Vascular Fibrosis Correlates with Hypertension, Kidney Function, and Diabetes in a Wide Range of Vascular Tissues
TC Cornish, K Lecksell, MK Halushka. Johns Hopkins Medical Institutions, Baltimore, MD
Background: Chronic disease states are thought to affect vascular fibrosis in atherosclerosis-prone, large caliber blood vessels. We compared the degree of fibrosis in these vessels to fibrosis in other medium-sized atherosclerosis resistant vessels from the same subjects to determine if vascular fibrosis is a global phenomenon.
Design: Eight unique blood vessels (carotid, coronary, dorsalis pedis, iliac, internal mammary, mesenteric, pulmonary and renal arteries) were harvested from 100 subjects undergoing autopsy, generating 17 vascular tissue microarrays (TMAs). Slides cut from TMA blocks were stained with Masson's trichrome, and automated image analysis methods were used to quantify fibrosis in these vessels. Clinical and sociodemographic variables from the subjects were evaluated relative to the amount of fibrosis present in the tunica media and tunica intima using correlation and t-tests.
Results: In 7 of the 8 studied vessels, the percentage of fibrosis in the tunica media was associated with a clinical history of hypertension (overall p < 0.001, t-test). Only the pulmonary artery, which is not subject to systemic pressures, did not associate with hypertension. Also, for any given subject, poor renal function (estimated glomerular filtration rate < 30 ml/min/1.73 m; p < 0.001) and a history of diabetes (p = 0.008) was associated with an overall increase in medial fibrosis. The age, sex, ethnicity, and smoking history of a subject showed no correlation with the degree of fibrosis in any vessel. Media tunica fibrosis was strongly correlated among all vessels within a given subject (r = 0.24 to 0.72; p < 0.03).
Conclusions: This study is the first to compare the extent of fibrosis in eight distinct blood vessels collected from the same subjects. We confirmed that hypertension, attenuated kidney function and diabetes are risk factors for medial fibrosis in atherosclerosis-prone vessels, and identified new associations in smaller atherosclerosis-resistant vessels. We demonstrated that medial vascular fibrosis is a global process within a given subject, as demonstrated by strong correlations among vessels within a given subject. Finally, a lack of correlation between age and medial fibrosis supports the hypothesis that vessels age as a result of chronic disease, independent of chronological age. These findings advance our understanding of the role of chronic disease in vascular fibrosis.
Tuesday, March 10, 2009 1:00 PM
Poster Session IV # 56, Tuesday Afternoon