On March 11 2020 WHO declares corona viral disease as a global pandemic .COVID 19 pandemic has taken the world by storm and many countries like India is now experiencing a second surge due to mutant strains. Global health emergency has been precipitated by this corona virus disease caused by SARS CoV2.Acute and intermediate effects on cardiovascular system are becoming obvious with progression of time. SARS-CoV-2-related endothelial dysfunction results in an augmented risk for venous thromboembolism, systemic vasculitis, endothelial cell apoptosis, and inammation in various organs. Acute infections have troponin elevation more due to indirect cardiac damage though denite patterns of direct damage do exist. Intermediate evaluation in patients with resolved infections shows increased incidence of exercise induced arrhythmias and residual cardiovascular symptoms. The virus with its zoonotic origin based upon its genomic identity to bat derived SARS corona virus has a human to human transmission mode.ACE 2 receptors facilitate cellular entry and has been implicated in direct and indirect myocardial damage. Myocarditis, acute myocardial injury, arrhythmias and thromboembolism dominates the clinical picture. Role of imaging must be dened in relation to relevant clinical ndings. With arrival of vaccine and widespread vaccination global programs, we can look forward to understanding and managing long term complications of this disease. Prognostic implications of a resolved disease need to be evaluated by future studies.
Aortic root abscess results when uncontrolled infective endocarditis causes aneurysm of one of the sinuses of Valsalva that is in free communication with the aortic root above the valve cusps. The risk factors for aortic root abscess in endocarditis are bicuspid aortic valve, aortic valve regurgitation, degenerative aortic stenosis and patients with multi valvular disease. In general terms, prognosis is better if surgery is undertaken early, before cardiac tissue destruction and deterioration in the overall condition of the patient increase the hazards of intervention.
Donor organ shortage has been the Achilles heel of organ transplantation programmes. Bioprinted organs promise to bridge the gap and provide succor to this group of patients. Fusion of disciplines relating to cell biology, bioinformatics, physics, geneticists and material science could well make commercially available human organs a reality in near future. Biofabricated tissues have made a promising entry in this region augmenting our hopes on this technology to provide human organs in future too. Key materials that would be the limiting links in this journey to commercial success and viability would be recombinant protein biolinks, maturation and other growth factors.
Advanced glycation end products (AGEs) are proteins or lipids that become glycated after exposure to sugars. AGEs may modify the extracellular matrix (ECM); modify the action of hormones, cytokines, and free radicals via engagement of cell surface receptors; and impact the function of intracellular proteins..AGEs block nitric oxide activity in the endothelium and cause the production of reactive oxygen species. AGEs cause microvascular and macrovascular complications by formation of cross-links between molecules in the basement membrane of the extracellular matrix and by engaging the receptor for advanced glycation end products (RAGE). Activation of RAGE by AGEs causes upregulation of the transcription factor nuclear factor-κB and its target genes. AGEs can be formed either endogenously or exogenously. Endogenously, advanced glycation takes place in all cell types via the Maillard reaction between reducing sugars and amino residues present in proteins, lipids, and DNA, resulting in loss of protein structure and function followed in some instances by cellular apoptosis. Transition to plant based antioxidant diet with traditional Indian cooking methods seems to confer multitude of health benets.
The aim of cardiovascular nanomedicine- CVN is to reduce off-target toxicity issues with therapeutic selectivity to the heart .The lipophilic barrier of the cellular membranes should be circumvented to deliver cargo inside the cell. Lipidbased NPs, which show low side effects and greater ability to passively accumulate at tissues with higher vascular permeability (enhanced permeation rate), have been largely used since the earlier times of cardiovascular nanomedicine-CVN. Polymeric NPs, silica NPs, carbon nanotubes, polymeric micelles, quantum dots, nanobers and nanocrystals represent other examples of nano-formulations for controlled drug delivery. NP-loaded drugs are expected to be protected from systemic degradation, show reduced toxicity and immunogenicity, possess ameliorated pharmacokinetics and increased half-life and exhibit increased bioavailability and precise bio distribution. Nanodrug formulations are expected to enhance selective delivery to the site of interest and benet from a lower clearance from the body. Nanotechnology represents a convergent discipline in which the margins separating research areas, such as chemistry, biology, physics, mathematics and engineering become blurred with the much needed emergence of integrated science as a new discipline.
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