Nanomedicinal Approaches Towards Cardiovascular Disease

Worldwide, cardiovascular diseases claim a number of lives; however, some of them are preventable with an early and proper management. Still, the treatment of cardiovascular diseases is limited as it deals with prescribed medicines administered orally and under critical condition with invasive surgery. Due to this, there exists an enormous gap in the area of medicine for the development of therapies for better patient outcomes. In this regard, recently, nanotechnological aspects of the development of medicines are sought, which may provide a solution for more effective treatment of disease, having better therapeutic outcomes with reduced side effect profile. Further, the regenerative nanomedicine therapeutic approach opens up a paradigm that deals with the repair of damaged heart tissue and future potential use of such systems.

There is hardly any approved drug product for a cardiovascular ailment that utilizes nanotechnology. Although there are a few products in this category, they do not claim to be nano-therapeutics. An exhaustive evaluation of clinical trial databases indicates that in the near future, we may see some drug products in the market in this category. There are several similar investigational products by different groups across the globe. A comprehensive collection of published literature augurs the inclination of scientists in this field. The use of nanotechnology in cardiovascular is beneficial owing to Critical Quality Attributes that can be imparted based on the size, spatial arrangement of drug molecules, release profile, etc. In some cases, drug release characteristics have to be in sync with circadian rhythm, which can be easily obtained using this technology. The section of the book tries to highlight some of the aspects related to the exploration of nanotechnology in the case of cardiovascular treatment.

Various lifestyle related factors are primarily responsible for the increase of cardiovascular diseases. The development of numerous diseases such as acute myocardial infarction, stroke and thrombosis need multiple therapies. These therapies are based on synthetic active ingredients, which in long-term usage, give adverse side effects. Currently, a lot of attention has been focused on nanotechnology based drug formulation, which can provide sustained drug release, increased half-life, and in turn, can circumvent limitations of conventional therapies. With the advent of the nanomedical approach, the survival length of the patients can be prolonged. This chapter mostly focuses on widely used nanomedicines in therapy and imaging of cardiovascular diseases.

Nanoparticulate formulations have been valuable imaging tools in preclinical cardiovascular disease research. Nanocarriers' distinct properties are useful to carry out imaging with significant functional versatility, which is not achieved by traditional small-molecule agents. Various cardiovascular diseases (CVDs) require molecular and cellular mechanisms understanding, which will provide valuable insight towards theranostic (diagnostic and therapeutic) applications. Nanocarriers and radiolabeled nanoparticulate probes demonstrate their utility in several CVDs applications such as blood pool imaging and molecular imaging of ischemia, angiogenesis, atherosclerosis, and inflammation. Further, these emergent technologies need to address safety, toxicity and regulatory obligations for their clinical translation.

Cardiovascular diseases are presently the leading cause of death worldwide. Prescribed drugs in terms of therapeutic modalities of clinical management have treated patients, but still a limitation exists. This administered drug displays unwanted health adversity due to the side effects. In this regard, the current focus has been drawn towards nanomedicine-based drug formulation, which illustrates better therapeutic ability, sustained release, bioavailability and less toxicity. To address this, various nanocarriers are developed and are being involved in and studied for clinical application. In this chapter, the potential application of different nanocarrier-based therapeutic delivery has been discussed.

Cardiovascular diseases (CVDs), predominant global disabilities, are solely responsible for causing a significant number of deaths annually. The arising issues of conventional therapeutics, such as high insufficiency in reducing disease progression, unpleasant side effects, etc., have made CVDs a significant clinical challenge. Henceforth, the exploration of newer technologies and strategies for CVD management has become a need of present times. Recently, CVDs have become a major area of focus for medical, scientific and technological development. One such area of particular interest is an advancement of nanoparticle drug delivery systems for targeting CVDs, which offers a bouquet of positive attributes such as a high - targeted approach for specific disease sites, drug bioavailability and functional payloads. The present article mainly emphasis on the growing concept of ‘theranostic nanoparticles or nanotheranostics’ in the field of CVDs. The term ‘Theranostic’ combinedly refers to the union of diagnostics and therapeutics, with the purpose of enhancing the safety and efficacy of the treatment. Although it is still in its infancy stage for cardiovascular complications, the idea of theranostics has already been applied in the field of oncology and is giving fruitful results as well. The present chapter gives its description in the field of diagnosis as well as therapeutics, which may improve the status of nanomedical research in CVDs.

As cardiovascular diseases remain the leading cause of mortality worldwide, a large number of clinical trials are under development, investigating the safety and efficacy of RNA therapeutics in clinical conditions. Nanomedicine based drug delivery systems are currently the new avenue for the treatment of CVDs, providing great advantages to the treatment regime of CVDs. Currently, antisense therapy DNA- and RNA-based and microRNAs are widely applied therapeutic strategies to regulate gene expression and its effect on CVDs. In this review, different biological-based targeting therapies for cardiovascular diseases and their outcomes are discussed.

Ethics deals with human values and conduct, with respect to right and wrong in certain motives. The rapid development of therapeutics has raised a number of ethical issues pertaining to philosophical, legal, religious and moral beliefs. With the advancement of science, inclusion of ethical values is of absolute necessity in different aspects of clinical practice. The introduction of nanotechnology has helped in fighting many complex illnesses, including cardiovascular diseases. Nanotechnology may provide a solution for better prognoses and a reduced side effect. In this regard, cardiovascular therapeutic involvement needs a testimony with respect to societal benefits for developing a code of ethics.

Globally, cardiovascular disease is one of the predominant clinical conditions, which accounts for about 50% of human mortality and morbidity. No doubt pharmacological and surgical interventions have dramatically improved the quality of life of patients with cardiovascular diseases. However, the demand for new therapeutic interventions as well as regenerative strategies is currently increasing. Biomaterials, both natural and synthetic, have exhibited great potential in cardiac regenerative therapy. Therefore, the development of biomaterials based extracellular matrix, grafts or stents, etc. would be highly beneficial for supporting the natural function and physiology of heart tissues.

Globally, heart failure is among the principal cause of death. Heart transplantation is the only way out to replace the diseased or damaged heart. Since this technique has several disadvantages, newer therapeutic approaches are required for cardiac repair. One such approach is cardiac tissue engineering, which helps in designing and developing biomimetic materials that mimic the microenvironment of the myocardium. Approaches for cardiac tissue engineering consists of cell injection, tissue patch implantation, replacement of the valve, and injection of acellular materials. Biomaterials are designed to support stem cell expansion, protection, and differentiation. They also facilitate cell retention, cell survival and provide mechanical support. Advances in nanotechnology have made the biomimetic material design more advanced as it can deliver bioactive factors, manipulate surface topography, control cell behavior, and align cells and tissues properly. Furthermore, electrical conductivity and mechanical stiffness can be modulated as well. Overall, biomimetic materials are the new therapeutic approaches in the field of cardiac regenerative medicine, demonstrating their potential in treating heart disease.

Cardiovascular diseases are the main reason for morbidity in developed countries, and congestive heart failure represents the major health burden. Although clinical application of cardiac regeneration is still in its infancy, studies on rodents have proven its feasibility. Also, the technique of direct cardiac reprogramming has unveiled new paths for the success of cardiac regeneration, wherein one cell type can be directly converted into the cardiac myocytes without involving the pluripotent intermediate cell. Firstly designed for the management of cancer, nanotechnology has opened up newer vistas for direct cardiac reprogramming for cardiac regeneration. This chapter discusses cardiac regeneration and the limitations of current approaches to cardiac regeneration in brief. Direct cardiac reprogramming involving both in-vitro and in-vivo trials has been duly explored to enlighten the readers. An attempt has been made by the contributors to elaborate the various approaches of nanotechnology such as nanomaterials and stem cells in regenerative medicine and their impact on direct cardiac reprogramming. This chapter involves an exhaustive effort of the contributors to enlighten the understanding of a broad readership about the nanotechnology-based direct cardiac reprogramming for cardiac regeneration.

Cardiovascular disease (CVDs) have been observed as the major cause of death worldwide. During the cardiac attack, the blood flow slows down, by which the pumping gets affected. For getting the heart functional, sometimes several surgeries are done that weakens the heart. In ultima cases, loss of heart cells led to a heart attack. The therapeutic options that are adapted for preventing CVDs patients are often being treated with invasive cardiac surgery. Lack of solution to heart troubles and its underlying mechanism led towards the drive of regeneration therapy. Tissue engineering and regenerative strategies goal serves a dual purpose, firstly to stop disease progression and secondly to reverse disease effects to regain and restore heart function. Nanotechnology has been a revolutionary step towards cardiac therapy. Through nanotechnology, there has been a great paradigm shift in the treatment of coronary heart diseases, heart injury, muscle cells improvement, normal functioning of the heart after massive injuries. Tissue-engineered therapeutics are basically delivered to the heart by two approaches, such as cardiac injections and cardiac patches. Engineered nanoparticles for the specific purpose of cardiac ailment play a vital role in heart cure and biomedical application.

The heart of adult humans is usually less capable of regeneration; several strategies have been used for the repairment of a damaged heart and to recover its function. However, stem cell technology showed a promising approach for cardiac therapy. More advanced strategies are used for improved stem cell-mediated cardiac regenerative therapy and to develop vascularization between scaffold (established by 3D engineered techniques) and host hearts. Through understanding the cellular and molecular mechanisms regulating heart regeneration, considerable progress has been made, which offers potentiality in controlling cardiac remodeling and redirecting the adult human heart towards a regenerative state.