1 Introduction Inflammation is one of the main mechanisms in the pathogenesis of atherosclerosis,and the interest to the evaluation of inflammatory biomarkers in coronary artery disease(CAD)has been increasing over th...1 Introduction Inflammation is one of the main mechanisms in the pathogenesis of atherosclerosis,and the interest to the evaluation of inflammatory biomarkers in coronary artery disease(CAD)has been increasing over the last decade.[1,2]Destabilization of chronic artery plaques,which leads to acute coronary syndromes,has been associated with inflammatory status.[1,3]。展开更多
Heart rhythm disturbances become of special importancewhen patients reach a senior age. Atrial fibrillation （AF） isthe most prevalent arrhythmia among the old age groups,and its impact on morbidity and mortality bec...Heart rhythm disturbances become of special importancewhen patients reach a senior age. Atrial fibrillation （AF） isthe most prevalent arrhythmia among the old age groups,and its impact on morbidity and mortality becomes of para-mount significance. In this population, AF is responsible forsignificant amount of thromboembolic cerebrovascularevents, especially for disabling and fatal strokes, Follow-ing announcement of the special issue of the Journal of Geri-atric Cardiology devoted to heart rhythm disorders in theelderly, a number of submissions have been received withAF as the major topic of authors＇ researches.展开更多
Transcutaneous renal artery denervation （RND） has beeninitially developed for destruction of efferent nerve fireswith luminal delivery of radiofrequency or ultrasonic energyaiming blood pressure reduction in patient...Transcutaneous renal artery denervation （RND） has beeninitially developed for destruction of efferent nerve fireswith luminal delivery of radiofrequency or ultrasonic energyaiming blood pressure reduction in patients with refractoryhypertension. However, other positive results of RNDwere described afterwards, and they include suppression ofatrial fibrillation and ventricular tachycardia （VT） storm.展开更多
Differential diagnosis of supraventricular tachycardia (SVT) and ventricular tachycardia (VT) is of paramount importance for appropriate patient management. Several diagnostic algorithms for discrimination of VT and S...Differential diagnosis of supraventricular tachycardia (SVT) and ventricular tachycardia (VT) is of paramount importance for appropriate patient management. Several diagnostic algorithms for discrimination of VT and SVT based on surface electrocardiogram (ECG) analysis have been proposed. Following established diagnosis of VT,a specific origination tachycardia site can be supposed according to QRS complex characteristics. This review aims to cover comprehensive and comparative description of the main VT diagnostic algorithms and to present ECG characteristics which permit to suggest the most common VT origination sites.展开更多
Heart failure is common in adult population,accounting for substantial morbidity and mortality worldwide.The main risk factors for heart failure are coronary artery disease,hypertension,obesity,diabetes mellitus,chron...Heart failure is common in adult population,accounting for substantial morbidity and mortality worldwide.The main risk factors for heart failure are coronary artery disease,hypertension,obesity,diabetes mellitus,chronic pulmonary diseases,family history of cardiovascular diseases,cardiotoxic therapy.The main factor associated with poor outcome of these patients is constant progression of heart failure.In the current review we present evidence on the role of established and candidate neurohumoral biomarkers for heart failure progression management and diagnostics.A growing number of biomarkers have been proposed as potentially useful in heart failure patients,but not one of them still resembles the characteristics of the"ideal biomarker."A single marker will hardly perform well for screening,diagnostic,prognostic,and therapeutic management purposes.Moreover,the pathophysiological and clinical significance of biomarkers may depend on the presentation,stage,and severity of the disease.The authors cover main classification of heart failure phenotypes,based on the measurement of left ventricular ejection fraction,including heart failure with preserved ejection fraction,heart failure with reduced ejection fraction,and the recently proposed category heart failure with mid-range ejection fraction.One could envisage specific sets of biomarker with different performances in heart failure progression with different left ventricular ejection fraction especially as concerns prediction of the future course of the disease and of left ventricular adverse/reverse remodeling.This article is intended to provide an overview of basic and additional mechanisms of heart failure progression will contribute to a more comprehensive knowledge of the disease pathogenesis.展开更多
The autonomic nervous system plays an important role in the pathogenesis of cardiovascular diseases.With aging,autonomic activity changes,and this impacts the physiological reactions to internal and external signals.B...The autonomic nervous system plays an important role in the pathogenesis of cardiovascular diseases.With aging,autonomic activity changes,and this impacts the physiological reactions to internal and external signals.Both sympathetic and parasympathetic responses seem to decline,reflecting functional and structural changes in nervous regulation.Although some investigators suggested that both the sympathetic and parasympathetic activities were suppressed,others found that only the parasympathetic activity was suppressed while the sympathetic activity increased.In addition,cardiac innervation progressively diminishes with aging.Therefore,one may suggest that neuromodulation interventions may have different effects,and older age groups can express an attenuated response.This article aims to discuss the effect of device-based neuromodulation in different cardiovascular diseases,depending on the patient’s age.Thus,we cover renal denervation,pulmonary artery denervation,baroreceptor activation therapy,vagus nerve stimulation,spinal cord stimulation,ganglionated plexi ablation for the management of arterial and pulmonary hypertension,heart failure,angina and arrhythmias.The results of many clinical studies appeared to be unconvincing.In view of the low rate of positive findings in clinical studies incorporating neuromodulation approaches,we suggest the underestimation of advanced age as a potential contributing factor to poorer response.Analysis of outcomes between different age groups in clinical trials may shed more light on the true effects of neuromodulation when neutral/ambiguous results are obtained.展开更多
基金Supported by the Ministry of Science and Higher Education grant(#MD-2314.2020.7).The authors declare no conflict of interest.
文摘1 Introduction Inflammation is one of the main mechanisms in the pathogenesis of atherosclerosis,and the interest to the evaluation of inflammatory biomarkers in coronary artery disease(CAD)has been increasing over the last decade.[1,2]Destabilization of chronic artery plaques,which leads to acute coronary syndromes,has been associated with inflammatory status.[1,3]。
文摘Heart rhythm disturbances become of special importancewhen patients reach a senior age. Atrial fibrillation （AF） isthe most prevalent arrhythmia among the old age groups,and its impact on morbidity and mortality becomes of para-mount significance. In this population, AF is responsible forsignificant amount of thromboembolic cerebrovascularevents, especially for disabling and fatal strokes, Follow-ing announcement of the special issue of the Journal of Geri-atric Cardiology devoted to heart rhythm disorders in theelderly, a number of submissions have been received withAF as the major topic of authors＇ researches.
文摘Transcutaneous renal artery denervation （RND） has beeninitially developed for destruction of efferent nerve fireswith luminal delivery of radiofrequency or ultrasonic energyaiming blood pressure reduction in patients with refractoryhypertension. However, other positive results of RNDwere described afterwards, and they include suppression ofatrial fibrillation and ventricular tachycardia （VT） storm.
文摘Differential diagnosis of supraventricular tachycardia (SVT) and ventricular tachycardia (VT) is of paramount importance for appropriate patient management. Several diagnostic algorithms for discrimination of VT and SVT based on surface electrocardiogram (ECG) analysis have been proposed. Following established diagnosis of VT,a specific origination tachycardia site can be supposed according to QRS complex characteristics. This review aims to cover comprehensive and comparative description of the main VT diagnostic algorithms and to present ECG characteristics which permit to suggest the most common VT origination sites.
基金supported by the grant from the Ministry of Science and Higher Education of the Russian Federation(agreement 075-15-2020-800)。
文摘Heart failure is common in adult population,accounting for substantial morbidity and mortality worldwide.The main risk factors for heart failure are coronary artery disease,hypertension,obesity,diabetes mellitus,chronic pulmonary diseases,family history of cardiovascular diseases,cardiotoxic therapy.The main factor associated with poor outcome of these patients is constant progression of heart failure.In the current review we present evidence on the role of established and candidate neurohumoral biomarkers for heart failure progression management and diagnostics.A growing number of biomarkers have been proposed as potentially useful in heart failure patients,but not one of them still resembles the characteristics of the"ideal biomarker."A single marker will hardly perform well for screening,diagnostic,prognostic,and therapeutic management purposes.Moreover,the pathophysiological and clinical significance of biomarkers may depend on the presentation,stage,and severity of the disease.The authors cover main classification of heart failure phenotypes,based on the measurement of left ventricular ejection fraction,including heart failure with preserved ejection fraction,heart failure with reduced ejection fraction,and the recently proposed category heart failure with mid-range ejection fraction.One could envisage specific sets of biomarker with different performances in heart failure progression with different left ventricular ejection fraction especially as concerns prediction of the future course of the disease and of left ventricular adverse/reverse remodeling.This article is intended to provide an overview of basic and additional mechanisms of heart failure progression will contribute to a more comprehensive knowledge of the disease pathogenesis.
基金supported by the grant from the Ministry of Science and Higher Education of the Russian Federation (agreement#075-15-2020-800)
文摘The autonomic nervous system plays an important role in the pathogenesis of cardiovascular diseases.With aging,autonomic activity changes,and this impacts the physiological reactions to internal and external signals.Both sympathetic and parasympathetic responses seem to decline,reflecting functional and structural changes in nervous regulation.Although some investigators suggested that both the sympathetic and parasympathetic activities were suppressed,others found that only the parasympathetic activity was suppressed while the sympathetic activity increased.In addition,cardiac innervation progressively diminishes with aging.Therefore,one may suggest that neuromodulation interventions may have different effects,and older age groups can express an attenuated response.This article aims to discuss the effect of device-based neuromodulation in different cardiovascular diseases,depending on the patient’s age.Thus,we cover renal denervation,pulmonary artery denervation,baroreceptor activation therapy,vagus nerve stimulation,spinal cord stimulation,ganglionated plexi ablation for the management of arterial and pulmonary hypertension,heart failure,angina and arrhythmias.The results of many clinical studies appeared to be unconvincing.In view of the low rate of positive findings in clinical studies incorporating neuromodulation approaches,we suggest the underestimation of advanced age as a potential contributing factor to poorer response.Analysis of outcomes between different age groups in clinical trials may shed more light on the true effects of neuromodulation when neutral/ambiguous results are obtained.
