Increased Prevalence of Coronary Ectasia in Heterozygous Familial Hypercholesterolemia

Sudhir, Krishnankutty; Ports, Thomas A.; Amidon, Thomas M.; Goldberger, Jeffrey J.; Bhushan, Vikas; Kane, John P.; Yock, Paul G.; Malloy, Mary J.

doi:10.1161/01.cir.91.5.1375

Cited by 92 publications

(79 citation statements)

References 33 publications

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“…We also demonstrated a high (20%) prevalence of ectasia in the FH patients similar to that in these studies. Although there was no difference in the prevalence of coronary ectasia between the high and normal VF groups, the patients with ectasia in the high VF group had multiple lesions that were associated with more severe stenoses in agreement with Sudhir et al 46 Further observation is required to reveal the relationship between visceral fat accumulation and coronary ectasia in FH.…”

Section: Discussionsupporting

confidence: 85%

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Importance of intra-abdominal visceral fat accumulation to coronary atherosclerosis in heterozygous familial hypercholesterolaemia

et al. 1997

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OBJECTIVES: Hyper-low-density lipoprotein (LDL)-cholesterolaemia is a potent risk factor for coronary atherosclerosis. We have recently demonstrated that a cluster of risk factors including insulin resistance, glucose intolerance, hypertriglyceridaemia, and hypertension based on intra-abdominal visceral fat accumulation are closely related to coronary artery disease. In the current study, we evaluated the relationship between visceral fat accumulation and the severity and distribution of coronary atherosclerosis in familial hypercholesterolaemia (FH). DESIGN: The effect of visceral fat accumulation on coronary lesions and risk factors in patients with FH was investigated. SUBJECTS: Thirty-one male patients with heterozygous FH who underwent coronary angiography. MEASUREMENTS: Abdominal fat distribution was estimated by a cross-sectional computed tomographic scan at the umbilical level. Plasma lipid, glucose and insulin concentrations and blood pressure were measured. A 75 g oral glucose tolerance test was also performed. RESULTS: The patients were divided into two groups according to the degree of visceral fat accumulation. Fifteen patients had high visceral fat accumulation (High VF group) and 16 patients had normal visceral fat accumulation (Normal VF group). Body mass index (BMI) and subcutaneous fat area were signi®cantly higher in the high VF group. Baseline serum triglyceride was signi®cantly higher and baseline low-density lipoprotein (LDL)-cholesterol and reduction of LDL-cholesterol during treatment were signi®cantly lower in High VF group. Fasting plasma glucose and insulin concentrations, and systolic and diastolic pressures were signi®cantly higher in the High VF group. Signi®cant correlations were found between visceral fat area and the sum of the glucose and insulin concentration during an oral glucose tolerance test. Visceral fat area was signi®cantly correlated with the severity of coronary stenosis index. Distal coronary lesions were signi®cantly more frequent in the High VF group. moreover, the correlation between the visceral fat area and coronary stenosis index was found to be independent of age, BMI, and subcutaneous fat area by multiple regression analysis. CONCLUSIONS: Visceral fat accumulation is a potent cardiovascular risk factor in heterozygous FH.

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Section: Discussionsupporting

confidence: 85%

“…Further studies are necessary to clarify this relationship. Both Genda et al 45 and Sudhir et al 46 have demonstrated that coronary ectasia is more prevalent (18 and 15%) in FH patients than in non-FH patients with CAD. We also demonstrated a high (20%) prevalence of ectasia in the FH patients similar to that in these studies.…”

Section: Discussionmentioning

confidence: 97%

Importance of intra-abdominal visceral fat accumulation to coronary atherosclerosis in heterozygous familial hypercholesterolaemia

et al. 1997

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“…Diabetes thus could have a "protective" effect on aneurysmatosis because of an increased arterial stiffness. Sudhir et al [28] have shown an increased prevalence of CEA in heterozygous familial hypercholesterolaemia. They proposed that structural weakening or active lysis of connective tissue elements in the arterial wall may result from interaction with LDL-cholesterol.…”

Section: Discussionmentioning

confidence: 97%

Severe coronary artery ectasia and abdominal aortic aneurysm

2006

Schweiz Ärzteztg

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SummaryCoronary artery ectasia (CAE), a discrete or fusiform arterial dilatation, is an uncommon angiographic finding. We report the case of a patient presenting with an acute coronary syndrome in whom further evaluation revealed coronary artery disease with severe CAE in the presence of an abdominal aortic aneurysm (AAA). Since both entities are strongly associated with local and systemic atherosclerosis, they have traditionally been viewed as a variant of atherosclerosis. The combined occurrence of CAE and AAA, as in the present case, raises questions about common pathogenetic mechanisms apart from atherosclerosis. The respective evidence will be reviewed.

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“…KAE olgularının histopatolojik incelemesinde mediada yaygın dejenerasyon olduğu, metalloproteinaz enzim aktivitesinde artış olduğu, inflamatuvar süreçlerin etkili olabileceği belirtilmiştir (6,25). KAE olan olgularda ailevi hiperkolesteroleminin daha sık görüldüğü belirtilmiştir (8).…”

Section: Discussionunclassified

“…Ektaziye gidiş sürecini koroner arter media tabakasında-ki ektraselüler matriks yıkımından sorumlu enzimlerin başlattığı düşünülmektedir (6). Bu süreçte yüksek yoğunluklu lipoprotein kolesterolünde (HDLK) azalma, okside düşük yoğunluklu lipoprotein kolesteroldeki deki (LDLK) artmanın da rol oynadığı yapılan çalışmalarda gösterilmiştir (7,8). HDLK'ün hangi mekanizma ile patogenezde rol oynadığı net olarak bilinmemektedir.…”

Section: Introductionunclassified

The relation of serum paraoxonase-1 activity with isolated coronary artery ectasia: an observational study

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Kaya²,

Sezen³

et al. 2012

Anadolu Kardiyol Derg

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Objective: Coronary artery ectasia (CAE) is a congenital or acquired anomaly characterized with localized or diffuse dilatations of coronary arteries. Paraoxonase (PON-1) is a high-density lipoprotein-cholesterol (HDLC) associated antioxidant enzyme that prevents atherosclerosis. The aim of this study was to investigate serum paraoxonase-1 enzyme activity (SPA) in patients with CAE in comparison patients with coronary artery disease (CAD) and normal coronary arteries. Methods: We have evaluated 44 patients with isolated IKAE, 40 cases with normal coronary arteries (NCA), 40 cases with critical CAD (CAD) and 40 cases with minimal CAD (MCAD) in this cross-sectional observational study. Demographic and biochemical data of patients were collected. SPA was determined spectrophotometrically. Among-group comparisons, ANOVA, Kruskal-Wallis and Chi-square tests were used; Bonferroni test was used for post-hoc analysis, Pearson's correlation analysis to determine the parameters associated with the SPA. Results: There were no differences among groups with regard to age, sex, presence of diabetes, hypertension and smoking (p>0.05 for all). The highest HDLC was detected in patients with NCA and lowest HDLC was detected in patients with CAD (respectively 52±15 mg/dL; 41±16 mg/d L, p=0.021). CAD and CAE groups were similar with respect to HDLC levels (p>0.05). The highest SPA level was detected in patients 307 ÖZET Amaç: Koroner arter ektazisi (KAE), konjenital veya edinsel olabilen koroner arter dilatasyonlarıdır. Paraoksonaz, yüksek-dansiteli lipoprotein-kolesterol (HDLK) aracılı antioksidan bir enzimdir ve düşük-dansiteli lipoprotein-kolesterol (LDLK)'ü bakır iyonu ve serbest radikallerin indüklemiş olduğu oksidasyondan koruyarak aterosklerozun önlenmesinde rol oynar. Bu çalışmada amaç izole KAE (İKAE) olan hastalarla normal koronerleri olan ve KAH olan hastalarda serum paroksanaz-1 enzim aktivitesini (SPA) açısından fark olup olmadığını araştırmak idi. Yöntemler: Bu enine-kesitli gözlemsel çalışmaya İKAE'si bulunan 44 hasta ile birlikte minimal koroner arter hastalığı (MKAH) olan 40; kritik koroner darlığı olan (KAH) 40 ve normal koroner arterleri olan (NKA) 40 olgu dâhil edildi. Tüm olgularda demografik veriler ve biyokimyasal veriler yanında SPA spektrofotometrik olarak değerlendirildi. Gruplar arası karşılaştırmalarda ANOVA, Kruskal-Wallis ve Ki-kare testleri, post-hoc analizler için Bonferroni testi, SPA'nın ilişkili parametrelerin belirlenmesinde Pearson korelasyon analizi kullanıldı. Bulgular: İKAE ve diğer gruplar arasında, yaş, cinsiyet, diyabet, hipertansiyon varlığı ve sigara içiciliği açısından istatistiksel anlamlı fark yoktu (hepsi için p>0.05). Gruplar arasında HDLK yönünden fark vardı (p=0.021). En yüksek SPA NKA grubunda saptanırken en düşük SPA KAH grubunda saptandı (sırası ile 250.78±59.37U/L; 163.39±49.28 U/L; p=0.005). Post-hoc analizlerde bu farkın İKAE grubu ile NKA grubu ve KAH grubu ile NKA grubu arasında olduğu gözlendi [p=0.005 (NKA ve İKAE); p=0.0045 (NKA ve MKAH ); p=0.007 (NKA ve KAH)]....

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Increased Prevalence of Coronary Ectasia in Heterozygous Familial Hypercholesterolemia

Cited by 92 publications

References 33 publications

Importance of intra-abdominal visceral fat accumulation to coronary atherosclerosis in heterozygous familial hypercholesterolaemia

Importance of intra-abdominal visceral fat accumulation to coronary atherosclerosis in heterozygous familial hypercholesterolaemia

Severe coronary artery ectasia and abdominal aortic aneurysm

The relation of serum paraoxonase-1 activity with isolated coronary artery ectasia: an observational study

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