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)

A retrospective analysis of peripheral and renal vein plasma renin activity has been performed in 9 patients with bilateral renal artery stenosis (3 fibromuscular dysplasia and 7 atherosclerosis). In all cases angiography showed a reduction of the arterial diameter of more than 70 p. 100. The renal artery was occluded in 3 cases. All patients received a constant sodium diet (100 mEq/day). Peripheral PRA values were classified as normal or low in 6 cases (less than 2.8 ng/ml/h) and high in one case (greater than 2.8 ng/ml/h): this values concerned 2 cases with renal artery occlusion and 1 case with a narrowing of 90 p. 100. Renal venous renin ratio of 1.5 or more has been found in 8 cases. In one case, the stenosis was quite symmetrical (70 p. 100) and the ratio less than 1.5. The secretion index has been calculated as the ratio between the venoarterial difference of both affected and unaffected side over the arterial value of PRA (V-A/A). On the more stenosed side, was found a V-A/A ratio of 0.5 or more. This ratio is particularly high in case of artery thrombosis, but there is no correlation between the ratio and the degree of stenosis. On the contralateral side, where the lesions were less important, the V-A/A ratio was low, ranging from 0 to 0.2; this estimation of renin secretion was found despite a significant stenosis on the angiography. 7 patients underwent PTA or surgery. 2 kidneys with arterial thrombosis were nephrectomized. In 5 cases the surgical treatment is performed on the 2 sides during the same procedure.(ABSTRACT TRUNCATED AT 250 WORDS)
Arch Mal Coeur Vaiss 1988 Jun
PMID:[Lateralization of renin secretion in renovascular hypertension with bilateral arterial stenosis]. 314 9

The possibility of elastase contributing to degradation of the arterial wall in atherosclerosis and to the formation of ectasia has prompted us to assay the main protease inhibitors, alpha 1-antitrypsin and alpha 2-macroglobulin, in patients with angiographic coronary disease with and without coronary ectasia. Serum concentrations of these two proteins were measured by immunonephelometry in 203 patients admitted for coronary arteriography. The results obtained were analyzed according to the presence of atheromatous lesions and their severity and to the presence or absence of ectasia. There was no correlation between the values observed and the presence or severity of coronary atherosclerosis, but the concentration of alpha 1-antitrypsin was significantly higher in patients with coronary ectasia (247.2 +/- 40.5 mg/ml) than in patients without ectasia (213.5 +/- 36.6 mg/100 ml; p less than 0.001). This study shows that coronary ectasia is associated with disturbances in the protease-antiprotease system, which may be consecutive to initial changes in elastase activity. Our results support the theory that elastase and protease inhibitors play a specific role in some atheromatous processes.
Arch Mal Coeur Vaiss 1988 Sep
PMID:[Protease inhibitors and ectasia in coronary atherosclerosis]. 314 27

Numerous studies carried out on animal models (apes excepted) have given encouraging results as regards the regression of experimental atherosclerosis after return to a normal or hypocaloric diet combined or not with various drugs. Regression is more obvious when lesions are recent and less severe: lipid striae disappear in less than 12 months, whereas more advanced and complicated lesions take years to regress. Intracellular lipids and cell alterations vanish more readily than extracellular lipids and alterations of connective and matrical tissues. Excessive accumulation of collagen accounts for the irreversibility of complicated plaques. Lesions of the intima are less stubborn than those of the media. Involution does not take place at the same time in coronary vessels and in the aorta. In non human primates, however, no noticeable regression is observed before several months if not years. In these animals, the degree and rapidity of involution after return to the normal vegetarian diet depend on the severity of the lesions induced, on the degree of fibrosis, on the level of residual hypercholesterolaemia and on the adjunction to the diet of certain drugs such as cholestyramine or alpha-alpha. The results of therapeutic trials conducted in man have not been so good because the patients treated had old and severe atherosclerosis: after a few years' treatment with low-cholesterol diet and appropriate drugs less than 10 p. 100 of them showed a clear-cut angiographic improvement. It is therefore illusory to rely on spontaneous regression when tackling a case of clinically detectable atherosclerosis. A preventive treatment is more promising, since infraclinical lesions may regress.
Arch Mal Coeur Vaiss 1988 Nov
PMID:[Natural history of the regression of atherosclerosis: from animal models to men]. 314 34

Although transluminal coronary angioplasty is now acknowledged as an effective treatment for coronary artery disease, the long-term outcome of patients treated by this method is still under evaluation. A french multicenter trial was set up and the long-term efficacy of transluminal coronary angioplasty was assessed in 546 patients undergoing the procedure before the 31/3/83. 380 initial successes (69 p. 100) were followed up for a period ranging from 6 to 48 months (average 19.9 +/- 10.4 months). A control coronary angiography was carried out in 88 p. 100 of cases. Restenosis (loss of over 50 p. 100 of initial angiographic improvement) was observed in 27 p. 100 of cases. Including the repeat procedures, the patency rate of the dilated vessels was 82 p. 100. Progression of atherosclerosis on another coronary artery was observed in 1.3 p. 100 of cases. After transluminal coronary angioplasty, 72 p. 100 of patients remained improved, 11 p. 100 underwent repeat angioplasty, 8 p. 100 underwent coronary bypass surgery, 1.3 p. 100 suffered myocardial infarction and 1.3 p. 100 died. Restenosis was associated with recurrence of angina pectoris in 90 p. 100 of cases (within 3.3 +/- 1.6 months) and a positive exercise stress test in 87 p. 100 of cases. Recurrence of angina due to progression of disease on the dilated vessel was observed in 24.2 p. 100 of cases; repeat transluminal coronary angioplasty was carried out for this indication in 38 p. 100 of cases, coronary bypass in 34.8 p. 100 and medical treatment was continued in 27.2 p. 100 of cases.(ABSTRACT TRUNCATED AT 250 WORDS)
Arch Mal Coeur Vaiss 1985 Feb
PMID:[Long-term effects of transluminal coronary angioplasty. French multicenter study]. 315 56

The 50s represent a hinge age-period during which atherosclerosis is more frequent but arterial disease does not appear to present features differing from those observed in neighbouring age groups. There is of course a higher frequency of atherosclerotic lesions of other arterial territories and a fairly high incidence of diabetes. With respect to the latter disease, apart from the typical association arteritis-diabetes, some cases are simply of atherosclerosis developing at the same time as the diabetes. Arteritis of lower limbs can present as two principal types in patient in their 50s: elective aorto-iliac arterial disease similar to early onset atherosclerosis in younger patients and more diffuse forms more typical of arterial disease in the elderly.
J Mal Vasc 1987
PMID:[Do arteriopathies in patients in their 50s present special characteristics?]. 355 19

A study of hearts removed during medicolegal autopsy of drug addicts after their sudden death demonstrated the constant presence of coronary lesions very similar to common atherosclerosis but remarkable by their magnitude, especially in patients dying at an age when atheromatous disease is relatively rare. Coronary circulation was studied in 10 cases by histoenzymatic, immunologic, histologic and ultrastructural examination of fresh and fixed tissues. The parietal thickening, noted in all cases to variable degrees, had provoked stenosis in several cases, preferentially in the proximal portion of the anterior interventricular vessel. On light and ultrastructural microscopy, the lesions observed were similar to atherosclerotic lesions, but differed in several respects and notably the absence of antiglobulin and the lack of increase of glycosaminoglycans. Although the relations between the drug and atheroma are undeniable, their mechanism is at present unknown.
J Mal Vasc 1987
PMID:[Lesions of coronary atherosclerosis in drug users. Preliminary studies]. 358 89

The results of a consecutive series of 24 patients reoperated for coronary bypass grafting between May 1977 and February 1983 are reported. The overall incidence of reoperation was 1.4 p. 100 (24 out of 1 716 cases); the incidence is tending to increase (2.3 p. 100 in 1982). Preoperative assessment revealed the persistence of cardiovascular risk factors: 75 p. 100 of patients had continued to smoke; 61 p. 100 had persistent hyperlipidaemia. The usual presenting syndrome was recurrence of chest pain (21 out of 24 cases) leading to control coronary arteriography on the results of which the surgical indication was based. The average time between the two operations was 38.7 months. The patients were classified into two groups; early reoperation (6 cases) for a technical problem or incomplete revascularisation, and late reoperation (8 cases) for disease of the graft and atherosclerosis. Progression of coronary atherosclerosis was the major long-term cause of occlusion of the saphenous graft (10-14 cases). The arteries most commonly bypassed at reoperation were the left anterior descending and right coronary arteries (12 times each). Reoperation comprised single bypass (13 cases), double bypass (10 cases) and triple bypass (1 case) with an average of 1.5 grafts per patient. The most commonly used vein was the internal saphenous vein (32 out of 36 grafts). Myocardial protection was insured by cardioplegia (13 cases) and intermittent clamping (10 cases) after cooling (general hypothermia at 22 degrees C). Global reoperative mortality (4 p. 100) was higher than for elective primary coronary surgery (2.3 p. 100). The incidence of perioperative infarction was 8 p. 100.(ABSTRACT TRUNCATED AT 250 WORDS)
Arch Mal Coeur Vaiss 1985 Jan
PMID:[Reoperation after saphenous aortocoronary bypass]. 391 77

Episodic mitral regurgitation due to ischaemia of one or both papillary muscles was studied in a review of 39 cases with complementary investigations and compared with previously reported data. The condition occurred after myocardial infarction in 69 p. 100 of cases (usually after inferior infarction: 54 p. 100) associated with ischaemia of the controlateral territory; there was no history of myocardial infarction in 31 p. 100 of cases. The patients were usually elderly (73 years), often hypertensive (77 p. 100) and diabetic (62 p. 100). The clinical syndrome was that of severe anginal pain, mitral regurgitation and left ventricular failure which was critical in some cases. The ECG showed typical ST depression (4.1 +/- 1.6 mm) especially in the antero-lateral leads; left bundle branch block (28 p. 100) with left axis deviation (18 p. 100), sometimes associated with changes of chronic infarction (64 p. 100) was also recorded. Mitral regurgitation and left ventricular failure regressed almost completely in typical cases between attacks, whilst the ECG showed slight residual sub-endocardial ischaemia (ST depression of 1.5 +/- 0.4 mm) in 30 cases and/or subepicardial ischaemia observed in the anterolateral leads in 13 cases. Phonomechanographic recordings (n = 32) showed moderate mitral regurgitation (1-2/6), usually parasystolic (47 p. 100) or early and mid systolic (36 p. 100) in 87.5 p. 100 of cases between attacks, aggravated by handgrip exercise and improved by trinitrin administration. Echocardiography (n = 27) only showed mitral valve changes in 2 patients (increased density of the papillary muscle in 1 case and prolapse of the anterior leaflet in 1 case); however, segmental wall hypokinetic (51 p. 100) or dyskinetic (15 p. 100) motion, was common with increased left ventricular end diastolic dimensions (mean 56.3 +/- 8.0 mm) and decreased fractional shortening (mean 0.30 +/- 0.07) (67 p. 100). Left atrial dimensions were increased (mean 39.7 +/- 6.4 mm) in 52 p. 100 of patients. Thallium 201 myocardial scintigraphy (n = 32) showed hypofixation in 57 (36 p. 100) and a lacuna in 23 (14 p. 100) of the 160 segments analysed. Left ventricular angioscintigraphy (n = 27; 135 segments) showed hypokinesia in 72 segments (53 p. 100); 2.7 segments per patient), akinesia in 19 segments (15 p. 100; 0.7 segment per patient) and dyskinesia in 2 segments (1.5 p. 100); 0.1 segment per patient). The global ejection fraction was 46 +/- 13 p. 100. Coronary angiography (n = 8) showed significant diffuse atherosclerosis.(ABSTRACT TRUNCATED AT 400 WORDS)
Arch Mal Coeur Vaiss 1985 Jan
PMID:[Paroxysmal mitral insufficiency caused by ischemic dysfunction of the papillary muscles. Apropos of 39 cases]. 391 82

The heart is the source of about 50 p. 100 of cerebral emboli. In the absence of clinically obvious cardiac disease, the heart is nevertheless suspected to be the origin, especially in young patients without atherosclerosis. Cardiac catheterisation and angiography were performed systematically to detect minor predisposing cardiac abnormalities which did not appear on standard clinical examination, and which could increase the risk of recurrent embolism. 64 patients aged 21 to 69 years were studied prospectively a few weeks after a cerebral vascular accident attributed to embolism on the results of complementary neurological investigation, or, more rarely, after systemic embolism to one of the limb arteries. Clinical examination, chest X-ray and the electrocardiogram were normal in all cases. The investigation consisted in right and left cardiac catheterisation, global angiography after right atrial injection, selective left ventricular angiography and coronary angiography in all patients over 40 years of age. Unsuspected cardiac abnormalities were detected in 39 of the 64 patients (60 p. 100); the main abnormalities were mild or moderate mitral valve prolapse (30 p. 100 of cases) and slight decreases in left ventricular contractility possibly related to a minor form of cardiomyopathy (23 p. 100 of cases). Ambulatory 24 hour monitoring showed supraventricular arrhythmias in 30 p. 100 of cases. The results of echocardiography were disappointing in the diagnosis of these minor abnormalities. In conclusion, cardiac abnormalities were detected in the majority of cases of cerebral embolism by cardiac catheterisation. These results support the indications for long-term anticoagulant and/or anti-arrhythmic treatment in these patients.
Arch Mal Coeur Vaiss 1985 Mar
PMID:[Cerebral embolism without apparent cause: angiographic study of minor predisposing cardiac anomalies. Prospective study of 64 patients]. 392 71

Prostacycline may play a preventive role in the development of ischaemic complications of coronary atherosclerosis through its vasodilatory and platelet antiaggregant properties. Its biological instability makes it difficult to measure in the plasma; however, it is possible to determine plasma concentrations by radioimmune assay of one of its stable derivatives, 6-Keto-prostaglandin F1 alpha (6KPGF1 alpha). Systemic plasma concentrations at rest of 30 patients with severe atherosclerosis were not significantly different from those of healthy control subjects (7.5 +/- 6.5 vs 10 +/- 5 pg/ml). In addition ischaemia during exercise is not associated with significant variations; at rest 7.1 +/- 6 pg/ml in the "ischaemic" group (n = 20) compared to 7.6 +/- 6.4 pg/ml in the "non-ischaemic" group (n = 10); on effort: 9 +/- 10 pg/ml compared to 13.3 +/- 14 pg/ml. These results show that measuring the plasma 6KPGF1 alpha by peripheral vein blood sampling is of no use in the diagnosis of coronary atherosclerosis or of myocardial ischaemia on effort.
Arch Mal Coeur Vaiss 1985 Aug
PMID:[Endogenous prostacycline and coronaropathy. Plasma levels of 6-keto-PGF1 alpha]. 393 71


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