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Accurately identifying coronary artery disease (CAD) is the key element in guiding the work-up of patients with suspected angina. Thickening of the arterial wall is a hallmark of atherosclerosis. Therefore, the main purpose of this study was to determine whether abdominal aortic intima-media thickness (AAIMT), which is the earliest zone of atherosclerotic manifestations, has a predictive value in CAD severity. A total of 255 consecutive patients who were referred for invasive coronary angiography due to suspected stable angina pectoris were prospectively included in the study. B-mode ultrasonography was used to determine AAIMT before coronary angiography. Coronary artery disease severity was assessed with the SYNTAX score (SS). A history of hypertension, age, dyslipidemia, and higher AAIMT (odds ratio: 2.570; 95%CI 1.831-3.608; P < .001) were independent predictors of intermediate or high SS. An AAIMT

Objective The aim: To study the effect of a high-fat diet (HFD) on the structural changes in the aortic intima in intact and HSV-1-infected mice using Scanning electron microscopy (SEM) and Transmission electron microscopy (TEM). Patients and methods Materials and methods: In experiments Balb/c mice were infected with the HVS-1 and fed high-fat diet and 12 weeks later aortic ultrastructure was examined by SEM and TEM methods. The animals were subdivided into four experimental groups: 1st group - HSV-1-infected animals; 2nd - animals consuming high-fat diet (HFD); 3rd - infected animals that were subsequently consuming a high-fat diet (HSV / HFD); 4th - animals consuming a high-fat diet that were subsequently infected with HSV-1 (HFD / HSV) (n = 6); and control group - intact animals. Results Results: HVS-1 impaired ultrastructural changes in aorta greater than high-fat diet and HVS-1 alone (higher density of lipid inclusions in the subendothelial space, necrosis of endothelial cells), and infection of mice after high-fat diet ended 100% mortality. The formation of atheroma in the aortic wall during HFD was not detected, but the initiative manifestations of atherogenesis have been identified and restricted in the aortic intima. These structural changes included lipid inclusions in the subendothelial space, cell damage and destruction, which lead to an increase cellular detritus in the 3rd (HSV / HFD) group. Conclusion Conclusions: HSV infection potentiates the accumulation of lipid inclusions in the aortic intima during a HFD, facilitates infection and contributes to the development of acute infection.

Objective Smoking during pregnancy has harmful effects on the fetus and infant. Although some studies suggest that exposure to fetal-maternal smoking adversely affects both fetal growth and cardiovascular development, the mechanisms and biochemical consequences of smoking in pregnancy and newborns are not yet fully understood. We aimed to investigate whether maternal smoking during pregnancy causes fetal cardiovascular effect by measuring serum asymmetric dimethylarginine (ADMA) level and abdominal aortic intima-media thickness (aIMT). Study design This prospective study was conducted in newborns of smoking mothers and never-smoker control mothers during their pregnancies. The babies were evaluated echocardiographically on the first day following birth. In two-dimensional mode, abdominal aIMT measurements were performed. ADMA was measured in umbilical cord blood at birth. Results There were 25 mothers in the study group and 25 mothers in the control group. Serum ADMA levels were 0.459 ± 0.119 μmol/L in the study group and 0.374 ± 0.1127 μmol/L in the control group (p = 0.034). The aIMT value in the study group was 0.84 ± 0.026 mm and the aIMT value in the control group was 0.63 ± 0.011 mm (p = 0.005). Conclusion We found that both the serum ADMA and the aIMT significantly increased in the group with newborns of smoker mothers compared with the group of the newborns of never-smoker mothers. It may also be suggested that exposure to fetal-maternal smoking adversely affects cardiovascular development. Key points · It is a known fact that smoking during pregnancy has harmful effects on the development of the fetus and infant.. · We found that both the serum ADMA and aIMT were significantly higher in the group of infants of smoker mothers..

The primary objective was to correlate aortic intima-media thickness (aIMT) measured at L1-L2 with birth weight in neonates born at ≥35 week of gestation. The secondary objective was to compare aIMT in small for gestational age (SGA) and appropriate for gestational age (AGA) babies in this cohort. Prospective observational study enrolling 200 newborns. aIMT was measured on day 3 of life using 10–12 MHz ultrasound probe. Relevant maternal and baby details were collected and analyzed. Mean (SD) aIMT was 0.43 (0.15) mm. There was a negative correlation between aIMT and birthweight (r = −0.64). Mean (SD) aIMT in AGA was significantly lesser than in SGA babies (0.36 (0.11) vs. 0.64 (0.08) mm; P

Background Intraoperative vascular imaging is a useful tool to evaluate coronary ostia in congenital heart patients with suboptimal preoperative imaging findings. Additionally, vascular imaging has potential value for visualization of the ascending aortic intima media thickness (IMT) in certain clinical scenarios. This study sought to evaluate the feasibility of intraoperative vascular imaging of coronary ostia and IMT during congenital heart surgery. Methods We describe the technique for performance of intraoperative vascular imaging by a pediatric cardiologist using a high-resolution linear sequential array transducer. Results Intraoperative vascular imaging was obtained on seven patients. Coronary ostia were normal in all except one. This patient had congenital stenosis of the left coronary ostium discovered during intraoperative imaging and confirmed by the surgeon. In another patient with Williams syndrome, the IMT was noted to be prominent. Conclusions It is feasible to perform intraoperative vascular imaging in less than 5 minutes of operator's time and provides superior visualization of the coronary ostia and IMT.

Objective : to analyze the nanostructure of human aortic intima in atherosclerosis and demonstrate the poten tial effect of Niodex on cholesterol plaques. Materials and methods . Samples of intima were taken from those parts of aorta, where different stages of atherosclerotic chages were obvious. Aortic samples were incubated in a solution containing cyclodextrins. A solution of NIODEX, a propylene glycol ester of betacyclodextrin, was used in the study. A layer of aortic intima was formed on the glass slide surface with polylysine. The samples were placed into the working area of an atomicforce microscope (Integra Prima, NTMDT, Russian Federation), and their surfaces were scanned. The number of imaging points was 512; and the imaging regions were as follows: 100100 μm, 20002000 nm. Results . Classification of nanosurface objects was performed and typical fragments (craters, ridges, and trabecular fibers) were identified, and quantitative assessment of their sizes was carried out. 27 fragments were identified as growing cholesterol plaques. 16 of them measuring 900—1200 nm were identified near ridges, and 11 near craters (600—1050 nm). Niodex caused destruction of lipid spots and smoothing of the intima surface. More than a half of the 27 identified objects (15) demostrated a 30% and more decrease in size (median 340—400 nm). A 10—15% decrease was registered in 7 fragments; in the remaining 5 fragments, the decrease in the lesion size was less than 10%. Conclusion . Raw data permit to suppose that the effect of Niodex on the aortic intima results in decceleartion and decreased intensity of atherosclerotic plaque growth on the intima fragments.

Atherosclerosis underlies most myocardial infarctions and ischemic strokes. The timing of onset and the rate of progression of atherosclerosis differ between individuals and among arterial sites. Physical manifestations of atherosclerosis may begin in early life, particularly in the abdominal aorta. Measurement of the abdominal aortic intima-media thickness by external ultrasound is a non-invasive methodology for quantifying the extent and severity of early atherosclerosis in children, adolescents, and young adults. This review provides an evidence-based rationale for the assessment of abdominal aortic intima-media thickness—particularly as an age-appropriate methodology for studying the natural history of atherosclerosis in the young in comparison to other methodologies—establishes best practice methods for assessing abdominal aortic intima-media thickness, and identifies key gaps in the literature, including those that will identify the clinical relevance of this measure.

Keskin, Muhammed/0000-0002-4938-0097; Cinar, Tufan/0000-0001-8188-5020 WOS: 000470864700015 PubMed: 30270633 …

Aortic intima-media thickness (aIMT) and its ratio to aortic diameter (aIMT/AoD) were measured on the second and fifth postnatal day in 39 neonates exposed to early-onset preeclampsia and 39 controls. Both aIMT and aIMT/AoD were higher in neonates exposed to preeclampsia (P 0.001 for all comparisons).

Transmural-pressure (ΔP)-driven plasma advection carries macromolecules into the vessel wall, the earliest prelesion atherosclerotic event. The wall's hydraulic conductivity, LP, the water flux-to-ΔP ratio, is high at low pressures, rapidly decreases, and remains flat to high pressures (Baldwin AL, Wilson LM. Am J Physiol Heart Circ Physiol 264: H26–H32, 1993; Nguyen T, Toussaint, Xue JD, Raval Y, Cancel CB, Russell LM, Shou S, Sedes Y, Sun O, Yakobov Y, Tarbell JM, Jan KM, Rumschitzki DS. Am J Physiol Heart Circ Physiol 308: H1051–H1064, 2015; Tedgui A, Lever MJ. Am J Physiol Heart Circ Physiol. 247: H784–H791, 1984. Shou Y, Jan KM, Rumschitzki DS. Am J Physiol Heart Circ Physiol 291: H2758–H2771, 2006) due to pressure-induced subendothelial intima (SI) compression that causes endothelial cells to partially block internal elastic laminar fenestrae. Nguyen et al. showed that rat and bovine aortic endothelial cells express the membrane protein aquaporin-1 (AQP1) and transmural water transport is both transcellular and paracellular. They found that LPlowering by AQP1 blocking was perplexingly ΔP dependent. We hypothesize that AQP1 blocking lowers average SI pressure; therefore, a lower ΔP achieves the critical force/area on the endothelium to partially block fenestrae. To test this hypothesis, we improve the approximate model of Huang et al. (Huang Y, Rumschitzki D, Chien S, Weinbaum SS. Am J Physiol Heart Circ Physiol 272: H2023–H2039, 1997) and extend it by including transcellular AQP1 water flow. Results confirm the observation by Nguyen et al.: wall LPand water transport decrease with AQP1 disabling. The model predicts 1) low-pressure LPexperiments correctly; 2) AQP1s contribute 30–40% to both the phenomenological endothelial + SI and intrinsic endothelial LP; 3) the force on the endothelium for partial SI decompression with functioning AQP1s at 60 mmHg equals that on the endothelium at ∼43 mmHg with inactive AQP1s; and 4) increasing endothelial AQP1 expression increases wall LPand shifts the ΔP regime where LPdrops to significantly higher ΔP than in Huang et al. Thus AQP1 upregulation (elevated wall LP) might dilute and slow low-density lipoprotein binding to SI extracellular matrix, which may be beneficial for early atherogenesis.

Background Health care programs for children with Down syndrome (DS) help improve the overall outcome and quality of life of these children. It is therefore very important to focus on the most common and serious problems of these patients, such as congenital heart defects and cardiac problems, and to keep medical guidelines updated with regard to these problems. Objectives The aim of this study was to evaluate aortic intima-media thickness (aIMT), lipid profiles and blood pressure in DS patients in comparison with a control group of ageand gender-matched neonates without DS. Material and methods Serum concentrations of lipids (total cholesterol, LDL-cholesterol, HDL-cholesterol, and triglyceride), blood pressure and abdominal aIMT were measured in newborns with DS, and compared with the measurements from ageand gender-matched newborns without DS. Results No statistically significant differences between the 2 groups of newborns were detected with respect to aIMT, lipid levels or blood pressure. Conclusions This study represents the first investigation of aIMT - one of the most important indicators of atherosclerosis - in DS patients, but neither a significantly increased aIMT, nor any significant changes in lipid profiles or blood pressure were detected in this group of patients. Whether aIMT differs according to the type of congenital heart defect (such as atrial septal defect, ventricular septal defect, patent ductus arteriosus, and atrioventricular septal defect) among DS patients remains to be determined in future studies.

To assess thoracic aortic intima-media thickness (aIMT) as a marker of thoracic aortic remodeling in children born small for gestational age (SGA).We assessed thoracic aIMT, carotid intima-media thickness (cIMT), and pulse wave velocity (PWV) in 239 patients (117 SGA; 122 appropriate for gestational age controls) age 6-8 years. Each SGA participant was matched 1:1 based on sex, gestational age, and birth date. Thoracic aIMT was determined by 2-dimensional transthoracic echocardiography.SGA children showed a significant increase in both aIMT (0.89 mm [0.12] vs 0.79 mm [0.11], P .001) and cIMT (.50 mm [0.05] vs 0.49 mm [0.04], P .001) compared with appropriate for gestational age controls, but the magnitude of the difference in aIMT was greater than that in cIMT (standardized difference of the means: +84% vs +27%). aIMT was linearly correlated with aortic arch PWV as measured by echocardiography (r = 0.211, P .001) but not with carotid-femoral PWV (r = 0.113, P = .111). Born SGA was independently associated with increased aIMT after controlling for perinatal, anthropometric, and biochemical determinants in linear regression models.SGA children exhibit increased thoracic aIMT and aortic arch PWV in early childhood that may suggest the presence of structural changes in the thoracic aorta wall architecture. Measurement of ascending aIMT by transthoracic echocardiography is feasible and reproducible and may be a useful marker of vascular disease.

Introduction: Adiponectin has important anti-inflammatory and anti-atherogenic effects. Although adiponectin and atherosclerosis correlate inversely in children and adults, we have little information regarding this relationship in neonates. Methods: We measured cord blood adiponectin levels and abdominal aortic intima media thickness (aIMT) in 80 healthy, term neonates and investigated the relationship between adiponectin and total cholesterol (TC), LDL-cholesterol (LDL-C), HDL-cholesterol (HDL-C), and triglyceride, and their relationships to infant anthropometry and gender. Results: Mean birth weight, length, head circumference and aIMT values for male neonates were statistically significantly higher than those for female neonates. Adiponectin levels were not significantly different with respect to gender. In correlation analysis, the mean adiponectin level correlated positively with TC, HDL-C and LDL-C levels and birth weight, length and head circumference. There was no significant correlation between aIMT and any other parameters. Conclusion: The cord blood adiponectin and aIMT values reported here for the first time, represent reference values in the early neonatal period. The positive correlations between adiponectin levels and birth weight, length and head circumference, and TC, HDL-C and LDL-C indicate that further studies are required to demonstrate the exact relationship and clinical importance of adiponectin metabolism during the neonatal period.

Background/Aims: Congenital hypothyroidism (CH) in neonates is associated with lipid alterations that might be a risk factor for early cardiovascular disease in adult life. The aim of this study was to investigate the effect of CH on lipid metabolism and aortic intima media thickness (aIMT) as a unique finding of the increased risk of atherogenic risk in neonatal age. Methods: The study group consisted of 15 newborns with CH who were identified by neonatal mass screening (patient group), and 25 healthy newborns (control group). Serum lipid profiles and aIMT obtained from abdominal aorta were measured in all subjects. Results: The mean aIMT were higher in the patient group (0.46 +/- 0.062 mm) compared with the control group (0.34 +/- 0.035 mm; p = 0.006). The weight-adjusted aIMT of patients (0.13 +/- 0.017 mm/kg) was also significantly greater than that of the controls (0.10 +/- 0.019 mm/kg; p < 0.001). Total serum cholesterol levels were significantly higher in patients than those in healthy controls (130.80 +/- 44.46 vs. 99.96 +/- 18.87 mg/dl). The other lipid levels including triglyceride, low-density lipoprotein (LDL), high-density lipoprotein cholesterol and LDL cholesterol levels of the patients were slightly higher than those of the controls, without statistical significance. Conclusion: Neonates with CH have significantly higher aIMT with lipid alterations. Hypothyroidism might increase the risk of early atherosclerosis even in the neonatal period. Copyright (C) 2013 S. Karger AG, Basel, Abstract Background/Aims: Congenital hypothyroidism (CH) in neonates is associated with lipid alterations that might be a risk factor for early cardiovascular disease in adult life. The aim of this study was to investigate the effect of CH on lipid metabolism and aortic intima media thickness (aIMT) as a unique finding of the increased risk of atherogenic risk in neonatal age. Methods: The study group consisted of 15 newborns with CH who were identified by neonatal mass screening (patient group), and 25 healthy newborns (control group). Serum lipid profiles and aIMT obtained from abdominal aorta were measured in all subjects. Results: The mean aIMT were higher in the patient group (0.46 ± 0.062 mm) compared with the control group (0.34 ± 0.035 mm; p = 0.006). The weight-adjusted aIMT of patients (0.13 ± 0.017 mm/kg) was also significantly greater than that of the controls (0.10 ± 0.019 mm/kg; p < 0.001). Total serum cholesterol levels were significantly higher in patients than those in healthy controls (130.80 ± 44.46 vs. 99.96 ± 18.87 mg/dl). The other lipid levels including triglyceride, low-density lipoprotein (LDL), high-density lipoprotein cholesterol and LDL cholesterol levels of the patients were slightly higher than those of the controls, without statistical significance. Conclusion: Neonates with CH have significantly higher aIMT with lipid alterations. Hypothyroidism might increase the risk of early atherosclerosis even in the neonatal period. Copyright © 2013 S. Karger AG, Basel. &nbsp

Amac : Bu calismada, aorta duvarinda yasin ilerlemesine kosut olaylanan yapisal degisikliklerin belirlenmesi amaclandi. Yenidogandan baslayarak belirli yas gruplarini kapsayan doku orneklerinde yasin ilerlemesiyle, elastik liflerin, dagilimi, yogunlugu, dizilimleri, yapisal ozellikleri, kalinliklari ve sayisal degisimleri ince yapi duzeyinde incelendi. Yontemler : Bu calismada kullanilan aorta doku ornekleri Ankara Ibni Sina Hastanesi’nden saglanan sicanlardan elde edildi. Disi, Wistar-albino cinsi sicanlar; yenidogan, 5 hafta, 7 hafta, 3 ay ve 1 yas olmak uzere bes farkli yas gruba ayrildi. Sicanlarin agirliklari ortalama; yenidoganlar 4,5-6 g, 5 haftalik olan grup 110 g, 7 haftalik olan grup 130 g, 3 aylik olan grup 220 g ve 1 yasinda olan grup 350 g olarak belirlendi. Her gruba ait aorta ornekleri alinarak, elektron mikroskobik izleme yonteminden gecirildi. Gruplardan alinan dokular Gecirmeli Elektron Mikroskop (TEM)’da ve toluidin mavisi ile boyanan yari ince kesitler isik mikroskopta degerlendirildi. Bulgular : Isik mikroskobu ve TEM ile yapilan incelemelerde yaslanma ile birlikte internal elastik laminanin belli bir sure kalinlastigini ancak daha da ileri yaslarda incelmeye basladigini belirledik. Genc sicanlarda pinositotik vezikullerin hem bazalde hem de apikal yuzde hemen hemen esit oldugunu, ileri yastaki sicanlarda ise; vezikullerin apikal yuzde yogunlastigini ve endotel hucrelerinin duzensiz sekilli oldugunu izledik. Yasa kosut olarak duz kas hucre proliferasyonunun arttigini, internal elastik lamina bolgelerinde bu hucre artisinin belirginlestigini saptadik. Sonuc : Yaslanma, aortada, intima ve elastik lamellerin incelmesi ve bunun yerine elastik lifler arasinda bag dokusu ve kas hucrelerinin artisi, endotel hucrelerinde bozulma ve bazi bolgelerde dejenerasyonlarinin gozlemlendigi, organel ve organlarin aktivitelerinin yavasladigi ya da bozuldugu oldukca karmasik bir olaydir. Sonuc olarak aortanin yaslanma ile dejenerasyona ugradigi tespit edilmistir. Anahtar Kelimeler: Aort, yaslanma, TEM Structural Variations in Aortic Intima According to Age Objective : The purpose of this study is to examine the structural variations in aortic wall according to age, including a specific age group in the age spectrum using newborn tissue samples The distribution, density, sequences, structural characteristics, thickness and quantitative changes of the elastic fibers were examined ultrastructurally. Methods : The aorta tissue samples used in this study were taken from rats supplied from Ankara Ibni Sina Hospital. The female Wistar-albino rats were selected from five different age groups, which are- infants, 5 week, 7 week, 3 months and 1 year. The average weights of the rats were determined as 4,5-6 gr for infants, 110 g for 5 week age group, 130 g for 7 week age group, 220 g for 3 month age group and 350 g for 1 year age group. The aorta tissue samples from all age groups were prepared for electron microscopy method. The half thin sections were stained with toluidine blue for light microscopy and the tissues stained with osmium for Transmission Electron Microscope were also evaluated. Results : In the investigations with light microscopy and TEM, the internal elastic lamina was thickened for a while and in older ages it became thinner. We observed that pinocytotic vesicles of young rats in both the basal and apical cell membrane were almost equal and in older rats the vesicles on apical surface were concentrated and the endothelial cells became irregular. Depending on age, the proliferation of smooth muscle cells increased, and significant increase of smooth cells were found in internal elastic lamina. Conclusion : Aging is a very complex process, in which it is observed that intima and elastic lamels in aorta become thinner, the connective tissue and muscle cells increase between elastic fibers, distortion and degeneration occur in some places in endothelial cells and the activities of organelles and organs decelerate or distort. In conclusion, it was determined that aorta was degenerated by aging. Key Words: Aorta, aging, TEM

Endothelial injury has for a long time been suggested to be an important factor for the development of atherosclerotic lesions. In this study, a superficial, circumferential, injury to the aortic intima was induced via a catheter covered with small stones, introduced into the femoral artery of rabbits. The immediate answer of the arterial wall and the formed elements of the blood was studied with combined scanning and transmission electron microscopy. De-endothelialization was noted and the denuded areas were almost immediately covered by platelets, spreading over the surface and releasing the contents of their granules by time. At some locations deeper injuries to the elastic laminae of the wall could be noted. Especially frequent around these areas, but also common all over the de-endothelialized surface, leukocytes were seen. Both neutrophils, lymphocytes and monocytes could be found. A demarcation of the border of the injury was noted three days after catheterization.

Much epidemiological evidence has linked low birth weight with late cardiovascular risk. In order to investigate the effect of intrauterine growth restriction (IUGR) on early atherosclerosis in the fetus, we measured aortic wall thickness (abdominal aortic intima-media thickness: aIMT) by ultrasonography in 15 neonates with IUGR and in 31 neonates considered to be appropriate for gestational age (AGA). Furthermore, we evaluated the relationship between aIMT, serum insulin-like growth factor-I (IGF-I) and low-density lipoprotein (LDL) particle size to investigate the possible effect of these atherosclerosis-related factors on the early atherosclerosis process. The results showed that the mean aIMT was significantly greater in the IUGR neonates than in the AGA neonates (least squares mean ± SE, 537 ± 24.8 vs. 471 ± 17.0 µm, p=0.037). The serum IGF-I levels were lower in the IUGR neonates than in the AGA neonates (27.9 ± 4.3 vs. 42.7 ± 2.9 ng/ml, p=0.009). A significant negative correlation was observed between aIMT and IGF-I in the IUGR neonates (r=-0.646, p=0.009); however, a positive correlation was observed between aIMT and IGF-I (r=0.416, p=0.020) in the AGA neonates. There appeared to be no relationship between aIMT and LDL particle diameter. Atherogenic small, dense LDL was not detected in the IUGR infants. In conclusion, neonates with IUGR have significant aortic thickening with decreased IGF-I, suggesting that prenatal events might predispose them to later cardiovascular risk.