Madrid, 22 Mar Activation of the bone marrow could play a fundamental role in the origin and development of atherosclerosis, the underlying process of many cardiovascular diseases such as heart attack or stroke. A study by a team of researchers from Spain's National Center for Cardiovascular Research (CNIC), led by cardiologists Valentín Fuster and Borja Ibáñez, suggests that bone marrow is activated in response to cardiovascular risk factors. This activation leads to an increase in inflammatory cells in the blood, which trigger a process that would lead to the onset and subsequent progression of atherosclerotic disease, reports a CNIC note released today, following the publication of the results in the European Heart Journal. Atherosclerosis is a process by which a progressive deposition of fat and inflammatory material occurs on the walls of the arteries, the so-called “atheroma plaques”, and after many years of silent course, such plaques can cause thrombosis, causing acute myocardial infarction, cerebral stroke or even sudden death. Atherosclerosis is considered the “silent killer”, as it is the most frequent cause of death worldwide, and it has a long course before giving its face. Therefore, identifying atherosclerotic disease in its early stages, before it even causes symptoms, is one of the main objectives of the PESA-CNIC-Santander (Progression of Early Subclinical Atherosclerosis) study led by Valentín Fuster, director general of the CNIC and medical director of the Mount Sinai Hospital in New York. This work lays the foundations to fight this disease, attacking the roots of its development, emphasized the CNIC. Borja Ibáñez, director of the Department of Clinical Research at CNIC and cardiologist at the Fundación Jiménez Díaz University Hospital, stressed that “the early identification of atherosclerosis will allow us to advance our understanding of the mechanisms by which it occurs, which opens the door to finding new treatments that can prevent the progression of this lethal disease”. The researcher has emphasized that atherosclerosis has been known for many decades, but also that the ultimate mechanisms responsible for the onset of the disease have not been fully clarified. CNIC cardiologist Ana Devesa, the first author of the article, explained that the risk factors that cause bone marrow activation are those that are related to metabolic syndrome: central obesity (increased waist circumference), high triglycerides, low HDL cholesterol, elevated blood glucose, insulin resistance and high blood pressure. These factors cause an increase in metabolic activity in the bone marrow that can be observed using advanced imaging techniques, such as hybrid positron emission tomography (PET) and magnetic resonance imaging (MRI) technology, a technology available from the CNIC. “The increased activity in the bone marrow triggers an inflammatory process that activates the process of atherosclerosis, from its earliest stages to the appearance of the established plaque,” said Dr. Devesa. The work has been carried out within the PESA CNIC-Santander study, a joint project between the CNIC and Banco Santander that began more than 10 years ago and which involves the participation of 4,200 middle aged (40-55 years old when they were included in the study), apparently healthy, who are regularly followed by cutting-edge imaging technology, as well as through blood samples. The study has recently been expanded and will last until at least 2029, so that follow-up will be up to almost 20 years in all participants, something that its promoters say is “unique” in the world. CHIEF rc/lml
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