Journal of Cardiovascular Development and Disease

9 pages, 453 KiB

Open AccessArticle

Hypertension-Mediated Organ Damage in Relation to Severity of Chronic Low Back Pain in Hypertensive Patients

by Maciej Skrzypek, Rafał Kolec, Michał Słaboszewski, Katarzyna Góra, Agnieszka Olszanecka, Piotr Wróbel, Katarzyna Stolarz-Skrzypek and Marek W. Rajzer

J. Cardiovasc. Dev. Dis. 2024, 11(9), 266; https://doi.org/10.3390/jcdd11090266 (registering DOI) - 28 Aug 2024

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Abstract

Introduction: Chronic pain triggers a stress response, which results in increased blood pressure (BP). We investigated whether chronic low back pain (cLBP) in hypertensive patients is associated with an increased risk of hypertension-related organ damage. Methods: We studied 85 consecutive hypertensive patients with [...] Read more.

Introduction: Chronic pain triggers a stress response, which results in increased blood pressure (BP). We investigated whether chronic low back pain (cLBP) in hypertensive patients is associated with an increased risk of hypertension-related organ damage. Methods: We studied 85 consecutive hypertensive patients with a median age of 62 years (55–67), who suffered from cLBP, the severity of which was evaluated according to the Oswestry Disability Index (ODI). Patients underwent transthoracic echocardiography, arterial ultrasonography and vascular tonometry. We assessed carotid artery atherosclerotic plaques, along with carotid-femoral pulse wave velocity (cf-PWV) and left ventricular mass index (LVMI). Results: An equal to or higher than median (16 points) ODI score in 48 subjects (56.5%) was associated with the presence of carotid artery plaques (p = 0.014). In multivariate analysis, after adjusting for covariates, the presence of carotid artery plaques remained independently associated with an ODI score equal to or higher than the median (OR, 3.71; 95% CI, 1.04–13.25; p = 0.044). None of the other analyzed parameters of hypertension-related organ damage demonstrated a significant relationship with the ODI score. Conclusions: We observed that more severe cLBP is associated with a higher prevalence of carotid artery atherosclerotic plaques among hypertensive patients. Full article

(This article belongs to the Special Issue Clinical Burden of Comorbidities on Cardiovascular System and Beyond)

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10 pages, 271 KiB

Open AccessArticle

Characteristics, Treatment, and Prognosis of Heart Failure Patients with Chronic Obstructive Pulmonary Disease in the Colombian Heart Failure Registry (RECOLFACA)

by Jorge Alberto Sandoval-Luna, Alex Rivera-Toquica, Clara Saldarriaga, Erika Martínez-Carreño, Alexis Llamas, Gustavo Adolfo Moreno-Silgado, Julián Vanegas-Eljach, Nelson Eduardo Murillo-Benítez, Ricardo Gómez-Palau, Carlos Andrés Arias-Barrera, Fernán Mendoza-Beltrán, Diego Hernán Hoyos-Ballesteros, Carlos Andrés Plata-Mosquera, Luis Eduardo Echeverría and Juan Esteban Gómez-Mesa

J. Cardiovasc. Dev. Dis. 2024, 11(9), 265; https://doi.org/10.3390/jcdd11090265 (registering DOI) - 28 Aug 2024

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Abstract

The impact of chronic obstructive pulmonary disease (COPD) on heart failure (HF) has yet to be well assessed in the Latin American population. This study aimed to analyze the impact of COPD on HF patients from the Colombian Heart Failure Registry (RECOLFACA). The [...] Read more.

The impact of chronic obstructive pulmonary disease (COPD) on heart failure (HF) has yet to be well assessed in the Latin American population. This study aimed to analyze the impact of COPD on HF patients from the Colombian Heart Failure Registry (RECOLFACA). The primary outcome was all-cause mortality. A Cox proportional-hazards regression model was used to assess the impact of COPD on mortality. From the total of 2528 patients in the registry, 2514 patients had information regarding COPD diagnosis. COPD diagnosis was associated with a worse functional class and higher use of diuretics than non-COPD patients (p < 0.001). Patients with this comorbidity had a significantly better ejection fraction (median ejection fraction 35% vs. 32% in non-COPD patients; p = 0.004), with a higher occurrence of HF with preserved ejection fraction (HFpEF) in the COPD group (p = 0.000). Finally, patients with COPD had a significantly higher risk of mortality in the multivariate regression model (HR 1.47; 95% CI 1.02, 2.11). COPD is a prevalent comorbidity among patients with HF in Colombia, showing a different clinical profile and a worse functional class than patients without this condition. Patients with COPD and HFpEF have a high mortality risk according to our results. Full article

(This article belongs to the Section Cardiovascular Clinical Research)

10 pages, 1056 KiB

Open AccessArticle

Exploring Sex Differences in Pain Manifestation of Coronary Artery Disease through Mendelian Randomization

by Ruben Methorst, Monique R. M. Jongbloed, Raymond Noordam and Marco C. DeRuiter

J. Cardiovasc. Dev. Dis. 2024, 11(9), 264; https://doi.org/10.3390/jcdd11090264 (registering DOI) - 27 Aug 2024

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Abstract

Pain manifestation following coronary artery disease (CAD) disease differs between men and women. Here, we aimed to provide evidence favoring possible differences in pain manifestation between men and women following CAD using Mendelian randomization (MR). We used summary-level data from sex-stratified genome-wide association [...] Read more.

Pain manifestation following coronary artery disease (CAD) disease differs between men and women. Here, we aimed to provide evidence favoring possible differences in pain manifestation between men and women following CAD using Mendelian randomization (MR). We used summary-level data from sex-stratified genome-wide association studies on CAD and self-reported and clinically diagnosed chest, neck and shoulder, back, and facial pain using data from the UK Biobank cohort (N > 450,000) followed by two-sample MR (sensitivity) analyses. We identified 32 and 19 independent genetic variants associated with CAD for men and women, respectively, as instrumental variables. Genetically influenced CAD was associated with a higher risk of self-reported chest pain in both men (OR: 1.27, CI: 1.2–1.33) and women (OR: 1.44, CI: 1.20–1.73), with similar results for clinically diagnosed chest pain (men OR: 1.22, CI: 1.17–1.26; women OR: 1.31, CI: 1.18–1.46). In addition, in women only, genetically influenced CAD was associated with a higher risk of back pain (OR: 1.35, CI: 1.03–1.66) and neck and shoulder pain (OR: 1.22, CI: 0.91–1.63) (p-values for interaction with men: 0.030 and 0.041, respectively). Sensitivity analysis did not indicate the results were biased by directional pleiotropy. We found evidence, based on genetic predisposition for CAD, for different pain manifestations of CAD in men and women. While CAD was associated with chest pain in both sexes, we only found evidence for a higher risk of back pain and neck and shoulder pain in women, supporting common notions that women may present more often with uncharacteristic anginal symptoms. Full article

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26 pages, 1472 KiB

Open AccessReview

Cancer and Heart Failure: Dangerous Liaisons

by Davide Bertolini, Carmine Pizzi, Erwan Donal and Elena Galli

J. Cardiovasc. Dev. Dis. 2024, 11(9), 263; https://doi.org/10.3390/jcdd11090263 - 27 Aug 2024

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Abstract

Cancer and heart failure (HF) are increasingly relevant worldwide, both from an epidemiologic and clinical point of view. This review aims to explore the relationship between cancer and HF by underscoring risk factors and disclosing the cardiotoxic effects of the current chemotherapy agents. [...] Read more.

Cancer and heart failure (HF) are increasingly relevant worldwide, both from an epidemiologic and clinical point of view. This review aims to explore the relationship between cancer and HF by underscoring risk factors and disclosing the cardiotoxic effects of the current chemotherapy agents. We also deal with the current evidence on the diagnosis and management of HF related to cancer therapy. Finally, we will address the main gaps in knowledge and future perspectives in this field. Full article

(This article belongs to the Special Issue Prevention and Management of Heart Failure)

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11 pages, 2407 KiB

Open AccessArticle

Apical Sparing in Routine Echocardiography: Occurrence and Clinical Significance

by Marina Leitman and Vladimir Tyomkin

J. Cardiovasc. Dev. Dis. 2024, 11(9), 262; https://doi.org/10.3390/jcdd11090262 - 27 Aug 2024

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Abstract

Apical sparing is an echocardiographic pattern where myocardial strain is preserved at the apex compared to the basal segments. In a normal heart, longitudinal strain shows a gradient with lower values at the base and higher at the apex. This gradient becomes more [...] Read more.

Apical sparing is an echocardiographic pattern where myocardial strain is preserved at the apex compared to the basal segments. In a normal heart, longitudinal strain shows a gradient with lower values at the base and higher at the apex. This gradient becomes more pronounced in pathological states, such as cardiac amyloidosis, resulting in a relative apical sparing effect. This study explores cardiac conditions associated with apical sparing and the underlying mechanisms. We reviewed echocardiography examinations reporting apical sparing from 2021 to 2024 in our hospital database. Relevant echo exams and clinical data were retrieved and analyzed. Apical sparing was identified in 74 patients. Cardiac amyloidosis was diagnosed in 12 patients (16.2%). Other cardiac pathologies potentially contributing to apical sparing included hypertrophic cardiomyopathy, left ventricular hypertrophy due to hypertension, end-stage renal disease, coronary artery disease (involving the right coronary artery and left circumflex), reversed Takotsubo syndrome, and chemotherapy-induced cardiomyopathy. The clinical context of echocardiography was crucial in guiding the diagnostic work-up. Apical sparing is a nonspecific echocardiographic finding associated with various cardiac conditions. Its diagnostic value depends heavily on the clinical context. Understanding the broader clinical picture is essential for accurate interpretation and diagnosis. Full article

(This article belongs to the Special Issue The Role of Echocardiography in Cardiovascular Diseases)

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12 pages, 2155 KiB

Open AccessArticle

Prognostic Value of Estimated Glucose Disposal Rate and Systemic Immune-Inflammation Index in Non-Diabetic Patients Undergoing PCI for Chronic Total Occlusion

by Wenjie Chen, Yiming Liu, Yuchen Shi and Jinghua Liu

J. Cardiovasc. Dev. Dis. 2024, 11(9), 261; https://doi.org/10.3390/jcdd11090261 - 26 Aug 2024

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Abstract

Background and Objectives: Chronic total occlusion (CTO) is a complex lesion of coronary artery disease (CAD) with a detection rate of approximately 25% on coronary angiography. CTO patients generally experience poor quality of life and prognosis. This study aims to evaluate the association [...] Read more.

Background and Objectives: Chronic total occlusion (CTO) is a complex lesion of coronary artery disease (CAD) with a detection rate of approximately 25% on coronary angiography. CTO patients generally experience poor quality of life and prognosis. This study aims to evaluate the association between the estimated glucose disposal rate (eGDR), a surrogate marker for insulin resistance (IR), and the prognosis of CTO PCI patients, as well as to investigate the potential role of the systemic immune-inflammation index (SII) in this process. Methods: We retrospectively included 1482 non-diabetic patients who underwent successful CTO PCI at Anzhen Hospital between January 2018 and December 2021. The primary endpoint was major adverse cardiovascular events (MACEs). Clinical characteristics, biochemical markers, and interventional records were collected, and the eGDR and SII were calculated. Cox regression, restricted cubic splines (RCSs), receiver operating characteristic (ROC) analysis, and Kaplan–Meier curves were used to assess associations. Results: MACEs occurred in 158 patients (10.67%). Patients with MACEs had lower eGDR and higher SII levels. A high eGDR significantly reduced MACE risk (Q4 vs. Q1: HR 0.06, 95% CI 0.03–0.12), while a high SII increased it (Q4 vs. Q1: HR 3.32, 95% CI 1.78–6.33). The combination of low eGDRs and high SIIs predicted the highest MACE risk (HR 4.36, 95% CI 2.71–6.01). The SII partially mediated the relationship between eGDR and MACEs. Conclusions: A low eGDR and high SII are significant predictors of poor prognosis in non-diabetic CTO PCI patients. Combining the eGDR and the SII provides a comprehensive assessment for better predicting cardiovascular outcomes. Full article

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15 pages, 1078 KiB

Open AccessReview

Spinal Cord Stimulation for Intractable Chronic Limb Ischemia: A Narrative Review

by Roberto Gazzeri, Tommaso Castrucci, Matteo Luigi Giuseppe Leoni, Marco Mercieri and Felice Occhigrossi

J. Cardiovasc. Dev. Dis. 2024, 11(9), 260; https://doi.org/10.3390/jcdd11090260 - 26 Aug 2024

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Abstract

Critical limb ischemia (CLI) is the most severe form of peripheral arterial disease, significantly impacting quality of life, morbidity and mortality. Common complications include severe limb pain, walking difficulties, ulcerations and limb amputations. For cases of CLI where surgical or endovascular reconstruction is [...] Read more.

Critical limb ischemia (CLI) is the most severe form of peripheral arterial disease, significantly impacting quality of life, morbidity and mortality. Common complications include severe limb pain, walking difficulties, ulcerations and limb amputations. For cases of CLI where surgical or endovascular reconstruction is not possible or fails, spinal cord stimulation (SCS) may be a treatment option. Currently, SCS is primarily prescribed as a symptomatic treatment for painful symptoms. It is used to treat intractable pain arising from various disorders, such as neuropathic pain secondary to persistent spinal pain syndrome (PSPS) and painful diabetic neuropathy. Data regarding the effect of SCS in treating CLI are varied, with the mechanism of action of vasodilatation in the peripheral microcirculatory system not yet fully understood. This review focuses on the surgical technique, new modalities of SCS, the mechanisms of action of SCS in vascular diseases and the parameters for selecting CLI patients, along with the clinical outcomes and complications. SCS is a safe and effective surgical option in selected patients with CLI, where surgical or endovascular revascularization is not feasible. Full article

(This article belongs to the Special Issue Peripheral Artery Disease (PAD): Risk Factors, Diagnosis and Treatment)

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9 pages, 3362 KiB

Open AccessBrief Report

The Role of Cardiac Magnetic Resonance in mRNA COVID-19 Vaccine-Related Myopericarditis: An Evolutive Case Series

by Gisela Feltes, Violeta Sánchez Sánchez, Esther Pérez-David, José Luis Moreno-Hurtrez, Juan Delgado Jiménez and Iván J. Núñez-Gil

J. Cardiovasc. Dev. Dis. 2024, 11(9), 259; https://doi.org/10.3390/jcdd11090259 - 25 Aug 2024

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Abstract

Numerous cases of myocarditis related to mRNA vaccines for COVID-19 have recently been described, usually in young men. Long-term evolutive cardiac magnetic resonance imaging (CMR) data are lacking. We describe four consecutive cases of COVID-19 vaccine-induced myocarditis. The pathological findings of cardiac magnetic [...] Read more.

Numerous cases of myocarditis related to mRNA vaccines for COVID-19 have recently been described, usually in young men. Long-term evolutive cardiac magnetic resonance imaging (CMR) data are lacking. We describe four consecutive cases of COVID-19 vaccine-induced myocarditis. The pathological findings of cardiac magnetic resonance confirmed the diagnosis in the acute phase, showing edema, as well as pericardial enhancement, with light pericardial effusion and late gadolinium enhancement (LGE), predominantly in the inferolateral wall. These cases highlight the unique value of cardiac magnetic resonance in patients with suspected myocarditis induced by COVID-19 RNAm vaccines as a tool to confirm the diagnosis, avoiding other invasive techniques, as well as for the long-term follow-up of patients. Our iterative CMR imaging demonstrated frequent long-term LGE persistence. Full article

(This article belongs to the Special Issue Current Practice in Cardiac Imaging)

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12 pages, 694 KiB

Open AccessArticle

A Multi-Biomarker Approach to Increase the Accuracy of Diagnosis and Management of Coronary Artery Disease

by Lenka Hostačná, Jana Mašlanková, Dominik Pella, Beáta Hubková, Mária Mareková and Daniel Pella

J. Cardiovasc. Dev. Dis. 2024, 11(9), 258; https://doi.org/10.3390/jcdd11090258 - 23 Aug 2024

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Abstract

Non-invasive possibilities of predicting cardiovascular risk and monitoring the treatment and progression of coronary artery disease (CAD) are important subjects of cardiovascular research. Various inflammatory markers have been identified as potential biomarkers of CAD, including interleukin-6 (IL-6), lipocalin-2 (LCN-2), growth differentiation factor 15 [...] Read more.

Non-invasive possibilities of predicting cardiovascular risk and monitoring the treatment and progression of coronary artery disease (CAD) are important subjects of cardiovascular research. Various inflammatory markers have been identified as potential biomarkers of CAD, including interleukin-6 (IL-6), lipocalin-2 (LCN-2), growth differentiation factor 15 (GDF-15), and T cell immunoglobulin and mucin domain-3 (TIM-3). This research aims to identify their utility in the investigation of CAD severity and progression. The basic anthropometric parameters, as well as the levels of urea, creatinine, CRP, leukocytes, fibrinogen, and biomarkers of inflammation, were measured in 130 patients who underwent coronary angiography. In male patients, divided according to findings on coronary angiography, we observed an increasing expression of GDF-15 with increasing stenosis (with worsening findings). In females, we observed increasing fibrinogen expression with increasing stenosis, i.e., findings on coronary angiography. Correlation analysis did not confirm the relationship between TIM-3, LCN and 2, IL-6 and the severity of findings obtained by coronary angiography; however, the correlation of TIM-3 and LCN-2 expression was positive with the finding, and the correlation of IL-6 with the finding was surprisingly negative. Understanding the role of these inflammatory markers in CAD can be helpful in risk stratification, guiding therapeutic strategies, and monitoring treatment responses in patients with CAD. Full article

(This article belongs to the Topic Molecular and Cellular Mechanisms of Heart Disease)

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17 pages, 676 KiB

Open AccessReview

Diagnosis and Treatment of Eclampsia

by Vasiliki Katsi, Asimenia Svigkou, Ioanna Dima and Konstantinos Tsioufis

J. Cardiovasc. Dev. Dis. 2024, 11(9), 257; https://doi.org/10.3390/jcdd11090257 - 23 Aug 2024

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Abstract

Hypertensive disorders of pregnancy affect approximately 5% to 10% of pregnant women. Eclampsia is a serious hypertensive disorder that is primarily characterized by the onset of grand mal seizure activity in the absence of other causative conditions. While eclampsia is diagnosed clinically, laboratory [...] Read more.

Hypertensive disorders of pregnancy affect approximately 5% to 10% of pregnant women. Eclampsia is a serious hypertensive disorder that is primarily characterized by the onset of grand mal seizure activity in the absence of other causative conditions. While eclampsia is diagnosed clinically, laboratory tests are recommended to assess for complications. Treatment strategies for eclampsia focus on controlling seizures and managing hypertension. Acute care during a seizure is critical because of the need for immediate medical interventions, including the management of the airway, breathing, and circulation, as well as ensuring the safety of the patient during convulsions. Magnesium sulfate is the preferred anticonvulsant drug. Care must be taken during administration to prevent magnesium toxicity. Antihypertensive drugs used in eclampsia include labetalol, hydralazine and nifedipine. The definitive treatment of eclampsia is delivery. Close monitoring of both mother and fetus is important to identify any indications for delivery. The timing and mode of delivery depend on obstetric indications, the severity of eclampsia, the gestational age of the fetus, and the overall clinical status of the patient. Neuraxial anesthesia is the anesthesia of choice for conscious, seizure-free, and with stable vital signs women undergoing cesarean section. Full article

(This article belongs to the Special Issue Clinical Burden of Comorbidities on Cardiovascular System and Beyond)

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7 pages, 695 KiB

Open AccessArticle

Epidemiological and Prognostic Importance of New-Onset Cancer as a Net Adverse Clinical Outcome after ST-Elevation Myocardial Infarction

by Toshiharu Fujii and Yuji Ikari

J. Cardiovasc. Dev. Dis. 2024, 11(9), 256; https://doi.org/10.3390/jcdd11090256 - 23 Aug 2024

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Abstract

The study assessed the epidemiological frequency and prognostic impact of new-onset cancer as an additional net adverse clinical outcome in patients after ST-elevation myocardial infarction (STEMI), considering its potential clinical significance alongside classical endpoints. This study was designed as a single-center observational study, [...] Read more.

The study assessed the epidemiological frequency and prognostic impact of new-onset cancer as an additional net adverse clinical outcome in patients after ST-elevation myocardial infarction (STEMI), considering its potential clinical significance alongside classical endpoints. This study was designed as a single-center observational study, including 1285 consecutive patients who were diagnosed as STEMI patients as the subject, and the frequency and prognosis of new-onset cancer after STEMI onset were assessed. The incidence of all-cause death, nonfatal myocardial infarction (MI), stroke, and bleeding were analyzed as classical endpoints. Throughout an average of a 1241.4 days observation period, cancers were observed in 7.0% of patients (n = 90), showing development at a constant rate throughout this period (incidence rate, 0.06/1000 person-years). The average duration from STEMI onset to cancer diagnosis was 1371.4 days. Death, MI, or stroke were observed in 21.3%, 4.0%, 6.5%, and 12.8%, giving incidence rates of 0.18, 0.03, 0.06, and 0.11/1000 person-years, respectively. Long-term mortality was higher in patients with newly diagnosed cancer than in patients without cancer (36.7% vs. 20.1%, p < 0.01). Cancer after STEMI should be considered as an additional major adverse clinical event because of its high incidence, constant development, and high mortality in comparison to classical endpoints. Full article

(This article belongs to the Special Issue Recent Progress in Cardiovascular Epidemiology)

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12 pages, 256 KiB

Open AccessArticle

Evaluating the Clinical Effectiveness of Cardiac Rehabilitation among Patients of Very Low Socioeconomic Status Living in Colombia

by Gabriela L. M. Ghisi, Ana Paula Delgado Bomtempo, Nelson F. Gonzalez, Giovanna Patricia Reyes and Claudia V. Anchique

J. Cardiovasc. Dev. Dis. 2024, 11(9), 255; https://doi.org/10.3390/jcdd11090255 - 23 Aug 2024

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Abstract

Cardiovascular disease (CVD) poses a significant health burden, particularly among individuals of low socioeconomic status (SES) in low- and middle-income countries (LMICs). This study evaluates the clinical effectiveness of cardiac rehabilitation (CR) in addressing CVD outcomes among very low-SES patients in Colombia. Data [...] Read more.

Cardiovascular disease (CVD) poses a significant health burden, particularly among individuals of low socioeconomic status (SES) in low- and middle-income countries (LMICs). This study evaluates the clinical effectiveness of cardiac rehabilitation (CR) in addressing CVD outcomes among very low-SES patients in Colombia. Data from participants enrolled in a CR program in Colombia between 2022 and 2023 were analyzed retrospectively. Measures included heart-healthy behaviors, physical/psychological outcomes, and quality of life assessed at 18, 36, and 60 sessions. Significant improvements were observed in exercise capacity, psychological well-being, and quality of life metrics throughout the CR program. However, barriers to CR attendance and the critical need for expanded program availability remain evident, particularly in LMIC settings like Colombia. In conclusion, structured CR programs demonstrate substantial benefits for very low-SES individuals in a LMIC country, highlighting the urgent need for increased program accessibility and equitable healthcare provision to optimize cardiovascular health outcomes. Full article

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J. Cardiovasc. Dev. Dis., Volume 11, Issue 9 (September 2024) – 12 articles

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