(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.

Background: With a steady increase in prevalence, chronic obstructive pulmonary disease (COPD) is recognized as a leading contributor to global mortality, which underscores the need to identify prognostic biomarkers that are easy to use in everyday practice. As both local and systemic inflammation play a pivotal part in the development and progression of COPD, the purpose of our study was to assess the role of inflammatory markers in estimating disease severity (GOLD 1 to 4) to guide the management and treatment of patients with COPD, thus helping to reduce episodes of decompensation and fatal outcomes in both immediate and long-term contexts. Methods: We performed a descriptive observational analysis with a cross-sectional design including 100 patients with stable COPD. All subjects underwent standard clinical examination, lung function tests and a comprehensive inflammation blood panel. Results: We included 55 patients with mild–moderate COPD (GOLD 1–2), 33 patients with advanced stages of COPD (GOLD 3) and 12 patients with very severe forms of the disease (GOLD 4). Male sex, smoking status, BMI, IL-1 beta, NLR, and nocturnal heart rate were parameters with significant value for assessing COPD severity (p < 0.05 for all). NLR correlates significantly with the predicted distance in the 6 MWT (p = 0.039). Significant associations were identified between IL-8 and duration of exposure of biomass fuel (p = 0.045) as well as between IL-6 and pack-years (p = 0.024), with both prognostic and therapeutic impact. Furthermore, the analysis of the total cohort revealed positive correlations between serum IL-6 and FVC (%) (p = 0.033) or NLR and the ratio between FEV1 and FVC (p = 0.048). The neutrophil-to-lymphocyte ratio (NLR) proved to be a reliable indicator of stages 3–4 GOLD (AUC 0.66, threshold value 2.3045, p = 0.004—a one-point increase in NLR corresponded to a 2.148 increase in FEV1). Conclusions: NLR emerged as a simple, accessible and highly informative biomarker in COPD, linked to disease severity and functional decline. Its integration into routine assessment could enhance prognosis and guide clinical decisions, a finding that warrants confirmation in future multicenter studies.

Cardiovascular disease is one of the leading causes of morbid-mortality, although better outcomes and lower mortality of age-adjusted coronary artery disease were registered since 1980s, especially in high-income populations, sustaining the cost effective of cardiac prevention methods. The aim of this prospective study was to evaluate the role of cardiac rehabilitation in improving psycho-emotional risk scores: the Hamilton Depression (HAM-D) and Anxiety Rating Scale (HAM-A) in coronary artery bypass grafting (CABG) patients, in less than one week after cardiovascular surgery and in 6 months follow-up after the engagement in the cardiac recovery program. Methods – During 01.05.2015 – 01.03.2017, CABG was performed in 100 patients, aged 40-80 years old, who followed rehabilitation in the Cardiovascular Rehabilitation Clinic. The mean age of the patients under study was 65.70 ± 9.91 years old. Results – In the fi rst phase of the cardiovascular rehabilitation program, the mean values were: 16 points for HAM-D, and 25 points on HAM-A scale. By comparing the Phase I and Phase III results, the median HAM-D score improved more than 50%, and HAM-A about 36% (p<0.05). Conclusion – The study highlighted the role of early rehabilitation after CABG surgery and the HAM-D and HAM-A scores improvement, emphasizing the importance of including psycho-emotional status assessment in the management of the patient who benefi ted from cardiac surgery. Apart from clinical data and the cardiovascular risk scores, the psycho-emotional risk stratification can provide important information regarding outcomes and prognosis.

Razan Al Namat, Maura Gabriela Felea, Irina Iuliana Costache, Viviana Aursulesei, Antoniu Petris, Ovidiu Mitu, Mihai Constantin, Victorita Sorodoc, Laurentiu Sorodoc, Ionela Larisa Miftode, Radu Miftode, Nadia Al Namat, Dina Al Namat, Andreea Luta, Adriana Ion, Mirela Mihaela Mihalcia, Manuela Ciocoiu, Grigore Tinica, Florin Mitu - Heart-Type Fatty Acid-Binding Protein (H-FABP) in Patients with Type 2 Diabetes Beneficiaries of Rehabilitation Program Post Coronary Artery Bypass Grafting

Chronic obstructive pulmonary disease (COPD) is increasingly recognized as a systemic disease characterized by chronic inflammation and oxidative stress, with frequent cardiovascular involvement. This study investigated the associations between oxidative stress-related inflammatory markers and structural and electrical cardiac abnormalities in patients with COPD using a comprehensive multimodal cardiopulmonary assessment. A total of 100 clinically stable patients with COPD underwent inflammatory biomarker evaluation (IL-6, IL-8, IL-1β, and TNF-α), transthoracic echocardiography and 24 h Holter ECG monitoring. Advanced COPD was associated with significant differences in several structural cardiac parameters, including left atrial volume (p = 0.016), left atrial height (p = 0.027), and selected left ventricular parameters, while left ventricular ejection fraction remained preserved. Electrical abnormalities were significantly associated with systemic inflammatory markers. SII showed the highest discriminatory performance for sinus rhythm abnormalities (AUC = 0.736), whereas IL-6 showed the highest discriminatory performance for ventricular premature complexes (AUC = 0.732). Ventricular ectopic activity was also associated with significantly higher SII, SIRI, MLR, NLR, and PLR. Systemic inflammatory markers were associated with structural and electrical cardiac abnormalities in COPD, suggesting that they may provide complementary information regarding cardiovascular involvement. However, given the cross-sectional design and moderate discriminatory performance of these biomarkers, the findings should be considered exploratory and do not establish causal relationships. Prospective studies are needed to determine their potential role in cardiovascular risk stratification.