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Atherosclerotic Cardiovascular Disease: Risk Assessment, Prevention and Treatment Strategies
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Atherosclerotic Cardiovascular Disease: Risk Assessment, Prevention and Treatment Strategies

A special issue of Journal of Cardiovascular Development and Disease (ISSN 2308-3425).

Deadline for manuscript submissions: closed (31 May 2022) | Viewed by 31718

Special Issue Editors

Dr. Miran Sebestjen

E-Mail Website
Guest Editor
1. Advanced Heart Failure and Transplantation Center, Department of Cardiology, University Medical Center Ljubljana, 1000 Ljubljana, Slovenia
2. Department of Internal Medicine, Faculty of Medicine, University of Ljubljana, 1000 Ljubljana, Slovenia
Interests: endothelial dysfunction; vascular medicine; hypertension; endothelial function; atherosclerosis; cardiovascular medicine; cholesterol; endothelium; cardiology
Prof. Dr. Juš Kšela

E-Mail
Guest Editor
Department of Cardiovascular surgery, University Medical Center Ljubljana, 1000 Ljubljana, Slovenia
Interests: advanced heart failure; heart transplantation; ischemic heart disease

Special Issue Information

Dear Colleagues,

Despite enormous progress in the management of cardiovascular diseases, they are still one of the most important causes of morbidity and mortality in the Western world. The term “cardiovascular diseases” encompasses a broad group of different clinical manifestations such as ischemic heart disease, heart failure, rhythm disturbances, peripheral artery disease, cerebrovascular disease, and others. This Special Issue will address all these states of atherosclerosis, focusing in particular on risk assesment, prevention, and treatment strategies. Special emphasis will be placed on the recent advances in non-invasive and invasive treatment of atherosclerotic cardiovascular disease as well as novel protocols for the early diagnosis of high-risk patients and the identification of those who will benefit the most from different treatment options. You are kindly invited to contribute original research or a review paper on any aspect related to the topic of this Special Issue. This may also be an opportunity not only for cardiologist and cardiac surgeons but for a broad spectrum of researchers dealing with preclinical or clinical research of atherosclerosis.

Prof. Dr. Miran Šebeštjen
Prof. Dr. Juš Kšela
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. 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

  • cardiovascular diseases
  • atherosclerosis
  • risk stratification
  • prevention
  • novel treatment strategies

Published Papers (15 papers)

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Editorial

Jump to: Research, Review

4 pages, 196 KiB  
Editorial
Atherosclerotic Cardiovascular Disease: Risk Assessment, Prevention and Treatment Strategies
by Jernej Jeras, Sabina Ugovšek, Andreja Rehberger Likozar and Miran Šebeštjen
J. Cardiovasc. Dev. Dis. 2022, 9(12), 460; https://0-doi-org.brum.beds.ac.uk/10.3390/jcdd9120460 - 14 Dec 2022
Viewed by 1105
Abstract
Despite enormous advances in both surgical and pharmacological treatment, cardiovascular diseases are still the most common cause of morbidity and disability in the western world [...] Full article
(This article belongs to the Special Issue Atherosclerotic Cardiovascular Disease: Risk Assessment, Prevention and Treatment Strategies)

Research

Jump to: Editorial, Review

11 pages, 772 KiB  
Article
TNF-α Predicts Endothelial Function and Number of CD34+ Cells after Stimulation with G-CSF in Patients with Advanced Heart Failure
by Sabina Ugovšek, Andreja Rehberger Likozar, Sanjo Finderle, Gregor Poglajen, Renata Okrajšek, Bojan Vrtovec and Miran Šebeštjen
J. Cardiovasc. Dev. Dis. 2022, 9(8), 281; https://0-doi-org.brum.beds.ac.uk/10.3390/jcdd9080281 - 20 Aug 2022
Cited by 2 | Viewed by 1316
Abstract
Patients with advanced heart failure (HF) have reduced cardiac output and impaired peripheral blood flow, which diminishes endothelial shear stress and consequently flow-mediated dilatation (FMD). The aim of our study was to find out whether endothelial dysfunction is associated with the number of [...] Read more.
Patients with advanced heart failure (HF) have reduced cardiac output and impaired peripheral blood flow, which diminishes endothelial shear stress and consequently flow-mediated dilatation (FMD). The aim of our study was to find out whether endothelial dysfunction is associated with the number of CD34+ cells and TNF-α levels in patients with ischemic and non-ischemic HF after stimulation with granulocyte colony-stimulating factor (G-CSF). We included 56 patients with advanced HF (LVEF < 35%). Eighteen patients (32.14%) had ischemic and 38 (67.86%) patients had non-ischemic HF. FMD of the brachial artery was performed before the patients underwent 5-day bone marrow stimulation with daily subcutaneous injections of G-CSF (5 μg/kg bid). On the fifth day peripheral blood CD34+ cell count was measured. No statistically significant differences were found between the patient groups in NT-proBNP levels ((1575 (425–2439) vs. 1273 (225–2239)) pg/mL; p = 0.40), peripheral blood CD34+ cell count ((67.54 ± 102.32 vs. 89.76 ± 71.21) × 106; p = 0.32), TNF-α ((8.72 ± 10.30 vs. 4.96 ± 6.16) ng/mL; p = 0.13) and FMD (6.7 ± 5.4 vs. 7.2 ± 5.9%; p = 0.76). In a linear regression model, only FMD (p = 0.001) and TNF-α (p = 0.003) emerged as statistically significant predictors of CD34+ cells counts. Our study suggests that TNF-α is a good predictor of impaired endothelial function and of CD34+ cells mobilization after G-CSF stimulation in patients with advanced HF of ischemic and non-ischemic origin. Full article
(This article belongs to the Special Issue Atherosclerotic Cardiovascular Disease: Risk Assessment, Prevention and Treatment Strategies)
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10 pages, 449 KiB  
Article
The Effect of Aquatic Exercise Training on Heart Rate Variability in Patients with Coronary Artery Disease
by Borut Jug, Danijela Vasić, Marko Novaković, Viktor Avbelj, Lea Rupert and Juš Kšela
J. Cardiovasc. Dev. Dis. 2022, 9(8), 251; https://0-doi-org.brum.beds.ac.uk/10.3390/jcdd9080251 - 06 Aug 2022
Cited by 2 | Viewed by 1832
Abstract
(1) Background: Aquatic exercise training is a relatively understudied exercise modality in patients with CAD; with the present study, we sought to compare the impact of short-term 14-day water- and land-based exercise training on heart rate variability (HRV). (2) Methods: We randomized 90 [...] Read more.
(1) Background: Aquatic exercise training is a relatively understudied exercise modality in patients with CAD; with the present study, we sought to compare the impact of short-term 14-day water- and land-based exercise training on heart rate variability (HRV). (2) Methods: We randomized 90 patients after a recent CAD event (myocardial infarction and/or revascularization within 2 months prior to inclusion) to either (i) water-based or (ii) land-based exercise training (14 days, two 30 min sessions daily), or (iii) controls. Before and after the intervention period, all participants underwent 20 min 12-channel high-resolution ECG recordings with off-line HRV analysis, including conventional linear time- and frequency-domain analysis (using the Welch method for fast-Fourier transformation), and preselected non-linear analysis (Poincaré plot-derived parameters, sample entropy, and the short-term scaling exponent α1 obtained by detrended fluctuation analysis). (3) Results: Eighty-nine patients completed the study (mean age 60 ± 8 years; 20 % women). We did not detect significant differences in baseline- or age-adjusted end-of-study HRV parameters, but aquatic exercise training was associated with a significant increase in the linear LF/HF parameter (from 2.6 [1.2–4.0] to 3.0 [2.1–5.5], p = 0.046) and the non-linear α1 parameter (from 1.2 [1.1–1.4] to 1.3 [1.2–1.5], p = 0.043). (4) Conclusions: Our results have shown that a short-term 14-day aquatic exercise training program improves selected HRV parameters, suggesting this mode of exercise is safe and may be beneficial in patients with CAD. Full article
(This article belongs to the Special Issue Atherosclerotic Cardiovascular Disease: Risk Assessment, Prevention and Treatment Strategies)
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12 pages, 1126 KiB  
Article
Altered Heart Rate Turbulence and Variability Parameters Predict 1-Year Mortality in Heart Failure with Preserved Ejection Fraction
by Jus Ksela, Lea Rupert, Anze Djordjevic, Miha Antonic, Viktor Avbelj and Borut Jug
J. Cardiovasc. Dev. Dis. 2022, 9(7), 213; https://0-doi-org.brum.beds.ac.uk/10.3390/jcdd9070213 - 02 Jul 2022
Cited by 5 | Viewed by 2014
Abstract
Background: Heart failure with preserved ejection fraction (HFpEF) is a complex and heterogeneous clinical syndrome. In the absence of effective and potent treatment strategies, the main challenge in HFpEF management remains the availability of strong predictors of unfavourable outcomes. In our study, we [...] Read more.
Background: Heart failure with preserved ejection fraction (HFpEF) is a complex and heterogeneous clinical syndrome. In the absence of effective and potent treatment strategies, the main challenge in HFpEF management remains the availability of strong predictors of unfavourable outcomes. In our study, we sought to evaluate the potential prognostic value of heart rate turbulence (HRT) and variability (HRV) parameters on mortality in ambulatory HFpEF patients. Methods: This was a case–control study comparing HRT and HRV parameters in HFpEF survivors vs. non-survivors. Patients from the RESPOND Heart Failure Registry with HFpEF who underwent 24 h ECG monitoring (Holter) were included; HRT parameters (i.e., turbulence onset (TO) and turbulence slope (TS)) and HRV parameters (i.e., standard deviation of NN intervals (SDNN)) derived from 24 h Holter ECGs were calculated in patients who died within 12 months, and compared to their age-, gender-, LVEF-, ECHO-, aetiology-, and therapy-matched alive controls. Results: A total of 22 patients (mean age 80 ± 7 years, 18% female, mean LVEF 57 ± 9%) were included in the final analysis. In deceased patients, values of TO were significantly higher, and values of TS and SDNN were significantly lower as compared to survivors. Conclusions: HRT and HRV parameters have the ability to differentiate individuals with HFpEF who are at the greatest risk of unfavourable outcomes. The extent of autonomic disbalance as determined by HRT and HRV could potentially assist in the prognostic assessment and risk stratification of HFpEF patients. Full article
(This article belongs to the Special Issue Atherosclerotic Cardiovascular Disease: Risk Assessment, Prevention and Treatment Strategies)
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12 pages, 2014 KiB  
Article
Gene Expression Profiling of Markers of Inflammation, Angiogenesis, Coagulation and Fibrinolysis in Patients with Coronary Artery Disease with Very High Lipoprotein(a) Levels Treated with PCSK9 Inhibitors
by Katja Hrovat, Andreja Rehberger Likozar, Janja Zupan and Miran Šebeštjen
J. Cardiovasc. Dev. Dis. 2022, 9(7), 211; https://0-doi-org.brum.beds.ac.uk/10.3390/jcdd9070211 - 01 Jul 2022
Cited by 7 | Viewed by 1963
Abstract
Besides lipids, inflammation, angiogenesis, coagulation and fibrinolysis play very important roles in coronary artery disease (CAD). We measured gene expression of the inflammatory markers interleukin (IL)-1β (IL1B) and interferon (IFN)-γ (IFNG), vascular endothelial growth factor-A (VEGF-A) (VEGFA), [...] Read more.
Besides lipids, inflammation, angiogenesis, coagulation and fibrinolysis play very important roles in coronary artery disease (CAD). We measured gene expression of the inflammatory markers interleukin (IL)-1β (IL1B) and interferon (IFN)-γ (IFNG), vascular endothelial growth factor-A (VEGF-A) (VEGFA), and coagulation and fibrinolysis markers tissue factor (TF) (F3) and plasminogen activator inhibitor-1 (PAI-1) (SERPINE) in healthy controls and CAD patients with high lipoprotein(a) (Lp(a)). The aim of our study was to identify, first, if there is a difference in these markers between controls and patients; secondly, if these markers are associated with lipids; and third, what the influence of proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitors is on these markers. We included 124 subjects, 27 controls and 97 patients with CAD (30 in placebo and 67 in the PCSK9 group). Blood samples were collected for lipid and gene measurement. The results showed higher expression of IL1B (p < 0.0001), VEGFA (p < 0.0001), and F3 (p = 0.018) in controls in comparison with patients. Significant correlations were observed between IL1B and lipids. Treatment with PCSK9 inhibitors increased VEGFA (p < 0.0001) and F3 (p = 0.001), and decreased SERPINE (p = 0.043). The results of our study underpin the importance of IL-1β, VEGF-A and TF in CAD as well as the effect of PCSK9 treatment on these markers. Full article
(This article belongs to the Special Issue Atherosclerotic Cardiovascular Disease: Risk Assessment, Prevention and Treatment Strategies)
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10 pages, 799 KiB  
Article
Enhanced Detection of Cardiac Surgery-Associated Acute Kidney Injury by a Composite Biomarker Panel in Patients with Normal Preoperative Kidney Function
by Jurij Matija Kalisnik, Klemen Steblovnik, Eva Hrovat, Ales Jerin, Milan Skitek, Christian Dinges, Theodor Fischlein and Janez Zibert
J. Cardiovasc. Dev. Dis. 2022, 9(7), 210; https://0-doi-org.brum.beds.ac.uk/10.3390/jcdd9070210 - 01 Jul 2022
Cited by 3 | Viewed by 1630
Abstract
We have recently shown that minor subclinical creatinine dynamic changes enable the excellent detection of acute kidney injury (AKI) within 6–12 h after cardiac surgery. The aim of the present study was to examine a combination of neutrophil gelatinase-associated lipocalin (NGAL), cystatin C [...] Read more.
We have recently shown that minor subclinical creatinine dynamic changes enable the excellent detection of acute kidney injury (AKI) within 6–12 h after cardiac surgery. The aim of the present study was to examine a combination of neutrophil gelatinase-associated lipocalin (NGAL), cystatin C (CysC) and creatinine for enhanced AKI detection early after cardiac surgery. Elective patients with normal renal function undergoing cardiac surgery using cardiopulmonary bypass were enrolled. Concentrations of plasma NGAL, serum CysC and serum creatinine were determined after the induction of general anesthesia, at the termination of the cardiopulmonary bypass and 2 h thereafter. Out of 119 enrolled patients, 51 (43%) developed AKI. A model utilizing an NGAL, CysC and creatinine triple biomarker panel including sequential relative changes provides a better prediction of cardiac surgery-associated acute kidney injury than any biomarker alone already 2 h after the termination of the cardiopulmonary bypass. The area under the receiver-operator curve was 0.77, sensitivity 77% and specificity 68%. Full article
(This article belongs to the Special Issue Atherosclerotic Cardiovascular Disease: Risk Assessment, Prevention and Treatment Strategies)
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13 pages, 2385 KiB  
Article
Biventricular versus Conduction System Pacing after Atrioventricular Node Ablation in Heart Failure Patients with Atrial Fibrillation
by Maja Ivanovski, Miha Mrak, Anja Zupan Mežnar and David Žižek
J. Cardiovasc. Dev. Dis. 2022, 9(7), 209; https://0-doi-org.brum.beds.ac.uk/10.3390/jcdd9070209 - 01 Jul 2022
Cited by 15 | Viewed by 2849
Abstract
Conduction system pacing (CSP) modalities, including His-bundle pacing (HBP) and left bundle branch pacing (LBBP), are increasingly used as alternatives to biventricular (BiV) pacing in heart failure (HF) patients scheduled for pace and ablate strategy. The aim of the study was to compare [...] Read more.
Conduction system pacing (CSP) modalities, including His-bundle pacing (HBP) and left bundle branch pacing (LBBP), are increasingly used as alternatives to biventricular (BiV) pacing in heart failure (HF) patients scheduled for pace and ablate strategy. The aim of the study was to compare clinical outcomes of HF patients with refractory AF who received either BiV pacing or CSP in conjunction with atrio-ventricular node ablation (AVNA). Fifty consecutive patients (male 48%, age 70 years (IQR 9), left ventricular ejection fraction (LVEF) 39% (IQR 12)) were retrospectively analysed. Thirteen patients (26%) received BiV pacing, 27 patients (54%) HBP and 10 patients (20%) LBBP. All groups had similar baseline characteristics and acute success rate. While New York Heart. Association (NYHA) class improved in both HBP (p < 0.001) and LBBP (p = 0.008), it did not improve in BiV group (p = 0.096). At follow-up, LVEF increased in HBP (form 39% (IQR 15) to 49% (IQR 16), p < 0.001) and LBBP (from 28% (IQR 13) to 40% (IQR 13), p = 0.041), but did not change in BiV group (p = 0.916). Conduction system pacing modalities showed superior symptomatic and echocardiographic improvement compared to BiV pacing after AVNA. With more stable pacing parameters, LBBP could present a more feasible pacing option compared to HBP. Full article
(This article belongs to the Special Issue Atherosclerotic Cardiovascular Disease: Risk Assessment, Prevention and Treatment Strategies)
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13 pages, 882 KiB  
Article
Clinical Outcomes after Endovascular Revascularisation of the Femoropopliteal Arterial Segment in Patients with Anticoagulant versus Antiplatelet Therapy: A Single-Centre Retrospective Cohort Study
by Kevin Pelicon, Klemen Petek, Anja Boc, Vinko Boc, Nataša Kejžar, Tjaša Vižintin Cuderman and Aleš Blinc
J. Cardiovasc. Dev. Dis. 2022, 9(7), 207; https://0-doi-org.brum.beds.ac.uk/10.3390/jcdd9070207 - 30 Jun 2022
Cited by 2 | Viewed by 2140
Abstract
To prevent atherothrombotic events, patients with peripheral arterial disease are typically prescribed antiplatelet therapy (APT). However, some of them receive anticoagulant therapy (ACT) due to comorbidities. Our aim was to determine possible differences in the effectiveness and safety of both treatments in patients [...] Read more.
To prevent atherothrombotic events, patients with peripheral arterial disease are typically prescribed antiplatelet therapy (APT). However, some of them receive anticoagulant therapy (ACT) due to comorbidities. Our aim was to determine possible differences in the effectiveness and safety of both treatments in patients after endovascular femoropopliteal revascularisation. We retrospectively analysed 1247 patients after successful femoropopliteal revascularisation performed in a single tertiary medical centre and classified them into the ACT or APT group, based on their prescribed treatment. The groups were characterised by descriptive statistics, and their characteristics were adjusted for confounders by propensity score matching. Effectiveness and safety outcomes were assessed within one year after revascularisation. The odds ratio for the composite outcome of all-cause death, PAD exacerbation, and major amputation due to vascular causes with ACT versus APT was 1.21 (95% CI 0.53–2.21; p = 0.484). The odds ratio for major bleeding as defined by the International Society on Thrombosis and Haemostasis with ACT versus APT was 0.77 (95% CI 0.13–3.84; p = 0.251). We found no statistically significant difference in the effectiveness and safety of ACT, when compared to APT in patients with similar cardiovascular risk factors and other baseline characteristics. Further prospective research is warranted. Full article
(This article belongs to the Special Issue Atherosclerotic Cardiovascular Disease: Risk Assessment, Prevention and Treatment Strategies)
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8 pages, 470 KiB  
Article
Biological Variation in Rotational Thromboelastometry in Patients with Atrial Fibrillation Receiving Rivaroxaban
by Mojca Božič Mijovski, Jovan P. Antovic, Rickard E. Malmström and Alenka Mavri
J. Cardiovasc. Dev. Dis. 2022, 9(7), 205; https://doi.org/10.3390/jcdd9070205 - 29 Jun 2022
Cited by 1 | Viewed by 1234
Abstract
Rotational thromboelastometry (ROTEM) is a viscoelastic hemostasis test used primarily in the management of bleeding after trauma or in cardiac surgery. To allow safe and valid clinical interpretation of test results, objective specifications for analytical performance are needed, which are generally based on [...] Read more.
Rotational thromboelastometry (ROTEM) is a viscoelastic hemostasis test used primarily in the management of bleeding after trauma or in cardiac surgery. To allow safe and valid clinical interpretation of test results, objective specifications for analytical performance are needed, which are generally based on biological variation within (CVI) and between (CVG) individuals. The aim of this study was to evaluate biological variation in ROTEM in patients receiving rivaroxaban. Sixty patients with atrial fibrillation on stable rivaroxaban therapy were included, from whom blood was collected on six occasions: three times at trough and three at peak rivaroxaban concentrations. ROTEM® Extem and LowTF were measured as well as rivaroxaban concentration, PT, APTT, and anti-Xa. Within- (CVI) and between-subject (CVG) biological estimates were calculated. Knowledge of these biological variation components will help to establish the appropriate objective analytical performance specifications for ROTEM analysis. Full article
(This article belongs to the Special Issue Atherosclerotic Cardiovascular Disease: Risk Assessment, Prevention and Treatment Strategies)
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9 pages, 1111 KiB  
Article
Evaluation of the Appropriate Use of Coronary Computed Tomography Angiography: A Retrospective, Single-Center Analysis
by Katharina Birkl, Christoph Beyer, Fabian Plank, Gudrun Maria Feuchtner and Guy Friedrich
J. Cardiovasc. Dev. Dis. 2022, 9(6), 180; https://0-doi-org.brum.beds.ac.uk/10.3390/jcdd9060180 - 04 Jun 2022
Cited by 2 | Viewed by 1698
Abstract
Purpose: We assessed the application of appropriate use criteria of coronary computed tomography angiography (CCTA) in comparison to invasive coronary angiography results and revascularization rates in patients with coronary artery disease (CAD). Methods: 1305 patients referred to invasive coronary angiography (ICA) after CCTA [...] Read more.
Purpose: We assessed the application of appropriate use criteria of coronary computed tomography angiography (CCTA) in comparison to invasive coronary angiography results and revascularization rates in patients with coronary artery disease (CAD). Methods: 1305 patients referred to invasive coronary angiography (ICA) after CCTA were evaluated retrospectively. The primary indication for CCTA was assessed according to the consensus for intermediate-risk (15–85% pre-test probability) into appropriate (A), inappropriate (I), and uncertain while referring to published guidelines. Patients’ risk factors, angina, and heart failure symptoms (Canadian Cardiovascular Society classification (CCSC), New York Heart Association (NYHA); clinical data; and ICA results were gathered. Results: Of 1305 patients referred to CCTA prior to ICA, 496 (38.0%) were appropriate, 766 (56.9%) inappropriate, and 43 (3.3%) uncertain. Of 766 patients with inappropriate CCTA referrals, 370 (48.3%) were classified as “inappropriately low” (<15% pre-test probability) and 396 (51.7%) as “inappropriately high” (>85%) in regard to the recommended CCTA utilization. Sub-analysis of the adherence to the appropriate use criteria did not differ between the source of the referring physicians (intramural tertiary, private practice primary care, or external secondary care hospitals). Obstructive CAD with subsequent revascularization rates (total of 39.2%) did not differ significantly between the appropriate (38.3%), inappropriate (41.0%), or uncertain (23.3%) groups (p = 0.068). Conclusion: The total coronary revascularization rate after CCTA was 39.2% and not different among low, intermediate, and pre-test probability groups. These findings support the role of CCTA as an excellent gatekeeper in patients with suspected obstructive CAD even beyond pre-test probability calculation models. Full article
(This article belongs to the Special Issue Atherosclerotic Cardiovascular Disease: Risk Assessment, Prevention and Treatment Strategies)
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9 pages, 1069 KiB  
Article
The Cardiovascular-Mortality-Based Estimate for Normal Range of the Ankle–Brachial Index (ABI)
by Essi Peltonen, Mirjami Laivuori, Damir Vakhitov, Päivi Korhonen, Maarit Venermo and Harri Hakovirta
J. Cardiovasc. Dev. Dis. 2022, 9(5), 147; https://0-doi-org.brum.beds.ac.uk/10.3390/jcdd9050147 - 05 May 2022
Cited by 5 | Viewed by 3865
Abstract
Background: The ankle–brachial index (ABI) is a first-line examination in cardiovascular risk evaluation. Since cut-off values for normal ABI vary, the aim of the present study was to identify the cardiovascular-mortality-based estimate for the normal range of the ABI. After determining the reference [...] Read more.
Background: The ankle–brachial index (ABI) is a first-line examination in cardiovascular risk evaluation. Since cut-off values for normal ABI vary, the aim of the present study was to identify the cardiovascular-mortality-based estimate for the normal range of the ABI. After determining the reference range for the ABI, the corresponding toe–brachial index (TBI) and toe pressure for normal ABI were analyzed. Methods: All consecutive non-invasive pressure measurements in the vascular laboratory of a large university hospital 2011–2013 inclusive were collected and combined with patient characteristics and official dates and causes of death. Patients with an ABI range of 0.8–1.4 on both lower limbs were included in this study. Results: From 2751 patients, 868 had bilateral ABI values within the inclusion. Both ABI category ranges 0.80–0.89 and 0.90–0.99 had poorer survival compared to ABI categories 1.00–1.29 (p < 0.05). The 1-, 3-, and 5-year cardiovascular-death-free survival for respective ABI categories 0.80–0.99 vs. 1.00–1.29 were 90% vs. 96%, 84% vs. 92%, and 60% vs. 87%. The 1-, 3-, and 5-year overall survival for ABI categories 0.80–0.99 vs. 1.00–1.29 were 85% vs. 92%, 75% vs. 83%, and 42% vs. 74%. Conclusions: Borderline ABI (0.90–0.99) associates with higher overall and cardiovascular mortality compared to ABI values 1.00–1.29. Full article
(This article belongs to the Special Issue Atherosclerotic Cardiovascular Disease: Risk Assessment, Prevention and Treatment Strategies)
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12 pages, 739 KiB  
Article
The Influence of Treatment with PCSK9 Inhibitors and Variants in the CRP (rs1800947), TNFA (rs1800629), and IL6 (rs1800795) Genes on the Corresponding Inflammatory Markers in Patients with Very High Lipoprotein(a) Levels
by Tina Levstek, Nik Podkrajšek, Andreja Rehberger Likozar, Miran Šebeštjen and Katarina Trebušak Podkrajšek
J. Cardiovasc. Dev. Dis. 2022, 9(5), 127; https://0-doi-org.brum.beds.ac.uk/10.3390/jcdd9050127 - 22 Apr 2022
Cited by 7 | Viewed by 2189
Abstract
Chronic inflammation contributes significantly to the development and progression of atherosclerosis. However, the factors that lead to an inflammatory imbalance towards a proinflammatory state are not yet fully understood. The CRP rs1800947, TNFA rs1800629, and IL6 rs1800795 polymorphisms may play a role in [...] Read more.
Chronic inflammation contributes significantly to the development and progression of atherosclerosis. However, the factors that lead to an inflammatory imbalance towards a proinflammatory state are not yet fully understood. The CRP rs1800947, TNFA rs1800629, and IL6 rs1800795 polymorphisms may play a role in the pathogenesis of atherosclerosis and were therefore selected to investigate the influence of genetic variability on the corresponding plasma levels after treatment with a proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitor. A group of 69 patients with stable coronary artery disease after myocardial infarction before the age of 50 years and very high lipoprotein(a) levels were enrolled in the study. All patients received a PCSK9 inhibitor (evolocumab or alirocumab). Genotyping was performed using TaqMan assays (CRP rs1800947, TNFA rs1800629, and IL6 rs1800795). Consistent with previous studies, no significant change in levels of inflammatory biomarkers was observed after 6 months of treatment with PCSK9 inhibitors. We also did not detect any significant association between single nucleotide polymorphisms CRP rs1800947, TNFA rs1800629, and IL6 rs1800795 and plasma levels of high-sensitivity C-reactive protein (hsCRP), tumor necrosis factor-α (TNF-α), or interleukin 6 (IL6), respectively, at enrollment. However, the difference in IL6 levels after treatment with PCSK9 inhibitors was statistically significant (p = 0.050) in patients with IL6-74CC genotype, indicating the possible role of the IL6 rs1800795 polymorphism in modulating inflammation. Full article
(This article belongs to the Special Issue Atherosclerotic Cardiovascular Disease: Risk Assessment, Prevention and Treatment Strategies)
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17 pages, 917 KiB  
Article
Higher Levels of Stress-Related Hair Steroid Hormones Are Associated with the Increased SCORE2 Risk Prediction Algorithm in Apparently Healthy Women
by Eglė Mazgelytė, Neringa Burokienė, Agata Vysocka, Martynas Narkevičius, Tomas Petrėnas, Andrius Kaminskas, Jurgita Songailienė, Algirdas Utkus and Dovilė Karčiauskaitė
J. Cardiovasc. Dev. Dis. 2022, 9(3), 70; https://0-doi-org.brum.beds.ac.uk/10.3390/jcdd9030070 - 27 Feb 2022
Cited by 3 | Viewed by 2541
Abstract
Cardiovascular diseases (CVDs) are the major cause of death worldwide. Although the importance of conventional CVD risk factors, including older age, male gender, hypertension, obesity, dyslipidemia and hyperglycemia, is well-studied, psychosocial stress, which is considered an independent CVD risk factor, requires further investigation. [...] Read more.
Cardiovascular diseases (CVDs) are the major cause of death worldwide. Although the importance of conventional CVD risk factors, including older age, male gender, hypertension, obesity, dyslipidemia and hyperglycemia, is well-studied, psychosocial stress, which is considered an independent CVD risk factor, requires further investigation. Thus, we aimed to investigate the association between long-term secretion of stress-related steroid hormones, including cortisol, cortisone and dehydroepiandrosterone, and the 10-year fatal and non-fatal CVD risk estimated by the SCORE2 risk prediction algorithm, as well as traditional CVD risk factors in a group of apparently healthy women. A total of 145 women (aged 50–64 years) participating in the national CVD prevention program were enrolled in the study. Sociodemographic, lifestyle, health-related characteristics, stress, anxiety and sleep quality indicators were evaluated using specific questionnaires. Anthropometric and arterial blood pressure measures were assessed by trained personnel, lipid and glucose metabolism biomarkers were measured using routine methods, and hair steroid hormone levels were determined by ultra-high-performance liquid chromatography-tandem mass spectrometry. The results showed that higher levels of hair cortisol and cortisone are associated with increased SCORE2 values. Moreover, significant associations between hair glucocorticoids and individual cardiovascular risk factors, including obesity, hypertension, dyslipidemia and hyperglycemia, were found. These findings indicate that stress-related hair steroid hormones might be valuable biomarkers for CVD prediction and prevention. Full article
(This article belongs to the Special Issue Atherosclerotic Cardiovascular Disease: Risk Assessment, Prevention and Treatment Strategies)
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Review

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19 pages, 498 KiB  
Review
Contemporary Challenges of Regenerative Therapy in Patients with Ischemic and Non-Ischemic Heart Failure
by Marko Banovic, Gregor Poglajen, Bojan Vrtovec and Arsen Ristic
J. Cardiovasc. Dev. Dis. 2022, 9(12), 429; https://0-doi-org.brum.beds.ac.uk/10.3390/jcdd9120429 - 01 Dec 2022
Cited by 6 | Viewed by 1939
Abstract
It has now been almost 20 years since first clinical trials of stem cell therapy for heart repair were initiated. While initial preclinical data were promising and suggested that stem cells may be able to directly restore a diseased myocardium, this was never [...] Read more.
It has now been almost 20 years since first clinical trials of stem cell therapy for heart repair were initiated. While initial preclinical data were promising and suggested that stem cells may be able to directly restore a diseased myocardium, this was never unequivocally confirmed in the clinical setting. Clinical trials of cell therapy did show the process to be feasible and safe. However, the clinical benefits of this treatment modality in patients with ischemic and non-ischemic heart failure have not been consistently confirmed. What is more, in the rapidly developing field of stem cell therapy in patients with heart failure, relevant questions regarding clinical trials’ protocol streamlining, optimal patient selection, stem cell type and dose, and the mode of cell delivery remain largely unanswered. Recently, novel approaches to myocardial regeneration, including the use of pluripotent and allogeneic stem cells and cell-free therapeutic approaches, have been proposed. Thus, in this review, we aim to outline current knowledge and highlight contemporary challenges and dilemmas in clinical aspects of stem cell and regenerative therapy in patients with chronic ischemic and non-ischemic heart failure. Full article
(This article belongs to the Special Issue Atherosclerotic Cardiovascular Disease: Risk Assessment, Prevention and Treatment Strategies)
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12 pages, 304 KiB  
Review
Technical Aspects and Development of Transcatheter Aortic Valve Implantation
by Klemen Steblovnik and Matjaz Bunc
J. Cardiovasc. Dev. Dis. 2022, 9(8), 282; https://0-doi-org.brum.beds.ac.uk/10.3390/jcdd9080282 - 22 Aug 2022
Cited by 4 | Viewed by 2340
Abstract
Aortic stenosis is the most common valve disease requiring surgery or percutaneous treatment. Since the first-in-man implantation in 2002 we have witnessed incredible progress in transcatheter aortic valve implantation (TAVI). In this article, we review the technical aspects of TAVI development with a [...] Read more.
Aortic stenosis is the most common valve disease requiring surgery or percutaneous treatment. Since the first-in-man implantation in 2002 we have witnessed incredible progress in transcatheter aortic valve implantation (TAVI). In this article, we review the technical aspects of TAVI development with a look at the future. Durability, low thrombogenicity, good hydrodynamics, biocompatibility, low catheter profile, and deployment stability are the attributes of an ideal TAVI device. Two main design types exist—balloon-expandable and self-expanding prostheses. Balloon-expandable prostheses use a cobalt-chromium alloy frame providing high radial strength and radiopacity, while the self-expanding prostheses use a nickel-titanium (Nitinol) alloy frame, which expands to its original shape once unsheathed and heated to the body temperature. The valve is sewn onto the frame and consists of the porcine or bovine pericardium, which is specially treated to prevent calcinations and prolong durability. The lower part of the frame can be covered by polyethylene terephthalate fabric or a pericardial skirt, providing better sealing between the frame and aortic annulus. The main future challenges lie in achieving lower rates of paravalvular leaks and new pacemaker implantations following the procedure, lower delivery system profiles, more precise positioning, longer durability, and a good hemodynamic profile. Patient-specific design and the use of autologous tissue might solve these issues. Full article
(This article belongs to the Special Issue Atherosclerotic Cardiovascular Disease: Risk Assessment, Prevention and Treatment Strategies)
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