What Is Cardiovascular Disease – Cardiovascular disease (CVD) is the leading cause of death and morbidity worldwide and a major contributor to healthcare costs. Although much progress has been made in the diagnosis of cardiovascular disease, there is an urgent need to improve early detection and develop new diagnostic tools. Currently, the diagnosis of CVD is mainly based on molecular imaging (MOI)-based clinical symptoms or CVD-related biomarkers. However, sensitivity, specificity and accuracy remain a challenge for early CVD. The platform of nanomaterials has been recognized as an interesting candidate for improving the practical use of diagnostic tools due to their unique physicochemical properties. In this review article, we present the cardiovascular markers and imaging techniques currently used to diagnose CVD. We present the use of various nanotechnologies in diagnostics in cardiac immunoassays (CIA) and genetic imaging. We also summarize and compare different cardiac immunoassays in terms of sensitivity and extent of biomarker activity.
Cardiovascular diseases (CVD) are the leading cause of death in the world (Ho, 2018). Cardiovascular disease can be medically defined as a group of diseases that affect the heart, brain and blood, including but not limited to coronary artery disease, coronary heart disease, rheumatic heart disease, deep vein thrombosis and cerebrovascular disease – anything that causes ischemia. and tissue death (Yang et al., 2009, 2012; Laflamme et al., 2012; Chakrabarti et al., 2013; Yu et al., 2015; Fan et al., 2020a, b). Cardiovascular disease can be broadly classified into five categories: atherosclerosis, myocardial infarction (AMI), heart failure (HF), stroke, and hypertension (Lichtenstein and Matthan, 2007; Govindappa et al., 2020; Joshi et al., 2020 ). Individuals with cigarette smoking, high levels of low-density lipoprotein (LDL)-cholesterol, glucose, and diabetes, and who are overweight and obese, are prone to cardiovascular disease and mortality (D’Agostino et al., 2008). Screening those most susceptible to CVD effectively opens the door to better treatment, thereby reducing mortality. Since early-onset CVD has high survival rates, early prediction of CVD is important.
What Is Cardiovascular Disease
Current clinical CVD methods include electrocardiography (ECG), plain radiography, computed tomography (CT), and magnetic resonance imaging (MRI) and other MOI techniques (Anderson et al., 2013). ECG measures differences in cardiac conduction and chest pain control in patients with AMI (Fesmire et al., 1998). Computed tomography scans X-ray images of the body and produces cross-sectional images of bones, blood vessels and tissues, which is suitable for the diagnosis of cardiovascular disease in high-contrast and accurate surfaces (Kirkpatrick et al., 2003). Magnetic resonance imaging is widely used in the detection of atherosclerosis and stroke because it examines three-dimensional images of the body in a noninvasive manner (Pykett et al., 1983). However, these traditional methods are limited to low sensitivity and specificity.
Cardiovascular Disease Concept Icon. Cardiology Idea Thin Line Illustration. Healthcare. Vector Isolated Outline Drawing Stock Vector Image & Art
To overcome these aforementioned problems, various new platforms such as cardiac immunoassays (CIA) and advanced molecular imaging (MOI) have been introduced, which have improved the quality of CVD diagnosis over the years (Qureshi et al., 2012). ; Osborn and Jaffer). . , 2013). Cardiac vital signs are certain substances in the blood when the heart and brain are damaged or not working properly. For example, cardiac troponin I (cTnI) has been shown to be a promising biomarker for AMI (Apple et al., 1997). MOI is capable of detecting cellular and biological processes, but each technique has advantages and limitations. Therefore, advanced MOIs have been developed in combination of different MOI techniques (for example, dual module, triple module-CT) to obtain more detailed imaging information, which has improved the accuracy of diagnostic results (Hur et al., 2011, 2012). .
Despite the high value of the previous methods, early diagnosis is still a challenge due to the complex anatomy, poor clinical picture and low rate of cardiovascular disease. These complications increase the severity and mortality of cardiovascular disease. For example, atherosclerosis shows no signs or symptoms and low levels of genetic factors in some patients even after a heart attack (Libby, 2002). Furthermore, rapid and appropriate measures are not sufficient to address the ever-increasing needs of patients with cardiovascular disease. Therefore, a rapid, accurate and highly sensitive and specific platform for early CVD is required.
Nanotechnology consists of nanoscale growth systems (Johnson, 2012; Zhou et al., 2014), have special physicochemical properties that make them interesting for ameliorating current disease (Kuriyama et al., 2011; Sun et al., 2016). . , 2019; Chen Z. et al., 2017; Liu et al., 2017; Yang et al., 2020a). Nanomaterials have been widely used for CIA, including electrochemiluminescence (ECL), electrochemistry (EC), and photoelectrochemistry (PEC) due to their unique optical properties, electrical properties, and good biocompatibility (Figure 1) (Abdorahim et al. , 2016). ). For example, gold nanoparticles (AuNPs) can be conjugated to biotinylated antibodies to reduce binding specificity or conjugated to molecules with specific physical properties [e.g. enhancer chain (HCR)] to enhance signaling. Liu G. et al. (2016) detected antigen-antibody affinity cTnI with a low detection limit using AuNPs and graphene oxide. AuNPs and other metal nanoparticles can modify the substrate (e.g., boron nitride nanoplates, titanium) in EC analysis also due to their good electrical properties (Golberg et al., 2010). Other nanomaterials such as silicon/Pt NPs are common signal amplifiers in PEC and surface plasmon resonance (SPR) due to their excellent damping ability and unique plasmonic properties (Homola et al., 1999). After that, photocatalytic nanoparticles (UCNPs) were used in light experiments due to their excellent ability to convert photons (Haase and Schäfer, 2011). Also, clusters of small nanomaterials (eg, nanoplates, nanotubes, nanowires, and nanoclusters) with large surface area enhance the growth of biological cells to enhance signaling (Kong et al., 2000). Nanomaterials also play an important role in MOI. Nanomaterials with photoacoustic, fluorescent, radioactive, and paramagnetic elements can act as contrast agents at MOI settings to increase the detection signal (Van Schooneveld et al., 2010).
Figure 1. Cardiovascular diseases (CVD), risk factors and their diagnostic settings, including molecular imaging and cardiac immunoassay on a nanotechnology platform. Ab
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In this review, we will present the recent advances in nanotechnology for the diagnosis of cardiovascular disease. Applications of CIA and MOI nanotechnology will be covered. First, we summarized the common characteristics of CVD and MOI settings. Then, the application of nanotechnology for the diagnosis of cardiovascular diseases will be presented in various platforms based on the properties of different nanomaterials, including ECL, fluorescence, PEC, EC surface Raman scattering (SERS), SPR, field effect transistor (FET). , an enzyme. – Linked immunoassay (ELISA) and lateral flow assay (LFA). We compare different CIAs based on the sensitivity and performance of cardiac biomarkers. After that, we complemented the current achievements of MOI diagnosis with the help of an active nanoparticle.
Cardiovascular biomarkers in human body fluids are reliable and reproducible risk factors for the development of cardiovascular disease. They can be detected and quantified by various antigen-antibody-based CIAs. Measuring the expression levels of cardiac biomarkers in CIA shows advantages such as high sensitivity, sensitivity, low cost and non-invasiveness for the prediction and diagnosis of the disease. Cardiovascular biomarkers can be classified as circulating biomarkers and extracorporeal biomarkers. Circulating biomarkers are freely available in body fluids and bound within or on the surface of extracellular vesicles (EVs) secreted by cells.
Circulating biomarkers include miRNA, mRNA, long noncoding RNA, proteins, and other components in human blood, milk, saliva, urine, and vertebrate biofluids (Durrani-Kolarik et al., 2017; Wang et al., 2017a, b; Wang X et al., 2018; Yang et al., 2020b). Currently, many cardiovascular markers such as cardiac troponin I (cTnI), troponin I (TnI), myoglobin (MB), C-reactive protein (CRP) and creatine kinase-MB (CK-MB) are of interest. biomarkers for AMI (Christenson and Christenson, 2013). In particular, cTnI has high specificity and sensitivity for AMI (Jo et al., 2015), and MB is a good candidate for the diagnosis of AMI (Korff et al., 2006). Myeloperoxidase (MPO), glycogen phosphorylase BB isoenzyme (GPBB), B-type natriuretic peptide (BNP), N-terminal pro-B-type natriuretic peptide (NT-proBNP), C-type natriuretic peptide (c-TNP), Matrix Metalloproteinase-8 (MMP-8), MMP-9 and tissue inhibitor of MMP-8 (TIMP-1) and leukotriene B4 are biomarkers (Anderon, 2005).
Recently, researchers discovered that some miRNAs circulating in blood or plasma are associated with CPD. For example, miR-208 could not be detected in healthy donors, but was successfully detected in 90.9% of AMI patients (Ji et al., 2009). There are approximately 50 circulating miRNAs that have been shown to be important in cardiovascular disease. Specifically, miR-208a, miR-208b, and miR133 are proliferative AMI biomarkers, while miR150, let-7b, and miR-126 are downregulated AMI biomarkers (Corsten et al., 2010; Wang et al., 2010) Gidlöf ., 2011; Long et al., 2012a,b; Devaux et al., 2013; Friese et al., 2013; Li et al., 2013). In addition, miR-423, miR-18b, miR-499, miR-142, miR-320a, miR-22, miR-20b and miR-26b are associated with heart failure, but miR-103 has been shown to have intrinsic . Patients with heart failure (Corsten et al., 2010; Tijsen et al., 2010; Goren et al., 2012; Ellis et al., 2013; Marfella et al., 2013). In addition, let-7e, Hcmv-miR-UL112, miR-605, miR623, miR-516b, miR-132 were found to be slightly increased in blood in hypertensive states. In contrast, miR-296, miR-133b, miR-625, miR-1236 are regulatory markers (Li et al., 2011). In addition, miR-145, miR21 are biological regulators of stroke, and miR-221, miR-210, miR-30a and miR-126 have been shown to be low in human blood from stroke patients (Zeng et al., 2011). ; Look