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Cardiovascular and Cerebrovascular Emergencies: Advances in Clinical Research
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Cardiovascular and Cerebrovascular Emergencies: Advances in Clinical Research

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Cardiovascular Medicine".

Deadline for manuscript submissions: 30 April 2025 | Viewed by 4064

Special Issue Editor

Dr. Andrew Fu Wah Ho

E-Mail Website
Guest Editor
1. Department of Emergency Medicine, Singapore General Hospital, Singapore 169608, Singapore
2. Pre-Hospital & Emergency Research Centre, Duke-National University of Singapore Medical School, Singapore 169857, Singapore
3. Centre for Population Health Research and Implementation, Singhealth Regional Health System, Singapore 168753, Singapore
Interests: emergency medicine; resuscitation science; environmental epidemiology; public health

Special Issue Information

Dear Colleagues,

Cardiovascular and neurovascular emergencies are some of the most catastrophic and time-sensitive diseases. However, therein lies exciting opportunities to improve clinical outcomes.

This Special Issue of the Journal of Clinical Medicine focuses the readers' attention on emerging topics on the diagnosis, risk stratification, prognostication, and treatment of cardiovascular and neurovascular emergencies. Of particular interest is the inclusion of multidisciplinary studies that involve the interaction of the heart and brain.

This Special Issue will be an invaluable resource for emergency physicians, intensivists, cardiologists, and scientists working in this space, providing cutting-edge reports ranging from early exploratory studies that stimulate further research to practical guidance for clinicians. The high-quality content, provided by internationally renowned experts from various institutions, will make this Special Issue a must-read for anyone interested in this field.

Dr. Andrew Fu Wah Ho
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 Clinical Medicine 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 emergencies
  • neurovascular emergencies
  • stroke
  • cardiac arrest
  • acute myocardial infarction

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Further information on MDPI's Special Issue policies can be found here.

Published Papers (4 papers)

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Research

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9 pages, 228 KiB  
Article
What Is the Efficacy of Bilateral Antegrade Cerebral Perfusion in Cerebral Protection?
by Hasan Iner, Ihsan Peker, Erturk Karaagac, Serkan Yazman, Huseyin Durmaz, Cagri Kandemir, Tahsin Murat Tellioglu, Orhan Gokalp, Levent Yilik and Ali Gurbuz
J. Clin. Med. 2024, 13(23), 7452; https://doi.org/10.3390/jcm13237452 - 7 Dec 2024
Viewed by 700
Abstract
Background/Objectives: Acute type A aortic dissection is among the many types of catastrophic cardiovascular emergencies. The development of serious morbidity, especially neurological complications after the operation, remains a huge threat. We aimed to present comparatively the results of using unilateral or bilateral antegrade [...] Read more.
Background/Objectives: Acute type A aortic dissection is among the many types of catastrophic cardiovascular emergencies. The development of serious morbidity, especially neurological complications after the operation, remains a huge threat. We aimed to present comparatively the results of using unilateral or bilateral antegrade cerebral perfusion to minimize these threats and to demonstrate the postoperative effects of antegrade cerebral perfusion choices. Methods: The 147 patients who underwent emergency acute type A aortic dissection surgery between January 2018 and January 2023 were evaluated retrospectively. The patients were divided into two groups: those who underwent unilateral antegrade cerebral perfusion (Group 1) (n = 89) and those who underwent bilateral antegrade cerebral perfusion (Group 2) (n = 59). Baseline demographics, and preoperative, operative, and postoperative data of patients were compared statistically. Results: When the analyses of baseline demographics, and preoperative and operative data were evaluated, no significant difference was found between the groups. In addition, when comparing postoperative results, no statistical difference was found between the groups except for new-onset permanent neurological complications. The rate of postoperative new-onset permanent neurological complications was found to be 17.9% in group 1, where unilateral antegrade cerebral perfusion was applied, and 5.1% in group 2, where bilateral antegrade cerebral perfusion was applied, and this comparison was statistically significant. Conclusions: The competence of the Willis Polygon should not be relied upon without any evidence, and we believe that bilateral antegrade cerebral perfusion can be performed with a technique that does not compromise surgical comfort. Full article
(This article belongs to the Special Issue Cardiovascular and Cerebrovascular Emergencies: Advances in Clinical Research)
16 pages, 2161 KiB  
Article
Validation of EuroSCORE II, ACEF Score, CHA2DS2-VASc, and CHA2DS2-VA in Patients Undergoing Left Main Coronary Artery Angioplasty: Analysis from All-Comers BIA-LM Registry
by Emil Julian Dąbrowski, Paweł Kralisz, Konrad Nowak, Kamil Gugała, Przemysław Prokopczuk, Grzegorz Mężyński, Michał Święczkowski, Sławomir Dobrzycki and Marcin Kożuch
J. Clin. Med. 2024, 13(22), 6907; https://doi.org/10.3390/jcm13226907 - 16 Nov 2024
Viewed by 798
Abstract
Background: Simple surgical and clinical risk scores are useful in mortality prediction. Aims: The study’s aim was to validate three scores in real-world registry of percutaneous coronary intervention (PCI) for the left main coronary artery (LMCA). Methods: All data were [...] Read more.
Background: Simple surgical and clinical risk scores are useful in mortality prediction. Aims: The study’s aim was to validate three scores in real-world registry of percutaneous coronary intervention (PCI) for the left main coronary artery (LMCA). Methods: All data were obtained from the BIA-LM Registry. Discrimination and calibration of EuroSCORE II, ACEF, CHA2DS2-VASc, and CHA2DS2-VA were assessed with receiver operating characteristic (ROC) curves analysis and Hosmer–Lemeshow (HL) test. Results: The final cohort included 851 patients, median age was 71, and 156 patients had history of previous coronary artery bypass grafting (CABG). Median EuroSCORE II, ACEF, CHA2DS2-VASc, and CHA2DS2-VA were 3.1% (IQR 5.4%), 1.56 (IQR 0.9), 4 (IQR 2), and 4 (IQR 2), respectively. In the short- (30 days) and long-term (mean 4.1 years), there were 27 and 318 deaths. In short-term, EuroSCORE II showed the best discrimination in the overall population and subgroup with unprotected LMCA [area under the curve (AUC) 0.804, 95% CI 0.717–0.890 and AUC 0.826, 95% CI 0.737–0.913, respectively, p < 0.001 for comparisons with other models), with the best cut-off value at 7.1%. In long-term observation, EuroSCORE II and ACEF showed good predictive value (overall population: AUC 0.716, 95% CI 0.680–0.750 and AUC 0.725, 95% CI 0.690–760, respectively). In short- and long-term observation, EuroSCORE II and ACEF showed poor calibration (HL test p < 0.05) as compared to CHA2DS2-VASc (HL test p = 0.40 and 0.18). Conclusions: EuroSCORE II showed good mortality prediction in short-term observation; however, its predicted risk should be interpreted with caution due to poor calibration. ACEF and EuroSCORE II may be useful in long-term mortality prediction. Full article
(This article belongs to the Special Issue Cardiovascular and Cerebrovascular Emergencies: Advances in Clinical Research)
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Review

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27 pages, 9700 KiB  
Review
Clinical and Neuroradiological Manifestations of Cerebral Amyloid Angiopathy: A Closer Look into the Natural History of a Frequent Disease
by Marialuisa Zedde, Fabrizio Piazza and Rosario Pascarella
J. Clin. Med. 2025, 14(5), 1697; https://doi.org/10.3390/jcm14051697 - 3 Mar 2025
Viewed by 1330
Abstract
Cerebral amyloid angiopathy (CAA) is one of the most prevalent small vessel diseases (SVDs). Its neuroradiological hallmarks are both hemorrhagic and non-hemorrhagic ones. Among the clinical manifestations, transient focal neurological episodes (TFNEs) are associated with an increased risk of bleeding in a short [...] Read more.
Cerebral amyloid angiopathy (CAA) is one of the most prevalent small vessel diseases (SVDs). Its neuroradiological hallmarks are both hemorrhagic and non-hemorrhagic ones. Among the clinical manifestations, transient focal neurological episodes (TFNEs) are associated with an increased risk of bleeding in a short time period and with convexal subarachnoid hemorrhage (SAH). The natural history of CAA is incompletely characterized in the literature, because the focus has been mostly on hemorrhagic events, while both clinical and non-hemorrhagic presentations are possible and sometimes underestimated. Furthermore, new diagnostic criteria have incorporated non-hemorrhagic Magnetic Resonance Imaging (MRI) markers and non-hemorrhagic clinical presentations. Disease trajectories are often individual and help provide food for thought and discussion on some issues, thus allowing for a greater and deeper evaluation. We, therefore, present a case that exemplifies how the natural history of CAA can be atypical compared to its expected course, which is long and not only hemorrhagic. Several episodes of CAA-related inflammation, with prevalent, but not exclusive, leptomeningeal involvement, were evaluated and treated in the presented case, in which the intraparenchymal cerebral hemorrhagic manifestation was the last in the patient’s history. CAA may have a very long natural history. During the disease’s course, inflammatory features might be prominent in neuroimaging but not strongly symptomatic, and intraparenchymal cerebral hemorrhage (ICH) may be a late event. The awareness of this subtype of the disease allows us to better explore the pathophysiology of CAA and to increase the level of clinical suspicion for the diagnosis. Furthermore, the distinction between different disease phenotypes can provide useful information for patient management in clinical practice. Full article
(This article belongs to the Special Issue Cardiovascular and Cerebrovascular Emergencies: Advances in Clinical Research)
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Other

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15 pages, 4425 KiB  
Systematic Review
Prevalence of Depression, Anxiety and Post-Traumatic Stress Disorder (PTSD) After Acute Myocardial Infarction: A Systematic Review and Meta-Analysis
by Ray Junrui Chong, Yunrui Hao, Emily Wei Qi Tan, Grace Jing Le Mok, Ching-Hui Sia, Jamie Sin Ying Ho, Mark Yan Yee Chan and Andrew Fu Wah Ho
J. Clin. Med. 2025, 14(6), 1786; https://doi.org/10.3390/jcm14061786 - 7 Mar 2025
Viewed by 790
Abstract
Background: Mental illnesses following an acute myocardial infarction (AMI) are a growing concern, as they are associated with worse outcomes for AMI patients. Our understanding of the prevalence of mental illnesses after an AMI is incomplete, as most studies investigate depression while [...] Read more.
Background: Mental illnesses following an acute myocardial infarction (AMI) are a growing concern, as they are associated with worse outcomes for AMI patients. Our understanding of the prevalence of mental illnesses after an AMI is incomplete, as most studies investigate depression while overlooking other conditions like anxiety and PTSD. Existing studies often rely on patient-reported questionnaires for mental illness diagnoses, a method that can be subjective. To address this, we conducted a systematic review and meta-analysis to determine the prevalence and risk factors of depression, anxiety, and PTSD after AMI, including only studies with formal mental illness diagnoses. Methods: Searches in MEDLINE, EMBASE, and PsycINFO up to 23 January 2025 identified 23 qualifying studies that assessed the prevalence of depression, anxiety, and PTSD after AMI, with cases defined exclusively by formal diagnoses established through psychiatrist-administered structured interviews according to the Diagnostic and Statistical Manual for Mental Disorders (DSM) criteria (versions III to V). For each outcome, the pooled prevalence was estimated using meta-analyses of proportions with random-effects models. If significant heterogeneity was detected, subgroup analyses and meta-regression were performed to explore the factors contributing to this heterogeneity. Results: A total of 25 studies were included in the meta-analysis. Among the 20 studies included, the pooled prevalence of depression after AMI was 23.58% (95% CI: 22.86%; 24.32%). When stratified by time since AMI, the prevalence was 19.46% (95% CI: 15.47%; 24.19%) for those assessed within 3 months and 14.87% (95% CI: 9.55%; 22.43%) for those assessed after 3 months. The pooled prevalence of anxiety (seven studies) and PTSD (three studies) was 11.96% (95% CI: 6.15; 21.96%) and 10.26% (95% CI: 5.49%; 18.36%), respectively. Further pooled prevalence subgroup analysis of depression and anxiety revealed significantly higher rates in the female sex (29.89%, 95% CI: 21.85; 39.41%), in those with hypertension (25.01%, 95% CI: 21.68; 28.67%), diabetes (25.01%, 95% CI: 21.68; 28.67%), or hyperlipidemia (28.96% 95% CI: 23.44; 35.17%), and in smokers (25.23%., 95% CI: 19.48; 32.00%), while the pooled prevalence of depression is higher in unmarried (35.44%, 95% CI: 19.61; 55.26%) than married individuals (28.63%, 95% CI: 18.67; 41.20%) and in those with a history of depression (57.41%, 95% CI: 31.47; 78.92%). The results of the meta-regression indicated that a prior history of depression was a significant predictor of depression prevalence (p = 0.0035, regression coefficient 1.54). Conclusions: The prevalence of mental illnesses, including depression, anxiety, and PTSD, is notable following an AMI. Identified risk factors encompass female sex, hypertension, diabetes mellitus, hyperlipidemia, smoking, a history of depressive illness, and social context. Full article
(This article belongs to the Special Issue Cardiovascular and Cerebrovascular Emergencies: Advances in Clinical Research)
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