1 755 199 CARDIOVASCULAR RISK IN FATTY LIVER DISEASE: THE LIVER-HEART AXIS-LITERATURE REVIEW. ACCORDING TO THE WORLD HEALTH ORGANIZATION, CARDIOVASCULAR DISEASE (CVD) REMAINS THE LEADING CAUSE OF DEATH WORLDWIDE, ACCOUNTING FOR APPROXIMATELY 18 MILLION DEATHS PER YEAR. NEVERTHELESS, THE WORLDWIDE PREVALENCE OF METABOLIC DISEASES, SUCH AS TYPE 2 DIABETES MELLITUS, OBESITY, AND NON-ALCOHOLIC FATTY LIVER DISEASE (NAFLD), ALSO KNOWN TO BE COMMON RISK FACTORS FOR CVD, HAVE DRAMATICALLY INCREASED OVER THE LAST DECADES. CHRONIC ALCOHOL CONSUMPTION IS A MAJOR CAUSE OF CHRONIC LIVER DISEASES (CLD) AS WELL AS BEING A MAJOR HEALTH CARE COST EXPENDITURE ACCOUNTING FOR THE SPENDING OF TREMENDOUS AMOUNTS OF MONEY ANNUALLY. NAFLD HAS BECOME ONE OF THE MAJOR DISEASES PLAGUING THE WORLD WHILE STANDING AS THE MOST COMMON CAUSE OF LIVER DISEASE IN THE WESTERN COUNTRIES BY REPRESENTING ABOUT 75% OF ALL CLD. CURRENTLY, THE MOST COMMON CAUSE OF DEATH IN NAFLD REMAINS TO BE CVD. SEVERAL MECHANISMS HAVE BEEN SUGGESTED TO BE RESPONSIBLE FOR ASSOCIATING FLD WITH CVD THROUGH SEVERAL MECHANISMS INCLUDING LOW-GRADE SYSTEMIC INFLAMMATION, OXIDATIVE STRESS, ADIPOKINES, ENDOPLASMIC RETICULUM STRESS, LIPOTOXICITY AND MICROBIOTA DYSBIOSIS WHICH MAY ALSO BE INFLUENCED BY OTHER FACTORS SUCH AS GENETIC AND EPIGENETIC VARIATIONS. DESPITE OF ALL THIS EVIDENCE, THE EXACT MECHANISMS OF HOW FLD CAN CAUSALLY CONTRIBUTE TO CVD ARE NOT FULLY ELUCIDATED AND MUCH REMAINS UNKNOWN. MOREOVER, THE CURRENT LITERATURE SUPPORTS THE INCREASING EVIDENCE ASSOCIATING FLD WITH SEVERAL CARDIOVASCULAR (CV) ADVERSE EVENTS INCLUDING CORONARY ARTERY DISEASE, INCREASED SUBCLINICAL ATHEROSCLEROSIS RISK, STRUCTURAL ALTERATIONS MAINLY LEFT VENTRICULAR HYPERTROPHY, INCREASED EPICARDIAL FAT THICKNESS, VALVULAR CALCIFICATIONS INCLUDING AORTIC VALVE SCLEROSIS AND MITRAL ANNULAR CALCIFICATION AND FUNCTIONAL CARDIAC MODIFICATIONS MAINLY DIASTOLIC DYSFUNCTION IN ADDITION TO CARDIAC ARRHYTHMIAS SUCH AS ATRIAL FIBRILLATION AND VENTRICULAR ARRYTHMIAS AND CONDUCTION DEFECTS INCLUDING ATRIOVENTRICULAR BLOCKS AND BUNDLE BRANCH BLOCKS. PATIENTS WITH FLD SHOULD BE EVALUATED AND MANAGED ACCORDINGLY IN ORDER TO PREVENT FURTHER COMPLICATIONS. POSSIBLE MANAGEMENT METHODS INCLUDE NON-PHARMACOLOGICAL STRATEGIES INCLUDING LIFE STYLE MODIFICATIONS, PHARMACOLOGICAL THERAPIES AS WELL AS SURGICAL MANAGEMENT. THIS REVIEW AIMS TO SUMMARIZE THE CURRENT STATE OF KNOWLEDGE REGARDING THE PATHOPHYSIOLOGICAL MECHANISMS LINKING FLD WITH AN INCREASED CV RISK, IN ADDITION TO ASSOCIATED CV ADVERSE EVENTS AND CURRENT MANAGEMENT MODALITIES. 2019 2 6357 53 THE ROLE OF HYPERGLYCAEMIA IN THE DEVELOPMENT OF DIABETIC CARDIOMYOPATHY. DIABETES MELLITUS IS A METABOLIC DISORDER WITH A CHRONIC HYPERGLYCAEMIC STATE. CARDIOVASCULAR DISEASES ARE THE PRIMARY CAUSE OF MORTALITY IN PATIENTS WITH DIABETES. INCREASING EVIDENCE SUPPORTS THE EXISTENCE OF DIABETIC CARDIOMYOPATHY, A CARDIAC DYSFUNCTION WITH IMPAIRED CARDIAC CONTRACTION AND RELAXATION, INDEPENDENT OF CORONARY AND/OR VALVULAR COMPLICATIONS. DIABETIC CARDIOMYOPATHY CAN LEAD TO HEART FAILURE. SEVERAL PRECLINICAL AND CLINICAL STUDIES HAVE AIMED TO DECIPHER THE UNDERLYING MECHANISMS OF DIABETIC CARDIOMYOPATHY. AMONG ALL THE CO-FACTORS, HYPERGLYCAEMIA SEEMS TO PLAY AN IMPORTANT ROLE IN THIS PATHOLOGY. HYPERGLYCAEMIA HAS BEEN SHOWN TO ALTER CARDIAC METABOLISM AND FUNCTION THROUGH SEVERAL DELETERIOUS MECHANISMS, SUCH AS OXIDATIVE STRESS, INFLAMMATION, ACCUMULATION OF ADVANCED GLYCATED END-PRODUCTS AND UPREGULATION OF THE HEXOSAMINE BIOSYNTHESIS PATHWAY. THESE MECHANISMS ARE RESPONSIBLE FOR THE ACTIVATION OF HYPERTROPHIC PATHWAYS, EPIGENETIC MODIFICATIONS, MITOCHONDRIAL DYSFUNCTION, CELL APOPTOSIS, FIBROSIS AND CALCIUM MISHANDLING, LEADING TO CARDIAC STIFFNESS, AS WELL AS CONTRACTILE AND RELAXATION DYSFUNCTION. THIS REVIEW AIMS TO DESCRIBE THE HYPERGLYCAEMIC-INDUCED ALTERATIONS THAT PARTICIPATE IN DIABETIC CARDIOMYOPATHY, AND THEIR CORRELATION WITH THE SEVERITY OF THE DISEASE AND PATIENT MORTALITY, AND TO PROVIDE AN OVERVIEW OF CARDIAC OUTCOMES OF GLUCOSE-LOWERING THERAPY. 2021 3 716 43 CALCIFIC AORTIC VALVE DISEASE-NATURAL HISTORY AND FUTURE THERAPEUTIC STRATEGIES. CALCIFIC AORTIC VALVE DISEASE (CAVD) IS THE MOST FREQUENT HEART VALVE DISORDER. IT IS CHARACTERIZED BY AN ACTIVE REMODELING PROCESS ACCOMPANIED WITH VALVE MINERALIZATION, THAT RESULTS IN A PROGRESSIVE AORTIC VALVE NARROWING, SIGNIFICANT RESTRICTION OF THE VALVULAR AREA, AND IMPAIRMENT OF BLOOD FLOW.THE PATHOPHYSIOLOGY OF CAVD IS A MULTIFACETED PROCESS, INVOLVING GENETIC FACTORS, CHRONIC INFLAMMATION, LIPID DEPOSITION, AND VALVE MINERALIZATION. MINERALIZATION IS STRICTLY RELATED TO THE INFLAMMATORY PROCESS IN WHICH BOTH, INNATE, AND ADAPTIVE IMMUNITY ARE INVOLVED. THE UNDERLYING PATHOPHYSIOLOGICAL PATHWAYS THAT GO FROM INFLAMMATION TO CALCIFICATION AND, FINALLY LEAD TO SEVERE STENOSIS, REMAIN, HOWEVER, INCOMPLETELY UNDERSTOOD. HISTOPATHOLOGICAL STUDIES ARE LIMITED TO PATIENTS WITH SEVERE CAVD AND NO SAMPLES ARE AVAILABLE FOR LONGITUDINAL STUDIES OF DISEASE PROGRESSION. THEREFORE, ALTERNATIVE ROUTES SHOULD BE EXPLORED TO INVESTIGATE THE PATHOGENESIS AND PROGRESSION OF CAVD.RECENTLY, INCREASING EVIDENCE SUGGESTS THAT EPIGENETIC MARKERS SUCH AS NON-CODING RNAS ARE IMPLICATED IN THE LANDSCAPE OF PHENOTYPICAL CHANGES OCCURRING IN CAVD. FURTHERMORE, THE MICROBIOME, AN ESSENTIAL PLAYER IN SEVERAL DISEASES, INCLUDING THE CARDIOVASCULAR ONES, HAS RECENTLY BEEN LINKED TO THE INFLAMMATION PROCESS OCCURRING IN CAVD. IN THE PRESENT REVIEW, WE ANALYZE AND DISCUSS THE CAVD PATHOPHYSIOLOGY AND FUTURE THERAPEUTIC STRATEGIES, FOCUSING ON THE REAL AND PUTATIVE ROLE OF INFLAMMATION, CALCIFICATION, AND MICROBIOME. 2020 4 465 55 ARE TARGETED THERAPIES FOR DIABETIC CARDIOMYOPATHY ON THE HORIZON? DIABETES INCREASES THE RISK OF HEART FAILURE APPROXIMATELY 2.5-FOLD, INDEPENDENT OF CORONARY ARTERY DISEASE AND OTHER COMORBIDITIES. THIS PROCESS, TERMED DIABETIC CARDIOMYOPATHY, IS CHARACTERIZED BY INITIAL IMPAIRMENT OF LEFT VENTRICULAR (LV) RELAXATION FOLLOWED BY LV CONTRACTILE DYSFUNCTION. POST-MORTEM EXAMINATION REVEALS THAT HUMAN DIASTOLIC DYSFUNCTION IS CLOSELY ASSOCIATED WITH LV DAMAGE, INCLUDING CARDIOMYOCYTE HYPERTROPHY, APOPTOSIS AND FIBROSIS, WITH IMPAIRED CORONARY MICROVASCULAR PERFUSION. THE PATHOPHYSIOLOGICAL MECHANISMS UNDERPINNING THE CHARACTERISTIC FEATURES OF DIABETIC CARDIOMYOPATHY REMAIN POORLY UNDERSTOOD, ALTHOUGH MULTIPLE FACTORS INCLUDING ALTERED LIPID METABOLISM, MITOCHONDRIAL DYSFUNCTION, OXIDATIVE STRESS, ENDOPLASMIC RETICULUM (ER) STRESS, INFLAMMATION, AS WELL AS EPIGENETIC CHANGES, ARE IMPLICATED. DESPITE A RECENT RISE IN RESEARCH INTERROGATING THESE MECHANISMS AND AN INCREASED UNDERSTANDING OF THE CLINICAL IMPORTANCE OF DIABETIC CARDIOMYOPATHY, THERE REMAINS A LACK OF SPECIFIC TREATMENT STRATEGIES. HOW THE CHRONIC METABOLIC DISTURBANCES OBSERVED IN DIABETES LEAD TO STRUCTURAL AND FUNCTIONAL CHANGES REMAINS A PERTINENT QUESTION, AND IT IS HOPED THAT RECENT ADVANCES, PARTICULARLY IN THE AREA OF EPIGENETICS, AMONG OTHERS, MAY PROVIDE SOME ANSWERS. THIS REVIEW HENCE EXPLORES THE TEMPORAL ONSET OF THE PATHOLOGICAL FEATURES OF DIABETIC CARDIOMYOPATHY, AND THEIR RELATIVE CONTRIBUTION TO THE RESULTANT DISEASE PHENOTYPE, AS WELL AS BOTH CURRENT AND POTENTIAL THERAPEUTIC OPTIONS. THE EMERGENCE OF GLUCOSE-OPTIMIZING AGENTS, NAMELY GLUCAGON-LIKE PEPTIDE-1 (GLP-1) AGONISTS AND SODIUM/GLUCOSE CO-TRANSPORTER (SGLT)2 INHIBITORS THAT CONFER BENEFITS ON CARDIOVASCULAR OUTCOMES, TOGETHER WITH NOVEL EXPERIMENTAL APPROACHES, HIGHLIGHT A NEW AND EXCITING ERA IN DIABETES RESEARCH, WHICH IS LIKELY TO RESULT IN MAJOR CLINICAL IMPACT. 2017 5 543 38 ATRIAL FIBRILLATION IS ASSOCIATED WITH HYPERMETHYLATION IN HUMAN LEFT ATRIUM, AND TREATMENT WITH DECITABINE REDUCES ATRIAL TACHYARRHYTHMIAS IN SPONTANEOUSLY HYPERTENSIVE RATS. ATRIAL FIBRILLATION (AF) IS THE MOST COMMON CARDIAC ARRHYTHMIA. AS THE MOLECULAR MECHANISMS UNDERLYING THE PATHOLOGY ARE LARGELY UNKNOWN, THIS CARDIAC ARRHYTHMIA REMAINS DIFFICULT TO TREAT. TO IDENTIFY SPECIFIC MOLECULAR ACTORS INVOLVED IN AF, WE HAVE PERFORMED A TRANSCRIPTOMIC ANALYSIS ON LEFT ATRIUM (LA) FROM PATIENTS WITH VALVULAR HEART DISEASE WITH OR WITHOUT AF. WE SHOWED THAT 1627 GENES HAD ALTERED BASAL EXPRESSION LEVEL IN LA TISSUE OF AF PATIENTS COMPARED WITH THE CONTROL GROUP. THE SIGNIFICANTLY ENRICHED GENE ONTOLOGY BIOLOGICAL PROCESS "ANATOMICAL STRUCTURE MORPHOGENESIS" CONTAINED THE HIGHEST NUMBER OF GENES IN LINE WITH CHANGES IN STRUCTURE THAT OCCUR WHEN THE HUMAN HEART REMODELS FOLLOWING AF DEVELOPMENT (IE, LA DILATATION AND INTERSTITIAL FIBROSIS). WE THEN FOCUSED THE STUDY ON PITX2 (PAIRED-LIKE HOMEODOMAIN 2), BEING THE MOST ALTERED TRANSCRIPTION FACTOR IN LA FROM AF PATIENTS AND FROM WHICH COMPELLING EVIDENCE HAVE INDICATED THAT ITS REDUCED EXPRESSION CAN BE CONSIDERED AS A MARKER FOR THE DISEASE. IN ADDITION, ITS EXPRESSION WAS INVERSELY CORRELATED WITH LA SIZE. WE DEMONSTRATED THAT AF IS ASSOCIATED WITH PITX2 PROMOTER HYPERMETHYLATION BOTH IN HUMANS AND ARRHYTHMIC AGING SPONTANEOUSLY HYPERTENSIVE RATS. CHRONIC ADMINISTRATION OF A DNA METHYLATION INHIBITOR (IE, 5-AZA-2'-DEOXYCITIDINE) IMPROVED ECG ARRHYTHMIC PROFILES AND SUPEROXIDE DISMUTASE ACTIVITIES AND REDUCED FIBROSIS IN THE LEFT VENTRICLE OF SPONTANEOUSLY HYPERTENSIVE RATS. TAKEN TOGETHER, THESE DATA SUPPORT THE NOTION THAT AF IS ASSOCIATED WITH EPIGENETIC CHANGES IN LA AND PROVIDE A PROOF-OF-CONCEPT THAT HYPOMETHYLATING AGENTS HAVE TO BE CONSIDERED IN THE TREATMENT OF ATRIAL ARRHYTHMIAS. 2017 6 4734 45 NOVEL CONCEPTS IN RADIATION-INDUCED CARDIOVASCULAR DISEASE. RADIATION-INDUCED CARDIOVASCULAR DISEASE (RICVD) IS THE MOST COMMON NONMALIGNANT CAUSE OF MORBIDITY AND MORTALITY AMONG CANCER SURVIVORS WHO HAVE UNDERGONE MEDIASTINAL RADIATION THERAPY (RT). CARDIOVASCULAR COMPLICATIONS INCLUDE EFFUSIVE OR CONSTRICTIVE PERICARDITIS, CARDIOMYOPATHY, VALVULAR HEART DISEASE, AND CORONARY/VASCULAR DISEASE. THESE ARE PATHOPHYSIOLOGICALLY DISTINCT DISEASE ENTITIES WHOSE PREVALENCE VARIES DEPENDING ON THE TIMING AND EXTENT OF RADIATION EXPOSURE TO THE HEART AND GREAT VESSELS. ALTHOUGH REFINEMENTS IN RT DOSIMETRY AND SHIELDING WILL INEVITABLY LIMIT FUTURE CASES OF RICVD, THE INCREASING NUMBER OF LONG-TERM CANCER SURVIVORS, INCLUDING THOSE TREATED WITH OLDER HIGHER-DOSE RT REGIMENS, WILL ENSURE A STEADY FLOW OF AFFLICTED PATIENTS FOR THE FORESEEABLE FUTURE. THUS, THERE IS A PRESSING NEED FOR ENHANCED UNDERSTANDING OF THE DISEASE MECHANISMS, AND IMPROVED DETECTION METHODS AND TREATMENT STRATEGIES. NEWLY CHARACTERIZED MECHANISMS RESPONSIBLE FOR THE ESTABLISHMENT OF CHRONIC FIBROSIS, SUCH AS OXIDATIVE STRESS, INFLAMMATION AND EPIGENETIC MODIFICATIONS, ARE DISCUSSED AND LINKED TO POTENTIAL TREATMENTS CURRENTLY UNDER STUDY. NOVEL IMAGING MODALITIES MAY SERVE AS POWERFUL SCREENING TOOLS IN RICVD, AND RECENT RESEARCH AND EXPERT OPINION ADVOCATING THEIR USE IS INTRODUCED. DATA ARGUING FOR THE AGGRESSIVE USE OF PERCUTANEOUS INTERVENTIONS, SUCH AS TRANSCUTANEOUS VALVE REPLACEMENT AND DRUG-ELUTING STENTS, ARE EXAMINED AND CONSIDERED IN THE CONTEXT OF PRIOR THERAPEUTIC APPROACHES. RICVD AND ITS TREATMENT OPTIONS ARE THE SUBJECT OF A RICH AND DYNAMIC BODY OF RESEARCH, AND PATIENTS WHO ARE AT RISK OR SUFFERING FROM THIS DISEASE WILL BENEFIT FROM THE CARE OF PHYSICIANS WITH SPECIALTY EXPERTISE IN THE EMERGING FIELD OF CARDIO-ONCOLOGY. 2016 7 74 59 A MULTIDISCIPLINARY APPROACH AND CURRENT PERSPECTIVE OF NONALCOHOLIC FATTY LIVER DISEASE: A SYSTEMATIC REVIEW. IN RECENT TIMES, NONALCOHOLIC FATTY LIVER DISEASE (NAFLD) HAS BEEN CONSIDERED ONE OF THE MAJOR CAUSES OF LIVER DISEASE ACROSS THE WORLD. NAFLD IS DEFINED AS THE DEPOSITION OF TRIGLYCERIDES IN THE LIVER AND IS ASSOCIATED WITH OBESITY AND METABOLIC SYNDROME. HYPERINSULINEMIA, INSULIN RESISTANCE (IR), FATTY LIVER, HEPATOCYTE INJURY, UNBALANCED PROINFLAMMATORY CYTOKINES, MITOCHONDRIAL DYSFUNCTION, OXIDATIVE STRESS, LIVER INFLAMMATION, AND FIBROSIS ARE THE MAIN PATHOGENESIS IN NAFLD. RECENT STUDIES SUGGEST THAT THE ACTION OF INTESTINAL MICROBIOTA THROUGH CHRONIC INFLAMMATION, INCREASED INTESTINAL PERMEABILITY, AND ENERGY UPTAKE PLAYS A VITAL ROLE IN NAFLD. MOREOVER, POLYCYSTIC OVARIAN SYNDROME ALSO CAUSES NAFLD DEVELOPMENT THROUGH IR. AGE, GENDER, RACE, ETHNICITY, SLEEP, DIET, SEDENTARY LIFESTYLE, AND GENETIC AND EPIGENETIC PATHWAYS ARE SOME CONTRIBUTING FACTORS OF NAFLD THAT CAN EXACERBATE THE RISK OF LIVER CIRRHOSIS AND HEPATOCELLULAR CARCINOMA (HCC) AND EVENTUALLY LEAD TO DEATH. NAFLD HAS VARIOUS PRESENTATIONS, INCLUDING FATIGUE, UNEXPLAINED WEIGHT LOSS, BLOATING, UPPER ABDOMINAL PAIN, DECREASED APPETITE, HEADACHE, ANXIETY, POOR SLEEP, INCREASED THIRST, PALPITATION, AND A FEELING OF WARMTH. SOME STUDIES HAVE SHOWN THAT NAFLD WITH SEVERE CORONAVIRUS DISEASE 2019 (COVID-19) HAS POOR OUTCOMES. THE GOLD STANDARD FOR NAFLD DIAGNOSIS IS LIVER BIOPSY. OTHER DIAGNOSTIC TOOLS ARE IMAGING TESTS, SERUM BIOMARKERS, MICROBIOTA MARKERS, AND TESTS FOR EXTRAHEPATIC COMPLICATIONS. THERE ARE NO SPECIFIC TREATMENTS FOR NAFLD. THEREFORE, THE MAIN CONCERN FOR NAFLD IS TREATING THE COMORBID CONDITIONS SUCH AS ANTI-DIABETIC AGENTS FOR TYPE 2 DIABETES MELLITUS, STATINS TO REDUCE HCC PROGRESSION, ANTIOXIDANTS TO PREVENT HEPATOCELLULAR DAMAGE, AND BARIATRIC SURGERY FOR PATIENTS WITH A BMI OF >40 KG/M(2) AND >35 KG/M(2) WITH COMORBIDITIES. LIFESTYLE AND DIETARY CHANGES ARE CONSIDERED PREVENTIVE STRATEGIES AGAINST NAFLD ADVANCEMENT. INADEQUATE TREATMENT OF NAFLD FURTHER LEADS TO CARDIAC CONSEQUENCES, SLEEP APNEA, CHRONIC KIDNEY DISEASE, AND INFLAMMATORY BOWEL DISEASE. IN THIS SYSTEMATIC REVIEW, WE HAVE BRIEFLY DISCUSSED THE RISK FACTORS, PATHOGENESIS, CLINICAL FEATURES, AND NUMEROUS CONSEQUENCES OF NAFLD. WE HAVE ALSO REVIEWED VARIOUS GUIDELINES FOR NAFLD DIAGNOSIS ALONG WITH EXISTING THERAPEUTIC STRATEGIES FOR THE MANAGEMENT AND PREVENTION OF THE DISEASE. 2022 8 5572 33 ROLE OF MICRORNA IN DIABETIC CARDIOMYOPATHY: FROM MECHANISM TO INTERVENTION. DIABETIC CARDIOMYOPATHY IS A CHRONIC AND IRREVERSIBLE HEART COMPLICATION IN DIABETIC PATIENTS, AND IS CHARACTERIZED BY COMPLEX PATHOPHYSIOLOGIC EVENTS INCLUDING EARLY DIASTOLIC DYSFUNCTION, CARDIAC HYPERTROPHY, VENTRICULAR DILATION AND SYSTOLIC DYSFUNCTION, EVENTUALLY RESULTING IN HEART FAILURE. DESPITE THESE CHARACTERISTICS, THE UNDERLYING MECHANISMS LEADING TO DIABETIC CARDIOMYOPATHY ARE STILL ELUSIVE. RECENT STUDIES HAVE IMPLICATED MICRORNA, A SMALL AND HIGHLY CONSERVED NON-CODING RNA MOLECULE, IN THE ETIOLOGY OF DIABETES AND ITS COMPLICATIONS, SUGGESTING A POTENTIALLY NOVEL APPROACH FOR THE DIAGNOSIS AND TREATMENT OF DIABETIC CARDIOMYOPATHY. THIS BRIEF REVIEW AIMS AT CAPTURING RECENT STUDIES RELATED TO THE ROLE OF MICRORNA IN DIABETIC CARDIOMYOPATHY. THIS ARTICLE IS PART OF A SPECIAL ISSUE ENTITLED: GENETIC AND EPIGENETIC CONTROL OF HEART FAILURE - EDITED BY JUN REN & MEGAN YINGMEI ZHANG. 2017 9 246 45 ADULT STEM CELL THERAPY FOR CARDIAC REPAIR IN PATIENTS AFTER ACUTE MYOCARDIAL INFARCTION LEADING TO ISCHEMIC HEART FAILURE: AN OVERVIEW OF EVIDENCE FROM THE RECENT CLINICAL TRIALS. BACKGROUND: CARDIOVASCULAR DISEASES (CVD) STILL REPRESENT THE LEADING CAUSE OF MORTALITY WORLDWIDE, DESPITE THE REMARKABLE ADVANCES IN INTERVENTIONAL CARDIOLOGY, CARDIAC SURGERY, AND MODERN PHARMACOTHERAPY, PARTICULARLY IN THE SETTING OF ACUTE MYOCARDIAL INFARCTION (AMI), CHRONIC ISCHEMIC HEART FAILURE (HF), CARDIOMYOPATHY (CM), AND THE ASSOCIATED LEFT VENTRICULAR (LV) DYSFUNCTION. A SIGNIFICANT LOSS OF CARDIOMYOCYTES THAT UNDERLIES ALL OF THESE CONDITIONS WAS PREVIOUSLY CONSIDERED IRREVERSIBLE. HOWEVER, CURRENT EVIDENCE INDICATES THAT THE HUMAN HEART HAS SOME POTENTIAL FOR REPAIR, AND OVER THE PAST DECADE, MANY RESEARCH STUDIES HAVE BEEN EXPLORING THE USE OF STEM CELLS (SCS) TO FACILITATE RESTORATION OF MYOCARDIUM. CONSEQUENTLY, THE SAFETY, FEASIBILITY, AND EFFECTIVENESS OF SC THERAPY HAVE BEEN REPORTED IN MANY RANDOMIZED CLINICAL TRIALS (RCTS), USING DIFFERENT LINEAGES OF ADULT SCS. NEVERTHELESS, THE CLINICAL BENEFITS OF SC THERAPY ARE NOT YET WELL ESTABLISHED. IN THE NEAR FUTURE, UNDERSTANDING OF THE COMPLEX INTERRELATIONS BETWEEN SCS, PARACRINE FACTORS, GENETIC OR EPIGENETIC PREDISPOSITIONS, AND MYOCARDIAL MICROENVIRONMENT, IN THE CONTEXT OF AN INDIVIDUAL PATIENT, WILL BE CRUCIAL FOR TRANSLATION OF THIS KNOWLEDGE INTO PRACTICAL DEVELOPMENT OF SUCCESSFUL, LONG-TERM REGENERATIVE SC THERAPEUTIC APPLICATIONS, IN A GROWING POPULATION OF PATIENTS SUFFERING FROM PREVIOUS MYOCARDIAL INFARCTION (MI) LEADING TO CHRONIC ISCHEMIC CARDIOMYOPATHY. CONCLUSION: THIS OVERVIEW HIGHLIGHTS THE THERAPEUTIC POTENTIAL OF ADULT SCS IN TERMS OF THEIR POSSIBLE REGENERATIVE CAPACITY, SAFETY, AND CLINICAL OUTCOMES, IN PATIENTS WITH AMI, AND/OR SUBSEQUENT HF (DUE TO CHRONIC ISCHEMIC CARDIOMYOPATHY). THIS REVIEW WAS BASED UPON PUBMED DATABASE SEARCH FOR TRIALS ON SC THERAPY, IN PATIENTS WITH AMI AND HF, AND THE MAIN TIMEFRAME WAS SET FROM 2006 TO 2016. 2017 10 1157 48 CONTAMINANT METALS AS CARDIOVASCULAR RISK FACTORS: A SCIENTIFIC STATEMENT FROM THE AMERICAN HEART ASSOCIATION. EXPOSURE TO ENVIRONMENTAL POLLUTANTS IS LINKED TO INCREASED RISK OF CARDIOVASCULAR DISEASE. BEYOND THE EXTENSIVE EVIDENCE FOR PARTICULATE AIR POLLUTION, ACCUMULATING EVIDENCE SUPPORTS THAT EXPOSURE TO NONESSENTIAL METALS SUCH AS LEAD, CADMIUM, AND ARSENIC IS A SIGNIFICANT CONTRIBUTOR TO CARDIOVASCULAR DISEASE WORLDWIDE. HUMANS ARE EXPOSED TO METALS THROUGH AIR, WATER, SOIL, AND FOOD AND EXTENSIVE INDUSTRIAL AND PUBLIC USE. CONTAMINANT METALS INTERFERE WITH CRITICAL INTRACELLULAR REACTIONS AND FUNCTIONS LEADING TO OXIDATIVE STRESS AND CHRONIC INFLAMMATION THAT RESULT IN ENDOTHELIAL DYSFUNCTION, HYPERTENSION, EPIGENETIC DYSREGULATION, DYSLIPIDEMIA, AND CHANGES IN MYOCARDIAL EXCITATION AND CONTRACTILE FUNCTION. LEAD, CADMIUM, AND ARSENIC HAVE BEEN LINKED TO SUBCLINICAL ATHEROSCLEROSIS, CORONARY ARTERY STENOSIS, AND CALCIFICATION AS WELL AS TO INCREASED RISK OF ISCHEMIC HEART DISEASE AND STROKE, LEFT VENTRICULAR HYPERTROPHY AND HEART FAILURE, AND PERIPHERAL ARTERY DISEASE. EPIDEMIOLOGICAL STUDIES SHOW THAT EXPOSURE TO LEAD, CADMIUM, OR ARSENIC IS ASSOCIATED WITH CARDIOVASCULAR DEATH MOSTLY ATTRIBUTABLE TO ISCHEMIC HEART DISEASE. PUBLIC HEALTH MEASURES REDUCING METAL EXPOSURE ARE ASSOCIATED WITH REDUCTIONS IN CARDIOVASCULAR DISEASE DEATH. POPULATIONS OF COLOR AND LOW SOCIOECONOMIC MEANS ARE MORE COMMONLY EXPOSED TO METALS AND THEREFORE AT GREATER RISK OF METAL-INDUCED CARDIOVASCULAR DISEASE. TOGETHER WITH STRENGTHENING PUBLIC HEALTH MEASURES TO PREVENT METAL EXPOSURES, DEVELOPMENT OF MORE SENSITIVE AND SELECTIVE MEASUREMENT MODALITIES, CLINICAL MONITORING OF METAL EXPOSURES, AND THE DEVELOPMENT OF METAL CHELATION THERAPIES COULD FURTHER DIMINISH THE BURDEN OF CARDIOVASCULAR DISEASE ATTRIBUTABLE TO METAL EXPOSURE. 2023 11 5025 41 PERSONALIZED MANAGEMENT OF CARDIOVASCULAR DISORDERS. PERSONALIZED MANAGEMENT OF CARDIOVASCULAR DISORDERS (CVD), ALSO REFERRED TO AS PERSONALIZED OR PRECISION CARDIOLOGY IN ACCORDANCE WITH GENERAL PRINCIPLES OF PERSONALIZED MEDICINE, IS SELECTION OF THE BEST TREATMENT FOR AN INDIVIDUAL PATIENT. IT INVOLVES THE INTEGRATION OF VARIOUS "OMICS" TECHNOLOGIES SUCH AS GENOMICS AND PROTEOMICS AS WELL AS OTHER NEW TECHNOLOGIES SUCH AS NANOBIOTECHNOLOGY. MOLECULAR DIAGNOSTICS AND BIOMARKERS ARE IMPORTANT FOR LINKING DIAGNOSIS WITH THERAPY AND MONITORING THERAPY. BECAUSE CVD INVOLVE PERTURBATIONS OF LARGE COMPLEX BIOLOGICAL NETWORKS, A SYSTEMS BIOLOGY APPROACH TO CVD RISK STRATIFICATION MAY BE USED FOR IMPROVING RISK-ESTIMATING ALGORITHMS, AND MODELING OF PERSONALIZED BENEFIT OF TREATMENT MAY BE HELPFUL FOR GUIDING THE CHOICE OF INTERVENTION. BIOINFORMATICS TOOLS ARE HELPFUL IN ANALYZING AND INTEGRATING LARGE AMOUNTS OF DATA FROM VARIOUS SOURCES. PERSONALIZED THERAPY IS CONSIDERED DURING DRUG DEVELOPMENT, INCLUDING METHODS OF TARGETED DRUG DELIVERY AND CLINICAL TRIALS. INDIVIDUALIZED RECOMMENDATIONS CONSIDER MULTIPLE FACTORS - GENETIC AS WELL AS EPIGENETIC - FOR PATIENTS' RISK OF HEART DISEASE. EXAMPLES OF PERSONALIZED TREATMENT ARE THOSE OF CHRONIC MYOCARDIAL ISCHEMIA, HEART FAILURE, AND HYPERTENSION. SIMILAR APPROACHES CAN BE USED FOR THE MANAGEMENT OF ATRIAL FIBRILLATION AND HYPERCHOLESTEROLEMIA, AS WELL AS THE USE OF ANTICOAGULANTS. PERSONALIZED MANAGEMENT INCLUDES PHARMACOTHERAPY, SURGERY, LIFESTYLE MODIFICATIONS, AND COMBINATIONS THEREOF. FURTHER PROGRESS IN UNDERSTANDING THE PATHOMECHANISM OF COMPLEX CARDIOVASCULAR DISEASES AND IDENTIFICATION OF CAUSATIVE FACTORS AT THE INDIVIDUAL PATIENT LEVEL WILL PROVIDE OPPORTUNITIES FOR THE DEVELOPMENT OF PERSONALIZED CARDIOLOGY. APPLICATION OF PRINCIPLES OF PERSONALIZED MEDICINE WILL IMPROVE THE CARE OF THE PATIENTS WITH CVD. 2017 12 4188 46 METABOLIC ASSOCIATED FATTY LIVER DISEASE IN CHILDREN AND ADOLESCENTS: MECHANISMS OF A SILENT EPIDEMIC AND THERAPEUTIC OPTIONS. NON-ALCOHOLIC FATTY LIVER DISEASE (NAFLD) IS NOW IDENTIFIED AS A HEPATIC SIGN OF METABOLIC SYNDROME AND IS THE MOST FREQUENT CAUSE OF CHRONIC LIVER DISEASE IN ALL AGES. IT IS ASSUMED THAT A GENETIC PREDISPOSITION ASSOCIATED WITH EPIGENETIC FACTORS PARTICIPATES IN THE EVOLUTION OF THIS CONDITION. VISCERAL OBESITY AND INSULIN RESISTANCE (IR) HAVE ALWAYS BEEN CONSIDERED THE MOST IMPORTANT CAUSATIVE FACTORS OF METABOLIC SYNDROME (METS) AND NAFLD, BUT CURRENTLY, THE INTERACTION BETWEEN GENETIC HERITAGE AND ENVIRONMENTAL FACTORS IS INCREASINGLY CONSIDERED FUNDAMENTAL IN THE GENESIS OF METABOLIC DISORDERS ASSOCIATED WITH NAFLD. IN FACT, IN PATIENTS WITH NAFLD, INSULIN RESISTANCE, ARTERIAL HYPERTENSION, ABDOMINAL OBESITY, DYSLIPIDEMIA AND REDUCED INTESTINAL PERMEABILITY HAVE OFTEN BEEN FOUND, AS WELL AS A HIGHER PREVALENCE OF CORONARY ARTERY DISEASE, OBSTRUCTIVE SLEEP APNEA, POLYCYSTIC OVARY SYNDROME AND OSTEOPENIA, WHICH DEFINE A METS FRAMEWORK. EARLY DIAGNOSIS IS NEEDED TO PREVENT DISEASE PROGRESSION THROUGH PRIMARILY LIFESTYLE INTERVENTIONS. UNFORTUNATELY, AT PRESENT, THERE ARE NO MOLECULES RECOMMENDED FOR PEDIATRIC PATIENTS. HOWEVER, SEVERAL NEW DRUGS ARE IN CLINICAL TRIALS. FOR THIS REASON, TARGETED STUDIES ON THE INTERACTION BETWEEN GENETICS AND ENVIRONMENTAL FACTORS INVOLVED IN THE DEVELOPMENT OF NAFLD AND METS AND ON THE PATHOGENETIC MECHANISMS THAT DETERMINE THE EVOLUTION IN NON-ALCOHOLIC STEATOHEPATITIS (NASH), SHOULD BE IMPLEMENTED. THEREFORE, IT IS DESIRABLE THAT FUTURE STUDIES MAY BE USEFUL IN IDENTIFYING PATIENTS AT RISK OF DEVELOPING NAFLD AND METS EARLY. 2023 13 4191 43 METABOLIC LANDSCAPE IN CARDIAC AGING: INSIGHTS INTO MOLECULAR BIOLOGY AND THERAPEUTIC IMPLICATIONS. CARDIAC AGING IS EVIDENT BY A REDUCTION IN FUNCTION WHICH SUBSEQUENTLY CONTRIBUTES TO HEART FAILURE. THE METABOLIC MICROENVIRONMENT HAS BEEN IDENTIFIED AS A HALLMARK OF MALIGNANCY, BUT RECENT STUDIES HAVE SHED LIGHT ON ITS ROLE IN CARDIOVASCULAR DISEASES (CVDS). VARIOUS METABOLIC PATHWAYS IN CARDIOMYOCYTES AND NONCARDIOMYOCYTES DETERMINE CELLULAR SENESCENCE IN THE AGING HEART. METABOLIC ALTERATION IS A COMMON PROCESS THROUGHOUT CARDIAC DEGENERATION. IMPORTANTLY, THE INVOLVEMENT OF CELLULAR SENESCENCE IN CARDIAC INJURIES, INCLUDING HEART FAILURE AND MYOCARDIAL ISCHEMIA AND INFARCTION, HAS BEEN REPORTED. HOWEVER, METABOLIC COMPLEXITY AMONG HUMAN AGING HEARTS HINDERS THE DEVELOPMENT OF STRATEGIES THAT TARGETS METABOLIC SUSCEPTIBILITY. ADVANCES OVER THE PAST DECADE HAVE LINKED CELLULAR SENESCENCE AND FUNCTION WITH THEIR METABOLIC REPROGRAMMING PATHWAY IN CARDIAC AGING, INCLUDING AUTOPHAGY, OXIDATIVE STRESS, EPIGENETIC MODIFICATIONS, CHRONIC INFLAMMATION, AND MYOCYTE SYSTOLIC PHENOTYPE REGULATION. IN ADDITION, METABOLIC STATUS IS INVOLVED IN CRUCIAL ASPECTS OF MYOCARDIAL BIOLOGY, FROM FIBROSIS TO HYPERTROPHY AND CHRONIC INFLAMMATION. HOWEVER, FURTHER ELUCIDATION OF THE METABOLISM INVOLVEMENT IN CARDIAC DEGENERATION IS STILL NEEDED. THUS, DECIPHERING THE MECHANISMS UNDERLYING HOW METABOLIC REPROGRAMMING IMPACTS CARDIAC AGING IS THOUGHT TO CONTRIBUTE TO THE NOVEL INTERVENTIONS TO PROTECT OR EVEN RESTORE CARDIAC FUNCTION IN AGING HEARTS. HERE, WE SUMMARIZE EMERGING CONCEPTS ABOUT METABOLIC LANDSCAPES OF CARDIAC AGING, WITH SPECIFIC FOCUSES ON WHY METABOLIC PROFILE ALTERS DURING CARDIAC DEGENERATION AND HOW WE COULD UTILIZE THE CURRENT KNOWLEDGE TO IMPROVE THE MANAGEMENT OF CARDIAC AGING. 2023 14 4779 41 NUTRIENTS, GENETIC FACTORS, AND THEIR INTERACTION IN NON-ALCOHOLIC FATTY LIVER DISEASE AND CARDIOVASCULAR DISEASE. NON-ALCOHOLIC FATTY LIVER DISEASE (NAFLD) IS THE MOST COMMON CHRONIC LIVER DISEASE IN WESTERN COUNTRIES AND EXPOSE PATIENTS TO INCREASED RISK OF HEPATIC AND CARDIOVASCULAR (CV) MORBIDITY AND MORTALITY. BOTH ENVIRONMENTAL FACTORS AND GENETIC PREDISPOSITION CONTRIBUTE TO THE RISK. AN INAPPROPRIATE DIET, RICH IN REFINED CARBOHYDRATES, ESPECIALLY FRUCTOSE, AND SATURATED FATS, AND POOR IN FIBERS, POLYUNSATURATED FATS, AND VITAMINS IS ONE OF THE MAIN KEY FACTORS, AS WELL AS THE POLYMORPHISM OF PATATIN-LIKE PHOSPHOLIPASE DOMAIN CONTAINING 3 (PNPLA3 GENE) FOR NAFLD AND THE APOLIPOPROTEINS AND THE PEROXISOME PROLIFERATOR-ACTIVATED RECEPTOR (PPAR) FAMILY FOR THE CARDIOVASCULAR DAMAGE. BEYOND GENETIC INFLUENCE, ALSO EPIGENETICS MODIFICATIONS ARE RESPONSIBLE FOR VARIOUS CLINICAL MANIFESTATIONS OF BOTH HEPATIC AND CV DISEASE. INTERESTINGLY, DATA ARE ACCUMULATING ON THE INTERPLAY BETWEEN DIET AND GENETIC AND EPIGENETIC MODIFICATIONS, MODULATING PATHOGENETIC PATHWAYS IN NAFLD AND CV DISEASE. WE REPORT THE MAIN EVIDENCE FROM LITERATURE ON THE INFLUENCE OF BOTH MACRO AND MICRONUTRIENTS IN NAFLD AND CV DAMAGE AND THE ROLE OF GENETICS EITHER ALONE OR COMBINED WITH DIET IN INCREASING THE RISK OF DEVELOPING BOTH DISEASES. UNDERSTANDING THE INTERACTION BETWEEN METABOLIC ALTERATIONS, GENETICS AND DIET ARE ESSENTIAL TO TREAT THE DISEASES AND TAILORING NUTRITIONAL THERAPY TO CONTROL NAFLD AND CV RISK. 2020 15 4711 52 NON-ALCOHOLIC FATTY LIVER DISEASE IN OBESE CHILDREN AND ADOLESCENTS: A ROLE FOR NUTRITION? NON-ALCOHOLIC FATTY LIVER DISEASE (NAFLD) HAS BECOME THE MOST COMMON CAUSE OF CHRONIC LIVER DISEASE IN CHILDREN, PARALLELING THE INCREASING PREVALENCE OF OBESITY WORLDWIDE. THE PATHOGENESIS OF PAEDIATRIC NAFLD IS NOT FULLY UNDERSTOOD, BUT IT IS KNOWN THAT OBESITY, NUTRITION, LIFESTYLE VARIABLES, GENETIC AND EPIGENETIC FACTORS MAY BE CAUSALLY INVOLVED IN THE DEVELOPMENT OF THIS COMMON METABOLIC LIVER DISEASE. IN PARTICULAR, OBESITY AND NUTRITION ARE AMONG THE STRONGEST RISK FACTORS FOR PAEDIATRIC NAFLD, WHICH MAY EXERT THEIR ADVERSE HEPATIC EFFECTS ALREADY BEFORE BIRTH. EXCESS ENERGY INTAKE INDUCES HYPERTROPHY AND HYPERPLASIA OF ADIPOSE TISSUE WITH SUBSEQUENT DEVELOPMENT OF SYSTEMIC INSULIN RESISTANCE, WHICH IS ANOTHER IMPORTANT RISK FACTOR FOR NAFLD. DIET COMPOSITION AND IN PARTICULAR SIMPLE CARBOHYDRATE INTAKE (ESPECIALLY HIGH FRUCTOSE INTAKE) MAY PROMOTE THE DEVELOPMENT OF NAFLD, WHEREAS NON-DIGESTIBLE CARBOHYDRATES (DIETARY FIBER), BY AFFECTING GUT MICROBIOTA, MAY FAVOUR THE INTEGRITY OF GUT WALL AND REDUCE INFLAMMATION, OPPOSING THIS PROCESS. SATURATED FAT INTAKE MAY ALSO PROMOTE NAFLD DEVELOPMENT, WHEREAS UNSATURATED FAT INTAKE HAS SOME BENEFICIAL EFFECTS. PROTEIN INTAKE DOES NOT SEEM TO AFFECT THE DEVELOPMENT OF NAFLD, BUT FURTHER INVESTIGATION IS NEEDED. IN CONCLUSION, LIFESTYLE MODIFICATIONS TO INDUCE WEIGHT LOSS, THROUGH DIET AND PHYSICAL ACTIVITY, REMAIN THE MAINSTAY OF TREATMENT FOR PAEDIATRIC NAFLD. THE USE OF DIETARY SUPPLEMENTS, SUCH AS OMEGA-3 FATTY ACIDS AND PROBIOTICS, NEEDS FURTHER STUDY BEFORE RECOMMENDATION. 2022 16 5366 41 RECENT ADVANCES IN LEAN NAFLD. AS THE PREDOMINANT TYPE OF CHRONIC LIVER DISEASE, THE GROWING PREVALENCE OF NONALCOHOLIC FATTY LIVER DISEASE (NAFLD) HAS BECOME A CONCERN WORLDWIDE. ALTHOUGH OBESITY PLAYS THE MOST PIVOTAL ROLE IN NAFLD, APPROXIMATELY 10-20% OF INDIVIDUALS WITH NAFLD WHO ARE NOT OVERWEIGHT OR OBESE (BMI < 25 KG/M2, OR BMI < 23 KG/M2 IN ASIANS) HAVE "LEAN NAFLD." LEAN INDIVIDUALS WITH NAFLD HAVE A LOWER PREVALENCE OF DIABETES, HYPERTENSION, HYPERTRIGLYCERIDEMIA, CENTRAL OBESITY, AND METABOLIC SYNDROME THAN NONLEAN INDIVIDUALS WITH NAFLD, BUT HIGHER FIBROSIS SCORES AND RATES OF CARDIOVASCULAR MORBIDITY AND ALL-CAUSE MORTALITY IN ADVANCED STAGES. THE PATHOPHYSIOLOGICAL MECHANISMS OF LEAN NAFLD REMAIN POORLY UNDERSTOOD. STUDIES HAVE SHOWN THAT LEAN NAFLD IS MORE CORRELATED WITH FACTORS SUCH AS ENVIRONMENTAL, GENETIC SUSCEPTIBILITY, AND EPIGENETIC REGULATION. THIS REVIEW WILL EXAMINE THE WAY IN WHICH THE RESEARCH PROGRESS AND CHARACTERISTIC OF LEAN NAFLD, AND EXPLORE THE FUNCTION OF EPIGENETIC MODIFICATION TO PROVIDE THE BASIS FOR THE CLINICAL TREATMENT AND DIAGNOSIS OF LEAN NAFLD. 2022 17 1388 37 DIABETIC PATIENTS WITH CHRONIC KIDNEY DISEASE: NON-INVASIVE ASSESSMENT OF CARDIOVASCULAR RISK. THE PREVALENCE AND BURDEN OF DIABETES MELLITUS AND CHRONIC KIDNEY DISEASE ON GLOBAL HEALTH AND SOCIOECONOMIC DEVELOPMENT IS ALREADY HEAVY AND STILL RISING. DIABETES MELLITUS BY ITSELF IS LINKED TO ADVERSE CARDIOVASCULAR EVENTS, AND THE PRESENCE OF CONCOMITANT CHRONIC KIDNEY DISEASE FURTHER AMPLIFIES CARDIOVASCULAR RISK. THE CULMINATION OF TRADITIONAL (MALE GENDER, SMOKING, ADVANCED AGE, OBESITY, ARTERIAL HYPERTENSION AND DYSLIPIDEMIA) AND NON-TRADITIONAL RISK FACTORS (ANEMIA, INFLAMMATION, PROTEINURIA, VOLUME OVERLOAD, MINERAL METABOLISM ABNORMALITIES, OXIDATIVE STRESS, ETC.) CONTRIBUTES TO ADVANCED ATHEROSCLEROSIS AND INCREASED CARDIOVASCULAR RISK. TO DECREASE THE MORBIDITY AND MORTALITY OF THESE PATIENTS DUE TO CARDIOVASCULAR CAUSES, TIMELY AND EFFICIENT CARDIOVASCULAR RISK ASSESSMENT IS OF HUGE IMPORTANCE. CARDIOVASCULAR RISK ASSESSMENT CAN BE BASED ON LABORATORY PARAMETERS, IMAGING TECHNIQUES, ARTERIAL STIFFNESS PARAMETERS, ANKLE-BRACHIAL INDEX AND 24 H BLOOD PRESSURE MEASUREMENTS. NEWER METHODS INCLUDE EPIGENETIC MARKERS, SOLUBLE ADHESION MOLECULES, CYTOKINES AND MARKERS OF OXIDATIVE STRESS. IN THIS REVIEW, THE AUTHORS PRESENT SEVERAL NON-INVASIVE METHODS OF CARDIOVASCULAR RISK ASSESSMENT IN PATIENTS WITH DIABETES MELLITUS AND CHRONIC KIDNEY DISEASE. 2021 18 6607 57 TYPE 2 DIABETES MELLITUS AND CARDIOVASCULAR DISEASE: GENETIC AND EPIGENETIC LINKS. TYPE 2 DIABETES MELLITUS (DM) IS A COMMON METABOLIC DISORDER PREDISPOSING TO DIABETIC CARDIOMYOPATHY AND ATHEROSCLEROTIC CARDIOVASCULAR DISEASE (CVD), WHICH COULD LEAD TO HEART FAILURE THROUGH A VARIETY OF MECHANISMS, INCLUDING MYOCARDIAL INFARCTION AND CHRONIC PRESSURE OVERLOAD. PATHOGENETIC MECHANISMS, MAINLY LINKED TO HYPERGLYCEMIA AND CHRONIC SUSTAINED HYPERINSULINEMIA, INCLUDE CHANGES IN METABOLIC PROFILES, INTRACELLULAR SIGNALING PATHWAYS, ENERGY PRODUCTION, REDOX STATUS, INCREASED SUSCEPTIBILITY TO ISCHEMIA, AND EXTRACELLULAR MATRIX REMODELING. THE CLOSE RELATIONSHIP BETWEEN TYPE 2 DM AND CVD HAS LED TO THE COMMON SOIL HYPOTHESIS, POSTULATING THAT BOTH CONDITIONS SHARE COMMON GENETIC AND ENVIRONMENTAL FACTORS INFLUENCING THIS ASSOCIATION. HOWEVER, ALTHOUGH THE COMMON RISK FACTORS OF BOTH CVD AND TYPE 2 DM, SUCH AS OBESITY, INSULIN RESISTANCE, DYSLIPIDEMIA, INFLAMMATION, AND THROMBOPHILIA, CAN BE IDENTIFIED IN THE MAJORITY OF AFFECTED PATIENTS, LESS IS KNOWN ABOUT HOW THESE FACTORS INFLUENCE BOTH CONDITIONS, SO THAT EFFORTS ARE STILL NEEDED FOR A MORE COMPREHENSIVE UNDERSTANDING OF THIS RELATIONSHIP. THE GENETIC, EPIGENETIC, AND ENVIRONMENTAL BACKGROUNDS OF BOTH TYPE 2 DM AND CVD HAVE BEEN MORE RECENTLY STUDIED AND UPDATED. HOWEVER, THE UNDERLYING PATHOGENETIC MECHANISMS HAVE SELDOM BEEN INVESTIGATED WITHIN THE BROADER SHARED BACKGROUND, BUT RATHER STUDIED IN THE SPECIFIC CONTEXT OF TYPE 2 DM OR CVD, SEPARATELY. AS THE PRECISE PATHOPHYSIOLOGICAL LINKS BETWEEN TYPE 2 DM AND CVD ARE NOT ENTIRELY UNDERSTOOD AND MANY ASPECTS STILL REQUIRE ELUCIDATION, AN INTEGRATED DESCRIPTION OF THE GENETIC, EPIGENETIC, AND ENVIRONMENTAL INFLUENCES INVOLVED IN THE CONCOMITANT DEVELOPMENT OF BOTH DISEASES IS OF PARAMOUNT IMPORTANCE TO SHED NEW LIGHT ON THE INTERLINKS BETWEEN TYPE 2 DM AND CVD. THIS REVIEW ADDRESSES THE CURRENT KNOWLEDGE OF OVERLAPPING GENETIC AND EPIGENETIC ASPECTS IN TYPE 2 DM AND CVD, INCLUDING MICRORNAS AND LONG NON-CODING RNAS, WHOSE ABNORMAL REGULATION HAS BEEN IMPLICATED IN BOTH DISEASE CONDITIONS, EITHER ETIOLOGICALLY OR AS CAUSE FOR THEIR PROGRESSION. UNDERSTANDING THE LINKS BETWEEN THESE DISORDERS MAY HELP TO DRIVE FUTURE RESEARCH TOWARD AN INTEGRATED PATHOPHYSIOLOGICAL APPROACH AND TO PROVIDE FUTURE DIRECTIONS IN THE FIELD. 2018 19 3022 42 GENETICS AND EPIGENETICS PURPOSE IN NONALCOHOLIC FATTY LIVER DISEASE. INTRODUCTION: NONALCOHOLIC FATTY LIVER DISEASE (NAFLD) COMPRISES A BROAD SPECTRUM OF DISEASES, WHICH CAN PROGRESS FROM BENIGN STEATOSIS TO NONALCOHOLIC STEATOHEPATITIS, LIVER CIRRHOSIS AND HEPATOCELLULAR CARCINOMA. NAFLD IS THE MOST COMMON CHRONIC LIVER DISEASE IN DEVELOPED COUNTRIES, AFFECTING APPROXIMATELY 25% OF THE GENERAL POPULATION. INSULIN RESISTANCE, ADIPOSE TISSUE DYSFUNCTION, MITOCHONDRIAL AND ENDOPLASMIC RETICULUM STRESS, CHRONIC INFLAMMATION, GENETIC AND EPIGENETIC FACTORS ARE NAFLD TRIGGERS THAT CONTROL THE DISEASE SUSCEPTIBILITY AND PROGRESSION. AREAS COVERED: IN RECENT YEARS A LARGE NUMBER OF INVESTIGATIONS HAVE BEEN CARRIED OUT TO ELUCIDATE GENETIC AND EPIGENETIC FACTORS IN THE DISEASE PATHOGENESIS, AS WELL AS THE SEARCH FOR DIAGNOSTIC MARKERS AND THERAPEUTIC TARGETS. THIS PAPER OBJECTIVE IS TO REPORT THE MOST STUDIED GENETIC AND EPIGENETIC VARIANTS AROUND NAFLD. EXPERT OPINION: NAFLD LEAD TO VARIOUS COMORBIDITIES, WHICH HAVE A CONSIDERABLE IMPACT ON THE PATIENT WELLNESS AND LIFE QUALITY, AS WELL AS ON THE COSTS THEY GENERATE FOR THE COUNTRY'S HEALTH SERVICES. IT IS ESSENTIAL TO CONTINUE WITH MOLECULAR RESEARCH, SINCE IT COULD BE USED AS A CLINICAL TOOL FOR PROGNOSIS AND DISEASE SEVERITY. SPECIFICALLY, IN THE FIELD OF HEPATOLOGY, PLASMA MIRNAS COULD PROVIDE A NOVEL TOOL IN LIVER DISEASES DIAGNOSIS AND MONITORING, REPRESENTING AN ALTERNATIVE TO INVASIVE DIAGNOSTIC PROCEDURES. 2020 20 4709 46 NON-ALCOHOLIC FATTY LIVER DISEASE AND ALCOHOL-RELATED LIVER DISEASE: TWO INTERTWINED ENTITIES. NON-ALCOHOLIC FATTY LIVER DISEASE (NAFLD) IS THE MOST COMMON CAUSE OF CHRONIC LIVER DISEASE WORLDWIDE, WITH A PREVALENCE OF 25-30%. SINCE ITS FIRST DESCRIPTION IN 1980, NAFLD HAS BEEN CONCEIVED AS A DIFFERENT ENTITY FROM ALCOHOL-RELATED FATTY LIVER DISEASE (ALD), DESPITE THAT, BOTH DISEASES HAVE AN OVERLAP IN THE PATHOPHYSIOLOGY, SHARE GENETIC-EPIGENETIC FACTORS, AND FREQUENTLY COEXIST. BOTH ENTITIES ARE CHARACTERIZED BY A BROAD SPECTRUM OF HISTOLOGICAL FEATURES RANGING FROM ISOLATED STEATOSIS TO STEATOHEPATITIS AND CIRRHOSIS. DISTINCTION BETWEEN NAFLD AND ALD IS BASED ON THE AMOUNT OF CONSUMED ALCOHOL, WHICH HAS BEEN ARBITRARILY ESTABLISHED. IN THIS CONTEXT, A PROPOSAL OF POSITIVE CRITERIA FOR NAFLD DIAGNOSIS NOT CONSIDERING EXCLUSION OF ALCOHOL CONSUMPTION AS A PREREQUISITE CRITERION FOR DIAGNOSIS HAD EMERGED, RECOGNIZING THE POSSIBILITY OF A DUAL ETIOLOGY OF FATTY LIVER IN SOME INDIVIDUALS. THE IMPACT OF MODERATE ALCOHOL USE ON THE SEVERITY OF NAFLD IS ILL-DEFINED. SOME STUDIES SUGGEST PROTECTIVE EFFECTS IN MODERATE DOSES, BUT CURRENT EVIDENCE SHOWS THAT THERE IS NO SAFE THRESHOLD FOR ALCOHOL CONSUMPTION FOR NAFLD. IN FACT, GIVEN THE SYNERGISTIC EFFECT BETWEEN ALCOHOL CONSUMPTION, OBESITY, AND METABOLIC DYSFUNCTION, IT IS LIKELY THAT ALCOHOL USE SERVES AS A SIGNIFICANT RISK FACTOR FOR THE PROGRESSION OF LIVER DISEASE IN NAFLD AND METABOLIC SYNDROME. THIS ALSO AFFECTS THE INCIDENCE OF HEPATOCELLULAR CARCINOMA. IN THIS REVIEW, WE SUMMARIZE THE OVERLAPPING PATHOPHYSIOLOGY OF NAFLD AND ALD, THE CURRENT DATA ON ALCOHOL CONSUMPTION IN PATIENTS WITH NAFLD, AND THE EFFECTS OF METABOLIC DYSFUNCTION AND OVERWEIGHT IN ALD. 2020