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2.
Autops. Case Rep ; 11: e2021263, 2021. tab, graf
Article in English | LILACS | ID: biblio-1249034

ABSTRACT

Blunt chest trauma (BCT) is one of the rarest causes of acute myocardial infarction (AMI). This paper reports the case of a young married man who suffered from AMI due to BCT sustained in a fight with his wife. The histopathology examination revealed a rupture of atherosclerotic plaque with superimposed thrombus in the proximal left anterior descending artery. This report also reviews previously reported BCT-induced AMI cases in the literature.


Subject(s)
Humans , Male , Adult , Thoracic Injuries/pathology , Myocardial Infarction/etiology , Autopsy , Coronary Thrombosis , Plaque, Atherosclerotic , Morphological and Microscopic Findings
3.
Acta Physiologica Sinica ; (6): 42-50, 2021.
Article in Chinese | WPRIM | ID: wpr-878234

ABSTRACT

This study was designed to evaluate the role of short-chain fatty acid butyrate acid on intestinal morphology and function, and atherosclerotic plaque formation in apolipoprotein E-knockout (ApoE


Subject(s)
Animals , Apolipoproteins E/genetics , Atherosclerosis/prevention & control , Butyrates/pharmacology , Caco-2 Cells , Diet, High-Fat/adverse effects , Fatty Acids, Volatile , Humans , Mice , Mice, Inbred C57BL , Mice, Knockout , Plaque, Atherosclerotic
4.
Rev. cuba. med ; 59(4): e1366, oct.-dic. 2020. tab, graf
Article in Spanish | LILACS, CUMED | ID: biblio-1144500

ABSTRACT

Introducción: La enfermedad arterial de miembros inferiores es un marcador de riesgo coronario, causa de invalidez y muerte en quienes la padecen, su identificación temprana puede atenuar estos efectos. Objetivo: Identificar la enfermedad arterial de miembros inferiores no diagnosticada a través de Eco-Doppler en pacientes con factores de riesgo aterogénicos. Método: Se realizó un estudio descriptivo de tipo transversal que incluyó a 100 pacientes de 40 años o más, fumadores, diabéticos y/o hipertensos, sin diagnóstico de enfermedad arterial de miembros inferiores, a quienes se le realizó Eco-Doppler de miembro inferior. Resultados: Se identificaron lesiones compatibles con EAMI en 69 por ciento de los estudiados, cuya edad media fue de 64,81 ± 10,12 años, y discreto predominio del sexo masculino. Las arterias más afectadas fueron la tibial posterior y la pedia con 43 por ciento y 39 por ciento respectivamente, las medidas de asociación mostraron OR (IC 95 por ciento) de 4,15 para la diabetes mellitus, 1,63 para el tabaquismo seguido de la hipertensión arterial con 0,27. Conclusiones: Seis de cada diez pacientes presentaron lesiones ateroscleróticas identificables por Eco-Doppler, predominaron las del sector tibial posterior y pedio en fumadores y diabéticos, estos últimos tuvieron cuatro veces más riesgo de padecer la enfermedad(AU)


Introduction: Arterial disease of the lower limbs is a marker of coronary risk, causing disability and death in those who suffer from it. Early detection can mitigate these effects. Objective: To identify undiagnosed lower limb arterial disease through Echo-Doppler in patients with atherogenic risk factors. Method: A descriptive, cross-sectional study was carried out in 100 patients aged 40 years or older, smoking habits history, and diabetic and / or hypertensive patients, with no diagnosis of arterial disease in the lower limbs, who underwent Eco-Doppler of the lower limb. Results: EAMI compatible lesions were identified in 69 percent of those studied, whose mean age was 64.81 ± 10.12 years, and a discrete male predominance. The most affected arteries were the posterior tibial and pediatric arteries in 43 percent and 39 percent respectively, the association measures showed OR (95 percent CI) of 4.15 for diabetes mellitus, 1.63 for smoking followed by arterial hypertension with 0.27. Conclusions: Six out of ten patients showed atherosclerotic lesions identifiable by Echo-Doppler, those of the posterior tibial sector and pedium predominated in smokers and diabetics, the latter had four times the risk of suffering from the disease(AU)


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Aged , Echocardiography, Doppler/methods , Risk Factors , Peripheral Arterial Disease/diagnostic imaging , Plaque, Atherosclerotic/diagnostic imaging , Cross-Sectional Studies , Observational Study
5.
J. oral res. (Impresa) ; 9(6): 511-515, dic. 31, 2020. ilus
Article in English | LILACS | ID: biblio-1178949

ABSTRACT

Introduction: Atherosclerosis is a progressive inflammatory disease that can trigger serious medical consequences like acute myocardial infarction or stroke. Case Report: The purpose of this study is to report an unusual case of finding calcified atheromatous plaques in the carotid arteries bilaterally using a panoramic radiography (PR). A 75-year-old female with a morbid history, attends the Teaching Dental Clinic of the Pontifical Catholic University with complementary exams. PR showed well-defined radiopaque structures adjacent to C4. Using a Doppler ultrasound, the presence of calcified atheromas in the right and left carotid arteries were confirmed. The patient was informed of these findings and is currently under medical follow-up. Conclusion: PR is a useful complementary resource in the detection of atherosclerotic plaques of the upper carotid region.


Introducción: La aterosclerosis es una enfermedad inflamatoria progresiva que puede desencadenar graves consecuencias médicas como infarto agudo de miocardio o accidente cerebrovascular. Case Report: El propósito de este estudio es reportar un caso inusual de hallazgo de placas ateromatosas calcificadas en las arterias carótidas de forma bilateral mediante una radiografía panorámica. Mujer de 75 años con antecedentes mórbidos, acude a la Clínica Odontológica Docente de la Pontificia Universidad Católica con exámenes complementarios. La radiografía panorámica mostró estructuras radiopacas bien definidas adyacentes a C4. Mediante ecografía Doppler se confirmó la presencia de ateromas calcificados en las arterias carótidas derecha e izquierda. El paciente fue informado de estos hallazgos y actualmente se encuentra en seguimiento médico. Conclusión: La radiografía panorámica es un recurso complementario útil en la detección de placas ateroscleróticas de la región carotídea superior.


Subject(s)
Humans , Female , Aged , Radiography, Panoramic , Carotid Artery Diseases/diagnostic imaging , Carotid Stenosis/diagnostic imaging , Ultrasonography , Stroke , Atherosclerosis/complications , Plaque, Atherosclerotic , Infarction
6.
Rev. colomb. cardiol ; 27(6): 511-516, nov.-dic. 2020. tab, graf
Article in Spanish | LILACS, COLNAL | ID: biblio-1289266

ABSTRACT

Resumen Introducción: Los pacientes con enfermedad aterosclerótica establecida requieren tratamiento con estatinas para reducir la probabilidad de nuevos eventos. Objetivo: Identificar el porcentaje de pacientes con enfermedad coronaria aterosclerótica establecida que logran niveles de cLDL (colesterol LDL) inferiores a 70mg/dl y describir su distribución en tres grupos terapéuticos: estatinas, otros hipolipemiantes y sin tratamiento. Métodos: Estudio observacional descriptivo de corte transversal, en el que se seleccionaron pacientes de tres hospitales de alta complejidad, mayores de 18 años, con enfermedad aterosclerótica diagnosticada a partir del año 2017. El registro del perfil lipídico corresponde al realizado al menos tres meses después del diagnóstico. Resultados: Se incluyeron en total 746 pacientes con enfermedad coronaria aterosclerótica, con un promedio de edad de 65,3±10,9 años y predominio del sexo masculino (75,5%). Del total de los pacientes evaluados se prescribieron un 97,8% de terapia con al menos una estatina, 0,7% de otros hipolipemiantes y 1,5% no presentaron tratamiento. Los pacientes con niveles de cLDL inferior a 70mg/dl corresponden al 56%. Conclusiones: La extensa divulgación de guías de práctica clínica para dislipidemias en adultos en Colombia, y la incorporación de estatinas de alta intensidad, demuestran una mejoría en la proporción del cumplimiento en metas de cLDL para pacientes con enfermedad aterosclerótica establecida. Sin embargo, una alta proporción aún persiste fuera de metas, lo cual constituye una oportunidad de optimización del uso de terapias disponibles y recientemente desarrolladas.


Abstract Introduction: Patients with established atherosclerotic disease require treatment with statins in order to reduce the probability of new events. Objective: To identify the percentage of patients with established atherosclerotic coronary disease that achieve cLDL (LDL - cholesterol) levels less than 70mg/dL, and to describe its distribution in three treatment groups: statins, other lipid lowering drugs, and without treatment. Methods: A cross-sectional, descriptive observational study was conducted on patients diagnosed with atherosclerotic disease from 2017 and over 18-years-old from 3 tertiary hospitals. A record was made of the lipid profile that was performed at least three months after the diagnosis. Results: A total of 746 patients with atherosclerotic coronary disease were included. The mean age was 65.3±10.9 years and the majority (75.5%) were males. Of the total number of patients evaluated, 97.8% were prescribed a therapy with at least one statin, 0.7% with other lipid-lowering drugs, and 1.5% had no treatment. Just over half (56%) of the patients had cLDL levels of less than 70mg/dL. Conclusions: The widespread use of clinical practice guidelines for dyslipidaemias in adults in Colombia, and the incorporation of high-intensity statins, has led to an improvement in the proportion of patients with established atherosclerotic disease achieving cLDL targets. However, a high percentage still does not reach the targets, which suggests a need for an improving of the use of available and recently developed therapies.


Subject(s)
Humans , Male , Female , Middle Aged , Cholesterol, LDL , Hydroxymethylglutaryl-CoA Reductase Inhibitors , Plaque, Atherosclerotic , Heart Disease Risk Factors , Lipids
7.
Rev. cuba. med ; 59(4): e1633, oct.-dic. 2020. tab, graf
Article in Spanish | LILACS, CUMED | ID: biblio-1144501

ABSTRACT

Introducción: La aterosclerosis subclínica es predictora de eventos vasculares futuros y es diagnosticada por imágenes y biomarcadores sin que existan manifestaciones clínicas. Objetivo: Identificar los factores pronósticos asociados con la aterosclerosis subclínica en pacientes dislipidémicos. Método: Se realizó un estudio de cohorte en el Hospital Hermanos Ameijeiras en 1028 pacientes en el periodo de 2016 al 2019. Resultados: La existencia de placa de ateroma fue de 26,9 por ciento. Existieron diferencias significativas relacionadas al tabaquismo (30,0 por ciento vs 23,7 por ciento). En las variables lipídicas, el promedio de los valores de la LDLc fue superior en los pacientes con placa de ateroma y la relación CT/LDL fue mayor en los que no tienen esta alteración. La frecuencia de engrosamiento del complejo íntima-media mayor de 1,0 mm fue de 37,1 por ciento. Existieron diferencias significativas relacionadas al tabaquismo (30,4 por ciento vs 22,4 por ciento) y la presencia de HTA (56,7 por ciento vs 48,8 por ciento ) en las variables lipídicas el promedio de los valores de la HDLc fue superior en los pacientes sin aumento del grosor del complejo íntima-media y la elevación CT/HDL fue mayor en los que presentan dicha alteración. Conclusiones: Los factores que influyen de manera independiente en la probabilidad de formación de las placas de ateroma son la LDLc (elevada), la edad, los triglicéridos y el sexo masculino y los que influyen en la probabilidad para el engrosamiento del complejo íntima-media son la HDLc (baja), el tabaquismo, y la hipertensión arterial(AU)


Introduction: Subclinical atherosclerosis is a predictor of future vascular events and is diagnosed by imaging and biomarkers without any clinical manifestations. Objective: To identify the prognostic factors that are associated with subclinical atherosclerosis in dyslipidemic patients. Method: A cohort study was carried out at the Hermanos Ameijeiras Hospital in 1028 patients in the period from 2016 to 2019. Results: The existence of atheroma plaque was 26.9 percent. There were significant differences related to smoking (30.0 percent vs 23.7 percent). In the lipid variables, the average of the LDLc values ​​is higher in patients with atheroma plaque and the CT/LDL ratio is higher in those without this alteration. Regarding the frequency of thickening of the intima-media complex greater than 1.0 mm, it was 37.1 percent. There were significant differences related to smoking (30.4 percent vs 22.4 percent) and the presence of HTA (56.7 percent vs 48.8 percent in the lipid variables, the average of the HDLc values ​​is higher in the patients without an increase in the thickness of the intima-media complex and the CT/HDL elevation is greater in those with said alteration. Conclusions: The factors that independently influence the probability of atheroma plaque formation are LDLc (elevated), age, triglycerides and male sex, and those that influence the probability of thickening of the intima-media complex. They are HDLc (low), smoking, and high blood pressure(AU)


Subject(s)
Humans , Male , Female , Prognosis , Atherosclerosis/diagnostic imaging , Dyslipidemias/complications , Plaque, Atherosclerotic/prevention & control , Cohort Studies
8.
Int. j. med. surg. sci. (Print) ; 7(2): 6-16, jun. 2020. ilus, tab
Article in English | LILACS | ID: biblio-1179270

ABSTRACT

This study had as a goal to analyze the prevalence of suggestive images of atheromatous calcification in the common carotid artery, aiming to relate it to age, sex, antimere and to analyze the morphology of its calcification, through digital panoramic radiographs of the jaws. It's an observational, transversal and retrospective study, on which there were analyzed 4.837 radiographs, that came from the files of a dental radiology private service in the city of Cabo de Santo Agostinho-PE, Brazil, referring to the period between 2011-2017. The morphology of the calcified atheromatous plaque was classified in: Grade I ­ normal (plaque not displayed); Grade II ­ intimal thickening; Grade III ­ simple plaque (less than 5mm thick); Grade IV ­ complex plaque (over 5mm thick) and Grade V ­ debris (irregular plaque with moving projections). The data collected was expressed in absolute values and frequency, analyzed through the chi-square, considering p< 0,05. Of the analyzed radiographs, 1.321 filled the eligibility criteria, of these 51 (3,8%0 presented suggestive image of atheromatous plaque, 71% were of the female sex (p = 0,003), 45% were at the age range between 5th and 6th decade of life (p= 0,001), most of the identified plaques were unilateral, to the left (p=0,02) and 76% were morphologically classified as grade III (less than 5mm thick). In this study, it was verified the low prevalence of suggestive images of atheromatous in carotid artery, with greater occurrence on the female sex, between the 5th and 6th decade of life, unilaterally, to the left and morphologically classified in grade III.


Este estudio tuvo como objetivo analizar la prevalencia de imágenes sugerentes de calcificación ateromatosa en la arteria carótida común, con el objetivo de relacionarla con la edad, sexo, antimería y analizar el aspecto morfológico de la calcificación, a través de radiografías panorámicas digitales de los maxilares. Se trata de un estudio observacional, transversal y retrospectivo, en el que se analizaron 4.837 radiografías, provenientes de los archivos de un servicio privado de radiología dental en la ciudad de Cabo de Santo Agostinho-PE, Brasil, referido al período 2011-2017. La morfología de la placa ateromatosa calcificada se clasificó en: Grado I - normal (no aparece placa); Grado II: engrosamiento de la íntima; Grado III: placa simple (menos de 5 mm de espesor); Grado IV: placa compleja (más de 5 mm de grosor) y grado V: Irregular o amorfo (placa irregular con proyecciones móviles). Los datos recolectados se expresaron en valores absolutos y frecuencia, analizados mediante el chi-cuadrado, considerando p <0,05. De las radiografías analizadas, 1.321 cumplieron los criterios de elegibilidad, de estas 51 (3,8% presentaron imagen sugerente de placa ateromatosa, 71% eran del sexo femenino (p = 0,003), 45% estaban en el rango de edad entre 5 y 6a década de la vida (p = 0,001), la mayoría de las placas identificadas eran unilaterales, hacia la izquierda (p = 0,02) y el 76% se clasificaron morfológicamente como grado III (menos de 5mm de espesor). verificó la baja prevalencia de imágenes sugerentes de ateromatosas en arteria carótida, con mayor ocurrencia en el sexo femenino, entre la 5ª y 6ª década de la vida, unilateralmente, hacia la izquierda y clasificadas morfológicamente en grado III.


Subject(s)
Humans , Radiography, Panoramic/methods , Carotid Artery, Common/diagnostic imaging , Plaque, Atherosclerotic/epidemiology , Plaque, Atherosclerotic/diagnostic imaging , Brazil , Chi-Square Distribution , Prevalence , Cross-Sectional Studies , Retrospective Studies , Observational Study
9.
Rev. Assoc. Med. Bras. (1992) ; 66(1): 31-35, Jan. 2020. tab, graf
Article in English | LILACS | ID: biblio-1091903

ABSTRACT

SUMMARY Homozygous familial hypercholesterolemia is a rarely agentic disorder of the lipoprotein metabolism intimately related to premature atherosclerotic cardiovascular disease that can lead to high disability and mortality. Homozygous familial hypercholesterolemia typically affects not only the aortic root, compromising the coronary ostia, but also affects other territories such as the carotid, descending aorta, and renal arteries. Multi-contrast high-resolution magnetic resonance imaging (MRI) provides a validated and useful method to characterize carotid artery atherosclerotic plaques quantitatively. However, very few studies have been done on assessing plaque composition in patients with Homozygous familial hypercholesterolemia using high-resolution MRI. This report is to evaluate the value of MRI in accessing carotid artery disease in patients with Homozygous familial hypercholesterolemia. We describe a 28-year-old patient from Beijing, China, who presented to the Neurology Clinic with intermittent blurred vision of the right eye, headache, nausea, and vomiting for eight years without obvious causes. Familial hypercholesterolemia was suspected based on medical history and laboratory examination. Carotid Doppler ultrasound showed bilateral common carotid artery, internal carotid artery, and external carotid artery wall thickening with hyperechoic signals. Subsequently, high-resolution multi-contrast MRI of the carotid showed calcification with hypo-intense areas located at the middle layer of the plaque, with moderate stenosis. The plaque located at the right bifurcation of the common carotid artery extended to the internal carotid artery, causing lumen stenosis close to occlusion. The patient was treated with right carotid artery endarterectomy. At a 6-month follow-up, there had been no recurrence of the patient's symptoms.


RESUMO A hipercolesterolemia familiar homozigótica, uma doença patogênica rara do metabolismo da lipoproteína intimamente relacionada com a doença cardiovascular aterosclerótica prematura, pode conduzir a uma elevada deficiência e mortalidade. A hipercolesterolemia familiar homozigótica afeta tipicamente não só a raiz aórtica, comprometendo os óstios coronários, mas também outros territórios, como a carótida, a aorta descendente e as artérias renais. Imagens de ressonância magnética multicontraste de alta resolução (RM) fornecem um método validado e útil para caracterizar quantitativamente as placas de aterosclerose da artéria carótida. No entanto, muito poucos estudos foram feitos sobre a avaliação da composição da placa em doentes com hipercolesterolemia familiar homozigótica utilizando ressonância magnética de alta resolução. Este trabalho deve avaliar o valor da ressonância magnética no acesso à doença da artéria carótida em doentes com hipercolesterolemia familiar homozigótica. Descrevemos um paciente de 28 anos de Pequim, China, que se apresentou à clínica neurológica com visão turva intermitente do olho direito, dor de cabeça, náuseas e vômitos por oito anos sem causas aparentes. Suspeitava-se de hipercolesterolemia familiar com base no histórico médico e no exame laboratorial. O ultrassom Doppler carotídeo mostrou uma artéria carótida bilateral comum, artéria carótida interna e parede da carótida externa espessando-se com sinais hiperecoicos. Posteriormente, a ressonância multicontraste de alta resolução da carótida mostrou calcificação com áreas hipointensas localizadas na camada média da placa, com estenose moderada. A placa localizada na bifurcação direita da artéria carótida comum estendia-se até a artéria carótida interna, causando estenose do lúmen próxima à oclusão. O paciente foi tratado com endarterectomia da artéria carótida direita. Em seis meses de acompanhamento, não houve recorrência dos sintomas do paciente.


Subject(s)
Humans , Female , Adult , Thrombosis/diagnostic imaging , Coronary Artery Disease/diagnostic imaging , Magnetic Resonance Imaging/methods , Carotid Stenosis/diagnostic imaging , Plaque, Atherosclerotic/diagnostic imaging , Hyperlipoproteinemia Type II/diagnostic imaging , Carotid Artery, External/pathology , Carotid Artery, External/diagnostic imaging , Carotid Artery, Internal/pathology , Carotid Artery, Internal/diagnostic imaging , Ultrasonography, Doppler, Color/methods , Plaque, Atherosclerotic/pathology , Carotid Intima-Media Thickness , Computed Tomography Angiography/methods
10.
Biociencias ; 15(1): 51-58, jun.2020.
Article in Spanish | LILACS, COLNAL | ID: biblio-1122934

ABSTRACT

Introducción: A nivel mundial el consumo Hibiscus sabdariffa, ha venido creciendo gracias a su contenido rico en compuestos bioactivos como flavonoides y antocianinas. Por medio de sus cálices ha sido utilizada para prevenir y tratar enfermedades degenerativas como el cáncer, anomalías cardiovasculares e hiperlipidemia. Objetivo: Evaluar el efecto antioxidante de un extracto de H. sabdariffa, por medio del ensayo de oxidación de lipoproteínas de baja densidad (LDL) aisladas de plasma sanguíneo. Métodos: Se emplearon cálices deshidratados obtenidos de un cultivo propio, obteniendo un extracto acuso bajo condiciones similares a la forma de consumo habitual. Se determino el contenido de fenoles totales empleando el método de Folin-Ciocalteu. Caracterizado el extracto se evaluó su actividad antioxidante por el ensayo de oxidación de LDL, obtenida de una muestra sanguínea de tres pacientes sin hiperlipidemia. Resultados: Se evidenció una inhibición de la oxidación de LDL estadísticamente significativa del extracto y su respectivo al control en cada una de las muestras ( p<0,05). Conclusiones: estos resultados respaldan que H. sabdariffa, es una alternativa real en el control de la hiperlipidemia y reducción de la oxidación de las LDL, responsable de la formación de la placa de ateroma a nivel de las arterias. Sin embargo el consumo de esta planta debe hacerse bajo condiciones controlados y guiadas por especialistas a fin de obtener los resultados deseados


Introduction: Worldwide consumption Hibiscus sabdariffa, has been growing thanks to its high content rich in bioactive compounds such as flavonoids and anthocyanins. Through its calyces it has been used to prevent and treat degenerative diseases such as cancer, cardiovascular abnormalities, and hyperlipidemia. Objective: To evaluate the antioxidant effect of an extract of H. sabdariffa, by means of the low-density lipoprotein oxidation (LDL) assay. Methods: Dehydrated chalices obtained from an own culture were used, obtaining an acuso extract under conditions similar to the usual consumption. The total phenol content was determined using the Folin-Ciocalteu method. Characterized the extract, its antioxidant activity was evaluated by the LDL oxidation test, obtained from a blood sample from three patients without hyperlipidemia. Results: A statistically significant inhibition of LDL oxidation of the extract and its respective control was evidenced in each of the samples (p <0.05). Conclusions: these results demonstrate that H. sabdariffa is a real alternative in the control of hyperlipidemia and reduction of oxidation of LDL, responsible for the formation of atheroma plaque at the level of the arteries. However, the consumption of this plant must be done under controlled conditions and guided by specialists in order to obtain the desired results.


Subject(s)
Humans , Hibiscus , Phenols , Plaque, Atherosclerotic , Antioxidants
11.
Article in Chinese | WPRIM | ID: wpr-828534

ABSTRACT

OBJECTIVE@#To investigate the prognosis of patients with vulnerable plaque indicated by coronary CT angiography (CCTA).@*METHODS@#Totally 1963 patients underwent CCTA from February 2nd 2015 to September 13th 2015, and 2728 coronary borderline lesions (stenosis of 50%-70%) were detected. Among them 804 patients had vulnerable plaques and 1159 patients had stable plaques. The primary endpoint was major cardiac adverse events (MACE), including cardiac death, acute myocardial infarction and target lesion revascularization.@*RESULTS@#Patients were followed up for a mean follow-up of 27.4±2.3 months. The incidence of MACE in the vulnerable plaque group was significantly higher than that in the stable plaque group (10.8%vs 2.3%, < 0.01). After adjusting for age, gender, smoking, hypertension, diabetes, hyperlipidemia, the MACE hazard ratio () in the vulnerable plaque group was 5.022 (95% :3.254-7.751, < 0.01).Subgroup analysis showed that in the vulnerable plaque group, the incidence of MACE in patients taking antiplatelet and statin ≤3 months and those taking antiplatelet and statin > 3 months was 17.0%and 5.8%, respectively (=3.149, 95% :1.987-4.992, < 0.01); but the difference did not seen in stable plaque group (=1.721, 95% :0.798-3.712, >0.05).@*CONCLUSIONS@#This study confirmed the risk of MACE in patients with vulnerable plaque detected by CCTA and the drug treatment may reduce the risk for patients with vulnerable plaque.


Subject(s)
Computed Tomography Angiography , Coronary Angiography , Coronary Artery Disease , Diagnostic Imaging , Coronary Stenosis , Diagnostic Imaging , Humans , Infant , Plaque, Atherosclerotic , Diagnostic Imaging , Pathology , Prognosis , Risk Factors
12.
Article in English | WPRIM | ID: wpr-827423

ABSTRACT

Urinary calculi are characterized by high incidence and recurrence rate, which is a challenge in urology. The theory of Randall plaque is widely recognized by scholars. The mechanism of Randall plaque formation includes vascular calcification, osteogenic transformation and so on. However, it still lacks a unified theory for the Randall plaque formation. As an important type of non-coding RNA, long non-coding RNA (lncRNA) is closely related to the occurrence and progress of many diseases. The difference in lncRNA expression between the renal papillary tissues of non-calculous patients and the renal papillary tissues of Randall plaque in renal calculous patients suggests that lncRNA may be involved in the formation of Randall plaque. Pseudoxanthoma elasticum is a rare autosomal recessive hereditary disease, caused by a mutation in the ABCC6 gene. Patients with pseudoxanthoma elasticum have a high prevalence of calculi, and plaque formation is observed in the patient's kidney, which may suggest that mutation in the ABCC6 gene might be involved in the formation of Randall plaque.


Subject(s)
Humans , Kidney , Kidney Calculi , Multidrug Resistance-Associated Proteins , Mutation , Plaque, Atherosclerotic , Pseudoxanthoma Elasticum , Vascular Calcification
13.
Korean Circulation Journal ; : 443-457, 2020.
Article in English | WPRIM | ID: wpr-816671

ABSTRACT

BACKGROUND AND OBJECTIVES: We sought to investigate an anti-atherosclerotic and anti-inflammatory effect of sodium-glucose cotransporter-2 (SGLT-2) inhibitors in normoglycemic atherosclerotic rabbit model.METHODS: Male New Zealand white rabbits (n=26) were fed with a 1% high-cholesterol diet for 7 weeks followed by normal diet for 2 weeks. After balloon catheter injury, the rabbits were administered with the Dapagliflozin (1mg/kg/day) or control-medium for 8 weeks (n=13 for each group). All lesions were assessed with angiography, optical coherence tomography (OCT), and histological assessment.RESULTS: Atheroma burden (38.51±3.16% vs. 21.91±1.22%, p<0.01) and lipid accumulation (18.90±3.63% vs. 10.20±2.03%, p=0.047) was significantly decreased by SGLT-2 inhibitor treatment. The SGLT-2 inhibitor group showed lower macrophage infiltration (20.23±1.89% vs. 12.72±1.95%, p=0.01) as well as tumor necrosis factor (TNF)-α expression (31.17±4.40% vs. 19.47±2.10%, p=0.025). Relative area of inducible nitric oxide synthase+ macrophages was tended to be lower in the SGLT-2 inhibitor-treated group (1.00±0.16% vs. 0.71±0.10%, p=0.13), while relative proportion of Arg1⁺ macrophage was markedly increased (1.00±0.27% vs. 2.43±0.64%, p=0.04). As a result, progression of atherosclerosis was markedly attenuated in SGLT-2 inhibitor treated group (OCT area stenosis, 32.13±1.20% vs. 22.77±0.88%, p<0.01). Mechanistically, SGLT-2 treatment mitigated the inflammatory responses in macrophage. Especially, Toll-like receptor 4/nuclear factor-kappa B signaling pathway, and their downstream effectors such as interleukin-6 and TNF-α were markedly suppressed by SGLT-2 inhibitor treatment.CONCLUSIONS: These results together suggest that SGLT-2 inhibitor exerts an anti-atherosclerotic effect through favorable modulation of inflammatory response as well as macrophage characteristics in non-diabetic situation.


Subject(s)
Angiography , Atherosclerosis , Catheters , Constriction, Pathologic , Diet , Humans , Interleukin-6 , Macrophages , Male , Nitric Oxide , Plaque, Atherosclerotic , Rabbits , Toll-Like Receptors , Tomography, Optical Coherence , Tumor Necrosis Factor-alpha
14.
Article in Chinese | WPRIM | ID: wpr-879224

ABSTRACT

Atherosclerosis is a complex and multi-factorial pathophysiological process. Researches over the past decades have shown that the development of atherosclerotic vulnerable plaque is closely related to its components, morphology, and stress status. Biomechanical models have been developed by combining with medical imaging, biological experiments, and mechanical analysis, to study and analyze the biomechanical factors related to plaque vulnerability. Numerical simulation could quantify the dynamic changes of the microenvironment within the plaque, providing a method to represent the distribution of cellular and acellular components within the plaque microenvironment and to explore the interaction of lipid deposition, inflammation, angiogenesis, and other processes. Studying the pathological mechanism of plaque development would improve our understanding of cardiovascular disease and assist non-invasive inspection and early diagnosis of vulnerable plaques. The biomechanical models and numerical methods may serve as a theoretical support for designing and optimizing treatment strategies for vulnerable atherosclerosis.


Subject(s)
Atherosclerosis , Biomechanical Phenomena , Computer Simulation , Humans , Inflammation , Models, Cardiovascular , Plaque, Atherosclerotic/diagnostic imaging
15.
Chinese Medical Journal ; (24): 2415-2421, 2020.
Article in English | WPRIM | ID: wpr-877827

ABSTRACT

BACKGROUND@#Acute coronary syndromes mainly result from abrupt thrombotic occlusion caused by atherosclerotic vulnerable plaques (VPs) that suddenly rupture or erosion. Fibrous cap thickness (FCT) is a major determinant of the propensity of a VP to rupture and is recognized as a key factor. The intensive use of statins is known to have the ability to increase FCT; however, there is a risk of additional adverse effects. However, lower dose statin with ezetimibe is known to be tolerable by patients. The present study aimed to investigate the effect of intensive statin vs. low-dose stain + ezetimibe therapy on FCT, as evaluated using optical coherence tomography.@*METHOD@#Patients who had VPs (minimum FCT 90°) and deferred from intervention in our single center from January 2014 to December 2018 were included in the trial. They were divided into the following two groups: intensive statin group (rosuvastatin 15-20 mg or atorvastatin 30-40 mg) and combination therapy group (rosuvastatin 5-10 mg or atorvastatin 10-20 mg + ezetimibe 10 mg). At the 12-month follow-up, we compared the change in the FCT (ΔFCT%) between the two groups and analyzed the association of ΔFCT% with risk factors. Fisher exact test was used for all categorical variables. Student's t test or Mann-Whitney U-test was used for analyzing the continuous data. The relationship between ΔFCT% and risk factors was analyzed using linear regression analysis.@*RESULT@#Total 53 patients were finally enrolled, including 26 patients who were in the intensive statin group and 27 who were in the combination therapy group. At the 12-month follow-up, the serum levels of total cholesterol (TC), total triglyceride, low-density lipoprotein (LDL-C), hypersensitive C-reactive protein (hs-CRP), and lipoprotein-associated phospholipase A2 (Lp-PLA2) levels were reduced in both the groups. The ΔTC%, ΔLDL-C%, and ΔLp-PLA2% were decreased further in the combination therapy group. FCT was increased in both the groups (combination treatment group vs. intensive statin group: 128.89 ± 7.64 vs. 110.19 ± 7.00 μm, t = -9.282, P < 0.001) at the 12-month follow-up. The increase in ΔFCT% was more in the combination therapy group (123.46% ± 14.05% vs. 91.14% ± 11.68%, t = -9.085, P < 0.001). Based on the multivariate linear regression analysis, only the serum Lp-PLA2 at the 12-month follow-up (B = -0.203, t = -2.701, P = 0.010), ΔTC% (B = -0.573, t = -2.048, P = 0.046), and Δhs-CRP% (B = -0.302, t = -2.963, P = 0.005) showed an independent association with ΔFCT%.@*CONCLUSIONS@#Low-dose statin combined with ezetimibe therapy maybe provide a profound and significant increase in FCT as compared to intensive statin monotherapy. The reductions in Lp-PLA2, ΔTC%, and Δhs-CRP% are independently associated with an increase in FCT.


Subject(s)
Anticholesteremic Agents/therapeutic use , Drug Therapy, Combination , Ezetimibe/therapeutic use , Humans , Hydroxymethylglutaryl-CoA Reductase Inhibitors/therapeutic use , Plaque, Atherosclerotic/drug therapy , Rosuvastatin Calcium/therapeutic use , Tomography, Optical Coherence , Treatment Outcome
17.
Rev. Soc. Cardiol. Estado de Säo Paulo ; 29(3 Supl): 306-313, jul.-set. 2019. tab
Article in English, Portuguese | LILACS | ID: biblio-1023176

ABSTRACT

A doença arterial coronariana (DAC) é umas das doenças cardiovasculares que mais mata no Brasil e no mundo. É uma doença multifatorial, associada a fatores de risco modificáveis. Além dos tratamentos convencionais, é recomendado que pacientes com DAC também incluam modificações no estilo de vida e programas de reabilitação cardiovascular com ênfase no exercício físico (RCEE) em seu tratamento. Sabidamente, o exercício físico regular somado às mudanças no estilo de vida contribui para a diminuição do avanço da doença aterosclerótica e da mortalidade dos pacientes com DAC. Além disso, o exercício físico tem impacto benéfico na capacidade funcional e qualidade de vida. Um programa de RCEE é uma estratégia eficaz, segura e com excelente razão de custo-benefício para o tratamento da DAC. Contudo, mesmo sendo uma terapia recomendada pelos principais órgãos de saúde, no Brasil as políticas públicas de saúde são extremamente escassas e a quantidade de centros especializados que oferecem a RCEE também é baixa. Problemas de adesão, participação e motivação são evidentes quando os programas são avaliados. Esta revisão mostra os principais estudos que, ao longo das últimas décadas, deram base para as recomendações da RCEE e faz uma análise crítica do cenário atual, deixando claro que novas estratégias de atuação e monitoramento devem ser exploradas e incentivadas para que os programas de RCEE sejam incluídos efetivamente no tratamento dos pacientes com DAC


Coronary artery disease (CAD) is one of the most lethal cardiovascular diseases both in Brazil and worldwide. It is a multifactorial disease associated with modifiable risk factors. In addition to conventional treatments, it is recommended that patients with CAD also include lifestyle changes and exercise-based cardiovascular rehabilitation (CR) programs in their treatment. It is well known that regular physical exercise combined with lifestyle changes contributes to a reduction in the progression of atherosclerosis and in mortality in patients with CAD. Moreover, physical exercise has a beneficial impact on functional capacity and quality of life. A CR program is an effective, safe strategy for the treatment of CAD with an excellent cost-benefit ratio. However, even though it is a therapy recommended by the main health agencies, public health policies in Brazil are extremely scarce and the number of specialized centers that offer CR is low. Problems of adherence, participation, and motivation are evident when these programs are evaluated. This review looks at the main studies that have been the basis for the recommendations of CR over last decades and critically analyzes the current scenario, making it clear that new strategies for action and monitoring should be explored and encouraged such that CR programs will be included effectively in the treatment of patients with CAD


Subject(s)
Humans , Male , Female , Middle Aged , Coronary Artery Disease , Exercise , Cardiac Rehabilitation/methods , Quality of Life , Cardiovascular Diseases/mortality , Cardiovascular Diseases/therapy , Chronic Disease/mortality , Risk Factors , Plaque, Atherosclerotic , Heart Rate
18.
Rev. Soc. Cardiol. Estado de Säo Paulo ; 29(2): 126-132, abr.-jun. 2019. ilus, tab
Article in English, Portuguese | LILACS, SES-SP, SESSP-IDPCPROD, SES-SP | ID: biblio-1009412

ABSTRACT

A doença aterosclerótica tem evolução lenta, o que dá a oportunidade de intervir no estilo de vida e até farmacologicamente na tentativa de aumentar a expectativa de vida livre de eventos. Para esse fim, habitualmente utilizam-se modelos de estratificação de risco baseada em modelos clássicos, como os critérios de Framingham, mas há um número representativo de eventos que acontecem em casos considerados de baixo risco. As principais dúvidas surgem nos casos considerados de risco intermediário, e, nessa situação, os exames de imagem podem auxiliar a identificar e tratar adequadamente casos de maior gravidade. Habitualmente, as avaliações são feitas por ultrassom das artérias carótidas (ACa) e pela medida do escore de cálcio por tomografia, cada um com suas particularidades e limitações técnicas. O desempenho dos métodos depende, em grande parte, do equipamento disponível e da expertise da equipe médica envolvida. Contudo, há claras vantagens da pesquisa de placas nas ACa e da quantificação da calcificação nas artérias carótidas (CAC) sobre a avaliação da espessura médio intimal (IMT - do inglês intima-media thickness), enquanto a pesquisa do grau de calcificação coronariana é recomendada em recentes diretrizes internacionais. Ao mesmo tempo, persistem algumas dúvidas se os exames têm desempenho distinto na estratificação de risco de infarto e acidente vascular cerebral


Atherosclerotic disease is a slowly progressive condition, thereby providing the opportunity to intervene in the patient's lifestyle, and even pharmacologically, in an attempt to increase event-free life expectancy. To this end, risk stratification models based on classic criteria such as the Framingham criteria are generally used to stratify the individual patient risk, but there is a considerable number of events that occur in cases considered low risk. The main uncertainty arises in cases considered intermediate risk, and in these situations, imaging tests can help identify and appropriately treat cases of greater severity. The assessments are generally performed using carotid artery ultrasound and the measurement of calcium score by computed tomography, with each method having its own particularities and technical limitations. The performance of the methods largely depends on the available equipment and the expertise of the medical staff involved. However, there are clear advantages of plaque research in carotid arteries (ACA) and of the quantification of calcification in the carotid arteries (CAC) over the evaluation of intima - medial thickness (IMT), while investigation of the degree of coronary calcification is recommended in recent international guidelines. Meanwhile, questions remain as to whether the techniques perform differently in the risk stratification of infarction and stroke


Subject(s)
Humans , Male , Female , Biomarkers , Risk Factors , Atherosclerosis/diagnostic imaging , Plaque, Atherosclerotic/diagnostic imaging , Quality of Life , Diagnostic Imaging/methods , Carotid Arteries/diagnostic imaging , Tomography, X-Ray Computed/methods , Vascular Calcification/diagnostic imaging , Carotid Intima-Media Thickness , Myocardial Infarction
20.
Int. j. odontostomatol. (Print) ; 13(1): 75-81, mar. 2019. graf
Article in English | LILACS | ID: biblio-990068

ABSTRACT

ABSTRACT: Carotid stenosis usually results from the accumulation of atherosclerotic plaque in the carotid artery wall and is an important risk factor for ischemic cerebral vascular accident (CVA). This study describes the importance of diagnostic imaging exams used in dentistry for the early identification of atheroma plaques in the extracranial and intracranial internal carotid artery. A male patient was referred to a radiology clinic to perform panoramic radiography (PR) and a cone beam computed tomography (CBCT) to develop treatment plan options. In the PR and CBCT a radiopaque image, suggestive of atheroma in the extracranial internal carotid artery, was observed on the right side. The diagnosis was confirmed by color DOPPLER ultrasonography. In the CBCT, the presence of calcifications in the intracranial internal carotid artery was also observed. Diagnostic imaging exams used in dentistry allow the identification of asymptomatic individuals, facilitating early intervention and consequent reduction in the risk of ischemic CVA.


RESUMEN: La estenosis carotídea generalmente es consecuencia de la acumulación de placa aterosclerótica en la pared de la arteria carótida y es un factor de riesgo importante para el accidente cerebral vascular (ACV) isquémico. Este estudio describe la importancia de los exámenes de diagnóstico por imágenes utilizados en odontología para la identificación precoz de placas de ateroma en la arteria carótida interna, a nivel extracraneal e intracraneal. Un paciente masculino fue remitido a una clínica de radiología para realizar una radiografía panorámica (RP) y tomografía computarizada de haz cónico (TCHC) para analizar opciones de tratamiento. En el RP y TCHC se observó una imagen radiopaca, sugestiva de ateroma en la arteria carótida, extracraneal, en el lado derecho. El diagnóstico fue confirmado por ultrasonido DOPPLER color carotídeo. En el TCHC, también se observó la presencia de calcificaciones en la arteria carótida interna, intracraneal. Los exámenes de imagenología diagnóstica utilizados en odontología permiten la identificación de individuos asintomáticos, lo que facilita la intervención temprana y la consiguiente reducción en el riesgo de ACV isquémico.


Subject(s)
Humans , Male , Aged , Radiography, Panoramic , Carotid Arteries/diagnostic imaging , Cone-Beam Computed Tomography , Plaque, Atherosclerotic/diagnostic imaging , Ultrasonography, Doppler, Color , Stroke/prevention & control , Early Diagnosis
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