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Yang J, Gao P, Li Q, Wang T, Guo S, Zhang J, Zhang T, Wu G, Guo Y, Wang Z, Tian Y. Arterial Adventitial Vasa Vasorum Density Reflects The Progression Of Unstable Plaques: A Retrospective Clinical Study. ULTRASOUND IN MEDICINE & BIOLOGY 2024; 50:712-721. [PMID: 38365464 DOI: 10.1016/j.ultrasmedbio.2024.01.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Revised: 01/10/2024] [Accepted: 01/14/2024] [Indexed: 02/18/2024]
Abstract
OBJECTIVE Arterial adventitial vasa vasorum (AVV) plays an important role in the occurrence and development of atherosclerotic (AS) disease. AS is a systemic disease, and plaque is not only a local vascular event, but also occurs at multiple sites throughout the vascular bed. Currently, effective anti-AVV therapies are lacking. Therefore, we posed the following scientific questions: "does human carotid adventitial vasa vasorum density reflect plaque neovascularization and intimal-media hyperplasia in carotid?"; and "is it possible to reduce human AVV density by sonodynamic therapy (SDT)?" METHODS A retrospective study was conducted on 160 patients with carotid atherosclerosis. Duplex ultrasound scanning (DUS), contrast-enhanced ultrasound (CEUS), coronary angiography, and coronary CT angiography (CTA) were used for diagnosis and screening. Pearson correlation tests and Receiver operating characteristic (ROC) curve were used to analyze the relationships between AVV hyperplasia, vasa vasorum (VV) hyperplasia and the intima-media thickness (IMT). SDT was developed for the treatment of arterial AVV hyperplasia and AS plaques. RESULTS The presence of local AVV in carotid unstable plaques correlated with the echogenic properties of the carotid plaque and the extent of plaque progression; Furthermore local AVV hyperplasia in patients with carotid atherosclerotic plaques was associated with acute coronary syndrome (ACS) events; Local AVV hyperplasia in patients with carotid atherosclerotic plaques was associated with coronary artery stenosis. Notably, SDT reduced local AVV hyperplasia and shrank the plaques in human femoral and carotid atherosclerotic lesions. CONCLUSIONS The presence of AVV in human carotid arteries reflects the severity of carotid and coronary artery AS. Further, SDT can reduce the hyperplasia of local AVV in human femoral and carotid plaques.
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Affiliation(s)
- Jiemei Yang
- Department of Cardiology, the First Affiliated Hospital, Cardiovascular Institute, Harbin Medical University, Harbin, P.R. China; Cardiac Ultrasound Division, the First Affiliated Hospital, Cardiovascular Institute, Harbin Medical University, Harbin, P.R. China
| | - Penghao Gao
- Department of Cardiology, the First Affiliated Hospital, Cardiovascular Institute, Harbin Medical University, Harbin, P.R. China
| | - Qiannan Li
- Department of General Practice, the Second Affiliated Hospital, Cardiovascular Institute, Harbin Medical University, Harbin, P.R. China
| | - Tengyu Wang
- Department of Cardiology, the First Affiliated Hospital, Cardiovascular Institute, Harbin Medical University, Harbin, P.R. China
| | - Shuyuan Guo
- Department of Cardiology, the First Affiliated Hospital, Cardiovascular Institute, Harbin Medical University, Harbin, P.R. China
| | - Jingyu Zhang
- Department of Geriatrics, the First Affiliated Hospital, Cardiovascular Institute, Harbin Medical University, Harbin, P.R. China
| | - Tianyi Zhang
- Department of Cardiology, the First Affiliated Hospital, Cardiovascular Institute, Harbin Medical University, Harbin, P.R. China
| | - Guodong Wu
- Department of Cardiology, the First Affiliated Hospital, Cardiovascular Institute, Harbin Medical University, Harbin, P.R. China
| | - Yuanyuan Guo
- Department of Cardiology, the First Affiliated Hospital, Cardiovascular Institute, Harbin Medical University, Harbin, P.R. China; Cardiac Ultrasound Division, the First Affiliated Hospital, Cardiovascular Institute, Harbin Medical University, Harbin, P.R. China
| | - Zeng Wang
- Department of Cardiology, the First Affiliated Hospital, Cardiovascular Institute, Harbin Medical University, Harbin, P.R. China
| | - Ye Tian
- Department of Cardiology, the First Affiliated Hospital, Cardiovascular Institute, Harbin Medical University, Harbin, P.R. China.
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Wang Y, Liu X, Wang Y, Qi H, Liu X, Kong X, Zhang Q, Dou J, Wang J, Chen H. Optimization of the Contrast Agent Injection Protocol for Carotid Artery Dynamic Contrast-Enhanced Magnetic Resonance Imaging. J Magn Reson Imaging 2022; 56:1372-1381. [PMID: 35324034 DOI: 10.1002/jmri.28175] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2022] [Accepted: 03/11/2022] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND The injection protocol used in previous carotid artery dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) studies varied. PURPOSE To investigate the effect of contrast injection protocol and optimize this protocol for carotid artery DCE-MRI. STUDY TYPE Prospective. SUBJECTS Digital phantom and seven patients with carotid atherosclerosis. FIELD STRENGTH/SEQUENCE 3 T, spoiled gradient recalled echo sequence. ASSESSMENT Different injection doses (0.01-0.3 mmol/kg) and effective injection rates (0.01-1 mmol/sec) were tested using a digital carotid plaque phantom considering the contrast pharmacokinetics, DCE-MRI imaging, contrast variation and flow-related imaging artifacts, random time delay between the contrast injection and image acquisition, and pharmacokinetic analysis process. For each injection protocol, combining the root mean square relative error (RMSRE) of the measured K trans and v P maps within the adventitial vasa vasorum from 10 tested time delays by the root mean square produced RMSREoverall-vv which was used to measure the overall accuracy of the pharmacokinetic parameters. In vivo validation was performed on seven patients with carotid atherosclerosis by imaging them twice using the traditional commonly used protocol and the recommended protocol found by simulation. STATISTICAL TEST Student's t-test, chi-square test, and paired t-test, P < 0.05 was considered statistically significant. RESULTS A low region of RMSREoverall-vv with the combination of medium injection dose and low effective injection rate was found. The protocol with injection dose of 0.07 mmol/kg and effective injection rate of 0.06 mmol/sec achieved the minimal RMSREoverall-vv (4.29%), thus was recommended, which showed more accurate arterial input function. Coinciding with the simulation results, this recommended protocol in in vivo experiments produced significantly fewer image artifacts, lower K trans and v P (P all <0.05) than traditional protocol which overestimated these parameters in simulation. DATA CONCLUSION The contrast injection protocol influenced the accuracy of the pharmacokinetics parameter estimation in carotid artery DCE-MRI. The injection protocol with injection dose of 0.07 mmol/kg and effective injection rate of 0.06 mmol/sec was recommended. LEVEL OF EVIDENCE 2 TECHNICAL EFFICACY STAGE: 1.
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Affiliation(s)
- Yajie Wang
- Center for Biomedical Imaging Research, Department of Biomedical Engineering, School of Medicine, Tsinghua University, Beijing, China
| | - Xiaoming Liu
- Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China.,Hubei Province Key Laboratory of Molecular Imaging, Wuhan, Hubei, China
| | | | - Haikun Qi
- School of Biomedical Engineering, ShanghaiTech University, Shanghai, China
| | - Xian Liu
- Center for Biomedical Imaging Research, Department of Biomedical Engineering, School of Medicine, Tsinghua University, Beijing, China
| | - Xiangchuang Kong
- Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China.,Hubei Province Key Laboratory of Molecular Imaging, Wuhan, Hubei, China
| | - Qiang Zhang
- Center for Biomedical Imaging Research, Department of Biomedical Engineering, School of Medicine, Tsinghua University, Beijing, China
| | - Jiaqi Dou
- Center for Biomedical Imaging Research, Department of Biomedical Engineering, School of Medicine, Tsinghua University, Beijing, China
| | - Jing Wang
- Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China.,Hubei Province Key Laboratory of Molecular Imaging, Wuhan, Hubei, China
| | - Huijun Chen
- Center for Biomedical Imaging Research, Department of Biomedical Engineering, School of Medicine, Tsinghua University, Beijing, China
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Zhang W, Lv Z, Zhang Y, Gopinath SCB, Yuan Y, Huang D, Miao L. Targeted Diagnosis, Therapeutic Monitoring, and Assessment of Atherosclerosis Based on Mesoporous Silica Nanoparticles Coated with cRGD-Platelets. OXIDATIVE MEDICINE AND CELLULAR LONGEVITY 2022; 2022:6006601. [PMID: 36211824 PMCID: PMC9537012 DOI: 10.1155/2022/6006601] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/05/2022] [Accepted: 08/20/2022] [Indexed: 12/07/2022]
Abstract
Objective The off-target effects and severe side effects of PPARα and LXRα agonists greatly limit their application in atherosclerosis (AS). Therefore, this study intended to use mesoporous silica nanoparticles as carriers to generate MnO nanoparticles in situ with T1WI-MRI in mesoporous pores and simultaneously load PPARα and LXRα agonists. Afterward, cRGD-chelated platelet membranes can be used for coating to construct a new nanotheranostic agent. Methods cRGD-platelet@MnO/MSN@PPARα/LXRα nanoparticles were synthesized by a chemical method. Dynamic light scattering (DLS) was utilized to detect the size distribution and polydispersity index (PDI) of the nanoparticles. The safety of the nanoparticles was detected by CCK8 in vitro and HE staining and kidney function in vivo. Cell apoptosis was detected by flow cytometry detection and TUNEL staining. Oxidative stress responses (ROS, SOD, MDA, and NOX levels) were tested via a DCFH-DA assay and commercial kits. Immunofluorescence and phagocytosis experiments were used to detect the targeting of nanoparticles. Magnetic resonance imaging (MRI) was used to detect the imaging performance of cRGD-platelet@MnO/MSN@PPARα/LXRα nanoparticles. Using western blotting, the expression changes in LXRα and ABCA1 were identified. Results cRGD-platelet@MnO/MSN@PPARα/LXRα nanoparticles were successfully established, with a particle size of approximately 150 nm and PDI less than 0.3, and showed high safety both in vitro and in vivo. cRGD-platelet@MnO/MSN@PPARα/LXRα nanoparticles showed good targeting properties and better MRI imaging performance in AS. cRGD-platelet@MnO/MSN@PPARα/LXRα nanoparticles showed better antioxidative capacities, MRI imaging performance, and diagnostic and therapeutic effects on AS by regulating the expression of LXRα and ABCA1. Conclusion In the present study, cRGD-platelet@MnO/MSN@PPARα/LXRα nanoparticles with high safety and the capacity to target vulnerable plaques of AS were successfully established. They showed better performance on MRI images and treatment effects on AS by promoting cholesterol efflux through the regulation of ABCA1. These findings might address the problems of off-target effects and side effects of nanoparticle-mediated drug delivery, which will enhance the efficiency of AS treatment and provide new ideas for the clinical treatment of AS.
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Affiliation(s)
- Wei Zhang
- Department of Radiology, Liuzhou People's Hospital Affiliated to Guangxi Medical University, Liuzhou, Guangxi 545006, China
| | - Zheng Lv
- Department of Radiology, Affiliated Hospital of Guilin Medical University, Guilin, Guangxi 541001, China
| | - Yupeng Zhang
- Department of Radiology, Affiliated Hospital of Guilin Medical University, Guilin, Guangxi 541001, China
| | - Subash C. B. Gopinath
- Faculty of Chemical Engineering & Technology, Micro System Technology, Centre of Excellence (CoE), and Institute of Nano Electronic Engineering, Universiti Malaysia Perlis (UniMAP), Perlis, Malaysia
| | - Yi Yuan
- Institute of Life Sciences, Jiangsu University, Zhengjiang, Jiangsu 212013, China
| | - Deyou Huang
- Department of Radiology, The Affiliated Hospital of Youjiang Medical University for Nationalities, Baise, Guangxi 533000, China
| | - Liu Miao
- Department of Cardiology, Liuzhou People's Hospital Affiliated to Guangxi Medical University, Liuzhou, Guangxi 545006, China
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Lin X, Guo W, She D, Wang F, Xing Z, Cao D. Follow-up assessment of atherosclerotic plaques in acute ischemic stroke patients using high-resolution vessel wall MR imaging. Neuroradiology 2022; 64:2257-2266. [PMID: 35767010 DOI: 10.1007/s00234-022-03002-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Accepted: 06/22/2022] [Indexed: 10/17/2022]
Abstract
PURPOSE Data on evolution of intracranial plaques in acute ischemic stroke patients after receiving medical therapy is still limited. We aimed to investigate the plaque features associated with culprit lesions and to explore the plaque longitudinal changes during treatment using high-resolution vessel wall MR imaging (VW-MRI). METHODS Twenty-three patients (16 men; mean age, 51.4 years ± 11.1) with acute ischemic stroke underwent 3-T VW-MRI for intracranial atherosclerosis and were taken follow-up assessments. Each identified plaque was retrospectively classified as culprit, probably culprit, or nonculprit. Plaque features were analyzed at both baseline and follow-up and were compared using paired t-test, paired Wilcoxon test, or McNemar's test. RESULTS A total of 87 intracranial plaques were identified (23 [26.4%] culprit, 10 [11.5%] probably culprit, and 54 [62.1%] nonculprit plaques). The median time interval between initial and follow-up MRI scans was 8.0 months. In the multiple ordinal logistic regression analysis, plaque contrast ratio (CR) (OR, 1.037; 95% CI, 1.013-1.062; P = 0.002) and surface irregularity (OR, 4.768; 95% CI, 1.064-21.349; P = 0.041) were independently associated with culprit plaques. During follow-up, plaque length, maximum thickness, normalized wall index (NWI), stenosis degree, and CR significantly decreased (all P-values < 0.05) in the culprit plaque group. The plaque NWI and CR dropped in the probably culprit plaques (P = 0.041, 0.026, respectively). In the nonculprit plaque group, only plaque NWI and stenosis degree showed significant decrement (P = 0.017, 0.037, respectively). CONCLUSION Follow-up VW-MRI may contribute to plaque risk stratification and may provide valuable insights into the evolution of different plaques in vivo.
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Affiliation(s)
- Xuehua Lin
- Department of Radiology, The First Affiliated Hospital of Fujian Medical University, 20 Cha-Zhong Road, 20 Cha-Zhong Road, Fuzhou, Fujian, 350005, People's Republic of China
| | - Wei Guo
- Department of Radiology, The First Affiliated Hospital of Fujian Medical University, 20 Cha-Zhong Road, 20 Cha-Zhong Road, Fuzhou, Fujian, 350005, People's Republic of China
| | - Dejun She
- Department of Radiology, The First Affiliated Hospital of Fujian Medical University, 20 Cha-Zhong Road, 20 Cha-Zhong Road, Fuzhou, Fujian, 350005, People's Republic of China
| | - Feng Wang
- Department of Radiology, The First Affiliated Hospital of Fujian Medical University, 20 Cha-Zhong Road, 20 Cha-Zhong Road, Fuzhou, Fujian, 350005, People's Republic of China
| | - Zhen Xing
- Department of Radiology, The First Affiliated Hospital of Fujian Medical University, 20 Cha-Zhong Road, 20 Cha-Zhong Road, Fuzhou, Fujian, 350005, People's Republic of China
| | - Dairong Cao
- Department of Radiology, The First Affiliated Hospital of Fujian Medical University, 20 Cha-Zhong Road, 20 Cha-Zhong Road, Fuzhou, Fujian, 350005, People's Republic of China. .,Department of Radiology, Fujian Key Laboratory of Precision Medicine for Cancer, The First Affiliated Hospital, Fujian Medical University, Fuzhou, 350005, Fujian, China. .,Key Laboratory of Radiation Biology of Fujian Higher Education Institutions, the First Affiliated Hospital, Fujian Medical University, Fuzhou, 350005, Fujian, China.
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Sun B, Ge X, Li X, Zhang J, Zhao Z, Liu X, Zhou Y, Xu J, Zhao H, Sun J. Elevated Hemoglobin A1c Is Associated With Leaky Plaque Neovasculature as Detected by Dynamic Contrast-Enhanced Magnetic Resonance Imaging. Arterioscler Thromb Vasc Biol 2022; 42:504-513. [PMID: 35236109 DOI: 10.1161/atvbaha.121.317190] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2020] [Accepted: 02/14/2022] [Indexed: 11/16/2022]
Abstract
BACKGROUND Patients with diabetes have accelerated atherosclerosis progression, but the underlying mechanisms are not fully understood. Dynamic contrast-enhanced magnetic resonance imaging has allowed in vivo characterization of plaque neovasculature, which plays a critical role in plaque progression. We aimed to evaluate the impact of diabetes on carotid plaque neovasculature as assessed by dynamic contrast-enhanced magnetic resonance imaging. METHODS Patients with recent ischemic stroke and ipsilateral carotid plaque underwent multicontrast magnetic resonance imaging for characterizing plaque morphology and dynamic contrast-enhanced magnetic resonance imaging for pharmacokinetic parameters of plaque neovasculature, including transfer constant (Ktrans, reflecting flow, endothelial surface area, and permeability) and fractional plasma volume (νp). RESULTS Sixty-five patients were enrolled, including 30 patients with diabetes (years since diagnosis: median 5.0 [interquartile range, [3.0-12.0]) and 35 patients without diabetes. Subjects with diabetes had a greater plaque burden and a higher prevalence of high-risk characteristics. Additionally, carotid plaques in the subjects with diabetes showed higher Ktrans than those in the subjects without diabetes (0.100±0.048 min-1 versus 0.067±0.042 min-1, P=0.005) but νp was numerically lower in the subjects with diabetes (5.2±3.7% versus 6.2±4.3%, P=0.31). The association of diabetes with high Ktrans (β=0.033, P=0.005) was independent of patient and plaque characteristics and remained largely intact after adjusting for serum lipids, glucose, or hs-CRP (high-sensitivity C-reactive protein). However, it became nonexistent after adjusting for hemoglobin A1c (β=-0.010, P=0.49). CONCLUSIONS Dynamic contrast-enhanced magnetic resonance imaging of carotid plaques suggested that plaque neovasculature in patients with diabetes is leaky, indicating enhanced capability of bringing blood constituents and facilitating extravasation of inflammatory cells, erythrocytes, and plasma proteins. Leaky plaque neovasculature correlated with hemoglobin A1c and may play a role in accelerated atherosclerosis progression in diabetes.
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Affiliation(s)
- Beibei Sun
- Department of Radiology, Ren Ji Hospital, Shanghai Jiao Tong University School of Medicine, China (B.S., X.G., X.L., J.Z., Z.Z., X.L., Y.Z., J.X., H.Z.)
| | - Xiaoqian Ge
- Department of Radiology, Ren Ji Hospital, Shanghai Jiao Tong University School of Medicine, China (B.S., X.G., X.L., J.Z., Z.Z., X.L., Y.Z., J.X., H.Z.)
- Department of Radiology, Shandong Second Provincial General Hospital, Jinan, China (X.G.)
| | - Xiao Li
- Department of Radiology, Ren Ji Hospital, Shanghai Jiao Tong University School of Medicine, China (B.S., X.G., X.L., J.Z., Z.Z., X.L., Y.Z., J.X., H.Z.)
- Department of Radiology, Shandong Second Provincial General Hospital, Jinan, China (X.G.)
| | - Jianjian Zhang
- Department of Radiology, Ren Ji Hospital, Shanghai Jiao Tong University School of Medicine, China (B.S., X.G., X.L., J.Z., Z.Z., X.L., Y.Z., J.X., H.Z.)
| | - Zizhou Zhao
- Department of Radiology, Ren Ji Hospital, Shanghai Jiao Tong University School of Medicine, China (B.S., X.G., X.L., J.Z., Z.Z., X.L., Y.Z., J.X., H.Z.)
| | - Xiaosheng Liu
- Department of Radiology, Ren Ji Hospital, Shanghai Jiao Tong University School of Medicine, China (B.S., X.G., X.L., J.Z., Z.Z., X.L., Y.Z., J.X., H.Z.)
| | - Yan Zhou
- Department of Radiology, Ren Ji Hospital, Shanghai Jiao Tong University School of Medicine, China (B.S., X.G., X.L., J.Z., Z.Z., X.L., Y.Z., J.X., H.Z.)
| | - Jianrong Xu
- Department of Radiology, Ren Ji Hospital, Shanghai Jiao Tong University School of Medicine, China (B.S., X.G., X.L., J.Z., Z.Z., X.L., Y.Z., J.X., H.Z.)
| | - Huilin Zhao
- Department of Radiology, Ren Ji Hospital, Shanghai Jiao Tong University School of Medicine, China (B.S., X.G., X.L., J.Z., Z.Z., X.L., Y.Z., J.X., H.Z.)
| | - Jie Sun
- Department of Radiology, University of Washington, Seattle (J.S.)
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Lepor NE, Sun J, Canton G, Contreras L, Hippe DS, Isquith DA, Balu N, Kedan I, Simonini AA, Yuan C, Hatsukami TS, Zhao XQ. Regression in carotid plaque lipid content and neovasculature with PCSK9 inhibition: A time course study. Atherosclerosis 2021; 327:31-38. [PMID: 34038761 DOI: 10.1016/j.atherosclerosis.2021.05.008] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2021] [Revised: 05/07/2021] [Accepted: 05/12/2021] [Indexed: 10/21/2022]
Abstract
BACKGROUND AND AIMS Proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitors reduce cardiovascular events, but their effects on atherosclerotic plaque remain elusive. Using serial magnetic resonance imaging (MRI), we studied changes in carotid plaque lipid content and neovasculature under PCSK9 inhibition with alirocumab. METHODS Among patients with low-density lipoprotein cholesterol (LDL-C) ≥70 mg/dl but ineligible for high-dose statin therapy, those with lipid core on carotid MRI were identified to receive alirocumab 150 mg every 2 weeks. Follow-up MRI was performed at 3, 6, and 12 months after treatment. Pre- and post-contrast MRI were acquired to measure percent lipid core volume (% lipid core). Dynamic contrast-enhanced MRI was acquired to measure the extravasation rate of gadolinium contrast (Ktrans), a marker of plaque neovasculature. RESULTS Of 31 patients enrolled, 27 completed the study (mean age: 69 ± 9; male: 67%). From 9.8% at baseline, % lipid core was progressively reduced to 8.4% at 3 months, 7.5% at 6 months, and 7.2% at 12 months (p = 0.014 for trend), which was accompanied by a progressive increase in % fibrous tissue (p = 0.009) but not % calcification (p = 0.35). Ktrans was not reduced until 12 months (from 0.069 ± 0.019 min-1 to 0.058 ± 0.020 min-1; p = 0.029). Lumen and wall areas did not change significantly during the study period. CONCLUSIONS Regression in plaque composition and neovasculature were observed under PCSK9 inhibition on carotid MRI, which provides unique insight into the biological process of plaque stabilization with disease-modifying therapies.
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Affiliation(s)
- Norman E Lepor
- Westside Medical Associates of Los Angeles, Beverly Hills, CA, USA; Smidt Cedars-Sinai Heart Institute, Los Angeles, CA, USA
| | - Jie Sun
- University of Washington, Seattle, WA, USA.
| | | | - Laurn Contreras
- Westside Medical Associates of Los Angeles, Beverly Hills, CA, USA
| | | | | | | | - Ilan Kedan
- Smidt Cedars-Sinai Heart Institute, Los Angeles, CA, USA
| | | | - Chun Yuan
- University of Washington, Seattle, WA, USA
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Han T, Paramsothy P, Hong J, Isquith D, Xu D, Bai H, Neradilek M, Gill E, Zhao XQ. High-resolution MRI assessed carotid atherosclerotic plaque characteristics comparing men and women with elevated ApoB levels. Int J Cardiovasc Imaging 2020; 36:481-489. [PMID: 32020410 DOI: 10.1007/s10554-019-01600-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/19/2019] [Accepted: 04/06/2019] [Indexed: 01/14/2023]
Abstract
Previous studies demonstrated that men were more likely to have plaque rupture and are at greater risk for myocardial infarction and stroke than women. We evaluated differences in carotid plaque characteristics by MRI between men and women with mild-moderate atherosclerosis and elevated ApoB levels. One hundred eighty-two subjects (104 men and 78 women) with CAD or carotid stenosis (≥ 15% by ultrasound), ApoB ≥ 120 mg/dL and carotid MRI scan were included. Percent wall volume (%WV) was calculated as (wall volume/total vessel volume) × 100%. Three major plaque compositions, fibrous tissue (FT), calcification (CA) and lipid rich necrotic core (LRNC), were identified and quantified using published MRI criteria. Adventitial and plaque neovascularization as fractional plasma volume (Vp) and permeability as transfer constant (Ktrans) were analyzed using kinetic modeling. These characteristics were compared between men and women. Men, compared to women, were younger (54 ± 8 vs. 58 ± 8 years, p = 0.01), had higher rate of previous MI (46 vs. 26%, p = 0.005) but lower proportions of metabolic syndrome (37 vs. 59%, p = 0.003). After adjusting for between-gender differences, men were significantly more likely to have LRNC (OR 2.22, 95% CI 1.04-4.89, p = 0.04) and showed significantly larger %LRNC than women (diff = 4.3%, 95% CI 1.6-6.9%, p = 0.002), while %WV, FT, and CA were similar between men and women. There were no statistically significant differences in adventitial and plaque Vp or Ktrans. Men were significantly more likely to have LRNC and had larger LRNC than women. However, men and women showed relatively similar levels of adventitial and plaque neovascularization and permeability.Trial registration: NCT00715273 at ClinicalTrials.gov. Registered 15 July 2008, retrospectively registered.
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Affiliation(s)
- Tianwen Han
- Department of Medicine, Division of Cardiology, University of Washington, Seattle, WA, 98104, USA
| | - Pathmaja Paramsothy
- Department of Medicine, Division of Cardiology, University of Washington, Seattle, WA, 98104, USA
| | - Jaekyoung Hong
- Department of Medicine, Division of Cardiology, University of Washington, Seattle, WA, 98104, USA
| | - Daniel Isquith
- Department of Medicine, Division of Cardiology, University of Washington, Seattle, WA, 98104, USA
| | - Dongxiang Xu
- Department of Radiology, University of Washington, Seattle, WA, 98109, USA
| | - Hua Bai
- Clinical Pharmacology Research Center, Peking Union Medical College Hospital, Beijing, 100032, China
| | - Moni Neradilek
- The Mountain-Whisper-Light Statistics, Seattle, WA, 98112, USA
| | - Edward Gill
- Department of Medicine, Division of Cardiology, University of Washington, Seattle, WA, 98104, USA
| | - Xue-Qiao Zhao
- Department of Medicine, Division of Cardiology, University of Washington, Seattle, WA, 98104, USA. .,Harborview Medical Center, University of Washington, GEC-37, 325 9th Ave, Box 359720, Seattle, WA, 98104, USA.
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Wang J, Wei L, Yang X, Zhong J. Roles of Growth Differentiation Factor 15 in Atherosclerosis and Coronary Artery Disease. J Am Heart Assoc 2019; 8:e012826. [PMID: 31432727 PMCID: PMC6755840 DOI: 10.1161/jaha.119.012826] [Citation(s) in RCA: 44] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Affiliation(s)
- Juan Wang
- Heart Center and Beijing Key Laboratory of Hypertension Beijing Chaoyang Hospital Affiliated to Capital Medical University Beijing China
| | - Liqun Wei
- Heart Center and Beijing Key Laboratory of Hypertension Beijing Chaoyang Hospital Affiliated to Capital Medical University Beijing China
| | - Xinchun Yang
- Heart Center and Beijing Key Laboratory of Hypertension Beijing Chaoyang Hospital Affiliated to Capital Medical University Beijing China
| | - Jiuchang Zhong
- Heart Center and Beijing Key Laboratory of Hypertension Beijing Chaoyang Hospital Affiliated to Capital Medical University Beijing China
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9
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Gerstein HC, Nair V, Chaube R, Stoute H, Werstuck G. Dysglycemia and the Density of the Coronary Vasa Vasorum. Diabetes Care 2019; 42:980-982. [PMID: 30862652 DOI: 10.2337/dc18-2483] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/04/2018] [Accepted: 01/30/2019] [Indexed: 02/03/2023]
Abstract
OBJECTIVE This study was conducted to determine the relationship between dysglycemia and the coronary artery vasa vasorum density. RESEARCH DESIGN AND METHODS The left anterior descending coronary artery was removed from 57 deceased individuals during autopsy, and the capillaries in the vessel wall were identified using fluorescent immunohistochemical staining. HbA1c was determined in postmortem whole blood for each individual. The density of the vasa vasorum in the intima-media and the adventitia was manually quantified and recorded by readers unaware of the individual's other characteristics. RESULTS The individuals with diabetes had a lower density of the coronary vasa vasorum than those without diabetes. The higher the HbA1c, the lower the density of these vessels in the adventitia and entire vessel wall. CONCLUSIONS Dysglycemia-induced damage to the vasa vasorum may promote ischemic heart disease in people with diabetes.
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Affiliation(s)
- Hertzel C Gerstein
- Department of Medicine, McMaster University and Hamilton Health Sciences, Hamilton, Canada .,Population Health Research Institute, McMaster University and Hamilton Health Sciences, Hamilton, Canada
| | - Vidhya Nair
- Department of Medicine, McMaster University and Hamilton Health Sciences, Hamilton, Canada.,Department of Pathology and Molecular Medicine, McMaster University and Hamilton Health Sciences, Hamilton, Canada.,University of Ottawa and The Ottawa Hospital, Ottawa, Canada
| | - Ruchi Chaube
- Thrombosis and Atherosclerosis Research Institute, McMaster University and Hamilton Health Sciences, Hamilton, Canada
| | - Heidi Stoute
- Thrombosis and Atherosclerosis Research Institute, McMaster University and Hamilton Health Sciences, Hamilton, Canada
| | - Geoff Werstuck
- Department of Medicine, McMaster University and Hamilton Health Sciences, Hamilton, Canada.,Thrombosis and Atherosclerosis Research Institute, McMaster University and Hamilton Health Sciences, Hamilton, Canada
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10
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Quan K, Song J, Yang Z, Wang D, An Q, Huang L, Liu P, Li P, Tian Y, Zhou L, Zhu W. Validation of Wall Enhancement as a New Imaging Biomarker of Unruptured Cerebral Aneurysm. Stroke 2019; 50:1570-1573. [PMID: 31035900 DOI: 10.1161/strokeaha.118.024195] [Citation(s) in RCA: 66] [Impact Index Per Article: 13.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background and Purpose- High-resolution vessel wall magnetic resonance imaging is a promising technique for assessing wall structures of unruptured intracranial aneurysms (UIAs). However, the relationship between aneurysmal high-resolution vessel wall magnetic resonance imaging features and their histopathologic mechanism remains poorly understood. Methods- From February 2016 to February 2018, a total of 19 men and 28 women with 54 UIAs treated surgically were prospectively enrolled. The intraoperative observed gross pathology of the aneurysmal wall was compared with the enhancement features on high-resolution vessel wall magnetic resonance imaging. Specimens of the UIAs were harvested for histopathologic and immunohistochemistry analysis. Results- An irregular shape and large size was significantly related to UIA wall enhancement. Both uniform and focal wall enhancement may demonstrate the inflammation processes of UIA walls, although the latter may indicate more atherosclerotic plaque formation. Conclusions- Different high-resolution vessel wall magnetic resonance imaging enhancement features may represent variable inflammation status of a UIA wall, which may provide new insights into assessing the UIA wall structure and optimizing treatment.
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Affiliation(s)
- Kai Quan
- From the Department of Neurosurgery (K.Q., J.S., Z.Y., Q.A., P. Liu, P. Li, Y.T., L.Z., W.Z.), Huashan Hospital, Fudan University, Shanghai, China
| | - Jianping Song
- From the Department of Neurosurgery (K.Q., J.S., Z.Y., Q.A., P. Liu, P. Li, Y.T., L.Z., W.Z.), Huashan Hospital, Fudan University, Shanghai, China
| | - Zixiao Yang
- From the Department of Neurosurgery (K.Q., J.S., Z.Y., Q.A., P. Liu, P. Li, Y.T., L.Z., W.Z.), Huashan Hospital, Fudan University, Shanghai, China
| | - Dongdong Wang
- Department of Radiology (D.W., L.H.), Huashan Hospital, Fudan University, Shanghai, China
| | - Qingzhu An
- From the Department of Neurosurgery (K.Q., J.S., Z.Y., Q.A., P. Liu, P. Li, Y.T., L.Z., W.Z.), Huashan Hospital, Fudan University, Shanghai, China
| | - Lei Huang
- Department of Radiology (D.W., L.H.), Huashan Hospital, Fudan University, Shanghai, China
| | - Peixi Liu
- From the Department of Neurosurgery (K.Q., J.S., Z.Y., Q.A., P. Liu, P. Li, Y.T., L.Z., W.Z.), Huashan Hospital, Fudan University, Shanghai, China
| | - Peiliang Li
- From the Department of Neurosurgery (K.Q., J.S., Z.Y., Q.A., P. Liu, P. Li, Y.T., L.Z., W.Z.), Huashan Hospital, Fudan University, Shanghai, China
| | - Yanlong Tian
- From the Department of Neurosurgery (K.Q., J.S., Z.Y., Q.A., P. Liu, P. Li, Y.T., L.Z., W.Z.), Huashan Hospital, Fudan University, Shanghai, China
| | - Liangfu Zhou
- From the Department of Neurosurgery (K.Q., J.S., Z.Y., Q.A., P. Liu, P. Li, Y.T., L.Z., W.Z.), Huashan Hospital, Fudan University, Shanghai, China
| | - Wei Zhu
- From the Department of Neurosurgery (K.Q., J.S., Z.Y., Q.A., P. Liu, P. Li, Y.T., L.Z., W.Z.), Huashan Hospital, Fudan University, Shanghai, China
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11
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Crombag GAJC, van Hoof RHM, Holtackers RJ, Schreuder FHBM, Truijman MTB, Schreuder TAHCML, van Orshoven NP, Mess WH, Hofman PAM, van Oostenbrugge RJ, Wildberger JE, Kooi ME. Symptomatic Carotid Plaques Demonstrate Less Leaky Plaque Microvasculature Compared With the Contralateral Side: A Dynamic Contrast-Enhanced Magnetic Resonance Imaging Study. J Am Heart Assoc 2019; 8:e011832. [PMID: 30971168 PMCID: PMC6507193 DOI: 10.1161/jaha.118.011832] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Background Rupture of a vulnerable carotid atherosclerotic plaque is an important underlying cause of ischemic stroke. Increased leaky plaque microvasculature may contribute to plaque vulnerability. These immature microvessels may facilitate entrance of inflammatory cells into the plaque. The objective of the present study is to investigate whether there is a difference in plaque microvasculature (the volume transfer coefficient Ktrans) between the ipsilateral symptomatic and contralateral asymptomatic carotid plaque using noninvasive dynamic contrast‐enhanced magnetic resonance imaging. Methods and Results Eighty‐eight patients with recent transient ischemic attack or ischemic stroke and ipsilateral >2 mm carotid plaque underwent 3 T magnetic resonance imaging to identify plaque components and to determine characteristics of plaque microvasculature. The volume transfer coefficient Ktrans, indicative for microvascular density, flow, and permeability, was calculated for the ipsilateral and asymptomatic plaque, using a pharmacokinetic model (Patlak). Presence of a lipid‐rich necrotic core, intraplaque hemorrhage, and a thin and/or ruptured fibrous cap was assessed on multisequence magnetic resonance imaging. We found significantly lower Ktrans in the symptomatic carotid plaque compared with the asymptomatic side (0.057±0.002 min−1 versus 0.062±0.002 min−1; P=0.033). There was an increased number of slices with intraplaque hemorrhage (0.9±1.6 versus 0.3±0.8, P=0.002) and lipid‐rich necrotic core (1.4±1.9 versus 0.8±1.4, P=0.016) and a higher prevalence of plaques with a thin and/or ruptured fibrous cap (32% versus 17%, P=0.023) at the symptomatic side. Conclusions Ktrans was significantly lower in symptomatic carotid plaques, indicative for a decrease of plaque microvasculature in symptomatic plaques. This could be related to a larger amount of necrotic tissue in symptomatic plaques. Clinical Trial Registration URL: http://www.clinicaltrials.gov.uk. Unique identifier: NCT01208025.
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Affiliation(s)
- Geneviève A J C Crombag
- 1 Department of Radiology and Nuclear Medicine Maastricht University Medical Centre Maastricht The Netherlands.,4 CARIM School for Cardiovascular Diseases Maastricht University Medical Centre Maastricht The Netherlands
| | - Raf H M van Hoof
- 1 Department of Radiology and Nuclear Medicine Maastricht University Medical Centre Maastricht The Netherlands.,4 CARIM School for Cardiovascular Diseases Maastricht University Medical Centre Maastricht The Netherlands.,5 Control Systems Technology Department of Mechanical Engineering Eindhoven University of Technology Eindhoven The Netherlands
| | - Robert J Holtackers
- 1 Department of Radiology and Nuclear Medicine Maastricht University Medical Centre Maastricht The Netherlands.,4 CARIM School for Cardiovascular Diseases Maastricht University Medical Centre Maastricht The Netherlands
| | - Floris H B M Schreuder
- 6 Department of Neurology Donders Institute for Brain Cognition & Behaviour Radboud University Medical Centre Nijmegen The Netherlands
| | - Martine T B Truijman
- 2 Department of Neurology Maastricht University Medical Centre Maastricht The Netherlands
| | | | | | - Werner H Mess
- 3 Department of Clinical Neurophysiology Maastricht University Medical Centre Maastricht The Netherlands.,4 CARIM School for Cardiovascular Diseases Maastricht University Medical Centre Maastricht The Netherlands
| | - Paul A M Hofman
- 1 Department of Radiology and Nuclear Medicine Maastricht University Medical Centre Maastricht The Netherlands
| | - Robert J van Oostenbrugge
- 2 Department of Neurology Maastricht University Medical Centre Maastricht The Netherlands.,4 CARIM School for Cardiovascular Diseases Maastricht University Medical Centre Maastricht The Netherlands
| | - Joachim E Wildberger
- 1 Department of Radiology and Nuclear Medicine Maastricht University Medical Centre Maastricht The Netherlands.,4 CARIM School for Cardiovascular Diseases Maastricht University Medical Centre Maastricht The Netherlands
| | - M Eline Kooi
- 1 Department of Radiology and Nuclear Medicine Maastricht University Medical Centre Maastricht The Netherlands.,4 CARIM School for Cardiovascular Diseases Maastricht University Medical Centre Maastricht The Netherlands
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12
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Qi H, Liu X, Liu P, Yuan W, Liu A, Jiang Y, Li Y, Sun J, Chen H. Complementary Roles of Dynamic Contrast-Enhanced MR Imaging and Postcontrast Vessel Wall Imaging in Detecting High-Risk Intracranial Aneurysms. AJNR Am J Neuroradiol 2019; 40:490-496. [PMID: 30792252 DOI: 10.3174/ajnr.a5983] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2018] [Accepted: 01/02/2019] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE Individual assessment of the absolute risk of intracranial aneurysm rupture remains challenging. Emerging imaging techniques such as dynamic contrast-enhanced MR imaging and postcontrast vessel wall MR imaging may improve risk estimation by providing new information on aneurysm wall properties. The purpose of this study was to investigate the relationship between aneurysm wall permeability on dynamic contrast-enhanced MR imaging and aneurysm wall enhancement on postcontrast vessel wall MR imaging in unruptured intracranial aneurysms. MATERIALS AND METHODS Patients with unruptured saccular intracranial aneurysms were imaged with vessel wall MR imaging before and after gadolinium contrast administration. Dynamic contrast-enhanced MR imaging was performed coincident with contrast injection using 3D T1-weighted spoiled gradient-echo imaging. The transfer constant (K trans) was measured adjacent to intracranial aneurysm and adjacent to the normal intracranial artery. RESULTS Twenty-nine subjects were analyzed (mean age, 53.9 ± 13.5 years; 24% men; PHASES score: median, 8; interquartile range, 4.75-10). K trans was higher in intracranial aneurysms compared with the normal intracranial artery (median, 0.0110; interquartile range, 0.0060-0.0390 versus median, 0.0032; interquartile range, 0.0018-0.0048 min-1; P < .001), which correlated with intracranial aneurysm size (Spearman ρ = 0.54, P = .002) and PHASES score (ρ = 0.40, P = .30). Aneurysm wall enhancement, detected in 19 (66%) aneurysms, was associated with intracranial aneurysm size and the PHASES score but not significantly with K trans (P = .30). Aneurysms of 2 of the 9 patients undergoing conservative treatment ruptured during 1-year follow-up. Both ruptured aneurysms had increased K trans, whereas only 1 had aneurysm wall enhancement at baseline. CONCLUSIONS Dynamic contrast-enhanced MR imaging showed increased K trans adjacent to intracranial aneurysms, which was independent of aneurysm wall enhancement on postcontrast vessel wall MR imaging. Increased aneurysm wall permeability on dynamic contrast-enhanced MR imaging provides new information that may be useful in intracranial aneurysm risk assessment.
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Affiliation(s)
- H Qi
- From the Department of Biomedical Engineering (H.Q., X.L., H.C.), Tsinghua University, Beijing, China
| | - X Liu
- From the Department of Biomedical Engineering (H.Q., X.L., H.C.), Tsinghua University, Beijing, China
| | - P Liu
- Department of Interventional Neuroradiology (P.L., A.L.,Y.J., Y.L.), Beijing Neurosurgical Institute and Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - W Yuan
- Department of Radiology (W.Y.), Navy Qingdao No. 1 Sanatorium of People's Liberation Army, Qingdao, China
| | - A Liu
- Department of Interventional Neuroradiology (P.L., A.L.,Y.J., Y.L.), Beijing Neurosurgical Institute and Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Y Jiang
- Department of Interventional Neuroradiology (P.L., A.L.,Y.J., Y.L.), Beijing Neurosurgical Institute and Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Y Li
- Department of Interventional Neuroradiology (P.L., A.L.,Y.J., Y.L.), Beijing Neurosurgical Institute and Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - J Sun
- Department of Radiology (J.S.), University of Washington, Seattle, Washington
| | - H Chen
- From the Department of Biomedical Engineering (H.Q., X.L., H.C.), Tsinghua University, Beijing, China
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13
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Pereira T, Betriu A, Alves R. Non-invasive imaging techniques and assessment of carotid vasa vasorum neovascularization: Promises and pitfalls. Trends Cardiovasc Med 2018; 29:71-80. [PMID: 29970286 DOI: 10.1016/j.tcm.2018.06.007] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2018] [Revised: 06/12/2018] [Accepted: 06/14/2018] [Indexed: 12/17/2022]
Abstract
Carotid adventitia vasa vasorum neovascularization (VVn) is associated with the initial stages of arteriosclerosis and with the formation of unstable plaque. However, techniques to accurately quantify that neovascularization in a standard, fast, non-invasive, and efficient way are still lacking. The development of such techniques holds the promise of enabling wide, inexpensive, and safe screening programs that could stratify patients and help in personalized preventive cardiovascular medicine. In this paper, we review the recent scientific literature pertaining to imaging techniques that could set the stage for the development of standard methods for quantitative assessment of atherosclerotic plaque and carotid VVn. We present and discuss the alternative imaging techniques being used in clinical practice and we review the computational developments that are contributing to speed up image analysis and interpretation. We conclude that one of the greatest upcoming challenges will be the use of machine learning techniques to develop automated methods that assist in the interpretation of images to stratify patients according to their risk.
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Affiliation(s)
- T Pereira
- Institute for Biomedical Research in Lleida Dr. Pifarré Foundation, Catalonia, Spain; Departament de Ciències Mèdiques Bàsiques, University of Lleida, Catalonia, Spain.
| | - A Betriu
- Unit for the Detection and Treatment of Atherothrombotic Diseases, Hospital Universitari Arnau de Vilanova de Lleida, Catalonia, Spain; Vascular and Renal Translational Research Group - IRBLleida, Catalonia, Spain
| | - R Alves
- Institute for Biomedical Research in Lleida Dr. Pifarré Foundation, Catalonia, Spain; Departament de Ciències Mèdiques Bàsiques, University of Lleida, Catalonia, Spain
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14
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van Hoof RHM, Schreuder FHBM, Nelemans P, Truijman MTB, van Orshoven NP, Schreuder TH, Mess WH, Heeneman S, van Oostenbrugge RJ, Wildberger JE, Kooi ME. Ischemic Stroke Patients Demonstrate Increased Carotid Plaque Microvasculature Compared to (Ocular) Transient Ischemic Attack Patients. Cerebrovasc Dis 2017; 44:297-303. [PMID: 28946147 DOI: 10.1159/000481146] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2016] [Accepted: 08/24/2017] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND Patients with a recent ischemic stroke have a higher risk of recurrent stroke compared to (ocular) transient ischemic attack (TIA) patients. Plaque microvasculature is considered as a feature of plaque vulnerability and can be quantified with carotid dynamic contrast-enhanced MRI (DCE-MRI). The purpose of this cross-sectional study was to explore the association between plaque microvasculature and the type of recent cerebrovascular events in symptomatic patients with mild-to-moderate carotid stenosis. METHODS A total of 87 symptomatic patients with a recent stroke (n = 35) or (ocular) TIA (n = 52) underwent carotid DCE-MRI examination. Plaque microvasculature was studied in the vessel wall and adventitia using DCE-MRI and the pharmacokinetic modeling parameter Ktrans. Statistical analysis was performed with logistic regression, correcting for associated clinical risk factors. RESULTS The 75th percentile adventitial (OR 1.97, 95% CI 1.18-3.29) Ktrans was significantly associated with a recent ischemic stroke compared to (ocular) TIA in multivariate analysis, while clinical risk factors were not significantly associated with the type of event. CONCLUSIONS This study indicates a positive association of leaky plaque microvasculature with a recent ischemic stroke compared to (ocular) TIA. Prospective longitudinal studies are needed to investigate whether Ktrans or other plaque characteristics may serve as an imaging marker for predicting (the type of) future cerebrovascular events.
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Affiliation(s)
- Raf H M van Hoof
- Department of Radiology and Nuclear Medicine, Maastricht University Medical Center, Maastricht, The Netherlands
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15
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Plaque microvascularization and permeability: Key players in atherogenesis and plaque rupture. Atherosclerosis 2017; 263:320-321. [PMID: 28673479 DOI: 10.1016/j.atherosclerosis.2017.06.915] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/15/2017] [Accepted: 06/20/2017] [Indexed: 12/29/2022]
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