All Articles

Sara Sóñora-López ¹, Nuria Rivas-Gándara ^1,2,3, Gerard Oristrell-Santamaria ^1,2,3, Ignacio Ferreira-González ^1,3,4,5

¹Cardiology Department, Vall d’Hebron University Hospital (HUVH), Barcelona, Spain

²Biomedical Research Networking Centre on Cardiovascular Diseases (CIBERCV), Barcelona, Spain

³Vall d’Hebron Research Institute (VHIR), Barcelona, Spain

⁴Faculty of Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain

⁵Epidemiology and Public Health Networking Biomedical Research Centre (CIBERESP), Madrid, Spain

Acute pulmonary embolism (PE) presents with a wide clinical spectrum ranging from asymptomatic cases to obstructive shock and sudden cardiac death. While supraventricular arrhythmias, particularly atrial fibrillation and sinus tachycardia, are well recognized and associated with worse outcomes, ventricular arrhythmias remain poorly defined and are not routinely included in clinical guidelines. Emerging evidence from case reports suggests that ventricular tachycardia (VT), often with a morphology suggestive of a right ventricular origin, may occasionally represent an initial manifestation of acute PE in patients without structural heart disease. Reported cases consistently show resolution of VT following anticoagulation and treatment of PE, supporting the concept of a transient and reversible arrhythmogenic trigger. Proposed mechanisms include acute right ventricular pressure overload, ischemia, sympathetic activation, hypoxemia, and mechanical stimulation. In contrast, syncope and cardiac arrest associated with PE are more commonly linked to non-shockable rhythms reflecting hemodynamic collapse rather than primary ventricular arrhythmia. Despite these observations, the true incidence and prognostic significance of ventricular arrhythmias in PE remain unknown. This narrative review summarizes current evidence, explores potential mechanisms, and discusses diagnostic and therapeutic implications, highlighting the need for further studies to better define this underrecognized clinical association.

Luigi Tritapepe¹, Laura Cascarano, Marta Iaconi, Marco Cinicola, Cristina Dantimi, Maria Vittoria Antonica, Giulia De Fazio, Manuel Delli Compagni, Micaela Maritti

¹Anesthesia and Intensive Care, San Camillo-Forlanini Hospital, Rome, Italy

End-stage liver disease (ESLD) induces a profound remodeling of the cardiovascular system, leading to a state of chronic hyperdynamic circulation and latent myocardial dysfunction known as cirrhotic cardiomyopathy (CCM). As liver transplantation (LT) remains the definitive treatment for ESLD, the perioperative period presents extreme hemodynamic challenges, including the “reperfusion syndrome” and massive fluid shifts. This paper explores the critical role of advanced echocardiography—moving beyond traditional ejection fraction toward deformation imaging (2D-Speckle Tracking) and intraoperative transesophageal monitoring—as the cornerstone for risk stratification and real-time hemodynamic optimization.

Antonio Maria Labate¹, Provvidenza Villari²

¹ASST Franciacorta, UOSD Diabetologia, Viale Mazzini 4, 25032 Chiari, Italy

²ASST Garda, Specialistica Ambulatoriale, Branca Diabetologia, Località Montecroce, 25015 Desenzano del Garda, Italy

Background: Acute pulmonary embolism (PE) remains one of the most clinically relevant manifestations of venous thromboembolism and continues to pose important diagnostic and prognostic challenges. In routine practice, however, PE is still often considered separately from the broader framework of cardiometabolic disease.

Methods & Scope: This mini-review discusses acute PE in the cardiometabolic patient, focusing on the intersection between obesity, visceral adiposity, type 2 diabetes, and metabolic dysfunction-associated steatotic liver disease (MASLD).

Results: Current evidence suggests that obesity, particularly central and visceral adiposity, represents the most consistent cardiometabolic determinant of venous thromboembolic risk, through mechanisms involving chronic low-grade inflammation, endothelial dysfunction, impaired fibrinolysis, and procoagulant imbalance. Type 2 diabetes appears to play a more nuanced role, acting less as an isolated driver and more as a marker of clustered metabolic vulnerability, especially in the presence of poor glycemic control, renal impairment, and long disease duration. MASLD may further amplify thrombo-inflammatory susceptibility through the liver’s central role in coagulation and fibrinolytic pathways.

Conclusion: In this setting, PE may be more difficult to recognize because symptoms frequently overlap with those of obesity, heart failure, respiratory disease, and general functional limitation. A more integrated cardiometabolic perspective may improve diagnostic vigilance, risk interpretation, and post-event clinical management.

Alyssa Ahern, DO¹, Hossam Albeyoumi, M.B.B.C.H¹, Stephanie Saucier, MD²

¹University of Connecticut, Department of Internal Medicine

²Hartford Healthcare, Department of Cardiology

Introduction: Approximately 1.4 million adults in the United States identify as transgender, about half of whom are treated with gender-affirming hormone therapy (GAHT). Transgender individuals experience increased cardiovascular risk, which may be partly related to GAHT. However, GAHT’s effects on cardiac morphology and function are not well understood. The role of echocardiography in assessing these potential effects remains unclear.

Methods: A literature review was conducted using four major databases with keywords relevant to transgender and cardiovascular health. Articles were screened for relevance based on titles, and selected abstracts were reviewed for the initial inclusion criterion: (1) GAHT and potential effects on cardiovascular health. Remaining articles were read in full and eliminated or stratified based on research themes: (a) GAHT’s effect on cardiac myocardium, (b) effects on ventricular morphology or function, or (c) the role of echocardiography in evaluating GAHT-related cardiac changes.

Results: 960 articles were initially identified, of which 214 distinct abstracts were reviewed, and 85 publications were read in full. 9 articles contained information regarding at least one of the three research themes. Reviewed data suggest GAHT may affect myocardial mass, end diastolic volume, and diastolic function in transgender men. Transgender women may have increased LVEF during exercise. Few studies used echocardiography to evaluate these changes.

Conclusion: GAHT may increase cardiovascular risk in transgender individuals, though underlying mechanisms remain unclear. Few articles evaluate GAHT’s effect on cardiac structure and function, though current data suggest possible cardiac effects. The use of echocardiography to assess GAHT-related cardiac changes remains underexplored.

Claudia Stefanutti

¹Department of Molecular Medicine, Extracorporeal Therapeutic Techniques Unit, Lipid Clinic and Atherosclerosis Prevention Centre, Regional Centre for Rare Diseases, Immunohematology and Transfusion Medicine, Umberto I Hospital, "Sapienza" University of Rome, Viale del Policlinico 155, Rome, 00161, Italy.

Familial hypercholesterolemia (FH) is a genetic autosomal dominant metabolic disorder that is characterized by elevated plasma and lipoprotein levels, such as low-density lipoprotein cholesterol (LDL-C) that carry atherogenic lipids in plasma. There are two forms of FH: Heterozygous Familial Hypercholesterolemia (HeFH), a relatively frequent genetic disorder affecting roughly 1 in 200–300 people worldwide, causing high LDL-C and early atherosclerotic cardiovascular disease (ASCVD). Homozygous Familial Hypercholesterolemia (HoFH) is a rare, severe form occurring in 1 in 160,000 to 1,000,000 people. Early diagnosis and lifelong treatment are essential for patients with FH to reduce the risk of developing cardiovascular disease early in life, increase life expectancy, and improve quality of life. This mini review offers a targeted historical and clinical review of the 5-decade development of extracorporeal treatment methods, especially Lipoprotein Apheresis (LA), in the treatment of HoFH. Besides the overview of its proven efficacy, safety, and pleiotropic activity, the review briefly describes the modern role of LA and new lipid-lowering treatments and their role in the remaining patient groups.

Aarushi Kalra^1*, Henry L.Colorado ¹, Fardeen Faiz ², Ioannis Parastatidis ²

¹Northeast Georgia Medical Center, Gainesville, GA, USA

²Georgia Heart Institute, Gainesville, GA, USA

Background: Pericarditis accounts for approximately 5% of chest pain visits in the emergency department. Standard therapy includes NSAIDs, colchicine, and corticosteroids; however, recurrence and readmissions remain common despite treatment. Few European studies suggest that beta blockers may decrease symptoms and arrhythmia burden; however, the role of beta blockers in acute pericarditis outcomes is limited.

Objective: We sought to examine whether beta blockers influence the clinical outcomes of acute pericarditis.

Methods: We performed a retrospective cohort chart review which analyzed adult patients in the Northeast Georgia Health System diagnosed with pericarditis between 2018 and 2024. A total of 435 patients were included: 155 were not on beta blockers (no BB) and 280 were on beta blockers (BB). Primary outcomes included length of stay (LOS), 365-day cardiovascular and all-cause hospital and emergency department readmissions. 

Results: Based on the results, mean length of stay did not differ between the BB group and the no BB group (4.0 vs 3.0 days, p=0.228). At 1-year, cardiovascular readmissions occurred in 35/280 (12.5%) for the BB group versus 16/155 (10.3%) for the no-BB group (p=0.69). Similar nonsignificant differences were observed for all-cause hospital and ED readmissions. Since arrhythmia events were infrequent, no formal statistical analysis was performed.

Conclusions: In our cohort, beta-blocker use in acute pericarditis was not significantly associated with reduction in LOS or readmission rates. While European data suggests potential benefits, our results do not confirm a clear advantage. Further trials are necessary to define whether beta blockers have a role in pericarditis management.

Federico Virgili^1*, Tommaso Rossi²

¹Department of Medical Surgical Science and Translational Medicine, Sapienza-University of Rome, Radiology Unit-Sant’Andrea University Hospital, 00189 Rome, Italy.

²Department of Radiological Sciences, Oncology and Pathology, Policlinico Umberto I Hospital, Sapienza University of Rome, Viale del Policlinico 155 Sapienza, Rome, 00161, Italy.

Gonzalo Martínez de las Cuevas^1,2*

¹ Servicio de Medicina Interna, Hospital Universitario Marqués de Valdecilla, Santander, Cantabria, Spain

²Departamento de Medicina y Psiquiatría, Universidad de Cantabria, Spain

Heart failure with reduced ejection fraction (HFrEF) is highly prevalent among elderly patients, who frequently present with multimorbidity and frailty and are therefore at very high risk of hospitalization and mortality. Despite strong evidence supporting guideline-directed medical therapy (GDMT), therapeutic optimization remains suboptimal in this population, largely due to concerns regarding tolerability and comorbidities.

Emerging real-world data suggest that the early post-discharge period may represent a critical “window of opportunity” for therapeutic optimization in elderly patients with HFrEF. In this very high-risk population, early initiation and structured titration of disease-modifying therapies may confer substantial absolute benefits, potentially greater than those observed in lower-risk profiles, although this hypothesis requires further investigation.

This mini-review summarizes current evidence on GDMT implementation in elderly patients with HFrEF, with a focus on real-world experience, barriers to optimization, and the prognostic relevance of reducing heart failure hospitalizations. Unresolved controversies regarding patient selection, frailty, and outcome prioritization are discussed. Overall, available evidence suggests that age alone should not preclude therapeutic optimization and that structured, individualized approaches during this early phase may improve outcomes in elderly patients with HFrEF.

Hannah Stillman¹, Ehsan Rahimy^2,3, Prithvi Mruthyunjaya², Karen Wai^2*

¹Division of Ophthalmology, The Warren Alpert Medical School of Brown University, Providence, RI, USA

²Byers Eye Institute, Stanford University School of Medicine, Palo Alto, CA, USA

³Department of Ophthalmology, Palo Alto Medical Foundation, Palo Alto, CA, USA

Introduction: Retinal vein occlusion (RVO) is a condition in which one of the veins supplying the retina is occluded, causing acute vision changes. This event is often a signal of underlying cardiovascular disease and increases the risk for future adverse cardiovascular events.

Aim & method: This mini-review aims to provide an overview of pertinent studies investigating the relationship between RVO and increased risk of cardiovascular events and mortality, as well as treatments proposed to mitigate this risk.

Results: Pubmed database was searched for studies on RVO and risk of cardiovascular and mortality. 41 studies met criteria for inclusion. Following RVO, there was found to be a consistently elevated risk for myocardial infarction and cerebrovascular event, highest in the first year. There was also a mildly increased risk post-RVO for deep vein thrombosis and atrial fibrillation, but not for pulmonary embolism. Recent studies have also suggested that there is an increased risk for all-cause mortality after RVO. Central RVO may be more strongly associated with cardiovascular events as compared to branch RVO. To mitigate cardiovascular morbidity and mortality, treatment has been aimed at preventing atherosclerosis. Statin therapy post-RVO was found to significantly decrease cardiovascular risk.

Conclusion: While the relationship between RVO and cardiovascular disease has yet to be fully elucidated, evidence indicates that RVO is a strong predictor for future cardiovascular events, particularly acute myocardial infarction and cerebrovascular event. Ophthalmologists should work closely with primary care physicians and cardiologists following RVO to ensure proper risk assessment and treatment. These preventative interventions could reduce mortality and morbidity after RVOs.

Maho Kakemizu-Watanabe, Atsuko Hara, Masakazu Hayashida^*

Department of Anesthesiology and Pain Medicine, Juntendo University School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo 113-8421, Japan

Background: Cerebral tissue oxygen saturation monitoring using near-infrared spectroscopy (NIRS) is widely employed during cardiac surgery. Although NIRS devices are approved for monitoring cerebral oxygenation, they are not licensed for prognostic purposes. Nevertheless, multiple studies have demonstrated significant associations between baseline cerebral NIRS values measured before anesthesia induction and postoperative mortality after cardiac and noncardiac surgery in adults, suggesting a potential role for baseline NIRS values in mortality risk prediction. This narrative review summarizes current evidence regarding the association between baseline cerebral NIRS values and postoperative mortality, focusing primarily on adult cardiac and noncardiac surgery and exclusively on mortality rather than composite morbidity endpoints.

Methods: A comprehensive PubMed search was conducted to identify studies investigating the relationship between cerebral NIRS values and postoperative mortality in adult surgical patients.

Results: Six studies evaluating adult cardiac surgery patients and three studies involving adult noncardiac surgery patients were identified. All studies but one demonstrated a significant association between low baseline cerebral NIRS values recorded before anesthesia induction and increased postoperative mortality. These findings suggest that baseline NIRS values reflect underlying cardiac functional reserve and systemic oxygen delivery capacity. Emerging evidence also suggests potential inter-device differences in mortality prediction performance among commonly used NIRS technologies.

Conclusions: Baseline cerebral NIRS values may serve as convenient, useful predictors of postoperative mortality. This review highlights the mechanistic basis of this association and discusses potential differences in prognostic performance among NIRS devices, underscoring the need for further large-scale comparative studies.

Arnav Mana¹, Susan X. Zhao, MD^2*

¹Los Gatos High School, Los Gatos, CA, USA

²Santa Clara Valley Medical Center, San Jose, CA, USA

Despite significant advances in cardiopulmonary resuscitation (CPR) and post-cardiac arrest care, out-of-hospital cardiac arrest (OHCA) remains a major public health problem, with high rates of death and severe long-term neurological impairment among survivors. This systematic review addresses the current methods in predicting poor neurological outcomes in comatose OHCA survivors, including both pre- and post hospital factors, neurophysiological tests, neurological exam, biomarkers, and neuroimaging. A multimodality, multidisciplinary approach incorporating these factors as well as the OCHA survivors and their surrogate decision makers’ values is proposed (WEMuV) to guide neuroprognostication and counseling. The review also identifies emerging technologies such as artificial intelligence and machine learning as promising innovations that could integrate and automate complex patient data analysis to provide more accurate, personalized risk assessments and improve outcomes in OHCA patients.

Liudmila Iamukova¹

¹School of Pharmacy, University of California San Diego, La Jolla, United States

Cardiovascular diseases remain the leading cause of mortality worldwide, with limited capacity for myocardial regeneration following injury. Regenerative strategies, including autologous and allogeneic cell-based therapies, gene therapy, and tissue constructs, are being investigated as potential approaches to restore cardiac function. We searched ClinicalTrials.gov on August 16, 2025, using the terms “heart regeneration”, restricting to interventional trials in phases 1-3. Trials unrelated to cardiac regeneration were excluded. Study characteristics were analyzed by condition, intervention type, phase, geographic distribution, sponsor, age group, and enrollment size. For completed studies, associated publications were reviewed to summarize efficacy and safety outcomes. Of 41 identified trials, 23 met inclusion criteria. Most were early-phase studies (11 phase 1, 9 phase 2, 3 phase 3). Myocardial infarction was the most common target (9 trials), followed by heart failure (8), coronary artery disease (5), and congenital heart disease (1). Autologous strategies predominated, though several allogeneic stem cell and gene therapy trials were also represented. The United States (6 trials) and Spain (5) were the leading contributors, followed by Germany (3), the Republic of Korea (3), and Poland (2). Enrollment ranged from 6 to 420 participants. Publications from completed trials demonstrated consistent safety but variable efficacy in improving left ventricular function and infarct size. Clinical research into cardiac regeneration remains dominated by small, early-phase, investigator-led studies, with limited large-scale, industry-driven development. While feasibility and safety have been established, efficacy signals remain inconsistent, underscoring the need for larger trials to clarify therapeutic benefit.

Tetiana Poliakova¹ and Cheryl L. Wellington^1*

¹Department of Pathology and Laboratory Medicine, Djavad Mowafaghian Centre for Brain Health, The University of British Columbia, Vancouver, British Columbia, Canada, V6T 1Z3

Alzheimer’s disease (AD) remains a leading cause of dementia worldwide, with complex pathophysiology involving amyloid deposition and tau pathology that precedes cognitive decline. Cardiovascular risk factors, including hypertension, type II diabetes, and dyslipidemia, are recognized as modifiable risk factors of AD, especially during midlife, underscoring the close interplay between AD and vascular contributions to cognitive impairment and dementia (VCID). Anti-amyloid immunotherapies offer potential for disease modification; however, they can transiently increase cerebral amyloid angiopathy (CAA), which may lead to serious and potentially fatal adverse effects known as amyloid-related imaging abnormalities (ARIA). These risks are particularly elevated in apolipoprotein E4 (APOE4) carriers, the major genetic risk factor for late-onset AD, underscoring the urgent need for improved safety measures and patient stratification strategies. Notably, the vascular pathways implicated in ARIA may overlap with mechanisms of amyloid clearance influenced by lipid metabolism. The objective of this study is to review how lipoproteins, including low-density lipoprotein cholesterol (LDL-C) and high-density lipoprotein cholesterol (HDL-C), influence amyloid clearance and vascular health, and discuss how cholesteryl ester transfer protein (CETP), a key regulator of lipoprotein exchange, has emerged as a potential therapeutic target in dementia. In addition to effectively lowering LDL-C and increasing HDL-C, the CETP inhibitor obicetrapib has recently shown promising results in slowing progression of a key AD biomarker, p-tau-217, over 12-month of treatment in patients with atherosclerotic cardiovascular disease, with more pronounced effects in APOE4 carriers. This minireview thus highlights the intersection of cardiovascular and neurodegenerative pathways and supports further exploration of lipid-modulating therapies in AD and VCID.

Stefan Duschek¹, Rainer Schandry² & Gustavo A. Reyes del Paso³

¹UMIT Tirol – University of Medical Sciences and Technology, Hall in Tirol, Austria

²University of Munich, Germany

³University of Jaén, Spain

In addition to physical complaints like fatigue, reduced drive, dizziness, and cold limbs, chronic low blood pressure (hypotension) is associated with cognitive impairments and negative mood states. This review is concerned with autonomic and hemodynamic factors implicated in the origin of chronic hypotension and associated symptoms. There is strong evidence of reduced stroke volume and cardiac output, and prolonged pre-ejection period, at rest, during mental challenge and during sleep, indicating reduced myocardial contractility due to low beta-adrenergic drive in chronic hypotension. While studies investigating parasympathetic cardiac control and alpha-adrenergic vascular influences revealed inconsistent results, increased sensitivity of the cardiac baroreflex is well-supported in chronic hypotension. Moreover, cardiovascular stress reactivity is reduced. Low myocardial contractility constitutes the main factor in the manifestation of chronic hypotension; increased responsiveness of the baroreflex may play an additional role. Diminished cardiac output leads to insufficient blood supply of the organism and symptoms like low skin temperature and cold limbs; moreover, low beta-adrenergic activity is involved in hypotension-related mood impairments. Deficits in systemic hemodynamics are partly transferred to brain perfusion, expressed as lower cerebral blood flow at rest and impaired blood flow adjustment during cognitive activity in chronic hypotension. Blunted cardiovascular reactivity reflects reduced autonomic flexibility, limiting the adaptive resources of the organism.

Kayo Sugiyama^1*, Hirotaka Watanuki¹, Masato Tochii¹, Katsuhiko Matsuyama¹

¹Department of Cardiac Surgery, Aichi Medical University Hospital

      1 - 1  Yazako Karimata, Nagakute, Aichi, 480-1195, Japan

Purpose: To evaluate the clinical background and postoperative outcomes of patients with infective endocarditis in the aortic valve position and discuss the appropriate approach in the era of minimum invasive cardiac surgery.

Methods: We evaluated the preoperative background, intraoperative procedure, and postoperative outcomes of infective endocarditis in the aortic valve including 13 patients at our hospital. The right lateral mini-thoracotomy approach was introduced in six patients with localized infectious changes in the aortic valve.

Results: All surgical treatment were performed successfully, and there were no mortality or cardiac events related to recurrent infection. The right lateral mini-thoracotomy approach was completed safely; however, ventricular diverticulum was detected in multidetector computed tomography after surgery.

Conclusions: Infective endocarditis in the aortic valve was appropriately treated, and the postoperative course was favorable. The right lateral mini-thoracotomy approach is feasible, but it should be selected carefully only for cases with localized infection in the aortic valve.

Aima Mustafa Bhatti¹, Khawaja Husnain Haider²

¹Sargent College of Health and Rehabilitation Sciences, Boston University, Boston, Massachusetts 02215

²Department of Basic Sciences, Sulaiman AlRajhi University, AlQaseem, Kingdom of Saudi Arabia

Mesenchymal stem cells (MSCs) are rapidly emerging as living biodrugs with significant potential in regenerative medicine, particularly cardiovascular applications. The recent FDA approval of the first allogenic MSC-based product, Ryoncil (remestemcel-L-rknd), for steroid-refractory acute graft vs. host disease (GvHD), underscores their safety and effectiveness. This paves the way for MSCs to be a safe and effective innovative treatment strategy for acute and chronic ischemic heart disease and cardiomyopathy. Preclinical experiments and translational study data have shown that MSCs have the potential to improve cardiac pump function significantly, opening up a promising avenue for further research. This mini-review explores the promising potential of MSCs as a living drug, offering hope for patients with cardiovascular pathologies.

Niti Dalal¹, Aabha Divya²

¹Department of Epidemiology, Tulane School of Public Health and Tropical Medicine, New Orleans, LA

²Division of Cardiothoracic Surgery, Department of Surgery, Tulane School of Medicine, New Orleans, LA

Patients undergoing pulmonary endarterectomy surgery require lifelong anticoagulation to prevent thromboembolic complications. However, spontaneous retroperitoneal hemorrhage (SRH) represents a rare but severe complication of long-term anticoagulation. There are controversies regarding the optimal timing and strategy for resuming anticoagulation. This review explores the current evidence on long-term anticoagulation management following spontaneous retroperitoneal hemorrhage. This review aims to analyze risks, diagnostic tests, therapeutic approaches, and clinical outcomes. We refer to a case report of SRH following pulmonary thromboembolectomy surgery, and we discuss conservative and interventional management strategies for the management of long-term anticoagulation after significant bleeding complications such as SRH.

Zhuang Lu^1#, Jing Liu^2#, Tangjia Cui¹, Yehua Lu¹, Zhongwei Bao¹, Qiuming He³, Yaming Yan^1*

¹Kangqiao Community Health Center, Shanghai 201319, China

²Department of Microbiology and Immunity, The College of Medical Technology, Shanghai University of Medicine & Health Sciences, Shanghai 201318, P.R. China

³Ruzhou Renai Hospital, Henan 467500, China
^#These authors contributed equally to this work

Objective: This study aimed to examine the effects of low-dose statins on blood pressure in individuals diagnosed with prehypertension and borderline elevated blood lipids.

Methods: From January 2020 to June 2021, a cohort of 150 patients with prehypertension and borderline elevated blood lipids was recruited from the Kangqiao Community Health Service Center, Pudong New Area, Shanghai. Participants were randomly divided into an experimental group and a control group, each comprising 75 patients. Both groups received standard lifestyle interventions. Additionally, the experimental group was treated with low-dose statins, while the control group was given with placebo. The treatment duration was three months. Blood pressure (systolic blood pressure (SBP), diastolic blood pressure (DBP)), blood lipids (total cholesterol (TC), triglycerides (TG), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C)), vascular endothelial function (nitric oxide (NO), endothelin-1 (ET-1), flow-mediated dilation (FMD)), and carotid intima-media thickness (IMT) were measured. These parameters were assessed at baseline, one month into treatment, and at the end of the three-month treatment period. Subsequently, patients were followed for two years to evaluate the incidence of hypertension.

Results: Both SBP and DBP showed a progressive decrease from baseline to three months in both the experimental group and control group, with the experimental group experiencing a more significant reduction. Statistically significant differences were observed between the two groups, over time, and in group-by-time interactions (P < 0.05). Similarly, reductions in TC, TG, and LDL-C were more pronounced in the experimental group, with significant differences between the two groups, time points, and group-by-time interactions (P < 0.05). Improvements in NO and FMD levels and reductions in ET-1 levels were more marked in the experimental group, with statistically significant differences (P < 0.05). IMT reduction was also more notable in the experimental group, with significant differences between groups, over time, and in group-by-time interactions (P < 0.05). After two years of follow-up, the experimental group had a lower prevalence of hypertension compared to the control group (P <0.05).

Conclusion: Low-dose statin therapy could effectively lower blood pressure and blood lipid levels, enhance vascular endothelial function, delay arteriosclerosis progression, and reduce the incidence of hypertension in patients with prehypertension and borderline elevated blood lipids.

Antonio Coca

School of Health and Life Sciences, Universitat Abat Oliba CEU, CEU Universities, Barcelona, Spain

Mohammed Yunus Khan^1*, Sadanand Shetty², Abraham Oomman³, Peeyush Jain⁴, Kumar Gaurav⁵

¹Global Generics India, Dr. Reddy’s Laboratories, India

²Dr. D.Y. Patil Medical College, India

³Apollo Heart Institute, Apollo Hospitals, India

⁴Department of Preventive and Rehabilitative Cardiology with Fortis Escorts Heart Institute, India

⁵Global Generics India, Dr. Reddy’s Laboratories, India

High blood pressure is considered one of the major risk factors for heart disease. In addition to evidence of low heart disease and death with adequate control of blood pressure, antihypertensive treatment is still less effective in clinical practice. It is well documented that there is a decrease in cardiovascular events, such as stroke and MI, with potent therapies to combat high blood pressure. This, however, is generally believed to be the result of a phase. This review paper includes and focuses on evidence from clinical trials in support of amlodipine as a first-line anti-hypertensive agent, showing how its unique properties can provide better cardiovascular protection compared to other antihypertensive agents to prevent stroke and cardiovascular disease. Evidence from the many randomized controlled trials presented below shows that amlodipine has excellent efficacy and safety, as a first-rate anti-hypertensive agent not only to control BP but also to safely improve patient outcomes. Patients treated with this drug have benefited as they have fewer hospitals and lower rates of recovery. Its unique mechanism of action leads to a reduction in the development of atherosclerosis. In addition, amlodipine with effective BP control for 24 hours may also be helpful as an adjunct to the treatment of patients with renal impairment by reducing the progression of end-stage renal disease.

Lauren Johnston, Maria Boumpouli, Asimina Kazakidi^*

^*Department of Biomedical Engineering, University of Strathclyde, Glasgow, UK

Congenital heart disease, which affects more than one million newborns globally each year, contributes to an increased risk of cardiovascular disease and ultimately reduced life expectancy. Computational fluid dynamics (CFD) enables detailed, non-invasive characterization of complex physiological pressure and flow fields, thus improving our understanding of congenital heart disease hemodynamics.

In recent years, this has driven clinical decision-making, surgical planning, and the evaluation of innovative surgical techniques. In this mini review, CFD methods applied to the study of congenital abnormalities, with a focus on the aorta and pulmonary bifurcation, are discussed. The clinical relevance and future directions of CFD modelling are also reviewed.

Yuling He¹, Jingjing Wang¹, Lingdong Kong¹, Bo Jia¹, Yujia Chi¹, Xiaoyu Zhai¹, Han Jin², Ziping Wang¹*

¹Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Thoracic Medical Oncology, Peking University Cancer Hospital and Institute, China

²Department of Cardiology, Peking University First Hospital, China

Background: Cardiac and pericardial metastasis in small cell lung cancer (SCLC) is more common than estimated, but there are a few related studies in the literature. This study aims to raise the attention of such clinical circumstances.

Methods: We analyzed the clinical data of 62 SCLC patients with arrhythmia and confirmed eleven cases of SCLC with cardiac and/or pericardial metastasis by cytology or imaging diagnosis. Survival analysis was performed by the Kaplan-Meier method.

Results: Among 11 patients, 6 had pericardial involvement, 10 had mediastinal lymph node metastasis, and 8 had hilar lymph node metastasis. The most common type of electrocardiogram (ECG) abnormality was supraventricular arrhythmias (10/11). Complete imaging data were obtained in 7 patients through whole treatment after diagnosed with cardiac metastasis. Among them, 5 patients achieved partial response, and 2 of them achieved improvements in ECG abnormality. In the two remaining patients, advances in imaging diagnosis were identified after treatment, and new abnormalities were found in their ECG. The median overall survival time of the 11 patients was 11 months.

Conclusions: Cardiac and pericardial metastasis of SCLC can present different types of arrhythmia, and the ECG may change after treatment. Clinicians should take this condition into consideration, and aggressive treatment may achieve significant remission. 

Yanyi Tian^1,4,5, Wei Tian^2,4,5, Ting Li³, Jingman Xu^1,4,5*

¹Heart Institute, School of Public Health, North China University of Science and Technology, Tangshan, Hebei, China

²Analysis and Test Center, North China University of Science and Technology, Tangshan, Hebei, China

³College of Foreign Language, North China University of Science and Technology, Tangshan, Hebei, China

⁴Hebei Province Key Laboratory of Organ Fibrosis, Tangshan, Hebei, China

⁵International Scientific and Technological Cooperation Base of Geriatrics Medicine, Tangshan, Hebei, China

César Del Castillo Gordillo^1,2*, Mario Alfaro Diaz¹

¹Cardiovascular center, San Borja Arriaran Hospital, Santiago, Chile

²Cardiovascular center, DIPRECA Hospital, Santiago, Chile

Akanksha Agrawal¹*, Deepanshu Jain², Jefferson Baer¹, Michael McDaniel¹

¹Division of Cardiology, Emory University School of Medicine, Atlanta, GA, USA

²Center for Interventional Endoscopy, AdventHealth, Orlando, FL, USA

Coronavirus Disease 2019 (COVID-19) is a primary respiratory illness with various cardiac manifestations. This case describes a patient presenting as acute myocardial infarction (AMI) with cardiogenic shock and acute hypoxic respiratory failure secondary to COVID-19 complicated by acute embolic stroke.