Common Shared Pathogenic Aspects of Small Vessels in Heart and Brain Disease

• Published in: Biomedicines Vol. 10; no. 5; p. 1009
• Main Authors: Moretti, Rita, Janjusevic, Milijana, Fluca, Alessandra Lucia, Saro, Riccardo, Gagno, Giulia, Pierri, Alessandro, Padoan, Laura, Restivo, Luca, Derin, Agnese, Beltrami, Antonio Paolo, Caruso, Paola, Sinagra, Gianfranco, Aleksova, Aneta
• Format: Journal Article
• Language: English
• Published: Switzerland MDPI AG 27-04-2022; MDPI
• Subjects: Antioxidants; Atherosclerosis; atrial fibrillation; Bioavailability; Blood flow; Blood vessels; C-reactive protein; Cardiovascular disease; Coronary artery; Coronary artery disease; Coronary vessels; Dementia; Diabetes; Endothelium; Epidemiology; Growth factors; Heart attacks; Heart diseases; Interleukin 6; Ischemia; ischemic-heart disease; Metabolites; microvascular dysfunction; Microvasculature; myocardial infarction with non-obstructive coronary arteries (MINOCA); Neuroimaging; Nitric oxide; Oxidative stress; Pathology; Permeability; Review; Risk factors; small-vessel disease; Tumors; myocardial infarction with non-obstructive coronary arteries (MINOCA); nitric oxide; small-vessel disease; C-reactive protein (CRP); coronary-artery disease; tumor-necrosis-factor α (TNF-α); endothelial dysfunction; stroke; atrial fibrillation; cerebral-amyloid angiopathy; microvascular dysfunction; blood–brain barrier; inflammation; ischemic-heart disease; amyloid β-peptide; interleukin (IL-6); subcortical-vascular dementia; microglial activation
• ISSN: 2227-9059; 2227-9059
• DOI: 10.3390/biomedicines10051009

Small-vessel disease (SVD), also known as microvascular endothelial dysfunction, is a disorder with negative consequences for various organs such as the heart and brain. Impaired dilatation and constriction of small vessels in the heart lead to reduced blood flow and ischemia independently of coronary artery disease (CAD) and are associated with major cardiac events. SVD is usually a silent form of subcortical vascular burden in the brain with various clinical manifestations, such as silent-lacunar-ischemic events and confluent white-matter hyperintensities. Imaging techniques are the main help for clinicians to diagnose cardiac and brain SVD correctly. Markers of inflammation, such as C-reactive protein, tumor-necrosis-factor α, and interleukin 6, provide insight into the disease and markers that negatively influence nitric-oxide bioavailability and promote oxidative stress. Unfortunately, the therapeutic approach against SVD is still not well-defined. In the last decades, various antioxidants, oxidative stress inhibitors, and superoxide scavengers have been the target of extensive investigations due to their potential therapeutic effect, but with unsatisfactory results. In clinical practice, traditional anti-ischemic and risk-reduction therapies for CAD are currently in use for SVD treatment.