Abril - 2017

52 / 103

Silveira LAM et al.
336 Rev Assoc Med Bras 2017; 63(4):336-340
ORIGINAL ARTICLE
Implications of alcoholic cirrhosis in atherosclerosis of
autopsied patients
Luciano Alves Matias da Silveira1*, Bianca Gonçalves Silva Torquato1, Mariana Silva Oliveira1, Guilherme Ribeiro Juliano 1,
Lívia Ferreira Oliveira1, Camila Lourencini Cavellani1, Luciana Santos Ramalho1, Ana Paula Espindula1,
Vicente de P aula Antunes Teixeira1, Mara L úcia F onseca Ferraz1
1General Pathology Sector, Biological and Natural Sciences Institute (ICBN), Universidade Federal do Triângulo Mineiro (UFTM), Uberaba, MG, Brazil
Summary
Study conducted at the General Pathology
Division, Universidade Federal do Triângulo
Mineiro (UFTM), Uberaba, MG, Brazil
Article received: 6/29/2016
Accepted for publication: 10/19/2016
*Correspondence:
Disciplina de Patologia Geral, Instituto de
Ciências Biológicas e Naturais, UFTM
Address: Av. Frei Paulino, 30
Uberaba, MG – Brazil
Postal code: 38025-180
Introduction: Alcoholism is a major public health problem, which has a high
social cost and affects many aspects of human activity. Liver disease is one of the
first consequences of alcohol abuse, and steatosis, liver cirrhosis and hepatitis
may occur. Other organs are also affected with pathological changes, such as
pancreatitis, cardiomyopathies, dyslipidemias and atherosclerosis.
Objective: To identify the occurrence and degree of atherosclerosis in alcohol-
-dependent individuals with liver cirrhosis, observing macroscopic and micros-
copic changes in lipid and collagen deposits and in the liver. We also aimed to
verify the association of lipid and collagen fiber deposits with gender, age and
body mass index, and to relate alcoholism, liver cirrhosis and atherosclerosis.
Method: We performed a study based on autopsy reports of patients with
alcoholic liver cirrhosis, with analysis of aorta and liver fragments to verify the
occurrence and degree of atherosclerosis, as well as collagen contents.
Results: Microscopic atherosclerosis was higher in young subjects (early injury)
and in patients with alcoholic liver cirrhosis. The macroscopic analysis of
atherosclerosis in aortas showed that patients inmore advanced age groups presented
more severe classifications. Atherosclerosis, both micro and macroscopically, and
the percentage of fibrosis in the liver and aorta were more expressive in females.
Conclusion: Cirrhotic patients presented a higher percentage of fibrosis and
lipidosis, and may represent a group susceptible to the accelerated progression of
cardiovascular diseases. Investigative studies contribute to targeting health-promoting
interventions, reducing the mortality and costs of treating cardiovascular disease.
Keywords: atherosclerosis, alcoholic liver cirrhosis, autopsy.
Introduction
Alcoholism is a major public health problem and has a
high social cost, affecting various aspects of human acti-
vity.1 In the liver, the alcohol produces toxic products
such as acetaldehyde and acetic free radicals, highly reac-
tive and potentially damaging to liver cells.2 Acetaldehyde
is one of the causes of liver fibrogenesis, which triggers
an interrelationship between two cell types resident in
the hepatic sinusoids: Kupffer cells and stellate Ito cells.3
Liver disease is one of the first consequences of alco-
hol abuse.4,5 Some complications include steatosis, liver
cirrhosis and hepatitis, but other organs are also affected,
with pathological changes such as pancreatitis, cardio-
myopathy, cardiac arrhythmias, hypertension, hemor-
rhagic outbreak, anemia, cancer, immunosuppression,
sudden death, dyslipidemia and atherosclerosis.1,6,7
These products can interfere with the normal me-
tabolism of other nutrients, particularly lipids, and con-
tribute to liver cell damage. Atherosclerosis is the term
used to describe “damage to the large and medium-sized
arteries with deposit of yellow plaques containing cho-
lesterol and lipoid material.” Such plaques – formed by
the proliferation of smooth muscle cells, cholesterol de-
position and infiltration of mononuclear cells – reduce