Endothelium And Cardiovascular Diseases

Endothelium and Cardiovascular Diseases: Vascular Biology and Clinical Syndromes provides an in-depth examination of the role of endothelium and endothelial dysfunction in normal vascular function, and in a broad spectrum of clinical syndromes, from atherosclerosis, to cognitive disturbances and eclampsia. The endothelium is a major participant in the pathophysiology of diseases, such as atherosclerosis, diabetes and hypertension, and these entities are responsible for the largest part of cardiovascular mortality and morbidly. Over the last decade major new discoveries and concepts involving the endothelium have come to light. This important reference collects this data in an easy to reference resource. Written by known experts, and covering all aspects of endothelial function in health and disease, this reference represents an assembly of recent knowledge that is essential to both basic investigators and clinicians. Provides a complete overview of endothelial function in health and diseases, along with an assessment of new information Includes coverage of groundbreaking areas, including the artificial LDL particle, the development of a new anti-erectile dysfunction agent, a vaccine for atherosclerosis, coronary calcification associated with red wine, and the interplay of endoplasmic reticulum/oxidative stress Explores the genetic features of endothelium and the interaction between basic knowledge and clinical syndromes

Since the endothelium plays such an important role in the pathophysiology of the circulatory system, the readers attention is directed here towards the possible involvement of these polypeptides in the aetiology of ischaemic heart disease, cerebrovascular accidents, hypertension, atherosclerosis and renal failure.

The endothelium, a monolayer of endothelial cells, constitutes the inner cellular lining of the blood vessels (arteries, veins and capillaries) and the lymphatic system, and therefore is in direct contact with the blood/lymph and the circulating cells. The endothelium is a major player in the control of blood fluidity, platelet aggregation and vascular tone, a major actor in the regulation of immunology, inflammation and angiogenesis, and an important metabolizing and an endocrine organ. Endothelial cells controls vascular tone, and thereby blood flow, by synthesizing and releasing relaxing and contracting factors such as nitric oxide, metabolites of arachidonic acid via the cyclooxygenases, lipoxygenases and cytochrome P450 pathways, various peptides (endothelin, urotensin, CNP, adrenomedullin, etc.), adenosine, purines, reactive oxygen species and so on. Additionally, endothelial ectoenzymes are required steps in the generation of vasoactive hormones such as angiotensin II. An endothelial dysfunction linked to an imbalance in the synthesis and/or the release of these various endothelial factors may explain the initiation of cardiovascular pathologies (from hypertension to atherosclerosis) or their development and perpetuation. Table of Contents: Introduction / Multiple Functions of the Endothelial Cells / Calcium Signaling in Vascular Cells and Cell-to-Cell Communications / Endothelium-Dependent Regulation of Vascular Tone / Conclusion / References

The endothelium is a thin mono-cellular layer which covers the inner surface of the blood vessels, separating the circulating blood from the tissues and also has the responsibility for uninterrupted maintenance of circulation to all the vital tissues. Endothelium is a very active organ, it works as a receptor-effector organ and responds to each physical or chemical stimulus with the release of the appropriate substance with which it may maintain vasomotor balance and vascular-tissue homeostasis. It has the property of producing, independently, both agonistic and antagonistic substances that help to keep homeostasis and its function is not only autocrine, but also paracrine and endocrine. In this way it modulates the vascular smooth muscle cells producing relaxation or contraction, and therefore vasodilatation or vasoconstriction. The vascular endothelium is vulnerable to maximum wear and tear due to its positioning and requires prompt regeneration of the cells. Whenever the imbalance between substances with vasodilating, antimitogenic, and antithrombogenic properties and substances with vasoconstricting, prothrombotic and proliferative characteristics takes place, it causes a pathological condition known as endothelial dysfunction. These substances intervenes in cell proliferation and migration, in leukocyte adhesion and activation and in immunological and inflammatory processes, further which is responsible for apoptosis of vascular endothelial cells resulting in overall endothelial dysfunction and vasculopathy. This book discusses, in further detail, the risk factors, and the role of endothelial dysfunction in cardiovascular diseases and therapeutic approaches to dealing with endothelial dysfunction.

The opening chapter of this book, by scientist Dr. Robert Furchgott, details the discovery of endothelium’s role in the vasodilator effect of acetycholine in 1978. Its subsequent identification as nitric oxide has been critical to cardiovascular medicine in understanding the regulation of vascular homeostasis. This simple observation won Dr. Furchgott a Nobel Prize in 1998. Spanning from these initial observations to recent clinical investigations, this work offers an invaluable historical reference and clinical explanation about the intracellular mechanisms that regulate and stimulate endothelial nitric oxide synthase (eNOS). The basic mechanisms leading to endothelial dysfunction in cardiovascular disease complement information about the biological role and regulation of endothelial nitric oxide. Clinical studies of impaired endothelial function in patients with different cardiovascular conditions also reveal important and effective therapeutic strategies. Written for both established physicians and scientists investigating the basic mechanisms and treatment of cardiovascular disease, as well as medical students who want to initiate themselves in the study of endothelial regulation of vascular physiology, many will find this comprehensive review a stimulus for new research.

The endothelium enables communication between blood and tissues and is actively involved in cardiovascular homeostasis. Endothelial dysfunction has been recognized as an early step in the development of cardiovascular diseases: respectively, endothelium represents a potential therapeutic niche with multiple targets. The purpose of the book is to point out some recent findings of endothelial physiology and pathophysiology emphasizing various aspects of endothelial dysfunction connected to the body's internal and external environment. While basic features of the endothelium are presented in an introductory chapter, the authors of the following 17 chapters have provided extensive insight into some selected topics of endothelial (dys)function. The book would hopefully be useful for anyone interested in recapitulating endothelial (patho)physiology and expanding knowledge of molecular mechanisms involved in endothelial dysfunction, relevant also for further clinical investigations.