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European Heart Journal 1994 15(Supplement C):57-61; doi:10.1093/eurheartj/15.suppl_C.57
Copyright © 1994 by the European Society of Cardiology.
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© 1994 The European Society of Cardiology

Infection and Intimal Thickening: Evidence from Coronary Arteries in Children

E. Pesonen

The Children's Hospital, University of Helsinki Helsinki, Finland

Correspondence: Erkki Personen, MD. The Children's Hospital, University of Helsinki, Stenbäckinkatu 11, 00290 Helsinki, Finland

Post-mortem examination in children may reveal narrowing of coronary artery diameter by up to 60% due to intimal thickening. This is statistically associated with recent or interciurrent infection. Endothelial injury is known to be caused by septicamia, for example, and endothelial injury initiates atherogenesis. Elevation of tumour necrosis factor {alpha} (TNF{alpha}) levels is a feature of both septicaemia and atheroma, and TNF{alpha} can damage endothelium, stimulate platelet-derived-growth-factor (PDGF) secretion and thereby promote vascular smooth muscle cell proliferation. Episodes of infection-related endothelial damage, leading to intimal thickening followed by partial regression, may start in infancy and contribute cumulatively to the development of coronary atheroma.

Key Words: Infection • endothelium • smooth muscle cell • intimal thickening • tumour necrosis factor • interleukin-1 • platelet derived growth factor • atherosclerosis


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