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Life
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Interdisciplinarity in Cardiovascular Diseases: From Pathophysiology to Diagnosis and Treatment
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Interdisciplinarity in Cardiovascular Diseases: From Pathophysiology to Diagnosis and Treatment

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

Deadline for manuscript submissions: closed (30 April 2023) | Viewed by 25824

Special Issue Editors

Prof. Dr. Anca Trifan

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Guest Editor
1. Department of Gastroenterology, “Grigore T. Popa” University of Medicine and Pharmacy, Iasi, Romania
2. Institute of Gastroenterology and Hepatology, "St. Spiridon" University Hospital, Iasi, Romania
Interests: acute and chronic liver disease; steatohepatitis; liver transplantation; inflammatory bowel disease; celiac disease; endomicroscopy
Special Issues, Collections and Topics in MDPI journals
Prof. Dr. Mariana Floria

E-Mail Website
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

E-Mail Website
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,

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 therefore imply interdisciplinary collaboration with the gastroenterologist, nephrologist, pulmonologist, neurologist, rheumatologist, hematologist, etc.

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

Despite the importance of cardiorenal syndrome and the cardiac complications of chronic kidney disease or kidney transplantation, the interaction between nephrology and cardiovascular medicine is much broader. There have recently been 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, who 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 frequent interferences between cardiology and gastroenterohepatology, nephrology or respiratory medicine, there are many others, such as metabolic, endocrinological or hematological disease, 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. Liver–heart, bowel–heart, brain–heart and kidney–heart axes might explain the pathophysiologic interferences and the multiple clinical consequences. Therefore, the 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 a diagnostic or therapeutic point of view in some cardiovascular diseases.

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

Manuscript Submission Information

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Keywords

  • interdisciplinarity 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 (10 papers)

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Research

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11 pages, 290 KiB  
Article
Toxoplasma gondii Infection in Patients with Cardiovascular Diseases from Western Romania: A Case–Control Study
by Angela Dragomir, Maria Alina Lupu, Rodica Lighezan, Ana Alexandra Paduraru and Tudor Rares Olariu
Life 2023, 13(7), 1575; https://doi.org/10.3390/life13071575 - 17 Jul 2023
Cited by 3 | Viewed by 1517
Abstract
(1) Background: Toxoplasma gondii infects approximately one third of the world’s human population. The seroepidemiology of T. gondii in cardiovascular patients is poorly discussed in the existing literature. We aimed to evaluate, for the first time, the seroprevalence of T. gondii in cardiovascular [...] Read more.
(1) Background: Toxoplasma gondii infects approximately one third of the world’s human population. The seroepidemiology of T. gondii in cardiovascular patients is poorly discussed in the existing literature. We aimed to evaluate, for the first time, the seroprevalence of T. gondii in cardiovascular patients from Western Romania. (2) Methods: Serologic testing to demonstrate the presence of T. gondii antibodies was conducted in 256 patients with cardiovascular diseases and 261 matched blood donors. (3) Results: The overall seroprevalence of T. gondii antibodies was 64.06% in patients with cardiovascular diseases and 52.88% in blood donors and tended to increase with age in both groups. The seroprevalence of T. gondii antibodies was significantly higher in cardiovascular male patients (69.94%) compared to male blood donors (55.69%) (p = 0.006). When compared to the control group, a significantly higher prevalence of T. gondii antibodies was found among patients with hypertension (82.35%; p = 0.01) and unstable angina (67.56%; p = 0.02). (4) Conclusions: This study brings new epidemiological information on the prevalence of T. gondii in Romanian cardiovascular patients. T. gondii seroprevalence was significantly higher in patients with hypertension and unstable angina, suggesting that individuals with these diagnoses may be more frequently infected with T. gondii. This study may be a valuable starting point for further research to better evaluate the impact of T. gondii exposure on patients with cardiovascular diseases. Full article
(This article belongs to the Special Issue Interdisciplinarity in Cardiovascular Diseases: From Pathophysiology to Diagnosis and Treatment)
15 pages, 1197 KiB  
Article
The Prognostic Role of Spot Urinary Sodium and Chloride in a Cohort of Hospitalized Advanced Heart Failure Patients: A Pilot Study
by Andrew Xanthopoulos, Charalambos Christofidis, Chris Pantsios, Dimitrios Magouliotis, Angeliki Bourazana, Ioannis Leventis, Niki Skopeliti, Evangelia Skoularigki, Alexandros Briasoulis, Grigorios Giamouzis, Filippos Triposkiadis and John Skoularigis
Life 2023, 13(3), 698; https://doi.org/10.3390/life13030698 - 5 Mar 2023
Cited by 4 | Viewed by 2520
Abstract
Recent studies have demonstrated the prognostic value of spot urinary sodium (UNa+) in acutely decompensated chronic HF (ADCHF) patients. However, data on the prognostic role of UNa+ and spot urinary chloride (UCl−) in patients with advanced HF are [...] Read more.
Recent studies have demonstrated the prognostic value of spot urinary sodium (UNa+) in acutely decompensated chronic HF (ADCHF) patients. However, data on the prognostic role of UNa+ and spot urinary chloride (UCl−) in patients with advanced HF are limited. In the present prospective pilot study, we examined the predictive value of UNa+ and UCl− concentration at baseline, at 2 h and at 24 h after admission for all-cause mortality and HF rehospitalization up to 3 months post-discharge. Consecutive advanced HF patients (n = 30) admitted with ADCHF and aged > 18 years were included in the study. Loop diuretics were administered based on the natriuresis-guided algorithm recommended by the recent HF guidelines. Exclusion criteria were cardiogenic shock, acute coronary syndrome, estimated glomerular filtration rate < 15 mL/min/1.73 m2, severe hepatic dysfunction (Child–Pugh category C), and sepsis. UNa+ at baseline (Area Under the Curve (AUC) = 0.75, 95% Confidence Interval (CI) (0.58–0.93), p = 0.019) and at 2 h after admission (AUC = 0.80, 95% CI: 0.64–0.96, p = 0.005) showed good and excellent discrimination, respectively. UCl− at 2 h after admission (AUC = 0.75, 95%CI (0.57–0.93), p = 0.017) demonstrated good discrimination. In the multivariate logistic regression analysis, UNa+ at 2 h (p = 0.02) and dose of loop diuretics at admission (p = 0.03) were the only factors independently associated with the study outcome. In conclusion, UNa+ and UCl− may have a prognostic role in hospitalized advanced HF patients. Full article
(This article belongs to the Special Issue Interdisciplinarity in Cardiovascular Diseases: From Pathophysiology to Diagnosis and Treatment)
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11 pages, 874 KiB  
Article
Changes in Components of Metabolic Syndrome after Antiviral Eradication in Hepatitis C Virus Infection
by Anca Trifan, Tudor Cuciureanu, Robert Nastasa, Ermina Stratina, Sebastian Zenovia, Cristina Maria Muzica, Laura Huiban, Ana-Maria Singeap, Stefan Chiriac, Catalin Sfarti, Camelia Cojocariu, Irina Girleanu, Horia Minea, Remus Stafie, Adrian Rotaru and Carol Stanciu
Life 2023, 13(2), 534; https://doi.org/10.3390/life13020534 - 15 Feb 2023
Cited by 3 | Viewed by 1572
Abstract
Chronic hepatitis C infection is a systemic disease that affects over 71 million patients all over the world and it is to be considered nowadays as a new cardiometabolic risk factor. This study aimed to evaluate the weight and metabolic changes after viral [...] Read more.
Chronic hepatitis C infection is a systemic disease that affects over 71 million patients all over the world and it is to be considered nowadays as a new cardiometabolic risk factor. This study aimed to evaluate the weight and metabolic changes after viral eradication in patients with hepatitis C virus (HCV) infection. We conducted a prospective study between October 2017 to December 2021, in a tertiary care center, in which we included 132 patients with HCV or cirrhosis. All patients received treatment with direct antivirals (DAAs) and achieved sustained viral response at 12 weeks (SVR12). During the study, clinical laboratory data and Fibroscan examinations were recorded in all patients. The study group was evaluated at the initiation of antiviral treatment, at SVR12, and within an average follow-up period of 6 months to 12 months after the previous evaluation. Evaluation at SVR12 and the data recorded in the post-SVR surveillance period show a further increase in BMI compared with baseline measurements with a statistically significant difference (27.11 ± 3.22 vs. 27.415 ± 3.03 vs. 28.04 ± 1.11 kg/m2, p = 0.012). The same observation was noticed for waist circumference (WC) at post-SVR evaluation (87.6 ± 13.1 vs. 88.4 ± 13.6 cm, p = 0.031). Moreover, the study population registered an increase in the average total cholesterol (TC) values at post-SVR evaluation (177.01 ± 42.2 mg/dL, p = 0.014) compared to baseline. In addition, the serum level of triglycerides had been modified after viral clearance, with a minimal decrease in the mean values of triglycerides (TGD) at SVR-12 assessment (133.48 ± 41.8 mg/dL, p = 0.78), followed by a significant increase to the mean value of 145.4 ± 47.2 mg/dL (p = 0.026) in the third evaluation. Our study highlights that HCV eradication does not improve the lipid profile in the short term, and these patients still have an additional cardiovascular risk factor due to high levels of TC, TGD, and weight gain. Full article
(This article belongs to the Special Issue Interdisciplinarity in Cardiovascular Diseases: From Pathophysiology to Diagnosis and Treatment)
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12 pages, 807 KiB  
Article
Association of Circulating Neutrophils with Relative Volume of Lipid-Rich Necrotic Core of Coronary Plaques in Stable Patients: A Substudy of SMARTool European Project
by Silverio Sbrana, Antonella Cecchettini, Luca Bastiani, Annamaria Mazzone, Federico Vozzi, Chiara Caselli, Danilo Neglia, Alberto Clemente, Arthur J. H. A. Scholte, Oberdan Parodi, Gualtiero Pelosi and Silvia Rocchiccioli
Life 2023, 13(2), 428; https://doi.org/10.3390/life13020428 - 2 Feb 2023
Cited by 2 | Viewed by 2077
Abstract
Background and Aims: Coronary atherosclerosis is a chronic non-resolving inflammatory process wherein the interaction of innate immune cells and platelets plays a major role. Circulating neutrophils, in particular, adhere to the activated endothelium and migrate into the vascular wall, promoting monocyte recruitment and [...] Read more.
Background and Aims: Coronary atherosclerosis is a chronic non-resolving inflammatory process wherein the interaction of innate immune cells and platelets plays a major role. Circulating neutrophils, in particular, adhere to the activated endothelium and migrate into the vascular wall, promoting monocyte recruitment and influencing plaque phenotype and stability at all stages of its evolution. We aimed to evaluate, by flow cytometry, if blood neutrophil number and phenotype—including their phenotypic relationships with platelets, monocytes and lymphocytes—have an association with lipid-rich necrotic core volume (LRNCV), a generic index of coronary plaque vulnerability, in a group of stable patients with chronic coronary syndrome (CCS). Methods: In 55 patients, (68.53 ± 1.07 years of age, mean ± SEM; 71% male), the total LRNCV in each subject was assessed by a quantitative analysis of all coronary plaques detected by computed tomography coronary angiography (CTCA) and was normalized to the total plaque volume. The expression of CD14, CD16, CD18, CD11b, HLA-DR, CD163, CCR2, CCR5, CX3CR1, CXCR4 and CD41a cell surface markers was quantified by flow cytometry. Adhesion molecules, cytokines and chemokines, as well as MMP9 plasma levels, were measured by ELISA. Results: On a per-patient basis, LRNCV values were positively associated, by a multiple regression analysis, with the neutrophil count (n°/µL) (p = 0.02), neutrophil/lymphocyte ratio (p = 0.007), neutrophil/platelet ratio (p = 0.01), neutrophil RFI CD11b expression (p = 0.02) and neutrophil–platelet adhesion index (p = 0.01). Significantly positive multiple regression associations of LRNCV values with phenotypic ratios between neutrophil RFI CD11b expression and several lymphocyte and monocyte surface markers were also observed. In the bivariate correlation analysis, a significantly positive association was found between RFI values of neutrophil–CD41a+ complexes and neutrophil RFI CD11b expression (p < 0.0001). Conclusions: These preliminary findings suggest that a sustained increase in circulating neutrophils, together with the up-regulation of the integrin/activation membrane neutrophil marker CD11b may contribute, through the progressive intra-plaque accumulation of necrotic/apoptotic cells exceeding the efferocytosis/anti-inflammatory capacity of infiltrating macrophages and lymphocytes, to the relative enlargement of the lipid-rich necrotic core volume of coronary plaques in stable CAD patients, thus increasing their individual risk of acute complication. Full article
(This article belongs to the Special Issue Interdisciplinarity in Cardiovascular Diseases: From Pathophysiology to Diagnosis and Treatment)
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12 pages, 1302 KiB  
Article
Dynamic Arterial Elastance to Predict Mean Arterial Pressure Decrease after Reduction of Vasopressor in Septic Shock Patients
by Paolo Persona, Tommaso Tonetti, Ilaria Valeri, Emanuele Pivetta, Francesco Zarantonello, Tommaso Pettenuzzo, Alessandro De Cassai and Paolo Navalesi
Life 2023, 13(1), 28; https://doi.org/10.3390/life13010028 - 22 Dec 2022
Cited by 3 | Viewed by 2279
Abstract
After fluid status optimization, norepinephrine infusion represents the cornerstone of septic shock treatment. De-escalation of vasopressors should be considered with caution, as hypotension increases the risk of mortality. In this prospective observational study including 42 patients, we assess the role of dynamic elastance [...] Read more.
After fluid status optimization, norepinephrine infusion represents the cornerstone of septic shock treatment. De-escalation of vasopressors should be considered with caution, as hypotension increases the risk of mortality. In this prospective observational study including 42 patients, we assess the role of dynamic elastance (EaDyn), i.e., the ratio between pulse pressure variation and stroke volume variation, which can be measured noninvasively by the MostCare monitoring system, to predict a mean arterial pressure (MAP) drop > 10% 30 min after norepinephrine reduction. Patients were divided into responders (MAP falling > 10%) and non-responders (MAP falling < 10%). The receiver-operating-characteristic curve identified an area under the curve of the EaDyn value to predict a MAP decrease > 10% of 0.84. An EaDyn cut-off of 0.84 predicted a MAP drop > 10% with a sensitivity of 0.71 and a specificity of 0.89. In a multivariate logistic regression, EaDyn was significantly and independently associated with MAP decrease (OR 0.001, 95% confidence interval 0.00001–0.081, p < 0.001). The nomogram model for the probability of MAP decrease > 10% showed a C-index of 0.90. In conclusion, in a septic shock cohort, EaDyn correlates well with the risk of decrease of MAP > 10% after norepinephrine reduction. Full article
(This article belongs to the Special Issue Interdisciplinarity in Cardiovascular Diseases: From Pathophysiology to Diagnosis and Treatment)
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16 pages, 2920 KiB  
Article
The Interplay between Conventional Cardiovascular Risk Factors and Health-Related Quality of Life in a Cohort of Working Young and Middle-Aged Adults: A Prospective Study
by Cristina Florescu, Petre Ciobanu, Diana Ruxandra Hădăreanu, Veronica Gheorman, Edme Roxana Mustafa, Adina Dorina Glodeanu, Marius Gabriel Bunescu, Adrian Mită and Venera Cristina Dinescu
Life 2022, 12(12), 2132; https://doi.org/10.3390/life12122132 - 16 Dec 2022
Cited by 3 | Viewed by 1635
Abstract
Psychosocial and work stress, socioeconomic status, and environmental health directly impact the onset and progression of cardiovascular diseases, irrespective of sex or conventional cardiovascular risk factors (cCRFs). On the other hand, the impact of cCRFs on health-related quality of life (HRQoL) is not [...] Read more.
Psychosocial and work stress, socioeconomic status, and environmental health directly impact the onset and progression of cardiovascular diseases, irrespective of sex or conventional cardiovascular risk factors (cCRFs). On the other hand, the impact of cCRFs on health-related quality of life (HRQoL) is not well known, and the psychological socioeconomic environmental somatic health interaction is often neglected. Accordingly, we aimed to: (i) compare the self-reported HRQoL using the WHOQOL-BREF questionnaire between healthy subjects and those with cCRFs; and (ii) evaluate the interplay between HRQoL, cCRFs, and cardiovascular treatment adherence. We prospectively included 90 working adults (46 healthy and 44 with cCRFs age- and sex-matched adults) evaluated by clinical examination, 12-leads electrocardiography, and transthoracic echocardiography as part of a cardiovascular diseases screening program, that also filled in the WHOQOL-BREF questionnaire. Subjects with CRFs were less satisfied with their own individual health. The presence and the number of CRFs, as well as the need for cardiovascular treatment and the number of drugs taken correlated with reduced scores at the majority of HRQoL domains. The results in the social relationships domain were the best predictor of cardiovascular treatment adherence. Finally, the results of all HRQoL domains were strongly correlated to each other demonstrating the psychological socioeconomic environmental somatic health interaction. Full article
(This article belongs to the Special Issue Interdisciplinarity in Cardiovascular Diseases: From Pathophysiology to Diagnosis and Treatment)
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14 pages, 2919 KiB  
Article
Infrared Spectroscopic Verification of a α-Helical Collagen Structure in Glutaraldehyde-Free Crosslinked Bovine Pericardium for Cardiac Implants
by Cindy Welzel, Ulla König, Anett Jannasch, Klaus Matschke, Sems-Malte Tugtekin, Claudia Dittfeld and Gerald Steiner
Life 2022, 12(12), 2035; https://doi.org/10.3390/life12122035 - 6 Dec 2022
Cited by 1 | Viewed by 1689
Abstract
The degeneration of heart valve bioprostheses due to calcification processes is caused by the intercalation of calciumhydroxyapatite in pericardium collagen bundles. Variations of the protein secondary structure of biomaterials according to preparation are relevant for this mineralization process and thus the structural characterization [...] Read more.
The degeneration of heart valve bioprostheses due to calcification processes is caused by the intercalation of calciumhydroxyapatite in pericardium collagen bundles. Variations of the protein secondary structure of biomaterials according to preparation are relevant for this mineralization process and thus the structural characterization of innovative bioprostheses materials is of great importance. The gold standard for prostheses preparation is glutaraldehyde (GA)-fixation of bovine pericardium that adversely promotes calcification. The novel GA-free SULEEI-treatment of bovine pericardium includes decellularization, UV-crosslinking, and electron beam sterilization. The aim of this study is the structural characterization of SULEEI-treated and GA-fixed bovine pericardium. IR spectroscopic imaging combined with multivariate data and curve fit analysis was applied to investigate the amide I and amide II regions of SULEEI-treated and GA-fixed samples. The spectroscopic images of GA-fixed pericardial tissue exhibited a generally high content of amine groups and side chains providing nucleation points for calcification processes. In contrast, in SULEEI-treated tissue, the typical α-helical structure was retained and was supposed to be less prone to deterioration. Full article
(This article belongs to the Special Issue Interdisciplinarity in Cardiovascular Diseases: From Pathophysiology to Diagnosis and Treatment)
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12 pages, 486 KiB  
Article
The Hemisphere of the Brain in Which a Stroke Has Occurred Visible in the Heart Rate Variability
by Joanna Aftyka, Jacek Staszewski, Aleksander Dębiec, Aleksandra Pogoda-Wesołowska, Agata Kowalska, Anna Jankowska and Jan Żebrowski
Life 2022, 12(10), 1659; https://doi.org/10.3390/life12101659 - 20 Oct 2022
Cited by 5 | Viewed by 2223
Abstract
The aim of this study was to assess whether heart rate variability (HRV) could predict which hemisphere of the brain was affected during an acute ischemic stroke (AIS). To achieve this goal, we compared HRV between patients with a right (RH) and left [...] Read more.
The aim of this study was to assess whether heart rate variability (HRV) could predict which hemisphere of the brain was affected during an acute ischemic stroke (AIS). To achieve this goal, we compared HRV between patients with a right (RH) and left hemispheric (LH) stroke. The studied group consisted of 64 patients with AIS (25 with RH and 39 with LH stroke, with a mean age of 64 ± 12 and 66 ± 13, p = 0.3, respectively) using 24 h Holter ECG records at NN intervals performed at a mean of 4.3 ± 2 days following their AIS. Standard linear methods were used to analyze HRV in the time and frequency domains, as well as nonlinear methods, including sample entropy, detrended fluctuation analysis, and asymmetry measures. Patients with an LH stroke had significantly greater values for sample entropy compared to subjects with an RH stroke (1.31 ± 0.53 vs. 0.92 ± 0.46, p = 0.003, Bonferroni-corrected p = 0.033, effect size = 0.8). The LH stroke group also had higher RMSSD (113 ± 81 vs. 76 ± 61, p = 0.06), pNN50 (33.35 ± 28.54 vs. 18.52 ± 23.75, p = 0.02), and HFnu (48.42 ± 16.41 vs. 42.66 ± 17.88, p = 0.11) values, when compared to the RH group, which was possibly related to higher activity in the parasympathetic system in the LH group. Conversely, subjects with RH stroke had higher LFnu (57.34 ± 17.88 vs. 51.58 ± 16.41, p-value = 0.11) and LF/HF ratios (2.24 ± 2.87 vs. 1.68 ± 2.50, p-value = 0.11), which were likely related to higher activity in the sympathetic nervous system, when compared to the LH stroke group. Our pilot study demonstrated that patients with RH stroke had lower HRV complexity than those with LH stroke, indicating that HRV could be useful in the discrimination of hemispheric involvement in AIS. Full article
(This article belongs to the Special Issue Interdisciplinarity in Cardiovascular Diseases: From Pathophysiology to Diagnosis and Treatment)
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Review

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20 pages, 809 KiB  
Review
The Oral Microbiota in Valvular Heart Disease: Current Knowledge and Future Directions
by Ecaterina Neculae, Evelina Maria Gosav, Emilia Valasciuc, Nicoleta Dima, Mariana Floria and Daniela Maria Tanase
Life 2023, 13(1), 182; https://doi.org/10.3390/life13010182 - 8 Jan 2023
Cited by 3 | Viewed by 4756
Abstract
Oral microbiota formation begins from birth, and everything from genetic components to the environment, alongside the host’s behavior (such as diet, smoking, oral hygiene, and even physical activity), contributes to oral microbiota structure. Even though recent studies have focused on the gut microbiota’s [...] Read more.
Oral microbiota formation begins from birth, and everything from genetic components to the environment, alongside the host’s behavior (such as diet, smoking, oral hygiene, and even physical activity), contributes to oral microbiota structure. Even though recent studies have focused on the gut microbiota’s role in systemic diseases, the oral microbiome represents the second largest community of microorganisms, making it a new promising therapeutic target. Periodontitis and dental caries are considered the two main consequences of oral bacterial imbalance. Studies have shown that oral dysbiosis effects are not limited locally. Due to technological advancement, research identified oral bacterial species in heart valves. This evidence links oral dysbiosis with the development of valvular heart disease (VHD). This review focuses on describing the mechanism behind prolonged local inflammation and dysbiosis, that can induce bacteriemia by direct or immune-mediated mechanisms and finally VHD. Additionally, we highlight emerging therapies based on controlling oral dysbiosis, periodontal disease, and inflammation with immunological and systemic effects, that exert beneficial effects in VHD management. Full article
(This article belongs to the Special Issue Interdisciplinarity in Cardiovascular Diseases: From Pathophysiology to Diagnosis and Treatment)
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9 pages, 1627 KiB  
Review
Left Atrial Remodeling in Response to Aortic Valve Replacement: Pathophysiology and Myocardial Strain Analysis
by Matteo Lisi, Maria Concetta Pastore, Alessio Fiorio, Matteo Cameli, Giulia Elena Mandoli, Francesca Maria Righini, Luna Cavigli, Flavio D’Ascenzi, Marta Focardi, Andrea Rubboli, Gianluca Campo, Sergio Mondillo and Michael Y. Henein
Life 2022, 12(12), 2074; https://doi.org/10.3390/life12122074 - 10 Dec 2022
Cited by 6 | Viewed by 3968
Abstract
Severe aortic stenosis (AS) is the most common valve disease in the elderly and is associated with poor prognosis if treated only medically. AS causes chronic pressure overload, concentric left ventricular (LV) hypertrophy, myocardial stiffness, and diastolic dysfunction. This adverse remodeling also affects [...] Read more.
Severe aortic stenosis (AS) is the most common valve disease in the elderly and is associated with poor prognosis if treated only medically. AS causes chronic pressure overload, concentric left ventricular (LV) hypertrophy, myocardial stiffness, and diastolic dysfunction. This adverse remodeling also affects the left atrium (LA), which dilates and develops myocardial fibrosis, with a reduction in intrinsic function and a consequent high risk of the development of atrial fibrillation. Speckle-tracking echocardiography is able to detect myocardial dysfunction before other conventional parameters, such as LV ejection fraction, and also predict clinical outcomes. This review aims at describing LV and LA remodeling in AS and before and after aortic valve replacement and the usefulness of myocardial strain analysis in this clinical setting. Full article
(This article belongs to the Special Issue Interdisciplinarity in Cardiovascular Diseases: From Pathophysiology to Diagnosis and Treatment)
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