Background: Doxorubicin (Dox)-induced cardiotoxicity is the most important side effect of the drug and significantly limits its use in susceptible patients. Therefore, preventive measures are required to alleviate the Dox-induced cardiac failure. In this study, curcumin, a strong antioxidant agent, was investigated for its potential protective effect on dox-induced cardiotoxicity with its effect on Apelin expression as a mediator of cardiac function. Methods: Wistar albino rats were equally divided into four groups as Control, DOX, CUR, and CUR+DOX. Dox was administered a single dose of 20 mg/kg bw intraperitoneally while 100 mg/kg bw curcumin was given orally for 14 days before the Dox use. Results: DOX group showed a prolonged QT interval on an electrocardiogram and elevated cardiac troponin levels. In biochemical analyses, decreased Superoxide Dismutase activity and increased Malondialdehyde level and Catalase activity were detected in DOX group. Gene expression of Apelin decreased significantly while NF-κB increased in DOX group. Degenerative changes in histopathology, and increased iNOS and nitrotyrosine immunoreactivity were detected in DOX group. However, no significant changes were observed at reduced Glutathione, TNF-, and IL-1β levels. Curcumin use in Dox-given rats altered most of the disturbed parameters investigated in this study, indicating an alleviating effect on Dox-induced cardiotoxicity. Serum and heart Apelin levels and mRNA expression in heart tissue were detected to significantly increase in CUR+DOX group as compared to DOX group. Furthermore, NF-κB mRNA expression was significantly decreased in heart tissue of CUR+DOX group compared with the DOX group. Conclusions: The results suggest that Apelin acts as an important mediator in Dox cardiotoxicity and may be used as a target for treatment of certain cardiomyopathies. By regulating Apelin expression, curcumin may serve as a potential adjunct in cardioprotective approaches.

Objective: To evaluate the diagnostic value of ultrasonography (US) and shear wave elastography (SWE) in detecting early renal parenchymal changes in patients with congestive heart failure (CHF) with preserved or mildly impaired renal function. Methods: This prospective study included 53 patients with CHF patients and 40 age- and demographic-matched healthy controls. Kidney length and cortical thickness were evaluated by US, and parenchymal stiffness was measured using SWE. Subgroup analyses were conducted based on ejection fraction (EF). Correlation and regression analyses assessed associations between imaging findings and laboratory parameters. Results: Kidney length and cortical thickness were significantly lower in CHF patients than controls (P < .05) but remained within normal limits. No significant differences were observed between patient subgroups (P > .05). Parenchymal stiffness was significantly higher in CHF patients (right: 6.5 ± 1.6 kPa; left: 6.4 ± 2.0 kPa) compared to controls (right: 4.8 ± 0.4 kPa; left: 4.9 ± 0.5 kPa; P < .001), with subgroup differences by EF (P < .01). ROC analysis identified optimal SWE thresholds of 5.05 kPa (right) and 5.03 kPa (left), with sensitivities of 78% and 80% and specificities of 69% and 70%. Regression analysis showed GFR (β = −.48, P < .001) and comorbidities (β = .397, P = .010) independently predicted stiffness, whereas EF, pro-BNP, and creatinine did not. Conclusions: SWE can detect subclinical renal changes in CHF before functional deterioration, offering a non-invasive biomarker for early diagnosis and personalized treatment strategies. Advances in knowledge: SWE may provide earlier detection of parenchymal alterations than conventional US.

Background: Determining a relationship between coronavirus disease 2019 (COVID-19) and the ECG findings of the patients with this disease can assist in early diagnosis and patient management based on these findings. This study aimed to investigate whether COVID-19 patients had characteristic ECG findings in the acute period. Methods: A total of 124 patients were divided into two groups as those diagnosed with COVID-19 and controls. The ECGs of these patients were evaluated in terms of rate, rhythm, presence of ST changes, PR interval, QRS width, QTc and QT interval, and presence of right and left bundle branch blocks. Results: On the ECG, the median heart rate of the COVID-19 patients was 104/min (IQR: 99–114), and there was a significant difference compared to the control group (P<0.001). The median PR interval was 157/ms, the QRS width was 86 ± 9/ms in the COVID-19 patients, with no significant difference compared to the controls (P = 0.161 and P = 0.631, respectively). The median QT interval of the COVID-19 patients was normal (400/ms), but a significant difference was detected compared to the controls (P = 0.005). The QTc, ST change, AF, and presence of right and left bundle branch blocks were not significantly different between the two groups. Conclusion: Considering the importance of ECG findings in order to diagnose COVID-19 disease early, we can state that sinus tachycardia is very common in COVID-19 patients, but there is no characteristic ECG finding for COVID-19, including tachycardia.

Doxorubicin (DOX) is an anthracycline derivative used for treatment of malignancies; however, its clinical use is limited by its cardiotoxicity. We investigated the effects of angiotensin II type 2 receptor agonist compound 21 (C21) on DOX induced heart failure in rat heart. We compared C21 with losartan (LOS), an AT 1 receptor antagonist used for treating heart failure. We allocated 40 rats into five groups of eight: saline treated control group, DOX group administered a single 20 mg/kg dose of DOX, DOX + C21 group administered 0.3 mg/kg C21 for 21 days following the 20 mg/kg dose of DOX, DOX + losartan (LOS) group administered a 21 day regimen of 20 mg/kg LOS following the single dose of DOX, and a DOX + LOS + C21 group administered 0.3 mg/kg C21 and 20 mg/kg LOS for 21 days following the single dose of DOX. We assessed histopathology and conducted echocardiograpic and hemodynamic measurements. Left ventricular ejection fraction (EF) was reduced only in the DOX treated group. C21, LOS and C21 + LOS therapy prevented decreased EF due to DOX. Less histopathology was observed in the DOX + LOS + C21 group than for the other treatment groups. Application of C21 decreased DOX induced cardiac injury similar to LOS. Combined use of C21 and LOS was most beneficial for DOX induced heart failure.