<abstract xmlns="http://www.w3.org/1999/xhtml">

<p>Atrial fibrillation (AF) is the most common sustained cardiac arrhythmia and is associated with a five-fold increase in the risk for ischemic stroke. Therefore, lifelong use of anticoagulants is crucial to reduce the morbidity and mortality burden of AF. The incidence of AF in chronic kidney disease (CKD) is two to three times greater than in the general population, and there is a mutual aggravation of the two conditions as well as the presence of both an increased thromboembolic risk in CKD and an increased bleeding risk in severe CKD. The preservation of kidney function in patients with cardiovascular diseases is important, as the latter is the leading cause of death in patients with eGFR &lt;60 mL/min/1.73 m<sup>2</sup>. Similarly, kidney dysfunction is a serious limitation to the use of many cardiovascular drugs, including anticoagulants. Evidence is present for the faster progression of kidney disease with vitamin K antagonists, likely due to the vitamin K-related process of vascular calcification. Conversely, direct oral anticoagulants (DOACs) have been shown to reduce the progression of CKD and have a beneficial effect as far as the modulation of inflammation and oxidative stress are concerned in experimental models. Another less-discussed problem is the use of DOACs in advanced CKD.</p>
</abstract>

Kidney Function and the Use of Vitamin K Antagonists or Direct Oral Anticoagulants in Atrial Fibrillation

<abstract xmlns="http://www.w3.org/1999/xhtml">

<sec><h3>Introduction</h3>
<p>In vascular reconstruction in arterial trauma, ruptured abdominal aortic aneurysm or ruptured aneurysmal arteriovenous fistula, the challenge no longer lies in the surgical procedure itself, but rather the prevention of intimal hyperplasia, thrombosis and aneurysm formation, in parallel with extending as long as possible the patency of the grafts.</p>
</sec>
<sec><h3>The aim</h3> <p>of this study is to present the preliminary findings of a novel non-ionizing radiation-based therapeutic method for stabilizing and strengthening the extracellular matrix of the venous wall, improving the biomechanical profile of the autologous graft used in myocardial and lower limb revascularization.</p></sec>
<sec><h3>Material and methods</h3>
<p>We developed the protocol and method for UV-A irradiation as a new method of mechanical augmentation of the resistance structure of the venous graft. Samples of the superficial femoral artery, superficial femoral vein, and great saphenous vein (GSV) were extracted from a 58-year-old patient who underwent above-the-knee amputation, and were prepared in 5 × 5 cm<sup>2</sup> patches. Additionally, we analyzed the samples biomechanically biaxially with the BioTester<sup>®</sup> 5000, in which we established a 25% equibiaxial stretch. The GSV sample was also treated by UV-A irradiation after being kept in riboflavin 5′-phosphate monosodium salt for 30 min.</p>
</sec>
<sec><h3>Results</h3>
<p>After UV-A treatment of the GSV wall, we observed an important increase of Cauchy stress from 82 kPa to 131 kPa in the longitudinal axis and from 66 kPa to 115 kPa in the circumferential axis. Young’s modulus also changed after treating the GSV wall from 0.564 MPa to 1.218 MPa (longitudinal) and from 0.397 MPa to 0.709 MPa (circumferential). As a result of the therapy, we observed a considerable similarity of the mechanical behavior of the GSV wall to that of the artery wall.</p>
</sec>
<sec><h3>Conclusion</h3>
<p>The photocrosslinking of collagen fibbers at the vein graft adventitia hardens and stiffens the venous wall, making it behave like the arterial wall after treatment. These preliminary ex vivo results on human vascular tissue may serve as the foundation for the development of new treatment approaches utilizing mechanical augmentation of the vein grafts.</p>
</sec>
</abstract>

“George Emil Palade” University of Medicine, Pharmacy, Science and Technology

Ex-vivo Mechanical Augmentation of Human Saphenous Vein Graft By UV-A Irradiation in Emergency Vascular Reconstruction – Preliminary Results

<abstract xmlns="http://www.w3.org/1999/xhtml">

<sec><h3>Background</h3>
<p>It is estimated that 2 to 8% of pregnancies are complicated by gestational hypertension and preeclampsia, the latter being considered a major cardiovascular emergency due to its possible progression to severe eclampsia and HELLP syndrome. New inflammatory biomarkers, such as the neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR), may predict the progression of gestational hypertension.</p>
</sec>
<sec><h3>Aim of the study</h3>
<p>The aim of this study was to assess whether NLR, PLR, and uric acid play a role in predicting preeclampsia and its severe forms.</p>
</sec>
<sec><h3>Methods</h3>
<p>This prospective, single-center cohort study, conducted between January 1, 2020 and December 31, 2022, included 107 pregnant women with gestational hypertension, preeclampsia and its severe forms, HELLP syndrome and eclampsia. Patients were divided into two groups: the first group included 88 patients with gestational hypertension (GH group), and the second group included 19 patients with preeclampsia and its severe forms (PE group). We compared demographic, clinical and biochemistry data between the two groups.</p>
</sec>
<sec><h3>Results</h3>
<p>PLR was significantly lower in women with preeclampsia (85.47 ± 7.91 vs. 115.90 ± 4.63, p = 0.005). The mean serum uric acid level in the PE group was significantly higher than in the GH group (6.71 ± 0.44 mg/dL vs. 4.59 ± 0.12 mg/dL, p &lt;0.0001).</p>
</sec>
<sec><h3>Conclusion</h3>
<p>In this study, low-cost biomarkers PLR and serum uric acid were associated with a higher risk of PE and its severe forms and may be used to predict the progression of gestational hypertension.</p>
</sec>
</abstract>

Are NLR, PLR, and Elevated Uric Acid Levels Predictive of Preeclampsia?

<abstract xmlns="http://www.w3.org/1999/xhtml">

<sec><h3>Background</h3>
<p>Rheumatoid arthritis (RA) is a chronic, systemic inflammatory disease. Left atrial (LA) dysfunction is strongly linked to cardiovascular diseases, and the early detection of LA function in patients with RA is vital. Real-time three-dimensional echocardiography (RT-3DE) offers a noninvasive method to assess the structure and function of the LA.</p>
</sec>
<sec><h3>Aim of the study</h3>
<p>To assess LA volumes and phasic function in patients with RA using 3D transthoracic echocardiography.</p>
</sec>
<sec><h3>Materials and Methods</h3>
<p>This prospective case-control study included 162 subjects classified into two groups: Group 1 included 82 patients with RA, subdivided into an active RA group (n = 40) and an inactive RA group (n = 42), and Group 2 included 80 healthy matched controls. All study participants were examined using 2D and 3D transthoracic echo-cardiography.</p>
</sec>
<sec><h3>Results</h3>
<p>Diastolic dysfunction was significantly greater in patients with moderate and severe disease activity than in patients with mild disease activity. RT-3DE analysis of RA groups showed significantly higher maximum, minimum, and pre-atrial LA volumes compared to controls (p &lt;0.01), and these volumes were significantly higher in the active RA group than in the inactive RA group (p &lt;0.01). We also found significantly lower LA passive ejection fraction (EF) and active EF in both RA groups than the control group (p &lt;0.01), and significantly lower total EF in the active RA group than the inactive RA group (p &lt;0.01).</p>
</sec>
<sec><h3>Conclusion</h3>
<p>Patients with RA had increased 3D LA volumes and impaired mechanical function, especially in active RA. RT-3DE provides an accurate measurement of LA volumes and function, being a feasible and reproducible method in clinical applications.</p>
</sec>
</abstract>

Department of Cardiology, Faculty of Medicine

Department of Rheumatology, Faculty of Medicine

Three-dimensional Echocardiography for the Early Detection of Cardiac Dysfunction in Patients with Rheumatoid Arthritis

<abstract xmlns="http://www.w3.org/1999/xhtml">

<p>The link between COVID-19 and cardiovascular diseases, specifically myocardial infarction, has been well documented, but the interactions between these comorbidities in the context of pregnancy has not been elucidated so far. We report an intriguing case of a 35-year-old woman in her 35th week of pregnancy, with SARS-CoV-2 infection, who developed an acute coronary syndrome caused by a spontaneous coronary dissection. To our knowledge, this paper presents one of the first cases reported in the literature of acute coronary syndrome and COVID-19 infection in a pregnant patient.</p>
</abstract>

COVID Infection and Spontaneous Coronary Dissection in a Pregnant Woman — a Therapeutic Challenge

AHEAD OF PRINT

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Journal of Cardiovascular Emergencies

 The Journal of Cardiovascular Emergencies aims to publish top quality papers related to acute conditions in any cardiovascular pathology. The journal will mainly focus on recent advances in the field of diagnosis and treatment of the most common causes of cardiovascular emergencies, including acute coronary syndromes, acute heart failure, acute aortic diseases, pulmonary embolism, peripheral arterial diseases or cardiac arrhythmia. Interdisciplinary approaches will be extremely welcomed, presenting new advances in the approach of different other pathologies (i.e. stroke) from the cardiovascular perspective.  The Journal of Cardiovascular Emergencies will publish high-quality basic and clinical research related to these topics, in a common approach that will integrate the clinical studies with the pre-clinical work dedicated to discovery of new mechanisms involved in the development and progression of acute cardiovascular conditions.  Especially in the case of acute coronary syndromes, the journal will try to provide the entire cardiology community with the perspective of the regional cardiology networks in Central and Eastern European countries, reflecting the regional model of care in cardiovascular acute conditions.  The journal will primarily focus on publishing original research papers, but also other types of materials (such as review articles, case reports, state of the art papers, comments to editor, etc) will be extremely welcomed.  Rejection Rate   30%   Archiving  Sciendo archives the contents of this journal in Portico - digital long-term preservation service of scholarly books, journals and collections.  Plagiarism Policy  The editorial board is participating in a growing community of Similarity Check System's users in order to ensure that the content published is original and trustworthy. Similarity Check is a medium that allows for comprehensive manuscripts screening, aimed to eliminate plagiarism and provide a high standard and quality peer-review process. 