Heart failure(HF) is a disease with high morbility and mortality. The benefits of current pharmacological and device therapy for survival outcomes of patients with HF are limited. Gene therapy represents a novel promising strategy in treating HF, as it can theoretically normalize the aberrantly expressed genes and their regulatory mechanisms permanently. However, the translation of gene therapy for HF from bench to bedside has been less successful. There are many challenges ahead for gene therapy, especially in the areas of selection of the optimal targets, the needs for developing delivery systems and the improvement in design of clinical trials. In this review, we summarize the most promising gene targets which have been used in experimental and clinical studies for treating HF, highlighting the results from several clinical trials. We also review the latest development in gene therapy vectors and delivery methods, aiming to provide directions for future studies. Show less

Background Cardiovascular disease, and ischemic heart disease (IHD), is a major cause of morbidity and mortality in the very elderly patients worldwide. In the developing countries like Bangladesh it has been increasing with time. Due to life style, food habits and urbanisation. These patients represent a rapidly growing cohort presenting for percutaneous coronary intervention (PCI), now constituting more than one in five patients treated with PCI in real-world practice. Materials and Methods From July 2020 we included 152 patients with IHD purposively in Cardiology department of Bangabandhu Sheikh Mujib Medical University Dhaka, Bangladesh undergone PCI who were divided into 2 groups according to age: e” 75 years (n = 51) and <75 years (n = 101). Baseline clinical characteristics, indications for coronary intervention, in hospital outcomes were obtained. Study endpoint was Renal impairment, MI, LVF, emergency revascularization and death. Results Very elderly patients were more frequently male (86.2%) and nonsmoker at present (41.1% vs. 63.3%, p=0.003), had higher prevalence of hypertension (60.7% vs. 50.4%, p<0.13), and more often presented with NSTEMI (54.9% vs. 23.7%, p<0.001). Elderly group had higher incidence of TVD and LM disease (37.2% vs. 26.7% and 9.8% vs. 2.9%, p=0.07) and more incidence of ostial (17.6% vs.5.9%,p=0.007) and calcified lesions (31.3% vs. 14.8%, p=0.004). Procedural success (TIMI III) were high in both groups, but still lower in the elderly as compared to younger group (96% vs. 97%, p=0.65). Very elderly patients had higher incidence of post PCI bleeding, CIN, MI, LVF and death (9.8% vs.5.9%, 7.8% vs.3.9%, 5.8% vs.5.9%, 9.8% vs. 4.9% and 5.8%vs.3.9%,p=0.07), whereas emergency revascularization were higher in younger group (5.8% vs. 6.9%, p=0.07). Conclusion Very elderly patients aged ≥80 years face more vascular site complications during PCI, usually have more LM and TVD with more ostial and calcified lesions in comparison with younger group. Though procedural success is similar with younger group, they face more post PCI CIN, LVF and MI. Repeat revascularization was higher in younger group. Show less

In this study, flow hemodynamic parameters and settling of LDL particles in healthy ideal and ideal with stenosis coronary artery have been studied using the Open FOAM software. Not only the effect of movement of the vessel on particles depositions have been studied, but also both non-Newtonian and Newtonian behaviors of blood have been investigated. The particle's motion and deposition have been simulated. It has resulted that only in small vessels, non-Newtonian behavior of blood can be seen and in bigger vessels, there is no remarkable difference between two Newtonian and non-Newtonian models. Vessel movement has no important effects on entered shear stress on its wall, but the alteration in flow lines causes a 70% increment in particles depositions on a vessel with stenosis. This shear stress has no considerable changes with inlet velocity alteration, but it has intensive dependence on geometry in the vessel with stenosis (13 times more oscillation in stenosis location than a healthy vessel). Show less