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Neuro-Cardiology: An Obligation for Combined Care of Stress and Heart Diseases

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

Deadline for manuscript submissions: 20 January 2026 | Viewed by 859

Special Issue Editors


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Guest Editor
1. Cardiology Division, Montefiore Medical Center, Bronx, NY, USA
2. Albert Einstein College of Medicine, Bronx, NY, USA
Interests: early imaging biomarkers for heart diseases; novel imaging in the early diagnosis of heart failure for optimal medical management
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Guest Editor
Department of Cardiology, UCSF HEALTH, School of Medicine, Cardiac Imaging, San Francisco, CA, USA
Interests: stressed heart morphology; ultimate phases of hypertensive disease; hemodynamic stress and microscopic remodeling
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

The Editors described “microscopic remodeling” and the hazardous mechanism of superposed multiple stressors on heart tissue in the first edition (https://www.mdpi.com/journal/jcm/special_issues/clinical_frontiers_heart_failure).

Segmental awareness in heart imaging for the detection of the predominant septal base could be the answer for the missing link in undiagnosed hypertension with a high stress score before mortal outcomes. Stress is likely to produce a stress septal sign or “Triple S” on the septal base (free location from the vagus), reflecting the gray zone between chronic and acute stressful cases. Beyond excessive exercise or pressure overload in hypertension on third-generation microscopic USG, “Triple S” even develops in animals undergoing emotional stress. After the first edition, we are motivated because of positive feedback from scientists who acknowledge hypertension and underlying emotional problems via segmental awareness in individuals with “Triple S”. We strongly believe that physicians should make a note of exercise hypertension and high stress scores due to anxiety/panic in cases with incidentally detected “Triple S”. In this new Special Issue, a novel neuro-cardiological perspective will consolidate the knowledge on stress in heart tissue. All researchers are invited to contribute original works and reviews. Topics include, but are not limited to, the following:

  • Cardiovascular aspects of sympathetic overdrive as a stressor in hypertension.
  • Types of stressors.
  • Emotion in superposed multiple stressors.
  • Segmental awareness in heart USG.
  • Hemodynamic overload.
  • Imaging criteria of segmental remodeling.
  • Routine imaging of heart remodeling.
  • Triple S in hypertensive patients.
  • Hemodynamic fluctuations.
  • High stress score.
  • Exercise hypertension.
  • Chronic and acute stressful pathologies.

Prof. Dr. Mario J. Garcia
Prof. Dr. Fatih Yalcin
Guest Editors

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Keywords

  • neuro-cardiology
  • cardiovascular
  • segmental remodeling
  • stressors
  • hypertension
  • triple S

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Related Special Issue

Published Papers (1 paper)

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Review

13 pages, 4853 KB  
Review
Stress Septal Sign (Triple S) Preexists in Hypertensive Hearts and Clarifies Critical Diagnostic Strategies
by Fatih Yalçin, Boran Cagatay, M. Roselle Abraham and Mario J. Garcia
J. Clin. Med. 2025, 14(17), 6143; https://doi.org/10.3390/jcm14176143 - 30 Aug 2025
Viewed by 427
Abstract
The interventricular septum is recognized as the first region to undergo remodeling, and a septal bulge is described as an early echocardiographic sign of hypertensive heart disease. Using third-generation microscopic ultrasonography in an animal model, we validated, for the first time, that remodeling [...] Read more.
The interventricular septum is recognized as the first region to undergo remodeling, and a septal bulge is described as an early echocardiographic sign of hypertensive heart disease. Using third-generation microscopic ultrasonography in an animal model, we validated, for the first time, that remodeling originates in the basal septum, presenting as basal septal hypertrophy (BSH), an early imaging biomarker, and subsequently progresses to other regions, leading to tissue dysfunction and heart failure. We have termed this finding the “stress septal sign” (Triple S) because a variety of stress stimuli, such as treadmill exercise or pressure overload from aortic banding in animals, induced BSH, a region with more intensive sympathetic innervation than the mid-apex. This finding also represents a conjunctive point between functional etiologies, such as hypertension, and emotional etiologies that precipitate acute stress cardiomyopathy. Microscopic analysis of the remodeling revealed that hemodynamic stress has a specific effect on cardiac geometry. The Triple S is associated with exercise-induced hypertension and high stress scores in patients with hypertension. Furthermore, three-dimensional segmental remodeling is more effective than cross-sectional measurements for detecting the impact of superimposed multiple stressors. A high-rate pressure product and blood pressure variability in patients exhibiting the Triple S should be managed comprehensively through an integrated approach to stress and hypertension to avoid high mortality in clinical practice. A precise etiologic evaluation of incidentally detected BSH may contribute to the early diagnosis of hypertensive disease. The integrated and timely management of stress and hypertension is important for patients presenting with the Triple S and high stress scores. This management strategy may provide a practical solution for avoiding the adverse hypertensive consequences of global remodeling and maladaptation to superimposed multiple stressors. Full article
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