Immunohistochemical localization of plasminogen activator inhibitor-1 in human coronary atherosclerotic lesions involved in acute myocardial infarction

Summary Immunohistochemical localization of plasminogen activator inhibitor-1 (PAI-1) was studied using the streptavidin-biotin method in human atherosclerotic coronary arteries. The patients (one male and two females), whose ages ranged from 61 to 78 years, died of anteroseptal acute myocardial infarction without having received any thrombolytic therapy. PAI-1 immunoreactivities (IRs) were mainly detected in the endothelial cells, smooth muscle cells, and collagen fibers of the coronary arterial intima and not in thrombi. Remarkable immunohistochemical staining was seen in intimal collagen fibers. In one patient, intimal PAI-1 IRs partly bordered a thrombus and surrounded a large atheroma rich in cholesterol crystals. Our results suggest that PAI-1 is present in both cellular and extracellular components of human coronary atherosclerotic lesions.     

Value of nail fold video capillaroscopy and carotid intima media thickness in assessment of micro and macro-vascular disease in systemic sclerosis patients

Aim of the work: To assess micro and macro-vascular involvement in systemic sclerosis (SSc) patients and their possible association with variable disease parameters using non invasive imaging techniques. Patients and Methods: Thirty (SSc) patients and twenty four controls were enrolled. Skin thickness was assessed using modified Rodnan skin score (mRss). Nailfold videocapillarscopy (NVC) was employed to detect microangiopathy and carotid intima media thickness (IMT) was assessed by power Doppler ultrasound. Results: Patients were 96.7% females and 3.3% males, mean age was 41.6 ± 11.5 years, with mean disease duration 4.7 ± 3 years. 73.3% had limited form while 26.7% had diffuse form. The mean mRss was 18.6 ± 8.5. Microangiopathic patterns detected by NVC were: early, active and late (36.65%), (26.7%) and (36.65%) respectively, and structural alterations included: scar (70%), large capillaries (60%), hemorrhage (41.4%), scanty (36.7%), branched (20%), mega capillaries (16.7%), and tall (10%), but neither crossed nor ramified capillaries were detected. The mean IMT was higher in patients (1 ± 0.2 mm) compared to controls (0.7 ± 0.09 mm) (p < 0.001). A significant inverse correlation was found between high density lipoprotein (HDL) with capillary length (r = ?0.27, p = 0.05), arterial and venous loop diameters (r = ?0.29,p = 0.03)(r = ?0.41, p = 0.003) respectively. On linear regression for prediction of HDL, only the relation to venous loop was significant (p = 0.03). Atherosclerosis on carotid doppler showed significant association with arterial loop diameter (p = 0.04), venous loop diameter (p = 0.02) and capillary length (p = 0.001). Conclusion: Micro- and macro-vascular disease in SSc are different entities that do not simultaneously exist in every patient, although endothelial dysfunction can eventually lead to both, and should be meticulously evaluated.     

他汀类药物对细胞因子及颈内动脉内膜的影响研究进展

他汀类药物在降脂的同时,还具有非调脂作用,如抑制血管炎症、稳定斑块、预防血栓形成、增加NO以改善内皮功能,这些可明显降低缺血性脑卒中的发生。脑动脉硬化是缺血性脑卒中的主要原因之一,动脉粥样硬化是由炎症反应介导的一个脂质沉积于动脉壁形成局部斑块的过程,其中细胞间黏附分子-1、巨噬细胞集落刺激因子、氧化修饰低密度脂蛋白在粥样硬化的形成和进展及加重过程中起着重要作用,本文就他汀类药物对动脉粥样硬化形成过程中炎症反应的细胞间黏附分子-1、巨噬细胞集落刺激因子、氧化修饰低密度脂蛋白及颈内动脉内膜的影响进行综述。     

Expressão de Proteína-1 Relacionada a Receptor de Lipoproteína de Baixa Densidade (LRP1) em Monócito em Correlação com EIMC em Pacientes Mexicanos Hipertensos

BackgroundArterial hypertension (HTA) represents a major risk factor for cardiovascular morbidity and mortality. It is not yet known which specific molecular mechanisms are associated with the development of essential hypertension.ObjectiveIn this study, we analyzed the association between LRP1 monocyte mRNA expression, LRP1 protein expression, and carotid intima media thickness (cIMT) of patients with essential hypertension.MethodsThe LRP1 monocyte mRNA expression and protein levels and cIMT were quantified in 200 Mexican subjects, 91 normotensive (NT) and 109 hypertensive (HT). Statistical significance was defined as p < 0.05.ResultsHT patients group had highly significant greater cIMT as compared to NT patients (p=0.002) and this correlated with an increase in the expression of LRP1 mRNA expression (6.54 vs. 2.87) (p = 0.002) and LRP1 protein expression (17.83 vs. 6.25), respectively (p = 0.001). These differences were maintained even when we divided our study groups, taking into account only those who presented dyslipidemia in both, mRNA (p = 0.041) and proteins expression (p < 0.001). It was also found that Ang II mediated LRP1 induction on monocytes in a dose and time dependent manner with significant difference in NT vs. HT (0.195 ± 0.09 vs. 0.226 ± 0.12, p = 0.046).ConclusionAn increase in cIMT was found in subjects with hypertension, associated with higher mRNA and LRP1 protein expressions in monocytes, irrespective of the presence of dyslipidemias in HT patients. These results suggest that LRP1 upregulation in monocytes from Mexican hypertensive patients could be involved in the increased cIMT. (Arq Bras Cardiol. 2021; 116(1):56-65)     

代谢综合征中医辨证分型与尿微量白蛋白及颈动脉内膜中层厚度关系

目的:探讨代谢综合征(MS)患者不同中医证型的尿微量白蛋白及颈动脉内膜中层厚度的关系,为中医辨证论治提供一定的客观依据。方法:选择MS患者80例,根据中医证候分为痰瘀互结型,气滞湿阻型,脾肾气虚型和气阴两虚型。对患者的一般资料、尿微量白蛋白检测结果及颈动脉内膜中层厚度进行比较。结果:MS痰瘀互结型患者的MAU高于气滞湿阻型及脾肾气虚型(P0.05);MS痰瘀互结型患者的IMT大于气滞湿阻型(P0.01),大于脾肾气虚型及气阴两虚型(P0.05)。结论:痰瘀互结型的MS患者更应注意肾脏及血管并发症的防治,尿微量白蛋白及颈动脉内膜中层厚度可以作为MS患者中医辨证分型的参考。     

老年人动态脉压及脉压指数与颈动脉内膜中层厚度的相关性分析

目的探讨老年人动态脉压及脉压指数与颈动脉内膜中层厚度的关系。方法随机抽样调查65岁以上人群200人进行24h动态血压监测,监测患者的动态脉压（APP）水平,按APP≤40mmHg（46例）、41～60mmHg（66例）、61—80mmHg（61例）和〉80mmHg（27例）分为4组;按动态脉压指数（APPI）≤0．40（49例）、0．41—0．50（70例）、0．51～0．60（57例）和〉0．60（24例）分为4组。分别以彩色多普勒超声测定其颈动脉内膜中层厚度（IMT）,并采集其静脉血测定血脂及高敏C-反应蛋白（hs—CRP）。结果随着APP及APPI的增加,颈动脉IMT明显增加,差异有统计学意义（P〈0．05）;Spearman相关分析,结果APP、APPI与颈动脉IMT呈正相关,其中以APPI相关系数（r）值大。结论动态脉压及脉压指数与颈动脉内膜中层厚度密切相关,且脉压指数在一定程度上较脉压在动脉硬化发展上有更大相关性。     

Asymptomatic atherosclerosis and hypertension in nondiabetic patients with chronic kidney disease

Abstract:  Atherosclerosis is accelerated in dialysis patients, but less is known about asymptomatic atherosclerosis and major risk factors in patients with different stages of chronic kidney disease (CKD). We compared intima media thickness (IMT) and plaque occurrence in the carotid arteries in 104 nondiabetic patients (stages 1–5 of CKD; mean age: 51.6 years) with those in 40 healthy control subjects. The IMT values (0.69 vs. 0.59 mm; P  < 0.002) were higher in patients. More patients had plaques (46.2 vs. 17.5%; P  < 0.002), and number of plaques was higher ( P  < 0.003). Negative correlation between IMT ( P  < 0.0001), presence of plaques ( P  < 0.0001), their number ( P  < 0.040), and chromium 51-labeled ethylenediaminetetraacetate (⁵¹Cr-EDTA) clearance were found in patients. With multiple regression analysis, relationship between IMT and ⁵¹Cr-EDTA clearance ( P  < 0.001) and presence of hypertension ( P  < 0.001) was found. Nondiabetic patients with CKD showed advanced atherosclerosis and IMT, plaque occurrence, and number increased directly with the level of renal dysfunction. Another important risk factor was hypertension.       

Systemic Inflammation and Cardiovascular Risk Factors: Are Morbidly Obese Subjects Different?

BACKGROUND: Systemic inflammation is a hallmark of obesity as well as of other chronic diseases, usually indicating increased cardiovascular risk; however, studies with arterial documentation in morbid obesity are extremely scarce. Aiming to analyze correlation between inflammatory markers, pulse-wave velocity (PWV), and intima-media thickness (IMT), a prospective study was designed. METHODS: Morbidly obese patients [n = 29, age 46.3 +/- 5.2 years, 82.8% females (24/29), BMI 44.9 +/- 5.2 kg/m(2)] with C-reactive protein/CRP > 5 mg/l but free from trauma, infection, inflammation, or cancer were enrolled in this study. All were clinically stable candidates for elective bariatric operation. Variables included comorbidities, metabolic profile, inflammatory and coagulatory markers, and arterial morpho-functional indices. RESULTS: Patients suffered from arterial hypertension (72.4%), metabolic syndrome (58.6%), and other comorbidities, but PWV and IMT were less aberrant than expected. Univariate correlation confirmed worse prognosis for those with metabolic syndrome and other accepted clinical risk factors. Multivariate confirmation was achieved for triglycerides (PWV) and D-dimer (IMT), but not for CRP, serum amyloid A, or neutrophil count, which were reversed in certain circumstances. CONCLUSIONS: (1) Metabolic syndrome, hyperglycemia, hypertriglyceridemia and D-dimer were positively correlated with arterial measurements, whereas inflammatory and coagulatory markers often exhibited paradoxical association; (2) stratification confirmed that at certain levels of systemic inflammation or body mass index, acute phase proteins and other markers became unreliable or shifted signals; (3) when controlled for blood pressure, PWV was only moderately elevated, and IMT remained normal; (4) taken together, these findings are consistent with a unique interaction between adiposity, inflammation, and cardiovascular risk in seriously obese subjects.     

Ten years outcome analysis of corporeal plication for Peyronie’s Disease

Objective To evaluate the long-term results of plication of tunica albuginea in patients with penile curvature secondary to Peyronie’s disease. Patients and methods A total of 78 men with penile curvature secondary to Peyronie’s disease underwent corporeal plication over a 10 year period. To assess the long-term results, a questionnaire-based study was undertaken on 73 of these patients with a time lapse of > 6 months after the operation. The questionnaire focussed on the presence or absence of penile deformity and pain, erectile function and the ability to perform sexual intercourse. Results Follow up ranged from 3 to 109 months with a median of 51 months. The cosmetic result was good or excellent (straight or almost straight penis) in 94% by 6 months. A total of 57 replies to the questionnaire were suitable for analysis. A total of 90% patients had a satisfactory cosmetic result, whereas only 71% reported a satisfactory functional result (straight or almost straight penis on erection with pain free penetration and normal sexual intercourse) in the long-term. In patients with > 3 years follow up, the cosmetic and functional success rates were 83% and 67%, respectively, and for patients with > 5 years follow up the corresponding figures were 82% and 71%, respectively. The main causes of functional failure were pain, erectile dysfunction and persisting deformity. There were no major complications associated with the procedure. Conclusions Corporeal plication is an effective surgical option for the correction of penile deformity in patients with Peyronie’s disease, with good cosmetic results and acceptable functional success rate in the long-term.     

2型糖尿病患者血清瘦素与颈动脉内膜中层厚度的相关性研究

目的探讨2型糖尿病（T2DM）患者血清瘦素水平与颈动脉内膜中层厚度（IMT）的关系。方法选择35例2型糖尿病患者、16例正常对照者,分别测定其血清瘦素、空腹血糖、糖化血红蛋白Alc（HbAlc）、C肽、血脂、血压、体重指数（BMI）及腰围,同时使用高分辨率超声检测双侧颈动脉IMT。结果T2DM患者血清瘦素浓度与颈动脉IMT呈显著正相关。结论血清瘦素浓度与颈动脉IMT的增厚有关,提示瘦素可能是导致T2DM患者动脉粥样硬化中的一项危险因素。