Microcirculation: target therapy in cardiovascular diseases - a clinical perspective.
Microcirculation conduit, distribution, exchange and reception vessels usually retain a demand-dependent vascular-tissue match as well as a nutrient friendly capillary-matrix tissue match. Various stimuli can initiate a vascular-capillary matrix-tissue mismatch. Counter-regulatory mechanisms result in hyperplasia or apoptosis. Microvascular disease (MVD) as a consequence or outcome of supply-demand mismatch has clinical therapeutic and prognostic implications in the hypertensive syndrome and coronary artery disease (CAD) cases. Recognition of the role of apoptosis and MVD may initiate a paradigm shift in clinical practice. Digitalis and other anti-hypertensive agents have anti-apoptotic action and MVD blunting effects that can control LVH development to reduce congestive heart failure (CHF) progression.
Abarquez
Ramon F
RF
Department of Medicine, Philippine General Hospital-College of Medicine, University of the Philippines, Manila, Philippines. cvlab@cm.upm.edu.ph
Cinco
Jude Erric L
JE
D000818:Animals; D017209:Apoptosis; D002318:Cardiovascular Diseases / Q000150:complications / Q000188:drug therapy / Q000503:physiopathology* / Q000601:surgery; D001026:Coronary Artery Bypass; D003326:Coronary Circulation / Q000187:drug effects; D015195:Drug Design; D004730:Endothelium, Vascular / Q000503:physiopathology; D005786:Gene Expression Regulation; D006801:Humans; D017379:Hypertrophy, Left Ventricular / Q000209:etiology / Q000517:prevention & control; D020935:MAP Kinase Signaling System; D024821:Metabolic Syndrome / Q000150:complications; D051379:Mice; D008833:Microcirculation / Q000187:drug effects; D014655:Vascular Resistance; D020257:Ventricular Remodeling