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Has Our Understanding of Calcification in Human Coronary Atherosclerosis Progressed?

Arteriosclerosis, thrombosis, and vascular biology, 2014-04, Vol.34 (4), p.724-736 [Peer Reviewed Journal]

2014 American Heart Association, Inc. ;ISSN: 1079-5642 ;EISSN: 1524-4636 ;DOI: 10.1161/ATVBAHA.113.302642 ;PMID: 24558104

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Title:
Has Our Understanding of Calcification in Human Coronary Atherosclerosis Progressed?
Author: Otsuka, Fumiyuki ; Sakakura, Kenichi ; Yahagi, Kazuyuki ; Joner, Michael ; Virmani, Renu
Subjects: Animals ; Apoptosis ; Continental Population Groups ; Coronary Artery Disease - ethnology ; Coronary Artery Disease - etiology ; Coronary Artery Disease - metabolism ; Coronary Artery Disease - pathology ; Coronary Vessels - metabolism ; Coronary Vessels - pathology ; Disease Progression ; Female ; Fibrosis ; Humans ; Macrophages - metabolism ; Macrophages - pathology ; Male ; Necrosis ; Plaque, Atherosclerotic ; Prognosis ; Risk Factors ; Rupture, Spontaneous ; Sex Factors ; Vascular Calcification - ethnology ; Vascular Calcification - etiology ; Vascular Calcification - metabolism ; Vascular Calcification - pathology
Is Part Of: Arteriosclerosis, thrombosis, and vascular biology, 2014-04, Vol.34 (4), p.724-736
Description: Coronary artery calcification is a well-established predictor of future cardiac events; however, it is not a predictor of unstable plaque. The intimal calcification of the atherosclerotic plaques may begin with smooth muscle cell apoptosis and release of matrix vesicles and is almost always seen microscopically in pathological intimal thickening, which appears as microcalcification (≥0.5 μm, typically <15 μm in diameter). Calcification increases with macrophage infiltration into the lipid pool in early fibroatheroma where they undergo apoptosis and release matrix vesicles. The confluence of calcified areas involves extracellular matrix and the necrotic core, which can be identified by radiography as speckled (≤2 mm) or fragmented (>2, <5 mm) calcification. The calcification in thin-cap fibroatheromas and plaque rupture is generally less than what is observed in stable plaques and is usually speckled or fragmented. Fragmented calcification spreads into the surrounding collagen-rich matrix forming calcified sheets, the hallmarks of fibrocalcific plaques. The calcified sheets may break into nodules with fibrin deposition, and when accompanied by luminal protrusion, it is associated with thrombosis. Calcification is highest in fibrocalcific plaques followed by healed plaque rupture and is the least in erosion and pathological intimal thickening. The extent of calcification is greater in men than in women especially in the premenopausal period and is also greater in whites compared with blacks. The mechanisms of intimal calcification remain poorly understood in humans. Calcification often occurs in the presence of apoptosis of smooth muscle cells and macrophages with matrix vesicles accompanied by expression of osteogenic markers within the vessel wall.
Publisher: United States: American Heart Association, Inc
Language: English
Identifier: ISSN: 1079-5642
EISSN: 1524-4636
DOI: 10.1161/ATVBAHA.113.302642
PMID: 24558104
Source: Geneva Foundation Free Medical Journals at publisher websites
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Has Our Understanding of Calcification in Human Coronary Atherosclerosis Progressed?

2014 American Heart Association, Inc. ;ISSN: 1079-5642 ;EISSN: 1524-4636 ;DOI: 10.1161/ATVBAHA.113.302642 ;PMID: 24558104

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