Management Of Cardiovascular Conditions Research Articles

PVDF/ZnO piezoelectric nanofibers designed for monitoring of internal micro-pressure.

Organic piezoelectric materials are emerging as integral components in the development of advanced implantable self-powered sensors for the next generation. Despite their promising applications, a key limitation lies in their reduced mechanical force-to-electricity conversion efficiency. In this study, we present a breakthrough in the fabrication of soft poly(vinylidene fluoride) (PVDF) organic electrospun piezoelectric nanofibers (OEPNs) with exceptional piezoelectric performance achieved through the incorporation of zinc oxide nanorods (ZnO NR). The inclusion of ZnO NR proved instrumental in augmenting the nanocrystallization of PVDF organic electrospun piezoelectric nanofibers (OEPNs), leading to a highly efficient crystal phase transformation from the α phase to the β/γ phase, serving as superior piezoelectric working dipoles. The resulting PVDF/ZnO NR OEPNs exhibited unparalleled piezoelectric output voltage and current density, particularly noteworthy under a micro-pressure of 1 kPa and a low frequency of 1.5 Hz. Utilizing the obtained PVDF/ZnO NR OEPNs as the piezoelectric working element, we engineered a soft self-powered micro-pressure sensor. This sensor was implanted simultaneously on the cardiovascular walls of the heart and femoral artery in pigs. The sensor demonstrated precise monitoring and recording capabilities for micro-pressure changes during various physiological states, spanning from wakefulness to coma, euthanasia, and notably, the formation of cardiac thrombus. These findings underscore the immense potential of the implantable self-powered sensor for the assessment and diagnosis of pressure-related cardiovascular diseases, such as thrombus and atherosclerosis, during the postoperative recovery phase. This innovative technology offers valuable insights into the dynamic physiological states, paving the way for enhanced postoperative care and management of cardiovascular conditions.

Synthesis and Pharmacological Properties of the Benzimidazole Scaffold: A Patent Review

AbstractBenzimidazole derivatives were first discovered in the late 19th and early 20th centuries, marking a significant milestone in the field of chemistry. These compounds have since played a pivotal role in pharmacology, demonstrating a wide array of pharmacological properties that have had a profound impact on medicine and healthcare. The significance of benzimidazole derivatives in pharmacology is undeniable. These compounds have been extensively studied and developed for their diverse and valuable properties. They exhibit potent anticancer activity, with some derivatives displaying the ability to hinder the growth of cancer cells, offering hope in the fight against this disease. Furthermore, benzimidazole derivatives have been involved in the management of cardiovascular conditions as antihypertensive agents, aiding in the control of high blood pressure. Their potential as antidiabetic agents, by influencing glucose metabolism and insulin secretion, holds promise in diabetes treatment. The recent patent literature has focused on structural modifications to the benzimidazole core to expand the arsenal of effective drugs. This review takes a disease‐centric perspective on patented benzimidazoles from 2016 to 2023. The relevant granted patent applications were located using patent databases, USPTO, Google Patents, EPO, WIPO, Lens and Espacenet.

Development and validation of an LC-MS/MS method for the simultaneous quantitation of angiotensin (1–7), (1–8), (1–9) and (1–10) in human plasma

Cardiovascular diseases have cast a significant negative impact on the lives of millions worldwide. Over the years, extensive efforts have been dedicated to enhancing diagnostic and prognostic tools for these diseases. A growing body of evidence indicates that the angiotensin convertase enzyme (ACE) and the angiotensin convertase enzyme 2 (ACE2), and angiotensin peptide levels could hold a pivotal role in assisting clinicians with the management of cardiovascular conditions, notably hypertension and heart failure. However, despite the considerable body of knowledge in this domain, a void remains in the field of analytical methodologies for these molecules. In this study, we present a fully validated LC-MS/MS method for the precise quantitation of plasma angiotensin (1–7), (1–8), (1–9), and (1–10), following the guidelines set by the Clinical and Laboratory Standards Institute (CLSI). Our method not only enables the accurate quantification of angiotensin peptides but also provides a means to assess ACE and ACE2 activity. Remarkably, our method achieved a Lower Limit of Measurement Interval (LLMI) as low as 5 pg/mL. This has enabled the detection of angiotensin (1–7), (1–8), (1–9) and (1–10) and the accurate quantitation of angiotensin (1–7), (1–8) and (1–10) in all analyzed groups, including healthy controls, patients with high blood pressure, and patients with chronic kidney disease. To our knowledge, our method represents the most sensitive approach allowing for simultaneous quantitation of these four angiotensin peptides. A distinct advantage of our method, when compared to immunoassays, is its high sensitivity combined with comprehensive chromatographic separation of all currently known angiotensin peptides. This combination translates to an exceptional level of selectivity, underscoring the value and potential of our methodology in advancing cardiovascular disease research.

Wearable Devices in Cardiovascular Medicine.

Wearable devices, such as smartwatches and activity trackers, are commonly used by patients in their everyday lives to manage their health and well-being. These devices collect and analyze long-term continuous data on measures of behavioral or physiologic function, which may provide clinicians with a more comprehensive view of a patients' health compared with the traditional sporadic measures captured by office visits and hospitalizations. Wearable devices have a wide range of potential clinical applications ranging from arrhythmia screening of high-risk individuals to remote management of chronic conditions such as heart failure or peripheral artery disease. As the use of wearable devices continues to grow, we must adopt a multifaceted approach with collaboration among all key stakeholders to effectively and safely integrate these technologies into routine clinical practice. In this Review, we summarize the features of wearable devices and associated machine learning techniques. We describe key research studies that illustrate the role of wearable devices in the screening and management of cardiovascular conditions and identify directions for future research. Last, we highlight the challenges that are currently hindering the widespread use of wearable devices in cardiovascular medicine and provide short- and long-term solutions to promote increased use of wearable devices in clinical care.

Contrast-Enhanced Ultrasound Molecular Imaging in Atherosclerosis Research.

The management of cardiovascular conditions will likely be improved by noninvasive in vivo molecular imaging technologies that can provide earlier or more accurate diagnosis. These techniques are already having a positive impact in preclinical research by providing insight into disease pathobiology or efficacy of new therapies. Contrast enhanced ultrasound (CEU) molecular imaging is a technique that relies on the ultrasound detection of targeted microbubble contrast agents to examine molecular or cellular events that occur at the blood pool-endothelial interface. For the most part, targeted contrast agents are composed of encapsulated gas microbubbles (MBs) that are 2-4μm in diameter, or other acoustically active micro- or nanoparticles. These agents bear several tens of thousands of binding molecules per particle. Because nonadhered agent is cleared rapidly, CEU molecular imaging can be performed in a matter of minutes. MBs are detected using contrast-specific techniques that generate and receive nonlinear signals produced by MB cavitation, thereby increasing signal-to-noise ratio. Dedicated kinetic models for molecular imaging have been generated that permit the elimination of signal from nonadherent agent.

Estudo da mortalidade por doenças cardiovasculares no município de vitória da conquista - ba: análise retrospectiva 2010-2020

Cardiovascular diseases are described in the literature as the main causes of death in the Brazilian population, and also have great repercussions worldwide. The aim of this study was to comparatively analyze mortality from cardiovascular diseases between 2010 and 2020, taking into account the record of death in the hospital environment, in the municipality of Vitória da Conquista - BA. This is a quantitative, exploratory, longitudinal research based on secondary data. The study was based on secondary data from the Department of Informatics of the Unified Health System (DATASUS), from the mortality information system (SIM). The study sample consisted of individuals of both sexes, whose death from cardiovascular causes occurred in the hospital network of the municipality of Vitória da Conquista - BA. The data analyzed in this study showed an increasing trend of mortality from cardiovascular diseases in the municipality of Vitória da Conquista - BA. However, between 2018-2020 there was a sharp decline in reported deaths. There was also a predominance of urgent and emergency care, to the detriment of elective care among the study sample. Based on the analyses performed, we highlight the need for a better approach to cardiovascular risk factors, promotion of healthy habits in the population, and early management of cardiovascular conditions, thus reducing the occurrence of emergency care, which seem to be associated with higher morbidity and mortality.

Ethyl acetate fraction of Cola hispida leaf protects against doxorubicin-induced myocardial injury in male albino rats

BackgroundCardiovascular diseases have continued to be the leading cause of death globally. In addition, some of the drugs used in the treatment of the diseases present some adverse effects which limit the usefulness of such drugs. Thus, there is a need for novel drugs whose side effect is either minimal or non-existent. The presence of bioactive compounds in Cola hispida leaf is of great significance in the treatment and management of cardiovascular conditions. This study investigated the cardio-protective potential against doxorubicin (Dox)-induced cardiac infarction in rats.ResultsDox induction resulted to muscle fiber degeneration in Dox-treated rats hence revealed significant (p < 0.05) elevation in the serum level of cardio biomarker enzymes and lipid peroxidation profile while significant (p < 0.05) fall in cardiac enzymatic antioxidant levels were observed relative to the normal control. Pre-treatment with ethyl acetate fraction of Cola hispida leaf expressed cardio-protective potentials against Dox-induced cardiotoxicity by significantly (p < 0.05) lowering the levels of cardiac biomarker enzymes towards normal, building up the activities of subdued antioxidant enzymes and depleting its malondialdehyde level. Histopathology photomicrograph of the heart tissues expressed myxomatous degeneration but was ameliorated through the administration of the fraction.ConclusionIn accordance with the findings from this study, the administration of ethyl acetate fraction of Cola hispida leaf is effective against Dox-induced redox imbalance due to its enriched antioxidant phytoconstituents.

Role of Statins in New-onset Diabetes Mellitus: The Underlying Cause, Mechanisms Involved, and Strategies to Combat.

Statins have transformed the treatment of cardiovascular diseases through primary and secondary prevention of events. Despite the success of statin's management of cardiovascular conditions, certain clinical trials, reviews, and meta-analysis point out that statins have the propensity to induce diabetes. The risk further increases with intensive statin therapy or in patients with diabetes. A proper mechanism for the induction of the diabetic condition has not yet been determined. The involvement of statin with beta cells in insulin secretion and peripheral cells in insulin resistance has been widely studied and established. The present review provides an update on the recent understanding of statin-induced diabetes. This covers the origin of statins, their development, possible mechanisms that explain the adverse effects in glucose homeostasis, and probable targets to remedy the condition.

Quality Assurance and Improvement Project in Echocardiography Laboratory: The Pivotal Importance of Organizational and Managerial Processes.

Echocardiography plays a vital role in the diagnosis and management of cardiovascular conditions. Echocardiography use is progressively increasing nowadays, and this is correlated to the evolving echo indications, to the relatively new available echocardiography modes (tissue Doppler imaging, speckle tracking imaging, three-dimensional mode, etc.) and modalities (transthoracic, transesophageal, and intracardiac) along with the various available clinical approaches (point of care echo, portable echo, etc.). Quality assurance in echocardiography is correlated to appropriate use criteria, adequate equipment, standardization of performance and reporting, along with timely storage and archiving. Quality improvement plan must target strategic planning, with metrics and timeline for assessment and re-assessment of results. Improvement project aims to ensure and enhance conformity with appropriate use criteria and standardization, timely completion of exams and reports, detection of discrepancies, and continuous improvement of knowledge and skills. Strategic planning is essential in this context in order to develop organizational and managerial processes, with regular auditing for a highly professional and advanced level of echocardiography, while ensuring teamwork and standards of ethical values.

A Survey of the Cardiology Care Delivered to Cancer Patients in Nigeria

BACKGROUND: The incidence of cardiovascular disease is on the rise and this is no less so amongst the population of individuals who are affected by cancer as improvement over the years in cancer treatment options have brought about improved outcomes in terms of overall patient survival and outcomes but has additionally also illuminated the side effects of these cancer treatment as patients live longer to manifest them thereby increasing morbidity and mortality. In Nigeria, there is paucity of data on cardio-oncology and this study will be the first documented study assessing the level of knowledge and the activity of cardiology care provided to oncology patients who develop cardiovascular disease in Nigeria and will therefore serve as a template towards the development of cardio-oncology services in Nigeria. METHODS: The survey was questionnaire-based involving cardiologist in Nigeria. They first part assessed the demographic characteristics of participants. The second part of the questionnaire assessed participants’ self-admitted expertise in the management of cardiovascular conditions complicating cancer treatment. RESULTS: There were more male (57.14%) than female (42.86%) respondents. More than two-thirds of respondents (71.4%, n=55) were aged 30-44 year. Cumulatively, the South-south and South-western regions accounted for over two-thirds of responses (72.43%, n=55). Over three-thirds of respondents (83.12%, n=) worked at teaching hospitals. Majority (89.5%, n=68) of ambulatory cancer patients in need of cardiology care received this service in a general cardiology clinic with only 10.5% (n=8) receiving care at a cardio-oncology centre. Majority of respondents (67.1%, n=51) dId not receive referrals from general practitioners or other specialists to evaluate cardiac problems in patients who had received cancer treatment. 80.5% of participants (n=62) said that they either did not know about the ESC position paper or knew about it but did not apply its suggestions to their practice. CONCLUSION: Most cancer patients requiring cardiovascular care are seen in the general cardiology clinic of Government owned hospitals in Nigeria. Although the knowledge of cardiologists in the management of cardiovascular complications of cancer patients is adequate, referral from General Practitioners is low. The ESC position paper on cardio-oncology is poorly known and utilized by cardiologist in the care of cancer patients with cardiovascular complications with the field of cardio-oncology generally regarded as a new topic in cardiology requiring more information on its dissemination and acceptance. This survey therefore makes obvious the dearth of knowledge regarding cardio-oncology that is prevalent in Nigeria. It is hoped that this will ignite a change in this aspect. There is therefore an urgent need to for all stakeholders to join force together towards the development of cardio-oncology skills and services in Nigeria.

Cardiovascular Health in Turner Syndrome: A Scientific Statement From the American Heart Association

Girls and women with Turner syndrome face a lifelong struggle with both congenital heart disease and acquired cardiovascular conditions. Bicuspid aortic valve is common, and many have left-sided heart obstructive disease of varying severity, from hypoplastic left-sided heart syndrome to minimal aortic stenosis or coarctation of the aorta. Significant enlargement of the thoracic aorta may progress to catastrophic aortic dissection and rupture. It is becoming increasingly apparent that a variety of other cardiovascular conditions, including early-onset hypertension, ischemic heart disease, and stroke, are the major factors reducing the life span of those with Turner syndrome. The presentations and management of cardiovascular conditions in Turner syndrome differ significantly from the general population. Therefore, an international working group reviewed the available evidence regarding the diagnosis and treatment of cardiovascular diseases in Turner syndrome. It is recognized that the suggestions for clinical practice stated here are only the beginning of a process that must also involve the establishment of quality indicators, structures and processes for implementation, and outcome studies.

Acetylsalicylic Acid Resistance After Simultaneous Pancreas-Kidney Transplantation.

The most common conditions leading to death after simultaneous pancreas-kidney transplantations (SPKs) are cardiovascular diseases. The aim of this study was to test the platelet aggregation inhibitor acetylsalicylic acid (ASA) resistance in patients after SPKs, including investigations into the triggering factors. Thirty-two patients (22 men, 10 women; overall age, 47.4 ± 8.6 years) were involved in our study and took 100 mg ASA per day. We used optical platelet aggregometry to detect resistance. Resistance occurred in 40.6% of the study group. However, with the use of logistic regression analysis, the examined 24 factors did not show any significant correspondence with resistance. The incidence of ASA resistance seems to be higher compared with other groups, but the triggering effect is still unproved. Clarifying this question should be important regarding the mortality- and morbidity-reducing capacity of antiplatelet drugs in the management of cardiovascular conditions.

Management of cardiovascular conditions in a cohort of patients with HIV: experience from a joint HIV/cardiology clinic

The aim of this study was to assess cardiovascular diagnoses and management in a cohort of patients diagnosed with HIV, and the performance of a joint HIV/Cardiology Clinic in a tertiary hospital setting. A retrospective analysis was performed on all patients referred to a joint HIV/Cardiology Clinic at our hospital. Data on 120 patients were collected. In this predominantly male population (male 101 and female 19) coronary artery disease (CAD) was the most common diagnosis (34%, n = 41). Other diseases included hypertension (12.5%, n = 15), cardiomyopathy (12.5%, n = 15) and arrhythmia (6%, n = 8). The majority of remaining cases included non-cardiac chest pain and palpitations. In addition to usual primary and secondary preventive measures for CAD, complex procedures, such as percutaneous coronary intervention, cardiac resynchronisation therapy for left ventricular systolic dysfunction and radiofrequency ablation for arrhythmias, were carried out. Overall cardiovascular mortality among the group was 2.5% (n = 3) over 4 years. The results indicate the efficacy of a specialist joint HIV/Cardiology Clinic in diagnosing and managing various cardiac conditions in a complex cohort of patients with HIV.

Effect of maternal cardiovascular conditions and risk factors on offspring cardiovascular disease.

Cardiovascular diseases (CVDs) constitute a particular challenge during pregnancy because physiological changes and fetal demands create an additional burden and fetal safety concerns limit treatment options. Other articles of this series review the physiological changes during pregnancy, the management of cardiovascular conditions most likely to endanger maternal and fetal health, and their long-term consequences for the cardiovascular health of the mother. This article focuses on their consequences in offspring. Developmental programming resulting from in utero or early postnatal exposure to specific risk factors is increasingly recognized to determine CVD in later life. Clinically manifest cardiovascular conditions during pregnancy such as preeclampsia/eclampsia and gestational hypertension may not only affect maternal health and pregnancy outcome but also reduce fetal growth, which is associated with increased adult CVD. Furthermore, extensive evidence indicates that maternal cardiovascular risk factors (hypercholesterolemia, smoking, obesity, and diabetes mellitus) program endothelial dysfunction, insulin resistance (IR), hypertension, atherosclerosis, and type 2 diabetes mellitus in offspring. The mechanisms of developmental programming remain largely unknown, but specific factors affecting in utero programming have been identified and experimental models established in which causal relationships, mechanisms, and protective effects of maternal treatment can be explored. These findings suggest that interventions targeting in utero programming may reduce the susceptibility to CVD in offspring, a high priority given the increasing prevalence of obese and dysmetabolic mothers and the concomitant increase in lifestyle risk in children. However, neither the cardiovascular consequences of many maternal risk factors nor the efficacy of maternal prevention and treatment is sufficiently supported by prospective double-blind studies. The present review provides a critical evaluation of the associations between maternal cardiovascular conditions during pregnancy and offspring CVD, the role of low birth weight, and the evidence for developmental programming of CVD by other maternal cardiovascular risk factors. It then proposes an integrated view of …

The Role of Cardiac MRI in Children’s Congenital and Acquired Heart Disease

: Cardiovascular magnetic resonance (CMR) is a valuable and accurate modality used in the evaluation of both structure and function of the heart. As a result of significant advances in MR technologies, it is increasingly considered to be a useful non-invasive modality which is instrumental in the management of cardiovascular conditions. Ongoing technological advancements in both data acquisition and data presentation have made integration of CMR into clinical practice possible. Evaluation of congenital heart disease is an important application of cardiac MRI as the morphological details of chambers, septum, defects, and anomalous connections are depicted accurately. Additionally, flow information across valves, chambers, outflow tracts, and shunts are also provided. The combination of exquisite 3D anatomy with physiological data enables CMR to provide a unique perspective for the management of many patients with congenital heart disease (CHD). Its utility is further increased after corrective surgery during the follow up period. Imaging small children with CHD is challenging, and in this manuscript, we will review the technical adjustments, imaging protocols, and application of CMR in the pediatric setting.

Fresh and Decayed Stem Juice of Musa acuminata x balbisiana (Musa paradisiaca) Reduce the Force and Rate of Contractility of an Isolated Perfused Rabbit Heart

Background: Decaying stem juice of Musa acuminata × balbisiana is commonly used by local communities and traditional herbalist in Central Uganda in the management of cardiovascular conditions like hypertension. Aims: The study investigated the ionotropic and chronotropic effect of fresh and decaying stem juice of Musa acuminata × balbisiana on the isolated perfused rabbit heart. Materials and Methods: Methods. Study Design: An experimental study. Place and Duration of Study: Study was done at the Dept of Pharmacology &amp; Therapeutics Pharmacology Lab between December 2012 to March 2013. Experimental Procedure: An experimental study determined the effects of fresh and decayed stem juices of Musa acuminate X balbisiana on the rate and force of contraction of an isolated rabbit heart using Langendorff’s heart perfusion experiment and methods. The heart rate (beats/minute) was determined. The force of contraction of the heart was determined by measuring the height of each peak on the kymogram. Results: The force and rate of contractility of an isolated perfused rabbit decreased with increasing doses of the stem juice from 0.156 mg/mL to 100mg/mL for both the fresh and decayed stem juice of M. acuminata. The decrease could be associated with the high [K+] ions that decrease the membrane potential or cause hyperpolarization the myocardial cell membranes leading to reduced force and rate of heart contractility. The effect of the fresh stem juice was short lived and at very high concentrations, it caused a cardiac arrest while the effect of the decayed stem juice was prolonged. Conclusion: Fresh and decayed stem juice of Musa acuminata × balbisiana have compounds that cause a negative ionotropic and chronotropic effect on an isolated perfused rabbit heart.

Patient Education Strategies for Hospitalized Cardiovascular Patients

Although mortality from cardiovascular (CV) disease has fallen in the past decade, the burden of CV disease and related conditions remains high, with rates of hospitalization and disability and cost on the rise. Prevention and treatment of CV conditions often involve a complex regimen of lifestyle modification, medications, and/or symptom monitoring and management. Cardiovascular health professionals spend a great deal of time promoting awareness of and adherence to national guidelines for the prevention and management of CV conditions. In addition, patient education for hospitalized patients is becoming increasingly regulated by national organizations and payors. However, it is unclear which educational intervention elements or strategies are most effective for educating hospitalized CV patients and their families. The purpose of this systematic review of experimental and quasi-experimental studies was to identify and examine the characteristics and outcomes of CV health education interventions for hospitalized CV patients.

The Role of cardiac MRI in congenital heart disease

AbstractCardiac MRI is a valuable and an accurate modality used in the evaluation of structure and function of the heart. It is increasingly considered as a useful non invasive examination in management of cardiovascular conditions, a situation resulting from significant advances in MR technologies. Evaluation of congenital heart disease is an important application of Cardiac MRI since the morphological details of chambers, septum, defects and anomalous connections are depicted accurately. Additionally, flow information across valves, chambers, outflow tracts and shunts are also provided. Its utility is further increased especially during follow up of patients after corrective surgery. This article reviews current state-of-the-art MRI application in common congenital heart diseases.

Cardiac ATP-sensitive K+ channels: regulation by intracellular nucleotides and K+ channel-opening drugs.

ATP-sensitive K+ (KATP) channels are present at high density in membranes of cardiac cells where they regulate cardiac function during cellular metabolic impairment. KATP channels have been implicated in the shortening of the action potential duration and the cellular loss of K+ that occurs during metabolic inhibition. KATP channels have been associated with the cardioprotective mechanism of ischemia-related preconditioning. Intracellular ATP (ATPi) is the main regulator of KATP channels. ATPi has two functions: 1) to close the channel (ligand function) and 2) in the presence of Mg2+, to maintain the activity of KATP channels (presumably through an enzymatic reaction). KATP channel activity is modulated by intracellular nucleoside diphosphates that antagonize the ATPi-induced inhibition of channel opening or induce KATP channels to open. How nucleotides will affect KATP channels depends on the state of the channel. K+ channel-opening drugs are pharmacological agents that enhance KATP channel activity through different mechanisms and have great potential in the management of cardiovascular conditions. KATP channel activity is also modulated by neurohormones. Adenosine, through the activation of a GTP-binding protein, antagonizes the ATPi-induced channel closure. Understanding the molecular mechanisms that underlie KATP channel regulation should prove essential to further define the function of KATP channels and to elucidate the pharmacological regulation of this channel protein. Since the molecular structure of the KATP channel has now become available, it is anticipated that major progress in the KATP channel field will be achieved.