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The neutrophil–lymphocyte ratio (NLR) is an emerging cardiovascular risk factor. Patients with mixed plaques (MPs) or noncalcified plaques (NCPs) have a higher risk of poor outcomes. However, there are few published data on the relationship between the NLR and the presence of NCP or MP (NCP/MP). We retrospectively collected the clinical and laboratory data of 598 patients with chest pain. According to whether they had coronary atherosclerotic plaques and the characteristics of the most stenotic plaque, we divided them into no plaque, calcified plaques, NCP, and MP. Those with NCP/MP had significantly elevated neutrophil count and NLR (P < .05). The proportion of NCP/MP was significantly increased from 28.6% in the NLR < 1.55 to 42.7% in the NLR > 2.21 group (P = .013). Multiple logistic regression analysis showed that NLR was an independent risk factor for the presence of NCP/MP (odds ratio = 1.195; 95% CI: 1.020-1.400; P = .028). The present study demonstrated that the NLR was independently associated with the presence of NCP/MP. [ABSTRACT FROM AUTHOR]

The differences in angiographic characteristics and cardiovascular (CV) risk factors between coronary artery aneurysm (CAA) and coronary artery ectasia (CAE) have not been compared systematically. Of 10 876 patients undergoing coronary angiography, patients with CAA (n = 85) and CAE (n = 51) were screened. The prevalence of CAA was greater than that of CAE (P < .05). The right coronary artery was the most involved (70.6%) in CAE compared with left circumflex (52.9%) and left anterior descending (41.2%). Coronary artery aneurysm coexisted with coronary artery disease (CAD) more frequently than CAE (P = .002), and the modified Gensini score of CAA was also higher than that of CAE (P < .001). The average maximum diameter was smaller, and corrected Thrombolysis in Myocardial Infarction (TIMI) frame count was lower in CAA than CAE in all 3 coronary arteries (P < .001). Multivariate analysis showed that hyperlipidemia (P = .02), smoking (P = .04), and family history of CAD (P = .02) were the independent variables most strongly associated with CAA, but not CAE. This study suggests that there are significant differences in coronary angiographic characteristics and CV risk factors between CAA and CAE. [ABSTRACT FROM AUTHOR]

We sought to noninvasively assess the relationship between arterial remodeling, endothelial shear stress (ESS), and wall stiffness in coronary arteries. We studied 28 coronary arteries from 22 patients undergoing coronary computed tomography angiography (CCTA). The ESS was calculated in 2-mm long segments using computational fluid dynamics. Local remodeling, plaque dimensions, and local wall stiffness were assessed in each segment. The ESS was lower in the regions of excessive expansive remodeling versus compensatory expansive versus inadequate expansive versus constrictive remodeling. Areas of decreased wall stiffness more frequently exhibited excessive expansive remodeling. Plaque volume was higher in segments showing excessive expansive and inadequate remodeling than segments with constrictive remodeling. In conclusion, CCTA enables the noninvasive assessment of coronary hemodynamics and arterial/plaque morphology. Excessive expansive remodeling is associated with high-risk plaque features, such as low ESS, decreased plaque stiffness, and increased plaque volume. This methodology may be useful in the risk assessment of individual coronary lesions. [ABSTRACT FROM PUBLISHER]

We investigated the association between coronary artery ectasia (CAE) and Neutrophil-to-lymphocyte ratio (NLR), an indicator of the inflammatory state. The study population included 434 patients (247 males, mean age 62 ± 10 years) including 230 patients with isolated CAE and 104 patients with coronary artery disease and 100 patientss with normal coronary arteries. The NLR was measured at admission and 30 days after coronary angiography in all the patients. The NLR was significantly higher in patients with CAE than those with normal coronary arteries (2.2 ± 0.6-1.3 ± 0.6, P < .001). Linear regression analyses revealed that NLR (coefficient β = −.61, P < .001) was significantly associated with severity of CAE. The NLR is significantly higher in patients with CAE compared to controls with normal coronary arteries, and NLR is associated with severity of CAE. [ABSTRACT FROM PUBLISHER]

The authors investigated the role of muscarinic receptors in functional control of coronary arteries affected by intimal thickening due to arteriosclerosis. They first examined the genetic subtypes of muscarinic receptors expressed in human coronary arteries. Twelve samples of human coronary artery, obtained by autopsy from eight subjects, were examined for the expression of four genetic subtypes of muscarinic receptor, m1 to m4, by reverse transcription and polymerase chain reaction (RT-PCR). Two subtypes, m2 and m3, were found to be expressed in the coronary artery. The m2 gene was expressed in seven of the 12 vessels, and m3 in eight of the 12. Expression of both m2 and m3 genes was observed in five of the 12 vessels. Neither the mi nor m4 was expressed in these samples. These results indicate that the m2 and m3 genes are mainly expressed in the coronary arteries and suggest that these patterns of expression are differentially controlled to induce the diversity of contraction/relaxation reactions induced in the coronary arteries by acetylcholine. [ABSTRACT FROM AUTHOR]

The authors report a rare case of a malignant hemangioendothelioma (MH) originating in the pericardium. In this case, a metastatic skin lesion was found first, and subsequently the existence of a primary cardiac lesion was confirmed. Generally, primary cardiac tumors grow slowly, and the prognosis of MH is relatively good. In this case, however, the patient died suddenly during the creation of a pericardial window for drainage. An autopsy showed that the MH originated from a pericardial lesion in the right atrium. [ABSTRACT FROM AUTHOR]

Left atrial wall elasticity is one of the important factors regulating left atrial stiffness and functions. The authors evaluated left atrial wall elasticity by measuring the sound speed through the left atrial wall, based on the hypothesis that high elasticity tissues will yield larger sound speed values through the tissue, and examined age-associated changes in left atrial wall elasticity. Left atrium specimens were obtained from 30 normal subjects (age, 15–95 years) at autopsy. An acoustic microscope, operating at 450 MHz, was used to measure the sound speed in the endocardium and the myocardium of the left atrium. The sound speeds in endocardium and myocardium demonstrated significant correlation with age (r=0.74, p<0.0001 and r=0.47, p<0.01, respectively). These findings indicate that left atrial wall elasticity increased with advancing age. These changes may lead to deterioration of left atrial compliance and eventual left atrial failure in older subjects. [ABSTRACT FROM AUTHOR]

During fetal life the pulmonary circulation is one of high resistance. Soon after birth with the onset of breathing and thereafter, sequential structural changes in the pulmonary vasculature take place. Several authors have reported differently on this structural remodeling. This study describes the changes in the pulmonary vasculature occurring following birth. Twenty-five cases submitted to autopsy with ages ranging from newborns up to fourteen years were studied. Postmortem arteriography was undertaken in most of the cases and arterial morphology was quantitated by histomorphometry. It was found that the thick-walled pulmonary arteries of the newborn show a reduction in medial thickness over a period of one month, the reduction being most rapid in the first three days. After one month there is no significant change in medial thickness until fourteen years of age. [ABSTRACT FROM AUTHOR]

Nonbacterial thrombotic endocarditis is the most common form of endocarditis found at autopsy. Systemic embolization may complicate this condition in patients with mitral valve prolapse. The authors report a case of mitral valve prolapse and nonbacterial thrombotic endocarditis in which the presenting feature was Parinaud's syndrome. [ABSTRACT FROM AUTHOR]

The biochemical analysis of samples of aortic connective tissue was carried out in 22 subjects from 9 to 84 years old. Aortic samples were taken at necropsy performed after sudden or, more often, traumatic death. The results suggest that aging of the aorta is accompanied by an increase both in collagen content and in total sugar content when expressed as mg/cm' while the elastin content, when expressed in the same way, does not undergo any variation. [ABSTRACT FROM AUTHOR]

Occurrence of Takayasu's arteritis (TA) is described in this work in a defined area of Sweden, namely the Uppsala Hospital region (1.3 million inhabitants). During the eight year period 1969-1976 there were 15 cases of TA discharged from the hospitals in this region. The estimated yearly prevalence was 0.64 per 100,000 inhabitants. All subjects underwent angiography of the aorta and the main vessels. The authors point to the necessity of performing a total aortography. The most common lesions in this study were confined to the subclavian arteries in contrast to the commonly reported lesions of the aortic arch. Six of the fifteen subjects died during the study period. Those who died more often had hypertension hypercholesterolemia and were smokers to a greater extent than those who survived. Treatment with corticosteroids and azathioprin seemed to improve the prognosis. At present a total aortography and/or biopsy of the vessel at autopsy or operation is the most accurate way of establishing the diagnosis. [ABSTRACT FROM AUTHOR]

Examines the pathological anatomy of atherosclerosis and its relation to peripheral artery grafting. Rare occurrence of atherosclerosis to affect the smaller vessels; Identification of the most common site of obstruction in the thigh; Diffusion of intimal disease throughout the length of the superficial femoral artery and the proximal part of the popliteal artery.

Hypertensive ulcer is a rather infrequent cutaneous complication of hypertensive disease. It was described for the first time in 1945 by Martorell, who reported the first four cases in the literature. It is a lesion of a typical location and of pathological anatomy similar to that of other changes of hypertensive disease. The most effective treatment seems to be lumbar sympathectomy. [ABSTRACT FROM AUTHOR]

An infant with multiple congenital anomalies had an uncommon cardiac malformation which was verified by angiography and at autopsy. This defect consisted of severe tricuspid atresia, severe pulmonary stenosis, and a persistent left superior vena cava entering a very dilated coronary sinus—‘cor triatriatum dexter’ (Hudson2). There were also a horesehoe-kidney, an imperforate anus, and other anatomic alterations indicating a probable multifactorial8 mode of inheritance. [ABSTRACT FROM AUTHOR]

A technique for the postmortem intraosseous phlebography of the legs by injection of contrast medium into the calcaneous is described. The results of a comparative postmortem pathoanatomic and phlebographic study are reported in which intraosseous phlebography and complete venous dissection of the lower limbs were performed. Venous thrombosis was found in 43 of 100 geriatric cases (in 65 legs out of a total of 199 investigated, i.e., in 33 per cent of legs. Extensive thrombi affecting both the veins of the lower leg and the iliofemoral veins were frequent; they comprised 65 percent of all thrombi (45 per cent were continuous and 20 per cent discontinuous), whereas 20 per cent were localized in the iliofemoral veins. Exclusive localization in the iliofemoral veins indicates a primary site of origin in this area of a comparatively large number of venous thrombi in the leg. Apparently early primary thrombi were often adherent to valve pockets, from which they seemed to originate. In the 65 thrombosed legs, partial failure of phlebography to reveal thrombi occurred in 10.7 per cent (thrombosis was correctly diagnosed in one venous trunk but not in the other). Complete failure of phlebography was noted in only 3.1 per cent of the thrombosed legs. A false-positive phlebographic diagnosis of thrombosis (mainly due to misinterpretation of clots) was experienced in 7 out of 134 legs pathoanatomically free of thrombosis (5 per cent). It is envisaged that the method of postmortem intraosseous phlebography may be used as a supplement to ordinary postmortem examination, especially in systematic studies of thromboembolic disease states. Certain modifications of the technique and a broader experience concerning the interpretation of the postmortem phlebograms appear, however, to be needed prior to the routine application of the technique. The radiographic postmortem examination of the veins may not only be used as a guidance and supplement to autopsy; it may be of considerable diagnostic value in certain cases where regular postmortem autopsy cannot be performed. Preliminary observations in this study may suggest that extensive angiographic investigations for postmortem diagnostic purposes are feasible since both the inferior and superior caval systems as well as the right side of the heart and the pulmonary arteries may be visualized under certain conditions making possible the diagnosis of pathologic conditions such as tumors, pulmonary emboli, and septal defects in the heart. [ABSTRACT FROM AUTHOR]

Discusses the autopsy report of a female patient diagnosed with unilateral renovascular hypertension. Revelation of a primary aoritis involving the right renal artery; Aim of the exercise to enhance the understanding of renovascular hypertension in children for potential improvements in surgical intervention; Medical history; Symptoms observed; Primary diagnosis; Discovery of leukocytosis; Physical condition; Laboratory findings at admission; Microscopic findings through histologic examinations.

We have reported our experiences with 73 patients and 18 dogs in which a TRC was done. We have considered it useful in cases with suspected pathology of the renal veins and the inferior vena cava. We have been able to identify 4 cases of occlusion of the inferior vena cava, 2 cases of combined obstruction of the inferior vena cava and the renal veins, 4 cases of isolated obstruction of the left renal vein, 1 case of isolated obstruction of the right renal, 2 cases of stenosis of the inferior vena cava, 2 cases of stenosis of the inferior vena cava and the renal vein and 3 cases of stenosis of the left renal vein. We have studied 22 cases of cirrhosis of the liver. In 10 of the cases the TRC was abnormal, 8 cases showed increased lumbovertebral venous circulation and 1 case had a thrombosis of the inferior vena cava and a splenorenal shunt. There was 1 case of occlusion of the left renal vein, and 2 cases had a combined stenosis of the inferior vena cava and the renal vein. In one case we found a solitary cyst of the kidney and a renoportal shunt, which probably represent a congenital malformation. We have not found serious complications and these are comparable to the ones encountered in renal biopsies. We have studied the kidney of 18 dogs, and the surgical .specimen of the surgical cases. The results of the autopsies performed are included. The technique failed in 16 of 73 cases, but in the others a clear visualization of the inferior vena cava and the renal veins was obtained. [ABSTRACT FROM AUTHOR]

1. The authors made quantitative determinations of the elastin content of the aorta and the pulmonary artery in autopsy tissue specimens from Japanese varying in age from newborn infants to an 81-year old, in cases of accidental deaths (35 males and 22 females), using Scarselli's method. 2. Preliminary electron microscopic observations revealed that elastic fibers of rabbit aorta were fairly selectively diminished by the 4 per cent pancreatin solution, pH 9.5, which was used in Scarselli's method. 3. Elastin content of the aorta in each decade is as follows: 0 to 10 years, 32.9 per cent per nig of sample, dry weight; 11 to 20 years, 36.0 per cent; 21 to 30 years, 29.3 per cent; 31 to 40 years, 24.8 per cent; 41 to 50 years, 25,1 per cent; 51 to 60 years, 21.6 per cent; 61 to 70 years, 22.0 per cent; and 71 to 81 years, 21.1 per cent. 4. Elastin content of the pulmonary artery in each decade is as follows: 0 to 10 years, 27.7 per rent; 11 to 20 years, 31.2 per cent; 21 to 30 years, 26.8 per cent; 31 to 40 years, 27.4 per cent; 41 to 50 years, 27.6 per cent; 51 to 60 years, 25.4 per cent; 61 to 70 years, 23.6 per cent; and 71 to 80 years, 27.5 per cent. Elastin content of the pulmonary artery shows the maximal value in the 2nd decade, as does the aorta, but the decrease of the content is far less marked than that of the aorta. 5. The possible significance of these results was discussed. [ABSTRACT FROM AUTHOR]

An autopsy case report of salmonella infection (group C2) of an arterioselerotic aneurysm of the aorta is presented. Organisms were seen in tissue sections, recovered from postmortem blood culture and demonstrated in the aneurysm by fluorescent antibody technique. The authors are indebted to Dr. Israel Davidsohn, Dr. John G. Gruhn, Dr. Chang Ling Lee, and Mr. Milton Goldin for their valuable assistance. [ABSTRACT FROM AUTHOR]

The findings are discussed in three patients with isolated dissecting aneurysm of the artery to the superior pole of the right kidney. These were incidental findings at autopsy and did not contribute to death, which in one case was due to (cerebral trauma secondary to a fall, in another to bronchopneumonia, and in the third, to hemorrhage from esophageal varices. Degenerative changes were found in the media of arteries remote from the site of involvement, and it is thought that these were a predisposing factor in the development of the dissection, which occurred as a preterminal event in all cases. [ABSTRACT FROM AUTHOR]

Twenty-nine postmortem coronary arteriograms were correlated with electrocardiographic and anatomic findings. Accurate correlation with anatomic findings was found; electrocardiographic correlation was less satisfactory. [ABSTRACT FROM AUTHOR]

Tricuspid valve perforation with pacemaker lead is one of the extremely rare complications of transvenous pacemaker implantation. Approximately all reported cases have been diagnosed at autopsy. The authors present a case of tricuspid valve perforation caused by pacemaker lead that was diagnosed during cardiac surgery and treated successfully by removing the lead and suturing the tricuspid valve. [ABSTRACT FROM AUTHOR]

Owing to the operation of Nov. 1944, this patient lived for 8 years and 4 months. This was a dissecting aneurysm of a hypoplastic left internal carotid artery healed in part, and in part showing signs of new lesions. In consequence, the presence of other aneurysms could be foreseen. The patient died at the age of 39, from the rupture of another aneurysm which in all probability was also a dissecting aneurysm. The autopsy report reveals that there were definitely four other aneurysms: one on the ligated left internal carotid (see figure 1), one on the right internal carotid which ruptured and caused death (an indicator thread was placed in the canal caused by the rupture) (see figure 2), and two more on the vertebral arteries (see figures 3 and 4). [ABSTRACT FROM AUTHOR]

A letter to the editor is presented in response to the article "Assessment of Association Between Neutrophil-to-Lymphocyte Ratio and Coronary Artery Ectasia" by E. Yalcinkaya and colleagues in the previous issue of journal "Angiology."

A letter to the editor is presented in response to the article "Neutrophil-to-lymphocyte ratio is associated with severity of coronary artery ectasia" by B. Sarli and colleagues that appeared in the previous issue of medical journal "Angiology."