Development Of Coronary Artery Stenosis Research Articles

The relationship between epicardial adipose tissue thickness and coronary artery disease progress.

The relationship between epicardial adipose tissue and inflammatory events has been shown in many studies. Because it is an inflammatory process in coronary progression, it is aimed to examine the relationship between coronary artery disease progression and epicardial adipose tissue thickness. Our research was conducted with 50 patients (33 men, 17 women) who underwent planned or emergency coronary angiography, by evaluating the coronary artery disease progression from the coronary angiography images together with the echocardiographic epicardial adipose tissue thickness measurement. Patients were examined in two groups according to their tissue thickness, 17 patients with less than 0.55 cm were defined as group 1 and 33 patients with ≥ 0.55 were determined as group 2. There was no significant difference between the groups in terms of gender, diabetes, age, hypertension. In addition, a significant relationship was found with epicardial adipose tissue thickness (> 0.5 cm), ejection fraction and smoking in the group with coronary progression. Patients without stenotic changes were found to be statistically significantly lower p < 0.005. An independent relationship was found between epicardial adipose tissue and coronary artery progression. In the light of these findings, it can be concluded that epicardial adipose tissue residue is effective in the development of coronary artery stenosis and calcific-atherosclerotic changes in the coronary arteries. In the light of the information obtained, a positive correlation was determined between epicardial adipose tissue thickness and coronary artery disease (Tab. 3, Fig. 2, Ref. 15). Text in PDF www.elis.sk Keywords: coronary artery disease, epicardial adipose tissue, progression.

Infrared study and computational simulations of coronary arteries atherosclerotic lesions for early diagnosis of disease progression

Abstract Introduction Coronary artery atherosclerotic disease is the most common cardiovascular disease and bypass grafting surgery (CABG) is an effective treatment. However, the pathogenic mechanism of coronary arteries atherosclerosis and disease progression is not yet clear. Purpose The use of FT-IR spectroscopy, hyperspectral microscope and mathematical simulation models are some of the tools to predict the morphological and elasticity disorders in the vessel wall due to molecular structure changes. Methods Biopsies of atherosclerotic native coronary arteries from 54 patients (44–85 years), who underwent coronary endarterectomy during bypass grafting surgery (CABG), were examined ex vivo. The FT-IR-spectra were recorded with a Nicolet-6700 spectrometer. Morphological changes of atheromatic plaques were performed with SEM-EDX, Fei-Co. CytoVita-Olympus hyperspectral microscope was used to obtain the cells. Results FT-IR spectroscopy (Figure 1A) showed that the disease affects the protein folding, leading to amyloid formation (beta-sheets), lipid peroxidation and AGEs (Advanced Glycation end products) production. The detection of amorphous CaCO3 (1415 and 872 cm–1) deposits in high lipophilic regions was of high importance. Increased mineral concentration leads to increased formation of crystalline deposits, consisting of CaCO3, CaHPO4, Ca3(PO4)2 and inorganic hydroxyapatite, resulting in arterial stenosis. Hyperspectral images confirmed the formation of micelles (1) due to amyloidosis and calcified cells (2), in agreement with FT-IR, ImageJ analysis data. Mathematical simulation model based on finite element method (Figure 1E) showed that arterial wall damage and elasticity changes were not homogenous. This model provides the time of crystallization of the calcium salts, which play crucial role to stenosis. Conclusions FT-IR spectra showed that the formation of amorphous CaCO3 in the presence of Mg2+, in reach of oxidized lipids regions, inhibit the development of coronary artery stenosis. Excessive of Ca2+ efflux promotes the crystallinity of CaCO3 and Ca3(PO4)2 deposits, leading to the development of atherosclerotic plaques and coronary artery stenosis. Mathematical models approach in a much better way the progression of arterial atherosclerosis. Funding Acknowledgement Type of funding sources: None. Figure 1

Influence of Genetic Polymorphism in Matrix Metalloproteinase-3 on Extent of Coronary Atherosclerosis and Risk of Coronary Artery Stenosis

Matrix metalloproteinase-3 (MMP3) is key member of the MMP family. It is known to be present in coronary atherosclerosis. Several studies have demonstrated that MMP-3 5A/6A polymorphism modifies each transcriptional activity in an allele-specific manner. We hypothesized that this polymorphism may be a risk factor for the development of coronary artery stenosis (CAS). We estimated the effect of MMP3 (5A/6A) gene polymorphism on CAS risk in an Iranian population. One hundred ninety patients with CAS and 200 healthy controls were in this study. MMP3 genotypes were determined by polymerase chain reaction (PCR) and restriction fragment length polymorphism (RFLP). Significant differences between cases and controls were observed for MMP3 genotype frequencies (chi(2)=199.305, p<0.001). The 6A allele was less frequently seen in the control group compared with the disease group (85.79 vs. 78%, 6A/6A+5A/6A vs. 5A/5A, p< or =0.05). Association of this polymorphism with CAS severity was evaluated in the two groups, and distribution of the MMP3 genotype was not significantly different as compared with CAS severity (p>0.05). These data imply involvement of the -1612 5A/6A polymorphism in CAS and also that the 6A/6A MMP-3 genotype is a genetic susceptibility factor for CAS (but does not affect disease severity).

Impaired compensatory coronary artery enlargement in atherosclerosis contributes to the development of coronary artery stenosis in diabetic patients. An in vivo intravascular ultrasound study.

Coronary arteries affected by atherosclerosis undergo focal compensatory enlargement, which can be detected by intracoronary ultrasound but not by angiography. Diabetic patients when compared with non-diabetics have a more accelerated progression of coronary artery disease and a more diffuse narrowing of the coronary arteries. Intracoronary ultrasound can clarify if this is due to less compensatory coronary artery enlargement as a response to atherosclerosis. Ten non-diabetic and 15 diabetic patients with coronary artery disease, with angiographically determined one- or two-vessel disease, underwent intracoronary ultrasound examination of the non-stenotic coronary artery. Forty-five sites with luminal stenosis, detected by intracoronary ultrasound, were analysed (15 in non-diabetics, 30 in diabetics). Vessel and lumen area, atherosclerotic plaque area and plaque composition were evaluated. Vessel area was also measured proximal and distal to the healthy segment. In the diabetic patients, there was less vessel area increase from the proximal healthy segment into the atherosclerotic segment than in the non-diabetic patients (99% separate-variance confidence intervals for differences between diabetics' and non-diabetics' means = 0.29 mm2, 2.71 mm2). The proximal plaque free vessel area, the atherosclerotic plaque area and plaque composition were similar between the two groups. Diabetics with atherosclerosis have less compensatory coronary artery enlargement than non-diabetics. This may explain the diffuse and accelerated course of coronary artery disease in these patients.

冠動脈および大動脈硬化の関連についての臨床的研究

The relationship between coronary arterosclerosis and aortic sclerosis was evaluated for patients who received coronary angiography (CAG) by measuring pulse wave velocity (PWV) and serum lipids. Nine patients in their 40's, 27 patients in their 50's and 28 patients in their 60's underwent coronary angiography. Two out of 9 patients in their 40's, 14 out of 27 patients in their 50's and 21 out of 28 patients in their 60's showed significant narrowing of coronary arteries with CAG. PWV for the 60's category was significantly higher than for the 50's and 40's categories, 8.22±1.33m/sec, 7.13±0.90m/sec and 6.87±0.63m/sec respectively. Sevirity of coronary artery stenosis was classified into 3 groups according to the Gensini's method, Group I with scores of 20 or less, Group II scores of 21 to 50, Group III with scores of more than 51. In 60's, 8 patients belong to group I, 14 patients belong to group II, 6 patients belong to group III. In 50's, 12 patients belong to group I, 9 patients belong to group II, 6 patients belong to group III. PWV, which is an indication of aortic sclerosis showed more prominent increase among groups of the 60's category, whereas the progression between groups of the 50's category was relatively stable. HDL cholesterol decreased as group progress in the 60's category, wheres there was no difference between levels among groups in the 50's category. Atherogenic index (AI) increased more when the group progressed from group I to group III in both 50's and 60's. The value of AI increased significantly in group III compared with group I, in 60's.The influence of general arterosclerotic change on the development of coronary artery stenosis is more prominent in 60's compared with that in 50's category. The disparity between 50's and 60's categories, for the development of coronary artery sclerosis suggests that there are other factors involved in 50's in addition to general arterosclerotic change.