Arterial neovascularization and inflammation in vulnerable patients - Early and late signs of symptomatic atherosclerosis
Arterial neovascularization and inflammation in vulnerable patients - Early and late signs of symptomatic atherosclerosis
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DOI：
10.1161/01.cir.0000146787.16297.e8
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发表时间：
2004-11-02
期刊：
影响因子：
37.8
通讯作者：
Biedermann, BC
中科院分区：
文献类型：
--
作者：
Fleiner, M;Kummer, M;Biedermann, BC
背景 - 动脉粥样硬化因心肌梗塞、中风或外周动脉闭塞性疾病等心血管事件而变得复杂。炎症和病理性新生血管形成被认为会加速斑块破裂或侵蚀，这两者都是动脉血栓形成和心血管事件的原因。我们测试了这样的假设：与从未遭受动脉粥样硬化并发症的患者相比，易受影响的患者（即患有心血管事件的患者）整个动脉树的动脉炎症和血管生成事件增加。方法和结果 - 在尸检研究中，我们量化了髂动脉、颈动脉和肾动脉动脉壁中的炎症浸润和微血管网络。采用组织微阵列技术来研究全层动脉部分。我们将 22 名有症状的动脉粥样硬化患者与 27 名从未患过任何心血管事件的患者进行了比较。在分析的所有 3 个动脉部位，脆弱患者的内膜巨噬细胞绝对含量高出 2 至 4 倍（P < 0.05）。有症状的动脉粥样硬化患者比无症状的患者具有更密集的血管网络（每 1 mm 33 +/- 2 个外膜微血管与 25 +/- 2 个外膜微血管（2）；P = 0.008）。滋养血管增生是有症状的动脉粥样硬化的早期征兆，巨噬细胞浸润是有症状的动脉粥样硬化的晚期征兆。结论 - 内膜巨噬细胞含量高和滋养血管增生网络是患有症状动脉粥样硬化的易受影响患者的特征。这些变化均匀地存在于不同的动脉床中，支持有症状的动脉粥样硬化作为一种全动脉疾病的概念。
Background - Atherosclerosis is complicated by cardiovascular events such as myocardial infarction, stroke, or peripheral arterial occlusive disease. Inflammation and pathological neovascularization are thought to precipitate plaque rupture or erosion, both causes of arterial thrombosis and cardiovascular events. We tested the hypothesis that arterial inflammation and angiogenic events are increased throughout the arterial tree in vulnerable patients, ie, in patients who suffered from cardiovascular events, compared with patients who never suffered from complications of atherosclerosis.Methods and Results - In a postmortem study, we quantified the inflammatory infiltrate and microvascular network in the arterial wall of iliac, carotid, and renal arteries. Tissue microarray technology was adapted to investigate full-thickness arterial sectors. We compared 22 patients with symptomatic atherosclerosis with 27 patients who never had suffered from any cardiovascular event. The absolute intimal macrophage content was 2- to 4-fold higher in vulnerable patients at all 3 arterial sites analyzed ( P < 0.05). Patients with symptomatic atherosclerosis had a denser network of vasa vasorum than patients with asymptomatic disease ( 33 +/- 2 versus 25 +/- 2 adventitial microvessels per 1 mm(2); P = 0.008). Hyperplasia of vasa vasorum was an early and macrophage infiltration was a late sign of symptomatic atherosclerosis.Conclusions - High intimal macrophage content and a hyperplastic network of vasa vasorum characterize vulnerable patients suffering from symptomatic atherosclerosis. These changes are uniformly present in different arterial beds and support the concept of symptomatic atherosclerosis as a panarterial disease.