Resveratrol

Cardiovascular disease (CVD) is the leading cause of death in both men and women and has largely been attributed to genetic makeup and lifestyle factors. However, genetic regulation does not fully explain the pathophysiology. Recently, epigenetic regulation, the regulation of the genetic code by modifications that affect the transcription and translation of target genes, has been shown to be important. Silent information regulator-2 proteins or sirtuins are an epigenetic regulator family of class III histone deacetylases (HDACs), unique in their dependency on coenzyme NAD+, that are postulated to mediate the beneficial effects of calorie restriction, thus promoting longevity by reducing the incidence of chronic diseases such as cancer, diabetes, and CVD. Emerging evidence shows that SIRT1 is ubiquitously expressed throughout the body. Resveratrol, a plant polyphenol, has cardioprotective effects and its mechanism of action is attributed to regulation of SIRT1. Incoproation of resveratrol into the diet may be a powerful therapeutic option for the prevention and treatment of CVD.

Platelet Function Disorders

Platelets play an important role in thrombosis and hemostasis. Moreover, platelet dysfunction due to congenital and acquired etiologies is also one of the most common causes of bleeding encountered in clinical practice. Mostly, platelet function disorders are deficiencies of glycoprotein mediators of adhesion and aggregation, whereas defects of primary receptors for stimuli include those of the P2Y12 ADP receptor. Studies on inherited defects of (1) secretion for storage organelles (dense and alpha-granules), (2) the platelet cytoskeleton, and (3) the generation of pro-coagulant activity have allowed for the identification of genes directly and/or indirectly controlling specific functional responses. This chapter will review recent advances in the molecular characterization of platelet function defects, the spectrum of clinical manifestations of these disorders and their management.

Signaling Mechanisms Regulating Vascular Endothelial Barrier Function

During inflammatory conditions, such as sepsis, myocardial infarction and acute respiratory distress syndrome, endothelial cell-cell junctions start to disrupt because of the internalization of the junctional proteins such as vascular endothelial (VE) cadherin. This leads to the formation of minute inter-endothelial gaps, and the infiltration of protein-rich fluid and immune cells in the interstitial space. If remains unchecked, the persistent buildup of edema underlying the endothelial lining sets the stage for the serious life-threatening complications and ultimately leads to the multi-organ failure and death. Thus, to determine the molecular mechanisms underlying the opening and resolution phase of the gap formation, will provide an insight to better understand the pathology of the cardiovascular and pulmonary inflammatory disorders. In this chapter, we will discuss about how the signaling mechanisms activated by the known inflammatory molecules increase endothelial permeability.

The Effects of Social and Demographic Factors on Cardiovascular Disease

The chapter investigates the effects of social and demographic factors on cardiovascular disease (CVD) controlling health related factors. The data used in this study is the National Health and Nutrition Examination Survey data, and are merged the three waves, 2009-2010, 2011-2012, and 2013-2014. The logit regression analysis is used as a statistical model, and the results of this study confirm the significant associations with CVD in age, race/ethnicity, marital status, and educational attainment as expected ways. Health behaviors also show significant and strong relationships with CVD, which support the current prevention and intervention programs' strategy that focuses on changing lifestyles on an individual and a community level. The results of the social and demographic factors on CVD confirm that having CVD is not only a medical or biological process but also a social outcome. Thus, a better understanding of the social and demographic factors on CVD helps us to not only reduce the mortality rate, but also develop more effective policies and programs.

Complementary and Alternative Medicine Use in Hypertension

Thirty six percent of people in USA and Canada regularly use complementary and alternative medicine (CAM) for the prevention and treatment of different diseases, including hypertension. Generally, majority of the hypertensive patients do not disclose the use of such remedies, and also health care providers do not usually ask their hypertensive patients if they use CAM. The widespread consumption of CAM in hypertension requires clear understanding of their underlying mechanism of action, efficacy and safety. This chapter will provide a comprehensive list of CAM commonly used by Americans for the prevention and treatment of hypertension as well as their postulated mechanism of action. Modulation of drug metabolizing enzymes and their safety will also be covered along with the clinical consequences, i.e. drug-herb or herb-disease interactions. patients and healthcare providers should also be careful with using CAM therapies, because not only is there minimal evidence that several CAM products work to treat hypertension, but their safety hasn't been well-established.

Recent Innovations in Coronary Stents

In heart diseases, there are frequent incidents of narrowing or blocking coronary arteries by fatty plaque deposition. As a result, blood pressure rises and the arteries weaken. This can lead to rapid rupture of the blood vessels, also known as heart attack or brain stroke. In some cases the arteries lose elasticity over old age. Heart stent or coronary stent inserts in the blocked/fragile region of coronary artery. It helps to expand the artery to allow free flow of blood and consequently, reduces blood pressure. Over past 20 years there are many modifications and innovations in the field of cardiac stents, in this chapter we will discuss few of those.

Cardiac Remodeling Under Hyperoxic Conditions

Cardiovascular complications and arrhythmias account for high mortality in cardiopulmonary patients in intensive care unites (ICU) and critical care unites. Patients in ICU are often administered with 100% oxygen for treatment with many diseases. According to American Heart Association (AHA), more than 2200 deaths related to cardiac failure are reported every day with an average of 1 in every 39 seconds. Cardiomyopathy is also reported in many diseased conditions including acute lung injury, diabetes, obesity, hypertension, and cancer. Recent studies indicate that hyperoxia induces cardiac injury due to dysfunctional lung and compromised pulmonary functioning. The exact mechanism of cardiovascular complications in ICU/ critical care remains unknown. This review will discuss the effect of hyeproxia on cardiac remodeling with more emphasis on ventricular and electrical remodeling. Understanding the exact mechanism of hyperoxia induced cardiomyopathy is not only important to understand the disease development and progression but also open new avenues for targeted therapy.

Store-Operated Calcium Entry Channels

Store-operated Ca2+ entry (SOCE) channels mediate Ca2+ influx from the extracellular milieu into the cytosol to regulate a myriad of cellular functions. The Ca2+-release activated Ca2+ current has been well characterized in non-excitable cells such as immune cells. However, the role of SOCE proteins in cardiomyocytes and cardiac function has only been recently investigated. The localized endoplasmic reticulum protein, stromal interaction molecule (STIM) and plasma membrane Ca2+ channels, ORAI form the minimal functional unit of SOCE. The documentation of STIM and Orai expression in cardiomyocytes has raised questions regarding their role in cardiac function. Recent evidence supports the central role of STIM and Orai in gene transcription and, subsequent phenotypic changes associated with cardiac remodeling and hypertrophy. The purpose of this chapter is to provide an overview of our current understanding of SOCE proteins and, to explore their contributions to cardiovascular function and role in cardiac disorders.

Forensic Assessment of Natural Unexpected Cardiovascular Death

In the United States, sudden unexpected deaths attributable to diseases of the cardiovascular system account for almost 50% of all natural deaths with up to 600,000 deaths per year. Over the past decade, substantial developments have been made to provide definitive determinations in the diagnosis of cardiac death for adjudication in the criminal justice system and closure for decedent's families. In order to make postmortem diagnostic determinations, coordinated multidisciplinary efforts include collaboration between clinical and forensic pathologists. Forensic protocols include examination of the heart, histological sampling, toxicology testing, and molecular analyses. Lack of alternative diagnoses generally prompts pathologists to report sudden cardiac arrest as the main cause of death in many cases even though the accuracy of this finding might be in question; therefore, a forensic pathologist should examine unexplained cases of death in more depth to avoid this possible misdiagnosis.

Nanoparticle-Based Drug Delivery Systems for Cardiovascular Applications

Nanomedicine has vastly improved the treatment and diagnosis of many cardiovascular conditions such as atherosclerosis, myocardial ischemia, myocardial infarction, restenosis, and thrombosis. A few nanoparticle drug delivery systems that are currently being tested and used in clinical trials include lipid-based drug delivery, controlled drug release, and specific targeting. The chapter describes the various drug delivery methods, the various nanoparticles, and their application on specific cardiovascular conditions. This chapter compiles examples of specific clinical trials that are being conducted, using nanoparticles for therapy of cardiovascular conditions.