Study on the prevalence of eccentric and concentric atherosclerotic plaques in various segments of the coronary arterial tree, in unselected and selected Bucharest population samples.

A study was carried out on the prevalence and distribution of eccentric and concentric atherosclerotic plaques in the coronary arterial tree of 916 unselected apparently healthy subjects who died from accidents and of 150 selected patients who died from coronary heart disease. The results show that the percentages of eccentric and concentric plaques vary with age, sex, anatomical branching pattern and cause of death; there are also differences between major coronary arteries and main branch vessels. In addition to eccentric and concentric plaques, we revealed the existence of mixed (both eccentric and concentric) plaques, mainly located at branch points.

The onset and progression of atherosclerotic plaques as related to arterial wall changes.

The coronary arterial beds from more than 1200 subjects aged 1 to 65 years were investigated by both histopathological, histochemical and morphometric methods. Light microscopic aspects were analysed to reveal if plaque development and progression toward obstructive lesions were associated with arterial wall changes, particularly of the intimal connective tissue adjacent to lesions. Six patterns of plaque development in the coronary arterial tree were delineated, emphasis being placed on the observation that the onset and progression of plaques frequently appeared independent of arterial wall changes, in contrast to fatty streaks, gelatinous lesions, intimal necrotic areas, incorporated microthrombi and intramural thrombi.

Influence of coronary heart disease risk factors (CHDRFs) on the natural history of coronary atherosclerosis as revealed by a post-mortem study.

A postmortem study was carried out on the whole coronary arterial bed of 430 selected apparently healthy subjects, aged 38 to 65 years, in an effort to reveal the influence exerted by coronary heart disease risk factors (CHDRFs) on the development of coronary obstructive plaques. A clear positive correlation was found in 31% of cases and in more than 50% of 28 selected topographic sites of the coronary arterial bed. On the other hand, the subgroup without CHDRFs also exhibited severe coronary narrowings.

[The detection and treatment of asymptomatic myocardial ischemia to reduce morbidity and mortality from ischemic cardiopathy].

The paper reports and assesses the most topical data having led to delimiting the asymptomatic myocardial ischemia as the most precocious form of manifestation of ischemic cardiopathy. The role of asymptomatic myocardial ischemia involvement in angina pectoris, myocardial infarction and serious arrhythmias leading to sudden cardiac death are also underlined from the viewpoint of prognosis severity. Likewise, the authors discuss; the prevalence of asymptomatic myocardial ischemia as a distinct manifestation form of myocardial ischemia; the way of selecting the cases; the anti-ischemic treatment that gave good results in diminishing morbidity and mortality induced by ischemic cardiopathy.

Coronary anatomy and microarchitecture as related to coronary atherosclerotic involvement.

A report is given on the authors' main results concerning the anatomy and microarchitecture of human coronary arteries as related to atherosclerotic involvement and to the clinical manifestations of coronary heart disease. The peculiarities of anatomical branching pattern, of the intimal thickening, muscle columns development, of age-related changes, in the intima/media thickness ratio, as well as the segmental characteristics in susceptibility to plaque development and in the plaque pattern are presented. Our results allow to delineate the coronary arterial bed as an entity in anatomical, histological and pathological sense.