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PubMed1989

[Regression of human arteriosclerosis].

An account is given of possibilities and mechanisms of regression of arteriosclerosis. Reference is made to animal experiments and to angiographic investigations of man, and the assumption is derived that even in man arteriosclerosis is to a certain extent capable of regression. This view applies preferentially to lipidous alterations. A distinction is made between two mechanisms underlying regression. One of them is attributed to reduction of existing hypercholesterolaemia, while the other is related to regression via action of so far unknown wall factors, without lowering of blood cholesterol.

Arteriosclerosis↗

PubMed1989

Mechanisms responsible for inhibition of vein-graft arteriosclerosis by fish oil.

Favorable changes in lipoproteins, inhibition of platelet aggregation, reduction of serum thromboxane (TX), altered plasma-membrane fluidity, and reduced production of growth factors (mitogens) have all been implicated as possibly being involved in the inhibition of arteriosclerosis by fish oil (FO), which is rich in omega 3 fatty acids; however, causal relations are mostly lacking. Several putative mechanisms responsible for the salutary effects of FO were investigated in a canine model of accelerated vein-graft arteriosclerosis. Venoarterial autografts (N = 192) were implanted in 48 hypercholesterolemic dogs divided into six groups: group A, control; B, FO (as MaxEPA, 200 mg/kg/day eicosapentaenoic acid); C, aspirin (ASA, 50 mg/kg/day); D, TX synthetase inhibitor (TXSI [CGS-12970], 10 mg/kg/day); E, FO + ASA; and F, FO + TXSI. At sacrifice 3 months later, there was no significant difference in plasma lipoproteins, hepatic low density lipoprotein-receptor concentration, red blood cell fragility, bleeding time, or platelet count compared with controls; the decrease in platelet aggregation (30 +/- 5% [mean +/- SEM]) was similar in all treatment groups. Arterialized vein-graft intimal thickening was significantly inhibited by FO (with or without ASA), while ASA alone was ineffective. Conversely, serum TX was significantly lower only in the ASA and FO + ASA groups. Serum mitogenic activity was higher at 3 months in the control group versus all treatment groups. Compared with baseline values, serum mitogenic activity rose significantly over time in the control and the TXSI groups, and an increase or rising trend was present in all other treatment groups except for the FO-treated animals. Thus, the salutary biologic effect of FO in this hypercholesterolemic model of arterialized vein grafts may have been more related to in vivo inhibition of platelet-mitogen growth factor release than to changes in lipoproteins, low density lipoprotein receptors, platelet function, or eicosanoid metabolism. These observations underscore the need for further studies to clarify the interactions between FO (omega 3 fatty acids) and paracrine cellular mitogenic factors in the context of atherosclerosis prevention.

Animals↗

PubMedDate not supplied

Evaluation of a laser Doppler multiprobe for detecting skin microcirculatory disturbances in patients with obliterative arteriosclerosis.

Laser Doppler fluxmetry (LDf) is a noninvasive technique measuring blood cell flux, e.g. in human skin. By a new integrated probe the measuring volume has been increased sevenfold. Using this probe we have investigated dynamic reactions in the skin microcirculation of the big toe in nine patients with various degrees of obliterative arteriosclerosis and in ten healthy control subjects. When position was changed from the supine to the sitting a significant decrease in skin perfusion was seen in healthy subjects but not in the patients. The time to peak flow during reactive hyperemia after a three minute arterial occlusion was significantly (p less than 0.01) longer in the patients (117 +/- 81 s) than in the controls (24 +/- 6 s). We conclude that LDf, using this multiprobe, is of value for diagnosing patients with obliterative arteriosclerosis, as well as for studying dynamic reactions in the human skin microcirculation in health and disease.

Aged↗

PubMed1977

Occlusive arterial disease in uraemic and haemodialysis patients and renal transplant recipients. A study of the incidence of arterial disease and of the prevalence of risk factors implicated in the pathogenesis of arteriosclerosis.

The prevalence of clinical and sub-clinical occlusive arterial disease and of risk factors implicated in the pathogenesis of arteriosclerosis was assessed in 21 patients with chronic renal failure, 27 on maintenance haemodialysis and 51 renal allograft recipients. Clinical occlusive arterial disease was present in 27 patients, and sub-clinical arterial disease in 34. Myocardial infarction, cerebral thrombosis and lower limb arterial thrombosis had occurred only in the transplant recipients; these patients had, however, been followed for a longer period of time than the other two groups. In the allograft recipients, the cumulative incidence of any occlusive arterial disease was 416 per 1000, and that of coronary heart disease was 267 per 1000 at six years. Hypertension was present in 76 per cent of patients prior to renal replacement therapy. Following institution of definitive therapy, hypertension was of shorter duration and less common in haemodialysis patients than in renal transplant recipients. Uraemic and haemodialysis patients with occlusive arterial disease had required antihypertensive medication for significantly longer than those free of arterial disease. Transplant recipients with hypertension had a greater mean serum creatinine, were receiving a larger maintenance dosage of corticosteroids and less frequently had undergone prior bilateral nephrectomy than those transplant patients without hypertension. Serum lipid levels were elevated in 62 per cent of patients. In the uraemic and haemodialysis patients hypertriglyceridaemia was the predominant abnormality while in the transplant recipients combined hypertriglyceridaemia/hypercholesterolaemia was more frequent. Despite regular aluminium hydroxide therapy 81 per cent of uraemic and haemodialysis patients had a calcium X phosphate product higher than normal. Arterial and/or soft tissue calcification as demonstrable in 20-38 per cent of patients within each group, but could not be related to the calcium X phosphate product of radiographic evidence of hyperparathyroidism. Glucose intolerance was present in 71 per cent of the uraemic and haemodialysis patients and 33 per cent of the transplant recipients. Hyperuricaemia, cigarette smoking, obesity and a sedentary existence were also prevalent. The majority of patients had several risk factors implicated in the pathogenesis of arteriosclerosis. Occlusive arterial disease is a major problem in patients with end stage renal disease, being no less common after transplantation than with long-term maintenance dialysis. The aetiology is multifactorial.

Adult↗

PubMed1978

[Prevention and therapy of arteriosclerosis (author's transl)].

Arteriosclerosis is caused by many factors. These pathogenic factors especially over-nutrition, nicotinabusus, deficiency of muscular exercise, muscular overstrain, emotional stress and concomitant basic diseases, especially arterial hypertension, diabetes mellitus and dyslipidemia are the most important points for preventive and therapeutical action. When possible the risk factors has to be eliminated, arterial hypertension, diabetes mellitus and dyslipidemia have to be treated orderly. In the pathogenesis of arteriosclerosis and atherosclerosis are known disturbances of the lipid metabolism, the blood coagulation and the metabolism of the arterial wall cells most important. Application of anticoagulants and lipid lowering medicaments did not come up to our expectations. Experiences with animal models and a double blind study (secondary prevention of myocardial infarction) have given good reason for recommending antirheumatic or as we like to say, mesenchyme suppressive drugs.

Aged↗

PubMed1988

Hemodynamic basis of renal arteriosclerosis in young greyhounds.

Renal arteriosclerosis occurs with unusually high frequency in young race-trained greyhounds. Light and electron microscopic studies were used to examine the arterial walls of renal vessels in six greyhounds. Lesions characteristic of mechanical forces, namely pressure and shear stresses, were found consistently on the endothelial surfaces of damaged vessels. Such damage was found in both the main renal vessel and its branches. Although the patterns of endothelial damage showed quantitative differences among individuals, the qualitative features were remarkably similar in the group. Quantitatively, fibrous plaques were greatest in narrow and curved portions of renal vessels. The plaques were found on the outer luminal surface of the bend and the bifurcation segments, but were absent on the flow dividers. Hemodynamic forces appear to play an important role in the pathogenesis of renal fibrous plaques. Renal arteriosclerosis in greyhounds provides an excellent model for the study of pressure pulse velocity and shear stress damage under various physiological conditions.

Animals↗

PubMed1987

The relationship between obesity and degree of arteriosclerosis. New autopsy findings.

The degree of arteriosclerotic changes in the aorta and major vessels was inversely related to obesity (P less than 0.05) in an unselected series of 300 autopsies on subjects older than 50 years who had no hypertensive diseases. In addition, out of 11 subjects with very severe obesity, 9 showed no arteriosclerosis, and only 2 showed mild arteriosclerosis.

Aged↗

PubMed1979

[Long-term course of aortic arch syndrome caused by arteriosclerosis].

The course of the extracranially conditioned cerebrovascular disease is characterized by a worse prognosis in comparison with the average population of the GDR (11 years older) and by increased cardiovascular complication rate (every fifth patient suffered a myocardial infarction, every fourth patient suffered an apoplexy). Younger age of manifestation and increasing number of concomitant diseases form the basis of a course which is altogether endangered by complications, which, however, compared with peripheral and coronary arteriosclerosis, is more favourable. Operative reconstruction of the path of a vessel leads to an enduring improvement of the picture of the complaint. The total prognosis corresponds to the so-called spontaneous course. Under permanent treatment with anticoagulants a retardation of the general progressing of arteriosclerosis and improvement of the survival rates is to be proved.

Aged↗

PubMed1977

[Early arteriosclerosis with increased thrombocyte aggregation (author's transl)].

The importance of thrombocyte function in atherogenesis is discussed in the light of experimental and clinical results. Adhesion and aggregation of thrombocytes on an intact or injured artery wall may be the first step to atherosclerotic plaque. In vitro measurements of aggregation, in vivo measurements of thrombocytic survival time and microscopic and histological examinations are all consistent in showing a rise in aggregation of thrombocytes in the early stages of arteriosclerosis. The measurement of thrombocyte function is therefore recommended in addition to the known risk factors in patients with a greater risk of arteriosclerosis.

Animals↗

PubMed1979

[Precursors of arteriosclerosis in childhood. Protocol and firsts results concerning plasma lipids and carbohydrate tolerance in 520 school children at Pordenone (Italy) (author's transl)].

The cardiological centers of Pordenone and Cittadella (Italy) organized by the Institute of Clinica Medica II of Padua University, have carried out a study on the "Precursors of arteriosclerosis in children", according to a WHO protocol. In this paper some results of the Pordenone study are reported, concerning serum cholesterol (TC), triglycerides (TG) and blood glucose 1 h after 1 g/Kg glucose per os. 520 school children, males and females, aged 6, 9, 12, 15 years, entered the study. Mean serum TC resulted significantly higher at age 12 as compared to the other age classes. Serum TG progressively increased with age. Mean serum TC and TG in our italian children and adolescents were silimar to those reported in studies from other countries. Blood glucose resulted significantly higher in children than in adolescents. The distribution of the blood glucose values was bimodal. After having arbitrarily fixed cut-off points for serum TC, TG and blood glucose, the prevalence of hyperlipidemia and hyperglycemia was determined. The prevalence figures have shown that at the pediatric age it is possible to identify subjects at "risk" of developing arteriosclerosis.

Adolescent↗

PubMed1984

Role of magnesium and potassium in the pathogenesis of arteriosclerosis.

In studies concerning risk factors for cardiovascular diseases, a number of reports have emphasized the influence of lipids, but the role of dietary minerals other than sodium has been less studied. However, epidemiological studies have suggested that dietary intake of magnesium and potassium may be involved in such pathogenesis. Studies of the influence of magnesium deficiency on arteriosclerosis include its effect on the initial lesion, altered metabolism of elastin, proliferation of collagen, calcification, lipid metabolism, platelet aggregation and hypertension. Magnesium and potassium metabolism are closely related and magnesium is required for maintaining the level of cellular potassium. As a consequence, magnesium and potassium deficiency frequently occur together and potassium deficiency may be an aggravating factor in pathogenesis. The development of the initial lesion in the arterial wall may be facilitated by loss of cellular magnesium and potassium. Experimental magnesium deficiency induces arterial damage, a loss of magnesium and potassium and an increase in the calcium and sodium content of the cell. Experimental models that have been used to produce cardiovascular lesions induce similar changes and losses of major intracellular cations may affect the main metabolic processes of the cell. This report summarizes the experimental evidence that magnesium deficiency may affect several different stages involved in arteriosclerosis and that potassium deficiency may exacerbate this. Magnesium deficiency results in vascular calcification. Experiments indicate that elastin is the site of the initial calcification and the metabolism of elastin is altered. This vascular lesion then brings about an increase in the collagen content of the wall. Low magnesium status could probably affect this process by slowing collagen resorption and lead to an irreversible accumulation of connective tissue. Results showing a different distribution of the various types of lipoprotein during experimental magnesium deficiency strongly suggest that lipid exchange between the vessel walls and blood can be modified. Severe magnesium deficiency in weanling rats produces a marked hypertriglyceridemia, a decrease in the percentage of cholesterol transported by HDL lipoprotein and a reduction in LCAT activity. The decreased clearance of circulatory triglycerides appears to be the major mechanism contributing to hyperlipemia. Magnesium deficiency could therefore contribute to accumulation of vascular lipid. Magnesium and potassium depletion have also been reported in diabetes and the vascular implications of this should be considered.(ABSTRACT TRUNCATED AT 400 WORDS)

Animals↗

PubMed1984

Crystallinity of mineral deposited in arterial walls in the course of arteriosclerosis in diabetics and in patients with normal carbohydrate metabolism.

A comparison was made of the amount and crystallinity of mineral deposited in the course of the arteriosclerosis in arterial walls in diabetic patients and in individuals with normal carbohydrate metabolism. The macroscopically unchanged tunica intima, fibro-lipidic plaques and bone-like lamellae were taken from aorta thoracalis , aorta abdominalis, arteriae femorales and arteriae coronariae in the course of the autopsy of 17 insulin dependent diabetic individuals and of 9 persons with arteriosclerosis, but with normal carbohydrate metabolism, called control group. The total inorganic constituents in the three kinds of samples were determined by ashing of dried samples at 600 degrees C for 6 h. Crystallinity of mineral was defined as the ratio of the spins connected with the radiation-induced stable paramagnetic centers present in the crystalline lattice of hydroxyapatite crystal, to the total ash content of the sample. An increase in the amount and in the crystallinity of deposited mineral was observed when consecutive stadia of development of arteriosclerotic lesions were compared. This phenomenon resembles the maturation of mineral observed in the course of bone development.

Aged↗

PubMed1978

[Nutrition and arteriosclerosis].

Issuing from the present state of the influence of the basic nutritive substances (protein, fat, carbohydrates) and various nutritive factors discussed again and again (cholesterol, erucaic acid, sodium, calcium/magnesium quotient, pressor amines) on the development of the arteriosclerosis, the indididual factors of influence are critically evaluated. The investigations are getting under way, so that ascertained results are standing beside insufficiently claified or open problems, From the abundance of the observations conclusions are drawn which are of significance for practice. Unfavourable influences of nutrition on the factors of risk (hyperlipoproteinaemia, disturbance of the carbohydrate tolerance, hyperuricaemia, hyperalimentation) and on the manifest diseases (hypertension, diabetes mellitus, uric arthritis, obesity) of the metabolic syndrome which finally contribute to the development of arteriosclerosis are emphasized. In front of this background a clinically and ambulatorily tested basic metabolic diet is described. About 20% of the energy content (kcal or kJ) of this diet are protein, 35% fat and 45% are carbohydrates. The saturated fatty acids lie below 30%, the manifold saturated fatty acids, however, above 20% of the total fat proportion. The cholesterol content is below 400 mg, the purin-nitrogen below 200 mg, and the sodium content is about 2g per day. This diet can be produced for the treatment of persons with normal weight and overweight in different energetic degradations.

Arteriosclerosis↗

PubMed1980

Continuous heparin anticoagulation in patients with arteriosclerosis and arterial emboli.

Management of arterial emboli occurring in patients having generalized arteriosclerosis presents a therapeutic challenge to the vascular surgeon. Adequate cardiac function must be vigorously supported. Perioperative metabolic alterations must be recognized and corrected. Continuous anticoagulation with heparin sodium appears indicated among such patients with coexisting peripheral arterial occlusive disease, stasis, poor collateral flow and areas of intimal damage secondary to operative trauma. Rarity of wound complications, less than 5 per cent, may be attributed to meticulous operative technique and use of continuous infusion method for the administration of heparin. Improved patient survival and limb salvage rates may be attributed, in part, to continuing heparin therapy in the postoperative period and appears justified among those with arteriosclerosis.

Adult↗

PubMed1994

[Preferentially affected sites of cerebral arteriosclerosis in vascular dementia of Binswanger type--a study of MRI and MR angiography].

MRI and MR angiography (MRA) were analyzed to evaluate the preferential sites of cerebral arteriosclerosis in 129 normal controls and 27 patients with vascular dementia of Binswanger type (BVD; mean age 75.0 years). Small vessel disease, indicated as advanced high intensity areas on T2-weighted MRI, increased with advancing age, while large vessel sclerosis detected with MRA did not increase after the age of 80 years. Large vessel sclerosis was not always accompanied with advanced high intensity areas. Large vessel sclerosis was found in 12 (44.4%) of 27 patients with BVD, and was as common as that of the controls of the eighth decade. Large vessel sclerosis was frequently seen in the cases suffering from BVD below 70 years of age or with hypertension. In conclusion, patients with BVD develop cerebral arteriosclerosis more preferentially in the small vessels rather than the large vessels especially in aged cases, of which incidence is similar to that of the normal controls over 80 years of age.

Age Factors↗

PubMed1995

Prevention of chronic rejection and graft arteriosclerosis by tolerance induction.

Chronic rejection is a major cause of graft failure in solid organ transplants after the first year. A characteristic lesion in a variety of chronically rejecting organs is a fibrointimal proliferative arteriosclerosis. It has been speculated that approaches to tolerance induction may be effective in obviating not only acute, but also chronic, rejection. A picture of chronic rejection develops naturally in heart grafts transplanted from the Lewis-to-F-344 strain of rat. We examined whether tolerance induction by bone marrow transplantation and development of hematopoietic chimerism or tolerance induction by intrathymic inoculation of alloantigen could effectively prevent chronic rejection in an established model of chronic rejection. Bone marrow chimeras were developed in F-344 hosts by transplantation of T cell-depleted allogeneic marrow (TCD A BMT). Another set of F-344 hosts was inoculated with intrathymic allogeneic bone marrow cells. Heart grafts in these animals demonstrated tolerance for 120 days after transplantation. Control F-344 animals treated with a short course of cyclosporine consistently developed chronic rejection by 120 days following heart transplantation. Strikingly absent from the tolerant animals was any sign of graft arteriosclerosis, which was demonstrated in the vast majority of control animals. Analysis of cytokine mRNA profiles at 30 days following heart transplantation demonstrated differences between control and tolerant animals. These results suggest that tolerance induction can effectively prevent chronic rejection.

Animals↗

PubMed1976

[Cause and significance of increased endothelial permeability in the development of arteriosclerosis].

The above survey described the physiological and pathological transport of molecules through the arterial endothelium. The barrier function of the endothelium can be interrupted by the humoral substances and such ones be longing to the vascular wall as well as by haemodynamic stress. With the intercellular junctions being opened by destruction or contraction of the endothelium, macromolecular plasma constituents get into the subendothelium where they are retained. By this retentive effect an increased endothelial permeability causes, even with physiological plasma-lipid concentrations, an accumulation of lipoproteins and other large plasma particles in the intima and upper media. The continuous plasma insudation consequently leads to the formation of an intimal regneration tissue, the intimal proliferation. Under the conditions of pathological plasma-lipid concentrations there is to be noticed an acceleration of regeneration processes. Though the new experimental results characterize the endothelial alteration as an initial process, the individual reaction of the vascular wall forms the biochemical and structural correlate of arteriosclerosis. From the results described it can be concluded that the inhibition of permeability disturbances and the involved proliferation processes of the arterial wall as well as the prevention of a hyperlipoproteinaemia are a causative therapeutical basis of prophylaxis and metaphylaxis of arteriosclerosis.

Arteries↗

PubMed1976

[Correlation between age, arteriosclerosis and elastinolytic activity of human aorta wall].

An elastolytic protease was isolated recently from human and animal aortic wall. We report here the positive correlation between the activity of human aortic elastase, the degree of atherosclerosis and age. These two parameters appear to influence independently and in an additive fashion the level of aortic elastase. There appears to be an increasing synthesis and/or liberation of aortic elastase with age. This process is accelerated in the presence of arteriosclerosis. It appears probable that the increasing elastolytic activity is mainly responsible for the fregmentation and lysis of the elastic fibers with age and arteriosclerosis as observed with histochemical techniques.

Aging↗