Hypertension is a major risk factor for heart disease and stroke. Garlic has a long history of use in traditional medicine for various conditions, including hypertension. This narrative review examined the scientific evidence on the efficacy of garlic in lowering blood pressure. It explores the historical uses of garlic in different cultures for medicinal purposes and delves into the phytochemical composition of garlic, highlighting key components, like allicin and ajoene, that are believed to contribute to its potential health benefits. Clinical studies that investigated the effects of garlic and garlic-based supplements on blood pressure are presented, with the findings suggesting that garlic consumption may modestly reduce blood pressure, particularly in individuals with mild hypertension. Potential mechanisms of action include increased nitric oxide production, improved endothelial function, and antioxidant properties. While garlic may offer some benefits for blood pressure management, it should not be considered a substitute for conventional antihypertensive medications. Further large-scale, long-term clinical trials are warranted to establish the efficacy of garlic in managing hypertension, including the optimal dosage and formulation.

The management of advanced heart failure (HF) has long posed significant challenges due to its complex and chronic nature. Heart transplantation, while effective, is not always feasible due to the limited availability of donor organs. In this context, long term mechanical circulatory support and mainly left ventricular assist devices (LVADs) have emerged as a vital intervention to fill this gap. LVAD superiority compared to medical therapy for some patients in advanced heart failure has been demonstrated either as a bridge to transplantation or as destination therapy. This literature review provides a comprehensive overview of the effectiveness, challenges, and advancements in the use of LVADs for treating advanced heart failure. It evaluates clinical outcomes associated with LVAD therapy, focusing on survival rates and quality of life improvements. The review synthesizes findings from recent studies, highlighting both the benefits and complications of LVAD implantation, such as infectious risk, thromboembolic events, hemorrhage and device malfunction. Additionally, it explores the latest technological and biomedical advancements in LVAD design, including innovations in biocompatibility, miniaturization, and power management. By examining current research, this review aims to elucidate how LVADs are transforming heart failure treatment and to offer insights into future directions for clinical practice and research.

Atrial Fibrillation | Epidemiology | Lebanon | Fibrillation Auriculaire | Épidémiologie | Liban

Electrocardiogram | Outcome | Predictors | Premature Ventricular Complexes | Radiofrequency Catheter Ablation

Cardiovascular diseases remain the leading cause of morbidity and mortality worldwide, with cardioembolic events accounting for a substantial proportion of adverse outcomes. Left atrial strain (LAS), particularly left atrial reservoir strain (LASr), has recently been incorporated into contemporary guideline‐based assessment of left ventricular diastolic function, representing its only established routine clinical application. Beyond this role, accumulating evidence identifies LAS as a sensitive marker of atrial mechanical dysfunction, capturing early alterations in reservoir, conduit, and contractile function. Reduced LAS is consistently associated with elevated left ventricular filling pressures and with increased risks of ischemic stroke, atrial fibrillation, adverse cardiac remodeling, and heart failure. These observations position LAS as a promising tool for refined risk stratification, early disease detection, and prognostic evaluation across a broad spectrum of cardiovascular conditions. However, outside diastolic function assessment, these applications remain investigational and are not yet validated for routine clinical use. Ongoing advances in speckle‐tracking echocardiography, multimodality imaging, and artificial intelligence are expected to enhance the reproducibility and clinical integration of LAS. This paper provides a comprehensive review of the emerging role of LAS as a potential noninvasive sensitive biomarker for the early detection, risk evaluation, prognostic assessment, and therapeutic guidance of major cardiovascular events, specifically cardioembolic strokes, heart failure, cardiomyopathies, and coronary artery diseases. Abbreviations: ACM or AtCM, atrial cardiomyopathy; ACS, acute coronary syndrome; AF, atrial fibrillation; AI, artificial intelligence; ARVC, arrhythmogenic right ventricular cardiomyopathy; AUC, area under the curve; BMI, body mass index; CA, cardiac amyloidosis; CAD, coronary artery disease; CCT, cardiac computed tomography; CCTA, cardiac computed tomography angiography; CHF, congestive heart failure; CIS, cryptogenic ischemic stroke; CKD, chronic kidney disease; CMR, cardiac magnetic resonance; CRP, C‐reactive protein; CRT, cardiac resynchronization therapy; CS, cryptogenic stroke; DCM, dilated cardiomyopathy; EAT, epicardial adipose tissue; ECG, electrocardiogram; ESE, exercise stress echocardiography; ESUS, embolic strokes of undetermined source; HCM, hypertrophic cardiomyopathy; HF, heart failure; HFpEF, heart failure with preserved ejection fraction; HR, heart rate; HTN, hypertension; ILs, interleukins; LA, left atrial; LAA, left atrial appendage; LAA MD, Left atrial appendage mechanical dispersion; LACI, LA coupling index; LACM, left atrial cardiomyopathy; LAEF, LA emptying fraction; LAGLS, reduced left atrial global longitudinal strain; LAS, left atrial strain; LAScd, LA strain conduit; LASct, LA contractile strain; LASr, Left atrial reservoir strain; LASTI, left atrial strain time integral; LAVI, left atrial volume index; LAViH ² , LA volume indexed to height ² ; LAVImin, the LA minimum volume index; LBBB, left bundle branch block; LGE, late Gadolinium enhancement; LV, left ventricular; LVAs, low‐voltage areas; LVDD, left ventricular diastolic dysfunction; LVEDD, left ventricular end‐diastolic diameter; LVEF, left ventricular ejection fraction; LVH, left ventricular hypertrophy; MACE, major adverse cardiovascular events; METs, metabolic equivalents; MPO, myeloperoxidase; NOHCM, nonobstructive HCM; NOS, nitric oxide synthase; Nox, NADPH oxidase; NT‐proBNP, N‐terminal‐pro brain natriuretic peptide; PALS, peak atrial longitudinal strain; PTFV1, P‐terminal force in lead V1; PVI, pulmonary vein isolation; RA, right atrial; RASr, lower RA reservoir strain; RCM, restrictive cardiomyopathy; ROI, region of interest; ROS, reactive oxidant species; SCD, sudden cardiac death; SEC, spontaneous echo contrast; STE, speckle tracking echocardiography; STEMI, ST‐elevation myocardial infarction; TAC, transverse aortic constriction; TAVI, transcatheter aortic valve implantation; TNF‐α, tumor necrosis factor‐alpha; vWf, von Willebrand factor; WMH, white matter hyperintensities. Mohamad Al Qassab, Christopher Sleiman these authors contributed equally.

Several randomized controlled trials (RCTs), animal studies, and observational studies have demonstrated the cardioprotective effects of statins, though their effectiveness varies. The observed variability may be attributed to individual differences, patient ages, disparities in statin type and dosage of anthracyclines (ANT) administered, and variations in cancer conditions among patients. Overall, statins play a beneficial role in reducing oxidative stress and inflammation, enhancing tumor sensitivity to chemotherapeutic drugs, improving mitochondrial function in cardiac cells, exerting antiapoptotic effects, and preserving left ventricular ejection fraction (LVEF). Despite these promising findings, the long‐term effects of statins remain unclear due to the lack of a standardized protocol. Statins may also cause side effects by depleting essential substances in the body. This limitation underscores the need for further research to assess their long‐term impact and establish standardized guidelines for dosing, duration, and potential side effects. The implications of this review highlight the importance of understanding the pleiotropic effects of statins to develop targeted therapies for chemotherapy‐induced cardiotoxicity. Additionally, integrating ongoing research into clinical guidelines is essential, ensuring that clinicians carefully consider patient‐specific factors when prescribing statins alongside ANT. This present review explores the potential role of statins in mitigating ANT‐induced cardiotoxicity, a major complication of chemotherapy that reduces LVEF and leads to heart failure (HF).