Endothelium, Vascular ; pathology ; physiopathology ; Epithelial-Mesenchymal Transition ; Humans ; Hypertension, Pulmonary ; physiopathology ; Lung ; blood supply ; pathology ; physiopathology ; Mesoderm ; pathology ; physiopathology

Increased intima-media thickness (IMT) and pulse wave velocity (PWV) are noninvasive markers of early arterial wall alteration and are more widely used in adult clinical research. We investigated whether IMT and PWV are useful predictors of cardiovascular risk in hypertensive adolescents. Fifteen hypertensive adolescents (13-18 yr old, systolic BP > or = 140 mmHg, diastolic BP > or = 90 mmHg) and seventeen normotensive subjects were included. Height, weight, obesity index, body mass index (BMI), and fat distribution were obtained from each group. Serum lipid, insulin, vitamine B12, folate, renin, aldosterone, angiotensin-converting enzyme (ACE), and homocysteine levels were compared. The carotid IMT and PWV were measured. Arterial wall compliance and distensibility were calculated with the equation. High systolic blood pressure significantly correlated with height, weight, BMI, obesity index, arm circumference, fat mass, and fat distribution. Hypertensive adolescents had significantly greater cIMT (carotid intima-media thickness) and lower elastic properties such as cross-sectional compliance and distensibility of the carotid artery. The carotid IMT significantly correlated with brachial-ankle PWV. In conclusion, the measurement of carotid IMT and brachial-ankle PWV might be useful to predict the development of atherosclerosis in hypertensive adolescents.
Adolescent ; Arteries/*pathology/physiopathology ; Body Mass Index ; Elasticity ; Female ; Humans ; Hypertension/*pathology/physiopathology ; Male ; Tunica Intima/*pathology/physiopathology ; Tunica Media/*pathology/physiopathology

Animals ; Humans ; Hydrogen Sulfide ; Hypertension, Pulmonary ; etiology ; pathology ; physiopathology ; Pulmonary Artery ; physiopathology ; Pulmonary Circulation

We studied the wall motion characteristics of the ascending aorta by velocity vector imaging (VVI) in primary hypertension patients. The ascending aortas both in 30 patients with primary hypertension and 30 normal controls were examined by Acuson sequoia 512 equiped with VVI. The maximum velocity (Vs, Ve) of every point on the anterior wall of ascending aorta both in systole and diastole was measured. The aortic diameter was wider in the hypertension patients than that in the healthy subjects (P<0.05). The movement amplitude of the anterior wall of the ascending aorta in long axis view in the hypertension patients was lower than that in the healthy subjects (P<0.05). The motion and time to peak in systole of each point of the ascending aorta in the healthy subjects had no significant difference (P>0.05). The velocity curves of the anterior wall of ascending aorta both in the hypertension and healthy subjects were regular, and the curve in systole was named S wave and that in diastole named E wave. The velocity of S wave and E wave was slower in the hypertension patients than that in the healthy subjects (P<0.05). The time to peak of S wave on the anterior wall of ascending aorta in systole was shorter in the hypertension patients than in the healthy subjects (P<0.05). VVI could be used to accurately and directly observe the movement character of the ascending aorta walls, which would help us understand the elasticity of great arteries in patients with hypertension.
Aorta/pathology ; Aorta/*physiopathology ; Aorta/ultrasonography ; Blood Flow Velocity ; Case-Control Studies ; Echocardiography/*methods ; Elasticity ; Hypertension/pathology ; Hypertension/*physiopathology ; Vectorcardiography/*methods ; Ventricular Dysfunction, Left/physiopathology ; Young Adult

OBJECTIVEPulmonary hypertension (PH) is a common complication of congenital heart defects with a left-to-right shunt characterized by high pulmonary blood flow. Pulmonary vascular structural remodeling (PVSR) is the pathological basis of PH. However, the pathophysiologic features and mechanisms responsible for PH and PVSR induced by increased pulmonary blood flow have not been fully understood. The present study was designed to explore the possible effect and mechanism of hydrogen sulfide (H(2)S) on the regulation of PVSR induced by high pulmonary flow in rats.

METHODSThirty-two male SD rats, weighing 120 - 140 g, were randomly divided into shunt group (n = 8), shunt + NaHS group (n = 8), control group (n = 8) and control + NaHS group (n = 8). Rats in shunt group and shunt + NaHS group were subjected to an abdominal aorta-inferior vena cava shunt to create an animal model of high pulmonary flow. Rats in the control and control + NaHS groups underwent the same experimental protocol as mentioned above except for the shunt procedure. Rats in the shunt + NaHS and control + NaHS groups were intraperitoneally injected with NaHS at 56 micromol/(kgxd), and rats in the shunt and control groups were injected with the same volume of physiological saline. After 11 weeks of experiment, rats were sacrificed and lung tissues were obtained. The percentage of muscularized artery (MA) was calculated. The changes in relative medial thickness (RMT) in small pulmonary arteries and median pulmonary arteries were examined. Proliferative cell nuclear antigen (PCNA), extracellular signal-regulated kinase (ERK1) and phosphorylation extracellular signal-regulated kinase (P-ERK1) protein expression were examined by Western blot, and at the same time, PCNA protein expression by pulmonary artery smooth muscle cells was observed by immunohistochemistry.

RESULTSAfter 11 weeks of shunt, compared with control group, the percentage of MA increased significantly (25.12 +/- 2.26 vs 14.42 +/- 3.41, P < 0.05), and RMT in small pulmonary arteries and median pulmonary arteries increased significantly in rats of shunt group (23.6 +/- 3.5 vs 12.6 +/- 2.1, 24.8 +/- 1.9 vs 13.5 +/- 2.2, P < 0.05 for all). PCNA protein expression in small and median pulmonary arteries increased significantly (0.49 +/- 0.04 vs 0.39 +/- 0.07, 0.46 +/- 0.08 vs 0.36 +/- 0.05, P < 0.01 for all), and the ratio of PERK/ERK1 protein expression of pulmonary arteries increased significantly (P < 0.01) in rats of shunt group compared with those of control group. After the administration of exogenous H(2)S donor, NaHS, for 11 weeks, in contrast to rats in shunt group, the percentage of MA decreased significantly (21.5 +/- 2.0 vs 25.1 +/- 2.3, P < 0.05), and RMT in small and median pulmonary arteries decreased significantly (20.2 +/- 2.8 vs 23.6 +/- 3.5, 20.8 +/- 3.1 vs 20.8 +/- 3.1, P < 0.05 for all) in rats of shunt + NaHS group. PCNA protein expression in small and median pulmonary artery smooth muscle cells decreased significantly (0.32 +/- 0.06 vs 0.49 +/- 0.04, 0.29 +/- 0.07 vs 0.46 +/- 0.08, P < 0.01 for all), and the ratio of PERK/ERK1 protein expression of pulmonary arteries decreased significantly (P < 0.01) in rats of shunt + NaHS group compared with that of shunt group.

CONCLUSIONH(2)S may play a regulatory role in pulmonary vascular structural remodeling induced by high pulmonary blood flow via mitogen-activated protein kinase (MAPK)/ERK signal transduction pathway.

Animals ; Hydrogen Sulfide ; pharmacology ; Hypertension, Pulmonary ; pathology ; physiopathology ; Lung ; pathology ; Male ; Pulmonary Artery ; drug effects ; physiopathology ; Rats ; Rats, Sprague-Dawley

OBJECTIVETo investigate the changes of pulmonary tissue area density and their mechanisms in rats with hypoxic pulmonary hypertension (HPH).

METHODS54 Wistar rats were divided into hypoxia 10 d (n = 12), 20 d (n = 12), 30 d (n = 12) groups and control group (n = 18). The rats in hypoxia groups were exposed to a simulated hypoxia environment at a height of 5 km above sea level to establish HPH models. The changes in pulmonary tissue area density and pathological morphology were determined by image analysis, optical microscope, electron microscope and histochemistry.

RESULTSAfter hypoxia, the pulmonary tissue area density markedly increased on 10 d (27.08% +/- 1.29%, P < 0.05), especially on 20 d (31.33% +/- 0.27%) and 30 d (31.10% +/- 1.95%) while that in control group was 22.78% +/- 1.17% (P < 0.01). The area density on 20 d was higher than that on 10 d (P < 0.05) but there wasn't significantly different between 10 d and 30 d (P = 0.057) after hypoxia. Pathological examination showed: edema and collapse of pulmonary tissue, swelling and degeneration of type II alveolus epithelial cells (PII); congestion, accumulation of polymorphonuclear neutrophils and platelets in capillaries; swelling and degeneration of endothelial cells, thickening of basement membranes.

CONCLUSIONSHypoxia can induce increase in pulmonary tissue area density and decrease in aerial exchange area in alveoli. These changes may be related to the pulmonary collapse caused by the damage of PII and pulmonary surfactant system, structural remodeling of small pulmonary arteries, increase in blood cells and protein granules in alveolar cavity.

Animals ; Hypertension, Pulmonary ; etiology ; pathology ; physiopathology ; Hypoxia ; physiopathology ; Lung ; pathology ; ultrastructure ; Male ; Microscopy, Electron ; Random Allocation ; Rats ; Rats, Wistar

OBJECTIVETo investigate the changes in the structure and function of the carotid artery and their relationship with subclinical inflammation in patients with H-type hypertension.

METHODSSixty patients with H-type hypertension and 49 with non-H-type hypertension were enrolled in this study, with 20 healthy volunteers as the control group. All the subjects underwent color Doppler ultrasound examination of the carotid artery, and their blood levels of hyper-sensitive C-reactive protein (hs-CRP), fibrinogen (FIB), and tumor necrosis factor-α (TNF-α) were measured to investigate the correlation between the structural and functional changes of the carotid artery and the inflammatory factors.

RESULTSNo significant difference was found in the blood pressure level between the H-type and non-H-type hypertension groups (136.0∓10.1 vs 131.9∓7.0 mmHg for systolic blood pressure, P>0.05; 80.9∓8.9 vs 73.2∓7.9 mmHg for diastolic pressure, P>0.05). The intima-media thickness, distensibility of the common carotid artery, carotid artery stiffness, and blood homocysteine level all showed significant differences between patients with H-type and non-H-type hypertension (1.52∓0.08 vs 1.09∓0.06 mm, 0.23∓0.14 mmHg(-1)×100 vs 0.46∓0.14 mmHg(-1)×100, and 15.37∓5.89 vs 8.19∓4.53 µmol/L, respectively, P<0.05). The H-type hypertensive patients showed significantly higher hs-CRP, FIB, and TNF-α levels than the non-H-type hypertensive patients, and these inflammatory factors were positively correlated with the structural and functional changes of the carotid artery.

CONCLUSIONThe patients with H-type hypertension are more likely to have carotid artery structure and function impairments, which closely correlate with the subclinical inflammatory factors. These changes might be attributed to the synergism of subclinical inflammation and hyperhomocysteinemia, for which active intervention may prove beneficial.

Adult ; Aged ; Carotid Arteries ; pathology ; physiopathology ; Case-Control Studies ; Female ; Humans ; Hypertension ; classification ; pathology ; physiopathology ; Inflammation ; Male ; Middle Aged

Cirrhosis with portal hypertension is a common disease which has a significant impact on the quality of patients' life. Esophagogastric devascularization (EGDV) has been demonstrated to be an effective method to treat portal hypertension, however certain complications are associated with it. The purpose of this study was to evaluate the effectiveness and clinical outcome of the selective EGDV (sEGDV) for the treatment of portal hypertension. The study was conducted prospectively from Jan. 1 2011 to Dec. 31, 2012, and 180 patients were randomized to the sEGDV group (n=90) or the non-sEGDV (n-sEGDV) group (n=90). Patients' demographics, preoperative lab test results and operative details were comparable between the two groups. Postoperative and short-term complications were analyzed in two groups. There was statistically significant difference (P<0.01) in the PVF reduction between the two groups. Post-operative complications showed no statistically significant difference between the two groups in the incidence of bleeding, ascites, acute portal vein thrombosis, fever and hepatic encephalopathy. Mortality between two groups was comparable. The incidence of splenic fossa effusion after the surgery was lower in sEGDV group than in n-sEGDV group. There were no significant differences in the short-term follow-up data such as esophageal varices and portal hypertensive gastropathy (P>0.05). It is suggested that sEGDV is a safe, simple and effective surgical procedure. It has both the advantages of the shunt and devascularization because it preserves body's voluntary diversion. With the advantage of low incidence of postoperative complications, it is an ideal surgical approach for the treatment of portal hypertension.
Adult ; Esophagus ; blood supply ; surgery ; Female ; Gastrointestinal Hemorrhage ; etiology ; pathology ; physiopathology ; Hepatic Encephalopathy ; pathology ; physiopathology ; Humans ; Hypertension, Portal ; pathology ; physiopathology ; surgery ; In Vitro Techniques ; Male ; Middle Aged ; Postoperative Complications ; pathology ; physiopathology ; Prospective Studies ; Stomach ; blood supply ; surgery ; Thrombosis ; etiology ; pathology ; physiopathology

OBJECTIVETo observe the characteristics of coronary microvascular lesions (CML) in the autopsied elderly cases with hypertensive left ventricular hypertrophy (LVH) and the difference of CML among the groups of essential hypertension (EHT), coronary heart disease (CHD) and diabetes (NIDDM) also with LVH.

METHODSA retrospective study was performed in 206 cases > or = 60 years old of EHT, CHD and NIDDM with LVH and 30 normal cases as control, out of 3195 consecutive autopsied cases from 1954 to 1996 in our hospital. Arterioles with diameters of 10 - 60 microm and capillaries in the muscular layer were shown by the methods of HE, Elastic fiber + VG staining and immunohistochemistry of CD31. Quantitative measurements on the arteriole density (AD), the ratio of arteriolar wall and cavity (RWC), capillary density (CD) and the area of endothelial cell (AEC) were performed with light microscope observation and image analysis by computer. According to the thickness of the left ventricle free wall, the severity of LVH was divided into four degrees from 0 to III. LVH of degree 0-III was observed in EHT group, while only LVH of degree I was found in CHD, EHT + CHD, and NIDDM groups. SAS system was used for statistical analysis.

RESULTSAD and RWC increased while CD and AEC decreased significantly with the progression of LVH in EHT groups (P < 0.05 - 0.01). There was a similar but more severe change in the (HT + CHD) group (P < 0.01); the AD increased (P < 0.05) while all other measurements did not show obvious changes in the CHD group. The AD increased, CD and AEC decreased (all P < 0.05), but RWC did not change very much in the NIDDM group.

CONCLUSIONCML in the EHT group was characterized by an increased AD and RWC, decreased CD and AEC, among which the increased RWC was the typical change in EHT groups compared with the groups of CHD and NIDDM. Damaged CML may be one of the main factors for decreased coronary flow reserve and myocardial ischemia in cases of EHT with LVH.

Aged ; Autopsy ; Coronary Circulation ; Coronary Disease ; complications ; pathology ; physiopathology ; Coronary Vessels ; pathology ; physiopathology ; Diabetes Mellitus, Type 2 ; complications ; pathology ; physiopathology ; Female ; Humans ; Hypertension ; complications ; pathology ; physiopathology ; Hypertrophy, Left Ventricular ; complications ; pathology ; physiopathology ; Male ; Middle Aged

PURPOSE: This study aimed to determine the impaired glucose tolerance and diabetes prevalence in patients with essential hypertension (HT) and to compare the developed microvascular complications of these groups. MATERIALS AND METHODS: An oral glucose tolerance test (OGTT) was performed on 338 essential hypertensive cases and glucose tolerances were classified according to ADA-2002 criteria. RESULTS: Of the 338 cases, 32 people had diabetes (DM, 9.46%), 78 people had glucose intolerance (IGT, 23.1%), and 228 people had only hypertension but not IGT and DM (67.4%). Both the mean ages of the DM group (56.9 +/- 6.7 years, p = 0.002) and IGT group (56.3 +/- 8.4 years, p = 0.003) were older than the mean age of the control group (51.1 +/- 6.4 years). The risk of IGT development was found to be four times greater in male cases than female cases when compared to the control group (p = 0.004, add ratio = 4.194). There were no significant differences in the body mass indexes (BMI's), hypertension durations, and microvascular complications between the groups. CONCLUSION: In conclusion, the risk of IGT and DM development in hypertensive cases increases with aging and longer hypertension duration. The risk of IGT development in hypertensive cases is four times more in males.
Aged ; Blood Glucose ; Diabetes Mellitus, Type 2/pathology/physiopathology ; Female ; Glucose Intolerance/pathology/*physiopathology ; Humans ; Hypertension/pathology/*physiopathology ; Male ; Middle Aged