Cardiovascular Diseases & Diagnosis

Background: Many chronic conditions, as Diabetes Mellitus (DM) and cardiovascular Diseases, suffer Major Adverse Cardiac Events (MACE): myocarditis, congestive heart failure (CHF), Ventricular Tachycardia (VT), Ventricular Fibrillation (VF), Acute Coronary Syndromes [ACSs], and Sudden Cardiac Death (SCD) Acute infections, like COVID-19, also involve oxidative stress, leading to increased Sympathetic tone (S) and decreased Parasympathetic tone (P), increasing Sympathovagal Balance (SB) and MACE. The antioxidant (r) Alpha Lipoic Acid (ALA) improves SB. The anti-anginal Ranolazine (RAN), also an antioxidant, is an anti-arrhythmic. Our studies of their effects on MACE, in DM, and non-DM patients with CHF, ventricular arrhythmias and SCD are reviewed herein, as our findings may apply to acute diseases, such as COVID-19.

Methods: (1) In a case-control study, 109 CHF patients, 54 were given adjunctive off-label RAN added to ACC/AHA Guideline therapy (RANCHF). MACE and SB were compared with 55 NORANCHF patients; mean f/u 23.7 mo. (2) 59 adults with triggered premature ventricular contractions (PVCs), bigeminy, and VT were given off-label RAN. Pre- and post-RAN Holters were compared; mean f/u 3.1 mo. (3) 133 DM II with cardiac diabetic autonomic neuropathy were offered (r) ALA; 83 accepted; 50 refused. P&S were followed a mean of 6.31 years, and SCDs recorded.

Results: (1) 70% of RANCHF patients increased LVEF 11.3 EFUs (p ≤ 0.003), SCD reduced 56%; VT/VF therapies decreased 53%. (2) 95% of patients responded: VT decreased 91% (p<0.001). (3) SCD was reduced 43% in DM II patients taking (r) ALA (p=0.0076).

Conclusion: RAN, (r) ALA treats CHF, VT, and prevents SCD. Trials in COVID-19 are needed.

The pathogenesis of atrial fibrillation is driven by three key elements: an electrical trigger for arrhythmia initiation, an arrhythmogenic substrate for its maintenance and factors which may modulate the condition. A hybrid epicardial-endocardial approach, particularly the minimally invasive Convergent hybrid technique, to isolate pulmonary veins and silence the left atrial posterior wall is likely to provide improved outcomes.

Bicuspid aortic valve (BAV) is the commonest congenital heart disease affecting predominantly male sex (male to female ratio 3:1), with an estimated incidence in general population ranging from 0.9 to 2%. Due to its abnormal geometry and mechanical stress, this valve anatomy is a predisposing condition for the development of calcific aortic stenosis.

Journal of Cardiovascular Diseases & Diagnosis aims to publish most complete and reliable source of information on the discoveries and current developments in cardiovascular medicine and making them freely available through online Open Access without any restrictions or any other subscriptions to researchers worldwide.

Acute coronary syndrome is most often caused by plaque rupture or clot formation in the heart's arteries. Symptoms may include heart attack-like chest pressure, chest pressure while resting or doing light activity or sudden heart stoppage