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Okamoto N, Vengrenyuk Y, Fuster V, Samady H, Yasumura K, Baber U, Barman N, Suleman J, Sweeny J, Krishnan P, Mehran R, Sharma SK, Narula J, Kini AS. Relationship between high shear stress and OCT-verified thin-cap fibroatheroma in patients with coronary artery disease. PLoS One 2020; 15:e0244015. [PMID: 33332434 PMCID: PMC7746187 DOI: 10.1371/journal.pone.0244015] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2020] [Accepted: 12/01/2020] [Indexed: 12/16/2022] Open
Abstract
High-risk coronary plaques have been considered predictive of adverse cardiac events. Both wall shear stress (WSS) in patients with hemodynamically significant lesions and optical coherence tomography (OCT) -verified thin-cap fibroatheroma (TCFA) are associated with plaque rupture, the most common underlying mechanism of acute coronary syndrome. The aim of the study was to test the hypothesis that invasive coronary angiography-based high WSS is associated with the presence of TCFA detected by OCT in obstructive lesions. From a prospective study of patients who underwent OCT examination for angiographically obstructive lesions (Yellow II), we selected patients who had two angiographic projections to create a 3-dimensional reconstruction model to allow assessment of WSS. The patients were divided into 2 groups according to the presence and absence of TCFA. Mean WSS was assessed in the whole lesion and in the proximal, middle and distal segments. Of 70 patients, TCFA was observed in 13 (19%) patients. WSS in the proximal segment (WSSproximal) (10.20 [5.01, 16.93Pa]) and the whole lesion (WSSlesion) (12.37 [6.36, 14.55Pa]) were significantly higher in lesions with TCFA compared to WSSproximal (5.84 [3.74, 8.29Pa], p = 0.02) and WSSlesion (6.95 [4.41, 11.60], p = 0.04) in lesions without TCFA. After multivariate analysis, WSSproximal was independently associated with the presence of TCFA (Odds ratio 1.105; 95%CI 1.007-1.213, p = 0.04). The optimal cutoff value of WSSproximal to predict TCFA was 6.79 Pa (AUC: 0.71; sensitivity: 0.77; specificity: 0.63 p = 0.02). Our results demonstrate that high WSS in the proximal segments of obstructive lesions is an independent predictor of OCT-verified TCFA.
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Affiliation(s)
- Naotaka Okamoto
- Division of Cardiology, Mount Sinai Hospital and Icahn School of Medicine at Mount Sinai, New York, NY, United States of America
| | - Yuliya Vengrenyuk
- Division of Cardiology, Mount Sinai Hospital and Icahn School of Medicine at Mount Sinai, New York, NY, United States of America
| | - Valentin Fuster
- Division of Cardiology, Mount Sinai Hospital and Icahn School of Medicine at Mount Sinai, New York, NY, United States of America
| | - Habib Samady
- Division of Cardiology, Department of Medicine, Emory University School of Medicine, Atlanta, GA, United States of America
| | - Keisuke Yasumura
- Division of Cardiology, Mount Sinai Hospital and Icahn School of Medicine at Mount Sinai, New York, NY, United States of America
| | - Usman Baber
- Division of Cardiology, Mount Sinai Hospital and Icahn School of Medicine at Mount Sinai, New York, NY, United States of America
| | - Nitin Barman
- Division of Cardiology, Mount Sinai Hospital and Icahn School of Medicine at Mount Sinai, New York, NY, United States of America
| | - Javed Suleman
- Division of Cardiology, Mount Sinai Hospital and Icahn School of Medicine at Mount Sinai, New York, NY, United States of America
| | - Joseph Sweeny
- Division of Cardiology, Mount Sinai Hospital and Icahn School of Medicine at Mount Sinai, New York, NY, United States of America
| | - Prakash Krishnan
- Division of Cardiology, Mount Sinai Hospital and Icahn School of Medicine at Mount Sinai, New York, NY, United States of America
| | - Roxana Mehran
- Division of Cardiology, Mount Sinai Hospital and Icahn School of Medicine at Mount Sinai, New York, NY, United States of America
| | - Samin K. Sharma
- Division of Cardiology, Mount Sinai Hospital and Icahn School of Medicine at Mount Sinai, New York, NY, United States of America
| | - Jagat Narula
- Division of Cardiology, Mount Sinai Hospital and Icahn School of Medicine at Mount Sinai, New York, NY, United States of America
| | - Annapoorna S. Kini
- Division of Cardiology, Mount Sinai Hospital and Icahn School of Medicine at Mount Sinai, New York, NY, United States of America
- * E-mail:
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Casolo G, Del Meglio J, Tessa C. Epidemiology and pathophysiologic insights of coronary atherosclerosis relevant for contemporary non-invasive imaging. Cardiovasc Diagn Ther 2020; 10:1906-1917. [PMID: 33381434 PMCID: PMC7758762 DOI: 10.21037/cdt-20-157] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2020] [Accepted: 08/17/2020] [Indexed: 12/20/2022]
Abstract
In the past few years significant changes have taken place in the diagnostic and therapeutic approach to patients with coronary artery disease (CAD) and/or ischemic heart disease (IHD). New discoveries about the development and progression of coronary atherosclerosis have changed the clinical landscape. At the same time a marked decrease in cardiovascular (CV) mortality and CAD incidence have been observed in many Countries but particularly in the most industrialized ones. This fall has been also observed in the incidence of stroke, sudden death, myocardial ischemia, myocardial infarction (MI), and prevalence of CAD. As a consequence, an increasing number of patients with chest pain exhibits non-significant stenosis at both invasive and non-invasive coronary angiography and the rate of coronary vessels revascularizations has greatly reduced. Coronary atherosclerosis and its characteristics have shown to be both diagnostic and therapeutic targets beyond obstructive CAD. The decreased prevalence of CAD in the general population has modified the pre-test probability (PTP) of disease. In this landscape the conventional stress imaging tests appear to have limited accuracy making the diagnosis of obstructive CAD very challenging. These diagnostic tests have been introduced and tested in a population with a much higher probability of disease and therefore the contemporary accuracy of these old tests appear much lower than in the past. In addition, in the past few years the relevance of the traditional ischemia guided coronary intervention strategy has been questioned. Given the low CV events granted by an optimal medical therapy in CAD the major attention has been directed on detecting coronary atherosclerosis. The earlier the better. At the same time, a growing number of data from clinical studies have shown a significant prognostic role for non-obstructive CAD and coronary atherosclerosis. All these facts have shifted the clinicians' attention from the functional evaluation of the coronary circulation to the anatomic burden of disease.
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Affiliation(s)
- Giancarlo Casolo
- Cardiology Department, Versilia Hospital, Lido di Camaiore, Italy
| | | | - Carlo Tessa
- Radiology Department, Versilia Hospital, Lido di Camaiore, Italy
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53
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Sterpetti AV. Inflammatory Cytokines and Atherosclerotic Plaque Progression. Therapeutic Implications. Curr Atheroscler Rep 2020; 22:75. [PMID: 33025148 PMCID: PMC7538409 DOI: 10.1007/s11883-020-00891-3] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/16/2020] [Indexed: 12/19/2022]
Abstract
PURPOSE OF THE REVIEW Inflammatory cytokines play a major role in atherosclerotic plaque progression. This review summarizes the rationale for personalized anti-inflammatory therapy. RECENT FINDINGS Systemic inflammatory parameters may be used to follow the clinical outcome in primary and secondary prevention. Medical therapy, both in patients with stable cardiovascular disease, or with acute events, may be tailored taking into consideration the level and course of systemic inflammatory mediators. There is significant space for improvement in primary prevention and in the treatment of patients who have suffered from severe cardiovascular events, paying attention to not only blood pressure and cholesterol levels but also including inflammatory parameters in our clinical analysis. The potential exists to alter the course of atherosclerosis with anti-inflammatory drugs. With increased understanding of the specific mechanisms that regulate the relationship between inflammation and atherosclerosis, new, more effective and specific anti-inflammatory treatment may become available.
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Affiliation(s)
- Antonio V Sterpetti
- University of Rome Sapienza, Rome, Italy.
- AV Sterpetti- Policlinico Umberto I, Viale del Policlinico, 00167, Rome, Italy.
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Otsuka K, Villiger M, Nadkarni SK, Bouma BE. Intravascular Polarimetry: Clinical Translation and Future Applications of Catheter-Based Polarization Sensitive Optical Frequency Domain Imaging. Front Cardiovasc Med 2020; 7:146. [PMID: 33005632 PMCID: PMC7485575 DOI: 10.3389/fcvm.2020.00146] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2020] [Accepted: 07/10/2020] [Indexed: 11/13/2022] Open
Abstract
Optical coherence tomography (OCT) and optical frequency domain imaging (OFDI) visualize the coronary artery wall and plaque morphology in great detail. The advent of these high-resolution intracoronary imaging modalities has propelled our understanding of coronary atherosclerosis and provided enhanced guidance for percutaneous coronary intervention. Yet, the lack of contrast between distinct tissue types and plaque compositions impedes further elucidation of the complex mechanisms that contribute to acute coronary syndrome (ACS) and hinders the prospective identification of plaques susceptible to rupture. Intravascular polarimetry with polarization-sensitive OFDI measures polarization properties of the coronary arterial wall using conventional intravascular imaging catheters. The quantitative polarization metrics display notable image contrast between several relevant coronary plaque microstructures that are difficult to identify with conventional OCT and OFDI. Tissues rich in collagen and smooth muscle cells exhibit birefringence, while lipid and macrophages cause depolarization. In this review, we describe the basic principles of intravascular polarimetry, discuss the interpretation of the polarization signatures, and outline promising avenues for future research and clinical implications.
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Affiliation(s)
- Kenichiro Otsuka
- Wellman Center for Photomedicine, Harvard Medical School, Massachusetts General Hospital, Boston, MA, United States
| | - Martin Villiger
- Wellman Center for Photomedicine, Harvard Medical School, Massachusetts General Hospital, Boston, MA, United States
| | - Seemantini K Nadkarni
- Wellman Center for Photomedicine, Harvard Medical School, Massachusetts General Hospital, Boston, MA, United States
| | - Brett E Bouma
- Wellman Center for Photomedicine, Harvard Medical School, Massachusetts General Hospital, Boston, MA, United States.,Institute for Medical Engineering and Science, Massachusetts Institute of Technology, Cambridge, MA, United States.,Department of Cardiology, Erasmus University Medical Center, Rotterdam, Netherlands
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55
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Teren A, Vogel A, Beutner F, Gielen S, Burkhardt R, Scholz M, Thiery J, Ceglarek U. Relationship between fermented dairy consumption, circulating short-chain acylcarnitines and angiographic severity of coronary artery disease. Nutr Metab Cardiovasc Dis 2020; 30:1662-1672. [PMID: 32684363 DOI: 10.1016/j.numecd.2020.05.031] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2019] [Revised: 05/13/2020] [Accepted: 05/27/2020] [Indexed: 11/26/2022]
Abstract
BACKGROUND AND AIMS Current epidemiologic data suggest beneficial cardiovascular effects of fermented dairy products (FDP). However, the relationship between FDP consumption and angiographic coronary status has not been previously studied. Furthermore, the role of novel metabolomic biomarkers of cardiovascular risk in this context is unclear. We hypothesize that short-chain acylcarnitines (SCA) reflect the link between FDP intake and angiographic extent of stable coronary artery disease (CAD). METHODS AND RESULTS We recruited 1185 patients admitted for suspected CAD [median age 62 years (interquartile range: 54-69); 714 men (60.3%)]. Prior to coronary angiography, each patient completed a validated Food Frequency Questionnaire. In addition, venous blood was collected from each patient for whole blood metabolomic analysis, using targeted mass-spectrometry. CAD was defined by the presence of ≥1 coronary stenosis ≥50%. Patients with CAD (n = 441) reported lower median FDP intake [86.8 g/day (IQR: 53.4-127.6)] than patients without CAD [n = 744; 103.9 g/day (IQR: 62.9-152.7); p < 0.001]. Upon adjustment for relevant confounders, increased circulating SCA, particularly level of acetylcarnitine (C2) associated with both higher CAD probability [SCA:β(SE) = 0.584 (0.235), p = 0.013; C2:β(SE) = 0.575 (0.242), p = 0.017] and decreased FDP consumption [SCA:β/100 g FDP-increment/day (SE) = -0.785 (0.242), p = 0.001; C2:β(SE) = -0.560 (0.230), p = 0.015]. By mediation analysis, neither SCA nor C2 showed relevant mediator effect linking FDP consumption to the risk of CAD. CONCLUSION Increased consumption of fermented milk was associated with lower prevalence of CAD and correlated inversely with circulating SCA, in particular with acetylcarnitine. No substantial mediator effect of SCA linking fermented milk intake with risk of CAD was found. CLINICAL TRIAL REGISTRY NCT00497887.
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Affiliation(s)
- Andrej Teren
- LIFE - Leipzig Research Center for Civilization Diseases, Germany; University Leipzig, Germany; Department of Cardiology, Angiology and Intensive Care, Detmold, Germany; Klinikum Lippe, Detmold, Germany.
| | - Anika Vogel
- Institute of Laboratory Medicine, Clinical Chemistry and Molecular Diagnostics, University Leipzig, Germany
| | - Frank Beutner
- LIFE - Leipzig Research Center for Civilization Diseases, Germany; University Leipzig, Germany; Department of Internal Medicine/Cardiology, Germany; Heart Center University Leipzig, Germany; Institute of Laboratory Medicine, Clinical Chemistry and Molecular Diagnostics, University Leipzig, Germany
| | - Stephan Gielen
- LIFE - Leipzig Research Center for Civilization Diseases, Germany; University Leipzig, Germany; Department of Cardiology, Angiology and Intensive Care, Detmold, Germany; Klinikum Lippe, Detmold, Germany
| | - Ralph Burkhardt
- LIFE - Leipzig Research Center for Civilization Diseases, Germany; University Leipzig, Germany; Institute of Laboratory Medicine, Clinical Chemistry and Molecular Diagnostics, University Leipzig, Germany
| | - Markus Scholz
- LIFE - Leipzig Research Center for Civilization Diseases, Germany; University Leipzig, Germany; Institute of Medical Informatics, Statistics and Epidemiology, Germany
| | - Joachim Thiery
- LIFE - Leipzig Research Center for Civilization Diseases, Germany; University Leipzig, Germany; Institute of Laboratory Medicine, Clinical Chemistry and Molecular Diagnostics, University Leipzig, Germany
| | - Uta Ceglarek
- LIFE - Leipzig Research Center for Civilization Diseases, Germany; University Leipzig, Germany; Institute of Laboratory Medicine, Clinical Chemistry and Molecular Diagnostics, University Leipzig, Germany
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56
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Impacts of smoking status on the clinical outcomes of coronary non-target lesions in patients with coronary heart disease: a single-center angiographic study. Chin Med J (Engl) 2020; 133:2295-2301. [PMID: 32925280 PMCID: PMC7546875 DOI: 10.1097/cm9.0000000000001024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Background Coronary atherosclerotic plaque could go through rapid progression and induce adverse cardiac events. This study aimed to evaluate the impacts of smoking status on clinical outcomes of coronary non-target lesions. Methods Consecutive patients with coronary heart disease who underwent two serial coronary angiographies were included. All coronary non-target lesions were recorded at first coronary angiography and analyzed using quantitative coronary angiography at both procedures. Patients were grouped into non-smokers, quitters, and smokers according to their smoking status. Clinical outcomes including rapid lesion progression, lesion re-vascularization, and myocardial infarction were recorded at second coronary angiography. Multivariable Cox regression analysis was used to investigate the association between smoking status and clinical outcomes. Results A total of 1255 patients and 1670 lesions were included. Smokers were younger and more likely to be male compared with non-smokers. Increase in percent diameter stenosis was significantly lower (2.7 [0.6, 7.1] % vs. 3.5 [0.9, 8.9]%) and 3.4 [1.1, 7.7]%, P = 0.020) in quitters than those in smokers and non-smokers. Quitters tended to have a decreased incidence of rapid lesions progression (15.8% [76/482] vs. 21.6% [74/342] and 20.6% [89/431], P = 0.062), lesion re-vascularization (13.1% [63/482] vs. 15.5% [53/432] and 15.5% [67/431], P = 0.448), lesion-related myocardial infarction (0.8% [4/482] vs. 2.6% [9/342] and 1.4% [6/431], P = 0.110) and all-cause myocardial infarction (1.9% [9/482] vs. 4.1% [14/342] and 2.3% [10/431], P = 0.128) compared with smokers and non-smokers. In multivariable analysis, smoking status was not an independent predictor for rapid lesion progression, lesion re-vascularization, and lesion-related myocardial infarction except that a higher risk of all-cause myocardial infarction was observed in smokers than non-smokers (hazards ratio: 3.00, 95% confidence interval: 1.04–8.62, P = 0.042). Conclusion Smoking cessation mitigates the increase in percent diameter stenosis of coronary non-target lesions, meanwhile, smokers are associated with increased risk for all-cause myocardial infarction compared with non-smokers.
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57
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Abdelrahman KM, Chen MY, Dey AK, Virmani R, Finn AV, Khamis RY, Choi AD, Min JK, Williams MC, Buckler AJ, Taylor CA, Rogers C, Samady H, Antoniades C, Shaw LJ, Budoff MJ, Hoffmann U, Blankstein R, Narula J, Mehta NN. Coronary Computed Tomography Angiography From Clinical Uses to Emerging Technologies: JACC State-of-the-Art Review. J Am Coll Cardiol 2020; 76:1226-1243. [PMID: 32883417 PMCID: PMC7480405 DOI: 10.1016/j.jacc.2020.06.076] [Citation(s) in RCA: 130] [Impact Index Per Article: 32.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2020] [Revised: 05/08/2020] [Accepted: 06/10/2020] [Indexed: 12/14/2022]
Abstract
Evaluation of coronary artery disease (CAD) using coronary computed tomography angiography (CCTA) has seen a paradigm shift in the last decade. Evidence increasingly supports the clinical utility of CCTA across various stages of CAD, from the detection of early subclinical disease to the assessment of acute chest pain. Additionally, CCTA can be used to noninvasively quantify plaque burden and identify high-risk plaque, aiding in diagnosis, prognosis, and treatment. This is especially important in the evaluation of CAD in immune-driven conditions with increased cardiovascular disease prevalence. Emerging applications of CCTA based on hemodynamic indices and plaque characterization may provide personalized risk assessment, affect disease detection, and further guide therapy. This review provides an update on the evidence, clinical applications, and emerging technologies surrounding CCTA as highlighted at the 2019 National Heart, Lung and Blood Institute CCTA Summit.
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Affiliation(s)
- Khaled M Abdelrahman
- National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland
| | - Marcus Y Chen
- National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland
| | - Amit K Dey
- National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland
| | - Renu Virmani
- Department of Pathology, CVPath Institute, Gaithersburg, Maryland
| | - Aloke V Finn
- Department of Pathology, CVPath Institute, Gaithersburg, Maryland
| | - Ramzi Y Khamis
- Vascular Sciences Section, National Heart and Lung Institute, Imperial College London, London, United Kingdom
| | - Andrew D Choi
- Division of Cardiology and Department of Radiology, The George Washington University School of Medicine, Washington, DC
| | - James K Min
- Department of Radiology, New York-Presbyterian Hospital and Weill Cornell Medicine, New York, New York
| | - Michelle C Williams
- British Heart Foundation Centre for Cardiovascular Science, University of Edinburgh, Edinburgh, United Kingdom; Edinburgh Imaging, Queen's Medical Research Institute University of Edinburgh, Edinburgh, United Kingdom
| | | | | | | | - Habib Samady
- Division of Cardiology, Emory University School of Medicine, Atlanta, Georgia
| | - Charalambos Antoniades
- Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford, Oxford, United Kingdom
| | - Leslee J Shaw
- Department of Radiology, New York-Presbyterian Hospital and Weill Cornell Medicine, New York, New York
| | - Matthew J Budoff
- Lundquist Institute at Harbor-UCLA Medical Center, Torrance, California
| | - Udo Hoffmann
- Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
| | - Ron Blankstein
- Departments of Medicine (Cardiovascular Division) and Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Jagat Narula
- Zena and Michael A. Wiener Cardiovascular Institute, Marie-Josée and Henry R. Kravis Center for Cardiovascular Health Icahn School of Medicine at Mount Sinai, Mount Sinai Heart, New York, New York
| | - Nehal N Mehta
- National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland.
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Poels K, van Leent MMT, Reiche ME, Kusters PJH, Huveneers S, de Winther MPJ, Mulder WJM, Lutgens E, Seijkens TTP. Antibody-Mediated Inhibition of CTLA4 Aggravates Atherosclerotic Plaque Inflammation and Progression in Hyperlipidemic Mice. Cells 2020; 9:E1987. [PMID: 32872393 PMCID: PMC7565685 DOI: 10.3390/cells9091987] [Citation(s) in RCA: 40] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2020] [Revised: 08/19/2020] [Accepted: 08/27/2020] [Indexed: 12/18/2022] Open
Abstract
T cell-driven inflammation plays a critical role in the initiation and progression of atherosclerosis. The co-inhibitory protein Cytotoxic T-Lymphocyte Associated protein (CTLA) 4 is an important negative regulator of T cell activation. Here, we studied the effects of the antibody-mediated inhibition of CTLA4 on experimental atherosclerosis by treating 6-8-week-old Ldlr-/- mice, fed a 0.15% cholesterol diet for six weeks, biweekly with 200 μg of CTLA4 antibodies or isotype control for six weeks. 18F-fluorodeoxyglucose Positron Emission Tomography-Computed Tomography showed no effect of the CTLA4 inhibition of activity in the aorta, spleen, and bone marrow, indicating that monocyte/macrophage-driven inflammation was unaffected. Correspondingly, flow cytometry demonstrated that the antibody-mediated inhibition of CTLA4 did not affect the monocyte populations in the spleen. αCTLA4 treatment induced an activated T cell profile, characterized by a decrease in naïve CD44-CD62L+CD4+ T cells and an increase in CD44+CD62L- CD4+ and CD8+ T cells in the blood and lymphoid organs. Furthermore, αCTLA4 treatment induced endothelial activation, characterized by increased ICAM1 expression in the aortic endothelium. In the aortic arch, which mainly contained early atherosclerotic lesions at this time point, αCTLA4 treatment induced a 2.0-fold increase in the plaque area. These plaques had a more advanced morphological phenotype and an increased T cell/macrophage ratio, whereas the smooth muscle cell and collagen content decreased. In the aortic root, a site that contained more advanced plaques, αCTLA4 treatment increased the plaque T cell content. The short-term antibody-mediated inhibition of CTLA4 thus accelerated the progression of atherosclerosis by inducing a predominantly T cell-driven inflammation, and resulted in the formation of plaques with larger necrotic cores and less collagen. This indicates that existing therapies that are based on αCTLA4 antibodies may promote CVD development in patients.
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Affiliation(s)
- Kikkie Poels
- Department of Medical Biochemistry, Amsterdam Cardiovascular Sciences (ACS), Amsterdam University Medical Centers, University of Amsterdam, 1105AZ Amsterdam, The Netherlands; (K.P.); (M.M.T.v.L.); (M.E.R.); (P.J.H.K.); (S.H.); (M.P.J.d.W.); (W.J.M.M.); (E.L.)
| | - Mandy M. T. van Leent
- Department of Medical Biochemistry, Amsterdam Cardiovascular Sciences (ACS), Amsterdam University Medical Centers, University of Amsterdam, 1105AZ Amsterdam, The Netherlands; (K.P.); (M.M.T.v.L.); (M.E.R.); (P.J.H.K.); (S.H.); (M.P.J.d.W.); (W.J.M.M.); (E.L.)
- Biomedical Engineering and Imaging Institute, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
| | - Myrthe E. Reiche
- Department of Medical Biochemistry, Amsterdam Cardiovascular Sciences (ACS), Amsterdam University Medical Centers, University of Amsterdam, 1105AZ Amsterdam, The Netherlands; (K.P.); (M.M.T.v.L.); (M.E.R.); (P.J.H.K.); (S.H.); (M.P.J.d.W.); (W.J.M.M.); (E.L.)
| | - Pascal J. H. Kusters
- Department of Medical Biochemistry, Amsterdam Cardiovascular Sciences (ACS), Amsterdam University Medical Centers, University of Amsterdam, 1105AZ Amsterdam, The Netherlands; (K.P.); (M.M.T.v.L.); (M.E.R.); (P.J.H.K.); (S.H.); (M.P.J.d.W.); (W.J.M.M.); (E.L.)
| | - Stephan Huveneers
- Department of Medical Biochemistry, Amsterdam Cardiovascular Sciences (ACS), Amsterdam University Medical Centers, University of Amsterdam, 1105AZ Amsterdam, The Netherlands; (K.P.); (M.M.T.v.L.); (M.E.R.); (P.J.H.K.); (S.H.); (M.P.J.d.W.); (W.J.M.M.); (E.L.)
| | - Menno P. J. de Winther
- Department of Medical Biochemistry, Amsterdam Cardiovascular Sciences (ACS), Amsterdam University Medical Centers, University of Amsterdam, 1105AZ Amsterdam, The Netherlands; (K.P.); (M.M.T.v.L.); (M.E.R.); (P.J.H.K.); (S.H.); (M.P.J.d.W.); (W.J.M.M.); (E.L.)
| | - Willem J. M. Mulder
- Department of Medical Biochemistry, Amsterdam Cardiovascular Sciences (ACS), Amsterdam University Medical Centers, University of Amsterdam, 1105AZ Amsterdam, The Netherlands; (K.P.); (M.M.T.v.L.); (M.E.R.); (P.J.H.K.); (S.H.); (M.P.J.d.W.); (W.J.M.M.); (E.L.)
- Biomedical Engineering and Imaging Institute, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
- Laboratory of Chemical Biology, Department of Biomedical Engineering and Institute for Complex Molecular Systems, Eindhoven University of Technology, 5612AZ Eindhoven, The Netherlands
| | - Esther Lutgens
- Department of Medical Biochemistry, Amsterdam Cardiovascular Sciences (ACS), Amsterdam University Medical Centers, University of Amsterdam, 1105AZ Amsterdam, The Netherlands; (K.P.); (M.M.T.v.L.); (M.E.R.); (P.J.H.K.); (S.H.); (M.P.J.d.W.); (W.J.M.M.); (E.L.)
- Institute for Cardiovascular Prevention (IPEK), Ludwig Maximilian’s University, 80336 Munich, Germany
- German Centre for Cardiovascular Research (DZHK), Partner Site Munich Heart Alliance, 80802 Munich, Germany
| | - Tom T. P. Seijkens
- Department of Medical Biochemistry, Amsterdam Cardiovascular Sciences (ACS), Amsterdam University Medical Centers, University of Amsterdam, 1105AZ Amsterdam, The Netherlands; (K.P.); (M.M.T.v.L.); (M.E.R.); (P.J.H.K.); (S.H.); (M.P.J.d.W.); (W.J.M.M.); (E.L.)
- Department of Internal Medicine, Amsterdam University Medical Centers, Vrije Universiteit Amsterdam, 1081AV Amsterdam, The Netherlands
- Department of Hematology, Amsterdam University Medical Centers, Vrije Universiteit Amsterdam, 1081AV Amsterdam, The Netherlands
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Sezer M, Aslanger E, Cakir O, Atici A, Sezer I, Ozcan A, Umman B, Bugra Z, Umman S. The Interplay between Features of Plaque Vulnerability and Hemodynamic Relevance of Coronary Artery Stenoses. Cardiology 2020; 146:1-10. [PMID: 32846410 DOI: 10.1159/000508885] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/26/2019] [Accepted: 05/23/2020] [Indexed: 11/19/2022]
Abstract
Fractional flow reserve (FFR) may not be immune from hemodynamic perturbations caused by both vessel and lesion related factors. The aim of this study was to investigate the impact of plaque- and vessel wall-related features of vulnerability on the hemodynamic effect of intermediate coronary stenoses. Methods and Results: In this cross-sectional study, patients referred to catheterization laboratory for clinically indicated coronary angiography were prospectively screened for angiographically intermediate stenosis (50-80%). Seventy lesions from 60 patients were evaluated. Mean angiographic stenosis was 62.1 ± 16.3%. After having performed FFR assessment, intravascular ultrasound (IVUS) was performed over the FFR wire. Virtual histology IVUS was used to identify the plaque components and thin cap fibroatheroma (TCFA). TCFA was significantly more frequent (65 vs. 38%, p = 0.026), and necrotic core volume (26.15 ± 14.22 vs. 16.21 ± 8.93 mm3, p = 0.04) was significantly larger in the positively remodeled than non-remodeled vessels. Remodeling index correlated with necrotic core volume (r = 0.396, p = 0.001) and with FFR (r = -0. 419, p = 0.001). With respect to plaque components, only necrotic core area (r = -0.262, p = 0.038) and necrotic core volume (r = -0.272, p = 0.024) were independently associated with FFR. In the multivariable model, presence of TCFA was independently associated with significantly lower mean FFR value as compared to absence of TCFA (adjusted, 0.71 vs. 0.78, p = 0.034). Conclusion: The current study demonstrated that for a given stenosis geometry, features of plaque vulnerability such as necrotic core volume, TCFA, and positive remodeling may influence the hemodynamic relevance of intermediate coronary stenoses.
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Affiliation(s)
- Murat Sezer
- Department of Cardiology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey,
| | - Emre Aslanger
- Department of Cardiology, Yeditepe University, Istanbul, Turkey
| | - Ozan Cakir
- Department of Cardiology, Faculty of Medicine, Bulent Ecevit University, Zonguldak, Turkey
| | - Adem Atici
- Department of Cardiology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Irem Sezer
- Department of Cardiology, School of Medicine, Acibadem University, Istanbul, Turkey
| | - Alp Ozcan
- Department of Cardiology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Berrin Umman
- Department of Cardiology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Zehra Bugra
- Department of Cardiology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Sabahattin Umman
- Department of Cardiology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
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60
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Potential role of perivascular adipose tissue in modulating atherosclerosis. Clin Sci (Lond) 2020; 134:3-13. [PMID: 31898749 PMCID: PMC6944729 DOI: 10.1042/cs20190577] [Citation(s) in RCA: 33] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2019] [Revised: 12/16/2019] [Accepted: 12/23/2019] [Indexed: 02/06/2023]
Abstract
Perivascular adipose tissue (PVAT) directly juxtaposes the vascular adventitia and contains a distinct mixture of mature adipocytes, preadipocytes, stem cells, and inflammatory cells that communicate via adipocytokines and other signaling mediators with the nearby vessel wall to regulate vascular function. Cross-talk between perivascular adipocytes and the cells in the blood vessel wall is vital for normal vascular function and becomes perturbed in diseases such as atherosclerosis. Perivascular adipocytes surrounding coronary arteries may be primed to promote inflammation and angiogenesis, and PVAT phenotypic changes occurring in the setting of obesity, hyperlipidemia etc., are fundamentally important in determining a pathogenic versus protective role of PVAT in vascular disease. Recent discoveries have advanced our understanding of the role of perivascular adipocytes in modulating vascular function. However, their impact on cardiovascular disease (CVD), particularly in humans, is yet to be fully elucidated. This review will highlight the complex mechanisms whereby PVAT regulates atherosclerosis, with an emphasis on clinical implications of PVAT and emerging strategies for evaluation and treatment of CVD based on PVAT biology.
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Ge J, Song C, Zhang C, Liu X, Chen J, Dou K, Chen L. Personalized Early-Warning Signals during Progression of Human Coronary Atherosclerosis by Landscape Dynamic Network Biomarker. Genes (Basel) 2020; 11:E676. [PMID: 32575789 PMCID: PMC7350211 DOI: 10.3390/genes11060676] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2020] [Revised: 05/24/2020] [Accepted: 06/15/2020] [Indexed: 12/11/2022] Open
Abstract
Coronary atherosclerosis is one of the major factors causing cardiovascular diseases. However, identifying the tipping point (predisease state of disease) and detecting early-warning signals of human coronary atherosclerosis for individual patients are still great challenges. The landscape dynamic network biomarkers (l-DNB) methodology is based on the theory of dynamic network biomarkers (DNBs), and can use only one-sample omics data to identify the tipping point of complex diseases, such as coronary atherosclerosis. Based on the l-DNB methodology, by using the metabolomics data of plasma of patients with coronary atherosclerosis at different stages, we accurately detected the early-warning signals of each patient. Moreover, we also discovered a group of dynamic network biomarkers (DNBs) which play key roles in driving the progression of the disease. Our study provides a new insight into the individualized early diagnosis of coronary atherosclerosis and may contribute to the development of personalized medicine.
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Affiliation(s)
- Jing Ge
- Shanghai Institute of Biochemistry and Cell Biology, Center for Excellence in Molecular Cell Science, Chinese Academy of Sciences, Shanghai 200031, China; (J.G.); (C.Z.); (X.L.)
| | - Chenxi Song
- State Key Laboratory of Cardiovascular Disease, Department of Cardiology, Fuwai Hospital, Chinese Academy of Medical Sciences, National Center for Cardiovascular Diseases & Peking Union Medical College, Beijing 100037, China; (C.S.); (J.C.)
| | - Chengming Zhang
- Shanghai Institute of Biochemistry and Cell Biology, Center for Excellence in Molecular Cell Science, Chinese Academy of Sciences, Shanghai 200031, China; (J.G.); (C.Z.); (X.L.)
- Key Laboratory of Systems Biology, Hangzhou Institute for Advanced Study, University of Chinese Academy of Sciences, Chinese Academy of Sciences, Hangzhou 310024, China
| | - Xiaoping Liu
- Shanghai Institute of Biochemistry and Cell Biology, Center for Excellence in Molecular Cell Science, Chinese Academy of Sciences, Shanghai 200031, China; (J.G.); (C.Z.); (X.L.)
- School of Mathematics and Statistics, Shandong University at Weihai, Weihai 264209, China
| | - Jingzhou Chen
- State Key Laboratory of Cardiovascular Disease, Department of Cardiology, Fuwai Hospital, Chinese Academy of Medical Sciences, National Center for Cardiovascular Diseases & Peking Union Medical College, Beijing 100037, China; (C.S.); (J.C.)
| | - Kefei Dou
- State Key Laboratory of Cardiovascular Disease, Department of Cardiology, Fuwai Hospital, Chinese Academy of Medical Sciences, National Center for Cardiovascular Diseases & Peking Union Medical College, Beijing 100037, China; (C.S.); (J.C.)
| | - Luonan Chen
- Shanghai Institute of Biochemistry and Cell Biology, Center for Excellence in Molecular Cell Science, Chinese Academy of Sciences, Shanghai 200031, China; (J.G.); (C.Z.); (X.L.)
- Key Laboratory of Systems Biology, Hangzhou Institute for Advanced Study, University of Chinese Academy of Sciences, Chinese Academy of Sciences, Hangzhou 310024, China
- Center for Excellence in Animal Evolution and Genetics, Chinese Academy of Sciences, Kunming 650223, China
- School of Life Science and Technology, ShanghaiTech University, 100 Haike Road, Shanghai 201210, China
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Ahmadi A, Argulian E, Leipsic J, Newby DE, Narula J. From Subclinical Atherosclerosis to Plaque Progression and Acute Coronary Events: JACC State-of-the-Art Review. J Am Coll Cardiol 2020; 74:1608-1617. [PMID: 31537271 DOI: 10.1016/j.jacc.2019.08.012] [Citation(s) in RCA: 192] [Impact Index Per Article: 48.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2019] [Revised: 07/30/2019] [Accepted: 08/01/2019] [Indexed: 12/30/2022]
Abstract
It has been believed that most acute coronary events result from the rupture of mildly stenotic plaques, based on studies in which angiographic information was available from many months to years before the event. However, serial studies in which angiographic data were available from the past as also within 1 to 3 months of myocardial infarction have clarified that nonobstructive lesions progressively enlarged relatively rapidly before the acute event occurred. Noninvasive computed tomography angiography imaging data have confirmed that lesions that did not progress voluminously over time rarely led to events, regardless of the extent of luminal stenosis or baseline high-risk plaque morphology. Therefore, plaque progression could be proposed as a necessary step between early, uncomplicated atherosclerosis and plaque rupture. On the other hand, it has been convincingly demonstrated that intensive lipid-lowering therapy (to a low-density lipoprotein cholesterol level of <70 mg/dl) halts plaque progression. Given the current ability to noninvasively detect the presence of early atherosclerosis, the importance of plaque progression in the pathogenesis of myocardial infarction, and the efficacy of maximum lipid-lowering therapy, it has been suggested that plaque progression is a modifiable step in the evolution of atherosclerotic plaque. A personalized approach based on the detection of early atherosclerosis can trigger the necessary treatment to prevent plaque progression and hence plaque instability. Therefore, this approach can redefine the traditional paradigm of primary and secondary prevention based on population-derived risk estimates and can potentially improve long-term outcomes.
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Affiliation(s)
- Amir Ahmadi
- Icahn School of Medicine at Mount Sinai Hospital, New York, New York; St. Paul's Hospital, University of British Columbia, Vancouver, British Columbia, Canada
| | - Edgar Argulian
- Icahn School of Medicine at Mount Sinai Hospital, New York, New York
| | - Jonathon Leipsic
- St. Paul's Hospital, University of British Columbia, Vancouver, British Columbia, Canada
| | - David E Newby
- British Heart Foundation Centre for Cardiovascular Science, University of Edinburgh, Edinburgh, Scotland
| | - Jagat Narula
- Icahn School of Medicine at Mount Sinai Hospital, New York, New York.
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63
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Zaky AF, Berkowitz DE. Mythical metrics and methods: Needed paradigm shift in disease recognition and therapy. Med Hypotheses 2020; 141:109734. [PMID: 32298922 DOI: 10.1016/j.mehy.2020.109734] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2020] [Revised: 03/23/2020] [Accepted: 04/08/2020] [Indexed: 11/26/2022]
Abstract
Current medicine is practiced in an organ-based, function-appraised manner with less attention paid to the tissue characteristics of the appraised organs. The fundamentals of this paradigm have been the product of an oversimplified and often layman-based perceptions of the studied organ over the years. These perceptions drove the current definitions of normality and abnormality, parameters used in the diagnosis of the disease, goals of treatment and studied outcomes. Despite the explosive advancement in technology that could have potentially changed our 'upstream' thinking, practitioners remain captives of these old beliefs and have streamlined current technology in a 'downstream' fashion; in the form of goal-directed protocols, and engineering systems that would study their implementations. As a result, diseases continue to evolve, become more resistant to therapy, late to diagnose, and with a persistent worsening of outcomes. With a primarily focus on the heart and from an anesthesiologist prospective, we challenge the fundamentals of the current paradigm from an 'upstream' prospective. We challenge the current 'territorial' definitions of the organs studied, the current terminology of some diseases, the parameters used in their diagnosis, the diagnostic modalities used and their goals of treatment. We illustrate some examples when the current collective 'myth' meets the 'reality' in an acute care setting, further clarifying the limitations of the current paradigm. We also, provide a theoretical hypothesis of what we believe to be a potential substitute of the current paradigm. Our theory redefines disease from an organ-based functional phenomenon to a structural-based tissue phenomenon, calling for an integrative and holistic approach of tissue assessment rather than a discrete approach that may potentially obscure the interaction of non-appraised organs. We also believe in redirecting technology in an upstream direction to better redefine and early detect diseases rather than submitting to generationally inherited beliefs. Whereas we have started some of our research on our proposed paradigm, our theoretical framework remains to be thought-provoking, and hypothesis-generating at the present time.
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Affiliation(s)
- Ahmed F Zaky
- Department of Anesthesiology and Perioperative Medicine, University of Alabama at Birmingham, United States.
| | - Dan E Berkowitz
- Department of Anesthesiology and Perioperative Medicine, University of Alabama at Birmingham, United States
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64
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Sun C, Fu Y, Gu X, Xi X, Peng X, Wang C, Sun Q, Wang X, Qian F, Qin Z, Qu W, Piao M, Zhong S, Liu S, Zhang M, Fang S, Tian J, Li C, Maegdefessel L, Tian J, Yu B. Macrophage-Enriched lncRNA RAPIA: A Novel Therapeutic Target for Atherosclerosis. Arterioscler Thromb Vasc Biol 2020; 40:1464-1478. [PMID: 32268789 DOI: 10.1161/atvbaha.119.313749] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
OBJECTIVE Despite the current antiatherosclerotic and antithrombotic therapies, the incidence of advanced atherosclerosis-associated clinical events remains high. Whether long noncoding RNAs (lncRNAs) affect the progression of atherosclerosis and whether they are potential targets for the treatment of advanced atherosclerosis are poorly understood. Approach and Results: The progression of atherosclerotic lesions was accompanied by dynamic alterations in lncRNA expression, as revealed by RNA sequencing and quantitative polymerase chain reaction. Among the dynamically changing lncRNAs, we identified a novel lncRNA, lncRNA Associated with the Progression and Intervention of Atherosclerosis (RAPIA), that was highly expressed in advanced atherosclerotic lesions and in macrophages. Inhibition of RAPIA in vivo not only repressed the progression of atherosclerosis but also exerted atheroprotective effects similar to those of atorvastatin on advanced atherosclerotic plaques that had already formed. In vitro assays demonstrated that RAPIA promoted proliferation and reduced apoptosis of macrophages. A molecular sponge interaction between RAPIA and microRNA-183-5p was demonstrated by dual-luciferase reporter and RNA immunoprecipitation assays. Rescue assays indicated that RAPIA functioned at least in part by targeting the microRNA-183-5p/ITGB1 (integrin β1) pathway in macrophages. In addition, the transcription factor FoxO1 (forkhead box O1) could bind to the RAPIA promoter region and facilitate the expression of RAPIA. CONCLUSIONS The progression of atherosclerotic lesions was accompanied by dynamic changes in the expression of lncRNAs. Inhibition of the pivotal lncRNA RAPIA may be a novel preventive and therapeutic strategy for advanced atherosclerosis, especially in patients resistant or intolerant to statins.
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Affiliation(s)
- Changbin Sun
- From the Department of Cardiology, Second Affiliated Hospital of Harbin Medical University, Key Laboratory of Myocardial Ischemia, Ministry of Education, Harbin, China (C.S., Y.F., X.X., X.P., X.W., Z.Q., W.Q., M.P., S.Z., S.L., M.Z., S.F., Jiangtian Tian, Jinwei Tian, B.Y.)
| | - Yahong Fu
- From the Department of Cardiology, Second Affiliated Hospital of Harbin Medical University, Key Laboratory of Myocardial Ischemia, Ministry of Education, Harbin, China (C.S., Y.F., X.X., X.P., X.W., Z.Q., W.Q., M.P., S.Z., S.L., M.Z., S.F., Jiangtian Tian, Jinwei Tian, B.Y.)
| | - Xia Gu
- Department of Cardiology, Heilongjiang Provincial Hospital, Harbin, China (X.G.)
| | - Xiangwen Xi
- From the Department of Cardiology, Second Affiliated Hospital of Harbin Medical University, Key Laboratory of Myocardial Ischemia, Ministry of Education, Harbin, China (C.S., Y.F., X.X., X.P., X.W., Z.Q., W.Q., M.P., S.Z., S.L., M.Z., S.F., Jiangtian Tian, Jinwei Tian, B.Y.)
| | - Xiang Peng
- From the Department of Cardiology, Second Affiliated Hospital of Harbin Medical University, Key Laboratory of Myocardial Ischemia, Ministry of Education, Harbin, China (C.S., Y.F., X.X., X.P., X.W., Z.Q., W.Q., M.P., S.Z., S.L., M.Z., S.F., Jiangtian Tian, Jinwei Tian, B.Y.)
| | - Chuhan Wang
- Department of Pathology, Harbin Medical University, China (C.W.)
| | - Qi Sun
- Key Laboratory of Heilongjiang Province for Cancer Prevention and Control, Mudanjiang Medical University, China (Q.S.)
| | - Xueyu Wang
- From the Department of Cardiology, Second Affiliated Hospital of Harbin Medical University, Key Laboratory of Myocardial Ischemia, Ministry of Education, Harbin, China (C.S., Y.F., X.X., X.P., X.W., Z.Q., W.Q., M.P., S.Z., S.L., M.Z., S.F., Jiangtian Tian, Jinwei Tian, B.Y.)
| | - Fengcui Qian
- School of Medical Informatics, Daqing Campus, Harbin Medical University, China (F.Q., C.L.)
| | - Zhifeng Qin
- From the Department of Cardiology, Second Affiliated Hospital of Harbin Medical University, Key Laboratory of Myocardial Ischemia, Ministry of Education, Harbin, China (C.S., Y.F., X.X., X.P., X.W., Z.Q., W.Q., M.P., S.Z., S.L., M.Z., S.F., Jiangtian Tian, Jinwei Tian, B.Y.)
| | - Wenbo Qu
- From the Department of Cardiology, Second Affiliated Hospital of Harbin Medical University, Key Laboratory of Myocardial Ischemia, Ministry of Education, Harbin, China (C.S., Y.F., X.X., X.P., X.W., Z.Q., W.Q., M.P., S.Z., S.L., M.Z., S.F., Jiangtian Tian, Jinwei Tian, B.Y.)
| | - Minghui Piao
- From the Department of Cardiology, Second Affiliated Hospital of Harbin Medical University, Key Laboratory of Myocardial Ischemia, Ministry of Education, Harbin, China (C.S., Y.F., X.X., X.P., X.W., Z.Q., W.Q., M.P., S.Z., S.L., M.Z., S.F., Jiangtian Tian, Jinwei Tian, B.Y.)
| | - Shan Zhong
- From the Department of Cardiology, Second Affiliated Hospital of Harbin Medical University, Key Laboratory of Myocardial Ischemia, Ministry of Education, Harbin, China (C.S., Y.F., X.X., X.P., X.W., Z.Q., W.Q., M.P., S.Z., S.L., M.Z., S.F., Jiangtian Tian, Jinwei Tian, B.Y.)
| | - Shengliang Liu
- From the Department of Cardiology, Second Affiliated Hospital of Harbin Medical University, Key Laboratory of Myocardial Ischemia, Ministry of Education, Harbin, China (C.S., Y.F., X.X., X.P., X.W., Z.Q., W.Q., M.P., S.Z., S.L., M.Z., S.F., Jiangtian Tian, Jinwei Tian, B.Y.)
| | - Maomao Zhang
- From the Department of Cardiology, Second Affiliated Hospital of Harbin Medical University, Key Laboratory of Myocardial Ischemia, Ministry of Education, Harbin, China (C.S., Y.F., X.X., X.P., X.W., Z.Q., W.Q., M.P., S.Z., S.L., M.Z., S.F., Jiangtian Tian, Jinwei Tian, B.Y.)
| | - Shaohong Fang
- From the Department of Cardiology, Second Affiliated Hospital of Harbin Medical University, Key Laboratory of Myocardial Ischemia, Ministry of Education, Harbin, China (C.S., Y.F., X.X., X.P., X.W., Z.Q., W.Q., M.P., S.Z., S.L., M.Z., S.F., Jiangtian Tian, Jinwei Tian, B.Y.)
| | - Jiangtian Tian
- From the Department of Cardiology, Second Affiliated Hospital of Harbin Medical University, Key Laboratory of Myocardial Ischemia, Ministry of Education, Harbin, China (C.S., Y.F., X.X., X.P., X.W., Z.Q., W.Q., M.P., S.Z., S.L., M.Z., S.F., Jiangtian Tian, Jinwei Tian, B.Y.)
| | - Chunquan Li
- School of Medical Informatics, Daqing Campus, Harbin Medical University, China (F.Q., C.L.)
| | - Lars Maegdefessel
- Department of Vascular and Endovascular Surgery, Technical University Munich, Germany (L.M.)
| | - Jinwei Tian
- From the Department of Cardiology, Second Affiliated Hospital of Harbin Medical University, Key Laboratory of Myocardial Ischemia, Ministry of Education, Harbin, China (C.S., Y.F., X.X., X.P., X.W., Z.Q., W.Q., M.P., S.Z., S.L., M.Z., S.F., Jiangtian Tian, Jinwei Tian, B.Y.)
| | - Bo Yu
- From the Department of Cardiology, Second Affiliated Hospital of Harbin Medical University, Key Laboratory of Myocardial Ischemia, Ministry of Education, Harbin, China (C.S., Y.F., X.X., X.P., X.W., Z.Q., W.Q., M.P., S.Z., S.L., M.Z., S.F., Jiangtian Tian, Jinwei Tian, B.Y.)
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Janssen H, Felgner L, Kummer L, Gillmann HJ, Schrimpf C, Rustum S, Lichtinghagen R, Sahlmann B, Weigand MA, Teebken OE, Theilmeier G, Larmann J. Sequential Surgical Procedures in Vascular Surgery Patients Are Associated With Perioperative Adverse Cardiac Events. Front Cardiovasc Med 2020; 7:13. [PMID: 32133374 PMCID: PMC7040239 DOI: 10.3389/fcvm.2020.00013] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2019] [Accepted: 01/28/2020] [Indexed: 01/31/2023] Open
Abstract
Patients at elevated cardiovascular risk are prone to perioperative cardiovascular complications, like myocardial injury after non-cardiac surgery (MINS). We have demonstrated in a mouse model of atherosclerosis that perioperative stress leads to an increase in plaque volume and higher plaque vulnerability. Regulatory T cells (Tregs) play a pivotal role in development and destabilization of atherosclerotic plaques. For this exploratory post-hoc analysis we identified 40 patients recruited into a prospective perioperative biomarker study, who within the inclusion period underwent sequential open vascular surgery. On the basis of protein markers measured in the biomarker study, we evaluated the perioperative inflammatory response in patients' plasma before and after index surgery as well as before and after a second surgical procedure. We also analyzed available immunohistochemistry samples to describe plaque vulnerability in patients who underwent bilateral carotid endarterectomy (CEA) in two subsequent surgical procedures. Finally, we assessed if MINS was associated with sequential surgery. The inflammatory response of both surgeries was characterized by postoperative increases of interleukin-6,−10, Pentraxin 3 and C-reactive protein with no clear-cut difference between the two time points of surgery. Plaques from CEA extracted during the second surgery contained less Tregs, as measured by Foxp3 staining, than plaques from the first intervention. The 2nd surgical procedure was associated with MINS. In conclusion, we provide descriptive evidence that sequential surgical procedures involve repeat inflammation, and we hypothesize that elevated rates of cardiovascular complications after the second procedure could be related to reduced levels of intraplaque Tregs, a finding that deserves confirmatory testing and mechanistic exploration in future populations.
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Affiliation(s)
- Henrike Janssen
- Department of Anesthesiology, University Hospital Heidelberg, Heidelberg, Germany.,Department of Anesthesiology and Intensive Care Medicine, Hannover Medical School, Hanover, Germany
| | - Larissa Felgner
- Department of Anesthesiology, University Hospital Heidelberg, Heidelberg, Germany
| | - Laura Kummer
- Department of Anesthesiology, University Hospital Heidelberg, Heidelberg, Germany
| | - Hans-Jörg Gillmann
- Department of Anesthesiology and Intensive Care Medicine, Hannover Medical School, Hanover, Germany
| | - Claudia Schrimpf
- Department of Cardiothoracic, Transplantation and Vascular Surgery, Hannover Medical School, Hanover, Germany
| | - Saad Rustum
- Department of Cardiothoracic, Transplantation and Vascular Surgery, Hannover Medical School, Hanover, Germany
| | - Ralf Lichtinghagen
- Institute for Clinical Chemistry, Medical School Hannover, Hanover, Germany
| | - Bianca Sahlmann
- Department of Human Medicine, Perioperative Inflammation and Infection, Faculty of Medicine and Health Sciences, University of Oldenburg, Oldenburg, Germany
| | - Markus A Weigand
- Department of Anesthesiology, University Hospital Heidelberg, Heidelberg, Germany
| | - Omke E Teebken
- Department of Cardiothoracic, Transplantation and Vascular Surgery, Hannover Medical School, Hanover, Germany
| | - Gregor Theilmeier
- Department of Human Medicine, Perioperative Inflammation and Infection, Faculty of Medicine and Health Sciences, University of Oldenburg, Oldenburg, Germany.,Department of Anesthesiology, University Medical Center Groningen, Groningen, Netherlands
| | - Jan Larmann
- Department of Anesthesiology, University Hospital Heidelberg, Heidelberg, Germany.,Department of Anesthesiology and Intensive Care Medicine, Hannover Medical School, Hanover, Germany
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66
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Han D, Kolli KK, Al'Aref SJ, Baskaran L, van Rosendael AR, Gransar H, Andreini D, Budoff MJ, Cademartiri F, Chinnaiyan K, Choi JH, Conte E, Marques H, de Araújo Gonçalves P, Gottlieb I, Hadamitzky M, Leipsic JA, Maffei E, Pontone G, Raff GL, Shin S, Kim YJ, Lee BK, Chun EJ, Sung JM, Lee SE, Virmani R, Samady H, Stone P, Narula J, Berman DS, Bax JJ, Shaw LJ, Lin FY, Min JK, Chang HJ. Machine Learning Framework to Identify Individuals at Risk of Rapid Progression of Coronary Atherosclerosis: From the PARADIGM Registry. J Am Heart Assoc 2020; 9:e013958. [PMID: 32089046 PMCID: PMC7335586 DOI: 10.1161/jaha.119.013958] [Citation(s) in RCA: 34] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
Background Rapid coronary plaque progression (RPP) is associated with incident cardiovascular events. To date, no method exists for the identification of individuals at risk of RPP at a single point in time. This study integrated coronary computed tomography angiography–determined qualitative and quantitative plaque features within a machine learning (ML) framework to determine its performance for predicting RPP. Methods and Results Qualitative and quantitative coronary computed tomography angiography plaque characterization was performed in 1083 patients who underwent serial coronary computed tomography angiography from the PARADIGM (Progression of Atherosclerotic Plaque Determined by Computed Tomographic Angiography Imaging) registry. RPP was defined as an annual progression of percentage atheroma volume ≥1.0%. We employed the following ML models: model 1, clinical variables; model 2, model 1 plus qualitative plaque features; model 3, model 2 plus quantitative plaque features. ML models were compared with the atherosclerotic cardiovascular disease risk score, Duke coronary artery disease score, and a logistic regression statistical model. 224 patients (21%) were identified as RPP. Feature selection in ML identifies that quantitative computed tomography variables were higher‐ranking features, followed by qualitative computed tomography variables and clinical/laboratory variables. ML model 3 exhibited the highest discriminatory performance to identify individuals who would experience RPP when compared with atherosclerotic cardiovascular disease risk score, the other ML models, and the statistical model (area under the receiver operating characteristic curve in ML model 3, 0.83 [95% CI 0.78–0.89], versus atherosclerotic cardiovascular disease risk score, 0.60 [0.52–0.67]; Duke coronary artery disease score, 0.74 [0.68–0.79]; ML model 1, 0.62 [0.55–0.69]; ML model 2, 0.73 [0.67–0.80]; all P<0.001; statistical model, 0.81 [0.75–0.87], P=0.128). Conclusions Based on a ML framework, quantitative atherosclerosis characterization has been shown to be the most important feature when compared with clinical, laboratory, and qualitative measures in identifying patients at risk of RPP.
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Affiliation(s)
- Donghee Han
- Division of Cardiology Severance Cardiovascular Hospital Yonsei University College of Medicine Yonsei University Health System Seoul South Korea
| | - Kranthi K Kolli
- Department of Radiology NewYork-Presbyterian Hospital and Weill Cornell Medicine New York NY
| | - Subhi J Al'Aref
- Department of Radiology NewYork-Presbyterian Hospital and Weill Cornell Medicine New York NY
| | - Lohendran Baskaran
- Department of Radiology NewYork-Presbyterian Hospital and Weill Cornell Medicine New York NY
| | | | - Heidi Gransar
- Department of Imaging Cedars Sinai Medical Center Los Angeles CA
| | | | - Matthew J Budoff
- Department of Medicine Los Angeles Biomedical Research Institute Torrance CA
| | | | | | | | | | - Hugo Marques
- UNICA Unit of Cardiovascular Imaging Hospital da Luz Lisboa Portugal
| | | | - Ilan Gottlieb
- Department of Radiology Casa de Saude São Jose Rio de Janeiro Brazil
| | - Martin Hadamitzky
- Department of Radiology and Nuclear Medicine German Heart Center Munich Germany
| | - Jonathon A Leipsic
- Department of Medicine and Radiology University of British Columbia Vancouver BC Canada
| | - Erica Maffei
- Department of Radiology Area Vasta 1/ASUR Urbino Italy
| | | | - Gilbert L Raff
- Department of Cardiology William Beaumont Hospital Royal Oak MI
| | | | - Yong-Jin Kim
- Seoul National University Hospital Seoul South Korea
| | - Byoung Kwon Lee
- Gangnam Severance Hospital Yonsei University College of Medicine Seoul Korea
| | - Eun Ju Chun
- Seoul National University Bundang Hospital Sungnam South Korea
| | - Ji Min Sung
- Division of Cardiology Severance Cardiovascular Hospital Yonsei University College of Medicine Yonsei University Health System Seoul South Korea
| | - Sang-Eun Lee
- Division of Cardiology Severance Cardiovascular Hospital Yonsei University College of Medicine Yonsei University Health System Seoul South Korea
| | - Renu Virmani
- Department of Pathology CVPath Institute Gaithersburg MD
| | - Habib Samady
- Division of Cardiology Emory University School of Medicine Atlanta GA
| | - Peter Stone
- Cardiovascular Division Brigham and Women's Hospital Harvard Medical School Boston MA
| | - Jagat Narula
- Icahn School of Medicine at Mount Sinai Mount Sinai Heart, Zena and Michael A. Wiener Cardiovascular Institute, and Marie-Josée and Henry R. Kravis Center for Cardiovascular Health New York NY
| | - Daniel S Berman
- Department of Imaging and Medicine Cedars Sinai Medical Center Los Angeles CA
| | - Jeroen J Bax
- Department of Cardiology Leiden University Medical Center Leiden the Netherlands
| | - Leslee J Shaw
- Department of Radiology NewYork-Presbyterian Hospital and Weill Cornell Medicine New York NY
| | - Fay Y Lin
- Department of Radiology NewYork-Presbyterian Hospital and Weill Cornell Medicine New York NY
| | - James K Min
- Department of Radiology NewYork-Presbyterian Hospital and Weill Cornell Medicine New York NY
| | - Hyuk-Jae Chang
- Division of Cardiology Severance Cardiovascular Hospital Yonsei University College of Medicine Yonsei University Health System Seoul South Korea
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Huang R, Cao Y, Li H, Hu Z, Zhang H, Zhang L, Su W, Xu Y, Liang L, Melgiri ND, Jiang L, Li X. miR-532-3p-CSF2RA Axis as a Key Regulator of Vulnerable Atherosclerotic Plaque Formation. Can J Cardiol 2019; 36:1782-1794. [PMID: 32473103 DOI: 10.1016/j.cjca.2019.12.018] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2019] [Revised: 12/26/2019] [Accepted: 12/26/2019] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND The most dangerous atherosclerotic plaques, referred to as "vulnerable," are most likely to trigger acute atherothrombotic events such as myocardial infarction (heart attack) and stroke. Our goal was to uncover the molecular drivers of vulnerable plaque formation. METHODS To elucidate the functional gene modules that drive vulnerable plaque formation, we performed a weighted gene coexpression network analysis integrated with a protein-protein interaction network analysis in human atherosclerotic carotid samples, which identified the candidate gene granulocyte-macrophage colony-stimulating factor 2 (GM-CSF) receptor alpha subunit (CSF2RA). Follow-up in vitro experiments were performed to elucidate the regulatory relationship between CSF2RA and the microRNA miR-532-3p as well as modifiers of macrophagic miR-532-3p-CSF2RA axis expression. Microarray and quantitative reverse transcription polymerase chain reaction (qRT-PCR) studies elucidated the effect of statins on carotid miR-532-3p-CSF2RA axis expression in patients with carotid atherosclerotic disease. Apoe-/-, Ldlr-/-, and Csf2ra mutant Apoe-/- mouse models of atherosclerosis were employed to assess the effects of agomiR-532-3p therapy in vivo. RESULTS The integrated weighted gene coexpression network analysis/protein-protein interaction network analysis revealed that the macrophagic GM-CSF receptor CSF2RA is significantly upregulated in macrophage-rich vulnerable plaques. Follow-up analysis identified the miR-532-3p-CSF2RA axis, as miR-532-3p downregulates CSF2RA via binding to CSF2RA's 3'UTR. Macrophagic miR-532-3p-CSF2RA dysregulation was enhanced via modified low-density lipoprotein or tumor necrosis factor α exposure in vitro. Moreover, this miR-532-3p-CSF2RA dysregulation was observed in human vulnerable plaques and Apoe-/- mouse plaques, effects rescued by statin therapy. In vivo, agomiR-532-3p therapy suppressed murine plaque formation and promoted plaque stabilization in a Csf2ra-dependent manner. CONCLUSION Macrophagic miR-532-3p-CSF2RA axis dysregulation is a key driver in vulnerable plaque formation.
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Affiliation(s)
- Rongzhong Huang
- Department of Gerontology, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Yu Cao
- Department of Cardiothoracic Surgery, The First People's Hospital of Yunnan Province, Kunming, Yunnan, China
| | - Hongrong Li
- Department of Cardiothoracic Surgery, The First People's Hospital of Yunnan Province, Kunming, Yunnan, China
| | - Zicheng Hu
- Department of Neurology, Institute of Surgery Research, Daping Hospital, Third Military Medical University, Chongqing, China
| | - Hong Zhang
- Department of Cardiology, the First People's Hospital of Yunnan Province, Kunming, Yunnan, China
| | - Lujun Zhang
- Statistical Laboratory, Chuangxu Institute of Life Science, Chongqing, China; Department of Cardiology, Changhai Hospital, Second Military Medical University, Shanghai, China
| | - Wenhua Su
- Department of Cardiology, the First People's Hospital of Yunnan Province, Kunming, Yunnan, China
| | - Yu Xu
- Statistical Laboratory, Chuangxu Institute of Life Science, Chongqing, China
| | - Liwen Liang
- Department of Cardiology, the First People's Hospital of Yunnan Province, Kunming, Yunnan, China
| | - Narayan D Melgiri
- Impactys Foundation for Biomedical Research, San Diego, California, USA
| | - Lihong Jiang
- Department of Cardiothoracic Surgery, The First People's Hospital of Yunnan Province, Kunming, Yunnan, China
| | - Xingsheng Li
- Department of Gerontology, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China.
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Yao J, Gao W, Wang Y, Wang L, Diabakte K, Li J, Yang J, Jiang Y, Liu Y, Guo S, Zhao X, Cao Z, Chen X, Li Q, Zhang H, Wang W, Tian Z, Li B, Tian F, Wu G, Pourteymour S, Huang X, Tan F, Cao X, Yang Z, Li K, Zhang Y, Li Y, Zhang Z, Jin H, Tian Y. Sonodynamic Therapy Suppresses Neovascularization in Atherosclerotic Plaques via Macrophage Apoptosis-Induced Endothelial Cell Apoptosis. ACTA ACUST UNITED AC 2019; 5:53-65. [PMID: 32043020 PMCID: PMC7000870 DOI: 10.1016/j.jacbts.2019.10.007] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2019] [Revised: 10/07/2019] [Accepted: 10/07/2019] [Indexed: 01/26/2023]
Abstract
DVDMS-SDT reduces neovascularization in late-stage atherosclerotic lesions in both rabbit and mouse models. DVDMS-SDT enhances macrophage foam cell apoptosis, which in turn induces neovessel endothelial cell apoptosis and inhibits its proliferation, migration, and tubulogenesis, termed apoptosis-induced apoptosis. Mechanistically, DVDMS-SDT induces macrophage foam cell apoptosis via mitochondrial-caspase pathway, which activates caspase 3 to cleave SP-1, leading to the reduction of HIF-1α and VEGF-A. In the pilot translational study, DVDMS-SDT reduces plaque angiogenesis and inhibits vessel inflammation.
During atherosclerosis plaque progression, pathological intraplaque angiogenesis leads to plaque rupture accompanied by thrombosis, which is probably the most important cause of arteries complications such as cerebral and myocardial infarction. Even though few treatments are available to mitigate plaque rupture, further investigation is required to develop a robust optimized therapeutic method. In this study using rabbit and mouse atherosclerotic models, sinoporphyrin sodium (DVDMS)-mediated sonodynamic therapy reduced abnormal angiogenesis and plaque rupture. Briefly, DVDMS is injected to animals, and then the plaque was locally exposed to pulse ultrasound for a few minutes. Furthermore, a small size clinical trial was conducted on patients with atherosclerosis. Notably, a significant reduction of arterial inflammation and angiogenesis was recorded following a short period of DVDMS-mediated sonodynamic therapy treatment. This beneficial outcome was almost equivalent to the therapeutic outcome after 3-month intensive statin treatment.
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Key Words
- ALA, 5-aminolevulinic acid
- ApoE, apolipoprotein E
- ChIP, chromatin immunoprecipitation
- DVDMS, sinoporphyrin sodium
- DVDMS-SDT, sinoporphyrin sodium-mediated sonodynamic therapy
- HIF, hypoxia inducible factor
- HUVEC, human umbilical vein endothelial cells
- MVE, normalized maximal video-intensity enhancement
- SDT, sonodynamic therapy
- SP, specificity protein
- TBR, target-to-background ratio
- VEGF-A, vascular endothelial growth factor A
- apoptosis-induced apoptosis
- atherosclerotic plaque
- endothelial cell
- macrophage
- neovascularization
- sonodynamic therapy
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Affiliation(s)
- Jianting Yao
- Department of Cardiology, the First Affiliated Hospital, Cardiovascular Institute, Harbin Medical University, Harbin, People’s Republic of China
| | - Weiwei Gao
- Department of Cardiology, the First Affiliated Hospital, Cardiovascular Institute, Harbin Medical University, Harbin, People’s Republic of China
| | - Yu Wang
- Department of Cardiology, the First Affiliated Hospital, Cardiovascular Institute, Harbin Medical University, Harbin, People’s Republic of China
| | - Lu Wang
- Department of Cardiology, the First Affiliated Hospital, Cardiovascular Institute, Harbin Medical University, Harbin, People’s Republic of China
| | - Kamal Diabakte
- Department of Cardiology, the First Affiliated Hospital, Cardiovascular Institute, Harbin Medical University, Harbin, People’s Republic of China
| | - Jinyang Li
- Department of Pathophysiology and Key Laboratory of Cardiovascular Pathophysiology, Harbin Medical University, Harbin, People’s Republic of China
- Key Laboratory of Cardiovascular Medicine Research (Harbin Medical University), Ministry of Education, Harbin, People’s Republic of China
| | - Jiemei Yang
- Department of Cardiology, the First Affiliated Hospital, Cardiovascular Institute, Harbin Medical University, Harbin, People’s Republic of China
| | - Yongxing Jiang
- Department of Cardiology, the First Affiliated Hospital, Cardiovascular Institute, Harbin Medical University, Harbin, People’s Republic of China
| | - Yuerong Liu
- Department of Cardiology, the First Affiliated Hospital, Cardiovascular Institute, Harbin Medical University, Harbin, People’s Republic of China
| | - Shuyuan Guo
- Department of Cardiology, the First Affiliated Hospital, Cardiovascular Institute, Harbin Medical University, Harbin, People’s Republic of China
| | - Xuezhu Zhao
- Department of Cardiology, the First Affiliated Hospital, Cardiovascular Institute, Harbin Medical University, Harbin, People’s Republic of China
| | - Zhengyu Cao
- Department of Cardiology, the First Affiliated Hospital, Cardiovascular Institute, Harbin Medical University, Harbin, People’s Republic of China
| | - Xi Chen
- Department of Cardiology, the First Affiliated Hospital, Cardiovascular Institute, Harbin Medical University, Harbin, People’s Republic of China
| | - Qiannan Li
- Department of Cardiology, the First Affiliated Hospital, Cardiovascular Institute, Harbin Medical University, Harbin, People’s Republic of China
| | - Haiyu Zhang
- Department of Cardiology, the First Affiliated Hospital, Cardiovascular Institute, Harbin Medical University, Harbin, People’s Republic of China
| | - Wei Wang
- Department of Cardiology, the First Affiliated Hospital, Cardiovascular Institute, Harbin Medical University, Harbin, People’s Republic of China
| | - Zhen Tian
- Department of Pathophysiology and Key Laboratory of Cardiovascular Pathophysiology, Harbin Medical University, Harbin, People’s Republic of China
- Key Laboratory of Cardiovascular Medicine Research (Harbin Medical University), Ministry of Education, Harbin, People’s Republic of China
| | - Bicheng Li
- Department of Cardiology, the First Affiliated Hospital, Cardiovascular Institute, Harbin Medical University, Harbin, People’s Republic of China
| | - Fang Tian
- Department of Cardiology, the First Affiliated Hospital, Cardiovascular Institute, Harbin Medical University, Harbin, People’s Republic of China
| | - Guodong Wu
- Department of Cardiology, the First Affiliated Hospital, Cardiovascular Institute, Harbin Medical University, Harbin, People’s Republic of China
| | | | - Xi Huang
- Department of Cardiology, the First Affiliated Hospital, Cardiovascular Institute, Harbin Medical University, Harbin, People’s Republic of China
| | - Fancheng Tan
- Department of Pathophysiology and Key Laboratory of Cardiovascular Pathophysiology, Harbin Medical University, Harbin, People’s Republic of China
- Key Laboratory of Cardiovascular Medicine Research (Harbin Medical University), Ministry of Education, Harbin, People’s Republic of China
| | - Xiaoru Cao
- Department of Pathophysiology and Key Laboratory of Cardiovascular Pathophysiology, Harbin Medical University, Harbin, People’s Republic of China
- Key Laboratory of Cardiovascular Medicine Research (Harbin Medical University), Ministry of Education, Harbin, People’s Republic of China
| | - Zhuowen Yang
- Department of Cardiology, the First Affiliated Hospital, Cardiovascular Institute, Harbin Medical University, Harbin, People’s Republic of China
| | - Kang Li
- Department of Epidemiology and Biostatistics, Harbin Medical University, Harbin, People’s Republic of China
| | - Yan Zhang
- School of Life Science and Technology, Research Center for Computational Biology, Harbin Institute of Technology, Harbin, People’s Republic of China
| | - Yong Li
- Department of Positron Emission Tomography–Computed Tomography, the First Affiliated Hospital of Harbin Medical University, Harbin, People’s Republic of China
| | - Zhiguo Zhang
- Laboratory of Photo- and Sono-theranostic Technologies and Condensed Matter Science and Technology Institute, Harbin Institute of Technology, Harbin, People’s Republic of China
| | - Hong Jin
- Department of Medicine, Karolinska Institute, Stockholm, Sweden
- Dr. Hong Jin, Molecular Vascular Medicine, Medicine Department, Bioclinicum, Akademiska Stråket 1, J8:20, Karolinska University Hospital, 17164 Solna, Sweden.
| | - Ye Tian
- Department of Cardiology, the First Affiliated Hospital, Cardiovascular Institute, Harbin Medical University, Harbin, People’s Republic of China
- Department of Pathophysiology and Key Laboratory of Cardiovascular Pathophysiology, Harbin Medical University, Harbin, People’s Republic of China
- Key Laboratory of Cardiovascular Medicine Research (Harbin Medical University), Ministry of Education, Harbin, People’s Republic of China
- Address for correspondence: Dr. Ye Tian, Department of Cardiology, The First Affiliated Hospital, Cardiovascular Institute, Harbin Medical University, 23 Youzheng Street, Harbin 150001, China.
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Achenbach S. Imaging the Vulnerable Plaque on Coronary CTA. JACC Cardiovasc Imaging 2019; 13:1418-1421. [PMID: 31864980 DOI: 10.1016/j.jcmg.2019.11.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/21/2019] [Accepted: 11/07/2019] [Indexed: 11/29/2022]
Affiliation(s)
- Stephan Achenbach
- Department of Cardiology, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany.
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Xiao Q, Che X, Cai B, Tao Z, Zhang H, Shao Q, Pu J. Macrophage autophagy regulates mitochondria-mediated apoptosis and inhibits necrotic core formation in vulnerable plaques. J Cell Mol Med 2019; 24:260-275. [PMID: 31660692 PMCID: PMC6933382 DOI: 10.1111/jcmm.14715] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2019] [Revised: 08/27/2019] [Accepted: 08/31/2019] [Indexed: 12/19/2022] Open
Abstract
The vulnerable plaque is a key distinguishing feature of atherosclerotic lesions that can cause acute atherothrombotic vascular disease. This study was designed to explore the effect of autophagy on mitochondria-mediated macrophage apoptosis and vulnerable plaques. Here, we generated the mouse model of vulnerable carotid plaque in ApoE-/- mice. Application of ApoE-/- mice with rapamycin (an autophagy inducer) inhibited necrotic core formation in vulnerable plaques by decreasing macrophage apoptosis. However, 3-methyladenine (an autophagy inhibitor) promoted plaque vulnerability through deteriorating these indexes. To further explore the mechanism of autophagy on macrophage apoptosis, we used macrophage apoptosis model in vitro and found that 7-ketocholesterol (7-KC, one of the primary oxysterols in oxLDL) caused macrophage apoptosis with concomitant impairment of mitochondria, characterized by the impairment of mitochondrial ultrastructure, cytochrome c release, mitochondrial potential dissipation, mitochondrial fragmentation, excessive ROS generation and both caspase-9 and caspase-3 activation. Interestingly, such mitochondrial apoptotic responses were ameliorated by autophagy activator, but exacerbated by autophagy inhibitor. Finally, we found that MAPK-NF-κB signalling pathway was involved in autophagy modulation of 7-KC-induced macrophage apoptosis. So, we provide strong evidence for the potential therapeutic benefit of macrophage autophagy in regulating mitochondria-mediated apoptosis and inhibiting necrotic core formation in vulnerable plaques.
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Affiliation(s)
- Qingqing Xiao
- Department of Cardiology, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Xinyu Che
- Department of Cardiology, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Bin Cai
- Shanghai Institute of Rheumatology, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Zhenyu Tao
- Department of Cardiology, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Hengyuan Zhang
- Department of Cardiology, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Qin Shao
- Department of Cardiology, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Jun Pu
- Department of Cardiology, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
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71
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Long-Term Evolution of Premature Coronary Artery Disease. J Am Coll Cardiol 2019; 74:1868-1878. [DOI: 10.1016/j.jacc.2019.08.1002] [Citation(s) in RCA: 46] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2019] [Revised: 07/29/2019] [Accepted: 08/01/2019] [Indexed: 11/20/2022]
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72
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Michos ED, Choi AD. Coronary Artery Disease in Young Adults. J Am Coll Cardiol 2019; 74:1879-1882. [DOI: 10.1016/j.jacc.2019.08.1023] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/14/2019] [Accepted: 08/26/2019] [Indexed: 11/25/2022]
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73
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Li C, Zhang Z, Peng Y, Gao H, Wang Y, Zhao J, Pan C. Plasma neutrophil gelatinase-associated lipocalin levels are associated with the presence and severity of coronary heart disease. PLoS One 2019; 14:e0220841. [PMID: 31387110 PMCID: PMC6684288 DOI: 10.1371/journal.pone.0220841] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2018] [Accepted: 07/24/2019] [Indexed: 12/12/2022] Open
Abstract
OBJECTIVE This study aimed to compare the levels of plasma neutrophil gelatinase-associated lipocalin (NGAL), matrix metalloproteinase (MMP)-9, high-sensitivity C-reactive protein (hs-CRP), and interleukin (IL)-1β across different clinical presentations of coronary artery disease and to evaluate the relationship between those biomarkers and the severity of coronary artery lesions in patients without kidney disease. METHODS We examined 365 eligible patients who underwent coronary angiography. A total of 124 ST-segment elevation myocardial infarction (STEMI) patients, 117 stable angina pectoris (SAP) patients and 124 patients without atherosclerotic plaques were enrolled in the study. Plasma NGAL, MMP-9, hs-CRP, and IL-1β were measured in all patients using the enzyme-linked immunosorbent assay (ELISA) method. According to the SYNTAX score, the STEMI patients and SAP patients were divided into another set of 2 groups: a high score group (≥ 33, n = 29) and a low score group (<33, n = 212). The relationship between those biomarkers and the severity of coronary stenosis was examined by Spearman correlation analysis; the ability for NGAL to discriminate severe coronary stenosis was examined by receiver operating characteristic (ROC) curve; the influencing factors for the SYNTAX score were determined by logistic regression analysis. RESULTS Plasma NGAL, MMP-9, and hs-CRP levels in STEMI patients were higher than in the SAP patients and control subjects (P<0.05, respectively), and plasma NGAL and hs-CRP levels were significantly higher in the SAP patients than in control subjects (P<0.05, respectively), while plasma IL-1β was similar among the 3 groups (P>0.05, respectively). The SYNTAX score was positively related to NGAL (r = 0.363, P<0.001), MMP-9 (r = 0.377, P<0.001), and hs-CRP (r = 0.163, P<0.011); the SYNTAX score was not related to IL-1β (r = -0.043, P = 0.510). Plasma NGAL was positively related to MMP-9 (r = 0.601, P<0.001) and IL-1β (r = 0.159, P = 0.014). The area under the ROC curve for NGAL discriminating severe coronary stenosis was 0.838 (95% CI: 0.752-0.923, P<0.001), which was greater than that for MMP-9 [0.818, (95% CI: 0.724-0.912, P<0.001)], IL-1β [0.485, (95% CI: 0.369-0.601, P = 0.791)], and hs-CRP [0.607, (95% CI: 0.492-0.722, P = 0.061)]. Multivariate regression analysis showed that plasma NGAL levels were independently related to high SYNTAX scores [OR = 1.109, (95% CI: 1.104-1.114), P<0.001]. CONCLUSION Plasma NGAL, MMP-9, and hs-CRP levels in STEMI patients were higher than those in the SAP patients and control subjects. NGAL had a better ability to discriminate severe coronary stenosis than MMP-9, IL-1β, and hs-CRP. NGAL may be a novel biomarker to aid in risk stratification in coronary heart disease patients.
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Affiliation(s)
- Chao Li
- The First Clinical College of Lanzhou University, Lanzhou, Gansu, China
- Department of Cardiology, The First Hospital of Lanzhou University, Lanzhou, Gansu, China
- Gansu Key Laboratory of Cardiovascular Disease, Lanzhou, Gansu, China
| | - Zheng Zhang
- Department of Cardiology, The First Hospital of Lanzhou University, Lanzhou, Gansu, China
- * E-mail:
| | - Yu Peng
- Department of Cardiology, The First Hospital of Lanzhou University, Lanzhou, Gansu, China
| | - Hanxiang Gao
- Department of Cardiology, The First Hospital of Lanzhou University, Lanzhou, Gansu, China
| | - Yongxiang Wang
- Department of Cardiology, The First Hospital of Lanzhou University, Lanzhou, Gansu, China
| | - Jing Zhao
- Department of Cardiology, The First Hospital of Lanzhou University, Lanzhou, Gansu, China
| | - Chenliang Pan
- Department of Cardiology, The First Hospital of Lanzhou University, Lanzhou, Gansu, China
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74
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Moss AJ, Doris MK, Andrews JPM, Bing R, Daghem M, van Beek EJR, Forsyth L, Shah ASV, Williams MC, Sellers S, Leipsic J, Dweck MR, Parker RA, Newby DE, Adamson PD. Molecular Coronary Plaque Imaging Using 18F-Fluoride. Circ Cardiovasc Imaging 2019; 12:e008574. [PMID: 31382765 PMCID: PMC7668410 DOI: 10.1161/circimaging.118.008574] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/22/2018] [Accepted: 06/03/2019] [Indexed: 12/22/2022]
Abstract
BACKGROUND Coronary 18F-fluoride positron emission tomography identifies ruptured and high-risk atherosclerotic plaque. The optimal method to identify, to quantify, and to categorize increased coronary 18F-fluoride uptake and determine its reproducibility has yet to be established. This study aimed to optimize the identification, quantification, categorization, and scan-rescan reproducibility of increased 18F-fluoride activity in coronary atherosclerotic plaque. METHODS In a prospective observational study, patients with multi-vessel coronary artery disease underwent serial 18F-fluoride positron emission tomography. Coronary 18F-fluoride activity was visually assessed, quantified, and categorized with reference to maximal tissue to background ratios. Levels of agreement for both visual and quantitative methods were determined between scans and observers. RESULTS Thirty patients (90% male, 20 patients with stable coronary artery disease, and 10 with recent type 1 myocardial infarction) underwent paired serial positron emission tomography-coronary computed tomography angiography imaging within an interval of 12±5 days. A mean of 3.7±1.8 18F-fluoride positive plaques per patient was identified after recent acute coronary syndrome, compared with 2.4±2.3 positive plaques per patient in stable coronary artery disease. The bias in agreement in maximum tissue to background ratio measurements in visually positive plaques was low between observers (mean difference, -0.01; 95% limits of agreement, -0.32 to 0.30) or between scans (mean difference, 0.06; 95% limits of agreement, -0.49 to 0.61). Good agreement in the categorization of focal 18F-fluoride uptake was achieved using visual assessment alone (κ=0.66) and further improved at higher maximum tissue to background ratio values. CONCLUSIONS Coronary 18F-fluoride activity is a precise and reproducible metric in the coronary vasculature. The analytical performance of 18F-fluoride is sufficient to assess the prognostic utility of this radiotracer as a noninvasive imaging biomarker of plaque vulnerability. CLINICAL TRIAL REGISTRATION URL: http://www.clinicaltrials.gov. Unique identifiers: NCT02110303 and NCT02278211.
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Affiliation(s)
- Alastair J Moss
- British Heart Foundation Centre for Cardiovascular Science (A.J.M., M.K.D., J.P.M.A., R.B., M.D., A.S.V.S., M.C.W., M.R.D., D.E.N., P.D.A.), University of Edinburgh, United Kingdom
| | - Mhairi K Doris
- British Heart Foundation Centre for Cardiovascular Science (A.J.M., M.K.D., J.P.M.A., R.B., M.D., A.S.V.S., M.C.W., M.R.D., D.E.N., P.D.A.), University of Edinburgh, United Kingdom
| | - Jack P M Andrews
- British Heart Foundation Centre for Cardiovascular Science (A.J.M., M.K.D., J.P.M.A., R.B., M.D., A.S.V.S., M.C.W., M.R.D., D.E.N., P.D.A.), University of Edinburgh, United Kingdom
| | - Rong Bing
- British Heart Foundation Centre for Cardiovascular Science (A.J.M., M.K.D., J.P.M.A., R.B., M.D., A.S.V.S., M.C.W., M.R.D., D.E.N., P.D.A.), University of Edinburgh, United Kingdom
| | - Marwa Daghem
- British Heart Foundation Centre for Cardiovascular Science (A.J.M., M.K.D., J.P.M.A., R.B., M.D., A.S.V.S., M.C.W., M.R.D., D.E.N., P.D.A.), University of Edinburgh, United Kingdom
| | - Edwin J R van Beek
- Edinburgh Imaging, Queen's Medical Research Institute University of Edinburgh, United Kingdom (E.J.R.v.B., M.C.W.)
| | - Laura Forsyth
- Edinburgh Clinical Trials Unit (L.F., R.A.P.), University of Edinburgh, United Kingdom
| | - Anoop S V Shah
- British Heart Foundation Centre for Cardiovascular Science (A.J.M., M.K.D., J.P.M.A., R.B., M.D., A.S.V.S., M.C.W., M.R.D., D.E.N., P.D.A.), University of Edinburgh, United Kingdom
| | - Michelle C Williams
- British Heart Foundation Centre for Cardiovascular Science (A.J.M., M.K.D., J.P.M.A., R.B., M.D., A.S.V.S., M.C.W., M.R.D., D.E.N., P.D.A.), University of Edinburgh, United Kingdom
- Edinburgh Imaging, Queen's Medical Research Institute University of Edinburgh, United Kingdom (E.J.R.v.B., M.C.W.)
| | - Stephanie Sellers
- Department of Radiology, St Paul's Hospital and University of British Columbia, Vancouver, Canada (S.S., J.L.)
| | - Jonathon Leipsic
- Department of Radiology, St Paul's Hospital and University of British Columbia, Vancouver, Canada (S.S., J.L.)
| | - Marc R Dweck
- British Heart Foundation Centre for Cardiovascular Science (A.J.M., M.K.D., J.P.M.A., R.B., M.D., A.S.V.S., M.C.W., M.R.D., D.E.N., P.D.A.), University of Edinburgh, United Kingdom
| | - Richard A Parker
- Edinburgh Clinical Trials Unit (L.F., R.A.P.), University of Edinburgh, United Kingdom
| | - David E Newby
- British Heart Foundation Centre for Cardiovascular Science (A.J.M., M.K.D., J.P.M.A., R.B., M.D., A.S.V.S., M.C.W., M.R.D., D.E.N., P.D.A.), University of Edinburgh, United Kingdom
| | - Philip D Adamson
- British Heart Foundation Centre for Cardiovascular Science (A.J.M., M.K.D., J.P.M.A., R.B., M.D., A.S.V.S., M.C.W., M.R.D., D.E.N., P.D.A.), University of Edinburgh, United Kingdom
- Christchurch Heart Institute, University of Otago, New Zealand (P.D.A.)
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Integration of CTA in the Diagnostic Workup of New Onset Chest Pain in Clinical Practice. BIOMED RESEARCH INTERNATIONAL 2019; 2019:2647079. [PMID: 31360708 PMCID: PMC6642786 DOI: 10.1155/2019/2647079] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/28/2019] [Accepted: 06/16/2019] [Indexed: 01/01/2023]
Abstract
Background Recently, NICE guidelines recommend the use of computed tomographic angiography (CTA) as the first line of investigation for new onset chest pain. We sought to evaluate the impact of the integration of CTA in the diagnostic workup, as either a first- or second-line of investigation, in the clinical practice for patients presenting with new onset chest pain, with suspicion that it may be due to coronary artery disease (CAD). Method and Results From 2014 to 2016, 208 outpatients (mean age 63.8 ± 12.7, 37% female) with an unknown CAD diagnosis were evaluated. About half (n=106, 51%) received usual testing care plus CTA as a second-line investigation (group A), while the other half (n=102, 49%) received CTA as a first-line investigation (group B). Care decisions and test interpretations were made by the attending physician. Obstructive CAD (O-CAD) was defined as >50% stenosis in the principal branch. As determined by CTA, the rates of CAD in group A vs. group B were the following (P=0.001): 31.1% vs. 27.4% for normal/minimal CAD; 42.5% vs. 63.7% for no O-CAD; and 26.4% vs. 8.8% with O-CAD. Based on a diagnostic result of no O-CAD, invasive angiography was cancelled in 42.6% (n=45) of group A patients, and additional functional tests were cancelled for the same reason in 63.7% (n=65) of group B patients, without adverse events at median 3-year. The average diagnostic cost for patients in our study was lower in group B (206 vs. 324.42 euro; P<0.0001). Conclusions In clinical practice, CTA, as a first- or second-line investigation, most commonly detected no O-CAD in new onset chest pain patients, leading us to safely avoid unnecessary ICA or additional functional tests. The use of CTA as a first-line investigation also appears to be cost saving, but its cost-effectiveness remains to be demonstrated in larger studies.
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Increased hepcidin in hemorrhagic plaques correlates with iron-stimulated IL-6/STAT3 pathway activation in macrophages. Biochem Biophys Res Commun 2019; 515:394-400. [DOI: 10.1016/j.bbrc.2019.05.123] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2019] [Accepted: 05/19/2019] [Indexed: 01/24/2023]
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Dell'Italia LJ, Collawn JF, Ferrario CM. Multifunctional Role of Chymase in Acute and Chronic Tissue Injury and Remodeling. Circ Res 2019; 122:319-336. [PMID: 29348253 DOI: 10.1161/circresaha.117.310978] [Citation(s) in RCA: 64] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Chymase is the most efficient Ang II (angiotensin II)-forming enzyme in the human body and has been implicated in a wide variety of human diseases that also implicate its many other protease actions. Largely thought to be the product of mast cells, the identification of other cellular sources including cardiac fibroblasts and vascular endothelial cells demonstrates a more widely dispersed production and distribution system in various tissues. Furthermore, newly emerging evidence for its intracellular presence in cardiomyocytes and smooth muscle cells opens an entirely new compartment of chymase-mediated actions that were previously thought to be limited to the extracellular space. This review illustrates how these multiple chymase-mediated mechanisms of action can explain the residual risk in clinical trials of cardiovascular disease using conventional renin-angiotensin system blockade.
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Affiliation(s)
- Louis J Dell'Italia
- From the Department of Medicine, Division of Cardiology, Birmingham Veteran Affairs Medical Center (L.J.D.), Division of Cardiovascular Disease, Department of Medicine (L.J.D.), and Department of Cell, Developmental and Integrative Biology (J.F.C.), University of Alabama at Birmingham; and Division of Surgical Sciences, Wake Forest University School of Medicine, Winston-Salem, NC (C.M.F.).
| | - James F Collawn
- From the Department of Medicine, Division of Cardiology, Birmingham Veteran Affairs Medical Center (L.J.D.), Division of Cardiovascular Disease, Department of Medicine (L.J.D.), and Department of Cell, Developmental and Integrative Biology (J.F.C.), University of Alabama at Birmingham; and Division of Surgical Sciences, Wake Forest University School of Medicine, Winston-Salem, NC (C.M.F.)
| | - Carlos M Ferrario
- From the Department of Medicine, Division of Cardiology, Birmingham Veteran Affairs Medical Center (L.J.D.), Division of Cardiovascular Disease, Department of Medicine (L.J.D.), and Department of Cell, Developmental and Integrative Biology (J.F.C.), University of Alabama at Birmingham; and Division of Surgical Sciences, Wake Forest University School of Medicine, Winston-Salem, NC (C.M.F.)
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İyigün T, Kyaruzi MM, Timur B, Satılmışoğlu MH, İyigün M, Kaya M. The Predictive Effects of Clinical Hematological Changes on Saphenous Graft Patency after Coronary Artery Surgery. Braz J Cardiovasc Surg 2019; 34:297-304. [PMID: 31310468 PMCID: PMC6629236 DOI: 10.21470/1678-9741-2018-0211] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Objectives To investigate the association between clinical hematologic parameters and
saphenous vein graft failure after on-pump coronary artery bypass
surgery. Methods A total of 1950 consecutive patients underwent isolated on-pump coronary
artery surgery between November 2010 and February 2013. Of these, 284
patients met our inclusion criteria; their preoperative clinical
hematological parameters were retrospectively obtained for this cohort
study. And of them, 109 patients underwent conventional coronary angiography
after graft failure was revealed by coronary computed tomography
angiography. The primary endpoint was to catch at least one saphenous vein
graft stenosis or occlusion following the coronary angiogram. We then
analyzed risk factors for graft failure. In sequential or T grafts, each
segment was analyzed as a separate graft. Results In logistic regression analysis, older age, platelet distribution width, and
diabetes mellitus were identified as independent predictors of saphenous
vein graft failure (P<0.). In contrast, preserved
ejection fraction value favored graft patency
(P<0.001). Conclusion Increased platelet distribution width is easily measurable and can be used as
a simple and valuable marker in the prediction of saphenous vein graft
failure.
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Affiliation(s)
- Taner İyigün
- Cardiovascular Surgery Training and Research Hospital Department of Cardiovascular Surgery Istanbul Turkey Department of Cardiovascular Surgery, Istanbul Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Training and Research Hospital, Istanbul, Turkey
| | - Mugisha Markior Kyaruzi
- Cardiovascular Surgery Training and Research Hospital Department of Cardiovascular Surgery Istanbul Turkey Department of Cardiovascular Surgery, Istanbul Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Training and Research Hospital, Istanbul, Turkey
| | - Barış Timur
- Cardiovascular Surgery Training and Research Hospital Department of Cardiovascular Surgery Istanbul Turkey Department of Cardiovascular Surgery, Istanbul Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Training and Research Hospital, Istanbul, Turkey
| | - Muhammed Hulusi Satılmışoğlu
- Cardiovascular Surgery Training and Research Hospital Department of Cardiology Istanbul Turkey Department of Cardiology, Istanbul Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Training and Research Hospital, Istanbul, Turkey
| | - Müzeyyen İyigün
- Acıbadem University Department of Anesthesiology and Reanimation Istanbul Turkey Department of Anesthesiology and Reanimation, Acıbadem University, Istanbul, Turkey
| | - Mehmet Kaya
- Cardiovascular Surgery Training and Research Hospital Department of Cardiovascular Surgery Istanbul Turkey Department of Cardiovascular Surgery, Istanbul Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Training and Research Hospital, Istanbul, Turkey
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Si D, Du B, Zhao Y, Li X, Wang X, Liu K, He Y, Yang P. Combined intracoronary assessment and treatment of a patient with coronary plaque rapid progression prior to acute myocardial infarction: A case report. Medicine (Baltimore) 2019; 98:e15621. [PMID: 31083259 PMCID: PMC6531148 DOI: 10.1097/md.0000000000015621] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
RATIONAL Plaque rapid progression prior to acute myocardial infarction is not a common phenomenon, and its mechanism remains unknown. Intracoronary imaging may help to assess the plaque characteristics and progression. PATIENT CONCERN A 37-year-old male patient suffered an acute myocardial infarction (AMI) 1 month after the diagnosis of a mildly stenosed coronary artery. Intracoronary imaging was done to seek the underlying causes and guide further treatment. DIAGNOSIS Two coronary angiograms in 1 month showed plaque rapid progressing prior to the AMI. Intracoronary optical coherence tomography (OCT) post-AMI showed plaque erosion and heavy burden of thrombus. INTERVENTION The patient was advised to defer stent deployment. The patient was then given intensified antithrombotic therapy. Three weeks later, OCT imaging revealed sufficient lumen area and the intact endothelium without remaining thrombus. Fractional flow reverse (FFR) showed no functional ischemia. Dual-antiplatelet therapy without stenting was recommended for 12 months. OUTCOMES The 6-month follow-up showed good recovery and normal cardiac function. LESSONS First, for patients with mild coronary stenosis and typical angina symptoms, further intracoronary assessment should be performed. Second, OCT can not only help to determine the plaque characteristics but can also help to develop patient-tailored strategies for AMI patients.
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Affiliation(s)
- Daoyuan Si
- Jilin Provincial Engineering Laboratory for Endothelial Function and Genetic Diagnosis of Cardiovascular Disease, Department of Cardiology, China-Japan Union Hospital of Jilin University
| | - Beibei Du
- Jilin Provincial Engineering Laboratory for Endothelial Function and Genetic Diagnosis of Cardiovascular Disease, Department of Cardiology, China-Japan Union Hospital of Jilin University
| | - Yanan Zhao
- Jilin Provincial Engineering Laboratory for Endothelial Function and Genetic Diagnosis of Cardiovascular Disease, Department of Cardiology, China-Japan Union Hospital of Jilin University
| | - Xiangdong Li
- Jilin Provincial Engineering Laboratory for Endothelial Function and Genetic Diagnosis of Cardiovascular Disease, Department of Cardiology, China-Japan Union Hospital of Jilin University
| | - Xingtong Wang
- Department of Oncology and Hematology, Cancer Center, The First Hospital of Jilin University, Changchun, Jilin, China
| | - Kun Liu
- Jilin Provincial Engineering Laboratory for Endothelial Function and Genetic Diagnosis of Cardiovascular Disease, Department of Cardiology, China-Japan Union Hospital of Jilin University
| | - Yuquan He
- Jilin Provincial Engineering Laboratory for Endothelial Function and Genetic Diagnosis of Cardiovascular Disease, Department of Cardiology, China-Japan Union Hospital of Jilin University
| | - Ping Yang
- Jilin Provincial Engineering Laboratory for Endothelial Function and Genetic Diagnosis of Cardiovascular Disease, Department of Cardiology, China-Japan Union Hospital of Jilin University
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van Assen M, Varga-Szemes A, Schoepf UJ, Duguay TM, Hudson HT, Egorova S, Johnson K, St Pierre S, Zaki B, Oudkerk M, Vliegenthart R, Buckler AJ. Automated plaque analysis for the prognostication of major adverse cardiac events. Eur J Radiol 2019; 116:76-83. [PMID: 31153577 DOI: 10.1016/j.ejrad.2019.04.013] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2019] [Revised: 03/26/2019] [Accepted: 04/21/2019] [Indexed: 01/17/2023]
Abstract
OBJECTIVE The purpose of this study is to assess the value of an automated model-based plaque characterization tool for the prediction of major adverse cardiac events (MACE). METHODS We retrospectively included 45 patients with suspected coronary artery disease of which 16 (33%) experienced MACE within 12 months. Commercially available plaque quantification software was used to automatically extract quantitative plaque morphology: lumen area, wall area, stenosis percentage, wall thickness, plaque burden, remodeling ratio, calcified area, lipid rich necrotic core (LRNC) area and matrix area. The measurements were performed at all cross sections, spaced at 0.5 mm, based on fully 3D segmentations of lumen, wall, and each tissue type. Discriminatory power of these markers and traditional risk factors for predicting MACE were assessed. RESULTS Regression analysis using clinical risk factors only resulted in a prognostic accuracy of 63% with a corresponding area under the curve (AUC) of 0.587. Based on our plaque morphology analysis, minimal cap thickness, lesion length, LRNC volume, maximal wall area/thickness, the remodeling ratio, and the calcium volume were included into our prognostic model as parameters. The use of morphologic features alone resulted in an increased accuracy of 77% with an AUC of 0.94. Combining both clinical risk factors and morphological features in a multivariate logistic regression analysis increased the accuracy to 87% with a similar AUC of 0.924. CONCLUSION An automated model based algorithm to evaluate CCTA-derived plaque features and quantify morphological features of atherosclerotic plaque increases the ability for MACE prognostication significantly compared to the use of clinical risk factors alone.
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Affiliation(s)
- Marly van Assen
- Division of Cardiovascular Imaging, Department of Radiology and Radiological Science, Medical University of South Carolina, Charleston, SC, USA; University of Groningen, University Medical Center Groningen, Center for Medical Imaging, Groningen, the Netherlands.
| | - Akos Varga-Szemes
- Division of Cardiovascular Imaging, Department of Radiology and Radiological Science, Medical University of South Carolina, Charleston, SC, USA.
| | - U Joseph Schoepf
- Division of Cardiovascular Imaging, Department of Radiology and Radiological Science, Medical University of South Carolina, Charleston, SC, USA.
| | - Taylor M Duguay
- Division of Cardiovascular Imaging, Department of Radiology and Radiological Science, Medical University of South Carolina, Charleston, SC, USA.
| | - H Todd Hudson
- Division of Cardiovascular Imaging, Department of Radiology and Radiological Science, Medical University of South Carolina, Charleston, SC, USA.
| | | | | | | | - Beatrice Zaki
- Division of Cardiovascular Imaging, Department of Radiology and Radiological Science, Medical University of South Carolina, Charleston, SC, USA.
| | - Matthijs Oudkerk
- University of Groningen, University Medical Center Groningen, Center for Medical Imaging, Groningen, the Netherlands.
| | - Rozemarijn Vliegenthart
- Division of Cardiovascular Imaging, Department of Radiology and Radiological Science, Medical University of South Carolina, Charleston, SC, USA; University of Groningen, University Medical Center Groningen, Center for Medical Imaging, Groningen, the Netherlands; University of Groningen, University Medical Center Groningen, Department of Radiology, Groningen, the Netherlands.
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Zhang M, Liu Y, Xu M, Zhang L, Liu Y, Liu X, Zhao Y, Zhu F, Xu R, Ou Z, Wang Y, Liu Q, Ma S, Wang T, He M, Lu Q, Li H, Huang J, Zhang Y. Carotid artery plaque intervention with Tongxinluo capsule (CAPITAL): A multicenter randomized double-blind parallel-group placebo-controlled study. Sci Rep 2019; 9:4545. [PMID: 30872737 PMCID: PMC6418108 DOI: 10.1038/s41598-019-41118-z] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2017] [Accepted: 02/28/2019] [Indexed: 11/18/2022] Open
Abstract
To determine whether the traditional Chinese medicine Tongxinluo (TXL) is efficacious at retarding the progression of carotid atherosclerotic lesions, a total of 1,212 patients with a focal intima-media thickness (IMT) of ≥1.2 mm of the carotid arteries received TXL or placebo capsules in addition to current routine therapy. The primary outcome was between-group differences in annualized change in mean IMT of 12 sites of bilateral carotid arteries over 24 months. The secondary outcomes were between-group differences in plaque area, vascular remodeling index (RI), serum levels of lipids and high-sensitivity C-reactive protein, and a composite of first major cardiovascular events. The results showed that the annualized change in mean IMT in the TXL and placebo groups was -0.00095 (95% CI, -0.00330 to 0.00141) mm and 0.01312 (95% CI, 0.01076 to 0.01548) mm, respectively, with a difference between the two groups of -0.01407 (95% CI, -0.01740 to -0.01073) mm (P < 0.001). Compared with placebo, TXL treatment significantly reduced the change from baseline in the plaque area and RI, as well as the first major cardiovascular events. In conclusion, TXL retarded the progression of mean IMT, plaque area and vascular remodeling of the carotid artery with a good safety profile.
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Affiliation(s)
- Mei Zhang
- Department of Cardiology, Qilu Hospital of Shandong University, Jinan, China
| | - Yan Liu
- Department of Cardiology, Qilu Hospital of Shandong University, Jinan, China
| | - Mingjun Xu
- Department of Cardiology, Qilu Hospital of Shandong University, Jinan, China
| | - Lei Zhang
- Department of Cardiology, Qilu Hospital of Shandong University, Jinan, China
| | - Yan Liu
- Department of Cardiology, Qilu Hospital of Shandong University, Jinan, China
| | - Xiaoling Liu
- Department of Cardiology, Qilu Hospital of Shandong University, Jinan, China
| | - Yuxia Zhao
- Department of Cardiology, Qilu Hospital of Shandong University, Jinan, China
| | - Fang Zhu
- Department of Cardiology, People's Hospital of Liaoning Province, Shen Yang, China
| | - Rui Xu
- Department of Cardiology, Shandong Provincial Qianfoshan Hospital, Jinan, China
| | - Zhihong Ou
- Department of Cardiology, People's Hospital of Linyi City, Lin Yi, China
| | - Ying Wang
- Department of Cardiology, Second Affiliated Hospital of Shandong Traditional Chinese Medicine University, Jinan, China
| | - Qigong Liu
- Department of Cardiology, Hospital Affiliated with Tongji Medical College of Huazhong University of Science and Technology, Wuhan, China
| | - Shuping Ma
- Department of Cardiology, Hebei Provincial People's Hospital, Shi Jiazhuang, China
| | - Tian Wang
- Department of Cardiology, Traffic Hospital of Shandong Province, Jinan, China
| | - Maolin He
- Department of Cardiology, Beijing Shijitan Hospital, Beijing, China
| | - Qinghua Lu
- Department of Cardiology, Second Affiliated Hospital of Shandong University, Jinan, China
| | - Honghua Li
- Department of Cardiology, Wuhan General Hospital of Guangzhou Military Region, Wuhan, China
| | - Jihan Huang
- Center for Drug Clinical Research, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Yun Zhang
- Department of Cardiology, Qilu Hospital of Shandong University, Jinan, China.
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Monteiro G, Cury RC, Bittencourt MS. Plaque Assessment on Serial Coronary CTA. CURRENT CARDIOVASCULAR IMAGING REPORTS 2019. [DOI: 10.1007/s12410-019-9483-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Outcomes in Stable Coronary Disease: Is Defining High-Risk Atherosclerotic Plaque Important? J Am Coll Cardiol 2019; 73:302-304. [PMID: 30678760 DOI: 10.1016/j.jacc.2018.11.017] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/01/2018] [Accepted: 11/02/2018] [Indexed: 01/07/2023]
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Lindeman JH, Hulsbos L, van den Bogaerdt AJ, Geerts M, van Gool AJ, Hamming JF, van Dijk RA, Schaapherder AF. Qualitative evaluation of coronary atherosclerosis in a large cohort of young and middle-aged Dutch tissue donors implies that coronary thrombo-embolic manifestations are stochastic. PLoS One 2018; 13:e0207943. [PMID: 30481212 PMCID: PMC6258539 DOI: 10.1371/journal.pone.0207943] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2018] [Accepted: 11/08/2018] [Indexed: 01/14/2023] Open
Abstract
Background and aims With the intention to gain support for the hypothesis that incident ischemic complications of atherosclerotic disease involve a stochastic aspect, we performed a histological, qualitative evaluation of the epidemiology of coronary atherosclerotic disease in a cohort of aortic valve donors. Patients and methods Donors (n = 695, median age 54, range 11–65 years) were dichotomized into a non-cardiovascular (non-CVD) and a cardiovascular disease death (CVD) group. Consecutive 5 mm proximal left coronary artery segments were Movat stained, and the atherosclerotic burden for each segment was graded (revised AHA-classification). Results Non-CVD and CVD groups showed steep increase of atherosclerosis severity beyond the age of 40, resulting in an endemic presence of advanced atherosclerosis in men over 40 and women over 50 years. In fact, only 19% of the non-CVD and 6% of the CVD donors over 40 years were classified with a normal LCA or a so called non-progressive lesion type. Fibrous calcified plaques (FCP), the consolidated remnants of earlier ruptured lesions, dominated in both non-CVD and CVD donors. Estimates of the atherosclerosis burden (i.e. average lesion grade, proportion of FCPs, and average number of FCPs per cross-section) were all higher in the CVD group (p<1.10−16, p<0.0001, and p<0.05, respectively). Conclusions Dominance of consolidated FCP lesions in males over 40 and females over 50 years, show that plaque ruptures in the left coronary artery are common. However, the majority of these ruptures remain asymptomatic. This implies that the atherosclerotic process is repetitive. A relative difference in disease burden between CVD and non-CVD donors supports the concept that complications of atherosclerotic disease involve a stochastic element.
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Affiliation(s)
- Jan H. Lindeman
- Dept. of Surgery, Leiden University Medical Center, Leiden, The Netherlands
- Einthoven Laboratory for Experimental Vascular Medicine, Leiden University Medical Center, Leiden, The Netherlands
- * E-mail:
| | - Luuk Hulsbos
- Dept. of Surgery, Leiden University Medical Center, Leiden, The Netherlands
| | | | - Marlieke Geerts
- Dept. of Surgery, Leiden University Medical Center, Leiden, The Netherlands
- Einthoven Laboratory for Experimental Vascular Medicine, Leiden University Medical Center, Leiden, The Netherlands
| | | | - Jaap F. Hamming
- Dept. of Surgery, Leiden University Medical Center, Leiden, The Netherlands
- Einthoven Laboratory for Experimental Vascular Medicine, Leiden University Medical Center, Leiden, The Netherlands
| | - Rogier A. van Dijk
- Dept. of Surgery, Leiden University Medical Center, Leiden, The Netherlands
- Einthoven Laboratory for Experimental Vascular Medicine, Leiden University Medical Center, Leiden, The Netherlands
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Old and New NICE Guidelines for the Evaluation of New Onset Stable Chest Pain: A Real World Perspective. BIOMED RESEARCH INTERNATIONAL 2018; 2018:3762305. [PMID: 30533431 PMCID: PMC6250018 DOI: 10.1155/2018/3762305] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/06/2018] [Revised: 08/01/2018] [Accepted: 10/10/2018] [Indexed: 01/11/2023]
Abstract
Stable chest pain is a common clinical presentation that often requires further investigation using noninvasive or invasive testing, resulting in a resource-consuming problem worldwide. At onset of 2016, the National Institute for Health and Care Excellence (NICE) published an update on its guideline on chest pain. Three key changes to the 2010 version were provided by the new NICE guideline. First, the new guideline recommends that the previously proposed pretest probability risk score should no longer be used. Second, they also recommend that a calcium score of zero should no longer be used to rule out coronary artery disease (CAD) in patients with low pretest probability. Third, the new guideline recommends that all patients with new onset chest pain should be investigated with a coronary computed tomographic angiography (CTA) as a first-line investigation. However, in real world the impact of implementation of CTA for the evaluation of new onset chest pain remains to be evaluated, especially regarding its cost effectiveness. The aim of the present report was to discuss the results of the studies supporting new NICE guideline and its comparison with European and US guidelines.
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Abstract
INTRODUCTION Coronary artery calcification (CAC) is reflective of atherosclerotic disease and incrementally predictive of future cardiovascular events (CVE), independent of traditional risk factors. Extra coronary calcium such as aortic valve calcification, which can be identified and quantified by computed tomography (CT) imaging, has shown to predict future CVE in both asymptomatic and symptomatic (i.e. stable angina and acute coronary syndrome [ACS]) settings. It has hence been a vital tool in studies involving new therapies for cardiovascular disease. Areas covered: In this review, promising therapies on the horizon are reviewed, along with the role of cardiac CT and coronary calcification in these studies. A Medline search for peer-reviewed publications using keywords related to coronary calcium score, aortic valve calcium, and therapies targeting the same was carried out. Expert commentary: CT scanning provides a distinct means of detecting and quantifying coronary plaque as well as valvular calcification with excellent reproducibility. Based on voluminous data available, the absence of coronary calcium serves as a factor to de-risk patients for cardiovascular risk stratification and management algorithms. Newer therapies have shown to lower progression of coronary calcification, thus being beneficial in slowing progression of atherosclerotic disease. As British Epidemiologist Geoffrey Rose states, the best predictor of a life-threatening disease is the early manifestation of that disease. As CAC represents the early manifestation of atherosclerosis, it is the best-known stratifier of risk today, and its clinical use will continue to rise.
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Affiliation(s)
- Chandana Shekar
- a Department of Cardiology , Los Angeles Biomedical Research Institute at Harbor-UCLA , Los Angeles , CA , USA
| | - Matthew Budoff
- a Department of Cardiology , Los Angeles Biomedical Research Institute at Harbor-UCLA , Los Angeles , CA , USA
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Ferencik M. Paradigms of Noninvasive Assessment of Coronary Atherosclerosis in Diabetic Patients: Insights From the PARADIGM Registry. JACC Cardiovasc Imaging 2018; 11:1472-1474. [PMID: 29778851 DOI: 10.1016/j.jcmg.2018.04.024] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2018] [Accepted: 04/30/2018] [Indexed: 12/21/2022]
Affiliation(s)
- Maros Ferencik
- Knight Cardiovascular Institute, Oregon Health and Science University, Portland, Oregon; and the Cardiac MR PET CT Program, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts.
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Zeng X, Guo R, Dong M, Zheng J, Lin H, Lu H. Contribution of TLR4 signaling in intermittent hypoxia-mediated atherosclerosis progression. J Transl Med 2018; 16:106. [PMID: 29673358 PMCID: PMC5907703 DOI: 10.1186/s12967-018-1479-6] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2017] [Accepted: 04/10/2018] [Indexed: 12/05/2022] Open
Abstract
Background Intermittent hypoxia (IH), a typical character of obstructive sleep apnea (OSA), is related to atherogenesis. However, the role of IH on atherosclerosis (AS) progression and the mechanisms involved remains poorly understood. Methods In the present study, high-fat fed ApoE−/− mice were treated with recombinant shRNA-TLR4 lentivirus and exposed to IH. Atherosclerotic lesions on the en face aorta and cross-sections of aortic root were examined by Oil-Red O staining. The content of lipids and collagen of aortic root plaques were detected by Oil-Red O staining and Sirius red staining, respectively. The TLR4, NF-κB p65, α-SMA and MOMA-2 expression in aorta and IL-6 and TNF-α expression in the mice serum were also detected. Results Compared with the Sham group, the IH treated group further increased atherosclerotic plaque loads and plaque vulnerability in the aortic sinus. Along with increased TLR4 expression, enhanced NF-κB activation, inflammatory activity and aggravated dyslipidemia were observed in the IH treated group. TLR4 interference partly inhibited IH-mediated AS progression with decreased inflammation and improved cholesterol levels. Similarly, in endothelial cells, hypoxia/reoxygenation exposure has been shown to promote TLR4 expression and activation of proinflammatory TLR4/NF-κB signaling, while TLR4 interference inhibited these effects. Conclusions We found that the IH accelerated growth and vulnerability of atherosclerotic plaque, which probably acted by triggering the activation of proinflammatory TLR4/NF-κB signaling. These findings may suggest that IH is a risk factor for vulnerable plaque and provide a new insight into the treatment of OSA-induced AS progression.
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Affiliation(s)
- Xianqin Zeng
- Department of Cardiology, The Second Affiliated Hospital of Fujian Medical University, Quanzhou, 362000, Fujian, People's Republic of China.,The Key Laboratory of Cardiovascular Remodeling and Function Research, Chinese Ministry of Education and Chinese Ministry of Health, The State and Shandong Province Joint Key Laboratory of Translational Cardiovascular Medicine, Department of Cardiology, Qilu Hospital of Shandong University, No. 107, Wen Hua Xi Road, Jinan, 250012, Shandong, China.,Department of Cardiology, Ji'an Municipal Center People's Hospital, Ji'an, Jiangxi, China
| | - Rong Guo
- Department of Cardiology, The Second Affiliated Hospital of Fujian Medical University, Quanzhou, 362000, Fujian, People's Republic of China
| | - Mei Dong
- The Key Laboratory of Cardiovascular Remodeling and Function Research, Chinese Ministry of Education and Chinese Ministry of Health, The State and Shandong Province Joint Key Laboratory of Translational Cardiovascular Medicine, Department of Cardiology, Qilu Hospital of Shandong University, No. 107, Wen Hua Xi Road, Jinan, 250012, Shandong, China
| | - Julia Zheng
- Rutgers Robert Wood Johnson Medical School, New Jersey, New Brunswick, USA
| | - Huili Lin
- Department of Cardiology, The Second Affiliated Hospital of Fujian Medical University, Quanzhou, 362000, Fujian, People's Republic of China.
| | - Huixia Lu
- The Key Laboratory of Cardiovascular Remodeling and Function Research, Chinese Ministry of Education and Chinese Ministry of Health, The State and Shandong Province Joint Key Laboratory of Translational Cardiovascular Medicine, Department of Cardiology, Qilu Hospital of Shandong University, No. 107, Wen Hua Xi Road, Jinan, 250012, Shandong, China.
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90
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Ying R, Li SW, Chen JY, Zhang HF, Yang Y, Gu ZJ, Chen YX, Wang JF. Endoplasmic reticulum stress in perivascular adipose tissue promotes destabilization of atherosclerotic plaque by regulating GM-CSF paracrine. J Transl Med 2018; 16:105. [PMID: 29669585 PMCID: PMC5907173 DOI: 10.1186/s12967-018-1481-z] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2017] [Accepted: 04/10/2018] [Indexed: 01/24/2023] Open
Abstract
Background Perivascular adipose tissue (PVAT) accelerates plaque progression and increases cardiovascular risk. We tested the hypothesis that PVAT contributed to plaque vulnerability and investigated whether endoplasmic reticulum stress (ER stress) in PVAT played an important role in vulnerable plaque. Methods We transplanted thoracic aortic PVAT or subcutaneous adipose tissue as a control, from donor mice to carotid arteries of recipient apolipoprotein E deficient (apoE−/−) mice after removing carotid artery collar placed for 6 weeks. Two weeks after transplantation, ER stress inhibitor 4-phenyl butyric acid (4-PBA) was locally administrated to the transplanted PVAT and then animals were euthanized after 4 weeks. Immunohistochemistry was performed to quantify plaque composition and neovascularization. Mouse angiogenesis antibody array kit was used to test the angiogenic factors produced by transplanted adipose tissue. In vitro tube formation assay, scratch wound migration assay and mouse aortic ring assay were used to assess the angiogenic capacity of supernatant of transplanted PVAT. Results Ultrastructural detection by transmission electron microscopy showed transplanted PVAT was a mixed population of white and brown adipocytes with abundant mitochondria. Transplanted PVAT increased the intraplaque macrophage infiltration, lipid core, intimal and vasa vasorum neovascularization and MMP2/9 expression in plaque while decreased smooth muscle cells and collagen in atherosclerotic plaque, which were restored by local 4-PBA-treatment. Antibody array analysis showed that 4-PBA reduced several angiogenic factors [Granulocyte Macrophage Colony Stimulating Factor (GM-CSF), MCP-1, IL-6] secreted by PVAT. Besides, conditioned medium from 4-PBA treated-PVAT inhibited tube formation and migration capacity of endothelial cells and ex vivo mouse aortic ring angiogenesis compared to conditioned medium from transplanted PVAT. mRNA expression and protein levels of GM-CSF were markedly elevated in adipocytes under ER stress which would be suppressed by 4-PBA. In addition, ER stress enhanced NF-κB binding to the promoter of the mouse GM-CSF gene in adipocytes confirmed by Chromatin immunoprecipitation analyses. Conclusions Our findings demonstrate that ER stress in PVAT destabilizes atherosclerotic plaque, in part through increasing GM-CSF paracrine via transcription factor NF-κB. Electronic supplementary material The online version of this article (10.1186/s12967-018-1481-z) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Ru Ying
- Department of Cardiology, Sun Yat-sen Memorial Hospital of Sun Yat-sen University, No.107, Yanjiang West Road, Yuexiu District, Guangzhou, 510120, China.,Department of Cardiology, The First Affiliated Hospital of NanChang University, Nanchang, 330006, China
| | - Sheng-Wei Li
- Department of Respiratory Medicine, The 94th Hospital of Chinese People's Liberation Army, Nanchang, 330026, China
| | - Jia-Yuan Chen
- Department of Cardiology, Sun Yat-sen Memorial Hospital of Sun Yat-sen University, No.107, Yanjiang West Road, Yuexiu District, Guangzhou, 510120, China
| | - Hai-Feng Zhang
- Department of Cardiology, Sun Yat-sen Memorial Hospital of Sun Yat-sen University, No.107, Yanjiang West Road, Yuexiu District, Guangzhou, 510120, China
| | - Ying Yang
- Department of Cardiology, Sun Yat-sen Memorial Hospital of Sun Yat-sen University, No.107, Yanjiang West Road, Yuexiu District, Guangzhou, 510120, China
| | - Zhen-Jie Gu
- Department of Cardiology, Sun Yat-sen Memorial Hospital of Sun Yat-sen University, No.107, Yanjiang West Road, Yuexiu District, Guangzhou, 510120, China
| | - Yang-Xin Chen
- Department of Cardiology, Sun Yat-sen Memorial Hospital of Sun Yat-sen University, No.107, Yanjiang West Road, Yuexiu District, Guangzhou, 510120, China.
| | - Jing-Feng Wang
- Department of Cardiology, Sun Yat-sen Memorial Hospital of Sun Yat-sen University, No.107, Yanjiang West Road, Yuexiu District, Guangzhou, 510120, China.
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91
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Exercise electrocardiogram in middle-aged and older leisure time sportsmen: 100 exercise tests would be enough to identify one silent myocardial ischemia at risk for cardiac event. Int J Cardiol 2018; 257:16-23. [DOI: 10.1016/j.ijcard.2017.10.081] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/12/2017] [Revised: 10/05/2017] [Accepted: 10/19/2017] [Indexed: 02/02/2023]
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92
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Ahmadi A, Leipsic J, Øvrehus KA, Gaur S, Bagiella E, Ko B, Dey D, LaRocca G, Jensen JM, Bøtker HE, Achenbach S, De Bruyne B, Nørgaard BL, Narula J. Lesion-Specific and Vessel-Related Determinants of Fractional Flow Reserve Beyond Coronary Artery Stenosis. JACC Cardiovasc Imaging 2018; 11:521-530. [DOI: 10.1016/j.jcmg.2017.11.020] [Citation(s) in RCA: 73] [Impact Index Per Article: 12.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2017] [Revised: 11/07/2017] [Accepted: 11/08/2017] [Indexed: 11/25/2022]
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93
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Dasagrandhi D, R ASK, Muthuswamy A, Lennox AM, Jayavelu T, Devanathan V, Kesavan Swaminathan J. Ischemia/reperfusion injury in male guinea pigs: An efficient model to investigate myocardial damage in cardiovascular complications. Biomed Pharmacother 2018; 99:469-479. [PMID: 29665648 DOI: 10.1016/j.biopha.2018.01.087] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2017] [Revised: 12/20/2017] [Accepted: 01/12/2018] [Indexed: 12/28/2022] Open
Abstract
Myocardial ischemia/reperfusion (I/R) injury is the major problem that aggravates cardiac damage. Several established animal models fail to explain the similarity in disease mechanism and progression as seen in humans; whereas guinea pig shows high similarity in cardiovascular parameters. Hence, current study is aimed to develop an animal model using guinea pigs that may best correlate with disease mechanism of human myocardial I/R injury. Male guinea pigs were randomized into three groups: normal diet (ND), high fat diet (HFD) and sham; fed with respective diets for 90 days. Myocardial infarction (MI) was induced by ligating left anterior descending artery (LAD) for 30 min followed by 24 h and 7 days of reperfusion in ND and HFD groups. Electrocardiogram (ECG) showed the alterations in electrical conduction during myocardial I/R injury. Elevated levels of lactate dehydrogenase (LDH) and creatine kinase-MB ((CK-MB)) were higher in HFD compared to ND. Inflammatory markers such as tumor necrosis factor-α (TNF-α) and interleukin-6 (IL-6) were up-regulated in I/R injury animals compared to sham. Fold change of these protein expression levels were higher in HFD compared to ND. Elevated lipid profile and increased aortic wall thickness in HFD animals depicts the risk of developing cardiovascular complications. ECG analysis strongly confirmed MI through changes in sinus rhythm that are reflected in infarcted tissue as verified through TTC staining. Thus the combination of HFD followed by I/R injury proved to be an efficient model to study pathophysiology of myocardial I/R injury with minimal tissue damage and surgical mortality.
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Affiliation(s)
- Divya Dasagrandhi
- Drug Discovery and Molecular Cardiology Laboratory, Department of Bioinformatics, Bharathidasan University, Tiruchirappalli, 620024, India
| | - Arul Salomee Kamalabai R
- Drug Discovery and Molecular Cardiology Laboratory, Department of Bioinformatics, Bharathidasan University, Tiruchirappalli, 620024, India
| | - Anusuyadevi Muthuswamy
- Molecular Gerontology Laboratory, Department of Biochemistry, Bharathidasan University, Tiruchirappalli, 620024, India
| | - Angela Marie Lennox
- Department of Veterinary Clinical Sciences, Purdue University College of Veterinary Medicine, West Lafayette, IN 47907, United States
| | | | - Vasudharani Devanathan
- Department of Biological Sciences, Indian Institute of Science Education and Research, Tirupati, 517507, India
| | - Jayachandran Kesavan Swaminathan
- Drug Discovery and Molecular Cardiology Laboratory, Department of Bioinformatics, Bharathidasan University, Tiruchirappalli, 620024, India.
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Qi H, Sun J, Qiao H, Chen S, Zhou Z, Pan X, Wang Y, Zhao X, Li R, Yuan C, Chen H. Carotid Intraplaque Hemorrhage Imaging with Quantitative Vessel Wall T1 Mapping: Technical Development and Initial Experience. Radiology 2017; 287:276-284. [PMID: 29117484 DOI: 10.1148/radiol.2017170526] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Purpose To develop a three-dimensional (3D) high-spatial-resolution time-efficient sequence for use in quantitative vessel wall T1 mapping. Materials and Methods A previously described sequence, simultaneous noncontrast angiography and intraplaque hemorrhage (SNAP) imaging, was extended by introducing 3D golden angle radial k-space sampling (GOAL-SNAP). Sliding window reconstruction was adopted to reconstruct images at different inversion delay times (different T1 contrasts) for voxelwise T1 fitting. Phantom studies were performed to test the accuracy of T1 mapping with GOAL-SNAP against a two-dimensional inversion recovery (IR) spin-echo (SE) sequence. In vivo studies were performed in six healthy volunteers (mean age, 27.8 years ± 3.0 [standard deviation]; age range, 24-32 years; five male) and five patients with atherosclerosis (mean age, 66.4 years ± 5.5; range, 60-73 years; five male) to compare T1 measurements between vessel wall sections (five per artery) with and without intraplaque hemorrhage (IPH). Statistical analyses included Pearson correlation coefficient, Bland-Altman analysis, and Wilcoxon rank-sum test with data permutation by subject. Results Phantom T1 measurements with GOAL-SNAP and IR SE sequences showed excellent correlation (R2 = 0.99), with a mean bias of -25.8 msec ± 43.6 and a mean percentage error of 4.3% ± 2.5. Minimum T1 was significantly different between sections with IPH and those without it (mean, 371 msec ± 93 vs 944 msec ± 120; P = .01). Estimated T1 of normal vessel wall and muscle were 1195 msec ± 136 and 1117 msec ± 153, respectively. Conclusion High-spatial-resolution (0.8 mm isotropic) time-efficient (5 minutes) vessel wall T1 mapping is achieved by using the GOAL-SNAP sequence. This sequence may yield more quantitative reproducible biomarkers with which to characterize IPH and monitor its progression. © RSNA, 2017.
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Affiliation(s)
- Haikun Qi
- From the Center for Biomedical Imaging Research, Department of Biomedical Engineering, Room 109, School of Medicine, Tsinghua University, Haidian District, Beijing 100084, China (H. Qi, H. Qiao, S.C., X.P., Y.W., X.Z., R.L., C.Y., H.C.); Philips Research China, Shanghai, China (Z.Z.); and Department of Radiology, University of Washington, Seattle, Wash (J.S., C.Y.)
| | - Jie Sun
- From the Center for Biomedical Imaging Research, Department of Biomedical Engineering, Room 109, School of Medicine, Tsinghua University, Haidian District, Beijing 100084, China (H. Qi, H. Qiao, S.C., X.P., Y.W., X.Z., R.L., C.Y., H.C.); Philips Research China, Shanghai, China (Z.Z.); and Department of Radiology, University of Washington, Seattle, Wash (J.S., C.Y.)
| | - Huiyu Qiao
- From the Center for Biomedical Imaging Research, Department of Biomedical Engineering, Room 109, School of Medicine, Tsinghua University, Haidian District, Beijing 100084, China (H. Qi, H. Qiao, S.C., X.P., Y.W., X.Z., R.L., C.Y., H.C.); Philips Research China, Shanghai, China (Z.Z.); and Department of Radiology, University of Washington, Seattle, Wash (J.S., C.Y.)
| | - Shuo Chen
- From the Center for Biomedical Imaging Research, Department of Biomedical Engineering, Room 109, School of Medicine, Tsinghua University, Haidian District, Beijing 100084, China (H. Qi, H. Qiao, S.C., X.P., Y.W., X.Z., R.L., C.Y., H.C.); Philips Research China, Shanghai, China (Z.Z.); and Department of Radiology, University of Washington, Seattle, Wash (J.S., C.Y.)
| | - Zechen Zhou
- From the Center for Biomedical Imaging Research, Department of Biomedical Engineering, Room 109, School of Medicine, Tsinghua University, Haidian District, Beijing 100084, China (H. Qi, H. Qiao, S.C., X.P., Y.W., X.Z., R.L., C.Y., H.C.); Philips Research China, Shanghai, China (Z.Z.); and Department of Radiology, University of Washington, Seattle, Wash (J.S., C.Y.)
| | - Xinlei Pan
- From the Center for Biomedical Imaging Research, Department of Biomedical Engineering, Room 109, School of Medicine, Tsinghua University, Haidian District, Beijing 100084, China (H. Qi, H. Qiao, S.C., X.P., Y.W., X.Z., R.L., C.Y., H.C.); Philips Research China, Shanghai, China (Z.Z.); and Department of Radiology, University of Washington, Seattle, Wash (J.S., C.Y.)
| | - Yishi Wang
- From the Center for Biomedical Imaging Research, Department of Biomedical Engineering, Room 109, School of Medicine, Tsinghua University, Haidian District, Beijing 100084, China (H. Qi, H. Qiao, S.C., X.P., Y.W., X.Z., R.L., C.Y., H.C.); Philips Research China, Shanghai, China (Z.Z.); and Department of Radiology, University of Washington, Seattle, Wash (J.S., C.Y.)
| | - Xihai Zhao
- From the Center for Biomedical Imaging Research, Department of Biomedical Engineering, Room 109, School of Medicine, Tsinghua University, Haidian District, Beijing 100084, China (H. Qi, H. Qiao, S.C., X.P., Y.W., X.Z., R.L., C.Y., H.C.); Philips Research China, Shanghai, China (Z.Z.); and Department of Radiology, University of Washington, Seattle, Wash (J.S., C.Y.)
| | - Rui Li
- From the Center for Biomedical Imaging Research, Department of Biomedical Engineering, Room 109, School of Medicine, Tsinghua University, Haidian District, Beijing 100084, China (H. Qi, H. Qiao, S.C., X.P., Y.W., X.Z., R.L., C.Y., H.C.); Philips Research China, Shanghai, China (Z.Z.); and Department of Radiology, University of Washington, Seattle, Wash (J.S., C.Y.)
| | - Chun Yuan
- From the Center for Biomedical Imaging Research, Department of Biomedical Engineering, Room 109, School of Medicine, Tsinghua University, Haidian District, Beijing 100084, China (H. Qi, H. Qiao, S.C., X.P., Y.W., X.Z., R.L., C.Y., H.C.); Philips Research China, Shanghai, China (Z.Z.); and Department of Radiology, University of Washington, Seattle, Wash (J.S., C.Y.)
| | - Huijun Chen
- From the Center for Biomedical Imaging Research, Department of Biomedical Engineering, Room 109, School of Medicine, Tsinghua University, Haidian District, Beijing 100084, China (H. Qi, H. Qiao, S.C., X.P., Y.W., X.Z., R.L., C.Y., H.C.); Philips Research China, Shanghai, China (Z.Z.); and Department of Radiology, University of Washington, Seattle, Wash (J.S., C.Y.)
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Echolucency of the carotid artery is associated with short-term plaque progression and positive remodeling in the culprit coronary artery in AMI survivors. J Cardiol 2017; 70:438-445. [DOI: 10.1016/j.jjcc.2017.01.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/16/2016] [Revised: 01/05/2017] [Accepted: 01/13/2017] [Indexed: 11/20/2022]
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96
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Fan Z, Ji H, Li Y, Jian X, Li L, Liu T. Relationship between monocyte-to-lymphocyte ratio and coronary plaque vulnerability in patients with stable angina. Biomark Med 2017; 11:979-990. [PMID: 28891324 DOI: 10.2217/bmm-2017-0235] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
Aim: To investigate the relationship between monocyte-to-lymphocyte ratio (MLR) and plaque vulnerability assessed by virtual histology intravascular ultrasound in patients with stable angina. Methods: 133 patients with stable angina were enrolled. Results: MLR was found to be an independent risk factor of thin cap fibrous atheroma (OR: 2.61; p = 0.025). MLR could differentiate thin cap fibrous atheroma with a sensitivity of 73.7% and a specificity of 61.8%. MLR level was positively correlated with the percentage of necrotic core (NC) area at the sites of minimum lumen area and the largest NC area, and positively related to the percentage of NC volume. Conclusion: Circulating MLR level has potential in identifying the vulnerable plaques in the setting of stable angina.
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Affiliation(s)
- Zeyuan Fan
- Department of Cardiovascular Diseases, Civil Aviation General Hospital, Civil Aviation Clinical Medical College of Peking University, Beijing, China
| | - Hanhua Ji
- Department of Cardiovascular Diseases, Civil Aviation General Hospital, Civil Aviation Clinical Medical College of Peking University, Beijing, China
| | - Yang Li
- Department of Cardiovascular Diseases, Civil Aviation General Hospital, Civil Aviation Clinical Medical College of Peking University, Beijing, China
| | - Xinwen Jian
- Department of Cardiovascular Diseases, Civil Aviation General Hospital, Civil Aviation Clinical Medical College of Peking University, Beijing, China
| | - Li Li
- Department of Cardiovascular Diseases, Civil Aviation General Hospital, Civil Aviation Clinical Medical College of Peking University, Beijing, China
| | - Tao Liu
- Department of Cardiovascular Diseases, Civil Aviation General Hospital, Civil Aviation Clinical Medical College of Peking University, Beijing, China
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97
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Strauss HW, Narula J. 18
F-Fluoride Imaging and Other Plaque-Seeking Diagnostic Strategies. Circ Cardiovasc Imaging 2017; 10:CIRCIMAGING.117.007110. [DOI: 10.1161/circimaging.117.007110] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Affiliation(s)
- H. William Strauss
- From the Molecular Imaging and Therapy Service, Memorial Sloan Kettering Cancer Center, New York (H.W.S.); and Zena and Michael Wiener Cardiovascular Institute and Kravis Center for Cardiovascular Health, Mt Sinai School of Medicine, New York (H.W.S., J.N.)
| | - Jagat Narula
- From the Molecular Imaging and Therapy Service, Memorial Sloan Kettering Cancer Center, New York (H.W.S.); and Zena and Michael Wiener Cardiovascular Institute and Kravis Center for Cardiovascular Health, Mt Sinai School of Medicine, New York (H.W.S., J.N.)
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98
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Comparison of circulating dendritic cell and monocyte subsets at different stages of atherosclerosis: insights from optical coherence tomography. BMC Cardiovasc Disord 2017; 17:270. [PMID: 29047360 PMCID: PMC5648428 DOI: 10.1186/s12872-017-0702-3] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2017] [Accepted: 10/10/2017] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND While specific patterns of circulating dendritic cells (DCs) and monocytes are associated with the incidence of coronary artery disease, the characterization of circulating DC and monocyte subsets in patients with different stages of atherosclerosis remains unclear. METHODS Forty-eight patients with unstable angina pectoris (UAP) diagnosed by angiography were enrolled. Likewise, 31 patients with ST-segment elevation myocardial infarction (STEMI) were enrolled and confirmed with the presence of thrombosis by angiography. Plaque features of 48 UAP patients were evaluated at the culprit lesions by OCT. Circulating myeloid DCs (mDCs), plasmacytoid DCs (pDCs) and monocyte subsets were analyzed using flow cytometry. RESULTS The proportions and absolute counts of mDC2s, which specifically express CD141 and possess the ability to activate CD8+ T lymphocytes, significantly decreased in patients with UAP and STEMI when compared with controls (0.08 × 104 ± 0.05 × 104/ml and 0.08 × 104 ± 0.06 × 104/ml vs. 0.11 × 104 ± 0.06 × 104/ml, p = 0.027). On the other hand, patients with UAP and STEMI had significantly higher proportions and counts of Mon2 subsets. In the OCT subgroup, patients with thin-cap fibroatheroma (TCFA) had higher proportions and absolute number of Mon2 (11.96% ± 4.27% vs. 9.42% ± 4.05%, p = 0.034; 5.17 × 104/ml ± 1.92 × 104/ml vs. 3.53 × 104/ml ± 2.65 × 104/ml, p = 0.045) than those without TCFA. However, there was no remarkable difference in mDC2s between patients with and without TCFA. CONCLUSIONS Circulating Mon2 appears to be a promising marker for the severity of atherosclerotic plaque.
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99
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Ceponiene I, Nakanishi R, Osawa K, Kanisawa M, Nezarat N, Rahmani S, Kissel K, Kim M, Jayawardena E, Broersen A, Kitslaar P, Budoff MJ. Coronary Artery Calcium Progression Is Associated With Coronary Plaque Volume Progression: Results From a Quantitative Semiautomated Coronary Artery Plaque Analysis. JACC Cardiovasc Imaging 2017; 11:1785-1794. [PMID: 29055625 DOI: 10.1016/j.jcmg.2017.07.023] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/22/2017] [Revised: 07/05/2017] [Accepted: 07/21/2017] [Indexed: 01/07/2023]
Abstract
OBJECTIVES The aim of this study was to determine whether coronary artery calcium (CAC) progression was associated with coronary plaque progression on coronary computed tomographic angiography. BACKGROUND CAC progression and coronary plaque characteristics are associated with incident coronary heart disease. However, natural history of coronary atherosclerosis has not been well described to date, and the understanding of the association between CAC progression and coronary plaque subtypes such as noncalcified plaque progression remains unclear. METHODS Consecutive patients who were referred to our clinic for evaluation and had serial coronary computed tomography angiography scans performed were included in the study. Coronary artery plaque (total, fibrous, fibrous-fatty, low-attenuation, densely calcified) volumes were calculated using semiautomated plaque analysis software. RESULTS A total of 211 patients (61.3 ± 12.7 years of age, 75.4% men) were included in the analysis. The mean interval between baseline and follow-up scans was 3.3 ± 1.7 years. CAC progression was associated with a significant linear increase in all types of coronary plaque and no plaque progression was observed in subjects without CAC progression. In multivariate analysis, annualized and normalized total plaque (β = 0.38; p < 0.001), noncalcified plaque (β = 0.35; p = 0.001), fibrous plaque (β = 0.56; p < 0.001), and calcified plaque (β = 0.63; p = 0.001) volume progression, but not fibrous-fatty (β = 0.03; p = 0.28) or low-attenuation plaque (β = 0.11; p = 0.1) progression, were independently associated with CAC progression. Plaque progression did not differ between the sexes. A significantly increased total and calcified plaque progression was observed in statin users. CONCLUSIONS In a clinical practice setting, progression of CAC was significantly associated with an increase in both calcified and noncalcified plaque volume, except fibrous-fatty and low-attenuation plaque. Serial CAC measurements may be helpful in determining the need for intensification of preventive treatment.
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Affiliation(s)
- Indre Ceponiene
- Los Angeles Biomedical Research Institute at Harbor UCLA Medical Center, Torrance, California; Departments of Cardiology and Radiology, Academy of Medicine, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Rine Nakanishi
- Los Angeles Biomedical Research Institute at Harbor UCLA Medical Center, Torrance, California.
| | - Kazuhiro Osawa
- Los Angeles Biomedical Research Institute at Harbor UCLA Medical Center, Torrance, California
| | - Mitsuru Kanisawa
- Los Angeles Biomedical Research Institute at Harbor UCLA Medical Center, Torrance, California
| | - Negin Nezarat
- Los Angeles Biomedical Research Institute at Harbor UCLA Medical Center, Torrance, California
| | - Sina Rahmani
- Los Angeles Biomedical Research Institute at Harbor UCLA Medical Center, Torrance, California
| | - Kendall Kissel
- Los Angeles Biomedical Research Institute at Harbor UCLA Medical Center, Torrance, California
| | - Michael Kim
- Los Angeles Biomedical Research Institute at Harbor UCLA Medical Center, Torrance, California
| | - Eranthi Jayawardena
- Los Angeles Biomedical Research Institute at Harbor UCLA Medical Center, Torrance, California
| | - Alexander Broersen
- Division of Image Processing, Department of Radiology, Leiden University Medical Center, Leiden, the Netherlands
| | - Pieter Kitslaar
- Division of Image Processing, Department of Radiology, Leiden University Medical Center, Leiden, the Netherlands; Medis Medical Imaging Systems, Leiden, the Netherlands
| | - Matthew J Budoff
- Los Angeles Biomedical Research Institute at Harbor UCLA Medical Center, Torrance, California
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100
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Su T, Wang YB, Han D, Wang J, Qi S, Gao L, Shao YH, Qiao HY, Chen JW, Liang SH, Nie YZ, Li JY, Cao F. Multimodality Imaging of Angiogenesis in a Rabbit Atherosclerotic Model by GEBP11 Peptide Targeted Nanoparticles. Am J Cancer Res 2017; 7:4791-4804. [PMID: 29187904 PMCID: PMC5706100 DOI: 10.7150/thno.20767] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2017] [Accepted: 09/16/2017] [Indexed: 12/12/2022] Open
Abstract
Background and Aims: Angiogenesis is an important pathological process during progression of plaque formation, which can result in plaque hemorrhage and vulnerability. This study aims to explore non-invasive imaging of angiogenesis in atherosclerotic plaque through magnetic resonance imaging (MRI) and positron emission tomography (PET) by using GEBP11 peptide targeted magnetic iron oxide nanoparticles in a rabbit model of atherosclerosis. Methods: The dual-modality imaging probe was constructed by coupling 2, 3-dimercaptosuccinnic acid-coated paramagnetic nanoparticles (DMSA-MNPs) and the PET 68Ga chelator 1,4,7-triazacyclononane-N, N', N''-triacetic acid (NOTA) to GEBP11 peptide. The atherosclerosis model was induced in New Zealand white rabbits by abdominal aorta balloon de-endothelialization and atherogenic diet for 12 weeks. The plaque areas in abdominal artery were detected by ultrasound imaging and Oil Red O staining. Immunofluorescence staining and Prussian blue staining were applied respectively to investigate the affinity of GEBP11 peptide. MTT and flow cytometric analysis were performed to detect the effects of NGD-MNPs on cell proliferation, cell cycle and apoptosis in Human umbilical vein endothelial cells (HUVECs). In vivo MRI and PET imaging of atherosclerotic plaque were carried out at different time points after intravenous injection of nanoparticles. Results: The NGD-MNPs with hydrodynamic diameter of 130.8 nm ± 7.1 nm exhibited good imaging properties, high stability, low immunogenicity and little cytotoxicity. In vivo PET/MR imaging revealed that 68Ga-NGD-MNPs were successfully applied to visualize atherosclerotic plaque angiogenesis in the rabbit abdominal aorta. Prussian blue and CD31 immunohistochemical staining confirmed that NGD-MNPs were well co-localized within the blood vessels' plaques. Conclusion:68Ga-NGD-MNPs might be a promising MR and PET dual imaging probe for visualizing the vulnerable plaques.
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