1
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Gallucci G, Turazza FM, Inno A, Canale ML, Silvestris N, Farì R, Navazio A, Pinto C, Tarantini L. Atherosclerosis and the Bidirectional Relationship between Cancer and Cardiovascular Disease: From Bench to Bedside-Part 1. Int J Mol Sci 2024; 25:4232. [PMID: 38673815 PMCID: PMC11049833 DOI: 10.3390/ijms25084232] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2024] [Revised: 04/08/2024] [Accepted: 04/09/2024] [Indexed: 04/28/2024] Open
Abstract
Atherosclerosis, a complex metabolic-immune disease characterized by chronic inflammation driven by the buildup of lipid-rich plaques within arterial walls, has emerged as a pivotal factor in the intricate interplay between cancer and cardiovascular disease. This bidirectional relationship, marked by shared risk factors and pathophysiological mechanisms, underscores the need for a comprehensive understanding of how these two formidable health challenges intersect and influence each other. Cancer and its treatments can contribute to the progression of atherosclerosis, while atherosclerosis, with its inflammatory microenvironment, can exert profound effects on cancer development and outcomes. Both cancer and cardiovascular disease involve intricate interactions between general and personal exposomes. In this review, we aim to summarize the state of the art of translational data and try to show how oncologic studies on cardiotoxicity can broaden our knowledge of crucial pathways in cardiovascular biology and exert a positive impact on precision cardiology and cardio-oncology.
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Affiliation(s)
| | - Fabio Maria Turazza
- Struttura Complessa di Cardiologia, Fondazione IRCCS Istituto Nazionale dei Tumori, 20133 Milano, Italy;
| | - Alessandro Inno
- Oncologia Medica, IRCCS Ospedale Sacro Cuore Don Calabria, 37024 Negrar di Valpolicella, Italy;
| | - Maria Laura Canale
- Division of Cardiology, Azienda USL Toscana Nord-Ovest, Versilia Hospital, 55041 Lido di Camaiore, Italy;
| | - Nicola Silvestris
- Medical Oncology Unit, Department of Human Pathology “G.Barresi”, University of Messina, 98100 Messina, Italy;
| | - Roberto Farì
- Clinical and Experimental Medicine PhD Program, University of Modena and Reggio Emilia, 41100 Modena, Italy
| | - Alessandro Navazio
- Cardiologia Ospedaliera, Department of Specialized Medicine, AUSL—IRCCS in Tecnologie Avanzate e Modelli Assistenziali in Oncologia, 42100 Reggio Emilia, Italy;
| | - Carmine Pinto
- Provincial Medical Oncology, Department of Oncology and Advanced Technologies, AUSL—IRCCS in Tecnologie Avanzate e Modelli Assistenziali in Oncologia, 42100 Reggio Emilia, Italy;
| | - Luigi Tarantini
- Cardiologia Ospedaliera, Department of Specialized Medicine, AUSL—IRCCS in Tecnologie Avanzate e Modelli Assistenziali in Oncologia, 42100 Reggio Emilia, Italy;
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2
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Nadel J, Wang X, Saha P, Bongers A, Tumanov S, Giannotti N, Chen W, Vigder N, Chowdhury MM, da Cruz GL, Velasco C, Prieto C, Jabbour A, Botnar RM, Stocker R, Phinikaridou A. Molecular magnetic resonance imaging of myeloperoxidase activity identifies culprit lesions and predicts future atherothrombosis. EUROPEAN HEART JOURNAL. IMAGING METHODS AND PRACTICE 2024; 2:qyae004. [PMID: 38370393 PMCID: PMC10870993 DOI: 10.1093/ehjimp/qyae004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/20/2023] [Accepted: 01/22/2024] [Indexed: 02/20/2024]
Abstract
Aims Unstable atherosclerotic plaques have increased activity of myeloperoxidase (MPO). We examined whether molecular magnetic resonance imaging (MRI) of intraplaque MPO activity predicts future atherothrombosis in rabbits and correlates with ruptured human atheroma. Methods and results Plaque MPO activity was assessed in vivo in rabbits (n = 12) using the MPO-gadolinium (Gd) probe at 8 and 12 weeks after induction of atherosclerosis and before pharmacological triggering of atherothrombosis. Excised plaques were used to confirm MPO activity by liquid chromatography-tandem mass spectrometry (LC-MSMS) and to determine MPO distribution by histology. MPO activity was higher in plaques that caused post-trigger atherothrombosis than plaques that did not. Among the in vivo MRI metrics, the plaques' R1 relaxation rate after administration of MPO-Gd was the best predictor of atherothrombosis. MPO activity measured in human carotid endarterectomy specimens (n = 30) by MPO-Gd-enhanced MRI was correlated with in vivo patient MRI and histological plaque phenotyping, as well as LC-MSMS. MPO-Gd retention measured as the change in R1 relaxation from baseline was significantly greater in histologic and MRI-graded American Heart Association (AHA) type VI than type III-V plaques. This association was confirmed by comparing AHA grade to MPO activity determined by LC-MSMS. Conclusion We show that elevated intraplaque MPO activity detected by molecular MRI employing MPO-Gd predicts future atherothrombosis in a rabbit model and detects ruptured human atheroma, strengthening the translational potential of this approach to prospectively detect high-risk atherosclerosis.
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Affiliation(s)
- James Nadel
- Heart Research Institute, Arterial Inflammation and Redox Biology Group, 7 Eliza St, Newtown, Sydney, NSW 2042, Australia
- Department of Cardiology, St Vincent’s Hospital, Sydney, NSW, Australia
- Department of Medicine and Health, University of New South Wales, Sydney, NSW, Australia
| | - Xiaoying Wang
- School of Biomedical Engineering & Imaging Sciences, King’s College London, London, UK
| | - Prakash Saha
- Academic Department of Surgery, Cardiovascular Division, King’s College London, London, UK
| | - André Bongers
- Biological Resources Imaging Laboratory, University of New South Wales, Sydney, NSW, Australia
| | - Sergey Tumanov
- Heart Research Institute, Arterial Inflammation and Redox Biology Group, 7 Eliza St, Newtown, Sydney, NSW 2042, Australia
- Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
| | - Nicola Giannotti
- Medical Imaging Science, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
| | - Weiyu Chen
- Heart Research Institute, Arterial Inflammation and Redox Biology Group, 7 Eliza St, Newtown, Sydney, NSW 2042, Australia
| | - Niv Vigder
- Heart Research Institute, Arterial Inflammation and Redox Biology Group, 7 Eliza St, Newtown, Sydney, NSW 2042, Australia
| | | | | | - Carlos Velasco
- School of Biomedical Engineering & Imaging Sciences, King’s College London, London, UK
| | - Claudia Prieto
- School of Biomedical Engineering & Imaging Sciences, King’s College London, London, UK
- Pontificia Universidad Católica de Chile, Institute for Biological and Medical Engineering, Santiago, Chile
| | - Andrew Jabbour
- Department of Cardiology, St Vincent’s Hospital, Sydney, NSW, Australia
- Department of Medicine and Health, University of New South Wales, Sydney, NSW, Australia
| | - René M Botnar
- School of Biomedical Engineering & Imaging Sciences, King’s College London, London, UK
- Pontificia Universidad Católica de Chile, Institute for Biological and Medical Engineering, Santiago, Chile
- King’s BHF Centre of Research Excellence, London, UK
| | - Roland Stocker
- Heart Research Institute, Arterial Inflammation and Redox Biology Group, 7 Eliza St, Newtown, Sydney, NSW 2042, Australia
| | - Alkystis Phinikaridou
- School of Biomedical Engineering & Imaging Sciences, King’s College London, London, UK
- King’s BHF Centre of Research Excellence, London, UK
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3
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Garg PK, Bhatia HS, Allen TS, Grainger T, Pouncey AL, Dichek D, Virmani R, Golledge J, Allison MA, Powell JT. Assessment of Subclinical Atherosclerosis in Asymptomatic People In Vivo: Measurements Suitable for Biomarker and Mendelian Randomization Studies. Arterioscler Thromb Vasc Biol 2024; 44:24-47. [PMID: 38150519 PMCID: PMC10753091 DOI: 10.1161/atvbaha.123.320138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2023]
Abstract
BACKGROUND One strategy to reduce the burden of cardiovascular disease is the early detection and treatment of atherosclerosis. This has led to significant interest in studies of subclinical atherosclerosis, using different phenotypes, not all of which are accurate reflections of the presence of asymptomatic atherosclerotic plaques. The aim of part 2 of this series is to provide a review of the existing literature on purported measures of subclinical disease and recommendations concerning which tests may be appropriate in the prevention of incident cardiovascular disease. METHODS We conducted a critical review of measurements used to infer the presence of subclinical atherosclerosis in the major conduit arteries and focused on the predictive value of these tests for future cardiovascular events, independent of conventional cardiovascular risk factors, in asymptomatic people. The emphasis was on studies with >10 000 person-years of follow-up, with meta-analysis of results reporting adjusted hazard ratios (HRs) with 95% CIs. The arterial territories were limited to carotid, coronary, aorta, and lower limb arteries. RESULTS In the carotid arteries, the presence of plaque (8 studies) was independently associated with future stroke (pooled HR, 1.89 [1.04-3.44]) and cardiac events (7 studies), with a pooled HR, 1.77 (1.19-2.62). Increased coronary artery calcium (5 studies) was associated with the risk of coronary heart disease events, pooled HR, 1.54 (1.07-2.07) and increasing severity of calcification (by Agaston score) was associated with escalation of risk (13 studies). An ankle/brachial index (ABI) of <0.9, the pooled HR for cardiovascular death from 7 studies was 2.01 (1.43-2.81). There were insufficient studies of either, thoracic or aortic calcium, aortic diameter, or femoral plaque to synthesize the data based on consistent reporting of these measures. CONCLUSIONS The presence of carotid plaque, coronary artery calcium, or abnormal ankle pressures seems to be a valid indicator of the presence of subclinical atherosclerosis and may be considered for use in biomarker, Mendelian randomization and similar studies.
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Affiliation(s)
- Parveen K Garg
- Division of Cardiology, University of Southern California, Keck School of Medicine, Los Angeles (G.P.)
| | - Harpreet S Bhatia
- Division of Cardiovascular Medicine, University of California San Diego (B.H., A.T., A.M.A.)
| | - Tara S Allen
- Division of Cardiovascular Medicine, University of California San Diego (B.H., A.T., A.M.A.)
| | - Tabitha Grainger
- Department of Surgery & Cancer, Imperial College London (G.T., P.A.-L., P.J.T.)
| | - Anna L Pouncey
- Department of Surgery & Cancer, Imperial College London (G.T., P.A.-L., P.J.T.)
| | - David Dichek
- Division of Cardiology, Department of Medicine, University of Washington, Seattle (D.D.)
| | | | - Jonathan Golledge
- Queensland Research Centre for Peripheral Vascular Disease, James Cook University and Townsville University Hospital, Australia (G.J.)
| | - Matthew A Allison
- Division of Cardiovascular Medicine, University of California San Diego (B.H., A.T., A.M.A.)
| | - Janet T Powell
- Department of Surgery & Cancer, Imperial College London (G.T., P.A.-L., P.J.T.)
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Mackley R, Huband S, Schiller TL. Sample Preparation of Atherosclerotic Plaque for SAXS/WAXS Experimentation. ACS OMEGA 2023; 8:13833-13839. [PMID: 37091388 PMCID: PMC10116636 DOI: 10.1021/acsomega.3c00060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/04/2023] [Accepted: 03/22/2023] [Indexed: 05/03/2023]
Abstract
Atherosclerosis is often described as a single disease entity; however, the morphology of each plaque is unique to the individual. The field currently lacks a technique that can discriminate stable from unstable plaques, to identify those at risk of a thromboembolic event. Small- and wide-angle X-ray scattering (SAXS/WAXS) holds the potential to be able to identify key materials present in a plaque, such as cholesterol species, collagen, low-density lipoproteins (LDLs), and hydroxyapatite. Protocols have been established for the preparation of excised human atherosclerotic tissue that are investigated herein. This includes the fixing, sectioning, and substrate selection of the sample. Through several sample preparation methods, vast improvements have been made to sample-to-noise ratio and background subtraction.
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Affiliation(s)
- Rebecca
R. Mackley
- Warwick
Medical School, University of Warwick, Coventry, West Midlands CV4 7AL, United
Kingdom
- Warwick
Manufacturing Group, University of Warwick, Coventry, West Midlands CV4 7AL, United
Kingdom
| | - Steven Huband
- X-ray
Diffraction Facility, Department of Physics, University of Warwick, Coventry, West Midlands CV4 7AL, United Kingdom
| | - Tara L. Schiller
- Warwick
Manufacturing Group, University of Warwick, Coventry, West Midlands CV4 7AL, United
Kingdom
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5
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Zhang Y, Fatima M, Hou S, Bai L, Zhao S, Liu E. Research methods for animal models of atherosclerosis (Review). Mol Med Rep 2021; 24:871. [PMID: 34713295 PMCID: PMC8569513 DOI: 10.3892/mmr.2021.12511] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Accepted: 05/20/2021] [Indexed: 11/17/2022] Open
Abstract
Atherosclerosis is a chronic inflammatory disease that threatens human health and lives by causing vascular stenosis and plaque rupture. Various animal models have been employed for elucidating the pathogenesis, drug development and treatment validation studies for atherosclerosis. To the best of our knowledge, the species used for atherosclerosis research include mice, rats, hamsters, rabbits, pigs, dogs, non-human primates and birds, among which the most commonly used ones are mice and rabbits. Notably, apolipoprotein E knockout (KO) or low-density lipoprotein receptor KO mice have been the most widely used animal models for atherosclerosis research since the late 20th century. Although the aforementioned animal models can form atherosclerotic lesions, they cannot completely simulate those in humans with respect to lesion location, lesion composition, lipoprotein composition and physiological structure. Hence, an appropriate animal model needs to be selected according to the research purpose. Additionally, it is necessary for atherosclerosis research to include quantitative analysis results of atherosclerotic lesion size and plaque composition. Laboratory animals can provide not only experimental tissues for in vivo studies but also cells needed for in vitro experiments. The present review first summarizes the common animal models and their practical applications, followed by focus on mouse and rabbit models and elucidating the methods to quantify atherosclerotic lesions. Finally, the methods of culturing endothelial cells, macrophages and smooth muscle cells were elucidated in detail and the experiments involved in atherosclerosis research were discussed.
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Affiliation(s)
- Yali Zhang
- Research Institute of Atherosclerotic Disease, Xi'an Jiaotong University Cardiovascular Research Centre, Xi'an, Shaanxi 710061, P.R. China
| | - Mahreen Fatima
- Research Institute of Atherosclerotic Disease, Xi'an Jiaotong University Cardiovascular Research Centre, Xi'an, Shaanxi 710061, P.R. China
| | - Siyuan Hou
- Laboratory Animal Center, Xi'an Jiaotong University Health Science Centre, Xi'an, Shaanxi 710061, P.R. China
| | - Liang Bai
- Research Institute of Atherosclerotic Disease, Xi'an Jiaotong University Cardiovascular Research Centre, Xi'an, Shaanxi 710061, P.R. China
| | - Sihai Zhao
- Research Institute of Atherosclerotic Disease, Xi'an Jiaotong University Cardiovascular Research Centre, Xi'an, Shaanxi 710061, P.R. China
| | - Enqi Liu
- Research Institute of Atherosclerotic Disease, Xi'an Jiaotong University Cardiovascular Research Centre, Xi'an, Shaanxi 710061, P.R. China
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6
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Qiao R, Huang X, Qin Y, Li Y, Davis TP, Hagemeyer CE, Gao M. Recent advances in molecular imaging of atherosclerotic plaques and thrombosis. NANOSCALE 2020; 12:8040-8064. [PMID: 32239038 DOI: 10.1039/d0nr00599a] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
As the complications of atherosclerosis such as myocardial infarction and stroke are still one of the leading causes of mortality worldwide, the development of new diagnostic tools for the early detection of plaque instability and thrombosis is urgently needed. Advanced molecular imaging probes based on functional nanomaterials in combination with cutting edge imaging techniques are now paving the way for novel and unique approaches to monitor the inflammatory progress in atherosclerosis. This review focuses on the development of various molecular probes for the diagnosis of plaques and thrombosis in atherosclerosis, along with perspectives of their diagnostic applications in cardiovascular diseases. Specifically, we summarize the biological targets that can be used for atherosclerosis and thrombosis imaging. Then we describe the emerging molecular imaging techniques based on the utilization of engineered nanoprobes together with their challenges in clinical translation.
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Affiliation(s)
- Ruirui Qiao
- State Key Laboratory of Radiation Medicine and Protection, School for Radiological and Interdisciplinary Sciences (RAD-X), Collaborative Innovation Center of Radiation Medicine of Jiangsu Higher Education Institutions, Soochow University, Suzhou 215123, China
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7
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Chin DD, Poon C, Trac N, Wang J, Cook J, Joo J, Jiang Z, Maria NSS, Jacobs RE, Chung EJ. Collagenase-Cleavable Peptide Amphiphile Micelles as a Novel Theranostic Strategy in Atherosclerosis. ADVANCED THERAPEUTICS 2020; 3:1900196. [PMID: 34295964 PMCID: PMC8294202 DOI: 10.1002/adtp.201900196] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2019] [Indexed: 11/10/2022]
Abstract
Atherosclerosis is an inflammatory disease characterized by plaques that can cause sudden myocardial infarction upon rupture. Such rupture-prone plaques have thin fibrous caps due to collagenase degradation, and a noninvasive diagnostic tool and targeted therapy that can identify and treat vulnerable plaques and may inhibit the onset of acute cardiac events. Toward this goal, monocyte-binding, collagenase-inhibiting, and gadolinium-modified peptide amphiphile micelles (MCG PAMs) are developed. Monocyte chemoattractant protein-1 (MCP-1) binds to C-C chemokine receptor-2 expressed on pathological cell types present within plaques. Through the peptide binding motif of MCP-1, MCG PAMs bind to monocytes and vascular smooth muscle cells in vitro. Moreover, using magnetic resonance imaging, MCG PAMs show enhanced targeting and successful detection of plaques in diseased mice in vivo and act as contrast agents for molecular imaging. Through the collagenase-cleaving peptide sequence of collagen [VPMS-MRGG], MCG PAMs can compete for collagenases that degrade the fibrous cap of plaques, providing therapy. MCG PAM-treated mice show increased fibrous cap thickness by 61% and 113% histologically compared to nontargeting micelle- or PBS-treated mice (p = 0.0075 and 0.001, respectively). Overall, this novel multimodal nanoparticle offers new theranostic opportunities for noninvasive diagnosis and treatment of atherosclerotic plaques.
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Affiliation(s)
- Deborah D Chin
- Department of Biomedical Engineering, University of Southern California, Los Angeles USC 90089 CA, USA
| | - Christopher Poon
- Department of Biomedical Engineering, University of Southern California, Los Angeles USC 90089 CA, USA
| | - Noah Trac
- Department of Biomedical Engineering, University of Southern California, Los Angeles USC 90089 CA, USA
| | - Jonathan Wang
- Department of Biomedical Engineering, University of Southern California, Los Angeles USC 90089 CA, USA
| | - Jackson Cook
- Department of Biomedical Engineering, University of Southern California, Los Angeles USC 90089 CA, USA
| | - Johan Joo
- Department of Biomedical Engineering, University of Southern California, Los Angeles USC 90089 CA, USA
| | - Zhangjingyi Jiang
- Department of Biomedical Engineering, University of Southern California, Los Angeles USC 90089 CA, USA
| | - Naomi Sulit Sta Maria
- Department of Physiology and Neuroscience, Zilkha Neurogenetic, Institute and Keck School of Medicine, University of Southern California, Los Angeles 90033 CA, USA
| | - Russell E Jacobs
- Department of Physiology and Neuroscience, Zilkha Neurogenetic, Institute and Keck School of Medicine, University of Southern California, Los Angeles 90033 CA, USA
| | - Eun Ji Chung
- Department of Biomedical Engineering, University of Southern California, Los Angeles USC 90089 CA, USA
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8
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Vigne J, Thackeray J, Essers J, Makowski M, Varasteh Z, Curaj A, Karlas A, Canet-Soulas E, Mulder W, Kiessling F, Schäfers M, Botnar R, Wildgruber M, Hyafil F. Current and Emerging Preclinical Approaches for Imaging-Based Characterization of Atherosclerosis. Mol Imaging Biol 2019; 20:869-887. [PMID: 30250990 DOI: 10.1007/s11307-018-1264-1] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Atherosclerotic plaques can remain quiescent for years, but become life threatening upon rupture or disruption, initiating clot formation in the vessel lumen and causing acute myocardial infarction and ischemic stroke. Whether and how a plaque ruptures is determined by its macroscopic structure and microscopic composition. Rupture-prone plaques usually consist of a thin fibrous cap with few smooth muscle cells, a large lipid core, a dense infiltrate of inflammatory cells, and neovessels. Such lesions, termed high-risk plaques, can remain asymptomatic until the thrombotic event. Various imaging technologies currently allow visualization of morphological and biological characteristics of high-risk atherosclerotic plaques. Conventional protocols are often complex and lack specificity for high-risk plaque. Conversely, new imaging approaches are emerging which may overcome these limitations. Validation of these novel imaging techniques in preclinical models of atherosclerosis is essential for effective translational to clinical practice. Imaging the vessel wall, as well as its biological milieu in small animal models, is challenging because the vessel wall is a small structure that undergoes continuous movements imposed by the cardiac cycle as it is adjacent to circulating blood. The focus of this paper is to provide a state-of-the-art review on techniques currently available for preclinical imaging of atherosclerosis in small animal models and to discuss the advantages and limitations of each approach.
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Affiliation(s)
- Jonathan Vigne
- Department of Nuclear Medicine, Bichat University Hospital, AP-HP; INSERM, U-1148, DHU FIRE, University Diderot, Paris, France
| | - James Thackeray
- Department of Nuclear Medicine, Hannover Medical School, Hannover, Germany
| | - Jeroen Essers
- Departments of Vascular Surgery, Molecular Genetics, Radiation Oncology, Erasmus MC, Rotterdam, The Netherlands
| | - Marcus Makowski
- Department of Radiology, Charité-University Medicine Berlin, Berlin, Germany
| | - Zoreh Varasteh
- Department of Nuclear Medicine, Klinikum rechts der Isar, Technische Universität München, Munich, Germany
| | - Adelina Curaj
- Institute for Molecular Cardiovascular Research (IMCAR), Institute for Experimental Molecular Imaging (ExMI), University Hospital Aachen, RWTH, Aachen, Germany
| | - Angelos Karlas
- Institute for Biological and Medical Imaging, Helmholtz Zentrum München, Oberschleissheim, Germany
| | - Emmanuel Canet-Soulas
- Laboratoire CarMeN, INSERM U-1060, Lyon/Hospices Civils Lyon, IHU OPERA Cardioprotection, Université de Lyon, Bron, France
| | - Willem Mulder
- Translational and Molecular Imaging Institute, Icahn School of Medicine at Mount Sinai, Mount Sinai, New York, USA
| | - Fabian Kiessling
- Institute for Experimental Molecular Imaging (ExMI), University Hospital Aachen, RWTH, Aachen, Germany
| | - Michael Schäfers
- Department of Nuclear Medicine, European Institute for Molecular Imaging (EIMI), Westfälische Wilhelms-Universität Münster, Münster, Germany
| | - René Botnar
- School of Biomedical Engineering and Imaging Sciences, King's College London, London, UK
| | - Moritz Wildgruber
- Translational Research Imaging Center, Institut für Klinische Radiologie, Universitätsklinikum Münster, Albert-Schweitzer-Campus 1, 48149, Münster, Germany
| | - Fabien Hyafil
- Department of Nuclear Medicine, Bichat University Hospital, AP-HP; INSERM, U-1148, DHU FIRE, University Diderot, Paris, France. .,Département de Médecine Nucléaire, Centre Hospitalier Universitaire Bichat, 46 rue Henri Huchard, 75018, Paris, France.
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9
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Herrod PJJ, Blackwell JEM, Moss BF, Gates A, Atherton PJ, Lund JN, Williams JP, Phillips BE. The efficacy of 'static' training interventions for improving indices of cardiorespiratory fitness in premenopausal females. Eur J Appl Physiol 2019; 119:645-652. [PMID: 30591963 PMCID: PMC6394674 DOI: 10.1007/s00421-018-4054-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2018] [Accepted: 12/10/2018] [Indexed: 02/07/2023]
Abstract
PURPOSE Cardiovascular disease (CVD) is the leading cause of death worldwide. Many risk factors for CVD can be modified pharmacologically; however, uptake of medications is low, especially in asymptomatic people. Exercise is also effective at reducing CVD risk, but adoption is poor with time-commitment and cost cited as key reasons for this. Repeated remote ischaemic preconditioning (RIPC) and isometric handgrip (IHG) training are both inexpensive, time-efficient interventions which have shown some promise in reducing blood pressure (BP) and improving markers of cardiovascular health and fitness. However, few studies have investigated the effectiveness of these interventions in premenopausal women. METHOD Thirty healthy females were recruited to twelve supervised sessions of either RIPC or IHG over 4 weeks, or acted as non-intervention controls (CON). BP measurements, flow-mediated dilatation (FMD) and cardiopulmonary exercise tests (CPET) were performed at baseline and after the intervention period. RESULTS IHG and RIPC were both well-tolerated with 100% adherence to all sessions. A statistically significant reduction in both systolic (- 7.2 mmHg) and diastolic (- 6 mmHg) BP was demonstrated following IHG, with no change following RIPC. No statistically significant improvements were observed in FMD or CPET parameters in any group. CONCLUSIONS IHG is an inexpensive and well-tolerated intervention which may improve BP; a key risk factor for CVD. Conversely, our single arm RIPC protocol, despite being similarly well-tolerated, did not elicit improvements in any cardiorespiratory parameters in our chosen population.
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Affiliation(s)
- P J J Herrod
- MRC-ARUK Centre for Musculoskeletal Ageing Research, University of Nottingham, Royal Derby Hospital Centre, DE22 3DT, Derby, UK
- Department of Anaesthetics and Surgery, Royal Derby Hospital, Derby, UK
| | - J E M Blackwell
- MRC-ARUK Centre for Musculoskeletal Ageing Research, University of Nottingham, Royal Derby Hospital Centre, DE22 3DT, Derby, UK
- Department of Anaesthetics and Surgery, Royal Derby Hospital, Derby, UK
| | - B F Moss
- MRC-ARUK Centre for Musculoskeletal Ageing Research, University of Nottingham, Royal Derby Hospital Centre, DE22 3DT, Derby, UK
- Department of Anaesthetics and Surgery, Royal Derby Hospital, Derby, UK
| | - A Gates
- MRC-ARUK Centre for Musculoskeletal Ageing Research, University of Nottingham, Royal Derby Hospital Centre, DE22 3DT, Derby, UK
| | - P J Atherton
- MRC-ARUK Centre for Musculoskeletal Ageing Research, University of Nottingham, Royal Derby Hospital Centre, DE22 3DT, Derby, UK
| | - J N Lund
- MRC-ARUK Centre for Musculoskeletal Ageing Research, University of Nottingham, Royal Derby Hospital Centre, DE22 3DT, Derby, UK
- Department of Anaesthetics and Surgery, Royal Derby Hospital, Derby, UK
| | - J P Williams
- MRC-ARUK Centre for Musculoskeletal Ageing Research, University of Nottingham, Royal Derby Hospital Centre, DE22 3DT, Derby, UK
- Department of Anaesthetics and Surgery, Royal Derby Hospital, Derby, UK
| | - B E Phillips
- MRC-ARUK Centre for Musculoskeletal Ageing Research, University of Nottingham, Royal Derby Hospital Centre, DE22 3DT, Derby, UK.
- Department of Anaesthetics and Surgery, Royal Derby Hospital, Derby, UK.
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10
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An innovative flow cytometry method to screen human scFv-phages selected by in vivo phage-display in an animal model of atherosclerosis. Sci Rep 2018; 8:15016. [PMID: 30302027 PMCID: PMC6177473 DOI: 10.1038/s41598-018-33382-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2017] [Accepted: 08/29/2018] [Indexed: 12/20/2022] Open
Abstract
Atherosclerosis is a chronic, progressive inflammatory disease that may develop into vulnerable lesions leading to thrombosis. This pathology is characterized by the deposition of lipids within the arterial wall and infiltration of immune cells leading to amplification of inflammation. Nowadays there is a rising interest to assess directly the molecular and cellular components that underlie the clinical condition of stroke and myocardial infarction. Single chain fragment variable (scFv)-phages issuing from a human combinatorial library were selected on the lesions induced in a rabbit model of atherosclerosis after three rounds of in vivo phage display. We further implemented a high-throughput flow cytometry method on rabbit protein extracts to individually test one thousand of scFv-phages. Two hundred and nine clones were retrieved on the basis of their specificity for atherosclerotic proteins. Immunohistochemistry assays confirmed the robustness of the designed cytometry protocol. Sequencing of candidates demonstrated their high diversity in VH and VL germline usage. The large number of candidates and their diversity open the way in the discovery of new biomarkers. Here, we successfully showed the capacity of combining in vivo phage display and high-throughput cytometry strategies to give new insights in in vivo targetable up-regulated biomarkers in atherosclerosis.
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11
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Optimization of Computed Tomography Coronary Angiography for Improved Plaque Detection. J Comput Assist Tomogr 2018; 42:240-247. [PMID: 28937481 DOI: 10.1097/rct.0000000000000663] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
OBJECTIVE The study aims to optimize visualization of the coronary wall during computed tomography coronary angiography. METHODS A coronary plaque phantom was scanned on a wide-volume computed tomography scanner. Spatial resolution, contrast resolution, and vessel wall thickness were measured at different x-ray tube currents and voltages. RESULTS Spatial resolution ranged from 0.385 to 0.625 mm and was significantly lower at higher currents. Contrast-to-noise ratio was significantly higher at higher currents. The most accurate wall thickness measurements were quantified at 300 and 400 mA for 80 and 100 kVp and 300 mA for 120 and 135 kVp. CONCLUSIONS Lower spatial resolution at higher currents was due to added blur from increased focal spot size. Contrast-to-noise ratio was higher at higher currents owing to decreased quantum noise. Wall thickness was measured more accurately at intermediate currents with midrange contrast-to-noise ratio but optimal spatial resolution. For accurate coronary wall thickness measurement, contrast-to-noise ratio is compromised to achieve optimal spatial resolution.
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12
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Cardoso L, Weinbaum S. Microcalcifications, Their Genesis, Growth, and Biomechanical Stability in Fibrous Cap Rupture. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2018; 1097:129-155. [PMID: 30315543 DOI: 10.1007/978-3-319-96445-4_7] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
For many decades, cardiovascular calcification has been considered as a passive process, accompanying atheroma progression, correlated with plaque burden, and apparently without a major role on plaque vulnerability. Clinical and pathological analyses have previously focused on the total amount of calcification (calcified area in a whole atheroma cross section) and whether more calcification means higher risk of plaque rupture or not. However, this paradigm has been changing in the last decade or so. Recent research has focused on the presence of microcalcifications (μCalcs) in the atheroma and more importantly on whether clusters of μCalcs are located in the cap of the atheroma. While the vast majority of μCalcs are found in the lipid pool or necrotic core, they are inconsequential to vulnerable plaque. Nevertheless, it has been shown that μCalcs located within the fibrous cap could be numerous and that they behave as an intensifier of the background circumferential stress in the cap. It is now known that such intensifying effect depends on the size and shape of the μCalc as well as the proximity between two or more μCalcs. If μCalcs are located in caps with very low background stress, the increase in stress concentration may not be sufficient to reach the rupture threshold. However, the presence of μCalc(s) in the cap with a background stress of about one fifth to one half the rupture threshold (a stable plaque) will produce a significant increase in local stress, which may exceed the cap rupture threshold and thus transform a non-vulnerable plaque into a vulnerable one. Also, the classic view that treats cardiovascular calcification as a passive process has been challenged, and emerging data suggest that cardiovascular calcification may encompass both passive and active processes. The passive calcification process comprises biochemical factors, specifically circulating nucleating complexes, which would lead to calcification of the atheroma. The active mechanism of atherosclerotic calcification is a cell-mediated process via cell death of macrophages and smooth muscle cells (SMCs) and/or the release of matrix vesicles by SMCs.
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Affiliation(s)
- Luis Cardoso
- Department of Biomedical Engineering, The City College of New York, New York, NY, USA.
| | - Sheldon Weinbaum
- Department of Biomedical Engineering, The City College of New York, New York, NY, USA
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Olin JW, Jang J, Jaff MR, Beckman JA, Rooke T. Vascular Imaging: An Unparalleled Decade. J Endovasc Ther 2016; 11 Suppl 2:II21-31. [PMID: 15760260 DOI: 10.1177/15266028040110s618] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Vascular imaging techniques, such as catheter angiography, ultrasound, computed tomography (CT), and magnetic resonance (MR), have all undergone unprecedented innovation and incredible technological leaps in the last 10 years. Ultrasound, CT, and MR have progressed in acquisition speed, resolution, and accuracy to the point that they have now supplanted the former mainstay, invasive catheter-based angiography, despite the advent of digitized angiographic image recording. This review explores the advantages and shortcomings of each technique and how they have changed the diagnosis and assessment of the cardiovascular system for endovascular intervention.
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Affiliation(s)
- Jeffrey W Olin
- Zena and Michael A. Wiener Cardiovascular Institute, Mount Sinai School of Medicine, New York, NY 10029, USA.
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14
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Comparison of statin eligibility according to the Adult Treatment Panel III, ACC/AHA blood cholesterol guideline, and presence of carotid plaque by ultrasound in Mexican mestizo patients with rheumatoid arthritis. Clin Rheumatol 2016; 35:2823-2827. [DOI: 10.1007/s10067-016-3312-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2016] [Revised: 04/25/2016] [Accepted: 05/15/2016] [Indexed: 10/21/2022]
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15
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Wann LS, Thompson RC, Allam AH, Finch CE, Zink A, Frohlich B, Kaplan H, Lombardi GP, Sutherland ML, Sutherland JD, Watson L, Cox SL, Miyamoto MI, Stewart AFR, Narula J, Thomas GS. Atherosclerosis: a longue durée approach. Glob Heart 2015; 9:239-44. [PMID: 25667094 DOI: 10.1016/j.gheart.2014.02.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2013] [Revised: 12/08/2013] [Accepted: 02/19/2014] [Indexed: 11/19/2022] Open
Affiliation(s)
- L Samuel Wann
- Cardiovascular Physicians, Columbia St. Mary's Healthcare, Milwaukee, WI, USA.
| | - Randall C Thompson
- Saint Luke's Mid America Heart Institute, University of Missouri-Kansas City, Kansas City, MO, USA
| | | | - Caleb E Finch
- Davis School of Gerontology, University of Southern California, Los Angeles, CA, USA
| | - Albert Zink
- Institute for Mummies and the Iceman, European Academy of Bolzano/Bozen (EURAC), Bolzano/Bozen, Italy
| | - Bruno Frohlich
- National Museum of Natural History, Smithsonian Institution, Washington, DC, USA
| | - Hillard Kaplan
- Department of Anthropology, University of New Mexico, Albuquerque, NM, USA
| | | | | | | | - Lucia Watson
- Universidad Nacional Autónoma de México, Mexico City, Mexico
| | - Samantha L Cox
- Department of Archeology, University of Cambridge, Cambridge, United Kingdom
| | - Michael I Miyamoto
- Mission Heritage Medical Group, St. Joseph Heritage Health, Mission Viejo, CA, USA
| | - Alexandre F R Stewart
- John and Jennifer Ruddy Canadian Cardiovascular Genetics Centre, University of Ottawa Heart Institute, Ottawa, Ontario, Canada
| | - Jagat Narula
- Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Gregory S Thomas
- MemorialCare Heart & Vascular Institute, Long Beach Memorial, Long Beach, CA, USA; University of California, Irvine, Irvine, CA, USA
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Hua N, Baik F, Pham T, Phinikaridou A, Giordano N, Friedman B, Whitney M, Nguyen QT, Tsien RY, Hamilton JA. Identification of High-Risk Plaques by MRI and Fluorescence Imaging in a Rabbit Model of Atherothrombosis. PLoS One 2015; 10:e0139833. [PMID: 26448434 PMCID: PMC4598148 DOI: 10.1371/journal.pone.0139833] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2015] [Accepted: 09/17/2015] [Indexed: 12/25/2022] Open
Abstract
Introduction The detection of atherosclerotic plaques at risk for disruption will be greatly enhanced by molecular probes that target vessel wall biomarkers. Here, we test if fluorescently-labeled Activatable Cell Penetrating Peptides (ACPPs) could differentiate stable plaques from vulnerable plaques that disrupt, forming a luminal thrombus. Additionally, we test the efficacy of a combined ACPP and MRI technique for identifying plaques at high risk of rupture. Methods and Results In an atherothrombotic rabbit model, disrupted plaques were identified with in vivo MRI and co-registered in the same rabbit aorta with the in vivo uptake of ACPPs, cleaved by matrix metalloproteinases (MMPs) or thrombin. ACPP uptake, mapped ex vivo in whole aortas, was higher in disrupted compared to non-disrupted plaques. Specifically, disrupted plaques demonstrated a 4.5~5.0 fold increase in fluorescence enhancement, while non-disrupted plaques showed only a 2.2~2.5 fold signal increase. Receiver operating characteristic (ROC) analysis indicates that both ACPPs (MMP and thrombin) show high specificity (84.2% and 83.2%) and sensitivity (80.0% and 85.7%) in detecting disrupted plaques. The detection power of ACPPs was improved when combined with the MRI derived measure, outward remodeling ratio. Conclusions Our targeted fluorescence ACPP probes distinguished disrupted plaques from stable plaques with high sensitivity and specificity. The combination of anatomic, MRI-derived predictors for disruption and ACPP uptake can further improve the power for identification of high-risk plaques and suggests future development of ACPPs with molecular MRI as a readout.
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Affiliation(s)
- Ning Hua
- Department of Physiology and Biophysics, Boston University School of Medicine, Boston, Massachusetts, United States of America
| | - Fred Baik
- Division of Head and Neck Surgery, University of California at San Diego, La Jolla, California, United States of America
| | - Tuan Pham
- Department of Biomedical Engineering, Boston University, Boston, Massachusetts, United States of America
| | - Alkystis Phinikaridou
- Division of Imaging Sciences and Biomedical Engineering, King’s College London, London, United Kingdom
| | - Nick Giordano
- Department of Physiology and Biophysics, Boston University School of Medicine, Boston, Massachusetts, United States of America
| | - Beth Friedman
- Department of Pharmacology, University of California at San Diego, La Jolla, California, United States of America
| | - Michael Whitney
- Department of Pharmacology, University of California at San Diego, La Jolla, California, United States of America
| | - Quyen T. Nguyen
- Division of Head and Neck Surgery, University of California at San Diego, La Jolla, California, United States of America
| | - Roger Y. Tsien
- Department of Pharmacology, University of California at San Diego, La Jolla, California, United States of America
- Howard Hughes Medical Institute, University of California at San Diego, La Jolla, CA, United States of America
| | - James A. Hamilton
- Department of Physiology and Biophysics, Boston University School of Medicine, Boston, Massachusetts, United States of America
- * E-mail:
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Heinze T, Siebert M, Berlin P, Koschella A. Biofunctional Materials Based on Amino Cellulose Derivatives - A Nanobiotechnological Concept. Macromol Biosci 2015; 16:10-42. [DOI: 10.1002/mabi.201500184] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2015] [Revised: 06/22/2015] [Indexed: 01/22/2023]
Affiliation(s)
- Thomas Heinze
- Center of Excellence for Polysaccharide Research; Institute of Organic Chemistry and Macromolecular Chemistry; Friedrich Schiller University of Jena; Humboldtstraße 10 07743 Jena Germany
| | - Melanie Siebert
- Center of Excellence for Polysaccharide Research; Institute of Organic Chemistry and Macromolecular Chemistry; Friedrich Schiller University of Jena; Humboldtstraße 10 07743 Jena Germany
| | - Peter Berlin
- Center of Excellence for Polysaccharide Research; Institute of Organic Chemistry and Macromolecular Chemistry; Friedrich Schiller University of Jena; Humboldtstraße 10 07743 Jena Germany
| | - Andreas Koschella
- Center of Excellence for Polysaccharide Research; Institute of Organic Chemistry and Macromolecular Chemistry; Friedrich Schiller University of Jena; Humboldtstraße 10 07743 Jena Germany
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Parolini C, Busnelli M, Ganzetti GS, Dellera F, Manzini S, Scanziani E, Johnson JL, Sirtori CR, Chiesa G. Magnetic resonance imaging visualization of vulnerable atherosclerotic plaques at the brachiocephalic artery of apolipoprotein E knockout mice by the blood-pool contrast agent B22956/1. Mol Imaging 2015; 13. [PMID: 24825406 DOI: 10.2310/7290.2014.00012] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
The aim of this study was to identify, by magnetic resonance imaging (MRI), the ability of the blood-pool contrast agent B22956/1 to detect atherosclerotic plaques developing at the brachiocephalic artery of apolipoprotein E knockout (apoE-KO) mice and to possibly identify vulnerable atherosclerotic lesions. After high-fat feeding for 8 or 12 weeks, MRIs of brachiocephalic arteries were acquired before and after B22956/1 administration; then vessels were removed and analyzed by histology. B22956/1 injection caused a rapid increase in plaque signal enhancement and plaque to muscle contrast values, which remained stable up to 70 minutes. A linear correlation between signal enhancement and macrophage content was found 10 minutes after B22956/1 injection (p < .01). Signal enhancement and plaque to muscle contrast values correlated with macrophage content 40 minutes after contrast agent administration (p < .01). Finally, 70 minutes after B22956/1 infusion, plaque to muscle contrast significantly correlated with the percentage of stenosis (p < .005). B22956/1 administration to high fat-fed apoE-KO mice resulted in a rapid enhancement of atherosclerotic plaques and in a great ability to rapidly visualize vulnerable plaques, characterized by a high macrophage content. These results suggest that B22956/1 could represent an interesting tool for the identification of atherosclerotic plaques potentially leading to acute cardiovascular events.
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19
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Teresa Albelda M, Garcia-España E, Frias JC. Visualizing the atherosclerotic plaque: a chemical perspective. Chem Soc Rev 2014; 43:2858-76. [PMID: 24526041 DOI: 10.1039/c3cs60410a] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Atherosclerosis is the major underlying pathologic cause of coronary artery disease. An early detection of the disease can prevent clinical sequellae such as angina, myocardial infarction, and stroke. The different imaging techniques employed to visualize the atherosclerotic plaque provide information of diagnostic and prognostic value. Furthermore, the use of contrast agents helps to improve signal-to-noise ratio providing better images. For nuclear imaging techniques and optical imaging these agents are absolutely necessary. We report on the different contrast agents that have been used, are used or may be used in future in animals, humans, or excised tissues for the distinct imaging modalities for atherosclerotic plaque imaging.
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Affiliation(s)
- Ma Teresa Albelda
- Universidad de Valencia, Instituto de Ciencia Molecular, Edificio de Institutos de Paterna, c/ Catedrático José Beltrán 2, 46071 Valencia, Spain
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Atherosclerosis and atheroma plaque rupture: imaging modalities in the visualization of vasa vasorum and atherosclerotic plaques. ScientificWorldJournal 2014; 2014:312764. [PMID: 24688380 PMCID: PMC3944209 DOI: 10.1155/2014/312764] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2013] [Accepted: 12/30/2013] [Indexed: 11/24/2022] Open
Abstract
Invasive angiography has been widely accepted as the gold standard to diagnose cardiovascular pathologies. Despite its superior resolution of demonstrating atherosclerotic plaque in terms of degree of lumen stenosis, the morphological assessment for the plaque is insufficient for the analysis of plaque components, and therefore, unable to predict the risk status or vulnerability of atherosclerotic plaque. There is an increased body of evidence to show that the vasa vasorum play an important role in the initiation, progression, and complications of atherosclerotic plaque leading to major adverse cardiac events. This paper provides an overview of the evidence-based reviews of various imaging modalities with regard to their potential value for comprehensive characterization of the composition, burden, and neovascularization of atherosclerotic plaque.
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Nicholls SJ, Andrews J, Moon KW. Exploring the natural history of atherosclerosis with intravascular ultrasound. Expert Rev Cardiovasc Ther 2014; 5:295-306. [PMID: 17338673 DOI: 10.1586/14779072.5.2.295] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Intravascular ultrasound has emerged as the preferred imaging modality for the characterization of atherosclerotic plaque within the coronary arteries. Ultrasonic imaging reveals the presence of more extensive atheroma than suggested by conventional angiography in patients with coronary artery disease. The ability to precisely quantify atheroma volume in an arterial segment at different time points provides the unique opportunity to investigate the factors that influence the natural history of atheroma progression. Accordingly, serial intravascular ultrasound has been incorporated into a number of clinical trials that have evaluated the impact of medical therapies that modify established risk factors and novel pathological targets. This article will review the increasing role of imaging modalities in the assessment of atherosclerosis and factors that influence its natural history.
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Affiliation(s)
- Stephen J Nicholls
- Cleveland Clinic, Department of Cardiovascular Medicine, Mail Code JJ65, 9500 Euclid Ave, Cleveland OH, USA.
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Abstract
Endothelial cells represent important targets for therapeutic and diagnostic interventions in many cardiovascular, pulmonary, neurological, inflammatory, and metabolic diseases. Targeted delivery of drugs (especially potent and labile biotherapeutics that require specific subcellular addressing) and imaging probes to endothelium holds promise to improve management of these maladies. In order to achieve this goal, drug cargoes or their carriers including liposomes and polymeric nanoparticles are chemically conjugated or fused using recombinant techniques with affinity ligands of endothelial surface molecules. Cell adhesion molecules, constitutively expressed on the endothelial surface and exposed on the surface of pathologically altered endothelium—selectins, VCAM-1, PECAM-1, and ICAM-1—represent good determinants for such a delivery. In particular, PECAM-1 and ICAM-1 meet criteria of accessibility, safety, and relevance to the (patho)physiological context of treatment of inflammation, ischemia, and thrombosis and offer a unique combination of targeting options including surface anchoring as well as intra- and transcellular targeting, modulated by parameters of the design of drug delivery system and local biological factors including flow and endothelial phenotype. This review includes analysis of these factors and examples of targeting selected classes of therapeutics showing promising results in animal studies, supporting translational potential of these interventions.
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Rantner B, Sojer M, Kremser C, Cartes-Zumelzu F, Fraedrich G, Jaschke W, Chemelli-Steingruber I. Enhancement patterns in the fibro cellular tissue in different kinds of plaques of the internal carotid artery. Eur J Radiol 2013; 82:1989-95. [PMID: 23910043 DOI: 10.1016/j.ejrad.2013.07.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2013] [Revised: 06/11/2013] [Accepted: 07/04/2013] [Indexed: 10/26/2022]
Abstract
BACKGROUND The differentiation between stable and vulnerable plaques in the internal carotid artery (ICA) remains a matter of interest. With the implementation of contrast agent in magnetic resonance imaging (MRI) a more detailed plaque characterization is possible. The study at hand focuses on enhancement patterns of fibro cellular tissue in different kinds of plaques in the ICA. METHODS Between May 2011 and December 2012, 49 patients (39 male) with >50% stenosis of the ICA were consecutively enrolled. In 10 patients with bilateral ICA stenosis, both plaques were included for analysis. We performed a classification of plaques according to Cai and observed 11 type 4-5 plaques, 15 type 6 plaques and 33 type 8 plaques. MRI was performed on a 3T whole body MR system. The standard 12 channel head coil was combined with the neck extension coil and two bilateral 7 cm loop coils. Post-contrast T1w images were subtracted from pre contrast images to identify late enhancement in fibro cellular tissue. Enhancement patterns were allocated as intraluminal, intraplaque and vasa vasorum enhancement in different types of plaques. RESULTS Fibro cellular tissue always exhibited a higher contrast enhancement compared to the sternocleidomastoid muscle. This reflects a higher grade of vascularization of the fibrocellular tissue. Contrast enhancement was present irrespective of the plaque type. In detail, intraluminal, intraplaque and vasa vasorum enhancement were observed in all types of plaques. Even type 8 plaques, according to the classification of Cai, had a significant contrast enhancement, though supposed to be with low inflammatory activity. CONCLUSION Type 8 plaques might not be as stable as postulated. Whether the relevant uptake of contrast agent is due to the fibrous tissue or reflects the inflammatory activity of the plaque should be matter of further investigations.
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Affiliation(s)
- Barbara Rantner
- Department of Vascular Surgery, Innsbruck Medical University, Innsbruck, Austria.
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Cardoso L, Weinbaum S. Changing views of the biomechanics of vulnerable plaque rupture: a review. Ann Biomed Eng 2013; 42:415-31. [PMID: 23842694 DOI: 10.1007/s10439-013-0855-x] [Citation(s) in RCA: 45] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2013] [Accepted: 06/20/2013] [Indexed: 12/21/2022]
Abstract
This review examines changing perspectives on the biomechanics of vulnerable plaque rupture over the past 25 years from the first finite element analyses (FEA) showing that the presence of a lipid pool significantly increases the local tissue stress in the atheroma cap to the latest imaging and 3D FEA studies revealing numerous microcalcifications in the cap proper and a new paradigm for cap rupture. The first part of the review summarizes studies describing the role of the fibrous cap thickness, tissue properties, and lesion geometry as main determinants of the risk of rupture. Advantages and limitations of current imaging technologies for assessment of vulnerable plaques are also discussed. However, the basic paradoxes as to why ruptures frequently did not coincide with location of PCS and why caps >65 μm thickness could rupture at tissue stresses significantly below the 300 kPa critical threshold still remained unresolved. The second part of the review describes recent studies in the role of microcalcifications, their origin, shape, and clustering in explaining these unresolved issues including the actual mechanism of rupture due to the explosive growth of tiny voids (cavitation) in local regions of high stress concentration between closely spaced microinclusions oriented along their tensile axis.
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Affiliation(s)
- Luis Cardoso
- Department of Biomedical Engineering, The City College of New York, Steinman Hall, 160 Convent Ave, New York, NY, 10031, USA
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den Adel B, Daemen MJ, Poelmann RE, van der Weerd L. Molecular Magnetic Resonance Imaging for the Detection of Vulnerable Plaques: Is It Possible?: Retracted. Arterioscler Thromb Vasc Biol 2013:ATVBAHA.112.300108. [PMID: 23413424 DOI: 10.1161/atvbaha.112.300108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2012] [Accepted: 01/13/2013] [Indexed: 11/16/2022]
Abstract
Recent advances in molecular resonance imaging of atherosclerosis enable to visualize atherosclerotic plaques in vivo using molecular targeted contrast agents. This offers opportunities to study atherosclerosis development and plaque vulnerability noninvasively. In this review, we discuss MRI contrast agents targeted toward atherosclerotic plaques and illustrate how these new imaging platforms could assist in our understanding of atherogenesis and atheroprogression. In particular, we highlight the challenges and limitations of the different contrast agents and hurdles for clinical application. We describe the most promising existing compounds to detect atherosclerosis and plaque vulnerability. Of particular interest are the fibrin-targeted compounds that detect thrombi and, furthermore, the contrast agents targeted to integrins that allow to visualize plaque neovascularization. Moreover, vascular cell adhesion molecule 1-targeted iron oxides seem promising for early detection of atherosclerosis. These targeted MRI contrast agents, however promising and well characterized in (pre)clinical models, lack specificity for plaque vulnerability.
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Affiliation(s)
- Brigit den Adel
- From the Department of Anatomy and Embryology, Leiden University Medical Center, Leiden, The Netherlands (B.d.A., R.E.P., L.v.d.W.)
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Rodríguez-Flores M, Rodríguez-Saldaña J, Cantú-Brito C, Aguirre-García J, Alejandro GG. Prevalence and severity of atherosclerosis in different arterial territories and its relation with obesity. Cardiovasc Pathol 2013; 22:332-8. [PMID: 23465353 DOI: 10.1016/j.carpath.2013.01.008] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2012] [Revised: 01/16/2013] [Accepted: 01/17/2013] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND There is uneven association between obesity, traditional risk factors, and cardiovascular events. We aimed to analyze the relation between cardiovascular risk factors, including obesity, with the severity of atherosclerosis in different arterial territories. METHODS Arteries from five territories (circle of Willis, carotids, coronaries, aorta, and renal) were taken from 185 persons, newborn to 90 years undergoing autopsy in the Forensic Medical Service in Mexico City, to determine atherosclerotic lesions by histopathological study. Lesions were classified according to the American Heart Association grading system as early (types I-III) and advanced (types IV-VI). The degree of atherosclerosis was correlated with arterial territories and risk factors. RESULTS Frequencies of advanced lesions according to arterial territories were as follows: circle of Willis, 28%; right carotid, 36%; left carotid, 25%; right coronary, 71%; left coronary, 85%; right renal, 26%; left renal, 29%; and aorta, 52%; P=.0001, for all analyses. There was a higher risk for advanced lesions with increasing body mass index (BMI) (P=.004). However, after adjusting for age, gender, smoking status, hypertension, and diabetes mellitus, BMI was not independently associated with advanced lesions. CONCLUSIONS Coronary arteries are significantly more affected than other arterial territories regardless of risk factors, showing the effect of local and systemic factors in the severity of atherosclerosis. We did not find an independent association between advanced atherosclerotic lesions and obesity.
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Affiliation(s)
- Marcela Rodríguez-Flores
- Obesity and Eating Disorders Clinic, Instituto Nacional de Ciencias Médicas y Nutrición "Salvador Zubirán," SS. Vasco de Quiroga No. 15. Colonia Sección XVI. Tlalpan, Mexico City, Mexico, PC 14000.
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Fernández-Friera L, García-Álvarez A, Ibáñez B. Imagining the future of diagnostic imaging. ACTA ACUST UNITED AC 2012; 66:134-43. [PMID: 24775390 DOI: 10.1016/j.rec.2012.11.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2012] [Accepted: 10/01/2012] [Indexed: 01/21/2023]
Abstract
Cardiovascular imaging has become essential to achieving a better understanding of cardiovascular diseases. Due to the advent of new technology and the refinement of existing technologies, imaging's role has extended into the biological, functional, and hemodynamic diagnosis of multiple pathophysiologic processes. Current and future trends in cardiovascular imaging will focus on improving early diagnosis of vascular disease, so as to be able to promote cardiovascular health, and on its development as a useful tool in clinical decision-making. Imaging is also increasingly used to quantify the effect of novel therapies. The rapid development of molecular imaging and fusion imaging techniques improves our understanding of cardiovascular processes from the molecular and cellular points of view and makes it possible to design and test new preventive interventions. The proliferation and integration of imaging techniques in different clinical areas and their role in "translational imaging" plays an important part in the implementation of personalized therapeutic and preventive management strategies for patients with cardiovascular disease.
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Affiliation(s)
- Leticia Fernández-Friera
- Centro Nacional de Investigaciones Cardiovasculares (CNIC) - Imaging in Experimental Cardiology Laboratory (IExC Lab), Madrid, Spain; Servicio de Cardiología, Hospital Universitario Montepríncipe, Madrid, Spain
| | - Ana García-Álvarez
- Centro Nacional de Investigaciones Cardiovasculares (CNIC) - Imaging in Experimental Cardiology Laboratory (IExC Lab), Madrid, Spain; Servicio de Cardiología, Hospital Clínic, Barcelona, Spain
| | - Borja Ibáñez
- Centro Nacional de Investigaciones Cardiovasculares (CNIC) - Imaging in Experimental Cardiology Laboratory (IExC Lab), Madrid, Spain; Instituto Cardiovascular, Hospital Clínico San Carlos, Madrid, Spain.
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Gallino A, Stuber M, Crea F, Falk E, Corti R, Lekakis J, Schwitter J, Camici P, Gaemperli O, Di Valentino M, Prior J, Garcia-Garcia HM, Vlachopoulos C, Cosentino F, Windecker S, Pedrazzini G, Conti R, Mach F, De Caterina R, Libby P. “In vivo” imaging of atherosclerosis. Atherosclerosis 2012; 224:25-36. [DOI: 10.1016/j.atherosclerosis.2012.04.007] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2011] [Revised: 04/18/2012] [Accepted: 04/18/2012] [Indexed: 12/20/2022]
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Lindsay AC, Biasiolli L, Lee JMS, Kylintireas I, MacIntosh BJ, Watt H, Jezzard P, Robson MD, Neubauer S, Handa A, Kennedy J, Choudhury RP. Plaque features associated with increased cerebral infarction after minor stroke and TIA: a prospective, case-control, 3-T carotid artery MR imaging study. JACC Cardiovasc Imaging 2012; 5:388-96. [PMID: 22498328 DOI: 10.1016/j.jcmg.2011.10.007] [Citation(s) in RCA: 49] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2011] [Accepted: 10/17/2011] [Indexed: 10/28/2022]
Abstract
OBJECTIVES The goal of this study was to determine whether a 3-T magnetic resonance imaging (MRI) protocol combining carotid atherosclerotic plaque and brain imaging can identify features of high-risk acutely symptomatic plaque that correlate with brain injury. BACKGROUND It has previously been demonstrated that, in asymptomatic patients, MRI can identify features of carotid plaque that are associated with stroke, such as the presence of a large lipid core. We hypothesized that the early phase (<7 days) after a cerebrovascular event, when risk of recurrence is highest, may be associated with particular plaque characteristics that associate with cerebral injury. METHODS Eighty-one patients (41 presenting acutely with transient ischemic attack [TIA] or minor stroke and 40 asymptomatic controls) underwent multicontrast carotid artery MRI on 2 separate occasions, each accompanied by diffusion-weighted imaging (DWI) and fluid-attenuated inversion recovery (FLAIR) imaging of the brain. RESULTS Complex (American Heart Association [AHA] type VI) plaques were seen in 22 of 41 patients (54%) in the symptomatic group versus 8 of 40 (20%) in the asymptomatic group (p < 0.05). They were caused by intraplaque hemorrhage (34% vs. 18%; p = 0.08), surface rupture (24% vs. 5%; p = 0.03), or luminal thrombus (7% vs. 0%; p = 0.24). Noticeably, 17 of 30 (57%) cases of AHA type VI plaque were in vessels with <70% stenosis. At follow-up scanning (>6 weeks later), only 2 cases of symptomatic AHA type VI plaque showed evidence of full healing. The presence of fibrous cap rupture was associated with higher DWI brain injury at presentation and higher total cerebral FLAIR signal at follow-up (p < 0.05). CONCLUSIONS Early carotid wall MRI in patients experiencing minor stroke or TIA showed a higher proportion of "complex" plaques compared with asymptomatic controls; a majority were in arteries of <70% stenosis. Fibrous cap rupture was associated with increases in DWI and FLAIR lesions in the brain. Combined carotid plaque and brain MRI may aid risk stratification and treatment selection in acute stroke and TIA.
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Affiliation(s)
- Alistair C Lindsay
- Department of Cardiovascular Medicine, University of Oxford, Oxford, United Kingdom
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van Bochove GS, Sanders HMHF, de Smet M, Keizer HM, Mulder WJM, Krams R, Strijkers GJ, Nicolay K. Molecular MR Imaging of Collagen in Mouse Atherosclerosis by Using Paramagnetic CNA35 Micelles. Eur J Inorg Chem 2012. [DOI: 10.1002/ejic.201200010] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
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Baune BT, Stuart M, Gilmour A, Wersching H, Heindel W, Arolt V, Berger K. The relationship between subtypes of depression and cardiovascular disease: a systematic review of biological models. Transl Psychiatry 2012; 2:e92. [PMID: 22832857 PMCID: PMC3309537 DOI: 10.1038/tp.2012.18] [Citation(s) in RCA: 96] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2012] [Accepted: 02/04/2012] [Indexed: 12/13/2022] Open
Abstract
A compelling association has been observed between cardiovascular disease (CVD) and depression, suggesting individuals with depression to be at significantly higher risk for CVD and CVD-related mortality. Systemic immune activation, hypothalamic-pituitary-adrenal (HPA) axis hyperactivity, arterial stiffness and endothelial dysfunction have been frequently implicated in this relationship. Although a differential epidemiological association between CVD and depression subtypes is evident, it has not been determined if this indicates subtype specific biological mechanisms. A comprehensive systematic literature search was conducted using PubMed and PsycINFO databases yielding 147 articles for this review. A complex pattern of systemic immune activation, endothelial dysfunction and HPA axis hyperactivity is suggestive of the biological relationship between CVD and depression subtypes. The findings of this review suggest that diagnostic subtypes rather than a unifying model of depression should be considered when investigating the bidirectional biological relationship between CVD and depression. The suggested model of a subtype-specific biological relationship between depression and CVDs has implications for future research and possibly for diagnostic and therapeutic processes.
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Affiliation(s)
- B T Baune
- Discipline of Psychiatry, School of Medicine, University of Adelaide, Adelaide, SA, Australia.
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Maiseyeu A, Badgeley MA, Kampfrath T, Mihai G, Deiuliis JA, Liu C, Sun Q, Parthasarathy S, Simon DI, Croce K, Rajagopalan S. In vivo targeting of inflammation-associated myeloid-related protein 8/14 via gadolinium immunonanoparticles. Arterioscler Thromb Vasc Biol 2012; 32:962-70. [PMID: 22308043 DOI: 10.1161/atvbaha.111.244509] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
OBJECTIVE Myeloid-related protein (Mrp) 8/14 complex (is a highly expressed extracellularly secreted protein, implicated in atherosclerosis. In this study, we evaluated the feasibility of targeting Mrp in vivo through synthetic immuno-nanoprobes. METHODS AND RESULTS Anti-Mrp-14 and nonspecific IgG-conjugated gadolinium nanoprobes (aMrp-) were synthesized and characterized. Pharmacokinetics and vascular targeting via MRI of the formulations were assessed in vivo in high fat-fed apolipoprotein E deficient (ApoE(-/-)), ApoE(-/-)/Mrp14(-/-) (double knockout) and chow-fed wild-type (C57BL/6) mice. Bone marrow-derived myeloid progenitor cells were isolated from both ApoE(-/-) and double knockout mice, differentiated to macrophages, and were treated with LPS, with or without Mrp8, Mrp14, or Mrp8/14; conditioned media was used for in vitro studies. Mrp-activated cells secreted significant amounts of proinflammatory cytokines, which was abolished by pretreatment with aMrp-NP. We show in vitro that aMrp-NP binds endothelial cells previously treated with conditioned media containing Mrp8/14. MRI following intravenous delivery of aMrp-NP revealed prolonged and substantial delineation of plaque in ApoE(-/-) but not double knockout or wild-type animals. Nonspecific IgG-conjugated gadolinium nanoprobe-injected animals in all groups did not show vessel wall enhancement. Flow-cytometric analysis of aortic digesta revealed that aMrp-NP present in Ly-6G(+), CD11b(+), CD11c(+), and CD31(+) cells in ApoE(-/-) but not in double knockout animals. CONCLUSIONS Targeted imaging with aMrp-NP demonstrates enhancement of plaque with binding to inflammatory cells and reduction in inflammation. This strategy has promise as a theranostic approach for atherosclerosis.
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Affiliation(s)
- Andrei Maiseyeu
- Davis Heart & Lung Research Institute, The Ohio State University College of Medicine, Columbus, USA
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Kylintireas I, Shirodaria C, Lee JMS, Cunningon C, Lindsay A, Francis J, Robson MD, Neubauer S, Channon KM, Choudhury RP. Multimodal cardiovascular magnetic resonance quantifies regional variation in vascular structure and function in patients with coronary artery disease: relationships with coronary disease severity. J Cardiovasc Magn Reson 2011; 13:61. [PMID: 22017860 PMCID: PMC3256113 DOI: 10.1186/1532-429x-13-61] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2011] [Accepted: 10/21/2011] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Cardiovascular magnetic resonance (CMR) of the vessel wall is highly reproducible and can evaluate both changes in plaque burden and composition. It can also measure aortic compliance and endothelial function in a single integrated examination. Previous studies have focused on patients with pre-identified carotid atheroma. We define these vascular parameters in patients presenting with coronary artery disease and test their relations to its extent and severity. METHODS AND RESULTS 100 patients with CAD [single-vessel (16%); two-vessel (39%); and three-vessel (42%) non-obstructed coronary arteries (3%)] were studied. CAD severity and extent was expressed as modified Gensini score (mean modified score 12.38 ± 5.3). A majority of carotid plaque was located in the carotid bulb (CB). Atherosclerosis in this most diseased segment correlated modestly with the severity and extent of CAD, as expressed by the modified Gensini score (R = 0.251, P < 0.05). Using the AHA plaque classification, atheroma class also associated with CAD severity (rho = 0.26, P < 0.05). The distal descending aorta contained the greatest plaque, which correlated with the degree of CAD (R = 0.222; P < 0.05), but with no correlation with the proximal descending aorta, which was relatively spared (R = 0.106; P = n. s.). Aortic distensibility varied along its length with the ascending aorta the least distensible segment. Brachial artery FMD was inversely correlated with modified Gensini score (R = -0.278; P < 0.05). In multivariate analysis, distal descending aorta atheroma burden, distensibility of the ascending aorta, carotid atheroma class and FMD were independent predictors of modified Gensini score. CONCLUSIONS Multimodal vascular CMR shows regional abnormalities of vascular structure and function that correlate modestly with the degree and extent of CAD.
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Affiliation(s)
- Ilias Kylintireas
- Department of Cardiovascular Medicine, University of Oxford and Oxford Centre for Clinical Magnetic Resonance Research (OCMR), Oxford, UK
| | - Cheerag Shirodaria
- Department of Cardiovascular Medicine, University of Oxford and Oxford Centre for Clinical Magnetic Resonance Research (OCMR), Oxford, UK
| | - Justin MS Lee
- Department of Cardiovascular Medicine, University of Oxford and Oxford Centre for Clinical Magnetic Resonance Research (OCMR), Oxford, UK
| | - Colin Cunningon
- Department of Cardiovascular Medicine, University of Oxford and Oxford Centre for Clinical Magnetic Resonance Research (OCMR), Oxford, UK
| | - Alistair Lindsay
- Department of Cardiovascular Medicine, University of Oxford and Oxford Centre for Clinical Magnetic Resonance Research (OCMR), Oxford, UK
| | - Jane Francis
- Department of Cardiovascular Medicine, University of Oxford and Oxford Centre for Clinical Magnetic Resonance Research (OCMR), Oxford, UK
| | - Matthew D Robson
- Department of Cardiovascular Medicine, University of Oxford and Oxford Centre for Clinical Magnetic Resonance Research (OCMR), Oxford, UK
| | - Stefan Neubauer
- Department of Cardiovascular Medicine, University of Oxford and Oxford Centre for Clinical Magnetic Resonance Research (OCMR), Oxford, UK
| | - Keith M Channon
- Department of Cardiovascular Medicine, University of Oxford and Oxford Centre for Clinical Magnetic Resonance Research (OCMR), Oxford, UK
| | - Robin P Choudhury
- Department of Cardiovascular Medicine, University of Oxford and Oxford Centre for Clinical Magnetic Resonance Research (OCMR), Oxford, UK
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Jacobin-Valat MJ, Deramchia K, Mornet S, Hagemeyer CE, Bonetto S, Robert R, Biran M, Massot P, Miraux S, Sanchez S, Bouzier-Sore AK, Franconi JM, Duguet E, Clofent-Sanchez G. MRI of inducible P-selectin expression in human activated platelets involved in the early stages of atherosclerosis. NMR IN BIOMEDICINE 2011; 24:413-424. [PMID: 21192086 DOI: 10.1002/nbm.1606] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/10/2010] [Revised: 07/02/2010] [Accepted: 07/26/2010] [Indexed: 05/30/2023]
Abstract
The noninvasive imaging of atherosclerotic plaques at an early stage of atherogenesis remains a major challenge for the evaluation of the pathologic state of patients at high risk of acute coronary syndromes. Recent studies have emphasized the importance of platelet-endothelial cell interactions in atherosclerosis-prone arteries at early stages, and the prominent role of P-selectin in the initial loose contact between platelets and diseased vessel walls. A specific MR contrast agent was developed here for the targeting, with high affinity, of P-selectin expressed in large amounts on activated platelets and endothelial cells. For this purpose, PEGylated dextran/iron oxide nanoparticles [PEG, poly(ethylene glycol)], named versatile ultrasmall superparamagnetic iron oxide (VUSPIO) particles, labeled with rhodamine were coupled to an anti-human P-selectin antibody (VH10). Flow cytometry and microscopy experiments on human activated platelets were highly correlated with MRI (performed at 4.7 and 0.2 T), with a 50% signal decrease in T(2) and T(1) values corresponding to the strong labeling of activated vs resting platelets. The number of 1000 VH10-VUSPIO nanoparticles attained per activated platelet appeared to be optimal for the detection of hypo- and hyper-signals in the platelet pellet on T(2) - and T(1) -weighted MRI. Furthermore, in vivo imaging of atherosclerotic plaques in ApoE mice at 4.7 T showed a spatial resolution adapted to the imaging of intimal thickening and a hypo-signal at 4.7 T, as a result of the accumulation of VH10-VUSPIO nanoparticles in the plaque. Our work provides support for the further assessment of the use of VH10-VUSPIO nanoparticles as a promising imaging modality able to identify the early stages of atherosclerosis with regard to the pertinence of both the target and the antibody-conjugated contrast agent used.
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Greenland P, Alpert JS, Beller GA, Benjamin EJ, Budoff MJ, Fayad ZA, Foster E, Hlatky MA, Hodgson JM, Kushner FG, Lauer MS, Shaw LJ, Smith SC, Taylor AJ, Weintraub WS, Wenger NK, Jacobs AK, Smith SC, Anderson JL, Albert N, Buller CE, Creager MA, Ettinger SM, Guyton RA, Halperin JL, Hochman JS, Kushner FG, Nishimura R, Ohman EM, Page RL, Stevenson WG, Tarkington LG, Yancy CW. 2010 ACCF/AHA guideline for assessment of cardiovascular risk in asymptomatic adults: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines. J Am Coll Cardiol 2011; 56:e50-103. [PMID: 21144964 DOI: 10.1016/j.jacc.2010.09.001] [Citation(s) in RCA: 1001] [Impact Index Per Article: 77.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
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Matsushita E, Asai N, Enomoto A, Kawamoto Y, Kato T, Mii S, Maeda K, Shibata R, Hattori S, Hagikura M, Takahashi K, Sokabe M, Murakumo Y, Murohara T, Takahashi M. Protective role of Gipie, a Girdin family protein, in endoplasmic reticulum stress responses in endothelial cells. Mol Biol Cell 2011; 22:736-47. [PMID: 21289099 PMCID: PMC3057699 DOI: 10.1091/mbc.e10-08-0724] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2010] [Revised: 01/12/2011] [Accepted: 01/18/2011] [Indexed: 12/18/2022] Open
Abstract
Continued exposure of endothelial cells to mechanical/shear stress elicits the unfolded protein response (UPR), which enhances intracellular homeostasis and protect cells against the accumulation of improperly folded proteins. Cells commit to apoptosis when subjected to continuous and high endoplasmic reticulum (ER) stress unless homeostasis is maintained. It is unknown how endothelial cells differentially regulate the UPR. Here we show that a novel Girdin family protein, Gipie (78 kDa glucose-regulated protein [GRP78]-interacting protein induced by ER stress), is expressed in endothelial cells, where it interacts with GRP78, a master regulator of the UPR. Gipie stabilizes the interaction between GRP78 and the ER stress sensor inositol-requiring protein 1 (IRE1) at the ER, leading to the attenuation of IRE1-induced c-Jun N-terminal kinase (JNK) activation. Gipie expression is induced upon ER stress and suppresses the IRE1-JNK pathway and ER stress-induced apoptosis. Furthermore we found that Gipie expression is up-regulated in the neointima of carotid arteries after balloon injury in a rat model that is known to result in the induction of the UPR. Thus our data indicate that Gipie/GRP78 interaction controls the IRE1-JNK signaling pathway. That interaction appears to protect endothelial cells against ER stress-induced apoptosis in pathological contexts such as atherosclerosis and vascular endothelial dysfunction.
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Affiliation(s)
- Etsushi Matsushita
- Department of Pathology, Nagoya University Graduate School of Medicine, Nagoya 466–8550, Japan
- Department of Cardiology, Nagoya University Graduate School of Medicine, Nagoya 466–8550, Japan
| | - Naoya Asai
- Department of Pathology, Nagoya University Graduate School of Medicine, Nagoya 466–8550, Japan
| | - Atsushi Enomoto
- Department of Pathology, Nagoya University Graduate School of Medicine, Nagoya 466–8550, Japan
- Institute for Advanced Research, Nagoya University, Nagoya 464–8601, Japan
| | - Yoshiyuki Kawamoto
- Department of Biomedical Sciences, College of Life and Health Sciences, Chubu University, Aichi 487–8501, Japan
| | - Takuya Kato
- Department of Pathology, Nagoya University Graduate School of Medicine, Nagoya 466–8550, Japan
| | - Shinji Mii
- Department of Pathology, Nagoya University Graduate School of Medicine, Nagoya 466–8550, Japan
| | - Kengo Maeda
- Department of Cardiology, Nagoya University Graduate School of Medicine, Nagoya 466–8550, Japan
| | - Rei Shibata
- Department of Cardiology, Nagoya University Graduate School of Medicine, Nagoya 466–8550, Japan
| | - Shun Hattori
- Department of Pathology, Nagoya University Graduate School of Medicine, Nagoya 466–8550, Japan
| | - Minako Hagikura
- Department of Pathology, Nagoya University Graduate School of Medicine, Nagoya 466–8550, Japan
| | - Ken Takahashi
- Department of Physiology, Nagoya University Graduate School of Medicine, Nagoya 466–8550, Japan
- International Cooperative Research Project/Solution Oriented Research for Science and Technology, Cell Mechanosensing, Japan Science and Technology Agency, Nagoya 466–8550, Japan
| | - Masahiro Sokabe
- Department of Physiology, Nagoya University Graduate School of Medicine, Nagoya 466–8550, Japan
- International Cooperative Research Project/Solution Oriented Research for Science and Technology, Cell Mechanosensing, Japan Science and Technology Agency, Nagoya 466–8550, Japan
| | - Yoshiki Murakumo
- Department of Pathology, Nagoya University Graduate School of Medicine, Nagoya 466–8550, Japan
| | - Toyoaki Murohara
- Department of Cardiology, Nagoya University Graduate School of Medicine, Nagoya 466–8550, Japan
| | - Masahide Takahashi
- Department of Pathology, Nagoya University Graduate School of Medicine, Nagoya 466–8550, Japan
- Division of Molecular Pathology, Center for Neurological Disease and Cancer, Nagoya University Graduate School of Medicine, Nagoya 466–8550, Japan
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Price AN, Cheung KK, Cleary JO, Campbell AE, Riegler J, Lythgoe MF. Cardiovascular magnetic resonance imaging in experimental models. Open Cardiovasc Med J 2010; 4:278-92. [PMID: 21331311 PMCID: PMC3040459 DOI: 10.2174/1874192401004010278] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2010] [Revised: 09/27/2010] [Accepted: 10/04/2010] [Indexed: 12/19/2022] Open
Abstract
Cardiovascular magnetic resonance (CMR) imaging is the modality of choice for clinical studies of the heart and vasculature, offering detailed images of both structure and function with high temporal resolution. Small animals are increasingly used for genetic and translational research, in conjunction with models of common pathologies such as myocardial infarction. In all cases, effective methods for characterising a wide range of functional and anatomical parameters are crucial for robust studies. CMR is the gold-standard for the non-invasive examination of these models, although physiological differences, such as rapid heart rate, make this a greater challenge than conventional clinical imaging. However, with the help of specialised magnetic resonance (MR) systems, novel gating strategies and optimised pulse sequences, high-quality images can be obtained in these animals despite their small size. In this review, we provide an overview of the principal CMR techniques for small animals for example cine, angiography and perfusion imaging, which can provide measures such as ejection fraction, vessel anatomy and local blood flow, respectively. In combination with MR contrast agents, regional dysfunction in the heart can also be identified and assessed. We also discuss optimal methods for analysing CMR data, particularly the use of semi-automated tools for parameter measurement to reduce analysis time. Finally, we describe current and emerging methods for imaging the developing heart, aiding characterisation of congenital cardiovascular defects. Advanced small animal CMR now offers an unparalleled range of cardiovascular assessments. Employing these methods should allow new insights into the structural, functional and molecular basis of the cardiovascular system.
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Affiliation(s)
- Anthony N Price
- UCL Centre for Advanced Biomedical Imaging, Department of Medicine and UCL Institute of Child Health, University College London, UK
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Greenland P, Alpert JS, Beller GA, Benjamin EJ, Budoff MJ, Fayad ZA, Foster E, Hlatky MA, Hodgson JM, Kushner FG, Lauer MS, Shaw LJ, Smith SC, Taylor AJ, Weintraub WS, Wenger NK, Jacobs AK. 2010 ACCF/AHA guideline for assessment of cardiovascular risk in asymptomatic adults: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines. Circulation 2010; 122:e584-636. [PMID: 21098428 DOI: 10.1161/cir.0b013e3182051b4c] [Citation(s) in RCA: 402] [Impact Index Per Article: 28.7] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Jarrett BR, Correa C, Ma KL, Louie AY. In vivo mapping of vascular inflammation using multimodal imaging. PLoS One 2010; 5:e13254. [PMID: 20949008 PMCID: PMC2952595 DOI: 10.1371/journal.pone.0013254] [Citation(s) in RCA: 51] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2010] [Accepted: 09/08/2010] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Plaque vulnerability to rupture has emerged as a critical correlate to risk of adverse coronary events but there is as yet no clinical method to assess plaque stability in vivo. In the search to identify biomarkers of vulnerable plaques an association has been found between macrophages and plaque stability--the density and pattern of macrophage localization in lesions is indicative of probability to rupture. In very unstable plaques, macrophages are found in high densities and concentrated in the plaque shoulders. Therefore, the ability to map macrophages in plaques could allow noninvasive assessment of plaque stability. We use a multimodality imaging approach to noninvasively map the distribution of macrophages in vivo. The use of multiple modalities allows us to combine the complementary strengths of each modality to better visualize features of interest. Our combined use of Positron Emission Tomography and Magnetic Resonance Imaging (PET/MRI) allows high sensitivity PET screening to identify putative lesions in a whole body view, and high resolution MRI for detailed mapping of biomarker expression in the lesions. METHODOLOGY/PRINCIPAL FINDINGS Macromolecular and nanoparticle contrast agents targeted to macrophages were developed and tested in three different mouse and rat models of atherosclerosis in which inflamed vascular plaques form spontaneously and/or are induced by injury. For multimodal detection, the probes were designed to contain gadolinium (T1 MRI) or iron oxide (T2 MRI), and Cu-64 (PET). PET imaging was utilized to identify regions of macrophage accumulation; these regions were further probed by MRI to visualize macrophage distribution at high resolution. In both PET and MR images the probes enhanced contrast at sites of vascular inflammation, but not in normal vessel walls. MRI was able to identify discrete sites of inflammation that were blurred together at the low resolution of PET. Macrophage content in the lesions was confirmed by histology. CONCLUSIONS/SIGNIFICANCE The multimodal imaging approach allowed high-sensitivity and high-resolution mapping of biomarker distribution and may lead to a clinical method to predict plaque probability to rupture.
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Affiliation(s)
- Benjamin R. Jarrett
- Department of Biomedical Engineering, University of California Davis, Davis, California, United States of America
| | - Carlos Correa
- Department of Computer Science, University of California Davis, Davis, California, United States of America
| | - Kwan Liu Ma
- Department of Computer Science, University of California Davis, Davis, California, United States of America
| | - Angelique Y. Louie
- Department of Biomedical Engineering, University of California Davis, Davis, California, United States of America
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Abstract
Cardiovascular disease (CVD) is the leading cause of death worldwide, and its prevalence is likely to increase in the near future. The morbidity and mortality associated with CVD causes an enormous economic burden, which has become a major problem for many societies across the globe. The current prevention strategies are aimed at identifying and reducing established risk factors for atherosclerosis including hypertension, hypercholesterolemia, diabetes, obesity, smoking, and sedentary lifestyle. However, some of our prevention goals, such as reducing LDL cholesterol, change dramatically once a subject has been diagnosed with coronary atherosclerosis. At the present time, atherosclerosis is frequently diagnosed relatively late in the course of the disease, when a patient develops symptoms or presents with acute events such as an acute coronary syndrome or a stroke. Several studies have demonstrated that novel noninvasive imaging techniques have the potential to identify subclinical atherosclerosis and high-risk plaques. Early detection of subclinical atherosclerosis may enable clinicians to improve the control of cardiovascular risk factors in affected patients earlier, thereby helping to prevent some of the manifestations of CVD.
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Affiliation(s)
- Valentin Fuster
- Centro Nacional de Investigaciones Cardiovasculares (CNIC), Madrid, Spain.
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Yu F, Li R, Ai L, Edington C, Yu H, Barr M, Kim ES, Hsiai TK. Electrochemical impedance spectroscopy to assess vascular oxidative stress. Ann Biomed Eng 2010; 39:287-96. [PMID: 20652746 DOI: 10.1007/s10439-010-0127-y] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2010] [Accepted: 07/09/2010] [Indexed: 10/19/2022]
Abstract
Vascular inflammatory responses are intimately linked with oxidative stress, favoring the development of pre-atherosclerotic lesions. We proposed that oxidized low density lipoprotein (oxLDL) and foam cell infiltrates in the subendothelial layer engendered distinct electrochemical properties that could be measured in terms of the electrochemical impedance spectroscopy (EIS). Concentric bipolar microelectrodes were applied to interrogate EIS of aortas isolated from fat-fed New Zealand White (NZW) rabbits and explants of human aortas. Frequency-dependent EIS measurements were assessed between 10 kHz and 100 kHz, and were significantly elevated in the pre-atherosclerotic lesions in which oxLDL and macrophage infiltrates were prevalent (At 100 kHz: aortic arch lesion=26.7±2.7 kΩ vs. control=15.8±2.4 kΩ; at 10 kHz: lesions=49.2±7.3 kΩ vs. control=27.6±2.7 kΩ, n=10, p<0.001). Similarly, EIS measurements were significantly elevated in the human descending aorta where pre-atherosclerotic lesions or fatty streaks were prominent. EIS measurements remained unchanged in spite of various depths of electrode submersion or orientation of the specimens. Hence, the concentric bipolar microelectrodes provided a reliable means to measure endoluminal electrochemical modifications in regions of pro-inflammatory with high spatial resolution and reproducibility albeit uneven lesion topography and non-uniform current distribution.
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Affiliation(s)
- Fei Yu
- Department of Biomedical Engineering and Cardiovascular Medicine, University of Southern California, Los Angeles, CA 90089, USA
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Biomimetic MRI contrast agent for imaging of inflammation in atherosclerotic plaque of ApoE-/- mice: a pilot study. Invest Radiol 2010; 44:151-8. [PMID: 19169144 DOI: 10.1097/rli.0b013e31819472ac] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE Atherosclerosis involves an inflammatory process characterized by cellular and molecular responses. A slow-clearance blood-pool paramagnetic agent (CMD-A2-Gd-DOTA: P717) chemically modified to create a functionalized product (F-P717) for targeting inflammation in vessel walls was evaluated in vivo in mice. METHODS AND RESULTS Carboxylate and sulfate groups were grafted onto the macromolecular paramagnetic Gd-DOTA-dextran backbone. Products were also fluorescently labeled with rhodamine isothiocyanate. Pre- and postcontrast MRI was performed on a 2-Tesla magnet in ApoE-/- and control C57BL/6 mice after P717 or F-P717 injection at a dose of 60 micromol Gd/kg. Axial T1-weighted images of the abdominal aorta were obtained using a 2D multislice spin-echo sequence. F-P717 significantly enhanced the magnetic resonance imaging (MRI) signal in the abdominal aortic wall of ApoE-/- mice (>50% signal-to-noise ratio increase between 10 and 30 minutes), but not of control mice. P717 produced only moderate (<20%) MRI signal enhancement within the same time frame. The MRI data were correlated to histopathology. Immunofluorescence in ApoE-/- mice colocalized F-P717 but not P717 with the inflammatory area revealed by P-selectin labeling. CONCLUSION This study demonstrates the efficacy of F-P717 as a new molecular imaging agent for noninvasive in vivo MRI location of inflammatory vascular tree lesions in ApoE-/- mice.
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In Vitro Angioplasty of Atherosclerotic Human Femoral Arteries: Analysis of the Geometrical Changes in the Individual Tissues Using MRI and Image Processing. Ann Biomed Eng 2010; 38:1276-87. [DOI: 10.1007/s10439-010-9954-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2007] [Accepted: 01/31/2010] [Indexed: 10/19/2022]
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Dong L, Kerwin WS, Ferguson MS, Li R, Wang J, Chen H, Canton G, Hatsukami TS, Yuan C. Cardiovascular magnetic resonance in carotid atherosclerotic disease. J Cardiovasc Magn Reson 2009; 11:53. [PMID: 20003520 PMCID: PMC2806867 DOI: 10.1186/1532-429x-11-53] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2009] [Accepted: 12/15/2009] [Indexed: 11/13/2022] Open
Abstract
Atherosclerosis is a chronic, progressive, inflammatory disease affecting many vascular beds. Disease progression leads to acute cardiovascular events such as myocardial infarction, stroke and death. The diseased carotid alone is responsible for one third of the 700,000 new or recurrent strokes occurring yearly in the United States. Imaging plays an important role in the management of atherosclerosis, and cardiovascular magnetic resonance (CMR) of the carotid vessel wall is one promising modality in the evaluation of patients with carotid atherosclerotic disease. Advances in carotid vessel wall CMR allow comprehensive assessment of morphology inside the wall, contributing substantial disease-specific information beyond luminal stenosis. Although carotid vessel wall CMR has not been widely used to screen for carotid atherosclerotic disease, many trials support its potential for this indication. This review summarizes the current state of knowledge regarding carotid vessel wall CMR and its potential clinical application for management of carotid atherosclerotic disease.
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Affiliation(s)
- Li Dong
- Department of Radiology, University of Washington, Seattle, WA, USA
| | - William S Kerwin
- Department of Radiology, University of Washington, Seattle, WA, USA
| | | | - Rui Li
- Department of Radiology, University of Washington, Seattle, WA, USA
| | - Jinnan Wang
- Clinical Sites Research Program, Philips Research North America, Briarcliff Manor, NY, USA
| | - Huijun Chen
- Department of Radiology, University of Washington, Seattle, WA, USA
| | - Gador Canton
- Department of Radiology, University of Washington, Seattle, WA, USA
| | | | - Chun Yuan
- Department of Radiology, University of Washington, Seattle, WA, USA
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Bang OY. Multimodal MRI for ischemic stroke: from acute therapy to preventive strategies. J Clin Neurol 2009; 5:107-19. [PMID: 19826561 PMCID: PMC2760715 DOI: 10.3988/jcn.2009.5.3.107] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2009] [Revised: 07/17/2009] [Accepted: 07/17/2009] [Indexed: 01/09/2023] Open
Abstract
Background and Purpose Conventional therapies for ischemic stroke include thrombolytic therapy, prevention of inappropriate coagulation and thrombosis, and surgery to repair vascular abnormalities. Over 10 years have passed since the US Food and Drug Administration approved intravenous tissue plasminogen activator for use in acute stroke patients, but most major clinical trials have failed during the last 2 decades, including large clinical trials for secondary prevention and neuroprotection. These results suggest the presence of heterogeneity among stroke patients. Neuroimaging techniques now allow changes to be observed in patients from the acute to the recovery phase. The role of MRI in stroke evaluation and treatment is discussed herein. Main Contents Three MRI strategies are discussed with relevant examples. First, the following MRI strategies for acute ischemic stroke are presented: diffusion-perfusion mismatch, deoxygenation (oxygen extraction and cerebral metabolic rate of oxygen), and blood-brain barrier permeability derangement in selected patients for recanalization therapy. Second, multimodal MRI for identifying stroke mechanisms and the specific causes of stroke (i.e., patent foramen ovale, infective endocarditis, and nonbacterial thrombotic endocarditis) are presented, followed by MRI strategies for prevention of recurrent stroke: plaque images and flow dynamics for carotid intervention. Expectations The studies reviewed herein suggest that using MRI to improve the understanding of individual pathophysiologies will further promote the development of rational stroke therapies tailored to the specifics of each case.
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Affiliation(s)
- Oh Young Bang
- Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
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Becker CR, Saam T. Evaluation of coronary atherosclerotic plaques. Cardiol Clin 2009; 27:611-7. [PMID: 19766918 DOI: 10.1016/j.ccl.2009.06.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
In many patients, unheralded myocardial infarction associated with a mortality of approximately 20% is the first manifestation of coronary artery disease. Approximately 40% of the population is considered to have a moderate midterm risk of 10% to 20%. Any of the stratification schemes suffers from a lack of accuracy to correctly determine the risk, and uncertainty exists regarding how to treat individuals who have been identified to be at intermediate risk. Other tools providing information about the necessity to reassure or to treat these patients are warranted. Currently, the assessment of the atherosclerotic plaque burden by CT may be able provide valid information for this cohort. This article discusses the potential value and limitations of cardiac CT for evaluating coronary atherosclerotic plaque.
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Affiliation(s)
- Christoph R Becker
- Department of Clinical Radiology, Ludwig-Maximilians-University Munich, Grosshadern Clinics, 81377 Munich, Germany.
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Dietrich T, Hucko T, Bourayou R, Jahnke C, Paetsch I, Atrott K, Stawowy P, Gräfe M, Klein C, Schnackenburg B, Fleck E, Graf K. High resolution magnetic resonance imaging in atherosclerotic mice treated with ezetimibe. Int J Cardiovasc Imaging 2009; 25:827-36. [DOI: 10.1007/s10554-009-9487-5] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2009] [Accepted: 07/27/2009] [Indexed: 11/24/2022]
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Choudhury RP, Fisher EA. Molecular imaging in atherosclerosis, thrombosis, and vascular inflammation. Arterioscler Thromb Vasc Biol 2009; 29:983-91. [PMID: 19213945 DOI: 10.1161/atvbaha.108.165498] [Citation(s) in RCA: 85] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Appreciation of the molecular and cellular processes of atherosclerosis, thrombosis, and vascular inflammation has identified new targets for imaging. The common goals of molecular imaging approaches are to accelerate and refine diagnosis, provide insights that reveal disease diversity, guide specific therapies, and monitor the effects of those therapies. Here we undertake a comparative analysis of imaging modalities that have been used in this disease area. We consider the elements of contrast agents, emphasizing how an understanding of the biology of atherosclerosis and its complications can inform optimal design. We address the potential and limitations of current contrast approaches in respect of translation to clinically usable agents and speculate on future applications.
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Hilty KC, Steinberg DH. Vulnerable Plaque Imaging—Current Techniques. J Cardiovasc Transl Res 2009; 2:9-18. [DOI: 10.1007/s12265-008-9086-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2008] [Accepted: 12/16/2008] [Indexed: 11/28/2022]
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