Batinac Tanja, Batičić Lara, Kršek Antea, Knežević Danijel, Marcucci Emanuela, Sotošek Vlatka, Ćurko-Cofek Božena
Department of Clinical Medical Sciences I, Faculty of Health Studies, University of Rijeka, Viktora Cara Emina 2, 51000 Rijeka, Croatia.
Department of Underwater and Hyperbaric Medicine, Clinical Hospital Center Rijeka, Tome Strižića 3, 51000 Rijeka, Croatia.
J Cardiovasc Dev Dis. 2024 Dec 19;11(12):408. doi: 10.3390/jcdd11120408.
Maintaining the physiological function of the vascular endothelium and endothelial glycocalyx is crucial for the prevention of cardiovascular disease, which is one of the leading causes of morbidity and mortality worldwide. Damage to these structures can lead to atherosclerosis, hypertension, and other cardiovascular problems, especially in individuals with risk factors such as diabetes and obesity. Endothelial dysfunction is associated with ischemic disease and has a negative impact on overall cardiovascular health. The aim of this review was to comprehensively summarize the crucial role of the vascular endothelium and glycocalyx in cardiovascular health and associated thrombo-inflammatory conditions. It highlights how endothelial dysfunction, influenced by factors such as diabetes, chronic kidney disease, and obesity, leads to adverse cardiovascular outcomes, including heart failure. Recent evidence suggests that hyperbaric oxygen therapy (HBOT) may offer therapeutic benefits in the treatment of cardiovascular risk factors and disease. This review presents the current evidence on the mechanisms by which HBOT promotes angiogenesis, shows antimicrobial and immunomodulatory effects, enhances antioxidant defenses, and stimulates stem cell activity. The latest findings on important topics will be presented, including the effects of HBOT on endothelial dysfunction, cardiac function, atherosclerosis, plaque stability, and endothelial integrity. In addition, the role of HBOT in alleviating cardiovascular risk factors such as hypertension, aging, obesity, and glucose metabolism regulation is discussed, along with its impact on inflammation in cardiovascular disease and its potential benefit in ischemia-reperfusion injury. While HBOT demonstrates significant therapeutic potential, the review also addresses potential risks associated with excessive oxidative stress and oxygen toxicity. By combining information on the molecular mechanisms of HBOT and its effects on the maintenance of vascular homeostasis, this review provides valuable insights into the development of innovative therapeutic strategies aimed at protecting and restoring endothelial function to prevent and treat cardiovascular diseases.
维持血管内皮和内皮糖萼的生理功能对于预防心血管疾病至关重要，心血管疾病是全球发病和死亡的主要原因之一。这些结构的损伤会导致动脉粥样硬化、高血压和其他心血管问题，尤其是在患有糖尿病和肥胖等风险因素的个体中。内皮功能障碍与缺血性疾病相关，并对整体心血管健康产生负面影响。本综述的目的是全面总结血管内皮和糖萼在心血管健康及相关血栓炎症性疾病中的关键作用。它强调了受糖尿病、慢性肾病和肥胖等因素影响的内皮功能障碍如何导致包括心力衰竭在内的不良心血管结局。最近的证据表明，高压氧疗法（HBOT）可能在治疗心血管风险因素和疾病方面具有治疗益处。本综述介绍了关于HBOT促进血管生成、显示抗菌和免疫调节作用、增强抗氧化防御以及刺激干细胞活性的机制的当前证据。将介绍重要主题的最新发现，包括HBOT对内皮功能障碍、心脏功能、动脉粥样硬化、斑块稳定性和内皮完整性的影响。此外，还讨论了HBOT在减轻高血压、衰老、肥胖和葡萄糖代谢调节等心血管风险因素方面的作用，以及其对心血管疾病炎症的影响及其在缺血再灌注损伤中的潜在益处。虽然HBOT显示出显著的治疗潜力，但本综述也讨论了与过度氧化应激和氧毒性相关的潜在风险。通过结合关于HBOT的分子机制及其对维持血管稳态的影响的信息，本综述为旨在保护和恢复内皮功能以预防和治疗心血管疾病的创新治疗策略的开发提供了有价值的见解。
