fibrin and Cardiomegaly

There are few histologic studies of intracoronary stents found at autopsy. We studied histologic findings of 87 intracoronary stents from 45 autopsy hearts. There were 40 patients with chronically implanted stents and five shorter than 30 days. Of five patients with recent stent placement, the cause of death was related to the stent (in-stent thrombosis) in one case. Of the 40 patients with chronic stents, there were 16 sudden coronary deaths and 24 noncoronary deaths (controls). There were no late stent thromboses in the coronary deaths. In the coronary deaths, 26% of stents showed restenosis versus 11% in controls (p = 0.1). The rate of healed infarcts and cardiomegaly was similar in the coronary and noncoronary groups, and acute thrombi in native arteries were seen only in three hearts in the coronary group. We conclude that the cause of death is rarely impacted by in-stent findings at autopsy, especially in chronically implanted stents.

Topics: Cardiomegaly; Case-Control Studies; Coronary Occlusion; Coronary Restenosis; Coronary Thrombosis; Coronary Vessels; Death, Sudden, Cardiac; Female; Fibrin; Forensic Pathology; Giant Cells; Humans; Male; Middle Aged; Myocardial Infarction; Myocardium; Neointima; Prospective Studies; Stents

Several biological pathways are activated concomitantly during left ventricular (LV) remodeling. However, the relative contribution of circulating biomarkers representing these distinct pathways to LV geometry is unclear.. We evaluated 2119 Framingham Offspring Study participants (mean age, 57 years; 57% women) who underwent measurements of biomarkers of inflammation (C-reactive protein), hemostasis (fibrinogen and plasminogen activator inhibitor-1), neurohormonal activation (B-type natriuretic peptide), and renin-angiotensin-aldosterone system (aldosterone and renin modeled as a ratio [ARR]) and echocardiography at a routine examination. LV geometry was defined on the basis of sex-specific distributions of LV mass (LVM) and relative wall thickness (RWT): normal (LVM and RWT <80th percentile), concentric remodeling (LVM <80th percentile but RWT >or=80th percentile), eccentric hypertrophy (LVM >or=80th percentile but RWT <80th percentile), and concentric hypertrophy (LVM and RWT >or=80th percentile). We related the biomarker panel to LV geometry using polytomous logistic regression adjusting for clinical covariates and used backwards elimination to identify a parsimonious set of biomarkers associated with LV geometry. Modeled individually, C-reactive protein, fibrinogen, plasminogen activator inhibitor-1, and ARR were related to LV geometry (P<0.01). In multivariable analyses, the biomarker panel was significantly related to altered LV geometry (P<0.0001). On backwards elimination, logARR alone was significantly and positively associated with eccentric (odds ratio per SD increment, 1.20; 95% confidence interval, 1.05 to 1.37) and concentric LV hypertrophy (odds ratio per SD increment, 1.29; 95% confidence interval, 1.06 to 1.58).. Our cross-sectional observations on a large community-based sample identified ARR as a key correlate of concentric and eccentric LV hypertrophy, consistent with a major role for the renin-angiotensin-aldosterone system in LV remodeling.

Topics: Aldosterone; Biomarkers; C-Reactive Protein; Cardiomegaly; Electrocardiography; Female; Fibrin; Heart Ventricles; Humans; Inflammation; Male; Middle Aged; Natriuretic Peptide, Brain; Plasminogen Activator Inhibitor 1; Regression Analysis; Renin-Angiotensin System; Ultrasonography; Ventricular Function, Left; Ventricular Remodeling

Following Skelton's procedure with unilateral adrenonephrectomy, contralateral adrenal enucleation and application of 1% NaCl with drinking fluid, normal rats develop hypertension and generalized severe arteriosclerosis within 7 weeks, experimental group I. Thereby the mean systolic blood pressure increased from 108 +/- 10 to 223 +/- 12 mm Hg, and 90 arteriosclerotic blood vessels could be counted in 100 histological sections (10 from each animal) of the hearts. Following Skelton's procedure and admixture of flunarizine with the food (40 mg flunarizine per kg for 8 weeks, started 1 week before the operation; mean plasma flunarizine value: 336 +/- 136 ng/ml at the end of the experiment), experimental group II, all rats developed hypertension too, whereby the mean systolic blood pressure increased from 109 +/- 10 to 214 +/- 16 mm Hg, but in contrast to experimental group I, only one artery with sclerosis could be observed in 100 comparable histological sections of the hearts. The untreated control rats, experimental group III, remained normotensive, and no arteriosclerotic blood vessels could be observed. The findings presented show that the calcium-antagonist flunarizine with the dosage used does not reduce hypertension, but almost completely suppresses hypertension-induced arteriosclerosis of the myocardial blood vessels without lowering the high blood pressure.

Topics: Animals; Blood Pressure; Cardiomegaly; Coronary Artery Disease; Coronary Vessels; Endothelium, Vascular; Fibrin; Flunarizine; Hypertension; Male; Muscle, Smooth, Vascular; Organ Size; Rats; Rats, Inbred Strains

Investigations were carried out to determine the lung lesions responsible for the development of pulmonary heart disease, cor pulmonale, in rats treated with monocrotaline pyrrole or monocrotaline. Animals with right ventricular hypertrophy showed microscopic lung alterations consisting of alveolar edema; fibrin thrombi with partial to complete occlusion of arteries, arterioles, capillaries, and veins; connective tissue proliferation of alveolar septae; cellular hyperplasia of septae; and medial hypertrophy of arterioles. Due to the high incidence of fibrin thrombi in animals with right ventricular hypertrophy, we believe that formation of fibrin thrombi plays a decisive role in the development of chemically induced cor pulmonale.

Topics: Animals; Cardiomegaly; Endothelium; Fibrin; Hypertension, Pulmonary; Lung; Male; Monocrotaline; Pulmonary Embolism; Pulmonary Heart Disease; Pyrroles; Pyrrolizidine Alkaloids; Rats

Topics: Animals; Blood Platelets; Blood Pressure; Capillaries; Cardiomegaly; Disease Models, Animal; Endothelium; Erythrocyte Count; Fibrin; Hematocrit; Hemoglobins; Lung; Male; Microscopy, Electron; Muscle, Smooth; Myocardium; Organ Size; Pulmonary Circulation; Pyrroles; Pyrrolizidine Alkaloids; Rats; Time Factors

Topics: Alkaloids; Animals; Autopsy; Blood Platelets; Capillaries; Cardiomegaly; Dilatation; Disease Models, Animal; Endothelium; Fibrin; Haplorhini; Heart Ventricles; Heterocyclic Compounds; Lung; Macaca; Microscopy, Electron; Thrombosis; Vascular Diseases

Topics: Adult; Cardiomegaly; Cardiomyopathies; Electrocardiography; Fibrin; Heart Conduction System; Heart Ventricles; Humans; Male; Radiography, Thoracic; Thromboembolism

Topics: Adolescent; Adult; Autoantibodies; Blood Protein Electrophoresis; Cardiomegaly; Child; Cryoglobulins; Endomyocardial Fibrosis; Female; Fibrin; Fluorescent Antibody Technique; Gastric Mucosa; Humans; Immunoelectrophoresis; Kidney; Liver; Lung; Male; Myocardium; Pancreas; Spleen; Thyroid Gland