CVD 1 Flashcards
pathophysiological events of atherosclerosis:
inflammation and activation of __ cells
__ deposition and modification (__ cell formation)
pathophysiological events of atherosclerosis:
inflammation and activation of endothelial cells
lipoprotein deposition and modification (foam cell formation)
pathophysiological events of atherosclerosis:
__ formation, __ core, thrombosis, and __
precipitation of __ events
pathophysiological events of atherosclerosis:
plaque formation, necrotic core, thrombosis, and remodeling
precipitation of acute events
when do atherosclerosis symptoms arise
only once the artery is severely blocked
when do atherosclerosis warning signs appear
sometimes days or weeks before a medical emergency
3 types of atherosclerosis symtpoms
neurological
pulmonary
cardiological
neurological symptoms of atherosclerosis
dizziness and fatigue
pulmonary symptoms of atherosclerosis
shortness of breath
cardiological symptoms of atherosclerosis
chest discomfort/pain
symptoms of stroke
- Sudden numbness or weakness in face, arms, or legs (especially on one side of body)
- Sudden trouble speaking or understanding others
- Slurred or confused speech
- Trouble seeing in one or both eyes
- Severe dizziness or loss of balance
- Trouble walking
- Sudden and severe headache
symtpoms of stroke are typically located
only in one side of the body
symptoms of heart attack
- Chest pain (mild discomfort or severe, crushing pain)
- Pain in one or both arms or shoulders
- Discomfort in neck or jaw
- Nausea or vomiting
- Heart palpitations
- Anxiety or a feeling of “impending doom”
- Sweating, dizziness, and/or fainting
what symptom can be both stroke and heart attack
dizziness
__ is causal of atherosclerosis
LDL is causal of atherosclerosis
3 steps of atherosclerosis
- initiation
- progression
- rupture
initiation:
__ dysfunction
atherogenic __ deposition
__ conditions
Injury/cell death, glycocalyx degradation, hyperpermeability, leukocyte adhesion
initiation:
endothelial dysfunction
atherogenic lipid deposition
proinflammatory conditions
Injury/cell death, glycocalyx degradation, hyperpermeability, leukocyte adhesion
progression:
__
formation of __
__ and necrotic cores
progression:
vasoconstriction
formation of fatty streak
plaques and necrotic cores
rupture:
impaired __
__ Atherothrombosis
intraplaque __/__
rupture:
impaired inflammation
resolution Atherothrombosis
intraplaque hemorrhage/neoangiogenesis
immune system LDL steps
- cytokines oxidize LDL particles
- oxidized LDL particles are internalized by macrophages –> become foam cells
3 steps of foam cell formation
capture
rolling
penetration
foam cell formation: capture
__ capture by E-Selectins
foam cell formation: capture
leukocytes capture by E-Selectins
foam cell formation: rolling
__ rolling, activation of __, adhesion to __
this all increases endothelial __
foam cell formation: rolling
leukocyte rolling, activation of chemokines, adhesion to endothelial cells
this all increases endothelial permeability
foam cell formation: penetration
__ penetrates arterial intima
foam cell formation: penetration
monocyte penetrates arterial intima
final step of foam cell formation
monocyte uptakes __ molecules via __ receptors and forms __ on __ wall
final step of foam cell formation
monocyte uptakes LDL molecules via scavenger receptors and forms plaque on arterial wall
pathways that activate __ expression affect atherosclerosis by __ inflammation
pathways that activate NF-kB expression affect atherosclerosis by increasing inflammation
characteristics of vulnerable plaques
thickening and accumulation of lipids and foam cells –> rupture
4 therapeutic options to treat atherosclerosis
- environmental factor modification
- drug therapy
- clinical intervention
- gene therapy
environmental modification to treat atherosclerosis
- smoking cessation
- weight management
- physical activity interventions
drug therapy for atherosclerosis
- HMG-CoA reductase inhibitors
- Ezetimbe
- Fibrates
- Anti-hypertensive agents
- Anti-hyperglycemic agents
clinical interventions for atherosclerosis
- intra-arterial catheterization balloon angioplasty
- stenting
- operation
gene therapy for atherosclerosis
- genetic manipulation of scavenger receptors by delivering a transgene or gene blockade
- EX: decoy oligonucleotides, siRNA
n-6 FA __ inflammation
n-3 FA __ inflammation
n-6 FA increase inflammation
n-3 FA decrease inflammation
general benefits of n-3 FA
- inflammation
- metabolic syndrome
- some cancers
- pregnancy
- brain and CNS
- CVD
n-3 FA help inflammation by improving __ function
n-3 FA help inflammation by improving immune function
n-3 FA help metabolic syndrome by improving __
n-3 FA help metabolic syndrome by improving insulin sensitivity
n-3 FAs help cancer by limiting __ and causing a better response to __
n-3 FAs help cancer by limiting tumor growth and causing a better response to chemotherapy
n-3 FA in CVD helps (3)
- BP
- plasma lipids
- vascular/cardiac function
n-3 FA in atherosclerosis
decreased arterial __ deposition
decreased __ cytokines
decreased __ cells
increased __ __ mediators
n-3 FA in atherosclerosis
decreased arterial lipid deposition
decreased pro-inflammatory cytokines
decreased pro-inflammatory cells
increased anti-inflammatory lipid mediators
pro-inflammtory cytokines reduced by n-3 FA
monocytes
macrophages
dendritic cells (DC)
increased anti-inflammatory lipid mediators by n-3 FA
eicosanoids
resolvins
protectins
decreased arterial lipid depositon by n-3 FA
arterial LpL
arterial macrophages
decreased pro-inflammatory cells
activation endothelium
NE/MO recruitment
DC maturation
