Ischemic Heart Disease in the Context of Different Comorbidities

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

Deadline for manuscript submissions: closed (16 June 2022) | Viewed by 43606

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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
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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

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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: 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 appear 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.

To summarize, 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.

Prof. 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 (12 papers)

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Editorial

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3 pages, 189 KiB  
Editorial
Ischemic Heart Disease in the Context of Different Comorbidities
by Irina-Iuliana Costache, Bogdan-Mircea Mihai and Minerva Codruta Badescu
Life 2022, 12(10), 1558; https://doi.org/10.3390/life12101558 - 7 Oct 2022
Cited by 2 | Viewed by 1264
Abstract
Ischemic heart disease (IHD) is a leading cause of morbidity and mortality worldwide [...] Full article
(This article belongs to the Special Issue Ischemic Heart Disease in the Context of Different Comorbidities)

Research

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11 pages, 276 KiB  
Article
Rare Causes of Acute Coronary Syndrome: Carbon Monoxide Poisoning
by Raluca Ecaterina Haliga, Bianca Codrina Morărașu, Victorița Șorodoc, Cătălina Lionte, Oana Sîrbu, Alexandra Stoica, Alexandr Ceasovschih, Mihai Constantin and Laurentiu Șorodoc
Life 2022, 12(8), 1158; https://doi.org/10.3390/life12081158 - 29 Jul 2022
Cited by 5 | Viewed by 1768
Abstract
Acute coronary syndrome (ACS) is a spectrum of clinical and paraclinical disorders arising from an imbalance of oxygen demand and supply to the myocardium. The most common cause is atherosclerosis; however, other rare causes such as carbon monoxide (CO) poisoning should be considered. [...] Read more.
Acute coronary syndrome (ACS) is a spectrum of clinical and paraclinical disorders arising from an imbalance of oxygen demand and supply to the myocardium. The most common cause is atherosclerosis; however, other rare causes such as carbon monoxide (CO) poisoning should be considered. Through tissue hypoxia and direct cell injury, CO poisoning can lead to a broad spectrum of cardiac disorders, especially ACS. Materials and Methods. We have conducted a retrospective study in the Toxicology Department of Saint Spiridon Emergency University Hospital, including all patients admitted through the emergency department with CO poisoning. We divided the cohort into event group (myocardial injury) and non-event group (patients without myocardial injury) and performed a subset analysis of the former. Results. A total of 65 patients were included, 22 in the event and 43 in the non-event group. The severity of poisoning did not correlate with myocardial injury; however, 50% of the event group had severe poisoning with carboxyhaemoglobin ≥ 20%. Cardiac enzyme markers (troponin and creatin-kinase MB) had a statistically significant increase in the event group compared to the non-event group (p < 0.05). Most of the patients in the STEMI (50%) and NSTEMI (66.7%) groups had severe CO intoxication. The STEMI group had a mean age of 27.7 years old and no comorbidities. Conclusions. Myocardial injury can develop in CO poisoning irrespective of the severity of poisoning, and it can be transient, reversible, or permanent. Our study introduces new information on adverse cardiac events in patients with CO poisoning, focusing on the ACS. We found that the severity of CO poisoning plays an important role in developing myocardial injury, as 50% of patients in the event group were severely intoxicated. While in-hospital mortality in our study was low, further prospective studies should investigate the long-term mortality in these patients. Full article
(This article belongs to the Special Issue Ischemic Heart Disease in the Context of Different Comorbidities)
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Review

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25 pages, 899 KiB  
Review
New Insights into Non-Alcoholic Fatty Liver Disease and Coronary Artery Disease: The Liver-Heart Axis
by Georgiana-Diana Cazac, Cristina-Mihaela Lăcătușu, Cătălina Mihai, Elena-Daniela Grigorescu, Alina Onofriescu and Bogdan-Mircea Mihai
Life 2022, 12(8), 1189; https://doi.org/10.3390/life12081189 - 4 Aug 2022
Cited by 17 | Viewed by 4327
Abstract
Non-alcoholic fatty liver disease (NAFLD) represents the hepatic expression of the metabolic syndrome and is the most prevalent liver disease. NAFLD is associated with liver-related and extrahepatic morbi-mortality. Among extrahepatic complications, cardiovascular disease (CVD) is the primary cause of mortality in patients with [...] Read more.
Non-alcoholic fatty liver disease (NAFLD) represents the hepatic expression of the metabolic syndrome and is the most prevalent liver disease. NAFLD is associated with liver-related and extrahepatic morbi-mortality. Among extrahepatic complications, cardiovascular disease (CVD) is the primary cause of mortality in patients with NAFLD. The most frequent clinical expression of CVD is the coronary artery disease (CAD). Epidemiological data support a link between CAD and NAFLD, underlain by pathogenic factors, such as the exacerbation of insulin resistance, genetic phenotype, oxidative stress, atherogenic dyslipidemia, pro-inflammatory mediators, and gut microbiota. A thorough assessment of cardiovascular risk and identification of all forms of CVD, especially CAD, are needed in all patients with NAFLD regardless of their metabolic status. Therefore, this narrative review aims to examine the available data on CAD seen in patients with NAFLD, to outline the main directions undertaken by the CVD risk assessment and the multiple putative underlying mechanisms implicated in the relationship between CAD and NAFLD, and to raise awareness about this underestimated association between two major, frequent and severe diseases. Full article
(This article belongs to the Special Issue Ischemic Heart Disease in the Context of Different Comorbidities)
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18 pages, 679 KiB  
Review
The Value of Troponin as a Biomarker of Chemotherapy-Induced Cardiotoxicity
by Victorita Sorodoc, Oana Sirbu, Catalina Lionte, Raluca Ecaterina Haliga, Alexandra Stoica, Alexandr Ceasovschih, Ovidiu Rusalim Petris, Mihai Constantin, Irina Iuliana Costache, Antoniu Octavian Petris, Paula Cristina Morariu and Laurentiu Sorodoc
Life 2022, 12(8), 1183; https://doi.org/10.3390/life12081183 - 3 Aug 2022
Cited by 10 | Viewed by 2731
Abstract
In cancer survivors, cardiac dysfunction is the main cause of mortality. Cardiotoxicity represents a decline in cardiac function associated with cancer therapy, and the risk factors include smoking, dyslipidemia, an age of over 60 years, obesity, and a history of coronary artery disease, [...] Read more.
In cancer survivors, cardiac dysfunction is the main cause of mortality. Cardiotoxicity represents a decline in cardiac function associated with cancer therapy, and the risk factors include smoking, dyslipidemia, an age of over 60 years, obesity, and a history of coronary artery disease, diabetes, atrial fibrillation, or heart failure. Troponin is a biomarker that is widely used in the detection of acute coronary syndromes. It has a high specificity, although it is not exclusively associated with myocardial ischemia. The aim of this paper is to summarize published studies and to establish the role of troponin assays in the diagnosis of cardiotoxicity associated with various chemotherapeutic agents. Troponin has been shown to be a significant biomarker in the diagnosis of the cardiac dysfunction associated with several types of chemotherapeutic drugs: anthracyclines, anti-human epidermal growth factor receptor 2 treatment, and anti-vascular endothelial growth factor therapy. Based on the data available at this moment, troponin is useful for baseline risk assessment, the diagnosis of cardiotoxicity, and as a guide for the initiation of cardioprotective treatment. There are currently clear regulations regarding the timing of troponin surveillance depending on the patient’s risk of cardiotoxicity and the type of medication administered, but data on the cut-off values of this biomarker are still under investigation. Full article
(This article belongs to the Special Issue Ischemic Heart Disease in the Context of Different Comorbidities)
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14 pages, 577 KiB  
Review
Chronic Coronary Syndrome in Frail Old Population
by Adina Carmen Ilie, Sabinne Marie Taranu, Ramona Stefaniu, Ioana Alexandra Sandu, Anca Iuliana Pislaru, Calina Anda Sandu, Ana-Maria Turcu and Ioana Dana Alexa
Life 2022, 12(8), 1133; https://doi.org/10.3390/life12081133 - 27 Jul 2022
Cited by 3 | Viewed by 2384
Abstract
The demographic trend of aging is associated with an increased prevalence of comorbidities among the elderly. Physical, immunological, emotional and cognitive impairment, in the context of the advanced biological age segment, leads to the maintenance and precipitation of cardiovascular diseases. Thus, more and [...] Read more.
The demographic trend of aging is associated with an increased prevalence of comorbidities among the elderly. Physical, immunological, emotional and cognitive impairment, in the context of the advanced biological age segment, leads to the maintenance and precipitation of cardiovascular diseases. Thus, more and more data are focused on understanding the pathophysiological mechanisms underlying each fragility phenotype and how they potentiate each other. The implications of inflammation, sarcopenia, vitamin D deficiency and albumin, as dimensions inherent in fragility, in the development and setting of chronic coronary syndromes (CCSs) have proven their patent significance but are still open to research. At the same time, the literature speculates on the interdependent relationship between frailty and CCSs, revealing the role of the first one in the development of the second. In this sense, depression, disabilities, polypharmacy and even cognitive disorders in the elderly with ischemic cardiovascular disease mean a gradual and complex progression of frailty. The battery of tests necessary for the evaluation of the elderly with CCSs requires a permanent update, according to the latest guidelines, but also an individualized approach related to the degree of frailty and the conditions imposed by it. By summation, the knowledge of frailty screening methods, through the use of sensitive and individualized tools, is the foundation of secondary prevention and prognosis in the elderly with CCSs. Moreover, a comprehensive geriatric assessment remains the gold standard of the medical approach of these patients. The management of the frail elderly, with CCSs, brings new challenges, also from the perspective of the treatment particularities. Sometimes the risk–benefit balance is difficult to achieve. Therefore, the holistic, individualized and updated approach of these patients remains a desired objective, by understanding and permanently acquiring knowledge on the complexity of the frailty syndrome. Full article
(This article belongs to the Special Issue Ischemic Heart Disease in the Context of Different Comorbidities)
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13 pages, 602 KiB  
Review
Ischemic Heart Disease in Patients with Inflammatory Bowel Disease: Risk Factors, Mechanisms and Prevention
by Alina Ecaterina Jucan, Otilia Gavrilescu, Mihaela Dranga, Iolanda Valentina Popa, Bogdan Mircea Mihai, Cristina Cijevschi Prelipcean and Cătălina Mihai
Life 2022, 12(8), 1113; https://doi.org/10.3390/life12081113 - 24 Jul 2022
Cited by 6 | Viewed by 2800
Abstract
According to new research, a possible association between inflammatory bowel disease (IBD) and an increased risk of ischemic heart disease (IHD) has been demonstrated, but this concern is still debatable. The purpose of this review is to investigate the link between IHD and [...] Read more.
According to new research, a possible association between inflammatory bowel disease (IBD) and an increased risk of ischemic heart disease (IHD) has been demonstrated, but this concern is still debatable. The purpose of this review is to investigate the link between IHD and IBD, as well as identify further research pathways that could help develop clinical recommendations for the management of IHD risk in IBD patients. There is growing evidence suggesting that disruption of the intestinal mucosal barrier in IBD is associated with the translocation of microbial lipopolysaccharides (LPS) and other endotoxins into the bloodstream, which might induce a pro-inflammatory cytokines response that can lead to endothelial dysfunction, atherosclerosis and acute cardiovascular events. Therefore, it is considered that the long-term inflammation process in IBD patients, similar to other chronic inflammatory diseases, may lead to IHD risk. The main cardiovascular risk factors, including high blood pressure, dyslipidemia, diabetes, smoking, and obesity, should be checked in all patients with IBD, and followed by strategies to reduce and manage early aggression. IBD activity is an important risk factor for acute cardiovascular events, and optimizing therapy for IBD patients should be followed as recommended in current guidelines, especially during active flares. Large long-term prospective studies, new biomarkers and scores are warranted to an optimal management of IHD risk in IBD patients. Full article
(This article belongs to the Special Issue Ischemic Heart Disease in the Context of Different Comorbidities)
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23 pages, 1338 KiB  
Review
Left Ventricular Remodeling after Myocardial Infarction: From Physiopathology to Treatment
by Sabina Andreea Leancă, Daniela Crișu, Antoniu Octavian Petriș, Irina Afrăsânie, Antonia Genes, Alexandru Dan Costache, Dan Nicolae Tesloianu and Irina Iuliana Costache
Life 2022, 12(8), 1111; https://doi.org/10.3390/life12081111 - 24 Jul 2022
Cited by 30 | Viewed by 8815
Abstract
Myocardial infarction (MI) is the leading cause of death and morbidity worldwide, with an incidence relatively high in developed countries and rapidly growing in developing countries. The most common cause of MI is the rupture of an atherosclerotic plaque with subsequent thrombotic occlusion [...] Read more.
Myocardial infarction (MI) is the leading cause of death and morbidity worldwide, with an incidence relatively high in developed countries and rapidly growing in developing countries. The most common cause of MI is the rupture of an atherosclerotic plaque with subsequent thrombotic occlusion in the coronary circulation. This causes cardiomyocyte death and myocardial necrosis, with subsequent inflammation and fibrosis. Current therapies aim to restore coronary flow by thrombus dissolution with pharmaceutical treatment and/or intravascular stent implantation and to counteract neurohormonal activation. Despite these therapies, the injury caused by myocardial ischemia leads to left ventricular remodeling; this process involves changes in cardiac geometry, dimension and function and eventually progression to heart failure (HF). This review describes the pathophysiological mechanism that leads to cardiac remodeling and the therapeutic strategies with a role in slowing the progression of remodeling and improving cardiac structure and function. Full article
(This article belongs to the Special Issue Ischemic Heart Disease in the Context of Different Comorbidities)
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23 pages, 1148 KiB  
Review
A Real Pandora’s Box in Pandemic Times: A Narrative Review on the Acute Cardiac Injury Due to COVID-19
by Amalia-Stefana Timpau, Radu-Stefan Miftode, Daniela Leca, Razvan Timpau, Ionela-Larisa Miftode, Antoniu Octavian Petris, Irina Iuliana Costache, Ovidiu Mitu, Ana Nicolae, Alexandru Oancea, Alexandru Jigoranu, Cristina Gabriela Tuchilus and Egidia-Gabriela Miftode
Life 2022, 12(7), 1085; https://doi.org/10.3390/life12071085 - 20 Jul 2022
Cited by 12 | Viewed by 3383
Abstract
The intricate relationship between severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and the cardiovascular system is an extensively studied pandemic topic, as there is an ever-increasing amount of evidence that reports a high prevalence of acute cardiac injury in the context of viral [...] Read more.
The intricate relationship between severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and the cardiovascular system is an extensively studied pandemic topic, as there is an ever-increasing amount of evidence that reports a high prevalence of acute cardiac injury in the context of viral infection. In patients with Coronavirus disease 2019, COVID-19, a significant increase in serum levels of cardiac troponin or other various biomarkers was observed, suggesting acute cardiac injury, thus predicting both a severe course of the disease and a poor outcome. Pathogenesis of acute cardiac injury is not yet completely elucidated, though several mechanisms are allegedly involved, such as a direct cardiomyocyte injury, oxygen supply-demand inequity caused by hypoxia, several active myocardial depressant factors during sepsis, and endothelial dysfunction due to the hyperinflammatory status. Moreover, the increased levels of plasma cytokines and catecholamines and a significantly enhanced prothrombotic environment may lead to the destabilization and rupture of atheroma plaques, subsequently triggering an acute coronary syndrome. In the present review, we focus on describing the epidemiology, pathogenesis, and role of biomarkers in the diagnosis and prognosis of patients with acute cardiac injury in the setting of the COVID-19 pandemic. We also explore some novel therapeutic strategies involving immunomodulatory therapy, as well as their role in preventing a severe form of the disease, with both the short-term outcome and the long-term cardiovascular sequelae being equally important in patients with SARS-CoV-2 induced acute cardiac injury. Full article
(This article belongs to the Special Issue Ischemic Heart Disease in the Context of Different Comorbidities)
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14 pages, 1056 KiB  
Review
Ischemic Heart Disease and Liver Cirrhosis: Adding Insult to Injury
by Irina Gîrleanu, Anca Trifan, Laura Huiban, Cristina Muzîca, Oana Cristina Petrea, Ana Maria Sîngeap, Camelia Cojocariu, Stefan Chiriac, Tudor Cuciureanu, Irina Iuliana Costache and Carol Stanciu
Life 2022, 12(7), 1036; https://doi.org/10.3390/life12071036 - 12 Jul 2022
Cited by 2 | Viewed by 4104
Abstract
The link between heart and liver cirrhosis was recognized decades ago, although much data regarding atherosclerosis and ischemic heart disease are still missing. Ischemic heart disease or coronary artery disease (CAD) and liver cirrhosis could be associated with characteristic epidemiological and pathophysiological features. [...] Read more.
The link between heart and liver cirrhosis was recognized decades ago, although much data regarding atherosclerosis and ischemic heart disease are still missing. Ischemic heart disease or coronary artery disease (CAD) and liver cirrhosis could be associated with characteristic epidemiological and pathophysiological features. This connection determines increased rates of morbidity and all-cause mortality in patients with liver cirrhosis. In the era of a metabolic syndrome and non-alcoholic fatty liver disease pandemic, primary prevention and early diagnosis of coronary artery disease could improve the prognosis of liver cirrhosis patients. This review outlines a summary of the literature regarding prevalence, risk assessment and medical and interventional treatment options in this particular population. A collaborative heart–liver team-based approach is imperative for critical management decisions for patients with CAD and liver cirrhosis. Full article
(This article belongs to the Special Issue Ischemic Heart Disease in the Context of Different Comorbidities)
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22 pages, 405 KiB  
Review
Myocardial Ischemia Related to Common Cancer Therapy—Prevention Insights
by Minerva Codruta Badescu, Oana Viola Badulescu, Dragos Viorel Scripcariu, Lăcrămioara Ionela Butnariu, Iris Bararu-Bojan, Diana Popescu, Manuela Ciocoiu, Eusebiu Vlad Gorduza, Irina Iuliana Costache, Elena Rezus and Ciprian Rezus
Life 2022, 12(7), 1034; https://doi.org/10.3390/life12071034 - 12 Jul 2022
Cited by 2 | Viewed by 1945
Abstract
Modern antineoplastic therapy improves survival and quality of life in cancer patients, but its indisputable benefits are accompanied by multiple and major side effects, such as cardiovascular ones. Endothelial dysfunction, arterial spasm, intravascular thrombosis, and accelerated atherosclerosis affect the coronary arteries, leading to [...] Read more.
Modern antineoplastic therapy improves survival and quality of life in cancer patients, but its indisputable benefits are accompanied by multiple and major side effects, such as cardiovascular ones. Endothelial dysfunction, arterial spasm, intravascular thrombosis, and accelerated atherosclerosis affect the coronary arteries, leading to acute and chronic coronary syndromes that negatively interfere with the oncologic treatment. The cardiac toxicity of antineoplastic agents may be mitigated by using adequate prophylactic measures. In the absence of dedicated guidelines, our work provides the most comprehensive, systematized, structured, and up-to-date analyses of the available literature focusing on measures aiming to protect the coronary arteries from the toxicity of cancer therapy. Our work facilitates the implementation of these measures in daily practice. The ultimate goal is to offer clinicians the necessary data for a personalized therapeutic approach for cancer patients receiving evidence-based oncology treatments with potential cardiovascular toxicity. Full article
(This article belongs to the Special Issue Ischemic Heart Disease in the Context of Different Comorbidities)
20 pages, 3084 KiB  
Review
Myocardial Ischemia in Patients with COVID-19 Infection: Between Pathophysiological Mechanisms and Electrocardiographic Findings
by Ștefania Teodora Duca, Adriana Chetran, Radu Ștefan Miftode, Ovidiu Mitu, Alexandru Dan Costache, Ana Nicolae, Dan Iliescu-Halițchi, Codruța-Olimpiada Halițchi-Iliescu, Florin Mitu and Irina Iuliana Costache
Life 2022, 12(7), 1015; https://doi.org/10.3390/life12071015 - 8 Jul 2022
Cited by 8 | Viewed by 3565
Abstract
Given the possible pathophysiological links between myocardial ischemia and SARS-CoV-2 infection, several studies have focused attention on acute coronary syndromes in order to improve patients’ morbidity and mortality. Understanding the pathophysiological aspects of myocardial ischemia in patients infected with SARS-CoV-2 can open a [...] Read more.
Given the possible pathophysiological links between myocardial ischemia and SARS-CoV-2 infection, several studies have focused attention on acute coronary syndromes in order to improve patients’ morbidity and mortality. Understanding the pathophysiological aspects of myocardial ischemia in patients infected with SARS-CoV-2 can open a broad perspective on the proper management for each patient. The electrocardiogram (ECG) remains the easiest assessment of cardiac involvement in COVID-19 patients, due to its non-invasive profile, accessibility, low cost, and lack of radiation. The ECG changes provide insight into the patient’s prognosis, indicating either the worsening of an underlying cardiac illnesses or the acute direct injury by the virus. This indicates that the ECG is an important prognostic tool that can affect the outcome of COVID-19 patients, which important to correlate its aspects with the clinical characteristics and patient’s medical history. The ECG changes in myocardial ischemia include a broad spectrum in patients with COVID-19 with different cases reported of ST-segment elevation, ST-segment depression, and T wave inversion, which are associated with severe COVID-19 disease. Full article
(This article belongs to the Special Issue Ischemic Heart Disease in the Context of Different Comorbidities)
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37 pages, 1361 KiB  
Review
Etiologic Puzzle of Coronary Artery Disease: How Important Is Genetic Component?
by Lăcrămioara Ionela Butnariu, Laura Florea, Minerva Codruta Badescu, Elena Țarcă, Irina-Iuliana Costache and Eusebiu Vlad Gorduza
Life 2022, 12(6), 865; https://doi.org/10.3390/life12060865 - 9 Jun 2022
Cited by 11 | Viewed by 4269
Abstract
In the modern era, coronary artery disease (CAD) has become the most common form of heart disease and, due to the severity of its clinical manifestations and its acute complications, is a major cause of morbidity and mortality worldwide. The phenotypic variability of [...] Read more.
In the modern era, coronary artery disease (CAD) has become the most common form of heart disease and, due to the severity of its clinical manifestations and its acute complications, is a major cause of morbidity and mortality worldwide. The phenotypic variability of CAD is correlated with the complex etiology, multifactorial (caused by the interaction of genetic and environmental factors) but also monogenic. The purpose of this review is to present the genetic factors involved in the etiology of CAD and their relationship to the pathogenic mechanisms of the disease. Method: we analyzed data from the literature, starting with candidate gene-based association studies, then continuing with extensive association studies such as Genome-Wide Association Studies (GWAS) and Whole Exome Sequencing (WES). The results of these studies revealed that the number of genetic factors involved in CAD etiology is impressive. The identification of new genetic factors through GWASs offers new perspectives on understanding the complex pathophysiological mechanisms that determine CAD. In conclusion, deciphering the genetic architecture of CAD by extended genomic analysis (GWAS/WES) will establish new therapeutic targets and lead to the development of new treatments. The identification of individuals at high risk for CAD using polygenic risk scores (PRS) will allow early prophylactic measures and personalized therapy to improve their prognosis. Full article
(This article belongs to the Special Issue Ischemic Heart Disease in the Context of Different Comorbidities)
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