2nd Edition: Cardiovascular Diseases: Diagnosis, Treatment, and Management—for the Up-to-Date Practitioner

A special issue of Diagnostics (ISSN 2075-4418). This special issue belongs to the section "Pathology and Molecular Diagnostics".

Deadline for manuscript submissions: closed (31 July 2023) | Viewed by 3802

Special Issue Editor

Department of Internal Medicine IV, University of Medicine, Pharmacy, Science and Technology, “George Emil Palade” of Targu Mures, 540139 Târgu Mureș, Romania
Interests: hypertrophic cardiomyopathy; cardiac imaging; echocardiography; MRI; computed tomography; invasive imaging; diagnosis; therapy; risk stratification; prognosis
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Special Issue Information

Dear Colleagues,

Cardiovascular diseases are still increasingly prevalent, and often represent a major challenge for the practitioner facing real-life patients. Despite the recent and important progress made in better understanding and managing heart diseases, we are far from reaching definitive answers for everyday clinical problems. The scope, the principal idea behind the Special Issue, is to provide relevant, new information concerning the diagnosis and management of cardiovascular diseases, useful for daily practice and based on the most recent, available data. In this regard, the Issue seeks to collate articles which give a comprehensive, up-to-date presentation of clinical aspects related to frequently encountered or emerging cardiovascular pathologies, with an impact on improving everyday cardiac care.

Dr. Attila Frigy
Guest Editor

Manuscript Submission Information

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Keywords

  • heart failure
  • diagnosis
  • cardiac imaging
  • echocardiography
  • MRI
  • biomarkers
  • therapy
  • pharmacotherapy
  • invasive therapy
  • device therapy
  • comorbidities
  • cardiac rehabilitation

Published Papers (3 papers)

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Research

10 pages, 1755 KiB  
Article
Considering Diastolic Dyssynchrony as a Predictor of Favorable Response in LV-Only Fusion Pacing Cardiac Resynchronization Therapy
by Andra Gurgu, Constantin-Tudor Luca, Cristina Vacarescu, Lucian Petrescu, Emilia-Violeta Goanta, Mihai-Andrei Lazar, Diana-Aurora Arnăutu and Dragos Cozma
Diagnostics 2023, 13(6), 1186; https://doi.org/10.3390/diagnostics13061186 - 21 Mar 2023
Cited by 1 | Viewed by 1121
Abstract
Background: CRT improves systolic and diastolic function, increasing cardiac output. Aim of the study: to assess the outcome of LV diastolic dyssynchrony in a population of fusion pacing CRT. Methods: Diastolic dyssynchrony was measured by offline speckle-tracking-derived TDI timing assessment of the simultaneity [...] Read more.
Background: CRT improves systolic and diastolic function, increasing cardiac output. Aim of the study: to assess the outcome of LV diastolic dyssynchrony in a population of fusion pacing CRT. Methods: Diastolic dyssynchrony was measured by offline speckle-tracking-derived TDI timing assessment of the simultaneity of E″ and A″ basal septal and lateral walls. New parameters introduced: E″ and, respectively, A″ time (E″T/A″T) as the time difference between E″ (respectively, A″) peak septal and lateral wall. Patients were divided into super-responders (SR), responders (R), and non-responders (NR). Results: Baseline characteristics: 62 pts (62 ± 11 y.o.) with idiopathic DCM, EF 27 ± 5.2%; 29% type III diastolic dysfunction (DD), 63% type II, 8% type I. Average follow-up 45 ± 19 months: LVEF 37 ± 7.9%, 34%SR, 61%R, 5%NR. The E″T decreased from 90 ± 20 ms to 25 ± 10 ms in SR with significant LV reverse remodeling (LV end-diastolic volume 193.7 ± 81 vs. 243.2 ± 82 mL at baseline, p < 0.0028) and lower LV filling pressures (E/E′ 13.2 ± 4.6 vs. 11.4 ± 4.5, p = 0.0295). DD profile improved in 65% of R with a reduction in E/E′ ratio (21 ± 9 vs. 14 ± 4 ms, p < 0.0001). Significant cut-off value calculated by ROC curve for LV diastolic dyssynchrony is E″T > 80 ms and A″T > 30 msec. Conclusions: The study identifies the cut-off values of diastolic dyssynchrony parameters as predictors of favorable outcomes in responders and super-responder patients with fusion CRT pacing. These findings may have important implications in patient selection and follow-up. Full article
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15 pages, 2034 KiB  
Article
[68Ga]Ga-NODAGA-E[(cRGDyK)]2 and [64Cu]Cu-DOTATATE PET Predict Improvement in Ischemic Cardiomyopathy
by Bjarke Follin, Cecilie Hoeeg, Ingrid Hunter, Simon Bentsen, Morten Juhl, Jacob Kildevang Jensen, Tina Binderup, Carsten Haagen Nielsen, Rasmus Sejersten Ripa, Jens Kastrup, Annette Ekblond and Andreas Kjaer
Diagnostics 2023, 13(2), 268; https://doi.org/10.3390/diagnostics13020268 - 11 Jan 2023
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Abstract
An increasing number of patients are living with chronic ischemic cardiomyopathy (ICM) and/or heart failure. Treatment options and prognostic tools are lacking for many of these patients. Our aim was to investigate the prognostic value of imaging angiogenesis and macrophage activation via positron [...] Read more.
An increasing number of patients are living with chronic ischemic cardiomyopathy (ICM) and/or heart failure. Treatment options and prognostic tools are lacking for many of these patients. Our aim was to investigate the prognostic value of imaging angiogenesis and macrophage activation via positron emission tomography (PET) in terms of functional improvement after cell therapy. Myocardial infarction was induced in rats. Animals were scanned with [18F]FDG PET and echocardiography after four weeks and randomized to allogeneic adipose tissue-derived stromal cells (ASCs, n = 18) or saline (n = 9). Angiogenesis and macrophage activation were assessed before and after treatment by [68Ga]Ga-RGD and [64Cu]Cu-DOTATATE. There was no overall effect of the treatment. Rats that improved left ventricular ejection fraction (LVEF) had higher uptake of both [68Ga]Ga-RGD and [64Cu]Cu-DOTATATE at follow-up (p = 0.006 and p = 0.008, respectively). The uptake of the two tracers correlated with each other (r = 0.683, p = 0.003 pre-treatment and r = 0.666, p = 0.004 post-treatment). SUVmax at follow-up could predict improvement in LVEF (p = 0.016 for [68Ga]Ga-RGD and p = 0.045 for [64Cu]Cu-DOTATATE). High uptake of [68Ga]Ga-RGD and [64Cu]Cu-DOTATATE PET after injection of ASCs or saline preceded improvement in LVEF. The use of these tracers could improve the monitoring of heart failure patients in treatment. Full article
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14 pages, 785 KiB  
Article
Tricuspid Regurgitation in Acute Heart Failure: Predicting Outcome Using Novel Quantitative Echocardiography Techniques
by Max Berrill, Eshan Ashcroft, David Fluck, Isaac John, Ian Beeton, Pankaj Sharma and Aigul Baltabaeva
Diagnostics 2023, 13(1), 109; https://doi.org/10.3390/diagnostics13010109 - 29 Dec 2022
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Abstract
Background: The prognostic impact of tricuspid regurgitation (TR) in acute heart failure (AHF) remains uncertain. Methods: We retrospectively assessed 418 consecutive AHF patients who underwent comprehensive echocardiographic assessment within 24 h of study recruitment. TR was quantitatively assessed with 3 guideline-directed measures: regurgitant [...] Read more.
Background: The prognostic impact of tricuspid regurgitation (TR) in acute heart failure (AHF) remains uncertain. Methods: We retrospectively assessed 418 consecutive AHF patients who underwent comprehensive echocardiographic assessment within 24 h of study recruitment. TR was quantitatively assessed with 3 guideline-directed measures: regurgitant volumes (RgVol), effective regurgitant orifice area (ERO) and vena contracta (VC) diameter. Disproportionate TR was assessed by the ratio of the VC diameter to the tricuspid annulus diameter (VC/TA) ≥ 0.24. Results: The prevalence of significant (i.e., >mild) TR differed when various standard assessment parameters were applied to quantification: RgVol 50.3% (173/344), ERO 75.6% (260/344) and VC diameter 94.6% (335/354). None were able to delineate those at excess risk of all-cause 2-year mortality using guideline-directed cut-offs of mild, moderate and severe TR. Using a cut-off of VC/TA ≥ 0.24, we identified that 36.9% (130/352) had “disproportionate” TR. Disproportionate TR was associated with an excess risk of mortality at 2 years compared to proportionate TR; HR 1.48 (95% CI 1.06–2.06 [p = 0.02]) which was not significant on multivariate assessment (p = 0.94). Conclusions: TR was not associated with outcome in AHF using guideline measures. A new assessment of “Disproportionate” TR carries a higher risk than proportionate TR but was not related to outcome based on multivariate analysis. Further research is needed to quantify TR more effectively to identify cut-offs for future guidelines and disproportionate TR may be an important part of Heart Failure 2.0. Full article
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