Impact of passive smoking on renal vascular morphology

ABSTRACT Objective To determine whether passive smoking causes morphological and structural changes in the arcuate arteries of rats exposed for 7 to 28 days. Methods Wistar rats aged eight weeks and weighing 260g on average were allocated to a Control or a Smoker Group. Groups were further divided into 4 groups containing 5 animals each. Morphological-functional analysis of the right kidneys was carried out after 7 and 28 days of exposure to the smoke of 40 cigarettes per day. Cigarettes were burned at set times using automated cigarette-burning equipment ("Smoking Machine" - SM-MC-01). At the end of each exposure period, the kidneys were dissected and submitted to histological processing for morphological and quantitative analysis. Results Exposure to cigarette smoke for 7 days led to a decrease in inner vascular diameter. Decreased thickness of the vascular tunica media was observed after exposure for 28 days. Increased thickness of the tunica adventitia, increased total vascular wall thickness, increased total vascular diameter and qualitative increase in collagen deposition were observed. Vascular volume increased after 28 days of exposure. Conclusion Passive smoking has a negative impact on renal vasculature.

Association between carotid intima-media thickness and visceral fat area in children aged 6-7 years / 中国学校卫生

Objective@#To identify the association of carotid intima-media thickness (cIMT) and visceral fat area (VFA) to inform prevention of cardiovascular disease in later life.@*Methods@#All the grade one students of six non-boarding primary schools in Shunyi District, Beijing were enrolled, based on population-based survey design, to establish the child cohort on sensitization, puberty, obesity and cardiovascular risk (PROC). Socio-demographic information survey and anthropometric measure, blood and urine test were carried out. Robust linear regression was used to determine the relationship between cIMT and other factors.@*Results@#Among 1 711 participants, a significant difference were observed between normal, overweight and obesity children on cIMT [(0.35±0.02)(0.36±0.02)(0.37±0.03)mm] (F=41.4, P<0.01) and VFA [16.2(13.6-19.3), 22.7(18.6-27.3), 51.5(33.9-73.0)cm2] (χ2=854.5, P<0.01). After adjusting age and sex, univariate robust linear regression showed that cIMT was associated with height, SBP, DBP, HDL-C, VFA (P<0.05) and TG (P=0.055). Multivariable robust linear regression indicated that in total and boys only included models, cIMT was associated with VFA and SBP(β=0.000 2, 0.000 2, 0.000 2, 0.000 2, P<0.05); while in girls only included model cIMT was associated with VFA and TG (β=0.000 2, 0.006 2, P<0.05).@*Conclusion@#VFA is stable to predict the increase of cIMT in children. We can use VFA to simplify the classification management of children and inform targeted early prevention of cardiovascular disease in adulthood.

Study of Morphometry and Elastic Fibre Distribution in Left and Right Coronary Arteries.

Background: Coronary artery disease also called asischemic heart disease which develops when majorblood vessels that supply blood to heart becomedamaged or diseased. It is also one of the leading causesof death. Morphometry and elastic fibre distribution incoronary arteries may help in using appropriate sizecatheters for diagnostic procedures. Aim andObjectives: To study the morphometry and elastic fibredistribution in left and right coronary artery. Materialand Methods: Segment of left and right coronaryarteries each having length of 0.5 cm were collectedfrom 30 adult human heart specimens fixed in 10%formalin. Outer and inner diameters were measured.Tissues were processed and stained by verhoeff's VanGeison stain. Stained slides were scanned by “IScapture software” under 10 × magnifications. Results:Outer diameter of left coronary artery is 4.225 ±0.6963mm and right coronary artery is 3.827 ±0.6869mm. Inner diameter of left coronary artery is3.338 ± 0.5853 and that of right coronary is 2.869 ±0.6104mm.Conclusion: Diameter, wall thickness,thickness of tunica intima, tunica media is more in leftcoronary artery than the right. Also left coronary arteryshows more number of elastic fibers than right coronaryartery.

Association between obesity and carotid intima-media thickness in hypertensive children and adolescents / 中国学校卫生

Objective@#To examine the relationship between obesity and carotid intima-media thickness (cIMT) in children and adolescents in order to provide scientific evidence for the prevention and control of cardiovascular diseases.@*Methods@#A total of 289 children and adolescents aged 6 to 17 years were included in the study, and weight, height, blood pressure and cIMT were measured. Multivariable Logistic regression model was used to analyze the relationship between obesity and cIMT.@*Results@#The level of cIMT and prevalence of high cIMT in obese males were higher than those in non-obese males(P<0.05), while there was no statistical significance between two weight groups in females (P>0.05). After adjusted for sex, age and blood pressure, compared with the non-obese children and adolescents, the odds ratios (OR s) of obesity for high cIMT in total sample, males and females were 3.03 (95%CI=1.11-8.28), 4.32 (95%CI=1.23-15.21) and 1.45 (95%CI=0.23-9.37) respectively.@*Conclusion@#Obesity may increase cIMT levels and risk of high cIMT in children and adolescents. Effective measures should be taken to prevent and control the obesity, and to reduce the risk of abnormal vascular structure in children and adolescents.

Arterioesclerosis de Monckeberg en vasos uterinos: un interesante hallazgo incidental / Arteriosclerose de Monckeberg nos vasos uterinos: um achado incidental interessante / Monckeberg arteriosclerosis in uterine vessels: an interesting incidental finding

Se realizó la comunicación de un caso clínico-patológico, diagnosticado en el Hospital Docente Clínico Quirúrgico "Joaquín Albarrán" de La Habana. En dicha entidad se presentó en una paciente femenina de 85 años de edad con antecedentes de diabetes mellitus tipo 2, ingresada por cuadro de insuficiencia arterial de miembro inferior izquierdo por lo cual se le realizan amputación supracondilia y al tercer día de su estadía hospitalaria, fallece. En la autopsia se arribó al diagnóstico anatomopatológico de arterioesclerosis de Mönckeberg de vasos del útero. Esta es una forma de arterioesclerosis muy relacionada con la senectud, pero factores de riesgo como diabetes mellitus y la enfermedad renal crónica pueden contribuir de forma directa en su desarrollo y progresión. Su diagnóstico es un hallazgo incidental en muestras histopatológicas(AU)

A clinical-pathological case was reported, diagnosed at the Joaquín Albarrán Clinical Surgical Teaching Hospital in Havana. In this entity, an 85-year-old female patient with a history of type 2 diabetes mellitus was presented, admitted due to arterial insufficiency of the lower left limb, for which she underwent supracondylar amputation and died on the third day of her hospital stay. At the autopsy, the pathological diagnosis of Mönckeberg arteriosclerosis of vessels of the uterus was reached. This is a form of arteriosclerosis closely related to old age, but risk factors such as diabetes mellitus and chronic kidney disease can directly contribute to its development and progression. Its diagnosis is an incidental finding in histopathological samples(AU)

Um caso clínico-patológico foi relatado, diagnosticado no Hospital de Clínica Cirúrgica "Joaquín Albarrán" em Havana. Nessa entidade, apresentou-se uma paciente de 85 anos, com história de diabetes mellitus tipo 2, internada por insuficiência arterial do membro inferior esquerdo, para a qual sofreu amputação aupracondiliana e faleceu no terceiro dia de internação. Na autopsia, o diagnóstico patológico da arteriosclerose de Mönckeberg de navios do útero foi conseguido. Essa é uma forma de arteriosclerose intimamente relacionada à velhice, mas fatores de risco como diabetes mellitus e doença renal crônica podem contribuir diretamente para seu desenvolvimento e progressão. Seu diagnóstico é um achado incidental em amostras histopatológicas(AU)

Association of blood glucose control with carotid plaque and pulse wave velocity in elderly patients with type 2 diabetes mellitus / 中华老年医学杂志

Objective To investigate the correlation of glycosylated hemoglobin(HbA1C)levels with carotid atherosclerotic plaque and pulse wave velocity (PWV) in elderly patients with type 2 diabetes mellitus (T2DM).Methods There were 130 cases of elderly patients with T2DM,aged from 60 to 92 years,of whom there were 59 males.All subjects were divided into 3 groups based on the HbA1Clevels:the low level group (HbA1C＜7％,n=49),the middle level group (77％≤HbA1C＜ 8.5 ％,n =58) and the high level group (HbA1C ≥8.5 ％,n=23).Height,body weight,blood pressure,blood glucose,blood lipids,HbA1C and other indexes were collected and compared among groups.In addition,carotid ultrasound and PWV examinations were performed.Results There were significant difference in levels of systolic blood pressure (SBP),fasting blood glucose (FBG),high density lipoprotein cholesterol (HDL-C),carotid intima-media thickness (IMT),plaque score,plaque stability and PWV among groups (all P＜0.05).Correlation analysis showed that IMT levels were correlated with gender (r=0.389),age (r=0.296),FBG (r=0.203),HbA1C(r=0.405) and HDL-C (r =-0.208),all P ＜ 0.05.Carotid artery plaque score correlated with gender (r =0.321),age (r =0.355),HbA1C(r=0.340) and HDL-C (r=-0.249) (all P＜0.01)and there is a correlation between the stability of carotid plaques with body mass index (BMI) (r =-0.286),SBP (r =-0.188),HbA1C(r=-0.368) and HDL-C (r=0.405) (all P＜0.05);PWV was correlated with age (r=0.516),SBP (r=0.521),diastolic blood pressure (r=0.225),FBG (r=0.181),HbA1C(r=0.229),triglyceride (r =-0.253),total cholesterol (r=-0.311) and LDL-C (r=-0.244),all P＜ 0.05.Moreover,there was a correlation between IMT and PWV (r =0.234,P ＜ 0.01).Logistic regression analysis showed that gender,age and HbA1C were independently associated with IMT;gender,age,BMI and HbA1C were independently associated with carotid atherosclerosis plaque score;age,HbA1C and HDL-C were independently associated with the stability of carotid atherosclerotic plaque;age and SBP were independently associated with PWV.Conclusions HbA1C,SBP,HDL-C and BMI are independent risk factors for arteriosclerosis in elderly diabetics.

Change and significance of osteoprotegerin/receptor activator of NF-κB ligand during differentiation of rat arterial smooth muscle cells into the osteoblast-like cells / 中华老年医学杂志

Objective To study the change and significance of osteoprotegerin(OPG)/receptor activator of NF κB ligand(RANKL)during the process of rat arterial smooth muscle cells (SMC) to differentiate subgroups:7 d (early) subgroup and 14 d (late) subgroup.into osteoblast-like cells.Methods The rat arterial SMCs were divided randomly into the SMC group,atorvastatin group,and osteoblast-like group.Each group was also divided into 2.The osteoblast-like group was given β-glycerophosphate and vitamin C in culture medium,the atorvastatin group was given both β-glycerophosphate,vitamin C and atorvastatin.Von Kossa staining,Ca2+ content assay,ALP activity assay and osteocalcin assayed with Western blot were used to check the level of calcification.Real-time PCR was used to check the mRNA expressions of OPG and RANKL.Results There was high expression of OPG (early 2.71 ±0.08,late 2.69 ±0.02) but no RANKL in the SMC group all the time.The expressions of OPG were increased in the early subgroup and decreased in late subgroup in the atorvastatin group (early 3.52±0.05,late 2.50±0.03) and osteoblast-like group (early 4.18±0.10,late 2.30 ± 0.11).And the expressions of RANKL were both increased in the atorvastatin group and osteoblast-like group dnring the calcification process (from 1.01 ± 0.19 to 2.40 ± 0.10,and from 1.70±0.07 to 3.22±0.11,respectively).Among the three groups,the ratio of OPG/RANKL was decreased with the increasing calcification level (F =52.93,2.33,both P＜0.05).And compared with the early subgroups,the ratio of OPG/RANKL in the late subgroups was also decreased along with the increase of calcification level in each group(F=38.71,1.74,both P＜0.05).Conclusions The ratio of OPG/RANKL has a negative correlation with the level of the osteoblast-like cells differentiation,and atorvastatin could inhibit the calcification.

Association between circulating endothelial cells and atherosclerosis in maintenance hemodialysis patients / 中华肾脏病杂志

Objective To explore the association between circulating endothelial cells (CECs)and atherosclerosis in maintenance hemodialysis(MHD)patients. Methods A crosssectional study was performed to investigate the association between CECs and carotid atherosclerotic change in 65 MHD patients,25 non-hemodialysis patients with chronic kidney disease(CKD)of stage 4 or 5(CKD-non-HD)and 24 age-and Sex-matched healthy controls. CECs in peripheral blood were determined by multiparametrie flow cytometry(FCM).CECs were labeled with CD3-PerCP and CD146-PE before FCM and identified as CD3dim,CD146bright.Atherosclerosis in both groups Was assessed by the measurement of common carotid arery intimamedia thickness (CCA-IMT)and plaque of the common carotid arteries with ultrasound scanner. Results CECs were significantly higher in pre-dialysis patients[(151.52±98.24) cell/ml]and CKD-non-HD patients[(183.00±81.38)cell/ml ] compared with control group[(106.50± 24.14)cell/ml](P<0.05 and P<0.01,respectively).But the number of CECs was not significantly different between MHD and CKD-non-HD patients.CCA-IMT was also significantly higher in MHD patients[(0.94±0.36)mm]and CKD-non-HD patients [(1.02±0.37)mml compared with control group[(0.75±0.15)mm](P<0.05 and P<0.01,respectively).The number of pre-dialysis CECs was positively correlated with CCA-IMT in MHD patients(r=0.328,P<0.01).Multivariate analysis showed that CEC level was a strong independent risk factor of CCA-IMT. Conclusion InMHD patients, CEC level is associated with carotid atherosclerosis and may be used as a marker to evaluate the endothelial damage.

The predicting effects of ACE gene and PAI-I gene polymorphisms on CCA-IMT progression in newly diagnosed T2DM / 中国医师杂志

Objective The study was to investigate the relationship among angiotensin 1-converting enzyme(ACE), plasminogen activator inhibitor-1 (PAI-1)gene polymorphisms and the common carotid artery (CCA-IMT), and the predicting effects of them on CCA-IMT in newly diagnosed type 2 diabetes (T2DM). Methods The polymorphisms of ACE (I/D) gene and PAI-I (4G/5G) gene were deter-mined by polymemse chain reaction-restriction fragment length polymorphism (PCR-RFLP) and allele-specific polymerase chain reaction (AS-PCR) method in 308 cases with T2DM. CCA-IMT was compared among the groups with different genotypes of ACE and PAI-1. The in-dependent or synergistic effects of the ACE I/D and PAI-1 40/5G polymorphisms on CCA-IMT in 308 patients with T2DM were analyzed with multivariate linear regression. Then the 156 newly diagnosed type 2 diabetics (durations< I year) without AS received the maltifactorial targeted intervention, including taking aspirin and controlling blood glucose, blood pressure, blood lipid and body weight. The differences of metabolic control, ACE (I/D) and PAId (40/5G) gene polymorphisms were analyzed. Logistic regression analysis was used to analyze the eorrelation among the CCA-IMT, ACE (I/D) and PAI-1 (4G/5G) polymorphisms. Results Patients with ACE DD genotypes had higher CCA-IMT than those with ACE-Ⅱ or ACE ID genotypes. Patients with both ACE DD and PAI-1 404G genotypes had a higher CCA-IMT than those with any other pairs of genotypes. Multivariate linear regression analysis showed that ACE DD and PAI-1 4G4G gene polymorphisms had synergistic effect on the CCA-IMT in T2DM patients. After 2 years multifactorial intervention, the frequencies of PAI-1 4G alleles and 404G genotypas were lower than those in the CCA-IMT non-inereasing group. Conclusions These findings indicate that the ACE-DD geno-type and its synergistic effects with the PAI-1 4G/4G genotype are independent risk factors for the CCA-IMT in T2DM patients. Under multi-factorial intervention for 2 years, PAI-1 4G/4G genotype may be a negative predictor for the progression of CCA-IMT in T2DM patients.

Increased carotid intima-media thickness in hypertensive patients is caused by increased medial thickness / 대한내과학회지

BACKGROUNDS/AIMS: It has been suggested that there is a differential response of the vasculature to systemic risk factors for atherosclerosis. We sought to evaluate the impact of hypertension on the carotid arterial wall using new methods that can measure each arterial wall layer. METHODS: The study subjects consisted of 163 patients who underwent carotid arterial scanning using high-resolution ultrasound that could measure the left carotid intima-media, intima, and media separately. The individual carotid arterial wall thickness was measured off-line by a new method using the Canny edge-detection algorithm. RESULTS: Hypertensive patients (n=79, mean age 61.8 years) had a higher prevalence of diabetes (31.6% vs 11.9%, p=0.004) and a lower level of HDL-cholesterol than did normotensive patients (41.8+/-11.0 mg/dL vs 45.7+/-10.0 mg/dL, p=0.019). Hypertensive patients had higher carotid intima-media thickness (CIMT, 0.81+/-0.21 mm vs 0.74+/-0.18 mm, p=0.003) and carotid medial thickness (CMT, 0.46+/-0.12 mm vs 0.42+/-0.09 mm, p=0.007) than did normotensive patients, whereas carotid intimal thickness (CIT) was not significantly different (0.34+/-0.04 mm vs 0.34+/-0.04 mm, p=0.196). Multivariate analysis revealed that the independent factors of CIMT were CMT (beta=0.915, p<0.001), hypertension (beta=0.076, p=0.008), age (beta=0.074, p=0.010), and sex (beta=-0.079, p=0.005). Pearson correlation coefficient between CIMT and CMT was higher (r=0.932, p<0.001 vs r=0.445, p<0.001) than that between CIMT and CIT. The correlation between CIMT and CMT was higher (r=0.940, p<0.001 vs r=0.910, p<0.001) in hypertensive patients than in normotensive patients, whereas that between CIMT and CIT was lower (r=0.344, p=0.002 vs r=0.583, p<0.001) in hypertensive patients. CONCLUSIONS: The increased CIMT is caused by increased CMT in hypertensive patients, and this finding is compatible with the medial hypertrophy seen in hypertension. The carotid medial layer should be the focus of attention in future studies looking at hypertensive patients.

Carotid Intima Media Thickness is Associated with the Framingham Risk Score in Korean Patients with Coronary Arteriosclerosis: Association between IMT and Framingham Risk Score

BACKGROUND AND OBJECTIVES: Carotid intima media thickness (IMT) is associated with an increased risk of cardiovascular events whereas the Framingham risk score (FRS) is globally used to evaluate cardiovascular risk. We sought to evaluate the relationship between carotid IMT and FRS in Korean patients with coronary arteriosclerosis. SUBJECTS AND METHODS: The study population consisted of angiographically proven 267 consecutive patients with coronary arteriosclerosis (mean age 59 years, 141 males). Carotid IMT was measured by high-resolution ultrasound and semiautomatic methods. The FRS was derived from the algorithm published in the National Cholesterol Education Program Adult Treatment Panel III guidelines (NCEP-ATP III) using age, gender, smoking, systolic blood pressure level, use of antihypertensive treatment and total and high-density lipoprotein cholesterol levels. RESULTS: Carotid IMT correlated with the FRS in men (r=0.307, p<0.001) and in women (r=0.429, p<0.001). The severity of CAD, which was graded on the number of stenosed major coronary arteries more than 50%, showed a significant positive correlation with the FRS (r=0.266, p<0.001) and carotid IMT (r=0.166, p=0.007). The mean value of the FRS in patients with carotid plaque was higher than in patients without carotid plaque (15.0+/-3.9 and 12.0+/-4.4, p<0.001). The FRS was independently associated with carotid IMT in men and women (beta=6.433, p=0.001 and beta=11.271, p<0.001, respectively). CONCLUSION: The FRS for primary prevention was significantly associated with carotid IMT even in patients with CAD and also a correlation with the severity of CAD. The FRS may be helpful to predict the prognosis in patients with coronary arteriosclerosis such as carotid IMT and a prospective cohort study may be required to certify the usefulness of the FRS.

An early stage morphologic analysis for non-restrictive external stent to prevent vein graft failure / 中华胸心血管外科杂志

0.05; at 14 d,28 d, the thickness and area of the intiam in group S were smaller than those in group NS,P

Association of PAI-1 gene polymorphisms with the femoral artery intima-media thickness in patients with type 2 diabetes / 中国医师杂志

0.05).Conclusion The PAI-1 genotype perhaps may not be one of independent risk factors for both T2DM and FA-IMT in T2DM patients.