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 existence of endothelial damage in impaired coronary arteries, both aneurysms and regressed aneurysms, even during the chronic stage of Kawasaki disease (KD) has been reported by morphologic and functional studies. In addition, based on our results of endothelial-dependent dilatation in systemic arteries or the pathological findings in weaning rabbits in the chronic stage of KD-like allergic coronary arteritis by administering a hypercholesterol diet, it is suggested that vascular endothelial dysfunction, not only in coronary arteries but also in systemic arteries, could exist in the KD patients even in a chronic stage, and also suggested that a history of KD was possible to be one of the risk factor for the early onset of atherosclerosis.
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PMID:[Kawasaki disease and atherosclerosis]. 1826 60

Intravenous immunoglobulin (IVIG) is efficient in various immune mediated conditions. Various cardiovascular diseases are mediated by inflammatory processes and autoimmune mechanisms. Therefore, it seems conceivable to employ IVIG as an immunomodulating therapy in such indications. In this paper we review the possible anti-inflammatory effects of IVIG transfusion, and discuss the possible clinical implications in cardiology. Besides the established use of IVIG in Kawasaki disease, IVIG may be beneficial in some cases of heart failure, dilated cardiomyopathy, myocarditis, pericardial diseases, neonatal lupus, in the prevention of cardiac rejection following transplantation, and in modulating atherosclerosis. IVIG has been proven to be ineffective in rheumatic fever. Although uncommon, complications may arise including myocardial infarction, renal failure and hyperviscosity. IVIG should be administered based on accepted modes of transfusion.
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PMID:Intravenous immunoglobulin - indications and mechanisms in cardiovascular diseases. 1855 60

Coronary aneurysms are very rare: their frequency ranges between 1% and 2%. The most frequent associated disease in atherosclerosis, although they have also been described associated to: infections or connective tissue diseases, Kawasaki's disease, thoracic traumas and of congenital origin. Furthermore, they are sometimes related to coronary stenting (including drug-eluting stenting) and intracoronary brachytherapy. Their evolution is not well known and their most serious complications are: thrombosis, embolization and rupture. The literature review revealed that they can be treated safely with stent grafts.
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PMID:[Obliteration of a coronary artery aneurysm with a PTFE-covered stent (stent graft)]. 1858 19

Coronary artery aneurysms (CAAs) can occur congenitally or secondary to specific disorders such as Kawasaki disease or atherosclerosis. Apart from a surgical approach, CAA can be treated by coronary stent graft (CSG) implantation. However, restenosis is frequent after CSG placement, precluding a wider use of this technique. We hypothesized that implantation of a drug-eluting stent (DES) within a CSG could be of use to avoid CSG restenosis. We report the case of a patient with a large aneurysm of the right coronary artery who underwent CSG implantation followed by DES placement. The immediate angiographic result showed complete exclusion of the aneurysm. Intravascular ultrasound confirmed good apposition of both the CSG and DES. Follow-up angiography after 23 weeks demonstrated a good long-term result without restenosis. The patient has remained asymptomatic during 12 months of follow-up. In conclusion, the present case suggests that CSG placement followed by DES implantation is a safe and effective approach to treat coronary aneurysms interventionally.
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PMID:Percutaneous treatment of a coronary aneurysm by stent graft and drug-eluting stent implantation: a potential method to reduce stent graft restenosis. 1875 68

Kawasaki disease (KD) is a multisystemic vasculitis that often includes coronary artery involvement. The serum levels of matrix metalloproteinase (MMP)-3 and -9 are significantly elevated in KD patients, and polymorphisms in the genes encoding MMP-3 and MMP-9 have been associated with the susceptibility, severity, and progression of atherosclerosis and aneurysm. However, the association between MMP-3 gene polymorphisms and development of aneurysm is somewhat controversial in a number of diseases. Ninety-seven children with KD and 194 children with congenital heart disease (CHD) were included in this study. Echocardiography was used to examine all children in the KD group for coronary artery aneurysm. Genotyping of the MMP-3 (-439C/G) promoter polymorphism was performed using the single-base extension method, and serum MMP-3 levels were estimated using the sandwich enzyme immunoassay method. There was no significant difference in MMP-3 (-439C/G) genotypes between KD and control groups. There was no association between this MMP-3 polymorphism and development of coronary aneurysm in KD. Serum MMP-3 levels were significantly higher in KD patients compared to control subjects. Among the KD patients, serum MMP-3 levels were higher in children with genotypes CG+GG compared to the CC group, but this difference was not significant. Although further large-scale studies will be required to fully examine the relationship between MMP-3 gene polymorphisms and coronary artery lesions (CAL) in KD, the present findings suggest that while MMP-3 may play a role in the pathogenesis of KD, there is no apparent association between CAL and the MMP-3 (-439C/G) gene polymorphism in Korean children with KD.
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PMID:Association of the matrix metalloproteinase-3 (-439C/G) promoter polymorphism with Kawasaki disease in Korean children. 1881 May 83

The objective of this study was to test the hypothesis that accelerated endothelial dysfunction and the development of premature atherosclerosis are associated with age in subjects with coronary artery lesions after Kawasaki disease (KD). A case-control study was performed at a university hospital that included 35 post-KD subjects across a wide age range (range, 8-42 years) without traditional cardiovascular risk factors and 35 age- and sex-matched healthy control subjects (Cont). Flow-mediated dilatation (FMD) of the brachial artery-induced by reactive hyperemia, intima media thickness (IMT), and elastic modulus (Ep) of the common carotid artery were compared between KD and Cont subjects assessed against age. KD subjects had slightly higher levels of body mass index, lipid profile, and HbA1c than Cont subjects, but the differences were not significant. The mean IMT (p < 0.001), age-adjusted percentage normal IMT (%N IMT; p < 0.0001), and Ep (p < 0.001) were significantly higher in KD than Cont subjects, and the peak FMD% (p < 0.01) was significantly lower in KD than Cont subjects. There were significant correlations between FMD% and age (r = -0.51 p < 0.0001), IMT and age (r = 0.68, p < 0.001), and Ep and age (r = 0.58, p < 0.01) in KD but not Cont subjects. When the difference in FMD% between KD and matched Cont subjects (DeltaFMD%) was plotted against age, no significant relationship was found, although significant correlations between DeltaIMT and age (r = 0.52, p < 0.01) as well as between DeltaEp and age (r = 0.46, p < 0.05) were observed. When we defined values that were +2.0 SD over the mean control values (i.e., %N IMT >or= 120% and/or Ep >or= 50 kPa) as markers of subclinical atherosclerosis, 15 subjects met the criteria. Subjects over the age of 22 years were more likely to have (OR = 16.54, p = 0.0001) subclinical atherosclerosis in this cohort. Our results suggest that endothelial dysfunction and the development of premature atherosclerosis were accelerated in adult post-KD compared to Cont subjects.
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PMID:Age-related acceleration of endothelial dysfunction and subclinical atherosclerosis in subjects with coronary artery lesions after Kawasaki disease. 1902 Jul 92

Left main (LM) coronary artery aneurysm is rare and usually found incidentally during coronary angiography. Except for rare Kawasaki disease, iatrogenic and mycotic aneurysms, atherosclerosis is the primary cause of coronary aneurysm. In most clinical scenarios, coronary artery disease is accompanied with LM coronary aneurysm. Although coronary artery aneurysm does not confer added risk in patients with coexisting obstructive coronary artery disease, LM coronary aneurysm itself remains a significant clinical concern. Thrombosis and distal embolization are the most likely reasons to cause morbidities. Aggressive surgical treatment should be considered. Here, we report a 65-year-old man presenting with effort angina. LM coronary aneurysm was noted in coronary angiogram and images including computed tomography, transesophageal echocardiography and operative photography were presented.
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PMID:Surgical treatment of left main coronary artery aneurysm: a case report. 1907 21

Kawasaki disease usually affects younger age groups, but cardiac sequelae of 'missed' (incomplete) childhood Kawasaki disease may first present in adult life. We report a case of a 28-year-old white man presenting with ST elevation myocardial infarction and later found to have triple vessel coronary artery aneurysmal disease, probably secondary to childhood Kawasaki disease for which he underwent cardiac bypass surgery. The patient has remained well and asymptomatic at 1-year follow-up. This case is highlighted as the incidence of Kawasaki disease is relatively low among the white population, and yet there are increasing reports of adult patients presenting with coronary artery aneurysmal disease secondary to childhood Kawasaki disease. There has been a relative paucity of reports of surgical revascularization for adult survivors of childhood Kawasaki disease. This report also emphasizes the importance of early recognition and aggressive treatment of the often missed, incomplete, form of Kawasaki disease, which may reduce the risk of late development of coronary artery aneurysms. There should be a high index of suspicion of Kawasaki disease in young adults presenting with aneurysmal coronary artery disease with no significant coronary risk factors and in the absence of generalized atherosclerosis.
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PMID:Severe triple vessel coronary artery disease and aneurysms in a young white man: disease progression of childhood Kawasaki disease. 1919 77

Coronary aneurysms represent anomalies identified in 0.15-4.9% of patients undergoing coronary angiography. At present there is no uniform definition of this pathology. According to current definitions, the term "aneurysm" refers to both diffuse over 150% dilation of the largest diameter of a coronary artery, and limited spherical or saccular dilation. Aneurysms are observed most commonly in the right coronary artery, and least frequently in the left main coronary artery. It has been demonstrated that atherosclerosis is the main cause of these anomalies in adults, and Kawasaki disease in children and adolescents. However, regardless of the pathogenesis of the aneurysm, pathology of the media of the blood vessel plays a major role in its formation. The most prevalent consequence of aneurysms in the coronary arteries is formation of a thrombus with distal embolization, vasospasm or vessel disruption at the site of wall injury. Therefore, therapeutic management in this anomaly involves both the prevention of thromboembolic complications and percutaneous or surgical closure of the aneurysm entry.
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PMID:Coronary aneurysms. 1920 53

A 40-year-old man was referred to our hospital because of an abnormal shadow on the left cardiac border on the chest roentgenogram at the regular medical health examination without any symptoms. A giant coronary artery aneurysm of left anterior descending artery with a maximum diameter of approximately 50 mm was detected with computed tomography and coronary angiography. The patient was treated and followed up medically. Four years later, the size of the coronary artery aneurysm became larger. Then resection of the coronary artery aneurysm and coronary artery bypass grafting were successfully performed. Coronary artery aneurysms are rare in adults and are usually found in association with Kawasaki disease, coronary atherosclerosis, and so on. We also review the literature of giant coronary artery aneurysms exceeding 50 mm in diameter.
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PMID:A case of giant coronary artery aneurysm and literature review. 1930 36


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