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Baj J, Kowalska B, Barbachowska A, Forma A, Flieger M, Majerek D, Teresiński G, Flieger W, Portincasa P, Buszewicz G, Radzikowska-Büchner E, Flieger J. Linking Metallic Micronutrients and Toxic Xenobiotics to Atherosclerosis and Fatty Liver Disease-Postmortem ICP-MS Analysis of Selected Human Tissues. Nutrients 2023; 15:3458. [PMID: 37571395 PMCID: PMC10420647 DOI: 10.3390/nu15153458] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Revised: 07/30/2023] [Accepted: 08/02/2023] [Indexed: 08/13/2023] Open
Abstract
Dyslipidaemia is a disorder of the lipid metabolism, caused mainly by poor eating habits. The most severe consequence of an inappropriate diet is the development of atherosclerosis and hepatic steatosis. It is generally believed that a change in nutrition, and increased physical activity can eliminate these health problems. The contemporary research and therapies used to treat dyslipidemia mainly focus on lowering the triglyceride and cholesterol levels. However, disturbances in trace element homeostasis or the accumulation of toxic elements can also affect physiological processes, and be involved in the development of metabolically mediated diseases. The present study aimed to determine the mineral profiles of liver and brain tissues collected at autopsy (n = 39) in groups of people with hepatic steatosis (n = 5), atherosclerosis (n = 9), hepatic steatosis, and atherosclerosis (n = 16), and others without the selected disorders (n = 9). Concentrations of 51 elements were analysed via inductively coupled plasma mass spectrometry (ICP-MS) after the initial wet mineralisation of the samples with nitric acid. The results obtained allow us to conclude that the hepatic steatosis group suffers from a deficiency of important trace elements, such as copper, zinc, and molybdenum (p < 0.05), whereas the group with atherosclerosis is characterised by elevated levels of cadmium in the liver tissue (p = 0.01). Analysing the mean values of the element concentrations measured in 11 brain areas, statistically significant higher levels of calcium and copper (p < 0.001) were found in the atherosclerosis group, compared to the hepatic steatosis group, confirming the involvement of these elements in the pathogenesis of atherosclerosis. In addition, an accumulation of cadmium, lead, titanium, and strontium in the brain tissue was observed in the atherosclerosis group. While the accumulation of individual elements differs in different parts of the brain, the differences in the cadmium content (p < 0.05) between the study groups apply to the whole brain, except for the nucleus accumbens septi area, where a statistically significant titanium accumulation occurs in the atherosclerosis and steatosis groups, compared to the others (p < 0.05). In addition, the disruption of elemental homeostasis in the brain of a single case with bipolar disorder, and a case with hip replacement was observed. Our results confirm the involvement of chemical elements in the pathogenesis of selected metabolic diseases, and the need for further studies in larger populations.
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Affiliation(s)
- Jacek Baj
- Chair and Department of Anatomy, Medical University of Lublin, 20-090 Lublin, Poland; (A.F.); (W.F.)
| | - Beata Kowalska
- Department of Water Supply and Wastewater Disposal, Lublin University of Technology, 20-618 Lublin, Poland;
| | - Aleksandra Barbachowska
- Department of Plastic, Reconstructive and Burn Surgery, ul. Krasnystawska, 21-010 Łęczna, Poland;
| | - Alicja Forma
- Chair and Department of Anatomy, Medical University of Lublin, 20-090 Lublin, Poland; (A.F.); (W.F.)
| | - Michał Flieger
- Chair and Department of Forensic Medicine, Medical University of Lublin, 20-090 Lublin, Poland; (M.F.); (G.T.); (G.B.)
| | - Dariusz Majerek
- Department of Applied Mathematics, University of Technology, 20-618 Lublin, Poland;
| | - Grzegorz Teresiński
- Chair and Department of Forensic Medicine, Medical University of Lublin, 20-090 Lublin, Poland; (M.F.); (G.T.); (G.B.)
| | - Wojciech Flieger
- Chair and Department of Anatomy, Medical University of Lublin, 20-090 Lublin, Poland; (A.F.); (W.F.)
| | - Piero Portincasa
- Clinica Medica “A. Murri”, Department of Biomedical Sciences & Human Oncology, University of Bari Meical School, 70124 Bari, Italy;
| | - Grzegorz Buszewicz
- Chair and Department of Forensic Medicine, Medical University of Lublin, 20-090 Lublin, Poland; (M.F.); (G.T.); (G.B.)
| | | | - Jolanta Flieger
- Department of Analytical Chemistry, Medical University of Lublin, 20-093 Lublin, Poland
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Doolub G, Kandoole-Kabwere V, Felekos I. Acute Coronary Syndromes Due to Atherosclerotic Coronary Artery Disease in Young Patients. Cardiol Rev 2022; 30:286-292. [PMID: 34224452 DOI: 10.1097/crd.0000000000000402] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Young patients represent about 4-10% of the population presenting with acute coronary syndrome. In this focused mini-review, we highlight the data regarding acute coronary syndromes in young patients with atherosclerotic coronary artery disease. Differences in the underlying pathologies and pathophysiological mechanisms should yield to different clinical management and treatment strategies.
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Affiliation(s)
- Gemina Doolub
- From the Bristol Heart Institute, University Hospitals Bristol NHS FT, Bristol, United Kingdom
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Michaud K, Magnin V, Faouzi M, Fracasso T, Aguiar D, Dedouit F, Grabherr S. Postmortem coronary artery calcium score in cases of myocardial infarction. Int J Legal Med 2021; 135:1829-1836. [PMID: 33847801 PMCID: PMC8354952 DOI: 10.1007/s00414-021-02586-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Accepted: 03/24/2021] [Indexed: 12/19/2022]
Abstract
Sudden cardiac death (SCD) related to atherosclerotic coronary artery disease (ACAD) resulting in myocardial infarction is the most prevalent cause of death in western countries. In clinical practice, coronary artery calcium score (CACS) is considered an independent predictor of coronary events, closely related to atherosclerotic burden and is quantified radiologically by the Agatston score being calculated through computed tomography. Postmortem computed tomography (PMCT) allows the visualization and quantification of coronary calcifications before the autopsy. However, it was reported that some patients who died from severe ACAD had a zero CACS in PMCT. In this study, a retrospective evaluation of CACS in adult's myocardial infarction cases related to ACAD, with available CACS and histological slides of coronary arteries, was performed in order to gain a deeper understanding of coronary calcifications and their role in myocardial infarction cases. The CACS was calculated by using the software Smartscore 4.0 after the radiological examination on a 64-row CT unit using a specific cardiac protocol. Thirty-six cases were identified out of 582 autopsies, recorded during a 2-year study period (29 men, 7 women; age 56.3 ± 11.7). CACS was 0-10 in 5 cases (5 men, 44.8 ± 13.7), 11-100 in 8 cases (6 men, 2 women, 53.1 ± 7.7), 101-400 in 13 cases (11 men, 2 women, 57.4 ± 9.6), and > 400 in 10 cases (9 men, 1 woman, 63.1 ± 11.9). Coronary thrombosis was found in 28 cases, histologically identified as plaque erosions in 6 cases and as plaque ruptures in 22 cases. Statistical analyses showed that CACS increases significantly with age (p-value < 0.05) and does not show significant correlation with gender, body weight, body mass index, and heart weight. CACS was significantly higher in plaque ruptures than in plaque erosions (p-value < 0.01). Zero or low CACS on unenhanced PMCT cannot exclude the presence of myocardial infarction related to ACAD. This paradoxical discrepancy between imaging and autopsy findings can be explained considering the histological aspect of fatal coronary plaques.
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Affiliation(s)
- Katarzyna Michaud
- University Center of Legal Medicine Lausanne-Geneva, Chemin de la Vulliette 4, CH - 1000, Lausanne 25, Switzerland.
- Lausanne University Hospital, University of Lausanne, Lausanne, Switzerland.
| | - Virginie Magnin
- University Center of Legal Medicine Lausanne-Geneva, Chemin de la Vulliette 4, CH - 1000, Lausanne 25, Switzerland
- Lausanne University Hospital, University of Lausanne, Lausanne, Switzerland
| | - Mohamed Faouzi
- Lausanne University Hospital, University of Lausanne, Lausanne, Switzerland
- Division of Biostatistics, Center for Primary Care and Public Health (Unisanté), Lausanne, Switzerland
| | - Tony Fracasso
- University Center of Legal Medicine Lausanne-Geneva, Chemin de la Vulliette 4, CH - 1000, Lausanne 25, Switzerland
- Geneva University Hospital, University of Geneva, Geneva, Switzerland
| | - Diego Aguiar
- University Center of Legal Medicine Lausanne-Geneva, Chemin de la Vulliette 4, CH - 1000, Lausanne 25, Switzerland
- Geneva University Hospital, University of Geneva, Geneva, Switzerland
| | - Fabrice Dedouit
- Department of Forensic Pathology, Rangueil University Hospital, Toulouse, France
| | - Silke Grabherr
- University Center of Legal Medicine Lausanne-Geneva, Chemin de la Vulliette 4, CH - 1000, Lausanne 25, Switzerland
- Lausanne University Hospital, University of Lausanne, Lausanne, Switzerland
- Geneva University Hospital, University of Geneva, Geneva, Switzerland
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Marmitt DJ, Bitencourt S, da Silva GR, Rempel C, Goettert MI. Traditional plants with antioxidant properties in clinical trials-A systematic review. Phytother Res 2021; 35:5647-5667. [PMID: 34165846 DOI: 10.1002/ptr.7202] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2020] [Revised: 05/20/2021] [Accepted: 06/08/2021] [Indexed: 01/08/2023]
Abstract
There is a trend toward the use of natural substances present in plants and vegetables. In general, foods rich in antioxidants are complex matrices; therefore, understanding its absorption effects is extremely relevant to know its bioactive potential. Thus, this systematic review focused on clinical trials involving plants (or compounds) registered on the National List of Medicinal Plants of Interest to the Unified Health System (RENISUS) with antioxidant properties. Following the reporting guidelines of Preferred Reporting Items for Systematic Reviews and Meta-Analyzes studies of interest indexed in the PubMed and ClinicalTrials.gov databases were analyzed. Of the 59 clinical trials found, Allium sativum and Curcuma longa are the plant species with the highest percentage of clinical research. Prevention/attenuation of oxidative stress was one of the main antioxidant mechanisms indicated in the studies. The most tested compounds of the RENISUS plants in clinical trials were curcumin and soy isoflavone. In this review, we selected studies in advanced stages that highlight plants' value in optimizing antioxidant status; however, even with high-quality studies, it is not prudent to overstate the clinical efficacy of these plants.
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Affiliation(s)
- Diorge Jônatas Marmitt
- Programa de Pós-graduação em Biotecnologia, Universidade do Vale do Taquari (Univates), Lajeado, RS, Brazil
| | - Shanna Bitencourt
- Programa de Pós-graduação em Biotecnologia, Universidade do Vale do Taquari (Univates), Lajeado, RS, Brazil
| | | | - Claudete Rempel
- Programa de Pós-graduação em Ambiente e Desenvolvimento/Programa de Pós-graduação em Sistemas Ambientais Sustentáveis, Universidade do Vale do Taquari (Univates), Lajeado, RS, Brazil
| | - Márcia Inês Goettert
- Programa de Pós-graduação em Biotecnologia, Universidade do Vale do Taquari (Univates), Lajeado, RS, Brazil
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Liu H, Wingert A, Wang J, Zhang J, Wang X, Sun J, Chen F, Khalid SG, Jiang J, Zheng D. Extraction of Coronary Atherosclerotic Plaques From Computed Tomography Imaging: A Review of Recent Methods. Front Cardiovasc Med 2021; 8:597568. [PMID: 33644127 PMCID: PMC7903898 DOI: 10.3389/fcvm.2021.597568] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2020] [Accepted: 01/18/2021] [Indexed: 12/21/2022] Open
Abstract
Background: Atherosclerotic plaques are the major cause of coronary artery disease (CAD). Currently, computed tomography (CT) is the most commonly applied imaging technique in the diagnosis of CAD. However, the accurate extraction of coronary plaque geometry from CT images is still challenging. Summary of Review: In this review, we focused on the methods in recent studies on the CT-based coronary plaque extraction. According to the dimension of plaque extraction method, the studies were categorized into two-dimensional (2D) and three-dimensional (3D) ones. In each category, the studies were analyzed in terms of data, methods, and evaluation. We summarized the merits and limitations of current methods, as well as the future directions for efficient and accurate extraction of coronary plaques using CT imaging. Conclusion: The methodological innovations are important for more accurate CT-based assessment of coronary plaques in clinical applications. The large-scale studies, de-blooming algorithms, more standardized datasets, and more detailed classification of non-calcified plaques could improve the accuracy of coronary plaque extraction from CT images. More multidimensional geometric parameters can be derived from the 3D geometry of coronary plaques. Additionally, machine learning and automatic 3D reconstruction could improve the efficiency of coronary plaque extraction in future studies.
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Affiliation(s)
- Haipeng Liu
- Research Centre for Intelligent Healthcare, Coventry University, Coventry, United Kingdom.,Faculty of Health, Education, Medicine, and Social Care, Anglia Ruskin University, Chelmsford, United Kingdom
| | - Aleksandra Wingert
- Faculty of Health, Education, Medicine, and Social Care, Anglia Ruskin University, Chelmsford, United Kingdom
| | - Jian'an Wang
- Department of Cardiology, School of Medicine, The Second Affiliated Hospital, Zhejiang University, Hangzhou, China
| | - Jucheng Zhang
- Department of Clinical Engineering, School of Medicine, The Second Affiliated Hospital, Zhejiang University, Hangzhou, China
| | - Xinhong Wang
- Department of Radiology, School of Medicine, The Second Affiliated Hospital, Zhejiang University, Hangzhou, China
| | - Jianzhong Sun
- Department of Radiology, School of Medicine, The Second Affiliated Hospital, Zhejiang University, Hangzhou, China
| | - Fei Chen
- Department of Electrical and Electronic Engineering, Southern University of Science and Technology, Shenzhen, China
| | - Syed Ghufran Khalid
- Research Centre for Intelligent Healthcare, Coventry University, Coventry, United Kingdom
| | - Jun Jiang
- Department of Cardiology, School of Medicine, The Second Affiliated Hospital, Zhejiang University, Hangzhou, China
| | - Dingchang Zheng
- Research Centre for Intelligent Healthcare, Coventry University, Coventry, United Kingdom
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Vermiglio E, Bortoletto E, Brunelli M, Sipala S, De Leo D. Sudden death in a 39-year-old woman due to three-vessel coronary artery disease: A case report and literature review. MEDICINE, SCIENCE, AND THE LAW 2021; 61:150-154. [PMID: 33591868 DOI: 10.1177/0025802420929210] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Coronary atherosclerosis may be underestimated in previously asymptomatic and apparently healthy young people, although it has been reported in various epidemiological studies. Between 7% and 21% of sudden cardiac deaths in previously asymptomatic people aged <45 years are due to three-vessel coronary artery disease. So, clinical services need to vigilant for this condition. We report a single case of sudden death in a young woman who was affected by three-vessel coronary artery disease. This 39-year-old woman attended an emergency department for non-specific chest pain. After a brief observation period, in the absence of signs of an acute myocardial event, she self-discharged. However, she died suddenly the next day. The subsequent autopsy did not show significant pathological findings, although macroscopic examination of the heart revealed critical three-vessel coronary artery disease. Standard histological examination confirmed an atheromatous plaque obstructing >75% of the lumen of the anterior descending artery, complicated by haemorrhagic phenomena, with diffuse calcified and sub-totally occluded atherosclerotic plaques in the other vascular sections, without ischaemic signs of the cardiomyocytes or fibrosis. When young people present with chest pain, they must be carefully evaluated. Risks need to be clearly explained, particularly when self-discharge is requested.
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Affiliation(s)
- Elisa Vermiglio
- Department of Diagnostics and Public Health - Legal Medicine and Forensic Pathology Unit, University of Verona, Italy
| | - Elena Bortoletto
- Department of Diagnostics and Public Health - Legal Medicine and Forensic Pathology Unit, University of Verona, Italy
| | - Matteo Brunelli
- Department of Diagnostics and Public Health - Unit of Pathology, University of Verona, Italy
| | - Stefania Sipala
- Department of Diagnostics and Public Health - Legal Medicine and Forensic Pathology Unit, University of Verona, Italy
| | - Domenico De Leo
- Department of Diagnostics and Public Health - Legal Medicine and Forensic Pathology Unit, University of Verona, Italy
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