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1.
Kardiologiia ; 61(7): 79-84, 2021 Jul 31.
Artigo em Russo | MEDLINE | ID: mdl-34397345

RESUMO

This review addresses morphological changes in coronary arteries following stenting, which result from damage to the vascular wall. These changes include 1) formation of a thrombus in the site of intimal injury; 2) inflammation; 3) proliferation and migration of smooth muscle cells; 4) formation of extracellular matrix. Each of these pathological processes has specific morpho-biological features. The review shows the role of von Willebrand factor in development of early thrombosis after intimal injury, which provokes activation of the inflammatory response followed by proliferation of smooth muscle cell that synthetize the extracellular matrix. These cellular and intercellular changes are based on overexpression of TGF-ß1 protein, which facilitates modulation of various types of smooth muscle cells, including contractile and secretory ones. Issues of fine regulation of cellular and intercellular interactions by apoptosis, activation of mTOR signaling molecules, and microRNA are still understudied. Dynamic changes in drug-coated stents during development of neoatherosclerosis and late thrombosis remain not elucidated. Current reports show that initial mechanisms triggering pathological regenerative and hyperplastic processes that result in coronary restenosis in the area of implanted stents may form early (first hours or days) after stenting. Most studies were performed on experimental rather than on autopsy material, which does not allow fully unbiased interpretation of obtained data. Studying dynamics of morphological and molecular changes in coronary arteries after stenting, including on autopsy material, will allow one to express an opinion on the risk of postoperative thrombosis and restenosis.


Assuntos
Reestenose Coronária , Stents Farmacológicos , Reestenose Coronária/etiologia , Vasos Coronários/patologia , Vasos Coronários/cirurgia , Humanos , Hiperplasia/patologia , Stents/efeitos adversos
2.
Int J Mol Sci ; 22(15)2021 Jul 31.
Artigo em Inglês | MEDLINE | ID: mdl-34361033

RESUMO

Apolipoprotein E (ApoE), an essential plasma apolipoprotein, has three isoforms (E2, E3, and E4) in humans. E2 is associated with type III hyperlipoproteinemia. E4 is the major susceptibility gene to Alzheimer's disease (AD) and coronary heart disease (CHD). We investigated lipid metabolism and atherosclerotic lesions of novel humanized ApoE knockin (hApoE KI) rats in comparison to wide-type (WT) and ApoE knockout (ApoE KO) rats. The hApoE2 rats showed the lowest bodyweight and white fat mass. hApoE2 rats developed higher serum total cholesterol (TC), total triglyceride (TG), and low- and very low density lipoprotein (LDL-C&VLDL-C). ApoE KO rats also exhibited elevated TC and LDL-C&VLDL-C. Only mild atherosclerotic lesions were detected in hApoE2 and ApoE KO aortic roots. Half of the hApoE2 rats developed hepatic nodular cirrhosis. A short period of the Paigen diet (PD) treatment led to the premature death of the hApoE2 and ApoE KO rats. Severe vascular wall thickening of the coronary and pulmonary arteries was observed in 4-month PD-treated hApoE4 rats. In conclusion, hApoE2 rats develop spontaneous hyperlipidemia and might be suitable for studies of lipid metabolism-related diseases. With the PD challenge, hApoE4 KI rats could be a novel model for the analysis of vascular remodeling.


Assuntos
Apolipoproteínas E/genética , Aterosclerose/genética , Hiperlipidemias/genética , Metabolismo dos Lipídeos , Cirrose Hepática/genética , Animais , Apolipoproteínas E/metabolismo , Colesterol/sangue , Vasos Coronários/metabolismo , Vasos Coronários/patologia , Técnicas de Introdução de Genes , Humanos , Lipoproteínas LDL/sangue , Masculino , Artéria Pulmonar/metabolismo , Artéria Pulmonar/patologia , Ratos , Ratos Sprague-Dawley , Triglicerídeos/sangue , Remodelação Vascular
3.
J Am Coll Cardiol ; 78(1): 27-38, 2021 07 06.
Artigo em Inglês | MEDLINE | ID: mdl-34210411

RESUMO

BACKGROUND: The benefit of optimal medical therapy (OMT) on 5-year outcomes in patients with 3-vessel disease and/or left main disease after percutaneous coronary intervention or coronary artery bypass grafting (CABG) was demonstrated in the randomized SYNTAX (Synergy Between PCI With Taxus and Cardiac Surgery) trial. OBJECTIVES: The objective of this analysis is to assess the impact of the status of OMT at 5 years on 10-year mortality after percutaneous coronary intervention or CABG. METHODS: This is a subanalysis of the SYNTAXES (Synergy Between PCI With Taxus and Cardiac Surgery Extended Survival) study, which evaluated for up to 10 years the vital status of patients who were originally enrolled in the SYNTAX trial. OMT was defined as the combination of 4 types of medications: at least 1 antiplatelet drug, statin, angiotensin-converting enzyme inhibitor/angiotensin receptor blocker, and beta-blocker. After stratifying participants by the number of individual OMT agents at 5 years and randomized treatment, a landmark analysis was conducted to assess the association between treatment response and 10-year mortality. RESULTS: In 1,472 patients, patients on OMT at 5 years had a significantly lower mortality at 10 years compared with those on ≤2 types of medications (13.1% vs 19.9%; adjusted HR: 0.470; 95% CI: 0.292-0.757; P = 0.002) but had a mortality similar to those on 3 types of medications. Furthermore, patients undergoing CABG with the individual OMT agents, antiplatelet drug and statin, at 5 years had lower 10-year mortality than those without. CONCLUSIONS: In patients with 3-vessel and/or left main disease undergoing percutaneous coronary intervention or CABG, medication status at 5 years had a significant impact on 10-year mortality. Patients on OMT with guideline-recommended pharmacologic therapy at 5 years had a survival benefit. (Synergy Between PCI With Taxus and Cardiac Surgery: SYNTAX Extended Survival [SYNTAXES]; NCT03417050; Taxus Drug-Eluting Stent Versus Coronary Artery Bypass Surgery for the Treatment of Narrowed Arteries [SYNTAX]; NCT00114972).


Assuntos
Antagonistas Adrenérgicos beta/administração & dosagem , Antagonistas de Receptores de Angiotensina/administração & dosagem , Inibidores da Enzima Conversora de Angiotensina/administração & dosagem , Ponte de Artéria Coronária , Doença da Artéria Coronariana , Inibidores de Hidroximetilglutaril-CoA Redutases/administração & dosagem , Intervenção Coronária Percutânea , Inibidores da Agregação Plaquetária/administração & dosagem , Ponte de Artéria Coronária/efeitos adversos , Ponte de Artéria Coronária/métodos , Doença da Artéria Coronariana/diagnóstico , Doença da Artéria Coronariana/tratamento farmacológico , Doença da Artéria Coronariana/mortalidade , Doença da Artéria Coronariana/cirurgia , Vasos Coronários/diagnóstico por imagem , Vasos Coronários/patologia , Vasos Coronários/cirurgia , Quimioterapia Combinada/métodos , Quimioterapia Combinada/estatística & dados numéricos , Stents Farmacológicos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Mortalidade , Intervenção Coronária Percutânea/efeitos adversos , Intervenção Coronária Percutânea/instrumentação , Intervenção Coronária Percutânea/métodos , Período Pós-Operatório , Resultado do Tratamento
4.
J Cardiothorac Surg ; 16(1): 177, 2021 Jun 19.
Artigo em Inglês | MEDLINE | ID: mdl-34147120

RESUMO

BACKGROUND: Coronary artery aneurysms are rare findings in patients undergoing coronary angiography. The presence of multiple coronary artery aneurysms located in more than one coronary artery is even more uncommon. The pathophysiology of such aneurysms is unknown, but the majority are often due to atherosclerosis, congenital heart disease, or vasculitis. CASE PRESENTATION: We present a rare case of a 78-year-old female patient who presented with unstable angina and non-ST segment elevation myocardial infarction. On coronary angiography, she was found to have three separate 1 cm saccular aneurysms involving the proximal left anterior descending coronary artery. The right coronary artery could not be visualized. Computed chest tomography revealed a 6.6 × 6.3 cm saccular aneurysm of the right coronary artery, and a 4.4 cm fusiform aneurysm of the ascending aorta. The patient gave no history of percutaneous coronary intervention or cardiac surgical procedures. She had a previous history of endovascular stenting of an abdominal aortic aneurysm. The sizable right coronary artery aneurysm showed extrinsic compression of both the right atrium and ventricle with right ventricular hypokinesis. Serological studies for vasculitis were all negative. Pathology of the aneurysm wall revealed calcific atherosclerosis without evidence of vasculitis. The patient underwent subtotal resection of the right coronary aneurysm with ligation of the proximal and distal ends of the right coronary artery and double bypass surgery to the left anterior descending and right posterior descending coronary arteries. CONCLUSION: The presence of multiple, large coronary artery aneurysms is very rare. Treatment can be challenging and should be individualized. Surgical treatment is recommended for giant coronary artery aneurysms to prevent potential complications.


Assuntos
Aneurisma Coronário/cirurgia , Vasos Coronários/diagnóstico por imagem , Idoso , Procedimentos Cirúrgicos Cardíacos , Aneurisma Coronário/diagnóstico por imagem , Angiografia Coronária , Vasos Coronários/patologia , Feminino , Humanos , Tomografia Computadorizada por Raios X
6.
Methods Mol Biol ; 2275: 49-64, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34118031

RESUMO

We have previously reported that radiolabeled phosphonium cations accumulate in the mitochondria down a transmembrane potential gradient. We present an optimized procedure for synthesis of three [18F]-labeled fluoroalkyl triphenylphosphonium salts ([18F]FATPs) via two-step simple nucleophilic substitution reactions to develop new myocardial imaging agents for positron emission tomography (PET) . The total reaction time of [18F]FATPs was within 60 min, and the overall decay-corrected radiochemical yield was approximately 15-30% (decay corrected). Radiochemical purity was >98% according to analytical high-performance liquid chromatography (HPLC) . The specific activity of [18F]FATPs was >6.1 TBq/µmol. The [18F]FATPs exhibited higher first-pass extraction fraction values in isolated heart, higher uptake in the myocardium, and a more rapid clearance from the liver and lung than [13N]NH3 in normal rats. The images from rats with an occluded left coronary artery demonstrated sharply defined myocardial defects in the corresponding area of the myocardium. This imaging technology may enable high-throughput, multiple studies daily and wide distribution of PET myocardial studies in clinic.


Assuntos
Arteriopatias Oclusivas/diagnóstico por imagem , Vasos Coronários/diagnóstico por imagem , Radioisótopos de Flúor/química , Coração/diagnóstico por imagem , Compostos Organofosforados/síntese química , Compostos Radiofarmacêuticos/química , Animais , Cromatografia Líquida de Alta Pressão , Vasos Coronários/patologia , Modelos Animais de Doenças , Vias de Eliminação de Fármacos , Masculino , Mitocôndrias Cardíacas/metabolismo , Compostos Organofosforados/administração & dosagem , Compostos Organofosforados/química , Compostos Organofosforados/farmacocinética , Tomografia por Emissão de Pósitrons , Ratos , Sais/administração & dosagem , Sais/síntese química , Sais/química
8.
Nutrients ; 13(6)2021 May 22.
Artigo em Inglês | MEDLINE | ID: mdl-34067500

RESUMO

BACKGROUND: Sugar-sweetened beverage (SSB) intake is associated with higher risk of weight gain, diabetes, hypertension, cardiovascular disease, and cardiovascular mortality. However, the association of SSB with subclinical atherosclerosis in the general population is unknown. OBJECTIVE: Our primary objective was to investigate the association between SSB intake and prevalence of atherosclerotic plaque in the coronary arteries in The National Heart, Lung, and Blood Institute (NHLBI) Family Heart Study. METHODS: We studied 1991 participants of the NHLBI Family Heart Study without known coronary heart disease. Intake of SSB was assessed through a semi-quantitative food frequency questionnaire. Coronary artery calcium (CAC) was measured by cardiac Computed Tomography (CT) and prevalent CAC was defined as an Agatston score ≥100. We used generalized estimating equations to calculate adjusted prevalence ratios of CAC. A sensitivity analysis was also performed at different ranges of cut points for CAC. RESULTS: Mean age and body mass index (BMI) were 55.0 years and 29.5 kg/m2, respectively, and 60% were female. In analysis adjusted for age, sex, BMI, smoking, alcohol use, physical activity, energy intake, and field center, higher SSB consumption was not associated with higher prevalence of CAC [prevalence ratio (95% confidence interval) of: 1.0 (reference), 1.36 (0.70-2.63), 1.69 (0.93-3.09), 1.21 (0.69-2.12), 1.05 (0.60-1.84), and 1.58 (0.85-2.94) for SSB consumption of almost never, 1-3/month, 1/week, 2-6/week, 1/day, and ≥2/day, respectively (p for linear trend 0.32)]. In a sensitivity analysis, there was no evidence of association between SSB and prevalent CAC when different CAC cut points of 0, 50, 150, 200, and 300 were used. CONCLUSIONS: These data do not provide evidence for an association between SSB consumption and prevalent CAC in adult men and women.


Assuntos
Doença da Artéria Coronariana/epidemiologia , Placa Aterosclerótica/epidemiologia , Bebidas Adoçadas com Açúcar/efeitos adversos , Calcificação Vascular/epidemiologia , Adulto , Idoso , Aterosclerose/epidemiologia , Cálcio/metabolismo , Vasos Coronários/patologia , Estudos Transversais , Ingestão de Energia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , National Heart, Lung, and Blood Institute (U.S.) , Inquéritos Nutricionais , Prevalência , Fatores de Risco , Fumar , Estados Unidos
9.
Nat Commun ; 12(1): 3447, 2021 06 08.
Artigo em Inglês | MEDLINE | ID: mdl-34103494

RESUMO

Congenital heart disease (CHD) is the most common class of human birth defects, with a prevalence of 0.9% of births. However, two-thirds of cases have an unknown cause, and many of these are thought to be caused by in utero exposure to environmental teratogens. Here we identify a potential teratogen causing CHD in mice: maternal iron deficiency (ID). We show that maternal ID in mice causes severe cardiovascular defects in the offspring. These defects likely arise from increased retinoic acid signalling in ID embryos. The defects can be prevented by iron administration in early pregnancy. It has also been proposed that teratogen exposure may potentiate the effects of genetic predisposition to CHD through gene-environment interaction. Here we show that maternal ID increases the severity of heart and craniofacial defects in a mouse model of Down syndrome. It will be important to understand if the effects of maternal ID seen here in mice may have clinical implications for women.


Assuntos
Sistema Cardiovascular/embriologia , Embrião de Mamíferos/patologia , Ferro/deficiência , Animais , Aorta Torácica/anormalidades , Biomarcadores/metabolismo , Diferenciação Celular , Vasos Coronários/embriologia , Vasos Coronários/patologia , Suplementos Nutricionais , Edema/patologia , Embrião de Mamíferos/anormalidades , Desenvolvimento Embrionário , Feminino , Perfilação da Expressão Gênica , Interação Gene-Ambiente , Proteínas de Fluorescência Verde/metabolismo , Ferro/metabolismo , Vasos Linfáticos/embriologia , Vasos Linfáticos/patologia , Camundongos Endogâmicos C57BL , Miocárdio/patologia , Miócitos Cardíacos/metabolismo , Miócitos Cardíacos/patologia , Penetrância , Fenótipo , Gravidez , Transdução de Sinais , Células-Tronco/patologia , Transgenes , Tretinoína/metabolismo
10.
Am J Med ; 134(9): 1091-1095, 2021 09.
Artigo em Inglês | MEDLINE | ID: mdl-34019857

RESUMO

In 2018, cardiovascular society cholesterol guidelines recommended the use of coronary artery calcium to guide statin therapy in patients 40-79 years of age who are at intermediate risk by multiple risk factor equations (ie, estimated 10-year risk for atherosclerotic disease of 7.5%-19.9% but in whom statin benefit is uncertain). Many such patients have no coronary calcium and remain at <5% risk over the next decade; hence, statin therapy can be delayed until a repeat calcium scan is conducted. Exceptions include patients with severe hypercholesterolemia, diabetes, and a strong family history of atherosclerotic disease. If coronary calcium equals 1-99 Agatston units, the 10-year risk is borderline (5% to <7.5%) and statin therapy is optional pending a repeat scan. If coronary calcium equals 100-299 Agatston units, the patient is clearly statin eligible (7.5% to <20% 10-year risk). And finally, if coronary calcium is ≥300 Agatston units, a patient is at high risk and is a candidate for high-intensity statins. Risk factor analysis combined judiciously with coronary calcium scanning offers the strongest evidence-based approach to use of statins in primary prevention.


Assuntos
Doença da Artéria Coronariana , Vasos Coronários/patologia , Inibidores de Hidroximetilglutaril-CoA Redutases/farmacologia , Calcificação Vascular , Doença da Artéria Coronariana/diagnóstico , Doença da Artéria Coronariana/metabolismo , Doença da Artéria Coronariana/prevenção & controle , Prática Clínica Baseada em Evidências , Humanos , Seleção de Pacientes , Prevenção Primária/métodos , Calcificação Vascular/diagnóstico por imagem , Calcificação Vascular/prevenção & controle
11.
Mayo Clin Proc ; 96(7): 1822-1834, 2021 07.
Artigo em Inglês | MEDLINE | ID: mdl-33992454

RESUMO

OBJECTIVE: To define the diagnostic yield of cardiac magnetic resonance (CMR) in differentiating the underlying causes of myocardial infarction with nonobstructive coronary arteries (MINOCA) and to determine the long-term prognostic implications of such diagnoses. METHODS: Cardiac magnetic resonance evaluation was performed in 227 patients (mean age, 56.4±14.9 years; 120 [53%] female) with a "working diagnosis" of MINOCA as defined by presentation with a troponin-positive acute coronary syndrome (troponin I >0.04 µg/L) and nonobstructed coronary arteries between January 1, 2007, and February 28, 2013. Follow-up was performed to assess the primary composite end point of myocardial infarction, heart failure, and all-cause mortality. RESULTS: Cardiac magnetic resonance identified nonstructural cardiomyopathies in 97 (43%) patients, myocardial infarction in 55 (24%) patients, structural cardiomyopathies in 27 (12%) patients, and pulmonary embolism in 1 patient. No CMR abnormalities were identified in the remaining patients. Kaplan-Meier analysis demonstrated the ability of a CMR diagnosis to predict the risk of the primary composite end point (P=.005) at 5-year follow-up. Worse outcomes were seen among patients with "true" MINOCA and a normal CMR image compared with those with CMR-confirmed myocardial infarction (P=.02). Use of antiplatelets (78% [37/45] vs 95% [52/55]; P=.01), beta blockers (56% [25/45] vs 82% [45/55]; P=.004), and statins (64% [29/45] vs 85% [47/55]; P=.01) was significantly lower in patients with true MINOCA with normal CMR imaging compared with those with CMR-confirmed myocardial infarction. CONCLUSIONS: Cardiac magnetic resonance carries a high diagnostic yield in patients with MINOCA and predicts long-term prognosis. Patients with MINOCA with normal CMR imaging had an increased rate of major adverse cardiac events and lower use of guideline-recommended myocardial infarction therapy compared with those with CMR-confirmed myocardial infarction.


Assuntos
Síndrome Coronariana Aguda/diagnóstico , Cardiomiopatias , Vasos Coronários , Imagem Cinética por Ressonância Magnética/métodos , Infarto do Miocárdio , Troponina/sangue , Cardiomiopatias/complicações , Cardiomiopatias/diagnóstico , Cardiomiopatias/epidemiologia , Angiografia Coronária/métodos , Vasos Coronários/diagnóstico por imagem , Vasos Coronários/patologia , Feminino , Seguimentos , Insuficiência Cardíaca/complicações , Insuficiência Cardíaca/diagnóstico , Insuficiência Cardíaca/epidemiologia , Humanos , Estimativa de Kaplan-Meier , Masculino , Pessoa de Meia-Idade , Mortalidade , Infarto do Miocárdio/diagnóstico , Infarto do Miocárdio/etiologia , Infarto do Miocárdio/mortalidade , Valor Preditivo dos Testes , Prognóstico , Medição de Risco/métodos
12.
Am Heart J ; 239: 129-134, 2021 09.
Artigo em Inglês | MEDLINE | ID: mdl-34051172

RESUMO

BACKGROUND: Several recent trials have evaluated invasive versus medical therapy for stable ischemic heart disease. Importantly, patients with significant left main coronary stenosis (LMCS) were excluded from these trials. In the ISCHEMIA trial, these patients were identified by a coronary CT angiogram (CCTA), which adds time, expense, and contrast exposure. We tested whether a coronary artery calcium scan (CACS), a simpler, less expensive test, could replace CCTA to exclude significant LMCS. METHODS: We hypothesized that patients with ≥50% LMCS would have a LM CACS score > 0. As a corollary, we postulated that a LM CACS = 0 would exclude patients with LMCS. To test this, we searched Intermountain Healthcare's electronic medical records database for all adult patients who had undergone non-contrast cardiac CT for quantitative CACS scoring prior to invasive coronary angiography (ICA). Patients aged <50 and those with a heart transplant were excluded. Cases with incomplete (qualitative) angiographic reports for LMCS and those with incomplete or discrepant LM CACS results were reviewed and reassessed blinded to CACS or ICA findings, respectively. RESULTS: Among 669 candidate patients with CACS followed by ICA, 36 qualifying patients were identified who had a quantitative CACS score and LMCS ≥ 50%. Their age averaged 71.8 years, and 81% were men. Angiographic LMCS averaged 72% (range 50%-99%). Median time between CACS and ICA was 6 days. Total CACS score averaged 2,383 Agatston Units (AU), range 571-6,636. LM CACS score averaged 197 AU, range 31-610. Importantly, no LMCS patient had a LM CACS score of 0 vs 57% (362/633) of non-LMCS controls (P < .00001). CONCLUSIONS: Our results support the hypothesis that an easily administered, inexpensive, low radiation CACS can identify a large subset of patients with a very low risk of LMCS who would not have the need for routine CCTA. Using CACS to exclude LMCS may efficiently allow for safe implementation of an initial medical therapy strategy of patients with stable ischemic heart disease in clinical practice. These promising results deserve validation in larger data sets.


Assuntos
Angiografia Coronária/métodos , Vasos Coronários , Tomografia Computadorizada por Raios X/métodos , Calcificação Vascular/diagnóstico por imagem , Idoso , Algoritmos , Pesquisa Comparativa da Efetividade , Doença da Artéria Coronariana/diagnóstico , Vasos Coronários/diagnóstico por imagem , Vasos Coronários/patologia , Análise Custo-Benefício , Registros Eletrônicos de Saúde/estatística & dados numéricos , Feminino , Humanos , Masculino , Estudos Observacionais como Assunto , Avaliação de Processos e Resultados em Cuidados de Saúde , Medição de Risco/economia , Medição de Risco/métodos
13.
Int Heart J ; 62(3): 682-686, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34054003

RESUMO

Usage of an optimal guide extension catheter often helps successful outcomes in complex percutaneous coronary intervention. Here, we report a case of successfully retrieving a guide extension catheter entrapped by a coronary stent in the middle RCA. The guide extension catheter was retrieved by anchoring with the stent delivery balloon. Also, our in vitro experiment demonstrated that a "deep seating method" and an "anchoring guide extension catheter method" could be effective in bailing out guide extension catheter entrapment.


Assuntos
Reestenose Coronária/cirurgia , Vasos Coronários/patologia , Intervenção Coronária Percutânea/efeitos adversos , Stents/efeitos adversos , Idoso de 80 Anos ou mais , Angioplastia Coronária com Balão/efeitos adversos , Angioplastia Coronária com Balão/métodos , Calcinose/cirurgia , Cateteres/efeitos adversos , Angiografia Coronária/métodos , Doença da Artéria Coronariana/diagnóstico , Doença da Artéria Coronariana/cirurgia , Vasos Coronários/diagnóstico por imagem , Vasos Coronários/cirurgia , Remoção de Dispositivo/métodos , Humanos , Masculino , Intervenção Coronária Percutânea/métodos , Resultado do Tratamento
14.
Biomed Res Int ; 2021: 8127873, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33969126

RESUMO

Objective: To study the correlation between occupational stress and coronary heart disease in western China. Method: A case-control design was used. From June 2016 to May 2017, 310 patients with coronary heart disease (CHD) confirmed by coronary angiography (CAG) at the Heart Center of the First Affiliated Hospital of Xinjiang Medical University were recruited by cluster sampling, along with 536 healthy controls. The questionnaire was developed based on a Job Content Questionnaire (JCQ). An epidemiological survey was conducted to collect clinical data. Chi-squared test, analysis of variance, and binary logistic regression analysis were adopted. Results: (1) In the Han population, there were statistically significant differences in the composition of smoking, diets, sleep duration, sleep quality, and physical activity between two groups (all P < 0.05). In the Uygur population, statistically significant differences in the composition of smoking, drinking, diets, sleep quality, and physical activity were found between two groups (all P < 0.05). (2) Differences in sleep duration and physical activity between the Han and Uygur case groups were statistically significant (P < 0.05). (3) Differences in Gensini scores between the Han and Uygur case groups were statistically significant (P < 0.05). Differences in coronary artery lesions between the Han and Uygur case groups were statistically significant (P < 0.05). (4) In the Uygur population, the difference between the occupational stress level and CHD were statistically significant (P < 0.05). (5) The differences between the number of different pathological changes and the level of occupational stress in the Han and Uygur case groups were not statistically significant (P > 0.05). In the Han and Uygur case groups, the difference between the occupational stress level and Gensini high-level group were statistically significant (P < 0.05). (6) After adjustment for age and sex, significant increased risk effects for Han patients with CHD were found to be associated with sleep quality (OR = 1.88; 95% CI: 1.047-1.782; P < 0.05). Uygur patients with CHD was significantly associated with smoking (OR = 3.094; 95% CI: 1.025-1.103; P < 0.05) and occupation stress (OR = 1.523; 95% CI: 1.757-3.062; P < 0.05). Conclusion: Occupational stress is correlated with CHD for the Uygur population.


Assuntos
Doença das Coronárias/epidemiologia , Doença das Coronárias/etiologia , Estresse Ocupacional/complicações , Adulto , Estudos de Casos e Controles , China/epidemiologia , Vasos Coronários/patologia , Grupos Étnicos , Feminino , Humanos , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Fatores de Risco
15.
Am J Forensic Med Pathol ; 42(3): 307-310, 2021 Sep 01.
Artigo em Inglês | MEDLINE | ID: mdl-33833196

RESUMO

ABSTRACT: Atherosclerotic cardiovascular disease (ASCVD) is often investigated by medical examiners as a cause of sudden death. Because of the variation in presentation of atherosclerotic cardiovascular disease, the examiner must be cautious when assigning a final diagnosis. The presented case depended upon histologic examination of coronary artery lesions to reach an appropriate final diagnosis of vasculitis with mixed features. Autopsy findings showed hepatosplenic vasculitis with noncaseating granulomas, and multifocal diffuse coronary fibrosis with histologic findings consistent with late-stage polyarteritis nodosa (PAN). However, the patient lacked the hallmark renal involvement observed in PAN. Furthermore, the vasculitis within the liver showed a highly granulomatous appearance, more consistent with IgG4 disease. In these mixed-appearance cases with limited history, exact categorization of the disease may prove difficult to impossible. Herein, we review a differential diagnosis of classic vasculitides with a focus on those that commonly affect the coronary arteries in adults, namely, PAN.


Assuntos
Vasos Coronários/patologia , Vasculite/diagnóstico , Idoso , Parada Cardíaca/etiologia , Humanos , Fígado/patologia , Masculino , Baço/patologia
16.
Aging (Albany NY) ; 13(8): 12239-12257, 2021 04 19.
Artigo em Inglês | MEDLINE | ID: mdl-33872218

RESUMO

Endothelial dysfunction, and the differentiation of smooth muscle cells (SMCs) into proliferative, secretory phenotypes, are two major pathophysiological processes in atherosclerosis. SMCs have the potential to recruit macrophages in atherosclerotic plaques, in which macrophages drive inflammatory responses. In this study, we found that microRNA-503-5p (miR-503-5p) was enriched in either extracellular vesicles (EVs), secreted by oxidized low-density lipoprotein-treated macrophages, or the EVs from peripheral blood mononuclear cells of atherosclerosis patients. miR-503-5p was transferred intercellularly from macrophages to the co-cultured human coronary artery endothelial cells (HCAECs) and HCASMCs via EVs, thus reducing the proliferative and angiogenic abilities of HCAECs and accelerating the proliferative and migrating abilities of HCASMCs. Smad family members 1, 2 and 7 were negatively regulated by miR-503-5p in HCAECs and HCASMCs. miR-503-5p was verified as an enhancer of inflammatory cytokines and adhesion molecules released by macrophages, in part via the down-regulation of smad family members 1, 2 and 7. The inhibition of miR-503-5p by lentivirus reduced atherosclerotic lesion formations in the aorta of atherosclerotic mice. Our work demonstrated a miR-503-5p- and EV-mediated mechanism for macrophage communication with HCAECs and HCASMCs in atherosclerosis. miR-503-5p is pro-atherosclerotic stimuli that may be a therapeutic target for atherosclerosis treatment.


Assuntos
Aterosclerose/imunologia , Comunicação Celular/genética , Vesículas Extracelulares/metabolismo , Macrófagos/imunologia , MicroRNAs/metabolismo , Adulto , Animais , Aterosclerose/sangue , Aterosclerose/genética , Aterosclerose/patologia , Comunicação Celular/imunologia , Movimento Celular/genética , Movimento Celular/imunologia , Proliferação de Células/genética , Técnicas de Cocultura , Vasos Coronários/citologia , Vasos Coronários/patologia , Modelos Animais de Doenças , Células Endoteliais/citologia , Células Endoteliais/imunologia , Células Endoteliais/metabolismo , Endotélio Vascular/citologia , Endotélio Vascular/patologia , Feminino , Humanos , Leucócitos Mononucleares/citologia , Leucócitos Mononucleares/metabolismo , Lipoproteínas LDL/imunologia , Macrófagos/citologia , Macrófagos/metabolismo , Masculino , Camundongos , Camundongos Knockout para ApoE , Pessoa de Meia-Idade , Miócitos de Músculo Liso , Cultura Primária de Células , Células RAW 264.7 , Células THP-1
17.
Medicine (Baltimore) ; 100(14): e25378, 2021 Apr 09.
Artigo em Inglês | MEDLINE | ID: mdl-33832124

RESUMO

INTRODUCTION: Multimodality assessment of coronary artery lesions has demonstrated superior effectiveness compared to the conventional approach, for assessing both anatomical and functional significance of a coronary stenosis. Multiple imaging modalities can be integrated into a fusion imaging tool to better assess myocardial ischemia. MATERIAL AND METHODS: The FUSE-HEART trial is a single center, prospective, cohort study that will assess the impact of a coronary artery stenosis on myocardial function and viability, based on advanced fusion imaging technics derived from Cardiac Computed Tomography Angiography (CCTA). Moreover, the study will investigate the correlation between morphology and composition of the coronary plaques and myocardial ischemia in the territory irrigated by the same coronary artery. At the same time, imaging parameters will be correlated with inflammatory status of the subjects. The trial will include 100 subjects with coronary lesions found on CCTA examination. The study population will be divided into 2 groups: first group will consist of subjects with anatomically significant coronary lesions on native coronary arteries and the second one will include subjects surviving an acute myocardial infarction. The vulnerability score of the subjects will be calculated based on presence of CCTA vulnerability markers of the coronary plaques: napkin ring sign, positive remodeling, spotty calcifications, necrotic core, and low-density plaques. 3D fusion images of the coronary tree will be generated, integrating the images reflecting wall motion with the ones of coronary circulation. The fusion models will establish the correspondence between plaque composition and wall motion in the subtended myocardium of the coronary artery. The study primary outcome will be represented by the rate of major adverse cardiac events related to myocardial ischemia at 1-year post assessment, in correlation with the degree of coronary artery stenosis and myocardial ischemia or viability.The secondary outcomes are represented by the rate of re-hospitalization, rate of survival and rate of major adverse cardiovascular events (including cardiovascular death or stroke), in correlation with the morphology and composition of atheromatous plaques located in a coronary artery, and myocardial ischemia in the territory irrigated by the same coronary artery. CONCLUSION: In conclusion, FUSE-HEART will be a study based on modern imaging tools that will investigate the impact of a coronary artery stenosis on myocardial function and viability, using advanced fusion imaging technics derived from CCTA, sighting to validate plaque composition and morphology, together with inflammatory biomarkers, as predictors to myocardial viability.


Assuntos
Vasos Coronários/diagnóstico por imagem , Imagem Multimodal/métodos , Isquemia Miocárdica/complicações , Imagem de Perfusão do Miocárdio/métodos , Estudos de Coortes , Angiografia por Tomografia Computadorizada/métodos , Estenose Coronária/complicações , Estenose Coronária/diagnóstico por imagem , Estenose Coronária/fisiopatologia , Vasos Coronários/patologia , Humanos , Mediadores da Inflamação/metabolismo , Ensaios Clínicos Controlados não Aleatórios como Assunto , Avaliação de Resultados em Cuidados de Saúde , Placa Aterosclerótica/diagnóstico por imagem , Placa Aterosclerótica/fisiopatologia , Estudos Prospectivos
18.
Expert Rev Cardiovasc Ther ; 19(5): 379-386, 2021 May.
Artigo em Inglês | MEDLINE | ID: mdl-33823735

RESUMO

Introduction: Coronary angiography (CAG) is the standard modality for assessing coronary stenosis; however, it has limitations in assessing coronary plaque morphology. Optical coherence tomography (OCT) is a high-resolution (10-20 µm) light-based intravascular imaging technique that can identify more detailed coronary plaque morphology compared to other intravascular imaging modalities. OCT is remarkable for characterizing fibrous, fibrocalcific, and lipid-rich plaques. The capabilities of OCT are well suited for discriminating three types of unstable plaque morphologies underlying coronary thrombosis, such as plaque rupture, erosion, and calcified nodules. The high resolution of OCT makes it possible to identify important features of vulnerable plaques, such as thin-cap (<65 µm thick) fibroatheroma, macrophages, vasa vasorum, and cholesterol crystals.Areas covered: This review summarizes the clinical impact of OCT and its efficacy in identifying plaque components and morphological features associated with plaque vulnerability.Expertopinion: The unique properties of OCT as a tool for investigating high-risk lesions have greatly contributed to a better understanding of plaque vulnerability. Consequently, OCT has led to significant changes in medical treatment and percutaneous coronary intervention strategies for acute coronary syndrome. Further development and investigation of OCT are necessary to better predict and manage acute coronary events in the future.


Assuntos
Aterosclerose/diagnóstico por imagem , Placa Aterosclerótica/patologia , Tomografia de Coerência Óptica/métodos , Síndrome Coronariana Aguda/terapia , Angiografia Coronária , Doença da Artéria Coronariana/terapia , Estenose Coronária/patologia , Vasos Coronários/patologia , Humanos , Intervenção Coronária Percutânea
19.
Aging (Albany NY) ; 13(8): 11188-11206, 2021 03 26.
Artigo em Inglês | MEDLINE | ID: mdl-33819189

RESUMO

Long non-coding RNA (lncRNA) myocardial infarction-associated transcript (MIAT) has been widely-demonstrated to function as diagnostic markers for acute myocardial infarction (MI). This study was designed to explore the modulatory role of MIAT and its underlying molecular mechanism in MI. Firstly, MI mouse model was developed via ligation of the descending branch of the left coronary artery, and cell model was established through exposure to hypoxic conditions. Online prediction indicated that MIAT could bind to microRNA-10a-5p (miR-10a-5p), while miR-10a-5p was highlighted to bind to early growth response gene-2 (EGR2). MIAT and EGR2 were subsequently determined to be highly-expressed, whereas miR-10a-5p was found to be poorly-expressed in cardiomyocytes exposed to hypoxia as well as in MI mice using RT-qPCR and Western blot assay. The binding relationships between MIAT and miR-10a-5p, and between miR-10a-5p and EGR2 were further confirmed by dual-luciferase reporter and RNA immunoprecipitation assays. The results of in vitro and in vivo experimentation also suggested that overexpression of miR-10a-5p or silencing of MIAT and EGR2 reduced cardiomyocyte apoptosis and increased ATP content, thus alleviating the impairment of cardiac function following MI. In a word, inhibition of MIAT protects against cardiac dysfunction induced by MI through the crosstalk with miR-10a-5p/EGR2.


Assuntos
Proteína 2 de Resposta de Crescimento Precoce/genética , MicroRNAs/metabolismo , Infarto do Miocárdio/genética , Miocárdio/patologia , RNA Longo não Codificante/metabolismo , Animais , Hipóxia Celular/genética , Linhagem Celular , Biologia Computacional , Vasos Coronários/patologia , Modelos Animais de Doenças , Técnicas de Silenciamento de Genes , Humanos , Masculino , Camundongos , Infarto do Miocárdio/patologia , Miócitos Cardíacos/patologia , RNA Longo não Codificante/genética , Organismos Livres de Patógenos Específicos , Regulação para Cima
20.
Biochim Biophys Acta Mol Basis Dis ; 1867(6): 166116, 2021 06 01.
Artigo em Inglês | MEDLINE | ID: mdl-33667626

RESUMO

AIMS: Coronary artery disease (CAD) is described as a range of clinical conditions including myocardial infarction (MI) and unstable angina. Lipid and apolipoprotein profiles together with the study of cholesterol deposit and efflux serve to identify novel pre and post infarct scenarios for the treatment of these patients. In (non-ST elevation myocardial infarction) NSTEMI patients, we analysed both systemic and intracoronary serum ability to accept cholesterol as well as cholesterol efflux capacity (CEC) of monocytes in terms of expression of genes involved in the reverse cholesterol transport (RCT). METHODS AND RESULTS: While HDL-C quantity was similar between systemic and coronary arterial blood, in 21 NSTEMI patients we observed a significant reduction of the preß-HDL fraction and the levels of Apolipoproteins AI, AII, B and E in coronary versus systemic serum. These data are complemented with the observed reduction of CEC. On the contrary, compared to systemic arterial monocytes, in coronary microenvironment of NSTEMI patients after myocardial infarction, the monocytes exhibited a higher mRNA expression of nuclear receptor LXRα and its targets ABCA1 and APOE, which drive cholesterol efflux capacity. CONCLUSION: In this cross-sectional study we observe that in the immediate post infarction period, there is a spontaneous bona fide ligand-induced activation of the LXR driven cholesterol efflux capacity of intracoronary monocytes to overcome the reduced serum ability to accept cholesterol and to inhibit the post-infarction pro-inflammatory local microenvironment.


Assuntos
HDL-Colesterol/metabolismo , Vasos Coronários/metabolismo , Lipídeos/análise , Monócitos/metabolismo , Infarto do Miocárdio sem Supradesnível do Segmento ST/metabolismo , Vasos Coronários/patologia , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Monócitos/patologia , Infarto do Miocárdio sem Supradesnível do Segmento ST/patologia
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