cardiovascular disease

Cardiovascular diseases (CVD) are considered as “lifestyle” diseases and so far “No unified procedure” or medicines are effective in the management of this group of diseases. Researchers and clinicians have indicated that no safe therapeutic window is available in therapeutics at present. Recent research showed that gut microbiota are effective in managing lifestyle diseases therefore we introduced the influence of gut microbiota in the prognosis of the CVDs. Faecal transplant therapy(FMT) has been anticipated to treat many diseases similar to recurrent bacterial Clostridioides difficile infection which has been used worldwide. Recently, FMT was tried on an animal model to treat CVDs, and recent human trials that were tried to manage CVDs in humans by FMT showed encouraging results. The mechanism of action of transplanted bacteria to manage CVDs in the human population is also discussed. In-depth knowledge on the pros and cons of FMT will pave the way to standardize the procedure once the lacuna existing at present in treating CVDs, is paved, this technology will be useful for the masses.

Background: Patients undergoing percutaneous coronary intervention are at risk of different complications such as periprocedural bleeding and acute hemoglobin reduction that can lead to myocardial injury. Blood loss through the catheter during the procedure and through puncture site haematoma causes periprocedural acute haemoglobin drop.Objectives: To find out the association between acute haemoglobin reduction and myocardial injury after PCI in patients with unstable angina. Methods: This prospective observational study was conducted at the National Institute of Cardiovascular Diseases (NICVD) for one year of time. A total of 130 patients were enrolled based on inclusion and exclusion criteria during the study period. Haemoglobin and troponin-I were measured before and after PCI within 24 to 48 hours of the procedure. On the basis of post-procedural acute haemoglobin level, the study population was categorized into two groups: Group I patients with normal haemoglobin levels and Group II patients with significant acute haemoglobin reduction (≥ 1 gm/dl). Results: A total of 24 patients developed a periprocedural myocardial injury, among them 17 (70.8%) were in the reduced haemoglobin group and 7 (29.2%) in the normal haemoglobin group. Elevation of troponin I after PCI was higher in group II than in group I patients with a statistically significant difference. Multivariate logistic regression analysis showed that haemoglobin reduction was an independent predictor of PMI (OR 1.94; 95% CI, 1.241-8.684; p = 0.01). Conclusion: Periprocedural haemoglobin reduction in patients with unstable angina was associated with myocardial injury after percutaneous coronary intervention (PCI).

The intricate interplay between viral infections and cardiovascular complications has garnered significant attention from 2018 to 2023. Extensive research during this period has unveiled substantial connections between various viruses and cardiovascular diseases. Notable examples include Cytomegalovirus (CMV), coxsackievirus, influenza, Human Immunodeficiency Virus (HIV), Epstein-Barr Virus (EBV), Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2), as well as coxsackievirus A and B, enteroviruses, adenovirus, and parvovirus B19. These viruses exert diverse influences on cardiovascular health through various pathways, contributing to endothelial dysfunction, inflicting direct damage on cardiac tissue, and triggering inflammatory responses. The intricate interplay between viral infections and cardiovascular health underscores the importance of considering viral pathogens within the framework of cardiovascular disease development, clinical management practices, and future research initiatives. This systematic review comprehensively scrutinizes the cardiovascular impacts stemming from various viral infections, casting a revealing light on their underlying mechanisms and associated clinical implications. These valuable insights can guide clinical management strategies, preventive measures and further investigations into the complex connection between viral infections and cardiovascular diseases, emphasizing the necessity for ongoing research and vigilance in comprehending and managing these pathogen-induced cardiac manifestations.

Cardiovascular disease (CVD), including coronary artery disease and stroke, is the leading cause of death worldwide. Advances in primary and secondary prevention of CVD have improved patient prognoses and outcomes, however, it is imperative that the clinician and patient engage in early risk factor screening and preventive management of modifiable risk factors for CVD. In addition to blood lipid and blood pressure lowering medications, aspirin has been a long-standing therapy targeted to the prevention of CVD based on its antiplatelet and anti-inflammatory activity. However, recent articles and reports on updates to clinical guidelines for the primary prevention of CVD have resulted in confusion about aspirin recommendations. This review aims to assess the latest guidance on aspirin in CVD prevention and how to identify appropriately at-risk patients who may benefit from low-dose aspirin therapy as part of their CVD preventive healthcare choices. Additionally, this review will provide practical application guidance about clinician-patient conversations to clearly explain the benefits and risks of aspirin use and ensure a patient-centric decision to initiate aspirin therapy.

Background: Acute Myocardial Infarction (AMI) results in a reduction in patients’ life expectancy. Different risk factors affect the risk of Major Adverse Cardiac Events (MACE). Although the role of kidney dysfunction in patients with Chronic Kidney Disease (CKD) in cardiac events has been identified, many patients with AMI are unaware of their underlying kidney disease. This study aimed to compare the incidence of adverse cardiovascular events and identify predictors of major adverse cardiovascular events in the medium term among patients with and without renal dysfunction following AMI. Methods: This retrospective cohort study was conducted on 1039 patients who were hospitalized for Acute Myocardial Infarction (AMI) between 2018 and 2019. The patient cohort comprised 314 women (mean age: 69.8 ± 13.2 years) and 725 men (mean age: 60.5 ± 13.8 years). Patient data were obtained from the registry of patients with acute myocardial infarction and the participants were followed up for a minimum of one year following hospital discharge to assess the incidence of MACE.Results: The study found that patients with a Glomerular Filtration Rate (GFR) level below 60 had a significantly higher mortality rate than those with a GFR level of 60 or above (15.7% vs. 3.5%,p < 0.0001). The multivariate analysis showed that Diabetes Mellitus (DM), GFR, and Non-ST Elevation Myocardial Infarction (NSTEMI) are significant risk factors for cardiovascular events. (p = 0.016, p = 0.015, p = 0.006 respectively), while variables such as sex, age, and Hypertension (HTN) were not significant risk factors. There was a negative correlation between GFR and death (0.241 - = r, p < 0.0001)Conclusion: This study highlights the importance of detecting kidney disease during an AMI and managing risk factors for cardiovascular disease to improve health outcomes and reduce the risk of mortality.

Background: Obesity remains a global epidemic with over 2.8 million people dying due to complications of being overweight or obese every year. The low-carbohydrate and high-fat ketogenic diet has a rising popularity for its rapid weight loss potential. However, most studies have a maximal 2-year follow-up, and therefore long-term adverse events remain unclear including the risk of Atherosclerotic Cardiovascular Disease (ASCVD).Results: Based on current evidence on PubMed and Google Scholar, there is no strong indication ketogenic diet is advantageous for weight loss, lipid profile, and mortality. When comparing a hypocaloric ketogenic diet with a low-fat diet, there may be faster weight loss until 6 months, however, this then appears equivalent. Ketogenic diets have shown inconsistent Low-Density Lipoprotein (LDL) changes; perhaps from different saturated fat intake, dietary adherence, and genetics. Case reports have shown a 2-4-fold elevation in LDL in Familial hypercholesterolaemic patients which has mostly reversed upon dietary discontinuation. There is also concern about possible increased ASCVD and mortality: low (< 40%) carbohydrate intake has been associated with increased mortality, high LDL from saturated fats, high animal product consumption can increase trimethylamine N-oxide, and cardioprotective foods are likely minimally ingested.Conclusion: Ketogenic diets have been associated with short-term positive effects including larger weight reductions. However, by 2 years there appears no significant differences for most cardiometabolic risk markers. Therefore, this raises the question, excluding those who have a critical need to lose weight fast, is this diet worth the potentially higher risks of ASCVD and mortality while further long-term studies are awaited?

The β1 receptor is one of the three beta receptors present in the human body, namely β1, β2, and β3. The β1 receptor is predominantly located in the heart, where it plays a crucial role in regulating the heart rate and the force of contraction, thereby increasing the cardiac output and the efficiency of blood pumping throughout the body. This receptor is targeted by a variety of pharmaceutical agents known as beta-blockers, which are commonly used in the treatment of cardiovascular conditions such as hypertension, angina, and arrhythmias.The β1 receptor exhibits stereoselectivity, meaning that different enantiomers (chiral molecules) of beta blockers can have varying levels of effectiveness and side effects. This study focuses on the stereoselectivity of the β1 receptor and the clinical implications of this property. It includes an examination of various β1 blockers, such as propranolol (a non-selective beta  blocker), and selective β1 blockers like atenolol, bisoprolol, nebivolol, metoprolol, esmolol, acebutolol, and betaxolol. Each of these drugs has a unique chemical structure, with specific functional groups that contribute to their selective action on the β1 receptor.Furthermore, the β2 receptor, which is mainly present in the bronchi and bronchioles, is responsible for bronchodilation, and the β3 receptor, found in the bladder, helps reduce urinary urgency. Understanding the distinct locations and functions of these receptors allows for the development of targeted therapies with minimal off-target effects.This review highlights the importance of stereoselectivity in the development and use of β1 blockers, discussing their chemical structures, pharmacological activities, and therapeutic uses. It also explores the potential for future research and development of more selective and effective β1 receptor agonists and antagonists, which could offer improved therapeutic outcomes for patients with cardiovascular diseases.This study underscores the significant role of the β1 receptor in cardiovascular health and provides insights into the ongoing advancements in beta-blocker therapy. By delving into the stereoselectivity and specific actions of these drugs, the research aims to enhance the understanding and optimization of β1 receptor-targeted treatments in clinical practice.

Atherosclerosis Ischemic Cardiovascular Disease (ASICD), one of the leading causes of global deaths, is mainly caused due to the development of plaque on the inner walls of arteries of the human heart. Ischemia refers to the lack of enough oxygen (O2), nutrient delivery, and improper waste removal in the cardiac cells. About 90% of cardiovascular diseases in the present world are due to the formation of lipid/cholesterol-based plaques that can form under the lining of the smooth epithelial blood cells. In the US, a study published in the Journal of the American College of Cardiology estimated that poor diet is responsible for about 45% of Cardiovascular Disease. Atherosclerosis doesn’t cause much effect until and unless the plaque becomes unstable due to the accumulation of thrombus that shows Acute Coronary Syndrome. Acute Coronary Syndrome is the result of blockage of blood vessels leading to Myocardial Infarction (Unstable Angina Pectoris). Cardiac Cells require a sufficient amount of Oxygen to function properly. Thus, the demand and supply of oxygen to the cardiac cells should be properly balanced. Atherosclerosis Ischemic Cardiovascular syndrome can worsen if the person is more involved in exercise or emotional stress because at that time their body requires higher oxygen but blood flow gets disrupted due to the formation of plague. Later in the paper, we will discuss the New York Heart Association classification, followed by the top 3 poor diets that are considered to be increasing the cases of cardiovascular disease around the world.

Insulin resistance, often referred to as impaired insulin sensitivity. This clinical case focusses on a woman with insulin resistance and a long-standing and recurring history of obesity to demonstrate how diet therapy can be applied in addition to standard medication therapy.

Sleep disorders represent a significant public health concern due to their widespread prevalence, impact on overall health, and the economic burden they impose. These disorders encompass a broad spectrum of conditions, ranging from insomnia and obstructive sleep apnea (OSA) to narcolepsy, restless legs syndrome (RLS), and parasomnias. They are often associated with comorbidities such as cardiovascular diseases, metabolic dysfunctions, and mental health disorders, making their identification and management critical.The publication of this work is of high interest as it contributes to the expanding body of literature focused on understanding the complex interplay between sleep disorders and health outcomes. By presenting detailed case reports, this study provides valuable insights into the diagnostic challenges, treatment modalities, and potential avenues for personalized interventions in sleep medicine. Case reports are particularly important in this field as they shed light on unique presentations and rare conditions that might otherwise go unnoticed in large-scale epidemiological studies. From an epidemiological perspective, sleep disorders are highly prevalent globally. According to the World Health Organization (WHO), approximately 30% - 45% of the global population experiences sleep disturbances. Obstructive sleep apnea, for instance, affects nearly 1 billion individuals worldwide, with varying prevalence across age, gender, and geographic regions. Insomnia affects roughly 10% - 30% of adults, with rates as high as 50% - 60% in older populations.Meanwhile, narcolepsy, though rare, is estimated to affect 1 in 2,000 people in the general population. These statistics underscore the pressing need for enhanced diagnostic methods, improved treatment strategies, and comprehensive patient management. By detailing real-world cases, this publication aims to bridge the gap between clinical observations and broader scientific understanding. The insights gained from these case studies have the potential to inform future research directions, improve clinical practices, and ultimately enhance patient outcomes in sleep medicine.Sleep disorders affect millions of individuals globally, disrupting physical, mental, and emotional well-being. Conditions such as insomnia, obstructive sleep apnea (OSA), narcolepsy, and restless legs syndrome (RLS) are among the most studied. This paper examines the etiology, diagnosis, and management of sleep disorders, presenting detailed case reports and integrating relevant sleep study findings. Figures such as polysomnography (PSG) outputs and statistical trends provide visual insights into diagnostic and therapeutic interventions. Sleep disorders encompass a wide range of conditions that significantly disrupt sleep quality and overall well-being. Common disorders such as insomnia, obstructive sleep apnea (OSA), narcolepsy, and restless legs syndrome (RLS) affect millions globally, posing risks to physical health, mental stability, and cognitive performance. This study explores the clinical presentation, diagnostic approaches, and management of sleep disorders through the lens of detailed case reports and sleep study data.Polysomnography (PSG), the gold standard for sleep disorder diagnosis, plays a pivotal role in identifying abnormal sleep patterns, respiratory irregularities, and neural disruptions. Multiple sleep latency tests (MSLT) and actigraphy complement PSG, offering insights into disorders like narcolepsy and circadian rhythm abnormalities. This paper presents three representative case reports: chronic insomnia, severe OSA, and narcolepsy with cataplexy. Each case is analyzed in-depth, highlighting patient history, PSG findings, treatment interventions, and outcomes. For chronic insomnia, cognitive-behavioral therapy for insomnia (CBT-I) and pharmacological intervention resulted in marked improvements in sleep latency and efficiency. In the OSA case, continuous positive airway pressure (CPAP) therapy significantly reduced the apnea-hypopnea index (AHI) and alleviated daytime symptoms. The narcolepsy case demonstrates the efficacy of modafinil and sodium oxybate in managing excessive daytime sleepiness and cataplexy.Despite advancements, challenges persist in the field, including patient adherence to therapy, accessibility to specialized sleep studies, and the ethical implications of AI-driven diagnostic tools. Future research should focus on scalable, patient-centric approaches and the role of emerging technologies in enhancing diagnostic accuracy and treatment efficacy. This paper aims to contribute to the evolving understanding of sleep disorders, bridging clinical case insights with the broader implications for sleep health and research.

Burnout among clinicians is a pressing concern worldwide, manifesting as emotional exhaustion, depersonalization, and reduced professional efficacy. This article explores the intersection of burnout and allostatic load, the physiological burden resulting from chronic stress, to elucidate the consequences for healthcare providers. Burnout impacts clinicians’ mental and physical health, leading to compromised patient care, reduced job satisfaction, and increased attrition rates. A comparative analysis of recent scholarly works reveals converging evidence on systemic contributors such as excessive workloads, inadequate support systems, and organizational inefficiencies, further compounded by individual vulnerabilities like lack of resilience. These challenges have been exacerbated by the COVID-19 pandemic, which has significantly increased stress levels among healthcare professionals globally. This article synthesizes insights from studies conducted between 2020 and 2024, emphasizing the need for holistic approaches to mitigate burnout. It highlights the physiological underpinnings of allostatic load, including chronic dysregulation of stress-response systems that predispose clinicians to adverse health outcomes like cardiovascular diseases, immune dysfunction, and mental health disorders. To address these issues, the article proposes a multidimensional strategy encompassing organizational reforms, evidence-based interventions, and policy advocacy. Recommendations include reducing administrative burdens, fostering supportive work environments, and integrating wellness programs targeting both systemic and individual stressors. Limitations and directions for future research emphasize the importance of inclusive, longitudinal studies focusing on diverse populations to develop tailored solutions. This comprehensive approach aims to enhance clinician well-being and improve healthcare outcomes globally.

Antioxidants are groups of compounds that neutralize free radicals and Reactive Oxygen Species (ROS) in the cell [1]. Antioxidant activity in food and beverages has become one of the most interesting features in the science community. These antioxidants provide protection against damage caused by free radicals played important roles in the development of many chronic diseases including cardiovascular diseases, aging, heart disease, anemia, cancer, and inflammation [2].

Cardiovascular Diseases (CVDs) remain a major global health concern, necessitating accurate and comprehensive diagnostic techniques. Traditional medical imaging modalities, such as CT angiography, PET, MRI, and ultrasound, provide crucial but limited information when used independently. Image fusion techniques integrate complementary modalities, enhance visualization, and improve diagnostic accuracy. This paper presents a theoretical study of advanced image fusion methods applied to cardiovascular imaging. We explore wavelet-based, Principal Component Analysis (PCA), and deep learning-driven fusion models, emphasizing their theoretical underpinnings, mathematical formulation, and potential clinical applications. The proposed framework enables improved coronary artery visualization, cardiac function assessment, and real-time hemodynamic analysis, offering a non-invasive and highly effective approach to cardiovascular diagnostics.MSC Codes: 68U10,94A08,92C55,65T60,62H25,68T07.