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Diagnosis, Emergency Management, and Prognosis of Hypertension and Cardiovascular Disease: Current Status and Future Directions

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Cardiovascular Medicine".

Deadline for manuscript submissions: closed (31 August 2024) | Viewed by 8439

Special Issue Editor

Dr. Costantino Mancusi

E-Mail Website
Guest Editor
Department of Advanced Biomedical Sciences, Federico II University of Naples, Via S. Pansini 5, 80131 Napoli, Italy
Interests: cardiovascular disease; hypertension; heart failure
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Hypertension and the related CV diseases represent a major issue in the management of patients with CV disease. The current management of patients with arterial hypertension faces new challenges with the introduction of new technology and telemedicine approaches for the improved prediction of CV disease. Blood pressure control and measurement are also faced with the consequence of the rapid increase in new technologies and with the development of cuffless methods and telemonitoring. Our Special Issue will focus on the pathophysiology, clinical advances and current management of cardiovascular disease with a particular focus on hypertension and related CV disorders.

Prof. Dr. Costantino Mancusi
Guest Editor

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Keywords

  • hypertension
  • hypertension-mediated target organ damage
  • echocardiography
  • heart failure
  • hypertensive emergency
  • hypertensive urgency
  • epidemiology

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Published Papers (4 papers)

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Research

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17 pages, 3699 KiB  
Article
Radiological Parameters for the Detection of Pulmonary Hypertension in Severe Aortic Valve Stenosis and Their Influence on Mortality: Does Sex Matter?
by Joseph Kletzer, Bernhard Scharinger, Ozan Demirel, Reinhard Kaufmann, Michaela Medved, Christian Reiter, Matthias Hammerer, Clemens Steinwender, Stefan Hecht, Kristen Kopp, Uta C. Hoppe, Klaus Hergan and Elke Boxhammer
J. Clin. Med. 2024, 13(7), 1999; https://doi.org/10.3390/jcm13071999 - 29 Mar 2024
Viewed by 877
Abstract
Background: Echocardiography has long been established as the primary noninvasive method for diagnosing pulmonary hypertension (PH) prior to transcatheter aortic valve replacement (TAVR) in patients with severe aortic valve stenosis (AS). In recent years, radiological methods for diagnosing PH have been investigated. Measurements [...] Read more.
Background: Echocardiography has long been established as the primary noninvasive method for diagnosing pulmonary hypertension (PH) prior to transcatheter aortic valve replacement (TAVR) in patients with severe aortic valve stenosis (AS). In recent years, radiological methods for diagnosing PH have been investigated. Measurements such as the computed tomography angiography (CTA)-derived pulmonary artery (PA) diameter and PA diameter/body surface area (PA/BSA) have shown promising results regarding their diagnostic strength. However, it has yet to be determined if a patient’s sex has any impact on the effectiveness of these diagnostic measurements. Methods: In all, 271 patients (51.3% male, mean age 82.6 ± 4.8 years) with severe AS undergoing TAVR were separated into male and female groups. The cut-off values for the diagnosis of PH were calculated for the CTA-derived PA diameter and PA/BSA based on different systolic pulmonal artery pressure values (40–45–50 mmHg). Patients were then subclassified according to measurements above or below these PA diameters and PA/BSA cut-off values. A PA diameter ≥29.5 mm and PA/BSA ≥ 15.7 mm/m2 qualified for PH. The 1–5 year survival rate in these cohorts was further analyzed. Results: Patients with a PA diameter ≥29.5 mm showed a significantly higher 1 year mortality rate (p = 0.014). This observation could only be confirmed for the male sex (p = 0.018) and not for the female sex (p = 0.492). As for the PA/BSA, in patients over the cut-off value, no significant increase in mortality was noted in the overall cohort. However, the male patients showed increased 3 year (p = 0.048) and 5 year mortality rates (p = 0.033). Conclusions: The CTA-obtained PA diameter and PA/BSA are both useful in the diagnosis of PH and mortality risk stratification in patients with severe AS undergoing TAVR, especially in males. Male patients with PA ≥ 29.5 mm or PA/BSA ≥ 15.7 mm/m2 seem to be at a higher risk of death during follow-up after undergoing TAVR. In females, no such correlation was observed. Full article
(This article belongs to the Special Issue Diagnosis, Emergency Management, and Prognosis of Hypertension and Cardiovascular Disease: Current Status and Future Directions)
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16 pages, 791 KiB  
Article
Stiffness and Elasticity of Aorta Assessed Using Computed Tomography Angiography as a Marker of Cardiovascular Health—A Cross-Sectional Study
by Wojciech Hajdusianek, Aleksandra Żórawik, Piotr Macek, Małgorzata Poręba, Rafał Poręba and Paweł Gać
J. Clin. Med. 2024, 13(2), 384; https://doi.org/10.3390/jcm13020384 - 10 Jan 2024
Cited by 1 | Viewed by 1252
Abstract
Cardiovascular (CV) health can be measured using the American Health Association’s Life’s Simple 7 scale (ALS7). Aortic stiffness (AoS) and elasticity (AoE) can be assessed using various methods, e.g., computed tomography (CT). To measure AoE, we use aortic strain and distensibility (AoD). The [...] Read more.
Cardiovascular (CV) health can be measured using the American Health Association’s Life’s Simple 7 scale (ALS7). Aortic stiffness (AoS) and elasticity (AoE) can be assessed using various methods, e.g., computed tomography (CT). To measure AoE, we use aortic strain and distensibility (AoD). The aim of this study was to examine the relationship between ALS7, AoS, and AoE. The study group (SG) was composed of 96 patients (mean age 70.41 ± 8.32 years) with a BMI of 25.58 ± 3.12 kg/m2; 28.1% were smokers, 54.2% had hypertension, 11.4% had diabetes, and 67.7% had hypercholesterolemia. The SG was further divided into three subgroups (optimal (ALS7-H), intermediate (ALS7-I), and inadequate (ALS7-L)) based on the ALS7. The AoS and AoE were assessed in each of them. We found that the ALS7-I and ALS7-H had significantly lower AoS values compared to the ALS7-L (AoS: 3.50 ± 0.53 and 4.10 ± 0.70 vs. 4.57 ± 1.03, respectively). The opposite relationship was observed for AoE measured with AoD in the ALS7-H vs. ALS7-L (AoD: 0.23 ± 0.14 vs. 0.11 ± 0.09 cm2/dyn). AoS correlated (r = 0.61) with systolic blood pressure (BP). In our regression model, higher scores on the ALS7 in BP, smoking, and BMI were independent protective factors against greater AoS. Higher ALS7 scores in BP, smoking, BMI, and physical activity were protective factors against lesser aortic strain. Higher scores in ALS7 for BP and smoking were protective factors against lesser AoD. We conclude that better cardiovascular health expressed via higher scores obtained on the ALS7 is associated with lower AoS and higher AoE on CT. Full article
(This article belongs to the Special Issue Diagnosis, Emergency Management, and Prognosis of Hypertension and Cardiovascular Disease: Current Status and Future Directions)
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Review

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17 pages, 583 KiB  
Review
Comorbidities in COPD: Current and Future Treatment Challenges
by Domenica Francesca Mariniello, Vito D’Agnano, Donatella Cennamo, Stefano Conte, Gianluca Quarcio, Luca Notizia, Raffaella Pagliaro, Angela Schiattarella, Rosario Salvi, Andrea Bianco and Fabio Perrotta
J. Clin. Med. 2024, 13(3), 743; https://doi.org/10.3390/jcm13030743 - 27 Jan 2024
Cited by 6 | Viewed by 4435
Abstract
Chronic obstructive pulmonary disease (COPD) is a heterogeneous lung condition, primarily characterized by the presence of a limited airflow, due to abnormalities of the airways and/or alveoli, that often coexists with other chronic diseases such as lung cancer, cardiovascular diseases, and metabolic disorders. [...] Read more.
Chronic obstructive pulmonary disease (COPD) is a heterogeneous lung condition, primarily characterized by the presence of a limited airflow, due to abnormalities of the airways and/or alveoli, that often coexists with other chronic diseases such as lung cancer, cardiovascular diseases, and metabolic disorders. Comorbidities are known to pose a challenge in the assessment and effective management of COPD and are also acknowledged to have an important health and economic burden. Local and systemic inflammation have been proposed as having a potential role in explaining the association between COPD and these comorbidities. Considering that the number of patients with COPD is expected to rise, understanding the mechanisms linking COPD with its comorbidities may help to identify new targets for therapeutic purposes based on multi-dimensional assessments. Full article
(This article belongs to the Special Issue Diagnosis, Emergency Management, and Prognosis of Hypertension and Cardiovascular Disease: Current Status and Future Directions)
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Other

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9 pages, 275 KiB  
Viewpoint
Due Diligence of a Diastolic Index as a Prognostic Factor in Heart Failure with Preserved Ejection Fraction
by Shiro Hoshida
J. Clin. Med. 2023, 12(20), 6692; https://doi.org/10.3390/jcm12206692 - 23 Oct 2023
Cited by 1 | Viewed by 1117
Abstract
Of the existing non-invasive diastolic indices, none consider arterial load. This article reveals points of caution for determining the diastolic prognostic index using a novel index of vascular resistance-integrated diastolic function in old, real-world patients with heart failure with preserved ejection fraction (HFpEF) [...] Read more.
Of the existing non-invasive diastolic indices, none consider arterial load. This article reveals points of caution for determining the diastolic prognostic index using a novel index of vascular resistance-integrated diastolic function in old, real-world patients with heart failure with preserved ejection fraction (HFpEF) in Japan. This index represents the ratio of left ventricular diastolic elastance (Ed) to arterial elastance (Ea), where Ed/Ea = (E/e′)/(0.9 × systolic blood pressure), showing a relative ratio of left atrial filling pressure to left ventricular end-systolic pressure. The role of hemodynamic prognostic factors related to diastolic function, such as Ed/Ea, may differ according to the clinical endpoint, follow-up duration, and sex. In HFpEF patients with heterogenous cardiac structure and function, an assessment using a serial echocardiographic diastolic index in clinical care can provide an accurate prognosis. Full article
(This article belongs to the Special Issue Diagnosis, Emergency Management, and Prognosis of Hypertension and Cardiovascular Disease: Current Status and Future Directions)
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