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Role of rhythmic structures of aortic intima in the development of atherosclerosis
1Department of Human Cardiovascular Pathology, USSR Academy of Medical Sciences, Moscow.
Insights
Rhythmic structures in aortas increase with age, becoming fibrous plaques. These plaques, common in older adults, show a clear transformation from initial wave-like changes.
Area of Science:
- Cardiovascular pathology
- Vascular biology
- Histopathology
Background:
- Aortic pathology can develop early in life.
- Understanding the progression of aortic changes is crucial for cardiovascular health.
- The relationship between early aortic structures and later plaque formation requires further investigation.
Purpose of the Study:
- To investigate the prevalence and age-related changes of rhythmic structures in the aorta.
- To examine the transformation of these structures into fibrous plaques.
- To determine the association between aortic structures and the development of fibrous plaques.
Main Methods:
- Histopathological examination of 517 thoracic and abdominal aortas from newborns to 14-year-olds.
- Examination of 606 aortas from males aged 20-39 years.
- Analysis of the frequency and characteristics of rhythmic structures and fibrous plaques.
Main Results:
- Rhythmic structures were found in 4.7% of stillborns, increasing with age to 60% after 1 year and 70% after 20 years.
- Fibrous plaques were present in 39.4% of 20-29 year olds and 83% of 30-39 year olds, predominantly in areas with rhythmic structures.
- All stages of transformation from rhythmic structures to fibrous plaques were observed, with plaques being more extensive in aortas exhibiting rhythmic structures.
Conclusions:
- Rhythmic structures in the aorta are a precursor to fibrous plaque formation.
- Age is a significant factor in the development and prevalence of these aortic changes.
- The study highlights a distinct pathway of aortic pathology independent of lipid accumulation in early stages.
Abstract:
517 thoracic and abdominal aortas from newborns and children aged up to 14 years and 606 from males aged 20-39 years were examined. Rhythmic structures (wave lines) were detected in 4.7% of stillborns, but their frequency was found to increase with age. After the first year of life they occurred in 60% and after 20 years in 70%. Their frequency was significantly higher in the abdominal than in the thoracic aorta. Fibrous plaques were found in 39.4% of subjects aged 20-29 years and in 83% of those aged 30-39 years, and in 84% in the area of rhythmic structures. There were all stages of transformation of rhythmic structures into fibrous plaques. The extent of fibrous plaques was significantly higher in aortas with rhythmic structures than in those without. Initial microscopic changes in rhythmic structures involved smooth muscle cell proliferation in the underlying media and disintegration of the internal elastic membrane as well as migration of smooth muscle cells into the intima. The latter cases exhibited formation of an abundant irregular net of elastic and collagenous fibers and stromal edema with fibrin deposition, followed by sclerosis. Fibrous plaques contained no lipids. The latter were occasionally detected in some smooth muscle cells, whereas in subjects over 35 years they were also found extracellularly on the site of destructured foam cells.