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A special issue of Diagnostics (ISSN 2075-4418). This special issue belongs to the section "Pathology and Molecular Diagnostics".

Deadline for manuscript submissions: closed (31 August 2024) | Viewed by 16126

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Dr. Andrea De Martino

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Guest Editor

Cardiac Rehabilitation Unit, AUSL Toscana Nord-Ovest, Cecina Civil Hospital, Livorno, Italy
Interests: aortic diseases; cardiac surgery; coronary artery bypass surgery; mitral valve
Special Issues, Collections and Topics in MDPI journals

Dr. Marija D. Zdravković

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Guest Editor

1. University Hospital Medical Center Bežanijska Kosa, 11000 Belgrade, Serbia
2. Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia
Interests: cardiovascular disease; heart; coronary artery disease; cardiovascular imaging; interventional cardiology; heart failure; cardiomyopathy; stroke; peripheral vascular disease
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Cardiovascular disease is the main cause of death worldwide and consequently a massive burden for healthcare systems. Despite the improvements in diagnosis and treatment in the last few decades, variable risk factors are still inevitably leading to increased morbidity and mortality. This is why proper and early diagnosis as well as management can provide much better outcomes for these patients. This Special Issue should focus on basic, as well as novel and uninvestigated, diagnostic and therapeutic modalities. Research papers focused on diagnostics (echocardiography, cardiac magnetic resonance, CT coronary angiography, SPECT, and PET), risk stratification in patients with cardiovascular disease, and management (both interventional and non-interventional) are strongly encouraged.

I hope that this Special Issue will provide some new insights into the diagnosis, prognosis, and treatment of cardiovascular disease. Authors can submit communications, reviews, and original articles covering any aspect of this topic.

Dr. Andrea De Martino
Dr. Marija D. Zdravković
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Diagnostics is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

cardiovascular disease
heart
coronary artery disease
cardiovascular imaging
interventional cardiology
heart failure
cardiomyopathy
stroke
peripheral vascular disease

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Published Papers (9 papers)

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Research

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18 pages, 1157 KiB

Open AccessArticle

The Correlation between Cardiac Magnetic Resonance Findings and Post-COVID-19: The Impact of Myocardial Injury on Quality of Life

by Maja Popovic, Vladimir Cvetic, Viseslav Popadic, Kristina Ilic, Aleksandra Radojevic, Andrea Klasnja, Natasa Milic, Nina Rajovic, Ratko Lasica, Drasko Gostiljac, Slobodan Klasnja, Edvin Mahmutovic and Marija Zdravkovic

Diagnostics 2024, 14(17), 1937; https://doi.org/10.3390/diagnostics14171937 - 2 Sep 2024

Viewed by 1003

Abstract

Background: In the post-COVID-19 era, there is growing concern regarding its impact on cardiovascular health and the following effects on the overall quality of life of affected individuals. This research seeks to investigate cardiac magnetic resonance (CMR) findings following COVID-19 and their impact on the quality of life of affected individuals. Methods: An observational, cross-sectional study was conducted in consecutive patients with persistent cardiovascular symptoms after COVID-19 who were referred to CMR due to suspected myocardial injury. In addition, patients completed a questionnaire about symptoms and the quality of life during the post-COVID-19 period. Results: In this study, 85 patients were included. The study population consisted of patients with a mean age of 42.5 ± 13.4 years, predominantly women, who made up 69.4% of the study population, while men made up 30.6%. CMR findings showed non-ischemic myocardial injury in 78.8% of patients and myocardial edema in 14.1% of patients. Late pericardial enhancement was present in 40% of patients and pericardial effusion in 51.8% of patients. Pericardial effusion (p = 0.001) was more prevalent in patients who reported more pronounced symptoms in the post-COVID-19 period compared to the acute infection phase. Predictors of lower quality of life in the post-COVID-19 period were the presence of irregular heartbeat (p = 0.039), cardiovascular problems that last longer than 12 weeks (p = 0.018), and the presence of pericardial effusion (p = 0.037). Conclusion: Acute myocarditis was observed in a minority of patients after COVID-19, while non-ischemic LGE pattern and pericardial effusion were observed in the majority. Quality of life was worse during the post-COVID-19 period in patients with CMR abnormalities, primarily in patients with pericardial effusion. Also, irregular heartbeat, cardiovascular symptoms that last longer than 12 weeks, as well as pericardial effusion were independent predictors of lower quality of life during the post-COVID-19 period. Full article

(This article belongs to the Special Issue Diagnosis, Prognosis, and Management of Cardiovascular Disease)

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19 pages, 3477 KiB

Open AccessArticle

Insights into the Cardioprotective Effects of Pyridoxine Treatment in Diabetic Rats: A Study on Cardiac Oxidative Stress, Cardiometabolic Status, and Cardiovascular Biomarkers

by Slavica Mutavdzin Krneta, Kristina Gopcevic, Sanja Stankovic, Jovana Jakovljevic Uzelac, Dušan Todorovic, Milica Labudovic Borovic, Jelena Rakocevic and Dragan Djuric

Diagnostics 2024, 14(14), 1507; https://doi.org/10.3390/diagnostics14141507 - 12 Jul 2024

Cited by 1 | Viewed by 973

Abstract

The aims of this study were to examine the effects of pyridoxine administration on the activities of cardiac antioxidant stress enzymes superoxide dismutase (SOD) and catalase (CAT) and enzyme indicators of cardiometabolic status, lactate and malate dehydrogenase (LDH, MDH), as well as LDH and MDH isoforms’ distribution in the cardiac tissue of healthy and diabetic Wistar male rats. Experimental animals were divided into five groups: C1—control (0.9% sodium chloride—NaCl—1 mL/kg, intraperitoneally (i.p.), 1 day); C2—second control (0.9% NaCl 1 mL/kg, i.p., 28 days); DM—diabetes mellitus (streptozotocin 100 mg/kg in 0.9% NaCl, i.p., 1 day); P—pyridoxine (7 mg/kg, i.p., 28 days); and DM + P—diabetes mellitus and pyridoxine (streptozotocin 100 mg/kg, i.p., 1 day and pyridoxine 7 mg/kg, i.p., 28 days). Pyridoxine treatment reduced CAT and MDH activity in diabetic rats. In diabetic rats, the administration of pyridoxine increased LDH1 and decreased LDH4 isoform activities, as well as decreased peroxisomal MDH and increased mitochondrial MDH activities. Our findings highlight the positive effects of pyridoxine administration on the complex interplay between oxidative stress, antioxidant enzymes, and metabolic changes in diabetic cardiomyopathy. Full article

(This article belongs to the Special Issue Diagnosis, Prognosis, and Management of Cardiovascular Disease)

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12 pages, 1616 KiB

Open AccessArticle

Recovery from Severe COVID-19 Is an Independent Predictor of Electrocardiographic Abnormal P-Wave Axis

by Mücahid Yılmaz and Çetin Mirzaoğlu

Diagnostics 2024, 14(13), 1326; https://doi.org/10.3390/diagnostics14131326 - 22 Jun 2024

Viewed by 1279

Abstract

Aim: Abnormal P-wave axis (aPwa) have been correlated with an increased risk of supraventricular arrhythmias. The aim of this study was to analyze whether infection with COVID-19 may cause a predisposition for supraventricular arrhythmia in the long term, following recovery. Materials and Methods: In this study, a total of 252 subjects with a confirmed history of COVID-19 (recovered COVID-19) and 251 healthy subjects without a history of COVID-19 were included. The recovered COVID-19 group was divided into three subgroups designated as mild, moderate, and severe according to the severity score of their chest CT. The aPwa data were obtained using 12-lead electrocardiography (ECG) and compared between the healthy subjects and the recovered COVID-19 subgroups. Results: This study showed that in the recovered severe COVID-19 subgroup the prevalence of aPwa was significantly increased compared to the controls and the other COVID-19 subgroups. No correlation could be detected in Spearman’s Rho correlation between the existence of aPwa and the number of positive PCR tests for COVID-19 and the time elapsed after infection with COVID-19. The binary logistic regression analysis showed that recovery from severe COVID-19, the severity score of the chest CT in the recovered from COVID-19 subjects, and the existence of hypertension (HT) were all independent predictors of aPwa (hazard ratio: 3.542, 95% confidence interval: 1.398–8.969, p: 0.01; hazard ratio: 0.896, 95% confidence interval: 0.840–0.955, p < 0.001; hazard ratio: 2.710, 95% confidence interval: 1.079–6.804, p: 0.03, respectively). Conclusions: Individuals who have recovered from severe COVID-19 have shown an increased prevalence of aPwa. The existence of aPwa was not associated with the number of positive PCR tests for COVID-19 or the time elapsed after infection with COVID-19. Therefore, recovery from severe COVID-19 is an independent predictor of electrocardiographic abnormal P-wave axis. Full article

(This article belongs to the Special Issue Diagnosis, Prognosis, and Management of Cardiovascular Disease)

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16 pages, 1160 KiB

Open AccessArticle

Challenges Regarding the Value of Routine Perioperative Transesophageal Echocardiography in Mitral Valve Surgery

by Luminita Iliuta, Madalina-Elena Rac-Albu, Eugenia Panaitescu, Andreea Gabriella Andronesi, Horatiu Moldovan, Florentina Ligia Furtunescu, Alexandru Scafa-Udriște, Mihai Adrian Dobra, Cristina Mirela Dinescu, Gheorghe Dodu Petrescu and Marius Rac-Albu

Diagnostics 2024, 14(11), 1095; https://doi.org/10.3390/diagnostics14111095 - 24 May 2024

Cited by 1 | Viewed by 1094

Abstract

Background and Objectives: Transesophageal echocardiography (TEE) is considered an indispensable tool for perioperative evaluation in mitral valve (MV) surgery. TEE is routinely performed by anesthesiologists competent in TEE; however, in certain situations, the expertise of a senior cardiologist specializing in TEE is required, which incurs additional costs. The purpose of this study is to determine the indications for specialized perioperative TEE based on its utility and the correlation between intraoperative TEE diagnoses and surgical findings, compared with routine TEE performed by an anesthesiologist. Materials and Methods: We conducted a three-year prospective study involving 499 patients with MV disease undergoing cardiac surgery. Patients underwent intraoperative and early postoperative TEE and at least one other perioperative echocardiographic evaluation. A computer application was dedicated to calculating the utility of each type of specialized TEE indication depending on the type of MV disease and surgical intervention. Results: The indications for performing specialized perioperative TEE identified in our study can be categorized into three groups: standard, relative, and uncertain. Standard indications for specialized intraoperative TEE included establishing the mechanism and severity of MR (mitral regurgitation), guiding MV valvuloplasty, diagnosing associated valvular lesions post MVR (mitral valve replacement), routine evaluations in triple-valve replacements, and identifying the causes of acute, intraoperative, life-threatening hemodynamic dysfunction. Early postoperative specialized TEE in the intensive care unit (ICU) is indicated for the suspicion of pericardial or pleural effusions, establishing the etiology of acute hemodynamic dysfunction, and assessing the severity of residual MR post valvuloplasty. Conclusions: Perioperative TEE in MV surgery can generally be performed by a trained anesthesiologist for standard measurements and evaluations. In certain cases, however, a specialized TEE examination by a trained senior cardiologist is necessary, as it is indirectly associated with a decrease in postoperative complications and early postoperative mortality rates, as well as an improvement in immediate and long-term prognoses. Also, for standard indications, the correlation between surgical and TEE diagnoses was superior when specialized TEE was used. Full article

(This article belongs to the Special Issue Diagnosis, Prognosis, and Management of Cardiovascular Disease)

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11 pages, 1146 KiB

Open AccessArticle

Clinical Implications of High-Sensitivity Troponin Elevation Levels in Non-ST-Segment Elevation Myocardial Infarction Patients: Beyond Diagnostics

by Constanza Bravo, Geovanna Vizcarra, Antonia Sánchez, Francisca Cárdenas, Juan Pablo Canales, Héctor Ugalde and Alfredo Parra-Lucares

Diagnostics 2024, 14(9), 893; https://doi.org/10.3390/diagnostics14090893 - 25 Apr 2024

Viewed by 1849

Abstract

Standard troponin has long been pivotal in diagnosing coronary syndrome, especially Non-ST-Segment Elevation Myocardial Infarction (NSTEMI). The recent introduction of high-sensitivity troponin (hs-cTnI) has elevated it to the gold standard. Yet, its nuanced role in predicting angiographic lesions and clinical outcomes, notably in specific populations like obesity, remains underexplored. Aim: To evaluate the association between hs-cTnI magnitude in NSTEMI patients and angiographic findings, progression to acute heart failure, and its performance in obesity. Methods: Retrospective study of 208 NSTEMI patients at a large university center (2020–2023). Hs-cTnI values were assessed for angiographic severity, acute heart failure, and characteristics in the obese population. Data collected and diagnostic performance were evaluated using manufacturer-specified cutoffs. Results: 97.12% of patients had a single culprit vessel. Hs-cTnI elevation correlated with angiographic stenosis severity. Performance for detecting severe coronary disease was low, with no improvement using a higher cutoff. No association was found between hs-cTnI and the culprit vessel location. Hs-cTnI did not predict acute heart failure progression. In the obese population, hs-cTnI levels were higher, but acute heart failure occurred less frequently than in non-obese counterparts. Conclusions: In NSTEMI, hs-cTnI elevation is associated with significant stenosis, but not with location or acute heart failure. Obesity correlates with higher hs-cTnI levels but a reduced risk of acute heart failure during NSTEMI. Full article

(This article belongs to the Special Issue Diagnosis, Prognosis, and Management of Cardiovascular Disease)

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11 pages, 681 KiB

Open AccessArticle

Galectin-3 as a Prognostic Biomarker in Patients with First Acute Myocardial Infarction without Heart Failure

by Rada M. Vucic, Olivera M. Andrejic, Dragana Stokanovic, Tatjana Jevtovic Stoimenov, Lana McClements, Valentina N. Nikolic, Miodrag Sreckovic, Mirjana Veselinovic, Srdjan Aleksandric, Viseslav Popadic, Marija Zdravkovic and Milan Pavlovic

Diagnostics 2023, 13(21), 3348; https://doi.org/10.3390/diagnostics13213348 - 31 Oct 2023

Cited by 4 | Viewed by 1771

Abstract

Background: Galectin-3 (Gal-3) is a biomarker involved in a wide range of diseases including cardiac remodeling following acute myocardial infarction (AMI). Identification of prognostic markers in patients with AMI can guide strategies towards improved survival and quality of life. Methods: Our study included 59 patients with AMI and a preserved ejection fraction. We determined the Gal-3 plasma concentration within 24 h of chest pain onset from the aortic root, femoral/radial artery, coronary sinus and cubital vein. Major adverse cardiovascular events (MACEs) were evaluated at six months follow-up. Results: MACE at six months post-AMI was recorded in 20 patients (34%). The Gal-3 plasma concentration from the aortic root and the femoral/radial artery were independent predictors of MACE at six months follow-up after the first AMI (OR 1.228; 95%CI: 1.011–1.491; p = 0.038; OR 3.438; 95%CI: 1.275–9.265; p = 0.015). ROC analysis identifies the Gal-3 plasma concentration from the aortic root as a better predictor of MACE or death (cut-off ≥ 10.86 ng/mL; AUC 0.858; 95%CI: 0.744–0.973; p < 0.001) than Gal-3 plasma concentration from the femoral/radial artery (cut-off ≥ 10.18 ng/mL; AUC 0.742; 95%CI: 0.596–0.888; p = 0.006). Conclusion: the Gal-3 plasma concentration in patients with AMI determined during coronary angiography, especially from the aortic root, within 24 h after chest pain onset is a valuable biomarker of prognosis at six months follow-up. Full article

(This article belongs to the Special Issue Diagnosis, Prognosis, and Management of Cardiovascular Disease)

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Review

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16 pages, 902 KiB

Open AccessReview

New Therapeutic Approaches for the Treatment of Patients with Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD) and Increased Cardiovascular Risk

by Marija Branković, Marija Dukić, Tijana Gmizić, Višeslav Popadić, Novica Nikolić, Ana Sekulić, Milica Brajković, Jelena Đokić, Edvin Mahmutović, Ratko Lasica, Marko Vojnović and Tamara Milovanović

Diagnostics 2024, 14(2), 229; https://doi.org/10.3390/diagnostics14020229 - 22 Jan 2024

Cited by 10 | Viewed by 3731

Abstract

Metabolic dysfunction-associated steatotic liver disease (MASLD) was previously known as nonalcoholic fatty liver disease (NAFLD). The main characteristic of the disease is the process of long-term liver inflammation, which leads to hepatocyte damage followed by liver fibrosis and eventually cirrhosis. Additionally, these patients are at a greater risk for developing cardiovascular diseases (CVD). They have several pathophysiological mechanisms in common, primarily lipid metabolism disorders and lipotoxicity. Lipotoxicity is a factor that leads to the occurrence of heart disease and the occurrence and progression of atherosclerosis. Atherosclerosis, as a multifactorial disease, is one of the predominant risk factors for the development of ischemic heart disease. Therefore, CVD are one of the most significant carriers of mortality in patients with metabolic syndrome. So far, no pharmacotherapy has been established for the treatment of MASLD, but patients are advised to reduce their body weight and change their lifestyle. In recent years, several trials of different drugs, whose basic therapeutic indications include other diseases, have been conducted. Because it has been concluded that they can have beneficial effects in the treatment of these conditions as well, in this paper, the most significant results of these studies will be presented. Full article

(This article belongs to the Special Issue Diagnosis, Prognosis, and Management of Cardiovascular Disease)

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Other

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5 pages, 4013 KiB

Open AccessInteresting Images

The Role of CT Imaging in a Fractured Coronary Stent with Pseudoaneurysm Formation

by Radu Octavian Baz, George Gherghescu, Adnan Mustafa, Mihaly Enyedi, Cristian Scheau and Radu Andrei Baz

Diagnostics 2024, 14(8), 840; https://doi.org/10.3390/diagnostics14080840 - 18 Apr 2024

Cited by 2 | Viewed by 1381

Abstract

We report a case of a 63-year-old male patient with multiple cardiovascular risk factors and previous myocardial infarction who was referred to the emergency department on September 2023 with symptoms and clinical and biological data consistent with an acute coronary event. A coronary angiography revealed severe ostial stenosis of the left anterior descending artery (LAD) and intrastent thrombotic occlusion in the first two segments of the LAD. Two drug-eluting stents were implanted and the patient was discharged when hemodynamically stable; however, three weeks later, he returned to the emergency department complaining of fever, anterior chest pain, dyspnea at rest, and high blood pressure values at home. High levels of troponin T, C-reactive protein, and NT-proBNP were detected and blood cultures showed methicillin-resistant Staphylococcus aureus. The computed tomography (CT) examination showed a saccular dilatation had developed between two fragments of a stent mounted at the level of the LAD, surrounded by a hematic pericardial accumulation. LAD pseudoaneurysm ablation and a double aortocoronary bypass with inverted saphenous vein autograft were performed and the patient showed a favorable postoperative evolution. In this case, surgical revascularization was proven to be the appropriate treatment strategy, demonstrating the need to choose an individualized therapeutic option depending on case-specific factors. Full article

(This article belongs to the Special Issue Diagnosis, Prognosis, and Management of Cardiovascular Disease)

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11 pages, 4204 KiB

Open AccessBrief Report

Post-COVID-19 Vaccination Myocarditis: A Histopathologic Study on a Monocentric Series of Six Cases

by Hyo-Suk Ahn, Yuran Ahn, Jaehyuk Jang, Seonghyun Bu, Sungmin Lim, Chanjoon Kim, Jong-Min Lee, Kyungji Lee and Kyung-Jin Seo

Diagnostics 2024, 14(2), 219; https://doi.org/10.3390/diagnostics14020219 - 19 Jan 2024

Cited by 1 | Viewed by 2068

Abstract

Many reports on the development of myocarditis following coronavirus disease 2019 (COVID-19) vaccination (PCVM) have emerged. However, only a few case studies have investigated endomyocardial biopsy (EMB) results. This study describes the clinicopathologic features of PCVM. We surveyed all hospitalized patients in a single university hospital in Korea and identified six cases of PCVM. All six patients underwent EMB, five of whom were men aged 15–85 years. All patients developed cardiac dysfunction. Among these patients, two had mild disease without sequelae, whereas the other four had dilated cardiomyopathy with depressed cardiac function. All six cases demonstrated lymphohistiocytic myocarditis. Two of our cases fulfilled the criterion of CD3+ T lymphocytes > 7 cells/mm² (Case nos. 3 and 6), while the remaining four cases did not fulfill the Dallas criteria. In conclusion, most PCVM cases showed mild degree inflammation histopathologically, and some cases could not fulfill the Dallas criteria and were classified as borderline myocarditis. Full article

(This article belongs to the Special Issue Diagnosis, Prognosis, and Management of Cardiovascular Disease)

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