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Interdisciplinarity in Cardiovascular Diseases: From Pathophysiology to Diagnosis and Treatment—2nd...
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Interdisciplinarity in Cardiovascular Diseases: From Pathophysiology to Diagnosis and Treatment—2nd Edition

A special issue of Life (ISSN 2075-1729). This special issue belongs to the section "Physiology and Pathology".

Deadline for manuscript submissions: closed (3 December 2024) | Viewed by 25163

Special Issue Editors

Prof. Dr. Anca Trifan

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Guest Editor
Department of Gastroenterology, “Grigore T. Popa” University of Medicine and Pharmacy, Iasi, Romania
Interests: hepatic fibrosis; steatohepatitis; inflammatory bowel disease; alcoholic liver disease; gastroenterology and hepatology; cardiovascular complications
Special Issues, Collections and Topics in MDPI journals
Prof. Dr. Mariana Floria

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Guest Editor
Department of Internal Medicine, University of Medicine and Pharmacy “Grigore T. Popa”, 16 University Street, Iasi, Romania
Interests: arrhythmias; atrial fibrillation; left atrium; cardiovascular disease; cardiovascular risk factor; echocardiography; gastroesophageal reflux disease; metabolic associated steato-hepatitis; heart–liver axis
Special Issues, Collections and Topics in MDPI journals
Dr. Daniela Maria Tanase

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Guest Editor
Department of Internal Medicine, University of Medicine and Pharmacy “Grigore T. Popa”, 16 University Street, Iasi, Romania
Interests: cardiovascular diseases; cardiovascular complications; atherosclerosis; oxidative stress; inflammatory bowel disease; nonalcoholic fatty liver disease; gut microbiota; dysbiosis; type 2 diabetes
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

The first volume of this Special Issue was completed successfully. We intend to publish a second volume, so we invite you to submit your research for publication.

https://www.mdpi.com/journal/life/special_issues/56Z399BE63

Cardiovascular diseases are an important cause of death worldwide. Interdisciplinarity has become mandatory in many cardiovascular diseases like hypertension, ischemic heart disease, arrhythmias, congenital heart disease, pericarditis, arrhythmias or valvular heart disease. The heart team decision has become a common recommendation in cardiology guidelines. Diagnosis and treatment algorithms in cardiovascular disease imply, therefore, interdisciplinary collaboration with gastroenterologists, nephrologists, pulmonologists, neurologists, rheumatologists, hematologists, etc.

Gastroesophageal reflux disease, inflammatory bowel diseases, and metabolic-associated steatohepatitis are some of the digestive diseases that require a mixed team: cardiologist–gastroenterologist. These diseases share common physiopathological mechanisms or substrates and therefore there are diagnostic and therapeutic interferences.

Despite the importance of cardiorenal syndrome and cardiac complications of chronic kidney disease or kidney transplantation, the interaction between nephrology and cardiovascular medicine is much broader. Nowadays, there are many advancements in nephrology and cardiovascular medicine, which merge new diagnostic, monitoring and therapeutic modalities. Patients with acute or chronic kidney disease have pathologies like ischemia, dyslipidemia or hypertension, and need interdisciplinary collaboration with the cardiologist. Nephrocardiology or cardionephrology, defined as the interaction between nephrology and cardiovascular medicine, is the multidirectional interplay of cardiovascular diseases and nephrology-related conditions.

Respiratory medicine and cardiac pathology share multiple comorbidities such as pulmonary hypertension, pulmonary embolism and COPD. The cardiovascular and respiratory systems share common physiological and pathophysiological mechanisms and complications. The recent COVID-19 pandemic is the best example of the interdisciplinarity between cardiologists and pulmonologists.

Beyond the frequent interactions of cardiology with gastroenterohepatology, nephrology or respiratory medicine, there are many others like metabolic, endocrinology or hematology diseases, which share common risk factors, comorbidities and complications.

To conclude, the heart team concept brings to the fore the need for interdisciplinary collaboration in cardiology. The liver–heart, bowel–heart, brain–heart or kidney–heart axes might explain the pathophysiologic interferences and the multiples clinical consequences. Therefore, prevention, diagnosis and therapy of cardiovascular diseases increasingly involve collaboration with other specialties for the best decisions for our patients. In addition, interdisciplinarity in cardiovascular disease might create new algorithms from diagnostic or therapeutic points of view in some cardiovascular diseases.

Prof. Dr. Anca Trifan
Prof. Dr. Mariana Floria
Dr. Daniela Maria Tanase
Guest Editors

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Keywords

  • interdisciplinary team
  • cardiovascular diseases
  • cardiovascular complications
  • gastro-esophago-enterology and hepatology
  • metabolic associated steato-hepatitis
  • gut microbiota
  • nephrocardiology
  • pulmonary diseases
  • rheumatology diseases
  • endocrinology diseases

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Published Papers (11 papers)

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Editorial

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7 pages, 202 KiB  
Editorial
Interdisciplinarity in Cardiovascular Diseases—A Necessity Alongside the Heart Team
by Mariana Floria, Diana-Elena Floria, Anca Victorița Trifan and Daniela Maria Tănase
Life 2025, 15(2), 193; https://doi.org/10.3390/life15020193 - 28 Jan 2025
Viewed by 385
Abstract
Cardiovascular disease often requires multidisciplinary collaboration in order to achieve an appropriate diagnosis and optimal patient outcomes [...] Full article
(This article belongs to the Special Issue Interdisciplinarity in Cardiovascular Diseases: From Pathophysiology to Diagnosis and Treatment—2nd Edition)

Research

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10 pages, 521 KiB  
Article
Serum Malondialdehyde-Modified Low-Density Lipoprotein Level May Be a Biomarker Associated with Aortic Stiffness Among Patients Undergoing Peritoneal Dialysis
by Yu-Chi Chang, Chih-Hsien Wang, Chi-Chong Tang, Yu-Li Lin, Yu-Hsien Lai, Chiu-Huang Kuo and Bang-Gee Hsu
Life 2024, 14(11), 1385; https://doi.org/10.3390/life14111385 - 28 Oct 2024
Viewed by 994
Abstract
Background: Serum malondialdehyde-oxidized low-density lipoprotein (MDA-oxLDL) is associated with atherosclerosis and increased risk of cardiovascular disease (CVD). Vascular calcification frequently occurs with arterial stiffness in patients on peritoneal dialysis (PD). This cross-sectional study aimed to elucidate the correlation between aortic stiffness and MDA-oxLDL [...] Read more.
Background: Serum malondialdehyde-oxidized low-density lipoprotein (MDA-oxLDL) is associated with atherosclerosis and increased risk of cardiovascular disease (CVD). Vascular calcification frequently occurs with arterial stiffness in patients on peritoneal dialysis (PD). This cross-sectional study aimed to elucidate the correlation between aortic stiffness and MDA-oxLDL levels in patients on PD. Methods: Overall, 92 patients on PD were included. The carotid–femoral pulse wave velocity (cfPWV) was evaluated using cuff-based volumetric displacement, and blood samples were obtained from all patients. Aortic stiffness was classified based on cfPWV values (>10 m/s indicating aortic stiffness). Serum MDA-ox-LDL levels were quantified using commercial enzyme-linked immunosorbent assay kits. Results: In total, 33 (35.9%) patients were classified into the aortic stiffness group. Factors, including systolic blood pressure (SBP), serum triglyceride levels, C-reactive protein levels, age, weight, body mass index (BMI), waist circumference, MDA-oxLDL levels, and diabetes mellitus (DM) prevalence, were significantly higher in the aortic stiffness group. Multivariable logistic regression analysis revealed significant associations between aortic stiffness and MDA-oxLDL levels, BMI, and SBP. Furthermore, multivariable forward stepwise linear regression analysis revealed serum MDA-oxLDL levels as a significant independent predictor of cfPWV values. Conclusions: Serum MDA-oxLDL levels correlate positively with cfPWV values and may predict aortic stiffness among PD patients, highlighting its potential role in assessing CVD risk in this population. Full article
(This article belongs to the Special Issue Interdisciplinarity in Cardiovascular Diseases: From Pathophysiology to Diagnosis and Treatment—2nd Edition)
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13 pages, 560 KiB  
Article
The Genetic Architecture of Congenital Heart Disease in Neonatal Intensive Care Unit Patients—The Experience of University Medical Centre, Ljubljana
by Ana Peterlin, Sara Bertok, Karin Writzl, Luca Lovrečić, Aleš Maver, Borut Peterlin, Maruša Debeljak and Gregor Nosan
Life 2024, 14(9), 1118; https://doi.org/10.3390/life14091118 - 5 Sep 2024
Viewed by 911
Abstract
Congenital heart disease (CHD) is the most commonly detected congenital anomaly and affects up to 1% of all live-born neonates. Current guidelines support the use of chromosomal microarray analysis (CMA) and next-generation sequencing (NGS) as diagnostic approaches to identify genetic causes. The aim [...] Read more.
Congenital heart disease (CHD) is the most commonly detected congenital anomaly and affects up to 1% of all live-born neonates. Current guidelines support the use of chromosomal microarray analysis (CMA) and next-generation sequencing (NGS) as diagnostic approaches to identify genetic causes. The aim of our study was to evaluate the diagnostic yield of CMA and NGS in a cohort of neonates with both isolated and syndromic CHD. The present study included 188 infants under 28 days of age with abnormal echocardiography findings hospitalized at the Department of Neonatology, UMC Ljubljana, between January 2014 and December 2023. Phenotypic data were obtained for each infant via retrospective medical chart review. We established the genetic diagnosis of 22 distinct syndromes in 17% (32/188) of neonates. The most frequent genetic diagnoses in diagnosed cases were 22q11.2 microdeletion and CHARGE syndromes, followed by Noonan syndrome and Williams syndrome. In addition, we detected variants of uncertain significance in 4.8% (9/188) of neonates. Timely genetic diagnosis is important for the detection of syndrome-related comorbidities, prognosis, reproductive genetic risks and, when appropriate, genetic testing of other family members. Full article
(This article belongs to the Special Issue Interdisciplinarity in Cardiovascular Diseases: From Pathophysiology to Diagnosis and Treatment—2nd Edition)
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12 pages, 1352 KiB  
Article
Autonomic Dysfunction and Cardiac Performance in Pregnant Women with Hypertensive Disorders: A Comparative Study Using Heart Rate Variability and Global Longitudinal Strain
by Carina Bogdan, Adrian Apostol, Viviana Mihaela Ivan, Oana Elena Sandu, Ion Petre, Izabella Petre, Luciana-Elena Marc, Felix-Mihai Maralescu and Daniel Florin Lighezan
Life 2024, 14(8), 1039; https://doi.org/10.3390/life14081039 - 20 Aug 2024
Viewed by 1202
Abstract
(1) Background: Pregnancy induces significant physiological adaptations with substantial impacts on the cardiovascular system. Hypertensive disorders of pregnancy (HDPs) are connected to significant risks of maternal and fetal complications, contributing significantly to morbidity and mortality across the globe. This study focuses on evaluating [...] Read more.
(1) Background: Pregnancy induces significant physiological adaptations with substantial impacts on the cardiovascular system. Hypertensive disorders of pregnancy (HDPs) are connected to significant risks of maternal and fetal complications, contributing significantly to morbidity and mortality across the globe. This study focuses on evaluating autonomic dysfunction by analyzing heart rate variability (HRV) and assessing cardiac performance through global longitudinal strain (GLS) using speckle tracking echocardiography, as well as examining diastolic function in pregnant women with HDP compared to healthy pregnant controls. (2) Methods: A case–control study was conducted involving pregnant women diagnosed with gestational hypertension (GH), preeclampsia (PE), or severe preeclampsia (SPE) as the case group, and healthy pregnant women as the control group. HRV was measured to evaluate autonomic function, GLS was assessed using speckle tracking echocardiography, and diastolic function was evaluated through standard echocardiographic parameters. Data were analyzed to compare cardiac performance and autonomic regulation between the HDP and control group, as well as among the different HDP subgroups. (3) Results: The HDP group exhibited significantly reduced HRV parameters compared to healthy controls, indicating notable autonomic dysfunction. Speckle tracking echocardiography revealed lower GLS among women with HDP, particularly in those with SPE, compared to the control group. Diastolic dysfunction was also present in the HDP group. (4) Conclusions: HRV and GLS are valuable non-invasive tools for detecting autonomic dysfunction and cardiac performance impairments in pregnant women with hypertensive disorders. These findings suggest that autonomic and cardiac dysfunctions are prevalent in HDP. Full article
(This article belongs to the Special Issue Interdisciplinarity in Cardiovascular Diseases: From Pathophysiology to Diagnosis and Treatment—2nd Edition)
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18 pages, 1219 KiB  
Article
Cardiovascular Risk Profile on the Island of Santiago—Cabo Verde (PrevCardio.CV Study)
by Francisco Rodrigues, Kelly Mascarenhas, Júlio Rodrigues and Patrícia Coelho
Life 2024, 14(8), 966; https://doi.org/10.3390/life14080966 - 31 Jul 2024
Viewed by 982
Abstract
Cerebrocardiovascular diseases are a major global public health concern, significantly impacting morbidity, mortality, and posing substantial socio-economic challenges. In Cabo Verde, non-communicable diseases have become the leading causes of morbidity and mortality. This study aimed to estimate the prevalence of risk factors for [...] Read more.
Cerebrocardiovascular diseases are a major global public health concern, significantly impacting morbidity, mortality, and posing substantial socio-economic challenges. In Cabo Verde, non-communicable diseases have become the leading causes of morbidity and mortality. This study aimed to estimate the prevalence of risk factors for cerebrocardiovascular diseases and their association with cardiac electrical alterations in adults on Santiago Island, Cabo Verde. A cross-sectional population-based study using simple random sampling was conducted on individuals over 18 years of age. The sample size of 599 was based on Santiago Island’s 2021 population projection. Data collection occurred in October and November 2021, involving questionnaires on risk factors and cerebrocardiovascular diseases; blood pressure assessments; and capillary blood glucose measurements. The sample was predominantly female, with the 18–27 age group being the largest. Key risk factors included physical inactivity (65.1%), BMI ≥ 25 kg/m2 (42.6%), hypertension (32.6%), and family history of cerebrocardiovascular diseases (19.9%). Other factors were alcoholism (14.4%), hypercholesterolemia (8.3%), smoking (7.3%), diabetes (4.5%), and hypertriglyceridemia (1.3%). Notably, 9.3% had no risk factors, 27.5% had one, 36.2% had two, and 26.9% had three or more. There is a high prevalence of risk factors for cerebrocardiovascular diseases on Santiago Island, particularly among females. Full article
(This article belongs to the Special Issue Interdisciplinarity in Cardiovascular Diseases: From Pathophysiology to Diagnosis and Treatment—2nd Edition)
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Review

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23 pages, 1165 KiB  
Review
Alcohol Consumption and Cardiovascular Disease: A Narrative Review of Evolving Perspectives and Long-Term Implications
by Ovidiu Stefan Georgescu, Liviu Martin, Georgică Costinel Târtea, Alexandra-Daniela Rotaru-Zavaleanu, Sorin Nicolae Dinescu, Ramona Constantina Vasile, Andrei Gresita, Veronica Gheorman, Madalina Aldea and Venera Cristina Dinescu
Life 2024, 14(9), 1134; https://doi.org/10.3390/life14091134 - 9 Sep 2024
Cited by 1 | Viewed by 5233
Abstract
Cardiovascular illnesses remain the primary cause of death, accounting for at least 17.9 million fatalities per year and posing a significant public health problem because of its extensive predominance and effect on healthcare systems. The etiology of cardiovascular disease is complex and involves [...] Read more.
Cardiovascular illnesses remain the primary cause of death, accounting for at least 17.9 million fatalities per year and posing a significant public health problem because of its extensive predominance and effect on healthcare systems. The etiology of cardiovascular disease is complex and involves several environmental and lifestyle factors. Alcohol use is a highly important determinant because of its dual-edged effect on cardiovascular health. Multiple studies indicate that moderate alcohol consumption may have certain advantages, such as slight enhancements in lipid profiles. Conversely, excessive alcohol intake is associated with serious negative consequences, including cardiomyopathy, hypertension, arrhythmias, and even mortality. The aim of this study is to provide a comprehensive analysis of the several effects of alcohol on cardiovascular health and their understanding within the medical field over time. It uses an interpretative narrative review methodology and analyzes studies that focus on genetic risk factors, gender differences, and shifts in paradigms in recent years. This article highlights the need for obtaining a thorough understanding of the effects of alcohol on cardiovascular health to support public health guidelines and clinical practice, and it underscores the significance of including alcohol consumption into the broader context of cardiovascular risk management and identifies important subjects for further study. Full article
(This article belongs to the Special Issue Interdisciplinarity in Cardiovascular Diseases: From Pathophysiology to Diagnosis and Treatment—2nd Edition)
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20 pages, 351 KiB  
Review
The Prognostic Role of the Neutrophil-to-Lymphocytes Ratio in the Most Frequent Cardiovascular Diseases: An Update
by Evelina Maria Gosav, Daniela Maria Tanase, Oana Nicoleta Buliga-Finis, Ioana-Irina Rezuș, Paula Cristina Morariu, Mariana Floria and Ciprian Rezus
Life 2024, 14(8), 985; https://doi.org/10.3390/life14080985 - 7 Aug 2024
Cited by 3 | Viewed by 2460
Abstract
Given the continuous changes in the world, with an increasing trend of unhealthy lifestyles, metabolic comorbidities, and increased susceptibility to cardiovascular diseases (CVDs), researchers change their attention to improve not only the therapeutic platform but also current CVD predictive and prognostic tools to [...] Read more.
Given the continuous changes in the world, with an increasing trend of unhealthy lifestyles, metabolic comorbidities, and increased susceptibility to cardiovascular diseases (CVDs), researchers change their attention to improve not only the therapeutic platform but also current CVD predictive and prognostic tools to improve disease outcomes. As CVD is characterized by an inflammatory paradigm involving, to some degree, the innate and adaptative immune systems, the neutrophil-to-lymphocyte ratio (NLR) emerged as a potential low-cost, rapidly available, and reliable inflammatory marker, with substantial recent evidence showing its potential utility in clinical practice. Thus, in this literature review, we will present an up-to-date discussion of the prognostic role of NLR in the most frequent CVDs, such as acute and chronic coronary disease, atherosclerotic disease, heart failure, cardiac valvopathies, and cardiac arrhythmias with predilection to atrial fibrillation. Full article
(This article belongs to the Special Issue Interdisciplinarity in Cardiovascular Diseases: From Pathophysiology to Diagnosis and Treatment—2nd Edition)
17 pages, 734 KiB  
Review
Vascular Alterations Following COVID-19 Infection: A Comprehensive Literature Review
by Paschalis Karakasis, Athina Nasoufidou, Marios Sagris, Nikolaos Fragakis and Konstantinos Tsioufis
Life 2024, 14(5), 545; https://doi.org/10.3390/life14050545 - 24 Apr 2024
Cited by 4 | Viewed by 6215
Abstract
SARS-CoV-2, the causative agent of the ongoing COVID-19 pandemic, has revealed a broader impact beyond the respiratory system, predominantly affecting the vascular system with various adverse manifestations. The infection induces endothelial dysfunction and immune system dysregulation, creating an inflammatory and hypercoagulable state. It [...] Read more.
SARS-CoV-2, the causative agent of the ongoing COVID-19 pandemic, has revealed a broader impact beyond the respiratory system, predominantly affecting the vascular system with various adverse manifestations. The infection induces endothelial dysfunction and immune system dysregulation, creating an inflammatory and hypercoagulable state. It affects both microvasculature and macrovasculature, leading to thromboembolic events, cardiovascular manifestations, impaired arterial stiffness, cerebrovascular complications, and nephropathy, as well as retinopathy—frequently observed in cases of severe illness. Evidence suggests that SARS-CoV-2 infection may result in persistent effects on the vascular system, identified as long-term COVID-19. This is characterized by prolonged inflammation, endotheliopathy, and an increased risk of vascular complications. Various imaging modalities, histopathological studies, and diagnostic tools such as video capillaroscopy and magnetic resonance imaging have been employed to visualize vascular alterations. This review aims to comprehensively summarize the evidence concerning short and long-term vascular alterations following COVID-19 infection, investigating their impact on patients’ prognosis, and providing an overview of preventive strategies to mitigate associated vascular complications. Full article
(This article belongs to the Special Issue Interdisciplinarity in Cardiovascular Diseases: From Pathophysiology to Diagnosis and Treatment—2nd Edition)
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17 pages, 1108 KiB  
Review
Interleukin-1 Blockers: A Paradigm Shift in the Treatment of Recurrent Pericarditis
by Emilia Lazarou, Christos Koutsianas, Panagiotis Theofilis, George Lazaros, Dimitrios Vassilopoulos, Charalambos Vlachopoulos, Costas Tsioufis, Massimo Imazio, Antonio Brucato and Dimitris Tousoulis
Life 2024, 14(3), 305; https://doi.org/10.3390/life14030305 - 26 Feb 2024
Cited by 3 | Viewed by 2362
Abstract
Recurrent pericarditis is a problematic clinical condition that impairs the quality of life of the affected patients due to the need for repeated hospital admissions, emergency department visits, and complications from medications, especially glucocorticoids. Unfortunately, available treatments for recurrent pericarditis are very limited, [...] Read more.
Recurrent pericarditis is a problematic clinical condition that impairs the quality of life of the affected patients due to the need for repeated hospital admissions, emergency department visits, and complications from medications, especially glucocorticoids. Unfortunately, available treatments for recurrent pericarditis are very limited, including only a handful of medications such as aspirin/NSAIDs, glucocorticoids, colchicine, and immunosuppressants (such as interleukin-1 (IL-1) blockers, azathioprine, and intravenous human immunoglobulins). Until recently, the clinical experience with the latter class of medications was very limited. Nevertheless, in the last decade, experience with IL-1 blockers has consistently grown, and valid clinical data have emerged from randomized clinical trials. Accordingly, IL-1 blockers are a typical paradigm shift in the treatment of refractory recurrent pericarditis with a clearly positive cost/benefit ratio for those unfortunate patients with multiple recurrences. A drawback related to the above-mentioned medications is the absence of universally accepted and established treatment protocols regarding the full dose administration period and the need for a tapering protocol for individual medications. Another concern is the need for long-standing treatments, which should be discussed with the patients. The above-mentioned unmet needs are expected to be addressed in the near future, such as further insights into pathophysiology and an individualized approach to affected patients. Full article
(This article belongs to the Special Issue Interdisciplinarity in Cardiovascular Diseases: From Pathophysiology to Diagnosis and Treatment—2nd Edition)
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Other

8 pages, 1174 KiB  
Brief Report
Health Technology Assessment of Cardiopulmonary Bypass Circuit with and without Phosphorylcholine Coating: A Retrospective Study on Safety and Efficiency in Cardiac Surgery
by Ignazio Condello, Giuseppe Nasso, Salvatore Scrivo, Flavio Fiore and Giuseppe Speziale
Life 2024, 14(7), 851; https://doi.org/10.3390/life14070851 - 6 Jul 2024
Viewed by 1380
Abstract
Background: Phosphorylcholine has emerged as a potential adjunctive agent in cardiopulmonary bypass (CPB) circuits. Phosphorylcholine serves as a coating for the CPB circuit, potentially enhancing biocompatibility and reducing thrombotic events. However, its impact on specific patient populations and procedural outcomes remains underexplored. Materials [...] Read more.
Background: Phosphorylcholine has emerged as a potential adjunctive agent in cardiopulmonary bypass (CPB) circuits. Phosphorylcholine serves as a coating for the CPB circuit, potentially enhancing biocompatibility and reducing thrombotic events. However, its impact on specific patient populations and procedural outcomes remains underexplored. Materials and Methods: In this retrospective study, we analyzed data from 60 patients who underwent cardiac surgery with CPB, comprising 20 cases each of coronary artery bypass grafting (CABG), mitral valve repair, and aortic valve replacement. The patient cohort was divided into two groups—30 patients whose CPB circuits were coated with phosphorylcholine (phosphorylcholine-coated group) and 30 patients who did not receive phosphorylcholine supplementation or circuit coating. Both groups underwent surgery with identical CPB circuit designs. We assessed the absence of adverse events, safety, and efficacy parameters, including blood loss, clotting, and the structural integrity of the CPB circuit. Additionally, we measured changes in mean albumin levels (g/dL), mean platelet counts (×109/L), and antithrombin III (ATIII) levels before and after CPB. Results: The retrospective analysis revealed an absence of adverse events in both groups. In the phosphorylcholine-coated group compared to the non-phosphorylcholine-coated group, there was a notable difference in the delta change in mean albumin levels (0.87 ± 0.1 vs. 1.65 ± 0.2 g/dL, p-value 0.021), mean platelet counts (42.251 ± 0.121 vs. 54.21 ± 0.194 × 109/L, p-value 0.049), and ATIII levels (16.85 ± 0.2 vs. 31.21 ± 0.3 p-value 0.017). There was a notable reduction in the perioperative consumption of human complex units after CPB (3 vs. 12, p-value 0.019). Conclusions: Both groups, phosphorylcholine and non-phosphorylcholine, demonstrated the absence of adverse events and that the systems are safe for iatrogenic complication. Our findings suggest that the use of phosphorylcholine coating on the CPB circuit, in the absence of supplementary phosphorylcholine, in cardiac surgery is associated with favorable changes in mean albumin levels, mean platelet counts, and ATIII levels. Further research is warranted to elucidate the full extent of phosphorylcholine’s impact on patient outcomes and CPB circuit performance. Full article
(This article belongs to the Special Issue Interdisciplinarity in Cardiovascular Diseases: From Pathophysiology to Diagnosis and Treatment—2nd Edition)
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14 pages, 1655 KiB  
Systematic Review
Retinal Structural and Vascular Changes in Patients with Coronary Artery Disease: A Systematic Review and Meta-Analysis
by Alexandra Cristina Rusu, Karin Ursula Horvath, Grigore Tinica, Raluca Ozana Chistol, Andra-Irina Bulgaru-Iliescu, Ecaterina Tomaziu Todosia and Klara Brînzaniuc
Life 2024, 14(4), 448; https://doi.org/10.3390/life14040448 - 28 Mar 2024
Cited by 4 | Viewed by 1950
Abstract
Background: Retinal microvascular anomalies have been identified in patients with cardiovascular conditions such as arterial hypertension, diabetes mellitus, and carotid artery disease. We conducted a systematic review and meta-analysis (PROSPERO registration number CRD42024506589) to explore the potential of retinal vasculature as a biomarker [...] Read more.
Background: Retinal microvascular anomalies have been identified in patients with cardiovascular conditions such as arterial hypertension, diabetes mellitus, and carotid artery disease. We conducted a systematic review and meta-analysis (PROSPERO registration number CRD42024506589) to explore the potential of retinal vasculature as a biomarker for diagnosis and monitoring of patients with coronary artery disease (CAD) through optical coherence tomography (OCT) and optical coherence tomography angiography (OCTA). Methods: We systematically examined original articles in the Pubmed, Embase, and Web of Science databases from their inception up to November 2023, comparing retinal microvascular features between patients with CAD and control groups. Studies were included if they reported sample mean with standard deviation or median with range and/or interquartile range (which were computed into mean and standard deviation). Review Manager 5.4 (The Cochrane Collaboration, 2020) software was used to calculate the pooled effect size with weighted mean difference and 95% confidence intervals (CI) by random-effects inverse variance method. Results: Eleven studies meeting the inclusion criteria were incorporated into the meta-analysis. The findings indicated a significant decrease in the retinal nerve fiber layer (WMD −3.11 [−6.06, −0.16]), subfoveal choroid (WMD −58.79 [−64.65, −52.93]), and overall retinal thickness (WMD −4.61 [−7.05, −2.17]) among patients with CAD compared to controls (p < 0.05). Furthermore, vascular macular density was notably lower in CAD patients, particularly in the superficial capillary plexus (foveal vessel density WMD −2.19 [−3.02, −1.135], p < 0.0001). Additionally, the foveal avascular zone area was statistically larger in CAD patients compared to the control group (WMD 52.73 [8.79, 96.67], p = 0.02). Heterogeneity was significant (I2 > 50%) for most features except for subfoveal choroid thickness, retina thickness, and superficial foveal vessel density. Conclusion: The current meta-analysis suggests that retinal vascularization could function as a noninvasive biomarker, providing additional insights beyond standard routine examinations for assessing dysfunction in coronary arteries. Full article
(This article belongs to the Special Issue Interdisciplinarity in Cardiovascular Diseases: From Pathophysiology to Diagnosis and Treatment—2nd Edition)
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