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Li Y, Huo H, Liu H, Zheng Y, Tian Z, Jiang X, Jin S, Hou Y, Yang Q, Teng F, Liu T. Coronary CTA-based radiomic signature of pericoronary adipose tissue predict rapid plaque progression. Insights Imaging 2024; 15:151. [PMID: 38900243 PMCID: PMC11189889 DOI: 10.1186/s13244-024-01731-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2024] [Accepted: 05/08/2024] [Indexed: 06/21/2024] Open
Abstract
OBJECTIVES To explore the value of radiomic features derived from pericoronary adipose tissue (PCAT) obtained by coronary computed tomography angiography for prediction of coronary rapid plaque progression (RPP). METHODS A total of 1233 patients from two centers were included in this multicenter retrospective study. The participants were divided into training, internal validation, and external validation cohorts. Conventional plaque characteristics and radiomic features of PCAT were extracted and analyzed. Random Forest was used to construct five models. Model 1: clinical model. Model 2: plaque characteristics model. Model 3: PCAT radiomics model. Model 4: clinical + radiomics model. Model 5: plaque characteristics + radiomics model. The evaluation of the models encompassed identification accuracy, calibration precision, and clinical applicability. Delong' test was employed to compare the area under the curve (AUC) of different models. RESULTS Seven radiomic features, including two shape features, three first-order features, and two textural features, were selected to build the PCAT radiomics model. In contrast to the clinical model and plaque characteristics model, the PCAT radiomics model (AUC 0.85 for training, 0.84 for internal validation, and 0.81 for external validation; p < 0.05) achieved significantly higher diagnostic performance in predicting RPP. The separate combination of radiomics with clinical and plaque characteristics model did not further improve diagnostic efficacy statistically (p > 0.05). CONCLUSION Radiomic feature analysis derived from PCAT significantly improves the prediction of RPP as compared to clinical and plaque characteristics. Radiomic analysis of PCAT may improve monitoring RPP over time. CRITICAL RELEVANCE STATEMENT Our findings demonstrate PCAT radiomics model exhibited good performance in the prediction of RPP, with potential clinical value. KEY POINTS Rapid plaque progression may be predictable with radiomics from pericoronary adipose tissue. Fibrous plaque volume, diameter stenosis, and fat attenuation index were identified as risk factors for predicting rapid plaque progression. Radiomics features of pericoronary adipose tissue can improve the predictive ability of rapid plaque progression.
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Affiliation(s)
- Yue Li
- Department of Radiology, The First Hospital of China Medical University, Shenyang, China
| | - Huaibi Huo
- Department of Radiology, The First Hospital of China Medical University, Shenyang, China
| | - Hui Liu
- Department of Radiology, The First Hospital of China Medical University, Shenyang, China
| | - Yue Zheng
- Department of Radiology, The First Hospital of China Medical University, Shenyang, China
| | - Zhaoxin Tian
- Department of Radiology, The First Hospital of China Medical University, Shenyang, China
| | - Xue Jiang
- Department of Radiology, The First Hospital of China Medical University, Shenyang, China
| | - Shiqi Jin
- Department of Radiology, The First Hospital of China Medical University, Shenyang, China
| | - Yang Hou
- Department of Radiology, Shengjing Hospital of China Medical University, Shenyang, China
| | - Qi Yang
- Department of Radiology, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China
| | - Fei Teng
- Department of Radiology, Chinese Academy of Medical Sciences Fuwai Hospital Shenzhen Hospital, Shenzhen, China.
| | - Ting Liu
- Department of Radiology, The First Hospital of China Medical University, Shenyang, China.
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He Z, Chen Q, Duan X, Zhong Y, Zhu L, Mou N, Yang X, Cao Y, Han Z, He H, Wu S, Wang G, Qin X, Qu K, Zhang K, Liu J, Wu W. Reactive oxygen species-responsive nano-platform with dual-targeting and fluorescent lipid-specific imaging capabilities for the management of atherosclerotic plaques. Acta Biomater 2024; 181:375-390. [PMID: 38734284 DOI: 10.1016/j.actbio.2024.05.011] [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: 01/21/2024] [Revised: 04/04/2024] [Accepted: 05/05/2024] [Indexed: 05/13/2024]
Abstract
Atherosclerosis (AS), a pathological cause of cardiovascular disease, results from endothelial injury, local progressive inflammation, and excessive lipid accumulation. AS plaques rich in foam cells are prone to rupture and form thrombus, which can cause life-threatening complications. Therefore, the assessment of atherosclerotic plaque vulnerability and early intervention are crucial in reducing the mortality rates associated with cardiovascular disease. In this work, A fluorescent probe FC-TPA was synthesized, which switches the fluorescence state between protonated and non-protonated, reducing background fluorescence and enhancing imaging signal-to-noise ratio. On this basis, FC-TPA is loaded into cyclodextrin (CD) modified with phosphatidylserine targeting peptide (PTP) and coated with hyaluronic acid (HA) to construct the intelligent responsive diagnostic nanoplatform (HA@PCFT). HA@PCFT effectively targets atherosclerotic plaques, utilizing dual targeting mechanisms. HA binds strongly to CD44, while PTP binds to phosphatidylserine, enabling nanoparticle aggregation at the lesion site. ROS acts as a smart release switch for probes. Both in vitro and in vivo evaluations confirm impressive lipid-specific fluorescence imaging capabilities of HA@PCFT nanoparticles (NPs). The detection of lipid load in atherosclerotic plaque by fluorescence imaging will aid in assessing the vulnerability of atherosclerotic plaque. STATEMENT OF SIGNIFICANCE: Currently, numerous fluorescent probes have been developed for lipid imaging. However, some challenges including inadequate water solubility, nonspecific distribution patterns, and fluorescence background interference, have greatly limited their further applications in vivo. To overcome these limitations, a fluorescent molecule has been designed and synthesized, thoroughly investigating its photophysical properties through both theoretical and experimental approaches. Interestingly, this fluorescent molecule exhibits the reversible fluorescence switching capabilities, mediated by hydrogen bonds, which effectively mitigate background fluorescence interference. Additionally, the fluorescent molecules has been successfully loaded into nanocarriers functionalized with the active targeting abilities, which has significantly improved the solubility of the fluorescent molecules and reduced their nonspecific distribution in vivo for an efficient target imaging in atherosclerosis. This study provides a valuable reference for evaluating the performance of such fluorescent dyes, and offers a promising perspective on the design of the target delivery systems for atherosclerosis.
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Affiliation(s)
- Zhigui He
- Key Laboratory for Biorheological Science and Technology of Ministry of Education, State and Local Joint Engineering Laboratory for Vascular Implants, Bioengineering College of Chongqing University, Chongqing 400030, China
| | - Qiao Chen
- Key Laboratory for Biorheological Science and Technology of Ministry of Education, State and Local Joint Engineering Laboratory for Vascular Implants, Bioengineering College of Chongqing University, Chongqing 400030, China
| | - Xinmei Duan
- Key Laboratory for Biorheological Science and Technology of Ministry of Education, State and Local Joint Engineering Laboratory for Vascular Implants, Bioengineering College of Chongqing University, Chongqing 400030, China
| | - Yuan Zhong
- Key Laboratory for Biorheological Science and Technology of Ministry of Education, State and Local Joint Engineering Laboratory for Vascular Implants, Bioengineering College of Chongqing University, Chongqing 400030, China
| | - Li Zhu
- Key Laboratory for Biorheological Science and Technology of Ministry of Education, State and Local Joint Engineering Laboratory for Vascular Implants, Bioengineering College of Chongqing University, Chongqing 400030, China
| | - Nianlian Mou
- Key Laboratory for Biorheological Science and Technology of Ministry of Education, State and Local Joint Engineering Laboratory for Vascular Implants, Bioengineering College of Chongqing University, Chongqing 400030, China
| | - Xu Yang
- Key Laboratory for Biorheological Science and Technology of Ministry of Education, State and Local Joint Engineering Laboratory for Vascular Implants, Bioengineering College of Chongqing University, Chongqing 400030, China
| | - Yu Cao
- Key Laboratory for Biorheological Science and Technology of Ministry of Education, State and Local Joint Engineering Laboratory for Vascular Implants, Bioengineering College of Chongqing University, Chongqing 400030, China
| | - Zhiqiang Han
- Key Laboratory for Biorheological Science and Technology of Ministry of Education, State and Local Joint Engineering Laboratory for Vascular Implants, Bioengineering College of Chongqing University, Chongqing 400030, China
| | - Houhua He
- Key Laboratory for Biorheological Science and Technology of Ministry of Education, State and Local Joint Engineering Laboratory for Vascular Implants, Bioengineering College of Chongqing University, Chongqing 400030, China
| | - Shuai Wu
- Key Laboratory for Biorheological Science and Technology of Ministry of Education, State and Local Joint Engineering Laboratory for Vascular Implants, Bioengineering College of Chongqing University, Chongqing 400030, China
| | - Guixue Wang
- Key Laboratory for Biorheological Science and Technology of Ministry of Education, State and Local Joint Engineering Laboratory for Vascular Implants, Bioengineering College of Chongqing University, Chongqing 400030, China; JinFeng Laboratory, Chongqing 401329, China
| | - Xian Qin
- Key Laboratory for Biorheological Science and Technology of Ministry of Education, State and Local Joint Engineering Laboratory for Vascular Implants, Bioengineering College of Chongqing University, Chongqing 400030, China; Chongqing Municipality Clinical Research Center for Endocrinology and Metabolic Diseases, Chongqing University Three Gorges Hospital, Chongqing 404000, China
| | - Kai Qu
- Key Laboratory for Biorheological Science and Technology of Ministry of Education, State and Local Joint Engineering Laboratory for Vascular Implants, Bioengineering College of Chongqing University, Chongqing 400030, China; Chongqing Municipality Clinical Research Center for Endocrinology and Metabolic Diseases, Chongqing University Three Gorges Hospital, Chongqing 404000, China
| | - Kun Zhang
- Key Laboratory for Biorheological Science and Technology of Ministry of Education, State and Local Joint Engineering Laboratory for Vascular Implants, Bioengineering College of Chongqing University, Chongqing 400030, China; Chongqing Municipality Clinical Research Center for Endocrinology and Metabolic Diseases, Chongqing University Three Gorges Hospital, Chongqing 404000, China.
| | - Jie Liu
- Key Laboratory for Biorheological Science and Technology of Ministry of Education, State and Local Joint Engineering Laboratory for Vascular Implants, Bioengineering College of Chongqing University, Chongqing 400030, China.
| | - Wei Wu
- Key Laboratory for Biorheological Science and Technology of Ministry of Education, State and Local Joint Engineering Laboratory for Vascular Implants, Bioengineering College of Chongqing University, Chongqing 400030, China; JinFeng Laboratory, Chongqing 401329, China.
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Yang H, Huang G, Li X, Wu M, Zhou W, Yin X, Zhang M, Chen Z. High-resolution magnetic resonance vessel wall imaging provides new insights into Moyamoya disease. Front Neurosci 2024; 18:1375645. [PMID: 38665292 PMCID: PMC11043609 DOI: 10.3389/fnins.2024.1375645] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2024] [Accepted: 03/13/2024] [Indexed: 04/28/2024] Open
Abstract
Moyamoya disease (MMD) is a rare condition that affects the blood vessels of the central nervous system. This cerebrovascular disease is characterized by progressive narrowing and blockage of the internal carotid, middle cerebral, and anterior cerebral arteries, which results in the formation of a compensatory fragile vascular network. Currently, digital subtraction angiography (DSA) is considered the gold standard in diagnosing MMD. However, this diagnostic technique is invasive and may not be suitable for all patients. Hence, non-invasive imaging methods such as computed tomography angiography (CTA) and magnetic resonance angiography (MRA) are often used. However, these methods may have less reliable diagnostic results. Therefore, High-Resolution Magnetic Resonance Vessel Wall Imaging (HR-VWI) has emerged as the most accurate method for observing and analyzing arterial wall structure. It enhances the resolution of arterial walls and enables quantitative and qualitative analysis of plaque, facilitating the identification of atherosclerotic lesions, vascular entrapment, myofibrillar dysplasia, moyamoya vasculopathy, and other related conditions. Consequently, HR-VWI provides a new and more reliable evaluation criterion for diagnosing vascular lesions in patients with Moyamoya disease.
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Affiliation(s)
- Hui Yang
- Department of Neurology, Clinical Medical School of Jiujiang University, Jiujiang, China
- Jiujiang Clinical Precision Medicine Research Center, Jiujiang, China
- School of Basic Medicine, Jiujiang University, Jiujiang, China
| | - Guilan Huang
- Department of Neurology, Clinical Medical School of Jiujiang University, Jiujiang, China
- Jiujiang Clinical Precision Medicine Research Center, Jiujiang, China
| | - Xi Li
- Department of Neurology, University of California Irvine Medical Center, Irvine, CA, United States
| | - Moxin Wu
- Jiujiang Clinical Precision Medicine Research Center, Jiujiang, China
| | - Weixin Zhou
- Jiujiang Clinical Precision Medicine Research Center, Jiujiang, China
| | - Xiaoping Yin
- Department of Neurology, Clinical Medical School of Jiujiang University, Jiujiang, China
- Jiujiang Clinical Precision Medicine Research Center, Jiujiang, China
| | - Manqing Zhang
- School of Basic Medicine, Jiujiang University, Jiujiang, China
| | - Zhiying Chen
- Department of Neurology, Clinical Medical School of Jiujiang University, Jiujiang, China
- Jiujiang Clinical Precision Medicine Research Center, Jiujiang, China
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Abrahams T, Fujino M, Nelson AJ, Nicholls SJ. Impact of PCSK9 inhibitors on coronary atheroma phenotype following myocardial infarction: insights from intravascular imaging. Curr Opin Cardiol 2023; 38:504-508. [PMID: 37751373 DOI: 10.1097/hco.0000000000001080] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/28/2023]
Abstract
PURPOSE OF REVIEW The aim of this study was to review the impact of combination lipid lowering with statins and proprotein convertase subtilisin kexin type 9 (PCSK9) inhibitors on coronary atherosclerosis using serial intravascular imaging. RECENT FINDINGS Early studies using intravascular ultrasound established the ability of increasingly intensive lipid lowering to both slow progression and ultimately promote regression of coronary disease. More recent clinical trials that have employed serial imaging with optical coherence tomography have permitted the ability to evaluate the impact of intensive lipid lowering on compositional features associated with plaque vulnerability. In particular, the combination of intensive statin and PCSK9 inhibitor therapy promotes plaque stability in patients following an acute coronary syndrome. SUMMARY More intensive lipid lowering using the combination of statins and PCSK9 inhibitors promote plaque regression in addition to promoting calcification, fibrous cap thickening and reductions in plaque lipid. These plaque-stabilizing effects underscore the benefits of combination therapy on cardiovascular events and highlight the importance of combination lipid-lowering therapy.
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Affiliation(s)
- Timothy Abrahams
- Victorian Heart Institute, Monash University, Clayton, Victoria, Australia
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Li Y, Ma JQ, Wang CC, Zhou J, Sun YD, Wei XL, Zhao ZQ. Ferroptosis: A potential target of macrophages in plaque vulnerability. Open Life Sci 2023; 18:20220722. [PMID: 37791060 PMCID: PMC10543703 DOI: 10.1515/biol-2022-0722] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Revised: 08/04/2023] [Accepted: 08/16/2023] [Indexed: 10/05/2023] Open
Abstract
Plaque vulnerability has been the subject of several recent studies aimed at reducing the risk of stroke and carotid artery stenosis. Atherosclerotic plaque development is a complex process involving inflammation mediated by macrophages. Plaques become more vulnerable when the equilibrium between macrophage recruitment and clearance is disturbed. Lipoperoxides, which are affected by iron levels in cells, are responsible for the cell death seen in ferroptosis. Ferroptosis results from lipoperoxide-induced mitochondrial membrane toxicity. Atherosclerosis in ApoE(-/-) mice is reduced when ferroptosis is inhibited and iron intake is limited. Single-cell sequencing revealed that a ferroptosis-related gene was substantially expressed in atherosclerosis-modeled macrophages. Since ferroptosis can be regulated, it offers hope as a non-invasive method of treating carotid plaque. In this study, we discuss the role of ferroptosis in atherosclerotic plaque vulnerability, including its mechanism, regulation, and potential future research directions.
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Affiliation(s)
- Yu Li
- Department of Vascular Surgery, Changhai Hospital, The PLA Naval Medical University, 168 Changhai Road, Shanghai200433, China
| | - Ji-Qing Ma
- Department of Vascular Surgery, Changhai Hospital, The PLA Naval Medical University, 168 Changhai Road, Shanghai200433, China
| | - Chao-Chen Wang
- Department of Vascular Surgery, Changhai Hospital, The PLA Naval Medical University, 168 Changhai Road, Shanghai200433, China
| | - Jian Zhou
- Department of Vascular Surgery, Changhai Hospital, The PLA Naval Medical University, 168 Changhai Road, Shanghai200433, China
| | - Yu-Dong Sun
- Department of General Surgery, Jinling Hospital, Medical School of Nanjing University,
Nanjing201411, China
| | - Xiao-Long Wei
- Department of Vascular Surgery, Changhai Hospital, The PLA Naval Medical University, 168 Changhai Road, Shanghai200433, China
| | - Zhi-Qing Zhao
- Department of Vascular Surgery, Changhai Hospital, The PLA Naval Medical University, 168 Changhai Road, Shanghai200433, China
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Tanisawa H, Matsumoto H, Cadet S, Higuchi S, Ohya H, Isodono K, Irie D, Kaneko K, Sumida A, Hirano T, Otaki Y, Kitamura R, Slomka PJ, Dey D, Shinke T. Quantification of Low-Attenuation Plaque Burden from Coronary CT Angiography: A Head-to-Head Comparison with Near-Infrared Spectroscopy Intravascular US. Radiol Cardiothorac Imaging 2023; 5:e230090. [PMID: 37908555 PMCID: PMC10613924 DOI: 10.1148/ryct.230090] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Revised: 08/09/2023] [Accepted: 08/24/2023] [Indexed: 11/02/2023]
Abstract
Purpose To determine the association between low-attenuation plaque (LAP) burden at coronary CT angiography (CCTA) and plaque morphology determined with near-infrared spectroscopy intravascular US (NIRS-IVUS) and to compare the discriminative ability for NIRS-IVUS-verified high-risk plaques (HRPs) between LAP burden and visual assessment of LAP. Materials and Methods This Health Insurance Portability and Accountability Act-compliant retrospective study included consecutive patients who underwent CCTA before NIRS-IVUS between October 2019 and October 2022 at two facilities. LAPs were visually identified as having a central focal area of less than 30 HU using the pixel lens technique. LAP burden was calculated as the volume of voxels with less than 30 HU divided by vessel volume. HRPs were defined as plaques with one of the following NIRS-IVUS-derived high-risk features: maximum 4-mm lipid core burden index greater than 400 (lipid-rich plaque), an echolucent zone (intraplaque hemorrhage), or echo attenuation (cholesterol clefts). Multivariable analysis was performed to evaluate NIRS-IVUS-derived parameters associated with LAP burden. The discriminative ability for NIRS-IVUS-verified HRPs was compared using receiver operating characteristic analysis. Results In total, 273 plaques in 141 patients (median age, 72 years; IQR, 63-78 years; 106 males) were analyzed. All the NIRS-IVUS-derived high-risk features were independently linked to LAP burden (P < .01 for all). LAP burden increased with the number of high-risk features (P < .001) and had better discriminative ability for HRPs than plaque attenuation by visual assessment (area under the receiver operating characteristic curve, 0.93 vs 0.89; P = .02). Conclusion Quantification of LAP burden improved HRP assessment compared with visual assessment. LAP burden was associated with the accumulation of HRP morphology.Keywords: Coronary CT Angiography, Intraplaque Hemorrhage, Lipid-Rich Plaque, Low Attenuation Plaque, Near-Infrared Spectroscopy Intravascular Ultrasound Supplemental material is available for this article. See also the commentary by Ferencik in this issue.© RSNA, 2023.
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Affiliation(s)
- Hiroki Tanisawa
- From the Division of Cardiology, Showa University School of Medicine, 1-5-8 Hatanodai Shinagawa-ku, Tokyo 142-8555, Japan (H.T., H.M., S.H., K.K., A.S., T.S.); Biomedical Imaging Research Institute, Cedars-Sinai Medical Center, Los Angeles, Calif (S.C., P.J.S., D.D.); Department of Cardiology, Ijinkai Takeda General Hospital, Kyoto, Japan (H.O., K.I., D.I., R.K.); Department of Radiological Technology, Showa University Hospital, Tokyo, Japan (T.H.); and Department of Radiology, Sakakibara Heart Institute, Tokyo, Japan (Y.O.)
| | - Hidenari Matsumoto
- From the Division of Cardiology, Showa University School of Medicine, 1-5-8 Hatanodai Shinagawa-ku, Tokyo 142-8555, Japan (H.T., H.M., S.H., K.K., A.S., T.S.); Biomedical Imaging Research Institute, Cedars-Sinai Medical Center, Los Angeles, Calif (S.C., P.J.S., D.D.); Department of Cardiology, Ijinkai Takeda General Hospital, Kyoto, Japan (H.O., K.I., D.I., R.K.); Department of Radiological Technology, Showa University Hospital, Tokyo, Japan (T.H.); and Department of Radiology, Sakakibara Heart Institute, Tokyo, Japan (Y.O.)
| | - Sebastien Cadet
- From the Division of Cardiology, Showa University School of Medicine, 1-5-8 Hatanodai Shinagawa-ku, Tokyo 142-8555, Japan (H.T., H.M., S.H., K.K., A.S., T.S.); Biomedical Imaging Research Institute, Cedars-Sinai Medical Center, Los Angeles, Calif (S.C., P.J.S., D.D.); Department of Cardiology, Ijinkai Takeda General Hospital, Kyoto, Japan (H.O., K.I., D.I., R.K.); Department of Radiological Technology, Showa University Hospital, Tokyo, Japan (T.H.); and Department of Radiology, Sakakibara Heart Institute, Tokyo, Japan (Y.O.)
| | - Satoshi Higuchi
- From the Division of Cardiology, Showa University School of Medicine, 1-5-8 Hatanodai Shinagawa-ku, Tokyo 142-8555, Japan (H.T., H.M., S.H., K.K., A.S., T.S.); Biomedical Imaging Research Institute, Cedars-Sinai Medical Center, Los Angeles, Calif (S.C., P.J.S., D.D.); Department of Cardiology, Ijinkai Takeda General Hospital, Kyoto, Japan (H.O., K.I., D.I., R.K.); Department of Radiological Technology, Showa University Hospital, Tokyo, Japan (T.H.); and Department of Radiology, Sakakibara Heart Institute, Tokyo, Japan (Y.O.)
| | - Hidefumi Ohya
- From the Division of Cardiology, Showa University School of Medicine, 1-5-8 Hatanodai Shinagawa-ku, Tokyo 142-8555, Japan (H.T., H.M., S.H., K.K., A.S., T.S.); Biomedical Imaging Research Institute, Cedars-Sinai Medical Center, Los Angeles, Calif (S.C., P.J.S., D.D.); Department of Cardiology, Ijinkai Takeda General Hospital, Kyoto, Japan (H.O., K.I., D.I., R.K.); Department of Radiological Technology, Showa University Hospital, Tokyo, Japan (T.H.); and Department of Radiology, Sakakibara Heart Institute, Tokyo, Japan (Y.O.)
| | - Koji Isodono
- From the Division of Cardiology, Showa University School of Medicine, 1-5-8 Hatanodai Shinagawa-ku, Tokyo 142-8555, Japan (H.T., H.M., S.H., K.K., A.S., T.S.); Biomedical Imaging Research Institute, Cedars-Sinai Medical Center, Los Angeles, Calif (S.C., P.J.S., D.D.); Department of Cardiology, Ijinkai Takeda General Hospital, Kyoto, Japan (H.O., K.I., D.I., R.K.); Department of Radiological Technology, Showa University Hospital, Tokyo, Japan (T.H.); and Department of Radiology, Sakakibara Heart Institute, Tokyo, Japan (Y.O.)
| | - Daisuke Irie
- From the Division of Cardiology, Showa University School of Medicine, 1-5-8 Hatanodai Shinagawa-ku, Tokyo 142-8555, Japan (H.T., H.M., S.H., K.K., A.S., T.S.); Biomedical Imaging Research Institute, Cedars-Sinai Medical Center, Los Angeles, Calif (S.C., P.J.S., D.D.); Department of Cardiology, Ijinkai Takeda General Hospital, Kyoto, Japan (H.O., K.I., D.I., R.K.); Department of Radiological Technology, Showa University Hospital, Tokyo, Japan (T.H.); and Department of Radiology, Sakakibara Heart Institute, Tokyo, Japan (Y.O.)
| | - Kyoichi Kaneko
- From the Division of Cardiology, Showa University School of Medicine, 1-5-8 Hatanodai Shinagawa-ku, Tokyo 142-8555, Japan (H.T., H.M., S.H., K.K., A.S., T.S.); Biomedical Imaging Research Institute, Cedars-Sinai Medical Center, Los Angeles, Calif (S.C., P.J.S., D.D.); Department of Cardiology, Ijinkai Takeda General Hospital, Kyoto, Japan (H.O., K.I., D.I., R.K.); Department of Radiological Technology, Showa University Hospital, Tokyo, Japan (T.H.); and Department of Radiology, Sakakibara Heart Institute, Tokyo, Japan (Y.O.)
| | - Arihiro Sumida
- From the Division of Cardiology, Showa University School of Medicine, 1-5-8 Hatanodai Shinagawa-ku, Tokyo 142-8555, Japan (H.T., H.M., S.H., K.K., A.S., T.S.); Biomedical Imaging Research Institute, Cedars-Sinai Medical Center, Los Angeles, Calif (S.C., P.J.S., D.D.); Department of Cardiology, Ijinkai Takeda General Hospital, Kyoto, Japan (H.O., K.I., D.I., R.K.); Department of Radiological Technology, Showa University Hospital, Tokyo, Japan (T.H.); and Department of Radiology, Sakakibara Heart Institute, Tokyo, Japan (Y.O.)
| | - Takaho Hirano
- From the Division of Cardiology, Showa University School of Medicine, 1-5-8 Hatanodai Shinagawa-ku, Tokyo 142-8555, Japan (H.T., H.M., S.H., K.K., A.S., T.S.); Biomedical Imaging Research Institute, Cedars-Sinai Medical Center, Los Angeles, Calif (S.C., P.J.S., D.D.); Department of Cardiology, Ijinkai Takeda General Hospital, Kyoto, Japan (H.O., K.I., D.I., R.K.); Department of Radiological Technology, Showa University Hospital, Tokyo, Japan (T.H.); and Department of Radiology, Sakakibara Heart Institute, Tokyo, Japan (Y.O.)
| | - Yuka Otaki
- From the Division of Cardiology, Showa University School of Medicine, 1-5-8 Hatanodai Shinagawa-ku, Tokyo 142-8555, Japan (H.T., H.M., S.H., K.K., A.S., T.S.); Biomedical Imaging Research Institute, Cedars-Sinai Medical Center, Los Angeles, Calif (S.C., P.J.S., D.D.); Department of Cardiology, Ijinkai Takeda General Hospital, Kyoto, Japan (H.O., K.I., D.I., R.K.); Department of Radiological Technology, Showa University Hospital, Tokyo, Japan (T.H.); and Department of Radiology, Sakakibara Heart Institute, Tokyo, Japan (Y.O.)
| | - Ryoji Kitamura
- From the Division of Cardiology, Showa University School of Medicine, 1-5-8 Hatanodai Shinagawa-ku, Tokyo 142-8555, Japan (H.T., H.M., S.H., K.K., A.S., T.S.); Biomedical Imaging Research Institute, Cedars-Sinai Medical Center, Los Angeles, Calif (S.C., P.J.S., D.D.); Department of Cardiology, Ijinkai Takeda General Hospital, Kyoto, Japan (H.O., K.I., D.I., R.K.); Department of Radiological Technology, Showa University Hospital, Tokyo, Japan (T.H.); and Department of Radiology, Sakakibara Heart Institute, Tokyo, Japan (Y.O.)
| | - Piotr J Slomka
- From the Division of Cardiology, Showa University School of Medicine, 1-5-8 Hatanodai Shinagawa-ku, Tokyo 142-8555, Japan (H.T., H.M., S.H., K.K., A.S., T.S.); Biomedical Imaging Research Institute, Cedars-Sinai Medical Center, Los Angeles, Calif (S.C., P.J.S., D.D.); Department of Cardiology, Ijinkai Takeda General Hospital, Kyoto, Japan (H.O., K.I., D.I., R.K.); Department of Radiological Technology, Showa University Hospital, Tokyo, Japan (T.H.); and Department of Radiology, Sakakibara Heart Institute, Tokyo, Japan (Y.O.)
| | - Damini Dey
- From the Division of Cardiology, Showa University School of Medicine, 1-5-8 Hatanodai Shinagawa-ku, Tokyo 142-8555, Japan (H.T., H.M., S.H., K.K., A.S., T.S.); Biomedical Imaging Research Institute, Cedars-Sinai Medical Center, Los Angeles, Calif (S.C., P.J.S., D.D.); Department of Cardiology, Ijinkai Takeda General Hospital, Kyoto, Japan (H.O., K.I., D.I., R.K.); Department of Radiological Technology, Showa University Hospital, Tokyo, Japan (T.H.); and Department of Radiology, Sakakibara Heart Institute, Tokyo, Japan (Y.O.)
| | - Toshiro Shinke
- From the Division of Cardiology, Showa University School of Medicine, 1-5-8 Hatanodai Shinagawa-ku, Tokyo 142-8555, Japan (H.T., H.M., S.H., K.K., A.S., T.S.); Biomedical Imaging Research Institute, Cedars-Sinai Medical Center, Los Angeles, Calif (S.C., P.J.S., D.D.); Department of Cardiology, Ijinkai Takeda General Hospital, Kyoto, Japan (H.O., K.I., D.I., R.K.); Department of Radiological Technology, Showa University Hospital, Tokyo, Japan (T.H.); and Department of Radiology, Sakakibara Heart Institute, Tokyo, Japan (Y.O.)
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Liu W, Cai H, Zheng Y, Wen Y, Chen S, Xie X, Zeng H, Zhu H, Ni Z, Pei F, Cao J, Cao G. Predictive Value of Post-Percutaneous Coronary Intervention Quantitative Flow Ratio for Vessel-Oriented Composite Endpoint. J Interv Cardiol 2023; 2023:2438347. [PMID: 37720628 PMCID: PMC10505082 DOI: 10.1155/2023/2438347] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2022] [Revised: 08/08/2023] [Accepted: 08/31/2023] [Indexed: 09/19/2023] Open
Abstract
At present, there is a lack of indicators, which can accurately predict the post-percutaneous coronary intervention (post-PCI) vessel-oriented composite endpoint (VOCE). Recent studies showed that the post-PCI quantitative flow ratio (QFR) can predict post-PCI VOCE. PubMed, Embase, and Cochrane were searched from inception to March 27, 2022, and the cohort studies about that the post-PCI QFR predicts post-PCI VOCE were screened. Meta-analysis was performed, including 6 studies involving 4518 target vessels. The results of the studies included in this meta-analysis all showed that low post-PCI QFR was an independent risk factor for post-PCI VOCE after adjusting for other factors, HR (95% CI) ranging from 2.718 (1.347-5.486) to 6.53 (2.70-15.8). Our meta-analysis showed that the risk of post-PCI VOCE was significantly higher in the lower post-PCI QFR group than in the higher post-PCI QFR group (HR: 4.14, 95% CI: 3.00-5.70, P < 0.001, I2 = 27.9%). Post-PCI QFR has a good predictive value for post-PCI VOCE. Trial Registration. This trial is registered with CRD42022322001.
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Affiliation(s)
- Weibin Liu
- Department of Cardiology, Ganzhou People's Hospital, Ganzhou 341000, China
| | - Huaxiu Cai
- Department of Cardiology, Ganzhou People's Hospital, Ganzhou 341000, China
| | - Yin Zheng
- Gannan Medical University, Ganzhou 341000, China
| | - Yongkang Wen
- Gannan Medical University, Ganzhou 341000, China
| | - Sicheng Chen
- Gannan Medical University, Ganzhou 341000, China
| | - Xiuying Xie
- Department of General Practice, Ganzhou Hospital of Guangdong Provincial People's Hospital, Ganzhou Municipal Hospital, Ganzhou 341000, China
| | - Huan Zeng
- Department of Radiology and Imaging, Ganzhou Hospital of Guangdong Provincial People's Hospital, Ganzhou Municipal Hospital, Ganzhou 341000, China
| | - Hengqing Zhu
- Department of Cardiology, Ganzhou Hospital of Guangdong Provincial People's Hospital, Ganzhou Municipal Hospital, Ganzhou 341000, China
| | - Zhonghan Ni
- Department of Cardiology, Ganzhou Hospital of Guangdong Provincial People's Hospital, Ganzhou Municipal Hospital, Ganzhou 341000, China
| | - Fang Pei
- Department of Cardiology, Ganzhou Hospital of Guangdong Provincial People's Hospital, Ganzhou Municipal Hospital, Ganzhou 341000, China
| | - Jun Cao
- Department of Cardiology, Ganzhou Hospital of Guangdong Provincial People's Hospital, Ganzhou Municipal Hospital, Ganzhou 341000, China
| | - Gang Cao
- Department of Cardiology, Ganzhou Hospital of Guangdong Provincial People's Hospital, Ganzhou Municipal Hospital, Ganzhou 341000, China
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Yao Y, Zhang P. Novel ultrasound techniques in the identification of vulnerable plaques-an updated review of the literature. Front Cardiovasc Med 2023; 10:1069745. [PMID: 37293284 PMCID: PMC10244552 DOI: 10.3389/fcvm.2023.1069745] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2022] [Accepted: 05/08/2023] [Indexed: 06/10/2023] Open
Abstract
Atherosclerosis is an inflammatory disease partly mediated by lipoproteins. The rupture of vulnerable atherosclerotic plaques and thrombosis are major contributors to the development of acute cardiovascular events. Despite various advances in the treatment of atherosclerosis, there has been no satisfaction in the prevention and assessment of atherosclerotic vascular disease. The identification and classification of vulnerable plaques at an early stage as well as research of new treatments remain a challenge and the ultimate goal in the management of atherosclerosis and cardiovascular disease. The specific morphological features of vulnerable plaques, including intraplaque hemorrhage, large lipid necrotic cores, thin fibrous caps, inflammation, and neovascularisation, make it possible to identify and characterize plaques with a variety of invasive and non-invasive imaging techniques. Notably, the development of novel ultrasound techniques has introduced the traditional assessment of plaque echogenicity and luminal stenosis to a deeper assessment of plaque composition and the molecular field. This review will discuss the advantages and limitations of five currently available ultrasound imaging modalities for assessing plaque vulnerability, based on the biological characteristics of the vulnerable plaque, and their value in terms of clinical diagnosis, prognosis, and treatment efficacy assessment.
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Meng L, Jiang M, Zhang C, Zhang J. Deep learning segmentation, classification, and risk prediction of complex vascular lesions on intravascular ultrasound images. Biomed Signal Process Control 2023. [DOI: 10.1016/j.bspc.2023.104584] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
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Okada K, Hibi K. Intravascular Ultrasound in Vulnerable Plaque and Acute Coronary Syndrome. Interv Cardiol Clin 2023; 12:155-165. [PMID: 36922057 DOI: 10.1016/j.iccl.2022.10.003] [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] [Indexed: 02/04/2023]
Abstract
Vulnerable plaque plays a pivotal role in the pathogenesis of acute coronary syndrome (ACS), being responsible for most ACS. The concept of vulnerable plaque has evolved with advancements in basic and clinical investigations along with developments and rapid expansion of coronary imaging modalities. Intravascular ultrasound (IVUS) is the first widely applied clinical technology with sufficient tissue penetration and enables us to identify vulnerable plaque and comprehensively understand the pathophysiology of ACS. In this review, we summarize current clinical evidence established by IVUS and the recent advancements in our understanding of vulnerable plaque and its role in ACS management.
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Affiliation(s)
- Kozo Okada
- Division of Cardiology, Yokohama City University Medical Center
| | - Kiyoshi Hibi
- Division of Cardiology, Yokohama City University Medical Center.
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Chen Q, Pan T, Wang YN, Schoepf UJ, Bidwell SL, Qiao H, Feng Y, Xu C, Xu H, Xie G, Gao X, Tao XW, Lu M, Xu PP, Zhong J, Wei Y, Yin X, Zhang J, Zhang LJ. A Coronary CT Angiography Radiomics Model to Identify Vulnerable Plaque and Predict Cardiovascular Events. Radiology 2023; 307:e221693. [PMID: 36786701 DOI: 10.1148/radiol.221693] [Citation(s) in RCA: 17] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/15/2023]
Abstract
Background A noninvasive coronary CT angiography (CCTA)-based radiomics technique may facilitate the identification of vulnerable plaques and patients at risk for future adverse events. Purpose To assess whether a CCTA-based radiomic signature (RS) of vulnerable plaques defined with intravascular US was associated with increased risk for future major adverse cardiac events (MACE). Materials and Methods In a retrospective study, an RS of vulnerable plaques was developed and validated using intravascular US as the reference standard. The RS development data set included patients first undergoing CCTA and then intravascular US within 3 months between June 2013 and December 2020 at one tertiary hospital. The development set was randomly assigned to training and validation sets at a 7:3 ratio. Diagnostic performance was assessed internally and externally from three tertiary hospitals using the area under the curve (AUC). The prognostic value of the RS for predicting MACE was evaluated in a prospective cohort with suspected coronary artery disease between April 2018 and March 2019. Multivariable Cox regression analysis was used to evaluate the RS and conventional anatomic plaque features (eg, segment involvement score) for predicting MACE. Results The RS development data set included 419 lesions from 225 patients (mean age, 64 years ± 10 [SD]; 68 men), while the prognostic cohort included 1020 lesions from 708 patients (mean age, 62 years ± 11; 498 men). Sixteen radiomic features, including two shape features and 14 textural features, were selected to build the RS. The RS yielded a moderate to good AUC in the training, validation, internal, and external test sets (AUC = 0.81, 0.75, 0.80, and 0.77, respectively). A high RS (≥1.07) was independently associated with MACE over a median 3-year follow-up (hazard ratio, 2.01; P = .005). Conclusion A coronary CT angiography-derived radiomic signature of coronary plaque enabled the detection of vulnerable plaques that were associated with increased risk for future adverse cardiac outcomes. © RSNA, 2023 Supplemental material is available for this article. See also the editorial by De Cecco and van Assen in this issue.
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Affiliation(s)
- Qian Chen
- From the Departments of Radiology (Q.C., H.X., G.X., X.Y.) and Cardiology (T.P., X.G., J. Zhang), Nanjing First Hospital, Nanjing Medical University, Nanjing, China; Department of Diagnostic Radiology, Jinling Hospital, Medical School of Nanjing University, 305 Zhongshan East Road, Xuanwu District, Nanjing 210002, China (Q.C., U.J.S., P.P.X., J. Zhong, L.J.Z.); Department of Radiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China (Y.N.W., C.X.); Division of Cardiovascular Imaging, Department of Radiology and Radiological Science, Medical University of South Carolina, Charleston, SC (U.J.S., S.L.B.); Department of Medical Imaging, Affiliated Hospital of Jiangnan University, Wuxi, China (H.Q.); Department of Medical Imaging, Medical Imaging Center, The Affiliated Huaian No.1 People's Hospital of Nanjing Medical University, Huaian, China (Y.F.); Bayer Healthcare, Shanghai, China (X.W.T.); School of Public Health, Shanghai JiaoTong University School of Medicine, Shanghai, China (M.L.); and Department of Biostatistics, School of Public Health, China International Cooperation Center for Environment and Human Health, Nanjing Medical University, Nanjing, China (Y.W.)
| | - Tao Pan
- From the Departments of Radiology (Q.C., H.X., G.X., X.Y.) and Cardiology (T.P., X.G., J. Zhang), Nanjing First Hospital, Nanjing Medical University, Nanjing, China; Department of Diagnostic Radiology, Jinling Hospital, Medical School of Nanjing University, 305 Zhongshan East Road, Xuanwu District, Nanjing 210002, China (Q.C., U.J.S., P.P.X., J. Zhong, L.J.Z.); Department of Radiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China (Y.N.W., C.X.); Division of Cardiovascular Imaging, Department of Radiology and Radiological Science, Medical University of South Carolina, Charleston, SC (U.J.S., S.L.B.); Department of Medical Imaging, Affiliated Hospital of Jiangnan University, Wuxi, China (H.Q.); Department of Medical Imaging, Medical Imaging Center, The Affiliated Huaian No.1 People's Hospital of Nanjing Medical University, Huaian, China (Y.F.); Bayer Healthcare, Shanghai, China (X.W.T.); School of Public Health, Shanghai JiaoTong University School of Medicine, Shanghai, China (M.L.); and Department of Biostatistics, School of Public Health, China International Cooperation Center for Environment and Human Health, Nanjing Medical University, Nanjing, China (Y.W.)
| | - Yi Ning Wang
- From the Departments of Radiology (Q.C., H.X., G.X., X.Y.) and Cardiology (T.P., X.G., J. Zhang), Nanjing First Hospital, Nanjing Medical University, Nanjing, China; Department of Diagnostic Radiology, Jinling Hospital, Medical School of Nanjing University, 305 Zhongshan East Road, Xuanwu District, Nanjing 210002, China (Q.C., U.J.S., P.P.X., J. Zhong, L.J.Z.); Department of Radiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China (Y.N.W., C.X.); Division of Cardiovascular Imaging, Department of Radiology and Radiological Science, Medical University of South Carolina, Charleston, SC (U.J.S., S.L.B.); Department of Medical Imaging, Affiliated Hospital of Jiangnan University, Wuxi, China (H.Q.); Department of Medical Imaging, Medical Imaging Center, The Affiliated Huaian No.1 People's Hospital of Nanjing Medical University, Huaian, China (Y.F.); Bayer Healthcare, Shanghai, China (X.W.T.); School of Public Health, Shanghai JiaoTong University School of Medicine, Shanghai, China (M.L.); and Department of Biostatistics, School of Public Health, China International Cooperation Center for Environment and Human Health, Nanjing Medical University, Nanjing, China (Y.W.)
| | - U Joseph Schoepf
- From the Departments of Radiology (Q.C., H.X., G.X., X.Y.) and Cardiology (T.P., X.G., J. Zhang), Nanjing First Hospital, Nanjing Medical University, Nanjing, China; Department of Diagnostic Radiology, Jinling Hospital, Medical School of Nanjing University, 305 Zhongshan East Road, Xuanwu District, Nanjing 210002, China (Q.C., U.J.S., P.P.X., J. Zhong, L.J.Z.); Department of Radiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China (Y.N.W., C.X.); Division of Cardiovascular Imaging, Department of Radiology and Radiological Science, Medical University of South Carolina, Charleston, SC (U.J.S., S.L.B.); Department of Medical Imaging, Affiliated Hospital of Jiangnan University, Wuxi, China (H.Q.); Department of Medical Imaging, Medical Imaging Center, The Affiliated Huaian No.1 People's Hospital of Nanjing Medical University, Huaian, China (Y.F.); Bayer Healthcare, Shanghai, China (X.W.T.); School of Public Health, Shanghai JiaoTong University School of Medicine, Shanghai, China (M.L.); and Department of Biostatistics, School of Public Health, China International Cooperation Center for Environment and Human Health, Nanjing Medical University, Nanjing, China (Y.W.)
| | - Samuel L Bidwell
- From the Departments of Radiology (Q.C., H.X., G.X., X.Y.) and Cardiology (T.P., X.G., J. Zhang), Nanjing First Hospital, Nanjing Medical University, Nanjing, China; Department of Diagnostic Radiology, Jinling Hospital, Medical School of Nanjing University, 305 Zhongshan East Road, Xuanwu District, Nanjing 210002, China (Q.C., U.J.S., P.P.X., J. Zhong, L.J.Z.); Department of Radiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China (Y.N.W., C.X.); Division of Cardiovascular Imaging, Department of Radiology and Radiological Science, Medical University of South Carolina, Charleston, SC (U.J.S., S.L.B.); Department of Medical Imaging, Affiliated Hospital of Jiangnan University, Wuxi, China (H.Q.); Department of Medical Imaging, Medical Imaging Center, The Affiliated Huaian No.1 People's Hospital of Nanjing Medical University, Huaian, China (Y.F.); Bayer Healthcare, Shanghai, China (X.W.T.); School of Public Health, Shanghai JiaoTong University School of Medicine, Shanghai, China (M.L.); and Department of Biostatistics, School of Public Health, China International Cooperation Center for Environment and Human Health, Nanjing Medical University, Nanjing, China (Y.W.)
| | - Hongyan Qiao
- From the Departments of Radiology (Q.C., H.X., G.X., X.Y.) and Cardiology (T.P., X.G., J. Zhang), Nanjing First Hospital, Nanjing Medical University, Nanjing, China; Department of Diagnostic Radiology, Jinling Hospital, Medical School of Nanjing University, 305 Zhongshan East Road, Xuanwu District, Nanjing 210002, China (Q.C., U.J.S., P.P.X., J. Zhong, L.J.Z.); Department of Radiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China (Y.N.W., C.X.); Division of Cardiovascular Imaging, Department of Radiology and Radiological Science, Medical University of South Carolina, Charleston, SC (U.J.S., S.L.B.); Department of Medical Imaging, Affiliated Hospital of Jiangnan University, Wuxi, China (H.Q.); Department of Medical Imaging, Medical Imaging Center, The Affiliated Huaian No.1 People's Hospital of Nanjing Medical University, Huaian, China (Y.F.); Bayer Healthcare, Shanghai, China (X.W.T.); School of Public Health, Shanghai JiaoTong University School of Medicine, Shanghai, China (M.L.); and Department of Biostatistics, School of Public Health, China International Cooperation Center for Environment and Human Health, Nanjing Medical University, Nanjing, China (Y.W.)
| | - Yun Feng
- From the Departments of Radiology (Q.C., H.X., G.X., X.Y.) and Cardiology (T.P., X.G., J. Zhang), Nanjing First Hospital, Nanjing Medical University, Nanjing, China; Department of Diagnostic Radiology, Jinling Hospital, Medical School of Nanjing University, 305 Zhongshan East Road, Xuanwu District, Nanjing 210002, China (Q.C., U.J.S., P.P.X., J. Zhong, L.J.Z.); Department of Radiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China (Y.N.W., C.X.); Division of Cardiovascular Imaging, Department of Radiology and Radiological Science, Medical University of South Carolina, Charleston, SC (U.J.S., S.L.B.); Department of Medical Imaging, Affiliated Hospital of Jiangnan University, Wuxi, China (H.Q.); Department of Medical Imaging, Medical Imaging Center, The Affiliated Huaian No.1 People's Hospital of Nanjing Medical University, Huaian, China (Y.F.); Bayer Healthcare, Shanghai, China (X.W.T.); School of Public Health, Shanghai JiaoTong University School of Medicine, Shanghai, China (M.L.); and Department of Biostatistics, School of Public Health, China International Cooperation Center for Environment and Human Health, Nanjing Medical University, Nanjing, China (Y.W.)
| | - Cheng Xu
- From the Departments of Radiology (Q.C., H.X., G.X., X.Y.) and Cardiology (T.P., X.G., J. Zhang), Nanjing First Hospital, Nanjing Medical University, Nanjing, China; Department of Diagnostic Radiology, Jinling Hospital, Medical School of Nanjing University, 305 Zhongshan East Road, Xuanwu District, Nanjing 210002, China (Q.C., U.J.S., P.P.X., J. Zhong, L.J.Z.); Department of Radiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China (Y.N.W., C.X.); Division of Cardiovascular Imaging, Department of Radiology and Radiological Science, Medical University of South Carolina, Charleston, SC (U.J.S., S.L.B.); Department of Medical Imaging, Affiliated Hospital of Jiangnan University, Wuxi, China (H.Q.); Department of Medical Imaging, Medical Imaging Center, The Affiliated Huaian No.1 People's Hospital of Nanjing Medical University, Huaian, China (Y.F.); Bayer Healthcare, Shanghai, China (X.W.T.); School of Public Health, Shanghai JiaoTong University School of Medicine, Shanghai, China (M.L.); and Department of Biostatistics, School of Public Health, China International Cooperation Center for Environment and Human Health, Nanjing Medical University, Nanjing, China (Y.W.)
| | - Hui Xu
- From the Departments of Radiology (Q.C., H.X., G.X., X.Y.) and Cardiology (T.P., X.G., J. Zhang), Nanjing First Hospital, Nanjing Medical University, Nanjing, China; Department of Diagnostic Radiology, Jinling Hospital, Medical School of Nanjing University, 305 Zhongshan East Road, Xuanwu District, Nanjing 210002, China (Q.C., U.J.S., P.P.X., J. Zhong, L.J.Z.); Department of Radiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China (Y.N.W., C.X.); Division of Cardiovascular Imaging, Department of Radiology and Radiological Science, Medical University of South Carolina, Charleston, SC (U.J.S., S.L.B.); Department of Medical Imaging, Affiliated Hospital of Jiangnan University, Wuxi, China (H.Q.); Department of Medical Imaging, Medical Imaging Center, The Affiliated Huaian No.1 People's Hospital of Nanjing Medical University, Huaian, China (Y.F.); Bayer Healthcare, Shanghai, China (X.W.T.); School of Public Health, Shanghai JiaoTong University School of Medicine, Shanghai, China (M.L.); and Department of Biostatistics, School of Public Health, China International Cooperation Center for Environment and Human Health, Nanjing Medical University, Nanjing, China (Y.W.)
| | - Guanghui Xie
- From the Departments of Radiology (Q.C., H.X., G.X., X.Y.) and Cardiology (T.P., X.G., J. Zhang), Nanjing First Hospital, Nanjing Medical University, Nanjing, China; Department of Diagnostic Radiology, Jinling Hospital, Medical School of Nanjing University, 305 Zhongshan East Road, Xuanwu District, Nanjing 210002, China (Q.C., U.J.S., P.P.X., J. Zhong, L.J.Z.); Department of Radiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China (Y.N.W., C.X.); Division of Cardiovascular Imaging, Department of Radiology and Radiological Science, Medical University of South Carolina, Charleston, SC (U.J.S., S.L.B.); Department of Medical Imaging, Affiliated Hospital of Jiangnan University, Wuxi, China (H.Q.); Department of Medical Imaging, Medical Imaging Center, The Affiliated Huaian No.1 People's Hospital of Nanjing Medical University, Huaian, China (Y.F.); Bayer Healthcare, Shanghai, China (X.W.T.); School of Public Health, Shanghai JiaoTong University School of Medicine, Shanghai, China (M.L.); and Department of Biostatistics, School of Public Health, China International Cooperation Center for Environment and Human Health, Nanjing Medical University, Nanjing, China (Y.W.)
| | - Xiaofei Gao
- From the Departments of Radiology (Q.C., H.X., G.X., X.Y.) and Cardiology (T.P., X.G., J. Zhang), Nanjing First Hospital, Nanjing Medical University, Nanjing, China; Department of Diagnostic Radiology, Jinling Hospital, Medical School of Nanjing University, 305 Zhongshan East Road, Xuanwu District, Nanjing 210002, China (Q.C., U.J.S., P.P.X., J. Zhong, L.J.Z.); Department of Radiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China (Y.N.W., C.X.); Division of Cardiovascular Imaging, Department of Radiology and Radiological Science, Medical University of South Carolina, Charleston, SC (U.J.S., S.L.B.); Department of Medical Imaging, Affiliated Hospital of Jiangnan University, Wuxi, China (H.Q.); Department of Medical Imaging, Medical Imaging Center, The Affiliated Huaian No.1 People's Hospital of Nanjing Medical University, Huaian, China (Y.F.); Bayer Healthcare, Shanghai, China (X.W.T.); School of Public Health, Shanghai JiaoTong University School of Medicine, Shanghai, China (M.L.); and Department of Biostatistics, School of Public Health, China International Cooperation Center for Environment and Human Health, Nanjing Medical University, Nanjing, China (Y.W.)
| | - Xin-Wei Tao
- From the Departments of Radiology (Q.C., H.X., G.X., X.Y.) and Cardiology (T.P., X.G., J. Zhang), Nanjing First Hospital, Nanjing Medical University, Nanjing, China; Department of Diagnostic Radiology, Jinling Hospital, Medical School of Nanjing University, 305 Zhongshan East Road, Xuanwu District, Nanjing 210002, China (Q.C., U.J.S., P.P.X., J. Zhong, L.J.Z.); Department of Radiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China (Y.N.W., C.X.); Division of Cardiovascular Imaging, Department of Radiology and Radiological Science, Medical University of South Carolina, Charleston, SC (U.J.S., S.L.B.); Department of Medical Imaging, Affiliated Hospital of Jiangnan University, Wuxi, China (H.Q.); Department of Medical Imaging, Medical Imaging Center, The Affiliated Huaian No.1 People's Hospital of Nanjing Medical University, Huaian, China (Y.F.); Bayer Healthcare, Shanghai, China (X.W.T.); School of Public Health, Shanghai JiaoTong University School of Medicine, Shanghai, China (M.L.); and Department of Biostatistics, School of Public Health, China International Cooperation Center for Environment and Human Health, Nanjing Medical University, Nanjing, China (Y.W.)
| | - Mengjie Lu
- From the Departments of Radiology (Q.C., H.X., G.X., X.Y.) and Cardiology (T.P., X.G., J. Zhang), Nanjing First Hospital, Nanjing Medical University, Nanjing, China; Department of Diagnostic Radiology, Jinling Hospital, Medical School of Nanjing University, 305 Zhongshan East Road, Xuanwu District, Nanjing 210002, China (Q.C., U.J.S., P.P.X., J. Zhong, L.J.Z.); Department of Radiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China (Y.N.W., C.X.); Division of Cardiovascular Imaging, Department of Radiology and Radiological Science, Medical University of South Carolina, Charleston, SC (U.J.S., S.L.B.); Department of Medical Imaging, Affiliated Hospital of Jiangnan University, Wuxi, China (H.Q.); Department of Medical Imaging, Medical Imaging Center, The Affiliated Huaian No.1 People's Hospital of Nanjing Medical University, Huaian, China (Y.F.); Bayer Healthcare, Shanghai, China (X.W.T.); School of Public Health, Shanghai JiaoTong University School of Medicine, Shanghai, China (M.L.); and Department of Biostatistics, School of Public Health, China International Cooperation Center for Environment and Human Health, Nanjing Medical University, Nanjing, China (Y.W.)
| | - Peng Peng Xu
- From the Departments of Radiology (Q.C., H.X., G.X., X.Y.) and Cardiology (T.P., X.G., J. Zhang), Nanjing First Hospital, Nanjing Medical University, Nanjing, China; Department of Diagnostic Radiology, Jinling Hospital, Medical School of Nanjing University, 305 Zhongshan East Road, Xuanwu District, Nanjing 210002, China (Q.C., U.J.S., P.P.X., J. Zhong, L.J.Z.); Department of Radiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China (Y.N.W., C.X.); Division of Cardiovascular Imaging, Department of Radiology and Radiological Science, Medical University of South Carolina, Charleston, SC (U.J.S., S.L.B.); Department of Medical Imaging, Affiliated Hospital of Jiangnan University, Wuxi, China (H.Q.); Department of Medical Imaging, Medical Imaging Center, The Affiliated Huaian No.1 People's Hospital of Nanjing Medical University, Huaian, China (Y.F.); Bayer Healthcare, Shanghai, China (X.W.T.); School of Public Health, Shanghai JiaoTong University School of Medicine, Shanghai, China (M.L.); and Department of Biostatistics, School of Public Health, China International Cooperation Center for Environment and Human Health, Nanjing Medical University, Nanjing, China (Y.W.)
| | - Jian Zhong
- From the Departments of Radiology (Q.C., H.X., G.X., X.Y.) and Cardiology (T.P., X.G., J. Zhang), Nanjing First Hospital, Nanjing Medical University, Nanjing, China; Department of Diagnostic Radiology, Jinling Hospital, Medical School of Nanjing University, 305 Zhongshan East Road, Xuanwu District, Nanjing 210002, China (Q.C., U.J.S., P.P.X., J. Zhong, L.J.Z.); Department of Radiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China (Y.N.W., C.X.); Division of Cardiovascular Imaging, Department of Radiology and Radiological Science, Medical University of South Carolina, Charleston, SC (U.J.S., S.L.B.); Department of Medical Imaging, Affiliated Hospital of Jiangnan University, Wuxi, China (H.Q.); Department of Medical Imaging, Medical Imaging Center, The Affiliated Huaian No.1 People's Hospital of Nanjing Medical University, Huaian, China (Y.F.); Bayer Healthcare, Shanghai, China (X.W.T.); School of Public Health, Shanghai JiaoTong University School of Medicine, Shanghai, China (M.L.); and Department of Biostatistics, School of Public Health, China International Cooperation Center for Environment and Human Health, Nanjing Medical University, Nanjing, China (Y.W.)
| | - Yongyue Wei
- From the Departments of Radiology (Q.C., H.X., G.X., X.Y.) and Cardiology (T.P., X.G., J. Zhang), Nanjing First Hospital, Nanjing Medical University, Nanjing, China; Department of Diagnostic Radiology, Jinling Hospital, Medical School of Nanjing University, 305 Zhongshan East Road, Xuanwu District, Nanjing 210002, China (Q.C., U.J.S., P.P.X., J. Zhong, L.J.Z.); Department of Radiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China (Y.N.W., C.X.); Division of Cardiovascular Imaging, Department of Radiology and Radiological Science, Medical University of South Carolina, Charleston, SC (U.J.S., S.L.B.); Department of Medical Imaging, Affiliated Hospital of Jiangnan University, Wuxi, China (H.Q.); Department of Medical Imaging, Medical Imaging Center, The Affiliated Huaian No.1 People's Hospital of Nanjing Medical University, Huaian, China (Y.F.); Bayer Healthcare, Shanghai, China (X.W.T.); School of Public Health, Shanghai JiaoTong University School of Medicine, Shanghai, China (M.L.); and Department of Biostatistics, School of Public Health, China International Cooperation Center for Environment and Human Health, Nanjing Medical University, Nanjing, China (Y.W.)
| | - Xindao Yin
- From the Departments of Radiology (Q.C., H.X., G.X., X.Y.) and Cardiology (T.P., X.G., J. Zhang), Nanjing First Hospital, Nanjing Medical University, Nanjing, China; Department of Diagnostic Radiology, Jinling Hospital, Medical School of Nanjing University, 305 Zhongshan East Road, Xuanwu District, Nanjing 210002, China (Q.C., U.J.S., P.P.X., J. Zhong, L.J.Z.); Department of Radiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China (Y.N.W., C.X.); Division of Cardiovascular Imaging, Department of Radiology and Radiological Science, Medical University of South Carolina, Charleston, SC (U.J.S., S.L.B.); Department of Medical Imaging, Affiliated Hospital of Jiangnan University, Wuxi, China (H.Q.); Department of Medical Imaging, Medical Imaging Center, The Affiliated Huaian No.1 People's Hospital of Nanjing Medical University, Huaian, China (Y.F.); Bayer Healthcare, Shanghai, China (X.W.T.); School of Public Health, Shanghai JiaoTong University School of Medicine, Shanghai, China (M.L.); and Department of Biostatistics, School of Public Health, China International Cooperation Center for Environment and Human Health, Nanjing Medical University, Nanjing, China (Y.W.)
| | - Junjie Zhang
- From the Departments of Radiology (Q.C., H.X., G.X., X.Y.) and Cardiology (T.P., X.G., J. Zhang), Nanjing First Hospital, Nanjing Medical University, Nanjing, China; Department of Diagnostic Radiology, Jinling Hospital, Medical School of Nanjing University, 305 Zhongshan East Road, Xuanwu District, Nanjing 210002, China (Q.C., U.J.S., P.P.X., J. Zhong, L.J.Z.); Department of Radiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China (Y.N.W., C.X.); Division of Cardiovascular Imaging, Department of Radiology and Radiological Science, Medical University of South Carolina, Charleston, SC (U.J.S., S.L.B.); Department of Medical Imaging, Affiliated Hospital of Jiangnan University, Wuxi, China (H.Q.); Department of Medical Imaging, Medical Imaging Center, The Affiliated Huaian No.1 People's Hospital of Nanjing Medical University, Huaian, China (Y.F.); Bayer Healthcare, Shanghai, China (X.W.T.); School of Public Health, Shanghai JiaoTong University School of Medicine, Shanghai, China (M.L.); and Department of Biostatistics, School of Public Health, China International Cooperation Center for Environment and Human Health, Nanjing Medical University, Nanjing, China (Y.W.)
| | - Long Jiang Zhang
- From the Departments of Radiology (Q.C., H.X., G.X., X.Y.) and Cardiology (T.P., X.G., J. Zhang), Nanjing First Hospital, Nanjing Medical University, Nanjing, China; Department of Diagnostic Radiology, Jinling Hospital, Medical School of Nanjing University, 305 Zhongshan East Road, Xuanwu District, Nanjing 210002, China (Q.C., U.J.S., P.P.X., J. Zhong, L.J.Z.); Department of Radiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China (Y.N.W., C.X.); Division of Cardiovascular Imaging, Department of Radiology and Radiological Science, Medical University of South Carolina, Charleston, SC (U.J.S., S.L.B.); Department of Medical Imaging, Affiliated Hospital of Jiangnan University, Wuxi, China (H.Q.); Department of Medical Imaging, Medical Imaging Center, The Affiliated Huaian No.1 People's Hospital of Nanjing Medical University, Huaian, China (Y.F.); Bayer Healthcare, Shanghai, China (X.W.T.); School of Public Health, Shanghai JiaoTong University School of Medicine, Shanghai, China (M.L.); and Department of Biostatistics, School of Public Health, China International Cooperation Center for Environment and Human Health, Nanjing Medical University, Nanjing, China (Y.W.)
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12
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Song Y, Zhang L, Huang Y. Differential Expression of Peripheral Circulating MicroRNA-146a Between Patients with Atherosclerotic Vulnerable Plaque and Stable Plaque. Int Heart J 2023; 64:847-855. [PMID: 37778988 DOI: 10.1536/ihj.23-006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/03/2023]
Abstract
Atherosclerotic plaque rupture and subsequent cardiovascular complications threaten the population's health worldwide. The polymorphism of miR-146a rs2910164 was significantly associated with the risk of vulnerable plaques. However, it remains unclear whether the circulating miR-146a is differentially expressed in stable and vulnerable plaques and thus, serves as a potential biomarker.This study aims to analyze the differential expression of circulating miR-146a between patients with stable and vulnerable plaques to explore the potential molecular mechanisms.Public databases were searched from their inception up to November 2022. A study reporting the specific circulating miR-146a levels between patients with stable and vulnerable plaques was included. The study quality was assessed using the modified genetic 8-stars Newcastle-Ottawa scale. The differential expression levels of miR-146a were evaluated using the standardized mean difference (SMD).Eight studies with 978 patients were included and analyzed. The results showed that miR-146a expression levels were significantly higher in the vulnerable plaque population than in the stable plaque population (SMD: 1.91; 95% confidence interval: 1.35, 2.47; P < 0.01). A similar statistical significance was found in subgroup analyses regarding sample source, disease type, and vulnerable plaque characteristics. Sensitivity analysis suggested the robustness of the results. Analysis of downstream genes suggested that miR-146a-targeted regulation of ACTN4, SARM1, and ULK2 may affect intraplaque hemorrhage.Patients with vulnerable plaque have higher circulating miR-146a levels than those with stable plaque. However, based on the limitations of this study, high-quality studies are still needed to confirm the results.
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Affiliation(s)
- Yenwen Song
- Department of Emergency, Xiyuan Hospital, Chinese Academy of Traditional Chinese Medicine
| | - Lei Zhang
- Department of Emergency, Xiyuan Hospital, Chinese Academy of Traditional Chinese Medicine
| | - Ye Huang
- Department of Emergency, Xiyuan Hospital, Chinese Academy of Traditional Chinese Medicine
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13
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Cholesterol crystals and atherosclerotic plaque instability: Therapeutic potential of Eicosapentaenoic acid. Pharmacol Ther 2022; 240:108237. [PMID: 35772589 DOI: 10.1016/j.pharmthera.2022.108237] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2021] [Revised: 06/22/2022] [Accepted: 06/23/2022] [Indexed: 12/15/2022]
Abstract
Atherosclerotic plaques associated with acute coronary syndromes (ACS), i.e. culprit lesions, frequently feature a ruptured fibrous cap with thrombotic complications. On imaging, these plaques exhibit a low attenuation, lipid-rich, necrotic core containing cholesterol crystals and are inherently unstable. Indeed, cholesterol crystals are causally associated with plaque vulnerability in vivo; their formation results from spontaneous self-assembly of cholesterol molecules. Cholesterol homeostasis is a central determinant of the physicochemical conditions leading to crystal formation, which are favored by elevated membrane free cholesterol content in plaque endothelial cells, smooth muscle cells, monocyte-derived macrophages, and foam cells, and equally by lipid oxidation. Emerging evidence from imaging trials in patients with coronary heart disease has highlighted the impact of intervention involving the omega-3 fatty acid, eicosapentaenoic acid (EPA), on vulnerable, low attenuation atherosclerotic plaques. Thus, EPA decreased features associated with unstable plaque by increasing fibrous cap thickness in statin-treated patients, by reducing lipid volume and equally attenuating intraplaque inflammation. Importantly, atherosclerotic plaques rapidly incorporate EPA; indeed, a high content of EPA in plaque tissue is associated with decreased plaque inflammation and increased stability. These findings are entirely consistent with the major reduction seen in cardiovascular events in the REDUCE-IT trial, in which high dose EPA was administered as its esterified precursor, icosapent ethyl (IPE); moreover, clinical benefit was proportional to circulating EPA levels. Eicosapentaenoic acid is efficiently incorporated into phospholipids, where it modulates cholesterol-enriched domains in cell membranes through physicochemical lipid interactions and changes in rates of lipid oxidation. Indeed, biophysical analyses indicate that EPA exists in an extended conformation in membranes, thereby enhancing normal cholesterol distribution while reducing propagation of free radicals. Such effects mitigate cholesterol aggregation and crystal formation. In addition to its favorable effect on cholesterol domain structure, EPA/IPE exerts pleiotropic actions, including antithrombotic, antiplatelet, anti-inflammatory, and proresolving effects, whose plaque-stabilizing potential cannot be excluded. Docosahexaenoic acid is distinguished from EPA by a higher degree of unsaturation and longer carbon chain length; DHA is thus predisposed to changes in its conformation with ensuing increase in membrane lipid fluidity and promotion of cholesterol aggregation into discrete domains. Such distinct molecular effects between EPA and DHA are pronounced under conditions of high cellular cholesterol content and oxidative stress. This review will focus on the formation and role of cholesterol monohydrate crystals in destabilizing atherosclerotic plaques, and on the potential of EPA as a therapeutic agent to attenuate the formation of deleterious cholesterol membrane domains and of cholesterol crystals. Such a therapeutic approach may translate to enhanced plaque stability and ultimately to reduction in cardiovascular risk.
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Intensive lipid lowering agents and coronary atherosclerosis: Insights from intravascular imaging. Am J Prev Cardiol 2022; 11:100366. [PMID: 35856069 PMCID: PMC9287145 DOI: 10.1016/j.ajpc.2022.100366] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2022] [Revised: 06/27/2022] [Accepted: 06/29/2022] [Indexed: 01/23/2023] Open
Abstract
Advances in intravascular imaging have permitted comprehensive evaluation of coronary atherosclerotic plaque from the perspective of its burden and individual components. These advances have been integrated in clinical trials that have evaluated the impact of intensive lipid lowering regimens. These trials have demonstrated that intensive lipid lowering, using high dose statins as monotherapy and in combination with new lipid lowering agents, produce favorable effects on coronary atheroma, resulting in regression and stabilization. These findings provide important biological insights to understand how intensive lipid lowering may reduce cardiovascular risk. This review aims to provide the reader with a contemporary overview of the findings of these studies and to propose the potential clinical implications for management of higher risk patients with atherosclerotic coronary artery disease.
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Escaned J, Jaffer FA, Mehilli J, Mehran R. The year in cardiovascular medicine: interventional cardiology. Eur Heart J 2022; 43:377-386. [PMID: 34974613 PMCID: PMC9383143 DOI: 10.1093/eurheartj/ehab884] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2021] [Revised: 12/09/2021] [Accepted: 12/13/2021] [Indexed: 12/27/2022] Open
Abstract
Since last year’s report in the European Heart Journal, we have witnessed substantial progress in all aspects of interventional cardiology. Of note, the practice of interventional cardiology took place amidst successive waves of the COVID-19 pandemic, which continues to be a major burden for all healthcare professionals around the globe. In our yearly review, we shall revisit the developments in percutaneous coronary intervention (PCI), structural heart interventions, and adjunctive pharmacotherapy.
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Affiliation(s)
- Javier Escaned
- Hospital Clínico San Carlos IDISCC, Complutense University of Madrid, Madrid, Spain
| | - Farouc A Jaffer
- Cardiology Division, Department of Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | - Julinda Mehilli
- Medizinische Klinik I, Landshut-Achdorf Hospital, Landshut, Klinikum der Universitaet München, Ludwig-Maximilians-Universitaet and German Centre for Cardiovascular Research (DZHK), Partner Site Munich Heart Alliance, Munich, Germany
| | - Roxana Mehran
- The Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
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Terada K, Kubo T, Madder R, Ino Y, Takahata M, Shimamura K, Shiono Y, Nishi T, Emori H, Higashioka D, Khalifa A, Wada T, Akasaka T. Near-infrared spectroscopy to predict microvascular obstruction after primary percutaneous coronary intervention. EUROINTERVENTION 2021; 17:e999-e1006. [PMID: 34105512 PMCID: PMC9724955 DOI: 10.4244/eij-d-20-01421] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
BACKGROUND Successful restoration of epicardial coronary artery patency by primary percutaneous coronary intervention (PPCI) for ST-elevation myocardial infarction (STEMI) does not always lead to adequate reperfusion at the microvascular level. AIMS This study sought to investigate the association between lipid-rich coronary plaque identified by near-infrared spectroscopy combined with intravascular ultrasound (NIRS-IVUS) and microvascular obstruction (MVO) detected by cardiac magnetic resonance imaging (MRI) after PPCI for STEMI. METHODS We investigated 120 patients with STEMI undergoing PPCI. NIRS-IVUS was used to measure the maximum lipid core burden index in 4 mm (maxLCBI4 mm) in the infarct-related lesions before PPCI. Delayed contrast-enhanced cardiac MRI was performed to evaluate MVO one week after PPCI. RESULTS MVO was identified in 40 (33%) patients. MaxLCBI4 mm in the infarct-related lesion was significantly larger in the MVO group compared with the no-MVO group (median [interquartile range]: 745 [522-853] vs 515 [349-698], p<0.001). A multivariable logistic regression model showed that maxLCBI4 mm was an independent predictor of MVO (odds ratio: 24.7 [95% confidence interval: 2.5-248.0], p=0.006). Receiver operating characteristic curve analysis demonstrated that maxLCBI4 mm >600 was the optimal cut-off value to predict MVO (Youden index=0.44 and area under the curve=0.71) with a sensitivity of 75% and a specificity of 69%. CONCLUSIONS Lipid content measured by NIRS in the infarct-related lesions was associated with the occurrence of MVO after PPCI in STEMI.
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Affiliation(s)
- Kosei Terada
- Department of Cardiovascular Medicine, Wakayama Medical University, Wakayama, Japan
| | - Takashi Kubo
- Department of Cardiovascular Medicine, Wakayama Medical University, 811-1, Kimiidera, Wakayama 641-8510, Japan. E-mail:
| | - Ryan Madder
- Frederik Meijer Heart & Vascular Institute, Spectrum Health, Grand Rapids, MI, USA
| | - Yasushi Ino
- Department of Cardiovascular Medicine, Wakayama Medical University, Wakayama, Japan
| | - Masahiro Takahata
- Department of Cardiovascular Medicine, Wakayama Medical University, Wakayama, Japan
| | - Kunihiro Shimamura
- Department of Cardiovascular Medicine, Wakayama Medical University, Wakayama, Japan
| | - Yasutsugu Shiono
- Department of Cardiovascular Medicine, Wakayama Medical University, Wakayama, Japan
| | - Takahiro Nishi
- Department of Cardiovascular Medicine, Wakayama Medical University, Wakayama, Japan
| | - Hiroki Emori
- Department of Cardiovascular Medicine, Wakayama Medical University, Wakayama, Japan
| | - Daisuke Higashioka
- Department of Cardiovascular Medicine, Wakayama Medical University, Wakayama, Japan
| | - Amir Khalifa
- Department of Cardiovascular Medicine, Wakayama Medical University, Wakayama, Japan
| | - Teruaki Wada
- Department of Cardiovascular Medicine, Wakayama Medical University, Wakayama, Japan
| | - Takashi Akasaka
- Department of Cardiovascular Medicine, Wakayama Medical University, Wakayama, Japan
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Sato S, Matsumoto H, Li D, Ohya H, Mori H, Sakai K, Ogura K, Oishi Y, Masaki R, Tanaka H, Kondo S, Tsujita H, Tsukamoto S, Isodono K, Kitamura R, Komori Y, Yoshii N, Sato I, Christodoulou AG, Xie Y, Shinke T. Coronary High-Intensity Plaques at T1-weighted MRI in Stable Coronary Artery Disease: Comparison with Near-Infrared Spectroscopy Intravascular US. Radiology 2021; 302:557-565. [PMID: 34904874 DOI: 10.1148/radiol.211463] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
Background The histologic nature of coronary high-intensity plaques (HIPs) at T1-weighted MRI in patients with stable coronary artery disease remains to be fully understood. Coronary atherosclerosis T1-weighted characterization (CATCH) enables HIP detection by simultaneously acquiring dark-blood plaque and bright-blood anatomic reference images. Purpose To determine if intraplaque hemorrhage (IPH) or lipid is the predominant substrate of HIPs on T1-weighted images by comparing CATCH MRI scans with findings on near-infrared spectroscopy (NIRS) intravascular US (IVUS) images. Materials and Methods This study retrospectively included consecutive patients who underwent CATCH MRI before NIRS IVUS between December 2019 and February 2021 at two facilities. At MRI, HIP was defined as plaque-to-myocardium signal intensity ratio of at least 1.4. The presence of an echolucent zone at IVUS (reported to represent IPH) was recorded. NIRS was used to determine the lipid component of atherosclerotic plaque. Lipid core burden index (LCBI) was calculated as the fraction of pixels with a probability of lipid-core plaque greater than 0.6 within a region of interest. Plaque with maximum LCBI within any 4-mm-long segment (maxLCBI4 mm) greater than 400 was regarded as lipid rich. Multivariable analysis was performed to evaluate NIRS IVUS-derived parameters associated with HIPs. Results There were 205 plaques analyzed in 95 patients (median age, 74 years; interquartile range [IQR], 67-78 years; 75 men). HIPs (n = 42) at MRI were predominantly associated with an echolucent zone at IVUS (79% [33 of 42] vs 8.0% [13 of 163], respectively; P < .001) and a higher maxLCBI4 mm at NIRS (477 [IQR, 258-738] vs 232 [IQR, 59-422], respectively; P < .001) than non-HIPs. In the multivariable model, HIPs were independently associated with an echolucent zone (odds ratio, 24.5; 95% CI: 9.3, 64.7; P < .001), but not with lipid-rich plaque (odds ratio, 2.0; 95% CI: 0.7, 5.4; P = .20). Conclusion The predominant substrate of T1-weighed MRI-defined high-intensity plaques in stable coronary artery disease was intraplaque hemorrhage, not lipid. © RSNA, 2021 Online supplemental material is available for this article. See also the editorial by Stuber in this issue.
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Affiliation(s)
- Shunya Sato
- From the Division of Cardiology, Showa University School of Medicine, 1-5-8 Hatanodai Shinagawa-ku, Tokyo 142-8555, Japan (S.S., H. Matsumoto, K.S., K.O., Y.O., R.M., H. Tanaka, S.K., H. Tsujita, S.T., T.S.); Biomedical Imaging Research Institute, Cedars-Sinai Medical Center, Los Angeles, Calif (D.L., A.G.C., Y.X.); Departments of Cardiology (H.O., K.I., R.K.) and Radiological Technology (I.S.), Ijinkai Takeda General Hospital, Kyoto, Japan; Division of Cardiology, Showa University Fujigaoka Hospital, Kanagawa, Japan (H. Mori); MR Research & Collaboration Department, Siemens Healthcare K.K., Tokyo, Japan (Y.K.); and Department of Radiological Technology, Showa University Hospital, Tokyo, Japan (N.Y.)
| | - Hidenari Matsumoto
- From the Division of Cardiology, Showa University School of Medicine, 1-5-8 Hatanodai Shinagawa-ku, Tokyo 142-8555, Japan (S.S., H. Matsumoto, K.S., K.O., Y.O., R.M., H. Tanaka, S.K., H. Tsujita, S.T., T.S.); Biomedical Imaging Research Institute, Cedars-Sinai Medical Center, Los Angeles, Calif (D.L., A.G.C., Y.X.); Departments of Cardiology (H.O., K.I., R.K.) and Radiological Technology (I.S.), Ijinkai Takeda General Hospital, Kyoto, Japan; Division of Cardiology, Showa University Fujigaoka Hospital, Kanagawa, Japan (H. Mori); MR Research & Collaboration Department, Siemens Healthcare K.K., Tokyo, Japan (Y.K.); and Department of Radiological Technology, Showa University Hospital, Tokyo, Japan (N.Y.)
| | - Debiao Li
- From the Division of Cardiology, Showa University School of Medicine, 1-5-8 Hatanodai Shinagawa-ku, Tokyo 142-8555, Japan (S.S., H. Matsumoto, K.S., K.O., Y.O., R.M., H. Tanaka, S.K., H. Tsujita, S.T., T.S.); Biomedical Imaging Research Institute, Cedars-Sinai Medical Center, Los Angeles, Calif (D.L., A.G.C., Y.X.); Departments of Cardiology (H.O., K.I., R.K.) and Radiological Technology (I.S.), Ijinkai Takeda General Hospital, Kyoto, Japan; Division of Cardiology, Showa University Fujigaoka Hospital, Kanagawa, Japan (H. Mori); MR Research & Collaboration Department, Siemens Healthcare K.K., Tokyo, Japan (Y.K.); and Department of Radiological Technology, Showa University Hospital, Tokyo, Japan (N.Y.)
| | - Hidefumi Ohya
- From the Division of Cardiology, Showa University School of Medicine, 1-5-8 Hatanodai Shinagawa-ku, Tokyo 142-8555, Japan (S.S., H. Matsumoto, K.S., K.O., Y.O., R.M., H. Tanaka, S.K., H. Tsujita, S.T., T.S.); Biomedical Imaging Research Institute, Cedars-Sinai Medical Center, Los Angeles, Calif (D.L., A.G.C., Y.X.); Departments of Cardiology (H.O., K.I., R.K.) and Radiological Technology (I.S.), Ijinkai Takeda General Hospital, Kyoto, Japan; Division of Cardiology, Showa University Fujigaoka Hospital, Kanagawa, Japan (H. Mori); MR Research & Collaboration Department, Siemens Healthcare K.K., Tokyo, Japan (Y.K.); and Department of Radiological Technology, Showa University Hospital, Tokyo, Japan (N.Y.)
| | - Hiroyoshi Mori
- From the Division of Cardiology, Showa University School of Medicine, 1-5-8 Hatanodai Shinagawa-ku, Tokyo 142-8555, Japan (S.S., H. Matsumoto, K.S., K.O., Y.O., R.M., H. Tanaka, S.K., H. Tsujita, S.T., T.S.); Biomedical Imaging Research Institute, Cedars-Sinai Medical Center, Los Angeles, Calif (D.L., A.G.C., Y.X.); Departments of Cardiology (H.O., K.I., R.K.) and Radiological Technology (I.S.), Ijinkai Takeda General Hospital, Kyoto, Japan; Division of Cardiology, Showa University Fujigaoka Hospital, Kanagawa, Japan (H. Mori); MR Research & Collaboration Department, Siemens Healthcare K.K., Tokyo, Japan (Y.K.); and Department of Radiological Technology, Showa University Hospital, Tokyo, Japan (N.Y.)
| | - Koshiro Sakai
- From the Division of Cardiology, Showa University School of Medicine, 1-5-8 Hatanodai Shinagawa-ku, Tokyo 142-8555, Japan (S.S., H. Matsumoto, K.S., K.O., Y.O., R.M., H. Tanaka, S.K., H. Tsujita, S.T., T.S.); Biomedical Imaging Research Institute, Cedars-Sinai Medical Center, Los Angeles, Calif (D.L., A.G.C., Y.X.); Departments of Cardiology (H.O., K.I., R.K.) and Radiological Technology (I.S.), Ijinkai Takeda General Hospital, Kyoto, Japan; Division of Cardiology, Showa University Fujigaoka Hospital, Kanagawa, Japan (H. Mori); MR Research & Collaboration Department, Siemens Healthcare K.K., Tokyo, Japan (Y.K.); and Department of Radiological Technology, Showa University Hospital, Tokyo, Japan (N.Y.)
| | - Kunihiro Ogura
- From the Division of Cardiology, Showa University School of Medicine, 1-5-8 Hatanodai Shinagawa-ku, Tokyo 142-8555, Japan (S.S., H. Matsumoto, K.S., K.O., Y.O., R.M., H. Tanaka, S.K., H. Tsujita, S.T., T.S.); Biomedical Imaging Research Institute, Cedars-Sinai Medical Center, Los Angeles, Calif (D.L., A.G.C., Y.X.); Departments of Cardiology (H.O., K.I., R.K.) and Radiological Technology (I.S.), Ijinkai Takeda General Hospital, Kyoto, Japan; Division of Cardiology, Showa University Fujigaoka Hospital, Kanagawa, Japan (H. Mori); MR Research & Collaboration Department, Siemens Healthcare K.K., Tokyo, Japan (Y.K.); and Department of Radiological Technology, Showa University Hospital, Tokyo, Japan (N.Y.)
| | - Yosuke Oishi
- From the Division of Cardiology, Showa University School of Medicine, 1-5-8 Hatanodai Shinagawa-ku, Tokyo 142-8555, Japan (S.S., H. Matsumoto, K.S., K.O., Y.O., R.M., H. Tanaka, S.K., H. Tsujita, S.T., T.S.); Biomedical Imaging Research Institute, Cedars-Sinai Medical Center, Los Angeles, Calif (D.L., A.G.C., Y.X.); Departments of Cardiology (H.O., K.I., R.K.) and Radiological Technology (I.S.), Ijinkai Takeda General Hospital, Kyoto, Japan; Division of Cardiology, Showa University Fujigaoka Hospital, Kanagawa, Japan (H. Mori); MR Research & Collaboration Department, Siemens Healthcare K.K., Tokyo, Japan (Y.K.); and Department of Radiological Technology, Showa University Hospital, Tokyo, Japan (N.Y.)
| | - Ryota Masaki
- From the Division of Cardiology, Showa University School of Medicine, 1-5-8 Hatanodai Shinagawa-ku, Tokyo 142-8555, Japan (S.S., H. Matsumoto, K.S., K.O., Y.O., R.M., H. Tanaka, S.K., H. Tsujita, S.T., T.S.); Biomedical Imaging Research Institute, Cedars-Sinai Medical Center, Los Angeles, Calif (D.L., A.G.C., Y.X.); Departments of Cardiology (H.O., K.I., R.K.) and Radiological Technology (I.S.), Ijinkai Takeda General Hospital, Kyoto, Japan; Division of Cardiology, Showa University Fujigaoka Hospital, Kanagawa, Japan (H. Mori); MR Research & Collaboration Department, Siemens Healthcare K.K., Tokyo, Japan (Y.K.); and Department of Radiological Technology, Showa University Hospital, Tokyo, Japan (N.Y.)
| | - Hideaki Tanaka
- From the Division of Cardiology, Showa University School of Medicine, 1-5-8 Hatanodai Shinagawa-ku, Tokyo 142-8555, Japan (S.S., H. Matsumoto, K.S., K.O., Y.O., R.M., H. Tanaka, S.K., H. Tsujita, S.T., T.S.); Biomedical Imaging Research Institute, Cedars-Sinai Medical Center, Los Angeles, Calif (D.L., A.G.C., Y.X.); Departments of Cardiology (H.O., K.I., R.K.) and Radiological Technology (I.S.), Ijinkai Takeda General Hospital, Kyoto, Japan; Division of Cardiology, Showa University Fujigaoka Hospital, Kanagawa, Japan (H. Mori); MR Research & Collaboration Department, Siemens Healthcare K.K., Tokyo, Japan (Y.K.); and Department of Radiological Technology, Showa University Hospital, Tokyo, Japan (N.Y.)
| | - Seita Kondo
- From the Division of Cardiology, Showa University School of Medicine, 1-5-8 Hatanodai Shinagawa-ku, Tokyo 142-8555, Japan (S.S., H. Matsumoto, K.S., K.O., Y.O., R.M., H. Tanaka, S.K., H. Tsujita, S.T., T.S.); Biomedical Imaging Research Institute, Cedars-Sinai Medical Center, Los Angeles, Calif (D.L., A.G.C., Y.X.); Departments of Cardiology (H.O., K.I., R.K.) and Radiological Technology (I.S.), Ijinkai Takeda General Hospital, Kyoto, Japan; Division of Cardiology, Showa University Fujigaoka Hospital, Kanagawa, Japan (H. Mori); MR Research & Collaboration Department, Siemens Healthcare K.K., Tokyo, Japan (Y.K.); and Department of Radiological Technology, Showa University Hospital, Tokyo, Japan (N.Y.)
| | - Hiroaki Tsujita
- From the Division of Cardiology, Showa University School of Medicine, 1-5-8 Hatanodai Shinagawa-ku, Tokyo 142-8555, Japan (S.S., H. Matsumoto, K.S., K.O., Y.O., R.M., H. Tanaka, S.K., H. Tsujita, S.T., T.S.); Biomedical Imaging Research Institute, Cedars-Sinai Medical Center, Los Angeles, Calif (D.L., A.G.C., Y.X.); Departments of Cardiology (H.O., K.I., R.K.) and Radiological Technology (I.S.), Ijinkai Takeda General Hospital, Kyoto, Japan; Division of Cardiology, Showa University Fujigaoka Hospital, Kanagawa, Japan (H. Mori); MR Research & Collaboration Department, Siemens Healthcare K.K., Tokyo, Japan (Y.K.); and Department of Radiological Technology, Showa University Hospital, Tokyo, Japan (N.Y.)
| | - Shigeto Tsukamoto
- From the Division of Cardiology, Showa University School of Medicine, 1-5-8 Hatanodai Shinagawa-ku, Tokyo 142-8555, Japan (S.S., H. Matsumoto, K.S., K.O., Y.O., R.M., H. Tanaka, S.K., H. Tsujita, S.T., T.S.); Biomedical Imaging Research Institute, Cedars-Sinai Medical Center, Los Angeles, Calif (D.L., A.G.C., Y.X.); Departments of Cardiology (H.O., K.I., R.K.) and Radiological Technology (I.S.), Ijinkai Takeda General Hospital, Kyoto, Japan; Division of Cardiology, Showa University Fujigaoka Hospital, Kanagawa, Japan (H. Mori); MR Research & Collaboration Department, Siemens Healthcare K.K., Tokyo, Japan (Y.K.); and Department of Radiological Technology, Showa University Hospital, Tokyo, Japan (N.Y.)
| | - Koji Isodono
- From the Division of Cardiology, Showa University School of Medicine, 1-5-8 Hatanodai Shinagawa-ku, Tokyo 142-8555, Japan (S.S., H. Matsumoto, K.S., K.O., Y.O., R.M., H. Tanaka, S.K., H. Tsujita, S.T., T.S.); Biomedical Imaging Research Institute, Cedars-Sinai Medical Center, Los Angeles, Calif (D.L., A.G.C., Y.X.); Departments of Cardiology (H.O., K.I., R.K.) and Radiological Technology (I.S.), Ijinkai Takeda General Hospital, Kyoto, Japan; Division of Cardiology, Showa University Fujigaoka Hospital, Kanagawa, Japan (H. Mori); MR Research & Collaboration Department, Siemens Healthcare K.K., Tokyo, Japan (Y.K.); and Department of Radiological Technology, Showa University Hospital, Tokyo, Japan (N.Y.)
| | - Ryoji Kitamura
- From the Division of Cardiology, Showa University School of Medicine, 1-5-8 Hatanodai Shinagawa-ku, Tokyo 142-8555, Japan (S.S., H. Matsumoto, K.S., K.O., Y.O., R.M., H. Tanaka, S.K., H. Tsujita, S.T., T.S.); Biomedical Imaging Research Institute, Cedars-Sinai Medical Center, Los Angeles, Calif (D.L., A.G.C., Y.X.); Departments of Cardiology (H.O., K.I., R.K.) and Radiological Technology (I.S.), Ijinkai Takeda General Hospital, Kyoto, Japan; Division of Cardiology, Showa University Fujigaoka Hospital, Kanagawa, Japan (H. Mori); MR Research & Collaboration Department, Siemens Healthcare K.K., Tokyo, Japan (Y.K.); and Department of Radiological Technology, Showa University Hospital, Tokyo, Japan (N.Y.)
| | - Yoshiaki Komori
- From the Division of Cardiology, Showa University School of Medicine, 1-5-8 Hatanodai Shinagawa-ku, Tokyo 142-8555, Japan (S.S., H. Matsumoto, K.S., K.O., Y.O., R.M., H. Tanaka, S.K., H. Tsujita, S.T., T.S.); Biomedical Imaging Research Institute, Cedars-Sinai Medical Center, Los Angeles, Calif (D.L., A.G.C., Y.X.); Departments of Cardiology (H.O., K.I., R.K.) and Radiological Technology (I.S.), Ijinkai Takeda General Hospital, Kyoto, Japan; Division of Cardiology, Showa University Fujigaoka Hospital, Kanagawa, Japan (H. Mori); MR Research & Collaboration Department, Siemens Healthcare K.K., Tokyo, Japan (Y.K.); and Department of Radiological Technology, Showa University Hospital, Tokyo, Japan (N.Y.)
| | - Nobuyuki Yoshii
- From the Division of Cardiology, Showa University School of Medicine, 1-5-8 Hatanodai Shinagawa-ku, Tokyo 142-8555, Japan (S.S., H. Matsumoto, K.S., K.O., Y.O., R.M., H. Tanaka, S.K., H. Tsujita, S.T., T.S.); Biomedical Imaging Research Institute, Cedars-Sinai Medical Center, Los Angeles, Calif (D.L., A.G.C., Y.X.); Departments of Cardiology (H.O., K.I., R.K.) and Radiological Technology (I.S.), Ijinkai Takeda General Hospital, Kyoto, Japan; Division of Cardiology, Showa University Fujigaoka Hospital, Kanagawa, Japan (H. Mori); MR Research & Collaboration Department, Siemens Healthcare K.K., Tokyo, Japan (Y.K.); and Department of Radiological Technology, Showa University Hospital, Tokyo, Japan (N.Y.)
| | - Ikumi Sato
- From the Division of Cardiology, Showa University School of Medicine, 1-5-8 Hatanodai Shinagawa-ku, Tokyo 142-8555, Japan (S.S., H. Matsumoto, K.S., K.O., Y.O., R.M., H. Tanaka, S.K., H. Tsujita, S.T., T.S.); Biomedical Imaging Research Institute, Cedars-Sinai Medical Center, Los Angeles, Calif (D.L., A.G.C., Y.X.); Departments of Cardiology (H.O., K.I., R.K.) and Radiological Technology (I.S.), Ijinkai Takeda General Hospital, Kyoto, Japan; Division of Cardiology, Showa University Fujigaoka Hospital, Kanagawa, Japan (H. Mori); MR Research & Collaboration Department, Siemens Healthcare K.K., Tokyo, Japan (Y.K.); and Department of Radiological Technology, Showa University Hospital, Tokyo, Japan (N.Y.)
| | - Anthony G Christodoulou
- From the Division of Cardiology, Showa University School of Medicine, 1-5-8 Hatanodai Shinagawa-ku, Tokyo 142-8555, Japan (S.S., H. Matsumoto, K.S., K.O., Y.O., R.M., H. Tanaka, S.K., H. Tsujita, S.T., T.S.); Biomedical Imaging Research Institute, Cedars-Sinai Medical Center, Los Angeles, Calif (D.L., A.G.C., Y.X.); Departments of Cardiology (H.O., K.I., R.K.) and Radiological Technology (I.S.), Ijinkai Takeda General Hospital, Kyoto, Japan; Division of Cardiology, Showa University Fujigaoka Hospital, Kanagawa, Japan (H. Mori); MR Research & Collaboration Department, Siemens Healthcare K.K., Tokyo, Japan (Y.K.); and Department of Radiological Technology, Showa University Hospital, Tokyo, Japan (N.Y.)
| | - Yibin Xie
- From the Division of Cardiology, Showa University School of Medicine, 1-5-8 Hatanodai Shinagawa-ku, Tokyo 142-8555, Japan (S.S., H. Matsumoto, K.S., K.O., Y.O., R.M., H. Tanaka, S.K., H. Tsujita, S.T., T.S.); Biomedical Imaging Research Institute, Cedars-Sinai Medical Center, Los Angeles, Calif (D.L., A.G.C., Y.X.); Departments of Cardiology (H.O., K.I., R.K.) and Radiological Technology (I.S.), Ijinkai Takeda General Hospital, Kyoto, Japan; Division of Cardiology, Showa University Fujigaoka Hospital, Kanagawa, Japan (H. Mori); MR Research & Collaboration Department, Siemens Healthcare K.K., Tokyo, Japan (Y.K.); and Department of Radiological Technology, Showa University Hospital, Tokyo, Japan (N.Y.)
| | - Toshiro Shinke
- From the Division of Cardiology, Showa University School of Medicine, 1-5-8 Hatanodai Shinagawa-ku, Tokyo 142-8555, Japan (S.S., H. Matsumoto, K.S., K.O., Y.O., R.M., H. Tanaka, S.K., H. Tsujita, S.T., T.S.); Biomedical Imaging Research Institute, Cedars-Sinai Medical Center, Los Angeles, Calif (D.L., A.G.C., Y.X.); Departments of Cardiology (H.O., K.I., R.K.) and Radiological Technology (I.S.), Ijinkai Takeda General Hospital, Kyoto, Japan; Division of Cardiology, Showa University Fujigaoka Hospital, Kanagawa, Japan (H. Mori); MR Research & Collaboration Department, Siemens Healthcare K.K., Tokyo, Japan (Y.K.); and Department of Radiological Technology, Showa University Hospital, Tokyo, Japan (N.Y.)
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Lüscher TF. Inflammation and features of the vulnerable plaque: from mechanisms and imaging to outcomes. Eur Heart J 2021; 41:2923-2927. [PMID: 33216918 DOI: 10.1093/eurheartj/ehaa686] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Affiliation(s)
- Thomas F Lüscher
- Professor of Cardiology, Imperial College, and Director of Research, Education & Development, Royal Brompton and Harefield Hospitals London, UK.,Professor and Chairman, Center for Molecular Cardiology, University of Zurich, Switzerland.,Editor-in-Chief, EHJ Editorial Office, Zurich Heart House, Hottingerstreet 14, 8032 Zurich, Switzerland
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