Nitric oxide and heart disease: New discoveries and innovations in diagnostics and therapeutics

Abstract

N oxide (NO) is a multifunctional signaling molecule, intricately involved with maintaining a host of physiological processes including but not limited to host defense, neuronal communication and the regulation of vascular tone. The endothelium-derived NO plays a crucial role in regulating a wide spectrum of functionsin the cardiovascular system, including vasorelaxation, inhibition of leukocyte-endothelial adhesion, vascular smooth muscle cell (SMC) migration and proliferation, as well as platelet aggregation. In this regard, NO is a potent vasodilator as well as a powerful anti-platelet and anti-leukocyte factor. NO is one of the most important signaling molecules in our body. Loss of NO function is one of the earliest indicators or markers of disease. Experimental and clinical studies provide evidence that defects of endothelial NO production, referred to as endothelial dysfunction, is not only associated with all major cardiovascular risk factors such as hyperlipidemia, diabetes, hypertension, erectile dysfunction, smoking and severity of atherosclerosis, but also has a profound predictive value for future atherosclerotic disease progression. Emerging published literature reveals that NO insufficiency may manifest itself differently in different patients. Thirty plus years after its discovery and over 14 years since a Nobel Prize was awarded for its discovery, there have been no hallmark therapeutic breakthroughs. We will review the current state of the science surrounding nitric oxide in the etiology of a number of different disease states and reveal the latest technology to safely and effectively restore nitric oxide in patients. The audience will learn the challenges and opportunities that exist in understand NO homeostasis in their patients and how this may translate into better management of their patients.