Ischemic Heart Disease in the Context of Different Comorbidities, Volume II

A special issue of Life (ISSN 2075-1729). This special issue belongs to the section "Medical Research".

Deadline for manuscript submissions: closed (28 February 2023) | Viewed by 8589

Special Issue Editors


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Guest Editor
Department of Internal Medicine, Faculty of Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, Romania
Interests: ischemic heart disease; arterial hypertension; pulmonary embolism; heart failure; biomarkers
Special Issues, Collections and Topics in MDPI journals

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Guest Editor
Department of Diabetes, Nutrition and Metabolic Diseases, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, Romania
Interests: diabetes; metabolic diseases; cardiology; diabetic kidney disease
Special Issues, Collections and Topics in MDPI journals

E-Mail Website
Guest Editor
Department of Internal Medicine, Faculty of Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, Romania
Interests: cardiovascular disease; atherosclerosis; arterial thrombosis; venous thrombosis; anticoagulants; hereditary thrombophilia; inflammation
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

The field of cardiology is very dynamic, and is constantly evolving and improving. Our knowledge about myocardial ischemia is deepening every day, as major progress is made both in understanding its pathophysiological substrate and in improving diagnostic algorithms and therapeutic protocols.

Myocardial ischemia is the fundamental substrate of acute and chronic coronary syndromes. Beyond this major role, its importance resides in its coexistence with many pathological conditions in which myocardial ischemia appears either as an associated factor or as a consequence.

Firstly, the diagnosis of myocardial ischemia in the context of non-cardiac comorbidities can be a challenge for the clinician, who has the difficult task of choosing appropriate paraclinical investigations from many options—ECG, biomarkers, stress test, invasive and non-invasive imaging procedures—to establish a correct diagnosis.

Secondly, the high incidence and severe prognosis of myocardial ischemia highlight the need for continuous research in the field to optimize diagnosis and treatment, and to improve the prognosis and survival of patients.

Thirdly, atherosclerotic disease as a whole and myocardial ischemia in particular are frequently associated with a complex metabolic background. Innovative therapies bring important benefits, providing protection against atherosclerotic disease and significantly reducing major adverse cardiovascular events in dedicated clinical trials.

These are the main reasons why we chose this broad topic. Our goal is to form a team of specialists whose advanced experience allows us to understand the complex mechanisms of the bidirectional relationship between myocardial ischemia and various pathologies. Therefore, we invite you to share your knowledge and experience, and thus help to identify the best diagnostic and therapeutic solutions for our patients.

Dr. Irina-Iuliana Costache
Prof. Dr. Bogdan-Mircea Mihai
Dr. Minerva Codruta Badescu
Guest Editors

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Keywords

  • myocardial ischemia
  • acute coronary syndrome
  • chronic coronary syndrome
  • atherothrombosis
  • biomarkers
  • coronary imaging
  • revascularization
  • prevention

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Published Papers (3 papers)

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Research

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12 pages, 675 KiB  
Article
Relationships between Easily Available Biomarkers and Non-Dipper Blood Pressure Pattern in Patients with Stable Coronary Artery Disease
by Andrei Drugescu, Mihai Roca, Ioana Mădălina Zota, Alexandru-Dan Costache, Maria-Magdalena Leon-Constantin, Oana Irina Gavril, Radu Sebastian Gavril, Teodor Flaviu Vasilcu, Ovidiu Mitu, Cristina Mihaela Ghiciuc and Florin Mitu
Life 2023, 13(3), 640; https://doi.org/10.3390/life13030640 - 25 Feb 2023
Cited by 1 | Viewed by 1412
Abstract
Introduction. Chronic inflammation plays an essential role in the pathophysiology of both arterial hypertension (HTN) and coronary artery disease (CAD), and is more pronounced in individuals with a non-dipper circadian blood pressure (BP) pattern. A non-dipping BP pattern is in turn is associated [...] Read more.
Introduction. Chronic inflammation plays an essential role in the pathophysiology of both arterial hypertension (HTN) and coronary artery disease (CAD), and is more pronounced in individuals with a non-dipper circadian blood pressure (BP) pattern. A non-dipping BP pattern is in turn is associated with increased cardiovascular morbi-mortality, and a higher risk of atherosclerotic events. Neutrophil to lymphocyte ratio (NLR), monocyte to lymphocyte ratio (MLR) and platelet to lymphocyte ratio (PLR) are readily available predictors of systemic inflammation and cardiovascular risk. The purpose of our study is to evaluate whether NLR, MLR and PLR can be used as cost-effective predictors of a non-dipping blood pressure pattern in hypertensive patients with stable CAD. Materials and Methods: We performed a cross-sectional retrospective analysis that included 80 patients with hypertension and stable CAD (mean age 55.51 ± 11.83 years, 71.3% male) referred to a cardiovascular rehabilitation center. All patients underwent clinical examination, 24 h ambulatory blood pressure monitoring (ABPM) and standard blood analysis. Results: Baseline demographic characteristics were similar in both groups. Patients with non-dipper pattern had significantly higher NLR (median = 2, IR (2–3), p < 0.001), MLR (median = 0.31, IR (0.23–0.39), p < 0.001) and PLR (median = 175, IR (144–215), p < 0.001) compared to dippers. Conclusion: Our results suggest that MLR and PLR are inexpensive and easily accessible biomarkers that predict a non-dipping pattern in hypertensive patients with stable CAD. Full article
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20 pages, 335 KiB  
Article
Genetic Determinants of Cardiovascular Disease: The Endothelial Nitric Oxide Synthase 3 (eNOS3), Krüppel-Like Factor-14 (KLF-14), Methylenetetrahydrofolate Reductase (MTHFR), MiRNAs27a and Their Association with the Predisposition and Susceptibility to Coronary Artery Disease
by Rashid Mir, Imadeldin Elfaki, Jamsheed Javid, Jameel Barnawi, Malik A. Altayar, Salem Owaid Albalawi, Mohammed M. Jalal, Faris J. Tayeb, Aadil Yousif, Mohammad Fahad Ullah and Faisel M. AbuDuhier
Life 2022, 12(11), 1905; https://doi.org/10.3390/life12111905 - 16 Nov 2022
Cited by 5 | Viewed by 1646
Abstract
Coronary artery disease (CAD) is an important cause of death worldwide. CAD is caused by genetic and other factors including hypertension, hyperlipidemia, obesity, stress, unhealthy diet, physical inactively, smoking and Type 2 diabetes (T2D). The genome wide association studies (GWASs) have revealed the [...] Read more.
Coronary artery disease (CAD) is an important cause of death worldwide. CAD is caused by genetic and other factors including hypertension, hyperlipidemia, obesity, stress, unhealthy diet, physical inactively, smoking and Type 2 diabetes (T2D). The genome wide association studies (GWASs) have revealed the association of many loci with risk to diseases such as cancers, T2D and CAD. Nitric oxide (NO) is a potent vasodilator and is required for normal vascular health. It is produced in the endothelial cells in a reaction catalyzed by the endothelial NO synthase (eNOS). Methylenetetrahydrofolate reductase (MTHFR) is a very important enzyme involved in metabolism of folate and homocysteine, and its reduced function leads to cardiovascular disease. The Krüppel-like factor-14 (KLF-14) is an important transcriptional regulator that has been implicated in metabolic syndrome. MicroRNA (MiRNAs) are short non-coding RNAs that regulate the gene expression of proteins involved in important physiological processes including cell cycle and metabolism. In the present study, we have investigated the potential impact of germline pathogenic variants of endothelial eNOS, KLF-14, MTHFR, MiRNA-27a and their association with risk to CAD in the Saudi population. Methods: Amplification Refractory Mutation System (ARMS) PCR was used to detect MTHFR, KLF-14, miRNA-27a and eNOS3 genotyping in CAD patients and healthy controls. About 125 CAD cases and 125 controls were enrolled in this study and statistical associations were calculated including p-value, risk ratio (RR), and odds ratio (OD). Results: There were statistically significant differences (p < 0.05) in genotype distributions of MTHFR 677 C>T, KLF-14 rs972283 G>A, miRNAs27a rs895819 A>G and eNOS3 rs1799983 G>T between CAD patients and controls. In addition, our results indicated that the MTHFR-TT genotype was associated with increased CAD susceptibility with an OR 2.75 (95%) and p < 0.049, and the KLF14-AA genotype was also associated with increased CAD susceptibility with an OR of 2.24 (95%) and p < 0.024. Moreover, the miRNAs27a-GG genotype protects from CAD risk with an OR = 0.31 (0.016), p = 0.016. Our results also indicated that eNOS3 -GT genotype is associated with CAD susceptibility with an OR = 2.65, and p < 0.0003. Conclusion: The MTHFR 677C>T, KLF14 rs972283 G>A, miRNAs27a A>G, and eNOS3 rs1799983 G>T genotypes were associated with CAD susceptibility (p < 0.05). These findings require verification in future large-scale population based studies before these loci are used for the prediction and identification of individuals at risk to CAD. Weight control, physical activity, and smoking cessation are very influential recommendations given by clinicians to the at risk individuals to reduce or delay the development of CAD. Full article

Review

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25 pages, 3684 KiB  
Review
Cardiac Reverse Remodeling in Ischemic Heart Disease with Novel Therapies for Heart Failure with Reduced Ejection Fraction
by Sabina Andreea Leancă, Irina Afrăsânie, Daniela Crișu, Iulian Theodor Matei, Ștefania Teodora Duca, Alexandru Dan Costache, Viviana Onofrei, Ionuţ Tudorancea, Ovidiu Mitu, Minerva Codruța Bădescu, Lăcrămioara Ionela Șerban and Irina Iuliana Costache
Life 2023, 13(4), 1000; https://doi.org/10.3390/life13041000 - 13 Apr 2023
Cited by 1 | Viewed by 4520
Abstract
Despite the improvements in the treatment of coronary artery disease (CAD) and acute myocardial infarction (MI) over the past 20 years, ischemic heart disease (IHD) continues to be the most common cause of heart failure (HF). In clinical trials, over 70% of patients [...] Read more.
Despite the improvements in the treatment of coronary artery disease (CAD) and acute myocardial infarction (MI) over the past 20 years, ischemic heart disease (IHD) continues to be the most common cause of heart failure (HF). In clinical trials, over 70% of patients diagnosed with HF had IHD as the underlying cause. Furthermore, IHD predicts a worse outcome for patients with HF, leading to a substantial increase in late morbidity, mortality, and healthcare costs. In recent years, new pharmacological therapies have emerged for the treatment of HF, such as sodium-glucose cotransporter-2 inhibitors, angiotensin receptor-neprilysin inhibitors, selective cardiac myosin activators, and oral soluble guanylate cyclase stimulators, demonstrating clear or potential benefits in patients with HF with reduced ejection fraction. Interventional strategies such as cardiac resynchronization therapy, cardiac contractility modulation, or baroreflex activation therapy might provide additional therapeutic benefits by improving symptoms and promoting reverse remodeling. Furthermore, cardiac regenerative therapies such as stem cell transplantation could become a new therapeutic resource in the management of HF. By analyzing the existing data from the literature, this review aims to evaluate the impact of new HF therapies in patients with IHD in order to gain further insight into the best form of therapeutic management for this large proportion of HF patients. Full article
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