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Related Concept Videos

Ischemic Heart Disease: Overview01:17

Ischemic Heart Disease: Overview

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Ischemic heart disease occurs when the heart's blood supply dwindles, causing an ominous lack of oxygen and nutrients. This deficiency, stemming from reduced or obstructed blood flow, spells danger, leading to heart muscle damage and dysfunction.
Atherosclerosis, the primary malefactor, orchestrates this dangerous condition. It manifests as the accumulation of fatty deposits, akin to insidious plaques, within arterial walls. As time elapses, these plaques metamorphose, hardening and...
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Coronary Artery Disease I: Introduction01:30

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Coronary Artery Disease (CAD): An Overview with Scientific InsightsCoronary Artery Disease (CAD), often referred to as C-A-D, is a prevalent blood vessel disorder classified under the broader category of atherosclerosis. Atherosclerosis is a pathological process characterized by the hardening and narrowing of arteries due to the accumulation of atherosclerotic plaques. These plaques are composed of cholesterol, fatty substances, inflammatory cells, calcium, and fibrin, reducing blood flow to...
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Coronary Artery Disease II: Pathophysiology01:26

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Coronary Artery Disease (CAD) originates from a series of events that impair the function of coronary arteries, the blood vessels responsible for delivering oxygen-rich blood to the heart muscle. The pathophysiology of CAD is closely linked to atherosclerosis, a chronic inflammatory and lipid-driven condition affecting the vascular endothelium.1. Endothelial DamageThe process begins with damage to the vascular endothelium, which serves as a protective barrier between the blood and the vessel...
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Coronary Artery Disease V: Interprofessional Care01:27

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Interprofessional care for coronary artery disease includes pharmacological therapy and revascularization procedures.Pharmacological therapy for Coronary Artery Disease (CAD) aims to manage symptoms, prevent complications, and improve patient outcomes through various classes of medications:Antiplatelet Agents:Aspirin and Clopidogrel: These medications inhibit platelet aggregation, preventing blood clots, which is crucial for avoiding heart attacks and strokes. Doctors often prescribe these...
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Rheumatic Heart Disease I: Introduction01:23

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Rheumatic heart disease or RHD is a chronic condition that results from rheumatic fever, causing permanent damage to the heart valves.Etiology and Risk FactorsIt primarily arises from rheumatic fever, an inflammatory disease that can develop after untreated or inadequately treated group A streptococcal (GAS) pharyngitis. Streptococcus spreads through direct contact with oral or respiratory secretions. While the bacteria are the causative agents, factors like malnutrition, overcrowding, poor...
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Coronary Artery Disease III: Clinical Manifestations01:30

Coronary Artery Disease III: Clinical Manifestations

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Coronary Artery Disease (CAD) is a primary health risk worldwide, leading to significant morbidity and mortality. The condition arises from the buildup of atherosclerotic plaques within the coronary arteries, resulting in diminished blood supply to the heart muscle.The clinical manifestations of CAD vary widely, from asymptomatic stages to severe, life-threatening conditions. Understanding these manifestations is crucial for early diagnosis and effective management.Angina Pectoris: The Warning...
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Novel Percutaneous Approach for Deployment of 3D Printed Coronary Stenosis Implants in Swine Models of Ischemic Heart Disease
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Coronary Microcirculation in Ischemic Heart Disease.

Axel R Pries1,2, Wolfgang M Kuebler1,2, Helmut Habazettl1,2

  • 1Charite - Universitatsmedizin Berlin, Corporate Member of Freie Universitat Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany, Institute of Physiology.

Current Pharmaceutical Design
|June 26, 2018
PubMed
Summary

Coronary microcirculation disturbances, not just vessel blockages, significantly impact ischemic heart disease and reperfusion injury. Understanding microvascular function is key for developing new cardiac protection strategies.

Keywords:
Microvesselsangioadaptationheterogeneityinflammationleucocyte-endothelium interactionvascular permeability.

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Area of Science:

  • Cardiovascular Physiology
  • Pathophysiology
  • Medical Research

Background:

  • Ischemic heart disease was traditionally attributed solely to coronary artery stenosis or occlusion.
  • Emerging evidence highlights the critical role of the coronary microcirculation in ischemic conditions.
  • Microvessels regulate local blood flow, vascular permeability, and inflammatory responses.

Purpose of the Study:

  • To review the physiological and pathophysiological mechanisms governing coronary microcirculatory control.
  • To focus on the heterogeneity of local perfusion, microvascular permeability, and inflammation.
  • To synthesize current knowledge on the microcirculation's role in heart disease.

Main Methods:

  • A selective literature search was conducted.
  • Key research articles on coronary microcirculation were reviewed.
  • Information was synthesized to address the study's objectives.

Main Results:

  • Microvascular networks exhibit heterogeneity affecting flow, oxygenation, and metabolic supply.
  • Dysregulation leads to perfusion imbalances (hypoxia/hyperperfusion) and impaired tissue oxygenation.
  • Increased microvascular permeability and inflammation contribute to myocardial damage and remodeling during ischemia-reperfusion.
  • Deterioration of the endothelial glycocalyx and inflammatory responses are implicated in tissue edema and injury.

Conclusions:

  • Disruptions in the coronary microcirculation are integral to the pathophysiology of reperfusion injury.
  • A multi-targeted approach is necessary for effective cardiac protection, moving beyond single anti-inflammatory therapies.