Hasil untuk "Diseases of the circulatory (Cardiovascular) system"

A. Crozier, I. Jaganath, M. Clifford

Hasan Zulfiqar, Zhiling Guo, Ramala Masood Ahmad et al.

Snake venom contains many toxic proteins that can destroy the circulatory system or nervous system of prey. Studies have found that these snake venom proteins have the potential to treat cardiovascular and nervous system diseases. Therefore, the study of snake venom protein is conducive to the development of related drugs. The research technologies based on traditional biochemistry can accurately identify these proteins, but the experimental cost is high and the time is long. Artificial intelligence technology provides a new means and strategy for large-scale screening of snake venom proteins from the perspective of computing. In this paper, we developed a sequence-based computational method to recognize snake toxin proteins. Specially, we utilized three different feature descriptors, namely g-gap, natural vector and word 2 vector, to encode snake toxin protein sequences. The analysis of variance (ANOVA), gradient-boost decision tree algorithm (GBDT) combined with incremental feature selection (IFS) were used to optimize the features, and then the optimized features were input into the deep learning model for model training. The results show that our model can achieve a prediction performance with an accuracy of 82.00% in 10-fold cross-validation. The model is further verified on independent data, and the accuracy rate reaches to 81.14%, which demonstrated that our model has excellent prediction performance and robustness.

Sergey A. Makarov, Alena S. Agienko, Artem N. Popsuyko et al.

Highlights The theoretical novelty of the work consists in using the regional target indicator of the mortality rate from diseases of the circulatory system as an indicator for assessing the effectiveness of management decisions at the level of municipalities in the constituent entity of the Russian Federation. To counteract the growing burden of cardiovascular diseases (CVD), the project solution “Long and active life” is being implemented in all constituent entities of the Russian Federation, indicating regional target indicators (RTI). A regional program is also in effect in the Kemerovo Region. In the absence of unified approaches to assessing the effectiveness of health care management technologies within the framework of the regional program, extrapolation of the RTI in municipalities seems promising for solving such a problem.   Aim. To assess the characteristics of the population’s appeal to medical organizations and the prevalence of individual risk factors for CVD in connection with the effectiveness of health care management in the municipalities of the Kemerovo Region-Kuzbass for 2019–2023. Methods. Data from the Federal State Statistics Service for the period 2019–2023 were used. regarding mortality due to CVD, disease codes: I00–I99, and federal statistical observation forms No. 30 and No. 131/o. Statistical processing was performed using descriptive statistics methods. Results. The average effectiveness of the regional program in the municipalities was in the range from 111.8 to 176.4%. In four municipalities, it is observed that the number of visits due to diseases exceeds the regional values. In these municipalities, the following dominate in the structure of the studied factors: poor nutrition in a share from 32 to 40.3%; hypercholesterolemia – from 3.8 to 16%; smoking – from 5.3 and 8.9%. Low physical activity and alcohol consumption do not act as a leading risk factor in the region. Conclusion. A relationship was established between the effectiveness of health care management technologies and the number of requests for help. In particular, low efficiency is associated with a higher proportion of visits for treatment purposes compared to preventive and outpatient observation; a higher prevalence of controllable risk factors for CVD (poor nutrition, hypercholesterolemia, and tobacco smoking).

Christine Espinola-Klein, Stavros Konstantinides

Jan Steffel, Thomas F. Lüscher

Danilo V. Rogayan, Jr., Edna M. Padre

Leslee J Shaw, Todd C Villines, Francesco Giammarile et al.

Background Understanding pandemic-related reductions and subsequent recovery of cardiovascular testing in Asia is important for guiding regional public health efforts.Objectives This study sought to evaluate the recovery of cardiovascular testing in Asia 1 year into the COVID-19 pandemic.Methods In this subanalysis of a worldwide survey on the impact of COVID-19 on cardiovascular diagnostic care in April 2020 and April 2021, recovery of testing volume in Asia was compared among subregions, World Bank income groups and imaging modalities.Results Of 669 sites worldwide, 164 sites were in 33 Asian countries. Cardiovascular testing volumes in Asia decreased by 53% from March 2019 to April 2020, then recovered 96% of this decrease by April 2021, compared with 98% recovery in the rest of the world. Eastern Asia and Western and Central Asia reported recovery rates of 123% and 110%, compared with 50% and 80% recovery in Southern and South-eastern Asia. Testing volumes among high-income and upper-middle-income Asian countries recovered to 117% and 121% but remained depressed at 49% and 14% recovery in lower-middle and low-income countries, respectively. Stress ECG, stress echo and stress positron emission tomography studies experienced median reductions of 48%, 35% and 57% in testing volume between March 2019 and April 2021, while volumes of coronary artery calcium, coronary CT angiography and cardiac MR remained stable during this period.Conclusions The recovery of cardiovascular testing in Asia 1 year into the COVID-19 pandemic lagged in the Southern and South-eastern subregions, as well as in lower-income countries. Recovery favoured advanced cardiac imaging modalities over standard stress testing modalities.

Albert J. Pedroza, MD, Alex R. Dalal, MD, Jennifer Kim, MD et al.

Objectives: Loeys-Dietz syndrome comprises genetically discrete subtypes of varying clinical severity. This study integrates longitudinal Loeys-Dietz syndrome clinical outcomes after aortic root replacement with transcriptomic analysis of aortic smooth muscle cell dysregulation to investigate mechanisms governing this subtype-specific aortic vulnerability. Methods: Single institutional experience with aortic root replacement for nondissected aneurysm in patients with Loeys-Dietz syndrome was reviewed for midterm survival and distal aortic events (subsequent aortic intervention, aneurysm, or dissection). Single-cell RNA sequencing was performed using fresh aortic aneurysm tissue to compare smooth muscle cell phenotypes between patients with TGFBR1/2 and SMAD3 variants. Results: A total of 62 patients with Loeys-Dietz syndrome were identified, including 59 genetically confirmed (n = 36 TGFBR1/2, n = 16 SMAD3, and n = 7 TGFB2/TGFB3). Valve-sparing operations were performed in 54 patients, 8 patients underwent composite root replacement operations, and 19 patients underwent concomitant arch replacement. Median follow-up was 6.16 years (interquartile range, 2.88-10.82). Estimated 5- and 10-year survivals for TGFBR1/2 patients were 97% (99%-82%) and 86% (96%-61%), respectively, and estimated incidence of aortic events at 5- and 10-year follow-up was 17% (7%-36%) and 28% (14%-51%), respectively. For SMAD3 patients, estimated survival was 94% (99%-63%) at both 5 and 10 years, and estimated incidence of aortic events at both 5- and 10-year follow-ups was 0%. Single-cell RNA sequencing analysis (n = 3 TGFBR1/2, n = 5 SMAD3) demonstrated altered smooth muscle cell phenotype modulation patterns, with greater retention of contractile gene expression, enriched collagen, and integrin receptor expression in TGFBR1/2 smooth muscle cells, whereas SMAD3 patients showed activation of osteochondrogenic matrix components (TNFRSF11B, CYTL1) and inflammatory pathways. Conclusions: Loeys-Dietz syndrome subtypes may demonstrate variable clinical outcomes after aortic root replacement. Distinct gene dysregulation patterns suggest varying smooth muscle cell–extracellular matrix interactions may participate in clinical variation.

Hany A. Zaki, Bilal Albaroudi, Eman E. Shaban et al.

BackgroundAcute aortic dissection (AAD) is a life-threatening medical condition with high early fatality. Therefore, a prompt and precise diagnosis, which can be achieved through invasive and non-invasive techniques is vital. Echocardiography, unlike MRI and CT, is accessible in emergency units and bedside-compatible. The recommended echocardiographic techniques for AAD are transthoracic and transoesophageal echocardiography (TTE and TOE). Therefore, our review compares their diagnostic roles in AAD.MethodsStudies relevant to our topic were attained through a database search and manual scrutiny of references lists of articles obtained from the electronic databases. The Quality Assessment of Diagnostic Accuracy Studies tool (QUADAS-2) has been used for quality assessment. All quantitative analyses were performed using either STATA 16 or Comprehensive Meta-Analyst software.ResultsThe search strategy yielded 1,798 articles, of which only 11 were eligible for inclusion. Our subgroup analysis showed that conventional TTE had a sensitivity and specificity of 85.35% and 84.51% for the diagnosis of Stanford type A AAD and was 45.89% sensitive and 87.05% specific for the diagnosis of type B AAD. However, the subgroup analysis shows that contrast-enhancement of TTE results in a sensitivity and specificity of 93.30% and 97.60% for diagnosis of type A AAD, and 83.60% and 94.50% for diagnosis of type B AAD, respectively. On the other hand, conventional TOE was 93.64% sensitive and 95.50% specific for the diagnosis of type A AAD, 99.80% sensitive and 99.87% specific for the diagnosis of type B AAD. Moreover, our analyses show that TTE has pooled false negative and positive rates of 28.6% and 18.6%, while TOE has shown false negative and positive rates of 2.4% and 4.3%, respectively.ConclusionTOE is the more favorable diagnostic tool for AAD diagnosis than TTE. However, it cannot be used as a stand-alone diagnostic tool since misdiagnosis cases are being reported. Contrast-enhanced TTE can also diagnose AAD since it provides similar results to conventional TOE.

Maryuri Chumbes, MD, Sergio Alfonso Patron-Chi, MD, Gabriela Melendez-Ramirez, MD et al.

Yinuo Li, Xi Liu, Qian Hong et al.

BackgroundRecent epidemiological studies have indicated a correlation between platelet indices and pulmonary arterial hypertension (PAH), yet the causality between them remains unclear. To explore the causal relationship between four platelet indices and PAH, with the aim of providing a theoretical basis for clinical prevention and treatment.MethodsSingle-nucleotide polymorphisms (SNPs) associated with platelet-related traits were selected as exposure factors from published genome-wide association studies (GWAS), including: platelet count (PLT), plateletcrit (PCT), mean platelet volume (MPV), and platelet distribution width (PDW). Summary-level data for PAH were obtained from the FinnGen study (248 cases and 289,117 controls). Two-sample and multivariable Mendelian randomization (MR) analyses were conducted to assess the causal relationship between exposure factors and the risk of outcomes. The inverse variance weighted (IVW) method was utilized as the primary MR analysis approach, supplemented by weighted median, mode-based estimation, MR-Egger regression, and the MR Pleiotropy Residual Sum and Outlier (MR-PRESSO) test to detect and adjust for pleiotropy, ensuring the reliability of the results through sensitivity analysis.Results(1) The IVW results from the two-sample MR analysis showed a positive causal association between PLT and the risk of developing PAH [(OR = 1.649, 95%CI: 1.206–2.256, P = 0.0017)], with the sensitivity analysis confirming the robustness of the causal relationship. The MR-Egger intercept analysis did not detect potential pleiotropy (P = 0.879). (2) The MVMR results showed no statistically significant causal relationship between these four markers and the risk of developing PAH. After adjusting for collinearity, a direct positive causal association was observed between PLT and the risk of developing PAH (OR = 1.525, 95%CI: 1.063–2.189, P = 0.022).ConclusionThe positive correlation between PLT and the risk of PAH suggests that correcting elevated platelet levels may reduce the risk of developing PAH.

Susumu Odajima, Wataru Fujimoto, Misa Takegami et al.

Background Stage B heart failure (HF) refers to structural heart disease without signs or symptoms of HF, so that early intervention may delay or prevent the onset of overt HF. However, stage B HF is a very broad concept, and risk stratification of such patients can be challenging. Methods and Results We conducted a prospective study of data for 1646 consecutive patients with HF from the KUNIUMI (Kobe University Heart Failure Registry in Awaji Medical Center) registry chronic cohort. The definition of HF stages was based on current guidelines for classification of 29 patients as stage A HF, 761 as stage B HF, 827 as stage C HF, and 29 patients as stage D HF. The primary end point was the time‐to‐first‐event defined as cardiovascular death or HF hospitalization within 2.0 years of follow‐up. A maximum of 6 adjustment factor points was assigned based on Cox proportional hazards analysis findings for the hazard ratio (HR) of independent risk factors for the primary end point: 1 point for anemia, estimated glomerular filtration rate <45 mL/min per 1.73 m2, brain natriuretic peptide ≥150 pg/mL, and average ratio of early transmitral flow velocity to early diastolic mitral annular velocity >14, and 2 points for clinical frailty scale >3. Patients with stage B HF were stratified into 3 groups, low risk (0–1 points), moderate risk (2–3 points), and high risk (4–6 points). Based on this scoring system (BEEAF2 [brain natriuretic peptide, estimated glomerular filtration rate, ratio of early transmitral flow velocity to early diastolic mitral annular velocity, anemia, and frailty]), the outcome was found to become worse in accordance with risk level. High‐risk patients with stage B HF and patients with stage C HF showed similar outcomes. Conclusions Our scoring system offers an easy‐to‐use evaluation of risk stratification for patients with stage B HF.

Jonathan Brown, Hytham Rashid, Siva T. Sarva et al.

Viral myocarditis is an important cause of non-ischemic cardiomyopathy. Multiple clinical manifestations have been reported, including acute heart failure, cardiogenic shock, and ventricular arrhythmias. We present three patients with clinically suspected viral myocarditis causing acute heart failure. Serum coxsackievirus B antibodies were positive in all three patients. Each case resulted in significant clinical improvement with hemodynamic support and acute recovery of left ventricular ejection fraction. Despite an initial critical presentation concerning for cardiogenic shock, we highlight three cases of clinically suspected coxsackie myocarditis with an excellent short-term prognosis.

E. Kodintseva, A. Akleyev

One of the main tasks of the contemporary radiobiology is to study mechanisms of the late effects development and to prove that radiation exposure either stimulates or suppresses the systemic immunity that could modify considerably the risks of cancer and cardio-vascular disease development. According to the epidemiological data chronically exposed residents of the Techa riverside settlements demonstrate increased risks of mortality from malignant neoplasms including leukemia and circulatory system diseases in the long-term period after the onset of radiation exposure. The changes in the immune system in these people have been registered over the course of decades and are pro-inflammatory. In the long-term period impairment of the functional activity of phagocytes, one of the most important effector cells of the anti-tumor immunity and inflammation, in chronically exposed people could be viewed as one of the pathophysiologic mechanisms of the carcinogenesis and cardiovascular pathology under long-term low-dose-rate exposure with predominant damage to the bone marrow. The objective of the study is to summarize and analyze the currently important scientific data on the functional activity of the human peripheral blood neutrophilic granulocytes after ionizing radiation exposure including the chronic low dose rate exposure, and phenotypes of the main subpopulations of neutrophilic granulocytes that reflect the specific features of their functioning. The review presents topical information on the main functions of neutrophilic granulocytes, changes in their functional activity under ionizing radiation exposure, and contemporary view of the phenotypes of the main subpopulations of the neutrophilic granulocytes circulating in the peripheral blood.

S. Park, Soo Youn Lee, M. Jung et al.

Most patients with heart failure (HF) have multiple comorbidities, which impact their quality of life, aggravate HF, and increase mortality. Cardiovascular comorbidities include systemic and pulmonary hypertension, ischemic and valvular heart diseases, and atrial fibrillation. Non-cardiovascular comorbidities include diabetes mellitus (DM), chronic kidney and pulmonary diseases, iron deficiency and anemia, and sleep apnea. In patients with HF with hypertension and left ventricular hypertrophy, renin-angiotensin system inhibitors combined with calcium channel blockers and/or diuretics is an effective treatment regimen. Measurement of pulmonary vascular resistance via right heart catheterization is recommended for patients with HF considered suitable for implantation of mechanical circulatory support devices or as heart transplantation candidates. Coronary angiography remains the gold standard for the diagnosis and reperfusion in patients with HF and angina pectoris refractory to antianginal medications. In patients with HF and atrial fibrillation, long-term anticoagulants are recommended according to the CHA2DS2-VASc scores. Valvular heart diseases should be treated medically and/or surgically. In patients with HF and DM, metformin is relatively safer; thiazolidinediones cause fluid retention and should be avoided in patients with HF and dyspnea. In renal insufficiency, both volume status and cardiac performance are important for therapy guidance. In patients with HF and pulmonary disease, beta-blockers are underused, which may be related to increased mortality. In patients with HF and anemia, iron supplementation can help improve symptoms. In obstructive sleep apnea, continuous positive airway pressure therapy helps avoid severe nocturnal hypoxia. Appropriate management of comorbidities is important for improving clinical outcomes in patients with HF.

D. Sadykova, K. Salakhova, L. F. Galimova et al.

Cardiovascular diseases are the leading cause of disability and mortality worldwide. Cardiovascular mortality rate is steadily increasing despite the large-scale preventive measures. Familial hypercholesterolemia is the most common genetically determined disorder of lipid metabolism as the major cause of blood circulatory system diseases development and progression. Worldwide, there are 6.8–8.5 million children with this primary dyslipidemia. Early (in childhood) diagnosis of familial hypercholesterolemia is crucial for the timely initiation of lipid-lowering therapy in order to reduce the atherosclerosis progression and the risk of life-threatening cardiovascular events. New screening programs have been implemented, new biomarkers of the disease have been studied, and lipid-lowering drugs with new mechanisms of hypolipidemic action have been developed to increase the efficacy of these activities in economically developed countries.

A. Molnár, G. Nádasy, G. Dörnyei et al.

Aging-induced pathological alterations of the circulatory system play a critical role in morbidity and mortality of older adults. While the importance of cellular and molecular mechanisms of arterial aging for increased cardiovascular risk in older adults is increasingly appreciated, aging processes of veins are much less studied and understood than those of arteries. In this review, age-related cellular and morphological alterations in the venous system are presented. Similarities and dissimilarities between arterial and venous aging are highlighted, and shared molecular mechanisms of arterial and venous aging are considered. The pathogenesis of venous diseases affecting older adults, including varicose veins, chronic venous insufficiency, and deep vein thrombosis, is discussed, and the potential contribution of venous pathologies to the onset of vascular cognitive impairment and neurodegenerative diseases is emphasized. It is our hope that a greater appreciation of the cellular and molecular processes of vascular aging will stimulate further investigation into strategies aimed at preventing or retarding age-related venous pathologies.

V. S. Sanal Kumar, Bharath Rajaghatta Sundararam, Pradeep Kumar Radhakrishnan et al.

Diagnostic investigations of aneurysm, hemorrhagic stroke, and other asymptomatic cardiovascular diseases and neurological disorders due to the flow choking (biofluid/boundary layer blockage persuaded flow choking) phenomenon in the circulatory system of humans and animals on the Earth and in the human spaceflight are active research topics of topical interest {Kumar et al., “boundary layer blockage persuaded flow choking leads to hemorrhagic stroke and other neurological disorders in earth and human spaceflight,” Paper presented at the Basic Cardiovascular Sciences Conference, 23–25 August 2021 (American Stroke Association, 2021) [Circ. Res. 129, AP422 (2021)] and “Lopsided blood-thinning drug increases the risk of internal flow choking and shock wave generation causing asymptomatic stroke,” in International Stroke Conference, 19–20 March 2021 (American Stroke Association, 2021) [Stroke 52, AP804 (2021)]}. The theoretical concept of flow choking [Kumar et al., “Lopsided blood-thinning drug increases the risk of internal flow choking leading to shock wave generation causing asymptomatic cardiovascular disease,” Global Challenges 5, 2000076 (2021); “Discovery of nanoscale boundary layer blockage persuaded flow choking in cardiovascular system—Exact prediction of the 3D boundary-layer-blockage factor in nanotubes,” Sci. Rep. 11, 15429 (2021); and “The theoretical prediction of the boundary layer blockage and external flow choking at moving aircraft in ground effects,” Phys. Fluids 33(3), 036108 (2021)] in the cardiovascular system (CVS) due to gas embolism is established herein through analytical, in vitro (Kumar et al., “Nanoscale flow choking and spaceflight effects on cardiovascular risk of astronauts—A new perspective,” AIAA Paper No. 2021-0357, 2021), in silico (Kumar et al., “Boundary layer blockage, Venturi effect and cavitation causing aerodynamic choking and shock waves in human artery leading to hemorrhage and massive heart attack—A new perspective,” AIAA Paper No. 2018-3962, 2018), and in vivo animal methodology [Jayaraman et al., “Animal in vivo: The proof of flow choking and bulging of the downstream region of the stenosis artery due to air embolism,” Paper presented at the Basic Cardiovascular Sciences Conference , 25–28 July 2022 (American Heart Association, 2022)]. The boundary layer blockage persuaded flow choking phenomenon is a compressible viscous flow effect, and it arises at a critical pressure ratio in continuum/non-continuum real-world yocto to yotta scale flow systems and beyond [Kumar et al., “Universal benchmark data of the three-dimensional boundary layer blockage and average friction coefficient for in silico code verification,” Phys. Fluids 34(4), 041301 (2022)]. The closed-form analytical models, capable of predicting the flow choking in CVS, developed from the well-established compressible viscous flow theory are reviewed and presented herein. The lower-critical flow-choking index of the healthy subject (human being/animal) is predicted through the speciation analysis of blood. The upper-critical flow-choking index is predicted from the specific heat of blood at constant pressure (Cp) and constant volume (Cv), estimated using the Differential Scanning Calorimeter. These flow-choking indexes, highlighted in terms of systolic-to-diastolic blood pressure ratio (SBP/DBP), are exclusively controlled by the biofluid/blood heat capacity ratio (BHCR = Cp/Cv). An in vitro study shows that nitrogen (N2), oxygen (O2), and carbon dioxide (CO2) gases are predominant in fresh-blood samples of the healthy humans and Guinea pigs at a temperature range of 37–40 °C (98.6–104 °F) causing gas embolism. In silico results demonstrated the existence of the biofluid/boundary layer blockage persuaded flow choking, stream tube flow choking, shock wave generation, and pressure overshoot in the downstream region of simulated arteries (with and without stenosis), at a critical pressure ratio, due to gas embolism. The flow choking followed by aneurysm (i.e., bulging of the downstream region of the stenosis artery due to shock wave generation) due to air embolism is demonstrated through small animal in vivo studies. We could corroborate herein, with the animal in vivo and three-dimensional in silico studies, that flow-choking followed by shock wave generation and pressure overshoot occurs in arteries with stenosis due to air embolism at a critical pressure ratio. Analytical models reveal that flow-choking occurs at relatively high and low blood viscosities in CVS at a critical blood pressure ratio (BPR), which leads to memory effect (stroke history/arterial stiffness) and asymptomatic cardiovascular diseases [Kumar et al., “Lopsided blood-thinning drug increases the risk of internal flow choking leading to shock wave generation causing asymptomatic cardiovascular disease,” Global Challenges 5, 2000076 (2021)]. We concluded that an overdose of drug for reducing the blood viscosity enhances the risk of flow choking (biofluid/boundary layer blockage persuaded flow choking) due to an enhanced boundary layer blockage (BLB) factor because of the rise in Reynolds number ( Re) and turbulence. An analytical model establishes that an increase in Re due to the individual or the joint effects of fluid density, fluid viscosity, fluid velocity, and the hydraulic diameter of the vessel creates high turbulence level in CVS instigating an escalated BLB factor heading to a rapid adverse flow choking. Therefore, prescribing the exact blood-thinning course of therapy is crucial for achieving the anticipated curative value and further annulling adverse flow choking (biofluid/boundary layer blockage persuaded flow choking) in CVS. We could conclude authoritatively herein, with the animal in vivo studies, that flow choking occurs in the artery with stenosis due to air embolism at a critical BPR (i.e., SBP/DBP = 1.892 9), which is regulated by the heat capacity ratio of air. The cardiovascular risk due to boundary layer blockage persuaded flow choking could be diminished by concurrently reducing the viscosity of biofluid/blood and flow-turbulence. This comprehensive review is a pointer toward achieving relentless unchoked flow conditions (i.e., flow Mach number < 1) in the CVS for prohibiting asymptomatic cardiovascular diseases and neurological disorders associated with flow choking and shock wave generation followed by pressure overshoot causing arterial stiffness. The unchoked flow condition can be achieved in every subject (human/animal) by suitably increasing the thermal-tolerance-level in terms of BHCR and/or by reducing the BPR within the pathophysiological range of individual subjects through the new drug discovery, the new companion drug with the conventional blood thinners and/or proper health care management for increasing the healthy-life span of one and all in the universe.

Yunfeng Pan, Jia Liu, Jiahui Ren et al.

Vascular diseases affect the circulatory system and comprise most human diseases. They cause severe symptoms and affect the quality of life of patients. Recently, since their identification, exchange proteins directly activated by cAMP (Epac) have attracted increasing scientific interest, because of their role in cyclic adenosine monophosphate (cAMP) signaling, a well-known signal transduction pathway. The role of Epac in cardiovascular disease and cancer is extensively studied, whereas their role in kidney disease has not been comprehensively explored yet. In this study, we aimed to review recent studies on the regulatory effects of Epac on various vascular diseases, such as cardiovascular disease, cerebrovascular disease, and cancer. Accumulating evidence has shown that both Epac1 and Epac2 play important roles in vascular diseases under both physiological and pathological conditions. Additionally, there has been an increasing focus on Epac pharmacological modulators. Therefore, we speculated that Epac could serve as a novel therapeutic target for the treatment of vascular diseases.

Zakir Eminov, Masid Masimov, A. Mammadova

The article compares the medical and geographical problems of the spread of non-communicable diseases in the world and in Azerbaijan. Cardiovascular diseases are the first among all causes of death, especially ischemic heart disease and cerebrovascular diseases as the first two causes of death. The first two places on the causes of death in our republic between 1999 and 2019 have been studied based on the facts of diseases of the circulatory system and neonatal diseases from non-communicable diseases, change in the ratio of causes of death. Thus, the impact of the 44-day Karabakh war on September 27, 2020 and the infection with the Covid-19 virus in our country was analyzed. It was learned from the statistical data that the increase in all causes of death was observed, in particular, the increase in mortality rates associated with diseases of the circulatory system is reported. Within 1 year, the number of deaths increased from 32,471 to 41,228 (8,757 people). Determination of indicators for assessing the localization of the disease among the population and ways to raise their awareness are identified. Keywords: non-communicable diseases, cardiovascular, infectious, medical-geographical, causes of death.