European Society of Cardiology guidance for the diagnosis and management of cardiovascular disease during the COVID-19 pandemic: part 1-epidemiology, pathophysiology, and diagnosis

Aims:Since its emergence in early 2020, the novel severe acute respiratory syndrome coronavirus 2 causing coronavirus disease 2019 (COVID-19) has reached pandemic levels, and there have been repeated outbreaks across the globe. The aim of this two-part series is to provide practical knowledge and guidance to aid clinicians in the diagnosis and management of cardiovascular disease (CVD) in association with COVID-19. Methods and results: A narrative literature review of the available evidence has been performed, and the resulting information has been organized into two parts. The first, reported here, focuses on the epidemiology, pathophysiology, and diagnosis of cardiovascular (CV) conditions that may be manifest in patients with COVID-19. The second part, which will follow in a later edition of the journal, addresses the topics of care pathways, treatment, and follow-up of CV conditions in patients with COVID-19. Conclusion: This comprehensive review is not a formal guideline but rather a document that provides a summary of current knowledge and guidance to practicing clinicians managing patients with CVD and COVID-19. The recommendations are mainly the result of observations and personal experience from healthcare providers. Therefore, the information provided here may be subject to change with increasing knowledge, evidence from prospective studies, and changes in the pandemic. Likewise, the guidance provided in the document should not interfere with recommendations provided by local and national healthcare authorities

ESC guidance for the diagnosis and management of cardiovascular disease during the COVID-19 pandemic: part 2-care pathways, treatment, and follow-up

Aims: Since its emergence in early 2020, the novel severe acute respiratory syndrome coronavirus 2 causing coronavirus disease 2019 (COVID-19) has reached pandemic levels, and there have been repeated outbreaks across the globe. The aim of this two part series is to provide practical knowledge and guidance to aid clinicians in the diagnosis and management of cardiovascular (CV) disease in association with COVID-19. Methods and results: A narrative literature review of the available evidence has been performed, and the resulting information has been organized into two parts. The first, which was reported previously, focused on the epidemiology, pathophysiology, and diagnosis of CV conditions that may be manifest in patients with COVID-19. This second part addresses the topics of: care pathways and triage systems and management and treatment pathways, both of the most commonly encountered CV conditions and of COVID-19; and information that may be considered useful to help patients with CV disease (CVD) to avoid exposure to COVID-19. Conclusion: This comprehensive review is not a formal guideline but rather a document that provides a summary of current knowledge and guidance to practicing clinicians managing patients with CVD and COVID-19. The recommendations are mainly the result of observations and personal experience from healthcare providers. Therefore, the information provided here may be subject to change with increasing knowledge, evidence from prospective studies, and changes in the pandemic. Likewise, the guidance provided in the document should not interfere with recommendations provided by local and national healthcare authorities

Cardiopoietic cell therapy for advanced ischemic heart failure: results at 39 weeks of the prospective, randomized, double blind, sham-controlled CHART-1 clinical trial

Cardiopoietic cells, produced through cardiogenic conditioning of patients' mesenchymal stem cells, have shown preliminary efficacy. The Congestive Heart Failure Cardiopoietic Regenerative Therapy (CHART-1) trial aimed to validate cardiopoiesis-based biotherapy in a larger heart failure cohort

Microwave spectrometry for the evaluation of coronary stents

Abstract Background Coronary artery disease (CAD) is the leading cause of death worldwide, and percutaneous coronary intervention with stenting the most widely performed procedure to treat CAD. However, current stent monitoring techniques are invasive and/or ionizing. Microwave spectrometry (MWS) may provide a non-invasive, non-ionizing and cost-effective alternative capable of detecting stent-related pathologies before fatal heart failure. Purpose To develop a new MWS-based technology to detect coronary stents in an in vivo swine model. Methodology First, using two new MWS devices, an in vitro experiment was carried out to demonstrate their ability of detecting the presence of: (1) a stent and (2) stent fractures (SF). To that end, an intact stent was distanced 3, 7, 11 and 15 mm from a MWS near-field probe in open-air conditions. Afterwards, three identical stents were piecemeal cut to emulate type I, II and III SF at different fractions of the stent's length (l): l/5, l/3 or l/2. Additionally, the stent was measured in a phantom substance, to simulate in vivo conditions: it was distanced from 0 to 40 mm in steps of 5 mm. Likewise, using a pair of MWS far-field antennas, the stent in phantom was measured at 10, 20, 30 and 40 mm. Finally, the MWS technology was assessed in vivo. To that end, six Landrace X Large White pigs were submitted to a stent implantation into the circumflex coronary artery (CX). The antennas measured the stent non-invasively, over the rib cage of the animals. MWS analysis were performed baseline (before stent implantation), and at 0, 3, 7, 14, 21 and 35 days of follow up. Measurements were performed only before ventricular systole to avoid differences in the stent position and deformation. Results In vitro, maxima and minima extrema in the microwave frequency response (see figure) were used to detect the stent. Type I and II SF produced 5 and 10% downshifts in the extrema frequencies with respect to the baseline values (unbroken stent), while type III produced 20% upshifts and a maxima splitting. Embedding the stent in phantom produced 25% downshift in the extrema frequencies. In vivo, the MWS antennas were useful to detect the stent presence into the CX artery during all time points of study, in all animals. Conclusions We have developed a new non-invasive and non-ionizing MWS technology capable of detecting the presence of a stent in a porcine model. Furthermore, we have proven how our technology can monitor structural damages in the stent (SF) and changes in its environment. This study proves the MWS potential to become a simple and yet effective method to arise stent-related pathologies in a pre-clinical stage; it could also provide physical insight about additional biological processes. Further improvements on the MWS device as well as in vivo measurements will ensure its consistency when monitoring human stents. Stent detection using MWS technique Funding Acknowledgement Type of funding source: Foundation. Main funding source(s): Fundaciό La MARATÓ de TV3, Generalitat de Catalunya, Red de Terapia Celular – TerCel, CIBER Cardiovascular, Spanish Agencia Estatal de Investigaciόn Unidad de Excelencia Maria de Maeztu, Sociedad Española de Cardilogía </jats:sec