Immunohistochemical Features of Different Types of Unstable Atherosclerotic Plaques of Coronary Arteries.

We performed a complex morphological study of samples of different types of unstable atherosclerotic plaques obtained from 33 men with occlusive coronary atherosclerosis, who underwent coronary artery endarterectomy during coronary artery bypass surgery. In the samples, expression of MMP-2 and MMP-9, collagen IV, CD31, CD34, factor VIII, and actin of smooth muscle cells was evaluated by morphometric and immunohistochemical methods. The maximum expression of MMP-9 was found in unstable plaques of the lipid type, where it 1.4- and 1.24-fold surpassed the corresponding levels in plaques of the inflammatory-erosive and degenerative-necrotic types. Unstable plaques of the degenerative-necrotic type are characterized by the most intensive expression of collagen IV in comparison with plaques of the inflammatory-erosive and lipid types (by 2.8 and 2.2 times, respectively). The maximum neovascularization was detected in inflammatory-erosive plaques, which was confirmed by enhanced expression of CD31 and CD34 markers in comparison with plaques of the lipid (by 7.6 and 18.95 times, respectively) and degenerative-necrotic (by 31.1 and 39.8 times) types.

Immunohistochemical Phenotypes of Stable and Unstable Occlusive Atherosclerotic Plaques in Coronary Arteries.

We performed a complex morphological analysis of atherosclerotic plaques obtained from 68 men with coronary atherosclerosis during coronary bypass surgery with endarterectomy. The expression of MMP-2 and MMP-9, collagen IV, CD31, CD34, factor VIII, and of smooth muscle cell actin was measured in the samples by morphometric and immunohistochemical methods. The expression of MMP-2 and MMP-9 as well as the intensity of neoangiogenesis estimated by the expression of CD31, CD34, and factor VIII in unstable plaques was significantly higher than in stable ones. Immunohistochemical analysis showed more intensive collagen IV expression in stable plaques. The observed differences in immunohistochemical phenotypes of stable and unstable atherosclerotic plaques reflect peculiarities of morphogenesis of atherosclerotic foci in the coronary arteries determining their further development.

[Changes of Content of Matrix Metalloproteinases and Their Tissue Expression in Various Types of Atherosclerotic Plaques].

AIM: to investigate diagnostically significant for atherosclerotic plaques (ASP) of various types parameters of activity of matrix metalloproteinases (MMP-3, MMP-7, MMP-9) in homogenates, as well as tissue expression of MMP-2, MMP-9 and collagen type IV. MATERIALS AND METHODS: We included in this study 54 men with coronary atherosclerosis without acute coronary syndrome who underwent coronary artery bypass surgery with endarterectomy. In the obtained samples we determined levels of MMP-3, MMP-7, and MMP-9 (by enzyme immunoassay), as well as tissue expression of antibodies to MMP-2, MMP-9 and collagen type IV. RESULTS: In unstable plaques we observed increased activity of MMP-7 and MMP-9, significant increase of tissue expression of MMP-2 and MMP-9, and decreased expression of type IV collagen. Of three types of unstable ASP the highest tissue expression of MMP-9 was found in plaques of lipid type compared with plaques of necrotic and inflammatory-erosive types. Expression of type IV collagen predominated in plaques of necrotic type. CONCLUSION: The data obtained allows us to speak about tissue expression of collagen as the marker of fibrous cap stability; the presence of metalloproteinases in necrotic detritus, collagen fibers, and cellular elements can characterize an ASP as unstable or being in the transitional structural state. The immunohistochemical method helps to detect structural elements that characterize instability in various types of ASP.

Ultrastructural and metabolic features of stress-adaptive rearrangements of myocardium in infants after surgery-induced up-regulation of lipoperoxidation processes.

Surgical correction of complicated congenital heart disease in infants is terminated by postischemic reperfusion of myocardium accompanied with closure of more than 20% microvessels in the coronary bed by edematous endothelial cells, their bleb-like fragments, and aggregates of the blood formed elements. Degradation of the transmission capacity of the coronary microvessels developed in parallel with moderation of activity of the antiradical protection enzymes and positively correlated with the level of LPO secondary products, whose elevation during the surgery stages was not reduced by catalase activation.

[Gender peculiarities of development of atherosclerosis and impairment of brain oxygen supply in excessive body weight].

Aim of the given study was to elucidate special characteristics of mechanisms of development of atherosclerosis and supply of oxygen to the brain in overweight men and women. We included into this study 80 patients with multifocal atherosclerosis without history of myocardial infarction. We analyzed parameters of blood lipid composition, data of cerebral oxymetry, echocardiography, and central hemodynamics. We found gender linked differences in structural-functional parameters of myocardium and in mechanisms of progression of atherosclerosis which increased with increase of excess body weight. This was associated with differences in oxygen brain supply between men and women.

[Heart failure and imbalance of chemical elements in myocardium of patients with ishemic heart disease].

Tissue content of chemical elements indirectly characterizes some metabolic processes. We have analyzed content of chemical elements in left and right ventricular myocardium of patients with ischemic heart disease with progressing heart failure and have shown that during development and progression of heart failure metabolic processes have unidirectional character in myocardium of both ventricles. Derangement of left ventricular contractile capacity is associated with lowering of content of microelements involved in antioxidant processes and energy metabolism in tissues (Cu, Mn, Cr) and elevated concentration of elements characterizing progressive of myocardial stiffness (Ca, Fe).

Structural and molecular reorganization of cardiomyocytes in transposition of the main vessels.

Studies of myocardial autopsy specimens from infants (0-12 months) with transposition of the main vessels showed the formation of a complex of compensatory adaptive, degenerative, and destructive changes, manifesting at a tissue level in cardiomyocyte heterogeneity and formation of cardiosclerosis zones. Cardiac myosin synthesis was replaced by synthesis of skeletal myosin, which was detected at the molecular level. Clinically it manifested in the progress of heart failure. Hyperplastic processes (intensive polyploid transformation of the nuclei) play an important role in heart remodeling in patients aged over 6 months. The findings of immunohistochemical and fluorescent studies seem to be prognostically important and provide more accurate data on the pathological processes in the myocardium at the initial stages of heart disease development starting from birth.

[Distribution of chemical elements in various parts of the heart of patients with acute heart failure].

By the method of autopsy in patients with ischemic heart disease (IHD) who died of acute heart failure we took samples of myocardium from 6 parts of the heart: left and right atrium, left and right ventricle, region of myocardial infarction, and scar of the left ventricle. Simultaneously we conducted histological study of these parts of myocardium. For the control we investigated content of chemical elements in myocardium of healthy victims of traffic accidents. By the method of roentgen fluorescent analysis with the use of synchrotron emission we detected content of 17 chemical elements: 4 macroelements (S, Cl, K, Ca) and 13 microelements (Cr, Mn, Fe, Ni, Cu, Zn, Se, Br, Rb, Sr, As, Mo, Hg). It was established that in patients with IHD who had died of acute heart failure content of Ca was elevated 4-8 fold in all parts of the heart. In infarction zone compared with other regions of the heart maximal quantity of Sr, Cr, Hg was contained. These elements can be looked upon as markers of infarction. In myocardium of patients with IHD especially in the zone of infarction elevation of activity of processes of lipid peroxidaton has been noted (calculated activity of malone aldehyde as example).

Anatomical variants of transposition of the main vessels and their relationship with the content of chemical elements in heart ventricles.

Cardiometrical characteristics of anatomical variants of the main vessels transposition are determined by different functional load of heart compartments and are associated with metabolic processes of different intensity, which is confirmed by the content of chemical elements in the right- and left-ventricular myocardium. It was shown that the content of chemicals was virtually the same in both cardiac ventricles in case of main vessels transposition and isolated atrial septal defect. Positive correlations between the degree of left-ventricular hypertrophy and content of S, K, Fe, and Sr in it and a negative correlation between this hypertrophy and Cu content were revealed. Transposition of the main vessels and defects of atrial and ventricular septa were associated with different levels of chemical elements in both ventricles, particularly of Zn, Mn, Fe, and Ca.