ABSTRACT
Despite the contemporary techniques and devices available for invasive cardiology procedures, the current diagnostic, and interventional modalities have many shortcomings. As a contemporary cross-disciplinary technique, nanotechnology has demonstrated great potential in interventional cardiology practice. It has a pivotal role in detecting sensitive cardiac biomarkers, nanoparticle-enhanced gadolinium (Gd) contrast to enhance the detection of atherosclerotic cardiovascular disease (ASCVD), and multimodal imaging like including optical coherence tomography (OCT)/infrared luminescence (IR) for coronary plaque characterization. Furthermore, in invasive cardiology, the potential benefit is in miniaturized cardiac implantable electronic devices (CIEDs), including leadless pacemakers and piezoelectric nanogenerators to self-power symbiotic cardiac devices. Nanoparticles are ideal for therapeutic drug delivery systems for atherosclerotic plaque regression, regeneration of fibrotic cardiomyocytes, and disruption of bacterial biofilm to enhance and prolong the effects of antimicrobial agents in infective endocarditis (IE). In summary, nanotechnology-assisted therapies can overtake conventional invasive cardiology and expand the horizon of microtechnology in the diagnosis and treatment of CAD in the foreseeable future.
ABSTRACT
INTRODUCTION: Ramadan is a month of obligatory fasting observed by the majority of 2 billion Muslims living around the globe. The guidelines for 'risk-free' fasting exist for chronic diseases, including diabetes mellitus, but recommendations for cardiovascular disease (CVD) patients are deficient due to the paucity of literature. AREAS COVERED: Databases were screened to find relevant studies for an evidence-based consensus regarding the risk stratification and management of CVD. Using practical guidelines of the European Society of Cardiology (ESC), we categorized patients into low-, moderate-, and high-risk categories and proposed a pre-Ramadan checklist for the assessment of cardiac patients before fasting. Regular moderate-intensity exercise is recommended for most cardiac patients, which has been demonstrated to provide an anti-inflammatory and antioxidant effect that improves immune function. EXPERT OPINION: In Ramadan, many physiological changes occur during fasting, which brings about a balanced metabolic homeostasis of the body. In addition, Ramadan fasting is a nonpharmacologic means of decreasing CV risk factors. As Islam exempts Muslims from fasting if they are unwell; therefore, patients with the acute coronary syndrome (ACS), advanced heart failure (HF), recent percutaneous coronary intervention (PCI), or cardiac surgery should avoid fasting.
