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Salimi M, Tabatabaei N, Villiger M. Artificial neural network for enhancing signal-to-noise ratio and contrast in photothermal optical coherence tomography. Sci Rep 2024; 14:10264. [PMID: 38704427 PMCID: PMC11069506 DOI: 10.1038/s41598-024-60682-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2023] [Accepted: 04/25/2024] [Indexed: 05/06/2024] Open
Abstract
Optical coherence tomography (OCT) is a medical imaging method that generates micron-resolution 3D volumetric images of tissues in-vivo. Photothermal (PT)-OCT is a functional extension of OCT with the potential to provide depth-resolved molecular information complementary to the OCT structural images. PT-OCT typically requires long acquisition times to measure small fluctuations in the OCT phase signal. Here, we use machine learning with a neural network to infer the amplitude of the photothermal phase modulation from a short signal trace, trained in a supervised fashion with the ground truth signal obtained by conventional reconstruction of the PT-OCT signal from a longer acquisition trace. Results from phantom and tissue studies show that the developed network improves signal to noise ratio (SNR) and contrast, enabling PT-OCT imaging with short acquisition times and without any hardware modification to the PT-OCT system. The developed network removes one of the key barriers in translation of PT-OCT (i.e., long acquisition time) to the clinic.
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Affiliation(s)
- Mohammadhossein Salimi
- Department of Mechanical Engineering, Lassonde School of Engineering, York University, Toronto, ON, M3J 1P3, Canada
| | - Nima Tabatabaei
- Department of Mechanical Engineering, Lassonde School of Engineering, York University, Toronto, ON, M3J 1P3, Canada.
- Center for Vision Research, York University, Toronto, ON, M3J 1P3, Canada.
| | - Martin Villiger
- Department of Mechanical Engineering, Lassonde School of Engineering, York University, Toronto, ON, M3J 1P3, Canada.
- Harvard Medical School, Wellman Center for Photomedicine, Massachusetts General Hospital, Boston, MA, 02114, USA.
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Chen Y, Li Z, Bai X, Feng Y, Feng L, Zhang D, Chen H, Chen H. Reduction of Erythrocyte Fluid Adaptability Due to Cell Membrane Hardening Based on Single-Cell Analysis. BIOCHIP JOURNAL 2021. [DOI: 10.1007/s13206-021-00005-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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3
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Xu X, Hua Y, Wang L, Hou W, Xia M. Correlation between risk factors of cerebrovascular disease and calcified plaque characteristics in patients with atherosclerotic severe carotid stenosis. Neurol Res 2020; 42:83-89. [PMID: 31900088 DOI: 10.1080/01616412.2019.1710403] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Objectives: The aim of this study was to evaluate the relationship between the risk factors of cerebral vascular diseases (CVD) and the characteristics of calcified plaques in patients with severe carotid arteriosclerosis stenosis (SCAS).Methods: A total of 402 patients with SCAS who were treated in our hospital between January to December 2016 were included in this study. The patients were divided into calcified plaque group and non-calcified plaque group according to the ultrasonography and computerized tomography angiography (CTA) or digital subtraction angiography (DSA) imaging of SCAS-responsible plaque and the characteristics of calcified plaques evaluated by high-frequency ultrasound.Results: The patients with long-term diabetes mellitus or higher levels of fasting blood glucose were more likely to develop calcified plaques (P = 0.00 and P = 0.021, respectively). In addition, the patients with calcified plaques were mostly smokers (P = 0.016). Their smoking duration and accumulative smoking exposure were higher than those without calcified plaque (P = 0.006 and P = 0.007, respectively). The basal location of calcification (P = 0.004) and the type of patchy calcification (P = 0.00) were both easier to appear in smokers, while non-smokers were more likely to have small granular calcification (P = 0.002). Furthermore, the carotid plaque calcification with mixed-location were more frequently seen in patients with hypertension (P = 0.016). The risk factors independently associated with plaque calcification were significantly associated with smoking status, smoking age, and accumulative smoking exposure, as well as age and diabetes mellitus (all P < 0.05).Conclusion: Smoking, diabetes mellitus and age were independent risk factors for carotid plaque calcification. Smoking and hypertension were associated with specific locations and types of plaque calcification.
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Affiliation(s)
- Xiangli Xu
- Department of vascular Ultrasonography, Xuanwu Hospital, Capital Medical University, Beijing, China.,Department of Ultrasound, The Second Hospital of Harbin, Harbin, Heilongjiang Province, China
| | - Yang Hua
- Department of vascular Ultrasonography, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Lili Wang
- Department of vascular Ultrasonography, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Weihong Hou
- Department of vascular Ultrasonography, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Mingyu Xia
- Department of vascular Ultrasonography, Xuanwu Hospital, Capital Medical University, Beijing, China
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Dodos I, Georgopoulos S, Dodos K, Konstantakopoulou O, Grammatoglou X, Dervisis K, Bakoyiannis C, Klonaris C. Correlation of Glycosylated Hemoglobin Levels with Histological and Ultrasound Characteristics of the Carotid Plaque in Diabetic and Nondiabetic Patients. Ann Vasc Surg 2019; 61:218-226. [PMID: 31344464 DOI: 10.1016/j.avsg.2019.04.013] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2019] [Accepted: 04/01/2019] [Indexed: 10/26/2022]
Abstract
BACKGROUND The purpose of this study is to investigate the correlation of glycosylated hemoglobin (HbA1c) levels with histological characters of atherosclerotic plaque that makes it vulnerable, as well as ultrasound (US) criteria that can contribute to the prognosis of carotid disease. MATERIAL AND METHODS This is a single-center prospective study. Our study population consists of 74 diabetic and nondiabetic patients with carotid atherosclerosis who underwent carotid endarterectomy in our department. Patient categorization was based on the following criteria: levels of HbA1c, gender, and risk factors (smoking, hypertension), carotid stenosis rate, symptomatic or asymptomatic carotid disease, histological examination of the atherosclerotic plaque, and US morphological criteria of the plaque. RESULTS The mean age of the patients was 68.2 years (standard deviation = 7.8); 58.1% were smokers, 71.6% had arterial hypertension, 37.8% had symptomatic carotid disease, and 64.9% had atherosclerotic plaque type 6. Futhermore, 95.9% of the patients had a carotid stenosis rate more than 70% and 4.1% had from 50% to 69%. Older patients had more frequent type 7 and 8 atherosclerotic plaque based on American Heart Association scoring system than younger patients (P = 0.041). The relative likelihood of atherosclerotic plaque type 7 and 8 was 1.12 times higher in older patients (Odds ratio [OR] = 1.12, P = 0.029). Patients with higher levels of HbA1cwere more likely to have type 6 atherosclerotic plaque than those with atherosclerotic lesions type 7 and 8 (P < 0.001). Specifically, increasing the level of HbA1c by 1 mg/dl increases the likelihood of the presence of vulnerable plaque by 2.55%. Moreover, the relative likelihood of a type 6 atherosclerotic plaque was 10.4 times higher in the older patients (OR = 10.4, P < 0.001). CONCLUSIONS This study demonstrates that levels of HbA1c and advanced age are 2 factors that may be correlated with the presence of vulnerable carotid plaques in diabetic population. Moreover, HbA1c is an independent factor that could possibly be used as a prognostic marker for carotid artery disease, although further studies are needed to explore this association to elucidate the precise role of HbA1c.
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Affiliation(s)
- Ilias Dodos
- General Hospital Konstantopouleio, Vascular Surgery Department, Athens, Attica, Greece.
| | - Sotirios Georgopoulos
- General Hospital of Athens Laiko, 1st Surgical Department, National and Kapodistrian University of Athens, Athens, Attica, Greece
| | - Konstantinos Dodos
- General Hospital of Kifisia Agioi Anargyroi, Internal Medicine Department, Athens, Attica, Greece
| | | | | | - Konstantinos Dervisis
- General Hospital Konstantopouleio, Vascular Surgery Department, Athens, Attica, Greece
| | - Christos Bakoyiannis
- General Hospital of Athens Laiko, 1st Surgical Department, National and Kapodistrian University of Athens, Athens, Attica, Greece
| | - Christos Klonaris
- General Hospital of Athens Laiko, 1st Surgical Department, National and Kapodistrian University of Athens, Athens, Attica, Greece
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Diab HMH, Rasmussen LM, Duvnjak S, Diederichsen A, Jensen PS, Lindholt JS. Computed tomography scan based prediction of the vulnerable carotid plaque. BMC Med Imaging 2017; 17:61. [PMID: 29237404 PMCID: PMC5729460 DOI: 10.1186/s12880-017-0233-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2017] [Accepted: 11/24/2017] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Primary to validate a commercial semi-automated computed tomography angiography (CTA) -software for vulnerable plaque detection compared to histology of carotid endarterectomy (CEA) specimens and secondary validating calcifications scores by in vivo CTA with ex vivo non-contrast enhanced computed tomography (NCCT). METHODS From January 2014 to October 2016 53 patients were included retrospectively, using a cross-sectional design. All patients underwent both CTA and CEA. Sixteen patients had their CEA specimen NCCT scanned. The semi-automated CTA software analyzed carotid stenosis using different HU values defining plaque components. The predictive values of CTA based detection of vulnerable plaques were calculated. Quantification of calcifications on CTA using region of interest (ROI)-function and mathematical equations was done manually, and validated by NCCT of the CEA specimen. RESULTS The semi-automated CTA software had a sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of 89.1% (95% CI, 73.6% - 96.4%), 31.3% (95% CI, 12.1% - 58.5%), 75% (95% CI, 59.3% - 86.2%) and 55.6% (95% CI, 22.6% - 84.6%). Strong correlation between in vivo CTA and ex vivo NCCT in quantification of calcification was observed, but CTA systematically underestimated calcificationsscore (CALS) with increasing calcification. CONCLUSION The CTA-software cannot be used in risk assessment of patients, due to poor specificity and NPV. The correlation between in vivo CTA and ex vivo NCCT was strong, proposing it to be used in both scientifically and clinical settings, but studies with larger sample sizes are needed.
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Affiliation(s)
- Hadi Mahmoud Haider Diab
- Department of Cardiothoracic and Vascular Surgery, Odense University Hospital, Sdr. Boulevard 29, 5000 Odense C, Denmark
| | - Lars Melholt Rasmussen
- Department of Clinical Biochemistry and Pharmacology, Odense University Hospital, Sdr. Boulevard 29, 5000 Odense C, Denmark
| | - Stevo Duvnjak
- Department of Radiology, Odense University Hospital, Sdr. Boulevard 29, 5000 Odense C, Denmark
| | - Axel Diederichsen
- Department of Cardiology, Odense University Hospital, Sdr. Boulevard 29, 5000 Odense C, Denmark
| | - Pia Søndergaard Jensen
- Department of Clinical Biochemistry and Pharmacology, Odense University Hospital, Sdr. Boulevard 29, 5000 Odense C, Denmark
| | - Jes Sanddal Lindholt
- Department of Cardiothoracic and Vascular Surgery, Odense University Hospital, Sdr. Boulevard 29, 5000 Odense C, Denmark
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McNally JS, Kim SE, Mendes J, Hadley JR, Sakata A, De Havenon AH, Treiman GS, Parker DL. Magnetic Resonance Imaging Detection of Intraplaque Hemorrhage. MAGNETIC RESONANCE INSIGHTS 2017; 10:1-8. [PMID: 28469441 PMCID: PMC5348123 DOI: 10.1177/1178623x17694150] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/29/2016] [Accepted: 01/25/2017] [Indexed: 11/16/2022]
Abstract
Carotid artery atherosclerosis is a major cause of ischemic stroke. For more than 30 years, future stroke risk and carotid stroke etiology have been determined using percent diameter stenosis based on clinical trials in the 1990s. In the past 10 years, magnetic resonance imaging (MRI) sequences have been developed to detect carotid intraplaque hemorrhage. By detecting carotid intraplaque hemorrhage, MRI identifies potential stroke sources that are often overlooked by lumen imaging. In addition, MRI can dramatically improve assessment of future stroke risk beyond lumen stenosis alone. In this review, we discuss the use of heavily T1-weighted MRI sequences used to detect carotid intraplaque hemorrhage. In addition, advances in ciné imaging, motion robust techniques, and specialized neck coils will be reviewed. Finally, the clinical use and future impact of MRI plaque hemorrhage imaging will be discussed.
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Affiliation(s)
- J Scott McNally
- Utah Center for Advanced Imaging Research, Department of Radiology and Imaging Sciences, The University of Utah, Salt Lake City, UT, USA
| | - Seong-Eun Kim
- Utah Center for Advanced Imaging Research, Department of Radiology and Imaging Sciences, The University of Utah, Salt Lake City, UT, USA
| | - Jason Mendes
- Utah Center for Advanced Imaging Research, Department of Radiology and Imaging Sciences, The University of Utah, Salt Lake City, UT, USA
| | - J Rock Hadley
- Utah Center for Advanced Imaging Research, Department of Radiology and Imaging Sciences, The University of Utah, Salt Lake City, UT, USA
| | - Akihiko Sakata
- Utah Center for Advanced Imaging Research, Department of Radiology and Imaging Sciences, The University of Utah, Salt Lake City, UT, USA
| | - Adam H De Havenon
- Department of Neurology, The University of Utah, Salt Lake City, UT, USA
| | - Gerald S Treiman
- Utah Center for Advanced Imaging Research, Department of Radiology and Imaging Sciences, The University of Utah, Salt Lake City, UT, USA
| | - Dennis L Parker
- Utah Center for Advanced Imaging Research, Department of Radiology and Imaging Sciences, The University of Utah, Salt Lake City, UT, USA
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Marzullo A, Ambrosi F, Inchingolo M, Manca F, Devito F, Angiletta D, Zito A, Scicchitano P, Ciccone MM. ST2L Transmembrane Receptor Expression: An Immunochemical Study on Endarterectomy Samples. PLoS One 2016; 11:e0156315. [PMID: 27223112 PMCID: PMC4880330 DOI: 10.1371/journal.pone.0156315] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2016] [Accepted: 05/12/2016] [Indexed: 12/12/2022] Open
Abstract
Background ST2 (suppression of tumorigenity) has been described as a receptor for the interleukin-33, a member of the IL-1 family of cytokines. It is associated to coronary artery disease, all-causes mortality and cardiovascular mortality. Aims The present study was designed to assess the immunohistochemical expression of the ST2 receptor (ST2L/Il-1R) in atherosclerotic plaques of formalin fixed paraffin-embedded internal carotid arteries of patients with and without cerebro-vascular symptoms. Methods and Results The study involved 41 cases (23 asymptomatic and 18 symptomatic). All the clinical and morphological parameters examined were uniformly distributed between the two groups, with a mild predominance of degree of calcification in asymptomatic cases (p = 0.01). ST2L expression was found to be more evident as a membrane pattern in macrophages when observing carotid atherosclerotic plaques of symptomatic patients, rather than in asymptomatic patients’ plaques (77.7% vs 39.1%; p = 0.015), and its expression was particularly remarkable in VI type plaque (AHA). Significantly, ST2L was marked by the endothelium of neoangiogenetic vessels on the shoulder region of the plaque, but not (apart from a few cases) in the endothelium covering the residual lumen of the vessel. Conclusions The ST2L immunohistochemical expression was for the first time investigated in a large number of human carotid atherosclerotic plaques, as for its pattern of distribution in the different plaque cell populations. Furthermore, ST2L was particularly remarkable on macrophages, as a membrane pattern, of symptomatic patients’ plaque. Considering our data, we hypothesize that ST2L/IL33 axis could drive the mechanism of plaque development and eventually rupture.
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Affiliation(s)
- Andrea Marzullo
- Pathology Section, Department of Emergency and Organ Transplantation (DETO), Medical School, University of Bari, Bari, Italy
| | - Francesca Ambrosi
- Pathology Section, Department of Emergency and Organ Transplantation (DETO), Medical School, University of Bari, Bari, Italy
| | - Mirjam Inchingolo
- Vascular Surgery Section, Medical School, Department of Emergency and Organ Transplantation (DETO), University of Bari, Bari, Italy
| | - Fabio Manca
- Department of Science of Educational, Psychology and Communication-University of Bari, Bari, Italy
| | - Fiorella Devito
- Cardiovascular Diseases Section, Department of Emergency and Organ Transplantation (DETO), University of Bari, Bari, Italy
| | - Domenico Angiletta
- Vascular Surgery Section, Medical School, Department of Emergency and Organ Transplantation (DETO), University of Bari, Bari, Italy
| | - Annapaola Zito
- Cardiovascular Diseases Section, Department of Emergency and Organ Transplantation (DETO), University of Bari, Bari, Italy
| | - Pietro Scicchitano
- Cardiovascular Diseases Section, Department of Emergency and Organ Transplantation (DETO), University of Bari, Bari, Italy
| | - Marco Matteo Ciccone
- Cardiovascular Diseases Section, Department of Emergency and Organ Transplantation (DETO), University of Bari, Bari, Italy
- * E-mail:
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Zhang MD, Zhao XC, Zhang YH, Yan YF, Wang ZM, Lv SZ, Zhao QM. Plaque Thrombosis is Reduced by Attenuating Plaque Inflammation with Pioglitazone and is Evaluated by Fluorodeoxyglucose Positron Emission Tomography. Cardiovasc Ther 2016; 33:118-26. [PMID: 25825053 DOI: 10.1111/1755-5922.12119] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
INTRODUCTION The relationship between the beneficial effects of pioglitazone in reducing clinical events and plaque inflammatory burden remains unknown. This study aimed to determine whether pioglitazone can reduce the number of plaque thrombosis incidences and whether decreasing plaque inflammation is the mechanism by which pioglitazone reduces plaque thromboses. METHODS AND RESULTS therosclerotic rabbits were divided into two groups: the atherosclerosis group (n = 13) and pioglitazone group (n = 10). The rabbits underwent pharmacological triggering to induce thrombosis. Serum inflammatory markers, FDG uptake, macrophage, and neovessel staining detected arterial inflammation. PET/CT scans were performed twice (baseline and posttreatment scans). Plaque area, macrophages, and neovessels were measured and the histologic sections were matched with the PET/CT scans. Serum MMP-9 and hsCRP were lower in the pioglitazone group compared to the atherosclerosis group. The SUVmean significantly decreased in the pioglitazone group (0.62 ± 0.21 vs. 0.55 ± 0.19, P = 0.008), but increased in the atherosclerosis group (0.61 ± 0.15 vs. 0.91 ± 0.20, P < 0.000). The incidence rate of plaque rupture, plaque area, macrophage density, and neovessel density was significantly lower in rabbits with pioglitazone than without (15% vs. 38%, P < 0.001; 18.00 ± 2.30 vs. 27.00 ± 1.60; P < 0.001; 8.80 ± 3.94 vs. 28.26 ± 2.49; P < 0.001; 16.50 ± 3.09 vs. 29.00 ± 2.11; P < 0.001, respectively). Moreover, plaque area and macrophage density were positively correlated with SUV values. CONCLUSIONS Our study suggests that pioglitazone can reduce the number of plaque thrombosis incidences by decreasing plaque inflammation. (18)F-FDG-PET/CT can detect plaque inflammation and assess the effects of antiatherosclerotic drugs.
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Affiliation(s)
- Ming-Duo Zhang
- Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China.,Beijing Institute of Heart, Lung and Blood Vessel Diseases, Beijing, China
| | - Xue-Cheng Zhao
- Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China.,Beijing Institute of Heart, Lung and Blood Vessel Diseases, Beijing, China
| | - Yu-Hui Zhang
- Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China.,Beijing Institute of Heart, Lung and Blood Vessel Diseases, Beijing, China
| | - Yun-Feng Yan
- Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China.,Beijing Institute of Heart, Lung and Blood Vessel Diseases, Beijing, China
| | - Zheng-Ming Wang
- Center for PET/CT, General Hospital of Second Artillery of PLA, Beijing, China
| | - Shu-Zheng Lv
- Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China.,Beijing Institute of Heart, Lung and Blood Vessel Diseases, Beijing, China
| | - Quan-Ming Zhao
- Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China.,Beijing Institute of Heart, Lung and Blood Vessel Diseases, Beijing, China
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Li X, de Boer OJ, Ploegmaker H, Teeling P, Daemen MJ, de Winter RJ, van der Wal AC. Granulocytes in coronary thrombus evolution after myocardial infarction--time-dependent changes in expression of matrix metalloproteinases. Cardiovasc Pathol 2015; 25:40-6. [PMID: 26490693 DOI: 10.1016/j.carpath.2015.09.007] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2015] [Revised: 09/20/2015] [Accepted: 09/22/2015] [Indexed: 10/22/2022] Open
Abstract
BACKGROUND Remodeling of extracellular matrix is a key process during wound healing, which is strictly regulated by matrix metalloproteinases (MMPs) and their tissue inhibitors [tissue inhibitors of metalloproteinases (TIMPs)]. In this study, we evaluated intrathrombotic MMPs and TIMPs and their cellular origin during thrombus evolution after disruption of coronary atherosclerotic plaque. MATERIALS AND METHODS Thrombectomy materials (N=120) obtained from patients with acute myocardial infarction were histologically classified in three groups based on thrombus age: fresh (<1day), lytic (1-5days), or organized (>5days) thrombi; materials showing a heterogeneous composition were classified according to oldest part. Presence and cellular origin of MMPs (MMP-1, MMP-2, MMP-8, MMP-9, and MMP-14) and TIMPs (TIMP-1, TIMP-2, and TIMP-3) was evaluated with immunostains (double) and with polymerase chain reaction. RESULTS AND CONCLUSION MMPs and TIMPs were present in all the thrombectomy samples. A distinct temporal change in extent and cellular origin of MMPs and TIMPs during thrombus evolution was observed. In the early (fresh and lytic) stages of thrombus, high numbers of neutrophilic granulocytes occupy the thrombus mass and produce large amounts of MMPs and TIMPs. However, with progression of thrombus evolution (organizing stage) and diminishment of neutrophil granulocytes, there is disappearance of MMP-8 and MMP-9, steep decline of MMP-1 and TIMP-2, and progressive decrease of TIMP-3. In contrast, intrathrombotic MMP-2 and MMP-14 are present at a constant high level during the entire process of thrombus evolution. These temporal changes indicate a complex time-dependent function of MMPs, which are largely granulocyte derived, in the healing process of thrombus after plaque disruption.
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Affiliation(s)
- Xiaofei Li
- Department of Pathology, Academic Medical Center, University of Amsterdam, 1012WX Amsterdam, The Netherlands
| | - Onno J de Boer
- Department of Pathology, Academic Medical Center, University of Amsterdam, 1012WX Amsterdam, The Netherlands
| | - Hanneke Ploegmaker
- Department of Pathology, Academic Medical Center, University of Amsterdam, 1012WX Amsterdam, The Netherlands
| | - Peter Teeling
- Department of Pathology, Academic Medical Center, University of Amsterdam, 1012WX Amsterdam, The Netherlands
| | - Mat Jap Daemen
- Department of Pathology, Academic Medical Center, University of Amsterdam, 1012WX Amsterdam, The Netherlands
| | - Robbert J de Winter
- Department of Cardiology, Academic Medical Center, University of Amsterdam, 1012WX Amsterdam, The Netherlands
| | - Allard C van der Wal
- Department of Pathology, Academic Medical Center, University of Amsterdam, 1012WX Amsterdam, The Netherlands.
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10
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Treiman GS, McNally JS, Kim SE, Parker DL. Correlation of Carotid Intraplaque Hemorrhage and Stroke Using 1.5 T and 3 T MRI. MAGNETIC RESONANCE INSIGHTS 2015; 8:1-8. [PMID: 26056469 PMCID: PMC4454204 DOI: 10.4137/mri.s23560] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/24/2015] [Revised: 04/06/2015] [Accepted: 04/13/2015] [Indexed: 01/06/2023]
Abstract
Carotid therosclerotic disease causes approximately 25% of the nearly 690,000 ischemic strokes each year in the United States. Current risk stratification based on percent stenosis does not provide specific information on the actual risk of stroke for most individuals. Prospective randomized studies have found only 10 to 12% of asymptomatic patients will have a symptomatic stroke within 5 years. Measurements of percent stenosis do not determine plaque stability or composition. Reports have concluded that cerebral ischemic events associated with carotid plaque are intimately associated with plaque instability. Analysis of retrospective studies has found that plaque composition is important in risk stratification. Only MRI has the ability to identify and measure the detailed components and morphology of carotid plaque and provides more detailed information than other currently available techniques. MRI can accurately detect carotid hemorrhage, and MRI identified carotid hemorrhage correlates with acute stroke.
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Affiliation(s)
- Gerald S Treiman
- Utah Center for Advanced Imaging Research, Department of Radiology, University of Utah, Salt Lake City, Utah, USA ; Department of Surgery, VA Salt Lake City Health Care System, Salt Lake City, Utah, USA ; Department of Surgery, University of Utah, Salt Lake City, Utah, USA
| | - J Scott McNally
- Utah Center for Advanced Imaging Research, Department of Radiology, University of Utah, Salt Lake City, Utah, USA
| | - Seong-Eun Kim
- Utah Center for Advanced Imaging Research, Department of Radiology, University of Utah, Salt Lake City, Utah, USA
| | - Dennis L Parker
- Utah Center for Advanced Imaging Research, Department of Radiology, University of Utah, Salt Lake City, Utah, USA
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11
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Wang H, Song Y, Zhang C, Zhan J, Zhang R, Wang H. Genetic relationship between serum pregnancy-associated plasma protein-A gene polymorphism and ischemic cerebrovascular disease in a Northern Han Chinese population. Neural Regen Res 2015; 7:528-33. [PMID: 25745440 PMCID: PMC4349000 DOI: 10.3969/j.issn.1673-5374.2012.07.009] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2011] [Accepted: 12/28/2011] [Indexed: 12/13/2022] Open
Abstract
The present study recruited 193 patients with ischemic cerebrovascular disease from Inpatient and Outpatient Departments at the Affiliated Hospital of Qingdao University Medical College, China from August 2008 to May 2010, as well as 120 healthy volunteers from the Medical Examination Center at the Affiliated Hospital of Qingdao University Medical College, China, who served as controls for this study. Patients and control subjects were from the Han population in northern China. Enzyme- linked immunosorbent assay analysis revealed increased levels of serum pregnancy-associated plasma protein-A (PAPP-A) in ischemic cerebrovascular disease patients compared with healthy controls. In addition, the patients exhibited greater frequency of genotype CC and C alleles in a missense A/C (Tyr/Ser) polymorphism (dbSNP: rs7020782) of exon 14 in the PAPP-A gene. Multiple-factor logistic regression analysis on correction of age, gender, history of smoking, hypertension, diabetes mellitus, hypercholesteremia, and ischemic stroke family history showed that the risk for ischemic cerebrovascular disease in the population without the A allele at the A/C genetic locus in exon 14 of the PAPP-A was 2-folds greater than the population expressing the A allele. These experimental findings suggested that ischemic cerebrovascular disease correlated with the C allele in exon 14 of PAPP-A. In addition, the A allele is likely a protective gene; individuals carrying the A allele were less prone to ischemic cerebrovascular disease compared with individuals without the A allele.
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Affiliation(s)
- Haiping Wang
- Department of Neurology, Affiliated Hospital of Qingdao University Medical College, Qingdao 266003, Shandong Province, China
| | - Yan Song
- Department of Gerontology, Affiliated Hospital of Qingdao University Medical College, Qingdao 266003, Shandong Province, China
| | - Chen Zhang
- Department of Neurology, Affiliated Hospital of Qingdao University Medical College, Qingdao 266003, Shandong Province, China
| | - Jingjing Zhan
- Department of Neurology, Affiliated Hospital of Qingdao University Medical College, Qingdao 266003, Shandong Province, China
| | - Rui Zhang
- Department of Neurology, Affiliated Hospital of Qingdao University Medical College, Qingdao 266003, Shandong Province, China
| | - Haiji Wang
- Department of Gerontology, Affiliated Hospital of Qingdao University Medical College, Qingdao 266003, Shandong Province, China
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Lemaire M, Lemarié CA, Flores Molina M, Guilbert C, Lehoux S, Mann KK. Genetic deletion of LXRα prevents arsenic-enhanced atherosclerosis, but not arsenic-altered plaque composition. Toxicol Sci 2014; 142:477-88. [PMID: 25273567 DOI: 10.1093/toxsci/kfu197] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Arsenic exposure has been linked to an increased incidence of atherosclerosis. Previously, we have shown in vitro and in vivo that arsenic inhibits transcriptional activation of the liver X receptors (LXRs), key regulators of lipid homeostasis. Therefore, we evaluated the role of LXRα in arsenic-induced atherosclerosis using the apoE(-/-) mouse model. Indeed, deletion of LXRα protected apoE(-/-) mice against the proatherogenic effects of arsenic. We have previously shown that arsenic changes the plaque composition in apoE(-/-) mice. Arsenic decreased collagen content in the apoE(-/-) model, and we have observed the same diminution in LXRα(-/-)apoE(-/-) mice. However, the collagen-producing smooth muscle cells (SMCs) were decreased in apoE(-/-), but increased in LXRα(-/-)apoE(-/-). Although transcriptional activation of collagen remained the same in SMC from both genotypes, arsenic-exposed LXRα(-/-)apoE(-/-) plaques had increased matrix metalloproteinase activity compared with both control LXRα(-/-)apoE(-/-) and apoE(-/-), which could be responsible for both the decrease in plaque collagen and the SMC invasion. In addition, arsenic increased plaque lipid accumulation in both genotypes. However, macrophages, the cells known to retain lipid within the plaque, were unchanged in arsenic-exposed apoE(-/-) mice, but decreased in LXRα(-/-)apoE(-/-). We confirmed in vitro that these cells retained more lipid following arsenic exposure and are more sensitive to apoptosis than apoE(-/-). Mice lacking LXRα are resistant to arsenic-enhanced atherosclerosis, but arsenic-exposed LXRα(-/-)apoE(-/-) mice still present a different plaque composition pattern than the arsenic-exposed apoE(-/-) mice.
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Affiliation(s)
- Maryse Lemaire
- *Department of Oncology, Lady Davis Institute for Medical Research, and Department of Medicine, McGill University, Montréal, Canada H3T 1E2 *Department of Oncology, Lady Davis Institute for Medical Research, and Department of Medicine, McGill University, Montréal, Canada H3T 1E2
| | - Catherine A Lemarié
- *Department of Oncology, Lady Davis Institute for Medical Research, and Department of Medicine, McGill University, Montréal, Canada H3T 1E2 *Department of Oncology, Lady Davis Institute for Medical Research, and Department of Medicine, McGill University, Montréal, Canada H3T 1E2
| | - Manuel Flores Molina
- *Department of Oncology, Lady Davis Institute for Medical Research, and Department of Medicine, McGill University, Montréal, Canada H3T 1E2
| | - Cynthia Guilbert
- *Department of Oncology, Lady Davis Institute for Medical Research, and Department of Medicine, McGill University, Montréal, Canada H3T 1E2
| | - Stéphanie Lehoux
- *Department of Oncology, Lady Davis Institute for Medical Research, and Department of Medicine, McGill University, Montréal, Canada H3T 1E2 *Department of Oncology, Lady Davis Institute for Medical Research, and Department of Medicine, McGill University, Montréal, Canada H3T 1E2
| | - Koren K Mann
- *Department of Oncology, Lady Davis Institute for Medical Research, and Department of Medicine, McGill University, Montréal, Canada H3T 1E2 *Department of Oncology, Lady Davis Institute for Medical Research, and Department of Medicine, McGill University, Montréal, Canada H3T 1E2
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Lee JG, Lee KB, Roh H, Ahn MY, Bae HJ, Lee JS, Woo HY, Hwang HW. Intracranial Arterial Calcification Can Predict Early Vascular Events after Acute Ischemic Stroke. J Stroke Cerebrovasc Dis 2014; 23:e331-7. [DOI: 10.1016/j.jstrokecerebrovasdis.2013.12.022] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2013] [Revised: 12/08/2013] [Accepted: 12/16/2013] [Indexed: 01/06/2023] Open
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Niesten JM, van der Schaaf IC, van Dam L, Vink A, Vos JA, Schonewille WJ, de Bruin PC, Mali WPTM, Velthuis BK. Histopathologic composition of cerebral thrombi of acute stroke patients is correlated with stroke subtype and thrombus attenuation. PLoS One 2014; 9:e88882. [PMID: 24523944 PMCID: PMC3921255 DOI: 10.1371/journal.pone.0088882] [Citation(s) in RCA: 163] [Impact Index Per Article: 16.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2013] [Accepted: 01/13/2014] [Indexed: 11/18/2022] Open
Abstract
Introduction We related composition of cerebral thrombi to stroke subtype and attenuation on non-contrast CT (NCCT) to gain more insight in etiopathogenesis and to validate thrombus attenuation as a new imaging biomarker for acute stroke. Methods We histopathologically investigated 22 thrombi retrieved after mechanical thrombectomy in acute stroke patients. First, thrombi were classified as fresh, lytic or organized. Second, percentages of red blood cells (RBCs), platelets and fibrin and number of red, white (respectively RBCs or platelets outnumbering other components with ≥15%) or mixed thrombi were compared between large artery atherosclerosis (LAA), cardioembolism, dissection and unknown subtype. Third, correlation between attenuation and RBCs, platelets and fibrin was calculated using Pearson's correlation coefficients (r). Results Thrombi were fresh in 73% (n = 16), lytic in 18% (n = 4) and organized in 9% (n = 2). The stroke cause was LAA in eight (36%), cardioembolism in six (27%), dissection in three (14%), and unknown in five (23%) patients. LAA thrombi showed the highest percentage RBCs (median 50 (range 35–90)), followed by dissection (35 (20–40), p = 0.05), cardioembolism (35 (5–45), p = 0.013) and unknown subtype (25 (2–40), p = 0.006). No differences in platelets (p = 0.16) and fibrin (p = 0.52) between subtypes were found. LAA thrombi were classified as red or mixed (both n = 4), cardioembolisms as mixed (n = 5) or white (n = 1) and dissection as mixed (n = 3). There was a moderate positive correlation between attenuation and RBCs (r = 0.401, p = 0.049), and weak negative correlations with platelets (r = −0.368, p = 0.09) and fibrin (r = −0.073, p = 0.75). Conclusions The majority of cerebral thrombi is fresh. There are no differences in age of thrombi between subtypes. LAA thrombi have highest percentages RBCs, cardioembolism and unknown subtype lowest. No relationship exists between subtype and platelets or fibrin percentages. We found a correlation between the RBC-component and thrombus attenuation, which improves validation of thrombus attenuation on NCCT as an imaging biomarker for stroke management.
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Affiliation(s)
- Joris M. Niesten
- Department of Radiology, University Medical Center Utrecht, Utrecht, The Netherlands
- * E-mail:
| | | | - Lievay van Dam
- Department of Radiology, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Aryan Vink
- Department of Pathology, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Jan Albert Vos
- Department of Radiology, St. Antonius Hospital, Nieuwegein, The Netherlands
| | | | - Peter C. de Bruin
- Department of Pathology, St. Antonius Hospital, Nieuwegein, The Netherlands
| | - Willem P. T. M. Mali
- Department of Radiology, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Birgitta K. Velthuis
- Department of Radiology, University Medical Center Utrecht, Utrecht, The Netherlands
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15
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Relationship between thrombus attenuation and different stroke subtypes. Neuroradiology 2013; 55:1071-9. [DOI: 10.1007/s00234-013-1217-y] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2013] [Accepted: 06/06/2013] [Indexed: 10/26/2022]
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16
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Li JJ, Meng X, Si HP, Zhang C, Lv HX, Zhao YX, Yang JM, Dong M, Zhang K, Liu SX, Zhao XQ, Gao F, Liu XL, Cui TX, Zhang Y. Hepcidin destabilizes atherosclerotic plaque via overactivating macrophages after erythrophagocytosis. Arterioscler Thromb Vasc Biol 2012; 32:1158-66. [PMID: 22383698 DOI: 10.1161/atvbaha.112.246108] [Citation(s) in RCA: 69] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
OBJECTIVE To explore a direct and causal relationship between vascular hepcidin and atherosclerotic plaque stability. METHODS AND RESULTS Accelerated atherosclerotic lesions were established by perivascular collar placement in apolipoprotein E-deficient (ApoE(-/-)) mice. Adenoviral overexpression of hepcidin in the carotid artery during plaque formation enhanced intraplaque macrophage infiltration and suppressed the contents of collagen and vascular smooth muscle cells, whereas hepcidin shRNA treatment exerts opposite effects. The overexpression or knockdown of hepcidin did not affect plaque lipid deposition but increased or decreased oxidized low-density lipoprotein (ox-LDL) levels within intraplaque macrophages. In cultured macrophages, ox-LDL not only increased reactive oxygen species formation, inflammatory cytokine production, and apoptosis but also upregulated hepcidin expression. However, hepcidin did not exaggerate the ox-LDL-induced activation of macrophages until an onset of erythrophagocytosis. Whereas hepcidin was critical for the upregulation of L-ferritin and H-ferritin in both ox-LDL-treated erythrophagocytosed macrophages and atherosclerotic plaques, the adding of iron chelators suppressed the intracellular lipid accumulation, reactive oxygen species formation, inflammatory cytokine expression, and apoptosis in erythrophagocytosed macrophages. CONCLUSIONS Hepcidin promotes plaque destabilization partly by exaggerating inflammatory cytokine release, intracellular lipid accumulation, oxidative stress, and apoptosis in the macrophages with iron retention.
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Affiliation(s)
- Jing Jing Li
- Key Laboratory of Cardiovascular Remodeling and Function Research, Chinese Ministry of Education, Shandong University, Jinan, Shandong, China
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Zheng M, Choi SY, Tahk SJ, Lim HS, Yang HM, Choi BJ, Yoon MH, Park JS, Hwang GS, Shin JH. The Relationship Between Volumetric Plaque Components and Classical Cardiovascular Risk Factors and the Metabolic Syndrome. JACC Cardiovasc Interv 2011; 4:503-10. [DOI: 10.1016/j.jcin.2010.12.015] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/27/2010] [Revised: 12/15/2010] [Accepted: 12/26/2010] [Indexed: 10/18/2022]
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18
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Wypasek E, Undas A, Sniezek-Maciejewska M, Kapelak B, Plicner D, Stępień E, Sadowski J. The increased plasma C-reactive protein and interleukin-6 levels in patients undergoing coronary artery bypass grafting surgery are associated with the interleukin-6−174G > C gene polymorphism. Ann Clin Biochem 2010; 47:343-9. [DOI: 10.1258/acb.2010.090305] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Background The interleukin-6 (IL-6) promoter −174G/C polymorphism (rs1800795) is associated with enhanced systemic inflammatory response to injury. However, data on the effect of this polymorphism on inflammatory markers in patients undergoing coronary artery bypass grafting surgery (CABG) are inconsistent. The aim of our study was to investigate whether −174G/C IL-6 polymorphism affects plasma IL-6 and C-reactive protein (CRP) concentrations in patients undergoing CABG. Methods A total of 179 consecutive white patients (77% men, aged 65 ± 8.6 standard deviation [SD] y) scheduled for elective isolated CABG were studied. Pre- and postoperative CRP and IL-6 levels were analysed in relation to the 174G/C IL-6 polymorphism determined by using TaqMan single-nucleotide polymorphism genotyping technique. Results The genotype distribution was as follows: GG –46 (26%), GC –93 (52%) and CC –40 (22%). The C allele carriers had higher baseline CRP (4.1 ± 0.35 versus 2.4 ± 0.59 mg/L, P = 0.02) and IL-6 levels (3.0 ± 0.17 versus 2.2 ± 0.3 pg/mL, P = 0.02) than GG patients. Five to seven days after CABG, CRP levels rose by 54% ( P = 0.03), and IL-6 levels tended to be higher ( P = 0.07) in −174C allele carriers than the non-carriers. There were no associations between −174G/C IL-6 polymorphism and any demographic-, clinical- or procedure-related variables as well as major adverse cardiovascular events. Multivariate regression analysis, including sex, age, body mass index, hypercholesterolaemia, smoking, hypertension diabetes, identified CG + CC genotype as the only independent predictor of preoperative CRP and IL-6 levels. Conclusions The presence of the −174C allele determines to some extent higher plasma CRP and IL-6 concentrations pre- and postoperatively in CABG patients.
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Affiliation(s)
- E Wypasek
- Institute of Cardiology, Jagiellonian University School of Medicine
- John Paul II Hospital, Cracow, Poland
| | - A Undas
- Institute of Cardiology, Jagiellonian University School of Medicine
| | | | - B Kapelak
- Institute of Cardiology, Jagiellonian University School of Medicine
| | - D Plicner
- Institute of Cardiology, Jagiellonian University School of Medicine
| | - E Stępień
- Institute of Cardiology, Jagiellonian University School of Medicine
- John Paul II Hospital, Cracow, Poland
| | - J Sadowski
- Institute of Cardiology, Jagiellonian University School of Medicine
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The vulnerable and unstable atherosclerotic plaque. Cardiovasc Pathol 2010; 19:6-11. [DOI: 10.1016/j.carpath.2008.08.004] [Citation(s) in RCA: 60] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2008] [Revised: 08/12/2008] [Accepted: 08/19/2008] [Indexed: 11/19/2022] Open
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Singh N, Moody AR, Gladstone DJ, Leung G, Ravikumar R, Zhan J, Maggisano R. Moderate Carotid Artery Stenosis: MR Imaging–depicted Intraplaque Hemorrhage Predicts Risk of Cerebrovascular Ischemic Events in Asymptomatic Men. Radiology 2009; 252:502-8. [PMID: 19508983 DOI: 10.1148/radiol.2522080792] [Citation(s) in RCA: 189] [Impact Index Per Article: 12.6] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Navneet Singh
- Department of Diagnostic Imaging, Sunnybrook Health Sciences Centre, University of Toronto, 2075 Bayview St, Toronto, ON, Canada M4N 3M5
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21
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Gardner CM, Tan H, Hull EL, Lisauskas JB, Sum ST, Meese TM, Jiang C, Madden SP, Caplan JD, Burke AP, Virmani R, Goldstein J, Muller JE. Detection of Lipid Core Coronary Plaques in Autopsy Specimens With a Novel Catheter-Based Near-Infrared Spectroscopy System. JACC Cardiovasc Imaging 2008; 1:638-48. [DOI: 10.1016/j.jcmg.2008.06.001] [Citation(s) in RCA: 312] [Impact Index Per Article: 19.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2008] [Revised: 05/12/2008] [Accepted: 06/10/2008] [Indexed: 11/25/2022]
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Ajduk M, Pavić L, Bulimbasić S, Sarlija M, Pavić P, Patrlj L, Brkljacić B. Multidetector-row computed tomography in evaluation of atherosclerotic carotid plaques complicated with intraplaque hemorrhage. Ann Vasc Surg 2008; 23:186-93. [PMID: 18657388 DOI: 10.1016/j.avsg.2008.05.008] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2007] [Revised: 03/03/2008] [Accepted: 05/08/2008] [Indexed: 11/30/2022]
Abstract
Our aim was to determine the sensitivity and specificity of multidetector-row computed tomography (CT) in detecting atherosclerotic carotid plaques complicated with intraplaque hemorrhage. We examined carotid plaques from 31 patients operated for carotid artery stenosis. Results of preoperative multidetector-row CT analysis of carotid plaques were compared with results of histological analysis of the same plaque areas. Carotid endarterectomy was performed within 1 week of multidetector-row CT. American Heart Association classification of atherosclerotic plaques was applied for histological classification. Median tissue density of carotid plaques complicated with intraplaque hemorrhage was 22 Hounsfield units (HU). Median tissue density of noncalcified segments of uncomplicated plaques was 59 HU (p=0.0062). The highest tissue density observed for complicated plaques was 31 HU. Multidetector-row CT detected plaques complicated with hemorrhage with sensitivity of 100% and specificity of 64.7%, with tissue density of 31 HU as a threshold value. Multidetector-row CT showed a high level of sensitivity and a moderate level of specificity in detecting atherosclerotic carotid plaques complicated with hemorrhage.
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Affiliation(s)
- Marko Ajduk
- Department of Vascular Surgery, University Hospital Dubrava, Zagreb, Croatia.
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23
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Bobryshev YV, Killingsworth MC, Lord RSA, Grabs AJ. Matrix vesicles in the fibrous cap of atherosclerotic plaque: possible contribution to plaque rupture. J Cell Mol Med 2008; 12:2073-82. [PMID: 18194456 PMCID: PMC4506172 DOI: 10.1111/j.1582-4934.2008.00230.x] [Citation(s) in RCA: 50] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
Plaque rupture is the most common type of plaque complication and leads to acute ischaemic events such as myocardial infarction and stroke. Calcification has been suggested as a possible indicator of plaque instability. Although the role of matrix vesicles in the initial stages of arterial calcification has been recognized, no studies have yet been carried out to examine a possible role of matrix vesicles in plaque destabilization. Tissue specimens selected for the present study represented carotid specimens obtained from patients undergoing carotid endarterectomy. Serial frozen cross-sections of the tissue specimens were cut and mounted on glass slides. The thickness of the fibrous cap (FCT) in each advanced atherosclerotic lesion, containing a well developed lipid/necrotic core, was measured at its narrowest sites in sets of serial sections. According to established criteria, atherosclerotic plaque specimens were histologically subdivided into two groups: vulnerable plaques with thin fibrous caps (FCT <100 μm) and presumably stable plaques, in which fibrous caps were thicker than 100 μm. Twenty-four carotid plaques (12 vulnerable and 12 presumably stable plaques) were collected for the present analysis of matrix vesicles in fibrous caps. In order to provide a sufficient number of representative areas from each plaque, laser capture microdissection (LCM) was carried out. The quantification of matrix vesicles in ultrathin sections of vulnerable and stable plaques revealed that the numbers of matrix vesicles were significantly higher in fibrous caps of vulnerable plaques than those in stable plaques (8.908±0.544 versus 6.208±0.467 matrix vesicles per 1.92 μm2 standard area; P= 0.0002). Electron microscopy combined with X-ray elemental microanalysis showed that some matrix vesicles in atherosclerotic plaques were undergoing calcification and were characterized by a high content of calcium and phosphorus. The percentage of calcified matrix vesicles/microcalcifications was significantly higher in fibrous caps in vulnerable plaques compared with that in stable plaques (6.705±0.436 versus 5.322±0A94; P= 0.0474). The findings reinforce a view that the texture of the extracellular matrix in the thinning fibrous cap of atherosclerotic plaque is altered and this might contribute to plaque destabilization.
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Affiliation(s)
- Y V Bobryshev
- Faculty of Medicine, University of New South Wales, Kensington NSW, Australia.
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Santos Filho E, Saijo Y, Tanaka A, Yoshizawa M. Detection and quantification of calcifications in intravascular ultrasound images by automatic thresholding. ULTRASOUND IN MEDICINE & BIOLOGY 2008; 34:160-5. [PMID: 17761383 DOI: 10.1016/j.ultrasmedbio.2007.06.025] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/18/2007] [Revised: 05/18/2007] [Accepted: 06/26/2007] [Indexed: 05/17/2023]
Abstract
An innovative application of automatic thresholding is used for the detection of calcification regions in intravascular ultrasound images. A priori knowledge of the acoustic shadow that usually accompanies calcification regions is used to discriminate these from other bright regions in the image. A method for the calculation of the angle of calcification has also been developed. The proposed algorithms are applied to in-vivo images obtained from left anterior descending coronary arteries during percutaneous transluminal coronary angioplasty (n = 14). The resulting specificity is 72% and the sensitivity 84%. The receiver operating characteristic curve, the area under the curve being equal to 0.91, is plotted to evaluate the algorithm performance.
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Affiliation(s)
- E Santos Filho
- Department of Medical Engineering and Cardiology, Institute of Development, Aging, and Cancer, Tohoku University, Sendai, Japan.
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Chen XY, Wong KS, Lam WWM, Zhao HL, Ng HK. Middle Cerebral Artery Atherosclerosis: Histological Comparison between Plaques Associated with and Not Associated with Infarct in a Postmortem Study. Cerebrovasc Dis 2007; 25:74-80. [PMID: 18033961 DOI: 10.1159/000111525] [Citation(s) in RCA: 126] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2006] [Accepted: 07/19/2007] [Indexed: 11/19/2022] Open
Affiliation(s)
- Xiang Yan Chen
- Department of Medicine and Therapeutics, Chinese University of Hong Kong, Shatin, Hong Kong SAR, China.
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Lin HL, Xu XS, Lu HX, Zhang L, Li CJ, Tang MX, Sun HW, Liu Y, Zhang Y. Pathological mechanisms and dose dependency of erythrocyte-induced vulnerability of atherosclerotic plaques. J Mol Cell Cardiol 2007; 43:272-80. [PMID: 17628589 DOI: 10.1016/j.yjmcc.2007.05.023] [Citation(s) in RCA: 49] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2007] [Revised: 05/26/2007] [Accepted: 05/30/2007] [Indexed: 02/06/2023]
Abstract
To test our hypothesis that erythrocytes may induce plaque vulnerability and investigate the mechanism involved, we established a novel model of intraplaque hemorrhage in 56 New Zealand white rabbits with established plaques. Three distinct abdominal aortic plaques with similar thickness were identified in each rabbit with use of intravascular ultrasound (IVUS) imaging. Rabbits were equally divided into 4 groups depending on dosage of treatment; with the guidance of IVUS, one of the three plaques from each rabbit was injected from adventitia with autologous erythrocytes (RBC) or cholesterol (CH) for the following groups: RBC, 50 microL or 100 microL, and CH, 50 microL or 100 microL. One of the other two plaques in each rabbit received an equal volume of normal saline (NS) and one received no injection. Plaques in the 100 microL RBC group had a higher plaque rupture rate than its respective NS or blank controls plaques (57.1% vs. 14.3% or 14.3%, P<0.05). Plaques from the RBC or cholesterol groups showed, dose-dependently, more macrophage infiltration, more superoxide and lipid content, thinner plaque fibrous cap, higher mRNA level of MCP-1, IL-1 or IFN-gamma and higher vulnerability index than controls, especially in the RBC group. Thus, erythrocyte treatment can dose-dependently induce the vulnerability of plaques. Accumulation of lipid content and augmentation of oxidative stress and inflammation in the plaques are the probable pathological mechanisms involved.
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Affiliation(s)
- Hui-li Lin
- The Key Laboratory of Cardiovascular Remodeling and Function Research, Chinese Ministry of Education and Chinese Ministry of Health, Shandong University Qilu Hospital, Jinan, Shandong, 250012, PR China
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Briley-Saebo KC, Mulder WJM, Mani V, Hyafil F, Amirbekian V, Aguinaldo JGS, Fisher EA, Fayad ZA. Magnetic resonance imaging of vulnerable atherosclerotic plaques: Current imaging strategies and molecular imaging probes. J Magn Reson Imaging 2007; 26:460-79. [PMID: 17729343 DOI: 10.1002/jmri.20989] [Citation(s) in RCA: 114] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
The vulnerability or destabilization of atherosclerotic plaques has been directly linked to plaque composition. Imaging modalities, such as magnetic resonance (MR) imaging, that allow for evaluation of plaque composition at a cellular and molecular level, could further improve the detection of vulnerable plaque and may allow for monitoring the efficacy of antiatherosclerotic therapies. In this review we focus on MR imaging strategies for the detection and evaluation of atherosclerotic plaques and their composition. We highlight recent advancements in the development of MR pulse sequences, computer image analysis, and the use of commercially available MR contrast agents, such as gadopentic acid (Gd-DTPA), for plaque characterization. We also discuss molecular imaging strategies that are currently being used to design specific imaging probes targeted to biochemical and cellular markers of atherosclerotic plaque vulnerability.
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Affiliation(s)
- Karen C Briley-Saebo
- Imaging Science Laboratories, Department of Radiology, Mount Sinai School of Medicine, New York, New York, USA
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Pham PH, Rao DS, Vasunilashorn F, Fishbein MC, Goldin JG. Computed tomography calcium quantification as a measure of atherosclerotic plaque morphology and stability. Invest Radiol 2006; 41:674-80. [PMID: 16896302 DOI: 10.1097/01.rli.0000233325.42572.08] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
OBJECTIVES We examined the relationship between computed tomography (CT)-quantified calcium and histopathologic atherosclerotic plaque morphology and rupture. MATERIALS AND METHODS Seven aortae were harvested from autopsy cases. All were scanned, ex vivo, on a 16-slice CT scanner and CT calcium scores (CTCS) were calculated using a Siemens Calcium Scoring package. The aorta segments were physically cross sectioned at 3-mm intervals corresponding to CT reconstructions. Two pathologists evaluated the cross sections for histology calcium score (HCS), plaque fibrous cap disruption, overlying thrombus, internal hemorrhage, size, lipid content, and inflammation. CT and histology data were subsequently paired using predetermined quadrant and slice conventions. RESULTS Three hundred forty-nine aorta cross sections yielded 41 atherosclerotic plaques. Eleven plaques demonstrated plaque disruption and thrombosis and all contained calcium. CTCS was not significantly different between atherosclerotic plaques with and without evidence of disruption/thrombosis (F[1,30] = 1.525, P = 0.227). CT was 100% sensitive for nodular calcification, but only 56% (5 of 9 plaques) sensitive for non-nodular calcification. There was no significant relationship between CTCS and intraplaque hemorrhage, lipid content, inflammation, and plaque size (P = 0.179, P = 0.230, P = 0.314, and P = 0.054). There was significant correlation between CTCS and HCS (Pearson coefficient = 0.535; P < 0.01). CONCLUSIONS Calcium quantity does not appear to predict plaque morphology or likelihood of rupture. CT has lower sensitivity for non-nodular compared with nodular calcification.
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Affiliation(s)
- Peter H Pham
- Department of Radiological Sciences, David Geffen School of Medicine at UCLA, University of California-Los Angeles, 10833 Le Conte Avenue, Los Angeles, CA 90095-1721, USA
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Mani V, Briley-Saebo KC, Hyafil F, Fayad ZA. Feasibility of in vivo identification of endogenous ferritin with positive contrast MRI in rabbit carotid crush injury using GRASP. Magn Reson Med 2006; 56:1096-106. [PMID: 17036302 DOI: 10.1002/mrm.21060] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
In vivo markers that allow for detection of ferritin within atheromatous plaque may be useful for identifying iron-catalyzed hydroxyl-radical formation and subsequent lipid peroxidation. Recently, a positive contrast MR technique--GRadient echo Acquisition for Superparamagnetic particles/suscePtibility (GRASP)--was used to identify the presence of magnetic entities in phantom models. The aim of the current study was to determine the feasibility of using GRASP in conjunction with conventional T(2) (*)-weighted (T(2) (*)W) gradient-echo (GRE) sequences for identifying ferritin/hemosiderin deposition using in vitro and in vivo models of thrombus. In vitro thrombi were prepared by incubating blood with ferritin. MRI was performed using conventional GRE sequences and GRASP. The results indicate that GRASP was able to verify ferritin deposition in in vitro thrombi. In vivo thrombi were created using a crush injury model in rabbits. The signal enhancement obtained using conventional GRE sequences and GRASP was compared with the location of iron deposition by histology. In all of the animals the GRASP signal correlated with signal loss by conventional GRE, and ferritin/hemosiderin deposition by histology. GRASP sequences in combination with conventional GRE sequences may be used to detect the presence of ferritin deposition in in vitro thrombi and in vivo crush-injured rabbit carotid arteries.
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Affiliation(s)
- Venkatesh Mani
- Imaging Science Laboratories, Mount Sinai School of Medicine, New York, New York 10029-6574, USA
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