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The Arrhythmic Burden of Cardiac Amyloidosis: A Comprehensive Review.

Cardiac amyloidosis (CA) represents a growing etiology of heart failure (HF) and arrhythmogenesis, driven by the intramyocardial deposition of aberrantly folded proteins, notably immunoglobulin light chains (AL) and transthyretin (ATTR). This infiltrative process compromises myocardial compliance and disrupts the cardiac conduction system, leading to a diverse spectrum of dysrhythmias. The escalating prevalence of CA, particularly within geriatric demographics and individuals with plasma cell dyscrasias, underscores the imperative for refined diagnostic and therapeutic paradigms. The considera

Autonomic control of ventricular function in health and disease: current state of the art.

PurposeCardiac autonomic dysfunction is one of the main pillars of cardiovascular pathophysiology. The purpose of this review is to provide an overview of the current state of the art on the pathological remodeling that occurs within the autonomic nervous system with cardiac injury and available neuromodulatory therapies for autonomic dysfunction in heart failure.MethodsData from peer-reviewed publications on autonomic function in health and after cardiac injury are reviewed. The role of and evidence behind various neuromodulatory therapies both in preclinical investigation and in-use in clini

Hypercalcemia in Cancer: Causes, Effects, and Treatment Strategies.

Calcium plays central roles in numerous biological processes, thereby, its levels in the blood are under strict control to maintain homeostatic balance and enable the proper functioning of living organisms. The regulatory mechanisms ensuring this balance can be affected by pathologies such as cancer, and as a result, hyper- or hypocalcemia can occur. These states, characterized by elevated or decreased calcium blood levels, respectively, have a significant effect on general homeostasis. This article focuses on a particular form of calcium metabolism disorder, which is hypercalcemia in neoplasm

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… Calcium has a positive inotropic effect up to a concentration of approximately 15 mg/dL, from which point it has a depressing effect on the strength of myocardial contraction. …

Patterns of multimorbidity in older adults with multiple myeloma: An analysis of SEER-Medicare.

OBJECTIVE: Multimorbidity influences the management of symptoms, treatment, and health outcomes for older adults with multiple myeloma. Our study characterized patient profiles defined by discrete chronic condition patterns and examined the distribution of their sociodemographic factors in older adults at time of diagnosis with multiple myeloma. METHODS: Using the Surveillance, Epidemiology and End Results (SEER) Program database linked with Medicare insurance claims (2007-2017), we examined 11,926 individuals diagnosed with multiple myeloma at age ≥ 65 years. Hierarchical cluster analysis wa

The penumbra of thalidomide, the litigation culture and the licensing of pharmaceuticals.

Fifty years ago several thousand children were born with severe limb defects after their mothers had been given thalidomide in pregnancy. This tragedy caused procedures for licensing new medicines to become much stricter. Where, nevertheless, significant side effects were found it became common to sue for damages. These consequences have caused possibly an even greater disaster damaging many more people and threatening ruin to health services everywhere. The huge increase in both time and cost in bringing medicines to market is increasing their price to unsupportable levels; and only wealthy c

Human-Induced Pluripotent Stem Cell Models for Amyloid Cardiomyopathy: From Mechanistic Insights to Therapeutic Discovery.

Amyloid cardiomyopathy (ACM), driven by transthyretin (TTR) and immunoglobulin light chain (LC) amyloid fibrils, remains a major clinical challenge due to limited mechanistic understanding and insufficient preclinical models. Human-induced pluripotent stem cells (iPSCs) have emerged as a transformative platform to model ACM, offering patient-specific and genetically controlled systems. In this review, we summarize recent advances in the use of iPSC-derived cardiomyocytes (iPSC-CMs) in both two-dimensional (2D) monolayer cultures and three-dimensional (3D) constructs-including spheroids, organo

Сердечно-сосудистые заболевания

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Herpes Zoster and Cardiovascular Disease: Exploring Associations and Preventive Measures through Vaccination.

Herpes zoster, induced by the reactivation of the varicella-zoster virus (VZV), is a unilaterally distributed vesicular rash that can cause multiple complications. VZV not only causes neurological problems, including postherpetic neuralgia and ocular zoster, but also causes inflammatory vasculopathy and increases the incidence of hemorrhagic or ischemic complications. Therefore, understanding the association between the development of herpes zoster and the subsequent occurrence of acute stroke or cardiovascular diseases, including myocardial infarction and heart failure, is of great interest.

Cancer treatment-related cardiotoxicity, molecular mechanism, challenges, and research trends.

Cancer treatment-related cardiotoxicity (CTRC) encompasses a spectrum of cardiovascular complications associated with chemotherapy, targeted therapy, and radiotherapy. This review synthesizes recent mechanistic insights to delineate distinct pathological pathways: anthracyclines provoke oxidative mitochondrial damage and disrupt cardiomyocyte iron homeostasis; HER2-targeted therapies inhibit the PI3K-Akt survival pathway, compromising contractile function and calcium regulation; tyrosine kinase inhibitors impair VEGF and PDGF signaling, inducing endothelial dysfunction and microvascular rarefa

The double-edged sword of tumor-targeted treatment: the influence of targeted therapy on the heart.

As an important means of modern cancer treatment, targeted therapy has significant efficacy, but cardiac toxicity cannot be ignored. From subclinical myocardial injury to severe heart failure (HF), it poses significant challenges to the long-term survival and quality of life of patients. This article summarizes the impact of targeted therapy drugs on cardiac function and their mechanisms, including cardiomyocyte damage, myocardial hypertrophy, and HF, and conducts in-depth research into potential molecular mechanisms. These include direct cardiomyocyte damage through targeted pathway inhibitio

Diagnostic and prognostic value of cardiac imaging in amyloidosis.

Amyloidosis is an infiltrative disease caused by extracellular protein deposition that has accumulated a lot of scientific production in recent years. Different types of amyloidosis can affect the heart. Transthyretin amyloidosis and light chain amyloidosis are the two most common types of cardiac amyloidosis. These entities have a poor prognosis, so accurate diagnostic techniques are imperative for determining an early therapeutic approach. Recent advances in cardiac imaging and diagnostic strategies show that these tools are safe and can avoid the use of invasive diagnostic techniques to his

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… In AL-CA patients with normal LVEF but symptomatic and with high cardiac biomarker values, parameters such as stroke volume index < 33 mL/min, myocardial contraction fraction (MCF) (calculated as a ratio between LV stroke volume and LV myocardial volume) < 34% and cardiac-index < 2.4 L/min/m 2 determine … Table 1 Early imaging tool for cardiac amyloidosis diagnosis 99m Tc-DPD: 99m Tc-labeled 3,3-diphosphono-1,2-propanodicarboxylic acid; CCT: Cardiac computed tomography; CMR: Cardiac magnetic resonance; ECV: Extracellular volume; MCF: Myocardial contraction fraction; MIBG: 123-iodine metaiodobenzylguanidine …

Cardiotoxicity of anti-cancer drugs: cellular mechanisms and clinical implications.

Cardio-oncology is an emerging field that seeks to enhance quality of life and longevity of cancer survivors. It is pertinent for clinicians to understand the cellular mechanisms of prescribed therapies, as this contributes to robust understanding of complex treatments and off-target effects, improved communication with patients, and guides long term care with the goal to minimise or prevent cardiovascular complications. Our aim is to review the cellular mechanisms of cardiotoxicity involved in commonly used anti-cancer treatments and identify gaps in literature and strategies to mitigate card

A review of chemotherapeutic drugs-induced arrhythmia and potential intervention with traditional Chinese medicines.

Significant advances in chemotherapy drugs have reduced mortality in patients with malignant tumors. However, chemotherapy-related cardiotoxicity increases the morbidity and mortality of patients, and has become the second leading cause of death after tumor recurrence, which has received more and more attention in recent years. Arrhythmia is one of the common types of chemotherapy-induced cardiotoxicity, and has become a new risk related to chemotherapy treatment, which seriously affects the therapeutic outcome in patients. Traditional Chinese medicine has experienced thousands of years of cli

Investigating key genes and molecular mechanisms of prostate cancer and coronary heart disease through transcriptomics and experimental validation.

BackgroundProstate cancer (PC), a common male urogenital malignancy, and coronary heart disease (CHD), a cardiovascular disease from coronary lesions causing myocardial ischemia, interact in comorbidity. This study integrated their transcriptome data to reveal comorbid mechanisms and develop cross-disease targets.MethodsIn this research, candidate genes were derived from differential analysis and intersection analysis. Subsequently, machine learning algorithms were integrated with receiver operating characteristic (ROC) curve assessment and expression confirmation to identify key genes. Nomogr

Cardiac Amyloid for the Internist.

Cardiac amyloid is an uncommon cause of diastolic dysfunction the recognition of which requires the internist to have clinical suspicion to guide diagnosis and treatment. Cardiac amyloid is an infiltrative cardiomyopathy with significant morbidity and mortality. Appropriate diagnosis is important because management of cardiac amyloid differs from typical heart failure with preserved ejection fraction. An astute internist must be able to recognize common findings of cardiac amyloidosis. Here we present a case of a patient presenting with diastolic heart failure and the steps leading towards dia

Standard Poster Abstracts for the 17th Asia Pacific Heart Rhythm Society (APHRS) Scientific Sessions

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Novel Therapeutics for Anthracycline Induced Cardiotoxicity.

Anthracyclines remain an essential component of the treatment of many hematologic and solid organ malignancies, but has important implications on cardiovascular disease. Anthracycline induced cardiotoxicity (AIC) ranges from asymptomatic LV dysfunction to highly morbid end- stage heart failure. As cancer survivorship improves, the detection and treatment of AIC becomes more crucial to improve patient outcomes. Current treatment modalities for AIC have been largely extrapolated from treatment of conventional heart failure, but developing effective therapies specific to AIC is an area of growing

Arrhythmic Risk Stratification in Cardiac Amyloidosis: A Review of the Current Literature.

Cardiac amyloidosis is the most frequent infiltrative disease caused by the deposition of misfolded proteins in the cardiac tissue, leading to heart failure, brady- and tachyarrhythmia and death. Conduction disorders, atrial fibrillation (AF) and ventricular arrhythmia (VA) significantly impact patient outcomes and demand recognition. However, several issues remain unresolved regarding early diagnosis and optimal management. Extreme bradycardia is the most common cause of arrhythmic death, while fast and sustained VAs can be found even in the early phases of the disease. Risk stratification an

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… Stroke volume and myocardial contraction fraction in transthyretin amyloidosis cardiomyopathy: A systematic review Front. Cardiovasc. Med. 2023 10 1085824 10.3389/fcvm.2023.1085824 36776259 PMC9911429 9. Wali E. Gruca M. Singulane C. Cotella J. Guile B. Johnson R. Mor-Avi V. Addetia K. Lang R.M. …

Purinergic Signalling: Therapeutic Developments.

Purinergic signalling, i.e., the role of nucleotides as extracellular signalling molecules, was proposed in 1972. However, this concept was not well accepted until the early 1990's when receptor subtypes for purines and pyrimidines were cloned and characterised, which includes four subtypes of the P1 (adenosine) receptor, seven subtypes of P2X ion channel receptors and 8 subtypes of the P2Y G protein-coupled receptor. Early studies were largely concerned with the physiology, pharmacology and biochemistry of purinergic signalling. More recently, the focus has been on the pathophysiology and the

Myomasp/LRRC39, a heart- and muscle-specific protein, is a novel component of the sarcomeric M-band and is involved in stretch sensing.

RATIONALE AND OBJECTIVE: The M-band represents a transverse structure in the center of the sarcomeric A-band and provides an anchor for the myosin-containing thick filaments. In contrast to other sarcomeric structures, eg, the Z-disc, only few M-band-specific proteins have been identified to date, and its exact molecular composition remains unclear. METHODS AND RESULTS: Using a bioinformatic approach to identify novel heart- and muscle-specific genes, we found a leucine rich protein, myomasp (Myosin-interacting, M-band-associated stress-responsive protein)/LRRC39. RT-PCR and Northern and West