Search

Different lifestyles have an impact on useful metabolic functions, causing disorders. Different lipids are involved in the metabolic functions that play various vital roles in the body, such as structural components, storage of energy, in signaling, as biomarkers, in energy metabolism, and as hormones. Inter-related disorders are caused when these functions are affected, like diabetes, cancer, infections, and inflammatory and neurodegenerative conditions in humans. During the Covid-19 period, there has been a lot of focus on the effects of metabolic disorders all over the world. Hence, this review collectively reports on research concerning metabolic disorders, mainly cardiovascular and diabetes mellitus. In addition, drug research in lipid metabolism disorders have also been considered. This review explores lipids, metabolism, lipid metabolism disorders, and drugs used for these disorders.

Hypertension is a most common cardiovascular disorder posing a major public health challenge to the population. Many factors e.g. heredity, obesity, sedentary habits, stressful life and many more makes a person prone to develop hypertension. Homoeopathy is a holistic system of treatment; it works on individuality of every patient. So, there is no medicine for hypertension, but for the patient. There is a wider scope for the hypertensive patient and homoeopathy works effectively on many accompanying complaints with hypertension and hypertension itself.

Hypertrophic cardiomyopathy (HCM) is a complex heterogeneous cardiovascular disorder characterized by hypertrophied and disorganized myocytes with varying degrees of interstitial fibrosis. The current management strategies include genetic and familial screening, symptom control and prevention of sudden cardiac death in those at high risk. Until recently, septal reduction therapy and heart transplantation were the only disease modifying treatments available to manage HCM, but emerging pharmacotherapies show promising results in controlled clinical trials. In this article, we will review the unmet needs in the treatment of HCM incorporating novel therapies.

Glucagon-like peptide-1 receptor (GLP-1R) agonists are a class of newly introduced antidiabetic medications that potentially lower blood glucose by several molecular pathways. DPP-4 inhibitors are the other type of novel antidiabetic medications which act by preventing GLP-1 inactivation and thereby increasing the activity levels of GLP-1, leading to more glucose-induced insulin release from islet β-cells and suppression of glucagon release. Most patients with diabetes have concurrent hypertension and cardiovascular disorder. If antihyperglycemic agents can attenuate the risk of hypertension and cardiovascular disease, they will amplify their overall beneficial effects. There is conflicting evidence on the cardiovascular benefits of GLP-1R induction in laboratory studies and clinical trials. In this study, we have reviewed the main molecular mechanisms by which GLP-1R induction may modulate the cardiovascular function and the results of cardiovascular outcome clinical trials.

The number of deaths due to heart attacks increases enormously day after day due to increased globalization. Cardiovascular disorder (CVD) is the name for the type of cardiac and blood artery disorders, namely hypertension (high blood pressure), coronary heart disease (heart attack), stroke, heart failure, rheumatic heart disease and congenital heart disease, stroke and several more. The overall projected death rate is 17.9 million, 30 percent of which is due to CVD. The vast majority of survivors of heart attacks take some steps to minimize their risk of another occurrence, but the concern is that most do not track or control all modifiable risk factors. Much of the time, cardiac failure or heart stroke inevitably happens and patients are unable to comprehend their symptoms. Researchers also found that prior to a heart attack, the body gives signs of abnormal heart functioning. If human beings can save their lives easily if these signs are captured and analysed and proper treatment and advice or proper guides are taken. Survey indicates that the latest growth of IoT in the improvement of health care system.

Background: coronary artery disease is one of the most common types of cardiovascular disorder and it occurs when the coronary artery that supply blood to the heart muscle is compromised due to the accumulation of materials such as plaque/cholesterol atherosclerosis risk factors associated with coronary artery disease men are susceptible at 45, women at 55 include age, gender, genetics, etc, Objective: To identify the patients at elevated risk for CAD, To identify patients required further investigation to confirm the diagnosis of CAD, To describe a management plan including lifestyle changes, medications, psychosocial support, cardiac rehabilitation, etc. Methods: A prospective observational study was conducted for a period of 6 months, from CAD patients attending max cure hospital. The data was collected from the participants after consent. Relevant patient lifestyles and lab data were documented in the data collection form (DCF). Results: The study findings are according to parameter wise, age categorization defines that in 51-60 ranging age group 27.22% that is the highest percent affected people are observed with CAD. Of the total number of subjects participated in the study (n=202) the gender-wise comparison males (144) are more than females (58).To observe patient region, urban people (68%) are mostly affected with CAD than rural people (32%). To identify risk factors of CAD, patients with DM (34.67%), HTN (23%), smoking (17.32%), alcohol (25.74%), and obesity (13.86%) are the major risk factors associated with CAD. Based on family history a total of 21 members were identified out of 202, among them with CAD were 7, with CKD were 6, with HTN were 5 and with DM were 3 members respectively. According to the past history in a total of 202 members, patients with Cerebrovascular accidents were 4, patients with MI/UA were 20, and CKD were 4 respectively. Conclusion: Evaluation of risk factors in patients with coronary artery disease in a tertiary care hospital was observed. Age, Diabetes mellitus, Hypertension, Smoking, Alcohol, and Obesity are more causing risk factors than others.

Objective Affecting 1 in 500 individuals; Hypertrophic cardiomyopathy (HCM) is an autosomal dominant cardiovascular disorder which is prevalent throughout the world. Surgical myectomy and alcohol septal ablation (ASA) are two methods currently used for the management of drug refractory Hypertrophic obstructive cardiomyopathy (HOCM). ASA may prove to be a useful, less invasive tool when confronting patients with HOCM especially those who are more elderly or deemed to be a higher surgical risk. Methods Electronic literature search was conducted to identify relevant articles that discussed invasive methods to treat drug refractory HOCM. No limits were placed on timing of the publication or the type of article. Key words and MeSH terms were used to conduct the search and the results were summarized in the relevant section. Results Current evidence suggests that alcohol septal ablation is a safe and effective procedure in treating patients with HOCM with similar short- and long-term outcomes when compared with surgical myectomy. Selection of patient with appropriate assessment is the key for satisfactory outcomes. Conclusion ASA has been shown to be a safe and reliable procedure; advanced imaging techniques and dedicated multi-disciplinary teams can be used to carefully select patients with HOCM. Though surgical myectomy is recommended as gold standard treatment for drug refractory HOCM, however, ASA may play an increasing role in the near future due an ageing population; both ASA and SM can have a synergistic effect in treating those who are affected by HOCM.

Maze‐like linear substrate modification in atrial fibrillation patients nonresponders to pulmonary vein isolation represents a feasible technique to gain left atrial appendage electrical isolation even in the presence of a Watchman occluder device.

Background β-Adrenergic blockers (BBs) have been associated with increased risk for severe anaphylactic reaction (AR) from contrast media; however, this was shown with intravenous contrast media, before widespread use of low osmolar contrast media, angiotensin-converting enzyme-inhibitors (ACE-Is), and cardioselective BBs. Objective To assess the risk for AR during cardiac catheterization (CC) associated with BB or ACE-I exposure. Methods Patients who experienced adverse reactions during CC from January 2004 to December 2013 were identified; 1 to 2 matched controls were assigned for each case. We analyzed AR rates in association with demographic variables, medication exposures (BBs, ACE-Is, angiotensin-receptor blockers, aspirin), and comorbidities: cardiovascular disorders, asthma, and atopy. Results We analyzed 71,782 CCs. Of these, severe 70 reactors were identified—46 (0.06%) fulfilled AR criteria. There were 35 cases of mild to moderate AR and 11 cases of severe AR (0.015%). There were no significant differences in age (61.3% vs 61.5%), sex (63% vs 64% males), cardiovascular disorder rate (78% vs 93%), and exposure to BBs (46% vs 51%; cardioselective: 77% vs 80%) and ACE-Is (37.0% vs 37.2%) in cases versus controls. Via multivariate logistic regression, BB exposure was not associated with greater AR frequency (P = .35) or severity (P = .40). Neither cardioselective BBs (P = 0.2) nor noncardioselective BBs (P = .5) influenced AR severity. ACE-Is had no effect on AR frequency (P = .35) or severity (P = .14). Lower AR frequency was associated with cardiovascular disorder (P = .01). Conclusions In this case-control study, severe AR was rarely observed. Exposure to BBs or ACE-Is did not significantly influence AR frequency or severity; however, most BBs were cardioselective. Our findings imply that cardioselective BB or ACE-I suspension is not warranted in association with CC.

Objective: To assess the prevalence of comorbidities and periodontal diseases severity in dental patients and to determine the socio-demographic, behavioral, and comorbidity-related predictors of periodontal diseases severity.Material and methods: This retrospective study sample consisted of 2458 patients who referred to faculty dentistry clinic. Socio-demographic, behavioral, and comorbidity characteristics of study participants were collected using hospital database and self-reported questionnaire. Descriptive, bivariate, and multivariate analyses were used to analyze study data.Results: Of these patients, 55.2% had mild-to-moderate periodontitis and 44.8% had severe periodontitis. The severity of periodontal disease was significantly associated with the presence of comorbidity, the number of comorbidities, age, gender, income level, smoking, and alcohol consumption. Patients with severe periodontitis were more likely being a current smoker, to report drinking alcohol sometimes or every day, to be a male, to have a pulmonary disease, to have an endocrinological and metabolic disorder, to have a cardiovascular disorder and to have a neurological disorder than those with mild/moderate periodontitis. Having a hematological disorder, having a muscle, skeletal and connective tissue disorder, to be a current smoker and lower age were found to be predictors of moderate periodontitis whereas being a female and lower number of comorbidities were predictors of mild periodontitis.Conclusions: The severity of periodontitis was associated with socio-demographic, behavioral, and comorbidity characteristics of periodontal patients.

The syndrome of heart failure (HF) with preserved ejection fraction (HFpEF) is now recognized to account for up to half of HF cases and is the dominant form of HF in older adults, especially women. Multiple factors conspire in this predilection of HFpEF for older women. This review will discuss the epidemiology, pathophysiology, prognosis, and treatment of HFpEF with emphasis on the similarities and differences in cardiovascular aging changes, and the differential impact of comorbidities in women versus men. Responses to pharmacologic and lifestyle interventions are also reviewed. We conclude by suggesting future directions for both prevention and treatment of this common and highly morbid cardiovascular disorder.

Preeclampsia is a life-threatening pregnancy-associated cardiovascular disorder characterized by hypertension and proteinuria at 20 weeks of gestation. Though its exact underlying cause is not precisely defined and likely heterogenous, a plethora of research indicates that in some women with preeclampsia, both maternal and placental vascular dysfunction plays a role in the pathogenesis and can persist into the postpartum period. Potential abnormalities include impaired placentation, incomplete spiral artery remodeling, and endothelial damage, which are further propagated by immune factors, mitochondrial stress, and an imbalance of pro- and antiangiogenic substances. While the field has progressed, current gaps in knowledge include detailed initial molecular mechanisms and effective treatment options. Newfound evidence indicates that vasopressin is an early mediator and biomarker of the disorder, and promising future therapeutic avenues include mitigating mitochondrial dysfunction, excess oxidative stress, and the resulting inflammatory state. In this review, we provide a detailed overview of vascular defects present during preeclampsia and connect well-established notions to newer discoveries at the molecular, cellular, and whole-organism levels.

Hypertrophic cardiomyopathy (HCM) is the most common genetic cardiovascular disorder, characterized by asymmetric hypertrophy of the interventricular septum that leads to intermittent obstruction of the left ventricular outflow tract (LVOT). Clinical presentation ranges from the absence of symptoms to sudden death at any age. Anesthesia and surgical stress can lead to exacerbation of the LVOT obstruction and may complicate the perioperative course. We hereby describe the perioperative management of two patients with HCM posted for orthopedic surgery.

Background: This case highlights the importance of motivational interviewing in a rare condition with comorbid psychiatric symptomology. Epstein-Barr Virus (EBV) induced myopericarditis has not been described in a healthy young woman. Her anxiety symptoms complicated the diagnosis of this condition. Case presentation: Ms. A is an otherwise healthy 26-year-old female with a history of generalized anxiety disorder. She presented to the emergency department with anxiety and a sense of impending doom. Her family history is positive for hypertension and unspecified mental health issues. She refused workup due to panic symptoms but was persuaded through motivational interviewing. Eventual cardiac MRI revealed viral induced myopericarditis. The outcome was both resolution of her cardiovascular and psychiatric symptomology. Conclusion: The implications of this case report is the value of addressing psychological resistance to pathophysiological workup. Once her concerns were addressed through psychological and psychopharmacological methods, a rare cardiovascular disorder was identified and treated. The lesson for healthcare providers is that nonjudgmental interviewing can lead to the diagnosis of very uncommon diseases.

Objective: To explore the association between statin therapy and the risk of erectile dysfunction by literature review. Methods: We conducted diversities of search strategies including electronic database searches of MEDLINE, Scopus, Pubmed and Web of Science using MeSH terms, keywords and title words during the search. Reference lists of identified and public articles were reviewed. In addition, only English articles were considered and case reports were not concerned in the review. The key features of recognized applicable search studies were considered and the conclusions were summarized in a narrative review. Results: Different studies gave a consensus that erectile dysfunction was regarded as an early sign of silent cardiovascular disorder and hidden atherosclerosis. Different studies reported that statins might induce erectile dysfunction through induction of peripheral neuropathy, cognitive deficits, and reduction of circulating testosterone. However, most of recent studies illustrated that statins led to a significant improvement in erectile function and sexual health in men with age over forty years. Atorvastatin advanced endothelial nitric oxide concentrations through activation and upregulation of endothelial nitric oxide synthase and rescued phosphodiesterase-5 inhibitors non-responders since nitric oxide and cyclic guanosine monophosphate increased penile blood flow and improved erectile function. Conclusions: According to the assorted view of preponderance, statins improved erectile dysfunction is more dominant than statins induced erectile dysfunction. Therefore, statins regardless of its property improve erectile dysfunction through amelioration of penile endothelial dysfunction, and penile neuronal reflexes that are inter-related during sexual excitation and penile erection.

Hypertrophic cardiomyopathy (HCM) is the most common inherited cardiovascular disorder, affecting 1 in 500 people in the general population. Although characterized by asymmetric left ventricular hypertrophy, cardiomyocyte disarray, and cardiac fibrosis, HCM is in fact a highly complex disease with heterogenous clinical presentation, onset, and complications. While HCM is generally accepted as a disease of the sarcomere, variable penetrance in families with identical genetic mutations challenges the monogenic origin of HCM and instead implies a multifactorial cause. Furthermore, large-scale genome sequencing studies revealed that many genes previously reported as causative of HCM in fact have little or no evidence of disease association. These findings thus call for a re-evaluation of the sarcomere-centered view of HCM pathogenesis. Here, we summarize our current understanding of sarcomere-independent mechanisms of cardiomyocyte hypertrophy, highlight the role of extracellular signals in cardiac fibrosis, and propose an alternative but integrated model of HCM pathogenesis.

Advanced age is associated with a decline in response to stress. This contributes to the establishment of chronic inflammation, one of the hallmarks of aging and age-related disease. Heat shock proteins (HSP) are determinants of life span, and their progressive malfunction leads to age-related pathology. To discuss the function of HSP on age-related chronic inflammation and illness. An updated review of literature and discussion of relevant work on the topic of HSP in normal aging and chronic inflammatory pathology was performed. HSP contribute to inflamm-aging. They also play a key role in age-associated pathology linked to chronic inflammation such as autoimmune disorders, neurological disease, cardiovascular disorder, and cancer. HSP may be targeted for control of their effects related to age and chronic inflammation. Research on HSP functions in age-linked chronic inflammatory disorders provides an opportunity to improve health span and delay age-related chronic disorders.

Long QT syndrome (LQTS) is a cardiovascular disorder characterized by an abnormality in cardiac repolarization leading to a prolonged QT interval and T-wave irregularities on the surface electrocardiogram. It is commonly associated with syncope, seizures, susceptibility to torsades de pointes, and risk for sudden death. LQTS is a rare genetic disorder and a major preventable cause of sudden cardiac death in the young. The availability of therapy for this lethal disease emphasizes the importance of early and accurate diagnosis. Additionally, understanding of the molecular mechanisms underlying LQTS could help to optimize genotype-specific treatments to prevent deaths in LQTS patients. In this review, we briefly summarize current knowledge regarding molecular underpinning of LQTS, in particular focusing on LQT1, LQT2, and LQT3, and discuss novel strategies to study ion channel dysfunction and drug-specific therapies in LQT1, LQT2, and LQT3 syndromes., Graphical abstract

BACKGROUND Little is known regarding whether hyperoxic reoxygenation was associated with higher risk of cardiovascular disorder following tetralogy of Fallot repair. METHODS We performed a nested case-control study among patients aged 1 month-18 years undergoing complete repair of tetralogy of Fallot in 2012-2018. We measured the highest perfusate oxygenation (PpO2) during aortic occlusion in 107 cardiovascular disorder cases and in 321 controls matched 1:3 to the cases on date of surgery, sex, and area of residence. We analyzed the association between PpO2 and outcome using multivariable conditional logistic regression adjusted for covariates. We further identified and integrated the risk covariates to build prediction nomograms. RESULTS Cases had higher percentage of exposure to PpO2 > 200 mmHg (86.0% vs. 76.1%, p = .019) than controls. Patients with PpO2 > 200 mmHg had an increased risk of cardiovascular disorder compared to those with PpO2 ≤ 200 mmHg (odd ratio [OR] = 2.075, 95% confidence interval [CI] = 1.035, 4.158, p = .039) adjusted for matching, clinical and procedural covariates. Categorical PpO2, lower body mass index, lower SpO2, untreated minor aortopulmonary collateral arteries, high immediately postoperative central venous pressure, and longer cardiopulmonary bypass time were independent risk factors for cardiovascular disorder (all p

Many studies have approved that COVID-19 disease was caused by Middle East respiratory syndrome coronavirus (MERS-CoV), severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), severe acute respiratory syndrome coronavirus-1(SARS-CoV-1), and has spread as an epidemic from across the world today. Initially, it affects the upper respiratory tract, induces viral infection in the lungs, and causes severe pneumonia in the COVID-19 infected patients. After the infection in the body, changes appear in other biomarkers in the body therby imbalancing the body response studied by the virus's pathophysiology. However, this infection starts comorbidity directly and indirectly in COVID-19 infected patients. During this period of infection, the immune system is also suppressed by the virus and initiates other diseases. The authors focus on the cardiovascular comorbidity study of COVID-19 in the current work. In the comorbidity study of COVID-19, the virus mainly affects hypertension patients. The risk factor of comorbidity of hypertension and cardiovascular disorder is 30.7%, and 11.9% with diabetes mellitus. In this study, we reveal the pathophysiology, treatment, and management of cardiovascular diseases, their risk factor, and medicine results on the COVID-19 infected patients. SARS-CoV-2 primarily targets ACE-2 receptors because this virus receives this receptor as a host for the cellular entry of the virus in the body, these shows down regulations in the maintenance of BP, and the body suffers from multi-organ failure. The other diseases related to CVS are Inflammatory cardiomyopathy, congestive heart failure, irregular heartbeat, embolism events, and Coronary infarction that also affect its pathophysiology.

Orthostatic hypotension is a common cardiovascular disorder, highly prevalent in the elderly, especially in patients with multiple comorbidities. It is considered a manifestation of the autonomic nervous system dysfunction and associated with coronary artery disease, heart failure, stroke, cognitive dysfunction, and increased mortality rates. Specific pharmacological and non-pharmacological management have been established for the treatment. However, the impact of these therapies on morbidity and mortality is not fully defined. In non-pharmacological management, lifestyle changes and therapeutic maneuvers are accepted methods. For individuals with persistent symptoms, pharmacological treatments that increase blood volume and peripheral vascular resistance are clinically in use. Treatment aims are to improve the symptoms and provide quality of life.

Teaching point: Hoarseness is a common condition that can be the initial symptom of cardiovascular disorder.

The coronavirus disease 2019 (COVID-19) pandemic is currently the biggest public health concern across the globe. On a global scale, from December 2019 to September 2020, more than 34,114,000 people were infected with the disease, with 1,016,000 deaths recorded (1). Although the etiology of the disease has long been investigated, it is still a harsh challenge for the medical and scientific community. COVID-19 infection is complex, and the risk factors are different from the known viral respiratory infections. People with chronic inflammatory diseases (such as obesity, hypertension, diabetes, and cardiovascular disorder) are at a huge risk of developing moderate to severe symptoms and being hospitalized in the intensive care unit (ICU) (2, 3). The most common phenomena among these conditions are chronic low-grade inflammation and increased cardiovascular complications. Several evidences have been put forward to support the association between COVID-19 and thromboinflammation (3, 4). Specifically, venous thrombosis has been found to be causally related to pulmonary embolism in many cases (5). Exercise is well-known for having a prophylactic and therapeutic effect on chronic inflammatory diseases, with a high impact on the vascular system. Furthermore, it has been reported that exercise may decrease the severity of infectious diseases and number of days of disease symptoms (6). Consistent with this, it is speculated that regular exercise represents a protective factor against the severity of COVID-19 relating to thromboinflammation and its complications.

Background Cannabis use is increasing in women of reproductive age, but whether cannabis use disorders increase the long-term risk of cardiovascular disease in this population is not known. Cannabis may cause tachycardia, hypertension, cerebral vasoconstriction, and other adverse cardiovascular effects and has been associated with acute myocardial infarction and stroke. Data on the long-term effects of cannabis on the cardiovascular system are more limited. We assessed the relationship between cannabis use disorders early in life and the future risk of cardiovascular disease in women. Methods We analyzed a longitudinal cohort of 1,247,035 pregnant women in Quebec, Canada, between 1989 and 2019. The main exposure was current or past history of cannabis use disorders at cohort entry. The main outcome measure included future hospital admission for any cardiovascular disorder during 18,998,986 person years of follow-up. We used Cox proportional hazards regression models adjusted for patient characteristics to compute hazard ratios (HR) and 95% confidence intervals (CI) for the association of cannabis use disorder with the later risk of cardiovascular hospitalization. Results Women with cannabis use disorders had a higher incidence of cardiovascular hospitalization than unexposed women (58.4 vs. 33.6 per 10,000 person years). Cannabis use disorder was associated with 1.48 times the risk of cardiovascular hospitalization (95% CI 1.27–1.72), compared with no cannabis use disorder. The association was greater for cannabis with concomitant use of other substances (HR 1.84, 95% CI 1.53–2.21) than for cannabis alone (HR 1.30, 95% CI 0.99–1.72). Cannabis use disorder was strongly associated with hemorrhagic stroke, even with adjustment for other substance use (HR 2.08, CI 1.07–4.05). Conclusions Cannabis use disorders may increase the long-term risk of cardiovascular disease in women, particularly hemorrhagic stroke. However, some of the excess risk may be due to concomitant use of other substances.

“The real voyage of discovery consists not in seeking new landscapes, but in having new eyes”—Marcel Proust. New perspectives can require a paradigm shift, and then innovative concepts can arise from incidental but penetrating insights. A new disease entity might require new diagnostic and conceptual approaches before achieving general acceptance. The establishment of diagnostic criteria is based on experience and essential differentiation from similar pathologies and secondary conditions. Essential pathophysiological and genetic approaches might lead to novel therapeutic methods that could rescue patients from lethal events. Hirano et al identified triglyceride deposit cardiomyovasculopathy (TGCV) in a patient who received a heart cardiac transplant in Japan during 2008.1 2 Microscopy revealed atherosclerotic triglyceride, rather than cholesterol deposits, in the coronary arteries, and numerous vacuoles in cardiomyocytes of the explanted heart. Genetic analysis discovered that the patient harboured a mutation in the adipose triglyceride lipase gene. One established cause of TGCV is a genetic deficiency of adipose triglyceride lipase that plays a key role in intracellular triglyceride hydrolysis. Thus, TGCV was encoded as a rare cardiovascular disorder in Orphanet (ORPHA code: 565612).3 This editorial discusses how to recognise and diagnose TGCV using current methods and provides some suggestions to help understand this rare disease entity. The principal disorder in TGCV is defective intracellular lipolysis, which causes excessive triglyceride accumulation in the myocardium and coronary artery vascular smooth muscle cells, leading to heart failure and coronary artery disease with a poor prognosis. The total number of patients diagnosed with TGCV in Japan between 2008 and 2014 was

Hypertrophic cardiomyopathy (HCM) is a common known monogenetic cardiovascular disorder which frequently leads to symptoms such as dyspnea and exercise intolerance. Current guideline-recommended pharmacotherapies have variable therapeutic responses. Mavacamten, a small molecule modulator of β-cardiac myosin, reduces hypercontractility, a central mechanism in the pathogenesis of HCM. Mavacamten has recently been evaluated in Phase 2 and 3 clinic trials for obstructive and nonobstructive symptomatic HCM.This article reviews available preclinical and clinical trials assessing the efficacy and safety of Mavacamten for the treatment of symptomatic obstructive and nonobstructive HCM.Findings from Phase 2 and 3 trials suggest that Mavacamten represents a very promising new therapy for the treatment of symptomatic patients with HCM. Treatment leads to an improvement in symptomatic and physiologic metrics for symptomatic patients with HCM with minimal adverse events. Patients with obstructive HCM demonstrated a significant improvement in LVOT gradient, NYHA functional class, Kansas City Cardiomyopathy Questionnaire (KCCQ), Overall Summary Score (OSS), and numerical rating scale (NRS) dyspnea scores; and patients with both obstructive and nonobstructive HCM had significant improvement in serum N-terminal pro-B-type natriuretic peptide (NT-proBNP) concentrations.

Hypertrophic cardiomyopathy, an inherited autosomal dominant disease, is the most common familial cardiovascular disorder and presents with heterogeneous pathobiological, clinical, and phenotypic features. This review will explore how multimodality cardiovascular imaging offers insight into understanding and identifying these heterogeneous features which are important to reliably diagnose and risk stratify patients with HCM. Beyond the left ventricular (LV) hypertrophy, multimodality imaging is able to fully characterize a number of structural and functional abnormalities seen in HCM such as mitral valve leaflet elongation, abnormal chordal attachment, accessory apical-basal muscle bundle, papillary muscle abnormalities, LV outflow tract (LVOT) obstruction, microvascular dysfunction, and fibrosis. These anatomical and functional abnormalities contribute to the spectrum of different HCM presentations. Recent research shows that various morphological subtypes of HCM present with distinct clinical, genetic, LVOT, and fibrosis characteristics. Late gadolinium enhancement as assessed by cardiac magnetic resonance imaging (CMR) is useful in risk stratification of patients with HCM. In addition, native T1 and extracellular volume may add to prognostication. Strain, as measured by echocardiography and CMR, and novel techniques, such as positron emission tomography, have shown promise in determining prognosis in HCM. Computed tomography evaluates not only for obstructive coronary artery disease, but also for variations in coronary anatomy. Complimentary use of these imaging modalities is crucial in comprehensive evaluation of HCM as well as in diagnosing various features of HCM, differentiating it from other cardiomyopathies, and in identifying prognosis.

Summary Background Congenital portosystemic shunts are rare vascular malformations that may have an impact on the heart-lung system. Associated congenital and/or acquired heart diseases are poorly reported. Aims To analyse cardiovascular disorders within a large congenital portosystemic shunt population, and develop a diagnostic strategy. Methods Among the 168 consecutive fetuses and children referred for congenital portosystemic shunt (1996–2019), patients presenting with at least one cardiovascular disorder, including congenital heart disease, heart failure, portopulmonary hypertension and/or hepatopulmonary syndrome, were reviewed retrospectively. Cardiovascular disorders were detected using echocardiography and one or more of the following: right-sided heart catheterization; contrast-enhanced transthoracic echocardiography; or lung perfusion radionuclide scan. Results Overall, 46/168 patients with a congenital portosystemic shunt (27.4%) had one or more clinically significant cardiovascular disorders. Congenital heart disease was present in 28 patients, including six with left heterotaxy. Heart failure was present in six fetuses and 21 neonates (eight without congenital heart disease, and 13 with congenital heart disease). In neonates without congenital heart disease, heart function recovered by the age of 3 years. Portopulmonary hypertension was identified in 11 patients (mean age at diagnosis: 9 years); it was fatal in one patient, and remained stable in five of six patients after congenital portosystemic shunt closure. In six patients, hepatopulmonary syndrome presented as hypoxia (mean age at diagnosis: 5.3 years), which reversed after congenital portosystemic shunt closure. Conclusions Evaluation and monitoring of the cardiopulmonary status of patients with a congenital portosystemic shunt is mandatory to detect and prevent cardiovascular complications. Furthermore, congenital portosystemic shunts must be sought in patients with unexplained cardiovascular disorders, especially when malformations are present.

Background: Atrial fibrillation is a common cardiovascular disorder, characterized by irregular electrical activity in the upper chambers of the heart. Both chronic cardiometabolic risk factors and genetics have been shown to contribute to the development of atrial fibrillation. Birthweight has also been associated with risk of atrial fibrillation. Methods: In the current study, we utilized a genetic approach to study the effect of birthweight on atrial fibrillation. We used 2-sample Mendelian randomization to consider the impact of birthweight on incident atrial fibrillation using summary data from the Early Growth Genetics Consortium GWAS of birthweight and a large biobank-based GWAS of atrial fibrillation. Results: Using the framework of 2-sample Mendelian randomization, we found that a 1-SD genetic elevation of birthweight was associated with increased risk of atrial fibrillation (odds ratio, 1.27 [95% CI, 1.14–1.41]; P =1×10 −5 ) with sensitivity analyses demonstrating robustness of this result. Conclusions: Our findings clarify the directionality of the relationship between birthweight and atrial fibrillation, supporting the growing body of evidence that intrauterine growth has a lifelong impact on cardiovascular health.

Introduction: Hypertension is a cardiovascular disorder rapidly emerging as a major health problem in developing countries. Uncontrolled or poorly managed hypertension leads to several complications such as coronary heart disease, peripheral vascular disease and kidney disease. These complications account for approx 9.4 million deaths worldwide every year. Consequently, it is an urgent need for authorities to act upon this issue. This study was done to determine the prevalence of Hypertension in Deurali village of Nuwakot. Methods: A descriptive cross-sectional study was done in the Deurali Village of Nuwakot district from May 2019 to July 2019. Ethical approval was taken from the Ethical Review Board of Nepal Health Research Council. A simple random sampling method was applied. Blood pressure was measured on three occasions along with the use of a self-administered questionnaire. Descriptive statistical analysis was done. Results: The study showed the prevalence of hypertension among the adult population to be 20 (8.5%) [8.5%±1.83% at 95% CI]. Prevalence was found to be higher among female than male. Age group more than 60 were major sufferers of the condition. The study population consisted of the majority of Tamang community. Almost 213 (91%) participants were reported to have taken alcohol at some point in their life whereas only 104 (45%) were smokers. Conclusions: The prevalence of hypertension was found to be lower than the previous study done in similar settings.

Cardiovascular disease is associated with significant mortality in zoo-housed great apes and yet little is know about its epidemiology and aetiopathogenesis, and therefore its diagnosis, treatment and prevention. In this retrospective study, the frequency and patterns of cardiovascular disease associated mortality in zoo-housed great apes is explored. Data relating to 71 great apes [Bonobos Pan paniscus (n = 13), Chimpanzees Pan troglodytes (n = 37), Western lowland gorillas Gorilla gorilla gorilla (n = 15), and Bornean orangutans Pongo pygmaeus and Sumatran orangutans Pongo abelii (n = 6)], which died between 2004 and 2014, were studied and key information relating to their signalment (taxa, age, sex), and manner and cause of death analysed. Male sex and increasing age were found to be associated with an increased risk of cardiovascular disease associated death. Relative to the other taxa, orangutans appeared to be less at risk of heart-disease associated mortality. Deaths were often found to be sudden and unexpected. Cardiomyopathies were the most frequently diagnosed cardiovascular disorder. Of these, a group of cardiomyopathies characterized by the presence of myocardial fibrosis were most common, although there were inconsistencies with regards the reporting of other histopathological features. The study identified potential risk factors involved in great ape cardiovascular disease aetiopathogenesis which warrant further exploration. The findings also suggest a need for proactive screening to identify those affected earlier in the disease course. Finally, the study highlights a critical need for improvements to be made to the current approach to post-mortem investigation of great ape heart disease and the subsequent reporting of cardiovascular lesions.

Arterial hypertension (AH) remains one of the most prevalent cardiovascular disorder in the world, as one of the main risk factors of myocardial infarction and stroke development. Monotherapy of AH is effective in no more than one half of patients even with moderate increase of blood pressure. Combinational antihypertension treatment does influence pathogenetic mechanisms of AH being an optimal solution. It is worthful to apply a fixed combination of telmisartan and hydrochlorothiazide. Such combination provides additional antihypertensive effect with more significant decrease of blood pressure than for the components separately. Also it is protective for organs and tissues that makes it to prescribe such combination to a broad range of patients.

Abstract: We present cases of blinding spontaneous suprachoroidal haemorrhage in anticoagulant taking wet-AMD patients. A retrospective study has been performed to present the clinical course, management and final outcome of spontaneous suprachoroidal haemorrhage in 7 eyes of six age-related macular degeneration patients seen in our clinic from January 2016 to April 2017. All patients were on chronic oral anticoagulant therapy because of cardiovascular disorder. In one patient, haematological disorder was also present modifying significantly the haemostasis. All eyes received prior anti-VEGF treatment for exsudative AMD. Acute angle closure glaucoma – with no response to topical and oral IOP lowering therapy – was the most frequent ocular complication in our cases. The final visual prognosis was usually very poor. The risk of spontaneous suprachoroidal haemorrhage is increased in wet-AMD patients who are on anticoagulant therapy. To prevent this blinding condition, a stronger communication between ophthalmologists and cardiologists would be beneficial, with an ophthalmological check-up in this group of patients before and during the use of anticoagulants. Orv Hetil. 2018, 159(24): 985–990.

The present review examines the recent advances in psychological interventions for two major lifestyle disorders in adults namely, type 2 diabetes mellitus and cardiovascular disorders. The review summarizes findings from studies carried out between the years 2015 and 2017.The effectiveness of psychological interventions in the management of lifestyle disorders has been examined with respect to adaptation, self-care, adherence, negative emotions and improving quality of life. There is an increasing recognition that psychological interventions are important for prevention of lifestyle disorders and promotion of health. Key psychological interventions include self-management and educational interventions based on learning and motivational principles, patient empowerment, cognitive behaviour therapy, behavioural skills and coaching. Recent developments also include the use of information technology to deliver these interventions through internet, mobile applications and text messages. Another significant development is that of mindfulness-based interventions within the third-generation behaviour therapy approaches to reduce distress and increase acceptance. In addition, family and couples interventions have also been emphasised as necessary in maintenance of healthy behaviours.Studies examining psychological interventions in cardiovascular and type 2 diabetes mellitus support the efficacy of these interventions in bringing about changes in biochemical / physiological parameters and in psychological outcomes such as self-efficacy, knowledge, quality of life and a sense of empowerment.

Chronic heart failure is a cardiovascular disorder with high prevalence and incidence worldwide. The course of heart failure is characterized by periods of stability and instability. Decompensation of heart failure is associated with frequent and prolonged hospitalizations and it worsens the prognosis for the disease and increases cardiovascular mortality among affected patients. It is therefore important to monitor these patients carefully to reveal changes in their condition. Remote monitoring has been designed to facilitate an early detection of adverse events and to minimize regular follow-up visits for heart failure patients. Several new devices have been developed and introduced to the daily practice of cardiology departments worldwide. Areas covered: Currently, special tools and techniques are available to perform remote monitoring. Concurrently there are a number of modern cardiac implantable electronic devices that incorporate a remote monitoring function. All the techniques that have a remote monitoring function are discussed in this paper in detail. All the major studies on this subject have been selected for review of the recent data on remote monitoring of HF patients and demonstrate the role of remote monitoring in the therapeutic decision making for heart failure patients. Expert commentary: Remote monitoring represents a novel intensified follow-up strategy of heart failure management. Overall, theoretically, remote monitoring may play a crucial role in the early detection of heart failure progression and may improve the outcome of patients.

Background: Hypertrophic cardiomyopathy (HCM) is a genetic cardiovascular disorder, primarily involving mutations in sarcomeric proteins. HCM patients present with hypertrophy, diastolic dysfunction, and fibrosis, but there is no specific treatment. The sphingosine-1-phosphate receptor modulator, FTY720/fingolimod, is approved for treatment of multiple sclerosis. We hypothesize that modulation of the sphingosine-1-phosphate receptor by FTY720 would be of therapeutic benefit in sarcomere-linked HCM. Methods: We treated mice with an HCM-linked mutation in tropomyosin (Tm-E180G) and nontransgenic littermates with FTY720 or vehicle for 6 weeks. Compared with vehicle-treated, FTY720-treated Tm-E180G mice had a significant reduction in left atrial size (1.99±0.19 [n=7] versus 2.70±0.44 [n=6] mm; P P =0.004) as assessed by echocardiography. Results: Pressure-volume relations revealed significant improvements in the end-diastolic pressure volume relationship, relaxation kinetics, preload recruitable stroke work, and ejection fraction. Detergent-extracted fiber bundles revealed a significant decrease in myofilament Ca 2+ -responsiveness (pCa 50 =6.15±0.11 [n=13] versus 6.24±0.06 [n=14]; P =0.041). We attributed these improvements to a downregulation of S-glutathionylation of cardiac myosin binding protein-C in FTY720-treated Tm-E180G mice and reduction in oxidative stress by downregulation of NADPH oxidases with no changes in fibrosis. Conclusions: This is the first demonstration that modulation of S1PR results in decreased myofilament-Ca 2+ -responsiveness and improved diastolic function in HCM. We associated these changes with decreased oxidative modification of myofilament proteins via downregulation of NOX2. Our data support the hypothesis that modification of sphingolipid signaling may be a novel therapeutic approach in HCM.

Heart failure (HF) is a common cardiovascular disorder and is associated with increased morbidity and mortality. HF is usually detected in the elderly population, in particular, in patients with coronary artery disease, valvular disease, myocarditis, and hypertension. Acute decompensated HF in previously healthy young patients should raise suspicion for other rare etiologies. We report a case of a 28-year-old male presenting with acutely decompensated HF secondary to performance-enhancing drugs (PED). The use of non-regulated, non-approved PED has become a world-wide health problem with patients often unaware of the potentially serious and fatal side effects.

Triglyceride deposit cardiomyovasculopathy (TGCV) is a phenotype primarily reported in patients carrying genetic mutations in PNPLA2 encoding adipose triglyceride lipase (ATGL) which releases long chain fatty acid (LCFA) as a major energy source by the intracellular TG hydrolysis. These patients suffered from intractable heart failure requiring cardiac transplantation. Moreover, we identified TGCV patients without PNPLA2 mutations based on pathological and clinical studies. We provided the diagnostic criteria, in which TGCV with and without PNPLA2 mutations were designated as primary TGCV (P-TGCV) and idiopathic TGCV (I-TGCV), respectively. We hereby report clinical profiles of TGCV patients. Between 2014 and 2018, 7 P-TGCV and 18 I-TGCV Japanese patients have been registered in the International Registry. Patients with I-TGCV, of which etiologies and causes are not known yet, suffered from adult-onset severe heart disease, including heart failure and coronary artery disease, associated with a marked reduction in ATGL activity and myocardial washout rate of LCFA tracer, as similar to those with P-TGCV. The present first registry-based study showed that TGCV is an intractable, at least at the moment, and heterogeneous cardiovascular disorder.

Hypertrophic cardiomyopathy (HCM) is a common autosomal dominant genetic cardiovascular disorder marked by genetic and phenotypic heterogeneity. Mutations in the gene encodes the cardiac myosin-binding protein C, cMYBPC3 is amongst the various sarcomeric genes that are associated with HCM. These mutations produce mutated mRNAs and truncated cMyBP-C proteins. In this review, we will discuss the implications and molecular mechanisms involved in MYBPC3 different mutations. Further, we will highlight the novel targets that can be developed into potential therapeutics for the treatment of HMC. J. Cell. Physiol. 232: 1650–1659, 2017. © 2016 Wiley Periodicals, Inc.

Autonomic dysreflexia (AD) is a serious cardiovascular disorder in patients with spinal cord injury (SCI). The primary underlying cause of AD is loss of supraspinal control over sympathetic preganglionic neurons (SPNs) caudal to the injury, which renders the SPNs hyper-responsive to stimulation. Central maladaptive plasticity, including C-fiber sprouting and propriospinal fiber proliferation exaggerates noxious afferent transmission to the SPNs, causing them to release massive sympathetic discharges that result in severe hypertensive episodes. In parallel, upregulated peripheral vascular sensitivity following SCI exacerbates the hypertensive response by augmenting gastric and pelvic vasoconstriction. Currently, the majority of clinically employed treatments for AD involve anti-hypertensive medications and Botox injections to the bladder. Although these approaches mitigate the severity of AD, they only yield transient effects and target the effector organs, rather than addressing the primary issue of central sympathetic dysregulation. As such, strategies that aim to restore supraspinal reinnervation of SPNs to improve cardiovascular sympathetic regulation are likely more effective for AD. Recent pre-clinical investigations show that cell transplantation therapy is efficacious in reestablishing spinal sympathetic connections and improving hemodynamic performance, which holds promise as a potential therapeutic approach.

Hypertrophic cardiomyopathy (HCM) is the most common inherited cardiovascular disorder, affecting 1 in 500 individuals worldwide. Existing epidemiological studies might have underestimated the prevalence of HCM, however, owing to limited inclusion of individuals with early, incomplete phenotypic expression. Clinical manifestations of HCM include diastolic dysfunction, left ventricular outflow tract obstruction, ischaemia, atrial fibrillation, abnormal vascular responses and, in 5% of patients, progression to a 'burnt-out' phase characterized by systolic impairment. Disease-related mortality is most often attributable to sudden cardiac death, heart failure, and embolic stroke. The majority of individuals with HCM, however, have normal or near-normal life expectancy, owing in part to contemporary management strategies including family screening, risk stratification, thromboembolic prophylaxis, and implantation of cardioverter-defibrillators. The clinical guidelines for HCM issued by the ACC Foundation/AHA and the ESC facilitate evaluation and management of the disease. In this Review, we aim to assist clinicians in navigating the guidelines by highlighting important updates, current gaps in knowledge, differences in the recommendations, and challenges in implementing them, including aids and pitfalls in clinical and pathological evaluation. We also discuss the advances in genetics, imaging, and molecular research that will underpin future developments in diagnosis and therapy for HCM.

BACKGROUND: Road accidents are one of the most important issues in Iran which more than eighteen thousand persons are died annually because of this problem. Among the major reasons for this issue, sleepiness and cardiovascular disorder can be mentioned. OBJECTIVE: To investigate the association between insomnia and cardiovascular risk factors among professional drivers who are at high risk during driving. METHODS: A total of 1232 male bus drivers were included in the study and two different kinds of data sets were collected: (1) Sleep disorder information using Athens Insomnia Scale (AIS) and (2) Cardiovascular parameters such as systematic measurement of blood pressure, electrocardiography (ECG), total cholesterol, and triglyceride. RESULTS: Our study demonstrated that the prevalence of insomnia in professional bus drivers was 8 percent. The study showed significant association between age, diastolic hypertension and work experience with final awakening earlier than desired (P < 0.05), the rate of the triglyceride level and total sleep duration (p = 0.02), and BMI and sleepiness during the day (P < 0.05). CONCLUSIONS: Our study suggested that elevated serum triglyceride levels and increased diastolic blood pressure may be associated with some sleep complaints in drivers. © 2016 - IOS Press and the authors. All rights reserved.

Congestive heart failure (CHF) is a chronic and often devastating cardiovascular disorder with no cure. There has been much advancement in the last two decades that has seen improvements in morbidity and mortality. Clinicians have also noted variations in the responses to therapies. More detailed observations also point to clusters of diseases, phenotypic groupings, unusual severity and the rates at which CHF occurs. Medical genetics is playing an increasingly important role in answering some of these observations. This developing field in many respects provides more information than is currently clinically applicable. This includes making sense of the established single gene mutations or uncommon private mutations. In this thematic series which discusses the many factors that could be relevant for CHF care, once established treatments are available in the communities; this section addresses a contextual role for medical genetics.

Acquired von Willebrand syndrome is a rare bleeding disorder characterised by a later age of onset without a personal or family history of bleeding diathesis. It is vital to discern acquired von Willebrand syndrome from inherited von Willebrand disease and other acquired bleeding disorders as management differs significantly. Acquired von Willebrand syndrome is usually secondary to an underlying disorder such as lymphoproliferative disorder, myeloproliferative neoplasm, solid tumour, cardiovascular disorder, autoimmune disorders or hypothyroidism. Diagnosis is often delayed with a significant risk of morbidity and even mortality. Here we present a case of a 74-year-old man with an acquired bleeding disorder and work up suggestive of acquired von Willebrand syndrome secondary to immunoglobulin G kappa multiple myeloma. He was treated successfully with intravenous immunoglobulin, von Willebrand Factor/Coagulation Factor VIII Complex (human), myeloma directed chemotherapy and autologous stem cell transplantation. We also discuss the management strategies that are largely based on retrospective studies and case reports.

By putting more clinical focus on the numerous cardiovascular problems associated with bipolar disorder, including premature death due to heart disease, Benjamin Goldstein, M.D., Ph.D., thinks more...

Background and Objectives: Essential hypertension is a complex progressive cardiovascular disorder. Renin–angiotensin aldosterone system (RAAS) plays a major role in blood pressure regulation. Aldosterone, synthesized in the adrenal cortex by aldosterone synthase is encoded by the CYP11B2 gene. This case-control study was aiming to investigate the relationship between the aldosterone synthase gene (CYP11B2) biallelic polymorphism in the promoter at position −344 (−344C/T) with essential hypertension and left ventricular hypertrophy in the Egyptian population. Methods: This study was conducted on 100 hypertensive patients (group I) and 50 healthy control subjects (group II). Serum aldosterone, plasma renin, ARR levels were investigated. Echocardiography was done to evaluate LV dimensions. Genotyping of the CYP11B2 gene was performed by PCR/RFLP confirmed by direct sequencing. Results: Our study revealed that CYP11B2 (−344T) allele was significantly higher than (−344C) allele in hypertensive patients as compared to healthy control (OR-2.51; 95% CI:1.3–3.5; P = 0.002) and −344TT genotype was associated with increased LVMI as compared with −344CC genotype (P = 0.001). Conclusion: A Significant association was observed between the CYP11B2 (−344C/T) polymorphism and −344T allele and essential hypertension in the Egyptian population. Also, we found that the CYP11B2 −344C/T polymorphism and −344T allele are associated with left ventricular hypertrophy which may predispose to cardiovascular complications of hypertension.

An incidence of diabetes is right away growing everywhere in the world at the startling rate. For the past 3 decades, the prominence of diabetes has been substantially changed, previously it’s been taken into consideration as a minor illness of the aged humans. A gift, it has become the most critical cause of morbidity and mortality affecting the young and center-elderly people. Type 2 diabetes mellitus is an advanced situation wherein the frame become immune to the normal outcomes of insulin and little by little loses the capacity to produce sufficient insulin in the pancreas. It is related to regulating lifestyle with strong genetic and circle of relatives associated hazard elements. This overview is primarily based on associated illnesses like Liver elements, the stiffness of intermediate-sized arteries in patients and cardiovascular disorder. Diagnosis and treatment based totally on numerous metabolic pathways and anti-diabetic retailers, control of sickness with social obligation. There are numerous anti-diabetics pills which might be administered orally or through injection, the synergistic effect of a few tablets would be extra powerful due to the complex components in it. The treatment couldn’t simply be energetic and secure, it ought to additionally enhance the satisfactory of existence.

Preeclampsia (PreE), a cardiovascular disorder of pregnancy, remains a major cause of maternal and fetal mortality worldwide. The early etiology of the disorder is unclear, though increased G protein-coupled receptor signaling has been implicated. Regulator of G protein Signaling-2 (RGS2) is a negative regulator of G protein signaling, and mutations of RGS2 have been associated with increased risk for PreE in humans. Our ongoing work has demonstrated that breeding wildtype C57BL/6J dams with Rgs2 -deficient ( Rgs2 -KO; B6.129P2- Rgs2 tm1Dgen /Mmnc) sires is sufficient to cause ~50% reduced placental expression of Rgs2 mRNA, and to induce hypertension, renal and placental morphological phenotypes typical of PreE in the wildtype dams. To test the hypothesis that reduced RGS2 (via paternal contribution of an Rgs2 -null allele) is sufficient to cause molecular changes within the placenta that are typical of PreE, we performed RNA sequencing on placentas collected on gestational day 12.5 from C57BL/6J dams mated with either Rgs2 -KO sires or wildtype littermates of these sires. RNA was isolated and sequenced using an Illumina HiSeq 4000. Transcript counts were quantified and aligned to the mouse genome (UCSC genome browser) using Kallisto, followed by differential gene expression analysis using DEseq2 (FDR = 0.1). 726 genes were differentially expressed (479 up, 247 down), including some ( Hsd11b2 (up), Adm (down)), that are similarly changed in human PreE placenta (PMID: 28618048 & 26268791). Ingenuity Pathway Analysis indicated that reduced placental Rgs2 expression was associated with mitochondrial dysfunction, unfolded protein response, and oxidative stress (all p < 1e-3), which also parallels findings in human PreE placenta. Collectively these data support the conclusion that reduced Rgs2 expression in the feto-placental unit is sufficient to induce transcriptomic changes within the placenta that are typical of PreE.

usc Introduction: Heart failure (HF), a major cardiovascular disorder, remains a grievous clinical condition regardless of advances in medical care. Hyponatremia is classified as a serum sodium concentration of