Diagnostics

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16 pages, 1491 KiB

Open AccessArticle

Impact of Psoas Muscle Area Index on Short- and Mid-Term Mortality in Patients Undergoing Valve Surgery for Infective Endocarditis: A Retrospective Analysis

by Christian Dinges, Matthias Hammerer, Nikolaos Schörghofer, Christoph Knapitsch, Gretha Hecke, Sophie Klaus, Johannes Steindl, Richard Rezar, Rainald Seitelberger, Uta C. Hoppe, Klaus Hergan, Elke Boxhammer and Bernhard Scharinger

Diagnostics 2024, 14(20), 2259; https://doi.org/10.3390/diagnostics14202259 - 10 Oct 2024

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Abstract

Background: Sarcopenia, characterized by the loss of skeletal muscle mass, is an emerging comorbidity associated with poor outcomes in cardiovascular surgery. Its impact on mortality in patients undergoing valve surgery for infective endocarditis (IE) remains underexplored. This study investigates the relationship between sarcopenia, [...] Read more.

Background: Sarcopenia, characterized by the loss of skeletal muscle mass, is an emerging comorbidity associated with poor outcomes in cardiovascular surgery. Its impact on mortality in patients undergoing valve surgery for infective endocarditis (IE) remains underexplored. This study investigates the relationship between sarcopenia, measured by the Psoas muscle area index (PMAi), and mortality in patients with IE undergoing valve surgery. Materials and Methods: We retrospectively analyzed 68 patients with IE who underwent valve surgery at a tertiary care center from 2013 to 2021. Sarcopenia was defined as being in the lowest quartile of PMAi, measured via preoperative computed tomography (CT). Baseline characteristics, survival outcomes, and factors influencing mortality were analyzed using Kaplan–Meier survival curves and Cox proportional hazards regression. The predictive value of PMAi for 1-year and 3-year mortality was assessed via receiver operating characteristic (ROC) curves. Results: Sarcopenia was strongly associated with increased mortality at both 1-year (HR: 0.378, p = 0.010) and 3-year follow-ups (HR: 0.457, p = 0.012). Female sex (OR: 275.748, p < 0.001) and older age (OR: 9.995, p = 0.003) were significant predictors of sarcopenia. Chronic kidney insufficiency (CKI) and the use of heart failure medication therapy also significantly impacted survival outcomes. Conclusions: Sarcopenia is a strong independent predictor of short- and mid-term mortality in patients undergoing valve surgery for IE. Routine radiological assessment of sarcopenia using PMAi could improve risk stratification and guide preoperative interventions. Tailored management strategies, especially in older women and patients with CKI, may enhance outcomes in this high-risk population. Full article

(This article belongs to the Special Issue Cardiovascular Diseases: Diagnosis and Management)

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13 pages, 1916 KiB

Open AccessArticle

The Prognostic Value of Left Atrial Function in Patients with Acute Myocardial Infarction

by Jorun Tangen, Thuy Mi Nguyen, Daniela Melichova, Lars Gunnar Klaeboe, Marianne Forsa, Kristoffer Andresen, Adrien Al Wazzan, Oyvind Lie, Kristina Haugaa, Helge Skulstad, Harald Brunvand and Thor Edvardsen

Diagnostics 2024, 14(18), 2027; https://doi.org/10.3390/diagnostics14182027 - 13 Sep 2024

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Abstract

The prognostic value of left atrial (LA) volume is well-established in acute myocardial infarction (AMI) patients. LA strain provides further patophysological insights. In the present study, we evaluated LA volume and LA strain in AMI patients including those with atrial fibrillation (AF). The [...] Read more.

The prognostic value of left atrial (LA) volume is well-established in acute myocardial infarction (AMI) patients. LA strain provides further patophysological insights. In the present study, we evaluated LA volume and LA strain in AMI patients including those with atrial fibrillation (AF). The aim of the study was to determine if LA strain provide additional prognostic value. Patients with AMI underwent two-dimensional echocardiography within 72 h of admission. The primary outcome was a composite of all-cause mortality and major adverse cardiovascular events. Cox regression analyses were performed. We included 501 patients and during follow-up, 132 patients (26.4%) met the primary outcome. Left ventricular (LV) global longitudinal strain (GLS) (HR 0.94 [95% CI 0.88–0.99], p = 0.029), indexed LA volume (LAVi) (HR 1.02 [95% CI 1.00–1.04], p = 0.015), and LA reservoir strain (HR 0.96 [95% CI 0.93–0.99], p = 0.017) were all independently associated with the primary outcome. A univariate Cox model conducted on the AF patients (n = 32) revealed that LA reservoir strain remained significantly associated with the primary outcome, while LV GLS and LAVi were not significant. The prognostic value of LA reservoir strain was comparable to LA volume and LV GLS, and might even be better in AF patients. Full article

(This article belongs to the Special Issue Cardiovascular Diseases: Diagnosis and Management)

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14 pages, 1247 KiB

Open AccessArticle

The Burden of Inpatient Hospitalizations with Cardiac and Cerebrovascular Diseases in Patients with Type 1 Diabetes: Insights from the National Inpatient Sample in the US

by Chun Shing Kwok, Adnan I. Qureshi, Anne Phillips, Gregory Y. H. Lip, Wasim Hanif and Josip Andelo Borovac

Diagnostics 2024, 14(15), 1607; https://doi.org/10.3390/diagnostics14151607 - 25 Jul 2024

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Abstract

Background: This study aimed to evaluate the burden and impact of cardiac and cerebrovascular disease (CCD) on hospital inpatients with type 1 diabetes mellitus (T1DM). Methods: This is a retrospective nationwide cohort study of people with T1DM with or without CCD in the [...] Read more.

Background: This study aimed to evaluate the burden and impact of cardiac and cerebrovascular disease (CCD) on hospital inpatients with type 1 diabetes mellitus (T1DM). Methods: This is a retrospective nationwide cohort study of people with T1DM with or without CCD in the US National Inpatient Sample between 2016 and 2019. The in-hospital mortality rates, length of stay (LoS), and healthcare costs were determined. Results: A total of 59,860 T1DM patients had a primary diagnosis of CCD and 1,382,934 did not. The median LoS was longer for patients with CCD compared to no CCD (4.6 vs. 3 days). Patients with T1DM and CCD had greater in-hospital mortality compared to those without CCD (4.1% vs. 1.1%, p < 0.001). The estimated total care cost for all patients with T1DM with CCD was approximately USD 326 million. The adjusted odds of mortality compared to patients with non-CCD admission was greatest for intracranial hemorrhage (OR 17.37, 95%CI 12.68–23.79), pulmonary embolism (OR 4.39, 95%CI 2.70–7.13), endocarditis (OR 3.46, 95%CI 1.22–9.84), acute myocardial infarction (OR 2.31, 95%CI 1.92–2.77), and stroke (OR 1.47, 95%CI 1.04–2.09). Conclusions: The burden of CCD in patients with T1DM is substantial and significantly associated with increased hospital mortality and high healthcare expenditures. Full article

(This article belongs to the Special Issue Cardiovascular Diseases: Diagnosis and Management)

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9 pages, 4250 KiB

Open AccessArticle

Neutrophilic Myocarditis: Insights from a Forensic Centre’s Retrospective Study

by Oana Neagu, Lăcrămioara Luca, Maria Bosa, Alina Tița and Mihail Constantin Ceaușu

Diagnostics 2024, 14(14), 1527; https://doi.org/10.3390/diagnostics14141527 - 15 Jul 2024

Viewed by 744

Abstract

Background: Neutrophilic myocarditis often stems from bacterial or fungal infections, and it is typically detectable through blood cultures or analyses of the primary infection site. However, research specifically addressing the morphological features of acute myocarditis in complex sepsis cases is scarce, with existing [...] Read more.

Background: Neutrophilic myocarditis often stems from bacterial or fungal infections, and it is typically detectable through blood cultures or analyses of the primary infection site. However, research specifically addressing the morphological features of acute myocarditis in complex sepsis cases is scarce, with existing studies primarily dating back to the pre-antibiotic era. Methods: This study constitutes a retrospective and descriptive analysis encompassing 22 forensic cases. We collected data from forensic reports emphasising clinical details, disease history, gross observations, and histopathological findings. Results: The results show that using positive-air-pressure ventilation could be related to cardiac inflammation (45.45%, 10/22). Despite large-spectrum antibiotic therapy, the blood samples were positive for Staphylococcus aureus (MRSA strain), Klebsiella pneumoniae (ESBL strain), Acinetobacter baumannii, and Pseudomonas aeruginosa. Colonies developed in the myocardium of 36% of the patients (8/22), where 4 of them had septic emboli. Fungal myocarditis accompanied bacterial infections (2/8) and were unsuspected clinically. Background changes, such as interstitial fibrosis and arteriosclerosis, were associated with a greater degree of inflammation and septic embolism. Conclusion: Neutrophilic myocarditis in patients with emerging sepsis is linked to fatal virulent infections, where bacteria and/or fungi contaminate and impair the myocardium syncytium. Prolonged hospitalisation and positive-air-pressure ventilation may be a risk factor for this condition and needs further research. Full article

(This article belongs to the Special Issue Cardiovascular Diseases: Diagnosis and Management)

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14 pages, 627 KiB

Open AccessArticle

Risk of Cardiovascular Events in Metabolically Healthy Overweight or Obese Adults: Role of LDL-Cholesterol in the Stratification of Risk

by Paolo Palatini, Agostino Virdis, Stefano Masi, Alessandro Mengozzi, Edoardo Casiglia, Valerie Tikhonoff, Arrigo F. G. Cicero, Andrea Ungar, Gianfranco Parati, Giulia Rivasi, Massimo Salvetti, Carlo Maria Barbagallo, Michele Bombelli, Raffaella Dell’Oro, Berardino Bruno, Luciano Lippa, Lanfranco D’Elia, Maria Masulli, Paolo Verdecchia, Gianpaolo Reboldi, Fabio Angeli, Rosario Cianci, Francesca Mallamaci, Massimo Cirillo, Marcello Rattazzi, Pietro Cirillo, Loreto Gesualdo, Elisa Russo, Alberto Mazza, Cristina Giannattasio, Alessandro Maloberti, Massimo Volpe, Giuliano Tocci, Guido Iaccarino, Pietro Nazzaro, Ferruccio Galletti, Claudio Ferri, Giovambattista Desideri, Francesca Viazzi, Roberto Pontremoli, Maria Lorenza Muiesan, Guido Grassi and Claudio Borghi Show full author list Hide full author list

Diagnostics 2024, 14(13), 1314; https://doi.org/10.3390/diagnostics14131314 - 21 Jun 2024

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Abstract

The objective of this study was to investigate the longitudinal association of metabolically healthy overweight/obese adults with major adverse cardiovascular events (MACE) and the effect of LDL-cholesterol levels on this association. This study was conducted with 15,904 participants from the URRAH study grouped [...] Read more.

The objective of this study was to investigate the longitudinal association of metabolically healthy overweight/obese adults with major adverse cardiovascular events (MACE) and the effect of LDL-cholesterol levels on this association. This study was conducted with 15,904 participants from the URRAH study grouped according to BMI and metabolic status. Healthy metabolic status was identified with and without including LDL-cholesterol. The risk of MACE during 11.8 years of follow-up was evaluated with multivariable Cox regressions. Among the participants aged <70 years, high BMI was associated with an increased risk of MACE, whereas among the older subjects it was associated with lower risk. Compared to the group with normal weight/healthy metabolic status, the metabolically healthy participants aged <70 years who were overweight/obese had an increased risk of MACE with an adjusted hazard ratio of 3.81 (95% CI, 1.34–10.85, p = 0.012). However, when LDL-cholesterol < 130 mg/dL was included in the definition of healthy metabolic status, no increase in risk was found in the overweight/obese adults compared to the normal weight individuals (hazard ratio 0.70 (0.07–6.71, p = 0.75). The present data show that the risk of MACE is increased in metabolically healthy overweight/obese individuals identified according to standard criteria. However, when LDL-cholesterol is included in the definition, metabolically healthy individuals who are overweight/obese have no increase in risk. Full article

(This article belongs to the Special Issue Cardiovascular Diseases: Diagnosis and Management)

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11 pages, 927 KiB

Open AccessArticle

Hypovitaminosis D and Leukocytosis to Predict Cardiovascular Abnormalities in Children with Kawasaki Disease: Insights from a Single-Center Retrospective Observational Cohort Study

by Donato Rigante, Gabriella De Rosa, Angelica Bibiana Delogu, Giulia Rotunno, Rossella Cianci, Claudia Di Pangrazio, Giorgio Sodero, Umberto Basile and Marcello Candelli

Diagnostics 2024, 14(12), 1228; https://doi.org/10.3390/diagnostics14121228 - 12 Jun 2024

Viewed by 1021

Abstract

Introduction: An aberrant immune response involving yet unidentified environmental and genetic factors plays a crucial role in triggering Kawasaki disease (KD). Aims: The aim of this study was to assess general and laboratory data at the onset of KD in a single-center cohort [...] Read more.

Introduction: An aberrant immune response involving yet unidentified environmental and genetic factors plays a crucial role in triggering Kawasaki disease (KD). Aims: The aim of this study was to assess general and laboratory data at the onset of KD in a single-center cohort of children managed between 2003 and 2023 and retrospectively evaluate any potential relationship with the development of KD-related cardiovascular abnormalities (CVAs). Patients and methods: We took into account a total of 65 consecutive children with KD (42 males, median age: 22 months, age range: 2–88 months) followed at the Department of Life Sciences and Public Health in our University; demographic data, clinical signs, and laboratory variables at disease onset, before IVIG infusion, including C-reactive protein, hemoglobin, white blood cell (WBC) count, neutrophil count, platelet count, aminotransferases, natremia, albumin, total bilirubin, and 25-hydroxyvitamin D were evaluated. Results: Twenty-one children (32.3% of the whole cohort) were found to have echocardiographic evidence of CVAs. Univariate analysis showed that diagnosis of KD at <1 year or >5 years was associated with CVAs (p = 0.001 and p = 0.01, respectively); patients with CVAs had a longer fever duration and mostly presented atypical or incomplete presentations. Interestingly, all patients with CVAs had lower levels of vitamin D (less than 30 mg/dL, p = 0.0001) and both higher WBC and higher neutrophil counts than those without CVAs (p = 0.0001 and p = 0.01, respectively). Moreover, blood levels of albumin were significantly lower in KD patients with CVAs compared to those without (11/21, 52% versus 13/44, 30%, p = 0.02). Multiple logistic regression with correction for sex showed that serum vitamin D < 30 ng/mL, WBC count > 20.000/mm³, and age > 60 months at KD onset were the only independent factors statistically associated with CVAs. Conclusions: Hypovitaminosis D, WBC count over 20.000/mm³, and age above 5 years at KD onset emerged as independent factors statistically associated with the occurrence of CVAs. Full article

(This article belongs to the Special Issue Cardiovascular Diseases: Diagnosis and Management)

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10 pages, 520 KiB

Open AccessArticle

Right Bundle Branch Block Predicts Appropriate Implantable Cardioverter Defibrillator Therapies in Patients with Non-Ischemic Dilated Cardiomyopathy and a Prophylactic Implantable Cardioverter Defibrillator

by Marta Jiménez-Blanco Bravo, Gonzalo Luis Alonso Salinas, Carolina Parra Esteban, Jorge Toquero Ramos, Miguel Amores Luque, Jose Luis Zamorano Gómez, Eusebio García-Izquierdo, Jesús Álvarez-García, Ignacio Fernández Lozano and Víctor Castro Urda

Diagnostics 2024, 14(11), 1173; https://doi.org/10.3390/diagnostics14111173 - 1 Jun 2024

Viewed by 677

Abstract

Background: The benefit of prophylactic implantable cardioverter defibrillators (ICDs) in patients with severe systolic dysfunction of non-ischemic origin is still unclear, and the identification of patients at risk for sudden cardiac death remains a major challenge. Aims/Methods: We retrospectively reviewed all consecutive patients [...] Read more.

Background: The benefit of prophylactic implantable cardioverter defibrillators (ICDs) in patients with severe systolic dysfunction of non-ischemic origin is still unclear, and the identification of patients at risk for sudden cardiac death remains a major challenge. Aims/Methods: We retrospectively reviewed all consecutive patients with non-ischemic dilated cardiomyopathy (NICM) who underwent prophylactic ICD implantation between 2008 and 2020 in two tertiary centers. Our main goal was to identify the predictors of appropriate ICD therapies (anti-tachycardia pacing [ATP] and/or shocks) in this cohort of patients. Results: A total of 224 patients were included. After a median follow-up of 51 months, 61 patients (27.2%) required appropriate ICD therapies. Patients with appropriate ICD therapies were more frequently men (87% vs. 69%, p = 0.006), of younger age (59 years, (53–65) vs. 64 years, (57–70); p = 0.02), showed more right bundle branch blocks (RBBBs) (15% vs. 4%, p = 0.007) and less left bundle branch blocks (LBBBs) (26% vs. 47%, p = 0.005) in the ECG, and had higher left ventricular end-diastolic (100 mL/m², (90–117) vs. 86, (71–110); p = 0.011) and systolic volumes (72 mL/m², (59–87) vs. 61, (47–81), p = 0.05). In a multivariate competing-risks regression analysis, RBBB (HR 2.26, CI 95% 1.02–4.98, p = 0.043) was identified as an independent predictor of appropriate ICD therapies. Conclusion: RBBBs may help to identify patients with NICM at high risk of ventricular arrhythmias and requiring ICD intervention. Full article

(This article belongs to the Special Issue Cardiovascular Diseases: Diagnosis and Management)

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10 pages, 2371 KiB

Open AccessArticle

Histological Changes in the Popliteal Artery Wall in Patients with Critical Limb Ischemia

by Octavian Andercou, Maria Cristina Andrei, Dan Gheban, Dorin Marian, Horațiu F. Coman, Valentin Aron Oprea, Florin Vasile Mihaileanu, Razvan Ciocan, Beatrix Cucuruz and Bogdan Stancu

Diagnostics 2024, 14(10), 989; https://doi.org/10.3390/diagnostics14100989 - 8 May 2024

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Abstract

Introduction: This prospective study aims to illustrate the histopathological arterial changes in the popliteal artery in peripheral arterial disease of the lower limbs. Material and method: A total of 60 popliteal artery segments taken from patients who had undergone lower limb amputation were [...] Read more.

Introduction: This prospective study aims to illustrate the histopathological arterial changes in the popliteal artery in peripheral arterial disease of the lower limbs. Material and method: A total of 60 popliteal artery segments taken from patients who had undergone lower limb amputation were examined between April and June 2023. The degree of arterial stenosis, medial calcinosis, and the vasa vasorum changes in the arterial adventitia were quantified. The presence of risk factors for atherosclerosis was also observed. Results: Atherosclerotic plaque was found in all of the examined segments. Medial calcinosis was observed in 40 (66.6%) of the arterial segments. A positive association between the degree of arterial stenosis and the vasa vasorum changes in the arterial adventitia was also found (p = 0.025). The level of blood sugar and cholesterol were predictive factors for the severity of atherosclerosis. Conclusions: Atherosclerosis and medial calcinosis are significant in patients who underwent lower limb amputation. Medial calcinosis causes damage to the arterial wall and leads to a reduction in responsiveness to dilator stimuli. Full article

(This article belongs to the Special Issue Cardiovascular Diseases: Diagnosis and Management)

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11 pages, 780 KiB

Open AccessArticle

B-Type Natriuretic Peptide—A Paradox in the Diagnosis of Acute Heart Failure with Preserved Ejection Fraction in Obese Patients

by Marius Rus, Loredana Ioana Banszki, Felicia Liana Andronie-Cioara, Oana Liliana Pobirci, Veronica Huplea, Alina Stanca Osiceanu, Gheorghe Adrian Osiceanu, Simina Crisan, Decebal Dumitru Pobirci, Madalina Ioana Guler and Paula Marian

Diagnostics 2024, 14(8), 808; https://doi.org/10.3390/diagnostics14080808 - 12 Apr 2024

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Abstract

Background and objectives: B-type natriuretic peptide (BNP) represents a clinical tool for the diagnosis and prognostic evaluation of acute and chronic heart failure patients. The purpose of this retrospective study was to evaluate BNP values in obese and non-obese patients with acute heart [...] Read more.

Background and objectives: B-type natriuretic peptide (BNP) represents a clinical tool for the diagnosis and prognostic evaluation of acute and chronic heart failure patients. The purpose of this retrospective study was to evaluate BNP values in obese and non-obese patients with acute heart failure with preserved ejection fraction. Materials and methods: In this study, we enrolled 240 patients who presented to the emergency department complaining of acute shortness of breath and fatigue. The patients were divided into two groups according to their body mass index (BMI) values. The BMI was calculated as weight (kilograms) divided by height (square meters). The BNP testing was carried out in the emergency department. Results: Group I included patients with a BMI of <30 kg/m² and group II included patients with a BMI of ≥30 kg/m². The average age of the patients was 60.05 ± 5.02 years. The patients in group II were significantly younger compared with those included in group I. Group II included a higher number of women compared to group I. Group I had fewer patients classified within New York Heart Association (NYHA) functional classes III and IV compared with group II. Echocardiography revealed an ejection fraction of ≥50% in all participants. Lower BNP levels were observed in patients from group II (median = 56, IQR = 53–67) in comparison to group I (median = 108.5, IQR = 106–112) (p < 0.001). Conclusions: Obesity and heart failure are continuously rising worldwide. In this retrospective study, we have highlighted the necessity to lower the threshold of BNP levels in obese patients with acute heart failure and preserved ejection fraction. Full article

(This article belongs to the Special Issue Cardiovascular Diseases: Diagnosis and Management)

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13 pages, 2197 KiB

Open AccessArticle

Casting Light on Early Heart Failure: Unveiling the Prognostic Potential of the E/(e′ × s′) Index

by Ioana Ionac, Mihai Andrei Lazar, Teodora Hoinoiu, Simina Crisan, Silvius Alexandru Pescariu, Ciprian Nicusor Dima, Constantin Tudor Luca and Cristian Mornos

Diagnostics 2024, 14(4), 409; https://doi.org/10.3390/diagnostics14040409 - 13 Feb 2024

Viewed by 883

Abstract

It has been shown that patients with NYHA class I and II have a high morbidity and mortality burden. We investigated the value of a new tissue Doppler index, E/(e′ × s′), to predict cardiac events in the long-term follow-up of patients at [...] Read more.

It has been shown that patients with NYHA class I and II have a high morbidity and mortality burden. We investigated the value of a new tissue Doppler index, E/(e′ × s′), to predict cardiac events in the long-term follow-up of patients at an early stage of heart failure (HF). Sequential echocardiography was conducted on a consecutive cohort of 212 hospitalized HF patients, pre-discharged and with three-month follow-up. The primary end point consisted of cardiac death or readmission due to HF worsening. During follow-up, cardiac events occurred in 99 patients (46.7%). The first cardiac event was represented by cardiac death in 8 patients (3.8%) and readmission for HF in 91 patients (42.9%). A Kaplan–Meier analysis did not show a significantly different event-free survival rate between patients with NYHA class I and II. The composite end point was significantly higher in patients with an E/(e′ × s′) >1.6. The E/(e′ × s′) at discharge was the best independent predictor of cardiac events. Those exhibiting an E/(e′ × s′) > 1.6 at discharge, with a subsequent deterioration after three months, displayed the poorest prognosis concerning cardiac events, HF-related rehospitalization, and cardiac mortality (all p < 0.05). In early-stage HF patients, an E/(e′ × s′) > 1.6 emerged as a robust predictor of clinical outcomes, especially when coupled with a deterioration in condition. Full article

(This article belongs to the Special Issue Cardiovascular Diseases: Diagnosis and Management)

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11 pages, 1590 KiB

Open AccessArticle

A Novel Tool for Distinguishing Type A Acute Aortic Syndrome from Heart Failure and Acute Coronary Syndrome

by Min Joon Seo, Jae Hoon Lee and Yang-Weon Kim

Diagnostics 2023, 13(22), 3472; https://doi.org/10.3390/diagnostics13223472 - 18 Nov 2023

Cited by 1 | Viewed by 1170

Abstract

Type A acute aortic syndrome (urgent AAS, UAAS) has a low incidence and high mortality rate; however, it is often missed or diagnosed late. Our aim was to create a new tool for distinguishing UAAS by using multiple modalities to select patients for [...] Read more.

Type A acute aortic syndrome (urgent AAS, UAAS) has a low incidence and high mortality rate; however, it is often missed or diagnosed late. Our aim was to create a new tool for distinguishing UAAS by using multiple modalities to select patients for CT aortography. This study included 75 patients with UAAS, 77 with acute coronary syndrome (ACS), and 81 with heart failure (HF) who received urgent treatment after propensity matching. Specific symptoms, past medical history, mediastinal width, region of interest (ROI) ratio in the lung base/apex, D-dimers, and troponin I were investigated to differentiate UAAS from ACS and HF. The most significant variables were selected to create a new scoring system. The UAAS score exhibited a performance AUC of 0.982. A simple UAAS score >1, excluding ROI ratios in lung base/apex, showed an AUC of 0.977, a sensitivity of 96%, and specificity of 92.41%. The results were validated using an external data set of 292 patients (simple UAAS score > 1: AUC of 0.966, sensitivity 93.33%, and specificity 95.36%). The simple UAAS score may be a valuable tool for suspecting UAAS and may reduce the likelihood of misdiagnosis or performing unnecessary CT aortography. Full article

(This article belongs to the Special Issue Cardiovascular Diseases: Diagnosis and Management)

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17 pages, 22244 KiB

Open AccessArticle

The Prognostic Value of Creatine Kinase-MB Dynamics after Primary Angioplasty in ST-Elevation Myocardial Infarctions

by Delia Melania Popa, Liviu Macovei, Mihaela Moscalu, Radu Andy Sascău and Cristian Stătescu

Diagnostics 2023, 13(19), 3143; https://doi.org/10.3390/diagnostics13193143 - 6 Oct 2023

Cited by 1 | Viewed by 1691

Abstract

Background: In STEMIs, the evaluation of the relationship between biomarkers of myocardial injury and patients’ prognoses has not been completely explored. Increased levels of CK-MB in patients with a STEMI undergoing primary angioplasty are known to be associated with higher mortality rates, yet [...] Read more.

Background: In STEMIs, the evaluation of the relationship between biomarkers of myocardial injury and patients’ prognoses has not been completely explored. Increased levels of CK-MB in patients with a STEMI undergoing primary angioplasty are known to be associated with higher mortality rates, yet the correlation of these values with short-term evolution remains unknown. Material and Methods: The research encompassed a sample of 80 patients diagnosed with STEMIs, and its methodology entailed a retrospective analysis of the data collected during their hospital stays. The study population was then categorized into three distinct analysis groups based on the occurrence or absence of acute complications and fatalities. Results: The findings indicated that there is a notable correlation between rising levels of CK-MB upon admission and peak CK-MB levels with a reduction in left ventricular ejection fraction. Moreover, the CK-MB variation established a point of reference for anticipating complications at 388 U/L, and a cut-off value for predicting death at 354 U/L. Conclusion: CK-MB values are reliable indicators of the progress of patients with STEMIs. Furthermore, the difference between the peak and admission CK-MB levels demonstrates a high accuracy of predicting complications and has a significant predictive power to estimate mortality risk. Full article

(This article belongs to the Special Issue Cardiovascular Diseases: Diagnosis and Management)

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16 pages, 762 KiB

Open AccessArticle

Reduced Left Ventricular Twist Early after Acute ST-Segment Elevation Myocardial Infarction as a Predictor of Left Ventricular Adverse Remodelling

by Mihai-Andrei Lazăr, Ioana Ionac, Constantin-Tudor Luca, Lucian Petrescu, Cristina Vacarescu, Simina Crisan, Dan Gaiță, Dragos Cozma, Raluca Sosdean, Diana-Aurora Arnăutu, Alina-Ramona Cozlac, Slivia-Ana Luca, Andra Gurgu, Claudia Totorean and Cristian Mornos

Diagnostics 2023, 13(18), 2896; https://doi.org/10.3390/diagnostics13182896 - 9 Sep 2023

Cited by 1 | Viewed by 1247

Abstract

Background: The left ventricular (LV) remodelling process represents the main cause of heart failure after a ST-segment elevation myocardial infarction (STEMI). Speckle-tracking echocardiography (STE) can detect early deformation impairment, while also predicting LV remodelling during follow-up. The aim of this study was to [...] Read more.

Background: The left ventricular (LV) remodelling process represents the main cause of heart failure after a ST-segment elevation myocardial infarction (STEMI). Speckle-tracking echocardiography (STE) can detect early deformation impairment, while also predicting LV remodelling during follow-up. The aim of this study was to investigate the STE parameters in predicting cardiac remodelling following a percutaneous coronary intervention (PCI) in STEMI patients. Methods: The study population consisted of 60 patients with acute STEMI and no history of prior myocardial infarction treated with PCI. The patients were assessed both by conventional transthoracic and ST echocardiography in the first 12 h after admission and 6 months after the acute phase. Adverse remodelling was defined as an increase in LVEDV and/or LVESV by 15%. Results: Adverse remodelling occurred in 26 patients (43.33%). By multivariate regression equation, the risk of adverse remodelling increases with age (by 1.1-fold), triglyceride level (by 1.009-fold), and midmyocardial radial strain (mid-RS) (1.06-fold). Increased initial twist decreases the chances of adverse remodelling (0.847-fold). The LV twist presented the largest area under the receiver operating characteristic (ROC) curve to predict adverse remodelling (AUROC = 0.648; 95% CI [0.506;0.789], p = 0.04). A twist value higher than 11° has a 76.9% specificity and a 72.7% positive predictive value for reverse remodelling at 6 months. Full article

(This article belongs to the Special Issue Cardiovascular Diseases: Diagnosis and Management)

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16 pages, 3738 KiB

Open AccessArticle

Assessment of the Severity of Left Anterior Descending Coronary Artery Stenoses by Enhanced Transthoracic Doppler Echocardiography: Validation of a Method Based on the Continuity Equation

by Carlo Caiati, Alessandro Stanca and Mario Erminio Lepera

Diagnostics 2023, 13(15), 2526; https://doi.org/10.3390/diagnostics13152526 - 29 Jul 2023

Cited by 1 | Viewed by 1360

Abstract

Background: To verify whether the severity of coronary stenosis could be non-invasively assessed by enhanced transthoracic coronary echo Doppler in convergent color Doppler mode (E-Doppler TTE) over a wide range of values (from mild to severe). Methods: Color-guided pulsed wave Doppler sampling in [...] Read more.

Background: To verify whether the severity of coronary stenosis could be non-invasively assessed by enhanced transthoracic coronary echo Doppler in convergent color Doppler mode (E-Doppler TTE) over a wide range of values (from mild to severe). Methods: Color-guided pulsed wave Doppler sampling in the left anterior descending coronary artery (LAD) was performed in 103 diseased LAD segments (corresponding to 94 patients examined) as assessed by quantitative coronary angiography (QCA) or intracoronary ultrasound (IVUS). The E-Doppler TTE examinations consisted of measuring the velocity (vel) at the stenosis site and a reference adjacent segment. Then the continuity equation (C-Eq) was applied to calculate the percent cross-sectional area reduction (%CSA) at the stenosis site. The applied formula was: %CSA = 100 × (1 − [TVIref × 0.5]/TVIs). TVI = the time velocity integral at the stenosis [s] and the reference site [ref], respectively); 0.5 = the correcting factor for a parabolic profile was used only when the % accelerated stenotic flow was >122% (AsF = diastolic peak vel at first site − diastolic peak vel at second site/diastolic peak vel at second site × 100). Results: E-Doppler TTE feasibility was 100%. Doppler and QCA/IVUS-derived %CSA stenosis showed very good agreement over a large range of values (from mild to severe), with no significant bias; the maximum difference between QCA/IVUS and transthoracic Doppler %CSA was mostly around 20% with a few patients exceeding this limit (limits of agreement = −27.53 to 23.5%). The scattering was slightly larger for the non-significant stenoses. The correlation was strong (r = 0.89, p < 0.001). Conclusion: E-Doppler TTE is a feasible and reliable method for assessing the severity of LAD stenosis by applying the C-Eq. Full article

(This article belongs to the Special Issue Cardiovascular Diseases: Diagnosis and Management)

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13 pages, 1439 KiB

Open AccessArticle

Heart Rate Recovery as a Predictor of Long-Term Adverse Events after Negative Exercise Testing in Patients with Chest Pain and Pre-Test Probability of Coronary Artery Disease from 15% to 65%

by Vojislav Giga, Nikola Boskovic, Ana Djordjevic-Dikic, Branko Beleslin, Ivana Nedeljkovic, Goran Stankovic, Milorad Tesic, Ivana Jovanovic, Ivana Paunovic and Srdjan Aleksandric

Diagnostics 2023, 13(13), 2229; https://doi.org/10.3390/diagnostics13132229 - 30 Jun 2023

Cited by 1 | Viewed by 1510

Abstract

Background: The prognosis of patients with chest pain after a negative exercise test is good, but some adverse events occur in this low-risk group. The aim of our study was to identify predictors of long-term adverse events after a negative exercise test in [...] Read more.

Background: The prognosis of patients with chest pain after a negative exercise test is good, but some adverse events occur in this low-risk group. The aim of our study was to identify predictors of long-term adverse events after a negative exercise test in patients with chest pain and a lower intermediate (15–65%) pre-test probability of coronary artery disease (CAD) and to assess the prognostic value of exercise electrocardiography and exercise stress echocardiography in this group of patients. Methods: We identified from our stress test laboratory database 862 patients with chest pain without previously known CAD and with a pre-test probability of CAD ranging from 15 to 65% (mean 41 ± 14%) who underwent exercise testing. Patients were followed for the occurrence of death, non-fatal myocardial infarction (MI) and clinically guided revascularization. Results: During the median follow-up of 94 months, 87 patients (10.1%) had an adverse event (AE). A total of 30 patients died (3.5%), 23 patients suffered non-fatal MI (2.7%) and 34 patients (3.9%) had clinically guided revascularization (20 patients percutaneous and 14 patients surgical revascularizations). Male gender, age, the presence of diabetes and a slow heart rate recovery (HRR) in the first minute after exercise were independently related to the occurrence of AEs. Adverse events occurred in 10.3% of patients who were tested by exercise stress echocardiography and in 10.0% of those who underwent stress electrocardiography (p = 0.888). Conclusion: The risk of AEs after negative exercise testing in patients with a pre-test probability of CAD of 15–65% is low. Male patients with a history of diabetes and slow HRR in the first minute after exercise have an increased risk of an adverse outcome. Full article

(This article belongs to the Special Issue Cardiovascular Diseases: Diagnosis and Management)

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13 pages, 2185 KiB

Open AccessArticle

Maximizing Equity in Acute Coronary Syndrome Screening across Sociodemographic Characteristics of Patients

by Gabrielle Bunney, Sean M. Bloos, Anna Graber-Naidich, Melissa A. Pasao, Rana Kabeer, David Kim, Kate Miller and Maame Yaa A. B. Yiadom

Diagnostics 2023, 13(12), 2053; https://doi.org/10.3390/diagnostics13122053 - 14 Jun 2023

Viewed by 2188

Abstract

We compared four methods to screen emergency department (ED) patients for an early electrocardiogram (ECG) to diagnose ST-elevation myocardial infarction (STEMI) in a 5-year retrospective cohort through observed practice, objective application of screening protocol criteria, a predictive model, and a model augmenting human [...] Read more.

We compared four methods to screen emergency department (ED) patients for an early electrocardiogram (ECG) to diagnose ST-elevation myocardial infarction (STEMI) in a 5-year retrospective cohort through observed practice, objective application of screening protocol criteria, a predictive model, and a model augmenting human practice. We measured screening performance by sensitivity, missed acute coronary syndrome (ACS) and STEMI, and the number of ECGs required. Our cohort of 279,132 ED visits included 1397 patients who had a diagnosis of ACS. We found that screening by observed practice augmented with the model delivered the highest sensitivity for detecting ACS (92.9%, 95%CI: 91.4–94.2%) and showed little variation across sex, race, ethnicity, language, and age, demonstrating equity. Although it missed a few cases of ACS (7.6%) and STEMI (4.4%), it did require ECGs on an additional 11.1% of patients compared to current practice. Screening by protocol performed the worst, underdiagnosing young, Black, Native American, Alaskan or Hawaiian/Pacific Islander, and Hispanic patients. Thus, adding a predictive model to augment human practice improved the detection of ACS and STEMI and did so most equitably across the groups. Hence, combining human and model screening––rather than relying on either alone––may maximize ACS screening performance and equity. Full article

(This article belongs to the Special Issue Cardiovascular Diseases: Diagnosis and Management)

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13 pages, 1733 KiB

Open AccessArticle

The Role of Cardiac Biomarkers in the Diagnosis of Hypertensive Emergency

by Mohammed A. Talle, Anton F. Doubell, Pieter-Paul S. Robbertse, Sa’ad Lahri and Philip G. Herbst

Diagnostics 2023, 13(9), 1605; https://doi.org/10.3390/diagnostics13091605 - 30 Apr 2023

Cited by 5 | Viewed by 2318

Abstract

There is a growing interest in the role of biomarkers in differentiating hypertensive emergency from hypertensive urgency. This study aimed to determine the diagnostic utility of lactate dehydrogenase (LDH), high-sensitivity cardiac troponin T (hscTnT), and N-terminal prohormone of brain-type natriuretic peptide (NT-proBNP) for [...] Read more.

There is a growing interest in the role of biomarkers in differentiating hypertensive emergency from hypertensive urgency. This study aimed to determine the diagnostic utility of lactate dehydrogenase (LDH), high-sensitivity cardiac troponin T (hscTnT), and N-terminal prohormone of brain-type natriuretic peptide (NT-proBNP) for identifying hypertensive emergency. A diagnosis of hypertensive emergency was made based on a systolic blood pressure of ≥180 mmHg and/or a diastolic blood pressure of ≥110 mmHg with acute hypertension-mediated organ damage. The predictive value of LDH, hscTnT, NT-proBNP, and models of these biomarkers for hypertensive emergency was determined using the area under the receiver operator characteristic curve (AUC). There were 66 patients (66.7% male) with a hypertensive emergency and 16 (31.3% male) with hypertensive urgency. LDH, NT-proBNP, and hscTnT were significantly higher in hypertensive emergency. Serum LDH > 190 U/L and high creatinine were associated with hypertensive emergency. LDH had an AUC ranging from 0.87 to 0.92 for the spectrum of hypertensive emergencies, while hscTnT had an AUC of 0.82 to 0.92, except for neurological emergencies, in which the AUC was 0.72. NT-proBNP was only useful in predicting acute pulmonary edema (AUC of 0.89). A model incorporating LDH with hscTnT had an AUC of 0.92 to 0.97 for the spectrum of hypertensive emergencies. LDH in isolation or combined with hscTnT correctly identified hypertensive emergency in patients presenting with hypertensive crisis. The routine assessment of these biomarkers has the potential to facilitate the timely identification of hypertensive emergencies, especially in patients with subtle and subclinical target organ injury. Full article

(This article belongs to the Special Issue Cardiovascular Diseases: Diagnosis and Management)

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15 pages, 3341 KiB

Open AccessArticle

The Influence of Different SARS-CoV-2 Strains on Changes in Maximal Oxygen Consumption, Ventilatory Efficiency and Oxygen Pulse of Elite Athletes

by Dragutin Stojmenovic, Tamara Stojmenovic, Marija Andjelkovic, Nenad Trunic, Nenad Dikic, Natasa Kilibarda, Ivan Nikolic, Ivana Nedeljkovic, Marina Ostojic, Milos Purkovic and Jovana Radovanovic

Diagnostics 2023, 13(9), 1574; https://doi.org/10.3390/diagnostics13091574 - 27 Apr 2023

Cited by 1 | Viewed by 1544

Abstract

Purpose: The aim of this study was to evaluate the influence of different SARS-CoV-2 strains on the functional capacity of athletes. Methods: In total, 220 athletes underwent cardiopulmonary exercise testing (CPET) after coronavirus infection and before returning to sports activities. Eighty-eight athletes were [...] Read more.

Purpose: The aim of this study was to evaluate the influence of different SARS-CoV-2 strains on the functional capacity of athletes. Methods: In total, 220 athletes underwent cardiopulmonary exercise testing (CPET) after coronavirus infection and before returning to sports activities. Eighty-eight athletes were infected by the Wuhan virus, and 66 were infected during the Delta and Omicron strain periods of the pandemic. Results: The CPET results showed significantly decreased maximal oxygen consumption, ventilatory efficiency, and oxygen pulse in athletes who were infected with Wuhan and Delta strains compared to athletes who suffered from Omicron virus infection. An early transition from aerobic to anaerobic metabolic pathways for energy production was observed in the Wuhan and Delta groups but not in athletes who were infected with the Omicron strain. There were no differences in the obtained results when Wuhan and Delta virus variants were compared. Conclusion: These results suggest that the Wuhan and Delta virus strains had a significantly greater negative impact on the functional abilities of athletes compared to the Omicron virus variant, especially in terms of aerobic capacity and cardiorespiratory function. Full article

(This article belongs to the Special Issue Cardiovascular Diseases: Diagnosis and Management)

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8 pages, 480 KiB

Open AccessArticle

New Onset Atrial Fibrillation in STEMI Patients: Main Prognostic Factors and Clinical Outcome

by Beatrice Dal Zotto, Lucia Barbieri, Gabriele Tumminello, Massimo Saviano, Domitilla Gentile, Stefano Lucreziotti, Loredana Frattini, Diego Tarricone and Stefano Carugo

Diagnostics 2023, 13(4), 613; https://doi.org/10.3390/diagnostics13040613 - 7 Feb 2023

Cited by 5 | Viewed by 2073

Abstract

The indications for the treatment of patients with known atrial fibrillation (AF) undergoing percutaneous coronary intervention (PCI) are clear, while less is available about the management of new-onset AF (NOAF) during ST-segment elevation myocardial infarction (STEMI). The aim of this study is to [...] Read more.

The indications for the treatment of patients with known atrial fibrillation (AF) undergoing percutaneous coronary intervention (PCI) are clear, while less is available about the management of new-onset AF (NOAF) during ST-segment elevation myocardial infarction (STEMI). The aim of this study is to evaluate mortality and clinical outcome of this high-risk subgroup of patients. We analyzed 1455 consecutive patients undergoing PCI for STEMI. NOAF was detected in 102 subjects, 62.7% males, with a mean age of 74.8 ± 10.6 years. The mean ejection fraction (EF) was 43.5 ± 12.1% and the mean atrial volume was increased (58 ± 20.9 mL). NOAF occurred mainly in the peri-acute phase and had a very variable duration (8.1 ± 12.5 min). During hospitalization, all the patients were treated with enoxaparin, but only 21.6% of them were discharged with long term oral anticoagulation. The majority of patients had a CHA2DS2-VASc score >2 and a HAS-BLED score of 2 or 3. The in-hospital mortality was 14.2%, while the 1-year mortality was 17.2% and long-term mortality 32.1% (median follow-up 1820 days). We identified age as an independent predictor of mortality both at short- and long-term follow-ups, while EF was the only independent predictor for in-hospital mortality and arrhythmia duration for 1-year mortality. At the 1-year follow-up, we recorded three ischemic strokes and no bleeding complications. Full article

(This article belongs to the Special Issue Cardiovascular Diseases: Diagnosis and Management)

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11 pages, 938 KiB

Open AccessArticle

Long COVID Syndrome and Cardiovascular Manifestations: A Systematic Review and Meta-Analysis

by Abhigan Babu Shrestha, Aashna Mehta, Pashupati Pokharel, Aakash Mishra, Lukash Adhikari, Sajina Shrestha, Randhir Sagar Yadav, Surakshya Khanal, Ranjit Sah, Behdin Nowrouzi-Kia, Bijaya Kumar Padhi and Vijay Kumar Chattu

Diagnostics 2023, 13(3), 491; https://doi.org/10.3390/diagnostics13030491 - 29 Jan 2023

Cited by 18 | Viewed by 12436

Abstract

(1) Background: Long COVID syndrome is a significant cause of morbidity in COVID-19 patients who remain symptomatic with varied clinical presentations beyond three weeks. Furthermore, the relevance of considering cardiovascular outcomes in post-COVID-19 syndrome is important in the current COVID-19 pandemic; (2) Methods: [...] Read more.

(1) Background: Long COVID syndrome is a significant cause of morbidity in COVID-19 patients who remain symptomatic with varied clinical presentations beyond three weeks. Furthermore, the relevance of considering cardiovascular outcomes in post-COVID-19 syndrome is important in the current COVID-19 pandemic; (2) Methods: The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed for this systematic review and meta-analysis. Systematic searches were conducted from multiple databases without language restrictions until October 8, 2022, to find studies evaluating cardiovascular outcomes such as arrhythmias, myocardium and pericardium diseases, coronary vessel disease, and thromboembolic disorders in post-COVID cases. The pooled odds ratio (OR), and standard mean difference (SMD) with their corresponding 95% confidence intervals (CI) were computed to find the association; (3) Results: Altogether, seven studies with a total of 8,126,462 (cases: 1,321,305; controls: 6,805,157) participants were included in the meta-analysis. Pooled odds ratios of cardiovascular outcomes were significantly higher in post-COVID cases (OR > 1, p < 0.05) than in controls. However, the mortality (OR: 4.76, p = 0.13), and heart rate variability (SMD: −0.06, p = 0.91) between cases and controls were not statistically significant; (4) Conclusions: Significant cardiovascular sequelae in long COVID syndrome highlight the importance of careful cardiac monitoring of COVID-19 patients in the post-COVID phase to address cardiovascular complications as soon as possible; larger-scale prospective studies are required for accurate estimation. Full article

(This article belongs to the Special Issue Cardiovascular Diseases: Diagnosis and Management)

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12 pages, 2786 KiB

Open AccessArticle

Association between Hepatic Venous Congestion and Adverse Outcomes after Cardiac Surgery

by Csaba Eke, András Szabó, Ádám Nagy, Balázs Szécsi, Rita Szentgróti, András Dénes, Miklós D. Kertai, Levente Fazekas, Attila Kovács, Bálint Lakatos, István Hartyánszky, Kálmán Benke, Béla Merkely and Andrea Székely

Diagnostics 2022, 12(12), 3175; https://doi.org/10.3390/diagnostics12123175 - 15 Dec 2022

Cited by 1 | Viewed by 2311

Abstract

Introduction: Hepatic venous flow patterns reflect pressure changes in the right ventricle and are also markers of systemic venous congestion. Fluid management is crucial in patients undergoing cardiac surgery. Methods: Our goal was to determine which factors are associated with the increased congestion [...] Read more.

Introduction: Hepatic venous flow patterns reflect pressure changes in the right ventricle and are also markers of systemic venous congestion. Fluid management is crucial in patients undergoing cardiac surgery. Methods: Our goal was to determine which factors are associated with the increased congestion of the liver as measured by Doppler ultrasound in patients undergoing cardiac surgery. This prospective, observational study included 41 patients without preexisting liver disease who underwent cardiac surgery between 1 January 2021 and 30 September 2021 at a tertiary heart center. In addition to routine echocardiographic examination, we recorded the maximal velocity and velocity time integral (VTI) of the standard four waves seen in the common hepatic vein (flow profile) using Doppler ultrasound preoperatively and at the 20–24th hour of the postoperative period. The ratios of the retrograde and anterograde hepatic venous waves were calculated, and the waveforms were compared to the baseline value and expressed as a delta ratio. Demographic data, pre- and postoperative echocardiographic parameters, intraoperative variables (procedure, cardiopulmonary bypass time), postoperative factors (fluid balance, vasoactive medication requirement, ventilation time and parameters) and perioperative laboratory parameters (liver and kidney function tests, albumin) were used in the analysis. Results: Of the 41 patients, 20 (48.7%) were males, and the median age of the patients was 65.9 years (IQR: 59.8–69.9 years). Retrograde VTI growth showed a correlation with positive fluid balance (0.89 (95% CI 0.785–0.995) c-index. After comparing the postoperative echocardiographic parameters of the two subgroups, right ventricular and atrial diameters were significantly greater in the “retrograde VTI growth” group. The ejection fraction and decrement in ejection fraction to preoperative parameters were significantly different between the two groups. (p = 0.001 and 0.003). Ventilation times were longer in the retrograde VTI group. The postoperative vs. baseline delta VTI ratio of the hepatic vein correlated with positive fluid balance, maximum central venous pressure, and ejection fraction. (B = −0.099, 95% CI = −0.022–0.002, p = 0.022, B = 0.011, 95% CI = 0.001–0.021, p = 0.022, B = 0.091, 95% CI = 0.052–0.213, p = 0.002, respectively.) Conclusion: The increase of the retrograde hepatic flow during the first 24 h following cardiac surgery was associated with positive fluid balance and the decrease of the right ventricular function. Measurement of venous congestion or venous abdominal insufficiency seems to be a useful tool in guiding fluid therapy and hemodynamic management. Full article

(This article belongs to the Special Issue Cardiovascular Diseases: Diagnosis and Management)

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12 pages, 750 KiB

Open AccessArticle

Autoantibodies to Oxidatively Modified Peptide: Potential Clinical Application in Coronary Artery Disease

by I-Jung Tsai, Wen-Chi Shen, Jia-Zhen Wu, Yu-Sheng Chang and Ching-Yu Lin

Diagnostics 2022, 12(10), 2269; https://doi.org/10.3390/diagnostics12102269 - 20 Sep 2022

Cited by 1 | Viewed by 1449

Abstract

Coronary artery disease (CAD) is a global health issue. Lipid peroxidation produces various by-products that associate with CAD, such as 4-hydroxynonenal (HNE) and malondialdehyde (MDA). The autoantibodies against HNE and MDA-modified peptides may be useful in the diagnosis of CAD. This study included [...] Read more.

Coronary artery disease (CAD) is a global health issue. Lipid peroxidation produces various by-products that associate with CAD, such as 4-hydroxynonenal (HNE) and malondialdehyde (MDA). The autoantibodies against HNE and MDA-modified peptides may be useful in the diagnosis of CAD. This study included 41 healthy controls (HCs) and 159 CAD patients with stenosis rates of <30%, 30–70%, and >70%. The plasma level of autoantibodies against four different unmodified and HNE-modified peptides were measured in this study, including CFAH^1211–1230, HPT^78–108, IGKC^2–19, and THRB^328–345. Furthermore, feature ranking, feature selection, and machine learning models have been utilized to exploit the diagnostic performance. Also, we combined autoantibodies against MDA and HNE-modified peptides to improve the models’ performance. The eXtreme Gradient Boosting (XGBoost) model received a sensitivity of 78.6% and a specificity of 90.4%. Our study demonstrated the combination of autoantibodies against oxidative modification may improve the model performance. Full article

(This article belongs to the Special Issue Cardiovascular Diseases: Diagnosis and Management)

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Review

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12 pages, 1092 KiB

Open AccessReview

Carbohydrate Antigen 125 (CA 125): A Novel Biomarker in Acute Heart Failure

by Mihai Cristian Marinescu, Violeta Diana Oprea, Sorina Nicoleta Munteanu, Aurel Nechita, Dana Tutunaru, Luiza Camelia Nechita and Aurelia Romila

Diagnostics 2024, 14(8), 795; https://doi.org/10.3390/diagnostics14080795 - 10 Apr 2024

Cited by 1 | Viewed by 2743

Abstract

Background: Heart failure is a global major healthcare problem with millions of hospitalizations annually and with a very high mortality. There is an increased interest in finding new and reliable biomarkers for the diagnostic, prognostic and therapeutic guidance of patients hospitalized for acute [...] Read more.

Background: Heart failure is a global major healthcare problem with millions of hospitalizations annually and with a very high mortality. There is an increased interest in finding new and reliable biomarkers for the diagnostic, prognostic and therapeutic guidance of patients hospitalized for acute heart failure; Our review aims to summarize in an easy-to-follow flow recent relevant research evaluating the possible use and the clinical value of measuring CA 125 serum levels in acute HF. Methods: A thorough search in the main international databases identified a relevant pool of 170 articles, providing recently published data for this narrative review that used PRISMA guidelines. Results: There are data to sustain the role of carbohydrate antigen 125 (CA 125), a worldwide used marker of ovarian cancer, in patients with heart failure. Several studies have shown links between CA 125 levels and congestion seen in acute heart failure, high mortality and readmission rates at 6 months follow-up after discharge from acute heart failure and also a role of CA 125 in the guidance of heart failure therapy. There are also clinical trials that showed that several particularities of CA 125 make it even better than N-terminal pro b-type natriuretic peptide (NT-pro BNP)—a classical and more utilized marker of heart failure) in several scenarios of acute heart failure. Conclusions: Although the mechanism behind the upregulation of serum CA 125 in patients with congestive HF has not been confirmed nor fully understood. Full article

(This article belongs to the Special Issue Cardiovascular Diseases: Diagnosis and Management)

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14 pages, 750 KiB

Open AccessReview

The Role of Dysbiotic Oral Microbiota in Cardiometabolic Diseases: A Narrative Review

by Sylvie Lê, Chiara Cecchin-Albertoni, Charlotte Thomas, Philippe Kemoun, Matthieu Minty and Vincent Blasco-Baque

Diagnostics 2023, 13(20), 3184; https://doi.org/10.3390/diagnostics13203184 - 12 Oct 2023

Cited by 1 | Viewed by 1875

Abstract

Over the past decade, there have been significant advancements in the high-flow analysis of “omics,” shedding light on the relationship between the microbiota and the host. However, the full recognition of this relationship and its implications in cardiometabolic diseases are still underway, despite [...] Read more.

Over the past decade, there have been significant advancements in the high-flow analysis of “omics,” shedding light on the relationship between the microbiota and the host. However, the full recognition of this relationship and its implications in cardiometabolic diseases are still underway, despite advancements in understanding the pathophysiology of these conditions. Cardiometabolic diseases, which include a range of conditions from insulin resistance to cardiovascular disease and type 2 diabetes, continue to be the leading cause of mortality worldwide, with a persistently high morbidity rate. While the link between the intestinal microbiota and cardiometabolic risks has been extensively explored, the role of the oral microbiota, the second-largest microbiota in the human body, and specifically the dysbiosis of this microbiota in causing these complications, remains incompletely defined. This review aims to examine the association between the oral microbiota and cardiometabolic diseases, focusing on the dysbiosis of the oral microbiota, particularly in periodontal disease. Additionally, we will dive into the mechanistic aspects of this dysbiosis that contribute to the development of these complications. Finally, we will discuss potential prevention and treatment strategies, including the use of prebiotics, probiotics, and other interventions. Full article

(This article belongs to the Special Issue Cardiovascular Diseases: Diagnosis and Management)

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11 pages, 488 KiB

Open AccessReview

Coronary Syndromes and High-Altitude Exposure—A Comprehensive Review

by Liviu Macovei, Carmen Mirela Macovei and Dragos Cristian Macovei

Diagnostics 2023, 13(7), 1317; https://doi.org/10.3390/diagnostics13071317 - 1 Apr 2023

Cited by 5 | Viewed by 2094

Abstract

The aim of this review is to identify a preventive strategy in order to minimize the risk of adverse events in patients with coronary syndromes and acute exposure to high-altitude. For this purpose we searched the electronic database of PubMed, EMBASE, and Web [...] Read more.

The aim of this review is to identify a preventive strategy in order to minimize the risk of adverse events in patients with coronary syndromes and acute exposure to high-altitude. For this purpose we searched the electronic database of PubMed, EMBASE, and Web of Science for studies published in the last 30 years in this field. The conclusions of this review are: patients with stable coronary artery disease on optimal treatment and in a good physical condition can tolerate traveling to high altitude up to 3500 m; on the other hand, patients with unstable angina or recent myocardial infarction no older than 6 months should take less interest in hiking or any activity involving high altitude. Air-traveling is contraindicated for patients with myocardial infarction within previous 2 weeks, angioplasty or intracoronary stent placement within previous 2 weeks, and unstable angina or coronary artery bypass grafting within previous 3 weeks. The main trigger for sudden cardiac death is the lack of gradual acclimatization to high-altitude and to the exercise activity, and the most important risk factor is prior myocardial infarction. Full article

(This article belongs to the Special Issue Cardiovascular Diseases: Diagnosis and Management)

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Other

Jump to: Research, Review

14 pages, 339 KiB

Open AccessSystematic Review

Prevalence of Myocardial Injury and Myocardial Infarction in Patients with a Hypertensive Emergency: A Systematic Review

by Mohammed A. Talle, Ellen Ngarande, Anton F. Doubell and Philip G. Herbst

Diagnostics 2023, 13(1), 60; https://doi.org/10.3390/diagnostics13010060 - 26 Dec 2022

Cited by 2 | Viewed by 2688

Abstract

Myocardial injury and myocardial infarction can complicate a hypertensive emergency, and both are associated with poor prognosis. However, little is known about the prevalence of myocardial injury and the different subtypes of myocardial infarction in patients with hypertensive emergencies. This systematic review aims [...] Read more.

Myocardial injury and myocardial infarction can complicate a hypertensive emergency, and both are associated with poor prognosis. However, little is known about the prevalence of myocardial injury and the different subtypes of myocardial infarction in patients with hypertensive emergencies. This systematic review aims to determine the prevalence of myocardial infarction and its subtypes, and the prevalence of myocardial injury in patients with hypertensive emergencies following the PRISMA guideline. A systematic search of PubMed, Web of Science, and EBSCOHost (MEDLINE) databases was carried out from inception to identify relevant articles. A total of 18 studies involving 7545 patients with a hypertensive emergency were included. Fifteen (83.3%) studies reported on the prevalence of myocardial infarction ranging from 3.6% to 59.6%, but only two studies specifically indicated the prevalence of ST-elevation and non-ST-elevation myocardial infarction. The prevalence of myocardial injury was obtained in three studies (16.7%) and ranged from 15% to 63%. Despite being common, very few studies reported myocardial injury and the subtypes of myocardial infarction among patients presenting with a hypertensive emergency, highlighting the need for more research in this area which will provide pertinent data to guide patient management and identify those at increased risk of major adverse cardiovascular events. Full article

(This article belongs to the Special Issue Cardiovascular Diseases: Diagnosis and Management)

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