Research progress on the molecular mechanism of coronary microvascular endothelial cell dysfunction

Deng, Jianying

doi:10.1016/j.ijcha.2021.100777

Cited by 5 publications

(5 citation statements)

References 78 publications

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“…ET-1 and NO are vasoactive substances that synthesize endothelial cells, whose synthesis, release and imbalance directly affect the basic tension of blood vessels, and are closely related to the occurrence and development of CHD. [39] Our meta-analysis suggested that ZXGD significantly decreased ET-1 and increased NO. Studies have shown that inflammatory response actives an important part in changing coronary plaques.…”

Section: Discussionmentioning

confidence: 98%

Zhishi Xiebai Guizhi Decoction for coronary heart disease: A systematic review and meta-analysis

Li,

Song,

Rong

et al. 2024

Medicine

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Background: Coronary heart disease (CHD) is a type of cardiovascular disease (CVD) caused by coronary atherosclerosis. It is a main cause of medical burden and cardiovascular related death. Zhishi Xiebai Guizhi Decoction (ZXGD) is a representative prescription of traditional Chinese medicine (TCM) in the treatment of CHD, but there is poor systemically evidence-based appraisal. Objective: To evaluate the efficacy and safety of ZXGD for CHD. Methods: Eight databases were retrieved for randomized controlled trials (RCTs). Data was extracted independently by 2 reviewers. The quality of the included studies was assessed by Cochrane Collaboration risk of bias tool. Clinical efficacy, blood lipid, vascular endothelial function, inflammatory factor and homocysteine (Hcy) were prespecified outcome measures. Results: Twenty-four studies (2272 patients) were included. Meta-analysis showed that compared with conventional western medicine (WM) alone, ZXGD was associated with a greater symptom improvement rate with a relative risk (RR) of 1.21 [95% CI (1.16, 1.26), P < .00001] and a greater electrocardiogram (ECG) improvement rate with a RR of 1.27 [95% CI (1.16, 1.40), P < .00001]. In terms of blood lipid, ZXGD reduced total cholesterol (TC) with a mean difference (MD) of −1.15 [95%CI (−1.75, −0.55), P = .0002] and triglyceride (TG) [MD = −0.72, 95%CI (−0.99, −0.45), P < .00001], reduced low-density lipoprotein cholesterol (LDL-C) [MD = −0.93, 95% CI (−1.17, −0.69), P < .00001], and increased high-density lipoprotein cholesterol (HDL-C) [MD = 0.31, 95%CI (0.20, 0.42), P < .00001]. In terms of vascular endothelial function, ZXGD decreased the level of endothelin-1 (ET-1) [MD = −7.81, 95%CI (−9.51, −6.10), P < .00001], and increased nitric oxide (NO) [MD = 8.90, 95%CI (7.86, 9.93), P < .00001]. ZXGD also reduced high-sensitivity C-reactive protein (hs-CRP) [MD = −1.73, 95% CI (−2.63, −0.83), P < .00001] and Hcy [MD = −2.03, 95%CI (−2.78, −1.28), P < .00001]. No significant differences were found in adverse event rate between the 2 groups with a RR of 0.77 [95% CI (0.44, 1.34), P = .36]. Conclusion: ZXGD is effective and safe in the treatment of CHD. However, more rigorous and high-quality RCTs are needed to verify the conclusion.

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Section: Discussionmentioning

confidence: 98%

Zhishi Xiebai Guizhi Decoction for coronary heart disease: A systematic review and meta-analysis

Li,

Song,

Rong

et al. 2024

Medicine

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“… 52 DM also decreases endothelial prostacyclin secretion, impairs fibrinolytic ability, alters endothelium-dependent hyperpolarizing factor-mediated responses, increases procoagulant activity, increases production of growth factors and extracellular matrix (ECM) proteins, and increases endothelial permeability, all contributing factor for CMD. 12 , 52 – 55 Simultaneously, due to altered calcium transport and accumulation, the mitochondrial transition pores open, causing cardiomyocyte apoptosis. 56 The elevated level of Ca 2+ plays a role in the activation of NADPH oxidase and ROS overproduction.…”

Section: Targeting Oxidative Stress In the Cardiac Cellsmentioning

confidence: 99%

“…These alterations markedly increase the risk of severe cardiovascular events like exertional angina or myocardial ischemia. 12 Additionally, DM also increases the risk of HF with preserved ejection fraction (HFpEF), a condition in which heart filling deficits are noted. 13 Meta-analysis has shown that 50% of diabetic patients are at heightened risk of developing HFpEF compared to non-diabetic patients.…”

Section: Introductionmentioning

confidence: 99%

A comprehensive review of the novel therapeutic targets for the treatment of diabetic cardiomyopathy

Dhar,

Venkadakrishnan,

Roy

et al. 2023

Therapeutic Advances in Cardiovascular Disease

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Diabetic cardiomyopathy (DCM) is characterized by structural and functional abnormalities in the myocardium affecting people with diabetes. Treatment of DCM focuses on glucose control, blood pressure management, lipid-lowering, and lifestyle changes. Due to limited therapeutic options, DCM remains a significant cause of morbidity and mortality in patients with diabetes, thus emphasizing the need to develop new therapeutic strategies. Ongoing research is aimed at understanding the underlying molecular mechanism(s) involved in the development and progression of DCM, including oxidative stress, inflammation, and metabolic dysregulation. The goal is to develope innovative pharmaceutical therapeutics, offering significant improvements in the clinical management of DCM. Some of these approaches include the effective targeting of impaired insulin signaling, cardiac stiffness, glucotoxicity, lipotoxicity, inflammation, oxidative stress, cardiac hypertrophy, and fibrosis. This review focuses on the latest developments in understanding the underlying causes of DCM and the therapeutic landscape of DCM treatment.

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“…Structural or functional damage to coronary microvascular endothelial cells (CMECs) is a key mechanism in the occurrence and development of CMD [ 37 ]. Abnormalities in CMECs, which account for approximately 1/3 of the total number of cells in the heart, lead to impaired cardiac microvascular vessel integrity and subsequent CMD [ 38 , 39 ].…”

Section: Endothelial Cell-mediated Correlation Between Coronary Micro...mentioning

confidence: 99%

Endothelial-cell-mediated mechanism of coronary microvascular dysfunction leading to heart failure with preserved ejection fraction

et al. 2022

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Although the prevalence of heart failure with preserved ejection fraction (HFpEF) is growing worldwide, its complex pathophysiology has yet to be fully elucidated, and multiple hypotheses have all failed to produce a viable target for therapeutic action or provide effective treatment. Cardiac remodeling has long been considered an important mechanism of HFpEF. Strong evidence has been reported over the past years that coronary microvascular dysfunction (CMD), manifesting as structural and functional abnormalities of coronary microvasculature, also contributes to the evolution of HFpEF. However, the mechanisms of CMD are still not well understood and need to be studied further. Coronary microvascular endothelial cells (CMECs) are one of the most abundant cell types in the heart by number and active players in cardiac physiology and pathology. CMECs are not only important cellular mediators of cardiac vascularization but also play an important role in disease pathophysiology by participating in the inception and progression of cardiac remodeling. CMECs are also actively involved in the pathogenesis of CMD. Numerous studies have confirmed that CMD is closely related to cardiac remodeling. ECs may serve a critical function in mediating the connection between CMD and HFpEF. It follows that CMECs participate in the mechanism of CMD leading to HFpEF. In this review article, we focus on the role of CMD in the pathogenesis of HFpEF resulting from cardiac remodeling and highlight the subsequent complexity of the EC-mediated correlation between CMD and HFpEF.

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Research progress on the molecular mechanism of coronary microvascular endothelial cell dysfunction

Cited by 5 publications

References 78 publications

Zhishi Xiebai Guizhi Decoction for coronary heart disease: A systematic review and meta-analysis

Zhishi Xiebai Guizhi Decoction for coronary heart disease: A systematic review and meta-analysis

A comprehensive review of the novel therapeutic targets for the treatment of diabetic cardiomyopathy

Endothelial-cell-mediated mechanism of coronary microvascular dysfunction leading to heart failure with preserved ejection fraction

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