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Cardiometabolic Disease and Atherosclerosis: Epidemiology, Prevention, Diagnosis, and Clinical Treatment
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Cardiometabolic Disease and Atherosclerosis: Epidemiology, Prevention, Diagnosis, and Clinical Treatment

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Cardiology".

Deadline for manuscript submissions: 20 February 2025 | Viewed by 3269

Special Issue Editors

Dr. Evangelos Oikonomou

E-Mail Website
Guest Editor
3rd Cardiology Department, “Sotiria” Chest Disease Hospital, Medical School National and Kapodistrian University of Athens, Athens, Greece
Interests: atherosclerosis; endothelium; heart failure; cardiovascular imaging; epidemiology
Dr. Konstantinos Mourouzis

E-Mail Website
Guest Editor
Medizinische Klinik und Poliklinik I, Klinikum der Universitaet München, Munich, Germany
Interests: atherosclerosis; endothelium; heart failure; inflammation; antiplatelet therapy; antihrombotic therapy

Special Issue Information

Dear Colleagues,

Atherosclerosis and atherosclerotic cardiovascular disease continue to be significant risk factors and the leading causes of death worldwide. Obesity, metabolic impairment, and their interaction within cardiometabolic disease pose substantial challenges to epidemiology and national health systems.

This Special Issue will provide a comprehensive overview of the intricate relationships between cardiometabolic disorders and atherosclerosis, shedding light on their prevalence, risk factors, and global impacts.

Key themes for this Special Issue include the following:

  • Epidemiology: Detailed analyses of the patterns, causes, and effects of cardiometabolic diseases and atherosclerosis in populations worldwide;
  • Prevention: Innovative strategies and interventions aimed at reducing the incidence and burden of these conditions, emphasizing lifestyle modifications and public health initiatives;
  • Diagnosis: Advances in diagnostic techniques, biomarkers, and screening methods that facilitate early detection and improve patient outcomes;
  • Clinical Treatment: Cutting-edge therapeutic approaches, clinical management guidelines.

We hope that this Special Issue will attract scientists and healthcare professionals from around the world who are involved in the treatment and prevention of cardiometabolic disease and atherosclerosis. Your contributions and insights are invaluable in advancing our understanding and management of these ongoing health challenges.

Dr. Evangelos Oikonomou
Dr. Konstantinos Mourouzis
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Clinical Medicine is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • atherosclerosis
  • obesity
  • cardiometabolic disease
  • prevention
  • diabetes mellitus
  • endothelium
  • arteriosclerosis
  • coronary artery disease

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Further information on MDPI's Special Issue polices can be found here.

Published Papers (5 papers)

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Research

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19 pages, 4022 KiB  
Article
Comprehensive Assessment of Biventricular and Biatrial Myocardial Strain Parameters at 4 Years Postpartum in a Cohort of Women with Previous Gestational Diabetes Mellitus
by Andrea Sonaglioni, Federica Casieri, Gian Luigi Nicolosi, Stefano Bianchi and Michele Lombardo
J. Clin. Med. 2025, 14(4), 1271; https://doi.org/10.3390/jcm14041271 - 14 Feb 2025
Viewed by 150
Abstract
Background/Objectives: No previous study has provided a comprehensive evaluation of all biventricular and biatrial myocardial strain parameters in women with previous gestational diabetes mellitus (pGDM). Accordingly, we aimed at investigating the structural and myocardial deformation properties of all cardiac chambers in a [...] Read more.
Background/Objectives: No previous study has provided a comprehensive evaluation of all biventricular and biatrial myocardial strain parameters in women with previous gestational diabetes mellitus (pGDM). Accordingly, we aimed at investigating the structural and myocardial deformation properties of all cardiac chambers in a cohort of pGDM women at 4 years postpartum. Methods: A consecutive cohort of pGDM women was compared to a control group of healthy women with previous uncomplicated pregnancy, matched by age, ethnicity and gestational week, at 4 years postpartum. Both groups of women underwent transthoracic echocardiography (TTE) implemented with speckle-tracking echocardiography (STE) and subsequent carotid ultrasonography. The primary endpoint was subclinical myocardial dysfunction, defined as left-ventricular (LV) global longitudinal strain (GLS) < 20%, whereas the secondary endpoint was early carotid atherosclerosis, defined as common carotid artery (CCA) intima-media thickness (IMT) ≥ 0.7 mm. Results: A total of 32 pGDM women (39.1 ± 6.5 yrs) and 30 matched healthy controls (40.8 ± 5.0 yrs) were analyzed. Despite normal and similar systolic function on conventional TTE, all biventricular and biatrial strain parameters were significantly lower in pGDM women than controls. Mean follow-up period was 4.0 ± 1.9 yrs. During follow-up, 62.5% of pGDM women developed subclinical myocardial dysfunction, and 78.1% of them were diagnosed with early carotid atherosclerosis. Third-trimester BMI (OR 1.88, 95% CI 1.19–2.98) and third-trimester glycosylated hemoglobin (HbA1C) (OR 2.34, 95% CI 1.08–5.04) were independently associated with the primary endpoint. Third-trimester BMI and HbA1C also independently predicted the secondary endpoint. Third-trimester BMI > 27 kg/m2 and HbA1C > 33 mmol/mol showed the best sensitivity and specificity for predicting both endpoints. Conclusions: Women with a previous history of GDM complicated by overweight/obesity and uncontrolled diabetes have a significantly increased risk of subclinical myocardial dysfunction and early carotid atherosclerosis at 4 years postpartum. Full article
(This article belongs to the Special Issue Cardiometabolic Disease and Atherosclerosis: Epidemiology, Prevention, Diagnosis, and Clinical Treatment)
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16 pages, 687 KiB  
Article
A Longitudinal Cohort Assessing the Carotid Intima-Media Thickness Progression and Cardiovascular Risk Factors in a Rural Black South African Community
by Given R. Mashaba, Wendy N. Phoswa, Sogolo L. Lebelo, Solomon S. R. Choma, Eric Maimela and Kabelo Mokgalaboni
J. Clin. Med. 2025, 14(3), 1033; https://doi.org/10.3390/jcm14031033 - 6 Feb 2025
Viewed by 578
Abstract
Background: Diabetes mellitus [DM) is a fast-increasing non-communicable disease in South Africa, with a prevalence of 11.3%. The present study aimed to longitudinally investigate the association of carotid intima-media thickness [CIMT) progression and cardiovascular risk factors in the T2DM and non-DM rural black [...] Read more.
Background: Diabetes mellitus [DM) is a fast-increasing non-communicable disease in South Africa, with a prevalence of 11.3%. The present study aimed to longitudinally investigate the association of carotid intima-media thickness [CIMT) progression and cardiovascular risk factors in the T2DM and non-DM rural black population of South Africa. Methods: This population-based retrospective cohort study was conducted in the Dikgale Mamabolo Mothiba Surveillance area between 2014 and 2023 by the Africa Wits INDEPTH Partnership for Genomic Research (AWI-Gen). The IBM Statistical Package for the Social Sciences version 27 was used to analyze data. The paired T-test was used to determine the mean differences between baseline and follow-up. Longitudinal estimates of the association of CIMT with CVD risk factors in the T2DM and non-DM groups were analyzed using linear mixed models. Results: The baseline mean age was 51.64 years. There was a significant increase in CIMT (left and mean CIMT), low-density lipoprotein-cholesterol (LDL-C), systolic blood pressure (SBP), diastolic blood pressure (DBP), and pulse rate in the T2DM and non-DM groups. In the T2DM group, there was a strong significant association between age (2.20 mm), LDL-C (4.30 mm), SBP (4.57 mm), and waist/hip ratio (0.24 mm) with CIMT progression. The non-DM group revealed a significant association between LDL-C (0.001 mm), SBP (1.41 mm), and CIMT progression. Conclusion: CIMT was associated with other main CVD-related risk factors (age, LDL-C, LDL-C/HDL-C ratio, TC/HDL-C ratio, waist/hip ratio, and SBP). CIMT progression was more pronounced in the T2DM group than non-DM, suggesting a higher risk of atherosclerosis and cardiovascular complications in T2DM individuals. Full article
(This article belongs to the Special Issue Cardiometabolic Disease and Atherosclerosis: Epidemiology, Prevention, Diagnosis, and Clinical Treatment)
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12 pages, 244 KiB  
Article
Dulaglutide and Dapagliflozin Combination Concurrently Improves the Endothelial Glycocalyx and Vascular and Myocardial Function in Patients with T2DM and Albuminuria vs. DPP-4i
by Emmanouil Korakas, John Thymis, Evangelos Oikonomou, Konstantinos Mourouzis, Aikaterini Kountouri, Loukia Pliouta, Sotirios Pililis, George Pavlidis, Stamatios Lampsas, Konstantinos Katogiannis, Lina Palaiodimou, Georgios Tsivgoulis, Gerasimos Siasos, Ignatios Ikonomidis, Athanasios Raptis and Vaia Lambadiari
J. Clin. Med. 2024, 13(24), 7497; https://doi.org/10.3390/jcm13247497 - 10 Dec 2024
Viewed by 812
Abstract
Background: The association between diabetic nephropathy and arterial elasticity and endothelial function is well established. In this study, we compared the effect of the combination of dulaglutide and dapagliflozin versus DPP-4 inhibitors on the endothelial glycocalyx, arterial stiffness, myocardial function, and albuminuria. [...] Read more.
Background: The association between diabetic nephropathy and arterial elasticity and endothelial function is well established. In this study, we compared the effect of the combination of dulaglutide and dapagliflozin versus DPP-4 inhibitors on the endothelial glycocalyx, arterial stiffness, myocardial function, and albuminuria. Methods: Overall, 60 patients were randomized to combined dulaglutide and dapagliflozin treatment (n = 30) or DPP-4 inhibitors (DPP-4i, n = 30) (ClinicalTrials.gov: NCT06611904). We measured at baseline and 4 and 12 months post-treatment: (i) the perfused boundary region of the sublingual arterial microvessels, (ii) pulse wave velocity (PWV) and central systolic blood pressure (cSBP), (iii) global left ventricular longitudinal strain (GLS), and (iv) urine albumin-to-creatinine ratio (UACR). Results: After twelve months, dual therapy showed greater improvements vs. DPP-4i in PBR (2.10 ± 0.31 to 1.93 ± 0.23 μm vs. 2.11 ± 0.31 to 2.08 ± 0.28 μm, p < 0.001), UACR (326 ± 61 to 142 ± 47 mg/g vs. 345 ± 48 to 306 ± 60 mg/g, p < 0.01), and PWV (11.77 ± 2.37 to 10.7 ± 2.29 m/s vs. 10.64 ± 2.44 to 10.54 ± 2.84 m/s, p < 0.001), while only dual therapy showed improvement in cSBP (130.21 ± 17.23 to 123.36 ± 18.42 mmHg). These effects were independent of glycemic control. Both treatments improved GLS, but the effect of dual therapy was significantly higher compared to DPP-4i (18.19% vs. 6.01%, respectively). Conclusions: Twelve-month treatment with dulaglutide and dapagliflozin showed a greater improvement in arterial stiffness, endothelial function, myocardial function, and albuminuria than DPP-4is. Early initiation of combined therapy as an add-on to metformin should be considered in these patients. Full article
(This article belongs to the Special Issue Cardiometabolic Disease and Atherosclerosis: Epidemiology, Prevention, Diagnosis, and Clinical Treatment)

Review

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32 pages, 1205 KiB  
Review
Coronary Microvascular Dysfunction and Vasospastic Angina—Pathophysiology, Diagnosis and Management Strategies
by Joanna Abramik, Mark Mariathas and Ioannis Felekos
J. Clin. Med. 2025, 14(4), 1128; https://doi.org/10.3390/jcm14041128 - 10 Feb 2025
Viewed by 472
Abstract
Coronary artery disease is one of the leading public health problems in the world in terms of mortality and economic burden from the disease. Traditionally, the focus of research and clinical pathways leading to the diagnosis and treatment of coronary artery disease was [...] Read more.
Coronary artery disease is one of the leading public health problems in the world in terms of mortality and economic burden from the disease. Traditionally, the focus of research and clinical pathways leading to the diagnosis and treatment of coronary artery disease was on the more common variant of the disease resulting from atherosclerosis in the epicardial coronary arteries. However, coronary microvasculature, representing the vast majority of the total heart circulation, has the greatest influence on overall coronary resistance and, therefore, blood flow. Coronary microvascular dysfunction (CMD), characterized by structural or functional abnormalities in the microvasculature, significantly impacts myocardial perfusion. Endothelial dysfunction results in inadequate coronary dilation during exercise or spontaneous spasm in the microvasculature or epicardial arteries. A significant proportion of people presenting for coronary angiography in the context of angina have unobstructed epicardial coronary arteries yet are falsely reassured about the benign nature of their condition. Meanwhile, increasing evidence indicates that patients diagnosed with CMD as well as vasospastic angina (VSA) face an increased risk of Major Adverse Cardiovascular Events (MACEs), including death. The aim of this review is to outline the current practice with regard to invasive and non-invasive methods of CMD and VSA diagnosis and assess the evidence supporting the existing treatment strategies. These include endotype-specific pharmacological therapies, a holistic approach to lifestyle modifications and risk factor management and novel non-pharmacological therapies. Furthermore, the review highlights critical gaps in research and suggests potential areas for future investigation, to improve understanding and management of these conditions. Full article
(This article belongs to the Special Issue Cardiometabolic Disease and Atherosclerosis: Epidemiology, Prevention, Diagnosis, and Clinical Treatment)
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13 pages, 278 KiB  
Review
Glycated Hemoglobin and Cardiovascular Disease in Patients Without Diabetes
by Grzegorz K. Jakubiak, Artur Chwalba, Aleksandra Basek, Grzegorz Cieślar and Natalia Pawlas
J. Clin. Med. 2025, 14(1), 53; https://doi.org/10.3390/jcm14010053 - 26 Dec 2024
Viewed by 979
Abstract
Cardiovascular diseases (CVDs) are one of the most critical public health problems in the contemporary world because they are the leading cause of morbidity and mortality. Diabetes mellitus (DM) is one of the most substantial risk factors for developing CVDs. Glycated hemoglobin is [...] Read more.
Cardiovascular diseases (CVDs) are one of the most critical public health problems in the contemporary world because they are the leading cause of morbidity and mortality. Diabetes mellitus (DM) is one of the most substantial risk factors for developing CVDs. Glycated hemoglobin is a product of the non-enzymatic glycation of hemoglobin present in erythrocytes. The determination of the percentage of glycated hemoglobin (HbA1c) is commonly used in clinical practice to assess glycemic control in patients diagnosed with DM. This method is much more informative than repeated blood glucose tests, because the HbA1c value reflects the degree of glycemic control over the last three months. It is, therefore, not surprising that the HbA1c value correlates with the presence and severity of diabetes complications, including CVDs, in the population of diabetic patients. The purpose of this publication was to present the results of a literature review on the relationship between the HbA1c value in people without DM, the presence and severity of subclinical cardiovascular dysfunction, and the presence of clinically overt CVDs. The most important tools used to assess subclinical cardiovascular dysfunction included the measurement of intima-media thickness (IMT), especially carotid IMT (cIMT), arterial stiffness assessment by the measurement of pulse wave velocity (PWV), and ankle–brachial index (ABI). According to the results of the studies cited in this literature review, it can be concluded that there are certain relationships between HbA1c, the presence and severity of subclinical cardiovascular dysfunction, and the presence of clinically overt CVDs such as coronary heart disease, cerebrovascular disease, and chronic lower extremity ischemia in non-diabetic patients. It is worth noting, however, that the results of studies conducted so far in this area are not fully unambiguous. Further studies are needed to better understand the influence of additional factors on the relationship between HbA1c and cardiovascular dysfunction in non-diabetic patients. Full article
(This article belongs to the Special Issue Cardiometabolic Disease and Atherosclerosis: Epidemiology, Prevention, Diagnosis, and Clinical Treatment)
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