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Clinical Burden of Comorbidities on Cardiovascular System and Beyond

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A special issue of Journal of Cardiovascular Development and Disease (ISSN 2308-3425). This special issue belongs to the section "Cardiovascular Clinical Research".

Deadline for manuscript submissions: closed (31 July 2024) | Viewed by 13707

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Prof. Dr. Zbigniew Siudak

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Guest Editor

Medical College, Jan Kochanowski University, 25-317 Kielce, Poland
Interests: epidemiology; co-morbidities; acute coronary syndromes; diabetes; inflammation; platelets; PCI; statistics

Special Issue Information

Dear Colleagues,

The scope of this JCDD Special Issue is to promote a multidisciplinary approach to cardiovascular disease and its burden. Atherosclerosis is a generalized inflammatory process that almost never impacts solely on the heart and coronary system. Recent decades, but also the COVID-19 pandemic, have underlined the importance of comorbidities on cardiovascular disease and outcomes. We seek novel and bold analyses of known and hypothetical but currently untested markers, imaging methods and co-morbidities on the heart and vessels.

This Special Issue will provide a platform for the presentation of recent advances in knowledge on the development of cardiovascular disease from diverse scientific disciplines including internal medicine, cardiac surgery, as well as basic sciences and dentistry. The broad focus of the issue will enhance our understanding of the range of cardiovascular disease burden.

Prof. Dr. Zbigniew Siudak
Guest Editor

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. Journal of Cardiovascular Development and Disease is an international peer-reviewed open access monthly 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 2700 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

co-morbidity
inflammation
valves
stents
epidemiology
coronary
diabetes
gender
age
markers

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Published Papers (9 papers)

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Research

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17 pages, 647 KiB

Open AccessArticle

Multivariate Analysis of the Determinants of Total Mortality in the European Union with Focus on Fat Intake, Diabetes, Myocardial Infarction, Life Expectancy, and Preventable Mortality: A Panel Data Fixed-Effects Panel Data Model Approach

by Silviu Marcel Stanciu, Emilia Rusu, Mariana Jinga, Cosmin Gabriel Ursu, Rares Ioan Stanciu, Daniela Miricescu, Valentin Marian Antohi and Elena Barbu

J. Cardiovasc. Dev. Dis. 2024, 11(10), 328; https://doi.org/10.3390/jcdd11100328 (registering DOI) - 15 Oct 2024

Viewed by 283

Abstract

Cardiovascular disease is the leading cause of death in the European Union (EU), and while the mortality rates of diabetes, myocardial infarction, and the total fat intake have been extensively studied, we believe that understanding the interaction between such closely correlated determinants is crucial to the development of effective health policies in the EU. Our paper’s novelty is represented by the econometric modelling, and its ability to capture both temporal and unit variations. The research methodology consists of using a panel data model with fixed effects for the 27 EU member states over the period 2010–2021. The results of the study show that the standardized mortality rate for deaths preventable by prevention and treatment and diabetes-related mortality are significant predictors of total mortality in the EU. The standardized mortality rate for deaths preventable by prevention and treatment had a significant positive impact, suggesting that improved preventive and therapeutic interventions can significantly reduce total mortality. Diabetes-associated mortality also showed a strong positive correlation with total mortality, emphasizing the need for effective diabetes management and prevention strategies. These results are useful for the formulation of public health strategies aimed at improving life expectancy and reducing the burden of chronic diseases. Full article

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

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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 - 28 Aug 2024

Viewed by 477

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 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, 3154 KiB

Open AccessArticle

Hemodynamic Evaluation of Coronary Artery Lesions after Kawasaki Disease: Comparison of Fractional Flow Reserve during Cardiac Catheterization with Myocardial Flow Reserve during ¹³N-Ammonia PET

by Makoto Watanabe, Ryuji Fukazawa, Tomonari Kiriyama, Shogo Imai, Ryosuke Matsui, Kanae Shimada, Yoshiaki Hashimoto, Koji Hashimoto, Masanori Abe, Mitsuhiro Kamisago and Yasuhiko Itoh

J. Cardiovasc. Dev. Dis. 2024, 11(8), 229; https://doi.org/10.3390/jcdd11080229 - 23 Jul 2024

Viewed by 706

Abstract

Coronary artery lesions (CALs) after Kawasaki disease present complex coronary hemodynamics. We investigated the relationship between coronary fractional flow reserve (FFR), myocardial flow reserve (MFR), and myocardial blood flow volume fraction (MBF) and their clinical usefulness in CALs after Kawasaki disease. Nineteen patients (18 men, 1 woman) who underwent cardiac catheterization and ¹³N-ammonia positron emission tomography, with 24 coronary artery branches, were included. Five branches had inconsistent FFR and MFR values, two had normal FFR but abnormal MFR, and three had abnormal FFR and normal MFR. The abnormal MFR group had significantly higher MBF at rest than the normal group (0.86 ± 0.13 vs. 1.08 ± 0.09, p = 0.001). The abnormal FFR group had significantly lower MBF at adenosine loading than the normal group (2.23 ± 0.23 vs. 1.88 ± 0.29, p = 0.021). The three branches with abnormal FFR only had stenotic lesions, but the MFR may have been normal because blood was supplied by collateral vessels. Combining FFR, MFR, and MBF will enable a more accurate assessment of peripheral coronary circulation and stenotic lesions in CALs and help determine treatment strategy and timing of intervention. Full article

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

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13 pages, 243 KiB

Open AccessArticle

The Association between Major Adverse Cardiovascular Events and Peripheral Artery Disease Burden

by Oskari Niiranen, Juha Virtanen, Ville Rantasalo, Amer Ibrahim, Maarit Venermo and Harri Hakovirta

J. Cardiovasc. Dev. Dis. 2024, 11(6), 157; https://doi.org/10.3390/jcdd11060157 - 21 May 2024

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Abstract

Objective: The aim of the present study was to investigate the possible relationship between the segmental burden of lower limb atherosclerosis and Major Adverse Cardiovascular Events (MACEs). Methods: All the consecutive symptomatic peripheral artery disease (PAD) patients admitted for digital subtraction angiography (DSA) at Turku University Hospital department of Vascular Surgery between 1 January 2009 and 30 July 2011 were retrospectively analyzed. Angiography due to symptomatic PAD was used as the index date for the inclusion in the study. The segmental burden of atherosclerosis based on DSA was divided into three categories according to the highest disease burden of the defined artery segment: aorto-iliac, femoropopliteal, or tibial segments. The major association for the study was MACEs (defined as a cerebrovascular event, heart failure (HF) and myocardial infarction requiring hospital admission). Demographic data and MACEs were obtained from the hospital electronic medical records system. Results. The lower limb atherosclerosis burden of tibial vessels was related to an increased probability for HF (OR 3.9; 95%CI 2.4–6.5) and for MACEs overall (OR 2.3; 95%CI 1.4–3.6). The probability of both HF and MACEs overall rose with the increasing severity of the atherosclerosis burden. Moreover, the more severe the tibial vessel atherosclerosis, the higher the risk of HF and MACEs. The most extensive tibial atherosclerosis patients had an OR 4.5; 95%CI 2.6–8.0 for HF and an OR 3.1; and 95%CI 1.7–5.6 for MACEs overall. The femoropopliteal disease burden was also associated with an increased risk of HF (OR 2.3; 95%CI 1.6–3.2) and MACE (OR 1.9; 95%CI 1.3–2.7). However, the increasing extent of atherosclerosis of the femoropopliteal segment solely increased the risk of MACEs. Conclusions: PAD patients with severe tibial atherosclerosis are likely to present with MACEs. The risk is further enhanced as the extent of tibial vessel atherosclerosis is increased. An association between MACE and severe atherosclerosis on the aortoiliac segment was not detected. However, when the femoropopliteal segment was the most affected artery segment, the risk of MACEs was increased. Full article

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

12 pages, 620 KiB

Open AccessArticle

Atrial Fibrillation in Heart Failure with Preserved Left Ventricular Systolic Function: Distinct Elevated Risk for Cardiovascular Outcomes in Women Compared to Men

by Alaa Mabrouk Salem Omar, Mohamed Ahmed Abdel Rahman, Osama Rifaie and Jonathan N. Bella

J. Cardiovasc. Dev. Dis. 2022, 9(12), 417; https://doi.org/10.3390/jcdd9120417 - 26 Nov 2022

Cited by 2 | Viewed by 1472

Abstract

Background: Heart failure with preserved ejection fraction (HFpEF) is prevalent in women and is associated with atrial fibrillation (AF). However, sex associations in AF-related HFpEF are not well explored. Aim: We studied differences between men and women with and without AF-related HFpEF symptoms on left ventricular (LV) geometry and diastolic dysfunction (DD) and their effect on cardiovascular events. Methods: Retrospectively, HFpEF patients with and without a history of AF referred for echocardiography were studied. Echocardiographic assessments were focused on LV geometry and diastolic functions. Patients were followed for the occurrence of cardiac events defined as death and cardiac hospitalization. Results: We studied 556 patients [age: 66.7 ± 17 years, 320 (58%) women, 91 (16%) AF]. Compared to HFpEF without AF (HFpEF-AF), HFpEF with AF patients (HFpEF+AF) were older (76 ± 13.8 vs. 64.9 ± 17.3 years, p < 0.001), had more risk factors, comorbidities, left ventricular hypertrophy (32 vs. 13%, p < 0.001), higher relative wall thickness (0.50 ± 0.14 vs. 0.44 ± 0.15, p < 0.001), and DD (56 vs. 30%, all p < 0.001). HFpEF+AF women had the worst clinical, LV geometric, and diastolic functional profiles and highest rates of cardiovascular outcomes compared to HFpEF+AF men and were the only group to predict outcomes (HR: 2.7, 95%CI: 1.4–5.1), while HFpEF-AF women were a low-risk group; HFpEF+AF and HFpEF-AF men had intermediate cardiovascular outcomes which were confirmed after propensity score matching. Conclusions: Among patients with HFpEF, women with AF had more abnormal LV geometry and diastolic function and had an increased risk of adverse cardiovascular outcomes independent of traditional risk factors, comorbidities, and baseline diastolic function. Full article

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

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Review

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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

Viewed by 2075

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 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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29 pages, 4826 KiB

Open AccessReview

Charting the Unseen: How Non-Invasive Imaging Could Redefine Cardiovascular Prevention

by Giancarlo Trimarchi, Fausto Pizzino, Umberto Paradossi, Ignazio Alessio Gueli, Matteo Palazzini, Piero Gentile, Francesco Di Spigno, Enrico Ammirati, Andrea Garascia, Andrea Tedeschi and Daniela Aschieri

J. Cardiovasc. Dev. Dis. 2024, 11(8), 245; https://doi.org/10.3390/jcdd11080245 - 9 Aug 2024

Cited by 7 | Viewed by 1523

Abstract

Cardiovascular diseases (CVDs) remain a major global health challenge, leading to significant morbidity and mortality while straining healthcare systems. Despite progress in medical treatments for CVDs, their increasing prevalence calls for a shift towards more effective prevention strategies. Traditional preventive approaches have centered around lifestyle changes, risk factors management, and medication. However, the integration of imaging methods offers a novel dimension in early disease detection, risk assessment, and ongoing monitoring of at-risk individuals. Imaging techniques such as supra-aortic trunks ultrasound, echocardiography, cardiac magnetic resonance, and coronary computed tomography angiography have broadened our understanding of the anatomical and functional aspects of cardiovascular health. These techniques enable personalized prevention strategies by providing detailed insights into the cardiac and vascular states, significantly enhancing our ability to combat the progression of CVDs. This review focuses on amalgamating current findings, technological innovations, and the impact of integrating advanced imaging modalities into cardiovascular risk prevention, aiming to offer a comprehensive perspective on their potential to transform preventive cardiology. Full article

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

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14 pages, 607 KiB

Open AccessReview

Monoclonal Gammopathy of Undetermined Cardiovascular Significance; Current Evidence and Novel Insights

by Anastasios Tentolouris, Ioannis Ntanasis-Stathopoulos, Maria Gavriatopoulou, Ioanna Andreadou and Evangelos Terpos

J. Cardiovasc. Dev. Dis. 2023, 10(12), 484; https://doi.org/10.3390/jcdd10120484 - 4 Dec 2023

Cited by 2 | Viewed by 3304

Abstract

Monoclonal gammopathy of undetermined significance (MGUS) is a premalignant condition characterized by the presence of low levels of a monoclonal protein in the serum and a low percentage of clonal plasma cells in the bone marrow. MGUS may progress to multiple myeloma or other plasma cell disorders at a rate of 1% annually. However, MGUS may also have adverse effects on the cardiovascular system independent of its malignant potential. Emerging data have shown that MGUS is associated with cardiovascular disease. The mechanisms underlying this association are not fully understood but may involve genetic abnormalities, vascular calcification, cryoglobulinemia, cold agglutinin disease, autoantibodies and the direct or indirect effects of the monoclonal protein on the vascular endothelium. Herein, we review current evidence in this field and we suggest that patients with MGUS may benefit from regular cardiovascular risk assessment to prevent severe cardiovascular complications, in parallel with close hematological follow-up to monitor potential disease progression. Full article

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

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10 pages, 737 KiB

Open AccessReview

Role of Fibrinolysis in the Management of Patients with COVID-19 and Thromboembolic Complications: A Review

by Patrycja Zając, Karol Kaziród-Wolski, Izabela Oleś, Janusz Sielski and Zbigniew Siudak

J. Cardiovasc. Dev. Dis. 2022, 9(10), 356; https://doi.org/10.3390/jcdd9100356 - 17 Oct 2022

Cited by 3 | Viewed by 1908

Abstract

An impaired fibrinolytic process has been demonstrated in patients infected with SARS-CoV-2, including those in severe or critical condition. Disruption of fibrinolysis leads to fibrin deposition, which exacerbates inflammation and fibrosis and damages the pulmonary surfactant. Numerous authors point out the different course of coagulopathy in patients with COVID-19. It is reported that they may have a state of secondary hyperfibrinolysis, which may explain, at least in part, the increased incidence of venous thromboembolism, even among those patients already receiving appropriate anticoagulant treatment. This raises the question of whether current guidelines for the prevention and treatment of embolic–thrombotic complications, among patients with severe COVID-19, are sufficient. Some studies show evidence of clinical improvement in patients who have received fibrinolytic therapy, beyond the current indications for its implementation. However, when considering the inclusion of systemic fibrinolytic therapy, the benefits of such treatment should always be weighed over the risk of adverse effects. Thromboelastography and rotational thromboelastometry can be helpful in making such decisions. The purpose of this study was to review the current knowledge regarding fibrinolysis and its role in the treatment of patients with severe COVID-19, including those with thromboembolic complications. Full article

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

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