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Cardiovascular Diseases—From Risk Factors to Diagnosis and Personalized Management

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A special issue of Journal of Personalized Medicine (ISSN 2075-4426). This special issue belongs to the section "Epidemiology".

Deadline for manuscript submissions: closed (31 October 2023) | Viewed by 25196

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Special Issue Editors

Prof. Dr. Stefan Grajek

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Guest Editor

1st Department of Cardiology, Poznań University of Medical Sciences, 61-848 Poznań, Poland
Interests: coronary artery disease; myocardial infarction; antiplatelet therapy; risk scores

Prof. Dr. Marta I. Kałużna-Oleksy

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Guest Editor

1st Department of Cardiology, Poznań University of Medical Sciences, 61-848 Poznań, Poland
Interests: coronary artery disease; heart failure; biomarkers; target therapy; cardiac remodeling; proteomics; metabolomics
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Special Issue Information

Dear Colleagues,

This Special Issue of the JPM will highlight the current state of the art and show case some of the latest findings in the field of heart diseases, with a main focus on coronary artery disease, microcirculation, as well as all types of heart failure. This involves the evaluation of non-invasive and invasive diagnostic tools, biomarkers, expanded advanced risk factor analysis, risk scoring systems, cardiovascular genetics, gene expression testing, as well as research and debate about the prevention and treatment, especially focused on individualized approaches.

This Special Issue aims to provide researchers with an opportunity to publish both original research and review articles related to recent advances in coronary artery disease and heart failure, with a particular focus on holistic and personalized management as well as novel diagnostic, treatment, and prevention strategies using an interdisciplinary approach involving chemical, biological, physiological, pharmacological, physicochemical, and psychological perspectives.

Prof. Dr. Stefan Grajek
Prof. Dr. Marta I. Kałużna-Oleksy
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 Personalized Medicine 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 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

Coronary artery disease
Microcirculation
Heart failure
Risk factors
Biomarkers
Pharmacotherapy
Target treatment

Published Papers (11 papers)

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13 pages, 1169 KiB

Open AccessArticle

Association between Tonsillectomy and Cardiovascular Diseases in Adults

by Sung Joon Park, Sei Young Lee, Hahn Jin Jung, Min Woo Park, Hyo Geun Choi, Heejin Kim and Jee Hye Wee

J. Pers. Med. 2024, 14(1), 16; https://0-doi-org.brum.beds.ac.uk/10.3390/jpm14010016 - 21 Dec 2023

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Abstract

This study aimed to evaluate the association between tonsillectomy and cardiovascular diseases (CVDs) in the Korean adult population. Using data from the 2002–2015 Korean National Health Insurance Service-Health Screening Cohort, a total of 1082 participants aged 40 years or older who had undergone tonsillectomy were matched with 4328 control individuals for age, sex, income, and region of residence. We evaluated the incidence of CVDs in both the tonsillectomy and control groups and calculated the hazard ratios (HRs) of stroke, ischemic heart disease (IHD), and heart failure (HF) for participants who underwent tonsillectomy using a stratified Cox proportional hazard model. The incidence rates of stroke (81.3 vs. 46.6 per 10,000 person-years) and IHD (112.3 vs. 64.9 per 10,000 person-years) were significantly higher in patients who had undergone tonsillectomy than in the control group. After adjustment, the tonsillectomy group exhibited a 1.78-fold and 1.60-fold higher occurrence of stroke (CI = 1.32–2.42, p < 0.001) and IHD (CI = 1.24–2.08, p < 0.001), respectively, compared to the control group. However, there was no significant difference in the incidence rate of tonsillectomy and control groups (11.1 vs. 6.1 per 10,000 person-years). The HR of HF did not differ significantly between the tonsillectomy and control groups in the adjusted model (p = 0.513). We identified a significant relationship between a history of tonsillectomy and occurrence of stroke/IHD in the Korean adult population. Full article

(This article belongs to the Special Issue Cardiovascular Diseases—From Risk Factors to Diagnosis and Personalized Management)

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10 pages, 276 KiB

Open AccessArticle

Evaluation of Arterial Stiffness Parameters and the Growth Differentiation Factor-15 Level in Patients with Premature Myocardial Infarction

by Zekeriya Dogan, Cigdem Ileri, Esin A. Kay, Murat Sunbul, Emre Y. Gurel, Beste Özben Sadıc, Nurten Sayar, Tulin Ergun and Kursat M. Tigen

J. Pers. Med. 2023, 13(10), 1489; https://0-doi-org.brum.beds.ac.uk/10.3390/jpm13101489 - 13 Oct 2023

Viewed by 885

Abstract

Background: Myocardial infarction (MI) is increasing at a younger age. Growth differentiation factor-15 (GDF-15) has been implicated in several key mechanisms of atherogenesis. Arterial stiffness parameters, including pulse wave velocity (PWV) and the augmentation index (AIx), can indicate the presence or progression of atherosclerosis. The aim of this study is to evaluate the GDF-15 level and arterial stiffness parameters in patients with premature MI. Method: Thirty patients aged ≤45 years (mean age: 39 ± 5 years, 23 male) who recovered from a MI and 15 age and sex-matched subjects were consecutively included. The serum GDF-15 concentration levels and arterial stiffness parameters of the patients and controls were measured. Results: GDF-15 levels were significantly higher in patients with premature MI, while there were no significant differences in PWV and AIx between the groups. The GDF-15 level was correlated negatively with high-density lipoprotein (HDL) cholesterol and positively with uric acid levels. Both GDF-15 (p = 0.046, odds ratio: 1.092, 95% confidence interval: 1.003–1.196) and HDL cholesterol (p = 0.037, odds ratio: 0.925, 95% confidence interval: 0.859–0.995) were found as independent factors associated with premature MI. Conclusions: GDF-15 could be a risk factor for premature MI. Further studies are needed to elucidate the central role of GDF-15 in the pathophysiology of early atherosclerosis and MI in the young population. Full article

(This article belongs to the Special Issue Cardiovascular Diseases—From Risk Factors to Diagnosis and Personalized Management)

12 pages, 4189 KiB

Open AccessArticle

Effects of Implementing Personalized Health Education in Ambulatory Care on Cardiovascular Risk Factors, Compliance and Satisfaction with Treatment

by Agata Bielecka-Dabrowa, Joanna Lewek, Agata Sakowicz, Aleksandra Paduszyńska, Marek Dąbrowa, Daria Orszulak-Michalak, Maciej Banach and CARDIOPLUS Investigators

J. Pers. Med. 2022, 12(10), 1583; https://0-doi-org.brum.beds.ac.uk/10.3390/jpm12101583 - 26 Sep 2022

Cited by 2 | Viewed by 1591

Abstract

Aim and Methods: Data from the CARDIOPLUS study (a prospective, multicenter, non-interventional study, which was conducted among patients and physicians from ambulatory patient care in Poland) were used to assess whether primary care behavioral counseling interventions to improve diet, increase physical activity, stop smoking and reduce alcohol consumption improve outcomes associated with cardiovascular (CVD) risk factors, metabolic parameters, compliance and satisfaction with treatment in adults. The study was carried out throughout Poland in the period from July to December 2019. Results: The study included 8667 patients—49% women and 51% men aged (63 ± 11 years)—and 862 physician-researchers. At the 3-month follow-up, there was a significant reduction in body weight (p = 0.008); reduction of peripheral arterial pressure, both systolic (p < 0.001) and diastolic (p < 0.001); reduction in total cholesterol levels (p < 0.001), triglycerides (p < 0.001), and LDL cholesterol (p < 0.001). The percentage of respondents who fully complied with the doctor’s recommendations increased significantly. The respondents assessed their own satisfaction with the implemented treatment as higher (by about 20%). Conclusions: As a result of pro-health education in the field of lifestyle modifications, a significant reduction of risk factors for cardiovascular diseases, as well as improved compliance and satisfaction with pharmacological treatment, was observed. Thus, appropriate personalized advice on lifestyle habits should be given to each examinee in a positive, systematic way following the periodic health check-ups in order to reduce the person’s risk and improve the effectiveness of the treatment. Full article

(This article belongs to the Special Issue Cardiovascular Diseases—From Risk Factors to Diagnosis and Personalized Management)

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16 pages, 385 KiB

Open AccessArticle

Risk Factors Predisposing to Angina in Patients with Non-Obstructive Coronary Arteries: A Retrospective Analysis

by Oskar Wojciech Wiśniewski, Franciszek Dydowicz, Szymon Salamaga, Przemysław Skulik, Jacek Migaj and Marta Kałużna-Oleksy

J. Pers. Med. 2022, 12(7), 1049; https://0-doi-org.brum.beds.ac.uk/10.3390/jpm12071049 - 27 Jun 2022

Cited by 1 | Viewed by 1922

Abstract

No hemodynamically significant atherosclerotic plaques are observed in up to 30% of patients reporting angina and undergoing coronary angiography. To investigate risk factors associated with non-obstructive coronary artery disease (NOCAD), we analyzed the medical records of, consecutively, 136 NOCAD subjects and 128 patients with significant stenosis in at least one coronary artery (the OCAD group). The blood concentrations of the TC (4.40 [3.78–5.63] mmol/L vs. 4.12 [3.42–5.01] mmol/L; p = 0.026), LDL-C (2.32 [1.80–3.50] mmol/L vs. 2.10 [1.50–2.70] mmol/L; p = 0.003), non-HDL-C (2.89 [2.29–4.19] mmol/L vs. 2.66 [2.06–3.39] mmol/L; p = 0.045), as well as the LDL-C/HDL-C ratio (1.75 [1.22–2.60] vs. 1.50 [1.10–1.95]; p = 0.018) were significantly increased in the NOCAD patients compared to the OCAD group due to the lower prevalence and intensity of the statin therapy in the NOCAD individuals (p < 0.001). Moreover, the abovementioned lipid parameters appeared to be valuable predictors of NOCAD, with the LDL-C (OR = 1.44; 95%CI = 1.14–1.82) and LDL-C/HDL-C (OR = 1.51; 95%CI = 1.13–2.02) showing the highest odds ratios. Furthermore, multivariable logistic regression models determined female sex as the independent risk factor for NOCAD (OR = 2.37; 95%CI = 1.33–4.20). Simultaneously, arterial hypertension substantially lowered the probability of NOCAD (OR = 0.21; 95%CI = 0.10–0.43). To conclude, female sex, the absence of arterial hypertension, as well as increased TC, LDL-C, non-HDL, and LDL-C/HDL-C ratio are risk factors for NOCAD in patients reporting angina, potentially as a result of poor hypercholesterolemia management. Full article

(This article belongs to the Special Issue Cardiovascular Diseases—From Risk Factors to Diagnosis and Personalized Management)

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34 pages, 5298 KiB

Open AccessArticle

Using Consumer-Wearable Activity Trackers for Risk Prediction of Life-Threatening Heart Arrhythmia in Patients with an Implantable Cardioverter-Defibrillator: An Exploratory Observational Study

by Diana My Frodi, Vlad Manea, Søren Zöga Diederichsen, Jesper Hastrup Svendsen, Katarzyna Wac and Tariq Osman Andersen

J. Pers. Med. 2022, 12(6), 942; https://0-doi-org.brum.beds.ac.uk/10.3390/jpm12060942 - 08 Jun 2022

Cited by 1 | Viewed by 2530

Abstract

Ventricular arrhythmia (VA) is a leading cause of sudden death and health deterioration. Recent advances in predictive analytics and wearable technology for behavior assessment show promise but require further investigation. Yet, previous studies have only assessed other health outcomes and monitored patients for short durations (7–14 days). This study explores how behaviors reported by a consumer wearable can assist VA risk prediction. An exploratory observational study was conducted with participants who had an implantable cardioverter-defibrillator (ICD) and wore a Fitbit Alta HR consumer wearable. Fitbit reported behavioral markers for physical activity (light, fair, vigorous), sleep, and heart rate. A case-crossover analysis using conditional logistic regression assessed the effects of time-adjusted behaviors over 1–8 weeks on VA incidence. Twenty-seven patients (25 males, median age 59 years) were included. Among the participants, ICDs recorded 262 VA events during 8093 days monitored by Fitbit (median follow-up period 960 days). Longer light to fair activity durations and a higher heart rate increased the odds of a VA event (p < 0.001). In contrast, lengthier fair to vigorous activity and sleep durations decreased the odds of a VA event (p < 0.001). Future studies using consumer wearables in a larger population should prioritize these outcomes to further assess VA risk. Full article

(This article belongs to the Special Issue Cardiovascular Diseases—From Risk Factors to Diagnosis and Personalized Management)

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13 pages, 2141 KiB

Open AccessArticle

B-Type Natriuretic Peptide at Admission Is a Predictor of All-Cause Mortality at One Year after the First Acute Episode of New-Onset Heart Failure with Preserved Ejection Fraction

by Liviu-Nicolae Ghilencea, Gabriel-Cristian Bejan, Marilena-Brîndusa Zamfirescu, Ana Maria Alexandra Stănescu, Lavinia-Lucia Matei, Laura-Maria Manea, Ismail Dogu Kilic, Serban-Mihai Bălănescu, Andreea-Catarina Popescu and Saul Gareth Myerson

J. Pers. Med. 2022, 12(6), 890; https://0-doi-org.brum.beds.ac.uk/10.3390/jpm12060890 - 28 May 2022

Viewed by 2042

Abstract

Background: Heart failure with preserved ejection fraction (HFpEF) has been assessed extensively, but few studies analysed the predictive value of the NT-proBNP in patients with de novo and acute HFpEF. We sought to identify NT-proBNP at admission as a predictor for all-cause mortality and rehospitalisation at 12 months in patients with new-onset HFpEF. Methods: We analysed 91 patients (73 ± 11 years, 68% females) admitted for de novo and acute HFpEF, using the Cox proportional hazard risk model. Results: An admission NT-proBNP level above the threshold of 2910 pg/mL identified increased all-cause mortality at 12 months (AUC = 0.72, sensitivity = 92%, specificity = 53%, p < 0.001). All-cause mortality adjusted for age, gender, medical history, and medication in the augmented NT-proBNP group was 16-fold higher (p = 0.018), but with no difference in rehospitalisation rates (p = 0.391). The predictors of increased NT-proBNP ≥ 2910 pg/mL were: age (p = 0.016), estimated glomerular filtration rate (p = 0.006), left atrial volume index (p = 0.001), history of atrial fibrillation (p = 0.006), and TAPSE (p = 0.009). Conclusions: NT-proBNP above 2910 pg/mL at admission for de novo and acute HFpEF predicted a 16-fold increased mortality at 12 months, whereas values less than 2910 pg/mL forecast a high likelihood of survival (99.3%) in the next 12 months, and should be considered as a useful prognostic tool, in addition to its utility in diagnosing heart failure. Full article

(This article belongs to the Special Issue Cardiovascular Diseases—From Risk Factors to Diagnosis and Personalized Management)

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11 pages, 819 KiB

Open AccessArticle

Short- and Long-Term Outcomes of Left Main Coronary Artery Stenting in Patients Disqualified from Coronary Artery Bypass Graft Surgery

by Wojciech Jan Skorupski, Marta Kałużna-Oleksy, Maciej Lesiak, Aleksander Araszkiewicz, Włodzimierz Skorupski, Stefan Grajek, Przemysław Mitkowski, Małgorzata Pyda and Marek Grygier

J. Pers. Med. 2022, 12(3), 348; https://0-doi-org.brum.beds.ac.uk/10.3390/jpm12030348 - 25 Feb 2022

Cited by 3 | Viewed by 1781

Abstract

The study aims to evaluate the short- and long-term outcomes of left main percutaneous coronary interventions (LM PCI) in patients disqualified from coronary artery bypass graft surgery (CABG). We included 459 patients (mean age: 68.4 ± 9.4 years, 24.4% females), with at least 1-year follow-up; 396 patients in whom PCI was offered as an alternative to CABG (Group 1); and 63 patients who were disqualified from CABG by the Heart Team (Group 2). The SYNTAX score (29.1 ± 9.5 vs. 23.2 ± 9.7; p < 0.001) and Euroscore II value (2.72 ± 2.01 vs. 2.15 ± 2.16; p = 0.007) were significantly higher and ejection fraction was significantly lower (46% vs. 51.4%; p < 0.001) in Group 2. Patients in Group 2 more often required complex stenting techniques (33.3% vs. 16.2%; p = 0.001). The procedure success rates were very high and did not differ between groups (100% vs. 99.2%; p = 0.882). We observed no difference in periprocedural complication rates (12.7% vs. 7.8%; p = 0.198), but the long-term all-cause mortality rate was higher in Group 2 (26% vs. 21%; p = 0.031). LM PCI in patients disqualified from CABG is an effective and safe procedure with a low in-hospital complication rate. Long-term results are satisfactory. Full article

(This article belongs to the Special Issue Cardiovascular Diseases—From Risk Factors to Diagnosis and Personalized Management)

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Review

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24 pages, 1466 KiB

Open AccessReview

Role of ABCA1 in Cardiovascular Disease

by Jing Wang, Qianqian Xiao, Luyun Wang, Yan Wang, Daowen Wang and Hu Ding

J. Pers. Med. 2022, 12(6), 1010; https://0-doi-org.brum.beds.ac.uk/10.3390/jpm12061010 - 20 Jun 2022

Cited by 20 | Viewed by 4594

Abstract

Cholesterol homeostasis plays a significant role in cardiovascular disease. Previous studies have indicated that ATP-binding cassette transporter A1 (ABCA1) is one of the most important proteins that maintains cholesterol homeostasis. ABCA1 mediates nascent high-density lipoprotein biogenesis. Upon binding with apolipoprotein A-I, ABCA1 facilitates the efflux of excess intracellular cholesterol and phospholipids and controls the rate-limiting step of reverse cholesterol transport. In addition, ABCA1 interacts with the apolipoprotein receptor and suppresses inflammation through a series of signaling pathways. Thus, ABCA1 may prevent cardiovascular disease by inhibiting inflammation and maintaining lipid homeostasis. Several studies have indicated that post-transcriptional modifications play a critical role in the regulation of ABCA1 transportation and plasma membrane localization, which affects its biological function. Meanwhile, carriers of the loss-of-function ABCA1 gene are often accompanied by decreased expression of ABCA1 and an increased risk of cardiovascular diseases. We summarized the ABCA1 transcription regulation mechanism, mutations, post-translational modifications, and their roles in the development of dyslipidemia, atherosclerosis, ischemia/reperfusion, myocardial infarction, and coronary heart disease. Full article

(This article belongs to the Special Issue Cardiovascular Diseases—From Risk Factors to Diagnosis and Personalized Management)

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14 pages, 591 KiB

Open AccessReview

What’s New in Cirrhotic Cardiomyopathy?—Review Article

by Aleksandra Bodys-Pełka, Maciej Kusztal, Joanna Raszeja-Wyszomirska, Renata Główczyńska and Marcin Grabowski

J. Pers. Med. 2021, 11(12), 1285; https://0-doi-org.brum.beds.ac.uk/10.3390/jpm11121285 - 03 Dec 2021

Cited by 5 | Viewed by 2463

Abstract

Cirrhotic cardiomyopathy (CCM) is a relatively new medical term. The constant development of novel diagnostic and clinical tools continuously delivers new data and findings about this broad disorder. The purpose of this review is to summarize current facts about CCM, identify gaps of knowledge, and indicate the direction in which to prepare an updated definition of CCM. We performed a review of the literature using scientific data sources with an emphasis on the latest findings. CCM is a clinical manifestation of disorders in the circulatory system in the course of portal hypertension. It is characterized by impaired left ventricular systolic and diastolic dysfunction, and electrophysiological abnormalities, especially QT interval prolongation. However, signs and symptoms reported by patients are non-specific and include reduced exercise tolerance, fatigue, peripheral oedema, and ascites. The disease usually remains asymptomatic with almost normal heart function, unless patients are exposed to stress or exertion. Unfortunately, due to the subclinical course, CCM is rarely recognized. Orthotopic liver transplantation (OLTx) seems to improve circulatory function although there is no consensus about its positive effect, with reported cases of heart failure onset after transplantation. Researchers indicate a careful pre-, peri-, and post-transplant cardiac assessment as a crucial point in detecting CCM and improving patients’ prognosis. There is also an urgent need to update the CCM definition and establish a diagnostic algorithm for early diagnosis of CCM as well as a specific treatment of this condition. Full article

(This article belongs to the Special Issue Cardiovascular Diseases—From Risk Factors to Diagnosis and Personalized Management)

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Other

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11 pages, 249 KiB

Open AccessCase Report

Genetic Predictors of the Development of Complications after Coronary Stenting

by Dana Taizhanova, Akerke Kalimbetova, Roza Bodaubay, Aliya Toleuova, Rakhima Toiynbekova, Zhazira Beysenbekova, Olga Visternichan, Zauresh Tauesheva, Irina Kadyrova, Dmitriy Babenko, Lyudmila Akhmaltdinova, Svetlana Kolesnichenko, Yevgeniya Kolesnikova, Olga V. Avdienko, Ainur Akilzhanova and Grigorios T. Gerotziafas

J. Pers. Med. 2023, 13(1), 14; https://0-doi-org.brum.beds.ac.uk/10.3390/jpm13010014 - 22 Dec 2022

Viewed by 1326

Abstract

Due to the fact that there are scientific discussions about the significance of gene polymorphisms in the risk of developing cardiovascular complications after a percutaneous coronary intervention, it is of interest to evaluate the genetic predictors of the development of cardiovascular events. This study is a molecular genetic study. Association with the genes of biomarkers for inflammation and immune response increases the risk of cardiovascular events: rs1234313 (TNFSF4): (A/G, OR-4.57 (2.35–8.87), p ≤ 0.0001), (A/G-A/A, OR-3.14 (1.75–5.63), p ≤ 0.0001), and (A/G, OR = 4.01 (2.19–7.36), p ≤ 0.0001); rs3184504 (SH2D3); ATXN2: (C/T, OR-2.53 (1.28–5.01), T/T, OR-2.99 (1.13–7.92), p = 0.017)), (C/T-T/T, OR-2.61 (1.35–5.07), p = 0.000), and (OR-1.89 (1.15–3.09), p = 0.009)). According to the lipid metabolism biomarker genes, rs2943634: (A/C OR-2.57 (1.18–5.62), p = 0.013); according to the endothelial biomarker genes, rs2713604: (DNAJB8-AS1; GATA2): (C/T, OR-4.27 (2.35–7.76), p ≤ 0.0001), (C/T-C/C, OR-4.13 (2.31–7.40), p ≤ 0.0001), (OR-4.05 (2.24–7.30), p ≤ 0.0001), and (C/T, OR-3.46 (1.99–6.00), p ≤ 0.0001). The regression analysis found that in the presence of the rs2943634 gene polymorphism, the risk of late cardiovascular events increases by 4.007 times with 95% CI (1.502:10.692), p = 0.006. The genes of biomarkers for the risk of cardiovascular events are rs1234313(TNFSF4), rs3184504 (SH2D3; ATXN2), rs2943634, and rs2713604 (DNAJB8-AS1; GATA2). The only predictor of the development of new cardiovascular events was rs2943634, which belongs to the group of lipid metabolism biomarkers. Full article

(This article belongs to the Special Issue Cardiovascular Diseases—From Risk Factors to Diagnosis and Personalized Management)

11 pages, 899 KiB

Open AccessSystematic Review

The Role of Hemodynamics through the Circle of Willis in the Development of Intracranial Aneurysm: A Systematic Review of Numerical Models

by Yuanyuan Shen, Rob Molenberg, Reinoud P. H. Bokkers, Yanji Wei, Maarten Uyttenboogaart and J. Marc C. van Dijk

J. Pers. Med. 2022, 12(6), 1008; https://0-doi-org.brum.beds.ac.uk/10.3390/jpm12061008 - 20 Jun 2022

Cited by 6 | Viewed by 3811

Abstract

Background: The role of regional hemodynamics in the intracranial aneurysmal formation, growth, and rupture has been widely discussed based on numerical models over the past decades. Variation of the circle of Willis (CoW), which results in hemodynamic changes, is associated with the aneurysmal formation and rupture. However, such correlation has not been further clarified yet. The aim of this systematic review is to investigate whether simulated hemodynamic indices of the CoW are relevant to the formation, growth, or rupture of intracranial aneurysm. Methods: We conducted a review of MEDLINE, Web of Science, and EMBASE for studies on the correlation between hemodynamics indices of the CoW derived from numerical models and intracranial aneurysm up to December 2020 in compliance with PRISMA guidelines. Results: Three case reports out of 1046 publications met our inclusion and exclusion criteria, reporting 13 aneurysms in six patients. Eleven aneurysms were unruptured, and the state of the other two aneurysms was unknown. Wall shear stress, oscillatory shear index, von-Mises tension, flow velocity, and flow rate were reported as hemodynamic indices. Due to limited cases and significant heterogeneity between study settings, meta-analysis could not be performed. Conclusion: Numerical models can provide comprehensive information on the cerebral blood flow as well as local flow characteristics in the intracranial aneurysm. Based on only three case reports, no firm conclusion can be drawn regarding the correlation between hemodynamic parameters in the CoW derived from numerical models and aneurysmal formation or rupture. Due to the inherent nature of numerical models, more sensitive analysis and rigorous validations are required to determine its measurement error and thus extend their application into clinical practice for personalized management. Prospero registration number: CRD42021125169. Full article

(This article belongs to the Special Issue Cardiovascular Diseases—From Risk Factors to Diagnosis and Personalized Management)

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