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                    <pubDate>Mon, 20 Jul 2026 09:33:26 +0000</pubDate>

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                    </image><item><title><![CDATA[Are Marital Status and Quality Risk Factors for Cardiovascular Diseases?]]></title><link>https://www.benthamscience.comarticle/147245</link><description><![CDATA[]]></description> </item><item><title><![CDATA[Cardiovascular Disorders in Systemic Lupus Erythematosus]]></title><link>https://www.benthamscience.comarticle/147532</link><description><![CDATA[Systemic Lupus Erythematosus (SLE) is a chronic autoimmune disease with multiorgan and system involvement, including the Cardiovascular (CV) system. Cardiac involvement in these patients is frequent and most often asymptomatic, at least in the early stages. It includes accelerated atherosclerosis, premature Coronary Artery Disease (CAD), and a high risk of CV complications. The risk of developing CV Disease (CVD) in SLE is linked not only with classical CV risk factors but also with disease-specific factors, like the degree of activity, autoantibodies, organ damage, and type of therapy. Clinical presentation comprises several clinical manifestations ranging from angina to acute Myocardial Infarction (MI) and Sudden Cardiac Death (SCD). The leading cause of death in SLE patients is from CVD due to accelerated atherosclerosis, which often has a more rapid progression compared with the general population. The CV risk in SLE is greater when antiphospholipid antibodies are present. Regarding diagnosis, apart from relevant blood tests, the simplest and readily available diagnostic test, echocardiography, with its contemporary techniques that include global longitudinal strain, is needed to provide a more thorough cardiac evaluation and allow for early management. These aspects of the disease, together with issues regarding phenotypes, biomarkers, neonatal lupus, heart block, SLE-related CV ailments such as coronary artery disease (CAD), myocarditis, valvular heart disease, and the antiphospholipid syndrome, as well as diagnostic modalities, drug and interventional therapies, and current relevant guidelines are all thoroughly reviewed and discussed in this article.]]></description> </item><item><title><![CDATA[Advances in Drug-Eluting Angioplasty Balloon Coatings, Clinical Implications and Future Directions: A Mini Review]]></title><link>https://www.benthamscience.comarticle/148618</link><description><![CDATA[Drug-eluting angioplasty balloons are a highly effective treatment for neointimal hyperplasia post-balloon angioplasty and in-stent restenosis. Current drug-eluting angioplasty balloons have restenosis rates approximating 20%, and both paclitaxel, the current drug coating of choice, and sirolimus, an alternative coating being evaluated in early clinical studies, delay re-endothelialisation, potentially predisposing to thrombosis. There remains a paucity of efficacious alternatives to these coatings. Research into alternative drug-eluting balloon coatings is the source of intense investigation in attempts to improve on efficacy and safety of this highly effective therapeutic intervention. We discuss recent clinical developments with regard to sirolimus drug-coated balloons, demonstrating efficacy in early studies in relation to coronary, peripheral arterial, and renal access applications. However, limited comparator studies with paclitaxel currently exist. In addition, we explore novel drug-eluting angioplasty balloon coatings currently under evaluation in the preclinical space, together with associated molecular mechanisms of action. Further in vivo evaluation of these potential alternative coatings is required, and an algorithm to support the rational evaluation of novel coatings and their subsequent clinical development has been provided.]]></description> </item><item><title><![CDATA[Validation of the Zwolle Risk Score in STEMI Patients Undergoing Primary PCI: Insights from the ISCAS-STEMI COVID-19 Registry]]></title><link>https://www.benthamscience.comarticle/147712</link><description><![CDATA[<p>Background: Several scores have been developed to facilitate risk stratification and early discharge following primary angioplasty, particularly the Zwolle Risk Score (ZRS). However, validation in large-sized studies is still lacking. Therefore, the aim of the current study was to validate the use of the ZRS in a contemporary global population, including patients who were treated during the SARS-CoV-2 pandemic and enrolled in a large intercontinental observational study. </p> <p> Methods: The ISACS-STEMI COVID-19 is a large-scale retrospective multicenter registry involving primary PCI centers from Europe, Latin America, South-East Asia, and NorthAfrica, including patients treated from March 1st until June 30th, in 2019 and 2020]. ZRS was calculated for each patient. The patients were additionally categorized according to the following values of the ZRS [≤3; 4-6; 7-9; ≥10]. Our study outcomes were in-hospital and 30-day mortality. The discriminatory capacity of the ZRS was assessed by the area under the ROC curve [c statistic] as an index of model performance. </p> <p> Results: Our population is represented by 16084 STEMI patients undergoing mechanical reperfusion enrolled in 109 centers. The score showed a very good performance in the predicting mortality both in-hospital [AUC=0.83 [0.82-0.85], p<0.0001] and at 30- day follow-up [AUC=0.82 [0.81-0.84, p<0.0001]. The results were confirmed when the ZRS was separately applied to patients treated in 2019 and 2020, with good stability across time. ZRS was able to identify a large cohort [n=10672, 66.3%] of low-risk patients [score ≤3] with a very low mortality rate at 2 days [1%] and between 3 and 10 days [0.7%], with a very good negative predictive value for in-hospital [98.3%] and 30-day mortality [97.7%], with similar results in 2019 and 2020. </p> <p> Conclusion: This study is the first to demonstrate the good prognostic performance of the ZRS in a large-scale contemporary global multicenter validation set. Similar results were obtained both in the pre-pandemic and the COVID-19 era. ZRS ≤3 identified a very low-risk population that could be discharged early, even during the COVID-19 pandemic, with expected advantages in the availability of hospital beds and nursing staff, costs of medical care, and in-hospital risk of contagion.</p>]]></description> </item><item><title><![CDATA[Association between Statin use and Abdominal Aortic Calcification in Male, Non-diabetic Elderly]]></title><link>https://www.benthamscience.comarticle/146995</link><description><![CDATA[<p>Aims: Our study was to investigate the association between statin use and the prevalence of abdominal aortic calcification (AAC). </p> <p> Methods: The population was enrolled in the 2013-2014 cycle of the National Health and Nutrition Examination Survey (NHANES). The statin use was determined from the questionnaire inquiring the medications taken in the past month. The presence of AAC and severe AAC were assessed based on the AAC score measured by abdominal dual-energy X-ray absorptiometry (DXA). Logistic regression analysis was performed to evaluate the association between statin treatment and AAC after adjustment for potential confounders. </p> <p> Results: The study included a total of 2074 individuals; the average age 61.6±11.8 years old and 922 (44.5%) were male. AAC (AAC score >0) was present in 35.4% of the population and 12.0% had severe AAC. There were 836 (40.3%) statin users. After adjustment for demographics, lifestyles, comorbidities, and laboratory examinations, statin use was associated with higher odds of AAC (OR 1.28, 95%CI 1.02-1.62; P=0.034) and severe AAC (OR 1.78, 95%CI 1.24-2.55; P=0.002), respectively. Subgroup analysis revealed that the association was stronger in male, non-diabetic participants and those aged >60 years old. </p> <p> Conclusion: Stain use was associated with a greater presence of AAC and severe AAC. This association was stronger for male, non-diabetic participants and those aged >60 years.</p>]]></description> </item><item><title><![CDATA[Hepatic Fibrosis Predicts the Prognosis of Patients with Acute Ischemic Stroke Through the Mediation of Cardioembolism]]></title><link>https://www.benthamscience.comarticle/146857</link><description><![CDATA[<p>Background: Hepatic fibrosis, a chronic pathological condition, is associated with adverse outcomes in stroke patients. Cardioembolism (CE) is a common etiology of stroke, yet the association between hepatic fibrosis and CE remains understudied. </p> <p> Aims: This study aims to investigate the association between hepatic fibrosis and CE-induced stroke, as well as its impact on stroke patient prognosis. </p> <p> Methods: This retrospective study included 344 acute ischemic stroke (AIS) patients who underwent thrombolytic therapy. Hepatic fibrosis was assessed using the Fibrosis-4 (FIB-4) index and the Aspartate Aminotransferase-Platelet Ratio Index (APRI). Mediation analysis examined the role of CE in the association between hepatic fibrosis and 3-month functional outcomes. </p> <p> Results: Among 344 patients, 319 were classified using the Trial of Org 10172 in Acute Stroke Treatment criteria. Severe fibrosis (FIB-4 ≥ 2.01) was observed in 131 patients (38.08%), and CE was identified in 79 patients. FIB-4 was an independent predictor of CE (OR: 2.038, 95%CI: 1.507- 2.757, p &#60; 0.001) and poor 3-month functional outcome (OR: 1.477, 95%CI: 1.103-1.978, p = 0.009) after adjusting for confounders. The effect of FIB-4 on poor 3-month functional outcomes was partially mediated by CE, with a mediation proportion of 30.63%. </p> <p> Conclusion: Hepatic fibrosis is a significant predictor of short-term functional outcomes in AIS, particularly cardioembolic stroke. The association between hepatic fibrosis and stroke outcomes is partially mediated through CE. These findings highlight the importance of assessing hepatic fibrosis in stroke patients, particularly those with CE etiology.</p>]]></description> </item><item><title><![CDATA[Tumor-Associated Pericytes: Tumorigenicity and Targeting for Cancer Therapy]]></title><link>https://www.benthamscience.comarticle/146760</link><description><![CDATA[Pericytes, also known as mural cells, are cells embedded between endothelial cells and the basement membrane of capillaries, where they orchestrate the morphological and functional homeostasis of blood vessels. Within the tumor microenvironment, pericytes interact closely with various cellular components, including tumor cells, stromal cells, and immune cells. Through these dynamic interactions, pericytes are activated and subsequently transform into tumor-associated pericytes (TPCs). The origin of TPCs varies depending on the tissue and tumor type, contributing to their phenotypic and functional heterogeneity. TPCs play pivotal roles in facilitating tumor progression, metastasis, immune evasion, and therapeutic resistance by promoting angiogenesis, engaging in reciprocal interactions with tumor cells, remodeling the extracellular matrix, and fostering an immunosuppressive microenvironment. This review synthesizes the latest significant advancements in targeted therapies against TPCs. It underscores the challenges inherent in developing effective anti-TPC therapies, which include the heterogeneity and pluripotency of TPCs, the absence of specific markers for precise TPC targeting, and the limited understanding of how current anti-tumor therapies affect TPCs and vice versa. This review furnishes a comprehensive understanding of the origins, markers, and functions of TPCs, and their interplays within the tumor microenvironment, providing prospective strategies for more effective anti-tumor therapy.]]></description> </item><item><title><![CDATA[Comparison of Clinical Outcomes between Newly Diagnosed and Pre-Existing Diabetes Mellitus Patients after Acute Coronary Syndrome]]></title><link>https://www.benthamscience.comarticle/146856</link><description><![CDATA[<p>Aims: This study aimed to evaluate clinical outcomes, including recurrent acute coronary syndrome (ACS) and mortality, in ACS patients with varying HbA1c levels, addressing the controversy over optimal targets in those with newly diagnosed and pre-existing diabetes mellitus (DM). </p> <p> Methods: From January 2005 to December 2019, a total of 33,990 patients were identified with ACS in the Chang Gung Research Database based on their medical history. After excluding patients without DM and baseline or subsequent HbA1C data, a cohort of 11,870 DM patients was divided into two groups: one consisting of 6,089 patients with newly diagnosed DM and the other comprising 5,781 patients with pre-existing DM. </p> <p> Results: During the three-year follow-up, the pre-existing DM group experienced worse clinical outcomes, such as increased rates of re-ACS, major bleeding, cardiovascular (CV) events, and all-cause mortality. Optimal HbA1c levels for mitigating re-ACS and/or CV mortality and all-cause mortality appeared to differ between the two DM cohorts. Re-ACS and CV mortality reached their highest at an HbA1c of 6.8% for all DM patients, 6.6% for newly diagnosed, and 6.7% for pre-existing cases. The greatest all-cause mortality risk was at an HbA1c of 7.4% for all DM patients, 7.0% in newly diagnosed, and 8.2% in pre-existing patients. </p> <p> Conclusion: Upon comparing newly diagnosed DM patients with those with pre-existing DM, a poorer prognosis was observed in the latter group, attributed to older age and a higher burden of comorbidities. Throughout the follow-up period, maintaining consistently low HbA1c levels did not reduce the incidence of re-ACS nor enhance survival rates.</p>]]></description> </item><item><title><![CDATA[Implementing Climate-Adaptive Strategies to Mitigate the Burden of Rheumatic Diseases]]></title><link>https://www.benthamscience.comarticle/148496</link><description><![CDATA[Climate change has been acknowledged as a major global public health concern that has influenced the general population. The reported changes in climate have been identified as a common risk factor in the development of rheumatic diseases in multiple ways. Extreme weather events can interfere with timely access to healthcare services, supply chain management of drugs and equipment, and the provision of rehabilitation services, which altogether can worsen the management of different rheumatic diseases. Acknowledging the impending changes in climate and their potential impact on the occurrence and progression of different rheumatic diseases, there is an immense need to implement targeted public health measures. In conclusion, climate change can influence the development and progression of existing rheumatic diseases in multiple ways. This calls for the need to design climate adaptation policies and implement targeted public health interventions to improve resilience to climate change.]]></description> </item><item><title><![CDATA[Comparison of Different Double-Stent Implantation Techniques on Coronary Bifurcation Lesions: A Finite Element Analysis]]></title><link>https://www.benthamscience.comarticle/149337</link><description><![CDATA[<p>Introduction: This study aims to investigate the impact of different double-stent methods on the structure and mechanics of coronary bifurcation lesions, providing reference indicators for clinicians in selecting an appropriate interventional procedure. </p> <p> Methods: Three-dimensional reconstruction of coronary Computed Tomography Angiography (CTA) image data of a patient with coronary bifurcation disease was performed. Two types of double-stent (Cullotte and Crush) procedures were simulated, and their effects were evaluated using Finite element analysis. Intravascular Ultrasound (IVUS) validation and retrospective clinical analysis were performed to support computational findings. </p> <p> Results: The stress distribution following the Cullotte stent was concentrated in the SB, whereas the stress after the Crush procedure was localized at the overlap with the proximal main vessel three-layer stent. Compared with the Crush procedure, the Culotte approach resulted in a lower percentage of double-stent malapposition, better dilation of vascular stenosis, and less narrowing of the SB stent, suggesting a more favorable clinical outcome. IVUS validation and retrospective clinical analysis were performed to support computational findings. </p> <p> Discussion: Culotte stenting resulted in better stent-vessel conformity and more favorable stress distribution. The findings support FEA as a valuable tool in procedural planning. </p> <p> Conclusion: The findings suggest that the Culotte technique may offer mechanical advantages over the Crush technique, potentially improving long-term clinical outcomes. These results emphasize the role of computational modeling in optimizing interventional strategies.</p>]]></description> </item><item><title><![CDATA[Role of Perturbations of Epigenetic Processes in Cardiac Hypertrophy and Fibrotic Scarring]]></title><link>https://www.benthamscience.comarticle/149392</link><description><![CDATA[<p>Introduction: Cardiac hypertrophy and fibrotic scarring are fundamental contributors to the progression of heart failure and are associated with poor clinical outcomes. Recent advancements in cardiovascular research have emphasized the central role of epigenetic mechanisms, including DNA methylation, histone modifications, chromatin remodeling, and non-coding RNAs, in regulating the gene expression changes underlying these pathological processes. </p> <p> Methods: A comprehensive literature review was conducted using databases, including PubMed, Scopus, and Web of Science. Predefined keywords and inclusion/exclusion criteria were applied to select relevant studies focusing on epigenetic regulation in cardiac hypertrophy and fibrosis. Particular attention was given to studies involving DNA methyltransferases, TET enzymes, histone deacetylases, demethylases, chromatin remodeling complexes, and non-coding RNAs. Methodological transparency was ensured through a structured screening and data extraction process. </p> <p>Results: The review highlights the dynamic regulation of cardiac gene expression by epigenetic factors. DNA methylation and demethylation influence fibroblast activation and extracellular matrix deposition. Histone-modifying enzymes reshape chromatin architecture, altering transcriptional accessibility. Chromatin remodeling complexes regulate nucleosome positioning during stress responses. Emerging insights into epigenetic memory and transgenerational epigenetic inheritance further reveal the heritable nature of disease susceptibility. </p> <p> Discussion: These epigenetic perturbations collectively orchestrate the maladaptive gene expression patterns seen in cardiac hypertrophy and fibrosis. Understanding their roles provides a mechanistic basis for identifying biomarkers and therapeutic targets. The review also discusses recent omics-based technologies that aid in the characterization of epigenetic alterations, thereby expanding diagnostic and therapeutic horizons. </p> <p> Conclusion: Epigenetic mechanisms are pivotal in the development and progression of cardiac hypertrophy and fibrosis. Advances in epigenomic profiling are facilitating the development of precise and targeted interventions. This review underscores the potential of epigenetic therapies and calls for intensified research efforts to translate these findings into clinical applications.</p>]]></description> </item><item><title><![CDATA[Artificial Intelligence Tools in Myocardial Infarction Prognosis: Evaluating the Performance of Machine Learning and Deep Learning Models]]></title><link>https://www.benthamscience.comarticle/149342</link><description><![CDATA[In clinical practice, mortality risk assessment in patients with myocardial infarction often relies on scales such as GRACE and TIMI. However, these scales were developed based on cohorts assembled many years ago. Since then, numerous changes have occurred, ranging from shifts in MI patient profiles to the introduction of new antiplatelet medications and the adoption of more restrictive lipid therapy targets. To address this issue, researchers are working to develop new stratification tools. Artificial intelligence (AI), which finds applications in nearly every area of medicine, also presents solutions to this problem. This review includes sixteen papers that contain machine learning and deep learning models used to prognosticate mortality risk at different points. Machine learning (ML) models, such as random forest, gradient boosting, and support vector machines, have demonstrated good to excellent performance. However, no single algorithm appears to be top-performing. Although artificial neural networks are considered one of the most promising algorithms, they do not invariably outperform other ML methods. The adaptability of AI models to various scenarios and their ability to handle complex datasets reassures us of their potential in cardiology. Concerning variables that influence the risk of mortality, most are well-established factors, such as age, left-ventricular ejection fraction, lipid parameters, and B-type natriuretic peptide. Additionally, less apparent indicators include platelet parameters, neutrophil count, and blood urea nitrogen. In conclusion, utilizing AI-based models in myocardial infarction risk stratification presents a significant opportunity to develop effective and tailored tools.]]></description> </item><item><title><![CDATA[The Role of Anthocyanins in Cardiovascular Health: A Review]]></title><link>https://www.benthamscience.comarticle/149552</link><description><![CDATA[Anthocyanins are natural polyphenols found in various fruits and vegetables, offering numerous health benefits. Clinical studies suggest that anthocyanin supplementation may regulate blood pressure, improve lipid profiles, reduce triglycerides (TG), thiobarbituric acid reactive substances (TBARS), cytokines, and platelet aggregation, while also reducing arterial stiffness. The multiple pathways, including the downregulation of proinflammatory markers and suppression of the nuclear factor kappa-light-chain-enhancer of activated B cells (NF-κB) pathway, prevention of lipoprotein oxidation, enhancement of nitric oxide (NO) bioavailability, improvement of endothelial function, and modulation of the gut microbiota, collectively contribute to managing cardiac health. However, some clinical studies have found no significant positive impact of anthocyanins on cardiovascular disease, possibly due to the varied form, stability, dosage, and study duration. Therefore, future research should investigate anthocyanin stability, establish standardised therapeutic strategies, and conduct large-scale longitudinal studies to elucidate the impact of anthocyanin consumption on cardiovascular health and quality of life.]]></description> </item><item><title><![CDATA[Serum Uric Acid Levels and Risk of Atrial Fibrillation in Heart Failure Patients]]></title><link>https://www.benthamscience.comarticle/149056</link><description><![CDATA[]]></description> </item><item><title><![CDATA[A Bibliometric Analysis of P2X7R in Cardiovascular Diseases from 2005 to 2024]]></title><link>https://www.benthamscience.comarticle/149029</link><description><![CDATA[<p>Introduction: The P2X7 receptor (P2X7R), which mediates inflammation, is implicated in an extensive variety of diseases, including cardiovascular dysfunction. Recently, studies focusing on the role of P2X7R in cardiovascular disorders have garnered significant attention. However, a bibliometric evaluation within this area has yet to be carried out. </p> <p> Methods: A bibliometric analysis was performed by searching for research related to P2X7R and cardiovascular diseases in the Web of Science Core Collection (WoSCC) database from 2005 to 2024. The tools CiteSpace and VOSviewer were utilized to analyze data and create visual representations of various elements, including countries, institutions, authors, journals and keywords. </p> <p> Results: Over the past two decades, 371 articles in English were obtained in the last 20 years. The People's Republic of China, Nanchang University, the journal 'Purinergic Signalling,' and author Shandong Liang had the highest productivity in their respective categories. The top 4 keywords were ''activation',' ''p2x7 receptor',' ''ATP',' and ''inflammation''. Burst keyword analysis indicated that ''purinergic signaling'' and ''oxidative stress'' are emerging key areas worthy of further investigation. These topics, seeing a surge in interest, are predicted to remain prominent in research. </p> <p> Discussion: This is the first bibliometric analysis of P2X7R in cardiovascular disorders, which reports the hot spots and emerging trends. The interaction between ''purinergic signaling'', ''inflammation'', and ''oxidative stress'' are considered to be the current research priorities, suggesting that these topics are likely to remain central in future research. </p> <p> Conclusion: This study underscores the growing importance of P2X7R in cardiovascular research and offers valuable insights to guide future investigations.</p>]]></description> </item><item><title><![CDATA[Role of eRNAs in Cardiovascular Diseases]]></title><link>https://www.benthamscience.comarticle/148738</link><description><![CDATA[Enhancer RNAs (eRNAs), a class of non-coding RNAs transcribed from enhancer regions, have emerged as critical regulators of gene expression in cardiovascular diseases (CVDs), which are among the leading causes of morbidity and mortality in China. The pathogenesis of CVD is complex, involving precise regulation of diverse biological processes. Recent advances in epigenetics have highlighted the pivotal role of eRNAs in gene regulation. This review summarizes the fundamental characteristics of eRNAs and their mechanisms of action in CVD, focusing on how they regulate gene expression through enhancer-promoter looping, chromatin remodeling, and transcriptional control. Key eRNAs, including IRENES, CARMEN, LINC00607, HERNA1, PSMB8-AS1, and WISPER, are discussed in detail, emphasizing their roles in pathological processes, such as cardiac development, vascular remodeling, atherosclerosis, and fibrosis. These eRNAs interact with transcription factors and others to influence cardiovascular gene regulatory networks. Advances in high-throughput sequencing have identified eRNAs as potential biomarkers and therapeutic targets in CVDs, offering implications for diagnosis, treatment, and precision medicine. For instance, targeting CARMEN may attenuate atherosclerosis, while LEENE could address endothelial dysfunction. Despite their therapeutic potential, further studies are needed to elucidate the mechanisms underlying eRNAs function and their roles in CVD pathogenesis. A deeper understanding of eRNAs may pave the way for novel therapeutic strategies in cardiovascular medicine.]]></description> </item><item><title><![CDATA[Heart Transplantation: Immunological Challenges Revisited]]></title><link>https://www.benthamscience.comarticle/149028</link><description><![CDATA[<p>Introduction: Immunologic responses to cardiac allografts initiate before transplantation during brain-dead organ procurement and might persist for years after transplantation, culminating in chronic allograft dysfunction. Despite remarkable advances in post-transplant care and immunosuppressive agents, acute cellular and antibody-mediated rejections as well as chronic allograft vasculopathy significantly affect cardiac allograft and patient survival. </p> <p> Methods: Herein, recent findings of the molecular mechanisms involved in the inflammatory responses before and after heart transplantation, including brain death donor inflammation, acute cellular rejection, antibody-mediated rejection, and chronic allograft dysfunction, have been summarized, along with novel therapeutic approaches for their treatment. Finally, recent developments in prognostic and diagnostic biomarkers for immunological complications have been provided, with an overview of the most promising biomarkers to date. </p> <p> Results and Discussion: Due to the recent developments in the description of molecular mechanisms involved in the immunopathogenesis of cardiac allograft rejection, some immune cells, proinflammatory cytokines, and adhesion molecules have been proposed as therapeutic targets for the prevention or treatment of alloimmune responses. In addition, several molecules derived from graft tissue or immune cells, e.g. natriuretic peptides, cardiac troponins, exosomal products, microRNAs, and donor-derived cell-free DNA, have been suggested as potential biomarkers for the prediction or diagnosis of cardiac transplant rejection. </p> <p> Conclusion: Considering the need to design non-invasive, low-cost tests for early diagnosis of post-transplant complications and convenient follow-up of the cardiac transplant recipients, peripheral blood biomarkers could be appropriate candidates for this purpose.</p>]]></description> </item><item><title><![CDATA[Cardiac Cancer: An Evidence-Based Study of Occurrence]]></title><link>https://www.benthamscience.comarticle/149531</link><description><![CDATA[<p>Introduction: From 1931 to 2025, spanning 94 years, cardiac cancer has remained a rare and sporadic tumor that poses both an investigative dilemma and a therapeutic challenge. Autopsy findings indicate that the incidence of primary cardiac malignancies is approximately 0.02 percent. Surgical resection is considered a viable and often successful treatment option. </p> <p> Aims: The present study aims to provide an overall assessment of cardiac cancer in Isfahan Province, Iran. </p> <p> Objectives: To provide detailed information on specific aspects, such as frequency and demographic characteristics of cardiac cancer. </p> <p> Methods: The representative data of this study were drawn from the general population of Isfahan Province. SEER (Surveillance, Epidemiology, and End Results) data were obtained from the Deputy of Health, Division of Registry of Cancer (between 2011 and 2015). With attention to subject selection (the authors followed the Sex and Gender Equity in Research (SAGER) Guidelines), and according to the ICDO topography code, C38 was considered for further investigation as heart cancer or cardiac tumors. </p> <p> Results and Discussion: During the study period, a total of 30,465 cancer patients were recorded, comprising 14,638 females and 15,827 males. Among these, 122 cases (0.4 percent) were identified as cardiac cancer, including 42 females and 80 males. The patients' ages ranged from 3 to 95 years, with a mean age of 46.8 ± 21.5 years. The annual distribution of reported cardiac tumors during the study period was as follows: 34, 37, 18, and 33 cases, respectively. Based on available data from the monographic code M, which does not specify subtypes, the following conditions were recorded: mesothelioma (n = 25), neoplasm (n = 11), Hodgkin lymphoma, nodular sclerosis, NOS (n = 14), and other unspecified conditions. A total of three deaths were reported. </p> <p> Conclusion: In the population studied, the frequency of cardiac cancer in men was significantly higher than in women. Age related to cardiac cancer in 51% was between 40-70 years old. For the patient satisfaction and financial aspects of the Iranian health system, further consideration is suggested regarding referral systems, evidence-based pharmacotherapy, and post-surgery outcome inquiries.</p>]]></description> </item><item><title><![CDATA[Phytoconstituents-mediated Targeting of Ferroptosis for the Treatment of Cardiovascular Disease]]></title><link>https://www.benthamscience.comarticle/148999</link><description><![CDATA[Ferroptosis, an instance of iron-dependent programmable cell death that results from oxidative stress & lipid peroxidation, has garnered interest due to its associations with cardiovascular diseases, such as atherosclerosis, myocardial infarction, as well as heart failure. Unlike necrosis or apoptosis, ferroptosis involves unique metabolic pathways that disrupt cellular redox balance and lipid homeostasis, leading to substantial cell damage in cardiovascular tissues. It is becoming recognized that phytoconstituents—bioactive compounds derived from plants—can modify ferroptosis pathways and provide cardioprotective advantages. Compounds including curcumin, resveratrol, quercetin, tanshinone IIA, and epigallocatechin gallate (EGCG) have shown potential in preclinical studies by concentrating on significant ferroptotic processes. Finally, by controlling iron homeostasis, boosting antioxidant responses (such as Nrf2 pathway activation), and reducing lipid peroxidation, these phytochemicals may mitigate ferroptosisinduced cardiac cell death. In animal studies, these natural compounds have shown promise in reducing oxidative damage and improving heart function after injury. This article summarises the mechanisms via which a variety of phytoconstituents influence ferroptosis and discusses their potential as an adjuvant treatment for CVD. While these findings are encouraging, further research is needed to use them in clinical settings, with a focus on long-term safety in human populations, optimal dose, and absorption. The cardioprotective properties of phytoconstituents, which focus on ferroptosis, may provide a unique, plant-based therapeutic strategy for the treatment of CVDs.]]></description> </item><item><title><![CDATA[The Emerging Roles of Resolvins: Potential Diagnostic Biomarkers for Cardiovascular Diseases]]></title><link>https://www.benthamscience.comarticle/148182</link><description><![CDATA[Cardiovascular diseases (CVDs) are the leading cause of death worldwide and include a range of conditions affecting the heart and vascular system. There is a growing priority on identifying and validating biomarkers for CVDs to increase early diagnosis and survival rates. Within this framework of research, there has been a notable increase in interest in resolvins, a class of specialized pro-resolving mediators. Resolvins are well-known for their capacity to promote tissue healing and reduce inflammation. They are categorized into three series: Dseries (RvD1 to RvD6), T-series (RvT1 to RvT4), and E-series (RvE1 to RvE4). These molecules are produced through biochemical pathways involving enzymes such as lipoxygenase (LOX), cyclooxygenase (COX), and cytochrome P450 (CYP). These enzymes utilize precursor molecules like docosahexaenoic acid (DHA), eicosapentaenoic acid (EPA), and docosapentaenoic acid (DPA). This review addresses a critical gap in the literature by evaluating the potential of resolvins as biomarkers for the diagnosis and prognosis of cardiovascular diseases. By synthesizing existing knowledge on their production pathways and receptors, it highlights the implications of altered resolvins levels in disease mechanisms and offers new perspectives on their clinical relevance.]]></description> </item><item><title><![CDATA[Novel Molecules Targeting Metabolism and Mitochondrial Function in Cardiac Diseases]]></title><link>https://www.benthamscience.comarticle/147777</link><description><![CDATA[Cardiovascular diseases (CVD) are the leading cause of death worldwide, creating the need for new therapeutic strategies targeting the pathological processes involved. Mitochondria, which comprise one-third of cardiac cell volume, maybe a potential therapeutic target for CVD. Known primarily for energy production, mitochondria are also involved in other processes including intermediary metabolism, mitophagy, calcium homeostasis, and regulation of cell apoptosis. Mitochondrial function is closely linked to morphology, which is altered through mitochondrial dynamics, including processes such as fission and fusion, which ensure that the energy needs of the cell are met. Recent data indicate that mitochondrial dysfunction is involved in the pathophysiology of several CVDs, including cardiac hypertrophy, heart failure, ischemia/reperfusion injury, and cardiac fibrosis. Furthermore, mitochondrial dysfunction is associated with oxidative stress related to atherosclerosis, hypertension, and pulmonary hypertension. In this review, we first briefly present the physiological mechanisms of mitochondrial function in the heart and then summarize the current knowledge on the impact of mitochondrial dysfunction on CVD. And finally, we highlight the evidence from <i>in vitro</i>, <i>in vivo</i>, and clinical studies of the cardioprotective effects of drugs that preserve mitochondrial function in CVD. It is hoped that this review may provide new insights into the need to discover new pharmacological targets with direct actions on mitochondria that may provide combined therapeutic strategies to optimally treat these pathologies.]]></description> </item><item><title><![CDATA[Predicting Coronary Artery Lesion Severity using Pulse Wave Harmonics: A SYNTAX Score-based Study]]></title><link>https://www.benthamscience.comarticle/148456</link><description><![CDATA[<p>Introduction: This study aimed to investigate the correlation between the differences in pulse wave harmonic indices between the left and right hands and the SYNTAX score and to explore the potential of pulse wave harmonics in predicting the degree of coronary artery lesions. </p> <p> Methods: The arterial pressure wave signals from both hands of the patients scheduled for coronary angiography were recorded using photoplethysmography. According to the \"visceral resonance theory\", taking integer multiples of the heartbeat from 0 to 11 as the resonance frequencies, the collected arterial pressure waves were decomposed into the 0th to 11th harmonics via the Fourier transform method. The harmonic characteristics were quantified by amplitude (Cn), phase (Pn), and energy (Dn) (n is the harmonic serial number), and the coefficient of variation of the indices was calculated and suffixed as CV. The difference between the measured values of the left- and right-hand parameters of the same patient was calculated (&#916;Cn, &#916;Pn, &#916;Dn, &#916;CnCV, &#916;PnCV), and the absolute value of the difference was obtained (|&#916;Cn|, |&#916;Pn|, |&#916;Dn|, |&#916;CnCV|, |&#916;PnCV|). Based on the coronary angiography imaging data, SYNTAX scores were computed for all participants, who were stratified by gender into male and female cohorts. For each group, logistic regression models were established with SYNTAX score&#916;22 as the dependent variable, and harmonic index differences as the independent variables. To determine the best prediction model, the Akaike Information Criterion (AIC) was used and model with the lowest score was selected. Finally, the discriminant ability of the prediction model was evaluated using the ROC curve analysis and the Bootstrap internal validation method. </p> <p> Results: A total of 348 patients were included, with 249 males and 99 females. In the male group, the discriminant model was based on |&#916;C10|, &#916;D6, |&#916;D9|, |&#916;D10|, |&#916;P8|, |&#916;P10|, &#916;P1CV, and &#916;C9CV, with the minimum AIC value of 105.47, the area under the ROC curve (AUC) of 0.89, and the average AUC of 0.85 in the Bootstrap internal validation. In the female group, the discriminant model was based on |&#916;D2|, |&#916;D3|, |&#916;D5|, |&#916;D6|, |&#916;D9|, |&#916;C2CV|, |&#916;C4CV|, |&#916;C5CV|, | &#916;C6CV|, and |&#916;C9CV|, with the minimum AIC value of 59.34. The AUC of the ROC curve of this prediction model was 0.92, and the average AUC in the Bootstrap internal validation was 0.84. </p> <p> Discussion: In this study, the degree of coronary artery occlusion was evaluated through a noninvasive method combined with the SYNTAX score, providing a valuable noninvasive tool for clinical evaluation of CAD. This detection method is easy to operate, has high repeatability, and the equipment is small in size, making it suitable for various environments, it can be operated independently by the patients. Yet, the current study, being cross-sectional, only found an association rather than a causal relationship, calling for future prospective studies to clarify the causal link. </p> <p> Conclusion: The different characteristics of pulse wave harmonics between the left and right hands can effectively reflect the degree of coronary artery lesions. Through the analysis of pulse wave harmonics, a diagnostic model with good discriminant ability for predicting the degree of coronary artery lesions can be constructed, which may offer a valuable non-invasive tool for the clinical assessment of CAD.</p>]]></description> </item><item><title><![CDATA[Association of Renal Impairment Severity with Surgical Outcomes in Patients with Infective Endocarditis]]></title><link>https://www.benthamscience.comarticle/148696</link><description><![CDATA[<p>Introduction: This study aimed to assess the association of renal impairment (RI) severity on short and mid-term outcomes in patients undergoing cardiac surgery for infective endocarditis (IE). </p> <p> Methods: Patients undergoing cardiac surgery for IE between January 2010 and October 2022 were included. They were stratified based on preoperative renal function into four groups: Normal (N: Creatinine clearance (CrCl) >85 mL/min), moderate RI (M: CrCl 51-85 mL/min), severe RI (S: CrCl ≤50 mL/min), and haemodialysis-dependent (H). Each group was compared with group N. Survival analysis was performed using Kaplan-Meier curves. </p> <p> Results and Discussion: A total of 487 patients (N: 198; M: 154; S: 96; H: 39) were included. Mean age 55.92 ± 14.60 years, 375 (77%) males. Groups M, S, and H vs N demonstrated more atrial fibrillation [17 (11.0%), 20 (20.8%), 6 (15.4%) vs 8 (4.0%); p&#60;0.05]. Groups S and H vs. N had increased incidence of left ventricular ejection fraction &#60;50% [43 (44.8%), 22 (56.4%) vs 43 (21.7%); p&#60;0.001] and preoperative cardiogenic shock [16 (16.7%), 13 (33.3%) vs 9 (4.5%); p&#60;0.001]. The need for postoperative haemodialysis was 21 (13.6%) in M and 23 (23.0%) in S vs. 13 (6.6%) in N (p&#60;0.05). In-hospital mortality was 13 (8.4%), 21 (21.9%), and 11 (28.2%) vs. 12 (6.1%) (p=0.388, &#60;0.001, &#60;0.001), and mortality at a mean of 69.1months was 49 (31.8%), 46 (46.9%), 30 (76.9%) vs. 49 (24.7%) (p=0.142, &#60;0.001, &#60;0.001) in groups M, S, H vs. N, respectively. </p> <p> Conclusions: The incidence of renal impairment in patients with IE undergoing surgery remains high. Early and mid-term outcomes of those with severe RI and haemodialysis dependence are significantly worse.</p>]]></description> </item><item><title><![CDATA[The Association of Neuropeptide Y with the Presence and Frequency of Ventricular Premature Beats]]></title><link>https://www.benthamscience.comarticle/148399</link><description><![CDATA[<p>Introduction: The estimated prevalence of ventricular extra systole (VES) in the general population is about 1-4% on ECG, but 24-hour Holter monitoring has shown a prevalence of 40-75%. While it may be asymptomatic in many patients, frequent VES persisting for a long time can negatively affect left ventricular (LV) systolic function in patients without structural heart disease. The etiology of VES is not completely known. In this study, we investigated the role of neuropeptide Y (NPY) in the occurrence of VES. </p> <p> Materials and Methods: In this study, we included 150 patients with VES and 86 cases without VES as the control group. 24-hour Holter monitoring was performed on all subjects. Patients with VES were divided into two subgroups according to the frequency of VES as those >15,000 (Group 1, n= 48) and &#60;15,000 (Group 2, n= 102). Venous blood was collected from all cases for biochemistry parameters and NPY level measurement. </p> <p> Results: There were statistically significant differences between the two groups in terms of gender, smoking, LVEF, NPY, total cholesterol, LVEDD, SDNN, SDNN INDEX, RMSD, PNN50, LF, HF, VLF, and LF/HF (p&#60;0.05, for all). Correlation analysis showed a significant positive correlation between serum NPY level and number of VES (r=0.577, p=0.001), LF (r=0140, p=0.032), LVEDD (r=0.162, p=0.013), and LVESD (r=0.290, p=0.001). Conversely, a negative correlation was observed between NPY and RMSSD (r=-0.162, p=0.012), SDNN INDEX (r=-0.136, p=0.037). Multivariate logistic regression analysis showed that NPY (odds ratio [OR]: 1.204; 95% confidence interval [CI]: 1.103-1.315; p=0.001) was an independent predictor of VES development. ROC curve analysis showed that NPY ≥ 47.9 ng/L predicted the occurrence of VES with a sensitivity of 82.0% and specificity of 81.4%. In addition, NPY ≥ 79.8 predicted the frequency of VES with a sensitivity of 85.5% and specificity of 87.3%. </p> <p> Conclusion: Our study showed that serum NPY levels may play an important role in the development of VES. Also, it was found that the frequency of VES increased as the NPY level increased.</p>]]></description> </item><item><title><![CDATA[Navigating Cardiotoxicity in Cancer Treatment: Insights into Fluoropyrimidine-induced Cardiac Events]]></title><link>https://www.benthamscience.comarticle/148015</link><description><![CDATA[<p>Introduction: Fluoropyrimidine (FP) is a key cancer treatment but often causes side effects, notably cardiotoxicity. This cardiotoxicity can present as angina, arrhythmia, dyspnea, and palpitations, requiring urgent cardiologist attention. The etiology, management, and frequency of FP-induced cardiotoxicity are still unknown despite long-term use. </p> <p> Objective: The article aims to provide an overview of the pathogenic occurrence, cardiac event risk factor, possible underlying mechanism of FP-cardiotoxicity, diagnostics, and therapeutic approach for the corrective management of this clinical condition. </p> <p> Methods: Review was performed by searching extensively for various existing literature search PubMed, Web of science and Scopus using suitable keywords to find articles that support our review study. </p> <p> Results and Discussion: FP induced cardiotoxicity results in morbidness and fatality in patient undergoing the treatment. Thus, an effective management system must be standardized to effectively treat and prevent this clinical condition. </p> <p> Conclusion: The cardiotoxic event following 5-FU has been lesser-known clinical entity with limited study on its pathophysiology and management. In the diagnosis procedure, each patient undergoing FP treatment ought to have early symptom identity, risk categorization, and therapy individualized based on benefit-risk ratio.</p>]]></description> </item><item><title><![CDATA[Mitochondrial Dysfunction in Cardiac Diseases: Insights into Pathophysiology and Clinical Outcomes]]></title><link>https://www.benthamscience.comarticle/148183</link><description><![CDATA[Mitochondrial dysfunction plays a crucial role in the pathogenesis of various cardiac diseases, including heart failure, ischemic cardiomyopathy, and drug-induced cardiotoxicity. Mitochondria are essential for cellular energy production, calcium homeostasis, redox balance, and apoptotic regulation, making their proper function vital for cardiac health. Dysfunctional mitochondria contribute to excessive reactive oxygen species (ROS) production, impaired ATP synthesis, and disruption of mitochondrial dynamics, leading to cardiomyocyte damage and cell death. Emerging research highlights mitochondrial dynamics, including fission, fusion, mitophagy, and biogenesis, as critical determinants of cardiac homeostasis. Perturbations in these processes exacerbate myocardial injury and heart failure progression. Additionally, chemotherapy-induced cardiotoxicity, primarily from anthracyclines, is closely linked to mitochondrial damage, underscoring the need for targeted therapeutic strategies. Pharmacological interventions, such as antioxidants, mitochondrial-targeted drugs, and cardioprotective agents, have shown promise in mitigating mitochondrial dysfunction-related cardiac toxicity. Furthermore, lifestyle modifications, including exercise and dietary interventions, are being explored to enhance mitochondrial resilience in cardiac tissues. Advanced imaging techniques and biomarker-based diagnostics are improving the early detection of mitochondrial dysfunction in cardiac diseases. Emerging therapeutic strategies, such as mitochondrial transplantation, gene therapy, and precision medicine approaches, hold potential for targeted intervention. Despite these advances, challenges remain in translating mitochondrial-targeted therapies into clinical practice due to complexities in mitochondrial regulation and inter-organ communication. Future research should focus on optimizing mitochondrial-targeted interventions, improving diagnostic precision, and exploring novel molecular pathways to mitigate cardiac mitochondrial dysfunction. A comprehensive understanding of mitochondrial pathophysiology in cardiac diseases will pave the way for innovative treatment strategies aimed at preserving cardiac function and reducing the burden of heart failure.]]></description> </item><item><title><![CDATA[Improvement of Hemodynamics and Quality of Life Before and After Interatrial Shunt Devices Implantation for Chronic Heart Failure: A Systematic Review and Meta-analysis]]></title><link>https://www.benthamscience.comarticle/148766</link><description><![CDATA[<p>Introduction: The objective of this study was to compare the quality of life and hemodynamic changes before and after transcatheter atrial septal shunt implantation. </p> <p> Methods: A systematic search was conducted in the Cochrane Library, PubMed, and Embase from inception to September 2023 for studies reporting on hemodynamics or quality of life in patients with chronic heart failure after atrial septal shunt implantation. A meta-analysis was performed, in which a total of 1026 participants from 13 articles were included. </p> <p> Results and Discussion: Following the implantation, pulmonary capillary wedge pressure (PCWP) decreased by 2.60 mmHg. Right atrial pressure (RAP) increased by 1.30 mmHg and left ventricular ejection fraction (LVEF) increased by 2.13%. However, there were no significant differences in cardiac output and mean pulmonary artery pressure (mPAP) after operation. Minnesota Living with Heart Failure (MLWHF) Score decreased by -19.28, while the Kansas City Cardiomyopathy Questionnaire (KCCQ) score increased by 25.41. Moreover, 6-minute walking distance (6MWD) increased by 32.22 m. The results of subgroup analysis showed that for patients with heart failure with preserved ejection fraction (HFpEF) and heart failure with mildly reduced ejection fraction (HFmrEF), LVEF increased by 3.09% while CO increased by 1.01 L/min after operation. Meanwhile, PCWP significantly decreased by 2.67 mmHg and MLWHF scores decreased by 19.28. Additionally, 6MWD significantly increased by 27.5 m. However, there were no significant changes in RAP and mPAP after operation. For patients with heart failure with reduced ejection fraction (HFrEF), interatrial shunt device implantation did not achieve a significant increase in LVEF. </p> <p> Conclusion: These findings suggest that while atrial septal shunt implantation might not yield LVEF elevation among patients with HFrEF, it improves hemodynamic parameters, exercise endurance, and QoL among individuals with HFpEF/HFmrEF.</p>]]></description> </item><item><title><![CDATA[Preface]]></title><link>https://www.benthamscience.comarticle/151792</link><description><![CDATA[]]></description> </item><item><title><![CDATA[Pharmacological Foundation and Novel Insights of Resveratrol in Cardiovascular System: A Review]]></title><link>https://www.benthamscience.comarticle/148371</link><description><![CDATA[Research into drugs that can enhance cardiovascular health has been sparked by the rising prevalence of cardiovascular illnesses (CVDs). In addition to its anti-inflammatory and antioxidant qualities, Resveratrol (RES) is well known for its capacity to increase endothelial NO synthase (eNOS) activity. This page summarises RES's wide effects on energy metabolism, resilience to stress, exercise mimicking, circadian rhythm, lifespan control, and microbiome composition. This article addresses the poor and contradictory results shown in preclinical and clinical trials provides an update on the cardiovascular preventive properties of RES. The activation of AMP-activated protein kinase (AMPK), silent information regulator 1 (SIRT1), and natural antioxidant enzymes is associated with some of the positive effects of RES on the cardiovascular system. A microarray data summary indicates a strong correlation between the heart's reaction to calorie restriction and the transcriptional responses to RES. RES has been demonstrated to reduce contractile dysfunction, cardiac remodelling, and hypertrophy in several animal models of heart failure. Its preventive properties are believed to be due to several molecular pathways, including the suppression of prohypertrophic signalling molecules, enhancement of cardiac Ca<sup>2+</sup> handling, control of autophagy, and decreases in inflammation. RES thus has the potential to be used in several novel therapeutic approaches for treating diseases such as atherosclerosis, ischemia/reperfusion damage, metabolic syndrome, heart failure, and inflammatory changes associated with ageing.]]></description> </item><item><title><![CDATA[Alirocumab <i>versus</i> Evolocumab on Cardiovascular Outcomes: A Systematic Review and Meta-analysis]]></title><link>https://www.benthamscience.comarticle/148765</link><description><![CDATA[<p>Introduction: The PCSK9 enzyme is present mainly in the liver and is responsible for the degradation of LDL-C receptors. Currently, there are some drugs that inhibit this enzyme, such as alirocumab and evolocumab. Consequently, these drugs reduce serum LDL-C levels. Therefore, a systematic review and a meta-analysis were carried out in order to compare alirocumab against evolocumab in reducing cardiovascular outcomes. </p> <p> Methods: This systematic review was carried out in accordance with PRISMA and was registered in PROSPERO (CRD42024573217). The following databases were searched on July, 9, 2024: PubMed, Web of Science and Scopus. Randomized clinical trials with a control group were included and meta-analyses were performed to assess relative risk (RR). The random effects model was used in heterogeneous samples. The articles were distributed into 2 subgroups: use of alirocumab and evolocumab. </p> <p> Results: Initially, 2,213 articles were found, of which 6 were included. In total, 62,119 patients participated. The RR values were significant for alirocumab in the following outcomes: myocardial infarction (MI) 0.85 (95% CI 0.77-0.93), stroke 0.75 (95% CI 0.60-0.94) and hospitalization for unstable angina 0.58 (95% CI 0.39-0.86), while for evolocumab they were significant for MI 0.75 (95% CI 0.68-0.83) and coronary revascularization 0.81 (95 CI % 0.75-0.88). There was a statistically significant difference between the drugs for hospitalization for unstable angina (p=0.02). </p> <p> Discussion: This study highlights the benefits of PCSK9 inhibitors, especially alirocumab, in reducing major cardiovascular events. Alirocumab significantly lowered hospitalizations for unstable angina, with a 42% reduction, and showed favorable outcomes in reducing myocardial infarction, coronary revascularization, and stroke. These reductions are clinically meaningful, as they lower morbidity, improve patient quality of life, and reduce healthcare costs. Both alirocumab and evolocumab are effective and safe, offering important therapeutic options for high-risk cardiovascular patients. </p> <p> Conclusion: The use of alirocumab is preferable if the focus is to avoid hospitalizations for unstable angina or stroke, while evolocumab may be an option if one wants to avoid coronary revascularization. Both drugs are effective in reducing cardiovascular outcomes, but alirocumab was superior to evolocumab.</p>]]></description> </item><item><title><![CDATA[The Dilemma in the Management of Patients with Heart Failure with Reduced Ejection Fraction, Sinus Rhythm and Left Ventricular Spontaneous Echo Contrast: A Narrative Review]]></title><link>https://www.benthamscience.comarticle/148604</link><description><![CDATA[Heart failure (HF) is a complex clinical syndrome that arises from structural or functional impairment of ventricular filling or ejection of blood, resulting in previous characteristic symptoms of fatigue, dyspnea, and fluid retention. Among the complications of heart failure is the development of spontaneous echo contrast (SEC), characterized by a smoke-resembling appearance on echocardiograms, which indicates blood stasis in heart chambers. Despite being identified as an echocardiographic marker in the left atrium that correlates with thrombus formation and causes thromboembolic events, the clinical importance of left ventricular spontaneous echo contrast (LV-SEC) and the appropriate management for patients with this condition remain uncertain due to insufficient data. Anticoagulant therapy is generally recommended for patients with established left ventricular thrombus (LVT). However, for patients with heart failure with reduced ejection fraction (HFrEF) and sinus rhythm (SR), as a result of a decrease in thromboembolic events over time, it is typically not recommended. The main challenge lies in assessing the thromboembolic risk and determining appropriate management in patients with HFrEF, sinus rhythm (SR), and left ventricular spontaneous echo contrast (LV-SEC), compared to those with left ventricular thrombus (LVT) and those with HFrEF and SR without LV-SEC. The aim of this paper is to review the guidelines and trials on clinical characteristics, outcomes, and management of patients with LV-SEC and compare the suggested management with the established management for LVT and HF patients with sinus rhythm without LV-SEC.]]></description> </item><item><title><![CDATA[Mitochondrial-Derived Peptides as Therapeutics and Biomarkers for Combating Vascular Aging and Associated Cardiovascular Diseases]]></title><link>https://www.benthamscience.comarticle/148940</link><description><![CDATA[Vascular aging profoundly affects the onset of cardiovascular diseases in the elderly, mostly as a result of mitochondrial dysfunction. This review examines the protective roles of mitochondrial- derived peptides such as humanin, MOTS-c, and small humanin-like peptides in mitigating vascular aging. These peptides, encoded by mitochondrial DNA, are crucial for regulating apoptosis, inflammation, and oxidative stress, which have a major role in vascular health. MDPs have significant prospects as therapeutic and biomarker possibilities for the early diagnosis and intervention of vascular aging. MDPs influence the functions of endothelial and vascular smooth muscle cells by modulating critical signaling pathways, including AMPK, mTOR, and sirtuins. These pathways are essential for facilitating cellular metabolism, enhancing stress resilience, and prolonging longevity. Moreover, MDPs are essential in mitochondrial bioenergetics and dynamics, vital for mitigating endothelial dysfunction and enhancing vascular resilience. Furthermore, MDPs contribute to immunological modulation and the regulation of inflammatory responses, underscoring their potential therapeutic applications in the treatment of age-related vascular disorders. This review analyzes the various functions of MDPs in vascular health and their therapeutic importance, advocating for more studies to optimize their clinical benefits. By understanding the comprehensive roles and mechanisms of these multifunctional peptides, we can better appreciate their capacity to prevent and treat vascular aging and associated cardiovascular disorders. Future research should aim to further elucidate their therapeutic effects and optimize their clinical applications.]]></description> </item><item><title><![CDATA[Effects of Watching <i>vs</i>. Performing Walking and Stair-climbing Exercises on Physiological Parameters in Healthy Males]]></title><link>https://www.benthamscience.comarticle/150053</link><description><![CDATA[<p>Introduction: Exercise is widely recognized for its various physiological impacts. Furthermore, it has been postulated that watching people engage in physical activities like sports might trigger physiological reactions that mimic actual participation in the activity. This study investigated the effect of watching aerobic exercise videos (walking and stair climbing) versus physically engaging in the exercises on cardiovascular indices, blood glucose, body temperature, pulmonary indices, urine creatinine, and electrolyte levels in healthy male participants at the University of Uyo, Akwa-Ibom State. </p> <p> Method: Twenty participants, aged 18-25, were randomly assigned to the video group (n=10) and the exercise group (n=10). The video group watched exercise videos of walking and stair climbing, respectively. The exercise group performed walking and stair climbing exercises, respectively. Before the commencement of the experiment, the participants were given a 15-minute rest, after which their blood pressure, pulse rate, body temperature, and blood glucose were measured. They were then given 600 mL of water and 15 g of glucose for hydration and energy. After 45 minutes, their cardiovascular indices, blood glucose, body temperature, pulmonary indices, and urine sample for assessment of urine electrolytes and creatinine levels were taken. After that, the video group watched a video of people engaged in walking exercise, while the exercise group walked for 15 minutes. After the first session, a 30-minute recuperation period was observed before the commencement of the second session (stair climbing). The same procedure was repeated in the second session. Blood pressure, pulse rate, blood glucose, and body temperature were measured immediately after the first session, 15 and 30 minutes after the first session, immediately after the second session, and 15, and 30 minutes after the second session. Pulmonary indices and urine samples were taken immediately after the first session, 30 minutes after the first session, immediately after the second session, and 30 minutes after the second session. </p> <p> Results: The results showed a significant increase in systolic blood pressure, mean arterial pressure, and pulse rate; however, there was no significant difference in diastolic blood pressure and pulmonary indices in the exercise group compared to the video group. Additionally, the exercise group showed a significant decrease in blood glucose level and an increase in urine potassium level during the 30-minute recuperation period compared to the video group. </p> <p> Discussion: Watching sports was postulated to elicit similar responses as though someone were performing the sport; however, the findings of this study showed that the participants who watched exercise videos exhibited no significant change in blood pressure and pulse rate when compared with those who performed the exercises. The inability of our study to uphold this claim might be due to the 15-minute exposure observed in the present study being short; perhaps a longer period of exposure could elicit such physiological responses. Another limitation of the present study is the relatively small sample size, which may have impacted the statistical power of the findings. Consequently, conducting comprehensive studies with a larger sample size is highly recommended. </p> <p> Conclusion: In conclusion, the results of this study showed that watching exercise videos of walking and stair climbing did not elicit similar cardiovascular effects as actually performing walking and stair climbing exercises, but mimicked the same effects on blood glucose, urine sodium, and chloride levels in healthy male participants. Further research is recommended in this line of study.</p>]]></description> </item><item><title><![CDATA[Cardioprotective Activity of Oroxylin-A in Doxorubicin-induced Myocardial Toxicity: Antioxidant and <i>In Vitro</i> Studies on H9c2 Cells]]></title><link>https://www.benthamscience.comarticle/148912</link><description><![CDATA[<p>Introduction: Oroxylin A is primarily sourced from the roots of Scutellaria baicalensis, a medicinal plant commonly used in traditional Chinese medicine. It can also be found in other Scutellaria species. The plant's rich bioactive profile makes it a significant source of various flavonoids, including Oroxylin A. </p> <p> Aims: The proposed aim of this study is to investigate <i>in-vitro</i> anti-oxidant activity, toxicity studies and in-vitro cardioprotective activity of Oroxylin-A against Doxorubicin mediated myocardial damage on H9c2. </p> <p> Methods: The total phenolic content was estimated using Folin-Ciocalteu test and in-vitro activity was performed using DPPH assay. Acute toxicity studies were performed according to OECD 423 guidelines. In vitro cardioprotective activity was performed on H9c2 cells and was estimated for the biomarkers. </p> <p> Results: Oroxylin-A showed good antioxidant activity. No abnormalities were found in animals upon its usage, indicating that Oroxylin-A was safe at 2000 mg/kg. 150ug/ml of Oroxylin-A significantly increased the cell viability up to 99% and also decreased the LDH and ROS generation indicating that Oroxylin-A showed significant cardioprotective activity on H9c2 cells. </p> <p> Discussion: Oroxylin-A demonstrated potent antioxidant and cardioprotective effects by reducing ROS generation and LDH release while enhancing H9c2 cell viability against doxorubicininduced toxicity. Its safety at higher doses further supports its therapeutic potential. These findings highlight Oroxylin-A as a promising natural cardioprotective agent, warranting further in vivo and mechanistic studies to validate its clinical applicability. </p> <p> Conclusion: This research underscores the potential of Oroxylin A as a candidate for further investigation as a cardioprotective agent. Also, the present study contributes to the growing body of knowledge aimed at identifying natural compounds that may offer protective effects against myocardial damage, providing hope for future therapeutic interventions in the field of cardiovascular medicine.</p>]]></description> </item><item><title><![CDATA[Mitigating Diabetic Cardiomyopathy: The Therapeutic Potential of a Poly Herbal Combination in Modulating ICAM-1, VCAM-1, and NF -&#954;B Expression in Rat Model]]></title><link>https://www.benthamscience.comarticle/149287</link><description><![CDATA[<p>Background: Diabetic Cardiomyopathy (DCM) remains a significant health concern, necessitating innovative therapeutic approaches. This study explores the potential of a polyherbal combination (PHC) in mitigating DCM and delves into the underlying molecular mechanisms. </p> <p> Methods: Rat models with induced diabetes and cardiomyopathy were administered the polyherbal combination. Molecular analyses included the assessment of ICAM-1, VCAM-1, and NF- &#954;B expression in cardiac tissue. Histopathological and functional evaluations of cardiac health were performed. </p> <p> Results and Discussion: The polyherbal-treated group showed a significant reduction in blood glucose levels and improved cardiac function, as indicated by increased ejection fraction and cardiac output. Cardiac injury markers, CK-MB and hs-CRP, were significantly reduced by 66.6% and 50% respectively. Lipid profile improvements included lower total cholesterol and triglycerides by 28.5% and 31.1%, respectively. TGF-&#9496; levels were markedly reduced, suggesting an anti-fibrotic effect. Additionally, NF-&#954;B, ICAM-1, and VCAM-1 expression were significantly downregulated, confirming the polyherbal formulation's anti-inflammatory potential. These findings highlight its cardioprotective effects, making it a promising therapeutic approach for mitigating diabetic cardiomyopathy. </p> <p> Conclusion: The study unveils a promising therapeutic strategy for DCM, characterized by the PHC's ability to modulate ICAM-1, VCAM-1, and NF-&#954;B expression. This molecular insight underscores the potential for innovative interventions in managing DCM and offers hope for improved cardiac health in individuals with diabetes.</p>]]></description> </item><item><title><![CDATA[Genetic, Cytogenetic and Hematological Features in Newly Diagnosed Acute Lymphoid Leukemia Patients under Eighteen Years Age Referred to Ali Asghar Hospital of Tehran, Iran, from 2013 to 2023]]></title><link>https://www.benthamscience.comarticle/148913</link><description><![CDATA[<p>Introduction: Acute lymphoblastic leukemia (ALL), a hematopoietic cancer of T or B lymphoblasts, is the most prevalent cancer in children. Ongoing research aims to better understand the factors contributing to ALL and create more successful treatment options. Therefore, the current study presented cytogenetic, genetic, and hematologic features from 318 ALL patients under eighteen years of age who were referred to Ali Asghar Hospital of Tehran, Iran, from 2013 to 2023. </p> <p> Methods: This study was designed as a retrospective cross-sectional analysis, focusing on 318 children in Tehran, Iran, who had been newly diagnosed with ALL. All data were extracted from the patient case files that included additional information, such as clinical data, and demographic information. The Flow cytometry technique was employed to perform immunophenotyping for various markers. Moreover, the standardized protocol was carried out for conventional cytogenetic analysis. </p> <p> Results and Discussion: Out of 318, 179 (56.3%) and 139 (43.7%) were males and females, respectively. The most common subtype of ALL was Common B Cell ALL, accounting for 182 cases (57.23%), followed by Pre B cell ALL with 74 cases (23.27%) and T cell ALL with 27 cases (8.49%). Out of 222 patients, 17 (7.7%) had genetic abnormalities, with the highest incidence of abnormalities being associated with Runx 1 (four cases). Additionally, out of 228 patients, 143 (62.7%) were identified as having cytogenetic abnormalities, with the most prevalent abnormalities being hyperdiploidy (54 cases) and t (12;21) (28 cases). </p> <p> Conclusion: Our findings showed that some cytogenetic abnormalities, such as t (9;22) and hyperdiploidy, were consistent with previous studies. These results offer valuable foundational insights that can help direct future research on ALL patients and inform potential treatment strategies.</p>]]></description> </item><item><title><![CDATA[Acknowledgement to Reviewers]]></title><link>https://www.benthamscience.comarticle/150493</link><description><![CDATA[]]></description> </item><item><title><![CDATA[Oral Semaglutide: A Step Forward in Cardiovascular Risk Management for Type 2 Diabetes]]></title><link>https://www.benthamscience.comarticle/150002</link><description><![CDATA[Recent cardiovascular outcome trials (CVOTs) have reshaped the therapeutic landscape of type 2 diabetes mellitus (T2DM), revealing that certain glucose-lowering agents, including glucagon-like peptide-1 receptor agonists (GLP-1RAs), offer substantial cardiovascular benefits beyond glycemic control. Injectable GLP-1RAs, such as semaglutide and liraglutide, have been shown to reduce major adverse cardiovascular events (MACE), but barriers, including cost, access, and the burden of injections, persist. The SOUL trial marks a significant milestone by evaluating oral semaglutide in high-risk patients, demonstrating a 14% reduction in MACE versus placebo and reinforcing GLP-1RAs cardioprotective potential in an oral formulation. This advancement holds promise for patient populations underrepresented in prior trials. However, gastrointestinal side effects and strict dosing requirements challenge long-term adherence. While the findings suggest improved accessibility and real-world applicability, further comparative trials with injectables, extended follow-up, and cost-effectiveness studies are essential. As evidence evolves, oral GLP-1RAs may represent a more patient-centered approach to managing diabetes and cardiovascular risk. This perspective article aims to explore the implications of the SOUL trial, highlight ongoing challenges in adherence and implementation, and discuss the future role of oral GLP-1RAs in cardiovascular and diabetes care.]]></description> </item><item><title><![CDATA[Utilization Trends and Outcomes of Alteplase in Acute Cerebral Ischemia among Patients with Hypertension or Diabetes: A Tertiary Care Experience from Southern Punjab]]></title><link>https://www.benthamscience.comarticle/148914</link><description><![CDATA[<p>Objectives: Stroke is the second leading cause of death and the third leading cause of disability worldwide, with hypertension and diabetes mellitus being its most prominent risk factors. This study aims to assess the utilization trends and clinical outcomes of Alteplase in patients presenting with acute cerebral ischemia and known history of hypertension and/or diabetes, within our local population in Southern Punjab, Pakistan-a region with limited stroke care infrastructure. </p> <p> Methods: This observational study was conducted at the emergency department of a tertiary care hospital. A total of 106 patients presenting with acute cerebral ischemia confirmed via CT scan and/or MRI were enrolled. All patients had a documented history of hypertension (n = 91), diabetes mellitus (n = 27), or both (n = 64). Patients who presented within 4.5 hours of symptom onset and met standard inclusion criteria were administered intravenous Alteplase as per AHA/ ASA guidelines. Patients were divided into two groups: Group 1 (received Alteplase, n = 56) and Group 2 (did not receive Alteplase, n = 82). Outcomes were measured using the modified Rankin Scale (mRS) at 3 months post-intervention, with favorable recovery defined as mRS 0-2. </p> <p> Results: Of the 44 patients who received Alteplase, 66% (n = 37) achieved favorable outcomes (mRS 0-2). In contrast, only 39% (n = 32) of the 62 patients in the non-Alteplase group had favorable recovery. No significant increase in hemorrhagic complications was observed in the Alteplase group. </p> <p> Discussion: The findings in this study are consistent with international evidence demonstrating the safety and efficacy of intravenous thrombolysis in carefully selected patients, including those with vascular comorbidities such as hypertension and diabetes. In our study, most patients were treated late due to limited stroke units and long travel times, reflecting barriers in Pakistan’s healthcare system. The mean age of stroke was 52 years, which is younger than that reported in Western populations, and men were more frequently affected, in contrast to existing literature that shows a higher prevalence in women. Left hemisphere involvement predominated. Hypertension and diabetes were universal risk factors, underscoring their role in stroke burden. Overall, timely Alteplase therapy remains crucial, highlighting the need for improved infrastructure and early intervention strategies. The improved functional outcomes observed in our cohort reinforce the need for early recognition, rapid triage, and timely administration of Alteplase. However, limited availability of specialized stroke units, delayed hospital presentations, and lack of trained personnel continue to hinder widespread implementation of thrombolytic therapy in lowresource settings like Southern Punjab. </p> <p> Conclusion: In patients with acute cerebral ischemia and pre-existing hypertension or diabetes, the timely administration of Alteplase significantly improves functional outcomes. Despite its proven efficacy, access to thrombolytic therapy remains inadequate in public sector hospitals in Southern Punjab. Efforts must be made to expand stroke services and standardize acute stroke care across the region.</p>]]></description> </item><item><title><![CDATA[Adropin and Spexin Peptides Ameloriate Cardiac Inflammation, Matrix Metalloproteinases, and Vascular Response]]></title><link>https://www.benthamscience.comarticle/148278</link><description><![CDATA[<p>Background: Chronic renal failure (CRF) triggers chronic systemic inflammation and causes vascular calcification, a prominent contributor to the progression of cardiovascular disease. Adropin and spexin peptides regulate energy balance; also, these peptides trigger anti-inflammatory pathways. </p> <p> Objectives: Our present study aimed to clarify the potentially protective impact of spexin and adropin peptides on cardiovascular inflammation in an adenine-induced chronic renal failure model. </p> <p> Methods: The CRF model in Sprague-Dawley rats was established by the administration of adenine hemisulfate for ten days. Then, rats were treated with saline or adropin, or/and spexin for four weeks. CRP, CK, and CK-MB levels in serum were measured by autoanalyzer. Aortic contraction- relaxation responses were determined by the organ bath system. H&E, PAS, and Masson's trichrome stainings evaluated histopathological alterations in both aorta and cardiac tissue. Gene expression levels of ILs (IL1&#946;, IL10, IL17A, IL18, IL21, and IL33), MMPs (MMP1, MMP2, MMP3, MMP9, MMP13, and MMP14), NGAL, TGF&#946;1, TIMP1, and TNF&#945; in cardiac tissue were evaluated by real-time PCR. </p> <p> Results and Discussion: We found increased CK and CK-MB levels by CRF induction. In addition, IL1&#946;, IL17A, IL18, IL21, MMP1, MMP3, MMP13, and MMP14 increased after CRF progression. While adropin has effects on CK levels, spexin decreases CK-MB levels. Also, adropin and spexin had a nitric oxide-dependent impact on vascular reactivity. Besides, spexin downregulated IL1&#946;, IL10, IL17A, TGF&#946;1, MMP1, MMP3, MMP9, MMP13, MMP14 and NGAL; however, the adropin peptide had a limited effect. </p> <p> Conclusion: These results suggest that adropin and spexin have potential preventive roles on vascular damage in CRF progression via modulation of MMPs and inflammatory genes.</p>]]></description> </item><item><title><![CDATA[From Flavor to Medicine: A Review Unveiling Phytochemistry and Potential Applications of <i>Coriandrum sativum</i>]]></title><link>https://www.benthamscience.comarticle/150108</link><description><![CDATA[<p>Introduction: <i>Coriandrum sativum (C. sativum)</i>, widely known as coriander, is a herb of global significance, valued for its flavor and therapeutic properties. Originating from the Mediterranean, it has acclimatized to various continents, including Europe, Africa, and Asia. </p> <p> Methods: This review article was compiled from the data obtained from Google Scholar, Pub- Med/Medline, ScienceDirect, Hinari, and EBSCO. </p> <p> Results: The herb thrives in areas with favorable agricultural climates, such as India, China, and parts of Europe. The plant's phytochemical spectrum is notably rich, featuring essential oils, flavonoids, phenolic compounds, and fatty acids. The seed oil is predominantly composed of linalool, complemented by γ-terpinene, decanal, and geranyl acetate. Both leaves and seeds are rich in nutrients, including tocopherols, carotenoids, chlorophylls, sugars, ascorbic acid, phenolics, and anthocyanins. <i>C. sativum</i> has shown beneficial effects in easing anxiety, depression, and convulsions, protecting neural health, combating bacteria and fungi, repelling insects, and supporting cardiovascular and diabetic health. </p> <p> Discussion: These benefits are mainly due to the combined action of its phytochemicals. The toxicity study of this plant revealed that it is safe when administered in single or multiple doses. The essential oils of the herb have also been explored for their repellent and fumigant capabilities. Various clinical trials have been conducted to evaluate its different pharmacological safety profiles and assess its therapeutic potential. </p> <p> Conclusion: This review aimed to discuss the botanical features, chemical constituents, pharmacological properties, toxicity studies, and clinical trials. Further study is needed related to embryonic and other toxicities.</p>]]></description> </item><item><title><![CDATA[The Predictive Value of Monocyte-to-HDL Cholesterol Ratio in Patients with Dilated Cardiomyopathy and Associated Pulmonary Hypertension]]></title><link>https://www.benthamscience.comarticle/150407</link><description><![CDATA[<p>Background: Pulmonary Hypertension (PH) is a significant contributor to cardiac mortality in Dilated Cardiomyopathy (DCM) patients. Inflammatory processes and oxidative stress play pivotal roles in the advancement of Pulmonary Hypertension (PH). The Monocyte- to-High-Density-Lipoprotein Cholesterol Ratio (MHR), a newly identified biomarker indicative of inflammatory and oxidative stress, has not been extensively researched in the context of pulmonary hypertension, especially within the scope of dilated cardiomyopathy. </p> <p> Objectives: Given the reason mentioned above, our research explores the correlation between the MHR and the severity of PH in patients suffering from DCM. </p> <p> Methods: In this study, we conducted a retrospective review of medical data from 107 individuals diagnosed with non-ischemic DCM, evaluating their clinical profiles, biochemical indicators, MHR, and echocardiographic parameters. We analyzed the relationships between Pulmonary Arterial Systolic Pressure (PASP) and the Ejection Fraction of the Left Ventricle (LVEF). Utilizing logistic regression analysis, we determined the predictors of PH. </p> <p> Results and Discussion: Findings indicated that the DCM-PH group exhibited a significantly larger male population and elevated New York Heart Association (NYHA) classification scores (both with p-values &#60;0.001 and 0.01, respectively) compared to the DCM-only group. A positive association was observed between the PASP and parameters, such as the Dimensions of the Left Atrium (LAD) and Left Ventricle in Systole (LVDs), Monocyte (M) levels, Direct Bilirubin (DB), and MHR. Conversely, an inverse relationship was noted with serum lipid profiles, including Total Cholesterol (TC), HDL Cholesterol (HDL-c), and apolipoprotein A1. LVEF demonstrated positive linkage with the same lipid profiles and the Left Ventricular Posterior Wall Thickness (LVPWT) yet showed negative correlations with the NYHA classification, Red Blood Cell Distribution Width Standard Deviation (RDW-SD), Total Bilirubin (TB), Direct Bilirubin (DB), and dimensions of the left ventricle in diastole and systole, as well as MHR. Through logistic regression analysis, several factors were recognized as significant predictors for the severity of PH within the DCM cohort, with weight (OR1.20, CI 1.022-1.409, p=0.026), RDW-SD (OR1.988, CI 1.015-3.895, p=0.045), LVPW (OR3.577, CI 1.307-9.792, p=0.013), LVDd (OR1.333, CI 1.058-1.680, p=0.015), MHR (OR3.575, CI 1.502-8.506, p=0.032), and TB (OR1.416, CI 1.014-1.979, p=0.041) showing positive associations, while apoB (OR0.001 CI0.001-0.824, p=0.045) exhibiting negative associations, all with p-values &#60;0.05. </p> <p> Conclusion: Higher MHR and LVD correlate with increased PASP and reduced LVEF in DCMPH patients. MHR and LVPW are independent predictors of PH severity, indicating their potential as novel severity markers in DCM-related PH.</p>]]></description> </item><item><title><![CDATA[Acknowledgement to Reviewers]]></title><link>https://www.benthamscience.comarticle/150565</link><description><![CDATA[]]></description> </item><item><title><![CDATA[The Effect of Sri Lankan Medicinal Herbs on the Reduction of Dyslipidemia]]></title><link>https://www.benthamscience.comarticle/149231</link><description><![CDATA[Cardiovascular disease remains a leading global cause of mortality, with dyslipidemia as a major risk factor. While conventional lipid-lowering therapies are effective, they may have adverse effects, highlighting the need for alternative approaches. With its rich biodiversity and long-standing traditional medicine practices, Sri Lanka offers a natural alternative through medicinal plants with antilipidemic properties. Many of these plants are commonly used in Sri Lankan cuisine, not only enhancing flavor but also providing bioactive compounds that regulate lipid levels. This review explores the role of <i>Murraya koenigii, Garcinia quesita, Garcinia zeylanica, Moringa oleifera, Tamarindus indica, Piper nigrum</i>, and <i>Trigonella foenum-graecum</i> in managing dyslipidemia. These plants have demonstrated lipid-lowering effects by reducing total cholesterol, LDL cholesterol, and triglycerides while increasing HDL cholesterol, enhancing fat metabolism, and exerting antioxidant and anti-inflammatory properties. The review also promotes the integration of these herbs into daily meals for cardiovascular disease management, offering a natural remedy and prevention method. By integrating traditional knowledge with scientific research, Sri Lanka can enhance its healthcare system and improve cardiovascular health outcomes.]]></description> </item><item><title><![CDATA[Acute Effect of Black Tea, Green Tea, and Coffee on Blood Pressure and Blood Glucose in Healthy Female Subjects]]></title><link>https://www.benthamscience.comarticle/149007</link><description><![CDATA[<p>Introduction: The consumption of tea and coffee as beverages is prevalent worldwide, with each having potential health implications. The study investigated the effect of black tea (BT), green tea (GT), and coffee on blood pressure (BP), heart rate (HR), and blood glucose level (BGL) in healthy females. </p> <p> Methods: Forty (40) participants aged 18 to 26 were randomly assigned to four groups: control (250 mL warm water), GT (2 g GT dissolved in 250 mL of hot water), coffee (2 g coffee dissolved in 250 mL of hot water), and BT (2 g BT dissolved in 250 mL of hot water) groups with 10 subjects each. Each group was given its designated drink once a day for three consecutive days. Baseline measurements of BP, HR, and BGL were taken after a 15-minute rest before the consumption of the beverages. Follow-up measurements were taken at 15, 30, 45, and 60 minutes after consumption for cardiovascular indices, and 30 and 60 minutes for BGL. This procedure was repeated for three days. </p> <p> Results: The results showed no significant changes in BP, HR, and BGL in all the experimental groups compared to the control group. </p> <p> Discussion: Coffee and tea are popular beverages enjoyed worldwide, recognized for their numerous health benefits largely due to their bioactive compounds, particularly polyphenols and caffeine. The different concentrations of polyphenols and caffeine in these drinks can affect various physiological functions in distinct ways. The results of the present study showed no significant changes in blood pressure, heart rate, or blood glucose level among healthy young female participants who consumed green tea, coffee, and black tea, respectively. Although some previous studies have indicated that these beverages can significantly impact these health metrics, other research has shown no notable changes. The lack of significant findings in this study may be attributed to its short duration; a more extended study could potentially uncover significant changes. </p> <p> Conclusion: The findings of this study revealed that green tea, black tea, and coffee have no acute effect on blood pressure, heart rate, and blood glucose levels in healthy female individuals. It can therefore be concluded that green tea, black tea, and coffee have a neutral effect on these physiological parameters, but a more elaborate study is highly recommended.</p>]]></description> </item><item><title><![CDATA[Potential Therapeutic Effects of Flavonoids in Cardiovascular Disorders: Review]]></title><link>https://www.benthamscience.comarticle/150246</link><description><![CDATA[<p>Introduction: Flavonoids in various fruits and vegetables exert multifaceted biological effects. They are widely explored for cardiovascular, antitumor, antioxidant, antibacterial, antifungal, neuroprotective, and anti-inflammatory effects. Flavonoid cardioprotection is helpful in the management of myocardial injury, stroke, atherosclerosis, hypertension, and ischemia. Cardiovascular disease (CVD) has become a global threat in recent years due to increased mortality and morbidity rates. The increased mortality due to CVD among women, children, and poor economic groups has boosted the socio-economic burden on health care. Various researchers have explored the commercial applications of flavonoids, including quercetin, apigenin, luteolin, and catechin, as dietary supplements. </p> <p> Methods: The findings were searched in the Google Scholar, Scopus, PubMed, and PubChem databases. </p> <p> Results: Preclinical and clinical investigations have promoted the safety of flavonoids, such as apigenin and quercetin, for use as nutraceuticals that promote health. Flavonoids and their potential mechanisms of action and clinical applications offer insights for researchers and scientists to explore in the fields of medical and nanomedicine sciences. Nanomedicine, like liposomes, carbon nanotubes, nanosponges, and nanoparticles containing flavonoids, is used for its efficacy, potency, and target delivery. </p> <p> Discussion: Flavonols have the potential to regulate vasodilation and prevent apoptosis. Furthermore, their supplementation may reduce the risk of cardiovascular complications. Flavonoids function as antioxidants and exhibit potent anti-inflammatory effects by mediating inflammatory pathways, thereby contributing to the management of cardiovascular complications. Emerging evidence from researchers suggests flavonoids improve endothelial function and reduce blood pressure. Furthermore, flavonoids derived from cocoa, such as catechins, and those found in tea also enhance endothelial function. Nanosystems can enhance the solubility, permeability, and effectiveness of flavonoids as antioxidants, while also promoting controlled drug delivery. Nanoformulations can enhance the effects of morin, rutin, quercetin, and other flavonoids, significantly improving therapeutic outcomes. </p> <p> Conclusion: These findings offer researchers and scientists a novel technological approach utilizing flavonoids to address metabolic syndromes and related health conditions, thereby supporting personalized care and improving patient outcomes.</p>]]></description> </item><item><title><![CDATA[Evaluation of Left Ventricular Function in Diabetic Patients: Insights from Dipyridamole-induced Heart Rate Variability and G-SPECT Imaging Techniques]]></title><link>https://www.benthamscience.comarticle/150275</link><description><![CDATA[<p>Introduction: Left Ventricular Dysfunction (LVD) is a frequent complication in Diabetes mellitus (DM) patients, often worsened by cardiovascular disease. This study explores the role of dipyridamole (DP)-induced heart rate variability and G-SPECT imaging in evaluating LVD in DM patients. This study aimed to evaluate the relationship between heart rate ratio (HRR) during DP stress and LVD parameters derived from gated SPECT (G-SPECT) in DM patients, aiming to identify if HRR can serve as a marker for early LVD assessment. </p> <p> Methods: A cross-sectional study of 125 patients referred for cardiac scanning. Patients were grouped by diabetic status and HRR (≤ 1.2 vs. > 1.2) post-DP. G-SPECT-derived left ventricular parameters were compared between groups. </p> <p> Results: G-SPECT showed that peak filling rate (PFR) was higher in non-DM patients. In the HRR ≤ 1.2 group, DM patients had significantly higher end-diastolic volume (EDV) and end-systolic volume (ESV) than non-DM patients (EDV: 66.41±31 vs. 51.34±18, p-value:0.009; ESV: 27.88±11.21 vs. 18.63±15.5, p- p-value: 0.015). </p> <p> Discussion: This study evaluated the role of heart rate response during dipyridamole stress testing combined with G-SPECT imaging in assessing left ventricular dysfunction (LVD) in diabetic patients. The findings indicate that changes in ventricular volume parameters, along with heart rate response, may serve as early markers of cardiac impairment, potentially facilitating earlier detection and improved management of cardiac complications in this population. </p> <p> Conclusion: Reduced HRR during DP stress, combined with G-SPECT, may aid in the assessment of LVD in DM patients, potentially facilitating earlier diagnostic insights.</p>]]></description> </item><item><title><![CDATA[Acknowledgements to Reviewers]]></title><link>https://www.benthamscience.comarticle/151705</link><description><![CDATA[]]></description> </item><item><title><![CDATA[Prevalence of Non-Adherence to Antihypertensive Medication in India: A Systematic Review and Meta-Analysis of 18,808 Hypertensive Patients]]></title><link>https://www.benthamscience.comarticle/150468</link><description><![CDATA[<p>Introduction: Hypertension is a major contributor to disability-adjusted life years (DALYs) worldwide, as highlighted by the Global Burden of Disease study (GBD 2021). Effective management of hypertension through medication can significantly lower the risks associated with the condition. It is important to recognize that not adhering to antihypertensive therapy often leads to negative health outcomes. </p> <p> Methods: We conducted a thorough search of databases such as “Embase, PubMed, Web of Science, Cochrane Library, EBSCOHost, and Scopus” from their inception up to December 4th, 2023. This search focused on studies involving patients with hypertension. Our review specifically targeted studies conducted in India, published in English, and focused on the prevalence of non-adherence to antihypertensive medication. We used a random-effects model to pool the findings and assessed heterogeneity using the I<sup>2</sup> statistic, with a significance level set at p &#60; 0.05. Subgroup analyses were performed to identify areas with a higher prevalence. This review was prospectively registered in PROSPERO (CRD42024489527). </p> <p> Results: This review included 40 studies from India, encompassing 18,808 patients with hypertension. The pooled prevalence of non-adherence to antihypertensive medication was 48% (95% CI 39%-56%, PI = 9%-90%), with a high degree of heterogeneity (I2=98%). Meta-regression showed that non-adherence was linked to younger age (p&#60;0.01). Subgroup analysis revealed a varying prevalence across India, with the eastern region showing the highest prevalence at 76% (95% CI 31%-96%), followed by the order East > North > West > South (p < 0.01). A higher prevalence was also observed in community settings (51%) and rural areas (57%). </p> <p> Discussion: Findings of this study shed light on the growing prevalence of nonadherence to antihypertensive medication among Indian hypertensive patients. Nonadherence patterns vary across settings and contexts, reinforcing the need for more longitudinal studies and context-specific targeted interventions. Subgroup analyses revealed no significant reduction in heterogeneity, highlighting the need for more qualitative studies. </p> <p> Conclusion: Given the high and regionally variable prevalence of non-adherence to antihypertensive medication in India, it is crucial to develop localized strategies to improve adherence to hypertension treatment.</p>]]></description> </item><item><title><![CDATA[Cardio-Ankle Vascular Index as a Marker of Arterial Stiffness: Principles, Application, and Clinical Utility]]></title><link>https://www.benthamscience.comarticle/149146</link><description><![CDATA[Large artery stiffness (LAS) is widely recognized as a highly clinically relevant determinant of cardiovascular health and an independent prognostic marker. However, routine assessment of LAS has not yet been integrated into clinical practice. Arterial wall stiffness is dependent on distending pressure (i.e., mean arterial pressure), which may confound the interpretation of individual measurements. The cardio-ankle vascular index (CAVI) is an index of arterial stiffness designed to mitigate the dependence of pulse wave velocity on blood pressure. However, because CAVI incorporates pulse wave velocity measured between the heart and the ankle, it is influenced by both the stiffness of the aorta and medium-sized muscular arteries. Several observational, longitudinal studies have demonstrated that higher CAVI is associated with cardiovascular events and mortality, although most available data are derived from Asian populations. Future studies of CAVI are needed to establish its prognostic value in addition to traditionally used cardiovascular risk factors in the setting of primary prevention. This review aims to provide a brief overview of the definition, theoretical principles, practical considerations, key strengths and limitations, and the clinical utility of CAVI.]]></description> </item><item><title><![CDATA[Advancing Pediatric Hypertension: Mechanism Insights, Clinical Trials and Innovation]]></title><link>https://www.benthamscience.comarticle/150277</link><description><![CDATA[Pediatric hypertension (PH) is an emerging global public health issue, increasingly linked to genetic, environmental, and lifestyle factors. Early-onset hypertension is associated with progressive long-term cardiovascular problems. This overview outlines the epidemiology, etiology, pathophysiology, treatment modalities, and current clinical studies related to hypertension in children and adolescents. A methodical search was conducted on PubMed, Scopus, and Web of Science using specific preset keywords. Recent high-quality peer-reviewed studies, trials, and reviews from the past decade were highlighted. The primary factors are genetic predisposition, renal artery stenosis, activation of the renin-angiotensin-aldosterone system (RAAS), obesity, metabolic syndrome, and sodium excess. Treatment involves lifestyle modifications and pharmacological intervention with ACE inhibitors, calcium channel blockers, beta-blockers, and diuretics. Recent clinical trials have provided insights into the safety and efficacy of therapies. The effective management of pediatric hypertension relies on prompt identification and individualized treatment. In future studies, priority should be given to precision medicine, long-term follow-up data, and the utilization of technological resources for surveillance.]]></description> </item><item><title><![CDATA[Sirt1/Drp1 Pathway Reduces Microvascular Endothelial Cell Injury in Diabetic Pateints’ Hearts by Inhibiting Excessive Mitochondrial Division]]></title><link>https://www.benthamscience.comarticle/146409</link><description><![CDATA[<p>Background: Cardiac microvessels are significantly reduced in diabetic patients, which is accompanied by a significant increase in the incidence of diabetic cardiac complications and increased mortality. This study aimed to investigate the role and possible mechanism of sirtuin 1 (Sirt1) in microvascular endothelial cell injury in diabetic hearts. </p> <p> Methods: Type 2 diabetes mouse models and cardiac microvascular endothelial cell (CMEC) cell models were established. Cardiac microvessel density (MVD) was detected using Platelet- Endothelial Cell Adhesion Molecule 1 (CD31) immunohistochemistry. Mitochondrial reactive oxygen species (ROS) was detected with MitoSOX and morphology was observed with mitochondrial staining. CMECs angiogenesis was evaluated via scratch and angiogenesis assays. We measured cell viability with a Cell Counting Kit (CCK)-8 assay and cell injury with lactate dehydrogenase (LDH) release assay. We assessed apoptosis using TUNEL staining, Caspase-3 activity, and Western blot. </p> <p> Results: The decrease in Sirt1 protein expression was accompanied by a decrease in cardiac microvessel density in type 2 diabetic mice. After 48 h of treating the CMECs with high-glucose and palmitic acid, it was discovered that the expression of Sirt1 and dynamin-related protein 1 (Drp1) Ser637 phosphorylated protein decreased, while the expression of Cleaved Caspase-3 protein increased. Also, the angiogenesis ability of endothelial cells was decreased, while mitochondrial ROS and mitochondrial division were increased, which culminated in aggravated endothelial cell injury and increased endothelial cell apoptosis. Increased Sirt1 protein expression and function at the gene and drug levels alleviated excessive mitochondrial division, reduced apoptosis, and improved the function of CMECs by increasing the phosphorylation of Drp1 Ser637. </p> <p> Conclusion: Under diabetic conditions, the Sirt1/Drp1 pathway reduces injury to CMECs by inhibiting excessive mitochondrial division.</p>]]></description> </item><item><title><![CDATA[Saphenous Vein Coronary Artery Bypass Grafts: Why Invest in VEST?]]></title><link>https://www.benthamscience.comarticle/147602</link><description><![CDATA[]]></description> </item><item><title><![CDATA[Music Therapy may Decrease Radial Artery Spasm Rates and Increase Satisfaction during Coronary Angiography]]></title><link>https://www.benthamscience.comarticle/146353</link><description><![CDATA[<p>Introduction: With the widespread use of the radial artery in catheterization procedures, radial artery spasm (RAS) is frequently considered an undesirable event. It is known that anxiety increases RAS, and listening to music helps individuals control anxiety during the procedure. This study aimed to investigate the effects of music concerts on RAS. </p> <p> Methods: In this prospective study, imaging and interventional coronary catheterization procedures using the radial artery were included. One group listened to a musical recital during the procedure, while the other group was treated in a quiet environment. The demographics, procedural parameters, and complications of both groups were compared. </p> <p> Results: The study included a total of 147 patients, with an average age of 51.6 ± 11.1 years. Of these, 78 patients (53%) listened to music, while 69 patients (46.9%) underwent catheterization in a quiet environment. The impact of music therapy on the RAS was found to be significant (11.5% vs. 20.3%; p=0.035). While music therapy showed a potential to reduce RAS rates, its effect was not statistically significant in multivariate analysis (p=0.055). </p> <p> Conclusion: Music is a feasible, simple, and inexpensive method for reducing anxiety levels in patients. Listening to music during catheterization can reduce procedural discomfort and the frequency of undesirable events by helping people control their anxiety.</p>]]></description> </item><item><title><![CDATA[Evaluation of Cardiovascular and Hepatic Changes in Myocardial Infarction Patients Post-Covid-19 Vaccination]]></title><link>https://www.benthamscience.comarticle/146759</link><description><![CDATA[<p>Introduction: The global COVID-19 vaccination campaign has significantly reduced severe illness and mortality; however, emerging evidence raises concerns regarding its potential cardiovascular effects, particularly myocardial infarction (MI). </p> <p> Methods: This study investigates the relationship between COVID-19 vaccination and MI incidence among first-time MI patients in Saudi Arabia. Post-COVID-19 vaccination within six months postvaccination accounted for potential confounding factors, such as pre-existing health conditions, age, and lifestyle. A total of 102 MI patients, with a male predominance of 60.8% and a significant correlation with middle age, were analysed. A+ blood group patients were the most prevalent (33.3%), followed by B+ (29.4%), while Rh-negative patients constituted only 7.8%. Elevated mean BNP (761.98 pg/ml), pulse rate (87.72 bpm), and systolic blood pressure (139.98 mmHg) indicated heightened cardiac stress (p &#60; 0.01). </p> <p> Results: Significant elevations in AST (121.65 U/L) and ALT (133.63 U/L) levels suggested liver stress post-Covid-19 vaccination (p &#60; 0.01). Males had higher AST, ALT, and bilirubin levels than females, with p-values of 0.02, 0.01, and 0.04, respectively, indicating hepatic differences. Elevated biomarkers like CK-MB (58.05 IU/L) and CPK (313.86 mcg/L) further affirmed significant myocardial damage post-vaccination (p &#60; 0.05). </p> <p> Conclusion: These findings suggest a link between vaccination and cardiovascular events and highlight the importance of considering individual health profiles in evaluating vaccine safety, cardiovascular health, and hepatic implications.</p>]]></description> </item><item><title><![CDATA[Glucagon-like Peptide-1 Receptor Agonists: Additional Improvement of Erectile Dysfunction in Type 2 Diabetes]]></title><link>https://www.benthamscience.comarticle/149018</link><description><![CDATA[]]></description> </item><item><title><![CDATA[Efficacy of Dapagliflozin and Telmisartan Combination Therapy in Reducing Albuminuria and Inflammatory Markers in Diabetic Nephropathy: A Prospective Observational Study]]></title><link>https://www.benthamscience.comarticle/146670</link><description><![CDATA[<p>Background: Diabetic nephropathy, a major contributor to chronic kidney disease, is closely associated with inflammatory responses. </p> <p> Objectives: This study aimed to evaluate the effectiveness of combination therapy with dapagliflozin and telmisartan in treating diabetic nephropathy and its effect on patient’s albuminuria levels. </p> <p> Materials and Methods: We conducted a 12-week prospective observational study to assess diabetic nephropathy. Patients with diabetic nephropathy were treated with either dapagliflozin and telmisartan (n=92) or telmisartan alone (n=92). Measurements of waist-to-hip ratio, fasting blood glucose, hemoglobin A1c (HbA1c), blood pressure, urinary albumin-to-creatinine ratio (UACR), estimated glomerular filtration rate (eGFR), uric acid, blood urea nitrogen, lipid profile, and inflammatory biomarkers, including C-C motif chemokine ligand 21 messenger RNA (CCL21 mRNA) and monocyte chemoattractant protein-1 (MCP-1), were obtained at baseline and following 12-weeks of treatment. </p> <p> Results: Dapagliflozin and telmisartan combination therapy demonstrated a significant decrease in UACR compared with baseline levels (p&#60;0.001). After treatment, the dapagliflozin and telmisartan group had significantly lower waist-to-hip ratio, fasting blood glucose, HbA1c, uric acid, total cholesterol, and low-density lipoprotein compared with the monotherapy group (p&#60;0.05). Additionally, inflammatory biomarkers, including CCL21 mRNA and MCP-1, were substantially lower in the combination therapy group than in the monotherapy group (p&#60;0.05). </p> <p> Conclusion: In comparison to monotherapy, combination therapy demonstrated more significant clinical effects in treating diabetic nephropathy. This combination therapy effectively controls blood glucose levels and UACR, reduces inflammatory responses, and improves kidney function recovery in diabetic nephropathy patients, thereby enhancing the overall clinical treatment outcomes for these patients.</p>]]></description> </item><item><title><![CDATA[Current Status and Future Trends in Myocarditis Related to the COVID-19 Vaccines: A Visual and Bibliometric Analysis]]></title><link>https://www.benthamscience.comarticle/145873</link><description><![CDATA[<p>Aims: This study aims to conduct a bibliometric and visual analysis of published studies on myocarditis and coronavirus disease 2019 (COVID-19) vaccines. </p> <p> Background: The widespread epidemic of COVID-19 has caused millions of deaths and profoundly affected the global medical landscape. Studies on COVID-19 vaccination and related myocarditis have also increased significantly. </p> <p> Objective: To analyze the current status and trends of myocarditis and COVID-19 vaccine research by bibliometric and to elucidate research hotspots and frontiers. </p> <p> Methods: Based on the Web of Science Core Collection SCI-Expanded database, we utilize Excel 2019 and visualization analysis tools VOSviewer, Co-Occurrence13.2 (COOC13.2), Citespace, HistCite, and Scimago Graphica for analysis. </p> <p> Results: Our study encompassed a total of 389 relevant articles, and we observed a consistent upward trend in the number of publications over time, indicating the growing interest in this subject. Among the countries and regions contributing to this body of literature, the United States emerged as the leading publisher, with Harvard Medical School being the most prominent institution associated with these studies. Notably, Matthew E. Oster from the United States emerged as one of the prominent authors in this field. Hotspot research and frontier areas include myocarditis and the different types of COVID-19 vaccines (e.g., mRNA vaccines, adenovirus vector vaccines, inactivated vaccines), the development of new vaccines in reducing the incidence and sequelae of COVID-19 without an increased incidence of myocarditis, and relief of vaccine hesitancy. </p> <p> Conclusion: Research on myocarditis and the COVID-19 vaccines has grown rapidly. Our research results can help researchers grasp the current status of myocarditis related to the COVID-19 vaccine research and find new research directions in the future.</p>]]></description> </item><item><title><![CDATA[Atrial Cardiomyopathy-associated Arrhythmia and the Impact of Sirtuin Signaling Pathway: A Narrative Review]]></title><link>https://www.benthamscience.comarticle/146307</link><description><![CDATA[With the aging population on the rise, the higher prevalence of atrial tachyarrhythmia is emerging as a significant healthcare concern. Atrial fibrillation (AF) stands out as the most common atrial tachyarrhythmia, potentially leading to adverse outcomes, such as stroke, heart failure (HF), or conduction dysfunction. Furthermore, AF may serve as a manifestation of underlying atrial cardiomyopathy, which forms the structural and electrical substrate for arrhythmias. Atrial cardiomyopathy is characterized by structural and electrical remodeling of the atria, resulting in impaired mechanical function and the generation of arrhythmias. Sodium-glucose cotransporter 2 inhibitors (SGLT2is) have recently emerged as a novel medical treatment for HF. Their use has been associated with a reduced incidence of new-onset AF, potentially attributing to the improvement of atrial cardiomyopathy. This effect is achieved through the regulation of glucose utilization and energy consumption within the myocardium. It is worth noting that the sirtuin signaling pathway plays a crucial role in regulating energy consumption, especially in the presence of increased oxidative stress and fibrosis. This pathway also exerts a significant influence on various cardiovascular diseases. This review aims to provide a comprehensive summary of the involvement of the sirtuin signaling pathway in cardiovascular diseases, with a specific focus on atrial cardiomyopathy and AF and the potential molecular mechanisms of SGLT2is in the sirtuin signaling pathway and atrial cardiomyopathy.]]></description> </item><item><title><![CDATA[Clinical Predictors of Warfarin Response Among Patients with Atrial Fibrillation: Evidence from the Middle Eastern JoFib Study]]></title><link>https://www.benthamscience.comarticle/146912</link><description><![CDATA[<p>Objectives: To describe clinical factors predictive of warfarin response in atrial fibrillation (AF) patients and to evaluate its association with adverse outcomes. </p> <p> Methods: Patients in the Middle Eastern JoFib study, a prospective, multicenter registry of AF patients, using warfarin with at least one international normalized ratio (INR) reading, were enrolled. We used the most recent INR as a measure of warfarin control. </p> <p> Results: Out of the total 2020 patients, 544 (26.9%) were using warfarin. Multivariable logistic regression analysis demonstrated that heart failure (adjusted OR 0.55, 95%CI 0.36-0.86) and increasing HAS-BLED score (adjusted OR 0.73, 95%CI 0.58-0.92) decreased the odds of having a therapeutic INR. Chronic kidney disease (adjusted OR 3.11, 95%CI 1.46-6.62), heart failure (adjusted OR 2.37, 95%CI 1.4-4.01), and cancer (adjusted OR 2.48, 95%CI 1.03-6.01) were independently predictive of having INR less than 2.0. The first episode of AF was independently predictive of having INR above 3.0 (adjusted OR 2.48, 95%CI 1.39-4.42). Multivariable Cox regression analysis demonstrated that INR below the therapeutic range (aHR 4.36, 95%CI 2.19-8.68) and INR above the therapeutic range (aHR 3.03, 95%CI 1.33-6.92) were predictive of all-cause mortality. Below-range INR also predicted cardiovascular mortality (aHR 3.69, 95%CI 1.66-8.16). </p> <p> Conclusion: Clinical factors predictive of sub-optimal INR in Middle Eastern AF patients using warfarin include chronic kidney disease, heart failure, cancer, high HAS-BLED score, and first episode of AF. Furthermore, sub-optimal INR is predictive of all-cause and cardiovascular mortality.</p>]]></description> </item><item><title><![CDATA[The Link between Arterial Atherosclerotic Disease and Venous Thromboembolic Disease]]></title><link>https://www.benthamscience.comarticle/146669</link><description><![CDATA[<p>Traditionally, arterial atherosclerosis (AA) and venous thromboembolic (VTE) diseases have been separated into two independent entities. However, a body of evidence suggests the link between arterial and venous disease. In this narrative review, the relationship between these two vascular diseases is discussed. Different risk factors are common in both diseases, such as dyslipidaemia, metabolic syndrome, and thrombophilia. Etiopathogenetic mechanisms of both diseases are similar. Inflammation, as a basic pathogenetic mechanism of arterial atherosclerosis, is also involved in the pathogenesis of VTE. Inflammation as a response to vessel wall injury promotes coagulation and inhibits endogenic fibrinolytic activity, which results in thromboembolic events in the arterial as well as in the venous system. A relationship has also been observed between preclinical or clinical arterial atherosclerosis and VTE. These findings indicate that atherosclerosis may induce VTE or that common risk factors simultaneously stimulate the development of both diseases. The relationship between arterial and venous disease is also supported by the efficacy of some drugs (antiplatelets, anticoagulants, statins) in the prevention of both diseases. </p> <p> In conclusion, arterial and venous diseases share similar pathophysiological mechanisms, often driven by common risk factors. This overlap suggests that a unified approach to prevention and treatment may be beneficial for both conditions, potentially improving patient outcomes by addressing the underlying shared pathways.</p>]]></description> </item><item><title><![CDATA[Cytokine and Oxidative Stress Imbalances in Relation to Complex Coronary Lesions in Elderly Patients]]></title><link>https://www.benthamscience.comarticle/146584</link><description><![CDATA[<p>Background: Complex coronary lesions have been an understudied aspect of coronary artery disease in elderly patients. Oxidative stress and inflammation may be implicated in the pathogenesis of complex coronary lesions. </p> <p> Objectives: The aim of this study is to investigate the complex interplay between pro-oxidative stress response, pro-inflammatory response, and complex coronary lesions in elderly patients. </p> <p> Methods: Enzyme-linked immunosorbent assays for the detection of serum biomarkers [reactive oxygen species (ROS), malondialdehyde (MDA), tumor necrosis factor-&#945; (TNF-&#945;), interferon-gamma (IFN-&#947;), superoxide dismutase (SOD) activity, total antioxidant capacity (TAC), transforming growth factor beta (TGF-&#946;) and interleukin-4 (IL-4)] were performed in elderly patients with complex coronary lesions. </p> <p> Results: The levels of pro-oxidative stress and pro-inflammatory markers (ROS, MDA, TNF-&#945; and IFN-&#947;) were increased in the complex coronary lesion group when compared with the non-complex coronary lesion group (P &#60; 0.01) in elderly patients. Anti-oxidative stress and anti-inflammatory markers (SOD activity, TAC, TGF-&#946;, and IL-4) were decreased in the complex coronary lesion group when compared with the non-complex coronary lesion group (P &#60; 0.01) in elderly patients. </p> <p> Conclusion: Our findings suggest that the pathogenesis of complex coronary lesions may involve pro-oxidant/anti-oxidant and pro-inflammation/anti-inflammation imbalance, as well as the interplay between oxidative stress and inflammation in elderly patients.</p>]]></description> </item><item><title><![CDATA[Acknowledgement to Reviewers]]></title><link>https://www.benthamscience.comarticle/150152</link><description><![CDATA[]]></description> </item><item><title><![CDATA[Nose-to-Brain Targeting of Resveratrol Nanoformulations]]></title><link>https://www.benthamscience.comarticle/146143</link><description><![CDATA[Resveratrol [RES] is a polyphenolic stilbene with therapeutic potential owing to its antioxidant, anti-inflammatory, neuroprotective, and cardioprotective properties. However, the very poor oral bioavailability, fast metabolism, and extremely low stability under physiological conditions pose a severe detriment to the clinical use of RES. This newly developed field of nanotechnology has led to the formulation of RES into nanoformulations with the goal of overcoming metabolicpharmacokinetic limitations and enhancing the targeted transport of RES to the central nervous system [CNS]. Among the various routes of administration, the combination of nose-to-brain [N2B] delivery via the intranasal [IN] route has recently garnered attention as a straightforward, noninvasive route for transport to the blood-brain barrier [BBB] for greater effects and less harmful systemic side effects by transporting nano-encapsulated RES into the neural tissues. This review critically summarizes the mechanisms and benefits of the N2B route for the delivery of RES nanoformulations, collating in vivo data demonstrating increased CNS bioavailability and stability and, consequently, improved therapeutic efficacy in animal models of neurodegenerative diseases. Compared with the more 'traditional' routes of administration, IN administration of RES nanoformulations is less toxic, cost-effective, and efficient in crossing the BBB. Therefore, this route represents a promising approach to the management of CNS disorders. Further optimization of nanoformulation design and clinical protocols is required to translate these promising findings into therapeutic strategies aimed at neuroprotection and disease modification in human CNS pathologies.]]></description> </item><item><title><![CDATA[Comparative Efficacy and Safety of Direct Oral Anticoagulants and Warfarin in Morbidly Obese Patients (BMI \>40 kg/m2): A Systematic Review and Meta-Analysis]]></title><link>https://www.benthamscience.comarticle/146605</link><description><![CDATA[<p>Introduction: Current guidelines and consensus statements advise caution in using direct oral anticoagulants (DOACs) for morbidly obese patients with body mass index (BMI) >40 kg/m2, indicating warfarin as the most studied treatment. </p> <p> Methods: We systematically searched databases from their inception to January 4, 2024, to identify studies that evaluated the effectiveness and safety of DOACs compared to warfarin in patients with BMI >40 kg/m<sup>2</sup> and atrial fibrillation (AF) or venous thromboembolism (VTE). The outcomes of allcause mortality, major and minor bleeding, stroke/systematic embolism (SE), VTE, and their composite endpoint were analyzed using a random-effects model. </p> <p> Results: This meta-analysis included 24 studies and 119,960 morbidly obese patients with AF or VTE on oral anticoagulation therapy: 51,363 on DOACs (43%) vs. (57%) 68,597 on warfarin. DOAC use was significantly associated with lower all-cause mortality and major bleeding risk compared to warfarin. Although the risk of composite endpoint, stroke/SE, and VTE was lower in the DOAC group, no statistically significant difference was observed, indicating no superiority of warfarin compared to DOAC use. The risk of minor bleeding events, hemorrhagic stroke, and ischemic stroke was lower in the DOAC compared to the warfarin group. The same trend favoring DOACs over warfarin in all assessed endpoints was observed in the subgroup analysis based on anticoagulation indication (AF or VTE). </p> <p> Conclusion: Our findings have documented a potentially more effective and safer profile of DOACs compared to warfarin in morbidly obese patients regardless of the indication for anticoagulation.</p>]]></description> </item><item><title><![CDATA[Updates on the Pathogenesis and Therapeutic Approaches for Hereditary Hemorrhagic Telangiectasia]]></title><link>https://www.benthamscience.comarticle/146308</link><description><![CDATA[Hereditary Hemorrhagic Telangiectasia (HHT), also known as Osler-Weber-Rendu syndrome, is a rare and inherited vascular disorder characterized by the development of arteriovenous malformations (AVMs) in various organs and telangiectasia (small AVM) in the mucocutaneous. The majority of HHT patients have haploinsufficiency of genes involved in the transforming growth factor- beta (TGF-&#946;) signaling pathway, including endoglin (<i>ENG</i>), activin receptor-like kinase 1 (<i>ALK1</i>, also known as <i>ACVRL1</i>), or <i>SMAD4</i>. Active angiogenesis is also required for telangiectasia and AVM development. Anti-angiogenic strategies have been tested in patients and animal models extensively. However, the exact mechanisms for telangiectasia and AVM development remain unclear. In this review, we discussed several important advances in the past 10 years in understanding HHT disease mechanisms and in therapeutic development.]]></description> </item><item><title><![CDATA[Roles of Empagliflozin in Diabetic Cardiomyopathy: A Review]]></title><link>https://www.benthamscience.comarticle/146144</link><description><![CDATA[Empagliflozin (EMPA), a sodium-glucose cotransporter 2 inhibitor (SGLT2i), represents a novel therapeutic agent for diabetes management. Over the past decade, studies have consistently demonstrated that EMPA not only effectively lowers blood glucose levels but also confers substantial cardiovascular benefits without inducing hypoglycemia. This holds for individuals with or without diabetes, highlighting EMPA’s potential in mitigating the risk of adverse cardiovascular events and cardiovascular mortality. The underlying mechanisms driving these advantageous effects remain incompletely understood, with presently elucidated pathways encompassing blood pressure reduction, oxidative stress attenuation, anti-inflammatory properties, metabolic regulation, uric acid level modulation, inhibition of Na+/H+ exchangers, preservation of mitochondrial function, vascular protection, and regulation of myocardial autophagy. In this review, we considered the effects and mechanisms of EMPA in combating diabetic cardiomyopathy (DCM), underscoring its therapeutic relevance in addressing cardiovascular complications associated with diabetes.]]></description> </item><item><title><![CDATA[Cardiopulmonary and Urine Electrolyte Changes in Healthy Males Exposed to Two Distinct Anaerobic Exercises]]></title><link>https://www.benthamscience.comarticle/148457</link><description><![CDATA[<p>Background: Anaerobic exercise, characterized by short bursts of high-intensity activity such as weightlifting, sprinting, and high-intensity interval training (HIIT), has been documented to influence the body physiology. </p> <p> Objectives: The study investigated the acute impact of weightlifting and rope jumping exercise sessions on blood pressure, pulse rate, blood glucose, body temperature, pulmonary indices, and urine creatinine and electrolyte levels in healthy male subjects. </p> <p> Methods: Twenty participants, aged 18-25, were randomly assigned to the control group (n=10) and the exercise group (n=10). The control group watched exercise videos of weightlifting and rope jumping, respectively. The anaerobic exercise group performed weightlifting and rope jumping exercise sessions, respectively. Before the commencement of the experiment, the participants were given a 15-minute rest, and their blood pressure, body temperature, and blood glucose were measured. Then they were given 600 mL of water and 15 g of glucose for hydration and energy. After 45 minutes, their cardiovascular indices, blood glucose, body temperature, pulmonary indices, and urine sample for assessment of urine electrolyte and creatinine levels were taken. After that, the control group watched a video of people engaged in weight lifting, and the exercise group lifted 6 kg dumbbells (3 kg per arm) for 15 minutes with a 20-second break period after every 2 minutes of performing the exercise or watching the video. After the first session, a 30- minute recuperation period was given before the commencement of the second session (rope jumping). The same procedure was repeated in the second session. Blood pressure, pulse rate, blood glucose, and body temperature were measured immediately after the first session, 15, 30 minutes after the first session, immediately after the second session, 15, and 30 minutes after the second session. Pulmonary indices and urine samples were taken immediately after the first session, 30 minutes after the first session, immediately after the second session, and 30 minutes after the second session. </p> <p> Results: The results showed a significant increase in systolic blood pressure, mean arterial pressure, pulse rate, and body temperature; however, there was no significant difference in diastolic blood pressure, lung function parameters, or blood glucose in the exercise group compared to the control group. In addition, the exercise group showed a significant increase in urine sodium and potassium levels, as well as a significant decrease in urine creatinine level, at the end of the 30- minute recuperation period compared to the control group. </p> <p> Conclusion: The study demonstrated that weightlifting and rope jumping exercise sessions significantly increased blood pressure, pulse rate, and body temperature, but had no significant effect on lung function and blood glucose level. These findings suggest that weightlifting and rope jumping have short-term effects on cardiovascular functions and body temperature, but do not alter lung function or blood glucose level in healthy young males. Significant changes may occur in lung function and blood glucose levels in a long-term study.</p>]]></description> </item><item><title><![CDATA[The Green Path to Liver Health: Herbal Solutions for Non-alcoholic Steatohepatitis]]></title><link>https://www.benthamscience.comarticle/147233</link><description><![CDATA[Non-alcoholic steatohepatitis (NASH) is a progressive liver disease marked by inflammation and fibrosis, stemming from non-alcoholic fatty liver disease (NAFLD). Despite its rising predominance, current therapeutic medications are limited in efficacy and safety. Recent attention has shifted towards herbal therapies as potential adjuncts or alternatives in NASH management, given their anti-inflammatory, antioxidant, and phospholipid-controlling characteristics. This research study attempted to assess critically existing literature on the efficacy of herbal interventions while managing NASH. The main goal was to assess the possible medicinal advantages of different herbs, highlight their mechanisms of action, and identify gaps in current research to guide future studies. A systematic review of peer-reviewed articles using databases, like PubMed, Scopus, and Google Scholar, was conducted. It included studies that investigated the effects of herbal extracts (e.g., silymarin, curcumin, berberine) on NASH-related outcomes, such as liver function, fibrosis, lipid metabolism, and inflammatory markers. The review identified several herbs with promising therapeutic effects on NASH. Silymarin showed consistent improvements in liver enzymes and fibrosis markers. Curcumin and berberine were effective in reducing inflammation of the liver and oxidative damage. However, the heterogeneity in research designs, dosages, and outcome measures has limited the generalizability of findings. Herbal therapies hold potential as complementary treatments for NASH, with evidence supporting their role in improving liver function and reducing inflammation. To prove their safety and effectiveness, however, greater sample numbers and longer follow-up times are required in standardised clinical studies.]]></description> </item><item><title><![CDATA[IL 6 Cascade in Post COVID Cardiovascular Complications: A Review of Endothelial Injury and Clotting Pathways]]></title><link>https://www.benthamscience.comarticle/149068</link><description><![CDATA[The COVID-19 pandemic has revealed various long-term cardiovascular complications linked to increased inflammatory responses, particularly through Interleukin-6 (IL-6) activity. IL-6 is a major cytokine in the immune system that plays a bimodal role: it supports acute immune defense but contributes to chronic inflammation and tissue damage when dysregulated. High levels of IL-6 during and after COVID-19 are linked with poor outcomes, such as Acute Respiratory Distress Syndrome (ARDS), myocarditis, endothelial dysfunction, and thrombotic events. Chronic IL-6 signaling impairs vascular homeostasis, leading to endothelial dysfunction and increased thrombosis. Viral and cytokine-driven inflammation leads to endothelial damage caused by COVID-19. These include mechanisms that implicate the downregulation of ACE2, oxidative stress, and reduced bioavailability of nitric oxide. All these contribute to arterial stiffness, atherosclerosis, and thrombosis. It is possible to reduce the risk of heart disease by using targeted therapies, such as IL-6 inhibitors, which can help reduce inflammation. Biomarkers of endothelial health and inflammation include EPCs and CECs. Pharmacological strategies, such as RAS inhibitors and statins, may have additive effects on endothelial function, but ACE2 upregulation remains a major question. Rehabilitation and exercise-based approaches are further supportive of vascular recovery. When IL-6 activity stays high after an infection, it causes blood to clot too easily and cause thrombotic problems. This makes patients more likely to experience an ischemic stroke or pulmonary embolism. Anticoagulants and IL-6 inhibitors like tocilizumab reduce these risks. IL-6's long-term effects on the heart need to be studied more, and biomarker screening, lifestyle changes, and personalized therapies must be used to prevent heart disease as much as possible. A holistic management approach that integrates anti-inflammatory and anticoagulation strategies will significantly improve outcomes in survivors of COVID-19.]]></description> </item><item><title><![CDATA[Expression of PIM1/ASK1 Molecular Pathway Related Genes in Ischemic Cardiomyopathy]]></title><link>https://www.benthamscience.comarticle/148790</link><description><![CDATA[<p>Introduction: Myocardial ischemia/reperfusion injuries (MI/RI) are responsible for fatal cardiovascular diseases. Myocardial infarction may lead to ischemic cardiomyopathy (ICM). Thereby, illustrating the MI/RI molecular basis could lead to the emergence of novel therapeutic options. <i>PIM1/ASK1 (MAP3K5)</i> pathway is well-known in renal ischemia/ reperfusion. PIM1 protein can promote autophagy after hypoxia. </p> <p> Materials and Methods: We selected the dataset GSE46224 from the National Center of Biotechnology Information (NCBI) Gene Expression Omnibus (GEO) database for evaluation. This dataset was analyzed using tools such as the Kyoto Encyclopedia of Genes and Genomes, Gene- Codis, and BioGRID. Three groups of patients were selected from the dataset. ICM group (n=8), non-failing (NF) group (n=8), and non-ischemic cardiomyopathy (NICM) group (n=8) evaluated for 15 genes expression levels. P-value <0.05 is statistically significant. </p> <p> Results: <i>JAK1</i> showed significantly lower gene expression in the ICM group compared to the NF group (p-value = 0.012, difference = -6.24). ASK1 was also significantly down-regulated in the ICM group compared to the NF group (p-value =0.0159, difference = -1.478). In contrast, STAT5B and NF-&#954;B were significantly up-regulated in the ICM group (STAT5B: p-value = 0.0238, difference = 2.388; NF-&#954;B: p-value = 0.0158, difference = 1.11). The analysis of differences and the volcano plot confirmed these findings, highlighting key dysregulated genes in ICM. </p> <p> Conclusion: In conclusion, ICM patients have altered ASK1 expression compared to NF individuals. The significant down-regulation of ASK1 and JAK1, along with the up-regulation of STAT5B and NF-&#954;B, suggests that targeting ASK1 could be an important strategy to ameliorate ischemia-related cardiomyocyte damage.</p>]]></description> </item><item><title><![CDATA[Reduced Erythrocyte Opsonization by Calreticulin, Lactadherin, Mannose-binding Lectin, and Thrombospondin-1 in MAFLD Patients]]></title><link>https://www.benthamscience.comarticle/149008</link><description><![CDATA[<p>Introduction: Metabolism dysfunction associated with fatty liver disease During metabolic hepatic inflammation (MAFLD), is characterized by systemic metabolism deregulation leading to increased hepatic erythrophagocytosis and subsequent iron overload and ferroptosis. Studies in animal models have shown that erythrocyte phosphatidylserine exposure drives erythrophagocytosis. However, the mechanism of erythrophagocytosis in human MAFLD has not been fully elucidated yet. Therefore, in this study, we explored the opsonins recognizing phosphatidylserine. In particular, we measured the levels of erythrocyte calreticulin, lactadherin, mannose-binding lectin, and thrombospondin-1. </p> <p> Methods: Twenty-four patients (15 men and 9 women) with MAFLD and 9 healthy controls (4 men and 5 women) were enrolled. Erythrocytes were isolated from EDTA-containing blood through multiple centrifugations and isotonic buffer. Protein levels were measured in erythrocyte lysates (triton X-100 0.1% v/v) or plasma with enzyme-linked immunosorbent assays. </p> <p> Results: Erythrocyte TSP-1 levels were reduced in MAFLD patients. This reduction was not followed by changes in plasma TSP-1 levels or erythrocyte calreticulin, lactadherin, and mannose- binding protein. </p> <p> Discussion: Our results suggest that erythrophagocytosis in human MALFD, unlike animal models, is not mediated by opsonization of exposed phosphatidylserine. </p> <p> Conclusion: Our study underlines the need for disease models that could better reflect the molecular pathogenesis of human MAFLD.</p>]]></description> </item><item><title><![CDATA[The Impact of Single Nucleotide Polymorphisms and Other Mechanisms on Aspirin Resistance]]></title><link>https://www.benthamscience.comarticle/147478</link><description><![CDATA[Atherosclerosis and ischemic events play a pivotal role in the pathogenesis of several cardiovascular diseases (CVD). The primary aim of preventing recurrent thrombosis in patients who underwent cardiovascular surgery is the antiplatelet agent administration. Nevertheless, despite the aspirin therapy or double (aspirin plus clopidogrel) therapy, the effectiveness of antithrombotic treatment remains controversial. In recent years, we have learned that some percentage of patients still demonstrate no clinical response to aspirin treatment and may experience a vascular complication. This article provides an overview of recent scientific studies that have focused on experimental detection and genotyping of single nucleotide polymorphisms (SNPs) in patients, involving the main therapeutic target genes: cyclooxygenase COX-1 and COX-2, guanylate cyclase GUCY1A3, the glycoprotein complex GPIIb-IIIa, and the platelet receptor protein PEAR1.\" The aspirin resistance (AR) ranges considerably from 0 % to 66% in patients with ischemic heart disease (IHD) and relatively healthy people (control group). SNP distribution analysis has been proposed to explain the inadequate high platelet reactivity (HPR) among patients with IHD under aspirin treatment. Various SNPs have been proposed to explain the development of CVD and the persistent HPR under aspirin treatment widely used in the prevention of recurrent cardiovascular thrombotic events. Meanwhile, the efficacy of aspirin therapy in secondary thrombosis prevention in patients with IHD is not strongly associated with known SNP. The inconsistent results of different AR clinical trials are likely due to the design of the experiments and methodological and quantitative issues; therefore, careful interpretation of the SNP genotyping results is necessary.]]></description> </item><item><title><![CDATA[The Effect of Risk Factors and Clinical Complications of Chronic Kidney Disease (CKD) on Renal Arterial Resistive Index (RRI)]]></title><link>https://www.benthamscience.comarticle/145814</link><description><![CDATA[<p>Background: Chronic Kidney Disease (CKD) is a known risk factor for End-Stage Renal Disease (ESRD) and Cardiovascular Diseases (CVD). Renal Doppler Ultrasound (RDU) can detect early renal involvement in CKD using the Renal Resistive Index (RRI). </p> <p> Aims: This study aimed to investigate the effects of risk factors and clinical complications associated with CKD on RRI among patients with different stages of CKD. </p> <p> Methods: In this analytical cross-sectional study, 186 patients referred to Poursina Hospital for RDU were categorized into six groups (normal and five stages of CKD). We analyzed the impact of demographic factors and clinical complications on RRI across all groups. </p> <p> Results: Our findings indicated that CKD prevalence was particularly high among older patients and those with CVD, type 2 diabetes mellitus (DM), and hypertension (HTN). Elevated RRI in CKD patients was significantly associated with age, CKD stage, CVD, and HTN (p &#60; 0.05). Furthermore, RRI was higher in CKD patients with elevated serum phosphorus (P) levels, higher low-density lipoproteins (LDL), and lower calcium (Ca) and hemoglobin (Hb) levels. Based on a multivariate regression model, CVD, lower Ca, high LDL, and proteinuria were identified as independent predictors of elevated RRI (p &#60; 0.05). </p> <p> Conclusion: This study concludes that elevated RRI is associated with the severity of CKD and its clinical complications, suggesting that RRI can serve as a reliable indicator for assessing CKD patients, managing treatment, and preventing early death complications.</p>]]></description> </item><item><title><![CDATA[Interactions between Hypertension and Breastfeeding: What Do We Know?]]></title><link>https://www.benthamscience.comarticle/147957</link><description><![CDATA[Substantial evidence indicates that breastfeeding reduces mortality and morbidity in infants. However, social changes in the 20th century resulted in a considerable decline in breastfeeding rates in many countries. Breast milk is crucial because of its nutritional, immunological, and emotional benefits and economic value. Approximately 10% of pregnancies are complicated by hypertensive syndromes, which are the most commonly diagnosed conditions during pregnancy. This perspective aims to explore how hypertension may interfere with the quality of human breast milk. While numerous studies have investigated the composition of breast milk and its numerous benefits for both infants and mothers, limited research examines the relationship between colostrum, breast milk, and hypertension. Given the diverse nutritional and immunological components of breast milk, many questions remain about this complex interaction.]]></description> </item><item><title><![CDATA[Nanotechnology-Enhanced Transdermal Patches for Hypertension: A Review]]></title><link>https://www.benthamscience.comarticle/148018</link><description><![CDATA[Transdermal Drug Delivery System (TDDS) is one of the controlled drug delivery systems whose purpose is to deliver medication through the skin at a predetermined and regulated rate. Nanotechnology has enhanced the skin’s absorption of lipophilic, low-molecular-weight medicines with low-dose efficacy, making transdermal drug delivery systems a viable technique for treating various conditions. TDDS permits greater skin permeation of hydrophilic drugs, and scientists are studying macromolecules to improve disease treatment and vaccine development. While additional study is needed to determine nanocarrier safety, this approach could increase the usage of transdermal routes for administering hypertension medicines. As hypertension remains the most prevalent form of cardiovascular illness, we focus on how nanoparticles as skin delivery methods might be used to better treat this global problem. In addition, patients may not be willing to comply with traditional doses due to the greater frequency of drug administration necessary for long-term care of hypertension conditions. Transdermal drug delivery has provided numerous benefits to the medical community since its inception. These benefits include the drug's non-invasive nature, extended therapeutic effect, reduced adverse effects, greater bioavailability, improved patient compliance, and simple termination. This review aims to explore the potential of several antihypertensive drugs for transdermal delivery.]]></description> </item><item><title><![CDATA[Exploring the Efficacy of Integrating Yoga and Ayurveda for Hypertension Treatment]]></title><link>https://www.benthamscience.comarticle/147814</link><description><![CDATA[Hypertension, a condition affecting 1.28 billion adults globally, poses significant health risks, including damage to the heart, kidneys, and brain. Factors such as unhealthy lifestyles, poor dietary habits, obesity, and diabetes contribute to its prevalence. While pharmaceutical interventions are effective in controlling blood pressure, their adverse effects have led to growing interest in alternative therapies such as Ayurveda and Yoga. This review explores the potential of these traditional practices, individually and in combination, for managing hypertension. A thorough literature review was conducted using databases like PubMed and Google Scholar to analyze peerreviewed studies up to 2024. Ayurvedic treatments, including therapies like Basti and Shirodhara and herbal formulations such as Raktadabashamak Ghana Vati and Sarpagandha Vati, have shown promise in reducing blood pressure. Similarly, Yoga practices, including OM chanting and Yoga Nidra, have demonstrated stress-reducing and blood pressure-lowering effects. Despite evidence supporting their efficacy, research on their integrated use remains limited. This review underscores the importance of combining Ayurveda and Yoga for holistic hypertension management. Further scientific studies are necessary to validate this integrative approach, which has the potential to offer a safer, non-pharmacological alternative for managing hypertension and improving overall wellbeing.]]></description> </item><item><title><![CDATA[Comparison of the Effect of Intermittent Fasting with Mediterranean Diet on Glycemic, Lipid, and Anthropometric Indices in Type 2 Diabetes: A Review of Randomized Controlled Trials]]></title><link>https://www.benthamscience.comarticle/147620</link><description><![CDATA[<p>Introduction: Type 2 diabetes is a metabolic disorder that is becoming more prevalent over time. Research has shown that the Mediterranean diet (MD) and intermittent fasting (IF) can improve the metabolic parameters of patients with type 2 diabetes. However, there has yet to be a study comparing the effectiveness of these two diets in diabetic patients. This review aims to compare the impact of the Mediterranean diet and intermittent fasting on glycemic, lipid, and anthropometric indices in patients with type 2 diabetes. </p> <p> Methods: We selected clinical trial studies published between 2013 and 2023 that examined the impact of the MD and the IF diet on glycemic, lipid, and anthropometric indices in patients with type 2 diabetes, in the PubMed and Scopus databases on November 23, 2023, and were included in our study following the PRISMA guidelines. </p> <p> Results: A total of 22 clinical trials meeting the inclusion criteria were chosen. Out of these, 13 clinical trials focused on the impact of the Mediterranean diet, while the remaining trials examined the effects of the IF diet on type 2 diabetes. The age range of participants in all studies was above 18 years, with the number of individuals investigated ranging from 9 to 557. The duration of the interventions varied from 1 week to 8 years. The MD and IF have both have been shown to effectively improve glycemic control, lipid profiles, and anthropometric measurements in patients with type 2 diabetes. However, the MD tends to offer more consistent and sustainable long-term benefits. This can be attributed to its rich composition of antioxidants, healthy fats, and dietary fiber. IF has demonstrated potential benefits for improving blood sugar levels and lipid profiles over short periods. However, its effectiveness may be compromised by the risk of hypoglycemia and the inconsistent commitment of patients. </p> <p> Conclusion: These findings suggest that the MD is preferable for long-term, while IF may serve as a complementary short-term strategy. Further research in this area is necessary to provide a definitive opinion.</p>]]></description> </item><item><title><![CDATA[Acknowledgements to Reviewers]]></title><link>https://www.benthamscience.comarticle/150360</link><description><![CDATA[]]></description> </item><item><title><![CDATA[Vericiguat: A Promising Drug for the Treatment of Heart Failure]]></title><link>https://www.benthamscience.comarticle/147502</link><description><![CDATA[The health and survival of people with heart failure is a growing concern due to the associated illness and death. Traditional treatments such as medication, surgery, and lifestyle changes have not significantly improved life expectancy, leading to a search for more effective drug options. A drug that can act on oxidative stress and cardiac inflammatory markers while carrying the benefits of existing therapies is needed. Targeting the soluble guanylate cyclase (sGC)-cyclic guanosine monophosphate (cGMP) dependent pathway significantly reduces cardiac myocyte death and improves ejection fraction. In 2021, the USFDA approved Vericiguat, a derivative of pyrazolo [3,4-b]pyridine, to decrease the risk of cardiovascular death and hospitalization. This review provides information on the structure, pharmacokinetics, pharmacodynamics, clinical status, and treatment of Vericiguat in heart failure. Riociguat was the first sGC stimulator used in pulmonary hypertension therapy, but its short half-life required multiple dosing, making it unsuitable for cardiovascular diseases. Vericiguat was developed to address this limitation by decreasing metabolism, and both preclinical and clinical investigations have indicated its minimal pharmacokinetic interactions. This makes it appropriate for long-term use in cardiac patients with multiple comorbidities who require several medications. Vericiguat represents a promising new option for heart failure treatment, potentially improving patient outcomes and quality of life. Its compatibility with other heart failure therapies without significant drug-drug interactions further highlights its potential as a cornerstone treatment. Ongoing studies continue to explore its benefits, suggesting that vericiguat may enable more comprehensive and effective management of heart failure, reducing the burden of this debilitating condition.]]></description> </item><item><title><![CDATA[Critical Challenges in Cancer Immunotherapy and Cardiac Health]]></title><link>https://www.benthamscience.comarticle/147873</link><description><![CDATA[Cancer immunotherapy is based on immune checkpoint inhibitors (ICIs) and has brought a revolution in oncology with promising treatment possibilities for diverse cancers. Yet, immune-related adverse events (irAEs) frequently limit the clinical efficacy of ICIs, with cardiotoxicity representing a significant salient consequence. These ICI side-effects underscore the need for well-established models for the assessment of cardiac risk. This review proposes a risk evaluation strategy that uses biomarkers, non-invasive imaging, and individual patient data. The goal is to elucidate the mechanism through which immune-related adverse events affecting the heart might arise, and the need for predictive tools to better tailor treatment regimens to increase both safety and efficacy. Biomarkers play a vital role in the detection and prevention of heart-related side effects, which means adequate intervention while preserving therapeutic outcomes. Moreover, the study discusses the acknowledgement of novel treatment regimens and the ability of integration of artificial intelligence (AI) and machine learning (ML) to improve the assessment of risk. AI/ML tools are experts at synthesizing heterogeneous datasets to reveal patterns and risk factors, providing clinicians with powerful capabilities to enhance safety and efficacy. This paper aims to develop sound risk assessment models to enhance both the safety and efficacy of cancer immunotherapies by exploring various strategies and interactions in immunotherapy.]]></description> </item><item><title><![CDATA[Trends in Readmissions Rates and Mortality after Cardiac Resynchronization Therapy in Patients with Nonischemic Cardiomyopathy]]></title><link>https://www.benthamscience.comarticle/146986</link><description><![CDATA[<p>Introduction: Advances in cardiac implanted electronic devices (CIED) have significantly improved outcomes for patients with heart failure. However, there is a bereft of recent real- world data on the relative effectiveness of cardiac resynchronization therapy with pacing and defibrillator (CRT-D) and continuous resynchronization therapy with pacing (CRT-P) in patients with nonischemic cardiomyopathy (NICM). We hypothesized that the addition of defibrillation therapy in patients with NICM would offer no significant benefit. </p> <p> Methods: We searched the National Readmissions Database (NRD) from 2016-2020 to identify hospitalizations with NICM using appropriate ICD-10 diagnosis and procedure codes. The cohort was further divided into groups with NICM and CRT-D implantation and NICM with CRTP implantation. </p> <p> Results and Discussion: Our final cohort included 8,801 hospitalizations with NICM and CRTD implantation and 3,399 hospitalizations with NICM and CRT-P implantation. Propensity matching was performed using comorbidities through multivariate logistic regression. Two thousand nine hundred seventeen hospitalizations were included in each of the two groups, CRT-D and CRT-P. Analysis of the propensity-matched cohorts at 180 days revealed a trend toward lower heart failure readmission, all-cause readmission, and all-cause mortality rates in the group with CRT-P implantation. However, there was no difference noted in the 180-day hazard ratios of HF readmission [1.08 (0.98-1.19); p = 0.1], all-cause readmission [1.04 (0.87- 1.12); p = 0.23], and all-cause mortality [0.83 (0.58-1.19); p = 0.32]. </p> <p> Conclusion: It was found that NICM patients with CRT-D have a trend towards higher HF readmissions, all-cause readmission, and all-cause mortality compared to those with CRT-P, but no significant difference was noted in hazard ratios. The findings of our study raise further questions about the need for defibrillator therapy in patients with NICM and merit further studies to better select candidates for each of these therapies.</p>]]></description> </item><item><title><![CDATA[Post-stroke Arrhythmias: Performance of Brain-heart Crosstalk Networks]]></title><link>https://www.benthamscience.comarticle/147871</link><description><![CDATA[Stroke and heart disease are two of the leading causes of the global disease burden. However, modern research has gradually revealed a potential causal link between these two conditions. Most studies have focused on the direct role of arrhythmias in stroke. However, clinical evidence suggests that the incidence of arrhythmias increases after stroke in patients without a history of arrhythmia, and cardiac disease after stroke has become the second leading cause of death after stroke. This article focuses on arrhythmias after stroke and reviews brain-heart crosstalk after stroke. This article examines the potential mechanisms of brain-heart interactions after stroke, including increased catecholamines due to autonomic imbalance, gut microbial dysbiosis, immune response, and systemic inflammation. In addition, this article discusses the impact of arrhythmia on stroke severity and the role of brain injury sites in brain-heart interactions. To address these mechanisms, we propose that post-stroke arrhythmia is a type of stroke-induced disease distinct from primary arrhythmia. We aimed to identify new therapeutic targets and treatments, both pharmacological and non-pharmacological, to achieve targeted treatment and provide guidance for future clinical prevention and treatment.]]></description> </item><item><title><![CDATA[From Pregnancy to Postpartum: The Cardiovascular Risks Associated with Gestational Diabetes]]></title><link>https://www.benthamscience.comarticle/147735</link><description><![CDATA[Cardiovascular disease is the leading cause of pregnancy-related mortality, with pregnancy-related cardiovascular issues extending into the postpartum period. Recent studies suggest hyperandrogenism alters sex hormone levels, contributing to gestational cardiovascular disease CVD. Most of the factors behind the onset of CVD in postpartum women remain unknown. Animal studies mimic adverse pregnancy outcomes to explore molecular causes of severe prenatal cardiac events and their role in postpartum cardiovascular disease development. This review will be focused on summarising human and animal research that shows how undesirable pregnancy outcomes, such as obesity in the mother and gestational diabetes (GD), have an impact on postpartum cardiovascular disease and prenatal cardiometabolic dysfunction. We will highlight the adverse effects of gestational hyperandrogenism as a potential biomarker for cardiovascular dysfunction in pregnant women and new mothers. Investigative cardiovascular (CV) risk variables in the early postpartum phase following pregnancy that were impacted by GD was the aim of this study. Current research strongly implies that women with GDM have a higher risk of developing CVD. Finding appropriate, reliable indicators of CVD and specific treatment modalities that can control obesity, diabetes, and metabolic syndrome are critical to reducing the burden of CVD on impacted women. GD and hypertensive disorders are two pregnancy- related illnesses that raise the risk of CVD in the long run. Despite a lack of awareness, early screening, lifelong monitoring, and continuous research to enhance detection and prevention are essential.]]></description> </item><item><title><![CDATA[Heart Failure Management in the Modern Era: A Comprehensive Review on Medical and Device-based Interventions]]></title><link>https://www.benthamscience.comarticle/147166</link><description><![CDATA[Heart failure remains a significant global health challenge, necessitating continuous advancements in management strategies to improve patient outcomes. This review aimed to elucidate the current scenario of heart failure and its management in the modern era, focusing on integrating medical therapy and implantable device interventions. According to guidelines, medical treatment remains the primary method of treating heart failure. Such medications include ACE inhibitors, neprilysin-angiotensin receptor inhibitors, beta-blockers, angiotensin II receptor blockers, mineralocorticoid receptor antagonists, and blockers of sodium-glucose co-transporter- 2. These pharmacologic agents have demonstrated efficacy in decreasing mortality and morbidity in patients. The advent of implantable devices has revolutionized treatment, providing substantial benefits in specific patient populations. Cardiac resynchronization therapy has emerged as a pivotal intervention for patients with reduced ejection fraction and dyssynchronous ventricular contraction, effectively enhancing cardiac function and quality of life. Furthermore, left bundle branch area pacing improvements provide fascinating alternatives to traditional cardiac resynchronization therapy. The essential significance of device-based therapies is further highlighted by the function of implanted cardioverter-defibrillators in preventing unexpected cardiac deaths in high-risk patients. Furthermore, integrating remote monitoring technologies and novel device innovations continues to enhance the precision and efficacy of heart failure management. This review comprehensively examines current guidelines and evidence supporting the use of these therapies, addressing their synergistic potential and the practical considerations for their implementation, while synthesizing recent advancements in pharmacologic and device-based interventions.]]></description> </item><item><title><![CDATA[Association of Hypertensive Disorders of Pregnancy and their Clinical Features with Peripartum Cardiomyopathy: A Systematic Review and Meta-analysis]]></title><link>https://www.benthamscience.comarticle/146637</link><description><![CDATA[<p>Background: Peripartum Cardiomyopathy (PPCM) is a rare yet fatal cardiac disease associated with pregnancy. PPCM has been shown to have similar etiopathogenesis with hypertensive disorders of pregnancy (HDP). Hence, this study aims to study the association between HDP and the development of PPCM. </p> <p> Methods: Three databases (PubMed, Scopus, Cochrane Library) were searched and screened based on prespecified inclusion and exclusion criteria. Predictors of PPCM evaluated were HDP (preeclampsia, superimposed preeclampsia, chronic hypertension, and gestational hypertension) and its clinical features (severe preeclampsia, age, parity, serum creatinine, etc.). Data were analyzed using the random effects model of pooled odds ratios (ORs) with the Mantel Haenszel method, and publication bias was assessed with a funnel plot. </p> <p> Results: A total of 13 observational studies with 11,951 PPCM cases from 7 countries were identified. All types of HDP were associated with significantly increased odds of developing PPCM, and severe preeclampsia was associated with the highest OR of 13.33 (CI: 5.95 - 29.83, p &#60; 0.01). Additionally, superimposed preeclampsia, chronic hypertension, preeclampsia, and lastly gestational hypertension were associated with increased odds of PPCM with OR 5.77, 4.73, 4.70, and 3.13, respectively. Other clinical features being statistically significant for PPCM development included advanced age > 35 years and multiple pregnancies (p &#60; 0.05). No significant difference in creatinine level was found between PPCM and no PPCM group. No publication bias was found based on funnel plot assessment. </p> <p> Conclusion: HDP, especially severe preeclampsia, is associated with increased odds of PPCM development; hence, a low threshold for PPCM screening in this high-risk group is required.</p>]]></description> </item><item><title><![CDATA[An Updated Review on the Complex Association of Cardiovascular Disease (CVD) and Depression]]></title><link>https://www.benthamscience.comarticle/147287</link><description><![CDATA[<p>Introduction: The presence of both cardiovascular disease (CVD) and depression is common, and their complex connection poses difficulties in therapy and affects patient outcomes. Thus, this study aims to examine the complex correlation between depression and cardiovascular disease (CVD), with a specific focus on potential biomarkers and innovative therapeutic approaches. </p> <p> Methods: Publications were considered between 2015-2024 from standard databases like Google Scholar, PubMed-Medline, and Scopus using standard keywords, “Depression”, “Cardiovascular Disease”, “Biomarkers”, and “Therapeutic Approaches”. Recent studies have discovered several potential biomarkers linked to depression and cardiovascular disease (CVD), including neuroendocrine factors, inflammatory markers, and signs of oxidative stress. Therapeutic approaches for depression and cardiovascular disease have emerged, with a focus on tackling their connections from multiple dimensions. </p> <p> Results and Discussion: Emerging research suggests that depression has an impact on both the prognosis and risk of CVD. Conversely, depression can be caused by CVD, which triggers a series of events that lead to higher rates of illness and death. </p> <p> Conclusion: A comprehensive understanding of the fundamental pathophysiological pathways is essential for the identification of biomarkers that can serve as diagnostic tools or therapy targets. Among these interventions, exercise and dietary adjustments have shown promising impacts on cardiovascular health and results, as well as mental health. Ultimately, the selection of diagnostic techniques and treatments hinges on comprehending the complex interplay between depression and CVD. Researchers are developing novel therapeutic techniques to enhance the cardiovascular and mental health outcomes of individuals with both depression and CVD.</p>]]></description> </item><item><title><![CDATA[Risk of Cardiovascular Diseases Associated with PCOS in India: A Review]]></title><link>https://www.benthamscience.comarticle/147872</link><description><![CDATA[In the modern world, Polycystic Ovary Syndrome (PCOS) is thought to be the most prevalent endocrine condition affecting women. Compared to their normal counterparts, PCOS patients have higher rates of morbidity and death because they are more susceptible to these anomalies from an early age. Cardiovascular disease (CVD) and PCOS are prevalent in women. PCOS often results from a combination of hereditary and environmental causes. Insulin resistance (IR) is considered the primary cause of several metabolic risk factors, such as Type 2 Diabetes Mellitus (T2DM), Metabolic Syndrome (MetS), dyslipidemia, obesity, and hypertension (HTN). Additionally, patients with PCOS may also have elevated levels of non-traditional factors, including C-reactive protein (CRP), carotid intima-media thickness (IMT), coronary artery calcification (CAC), as well as endothelial dysfunction, which raises the likelihood of complications from CVD. This review utilizes statistics and data mostly sourced from research in India, offering insight into the nation's distinct PCOS prevalence and related cardiovascular risks. To lessen the impact of PCOS in the modern world, prompt identification and effective management of these warning signs with food, lifestyle changes, and/or medication are crucial. The research that examined the potential impact of PCOS on the most prevalent CVDhypertension, insulin resistance, obesity, malignancy, diabetes mellitus, and dyslipidemiais reviewed in this study. Measuring subclinical atherosclerosis, such as coronary artery calcium or carotid plaque, might help inform shared decision-making over the start of statin therapy when CVD risk is unknown.]]></description> </item><item><title><![CDATA[Antiplatelet-Proton Pump Inhibitor Interactions and Arterial Thrombotic Events: A Pharmacovigilance Assessment using Disproportionality and Interaction Analysis]]></title><link>https://www.benthamscience.comarticle/148308</link><description><![CDATA[<p>Introduction: The concomitant use of PPIs with antiplatelet therapy remains controversial due to potential drug interactions affecting clinical outcomes. While PPIs are recommended for gastroprotection in patients receiving antiplatelet therapy, concerns persist regarding their impact on antiplatelet efficacy, particularly with dual antiplatelet therapy (DAPT). </p> <p> Aims: The aim of this study is to evaluate the safety profiles of antiplatelet-proton pump inhibitors (PPIs) combinations and assess the clinical implications of their concurrent use in real-world settings through pharmacovigilance data analysis. </p> <p> Objectives: The objective of this study is to analyze and compare the thrombo-embolic risk profiles of various antiplatelet-PPI combinations using the FDA Adverse Event Reporting System database. </p> <p> Methods: We conducted a comprehensive analysis of the FDA Adverse Event Reporting System (FAERS) database to evaluate the thrombo-embolic risk associated with antiplatelet-PPI combinations. The reporting odds ratio (ROR) and information component were calculated to detect safety signals. The interaction signal score (INTSS) was used to assess the protective or harmful effects of adding acetylsalicylic acid to clopidogrel-PPI combinations. </p> <p> Results and Discussion: Analysis revealed significant safety signals for thrombo-embolic events with clopidogrel-rabeprazole (ROR: 62.67, 95% CI: 38.38-102.32) and clopidogrel-omeprazole (ROR: 6.87, 95% CI: 4.89-9.66) combinations. DAPT-PPI combinations showed comparable safety profiles to monotherapy-PPI combinations. The INTSS analysis suggested a potential protective effect of acetylsalicylic acid when added to clopidogrel-PPI combinations. Genderspecific analysis revealed female predominance in monotherapy complications and male predominance in combination therapy events. Clinical outcomes, including mortality and hospitalization rates, were comparable between groups. </p> <p> Conclusion: This pharmacovigilance analysis suggests that while DAPT-PPI combinations demonstrate acceptable safety profiles, careful consideration should be given to PPI selection, particularly given the unexpected safety signals with rabeprazole and confirmed risks with omeprazole. The addition of acetylsalicylic acid to clopidogrel-PPI combinations may offer protective effects against thrombo-embolic events. These findings support individualized riskbenefit assessment in selecting antiplatelet-PPI combinations while ensuring adequate gastroprotection for high-risk patients.</p>]]></description> </item><item><title><![CDATA[Impact of Combined Treatment with ARNi and SGLT2i on Clinical and Echocardiographic Outcomes in Patients with CRT During Mid-term Period]]></title><link>https://www.benthamscience.comarticle/147183</link><description><![CDATA[<p>Background: Sodium-glucose co-transporter 2 inhibitors (SGLT2i) and angiotensin receptor neprilysin inhibitors (ARNi) are new classes of medications with an evolving role in heart failure (HF) patients. However, the effect of combining these drugs with cardiac resynchronization therapy (CRT) remains less certain. </p> <p> Objective: This study aimed to investigate the impact of combined treatment with ARNi and SGLT2i on clinical and echocardiographic outcomes in CRT patients during 12-month followup. Methods: HF patients with CRT implantation indications were enrolled in the non-randomized and retrospective study and were grouped in no ARNi and SGLT2i (1st group) and combined treatment with ARNi and SGLT2i (2nd group) cohorts. The CRT response criteria were as follows: improvement of NYHA class ≥1 and left ventricular end-systolic volume reduction ≥15% or left ventricular ejection fraction improvement ≥5% from the baseline during the 12-month follow- up. </p> <p> Results: A total of 52 patients were included. At the 12-month follow-up, 18 of 35 (51.4%) patients in the 1st group and 16 of 17 patients (94.1%) in the 2nd cohort met CRT responder criteria (p=0.002). In multivariable logistic regression, combined treatment with ARNi and SGLT2i [odds ratio (OR): 20.09; 95% confidence interval (CI): 2.10-192.15; p=0.009] and non-ischemic HF (OR 5.51; 95% CI 1.21-24.91; p=0.026) were associated with CRT response. </p> <p> Conclusion: The combined treatment with SGLT2i and ARNi in patients with CRT improved the echocardiographic and clinical outcomes during the 12-month follow-up. In our study cohort, the CRT response was associated with non-ischemic HF and combined treatment with ARNi and SGLT2i.</p>]]></description> </item><item><title><![CDATA[The Role of Artificial Intelligence in Cardiovascular Disease Risk Prediction: An Updated Review on Current Understanding and Future Research]]></title><link>https://www.benthamscience.comarticle/147734</link><description><![CDATA[Cardiovascular disease (CVD) Continues to be the leading cause of mortality worldwide, underscoring the critical need for effective prevention and management strategies. The ability to predict cardiovascular risk accurately and cost-effectively is central to improving patient outcomes and reducing the global burden of CVD. While useful, traditional tools used for risk assessment are often limited in their scope and fail to adequately account for atypical presentations and complex patient profiles. These limitations highlight the necessity for more advanced approaches, particularly integrating artificial intelligence (AI) into cardiovascular risk prediction. Our review explores the transformative role of AI in enhancing the accuracy, efficiency, and accessibility of cardiovascular risk prediction models. The implementation of AI-driven risk assessment tools has shown promising results, not only in improving CVD mortality rates but also in enhancing quality of life (QOL) markers and reducing healthcare costs. Machine learning (ML) algorithms predicted 2-year survival rates after MI with improved accuracy compared to traditional models. Deep learning (DL) forecasted hypertension risk with a 91.7% accuracy based on electronic health records. Furthermore, AI-driven ECG (Electrocardiography) analysis has demonstrated high precision in identifying left ventricular systolic dysfunction, even with noisy single-lead data from wearable devices. These tools enable more personalized treatment strategies, foster greater patient engagement, and support informed decision-making by healthcare providers. Unfortunately, the widespread adoption of AI in CVD risk assessment remains a challenge, largely due to a lack of education and acceptance among healthcare professionals. To overcome these barriers, it is crucial to promote broader education on the benefits and applications of AI in cardiovascular risk prediction. By fostering a greater understanding and acceptance of these technologies, we can accelerate their integration into clinical practice, ultimately aiming to mitigate the global impact of CVD.]]></description> </item><item><title><![CDATA[Unveiling the Hidden Culprit: A Case Report on Tachy-Bradyarrhythmias Presenting as Seizure Disorders]]></title><link>https://www.benthamscience.comarticle/147288</link><description><![CDATA[<p>Background/Introduction: The misdiagnosis of seizure disorders in patients with cardiogenic syncope and tachy-bradyarrhythmias is a significant diagnostic challenge as the differentials for altered mental status and syncope are broad and can mimic other clinical conditions. This case report presents a unique case of an elderly male with life-threatening ventricular arrhythmia, initially misdiagnosed as a seizure disorder associated with syncope and treated with anti-epileptics for a neurogenic cause, before an ambulatory cardiac monitor revealed a sinister cardiogenic etiology. </p> <p> Case Presentation: An 87-year-old man with ischemic cardiomyopathy (LVEF 20%) and persistent atrial fibrillation presented for implantable cardioverter-defibrillator (ICD) evaluation following a ventricular fibrillation (VF) arrest. He had a history of recurrent syncope accompanied by muscle jerking and was initially treated with anti-epileptic drugs. However, further evaluation with mobile telemetry revealed ventricular arrhythmias, including nonsustained VT, VF, and asystole. Anti-epileptic medications were discontinued, and the patient was started on amiodarone. A cardiac resynchronization therapy defibrillator (CRT-D) was implanted, which successfully resolved his symptoms. Post-treatment, he remained asymptomatic, with no new VT/VF episodes detected at one week and three months during follow-up device checks. </p> <p> Conclusion: This case underscores the importance of considering cardiogenic causes in patients with syncope and seizure-like symptoms. Therefore, a multidisciplinary approach is essential for accurate diagnosis and management.</p>]]></description> </item><item><title><![CDATA[Evolving Strategies in the Detection and Management of Left Ventricular Thrombus: A Clinical Summary]]></title><link>https://www.benthamscience.comarticle/148273</link><description><![CDATA[Recent advancements have emerged in understanding the epidemiology and optimal therapeutic options for left ventricular thrombi (LVT). With early percutaneous interventions in acute myocardial infarction, the prevalence of LVT has decreased. However, the best strategies for prevention, risk stratification, and management remain unclear, especially among nonischemic cardiomyopathy disorders. This review outlines these advancements and provides an overview of the diagnostic and therapeutic implications of LVT in ischemic and non-ischemic cardiomyopathies. Significant gaps in the current evidence persist, particularly regarding the optimal timing for LVT screening and the need for prophylactic anticoagulation, highlighting opportunities for prospective cohort studies. Furthermore, a better understanding of the unique risk factors that contribute to increased LVT risk would lead to more comprehensive algorithms that may quantify the risk of LVT development, aiding in developing preventive strategies targeted at reducing rates of LVT. Until more definitive evidence is available, clinicians should custom LVT screening, preventive measures, and management strategies based on individual patient risk factors.]]></description> </item><item><title><![CDATA[Advances in Anti-inflammatory Therapies for Cardiovascular Disease and Atherosclerosis]]></title><link>https://www.benthamscience.comarticle/147916</link><description><![CDATA[This study aims to provide clinical and scientific information about the effects of various anti-inflammatory medicines on patients with cardiovascular disease (CVD). We also discussed the anti-inflammatory strategies and molecular mechanisms being investigated in preclinical or clinical CVD research. Numerous studies on anti-inflammatory medicines for CVD have resulted from greater knowledge of how innate and adaptive immunity influence plaque development and rupture. Some of these are now being evaluated in clinical trials and use lower dosages of existing medications that were initially developed for other inflammatory disorders with a high risk of CVD, such as rheumatoid arthritis and psoriasis. Other research includes retrospective and meta-analyses of clinical trials that examine the risk of CVD among individuals with various inflammatory diseases. We also included natural bioactive compounds, nanodrug and multiomics approaches to treat CVD by utilizing inflammatory pathways. Chronic subclinical inflammation is a major contributor to the development of CVD and has been associated with both the onset and progression of atherosclerosis. Several pro-inflammatory cytokines, including C-reactive protein (CRP), tumor necrosis factor-alpha (TNF-α), interleukins-1 and 6 (IL-1 and IL-6), leukotrienes, and adiponectin, have been identified as independent risk factors for coronary heart disease and promoters of arterial development. Researchers are looking for ways to stop the different inflammatory pathways that lead to atherosclerosis. These include multiomics approach, antioxidants, phospholipase A2 inhibitors, leukotriene pathway inhibitors, Phospholipase A2 (PLA2) inhibitors, non-inhibitors anti-inflammatory drugs (like methotrexate), IL-1 inhibitors, and p-selectin inhibitors.]]></description> </item><item><title><![CDATA[Interplay between Pro-inflammatory Mediators and Oxidative Stressinvolved Recurrent Chronic Heart Failure in Elderly Patients with Coronary Stents]]></title><link>https://www.benthamscience.comarticle/142842</link><description><![CDATA[<p>Introduction: Inflammation and oxidative stress are related to congestive heart failure in patients with coronary heart disease. </p> <p> Objective: Chronic congestive heart failure is a serious stage of coronary artery disease and is mainly a disease of elderly people over the age of 65. Elderly heart failure patients are characterized by myocardial ischemia, and post-ischemic myocardial dysfunction. Oxidative Stress, inflammation, and immune response play important roles in the development of heart failure. We tried to examine the mutual triggering of oxidative stress (malondialdehyde), inflammatory cytokines (tumor necrosis factor-&#945; and soluble tumor necrosis factor receptor-1/2), immune response (toll-like receptors 2,3,4), and high sensitivity C-reactive protein expression in elderly patients with recurrent congestive heart failure after coronary stenting and investigated the effect of interplay of these changes on onset and progression of recurrent congestive heart failure in elderly patients underwent coronary stent implantation. </p> <p> Methods: A total of 726 patients were enrolled in this study. We determined the levels of malondialdehyde (MDA), high sensitivity C-reactive protein (hs-CRP), tumor necrosis factor-α (TNF- α), soluble tumor necrosis factor receptor-1 and 2 (sTNFR-1/2) and toll-like receptor 2,3,4 (TLR2/ 3/4) in elderly patients with recurrent congestive heart failure after coronary artery stent implantation. </p> <p> Results: Levels of MDA, hs-CRP, TNF-&#945;, sTNFR-1, sTNFR-2, TLR2, TLR3 and TLR4 were remarkably increased (p&#60;0.01) in elderly patients with recurrent congestive heart failure after coronary artery stenting. The results indicated that these markers were closely correlated to each other and showed that these markers were associated with increased New York Heart Association functional classification and low left ventricular ejection fractions. Further analysis confirmed that the independent clinical risk factors for recurrent congestive heart failure were MDA, hs-CRP, TNF-&#945;, sTNFR-1, sTNFR-2, TLR2, TLR3 and TLR4. The interplay of oxidative stress, inflammatory cytokines and toll-like receptors, and hs-CRP expression levels was an important factor involved in recurrent congestive heart failure of elderly patients after coronary stenting. </p> <p> Conclusion: High levels of MDA, hs-CRP, TNF-&#945;, sTNFR-1, sTNFR-2, TLR2, TLR3 and TLR4 had an important implication for recurrent heart failure with increased New York Heart Association functional classification and low left ventricular ejection fractions. These eight factors amplified each other's positive effects and this interaction may be a key element of their roles in recurrent heart failure. The eight risk factors were inter-dependent and occurred simultaneously, and exerted detrimental effects forming a vicious circle. MDA may trigger the over-expressions of pro-inflammatory risk factors (hs-CRP, TNF-&#945;, sTNFR-1, sTNFR-2) through the activation of TLRs as risk factors (TLR2, TLR3 and TLR4) contributing to the dysfunction of myocardial mitochondria, cardiomyocyte hypertrophy, maladaptive myocardial remodeling, myocardial interstitial fibrosis, cardiac systolic decrease and recurrent heart failure. These eight risk factors were the basis of the mechanisms of recurrent heart failure. Therefore, the mutual triggering of oxidative stress, inflammatory and toll-like receptor signaling pathways, and hs-CRP expression could play key roles in the development of recurrent congestive heart failure in elderly patients after coronary stenting.</p>]]></description> </item><item><title><![CDATA[Mitochondrial Dysfunction: Potential Therapy For Abdominal Aortic Aneurysms]]></title><link>https://www.benthamscience.comarticle/146520</link><description><![CDATA[Abdominal Aortic Aneurysm (AAA) is a life-threatening vascular disease. Despite advancements in understanding the pathogenesis of AAA, significant knowledge gaps persist. Recent evidence increasingly implicates mitochondrial dysfunction as a contributing factor that exacerbates AAA, inducing further expansion of aneurysm, rupture, and subsequent death. This review summarizes the latest research findings and theories associated with AAA pathogenesis, with a particular focus on mitochondrial dysfunction in AAA, including mitochondrial quality control, mitochondrial membrane potential, mitochondrial morphology, oxidation and antioxidation, normal functioning of the respiratory chain, mitochondrial mutations, and the regulation of other mitochondrial signaling pathways. Moreover, we highlight potential medical interventions based on regulating mitochondrial function for AAA treatment.]]></description> </item><item><title><![CDATA[Sodium Glucose Cotransporter-2 Inhibitors Improve Endothelial Function and Arterial Stiffness in Diabetic Individuals: A Systematic Review and Network Meta-Analysis]]></title><link>https://www.benthamscience.comarticle/145453</link><description><![CDATA[<p>Introduction: Sodium Glucose cotransporter-2 inhibitors (SGLT2is) possess pleiotropic effects, such as antioxidant, antifibrotic, anti-inflammatory, and vascular remodeling activities. Considering the lack of literature, a network meta-analysis was conducted to explore the impact of SGLT2is on endothelial dysfunction and arterial stiffness in the diabetic population. </p> <p> Methods: Electronic databases were searched to identify randomized clinical trials evaluating the effects of SGLT2is on outcomes, such as Flow-mediated Vasodilation (FMV), Pulse Wave Velocity (PWV), and Augmentation Index (AIx). Direct, indirect, and mixed treatment comparisons generated pooled estimates using random-effects modeling. Effect sizes were reported as Hedges' g with 95% Confidence Interval (95% CI). Bootstrap and permutation meta-analyses were performed using ranking plots. The certainty of evidence was graded. </p> <p> Results: Twelve articles (706 participants) were included. SGLT2is were associated with significant improvements in FMV (g: 0.48; 95% CI: 0.08, 0.88), confirmed by bootstrap meta-analysis (g: 0.48; 95% CI: 0.1, 0.85) and permutation meta-analysis of FMV (g: 0.48; 95% CI: 0.05, 0.9). Within SGLT2is, dapagliflozin (g: 0.39; 95% CI: 0.14, 0.65) significantly improved FMV, and dapagliflozin (g: -0.61, 95% CI: -0.98, -0.24) and tofogliflozin (g: -3.51; 95% CI: -4.05, -2.98) significantly improved PWV. A low risk of publication bias was observed, and the ranking plots revealed dapagliflozin to have the best probability (0.99) of being the most effective for improving FMV. Low certainty of evidence was observed for all outcomes. </p> <p> Conclusion: SGLT2 inhibitors improve endothelial function and arterial stiffness in the diabetic population. Clinical studies evaluating the association between improvements in endothelial function with SGLT2is and reduced adverse cardiovascular and cardiorenal events and mortality are urgently needed.</p>]]></description> </item><item><title><![CDATA[Introducing the Concept of Hypertensive Heart Disease to Improve Hypertensive Left Ventricular Hypertrophy]]></title><link>https://www.benthamscience.comarticle/146001</link><description><![CDATA[<p>Background: Among the organ damage mediated by hypertension, cardiac lesions hold significant importance. Numerous authors focus on hypertensive heart disease (HHD) rather than exclusively on left ventricular hypertrophy (LVH). </p> <p> Objectives: This narrative review aims to assess the incorporation of the concept of 'hypertensive heart disease' (HHD) in hypertension (HTN) guidelines. Furthermore, if HHD is not addressed, the review will evaluate the potential benefits of including this concept in future studies. </p> <p> Methods: The following databases were searched: Scopus, Medline, Springer, Science Direct, Wiley, SAGE, Cambridge, Oxford Journals, and Google Scholar. Attention was given to the guidelines related to hypertension (HTN); the search items were “guidelines” and “hypertension.” Within these guidelines, we specifically sought references to ‘hypertensive heart disease.’. </p> <p> Results: The concept of “HHD” is clearly advantageous compared to “HTN LVH,” as it not only addresses LVH but also considers other structures of the heart that may be severely affected, which can significantly influence treatment. The concept of “hypertensive heart disease” is mentioned in only 8 out of 36 guidelines on HTN. The therapeutic implications and recommendations are absent in the guidelines. </p> <p> Conclusion: The concept of HHD is reasonable and evidence-based, and there is no reason to focus only on LVH when considering HTN-induced damage to the heart. It is time to update our recommendations for heart treatment by using the phrase \"Treatment of hypertensive heart disease\" instead of \"Treatment of hypertensive LVH.\" This update can enhance our awareness of the need to improve not only HTN LVH but the other parts of the heart as well.</p>]]></description> </item><item><title><![CDATA[Association of ST2, Galectin-3, and NT- Probnp in Elderly Hypertensive Patients and Heart Failure with a Preserved Ejection Fraction]]></title><link>https://www.benthamscience.comarticle/146104</link><description><![CDATA[<p>Purpose: The objective of this study was to explore the relationship among serum levels of the growth-stimulating expressed gene 2 protein (ST<sub>2</sub>), Galectin-3 (GAL-3), N-terminal pro-Btype natriuretic peptide (NT-proBNP) in elderly hypertensive patients and heart failure with preserved ejection fraction (HFpEF). </p> <p> Materials and Methods: Eighty-five elderly hypertensive patients with HFpEF were registered as the HFpEF group, and 46 hypertensive patients without HF were registered as the Non-HF group. The levels of serum sST2 (soluble ST2), Galectin-3, and NT-proBNP were measured, and related indexes of heart function were performed with echocardiography in two groups, respectively.The obtained variables were applied to statistical software for analysis. </p> <p> Results: Age, BMI, SBP, DBP, TC, LDL-C, HCY, sST2, Galectin-3, NT- proBNP, LVEDD, IVSD, LVEF, and E/A were obviously different between the two groups (p &#60; 0.05). The levels of sST<sub>2</sub>, Galectin- 3 and NT- proBNP in the HFpEF group were higher than in the Non-HF group (P &#60; 0.05). ANOVA results indicated that sST2, Galectin-3, and NT- proBNP levels increased gradually with the increasing NYHA grades (P&#60;0.05). BMI, SBP, DBP, TC, LDL-C, FBG, UA, HCY, LVEDD, IVSD, LVEF, and E/A were significant differences in patients with different NYHA classes (P &#60; 0.05). Spearman indicated that sST2, Galectin-3, and NT-proBNP were positively correlated with BMI, SDP, DBP, LDL-C, FBG, and HCY (P &#60; 0.05). Logistic analysis indicated that BMI, SBP, DBP, FBG, HCY, sST2, Galectin-3, NT-proBNP, LVEDD, LVEF, and E/A were risk factors for hypertension with HFpEF (P &#60; 0.05). ROC indicated that the AUC of the diagnostic performance of sST<sub>2</sub>, Galectin-3, and NT-proBNP were all above 0.7, which may have some forecasting value for elderly hypertensive patients with HFpEF. </p> <p> Conclusion: The levels of sST<sub>2</sub>, Galectin-3, and NT-proBNP were closely related to cardiac function grades. sST2, Galectin-3, and NT-proBNP have similar diagnostic performance and predictive value for elderly hypertensive patients with HFpEF. sST2 was more sensitive than NT-proBNP. It is recommended that measurements of sST2, Galectin-3 and NT-proBNP levels in elderly hypertensive patients may be useful in classifying early HFpEF.</p>]]></description> </item><item><title><![CDATA[Vutrisiran for Transthyretin Amyloidosis Cardiomyopathy]]></title><link>https://www.benthamscience.comarticle/147747</link><description><![CDATA[]]></description> </item></channel></rss>