Preface

According to the World Health Organization (WHO), the two main causes of death in the world are directly related to cardiovascular system disorders, ischemic heart disease, and stroke. Clinical evidence demonstrates the relevance of knowledge about vascular biology, from molecular mechanisms to clinical applications.

This book includes chapters that describe mechanisms of vascular regulation, pathophysiological evidence of vascular diseases, and some clinical application microvascular surgery. Related to molecular mechanisms of regulation of vascular function, the book is focused on nitric oxide signaling and the activity of potassium channels. Both mechanisms are related to the function of the endothelial cells, a key cell-type in the homeostasis of the vascular system. Also reviewed is the effect of physical activity and insulin on endothelial function, as an essential physiological factor to maintain the vascular health.

In relation to vascular diseases, the second section of the book covers the disease of coronary arteries, mainly related with structural alteration, and also the alterations of the vascular system in systemic sclerosis, an autoimmune disease that affects several organs. This section includes two chapters related to vasculitis, which is the inflammation of blood vessels. The first chapter focuses on the pathophysiology and clinical characteristics and the second chapters describes the pharmacological treatments.

The third section of the book is focused on the microvasculature, mainly centered in the nail fold capillaroscopy, a simple, low-cost method that is extremely important in the evaluation of patients with rheumatic spectrum diseases. Finally, the last chapter presents a review of critical steps and recommendations for the transplant of microvascular tissues for improvement of functional and aesthetic results in microvascular surgery.

This book is an international effort of collaboration, with the purpose to create an academic tool for students of medical sciences or people interested in learning about vascular biology. I invite the readers to enjoy the chapters and contact the authors in the case of needing more information.

**II**

**Chapter 7 107**

**Chapter 8 121**

**Chapter 9 135**

**Chapter 10 157**

Methods for Diagnostic and Surgery in Microvascular Diseases **169**

**Chapter 11 171**

**Chapter 12 189**

**Chapter 13 203**

Anomalous Origin of Coronary Arteries *by Xhevdet Krasniqi and Hajdin Çitaku*

*by Murat Borlu and Eda Öksüm Solak*

*by Ana Paula Urzedo, Mariane Martins Manso* 

Treatment of Vasculitis: Beyond the Basics

*by Muhammad Ishaq Ghauri and Muhammad Shariq Mukarram*

The Impact of Nailfold Capillaroscopy in the Approach

*by Vera Bernardino, Ana Rodrigues, Ana Lladó,* 

Nailfold Capillaroscopy in Rheumatic Diseases

Basic Principles in Microvascular Anastomosis and

*by Ignacio Vila, Iván Couto-González and Beatriz Brea-García*

*Melissa Fernandes and António Panarra*

*by Abhishek Patil and Isha Sood*

Vasculitis and Vasculopathies

*and Thaisa Macarini de Faria*

Systemic Sclerosis

**Section 3**

of Microcirculation

Free Tissue Transfer

#### **Marcelo González**

Laboratorio de Investigación Materno-Fetal (LIMaF), Departamento de Obstetricia y Ginecología, Facultad de Medicina, Universidad de Concepción, Chile

**1**

Section 1

Physiological and

Pathophysiological

Mechanisms

Section 1

Physiological and Pathophysiological Mechanisms

**3**

**Chapter 1**

Disease

*and Sijia Liu*

will be highlighted.

**1. Introduction**

**Abstract**

Nitric Oxide and Oxidative

Stress-Mediated Cardiovascular

Functionality: From Molecular

Mechanism to Cardiovascular

*Weilue He, Maria Paula Kwesiga, Eyerusalem Gebreyesus* 

The underlying pathology of most cardiovascular diseases (CVDs) such as coronary artery disease, high blood pressure, and stroke involves decreased cardiovascular contractility and anatomic alterations in cardiovascular structures. Nitric oxide (NO) regulates vascular tone and contractile function of myocardium and maintains blood vessel homeostasis. Interestingly, the effect of NO is like a double-edged sword in the body. Insufficient NO causes hypertension and atherosclerosis, while an overproduction of NO may foster inflammation and cause heart infarction and shock. In addition, growing evidences have shown that oxidative stress plays pivotal roles in the initiation and progression of CVDs. This chapter will discuss in detail the roles NO plays in the cardiovascular system under both physiological and pathological conditions. We will focus on: (1) the molecular mechanism of cardiovascular contraction, (2) NO/Ca2+-induced muscle relaxation, (3) NO-related structural change in blood vessels, and (4) redox balance in the cardiovascular system. The relationships between these molecular mechanisms and the characteristics of CVDs

**Keywords:** cardiovascular diseases, muscle contraction and relaxation,

process of CVD progression is crucial to prevent and treat the disease.

Cardiovascular diseases (CVDs), i.e., ischemic heart disease and stroke, remain the leading cause of death in the past decades around the world, especially in the developed countries [1]. CVDs can start from risk factors that may cause local vascular lesion and end up with systematic complications, which lead to organ failure and death. Thus, understanding the biochemistry of events involved in the whole

Epidemiological data show that various factors are associated with the increase

of cardiovascular morbidity and mortality, including hypertension, smoking,

cytoskeleton, nitric oxide, nitroso-redox balance
