Alessandro Cavalcanti Lianza, Maria de Fátima Rodrigues Diniz, Karen Saori Shiraishi Sawamura, Carolina da Rocha Brito Menezes, Isabela de Sousa Lobo Silva, Gabriela Nunes Leal
The most severe complication of Kawasaki disease, an inflammatory disorder of young children, is the formation of coronary artery aneurysms. It is known that patients with coronary artery aneurysms, particularly those with medium and large lesions, have a higher risk of future major cardiovascular events. In contrast, there is a lack of data on the cardiovascular status in long-term follow-up for Kawasaki disease patients without coronary involvement or with self-limited coronary artery aneurysms, resulting in most patients being discharged after 5 years. Even though some paediatricians may believe these patients should not be followed at all, studies indicating a dysfunctional endothelium show the need for further investigation. Consequently, a review of the most significant aspects of Kawasaki disease, and the necessity of correctly identifying, treating and monitoring these patients, particularly those with a higher risk of complications, was conducted.
{"title":"Kawasaki Disease: A Never-ending Story?","authors":"Alessandro Cavalcanti Lianza, Maria de Fátima Rodrigues Diniz, Karen Saori Shiraishi Sawamura, Carolina da Rocha Brito Menezes, Isabela de Sousa Lobo Silva, Gabriela Nunes Leal","doi":"10.15420/ecr.2023.15","DOIUrl":"https://doi.org/10.15420/ecr.2023.15","url":null,"abstract":"<p><p>The most severe complication of Kawasaki disease, an inflammatory disorder of young children, is the formation of coronary artery aneurysms. It is known that patients with coronary artery aneurysms, particularly those with medium and large lesions, have a higher risk of future major cardiovascular events. In contrast, there is a lack of data on the cardiovascular status in long-term follow-up for Kawasaki disease patients without coronary involvement or with self-limited coronary artery aneurysms, resulting in most patients being discharged after 5 years. Even though some paediatricians may believe these patients should not be followed at all, studies indicating a dysfunctional endothelium show the need for further investigation. Consequently, a review of the most significant aspects of Kawasaki disease, and the necessity of correctly identifying, treating and monitoring these patients, particularly those with a higher risk of complications, was conducted.</p>","PeriodicalId":45957,"journal":{"name":"European Cardiology Review","volume":null,"pages":null},"PeriodicalIF":3.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/07/99/ecr-18-e47.PMC10398426.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9954880","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}
www.ECRjournal.com An increasing body of evidence demonstrates how sex influences the development of degenerative aortic valve stenosis (AS) at the aortic root, the valvular and the left ventricular (LV) levels. While the sex-specific impact of ageing and comorbidities promote differences in remodelling of the aortic root and the LV in AS,1,2 sex differences in tissue biology have been demonstrated in the aortic valve.3 These documented sex differences impact diagnosis, grading, treatment choice and outcome in AS. Still, sex-related differences are not well incorporated into current guidelines for the management of AS.4,5 In this special focus of European Cardiology Review, current evidence for sex differences in AS diagnosis and management is reviewed (Figure 1).6–8
{"title":"Time to Integrate Sex in Management of Aortic Valve Stenosis.","authors":"Eva Gerdts, Helga Midtbø","doi":"10.15420/ecr.2022.52","DOIUrl":"https://doi.org/10.15420/ecr.2022.52","url":null,"abstract":"www.ECRjournal.com An increasing body of evidence demonstrates how sex influences the development of degenerative aortic valve stenosis (AS) at the aortic root, the valvular and the left ventricular (LV) levels. While the sex-specific impact of ageing and comorbidities promote differences in remodelling of the aortic root and the LV in AS,1,2 sex differences in tissue biology have been demonstrated in the aortic valve.3 These documented sex differences impact diagnosis, grading, treatment choice and outcome in AS. Still, sex-related differences are not well incorporated into current guidelines for the management of AS.4,5 In this special focus of European Cardiology Review, current evidence for sex differences in AS diagnosis and management is reviewed (Figure 1).6–8","PeriodicalId":45957,"journal":{"name":"European Cardiology Review","volume":null,"pages":null},"PeriodicalIF":3.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/f2/18/ecr-18-e05.PMC10345976.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10184063","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 : 2022-12-19eCollection Date: 2022-02-01DOI: 10.15420/ecr.2022.33
Sonya Burgess, F Aaysha Cader, Elizabeth Shaw, Shrilla Banerjee, Julia Stehli, Roopa Krishnamorthy, Lynn Khor, Homa Forotan, Alexandra Bastiany, Sarita Rao, Jaya Chandrasekhar, Sarah Zaman, Mirvat Alasnag, Alaide Chieffo, Megan Coylewright
Women are under-represented among transcatheter aortic valve replacement (TAVR) and transcatheter mitral valve repair (TMVr) operators. This review assesses the representation of women as patients and as proceduralists and trial authors in major structural interventions. Women are under-represented as proceduralists in structural interventions: only 2% of TAVR operators and 1% of TMVr operators are women. Only 1.5% of authors in landmark clinical TAVR and TMVr trials are interventional cardiologists who are women (4/260). Significant under-representation and under-enrolment of women in landmark TAVR trials is evident: the calculated participation-to-prevalence ratio (PPR) is 0.73, and in TMVr trials, the PPR is 0.69. Under-representation of women is also evident in registry data (PPR = 0.84 for TAVR registries and for TMVr registries). In structural interventional cardiology, women are under-represented as proceduralists, trial participants and patients. This under-representation has the potential to affect the recruitment of women to randomised trials, subsequent guideline recommendations, selection for treatment, patient outcomes and sex-specific data analysis.
{"title":"Under-representation of Women as Proceduralists and Patients in TAVR and TMVr Procedures: Data, Implications and Proposed Solutions.","authors":"Sonya Burgess, F Aaysha Cader, Elizabeth Shaw, Shrilla Banerjee, Julia Stehli, Roopa Krishnamorthy, Lynn Khor, Homa Forotan, Alexandra Bastiany, Sarita Rao, Jaya Chandrasekhar, Sarah Zaman, Mirvat Alasnag, Alaide Chieffo, Megan Coylewright","doi":"10.15420/ecr.2022.33","DOIUrl":"10.15420/ecr.2022.33","url":null,"abstract":"<p><p>Women are under-represented among transcatheter aortic valve replacement (TAVR) and transcatheter mitral valve repair (TMVr) operators. This review assesses the representation of women as patients and as proceduralists and trial authors in major structural interventions. Women are under-represented as proceduralists in structural interventions: only 2% of TAVR operators and 1% of TMVr operators are women. Only 1.5% of authors in landmark clinical TAVR and TMVr trials are interventional cardiologists who are women (4/260). Significant under-representation and under-enrolment of women in landmark TAVR trials is evident: the calculated participation-to-prevalence ratio (PPR) is 0.73, and in TMVr trials, the PPR is 0.69. Under-representation of women is also evident in registry data (PPR = 0.84 for TAVR registries and for TMVr registries). In structural interventional cardiology, women are under-represented as proceduralists, trial participants and patients. This under-representation has the potential to affect the recruitment of women to randomised trials, subsequent guideline recommendations, selection for treatment, patient outcomes and sex-specific data analysis.</p>","PeriodicalId":45957,"journal":{"name":"European Cardiology Review","volume":null,"pages":null},"PeriodicalIF":3.2,"publicationDate":"2022-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/eb/1b/ecr-17-e27.PMC9947929.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10799437","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 : 2022-12-06eCollection Date: 2022-02-01DOI: 10.15420/ecr.2022.31
Nina Rashedi, Catherine M Otto
In adults with severe aortic stenosis, sex and age differences in symptoms and diagnosis may lead to delays in intervention. Choice of intervention partly depends on expected longevity because bioprosthetic valves have limited durability, particularly in younger patients. Current guidelines recommend the following: a mechanical valve in younger adults (aged <50 years) if lifelong anticoagulation is possible and acceptable and a valve-sparing procedure is not possible; surgical mechanical or bioprosthetic aortic valve replacement (SAVR) in adults aged 50-65 years; and transcatheter aortic valve implantation (TAVI) for those aged >80 years based on lower mortality and morbidity compared to SAVR and adequate valve durability. For patients aged 65-80 years, the choice between TAVI and a bioprosthetic SAVR depends on expected longevity, which is greater in women than men, as well as associated cardiac and noncardiac conditions, valvular and vascular anatomy, estimated risk of SAVR versus TAVI and expected complications and patient preferences.
{"title":"Treatment of Severe Aortic Valve Stenosis: Impact of Patient Sex and Life Expectancy on Treatment Choice.","authors":"Nina Rashedi, Catherine M Otto","doi":"10.15420/ecr.2022.31","DOIUrl":"10.15420/ecr.2022.31","url":null,"abstract":"<p><p>In adults with severe aortic stenosis, sex and age differences in symptoms and diagnosis may lead to delays in intervention. Choice of intervention partly depends on expected longevity because bioprosthetic valves have limited durability, particularly in younger patients. Current guidelines recommend the following: a mechanical valve in younger adults (aged <50 years) if lifelong anticoagulation is possible and acceptable and a valve-sparing procedure is not possible; surgical mechanical or bioprosthetic aortic valve replacement (SAVR) in adults aged 50-65 years; and transcatheter aortic valve implantation (TAVI) for those aged >80 years based on lower mortality and morbidity compared to SAVR and adequate valve durability. For patients aged 65-80 years, the choice between TAVI and a bioprosthetic SAVR depends on expected longevity, which is greater in women than men, as well as associated cardiac and noncardiac conditions, valvular and vascular anatomy, estimated risk of SAVR versus TAVI and expected complications and patient preferences.</p>","PeriodicalId":45957,"journal":{"name":"European Cardiology Review","volume":null,"pages":null},"PeriodicalIF":3.2,"publicationDate":"2022-12-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/9d/93/ecr-17-e25.PMC9947935.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10792894","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 : 2022-09-30eCollection Date: 2022-02-01DOI: 10.15420/ecr.2022.22
Peter Ong, Andreas Seitz
increase without percutaneous coronary intervention. During a mean follow-up of 3.4 ± 3.6 years, 3,321 deaths occurred (18.2%). Compared to patients without MI (16.1%), patients with type 1 MI (25.2%) and type 2 MI (29.1%) had significantly higher mortality rates (p<0.001). Kaplan–Meier analysis confirmed the lowest survival rates occurred in patients with type 2 MI. 2 Moreover, Barrett et al. showed that 1,544 MINOCA patients from Israel had a favourable short-term outcome but their long-term outcome was comparable to that of patients with acute MI due to obstructive coronary artery disease. 3 In addition, in a study including 712 Spanish patients with acute coronary syndrome (ACS), Espinosa Pascual et al. highlighted that pro-inflammatory states such as autoimmune pathologies, connective tissue disease, active cancer and infections should be regarded as risk factors for the occurrence of MINOCA. 4
{"title":"European Society of Cardiology Highlights: Late-breaking Science MINOCA/ANOCA.","authors":"Peter Ong, Andreas Seitz","doi":"10.15420/ecr.2022.22","DOIUrl":"10.15420/ecr.2022.22","url":null,"abstract":"increase without percutaneous coronary intervention. During a mean follow-up of 3.4 ± 3.6 years, 3,321 deaths occurred (18.2%). Compared to patients without MI (16.1%), patients with type 1 MI (25.2%) and type 2 MI (29.1%) had significantly higher mortality rates (p<0.001). Kaplan–Meier analysis confirmed the lowest survival rates occurred in patients with type 2 MI. 2 Moreover, Barrett et al. showed that 1,544 MINOCA patients from Israel had a favourable short-term outcome but their long-term outcome was comparable to that of patients with acute MI due to obstructive coronary artery disease. 3 In addition, in a study including 712 Spanish patients with acute coronary syndrome (ACS), Espinosa Pascual et al. highlighted that pro-inflammatory states such as autoimmune pathologies, connective tissue disease, active cancer and infections should be regarded as risk factors for the occurrence of MINOCA. 4","PeriodicalId":45957,"journal":{"name":"European Cardiology Review","volume":null,"pages":null},"PeriodicalIF":3.0,"publicationDate":"2022-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/c3/61/ecr-17-e18.PMC9819995.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10624869","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 : 2022-07-26eCollection Date: 2022-02-01DOI: 10.15420/ecr.2021.33
David K Ryan, Debasish Banerjee, Fadi Jouhra
Chronic kidney disease (CKD) is increasingly prevalent in patients with heart failure (HF) and HF is one of the leading causes of hospitalisation, morbidity and mortality in patients with impaired renal function. Currently, there is strong evidence to support the symptomatic and prognostic benefits of β-blockers, renin-angiotensin-aldosterone inhibitors (RAASis), angiotensin receptor-neprilysin inhibitors (ARNIs) and mineralocorticoid receptor antagonists (MRA) in patients with HF and CKD stages 1-3. However, ARNIs, RAASis and MRAs are often suboptimally prescribed for patients with CKD owing to concerns about hyperkalaemia and worsening renal function. There is growing evidence for the use of sodium-glucose co-transporter 2 inhibitors and IV iron therapy in the management of HF in patients with CKD. However, few studies have included patients with CKD stages 4-5 and patients receiving dialysis, limiting the assessment of the safety and efficacy of these therapies in advanced CKD. Interdisciplinary input from HF and renal specialists is required to provide integrated care for the growing number of patients with HF and CKD.
{"title":"Management of Heart Failure in Patients with Chronic Kidney Disease.","authors":"David K Ryan, Debasish Banerjee, Fadi Jouhra","doi":"10.15420/ecr.2021.33","DOIUrl":"10.15420/ecr.2021.33","url":null,"abstract":"<p><p>Chronic kidney disease (CKD) is increasingly prevalent in patients with heart failure (HF) and HF is one of the leading causes of hospitalisation, morbidity and mortality in patients with impaired renal function. Currently, there is strong evidence to support the symptomatic and prognostic benefits of β-blockers, renin-angiotensin-aldosterone inhibitors (RAASis), angiotensin receptor-neprilysin inhibitors (ARNIs) and mineralocorticoid receptor antagonists (MRA) in patients with HF and CKD stages 1-3. However, ARNIs, RAASis and MRAs are often suboptimally prescribed for patients with CKD owing to concerns about hyperkalaemia and worsening renal function. There is growing evidence for the use of sodium-glucose co-transporter 2 inhibitors and IV iron therapy in the management of HF in patients with CKD. However, few studies have included patients with CKD stages 4-5 and patients receiving dialysis, limiting the assessment of the safety and efficacy of these therapies in advanced CKD. Interdisciplinary input from HF and renal specialists is required to provide integrated care for the growing number of patients with HF and CKD.</p>","PeriodicalId":45957,"journal":{"name":"European Cardiology Review","volume":null,"pages":null},"PeriodicalIF":3.2,"publicationDate":"2022-07-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/9d/92/ecr-17-e17.PMC9376857.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40713310","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 : 2022-06-20eCollection Date: 2022-02-01DOI: 10.15420/ecr.2021.59
Jack Wei Chieh Tan, Leong Chai Leow, Serene Wong, See Meng Khoo, Takatoshi Kasai, Pipin Kojodjojo, Duong-Quy Sy, Chuen Peng Lee, Naricha Chirakalwasan, Hsueh-Yu Li, Natalie Koh, Adeline Tan, Thun How Ong, Aye Thandar Aung, Song Tar Toh, Chi-Hang Lee
Obstructive sleep apnoea (OSA) is strongly associated with cardiovascular disease (CVD). However, evidence supporting this association in the Asian population is scarce. Given the differences in the epidemiology of CVD and cardiovascular risk factors, as well as differences in the availability of healthcare resources between Asian and Western countries, an Asian Pacific Society of Cardiology (APSC) working group developed consensus recommendations on the management of OSA in patients with CVD in the Asia-Pacific region. The APSC expert panel reviewed and appraised the available evidence using the Grading of Recommendations Assessment, Development, and Evaluation system. Consensus recommendations were developed and put to an online vote. Consensus was reached when 80% of votes for a given recommendation were in support of 'agree' or 'neutral.' The resulting statements provide guidance on the assessment and treatment of OSA in patients with CVD in the Asia-Pacific region. The APSC hopes for these recommendations to pave the way for screening, early diagnosis and treatment of OSA in the Asia-Pacific region.
{"title":"Asian Pacific Society of Cardiology Consensus Statements on the Diagnosis and Management of Obstructive Sleep Apnoea in Patients with Cardiovascular Disease.","authors":"Jack Wei Chieh Tan, Leong Chai Leow, Serene Wong, See Meng Khoo, Takatoshi Kasai, Pipin Kojodjojo, Duong-Quy Sy, Chuen Peng Lee, Naricha Chirakalwasan, Hsueh-Yu Li, Natalie Koh, Adeline Tan, Thun How Ong, Aye Thandar Aung, Song Tar Toh, Chi-Hang Lee","doi":"10.15420/ecr.2021.59","DOIUrl":"https://doi.org/10.15420/ecr.2021.59","url":null,"abstract":"<p><p>Obstructive sleep apnoea (OSA) is strongly associated with cardiovascular disease (CVD). However, evidence supporting this association in the Asian population is scarce. Given the differences in the epidemiology of CVD and cardiovascular risk factors, as well as differences in the availability of healthcare resources between Asian and Western countries, an Asian Pacific Society of Cardiology (APSC) working group developed consensus recommendations on the management of OSA in patients with CVD in the Asia-Pacific region. The APSC expert panel reviewed and appraised the available evidence using the Grading of Recommendations Assessment, Development, and Evaluation system. Consensus recommendations were developed and put to an online vote. Consensus was reached when 80% of votes for a given recommendation were in support of 'agree' or 'neutral.' The resulting statements provide guidance on the assessment and treatment of OSA in patients with CVD in the Asia-Pacific region. The APSC hopes for these recommendations to pave the way for screening, early diagnosis and treatment of OSA in the Asia-Pacific region.</p>","PeriodicalId":45957,"journal":{"name":"European Cardiology Review","volume":null,"pages":null},"PeriodicalIF":3.0,"publicationDate":"2022-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/da/92/ecr-17-e16.PMC9247989.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40487808","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 : 2022-03-07eCollection Date: 2022-02-01DOI: 10.15420/ecr.2021.60
Jack C Barton, Juan Carlos Kaski
For decades, there has been great interest in ethnic differences in the management of angina and stable cardiovascular disease. Clinical decisionmaking is known to be both consciously and unconsciously influenced by a patient's demographics, and this is due to in part to differences in clinical guidance and opinion. However, the evidence supporting such decision-making is sparse. Nonetheless, there is overwhelming evidence that international, national, regional, institutional, departmental and individual bias disproportionately affect subgroups of the population, resulting in adverse patient outcomes. While without doubt there will be rapid advancements in individualised therapies over the coming years and decades, the most beneficial immediate action clinicians can take is to reduce disparities in both the evidence base and care provision. Doing so will require great collaborative effort.
{"title":"Ethnic and Regional Differences in the Management of Angina: The Way Forward.","authors":"Jack C Barton, Juan Carlos Kaski","doi":"10.15420/ecr.2021.60","DOIUrl":"https://doi.org/10.15420/ecr.2021.60","url":null,"abstract":"<p><p>For decades, there has been great interest in ethnic differences in the management of angina and stable cardiovascular disease. Clinical decisionmaking is known to be both consciously and unconsciously influenced by a patient's demographics, and this is due to in part to differences in clinical guidance and opinion. However, the evidence supporting such decision-making is sparse. Nonetheless, there is overwhelming evidence that international, national, regional, institutional, departmental and individual bias disproportionately affect subgroups of the population, resulting in adverse patient outcomes. While without doubt there will be rapid advancements in individualised therapies over the coming years and decades, the most beneficial immediate action clinicians can take is to reduce disparities in both the evidence base and care provision. Doing so will require great collaborative effort.</p>","PeriodicalId":45957,"journal":{"name":"European Cardiology Review","volume":null,"pages":null},"PeriodicalIF":3.0,"publicationDate":"2022-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/5a/9b/ecr-17-e07.PMC8924955.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40316589","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}
Coronary artery disease is among the leading causes of death worldwide. Nevertheless, available cardiovascular risk prediction algorithms still miss a significant portion of individuals at-risk. Thus, the search for novel non-invasive biomarkers to refine cardiovascular risk assessment is both an urgent need and an attractive topic, which may lead to a more accurate risk stratification and/or prognostic score definition for coronary artery disease. A new class of such non-invasive biomarkers is represented by extracellular microRNAs (miRNAs) circulating in the blood. MiRNAs are non-coding RNA of 22-25 nucleotides in length that play a significant role in both cardiovascular physiology and pathophysiology. Given their high stability and conservation, resistance to degradative enzymes, and detectability in body fluids, circulating miRNAs are promising emerging biomarkers, and specific expression patterns have already been associated with a wide range of cardiovascular conditions. In this review, an overview of the role of blood miRNAs in risk assessment and prognosis of coronary artery disease is given.
{"title":"Circulating MicroRNAs as Novel Biomarkers in Risk Assessment and Prognosis of Coronary Artery Disease.","authors":"Chiara Vavassori, Eleonora Cipriani, Gualtiero Ivanoe Colombo","doi":"10.15420/ecr.2021.47","DOIUrl":"https://doi.org/10.15420/ecr.2021.47","url":null,"abstract":"<p><p>Coronary artery disease is among the leading causes of death worldwide. Nevertheless, available cardiovascular risk prediction algorithms still miss a significant portion of individuals at-risk. Thus, the search for novel non-invasive biomarkers to refine cardiovascular risk assessment is both an urgent need and an attractive topic, which may lead to a more accurate risk stratification and/or prognostic score definition for coronary artery disease. A new class of such non-invasive biomarkers is represented by extracellular microRNAs (miRNAs) circulating in the blood. MiRNAs are non-coding RNA of 22-25 nucleotides in length that play a significant role in both cardiovascular physiology and pathophysiology. Given their high stability and conservation, resistance to degradative enzymes, and detectability in body fluids, circulating miRNAs are promising emerging biomarkers, and specific expression patterns have already been associated with a wide range of cardiovascular conditions. In this review, an overview of the role of blood miRNAs in risk assessment and prognosis of coronary artery disease is given.</p>","PeriodicalId":45957,"journal":{"name":"European Cardiology Review","volume":null,"pages":null},"PeriodicalIF":3.0,"publicationDate":"2022-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/2c/fd/ecr-17-e06.PMC8924954.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40316588","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 : 2022-03-07eCollection Date: 2022-02-01DOI: 10.15420/ecr.2021.52
Zaki Akhtar, Lisa Wm Leung, Christos Kontogiannis, Isaac Chung, Khalid Bin Waleed, Mark M Gallagher
Arrhythmias cause disability and an increased risk of premature death in the general population but far more so in patients with renal failure. The association between the cardiac and renal systems is complex and derives in part from common causality of renal and myocardial injury from conditions including hypertension and diabetes. In many cases, there is a causal relationship, with renal dysfunction promoting arrhythmias and arrhythmias exacerbating renal dysfunction. In this review, the authors expand on the challenges faced by cardiologists in treating common and uncommon arrhythmias in patients with renal failure using pharmacological interventions, ablation and cardiac implantable device therapies. They explore the most important interactions between heart rhythm disorders and renal dysfunction while evaluating the ways in which the coexistence of renal dysfunction and cardiac arrhythmia influences the management of both.
{"title":"Arrhythmias in Chronic Kidney Disease.","authors":"Zaki Akhtar, Lisa Wm Leung, Christos Kontogiannis, Isaac Chung, Khalid Bin Waleed, Mark M Gallagher","doi":"10.15420/ecr.2021.52","DOIUrl":"https://doi.org/10.15420/ecr.2021.52","url":null,"abstract":"<p><p>Arrhythmias cause disability and an increased risk of premature death in the general population but far more so in patients with renal failure. The association between the cardiac and renal systems is complex and derives in part from common causality of renal and myocardial injury from conditions including hypertension and diabetes. In many cases, there is a causal relationship, with renal dysfunction promoting arrhythmias and arrhythmias exacerbating renal dysfunction. In this review, the authors expand on the challenges faced by cardiologists in treating common and uncommon arrhythmias in patients with renal failure using pharmacological interventions, ablation and cardiac implantable device therapies. They explore the most important interactions between heart rhythm disorders and renal dysfunction while evaluating the ways in which the coexistence of renal dysfunction and cardiac arrhythmia influences the management of both.</p>","PeriodicalId":45957,"journal":{"name":"European Cardiology Review","volume":null,"pages":null},"PeriodicalIF":3.0,"publicationDate":"2022-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/31/64/ecr-17-e05.PMC8924956.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40316590","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}