Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0004153 (atherosclerosis)
 77,401 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The results of operative lumbar sympathectomy for both intermittent claudication and rest pain in 153 patients have been reviewed. Sympathectomy was performed as an initial procedure to further below the groin reconstructive surgery, should symptoms not be alleviated. Five year post-sympathectomy, 67% of the claudicant and 54% of the rest pain patients had avoided further surgery. Patient mortality from other manifestations of atherosclerosis was notably poor at five years and was significantly greater than the sympathectomy failure rate after the first year. The results in diabetics were not significantly different from those in non-diabetics. The possible value of lumbar sympathectomy in both claudication and rest pain is reviewed and discussed.
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PMID:The early use of operative lumbar sympathectomy in peripheral vascular disease. 320 16

We looked for antibodies against endothelial cells, monocytes, fibroblasts, lymphocytes and Epstein-Barr virus transformed lymphocytes in the sera of 28 elderly and 18 middle-aged patients with atherosclerotic peripheral arterial disease and 13 controls. Inclusion criteria were symptomatic peripheral arterial disease with intermittent claudication and ankle/radial Doppler pressure ratio less than 0.7 in the patient group and greater than 1 in the controls. The sera were tested using a standard cytotoxic technique against a cell panel of monocytes, T and B lymphocytes from 5 donors, and against endothelial cells, fibroblasts and Epstein-Barr virus transformed lymphocytes from one umbilical cord vein and blood. The sera of 30 of 46 (65.2%) patients showed toxicity against monocytes from at least one member of the cell panel and 12 of 19 sera tested (63%) reacted with endothelial cells. Only one of the control sera was positive against monocytes and none reacted with endothelial cells. None of the sera of either patients or controls contained cytotoxic antibodies against T and B lymphocytes, Epstein-Barr virus transformed lymphocytes or fibroblasts. The selective cytotoxicity suggests that the antibodies detected are not against HLA-antigens (which are expressed by normal lymphocytes and Epstein-Barr virus lymphocytes). Our results suggest that immune phenomena occur in atherosclerosis.
Atherosclerosis 1988 Nov
PMID:Antibodies against monocytes and endothelial cells in the sera of patients with atherosclerotic peripheral arterial disease. 326 60

Peripheral arterial obstructive disease with symptoms of ischemia in the limbs is a common cause of disability, morbidity, and even mortality in the elderly. The most important cause is atherosclerosis, which is ultimately a systemic problem, but the cardinal symptom in the limbs is intermittent claudication. Unfortunately, the elderly patient often displays severe ischemia with pain at rest, and ulceration or gangrene of the extremity, even where there was a paucity of prior claudication, perhaps due to associated illness which reduces mobility. The essential aspects of clinical diagnosis and assessment of severity of ischemia involve relatively simple bedside techniques, and noninvasive laboratory methodology is mainly of value in selection of patients for angiography and potential revascularization. While conventional therapy involves bypass surgery, an expanding array of drugs and the advent of interventional angiographic measures including angioplasty offer alternatives which were not available even a few years ago.
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PMID:Peripheral vascular disease: medical evaluation and treatment. 331 89

We evaluated lower limb arterial circulation in 37 patients with heterozygous familial hypercholesterolemia using strain-gauge plethysmography. Nineteen patients were initially allocated to surgical therapy (ileal bypass operation), and 18 control patients were treated conservatively. After a follow-up period of 3-12 years (mean 10 yrs) the surgically treated patients had significantly lower serum total (9.4 vs. 11.9 mmol/l, P less than 0.001) and LDL (6.2 vs. 8.1 mmol/l, P less than 0.01) cholesterol and apoprotein B levels and higher HDL cholesterol (1.2 vs. 1.0 mmol/l, P less than 0.05) and apoprotein A-I levels compared with controls. There was no significant difference in the prevalence of intermittent claudication (16 vs. 6%) or coronary heart disease (68 vs. 61%) between the operated and control groups. The ankle-arm systolic blood pressure ratio was pathologically low in 53% of the operated and 72% of the control patients, and the toe-arm pressure ratio in 50% and 44%, respectively. These differences or the differences in the mean ankle-arm and toe-arm pressure ratios between the groups were not significant. The toe-ankle pressure gradient was normal in all but 2 patients indicating that atherosclerotic changes predominantly affect the more proximal arteries in familial hypercholesterolemia. Patients with peripheral arterial disease could not be differentiated by serum lipoprotein levels, blood pressure or the presence of coronary heart disease. However, smoking was more prevalent (38% vs. 0%, P less than 0.05) in patients with impaired peripheral circulation. We conclude that asymptomatic peripheral arterial disease is quite common in familial hypercholesterolemia, and that smoking increases its risk.(ABSTRACT TRUNCATED AT 250 WORDS)
Atherosclerosis 1988 Mar
PMID:Peripheral arterial disease in heterozygous familial hypercholesterolemia: no difference between patients with and without partial ileal bypass. 335 14

On the basis of the data from the registry of cerebral stroke (CS) cases in Novosibirsk (covering 937 patients and 314 healthy control subjects) the authors have made a mathematical analysis of 19 factors of the risk of disease development. Nine factors have been isolated whose varying combinations were most contributory to the risk of the development of CS in the studied population: cardiac diseases, transient disorder of the cerebral circulation, arterial hypertension, atherosclerosis, aggravated heredity for cardiovascular diseases, intermittent claudication, diabetes mellitus, systematic alcohol abuse, and hypodynamia. The authors have developed a practicable and reliable system for predicting the development of cerebral stroke in apparently healthy subjects (the accuracy of prediction is 86%).
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PMID:[Experience of prognosis and the risk factors of stroke in Novosibirsk]. 336 95

Platelet activation, with subsequent formation of thromboxane A2 (TxA2), is thought to play a role in the development of arterial occlusion. In patients with severe atherosclerosis of the lower limbs, characterized by leg ulcers and rest pain, the basal formation of TxA2 and prostacyclin (PGI2) is increased. Corresponding data in patients with more moderate atherosclerosis of the lower limbs have not been reported. Since the capacity to physical exercise is not blunted in such patients proper evaluation of their TxA2-PGI2 synthesis should comprise not only assessment of the basal formation, but also TxA2/PGI2 biosynthesis during conditions of elevated cardiovascular activity. To address this, we analysed these eicosanoids in patients with a history of intermittent claudication. Urinary dinor-metabolites of TxB2 and PGI2 (Tx-M and PGI-M, respectively) were estimated by gas chromatography/negative ion-chemical ionization mass spectrometry in samples collected prior to, during and immediately after 20 min of severe treadmill exertion. The basal excretion of Tx-M was 105 +/- 26 pg/mg creatinine. It was not changed during exercise, but increased to 176 +/- 48 pg/mg creatinine (P less than 0.05) during the recovery. The basal excretion of PGI-M was 142 +/- 25 pg/mg creatinine. The PGI-M response to exercise varied from no change at all to a 30-fold increase, without any obvious correlation to experienced leg pain, walking distance or other recorded variables. During the recovery period the outflow of PGI-M was significantly higher than at rest (482 +/- 145 pg/mg creatinine; P less than 0.01). We conclude that in patients with intermittent claudication due to atherosclerosis (1) platelet activation does not occur during the course of the exercise, and (2) vascular prostacyclin formation can be dissociated from of TxA2 synthesis. The observed increase in PGI-M in some of the patients is suggested to reflect tissue ischaemia induced by the lack of adequate hyperaemia during exercise.
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PMID:Excretion of thromboxane A2 and prostacyclin metabolites during treadmill exercise in patients with intermittent claudication. 340 85

Cancer was diagnosed in 15 patients among 300 consecutive patients with intermittent claudication. The cancer-associated claudication is characterized by a more accelerated course of claudication, more often requires vascular surgery, and moreover, the lasting relief of claudication depends upon the efficiency of cancer therapy. It is the authors' impression that cancer-associated claudication is predetermined by atherosclerosis and aggravated by cancer through the chronic hypercoagulability state secondary to neoplasm. The clinical picture is characterized by rapid progression, with the frequent necessity of vascular surgery for limb salvage and a higher incidence of graft occlusion. Awareness of this possibility of hidden malignancy may be related to the clinical picture of hemodynamic deterioration of the underlying arterial insufficiency. A high index of suspicion leads to earlier diagnosis of neoplasm. Effective oncologic therapy will often bring the symptomatic relief of ischemic symptoms in the lower extremities. This report indicates that associated neoplasm has a more vicious course of the underlying arterial insufficiency and intermittent claudication.
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PMID:Intermittent claudication associated with cancer--case studies. 366 9

The kind of diagnostic procedures and treatment required in patients with arterial occlusive diseases in advanced age depends on the high risk of multimorbidity. Drug-interactions must be controlled in the multimedication of risk factors in atherosclerosis and of concomitant internal diseases. Intermittent claudication in older patients can also be treated successfully by physical training; in the late stages hemodilution and angioplasty are efficient modern procedures of treatment.
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PMID:[Significance of geriatric polypathy for conservative diagnosis and therapy of arterial occlusive disease in advanced age]. 400 13

While the resistance to flow offered by means of arterial narrowing and the collateral arteries are the major determinants affecting peripheral flow, there may be a contribution by those elements which affect the viscosity of the blood. To evaluate these factors, haematocrit, red blood cell aggregation and plasma viscosity were measured in 100 patients with occlusive arterial disease of the lower extremities. Disturbances in these parameters were noted and appeared to be related to the severity and extent of the occlusive disease. However, whether these factors contribute to the cause of intermittent claudication remains uncertain.
Atherosclerosis 1985 Jun
PMID:Clinical and rheological studies in patients with intermittent claudication. 401 51

The effect of plasma lipid reduction on the progression of femoral atherosclerosis was studied in hyperlipidaemic patients with stable intermittent claudication. 24 patients were randomly assigned to treatment and usual-care groups, the former receiving dietary advice and cholestyramine, nicotinic acid, or clofibrate depending on their lipoprotein phenotype. Biplanar arteriography was performed when the study began and after a mean period of 19 months. Angiograms were assessed visually, with blinding, and by computerised image analysis. Therapy reduced mean plasma total cholesterol by 25%, mean low density lipoprotein (LDL) cholesterol by 28%, and mean plasma triglycerides by 45%. Significantly fewer arterial segments showed detectable progression of atherosclerosis in the treatment group. The mean increase in plaque area (mm2/segment/year) in the treatment group was only one third of that in the usual-care group. The mean increase in edge irregularity index (a measure of the severity of disease) in the treatment group was only 40% of that in the usual care group. Twice as many arterial segments showed improvement in the treatment group. In both groups changes in edge irregularity index were directly related to plasma LDL cholesterol concentration. This study, the first randomised controlled trial of its type, provides evidence that effective treatment of hyperlipidaemia favourably influences the natural history of symptomatic peripheral atherosclerosis.
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PMID:Treatment of hyperlipidaemia retards progression of symptomatic femoral atherosclerosis. A randomised controlled trial. 613 93


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