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are not a substitute or replacement for medical advice. If
you are seeking medical advice, we encourage you to consult
a physician or other medical professional. The views expressed
in these Commentaries are those of the authors and are not
necessarily those of IAS.
FEBRUARY
2009
Discoidin Domain Receptors: Collagen Receptors Regulating Inflammation and
Fibrosis during Atherogenesis
Author: Christopher Franco and Michelle P. Bendeck
Collagens are abundant components of the extracellular
matrix in the atherosclerotic plaque. In addition to contributing
to lesion volume and mechanical stability, collagens can influence
the behavior of smooth muscle cells (SMCs) and macrophages
during plaque development. For example, collagens are known
to regulate SMC proliferation and migration, and collagen degradation
is essential for SMC remodeling of 3-dimensional tissue matrices
leading to inward vessel remodeling [1].
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Vessel Wall Imaging of Carotid Atherosclerosis: Identification of Vulnerable
Plaque Using Black-Blood MRI
Authors:
Kazumichi Yoshida, M.D., Ph.D., Katsumi Inoue,
M.D., Ph.D., and Sen Yamagata, M.D., Ph.D.
It has been found that not only the severity
of stenosis but also plaque stability plays an extremely important
role in the association between carotid atherosclerosis and
the risk of stroke [1-4]. According to recent vascular biology
studies, plaque stability depends on several factors, such
as plaque components, volume, and morphology. Furthermore,
it is generally accepted that the atherosclerotic vessel wall
can compensate for luminal narrowing by expansive arterial
remodeling [5-7], and that patients with carotid plaque, even
those in whom luminography reveals no significant stenosis,
have a potential risk of stroke.
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Nonalcoholic Fatty Liver Disease (NAFLD) and
Atherosclerosis: A Causal Relationship?
Authors: Anna Ludovica
Fracanzani, Luca Valenti, Larry Burdick, Alberico Catapano1,
Silvia Fargion
Though risk of hypertension increases gradually
without a threshold [1] and depends on the concomitant risk
profile of the subject, the designation “prehypertension” is
used to identify individuals (with a systolic BP 120-139 mmHg
or diastolic BP 80-89 mmHg) considered to be at higher risk
of developing hypertension than those with an optimal BP [2,3].
Progression to stage I hypertension over a 4-year period was
demonstrated in nearly two-thirds of patients with untreated
prehypertension [4].
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Prehypertension: Determinants, Contribution to Cardiometabolic Risk, and Potential
Gender-Specific Role of Adiponectin Dysfunction
Authors: Altan Onat, M.D.,
FESC, Mehmet Yazici, M.D., and Günay Can
Disorders of metabolic homeostasis,
including type 2 diabetes, obesity, and dyslipidemias, are
characterized by both insulin resistance and vascular dysfunction,
defined by a decreased capacity of arterial vessels to relax
in response to vasodilator stimuli [1]. Insulin resistance
and vascular dysfunction are also prominent features of important
cardiovascular disorders, including hypertension, coronary
artery disease, and atherosclerosis [2].
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Tumor Necrosis Factor- Antagonism Improves
Vasodilation During Hyperinsulinemia in Metabolic Syndrome
Author: Carmine Cardillo, M.D.
Disorders of metabolic homeostasis, including
type 2 diabetes, obesity, and dyslipidemias, are characterized
by both insulin resistance and vascular dysfunction, defined
by a decreased capacity of arterial vessels to relax in response
to vasodilator stimuli [1]. Insulin resistance and vascular
dysfunction are also prominent features of important cardiovascular
disorders, including hypertension, coronary artery disease,
and atherosclerosis [2].
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Effects of Ubiquitin-Proteasome System Deregulation on the Vascular Senescence
and Atherosclerosis Process in Elderly Patients
Author: Raffaele Marfella, M.D., Ph.D.
Epidemiological studies have shown that age is
a dominant risk factor for atherosclerotic cardiovascular diseases.
The incidence and prevalence of atherothrombotic diseases,
including coronary heart disease and stroke, both increase
with advancing age. However, the molecular mechanisms underlying
the increased risk of such diseases that is conferred by aging
remain unclear.
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Metabolic Syndrome: No Longer an Adult-Only
Disease and More Than Just Diabetes
Author: Revi P. Mathew, M.D.
The metabolic syndrome (MS) is a cluster of metabolic
abnormalities and cardiovascular risk factors [1]. These include
an increased waist circumference, systemic hypertension, elevated
fasting plasma triglycerides, and an elevated fasting plasma
glucose or insulin resistance. All of these components had
been identified in children, but they have not been used as
identifiers of pediatric MS when clustered.
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Adipose Tissue, Adipocytokine: Impact on Insulin Resistance in Indian Population
Author: Sujata R. Mahadik
The Asian Indian population suffers from an increased
susceptibility to type 2 diabetes (T2DM) and cardiovascular
disease (CVD) compared to the Caucasian population. Obesity
is a well-recognized risk factor for the development of insulin
resistance (IR) and T2DM. Although the overall obesity measured
as BMI is not very high in Asian Indians, they are relatively
more insulin resistant due to the high percentage of body fat
and higher abdominal obesity.
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Computational Models in Atherosclerosis: Concrete Help
Author: Francesco Pappalardo, Ph.D.
Atherosclerosis, a pathology affecting arterial
blood vessels, is one of most common diseases of developed
countries. It is, in large part, due to the deposition of low
density lipoproteins (LDL), i.e. plasma proteins carrying cholesterol
and triglycerides that determine the formation of multiple
plaques within the arteries [1]. The origin of atherosclerosis
is still not fully understood.
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Fatty Liver as a Risk Factor for Cardiovascular Disease
Authors: Silvia Sookoian, M.D., Ph.D. and Carlos Pirola,
Ph.D.
Nonalcoholic fatty liver disease (NAFLD), a clinical
entity almost unrecognized before 1980, is now an emerging
epidemic disease with increasingly prevalence worldwide, not
only affecting adult population but also more than 6 million
children in the United States [1]. The disease affects 10%
to 24% of the general population in various countries, and
parallels the frequency of the obesity and type 2 diabetes
epidemic [2].
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Quantitative Coronary
Angiography versus Intravascular Ultrasound for the Evaluation
of Plaque Regression in Coronary Artery Disease. Have We Reached "Imaging
Heaven"?
Authors: Ashok J. Prasad, M.D., Raul A. Schwartzman, M.D., and Sorin
J. Brener, M.D.
Atherosclerosis is the primary pathophysiological
process underlying vascular disease. This systemic process
manifests as distinct clinical entities depending on the vascular
bed it affects. Coronary artery disease (CAD) results from
atherosclerotic plaque formation and its subsequent effects
on the arterial wall. This can range from noncritical luminal
obstruction to total occlusion following plaque rupture and
thrombus formation.
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Metabolic Syndrome, Inflammation, and Non-HDL Cholesterol:
A Simplified Approach
Authors: Michael J. Blaha, M.D.,
M.P.H. and Andrew DeFilippis, M.D., M.Sc.
Increased caloric intake, increased refined carbohydrate
consumption, and physical inactivity have led to an explosion
in the incidence of abdominal obesity and an emerging epidemic
of insulin resistance. We stand at the cusp of an impending
global public health crisis for which clinicians are woefully
prepared.
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Atherosclerosis
Risk Factors and Alzheimer Disease
Author: Myron F. Weiner, M.D.
This commentary examines
the interrelationship of atherosclerosis and atherosclerosis
risk factors to Alzheimer disease (AD) and the variability
of this relationship in a specific ethnic group: the American
Indian. AD occurs as a familial and a sporadic disease
whose pathological hallmarks are extracellular neuritic
plaques and intracellular neurofibrillary tangles. The
pathophysiology of AD is thought to be primarily due to
the toxicity of high levels of amyloid beta (Aß)
dimers in brain tissue [1].
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