Acute tobacco cigarette (TC) smoking increases blood pressure and sympathetic nerve activity, whereas there are scarce data on the impact of electronic cigarette (EC) smoking. We assessed the acute effects of TC, EC and sham smoking on blood pressure, heart rate and sympathetic nervous system. Methods: We studied 12 normotensive male habitual smokers (mean age 33 years) free of cardiovascular disease. The study design was randomized and sham controlled with three experimental sessions (sham smoking, TC smoking and EC smoking). After baseline measurements at rest, the subjects were then asked to smoke (puffing habits left uncontrolled) two TC cigarettes containing 1.1 mg nicotine, EC smoking or simulated smoking with a drinking straw with a filter (sham smoking), in line with previous methodology. Results: EC smoking at 5 and 30 min compared to baseline was accompanied by the augmentation of mean arterial pressure (MAP) and heart rate (p < 0.001 for all). The muscle sympathetic nerve activity (MSNA) decrease was significant during both TC and EC sessions (p < 0.001 for both comparisons) and was similar between them (−25.1% ± 9.8% vs. −34.4% ± 8.3%, respectively, p = 0.018). Both MSNA decreases were significantly higher (p < 0.001 for both comparisons) than that elicited by sham smoking (−4.4% ± 4.8%). Skin sympathetic nerve activity increase was significant in both TC and EC groups (p < 0.001 for both comparisons) and similar between them (73.4% ± 17.9% and 71.9% ± 7%, respectively, p = 0.829). Conclusions: The unfavorable responses of sympathetic and arterial pressure to EC smoking are similar to those elicited by TC in healthy habitual smokers.

Background: Real-world data show limited utilization of direct oral anticoagulants (DOACs) in obese patients (body mass index [BMI] ≥ 30 kg/m²) due to concerns regarding their efficacy and safety in this demographic. Aim: This review aimed to consolidate current evidence on the efficacy and safety of DOACs versus warfarin in obese patients with non-valvular atrial fibrillation (AF) or venous thromboembolism (VTE). The primary efficacy outcome assessed a composite of all-cause mortality, stroke, systemic embolism (SE), and myocardial infarction (MI). Methods: A systematic search was conducted in MEDLINE, SCOPUS, and Cochrane databases from inception to December 28, 2023. Data were synthesized using random-effects meta-analysis. Results: A total of 35 studies involving 434,320 participants were analyzed. DOAC use was associated with a significant reduction in the risk of the composite outcome (RR = 0.80, 95% CI [0.65, 0.98], I² = 95%), hemorrhagic stroke (RR = 0.58, 95% CI [0.38, 0.88], I² = 92%), major bleeding (RR = 0.76, 95% CI [0.63, 0.92], I² = 94%), gastrointestinal bleeding (RR = 0.59, 95% CI [0.49, 0.72], I² = 88%), and intracranial bleeding (RR = 0.45, 95% CI [0.34, 0.60], I² = 44%) compared to warfarin. A non-significant benefit of DOACs was observed for all-cause mortality, MI, the composite of stroke or SE, ischemic stroke, SE, VTE, and minor bleeding compared to warfarin. Subgroup analysis indicated no significant effect modification based on the indication for anticoagulation or study design. Conclusions: DOACs demonstrated a favorable efficacy and safety profile in obese individuals compared to warfarin.

Heart failure (HF) poses a significant world health challenge due to the increase in the aging population and advancements in cardiac care. In the pathophysiology of HF, the inflammasome has been correlated with the development, progression, and complications of HF disease. Discovering biomarkers linked to inflammasomes enhances understanding of HF diagnosis and prognosis. Directing inflammasome signaling emerges as an innovative therapeutic strategy for managing HF. The present review aims to delve into this inflammatory cascade, understanding its role in the development of HF, its potential role as biomarker, as well as the prospects of modulating inflammasomes as a therapeutic approach for HF.

Cardiovascular disease is commonly accompanied by renal dysfunction. Multimorbidity in hospitalized patients impacts unfavorably on prognosis and hospital stay. We aimed to illustrate the contemporary burden of cardiorenal morbidity across inpatient cardiology care in Greece. The Hellenic Cardiorenal Morbidity Snapshot (HECMOS) used an electronic platform to collect demographic and clinically relevant information about all patients hospitalized on the 3^rd of March 2022 in Greece. The participating institutions covered all levels of inpatient cardiology care and most of the country's territories in order to collect a real-world, nation representative sample. 923 patients (males 68.4%, median age 73ys ± 14.8) were admitted in 55 different cardiology departments. 57.7% of the sample were older than 70 years of age. Hypertension was highly prevalent, present in 66% of cases. History of chronic HF, DM, AF and CKD was present in 38%, 31.8%, 30% and 26% respectively. 64.1% of the sample exhibited at least one of these four entities. Accordingly, a combination of at least 2 of them was recorded in 38.7%, of at least three in 18.2% whereas 4.3% of the sample combined all four morbid conditions in their past medical history. The most common combination was the coexistence of HF-AF accounting for 20.6% of the sample. 9 out of 10 non-electively admitted patients were hospitalized due to acute HF (39.9%), ACS (33.5%) or tachyarrhythmias (13.2%). HECMOS participants carried a remarkable burden of cardio-reno-metabolic disease. HF in conjunction with AF were found to be the most prevalent combination among the studied cardiorenal nexus of morbidities in the whole study population.

Obesity can cause the onset of heart failure and exacerbate the status of the pre-existing disease. Through intricate pathways, obesity activates hormonal factors that encourage the development of inflammation and lead to increased congestion. Consequently, this complex parallel pathophysiological cascade contributes to the echocardiographic and clinical signs of heart failure. In these patients, obesity frequently coexists with nutritional and muscular profile abnormalities that manifest as cachexia or sarcopenia. Patients with heart failure have a higher chance of surviving when obesity is treated. Interventional, pharmaceutical, and dietary strategies are used as forms of therapy. This review delves into the evaluation of the relationship between obesity and heart failure, and it targets to highlight the therapeutical impact of weight-loss programs on cardiac function in individuals with heart failure and obesity.

Takotsubo syndrome (TTS) is a clinical syndrome defined most typically by transient systolic dysfunction and dilatation of the apex of the left ventricle or other regional areas in the documented absence of obstructive coronary artery disease. Although more commonly presented in postmenopausal women, there are reports in the literature of TTS during the peripartum and postpartum periods. Early TTS diagnosis in pregnancy is of great importance in improving both maternal and fetal mortality. Although TTS involves many pathogenetic pathways, the imbalance between declining estrogen and arising sympathetic nervous system tone plays an important role. This review aims to provide recent published evidence of TTS in pregnancy and delve into the epidemiology of TTS in pregnancy, the pathophysiological mechanisms involved, the prognosis of TTS for the mother and the fetus, and its therapeutic multi-disciplinary management.