Definition of Vascular Remodeling Vascular remodeling is an active process of structural change that involves changes in at least four cellular processes: cell growth, cell death, cell migration, and the synthesis or degradation of extracellular matrix.
Why does vascular remodelling occur?
Growth, apoptosis, inflammation, and fibrosis of blood vessels may thus all contribute to vascular remodeling. The resulting arterial remodeling may initially be adaptive but eventually becomes maladaptive and compromises organ function, contributing to cardiovascular complications of hypertension.
Is vascular Remodelling a normal physiological response or a pathophysiological problem?
Vascular remodeling is central to the pathophysiology of hypertension and atherosclerosis. The pivotal role of vasoactive substances present in the blood vessel in the control of vascular growth is well known.
What is vascular remodeling in hypertension?
Vascular remodeling refers to alterations in the structure of resistance vessels contributing to elevated systemic vascular resistance in hypertension.
What is eutrophic remodeling?
It has been postulated that inward eutrophic remodeling occurs when resistance vessels exposed to high blood pressure are able to normalize circumferential stress via the repositioning of vascular smooth muscle cells around a smaller luminal diameter, a process that preserves wall cross-sectional area [31, 32, 47].
What is endothelial dysfunction?
Endothelial dysfunction is a type of coronary artery disease. A lack of nitric oxide gas inside of your blood vessel walls causes arteries to narrow. This narrowing slows blood flow to your heart. The condition causes angina (chest pain) and increases your risk of heart conditions.
What is cardiac remodeling?
Cardiac remodeling is defined as a group of molecular, cellular and interstitial changes that manifest clinically as changes in size, mass, geometry and function of the heart after injury. The process results in poor prognosis because of its association with ventricular dysfunction and malignant arrhythmias.
What is ventricular remodeling?
The term ventricular remodeling refers to alteration in ventricular architecture, with associated increased volume and altered chamber configuration, driven on a histologic level by a combination of pathologic myocyte hypertrophy, myocyte apoptosis, myofibroblast proliferation, and interstitial fibrosis (1, 2, 3).
What is pulmonary vascular Remodelling in COPD?
Pulmonary arterial remodeling is an umbrella term that describes a range of pulmonary vascular changes observed in COPD, including medial hypertrophy, longitudinal muscle deposition, intimal hyperplasia, elastin and collagen deposition, and muscularization of the pulmonary arterioles.
What is vascular changes?
Vascular Disease (Vasculopathy) Vascular disease (vasculopathy) affects the blood vessels that carry oxygen and nutrients throughout your body and remove waste from your tissues. Common vascular problems happen because plaque (made of fat and cholesterol) slows down or blocks blood flow inside your arteries or veins.
What are vascular conditions?
Vascular diseases affect the circulatory system. They include hypertension, stroke, aneurysms, and peripheral artery disease (PAD). Due to an aging population, an increase in obesity and chronic conditions like Type II diabetes, vascular diseases are a growing epidemic.
What is the pathophysiology of vascular disease?
Pathophysiology. Peripheral vascular disease is primarily driven by the progression of atherosclerotic disease leading to macro and microvascular dysfunction. PAD typically affects the lower extremity vascular beds, but larger arteries such as the abdominal aorta and iliac arteries are frequently involved.
What are the pathological changes of vessels and organs caused by hypertension?
In benign hypertension, the major changes are in the small arteries and arterioles especially in the kidney. Interlobular arteries exhibit intimal thickening and duplication of the elastic lamina (elastosis) and there is hyaline change in the media of many arterioles.
What is vascular remodeling in diabetes?
The vascular effects of DM are seen in many organs including the brain, mesentery and kidney. The effects of diabetes on the vasculature starts with endothelial dysfunction and lead to changes in the structure of large and small blood vessels, a change which is referred to as vascular remodeling (VRM).
What is microvascular remodeling?
Abstract. In the present review, microvascular remodelling refers to alterations in the structure of resistance vessels contributing to elevated systemic vascular resistance in hypertension.
What are the causes of vasoconstriction?
- Prescription medicines or non-prescription medicines like decongestants. These have ingredients that cause blood vessels to narrow to provide relief.
- Some medical conditions.
- Some psychological problems, such as stress.
- Smoking.
- Being outside in the cold.
What causes hypertension pathophysiology?
The pathophysiology of hypertension involves the impairment of renal pressure natriuresis, the feedback system in which high blood pressure induces an increase in sodium and water excretion by the kidney that leads to a reduction of the blood pressure.
What are blood vessels?
What are blood vessels? Blood vessels are channels that carry blood throughout your body. They form a closed loop, like a circuit, that begins and ends at your heart. Together, the heart vessels and blood vessels form your circulatory system. Your body contains about 60,000 miles of blood vessels.
Can you repair endothelial cells?
Some ‘master’ or progenitor cells exist in the blood vessel wall, which can be turned into new endothelial cells that could repair the damaged endothelium. But these cells can also become other types of cells, such as smooth muscle cells.
Can endothelial damage be reversed?
The recent demonstration that endothelial dysfunction may be reversible raises the possibility of slowing the progression of atherosclerosis or modifying arterial function, or both, to decrease the risk of acute cardiovascular events.
What does endothelial dysfunction feel like?
Chest pain, squeezing or discomfort (angina), which may get worse with activity or emotional stress. Discomfort in the left arm, jaw, neck, back or abdomen along with chest pain. Shortness of breath. Tiredness and lack of energy.
How long does it take for cardiac remodeling?
Cardiac remodelling is a dynamic and ongoing process up to 24 months following acute myocardial infarction. Long-term LVEF deterioration is characterised by an increase in end-systolic volume and less wall thickening in the remote zones.
What is remodeling after myocardial infarction?
Adverse ventricular remodeling after myocardial infarction (MI) is a process of regional and global structural and functional changes in the heart as a consequence of loss of viable myocardium, exuberant inflammatory response, increased wall stress in the border zone and remote myocardium, and neurohormonal activation …
What type of process is myocardial remodeling?
Myocardial remodeling (REM) is a deleterious process characterized by gradual cardiac enlargement, cardiac dysfunction and typical molecular changes. It is a universal phenomenon, being caused by many pathological conditions [1, 2]. Of these, myocardial infarction is the more common.
What causes ventricular remodeling in heart failure patients?
In response to pathophysiological stimuli such as ischemia/reperfusion or excessive mechanical load, multiple molecular and cellular processes contribute to ventricular remodeling. These include cardiomyocyte loss through cell death pathways such as necrosis, apoptosis, or possibly excessive autophagy.