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The optimization of the diagnosis and invasive treatment thereby of underlying of the morphofunctional and biochemical predictors of coronary restenosis


Author: Popovici Ion
Degree:doctor habilitat of medicine
Speciality: 14.00.06 - Cardiology and Reumatology
Year:2011
Scientific consultant: Savelie Costin
doctor habilitat, associate professor (docent)
Institution: Medical-Sanitary Public Institution Institute of Cardiology

Status

The thesis was presented on the 18 November, 2011
Approved by NCAA on the 22 December, 2011

Abstract

Adobe PDF document1.01 Mb / in romanian

Summary

The theses consists of 198 pages, contains introduction, 6 chapters, bibliography by 236 sources, 55 tables and 39 figures. The results are published in 81 scientific works.

Domain of research: cardiology

Aim of research: underlying of the morphofunctional and biochemical predictors of coronary restenosis secondary of PCI treatment and the pathways of interventional approach optimization.

Objectives of research: Evaluation of the factors influencing the ISR, of statine treatment efficiency as well as underlying of the restenosis mechanisms through IVUS. The expression and quantity assessment of the micro-RNA/143/145, collagenase and its specific tissue inhibitor in biologic pattern of stent restenosis. Elaboration and validation of the technical options of ISR.

Novelty and originality of research: Primary are evaluated aspects of modification of the smooth vascular cell (SMC) phenotype in ISR, of the extracellular matrix reorganization, as well as of the inflammatory process in neointima.

Theoretical significance: The resolved scientific problem in thesis concerns underlying of some key mechanisms of pathogenesis of the morphological substrate of IRS, of cell migration, and of extracellular matrix remodeling. Ii is proven the role of micro-RNA/143/145 expression and quantity reducing in proliferation of SMCs which form an important cellular stock of neointima. Is established the collagenase expression elevation due to its specific tissue inhibitor expression diminution as a mechanism of the extracellular matrix reorganization resulting in degraded collagen type I accumulation in neointima representing its molecular component.

Applied value: Is emphasized the predictive value of some indices regarding anatomic characteristics of boarded coronary segment and technical options of stent implantation, cardiovascular risk factors referred to IRS incidence as well as the diagnostic and guide feasibility of IVUS concerning coronary artery stenosis correction thereby angioplasty with stent. The options of stent restenosis re-boarding are validated.

Practical implementation: the study results were proven as scientific point and have been implemented in the clinic of the Institute of Cardiology, in private clinic “Medparc” and in the State Medical and Pharmaceutical University „Nicolae Testemitanu”.