Introduction: Increasingly, SGLT2 inhibitors save patients with heart failure and comorbidities such as type-2 diabetes mellitus (T2DM) and chronic kidney disease (CKD); the inhibition of sodium-glucose cotransporter 2 (SGLT2) was first studied in patients with diabetes as a solution to lower glucose levels by preventing glucose reabsorption and facilitating its elimination; in the process, researchers took notice of how SGLT2 inhibitors also seemed to have beneficial cardiovascular effects in patients with both diabetes and cardiovascular disease. Aim: Our single-center prospective study assesses outcomes of post-coronary artery bypass grafting (CABG) rehabilitation and SLGT2 inhibition in CABG patients with/without T2DM and with/without CKD. Materials and Methods: One hundred twenty consecutive patients undergoing CABG were included in the analysis. Patients were divided into four subgroups: diabetes patients with chronic kidney disease (T2DM + CKD), diabetes patients without chronic kidney disease (T2DM−CKD), prediabetes patients with chronic kidney disease (PreD+CKD), and prediabetes patients without chronic kidney disease (PreD−CKD). Echocardiographic and laboratory investigations post-surgery (phase I) and 6 months later (phase II) included markers for cardiac ischemia, glycemic status, and renal function, and metabolic equivalents were investigated. Results: One hundred twenty patients participated, mostly men, overweight/obese, hypertensive, smokers; 65 had T2DM (18 with CKD), and 55 were prediabetic (17 with CKD). The mean ejection fraction increased by 8.43% overall but significantly more in the prediabetes group compared to the T2DM group (10.14% vs. 6.98%, p < 0.05). Overall, mean heart-type fatty-acid-binding protein (H-FABP) levels returned to normal levels, dropping from 68.40 ng/mL to 4.82 ng/mL (p = 0.000), and troponin data were more nuanced relative to an overall, strongly significant decrease of 44,458 ng/L (p = 0.000). Troponin levels in patients with CKD dropped more, both in the presence of T2DM (by 82,500 ng/L, p = 0.000) and in patients without T2DM (by 73,294 ng/L, p = 0.047). As expected, the overall glycated hemoglobin (HbA1c) levels improved significantly in those with prediabetes (from 6.54% to 5.55%, p = 0.000); on the other hand, the mean HbA1c changed from 7.06% to 6.06% (p = 0.000) in T2DM, and the presence or absence of CKD did not seem to make any difference: T2DM+CKD 7.01–6.08% (p = 0.000), T2DM−CKD 7.08–6.04% (p = 0.000), PreD+CKD 5.66–4.98% (p = 0.014), and PreD−CKD 6.03–4.94% (p = 0.00). Compared to an overall gain of 11.51, the GFRs of patients with CKD improved by 18.93 (68.15–87.07%, p = 0.000) in the presence of established diabetes and 14.89 (64.75–79.64%, p = 0.000) in the prediabetes group. Conclusions: Regarding the patients’ cardiac statuses, the results from our single-center analysis revealed a significant decrease in ischemic risk (H-FABP and hs-cTnI levels) with improvements in mean ejection fraction, glycemic status, and renal function in patients post-CABG with/without T2DM, with/without CKD, and with SGLT2 inhibitor dapagliflozin treatment while undergoing cardiac rehabilitation.

Omphalocele is the most common ventral abdominal wall defect. Omphalocele is associated with other significant anomalies in up to 80% of cases, among which the cardiac ones are the most frequent. The aim of our paper is to highlight, through a review of the literature, the importance and frequency of association between the two malformations and what impact this association has on the management and evolution of patients with these pathologies. We reviewed the titles, the available abstracts, and the full texts of 244 papers from the last 23 years, from three medical databases, to extract data for our review. Due to the frequent association of the two malformations and the unfavorable effect of the major cardiac anomaly on the prognosis of the newborn, the electrocardiogram and echocardiography must be included in the first postnatal investigations. The timing of surgery for abdominal wall defect closure is mostly dictated by the cardiac defect severity, and usually the cardiac defect takes priority. After the cardiac defect is medically stabilized or surgically repaired, the omphalocele reduction and closure of the abdominal defect are performed in a more controlled setting, with improved outcomes. Compared to omphalocele patients without cardiac defects, children with this association are more likely to experience prolonged hospitalizations, neurologic, and cognitive impairments. Major cardiac abnormalities such as structural defects that require surgical treatment or result in developmental delay will significantly increase the death rate of patients with omphalocele. In conclusion, the prenatal diagnosis of omphalocele and early detection of other associated structural or chromosomal anomalies are of overwhelming importance, contributing to the establishment of antenatal and postnatal prognosis.

(1) Background: The heart-type fatty acid-binding protein (H-FABP) is a specific myocardial biomarker and high levels indicate ischemia regardless of patient-reported symptoms. Concurrently, major adverse cardiovascular events and surgery such as coronary artery by-pass grafting (CABG) cause substantial psycho-emotional distress e.g., depression and anxiety. Comprehensive cardiac rehabilitation is, therefore, essential to both physical and psychological recovery. (2) Methods: This is a unicentric, prospective study on 120 consecutive post-CABG patients undergoing a 6-month cardiac rehabilitation program based on physical exercise, Mediterranean diet principles, and Q10 coenzyme antioxidant supplements. H-FABP levels, depression, and anxiety scores (Hamilton HAM-D and HAM-A scales) were monitored after surgery and at 6 months. (3) Results: Mean H-FABP dropped from 60.56 to 4.81. Physical ability increased from 1–2 to 4–5 METS. Mean depression and anxiety improved from 15.88 to 6.96 and from 25.13 to 15.68, respectively. Median scores went down 50% for depression and 9% for anxiety. Explored associations between H-FABP and psycho-emotional status were statistically insignificant. (4) Conclusions: patients adhered to the program and improved significantly in all studied aspects. Clinical significance is discussed in the context of countries like Romania, where such programs are limited by systemic and financial constraints. Further research directions are identified.

The relationship between the classical cardiac biomarker and acute myocardial infarction (STEMI) in patients with COVID-19 is far from being elucidated. Furthermore, superoxide dismutase (SOD), a marker for oxidative stress, was associated with cardiac ischemia. Also, Galectin-3 is significant for defining the relationship between cardiac fibrosis and COVID-19. There are no studies on the effect of SARS-CoV-2 virus infection and vaccination on patients with STEMI and biomarkers above-mentioned. Aim: our single-center prospective study assesses the relationship between COVID-19 infection with/without vaccination and the value of SOD and Galectin-3 in STEMI patients. Material and methods: In total, 93 patients with STEMI and SARS-CoV-2 virus infection were included in the analysis, patients were divided in two groups based on COVID-19 vaccination status. Echocardiographic and laboratory investigations for cardiac ischemia, oxidative stress, and cardiac fibrosis biomarkers were investigated. Results: In total, 93 patients were included, the majority of which were male (72.0%), 45.2% (n = 42) were vaccinated against SARS-CoV-2; the mean age of vaccinated patients is 62 years, and 57% (n = 53) are smokers; blood pressure is found with a higher frequency in unvaccinated people (62.7%) compared to 28.6% in vaccinated people (p = 0.015), and 90.5% of the vaccinated people presented STEMI, compared with 96.1% of the unvaccinated ones. Revascularization with one stent was achieved in 47.6% of the vaccinated people and 72.5% for the unvaccinated people (p = 0.015). Galectin-3 was slightly more reduced in the vaccinated patients compared to the unvaccinated patients (0.73 vs. 0.99; p = 0.202), and the average level of Cu/ZnSOD was slightly more reduced in vaccinated patients compared to the unvaccinated patients (0.84 vs. 0.91; p = 0.740). Conclusions: Regarding patient’s SARS-CoV-2 infection functional status, the results from our single-center analysis did not find a statistically significant decrease in oxidative stress and cardiac fibrosis biomarkers along with cardiovascular complication following STEMI treated with percutaneous coronary angioplasty (PCI) in the case of patients with COVID-19 vaccination compared with patients who did not receive COVID-19 vaccine. Anyway, our data suggest that contemporary PCI techniques may offer an alternative revascularization strategy that enables complex CAD COVID-19 patients to be safely discharged from hospital.