Early left ventricular microvascular dysfunction in diabetic pigs: a longitudinal quantitative myocardial perfusion CMR study

Cardiovascular Diabetology, Journal Year: 2024, Volume and Issue: 23(1)

Published: Jan. 6, 2024

Abstract Background Microvascular pathology is one of the main characteristics diabetic cardiomyopathy; however, early longitudinal course microvascular dysfunction remains uncertain. This study aimed to investigate dynamic changes in left ventricular (LV) function pig model using cardiac magnetic resonance (CMR)-derived quantitative perfusion technique. Methods Twelve pigs with streptozotocin-induced diabetes mellitus (DM) were included this study, and CMR scanning was performed before 2, 6, 10, 16 months after modeling. CMR-derived semiquantitative parameters (upslope, maximal signal intensity, index, myocardial reserve index [MPRI]) fully (myocardial blood flow [MBF] [MPR]) analyzed evaluate LV function. Pearson correlation used analyze relationship between structure Results With progression DM duration, upslope at rest showed a gradually increasing trend (P = 0.029); stress MBF did not change significantly > 0.05). Regarding function, both MPRI MPR decreasing disease duration (MPRI, P 0.001; MPR, 0.042), high consistency (r 0.551, < 0.001). Furthermore, moderately associated strain − 0.353, 0.022), remodeling 0.312, 0.033), fasting glucose 0.313, 0.043), HbA1c 0.309, 0.046). Microscopically, pathological results that collagen volume fraction increased gradually, whereas no significant decrease density observed duration. Conclusions Myocardial decreased stage DM, which related structural (but reduced density) functional abnormalities microvessels, glucose, deformation, remodeling.

Language: Английский

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Coronary microvascular dysfunction assessment: A comparative analysis of procedural aspects

Catheterization and Cardiovascular Interventions, Journal Year: 2024, Volume and Issue: 103(5), P. 703 - 709

Published: March 23, 2024

Abstract Background Full adoption of coronary microvascular dysfunction (CMD) assessment faces challenges due to its invasive nature and concerns about prolonged procedure time increased contrast and/or radiation exposure. We compared procedural aspects CMD diagnostic left heart catheterization (DLHC) in patients with chest pain who were not found have obstructive artery disease. Methods A total 227 the Coronary Microvascular Disease Registry 1592 underwent DLHC from August 2021 November 2023. The two cohorts using propensity‐score matching; primary outcomes fluoroscopy use. Results participants' mean age was 64.1 ± 12.6 years. CMD‐assessed more likely be female (66.5% vs. 45.2%, p < 0.001) hypertension (80.2% 44.5%, 0.001), history stroke (11.9% 6.3%, = 0.002), myocardial infarction (20.3% 7.7%, 0.001). safe, without any reported adverse outcomes. propensity‐matched analysis showed that had slightly higher median exposure (50 40 mL, longer (6.9 4.7 min, However, there no difference dose (209.3 219 mGy, 0.58) overall (31 29 0.37). Conclusion Compared DLHC, is safe requires only additional use (10 mL) (2 min) clinical implications. These findings emphasize favorable safety feasibility assessment.

Language: Английский

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PFAS and their association with the increased risk of cardiovascular disease in postmenopausal women

Toxicological Sciences, Journal Year: 2024, Volume and Issue: 200(2), P. 312 - 323

Published: May 17, 2024

Abstract Cardiovascular diseases (CVDs) are one of the major causes death globally. In addition to traditional risk factors such as unhealthy lifestyles (smoking, obesity, sedentary) and genetics, common environmental exposures, including persistent contaminants, may also influence CVD risk. Per- polyfluoroalkyl substances (PFASs) a class highly fluorinated chemicals used in household consumer industrial products known persist our environment for years, causing health concerns that now linked endocrine disruptions related outcomes women, interference cardiovascular reproductive systems. postmenopausal higher levels PFAS observed than premenopausal women due cessation menstruation, which is crucial excretion. Because these findings, we explored association between perfluorooctanoic acid (PFOA), perfluorooctane sulfonate (PFOS), perfluorobutanesulfonic from previously established study. We liquid chromatography with tandem mass spectrometry, supported by machine learning approaches, detection quantification serum metabolites proteins. Here, show PFOS can be good predictor coronary artery disease, whereas PFOA an intermediate microvascular disease. found study significantly associated inflammation-related Our findings provide new insight into potential mechanisms underlying PFAS-induced CVDs this population. This shows exposure increased disease women. correlate amino acids proteins inflammation. These circulating biomarkers contribute etiology potentially implicate mechanistic relationship events

Language: Английский

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JCS/CVIT/JCC 2023 guideline focused update on diagnosis and treatment of vasospastic angina (coronary spastic angina) and coronary microvascular dysfunction

Journal of Cardiology, Journal Year: 2023, Volume and Issue: 82(4), P. 293 - 341

Published: Aug. 17, 2023

In 2008, the Guidelines for diagnosis and treatment of patients with vasospastic angina (coronary spastic angina) [[1]JCS Joint Working Group (JCS 2008): digest version.Circ J. 2010; 74: 1745-1762Crossref PubMed Scopus (231) Google Scholar] were developed by Japanese Circulation Society, revised version was published in 2013 [[2]JCS 2013): 2014; 78: 2779-2801Crossref Scholar]. Since then, new findings from various fields such as coronary microvascular dysfunction (CMD), biomarkers, imaging, physiological functions, genes have accumulated. Furthermore, together spread emergency angiography (CAG) acute syndrome (ACS) development diagnostic techniques using high-sensitive troponin, concepts myocardial infarction non-obstructive arteries (MINOCA) ischemia artery disease (INOCA) been proposed [[3]Bairey Merz C.N. Pepine C.J. Walsh M.N. Fleg J.L. Ischemia No Obstructive Coronary Artery Disease (INOCA): Developing evidence-based therapies research agenda next decade.Circulation. 2017; 135: 1075-1092Crossref (438) Scholar,[4]Beltrame J.F. Assessing nonobstructed (MINOCA).J Intern Med. 2013; 273: 182-185Crossref (87) The term “angina pectoris”, named mid-18th century, extended to include variant forms [[5]Prinzmetal M. Kennamer R. Merliss Wada T. Bor N. Angina pectoris. I. A form pectoris: preliminary report.Am J 1959; 27: 375-388Abstract Full Text PDF 20th a result advances both invasive noninvasive pharmaco- or catheter therapy, European Society Cardiology (ESC) concept chronic (CCS), taking into account need ongoing risk management 21st century [[6]Knuuti Wijns W. Saraste A. Capodanno D. Barbato E. Funck-Brentano C. et al.2019 ESC guidelines syndromes: task force syndromes (ESC).Eur Heart 2020; 41: 407-477Crossref (3299) spasm, which regional racial differences noted, is not rare Europe USA [[7]Yasue H. Nakagawa Itoh Harada Mizuno Y. spasm: clinical features, diagnosis, pathogenesis, treatment.J Cardiol. 2008; 51: 2-17Abstract (304) Scholar,[8]Pristipino Beltrame Finocchiaro M.L. Hattori Fujita Mongiardo al.Major constrictor response between Caucasians recent infarction.Circulation. 2000; 101: 1102-1108Crossref Vasomotion Disorders International Study (COVADIS) group, an international group on dysfunction, criteria (VSA) 2017 [[9]Beltrame Crea F. Kaski J.C. Ogawa Ong P. Sechtem U. al.Coronary (COVADIS). standardization angina.Eur 38: 2565-2568PubMed Scholar], (MVA) 2018 [[10]Ong Camici P.G. Shimokawa angina.Int 2018; 250: 16-20Abstract (398) case MINOCA INOCA, importance recognizing considering functional abnormalities absence organic lesions without seeking noncardiac causes chest symptoms challenged [11Ford T.J. Stanley B. Sidik Good Rocchiccioli McEntegart al.1-year outcomes guided function testing (CorMicA).JACC Cardiovasc Interv. 13: 33-45Crossref (115) Scholar, 12Reynolds H.R. Picard M.H. Spertus J.A. Peteiro Lopez Sendon Senior al.Natural history no obstructive disease: CIAO-ISCHEMIA Study.Circulation. 2021; 144: 1008-1023Crossref (0) 13Seitz Feenstra Konst R.E. Martínez Pereyra V. Beck S. Beijk al.Acetylcholine rechallenge: first step toward tailored spasm.JACC 2022; 15: 65-75Crossref (22) 14Shimokawa Suda Takahashi Berry al.Clinical characteristics prognosis angina: prospective cohort study Vasomotor Group.Eur 42: 4592-4600Crossref (57) 15Takahashi Samuels B.A. Li Parikh M.A. Wei Moses J.W. al.Safety provocative intracoronary acetylcholine implications standard protocols.J Am Coll 79: 2367-2378Crossref (17) 16Crea Montone R.A. Rinaldi Pathophysiology dysfunction.Circ 86: 1319-1328Crossref This focused update based (2013 revision) JCS Guideline [[17]JCS guideline syndrome.Circ 2019; 83: 1085-1196Google heart diseases [[18]JCS diseases.Circ 85: 402-572Google while position CMD, spasm (MVS), (CAD) field ischemic (IHD). Updates following topics provided.1.MINOCA INOCA are described related spasm.2.New pathophysiology, added since revision.(1)For pathophysiology: aldehyde dehydrogenase 2 (ALDH2) gene polymorphism, MVS, after implantation drug-eluting stents (DES), pediatric diseases.(2)For diagnosis: review criteria, intravascular imaging ultrasound (IVUS), optical coherence tomography (OCT), angioscopy, computed tomography-derived fractional flow reserve (FFRCT) magnetic resonance (MRI), physiologic examinations (CFR), index microcirculatory resistance (IMR), endothelial tests.(3)For treatment: pharmacotherapy, nonpharmacotherapy, cardiovascular rehabilitation.3.The diffuse well focal during added.4.The diagrams designed help reader understand relationship among epicardial MVS MVA CMD (Fig. 4, Fig. 5). this update, recommendations levels evidence classified accordance updated statement, encompassing estimated benefit proportion (Table 1, Table 2).Table 1Classes recommendation.Class IThere and/or general agreement that given procedure effective usefulClass IIaThere high probability efficacy/usefulness opinionClass IIbEffectiveness/usefulness established III (No benefit)There (Harm)There harmful Open table tab 2Levels evidence.Level ADemonstrated multiple randomized trials meta-analysesLevel BDemonstrated single trial large nonrandomized studiesLevel CConsensus expert opinion small (including retrospective studies series) participation 8 academic societies: College Cardiology, Association Cardiovascular Intervention Therapeutics, Pediatric Cardiac Surgery, Rhythm Rehabilitation, Association, Cardioangioscopy. Please note basic information edition, update. Cases (AMI) occlusion CAD reported [[19]Gross Steinberg W.H. Myocardial significant arteries.Arch Med (Chic). 1939; 64: 249-267Crossref Scholar,[20]Miller R.D. Burchell H.B. Edwards J.E. occlusion: pathologic study.AMA Arch 1951; 88: 597-604Crossref 2012, “MINOCA” describe AMI fixed stenosis (≥50%) CAG [[4]Beltrame It became widely accepted, technical innovation medical (MI) (MI-CAD). establishment measurement system highly sensitive capable detecting even minute injury, proposal Universal Definition troponin variation [[21]Thygesen K. Alpert J.S. Jaffe A.S. Chaitman B.R. Bax J.J. Morrow D.A. al.Fourth universal definition (2018).Circulation. 138: e618-e651Crossref (1426) availability routine widespread use reperfusion therapy ST-elevation MI improved patients. On other hand, there certain number cases “without arteries”, cardiologists faced more than few difficulty diagnosing treating them, challenging problem has become apparent. Fourth Infarction clearly stated MI, atherosclerosis, thrombosis, imbalance oxygen demand supply, distinguished although present elevation above 99th percentile healthy individuals Therefore, MINOCA, it necessary exclude injury cause (e.g., sepsis renal dysfunction) cardiac myocarditis cardiomyopathy) similar ACS. However, because “working diagnosis”, tentatively diagnosed at time [22Pasupathy Tavella what, when, who, why, how where (MINOCA).Circ 2016; 80: 11-16Crossref (56) 23Agewall Reynolds Niessner Rosano G. Caforio A.L. al.Working Pharmacotherapy. working paper arteries.Eur 143-153PubMed 24Tamis-Holland Jneid Agewall Brilakis E.S. Brown T.M. al.Contemporary scientific statement American Association.Circulation. 139: e891-e908Crossref (443) always practical all due nonischemic performing CAG. Thus, attention should be paid whether being used diagnosis” final diagnosis. To avoid confusion, “troponin-positive arteries” (TP-NOCA) conditions presenting elevated including [[25]Pasupathy nonobstructive (MINOCA): past, present, future management.Circulation. 1490-1493Crossref (124) 1). Importantly, considered CAG, differential failure (HF), performed modalities, Chapter I.1.3. Potential shown [[22]Pasupathy Scholar,[25]Pasupathy Main plaque rupture/erosion, dissection, embolism Scholar,24Tamis-Holland 25Pasupathy 26Shibata Kawakami Noguchi Tanaka Asaumi Kanaya al.Prevalence, attributable embolism.Circulation. 2015; 132: 241-250Crossref (196) non-CAD myocarditis, takotsubo syndrome, cardiomyopathy, congenital coagulation abnormalities, pulmonary thromboembolism, sepsis. Initially, then non-coronary differentiation CAD, excluded. daily practice, these might overlap some pathological [[27]Lindahl Baron Albertucci Prati disease.EuroIntervention. 17: e875-e887Crossref (6) etiology embolism, one mainly atrial fibrillation (AF), but septic emboli infective endocarditis paradoxical deep vein thrombosis may also occur [[26]Shibata possibility concurrent considered. addition, induced pharmacological provocation transient left ventricular [[28]Dote Sato Tateishi Uchida Ishihara stunning simultaneous multivessel spasms: 5 cases. [in Japanese].J 1991; 21: 203-214PubMed Scholar,[29]Tsuchihashi Ueshima Oh-mura Kimura Owa al.Angina Pectoris-Myocardial Investigations Japan. Transient apical ballooning stenosis: novel mimicking infarction: Japan.J 2001; 11-18Crossref practice management, physicians scrutinize overlapping etiologies consider according etiology. involves hypercontraction hyperactivity Rho-kinase pathway vascular smooth muscle cells (VSMCs) [[30]Shimokawa Seto Katsumata Amano Kozai Yamawaki al.Rho-kinase-mediated induces enhanced myosin light chain phosphorylations swine model spasm.Cardiovasc Res. 1999; 43: 1029-1039Crossref (282) decreased production nitric oxide (NO) endothelium [[31]Kugiyama Yasue Okumura Fujimoto Nakao al.Nitric activity deficient angina.Circulation. 1996; 94: 266-271Crossref inflammation adventitia perivascular adipose tissue [[32]Ohyama Matsumoto Takanami Ota Nishimiya Sugisawa adventitial angina.J 71: 414-425Crossref (116) increases localized contraction arteries, resulting blood subsequent ischemia. leads [[33]Oshima Matsuyama Fibrinopeptide released circulation spasm.Circulation. 1990; 82: 2222-2225Crossref (66) decreases fibrinolytic [[34]Misumi Masuda Sakamoto Increased plasma plasminogen activator inhibitor spasm.Int 1993; 21-29Abstract (13) promotion platelet activation release adhesion molecules [[35]Kaikita Suefuji Sumida al.Soluble P-selectin 1995; 92: 1726-1730Crossref (88) thrombogenic state. previous investigated thrombus formation spasm; researchers observed site OCT found 28% sites their proximal lesion, erosion 26% [[36]Shin Ann S.H. Singh G.B. Lim K.H. Yoon H.J. Hur al.OCT-defined morphological angina.JACC Imaging. 8: 1059-1067Crossref (71) Another observational comparing vessels responsible ACS (CSA) spasm-induced had frequency (69% vs. 27%), intimal tears (46% 7%), (28% 5%) CSA [[37]Park H.C. Shin J.H. Jeong W.K. Choi S.I. Kim S.G. Comparison morphologic obtained caused vasospasm stable 31: 229-237Crossref (23) Based autopsy [[38]Lin C.S. Penha P.D. Zak F.G. Lin Morphodynamic interpretation special reference volcano-like eruption atheromatous spasm.Angiology. 1988; 39: 535-547Crossref assumed mechanisms vulnerable rupture fibrous capsule surface protrusion contents vessel mechanical stress formation. spontaneous dissection (SCAD), another involvement pathogenesis [[39]Tsujita Miyazaki Kaikita Chitose Takaoka Soejima al.Premenopausal woman potential association vasospasm.Cardiovasc Interv Ther. 2012; 121-126Crossref Scholar,[40]Mori Macaya Escaned Mejía-Rentería Endothelial dissection.JACC e219-e220Google 10 SCAD control (ACh) CFR showed [[41]Waterbury Tweet M.S. Hayes S.N. Prasad Lerman Gulati dissection.Eur Acute Care. 9: 90-95Crossref large, studies. single-center investigating bridging, ACh-induced bridge [[42]Montone Gurgoglione F.L. Del Buono M.G. Meucci M.C. Iannaccone al.Interplay bridging arteries: pathogenic prognostic implications.J Assoc. 10e020535Crossref (35) it, suggesting involved bridge. We summarized reports Japan abroad regarding epidemiology [43Pasupathy Air Dreyer R.P. Systematic suspected arteries.Circulation. 131: 861-870Crossref 44Smilowitz N.R. Mahajan A.M. Roe M.T. Hellkamp Chiswell al.Mortality sex, age, status ACTION Registry-GWTG (Acute Treatment Outcomes Network Registry-Get With Guidelines).Circ Qual Outcomes. 10e003443Crossref (194) 45Lindahl Erlinge Hadziosmanovic Nordenskjöld Gard al.Medical secondary prevention long-term outcome disease.Circulation. 1481-1489Crossref (273) 46Montone Niccoli Fracassi Russo Cammà al.Patients safety relevance tests.Eur 91-98PubMed 47Safdar Spatz Lichtman al.Presentation, profile, young Nonobstructive Arteries results VIRGO Study.J 7e009174Crossref (223) 48Choo E.H. Chang Lee K.Y. J.G. Ahn al.KAMIR - NIH Investigators. Prognosis predictors mortality suffering arteries.J 8e011990Google 49Eggers K.M. Hjort Jernberg Tornvall al.Morbidity cause-specific first-time 285: 419-428Crossref (39) 50Dreyer Curtis J.P. Wang Pauspathy Messenger al.Myocardial compared Medicare population.Eur 870-878Crossref (59) 51Ishii Seki Nakai al.JROAD Characteristics in-hospital super-aging society.Int 301: 108-113Abstract 52Pasupathy Lindahl Litwin Williams M.J.A. al.Survival comprehensive systematic meta-analysis Global Collaboration.Circ 14e007880Crossref (26) 53Sueda Sakaue arteries.Heart Vessels. 36: 1804-1810Google 3). ranged approximately 3.5% 11.1%, reports, 3.7% 72.6%, wide reports. Because provoked higher Asians, Japanese, [[8]Pristipino Scholar,[54]Beltrame Sasayama Maseri Racial heterogeneity vasomotor reactivity: Caucasian patients.J 33: 1442-1452Crossref (291) factor difference spasm. ACOVA [[55]Ong Athanasiadis Borgulya Mahrholdt High prevalence pectoris unobstructed (Abnormal COronary VAsomotion arteries).J 59: 655-662Crossref (301) German Westerners [[56]Suda Seitz Odaka Pirozzolo al.Assessment responses similarities differences?.Heart 337-344Crossref common understanding issued protocol [[23]Agewall non-obstruc

Language: Английский

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Exercise to Prevent Accelerated Vascular Aging in People Living With HIV

Circulation Research, Journal Year: 2024, Volume and Issue: 134(11), P. 1607 - 1635

Published: May 23, 2024

Given advances in antiretroviral therapy, the mortality rate for HIV infection has dropped considerably over recent decades. However, people living with (PLWH) experience longer life spans coupled persistent immune activation despite viral suppression and potential toxicity from long-term therapy use. Consequently, PLWH face a cardiovascular disease (CVD) risk more than twice that of general population, making it leading cause death among this group. Here, we briefly review epidemiology CVD highlighting disparities at intersections sex gender, age, race/ethnicity, contributions social determinants health psychosocial stress to increased individuals marginalized identities. We then overview pathophysiology discuss primary factors implicated as contributors on therapy. Subsequently, highlight functional evidence premature vascular dysfunction an early pathophysiological determinant PLWH, several mechanisms underlying synthesize current research accelerated aging focusing activation, chronic inflammation, oxidative stress. consider understudied aspects such HIV-related changes gut microbiome stress, which may serve through exercise can abrogate aging. Emphasizing significance exercise, various modalities their impacts health, proposing holistic approach managing risks PLWH. The discussion extends critical future study areas related aging, CVD, efficacy interventions, call inclusive considers diversity population.

Language: Английский

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Microvascular Dysfunction across the Spectrum of Heart Failure Pathology: Pathophysiology, Clinical Features and Therapeutic Implications

International Journal of Molecular Sciences, Journal Year: 2024, Volume and Issue: 25(14), P. 7628 - 7628

Published: July 11, 2024

Coronary microvascular dysfunction (CMD) plays a crucial role across the spectrum of heart failure (HF) pathology, contributing to disease development, progression, and outcomes. The pathophysiological mechanisms linking CMD HF are complex still not completely understood include chronic inflammation, oxidative stress, neurohormonal activation. Despite diagnostic prognostic relevance in patients with HF, there is no specific therapeutic strategy targeting date. Moreover, diagnosis this clinical condition challenging. In review article, we aim discuss different pathogenetic spectra these diseases, their relevance, possible targets along remaining knowledge gaps field.

Language: Английский

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MINOCA: A Pathophysiological Approach of Diagnosis and Treatment—A Narrative Review

Biomedicines, Journal Year: 2024, Volume and Issue: 12(11), P. 2457 - 2457

Published: Oct. 25, 2024

Myocardial infarction with non-obstructive coronary arteries (MINOCA) is a clinical entity characterized by the absence of significant artery obstruction in epicardial (<50%) on angiography setting acute myocardial (AMI). This article aims to provide narrative review pathophysiological mechanisms, diagnostic challenges, and prognosis associated MINOCA based pathophysiology regarding atherosclerotic non-atherosclerotic causes. Etiological factors, including thromboembolism, spasm, spontaneous dissection, microvascular disease, supply-demand mismatch, are addressed. Imaging modalities such as echocardiography, advances like intravascular ultrasound (IVUS) optical coherence tomography (OCT), cardiac magnetic resonance (CMR), computed (CCTA) also analyzed. patients have better short-term compared those obstructive disease but face long-term risks, underscoring need for precise diagnosis management strategies. Elevated inflammatory markers specific genetic predispositions adverse outcomes MINOCA. focused from perspective diverse underlying challenges achieving accurate diagnosis, importance tailored therapeutic approach necessity further investigation outcomes.

Language: Английский

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Correlation of RETINAL Artery Diameter with Coronary Artery Disease: The RETINA CAD Pilot Study—Are the Eyes the Windows to the Heart?

Cardiology and Therapy, Journal Year: 2023, Volume and Issue: 12(3), P. 499 - 509

Published: June 15, 2023

This study aimed to determine whether there was any correlation between coronary artery disease (CAD) and retinal diameter at an academic tertiary medical center in Trinidad Tobago. prospective evaluated patients (n = 77) with recent invasive angiography (CAG) the Synergy Percutaneous Coronary Intervention Taxus Cardiac Surgery (SYNTAX) score who subsequently underwent optical coherence tomography–angiography (OCT–A) Eric Williams Medical Sciences Complex (EWMSC) from January 2021 March 2021. Routine history cardiovascular medications were also recorded. Spearman's rank coefficient Mann–Whitney U-tests used compare correlations medians groups. The average patient age 57.8 years old, majority being male [n 55 (71.4%)] of South Asian ethnicity 53 (68.8%)]. Retinal negatively correlated SYNTAX (−0.332 for right eye, p 0.003 −0.237 left 0.038). A statistically significant relationship demonstrated females diabetic patients. There no serious adverse events (SAEs). significantly negative observed score. alludes practical use as a noninvasive diagnostic modality (CVD). Further large-scale, multicentric studies are required confirm these exploratory findings. NCT04233619.

Language: Английский

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Genetic Insights Into Coronary Microvascular Disease

Microcirculation, Journal Year: 2025, Volume and Issue: 32(1)

Published: Jan. 1, 2025

ABSTRACT Coronary microvascular disease (CMVD) affects the coronary pre‐arterioles, arterioles, and capillaries can lead to blood supply–demand mismatch cardiac ischemia. CMVD present clinically as ischemia or myocardial infarction with no obstructive arteries (INOCA MINOCA, respectively). Currently, therapeutic options for are limited, there targeted therapies. Genetic studies have emerged an important tool gain rapid insights into molecular mechanisms of human diseases. For example, artery (CAD) genome‐wide association (GWAS) enrolled hundreds thousands patients identified > 320 loci, elucidating CAD pathogenic pathways helping identify targets. Here, we review current landscape genetic CMVD, consisting mostly genotype‐first approaches. We then hypothesis that GWAS heterogenous populations may be better characterized ischemic heart (IHD) GWAS. discuss how several loci currently associated involved in pathogenesis CMVD. could help accelerate progress understanding pathophysiology identifying putative Larger phenotype‐first genomic adequate sex ancestry representation needed. Given extensive functional validation data, future research should leverage these springboards research.

Language: Английский

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Ischemic Myocardium Targeting Peptide‐Guided Nanobubbles for Multimodal Imaging and Treatment of Coronary Microvascular Dysfunction

Advanced Healthcare Materials, Journal Year: 2025, Volume and Issue: unknown

Published: Jan. 24, 2025

Abstract Coronary microvascular dysfunction (CMD) refers to clinical symptoms caused by structural and functional damage coronary microcirculation. The timely precise diagnosis of CMD‐related myocardial ischemia is essential for improving patient prognosis. This study describes a method the multimodal (fluorescence, ultrasonic, photoacoustic) noninvasive imaging treatment CMD based on ischemic myocardium‐targeting peptide (IMTP)‐guided nanobubbles functionalized with indocyanine green (IMTP/ICG NBs) characterizes their basic characteristics in vitro targeting abilities. IMTP/ICG NBs enable accurate location via photoacoustic imaging, when loaded tannic acid (TA), can be used effectively treat fibrosis mice, achieving an effect superior that free TA. origin this high therapeutic efficiency revealed transcriptomic proteomic analyses. investigation lays groundwork visual monitoring drug‐targeted CMD.

Language: Английский

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