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)

Today, the pathology of large and medium-sized arteries is in most part considered as degenerative or inflammatory. The role of infection has been preponderant (syphilis) but has become quite modest now, restricted to infectious aneurysms. According to certain observations, infections may participate in initiating arterial inflammation, whether it be specific (Kawasaki's disease, Takayasu's arteritis, coronary artery disease of cardiac grafts) or less so ("plain" atherosclerosis). Suspected microbes (herpes viruses, Chlamydia pneumoniae, etc.) would damage the arterial wall either directly by infecting it, or indirectly by provoking an autoimmune reaction against some of its components (e.g. heat shock proteins). These hypotheses are worth serious consideration because, if established as correct, they would modify radically our etiologic, therapeutic and prophylactic conceptions of arterial diseases, including of course the main one, atherosclerosis.
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PMID:[The past, present and future of arterial infection]. 793 1

In this paper we review the main epidemiologic characteristics of Kawasaki disease (KD) and summarize the results of a prospective incidence survey conducted in Finland from 1981 to 1992, supplemented with some previously unpublished data. The epidemiologic features of KD have been well established in studies conducted during the past 20 years. However, continuous surveillance of KD is important to maintain a high level of awareness of the disease and to detect possible new risk factors. Epidemiologic studies should also be focused on individuals who have had KD to ascertain the final outcome of the disease, including the possible risk of premature coronary atherosclerosis.
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PMID:Epidemiology of Kawasaki disease. 795 34

The most important clinical aspect of Kawasaki disease is the cardiovascular problems. This article reports on the cardiovascular spectrum in acute Kawasaki disease, analysis of myocardial infarction and fatal cases, a follow-up study on the natural history of coronary artery lesions, long-term cardiovascular problems including premature atherosclerosis, problems in the adult cardiology and the treatment of acute Kawasaki disease. The etiology and pathogenesis of this disease are still unknown. Current hypotheses and leading studies on the etiology and the pathogenesis of Kawasaki disease are also reviewed.
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PMID:Current issues in Kawasaki disease. 825 32

Between April 1988 and August 1991, the right gastroepiploic artery (RGEA) was used as a pedicled arterial graft for coronary arterial bypass grafting (CABG) in 44 patients. Their ages ranged from 8 to 72 years (mean: 58.7 years), and body size was small for 21 patients (body surface area < 1.6 m2). The mean number of distal anastomoses was 3.2 +/- 0.7 per patient. The RGEA was anastomosed to the right coronary system in 35 patients and to the left in 9 patients. Perioperative vasospasm of the RGEA occurred in 4 patients, but no vasospasm was seen after intraluminal injection of diluted papaverine hydrochloride was used in the last 9 patients. The size of the RGEA at the site of anastomosis was 1.9 +/- 0.4 mm in diameter. The RGEA was harvested in 48 patients; however, two of the RGEAs were smaller than 1.0 mm in diameter and two showed severe calcification with stenosis of more than 75%. Consequently, those conduits were not used. Indications for the use of the RGEA were: relatively young age for 17, matching size of the coronary artery and the RGEA for 11, poor quality of the internal thoracic artery (ITA) or saphenous vein graft (SVG) for 10, lower leg atherosclerosis in 3, a diseased ascending aorta in 2, and Kawasaki disease in 1. The patency rate of the RGEA for 36 patients was 94.4% and relief of angina 95.5%. An exercise tolerance test performed within 2 months after operation showed improved capacity (mean 7.2 metabolic units).(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Use of the right gastroepiploic artery as a pedicled arterial graft for coronary revascularization. 843 1

The vascular function of the coronary arteries in children after Kawasaki disease (KD) as yet remains uncertain. Here we report our findings of the vascular response of the coronary arteries after intracoronary injection of acetylcholine in patients after KD. A total of 29 patients, 19 after KD and 10 as control, were examined using coronary angiography (CAG). These were divided into 4 groups according to the type of the coronary artery lesions: Group 1 consisted of those with regressed aneurysms and involved 29 sites. These aneurysms had developed in the acute stage and had subsequently regressed and demonstrated normal findings in follow-up CAG. Group 2 consisted of those with persistent aneurysms involved 30 sites. Group 3 involved 52 angiographically normal sites in patients after KD. And Group 4 consisted of control patients and involved 70 sites. These patients had congenital heart disease with normal coronary arteries. During CAG we infused 15 micrograms acetylcholine chloride into the right or left coronary artery. The luminal diameters were measured using a cine-videodensitometric analyser to study the distensibility of the coronary artery wall. The change in the diameter was an increase of 13.71% +/- 15.09% (mean +/- SD) in the normal KD Group 3, and 12.21% +/- 13.83% in the control Group 4, demonstrating marked vasodilatation. In contrast, the change in the regressed aneurysms Group 1, and in the persistent aneurysms Group 2, was -2.65% +/- 16.65%, and -0.08% +/- 6.51%, respectively, demonstrating no change or mild vasoconstriction. The change in Group 1, and in Group 2, was less than in normal Group 3 or control Group 4. The normal Group 3 showed no significant difference from control Group 4. These findings suggested that the coronary artery with regressed aneurysms, or with persistent aneurysms after KD has impaired vascular function and is therefore at risk for developing to atherosclerosis in the long-term.
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PMID:The vascular function of the long-term coronary artery after Kawasaki disease--evaluation by intracoronary injection of acetylcholine. 915 57

Kawasaki disease is an acute febrile illness affecting mainly infants and children. The fatal complication of Kawasaki disease is coronary involvement pertaining to coronary artery aneurysms. Surgical experience of adults that had childhood Kawasaki disease with coronary lesion has been rarely reported. We experienced coronary artery bypass grafting in a 44 year old man with no risk factors for atherosclerosis but with coronary lesions possibly secondary to Kawasaki disease. Coronary artery sequelae of Kawasaki disease may become part of a cause of coronary disease in young adults and we should recognize this condition in such patients with coronary disease but no coronary risk factors.
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PMID:Coronary artery revascularization in an adult with coronary aneurysms probably secondary to childhood Kawasaki disease. 928 24

This study was designed to clarify the clinical significance of and indications for performing preoperative internal thoracic artery (ITA) angiography in patients undergoing coronary artery bypass surgery. A total of 300 possible candidates for coronary artery bypass grafting (CABG) underwent ITA angiography during diagnostic catheterization. Semi-selective angiography of bilateral ITAs were performed by injecting contrast medium manually with a 5-F right Judkins coronary catheter. The posteroanterior view of the arteriograms was recorded on a 35-mm cine film or a cut-film. Unusual angiographic findings of the ITAs were observed in nine patients (3%). These findings included: an atrophic ITA in three patients with ipsilateral subclavian artery occlusions; enlarged ITAs giving collaterals to the lower extremities in one patient with extensive aortoiliac occlusive disease; occluded ITAs in one patient with Takayasu's arteritis and two patients with a history of CABG; and a small but nonsclerotic ITA in one patient. Atherosclerotic occlusive ITAs were found in only one patient. Thus, we concluded that routine preoperative angiography of the ITA is not necessary because it is rarely affected by atherosclerosis. However, it should be performed for any of the following reasons: a cervical or supraclavicular bruit; an upper extremity blood pressure difference of greater than 20 mmHg; an extensive aortoiliac occlusion; and certain disorders such as Takayasu's arteritis or Kawasaki disease, or a history of open heart surgery.
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PMID:The clinical significance of performing preoperative angiography of the internal thoracic artery in coronary artery bypass surgery. 960 2

Coronary artery aneurysm is a rare coronary abnormality, usually diagnosed incidentally by coronary angiography. Major causes of coronary aneurysms include coronary ectasia, Kawasaki disease, and atherosclerosis. Most of the discrete coronary aneurysms are of atherosclerotic origin. The incidence of atherosclerotic coronary aneurysms is about 0.2%, and the left main coronary artery is the least frequently involved artery. Only a few cases of left main coronary artery aneurysm have been reported in the literature, and a left main coronary artery aneurysm involving the proximal segments of the left anterior descending and the left circumflex arteries has not been reported previously. The authors describe this finding in a man who presented with worsening exertional angina pectoris. Coronary angiography demonstrated an aneurysm of the distal left main coronary artery extending into the proximal segments of the left anterior descending and the left circumflex arteries. In addition, a significant flow-limiting atherosclerotic lesion was present in the proximal portion of the left anterior descending artery distal to the aneurysm.
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PMID:Bifurcating aneurysm of the left main coronary artery involving left anterior descending and left circumflex arteries--a case report. 1053 28

Coronary artery abnormalities in Kawasaki syndrome develop in about 15-25% of young patients, mostly as aneurysms. In the long-term evolution of coronary artery disease thrombotic occlusion of aneurysms, premature atherosclerosis, and stenosis, are observed. Magnetic resonance is an emerging modality in the angiographic assessment of coronary arteries. The authors report a case of coronary artery aneurysms and stenosis in a 26-year-old patient with Kawasaki disease detected by magnetic resonance coronary angiography and confirmed by conventional coronary angiography.
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PMID:Coronary aneurysms and stenosis detected with magnetic resonance coronary angiography in a patient with Kawasaki disease. 1083 15

The clinical and epidemiological features of Kawasaki disease (KD) are consistent with an infectious cause. Because chronic infection with Chlamydia pneumoniae has been implicated in the pathogenesis of atherosclerosis, it has been suggested that it may also be involved in the pathogenesis of KD. Paired sera (baseline pretreatment and 1 year after treatment with intravenous immunoglobulin [IVIG]) from 26 children with KD and 29 age-matched controls were examined by microimmunofluorescence (MIF) serology and immunoblotting. There were no significant differences in the prevalence of anti-C. pneumoniae IgG, IgA, or IgM between cases and controls; however, 73%-85% of sera from cases and controls reacted with C. pneumoniae proteins by immunoblotting. There was significantly more reactivity in the pre-IVIG, but not post-IVIG, KD sera compared with sera from controls to proteins at 72-74 kDa and 74-76 kDa. They may be heat shock proteins. The results of this study do not support an association between KD and C. pneumoniae on the basis of MIF and immunoblot analysis.
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PMID:Is there an association between Kawasaki disease and Chlamydia pneumoniae? 1083 4


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