Dietary choices are inextricably linked to the incidence of cardiovascular disease (CVD), whereas an optimal dietary pattern to minimize CVD morbidity in high-risk subjects remains challenging.

Left bundle branch area pacing (LBBAP) has evolved into a practical and secure pacing procedure. However, previous studies of LBBAP focused on left heart function and synchronization and lacked assessment of right heart structure and function and interventricular synchrony. The objective of this study was to examine the impacts of LBBAP, right ventricular (RV) septal pacing (RVSP), and RV apical pacing (RVAP) on right heart structure, function and interventricular synchrony.

Previous research on the prognostic implications of left ventricular myocardial strain using cardiac magnetic resonance feature tracking (CMR-FT) in light-chain cardiac amyloidosis (AL-CA) has shown promising potential. This study aimed to evaluate the prognostic significance of global and segmental left ventricular myocardial strain in AL-CA patients, specifically analyzing the American Heart Association's 16 segments.

Atherosclerosis (AS) is an important cause of morbidity and mortality in cardiovascular diseases such as coronary atherosclerotic heart disease and stroke. As the primary natural barrier between blood and the vessel wall, damage to vascular endothelial cells (VECs) is one of the initiating factors for the development of AS. VECs primarily use aerobic glycolysis for energy supply, but several diseases can cause altered glucose metabolism in VECs. Glucose metabolism reprogramming of VECs is the core event of AS, which is closely related to the development of AS. In this review, we review how glucose metabolism reprogramming of VECs promotes the development of AS by inducing VEC barrier dysfunction, autophagy, altering the inflammatory response, and proliferation of VECs, in the hopes of providing new ideas and discovering new targets for the prevention and treatment of AS.

The selection of an appropriate implantable cardioverter-defibrillator (ICD) type and implantation strategy involves a myriad of considerations. While transvenous ICDs are standard, the rise of non-transvenous options like subcutaneous ICDs and extravascular ICDs is notable for their lower complication rates. Historical preferences for dual chamber ICDs have shifted to single-chamber ICDs. Single-coil ICDs are preferred for easier extraction, and the use of the DF-4 connector is generally recommended. Cephalic cutdown is the preferred venous access technique, while axillary vein puncture is a viable alternative. The right ventricular apex remains the preferred lead position until further evidence on conduction system pacing emerges. Left-sided, subcutaneous ICD implantation is considered reliable, contingent on specific cases. A meticulous perioperative plan, including antibiotic prophylaxis and an antithrombotic regimen, is crucial for successful implantation.

The purpose of this meta-analysis was to evaluate the efficacy and safety of pulsed field ablation (PFA) and to compare it with the efficacy and safety of traditional thermal ablation in patients with atrial fibrillation (AF).

Heart failure (HF) is a clinical syndrome characterized by the inability of the heart to provide adequate perfusion to tissues and organs, resulting in typical symptoms such as fatigue, dyspnea, dyspepsia, or swelling due to decreased cardiac output. With its increasing prevalence, heart failure has become one of the leading causes of morbidity and mortality worldwide, imposing a significant burden on the population by reducing long-term life expectancy and raising hospital costs. Indeed, over 20 million people worldwide suffer from heart failure, with a 5-year mortality rate of 60-70%. As heart failure progresses, various structural and metabolic changes occur within the myocardium and organ systems. In the past two decades, therapeutic options for heart failure patients have significantly expanded. In addition to novel pharmacological treatment, advanced surgical methods such as heart transplantation (HTx) and the implantation of durable left ventricular assist devices (LVADs) are available for patients with end-stage heart failure. This review discusses the pathophysiological aspects and metabolic consequences of heart failure and metabolic changes, as well as the benefits and challenges of implanting a left ventricular assist device. Furthermore, future targets for heart failure diagnostics and therapy will be highlighted.

Cancer patients have an increased risk of venous thromboembolism (VTE), and VTE is the second most common cause of death among them. Anticoagulation plays a key role in the treatment of cancer-associated thrombosis (CAT). Low-molecular-weight heparin (LMWH) or direct oral anticoagulants (DOACs) are effective and generally safe options for cancer-associated VTE. However, those patients have a 10-20% risk of VTE recurrence in spite of using anticoagulants. The main reasons for recurrent VTE (rVTE) can be non-compliance, inadequate dosing of anticoagulants, thrombocytopenia and malignancy progression. Despite the publication of major guidelines regarding the management of CAT, the treatment of patients with rVTE is undefined. Treatment options for rVTE include bridging to LMWH in cases of oral anticoagulants use, LMWH dose escalation, and sometimes considering inserting a vena cava filter. This review paper summarizes the management of cancer-associated VTE, risk factors for rVTE and the treatment algorithm of rVTE.

Extracellular vesicles (EVs) are nanoscale vesicles released by cells, which play an important role in intercellular communication by transporting proteins, lipids, nucleic acids, and other molecules. Different intensities of exercise can induce the release of EVs from cells and tissues, such as endothelial cells, skeletal muscle and adipose tissue, hepatocytes, immune cells, and neuronal cells. Exercise-induced EVs exert cardiovascular protective effects such as anti-inflammatory and anti-oxidative by altering their contents. This paper reviews the cell and tissue sources of EVs induced by exercise of different intensities, the regulatory effects of different exercise intensities on EVs, and their mechanisms of action in cardiovascular diseases. The aim is to provide new insights for the treatment of cardiovascular diseases and offer scientific evidence for the construction of engineered EVs mimicking the effects of exercise.

Diabetes mellitus (DM) and left ventricular (LV) systolic dysfunction are common in patients who receive percutaneous coronary intervention (PCI) for chronic total occlusion (CTO). This study aimed to investigate the clinical outcomes of LV systolic dysfunction patients who had successful PCI for CTO over two years, with or without DM.

Atrial fibrillation (AF) is the most common persistent arrhythmia, with increasing incidence worldwide. Transcatheter radiofrequency ablation (RFA) represents a first-line therapy for paroxysmal atrial fibrillation (PAF), although the long-term recurrence rate of AF remains relatively high. This study aimed to investigate the relationship between the average heart rate (AHR) on a dynamic electrocardiogram before transcatheter RFA and the postoperative recurrence of AF in patients with PAF.

Lipoprotein a (Lp(a)) is a lipid biomarker that binds cholesterol and bears independent cardiovascular risk. Strategies to lower the level of Lp(a) and mitigate such risk are important both for primary and secondary prevention. Currently there are no approved therapies targeting Lp(a) directly. Lipid lowering therapies prescribed routinely may have no effect on Lp(a) levels. Some agents such as niacin and estrogens can significantly decrease Lp(a), but their use is not recommended due to their adverse safety profile. Statins increase Lp(a) levels by 10-20%, questioning the benefit of such therapy when this biomarker is elevated. The Food and Drug Administration (FDA) endorses new agents to address dyslipidemia such as proprotein convertase subtilisin/kexin type 9 inhibitors (PCSK9-i) and Inclisiran, a small interfering RNA. These approaches have been shown to also significantly reduce Lp(a), but more clinical data is needed before implementing their use in clinical practice. Clinical trials are currently ongoing to test the efficacy of newly developed antisense oligonucleotides and small interfering RNAs targeting the gene encoding for Lp(a) in hepatocytes, while other investigations assess small molecules that inhibit Lp(a) assembly. This review summarizes the pathophysiology and clinical implications of Lp(a) elevation, and focuses on proposed Lp(a) therapies and the current state of the clinical trials of such novel agents.

This study aims to systematically review the efficacy of various surgical approaches in the treatment of ischemic mitral regurgitation (IMR).

There is limited data regarding the influence of lung compliance on the outcome of patients with cardiogenic shock (CS). Thus, a registry study was conducted to assess the prognostic influence of lung compliance in invasively ventilated patients with CS.

Salt substitution (SS) has been found to reduce blood pressure (BP). However, the impact of SS on cardiac structure, as assessed through ultrasonic cardiogram (UCG) and electrocardiograms (ECG), remains poorly understood. This study aims to evaluate the effects of SS on cardiac structure and ECG parameters.

This review addresses the diagnosis and management of ventricular septal defects (VSDs). The VSDs are classified on the basis of their size, their number, and their location in the ventricular septum. Natural history of VSDs includes spontaneous closure, development of pulmonary hypertension, onset of infundibular obstruction, and progression to aortic insufficiency. While initial diagnostic approaches such as careful history-taking, physical examination, chest X-rays, and electrocardiograms provide basic information, echo-Doppler studies are essential for assessing the defect's clinical significance and determining the need for intervention. Intervention is usually indicated for symptomatic patients with moderate- to large-sized VSDs. Surgical closure is advised for perimembranous, supracristal and inlet VSDs, and for deficits involving prolapsed aortic valve leaflets. While percutaneous methods to occlude perimembranous VSDs with Amplatzer Membranous VSD Occluder are feasible, they are not recommended due to a notable risk of inducing complete heart block in a significant number of patients. Alternatively, percutaneous and hybrid methods employing the Amplatzer Muscular VSD Occluder are effective for treating large muscular VSDs. The majority of treatment options have demonstrated satisfactory outcomes. However, practitioners are urged to exercise caution in managing small defects to avoid unnecessary procedures and to ensure timely intervention for large VSDs to prevent pulmonary vascular obstructive disease.

Venous thromboembolism presenting as deep vein thrombosis or pulmonary embolism (PE) remains to be an important cause of mortality and morbidity worldwide. Despite its significance and incidence, compared to many other cardiovascular conditions there are significant gaps in knowledge in many aspects of it, including its pathophysiology. A rare sequela of PE is chronic thromboembolic pulmonary hypertension (CTEPH). This complication has a poor outcome and data is scarce in this field. Many therapeutic approaches are based solely on clinical expertise, which can be explained by the complex and not fully understood pathobiology of this disease. Over the years, many theories have been proposed regarding its genesis. Although generally acute PE is accepted as a trigger for CTEPH, this condition is multifactorial and cannot be explained by recurring PEs only. By reviewing the current evidence, we have demonstrated that thrombus non-resolution in CTEPH is due to multiple mechanisms and predisposing factors including: inflammation, small-vessel disease, impaired angiogenesis, platelet dysfunction, coagulopathies, malignancy, impaired fibrinolysis, genetics and many other components. Based on the current evidence, we aimed to explain the pathophysiology CTEPH, PE and the connection between these two important diseases. Furthermore, we highlight the negative hemodynamic effects of CTEPH and PE on the right ventricle and its role in further exacerbation of these patients.

Coronary calcification is a well-established risk factor for cardiovascular events. This retrospective study sought to determine the predictive value of coronary calcification in a specific group of patients with chronic kidney disease.

Peripartum cardiomyopathy (PPCM) is a rare disease that causes maternal morbidity and mortality worldwide. However, the etiology of PPCM is still unclear, and the rate of recovery varies between patients. Understanding the genetic factors underpinning PPCM may provide new insights into its pathogenesis.

The relationship between cardiovascular outcomes and niacin consumption levels remains unclear. This study aimed to examine the correlation between niacin intake and the incidence of cardiovascular disease, as well as the mortality rates associated with cardiovascular disease and other causes.

Mitral regurgitation is the second most prevalent valvular disease, with primary mitral regurgitation (PMR) accounting for 61%-67% of cases. Chronic PMR can result in progressive left ventricular remodeling and dysfunction, ultimately leading to heart failure or other adverse cardiac events. This, in turn, necessitates frequent referrals, hospitalizations, and cardiac surgeries. The optimal timing for PMR surgery has been a subject of ongoing debate and remains a controversial issue. Presently, it is recommended that patients with chronic PMR undergo earlier mitral valve surgery to enhance post-operative outcomes. For example, the recommendation of European and American guidelines about left ventricular end-systolic diameter for surgery has been altered from 45 mm to 40 mm. Echocardiographic parameters are regarded as noteworthy indicators for intervention in patients with PMR. Extensive research has been undertaken in the field of echocardiography to identify more effective indicators that can propose the optimal timing for surgery, encompassing both conventional and novel echocardiography parameters. However, some parameters are not known to clinicians and the cut-off values for these parameters have shown some variations. Furthermore, a comprehensive review of this topic is currently missing. Consequently, this review aims to provide a thorough summary and elucidation of the prognostic significance of various echocardiographic measurements and their corresponding cut-off values, to help the clinical decision-making and further improve the outcomes of patients with PMR.