Inflammation is a key factor in the development of atherosclerosis, a disease characterized by the buildup of plaque in the arteries. COVID-19 infection is known to cause systemic inflammation, but its impact on local plaque vulnerability is unclear. Our study aimed to investigate the impact of COVID-19 infection on coronary artery disease (CAD) in patients who underwent computed tomography angiography (CCTA) for chest pain in the early stages after infection, using an AI-powered solution called CaRi-Heart^®. The study included 158 patients (mean age was 61.63 ± 10.14 years) with angina and low to intermediate clinical likelihood of CAD, with 75 having a previous COVID-19 infection and 83 without infection. The results showed that patients who had a previous COVID-19 infection had higher levels of pericoronary inflammation than those who did not have a COVID-19 infection, suggesting that COVID-19 may increase the risk of coronary plaque destabilization. This study highlights the potential long-term impact of COVID-19 on cardiovascular health, and the importance of monitoring and managing cardiovascular risk factors in patients recovering from COVID-19 infection. The AI-powered CaRi-Heart^® technology may offer a non-invasive way to detect coronary artery inflammation and plaque instability in patients with COVID-19.

Introduction: The prognostic value of epicardial fat thickness (EFT) and inflammatory biomarkers such as hs-CRP have not been fully investigated in patients with acute myocardial infarction (AMI) and type 2 diabetes mellitus (DM). The study aim was to assess the correlation between the EFT, the persistence of elevated circulating levels of hs-CRP at 7 ± 2 days after an AMI and the amplitude of the left ventricular (LV) remodeling, in patients with type 2 DM. Methods: The study included 98 patients (45 with type 2 DM and 43 with no DM): Group 1 included 22 low-to-intermediate risk patients (hsCRP 3 mg/l) patients. EFT, LV function and remodeling were assessed at baseline and at six months after AMI in both groups. Results: In the diabetic population, the EFT was significantly higher in patients who developed ventricular remodeling as compared with those who did not (8.02 ± 1.80 mm vs. 6.65 ± 2.17 mm, p = 0.02) and significantly correlated with the circulating levels of hs-CRP (r = 0.6251, p <0.0001). The levels of circulating hs-CRP, at baseline, significantly correlated with the RI at six months (r = 0.39, p <0.001). Also, in the diabetic population, the epicardial fat thickness was significantly higher in patients who developed ventricular remodeling as compared with those who did not (8.02 ± 1.80 mm vs. 6.65 ± 2.17 mm, p = 0.02). The epicardial adipose tissue thickness significantly correlated with the circulating levels of hs-CRP (r = 0.6251, p <0.0001), while in the non-diabetic population, EFT was not significantly higher in patients who developed ventricular remodeling as compared with those who did not (71.38 ± 9.09 vs. 67.4 ± 10.17, p = 0.23). Multivariate analysis identified the hs-CRP values (OR: 4.09, p = 0.03) and the EFT (OR: 6.11, p = 0.01) as significant independent predictors for LV remodeling in diabetic population. Conclusions: A larger EFT is associated with a more severe remodeling and impairment of ventricular function in patients with type 2 DM and AMI.

Background: This systematic review seeks to evaluate the role of epicardial adipose tissue (EAT), quantified either by thickness, assessed by transthoracic echocardiography, or by volume, assessed by cardiac computed tomography (CT), in the follow-up of patients with acute coronary syndromes (ACS). Method: One-hundred forty-four articles were screened, from which 56 were reviewed in full-text. From those, 47 studies were excluded for the following reasons: they did not meet the inclusion criteria; they were either reviews or meta-analyses; the study cohorts included only stable coronary artery disease patients; they did not state a clear and concise study design, endpoints, or follow-up. The final draft included nine studies for systematic evaluation. Results: Of the 2,306 patients included in the review, 170 underwent cardiac CT while the remaining 2,136 underwent transthoracic echocardiography for the measurement of EAT. The analysis found that the EAT thickness was significantly associated with major adverse cardiovascular events (MACE) rates during hospitalization (OR: -1.3, 95% CI: 1.05-1.62, p = 0.020) and at three years (HR: 1.524, 95% CI: 1.0-2.2, p = 0.038). The included studies found that EAT was correlated with the following clinical and angiographic risk scores for ACS: GRACE (r = 0.438, p <0.001), TIMI risk score (r = 0.363, p = 0.001), SYNTAX score (r = 0.690, p <0.0001; r = 0.610, p <0.01), and Gensini score (r = 0.438, p = 0.001). There was an inverse correlation between ST-segment resolution of <70% after revascularization and EAT (r = −0.414, p = 0.01), and the myocardial blush grade (r = −0.549, p <0.001). The EF aggregation ranged between 2.65 mm and 4.7 mm within the included studies. Conclusions: EAT, evaluated either by echocardiography or cardiac CT, correlates with the severity of coronary lesions, with the clinical and angiographic risk scores for acute coronary syndromes, with indicators for coronary reperfusion, and with short- and long-term MACE rates. Further studies are required to fully elucidate the role of this extensively studied but still novel cardiovascular biomarker as part of a risk prediction tool.

Wound healing is a complex restorative process of the altered cutaneous tissue, which is impaired by numerous local and systemic factors, leading to chronic non-healing lesions with few efficient therapeutic options. Stem cells possess the capacity to differentiate into various types of cell lines. Furthermore, stem cells are able to secrete cytokines and growth factors, modulating inflammation and ultimately leading to angiogenesis, fibrogenesis, and epithelization. Because of their paracrine activity, these cells are able to attract other cell types to the base of the wound, improving the formation of new skin layers. Mesenchymal stem cells derived from the adipose tissue, bone marrow, and placenta, offer numerous ways of implementation. The process of harvesting, growing, and administrating stem cells depends on the site and type of the cells, but recent trial results showed improvement of wound healing independent of the administration site. Bioengineered skin substitutes are validated for treatment of chronic wounds with direct application on the skin surface. These offer physical scaffolding for the migrating cells and promote secretion of growth factors, thus facilitating rapid wound healing. Obtaining further clinical data is essential, but stem cell therapy may become a first-line therapeutic choice for the treatment of non-healing chronic wounds.