The Non-Invasive Assessment of Coronary Atherosclerosis

Birnie, David Hugh (1997) The Non-Invasive Assessment of Coronary Atherosclerosis. MD thesis, University of Glasgow.

Abstract

Coronary heart disease (CHD) is the biggest single cause of death in the United Kingdom. The development of valid and reliable techniques of non-invasive assessment of coronary atherosclerosis would be invaluable in a number of ways and this thesis examined three techniques (titres of antibodies to heat shock protein 65, ultrasonographic measurement of carotid artery intimal-medial thickening (IMT) and levels of fibrinolytic factors). The second objective was to investigate the role of the immune response to hsp65 and H.pylori and of the endogenous fibrinolytic system in the pathogenesis of CHD. Anti-hsp65 titres correlated with the severity and extent of coronary atherosclerosis, but with insufficient predictive accuracy to be a useful clinical test. H.pylori would appear to be an important influence on IgG anti-hsp65 as the eradication of H.pylori lead to a significant fall in anti-hsp65 titre (from 25.64 AU/ml to 13.75 AU/ml, p=0.033). Thus an auto-immune response to hsp65 maybe the mechanism by which H.pylori lead to increased CHD risk. Significant correlations between carotid IMT and the angiographic severity and extent of coronary atherosclerosis were demonstrated. However the correlations were quite modest and this casts doubt on the use of carotid IMT as a surrogate marker of CHD mortality and morbidity. There was no evidence of a correlation between plasma PAI-1 antigen or activity or t-PA antigen levels and coronary atherosclerosis. Novel data is presented suggesting that gammaGT is an important influence on PAI-1 antigen levels in a normotriglyceridaemic population.

• Item Type: Thesis (MD)
• Qualification Level: Doctoral
• Additional Information: Adviser: Elizabeth Holme
• Keywords: Medicine
• Date of Award: 1997
• Depositing User: Enlighten Team
• Unique ID: glathesis:1997-74849
• Copyright: Copyright of this thesis is held by the author.
• Date Deposited: 27 Sep 2019 15:51
• Last Modified: 27 Sep 2019 15:51
• URI: https://theses.gla.ac.uk/id/eprint/74849