Pub Date : 2018-10-09DOI: 10.19080/jocct.2018.12.555838
V. M. Magro
Chronic Inflammatory Demyelinating Polyneuropathy (CIPD) belongs to the most common immune-mediated chronic disorders of the peripheral nervous system and intravenous immunoglobulin is considered the first-line treatment. in addition to being characterized by numerous phenotypic variants, this condition has been described as associated with other pathologies that have an immune pathogenesis. We describe the clinical case of a patient in whom this condition we discovered was associated with the presence of dilated cardiomyopathy. We tried to be learned from this clinical case report the implications, as well as clinics, even pathogenetic both on the CIDP pathogenesis and on cell-mediated and humoral mechanisms act synergistically to cause damage to cardiac muscle, to be able to derive a therapeutic approach that was optimal.
{"title":"Chronic Inflammatory Demyelinating Polyneuropathy (CIDP) and Dilated Cardiomyopathy: A New Association?","authors":"V. M. Magro","doi":"10.19080/jocct.2018.12.555838","DOIUrl":"https://doi.org/10.19080/jocct.2018.12.555838","url":null,"abstract":"Chronic Inflammatory Demyelinating Polyneuropathy (CIPD) belongs to the most common immune-mediated chronic disorders of the peripheral nervous system and intravenous immunoglobulin is considered the first-line treatment. in addition to being characterized by numerous phenotypic variants, this condition has been described as associated with other pathologies that have an immune pathogenesis. We describe the clinical case of a patient in whom this condition we discovered was associated with the presence of dilated cardiomyopathy. We tried to be learned from this clinical case report the implications, as well as clinics, even pathogenetic both on the CIDP pathogenesis and on cell-mediated and humoral mechanisms act synergistically to cause damage to cardiac muscle, to be able to derive a therapeutic approach that was optimal.","PeriodicalId":73635,"journal":{"name":"Journal of cardiology & cardiovascular therapy","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45622108","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2018-09-27DOI: 10.19080/jocct.2018.12.555836
Si Dung Chu
{"title":"Value on Surface Electrocardiogram for the Right Free Wall in Localizing Accessory Pathway by Simple Parameters in Typical Wolff-Parkinson-White Syndrome","authors":"Si Dung Chu","doi":"10.19080/jocct.2018.12.555836","DOIUrl":"https://doi.org/10.19080/jocct.2018.12.555836","url":null,"abstract":"","PeriodicalId":73635,"journal":{"name":"Journal of cardiology & cardiovascular therapy","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43953951","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2018-09-25DOI: 10.19080/jocct.2018.12.555835
Y. Kuroda
We describe a young adult who underwent surgery for sinus of Valsalva aneurysm and bicuspid aortic valve regurgitation, after undergoing radical repair of the aortic coarctation complex during childhood. A 22-year-old man had undergone radical repair for coarctation of the aorta and ventricular septal defect during childhood. He required surgical treatment of an enlarged ascending aorta and a sinus of Valsalva aneurysm with a congenital bicuspid aortic valve, as indicated using Computed Tomography (CT). Echocardiography revealed moderate regurgitation from the bicuspid aortic valve. We performed a repair of the sinus of Valsalva and replacement of the ascending aorta. Postoperatively, echocardiography revealed trivial aortic regurgitation, while CT indicated resolution of the enlarged ascending aorta and sinus of Valsalva aneurysm. The patient remains asymptomatic 1 year later. Valve sparing and aortic valve repair extensively benefit young patients exhibiting aortic root pathology following radical repair of congenital heart disease.
{"title":"Surgery for A Sinus of Valsalva Aneurysm After Radical Repair of the Aortic Coarctation Complex in A Young Adult with Congenital Bicuspid Aortic Valve: A Case Report","authors":"Y. Kuroda","doi":"10.19080/jocct.2018.12.555835","DOIUrl":"https://doi.org/10.19080/jocct.2018.12.555835","url":null,"abstract":"We describe a young adult who underwent surgery for sinus of Valsalva aneurysm and bicuspid aortic valve regurgitation, after undergoing radical repair of the aortic coarctation complex during childhood. A 22-year-old man had undergone radical repair for coarctation of the aorta and ventricular septal defect during childhood. He required surgical treatment of an enlarged ascending aorta and a sinus of Valsalva aneurysm with a congenital bicuspid aortic valve, as indicated using Computed Tomography (CT). Echocardiography revealed moderate regurgitation from the bicuspid aortic valve. We performed a repair of the sinus of Valsalva and replacement of the ascending aorta. Postoperatively, echocardiography revealed trivial aortic regurgitation, while CT indicated resolution of the enlarged ascending aorta and sinus of Valsalva aneurysm. The patient remains asymptomatic 1 year later. Valve sparing and aortic valve repair extensively benefit young patients exhibiting aortic root pathology following radical repair of congenital heart disease.","PeriodicalId":73635,"journal":{"name":"Journal of cardiology & cardiovascular therapy","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49474898","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2018-09-25DOI: 10.19080/JOCCT.2018.12.555834
G. Rao
The George Institute for Global Health of Australia, in their website claim that the epidemic of cardio-metabolic diseases is escalating worldwide, including India. The rapid socioeconomic transition is believed to have contributed to this rise, with the individuals being increasingly exposed to energy-dense foods, high stress levels, and sedentary work habits. Larry Husten in an article in Lancet wrote, that in 1960, the typical heart-attack“victim” was a middle-class US or European executive. Cardiovascular Disease (CVD) was largely unknown in the developing world, but now, a global epidemic of CVD is underway. In the 21st century, say epidemiologists, a typical patient presenting with heart attack will be a Moscow Taxi driver, or a Bombay factory worker [1]. Underlying causes may or may not be the same at each demography. For instance, another article written in the same year, drew the attention of this prediction. Larry Husten contemplated on the enormous rise in deaths from heart disease in Russia. The author of this article points out to the fact, that to a large extent, the pattern of alcohol consumption may play a big role in the cardiovascular deaths in Russia [2]. Since 1980, incidence of obesity has increased by two-fold and diabetes by four-fold worldwide, according to the NCD Risk Factor Collaborators report [3,4]. Hypertension is one of the primary risk factors for heart disease and stroke. Over 875 million were hypertensives in the year 2000 and will double by the year 2025 [5]. Another factor to be considered when discussing from a global perspective, is that nearly two-thirds of individuals with CMDs live in lowand middle-income countries. On the other hand, immigrant population is increasing rapidly in several countries, because of the economic attractiveness and public infrastructure. Just look at the UAE as an example, they have more immigrants than the native Arabs. Although conventional cardiovascular risk factors such as smoking, blood pressure and total cholesterol predict risk within these ethnic groups, they do not fully account for the differences in risk, between ethnic groups, suggesting that alternative explanations might exist. We feel strongly, that there is a great need to investigate the prevalence and pattern of metabolic risks in general, identify the unique risk factors responsible for development and/or progression of these condition’s and the economic and social costs for the treatment of these diseases. All of these metabolic diseases have risen to the status of an epidemic, and cost of combating these diseases will pose, in the very near future, a great economic burden to the global community.
{"title":"Cardiometabolic Diseases: A Global Perspective","authors":"G. Rao","doi":"10.19080/JOCCT.2018.12.555834","DOIUrl":"https://doi.org/10.19080/JOCCT.2018.12.555834","url":null,"abstract":"The George Institute for Global Health of Australia, in their website claim that the epidemic of cardio-metabolic diseases is escalating worldwide, including India. The rapid socioeconomic transition is believed to have contributed to this rise, with the individuals being increasingly exposed to energy-dense foods, high stress levels, and sedentary work habits. Larry Husten in an article in Lancet wrote, that in 1960, the typical heart-attack“victim” was a middle-class US or European executive. Cardiovascular Disease (CVD) was largely unknown in the developing world, but now, a global epidemic of CVD is underway. In the 21st century, say epidemiologists, a typical patient presenting with heart attack will be a Moscow Taxi driver, or a Bombay factory worker [1]. Underlying causes may or may not be the same at each demography. For instance, another article written in the same year, drew the attention of this prediction. Larry Husten contemplated on the enormous rise in deaths from heart disease in Russia. The author of this article points out to the fact, that to a large extent, the pattern of alcohol consumption may play a big role in the cardiovascular deaths in Russia [2]. Since 1980, incidence of obesity has increased by two-fold and diabetes by four-fold worldwide, according to the NCD Risk Factor Collaborators report [3,4]. Hypertension is one of the primary risk factors for heart disease and stroke. Over 875 million were hypertensives in the year 2000 and will double by the year 2025 [5]. Another factor to be considered when discussing from a global perspective, is that nearly two-thirds of individuals with CMDs live in lowand middle-income countries. On the other hand, immigrant population is increasing rapidly in several countries, because of the economic attractiveness and public infrastructure. Just look at the UAE as an example, they have more immigrants than the native Arabs. Although conventional cardiovascular risk factors such as smoking, blood pressure and total cholesterol predict risk within these ethnic groups, they do not fully account for the differences in risk, between ethnic groups, suggesting that alternative explanations might exist. We feel strongly, that there is a great need to investigate the prevalence and pattern of metabolic risks in general, identify the unique risk factors responsible for development and/or progression of these condition’s and the economic and social costs for the treatment of these diseases. All of these metabolic diseases have risen to the status of an epidemic, and cost of combating these diseases will pose, in the very near future, a great economic burden to the global community.","PeriodicalId":73635,"journal":{"name":"Journal of cardiology & cardiovascular therapy","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47414247","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2018-09-24DOI: 10.19080/jocct.2018.12.555833
F. Ribeiro
Nonbacterial thrombotic endocarditis, also known as marantic endocarditis, is a very rare complication of malignancy and other hypercoagulable states that is characterized by deposition of sterile vegetations (consisting of thrombi and fibrin) on the heart valves. The most commonly affected valves are the aortic valve, the mitral valve or both simultaneously; involvement of the right heart valves is less common. The marantic endocarditis occurs in the context of noninfectious chronic inflammatory conditions, particularly visceral malignancies, and the vegetations are much more prone to detach and embolize as compared to infectious endocarditis. Patients typically present with signs and symptoms of arterial emboli, such as ischemic cerebral events and acute coronary syndromes.
{"title":"Nonbacterial Thrombotic Endocarditis with Embolic Vascular Events as A Manifestation of Advanced Pancreatic Cancer: A Case Report","authors":"F. Ribeiro","doi":"10.19080/jocct.2018.12.555833","DOIUrl":"https://doi.org/10.19080/jocct.2018.12.555833","url":null,"abstract":"Nonbacterial thrombotic endocarditis, also known as marantic endocarditis, is a very rare complication of malignancy and other hypercoagulable states that is characterized by deposition of sterile vegetations (consisting of thrombi and fibrin) on the heart valves. The most commonly affected valves are the aortic valve, the mitral valve or both simultaneously; involvement of the right heart valves is less common. The marantic endocarditis occurs in the context of noninfectious chronic inflammatory conditions, particularly visceral malignancies, and the vegetations are much more prone to detach and embolize as compared to infectious endocarditis. Patients typically present with signs and symptoms of arterial emboli, such as ischemic cerebral events and acute coronary syndromes.","PeriodicalId":73635,"journal":{"name":"Journal of cardiology & cardiovascular therapy","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44998895","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2018-09-17DOI: 10.19080/jocct.2018.12.555832
M. Maladkar
Diabetes is one of the biggest global health emergencies of the 21st century. As per the International Diabetes Federation (IDF), approximately 50% of all people with diabetes live in just three countries: China (109.6 million), India (69.2 million) and the USA (29.3 million). According to ICMR-INDIAB National study, the Indian Diabetic study, around 62.4 million people had diabetes in 2011 and 77 million had prediabetes. Many Asian races show a tendency for fat deposition in the abdominal area which is known as central adiposity. Hyperinsulinemia and insulin resistance are closely associated with central adiposity. Traditionally diagnosis of diabetes was done by measuring FPG (Fasting Plasma Glucose) and OGTT (Oral Glucose Tolerance Test) is often despite several international guidelines recommending HbA1C to diagnose diabetes. However, HbA1c cannot be used as sole criteria for diagnosis of diabetes in Indian settings, but it can be used in settings where an appropriate standardization method is available.
{"title":"Redefining the Therapeutic Wheel of Diabetes Management","authors":"M. Maladkar","doi":"10.19080/jocct.2018.12.555832","DOIUrl":"https://doi.org/10.19080/jocct.2018.12.555832","url":null,"abstract":"Diabetes is one of the biggest global health emergencies of the 21st century. As per the International Diabetes Federation (IDF), approximately 50% of all people with diabetes live in just three countries: China (109.6 million), India (69.2 million) and the USA (29.3 million). According to ICMR-INDIAB National study, the Indian Diabetic study, around 62.4 million people had diabetes in 2011 and 77 million had prediabetes. Many Asian races show a tendency for fat deposition in the abdominal area which is known as central adiposity. Hyperinsulinemia and insulin resistance are closely associated with central adiposity. Traditionally diagnosis of diabetes was done by measuring FPG (Fasting Plasma Glucose) and OGTT (Oral Glucose Tolerance Test) is often despite several international guidelines recommending HbA1C to diagnose diabetes. However, HbA1c cannot be used as sole criteria for diagnosis of diabetes in Indian settings, but it can be used in settings where an appropriate standardization method is available.","PeriodicalId":73635,"journal":{"name":"Journal of cardiology & cardiovascular therapy","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43907129","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2018-08-27DOI: 10.19080/JOCCT.2018.12.555830
A. Salaskar
The patient was a 50-year-old female who had past medical history of hemiglossectomy for squamous cell carcinoma of tongue and recent diagnosis of lung metastasis now presented to emergency department with respiratory failure and sepsis. During resuscitation, CVC was erroneously placed into a R-CCA. CT scan of the neck revealed a CVC entering from right side of the neck then coursing directly into the R-CCA lumen. Patient was urgently taken to IR suite. Selective angiography demonstrated patent R-CCA without any extravasation and 7 Fr CVC entering into the lumen of R-CCA and then coursing into the aortic arch. Under fluoroscopy guidance, as the CVC was slowly being retracted over a wire, a 7 mm x 2.5 cm heparin bonded Viabahn covered stent was deployed to seal the defect in the R-CCA. The stent was then inflated with same size 7 mm balloon without exerting any stretch on the vessel wall. Completion angiography demonstrated patent R-CCA without any evidence of extravasation. Based on prior CT scans, patient did not have any atherosclerotic disease in the cardiovascular system. After carotid artery stenting, patient was placed on antiplatelet medication regimen with an intention to prevent a stent thrombosis as per the common clinical practices. However, we would like to question the need for any antiplatelet treatment after an endovascular stent placement for the treatment of iatrogenically injured non-atherosclerotic disease-free vessel.
患者为50岁女性，既往因舌鳞状细胞癌行半盲切除术，近期诊断为肺转移，现因呼吸衰竭及败血症就诊于急诊科。在复苏过程中，CVC被错误地放置在R-CCA中。颈部CT扫描显示CVC从颈部右侧进入，然后直接进入R-CCA管腔。病人被紧急送往急诊室。选择性血管造影显示R-CCA未闭，无任何外渗，7fr CVC进入R-CCA管腔，然后进入主动脉弓。在透视引导下，当CVC通过导线缓慢收缩时，放置一个7 mm x 2.5 cm的肝素结合Viabahn覆盖支架来密封R-CCA中的缺陷。然后用同样大小的7毫米球囊对支架进行充气，不对血管壁施加任何拉伸。血管造影显示R-CCA专利，无任何外渗迹象。根据先前的CT扫描，患者没有任何心血管系统的动脉粥样硬化性疾病。颈动脉支架植入术后，患者按照临床惯例给予抗血小板药物治疗，目的是防止支架内血栓形成。然而，我们想质疑在血管内支架置入治疗医源性损伤的非动脉粥样硬化性无病血管后是否需要任何抗血小板治疗。
{"title":"Is an Antiplatelet Treatment required after an Endovascular covered stent placement for Treatment of Iatrogenically Injured non diseased Arteries?","authors":"A. Salaskar","doi":"10.19080/JOCCT.2018.12.555830","DOIUrl":"https://doi.org/10.19080/JOCCT.2018.12.555830","url":null,"abstract":"The patient was a 50-year-old female who had past medical history of hemiglossectomy for squamous cell carcinoma of tongue and recent diagnosis of lung metastasis now presented to emergency department with respiratory failure and sepsis. During resuscitation, CVC was erroneously placed into a R-CCA. CT scan of the neck revealed a CVC entering from right side of the neck then coursing directly into the R-CCA lumen. Patient was urgently taken to IR suite. Selective angiography demonstrated patent R-CCA without any extravasation and 7 Fr CVC entering into the lumen of R-CCA and then coursing into the aortic arch. Under fluoroscopy guidance, as the CVC was slowly being retracted over a wire, a 7 mm x 2.5 cm heparin bonded Viabahn covered stent was deployed to seal the defect in the R-CCA. The stent was then inflated with same size 7 mm balloon without exerting any stretch on the vessel wall. Completion angiography demonstrated patent R-CCA without any evidence of extravasation. Based on prior CT scans, patient did not have any atherosclerotic disease in the cardiovascular system. After carotid artery stenting, patient was placed on antiplatelet medication regimen with an intention to prevent a stent thrombosis as per the common clinical practices. However, we would like to question the need for any antiplatelet treatment after an endovascular stent placement for the treatment of iatrogenically injured non-atherosclerotic disease-free vessel.","PeriodicalId":73635,"journal":{"name":"Journal of cardiology & cardiovascular therapy","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46393085","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2018-08-24DOI: 10.19080/JOCCT.2018.12.555828
A. Harky
we aim the impact of dedicated aortic teams, and surgeon or centre specific volumes on outcomes of acute type A aortic dissection.
我们的目标是专门的主动脉团队和外科医生或中心特定体积对急性A型主动脉夹层结果的影响。
{"title":"The Impact of Dedicated Aortic Teams and Centralisation of Aortic Services, and Surgeon or Centre Specific Volumes on Outcomes of Acute Type A Aortic Dissection","authors":"A. Harky","doi":"10.19080/JOCCT.2018.12.555828","DOIUrl":"https://doi.org/10.19080/JOCCT.2018.12.555828","url":null,"abstract":"we aim the impact of dedicated aortic teams, and surgeon or centre specific volumes on outcomes of acute type A aortic dissection.","PeriodicalId":73635,"journal":{"name":"Journal of cardiology & cardiovascular therapy","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-08-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44579381","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2018-08-24DOI: 10.19080/JOCCT.2018.12.555829
E. Greco
The best-documented genetic risk factor is the severe hereditary deficiency of alpha-1 antitrypsin 26, an important serum protease inhibitor. Although alpha-1 antitrypsin deficiency is only relevant for a small part of the world population, it is an example of gene interaction and environmental exposure leading to COPD [2]. Authors have confirmed that a first important step to assess the complexity of COPD is the development and validation of several multidimensional assessment indices, such as the BODE index (body mass index, FEV1, dyspnea, and exercise capacity), the ADO index (age, dyspnea, FEV1), and the DOSE index (dyspnea, FEV1, smoking status, and exacerbation frequency). All of them, however, are based on clinical and functional variables only, whereas it is well established that COPD is also a complex disease at the molecular and genetic levels; it is well known that only a percentage of smokers develop COPD, suggesting a genetically determined susceptibility for the disease. However, information at the genotype, molecular, cellular, and phenotype levels is important to understand and manage COPD [3].
{"title":"The Role of Gene Polymorphisms in the Exacerbation and Prognosis of Chronic Obstructive Pulmonary Disease (Copd)","authors":"E. Greco","doi":"10.19080/JOCCT.2018.12.555829","DOIUrl":"https://doi.org/10.19080/JOCCT.2018.12.555829","url":null,"abstract":"The best-documented genetic risk factor is the severe hereditary deficiency of alpha-1 antitrypsin 26, an important serum protease inhibitor. Although alpha-1 antitrypsin deficiency is only relevant for a small part of the world population, it is an example of gene interaction and environmental exposure leading to COPD [2]. Authors have confirmed that a first important step to assess the complexity of COPD is the development and validation of several multidimensional assessment indices, such as the BODE index (body mass index, FEV1, dyspnea, and exercise capacity), the ADO index (age, dyspnea, FEV1), and the DOSE index (dyspnea, FEV1, smoking status, and exacerbation frequency). All of them, however, are based on clinical and functional variables only, whereas it is well established that COPD is also a complex disease at the molecular and genetic levels; it is well known that only a percentage of smokers develop COPD, suggesting a genetically determined susceptibility for the disease. However, information at the genotype, molecular, cellular, and phenotype levels is important to understand and manage COPD [3].","PeriodicalId":73635,"journal":{"name":"Journal of cardiology & cardiovascular therapy","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-08-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47303583","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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