Social and environmental risks as contributors to the clinical course of heart failure

A systematic analysis and prediction of the disease burden of ischemic heart disease caused by hyperglycemia

OBJECTIVE

This study aims to analyze the disease burden of ischemic heart disease (IHD) caused by hyperglycemia and its changing trend, and to construct a visualization platform for disease burden and forecast trends on the Shiny platform.

MATERIALS AND METHODS

Using data from the 2021 Global Burden of Disease Study, we analyzed deaths and disability-adjusted life years (DALYs) due to IHD triggered by hyperglycemia, with detailed analysis by region, gender, and age. The age-period-cohort model was used to assess the impact of age, cohort, and period on age-standardized disease rates across different Socio-Demographic Index (SDI) regions, and decomposition analysis was employed to disentangle the contributions of population, aging, and epidemiological changes.

RESULTS

In 2021, approximately 14-15% of IHD's DALYs and deaths were attributed to high fasting plasma glucose (HFPG), with a nonsignificant decrease in the annual average percentage change of DALYs. In middle, low-middle, and low SDI regions, the age-standardized mortality rates caused by HFPG are increasing, particularly among males. In high-middle and high SDI regions, the effects of aging and epidemiological changes surpass population growth, whereas in low SDI regions, population growth is the main factor. By 2050, the global Age-Standardized Mortality Rate of IHD attributed to HFPG is projected to reach 16.96. More data can be accessed by visiting the disease burden visualization platform.

CONCLUSION

Global HFPG-induced IHD health presents significant imbalances. In low SDI regions with larger populations and more unbalanced healthcare distribution, there is a need to strengthen the construction of medical levels.

Chronic Heart Failure and Coronary Artery Disease: Pharmacological Treatment and Cardiac Rehabilitation

Coronary artery disease is the leading cause of acute and chronic heart failure. Patients with heart failure and ischemic heart disease need a tailored assessment to define the appropriate treatment, while a specific multidisciplinary management plan should be followed. Indeed, several factors should be assessed before starting treatment, such as heart failure symptoms and/or signs, angina, electrocardiographic features, right and left ventricular systolic and diastolic function, serological abnormalities, cardiac structural and functional integrity, and pulmonary function. New scenarios and developments have emerged recently in this field, increasing our knowledge regarding pathophysiology, exercise, and pharmacology. Effective and appropriate management and treatment reduce the risk of death and hospitalization for heart failure. Herein, we provide an updated, state-of-the-art overview of pharmacological treatment and cardiac rehabilitation in patients with chronic heart failure and coronary artery disease. Furthermore, tailored and contemporary management in clinical practice will be proposed for this specific and fragile patient population.

Roles of IL-33 in the Pathogenesis of Cardiac Disorders

Interleukin-33 (IL-33) is a member of the IL-1 cytokine family and is believed to play important roles in different diseases by binding to its specific receptor suppression of tumorigenicity 2 (ST2). In the heart, IL-33 is expressed in different cells including cardiomyocytes, fibroblasts, endothelium, and epithelium. Although many studies have been devoted to investigating the effects of IL-33 on heart diseases, its roles in myocardial injuries remain obscure, and thus further studies are mandatory to unravel the underlying molecular mechanisms. We highlighted the current knowledge of the molecular and cellular characteristics of IL-33 and then summarized its major roles in different myocardial injuries, mainly focusing on infection, heart transplantation, coronary atherosclerosis, myocardial infarction, and diabetic cardiomyopathy. This narrative review will summarize current understanding and insights regarding the implications of IL-33 in cardiac diseases and its diagnostic and therapeutic potential for cardiac disease management.