[The modern view of the clinical manifestation and classification of nonspecific aortoarteritis].
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Biomedical subjects
Publications and source records attributed to A B Sugraliev.
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Rheumatic manifestations of nonspecific aortic arteritis are described with a special focus on analysis of early symptoms of the disease.
The examination of 50 patients with nonspecific aortic arteritis (NAA) discovered that 14% of the patients had aneurysms. The latter occurred more frequently in the ascending aorta and manifest clinically as aortic regurgitation and angina pectoris. Immunological disorders were compared in NAA patients with stenotic and aneurysmic lesions (groups 1 and 2, respectively). In group 1 high IgE and CIC concentrations occurred more frequently suggesting the involvement of immunological abnormalities in genesis of aneurysms in NAA. Most of group I patients had disturbances of lipid metabolism indicated by elevated cholesterol level. The latter promoted development of atherosclerosis.
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To elucidate the physiological role of lipoprotein (a), a new independent atherosclerosis risk factor, the levels of lipoprotein (a) and 5 proteins of an acute phase were measured in acute (myocardial infarction, n = 21) and chronic (non-specific aortoarteritis, n = 15) tissue lesions. Blood was taken for analysis from patients with myocardial infarction when they were admitted to hospital for anginal attacks and then 4 times during a month and from patients with aortoarteritis at the stage of exacerbation 1 month before and after therapy. The findings indicate that in acute and chronic tissue lesions, there is a change in blood lipoprotein (a) levels, which is largely similar to that in the levels of acute phase proteins. One cause of such changes may be an increase in the synthesis of apolipoprotein (a) that is identical to that of other glycoproteins--acute phase proteins--in the reaction of the acute phase and then in the regeneration of damaged tissues.
Cardiolipin antibodies are detected in the sera from patients having a wide range of clinical manifestations, including venous and arterial thrombosis, obstetric abnormality, damaged CHS and diseased vascular wall. To clarify the clinical value of cardiolipin antibodies, 21 patients with non-specific aortic arteritis were studied. The antibodies were determined by enzyme immunoassay. Their higher levels were found in 5 (24%) patients. The patients who were positive for cardiolipin antibodies showed a significant increase in the incidence of occlusive lesions (p less than 0.001) and a moderate increase in that of valvular heart diseases. The findings suggest that cardiolipin antibodies might contribute to the pathogenesis of non-specific of aortic arteritis.