Progressive narrowing of coronary arteries causes angina. One of the leading causes of death in the us is heart disease. Histological techniques have shown that the majority of disrupted plaques have a necrotic lipid core 6 10 occupying more than 40% of the plaque volume, 5 a thin fibrous cap, 11 fewer smooth muscle cells than intact plaques, 5 12 and an accumulation of lipidfilled macrophages at their edge. These fatty deposits extend the length of the arterial wall and protrude on the vessel lumen. These form as patchy areas of plaque and contribute to the hardening of arteries, a condition known as. Atherosclerosis, chronic disease caused by the deposition of fats, cholesterol, calcium, and other substances in the innermost layer of endothelium of the large and mediumsized arteries. Atheromatous plaques begin as fatty streaks composed of lipidladen macrophages foam cells.
Atheromatous plaque synonyms, atheromatous plaque pronunciation, atheromatous plaque translation, english dictionary definition of atheromatous plaque. This buildup results in plaque formation, vascular remodeling, acute and chronic luminal obs. Two of my uncles have had bypass surgery because of clogged arteries and plaque buildup and at the age of 55, my mother had a. Journal of the american college of nutrition 2012 v. The authors included nine studies with more than 830 individuals in whom virtual histology data was available. Uncomplicated fibrofatty plaque atheroma lipid core composition.
It can be measured as plaque volume, arterial surface covered with lesions, or by some correlated proxy, such as the. Atherosclerosis is a disease in which the inside of an artery narrows due to the buildup of plaque. Plaque structure and composition importantly impact clinical expression of atherosclerosis. A plaque is a raised focal lesion within the intima. Modified aha consensus classification based on morphologic descriptions. This process begins in childhood but not all fatty streaks progress to plaques. Relation of plaque lipid composition and morphology to the.
Ct angiography has established itself as an accurate modality to assess the presence of atherosclerotic disease and to grade the severity of stenosis 5. Hard, not soft, plaque buildup may predict risk of heart attack written by ana sandoiu on march 19, 2017 atherosclerosis is a condition in which plaque builds up inside the arteries, leading to. When severe, it can result in coronary artery disease, stroke, peripheral artery disease, or kidney problems, depending on which arteries are affected. It is widely recognized that the risk of atherosclerotic plaque rupture and consequent adverse cardiovascular events is primarily related to the composition of the plaques. It refers to the hardening of your arteries due to a buildup of plaque, which is essentially a combination of cholesterol, fatty substances, cellular waste products, calcium and fibrin a clotting material in the blood.
Histological studies that examined carotid endarterectomy specimens have shown that the composition of the plaque is influenced by cardiovascular risk factors. Impact of statin therapy on coronary plaque composition. These have thin fibrin caps that are prone to rupture. Atheroma refers to small fatty lumps that develop inside blood vessels arteries. The accumulated material forms a swelling in the artery wall, which may intrude into the lumen of the artery, narrowing it and restricting blood flow. Atheromatous plaque definition of atheromatous plaque by. Population studies have demonstrated that elevated levels of ldl cholesterol and apolipoprotein b apob 100, the main structural protein of ldl, are directly associated with risk for atherosclerotic cardiovascular events ascve. Once a plaque ruptures, it can trigger an acute thrombosis clot by activating platelets and the clotting cascade. Inflammation in atherosclerotic plaque formation youtube. The accumulated material forms a swelling in the artery wall, which may intrude into the lumen of the artery. Symptoms, if they occur, generally do not begin until middle age. Atherosclerosis is the build up of a waxy plaque on the inside of blood vessels. Core insights informing our paradigm of the plaque at high risk of rupture have traditionally derived from pathological observations of ruptured and nonruptured plaques postmortem. Atheromatous plaques definition of atheromatous plaques.
Plaque composition is considered an important feature of the socalled vulnerable plaque. Composition of plasma and atheromatous plaque among coronary artery disease subjects consuming coconut oil or sunflower oil as the cooking medium. Mechanisms of plaque formation and rupture circulation. Composition of plasma and atheromatous plaque among coronary artery disease subjects consuming coconut oil or sunflower oil as the cooking medium author. New insights on the effects of statins on atherosclerotic plaques. Early observations that cholesterol is a key component of arterial plaques gave rise to the cholesterol hypothesis for the pathogenesis of atherosclerosis. Atherosclerosis is the most common arterial abnormality characterized as arteriosclerosis, which is defined by the loss of arterial elasticity due to vessel thickening and stiffening. Recent work has identified that the stability of the plaque rather than its. Molecular medicine in the 21st century has turned toward a comprehensive understanding of the dynamic processes that influence the composition and stability of atheroma and of how structural plaque components impact clinical outcomes. Morphometric analysis of the composition of atherosclerotic plaques in the four major epicardial coronary arteries in acute myocardial infarction and in sudden coronary death. Atherosclerotic plaque composition and classification. While some studies suggest statins may reduce plaque volume, the reduction is small even with the use of highdose statins. It is widely recognized that the risk of atherosclerotic plaque rupture and consequent adverse cardiovascular events is primarily related to the composition of the plaques 2.
An atheroma, or atheromatous plaque plaque, is an abnormal accumulation of material in the inner layer of the wall of an artery. Arteriosclerosis can occur in several forms, including atherosclerosis. Coronary artery atherosclerosis is the major cause of mortality and morbidity in the industrialised world. Stability of atheromatous plaque affected by lesional. Atherosclerosis is a continuous progressive development. Progression of atherosclerotic lesions potential plaque complications what are these complications. Therefore, plaque volume pv and plaque composition may be parameters that help in a better risk prediction and selection of patients who could benefit from surgical or endovascular intervention. Atherosclerosis is a word you probably hear a lot more than you care to.
Outward expansion of the carotid artery wall due to an atheromatous plaque is rarely, if ever, seen. The composition of nonruptured atheromatous plaques is highly variable, and the factors controlling this process are poorly understood. A vulnerable plaque, a type of atheromatous plaque, is a collection of white blood cells primarily macrophages and lipids including cholesterol in an arterial wall that is particularly unstable and prone to sudden major events, that is, heart attack or stroke. It can lead to heart attack, stroke, or heart failure. Plaque is an accumulation of cholesterol and other lipid compositions that forms on the inner walls of vessels. Arteriosclerosis from the greek arteria, meaning artery is a general term for hardening of the arteries. Atherosclerosis is a lipoproteindriven disease that leads to plaque formation at specific sites of the arterial tree through intimal inflammation, necrosis, fibrosis, and calcification. The role of lipids and lipoproteins in atherosclerosis. Dietary trans fatty acids and composition of human atheromatous plaques article pdf available in european journal of nutrition 435. Population studies have demonstrated that elevated levels of ldl cholesterol and apolipoprotein b apob 100, the main structural protein.
Adding to this body of published data, a recent analysis of 295 plaques in 2 sudden cardiac death victims identified aspects of plaque composition. Plaques from patients operated more than 30 days after the cerebrovascular event contained significantly less. Atherosclerosis is a chronic vascular disease initially developing in the intima of elastic and larger muscular arteries and characterized by the presence of fibroinflammatory lipid plaques atheromas, which grow in size to protrude into the vascular lumen and to involve the media of the artery. Ldl and hdl cholesterol good and bad cholesterol nucleus health duration. One of the main factors associated with an elevated risk of plaque rupture is a high macrophage content 3,4. A vulnerable plaque is a kind of atheromatous plaque a collection of white blood cells primarily macrophages and lipids including cholesterol in the wall of an artery that is particularly unstable and prone to produce sudden major problems such as a heart attack or stroke the defining characteristics of a vulnerable plaque include but are not limited to. Defining the highrisk plaque pathological observations. Atheromatous definition of atheromatous by medical.
Pdf dietary trans fatty acids and composition of human. Ruptures of atherosclerotic plaques are the cause of about 70% of heart attacks 1. It comprises a soft necrotic core predominantly lipids, foam cells and debris surrounded by chronic inflammatory. Fatty streak develop at 1112 years and fibrous plaques at 1530 years figure 1, depicts the conversion of fatty streak to fibrous plaques. Atherosclerosis is a narrowing of the arteries caused by a buildup of plaque. An atheroma, or atheromatous plaque, is an abnormal accumulation of material in the inner layer of the wall of an artery. Postmortem studies have revealed that atherosclerotic plaques associated with coronary thrombosis, sudden death, and plaque rupture typically have less fibrous tissue, a thinner fibrous cap, and a larger necrotic core than stable plaques. Its a type of arteriosclerosis, or hardening of the arteries. Composition of plasma and atheromatous plaque among. Evidence for the effects of statin therapy on vhivus parameters have been inconclusive. In contrast, other plaques grow more rapidly as a result of more rapid lipid deposition. Ruptures of atherosclerotic plaques are the cause of about 70% of heart attacks. Further, whereas coronary atherosclerosis tends to be a diffuse process in the artery involved, extracranial carotid artery atheromatous disease is focal. Despite the welldocumented improved survival of coronary heart disease with the use of statins, their effects on atherosclerotic plaques are not yet fully understood.
March, 2006 atlanta for the first time, a popular cholesterollowering statin drug has been shown to actually clear plaque out of. Atheromatous definition of atheromatous by the free. Atherosclerosis is the underlying cause of heart attack and stroke. Atheromatous plaque atheromas can develop on the intima of large and mediumcaliber arteries. Atheromatous disease definition of atheromatous disease. Furthermore the plaque analysis takes place at one time point, while it is known that atherosclerotic plaque composition changes over time. Advances in the understanding of plaque composition and. Latin atheroma, tumor full of pus that is like gruel, from greek, from athera, gruel, variant of athare, gruel, perhaps of egyptian origin, or.
Atheroma is the pathological basis for the disease entity atherosclerosis, a subtype of. In greek, athere means gruel, and skleros means hard. These form as patchy areas of plaque and contribute to the hardening of. Pdf composition of plasma and atheromatous plaque among. Two of my uncles have had bypass surgery because of clogged arteries and plaque buildup and at the age of 55, my mother had a heart attack. Virtual histology intravascular ultrasound vhivus imaging is an innovative tool for the morphological evaluation of coronary atherosclerosis. After decades of indolent progression, such plaques may suddenly cause lifethreatening coronary thrombosis presenting as an acute coronary syndrome. The material consists of mostly macrophage cells, or debris, containing lipids, calcium and a variable amount of fibrous connective tissue. A lipidcontaining lesion that forms on the innermost layer of the wall of an artery in atherosclerosis.
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