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PubMed1998

Thrombosis and cardiovascular disease.

The early stages of venous thrombosis originate at selective sites of reduced blood flow in the apices of venous valves. Stagnation of venous flow results in the formation of a platelet-fibrin thrombus, which serves as the nidus for thrombus propagation. Stasis alone, however, does not result in thrombosis necessarily. The presence of activated coagulation factors is essential. The major predisposing factors to venous thrombus are activation of blood coagulation and venous stasis. In contrast to venous thrombus formation, vascular abnormalities are the most important causative factor in arterial thrombosis.

Acute Disease↗
PubMed1997

Adult family members and their resemblance of coronary heart disease risk factors: the Cardiovascular Disease Study in Finnmark.

Coronary heart disease tends to run in families, and the familial resemblance of major risk factors for the disease was examined among various types of adult family members. Family units were assembled from a total of 4,738 men and women who took part in a cross sectional health survey in four Norwegian municipalities where all inhabitants between 20 and 52 years of age were invited. After adjusting for age and other confounders, correlation coefficients were derived as a measure of the degree of resemblance. Viewed across all types of investigated familial relationships, similarity was found to be stronger for total cholesterol than for high-density lipoprotein cholesterol and triglycerides, and also stronger for systolic than for diastolic blood pressure. Between husbands and wives (3,060 subjects), correlations were small (between 0.02 and 0.06), except for 0.11 for total cholesterol. Lipid and blood pressure correlations ranged from 0.13 to 0.27 for parents and their offspring (471 subjects, p < 0.05) and from 0.11 to 0.22 among siblings (2,166 subjects, p < 0.01). Sibling correlations were consistent across age groups. Furthermore, reports from each individual on daily smoking (yes or no) revealed that husbands and wives had similar habits in 63.5% of all marriages as compared with the expected 49.4% had no smoking similarity at all been present. Smoking concordance was also demonstrated among siblings (p < 0.01). The persistent pattern of lipid and blood pressure aggregation among genetically related individuals from 20 to 52 years of age and the much weaker such similarity between husbands and wives, point towards genes or commonly shared environment at early ages as a major reason why coronary heart disease runs in families.

Adult↗
PubMed1985

Prevalence and significance of cardiovascular disease and hypertension in elderly patients with dementia and depression.

The prevalence and significance of clinical heart disease and hypertension were compared in three groups of elderly patients. One group was diagnosed as dementia of an Alzheimer's type (AD), another as multiinfarct dementia (MID), and the third as major depression. Clinical heart disease and hypertension were uncommon in the AD group with the prevalence being lower than that reported in most epidemiologic studies. Four percent of the AD patients had a history of myocardial infarction, 5% angina, 1% arrhythmias, and 3% heart failure. Electrocardiographic changes of an old myocardial infarction were present in 9%, atrial fibrillation in 1%, and left ventricular hypertrophy in 3%. A history of hypertension was present in 24% of the AD patients. In comparison, a history of myocardial infarction, angina, and heart failure was five times greater, and electrocardiographic abnormalities were twice as prevalent in the MID group. A history of hypertension was three times more common and actual blood pressure readings were higher. In the depression group heart disease was not uncommon and the prevalence, in general, was comparable with the MID group. However, a history of increased blood pressure and actual increased blood pressure readings were statistically less than in the MID group.

Aged↗
PubMed1998

[Cognitive impairment and cardiovascular disease risk factors. Project CASCADE Kraków. VI. Magnetic resonance imaging of the aging brain in elderly persons (65-78 years old)].

Magnetic resonance imaging (MRI) is the most sensitive non-invasive method for the detection of brain lesions. The aim of the study was to examine the prevalence of brain abnormalities (white matter lesions, atrophy, and infarction) on MRI in an elderly population. Sample of 174 men and women, aged from 65 to 78 years, was examined. MRI scans were made using a mobile MRI 1.0 Tesla machine (Siemens). Imaging was performed with standard spin-echo sequences (slice thickness 5-6 mm thick and 20% gap): proton density, T1 and T2 images. All MRI scans were read using standardized methodology of assessment of deep white matter lesions, periventricular lesions, cortical atrophy and infarction. Medium subcortical white matter lesions (4-10 mm) were present in 55% participants. Large subcortical white matter lesions (> or = 10 mm) were observed in 27% people, 24% had periventricular white matter lesions (score > or = 3), 83% had cortical atrophy (score > or = 4) and 18% had at least 1 infarct. Frequency of cortical atrophy increased gradually by age group (p < 0.01). The cortical atrophy, deep and periventricular white matter lesions were more frequent only in the oldest group (75-78 years).

Aged↗
PubMed2000

[Use of radiotherapy in cardiovascular disease. Radiophysical basis, current results, indications and perspectives].

Restenosis is the main limitation of percutaneous angioplasty, especially in vessels of small diameters such as the coronary arteries, the femoro-popliteal and tibial-peroneal arteries and the arterio-venous dialysis grafts. The extensive use of tents has not entirely prevented its occurrence, whereas treating in-stent restenosis gives even more uncertain results. Endovascular radiotherapy has emerged over the past few years as a promising approach to both prevent and cure it. The analogy between the tumour-like cellular proliferations observed in post-angioplasty restenosis and tumour processes prompted pioneering works to study the effect of ionizing radiations in animal models of arterial restenosis. The demonstrated feasibility, tolerance and efficacy of this approach lead to test this strategy in humans. The results of 3 recently presented randomized double-blind trials in the treatment of coronary in-stent restenosis have been so promising that endovascular brachytherapy might now be considered the treatment of choice in this indication. Other randomized trials are currently carried out to test whether endovascular brachytherapy may prevent restenosis in coronary and femoro-popliteal arteries as well as in hemodialysis shunts. In the present review, we describe the basics of the biological effects of ionizing radiations, the technical modalities to deliver endovascular radiations, our current knowledge about their effects on the vascular wall and the restenosis mechanisms, and the results of the first clinical studies. Finally, we address the remaining problems in the use of endovascular curietherapy and question the promises and challenges of its clinical application.

Angioplasty, Balloon, Coronary↗
PubMed1992

Immunologic aspects of cardiovascular disease.

The spectrum of vasculitis is diverse, and numerous entities do not fit the aforementioned broad categories. Examples of these include Buerger's disease; vaso-occlusive vasculitis of the lower extremities associated with cigarette smoking; Behçet's disease, which is prevalent in the Orient and Middle East and is characterized by recurrent aphthous stomatitis, genital ulcerations, uveitis, meningoencephalitis, and phlebitis; and isolated central nervous system vasculitis, a rare disease with a poor prognosis that primarily affects intracranial arteries without a systemic acute-phase response. Improvement in the classification and definitive therapy of vasculitis awaits identification of etiologic agents and definition of host factors and the immune response responsible for the pathology.

Acute Disease↗