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People with diabetes mellitus have a higher-than-average risk of having a heart attack or stroke. However, the molecular mechanisms underlying the relationship between diabetes and cardiovascular disorders are not fully understood; therefore, successful attempts at designing rational interventions remain limited. Nonetheless, recent advances have opened numerous areas of investigation exploring this rapidly evolving research field, also showing the other side of the coin, i.e., how cardiovascular disease can affect insulin release and glucose homeostasis. The present eBook aims to present some of the more relevant and recent acquisitions on the molecular mechanisms linking diabetes and cardiovascular disease, maintaining a focus on the actual translatability in clinical practice.
Effective identification of patients at increased risk of malignant cardiac arrhythmia presently represents a clinically important unmet need. Existing guidelines for the selection of candidates for the prophylactic implantation of cardioverters-defibrillators (ICD) are based solely on the reduction of ventricular haemodynamic performance. Although this guidance is based on statistical results of previously conducted randomized clinical trials, available experience shows that it does not serve clinical needs efficiently. The majority of patients who are implanted with ICDs for prophylactic reasons never utilize the device during its technical longevity whilst, at the same time, many patients...
This book focuses on how to induce clinical arrhythmias in the electrophysiology (EP) laboratory, a procedure that is indispensable for analyzing the underlying mechanisms, and identifying the most effective treatment of the arrhythmia. In the main part of the book, the authors share their own experiences with 13 different medications that can be injected or infused for arrhythmia induction – ranging from isoprenaline and atropine to ephedrine – all of which can be easily found in any cardiology department. Each chapter begins with a description of the drug’s chemical structure and mechanism of actions, then illustrates the infusion preparation, dosage and side effects and lastly analyzes its electrophysiological properties and highlights the most important clinical studies on it. For each drug the authors list – in dedicated tables – administration protocols from their own hospital. This book is of interest to postgraduate students, cardiology residents, cardiologists and pediatric cardiologists with special interest in arrhythmias, as well as to trainees, technicians and nurses involved in the EP lab.
Diabetes, also known as diabetes mellitus (DM), is a disease that occurs when the glucose level in the blood becomes too high (hyperglycaemia). Chronic hyperglycaemia is accompanied by both biochemical and pathological complications such as retinopathy, nephropathy, neuropathy, and cardiovascular diseases. Diabetes mellitus can be classified into two types: type I which results from the destruction of pancreatic β-cells, leading to insulin insufficiency and type II diabetes mellitus, which is mainly related to insulin resistance. Optimal control of blood glucose levels remains the cornerstone of managing DM. To date, the major classes of antidiabetic medications used to treat diabetes include: biguanides, dipeptidyl peptidase 4 (DPP-4) inhibitors, sulfonylureas, meglitinides, thiazolidinediones (TZDs), sodium-glucose cotransporter (SGLT2) inhibitors, α-glucosidase inhibitors, glucose-dependent insulinotropic polypeptide (GIP) receptor and glucagon-like peptide-1 (GLP-1) receptor agonists and the various types of insulin. Several of these drugs may have, besides their antidiabetic properties, also important cardiovascular complications for the patients taking them.