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[Features of atherosclerosis in the ascending human aorta and the link between its development and the main risk factors of ischemic heart disease in patients after aortocoronary shunting].

Atherosclerosis was found in all ascending aorta biopsies of 125 patients aged 42 to 65 years who underwent aortocoronary bypass surgery. Lipid spots only were found in 91.2% of cases, in 11 patients (8.8%) there were lipid plaques. Three main types of lipid spots were recognized: type I--primary extracellular lipoidosis (40.0%); type II--mainly intracellular lipoidosis (24.8%) and type III--cell lipoidosis with a pronounced component of secondary extracellular lipoidosis (26.4%). A specific feature of ascending aorta atherosclerosis is a frequent combination of intima lipoidosis with media lipoidosis: 92% in type I, 100% in type II and 93.9% in type III. This is probably an important way of lipid elimination from the intima and this predetermines a "mild" course of atherosclerosis in this part of the aorta. Types II and III of lipoidosis occurred more frequently in lipid metabolism disturbances and only under these conditions clusters of foam cells were observed. Arterial hypertension and smoking have a leading role in development of intimal hyperplasia. When assessing atherosclerosis activity in the operated patients not only risk factors of ischemic heart disease but also the results of aorta biopsies studies should be taken into consideration.

Adult↗

[Monocytes/macrophages and lipidosis of the human aortic intima in atherosclerosis].

Immunomorphological and histochemical studies were carried out on the aorta serial sections of 20-40-year-old males. The results demonstrate that monocytes appear in the aortal intima after fat deposition. Intensification of lipoidosis in the aorta promotes an increase in monocyte count in the intima. Enzymes utilizing fat in the macrophages were not revealed at early stages of lipoidosis. Activation of lipoidosis is followed by the appearance of acid lipase, acid phosphatase and nonspecific esterase in monocytes. This is evidence of these cells capacity to phagocyte and utilize fat. The quantity of these cells increases with intensification of lipoidosis. Monocytes/macrophages are expressing HLA-DR antigen on their surface, this expressing their active immunological state.

Adult↗

Postlathyric fibroelastosis of the rat aorta related to topical factors of experimental atherosclerosis.

Postlathyric aortic fibroelastosis was produced in rats with the aid of low-percentage fetal lathyrism. Subsequently the rats were kept on an atherogenic regimen for one year, and at the end of that period the aortas were studied to detect the relation of postlathyric alterations to the experimental atherosclerotic lesions. In the ascending aorta and the arch the fibroelastosis neither enhanced nor suppressed the development of mixed atherosclerotic plaques. In contrast, fibroelastosis of the thoracic and abdominal aorta usually causing a slight tunnel-shaped stenosis of the affected segment significantly reduced the development of intimal lipoidosis. The present experiment permitted to identify a new postlathyric lesion, namely sac-shaped microaneurysms situated at the sites of origin of lumbar arteries. Despite the fact that otherwise virtually the only lesion developing in the abdominal aorta was intimal lipoidosis, the aneurysms were filled up with mixed atheromatous masses. The above postlathyric vascular lesion appeared to significantly support the local development of atherosclerosis. The results presented have been discussed in view of the some recent facts stressing the indisputable importance of haemodynamic factors for the localization and development of atherosclerosis.

Animals↗

Suppressive effect of simvastatin on intramural small coronary arterial lesions in cholesterol-fed rabbits.

The aim of this study was to examine the suppressive effect of simvastatin on intramural coronary arterial lesions in cholesterol-fed rabbits. In one experiment, six groups of rabbits were fed laboratory chow alone or with added 0.1%, 0.2%, 0.3%, 0.5% or 1.0% cholesterol for 16 weeks. In another experiment, four groups of rabbits were fed a 0.5% cholesterol diet and treated with simvastatin at 1, 3, or 5 mg/kg/day or placebo. In each rabbit, the levels of serum total cholesterol (TC) were determined at 1-week intervals to calculate the integrated values. The lesion induction ratio was defined as the ratio of intramural coronary arteries 50-150 microm in diameter with arterial lipoidosis to the total number of arteries of the same diameter. In the two experiments, there were positive correlations between the lesion induction ratio and integrated TC (r=0.785, P<0.0001 and r=0.763, P<0.0001, respectively). The slopes of the regression lines for integrated TC obtained in the two experiments were similar, but the lesion induction ratio in the simvastatin-treated group was always lower, by about 14%, in comparison with that in the non-simvastatin-treated group. These findings suggest that simvastatin induces lesion reduction not only by reducing the levels of circulating cholesterol but also by directly suppressing the development of lipoidosis.

Animals↗

[Inflammatory-immunological cellular reaction in intima of the aorta and pulmonary artery and development of atherosclerosis].

AIM: To assess morphological manifestations of inflammation at initial stages of atherosclerosis development in intima of the aorta and pulmonary artery both in its intact (lipid free) zones and those with lipoidosis. METHODS: Histological, histochemical and immune cytochemical methods with the use of monoclonal antibodies to monocytes/macrophages (CD-11) and T-lymphocytes (CD-4, CD-5, CD-8) were applied for the study of cellular elements in membranous preparations of intima and transverse cross-sections of the aorta and pulmonary artery from 64 apparently healthy persons aged 4 months-49 years who died of accidental causes. RESULTS: Signs of inflammatory cellular reaction (infiltration with monocytes/macrophages) were permanently present in aortic and pulmonary artery intima and progressed with age. This cellular reaction was consistently accompanied by infiltration of intima with mast cells. Compared with intact intima infiltration with lymphocytes/monocytes was more pronounced in zones with lipoidosis where helper-lymphocytes prevailed among T-cells and number of monocytes/macrophages was substantially increased. CONCLUSION: Mononuclear cellular infiltration with participation of mast cells was persistently present in aortic and pulmonary artery intima and obviously preceded its atherosclerotic changes. However there was no straightforward relationship between severity of this reaction and development of atherosclerosis in the aorta and especially in pulmonary artery.

Adolescent↗

[Pathomorphological criteria of anti-atherosclerotic effect of plant saponins in an experiment].

6-month hypercholesterol diet made it possible to obtain an adequate model of atherosclerosis in inbred rats. The model was characterized by lipoidosis and fibrous plaques which occupied half of the area of the aorta and coronary arteries, as well as secondary fibrosis of other organs. During atherogenesis changes in endothelial and myocyte cells appear, accumulation of acid glycosaminoglycans takes place, lipoidosis and elastofibrosis progress up to collagenization and hyalinosis of the arterial wall. Fibro-myocyte plaques are transformed into fibro-atheromatous plaques. Upon drug therapy with vegetative saponins and furastonolic glycosides fibrous lesions did not regress, but delipidization and translocation of glycosaminoglycans were observed in 30% of the area of the affected arteries, and elastofibrosis and changes in endothelial and myocyte cells were decreased. Long-term therapy with vegetative drugs produced a regression of the experimental atherosclerosis.

Animals↗

[Significance of atherosclerotic risk factors in the development of preatherosclerotic changes in the human aorta].

A study of the effect of the main risk factors of atherosclerosis in coronary patients on the prevalence of lipoidosis and prelipid changes in the aortal intima showed a week interrelationship between the studied risk factors and prevalence of lipoidosis. A noticeable significant interrelationship of the prevalence of prelipid changes in the aortal intima, patient's age, the IRI level and alpha-XC concentration in the blood plasma was established. An equation was described. A nomogram was presented permitting determination of the prevalence of prelipid changes in the aortal intima and, consequently, the phase of a course of atherosclerosis during the patient's lifetime on the basis of the above risk factors.

Adult↗

[Early stages of atherosclerosis. The morphogenesis of lipid spots in the aorta of children].

A comprehensive morphobiochemical study of aortal lipoidosis and a study of the serum lipid content were conducted in children. Fifty aortas from children who had died as a result of accidents and diseases at the age of 4 to 16 and the blood serum from 350 healthy children served as the material for the investigation. The development of aortal lipid spots in children was shown to be associated with lipid accumulation, particularly cholesterin ethers in smooth muscle cells of the intima. Lipid accumulation was accompanied by the proliferation of smooth muscle cells, phenomena of enhanced collagen- and elastin formation in parallel with the destruction of elastic fibers and membranes expressed quantitatively in an increased content of collagen and a decreased content of elastin. Aortal lipid spots were inhomogeneous depending on children age. "Juvenile" and "intermediate" types were singled out. Lipid spots of the "intermediate" type found in children over 10 may be of certain importance in the development of atherosclerotic arterial changes. There was no correlation between the frequency of hypercholesterinemia and the frequency of aortal lipoidosis in children.

Adolescent↗

Erdheim-Chester disease: radiographic findings in five patients.

We present the case histories of five patients with Erdheim-Chester disease, a rare lipoidosis that has several typical radiographic features. In all the patients, the diaphyses and metaphyses of the extremities demonstrated a symmetric pattern of diffuse or patchy increased density, a coarsened trabecular pattern, medullary sclerosis, and cortical thickening. The epiphyses were spared in four patients and partially involved in one. The axial skeleton was involved in one patient. Radiotracer 99mTc accumulated in areas of radiographic abnormalities in all patients. In one patient, MRI demonstrated an abnormal signal, corresponding to radiographic abnormalities. The signal was hypointense to muscle on T1-weighted sequences and heterogeneously hyperintense and hypointense to normal bone marrow on T2-weighted sequences. Xanthogranulomatous lesions infiltrated the retroperitoneum in one patient, the testes in one patient, the eyelids in one patient, and the orbits in two patients.

Aged↗