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Medial Thickness (medial + thickness)
Selected AbstractsRelationship of lipoprotein(a) with intimal medial thickness of the carotid artery in Type 2 diabetic patients in south IndiaDIABETIC MEDICINE, Issue 6 2003K. Velmurugan Abstract Objective The objective of this study was to investigate the association of lipoprotein(a) [Lp(a)] levels with intimal medial thickness (IMT) in Type 2 diabetic patients in south India. Study design We studied 587 consecutive Type 2 diabetic patients at the M.V. Diabetes Specialities Centre, Chennai. The mean age of the study group was 55 ± 10 years and 71.2% were males. IMT of the right common carotid artery was determined using high-resolution B mode ultrasonography. Lp(a) levels were measured using ELISA. Since the frequency distribution of Lp(a) was skewed, Lp(a) values were log transformed and the geometric mean was used for statistical analysis. The tertiles of IMT were determined to analyse the association of Lp(a) and other factors with IMT. Result The mean Lp(a) level in the study patients was 18.9 ± 3.1 mg/dl (geometric mean ± sd) and the mean IMT of the study subjects was 0.93 ± 0.19 mm (mean ± sd). The prevalence of carotid atherosclerosis (defined as IMT > 1.1 mm) among subjects with elevated Lp(a) levels > 20 mg/dl was significantly higher compared with those with Lp(a) levels , 20 mg/dl (26.9% vs. 16.3%, P = 0.003). Lp(a) levels increased with increase in tertiles of IMT (anova, P < 0.05). Pearson correlation analysis of carotid IMT with other cardiovascular risk factors revealed strong correlation of IMT with age (P < 0.0001), duration of diabetes (P < 0.0001), systolic blood pressure (P < 0.0001), diastolic blood pressure (P = 0.006), LDL-cholesterol (P = 0.023), HbA1c (P = 0.017) and Lp(a) (P < 0.0001). Multiple logistic regression analysis showed age (P = 0.010), LDL-cholesterol (P = 0.032) and Lp(a) (P = 0.021) to be associated with carotid atherosclerosis. Conclusion The results suggest that Lp(a) has a strong association with IMT of carotid arteries in Type 2 diabetic subjects in south India. Diabet. Med. 20, 455,461 (2003) [source] Biodegradable External Stents Inhibit Saphenous Vein Graft Thickening in the PigJOURNAL OF CARDIAC SURGERY, Issue 6 2002P Gadsdon Aim: External, non-restrictive, macro-porous stents prevent neointima formation in porcine vein grafts and have been proposed as a therapeutic approach to the prevention of late vein graft failure. Since these stents are non-biodegradable and therefore may elicit deleterious long-term, inflammatory, infective and mechanical complications the effect of external macro-porous biodegradable (polyglactin) stents on neointimal and medial thickening in porcine vein grafts was investigated. Methods: Bilateral vein saphenous vein-carotid artery interposition grafting was performed in Large White pigs (22,36 kg, n = 6) with external placement of 8 mm diameter polyglactin stents on one side, the contralateral side acting as a control. One month after surgery, graft wall dimensions were measured on histological sections using computer-aided planimetry and immunocytochemistry undertaken for selected parameters. Results: Polyglactin stents significantly reduced medial thickening compared to the All grafts were patent at explantation. Intimal thickness was significantly lower (p < 0.05) in the stented grafts (0.11 ± 0.01 mm) compared to the unstented controls (0.18 ± 0.01 mm). Similarly, medial thickness was significantly lower (p < 0.05) in the stented grafts (0.24 ± 0.03 mm) compared to the unstented controls (0.43 ± 0.04 mm) mm. Grafts externally supported with polyglactin had a pronounced increase in inflammatory cells (in particular, giant cells) around the biodegradable stent compared to both unstented controls and previously studied Dacron stented grafts. The space between graft and stent had become organised into a neo-adventitia with abundant microvessels which stained positively for VEGF and lectin (markers of micorvessels and endothelial cells). Conclusions: An over-size biodegradable stent reduces medial thickening, a component of late vein graft failure in experimental grafts. If subsequent studies confirm the preservation of this beneficial effect when the stent biodegrades completely, this form of stent may have an advantage over permanent stent material in the clinical use of external stenting to prevent vein graft thickening and failure. [source] Pathological changes in the cerebral medullary arteries of five autopsy cases of malignant nephrosclerosis: Observation by morphometry and reconstruction of serial sectionsNEUROPATHOLOGY, Issue 3 2003Riki Okeda Hypertension (HT) is a serious risk factor of not only cerebral infarction and bleeding, but also Binswanger's encephalopathy (BE). In BE especially, severe stiffening of the cerebral medullary arteries because of hypertensive changes with loss of medial smooth muscle cells (SMC) occurs, which induces diffuse atrophy of the cerebral white matter. But, it is not yet ascertained whether HT is particularly severe in BE. Therefore, a spectrum of the pathological changes of the cerebral arteries were investigated by reconstruction of serial sections and morphometry of the medial thickness in five autopsied patients with malignant nephrosclerosis (MN) of exacerbated form. Each presented clinically acute progression of long-standing HT at the terminal stage and pathologically typical renal changes. The heartweight was 380,900 g. Morphometry of the medial thickness of the arachnoid arteries presented significant medial hypertrophy in four cases of MN, but in the medullary arteries it presented in only two cases with marked cardiomegaly of 700 g and 900 g. In four cases of MN, only a few medullary arteries showed slight pathological changes. However, in another case with cardiomegaly of 900 g, all 10 medullary arteries showed multiple segments of atheroma, medial SMC loss, and prominent dilatation; edematous concentric intimal fibrosis with luminal obstruction and atrophy of the white matter were absent. In conclusion, only one case of MN showing marked cardiomegaly of 900 g presented severe pathological changes of the cerebral medullary arteries comparable with those of BE, although other MN-cases showing severe cardiac hypertrophy presented only trivial arterial changes. Therefore, the cerebral medullary artery seems to be protected from HT, yet it is involved in a case of severe and long-standing HT inducing an extreme cardiomegaly. [source] End organ protection by calcium-channel blockersCLINICAL CARDIOLOGY, Issue 2 2001Dan Tzivoni M.D. Abstract In recent years, much attention has been given to end organ protection by antihypertensive, anti-heart failure, and anti-ischemic medications. This review describes the available information on end organ protection by calcium-channel blockers (CCBs). In normotensive patients and patients with hypertension treated with long-acting dihydropyridines, medial thickness was thinner than in patients treated with atenolol or in untreated hypertensive patients. Long-term treatment was associated with significant reduction in left ventricular mass. Calcium-channel blockers also improved endothelial-dependent relaxation and reversed the vasoconstrictive response to nitric oxide inhibitors. In diabetic patients. CCBs were effective in preserving kidney function and microalbuminurea. The combination of angiotensin-converting enzyme (ACE) inhibitors and CCBs was more effective than ACE inhibitors alone in preserving kidney function. In animal experiments, CCBs prevented development of coronary atheroschlerosis; however, in humans only limited data are available on their antiatherogenic effect. Some studies suggest that CCBs exert antiplatelets properties and may therefore be beneficial in patients with coronary artery disease. [source] Obese children show increased intimal wall thickness and decreased pulse wave velocityCLINICAL PHYSIOLOGY AND FUNCTIONAL IMAGING, Issue 5 2008Frida Dangardt Summary Objective:, Childhood obesity confers an increased risk of vascular changes and adult cardiovascular disease. Using a high-resolution ultrasound technique that enables separation of intimal and medial layers, we examined the intimal thickness (IT) and intimal,medial thickness (IMT) of radial (RA) and dorsal pedal (DPA) arteries and the pulse wave velocity (PWV) in overweight/obese children and adolescents and in healthy subjects. Methods and results:, IT and IMT of RA and DPA and PWV were measured in 33 obese children and adolescents (13·9 ± 1·6 years) and in 18 matched lean controls (14·3 ± 2·2). Increased RA IT was found in the obese group, whereas no differences in RA IMT or medial thickness were observed. Obese females accounted for the entire difference in RA IT (P = 0·04). DPA IT was inversely correlated with HDL cholesterol in the obese group (,0·56, P = 0·0089). PWV was lower in the obese group than in the lean group (6·2 ± 0·8 versus 7·0 ± 0·9 m s,1, respectively; P = 0·001). Conclusions:, Obese children and adolescents, primarily females, present with increased RA IT. The decreased PWV in the obese versus lean subjects might reflect general vasodilatation. [source] | ||||||||||