The roles of androgens on cardiovascular physiology and pathophysiology are controversial as both beneficial and detrimental effects have been reported. Although the reasons for this discrepancy are unclear, multiple ...The roles of androgens on cardiovascular physiology and pathophysiology are controversial as both beneficial and detrimental effects have been reported. Although the reasons for this discrepancy are unclear, multiple factors such as genetic and epigenetic variation, sex-specificity, hormone interactions, drug preparation and route of administration may contribute. Recently, growing evidence suggests that androgens exhibit beneficial effects on cardiovascular function though the mechanism remains to be elucidated. Endothelial cells （ECs） which line the interior surface of blood vessels are distributed throughout the circulatory system, and play a crucial role in cardiovascular function. Endothelial progenitor cells （EPCs） are considered an indispensable element for the reconstitution and maintenance of an intact endothelial layer. Endothelial dysfunction is regarded as an initiating step in development of atherosclerosis and cardiovascular diseases. The modulation of endothelial functions by androgens through either genornic or nongenomic signal pathways is one possible mechanism by which androgens act on the cardiovascular system. Obtaining insight into the mechanisms by which androgens affect EC and EPC functions will allow us to determine whether androgens possess beneficial effects on the cardiovascular system. This in turn may be critical in the prevention and therapy of cardiovascular diseases. This article seeks to review recent progress in androgen regulation of endothelial function, the sex-specificity of androgen actions, and its clinical applications in the cardiovascular system.展开更多
The first case of Prinzmetal angina was described in 1959 by Prinzmetal, et al. Since this description, several triggering factors have been associated with vasospastic angina （VA） and included： illicit drugs such ...The first case of Prinzmetal angina was described in 1959 by Prinzmetal, et al. Since this description, several triggering factors have been associated with vasospastic angina （VA） and included： illicit drugs such as cocaine, amphetamine or marijuana, but also bitter-orange, alcohol, butane, chemotherapy drugs, over-the-counter medication and different antibiotics. Smoking is also a major risk factor for developing VA.t21 Thus, except for smoking, many of conventional atherosclerosis risk factors do not appear to be applicable to VA.t21 However, vasospastic angina can also occur without any triggering factor.展开更多
To investigate the association of carotid arterial intima- media thickness (IMT) with principal cardiovascular risk factors in the elderly. Methods. Carotid arterial IMT was measured by high resolution B mode ultrasou...To investigate the association of carotid arterial intima- media thickness (IMT) with principal cardiovascular risk factors in the elderly. Methods. Carotid arterial IMT was measured by high resolution B mode ultrasound in 94 elderly subjects (old- aged group), and compared with subjects aged Results. In comparison with the middle- aged group, the prevalence of coronary heart disease, cerebral vascular disease, hypertension and diabetes mellitus was significantly higher, and serum cholesterol and systolic blood pressure were also significantly higher in old- aged group. Although there was no obvious difference in IMT between the two groups, carotid plaque and carotid wall thickening were more frequently found in old- aged group. Age, systolic blood pressure and serum cholesterol were shown as the independent determinants for carotid IMT in the total participants, whereas no such independent relation was found in old- aged group. Conclusion. Age is the major risk factor for carotid atherosclerosis in the elderly. In other words, the occurrence of carotid atherosclerosis is the result of advancing age combined with the effect of multiple cardiovascular risk factors.展开更多
Angiotensin （Ang）-（1-7） is recognized as a new bioactive peptide in renin-angiotensin system （RAS）. Ang-（1-7） is a counter-regulatory mediator of Ang-II which appears to be protective against cardiovascular di...Angiotensin （Ang）-（1-7） is recognized as a new bioactive peptide in renin-angiotensin system （RAS）. Ang-（1-7） is a counter-regulatory mediator of Ang-II which appears to be protective against cardiovascular disease. Recent studies have found that Ang-（1-7） played an important role in reducing smooth muscle cell proliferation and migration, improving endothelial function and regulating lipid metabolism, leading to inhibition of atherosclerotic lesions and increase of plaque stability. Although clinical application of Ang-（1-7） is restricted due to its pharmacokinetic properties, identification of stabilized compounds, including more stable analogues and specific delivery compounds, has enabled clinical application of Ang-（1-7）. In this review, we discussed recent findings concerning the biological role of Ang-（1-7） and related mechanism during atherosclerosis development. In addition, we highlighted the perspective to develop therapeutic strategies using Ang-（1-7） to treat atherosclerosis.展开更多
Objective: To study the cause and mechanism of transplantation vasculopathy which characterized by accelerated graft arteriosclerosis (AGA), we established a mouse aorta graft model. Methods: A segment of thoracic aor...Objective: To study the cause and mechanism of transplantation vasculopathy which characterized by accelerated graft arteriosclerosis (AGA), we established a mouse aorta graft model. Methods: A segment of thoracic aortas of B10.A (2R) mice were transplanted to C57BL/10 mice abdominal aorta by end to side anastomoses. The different time point collected grafts were analyzed by morphological, histochemical and electro microscopic methods. Results: Rejection was manifested as a concentric progressive destruction of the smooth muscle cells. In contrast, the endothelial inflammation and subsequent neointimal proliferation characteristic of AGA was localized to the regions of turbulent flow, i.e. the junction of the graft with the recipient aorta. Conclusion: This model separates the processes of rejection and neointimal formation which usually manifested together in the lesion of AGA, elucidate that different mechanisms control vascular rejection and neointimal formation in chronic rejection.展开更多
Objective To investigate the cause of high cardiovascular lethality in patients with diabetics mellitus. Methods Sections from autopsied coronary arteries and myocardium of dead patients with non-insulin-dependent dia...Objective To investigate the cause of high cardiovascular lethality in patients with diabetics mellitus. Methods Sections from autopsied coronary arteries and myocardium of dead patients with non-insulin-dependent diabetics mellitus and 12 dead control subjects were used for histomorphometric studies. Results The coronary atherosclerotic lesion in diabetics patients was not different in severity fi＇om those in controls. Nor was there difference in number ofmyofibers or diameters of myoeardic fibers and capillaries.But the capillary density and the ratio of capillary number to myocardic fiber number in diabetics group were significeantly reduced compared with control group（P〈0.0 l）,and the capillary basement membrane in the former was significantly thicker than in the latter（P〈0.01）.Conclision The decrease in number of capillaries and the thickening of basement membrane enhance myocardiac vulnerability to further ischemia and hypoxia,which may undelie high lethality of myocardiopathy in diabetic patients.展开更多
Hypertension is a leading cause of mortality and morbidity around the world and,prevalence of hypertension is increasing with aging.Hypertension in the elderly is associated with increased occurrence rates of sodium s...Hypertension is a leading cause of mortality and morbidity around the world and,prevalence of hypertension is increasing with aging.Hypertension in the elderly is associated with increased occurrence rates of sodium sensitivity,isolated systolic hypertension,and ＇white coat effect＇.Arterial stiffness and endothelial dysfunction also increase with age.These factors should be considered in selecting antihypertensive therapy.The prime objective of this therapy is to prevent stroke.The fmdings of controlled trials show that there should be no cut-off age for treatment.A holistic program for controlling cardiovascular risks should be fully discussed with the patient,including evaluation to exclude underlying causes of secondary hypertension,and implementation of lifestyle measures.The choice of antihypertensive drug therapy is influenced by concomitant disease and previous medication history,but will typically include a thiazide diuretic as the first-line agent;to this will be added an angiotensin inhibitor and/or a calcium channel blocker.Beta blockers are not generally recommended,in part because they do not combat the effects of increased arterial stiffness.The hypertension-hypoten-sion syndrome requires case-specific management.Drug-resistant hypertension is important to differentiate from faulty compliance with medication.Patients resistant to the third-line drug therapy may benefit from treatment with extended-release isosorbide mononitrate.A trial of spironolactone may also be worthwhile.展开更多
基金The researches described in this article were partially supported by grants from the National Natural Science Foundation of China （No. 81570271 and 81400357） and NIH （UL1 RR024996）. We are very grateful to John R Lee （Assistant Professor of Medicine, Weill Comell Medical College, New York）, and Jeff J Zhu （Research Manager, Weill Comell Medical College, New York） for critical review of the article. The authors have nothing to disclosure.
文摘The roles of androgens on cardiovascular physiology and pathophysiology are controversial as both beneficial and detrimental effects have been reported. Although the reasons for this discrepancy are unclear, multiple factors such as genetic and epigenetic variation, sex-specificity, hormone interactions, drug preparation and route of administration may contribute. Recently, growing evidence suggests that androgens exhibit beneficial effects on cardiovascular function though the mechanism remains to be elucidated. Endothelial cells （ECs） which line the interior surface of blood vessels are distributed throughout the circulatory system, and play a crucial role in cardiovascular function. Endothelial progenitor cells （EPCs） are considered an indispensable element for the reconstitution and maintenance of an intact endothelial layer. Endothelial dysfunction is regarded as an initiating step in development of atherosclerosis and cardiovascular diseases. The modulation of endothelial functions by androgens through either genornic or nongenomic signal pathways is one possible mechanism by which androgens act on the cardiovascular system. Obtaining insight into the mechanisms by which androgens affect EC and EPC functions will allow us to determine whether androgens possess beneficial effects on the cardiovascular system. This in turn may be critical in the prevention and therapy of cardiovascular diseases. This article seeks to review recent progress in androgen regulation of endothelial function, the sex-specificity of androgen actions, and its clinical applications in the cardiovascular system.
文摘The first case of Prinzmetal angina was described in 1959 by Prinzmetal, et al. Since this description, several triggering factors have been associated with vasospastic angina （VA） and included： illicit drugs such as cocaine, amphetamine or marijuana, but also bitter-orange, alcohol, butane, chemotherapy drugs, over-the-counter medication and different antibiotics. Smoking is also a major risk factor for developing VA.t21 Thus, except for smoking, many of conventional atherosclerosis risk factors do not appear to be applicable to VA.t21 However, vasospastic angina can also occur without any triggering factor.
文摘To investigate the association of carotid arterial intima- media thickness (IMT) with principal cardiovascular risk factors in the elderly. Methods. Carotid arterial IMT was measured by high resolution B mode ultrasound in 94 elderly subjects (old- aged group), and compared with subjects aged Results. In comparison with the middle- aged group, the prevalence of coronary heart disease, cerebral vascular disease, hypertension and diabetes mellitus was significantly higher, and serum cholesterol and systolic blood pressure were also significantly higher in old- aged group. Although there was no obvious difference in IMT between the two groups, carotid plaque and carotid wall thickening were more frequently found in old- aged group. Age, systolic blood pressure and serum cholesterol were shown as the independent determinants for carotid IMT in the total participants, whereas no such independent relation was found in old- aged group. Conclusion. Age is the major risk factor for carotid atherosclerosis in the elderly. In other words, the occurrence of carotid atherosclerosis is the result of advancing age combined with the effect of multiple cardiovascular risk factors.
基金This work was supported by National Natural Science Foundation of China （NSFC） （No. 81400265 and No. 81270274）, and Peking University People＇s Hospital Research and Development funds （RDB2014-16）.
文摘Angiotensin （Ang）-（1-7） is recognized as a new bioactive peptide in renin-angiotensin system （RAS）. Ang-（1-7） is a counter-regulatory mediator of Ang-II which appears to be protective against cardiovascular disease. Recent studies have found that Ang-（1-7） played an important role in reducing smooth muscle cell proliferation and migration, improving endothelial function and regulating lipid metabolism, leading to inhibition of atherosclerotic lesions and increase of plaque stability. Although clinical application of Ang-（1-7） is restricted due to its pharmacokinetic properties, identification of stabilized compounds, including more stable analogues and specific delivery compounds, has enabled clinical application of Ang-（1-7）. In this review, we discussed recent findings concerning the biological role of Ang-（1-7） and related mechanism during atherosclerosis development. In addition, we highlighted the perspective to develop therapeutic strategies using Ang-（1-7） to treat atherosclerosis.
文摘Objective: To study the cause and mechanism of transplantation vasculopathy which characterized by accelerated graft arteriosclerosis (AGA), we established a mouse aorta graft model. Methods: A segment of thoracic aortas of B10.A (2R) mice were transplanted to C57BL/10 mice abdominal aorta by end to side anastomoses. The different time point collected grafts were analyzed by morphological, histochemical and electro microscopic methods. Results: Rejection was manifested as a concentric progressive destruction of the smooth muscle cells. In contrast, the endothelial inflammation and subsequent neointimal proliferation characteristic of AGA was localized to the regions of turbulent flow, i.e. the junction of the graft with the recipient aorta. Conclusion: This model separates the processes of rejection and neointimal formation which usually manifested together in the lesion of AGA, elucidate that different mechanisms control vascular rejection and neointimal formation in chronic rejection.
文摘Objective To investigate the cause of high cardiovascular lethality in patients with diabetics mellitus. Methods Sections from autopsied coronary arteries and myocardium of dead patients with non-insulin-dependent diabetics mellitus and 12 dead control subjects were used for histomorphometric studies. Results The coronary atherosclerotic lesion in diabetics patients was not different in severity fi＇om those in controls. Nor was there difference in number ofmyofibers or diameters of myoeardic fibers and capillaries.But the capillary density and the ratio of capillary number to myocardic fiber number in diabetics group were significeantly reduced compared with control group（P〈0.0 l）,and the capillary basement membrane in the former was significantly thicker than in the latter（P〈0.01）.Conclision The decrease in number of capillaries and the thickening of basement membrane enhance myocardiac vulnerability to further ischemia and hypoxia,which may undelie high lethality of myocardiopathy in diabetic patients.
文摘Hypertension is a leading cause of mortality and morbidity around the world and,prevalence of hypertension is increasing with aging.Hypertension in the elderly is associated with increased occurrence rates of sodium sensitivity,isolated systolic hypertension,and ＇white coat effect＇.Arterial stiffness and endothelial dysfunction also increase with age.These factors should be considered in selecting antihypertensive therapy.The prime objective of this therapy is to prevent stroke.The fmdings of controlled trials show that there should be no cut-off age for treatment.A holistic program for controlling cardiovascular risks should be fully discussed with the patient,including evaluation to exclude underlying causes of secondary hypertension,and implementation of lifestyle measures.The choice of antihypertensive drug therapy is influenced by concomitant disease and previous medication history,but will typically include a thiazide diuretic as the first-line agent;to this will be added an angiotensin inhibitor and/or a calcium channel blocker.Beta blockers are not generally recommended,in part because they do not combat the effects of increased arterial stiffness.The hypertension-hypoten-sion syndrome requires case-specific management.Drug-resistant hypertension is important to differentiate from faulty compliance with medication.Patients resistant to the third-line drug therapy may benefit from treatment with extended-release isosorbide mononitrate.A trial of spironolactone may also be worthwhile.
