Current Cardiology Reviews - Volume 20, Issue 5, 2024

Background: Physical exercise (PE) may improve plasma concentration of interleukin- 6 (IL-6), tumor necrosis factor-alpha (TNF-alpha), and adiponectin (adpN) in heart transplant (HT) patients. However, no consistent data is available on this population. Aim: Thus, we aimed to conduct a systematic review and meta-analysis on the effects of PE over these pro- and anti-inflammatory biomarkers in HT patients. Methods: Following the guidelines established by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 statement, we conducted a systematic literature search in the PubMed, Cochrane, and Scopus databases. Outcomes included IL-6, TNF-alpha, and adpN. Effect size (ES) was calculated using the standardized mean difference with a 95% confidence interval (CI). Results: The PE group (aerobic modality) was associated with reduced IL-6 compared to the control group (ES: −0.53; 95% CI: −0.99 to −0.06 pg/mL; P = 0.026). However, the PE group did not show a significant effect on TNF-alpha and adpN levels (ES: −0.33; 95% CI: −0.79 to 0.13; P = 0.16 and ES: −0.20; 95% CI: −0.70 to 0.30 pg/mL; P = 0.444, respectively). Conclusion: PE is associated with IL-6 reductions, although TNF alpha and adpN did not change after this intervention in HT patients. Therefore, PE is an effective intervention to downregulate IL-6 in post-HT patients.

Background: Echocardiography has been proven to be a useful tool for detecting atrial-occupying lesions, ranging from primary or secondary tumors to thrombi. Although the precise diagnosis is important as clinical treatment modalities differ, sometimes differentiating a thrombus from a myxoma is very difficult. Case Report: From January 2019 to December 2022, we retrospectively analyzed the echocardiographic findings of 8 patients who were found to have an interatrial mass. Of the 8 patients, 4 had a right atrial mass, and 4 had a left atrial mass. Based on ultrasonic examination, the initial diagnosis was a thrombus and the second diagnosis was a myxoma for all 8 patients. All masses were finally confirmed to be thrombi. Although an echocardiogram can provide significant information on the nature of atrial masses in many patients, qualitative diagnosis of a small percentage of atrial masses remains difficult. Conclusion: An atrial thrombus is occasionally difficult to differentiate from an atrial myxoma in patients without atrial fibrillation, especially when it is not attached to the left atrial appendage. Upon review of the echocardiographic findings of the 8 patients described in our study, it is essential to highlight the fact that a thrombus can mimic a myxoma and thereby create a diagnostic conundrum.

The cardiac and vascular systems work in coordination by activating various reflex mechanisms based on the body's needs. These may be during physiological variations or pathophysiological changes seen in disease conditions of varying degrees of severity. This article intends to explain various reflexes involved in the homeostasis of the cardiovascular system and the role of vagus as the key component in all these reflexes. The article also explains the components of the reflex arc, the stimulus and response, and the role of reflex in a few diseases. This article describes 22 different cardiovascular reflexes in detail.

Background: Cardiovascular diseases represent a significant global health burden, necessitating diverse approaches for effective management. Herbal interventions have gained attention as potential adjuncts or alternatives to conventional therapies due to their perceived safety and therapeutic potential. This structured abstract provides a comprehensive review of herbal interventions for the management of CVDs, summarising key findings, mechanisms of action, and clinical implications. Objective: This systematic review aims to evaluate the impact of various herbal interventions employed for managing cardiovascular diseases. Method: We conducted an extensive literature search across electronic databases, including PubMed, Scopus, and Web of Science, from inception to 2022. Studies were included if they investigated the use of herbal remedies for preventing or treating CVDs. Data extraction and synthesis focused on botanical sources, active compounds, mechanisms of action, and clinical outcomes. Result: Numerous herbal interventions have demonstrated promising cardiovascular benefits. A number of medicinal herbs well identified to treat CVD are Moringaoleifera, Ginseng, Ginkgo biloba, Celosia argentea, Gongronematrifolium, Gynostemmapentaphyllum, Bombaxceiba, Gentianalutea, Allium sativum, Crataegus spp, Curcuma longa, Camellia sinensis, and Zingiber officinale. Mechanistic insights reveal that herbal interventions often target multiple pathways involved in CVD pathogenesis. These mechanisms encompass anti-inflammatory, antioxidant, anti-thrombotic, anti-hypertensive, and lipid-lowering effects. Additionally, some herbs enhance endothelial function, promote nitric oxide production, and exert vasodilatory effects, contributing to improved cardiovascular health. Clinical studies have provided evidence of the efficacy of certain herbal interventions in reducing CVD risk factors and improving patient outcomes. However, more rigorous, large-scale clinical trials are needed to establish their long-term safety and effectiveness. It is crucial to consider potential herb-drug interactions and standardise dosages for reliable therapeutic outcomes. Conclusion: This comprehensive review highlights the potential of herbal interventions as valuable adjuncts or alternatives for managing cardiovascular diseases. Herbal remedies offer diverse mechanisms of action, targeting key CVD risk factors and pathways. While promising, their clinical utility warrants further investigation through well-designed trials to establish their safety and efficacy, paving the way for integrated approaches to cardiovascular disease management. Healthcare providers and patients should engage in informed discussions about the use of herbal interventions alongside conventional therapies in the context of CVD prevention and treatment.

Background: Internet Gaming Disorder (IGD) is recognized as a mental health condition associated with excessive video gaming, leading to functional impairments. The inclusion of IGD in the DSM-5 has underscored the importance of comprehensively understanding its physiological and psychological effects. Objective: This systematic review aims to analyze and synthesize existing literature on the cardiophysiological and neurophysiological activities of individuals diagnosed with IGD, with a focus on identifying patterns, trends, and implications for clinical practice and future research. Methods: A systematic search was conducted in PubMed and Scopus databases to identify relevant studies published up to 2023. The search strategy included terms related to IGD, cardiophysiology, neurophysiology, and relevant measurement techniques. Inclusion criteria encompassed peer-reviewed research articles and clinical trials examining cardiophysiological (e.g., heart rate variability, blood pressure) and neurophysiological (e.g., brain imaging, electroencephalography) parameters in individuals with IGD. Exclusion criteria were applied to ensure methodological rigor and relevance to the research question. Results: The initial search yielded 1320 papers related to IGD, of which twenty studies met the eligibility criteria and were included in the review. Data extraction and synthesis focused on key cardiophysiological and neurophysiological outcomes observed in individuals with IGD compared to healthy controls. Findings revealed decreased Heart Rate Variability (HRV), increased sympathetic activity, and executive control deficits in IGD individuals based on Electrocardiogram (ECG) recordings and cognitive assessments. Neuroimaging studies demonstrated heightened brain activation in the lateral and prefrontal cortex, altered reward processing, and impulse control mechanisms among IGD subjects. Gender-specific differences were noted, with males exhibiting distinct thalamic activation striatum and decreased Regional Homogeneity (ReHo) in the right Posterior Cingulate (rPCC) compared to females. Discussion: The synthesized evidence indicates a complex interplay between excessive gaming and cardiophysiological/neurophysiological changes, highlighting the need for multidimensional assessments in diagnosing and managing IGD. Implications for clinical practice include early detection using ECG, EEG, and advanced neuroimaging techniques, as well as personalized interventions tailored to individual characteristics and gender-specific differences. Conclusion: This systematic review provides a comprehensive overview of the cardiophysiological and neurophysiological activities associated with Internet Gaming Disorder. The findings underscore the need for further research to elucidate underlying mechanisms, develop standardized diagnostic protocols, and optimize targeted interventions for individuals with IGD.