Modeling Nonischemic Genetic Cardiomyopathies Using Induced Pluripotent Stem Cells.

PURPOSE OF REVIEW: The advent of induced pluripotent stem cells (iPSC) has paved the way for new in vitro models of human cardiomyopathy. Herein, we will review existing models of disease as well as strengths and limitations of the system. RECENT FINDINGS: Preclinical studies have now demonstrated that iPSCs generated from patients with both acquired or heritable genetic diseases retain properties of the disease in vitro and can be used as a model to study novel therapeutics. iPSCs can be differentiated in vitro into the cardiomyocyte lineage into cells resembling adult ventricular myocytes that retain properties of cardiovascular disease from their respective donor. iPSC pluripotency allows for them to be frozen, stored, and continually used to generate iPSC-derived myocytes for future experiments without need for invasive procedures or repeat myocyte isolations to obtain animal or human cardiac tissues. While not without their limitations, iPSC models offer new ways for studying patient-specific cardiomyopathies. iPSCs offer a high-throughput avenue for drug development, modeling of disease pathophysiology in vitro, and enabling experimental repair strategies without need for invasive procedures to obtain cardiac tissues.

Epidemiology, clinical ramifications, and cellular pathogenesis of COVID-19 mRNA-vaccination-induced adverse cardiovascular outcomes: A state-of-the-heart review.

The coronavirus disease 2019 (COVID-19) has overwhelming healthcare systems globally. To date, a myriad of therapeutic regimens has been employed in an attempt to curb the ramifications of a severe COVID-19 infection. Amidst the ongoing pandemic, the advent and efficacious uptake of COVID-19 vaccination has significantly reduced disease-related hospitalizations and mortality. Nevertheless, many side-effects are being reported after COVID-19 vaccinations and myocarditis is the most commonly reported sequelae post vaccination. Majority of these diseases are associated with COVID-19 mRNA vaccines. Various studies have established a temporal relationship between these complications, yet the causality and the underlying pathogenesis remain hypothetical. In this review, we aim to critically appraise the available literature regarding the cardiovascular side effects of the various mRNA vaccines and the associated pathophysiology.

Chilaiditi syndrome: A structural displacement in a heart failure patient.

BACKGROUND: Chilaiditi's sign is often found incidentally on chest or abdominal radiograph and can be accompanied by clinical symptoms such as abdominal pain, gastrointestinal complications, and less commonly associated with dyspnea. CASE PRESENTATION: In this interesting case, we discover lingering dyspnea in our 79 year old male with a past medical history of asthma and heart failure with preserved ejection fraction admitted for acute heart failure exacerbation with reduced ejection fraction along with a new incidental finding of Chilaiditi's sign on chest radiograph. Patient received optimal diuretics and guideline-directed medical treatment for heart failure exacerbation, but mild dyspnea with pleuritic chest pain persisted. Dyspnea with pleurisy was likely attributed to a structural anatomical defect (Chilaiditi's sign) that can be picked up on imaging. CONCLUSION: Chilaiditi syndrome can be an incidental cause of ongoing persistent dyspnea, and if symptoms are severe, intervention can be warranted for symptomatic resolution. LEARNING OBJECTIVE: Chilaiditi syndrome should be considered as a possible diagnosis among patients with a history of heart failure and incidental Chilaiditi's sign on chest radiographic imaging who suffer from persistent dyspnea and pleurisy despite optimal diuretics and guideline-directed medical treatment.

COVID-19 and mucormycosis superinfection: Exploring the missing pathophysiological links.

The coronavirus disease 2019 continues to unearth new facets that portend grave clinical implications. In recent times, there has been mounting fervor regarding coronavirus disease 2019 and mucormycosis superinfection. While the correlation between the two is conspicuous, the underlying pathophysiological mechanisms that render a patient with coronavirus disease 2019 susceptible to mucormycosis, or vice versa, are still elusive.

Safety and Efficacy of Low-Dose Corticosteroids in Patients With Non-severe Coronavirus Disease 2019: A Retrospective Cohort Study.

Background To date, several pharmacological agents have been employed in the treatment and management of the coronavirus disease 2019 (COVID-19). While the utility of corticosteroids in severe COVID-19 infection is now widely touted, their efficacy in thwarting the progression of non-severe disease remains elusive. Methods A retrospective cohort study involving 25 patients with a confirmed diagnosis of non-severe COVID-19 infection was conducted. Subjects were assigned to either the steroid or the non-steroid group. A low-dose, short-course corticosteroid regimen was administered for seven days and the disease outcomes were recorded and compared among the two groups. The Kolmogorov-Smirnov test was employed to discern the data normality. Results In patients treated with low-dose, short-course steroids, the overall all-cause mortality was significantly lower compared with the non-steroid group (8.3% and 61.5%, respectively; p = 0.005). The prevalence of acute respiratory distress syndrome in the steroid group was significantly lower than that in the non-steroid group at the seven-day mark (16.7% and 84.6%, respectively; p = 0.002). Within the steroid group, the incidence of developing secondary complications was also markedly lower than that in the non-steroid group. Conclusions In patients afflicted with non-severe COVID-19, the employment of low-dose, short-course corticosteroids may confer a therapeutic advantage, significantly curtailing the mortality rate, the length of hospital stay, and the risk of developing secondary complications.