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A special issue of Diagnostics (ISSN 2075-4418). This special issue belongs to the section "Pathology and Molecular Diagnostics".

Deadline for manuscript submissions: closed (20 December 2022) | Viewed by 19365

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Dr. Constantinos Bakogiannis

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3rd Cardiology Department, Cardiovascular Prevention and Digital Cardiology Lab, Aristotle University of Thessaloniki, Hippokration General Hospital, 541 24 Thessaloniki, Greece
Interests: cardiovascular prevention; heart failure; sports cardiology; digital cardiology; mHealth; artificial intelligence
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Dr. Alexandros Briasoulis

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Department of Clinical Therapeutics, Faculty of Medicine, National and Kapodistrian University of Athens, Alexandra Hospital, 11528 Athens, Greece
Interests: advanced heart failure; transplantation; cardio-oncology; pulmonary hypertension
Special Issues, Collections and Topics in MDPI journals

Dr. Emmanouel Androulakis

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Royal Brompton & Harefield Hospital NHS Foundation Trust, London, UK
Interests: multimodality cardiovascular imaging; cardiac magnetic resonance; inherited cardiac conditions; hypertension; heart failure; sports cardiology

Special Issue Information

Dear Colleagues,

Cardiovascular diseases are a leading cause of death worldwide. Remarkable progress in pharmacotherapy and biomedical innovation have led to a continuing reduction in mortality related to cardiovascular disease (CVD) in the last few decades. However, lifestyle factors and the aging of the population have slowed the decline in CVD mortality. Given the increasing socioeconomic effects related to CVD, there is an urgent need for action focused especially on CVD prevention. Novel and innovative diagnostic approaches could help in the early recognition of heart disease (primary prevention) or the early detection of heart disease progression (secondary prevention). Novel cardiovascular imaging techniques, such as cardiac magnetic resonance; biomarkers, including GDF-15, galectin-3 and microRNAs; and innovative digital tools, such as wearables, telemonitoring devices and others, could assist in the early recognition of CVD and risk stratification. This issue focuses on the latest and most pioneering diagnostic advances in the prevention of the most common cardiovascular diseases such as atherosclerosis, coronary artery disease, heart failure, cardiomyopathies and arrhythmias (i.e., atrial fibrillation).

Dr. Constantinos Bakogiannis
Prof. Dr. Alexandros Briasoulis
Dr. Emmanouel Androulakis
Guest Editors

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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.

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Keywords

Cardiovascular prevention
Cardiovascular imaging
eHealth/mHealth in cardiovascular prevention
Biomarkers
Genomics
Sports cardiology

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Published Papers (8 papers)

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11 pages, 2057 KiB

Open AccessArticle

Liver Stiffness Is Associated with the Burden of Carotid and Systemic Atherosclerosis in an Unorganized Cohort of Patients 40–64 Years Old

by Alla Kuznetsova, Anastasiya Dolgushina, Albina Savochkina, Lubov Pykhova, Veronika Sumerkina, Anna Selyanina, Yana Kudrinskaya and Vadim Genkel

Diagnostics 2022, 12(10), 2336; https://doi.org/10.3390/diagnostics12102336 - 27 Sep 2022

Cited by 2 | Viewed by 1581

Abstract

Background: The aim of the study is to research the relationship between the severity of liver fibrosis and the burden of carotid and systemic atherosclerosis. Methods: The study includes 163 patients 40 to 64 years of age without atherosclerotic CVD or liver disease. All patients underwent duplex scanning of the carotid and lower limb arteries. All patients underwent transient liver elastometry using the FibroScan (Echosens, France). Results: Carotid plaque was detected in 110 (67.5%) patients. Based on the results of linear regression analysis, relationships between liver stiffness and carotid total plaque area (r = 0.21; p = 0.025) were found. Significant relationships were established between liver stiffness and atherosclerosis burden score based on the results of linear regression (r = 0.17; p = 0.029). Liver stiffness showed moderate diagnostic performance (AUC 0.666; p = 0.01) with regard to generalized atherosclerosis. An increase in liver stiffness >4.5 kPa was associated with an odds ratio of generalized atherosclerosis of 3.48 (95% CI 1.07–11.3; p = 0.038) after adjusting confounding factors. Conclusion: Among patients 40–64 years of age without established atherosclerotic CVD and liver disease, liver stiffness directly correlates with the burden of carotid and systemic atherosclerosis. Liver stiffness showed moderate diagnostic performance (AUC 0.666; p = 0.01) with regard to generalized atherosclerosis. Full article

(This article belongs to the Special Issue Diagnostic Advances in Cardiovascular Prevention)

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15 pages, 2536 KiB

Open AccessArticle

Electrocardiographic Patterns of Depolarization Abnormalities Help to Identify Reduced Left Ventricular Ejection Fraction

by Maria Gordeeva, Irina Serdiukova, Alexander Krasichkov and Elena Parmon

Diagnostics 2022, 12(8), 2020; https://doi.org/10.3390/diagnostics12082020 - 21 Aug 2022

Viewed by 1936

Abstract

The aim of the study was to investigate the relationship between a decrease in the left ventricular ejection fraction (EF) and traditional ECG signs associated with structural changes of the myocardium (pathological Q wave, ventricular arrhythmias) and relatively new and poorly understood (fragmented QRS complex (fQRS), early repolarization pattern (ERP)) and evaluate their significance for identifying patients with mildly reduced EF (mrEF). The study included 148 patients who were treated and examined at the Almazov Medical Research Center. FQRS, ERP, pathological Q wave, and premature ventricular contractions (PVC) were described in the analysis of the ECG, and the results of echocardiography and statistical data were analyzed: Fisher’s test and chi-square, correlation analysis, and ROC analysis. According to the level of EF, patients were divided into three groups: group 1—patients with low EF (lEF) (less than 40%), group 2—patients with mildly reduced EF (mrEF) (40–49%); group 3—patients with preserved EF (pEF) (more than 50%). In the first group (EF), fQRS was registered in 16 (51.6%) patients, in the mrEF in 16 (18.2%). Pathological Q wave was detected in lEF in 20 (65%), in mrEF in 10 (35%), 15 (18%), in pEF in 15 (18%). The fQRS has been found to be more important in identifying patients with mrEF. In lEF in 2 (6.5%) patients, in mrEF in 2 (6.9%), in pEF in 11 (12.5%). There was no relationship between ERP, the amount of PVC, and the presence of ventricular tachycardia with EF. FQRS is significantly more common occurred with a decrease in EF and may be a marker of a mrEF. Thus, fQRS is associated with mrEF and pay close attention in routine clinical practice to identify patients at high risk of developing systolic dysfunction. Full article

(This article belongs to the Special Issue Diagnostic Advances in Cardiovascular Prevention)

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18 pages, 1857 KiB

Open AccessArticle

miR-146a-5p, miR-223-3p and miR-142-3p as Potential Predictors of Major Adverse Cardiac Events in Young Patients with Acute ST Elevation Myocardial Infarction—Added Value over Left Ventricular Myocardial Work Indices

by Alina Ioana Scărlătescu, Teodora Barbălată, Anca Volumnia Sima, Camelia Stancu, Loredan Ștefan Niculescu and Miruna Mihaela Micheu

Diagnostics 2022, 12(8), 1946; https://doi.org/10.3390/diagnostics12081946 - 12 Aug 2022

Cited by 10 | Viewed by 2082

Abstract

Acute ST elevation myocardial infarction (STEMI) remains a leading cause of morbidity and mortality worldwide despite continuous advances in diagnostic, prognostic and therapeutic methods. Myocardial work (MW) indices and miRNAs have both emerged as potential prognostic markers in acute coronary syndromes in recent years. In this study we aim to assess the prognostic role of myocardial work indices and of a group of miRNAs in young patients with STEMI. We enrolled 50 young patients (<55 years) with STEMI who underwent primary PCI and 10 healthy age-matched controls. We performed standard 2D and 3D echocardiography; we also calculated left ventricular global longitudinal strain (GLS) and the derived myocardial work indices. Using RT-PCR we determined the plasmatic levels of six miRNAs: miR-223-3p, miR-142-3p, miR-146a-5p, miR-125a-5p, miR-486-5p and miR-155-5p. We assessed the occurrence of major adverse cardiac events (MACE) at up to one year after STEMI. Out of 50 patients, 18% experienced MACE at the one-year follow-up. In a Cox univariate logistic regression analysis, myocardial work indices were all significantly associated with MACE. The ROC analysis showed that GWI, GCW and GWE as a group have a better predictive value for MACE than each separately (AUC 0.951, p = 0.000). Patients with higher miRNAs values at baseline (miR-223-3p, miR-142-3p and miR-146a-5p) appear to have a higher probability of developing adverse events at 12 months of follow-up. ROC curves outlined for each variable confirmed their good predictive value (AUC = 0.832, p = 0.002 for miR-223-3p; AUC = 0.732, p = 0.031 for miR-142-3p and AUC = 0.848, p = 0.001 for miR-146a-5p); the group of three miRNAs also proved to have a better predictive value for MACE together than separately (AUC = 0.862). Moreover, adding each of the miRNAs (miR-233, miR-142-3p and miR-146a-5p) or all together over the myocardial work indices in the regression models improved their prognostic value. In conclusion, both myocardial work indices (GWI, GCW and GWE) and three miRNAs (miR-223-3p, miR-142-3p and miR-146a-5p) have the potential to be used as prognostic markers for adverse events after acute myocardial infarction. The combination of miRNAs and MW indices (measured at baseline) rather than each separately has very good predictive value for MACE in young STEMI patients (C-statistic 0.977). Full article

(This article belongs to the Special Issue Diagnostic Advances in Cardiovascular Prevention)

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9 pages, 950 KiB

Open AccessArticle

Osteoprotegerin Gene Polymorphisms Are Associated with Subclinical Atherosclerosis in the Mexican Mestizo Population

by Benny Giovanni Cazarín-Santos, Nonanzit Pérez-Hernández, Rosalinda Posadas-Sánchez, Gilberto Vargas-Alarcón, Óscar Pérez-Méndez, Juan Rodríguez-Silverio, Bladimir Roque-Ramírez, Verónica Marusa Borgonio-Cuadra and José Manuel Rodríguez-Pérez

Diagnostics 2022, 12(6), 1433; https://doi.org/10.3390/diagnostics12061433 - 10 Jun 2022

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Abstract

Subclinical atherosclerosis (SA) is the presence of coronary calcification in the absence of cardiovascular symptoms, and it usually progresses to atherosclerotic disease. Studies have shown an association of osteoprotegerin gene (OPG) variants with calcification process in cardiovascular diseases; however, to this day there are no studies that evaluate individuals in the asymptomatic stage of atherosclerotic disease. Therefore, the purpose of this study was to analyze the association of four genetic variants and haplotypes of the OPG gene with the development of SA, through TaqMan genotyping assays. We also aimed to identify potential response elements for transcription factors in these genetic variants. The study included 1413 asymptomatic participants (1041 were controls and 372 were individuals with SA). The rs3102735 polymorphism appeared as a protective marker (OR = 0.693; 95% CI = 0.493–0.974; p_heterozygote = 0.035; OR = 0.699; 95% CI = 0.496–0.985; p_codominant ₁ = 0.040) and two haplotypes were associated with SA, one as a decreased risk: GACC (OR = 0.641, 95% CI = 0.414–0.990, p = 0.045) and another as an increased risk: GACT (OR = 1.208, 95% CI = 1.020–1.431, p = 0.029). Our data suggest a lower risk of SA in rs3102735 C carriers in a representative sample of Mexican mestizo population. Full article

(This article belongs to the Special Issue Diagnostic Advances in Cardiovascular Prevention)

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17 pages, 4474 KiB

Open AccessArticle

Beat-to-Beat P-Wave Analysis Outperforms Conventional P-Wave Indices in Identifying Patients with a History of Paroxysmal Atrial Fibrillation during Sinus Rhythm

by Dimitrios Tachmatzidis, Dimitrios Filos, Ioanna Chouvarda, Anastasios Tsarouchas, Dimitrios Mouselimis, Constantinos Bakogiannis, Charalampos Lazaridis, Konstantinos Triantafyllou, Antonios P. Antoniadis, Nikolaos Fragakis, Georgios Efthimiadis, Nicos Maglaveras, Dimitrios G. Tsalikakis and Vassilios P. Vassilikos

Diagnostics 2021, 11(9), 1694; https://doi.org/10.3390/diagnostics11091694 - 17 Sep 2021

Cited by 9 | Viewed by 3270

Abstract

Early identification of patients at risk for paroxysmal atrial fibrillation (PAF) is essential to attain optimal treatment and a favorable prognosis. We compared the performance of a beat-to-beat (B2B) P-wave analysis with that of standard P-wave indices (SPWIs) in identifying patients prone to PAF. To this end, 12-lead ECG and 10 min vectorcardiogram (VCG) recordings were obtained from 33 consecutive, antiarrhythmic therapy naïve patients, with a short history of low burden PAF, and from 56 age- and sex-matched individuals with no AF history. For both groups, SPWIs were calculated, while the VCG recordings were analyzed on a B2B basis, and the P-waves were classified to a primary or secondary morphology. Wavelet transform was used to further analyze P-wave signals of main morphology. Univariate analysis revealed that none of the SPWIs performed acceptably in PAF detection, while five B2B features reached an AUC above 0.7. Moreover, multivariate logistic regression analysis was used to develop two classifiers—one based on B2B analysis derived features and one using only SPWIs. The B2B classifier was found to be superior to SPWIs classifier; B2B AUC: 0.849 (0.754–0.917) vs. SPWIs AUC: 0.721 (0.613–0.813), p value: 0.041. Therefore, in the studied population, the proposed B2B P-wave analysis outperforms SPWIs in detecting patients with PAF while in sinus rhythm. This can be used in further clinical trials regarding the prognosis of such patients. Full article

(This article belongs to the Special Issue Diagnostic Advances in Cardiovascular Prevention)

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11 pages, 1325 KiB

Open AccessArticle

Association of the IL-37 Polymorphisms with Transaminases and Alkaline Phosphatase Levels in Premature Coronary Artery Disease Patients and Healthy Controls. Results of the Genetics of Atherosclerotic (GEA) Mexican Study

by Fabiola López-Bautista, Rosalinda Posadas-Sánchez and Gilberto Vargas-Alarcón

Diagnostics 2021, 11(6), 1018; https://doi.org/10.3390/diagnostics11061018 - 2 Jun 2021

Cited by 1 | Viewed by 3118

Abstract

Interleukin 37 (IL-37) is an anti-inflammatory cytokine expressed in foam cells located in the atherosclerosis plaques. The present study aimed to evaluate the association of the IL-37 polymorphisms with premature coronary artery disease (pCAD), cardiovascular risk factors, metabolic parameters, and levels of liver enzymes. Three IL-37 polymorphisms (rs6717710, rs2708961, and rs2708947) were determined in 1161 patients with pCAD and 951 healthy controls. IL-37 polymorphisms were not associated with the presence of pCAD. The association of the polymorphisms with cardiovascular risk factors, metabolic parameters, and levels of liver enzymes was evaluated independently in pCAD and healthy controls. In pCAD patients, under different models, the rs6717710 was associated with low risk of having elevated alkaline phosphatase (ALP) (p_additive = 0.020; p_dominant = 0.02; p_heterozygous = 0.04; p_codominant1 = 0.040). On the other hand, in healthy controls, the rs6717710 was associated with low risk of having elevated levels of alanine aminotransferase (ALT) (p_additive = 0.04, p_recessive = 0.01, p_codominant2 = 0.01) and aspartate aminotransferase (AST) (p_additive = 0.02, p_dominant = 0.02). The IL-37 polymorphisms were not associated with the risk of pCAD. In pCAD patients, the rs6717710 was associated with low risk of having elevated ALP levels, whereas in controls was associated with low risk of having elevated ALT and AST levels. Full article

(This article belongs to the Special Issue Diagnostic Advances in Cardiovascular Prevention)

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13 pages, 550 KiB

Open AccessArticle

Using Anti-Malondialdehyde Modified Peptide Autoantibodies to Import Machine Learning for Predicting Coronary Artery Stenosis in Taiwanese Patients with Coronary Artery Disease

by Yu-Cheng Hsu, I-Jung Tsai, Hung Hsu, Po-Wen Hsu, Ming-Hui Cheng, Ying-Li Huang, Jin-Hua Chen, Meng-Huan Lei and Ching-Yu Lin

Diagnostics 2021, 11(6), 961; https://doi.org/10.3390/diagnostics11060961 - 26 May 2021

Cited by 5 | Viewed by 2716

Abstract

Machine learning (ML) algorithms have been applied to predicting coronary artery disease (CAD). Our purpose was to utilize autoantibody isotypes against four different unmodified and malondialdehyde (MDA)-modified peptides among Taiwanese with CAD and healthy controls (HCs) for CAD prediction. In this study, levels of MDA, MDA-modified protein (MDA-protein) adducts, and autoantibody isotypes against unmodified peptides and MDA-modified peptides were measured with enzyme-linked immunosorbent assay (ELISA). To improve the performance of ML, we used decision tree (DT), random forest (RF), and support vector machine (SVM) coupled with five-fold cross validation and parameters optimization. Levels of plasma MDA and MDA-protein adducts were higher in CAD patients than in HCs. IgM anti-IGKC^76–99 MDA and IgM anti-A1AT^284–298 MDA decreased the most in patients with CAD compared to HCs. In the experimental results of CAD prediction, the decision tree classifier achieved an area under the curve (AUC) of 0.81; the random forest classifier achieved an AUC of 0.94; the support vector machine achieved an AUC of 0.65 for differentiating between CAD patients with stenosis rates of 70% and HCs. In this study, we demonstrated that autoantibody isotypes imported into machine learning algorithms can lead to accurate models for clinical use. Full article

(This article belongs to the Special Issue Diagnostic Advances in Cardiovascular Prevention)

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Review

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14 pages, 268 KiB

Open AccessReview

Cardiac Imaging and Management of Cardiac Disease in Asymptomatic Renal Transplant Candidates: A Current Update

by Eirini Lioudaki, Ariadni Androvitsanea, Ioannis Petrakis, Constantinos Bakogiannis and Emmanuel Androulakis

Diagnostics 2022, 12(10), 2332; https://doi.org/10.3390/diagnostics12102332 - 27 Sep 2022

Cited by 1 | Viewed by 1532

Abstract

Given the high cardiovascular risk accompanying end-stage kidney disease, it would be of paramount importance for the clinical nephrologist to know which screening method(s) identify high-risk patients and whether screening asymptomatic transplant candidates effectively reduces cardiovascular risk in the perioperative setting as well as in the longer term. Within this review, key studies concerning the above questions are reported and critically analyzed. The lack of unified screening criteria and of a prognostically sufficient screening cardiovascular effect for renal transplant candidates sets the foundation for a personalized patient approach in the near future and highlights the need for well-designed studies to produce robust evidence which will address the above questions. Full article

(This article belongs to the Special Issue Diagnostic Advances in Cardiovascular Prevention)

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