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Critical Issue on Heart Disease and Health

A special issue of International Journal of Environmental Research and Public Health (ISSN 1660-4601). This special issue belongs to the section "Health Behavior, Chronic Disease and Health Promotion".

Deadline for manuscript submissions: closed (30 September 2023) | Viewed by 15082

Special Issue Editors


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Guest Editor
Public Health Department, University of Naples Federico II, 80131 Naples, Italy
Interests: sports medicine; sports cardiology; pre-participation screening; sports injury rehabilitation; echocardiography; musculoskeletal ultrasound
Special Issues, Collections and Topics in MDPI journals

E-Mail Website
Guest Editor
Department of Public Health, University of Naples "Federico II", 80131 Naples, Italy
Interests: public health; epidemiology; rehabilitation; prevention; corporate wellness; health promotion; physical exercise; preventive medicine; human anatomy; sport medicine
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Cardiovascular diseases (CVDs) are the leading cause of death and disability in humans and their incidence is still increasing globally, despite the improvement in care and the prevention programs proposed worldwide by several international health agencies. Their pathogenesis is predominantly associated to atherosclerotic damage determining coronary artery disease, cerebrovascular disease, venous thromboembolism and peripheral vascular disease. Modifiable risk factors leading to the onset of CVDs are well recognized and include hyperlipidemia, hypertension, diabetes, obesity, smoking, physical inactivity and environmental factors. Acting on these factors can significantly reduce the global epidemic of CVDs, as demonstrated by large international studies. Lifestyle modifications, associated to the management of lipid, glycemic and blood pressure values, have demonstrated their effectiveness in primary and secondary prevention of CVDs. Moreover, advance in diagnostic and therapeutic procedures associated to CVDs have permitted a more specific and personalized approach able to reduce the risk of mortality and morbidity. Definitely, a gap still exists between preventive and therapeutic evidence and their practical application in a large-scale population. This Special Issue gives an overview of the most recent advances in the field of diagnosis, treatment and prevention of CVDs Potential topics include, but are not limited to:

  • Heart Disease
  • Cardiovascular Health
  • Public Health
  • Coronary Artery Disease
  • Sudden Cardiac Death
  • Cardiovascular Risk Factors
  • Physical Activity
  • Prevention programs
  • Cardiovascular Anatomy
  • Cardiovascular Physiology

Dr. Stefano Palermi
Dr. Felice Sirico
Guest Editors

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Keywords

  • cardiovascular disease
  • health
  • prevention

Published Papers (8 papers)

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Research

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13 pages, 2206 KiB  
Article
Circadian and Seasonal Pattern of Arrhythmic Events in Arrhythmogenic Cardiomyopathy Patients
by Silvia Castelletti, Michele Orini, Annina S. Vischer, William J. McKenna, Pier D. Lambiase, Antonios Pantazis and Lia Crotti
Int. J. Environ. Res. Public Health 2023, 20(4), 2872; https://doi.org/10.3390/ijerph20042872 - 07 Feb 2023
Cited by 2 | Viewed by 1698
Abstract
Arrhythmogenic right ventricular cardiomyopathy (ARVC) is an inherited cardiac disease associated with an increased risk of life-threatening arrhythmias. The aim of the present study was to evaluate the association of ventricular arrhythmias (VA) with circadian and seasonal variation in ARVC. One hundred two [...] Read more.
Arrhythmogenic right ventricular cardiomyopathy (ARVC) is an inherited cardiac disease associated with an increased risk of life-threatening arrhythmias. The aim of the present study was to evaluate the association of ventricular arrhythmias (VA) with circadian and seasonal variation in ARVC. One hundred two ARVC patients with an implantable cardioverter defibrillator (ICD) were enrolled in the study. Arrhythmic events included (a) any initial ventricular tachycardia (VT) or fibrillation (VF) prompting ICD implantation, (b) any VT or non-sustained VT (NSVT) recorded by the ICD, and (c) appropriate ICD shocks/therapy. Differences in the annual incidence of events across seasons (winter, spring, summer, autumn) and period of the day (night, morning, afternoon, evening) were assessed both for all cardiac events and major arrhythmic events. In total, 67 events prior to implantation and 263 ICD events were recorded. These included 135 major (58 ICD therapies, 57 self-terminating VT, 20 sustained VT) and 148 minor (NSVT) events. A significant increase in the frequency of events was observed in the afternoon versus in the nights and mornings (p = 0.016). The lowest number of events was registered in the summer, with a peak in the winter (p < 0.001). Results were also confirmed when excluding NSVT. Arrhythmic events in ARVC follow a seasonal variation and a circadian rhythm. They are more prevalent in the late afternoon, the most active period of the day, and in the winter, supporting the role of physical activity and inflammation as triggers of events. Full article
(This article belongs to the Special Issue Critical Issue on Heart Disease and Health)
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10 pages, 791 KiB  
Article
Preliminary Evaluation of Sedentary Lifestyle in Italian Children after Solid Transplant: What Role Could Physical Activity Play in Health? It Is Time to Move
by Eliana Tranchita, Giulia Cafiero, Ugo Giordano, Isabella Guzzo, Raffaella Labbadia, Stefano Palermi, Claudia Cerulli, Manila Candusso, Marco Spada, Lucilla Ravà, Federica Gentili, Fabrizio Drago and Attilio Turchetta
Int. J. Environ. Res. Public Health 2023, 20(2), 990; https://doi.org/10.3390/ijerph20020990 - 05 Jan 2023
Cited by 2 | Viewed by 1449
Abstract
Background: Advances in the medical–surgical field have significantly increased survival after solid organ transplantation in the pediatric population. However, these patients are predisposed to the development of long-term complications (e.g., cardiovascular disease). The therapeutic role of physical activity (PA) to counteract these complications [...] Read more.
Background: Advances in the medical–surgical field have significantly increased survival after solid organ transplantation in the pediatric population. However, these patients are predisposed to the development of long-term complications (e.g., cardiovascular disease). The therapeutic role of physical activity (PA) to counteract these complications is well known. The purpose of the study was to investigate the level of PA in a pediatric population after solid organ transplantation. Methods: In the first 4 weeks at the beginning of the school year, the Physical Activity Questionnaire for Older Children and Adolescents was administered to young patients who had previously undergone solid transplants at our institute. Results: Questionnaires of 49 patients (57.1% female, mean age 13.2 ± 3.5 years) were analyzed and 32.7% of subjects did not perform any exercise during school physical education classes. Only 24% practiced a moderate quantity of exercise in the previous week (2–3 times/week) and 72% engaged in sedentary behaviors during weekends. Conclusions: Preliminary data confirmed that young recipients are still far from meeting the minimum indications of the World Health Organization on PA and sedentary behavior. It will be necessary to increase their involvement in PA programs in order not only to increase their life expectancy but also to improve their quality of life. Full article
(This article belongs to the Special Issue Critical Issue on Heart Disease and Health)
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11 pages, 1314 KiB  
Article
Impaired Speckle-Tracking-Derived Left Ventricular Longitudinal Strain Is Associated with Transposition of Great Arteries in Neonates: A Single-Center Study
by Daniela Toma, Dorottya Gabor-Miklosi, Andreea Cerghit-Paler, Carmen Corina Șuteu, Marius-Catalin Cosma, Claudiu Mărginean, Mihaela Iancu and Liliana Gozar
Int. J. Environ. Res. Public Health 2023, 20(1), 674; https://doi.org/10.3390/ijerph20010674 - 30 Dec 2022
Viewed by 1111
Abstract
The transposition of great arteries (TGA) is one of the most frequent and severe congenital heart diseases. After newborn stabilization and while pending surgical correction, echocardiographic monitoring with a careful evaluation of left ventricle (LV) performance is warranted. In this study, our objectives [...] Read more.
The transposition of great arteries (TGA) is one of the most frequent and severe congenital heart diseases. After newborn stabilization and while pending surgical correction, echocardiographic monitoring with a careful evaluation of left ventricle (LV) performance is warranted. In this study, our objectives were (i) to compare myocardial function, assessed via speckle-tracking echocardiography, between neonates with TGA and neonates without TGA and (ii) to identify a strain parameter with a good discriminatory ability for TGA. We conducted a retrospective, single-center study. A total of 90 neonates were examined, of whom 66 were included (16 comprised the TGA group and 50 comprised the control group). The results of a bivariate analysis showed that classic echocardiography parameters displayed no significant differences between the two studied groups (p = 0.785 for EF, p = 0.286 for MAPSE and p = 0.315 for TAPSE). We found a statistically significant difference between the two groups for the mean values of the LVpGLS parameter (adjusted p = 0.0047), with impaired LV myocardium function being observed in the TGA group after adjusting for other covariates. Regarding segmental strain, the mean medial and apical inter-ventricular septum strain values were found to be significantly lower in the neonates with TGA than in the controls (95% CI for difference in means: [−6.45, −0.65], [−8.56, −1.97]). The results of an ROC analysis showed that LVpGLS had a significant ability to differentiate between neonates with TGA and controls (AUC = 0.712, 95% CI: [0.52, 0.903], p = 0.011). In conclusion, LVpGLS is a parameter with a significant discriminatory ability for LV dysfunction, and it is useful in the evaluation of ventricular myocardial function in newborns with TGA. Full article
(This article belongs to the Special Issue Critical Issue on Heart Disease and Health)
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9 pages, 311 KiB  
Article
Bicuspid Aortic Valve and Premature Ventricular Beats in Athletes
by Gloria Modica, Fabrizio Sollazzo, Massimiliano Bianco, Michela Cammarano, Riccardo Pella, Riccardo Monti, Vincenzo Palmieri and Paolo Zeppilli
Int. J. Environ. Res. Public Health 2022, 19(19), 12188; https://doi.org/10.3390/ijerph191912188 - 26 Sep 2022
Cited by 1 | Viewed by 1022
Abstract
Background: The aim of this study was to identify a possible link between bicuspid aortic valve (BAV) and premature ventricular beats (PVBs), particularly from left and right ventricular outflow tracts, and to investigate possible associations between these arrhythmias and echocardiographic abnormalities. Methods: A [...] Read more.
Background: The aim of this study was to identify a possible link between bicuspid aortic valve (BAV) and premature ventricular beats (PVBs), particularly from left and right ventricular outflow tracts, and to investigate possible associations between these arrhythmias and echocardiographic abnormalities. Methods: A comparison of sportspeople with and without BAV was performed to identify PVBs’ occurrence in these two series. Then, subdividing the BAV group on the presence of cardiovascular complications due to BAV, we compared arrhythmic features between these two subgroups and echocardiographic findings between athletes with and without left and right outflow tract PVBs. Results: PVBs in 343 athletes with BAV were compared with 309 athletes without BAV, showing an increased frequency (29% vs. 11.8%, p < 0.001; OR 3.1; CI 2.1–4.7) and origin from the left (18.4% vs. 3.2%, p < 0.001, OR 6.7; CI 3.4–13.4) and right (15.2% vs. 3.6%, p < 0.001, OR 4.8; CI 2.5–9.5) outflow tracts compared to other ventricular areas (fascicular PVBs p = 0.81, other morphologies p = 0.58). No difference in PVBs’ occurrence was found between near normal valve BAV and pathological BAV, nor was a difference in echocardiographic characteristics found between patients with and without outflow tract arrhythmias. Conclusions: A possible causal link between BAV and PVBs was highlighted, but no association between PVBs and complicated BAV was emphasized. Full article
(This article belongs to the Special Issue Critical Issue on Heart Disease and Health)
10 pages, 1010 KiB  
Article
COVID-19 Myocarditis: Prognostic Role of Bedside Speckle-Tracking Echocardiography and Association with Total Scar Burden
by Antonello D’Andrea, Luigi Cante, Stefano Palermi, Andreina Carbone, Federica Ilardi, Francesco Sabatella, Fabio Crescibene, Marco Di Maio, Francesco Giallauria, Giancarlo Messalli, Vincenzo Russo and Eduardo Bossone
Int. J. Environ. Res. Public Health 2022, 19(10), 5898; https://doi.org/10.3390/ijerph19105898 - 12 May 2022
Cited by 16 | Viewed by 2279
Abstract
SARS-CoV2 infection, responsible for the COVID-19 disease, can determine cardiac as well as respiratory injury. In COVID patients, viral myocarditis can represent an important cause of myocardial damage. Clinical presentation of myocarditis is heterogeneous. Furthermore, the full diagnostic algorithm can be hindered by [...] Read more.
SARS-CoV2 infection, responsible for the COVID-19 disease, can determine cardiac as well as respiratory injury. In COVID patients, viral myocarditis can represent an important cause of myocardial damage. Clinical presentation of myocarditis is heterogeneous. Furthermore, the full diagnostic algorithm can be hindered by logistical difficulties related to the transportation of COVID-19 patients in a critical condition to the radiology department. Our aim was to study longitudinal systolic cardiac function in patients with COVID-19-related myocarditis with echocardiography and to compare these findings with cardiac magnetic resonance (CMR) results. Patients with confirmed acute myocarditis and age- and gender-matched healthy controls were enrolled. Both patients with COVID-19-related myocarditis and healthy controls underwent standard transthoracic echocardiography and speckle-tracking analysis at the moment of admission and after 6 months of follow-up. The data of 55 patients with myocarditis (mean age 46.4 ± 15.3, 70% males) and 55 healthy subjects were analyzed. The myocarditis group showed a significantly reduced global longitudinal strain (GLS) and sub-epicardial strain, compared to the control (p < 0.001). We found a positive correlation (r = 0.65, p < 0.0001) between total scar burden (TSB) on CMR and LV GLS. After 6 months of follow-up, GLS showed marked improvements in myocarditis patients on optimal medical therapy (p < 0.01). Furthermore, we showed a strong association between baseline GLS, left ventricular ejection fraction (LVEF) and TSB with LVEF at 6 months of follow-up. After a multivariable linear regression analysis, baseline GLS, LVEF and TSB were independent predictors of a functional outcome at follow-up (p < 0.0001). Cardiac function and myocardial longitudinal deformation, assessed by echocardiography, are associated with TSB at CMR and have a predictive value of functional recovery in the follow-up. Full article
(This article belongs to the Special Issue Critical Issue on Heart Disease and Health)
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Review

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24 pages, 10836 KiB  
Review
The Incremental Role of Multiorgan Point-of-Care Ultrasounds in the Emergency Setting
by Antonello D’Andrea, Carmen Del Giudice, Dario Fabiani, Adriano Caputo, Francesco Sabatella, Luigi Cante, Stefano Palermi, Alfonso Desiderio, Ercole Tagliamonte, Biagio Liccardo and Vincenzo Russo
Int. J. Environ. Res. Public Health 2023, 20(3), 2088; https://doi.org/10.3390/ijerph20032088 - 23 Jan 2023
Cited by 3 | Viewed by 1949
Abstract
Point-of-care ultrasonography (POCUS) represents a goal-directed ultrasound examination performed by clinicians directly involved in patient healthcare. POCUS has been widely used in emergency departments, where US exams allow physicians to make quick diagnoses and to recognize early life-threatening conditions which require prompt interventions. [...] Read more.
Point-of-care ultrasonography (POCUS) represents a goal-directed ultrasound examination performed by clinicians directly involved in patient healthcare. POCUS has been widely used in emergency departments, where US exams allow physicians to make quick diagnoses and to recognize early life-threatening conditions which require prompt interventions. Although initially meant for the real-time evaluation of cardiovascular and respiratory pathologies, its use has been extended to a wide range of clinical applications, such as screening for deep-vein thrombosis and trauma, abdominal ultrasonography of the right upper quadrant and appendix, and guidance for invasive procedures. Moreover, recently, bedside ultrasounds have been used to evaluate the fluid balance and to guide decongestive therapy in acutely decompensated heart failure. The aim of the present review was to discuss the most common applications of POCUS in the emergency setting. Full article
(This article belongs to the Special Issue Critical Issue on Heart Disease and Health)
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Other

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11 pages, 2788 KiB  
Opinion
Endovascular Intervention for Aortic Dissection Is “Ascending”
by Antonio Rizza, Francesco Negro, Tim J. Mandigers, Cataldo Palmieri, Sergio Berti and Santi Trimarchi
Int. J. Environ. Res. Public Health 2023, 20(5), 4094; https://doi.org/10.3390/ijerph20054094 - 24 Feb 2023
Cited by 2 | Viewed by 1547
Abstract
Ascending aorta diseases represent an important cause of mortality worldwide. Notably, acute and chronic thoracic aorta pathologies have increased during the last years, but medical therapy does not seem to influence their natural history. Currently, although open surgery is the first choice of [...] Read more.
Ascending aorta diseases represent an important cause of mortality worldwide. Notably, acute and chronic thoracic aorta pathologies have increased during the last years, but medical therapy does not seem to influence their natural history. Currently, although open surgery is the first choice of treatment, many patients are still rejected or have poor outcomes. In this scenario, endovascular treatment is raised as a valuable option. In this review we describe the limitations of conventional surgery and the state-of-art of endovascular ascending aorta repair. Full article
(This article belongs to the Special Issue Critical Issue on Heart Disease and Health)
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12 pages, 2283 KiB  
Case Report
Penetrating Aortic Ulceration Treated with Castor Branched Aortic Stent Graft—A Case Series
by Antonio Rizza, Francesco Negro, Stefano Palermi, Cataldo Palmieri, Michele Murzi, Giovanni Credi and Sergio Berti
Int. J. Environ. Res. Public Health 2022, 19(8), 4809; https://doi.org/10.3390/ijerph19084809 - 15 Apr 2022
Cited by 3 | Viewed by 3134
Abstract
Penetrating aortic ulceration (PAU) is an acute aortic syndrome similar to aortic dissection and intramural hematoma. It is the result of a tunica intima ulceration due to atherosclerotic disease. This clinical condition can lead to serious complications and a poor short-term prognosis, especially [...] Read more.
Penetrating aortic ulceration (PAU) is an acute aortic syndrome similar to aortic dissection and intramural hematoma. It is the result of a tunica intima ulceration due to atherosclerotic disease. This clinical condition can lead to serious complications and a poor short-term prognosis, especially in high-surgical-risk patients. We report three cases of patients referred to “Ospedale del Cuore” of Massa (Italy) with PAU at the aortic arch-proximal descending aorta level who could not undergo surgical intervention. For the first time in Italy, we successfully treated these patients with a full percutaneous implantation of a Castor branched aortic stent graft. Our case series shows that this type of endovascular graft is an effective, safe, and feasible treatment for PAU involving a distal aortic arch and avoiding surgery and related complications. Full article
(This article belongs to the Special Issue Critical Issue on Heart Disease and Health)
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