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Medicina
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Clinical Cardiology in a New Era: Navigating Challenges and Embracing...
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Clinical Cardiology in a New Era: Navigating Challenges and Embracing Opportunities

A special issue of Medicina (ISSN 1648-9144). This special issue belongs to the section "Cardiology".

Deadline for manuscript submissions: 31 May 2025 | Viewed by 2850

Special Issue Editors

Dr. Rayan Yousefzai

E-Mail Website
Guest Editor
Houston Methodist DeBakey Heart & Vascular Center, Houston Methodist Hospital, Houston, TX, USA
Interests: heart transplant; left ventricular assist devices; mechanical circulatory support; heart failure; cardiomyopathy; ischemic heart disease; cardiac amyloidosis; infiltrative heart disease; heart catheterization
Prof. Dr. Cindy M. Martin

E-Mail Website
Guest Editor
Lillehei Heart Institute and Cardiovascular Division, Department of Medicine, University of Minnesota, Minneapolis, MN, USA
Interests: cardiology; regeneration; congenital heart disease; genetic heart defects; heart rhythm disorders; heart failure; coronary artery disease; transplantation

Special Issue Information

Dear Colleagues,

The realm of cardiovascular medicine is witnessing an unprecedented pace of evolution, characterized by continual breakthroughs in technologies, diagnostic methodologies, and therapeutic interventions. Novel devices and therapeutic strategies are incessantly introduced, altering the landscape and extending the scope of cardiology subspecialties.

Amid this rapid metamorphosis, we have observed the emergence of novel subspecialties, alterations in patient roles, and modifications in payment models, all of which have led to myriad challenges and, simultaneously, bountiful opportunities within the domain.

The approach to cardiology has transitioned from individual decision making to a heart-team-based practice. This paradigm necessitates an extensive amount of coordination and a multidisciplinary approach, seeing as multiple subspecialties may interface with a single patient. Concurrently, the significant overlap and increasing complexity of these subspecialties have engendered the creation of new areas of focus and specialization, necessitating the continual evolution of training paths to align with the dynamic needs of the field.

The escalation in the prevalence of cardiovascular disease, exacerbated by an aging population, has augmented the associated costs. In the USA, cardiovascular diseases and stroke incur an estimated annual cost of USD 316.6 billion, with projections indicating that over 40% of the population will be afflicted by cardiovascular disease by 2030. A similar scenario is unfolding in Europe, where cardiovascular diseases account for 47% of all deaths and impose an estimated annual economic burden of nearly EUR 196 billion. As the complexity and costs of cardiovascular care escalate, it is imperative that therapeutic decision making incorporates evaluations of efficacy, effectiveness, and rigorous cost–benefit and cost–effectiveness analyses.

Historically marginalized populations continue to experience disproportionately elevated rates of cardiovascular diseases and associated risk factors. Despite the demonstrated efficacy of evidence-based practices in enhancing outcomes, these populations encounter the most significant barriers to accessing these advanced practices. To ameliorate overall population health, it is crucial to bridge this disparity and establish pathways to facilitate cardiovascular health equity.

Recognizing the intricacies and the continual evolution endemic to cardiovascular medicine, Medicina is honored to announce the launch of a Special Issue titled “Clinical Cardiology in a New Era: Navigating Challenges and Embracing Opportunities”. This Special Issue seeks to collect insights from eminent experts across diverse subspecialties to delve into the multifaceted, transformative, and rapidly progressing field of cardiovascular medicine and the shifting healthcare landscape, thereby outlining prospective pathways for this domain.

We extend a warm invitation to you and your distinguished colleagues to contribute your original manuscripts to this journal, aiding in the illumination of the diverse and rapidly advancing dimensions of cardiovascular medicine.

Dr. Rayan Yousefzai
Prof. Dr. Cindy M. Martin
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. Medicina 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 2200 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 medicine
  • cardiology subspeciality
  • cardiomyopathy

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Published Papers (3 papers)

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12 pages, 3300 KiB  
Article
Impact of the Type of Anticoagulation Therapy on Long-Term Clinical Outcomes in Patients with Coronary Bifurcation Lesion and Atrial Fibrillation—Insights from the Bulgarian Bifurcation Registry
by Niya Mileva, Dobrin Vassilev, Panayot Panayotov, Pavel Nikolov, Georgi Dimitrov, Kiril Karamfiloff, Gianluca Rigatelli and Robert J. Gil
Medicina 2024, 60(8), 1294; https://doi.org/10.3390/medicina60081294 - 10 Aug 2024
Viewed by 606
Abstract
Background and Objectives: Patients with atrial fibrillation and coronary artery disease represent a group with a greater risk of mortality. To evaluate patients with atrial fibrillation (AF) and a significant coronary bifurcation lesion and compare the clinical outcomes between the patients on [...] Read more.
Background and Objectives: Patients with atrial fibrillation and coronary artery disease represent a group with a greater risk of mortality. To evaluate patients with atrial fibrillation (AF) and a significant coronary bifurcation lesion and compare the clinical outcomes between the patients on anticoagulant treatment with Vitamin K antagonist (VKA) and those on direct anticoagulant (DOAC). Materials and Methods: This is a prospective study of patients with AF and stable coronary artery disease, who had evidence of a significant coronary bifurcation lesion. A log-rank test was used to assess the difference in mortality between patients taking VKA and those on DOAC. The primary endpoint was the incidence of all-cause and cardiovascular death at mid-term. Results: A total of 226 patients with AF and a significant bifurcation lesion were included. The mean age was 70.9 ± 9.2, and 70% were males. Of the patients, 123 (54.7%) were on VKA treatment, and 103 (45.3%) were taking DOAC. For a median follow-up time of 55 (39–96) months, overall mortality was 40%, whereas CV mortality was 31%. Both all-cause (28.2% versus 50.4%, p = 0.020) and CV death (12.7% versus 24.9%, p = 0.032) were significantly lower in patients taking DOAC versus those on VKA. In patients treated with PCI, CV mortality was significantly lower in patients taking DOAC (21.4% versus 40.5%, p = 0.032). VKA therapy was an independent predictor of cardiovascular death (HR 1.88; 95% CI 1.11–3.18; p = 0.01), together with chronic kidney disease (HR 1.81; 95% CI 1.13–2.92; p = 0.01). Conclusions: Treatment with DOAC in patients with atrial fibrillation and coronary bifurcation lesion was associated with significantly lower mortality independently of the treatment approach. VKA was an independent predictor of CV mortality. Full article
(This article belongs to the Special Issue Clinical Cardiology in a New Era: Navigating Challenges and Embracing Opportunities)
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13 pages, 1728 KiB  
Article
Influence of Aortic Arch Morphology on Renal Perfusion in Patients with Coarctation of the Aorta: An Exploratory Study
by Sigitas Cesna, Augustinas Bielinis, Tadas Zvirblis, Marius Miglinas and Virgilijus Tarutis
Medicina 2024, 60(6), 886; https://doi.org/10.3390/medicina60060886 - 28 May 2024
Viewed by 979
Abstract
Objectives: The configuration of the aortic arch, particularly a Gothic arch shape, in individuals with corrected coarctation of the aorta (CoA) has been associated with a decreased systolic wave amplitude across the arch, which could potentially impair renal perfusion and elevate the [...] Read more.
Objectives: The configuration of the aortic arch, particularly a Gothic arch shape, in individuals with corrected coarctation of the aorta (CoA) has been associated with a decreased systolic wave amplitude across the arch, which could potentially impair renal perfusion and elevate the risk of arterial hypertension. This study aims to explore the relationship between the morphological characteristics of the aortic arch and their impact on renal perfusion in patients with CoA. Methods: Seventy-one subjects with corrected CoA underwent continuous 24 h ambulatory blood pressure monitoring, computed tomography to assess the aortic arch, and renal perfusion scanning. Subjects were stratified into three groups based on the height-to-width (H/W) ratio of their aortic arch: Group 1 with a H/W ratio of <0.65, Group 2 with a H/W ratio between 0.65 and 0.85, and Group 3 with a H/W ratio of >0.85. Results: Groups 1 and 2 (53,78% and 62.63%) presented with a higher hypertension prevalence of elevated blood pressure than Group 3 (38.89%). Notable variations were observed among the subjects in the time to peak perfusion (Tmax) in the left kidney across the groups. Group 1 showed a median Tmax at 0.27, Group 2 at 0.13, and Group 3 at −0.38 (p-value = 0.079). The differences in Tmax for the right kidney followed a similar trend but were not statistically significant (Group 1 at 0.61, Group 2 at 0.22, and Group 3 at 0.11; p-value = 0.229). Conclusions: This study suggests that variations in the aortic arch morphology might not significantly influence renal perfusion in CoA patients. This indicates the potential adaptability of the renal blood flow, which appears to compensate for reduced perfusion, thus minimizing adverse effects on the kidney function. This adaptability suggests an inherent physiological resilience, emphasizing the need for further targeted research to understand the specific interactions and impacts on treatment strategies for CoA. Full article
(This article belongs to the Special Issue Clinical Cardiology in a New Era: Navigating Challenges and Embracing Opportunities)
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8 pages, 2502 KiB  
Brief Report
Handheld 6-Lead ECG for Early Detection of Acute Inferior Wall ST-T Segment Elevation Myocardial Infarction: HINT-MI Study Design and Rationale
by Sodam Jung, In-Sook Kang, Sanghoon Shin, Choongki Kim and Junbeom Park
Medicina 2024, 60(7), 1164; https://doi.org/10.3390/medicina60071164 - 18 Jul 2024
Viewed by 877
Abstract
Background: ST-T segment elevation myocardial infarction (STEMI) is a critical condition that requires rapid diagnosis and treatment. Recently, various ECG recording devices have been developed. In this study, we aim to determine the utility of a 6-lead handheld ECG recording device to [...] Read more.
Background: ST-T segment elevation myocardial infarction (STEMI) is a critical condition that requires rapid diagnosis and treatment. Recently, various ECG recording devices have been developed. In this study, we aim to determine the utility of a 6-lead handheld ECG recording device to shorten the time taken for the diagnosis of inferior wall STEMI. Methods and Design: HINT-MI is an investigator-derived, observational, prospective study that will evaluate the ability of a handheld 6-lead ECG device to diagnose acute inferior wall STEMI. Patients who have undergone coronary angiography for STEMI or for other reasons will be enrolled in the study. This study aims to evaluate sensitivity and specificity of a handheld 6-lead ECG device by the level of agreement with a standard 12-lead ECG for diagnosing inferior wall STEMI. Further, we will determine whether the use of the handheld device can reduce the time needed for reperfusion treatment through faster diagnosis. Conclusions: This study aims to investigate the feasibility of a handheld 6-lead ECG device for diagnosing inferior wall STEMI to reduce the time required to diagnose inferior wall STEMI and to allow timely treatment. Full article
(This article belongs to the Special Issue Clinical Cardiology in a New Era: Navigating Challenges and Embracing Opportunities)
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