The Five Pillars of Acute Right Ventricular Heart Failure Therapy: Can We Keep the Pediment in Balance?

Acute right ventricular heart failure (aRHF), a long-neglected aspect of heart disease, has recently gained attention due to an improved understanding of its pathophysiology and the development of tailored therapeutic strategies. The therapeutic approach is now built on several pillars that aim to support the stable clinical condition of the patient, starting with the central pillar of etiological or specific therapy and extending to various aspects related to hemodynamic support, ventilation support, fluid optimization, and, when necessary, advanced resources such as right ventricular assist devices (e.g.

Predictive Value of NT-proBNP, FGF21, Galectin-3 and Copeptin in Advanced Heart Failure in Patients with Preserved and Mildly Reduced Ejection Fraction and Type 2 Diabetes Mellitus.

: Heart failure (HF) is one of the most common initial presentations of cardiovascular disease (CVD) in patients with type 2 diabetes mellitus (T2DM). There are different cardiac biomarkers related to the pathophysiological mechanisms of HF in T2DM. The current research aims to identify additional biomarkers that could improve the diagnosis and prognosis of HFpEF, which is currently assessed using NT pro-BNP levels.

The biomarkers associated with non-dipper pattern in patients with type 2 diabetes with hypertension.

Background And Aims: The non-dipper pattern is present in about 50 percent of patients with type 2 diabetes (T2D) and hypertension, a status associated with more frequent cardiovascular complications and restrained prognosis. This study aimed to identify simple biomarkers that can be used for the classification of dipper and non-dipper individuals with type 2 diabetes and hypertension.

Method: 138 consecutive patients with type 2 diabetes mellitus (DM) and hypertension underwent 24-hour ambulatory blood pressure monitoring (ABPM), 54 (39.

Importance of H-FABP in Early Diagnosis of Acute Myocardial Infarction.

Background: Over the years, troponins have aced the para-clinical tests for confirming the diagnosis of acute myocardial infarction. However, the rise in their levels is entirely time-dependent, which can cause a delay in the initiation of treatment protocols. Heart fatty acid binding protein (H-FABP) can serve comparatively as a better biological marker for overcoming this flaw of troponins, as it is quickly released into the bloodstream once the myocardial injury occurs due to decreased blood supply.

The predictive risk factors associated with non-dipper profile in patients with type 2 diabetes and hypertension.

Background And Aims: The non-dipper status represented by blood pressure reduction by less than 10 percent during sleep is present in about 50 percent of patients with type 2 diabetes (T2D) and hypertension, a pattern associated with more frequent cardiovascular complications and reserved prognosis. This study analyzed the predictive risk factors associated with the different dipper profiles, especially with the nocturnal pattern, following the mean arterial pressure (MAP), the mean heart rate (MHR), and the mean pulse pressure (MPP) in patients with T2D and hypertension, established by ambulatory blood pressure monitoring (ABPM).

Method: 166 consecutive patients with type 2 diabetes mellitus and hypertension were included in a cross-sectional study, and they underwent 24-hour ABPM.

Antiviral activity of silver nanoparticles against the influenza A virus.

Viral infections occupy an essential place in modern medicine, particularly a large group of diseases caused by the influenza viruses. They are rapidly transmitted and mutate quickly, which can lead to significant socio-economic consequences. Silver nanoparticles (AgNPs) are considered to be an effective antimicrobial agent.

Ups and downs of conducting a national representative survey on hypertension during pandemic time: main results of SEPHAR IV.

Objectives: This national representative survey sought to assess hypertension's prevalence, awareness, treatment and control in Romania.

Methods: A representative sample (by age, sex and residence) of 1477 Romanian adults (51.19 ± 16.

Social and Metabolic Determinants of Prevalent Hypertension in Men and Women: A Cluster Analysis from a Population-Based Study.

Essential hypertension (HTN) has a complex spectrum of pathophysiological determinants and current guidelines provide limited information on high-risk groups that should be targeted for its primary prevention. The objective of our research was to identify clusters of social and metabolic factors associated with prevalent HTN in men and women from a population-based survey in Romania. Of the 1477 participants in the main study, 798 with complete data were analyzed here.

Prevalence and Predictors of Renal Disease in a National Representative Sample of the Romanian Adult Population: Data from the SEPHAR IV Survey.

Background: The prevalence of chronic kidney disease (CKD) correlates with the prevalence of hypertension (HT). We studied the prevalence and predictors of CKD in a representative sample of the Romanian adult population. Methods: A sample of 1470 subjects were enrolled in the SEPHAR IV (Study for the Evaluation of Prevalence of Hypertension and Cardiovascular Risk) survey.

The Variation of Serotonin Values in Dogs in Different Environmental Conditions.

Serotonin is considered to be the neurotransmitter that controls several types of behavior: aggressiveness, impulsivity, food selection, stimulation, sexual behavior, reaction to pain, and emotional manifestations. The aim of this study was to determine the serotonin values in 43 dogs, divided into three different experimental variants: (1) between two groups of medium ( = 6) and small ( = 4) breed shelter dogs; (2) in dogs with ( = 15) and without ( = 10) owners after administration of pre-spaying/neutering anesthesia; (3) in different behavioral states ( = 8) classified as follows: M1-happy, M2-aggressive, M3-calmed status, post-exposure to a stressful situation, compared to the reference time referred to as M0. There were no significant differences ( ≥ 0.

Effect of Coated Silver Nanoparticles on Cancerous vs. Healthy Cells.

Unique properties of silver nanoparticles (NPs) ensure their wide applications, in biomedicine; for this reason, it is very important carefully to study the toxicity of such NPs. The influence of silver nanoparticles coated with natural resin (Ag NPs) on the morphological and functional features of healthy BHK-21 and cancerous Hep-2 cells were studied using fluorescence microscopy, MTT, and neutral red assays. Ag NPs induced morphological changes in both cell cultures.

Masked nocturnal hypertension as a result of high prevalence of non-dippers among apparently well-controlled hypertensive patients with type 2 diabetes mellitus: data from a prospective study.

Background: Ambulatory blood pressure monitoring (ABPM) in patients with diabetes mellitus (DM) and hypertension (HTN) show the dipping patterns, identify masked uncontrolled hypertension (MUCH), and demonstrate the effectiveness of the blood pressure (BP) treatment. MUCH is associated with a two-fold higher risk of adverse events. Prevalence in patients with DM is between 13.

Symptomatic Venous Thromboembolic Events in COVID-19 Patients after Hospital Discharge: Aspects to Consider.

Venous thromboembolic (VTE) events have been increasingly reported in patients with coronavirus disease 2019 (COVID-19) after hospital discharge. Acute pulmonary embolism (PE) is the most frequent type of post-discharge VTE complication. Levels of procoagulants (fibrinogen, factor VIII, von Willebrand factor), and D-dimer are higher during the SARS-CoV-2 infection.

The role of matrix metalloproteinases in patients with pulmonary hypertension: data from a prospective study.

Background: Despite several therapies, pulmonary hypertension (PH) is still a severe disease which can lead to right heart failure. Matrix metalloproteinases (MMPs) and tissue inhibitors of metalloproteinases (TIMPs) are involved in cardiac and vascular remodeling in PH. Therefore, these biomarkers play an important role in PH patients.

Gender Disparities in the Prevalence, Awareness, Treatment, and Control of High Blood Pressure.

The gender effects in arterial hypertension (HT) epidemiology remain poorly clarified to date. We present an up-to-date review of the data regarding gender disparities in HT's prevalence, awareness, treatment, and control. Based on the data from three consecutive national-representative SEPHAR (Study for the Evaluation of Prevalence of Hypertension and Cardiovascular Risk in Romania) surveys conducted between 2005 and 2016, we provide insights into gender differences in HT's epidemiology and their 11- years the evolutionary trend in a high-CV risk European country.

The Impact of Obesity on Left Ventricular Hypertrophy and Diastolic Function in Caucasian Children.

Left ventricular hypertrophy (LVH) and diastolic dysfunction are correlated with obesity and hypertension in adult patients, but few studies have investigated the association between obesity itself and left ventricular function in children. The aim of this study was to evaluate the effect of obesity and LVH on left ventricular diastolic function in pediatric subjects compared with children without obesity. A number of 454 patients from an outpatient cardiology service were enrolled in a prospective study, 33 children with obesity, 20 overweight children, and 401 children without obesity.

High-normal blood pressure and related cardiovascular risk factors prevalence in the Romanian adult population: insights from the SEPHAR III study.

High normal blood pressure (HNBP) is associated with an increased risk of incident high blood pressure (HBP) and of cardiovascular diseases (CVD). To estimate the prevalence of HNBP and related cardiovascular risk factors, a representative sample of 1970 Romanian adults was enrolled in SEPHAR III survey (Study for the Evaluation of Prevalence of Hypertension and Cardiovascular Risk in Romania). All were evaluated for blood pressure values and by a 71-item questionnaire, anthropometric measurements, together with extensive evaluation for target organ damage, blood, and urine sample collection.

Prospective Study of Pulmonary Embolism Presenting as Syncope.

Background: Syncope represents a common condition among the general population. It is also a frequent complaint of patients in the emergency department (ED). Pulmonary embolism (PE) considers a differential diagnosis, particularly in a case of syncope without chest pain.

The Association Between Six Surrogate Insulin Resistance Indexes and Hypertension: A Population-Based Study.

The relationship between insulin resistance and hypertension is well established, but the association of different surrogate insulin resistance indexes with the presence of hypertension is still under debate. The aim of this study was to compare the strength of the association between the presence of hypertension and six indexes: triglyceride/HDL cholesterol ratio (TG/HDL-C), Triglyceride Glucose (TyG) Index, Visceral adiposity index (VAI), Lipid accumulation product (LAP), TyG-Body mass index (TyG-BMI), and TyG-Waist circumference (TyG-WC). Data from a cross-sectional epidemiological study enrolling a sample representative for the Romanian population aged 18-80 years, excluding those with diabetes or requiring treatment for hypertriglyceridemia, were used to calculate the six indexes.

Benefits and Risks of Anticoagulation in Acute Coronary Syndrome.

Background: Both antiplatelets and anticoagulants are necessary in the management of acute coronary syndrome (ACS), although the exact proportion of antithrombotic effect that each drug and class should ideally provide remains a matter of ongoing study.

Area Of Uncertainty: Defining the best combination between the antiplatelet agents and oral anticoagulants (OACs) can be challenging. The choice is particularly important for special categories of patients with ACS who have an indication of a long-term OAC.

Anticoagulation in Acute Coronary Syndrome: Review of Major Therapeutic Advances.

Background: In patients with acute coronary syndrome (ACS), a persistent hypercoagulable state has been demonstrated and antithrombin therapy in addition to platelet inhibition has been proposed.

Areas Of Uncertainty: Vitamin K antagonists (VKAs) were used as oral anticoagulant (OAC) therapy and produced mixed results whereas trials are still ongoing with non-vitamin K OACs (NOACs).

Data Sources: A literature search regarding benefits and risks of different OAC therapies in ACS was conducted through MEDLINE and EMBASE (last 20 years until September 2018).