RESUMO
With increasing age, the thoracic aorta shows progressive fibroplastic intimal thickening, which is thought to be pre-atheromatous. A similar progressive intimal thickening in the renal cortical arteries is the distinguishing feature of the nephrosclerosis which underlies essential hypertension. Therefore, the earliest detectable youthful precursors of atherosclerosis and hypertension show strong morphological resemblances to each other. In this study, close statistical associations have been shown between the two types of arterial intimal fibroplasia. Both conditions show similar sigmoid growth curves from ages 6 to 70 years, thereby generating correlations across age groups of r = 0.99 in New Orleans and r = 0.95 in Mexico City. Specimens gathered in New Orleans were found to have about 1.4 times greater arterial intimal thickening than specimens from Mexico City, and this excess was seen at all ages in both the aortas and the renal cortical arteries. It seems likely that intimal fibroplasia of arteries is reflecting similar biological principles at all levels of the vascular tree. Whatever etiological factors vary between New Orleans and Mexico City, those factors appear to act directly at a tissue level to promote the early precursors of atherosclerosis and of the nephrosclerosis that underlies hypertension.
Assuntos
Envelhecimento/fisiologia , Doenças da Aorta/patologia , Arteriosclerose/patologia , Nefroesclerose/patologia , Adolescente , Adulto , Idoso , Aorta/patologia , Artérias/patologia , Criança , Feminino , Humanos , Córtex Renal/irrigação sanguínea , Masculino , México , Pessoa de Meia-Idade , Estados UnidosRESUMO
The presence of rigid coronary arterial segments was detected during a survey for coronary atherosclerosis in men who died of violent causes. These lesions which traditionally are considered of non-clinical significance, in the absence of stenosis are probably responsible of the clinical and electrocardiographical abnormalities as seen in patients with "normal" coronary arteries using coronary angiography, the best current procedure for the detection of isolated coronary atherosclerosis. We propose these lesions are to be considered as functional lesions and consequently that these lesions should be considered by both, the pathologist and the clinician. Our hypothesis is to be tested in the near future when new diagnostic advances with the possibility of detection of coronary pathology in vivo, appear. The prevalence of these abnormalities in different age-groups as well as the topography are presented. The concordance of these lesions with coronary stenosis is also presented.
Assuntos
Doença da Artéria Coronariana/patologia , Acidentes , Adolescente , Adulto , Autopsia , Constrição Patológica/patologia , Doença da Artéria Coronariana/epidemiologia , Doença da Artéria Coronariana/prevenção & controle , Estudos Transversais , Humanos , Masculino , México , Pessoa de Meia-IdadeRESUMO
This report compares quantitative measures of atherosclerosis in aortas and coronaries from autopsies of deceased men from Mexico City collected during 1960 to 1964 and 1986 to 1987. The comparison of lesions in two different time periods provides an opportunity for determining whether the extent of atherosclerosis has changed over time in Mexico City. Three pathologists independently evaluated the extent of fatty streaks (FS), fibrous plaques (FP), calcified plaques (CA), and complicated lesions (CO) in 165 aortas and 120 sets of coronary arteries collected during 1986 to 1987 for comparison with similar gradings of 128 aortas and coronary arteries from the International Atherosclerosis Project in 1960 to 1964. Neither FS nor more advanced lesions differed significantly in either the descending thoracic or abdominal aorta between the two collection periods. In contrast, there were more extensive FP and raised atherosclerotic lesions (RL = FP + CA + CO) in the coronary artery segments evaluated in the younger age groups in 1986 to 1987 versus 1960 to 1964. Additional analyses, based on 75 pairs of aortas and 32 pairs of coronary arteries from age-matched cases, all regraded by the team of pathologists after blind coding, showed more FS in both aortic segments and more extensive involvement with RL in the three main branches of the coronary arteries in the more recent study. An overview of our findings suggests that atherosclerosis, particularly in the coronary arteries, is increasing in Mexico City. This hypothesis merits careful testing in parallel with consideration of possible changes in the risk factors that could be responsible for changes in extent of lesions.
Assuntos
Arteriosclerose/epidemiologia , Adolescente , Adulto , Fatores Etários , Aorta Abdominal/patologia , Aorta Torácica/patologia , Arteriosclerose/patologia , Vasos Coronários/patologia , Humanos , Masculino , México , Pessoa de Meia-Idade , Distribuição Aleatória , Estudos RetrospectivosRESUMO
The severity and prevalence of coronary and aortic atherosclerosis was studied in 174 subjects who died from violent causes in Mexico City. As in other geographic areas, fatty streaks were found early in life (12 years old). Fibrolipid plaques were present in the thoracic aorta at age 15 and at age 19 in the abdominal segment. Complicated lesions were detected in the aorta after age 25. Because of the obvious clinical significance we looked for severe aortic lesions in the abdominal bifurcation. The prevalence of severe lesions in the bifurcation was 0 between 15 to 24 years and raised to 23.3% in the 45-54 age group. A moderate correlation was found between the severity of coronary and aortic lesions. The discordance most often found was the presence of severe coronary lesions without severe aortic involvement.
Assuntos
Doenças da Aorta/epidemiologia , Arteriosclerose/epidemiologia , Doença da Artéria Coronariana/epidemiologia , Adolescente , Adulto , Fatores Etários , Aorta Abdominal/patologia , Aorta Torácica/patologia , Doenças da Aorta/patologia , Arteriosclerose/patologia , Criança , Doença da Artéria Coronariana/patologia , Feminino , Humanos , Masculino , México , Pessoa de Meia-IdadeRESUMO
The prevalence of risk factors in civil servants living in Mexico City was investigated prospectively in 1942 individuals. Risk factors tended to increase with age and in some cases were related to sex. Hypertension was found to be as high as fifteen percent in the older age groups despite the fact that the critical limit was 160/95 in all decades. Hypercholesterolemia was found to be close to the rates reported in the so-called developed countries. Diabetes mellitus varied between 1 and 14%. Obesity and hypertrygliceridemia were also common findings and related. Smoking was independent of sex. Prevalence of the association between the major risk factors are presented. These data, are in agreement with the death causes among civil servants and indicate that preventive programs for ischemic heart disease are needed in civil servants in Mexico City.
Assuntos
Doença da Artéria Coronariana/epidemiologia , Adulto , Doença da Artéria Coronariana/prevenção & controle , Feminino , Humanos , Hipercolesterolemia/epidemiologia , Hipertensão/epidemiologia , Masculino , México/epidemiologia , Pessoa de Meia-Idade , Ocupações , Prevalência , Estudos Prospectivos , Fatores de RiscoRESUMO
The current prevalence of coronary atherosclerosis was investigated in 174 necropsic studies performed on males who died violently between 1984 and 1986 in Mexico City. In young adults, coronary atherosclerosis was found in 35% of the cases, 5% of whom had significant obstruction in one coronary vessel. In subjects aged 50-69 years, coronary atherosclerosis occurred in 69% of the cases and obstructive disease in 24%. Current figures suggest an increase in the severity of coronary atherosclerosis in this population which may be linked with nutritional changes. This makes further investigations, as well as the design of a program for ischemic heart disease prevention in Mexico City imperative.
Assuntos
Doença da Artéria Coronariana/epidemiologia , População Urbana , Adulto , Idoso , Doença da Artéria Coronariana/patologia , Doença da Artéria Coronariana/prevenção & controle , Vasos Coronários/patologia , Estudos Transversais , Gorduras na Dieta/efeitos adversos , Humanos , Masculino , Pessoa de Meia-Idade , Fatores de RiscoRESUMO
Topographic and morphologic aspects of coronary atherosclerotic "protruding" lesions were investigated in 119 accidental deaths in males living in Mexico City. Morphology and topography varied according to the arterial trunk studied and age. Left anterior descending and circumflex lesions were almost always confined to the initial 5 cms and if a lesion was present after the 3rd cm there was always a proximal lesion. Right coronary lesions occasionally were found distally even in the absence of proximal lesions. Third decade lesions were usually not calcified. Stenosis if present was rarely multivascular. Some fourth decade lesions were calcified; plurivascular stenosis was present in some cases. Fifth decade lesions show sequential stenotic lesions in the same vessel; calcium and plurivascular stenosis were often observed. However the features observed in the 3rd decade could be observed in the older subjects. Reference is made to lesions which are found in both the left main trunk and the left anterior descending. Epidemiological and clinical applications related with preventive programs are mentioned.
Assuntos
Doença da Artéria Coronariana/patologia , Adolescente , Adulto , Doença da Artéria Coronariana/epidemiologia , Doença da Artéria Coronariana/prevenção & controle , Humanos , Masculino , México , Pessoa de Meia-IdadeAssuntos
Coração/diagnóstico por imagem , Cateterismo Cardíaco , Doença da Artéria Coronariana/diagnóstico por imagem , Difosfatos , Doenças das Valvas Cardíacas/diagnóstico por imagem , Ventrículos do Coração/diagnóstico por imagem , Humanos , Radioisótopos , Cintilografia , Tecnécio , Pirofosfato de Tecnécio Tc 99m , TálioRESUMO
A right atrial myxoma was identified in two patients with radio-angiocardiography-99m Tc. Tumor is identified as a persistent photon-deficient region in both first-pass and equilibrium images. In addition there is an abnormal accumulation and sluggish disappearance of the radionuclide from the right atrium. Even though sensitivity of the procedure should be confirmed, it is a helpful non-invasive technique of great value in the diagnosis oF right atrial tumors.
Assuntos
Difosfatos , Neoplasias Cardíacas/diagnóstico por imagem , Mixoma/diagnóstico por imagem , Agregado de Albumina Marcado com Tecnécio Tc 99m , Tecnécio , Adolescente , Átrios do Coração/diagnóstico por imagem , Humanos , Masculino , Pessoa de Meia-Idade , Cintilografia , Pirofosfato de Tecnécio Tc 99mRESUMO
The prevalence of microscopic atheroma in the proximal left anterior descending coronary artery was studied in thirty young males aged 20 to 29 years, living in Mexico City, who died in urban accidents. All of them were either unemployed or labor workers with a socioeconomical status considered to be representative of the majority of young males living in Mexico City. It was found that coronary atheroma was present in 11 of them (33%) with variable degrees of luminal obstruction. In two of them the luminal obstruction was greater than 75%. The prevalence found in this group was significantly different to that found in younger and older males who also died in accidents. Since the prevalence of coronary atheroma was not related to ventricular hypertrophy, valvular or congenital heart disease our findings indicate that in Mexico City as in other geographical regions, coronary atherosclerosis is not an unusual finding in males in the third decade of life, with a low socioeconomical status.
Assuntos
Doença das Coronárias/epidemiologia , Acidentes , Adolescente , Adulto , Fatores Etários , Idoso , Criança , Pré-Escolar , Doença das Coronárias/patologia , Vasos Coronários/patologia , Humanos , Lactente , Masculino , México , Pessoa de Meia-Idade , Fatores SocioeconômicosRESUMO
La masa ventricular izquierda (MVI), fue determinada por ecocardiografia modo M en 34 pacientes con tirotoxicosis sin insuficiencia cardiaca y en 82 pacientes con enfemedades en donde la hipertrofia ventricular izquierda ocurre con frecuencia (acromegalia, hipertension arterial sistemica, insuficiencia renal cronica y obesidad). Los valores de la MVI fueron comparados con los obtenidos en 30 sujetos normales. Se encontro que la MVI, fue anormal en pacientes con acromegalia, hipertension arterial con tirotoxicosis sin insuficiencia cardiaca. Esta es la serie mas grande de pacientes con tirotoxicosis estudiados mediante ecocardiografia y nuestros resultados cuestionan las conclusiones de otros estudios con menor numero de pacientes
Assuntos
Adulto , Humanos , Masculino , Feminino , Ecocardiografia , Hipertireoidismo , HipertensãoAssuntos
Aneurisma Infectado/diagnóstico , Aneurisma Aórtico/diagnóstico , Adulto , Aneurisma Infectado/etiologia , Aneurisma Aórtico/etiologia , Valva Aórtica , Brucelose/complicações , Criança , Ecocardiografia , Endocardite Bacteriana/complicações , Endocardite Bacteriana Subaguda/complicações , Humanos , MasculinoRESUMO
It is presented a fatal case of cerebral arteriovenous tube in which it was obtained clinical, radiological, electric, echocardiographic and haemodinamic sequencial information since the birth. Data suggested biventricular overcharge's existence initially without cardiac insufficiency. Finally appeared right ventricular expansion's data and biventricular hypertrophy, with left ventricular fluxe's diminution and cardiac insufficiency's data and shock.