Significant associations between clinical history factors, lipid metabolism parameters, and type of atherosclerotic process (area of vascular lesions and severity of clinical manifestations) were detected. The predominance of generalized atherosclerosis in chronic coronary heart disease group was associated with patients' age, more incident excessive body weight and type 2 diabetes mellitus, and more severe course of arterial hypertension. Increased lipid spectrum atherogenicity was significantly more often observed in generalized atherosclerosis in the myocardial infarction group. Angiography and postmortem examination of coronary arteries detected two trends of atherogenic remodeling of the coronary vessels: more pronounced stenosis of the main vessels in autopsy specimens from myocardial infarction patients with mainly coronary atherosclerosis and more extensive coronary bed involvement in chronic coronary heart disease patients with generalized atherosclerosis.
Variants of dyslipidemias were studied in 78 patients with atherosclerosis of various localizations. We also studied HDL content and atherogenic index, which served as a predictor of polyvascular disease. Depending on localization atherosclerosis had specific features. Type II of dyslipidemia was typical for multifocal and coronary atherosclerosis, type IV was typical for brachiocephalic arteries.
Immunohistochemical analysis revealed 2.5-fold increased of expression MMP-2 in myocardium samples during the early period (up to 3 days) of postinfarction reparative regeneration. During this period, MMP-2 was detected mainly in monocytes/macrophages circulating in the blood and migrating to the necrotic zone, while expression in the intermuscular and perivascular connective tissue was lower. At later terms, with development of large focal and diffuse cardiosclerosis, MMP-2 expression significantly decreased (to the initial level) and was detected mainly in the foci of intermuscular and perivascular fibrosis, its area in the sections increased by 1.8 times. Evaluation of MMP-2 expression in the blood vessels showed that the immunohistochemical reaction was the most pronounced in the walls of new sinusoidal vessels and the minimum in the intramural arteries of medium diameter. These results attest to an important role of MMP in connective tissue remodeling (proteolytic degradation) during the early period of postinfarction reparative regeneration. The decrease in MMP-2 expression observed at later terms correlated with myocardial fibrosis progression.
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