Measures of vascular dysfunction, monocyte subsets and circulating microparticles in patients with diffuse coronary artery disease

Brown, Richard (2018). Measures of vascular dysfunction, monocyte subsets and circulating microparticles in patients with diffuse coronary artery disease. University of Birmingham. M.D.

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Abstract

Diffuse, multi vessel coronary artery disease (CAD) affects about one third of patients with CAD and is associated with worse outcomes. Abnormal vascular stiffness and function (e.g., reflected by increased endothelial microparticles and diminished microvascular endothelial-mediated responses), cell mediated pro-inflammatory status (e.g., reflected by levels of specific monocyte subsets), and platelet function (e.g., increased monocyte-platelet aggregates (MPAs) and platelet microparticles) have established roles in CAD pathogenesis but their contribution to the unfavourable diffuse CAD form is unclear. The aim of this study was to compare measures of vascular function, monocyte subsets, MP As, and endothelial and platelet microparticles in patients with diffuse and focal CAD and subjects without CAD. Additionally, prospective changes in these characteristics were analysed over one year. I found increased counts of aggregates of Mon2 monocyte subset with platelets and apoptotic endothelial microparticles in patients with diffuse CAD and I identified a negative correlation between Mon2 MPAs and microvascular endothelial function and increased diastolic elastance. My findings suggest that excessive levels of Mon2 aggregates with platelets and apoptotic endothelial micropa1iicles could be important contributors to the diffuse type of CAD by a mechanism involving microvascular endothelial dysfunction and abnonnal cardio-vascular interactions.

Type of Work:

Thesis (Higher Doctorates > M.D.)

Award Type:

Higher Doctorates > M.D.

Supervisor(s):