• 제목/요약/키워드: Atherosclerotic disease

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Targeting Cellular Antioxidant Enzymes for Treating Atherosclerotic Vascular Disease

  • Kang, Dong Hoon;Kang, Sang Won
    • Biomolecules & Therapeutics
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    • 제21권2호
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    • pp.89-96
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    • 2013
  • Atherosclerotic vascular dysfunction is a chronic inflammatory process that spreads from the fatty streak and foam cells through lesion progression. Therefore, its early diagnosis and prevention is unfeasible. Reactive oxygen species (ROS) play important roles in the pathogenesis of atherosclerotic vascular disease. Intracellular redox status is tightly regulated by oxidant and antioxidant systems. Imbalance in these systems causes oxidative or reductive stress which triggers cellular damage or aberrant signaling, and leads to dysregulation. Paradoxically, large clinical trials have shown that non-specific ROS scavenging by antioxidant vitamins is ineffective or sometimes harmful. ROS production can be locally regulated by cellular antioxidant enzymes, such as superoxide dismutases, catalase, glutathione peroxidases and peroxiredoxins. Therapeutic approach targeting these antioxidant enzymes might prove beneficial for prevention of ROS-related atherosclerotic vascular disease. Conversely, the development of specific antioxidant enzyme-mimetics could contribute to the clinical effectiveness.

다양한 비죽상경화 관상동맥 질환의 CT 영상 소견 (CT Imaging Findings in Non-Atherosclerotic Coronary Artery Disease)

  • 박종민;박병건;강은주;이종민
    • 대한영상의학회지
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    • 제83권1호
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    • pp.70-83
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    • 2022
  • 급성 관동맥 증후군(acute coronary syndrome)은 대부분 죽상경화 관상동맥 질환(atherosclerotic coronary artery disease)에 의해 발생하지만, 비죽상경화 관상동맥 질환에서도 발생할 수 있다. 고식적 관상동맥 혈관조영술은 동맥 내강의 협착이나 확장 등의 형상에 대한 정보만을 제공하고, 동맥경화반이나 동맥벽에 대한 평가가 어려워 관상동맥 이상의 원인 질환의 진단에 낮은 특이도를 보인다. 반면, 관상동맥 전산화단층촬영 혈관조영술은 혈관경화반의 특징, 혈관벽의 조영증강뿐 아니라 연접한 대동맥이나 폐동맥의 변화 등도 함께 관찰할 수 있어, 비죽상경화 관상상동맥질환의 진단 및 다양한 원인 감별에 도움이 된다. 따라서 이종설에서는 다양한 비죽상경화 관상동맥 질환들을 소개하고, 이의 병태생리 및 대표적인 관상동맥 전산화단층촬영 혈관조영술의 영상 소견에 대해 설명하고자 한다.

심근 경색증 환자의 죽상경화증 위험요인별 질병관련 지식과 건강행위 이행 (Disease-related Knowledge Level and Compliance of Health Behavior in Patients with Myocardial Infarction According to the Atherosclerotic Risk Factors)

  • 정혜선
    • 성인간호학회지
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    • 제13권4호
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    • pp.529-538
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    • 2001
  • Purpose: This study purposed to examine the disease-related knowledge level and compliance with good health behavior in patients with myocardial infarction according to the atherosclerotic risk factors. Method: The subjects consisted of 72 patients with myocardial infarction and the data were collected by interviewing the subjects with questionnaires and reviewing their medical records from September, 15, 1999 to July 31, 2000. Data were analyzed using the SAS program. Results: 1) With regard to atherosclerotic risk factors: of the subjects, 91.7% lacked regular exercise, followed by smoking (61.1%). 2) The average knowledge score of the patients was 19.7 and the average compliance score was 53.9. 3) There were no significant differences in the total knowledge scores according to the patients' atherosclerotic risk factors. 4) Non-diabetics were significantly higher in knowledge scores on domain of risk factors than the diabetics. 5) The overweight patients were significantly higher in knowledge score on domain of nature of disease than the normalweight patients. 6) The total compliance scores of the non-smokers were significantly higher than those of the smokers. 7) The total compliance scores of the patients who do regular exercise were significantly higher than those of the patients who forgo regular exercise. 8) The non-smokers were significantly higher in compliance scores on domain of diet than the smokers. 9) The diabetic patients were significantly higher in compliance scores on domain of smoking cessation than the non-diabetics. 10) Patients who do regular exercise were significantly higher in compliance scores on other domains than the patients who forgo regular exercise. Conclusion: According to the above findings, it can be concluded that intensive nursing care and education should be provided to patients who have atherosclerotic risk factors such as smoking, hypertension, diabetes mellitus, lack of exercise, over weight, or hypercholesterolemia to increase disease related knowledge level and to improve compliance with good health behavior.

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Significance of Clopidogrel Resistance Related to the Stent-Assisted Angioplasty in Patients with Atherosclerotic Cerebrovascular Disease

  • Rho, Gyoung-Jun;Shin, Woo-Ram;Kong, Tae-Sik;Kim, Min-Sun;Lee, Chang-Ju;Lee, Byung-Hee
    • Journal of Korean Neurosurgical Society
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    • 제50권1호
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    • pp.40-44
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    • 2011
  • Objective : To evaluate the prevalence and risk factors of clopidogrel resistance, and association between thromboembolic complications and clopidogrel resistance in patient with stent-assisted angioplasty for atherosclerotic cerebrovascular disease. Methods : Between September 2006 and June 2008, clopidogrel resistance test was performed on 41 patients who underwent stent-assisted angioplasty for atherosclerotic cerebrovascular disease. It was performed before drug administration and about 12 hours after drug administration (loading dose : 300 mg, maintain dose : 75 mg). Two patients were excluded, and 41 patients were included (mean : $67.59{\pm}7.10$ years, age range : 41-79). Among 41 patients, 18 patients had intracranial lesions, and 23 had extracranial lesions. We evaluated the prevalence, risk factors and complications related to clopidogrel resistance. Results : Twenty-one patients (51.2%) showed clopidogrel resistance [intracranial : 10 patients (55.6%), extracranial : 11 patients (47.8%)] and no clopidogrel resistance was seen in 20 patients. Hypercholesterolemia was an indepedent risk factor of clopidogrel resistance. Stent-assisted angioplasty was technically successful in all patients, but acute in-stent thrombosis occurred in 5 patients with intracranial lesions (4 patients with clopidogrel resistance and 1 without clopidogrel resistance). Acute thrombi were completely lysed after intra-arterial infusion of abciximab. Conclusion : There was relatively high prevalence of clopidogrel resistance in patients with atherosclerotic cerebrovascular disease. Hypercholesterolemia was an independent predictive factor of clopidogrel resistance. Acute in-stent thrombosis was more frequently seen in the clopidogrel resistant group. Therefore, clopidogrel resistance test should be performed to avoid thromboembolic complications related to stent-assisted angioplasty for atherosclerotic cerebrovascular disease, especially patients with hypercholeterolemia and intracranial lesion.

죽상동맥경화성 하지동맥폐쇄증에서 관상동맥조영술의 필요성 및 동반되는 관상동맥 질환의 양상 (The Necessity for Coronary Angiography in Atherosclerotic Arterial Obstruction in the Lower Extremities and the Clinical Features of Accompanied Coronary Arterial Diseases)

  • 이재욱;염욱;박영우;신화균;원용순
    • Journal of Chest Surgery
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    • 제39권8호
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    • pp.619-625
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    • 2006
  • 배경: 죽상동맥경화성 하지동맥폐쇄증은 대부분의 경우에 전신 동맥 경화증이 동반되며 사망의 원인으로는 주로 반 이상이 관상동맥질환에 의하여 발생한다. 또한 만성 동맥폐쇄증 수술 후 수술 사망 원인은 심장 합병증에 의한 사망이 가장 빈번한 것으로 알려져 있다. 특히 죽상동맥경화성 하지동맥폐쇄증 환자에게 과거에 심질환이 없거나 허혈성 심질환의 주증상이 없던 경우에 수술 후 높은 사망률을 보이는데 이런 이유로 이 환자군에 대한 관상동맥질환의 동반 여부에 대한 수술 전 검사의 필요성이 제기되는 바이다. 대상 및 방법: 2001년 2월부터 2004년 10월까지 죽상동맥경화성 하지동맥폐쇄증으로 입원한 환자 중 과거력상 심질환이 있었거나 허혈성 심질환이 주증상이었던 환자를 제외한 52명의 환자를 대상으로 관상동맥조영술과 하지동맥조영술을 동시에 시행하여 죽상동맥경화성 하지동맥폐쇄증에서 관상동맥질환의 동반 빈도를 파악하였다. 또한 죽상동맥경화성 하지동맥폐쇄증의 중증도를 나타내는 AVO score와 동반된 관상동맥질환과의 상관관계를 비교하였다. 결과: 죽상동맥경화성 하지동맥폐쇄증에서 관상동맥질환을 동반한 경우는 63%(33명)였고, 고령, 당뇨, 고혈압, 흡연력, 고콜레스테롤혈증 등의 동맥 경화증의 위험인자 중 고령과 고혈압이 관상동맥 질환을 동반하는 죽상동맥경화성 하지동맥폐쇄증의 중증도와 통계학적인 의미를 보였다. AVO score가 높을수록 관상동맥 질환의 동반이 흔하였고 관상동맥질환의 중증도 역시 증가되는 소견을 보였다. 관상동맥질환이 동반된 죽상동맥경화성 하지동맥폐쇄증 환자에서 관상동맥 우회술 및 관상동맥 중재적 시술을 병합하여 하지동맥 우회술을 시행한 경우, 하지동맥 우회술의 단독시행에 비해 사망률이 현저히 감소하였다. 결론: 과거력상 심질환이 없거나 허혈성 심질환의 주증상이 없는 죽상동맥경화성 하지동맥폐쇄증 환자에서 특히, 고령, 고혈압, AVO score가 높은 환자군에서는 수술 전 관상동맥조영술을 시행하여 동반되는 관상동맥 질환을 파악한 뒤 이에 대한 적극적인 치료를 시행하여야 한다.

국내 성인환자에서 죽상동맥경화성 심혈관질환 위험도와 스타틴 처방 현황 (Atherosclerotic Cardiovascular Disease Risk and Statin Prescription Status in Korean Adult Patients)

  • 김종윤;유기연
    • 한국임상약학회지
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    • 제31권3호
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    • pp.198-204
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    • 2021
  • Background: Cardiovascular (CV) disease is known as one of the major causes of death from disease worldwide. Statin therapy plays a pivotal role in atherosclerotic cardiovascular disease (ASCVD) lowering the LDL-cholesterol level effectively. The purpose of this study was to evaluate the association of the intensity of statin therapy in adult patients of Korea and the risk of ASCVD of the patient group. Methods: We used data from sample of patients from the Health Insurance Review and Assessment Service (HIRA-NPS-2018). We analyzed the patterns of prescribing statins including types of statin, statin intensity, and number of patients with ASCVD or risk of ASCVD. Results: 155,512 patients were included in the analysis, and 27,950 patients (18.0%) was over 75 years. High-intensity statin usage was increased in ASCVD patients compared with the low-intensity statin use. The OR (odds ratio) of high-intensity statin were increased in myocardial infarction patients compared with low-intensity statin use showing the highest OR; 12.40 (95% CI; 9.48-16.22). At patient groups of angina, ischemic heart disease and carotid disease, high-intensity statin prescription rate was increased compared with low-intensity statin. However, there was no statistical significance between both statin prescription rates in patients of peripheral arterial disease, abdominal aneurysm, diabetic mellitus and atherosclerosis. Conclusion: The statin prescription rate showed intensity increasing tendency according to the risk of ASCVD. More aggressive statin therapy might be beneficial for the ASCVD patients based on the recent guidelines of dyslipidemia.

Molecular imaging of atherosclerosis using reporter gene system

  • Yoo, Ran Ji;Lee, Kyochul;Kang, Joo Hyun;Lee, Yong Jin
    • 대한방사성의약품학회지
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    • 제4권1호
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    • pp.26-31
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    • 2018
  • Macrophages play a key role in atherosclerotic plaque formation, but their participation has been discerned largely via ex vivo analyses of atherosclerotic lesions. Therefore, we aimed to identify atherosclerosis on noninvasive in vivo imaging using reporter gene system. This study demonstrated that recruitment of macrophages could be detected in atherosclerotic plaques of Apolipoprotein E knockout (ApoE-/-) mice with a sodium iodide symporter (NIS) gene imaging system using $^{99m}Tc-SPECT$. This novel approach to tracking macrophages to atherosclerotic plaques in vivo could have applications in studies of arteriosclerotic vascular disease.

The Correlation of Pulse Wave Velocity and Atherosclerotic Risk Factor in Stroke Patients

  • Jin, Bok Hee;Han, Min Ho
    • 대한임상검사과학회지
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    • 제47권1호
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    • pp.28-34
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    • 2015
  • Pulse wave velocity (PWV) is used to non-invasively estimate the severity of arteriosclerosis by measuring arterial stiffness. Increased arterial stiffness measured by PWV stands for progressive arteriosclerosis and is caused by atherosclerotic risk factors. This study is focused on how brachial-ankle pulse wave velocity (baPWV) is related to the leading risk factors for arteriosclerosis or atherosclerosis. Subjects were 114, 69 males and 45 females who are in 60's and had baPWV test for acute stroke. The results are as follows: the group with increased arterial stiffness showed significant increase in HbA1c, total cholesterol, BSBP (brachial artery systolic blood pressure), BDBP (brachial artery diastolic blood pressure), CSBP (central artery systolic blood pressure), CDBP (central artery diastolic blood pressure), augmentation index (AIx) and diabetes mellitus. Correlation analysis between baPWV and atherosclerotic risk factor showed significant relationship in age, HbA1c, LDL cholesterol, BSBP, BDBP, CSBP, CDBP and augmentation index. baPWV was independently related to age and BSBP in multiple linear regression analysis. The group with increased arterial stiffness was independently related to BDBP in multiple logistic regression analysis. This study might be meaningful in evaluating the relationship between arterial stiffness and atherosclerotic risk factor in a new way, and be helped to make various studies for cardiovascular disease.

2형 당뇨병 및 대사증후군 (Type 2 diabetes mellitus and metabolic syndrome)

  • 황진순
    • Clinical and Experimental Pediatrics
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    • 제49권7호
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    • pp.710-717
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    • 2006
  • Type 2 diabetes mellitus in children and adolescents has been increasing for last 10 years. The increase in frequency of type 2 diabetes appears to parallel the increase in prevalence and severity of obesity in children and adolescents. The metabolic syndrome, cluster of potent risk factors for atherosclerotic cardiovascular disease and type 2 diabetes, consists of insulin resistance, obesity, hypertension and hyperlipidemia. The atherosclerotic cardiovascular disease are rarely seen in the young, but the pathologic processes and risk factors are associated its development have been shown to begin during childhood. In pediatrician it is important to recognize early and treat aggressively for prevention of future cardiovascular disease in children and adolescents with metabolic syndrome.

신장근접 대동맥 폐색증의 상복강대동맥 우회술 (Supraceliac Aorta Bypass Surgery For Juxtarenal Aortic Occlussive Disease -2 Cases -)

  • 오중환
    • Journal of Chest Surgery
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    • 제25권1호
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    • pp.105-111
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    • 1992
  • Total atherosclerotic obstruction of the juxtarenal abdominal aorta is a relatively rarely encountered form of atherosclerotic vascsular disease, accounting for less than 5% of all arterial obstrutive disease. We have encountered two patients with such lesions, both of whom were admitted for intermittent claudication of the lower extremities and symptoms of vascular ischemia. Digital subtraction angiography[DSA] was performed on both patients, the results of which revealed total obstruction of the aorta just inferior to the renal arteries without involving the latter. Operative technique involved the use of the sup-raceliac aorta as the site of proximal anastomosis of aortofemoral bypass followed by a fem-orofemoral bypass graft with Smm sized Woven Dacron[Vascutek] through a subcutaneous tunnel within the retroperitoneal space. Both patients experienced restoration of blood flow distal to the obstruction postoperatively without any complications, and OPD follow-up one month postoperatively and postoperative DSA showed evidence of continued graft patency with persistent symptomatic improvement.

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