Renovascular Disease - Lilach O. Lerman

Zilun Li, M.D.

Metabolic syndrome (MetS) is a constellation of risk factors for cardiovascular (CV) disease that include obesity, hyperlipidemia, insulin resistance, and hypertension. MetS doubles the risk for CV disease, more than triples the risk for CV mortality, and raises the risk for type 2 diabetes by about 5-fold. Its prevalence is increasing to epidemic proportions not only in the US and urbanized world, but also in developing countries. It affects up to 25% of adults in the US and 20-30% of the adult population in most countries, and continues to rise dramatically. The increased mortality of people with the MetS even in its earlier phases, suggests that the initial site of CV injury in MetS might in fact reside in the microcirculation of the heart. However, the mechanism of its momentous effects remains to be defined.

Our team has applied Multi-detector computed tomography (MDCT) and Magnetic Resonance Image (MRI) to assess the effects of MetS on the myocardial and renal structures and functions both at baseline and under challenge. The evaluation of microvascular endothelial function has been one of our major concerns. We have also been utilizing high resolution micro-CT to identify early changes of cardiac and renal vasculature.

I am currently engaged in using cutting-edge MDCT, MRI, and micro-CT as well as physiological and biological techniques to study underlying mechanisms of renal and cardiovascular stenosis, microvascular dysfunction, and remodeling in the unique Ossabaw pig model that develops MetS with a high cholesterol diet and a sedentary lifestyle. These studies are clinically significant in that they may shed important light on the mechanisms of development of MetS, which could ultimately lead to preventive and therapeutic measures.