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PubMed1989

[Arteriosclerosis and blood lipids].

In our examinations of the new-born and their parents, of the patients with coronary heart disease and their relations, of the healthy test persons of different age and of the families of the long-lived persons we have found that in the atherogenesis genetic factors and blood lipids play a great part. In future it is perhaps possible already early to recognize in children a genetically conditioned hyperlipoproteinaemia, all the more since in the patients with hereditary load was to be observed a clear increase of the indices of lipid metabolism in comparison to the healthy test persons. Furthermore, a connection between a hyperlipoproteinaemia and the AB0 blood groups was stated. A combination of the hyperlipoproteinaemia of type IIb with the blood group A in new-born and in patients after myocardial infarction belongs to the most important risk factors for the atherogenesis. On account of these findings it is possible to establish a hyperlipoproteinaemia in childhood in children with hereditary load, which gives the possibility by means of normalization of the lipids to perform an early prophylaxis of the arteriosclerosis. The examination of the long-lived persons showed that the arteriosclerosis is not certainly an accompanying appearance of old age, for the autopsies of persons 100 years of age and more did not show any arteriosclerotic changes of the vessels.

ABO Blood-Group System↗

PubMed1978

[Role of inflammatory cellular infiltrates in the pathogenesis of human coronary arteriosclerosis (author's transl)].

The ramus interventricularis anterior of the arteria coronaria cordis sinistra and the initial part of the arteria coronaria cordis dextra of 125 human patients aged between 20 and 90 years were studied for the occurrence and localisation of inflammatory cellular infiltrates in the vessel walls. A correlation between a pronounced inflammatory cellular infiltration and the presence and degree of severity of coronary arteriosclerosis was established. An inflammatory or immunpathologic cause of coronary arteriosclerosis is rejected. The highest incidence of inflammatory infiltrates was observed in the adventitia within the plaque area. Isolated macrophages were found to be present in all vessel wall layers and age groups.

Adolescent↗

PubMed1994

The pathogenesis of coronary arteriosclerosis ("chronic rejection") in transplanted hearts.

"Chronic rejection" of allografts may mean different things to different people. Some use this term to refer to a process more specifically described as arteriosclerotic obstruction of the coronary arteries of transplanted hearts. A number of mechanisms might contribute to the pathogenesis of this accelerated form of arterial disease, including administration of immunosuppressive agents such as corticosteroids with attendant hyperlipoproteinemia, viral infections, or ischemic injury of coronary artery endothelium occurring between harvest and reimplantation. However, involvement of the engrafted vessels with sparing of the host's native arteries suggested to us that immune phenomena underlie graft arteriosclerosis. In 1989 we proposed a model for the pathogenesis of accelerated arteriosclerosis associated with cardiac transplantation that linked a cellular immune response akin to delayed-type hypersensitivity to leukocyte recruitment and altered vascular cell function via a cytokine cascade (1). In support of this concept, coronary artery endothelium can express class II histocompatibility antigens (HLA) that might elicit a cellular immune response (2, 3). Leukocytes including macrophages and T lymphocytes accumulate in transplanted coronary arteries, as would be expected if an ongoing immune or inflammatory response contributed to this type of "chronic rejection". As we have previously suggested, T cells activated by graft endothelial cells that bear class II HLA probably secrete cytokines that could promote macrophage recruitment and activation, and proliferation and extracellular matrix synthesis by smooth muscle cells.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗

PubMed1996

L-arginine prevents heart transplant arteriosclerosis by modulating the vascular cell proliferative response to insulin-like growth factor-I and interleukin-6.

BACKGROUND: L-arginine, a nitric oxide precursor, inhibits myointimal hyperplasia induced by balloon injury in native vessels. No studies are published on L-arginine effects on transplant arteriosclerosis. Insulin-like growth factor-I and interleukin-6 are mitogenic for smooth muscle cells and are involved in the cell-mediated and humoral immune response. METHODS: New Zealand White rabbits received cardiac allografts from Dutch Belted rabbits. All animals were fed a 0.5% cholesterol diet and received drinking water with (eight pairs) or without (eight pairs) L-arginine (2.5%) from day 7 to until they were killed at day 42. The recipients received cyclosporine A 10 mg/kg/day from transplantation until the time they were killed. RESULTS: Dietary L-arginine reduces myointimal hyperplasia in allograft coronary arteries from 44% +/- 4% in the non-L-arginine group to 16% +/- 2% (p < 0.002). The L-arginine significantly inhibits graft vascular cell proliferation induced by (1) insulin-like growth factor-I, from 328% +/- 66% to 154% +/- 28% (p < 0.05), (2) interleukin-6, from 376% +/- 97% to 138% +/- 30% (p < 0.05) and (3) the combination of insulin-like growth factor-I and interleukin-6 from 710% +/- 201% to 226% +/- 72% (p < 0.05). In recipient native aorta explants L-arginine also abolishes vascular cell proliferation stimulated by insulin-like growth factor-I and interleukin-6. The rejection grading is similar in the L-arginine (2.9 +/- 0.1) and control groups (2.7 +/- 0.1). Class II major histocompatibility antigen expression, T-lymphocyte, and macrophage infiltration in the cardiac allograft are unaffected by L-arginine. However, the diet significantly increased plasma nitric oxide from 15.4 +/- 2.3 to 45.1 +/- 11 mumol (p < 0.05). CONCLUSIONS: Dietary L-arginine attenuates transplant arteriosclerosis in vivo without affecting rejection. The protective effect seen in these experiments may relate to the generation of sufficient nitric oxide to prevent smooth muscle cell response to mitogens like insulin-like growth factor-I and interleukin-6.

Animals↗

PubMed1998

[Significance of coronary risk factors and coronary arteriosclerosis for coronary vasospasm].

The clinical significance of coronary arteriosclerosis and coronary risk factors was investigated in patients with coronary spasm. Coronary spasm induction test with acetylcholine was performed in 140 consecutive patients (85 males and 55 females) with chest pain in our hospital. The patients were divided into positive, borderline, and negative groups according to the results of the test. The positive and borderline groups were categorized as the coronary contractive group. The coronary sclerosis index was used to evaluate the degree of coronary arteriosclerosis. Coronary risk factors were evaluated in terms of hypertension, diabetes mellitus, hyperlipidemia, obesity, history of smoking and drinking, and family history of cardiovascular events. Patients could be divided into 34.3% in the positive group and 23.6% in the borderline group, i.e. 57.9% in the coronary contractive group, and 42.1% in the negative group. There were more males than females in both positive and coronary contractive groups. The proportion of males in the coronary contractive group was higher in patients over 60 years of age than in patients under 60. In contrast, the proportion of females was higher in patients under 60 than in patients over 60. In male patients, the coronary sclerosis indices in the positive, borderline, and coronary contractive groups were higher than those in the negative group. The indices in female patients in the positive and coronary contractive groups were higher than the index in the negative group. There were no differences in terms of the presence or absence, or the degree of organic stenosis between spastic sites and nonspastic branches in the positive group. The history of smoking in male patients was significantly more common in the positive group than in the negative group. The family history was more relevant in female patients in the positive or coronary contractive group compared to the negative group. Moreover, the history of smoking in the coronary contractive group was significantly more common than that in the negative group. The development of coronary spasm may be determined, at least in part, by the degree of coronary sclerosis as well as by gender and age. Smoking habits in both sexes and family history in females are proposed as the most important risk factors for coronary spasm.

Acetylcholine↗

PubMed1975

[Arteriosclerosis: efficiency of angiography (author's transl)].

Stenosis, occlusion, and aneurysmatic dilation are the principle angiographic signs in arteriosclerosis. Aorto-arteriography, either by direct puncture or indirectly via a catheter, permits visualization of all vascular sites of surgical interest, determination of the location and extent of the lesion, and evaluation of the function of the collateral system as well as the inflow and outflow. This stresses the extreme importance of angiography in preoperative planning and postoperative documentation of successful therapy.

Aneurysm↗

PubMed1999

Evidence of arteriosclerosis in cremated remains.

Severely burned or cremated human remains (i.e., cremains) are among the most challenging cases investigated by forensic pathologists, odontologists, and anthropologists. Exposure to extreme heat of long duration destroys all organic components of the body, leaving only the inorganic component of the skeleton. The numerous calcined osseous or dental fragments that remain after the cremation process rarely convey useful information to the investigator. In most cases, it is associated nonosseous artifacts that provide evidence of the decedent's identity. In a case investigated at the University of Florida's C. A. Pound Human Identification Laboratory, as well as in several cases examined during data collection for a research project, several fragments were identified as calcined plaque tubules from sclerotic blood vessels. These tubules provide direct evidence that the cremated individual had a variety of arteriosclerosis.

Arteriosclerosis↗

PubMed2003

Effects of LDL apheresis and vitamin E-modified membrane on carotid atherosclerosis in hemodialyzed patients with arteriosclerosis obliterans.

BACKGROUND: Hemodialysis patients manifest accelerated atherosclerosis. Hemodialysis is associated with oxidative stress, which can be partially prevented with the use of a vitamin E-coated dialyzer. Adsorption of low-density lipoprotein (LDL) has been applied in the treatment of arteriosclerosis obliterans (ASO). The aim of the present study was to determine whether the vitamin E-coated dialyzer and/or LDL apheresis affects carotid atherosclerosis in hemodialysis patients with ASO. METHODS: Thirty hemodialysis patients with ASO were divided into four treatment groups: treatment with conventional cellulose or synthetic membranes (group A, n = 12), treatment with vitamin E-coated membrane (group B, n = 7), treatment with conventional membrane and LDL apheresis (group C, n = 6), and treatment with vitamin E-coated membrane and LDL apheresis (group D, n = 5). Carotid artery intima-media thickness (IMT) and arterial stiffness assessed by pulse wave velocity (PWV), plasma C-reactive protein (CRP) and interleukin (IL)-6 were measured before and 10 weeks after treatment and compared between groups. All values were referred to measurements after LDL apheresis. RESULTS: IMT and PWV, plasma CRP and IL-6 showed little change in group A throughout the experimental period. These decreased slightly from the baseline value in group B, but the change was not significant. In group C, IMT decreased from 1.12 +/- 0.24 to 1.02 +/- 0.18 mm (p < 0.05), and PWV decreased from 2,266 +/- 380 to 1,968 +/- 342 cm/s (p < 0.05). Plasma CRP and IL-6 concentrations also decreased significantly compared with baseline (p < 0.05). In group D, IMT decreased from 1.18 +/- 0.26 to 0.92 +/- 0.18 mm (p < 0.01), and PWV decreased from 2,284 +/- 390 to 1,786 +/- 284 cm/s (p < 0.01). Plasma CRP and IL-6 levels also decreased significantly compared with baseline (p < 0.01). CONCLUSION: These data suggest that LDL apheresis and the vitamin E-coated membrane dialysis in combination may prevent further progression of atherosclerosis in hemodialysis patients with ASO.

Anticholesteremic Agents↗

PubMed1998

[Cerebrovascular diseases in patients with arteriosclerotic aortic aneurysm and arteriosclerosis obliterans studied by carotid ultrasonography and by computed tomography of the brain].

To estimate the incidence of cerebrovascular diseases in arteriosclerotic aortic aneurysm (AA) and arteriosclerosis obliterans (ASO) and their characteristics, 92 patients with AA and 102 patients with ASO were studied with carotid ultrasonography and brain computed tomography (CT), and were compared with 49 patients with hypertension. The mean ages of the patients were 70 to 72 years old and all were male. Hypertension was common in the AA group: diabetes and cigarette smoking were common in the ASO group. Carotid plaque lesions seen on ultrasonography were significantly more common in the AA (66%) and ASO (85%) groups than in the patients with hypertension (39%). The mean carotid diameter was significantly greater in the AA group than in the other two groups. The mean wall thicknesses in the AA and ASO groups were greater than in the patients with hypertension. Computed tomography showed that low-density areas were also common in the AA group (56%) and ASO (53%) groups than in the patients with hypertension (24%). Most of the low-density areas were thought to be lacunae or dilated perivascular spaces in the subinsula and putamen. Moderately and highly severe periventricular lucencies were also common in the AA group. These findings indicate that carotid changes, seen in AA and ASO, reflected the characteristics of arterial lesions, and that arteriolosclerotic lesions were common in patients with AA and ASO. Therefore, cerebrovascular diseases should be taken into account in the management of patients with AA and ASO.

Aged↗

PubMed1979

[Indications for surgical and conservative treatment of arteriosclerosis (author's transl)].

Operation is contraindicated in acute cerebral insults and neurological lesions which are already irreversible. A complete obstruction in the region where the great vessels branch off from the aorta are always surgically treated if the vessels distal to the lesion are still patent. Aneurysms in the aortoiliac region require resection and reconstruction of the vessels, stenoses and obliterating changes need reconstructive interventions. Angina mesenterica must be surgically treated if at least two intestinal arteries are damaged. Operative intervention in renal arteriosclerosis is only justified if hypertension is also present. Conservative therapy consists of prophylaxis or elimination of the risk factors, of the medical treatment of hyperlipemia and of inhibition of thrombocyte function.

Anticholesteremic Agents↗

PubMed1964

THE FUNDUS OCULI IN HYPERTENSION AND ARTERIOSCLEROSIS.

Vascular and retinal changes seen with the ophthalmoscope in hypertension and arteriosclerosis are described, their pathogenesis is discussed, and the whole is integrated by means of a rational hypothesis.The morphological changes in the arterioles, in the venules, and at the arteriolarvenous crossings are considered, and a classification is suggested for ease of reference.Retinal changes (retinopathy) in these diseases and their pathogenesis are outlined, showing how their appearance may be used to assess the function of the peripheral vascular system and how they may reflect the general status.Because of the great variety of changes found in the fundus oculi, any adequate classification of the total fundus picture is not proposed. It is best to describe the findings objectively, and only then to speculate as to their significance.

Arterioles↗

PubMedDate not supplied

[Therapeutic efficacy of pyridinolcarbamate (Anginin) in patients with combined cerebral and peripheral arteriosclerosis].

A group of 20 patients (average age 55.5 yrs) with advanced arterioscleorosis obliterans and cerebral thrombosis were treated with pyridinolcarbamate. Anginin was given for 6 months, 1,5--2 g. per day. Observation period before, during and after the treatment lasted 2 yrs. Medical and psychological examinations were performed; laboratory test included: sphigmooscylography, photoplethysmography, EKG, EEG, cholesterol, triglyceridis and other routine biochemical blood tests. All data are statistically evaluated. Results. During Anginin treatment clinical improvement was noted in 8 cases, in 9 there was no change in neurological examination; 3 cases--deteriorated. Control examination 6 to 12 months after discontinuation of the treatment revealed no changes in 13 patients; 1 patient deteriorated and 6--died. There was improvement in blood circulation as shown by plethysmography and sphigmooscylography in patients with less advanced vascular changes and no change in cases with more advanced disease. In 75% of the patients there was statistically significant (p less than 0.001) decrease of cholesterol and in 50% of triglicerids (not statistically significant). In patients with advanced disease there was no clinical and EEG improvement, on the contrary 1/3 of them deteriorated clinically and in EEG. In cases with less advanced disease clinical improvement was recorded. Anginin seems to be a good drug for patients with moderately advanced combined peripheral and central arteriosclerosis.

Adult↗

PubMed2000

Role of dietary lipids in arteriosclerosis in experimental animals.

Effects of dietary fats include the development of arteriosclerosis in humans and experimental animals, in addition to hypercholesterolemia. None of the preceding studies explicitly compared the effects of individual fatty acids. To address these issues, we chose exogenously hypercholesterolemic (ExHC) rats and apolipoprotein (apo) E deficient mice as a model for atherosclerosis and assessed the individual role of fatty acids in animals' susceptibility to atherosclerosis. The rats fed on the diet containing DHA or EPA, compared with those fed on the safflower oil (SO) diet, lowered serum cholesterol concentration, prevented platelet aggregation and slowed thickening in the ascending aorta. Apo E deficient mice developed hypercholesterolemia and severe lesion area in aortic root and arch, to a similar extent when they received DHA or SO. These results suggest a direct action of polyunsaturated fatty acids in the arterial wall, in addition to their effects on hypocholesterolemic and haemodynamic action.

Animals↗

PubMed2004

Reduced intragraft mRNA expression of matrix metalloproteinases Mmp3, Mmp12, Mmp13 and Adam8, and diminished transplant arteriosclerosis in Ccr5-deficient mice.

Experimental and human organ transplant studies suggest an important role for chemokine (C-C-motif) receptor-5 (CCR5) in the development of acute and chronic allograft rejection. Because early transplant damage can predispose allografts to chronic dysfunction, we sought to identify potential pathophysiologic mechanisms leading to allograft damage by using wild-type and Ccr5-deficient mice as recipients of fully MHC-mismatched heart and carotid-artery allografts. Gene expression in rejecting heart allografts was analyzed 2 and 6 days after transplantation using Affymetrix GeneChips. Microarray analysis led to identification of four metalloproteinase genes [matrix metalloproteinase (Mmp)3, Mmp12, Mmp13 and a disintegrin and metalloprotease domain (Adam)8] with significantly diminished intragraft mRNA expression in Ccr5-deficient mice at day 6. Accordingly, allografts from Ccr5-deficient mice showed less tissue remodeling and hence better preservation of the myocardial architecture compared with allografts from wild-type recipients. Moreover, survival of cardiac allografts was significantly increased in Ccr5-deficient mice. Carotid artery allografts from Ccr5-deficient recipients showed better tissue preservation, and significant reduction of neointima formation and CD3+ T cell infiltration. Ccr5 appears to play an important role in transplant-associated arteriosclerosis that may involve metalloproteinase-mediated vessel wall remodeling. We conclude that early tissue remodeling may be a critical feature in the predisposition of allografts to the development of chronic dysfunction.

ADAM Proteins↗

PubMed1976

Pulsed Doppler ultrasound detection of flow disturbances in arteriosclerosis.

Pulsed Doppler ultrasound blood flow detection has been used in a noninvasive manner to detect arterial abnormalities associated with arteriosclerosis. Sound spectrograms of ultrasound signals obtained from in vitro and animal studies in which flow was disturbed by obstacles placed in the flow stream showed a different distribution of energy over frequency than signals obtained from studies with no flow disturbances. Similar findings were seen clinically. A technique has been developed which can detect disturbed flow patterns resulting from partial occlusion in important superficial arteries (e.g. femoral and carotid) up to 15 cm distal to localized arterial wall abnormalities. Thirty-five arterial examinations of normal and arteriographically abnormal arteries in 12 patients revealed a sensitivity of 83 percent and a specificity of 61 percent. This study suggests that pulsed Doppler ultrasound may be useful as a screening technique for detection of arteriosclerotic lesions in major superficial arteries.

Animals↗

PubMed1985

Laser applications to arteriosclerosis: angioplasty, angioscopy, and open endarterectomy.

We have studied laser radiation of arteriosclerotic cardiovascular disease to determine the best technique for evaluation. Rabbits with arteriosclerosis were treated by intraluminal laser angioplasty (N = 8), laser angioscopy (N = 2), and open laser endarterectomy (N = 5). All studies were performed with an argon ion laser delivering energy through a 400-microns quartz fiber. Power delivered was varied in order to determine the best value for this animal model. Following angioplasty, perforation was seen in three rabbits (in one case, it was due to mechanical trauma from the fiber optic), and early thrombosis occurred in two rabbits. Plaques were vaporized by angioscopy, but the depth of laser beam penetration or angle of incidence could not be controlled. Open laser endarterectomy gave consistently good results with removal of an arteriosclerotic plaque within the media. The optimum power was found to be 1.0-2.0 W. Endarterectomy required an energy density of 100-140 J/cm2. We conclude that open laser endarterectomy can be a standardized technique for the in vivo evaluation of laser radiation upon arteriosclerotic lesions.

Animals↗

PubMed2003

Effect of conversion from cyclosporine A to mizoribine on transplant arteriosclerosis in rat aortic allograft models.

Recent studies suggested that conversion from cyclosporine A (CsA) to antimetabolic agents protects allograft vasculopathy. However, the mechanism of this beneficial effect by the conversion therapy is not fully understood. In the present study, we investigated the effects of conversion from CsA to antimetabolic agent mizoribine (MZR) on the formation of transplant arteriosclerosis in rat aortic allografts. Conversion from CsA to MZR significantly prevented intimal hyperplasia and perivascular inflammatory cell infiltration at 28 days after aortic transplantation. These findings suggest that conversion therapy from CsA to antimetabolic agents might have therapeutic potential in transplant patients with chronic vascular rejection.

Animals↗

PubMed2003

Estimating the stenosis probabilities in arteriosclerosis obliterans using generalized estimating equations.

For each of 211 arteriosclerosis obliterans patients, the degree of stenosis of arteries at four sites were examined at Hiroshima University Hospital to analyse the relationship between the degree of stenosis and age, sex and site. The generalized estimating equations using a proportional odds model for the stenosis probability with exchangeable correlation was applied to this clustered, ordered polytomous data. Since the correlations between the responses were quite small, we could apply the independence estimating equations. The best mean model selected by Akaike information criterion suggested that age dependency of the stenosis probability was not observed in the central sites but was observed in the peripheral sites, and symmetry of the risk of stenosis was seen in the left and right sites. Details of the analysis will be described.

Adult↗