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Biomedical subjects

M S Chang

Publications and source records attributed to M S Chang.

At least 289 records · Page 16Linked to original sources

Radiofrequency catheter ablation of sustained intra-atrial reentrant tachycardia in adult patients. Identification of electrophysiological characteristics and endocardial mapping techniques.

BACKGROUND: Information about electrophysiological characteristics and radiofrequency ablation of intra-atrial reentrant tachycardia has not been reported before. We proposed that induction and termination of intra-atrial reentrant tachycardia by atrial extrastimuli or rapid atrial pacing and resetting the response pattern by atrial extrastimuli during intra-atrial reentrant tachycardia could ensure the mechanism of reentry and that the earliest site of endocardial activation and concealed entrainment pace mapping with the shortest stimulus-P wave interval could localize a critical area responsible for intra-atrial reentrant tachycardia and radiofrequency ablation. METHODS AND RESULTS: Seven patients with refractory atrial tachycardia were referred for electrophysiological studies and radiofrequency ablation. Electrophysiological studies and endocardial mapping found (1) 10 atrial foci with atrial tachycardia cycle length of 406 +/- 41 ms; (2) atrial tachycardia had induction and termination by atrial extrastimuli (8 of 10) or rapid atrial pacing (10 of 10); (3) atrial tachycardia had increasing (6 of 10) or mixed (flat and increasing, 4 of 10) resetting response pattern, with resetting interval of 57 +/- 13 ms (14 +/- 4% of atrial tachycardia cycle length); (4) exit sites of atrial tachycardia in right atrial free wall (6 of 10), right atrial septum (3 of 10), and midposterior left atrium (1 of 10); and (5) earliest activation site had timing relative to P wave by -37 +/- 7 ms, and concealed entrainment pace mapping had shortest stimulus-P interval 23 +/- 3 ms. By the endocardial activation pace-mapping technique, radiofrequency energy (8 +/- 1 pulses, 31 +/- 3 W, 101 +/- 11 seconds) successfully eliminated the 10 atrial foci without recurrence (follow-up, 16 +/- 5 months). CONCLUSIONS: Mechanism of intra-atrial reentrant tachycardia could be confirmed by the electrophysiological characteristics, and radiofrequency ablation energy delivered to a critical area in the atrial reentrant circuit is safe and effective for the treatment of intra-atrial reentrant tachycardia.

Aged↗

Diminished contractile response to increased heart rate in intact human left ventricular hypertrophy. Systolic versus diastolic determinants.

BACKGROUND: Experimental studies indicate that in addition to diastolic dysfunction, hypertrophied myocardium can display depressed contractile responses, particularly at rapid heart rates, compounding reserve limitations. This study tests whether such abnormalities exist in intact human subjects at physiological paced rates and, if so, whether they are linked to simultaneous rate-dependent deterioration in diastolic function. METHODS AND RESULTS: Ten subjects with left ventricular hypertrophy (LVH) and 8 normal control subjects were studied. Most LVH patients presented with dyspnea and/or pulmonary edema and had concentric hypertrophy. Since rapid pacing simultaneously alters cardiac filling volumes and pressures, pressure-volume relation analysis was used to better define changes in contractile response. Patients were instrumented with a conductance catheter and micromanometer for pressure-volume data recording and a balloon occluder at the right atrial-inferior vena caval junction to vary filling and thus generate function relations. Data were obtained at baseline and at three atrial pacing rates (100, 120, 150 min-1). In addition, single-beat force-interval data were used to indirectly examine calcium cycling kinetics. LVH subjects demonstrated baseline diastolic abnormalities, including prolonged relaxation, elevated end-diastolic pressure, and reduced chamber compliance. However, systolic function was similar to that in control subjects. With rapid pacing, normal subjects displayed a positive contractile response, whereas this was markedly diminished in LVH subjects. With abrupt termination of pacing and return to slower sinus rhythm, LVH subjects displayed greater initial potentiation followed by a more rapid decline than control subjects, suggesting abnormalities of calcium handling. Despite contractile abnormalities, diastolic function did not further deteriorate with rapid pacing and thus did not appear to be tightly linked to the systolic changes. CONCLUSIONS: Pacing stress in intact human LVH can result in systolic impairment superimposed on preexisting but not worsened diastolic dysfunction. Abnormal calcium handling probably contributes prominently to this response.

Calcium↗

Validation of a method for noninvasive measurement of central arterial pressure.

The goal of this study was to validate a newly improved noninvasive method for calibrated measurement of the ascending portion of the central arterial pressure wave in humans. Noninvasive pressure waveforms were generated by measuring the time delay between the R wave of the electrocardiogram and onset of brachial artery flow (by Doppler) during computer-controlled upper arm cuff deflation. This delay shortens with falling cuff pressure (becoming near constant at and below diastolic pressure), so that a plot of pressure versus time delay yields the ascending portion of the arterial waveform. These waveforms were compared with simultaneous invasive ascending aortic pressures in 57 adult patients (31 by fluid manometer [group A] and 26 by catheter-tipped micromanometer [group B]) during routine cardiac catheterization. Patient age ranged from 26 to 77 years. Eighty percent of group A patients and 40% of group B had coronary artery disease. Noninvasive systolic and diastolic pressures were very similar to invasive values in both groups (Pni = 0.98 x Pi, r = 0.99, p < 0.0001). Instantaneous pressure differences between waveforms were also similar in both groups, averaging between 4.5 and 5.5 mm Hg. Micromanometer and noninvasive pressure data were also obtained before and after intravenous nitroglycerin (n = 5) and isometric handgrip (n = 8) and demonstrated good agreement. A potential application of these pressures is for estimating maximal ventricular power to assess systolic function. This was tested using invasive pressure-volume data from four patients under a variety of conditions (exercise, pacing, etc.).(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

Arterial hemodynamics in human hypertension. Effects of angiotensin converting enzyme inhibition.

Previous studies have shown some distinct hemodynamic alterations in essential hypertension, including increased resistance, wave reflections, and pulse wave velocity and decreased systemic compliance. These abnormalities are completely normalized by nonspecific smooth muscle dilation with nitroprusside but not by combined alpha- and beta-adrenergic blockade. The renin-angiotensin system, acting possibly via both circulating and local tissue effects, is thought to play an important role in essential hypertension, so its role in the altered hemodynamics deserves careful investigation. A hypertensive patient group was compared with a normotensive group similar in age, body size, and proportion of men and women. During diagnostic cardiac catheterization, ascending aortic micromanometer pressures and electromagnetic flows were measured in the baseline state. Intravenous captopril of a sufficient dosage (11 mg) to normalize blood pressure then was given to the hypertensive patients while measurements were repeated. From the pressures and flows, aortic input impedance, wave reflection magnitude, and compliance were computed. In the hypertensive group, the important hemodynamic alterations consisted of increased peripheral resistance, first zero crossing of aortic impedance phase angle, and wave reflections and decreased systemic compliance. Captopril had a pronounced hemodynamic effect. It normalized blood pressure, resistance, and impedance phase angle zero crossing. Compliance, although increased substantially by captopril, was still slightly lower than normotensive levels. The magnitude of wave reflections, although substantially lowered by angiotensin converting enzyme inhibition, was still persistently greater than normal. The present results, together with those previously reported, demonstrate that a complex interplay of factors underlies the increased smooth muscle tone in essential hypertension.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

Effective renal plasma flow response and atrial natriuretic peptide in patients with uncomplicated acute myocardial infarction.

Effective renal plasma flow was determined by using I-131 labeled iodo-ortho-hippurate in 17 Chinese patients admitted to the coronary care unit with uncomplicated acute myocardial infarction. The first determination, immediately after admission, was significantly higher than the second determination done a week later, 444.5 +/- 153.9 vs. 371.1 +/- 124.9 ml/min (p < 0.02). The initial rise of effective renal plasma flow (ERPF) after acute myocardial infarction seemed to be correlated to the initial elevation of atrial natriuretic peptide (ANP), which was determined sequentially 6 times in each patient (91.3 +/- 39.4, 25.6 +/- 9.7, 37.4 +/- 12.3, 51.8 +/- 18.2, 65.6 +/- 20.8, 57.4 +/- 19.2 pg/ml, respectively). It was concluded that, in the presence of uncomplicated acute myocardial infarction, patients may show renal vasodilatation, and that the elevation of ANP may play some role in this.

Aged↗

Control of Mansonia mosquitos, vectors of brugian filariasis in Sarawak, Malaysia.

Two field trials in the control of subperiodic brugian filariasis vectors, mainly Mansonia bonneae and Mansonia dives were carried out in Sarawak, East Malaysia. In the first trial, malathion ultra-low volume (ULV) spray was used to control the Mansonia mosquitos in two filariasis endemic villages. Six spray rounds were applied at biweekly intervals at Kampung Rasau and two spray rounds were applied at monthly intervals in Kampung Triboh. ULV malathion spray reduced biting Ma. bonneae population for 3 days after spraying. The biting density decreased to 50% of the pre-treatment level by the 12th - 13th day and reached the pre-treatment level by the 24th - 25th day. Contact bioassay tests on caged Mansonia mosquitos revealed considerable penetration of the malathion aerosol indoors and relatively adequate coverage outdoors. The estimated number of bites per case per day was 1.09 to 4 times less in the sprayed kampung than in an unsprayed control kampung. The parous and daily survival rates of Mansonia mosquitos were not significantly affected by the spraying. In a second trial, chemotherapy with diethylcarbamazine citrate (DEC) was combined with vector control through indoor residual spraying in Kampung Ampungan. The results were compared with the use of only DEC mass treatment in Kampung Sebangkoi and Kampung Sebamban. The combined control measures in Kampung Ampungan reduced the MfD-50 to 44% of the pre-treatment level over a period of 4 years. In the other two kampungs where only mass DEC therapy was applied, the microfilarial rate and MfD-50 declined significantly in the second blood survey but increased gradually in two subsequent follow-up blood surveys. The total insecticidal impact for Ma. bonneae was 3.9 to 1 indoors and 2.7 to 1 outdoors. These results indicated that quarterly pirimiphos-methyl indoor spraying used in integrated control could reduce indoor transmission by 3.9 times. The infective rate from the Ma. bonneae dissected in all three kampungs after the interventions, irrespective of DEC treatment alone or in combination with pirimiphos-methyl residual spraying were reduced by two fold. However the infection rate of brugian filarial larvae in Kampung Ampungan was significantly reduced after the use of DEC and insecticide. Annual Transmission Potential (ATP) showed a high significant reduction in Kampung Ampungan (p > 0.001) compared with Kampungs Sebangkoi and Schambam. In Ampungan, the ATP was reduced by 8.5 times indoors after the MDA and insecticidal application and 3 times outdoors. The reduction rate for Sebangkoi and Sebamban both indoors and outdoors were less than 2 fold.(ABSTRACT TRUNCATED AT 400 WORDS)

Animals↗

Program description and preliminary health survey data in Kin-Hu, Kinmen.

The study subjects were those over 30 years of age in Kin-Hu, Kinmen. From January to February 1991, demographic data, physical data, life style and blood chemistry parameters were collected from 2929 respondents (1368 men and 1561 women) out of 4475 eligible subjects. The study, conducted by the Yang-Ming Crusade, used a structured questionnaire and venipuncture technique. After clarifying missing values, a total number of 2868 (64.1%; 1334 men and 1534 women) subjects had completed the data set. Of the total subjects, 32.3% were 30-39 years of age, 24.3% were 40-49 yrs, 22.4% were 50-59 yrs, and 21.0% were above 60 years old. Fifty-two percent of men and 2.8% of women, were current smokers. Most of the surveyed subjects described themselves as having infrequent physical activity (men vs. women, 66.4% vs. 81.0%, p < 0.001). Men had significantly lower body mass index (BMI) and higher waist-hip ratio (W/H) than women (BMI: 22.9 +/- 3.2 vs. 23.2 +/- 3.7, p < 0.01; W/H: 0.89 +/- 0.06 vs. 0.84 +/- 0.07, p < 0.01). Men also had higher fasting plasma glucose (FPG), systolic/diastolic blood pressure (SBP/DBP) than women (FPG: 99 +/- 25.3 vs. 95.7 +/- 25.3 mg/dl, p < 0.0001; SBP: 132.1 +/- 19 vs. 126.4 +/- 21.5 mmHg, p < 0.0001; DBP: 80.4 +/- 12.5 vs. 76.5 +/- 12.3 mmHg, p < 0.0001).(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

Mitral regurgitation after double balloon or Inoue balloon mitral valvuloplasty.

We performed serial color Doppler echocardiographic studies prospectively before and after double balloon or Inoue balloon mitral valvuloplasty in 44 patients (mean age 45 +/- 13, range 20-74) with pure rheumatic mitral stenosis (by angiography) selected in a case-control manner to compare the incidence and severity of mitral regurgitation. After balloon dilation, mitral valve area increased from 0.9 +/- 0.2 to 1.5 +/- 0.4 cm2 (p < 0.001) in the double balloon group and from 0.9 +/- 0.3 to 1.5 +/- 0.3 cm2 (p < 0.001) in the Inoue balloon group. Twenty-four hours after balloon dilation, 3 patients in the double balloon group and 12 patients in the Inoue balloon group developed moderate to severe mitral regurgitation (p < 0.05). The severity of mitral regurgitation tended to persist or progress during follow-up in both groups, although improvement could also be observed. Two patients with severe mitral regurgitation in the Inoue balloon group underwent mitral valve replacement during follow-up. In conclusion, double balloon and Inoue balloon techniques are both effective in relieving significant mitral stenosis. However, Inoue balloon technique may be associated with slightly higher frequency of mitral regurgitation.

Adult↗

Left ventricular opacification after peripheral venous injection of a modified albumin solution.

The usefulness of a modified albumin solution was assessed in 8 dogs after peripheral venous and inferior vena cava injections. The contrast agent is a mixed solution made of glucose, albumin and glycerin, with sonicated microbubble diameter of 5.0 +/- 2.3 microns. Multiple injections (8 ml each) of this contrast agent (total 80 injections) into peripheral vein and inferior cava were performed. The blood pressure from femoral artery was measured before, during and after injections. Two-dimensional echocardiograms were recorded in a modified long axis view on videotapes for play back analysis. The pulmonary transit time and left ventricular contrast persistent time was determined for each injection. The videodensity of the region of interest (ROI) at the center of right ventricle and left ventricle was measured. The background videodensity of both ventricles was evaluated. The videodensity over the ROI of both ventricles with peak contrast enhancement was measured in all frames for 3 consecutive cardiac cycles. The peak videodensity of right and left ventricle subtracting the background videodensity of each ventricles was further calculated respectively. The injections caused no change in blood pressure or heart rate. All injections produced right ventricular contrast echo. As much as 85% of peripheral venous and 82.5% of inferior vena cava injections resulted in left ventricular contrast which was 0.68 and 0.65 as bright as that produced in the right ventricle. Pulmonary transit time and left ventricle contrast persistent time of peripheral venous injection was 4.05 +/- 0.53 and 13.67 +/- 4.28 seconds respectively. No difference of these data (3.93 +/- 0.47 and 11.65 +/- 4.66 seconds) from those produced by inferior vena cava injections were noted.(ABSTRACT TRUNCATED AT 250 WORDS)

Albumins↗

Reversibility of left ventricular dysfunction after successful catheter ablation of supraventricular reentrant tachycardia.

Fourteen patients (mean age, 48 +/- 19 years) with left ventricular dysfunction in the absence of underlying organic heart disease underwent catheter ablation (nine with direct-current energy and five with radiofrequency energy) to treat drug-refractory, symptomatic supraventricular reentrant tachycardia (mean duration of tachycardia, 22 +/- 17 years). Clinical tachycardias were accessory pathway-mediated tachyarrhythmia (12 patients) and atrioventricular nodal reentrant tachycardia (two patients). Changes of ventricular function after successful ablation, as assessed by radionuclide ventriculography and echocardiography, showed a decrease in left ventricular end-systolic dimension (39 +/- 6 mm to 34 +/- 6 mm; 32 +/- 6 mm; p < 0.05) and in left ventricular end-diastolic dimension (55 +/- 5 mm to 52 +/- 3 mm; 51 +/- 3 mm; p < 0.05) in the early (2 to 3 months) and late (6 to 8 months) follow-up periods, increase of nuclear ejection fraction (38% +/- 8% to 46% +/- 7%; p < 0.05) and fractional shortening (28% +/- 7% to 36% +/- 8%; p < 0.05) in the late follow-up period. Increase of fractional shortening was mainly due to decrease in the end-systolic dimension. These findings suggest that prolonged attacks of uncontrolled supraventricular tachycardia may result in left ventricular dysfunction, which is reversible after successful catheter ablation of the arrhythmias.

Adult↗

Reappraisal of electrical cure of atrioventricular nodal reentrant tachycardia--lessons from a modified catheter ablation technique.

A modified catheter ablation technique was studied prospectively in 29 patients with atrioventricular (AV) nodal reentrant tachycardia. A His bundle electrode catheter was used for mapping and ablation. Cathodic electroshocks (100-250 J) were delivered from the distal two electrodes (connected in common) of the His bundle catheter to the site selected for ablation. The optimal ablation site recorded the earliest retrograde atrial depolarization, simultaneous or earlier than the QRS complex, with absence of a His bundle deflection during AV nodal reentrant tachycardia. One additional electrical shock was delivered if complete abolition of retrograde VA conduction persisted for more than 30 min and AV nodal reentrant tachycardia was not inducible during isoproterenol and/or atropine administration. With a cumulative energy of 323 +/- 27 J and a mean of 2.3 +/- 0.5 shocks interruption or impairment of retrograde nodal conduction was achieved. Antegrade conduction, although modified, was preserved in 27 patients, with persistence of complete AV block in 2 patients. Two of the 27 patients still need antiarrhythmic agents to control tachycardia, the other 25 patients were free of tachycardia within a mean follow-up period of 13 +/- 2 months (range 7 to 20 months). Twenty-three patients received late follow-up electrophysiological studies (3-6 months after the ablation procedures), and the AV nodal function curves were classified into 4 types. The majority of the patients (15/23) had loss of retrograde conduction. Among the 8 patients with prolongation of retrograde conduction, 4 patients still had antegrade dual AV nodal property but all without inducible tachycardia. In conclusion, preferential interruption or impairment of retrograde conduction was the major, but not the sole, mechanism of electrical cure of AV nodal reentrant tachycardia.

Adult↗

Epidemiology of isolated systolic hypertension in Pu-Li, Taiwan.

The clinical significance of isolated systolic hypertension (systolic blood pressure greater than or equal to 160 mmHg and diastolic blood pressure less than 90 mmHg) has long been recognized, but its prevalence and correlates have not been well characterized. A community-based study was carried out by the Yang-Ming Crusade in 1987-1988 in Pu-Li Town, Taiwan. Of the 2573 registered residents over 30 years old, 1738 were interviewed, and their fasting blood samples were drawn and tested. The prevalence of isolated systolic hypertension was 2.1%. Age-specific prevalence increased with age. No significant difference was found between men and women. No trend was found at the urbanizational level. To study the significant correlates of isolated systolic hypertension, univariate analyses were applied first. Stratified analyses by age and by sex were used for interaction assessment. Based on the above findings as well as from the clinical point of view, logistic regression was used for multivariate analyses. Logistic regression analysis showed that after controlling the covariates simultaneously, four variables were significantly correlated with isolated systolic hypertension: age (greater than or equal to 50 vs. less than 50 years, OR = 3.4, 95% CI = 1.6-7.2); diabetes (yes vs. no, OR = 2.4, 95% CI = 1.2-4.7); blood urea nitrogen (greater than or equal to 25 vs. less than 25 mg/dl, OR = 2.1, 95% CI = 1.2-3.9); and physical activity (frequent vs. infrequent, OR = 1.8, 95% CI = 1.0-3.1). In comparison with definite (greater than or equal than 160/95 mmHg) and borderline (140/90-160/95 mmHg) hypertension as defined by WHO, the different sets of predictors and the possible adverse effect of frequent physical activity on isolated systolic hypertension were found and discussed.

Adult↗

Community-based epidemiological study on hypertension in Pu-Li, Taiwan.

A community-based study was carried out by the Yang-Ming Crusade in 1987-1988 in Pu-Li Town, Taiwan. We interviewed 1738 out of 2573 registered residents more than 30 years old and their fasting blood samples were drawn and tested. The prevalences of definite hypertension (greater than or equal to 160/95 mm Hg) and borderline hypertension (140/90 to 160/95 mm Hg) were 18.7% and 16.0%, respectively. To study factors associated with hypertension, univariate analysis was applied first. Stratified analyses by age and sex were used for interaction assessment. Logistic regression was used for multivariate analysis. According to the final model, the significant factors related to definite hypertension were age (greater than or equal to 50 v less than 50 years of age, odds ratio [OR] 2.6, 95% confidence interval [CI] 1.6 to 4.3), physical activity (frequent v infrequent, OR 0.4, 95% CI 0.2 to 0.6), alcohol intake (yes v no, OR 2.3, 95% CI 1.1 to 4.6), and cholesterol (greater than or equal to 240 v less than 240 mg/dL, OR 1.7, 95% CI 1.0 to 2.9). Significant factors related to borderline hypertension were age (only for those cholesterol greater than or equal to 240 mg/dL, greater than or equal to 50 v less than 50 years of age, OR 4.1, 95% CI 2.1 to 7.9), cholesterol (only for those age less than 50, greater than or equal to 240 v less than 240 mg/dL, OR 3.6, 95% CI 1.6 to 7.8), physical activity (frequent v infrequent, OR 0.4, 95% CI 0.2 to 0.7), and alcohol intake (yes v no, OR 2.3, 95% CI 1.1 to 4.6).(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

Radiofrequency ablation of bilateral quadruple accessory pathways in a patient with Wolff-Parkinson-White syndrome.

A patient with drug refractory supraventricular tachycardia showed electrophysiological evidence of bilateral quadruple accessory pathways. The conduction was bidirectional in the left posteroseptal and left posterolateral accessory pathways, antegrade in the right lateral accessory pathway, and retrograde in the right anterior accessory pathway. The four pathways participated in seven types of reciprocating tachycardias. Radiofrequency ablation eliminated the four pathways successfully. The patient was asymptomatic and free of any drug during a 10-month follow-up.

Adult↗

The value of transesophageal echocardiography in the diagnosis of cardiac metastasis.

To assess the diagnostic value of transesophageal two-dimensional echocardiography (TEE) as compared with transthoracic echocardiography (TTE), TTE and TEE were performed in eight consecutive patients (age range from 20 to 76 years, six male and two female) with clinical evidence of malignant tumors arising from the liver (n = 1), lung (n = 3), larynx (n = 1), osteogenic sarcoma (n = 1), lymphoma (n = 1), and yolk sac tumor in the anterior mediastinum (n = 1). In one case, the gastroscope could not be inserted because of tumor compression of the esophagus. Transesophageal echocardiography provided superior imaging in the detection of intracavitary metastatic lesions. In the case of right ventricular outflow tract tumor and greater vessel involvement, TTE may provide more imaging than TEE due to a blind area in this region by the transesophageal approach. In conclusion, TEE is complementary to TTE in the diagnosis of metastatic cardiac tumor.

Adult↗

Usefulness of transesophageal echocardiography for the detection of left atrial thrombi in patients with rheumatic heart disease.

Transesophageal (TEE) and transthoracic (TTE) echocardiograms were performed in 110 patients with rheumatic heart disease to evaluate the usefulness of these methods for the detection of left atrial thrombi. TEE was better than TTE for detecting left atrial thrombi (21 vs 9). The thrombi not detected by TTE were in the left atrial appendage in ten and over the left atrial posterior wall in two. Patients with left atrial thrombi had significantly smaller mitral valve area (P less than 0.01) and greater left atrial dimension (P less than 0.05) than those without. All patients with left atrial thrombi had atrial fibrillation. Thirty-one patients underwent surgical intervention and 13 were found to have left atrial thrombi. TEE detected left atrial thrombi in all 13 patients with a sensitivity of 100%, specificity of 100%, and accuracy of 100%, while TTE detected left atrial thrombi in only nine of these 13 patients with a sensitivity of 69.2%, specificity of 100%, and accuracy of 87.1%. Thus, TEE is superior to TTE for the detection of left atrial thrombi, especially for those thrombi located in the left atrial appendage and along the left atrial posterior wall.

Adult↗

Long-term nicotine exposure increases aortic endothelial cell death and enhances transendothelial macromolecular transport in rats.

Repeated endothelial cell injury has been suggested as an initiating factor in atherogenesis. Dying or dead endothelial cells have been shown to make significant contributions to the local enhancement of transendothelial macromolecular transport. Since cigarette smoking is one of the major risk factors for atherosclerosis, we examined the hypothesis that smoking accelerates atherogenesis by increasing the frequency of endothelial cell death and hence transendothelial macromolecular transport. Sixteen male Sprague-Dawley rats were given nicotine at a weight-adjusted dose of 5 mg/kg body wt per day in their drinking water over a period of 6 weeks. A group of 16 age-matched male Sprague-Dawley rats not exposed to nicotine and maintained over the same time period served as the control group. In en face preparations of thoracic aorta, immunoglobulin G-containing dying or dead endothelial cells were identified by the indirect immunoperoxidase method, and endothelial leakage to Evans blue-albumin (EBA) complexes (5 minutes after intravenous injection) was visualized by fluorescence microscopy. The results showed that in nicotine-treated rats, 51% of dead endothelial cells were associated with EBA leakage, which was responsible for 57% of total EBA leaky foci. Both the frequency of endothelial cell death (0.94 +/- 0.11% versus 0.40 +/- 0.04%, p < 0.0001 by two-tailed, unpaired Student's t test) and the number density of EBA leaky foci (6.45 +/- 1.23/mm2 versus 3.30 +/- 0.49/mm2, p < 0.05 by two-tailed, unpaired t test) were significantly greater in nicotine-treated rats than in control rats.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗