A Non-Coronary, Peripheral Arterial Atherosclerotic Disease (Carotid, Renal, Lower Limb) in Elderly Patients—A Review: Part I—Epidemiology, Risk Factors, and Atherosclerosis-Related Diversities in Elderly Patients

Journal of Clinical Medicine, Journal Year: 2024, Volume and Issue: 13(5), P. 1471 - 1471

Published: March 3, 2024

Atherosclerosis is a generalized and progressive disease. Ageing key risk factor for atherosclerosis progression that associated with the increased incidence of ischemic events in supplied organs, including stroke, coronary events, limb ischemia, or renal failure. Cardiovascular disease leading cause death major disability adults ≥ 75 years age. Atherosclerotic occlusive affects everyday activity quality life, it reduced life expectancy. Although there evidence on artery management elderly, insufficient data older patients presented atherosclerotic lesions outside territory. Despite this, trials observational studies systematically exclude patients, particularly those severe comorbidities, physical cognitive dysfunctions, frailty, residence nursing home. This results serious critical gaps knowledge lack guidance appropriate medical treatment referral endovascular surgical interventions. Therefore, we attempted to gather prevalence, factors, strategies extra-coronary lesions.

Language: Английский

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Molecular Mechanisms and Therapeutic Implications of Endothelial Dysfunction in Patients with Heart Failure

International Journal of Molecular Sciences, Journal Year: 2023, Volume and Issue: 24(5), P. 4321 - 4321

Published: Feb. 21, 2023

Heart failure is a complex medical syndrome that attributed to number of risk factors; nevertheless, its clinical presentation quite similar among the different etiologies. displays rapidly increasing prevalence due aging population and success treatment devices. The pathophysiology heart comprises several mechanisms, such as activation neurohormonal systems, oxidative stress, dysfunctional calcium handling, impaired energy utilization, mitochondrial dysfunction, inflammation, which are also implicated in development endothelial dysfunction. with reduced ejection fraction usually result myocardial loss, progressively ends remodeling. On other hand, preserved common patients comorbidities diabetes mellitus, obesity, hypertension, trigger creation micro-environment chronic, ongoing inflammation. Interestingly, dysfunction both peripheral vessels coronary epicardial microcirculation characteristic categories has been associated worse cardiovascular outcomes. Indeed, exercise training drug display favorable effects against apart from their established direct benefit.

Language: Английский

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Inhibitors of NLRP3 Inflammasome in Ischemic Heart Disease: Focus on Functional and Redox Aspects

Antioxidants, Journal Year: 2023, Volume and Issue: 12(7), P. 1396 - 1396

Published: July 7, 2023

Myocardial ischemia-reperfusion injury (MIRI) is caused by several mechanisms, including the production of reactive oxygen species (ROS), altered cellular osmolarity, and inflammatory response. Calcium overload, levels, mitochondrial ROS are also involved in these MIRI processes, resulting irreversible opening permeability transition pore (mPTP). These mechanisms processes associated with NLRP3 inflammasome priming activation, which can induce cell death pyroptosis through up-regulation caspase-1 pathway IL-18 release. In addition, endothelial dysfunction, both presence absence MIRI, accompanied decreased nitric oxide production, overproduction, expression adhesion molecules leukocyte infiltration plays a central role, thus contributing, to alteration coronary flow, typical ischemic heart disease. Given intricate interrelationship between NLRP3, inhibitors reduce while oxidative stress inflammation. have been intensively studied as anti-inflammatory agents basic cardiovascular sciences. this review, we analyze interrelation disease effects some possible therapeutic condition. All compounds considered review need larger studies confirm their appropriate use clinical scenarios anti-ischemic drugs.

Language: Английский

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Potential Role of Natural Antioxidants in Countering Reperfusion Injury in Acute Myocardial Infarction and Ischemic Stroke

Antioxidants, Journal Year: 2023, Volume and Issue: 12(9), P. 1760 - 1760

Published: Sept. 13, 2023

Stroke and acute myocardial infarction are leading causes of mortality worldwide. The latter accounts for approximately 9 million deaths annually. In turn, ischemic stroke is a significant contributor to adult physical disability globally. While reperfusion crucial tissue recovery, it can paradoxically exacerbate damage through oxidative stress (OS), inflammation, cell death. Therefore, imperative explore diverse approaches aimed at minimizing ischemia/reperfusion injury enhance clinical outcomes. OS primarily arises from an excessive generation reactive oxygen species (ROS) and/or decreased endogenous antioxidant potential. Natural compounds counteract the mechanisms linked ROS. promising preclinical results, based on monotherapies, account protective effects against by ROS, translating these models into human applications has yielded controversial evidence. However, since wide spectrum antioxidants having chemical characteristics offers varied biological actions signaling pathways, multitherapy emerged as valuable therapeutic resource. Moreover, combination in holds potential synergistic effects. This study was designed with aim providing updated overview natural suitable preventing cerebral injuries.

Language: Английский

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Cardiac microRNAs: diagnostic and therapeutic potential

Archives of Medical Science, Journal Year: 2023, Volume and Issue: 19(5), P. 1360 - 1381

Published: Aug. 25, 2023

MicroRNAs are small non-coding post-translational biomolecules which, when expressed, modify their target genes. It is estimated that microRNAs regulate production of approximately 60% all human proteins and enzymes responsible for major physiological processes. In cardiovascular disease pathophysiology, there several cells produce microRNAs, including endothelial cells, vascular smooth muscle macrophages, platelets, cardiomyocytes. There a constant crosstalk between derived from various cell sources. Atherosclerosis initiation progression driven by many pro-inflammatory pro-thrombotic microRNAs. Atherosclerotic plaque rupture the leading cause death resulting acute coronary syndrome (ACS) leads to cardiac remodeling fibrosis following ACS. powerful modulators transformation into vulnerable state, which can eventually lead rupture. growing body evidence demonstrates ACS, might inhibit fibroblast proliferation scarring, as well harmful apoptosis cardiomyocytes, stimulate reprogramming induced progenitor cells. this review, we focus on role cardiomyocyte-derived fibroblast-derived involved in regulation genes associated with cardiomyocyte function atherosclerosis-related ischemia. Understanding mechanisms may development microRNA cocktails potentially be used regenerative cardiology.

Language: Английский

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The effect of sodium-glucose co-transporter-2 inhibitors on markers of subclinical atherosclerosis

Annals of Medicine, Journal Year: 2023, Volume and Issue: 55(2)

Published: Dec. 12, 2023

Background Despite the widespread use of classical cholesterol-lowering drugs to mitigate adverse impacts dyslipidaemia on atherosclerosis, many patients still face a substantial residual risk developing atherosclerotic cardiovascular disease (CVD). This is partially attributed non-traditional pathophysiological pathways. Latest evidence suggests that sodium glucose co-transporter-2 (SGLT2) inhibitors are beneficial for suffering from type 2 diabetes mellitus (T2DM) or established CVD by reducing morbidity and mortality. However, underlying mechanisms this benefit have not been clearly elucidated. It has hypothesized one possible mechanism could be attenuation subclinical atherosclerosis (SA) progression.

Language: Английский

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microRNAs Associated with Carotid Plaque Development and Vulnerability: The Clinician’s Perspective

International Journal of Molecular Sciences, Journal Year: 2022, Volume and Issue: 23(24), P. 15645 - 15645

Published: Dec. 9, 2022

Ischemic stroke (IS) related to atherosclerosis of large arteries is one the leading causes mortality and disability in developed countries. Atherosclerotic internal carotid artery stenosis (ICAS) contributes 20% all cerebral ischemia cases. Nowadays, prevention treatment measures aim at controlling risk factors, or interventional (surgical endovascular) management mature occlusive lesions. There a definite lack established circulating biomarkers which, once modulated, could prevent development atherosclerosis, consequently carotid-artery-related IS. Recent studies emphasize that microRNA (miRNA) are emerging particles potentially play pivotal role this approach. some research on association between expression small non-coding microRNAs with plaque vulnerability. However, data remain inconsistent. In addition, major atherosclerotic were conducted cell culture animal models; very few humans, whereas accumulating evidence demonstrates it cannot be automatically extrapolated processes humans. Therefore, paper aims review current knowledge how miRNA participate process formation rupture, as well occurrence. We discuss potential target used prognostic therapeutic tool.

Language: Английский

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Cellular Phenotypic Transformation During Atherosclerosis: The Potential Role of miRNAs as Biomarkers

International Journal of Molecular Sciences, Journal Year: 2025, Volume and Issue: 26(5), P. 2083 - 2083

Published: Feb. 27, 2025

Cellular phenotypic transformation is a key process that occurs during the development and progression of atherosclerosis. Within arterial wall, endothelial cells, vascular smooth muscle macrophages undergo changes contribute to pathogenesis miRNAs have emerged as potential biomarkers for cellular Monitoring miR-155-5p, miR-210-3p, miR-126-3p or 5p levels could provide valuable insights into disease progression, risk complications, response therapeutic interventions. Moreover, miR-92a-3p's elevated in atherosclerotic plaques present opportunities predicting related complications. Baseline miR-33a/b hold responses cholesterol-lowering therapies, such statins, likelihood dyslipidemia-related Additionally, assessment miR-122-5p may offer efficacy low-density-lipoprotein-lowering therapies. Understanding specific miRNA-mediated regulatory mechanisms involved transformations can atherosclerosis potentially identify novel targets.

Language: Английский

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Antiangiogenic effect of circulating extracellular vesicles in acute coronary syndrome: Role of miR‐199a‐3p and miR‐125a‐5p

European Journal of Clinical Investigation, Journal Year: 2025, Volume and Issue: unknown

Published: March 6, 2025

Circulating extracellular vesicles (EVs) have a great impact on human health as biomarkers and messengers in intercellular signalling. We aimed to determine how the miRNA profile of circulating EVs during an acute coronary event interferes with vasculogenic potential endothelial cells (EC). were purified from plasma patients phase non-ST segment elevation myocardial infarction (NSTEMI, n = 33) healthy donors (n 19) used control group. Human ECs treated EV suspension (5 × 107 particles/cm2) tested for their mRNA expression. The was determined by array. levels markedly increased NSTEMI (2.3 1011 ± 1.5 1010 particles/mL) versus (1.2 1.1 particles/mL; p .02). Treatment migration, tube formation, shaped more branched vessel-like structures comparison Sham-treated ECs. Nevertheless, lacked potential. Network analysis EC expression revealed correlation miR-199a-3p miR-125a-5p decrease components involved sprout stabilization. Combined therapy decreased Moreover, anti-miRNA combination anti-miR-125a-5p anti-miR-199a-3p restored impaired EVs. play important role angiogenesis. However, NSTEMI, communication via is modified loses its ability generate new blood vessels. loss angiogenic capacity may be player disease progression outcomes.

Language: Английский

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Empagliflozin Plays Vasoprotective Role in Spontaneously Hypertensive Rats via Activation of the SIRT1/AMPK Pathway

Cells, Journal Year: 2025, Volume and Issue: 14(7), P. 507 - 507

Published: March 29, 2025

Empagliflozin (EMPA), a sodium-glucose co-transporter 2 (SGLT2) inhibitor, prevents endothelial dysfunction, but its effects on vascular tone in hypertension remain unclear. This study investigated whether EMPA modulates vasomotor via sirtuin 1 (SIRT1) and AMP-activated protein kinase (AMPK) pathways spontaneously hypertensive rats (SHR) controls (Wistar Kyoto rats, WKY). Functional (wire myography, organ bath) biochemical (Western blot) studies were conducted the third-order of superior mesenteric arteries (sMAs) and/or aortas. induced concentration-dependent relaxation preconstricted sMAs both groups. In SHR, enhanced acetylcholine (Ach)-induced aortas reduced constriction by phenylephrine (Phe) U46619 sMAs. The SIRT1 inhibitor (EX527) abolished EMPA’s Ach-mediated U46619-induced vasoconstriction, while AMPK inhibition Phe-induced vasoconstriction. SHR showed increased SGLT2 expression decreased pAMPK/AMPK levels conclusion, might exert vasoprotective enhancing endothelium-dependent reducing AMPK/SIRT1 pathways. These properties could improve health patients with related conditions. Further are needed to explore new indications for inhibitors.

Language: Английский

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