BACKGROUND Heat-not-burn (HNB) technology by the U.S. Food and Drug Administration has been classified as a modified risk tobacco product, which can be a better option for those populations who cannot give up the habit of smoking. The outlook on the effects of these products is quite controversial in the scientific world. OBJECTIVE To present the effect of HNB tobacco products on the cardiovascular system, with reference to the existence of possible benefits of the technology. METHODS The literature search was conducted in PubMed/Medline, the Cochrane Central Register of Controlled Trials (CENTRAL), and ClinicalTrials.gov databases, with reliance on a well-defined guiding research statement. Quality appraisal was performed using the CASP checklist for randomized controlled trials. RESULTS The search of three databases identified 167 records, and after selection process, 25 randomized controlled trials were eligible for our study's criteria. Twenty studies investigated the effects of HNB products on biomarkers of clinical relevance. Five studies evaluated other functional heart parameters rather than biomarkers. CONCLUSION With HNB tobacco products, significant reductions were found in biomarkers of exposure and biological effect related to pathways involved in cardiovascular disease, including inflammation, oxidative stress, lipid metabolism, platelet function, and endothelial dysfunction.

Cardiotoxicity is one of the most important side effects of first-line chemotherapy medications. It is influenced by genetic variation, whereby the relationship between the chemotherapeutic dose and the risk of cardiotoxicity can be altered. The incidence of cardiotoxicity depends on the substance used in the therapeutic modality of cancer and can reach an incidence of 30% during a three-year follow-up. The main element of the clinical picture is systolic dysfunction of the left ventricle, with symptoms of heart failure, which can change or stop oncological therapy, along with pharmacological treatment of heart failure. These symptoms can occur during prolonged use of cancer therapies, monitoring the patient is advisable. Considering the increasing success of oncology therapy and the extension of life, as well as the improvement of the quality of life, a multidisciplinary approach, as well as the symbiosis of the work of cardiologists and oncologists, is imperative. Patient stratification concerning oncological treatment modality is imposed as part of a cardiologist's daily work from the beginning of cancer treatment.

Although there is clear dose-dependence of pulmonary toxicity caused by inhalation of normobaric oxygen in animal studies, the threshold of toxicity in humans remains largely unknown. The aim of this systematic review of published clinical studies was to establish threshold in terms of total oxygen dose administered under normal pressure by inhalation that causes first clinical signs of toxicity. MEDLINE, EBSCO, The Cochrane Central Register of Controlled Trials (Central), SCIndeks, Scopus, Google Scholar, and ClinicalTrials.gov were searched from their foundation to April 2022. The systematic review was performed according to the pre-registered protocol at PROSPERO. The studies were included if describing toxic effects of normobaric oxygen therapy in humans. In total 11 human studies of poor quality were found, with either experimental or observational design. In none of the analyzed studies did oxygen therapy cause toxic effects on the respiratory tract if the concentration of oxygen in the inhaled air was below 50%, regardless of the rate of administration. The toxic consequences of inhaling oxygen at a concentration of more than 50% occurred only after oxygen was administered for more than 6 hours, at a rate of more than 7 L/min, and were mainly reflected in inflammation of the tracheobronchial mucosa, with epithelial erosions. Normobaric oxygen therapy can have toxic effects in humans if the oxygen concentration in the inhaled air is higher than 50%, if the administration rate is above 7 L/min, and if the application lasts at least 6 hours.

Cardiomyopathies are diseases of the heart muscle, and present a heterogeneous group of myocardial diseases with mechanical or electrical dysfunction, characterized by ventricular hypertrophy or dilatation. They can be strictly related to the heart muscle (primary), or as part of a systemic disease (secondary), and represent a factor that leads to a reduced quality of life, the occurrence of heart failure and mortality. The primary ones are those that are genetic conditioning, the mixed ones include dilated and restrictive cardiomyopathy, and the acquired ones are caused by myocarditis, stress-induced, peripartum, tachycardia-induced and those caused by endocrine pathology (primarily in newborns of mothers with a diagnosis of diabetes mellitus). Etiologically, they can arise as a result of a genetic mutation, an inflammatory process, and they are also divided into metabolic, toxic and those caused by some other cause. The aim of the article was to present the characteristics of cardiomyopathies themselves in relation to the etiological factor, with review of the diagnostic and therapeutic modality.

Sodium-glucose co-transporter 2 inhibitors (SGLT2 inhibitors) represent a therapeutic modality option for type 2 diabetes mellitus. This group of drugs includes dapagliflozin, empagliflozin, canagliflozin, ertugliflozin and sotagliflozin. Given their proven benefit in the scope of heart failure through clinical studies, they have also gained their place in patients with reduced, moderately reduced, or preserved systolic function of the left ventricle. Due to the effect on both the systolic and diastolic function of the left ventricle, and the neurohumoral activity itself, their range of use has been expanded in patients without a history of diabetes mellitus, and empagliflozin in a dose of 10 mg, as well as dapagliflozin in a dose of 10 mg, have been implemented in patients without diabetes mellitus. New directions for the expansion of the use of SGLT2 inhibitors have pointed towards their applicability in acute heart failure (sotagliflozin) and type 1 diabetes (sotagliflozin). Recently, clinical studies concerning the use of empagliflozin and dapagliflozin in acute coronary syndrome (ACS), appeared. The aim of this paper was to highlight the possible benefit of including SGLT2 inhibitors in patients with ACS.

Abstract Aim: The study aimed to evaluate the acute effect of ultrafiltration on the mechanical properties of the aorta using brachial-ankle pulse wave velocity (PWV) before and after hemodialysis (HD). Patients and Methods: This study included 80 patients who were on a long-term HD program. The input variables were anamnestic data, body composition monitor (BCM) parameters, and echocardiography findings. The assessment of hydration status was determined by BCM, whose work is based on the principle of multifrequency bioimpedance spectroscopy. Another diagnostic procedure was the use of an arteriograph apparatus to assess PWV and Augmentation Index (AIx). All measurements were performed before and after dialysis on the middle dialysis day of the week. Results: The participants were divided into two groups based on hydration status: the experimental group consisted of 40 overhydrated participants and the control group consisted of 40 normovolemic participants. Statistically, the following BCM parameters correlated significantly positively with PWV: total body fat (r = 0.222; P < 0.05), overhydration (r = 0.290; P < 0.001), and relative overhydration (r = 0.290; P < 0.001). From echocardiography findings, only left atrial diameter correlated statistically significantly positively with PWV (r = 0.359; P < 0.001). Comparison of the mean PWV values within the experimental group before and after HD showed a statistically significant decrease from 14.32 ± 2.34 m/s to 8.72 ± 1.52 m/s (Z = 3.254; P = 0.0001). Mean PWV values within the control group did not decrease significantly from 13.39 ± 1.32 m/s to 10.39 ± 1.18 m/s (Z = 0.524; P = 0.742). If we compare the mean values of PWV between groups, then before HD treatment, there was no statistically significant difference between groups with PWV values in the experimental group of 14.32 ± 2.34 m/s and the control group of 13.39 ± 1.32 m/s (Z = 0.762; P = 0.852). According to the results of univariate regression analysis before and after HD treatment, only overhydration showed an absolute effect on PWV before and after HD. Conclusion: Overhydration showed an effect on brachial-ankle PWV before and after HD, and brachial-ankle PWV should be followed in HD patients.

The use of anticoagulant therapy is a part of the daily work of clinicians and a reason for fear, primarily due to the risk of bleeding. The use of anticoagulant drugs in rheumatology remains a challenge. first, a large number of clinicians consider rheumatic conditions as a hypercoagulable state, which often leads to wrong decisions. second, the use of drugs in the treatment of rheumatic diseases may be associated with an increased risk of venous thromboembolism (vte), and they can have effect on dose of anticoagulant agent. The aim of this paper is to present the properties of anticoagulant therapy through the prism of rheumatological pathology.

BACKGROUND: Prosthetic mechanical valve endocarditis (PVE) can be manifested as early PVE (acquired perioperatively) and late PVE (resulting from infections unrelated to the valve operation). Causes of both are similar but are late PVE are more prone to less virulent microbes. PVE resulting with paravalvular abscess is confirmed through echocardiography (transthoracic or transesophageal), it results with a high mortality rate especially if it is not early recognized. The aim of article was to present a patient with heart failure symptoms caused by PVE. CASE PRESENTATION: Male patient, 44 years old, was admitted because of dyspnea and swelling of lower extremities. The patient is a long-standing heroin addict who had aortic valve replacement done 8 years ago due to endocarditis. The implanted valve was a mechanical aortic valve – Edwards MIRA bi-leaflet valve No 32 (Edwards Lifesciences; Irvine, California). He also was already diagnosed with hepatitis C years before. In multiple occasions were hospitalized on the Department of cardiology due to signs and symptoms of heart failure. On transthoracic echocardiography, dilatation of all heart chambers was found. The left ventricular systolic function was moderately reduced with an ejection fraction of left ventricle of 42% according to Simpson with restrictive filling pattern. Hypoechoic mass along the right side of the mechanical aortic valve was noted measuring 3.57 × 1.03 cm. CONCLUSION: Paravalvular abscess of mechanical heart valves is a very serious complication with a high mortality rate. It is essential to recognize this type of pathology as early as possible, so aggressive parenteral antibiotic therapy could be started, while in many cases, surgical reoperation is needed.