Cardiovascular Diseases

Exposure to radiation is a key factor in the development of cardiovascular dis- eases. The effects of radiation or development of the cardiovascular disease may take time to develop after the initial exposure but with continued exposure, the disorders become evident. The level of radiation exposure also matters since the cardiovascular conditions are directly related to the levels of exposure; therefore the higher the levels of radiation the more serious the conditions will be [11]. High levels of exposure to radiation may even run through the generations of the exposed individuals or people, for instance the case of bombing in Japan. Gov- ernments and health organizations should endorse the reduction in the radiation exposure levels. This includes limitations in the use of X-rays and gamma radia- tors in the medical field and shifting to less dangerous methods of scanning and tests. Nuclear plants should also be automated and controlled and manned by robots and remote computers to reduce the possibility of death in case of the occurrence of an accident. Protective clothing should also be a compulsory op- tion for those working in areas with high radiations to keep their health a prior- ity. The high relationship between cancer and cardiovascular diseases is the treatment therapies that are radiation based. The high radiations applied in can- cer therapies facilitate the development of cardiovascular disorders. This means that cancer patients may recover from cancer but they often develop cardiovas- cular diseases later on in life.

Cardiovascular disease is the leading cause of death worldwide and is often associated with partial or full occlusion of the blood vessel network in the affected organs. Restoring blood supply is critical for the successful treatment of cardiovascular diseases. Therapeutic angio- genesis provides a valuable tool for treating cardiovascular diseases by stimulating the growth of new blood vessels from pre-existing vessels. In this review, we discuss strategies developed for therapeutic angiogenesis using single or combinations of biological signals, cells and polymeric biomaterials. Compared to direct delivery of growth factors or cells alone, pol- ymeric biomaterials provide a three-dimensional drug-releasing depot that is capable of fa- cilitating temporally and spatially controlled release. Biomimetic signals can also be incor- porated into polymeric scaffolds to allow environmentally-responsive or cell-triggered release of biological signals for targeted angiogenesis. Recent progress in exploiting genetically en- gineered stem cells and endogenous cell homing mechanisms for therapeutic angiogenesis is also discussed.

Resveratrol (RS) (3, 5, 4'-trihydroxy-trans-stilbene) belongs to a class of polyphenolic compounds called stilbene. Some types of plants produce resveratrol and other stilbene in response to stress, injury and fungal infection. Its presence was first reported in red wine leading to speculation that resveratrol might explain the “French Paradox”. More recently, reports on the potential for resveratrol to inhibit the development of cancer and cardiovascular diseases (CVD) have continued to generate scientific interest (1, 2, 3&4). Resveratrol has also been shown to offer protection against ischemic injuries (5), obesity (6) and diabetes (7). The objective of this review was to critically examine the results from recent research concerning potential effect of RS in various disease conditions especially CVD.

: Cardiovascular diseases are a group of disorders of the heart and blood vessels. Cardiovascular diseases are the leading cause of death in India, and its contribution to mortality is rising. According to WHO, most cardiovascular diseases can be prevented by addressing behavioral risk factors such as tobacco use, unhealthy diet, obesity, physical inactivity and harmful use of alcohol using population wide strategies and for successful prevention of cardiovascular diseases, uisite. Hence this study aimed to assess knowledge and perception on risk for cardiovascular diseases among the ministerial staffs. Materials and Methods: A cross sectional study was conducted among ministerial staffs working in various departments strative section, academic section and clinical departments) of JIPMER, Puducherry. 263 probability convenience sampling technique. The data was The study showed that majority 53.6% had moderate level of knowledge and most of them 87.5% had increased perception on risk for cardiovascular disease. There was no correlation between knowledge and perception. There was an with family history of cardiovascular diseases and between level of perception with smoking status & family history of cardiovascular disease at p<0.05. The above findings reveal the importance of the need for implementation of awareness

The results showed that more than a half million work- ing days were lost due to incapacity resulting from CVD (Table 2). Cerebrovascular and coronary heart diseases caused the longest absence from work, on average, 112.8 days and 100.7 days, respectively. The average length of in- capacity for all CVD patients was 95 days. The production losses due to CVD morbidity estimated using the human capital approach were € 11.6 million; with the friction cost method the estimate was lower at € 11 million. According to Fig. 1 – Number of patients diagnosed with cardiovascular diseases according to age. In brackets are the diagnoses defined

In this study, we have conducted the research on pulse waves collected from 127 subjects who have different types of cardiovascular diseases. The dynamic curve fit- ting is applied to the pulse waves of each subject in order to obtain the fitted function. Based on an entire cycle of pulse wave, we calculated the first derivative of the pulse Table 5. RSI and ratio of distance related to coronary heart disease and hypertension.

4 Parkin's relationship with cardiovascular disease In recent years, it has been found that Parkin-mediated mitophagy plays an important role in the maintenance of normal function of nerve cells and is essential for maintaining normal cardiac function. The heart is a highly energy-consuming organ, rich in mitochondria, mitochondrial structural damage and dysfunction involving the development and progression of cardiovascular disease. At present, Parkin-mediated mitophagy has become a hot spot for the study of cardiovascular diseases, as shown in Figure 2.

A proteomics study on platelets from patients with ACS, compared with stable patients, showed that levels of proteins involved in cytoskeleton formation (F-actin capping, β-tubulin, α-tubulin isotypes 1 and 2, vinculin, vimentin and two Ras-related protein Rab-7 isotypes), glycolytic reactions (glycer- aldehyde-3-phosphate dehydrogenase, lactate dehydrogenase and two pyruvate kinase isotypes) and redox balance (manganese-SOD) were reduced in ACS patients. Proteins associated with cell survival, such as the β subunit of the proteasome 1 were also decreased in platelets of patients with ACS compared to stable patients (López-Farré et al., 2011). Another study with similar objectives, comparing protein patterns of platelets from patients with stable or acute coronary atherosclerosis, identified six differentially expressed proteins; two involved in energy metabolism (2-ketoglutarate dehydrogenase [OGDH] and lactate dehydrogenase [LDH]), three associated with the cytoskeleton-based processes (γ-actin, 1B Coronin and Pleckstrin) and one involved in protein degradation (proteasome subunit type 8) (Banfi et al., 2010; Napoli et al., 2013). Some proteomics studies on platelets in cardiovascular diseases are summarized in Table 1. Most pivotal platelet proteins are situated on its membrane, because platelet activation and aggregation usually require surface contact with the surrounding tissue. Therefore, special interest focuses on this contacting region and hence on the subproteome of the platelet plasma membrane (Burkhart et al., 2012; Lewandrowski et al., 2009; Premsler, Lewandrowski, Sickmann and Zahedi, 2011). In a proteomics study by Lewandrowski and Burkhart, more than 4000 proteins on the plasma membrane of platelets were identified. In the last decade, the introduction of lipid rafts and microdomains as an action platform in membranes h a s c h a n g e d o u r v i s i o n o f t h e p l a s m a membrane(Pike, 2003). A cumulating body of evidence suggests that lipid-protein and lipid-lipid interactions in the plasma membrane limit the mobility of membrane proteins and interfere in their localization. Lipid rafts are about 10-200 nm in lipid- ordered microdomains enriched with sphingomyelin, glycosphingolipids and cholesterol (Rabani, Davani, Gambert-Nicot, Meneveau and Montange, 2016; Rabani, Davani, et al., 2016; Thomas et al., 2014). It is now established that some platelet proteins, such

The global burden of diseases is altering from infectious diseases to the non-communicable diseases, and now becoming the chief cause of the death in all over the world. There are many non- communicable diseases among of them; cardiovascular diseases are tremendously increasing in our society due to the change in the diet pattern, life style, and environmental conditions. However, vari- ous advance treatment and diagnostic techniques are available in the modern medicine for the pa- tients of cardiac diseases, but these techniques are not affordable by every patient and their family. In text of Ayurveda, there are a number of drugs likes, Arjuna, medicinal preparations, Pathya Apathya, Dinacharya and diverse techniques of Yoga which have wonderful preventive and curative effect on cardiac diseases. Furthermore, the good health is necessary for everyone, so all the section of Ayur- veda can work together in the prevention of cardiovascular and other diseases. This article explains how Hridroga resembles with the symptoms of cardiovascular diseases & how Ayurveda help us in the prevention & management of cardiovascular diseases.

Rheumatoid arthritis as chronic inflammatory joint disease is not limited to synovium, but cardiovascular involvement is the major concern now a day along with joint problems. Cynthia S Crownson et al, in her study reported that majority of RA patients with angina remained undiagnosed, myocardial infarction patients were less able to receive reperfusion therapy and there is lower prevalence of primary & secondary prevention regarding cardiovascular diseases. [11]

The pharmacist may play a relevant role in primary and secondary prevention of cardiovascular diseases, mainly through patient education and counselling, drug safety management, medication review, monitoring and reconciliation, detection and control of specific cardiovascular risk factors (eg, blood pressure, blood glucose, serum lipids) and clinical outcomes. Systematic reviews of randomised controlled and observational studies have documented an improved control of hypertension, dyslipidaemia or diabetes, smoking cessation and reduced hospitalisation in patients with heart failure, following a pharmacist’s intervention. Limited proof for effectiveness is available for humanistic (patient satisfaction, adherence and knowledge) and economic outcomes. A multidisciplinary approach, including medical input plus a pharmacist, specialist nurse or both, and a greater involvement of community rather than hospital pharmacists, seems to represent the most efficient and modern healthcare delivery model. However, further well- designed research is demanded in order to quantitatively and qualitatively evaluate the impact of pharmacist’s interventions on cardiovascular disease and to identify specific areas of impact of collaborative practice. Such research should particularly focus on the demonstration of a sensitivity to community pharmacist’s intervention. Since pharmacy services are easily accessible and widely distributed in the community setting, a maximum benefit should be expected from interventions provided in this context.

Swedish registry data were used to identify a cohort of patients with a di- agnosis of LCPD. This cohort was com- pared with a general population– based cohort without LCPD to assess the risk of cardiovascular diseases (in- cluding hypertensive diseases, isch- emic heart diseases, pulmonary heart diseases and diseases of the pulmo- nary circulation, cerebrovascular dis- eases, diseases of arteries, arterioles, and capillaries, and diseases of veins, lymphatic vessels, and lymph nodes, equivalent to International Classifica- tion of Diseases, 10th Revision, codes I00 –I99), as well as diseases of the blood and blood-forming organs (in- cluding nutritional, hemolytic, and aplastic anemias, coagulation defects, purpura, and other hemorrhagic con- ditions, equivalent to International Classification of Diseases, 10th Revi- sion, codes D50 –D89). A comparison cohort of siblings of patients with LCPD also was used. Registry data linkage

periodontitis is a multifacrious group of diseases whose common characteristics include loss of anatomical struc- tures around tooth. This process occurs due to imbalance between bacterial plaque influence and immunological system of the host – therefore inflammation in the periodontium occurs. clinical manifestations of periodontitis include: attachment loss, degradation of periodontal ligaments, proteolysis of alveolar process and finally hemor- rhage during clinical examination. There is a growing evidence that periodontitis is a significant factor influencing cardiovascular diseases, for instance coronary heart syndrome, peripheral arteries disease, atherosclerosis, myo- cardial infarction, infectious endocarditis – a disease manifesting itself by anatomical and functional changes in sinoatrial valves. Its relation to oral infection is well grounded. The main etiological factor is oral colonization by Streptococcus viridians. Apart from widely known risk factors common for periodontitis and cardiovascular dis- eases mentioned above, such as age, sex, socioeconomical status, metabolic factors, stress, smoking tobacco, it is postulated that there exists a link between these diseases through inflammation markers (for instance crp, Il-6, white blood cells count), infectious factors (transitionary bacteriema), hemostasis and fibrinolysis markers (pAI-1), metabolic markers (triglicerydes, ldl, blood glucose). This work is a review of most up-to-date scientific works referring to new factors that confirm clinical correlation between periodontis and cardiovascular diseases (Dent. Med. Probl. 2010, 47, 4, 472–477).

Authors who submit a manuscript accept full responsibility for its content as defined by the International Committee of Medical Journals Editors (ICMJE) (see www.icmje.org). The research reported in papers sent to Archives of Cardiovascular Diseases should have been conducted in accordance with internationally accepted recommendations for clinical investigation (Declaration of Helsinki, in the recently revised version of the World Medical Association; see www.wma.net/e/policy), or recommendations for laboratory research involving animals, published by

Figure 2. Role of TREM-1 in cardiovascular diseases and potential: (a) TREM-1 up regulation is implicated in atheroma formation in artery and its destabilization. TREM-1 modulation will reduce arthrosclerosis(b) TREM- 1 play role in the atherosclerotic plaque enlargement and instability, which manifests clinically by either coronary artery disease (CAD) or angina- when the coronary is partially clogged- or (c) AMI when it is completely blocked. TREM-1 inhibition will reduce AMI events in patient at risk. (d) TREM-1 is also link to the proclivity to develop endocarditis. In patient at risk TREM-1 inhibition can protect .

Our aim was to study how significant psychosocial factors are in occupational stress and cardiovascular diseases evolvement in workers employed at petrochemical production; we also intended to work out a set of preventive measures. Our hygienic and social-psychological research enabled us to detect factors causing stress evolvement in workers employed at petrochemical production. These factors included chemical impact, noise, unfavorable microclimate, labor hardness and labor intensity. High level of risk for their own lives and respon- sibility for safety of others, as well as work under time deficiency conditions with increased responsibility for the final results, were the most significant psychosocial factors for workers. In the course of questioning we detected that 74 % machine operators, 63 % tool men working with controllers and automatic devices, and 57 % repair- men mentioned having stress at work. Here 38 % workers gave a subjective estimation of their professional ac- tivity as having apparent "stress nature". The questioning revealed that 48 % workers with various occupations had increased parameters as per anxiety scale (HADS); 23 % workers had increased parameters as per depres- sions scale (HADS). Primary hypertension was the most widely spread nosologic form among chronic non- infectious diseases; it was found in 46.1 % operators and in 45.2 % repairmen dealing with processing stations repair. 30.1 % tool men working with controllers and automatic devices had average occupational causation of primary hypertension by production factors. We detected direct relation between hyperlipidemia and age and working period.

The relationship between cardiovascular diseases (CVD) and risk factors such as high blood pressure, cholesterol, smoking, diabetes and physical inactivity has been the subject of extensive study, resulting in an abundance of literature. On the other hand, fewer studies have documented social determinants such as working conditions, housing, or social relationships. In this paper, we suggest that social determinants should not only be juxtaposed with traditional risk factors acting directly on CVD, but also be examined as underlying determinants of some CVDs, and, indeed, as factors acting along causal chains, influencing the incidence and manage- ment of traditional risk factors as well as the management of acute coronary events. The goal of this review is not to be exhaustive in discussing all social determinants of CVD, but to emphasise their variety as well as the mechanisms through which they act upon disease, in the light of recent works.

Although it decreased pulmonary capillary wedge pressure, it caused no significant change in the stroke volume index in the patients without CHF. Concomitant significant reductions in total systemic resistance were observed in both groups of patients. The ANP infusion significantly increased the urine volume, the excretion of sodium, and the endogenous creatinine clearance in patients without CHF. In patients with CHF, it showed a tendency to increase all these variables, but the urine volume did not correlate with the reduction in pulmonary capillary wedge pressure. Although no significant difference was observed in the decrement of the plasma aldosterone concentration in the patients with and without CHF, the ANP infusion also decreased the plasma aldosterone concentrations. These findings indicate that the ANP infusion improves left ventricular function in patients with CHF, and suggest that this improvement mainly results mainly from the vasodilating activity of ANP [66]. Brain natriuretic peptide is of prognostic importance in cardiovascular diseases [67, 68]. In patients with heart failure, serum BNP concentrations are found to increase proportionally to the severity of the clinical condition evaluated according to the New York Heart Association (NYHA) classification, and may be 25 times higher than the values in subjects without this pathology [69]. In studies by Cosin et al., authors observed that NT-proBNP correlates with the patient’s condition in NYHA classification [70]. In the studies of McDonagh et al., the plasma level of the Nt-pro BNP concentration was 15.2 ± 14.2 pg/ml in healthy subjects, while in patients with chronic heart failure, it increased on average 45-fold to 691 ± 49 pg/ml [71]. In the studies of Dao et al., in patients with chronic heart failure, the mean values of serum BNP were: 95 pg/ml (NYHA I), 221 pg/ml (NYHA II), 459 pg/ml (NYHA III) and 1006 pg/ml (NYHA IV) as compared to 12 pg/ml found in healthy

Cardiovascular diseases share large and increasing global burden of morbidity and mortality worldwide. Although many types of cardio-vascular diseases are enlisted in contemporary science. Only a few explanations are available in ayurvedic classics. Ayurveda considers Hridaya as vital organ of the body. As it is one among the Tri-marmas, any injury to Hridaya leads to the severe complication and even death. Cardiovascular diseases are discussed under Hridroga in Ayurveda. Cardiovascular diseases accounted for around one fourth of all deaths in India in 2008. It will be the largest cause of death and disability by 2020 in India. It has been forecasted that 2.6 million peoples will die from coronary heart disease which constitutes 54% of deaths caused due to cardiovascular disease, making an impact to the society and the economy even more significant. Cardiovascular diseases are the current burning problem in the society understanding the heart diseases with respect to dosha & dushya involved in them is very essential. An attempt has been made in this paper for consideration of doshas & dushyas involved in the pathogenesis of various cardiac disorders.

Abstract Oxidative stress and inflammation are impli- cated in cardiovascular diseases such as atherosclerosis, reperfusion injury, hypertension, and heart failure. High levels of oxidative stress resulting from increased cardiac generation of reactive oxygen species (ROS) is thought to contribute to contractile and endothelial dysfunction, apoptosis and necrosis of myocytes, and extracellular matrix remodeling in the heart. ROS activate several transcription factors known as redox-regulated transcrip- tion factors, and these transcription factors play important roles in the pathophysiology of cardiovascular diseases. This review focuses on the pathological roles of environ- mental and redox stresses in cardiovascular diseases, especially severe cardiac dysfunction and the transition from compensated hypertrophy to heart failure. The aryl hydrocarbon receptor (AHR) and NF-E2 p45-related factor (Nrf2) are transcription factors involved in the regulation of drug-metabolizing enzymes. AHR has been studied as a receptor for environmental contaminants and as a mediator of chemical toxicity. However, other roles for AHR in cardiac and vascular development have recently been described. Moreover, Nrf2 protects against oxidative stress by increasing the transcription of genes, including those for several antioxidant enzymes. The roles of these transcrip- tion factors, AHR and Nrf2 in angiogenesis are also dis- cussed in this review.