Background: Myocardial infarction (MI), also referred to as a "heart attack," is brought on by a partial or total interruption of blood supply to the myocardium. Myocardial infarction can be "silent," go undiagnosed, or it can be a catastrophic occurrence that results in hemodynamic decline and untimely death. In recent years, herbal remedies for MI have become effective, secure, and readily accessible.
Objective: The purpose of this review was to examine the medicinal plants and phytochemicals that have been used to treat MI in order to assess the potential contribution of natural substances to the development of herbal MI treatments.
Methodology: A literature search was employed to find information utilizing electronic databases, such as Web of Science, Google Scholar, PubMed, Sci Finder, Reaxys, and Cochrane.
Results: The identification of 140 plants from 12 families led to the abstraction of data on the plant families, parts of the plant employed, chemical contents, extracts, model used, and dose.
Conclusion: The majority of the MI plants, according to the data, belonged to the Fabaceae (11%) and Asteraceae (9%) families, and the most prevalent natural components in plants with MI were flavonoids (43%), glucosides (25%), alkaloids (23%), phenolic acid (19%), saponins (15%), and tannins (12%).
背景:心肌梗塞(MI)又称 "心脏病发作",是由心肌供血部分或全部中断引起的。心肌梗塞可能是 "无声的",不会被诊断出来,也可能是灾难性的,导致血液动力学衰退和过早死亡。近年来,治疗心肌梗死的草药疗法变得有效、安全且容易获得:本综述旨在研究用于治疗心肌梗死的药用植物和植物化学物质,以评估天然物质对开发心肌梗死草药疗法的潜在贡献:方法:采用文献检索法,利用 Web of Science、Google Scholar、PubMed、Sci Finder、Reaxys 和 Cochrane 等电子数据库查找信息:结果:通过对 12 个科 140 种植物的鉴定,抽取了有关植物科、使用部分、化学成分、提取物、使用模式和剂量的数据:数据显示,大多数有MI的植物属于豆科(11%)和菊科(9%),有MI的植物中最常见的天然成分是黄酮类(43%)、苷类(25%)、生物碱类(23%)、酚酸类(19%)、皂苷类(15%)和单宁酸类(12%)。
{"title":"Medicinal Plants in the Treatment of Myocardial Infarction Disease: A Systematic Review.","authors":"Anamika Rathore, Anuj Kumar Sharma, Yogesh Murti, Sonal Bansal, Vibha Kumari, Varsha Snehi, Mayank Kulshreshtha","doi":"10.2174/011573403X278881240405044328","DOIUrl":"10.2174/011573403X278881240405044328","url":null,"abstract":"<p><strong>Background: </strong>Myocardial infarction (MI), also referred to as a \"heart attack,\" is brought on by a partial or total interruption of blood supply to the myocardium. Myocardial infarction can be \"silent,\" go undiagnosed, or it can be a catastrophic occurrence that results in hemodynamic decline and untimely death. In recent years, herbal remedies for MI have become effective, secure, and readily accessible.</p><p><strong>Objective: </strong>The purpose of this review was to examine the medicinal plants and phytochemicals that have been used to treat MI in order to assess the potential contribution of natural substances to the development of herbal MI treatments.</p><p><strong>Methodology: </strong>A literature search was employed to find information utilizing electronic databases, such as Web of Science, Google Scholar, PubMed, Sci Finder, Reaxys, and Cochrane.</p><p><strong>Results: </strong>The identification of 140 plants from 12 families led to the abstraction of data on the plant families, parts of the plant employed, chemical contents, extracts, model used, and dose.</p><p><strong>Conclusion: </strong>The majority of the MI plants, according to the data, belonged to the Fabaceae (11%) and Asteraceae (9%) families, and the most prevalent natural components in plants with MI were flavonoids (43%), glucosides (25%), alkaloids (23%), phenolic acid (19%), saponins (15%), and tannins (12%).</p>","PeriodicalId":10832,"journal":{"name":"Current Cardiology Reviews","volume":null,"pages":null},"PeriodicalIF":2.4,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11327834/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140848180","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-01-01DOI: 10.2174/011573403X290574240322041356
Yue Su, Jin-Yu Sun, Zhen-Yang Su, Wei Sun
As a major cause of various cardiovascular diseases, the prevalence of hypertension has been increasing in the past 30 years, leading to significant socioeconomic and health burdens. Obesity is one of the major risk factors for hypertension. Body mass index (BMI) is the most used anthropometric index to measure obesity in clinical practice and to assess the risk of obesity-related diseases. However, obesity is a heterogeneous disease, and the accumulation of fat in different body regions leads to differences in cardiovascular and metabolic risks. BMI only reflects the overall obesity but does not consider the distribution of fat and muscle mass. The limitation of BMI makes it insufficient to assess the risk of hypertension attributed to obesity. In addition, waist circumference is an easily obtainable anthropometric index to evaluate abdominal fat distribution. High waist circumference is an independent risk factor for various cardiovascular diseases and all-cause mortality regardless of BMI. Preliminary data indicate that waist circumference is significantly associated with the risk of hypertension at different BMI levels. However, routine measurement of waist circumference is currently not required in current clinical guidelines or is only recommended for obese populations, indicating an insufficient understanding of waist circumference. In this review, we summarize the measurement methods and diagnostic thresholds of waist circumference for abdominal obesity, the trend of central obesity prevalence, the superiority of waist circumference over other anthropometric indices, and recent cross-sectional and longitudinal studies on the association between obesity and hypertension.
{"title":"Revisiting Waist Circumference: A Hypertension Risk Factor that Requires a More In-depth Understanding.","authors":"Yue Su, Jin-Yu Sun, Zhen-Yang Su, Wei Sun","doi":"10.2174/011573403X290574240322041356","DOIUrl":"10.2174/011573403X290574240322041356","url":null,"abstract":"<p><p>As a major cause of various cardiovascular diseases, the prevalence of hypertension has been increasing in the past 30 years, leading to significant socioeconomic and health burdens. Obesity is one of the major risk factors for hypertension. Body mass index (BMI) is the most used anthropometric index to measure obesity in clinical practice and to assess the risk of obesity-related diseases. However, obesity is a heterogeneous disease, and the accumulation of fat in different body regions leads to differences in cardiovascular and metabolic risks. BMI only reflects the overall obesity but does not consider the distribution of fat and muscle mass. The limitation of BMI makes it insufficient to assess the risk of hypertension attributed to obesity. In addition, waist circumference is an easily obtainable anthropometric index to evaluate abdominal fat distribution. High waist circumference is an independent risk factor for various cardiovascular diseases and all-cause mortality regardless of BMI. Preliminary data indicate that waist circumference is significantly associated with the risk of hypertension at different BMI levels. However, routine measurement of waist circumference is currently not required in current clinical guidelines or is only recommended for obese populations, indicating an insufficient understanding of waist circumference. In this review, we summarize the measurement methods and diagnostic thresholds of waist circumference for abdominal obesity, the trend of central obesity prevalence, the superiority of waist circumference over other anthropometric indices, and recent cross-sectional and longitudinal studies on the association between obesity and hypertension.</p>","PeriodicalId":10832,"journal":{"name":"Current Cardiology Reviews","volume":null,"pages":null},"PeriodicalIF":2.4,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11327828/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140305176","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Cardiovascular and neurological diseases cause substantial morbidity and mortality globally. Moreover, cardiovascular diseases are the leading cause of death globally. About 17.9 million people are affected by cardiovascular diseases and 6.8 million people die every year due to neurological diseases. The common neurologic manifestations of cardiovascular illness include stroke syndrome which is responsible for unconsciousness and several other morbidities significantly diminished the quality of life of patients. Therefore, it is prudent need to explore the mechanistic and molecular connection between cardiovascular disorders and neurological disorders. The present review emphasizes the association between cardiovascular and neurological diseases specifically Parkinson's disease, Alzheimer's disease, and Huntington's disease.
{"title":"Cross Talks between CNS and CVS Diseases: An Alliance to Annihilate.","authors":"Shivani Chib, Sushma Devi, Rishabh Chalotra, Neeraj Mittal, Thakur Gurjeet Singh, Puneet Kumar, Randhir Singh","doi":"10.2174/011573403X278550240221112636","DOIUrl":"10.2174/011573403X278550240221112636","url":null,"abstract":"<p><p>Cardiovascular and neurological diseases cause substantial morbidity and mortality globally. Moreover, cardiovascular diseases are the leading cause of death globally. About 17.9 million people are affected by cardiovascular diseases and 6.8 million people die every year due to neurological diseases. The common neurologic manifestations of cardiovascular illness include stroke syndrome which is responsible for unconsciousness and several other morbidities significantly diminished the quality of life of patients. Therefore, it is prudent need to explore the mechanistic and molecular connection between cardiovascular disorders and neurological disorders. The present review emphasizes the association between cardiovascular and neurological diseases specifically Parkinson's disease, Alzheimer's disease, and Huntington's disease.</p>","PeriodicalId":10832,"journal":{"name":"Current Cardiology Reviews","volume":null,"pages":null},"PeriodicalIF":2.4,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11284694/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140027608","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The novel 2019 coronavirus disease (COVID-19) was first reported in the last days of December 2019 in Wuhan, China. The presence of certain co-morbidities, including cardiovascular diseases (CVDs), are the basis for worse outcomes in patients with COVID-19. Relevant English-language literature was searched and retrieved from the Google Scholar search engine and PubMed database up to 2023 using COVID-19, SARS-CoV-2, Heart failure, Myocardial infarction, and Arrhythmia and Cardiac complication as keywords. Increased hemodynamic load, ischemia-related dysfunction, ventricular remodeling, excessive neurohumoral stimulation, abnormal myocyte calcium cycling, and excessive or insufficient extracellular matrix proliferation are associated with heart failure (HF) in COVID-19 patients. Inflammatory reaction due to the excessive release of inflammatory cytokines, leads to myocardial infarction (MI) in these patients. The virus can induce heart arrhythmia through cardiac complications, hypoxia, decreased heart hemodynamics, and remarkable inflammatory markers. Moreover, studies have linked cardiac complications in COVID-19 with poor outcomes, extended hospitalization time, and increased mortality rate. Patients with COVID-19 and CVDs are at higher mortality risk and they should be given high priority when receiving the treatment and intensive care during hospitalization.
{"title":"Cardiac Complications and COVID-19: A Review of Life-threatening Co-morbidities.","authors":"Zeinab Eftekhar, Habib Haybar, Alireza Mohebbi, Najmaldin Saki","doi":"10.2174/011573403X279782240206091322","DOIUrl":"10.2174/011573403X279782240206091322","url":null,"abstract":"<p><p>The novel 2019 coronavirus disease (COVID-19) was first reported in the last days of December 2019 in Wuhan, China. The presence of certain co-morbidities, including cardiovascular diseases (CVDs), are the basis for worse outcomes in patients with COVID-19. Relevant English-language literature was searched and retrieved from the Google Scholar search engine and PubMed database up to 2023 using COVID-19, SARS-CoV-2, Heart failure, Myocardial infarction, and Arrhythmia and Cardiac complication as keywords. Increased hemodynamic load, ischemia-related dysfunction, ventricular remodeling, excessive neurohumoral stimulation, abnormal myocyte calcium cycling, and excessive or insufficient extracellular matrix proliferation are associated with heart failure (HF) in COVID-19 patients. Inflammatory reaction due to the excessive release of inflammatory cytokines, leads to myocardial infarction (MI) in these patients. The virus can induce heart arrhythmia through cardiac complications, hypoxia, decreased heart hemodynamics, and remarkable inflammatory markers. Moreover, studies have linked cardiac complications in COVID-19 with poor outcomes, extended hospitalization time, and increased mortality rate. Patients with COVID-19 and CVDs are at higher mortality risk and they should be given high priority when receiving the treatment and intensive care during hospitalization.</p>","PeriodicalId":10832,"journal":{"name":"Current Cardiology Reviews","volume":null,"pages":null},"PeriodicalIF":2.4,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11284692/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139982597","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-01-01DOI: 10.2174/011573403X289842240307114736
Bianca Araujo Almeida, Anderson Pontes Morales, José Ricardo Claudino Ribeiro, Felipe Sampaio-Jorge, Yasmin Garcia Ribeiro, Thiago Barth, Beatriz Gonçalves Ribeiro
Objectives: The objective of this systematic review and meta-analysis is to evaluate the influence of caffeine (CAF) intake strategies, taking into account their form, timing, and dosage, on heart rate variability (HRV) indices in the post-exercise recovery period.
Methods: The meta-analysis adhered to the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) guidelines and is registered in the PROSPERO database (CRD42023425885). A comprehensive literature search was carried out across MEDLINE, Web of Science, LILACS, and SCOPUS, concluding in May 2023. We concentrated on randomized clinical trials comparing CAF supplementation effects to placebo on HRV indices post-exercise in active adults aged 18 and above. The primary endpoint was the assessment of HRV indices, measured both prior to and following exercise.
Results: Of the 10 studies included, 7 were used for the meta-analysis, and all contributed to the systematic review. The research explored a variety of CAF strategies, spanning different forms (capsule, drink, gum), times (10, 45, 60 min) and doses (2.1 to 6.0 mg/kg). The outcomes revealed no substantial variations between the placebo and CAF conditions in terms of both the square root of the average of successive squared differences between adjacent RR intervals (RMSSD) (standardized mean difference (SMD) -0.03, 95% CI -0.265 to 0.197, p=0.77) and high frequency (HF) index (SMD -0.061, 95% CI -0.272 to 0.150, p=0.57). Furthermore, metaregression analysis, employing a fixed-effects model and accounting for the administered CAF doses, revealed no significant correlation between caffeine doses and HRV indices (p>0.05).
Conclusion: In conclusion, there is moderate-certainty evidence suggesting that different CAF intake strategies, encompassing aspects such as form, time, and dose, do not have a significant impact on HRV indices recovery post-exercise (i.e., vagal modulation).
{"title":"Impact of Caffeine Intake Strategies on Heart Rate Variability during Post-Exercise Recovery: A Systematic Review and Meta-Analysis.","authors":"Bianca Araujo Almeida, Anderson Pontes Morales, José Ricardo Claudino Ribeiro, Felipe Sampaio-Jorge, Yasmin Garcia Ribeiro, Thiago Barth, Beatriz Gonçalves Ribeiro","doi":"10.2174/011573403X289842240307114736","DOIUrl":"10.2174/011573403X289842240307114736","url":null,"abstract":"<p><strong>Objectives: </strong>The objective of this systematic review and meta-analysis is to evaluate the influence of caffeine (CAF) intake strategies, taking into account their form, timing, and dosage, on heart rate variability (HRV) indices in the post-exercise recovery period.</p><p><strong>Methods: </strong>The meta-analysis adhered to the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) guidelines and is registered in the PROSPERO database (CRD42023425885). A comprehensive literature search was carried out across MEDLINE, Web of Science, LILACS, and SCOPUS, concluding in May 2023. We concentrated on randomized clinical trials comparing CAF supplementation effects to placebo on HRV indices post-exercise in active adults aged 18 and above. The primary endpoint was the assessment of HRV indices, measured both prior to and following exercise.</p><p><strong>Results: </strong>Of the 10 studies included, 7 were used for the meta-analysis, and all contributed to the systematic review. The research explored a variety of CAF strategies, spanning different forms (capsule, drink, gum), times (10, 45, 60 min) and doses (2.1 to 6.0 mg/kg). The outcomes revealed no substantial variations between the placebo and CAF conditions in terms of both the square root of the average of successive squared differences between adjacent RR intervals (RMSSD) (standardized mean difference (SMD) -0.03, 95% CI -0.265 to 0.197, p=0.77) and high frequency (HF) index (SMD -0.061, 95% CI -0.272 to 0.150, p=0.57). Furthermore, metaregression analysis, employing a fixed-effects model and accounting for the administered CAF doses, revealed no significant correlation between caffeine doses and HRV indices (p>0.05).</p><p><strong>Conclusion: </strong>In conclusion, there is moderate-certainty evidence suggesting that different CAF intake strategies, encompassing aspects such as form, time, and dose, do not have a significant impact on HRV indices recovery post-exercise (i.e., vagal modulation).</p>","PeriodicalId":10832,"journal":{"name":"Current Cardiology Reviews","volume":null,"pages":null},"PeriodicalIF":2.4,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11284693/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140142938","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-01-01DOI: 10.2174/011573403X283768240124065853
Basheer Marzoog
Volatile organic compounds (VOCs) can be subdivided into exogenous and endogenous categories based on their origin. Analyzing the endogenous VOCs can provide insights into maintaining the internal organs' homeostasis. Despite the ongoing development and the current understanding, studies have suggested a link between cardiovascular metabolic alterations in patients with ischemic heart disease and elevated levels of ethane and isoprene detectable through exhaled breath analysis. Conversely, patients with chronic heart failure exhibit elevated acetone and pentane in their exhaled air. These substances originate from disturbances in the heart tissue, including cellular and subcellular modulations. Hypothetically, ethane levels in the exhaled breath analysis can demonstrate the severity of ischemic heart disease and, consequently, the risk of death in the next 10 years due to cardiovascular disease (CVD). Real-time direct mass spectrometry is the preferred method for assessing VOCs in exhaled breath analysis. The accuracy of this analysis depends on several factors, including the selection of the relevant breath fraction, the type of breath collection container (if used), and the pre-concentration technique.
{"title":"Breathomics Detect the Cardiovascular Disease: Delusion or Dilution of the Metabolomic Signature.","authors":"Basheer Marzoog","doi":"10.2174/011573403X283768240124065853","DOIUrl":"10.2174/011573403X283768240124065853","url":null,"abstract":"<p><p>Volatile organic compounds (VOCs) can be subdivided into exogenous and endogenous categories based on their origin. Analyzing the endogenous VOCs can provide insights into maintaining the internal organs' homeostasis. Despite the ongoing development and the current understanding, studies have suggested a link between cardiovascular metabolic alterations in patients with ischemic heart disease and elevated levels of ethane and isoprene detectable through exhaled breath analysis. Conversely, patients with chronic heart failure exhibit elevated acetone and pentane in their exhaled air. These substances originate from disturbances in the heart tissue, including cellular and subcellular modulations. Hypothetically, ethane levels in the exhaled breath analysis can demonstrate the severity of ischemic heart disease and, consequently, the risk of death in the next 10 years due to cardiovascular disease (CVD). Real-time direct mass spectrometry is the preferred method for assessing VOCs in exhaled breath analysis. The accuracy of this analysis depends on several factors, including the selection of the relevant breath fraction, the type of breath collection container (if used), and the pre-concentration technique.</p>","PeriodicalId":10832,"journal":{"name":"Current Cardiology Reviews","volume":null,"pages":null},"PeriodicalIF":2.4,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11327829/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139691448","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-01-01DOI: 10.2174/011573403X270178231228061314
Jonathan C H Chan, Areeb Siddiqui
Background: Heart failure is a clinical condition with high mortality and morbidity that occurs when the heart is unable to pump enough blood to meet the metabolic demands of the body. The pharmacological management of heart failure has been revolutionized over the past decade with novel treatments.
Objective: The aim of the review is to highlight the recent pharmacological advances in the management of heart failure.
Results: Sodium-glucose cotransporter-2 inhibitor (SGLT2i), iron carboxymaltose, finerenone, omecamtiv mecarbil, and vericiguat have been shown to reduce hospitalization for heart failure. However, only SGLT2i, vericiguat, and omecamtiv mecarbil have been shown to reduce cardiovascular death. Finerenone has been shown to reduce cardiovascular events and renal adverse outcomes in patients with diabetes and kidney disease. Currently, only SGLT2i has been studied in patients beyond the heart failure with reduced ejection fraction population.
Conclusion: The current quadruple therapy in the treatment of heart failure has demonstrated a reduction in the hospitalization of patients and a decrease in mortality associated with the condition. Individualized heart failure therapy research have shown some benefit in select heart failure patients. Further research on novel therapies will help improve heart failure patient outcomes.
{"title":"Pharmacological Treatment of Heart Failure: Recent Advances.","authors":"Jonathan C H Chan, Areeb Siddiqui","doi":"10.2174/011573403X270178231228061314","DOIUrl":"10.2174/011573403X270178231228061314","url":null,"abstract":"<p><strong>Background: </strong>Heart failure is a clinical condition with high mortality and morbidity that occurs when the heart is unable to pump enough blood to meet the metabolic demands of the body. The pharmacological management of heart failure has been revolutionized over the past decade with novel treatments.</p><p><strong>Objective: </strong>The aim of the review is to highlight the recent pharmacological advances in the management of heart failure.</p><p><strong>Results: </strong>Sodium-glucose cotransporter-2 inhibitor (SGLT2i), iron carboxymaltose, finerenone, omecamtiv mecarbil, and vericiguat have been shown to reduce hospitalization for heart failure. However, only SGLT2i, vericiguat, and omecamtiv mecarbil have been shown to reduce cardiovascular death. Finerenone has been shown to reduce cardiovascular events and renal adverse outcomes in patients with diabetes and kidney disease. Currently, only SGLT2i has been studied in patients beyond the heart failure with reduced ejection fraction population.</p><p><strong>Conclusion: </strong>The current quadruple therapy in the treatment of heart failure has demonstrated a reduction in the hospitalization of patients and a decrease in mortality associated with the condition. Individualized heart failure therapy research have shown some benefit in select heart failure patients. Further research on novel therapies will help improve heart failure patient outcomes.</p>","PeriodicalId":10832,"journal":{"name":"Current Cardiology Reviews","volume":null,"pages":null},"PeriodicalIF":2.4,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11107472/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139569981","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-01-01DOI: 10.2174/011573403X272750240109052319
Yonatan Akivis, Hussam Alkaissi, Samy I McFarlane, Inna Bukharovich
Triglycerides have long been recognized as a cardiovascular disease risk factor. However, their precise role in atherosclerosis and potential utility as a therapeutic target remains debated topics. This review aims to shed light on these aspects by exploring the complex relationship between triglycerides and atherosclerosis from pathophysiological and pharmacological perspectives. Triglycerides, primarily carried by chylomicrons and very low-density lipoproteins, play an essential role in energy storage and utilization. Dysregulation of triglyceride homeostasis and triglyceride- rich lipoproteins metabolism often leads to hypertriglyceridemia and subsequently increases atherosclerosis risk. Triglyceride-rich lipoproteins remnants interact with arterial wall endothelial cells, get retained in the subendothelial space, and elicit inflammatory responses, thereby accelerating atherogenesis. Despite the clear association between high triglyceride levels and increased cardiovascular disease risk, intervention trials targeting triglyceride reduction have produced mixed results. We discuss a range of triglyceride-lowering agents, from fibrates to omega-3 fatty acids, with a focus on their mechanism of action, efficacy, and major clinical trial outcomes. Notably, the role of newer agents, such as angiopoietin-like protein 3 and apolipoprotein C3 inhibitors, is also explored. We highlight the challenges and controversies, including the ongoing debate on the causal role of triglyceride in atherosclerosis and the discordant outcomes of recent clinical trials. The potential confounding effects of associated risk factors, such as elevated apolipoprotein B, insulin resistance, and metabolic syndrome, are considered. In conclusion, this review underscores the importance of a nuanced approach to understanding the role of triglycerides in atherosclerosis and their potential as a therapeutic target. Further research is needed to unravel the complex interplay between triglycerides, triglyceride-rich lipoproteins, and associated factors in atherosclerosis pathogenesis and refine triglyceride-targeted therapeutic strategies.
长期以来,人们一直认为甘油三酯是心血管疾病的危险因素。然而,它们在动脉粥样硬化中的确切作用以及作为治疗靶点的潜在效用仍是备受争议的话题。本综述旨在从病理生理学和药理学的角度探讨甘油三酯与动脉粥样硬化之间的复杂关系,从而阐明这些方面的问题。甘油三酯主要由乳糜微粒和极低密度脂蛋白携带,在能量储存和利用方面发挥着重要作用。甘油三酯稳态和富含甘油三酯的脂蛋白代谢失调往往会导致高甘油三酯血症,进而增加动脉粥样硬化的风险。富含甘油三酯的脂蛋白残渣与动脉壁内皮细胞相互作用,滞留在内皮下空间,引起炎症反应,从而加速动脉粥样硬化的发生。尽管甘油三酯水平高与心血管疾病风险增加之间存在明显的关联,但以降低甘油三酯为目标的干预试验却取得了好坏参半的结果。我们讨论了从纤维酸盐到欧米伽-3 脂肪酸等一系列降低甘油三酯的药物,重点关注其作用机制、疗效和主要临床试验结果。值得注意的是,我们还探讨了血管生成素样蛋白 3 和脂蛋白 C3 抑制剂等新型药物的作用。我们强调了面临的挑战和争议,包括正在进行的关于甘油三酯在动脉粥样硬化中的因果作用的争论以及近期临床试验的不一致结果。我们还考虑了相关风险因素的潜在混杂效应,如载脂蛋白 B 升高、胰岛素抵抗和代谢综合征。总之,本综述强调了采用细致入微的方法了解甘油三酯在动脉粥样硬化中的作用及其作为治疗靶点的潜力的重要性。还需要进一步的研究来揭示甘油三酯、富含甘油三酯的脂蛋白和动脉粥样硬化发病机制中相关因素之间复杂的相互作用,并完善甘油三酯靶向治疗策略。
{"title":"The Role of Triglycerides in Atherosclerosis: Recent Pathophysiologic Insights and Therapeutic Implications.","authors":"Yonatan Akivis, Hussam Alkaissi, Samy I McFarlane, Inna Bukharovich","doi":"10.2174/011573403X272750240109052319","DOIUrl":"10.2174/011573403X272750240109052319","url":null,"abstract":"<p><p>Triglycerides have long been recognized as a cardiovascular disease risk factor. However, their precise role in atherosclerosis and potential utility as a therapeutic target remains debated topics. This review aims to shed light on these aspects by exploring the complex relationship between triglycerides and atherosclerosis from pathophysiological and pharmacological perspectives. Triglycerides, primarily carried by chylomicrons and very low-density lipoproteins, play an essential role in energy storage and utilization. Dysregulation of triglyceride homeostasis and triglyceride- rich lipoproteins metabolism often leads to hypertriglyceridemia and subsequently increases atherosclerosis risk. Triglyceride-rich lipoproteins remnants interact with arterial wall endothelial cells, get retained in the subendothelial space, and elicit inflammatory responses, thereby accelerating atherogenesis. Despite the clear association between high triglyceride levels and increased cardiovascular disease risk, intervention trials targeting triglyceride reduction have produced mixed results. We discuss a range of triglyceride-lowering agents, from fibrates to omega-3 fatty acids, with a focus on their mechanism of action, efficacy, and major clinical trial outcomes. Notably, the role of newer agents, such as angiopoietin-like protein 3 and apolipoprotein C3 inhibitors, is also explored. We highlight the challenges and controversies, including the ongoing debate on the causal role of triglyceride in atherosclerosis and the discordant outcomes of recent clinical trials. The potential confounding effects of associated risk factors, such as elevated apolipoprotein B, insulin resistance, and metabolic syndrome, are considered. In conclusion, this review underscores the importance of a nuanced approach to understanding the role of triglycerides in atherosclerosis and their potential as a therapeutic target. Further research is needed to unravel the complex interplay between triglycerides, triglyceride-rich lipoproteins, and associated factors in atherosclerosis pathogenesis and refine triglyceride-targeted therapeutic strategies.</p>","PeriodicalId":10832,"journal":{"name":"Current Cardiology Reviews","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11107470/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139575469","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: Adherence to Congestive Heart Failure with reduced Ejection Fraction (CHFrEF) guidelines is not easily attainable everywhere, particularly in countries with a high prevalence of low socioeconomic status, which includes many Middle Eastern countries. However, it is well-established that adherence to the guidelines is associated with lower mortality and morbidity rates.
Objective: Our objective is to investigate the adherence to the degree of treatment guideline in CHFrEF within a patient population in the Middle East and correlate the level of compliance both fully and partially with morbidity and mortality outcomes. Methods and Statistics: We conducted a retrospective study on patients with CHFrEF in the Middle East region who were maintained on Sacubitril/Valsartan for up to 4 years (190 patients). This study included follow-up assessments for morbidity and mortality rates and their correlation with the level of adherence to guidelines.
Results: Statistical analysis was performed using IBM SPSS® 27th version. In both the partial adherence group and the full adherence group, there was a statistically significant improvement in NYHA (pretreatment and post-treatment) and Ejection fraction (pretreatment and posttreatment). This means that regardless of the level of adherence to the use of Sacubitril/Valsartan in CHFrEF, there was an overall improvement in the morbidity and mortality rates over the four years of follow-up.
Conclusion: While we fully support the idea of achieving full CHFrEF guideline adherence, we recognize the difficulty of this task. Nevertheless, this study reinforces the notion that any degree of adherence to guideline is correlated with better morbidity and mortality rates over a long-term follow-up.
{"title":"Adherence to Congestive Heart Failure Guidelines and Outcome in the Middle East.","authors":"Raed Aqel, Tareq Alzughayyar, Jihad Zalloum, Qais Salah, Qutaiba Qafisheh, Mahmoud Izraiq","doi":"10.2174/011573403X256576231017110252","DOIUrl":"10.2174/011573403X256576231017110252","url":null,"abstract":"<p><strong>Background: </strong>Adherence to Congestive Heart Failure with reduced Ejection Fraction (CHFrEF) guidelines is not easily attainable everywhere, particularly in countries with a high prevalence of low socioeconomic status, which includes many Middle Eastern countries. However, it is well-established that adherence to the guidelines is associated with lower mortality and morbidity rates.</p><p><strong>Objective: </strong>Our objective is to investigate the adherence to the degree of treatment guideline in CHFrEF within a patient population in the Middle East and correlate the level of compliance both fully and partially with morbidity and mortality outcomes. Methods and Statistics: We conducted a retrospective study on patients with CHFrEF in the Middle East region who were maintained on Sacubitril/Valsartan for up to 4 years (190 patients). This study included follow-up assessments for morbidity and mortality rates and their correlation with the level of adherence to guidelines.</p><p><strong>Results: </strong>Statistical analysis was performed using IBM SPSS® 27th version. In both the partial adherence group and the full adherence group, there was a statistically significant improvement in NYHA (pretreatment and post-treatment) and Ejection fraction (pretreatment and posttreatment). This means that regardless of the level of adherence to the use of Sacubitril/Valsartan in CHFrEF, there was an overall improvement in the morbidity and mortality rates over the four years of follow-up.</p><p><strong>Conclusion: </strong>While we fully support the idea of achieving full CHFrEF guideline adherence, we recognize the difficulty of this task. Nevertheless, this study reinforces the notion that any degree of adherence to guideline is correlated with better morbidity and mortality rates over a long-term follow-up.</p>","PeriodicalId":10832,"journal":{"name":"Current Cardiology Reviews","volume":null,"pages":null},"PeriodicalIF":2.4,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11284696/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138451157","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-01-01DOI: 10.2174/011573403X289572240206112303
Shashipriya Agress, Jannat S Sheikh, Aida A Perez Ramos, Durlav Kashyap, Soha Razmjouei, Joy Kumar, Mankaranvir Singh, Muhammad Ali Lak, Ali Osman, Muhammad Zia Ul Haq
Background: Chronic heart failure (HF) is frequently associated with various comorbidities. These comorbid conditions, such as anemia, diabetes mellitus, renal insufficiency, and sleep apnea, can significantly impact the prognosis of patients with HF.
Objective: This review aims to synthesize current evidence on the prevalence, impact, and management of comorbidities in patients with chronic HF.
Methods: A comprehensive review was conducted, with a rigorous selection process. Out of an initial pool of 59,030 articles identified across various research modalities, 134 articles were chosen for inclusion. The selection spanned various research methods, from randomized controlled trials to observational studies.
Results: Comorbidities are highly prevalent in patients with HF and contribute to increased hospitalization rates and mortality. Despite advances in therapies for HF with reduced ejection fraction, options for treating HF with preserved ejection fraction remain sparse. Existing treatment protocols often lack standardization, reflecting a limited understanding of the intricate relationships between HF and associated comorbidities.
Conclusion: There is a pressing need for a multidisciplinary, tailored approach to manage HF and its intricate comorbidities. This review underscores the importance of ongoing research efforts to devise targeted treatment strategies for HF patients with various comorbid conditions.
{"title":"The Interplay of Comorbidities in Chronic Heart Failure: Challenges and Solutions.","authors":"Shashipriya Agress, Jannat S Sheikh, Aida A Perez Ramos, Durlav Kashyap, Soha Razmjouei, Joy Kumar, Mankaranvir Singh, Muhammad Ali Lak, Ali Osman, Muhammad Zia Ul Haq","doi":"10.2174/011573403X289572240206112303","DOIUrl":"10.2174/011573403X289572240206112303","url":null,"abstract":"<p><strong>Background: </strong>Chronic heart failure (HF) is frequently associated with various comorbidities. These comorbid conditions, such as anemia, diabetes mellitus, renal insufficiency, and sleep apnea, can significantly impact the prognosis of patients with HF.</p><p><strong>Objective: </strong>This review aims to synthesize current evidence on the prevalence, impact, and management of comorbidities in patients with chronic HF.</p><p><strong>Methods: </strong>A comprehensive review was conducted, with a rigorous selection process. Out of an initial pool of 59,030 articles identified across various research modalities, 134 articles were chosen for inclusion. The selection spanned various research methods, from randomized controlled trials to observational studies.</p><p><strong>Results: </strong>Comorbidities are highly prevalent in patients with HF and contribute to increased hospitalization rates and mortality. Despite advances in therapies for HF with reduced ejection fraction, options for treating HF with preserved ejection fraction remain sparse. Existing treatment protocols often lack standardization, reflecting a limited understanding of the intricate relationships between HF and associated comorbidities.</p><p><strong>Conclusion: </strong>There is a pressing need for a multidisciplinary, tailored approach to manage HF and its intricate comorbidities. This review underscores the importance of ongoing research efforts to devise targeted treatment strategies for HF patients with various comorbid conditions.</p>","PeriodicalId":10832,"journal":{"name":"Current Cardiology Reviews","volume":null,"pages":null},"PeriodicalIF":2.4,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11284697/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139721994","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}