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

A prospective study of carotid artery atheroma by vascular echotomography and spectral analysis was performed in 40 patients with myocardial infarction and 40 control subjects. Carotid artery atheroma was commoner in the group of patients with myocardial infarction (72.5% +/- 6.8%), earlier (9 years), more commonly bilateral (37.5% +/- 7.6%) and more stenotic (32.5% +/- 7.4%) than in the control group (p less than 0.000a, p less than 0.0001 and p less than 0.002, respectively). The severity of carotid artery atheroma correlated with the site of coronary artery disease; the following significant relationships were found: stenosing 40% and/or bilateral carotid atherosclerosis and left anterior descending disease (p less than 0.02); carotid atherosclerosis and double or triple vessel disease (p less than 0.05). The authors conclude that detection of carotid artery atheroma after myocardial infarction is valuable for two reasons: it gives an indication as to the severity of the coronary disease; carotid endarterectomy may be considered at the same time as coronary artery bypass surgery.
Arch Mal Coeur Vaiss 1985 Oct
PMID:[Quantification of carotid atheroma, by vascular ultrasonics and spectral analysis, after myocardial infarction. Apropos of 80 cases]. 393 14

Multiple congenital coronary-left ventricular fistulae (CLVF) are rare (4.5% of all coronaro-cardiac fistulae, the same incidence as isolated CLVF); data obtained from 7 personal and 25 previously reported cases, showed that this anomaly, is diagnosed at coronary angiography performed for anginal chest pains in 2 out of 3 cases; cardiac auscultation was usually normal but the basal ECG was pathological in 3 out of 4 cases; the electrical changes suggested myocardial ischaemia in 20 out of 24 cases. However, exercise stress testing was negative in 47% of cases. Multiple CLVF usually arose from the same artery (59%); the commonest artery involved was the left anterior descending (84% of the single artery fistulae and 100% in cases of multiple CLVF arising from more than one artery). The angiographic appearances of multiple CLVF were constant: images of "intracavitary rain". Associated ventriculographic abnormalities were uncommon but coronary atherosclerosis was observed in 15% of cases. The main differential diagnosis is that of CLVF secondary to intra-left ventricular thrombosis due to the development of neovascularisation of the thrombus from the underlying endocardium. The value of non-invasive investigations (2D echocardiography alone or coupled with pulsed Doppler) has not been shown in this type of coronaro-cardiac fistulae. Surgical correction was attempted in 3 cases, 2 of which had associated cardiac pathology justifying surgery. The presence of unequivocal coronary insufficiency due to CLVF was not demonstrated despite some suggestive clinical and paraclinical indicators.
Arch Mal Coeur Vaiss 1985 Oct
PMID:[Multiple congenital coronaro-left ventricular fistulas. Apropos of 7 cases]. 393 22

The interactions of blood cells (platelets and leukocytes) with the components of the vessel wall (endothelial cells, extracellular subendothelial matrix and smooth muscle cells) play an important role in the initiation of thrombosis and the development of atherosclerosis. These cellular interactions are partially regulated by the formation of pharmacologically active lipids (PAL): prostaglandins, leukotrienes, PAF-acether and related compounds. These biochemical mediators are produced from the phospholipids of the cell membrane in response to external stimulation. The metabolic precursors, such as arachidonic acid, are common. The subsequent enzymatic differentiation leads to the formation of different terminal products according to the cells, thromboxane A2 in the platelets and prostacyclin in the endothelial cells.
Arch Mal Coeur Vaiss 1985 Dec
PMID:[Physiology of the interactions of blood and the blood vessel wall. Role of pharmacologically active lipids]. 393 41

Platelet aggregation response to collagen has been studied in 20 rabbits, randomly allocated to receive a normal (control) or high cholesterol diet. The sensitivity of platelets to collagen was significantly higher in the hypercholesterolaemic group (p less than 0.01) compared to controls. All hypercholesterolaemic rabbits developed generalised atherosclerosis and this may be due to increased circulating platelet activity.
J Mal Vasc 1986
PMID:Hypercholesterolaemia accentuates platelet activity. 394 21

The limitations of medical treatment in angina pectoris depend on its efficacity and indications. 1. Efficacity of medical treatment.--Anti-anginal drugs are able to relieve anginal pain in at least 3/4 of cases. However, the ability of medical measures (diet, exercise, stopping smoking, hypolipidemic drugs, antihypertensive drugs, anticoagulants, platelet anti-aggregants, antiarrhythmics, inotropic agents, vasodilators and diuretics) to prevent coronary atherosclerosis delay its progression and prevent its complications--so increasing the life expectancy of coronary patients--remains very uncertain. 2. Frontiers and judications of medical treatment.--Coronary patients with few or no symptoms appear to be best suited for long-term anti-anginal treatment with long acting nitrate derivatives and/or betablockers. The ability of the latter group to increase the life expectancy of all coronary patients remains to be shown. The limits of the indications of medical treatment are more difficult to define either by purely subjective criteria (incapacitating angina after trials of anti-anginal drugs at adapted doses) or by "objective" criteria (ergometry, coronary angiography).
Arch Mal Coeur Vaiss 1983 Feb
PMID:[The limits of the medical treatment of angina pectoris]. 613 4

This is a critical review of controlled therapeutic trials concerned with the use of anti-platelet agents in the prevention of cerebral ischaemic accidents due to atherosclerosis (CIADA). Amongst the 4 substances studied in 9 trials, dipyridamole, clofibrate, sulfinpyrazone and aspirin, only aspirin at the dose of 1 g brought about a statistically significant reduction in the risk of cerebral infarction and death in patients who had suffered an initial transient or rapidly regressive cerebral ischaemic accident. Nevertheless, this preventive action was seen in only one of the 5 studies devoted to aspirin and was found only in men, in particular where there was no history of diabetes or myocardial infarction. Although encouraging, this result requires confirmation by other studies before any definite conclusion is drawn as to the efficacy of aspirin in the secondary prevention of CIADA.
J Mal Vasc 1983
PMID:[Role of antiplatelet agents in the prevention of cerebral ischemic accidents]. 634 94

Effort angina is the result of acute myocardial ischemia on exercise due to an imbalance between myocardial oxygen demand and supply. During exercise, ischemia is provoked by an increase in myocardial oxygen needs (tachycardia, increased blood pressure, etc.) which cannot be met by increased coronary blood flow. The commonest cause of insufficient flow is coronary atherosclerosis. Coronary spasm does, however, play a role, whether it occurs during exercise on normal or atheromatous coronary vessels. Classical anti-anginal therapy is directed towards a reduction in the intense adrenergic activity associated with exercise, and to the limitation of myocardial oxygen consumption. Calcium inhibitors which cause peripheral vasodilation, decrease ventricular wall tension and coronary resistance, are usually reserved for unstable or resistant angina. We studied 10 patients with stable effort angina for over 2 years with significant (greater than 70 per cent) atheromatous lesions on coronary angiography unsuitable for surgical treatment. The patients underwent a randomised double blind trial to compare the effects of propranolol, diltiazem and placebo. Exercise ECG was performed after a treatment period of one week, 3 hours after drug administration. The results showed a significant improvement of work capacity with propranolol and diltiazem as compared to placebo. Propranolol (160 mg/day) was more effective than diltiazem (180 mg/day) in 6 patients. In 4 cases, the improvement with diltiazem and propranolol was the same. The association of the two drugs in one open study in 5 patients was even more effective in 3 patients. The small number of patients studied makes it impossible to draw any firm conclusions. Although calcium inhibitors are the treatment of choice in coronary spasm and betablockers in effort angina, diltiazem exerts an anti-anginal effect by reduction of myocardial oxygen consumption without depression of myocardial contractility, as other workers have shown.
Arch Mal Coeur Vaiss 1983 Feb
PMID:[Are calcium inhibitors useful in the treatment of effort angina pectoris]. 640 53

A three year prospective study was undertaken to determine the possible relationship of coronary atherosclerosis in subjects under 50 years of age, confirmed by coronary angiography, and structural changes of the connective tissue dystrophy. The independence of the histological changes with respect to other cardiovascular risk factors was also evaluated. The study was carried out by a double blind technique between the histological and clinical results. We present our preliminary results in 88 male patients, 64 with atherosclerosis and 24 controls. Histological abnormalities were found in 81.25% of patients with atherosclerosis compared to 33.3% in the control subjects. Accelerated skin aging, a simple diagnosis, requires only light microscopy for diagnosis and seems to be the simplest and most reliable screening test. It is found in 61% of atherosclerotic patients in the general population and in 74% of coronary patients under 45 years of age, independently of other risk factors especially cigarette smoking. As a screening test for coronary atherosclerosis before 45 years of age, the sensitivity was found to be 74.2% and specificity 57.1%, the predictive value being 79.3%. Connective tissue dystrophy needs electronic microscopy and seems to be less reliable in the detection of atherosclerosis as this condition is usually found in patients over 45 years of age. However, these changes are related to atherosclerosis and not to age. This study shows that skin biopsy in the search of accelerated skin aging, enables atherosclerosis to be detected simply and reliably, independently of other risk factors. This test, by defining the individual structural risk, is a method of following the progression or regression of atherosclerosis and so help control treatment.
Arch Mal Coeur Vaiss 1983 Dec
PMID:[Detection of coronary atherosclerosis before 45 or 50 years of age. Value of skin biopsy]. 642 75

Two coronary pulmonary fistulae were demonstrated between the right coronary and left anterior descending arteries and the main pulmonary artery at coronary angiography, in a 66 year old woman with a continuous murmur in the third left intercostal space. This double malformation, though uncommon is not rare (18 previously published cases). It is usually diagnosed late (17 to 76 years) and the presentation is limited in half the cases to a localised continuous murmur, the localisation of which may simulate a patent ductus arteriosus. The hypothesis of a supernumerary coronary artery arising from the main pulmonary artery is suggested by the constancy of the anatomical characteristics of the reported cases. Eight patients presented typical attacks of angina which were due to severe coronary atherosclerosis, affecting two or three main vessels except in one case. Therefore, it is unlikely that these fistulae cause coronary insufficiency by a coronary steal syndrome. However, this mechanism may aggravate symptoms in patients with coronary artery disease and necessitate surgical cure of the fistulae at the same time as coronary bypass surgery. On the other hand, surgery does not seem to be indicated in asymptomatic patients.
Arch Mal Coeur Vaiss 1984 Jan
PMID:[Bilateral coronaro-pulmonary fistula. Apropos of a new case with review of the literature]. 642 85

In recent epidemiological studies, apolipoprotein-B (apo B), the main low density lipoprotein (LDL), was found to be significantly elevated in patients with early atherosclerosis. The aim of this study was to compare plasma apo B in a population of men who had suffered myocardial infarction before 45 years of age (N = 31) with a control population (N = 22). In the coronary group, there were 27 angiographies between the end of the first and third month. The plasma lipoproteins were separated by ultracentrifugation, cholesterol and triglycerides measured by enzymatic methods and apo B by Laurell's technique of immunoelectrophoresis. Our results showed significantly higher apo B in the coronary group (p less than 0.05). Serum cholesterol, triglycerides, very low density lipoprotein (VLDL) and LDL cholesterol were also significantly higher whilst high density lipoprotein (HDL) cholesterol was significantly lower. In addition, apo B levels correlated with the severity of the coronary lesions on angiography. Therefore, the plasma apo B level is a good predictive indicator of the presence of early coronary atherosclerosis and its severity.
Arch Mal Coeur Vaiss 1984 Jan
PMID:[Predictive value of plasma apolipoprotein B in myocardial infarction in young subjects. Correlations with coronarographic data]. 642 90


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