المؤلفون: Bogdan-Sorin Tudurachi, Larisa Anghel, Andreea Tudurachi, Radu Andy Sascău, Răzvan-Liviu Zanfirescu, Cristian Stătescu

المصدر: Biomedicines, Vol 12, Iss 6, p 1314 (2024)

مصطلحات موضوعية: diabetes, myocardial infarction, heart failure, myocardial fibrosis, SGLT2 inhibitors, GLP-1 agonist, Biology (General), QH301-705.5

الوصف: Myocardial infarction (MI) often leads to heart failure (HF) through acute or chronic maladaptive remodeling processes. This establishes coronary artery disease (CAD) and HF as significant contributors to cardiovascular illness and death. Therefore, treatment strategies for patients with CAD primarily focus on preventing MI and lessening the impact of HF after an MI event. Myocardial fibrosis, characterized by abnormal extracellular matrix (ECM) deposition, is central to cardiac remodeling. Understanding these processes is key to identifying new treatment targets. Recent studies highlight SGLT2 inhibitors (SGLT2i) and GLP-1 receptor agonists (GLP1-RAs) as favorable options in managing type 2 diabetes due to their low hypoglycemic risk and cardiovascular benefits. This review explores inflammation’s role in cardiac fibrosis and evaluates emerging anti-diabetic medications’ effectiveness, such as SGLT2i, GLP1-RAs, and dipeptidyl peptidase-4 inhibitors (DPP4i), in preventing fibrosis in patients with diabetes post-acute MI. Recent studies were analyzed to identify effective medications in reducing fibrosis risk in these patients. By addressing these areas, we can advance our understanding of the potential benefits of anti-diabetic medications in reducing cardiac fibrosis post-MI and improve patient outcomes in individuals with diabetes at risk of HF.

وصف الملف: electronic resource

العلاقة: https://www.mdpi.com/2227-9059/12/6/1314Test; https://doaj.org/toc/2227-9059Test

الوصول الحر: https://doaj.org/article/706048c3cc2648c287b1ba3f13d665c8Test

المؤلفون: Alexandra-Simona Zamfir, Cristian Stătescu, Radu Andy Sascău, Grigore Tinică, Carmen Lăcrămioara Zamfir, Tudor-Andrei Cernomaz, Raluca Ozana Chistol, Daniela Boișteanu, Anca Sava

المصدر: Journal of Clinical Medicine, Vol 13, Iss 9, p 2555 (2024)

مصطلحات موضوعية: cardiovascular congenital disorders, coronary artery anomalies, hypoplastic coronary arteries, coronary computed tomography angiography (CCTA), Medicine

الوصف: Background and Objectives: Coronary artery anomalies (CAAs) represent a group of rare cardiac abnormalities with an incidence of up to 1.2%. The aim of this retrospective study was to conduct a comprehensive epidemiological assessment of the prevalence of hypoplastic coronary arteries using coronary computed tomography angiography (CCTA) in patients with diagnosed CAAs and individuals presenting with cardiovascular manifestations in the north-eastern region of Romania. This study was motivated by the limited investigation of the CAAs conducted in this area. Methods: We analyzed data collected from 12,758 coronary computed tomography angiography (CCTA) records available at the “Prof. Dr. George I.M. Georgescu” Cardiovascular Diseases Institute, spanning the years 2012 to 2022. Results: Among 350 individuals with CAAs (2.7% of the total cohort), 71 patients (20.3% of the anomaly presenting group and 0.5% of the entire CCTA cohort) exhibited at least one hypoplastic coronary artery. The mean age of individuals diagnosed with hypoplastic coronary artery disease (HCAD) was 61 years, while the age distribution among them ranged from 22 to 84 years. Nearly equal cases of right and left dominance (33 and 31, respectively) were observed, with only 7 cases of co-dominance. Conclusions: HCAD may be considered underexplored in current published research, despite its potentially significant implications ranging to an increased risk of sudden cardiac arrest. The specific prevalence of HCAD among CAAs might be higher than previously reported, possibly reflecting better diagnostic accuracy of CCTA over classic coronary imaging. The absence of standard diagnostic and therapeutic protocols for HCAD underscores the necessity of a personalized approach for such cases.

وصف الملف: electronic resource

العلاقة: https://www.mdpi.com/2077-0383/13/9/2555Test; https://doaj.org/toc/2077-0383Test

الوصول الحر: https://doaj.org/article/53dad5ff2e5a40b19c0d9410524b1e64Test

المؤلفون: Traian Chiuariu, Delia Șalaru, Carina Ureche, Laura Vasiliu, Ancuta Lupu, Vasile Valeriu Lupu, Adela Mihaela Șerban, Alexandra Zăvoi, Laura Catalina Benchea, Alexandra Clement, Bogdan-Sorin Tudurachi, Radu Andy Sascău, Cristian Stătescu

المصدر: Journal of Cardiovascular Development and Disease, Vol 11, Iss 2, p 62 (2024)

مصطلحات موضوعية: chronic kidney disease, heart failure, interstitial fibrosis, FGF23, Klotho, Diseases of the circulatory (Cardiovascular) system, RC666-701

الوصف: Cardiovascular disease (CVD) and chronic kidney disease (CKD) often coexist and have a major impact on patient prognosis. Organ fibrosis plays a significant role in the pathogenesis of cardio-renal syndrome (CRS), explaining the high incidence of heart failure and sudden cardiac death in these patients. Various mediators and mechanisms have been proposed as contributors to the alteration of fibroblasts and collagen turnover, varying from hemodynamic changes to the activation of the renin–angiotensin system, involvement of FGF 23, and Klotho protein or collagen deposition. A better understanding of all the mechanisms involved has prompted the search for alternative therapeutic targets, such as novel inhibitors of the renin–angiotensin–aldosterone system (RAAS), serelaxin, and neutralizing interleukin-11 (IL-11) antibodies. This review focuses on the molecular mechanisms of cardiac and renal fibrosis in the CKD and heart failure (HF) population and highlights the therapeutic alternatives designed to target the responsible pathways.

وصف الملف: electronic resource

العلاقة: https://www.mdpi.com/2308-3425/11/2/62Test; https://doaj.org/toc/2308-3425Test

الوصول الحر: https://doaj.org/article/b36c99748ac343e1b89efe5dc4cbccdcTest

المؤلفون: Ioana Mădălina Zota, Cristina Mihaela Ghiciuc, Doina Clementina Cojocaru, Corina Lucia Dima-Cozma, Maria Magdalena Leon, Radu Sebastian Gavril, Mihai Roca, Alexandru Dan Costache, Alexandra Maștaleru, Larisa Anghel, Cristian Stătescu, Radu Andy Sascău, Florin Mitu

المصدر: Journal of Clinical Medicine, Vol 12, Iss 24, p 7602 (2023)

مصطلحات موضوعية: blood flow restriction training, vascular stiffness, pulse wave velocity, vascular aging, resistance training, Medicine

الوصف: Arterial stiffness naturally increases with age and is a known predictor of cardiovascular morbimortality. Blood flow restriction (BFR) training involves decreasing muscle blood flow by applying a strap or a pneumatic cuff during exercise. BFR induces muscle hypertrophy even at low intensities, making it an appealing option for older, untrained individuals. However, BFR use in patients with cardiovascular comorbidities is limited by the increased pressor and chronotropic response observed in hypertensive elderly patients. Furthermore, the impact of BFR on vascular function remains unclear. We conducted a comprehensive literature review according to PRISMA guidelines, summarizing available data on the acute and long-term consequences of BFR training on vascular function. Although evidence is still scarce, it seems that BFR has a mild or neutral long-term impact on arterial stiffness. However, current research shows that BFR can cause an abrupt, albeit transient, increase in PWV and central blood pressure. BFR and, preferably, lower-body BFR, should be prescribed with caution in older populations, especially in hypertensive patients who have an exacerbated muscle metaboreflex pressor response. Longer follow-up studies are required to assess the chronic effect of BFR training on arterial stiffness, especially in elderly patients who are usually unable to tolerate high-intensity resistance exercises.

وصف الملف: electronic resource

العلاقة: https://www.mdpi.com/2077-0383/12/24/7602Test; https://doaj.org/toc/2077-0383Test

الوصول الحر: https://doaj.org/article/e2383910aabb46d6ac6eeefbc3a271ebTest

المؤلفون: Larisa Anghel, Bogdan-Sorin Tudurachi, Andreea Tudurachi, Alexandra Zăvoi, Alexandra Clement, Alexandros Roungos, Laura-Cătălina Benchea, Ioana Mădălina Zota, Cristina Prisacariu, Radu Andy Sascău, Cristian Stătescu

المصدر: Journal of Clinical Medicine, Vol 12, Iss 23, p 7367 (2023)

مصطلحات موضوعية: stent thrombosis, patient-related factors, percutaneous coronary intervention, cardiac death, heart attack, Medicine

الوصف: Over the past four decades, percutaneous coronary intervention (PCI) safety and efficacy have significantly improved, particularly with the advent of the drug-eluting stent (DES). First-generation DESs reduced in-stent restenosis rates and targeted lesion revascularization; however, safety issues emerged, due to high incidences of stent thrombosis (ST) linked to death, myocardial infarction, and repeat revascularization. Second-generation DESs were developed to overcome these issues, reducing late-thrombotic-event risk while maintaining anti-restenosis efficacy. Nevertheless, ST still occurs with second-generation DES use. Stent thrombosis etiology is multifaceted, encompassing lesion-, patient-, procedural-, and stent-related factors. Overall, most early-stent-thrombosis cases are linked to procedural and patient-related aspects. Factors like premature discontinuation of dual antiplatelet therapy, resistance to clopidogrel, smoking, diabetes mellitus, malignancy, reduced ejection fraction or undertaking coronary angioplasty for an acute coronary syndrome can increase the risk of stent thrombosis. The aim of this study is to assess patient-related factors that potentially heighten the risk of stent thrombosis, with the objective of pinpointing and addressing modifiable contributors to this risk. By focusing on both patient- and procedure-related factors, a multifaceted approach to coronary revascularization can help minimize complications and maximize long-term benefits in managing ST.

وصف الملف: electronic resource

العلاقة: https://www.mdpi.com/2077-0383/12/23/7367Test; https://doaj.org/toc/2077-0383Test

الوصول الحر: https://doaj.org/article/c291a9ead1bb43c2a8b505e581830189Test

المؤلفون: Manuela Andreea Ciapă, Delia Lidia Șalaru, Cristian Stătescu, Radu Andy Sascău, Camelia Margareta Bogdănici

المصدر: Current Issues in Molecular Biology, Vol 44, Iss 9, Pp 3959-3979 (2022)

مصطلحات موضوعية: inflammation, demyelination, remyelination, axonal degeneration, molecular mechanisms, Biology (General), QH301-705.5

الوصف: Multiple sclerosis is a central nervous system inflammatory demyelinating disease with a wide range of clinical symptoms, ocular involvement being frequently marked by the presence of optic neuritis (ON). The emergence and progression of ON in multiple sclerosis is based on various pathophysiological mechanisms, disease progression being secondary to inflammation, demyelination, or axonal degeneration. Early identification of changes associated with axonal degeneration or further investigation of the molecular processes underlying remyelination are current concerns of researchers in the field in view of the associated therapeutic potential. This article aims to review and summarize the scientific literature related to the main molecular mechanisms involved in defining ON as well as to analyze existing data in the literature on remyelination strategies in ON and their impact on long-term prognosis.

وصف الملف: electronic resource

العلاقة: https://www.mdpi.com/1467-3045/44/9/272Test; https://doaj.org/toc/1467-3037Test; https://doaj.org/toc/1467-3045Test

الوصول الحر: https://doaj.org/article/82a6394c038949668a87b64c383a9531Test

المؤلفون: Delia Melania Popa, Liviu Macovei, Mihaela Moscalu, Radu Andy Sascău, Cristian Stătescu

المصدر: Diagnostics, Vol 13, Iss 19, p 3143 (2023)

مصطلحات موضوعية: CK-MB, biomarkers, STEMI, primary angioplasty, prognosis, Medicine (General), R5-920

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

وصف الملف: electronic resource

العلاقة: https://www.mdpi.com/2075-4418/13/19/3143Test; https://doaj.org/toc/2075-4418Test

الوصول الحر: https://doaj.org/article/7ad2f8c073de4dda966c9c6f3f068098Test

المؤلفون: Bogdan-Sorin Tudurachi, Larisa Anghel, Andreea Tudurachi, Radu Andy Sascău, Cristian Stătescu

المصدر: International Journal of Molecular Sciences, Vol 24, Iss 18, p 14378 (2023)

مصطلحات موضوعية: acute myocardial infarction, neutrophil/lymphocyte ratio, platelet/lymphocyte ratio, monocyte/lymphocyte ratio, lymphocyte/monocyte ratio, young patients, Biology (General), QH301-705.5, Chemistry, QD1-999

الوصف: Cardiovascular disease, particularly coronary artery disease (CAD), remains a predominant cause of mortality globally. Factors such as atherosclerosis and inflammation play significant roles in the pathogenesis of CAD. The nexus between inflammation and CAD is underscored by the role of immune cells, such as neutrophils, lymphocytes, monocytes, and macrophages. These cells orchestrate the inflammatory process, a core component in the initiation and progression of atherosclerosis. The activation of these pathways and the subsequent lipid, fibrous element, and calcification accumulation can result in vessel narrowing. Hematological parameters derived from routine blood tests offer insights into the underlying inflammatory state. Recent studies have highlighted the potential of inflammatory hematological ratios, such as the neutrophil/lymphocyte ratio, platelet/lymphocyte ratio, monocyte/lymphocyte ratio and lymphocyte/monocyte ratio. These parameters are not only accessible and cost-effective but also mirror the degree of systemic inflammation. Several studies have indicated a correlation between these markers and the severity, prognosis, and presence of CAD. Despite the burgeoning interest in the relationship between inflammatory markers and CAD, there remains a paucity of data exploring these parameters in young patients with acute myocardial infarction. Such data could offer valuable insights into the unique pathophysiology of early-onset CAD and improve risk assessment and predictive strategies.

وصف الملف: electronic resource

العلاقة: https://www.mdpi.com/1422-0067/24/18/14378Test; https://doaj.org/toc/1661-6596Test; https://doaj.org/toc/1422-0067Test

الوصول الحر: https://doaj.org/article/f44814a19e5e4d0bbc0c4a0501545ce4Test

المؤلفون: Bogdan-Sorin Tudurachi, Alexandra Zăvoi, Andreea Leonte, Laura Țăpoi, Carina Ureche, Silviu Gabriel Bîrgoan, Traian Chiuariu, Larisa Anghel, Rodica Radu, Radu Andy Sascău, Cristian Stătescu

المصدر: International Journal of Molecular Sciences, Vol 24, Iss 13, p 10510 (2023)

مصطلحات موضوعية: hypertrophic cardiomyopathy (HCM), MYBPC3, MYH7, genetic mutations, Biology (General), QH301-705.5, Chemistry, QD1-999

الوصف: Hypertrophic cardiomyopathy (HCM) is the most prevalent genetically inherited cardiomyopathy that follows an autosomal dominant inheritance pattern. The majority of HCM cases can be attributed to mutation of the MYBPC3 gene, which encodes cMyBP-C, a crucial structural protein of the cardiac muscle. The manifestation of HCM’s morphological, histological, and clinical symptoms is subject to the complex interplay of various determinants, including genetic mutation and environmental factors. Approximately half of MYBPC3 mutations give rise to truncated protein products, while the remaining mutations cause insertion/deletion, frameshift, or missense mutations of single amino acids. In addition, the onset of HCM may be attributed to disturbances in the protein and transcript quality control systems, namely, the ubiquitin–proteasome system and nonsense-mediated RNA dysfunctions. The aforementioned genetic modifications, which appear to be associated with unfavorable lifelong outcomes and are largely influenced by the type of mutation, exhibit a unique array of clinical manifestations ranging from asymptomatic to arrhythmic syncope and even sudden cardiac death. Although the current understanding of the MYBPC3 mutation does not comprehensively explain the varied phenotypic manifestations witnessed in patients with HCM, patients with pathogenic MYBPC3 mutations can exhibit an array of clinical manifestations ranging from asymptomatic to advanced heart failure and sudden cardiac death, leading to a higher rate of adverse clinical outcomes. This review focuses on MYBPC3 mutation and its characteristics as a prognostic determinant for disease onset and related clinical consequences in HCM.

وصف الملف: electronic resource

العلاقة: https://www.mdpi.com/1422-0067/24/13/10510Test; https://doaj.org/toc/1661-6596Test; https://doaj.org/toc/1422-0067Test

الوصول الحر: https://doaj.org/article/a5b42b2410e74ca3b4e32dd8ee757b9bTest

المؤلفون: Cristian Stătescu, Larisa Anghel, Laura-Cătălina Benchea, Bogdan-Sorin Tudurachi, Andreea Leonte, Alexandra Zăvoi, Ioana Mădălina Zota, Cristina Prisacariu, Rodica Radu, Ionela-Lăcrămioara Șerban, Radu Andy Sascău

المصدر: International Journal of Molecular Sciences, Vol 24, Iss 6, p 5927 (2023)

مصطلحات موضوعية: lipoprotein (a), low-density lipoprotein, acute myocardial infarction, “young” patients, risk factors, Biology (General), QH301-705.5, Chemistry, QD1-999

الوصف: The presence of a myocardial infarction at a younger age is of special interest, considering the psychological and socioeconomic impact, as well as long-term morbidity and mortality. However, this group has a unique risk profile, with less traditional cardiovascular risk factors that are not well studied. This systematic review aims to evaluate traditional risk factors of myocardial infarction in the “young”, highlighting the clinical implications of lipoprotein (a). We performed a comprehensive search using Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) standards; we systematically searched the PubMed, EMBASE, and Science Direct Scopus databases, using the terms: “myocardial infarction”, “young”, “lipoprotein (a)”, “low-density lipoprotein”, “risk factors”. The search identified 334 articles which were screened, and, at the end, 9 original research articles regarding the implications of lipoprotein (a) in myocardial infarction in the “young” were included in the qualitative synthesis. Elevated lipoprotein (a) levels were independently associated with an increased risk of coronary artery disease, especially in young patients, where this risk increased by threefold. Thus, it is recommended to measure the lipoprotein (a) levels in individuals with suspected familial hypercholesterolaemia or with premature atherosclerotic cardiovascular disease and no other identifiable risk factors, in order to identify patients who might benefit from a more intensive therapeutic approach and follow-up.

وصف الملف: electronic resource

العلاقة: https://www.mdpi.com/1422-0067/24/6/5927Test; https://doaj.org/toc/1661-6596Test; https://doaj.org/toc/1422-0067Test

الوصول الحر: https://doaj.org/article/dea1115cdacb43779e88ead7b9af9cddTest