経皮的冠動脈形成術(PTCA)と冠動脈アテレクトミー(DCA)における再狭窄病変の組織学的検討 : ミオシン重鎖アイソフォームからみた血管平滑筋細胞形質の変化
スポンサーリンク
概要
- 論文の詳細を見る
SMI and SM2 are smooth muscle myosin heavy chain isoforms and specific molecular markers for well-differentiated smooth muscle cells (SMCs). SMemb is a nonmuscle myosin heavy chain abundantly expressed in undifferentiated SMCs which are observed in restenotic lesions. To test the hypothesis that the proliferative response of SMCs in coronary restenotic lesions after directional coronary atherectomy (DCA) was slower than those after percutaneous transluminal coronary angioplasty (PTCA), we studied 76 coronary plaque tissue specimens excised from 76 patients (pts) who underwent DCA for treatment of restenotic lesions after previous successful catheter intervention. Initial procedures were PTCA in 56 pts and DCA in 20 pts. The average time from first intervention was 5.6 ± 3.4 (2～9) months in PTCA group, and 6.5 ± 5.2 (4～13) months in DCA group (not significant). On light microscopic semiquantitative analysis, the proportion of hypercellular lesions found in abundant SMCs appeared to be greater in DCA group than that in PTCA group (45.6 ± 12.9% vs 34.0 ± 16.3% of total tissue area, p<0.01). On the contrary the proportion of fibrous tissue was quantitatively greater in PTCA group. In 16 pts from PTCA group and 12 pts from DCA group, we also examined immunohistochemical reactivities for SMI, SM2 and SMemb. In the early phase after the initial procedure (less than 6 months), intimal SMCs had lower score for SM2 but higher score for SMI and SMemb in both groups. In the late phase (more than 6 months) intimal SMCs had immunohistochemically higher score for SMI and SM2 but lower score for SMemb in PTCA group, while those in DCA group had lower immunoreactivity for SM2 (histochemmical score: 2.4 ± 0.5 vs 1.7 ± 0.8: PTCA group vs DCA group, p<0.01). The results are consistent with the view that the proportion of undifferentiated SMCs is significantly higher in DCA group compared to PTCA group, and that the differential expression, in the time course of coronary restenosis, of myosin heavy chain isoforms between SMCs of PTCA and DCA groups might have a predictive value for restenosis.
- 東京女子医科大学の論文
- 1996-11-25
著者
関連論文
- 0388 Marfan症候群に合併した上行大動脈瘤における中膜病変 : 平滑筋細胞アポトーシスの関与
- Acute coronary syndrome 発症時の病理組織学的所見 : 冠動脈アテレクトミー標本による検討
- 19. 大動脈炎症候群様の臨床症状を伴った強直性脊椎炎の1例(ブロックV,東京女子医科大学学会第311回例会)
- 37) 左心室局所壁運動異常を認めたSyndrome Xの一例
- P029 冠攣縮性狭心症と冠硬化性狭心症の運動負荷試験の比較 : ST-HR loopによる検討
- 4) 肥大型心筋症に合併した急性心筋梗塞の1例
- 1100 強皮症における心病変 : 連続43例の臨床的検討
- 9) 心不全にて発症し大動脈弁閉鎖不全症と大動脈炎症候群を合併した強直性脊椎炎の1例(日本循環器学会 第155回関東甲信越地方会)
- P698 冠動脈アテレクトミー切除組織の色調と病理所見および再狭窄率
- P581 血管障害後の細胞増殖の新しい指標 : Argyrophilic nucleolar organizer region(AgNOR)の有用性
- V14 PTCA後再狭窄病変とDCA後再狭窄病変の病理学的特徴
- P217 冠動脈硬化病変における誘導型NO合成酵素の発現と再狭窄
- 1033 冠動脈狭窄病変における平滑筋細胞密度とアポトーシス出現率 : 冠動脈アテレクトミー(DCA)切除組織による検討
- P278 アセチルコリン負荷による冠攣縮誘発性の日内変動
- 薬剤抵抗性心室頻拍で発症し急激な経過で死に至った心サルコイドーシスの1症例 : 日本循環器学会第136回関東甲信越地方会
- (91)経皮的冠動脈形成術(PTCA)と冠動脈アテレクトミー(DCA)における再狭窄病変の組織学的検討 : ミオシン重鎮アイソフォームからみた血管平滑筋細胞形質の変化(学位論文内容の要旨および審査の結果の要旨第36集)
- 経皮的冠動脈形成術(PTCA)と冠動脈アテレクトミー(DCA)における再狭窄病変の組織学的検討 : ミオシン重鎖アイソフォームからみた血管平滑筋細胞形質の変化