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Progress in Prevention and Care for Cardiovascular Diseases
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Progress in Prevention and Care for Cardiovascular Diseases

A special issue of Healthcare (ISSN 2227-9032). This special issue belongs to the section "Chronic Care".

Deadline for manuscript submissions: 30 April 2024 | Viewed by 7894

Special Issue Editor

Dr. Jerzy Wiliñski

E-Mail Website
Guest Editor
1. Center for Invasive Cardiology, Electrotherapy and Angiology, Intercard LLC, 33-300 Nowy Sacz, Poland
2. Department of Internal Medicine with Cardiology Subdivision, Blessed Marta Wiecka District Hospital, 32-700 Bochnia, Poland
Interests: heart failure; pulmonary embolism; heart arrhythmias; arterial hypertension; kidney diseases; echocardiography; cardiac pacing; cardiac ablation; pharmacotherapy

Special Issue Information

Dear Collogues,

Cardiovascular diseases are the leading cause of morbidity and mortality worldwide with a heavy burden on healthcare systems. Recent years in medicine and cardiology have been seriously affected by the COVID-19 pandemic. Now that the pandemic is in retreat, we should come back to bench and bedside and start creating our future straightaway. If we go back in time just 20 years, into a world without smartphones, and see what the treatment of the most common cardiovascular diseases looked like, we can appreciate the development in technology, pharmacotherapy, and knowledge sharing. The way it will be in the forthcoming decades is utterly up to us.

To address this issue, we invite both researchers and clinicians to submit the results of their studies on cardiovascular diseases. We expect papers with significant findings, making an impact on our knowledge and the way of thinking about certain cardiovascular diseases. The ultimate goal of this Special Issue is to create a scientific environment that will be able to improve patients’ well-being and outcomes.

Thank you for considering publishing with us. We look forward to hearing from you!

Dr. Jerzy Wiliñski
Guest Editor

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. Healthcare is an international peer-reviewed open access semimonthly 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

  • arterial hypertension
  • heart failure
  • atrial fibrillation
  • conduction system pacing
  • cardiac resynchronization therapy
  • valvular heart disease and treatment
  • venous thromboembolic disease
  • pulmonary embolism
  • pulmonary hypertension
  • diagnostic imaging
  • echocardiography
  • prevention of cardiovascular diseases
  • oral anticoagulant therapy
  • dyslipidemia
  • atherosclerosis
  • heart arrhythmia
  • cardiac arrhythmia ablation
  • stroke
  • oncology and cardiovascular diseases
  • myocardial infarction
  • myocardial revascularization

Published Papers (7 papers)

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Research

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15 pages, 329 KiB  
Article
Uncontrolled Hypertension, Treatment, and Predictors among Hypertensive Out-Patients Attending Primary Health Facilities in Johannesburg, South Africa
by Amaziah Makukule, Perpetua Modjadji, Ntevhe Thovhogi, Kabelo Mokgalaboni and Andre Pascal Kengne
Healthcare 2023, 11(20), 2783; https://doi.org/10.3390/healthcare11202783 - 20 Oct 2023
Viewed by 1266
Abstract
Hypertension is a poorly controlled risk factor for cardiovascular disease in South Africa, particularly among patients receiving care in the public sector who are mostly from low socioeconomic backgrounds. This cross-sectional study investigated uncontrolled hypertension, treatment, and predictors among hypertensive out-patients attending primary [...] Read more.
Hypertension is a poorly controlled risk factor for cardiovascular disease in South Africa, particularly among patients receiving care in the public sector who are mostly from low socioeconomic backgrounds. This cross-sectional study investigated uncontrolled hypertension, treatment, and predictors among hypertensive out-patients attending primary health care facilities in Johannesburg, South Africa. The WHO STEPwise approach to the surveillance of non-communicable diseases was used to collect data, including sociodemographic and lifestyle factors, health status, and measurements for anthropometry and blood pressure along with self-reported adherence to treatment, estimated through the general medication adherence scale. Uncontrolled hypertension was defined as systolic blood pressure ≥140 mmHg and/or diastolic blood pressure ≥90 mmHg in diagnosed patients receiving anti-hypertensive treatment. Overweight and obesity were defined as a body mass index ≥25 and ≥30 kg/m2, respectively. Logistic regression models were used to assess the predictors of uncontrolled hypertension. Four hundred (n = 400) hypertensive out-patients (mean age: 50 ± 8 years) participated in this study, with most living in poor sociodemographic environments. The prevalence rate of uncontrolled hypertension was 57%. Obesity (62% vs. 42%, p ≤ 0.0001), salt consumption (90% vs. 55%, p ≤ 0.0001), alcohol intake (42% vs. 19%, p ≤ 0.0001), a smoking habit (23% vs. 4%, p ≤ 0.0001), alternative medicine use (51% vs. 40%, p = 0.043), and comorbidities (64% vs. 36%, p ≤ 0.0001) were higher in the uncontrolled group than the controlled group, whereas the prevalence of physical activity (38% vs. 15%, p ≤ 0.0001) was high in the controlled group vs. the uncontrolled. Overall, 85% of the patients moderately adhered to treatment, only 2% exhibited high adherence, and 13% demonstrated low adherence; over half of the patients received tri-therapy treatment. The predictors of uncontrolled hypertension are a number of prescribed antihypertensive therapies [adjusted odds ration = 2.39; 95% confidence interval: 1.48–3.87], treatment adherence [0.46; 0.21–0.97], salt consumption [28.35; 7.87–102.04], physical activity [0.22; 0.13–0.37], current alcohol use [2.10; 1.22–3.61], and current cigarette smoking [4.79; 1.88–12.18]. The high prevalence of uncontrolled hypertension in this study suggests a need to optimize prescriptions, adherence to BP-lowering medications, and lifestyle modifications. The management of comorbidities such as diabetes could offer considerable benefits in controlling blood pressure. Full article
(This article belongs to the Special Issue Progress in Prevention and Care for Cardiovascular Diseases)
11 pages, 467 KiB  
Article
Indexing of Speckle Tracking Longitudinal Strain of Right Ventricle to Body Surface Area Does Not Improve Its Efficiency in Diagnosis and Mortality Risk Stratification in Patients with Acute Pulmonary Embolism
by Jerzy Wiliński, Anna Skwarek, Radosław Borek, Michał Medygrał, Iwona Chrzan, Marta Lechowicz-Wilińska and Ositadima Chukwu
Healthcare 2023, 11(11), 1629; https://doi.org/10.3390/healthcare11111629 - 02 Jun 2023
Viewed by 884
Abstract
Background: Acute pulmonary embolism (PE) is associated with a serious mortality rate. Thus, the rapid diagnosis and identification of patients at high risk of death is pivotal. The search for echocardiographic parameters for this purpose continues. Recent publications reveal correlations between myocardial longitudinal [...] Read more.
Background: Acute pulmonary embolism (PE) is associated with a serious mortality rate. Thus, the rapid diagnosis and identification of patients at high risk of death is pivotal. The search for echocardiographic parameters for this purpose continues. Recent publications reveal correlations between myocardial longitudinal strain (LS) and body surface area (BSA). The aim of the study was to evaluate the usefulness of indexing the right ventricular (RV) speckle tracking LS to BSA in detecting PE and stratifying the risk of 30-day all-cause mortality. Methods: the prospective cross-sectional observational study group consisted of 167 consecutive patients (76 men, 45.5%) aged 69.5 ± 15.3 years, and they were referred for computed tomography pulmonary angiography. Patients underwent a transthoracic echocardiographic examination within 24 h of admission to the hospital ward. RVLS and their derivatives indexed to BSA were included in the analysis. Results: PE was confirmed in 88 patients, while 79 patients had no radiological features of PE. The only echocardiographic parameters that differed between subgroups were pulmonary flow acceleration (Act), McConnell’s sign, LS of the middle segment of the RV free wall, and its derivative indexed to BSA. During the 30-day follow-up of a subgroup of subjects with PE, 12 patients died. The mortality predictors with increasing prediction value included a RV free wall mid-segment LS (cut-off value: −21%, Area Under the Curve—AUC 0.6, p = 0.02) and its derivative indexed to BSA (−14 %/m2, AUC 0.62, p = 0.003), body mass index (24.7 kg/m2, AUC 0.63, p = 0.002), D-dimer serum concentration (3559 pg/mL, AUC 0.66, p < 0.001), Act (67 ms, AUC 0.67, p < 0.001), septal basal LS (−15%, AUC 0.68, p = 0.02), RV free wall basal segment LS (−14%, AUC 0.7, p = 0.015), age (66 years, AUC 0.74, p = 0.004), NT-proBNP (1120 pg/mL, AUC 0.75, p = 0.01), troponin T (66 ng/mL, AUC 0.78, p = 0.005), and the complex score of the Pulmonary Embolism Severity Index (AUC 0.88, p < 0.001). Conclusions: indexing of RVLS to BSA does not improve its prognostic value in patients with acute PE. Full article
(This article belongs to the Special Issue Progress in Prevention and Care for Cardiovascular Diseases)
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Review

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17 pages, 1761 KiB  
Review
Harnessing the Synergy of SGLT2 Inhibitors and Continuous Ketone Monitoring (CKM) in Managing Heart Failure among Patients with Type 1 Diabetes
by Nicola Tecce, Giorgio de Alteriis, Giulia de Alteriis, Ludovica Verde, Mario Felice Tecce, Annamaria Colao and Giovanna Muscogiuri
Healthcare 2024, 12(7), 753; https://doi.org/10.3390/healthcare12070753 - 29 Mar 2024
Viewed by 786
Abstract
Heart failure (HF) management in type 1 diabetes (T1D) is particularly challenging due to its increased prevalence and the associated risks of hospitalization and mortality, driven by diabetic cardiomyopathy. Sodium–glucose cotransporter-2 inhibitors (SGLT2-is) offer a promising avenue for treating HF, specifically the preserved [...] Read more.
Heart failure (HF) management in type 1 diabetes (T1D) is particularly challenging due to its increased prevalence and the associated risks of hospitalization and mortality, driven by diabetic cardiomyopathy. Sodium–glucose cotransporter-2 inhibitors (SGLT2-is) offer a promising avenue for treating HF, specifically the preserved ejection fraction variant most common in T1D, but their utility is hampered by the risk of euglycemic diabetic ketoacidosis (DKA). This review investigates the potential of SGLT2-is in T1D HF management alongside emergent Continuous Ketone Monitoring (CKM) technology as a means to mitigate DKA risk through a comprehensive analysis of clinical trials, observational studies, and reviews. The evidence suggests that SGLT2-is significantly reduce HF hospitalization and enhance cardiovascular outcomes. However, their application in T1D patients remains limited due to DKA concerns. CKM technology emerges as a crucial tool in this context, offering real-time monitoring of ketone levels, which enables the safe incorporation of SGLT2-is into treatment regimes by allowing for early detection and intervention in the development of ketosis. The synergy between SGLT2-is and CKM has the potential to revolutionize HF treatment in T1D, promising improved patient safety, quality of life, and reduced HF-related morbidity and mortality. Future research should aim to employ clinical trials directly assessing this integrated approach, potentially guiding new management protocols for HF in T1D. Full article
(This article belongs to the Special Issue Progress in Prevention and Care for Cardiovascular Diseases)
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15 pages, 2203 KiB  
Review
The Significance of Coronary Artery Calcification for Percutaneous Coronary Interventions
by Paweł Lis, Marek Rajzer and Łukasz Klima
Healthcare 2024, 12(5), 520; https://doi.org/10.3390/healthcare12050520 - 22 Feb 2024
Viewed by 868
Abstract
The prevalence of calcium deposits in coronary arteries grows with age. Risk factors include, e.g., diabetes and chronic kidney disease. There are several underlying pathophysiological mechanisms of calcium deposition. Severe calcification increases the complexity of percutaneous coronary interventions. Invasive techniques to modify the [...] Read more.
The prevalence of calcium deposits in coronary arteries grows with age. Risk factors include, e.g., diabetes and chronic kidney disease. There are several underlying pathophysiological mechanisms of calcium deposition. Severe calcification increases the complexity of percutaneous coronary interventions. Invasive techniques to modify the calcified atherosclerotic plaque before stenting have been developed over the last years. They include balloon- and non-balloon-based techniques. Rotational atherectomy has been the most common technique to treat calcified lesions but new techniques are emerging (orbital atherectomy, intravascular lithotripsy, laser atherectomy). The use of intravascular imaging (intravascular ultrasound and optical coherence tomography) is especially important during the procedures in order to choose the optimal strategy and to assess the final effect of the procedure. This review provides an overview of the role of coronary calcification for percutaneous coronary interventions. Full article
(This article belongs to the Special Issue Progress in Prevention and Care for Cardiovascular Diseases)
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Other

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9 pages, 2861 KiB  
Case Report
Improvement in Atrioventricular Conduction Using Cardioneuroablation Performed Immediately after Pulmonary Vein Isolation
by Łukasz Zarębski, Piotr Futyma, Yashvi Sethia, Marian Futyma and Piotr Kułakowski
Healthcare 2024, 12(7), 728; https://doi.org/10.3390/healthcare12070728 - 27 Mar 2024
Viewed by 531
Abstract
In patients with atrial fibrillation (AF) recurrences after pulmonary vein isolation (PVI), concomitant treatment using anti arrhythmic drugs (AADs) can lead to clinical success. However, patients with atrioventricular (AV) block may not be good candidates for concomitant AAD therapy due to the risk [...] Read more.
In patients with atrial fibrillation (AF) recurrences after pulmonary vein isolation (PVI), concomitant treatment using anti arrhythmic drugs (AADs) can lead to clinical success. However, patients with atrioventricular (AV) block may not be good candidates for concomitant AAD therapy due to the risk of further worsening of conduction abnormalities. Cardioneuroablation (CNA), as an adjunct to PVI, may offer a solution to this problem. We present a case of a 74-year-old male with paroxysmal AF and first degree AV block in whom CNA following PVI led to PR normalization. The presented case describes an example of CNA utilization in patients with AF undergoing PVI who have concomitant problems with AV conduction and shows that CNA can be sometimes useful in older patients with functional AV block. Full article
(This article belongs to the Special Issue Progress in Prevention and Care for Cardiovascular Diseases)
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8 pages, 692 KiB  
Brief Report
The Impact of Non-Adherence to Antihypertensive Drug Therapy
by Syed Karam Mustafa Gardezi, William W. Aitken and Mohammad Hashim Jilani
Healthcare 2023, 11(22), 2979; https://doi.org/10.3390/healthcare11222979 - 18 Nov 2023
Viewed by 1402
Abstract
Medication non-adherence is a major healthcare barrier, especially among diseases that are largely asymptomatic, such as hypertension. The impact of poor medication adherence ranges from patient-specific adverse health outcomes to broader strains on health care system resources. The Centers for Disease Control (CDC) [...] Read more.
Medication non-adherence is a major healthcare barrier, especially among diseases that are largely asymptomatic, such as hypertension. The impact of poor medication adherence ranges from patient-specific adverse health outcomes to broader strains on health care system resources. The Centers for Disease Control (CDC) Wide-ranging Online Data for Epidemiologic Research (WONDER) database was used to retrieve Centers for Medicare and Medicaid Services’ data pertaining to blood pressure (BP) medication adherence, socio-economic variables, and cardiovascular (CV) outcomes across the United States. Multivariable linear regression models were used to estimate the change in total CV deaths as a function of non-adherence to BP medications. For every percent increase in the non-adherence rate, the total number of CV deaths increased by 7.13 deaths per 100,000 adults (95% CI: 6.34–7.92), even after controlling for the percentage of residents with access to insurance, the percentage of residents who were eligible for Medicaid, the percentage of residents without a college education, median home value, income inequality, and the poverty rate (p < 0.001). There is a significant association between non-adherence to BP medications and total CV deaths. Even a one percent increase in the adherence rate in the United States could result in tens of thousands of preventable CV deaths. Based on recently published CDC data, this could also have a tremendous impact on health care costs. This provides compelling evidence for increased efforts to improve adherence. Full article
(This article belongs to the Special Issue Progress in Prevention and Care for Cardiovascular Diseases)
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7 pages, 492 KiB  
Case Report
A COVID-19 Diagnosis Like an Avalanche Triggers a Series of Adverse Events but Saves a Life in the End
by Mateusz Iwański, Aldona Sokołowska, Piotr Wańczura, Justyna Filipowska and Katarzyna Styczkiewicz
Healthcare 2023, 11(13), 1847; https://doi.org/10.3390/healthcare11131847 - 26 Jun 2023
Viewed by 1238
Abstract
Patients diagnosed with cancer are less frequently covered by preventive measures for cardiovascular diseases. The frequent co-occurrence of these diseases makes it necessary to apply parallel diagnostics and cardiological treatment with anti-cancer therapy. Frequently. multidisciplinary team discussions are needed. Case report: We present [...] Read more.
Patients diagnosed with cancer are less frequently covered by preventive measures for cardiovascular diseases. The frequent co-occurrence of these diseases makes it necessary to apply parallel diagnostics and cardiological treatment with anti-cancer therapy. Frequently. multidisciplinary team discussions are needed. Case report: We present a case of a 73-year-old former smoker with hyperlipidemia, type 2 diabetes, and arterial hypertension, after a partial right nephrectomy in 2005 due to kidney cancer, diagnosed with SARS-CoV-2 infection in April 2022. Subsequent chest imaging showed a 20 mm focal lesion in the left lung further classified as a small-cell neuroendocrine carcinoma. Unexpectedly, the patient was hospitalized due to ST-segment elevation inferior left ventricular (LV) myocardial infarction. It was treated successfully with percutaneous coronary angioplasty (PCI) of the circumflex and first marginal artery with drug-eluting stent (DES) implantation. One day later, PCI of the left anterior artery was performed with two DES implantation; however, heart failure (HF) with a reduced left ventricle ejection fraction of 30% was diagnosed. One month later, the patient required hospitalization again due to HF decompensation, and cardiological treatment was optimized with flozin in addition to standard HF therapy. Subsequently, after cardiological approval the patient qualified for chemotherapy with the cisplatin–etoposide regimen. Therapy was continued for 6 months without HF decompensation and significant deterioration in renal function. After that, the patient underwent radical radiotherapy. Follow-up chest computed tomography scans showed regression of the neoplastic lesion. Conclusions: The coincidence of newly recognized cancer and inflammatory disease might contribute to and provoke serious cardiological events. To reduce the risk of cardiovascular complications, periodic cardiological surveillance and optimal pharmacotherapy are required. Full article
(This article belongs to the Special Issue Progress in Prevention and Care for Cardiovascular Diseases)
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