Ischemic Heart Disease
Ischemic Heart Disease (IHD) is a disease characterized by reduced blood supply to the heart muscle, usually due to atherosclerosis of the coronary arteries. Its risk increases with age, smoking, high cholesterol levels, diabetes and hypertension. It is more common in men and those who have a family history of IHD.
Symptoms of stable IHD include angina and decreased exercise tolerance. Unstable IHD presents itself as chest pain or other symptoms at rest, or rapidly worsening angina. Diagnosis of IHD is with an electrocardiogram, blood tests (cardiac markers), cardiac stress testing or a coronary angiogram. Depending on the symptoms and risk, treatment may be with medication, percutaneous coronary intervention (PCI) or coronary artery bypass surgery (CABG). Myocardial infarction (MI) or acute myocardial infarction (AMI), commonly known as a heart attack is caused by interruption of blood supply to parts of the heart, causing some heart cells to die. This is most commonly due to blockage of a coronary artery associated with an atherosclerotic plaque, which is an unstable collection of lipids and white blood cells in the wall of an artery. The resulting ischemia and associated oxygen shortage, if left untreated for a sufficient period of time, can cause necrosis followed by apoptosis or Programmed Cell Death in the affected parts of the myocardium. Classical symptoms of acute myocardial infarction include sudden chest pain, shortness of breath, nausea, vomiting, palpitations and sweating. Approximately 25% of all myocardial infarctions are silent, without chest pain or other symptoms.
Ischemic Heart Disease is the most common cause of death in most Western countries, and a major cause of hospital admissions. There is limited evidence for population screening, but prevention is used both to prevent IHD and to decrease the risk of complications. Myocardial Infarctions are one of the leading causes of death for both men and women all over the world. Important risk factors are previous cardiovascular disease, older age, tobacco smoking, high blood levels of certain lipids and low levels of high density lipoprotein, diabetes, high blood pressure, obesity, chronic kidney disease, excessive alcohol consumption, and chronic high stress levels.
The common theme of the many forms of IHD, including myocardial infarction, that have been characterized is the pathway of apoptosis-related cell death associated with reperfusion related injuries. MANF has been shown to be robustly upregulated, and to protect heart muscle in reperfusion models of cardiac ischemia.