ANTIATHEROGENIC PROPERTIES OF CALCIUM-ANTAGONISTS
ANTIATHEROGENIC PROPERTIES OF CALCIUM-ANTAGONISTS
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DOI：
10.1097/00005344-199100174-00017
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发表时间：
1991-01-01
影响因子：
3
通讯作者：
MERCURI, M
中科院分区：
文献类型：
--
作者：
BOND, MG;PURVIS, C;MERCURI, M
动脉粥样硬化由多种因素引起，涉及多种机制，包括内皮单核细胞和平滑肌细胞变化、胆固醇蓄积、管腔狭窄、坏死、矿化、斑块出血、破裂和血栓栓塞。钙拮抗剂已在高胆固醇血症动物模型中显示出减少动脉粥样硬化。这种效应不能根据血压变化来解释，因此表明钙通道拮抗剂对与斑块演变相关的动脉壁过程有直接影响。钙拮抗剂的抗动脉粥样硬化特性已在人类受试者中进行了测试，并表明这些化合物抑制新的病变发展。B型超声检查的最新发展使研究人员能够无创地检测和监测动脉粥样硬化。这种方法正在美国和欧洲的几项试验中使用，以评估对颈动脉粥样硬化的治疗效果。颈动脉疾病与短暂性脑缺血发作、缺血性脑梗死和冠状动脉疾病的风险有关。B型超声检查是监测动脉粥样硬化进展的有力方法。该技术与钙拮抗剂治疗的结合将允许在动脉粥样硬化进展的无症状阶段评估动脉壁干预的疗效。
Atherosclerosis results from multiple factors, and involves several mechanisms including endothelial monocyte and smooth muscle cell changes, cholesterol accumulation, lumen stenosis, necrosis, mineralization, plaque hemorrhage, rupture, and thromboembolism. Calcium antagonists have been shown in hypercholesterolemic animal models to reduce atherosclerosis. This effect cannot be explained on the basis of changes in blood pressure, therefore suggesting that calcium channel antagonists have a direct effect on arterial wall processes associated with plaque evolution. The antiatherosclerosis properties of calcium antagonists have been tested in human subjects and suggest that these compounds inhibit new lesion development. Recent developments in B-mode ultrasonography allow investigators to detect and monitor atherosclerosis noninvasively. This method is being used in several trials within the U.S. and Europe to evaluate treatment effects on carotid atherosclerosis. Carotid artery disease is associated with transient ischemic attacks, ischemic cerebral infarction, and with risk for coronary artery disease. B-mode ultrasonography is a powerful method for monitoring atherosclerosis progression. The combination of this technology with calcium antagonist treatment will allow evaluation of the efficacy of intervention on the arterial wall during the asymptomatic stages of atherosclerosis evolution.