Journal of Cardiovascular Development and Disease最新文献

{"title":"Advancements in Acute Pulmonary Embolism Diagnosis and Treatment: A Narrative Review of Emerging Imaging Techniques and Intravascular Interventions.","authors":"Michaela Cellina, Matilde Pavan, Niccolò Finardi, Francesco Cicchetti, Maurizio Cè, Pierpaolo Biondetti, Carolina Lanza, Serena Carriero, Gianpaolo Carrafiello","doi":"10.3390/jcdd12090333","DOIUrl":"10.3390/jcdd12090333","url":null,"abstract":"<p><p>Acute pulmonary embolism (APE) represents a significant cause of morbidity and mortality worldwide, requiring rapid and precise diagnosis and effective therapy strategies. Computed Tomography Pulmonary Angiography (CTPA) is currently the gold standard technique for diagnosing PE; however, it presents some disadvantages, including limited sensitivity in detecting sub-segmental emboli and contrast-related risks. Recent advancements in imaging technologies, including Dual-Energy Computed Tomography (DECT) and Photon Counting (PC), offer improved sensitivity and specificity for APE and perfusion abnormalities detection. Digital Dynamic Radiography (DDR) perfusion imaging represents a novel imaging that allows pulmonary perfusion assessment without contrast medium administration, able to detect anomalies at the patient's bedside, representing a promising advancement, particularly for critically ill or contrast-allergic patients. In parallel, interventional radiology has become integral to APE management, particularly for high-risk and intermediate-high-risk patients, with evolving intravascular treatment techniques such as catheter-directed thrombolysis, mechanical thrombectomy, and thrombus aspiration. This narrative review provides an overview of the latest developments in APE diagnostic imaging and interventional radiology, contextualizing them within current guideline recommendations for endovascular treatment.</p>","PeriodicalId":15197,"journal":{"name":"Journal of Cardiovascular Development and Disease","volume":"12 9","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12471078/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145149036","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Metabolic Syndrome Clusters and Arterial Stiffness: Unraveling Early Predictors of Cardiovascular Risk in a Follow-Up Study.","authors":"Agnė Jucevičienė, Ligita Ryliškytė, Jolita Badarienė, Aleksandras Laucevičius","doi":"10.3390/jcdd12090332","DOIUrl":"10.3390/jcdd12090332","url":null,"abstract":"<p><strong>Background: </strong>The aim of this study was to assess the association between different metabolic syndrome (MetS) component clusters, arterial stiffness as measured by aortic pulse wave velocity (aPWV) and cardio-ankle vascular index (CAVI), and the incidence of major cardiovascular events during long-term follow-up.</p><p><strong>Methods: </strong>The prospective cohort study included 5307 participants with MetS, aged 40 to 64 years, who had no evident cardiovascular disease and were enrolled in the Lithuanian High Cardiovascular Risk primary prevention program. All participants were followed up for an average of 4.57 ± 2.74 years to monitor the occurrence of major cardiovascular events. Arterial stiffness was assessed using aPWV and CAVI measurements. The associations between different MetS component clusters, arterial stiffness, and cardiovascular outcomes were analyzed.</p><p><strong>Results: </strong>During the follow-up period, 3.34% of the subjects experienced a major cardiovascular event. Individuals meeting four MetS criteria had a higher risk of events compared to those meeting three. Elevated triglycerides and elevated glucose were each significantly associated with increased risk. Specific MetS combinations, particularly clusters involving WTHB (increased waist circumference [W], elevated triglycerides [T], decreased HDL cholesterol [H], and elevated blood pressure [B]), as well as WBG (waist circumference, blood pressure, and glucose [G]), were significantly associated with cardiovascular events. The cross-sectional analysis also revealed that arterial stiffness, assessed as aPWV, was significantly higher in subjects with the WBG, WTBG, and WTHBG clusters. Meanwhile, higher CAVI was associated with the WTBG cluster. In the logistic regression analysis, the presence of the following clusters was linked to more than twice increased odds for having extremely stiff arteries: WTBG (OR = 2.351) and WTHBG (OR = 2.201) for aPWV values above the 95th percentile (>11.3 m/s) and WTB (OR = 2.096) for CAVI values above the 95th percentile (>10.2).</p><p><strong>Conclusions: </strong>Our findings demonstrate that higher risk of CV events is associated with increased arterial stiffness and higher number of MetS components present, as well as with the presence of specific MetS components; in particular, increased levels of triglycerides and glucose. Furthermore, the cross-sectional analysis demonstrated that subjects with the unfavorable combination of MetS components, such as WTBG, WTHBG, and WTB, are more than twice as likely to have extremely stiff arteries.</p>","PeriodicalId":15197,"journal":{"name":"Journal of Cardiovascular Development and Disease","volume":"12 9","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12471115/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145149190","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prognostic Value of Vascular Calcification in Long-Term Outcomes in Obese and Non-Obese Patients with Chronic Kidney Disease.","authors":"Jana Uhlinova, Anne Kuudeberg, Margus Lember, Mai Ots-Rosenberg","doi":"10.3390/jcdd12090329","DOIUrl":"10.3390/jcdd12090329","url":null,"abstract":"<p><p>The possible protective effect of obesity in the outcomes of chronic kidney disease (CKD) patients is an understudied field. We aimed to evaluate the prognostic value of vascular calcification (VC) on long-term outcomes in obese and non-obese CKD patients. We conducted a single-centre, prospective observational study of 150 CKD patients. Patients were divided into two groups using body mass index (BMI) scores (BMI ≥ 30 kg/m² and BMI < 30 kg/m²). Lateral lumbar X-rays (Kauppila score), the ankle-brachial index (ABI), and echocardiography were used for assessing VC. By the 11.2-year follow-up, 70 patients had died (47%). Twenty-four patients had had CV complications: stroke, myocardial infarction, decompensated heart failure, amputation caused by atherosclerosis, and aortic rupture. Among obese patients (BMI ≥ 30 kg/m²), only LVH was a significant predictor of CV complications (<i>p</i> = 0.01) and mortality (<i>p</i> = 0.004). In patients with BMI < 30 kg/m², predictors of CV complications and mortality were ABI (<i>p</i> = 0.03; <i>p</i> = 0.009), LVH (<i>p</i> = 0.02 for CV complications) and heart valve lesions (<i>p</i> = 0.009; <i>p</i> = 0.004). There were no differences in the measured parameters of VC between the obese and non-obese groups. Moreover, no significant differences were found comparing patients with and without obesity according to the studied parameters; we found no significant differences in complications and mortality. VC in patients with CKD is a significant complication that negatively impacts outcomes. Obesity does not have a protective effect in long-term outcomes in CKD patients.</p>","PeriodicalId":15197,"journal":{"name":"Journal of Cardiovascular Development and Disease","volume":"12 9","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12470804/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145149110","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical Characteristics and Cardiac Rehabilitation Outcomes During the Perioperative Period After MIDCAB and OPCAB Surgery: A Comparative Study.","authors":"Yao Wu, Bao Ren, Jing Li, Liqun Chi, Ping Li, Jiahui Wu","doi":"10.3390/jcdd12090331","DOIUrl":"10.3390/jcdd12090331","url":null,"abstract":"<p><strong>Background: </strong>Minimally invasive direct coronary artery bypass (MIDCAB) surgery offers advantages over off-pump coronary artery bypass (OPCAB), including reduced trauma and faster recovery. However, differences in perioperative cardiac rehabilitation (CR) outcomes between MIDCAB and OPCAB remain unclear. This study compared perioperative clinical characteristics, surgical features, and CR outcomes in patients undergoing MIDCAB versus OPCAB.</p><p><strong>Methods: </strong>This retrospective cohort analysis included 304 patients (31.2% MIDCAB, 68.8% OPCAB) who participated in a CR program, including the 6-min walk test (6MWT), from November 2023 to December 2024.</p><p><strong>Results: </strong>MIDCAB patients had shorter surgery times, fewer grafted vessels, shorter ventilator-assisted time, less total intraoperative fluid, less bleeding, and shorter postoperative hospital stays (all <i>p</i> < 0.05). After cardiac rehabilitation, MIDCAB patients showed shorter time to 6MWT, longer six-minute walk distance (6MWD) (200 ± 125 vs. 178 ± 125 m), higher 6MWD relative to predicted values, and greater metabolic equivalents (all <i>p</i> < 0.05). The median LVEF of MIDCAB patients was the same as that of OPCAB patients (<i>p</i> < 0.05).</p><p><strong>Conclusions: </strong>Our study demonstrates that MIDCAB patients exhibit superior exercise capacity following cardiac rehabilitation.</p>","PeriodicalId":15197,"journal":{"name":"Journal of Cardiovascular Development and Disease","volume":"12 9","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12470523/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145149192","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Severe Aortic Regurgitation and Ascending Aneurysm in a Patient with Pentacuspid Aortic Valve: Case Report and Review.","authors":"Nemanja Karamarković, Miloš Grujić, Milica Karadžić, Dejan Lazović, Ivana Đurošev, Mladen J Kočica","doi":"10.3390/jcdd12090330","DOIUrl":"10.3390/jcdd12090330","url":null,"abstract":"<p><p>Pentacuspid aortic valve is an exceptionally rare congenital anomaly that is often associated with functional deterioration and aortopathy. We report a case of a 39-year-old male presenting with severe aortic regurgitation and an ascending aortic aneurysm in the setting of a pentacuspid aortic valve. The patient underwent a successful Bentall and hemiarch replacement using a composite mechanical valved conduit. This case emphasizes the potential association between rare aortic valve morphologies and ascending aortic pathology and includes a brief review of the existing literature on the pentacuspid aortic valve.</p>","PeriodicalId":15197,"journal":{"name":"Journal of Cardiovascular Development and Disease","volume":"12 9","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12471185/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145149089","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Endothelial Dysfunction in Adolescent Hypertension: Diagnostic Challenges and Early Cardiovascular Risk.","authors":"Vladimir Micieta, Michaela Cehakova, Ingrid Tonhajzerova","doi":"10.3390/jcdd12090326","DOIUrl":"10.3390/jcdd12090326","url":null,"abstract":"<p><p>Hypertension in adolescence causes early vascular injury manifesting as endothelial dysfunction (ED), which signifies elevated cardiovascular risk. This review synthesizes recent insights (2020-2025) into ED's mechanisms and detection in hypertensive youth. We highlight how reduced nitric oxide bioavailability, oxidative stress, inflammation, and hormonal changes in puberty contribute to ED and consequent vascular remodeling. Non-invasive diagnostic tools (e.g., flow-mediated dilation, peripheral arterial tonometry) reveal that even asymptomatic hypertensive adolescents have measurable ED linked to arterial stiffness and cardiac changes. Encouragingly, ED in youth appears reversible: exercise and dietary interventions improve endothelial function, and pharmacotherapy (ACE inhibitors, ARBs) can restore endothelial health beyond blood pressure control. Early identification of ED in hypertensive adolescents is therefore critical-it not only refines risk stratification (e.g., unmasking high-risk \"white-coat\" hypertension) but also presents an opportunity to initiate lifestyle modifications and therapy to preserve vascular function.</p>","PeriodicalId":15197,"journal":{"name":"Journal of Cardiovascular Development and Disease","volume":"12 9","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12470387/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145149176","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Real-World Use of ARNI Within GDMT in HFrEF Patients with and Without Atrial Fibrillation: A Retrospective Analysis of Cardiac and Renal Functions and Clinical Outcomes.","authors":"Niccolò Bonini, Marta Mantovani, Marco Vitolo, Kevin Serafini, Enrico Tartaglia, Francesca Rampini, Francesca Grossule, Benedetta Cherubini, Maria Laura Mastronardi, Paola Trapanese, Jacopo F Imberti, Davide A Mei, Giuseppe Boriani","doi":"10.3390/jcdd12090328","DOIUrl":"10.3390/jcdd12090328","url":null,"abstract":"<p><p>The aim of this study was to describe changes in estimated glomerular filtration rate (eGFR), left ventricular ejection fraction (LVEF) and clinical outcomes in a real-world cohort of patients with heart failure with reduced ejection fraction (HFrEF) and atrial fibrillation (AF). A total of 321 patients (67 [58-74] years old, 19.3% females) were included; 134 (41.7%) had AF. AF patients were less frequently prescribed angiotensin receptor-neprilysin inhibitor (ARNi), with no differences concerning sodium-glucose transport protein 2 inhibitors (SGLT2is) and had lower median baseline eGFR values. At 6- and 12-month follow-ups, renal function declined similarly in both groups, with no difference in the proportion of patients experiencing an eGFR decrease of ≥30% from baseline. Regarding cardiac remodeling, patients without AF showed a higher proportion of individuals with an LVEF improvement of ≥10% from baseline, however with no differences between groups in LVEF final recovery. During a median follow-up of 582 (339-1481) days, AF patients showed a higher risk of composite outcome (aHR, 95% CI: 2.12, 1.16-3.86) and of hospitalization for heart failure (hHF) (2.80, 1.44-5.46), without differences in all-cause death. Delta eGFR changes with at least a 30% decline in eGFR were associated with a higher risk of the primary endpoint. Despite lower baseline renal function, AF patients exhibited similar LVEF improvement and renal decline, which emphasizes the importance of guideline-directed medical therapy. AF was associated with a higher risk of adverse events, primarily driven by hHF.</p>","PeriodicalId":15197,"journal":{"name":"Journal of Cardiovascular Development and Disease","volume":"12 9","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12470668/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145149077","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Transcatheter Aortic Valve Implantation in Nonagenarians: A Comparative Analysis of Baseline Characteristics and 1-Year Outcomes.","authors":"Murat Can Güney, Engin Bozkurt","doi":"10.3390/jcdd12090327","DOIUrl":"10.3390/jcdd12090327","url":null,"abstract":"<p><strong>Background: </strong>Transcatheter aortic valve implantation (TAVI) is increasingly used in elderly patients with severe aortic stenosis, yet data on nonagenarians remain limited. This study aimed to compare clinical characteristics and outcomes of patients aged ≥90 years with those aged <90 years undergoing TAVI.</p><p><strong>Methods: </strong>We retrospectively analyzed 620 patients who underwent transfemoral TAVI. Patients were divided into two groups: <90 years (<i>n</i> = 545) and ≥90 years (<i>n</i> = 75). Baseline clinical, procedural, and outcome data were compared.</p><p><strong>Results: </strong>Nonagenarians had lower body mass index (BMI) and a lower prevalence of comorbidities such as diabetes, hyperlipidemia, and prior coronary artery bypass grafting CABG (all <i>p</i> < 0.05). All-cause mortality was higher in nonagenarians at 1 month (8.0% vs. 5.5%, <i>p</i> = 0.425), 6 months (9.3% vs. 7.9%, <i>p</i> = 0.838), and 1 year (21.3% vs. 16.7%, <i>p</i> = 0.405), though these differences were not statistically significant. In-hospital stroke occurred more frequently in patients ≥ 90 years (6.7% vs. 2.2%, <i>p</i> = 0.044).</p><p><strong>Conclusions: </strong>Despite a higher rate of in-hospital stroke, nonagenarians undergoing TAVI had comparable mortality outcomes to younger patients. These findings support the feasibility of TAVI in selected very elderly patients, while highlighting the need for tailored stroke prevention strategies.</p><p><strong>Trial registration: </strong>The trial is retrospectively registered, and a clinical trial number is not applicable.</p>","PeriodicalId":15197,"journal":{"name":"Journal of Cardiovascular Development and Disease","volume":"12 9","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12470840/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145149084","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of Immunomodulatory Therapies for Cardiovascular Clinical and Inflammatory Markers Outcomes in Mild to Moderately Ill Hospitalized Multisystem Inflammatory Syndrome in Children Patients.","authors":"Rashmitha Dachepally, Reem Sarkis, Alvaro DonaireGarcia, Meghana Kovvuri, Karunya Jayasimha, Adrija Chaturvedi, Amr Ali, Sirada Panupattanapong, Samir Latifi, Hemant Agarwal","doi":"10.3390/jcdd12090324","DOIUrl":"10.3390/jcdd12090324","url":null,"abstract":"<p><p>Optimal treatment for non-critically ill multisystem inflammatory syndrome in children (MIS-C) remains unclear. We evaluated short-term outcomes in mild to moderately ill hospitalized MIS-C patients fulfilling CDC 2020 and CDC/CTSE 2023 criteria and treated between April 2020 and March 2022 with either intravenous immunoglobulin (IVIG) monotherapy (Group A, n = 17) or IVIG plus corticosteroids (GC) (Group B, n = 22). Cardiovascular clinical parameters, inflammatory markers, and cardiac imaging were compared on days 1, 3, and 5 relative to day 0. The two groups had no significant differences in demographics or illness severity. Group B showed improvement in heart rate (17.8; 95% CI [9.74, 25.8]), mean blood pressure (5.63 [1.61, 9.64]), and body temperature (1.45 [0.94, 1.95]) by day 1, followed by improvement in albumin (0.43 [0.2, 0.84]), CRP (7.56 [3.0, 12.11]), D-dimer (2344 [488.7, 4200.2]), ferritin (1448 [-609.4, 3505.5]), fibrinogen (110 [44.4, 176]), lymphocyte count (1006 [63.5, 1948]), and NT-proBNP (2901 [-349.3, 6153]) by day 3 and left ventricular ejection fraction by day 4-5 (3.84 [0.55, 8.23]). All results were statistically significant (<i>p</i> < 0.05). Group A required more additional therapies, with no difference in hospital stay. Our study concludes that combined IVIG and GC therapy yielded better short-term outcomes than IVIG monotherapy in this patient population, with improvement in cardiovascular clinical parameters preceding changes in inflammatory markers and cardiac imaging.</p>","PeriodicalId":15197,"journal":{"name":"Journal of Cardiovascular Development and Disease","volume":"12 9","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12471045/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145149234","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"From Acute Carditis, Rheumatic Carditis, and Morphologic Cardiac Reactions to Allergic Angina, Allergic Myocardial Infarction, and Kounis Syndrome: A Multidisciplinary and Multisystem Disease.","authors":"Nicholas G Kounis, Alexandros Stefanidis, Ming-Yow Hung, Uğur Özkan, Cesare de Gregorio, Alexandr Ceasovschih, Virginia Mplani, Christos Gogos, Stelios F Assimakopoulos, Christodoulos Chatzigrigoriadis, Panagiotis Plotas, Periklis Dousdampanis, Sophia N Kouni, Grigorios Tsigkas, Nicholas Patsouras, Gianfranco Calogiuri, Soheila Pourmasumi, Ioanna Koniari","doi":"10.3390/jcdd12090325","DOIUrl":"10.3390/jcdd12090325","url":null,"abstract":"<p><p>This narrative review explains the history of anaphylactic or hypersensitivity reactions, their connection to the cardiovascular system, and Kounis syndrome, which is linked to hypersensitivity. Additional subjects discussed include immunoglobulin E and serum tryptase, common pathways of allergic and nonallergic cardiovascular events, current perspectives on Kounis syndrome, allergic myocardial infarction, allergic angina, and the impact of COVID-19 and its vaccination on Kounis syndrome. Kounis syndrome is a distinct kind of acute vascular disease that affects the coronary, cerebral, mesenteric, peripheral, and venous systems. Kounis syndrome is currently used to describe coronary symptoms linked to disorders involving mast cell activation and inflammatory cell interactions, such as those involving T-lymphocytes and macrophages, which further induce allergic, hypersensitive, anaphylactic, or anaphylactic insults. Platelet activating factor, histamine, neutral proteases like tryptase and chymase, arachidonic acid products, and a range of cytokines and chemokines released during the activation process are among the inflammatory mediators that cause it. Proinflammatory cytokines are primarily produced by mast cells in COVID-19 infections. Mast cell-derived proteases and eosinophil-associated mediators are also more prevalent in the lung tissues and sera of COVID-19 patients. As a modern global threat to civilization, COVID-19 is linked to chemical patterns that can activate mast cells; therefore, allergic stimuli are usually the reason. Virus-associated molecular patterns can activate mast cells, but allergic triggers are typically the cause. By activating SARS-CoV-2 and other toll-like receptors, a variety of proinflammatory mediators, including IL-6 and IL-1β, are released, potentially contributing to the pathology of COVID-19.</p>","PeriodicalId":15197,"journal":{"name":"Journal of Cardiovascular Development and Disease","volume":"12 9","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12470948/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145149210","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}