Premature Cardiovascular Misdiagnosis of Senior Endurance-Trained Athletes

A mature Caucasian patient, an endurance-trained triathlete (age group), had a routine ECG. The patient was immediately referred to Emergency based on supposed ECG abnormalities indicating a heart attack. This diagnosis was quickly dismissed based on no symptoms, heart rate of 50 BPM, athletic status, excellent health, and no prior cardiovascular problems. The patient had a history of severe white coat hypertension and underwent a further stress test and echocardiogram. The stress test showed exaggerated systolic blood pressures (over 225 mmHg) and high in-clinic basal blood pressures (160/90 mmHg), and the patient was diagnosed as hypertensive with exercise blood pressure close to stroke territory. He was told to stop racing, reduce training, and was prescribed antihypertensive drugs (which he did not take). Subsequent at-home 24 h (values close to 120/80 mmHg) and stress blood pressure measurements reversed that decision when considered in combination with an excellent echocardiogram result. The literature clearly describes endurance-trained athletes with systolic pressures over 225 mmHg Hg as being conditioned with no pathological aspects. Endurance-trained athletes should be examined as special cases in the field of cardiovascular medicine as trained physiological responses often present as cardiac abnormalities, and misdiagnosis can inappropriately change the athlete’s life.