Cardiovascular disease (CVD) is a global health concern, causing significant morbidity and mortality. Both lifestyle and genetics influence the development of CVD. It is often diagnosed late, when the treatment options are limited. Early diagnosis of CVD with help of biomarkers is necessary to prevent adverse outcomes. SARS-CoV-2 infection can cause cardiovascular complications even in patients with no prior history of CVD. This review highlights cardiovascular biomarkers, including novel ones, and their applications as diagnostic and prognostic markers of cardiovascular complications related to SARS-CoV-2 infection. Patients with severe SARS-CoV-2 infection were shown to have elevated levels of cardiac biomarkers, namely N-terminal pro-brain natriuretic peptide (NT-pro-BNP), creatine kinase-myocardial band (CK-MB), and troponins, indicating acute myocardial damage. These biomarkers were also associated with higher mortality rates and therefore should be used throughout COVID-19 patient care to identify high-risk patients promptly to optimize their outcomes. Additionally, microRNAs (miRNAs) are also considered as potential biomarkers and predictors of cardiac and vascular damage in SARS-CoV-2 infection. Identifying molecular pathways contributing to cardiovascular manifestations in COVID-19 is essential for development of early biomarkers, identification of new therapeutic targets, and better prediction and management of cardiovascular outcomes.

Background and Objectives: Metabolic syndrome (MS) represents several diseases encompassing a heterogeneous group of biochemical and physiological abnormalities characterized by structural and functional alterations in the myocardium, including the endothelium of the coronary arteries. MS also affects a substantial portion of the global population. Understanding the risk factors, the development and treatment associated with MS are of paramount importance for early identification, treatment and prevention. This study was designed to evaluate the role of the supplementation of omega-3 polyunsaturated fatty acids (n-3 PUFAs) on endothelial function in patients with MS. Materials and Methods: A total of 80 patients with MS were enrolled in two groups. The study evaluated endothelial function (EF) in subjects before and after a three-month treatment with n-3 PUFAs in a dose of 2.4 g daily (800 mg, three times a day) vs. placebo, using an Endo-PAT2000 device (Itamar Medical Ltd., Caesarea, Israel) measuring the reactive hyperemia index (a parameter of EF) and augmentation index (a parameter of arterial stiffness). Plasmatic levels of glutathione peroxidase, homocysteine, apolipoprotein B and lipoprotein were also evaluated for comparison. Results: The results showed that the average value of reactive hyperemia index before the treatment with n-3 PUFAs was 1.62 ± 0.42, compared to 1.96 ± 0.62 at the end of the study (p < 0.005). The augmentation index changed from 14.66 ± 19.55 to 9.21 ± 15.64 after the treatment (p = 0.003) with n-3 PUFA. The results also revealed a statistically significant decrease in apolipoprotein B (0.94 ± 0.36 vs. 1.13 ± 0.35, p = 0.001) and homocysteine (19.31 ± 5.29 vs. 13.78 ± 3.05, p = 0.001) and an increase in glutathione peroxidase plasma levels (41.65 ± 8.90 vs. 45.20 ± 8.01), p = 0.001. Conclusions: The results of this prospective study showed a significant improvement in EF in subjects with MS treated with n-3 PUFAs in a dose of 2.4 g daily.

Aim: Evaluation of role of supplementation of omega-3 polyunsaturated fatty acids on endothelial function in patients with metabolic syndrome. Methods: Total of 80 patients with metabolic syndrome were enrolled to two groups. We evaluated endothelial function in subjects before and after three-month treatment with omega-3 polyunsaturated fatty acids in dose 2.4g daily (800mg 3 times a day) vs placebo. Using the Endo-PAT2000 device (Itamar Medical Ltd. Caesarea, Israel), reactive hyperemia index – a parameter of endothelial function and augmentation index– a parameter of arterial stiffness were measured. Plasmatic level of glutation peroxidase, homocysteine, apolipoprotein B and lipoprotein (a) were also evaluated. Results: The average values of reactive hyperemia index before the treatment with n-3PUFA was 1.62 ± 0.42 , whereas 1.96 ± 0.62 at the end of the study (p<0.005). Augmentation index changed from 14.66 ± 19.55 to 9.21 ± 15.64 after the treatment (p=0.003). We also observed statistically significant decrease of apolipopotein B (0.94 ± 0.36 vs 1.13 ± 0.35, p = 0.001) and homocysteine (19.31 ± 5.29 vs. 13.78 ± 3.05, p = 0.001) and increase of the glutathion perxidase plasma levels (41.65 ± 8.90 vs. 45.20 ± 8.01), p=0.001. Conclusion: We have observed significant improvement of the endothelial function in subjects with metabolic syndrome treated with omega-3 polyunsaturated fatty acids in dose 2.4g daily.