Onset Of Cardiovascular Disease Research Articles

Integrative Bioinformatics Approaches to Uncover Hub Genes and Pathways Involved in Cardiovascular Diseases.

Cardiovascular diseases (CVD) represent a significant global health challenge resulting from a complex interplay of genetic, environmental, and lifestyle factors. However, the molecular pathways and genetic factors involved in the onset and progression of CVDs remain incompletely understood. Here, we performed an integrative bioinformatic analysis to highlight specific genes and signaling pathways implicated in the pathogenesis of 80 CVDs. Differentially expressed genes (DEGs) were identified through the integrated analysis of microarray and GWAS datasets. Then, hub genes were identified after gene ontology functional annotation analysis and protein-protein internet (PPI) analysis. In addition, pathways were identified through KEGG and gene ontology enrichment analyses. A total of 821 hub genes related to 80 CVDs were identified, including 135 common and frequent CVD-associated genes. TNF, IL6, VEGFA, and TGFB.1 genes were the central core genes expressed in 50% or more of CVDs, confirming that the inflammation is a key pathological feature of CVDs. Analysis of hub genes by KEGG enrichment revealed predominant enrichment in 201 KEGG pathways, of which the AGE-RAGE signaling pathway in diabetic complications was identified as the common key KEGG implicated in 62 CVDs. In addition, the outcomes showed an overrepresentation in pathways categorized under human diseases, particularly in the subcategories of infectious diseases and cancers, which may be common risk factors for CVDs. In conclusion, this powerful approach for in silico fine-mapping of genes and pathways allowed the identification of determinant hubs genes and pathways implicated in the pathogenesis of CVDs which could be employed in developing more targeted and effective interventions for preventing, diagnosing, and treating CVDs. The function of these hub genes in CVDs needs further exploration to elucidate their biological characteristics.

Evaluation of Changes in Social Isolation and Loneliness with Incident Cardiovascular Events and Mortality.

It remains unknown how the patterns of change of social isolation and loneliness are associated with the onset of cardiovascular disease (CVD) and mortality. We aimed to investigate the longitudinal association of changes in social isolation and loneliness with incident CVD, all-cause mortality, CVD mortality and subsequent cardiac function. This prospective cohort study included 18,258 participants aged 38-73 years who participated in visit 0 (2006-2010) and visit 1 (2012-2013) using UK Biobank (mean age 57.1, standard deviation [SD] 7.4; 48.7% males). Social isolation or loneliness was categorized into four patterns: never, transient, incident, and persistent. Incident CVD, all-cause and CVD mortality were ascertained through linkage data. Cardiac function was assessed by cardiovascular magnetic resonance imaging in a subsample (N = 5188; visit 2, since 2014). Over a median follow-up of 8.3 (interquartile range [IQR] 8.1-8.6) years, compared with never social isolation, persistent social isolation was associated with the higher risk of incident CVD (hazard ratio [HR] 1.17, 95% confidence interval [CI] 1.03-1.33), all-cause (1.42, 1.12-1.81) and CVD (1.53, 1.05-2.23) mortality. Likewise, persistent loneliness was strongly associated with the greater risk of incident CVD (1.13, 1.00-1.27), all-cause (1.28, 1.02-1.61) and CVD mortality (1.52, 1.06-2.18). Persistent social isolation and loneliness posed a substantially higher risk for incident CVD, all-cause and CVD mortality, and cardiac dysfunction than other patterns. Persistent social isolation and loneliness, along with an increasing cumulative score, are associated with lower cardiac function.

Improving Cardiovascular Disease Forecasting with Machine Learning and Electronic Medical Record Data Characteristics Within a Local Healthcare Network

The PCE Risk Calculator, developed by the ACC/AHA, is frequently utilized in the United States for the purpose of averting the onset of Atherosclerotic cardiovascular disease (ASCVD) via first-line defense strategies. However, this calculator may not accurately estimate risk for certain populations, potentially leading to either under- or over-estimation of risk. We have created calculator for ASCVD risk specific to a population by leveraging advanced Machine Learning (ML) techniques and Electronic Medical Record (EMR) data. Our study involved comparing predictive accuracy of our calculator with PCE calculator. Between January 1, 2009, and April 30, 2020, data was gathered from 101,110 distinct EMRs of patients who were actively receiving treatment. Patient datasets underwent machine learning techniques containing Longitudinal (LT) and Cross-Sectional (CS) features, or solely CS features, derived from laboratory values and vital statistics. The models' effectiveness was assessed using fresh price metric (Screened Cases Percentage @Sensitivity level). In terms of prediction accuracy, every ML model that was tested performed better than the PCE risk calculator. Area Under Curve (AUC) score of 0.902 was obtained by Random Forest (RF) ML technique when CS and LT characteristics were combined (RF-LTC). Our machine learning model only needed to screen 43% of patients in order to identify 90% of positive ASCVD cases, in contrast to the PCE risk calculator, which required screening 69% of patients. Prediction models created using ML techniques reduce the amount number of tests necessary to forecast ASCVD and increase the accuracy of ASCVD prediction when compared to using PCE calculator alone. The combination of LT and CS features in these ML models leads to a significant enhancement in comparing the ASCVD prediction to utilizing CS features exclusively.

A Noninvasive Arterial Stiffness Index to Estimate the Severity of Coronary Atherosclerosis in Patients Undergoing Coronary Angiography

The early diagnosis and appropriate treatment of subclinical atherosclerosis before the onset of life-threatening cardiovascular (CV) diseases are major unmet medical needs in current clinical practice. Noninvasive arterial stiffness indices, the arterial velocity–pulse index (AVI) and the arterial pressure–volume index (API) have been associated with CV risks, conventional arterial stiffness indices, and the severity of coronary atherosclerosis. However, few studies have examined the relationship between these indices and the occurrence of CV events. We measured the AVI and API in 113 consecutive patients admitted to Yokohama City University Hospital for cardiac catheterization between June 2015 and March 2016. Patients were followed until September 2022, and the occurrence of CV events was assessed. The mean age was 71.2 ± 10.7 years, and 83 patients (73.5%) were male. In total, 80 patients (70.8%) had hypertension, 87 (77.0%) had dyslipidemia, and 91 (80.5%) had a history of ischemic heart disease (IHD). The mean follow-up duration was 1752 ± 819 days. Patients who received elective percutaneous coronary intervention (PCI) based on the results of coronary angiography (CAG) at the time of enrollment had significantly higher API than those who did not (38.5 ± 12.6, n = 17 vs. 31.3 ± 7.4, n = 96, p = 0.001). The API was independently associated with the risk of elective PCI in multiple logistic regression analysis. In conclusion, the API could be a useful indicator for estimating the need for coronary interventional treatment in patients with a high CV risk.

Atopic dermatitis is associated with an increased risk of cardiovascular diseases: A large-scale, propensity-matched US-based retrospective study.

Atopic dermatitis is a chronic relapsing inflammatory skin disease characterized by intense itch impacting heavily on patients' and caregivers' quality of life. Its clinical presentation is accompanied by a variety of type 2 comorbidities, e.g. asthma, hay fever, food allergies. However, current data on cardiovascular comorbidities are inconsistent. To identify risk of cardiovascular diseases in patients with atopic dermatitis. Data from Electronic Health Records (EHRs) of 1,070,965 atopic dermatitis patients and equally propensity score matched controls were retrieved from the US Collaborative Network part of the federated TriNetX network. Hazard ratios for risk of onset of cardiovascular diseases with a prevalence of ≥1% in both cohorts within 20 years after diagnosis were determined. A total of 55 cardiovascular diseases belonging to 8 major cardiovascular groups were identified. Of those, 53 diagnoses displayed a significantly increased risk in atopic dermatitis patients. Different diagnoses of heart failure and heart disease were found most often, followed by valve insufficiencies, arrhythmia, tachycardia, atrial fibrillation, flutter, but also MACE and venous thromboembolism. The individual diagnoses venous insufficiency, atherosclerosis of native arteries of the extremities, and unspecified diastolic (congestive) heart failure displayed highest hazard ratios. Atopic dermatitis is associated with an increased risk for multiple cardiovascular diseases.

Local Activation of Angiotensin II Type 2 Receptors Improves Microvascular Endothelial Function in Healthy Women With a History Preeclampsia

Women who had preeclampsia (hxPE) have a >4-fold risk for developing cardiovascular disease (CVD) compared to women who had an uncomplicated pregnancy (hxHC). These women demonstrate attenuated vascular endothelium- and nitric oxide (NO)-dependent dilation, secondary to exaggerated angiotensin (ang) II-mediated constriction, following pregnancy but before the onset of CVD. Despite the known dysregulation of ang II-mediated responses postpartum, the role of vasodilatory ang II type 2 receptors (AT2R) in this dysfunction is unknown. We hypothesized that, compared to hxHC, hxPE would have reduced AT2R-mediated dilation and reduced AT2R expression in primary biopsied endothelial cells. We further hypothesized that endothelium- and NO-dependent dilation would be attenuated in hxPE, and that local AT2R activation would improve these responses in hxPE. Nine hxPE (34±7 years, 25±14 months postpartum) and 9 hxHC (35±3 years, 32±12 months postpartum) had 4 intradermal microdialysis fibers placed in the ventral forearm. Sites 1-2 received graded infusions of compound 21 (C21, AT2R agonist; 10−14-10−3mol/L) alone or with L-NAME (NO-synthase inhibitor; 15mM). Sites 3-4 received lactated Ringer’s (control) or 10−11M C21 and underwent a standard local heating (LH) protocol (42°C; 0.1°C·s−1) to assess endothelium-dependent dilation. After full expression of the LH response, 15mM L-NAME was perfused to assess NO-dependent dilation. Red cell flux was measured over each site with laser-Doppler flowmetry. Cutaneous vascular conductance was calculated (CVC=flux/mean arterial pressure) and normalized to maximum (%CVCmax; 28mM SNP+43°C). AT2R protein expression in biopsied venous endothelial cells (n=4/group) was quantified using immunofluorescence. AT2R-mediated dilation (31±8 vs. hxHC: 95±25%CVCmax, p=0.01) and the NO-dependent portion of this response (21±9 vs. hxHC: 64±23%, p=0.04) was reduced in hxPE. AT2R expression in biopsied endothelial cells was attenuated in hxPE (0.59±0.10 vs. hxHC: 0.79±0.07 arbitrary units; p=0.008). hxPE had attenuated endothelium- (79±7 vs. hxHC: 94±9%CVCmax, p<0.001) and NO-dependent dilation (55±11 vs. hxHC: 71±13%; p=0.01) responses to LH. Local AT2R activation augmented endothelium- (92±11%CVCmax vs. control; p=0.02) and NO-dependent (78±12% vs. control; p<0.001) dilation in hxPE but had no effect in hxHC (all p>0.05). These data suggest that reductions in AT2R-mediated dilation and expression contribute to attenuated endothelial function after preeclampsia. Furthermore, AT2R activation may improve endothelial function through NO-dependent mechanisms in women who have had preeclampsia before the onset of CVD. Internal Funds. This is the full abstract presented at the American Physiology Summit 2024 meeting and is only available in HTML format. There are no additional versions or additional content available for this abstract. Physiology was not involved in the peer review process.

Differential effects of cigarette smoking on cardiovascular disease in females: A narrative review and call to action

ObjectiveCigarette smoking continues to be a major driver in the incidence and progression of cardiovascular disease (CVD). As females become an increasingly larger fraction of those who smoke it is imperative that the sex-specific effects of smoking be further explored and acted upon. MethodsThis narrative review describes current evidence on the differential effects of smoking on CVD in females and the need to improve treatment. ResultsEvidence to date suggests that smoking has disproportionately negative effects on the cardiovascular (CV) system in females, especially in those who are younger. Usually, the onset of CVD is later in females than males, but smoking decreases or eliminates this gap. Females are also more likely to develop types of CVD closely tied to smoking, such as ST-elevated myocardial infarctions, with even higher rates among those who are younger. Possible mechanisms for these worse outcomes in females include a complex interplay between nicotine, other products of combusted cigarettes, and hormones. Sex differences also exist in treatment for smoking. In females, Varenicline appears more effective than either Bupropion or nicotine replacement therapy while in males, all three therapies show similar efficacy. Disparities in smoking are also apparent in secondary prevention settings. Females and males are entering secondary prevention with equal rates of smoking, with potentially higher levels of exposure to the byproducts of smoking in females. ConclusionsThese disproportionately negative outcomes for females who smoke require additional research and these persisting rates of smoking suggest a need for female-specific approaches for treating smoking.

Preoperative Counseling and Surgical Practice: Gynecologic Surgeons' Approach to Ovary-Sparing Hysterectomy [ID 2683432

INTRODUCTION: Since the early 20th century, surgical practices on prophylactic oophorectomy at the time of hysterectomy have fluctuated. This study aims to assess how current gynecologic surgeons are counseling patients on ovary-sparing benign hysterectomies and assess any gaps in provider knowledge. METHODS: Institutional review board exception was obtained. A survey was piloted and underwent several rounds of editing before being sent to members of American Association of Gynecologic Laparoscopists (AAGL) in April 2023. The questionnaire evaluated preoperative counseling on risks and benefits of ovary-sparing hysterectomy for benign indications and surgical practices for when to perform bilateral salpingectomy and oophorectomy. Descriptive statistics and regression analyses were performed. RESULTS: The survey was sent out by email to 6,622 AAGL members, 3,576 opened the email, and 520 completed surveys (14% response rate). Approximately one-half (58%) completed subspeciality training. Most counsel patients on the benefits of ovarian conservation including the prevention of osteoporosis (88%), early onset menopause (87%), cardiovascular disease (84%), and dementia (52%). Fifty percent recommend routine bilateral salpingo-oophorectomy at time of hysterectomy starting at age 61, whereas 38% recommend this be performed at age 51–55 years. CONCLUSION: Gynecologic surgeons are counseling patients on the risks and benefits of ovarian conservation. How frequently ovary-sparing hysterectomies are offered and the age at which bilateral salpingo-oophorectomy is recommended vary by provider. Additional high-quality studies are needed to further understand the optimal timing of oophorectomy at time of benign hysterectomy, and there is also a need for provider education to minimize discrepancy in practice patterns.

Age and Handgrip Strength Induce Differences in Micro- and Macro-Vascular Responses

Purpose: Handgrip (HG) strength is a potent predictor of cardiovascular disease (CVD) and all-cause mortality. Advances in technology have provided novel assessments of peripheral microvascular and macrovascular health and function. These advances include measurements of skeletal muscle tissue oxygenation (StO2, %) with near-infrared spectroscopy (NIRS) during vascular occlusion tests (VOT) as well as carotid-femoral pulse-wave velocity (cfPWV), which is the current gold-standard to measure aortic stiffness. Although NIRS-VOT and cfPWV have been shown to change across the lifespan, it is unknown if these variables are sensitive to group differences as defined by HG strength. Therefore, our purpose was to examine mean differences in NIRS-VOT parameters and cfPWV between groups of low and high HG strength. We hypothesized that individuals with lower HG strength would exhibit lower vascular function. Methods: 67 adults were separated into age groups: young (19 – 40 yr), midlife (41 – 64 yr), and older (≥65 yr). Groups were divided into low and high strength at the median for HG strength, and quasi-balanced based on biological sex. This resulted in six participant groups (e.g., midlife low strength). The VOT included 3 min of rest, 5 min of ischemia, and 3 min of reperfusion to determine indices of reactive hyperemia. Indices included the initial (i.e., first 10 s) rate of re-saturation (upslope) and the maximal StO2 (StO2max) percent following ischemia. Aortic stiffness was defined as cfPWV using the time difference between the appearance of the carotid and femoral pulses. Separate 2×3 between factor (HG by Age Group) ANOVAs were conducted for each outcome. A p≤0.05 was considered significant, and data were presented as mean ± SD. Results: For upslope, there was a significant interaction (p=0.042, ηp2=0.078), and follow-up analyses revealed for young and midlife adults the high HG group exhibited greater upslopes than the low strength group (young: 2.24±0.9 vs. 1.64±0.7 and midlife: 2.21±0.9 vs. 1.59±0.7%∙s−1). There was no significant interaction (p=0.360) for StO2max, but there was a significant main effect (p<0.001) of Age such that it progressively decreased across the lifespan (83.9 ± 2.0 > 80.7 ± 2.3 > 77.3 ± 2.8%). Similarly, cfPWV exhibited a significant main effect (p<0.001; ηp2 =0.429) of Age indicating aortic stiffness worsened with age, independent of HG strength. Conclusions: These results indicated that upslope was sensitive to group differences in HG strength, but only in the young and midlife age groups. For StO2max and cfPWV, age differences appeared to elicit a stronger effect than HG strength. The current findings suggested that HG strength may be most reflective of a specific portion of the vascular tree, while the initial rate of re-saturation and StO2max may be influenced by different mechanisms associated with reactive hyperemia. Notably, the participants in this study were relatively healthy based on being free of any chronic disease. Future work is necessary to determine the predictive power of NIRS-VOT parameters for future onset of CVD. We would like to thank the American Physiology Society for support and the University of South Alabama for allowing us to use its facilities. We would also like to thank all of the participants who agreed to adhere to the protocol and procedures of this study. This is the full abstract presented at the American Physiology Summit 2024 meeting and is only available in HTML format. There are no additional versions or additional content available for this abstract. Physiology was not involved in the peer review process.

Progress in extracellular vesicle homeostasis as it relates to cardiovascular diseases.

Extracellular vesicles (EVs) are involved in both physiological and pathological processes in many organ systems and are essential in mediating intercellular communication and maintaining organismal homeostasis. It is helpful to propose new strategies for disease treatment by elucidating the mechanisms of EV release and sorting. An increasing number of studies have shown that there is specific homeostasis in EVs, which is helpful for the human body to carry out physiological activities. In contrast, an EV homeostasis im-balance promotes or accelerates disease onset and development. Alternatively, regulating the quality of EVs can maintain homeostasis and even achieve the purpose of treating conditions. An analysis of the role of EV homeostasis in the onset and development of cardiovascular disease is presented in this review. This article also summarizes the methods that regulate EV homeostasis and their application in cardiovascular diseases. In particular, this study focuses on the connection between EV steady states and the cardiovascular system and the potential value of EVs in treating cardiovascular diseases.

Prediction of various insulin resistance indices for the risk of hypertension among military young adults: the CHIEF cohort study, 2014–2020

BackgroundNon-insulin-based insulin resistance (NI-IR) indices have been reported to have an association with prevalent hypertension, however, no cohort studies to date have compared their prediction of hypertension among young adults.MethodsA total of 2,448 military men and women, aged 18–39 years, without baseline hypertension in Taiwan were followed for incident hypertension events from 2014 until the end of 2020. All subjects underwent annual health examinations including measurements of blood pressure (BP) in mmHg. Systolic BP (SBP) 130–139/diastolic BP (DBP) < 80, SBP < 130/DBP 80–89, and SBP 130–139/DBP 80–89 were respectively defined as stage I isolated systolic hypertension (ISH), isolated diastolic hypertension (IDH) and combined hypertension (CH). The cut-off levels of stage II hypertension for SBP and DBP were 140–159 and 90–99, respectively. Four NI-IR indices included the ratio of serum triglycerides (TG) to high-density lipoprotein cholesterol (HDL-C), TyG index defined as ln[TG* fasting glucose (FG)/2], Metabolic Score for IR (METS-IR) defined as ln[(2* FG) + TG)* body mass index (BMI)/(ln(HDL-C))], and ZJU index defined as BMI + FG + TG + 3* alanine transaminase/aspartate transaminase (+ 2 if female). Multivariable Cox regression analysis was performed with adjustments for baseline age, sex, body mass index, BP, substance use, family history for early onset cardiovascular diseases or hypertension, low-density lipoprotein cholesterol, kidney function, serum uric acid and physical activity to determine the associations.ResultsDuring a median follow-up of 6.0 years, there were 920 hypertension events (37.6%). Greater TyG, TG/HDL-C and METS-IR indices were associated with a higher risk of stage I IDH (hazard ratios (HRs) and 95% confidence intervals: 1.376 (1.123–1.687), 1.082 (1.039–1.127) and 3.455 (1.921–6.214), respectively), whereas only greater ZJU index was associated with a higher risk of stage II IDH [HRs: 1.011 (1.001–1.021)]. In addition, greater ZJU index was associated with a higher risk of stage II ISH [HR: 1.013 (1.003–1.023)], and greater TyG index was associated with a higher risk of stage II CH [HR: 2.821 (1.244–6.395)].ConclusionInsulin resistance assessed by various NI-IR indices was associated with a higher risk of hypertension in young adults, while the assessment ability for specific hypertension category may differ by NI-IR indices.

Peculiarities of adaptation of the cardiovascular system of combatants after exposure to combat stress and trauma

Abstract. Military operations are generally considered to be a pronounced psycho-traumatic situation due to specific factors that lead to persistent mental and somatic health disorders and a slowdown in the rate of further social adaptation of military personnel.&#x0D; Post-traumatic stress disorder (PTSD) is described as a set of complex somatic, cognitive, affective, and behavioral effects of psychological trauma.&#x0D; One of the essential features of combatants' PTSD is that after the end of the period of stay in the conditions of hostilities, a high incidence of chronic somatic diseases is manifested. There is a correlation in the neurotic symptoms (in all cases) of deterioration of the somatic condition, and exacerbation of somatic pathology aggravates mental disorders.&#x0D; The problem of morbidity and mortality from circulatory system diseases, blood poisoning and injuries is of particular relevance to combatants, as the onset of cardiovascular disease is closely related to the traumatic impact of wartime or PTSD. Particular attention to the medical and psychological consequences of the effects of extreme factors associated with combat on the body of military personnel is associated with both the prevalence of PTSD, which reaches 70-85%, and the duration of its symptoms.

Sex-associated differences in cardiac ageing: Clinical aspects and molecular mechanisms.

Despite the extensive clinical and scientific advances in prevention, diagnostics and treatment, cardiovascular diseases (CVD) remain the leading cause of morbidity and mortality worldwide for people aged 65 and over. Of all ageing-related diseases, CVD are responsible for almost one-third of deaths in the elderly, being above all cancers combined. Age is an independent and unavoidable risk factor contributing to the impairment of heart and blood vessels. As the average age of the population in industrialized countries has doubled in the last century, and almost a fifth of the world's population is predicted to be over 65 in the next decade, we can assume that the burden of CVD will fall primarily on the elderly. Evidence from basic and clinical science has shown that sex significantly influences the onset and severity of CVD. In women, CVD usually develop later than in men and with atypical symptomatology. After menopause, however, the incidence and severity of CVD increase in women, reaching equality in both sexes. Although intrinsic sexual dimorphism in cardiovascular ageing may contribute to the sex differences in CVD progression, the molecular mechanisms associated with cardiovascular ageing and their clinical value are not known in detail. In this review, we discuss the scientific knowledge available, focusing on structural, hormonal, genetic/epigenetic and inflammatory pathways, seeking to transfer these findings to the cardiovascular clinic in terms of prevention, diagnosis, prognosis and management of these pathologies and proposing possible validation of target specifics.

Depression Onset After a Spouse’s Cardiovascular Event

Although cardiovascular disease (CVD) is a known risk factor for depression, evidence is lacking regarding whether and to what extent a spouse's CVD is associated with the subsequent mental health of individuals. To examine the association between CVD onset in spouses and subsequent depression. This cohort study examined 277 142 matched married couples enrolled in the Japan Health Insurance Association health insurance program between April 2015 and March 2022, covering approximately 40% of the working-age population in Japan. Index individuals (primary insured) whose spouses (dependent) experienced incident CVD between April 2016 and March 2022 were 1:1 matched to controls whose spouses did not experience CVD. Matching was based on age, sex, income, or the onset date of the spouses' CVD. Data analysis was conducted from April 2016 to March 2022. Spousal onset of CVD between fiscal years 2016 and 2021. The International Statistical Classification of Diseases and Related Health Problems, Tenth Revision codes were used to identify the composite CVD outcomes (stroke, heart failure, and myocardial infarction). Multivariate Cox proportional hazards models were used to investigate the association between spouses' new-onset CVD and individuals' depression, adjusting for sociodemographic characteristics and comorbidities of index individuals (diabetes, hypertension, and CVD) and spouses (diabetes, hypertension, and depression). Subgroup analyses were conducted according to sex, age, income levels, and history of CVD. Among 277 142 matched pairs of married couples, 263 610 (95.1%) had a male index individual; the mean (SD) age of index individuals was 58.2 (10.2) years. A new onset of depression was observed in 4876 individuals (1.8%). In multivariable Cox models, there was an association between the spouse's CVD and the individuals' depression (hazard ratio, 1.13 [95% CI, 1.07-1.20]). The subgroup analysis found no evidence of heterogeneity in sex, age, income level, or CVD history. The results were consistent when additionally adjusted for health behaviors (smoking, alcohol consumption, physical activity, and use of antihypertensive drugs) and objectively measured physical health conditions (body mass index, blood pressure, cholesterol levels, glucose levels, and estimated glomerular filtration rate) (hazard ratio, 1.16 [95% CI, 1.06-1.28]). In this nationwide cohort study of matched couples, a spouse's onset of CVD was associated with an increased risk of an individual's depression. These findings highlight the importance of preventive care for mental health disorders in individuals whose spouses experience incident CVD.

A review of air pollution as a driver of cardiovascular disease risk across the diabetes spectrum.

The prevalence of diabetes is estimated to reach almost 630 million cases worldwide by the year 2045; of current and projected cases, over 90% are type 2 diabetes. Air pollution exposure has been implicated in the onset and progression of diabetes. Increased exposure to fine particulate matter air pollution (PM2.5) is associated with increases in blood glucose and glycated hemoglobin (HbA1c) across the glycemic spectrum, including normoglycemia, prediabetes, and all forms of diabetes. Air pollution exposure is a driver of cardiovascular disease onset and exacerbation and can increase cardiovascular risk among those with diabetes. In this review, we summarize the literature describing the relationships between air pollution exposure, diabetes and cardiovascular disease, highlighting how airborne pollutants can disrupt glucose homeostasis. We discuss how air pollution and diabetes, via shared mechanisms leading to endothelial dysfunction, drive increased cardiovascular disease risk. We identify portable air cleaners as potentially useful tools to prevent adverse cardiovascular outcomes due to air pollution exposure across the diabetes spectrum, while emphasizing the need for further study in this particular population. Given the enormity of the health and financial impacts of air pollution exposure on patients with diabetes, a greater understanding of the interventions to reduce cardiovascular risk in this population is needed.

The Metabolism of Coenzyme A and Its Derivatives Plays a Crucial Role in Diseases.

Coenzyme A (CoA) functions as a crucial carrier of acyl groups within cells, playing a fundamental role in regulating acyl transfer reactions and participating in cellular metabolic processes. As the principal substrate and cofactor engaged in diverse metabolic reactions, CoA and its derivatives exert central influence over various physiological processes, primarily modulating lipid and ketone metabolism, as well as protein modification. This paper presents a comprehensive review of the molecular mechanisms by which CoA influences the onset and progression of cancer, cardiovascular disease (CVD), neurodegenerative disorders, and other illnesses. The main focal points include the following. (1) In cancer, enzymes such as acetyl-CoA synthetase 2, ATP citrate lyase, and acetyl-CoA carboxylase regulate lipid synthesis and energy metabolism by modulating acetyl-CoA levels. (2) In CVD, the effects of enzymes such as stearoyl-CoA desaturase-1, 3-hydroxy-3-methylglutaryl-CoA (HMGC) synthase 2, and HMGC reductase on the formation and advancement of these diseases are elucidated by their regulation of CoA metabolism across multiple organs. (3) In neurodegenerative disorders, the significance of CoA in maintaining cholesterol homeostasis in the brain and its implications on the development of such disorders are thoroughly discussed. The metabolic processes involving CoA and its derivatives span all physiological aspects within cells, playing a critical role in the onset and progression of various diseases. Elucidating the role of CoA in these conditions yields important insights that can serve as valuable references and guidance for disease diagnosis, treatment, and drug development.

Extreme temperatures and morbidity in old age in Europe

Understanding the relationship between extreme temperatures and health among older adults is of paramount importance for public health in ageing societies. This study aims to enhance our understanding of the impact of extreme temperatures on morbidity, i.e. the risk of being hospitalised, using medications for heart conditions, and experiencing the onset of cardiovascular diseases (CVDs) among older adults in Europe (65+ years old) using five waves from the Survey of Health, Ageing and Retirement in Europe (SHARE, 2004–2015). It also explores heterogeneity in this impact depending on an array of factors that affect exposure and vulnerability to climate, including geographical location, gender, age, educational level, having a partner/child and living in an urban or a rural area. Results from individual fixed-effects models show that extremely cold temperatures increase the risk of being hospitalised and suffering from CVDs, while heat exposure has no noteworthy effect. Broken down by geographical location, the results indicate that one additional extremely cold day influences the risk of hospitalisation in the coldest and the warmest European regions, while extreme heat influences this risk in the warmest European regions. Finally, the oldest old and low educated individuals appear to be the most vulnerable social groups. The study concludes by discussing the advantages and the limitations of using survey data to study climate and health, and the strategies suggested by the relevant literature to prevent temperature-related illness.

TYG Index as a Novel Predictor of Clinical Outcomes in Advanced Chronic Heart Failure with Renal Dysfunction Patients.

The triglyceride-glucose (TYG) index is a novel and reliable marker reflecting insulin resistance. Its predictive ability for cardiovascular disease onset and prognosis has been confirmed. However, for advanced chronic heart failure (acHF) patients, the prognostic value of TYG is challenged due to the often accompanying renal dysfunction (RD). Therefore, this study focuses on patients with aHF accompanied by RD to investigate the predictive value of the TYG index for their prognosis. 717 acHF with RD patients were included. The acHF diagnosis was based on the 2021 ESC criteria for acHF. RD was defined as the eGFR < 90 mL/(min/1.73 m2). Patients were divided into two groups based on their TYG index values. The primary endpoint was major adverse cardiovascular events (MACEs), and the secondary endpoints is all-cause mortality (ACM). The follow-up duration was 21.58 (17.98-25.39) months. The optimal cutoff values for predicting MACEs and ACM were determined using ROC curves. Hazard factors for MACEs and ACM were revealed through univariate and multivariate COX regression analyses. According to the univariate COX regression analysis, high TyG index was identified as a risk factor for MACEs (hazard ratio = 5.198; 95% confidence interval [CI], 3.702-7.298; P < 0.001) and ACM (hazard ratio = 4.461; 95% CI, 2.962-6.718; P < 0.001). The multivariate COX regression analysis showed that patients in the high TyG group experienced 440.2% MACEs risk increase (95% CI, 3.771-7.739; P < 0.001) and 406.2% ACM risk increase (95% CI, 3.268-7.839; P < 0.001). Kaplan-Meier survival analysis revealed that patients with high TyG index levels had an elevated risk of experiencing MACEs and ACM within 30 months. This study found that patients with high TYG index had an increased risk of MACEs and ACM, and the TYG index can serve as an independent predictor for prognosis.

The impact of COVID-19 on cardiovasuar system

Background. Recent scientific reports have shown that there is a correlation between Covid 19 infection and cardiovascular function. This virus can exacerbate existing cardiovascular diseases and also cause the onset of new cardiovascular diseases. The purpose of this review is to present the effects of SARS-COV-2 virus infection on the cardiovascular system. Review methods. The literature review was conducted using the PubMed search engine. Brief description of the state of knowledge. Individuals with cardiovascular disease who have contracted the virus are at higher risk for serious clinical complications such as myocarditis, heart failure and pulmonary embolism, leading to higher mortality rates in this group of patients. The pathophysiological mechanisms underlying the effects of COVID-19 on the cardiovascular system are still poorly understood. However, the results of this review suggest that it may cause direct myocardial damage, as well as contribute to the development of cytokine storm effect and right ventricular burden due to pulmonary embolism. Conclusions. COVID 19 pandemic and cardiovascular disease are currently a great challenge for modern medicine. The fact that the two disease entities interact makes it crucial to further explore the relationship between these diseases. This review underscores the need for continued research into the effects of COVID-19 on the cardiovascular system, as well as the importance of early detection and treatment of cardiovascular complications in infected patients.

The impact of COVID-19 on cardiovasuar system

Background. Recent scientific reports have shown that there is a correlation between Covid 19 infection and cardiovascular function. This virus can exacerbate existing cardiovascular diseases and also cause the onset of new cardiovascular diseases. The purpose of this review is to present the effects of SARS-COV-2 virus infection on the cardiovascular system. Review methods. The literature review was conducted using the PubMed search engine. Brief description of the state of knowledge. Individuals with cardiovascular disease who have contracted the virus are at higher risk for serious clinical complications such as myocarditis, heart failure and pulmonary embolism, leading to higher mortality rates in this group of patients. The pathophysiological mechanisms underlying the effects of COVID-19 on the cardiovascular system are still poorly understood. However, the results of this review suggest that it may cause direct myocardial damage, as well as contribute to the development of cytokine storm effect and right ventricular burden due to pulmonary embolism. Conclusions. COVID 19 pandemic and cardiovascular disease are currently a great challenge for modern medicine. The fact that the two disease entities interact makes it crucial to further explore the relationship between these diseases. This review underscores the need for continued research into the effects of COVID-19 on the cardiovascular system, as well as the importance of early detection and treatment of cardiovascular complications in infected patients.