Angiogenesis represents a form of neovascularisation of exceptional importance in numerous pathological conditions including stroke. In this context it is directly related to neuroregeneration which is seen in close proximity. However, numerous experimental data have been drawn from studies that have ignored the age criterion. This is extremely important as angiogenesis is different in young versus old subjects. Extrapolating data obtained from studies performed in young subjects or "in vitro" to old-age patients could lead to inexact conclusions since the dynamics of angiogenesis is age-dependent.The current review covers the key features of brain senescence including morphological and functional changes related to the brain parenchyma, its vascular network and blood flow which could possibly influence the process of angiogenesis. This is followed by a description of post-stroke angiogenesis and its relationship to neuroregeneration and its modulation by vascular endothelial growth factor (VEGF) and insulin-like growth factor 1 (IGF 1), the most important factors active in old brain after ischemic injury.

Pulmonary arterial hypertension (PAH) is a well recognized, albeit uncommon, complication of systemic lupus erythematosus (SLE) and is characterized histologically by the presence of onionskin thickening of small arterioles. We described a 24 year-old female with SLE, complicated by pulmonary hypertension after a six-week exposure to dexfenfluramine, who died of acute myocardial infarction complicated with pneumococcal sepsis. Autopsy demonstrated pulmonary arteriolar thickening with severe sclerosis as well as the more advanced plexiform and angiomatoid lesions. Based on these findings, we hypothesize that in this case the use of dexfenfluramine, albeit for a relatively short period, exerted a synergistic effect on the predisposition to PAH already inherent in this patient with SLE.

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Transthoracic echocardiographic examination is known to be a safe, non-invasive and reproducible method, used in every day clinical practice to obtain important information about cardiac structure and function. Unfortunately, a significant proportion of studies have highlighted the considerable technically difficultly in producing diagnostic images due to a poor acoustic window and more than 33% of patients undergoing stress echocardiography have suboptimal echocardiographic images. All these limitations have led to the use of contrast agents to improve the quality of standard ultrasound examination to provide a better delineation of left ventricle endocardial borders or to obtain information that cannot be achieved by using standard echocardiography, such as assessing myocardial microcirculation and therefore perfusion. This paper sought to review the clinical efficacy and safety of ultrasound contrast agents focusing on stress echocardiography.