RESUMO
472 autopsy subjects were examined with the following aims: to study the association pattern of atherosclerotic lesions between different arterial sectors, the impact of serum lipid disorders (total cholesterol, HDL-c, LDL-c, VLDL-c, and triglycerides were analyzed) and the association pattern between the atherosclerotic lesions in different arterial sectors and the degree of heart damage. For morphometric analysis of the vessels (aorta, circle of Willis, coronary, renal, iliac, and femoral arteris) the atherometric system was used. The most relevant results were as follows: the lipid disorders show their greatest impact in the heart, coronary and femoral arteries and abdominal aorta, whereas the strongest correlations between the atherosclerotic lesions in different arterial sectors were found in those with anatomical continuity.
Assuntos
Artérias/patologia , Arteriosclerose/sangue , Arteriosclerose/patologia , Lipídeos/sangue , Miocárdio/patologia , Colesterol/sangue , HDL-Colesterol/sangue , LDL-Colesterol/sangue , VLDL-Colesterol/sangue , Traumatismos Cardíacos/sangue , Traumatismos Cardíacos/patologia , Humanos , Triglicerídeos/sangueRESUMO
An atherometric system (AS) was used to study coronary atherosclerotic lesions of a sample of 73 autopsy subjects. The content of nine chemical elements in the hair (K, Ca, Zn, Br, Sr, Pb, S, Cl, Cu) and the rates Zn/Cu and Ca/K were determined by energy dispersive X-ray fluorescence (EDXRF) analysis. Some canonical correlation analyses (CCA) were made of different combinations of chemical elements contents and of the following descriptive arterial variables of As: fatty streaks, fibrous plaques, severe (complicated plus calcified), plaques, and total atherosclerosis and the three weighted indices of AS, i.e. obstruction, stenosis and benignity. The arterial variables were obtained from the three major epicardial branches of the coronary arteries. Similar CCA analyses were performed to correlate chemical elements of the hair with some heart variables of AS, such as heart weight and estimated total volume of myocardium damaged by fibrosis and/or necrosis. The most remarkable results were as follows: Combinations of Pb, Ca/K, Zn/Cu and Fe, Ca/K, Zn/Cu were always strongly correlated with fatty streaks, fibrous plaques and severe plaques of the three coronary artery branches and the total coronary artery system, with the only exception of the left circumflex coronary artery when Fe was included. Similar results were recorded from obstruction, stenosis and benignity indices of AS. These two combinations of chemical elements were also correlated with the heart variables of AS. When the group of elements was integrated by Br, Ca/K, Zn/Cu, there were significant results with the heart variables, but not with the arterial variables of the AS.
Assuntos
Doença da Artéria Coronariana/patologia , Vasos Coronários/patologia , Cabelo/química , Oligoelementos/análise , Autopsia , Humanos , Espectrometria por Raios X/métodosRESUMO
An atherometric system (AS) was used to study the coronary atherosclerotic lesions of a consecutive series of 102 autopsies divided into two groups according to the principal cause of death, the myocardial infarction and the low atherosclerosis groups, respectively (MIG 67 cases, LAG 35 cases). The hair elements contents (K, Ca, Zn, Br, Sr, Pb, S, Cl, Cu, and their rates Ca/Sr, Zn/Cu and Ca/K) were determined by energy dispersive X-ray fluorescence (EDXRF) analysis. A PEARSON correlation analysis was done between each element and the following descriptive arterial variables of the AS: fatty streaks (X), fibrous plaques (Y), severe (complicated plus calcified) plaques (Z) and total atherosclerosis (sigma) and the three weighted indices of the AS: obstruction (omega), stenosis (P) and benignity (B). These variables were obtained from the three major epicardial branches of the coronary arteries (right RC, left anterior descending LAD and left circumflex LC). From a total of 189 possible correlations between the 9 elements and their 3 combinations and the 7 variables of the AS in the three coronary arteries, 86 (45.5%) were significant. The fatty streak was the best correlated variable. It correlated with all elements with the only exception of chloride. The fibrous plaque was poorly correlated. The severe plaques and total atherosclerosis correlated mainly with Zn and Pb in the MIG and Sr in the LAG. The weighted indices have the same behaviour. Also some correlations were found between K, Ca, Zn, Br, Sr, Pb, Ca/Sr, Zn/Cu and Ca/K ratios with some of the variables of the AS in each coronary artery.
Assuntos
Doença da Artéria Coronariana/patologia , Eletrólitos/análise , Cabelo/química , Metais/análise , Autopsia , Doença da Artéria Coronariana/diagnóstico , Humanos , Espectrometria por Raios XRESUMO
The three major epicardial coronary arteries of a set of 472 autopsy cases divided into four groups: a) non-diabetics and non-hypertensive, 322 subjects; b) hypertensive, 75 subjects; c) diabetics, 57 subjects and d) hypertensive and diabetic, 17 subjects, were studied. Classical pathomorphological procedures and an atherometric system (AS), suitable to characterize the atherosclerotic lesions, was used searching for differences between the level of atherosclerosis into these four groups and its eventual progression according to the time of evolution of these diseases. Raw data processing was full automated and some univariate and multivariate statistical procedures (means, standard deviations, ANOVA, MANOVA and principal components analysis) were performed using two commercial statistical packages: "NCSS" and "SYSTAT". The most remarkable findings were the following: Diabetes and hypertension have both strong impact upon the rate at which the atherosclerotic process takes place in subjects affected by these diseases. The time of evolution of both diseases correlates positively and independently of age with the velocity of the atherosclerotic process at the three coronary arteries. The impact of diabetes seems to be stronger and is particularly expressed by the severe plaques (Z) while the effect of hypertension is specially observable at the fibrous plaques (Y). There seems to be no significant interaction (synergism) between the two risk factors upon the measurement of the atherosclerotic lesions, that is, they have an additive effect. Two simple underlying factors can be used to account for interindividual differences. These two factors are "dominated", respectively, by fibrous (Y) and severe plaques (Z).
Assuntos
Doença da Artéria Coronariana/etiologia , Vasos Coronários/patologia , Complicações do Diabetes , Hipertensão/complicações , Análise de Variância , Doença da Artéria Coronariana/patologia , Humanos , Fatores de Risco , Fatores de TempoRESUMO
In 2043 autopsies divided into the high (HAG) and low (LAG) atherosclerosis group a set of variables of a new atherometric system (AS) was used to characterize the atherosclerotic lesion (AL) in the circle of Willis arteries: fatty streaks (X), fibrous plaques (Y), severe plaques (Z), index of stenosis (P) and index of benignity (B). Principal component analysis identified a first component of severity (Y, P and Z) and a second component of benignity (X and B). Fibrous plaques play the main role in the severity of AL in the circle of Willis. The new AS proved its usefulness in characterizing the state of AL, whereas discriminant analysis and AS distinguished between the HAG and the LAG. The classification was correct in 74.5% and 76.5% when using three (X, Y, Z) and five (X, Y, Z, P, B) variables, respectively.
Assuntos
Círculo Arterial do Cérebro/patologia , Arteriosclerose Intracraniana/patologia , Arteriosclerose/patologia , Análise Discriminante , Humanos , Análise Numérica Assistida por ComputadorRESUMO
Coronary arteries affected by atherosclerosis and its myocardial related damage in cardiac and non-cardiac sudden death subjects (152 and 98, respectively) including a low atherosclerosis group (250 subjects) were studied in autopsy material applying a new well standardized atherometric system. A high statistical significance of all variables of this system was found between the groups studied.
Assuntos
Doença da Artéria Coronariana/patologia , Vasos Coronários/patologia , Morte Súbita/patologia , Adulto , Fatores Etários , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Miocárdio/patologia , Fatores SexuaisRESUMO
A given set of autopsies (total 2043) divided into high and low atherosclerosis groups (HAG, LAG) according to the primary cause of death 1171 and 872 cases, respectively, was studied by an atherometric system. The variables of this system characterize the pathomorphological changes, i.e. fatty streaks (X), fibrous plaques (Y) and severe (complicated and calcified) plaques (Z) of atherosclerosis. In the present study were also included two indices, stenosis (P) and benignity (B), applicable for estimation of the severity of the process. In order to verify the discrimination between the HAG and LAG groups the utility of the classification should be demonstrated. The three main branches of the coronary arteries, right (RC), left anterior descending (LAD) and left circumflex (LC), were examined. Qualitative and quantitative analyses of the different vascular changes were made by means of a digitizer coupled to a personal computer NEC 9801 (Japan). The data were processed in a computer EC-1040 (GDR). The multivariate statistical techniques, including discriminant analysis were used applying the "SPSS" commercial statistical package programme. The atherometric system proved to be useful to distinguish between HAG and LAG. Correct classification was in all cases greater than 70% except for LC (68%). The three variables X, Y and Z were capable to separate the groups. The stenosis and benignity indices proved to be the most effective for discrimination. The sign of benignity index discriminating function is always the same of the LAG. This variable is indeed one to indicate benignity. The coherence and consistency of the atherometric system developed was proved by discriminant analysis.
Assuntos
Doença da Artéria Coronariana/patologia , Vasos Coronários/patologia , Humanos , Matemática , Microcomputadores , SoftwareRESUMO
A new approach to study the atherosclerotic lesions (AL) applying a vectorial system is presented. The "lesional state vector" (LSV) is formed by using as vectors the three main types of AL, e.g. fatty streak, fibrous plaque and severe plaque (complicated and calcified considered together) as the coordinates. This vectorial representation is part of a biometric system described in 1982 by Carlevaro and Fernández-Britto, to characterize the AL in any vascular sector or group of patients. The LSV is a suitable tool to study the AL since it conserves all the information available as primary data and it is extremely useful for comparative studies applying different statistical techniques, including multivariate approaches. To demonstrate its advantage, we studied the coronary vessels (right, left anterior descending and left circumflex arteries), the cerebral arteries (circle of Willis) and the aorta (thoracic and abdominal segments) in 2,043 autopsies performed during 5 years (1981-1985). The patients were classified according to the primary cause of death, as high atherosclerotic (HAG) or low atherosclerotic groups (LAG), comprising 1,171 and 872 cases, respectively. Qualitative and quantitative gross analysis were done by a digitizer joined to a personal computer (NEC 9801, Japan). These data were processed on computer ES 1040, GDR. The statistical techniques applied (including the multivariate analysis) were those available in the Statistical Package for Social Sciences (SPSS). Applying the LSV to the arteries studied it was found that in the coronary arteries and in the circle of Willis, the severe plaque and the fibrous plaque played the most important roles, respectively. Graphic representation can make differentiation between HAG and LAG easy.(ABSTRACT TRUNCATED AT 250 WORDS)
Assuntos
Arteriosclerose/patologia , Arteriosclerose/classificação , Vasos Coronários/patologia , HumanosRESUMO
UNLABELLED: To study the atherosclerotic lesion (a.l.) in the two aorta segments (thoracic and abdominal) in a given set of autopsies (total 2043) performed during five years (1981-85) in one of the principal general hospitals in the city of Havana, a set of five variables was used as part of a new biometric system (BS), to characterize the a.l. in any vascular sector. Three of these variables represent the main types of a.l., fatty streaks (X), fibrous plaques (Y) and severe (complicated and calcified) plaques (Z), while the others were indices of stenosis (P) and benignity (B). Classical dissection and pathological laboratory procedures were performed. Qualitative and quantitative gross morphometric analyses were done by a digitilizer joined to a NEC (9801) personal microcomputer (Japan). These data were processed in a medium size computer EC-1040 (GDR). The multivariate statistical techniques, the principal component analysis (PCA) and the discriminant analysis (DA), were used applying the "SPSS" programme. CONCLUSIONS: (1) PCA revealed in the two aorta segments studied a first component of benignity, fatty streaks (X) and benignity index (B) and a second component of severity, severe plaques (Z) and stenosis number (P). Because of the dimensions of the two aorta segments (width and length) the dominant, first component, is benignity. So the BS is useful in characterizing and describing the lesional state of any aorta segments; (2) DA and BS proved to be useful to distinguish between the high atherosclerotic group (HAG) and the low atherosclerotic group (LAG). The correct classification rate exceed in all cases 70%. The three components of the lesional state vector (X,Y,Z) distinguish the groups. The stenosis (P) and benignity (B) indices proved to be most relevant. The sign of benignity index is always the same as that of the LAG. Thus this variable truly represents benignity. The coherence and consistency of the BS was also proved by DA.