Twisted Blood Vessels: Symptoms, Etiology and Biomechanical Mechanisms

Han, Hugang

doi:10.1159/000335123

Cited by 380 publications

(388 citation statements)

References 285 publications

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“…Hormonal changes, such as elevated estrogen levels, which occur during pregnancy, have been reported to play a major role in the development of varicose veins (27). Alterations in hormonal levels inducing hypertrophy and the growth of the SMC layer in varicose veins have been suggested in different studies (28)(29)(30)(31). However, augmented estrogen levels have also been reported to reduce SMC migration and proliferation (17,32,33).…”

Section: Discussionmentioning

confidence: 99%

IQGAP1 modulates the proliferation and migration of vascular smooth muscle cells in response to estrogen

Huang

Jin

Zhou

et al. 2015

International Journal of Molecular Medicine

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Abstract. Vascular smooth muscle cell (VSMC) proliferation and migration has been proven to be a critical event in the development of varicosity. Variations in estrogen levels, a pathological event related to age and pregnancy, play a role in the pathogenesis of varicosity. Previous studies have reported a different response of VSMCs following estrogen stimulation. However, the exact mechanisms involved have not yet been elucidated. In the present study, we examined the responses of lesion and normal VSMCs treated with 10 -8 M 17β-estradiol (E 2 ) for 24 h. A differential effect of exposure to E 2 was observed in these cells. IQ-domain GTPase-activating protein 1 (IQGAP1), a scaffold protein, was overexpressed in the lesion VSMCs and was shown to modulate VSMC proliferation and migration in response to E 2 . Furthermore, the increased expression of IQGAP1 was found to be intimately associated with a high activity of estrogen receptor α (ERα), which has been implicated in the regulation of VSMC physiological function. Additionally, we found that two critical kinases, Akt and extracellular signal-regulated kinase (ERK), mediated the activation of ERα and VSMC proliferation. According to our results, we thus concluded that high levels of IQGAP1 in VSMCs regulate the physiological reaction of the cells in response to estrogen exposure, and that kinases are involved in the process by mediating ERα activation. In view of the essential role of IQGAP1 in the physiological function of VSMCs, targeting this molecule may prove to be a promising strategy for the treatment of varicosity.

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Section: Discussionmentioning

confidence: 99%

IQGAP1 modulates the proliferation and migration of vascular smooth muscle cells in response to estrogen

Huang

Jin

Zhou

et al. 2015

International Journal of Molecular Medicine

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“…Although little is known about it, abnormal cerebral vascular tortuosity could be an adaptive response to increased flow burden, which manifests mechanical instability in the arterial walls. 37 In tortuous vessels, flow impinges on the outer wall of bends. To make the turn of a bend, flow along the outer curve has to travel at a higher velocity than flow along the inner curve, and has to accelerate.…”

Section: Discussionmentioning

confidence: 99%

Aneurysmal Remodeling in the Circle of Willis after Carotid Occlusion in an Experimental Model

Tutino

Mandelbaum

Choi³

et al. 2013

J Cereb Blood Flow Metab

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Carotid occlusions are associated with de novo intracranial aneurysm formation in clinical case reports, but this phenomenon is not widely studied. We performed bilateral carotid ligation (n ¼ 9) in rabbits to simulate carotid occlusion, and sham surgery (n ¼ 3) for control. Upon euthanasia (n ¼ 3 at 5 days, n ¼ 6 at 6 months post ligation, and n ¼ 3 at 5 days after sham operation), vascular corrosion casts of the circle of Willis (CoW) were created. Using scanning electron microscopy, we quantified gross morphologic, macroscopic, and microscopic changes on the endocasts and compared findings with histologic data. At 5 days, CoW arteries of ligated animals increased caliber. The posterior communicating artery (PCom) increased length and tortuosity, and the ophthalmic artery (OA) origin presented preaneurysmal bulges. At 6 months, calibers were unchanged from 5 days, PComs further increased tortuosity while presenting segmental dilations, and the OA origin and basilar terminus presented preaneurysmal bulges. This exploratory study provides evidence that flow increase after carotid occlusion produces both compensatory arterial augmentation and pathologic remodeling such as tortuosity and saccular/fusiform aneurysm. Our findings may have considerable clinical implications, as these lesser-known consequences should be considered when managing patients with carotid artery disease or choosing carotid ligation as a therapeutic option.

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“…The aetiology and clinical importance of CT are still unclear. CT is associated with increased acute occlusion of coronary arteries, diabetes, and coronary artery fistula [4,15]. CT hampers ventricular function and has been proposed as an indicator of ventricular dysfunction [16].…”

Section: Discussionmentioning

confidence: 99%

“…Li et al [15], found that CT was positively correlated with essential hypertension. Tortuosity of coronary arteries is also a common finding seen with hypertension due to elongation and dilatation of the arteries associated with left ventricular hypertrophy [4,15]. The authors assumed that arteries may become tortuous due to reduced axial strain and hypertensive pressure in an elastic cylindrical arterial model.…”

Section: Discussionmentioning

confidence: 99%

“…The aetiology and clinical importance of CT are still unclear. CT is generally attributed to age-dependent, pathologic changes of elastic material in the vessel, and hypertension due to elongation and dilatation of the arteries with left ventricular hypertrophy [3,4]. A recent clinical trial showed that CT was associated with subclinical atherosclerosis and increased coronary artery calcification, even in the absence of significant obstructive lesion [5].…”

Section: Introductionmentioning

confidence: 99%

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Vitamin D insufficiency is associated with coronary artery tortuosity

et al. 2017

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A b s t r a c tBackground: Increasing evidence suggests a relationship between vitamin D (VD) insufficiency and cardiovascular disease. Aim:We aimed to investigate the association between serum 25-hydroxyvitamin D (25-OH VD) with coronary tortuosity (CT) in patients with normal or near-normal (< 40% stenosis) coronary arteries. Methods:The present study was cross-sectional and observational. We enrolled 356 consecutive patients who had undergone coronary angiography for suspected ischaemic heart disease and were found to have normal or near-normal coronary arteries. Patients were categorised as VD insufficient (< 30 ng/mL) or VD sufficient (≥ 30 ng/dL). CT was defined as the presence of ≥ three bends (defined as ≥ 45° change in vessel direction) along the main trunk of at least one coronary artery, present both in systole and in diastole. Results:The study populations were divided into two groups according to the presence of CT: patients with CT (n = 103, 29%) and patients without CT (NCT; n = 253, 71%). CT is more frequently seen in elderly women and is positively correlated with hypertension. The incidence of VD insufficiency was significantly higher in the CT group (n = 46, 45%) than in the NCT group (n = 90, 36%; p = 0.005). In further multivariate logistic regression analyses, adjustment for major clinical parameters affecting CT showed statistically significant correlations between 25-OH VD and CT (odds ratio = 0.77, 95% confidence interval 0.66-0.98, p = 0.006). Conclusions: Vitamin D insufficiency was independently associated with coronary tortuosity.Key words: vitamin D insufficiency, coronary tortuosity, coronary artery disease, biomarkers, coronary angiography Kardiol Pol 2017; 75, 2: 174-180 INTRODUCTIONCoronary artery disease (CAD) is the leading cause of mortality and morbidity worldwide. Coronary angiography is still the gold standard for the diagnosis of CAD, and coronary artery tortuosity (CT) is a common coronary angiography (CAG) finding [1][2][3]. The aetiology and clinical importance of CT are still unclear. CT is generally attributed to age-dependent, pathologic changes of elastic material in the vessel, and hypertension due to elongation and dilatation of the arteries with left ventricular hypertrophy [3,4]. A recent clinical trial showed that CT was associated with subclinical atherosclerosis and increased coronary artery calcification, even in the absence of significant obstructive lesion [5].

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Twisted Blood Vessels: Symptoms, Etiology and Biomechanical Mechanisms

Cited by 380 publications

References 285 publications

IQGAP1 modulates the proliferation and migration of vascular smooth muscle cells in response to estrogen

IQGAP1 modulates the proliferation and migration of vascular smooth muscle cells in response to estrogen

Aneurysmal Remodeling in the Circle of Willis after Carotid Occlusion in an Experimental Model

Vitamin D insufficiency is associated with coronary artery tortuosity

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