**Preface to "Ischemic Heart Disease in the Context of Different Comorbidities"**

Cardiovascular diseases are the most important health problem of modern times and have a pandemic spread. There are many structural and functional cardiac abnormalities and their clinical expression is very wide, from the complete absence of symptoms to chest pain and dyspnea, syncope, hemodynamic instability and death. Among cardiovascular diseases, ischemic heart disease ranks as the most prevalent and causes almost one-third of deaths worldwide.

The field of cardiology is very dynamic, constantly evolving and improving. Our knowledge about myocardial ischemia is deepening every day, as major progress is made both in understanding its pathophysiological substrate and in improving diagnostic algorithms and therapeutic protocols.

Myocardial ischemia is the fundamental substrate of acute and chronic coronary syndromes. Beyond this significant role, its importance also resides in the coexistence with many pathological conditions, in which myocardial ischemia appears either as an associated factor or a consequence.

Firstly, the diagnosis of myocardial ischemia in the context of non-cardiac comorbidities can be a challenge for the clinician, who has the difficult task of choosing from many options the appropriate paraclinical investigations-ECG, biomarkers, stress tests, invasive and non-invasive imaging procedures-to establish a correct diagnosis.

Secondly, the high incidence and severe prognosis of myocardial ischemia highlight the need for continuous research in the field, to optimize the diagnosis and treatment and to improve the prognosis and survival of the patients.

Thirdly, atherosclerotic disease as a whole and myocardial ischemia, in particular, is frequently associated with a complex metabolic background. Innovative therapies bring important benefits, providing protection against atherosclerotic disease and significantly reducing major adverse cardiovascular events in dedicated clinical trials.

To summarize, these were the main reasons why we chose this broad topic. We aimed to form a team of specialists whose advanced experience allows us to understand the complex mechanisms of the bidirectional relationship between myocardial ischemia and various pathologies. Only by working as a strong team can we identify the best diagnostic and therapeutic solutions for our patients. We believe that our goal was fully achieved, and we express our deepest gratitude to our colleagues, who shared their knowledge and experience.

#### **Irina-Iuliana Costache, Bogdan-Mircea Mihai, and Minerva Codruta Badescu** *Editors*

*life*

*Editorial*
