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Medicina
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Insights into Cardiovascular Diseases
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Insights into Cardiovascular Diseases

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

Deadline for manuscript submissions: 1 November 2024 | Viewed by 4919

Special Issue Editors

Dr. Vilnis Dzerve

E-Mail Website
Guest Editor
Institute of Cardiology and Regenerative Medicine, University of Latvia, Riga, Latvia
Interests: preventive cardiology; epidemiology of non-communicable diseases; research in hypertension
Prof. Dr. Aivars Lejnieks

E-Mail Website
Guest Editor
Department of Internal Diseases, Riga Stradins University, Riga, Latvia
Interests: metabolic problems; diabetes mellitus; cardiovascular risk factors; arterial hypertension; amiloidosis; osteoporosis
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Cardiovascular medicine is changing rapidly with the development, testing and introduction of new diagnostic and therapeutic methods. The utility of the widespread advent of wearable and implantable technologies, such as those for preventing, detecting and diagnosing cardiovascular diseases, is only just being explored. New technologies and treatment algorithms are showing great promise for achieving the ultimate aim of precision cardiology, i.e., personalized care tailored to individual patients.

With precision medicine methodology cardiologists should be able to predict which patients are at risk, and intervene at the right time.

This Special Issue will highlight the latest findings in the field of cardiovascular diseases, including the pathogenesis and mechanisms underlying the development of CVD, with a particular emphasis of new techniques and methods for personalized monitoring, diagnosis and treatment, aiming to promote implementation of the latest scientific discoveries and modern technologies into clinical practice to improve patient survival and quality of life. We would like to highlight three desired publication topics:

1) Clinical and epidemiological studies and systematic reviews with a focus on the management of cardiovascular disease;

2) Scientific and clinical, from all areas of cardiovascular imaging, including echocardiography, magnetic resonance, computed tomography, nuclear and invasive imaging, and the role of invasive intravascular imaging in advancing our understanding of the pathophysiology of atherosclerosis and the role of emerging non-invasive modalities in anatomical and functional assessment of atherosclerosis;

3) The development and investigation of new CVD markers, e.g., biochemical, cellular and imaging parameters which offer further refinement.

Authors are invited to contribute reviews, original papers and case reports.

Dr. Vilnis Dzerve
Prof. Dr. Aivars Lejnieks
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 epidemiology
  • atherosclerosis
  • CVD markers
  • invasive cardiology
  • cardiovascular imaging
  • pharmacological algorithms

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Published Papers (4 papers)

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Research

16 pages, 1120 KiB  
Article
Lipid-Lowering Treatment Gaps in Patients after Acute Myocardial Infarction: Using Global Database TriNetX
by Grete Talviste, Mall Leinsalu, Peeter Ross and Margus Viigimaa
Medicina 2024, 60(9), 1433; https://doi.org/10.3390/medicina60091433 - 2 Sep 2024
Viewed by 668
Abstract
Background and Objectives: Patients with previous acute myocardial infarction are at significantly higher risk of recurrent events. Early and intensive lipid-lowering therapy targeting low-density lipoprotein cholesterol is a key strategy for reducing cardiovascular risk in post-acute myocardial infarction patients worldwide. This study aimed [...] Read more.
Background and Objectives: Patients with previous acute myocardial infarction are at significantly higher risk of recurrent events. Early and intensive lipid-lowering therapy targeting low-density lipoprotein cholesterol is a key strategy for reducing cardiovascular risk in post-acute myocardial infarction patients worldwide. This study aimed to assess patients’ real-life lipid-lowering treatment gaps after acute myocardial infarction using a global network, TriNetX, of anonymous, real-time patient data. The uniqueness of the study was the use of the novel, evolving, and constantly improving TriNetX platform and the evaluation of its feasibility for clinical research. Materials and Methods: A retrospective study was conducted on global repository patients in 2020, diagnosed with acute myocardial infarction, with a three-year follow-up. Results: After acute myocardial infarction, the prescribing rate of lipid-lowering medication (statins, ezetimibe and PCSK9I) was insufficient to reach target LDL-C values. The mean LDL-C level decreased from 2.7 mmol/L (103 mg/dL) as measured on the day of AMI to 1.97 mmol/L (76 mg/dL) between 31D and 3M. During the second and third years, the mean LDL-C value was stable (around 2.0 mmol/L (78 mg/dL)). LDL-C goals were not sufficiently reached, as only 7–12% of patients were reported to have LDL-C values < 55 mg/dL (1.4 mmol/L) and 13–20% of patients were reported to have LDL-C values < 70 mg/dL (1.8 mmol/L) during the follow-up periods. This means that a substantial number of patients remain at a very high risk for CV complications and mortality. Most cardiovascular complications happen within three months after acute myocardial infarction. Conclusions: Gaps remain between the recommendations for managing LDL-C in guidelines and what occurs in real life. The TriNetX platform is an innovative platform with significant potential and should be further developed for clinical research, as it enables the use of valuable interinstitutional data. Full article
(This article belongs to the Special Issue Insights into Cardiovascular Diseases)
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11 pages, 2158 KiB  
Article
Bioresorbable Scaffold Use in Coronary Chronic Total Occlusions: A Long-Term, Single-Center Follow-Up Study
by Dace Sondore, Ieva Briede, Matiss Linde, Karlis Trusinskis, Inga Narbute, Sanda Jegere, Aigars Lismanis, Indulis Kumsars, Karlis Grikis, Uldis Strazdins and Andrejs Erglis
Medicina 2024, 60(8), 1233; https://doi.org/10.3390/medicina60081233 - 30 Jul 2024
Viewed by 1115
Abstract
Background and Objectives: Percutaneous coronary intervention (PCI) of chronic total occlusion (CTO) is often associated with longer total stent length. Our aim was to evaluate the long-term safety and effectiveness of bioresorbable scaffold (BRS) implantation in CTO to avoid using a full metal [...] Read more.
Background and Objectives: Percutaneous coronary intervention (PCI) of chronic total occlusion (CTO) is often associated with longer total stent length. Our aim was to evaluate the long-term safety and effectiveness of bioresorbable scaffold (BRS) implantation in CTO to avoid using a full metal jacket. Materials and Methods: We conducted a single-center prospective longitudinal case study including 34 patients who underwent PCI of CTO with at least one BRS and drug-eluting stent (DES) implantation (n = 27) or BRS-only at the Latvian Centre of Cardiology between 2016 and 2018. Quantitative coronary angiography (QCA) and intravascular ultrasound were performed during the index procedure and long-term follow-up. Results: Of 34 patients with a mean age of 60.6 ± 9.5 years, 76.5% were male. The most common CTO artery was the right coronary artery (73.5%, n = 25). The median length of occlusion was 23.0 mm (interquartile range (IQR) = 13.9–32.7), with a total mean BRS/DES length of 49.6 ± 20.4 mm. During the median follow-up of 5.6 years (IQR = 5.0–5.9), the primary endpoint of target vessel re-occlusion occurred in 5.9% (n = 2) of patients. Target lesion revascularization (TLR) was performed in 35.3% (n = 12) of patients, with a mean time to TLR of 62.5 (95% confidence interval (CI), 53.9–71.2) months. Through QCA, there was a statistically significant increase in median residual diameter stenosis (20.1–31.4%, p < 0.01) and residual length of stenosis (5.2–7.1%, p = 0.04) compared with the index procedure. Conclusions: Our study demonstrates that BRS is a safe and feasible option for PCI of CTO, allowing for the avoidance of long segment stenting and ensuring long-term patency of the coronary artery. Full article
(This article belongs to the Special Issue Insights into Cardiovascular Diseases)
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10 pages, 481 KiB  
Article
Differences in Heart Rate Variability in the Frequency Domain between Different Groups of Patients
by Artūrs Garbilis and Jānis Mednieks
Medicina 2024, 60(6), 900; https://doi.org/10.3390/medicina60060900 - 29 May 2024
Cited by 1 | Viewed by 1042
Abstract
Background and Objectives: Heart rate variability (HRV) is defined as a physiological variation in duration between sinus beats. The aim of this study was to research and analyze the HRV between various groups of patients. Materials and Methods: A retrospective study [...] Read more.
Background and Objectives: Heart rate variability (HRV) is defined as a physiological variation in duration between sinus beats. The aim of this study was to research and analyze the HRV between various groups of patients. Materials and Methods: A retrospective study was conducted in an outpatient setting. Patients who had undergone a tilt-table test were selected for this study and were divided into three groups based on their self-reported health anamnesis: group 1 (n = 84, mean age 45.8 ± 17.8) consisted of patients with no known orthostatic intolerance or neurodegenerative disease, group 2 consisted of patients with a known or suspected orthostatic intolerance (n = 50, mean age 46.5 ± 18.6), and group 3 consisted of patients with a known or suspected neurodegenerative disorder (n = 29, mean age 55.6 ± 20.4). During the tilt-table test, HRV frequency-domain parameters—normalized low frequency (LFnu) and high frequency (HFnu), absolute powers—absolute low frequency (LF-RRI), absolute high frequency (HF-RRI), and LF/HF ratio—were recorded during 5 min rest in the supine position. Results: Group 1 had a reduced LFnu at 52.93% (SD: 18.00) compared to group 2 at 58.57% (18.06) and group 3 at 61.80% (SD: 17.74), and group 1 had increased HFnu: group 1—47.08% (SD: 17.97), group 2—41.41% (SD: 18.03), and group 3—38.16% (SD: 14.7). LFnu and HFnu differences were statistically significant (p < 0.05). LF-RRI was reported as follows: group 1—531.32 ms2 (SD: 578.57), group 2—346.2 ms2 (SD: 447.96), and group 3—143.21 ms2 (SD: 166.96). HF-RRI was reported as follows: group 1—835.87 ms2 (SD: 1625.42), group 2—297.46 ms2 (SD: 507.15), and group 3—70.83 ms2 (SD: 75.67). LF-RRI and HF-RRI comparisons between groups were statistically significant (p < 0.001). LF/HF ratios were reported as follows: group 1—1.91 (SD: 2.29), group 2—2.43 (SD: 2.33), and group 3–2.54 (SD: 2.17). LF/HF ratio comparisons between groups were statistically significant at p < 0.05. Conclusions: This study shows that patients with known or suspected orthostatic intolerance and neurodegenerative disorders have reduced HRV, possibly caused by reduced parasympathetic modulation. HRV in patients with known or suspected neurodegenerative disorders is reduced more severely than in patients with orthostatic disorders. Other studies in HRV have indicated a possible increase of risk in cardiovascular disorders in patients with reduced HRV, and therefore, HRV analysis could be a potential clinical diagnostic tool. However, the lack of universally agreed upon methodology, reference values, and possible external and internal factor influence hinders the introduction of HRV examinations into wider clinical practice. Full article
(This article belongs to the Special Issue Insights into Cardiovascular Diseases)
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9 pages, 905 KiB  
Article
The Relationship between Frontal QRS-T Angle and Vitamin D Deficiency
by Fulya Avcı Demir, Gülsüm Bingöl, İbrahim Ersoy, Akif Arslan, Pınar Ersoy, Meltem Demir and Serkan Ünlü
Medicina 2024, 60(5), 776; https://doi.org/10.3390/medicina60050776 - 7 May 2024
Viewed by 1406
Abstract
Background and Objectives: A deficiency in serum 25-hydroxyvitamin D levels is associated with a number of cardiovascular situations, such as high blood pressure, heart failure, atherosclerotic heart disease, and peripheral artery disease. The frontal QRS-T angle has recently been proposed as a [...] Read more.
Background and Objectives: A deficiency in serum 25-hydroxyvitamin D levels is associated with a number of cardiovascular situations, such as high blood pressure, heart failure, atherosclerotic heart disease, and peripheral artery disease. The frontal QRS-T angle has recently been proposed as a marker of ventricular repolarization. A wider frontal QRS-T angle has been positively correlated with adverse cardiac events. The objective of our study was to examine the association between serum 25-hydroxyvitamin D level and the frontal QRS-T angle. Materials and Methods: A total of 173 consecutive patients aged 18–60 years undergoing routine cardiology check-up evaluation, and not receiving concurrent vitamin D treatment were included in the study. Patients were classified in three groups, depending on their vitamin D levels, and categorized as follows: Group 1—deficient (<20 ng/mL), Group 2—insufficient (20–29 ng/mL), or Group 3—optimal (≥30 ng/mL). The frontal QRS-T angle was determined using the automated reports generated by the electrocardiography machine. Results: The average age of participants was 45.8 (±12.2) years, and 55.5% of participants were female (p < 0.001). Individuals with low vitamin D concentrations exhibited a wider frontal QRS-T angle. It was determined that vitamin D level is an independent predictive factor for the frontal QRS-T angle. Conclusions: As the levels of 25-hydroxyvitamin D decrease, repolarization time assessed by frontal QRS-T angle is widened. Our findings indicate that lower concentrations of vitamin D may increase the susceptibility to ventricular arrhythmia. Full article
(This article belongs to the Special Issue Insights into Cardiovascular Diseases)
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