Microcirculation in Cardiovascular Diseases

This book provides an extensive review of the latest data on the pathophysiological role of structural and functional alterations in the microcirculation, particularly focusing on hypertension and diabetes. It covers several relevant and innovative aspects, including the possible mechanisms involved in the development of microvascular remodeling and rarefaction, the technical approaches available for the detection of microvascular alterations, the prognostic role of changes in small resistance artery structure, the possibility of preventing or regressing such alterations with appropriate treatment, and the potential clinical advantages of such intervention. Innovative areas of research are considered, including the role of the immune system, inflammation, and oxidative stress in the development of microvascular alterations. Lastly, it examines the availability of recent non-invasive methods for the evaluation of small resistance artery morphology in the retina, which may provide a useful tool for the stratification of cardiovascular risk and clinical decisions regarding drug treatment.

Format: Paperback / softback
Length: 216 pages
Publication date: 04 October 2021
Publisher: Springer Nature Switzerland AG

This comprehensive book delves into the latest data on the pathophysiological significance of structural and functional changes in the microcirculation, with a particular focus on hypertension and diabetes. It explores a wide range of relevant and cutting-edge topics, including the potential mechanisms underlying microvascular remodeling and rarefaction, the available technical methods for detecting such alterations, including non-invasive assessments, the prognostic importance of changes in small resistance artery structure, the potential for preventing or reversing these alterations through appropriate treatment, and the potential clinical benefits of such interventions. Additionally, the book examines innovative areas of research, such as the role of the immune system, inflammation, and oxidative stress in the development of microvascular alterations. Furthermore, it explores the availability of recent non-invasive methods for evaluating small resistance artery morphology in the retina, which hold great promise for stratifying cardiovascular risk and guiding clinical decisions regarding drug treatment. This book is of immense value to specialists (cardiology, internal medicine, and endocrinology) and general practitioners alike, as well as providing novel and stimulating insights to basic and clinical researchers.

Introduction:
The microcirculation plays a crucial role in the regulation of blood flow and the delivery of oxygen and nutrients to tissues. However, structural and functional alterations in the microcirculation can contribute to the development of various cardiovascular diseases, including hypertension and diabetes. This book aims to provide an extensive review of the most recent data on the pathophysiological role of structural and functional alterations in the microcirculation, particularly focusing on hypertension and diabetes.

Microvascular Remodeling and Rarefaction:
Microvascular remodeling refers to the changes in the structure and function of the small blood vessels in the body, which can occur in response to various factors such as hypertension, diabetes, and other cardiovascular diseases. These alterations can lead to a decrease in blood flow and the delivery of oxygen and nutrients to tissues, which can ultimately result in tissue damage and dysfunction. Rarefaction, on the other hand, refers to the enlargement of the blood vessels, which can also contribute to the development of hypertension and diabetes.

Potential Mechanisms Involved in Microvascular Remodeling and Rarefaction:
The potential mechanisms involved in the development of microvascular remodeling and rarefaction are still not fully understood. However, several studies have suggested that inflammation, oxidative stress, and the renin-angiotensin-aldosterone system (RAAS) may play a significant role in these processes. Inflammation can lead to the activation of immune cells, which can release pro-inflammatory cytokines that can damage the endothelium of the blood vessels. Oxidative stress can also damage the endothelium and promote the formation of atherosclerotic plaques. The RAAS system is involved in the regulation of blood pressure and the maintenance of homeostasis. However, excessive activation of the RAAS system can lead to the development of hypertension and the narrowing of the blood vessels.

Technical Approaches for Detecting Microvascular Alterations:
Several technical approaches are available for the detection of microvascular alterations, including non-invasive evaluations. Non-invasive evaluations include the use of ultrasound, laser Doppler flowmetry, and near-infrared spectroscopy. These methods can provide valuable information about the structure and function of the microcirculation, which can help in the diagnosis and management of cardiovascular diseases.

Prognostic Role of Changes in Small Resistance Artery Structure:
Changes in the structure of the small resistance arteries in the body, such as the narrowing of the arterioles, can have a significant prognostic role in the development of hypertension and diabetes. These changes can reduce blood flow and increase blood pressure, which can contribute to the development of cardiovascular diseases.

Preventing or Regressing Microvascular Alterations with Appropriate Treatment:
Several treatments are available for preventing or regressing microvascular alterations, including antihypertensive medications, antidiabetic medications, and lifestyle modifications. Antihypertensive medications, such as angiotensin-converting enzyme (ACE) inhibitors and angiotensin receptor blockers (ARBs), can help in reducing blood pressure and preventing the narrowing of the blood vessels. Antidiabetic medications, such as insulin and oral hypoglycemic agents, can help in controlling blood sugar levels and preventing the development of diabetes. Lifestyle modifications, such as regular exercise, a healthy diet, and smoking cessation, can also help in preventing the development of cardiovascular diseases.

Potential Clinical Advantages of Microvascular Intervention:
Microvascular intervention, such as percutaneous transluminal angioplasty (PTA) and stenting, can be used to treat the narrowing of the blood vessels and improve blood flow. These procedures can reduce blood pressure and improve the delivery of oxygen and nutrients to tissues, which can improve the quality of life and reduce the risk of cardiovascular complications.

Innovative Areas of Research:
Several innovative areas of research are being pursued in the field of microvascular alterations, including the role of the immune system, inflammation, and oxidative stress in the development of these alterations. Additionally, researchers are exploring the use of new therapeutic agents, such as stem cells and gene therapy, to treat microvascular diseases.

Conclusion:
In conclusion, this book provides valuable, clinically relevant information for specialists (cardiology, internal medicine, and endocrinology) and general practitioners, and also offers novel and stimulating data to basic and clinical researchers. The understanding of the pathophysiological role of structural and functional alterations in the microcirculation is crucial for the development of effective treatments and interventions for cardiovascular diseases.

Weight: 349g
Dimension: 235 x 155 (mm)
ISBN-13: 9783030478032
Edition number: 1st ed. 2020