Search

Diabetes is a major risk factor for cardiovascular disease. However, the exact mechanism by which diabetes contributes to vascular damage is not fully understood. The aim of this study was to investigate the role of SUMO-1 mediated SERCA2a SUMOylation in the development of atherosclerotic vascular injury associated with diabetes mellitus. ApoE−/− mice were treated with streptozotocin (STZ) injection combined with high-fat feeding to simulate diabetic atherosclerosis and vascular injury. Human aortic vascular smooth muscle cells (HAVSMCs) were treated with high glucose (HG, 33.3 mM) and palmitic acid (PA, 200 µM) for 24 h to mimic a model of diabetes-induced vascular injury in vitro. Aortic vascular function, phenotypic conversion, migration, proliferation, intracellular Ca2+ concentration, the levels of small ubiquitin-like modifier type 1 (SUMO1), SERCA2a and SUMOylated SERCA2a were detected. Diabetes-induced atherosclerotic mice presented obvious atherosclerotic plaques and vascular injury, companied by significantly lower levels of SUMO1 and SERCA2a in aorta. HG and PA treatment in HAVSMCs reduced the expressions of SUMO1, SERCA2a and SUMOylated SERCA2a, facilitated the HAVSMCs phenotypic transformation, proliferation and migration, attenuated the Ca2+ transport, and increased the resting intracellular Ca2+ concentration. We also confirmed that SUMO1 directly bound to SERCA2a in HAVSMCs. Overexpression of SUMO1 restored the function and phenotypic contractile ability of HAVSMCs by upregulating SERCA2a SUMOylation, thereby alleviating HG and PA-induced vascular injury. These observations suggest an essential role of SUMO1 to protect diabetes-induced atherosclerosis and aortic vascular injury by the regulation of SERCA2a-SUMOylation and calcium homeostasis. [ABSTRACT FROM AUTHOR]

Abstract Objective Effective time management is crucial for the survival of all patients, particularly those with cardiovascular conditions. This is especially true in the context of pre-hospital emergency services, where prompt intervention can significantly impact outcomes. This study delves into the timeliness of emergency services and the subsequent outcomes for hospitalized cardiovascular patients in EMS center in Fasa University of Medical Sciences, southern Iran. Results A total of 4972 emergency calls related to cardiac diagnoses were received between 2020 and 2023. The transport time was significantly correlated with age, location of the mission, and type of mission. Of the total, 86 underwent angioplasty within the standard time of less than 90 min, of which 81 were discharged and 5 died. 51 patients underwent angioplasty after more than 90 min, of which 47 were discharged and 4 died. In addition, 124 of these patients experienced cardiopulmonary resuscitation, of which 63 were successful and 61 were unsuccessful.

Bipolar disorder is a severe and recurring condition that has become a significant public health issue globally. Studies indicate a heightened risk and earlier onset of cardiovascular diseases among individuals with bipolar disorder, potentially increasing mortality rates. The chronic nature of bipolar disorder leads to disturbances across multiple systems, including autonomic dysfunction, over-activation of the hypothalamic-pituitary-adrenal axis and increased levels of peripheral inflammatory markers. These disruptions cause endothelial damage, the formation of plaques and blood clots, in addition to the medications used to treat bipolar disorder and genetic associations contributing to cardiovascular disease development. Understanding the complex interplay between bipolar disorder and cardiovascular events is essential for the prevention and effective management of cardiovascular conditions in individuals with bipolar disorder. Plain Language Summary Bipolar disorder is a mental health condition that affects mood and behavior, significantly impacting the lives of many people around the world. People with this disorder are also at a higher risk for heart diseases, including heart attacks and strokes. Certain lifestyle factors, common among people with bipolar disorder, such as smoking, poor diet and lack of exercise, can cause inflammation and stress, which damage blood vessels and increase the likelihood of heart conditions. The relationship between bipolar disorder and heart disease is complex. The condition affects how the body handles stress and can disrupt normal heart functions. For instance, stress from bipolar disorder can lead to high blood pressure and irregular heartbeats and certain medications taken by those with bipolar disorder can further damage the heart. To better manage these risks, it's important to understand the connection between bipolar disorder and heart disease. Future research should focus on creating guidelines for regular heart health check-ups for people with bipolar disorder and improving overall care to help prevent unfavorable outcomes. Article highlights Bipolar disorder: BD affects approximately 2.4% of the global population and is seen more commonly in young adults and females. Comorbidities include anxiety, substance abuse, ADHD, personality disorders and obesity. Impact of BD on cardiovascular health: BD increases the risk of CVDs, such as atherosclerosis, myocardial infarction and stroke, with a 1.5- to 2.5-fold increased risk in these patients compared with the general population. Pathophysiology Shared risk factors: Elevated triglycerides, high BMI, smoking and alcohol consumption contribute to both BD and CVD. Dysregulation of the HPA axis and increased oxidative stress play significant roles. Medication effects: Antipsychotics and mood stabilizers can exacerbate cardiovascular risks through metabolic syndrome and arrhythmias. Discussion Interplay of BD and CVD risk factors: BD contributes to chronic inflammation and oxidative stress, which are risk factors for CVD. Epidemiological disparities: Younger age groups and females with BD show higher cardiovascular morbidity and mortality compared with the general population. Bipolar disease and cardiovascular outcomes: BD patients experience earlier onset of myocardial infarction and higher rates of sudden cardiac death. Psychotropic medications contribute to increased cardiovascular risk through mechanisms like QT interval prolongation. BD patients have a higher prevalence of hyperlipidemia and metabolic syndrome, further elevating cardiovascular risk. [ABSTRACT FROM AUTHOR]

Objective: Effective time management is crucial for the survival of all patients, particularly those with cardiovascular conditions. This is especially true in the context of pre-hospital emergency services, where prompt intervention can significantly impact outcomes. This study delves into the timeliness of emergency services and the subsequent outcomes for hospitalized cardiovascular patients in EMS center in Fasa University of Medical Sciences, southern Iran. Results: A total of 4972 emergency calls related to cardiac diagnoses were received between 2020 and 2023. The transport time was significantly correlated with age, location of the mission, and type of mission. Of the total, 86 underwent angioplasty within the standard time of less than 90 min, of which 81 were discharged and 5 died. 51 patients underwent angioplasty after more than 90 min, of which 47 were discharged and 4 died. In addition, 124 of these patients experienced cardiopulmonary resuscitation, of which 63 were successful and 61 were unsuccessful. [ABSTRACT FROM AUTHOR]

Objective: We aimed to investigate antiplatelet drug resistance utilizing light transmission-lumiaggregometry (LT-LA) and the Platelet Function Analyzer-100 (PFA-100) in patients undergoing cardiovascular surgery. Materials and Methods: The study included 60 patients diagnosed with stable coronary artery disease and peripheral vascular diseases that required surgery. Participants were divided into three groups: patients receiving aspirin (ASA) (n=21), patients receiving clopidogrel (CLO) (n=19), and patients receiving dual therapy (ASA+CLO) (n=20). Aggregation and secretion tests by LT-LA and closure time by the PFA- 100 were used to measure antiplatelet drug resistance. Results: Based on the adenosine diphosphate (ADP)-induced aggregation test, 43% of patients were resistant to ASA, 22% to CLO, and 15% to dual therapy. Diabetes, hypertension, and hyperlipidemia were the most commonly identified comorbid disorders. In patients with comorbid risk factors, the median value of platelet aggregation response to ADP was significantly higher in the ASA group than in the CLO and dual therapy groups (p=0.0001). In patients receiving ASA monotherapy, the maximum amplitude of aggregation response to platelet agonists was ≥70% in 43% of patients for ADP and 28% for collagen by LT-LA. Elevated ADP (≥0.29 nmol) and collagen (≥0.41 nmol)-induced adenosine triphosphate release were found by LT-LA in 66% of patients utilizing an ADP agonist and 80% of patients using a collagen agonist undergoing ASA therapy. Closure times obtained with the PFA-100 were normal in 28% of patients using collagen- ADP cartridges and 62% of patients using collagen-epinephrine (CEPI) cartridges who received ASA. Recurrent thrombosis and bleeding were observed in 12 (20%) patients with cardiovascular disease. Three of these individuals (25%) showed ASA resistance with normal responses to ADP-induced aggregation (≥70%) and secretion (≥0.29 nmol), as well as normal CEPI closure times. Conclusion: Our findings suggest that antiplatelet drug monitoring with LT-LA and PFA-100 may be useful in high-risk and complicated cardiovascular patients.

Background: Patients with hidradenitis suppurativa (HS) often suffer from comorbid diabetes, metabolic syndrome, and hyperlipidemia and, therefore, are susceptible to the development of cardiovascular diseases (CVDs). Moreover, systemic inflammation plays a vital role in the development of atherosclerosis. The creation of atherosclerotic plaque is characterized by endothelial dysfunction driven by elevated concentrations of interleukin (IL)‐1, IL‐6, and IL‐18 among others, as well as tumor necrosis factor (TNF) alpha. Methods: This study aimed to assess the risk of HS patients developing CVDs. We performed a large‐scale, propensity‐matched global retrospective cohort study analyzing the risk of development of CVDs in patients suffering from HS. The analysis included 144,100 HS patients with 144,100 healthy controls (HC). The cohorts were matched regarding demographics and history of diseases relevant to CVDs, e.g., diabetes, obesity, and nicotine dependence. A total of 90 cardiovascular disorders were identified. The identification of cardiovascular disorders was based on ≥1% appearance of the event, based on absolute numbers, in both cohorts. Results: Before the matching, HS patients displayed a higher frequency in excess weight or obesity (25 vs. 14.4%, respectively), nicotine dependence, and diabetes mellitus, but lower odds of primary hypertension in comparison to healthy controls. A total of 47 CVDs are associated with an increased risk of onset in HS patients. Although the highest hazard ratio (HR; 2.1; 95% CI: 1.95–2.269) was found for unspecified heart failure, the HS cohort was exceptionally predisposed to developing myocardial infarction (HR: 2.06; 95% CI: 1.88–2.27) and an acute embolism and deep vein thrombosis of the lower extremity (HR: 1.93; 95% CI: 1.74–2.14). Conclusions: This is the most extensive study on the association of HS with CVDs. We demonstrated that HS patients are at significantly greater risk of developing various CVDs compared to matched controls, with heart failure being the most common one. [ABSTRACT FROM AUTHOR]

Copyright of Turkish Journal of Hematology is the property of Galenos Yayinevi Tic. LTD. STI and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Accurate diagnosis and treatment of cardiovascular diseases require the integration of cardiac imaging, which provides crucial information about the structure and function of the heart to improve overall patient care. This review explores the role of Artificial Intelligence (AI) in advancing cardiac imaging analysis, with a focus on unsupervised learning methods. Unlike supervised AI systems, which rely on annotated datasets, the use of unsupervised learning proves to be a game-changer. It effectively tackles issues related to limited datasets and sets the stage for scalable and adaptive solutions in cardiac imaging. This paper gives a comprehensive overview of the limitations of traditional methods and the potential of unsupervised AI in overcoming challenges related to dataset scarcity through an extensive literature review and analysis of unsupervised algorithms, including clustering techniques, dimensionality reduction, and generative models. This review study highlights the contributions of unsupervised techniques for enhancing diagnostic accuracy and efficiency in cardiac imaging. By comparing unsupervised and supervised methods, the paper aims to explain the benefits and limitations of each approach, offering valuable insights for advancing AI integration in cardiac healthcare. The findings are expected to guide future research and development, leading to innovative advancements in cardiovascular diagnostics.

Increased medical attention is needed as the prevalence of autism spectrum disorder (ASD) rises. Both cardiovascular disorder (CVD) and hyperlipidemia are closely associated with adult ASD. Shank3 plays a key genetic role in ASD. We hypothesized that Shank3 contributes to CVD development in young adults with ASD. In this study, we investigated whether Shank3 facilitates the development of atherosclerosis. Using Gene Set Enrichment Analysis software (Version No.: GSEA-4.0.3), we analyzed the data obtained from Shank3 knockout mice (Gene Expression Omnibus database), a human population-based study cohort (from Taiwan's National Health Insurance Research Database), and a Shank3 knockdown cellular model. Shank3 knockout upregulated the expression of genes of cholesterol homeostasis and fatty acid metabolism but downregulated the expression of genes associated with inflammatory responses. Individuals with autism had higher risks of hyperlipidemia (adjusted hazard ratio (aHR): 1.39; p < 0.001), major adverse cardiac events (aHR: 2.67; p < 0.001), and stroke (aHR: 3.55; p < 0.001) than age- and sex-matched individuals without autism did. Shank3 downregulation suppressed tumor necrosis factor-α-induced fatty acid synthase expression; vascular cell adhesion molecule 1 expression; and downstream signaling pathways involving p38, Jun N-terminal kinase, and nuclear factor-κB. Thus, Shank3 may influence the development of early-onset atherosclerosis and CVD in ASD. Furthermore, regulating Shank3 expression may reduce inflammation-related disorders, such as atherosclerosis, by inhibiting tumor necrosis factor-alpha-mediated inflammatory cascades. [ABSTRACT FROM AUTHOR]

Abstract Background The anion gap (AG) has been linked to the prognosis of many cardiovascular disorders. However, the correlation between albumin-corrected anion gap (ACAG) and 30 d all-cause mortality of intensive care patients with acute myocardial infarction (AMI) is unclear. Furthermore, owing to the lack of studies, it is also unknown whether ACAG is more accurate than AG in predicting the mortality of AMI. Methods The Medical Information Mart for Intensive Care IV (MIMIC IV) dataset was used to provide patient data in this retrospective cohort study. ACAG is computed using the formulae: [4.4—{albumin (g/dl)}] × 2.5 + AG. The primary outcome was 30 d all-cause mortality intensive care patients with AMI. To explore the prognostic worthiness of ACAG, the receiver operating characteristic curve, smooth curve fitting, Cox regression model, and Kaplan survival analysis was performed. Results We enrolled 2,160 patients in this study. ACAG had a better predictive value for 30 d all-cause mortality than AG, with an area under the curve of 0.66. The association between ACAG levels and overall mortality was nonlinear. In our model, after correcting for confounding factors, the ACAG was the independent predictor for 30 d all-cause mortality (HR 1.75, 95%CI 1.24, 2.47). ACAG K-M estimator curve analyses revealed that the group with ACAG ≥ 21.75 mmol/l had poor survival rate than the other group. Conclusions High serum ACAG levels were a significant risk factor for 30 d all-cause mortality in critically ill patients with AMI. ACAG concentration and 30 d all-cause mortality had a nonlinear relationship. ACAG had better predictive value in identifying 30 d all-cause mortality of patients with AMI in ICU than the AG.

Abstract Background Individuals with mental health problems have been shown to have an increased risk of cardiovascular disorder (CVD), but little is known about the risk of early-onset CVD among those with intellectual disability. We aimed to investigate the association between intellectual disability and subsequent CVD, taking into consideration the severity of intellectual disability and neurodevelopmental and neurologic comorbidity. Methods This population-based cohort study used individual-level linked data from Danish national health registries. Participants were all live-born singletons born in Denmark during 1978–2016 (n = 2,288,393). Follow-up began from birth and continued until the onset of CVD, death, emigration, or December 31, 2018, whichever came first. Clinical diagnosis of any CVD or type-specific CVDs was identified in the Danish National Patient Register. Time-varying Cox regression analyses were used to estimate the hazard ratio (HR) of intellectual disability associated with overall and type-specific CVDs. Results A total of 11,954 individuals received a diagnosis of intellectual disability (7434 males and 4520 females). During a median follow-up time of 18.5 years (interquartile range, 18.1 years), 652 individuals with intellectual disability (5.5%) received a diagnosis of CVD (incidence rate, 2.4 per 1000 person-years), compared with 78,088 (3.4%) CVD cases in individuals without intellectual disability (incidence rate, 1.9 per 1000 person-years), corresponding to a HR of 1.24 (95% CI, 1.15–1.34). Increased risks of CVD were similar in both childhood (HR, 1.24; 95% CI, 1.08–1.43) and early adulthood (HR, 1.25; 95% CI, 1.14–1.38). For type-specific CVDs, intellectual disability was significantly associated with cerebrovascular disease (HR, 2.50; 95% CI, 2.02–3.10), stroke (HR, 2.20; 95% CI, 1.69–2.86), heart failure (HR, 3.56; 95% CI, 2.37–5.35), hypertensive disease (HR, 1.30; 95% CI, 1.22–1.39), and deep vein thrombosis (HR, 2.10; 95% CI, 1.60–2.75). Stratified HRs of overall CVD were 1.14 (95% CI, 1.01–1.30) for borderline/mild intellectual disability, 1.25 (95% CI, 1.01–1.54) for moderate intellectual disability, and 1.91 (95% CI, 1.47–2.48) for severe/profound intellectual disability. After the exclusion of individuals with neurodevelopmental and neurologic comorbidity, intellectual disability remained significantly associated with increased risks of CVD. Conclusions Individuals with intellectual disability had increased risks of early-onset CVD, in particular, for cerebrovascular disease, stroke, heart failure, and deep vein thrombosis, and the risks also increased with the severity of intellectual disability. Our findings highlight the awareness of increased risks of CVD in intellectual disability patients.

Cardiovascular diseases are growing rapidly in this world. Around 70% of the world’s population is suffering from the same. The entire research work is grouped into the classification and analysis of heart sound. We defined a new squeeze network-based deep learning model—convolutional random forest (RF) for real-time valvular heart sound classification and analysis using industrial Raspberry Pi 4B. The proposed electronic stethoscope is Internet enabled using ESP32, and Raspberry Pi. The said Internet of Things (IoT)-based model is also low cost, portable, and can be reachable to distant remote places where doctors are not available. As far as the classification part is concerned, the multiclass classification is done for seven types of valvular heart sounds. The RF classifier scored a good accuracy among other ensemble methods in small training set data. The CNN-based squeeze net model achieved a decent accuracy of 98.65% after its hyperparameters were optimized for heart sound analysis. The proposed IoT-based model overcomes the drawbacks faced individually in both squeeze network and RF. CNN-based squeeze net model and RF classifier combined together improved the performance of classification accuracy. The squeeze net model plays a pivotal part in the feature extraction of heart sound, and an RF classifier acts as a classifier in the class prediction layer for predicting class labels. Experimental results on several datasets like the Kaggle dataset, the Physio net challenge, and the Pascal Challenge showed that the Conv-RF model works the best. The proposed IoT-based Conv-RF model is also applied on the selected subjects with different age groups and genders having a history of heart diseases. The Conv-RF method scored an accuracy of 99.37 ± 0.05% on the different test datasets with a sensitivity of 99.5 ± 0.12% and specificity of 98.9 ± 0.03%. The proposed model is also examined with the current state-of-the-art models in terms of accuracy.

Hypertrophic Cardiomyopathy (HCM) is a common inherited disorder that can lead to heart failure and sudden cardiac death, characterized at the histological level by focal areas of myocyte disarray, hypertrophy and fibrosis, and only a few disease-targeted therapies exist. To identify the focal and spatially restricted alterations in the transcriptional pathways and reveal novel therapeutic targets, we performed a spatial transcriptomic analysis of the areas of focal myocyte disarray compared to areas of normal tissue using a commercially available platform (GeoMx, nanoString). We analyzed surgical myectomy tissue from four patients with HCM and the control interventricular septum tissue from two unused organ donor hearts that were free of cardiovascular disease. Histological sections were reviewed by an expert pathologist, and 72 focal areas with varying degrees of myocyte disarray (normal, mild, moderate, severe) were chosen for analysis. Areas of interest were interrogated with the Human Cancer Transcriptome Atlas designed to profile 1800 transcripts. Differential expression analysis revealed significant changes in gene expression between HCM and the control tissue, and functional enrichment analysis indicated that these genes were primarily involved in interferon production and mitochondrial energetics. Within the HCM tissue, differentially expressed genes between areas of normal and severe disarray were enriched for genes related to mitochondrial energetics and the extracellular matrix in severe disarray. An analysis of the gene expression of the ligand–receptor pair revealed that the HCM tissue exhibited downregulation of platelet-derived growth factor (PDGF), NOTCH, junctional adhesion molecule, and CD46 signaling while showing upregulation of fibronectin, CD99, cadherin, and amyloid precursor protein signaling. A deconvolution analysis utilizing the matched single nuclei RNA-sequencing (snRNA-seq) data to determine cell type composition in areas of interest revealed significant differences in fibroblast and vascular cell composition in areas of severe disarray when compared to normal areas in HCM samples. Cell composition in the normal areas of the control tissue was also divergent from the normal areas in HCM samples, which was consistent with the differential expression results. Overall, our data identify novel and potential disease-modifying targets for therapy in HCM. [ABSTRACT FROM AUTHOR]

Large animal models of cardiac ischemia-reperfusion are critical for evaluation of the efficacy of cardioprotective interventions prior to clinical translation. Nonetheless, current cardioprotective strategies/interventions formulated in preclinical cardiovascular research are often limited to small animal models, which are not transferable or reproducible in large animal models due to different factors such as: (i) complex and varied features of human ischemic cardiac disease (ICD), which are challenging to mimic in animal models, (ii) significant differences in surgical techniques applied, and (iii) differences in cardiovascular anatomy and physiology between small versus large animals. This article highlights the advantages and disadvantages of different large animal models of preclinical cardiac ischemic reperfusion injury (IRI), as well as the different methods used to induce and assess IRI, and the obstacles faced in using large animals for translational research in the settings of cardiac IR. [ABSTRACT FROM AUTHOR]

Background: The anion gap (AG) has been linked to the prognosis of many cardiovascular disorders. However, the correlation between albumin-corrected anion gap (ACAG) and 30 d all-cause mortality of intensive care patients with acute myocardial infarction (AMI) is unclear. Furthermore, owing to the lack of studies, it is also unknown whether ACAG is more accurate than AG in predicting the mortality of AMI. Methods: The Medical Information Mart for Intensive Care IV (MIMIC IV) dataset was used to provide patient data in this retrospective cohort study. ACAG is computed using the formulae: [4.4—{albumin (g/dl)}] × 2.5 + AG. The primary outcome was 30 d all-cause mortality intensive care patients with AMI. To explore the prognostic worthiness of ACAG, the receiver operating characteristic curve, smooth curve fitting, Cox regression model, and Kaplan survival analysis was performed. Results: We enrolled 2,160 patients in this study. ACAG had a better predictive value for 30 d all-cause mortality than AG, with an area under the curve of 0.66. The association between ACAG levels and overall mortality was nonlinear. In our model, after correcting for confounding factors, the ACAG was the independent predictor for 30 d all-cause mortality (HR 1.75, 95%CI 1.24, 2.47). ACAG K-M estimator curve analyses revealed that the group with ACAG ≥ 21.75 mmol/l had poor survival rate than the other group. Conclusions: High serum ACAG levels were a significant risk factor for 30 d all-cause mortality in critically ill patients with AMI. ACAG concentration and 30 d all-cause mortality had a nonlinear relationship. ACAG had better predictive value in identifying 30 d all-cause mortality of patients with AMI in ICU than the AG. [ABSTRACT FROM AUTHOR]

Introduction: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), a new coronavirus, was originally recognized as a pandemic by the WHO on early, a new coronavirus, was originally recognized as a pandemic by the WHO on early 2020, and has infected over 243 million people worldwide, killing about five million people between then and October 2021. Objectives: We investigated the relationship between clinical characteristics, cardiovascular risk factors and echocardiographic findings and in-hospital outcomes of patients who were admitted for COVID-19. Patients and Methods: A retrospective review of 216 hospitalized patients with COVID-19 who were admitted to Chamran hospital from March 2019 to April 2021 was conducted. Patients’ characteristics cardiovascular risk factors, echocardiographic findings, clinical outcomes (discharge (complete recovery/ partial recovery) and in-hospital mortality) were recorded. To analyze risk factors associated with outcomes in patients with COVID-19, univariate and multivariate ordinal logistic regression models were conducted. Results: The most common underlying diseases in patients were hypertension (HTN) (57.9%) and diabetes mellitus (DM) (37.9%), respectively. Cognitive disorders (20.8%) and mitral regurgitation (MR) were the most complication and echocardiographic finding of the patients. In our study, six variables were found to be associated with patient’s outcomes, including age, body mass index (BMI), DM, chronic pulmonary diseases, number of hospitalization days and number of an intensive care unit (ICU) admission days. Conclusion: Our analysis suggests that age, male gender, BMI, number of hospitalization days and ICU admission, chronic pulmonary disease and diabetes are associated with a higher risk of in-hospital mortality and worst prognosis in patients infected by SARS-CoV-2.

Background: Individuals with mental health problems have been shown to have an increased risk of cardiovascular disorder (CVD), but little is known about the risk of early-onset CVD among those with intellectual disability. We aimed to investigate the association between intellectual disability and subsequent CVD, taking into consideration the severity of intellectual disability and neurodevelopmental and neurologic comorbidity. Methods: This population-based cohort study used individual-level linked data from Danish national health registries. Participants were all live-born singletons born in Denmark during 1978–2016 (n = 2,288,393). Follow-up began from birth and continued until the onset of CVD, death, emigration, or December 31, 2018, whichever came first. Clinical diagnosis of any CVD or type-specific CVDs was identified in the Danish National Patient Register. Time-varying Cox regression analyses were used to estimate the hazard ratio (HR) of intellectual disability associated with overall and type-specific CVDs. Results: A total of 11,954 individuals received a diagnosis of intellectual disability (7434 males and 4520 females). During a median follow-up time of 18.5 years (interquartile range, 18.1 years), 652 individuals with intellectual disability (5.5%) received a diagnosis of CVD (incidence rate, 2.4 per 1000 person-years), compared with 78,088 (3.4%) CVD cases in individuals without intellectual disability (incidence rate, 1.9 per 1000 person-years), corresponding to a HR of 1.24 (95% CI, 1.15–1.34). Increased risks of CVD were similar in both childhood (HR, 1.24; 95% CI, 1.08–1.43) and early adulthood (HR, 1.25; 95% CI, 1.14–1.38). For type-specific CVDs, intellectual disability was significantly associated with cerebrovascular disease (HR, 2.50; 95% CI, 2.02–3.10), stroke (HR, 2.20; 95% CI, 1.69–2.86), heart failure (HR, 3.56; 95% CI, 2.37–5.35), hypertensive disease (HR, 1.30; 95% CI, 1.22–1.39), and deep vein thrombosis (HR, 2.10; 95% CI, 1.60–2.75). Stratified HRs of overall CVD were 1.14 (95% CI, 1.01–1.30) for borderline/mild intellectual disability, 1.25 (95% CI, 1.01–1.54) for moderate intellectual disability, and 1.91 (95% CI, 1.47–2.48) for severe/profound intellectual disability. After the exclusion of individuals with neurodevelopmental and neurologic comorbidity, intellectual disability remained significantly associated with increased risks of CVD. Conclusions: Individuals with intellectual disability had increased risks of early-onset CVD, in particular, for cerebrovascular disease, stroke, heart failure, and deep vein thrombosis, and the risks also increased with the severity of intellectual disability. Our findings highlight the awareness of increased risks of CVD in intellectual disability patients. [ABSTRACT FROM AUTHOR]

The pressure exerted on the heart and blood vessels because of blood flow is considered an essential parameter for cardiovascular function. It determines sufficient blood perfusion, and transportation of nutrition, oxygen, and other essential factors to every organ. Pressure in the primary arteries near the heart and the brain is known as central blood pressure (CBP), while that in the peripheral arteries is known as peripheral blood pressure (PBP). Usually, CBP and PBP are correlated; however, various types of shocks and cardiovascular disorders interfere with their regulation and differently affect the blood flow in vital and accessory organs. Therefore, understanding blood pressure in normal and disease conditions is essential for managing shock-related cardiovascular implications and improving treatment outcomes. In this review, we have described the control systems (neural, hormonal, osmotic, and cellular) of blood pressure and their regulation in hemorrhagic/hypovolemic shock using centhaquine (Lyfaquin®) as a resuscitative agent. [ABSTRACT FROM AUTHOR]

Objectives: Based on the angiogenetic, transcriptional profile of non-diseased and arteriosclerotic vessels, we aim to identify the leucocytic markers as a potential, minimal invasive tool supporting diagnosis of vascular pathology. Methods: Transcriptional profiling was performed with Angiogenesis RT2 Profiler PCR (Polymerase Chain Reaction) array on three non-pathological and three arteriosclerotic vessels, followed by immunohistochemical staining. Based on these screening results, selected transcripts were employed for qPCR with specific primers and investigated on the blood RNA (RiboNucleic Acid) obtained from nine healthy controls and 29 patients with cardiovascular disorders. Thereafter, expression of these transcripts was investigated in vitro in human monocytes under calcification-mimicking conditions. Results and Conclusions: Transcriptional profiling on the vessels revealed that out of 84 targets investigated two were up-regulated more than 100-fold, 18 more than 30 and 15 more than 10, while the most noticeable down-regulation was observed by ephrin-A3 and platelet-derived growth factor alpha (PDGFA) genes. Based on the vessel results, investigations of the selected blood transcripts revealed that thrombospondin 1 (THBS1), thrombospondin 3 (THBS3), transforming growth factor, beta receptor 1 (TGFBR1), platelet-derived growth factor alpha, plasminogen activator, urokinase (PLAU) and platelet/endothelial cell adhesion molecule 1 (PECAM-1) were significantly elevated in cardiovascular blood as compared to corresponding controls. Induction of calcification-related conditions in vitro to human THP-1 monocytes led to noticeable modulation of these transcripts. Taken together, these data demonstrate that leucocytic THBS1, THBS3, TGFBR1, platelet-derived growth factor alpha, PLAU and PECAM-1 have a correlation with cardiovascular disorders and could be used as a supportive tool predicting development of this pathological condition. [ABSTRACT FROM AUTHOR]

This study aims to determine the association and risk of daily fluctuations of air pollution parameters in Klang Valley, Malaysia, with cardiovascular and respiratory admissions. The data on admissions and air pollution concentrations were obtained from various government agencies in Malaysia. The associations were estimated using a time series analysis of Poisson regression. The effects for every 10μ/m³ increase in pollutants were reported as Relative Risk (RR). SO2 showed the highest association with immediate effects at lag 0 for all cardiovascular admissions followed by NO2. Gaseous pollutants of SO2 and NO2 showed a higher risk among elderly more than 60 years old. Immediate effects were found in both genders, with higher risks observed in males. NO2 continues to be suggestively associated with all respiratory admissions. Children less than 9 years old presented a higher risk of NO2 at various lag times with the highest value at lag0, followed by PM10. Stratified analysis showed an incremental risk of respiratory admissions for males exposed to NO2 compared to females. We found noteworthy associations for overall and age-specific admissions of cardiovascular and respiratory with the pollutants. Compared to particulates pollutant, gaseous pollutants showed a higher risk in both admissions. [ABSTRACT FROM AUTHOR]

Objective: Polycystic ovary syndrome (PCOS) is an endocrine disorder associated with hyperandrogenism marked with hirsutism and ovarian dysfunction. These conditions may lead to the risk of insulin resistance (IR), type 2 diabetes, obesity, and cardiovascular disease. These conditions are related to PCOS complications hence our aim was to study and investigate the relationship between high-sensitivity C - reactive protein (hs-CPR) level and glycosylated hemoglobin (HbA1c) level in PCOS patients. Materials and Methods: Female patients visiting the obstetrics and gynecology outpatient department (OPD), aged between 19 and 45 years with a body mass index (BMI) of 25 to 29 kg/m2. The individuals fulfilling the National Institute of Health (NIH) criteria for PCOS; including amenorrhea or oligomenorrhea and had been clinically diagnosed with hyperandrogenism were served as subjects. Results: Two hundred and ten individuals with HbA1c of 5.4% have a higher risk of cardiovascular disorders. The study showed the association between increased cardiac risk as measured by hs-CRP and patients with normal HbA1c values with a sensitivity of 77.2% and specificity of 75.99%. The HbA1c cutoff value can be used in the PCOS patients to assess the cardiac risk due to association of HbA1c cut off value with false positivity rate of 15.24%. Conclusion: In PCOS patients with chronic low-grade inflammation, IR, and the degree of inflammation associated with HbA1c value was observed.

Introduction: The most fearful outcome of metabolic syndrome is cardiovascular events leading to morbidity and mortality. Q risk2 score was developed by physicians working in UK National Health Service to estimates the risk of cardiovascular disease incidence over the next 10 years. Qrisk2 score <10% indicates mild risk, 10-20-% moderate risk, >20% high risk of CVD. MRF are progressive inflammatory processes leading to rise in serum hsCRP and depletion of GSH, indicating increased oxidative stress which has been associated with higher risk of CVD. Therefore, this study has been designed to study the association of QRISK2 score with oxidative stress in apparently healthy adults at metabolic risk. Material and Methodology: Subjects of both genders, age between 25 to 45 years were enrolled as per inclusion & exclusion criteria and detailed clinical history was taken. All candidates were subjected to Anthropometry (height, weight, BMI, Waist Circumference), BP measurements, lipid profile, GSH, hsCRP and fasting blood sugar. Qrisk2 score was calculated by online calculator (https://qrisk.org/2017/) All subjects were screened for metabolic risk factors (MRF). Subjects without any MRF were put into Group A and those with any MRF were kept in Group B. All recruited subjects were divided into low-risk group (Qrisk2 score <10%) & highrisk group (Qrisk2 score >10%). Then, various components of metabolic syndrome and oxidative stress will be compared in both groups. Results: In this study, weight, BMI, BP, TG, LDL, total cholesterol, fasting blood sugar, GSH and hsCRP was statistically significantly higher in subjects with MRF. Smoking, diabetes, HTN and obesity was more common in high Qrisk2 score group (Qrisk2 score >10). Systolic BP was statistically significantly higher in high Qrisk2 score group but difference in diastolic BP was not statistically significant. TG, LDL, total cholesterol, fasting blood sugar, serum GSH and hsCRP was statistically higher in high Qrisk2 score group whereas, HDL was statistically significantly lower. Conclusion: Smoking, diabetes, HTN and obesity increases the future risk of CVD and systolic BP is more important than diastolic BP. We also observed high Qrisk 2 score is associated with increased oxidative stress. [ABSTRACT FROM AUTHOR]

Objective: Polycystic ovary syndrome (PCOS) is an endocrine disorder associated with hyperandrogenism marked with hirsutism and ovarian dysfunction. These conditions may lead to the risk of insulin resistance (IR), type 2 diabetes, obesity, and cardiovascular disease. These conditions are related to PCOS complications hence our aim was to study and investigate the relationship between high-sensitivity C - reactive protein (hs-CPR) level and glycosylated hemoglobin (HbA1c) level in PCOS patients. Materials and Methods: Female patients visiting the obstetrics and gynecology outpatient department (OPD), aged between 19 and 45 years with a body mass index (BMI) of 25 to 29 kg/m2. The individuals fulfilling the National Institute of Health (NIH) criteria for PCOS; including amenorrhea or oligomenorrhea and had been clinically diagnosed with hyperandrogenism were served as subjects. Results: Two hundred and ten individuals with HbA1c of 5.4% have a higher risk of cardiovascular disorders. The study showed the association between increased cardiac risk as measured by hs-CRP and patients with normal HbA1c values with a sensitivity of 77.2% and specificity of 75.99%. The HbA1c cutoff value can be used in the PCOS patients to assess the cardiac risk due to association of HbA1c cut off value with false positivity rate of 15.24%. Conclusion: In PCOS patients with chronic low-grade inflammation, IR, and the degree of inflammation associated with HbA1c value was observed. [ABSTRACT FROM AUTHOR]

Abstract 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.

Introduction: Cardiovascular Disorders (CVD) are significant cause of fetomaternal morbidity and mortality. Prevalence of CVD in pregnancy is less than 1% (varies from 0.3-3.5%). Aim: To study spectrum, prevalence and fetomaternal outcome of cardiac diseases in pregnancy at a tertiary care center. Materials and Methods: A retrospective study was conducted in which data of all antenatal patients visiting the hospital over a period of 27 months from March 2017 to June 2019 were analysed for cardiac diseases by clinical history, examination, Electocardiograpy and echocardiography. Type, Severity of heart disease was noted as per New York Heart Association (NYHA) criteria. Maternal outcome recorded in terms of Maternal death, Congestive Cardiac failure requiring ICU Care, Pregnancy Induced Hypertension, Antepartum Haemorrhage, Postpartum Haemorrhage, Deep vein Thrombosis, Anaemia and termination of pregnancy. Fetal outcome was recorded in terms Live Birth, Pre Term, Low Birth Weight, Intrauterine Death, Neonatal Death, Acute Fetal distress and Abortion. Results: A total of 9298 pregnant females were screened. A total of 73 had cardiac disease, with a based prevalence of 7.85/1000. About 22 (30.13%) patients were diagnosed first time during pregnancy. Mean age was 27.46±4.4 years. Thirty two (45%) were primigravida. About 58(80%) were in either NYHA Class I or II. Rheumatic Heart Disease (RHD) was the most common {36 (46.5%)} cardiac disorder. Maternal mortality occurred in 3 (4.1%) patients. Cardiac failure occurred in 10 (13.6%) patients. Fetal outcome included abortion in 1 (1.36%), acute fetal distress in 5 (6.84%), Intrauterine death in 2 (2.73%), Low birth weight in 8 (10.9%), preterm delivery in 4 (5.4%) patients and neonatal mortality in 1 (1.36%). Medical Termination of Pregnancy (MTP) was done in 6 (8.2%) patients. Predictors of combined maternal & fetal morbidity and mortality were advanced NYHA Class (III & IV) (p=0.0001, OR 5.98 95% CI 1.2940 to 27.3424), severe left sided obstructive lesions (p=0.0001, OR 14.0 95% CI 3.8430 to 51.0019) and left ventricular dysfunction (p=0.0018, OR 18.27 95% CI 2.0982 to 159.2223). Conclusion: RHD was the most common cardiac disorder reflecting need of secondary antibiotic prophylaxis. Patients who present with higher NYHA class, severe LV dysfunction and severe left heart obstructive disease represent high risk group.

Abstract Valve‐in‐valve transcatheter valve implantation (ViV‐TAVI) procedures for deteriorated bioprosthesis are an established therapeutic option for high‐risk patients. The presence of the fixed sewing ring of the bioprosthesis can hamper appropriate expansion of the TAVI. We present a case of a ViViV‐TAVI, as a salvage procedure for acute ViV‐TAVI failure.

Abstract Approximately 25% of patients undergoing transcatheter aortic valve implantation presents significant peripheral arterial disease. The purpose of this case report was to present a feasible approach for transcatheter heart valve in a patient with peripheral arterial disease where the presence of a subclavian stent jutting in the aortic arch made the delivery system passage a challenging procedure.

• Anatomic myocardial features significantly capture reduced ejection fraction. • Segment CMR effectively captures myocardial boundary in short and long-axis views. • BOA aids the tuning of ELM hyper-parameters and choice of relevant feature set. • Bio-inspired ELM framework effectively detects cardiovascular disorder progression. This study focuses on integration of anatomical left ventricle myocardium features and optimized extreme learning machine (ELM) for discrimination of subjects with normal, mild, moderate and severe abnormal ejection fraction (EF). The physiological alterations in myocardium have diagnostic relevance to the etiology of cardiovascular diseases (CVD) with reduced EF. This assessment is carried out on cardiovascular magnetic resonance (CMR) images of 104 subjects available in Kaggle Second Annual Data Science Bowl. The Segment CMR framework is used to segment myocardium from cardiac MR images, and it is subdivided into 16 sectors. 86 clinically significant anatomical features are extracted and subjected to ELM framework. Regularization coefficient and hidden neurons influence the prediction accuracy of ELM. The optimal value for these parameters is achieved with the butterfly optimizer (BO). A comparative study of BOELM framework with different activation functions and feature set has been conducted. Among the individual feature set, myocardial volume at ED gives a better classification accuracy of 83.3% compared to others. Further, the given BOELM framework is able to provide higher multi-class accuracy of 95.2% with the entire feature set than ELM. Better discrimination of healthy and moderate abnormal subjects is achieved than other sub groups. The combined anatomical sector wise myocardial features assisted BOELM is able to predict the severity levels of CVDs. Thus, this study supports the radiologists in the mass diagnosis of cardiac disorder. [ABSTRACT FROM AUTHOR]

Approximately 25% of patients undergoing transcatheter aortic valve implantation presents significant peripheral arterial disease. The purpose of this case report was to present a feasible approach for transcatheter heart valve in a patient with peripheral arterial disease where the presence of a subclavian stent jutting in the aortic arch made the delivery system passage a challenging procedure. [ABSTRACT FROM AUTHOR]

Introduction Cardiovascular disorders are responsible for over 32% of annual global deaths so patients must understand the relationship that exists between cardiovascular disorders and dental concerns. We believe that the DMFT system should efficiently be able to communicate these concerns in easy to understand numbers to the patient if there exists a difference between the DMFT scores of a cardiovascular disorder patient and a non-cardiovascular disorder patient. Aim The aim of this study is to compare the DMFT scores of cardiovascular disorder patients and non-cardiovascular disorder patients. Materials and Methodology A retrospective cross-sectional study was conducted using established records of calculated DMFT scores as mentioned in the hospital's online database from Saveetha Dental College between April 2020 and March 2021. Relevant data such as patient age, sex, type of cardiovascular status, DMFT score and their medication utilization status was acquired. This data was recorded in a Microsoft Excel spreadsheet and was later exported to the Statistical Package for the Social Sciences for Windows for statistical analysis. A Chi Square test was used with the level of significance set at p<0.05. Results and Discussion The findings of our study suggest that there is a statistically significant difference between the DMFT scores of a cardiovascular disorder and a non-cardiovascular disorder patient. Conclusion Within the limitations of the study we may conclude that gender and drug intake have a role to play in elevating the DMFT scores in a cardiovascular disorder patient as compared to a noncardiovascular disorder patient. [ABSTRACT FROM AUTHOR]

Objective: Anxiety is an unpleasant feeling characterized by symptoms of tachycardia, sweating, and stress. The exact relationship between anxiety and cardiovascular disorder is not well distinguished. The aim of the present study was to evaluate the relationship between anxiety disorders and anthropometric indices and risk factors, including fasting blood sugar (FBS), hyperlipidemia, and hypertension, according to the results, FBS low-density lipoprotein (LDL) and symptoms of cardiovascular disorder in children and adolescents aged 6 to 18 years. Method: In this community-based study, multistage cluster sampling method was used. We randomly selected 1174 children and adolescents who referred to Afshar hospital in Yazd, then, 167 blocks were randomly collected by each cluster head. Each cluster consisted of 6 cases, including three cases of each gender in different age groups (6-9, 10- 14, and 15-18 years). The clinical psychologists instructed the participants to complete the Persian version of Kiddie-Schedule for Affective Disorders and Schizophrenia - Present and Lifetime version (K-SADS-PL). In addition, cardiovascular risk factors were determined for participants and demographic data were obtained from the participants. Results: A total of 1035 children and adolescents participated in this study. The results showed that 228 of the participants (22.2%) suffered from anxiety disorder. There was an indirect significant correlation between anxiety disorder and the symptoms of heart palpitation, shortness of breath, and chest pain. There was no statistically significant relationship between the different types of anxiety disorders and FBS, hyperlipidemia, and hypertension. According to the results, FBS and LDL are a predictor for anxiety disorders. Conclusion: There was a statistically significant association between anxiety in children and adolescents and some risk factors of cardiovascular disorder. Also, this study introduces some cardiovascular predictors of anxiety. However, further studies are needed in this regard.

Objective: Anxiety is an unpleasant feeling characterized by symptoms of tachycardia, sweating, and stress. The exact relationship between anxiety and cardiovascular disorder is not well distinguished. The aim of the present study was to evaluate the relationship between anxiety disorders and anthropometric indices and risk factors, including fasting blood sugar (FBS), hyperlipidemia, and hypertension, according to the results, FBS low-density lipoprotein (LDL) and symptoms of cardiovascular disorder in children and adolescents aged 6 to 18 years. Method: In this community-based study, multistage cluster sampling method was used. We randomly selected 1174 children and adolescents who referred to Afshar hospital in Yazd, then, 167 blocks were randomly collected by each cluster head. Each cluster consisted of 6 cases, including three cases of each gender in different age groups (6-9, 10- 14, and 15-18 years). The clinical psychologists instructed the participants to complete the Persian version of Kiddie- Schedule for Affective Disorders and Schizophrenia - Present and Lifetime version (K-SADS-PL). In addition, cardiovascular risk factors were determined for participants and demographic data were obtained from the participants. Results: A total of 1035 children and adolescents participated in this study. The results showed that 228 of the participants (22.2%) suffered from anxiety disorder. There was an indirect significant correlation between anxiety disorder and the symptoms of heart palpitation, shortness of breath, and chest pain. There was no statistically significant relationship between the different types of anxiety disorders and FBS, hyperlipidemia, and hypertension. According to the results, FBS and LDL are a predictor for anxiety disorders. Conclusion: There was a statistically significant association between anxiety in children and adolescents and some risk factors of cardiovascular disorder. Also, this study introduces some cardiovascular predictors of anxiety. However, further studies are needed in this regard. [ABSTRACT FROM AUTHOR]

Platelet dysregulation is drastically increased with advanced age and contributes to making cardiovascular disorders the leading cause of death of elderly humans. Here, we reveal a direct differentiation pathway from hematopoietic stem cells into platelets that is progressively propagated upon aging. Remarkably, the aging-enriched platelet path is decoupled from all other hematopoietic lineages, including erythropoiesis, and operates as an additional layer in parallel with canonical platelet production. This results in two molecularly and functionally distinct populations of megakaryocyte progenitors. The age-induced megakaryocyte progenitors have a profoundly enhanced capacity to engraft, expand, restore, and reconstitute platelets in situ and upon transplantation and produce an additional platelet population in old mice. The two pools of co-existing platelets cause age-related thrombocytosis and dramatically increased thrombosis in vivo. Strikingly, aging-enriched platelets are functionally hyper-reactive compared with the canonical platelet populations. These findings reveal stem cell-based aging as a mechanism for platelet dysregulation and age-induced thrombosis. [Display omitted] • Aging leads to two parallel platelet specification paths from HSCs • The shortcut platelet pathway is perpetuated by highly expansive MkPs • Canonical MkPs are resilient to age-induced changes • The aging-induced shortcut path causes thrombocytosis and platelet hyper-reactivity With advanced age, platelets generated by a differentiation pathway that shortcuts the canonical progenitor cascade to directly make megakaryotic precursor cells from hematopoietic stem cells cause thrombocytosis and are more prone to thrombosis compared with canonically derived platelets. [ABSTRACT FROM AUTHOR]

Laith N AL-Eitan,1,2 Ayah Y Almasri,1 Sahar O Al-Habahbeh1 1Department of Applied Biological Sciences, Jordan University of Science and Technology, Irbid 22110, Jordan; 2Department of Biotechnology and Genetic Engineering, Jordan University of Science and Technology, Irbid 22110, Jordan Purpose: The purpose of this study was to investigate the influence of CYP/CYP450 2C9 (CYP2C9) promoter variable number tandem repeat (p-VNTR) polymorphism on susceptibility to cardiovascular disease and on warfarin sensitivity and responsiveness, in Jordanians with cardiovascular disease during initiation and stabilization phases of therapy. Patients and methods: A total of 211 cardiovascular patients who were being treated with warfarin anticoagulants and 205 healthy individuals were enrolled in this study. PCR-based methods were performed to analyze the effects of CYP2C9 p-VNTR polymorphism on warfarin metabolism. The p-VNTR polymorphism was composed of tandem repeat motifs sorted into three alleles based on the length and structure: short (p-VNTR-S), middle (p-VNTR-M), and long (p-VNTR-L). Results: We found that the genotypic and allelic frequencies differ significantly between patients and healthy individuals; therefore, our results suggest that this polymorphism is associated with cardiovascular disease in the Jordanian population. Moreover, during the initiation phase of therapy, 20% of warfarin-sensitive patients were homozygous for a short allele (p-VNTR-S), and 12.2% were heterozygous for this allele (p-VNTR-M/p-VNTR-S). During the stabilization phase, no significant differences were found between these groups and their genotypic frequencies. Additionally, we did not confirm any relationship between the CYP2C9 p-VNTR polymorphism and warfarin response during either the initiation or the stabilization phases of therapy. Conclusion: Our data show a significant difference between the CYP2C9 p-VNTR polymorphism and risk of cardiovascular disease, in addition to significant association between this polymorphism and sensitivity to warfarin at the initiation phase of therapy in a Jordanian population. However, there is no correlation between this polymorphism and warfarin response, international normalized ratio (INR) values, or required warfarin dose to achieve a target INR either at the initiation or stabilization phases of therapy. To further corroborate our results, additional studies are required with a larger number of samples and different ethnic groups. Keywords: warfarin, CYP2C9 promoter variable tandem repeat, polymorphism, cardiovascular disorder, oral anticoagulant, INR, warfarin dosage

Developmental origin of health and disease postulates that the footprints of early life exposure are followed as an endowment of risk for adult diseases. Epidemiological and experimental evidence suggest that an adverse fetal environment can affect the health of offspring throughout their lifetime. Exposure to endocrine disrupting chemicals (EDCs) during fetal development can affect the hormone system homeostasis, resulting in a broad spectrum of adverse health outcomes. In the present review, we have described the effect of prenatal EDCs exposure on cardio-metabolic-renal health, using the available epidemiological and experimental evidence. We also discuss the potential mechanisms of their action, which include epigenetic changes, hormonal imprinting, loss of energy homeostasis, and metabolic perturbations. The effect of prenatal EDCs exposure on cardio-metabolic-renal health, which is a complex condition of an altered biological landscape, can be further examined in the case of other environmental stressors with a similar mode of action.

Introduction: Hypertension is a cardiovascular risk factor of wide magnitude among people of African descent, especially those living in Quilombos. However, little is known about the factors associated with cardiovascular risk in residents of the urban Quilombola community. Objetive: To analyze the cardiovascular risk and health-related factors in the family context of hypertensive Afro-descendants living in an urban Quilombola. Materials and methods: It is a cross-sectional and community-based study carried out from November 2017 to March 2018. The study's population consisted of 303 hypertensive patients enrolled in the family health unit, with ages ranging from 35 to 79 years old, of both genders; and using antihypertensive drugs. The instruments used for data production were: The Primary Arterial Hypertension Questionnaire and the Framingham Risk Score. Results: There was a significant association between cardiovascular risk and cardiovascular disease (CVD) family history (p<0.011), type II diabetes (p<0.001) and overweight and obesity (p<0.010). Conclusion. Research has shown that hypertensive Quilombola people have consistent cardiovascular risk outcomes, especially with CVD family history, type II diabetes, overweight and obesity, schooling and gender with significant associations. [ABSTRACT FROM AUTHOR]

A recent meta-analysis identified a prospective association between depression and cardiovascular disease; however, there was no association for studies with long-term follow-up periods. The literature has primarily focused on baseline depression status or symptoms, which may not capture the chronic nature of depression. This study examined the prospective relationship between depressive symptoms and cardiovascular disease up to 15 years later in 274 cardiovascular disease–free older adults. Depressive and anxiety symptoms, mean arterial pressure, and cardiovascular disease status were assessed. Baseline and chronic depressive symptoms predicted increased risk of cardiovascular disease, underscoring the importance of assessing and treating depression in older adults. [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]

Intestinal microflora has been associated with obesity. While visceral fat is more strongly associated with cardiovascular disorder, a complication linked to obesity, than the body mass index (BMI), the association between intestinal microflora and obesity (as defined in terms of BMI) has been studied widely. However, the link between visceral fat area (VFA) and intestinal microflora has been little studied. In this study, we investigate the association between intestinal microflora and VFA and BMI using a longitudinal study on Japanese subjects with different VFA statuses (N = 767). Principal component analysis of the changes in intestinal microflora composition over the one-year study period revealed the different associations between intestinal microflora and VFA and BMI. As determined by 16S rRNA amplicon sequencing, changes in the abundance ratio of two microbial genera—Blautia and Flavonifractor—were significantly associated with VFA changes and changes in the abundance ratio of four different microbial genera were significantly associated with BMI changes, suggesting that the associated intestinal microbes are different. Furthermore, as determined by metagenomic shotgun sequences, changes in the abundance ratios of two Blautia species—Blautia hansenii and Blautia producta—were significantly and negatively associated with VFA changes. Our findings might be used to develop a new treatment for visceral fat.

Valve‐in‐valve transcatheter valve implantation (ViV‐TAVI) procedures for deteriorated bioprosthesis are an established therapeutic option for high‐risk patients. The presence of the fixed sewing ring of the bioprosthesis can hamper appropriate expansion of the TAVI. We present a case of a ViViV‐TAVI, as a salvage procedure for acute ViV‐TAVI failure. [ABSTRACT FROM AUTHOR]