Coronary artery necroses and calcification in chronic coronary heart disease


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Abstract

Aim. To study some particularly inadequately studied mechanisms for the development of coronary artery calcification (CAC), which are unassociated with calcified atheromatous masses of atherosclerotic plaques.
Subjects and methods. Endarterectomized coronary artery (CA) segments obtained during aortocoronary bypass surgery were pathomorphologically studied in 150 patients aged 49-72 years with coronary heart disease (CHD). CAC was found in 92% of cases. Two types of CAC were identified: one of them was associated with calcified atheromatous masses of atherosclerotic plaques; the other was related to necroses in the fibrous plaque parts. The atheromatous masses exhibited calcareous deposits as fine-grained masses of small extent. In chronic CHD, morphological signs of instability of atherosclerotic plaques were observed in 23.3% of cases, these being associated with lamellar CAC in two thirds.
Conclusion. Calcification in the necrotic area of fibrous parts of stenotic plaques is typical of chronic CHD and is frequently attended by the development of large-focal calcareous deposits generally as laminas (lamellar calcification). Impaired transmural perfusion of plasma is noted to be involved in the development of necroses in stenotic CA atherosclerotic plaques.

About the authors

Valentin Sergeevich Zhdanov

Email: vs.zhdanov@cardio.ru

Nina Mikhaylovna Cherpachenko

Iraida Petrovna Drobkova

Svetlana Petrovna Veselova

Tat'yana Petrovna Shlychkova

V S Zhdanov

A. L. Myasnikov Cardiology Research Institute, Russian Cardiology Research-and-Production Complex, Russian Agency for Medical Technologies

A. L. Myasnikov Cardiology Research Institute, Russian Cardiology Research-and-Production Complex, Russian Agency for Medical Technologies

N M Cherpachenko

A. L. Myasnikov Cardiology Research Institute, Russian Cardiology Research-and-Production Complex, Russian Agency for Medical Technologies

A. L. Myasnikov Cardiology Research Institute, Russian Cardiology Research-and-Production Complex, Russian Agency for Medical Technologies

I P Drobkova

A. L. Myasnikov Cardiology Research Institute, Russian Cardiology Research-and-Production Complex, Russian Agency for Medical Technologies

A. L. Myasnikov Cardiology Research Institute, Russian Cardiology Research-and-Production Complex, Russian Agency for Medical Technologies

S P Veselova

A. L. Myasnikov Cardiology Research Institute, Russian Cardiology Research-and-Production Complex, Russian Agency for Medical Technologies

A. L. Myasnikov Cardiology Research Institute, Russian Cardiology Research-and-Production Complex, Russian Agency for Medical Technologies

T P Shlychkova

A. L. Myasnikov Cardiology Research Institute, Russian Cardiology Research-and-Production Complex, Russian Agency for Medical Technologies

A. L. Myasnikov Cardiology Research Institute, Russian Cardiology Research-and-Production Complex, Russian Agency for Medical Technologies

References

  1. Вихерт А. М., Седов К. Р., Соколова Р. И. Кальциноз артерий. М.: Медицина; 1970.
  2. Вихерт А. М., Жданов В. С. Атеросклероз при различных заболеваниях. М.: Медицина; 1976.
  3. Жданов В. С., Вихерт А. М., Стернби Н. Г. Эволюция и патология атеросклероза человека. М.: Триада-Х; 2002.
  4. Аничков Н. Н. Сосуды. В кн.: Абрикосов А. И. Частная патанатомия. М.; 1947; т. 2: 262-483.
  5. Stary H. C. The development of calcium deposits in atherosclerotic lesions and their persistence after lipid regression. Am. J. Cardiol. 2001; 88(2A): 16E-19E.
  6. Терновой С. К., Синицын В. Е., Гагарина Н. В. Неинвазивная диагностика атеросклероза и кальциноза коронарных артерий. М.: Атмосфера; 2003.
  7. McClelland R. L., Bild D. E., Burke G. L. et al. Alcohol and coronary artery calcium prevalence, incidence, and progression: results from the Multi-Ethnic Study of Atherosclerosis (MESA). Am. J. Clin. Nutr. 2008; 88(6): 1953-1961.
  8. Лапин Ю. А. О морфогенезе вторичных обызвествлений венечных артерий сердца. Арх. пат. 1959; 21: 3-9.
  9. Шевченко О. П., Мишнев О. Д. Ишемическая болезнь сердца. М.: Реафарм; 2005.
  10. Jellinnek H., Detre Z., Veress B. Transmural plasma flow in atherogenesis. Budapest; 1983.
  11. Карпов Ю. А., Сорокин Е. В. Стабильная ишемическая болезнь сердца. М.; 2003.
  12. Лилли Л. (ред.). Патофизиология заболеваний сердечно-сосудистой системы. 2-е изд. М.; 2007.
  13. Mayer B., Lieb W., Radke P. W. et al. Association between arterial pressure and coronary artery calcification. J. Hypertens. 2007; 27(8): 1731-1738.
  14. Achenbach S., Ropers D., Pohle K. et al. Influence of lipid-lowering therapy on progression of coronary artery calcification: a prospective evaluation. Circulation 2002; 106(9): 1077-1082.
  15. Budoff V. J., Lane K. L., Bakhshenshi H. et al. Rates of progression of coronary calcium by electron beam tomography. Am. J. Cardiol. 2000; 86(1): 8-11.
  16. Nicholls S. J., Tuzcu E. M., Wolski K. et al. Coronary artery calcification and changes in atheroma burden in response to established medical therapies. J. Am. Coll. Cardiol. 2007; 49(2): 271-273.
  17. Terry J. G., Carr J. J., Kouva E. O. et al. Effect of simvastatin (80 mg) on coronary and abdominal aortic arterial calcium (from the coronary artery calcification treatment with zocor [CATZ] study). Am. J. Cardiol. 2007; 99(12): 1714-1717.

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