Cardiovascular & Haematological Disorders - Drug Targets - Online First
Description text for Online First listing goes here...
-
-
Evaluation of Cardiovascular Effects of the Hydroalcoholic Fruit Extract of Berberis vulgaris in Acute L-NAME Hypertensive Rats
Available online: 10 November 2025More LessIntroductionDue to the lack of sufficient studies on the mechanisms of the cardiovascular effects of Berberis vulgaris (B. vulgaris), this study aimed to evaluate the cardiovascular effects of the hydroalcoholic extract of B. vulgaris fruit on nitric oxide (NO) and acute hypertension caused by NG-nitro-L-arginine methyl ester (L-NAME; a NOS inhibitor).
MethodsIn total, 48 male rats were assigned to six groups (n = 8): the control group, which received saline intraperitoneally (i.p), the L-NAME group, which received L-NAME intravenously (10 mg/kg. i.v), the L-NAME + SNP group, which received sodium nitroprusside (SNP, 50 µg/kg, i.v), followed by L-NAME after 30 min, and three treatment groups, which received the B. vulgaris extract at doses of 100, 200, and 400 mg/kg, followed by L-NAME. The heart rate (HR), mean arterial pressure (MAP), and systolic blood pressure (SBP) were measured up to 30 min after L-NAME injection. Afterward, changes (Δ) in SBP, MAP, and HR were calculated and analyzed.
ResultsAll doses of the extract attenuated ΔSBP, ΔMAP, and ΔHR; however, these changes in the groups receiving the extract at the doses of 200 and 400 mg/kg were significantly lower than in the group receiving saline (P < 0.05-P < 0.01, respectively). In the L-NAME group, ΔSBP, ΔMAP, and ΔHR were significantly increased (P < 0.01-P < 0.001). In the L-NAME + SNP group, all responses were significantly lower than in the L-NAME group (P < 0.01-P < 0.001). The extract at the doses of 200 and 400 mg/kg significantly reduced ΔHR, ΔMAP, and ΔSBP induced by L-NAME (P < 0.05-P < 0.001). Moreover, these changes at the doses of 100 and 200 were significantly higher than in the L-NAME + SNP group.
DiscussionIn the present study, it was demonstrated that the B. vulgaris extract dose dependently decreased cardiovascular parameters in basal and L-NAME-induced hypertensive conditions. This response suggests that the cardiovascular effect of the hydroalcoholic extract of B. vulgaris is partly mediated by an increase in NO production. Given the vasodilatory effect of NO, it seems that NO reduces vascular resistance and causes a decrease in blood pressure.
ConclusionNO has a beneficial effect on the cardiovascular system, and the hypotensive effect of B. vulgaris extract is partly mediated by increased NO production.
-
-
-
Revisiting Congenital Atransferrinemia: A Rare but Treatable Cause of Pediatric Heart Failure
Available online: 10 November 2025More LessCongenital atransferrinemia is an extremely rare autosomal recessive disorder characterized by functional or quantitative deficiency of transferrin. This leads to a characteristic clinical picture that includes heart failure due to iron overload cardiomyopathy, severe anemia, as well as hepatic and endocrine dysfunction in early infancy. Although rare or may be underdiagnosed, congenital atransferrinemia is a treatable cause of infantile heart failure and iron overload cardiomyopathy. Therefore, it is important to keep this diagnosis as a possibility in childhood presentation of heart failure and anemia. Early diagnosis and timely treatment can prevent progressive myocardial dysfunction and recurrent heart failure. This article focuses on pathophysiology, diagnosis, genetics, and management of heart failure in congenital atransferrinemia.
-
-
-
Exploring the Cardioprotective Potential of Borago officinalis in Isoproterenol-induced Myocardial Infarction: A Preclinical Study on Rats
Authors: Zahra Sufwan, Javed Akhtar Ansari and Farogh AhsanAvailable online: 10 November 2025More LessIntroductionThe present study aimed to investigate the cardioprotective effect of Borago officinalis and its synergistic effect against isoproterenol-induced myocardial infarction in Sprague-Dawley (SD) rats.
Materials and MethodsMyocardial infarction was experimentally induced in SD rats (Rattus norvegicus) using subcutaneous administration of isoproterenol (ISO) 85 mg/kg/s.c on days 20 and 21. Experimental animals were divided into five groups (5 animals each): normal control (NC), negative control (ISO), test drug Borago officinalis leaf extract (BOL) group, standard drug metoprolol (SDG) group, and combination of test drug Borago officinalis and standard drug metoprolol (BOM) group. Physical (heart grading and heart/body weight ratio), biochemical (CK-MB, LDH, AST, and ALT), troponin, oxidative stress (TBARS), and antioxidant parameters (SOD, CAT, GSH, and GPx) were assessed. Additionally, histopathological analysis of heart tissues was performed.
ResultsISO significantly impaired cardiac function, as indicated by elevated biochemical markers (CK-MB, LDH, AST, and ALT) and oxidative stress markers (TBARS), and by heart tissue damage, with lowered antioxidant parameters (SOD, CAT, GSH, and GPx). Rats pre-treated with BOL, SDG, or their combination, BOM, effectively reduced these effects. Among them, the BOM group showed a significant cardioprotective effect, suggesting a synergistic action that outperformed metoprolol alone.
DiscussionRats that were pre-treated with Borago officinalis extract showed significant improvement in biochemical, antioxidant, and histopathological markers compared to the rats in the ISO group. However, the combination of Borago officinalis and metoprolol provided the most pronounced protection, suggesting a synergistic effect.
ConclusionThe findings of the present study highlight the potential of Borago officinalis as a complementary cardioprotective agent.
-
-
-
Temporary Spontaneous Remission of Adult Acute Lymphoblastic Leukemia Associated with Scrub Typhus Infection
Authors: Arjun Kachhwaha, Paras Satadeve, Adamya Gupta, Neha Singh and Uttam Kumar NathAvailable online: 22 October 2025More LessIntroductionAcute lymphoblastic leukemia (ALL) in adult patients usually poses a treatment challenge with intensive chemotherapeutic agents. Prognosis is worse in comparison to pediatric patients owing to disease biology and associated comorbidities. Spontaneous remission of ALL is rare and warrants close follow-up for progression.
Case PresentationHerein, we report the case of a male in his 40s initially admitted for febrile illness with pancytopenia; later, his serology was positive for scrub typhus infection, and he was managed for the same with antimicrobials. Due to the persistence of pancytopenia, a bone marrow examination revealed 14% blasts, which were confirmed as B lymphoblasts on flow cytometry. Molecular workup, including cytogenetic and next-generation sequencing, was done. There was no indication for treatment, and the hemogram subsequently improved spontaneously, with normalization of blood count parameters.
ConclusionThe patient was kept under close follow-up as an outpatient with clinical examination and hematological parameters. Five months later, the patient was diagnosed with ALL and, unfortunately, died during therapy.
-
-
-
Therapeutic Trends in Diabetes Management: A Review on Oral Hypoglycemic Agents (OHAs) Utilization in Tertiary Care
Available online: 06 October 2025More LessIntroductionType 2 Diabetes Mellitus (T2DM) is a chronic metabolic disorder marked by insulin resistance and impaired insulin secretion. Effective glycemic management is critical for preventing problems, which can be achieved through Oral Hypoglycemic Agents (OHAs). Metformin is the first-line drug due to its insulin-sensitizing effects, while other classes, such as sulfonylureas, meglitinides, DPP-4 inhibitors, SGLT2 inhibitors, thiazolidinediones, and α-glucosidase inhibitors, serve complementary roles. Evolving treatment strategies increasingly favour combination therapies to increase outcomes.
MethodsThe review involved an extensive search of scientific databases and relevant literature, including studies published to date in PubMed, Science Direct, and Google Scholar. Type 2 Diabetes Mellitus (T2DM), oral hypoglycaemic agents, pharmacoeconomics, insulin sensitivity, SGLT2 inhibitors, and Thiazolidinediones were among the search phrases used. The selected papers were carefully evaluated for methodological soundness and the significance of their results.
ResultsThere is an increased prescribing of fixed-dose combinations, such as metformin-vildagliptin, which has led to better adherence and control. Regional differences in costs have an impact on the accessibility of drugs. SGLT2 and GLP-1 drugs provide cardiovascular and renal effects, whereas DPP-4 drugs produce limited results. The difference in pharmacokinetics and a certain decline of β-cells may require the prescription of an individualized treatment, combination therapy, or the introduction of insulin over time.
DiscussionThe current inclination to fixed-dose combinations improves compliance and glycemic control. Regional inequity is affected by the differences in costs. Better results in the use of SGLT2 and GLP-1 drugs favor their application in vulnerable patients, whereas the DDP-4 blocking agent is more appropriate in milder patient populations. Individualized treatment programs are a necessity, even with impaired β-cell functioning, which necessitates intensification of the therapy or insulin.
ConclusionOptimizing T2DM management requires a personalized approach that integrates clinical efficacy, safety, and cost into account. Regular prescription audits and targeted pharmacoeconomic strategies are vital for equitable access and long-term disease control worldwide.
-
-
-
The Effects of Resveratrol on Menopausal Cardio-metabolic Changes: A Systematic Review
Available online: 23 September 2025More LessIntroductionMenopause is known as a stage in a woman's natural life cycle in which menstrual periods permanently stop with developing age. This review aims to review the modulating mechanistic effects of resveratrol (RSV) on cardiometabolic changes associated with menopause.
MethodsTo identify published studies before January 12, 2025, a comprehensive search was conducted across various electronic databases, such as Web of Science, PubMed/MEDLINE, Embase, Scopus, and the Cochrane Library. Based on the study's objectives, two reviewers independently performed data extraction to ensure accuracy and reduce bias. The extracted data were subsequently reviewed.
ResultsRSV has reductive effects on blood pressure, improves endothelial function, and enhances insulin-stimulated glucose uptake. It also decreases fasting blood glucose levels, insulin levels, total cholesterol, triglycerides, and adipocyte hypertrophy. Increased estradiol levels correlate with improved cerebrovascular function and enhanced neurovascular coupling. However, the effects on body weight, body mass index (BMI), and lipid metabolism are inconsistent; some studies reported reductions in fat volume and changes in thermogenesis-related gene expression. Moreover, total antioxidant capacity (TAC) and malondialdehyde (MDA) levels increase. While RSV demonstrates potential benefits for vascular function and metabolic regulation, further research is necessary to determine its long-term efficacy.
DiscussionThe findings align with existing evidence on RSV’s vascular and metabolic benefits, underscoring its complementary therapeutic potential. Limitations, like bioavailability, differences in patient characteristics, and inconsistent lipid outcomes, call for standardized and long-term studies.
ConclusionRSV, as a phytoestrogen, increases estrogen levels in the intervention groups. RSV shows potential effects in modulating the most studied menopausal cardio-metabolic changes.
-
-
-
CYP2C19 Genetic Variants Associated with Clopidogrel Resistance and Major Adverse Cardiovascular Events in Vietnamese Patients Undergoing Percutaneous Coronary Intervention
Available online: 19 August 2025More LessIntroductionAcute coronary syndrome (ACS) is a leading cause of death, and clopidogrel resistance remains a major challenge in its treatment. This study aims to determine the impact of CYP2C19 genetic variants on clopidogrel resistance (CR) and major adverse cardiovascular events (MACEs) in Vietnamese patients undergoing percutaneous coronary intervention (PCI).
MethodsWe carried out a descriptive cross-sectional study, supplemented by a prospective longitudinal follow-up, on 113 ACS patients undergoing PCI with drug-eluting stent implantation at the Department of Cardiology, Military Hospital 103, from January 2015 to May 2018. We excluded patients with a decreased platelet count (< 100 × 10^9/L), a decreased estimated glomerular filtration rate (< 15 mL/min), ongoing bleeding, coagulation disorders, planned or recent surgery, or a coexisting malignancy. CR was defined as platelet aggregation ≥ 46%. The Amplification Refractory Mutation System (ARMS)-PCR was used to determine the CYP2C19 genotype and phenotype. Causes leading to patient readmission, such as angina, recurrent acute myocardial infarction, stroke, or death within 30 days, were recorded as MACEs.
ResultsThe rate of CR was 29.9% (33/113 patients), and the incidence of MACEs was 15.9% (18/113 patients). The frequencies of CYP2C192 and CYP2C193 polymorphisms, as well as the PM CYP2C19 phenotype, were higher in the CR and MACE groups compared to those without these characteristics (p = 0.24, 0.006, and < 0.001, respectively). The PM CYP2C19 phenotype was predictive of 30-day MACEs in ACS patients undergoing PCI with stent implantation (p < 0.001).
DiscussionOur findings demonstrate a strong association between CYP2C19 PM phenotypes and increased risks of both clopidogrel resistance and 30-day MACEs in Vietnamese ACS patients undergoing PCI. These results underscore the clinical significance of CYP2C19 genotyping in optimizing antiplatelet therapy and enhancing outcomes in this patient population.
ConclusionPM CYP2C19 phenotypes were associated with an increased risk of CR and MACEs in Vietnamese patients undergoing PCI with stent implantation.
-
-
-
Impacts of Sacubitril-Valsartan versus Valsartan on Left Ventricular Remodeling and Cardiac Function in Patients with Ischemic Heart Failure and Reduced Ejection Fraction: A Randomized Double-blinded Controlled Trial
Available online: 13 August 2025More LessIntroductionSacubitril/valsartan (SAC/VAL) is a combination medication primarily used to treat heart failure with reduced ejection fraction (HFrEF). This randomized controlled trial (RCT) assessed the impacts of SAC/VAL compared with valsartan (VAL) on left ventricular (LV) remodeling, clinical outcomes, and cardiac function in patients with HFrEF.
MethodsA single-blinded run-in phase and a double-blinded treatment phase were conducted at Imam Hospital (Ahvaz, Iran) among 106 patients (SAC/VAL group: n=54; VAL group=52). Patients were randomly assigned to receive a combination of SAC/VAL (up-titrated to the target dosage of 200 mg, twice daily) or VAL (up-titrated to 160 mg, twice daily) for a six-month of intervention. Patients' clinical, demographic, and echocardiographic data were collected before and after the intervention.
ResultsAfter a six-month intervention, statistically significant mean differences were detected in various echocardiographic parameters (e.g., LV end-systolic volume, LV ejection fraction, and LV end-diastolic volume) within each group and between the two groups. Significant mean differences were noted in the six-minute walk test, serum levels of blood urea nitrogen, aspartate aminotransferase, sodium, creatinine, alanine aminotransferase, N-terminal pro–B-type natriuretic peptide, and scores of the Kansas City Cardiomyopathy questionnaire in post-intervention assessments within each group and between the two groups (P <0.05). There was a substantial within-group difference in the frequency of the New York Heart Association (NYHA) functional class from pre- to post-intervention (P <0.05).
DiscussionThis study revealed that SAC/VAL exhibited superior efficacy compared to VAL. However, the follow-up period was relatively short, and the potential risks associated with the prolonged administration of this medication have not been thoroughly evaluated.
ConclusionThis RCT indicated that the combination of SAC/VAL had better therapeutic effects than VAL on LV remodeling, clinical outcomes, and cardiac function in patients with ischemic HFrEF. These findings may help refine treatment priorities for patients with HFrEF and improve the quality of their care.
Clinical Trial Registration NumberIRCT20240117060713N1.
-
-
-
Updated Review of Current Therapeutic Approaches for the Management of Sickle Cell Disease
Authors: Devwati Puri, Bhupendra Verma, Harish Bhardwaj and Rajendra Kumar JangdeAvailable online: 14 July 2025More LessSickle cell disease is a severe genetic blood disorder marked by the production of abnormal hemoglobin (HbS), leading to sickle-shaped red blood cells that obstruct blood flow and cause various problems, such as the increased risk of infection, persistent anemia, acute pain episodes, and organ damage. Roughly 100,000 Americans suffer from SCD, with approximately 40,000 of them being children. Black people have the highest frequency of the disease. There are six Food and Drug Administration (FDA)-approved drugs, hydroxyurea, L-glutamine, crizanlizumab-TMCA, voxelotor, Casgevy, and Lyfgenia, that are used for the prophylaxis and treatment of serious complications of sickle cell disease. Current treatment approaches focus on symptom management, including pain control, hydroxyurea to reduce pain crises, and transfusions for severe anemia. Based on the clinical trial results, L-glutamine and crizanlizumab-TMCA prevent cell damage and hemoglobin sickling by reducing the sickle cell crisis episodes. At the same time, voxelotor improves hemoglobin oxygen-binding capacity in patients with SCD. Novel therapies, such as gene therapy and clustered regularly interspaced short palindromic repeats/CRISPR-associated protein 9 (CRISPR-Cas9) technology, aim to correct the genetic defect. At the same time, stem cell and bone marrow transplants offer potential cures but are limited by the availability of donors and side effects. Ongoing research seeks to enhance treatment options and develop potential cures for SCD. This review attempts to present a comprehensive overview of the current therapeutic approaches and newly developed innovative medicines to combat and potentially eradicate SCD with an emphasis on their mechanisms, efficacy, and clinical implications.
-