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

It has been proposed that diffuse coronary atherosclerosis influences the myocardial perfusion. We performed a study of 94 young men with previous myocardial infarction in order to find out whether the presence and extent of diffuse coronary atherosclerosis affected the relation between maximal stenosis and myocardial perfusion in areas remote from the infarction. The patients were examined by planar-imaging thallium-201 scintigraphy, following exercise, and coronary angiography within 6 months after myocardial infarction. The maximal distinct stenosis and diffuse coronary atherosclerosis, comprising both plaque size and extent, were semiquantitatively assessed. The correlation coefficients between maximal stenosis within the LAD, RCA, and LCX vascular territories and the corresponding initial uptake of thallium were 0.52 (P = 0.0001), 0.30 (P = 0.04), and 0.46 (P = 0.02), respectively. No change of the correlations was found, except for a slight increase of the r-value from 0.30 to 0.37 in regions corresponding to RCA, after controlling for the diffuse atherosclerosis score in a multiple stepwise regression analysis. These findings indicate no impact of diffuse coronary atherosclerosis on regional myocardial perfusion in areas remote from the infarction.
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PMID:Does diffuse coronary atherosclerosis affect the relation between coronary stenoses and uptake of thallium-201 after exercise? 150 69

An atherometric system (AS) was used to study the coronary atherosclerotic lesions of a consecutive series of 102 autopsies divided into two groups according to the principal cause of death, the myocardial infarction and the low atherosclerosis groups, respectively (MIG 67 cases, LAG 35 cases). The hair elements contents (K, Ca, Zn, Br, Sr, Pb, S, Cl, Cu, and their rates Ca/Sr, Zn/Cu and Ca/K) were determined by energy dispersive X-ray fluorescence (EDXRF) analysis. A PEARSON correlation analysis was done between each element and the following descriptive arterial variables of the AS: fatty streaks (X), fibrous plaques (Y), severe (complicated plus calcified) plaques (Z) and total atherosclerosis (sigma) and the three weighted indices of the AS: obstruction (omega), stenosis (P) and benignity (B). These variables were obtained from the three major epicardial branches of the coronary arteries (right RC, left anterior descending LAD and left circumflex LC). From a total of 189 possible correlations between the 9 elements and their 3 combinations and the 7 variables of the AS in the three coronary arteries, 86 (45.5%) were significant. The fatty streak was the best correlated variable. It correlated with all elements with the only exception of chloride. The fibrous plaque was poorly correlated. The severe plaques and total atherosclerosis correlated mainly with Zn and Pb in the MIG and Sr in the LAG. The weighted indices have the same behaviour. Also some correlations were found between K, Ca, Zn, Br, Sr, Pb, Ca/Sr, Zn/Cu and Ca/K ratios with some of the variables of the AS in each coronary artery.
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PMID:Coronary atherosclerosis and hair elements contents. A correlation study of 102 autopsy subjects using the energy dispersive X-ray fluorescence analysis and applying an atherometric system. 159 80

INTACT (International Nifedipine Trial on Antiatherosclerotic Therapy) is a prospective, placebo-controlled, randomized, double-blind, multicenter trial analyzing the influence of 80 mg nifedipine/day on the angiographic progression of early stage coronary atherosclerosis. Coronary angiograms were taken in identical projections before and after a treatment period of 3 years. Quantitative analysis of the angiograms was performed with the computer-assisted contour detection system CAAS. For definition purposes, the coronary artery system was subdivided into 25 different segments, including all anatomic variants. Measurement parameters of segments were mean and minimal diameter, and of stenoses minimal diameter, percentage diameter reduction (at least 20%), length, and plaque area. The variable extent of the changes of these parameters in the different projections analyzed per patient in the two study angiograms was considered by separate computation of the maximal, mean, and minimal changes over these projections; the comparison of the parameter changes between the two treatment groups was performed separately according to these three modes. For all parameters, this comparison was performed on the basis of the individual 25 segments, as well as after aggregation of individual segments to arteries (RCA, LAD, and LCX), to groups of large and small segments, and to the entire coronary artery system. Assessment of changes of the coronary (patho)morphology by quantitative analysis of coronary angiograms is associated with a number of methodical limitations, which may lead to a certain variability of the results. However, due to the double-blind feature of INTACT, this variability should be comparable in the two groups of this study, allowing for a conclusive comparison.
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PMID:Features of the angiographic evaluation of the INTACT study. International Nifedipine Trial on Antiatherosclerotic Therapy. 207 91

The approach to a proximal LAD stenosis in an asymptomatic patient depends on a number of factors. Most important among these are the presence and extent of ischemia, anatomic considerations, and the functional status of the myocardium subserved by the vessel. In patients with functionally and hemodynamically insignificant disease with no ischemia, it is appropriate simply to follow the patient and to modify the risk factors for atherosclerosis if they exist. All three of the currently available modalities are appropriate in individual patients, including medical management, percutaneous balloon angioplasty, and surgical revascularization. In ambiguous cases, the available studies suggest no benefit from aggressive strategies; therefore, a conservative approach that minimizes side effects and complications of treatment is best.
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PMID:Should the asymptomatic patient with a significant proximal LAD stenosis undergo PTCA? 211 33

In 396 of 423 (93.6%) patients with mild to moderate coronary artery disease participating in a coronary angiographic follow-up trial, diameters of the epicardial coronary arteries were measured with an automatic contour detection system (CAAS). The underlying INTACT study (International Nifedipine Trial on Antiatherosclerotic Therapy), a prospective, placebo-controlled, randomized, double-blind multicenter trial, investigates the influence of the calcium antagonist nifedipine (80 mg/day) on the progression of coronary atherosclerosis over a three-year interval. The study is based on coronary angiograms repeated in identical projections after premedication with 10 mg isosorbide dinitrate sublingually. For quantitative analysis the coronary artery system was, in consideration of all anatomical variations, subdivided into 25 segments. In the first angiograms of the 396 patients evaluated up to April 1, 1988, altogether 5,425 different coronary segments could be analyzed over their entire length in one or more angiographic projections--on the average 13.7 +/- 2.8 segments per patient. Analysis parameters were the mean diameters of the entire segments and of the individual subsegments (about 5 mm in length). The 10 major proximal segments could be evaluated in 76-94% of patients respectively in more than two different angiographic projections on the average; in 0-13% of patients the respective segments were occluded. In 1-4% of patients the evaluation of these segments was prevented by poor film quality and in 1-16% of patients prevented by anatomical abnormalities (e.g., segment too short or too small). 184 segments were found occluded (RCA 42%, LAD 30%, CX 28%) and 909 mostly low-grade to moderate stenoses (RCA 34%, CX 32%, LAD 30%, left main 4%) were analyzed with a special algorithm. The following obstruction parameters were derived: minimal diameter, percentage severity, length, and plaque area. The present data demonstrate that in an angiographical multicenter follow-up study such as INTACT a nearly complete quantitative morphometric analysis of the visualized coronary artery system can indeed be obtained in virtually all angiograms when a computer-assisted contour detection system is applied.
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PMID:[Computer-assisted geometric measuring technic in coronary angiography interval studies: results of initial angiograms of the International Nifedipine Trial of Anti-atherosclerotic Therapy (INTACT) study]. 264 38

Cigarette smoking is a risk factor for development of coronary atherosclerosis. We examined the relationship between smoking and the anatomic location of coronary artery stenosis in 8,705 patients undergoing cardiac catheterization for suspected coronary artery disease (CAD). The smoking history of patients with CAD (greater than or equal to 70 percent stenosis) was compared with that of control subjects (0 percent stenosis) for each of nine anatomic locations (proximal, middle, and distal segments of right [RCA], anterior descending [LAD], and circumflex arteries [LCX]), using a case-control method. The odds ratio (OR) estimate of relative risk of CAD for smokers relative to nonsmokers was 2.8, with a 95 percent confidence interval (CI) of 2.5 to 3.1. Relative risk was greater for RCA stenosis (OR = 5.8; CI = 4.6-7.2) than for LCX (OR = 3.5; CI = 2.7-4.5) or LAD (OR = 2.1; CI = 1.8-2.4) lesions when comparing smokers with nonsmokers. After control for age, gender, history of diabetes mellitus, and serum cholesterol level, the adjusted relative risk for an RCA lesion (Mantel-Haenszel odds ratio [MOR] = 4.9) was significantly elevated (p less than 0.05) compared with the LAD (MOR = 1.9) but not with the LCX (MOR = 3.1). The relative risks of CAD were the same (p greater than 0.05) for the proximal, middle, and distal coronary segments. Thus, smoking increased the risk of all coronary lesions but did so more for the RCA than for other vessels, suggesting a spatial pattern to the increased risk produced by smoking.
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PMID:The effect of cigarette smoking on the pattern of coronary atherosclerosis. A case-control study. 339 6

In order to document the localized prevalence of early atherosclerosis in the major coronary arteries, a study using 50 coronary arteriographies was made from Feb. 1984 to Sep. 1985 in Shinshu University Hospital. Early atherosclerotic stenosis had a spatial distribution with strong incidence on the LAD bifurcations which contained the first diagonal branch, RCA which contained RV branches and LCX which contained the OM branch. Upstream of the bifurcations, the stenotic changes were observed to be concentric with the vessel axes. Downstream of the flowdivider, the lesions were gathered proximally and quickly disappeared distally. Lesions tended to occur eccentrically at the lateral walls of the entrance of the smaller branch. The proximal portions of both the RCA and LCA were almost free of disease. We also tried to investigate the relationship between the bifurcation angle branching off the parent vessels and early sclerotic lesions. We found that the angle between the branches and the plane in contact with the surface of the heart is especially important.
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PMID:A morphometric study of the distribution of early coronary atherosclerosis using arteriography. 340 47

Using a computed image analyser, coronary arteries from 50 autopsied patients with systemic lupus erythematosus (SLE) were examined on the three vessels (RCA, LAD, LCX) and compared with those of age-matched controls. The intima of coronary artery was significantly thickened much more in the case of SLE than in the case of age-matched controls. This was statistically significant (p less than 0.01). Hypertension and glomerulonephritis did not but corticosteroid therapy had an influence on the development of intimal thickening ratio of the coronary arteries in SLE patients. The mean intimal thickening ratio of the coronary arteries in the patients with SLE and without corticosteroid therapy was larger than that of patients with corticosteroid therapy (p less than 0.1). It appears possible to conclude that inflammatory change of SLE itself is one of the promoting factors of coronary atherosclerosis.
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PMID:Coronary atherosclerosis in patients with systemic lupus erythematosus at autopsy. 357 64

The possible relationship between trace element (Al, As, Cd, Co, Cr, Cu, Fe, Hg, Mn, Mo, Ni, Pb, Sb, Se, Zn) concentrations in various human tissues (heart, liver, kidney, aorta, rib and head hair) and cardiovascular diseases was studied on the basis of indications in the literature that trace elements may be directly or indirectly involved in cardiovascular disease processes. The underlying theme was that (slightly) reduced, as well as (slightly) elevated, concentrations compared with optimum values could, in the long term, lead to atherosclerotic lesions. In this project the tissues were obtained by autopsy involving 200 individuals (hospitalised patients and victims of traffic accidents). The seriousness of cardiovascular disease was quantitatively expressed by the degree of atherosclerosis of the descending branch of the left coronary artery (LAD) and of the abdominal aorta, for which a special measurement method was developed. Correlations were evaluated by two different methods, i.e. by a comparison of patients with extremely high or extremely low degrees of atherosclerosis and by means of stepwise multiple linear regression (SMLR) analysis. Corrections were made for the influence of age. The element Cd was found to be positively, and the elements Cu, Co, Se and Zn negatively, correlated with the degree of atherosclerosis. The inclusion of risk factors (diabetes mellitus, hypercholesterolaemia, hypertension, obesity and smoking) did not improve the explained variance.
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PMID:Relationships between trace elements and atherosclerosis. 401 98

The prevalence of myocardial bridging in patients with angina pectoris but normal coronary arteries was evaluated in 1780 patients who consecutively underwent coronary angiography. 62 patients (3.5%) were free of coronary atherosclerosis or other organic heart disease. In four of these patients systolic narrowing of the LAD was present. The other 58 patients received 0.2 mg nitroglycerin (NTG) intracoronarily and 30 micrograms/ml orciprenalin (ORC) intravenously up to a heart rate of 130/min. Repeated angiography revealed systolic compression of the LAD due to myocardial bridging (MB) in 40% (25 of 62). The length of MB raised from 1.4 +/- 0.9 cm to 2.1 +/- 1.1 cm (p < 0.001) after NTG and to 2.8 +/- 1.1 cm (p < 0.001) after ORC. Coronary luminal stenosis increased from 48 +/- 29% to 67 +/- 25% after NTG (p < 0.001) and to 83 +/- 18% (p < 0.001) after ORC. The prevalence of myocardial bridging in 40% of patients with stress-induced angina pectoris but normal coronary arteries is high. Nearly always coronary compression by myocardial bridging is only evident after adrenergic stimulation or after afterload reduction. Therefore, NTG and ORC are useful drugs to facilitate diagnosis of myocardial bridging by increasing coronary compression.
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PMID:[Incidence of myocardial bridges after adrenergic stimulation and decreasing afterload in patients with angina pectoris, but normal coronary arteries]. 782 70


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