高密度脂蛋白胆固醇亚型抗动脉粥样硬化的研究进展

高密度脂蛋白胆固醇(HDL-C)与动脉粥样硬化性疾病的发生、发展密切相关,可以作为动脉粥样硬化性疾病的独立危险因素。但在一些情况下,HDL-C抗动脉粥样硬化的作用也可发生改变,甚至可能会起到促动脉粥样硬化的作用。目前关于HDL-C的研究主要集中于总体水平,而忽视了其是一类组成、密度、颗粒大小、功能等极不均一的脂蛋白。根据分离方式的不同,HDL-C可分为不同的亚型,不同亚型与动脉粥样硬化性疾病的关系亦各不相同。本文就HDL-C各亚型与动脉粥样硬化性疾病的关系进行综述。     

老年人踝臂指数与动脉粥样硬化研究进展

动脉粥样硬化是全身性、连续性疾病,除了累及冠状动脉、脑动脉外,还常累及全身的外周动脉等多处动脉血管床[1].冠状动脉性心脏病、缺血性脑卒中、外周动脉病等都是动脉粥样硬化性疾病的重要表现形式.动脉粥样硬化性疾病是老年常见病,动脉硬化的程度和进展的快慢,将直接影响老年人心脑血管疾病的发生率和死亡率,影响老年人的生存质量.     

程序性坏死与晚期动脉粥样硬化

动脉粥样硬化是一种与血脂异常、高血压、吸烟、肥胖等因素相关的慢性炎症性疾病。程序性坏死是一种可调控的坏死,参与多种炎症性疾病的病理过程。近年有研究认为程序性坏死在晚期动脉粥样硬化的进展中具有重要作用,因此,研究并调控程序性坏死可以为延缓动脉粥样硬化进展、稳定动脉粥样硬化斑块提供新思路。     

PET/CT及其结合用示踪剂无创检测动脉粥样硬化性斑块和炎症的研究进展

<正>动脉粥样硬化是众多心脑血管疾病(冠心病、脑卒中、腹主动脉瘤和外周动脉疾病)发生、发展的直接原因。研究表明动脉粥样硬化本质上是一种慢性炎症增生性疾病〔1〕。在长期的促动脉粥样硬化危险因子(如吸烟、高血压、高脂血症、糖尿病以及高同型半胱氨酸血症等)的作用下,血管内皮受到损伤或功能异常,导致动脉粥样硬化的形成;动脉粥样硬化斑块主要由脂质、钙盐和炎症细胞构成〔2〕。随着动脉粥样硬化性疾病的     

氧化三甲胺在动脉粥样硬化中的研究进展

氧化三甲胺是肠道菌群的代谢产物之一,通过多条信号通路影响冠状动脉粥样硬化性疾病的病理过程,具有促进血管内皮细胞损伤、参与血管壁脂质沉积、促进炎症发生发展并刺激平滑肌细胞衰老、迁移等作用。研究表明,通过介导氧化三甲胺的代谢及相关信号通路的激活,可以预防并治疗动脉粥样硬化性疾病。文章将围绕氧化三甲胺参与动脉粥样硬化的作用机制进行简要综述,以期为动脉粥样硬化性疾病的防治提供新的研究思路。     

内源性大麻素系统与动脉粥样硬化

动脉粥样硬化是一种慢性炎症性疾病。内源性大麻素系统在体内外具有抗炎及免疫调节作用,能够影响动脉粥样硬化相关细胞的趋化、迁移、增殖、凋亡等,可能对动脉粥样硬化进展及血管再狭窄产生抑制作用,并对代谢综合征等动脉粥样硬化危险因素具有治疗作用,对内源性大麻素系统的深入研究有助于为动脉粥样硬化提供新的治疗手段。     

β2整合素CD11/CD18与动脉粥样硬化

动脉粥样硬化是有免疫系统参与的慢性炎症反应性疾病,CD11/CD18在其炎性反应中发挥重要作用。CD11/CD18缺失或阻断可通过减少白细胞粘附、脂纹形成,干预经皮冠状动脉腔内成形术术后狭窄、再狭窄过程等多个环节影响动脉粥样硬化的形成过程。这些研究深化了对动脉粥样硬化分子机制的认识,以CD18为新靶点的药物,可能会给临床动脉粥样硬化性疾病的预防、诊断和治疗带来新的突破。     

细胞焦亡参与动脉粥样硬化形成的分子机制新进展

细胞焦亡是炎症小体引起炎症Caspase底物GSDMD蛋白剪切并多聚化造成细胞崩解,并促使IL-1β、IL-18等促炎症细胞因子释放的一种新型细胞死亡形式。已有研究认为细胞焦亡与病毒性疾病、代谢性疾病、神经性疾病等密切相关。目前一些报道认为细胞焦亡参与动脉粥样硬化斑块的形成,细胞焦亡受非编码RNA及其他机制调控。本文在介绍细胞焦亡的形态学和分子特点的基础上,着重对NOD样受体蛋白3(NLRP3)炎症小体介导的细胞焦亡在动脉粥样硬化形成中的潜在作用以及调控细胞焦亡的分子机制的最新进展进行综述,以期为动脉粥样硬化性疾病的防治寻找新的靶标。     

小而密低密度脂蛋白与动脉粥样硬化的研究进展

近年发现小而密低密度脂蛋白与动脉粥样硬化的发展关系密切，进而可能成为冠心病、糖尿病等动脉粥样硬化性疾病的危险因素，本文就这方面的进展加以综述。     

炎症与动脉粥样硬化

动脉粥样硬化是一种炎症性疾病。低密度脂蛋白异常、高血压、感染、糖尿病、肥胖等均可触发炎症反应，最终导致动脉粥样硬化。有关基因调控方面的研究进一步证实了动脉粥样硬化不是单纯的由于脂质沉积所致，炎症反应贯穿于动脉粥样硬化的全过程。本文就动脉粥样硬化中炎症反应的触发机制和基因调控进行综述。     

Importance of periodontal disease in the kidney patient.

End-stage renal disease (ESRD) patients on hemodialysis experience a greatly increased rate of atherosclerotic complications. In both hemodialysis and general populations, it has become evident that inflammation plays a central role in the pathogenesis of atherosclerotic complications. C-reactive protein (CRP), the major acute phase protein in man, has been found to predict all-cause and cardiovascular mortality in ESRD patients on hemodialysis maintenance therapy. Hepatic CRP synthesis is upregulated by proinflammatory cytokines released locally at sites of infection or inflammation, although many patients experience elevated CRP values in the absence of overt infection or inflammation. Destructive periodontal diseases in the general population have been associated with both an increased prevalence of atherosclerotic complications and an elevation in serum CRP values. In view of the prevalence of destructive periodontal diseases in the general population, and since periodontal evaluations are normally not performed as part of a medical assessment, destructive periodontal diseases may be an over looked source of inflammation in ESRD patients on hemodialysis therapy. The intent of this report is to review the possible role destructive periodontal diseases and associated periodontal infections may play in the management of the ESRD patient on hemodialysis maintenance therapy.     

动脉粥样硬化性疾病与肿瘤发生的相关性及机制研究进展

动脉粥样硬化性疾病和肿瘤严重威胁人类健康.临床研究显示,动脉粥样硬化性疾病和肿瘤的发生显著相关,动脉粥样硬化患者中肿瘤的发生率高于非动脉粥样硬化者,同时,肿瘤人群中动脉粥样硬化性疾病的发生率亦显著高于非肿瘤人群.动脉粥样硬化性疾病和肿瘤看似是两个独立的疾病,但是在发病机制上存在不同水平的关联,二者不仅存在共同的危险因素...     

Dermatomyositis and malignancy. A review of the literature.

Although there appears to be an increased incidence of malignancy among patients with dermatomyositis, demonstration of definitive statistical significance is precluded by the lack of large, controlled series. Patients with the two diseases tend to be older than the general dermatomyositis population and younger than those with cancer alone; and there is a preponderance of female patients. Tumors of the ovary and stomach are more frequently observed than in the general population, while colorectal malignancies are underrepresented. Most reported cases show development of the diseases within a year of one another, and, in some patients, the course of the myopathy follows that of the tumor. No definitive cause for the myopathy in these patients has been established.     

Inflammatory Bowel Disease and Cardiovascular Diseases

BackgroundEmerging data showed patients with chronic inflammatory disorders, including inflammatory bowel disease, are more likely to develop atherosclerotic cardiovascular diseases, heart failure, and atrial fibrillation. This article aims to review the evidence of those associations.MethodsPubMed was searched from inception to January 2022 using the keywords, including inflammatory bowel diseases, Crohn disease, ulcerative colitis, atherosclerotic cardiovascular disease, coronary artery disease, cardiovascular disease, atrial fibrillation, heart failure, and premature coronary artery disease. Relevant literature, including retrospective/prospective cohort studies, clinical trials, meta-analyses, and guidelines, were reviewed and summarized.ResultsBoth ulcerative colitis and Crohn disease are associated with an increased risk of atherosclerotic cardiovascular diseases, cerebrovascular accidents, premature coronary artery disease, and atrial fibrillation. Ulcerative colitis is associated with an increased risk of heart failure. The increased atrial fibrillation occurred during inflammatory bowel disease flares and persistent activity but not during periods of remission. Hypotheses for the mechanism underlying the association of inflammatory bowel disease and atherosclerotic cardiovascular diseases include shared risk factors (ie, obesity, diabetes, smoking, diet) and pathophysiology (gut microbiome dysfunction) or adverse effects from inflammatory bowel disease itself or its treatment (ie, chronic inflammation, dyslipidemia, thrombocytosis, steroids).ConclusionInflammatory bowel disease is associated with an increased risk of atherosclerotic cardiovascular diseases, heart failure, and atrial fibrillation. A multidisciplinary team with gastroenterologists and cardiologists is needed to optimize the care for patients with inflammatory bowel disease and associated cardiac diseases.     

Does the preventive effect of different drugs depend on location of the atherosclerotic process?

Atherosclerosis can affect nearly any part of the arterial system. Therefore, it is considered as a generalized disease. As most probably similar or identical etiopathogenetic mechanisms are involved in different atherosclerotic diseases, a different effect of treatment of risk factors on atherosclerotic lesions in different parts of the vascular system is expected. Until now, great emphasis has been placed on the aggressive pharmacological management of coronary artery disease, less attention has been devoted to the management of cerebrovascular and much less to peripheral arterial disease, despite their significant morbidity and mortality. The data from recent trials have indicated that treatment of patients with antiplatelet drugs, statins, antihypertensive and antidiabetic drugs prevents the progression of coronary atherosclerosis, reduces cardiovascular events and improves prognosis of coronary patients. Subgroup analyses from large studies have also shown that treatment of risk factors for atherosclerosis with drugs reduces cardiovascular events and improves prognosis of cerebrovascular and peripheral arterial occlusive disease. Although some studies indicate that the effects of distinct preventive procedures are to some extent dependent on the locations of atherosclerotic disease, it seems that the success of preventive measures is mostly related to the progression of the disease or the risk of treated population and not on the treated vascular bed.     

Impact of the atherosclerotic process in patients with diabetes

Between 120 and 140 million people suffer from diabetes mellitus (type 1 and type 2) worldwide, and this number may well double by the year 2025. Patients with diabetes are at increased risk of atherosclerosis and its clinical sequelae: coronary, peripheral vascular, and cerebrovascular diseases. Concurrently, the most common cause of death in persons with diabetes is myocardial infarction. The pathogenesis, progression, and epidemiology of atherosclerotic disease are distinct in patients with diabetes. Atherosclerosis can develop much earlier in life, and at an accelerated rate, compared with non-diabetic individuals. One of the factors responsible for increased atherosclerosis is related to the atherogenic lipid profile in diabetes. The pathobiological processes that are responsible for transforming dormant atherosclerotic plaques into active rupture-prone plaques may be enhanced in diabetes as well. It follows that a major challenge in the treatment of patients with diabetes is to reduce the risk of atherosclerotic disease. The third National Cholesterol Education Program (NCEP) report recently recommended that the management of dyslipidaemia in patients with diabetes should be as aggressive as in those with established coronary heart disease (CHD). The NCEP Adult Treatment Panel III guidelines recommend statins for patients at elevated risk for CHD.     

What determines age-related disease: do we know all the right questions?

The average human lifespan has increased throughout the last century due to the mitigation of many infectious diseases. More people now die of age-related diseases than ever before, but these diseases have been resistant to elimination. Progress has been made in treatments and preventative measures to delay the onsets of these diseases, but most cancers and vascular diseases are still with us and they kill about the same fraction of the population year after year. For example, US Caucasian female deaths from breast plus genital cancers have remained a fairly constant ~7% of the age-related disease deaths from 1938 to 1998 and have been consistently ~2-fold greater than female colon plus rectal cancer deaths over that span. This type of stability pattern pervades the age-related diseases and suggests that intrinsic properties within populations determine these fractions. Recognizing this pattern and deciphering its origin will be necessary for the complete understanding of these major causes of death. It would appear that more than the random processes of aging drive this effect. The question is how to meaningfully approach this problem. This commentary discusses the epidemiological and aging perspectives and their current limitations in providing an explanation. The age of bioinformatics offers hope, but only if creative systems approaches are forthcoming.     

Proposed guidelines for hypertriglyceridemia in Japan with non-HDL cholesterol as the second target

The Japan Atherosclerosis Society (JAS) guidelines for the prevention of atherosclerotic diseases, proposing management for LDL cholesterol as the primary target, have successfully contributed to the prevention of cardiovascular events; however, recently, the impact of hypertriglyceridemia as an additional cardiovascular risk has become understood, especially in light of the rise in obesity, metabolic syndrome, and diabetes in the Japanese population. Rather than waiting to obtain conclusive domestic data confirming that hypertriglyceridemia is a cardiovascular risk factor and that its management is efficacious, we propose guidelines for hypertriglyceridemia using non-HDL cholesterol as a second target.     

The imbalance between circulating endothelial cells and progenitors in cardiovascular diseases: a mirror of disrupted endothelial integrity

The disruption of endothelial integrity is at the crossroads of the initiation and progression of multiple cardiovascular diseases pathophysiology. During these last years, it has been evidenced that endothelium is a highly dynamic tissue in equilibrium with a circulating compartment composed of various sub-populations offering important opportunities for a non-invasive exploration. Among these, circulating endothelial cells (CEC) are mature cells detached from injured vessels. Rarely found in blood in the health, CEC number is raised in a wide variety of pathological conditions associated with profound vascular insult. An additional population are the endothelial progenitor cells derived from bone marrow and characterised by their ability to participate in endothelial repair. Reduced number and impaired function of EPC have been related to situations with increased cardiovascular risk or to clinical atherosclerotic diseases. This review will focus on present data concerning CEC and endothelial cells and progenitors (PEC) in the setting of cardiovascular diseases. Particular emphasis will be given on the clinical value of these endothelial biomarkers to monitor endothelial homeostasis depending on the balance between endothelial injury and repair.     

老年人肌少症与心血管疾病共病研究进展

随着人口老龄化到来,衰老相关性疾病已成为困扰各国政府的一个难题。心血管疾病作为代表性疾病,发病率逐年攀升。运动是心血管疾病防治的重要手段。老年人群运动能力及运动量的减低与心血管事件发生存在相关性。肌少症是一种以肌肉含量减少和(或)功能减退为表现的疾病,其与心血管疾病之间关系紧密。本文拟总结近年肌少症与心血管疾病的研究,从疾病的病理生理、相互作用、潜在机制、临床表现及诊断标准、治疗等多层面进行介绍,使上述疾病得到更为深入的理解。