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Cardio/cerebral-vascular diseases seriously threaten human health and are the leading cause of death. As such, there is great interest in identifying a potential mechanism that controls the development process of cardio/cerebral vascular diseases. Present studies demonstrate that inflammasomes play an important role in the process of ischemic cardio/cerebral vascular diseases (ICCVDs). Among the pathological process of ICCVDs, inflammasomes activated the sterile inflammatory response that accelerated the development of diseases and aggravated the acute lesion of tissue. As the most thoroughly studied inflammasome, the NLRP3 inflammasome has been proven to be a potential therapeutic target for ICCVDs. In this review, we summarized the mechanisms of Chinese herbal medicine which can affect ICCVDs via the regulation of the NLRP3 inflammasome. Our study discovers that active compounds of Chinese medicines have a negative effect on NLRP3 in different ICCVDs models. Astragaloside IV may influence the receptor of the cell membrane to inhibit NLRP3 activation. Resveratrol, colchicinesis, salvianolic acid B, chrysophanol and sulforaphane may directly damage the formation of NLRP3 by inhibiting ASC or Caspase-1. Most of the active natural compounds can negatively regulate the downstream products of NLRP3 inflammasome such as IL-18 and IL1$\beta$. In addition, Chinese medicines such as sinomenine, ruscogenin, resveratrol, arctigenin and cepharanthineas may downregulate NLRP3 inflammasome by inducing autophagy activation. Due to the advantages of multi-target effects, Chinese herbal medicine can be treated as a splendid therapy for ICCVDs by inhibiting NLRP3 inflammasome.

Neuraminidase, also known as sialidase, is ubiquitous in animals and microorganisms. It is predominantly distributed in the cell membrane, cytoplasmic vesicles, and lysosomes. Neuraminidase generally recognizes the sialic acid glycosidic bonds at the ends of glycoproteins or glycolipids and enzymatically removes sialic acid. There are four types of neuraminidases, named as Neu1, Neu2, Neu3, and Neu4. Among them, Neu1 is the most abundant in mammals. Recent studies have revealed the involvement of Neu1 in several diseases, including cardiovascular diseases, diabetes, cancers, and neurological disorders. In this review, we center the attention to the role of Neu1 in cardiovascular diseases, including atherosclerosis, ischemic myocardial injury, cerebrovascular disease, congenital heart disease, and pulmonary embolism. We also summarize inhibitors from Chinese herbal medicines (CHMs) in inhibiting virus neuraminidase or human Neu1. Many Chinese herbs and Chinese herb preparations, such as Lonicerae Japonicae Flos, Scutellariae Radix, Yupingfeng San, and Huanglian Jiedu Decoction, have neuraminidase inhibitory activity. We hope to highlight the emerging role of Neu1 in humans and potentially titillate interest for further studies in this area.

The treatment of cardiovascular diseases and obesity, two diseases posing a major risk to human health, has been plagued by the scarcity of potent and effective medication with fewer side effects. To address this problem, numerous efforts, and some progress, have been made. Among possible treatments are some medicinal herbs; particularly promising is Alisma orientale (AO). In the last decade, an increasing amount of research has shown that AO has some desirable therapeutic effects on cardiovascular diseases and obesity. Because of its efficacy, natural origin, and minimal adverse effects, AO has aroused great attention. Based on this, this review provides an overview of the latest progress from the last decade regarding the pharmacological and therapeutic effects, molecular mechanisms, and related effective constituents of AO in the treatment of cardiovascular diseases and obesity. Results from the research currently available reveal that active constituents of AO, such as alisol B 23-acetate, alisol A 24-acetace, and alisol A, have been proven to be effective for treating cardiovascular diseases by modulating the lipid metabolism of macrophages, improving the biological behavior of vascular smooth muscle cells (VSMCs), and enhancing anti-inflammatory effects. Moreover, the active constituents of AO can also intervene in obesity by modulating abnormal glucose and lipid metabolism and fat decomposition of the body by activating the AMPK- and PPAR-related signaling pathways. In summation, based upon our research of available literature, this review reveals that AO and its active constituents have a great potential to be used as drugs for treating cardiovascular diseases and ameliorating obesity.

Phytochemical flavonoids have been proven to be effective in treating various disorders, including cardiovascular diseases. Acacetin is a natural flavone with diverse pharmacological effects, uniquely including atrial-selective anti-atrial fibrillation (AF) via the inhibition of the atrial specific potassium channel currents $I_{\mathrm{\text{Kur}}}$ (ultra-rapidly delayed rectifier potassium current), $I_{\mathrm{\text{KACh}}}$ (acetylcholine-activated potassium current), $I_{\mathrm{\text{sKCa}}}$ (calcium-activated small conductance potassium current), and $I_{\mathrm{\text{to}}}$ (transient outward potassium current). $I_{\mathrm{\text{to}}}$ inhibition by acacetin, notably, suppresses experimental J-wave syndromes. In addition, acacetin provides extensive cardiovascular protection against ischemia/reperfusion injury, cardiomyopathies/heart failure, autoimmune myocarditis, pulmonary artery hypertension, vascular remodeling, and atherosclerosis by restoring the downregulated intracellular signaling pathway of Sirt1/AMPK/PGC-1α followed by increasing Nrf2/HO-1/SOD thereby inhibiting oxidation, inflammation, and apoptosis. This review provides an integrated insight into the capabilities of acacetin as a drug candidate for treating cardiovascular diseases, especially atrial fibrillation and cardiomyopathies/heart failure.

Panax notoginseng (PN) root is a renowned nutritional supplement, health food additive, and traditional medicine that maintains homeostasis within the human microcirculatory system. Notoginsenoside R1 (NG-R1), an active compound derived from PN root, has been reported to possess various pharmacological activities, including anti-inflammatory, antioxidant, anticancer, antimicrobial, and angiogenic effects. However, NG-R1’s pharmacokinetic properties and pharmacological activities have not been systematically elucidated. In this paper, the pharmacokinetic properties of NG-R1, its pharmacological effects, mechanisms of actions, and structure-activity relationship have been reviewed. Notably, NG-R1 inhibits tumor necrosis factor α (TNF-α) expression, enhances the expression of nuclear factor erythroid 2-related factor 2 (NRF2), and enhances the expression of vascular endothelial growth factor receptor (VEGFR). The pharmacological effects of NG-R1 are associated with the modulation of several signaling pathways, such as mitogen-activated protein kinase (MAPK)/nuclear factor κ-B (NF-κB), NRF2/antioxidant response element (ARE), Wnt/β-catenin, and phosphoinositide-3 kinase (PI3K)/protein kinase B (AKT). NG-R1 offers potentially protective effects against numerous diseases, including cardiovascular, neurological, renal, pulmonary, bone, and diabetes-related conditions. Although the pharmacological activities and diverse effects of NG-R1 have been demonstrated in various diseases, its clinical applications are limited by poor bioavailability. Several strategies have been explored to improve the pharmacokinetic profile of NG-R1, making it a promising candidate for drug development.

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APBN Interview with Professor Chng Wee Joo.

The interpretation of Electroencephalography (ECG) signals is difficult, because even subtle changes in the waveform can indicate a serious heart disease. Furthermore, these waveform changes might not be present all the time. As a consequence, it takes years of training for a medical practitioner to become an expert in ECG-based cardiovascular disease diagnosis. That training is a major investment in a specific skill. Even with expert ability, the signal interpretation takes time. In addition, human interpretation of ECG signals causes interoperator and intraoperator variability. ECG-based Computer-Aided Diagnosis (CAD) holds the promise of improving the diagnosis accuracy and reducing the cost. The same ECG signal will result in the same diagnosis support regardless of time and place. This paper introduces both the techniques used to realize the CAD functionality and the methods used to assess the established functionality. This survey aims to instill trust in CAD of cardiovascular diseases using ECG signals by introducing both a conceptional overview of the system and the necessary assessment methods.

Heart sound signal processing is a low-cost, and noninvasive method for the early diagnosis of various types of cardiovascular diseases. In this study, a parallel diagnosing method was proposed to detect various types of heart diseases and healthy heart samples. The proposed system can detect a person who might be simultaneously suffering from two or more heart diseases. Contributing to this line of investigation, effective features were obtained from the morphological and statistical features extracted from five frequency ranges of heart sounds. Applying such features in diagnosing any heart disease acts as a fingerprint specific to that disease. Therefore, the investigation of selected features, especially in each of the frequency ranges of heart sounds and murmurs, provided us with valuable information about the behavior of the diagnostic system in the detection of heart diseases. In addition to using features related to the nature of heart sounds, the proposed method of this study got rid of both the need to apply different filters needed to remove noise and dependence on a specific dataset. With the aid of the effective features in the parallel diagnosis of 15 different types of important and common heart diseases and a healthy class from each other, the diagnostic system of the present study was able to achieve the average accuracy of 97.06%, the average sensitivity of 97.99%, and the average specificity of 96.18% in the shortest possible time. The proposed approach is an important step in the screening and remote monitoring and tracking of disease progression.

Cardiovascular diseases are the leading cause of death worldwide. The development of models to support clinical decision is of great importance in the management of these diseases. This work aims to improve the performance exhibited by risk assessment scores that are applied in the clinical practice. This methodology has three main phases: (i) representation of scores as a decision tree; (ii) optimization of the decision tree thresholds using data from recent clinical datasets; (iii) transformation of the optimized decision tree into a new score.

This approach was validated in a cardiovascular disease secondary prevention context, supported by a dataset provided by the Portuguese Society of Cardiology ($N=13902$). The respective performance was assessed using statistical metrics and was compared with GRACE score, the reference in Portuguese clinical practice. The new model originated a better balance between the sensitivity and specificity when compared with the GRACE, originating an accuracy improvement of approximately 22%.

Cardiovascular diseases have been recently shown to have a pivotal role in human death and endangers lives of many people around the world. One of the most common cardiovascular diseases is poor performance of left ventricle. In this case, the ventricle cannot pump the blood into the aorta and circulatory system with a suitable power which is required for normal circulatory system. AVICENA is a new cardiac assist device which is implanted into the aorta to help the ventricle to pump the blood into circulatory system with more power and to make a better perfusion of the coronary arteries as well.

To reach a desire value of rotational speed of the pump, a control circuit is designed for counterpulsation of AVICENA based on the outcomes from previous studies. This control circuit uses a PID controller.

The present study aims to simulate the blood flow through the balloon part of AVICENA in a heart cycle with focusing on the calculation of its pump rotational speed by controlling the electrical current of the pump. Results revealed that the desired rotational speed of the pump can be achieved according to the previous aorta pressure cycle by electrical current control which is higher during balloon inflation in comparison with balloon deflation.

These findings may have implications not only for understanding the performance of AVICENA but also to help cardiac mechanics experts to improve the shortcoming of this newborn device.

This paper determines the risk for cardiovascular diseases (CVDs), and nutrition level in infants aged 0–6 months using Fuzzy Cognitive Maps (FCMs). The aim of this study is to facilitates the medical experts to early detects these diseases with accuracy, so that overall death ratio can be reduced. Firstly, we have introduced the concepts of FCMs and briefly refer to the applications of these methods in medical. After that, two intelligent decision support systems for cardiovascular and malnutrition are developed using FCMs. The proposed cardiovascular risk assessment system takes six inputs: chest pain, cholesterol, heart rate, blood pressure, blood sugar, and old peak and determines CVDs risk. The second decision support system of malnutrition diagnosis takes twelve inputs: breastfeeding, daily income, maternal education, colostrum intake, energy intake, protein intake, vitamin A intake, iron intake, family size, height, weight, head circumference, and skin fold thickness and diagnoses the nutrition level in infants. We have explained the working of both decision support systems using case studies.

Among female subjects of reproductive age, polycystic ovarian syndrome (PCOS) is a common endocrine disorder that may be linked to a number of health risks for cardiovascular diseases (CVDs). The study aims to determine some CVD risk variables and how they relate to body mass index (BMI) in female subjects with PCOS. Fifty healthy women without PCOS (controls) and 90 women with PCOS between the ages of 18 and 45 were enrolled in the study. Standard methods were used to evaluate the serum sex hormones, lipid profile, troponin-I, highly sensitive C-reactive protein (hs-CRP), fasting blood glucose, and atherogenic indices. Compared to controls, the mean age of women with PCOS was substantially lower ($p<0.001$). The mean values of BMI, waist circumference, and hip were not significantly different from one another. While the cardiometabolic variables were higher in women with PCOS than in healthy subjects, no significant difference between obese/overweight and nonobese women with PCOS in terms of mean BMI, fasting blood glucose, insulin, atherogenic index of plasma (AIP), troponin-I, hs-CRP, luteinizing hormone (LH), follicle-stimulating hormone (FSH), and estradiol were observed. In PCOS-affected women, AIP ($r=0.712$, $p<0.001$), lipid accumulation product (LAP) ($r=0.764$, $p<0.001$), and hs-CRP ($r=0.666$, $p<0.001$) all showed positive correlations with BMI. Regardless of BMI status, there was an independent correlation between cardiovascular risk factors (CVRFs) and PCOS. This implies that regardless of a woman’s BMI, PCOS may increase her risk of CVD. Treatment combined with lifestyle modifications may be useful in lowering the risk of CVD in PCOS-afflicted Nigerian women. The finding suggests that PCOS itself, independent of weight, may increase the risk of heart disease. Nigerian women with PCOS are at increased risk of CVD, regardless of their BMI, and early detection, prevention, and treatment of CVRFs in women with PCOS is desirable.

In epidemiological studies associations have been observed consistently and coherently between ambient concentrations of particulate matter and morbidity and mortality. With improvement of measurement techniques, the effects became clearer when smaller particle sizes were considered. Therefore, it seems worthwhile to look at the smallest size fraction available today, namely ultrafine particles (UPs, diameter below 0.1 μm) and to compare their health effects with those of fine particles (FPs, diameter below 2.5 μm). However, there are only few studies available which allow such a comparison.

Four panel studies with asthma patients have been performed in Germany and Finland. A decrease of peak expiratory flow and an increase of daily symptoms and medication use was found for elevated daily particle concentrations, and in three of these studies it was strongest for UPs. One large study on daily mortality is available from Germany. It showed comparable effects of fine and ultrafine particles in all size classes considered. However, FPs showed more immediate effects while UPs showed more delayed effects with a lag of four days between particulate concentrations and mortality. Furthermore, immediate effects were clearer in respiratory cases, whereas delayed effects were clearer in cardiovascular cases.

In total, the limited body of studies suggests that there are health effects, due to both UPs and FPs, which might be independent from each other. If this is confirmed in further investigations, it might have important implications for monitoring and regulation, which until now does not exist for UPs. Data from Germany show that FPs cannot be used as indicator for UPs: the time trends for FPs decreased, while UPs was stable and the smallest size fraction of UPs has continually increased since 1991/92.

Despite the great achievements of the evidence-based modern medicine and pharmacology, traditional Greco-Arab and Islamic Medicine-based herbal remedies are currently becoming more popular in Arab and Islamic world. Historical circumstances and the belief that these remedies are prepared according to the principles of Greco-Arab and Islamic Medicine, which was developed during the Golden Age of Arab-Islamic civilization. This medical system has influenced the fates and fortunes of countless human beings all over the world and it formed the roots from which modern Western Medicine and pharmacology arose. There is no doubt that the earlier Greco-Roman scholarly medical literature was the stem from which much Arab-Islamic Medicine grew, just as, several centuries later, Arab-Islamic Medicine was the core of late middle ages and early European medical system.

To compete with the growing pharmaceutical market, there is an urgency to utilize scientifically validated herbal products. Therefore, policy-makers in the Arab and Islamic world are forced to establish standardization and regulatory measures that regulate the quality, availability, and preservation of these products. Public demand has also grown for evidence on the safety and efficacy of herbal products as well as for national regulations for traditional healers and caregivers. This chapter provides a comprehensive overview on Traditional Arab-Islamic Herbal Medicine including the historical background, medical innovations introduced by Arab physicians, methods of therapies, and a state of the art and prospect description of Traditional Arab Herbal Medicine.

Zinc status, inflammation, and genetic determinants are prominent mechanisms in the pathogenesis of atherosclerosis (AT) and its compliances (cardiovascular diseases). In this review, we report the possible impact of zinc on AT development as well as the role played by a significant genetic determinant involved in inflammation, such as interleukin-6 (IL-6). Genetic polymorphism of IL-6 may affect a different inflammatory response as well as zinc turnover, predisposing to AT. Indeed, zinc deficiency is suggested as a risk factor for AT with advancing aging. The increment of dysfunctional proteins involved in zinc homeostasis, i.e. metallothioneins (MT), caused by persistent inflammation and oxidative stress may further contribute to zinc deficiency and consequently to the development of AT. A zinc supplementation may be useful to achieve healthy aging and, as such, to prevent AT, but it is necessary to consider the individual genetic background (especially when referred to IL-6 and MT polymorphisms) for the success of zinc intervention. Therefore, a zinc genomic approach may offer a reasonable hope for understanding the impact of zinc on molecular processes that maintain health and prevent the development of AT.

The link between cardiovascular diseases and neurological disorders has been widely observed in the aging population. Disease prevention and treatment rely on understanding the potential genetic nexus of multiple diseases in these categories. In this study, we were interested in detecting pleiotropy, or the phenomenon in which a genetic variant influences more than one phenotype. Marker-phenotype association approaches can be grouped into univariate, bivariate, and multivariate categories based on the number of phenotypes considered at one time. Here we applied one statistical method per category followed by an eQTL colocalization analysis to identify potential pleiotropic variants that contribute to the link between cardiovascular and neurological diseases. We performed our analyses on ~530,000 common SNPs coupled with 65 electronic health record (EHR)-based phenotypes in 43,870 unrelated European adults from the Electronic Medical Records and Genomics (eMERGE) network. There were 31 variants identified by all three methods that showed significant associations across late onset cardiac- and neurologic- diseases. We further investigated functional implications of gene expression on the detected “lead SNPs” via colocalization analysis, providing a deeper understanding of the discovered associations. In summary, we present the framework and landscape for detecting potential pleiotropy using univariate, bivariate, multivariate, and colocalization methods. Further exploration of these potentially pleiotropic genetic variants will work toward understanding disease causing mechanisms across cardiovascular and neurological diseases and may assist in considering disease prevention as well as drug repositioning in future research.

Osteoarthritis (OA) significantly compromises the life quality of affected individuals and imposes a substantial economic burden on our society. Unfortunately the pathogenesis of the disease is till poorly understood and no effective medications have been developed. OA is a complex disease that involves both genetic and environmental influences. To elucidate the complex interlinked structure of metabolic processes associated with OA, we developed a differential correlation network approach to detecting the interconnection of metabolite pairs whose relationships are significantly altered due to the diseased process. Through topological analysis of such a differential network, we identified key metabolites that played an important role in governing the connectivity and information flow of the network. Identification of these key metabolites suggests the association of their underlying cellular processes with OA and may help elucidate the pathogenesis of the disease and the development of novel targeted therapies.