OBJECTIVE Instability of coronary atheroma leads to the onset of acute coronary syndromes including myocardial infarction and death, as well as to the progression of the arteriosclerotic disease. As yet, the underlying factors and mechanisms causing plaque rupture are not completely understood. Since a low content of smooth muscle cells (SMCs) apparently plays a key role, the question points to...

A 69-yr-old woman presented with dyspnea on exertion was found to have moderate-to-severe mitral regurgitation with moderate left ventricular dysfunction (estimated ejection fraction was 30%) and was scheduled for elective mitral valve repair. The patient had undergone uneventful coronary artery bypass graft surgery 7 months earlier. Her medical history was otherwise significant for hypertensio...

Purpose: We studied by microarray analysis the tissue angiotensin system organization. We elucidated the expression of chymase, cathepsins D, G and angiotensin-converting enzyme (ACE), potentially involved in intraparietal angiotensin II formation and atheroma. Methods: mRNA gene expression was measured by an Affymetrix Gene Chip Human Gene 1.0 ST arrays (Affymetrix, Santa Clara, CA, USA) using...

OBJECTIVES This study sought to determine the relationship between coronary calcification and plaque progression in response to established medical therapies. BACKGROUND Coronary calcification correlates with the extent of atherosclerosis and predicts clinical outcome. METHODS Atheroma volume was determined in serial intravascular ultrasound pullbacks in matched arterial segments of 776 pat...

Coronary thrombosis is the most important cause of morbidity and mortality and the most severe manifestation of atherosclerosis. Knowledge of the pathophysiology of atheroma formation and the causes of atheroma accidents have allowed the development of new therapeutic measures for reducing thrombotic events after a coronary episode. Treating the thrombosis after plaque rupture is useful, but a ...

Background: Progression of aortic arch atheroma (AA) is associated with vascular events in patients with stroke or transient ischemic attack (TIA). Studies investigating effect of stroke prevention medication on AA progression are limited to post-cerebral segments that may not be related to stroke pathophysiology and do not use information from the relevant segments adjacent to the origin of th...

BACKGROUND Baseline C-reactive protein (CRP) levels predict major adverse cardiovascular events (MACE: death, myocardial infarction, stroke, coronary revascularization, and hospitalization for unstable angina). The association between changes in CRP levels with plaque progression and MACE in the setting of maximally intensive statin therapy is unknown. METHODS AND RESULTS The Study of Coronar...

OBJECTIVES The aim of this study was to investigate the relationship between intravascular ultrasound (IVUS)-derived measures of atherosclerosis and cardiovascular outcomes. BACKGROUND IVUS has been used in clinical trials to evaluate the effect of medical therapies on coronary atheroma progression. METHODS Coronary plaque progression was evaluated in 4,137 patients in 6 clinical trials tha...

BACKGROUND Cardiovascular magnetic resonance (CMR) of the vessel wall is highly reproducible and can evaluate both changes in plaque burden and composition. It can also measure aortic compliance and endothelial function in a single integrated examination. Previous studies have focused on patients with pre-identified carotid atheroma. We define these vascular parameters in patients presenting wi...