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Query: UMLS:C0004153 (atherosclerosis)
 77,401 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The cellular mechanisms involved in the pathogenesis of atherosclerosis may be similar to the events in the inflammatory response. Many of these processes are activated by the arachidonic acid cascade. The nonsteroidal anti-inflammatory drugs inhibit the cycloxegenase and possibly the lipoxegenase pathways, decreasing the production of prostaglandins, thromboxanes, and leukotrienes, all components of the inflammatory process. We have inhibited the arachidonic acid cascade with the nonsteroidal anti-inflammatory drugs, indomethacin (5 mg/kg/day) and phenylbutazone (10mg/kg/day). Forty-five New Zealand white rabbits were given a 0.25% cholesterol diet for 16 weeks in addition to the drugs or a placebo. Serial plasma lipid profiles were performed; aortic and peripheral arterial cholesterol content measurements were obtained at sacrifice. All groups showed markedly elevated plasma lipids. Thoracic aortic and carotid artery cholesterol contents were significantly decreased in both treated groups as compared to placebo (P < 0.05), despite the atherogenic lipid profiles. These results implicate the immune and inflammatory responses in the pathogenesis of atherogenesis.
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PMID:Reduction of atherosclerosis with nonsteroidal anti-inflammatory drugs. 842 41

Given the beneficial effects of HMG-CoA reductase and ACAT inhibitors on hypercholesterolemia and atherosclerosis, we hypothesized that coadministration would improve the hypolipidemic response and not only limit lesion development but also alter the cellular composition of atherosclerotic lesions so as to induce a stable atherosclerotic lesion morphology. Plasma total cholesterol exposure was reduced 29 and 39% with atorvastatin (2.5 mg/kg) and CI-976 (5 mg/kg), respectively, and 60% upon coadministration due primarily to reductions in VLDL-cholesterol. Modest changes in liver cholesterol ester (CE) content were observed with atorvastatin or CI-976; however, a striking 48% reduction was noted upon coadministration. Liver HMG-CoA reductase mRNA levels were reduced 73% by cholesterol feeding and drug treatment did not prevent the reduction; however, atorvastatin alone and upon coadministration blunted the decrease in LDL receptor mRNA levels. The CE content of the iliac-femoral was unaffected by atorvastatin but was reduced 35% by CI-976 and 53% upon coadministration. Thoracic aortic CE content was reduced 38% by atorvastatin, 48% by CI-976 and 80% upon coadministration. Iliac-femoral lesion and macrophage area were reduced 48 and 67% by atorvastatin, respectively, and 68 and 81% by CI-976 but upon coadministration only an 85% reduction in macrophage area was noted. Aortic arch cross-sectional lesion and macrophage area were unaffected by atorvastatin, decreased 72-80% by CI-976 and reduced 87-92% upon coadministration. We conclude that inhibition of HMG-CoA reductase and ACAT acts synergistically to lower plasma total and lipoprotein cholesterol levels and to limit the development of atherosclerotic lesions in the cholesterol-fed rabbit by presumably regulating cholesterol trafficking pathways within liver and vascular cells.
Atherosclerosis 1998 Jul
PMID:HMG-CoA reductase and ACAT inhibitors act synergistically to lower plasma cholesterol and limit atherosclerotic lesion development in the cholesterol-fed rabbit. 969 88

Bone marrow transplantation (BMT) is commonly used to study the participation of bone marrow-derived cells in atherosclerosis. To determine the effect of this methodology on lesions, 16 male low density lipoprotein (LDL) receptor knockout (LDLr-/-) mice were reconstituted with bone marrow from syngeneic LDLr-/- mice after 10 Gy gamma-irradiation and compared with 12 male LDLr-/- littermates that did not undergo BMT (no-BMT group). Mice were fed a high fat diet (HFD) for 16 weeks to induce atherosclerosis. Sixteen additional LDLr-/- mice underwent BMT, and 12 male LDLr-/- mice that did not undergo BMT were fed a chow diet for 56 weeks. Thoracic aorta lesion areas were smaller in BMT mice than in no-BMT mice fed the HFD (P<0.0001). In contrast, aortic root lesion areas were greater in the BMT mice fed the HFD (P<0.0001) as well as in those fed the chow diet (P=0.0001). Abdominal aorta free cholesterol and cholesteryl ester mass were minimal in all groups studied. Aortic root lesions from all no-BMT mice were densely collagenous and encapsulated by a cellular cap, whereas lesions in the BMT mice contained lipid cores and minimal collagen staining. Although the reason for these differences in lesion size and composition remains unresolved, this study suggests that multiple parameters of lesion formation should be examined to assess atherosclerosis.
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PMID:Effect of gamma-irradiation and bone marrow transplantation on atherosclerosis in LDL receptor-deficient mice. 1159 44

Thoracic aortic atherosclerosis has been shown to be an important cause of severe morbidity and mortality. At the present time, the case of performance, detailed information obtainable, and availability make TEE the procedure of choice for the imaging of thoracic aortic atherosclerosis; however, further technical advances in MR and CT, particularly in MR plaque characterization and the use of plaque specific contrast agents, may allow for a less invasive and more complete evaluation of thoracic aortic atherosclerosis in the near future. Gadolinium-enhanced 3DMRA is the procedure of choice for the noninvasive detection of plaque in the proximal aortic arch vessels. Furthermore, both CT and MRI are better suited to evaluate penetrating atherosclerotic ulcers and their complications such as intramural hematoma, pseudoaneurysm formation, and aortic rupture.
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PMID:Diagnostic imaging of aortic atherosclerosis and its complications. 1248 31

To investigate exercise effects on the vascular function in hypercholesterolemia, male New Zealand White rabbits were divided into four groups; i.e. the normal diet control, the high cholesterol diet control, normal diet with exercise, and high cholesterol diet with exercise. High cholesterol diet groups were fed 2% cholesterol rabbit chow for 8 weeks. Animals of exercise groups ran on a treadmill at 0.88 km/h for 10-60 min/day, 5 day/week, and 8 weeks in total. Thoracic aortae were, then, isolated for functional and immunohistochemical analysis. We found that in rabbit aortae, (1). high cholesterol diet feeding caused lipid deposition and intimal thickening, induced expression of P-selectin, VCAM-1, MCP-1 and iNOS, and impaired acetylcholine (ACh)-evoked vasorelaxation; (2). exercise significantly reduced the protein expression of adhesion molecules/iNOS, and the intimal thickness in hypercholesterolemia; (3). chronic exercise enhanced ACh-evoked vasorelaxation in normal rabbits, but it only significantly improved vascular responses to the high dose (10(-6) M) of ACh in hypercholesterolemic rabbits; (4). both exercise and diet effects on vascular responses were mediated by altering the release of NO and endothelium-derived hyperpolarization factor. We conclude that exercise training decreases the expression of adhesion molecules and iNOS, and ameliorates the severe vascular dysfunction induced by high cholesterol feeding.
Atherosclerosis 2003 Jul
PMID:Chronic exercise reduces adhesion molecules/iNOS expression and partially reverses vascular responsiveness in hypercholesterolemic rabbit aortae. 1286 Feb 46

Cardiovascular infections due to Salmonella enterica are infrequently reported, so their clinical features, prognosis, and optimal treatment are not completely known. Mortality associated with aortitis and endocarditis caused by nontyphoidal Salmonella remains exceedingly high. In this review of cases of cardiovascular infections due to Salmonella enterica studied in 2 hospitals in Madrid, we tried to assess the clinical manifestations and the procedures leading to diagnosis in addition to treatment and outcome. To complete the spectrum of infections related to cardiovascular surgery, cases of postoperative mediastinitis, pericarditis, and infections associated with cardiac devices were also included.Twenty-three patients were reviewed: 11 had mycotic aneurysms; 7 had endocarditis; 2 had device-related infections; and 3 had pericarditis, mediastinitis, and infection of an arteriovenous fistula, respectively. The risk of endovascular infection in patients older than 60 years with bacteremia due to nontyphoidal Salmonella was 23%. Most patients with aortitis had risk factors for atherosclerosis, and 6 had preexisting atherosclerotic aortic aneurysms. All except 1 patient with endocarditis had underlying cardiac disorders. Acquired immunodeficiency disease (AIDS) was a major risk factor for salmonella bacteremia in 1 patient with aortitis and 1 with endocarditis. Fever, unremitting sepsis, "breakthrough" and relapsing bacteremia were the most common clinical findings. In addition, abdominal or thoracic pain and cardiac failure and pericarditis were common features in patients with aortitis and endocarditis respectively. Computed tomography (CT) scan, arteriography, and echocardiography were the main diagnostic tools. Mortality associated with mycotic aneurysms and endocarditis due to S. enterica was 45% and 28%, respectively. Thoracic aneurysms, rupture, and shock at the time of diagnosis were associated with increased mortality in patients with aortitis. In situ bypass grafting was successfully performed in most cases. After surgery, antimicrobial therapy was continued for 4-9 weeks. No relapses were observed after a mean follow-up of 64 months. Antimicrobial therapy alone or combined with valve replacement or excision of a ventricular aneurysm was successful treatment for most patients with salmonella endocarditis. Combined medical and surgical treatment was required for patients with mediastinitis and pericarditis, and patients with device-related infections needed removal of the complete device. Diagnosis of aortitis due to nontyphoidal Salmonella should be established as early as possible to reduce mortality. Patients older than 60 years who have positive blood cultures for Salmonella along with fever and back, abdominal, or chest pain should have an extensive workup for infective aortitis. Immediate bactericidal antimicrobial therapy should be started and a CT scan should be performed on an emergency basis. If a mycotic aneurysm is found, surgical resection should follow as soon as possible. Resection of the aneurysm with in situ bypass grafting is the procedure of choice. Postoperative antimicrobial therapy for 6-8 weeks seems enough to avoid relapses. Optimal treatment of patients with endocarditis occurring on ventricular aneurysms must include resection of the aneurysmal sac. Salmonella endocarditis can be successfully treated with antimicrobials alone. Valve replacement should be reserved for patients with cardiac failure or persisting sepsis, and for those who relapse after discontinuation of antimicrobial therapy.
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PMID:The spectrum of cardiovascular infections due to Salmonella enterica: a review of clinical features and factors determining outcome. 1502 66

Epidemiological studies have reported an inverse association between dietary flavonoid intake and mortality for ischemic heart disease. Quercetin reduces blood pressure and restores endothelial dysfunction in hypertensive animals. However, quercetin (aglycone) is usually not present in plasma, but it is rapidly metabolized during absorption by methylation, glucuronidation and sulfation. We have analyzed the vasorelaxant effects and the role on NO bioavailability and endothelial function of quercetin and its conjugated metabolites (quercetin-3-glucuronide, isorhamnetin-3-glucuronide and quercetin-3'-sulfate) in rat aorta. Thoracic aortic rings isolated from Wistar rats were mounted for isometric force recording and endothelial function was tested by measuring the vasorelaxant response to acetylcholine. NADPH-enhanced O(2)(-) release was quantified in homogenates from cultured aortic smooth muscle cells using lucigenin chemiluminescence. Unlike quercetin, the conjugated metabolites had no direct vasorelaxant effect, and did not modify endothelial function or the biological activity of NO. However, all metabolites (at 10 micromol/L) prevented, at least partially, the impairment of endothelial-derived NO response under conditions of high oxidative stress induced by the SOD inhibitor DETCA. Furthermore, they protected the biological activity of exogenous NO when impaired by DETCA. Quercetin and quercetin-3'-sulfate (>or=10 micromol/L) or quercetin-3-glucuronide (100 micromol/L) inhibited NADPH oxidase-derived O(2)(-) release. Quercetin and quercetin-3-glucuronide (1 micromol/L) prevented the endothelial dysfunction induced by incubation with ET-1. These data indicate, for the first time, that the conjugated metabolites could be responsible for the in vivo protective activity of quercetin on endothelial dysfunction.
Atherosclerosis 2009 May
PMID:Glucuronidated and sulfated metabolites of the flavonoid quercetin prevent endothelial dysfunction but lack direct vasorelaxant effects in rat aorta. 1880 86

Purpose of this study was the evaluation of the thoracic aortic wall thickness as a potential identifier of patients at increased risk for future cardiac events. Thoracic aortic wall thickness was measured with MDCT in 160 patients. The CT-scans were implemented as non-invasive coronary angiography studies. Relationships between aortic wall thickness, sex, age, major risk factors and atherosclerotic plaque burden of the coronary arteries were explored. Higher values of maximum aortic wall thickness of the descending aorta (women P = 0.02, men P = 0.01) were found in patients with coronary atherosclerosis, compared to patients with same gender but excluded atherosclerosis. Aortic wall thickness of the mid-portion of the descending aorta of 3.0 mm is associated with coronary artery disease (CAD) with a specificity of 96.6% (sensitivity 27.5%) and a positive predictive value (PPV) of 93.3%. For patients with two or more major risk factors and a maximum wall thickness of equal or more than 2.6 mm we found a PPV of 100%. We conclude that measurements of maximum wall thickness of the descending aorta are a potential tool for detecting patients with coronary atherosclerosis. The potential effect of combining measurements of aortic wall thickness at routine chest CT studies with a possible cardiovascular screening is substantial and merits further study.
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PMID:Aortic wall thickness assessed by multidetector computed tomography as a predictor of coronary atherosclerosis. 1903 49

Thoracic aortic calcium (TAC) has been associated with a higher prevalence of coronary arterial calcium (CAC). The purpose of this study was to assess the relations between TAC and incident CAC and CAC progression in a cohort from the Multi-Ethnic Study of Atherosclerosis (MESA). MESA is a prospective cohort study of 6,814 participants free of clinical cardiovascular disease at entry who underwent noncontrast cardiac computed tomographic scanning at baseline examination and at a 2-year follow-up assessment. The independent associations between TAC and incident CAC in those without CAC at baseline and between TAC and CAC progression in those with CAC at baseline were investigated. The final study population consisted of 5,755 subjects (84%; mean age 62 +/- 10 years, 48% men) who had follow-up CAC scores an average of 2.4 years later. Incident CAC was significantly higher in those with TAC compared with those without TAC at baseline (11 per 100 patient-years vs 6 per 100 patient-years). Similarly, TAC was associated with a higher CAC change (p <0.0001) in those with some CAC at baseline. In analysis adjusted for demographics and follow-up duration, TAC was associated with incident CAC (relative risk 1.72, p <0.0001) as well as with a greater CAC change (first quartile: relative risk 2.89, 95% confidence interval -3.16 to 8.95; fourth quartile: relative risk 24.21, 95% confidence interval 18.25 to 30.18). In conclusion, TAC is associated with the incidence and progression of CAC. The detection of TAC may improve risk stratification efforts. Future clinical outcomes studies are needed to support such an approach.
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PMID:Relationship of thoracic aortic calcium to coronary calcium and its progression (from the Multi-Ethnic Study of Atherosclerosis [MESA]). 1946 16

Thoracic aorta aneurysms are life-threatening diseases which can lead to rupture or dissection due to structural alterations. The exact etiology is still unclear but extended life-expectancy with arterial hypertension, positive family history for aneurysmic diseases, atherosclerosis, smoking and chronic obstructive lung disease are all considered to be risk factors. Nowadays, a diagnosis can often be made in the symptom-free stage. The risk of rupture varies between 46 and 74% for a diameter clearly greater than 5.5 cm and with a 2-year mortality rate of 70%. The 5-year survival rate with conservative treatment can be as low as 13-34% compared to 70-79% after optimal surgical treatment. Medical, operative and percutaneous interventional therapeutic strategies are basically available.
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PMID:[Thoracic aorta aneurysms]. 1956 10


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