Subclinical Vascular Damage: Current Insights and Future Potential

Abstract

The cardiovascular risk assessment must be carried out during all the different phases of life because the cardiovascular risk and the related prevention actions are dynamic and constantly evolving. As patients age, they change their exposure to various risk factors and accumulate comorbidities by changing their subjective cardiovascular risk, so it is necessary to undertake personalized early and preventive diagnostic actions. The main approach to asymptomatic vascular disease is based on primary prevention with the adoption of a healthy lifestyle. Indeed, lifestyle influences most of the traditional risk factors. In recent years, important differences between the sexes regarding cardiovascular risk factors have emerged and in particular, risk factors specific for female sex have been identified. Women are more likely to be categorized into lower risk categories for cardiovascular disease and, as a result, receive less lifestyle counseling than men, as well as less intensive prevention. This narrative review aims to analyze CVD risk prevention in asymptomatic atherosclerosis with a look at new emerging factors. In the end, we quickly analyzed the effects of the recent pandemic on lifestyle and cardiovascular risk and the potential negative effects in the long term.

Vascular “Long COVID”: A New Vessel Disease?

“…This multifactorial pathological condition has been associated with alteration of the coagulation cascade, higher complement level, plasminogen activating factor I, and von Willebrand factor, leading to increased tissue factor expression in response to inflammatory cytokines, microvascular dysfunction, and promoting thrombotic events occluding vessels locally. 22,23,[30][31][32][33] About the COVID-19-induced micro-vascular lesions, we retrieved some fundamental pathophysiological data. Firstly, a widespread presence of ACE2 endothelial receptors favors direct virion penetration inside the vascular endothelium during the COVID-19 viremic phase, causing an "endotheliopathy," that is expressed by an accelerated necroptosis, or increased endothelial dysfunction.…”

The Role of Lonp1 on Mitochondrial Functions during Cardiovascular and Muscular Diseases

“…Mitochondria play a fundamental role in sustaining the cardiac contractility, and mitochondrial impairment has been implicated in several cardiovascular (CVD) diseases, including HF, by causing a decrease in ATP production and thus a cardiac energy deficiency [ 51 ]. Accordingly, risk factors of CVD diseases, such as atherosclerosis, metabolic syndrome, and diabetic hyperglycemia [ 52 , 53 , 54 , 55 , 56 ], have been correlated to mitochondrial dysfunction [ 57 , 58 ]. Cardiac cell apoptosis, induced by an excess of ROS under ischemia or I/R or ischemic preconditioning (IPC), is a noteworthy pathological event in the context of HF [ 59 ].…”