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Medicina
Special Issues
Advances in Chronic Coronary Syndrome and Coronary Heart Disease
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Advances in Chronic Coronary Syndrome and Coronary Heart Disease

A special issue of Medicina (ISSN 1648-9144). This special issue belongs to the section "Cardiology".

Deadline for manuscript submissions: closed (20 April 2024) | Viewed by 6490

Special Issue Editors

Prof. Dr. Florin Mitu

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Guest Editor
1. Department of Medical Specialties I, Faculty of Medicine, University of Medicine and Pharmacy “Grigore T. Popa”, 700115 Iasi, Romania
2. Clinical Rehabilitation Hospital, 700661 Iasi, Romania
Interests: cardiology; internal medicine; cardiac rehabilitation; sports medicine
Special Issues, Collections and Topics in MDPI journals
Prof. Dr. Maria-Magdalena Leon Constantin

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Guest Editor
1. Department of Medical Specialties I, Faculty of Medicine, University of Medicine and Pharmacy “Grigore T. Popa”, 700115 Iasi, Romania
2. Clinical Rehabilitation Hospital, 700661 Iasi, Romania
Interests: cardiology; internal medicine; cardiac rehabilitation; sports medicine
Alexandru Dan Costache

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Guest Editor Assistant
1. Department of Medical Specialties I, Faculty of Medicine, University of Medicine and Pharmacy “Grigore T. Popa”, 700115 Iasi, Romania
2. Clinical Rehabilitation Hospital, 700661 Iasi, Romania
Interests: cardiology; internal medicine; cardiac rehabilitation; sports medicine

Special Issue Information

Dear Colleagues,

Given the high number of ischemic heart disease cases and the growing incidence worldwide, it is important to be kept up to date with the newest recommendations regarding both diagnosis and treatment.

Apart from acute management, which is life-saving, it is important to acknowledge the long-term impact an ischemic cardiac event has on heart function and how the predisposition to a reoccurrence is increased. Periodic long-term supervision, together with a closely adhered and monitored treatment schedule, are paramount principles of patient management.

Additionally, patients are included in exercise-based cardiovascular rehabilitation programs, which have been shown to significantly reduce cardiac-related mortality and improve the quality of life of patients. These are being recommended by the newest guidelines as a required step to be undertaken.

The aim of this Special Issue is to gather the newest data and studies on the management of patients with chronic coronary syndromes. Therefore, we encourage to submit your articles on this topic.

Prof. Dr. Florin Mitu
Prof. Dr. Maria-Magdalena Leon Constantin
Guest Editors

Alexandru Dan Costache
Guest Editor Assistant

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. Medicina is an international peer-reviewed open access monthly 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 1800 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

  • chronic coronary syndrome
  • atherosclerosis
  • secondary prevention
  • cardiac rehabilitation
  • coronary obstruction
  • vasospasm

Published Papers (5 papers)

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Research

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13 pages, 1128 KiB  
Article
Does Psychological State Influence the Physiological Response to Cardiac Rehabilitation in Older Adults?
by Karolina Kowalewska, Kamil Radecki and Błażej Cieślik
Medicina 2024, 60(3), 361; https://doi.org/10.3390/medicina60030361 - 21 Feb 2024
Viewed by 783
Abstract
Background and Objectives: Cardiovascular diseases (CVDs) are a major global cause of death. Effective secondary prevention is crucial, involving risk factor modification and cardiac rehabilitation. However, mental factors, particularly depression, exert a significant influence on CVD outcomes by increasing cardiovascular risk and [...] Read more.
Background and Objectives: Cardiovascular diseases (CVDs) are a major global cause of death. Effective secondary prevention is crucial, involving risk factor modification and cardiac rehabilitation. However, mental factors, particularly depression, exert a significant influence on CVD outcomes by increasing cardiovascular risk and impeding treatment adherence. Therefore, the aim of this study is to assess the impact of psychological state on the effectiveness of rehabilitation in cardiac patients. Materials and Methods: Thirty-three patients referred for cardiac rehabilitation participated in a 3-week program, retrospectively categorized into two groups: those with and without depressive symptoms. The functional status of the patients was assessed using the R.A.M.P. protocol exercise test, conducted on a treadmill, during which resting and exercise heart rate (HR), systolic (SBP) and diastolic (DBP) blood pressure, and metabolic equivalent of task (MET) measurements were taken. The Hospital Anxiety and Depression Scale (HADS) and the Perceived Stress Scale (PSS-10) were utilized to evaluate the patients’ psychological state. Stepwise regression explored the psychological factors explaining physiological parameter variance. Results: Participants without depressive symptoms exhibited significantly greater improvements in exercise HR (15.58 vs. 1.07; p = 0.02), exercise SBP (7.93 vs. −2.05; p = 0.05), and exercise METs (1.52 vs. 0.50; p = 0.006) compared to those with depressive symptoms. The following predictors were found to be significant: for exercise HR—HADS-D (r2 = 12%; p = 0.04); for exercise DBP—PSS-10 (r2 = 27%; p = 0.002); and for METs—HADS-D and age (r2 = 26%; p = 0.01). Conclusions: In conclusion, cardiac rehabilitation improved psychological and physiological parameters in both groups, with greater effectiveness seen in those without depression. Depressive symptoms predicted exercise HR, SBP, and METs, highlighting their role in worsening cardiac disease. Emphasizing psychological factors, including depression and stress, in cardiac rehabilitation can enhance effectiveness and patient outcomes. Full article
(This article belongs to the Special Issue Advances in Chronic Coronary Syndrome and Coronary Heart Disease)
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24 pages, 1850 KiB  
Article
Harmony in Chaos: Deciphering the Influence of Ischemic Cardiomyopathy and Non-Cardiac Comorbidities on Holter ECG Parameters in Chronic Heart Failure Patients: A Pilot Study
by Ștefania-Teodora Duca, Minerva Codruta Badescu, Alexandru-Dan Costache, Adriana Chetran, Radu Ștefan Miftode, Ionuț Tudorancea, Ovidiu Mitu, Irina Afrăsânie, Radu-George Ciorap, Ionela-Lăcrămioara Șerban, D. Robert Pavăl, Bianca Dmour, Maria-Ruxandra Cepoi and Irina-Iuliana Costache-Enache
Medicina 2024, 60(2), 342; https://doi.org/10.3390/medicina60020342 - 19 Feb 2024
Viewed by 1861
Abstract
Background and Objective: In the landscape of heart failure, non-cardiac comorbidities represent a formidable challenge, imparting adverse prognostic implications. Holter ECG monitoring assumes a supplementary role in delineating myocardial susceptibility and autonomic nervous system dynamics. This study aims to explore the potential [...] Read more.
Background and Objective: In the landscape of heart failure, non-cardiac comorbidities represent a formidable challenge, imparting adverse prognostic implications. Holter ECG monitoring assumes a supplementary role in delineating myocardial susceptibility and autonomic nervous system dynamics. This study aims to explore the potential correlation between Holter ECG parameters and comorbidities in individuals with ischemic cardiomyopathy experiencing heart failure (HF), with a particular focus on the primary utility of these parameters as prognostic indicators. Materials and Methods: In this prospective inquiry, a cohort of 60 individuals diagnosed with heart failure underwent stratification into subgroups based on the presence of comorbidities, including diabetes, chronic kidney disease, obesity, or hyperuricemia. Upon admission, a thorough evaluation of all participants encompassed echocardiography, laboratory panel analysis, and 24 h Holter monitoring. Results: Significant associations were uncovered between diabetes and unconventional physiological indicators, specifically the Triangular index (p = 0.035) and deceleration capacity (p = 0.002). Pertaining to creatinine clearance, notable correlations surfaced with RMSSD (p = 0.026), PNN50 (p = 0.013), and high-frequency power (p = 0.026). An examination of uric acid levels and distinctive Holter ECG patterns unveiled statistical significance, particularly regarding the deceleration capacity (p = 0.045). Nevertheless, in the evaluation of the Body Mass Index, no statistically significant findings emerged concerning Holter ECG parameters. Conclusions: The identified statistical correlations between non-cardiac comorbidities and patterns elucidated in Holter ECG recordings underscore the heightened diagnostic utility of this investigative modality in the comprehensive evaluation of individuals grappling with HF. Furthermore, we underscore the critical importance of the thorough analysis of Holter ECG recordings, particularly with regard to subtle and emerging parameters that may be overlooked or insufficiently acknowledged. Full article
(This article belongs to the Special Issue Advances in Chronic Coronary Syndrome and Coronary Heart Disease)
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Review

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18 pages, 591 KiB  
Review
Lipid-Derived Biomarkers as Therapeutic Targets for Chronic Coronary Syndrome and Ischemic Stroke: An Updated Narrative Review
by Thomas Gabriel Schreiner, Bogdan Emilian Ignat, Cristina Grosu, Alexandru Dan Costache, Maria Magdalena Leon and Florin Mitu
Medicina 2024, 60(4), 561; https://doi.org/10.3390/medicina60040561 - 29 Mar 2024
Viewed by 593
Abstract
The incidence and prevalence of cardiac and cerebrovascular diseases are constantly increasing, with chronic coronary syndrome and ischemic stroke as the leading causes of morbidity and mortality worldwide. According to current knowledge, the heart–brain axis is more than a theoretical concept, with many [...] Read more.
The incidence and prevalence of cardiac and cerebrovascular diseases are constantly increasing, with chronic coronary syndrome and ischemic stroke as the leading causes of morbidity and mortality worldwide. According to current knowledge, the heart–brain axis is more than a theoretical concept, with many common pathophysiological mechanisms involved in the onset and evolution of both coronary and cerebral ischemia. Moreover, the focus is on the prevention and early intervention of risk factors in searching for targeted and personalized medical treatment. In this context, this narrative review aims to offer, in a didactic and practice-oriented manner, an up-to-date overview of the role played by lipid-derived biomarkers (from low-density lipoprotein cholesterol to oxylipin and apolipoproteins) in chronic coronary syndrome and ischemic stroke. Firstly, the authors highlight, via relevant epidemiological data, the significant burden of chronic coronary syndrome and ischemic stroke in the general population, thus explaining the need for updated information on this topic. Subsequently, the most important lipid-derived biomarkers and their multiple roles in the pathogenesis of these two disorders are listed. Currently available and experimental targeted therapies based on these lipid-derived biomarkers are presented in the final part of this paper, representing this manuscript’s original and novel input. Full article
(This article belongs to the Special Issue Advances in Chronic Coronary Syndrome and Coronary Heart Disease)
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14 pages, 352 KiB  
Review
Spontaneous Coronary Artery Dissection in Clinical Practice: Pathophysiology and Therapeutic Approaches
by Andrea D’Amato, Marco Valerio Mariani, Silvia Prosperi, Lorenzo Colombo, Andrea De Prisco, Carlo Lavalle, Massimo Mancone, Carmine Dario Vizza and Paolo Severino
Medicina 2024, 60(2), 217; https://doi.org/10.3390/medicina60020217 - 26 Jan 2024
Viewed by 999
Abstract
Spontaneous coronary artery dissection (SCAD) is a cause of myocardial infarction without obstructive coronary artery disease (MINOCA). It is determined by a coronary artery wall layers separation, which occurs regardless of traumatic or iatrogenic injuries. Even if it is often a missed diagnosis, [...] Read more.
Spontaneous coronary artery dissection (SCAD) is a cause of myocardial infarction without obstructive coronary artery disease (MINOCA). It is determined by a coronary artery wall layers separation, which occurs regardless of traumatic or iatrogenic injuries. Even if it is often a missed diagnosis, its incidence is growing along with the improvement of intracoronary imaging techniques that allow for better detection. The main angiographical classification distinguishes three different forms, with slightly different prognoses at long-term follow up. SCAD is a recurrent condition, severely hampering the life quality of affected patients. The predominantly young age of patients with SCAD and the high prevalence of females among them have made the topic increasingly important, especially regarding therapeutic strategies. According to the data, the most recommended treatment is conservative, based on the use of antiplatelet agents and supportive anti-ischemic therapy. However, there are conflicting opinions concerning the need for dual antiplatelet therapy and its duration. In the case of invasive treatment, the choice between percutaneous coronary intervention and coronary artery bypass graft depends on the patient’s clinical stability and the interested vessel. The purpose of the current review is to revise the pathophysiological mechanisms underlying SCAD and the current knowledge of its treatment. Full article
(This article belongs to the Special Issue Advances in Chronic Coronary Syndrome and Coronary Heart Disease)

Other

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13 pages, 11783 KiB  
Case Report
Takayasu’s Arteritis: A Special Case Report and Review of the Literature
by Paloma Moisii, Irina Jari, Alexandru Gratian Naum, Doina Butcovan and Grigore Tinica
Medicina 2024, 60(3), 456; https://doi.org/10.3390/medicina60030456 - 09 Mar 2024
Viewed by 1457
Abstract
Background: Takayasu’s arteritis is a rare type of vasculitis with severe complications like stroke, ischemic heart disease, pulmonary hypertension, secondary hypertension, and aneurysms. Diagnosis is achieved using clinical and angiographic criteria. Treatment is medical and surgical, but unfortunately, the outcome is limited. [...] Read more.
Background: Takayasu’s arteritis is a rare type of vasculitis with severe complications like stroke, ischemic heart disease, pulmonary hypertension, secondary hypertension, and aneurysms. Diagnosis is achieved using clinical and angiographic criteria. Treatment is medical and surgical, but unfortunately, the outcome is limited. Case presentation: A 34-year-old Caucasian woman had an ischemic stroke (2009). She was diagnosed with Takayasu’s arteritis and received treatment with methotrexate, prednisolone, and antiplatelet agents, with a mild improvement in clinical state. After 6 years (2015), she experienced an ascending aorta aneurysm, pulmonary hypertension, and mild aortic regurgitation. Surgical treatment solved both the ascending aorta aneurysm and left carotid artery stenosis (ultrasound in 2009 and computed tomography angiogram in 2014). Morphopathology revealed a typical case of Takayasu’s arteritis. Tumor necrosis factor inhibitors (TNF inhibitors) were prescribed with methotrexate. At 48 years old (2023), she developed coronary heart disease (angina, electrocardiogram); echocardiography revealed severe pulmonary hypertension, and angiography revealed normal coronary arteries, abdominal aorta pseudoaneurysm, and arterial–venous fistula originating in the right coronary artery with drainage in the medium pulmonary artery. The patient refused surgical/interventional treatment. She again received TNF inhibitors, methotrexate, antiplatelet agents, and statins. Conclusions: This case report presented a severe form of Takayasu’s arteritis. Our patient had multiple arterial complications, as previously mentioned. She received immunosuppressive treatment, medication targeted to coronary heart disease, and surgical therapy. Full article
(This article belongs to the Special Issue Advances in Chronic Coronary Syndrome and Coronary Heart Disease)
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