Incidence Of Atherosclerotic Plaques Research Articles

Atherosclerotic vascular lesion in the coal industry workers of average and high fatal risk groups

Introduction. Experts do not take into account the presence of subclinical atherosclerosis when stratifying risk on the SCORE scale, however, it is the main substrate for the occurrence of cardiovascular disasters. Most primary cardiovascular events occur in low cardiovascular risk groups, which requires timely detection of atherosclerosis and preventive measures to preserve the working population's ability to work and reduce the economic burden of treatment of cardiovascular diseases. The study aims to research the incidence of atherosclerosis in workers of the main professions of the coal industry in the South of Kuzbass in groups of medium and high risk of fatal events on the SCORE scale. Materials and methods. We divided the subjects into two groups using the SCORE scale: high-risk (main) — from 5 to 9%, which included 60 people, and moderate-risk group — from 2 to 4% (comparison) — 70 employees. The average age of the first was 50.98±0.43 years, the comparison group was 49.96±0.35 years (p=0.070). The scientists examined the indicators of blood pressure, lipid, carbohydrate and purine metabolism, and performed an ultrasound examination of the main arteries. Results. The incidence of atherosclerotic plaques in at least one vascular basin was 80.0% in the main group and 78.6% in the comparison group, p=0.845. The frequency of carotid artery atheromas in the high-risk group on the SCORE scale (52.7%) did not significantly differ from the comparison group (54.3%), p=0.862; a similar pattern in the arteries of the lower extremities: 80.0% vs. 70.0%, respectively, p=0.203. The frequency of carotid artery atheromas in the high-risk group on the SCORE scale (52.7%) did not significantly differ from the comparison group (54.3%), p=0.862; a similar pattern in the arteries of the lower extremities: 80.0% vs. 70.0%, respectively, p=0.203. The combination of thickening of the intima of vessels and the presence of atheromas tended to be more frequent in the main group — 83.6% compared with those in the comparison group — 70.1%, p=0.076 Limitations. The study is limited by the number of examined patients who underwent periodic medical examination at the Scientific Research Institute of Complex Problems of Hygiene and Occupational Diseases. Conclusion. The incidence of atherosclerosis among employees of coal enterprises turned out to be very high and did not statistically differ in the groups of medium and high fatal risk stratified on the SCORE scale, which requires more thorough screening and measures of enhanced angioprotective prevention, even in people with a low risk of fatal cardiovascular disasters. Ethics. All the subjects signed an informed consent to participate in the study, the Protocol of which corresponded to the requirements of the Bioethical Committee of the Research Institute of Complex Problems of Hygiene and Occupational Diseases, executed in accordance with the Helsinki Declaration of the World Medical Association "Ethical Principles of conducting medical research with human participation as a subject" as amended in 2013 and the "Rules of Good Clinical Practice" approved by the order Ministry of Health of the Russian Federation No. 200n dated April 1, 2016.

Features of Atherosclerosis of the Carotid Arteries in Elderly patients with Acute Coronary Syndrome

Aim. To study features of atherosclerosis and signs of instability of atherosclerotic plaque in the carotid arteries by ultrasound duplex scanning of elderly patients with myocardial infarction or unstable angina.Material and methods. The study included 87 patients with ACS and 78 patients without ACS aged 75 and over. Ultrasound duplex scanning of carotid arteries was carried out with Philips EPIQ5 ultrasound system and L12–3 linear array transducer on the 2–5 day from the moment of hospitalization. Quantitative and structural indicators of atherosclerosis of the carotid arteries were assessed .Results. The frequency of detection of atherosclerotic plaques in carotid arteries in elderly patients with ACS was signifi cantly higher than in patients without ACS – 78 and 67 % (p=0,179). Patients with ACS compared with the group without ACS more often had signs of instability of atherosclerotic plaque: heterogenous structure – 28,8 and 19,3 % (p=0,017), hypoechogenic component – 39,2 and 9,9 % (p<0,001), irregular surface – 46,3 and 8,2 % (р<0,001), local calcifi cation –14,2 and 7 % (р=0,001). At the same time, ulcerated atherosclerotic plaques were found only in the group of patients with ACS – 1,9 % (р=0,412). The incidence of atherosclerotic plaques in carotid arteries among men was higher in the group with ACS compared to patients without ACS – 36,2 and 23,4 % (р=0,003); among women the data are higher in the group without ACS compared with the group of patients with ACS – 76,6 and 63,8 % (р=0,003).Conclusion. Atherosclerotic plaques in carotid arteries among elderly patients are more common in the group of patients with ACS. As the same time, among this group atherosclerotic plaques with signs of instability were significantly more common found.

Cardiovascular system changes in rheumatoid arthritis patients with continued low disease activity

Systemic inflammation and disease activity seem to contribute to excessive prevalence of cardiovascular (CV) diseases (CVDs) in patients with rheumatoid arthritis (RA). The objective of the study was to assess chosen CV parameters in RA patients who have continuous low disease activity. The study group consisted of 70 RA patients without known CVD and 33 healthy controls, of a comparable age. All RA patients had continued low disease activity (DAS28 ≤ 3.2) from 2 to 7 years. The groups were assessed for: blood pressure, serum amino-terminal pro-brain natriuretic peptide (NT-proBNP), carotid intima media thickness (cIMT), electrocardiography (ECG), ejection fraction (EJ) and diastolic dysfunction (E/A ratio) in echocardiography. In RA patients in comparison with controls, significantly greater values of cIMT [0.83 (0.21) vs 0.62 (0.1) mm, p < 0.001] were found, as well as higher incidence of atherosclerotic plaques [43 (61.4%) vs 10 (30.3%), p = 0.003], prolonged QTc interval [439.6 (23.7) vs 414.0 (27.9) ms, p < 0.001]. High or very high Systemic Coronary Risk Evaluation (SCORE) was found in 32.9% of patients with RA and increased serum NT-proBNP in 71.4%. The mean values of CV parameters (cIMT, E/A, NT-proBNP, SCORE) were associated with age, disease duration, rheumatoid factor (RF-IgM), erythrocyte sedimentation rate (ESR). The results of our study indicate, that RA with continued low disease activity is associated with atherosclerosis and heart dysfunction. Strong relationships were found between CV parameters and patients’ age, disease duration. Deterioration of CV parameters was associated with higher DAS28, ESR, RF-IgM concentration and bone erosions.

The value of color Doppler ultrasound in the diagnosis of lower extremity vascular disease in type 2 diabetes and an analysis of related factors.

The aim of this paper is to explore the application and clinical significance of color Doppler ultrasound (CDU) in diagnosing lower extremity vascular disease in type 2 diabetes mellitus (T2DM) patients. The lower extremity arteries of 81 patients with T2DM and 50 control patients were examined by CDU for blood vessel diameter, intima-media thickness, plaque on the vessel wall, lumen stenosis and filling defect in blood flow. The occurrence of diabetes mellitus was investigated in additional T2DM patients of various ages. Left popliteal artery, left and right dorsal artery of the foot; the incidence of atherosclerotic plaque, stenosis and occlusion of the lower extremity vascular lumen of T2DM patients was significantly higher than that in the control group. Vascular disease in the lower extremities was mainly small and medium vascular disease (lower than popliteal artery), especially the dorsal artery of the foot, for which the difference was statistically significant (P<0.05). The elder patients had a greater chance of lower extremity arterial disease. CDU is the examination method of preference for T2DM patients with lower extremity vascular disease. It has a very important clinical significance for early diagnosis, prevention and treatment.

Interplay of Proximal Flow Confluence and Distal Flow Divergence in Patient-Specific Vertebrobasilar System

Approximately one-quarter of ischemic strokes involve the vertebrobasilar arterial system that includes the upstream flow confluence and downstream flow divergence. A patient-specific hemodynamic analysis is needed to understand the posterior circulation. The objective of this study is to determine the distribution of hemodynamic parameters in the vertebrobasilar system, based on computer tomography angiography images. Here, the interplay of upstream flow confluence and downstream flow divergence was hypothesized to be a determinant factor for the hemodynamic distribution in the vertebrobasilar system. A computational fluid dynamics model was used to compute the flow fields in patient-specific vertebrobasilar models (n = 6). The inlet and outlet boundary conditions were the aortic pressure waveform and flow resistances, respectively. A 50% reduction of total outlet area was found to induce a ten-fold increase in surface area ratio of low time-averaged wall shear stress (i.e., TAWSS ≤ 4 dynes/cm2). This study enhances our understanding of the posterior circulation associated with the incidence of atherosclerotic plaques.

Features of atherosclerosis in hemodialysis patients

BackgroundCardiovascular disease is the main cause of mortality in dialysis patients. Carotid intima–media thickness (CIMT) is used as a surrogate marker of early atherosclerosis. Atherosclerosis can cause vascular access failure. The purpose of this study was to define the clinical features of atherosclerosis in hemodialysis patients based on CIMT and to define the relationship between CIMT and access failure. MethodsIn this cross-sectional study, the CIMT of 60 patients on hemodialysis was examined using B-mode Doppler ultrasonography between May 2012 and November 2012. Carotid atherosclerosis was defined as a CIMT≥0.9mm or the incidence of atherosclerotic plaques. ResultsThe patients’ mean age was 54.5±10.6 years, and 60% of the patients were male. The CIMT was 0.81±0.47mm (range, 0.35–2.50mm). The group with atherosclerosis was characterized by older age compared with those without atherosclerosis. Patients with atherosclerosis showed much shorter durations of access patency than their counterparts in the nonatherosclerosis group (hazard ratio, 2.822; 95% confidence interval, 1.113–7.156; P=0.029). Moreover, being overweight was associated with a 2.47-fold (95% confidence interval, 1.101–5.548) increased primary access failure. ConclusionThis study shows that atherosclerosis is associated with older age. Patients who are overweight and have atherosclerosis may have shortened access patency.

A clinical study of carotid atheroaclerosis and cerebral infarction

Objective To explore the correlation of carotid atherosclerosis with cerebral infarction.Methods Using a retrospective analysis,we reviewed the data on 137 patients with cerebral infarction,including the findings of Carotid Colored Doppler uhrasonography,blood pressure,and blood glucose and lipids.Results The incidence of atherosclerotic plaque was higher in the patients with cerebral infarction ( 69.34％ ).Atherosclerotic plaque nostly developed in the crotch of carotid artery( 77.9％ ),mostly being soft plaque( 41.1％ ).The formation of atherosclerotic plaque was laterally related with infarction.Gender,hypertension,and elevated levels of blood glucoseand and lipids were markedly related with carotid atherosclerotic plaque ( P ＜ 0.05 ).Conclusions Carotid atherosclerosis is closely related with cerebral infarction.Male,hypertension,diabetes,and hyperlipoidemia can accelerate the occurrence of carotid atherosclerosis and the formation of plaque. Key words: Carotid atherosclerosis; Cerebral infarction

Myocardial Bridging of the Left Anterior Descending Coronary Artery: Depiction Rate and Morphologic Features by Dual-Source CT Coronary Angiography

ObjectiveTo evaluate the depiction rate and morphologic features of myocardial bridging (MB) of the left anterior descending coronary artery (LAD) using dual-source CT (DSCT).Materials and MethodsCT scans from a total of 1,353 patients who underwent DSCT were reviewed retrospectively for LAD-MB. Seventy-eight patients were excluded due to poor image quality or poor enhancement of the coronary artery. The length and depth of the MB were analyzed and classified as superficial or deep with respect to the depth (≤ 1 or > 1 mm) of the LAD tunneled segment. Superficial MB was subdivided into complete or incomplete types according to full or partial encasement of the myocardium.ResultsOf the 1,275 patients included in this study, 557 cases of MB were found from 536 patients (42%). Superficial MB was observed in 368 of 557 (66%) cases, and deep MB was seen in 189 of 557 (34%) cases. Superficial MB showed 2 types: complete (128 of 368, 35%) and incomplete (240 of 368, 65%). The mean length of a tunneled segment for superficial MB was 16.4 ± 8.6 mm. The mean length and depth of a tunneled segment for deep MB were 27.6 ± 12.8 mm and 3.0 ± 1.4 mm, respectively. The incidence of atherosclerotic plaques in a 2-cm-long segment proximal to MB was 16%.ConclusionThe depiction rate of LAD-MB using DSCT in a large series of patients was 42%, with two-thirds of MB segments being the superficial type.

The natural history of aortic atherosclerosis: A systematic histopathological evaluation of the peri-renal region

BackgroundRisk factor profiles for the different vascular beds (i.e. coronary, carotid, peripheral and aortic) are remarkably different, suggesting that atherosclerosis is a heterogeneous disorder. Little is known about the morphologic progression of atherosclerosis in the peri-renal aorta, one of the primary predilection sites of atherosclerosis. MethodsA systematic analysis was performed in 260 consecutive peri-renal aortic patches (stained with Movat Pentachrome and H&E) collected during organ transplantation (mean donor age 46.5 (range 5–76) years; 54% ♂; mean BMI 24.9; 40% smokers; 20% hypertensive). Plaque morphology was classified according to the modified AHA classification scheme proposed by Virmani et al. [4]. Immunostaining against CD68 was used to identify the distribution of intimal macrophages and monocytes in several predefined locations among various plaque types and fibrous cap thickness. ResultsThere was significant intimal thickening (p<0.013) and medial thinning (p<0.032) with advancing age. The incidence of atherosclerotic plaques in the abdominal aorta correlated with age (r=0.640, p=0.01). During the first three decades of life adaptive intimal thickening and intimal xanthomas were the predominant lesions. In contrast, the fourth, fifth and sixth decades hallmarked more complicated plaques of pathological intimal thickening, early and late fibroatheromas (EFAs and LFAs), thin-cap FAs (TCFAs; cap thickness <155μm), ruptured plaques (PRs), healed rupture and fibrotic calcified plaques. The mean percentage of lesional macrophages increased significantly from LFAs to TCFAs (5–17%; p<0.001). Macrophage infiltration of the fibrous cap was negatively correlated with fibrous cap thickness (p<0.0004); TCFAs and PRs (caps<100μm) contained significantly more macrophages (19%) compared with caps 101–300μm (6%) and >300μm (2%). Macrophages in shoulder regions were highest in early and late FAs (∼45%) followed by TCFAs (27%) and PR (20%). Further, intimal vasa vasorum were mostly seen adjacent to the necrotic core of advanced atherosclerotic plaques and remained confined to the intimo-medial border despite marked thickening of the intima. ConclusionThis study shows that peri-renal aortic atherosclerosis starts early in life. Gross plaque morphologies of the peri-renal abdominal aorta are similar to coronary atherosclerosis yet indications were found for site specific differences in macrophage content and neovascularization.

Combined oestrogen-progestin replacement therapy prevents atherosclerosis in postmenopausal women

The incidence of atherosclerotic plaques in the aorta and in the carotid and iliac arteries was investigated using high resolution B-mode ultrasonography in 40 postmenopausal women using sequentially combined oestradiol valerate 2 mg--levonorgestrel 0.25 mg replacement therapy. In addition, serum lipid, lipoprotein and apolipoprotein levels were measured. Similar studies were performed for 40 postmenopausal women using oestradiol valerate alone and for 40 women who had never used hormone replacement therapy (HRT). Ultrasonographically observed atherosclerotic plaques were less common (P = 0.011) in oestradiol valerate--levonorgestrel users than in women without HRT. More than three atherosclerotic plaques were observed in 62% of the women without HRT but only in 30% of the women using combined therapy (P = 0.003). The total number of plaques did not differ between the two hormone using groups. The mean serum triglyceride, total cholesterol and apolipoprotein B levels were lowest in oestradiol valerate--levonorgestrel users when compared with those of women with oestradiol valerate monotherapy and those of women without HRT. Combined oestradiol valerate--levonorgestrel replacement therapy, like oestradiol valerate monotherapy, prevents the progression of atherosclerosis in postmenopausal women. The lipid patterns were not adversely affected by the addition of the androgenic levonorgestrel.