Endothelial dysfunction in the pathogenesis of vascular accidents in cardiovascular diseases
DOI:
https://doi.org/10.14739/2310-1210.2017.4.105305Keywords:
endothelium vascular, cardiovascular deconditioning, heparin, lipid metabolismAbstract
Modern data about mechanism of endothelium contribution to onset and development of vascular failures in cardio-vascular diseases are represented in the article. Development of vascular failures – myocardial infarction, stroke, unstable angina, which lead to sudden death, can be as a result of acute vascular spasm, thrombus’ forming and rupture of atherosclerotic plaque.
Aim – to analyze scientific literature to summarize data about contemporary views on the role of endothelial dysfunction in the mechanisms of vascular events.
Key pathogenesis mechanisms, including the role of endothelium’s dysfunction, are arguable. Vascular wall defect is an important initial part of cardio-vascular pathology development – from risk factors to the death. Mechanism are multifaceted and associated with vascular tonus regulation, intactness of vascular wall, atherogenesis processes and hemostasis system. Endothelial dysfunction, determined by any pathogenic factor, leads to increased lipoproteins’ permeability and disturbance of lipid-transport system in general. Functional lipid-transport system disorders are associated with blood plasma’s lipolytic activity. New data about contribution of heparin deficiency in progressive endothelial dysfunction’s pathogenesis along with active correction of blood reologic properties in aterogenesis are represented.
Conclusions. Endothelial dysfunction in modern understanding is not only pathology of vascular wall, but a deep and complex system of disturbances and compensatory-adaptive reactions, which originates on molecular-genetic level. Study of the initial mechanisms of endothelial function dysregulation in vascular failures can be the prospective direction of modern medicine. Further researches of the primary injuring factor’s nature, which causes the vascular failures, can give not only the possibility to effect on pathogenetic mechanisms of cardio-vascular diseases development, but foresee and prevent the sudden death, increase the life expectancy.
References
Sherashov, V. S., & Sherashova, N. V. (2012). Sovremennye nauchnye predstavleniya o faktorakh riska razvitiya serdechno-sosudistykh zabolevanij (po materialam Vsemirnogo Kongressa Kardiologii, g. Dubai, OAE´) [Modern scientific knowledge about the risk factors of cardiovascular disease (proceedings of the world Congress of Cardiology, Dubai, UAE)]. Kardiovaskulyarnaya terapiya i profilaktika, 2, 96–100 [in Russian].
Kadykov, A. S., & Shakhparonova, N. V. (2007). Sosudistaya katastrofa [The vascular catastrophe]. Spravochnik poliklinicheskogo vracha, 2, 74–77. [in Russian].
Bulaeva, N. I., & Golukhova, E. Z. (2013). Endotelial'naya disfunkciya i oksidativnyj stress: rol' v razvitii kardiovaskulyarnoj patologii [Endothelial dysfunction and oxidant stress: the role in cardiovascular pathology]. Kreativnaya kardiologiya, 1, 14–22 [in Russian].
Maksimenko, А. V., & Turashev, A. D. (2011). Funkcii i sostoyanie e´ndotelial'nogo glikokaliksa v norme i patologii [Functions and state of endothelial glycocalyx in the norm and pathology conditions]. Ateroskleroz i dislipidemii, 2, 4–17. [in Russian].
Lavi, S., Bae, J. H., Rihal, C. S., Prasad, A., Barsness, G. W., Lennon, R. J., et al. (2009). Segmental coronary endothelial dysfunction in patients with minimal atherosclerosis is associated with necrotic core plaques. Heart, 95, 1525–1530. doi: 10.1136/hrt.2009.166017.
Titov, V. N. (2003). Funkcional'naya rol' intimy arterij. E´ndogennye, e´kzogennye patogenny i specifichnost' ateromatoza kak vospaleniya [Functional role of the intima of the arteries. Endogenous and exogenous pathogens and specificity of atheromatosis as an inflammation]. Klinicheskaya laboratirnaya diagnostika, 2, 23–37 [in Russian].
Kasatkina, S. G., & Panova, T. N. (2011). Vliyanie ryada aterogennykh faktorov riska na sostoyanie kompleksa intima-media obshhej sonnoj arterii u bol'nykh sakharnym diabetom 2 tipa [The influence of atherogenic risk factors on the condition of intima-media complex of the general carotid artery in patients with diabetes mellitus of the second type]. Astrakhanskij medicinskij zhurnal, 6(2), 66–69 [in Russian].
Zagidullin, N. Sh., Valeeva, K. F., Gassanov, N., & Zagidullin, Sh. Z. (2010). Znachenie disfunkcii e´ndoteliya pri serdechno-sosudistykh zabolevaniyakh i metody eyo medikamentoznoj korrekcii [Value of Endothelial Dysfunction in Cardiovascular Diseases and Methods of Its Correction With Drugs]. Kardiologiya, 5, 54–60 [in Russian].
Libby, P. (2002). Inflammation in atherosclerosis. Nature, 420, 868–874. doi: 10.1038/nature01323.
Sorrentino, S. A., Besler, C., Rohrer, L., Meyer, M., Heinrich, K., Bahlmann, F. H. et al. (2010). Endothelial-vasoprotective effects of high-density lipoprotein are impaired in patients with type 2 diabetes mellitus but are improved after extended-release niacin therapy. Circulation, 121(1), 110–122. doi.org/10.1161/circulationaha.108.836346.
Mohandas, R. & Segal, M. S. (2010). Endothelial progenitor cells and endothelial vesicles – what is the significance for patients with chronic kidney disease. Blood. Purif., 29, 158–162. doi: 10.1159/000245643.
Habib, S., & Ali, A. (2011). Biochemistry of nitric oxide. Ind. J. Clin. Biochem, 26, 3–17. doi: 10.1007/s12291-011-0108-4.
Markov, Kh. M. (2009) Oksid azota i ateroskleroz. Oksid azota, disfunkciya sosudistogo e´ndoteliya i patogenez ateroskleroza [Nitric oxide and atherosclerosis. Nitric oxide, dysfunction of the vascular endothelium and the pathogenesis of atherosclerosis]. Kardiologiya, 49(11), 64–74 [in Russian].
Gozhenko, A. I., Kovalevskaya, L. A., Kotyuzhinskaya, S. G., Vasyuk, V. L. & Zhukow, W. (2014). Atherosclerosis: new achievements and failures. J. of Health Sciences, 4(4), 101–114.
Stefano, G., Esch, T., Bilfinger, T., & Kream, R. M. (2010). Proinflammation and preconditioning protection are part of a common nitric oxide mediated process. Med. Sci. Monit., 16(6), 125–130.
Bogdan, C. (2011). Regulation of lymphocytes by nitric oxide. Methods Mol. Biol., 677, 375–393. doi: 10.1007/978-1-60761-869-0_24.
Khripun, I. A., Vorobyev, S. V., Morgunov, M. N., Belousov, I. I., Dzantieva, E. O., Gusova, Z. R., et al. (2015). Geneticheskie aspekty formirovaniya narusheniya funkcii e´ndoteliya u bol'nykh sakharnym diabetom 2 tipa [Genetic aspects of formation of dysfunction of endothelium in patients with diabetes mellitus type 2]. Medicinskij vestnik Severnogo Kavkaza, 10(4), 339–343. doi: http://dx.doi.org/10.14300/mnnc.2015.10083. [in Russian].
Heinzel, F. R., Gres, P., Boengler, K., Duschin, A., Konietzka, I., Rassaf, T. et al. (2008). Inducible nitric oxide synthase expression and cardiomyocyte dysfunction during sustained moderate ischemia in pigs. Circ. Res., 103, 1120–1127. doi: 10.1161/CIRCRESAHA.108.186015.
Fedoseev, A. N., Vaulina, A. S., Smirnov, V. V., & Ovsyannikov, K. V. (2014). Korrekciya e´ndotelial'noj disfunkcii u pacientov s terminal'noj pochechnoj nedostatochnost'yu [Correction of endothelial dysfunction in patients with terminal renal insufficiency]. Klinicheskaya praktika, 2, 30–34. [in Russian].
Bratus, V. V., Talaieva, T. V., Ambroskina, V. V., Kriachok, T. A., Korniienko, O. V., & Tretiak, I. V. (2007). Systemnyi kharakter porushen metabolizmu, aktyvnosti zapalennia, oksydantnoho stresu ta aterohennosti plazmy u khvorykh na ishemichnu khvorobu sertsia [Systemic metabolic disorders, of inflammation activity, oxidative stress and atherogenicity of plasma in patients with coronary heart disease]. Ukrainskyi kardiolohichnyi zhurnal, 2, 8–19 [in Ukrainian].
Ramzy, D., Rao, V., Tumiati, L. C., Xu, N., Sheshgiri, R., Jackman, J., et al. (2007). Endothelin-1 accentuates the proatherosclerotic effects associated with C-reactive protein. J. Thorac. Cardiovasc. Surg., 133, 1137–1146. doi: 10.1016/j.jtcvs.2006.11.034.
Förstermann, U. & Sessa, W. (2012) Nitric oxide synthases: regulation and function. Eur. Heart J., 33, 829–837. doi: 10.1093/eurheartj/ehr304.
Volkova, N. I., & Dzheriyeva, I. S. (2010). Arterial'naya gipertenziya i metabolicheskie narusheniya [The arterial hypertension and metabolic disorders]. Klinicheskaya medicina, 2, 4–8 [in Russian].
Xu, Y., & Fu, M. (2003). Alterations of HDL subclasses in hyperlipidemia. Clin. Chim. Acta, 332, 95–102. https://doi.org/10.1016/S0009-8981(03)00138-4.
Goberdhan, S., Chiew, S. K., Syed, J. (2016). Tender Endothelium Syndrome: Combination of Hypotension, Bradycardia, Contrast Induced Chest Pain, and Microvascular Angina. Case Reports in Cardiology, 2016, 101–104. doi: 10.1155/2016/8574025.
Pertseva, N. O. (2014). Vzaiemozviazok hiperhlikemii z endotelialnoiu funktsiieiu, funktsiieiu nyrok, lipidemichnym profilem i morfolohichnymy zminamy formenykh elementiv krovi u khvorykh iz nedostatnoiu kompensatsiieiu tsukrovoho diabetu 2 typu z arterialnoiu hipertenziieiu [Relationship of hyperglycemia with endothelial function, renal function, lipidemic profi le, and morphological changes of blood cells in patients with insuffi cient compensation of type 2 diabetes mellitus with hypertension]. Zaporozhye medical journal, 6, 11–17 [in Ukrainian]. doi: http://dx.doi.org/10.14739/2310-1210.2014.6.35636.
Lei, J., Vodovotz, Y., Tzeng, E., & Billiar, T. R. (2013). Nitric oxide, a protective molecule in the cardiovascular system. Nitric Oxide, 35, 175–185. doi: 10.1016/j.niox.2013.09.004.
Rerian, M. K., Lerman, L. O., & Lerman, A. (2010). Endothelial function as a functional expression of cardiovascular risk factors. Biomark. Med., 4(3), 351–360. doi: 10.2217/bmm.10.61.
Men'shikov, I. V., Makarova, M. I., Bulatova, N. I., Beduleva, L. V., Abisheva, N. N., Pozdeeva, M. G., et al. (2010). Autoimmunnye reakcii v patogeneze ateroskleroza [The role of autoimmune reactions in pathogenesis of atherosclerosis]. Immunologiya, 31(5), 242–246 [in Russian].
Yasuda, T., Ishida, T., & Rader, D. J. (2010). Update on the role of endothelial lipase in high-density lipoprotein metabolism, reverse cholesterol transport, and atherosclerosis. Circ. J., 74, 2263–2270.
Kim, L. B., Kulikov, V. Yu., & Mel´nikov, V. N. (2010). Rol' geparina v regulyacii transkapillyarnogo obmena i perekisnogo okisleniya lipidov u bol'nykh ishemicheskoj bolezn'yu serdca [The role of heparin in the regulation of transcapillary exchange and lipid peroxidation in patients with coronary heart disease]. Byulleten´ SO RAMN, 1, 72–77 [in Russian].
Kotyuzhinskaya, S. G., & Gozhenko, A. I. (2014). Patogeneticheskie mekhanizmy funkcionirovaniya lipidtransportnoj sistemy pri giperlipidemii [Pat hoge neti c me chan isms mal function lip id t ransport system hype rlip idemia]. Visnyk morfolohii, 20(2), 441–444 [in Russian].
Gozhenko, A. I., Kotyuzhinskaya, S. G., & Vasyuk, V. L. (2014). Osobennosti lipoproteinlipaznoj aktivnosti u bol'nykh s gipogeparinemicheskimi sostoyaniyami [The lipoproteinlipase activity in patients with hypoheparinemia states]. Tavricheskij mediko-biologicheskij vestnik, l17(1), 29–32 [in Russian].
Bratus,´ V. V., Talaeva, T. V., & Shumakov, V. A. (2009). Ozhirenie, insulinorezistentnost', metabolicheskij sindrom: fundamental'nye i klinicheskie aspekty [Obesity, insulin resistance, metabolic syndrome: basic and clinical aspects]. V.N. Kovalenko (Ed.). Kyiv: Chetverta khvylia [in Russian].
Kondashevskaya, M. V. (2010). Sovremennye predstavleniya o roli geparina v gemostaze i regulyacii fermentativnoj i gormonal'noj aktivnosti [Modern views of the role of heparin in hemostasis and regulation of enzymatic and hormonal activities]. Vestnik Rossiyskoj Akademii medicinskikh nauk, 7, 35–43 [in Russian].
Cole, J. E., Georgiou, E., & Monaco, C. (2010). The expression and functions of toll-like receptors in atherosclerosis. Mediators of Inflammation, 201, 1–18. doi: 10.1155/2010/393946.
Koreniev, M. M., Nosova, O. M., Bohmat, L. F., Yakovleva, I. M., & Nikonova, V. V. (2010). Osoblyvosti lipidnoho ta lipoproteiidnoho spektriv krovi u pidlitkiv iz riznymy formamy arterialnoi hipertenzii [The features of lipid and lipoprotein spectrum of the blood of adolescents with different forms of arterial hypertension]. Sovremennaya pediatriya, 6, 50–53 [in Ukrainian].
Poberezhna, A. V., & Sierkova, V. K. (2010). Rol lipoproteidu (A) ta aloproteiniv V i A-1 v otsintsi aterohennoho ryzyku v khvorykh na ishemichnu khvorobu sertsia [The role of lipoprotein (A) and apoprotein B and A-1 in the assessment of atherogenic risk in patients with coronary heart disease]. Visnyk problem biolohii ta medytsyny, 3, 177–181 [in Ukrainian].
Costa, L. G., Vitalone, A., Cole, T. B., & Furlong, C. E. (2005). Modulation of paraoxonase (PON1) activity. Biochem. Pharmacol, 69, 541–550. doi: 10.1016/j.bcp.2004.08.027.
Kotiuzhynska, S. H., & Hozhenko, A. I. (2014). Harakteristika lipidtransportnoj sistemy pri gipogeparinemii [Characterization of lipid transport system in patientswith hypoheparinemia]. Bukovynskyi medychnyi visnyk, 18(2), 57–59 [in Russian].
Kotiuzhynska, S. G., & Umanskyi, D. A. (2016). Rol' geparina v patologii lipidtransportnoj sistemy [The role of heparin in the pathology of lipid transport system]. Klinichna ta eksperymentalna medytsyna, 2, 112–118 [in Russian].
Gozhenko, A. I., Kotiuzhynska, S. H., & Kovalevska, L. A. (2014). Predyktory aterosklerozu: novi dosiahnennia [The predictors of atherosclerosis: new developments]. Likarska sprava, 12, 18–25 [in Ukrainian].
Malygina, N. A., Kostomarova, I. V., Melentyev, I. A., Melentyev, A. S., Vershinin, A. A., & Serova, L. D. (2009). Molekulyarno-geneticheskie markery dlya prognoza techeniya ishemicheskoj bolezni serdca u bol'nykh starshikh vozrastnykh grupp [Molecular and genetic markers for coronary heart disease prognosis in elderly patients]. Rossijskij kardiologicheskij zhurnal, 4, 68–72 [in Russian].
Liu, D., Jiang, Z., Dai, L., Zhang, X., Yan, C., & Han, Y. (2014). Association between the -786T>C1 polymorphism in the promoter region of endothelial nitric oxide synthese (eNOS) and risk of coronary artery disease: a systematic review and meta-analysis. Gene, 545(1), 175–183. doi: 10.1016/j.gene.2013.09.099.
Bebyakova, N. A., Khromova, A. V., & Feliksova, O. M. (2013). Vzaimosvyaz' perifericheskoj vazokonstrikcii s polimorfizmom T-786S gena e´ndotelial'noj sintazy oksida azota [The relationship of peripheral vasoconstriction with polymorphism T-786С of the gene of endothelial synthase nitric oxide]. Fundamental´nyye issledovaniya, 12(2), 176–179 [in Russian].
Niu, W., & Qi, Y. (2011). An updated meta-analysis of endothelial nitric oxide synthase gene: three well-characterized polymorphisms with hypertension. Plos. One, 6(9), 24266. doi: 10.1371/journal.pone.0024266.
Li, J., Wu, X., Li, X., Feng, G., He, L., & Shi, Y. (2010). The endothelial nitric oxide synthase gene is associated with coronary artery disease: A meta-analysis. Cardiology, 116, 271–278. doi: 10.1159/000316063.
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