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Vuong TNAM, Bartolf‐Kopp M, Andelovic K, Jungst T, Farbehi N, Wise SG, Hayward C, Stevens MC, Rnjak‐Kovacina J. Integrating Computational and Biological Hemodynamic Approaches to Improve Modeling of Atherosclerotic Arteries. ADVANCED SCIENCE (WEINHEIM, BADEN-WURTTEMBERG, GERMANY) 2024; 11:e2307627. [PMID: 38704690 PMCID: PMC11234431 DOI: 10.1002/advs.202307627] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/12/2023] [Revised: 03/12/2024] [Indexed: 05/07/2024]
Abstract
Atherosclerosis is the primary cause of cardiovascular disease, resulting in mortality, elevated healthcare costs, diminished productivity, and reduced quality of life for individuals and their communities. This is exacerbated by the limited understanding of its underlying causes and limitations in current therapeutic interventions, highlighting the need for sophisticated models of atherosclerosis. This review critically evaluates the computational and biological models of atherosclerosis, focusing on the study of hemodynamics in atherosclerotic coronary arteries. Computational models account for the geometrical complexities and hemodynamics of the blood vessels and stenoses, but they fail to capture the complex biological processes involved in atherosclerosis. Different in vitro and in vivo biological models can capture aspects of the biological complexity of healthy and stenosed vessels, but rarely mimic the human anatomy and physiological hemodynamics, and require significantly more time, cost, and resources. Therefore, emerging strategies are examined that integrate computational and biological models, and the potential of advances in imaging, biofabrication, and machine learning is explored in developing more effective models of atherosclerosis.
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Affiliation(s)
| | - Michael Bartolf‐Kopp
- Department of Functional Materials in Medicine and DentistryInstitute of Functional Materials and Biofabrication (IFB)KeyLab Polymers for Medicine of the Bavarian Polymer Institute (BPI)University of WürzburgPleicherwall 297070WürzburgGermany
| | - Kristina Andelovic
- Department of Functional Materials in Medicine and DentistryInstitute of Functional Materials and Biofabrication (IFB)KeyLab Polymers for Medicine of the Bavarian Polymer Institute (BPI)University of WürzburgPleicherwall 297070WürzburgGermany
| | - Tomasz Jungst
- Department of Functional Materials in Medicine and DentistryInstitute of Functional Materials and Biofabrication (IFB)KeyLab Polymers for Medicine of the Bavarian Polymer Institute (BPI)University of WürzburgPleicherwall 297070WürzburgGermany
- Department of Orthopedics, Regenerative Medicine Center UtrechtUniversity Medical Center UtrechtUtrecht3584Netherlands
| | - Nona Farbehi
- Graduate School of Biomedical EngineeringUniversity of New South WalesSydney2052Australia
- Tyree Institute of Health EngineeringUniversity of New South WalesSydneyNSW2052Australia
- Garvan Weizmann Center for Cellular GenomicsGarvan Institute of Medical ResearchSydneyNSW2010Australia
| | - Steven G. Wise
- School of Medical SciencesUniversity of SydneySydneyNSW2006Australia
| | - Christopher Hayward
- St Vincent's HospitalSydneyVictor Chang Cardiac Research InstituteSydney2010Australia
| | | | - Jelena Rnjak‐Kovacina
- Graduate School of Biomedical EngineeringUniversity of New South WalesSydney2052Australia
- Tyree Institute of Health EngineeringUniversity of New South WalesSydneyNSW2052Australia
- Australian Centre for NanoMedicine (ACN)University of New South WalesSydneyNSW2052Australia
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Okamura T, Tsukamoto K, Arai H, Fujioka Y, Ishigaki Y, Koba S, Ohmura H, Shoji T, Yokote K, Yoshida H, Yoshida M, Deguchi J, Dobashi K, Fujiyoshi A, Hamaguchi H, Hara M, Harada-Shiba M, Hirata T, Iida M, Ikeda Y, Ishibashi S, Kanda H, Kihara S, Kitagawa K, Kodama S, Koseki M, Maezawa Y, Masuda D, Miida T, Miyamoto Y, Nishimura R, Node K, Noguchi M, Ohishi M, Saito I, Sawada S, Sone H, Takemoto M, Wakatsuki A, Yanai H. Japan Atherosclerosis Society (JAS) Guidelines for Prevention of Atherosclerotic Cardiovascular Diseases 2022. J Atheroscler Thromb 2024; 31:641-853. [PMID: 38123343 DOI: 10.5551/jat.gl2022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2023] Open
Affiliation(s)
- Tomonori Okamura
- Preventive Medicine and Public Health, Keio University School of Medicine
| | | | | | - Yoshio Fujioka
- Faculty of Nutrition, Division of Clinical Nutrition, Kobe Gakuin University
| | - Yasushi Ishigaki
- Division of Diabetes, Metabolism and Endocrinology, Department of Internal Medicine, Iwate Medical University
| | - Shinji Koba
- Division of Cardiology, Department of Medicine, Showa University School of Medicine
| | - Hirotoshi Ohmura
- Department of Cardiovascular Biology and Medicine, Juntendo University Graduate School of Medicine
| | - Tetsuo Shoji
- Department of Vascular Medicine, Osaka Metropolitan University Graduate school of Medicine
| | - Koutaro Yokote
- Department of Endocrinology, Hematology and Gerontology, Chiba University Graduate School of Medicine
| | - Hiroshi Yoshida
- Department of Laboratory Medicine, The Jikei University Kashiwa Hospital
| | | | - Juno Deguchi
- Department of Vascular Surgery, Saitama Medical Center, Saitama Medical University
| | - Kazushige Dobashi
- Department of Pediatrics, School of Medicine, University of Yamanashi
| | | | | | - Masumi Hara
- Department of Internal Medicine, Mizonokuchi Hospital, Teikyo University School of Medicine
| | - Mariko Harada-Shiba
- Cardiovascular Center, Osaka Medical and Pharmaceutical University
- Department of Molecular Pathogenesis, National Cerebral and Cardiovascular Center Research Institute
| | - Takumi Hirata
- Institute for Clinical and Translational Science, Nara Medical University
| | - Mami Iida
- Department of Internal Medicine and Cardiology, Gifu Prefectural General Medical Center
| | - Yoshiyuki Ikeda
- Department of Cardiovascular Medicine and Hypertension, Graduate School of Medical and Dental Sciences, Kagoshima University
| | - Shun Ishibashi
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Jichi Medical University, School of Medicine
- Current affiliation: Ishibashi Diabetes and Endocrine Clinic
| | - Hideyuki Kanda
- Department of Public Health, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University
| | - Shinji Kihara
- Medical Laboratory Science and Technology, Division of Health Sciences, Osaka University graduate School of medicine
| | - Kazuo Kitagawa
- Department of Neurology, Tokyo Women's Medical University Hospital
| | - Satoru Kodama
- Department of Prevention of Noncommunicable Diseases and Promotion of Health Checkup, Department of Hematology, Endocrinology and Metabolism, Niigata University Faculty of Medicine
| | - Masahiro Koseki
- Department of Cardiovascular Medicine, Osaka University Graduate School of Medicine
| | - Yoshiro Maezawa
- Department of Endocrinology, Hematology and Gerontology, Chiba University Graduate School of Medicine
| | - Daisaku Masuda
- Department of Cardiology, Center for Innovative Medicine and Therapeutics, Dementia Care Center, Doctor's Support Center, Health Care Center, Rinku General Medical Center
| | - Takashi Miida
- Department of Clinical Laboratory Medicine, Juntendo University Graduate School of Medicine
| | | | - Rimei Nishimura
- Department of Diabetes, Metabolism and Endocrinology, The Jikei University School of Medicine
| | - Koichi Node
- Department of Cardiovascular Medicine, Saga University
| | - Midori Noguchi
- Division of Public Health, Department of Social Medicine, Graduate School of Medicine, Osaka University
| | - Mitsuru Ohishi
- Department of Cardiovascular Medicine and Hypertension, Graduate School of Medical and Dental Sciences, Kagoshima University
| | - Isao Saito
- Department of Public Health and Epidemiology, Faculty of Medicine, Oita University
| | - Shojiro Sawada
- Division of Metabolism and Diabetes, Faculty of Medicine, Tohoku Medical and Pharmaceutical University
| | - Hirohito Sone
- Department of Hematology, Endocrinology and Metabolism, Niigata University Faculty of Medicine
| | - Minoru Takemoto
- Department of Diabetes, Metabolism and Endocrinology, International University of Health and Welfare
| | | | - Hidekatsu Yanai
- Department of Diabetes, Endocrinology and Metabolism, National Center for Global Health and Medicine Kohnodai Hospital
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Wang Q, Ouyang H, Lv L, Gui L, Yang S, Hua P. Left main coronary artery morphological phenotypes and its hemodynamic properties. Biomed Eng Online 2024; 23:9. [PMID: 38254133 PMCID: PMC10804578 DOI: 10.1186/s12938-024-01205-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2023] [Accepted: 01/08/2024] [Indexed: 01/24/2024] Open
Abstract
BACKGROUND Atherosclerosis may be linked to morphological defects that lead to variances in coronary artery hemodynamics. Few objective strategies exit at present for generalizing morphological phenotypes of coronary arteries in terms of hemodynamics. We used unsupervised clustering (UC) to classify the morphology of the left main coronary artery (LM) and looked at how hemodynamic distribution differed between phenotypes. METHODS In this study, 76 LMs were obtained from 76 patients. After LMs were reconstructed with coronary computed tomography angiography, centerlines were used to extract the geometric characteristics. Unsupervised clustering was carried out using these characteristics to identify distinct morphological phenotypes of LMs. The time-averaged wall shear stress (TAWSS) for each phenotype was investigated by means of computational fluid dynamics (CFD) analysis of the left coronary artery. RESULTS We identified four clusters (i.e., four phenotypes): Cluster 1 had a shorter stem and thinner branches (n = 26); Cluster 2 had a larger bifurcation angle (n = 10); Cluster 3 had an ostium at an angulation to the coronary sinus and a more curved stem, and thick branches (n = 10); and Cluster 4 had an ostium at an angulation to the coronary sinus and a flatter stem (n = 14). TAWSS features varied widely across phenotypes. Nodes with low TAWSS (L-TAWSS) were typically found around the branching points of the left anterior descending artery (LAD), particularly in Cluster 2. CONCLUSION Our findings demonstrated that UC is a powerful technique for morphologically classifying LMs. Different LM phenotypes exhibited distinct hemodynamic characteristics in certain regions. This morphological clustering method could aid in identifying people at high risk for developing coronary atherosclerosis, hence facilitating early intervention.
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Affiliation(s)
- Qi Wang
- Department of Cardio-Vascular Surgery, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, No. 107 Yan Jiang West Road, Guangzhou, 510120, China
- Department of Cardiovascular Surgery, Qilu Hospital of Shandong University, Shandong University, Jinan, China
| | - Hua Ouyang
- Department of Cardio-Vascular Surgery, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, No. 107 Yan Jiang West Road, Guangzhou, 510120, China
| | - Lei Lv
- Department of Cardio-Vascular Surgery, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, No. 107 Yan Jiang West Road, Guangzhou, 510120, China
- Department of Cardiac and Vascular Surgery, The First Affiliated Hospital of Kunming Medical University, Kunming Medical University, Kunming, China
| | - Long Gui
- Department of Cardio-Vascular Surgery, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, No. 107 Yan Jiang West Road, Guangzhou, 510120, China
| | - Songran Yang
- Department of Biobank and Bioinformatics, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, No. 107 Yan Jiang West Road, Guangzhou, 510120, China.
| | - Ping Hua
- Department of Cardio-Vascular Surgery, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, No. 107 Yan Jiang West Road, Guangzhou, 510120, China.
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Li J, Zhang Y, Wang H, Guo Y, Shen X, Li M, Song J, Tan L, Xie A, Yu J. Exploring the links among peripheral immunity, biomarkers, cognition, and neuroimaging in Alzheimer's disease. ALZHEIMER'S & DEMENTIA (AMSTERDAM, NETHERLANDS) 2023; 15:e12517. [PMID: 38124758 PMCID: PMC10730778 DOI: 10.1002/dad2.12517] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/20/2023] [Accepted: 11/25/2023] [Indexed: 12/23/2023]
Abstract
INTRODUCTION We analyzed relationships among peripheral immunity markers, cognition, Alzheimer's disease (AD)-related biomarkers, and neuroimaging to understand peripheral immunity involvement in AD. METHODS Peripheral immunity markers were assessed in AD, non-AD neurodegenerative disorders, and controls, examining their connections with cognition, AD-related biomarkers, and neuroimaging using multiple regression models. RESULTS The study included 1579 participants. Higher levels of white blood cell, neutrophil, monocyte, neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), systemic immune-inflammation index (SII), and lower lymphocyte-to-monocyte ratio (LMR) were associated with cognitive decline and more severe anxiety and depression. The impact of lower LMR, lymphocyte count, and higher NLR on cognitive decline is mediated through cerebrospinal fluid amyloid beta (Aβ) levels. Additionally, increased PLR, NLR, and SII were associated with brain atrophy and hippocampal Aβ deposition (amyloid positron emission tomography). DISCUSSION Peripheral immunity markers offer a non-invasive and cost-effective means of studying AD-related pathophysiological changes, providing valuable insights into its pathogenesis and treatment. Highlights Peripheral immunity markers linked to cognitive decline and anxiety/depression.Low LMR, LYM, and high NLR linked to reduced CSF Aβ, impacting cognition.High PLR, NLR, SII associated with brain atrophy and hippocampal Aβ deposition.
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Affiliation(s)
- Jie‐Qiong Li
- Department of Neurologythe Affiliated Hospital of Qingdao UniversityQingdaoChina
- Department of Neurology and National Center for Neurological DisordersHuashan HospitalState Key Laboratory of Medical Neurobiology and MOE Frontiers Center for Brain ScienceShanghai Medical CollegeFudan UniversityShanghaiChina
| | - Ya‐Ru Zhang
- Department of Neurology and National Center for Neurological DisordersHuashan HospitalState Key Laboratory of Medical Neurobiology and MOE Frontiers Center for Brain ScienceShanghai Medical CollegeFudan UniversityShanghaiChina
| | - Hui‐Fu Wang
- Department of NeurologyQingdao Municipal HospitalQingdao UniversityQingdaoChina
- Department of NeurologyQingdao HospitalUniversity of Health and Rehabilitation Sciences (Qingdao Municipal Hospital)QingdaoChina
| | - Yu Guo
- Department of Neurology and National Center for Neurological DisordersHuashan HospitalState Key Laboratory of Medical Neurobiology and MOE Frontiers Center for Brain ScienceShanghai Medical CollegeFudan UniversityShanghaiChina
| | - Xue‐Ning Shen
- Department of Neurology and National Center for Neurological DisordersHuashan HospitalState Key Laboratory of Medical Neurobiology and MOE Frontiers Center for Brain ScienceShanghai Medical CollegeFudan UniversityShanghaiChina
| | - Meng‐Meng Li
- Department of Neurology and National Center for Neurological DisordersHuashan HospitalState Key Laboratory of Medical Neurobiology and MOE Frontiers Center for Brain ScienceShanghai Medical CollegeFudan UniversityShanghaiChina
| | - Jing‐Hui Song
- Department of Neurologythe Affiliated Hospital of Qingdao UniversityQingdaoChina
| | - Lan Tan
- Department of NeurologyQingdao Municipal HospitalQingdao UniversityQingdaoChina
- Department of NeurologyQingdao HospitalUniversity of Health and Rehabilitation Sciences (Qingdao Municipal Hospital)QingdaoChina
| | - An‐Mu Xie
- Department of Neurologythe Affiliated Hospital of Qingdao UniversityQingdaoChina
| | - Jin‐Tai Yu
- Department of Neurology and National Center for Neurological DisordersHuashan HospitalState Key Laboratory of Medical Neurobiology and MOE Frontiers Center for Brain ScienceShanghai Medical CollegeFudan UniversityShanghaiChina
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Chen LC, Hung KH, Tseng YJ, Wang HY, Lu TM, Huang WC, Tsao Y. Self-Supervised Learning-Based General Laboratory Progress Pretrained Model for Cardiovascular Event Detection. IEEE JOURNAL OF TRANSLATIONAL ENGINEERING IN HEALTH AND MEDICINE 2023; 12:43-55. [PMID: 38059127 PMCID: PMC10697297 DOI: 10.1109/jtehm.2023.3307794] [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: 03/14/2023] [Revised: 07/23/2023] [Accepted: 08/14/2023] [Indexed: 12/08/2023]
Abstract
OBJECTIVE Leveraging patient data through machine learning techniques in disease care offers a multitude of substantial benefits. Nonetheless, the inherent nature of patient data poses several challenges. Prevalent cases amass substantial longitudinal data owing to their patient volume and consistent follow-ups, however, longitudinal laboratory data are renowned for their irregularity, temporality, absenteeism, and sparsity; In contrast, recruitment for rare or specific cases is often constrained due to their limited patient size and episodic observations. This study employed self-supervised learning (SSL) to pretrain a generalized laboratory progress (GLP) model that captures the overall progression of six common laboratory markers in prevalent cardiovascular cases, with the intention of transferring this knowledge to aid in the detection of specific cardiovascular event. METHODS AND PROCEDURES GLP implemented a two-stage training approach, leveraging the information embedded within interpolated data and amplify the performance of SSL. After GLP pretraining, it is transferred for target vessel revascularization (TVR) detection. RESULTS The proposed two-stage training improved the performance of pure SSL, and the transferability of GLP exhibited distinctiveness. After GLP processing, the classification exhibited a notable enhancement, with averaged accuracy rising from 0.63 to 0.90. All evaluated metrics demonstrated substantial superiority ([Formula: see text]) compared to prior GLP processing. CONCLUSION Our study effectively engages in translational engineering by transferring patient progression of cardiovascular laboratory parameters from one patient group to another, transcending the limitations of data availability. The transferability of disease progression optimized the strategies of examinations and treatments, and improves patient prognosis while using commonly available laboratory parameters. The potential for expanding this approach to encompass other diseases holds great promise. CLINICAL IMPACT Our study effectively transposes patient progression from one cohort to another, surpassing the constraints of episodic observation. The transferability of disease progression contributed to cardiovascular event assessment.
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Affiliation(s)
- Li-Chin Chen
- Research Center for Information Technology InnovationAcademia SinicaTaipei11529Taiwan
| | - Kuo-Hsuan Hung
- Research Center for Information Technology InnovationAcademia SinicaTaipei11529Taiwan
| | - Yi-Ju Tseng
- Department of Computer ScienceNational Yang Ming Chiao Tung UniversityHsinchu30010Taiwan
| | - Hsin-Yao Wang
- Department of Laboratory MedicineLinkou Chang Gung Memorial HospitalTaoyuan City33342Taiwan
| | - Tse-Min Lu
- Division of CardiologyDepartment of Internal MedicineTaipei Veterans General HospitalTaipei112201Taiwan
- Department of Health Care CenterTaipei Veterans General HospitalTaipei112201Taiwan
- Department of Internal MedicineSchool of Medicine, College of MedicineNational Yang Ming Chiao Tung UniversityTaipei112304Taiwan
| | - Wei-Chieh Huang
- Division of CardiologyDepartment of Internal MedicineTaipei Veterans General HospitalTaipei112201Taiwan
- Department of Internal MedicineSchool of Medicine, College of MedicineNational Yang Ming Chiao Tung UniversityTaipei112304Taiwan
- Department of Biomedical EngineeringNational Taiwan UniversityTaipei10617Taiwan
| | - Yu Tsao
- Research Center for Information Technology InnovationAcademia SinicaTaipei11529Taiwan
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Araki M, Park S, Nakajima A, Lee H, Ye JC, Jang IK. Diagnosis of coronary layered plaque by deep learning. Sci Rep 2023; 13:2432. [PMID: 36765086 PMCID: PMC9918456 DOI: 10.1038/s41598-023-29293-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2022] [Accepted: 02/02/2023] [Indexed: 02/12/2023] Open
Abstract
Healed coronary plaques, morphologically characterized by a layered phenotype, are signs of previous plaque destabilization and healing. Recent optical coherence tomography (OCT) studies demonstrated that layered plaque is associated with higher levels of local and systemic inflammation and rapid plaque progression. However, the diagnosis of layered plaque needs expertise in OCT image analysis and is susceptible to inter-observer variability. We developed a deep learning (DL) model for an accurate diagnosis of layered plaque. A Visual Transformer (ViT)-based DL model that integrates information from adjacent frames emulating the cardiologists who review consecutive OCT frames to make a diagnosis was developed and compared with the standard convolutional neural network (CNN) model. A total of 237,021 cross-sectional OCT images from 581 patients collected from 8 sites were used for training and internal validation, and 65,394 images from 292 patients collected from another site were used for external validation. In the five-fold cross-validation, the ViT-based model provided better performance (area under the curve [AUC]: 0.860; 95% confidence interval [CI]: 0.855-0.866) than the standard CNN-based model (AUC: 0.799; 95% CI: 0.792-0.805). The ViT-based model (AUC: 0.845; 95% CI: 0.837-0.853) also surpassed the standard CNN-based model (AUC: 0.791; 95% CI: 0.782-0.800) in the external validation. The ViT-based DL model can accurately diagnose a layered plaque, which could help risk stratification for cardiac events.
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Affiliation(s)
- Makoto Araki
- Cardiology Division, Massachusetts General Hospital, Harvard Medical School, 55 Fruit Street, GRB 800, Boston, MA, 02114, USA
| | - Sangjoon Park
- Department of Bio and Brain Engineering, Korea Advanced Institute of Science and Technology, 291 Daehak-ro, Daejeon, 34141, South Korea
| | - Akihiro Nakajima
- Cardiology Division, Massachusetts General Hospital, Harvard Medical School, 55 Fruit Street, GRB 800, Boston, MA, 02114, USA
| | - Hang Lee
- Biostatistics Center, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Jong Chul Ye
- Department of Bio and Brain Engineering, Korea Advanced Institute of Science and Technology, 291 Daehak-ro, Daejeon, 34141, South Korea.
| | - Ik-Kyung Jang
- Cardiology Division, Massachusetts General Hospital, Harvard Medical School, 55 Fruit Street, GRB 800, Boston, MA, 02114, USA.
- Division of Cardiology, Kyung Hee University, Seoul, South Korea.
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Assessment of indices of conjunctival microvascular function in patients with and without obstructive coronary artery disease. CARDIOVASCULAR REVASCULARIZATION MEDICINE 2023; 50:26-33. [PMID: 36707373 DOI: 10.1016/j.carrev.2023.01.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Revised: 01/08/2023] [Accepted: 01/10/2023] [Indexed: 01/15/2023]
Abstract
BACKGROUND Atherosclerotic heart disease often remains asymptomatic until presentation with a major adverse cardiovascular event. Primary preventive therapies improve outcomes, but conventional screening often misattributes risk. Vascular imaging can be utilised to detect atherosclerosis, but often involves ionising radiation. The conjunctiva is a readily accessible vascular network allowing non-invasive hemodynamic evaluation. AIM To compare conjunctival microcirculatory function in patients with and without obstructive coronary artery disease. METHODS We compared the conjunctival microcirculation of myocardial infarction patients (MI-cohort) to controls with no obstructive coronary artery disease (NO-CAD cohort). Conjunctival imaging was performed using a smartphone and slit-lamp biomicroscope combination. Microvascular indices of axial (Va) and cross-sectional (Vcs) velocity; blood flow rate (Q); and wall shear rate (WSR) were compared in all conjunctival vessels between 5 and 45 μm in diameter. RESULTS A total of 127 patients were recruited (66 MI vs 61 NO-CAD) and 3602 conjunctival vessels analysed (2414 MI vs 1188 NO-CAD). Mean Va, Vcs and Q were significantly lower in the MI vs NO-CAD cohort (Va 0.50 ± 0.17 mm/s vs 0.55 ± 0.15 mm/s, p < 0.001; Vcs 0.35 ± 0.12 mm/s vs 0.38 ± 0.10 mm/s, p < 0.001; Q 154 ± 116 pl/s vs 198 ± 130 pl/s, p < 0.001). To correct for differences in mean vessel diameter, WSR was compared in 10-36 μm vessels (3268/3602 vessels) and was lower in the MI-cohort (134 ± 64 s-1 vs 140 ± 63 s-1, p = 0.002). CONCLUSIONS Conjunctival microcirculatory alterations can be observed in patients with obstructive coronary artery disease. The conjunctival microvasculature merits further evaluation in cardiovascular risk screening.
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Park HW, Ozcan I, Toya T, Ahmad A, Kanaji Y, Kushwaha SS, Lerman LO, Lerman A. Invasive aortic pulse pressure is linked to cardiac allograft vasculopathy after heart transplantation. Int J Cardiol 2023; 370:167-174. [PMID: 36346255 DOI: 10.1016/j.ijcard.2022.10.159] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2022] [Revised: 10/20/2022] [Accepted: 10/25/2022] [Indexed: 11/05/2022]
Abstract
BACKGROUND Pulse pressure (PP) has been linked to an increased risk of extent of coronary atherosclerosis and cardiovascular events. This study aimed to investigate the contribution of aortic PP on cardiac allograft vasculopathy (CAV) progression, and cardiovascular events after heart transplantation (HTx). METHODS A total of 330 HTx patients (mean age 49 ± 25 years, 70.0% male) undergoing routine serial coronary intravascular ultrasound (IVUS) studies and had invasive aortic PP were enrolled. The median time from HTx to first IVUS was 13.6 months. CAV progression was assessed by IVUS as the changes (Δ) in plaque volume divided by the segment length (PV/SL), adjusted for the time between IVUS (median, 3.99 years; interquartile range, 1.99-7.20 years), and was defined as ΔPV/SL ≥0.50 mm3/mm/year. Major adverse cardiovascular event (MACE) was defined as any incidence of mortality, myocardial infarction, coronary revascularization, heart failure hospitalization, or re-transplantation. RESULTS Recipient age, recipient sex, and renal dysfunction were independent determinant of high aortic PP (≥ 50 mmHg). High aortic PP was an independent determinant of CAV progression [odds ratio, 1.72; 95% confidence interval (CI), 1.01-2.93; p = 0.045]. Both high aortic PP (HR 1.46, 95% CI 1.01-2.11, p = 0.044) and high baseline CAV grade on angiogram (≥1, HR 1.50, 95% CI 1.03-2.21, p = 0.037) were independently associated with MACEs over 12 years. CONCLUSION In post-HTx patients, high aortic PP was significantly associated with plaque progression. Both aortic PP and CAV grade are independently associated with MACE during long-term follow-up. These findings suggest that arterial stiffness and CAV can be important predictors of MACEs.
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Affiliation(s)
- Hyun Woong Park
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN, USA; Department of Cardiology in Internal Medicine, Chungnam National University Sejong Hospital, Chungnam National University College of Medicine, Sejong, South Korea
| | - Ilke Ozcan
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN, USA
| | - Takumi Toya
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN, USA; Department of Internal Medicine, Saint Luis University School of Medicine, Saint Louis, MO, USA
| | - Ali Ahmad
- Division of Cardiology, National Defense Medical College, Tokorozawa, Saitama, Japan
| | - Yoshihisa Kanaji
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN, USA; Division of Cardiovascular Medicine, Tsuchiura Kyodo General Hospital, Ibaraki, Japan
| | - Sudhir S Kushwaha
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN, USA
| | - Lilach O Lerman
- Division of Nephrology and Hypertension, Mayo Clinic, Rochester, MN, USA
| | - Amir Lerman
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN, USA.
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Shen C, Gharleghi R, Li DD, Beier S. Helical Flow in Healthy and Diseased Patient-specific Coronary Bifurcations. ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL INTERNATIONAL CONFERENCE 2022; 2022:3977-3980. [PMID: 36086059 DOI: 10.1109/embc48229.2022.9871374] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Helical flow (HF) exists in healthy and diseased coronary bifurcations and was found to have a protective atherosclerotic vascular effect in other vessels. However, the role of HF in patient-specific human coronary arteries still needs further study, and is therefore the objective of this study in both healthy and diseased bifurcations. Computational studies were conducted on 16 patient-specific coronary bifurcations, including eight healthy and eight identical cases with idealized narrowing to represent disease. In general, higher HF intensity may have a favorable effect as it corelated to the reduction of the percentage vessel area exposed to adverse time averaged wall shear stress (TAWSS%) in both healthy and diseased models. The HF intensity and distribution of each model varies due to the complex shape of patient-specific models. The presence of disease appears to have an important impact on the downstream HF patterns and the TAWSS distributions. Clinical Relevance- By understanding the relationship between HF and hemodynamics, HF may be used as a predictor for the formation and progression of atherosclerotic plaque in coronary arteries instead of near-wall WSS measures, which can be determined with higher accuracy in vivo.
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Shishikura D, Octavia Y, Hayat U, Thondapu V, Barlis P. Atherogenesis and Inflammation. Interv Cardiol 2022. [DOI: 10.1002/9781119697367.ch1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
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Detection of Vulnerable Coronary Plaques Using Invasive and Non-Invasive Imaging Modalities. J Clin Med 2022; 11:jcm11051361. [PMID: 35268451 PMCID: PMC8911129 DOI: 10.3390/jcm11051361] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2022] [Revised: 02/11/2022] [Accepted: 02/25/2022] [Indexed: 11/16/2022] Open
Abstract
Acute coronary syndrome (ACS) mostly arises from so-called vulnerable coronary plaques, particularly prone for rupture. Vulnerable plaques comprise a specific type of plaque, called the thin-cap fibroatheroma (TFCA). A TCFA is characterized by a large lipid-rich necrotic core, a thin fibrous cap, inflammation, neovascularization, intraplaque hemorrhage, microcalcifications or spotty calcifications, and positive remodeling. Vulnerable plaques are often not visible during coronary angiography. However, different plaque features can be visualized with the use of intracoronary imaging techniques, such as intravascular ultrasound (IVUS), potentially with the addition of near-infrared spectroscopy (NIRS), or optical coherence tomography (OCT). Non-invasive imaging techniques, such as computed tomography coronary angiography (CTCA), cardiovascular magnetic resonance (CMR) imaging, and nuclear imaging, can be used as an alternative for these invasive imaging techniques. These invasive and non-invasive imaging modalities can be implemented for screening to guide primary or secondary prevention therapies, leading to a more patient-tailored diagnostic and treatment strategy. Systemic pharmaceutical treatment with lipid-lowering or anti-inflammatory medication leads to plaque stabilization and reduction of cardiovascular events. Additionally, ongoing studies are investigating whether modification of vulnerable plaque features with local invasive treatment options leads to plaque stabilization and subsequent cardiovascular risk reduction.
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12
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Park HW, Corban M, Toya T, Ahmad A, Ozcan I, Lerman L, Lerman A. Impact of invasive aortic pulse pressure on coronary microvascular endothelial-independent dysfunction and on mortality in non-obstructive coronary artery disease. Open Heart 2022; 9:openhrt-2021-001925. [PMID: 35105720 PMCID: PMC8808452 DOI: 10.1136/openhrt-2021-001925] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/29/2021] [Accepted: 01/09/2022] [Indexed: 11/04/2022] Open
Abstract
Background Pulse pressure (PP), a raw index of arterial stiffness, is inversely related to coronary microvascular function, even among patients with non-obstructive coronary artery disease (CAD), as per non-invasive studies. We aimed to determine whether invasive aortic PP is associated with coronary microvascular endothelial dysfunction (CMED) and/or coronary microvascular endothelial independent dysfunction (CMEID) in patients with non-obstructed CAD. Methods We retrospectively analysed a cohort of 1894 patients (mean age, 51.2 years; 1261 (66.6%) women) who presented with chest pain and non-obstructive CAD (angiographic stenosis <50%); coronary vasoreactivity was assessed in the mid-left anterior descending artery. The patients were classified based on whether aortic PP was high (≥50 mm Hg). CMEID was defined as abnormal coronary flow reserve (<2.5) or hyperaemic myocardial resistance (>2.0 mm Hg/cm/s), CMED was defined as abnormal acetylcholine-induced per cent change of coronary blood flow (≤50%). Results Patients with high aortic PP had a higher rate of CMEID than those with low aortic PP (40.9 vs 25.2%, p<0.001). Conversely, aortic PP was not associated with CMED. On multivariate analysis, high aortic PP was associated with CMEID occurrence (OR 1.42, 95% CI 1.13 to 1.78; p=0.003). On follow-up (median, 150 months), all-cause death was more frequent among patients with vs without high aortic PP (20.1% vs 7.3%, log-rank p<0.001) and HR was 2.08 (95% CI 1.34 to 3.32, p=0.002) on multivariate cox regression analysis. Furthermore, among patients with low aortic PP, CMEID was an independent risk factor for all-cause mortality (HR 2.04, 95% CI 1.01 to 4.16, p=0.048). Conclusion In patients with non-obstructive CAD, invasive aortic PP was significantly associated with CMEID, but not with CMED. High aortic PP was an independent predictor of all-cause mortality, but CMEID was an independent risk factor in patients with low aortic PP.
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Affiliation(s)
- Hyun Woong Park
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota, USA.,Department of Cardiovascular Disease, Chungnam National University Sejong Hospital, Sejong, Republic of Korea
| | - Michel Corban
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota, USA
| | - Takumi Toya
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota, USA.,Division of Cardiology, National Defense Medical College, Tokorozawa, Saitama, Japan
| | - Ali Ahmad
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota, USA
| | - Ilke Ozcan
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota, USA
| | - Lilach Lerman
- Division of Nephrology and Hypertension, Mayo Clinic, Rochester, Minnesota, USA
| | - Amir Lerman
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota, USA
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13
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Wang T, Zhou J, Zhang X, Wu Y, Jin K, Wang Y, Xu R, Yang G, Li W, Jiao L. X-box Binding Protein 1: An Adaptor in the Pathogenesis of Atherosclerosis. Aging Dis 2022; 14:350-369. [PMID: 37008067 PMCID: PMC10017146 DOI: 10.14336/ad.2022.0824] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Accepted: 08/24/2022] [Indexed: 11/18/2022] Open
Abstract
Atherosclerosis (AS), the formation of fibrofatty lesions in the vessel wall, is the primary cause of heart disease and stroke and is closely associated with aging. Disrupted metabolic homeostasis is a primary feature of AS and leads to endoplasmic reticulum (ER) stress, which is an abnormal accumulation of unfolded proteins. By orchestrating signaling cascades of the unfolded protein response (UPR), ER stress functions as a double-edged sword in AS, where adaptive UPR triggers synthetic metabolic processes to restore homeostasis, whereas the maladaptive response programs the cell to the apoptotic pathway. However, little is known regarding their precise coordination. Herein, an advanced understanding of the role of UPR in the pathological process of AS is reviewed. In particular, we focused on a critical mediator of the UPR, X-box binding protein 1 (XBP1), and its important role in balancing adaptive and maladaptive responses. The XBP1 mRNA is processed from the unspliced isoform (XBP1u) to the spliced isoform of XBP1 (XBP1s). Compared with XBP1u, XBP1s predominantly functions downstream of inositol-requiring enzyme-1α (IRE1α) and transcript genes involved in protein quality control, inflammation, lipid metabolism, carbohydrate metabolism, and calcification, which are critical for the pathogenesis of AS. Thus, the IRE1α/XBP1 axis is a promising pharmaceutical candidate against AS.
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Affiliation(s)
- Tao Wang
- Department of Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing, China.
- China International Neuroscience Institute (China-INI), Beijing, China.
| | - Jia Zhou
- Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China.
| | - Xiao Zhang
- Department of Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing, China.
- China International Neuroscience Institute (China-INI), Beijing, China.
| | - Yujie Wu
- Laboratory of Computational Biology and Machine Intelligence, National Laboratory of Pattern Recognition, Institute of Automation, Chinese Academy of Sciences, Beijing, China.
| | - Kehan Jin
- Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China.
| | - Yilin Wang
- Institute of Cerebrovascular Disease Research and Department of Neurology, Xuanwu Hospital of Capital Medical University, Beijing, China.
| | - Ran Xu
- Department of Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing, China.
- China International Neuroscience Institute (China-INI), Beijing, China.
| | - Ge Yang
- Laboratory of Computational Biology and Machine Intelligence, National Laboratory of Pattern Recognition, Institute of Automation, Chinese Academy of Sciences, Beijing, China.
- School of Artificial Intelligence, University of Chinese Academy of Sciences, Beijing, China.
- Correspondence should be addressed to: Dr. Ge Yang, Chinese Academy of Sciences, Beijing, China. , Dr. Wenjing Li, Chinese Academy of Sciences, Beijing, China. ; Dr. Liqun Jiao, Xuanwu Hospital, Capital Medical University, Beijing, China. .
| | - Wenjing Li
- Laboratory of Computational Biology and Machine Intelligence, National Laboratory of Pattern Recognition, Institute of Automation, Chinese Academy of Sciences, Beijing, China.
- School of Artificial Intelligence, University of Chinese Academy of Sciences, Beijing, China.
- Correspondence should be addressed to: Dr. Ge Yang, Chinese Academy of Sciences, Beijing, China. , Dr. Wenjing Li, Chinese Academy of Sciences, Beijing, China. ; Dr. Liqun Jiao, Xuanwu Hospital, Capital Medical University, Beijing, China. .
| | - Liqun Jiao
- Department of Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing, China.
- China International Neuroscience Institute (China-INI), Beijing, China.
- Department of Interventional Radiology, Xuanwu Hospital, Capital Medical University, Beijing, China.
- Correspondence should be addressed to: Dr. Ge Yang, Chinese Academy of Sciences, Beijing, China. , Dr. Wenjing Li, Chinese Academy of Sciences, Beijing, China. ; Dr. Liqun Jiao, Xuanwu Hospital, Capital Medical University, Beijing, China. .
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14
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McKenzie AJ, Doyle BJ, Aman ZM. Micromechanical Force Measurement of Clotted Blood Particle Cohesion: Understanding Thromboembolic Aggregation Mechanisms. Cardiovasc Eng Technol 2022; 13:816-828. [PMID: 35419664 PMCID: PMC9750917 DOI: 10.1007/s13239-022-00618-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2021] [Accepted: 03/19/2022] [Indexed: 01/27/2023]
Abstract
PURPOSE Arterial shear forces may promote the embolization of clotted blood from the surface of thrombi, displacing particles that may occlude vasculature, with increased risk of physiological complications and mortality. Thromboemboli may also collide in vivo to form metastable aggregates that increase vessel occlusion likelihood. METHODS A micromechanical force (MMF) apparatus was modified for aqueous applications to study clot-liquid interfacial phenomena between clotted porcine blood particles suspended in modified continuous phases. The MMF measurement is based on visual observation of particle-particle separation, where Hooke's Law is applied to calculate separation force. This technique has previously been deployed to study solid-fluid interfacial phenomena in oil and gas pipelines, providing fundamental insight to cohesive and adhesive properties between solids in multiphase flow systems. RESULTS This manuscript introduces distributed inter-particle separation force properties as a function of governing physio-chemical parameters; pre-load (contact) force, contact time, and bulk phase chemical modification. In each experimental campaign, the hysteresis and distributed force properties were analysed, to derive insight as to the governing mechanism of cohesion between particles. Porcine serum, porcine albumin and pharmaceutical agents (alteplase, tranexamic acid and hydrolysed aspirin) reduced the measurement by an order of magnitude from the baseline measurement-the apparatus provides a platform to study how surface-active chemistries impact the solid-fluid interface. CONCLUSION These results provide new insight to potential mechanisms of macroscopic thromboembolic aggregation via particles cohering in the vascular system-data that can be directly applied to computational simulations to predict particle fate, better informing the mechanistic developments of embolic occlusion.
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Affiliation(s)
- Angus J. McKenzie
- grid.1012.20000 0004 1936 7910Department of Chemical Engineering, The Centre for Long Subsea Tiebacks, Fluid Science and Resources Cluster, The University of Western Australia, 35 Stirling Highway, Crawley, WA 6009 Australia
| | - Barry J. Doyle
- grid.1012.20000 0004 1936 7910Vascular Engineering Laboratory, Harry Perkins Institute of Medical Research, Nedlands, and Centre for Medical Research, The University of Western Australia, Crawley, PER Australia ,Australian Research Council Centre for Personalised Therapeutics Technologies, Parkville, Australia ,grid.4305.20000 0004 1936 7988BHF Centre for Cardiovascular Science, The University of Edinburgh, Edinburgh, UK
| | - Zachary M. Aman
- grid.1012.20000 0004 1936 7910Department of Chemical Engineering, The Centre for Long Subsea Tiebacks, Fluid Science and Resources Cluster, The University of Western Australia, 35 Stirling Highway, Crawley, WA 6009 Australia
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15
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Kamangar S. Numerical simulation of pulsatile blood flow characteristics in a multi stenosed coronary artery. Biomed Mater Eng 2021; 32:309-321. [PMID: 33998530 DOI: 10.3233/bme-211234] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Coronary artery disease is reported as one of the most common sources of death all over the world. The presence of stenosis (plaque) in the coronary arteries results in the restriction of blood supply, which leads to myocardial infarction. OBJECTIVE The aim of this study was to investigate the effect of multi stenosis on hemodynamics parameters in idealized coronary artery models with varying degrees of stenosis and interspace distance between the stenosis. METHODS A finite volume-based software package (Ansys CFX version 17.2) was employed to model the blood flow. The hemodynamic stenosis parameters of blood, such as the pressure, velocity, and wall shear stress were obtained. RESULTS The computed results showed that the pressure drop is maximum across the 90% area stenosis (AS). The pressure drop is increased as the distance between the proximal and distal stenosis is decreased across the proximal stenosis for the model P70_D70 during the systolic period of the cardiac cycle. A recirculation zone is formed behind the stenosis and is restricted by the occurrence of distal stenosis as the interspacing distance decreases, which could lead to further progression of stenosis in the flow-disturbed area. The wall shear stress was found to increase as the distance between the proximal and distal stenosis is increased across the distal stenosis. The maximum wall shear stress was found at 90% AS. CONCLUSIONS In the clinical diagnosis, an overestimation of distal stenosis severity could be possible. Furthermore, the low wall shear stress zone in between the proximal and distal stenosis may help atherosclerotic growth or merge adjacent stenosis.
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Affiliation(s)
- Sarfaraz Kamangar
- Research Centre for Advanced Materials Science (RCAMS), King Khalid University, Abha, Kingdom Saudi Arabia.,Department of Mechanical Engineering, College of Engineering, King Khalid University, Abha, Kingdom Saudi Arabia E-mail:
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16
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Araki M, Yonetsu T, Russo M, Kurihara O, Kim HO, Shinohara H, Thondapu V, Soeda T, Minami Y, Higuma T, Lee H, Kakuta T, Jang IK. Predictors for layered coronary plaques: an optical coherence tomography study. J Thromb Thrombolysis 2021; 50:886-894. [PMID: 32306291 DOI: 10.1007/s11239-020-02116-5] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Healed coronary plaques, morphologically characterized by a layered pattern, are signatures of previous plaque disruption and healing. Recent optical coherence tomography (OCT) studies showed that layered plaque is associated with vascular vulnerability. However, factors associated with layered plaques have not been studied. The aim of this study was to investigate predictors for layered plaque at the culprit plaques and at non-culprit plaques. Patients with coronary artery disease who underwent pre-intervention OCT imaging of the culprit lesion were included. Layered plaques were defined as plaques with one or more layers of different optical density and a clear demarcation from underlying components. Among 313 patients, layered plaque at the culprit lesion was observed in 18.8% of ST-segment elevation myocardial infarction patients, 36.3% of non-ST-segment elevation acute coronary syndrome patients, and 53.4% of stable angina pectoris (SAP) patients (p < 0.001). In the multivariable model, SAP, multivessel disease, type B2/C lesion, and diameter stenosis > 70% were independent predictors for layered plaque at the culprit lesion. In addition, 394 non-culprit plaques in 190 patients were assessed to explore predictors for layered plaques at non-culprit lesions. SAP, and thin-cap fibroatheroma and layered plaque at the culprit lesion were independent predictors for layered plaques at non-culprit lesions. In conclusion, clinical presentation of SAP was a strong predictor for layered plaque at both culprit plaques and non-culprit plaques. Development and biologic significance of layered plaques may be related to a balance between pan-vascular vulnerability and endogenous anti-thrombotic protective mechanism.
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Affiliation(s)
- Makoto Araki
- Cardiology Division, Massachusetts General Hospital, Harvard Medical School, 55 Fruit Street, GRB 800, Boston, MA, 02114, USA.,Department of Interventional Cardiology, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo Ward, Tokyo, 113-8519, Japan
| | - Taishi Yonetsu
- Department of Interventional Cardiology, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo Ward, Tokyo, 113-8519, Japan.
| | - Michele Russo
- Cardiology Division, Massachusetts General Hospital, Harvard Medical School, 55 Fruit Street, GRB 800, Boston, MA, 02114, USA
| | - Osamu Kurihara
- Cardiology Division, Massachusetts General Hospital, Harvard Medical School, 55 Fruit Street, GRB 800, Boston, MA, 02114, USA
| | - Hyung Oh Kim
- Cardiology Division, Massachusetts General Hospital, Harvard Medical School, 55 Fruit Street, GRB 800, Boston, MA, 02114, USA
| | - Hiroki Shinohara
- Cardiology Division, Massachusetts General Hospital, Harvard Medical School, 55 Fruit Street, GRB 800, Boston, MA, 02114, USA
| | - Vikas Thondapu
- Cardiology Division, Massachusetts General Hospital, Harvard Medical School, 55 Fruit Street, GRB 800, Boston, MA, 02114, USA
| | - Tsunenari Soeda
- Department of Cardiovascular Medicine, Nara Medical University, Kashihara, Nara, Japan
| | - Yoshiyasu Minami
- Department of Cardiovascular Medicine, Kitasato University School of Medicine, Sagamihara, Kanagawa, Japan
| | - Takumi Higuma
- Division of Cardiology, Department of Internal Medicine, St. Marianna University School of Medicine, Kawasaki, Kanagawa, Japan
| | - Hang Lee
- Biostatistics Center, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Tsunekazu Kakuta
- Department of Cardiology, Tsuchiura Kyodo General Hospital, Tsuchiura, Ibaraki, Japan
| | - Ik-Kyung Jang
- Cardiology Division, Massachusetts General Hospital, Harvard Medical School, 55 Fruit Street, GRB 800, Boston, MA, 02114, USA. .,Division of Cardiology, Kyung Hee University Hospital, Seoul, South Korea.
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17
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Kamangar S, Anjum Badruddin I, Anqi AE, Ahamed Saleel C, Tirth V, Yunus Khan T, Anas Khan M, Mallick Z, Salman Ahmed N. Influence of bifurcation angle in left coronary artery with stenosis: A CFD analysis. Biomed Mater Eng 2020; 31:339-349. [DOI: 10.3233/bme-201107] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND: The left coronary artery commonly known as LCA gets divided into two branches, such as the left circumflex (LCX) and left anterior descending (LAD) at a particular angle. This angle is varies from person to person. The present computational study contributes remarkable expertise about the influence of this angle variation on the hemodynamic parameters in the presence of 80% area stenosis at the LAD branch. OBJECTIVE: This study aimed to compare the effect of the bifurcation angle on hemodynamic parameters in the left coronary artery with 80% stenosis. METHOD: Computational models of left coronary bifurcation angles of 30°, 60°, 90°, 120° were developed to understand the flow behavior of left coronary artery branches. The 80% area stenosis (AS) is considered at the LAD branch immediate to bifurcation. RESULTS: Measurements of pressure, velocity and wall shear stress were carried out corresponding to various bifurcation angles. It was found that the drop-in pressure increases as the angle increases from narrow to wider. A slight elevation in the velocity at the stenosis was observed. In addition, the obtained results further reveal a recirculation region immediately after the plaque, which leads to more deposition of plaque in the flow obstructed area. It is known that the shear stress at the arterial wall across the stenosis increases as the angle of bifurcation increases from narrow to wider. CONCLUSIONS: The bifurcation of the left coronary artery and size of the stenosis have a notable impact on the pressure and wall shear stress. These two factors should be given due consideration by cardiologists to assess the complexity of stenosis in the LCA branches.
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Affiliation(s)
| | | | - Ali E. Anqi
- , King Khalid University, , Kingdom of Saudi Arabia
| | | | - Vineet Tirth
- , King Khalid University, , Kingdom of Saudi Arabia
| | | | | | - Z. Mallick
- , King Khalid University, , Kingdom of Saudi Arabia
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18
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Li T, Wang J, Xie H, Hao P, Qing C, Zhang Y, Liao X, Liang T. Study on the related factors of post-herpetic neuralgia in hospitalized patients with herpes zoster in Sichuan Hospital of Traditional Chinese Medicine based on big data analysis. Dermatol Ther 2020; 33:e14410. [PMID: 33052606 DOI: 10.1111/dth.14410] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Revised: 09/11/2020] [Accepted: 10/01/2020] [Indexed: 10/23/2022]
Abstract
Although various factors were reported to be related to post-herpetic neuralgia (PHN), studies based on adequate and comprehensive data were absent. Data was extracted from cases of hospitalized patients with herpes zoster in dermatology department, Sichuan hospital of traditional Chinese medicine range from December, 2011 to February, 2018, and then cleaned to build prediction model with TREENET algorithms. Following evaluated the prediction model by ROC and confusion matrix, variables importance ranking and variables dependency analysis were performed, resulting in the importance ranking of factors for PHN and the dependency between factors and PHN. Based on strict inclusion and exclusion criteria, 1303 (571 PHN and 732 normal controls) cases and 2958 indicators were selected. Model evaluation showed high ROC value (training sample = 0.985, test samples = 0.752) and high accuracy value (70.27%), which indicated that the model was predictive. After variables importance ranking and variables dependency analysis, 62 variables in the model were associated with the occurrence of PHN. Our study identified 62 variables related to PHN and revealed that various variables were the important risk factors for PHN, including age, MCHC, sodium and UA.
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Affiliation(s)
- Tianhao Li
- Department of Dermatology, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Jundong Wang
- National Traditional Chinese Medicine Clinical Research Bases Office, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Hongyan Xie
- National Traditional Chinese Medicine Clinical Research Bases Office, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Pingsheng Hao
- Department of Dermatology, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Chun Qing
- Department of Dermatology, Wuxi Hospital of Traditional Chinese Medicine, Chengdu, China
| | - Yuzhen Zhang
- Department of Dermatology, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Xin Liao
- Information Department, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Tao Liang
- Technical Department, ChengDu QiYue Data Technology Co., Ltd, Chengdu, China
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19
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Souza VF, Santos AASMDD, Mesquita CT, Martins WDA, Pelandre GL, Marchiori E, Nacif MS. Quantification of Calcified Coronary Plaques by Chest Computed Tomography: Correlation with the Calcium Score Technique. Arq Bras Cardiol 2020; 115:493-500. [PMID: 33027372 PMCID: PMC9363106 DOI: 10.36660/abc.20190235] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2019] [Accepted: 08/18/2019] [Indexed: 12/03/2022] Open
Abstract
Fundamento A doença cardiovascular representa a principal causa de mortalidade no mundo. Calcificações parietais nas artérias podem ser visualizadas e quantificadas por tomografia computadorizada (TC) em estágios iniciais e subclínicos, sendo expressa em escore de cálcio (EC). Com esse número, é possível estimar o prognóstico de eventos cardiovasculares futuros. Objetivos Correlacionar a detecção e quantificação do EC pela TC do tórax utilizando como padrão-ouro a TC cardíaca sincronizada ao eletrocardiograma. Métodos Estudo transversal e descritivo que selecionou pacientes (n=73) consecutivos para investigação de doença arterial coronariana estável e que realizaram TC cardíaca no período de junho de 2013 a outubro de 2014. Realizado protocolo com TC do tórax e EC, em aparelho de 64 canais. Os valores de p<0,05 foram considerados estatisticamente significativos. Resultados Na avaliação por paciente, após a transformação logarítmica a média do EC sincronizado foi de 8,7 e na TC de tórax foi de 9,4. Prevalência de doença de 49,3% (n= 36). A sensibilidade foi de 97,2% e a especificidade de 100,0%. Observou-se excelente correlação entre os métodos (r= 0,993 com p<0,001). Na avaliação por segmento, a média do EC sincronizado foi de 3,0. Já a média do EC na TC de tórax foi de 3,2. Prevalência de doença de 29,5% (n= 86), com sensibilidade de 95,3% e especificidade de 97,5%. Observou-se também excelente correlação entre os métodos (r= 0,985 com p<0,001). Conclusão O EC sincronizado e não sincronizado têm boa correlação entre si e não mostram resultados estatisticamente diferentes. (Arq Bras Cardiol. 2020; 115(3):493-500)
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Affiliation(s)
- Vitor Frauches Souza
- Complexo Hospitalar de Niterói - Radiologia, Niterói, RJ - Brasil.,Hospital Universitário Antônio Pedro - Pós-Graduação em Ciências Cardiovasculares, Niterói, RJ - Brasil
| | - Alair Augusto Sarmet M D Dos Santos
- Complexo Hospitalar de Niterói - Radiologia, Niterói, RJ - Brasil.,Hospital Universitário Antônio Pedro - Pós-Graduação em Ciências Cardiovasculares, Niterói, RJ - Brasil
| | - Claudio Tinoco Mesquita
- Hospital Universitário Antônio Pedro - Pós-Graduação em Ciências Cardiovasculares, Niterói, RJ - Brasil
| | - Wolney de Andrade Martins
- Hospital Universitário Antônio Pedro - Pós-Graduação em Ciências Cardiovasculares, Niterói, RJ - Brasil
| | - Gustavo Lemos Pelandre
- Universidade Federal do Rio de Janeiro - Pós-Graduação em Radiologia, Rio de Janeiro, RJ - Brasil
| | - Edson Marchiori
- Universidade Federal do Rio de Janeiro - Pós-Graduação em Radiologia, Rio de Janeiro, RJ - Brasil
| | - Marcelo Souto Nacif
- Universidade Federal Fluminense - Pós-graduação em Ciências Cardiovasculares, Niterói, RJ - Brasil.,Complexo Hospitalar de Niterói, Niterói, RJ - Brasil
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20
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Araki M, Yonetsu T, Kurihara O, Nakajima A, Lee H, Soeda T, Minami Y, McNulty I, Uemura S, Kakuta T, Jang IK. Predictors of Rapid Plaque Progression: An Optical Coherence Tomography Study. JACC Cardiovasc Imaging 2020; 14:1628-1638. [PMID: 33011121 DOI: 10.1016/j.jcmg.2020.08.014] [Citation(s) in RCA: 48] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/09/2020] [Revised: 08/21/2020] [Accepted: 08/27/2020] [Indexed: 11/18/2022]
Abstract
OBJECTIVES This study sought to identify morphological predictors of rapid plaque progression. BACKGROUND Two patterns of plaque progression have been described: slow linear progression and rapid step-wise progression. The former pattern will cause stable angina when the narrowing reaches a critical threshold, whereas the latter pattern may lead to acute coronary syndromes or sudden cardiac death. METHODS Patients who underwent optical coherence tomography (OCT) imaging during the index procedure and follow-up angiography with a minimum interval of 6 months were selected. Nonculprit lesions with a diameter stenosis of ≥30% on index angiography were assessed. Lesion progression was defined as a decrease of angiographic minimum lumen diameter ≥0.4 mm at follow-up (mean, 7.1 months). Baseline morphological characteristics of plaques with rapid progression were evaluated by OCT. In a subgroup with follow-up OCT imaging for plaques with rapid progression, morphological changes from baseline to follow-up were assessed. RESULTS Among 517 lesions in 248 patients, 50 lesions showed rapid progression. These lesions had a significantly higher prevalence of lipid-rich plaque (76.0% vs. 50.5%, respectively), thin-cap fibroatheroma (TCFA) (20.0% vs. 5.8%, respectively), layered plaque (60.0% vs. 34.0%, respectively), macrophage accumulation (62.0% vs. 42.4%, respectively), microvessel (46.0% vs. 29.1%, respectively), plaque rupture (12.0% vs. 4.7%, respectively), and thrombus (6.0% vs. 1.1%, respectively) at baseline compared with those without rapid progression. Multivariate analysis identified lipid-rich plaque (odds ratio [OR]: 2.17; 95% confidence interval [CI]: 1.02 to 4.62; p = 0.045]), TCFA (OR: 5.85; 95% CI: 2.01 to 17.03; p = 0.001), and layered plaque (OR: 2.19; 95% CI: 1.03 to 4.17; p = 0.040) as predictors of subsequent rapid lesion progression. In a subgroup analysis for plaques with rapid progression, a new layer was detected in 25 of 41 plaques (61.0%) at follow-up. CONCLUSIONS Lipid-rich plaques, TCFA, and layered plaques were predictors of subsequent rapid plaque progression. A new layer, a signature of previous plaque disruption and healing, was detected in more than half of the lesions with rapid progression at follow-up. (Massachusetts General Hospital Optical Coherence Tomography Registry; NCT01110538).
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Affiliation(s)
- Makoto Araki
- Cardiology Division, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Taishi Yonetsu
- Department of Interventional Cardiology, Tokyo Medical and Dental University, Tokyo, Japan.
| | - Osamu Kurihara
- Cardiology Division, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Akihiro Nakajima
- Cardiology Division, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Hang Lee
- Biostatistics Center, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Tsunenari Soeda
- Department of Cardiovascular Medicine, Nara Medical University, Kashihara, Nara, Japan
| | - Yoshiyasu Minami
- Department of Cardiovascular Medicine, Kitasato University School of Medicine, Sagamihara, Kanagawa, Japan
| | - Iris McNulty
- Cardiology Division, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Shiro Uemura
- Department of Cardiology, Kawasaki Medical School, Kurashiki, Japan
| | - Tsunekazu Kakuta
- Department of Cardiology, Tsuchiura Kyodo General Hospital, Tsuchiura, Ibaraki, Japan
| | - Ik-Kyung Jang
- Cardiology Division, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA; Division of Cardiology, Kyung Hee University Hospital, Seoul, South Korea.
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Cho M, Park JK. Fabrication of a Perfusable 3D In Vitro Artery-Mimicking Multichannel System for Artery Disease Models. ACS Biomater Sci Eng 2020; 6:5326-5336. [DOI: 10.1021/acsbiomaterials.0c00748] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Affiliation(s)
- Minkyung Cho
- Department of Bio and Brain Engineering, Korea Advanced Institute of Science and Technology (KAIST), 291 Daehak-ro, Yuseong-gu, Daejeon 34141, Republic of Korea
| | - Je-Kyun Park
- Department of Bio and Brain Engineering, Korea Advanced Institute of Science and Technology (KAIST), 291 Daehak-ro, Yuseong-gu, Daejeon 34141, Republic of Korea
- KAIST Institute for Health Science and Technology, 291 Daehak-ro, Yuseong-gu, Daejeon 34141, Republic of Korea
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22
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Mehta S, Srivastava N, Bhatia A, Dhawan V. Exposure of cigarette smoke condensate activates NLRP3 inflammasome in vitro and in vivo: A connotation of innate immunity and atherosclerosis. Int Immunopharmacol 2020; 84:106561. [PMID: 32402952 DOI: 10.1016/j.intimp.2020.106561] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2020] [Revised: 04/21/2020] [Accepted: 05/02/2020] [Indexed: 12/18/2022]
Abstract
OBJECTIVE Smoking is known to have detrimental effects on cardiovascular system. However, the potential molecular basis of smoking-induced atherosclerosis remains unclear. NLRP3 inflammasome is implicated in perpetuation of inflammatory response in atherosclerosis. Therefore, we aimed to explore the cytotoxic effects of cigarette smoke condensate (CSC) on the activation of NLRP3 inflammasome in vitro and in vivo. METHODS For in vitro study, the pro-atherogenic effects of CSC were evaluated in THP-1 monocytes with different dose concentrations (0.1, 1, 5, 10 and 20 µg/ml) for varied time periods (6, 12, 24 and 48 h). For in vivo study, 30 male C57BL/6J mice were employed. 6 mice were sacrificed for baseline investigations. 24 mice were randomly divided into four groups: Group-I:Control mice, Group-II:CSC model, Group-III:High-fat diet(HFD) model, and Group-IV:HFD + CSC model for 14 weeks (n = 6/group). The group-II and IV mice were injected with 720 µg CSC/20 g body weight intraperitoneally (6 days/week). RESULTS In vitro, higher dosage of CSC (20 µg/ml) was toxic to cells as significant decline in cell viability and proliferation was observed. Furthermore, the mRNA expression of NLRP3 inflammasome and its pro-cytokine levels were significantly augmented on CSC exposure in a dose-dependent manner but impeded in time-dependent manner. In vivo, CSC and HFD independently augmented the expression of NLRP3 inflammasome (~4-10 fold-change) along with pro-cytokine levels in Group-II and III vs Group-I mice whereas, HFD + CSC treatment demonstrated synergistic effects in Group-IV. CONCLUSION Our data suggest that CSC activates NLRP3 inflammasome in vitro and in vivo and collectively with HFD has synergistic effects in vivo that may promote atherosclerosis.
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Affiliation(s)
- Sakshi Mehta
- Department of Experimental Medicine and Biotechnology, Postgraduate Institute of Medical Education and Research, Chandigarh 160012, India
| | - Niharika Srivastava
- Department of Dermatology, Postgraduate Institute of Medical Education and Research, Chandigarh 160012, India
| | - Alka Bhatia
- Department of Experimental Medicine and Biotechnology, Postgraduate Institute of Medical Education and Research, Chandigarh 160012, India
| | - Veena Dhawan
- Department of Experimental Medicine and Biotechnology, Postgraduate Institute of Medical Education and Research, Chandigarh 160012, India.
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Mehta S, Dhawan V. Exposure of cigarette smoke condensate activates NLRP3 inflammasome in THP-1 cells in a stage-specific manner: An underlying role of innate immunity in atherosclerosis. Cell Signal 2020; 72:109645. [PMID: 32305666 DOI: 10.1016/j.cellsig.2020.109645] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2020] [Revised: 03/24/2020] [Accepted: 04/15/2020] [Indexed: 12/18/2022]
Abstract
BACKGROUND Smoking is known to affect all the phases of atherosclerosis, thus is considered as an independent and major risk factor. The underlying mechanism responsible for the atherogenic effects of smoking is still uncertain and a major concern. Recent evidence implicates NLRP3 inflammasome, an innate immunity component in the pathogenesis of atherosclerosis. Therefore, we hypothesized that NLRP3 inflammasome may be an associated pathway between smoking and atherosclerosis. METHODS AND RESULTS Differentiation in monocytes, macrophages and foam cells are the key stages in atherosclerotic plaque development, best mimicked by THP-1 cells. Therefore, to determine whether cigarette smoke condensate (CSC) could induce differentiation of THP-1 monocytes into macrophages, morphological changes and the expression levels of the inflammatory surface markers, i.e. CD11b, CD14 and CD36 were analyzed. The results showed that CD14 and CD36 levels were significantly increased in CSC-treated THP-1 monocytes. Further, we investigated the effect of CSC exposure on the status of NLRP3 inflammasome markers, i.e. NLRP3, pro-caspase-1, caspase-1, pro-IL-18, pro-IL-1β, IL-1β and IL-18 in a stage-specific manner. For this, THP-1 monocytes, PMA-differentiated macrophages and oxidized-low density lipoprotein (ox-LDL)-induced macrophage foam cells were exposed to 10 μg/ml of CSC for 6 h. CSC exposure significantly upregulated the expression of NLRP3 inflammasome in CSC-treated cells at both transcriptional and translational levels. Moreover, downstream pro-cytokines, i.e. IL-1β and IL-18 levels were also significantly increased in culture supernatants of CSC-exposed cells. CONCLUSION These observations suggest that CSC exposure may activate NLRP3 inflammasome in a stage-specific manner and may promote initiation and progression of atherosclerosis.
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Affiliation(s)
- Sakshi Mehta
- Department of Experimental Medicine and Biotechnology, Postgraduate Institute of Medical Education and Research, Chandigarh 160012, India
| | - Veena Dhawan
- Department of Experimental Medicine and Biotechnology, Postgraduate Institute of Medical Education and Research, Chandigarh 160012, India.
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Araki M, Soeda T, Kim HO, Thondapu V, Russo M, Kurihara O, Shinohara H, Minami Y, Higuma T, Lee H, Yonetsu T, Kakuta T, Jang IK. Spatial Distribution of Vulnerable Plaques: Comprehensive In Vivo Coronary Plaque Mapping. JACC Cardiovasc Imaging 2020; 13:1989-1999. [PMID: 32912472 DOI: 10.1016/j.jcmg.2020.01.013] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/04/2019] [Revised: 01/06/2020] [Accepted: 01/09/2020] [Indexed: 11/15/2022]
Abstract
OBJECTIVES The authors performed a comprehensive analysis on the distribution of coronary plaques with different phenotypes from our 3-vessel optical coherence tomography (OCT) database. BACKGROUND Previous pathology studies demonstrated that thin-cap fibroatheroma (TCFA) is localized in specific segments of the epicardial coronary arteries. A detailed description of in vivo coronary plaques of various phenotypes has not been reported. METHODS OCT images of all 3 coronary arteries in 131 patients were analyzed every 1 mm to assess plaque phenotype and features of vulnerability. In addition, plaques were divided into tertiles according to percent area stenosis (%AS). RESULTS Among 534 plaques identified in 393 coronary arteries, 27.0% were fibrous plaques, 13.3% were fibrocalcific plaques, 40.8% were thick-cap fibroatheromas, and 18.9% were TCFAs. TCFAs showed clustering in the proximal segment, particularly in the left anterior descending artery. On the other hand, fibrous plaques were relatively evenly distributed throughout the entire length of the coronary arteries. In patients with acute coronary syndromes (ACS), TCFAs showed stronger proximal clustering in the left anterior descending, 2 clustering peaks in the right coronary artery, and 1 clustering peak in the circumflex artery. The pattern of TCFA distribution was less obvious in patients without ACS. The prevalence of TCFA was higher in the highest %AS tertile, compared with the lowest %AS tertile (30% vs. 9%; p < 0.001). CONCLUSIONS The present 3-vessel OCT study showed that TCFAs cluster at specific locations in the epicardial coronary arteries, especially in patients with ACS. TCFA was more prevalent in segments with tight stenosis. (The Massachusetts General Hospital Optical Coherence Tomography Registry; NCT01110538).
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Affiliation(s)
- Makoto Araki
- Cardiology Division, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
| | - Tsunenari Soeda
- Department of Cardiovascular Medicine, Nara Medical University, Kashihara, Nara, Japan.
| | - Hyung Oh Kim
- Cardiology Division, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
| | - Vikas Thondapu
- Cardiology Division, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
| | - Michele Russo
- Cardiology Division, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
| | - Osamu Kurihara
- Cardiology Division, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
| | - Hiroki Shinohara
- Cardiology Division, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
| | - Yoshiyasu Minami
- Department of Cardiovascular Medicine, Kitasato University School of Medicine, Sagamihara, Kanagawa, Japan
| | - Takumi Higuma
- Division of Cardiology, Department of Internal Medicine, St. Marianna University School of Medicine, Kanagawa, Japan
| | - Hang Lee
- Biostatistics Center, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
| | - Taishi Yonetsu
- Department of Interventional Cardiology, Tokyo Medical and Dental University, Tokyo, Japan
| | - Tsunekazu Kakuta
- Department of Cardiology, Tsuchiura Kyodo General Hospital, Tsuchiura, Ibaraki, Japan
| | - Ik-Kyung Jang
- Cardiology Division, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts; Division of Cardiology, Kyung Hee University Hospital, Seoul, South Korea.
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The Effectiveness of Neutrophil-Lymphocyte Ratio in Predicting in-Hospital Mortality in Non-ST-Elevation Myocardial Infarction. Emerg Med Int 2020; 2020:8718304. [PMID: 32211208 PMCID: PMC7085368 DOI: 10.1155/2020/8718304] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2019] [Revised: 01/27/2020] [Accepted: 02/04/2020] [Indexed: 01/31/2023] Open
Abstract
Background Myocardial infarction is the most common cause of death all over the world. There are many studies in predicting mortality. The aim of this study was to determine the effectiveness of hematologic parameters measured at the moment of admission to the emergency room in predicting in-hospital mortality and to determine cutoff values of strongly predictive values. Methods A total of 681 patients over 18 years of age, whose date could be obtained, were included in the study. From the hemogram parameters, white blood cells (WBC), red cell distribution width (RDW), mean platelet volume (MPV), and neutrophils-to-lymphocytes ratio (NLR) values were determined and recorded. CK-MB and high-sensitive troponin T values were recorded as cardiac markers. For statistical analysis, “SPSS for Windows version 21” package program was used. Results 62.6% (n = 426) of the patients were male, and 37.4% (n = 426) of the patients were male, and 37.4% ( Conclusion According to the hemogram results which were acquired with a simple and cheap method, we found that WBC and especially NLR values obtained with a simple method can be used as powerful predictors.
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Zgheib H, Al Souky N, El Majzoub I, Wakil C, Sweidan K, Kaddoura R, Al Hariri M, Chebel RB. Comparison of outcomes in ST-elevation myocardial infarction according to age. Am J Emerg Med 2020; 38:485-490. [DOI: 10.1016/j.ajem.2019.05.023] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2019] [Revised: 05/03/2019] [Accepted: 05/09/2019] [Indexed: 01/23/2023] Open
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Hajhosseiny R, Bahaei TS, Prieto C, Botnar RM. Molecular and Nonmolecular Magnetic Resonance Coronary and Carotid Imaging. Arterioscler Thromb Vasc Biol 2020; 39:569-582. [PMID: 30760017 DOI: 10.1161/atvbaha.118.311754] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Atherosclerosis is the leading cause of cardiovascular morbidity and mortality. Over the past 2 decades, increasing research attention is converging on the early detection and monitoring of atherosclerotic plaque. Among several invasive and noninvasive imaging modalities, magnetic resonance imaging (MRI) is emerging as a promising option. Advantages include its versatility, excellent soft tissue contrast for plaque characterization and lack of ionizing radiation. In this review, we will explore the recent advances in multicontrast and multiparametric imaging sequences that are bringing the aspiration of simultaneous arterial lumen, vessel wall, and plaque characterization closer to clinical feasibility. We also discuss the latest advances in molecular magnetic resonance and multimodal atherosclerosis imaging.
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Affiliation(s)
- Reza Hajhosseiny
- From the School of Biomedical Engineering and Imaging Sciences, King's College London, United Kingdom (R.H., T.S.B., C.P., R.M.B.).,National Heart and Lung Institute, Imperial College London, United Kingdom (R.H.)
| | - Tamanna S Bahaei
- From the School of Biomedical Engineering and Imaging Sciences, King's College London, United Kingdom (R.H., T.S.B., C.P., R.M.B.)
| | - Claudia Prieto
- From the School of Biomedical Engineering and Imaging Sciences, King's College London, United Kingdom (R.H., T.S.B., C.P., R.M.B.).,Escuela de Ingeniería, Pontificia Universidad Catolica de Chile, Santiago, Chile (C.P., R.M.B.)
| | - René M Botnar
- From the School of Biomedical Engineering and Imaging Sciences, King's College London, United Kingdom (R.H., T.S.B., C.P., R.M.B.).,Escuela de Ingeniería, Pontificia Universidad Catolica de Chile, Santiago, Chile (C.P., R.M.B.)
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Computational analysis of the coronary artery hemodynamics with different anatomical variations. INFORMATICS IN MEDICINE UNLOCKED 2020. [DOI: 10.1016/j.imu.2020.100314] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
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Association of QRS Complex Fragmentation with QT Interval Prolongation in Patients with Ischemic Heart Disease. CURRENT HEALTH SCIENCES JOURNAL 2019; 45:398-404. [PMID: 32110442 PMCID: PMC7014980 DOI: 10.12865/chsj.45.04.08] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/22/2019] [Accepted: 12/26/2019] [Indexed: 01/14/2023]
Abstract
Background: The fragmented QRS complex (FQRS) was found to be associated to malignant ventricular arrhythmias and sudden death in patients with hypertrophic cardiomyopathy and other entities. There is scant data available correlating the presence of FQRS with QT interval prolongation in patients with ischemic heart disease (IHD). Methods: A descriptive, retrospective, cross-sectional study was performed in 123 patients with IHD to analyze and correlate the presence of FQRS with QT interval prolongation in the conventional 12-leads electrocardiogram in patients with documented chronic IHD. Results: There were 62% male patients. The mean age was 63.8±12.6 years. Thirty six (44%) patients had fragmented QRS (64% men and 36% women). The duration of QT and QTc, the mean values were 413±59ms, and 463±67ms, respectively. Of the 36 patients with FQRS, 23 patients have prolongation of the QTc interval, and 13 patients did not present it. Of the 45 patients without FQRS, 21 of them have prolongation of the QTc interval, and 24 patients did not have it. These data resulted in a sensitivity of 52% with a moderate SnNout, a specificity of 65% with moderate SpPin, a positive predictive accuracy of 64%, a negative predictive accuracy of 53%. These data resulted in a prevalence of 54%. Conclusion: the presence of FQRS in the ECG has a moderate sensitivity and specificity, as well as, moderate negative and positive predictive value of the existence of QT interval prolongation in patients with ischemic heart disease.
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Kamangar S, Salman Ahmed N, Badruddin IA, Al-Rawahi N, Husain A, Govindaraju K, Yunus Khan T. Effect of stenosis on hemodynamics in left coronary artery based on patient-specific CT scan. Biomed Mater Eng 2019; 30:463-473. [DOI: 10.3233/bme-191067] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Kinoshita M, Yokote K, Arai H, Iida M, Ishigaki Y, Ishibashi S, Umemoto S, Egusa G, Ohmura H, Okamura T, Kihara S, Koba S, Saito I, Shoji T, Daida H, Tsukamoto K, Deguchi J, Dohi S, Dobashi K, Hamaguchi H, Hara M, Hiro T, Biro S, Fujioka Y, Maruyama C, Miyamoto Y, Murakami Y, Yokode M, Yoshida H, Rakugi H, Wakatsuki A, Yamashita S. Japan Atherosclerosis Society (JAS) Guidelines for Prevention of Atherosclerotic Cardiovascular Diseases 2017. J Atheroscler Thromb 2018; 25:846-984. [PMID: 30135334 PMCID: PMC6143773 DOI: 10.5551/jat.gl2017] [Citation(s) in RCA: 497] [Impact Index Per Article: 82.8] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2018] [Accepted: 06/11/2018] [Indexed: 11/30/2022] Open
Affiliation(s)
| | - Koutaro Yokote
- Department of Diabetes, Metabolism and Endocrinology, Chiba University Graduate School of Medicine, Chiba, Japan
| | - Hidenori Arai
- National Center for Geriatrics and Gerontology, Aichi, Japan
| | - Mami Iida
- Department of Internal Medicine and Cardiology, Gifu Prefectural General Medical Center, Gifu, Japan
| | - Yasushi Ishigaki
- Division of Diabetes and Metabolism, Department of Internal Medicine, Iwate Medical University, Iwate, Japan
| | - Shun Ishibashi
- Division of Endocrinology and Metabolism, Department of Medicine, Jichi Medical University, Tochigi, Japan
| | - Seiji Umemoto
- Center for Integrated Medical Research, Hiroshima University Hospital, Hiroshima, Japan
| | | | - Hirotoshi Ohmura
- Department of Cardiovascular Medicine, Juntendo University, Tokyo, Japan
| | - Tomonori Okamura
- Preventive Medicine and Public Health, Keio University School of Medicine, Tokyo, Japan
| | - Shinji Kihara
- Biomedical Informatics, Osaka University, Osaka, Japan
| | - Shinji Koba
- Division of Cardiology, Department of Medicine, Showa University School of Medicine, Tokyo, Japan
| | - Isao Saito
- Department of Community Health Systems Nursing, Ehime University Graduate School of Medicine, Ehime, Japan
| | - Tetsuo Shoji
- Department of Vascular Medicine, Osaka City University Graduate School of Medicine, Osaka, Japan
| | - Hiroyuki Daida
- Department of Cardiovascular Medicine, Juntendo University, Tokyo, Japan
| | - Kazuhisa Tsukamoto
- Department of Internal Medicine, Teikyo University School of Medicine, Tokyo, Japan
| | - Juno Deguchi
- Department of Vascular Surgery, Saitama Medical Center, Saitama, Japan
| | - Seitaro Dohi
- Chief Health Management Department, Mitsui Chemicals Inc., Tokyo, Japan
| | - Kazushige Dobashi
- Department of Pediatrics, Showa University School of Medicine, Tokyo, Japan
| | | | - Masumi Hara
- Department of Internal Medicine, Mizonokuchi Hospital, Teikyo University School of Medicine, Kanagawa, Japan
| | - Takafumi Hiro
- Division of Cardiology, Department of Medicine, Nihon University School of Medicine, Tokyo, Japan
| | | | - Yoshio Fujioka
- Faculty of Nutrition, Division of Clinical Nutrition, Kobe Gakuin University, Hyogo, Japan
| | - Chizuko Maruyama
- Department of Food and Nutrition, Faculty of Human Sciences and Design, Japan Women's University, Tokyo, Japan
| | - Yoshihiro Miyamoto
- Department of Preventive Cardiology, National Cerebral and Cardiovascular Center, Osaka, Japan
| | | | - Masayuki Yokode
- Department of Clinical Innovative Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Hiroshi Yoshida
- Department of Laboratory Medicine, Jikei University Kashiwa Hospital, Chiba, Japan
| | - Hiromi Rakugi
- Department of Geriatric and General Medicine, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Akihiko Wakatsuki
- Department of Obstetrics and Gynecology, Aichi Medical University, Aichi, Japan
| | - Shizuya Yamashita
- Department of Community Medicine, Department of Cardiovascular Medicine, Osaka University Graduate School of Medicine, Osaka, Japan
- Rinku General Medical Center, Osaka, Japan
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Liu W, Xie Y, Wang C, Du Y, Nguyen C, Wang Z, Fan Z, Dong L, Liu Y, Bi X, An J, Gu C, Yu W, Li D. Atherosclerosis T1-weighted characterization (CATCH): evaluation of the accuracy for identifying intraplaque hemorrhage with histological validation in carotid and coronary artery specimens. J Cardiovasc Magn Reson 2018; 20:27. [PMID: 29695254 PMCID: PMC5918570 DOI: 10.1186/s12968-018-0447-x] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2017] [Accepted: 03/20/2018] [Indexed: 01/16/2023] Open
Abstract
BACKGROUND Coronary high intensity plaques (CHIPs) detected using cardiovascular magnetic resonance (CMR) coronary atherosclerosis T1-weighted characterization with integrated anatomical reference (CATCH) have been shown to be positively associated with high-risk morphology observed on intracoronary optical coherence tomography (OCT). This study sought to validate whether CHIPs detected on CATCH indicate the presence of intraplaque hemorrhage (IPH) through ex vivo imaging of carotid and coronary plaque specimens, with histopathology as the standard reference. METHODS Ten patients scheduled to undergo carotid endarterectomy underwent CMR with the conventional T1-weighted (T1w) sequence. Eleven carotid atherosclerotic plaques removed at carotid endarterectomy and six coronary artery endarterectomy specimens removed from patients undergoing coronary artery bypass grafting (CABG) were scanned ex vivo using both the conventional T1w sequence and CATCH. Both in vivo and ex vivo images were examined for the presence of IPH. The sensitivity, specificity, and Cohen Kappa (k) value of each scan were calculated using matched histological sections as the reference. k value between each scan in the discrimination of IPH was also computed. RESULTS A total of 236 in vivo locations, 328 ex vivo and matching histology locations were included for the analysis. Sensitivity, specificity, and k value were 76.7%, 95.3%, and 0.75 for in vivo T1w imaging, 77.2%, 97.4%, and 0.78 for ex vivo T1w imaging, and 95.0%, 92.1%, and 0.84 for ex vivo CATCH, respectively. Moderate agreement was reached between in vivo T1w imaging, ex vivo T1w imaging, and ex vivo CATCH for the detection of IPH: between in vivo T1w imaging and ex vivo CATCH (k = 0.68), between ex vivo T1w imaging and ex vivo CATCH (k = 0.74), between in vivo T1w imaging and ex vivo T1w imaging (k = 0.83). None of the coronary artery plaque locations showed IPH. CONCLUSION This study demonstrated that carotid CHIPs detected by CATCH can be used to assess for IPH, a high-risk plaque feature.
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Affiliation(s)
- Wen Liu
- Department of Radiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
| | - Yibin Xie
- Biomedical Imaging Research Institute, Cedars-Sinai Medical Center, Los Angeles, CA USA
| | - Chuan Wang
- Department of Cardiac Surgery, Anzhen Hospital, Capital Medical University, Beijing, China
| | - Yanni Du
- Department of Radiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
| | - Christopher Nguyen
- Cardiovascular Research Center, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA USA
| | - Zhenjia Wang
- Department of Radiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
| | - Zhaoyang Fan
- Biomedical Imaging Research Institute, Cedars-Sinai Medical Center, Los Angeles, CA USA
| | - Li Dong
- Department of Radiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
| | - Yi Liu
- Department of Radiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
| | - Xiaoming Bi
- MR R&D, Siemens Healthineers, Los Angeles, CA USA
| | - Jing An
- MR Collaborations NE Asia, Siemens Healthcare, Beijing, China
| | - Chengxiong Gu
- Department of Cardiac Surgery, Anzhen Hospital, Capital Medical University, Beijing, China
| | - Wei Yu
- Department of Radiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
| | - Debiao Li
- Biomedical Imaging Research Institute, Cedars-Sinai Medical Center, Los Angeles, CA USA
- Departments of Medicine and Bioengineering, University of California, Los Angeles, CA USA
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Lee JH, Han D, Hartaigh BÓ, Gransar H, Lu Y, Rizvi A, Park MW, Roudsari HM, Stuijfzand WJ, Berman DS, Callister TQ, DeLago A, Hadamitzky M, Hausleiter J, Al-Mallah MH, Budoff MJ, Kaufmann PA, Raff G, Chinnaiyan K, Cademartiri F, Maffei E, Villines TC, Kim YJ, Leipsic J, Feuchtner G, Pontone G, Andreini D, Marques H, Rubinshtein R, Achenbach S, Shaw LJ, Chang HJ, Bax J, Chow B, Cury RC, Gomez M, Jones EC, Lin FY, Min JK, Peña JM. Influence of symptom typicality for predicting MACE in patients without obstructive coronary artery disease: From the CONFIRM Registry (Coronary Computed Tomography Angiography Evaluation for Clinical Outcomes: An International Multicenter Registry). Clin Cardiol 2018. [PMID: 29521447 DOI: 10.1002/clc.22940] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Our objective was to assess the prognostic value of symptom typicality in patients without obstructive coronary artery disease (CAD), determined by coronary computed tomographic angiography (CCTA). We identified 4215 patients without prior history of CAD and without obstructive CAD (<50% CCTA stenosis). CAD severity was categorized as nonobstructive (1%-49%) and none (0%). Based upon the Diamond-Forrester criteria for angina pectoris, symptom typicality was classified as asymptomatic, nonanginal, atypical, and typical. Multivariable Cox proportional hazards models were used to assess the risk of major adverse cardiac events (MACE), comprising all-cause mortality, myocardial infarction, unstable angina, and late revascularization, according to symptom typicality. Mean patient age was 57.0 ±12.0 years (54.9% male). During a median follow-up of 5.3 years (interquartile range, 4.6-5.9 years), MACE were reported in 312 (7.4%) patients. Among patients with nonobstructive CAD, there was an association between symptom typicality and MACE (P for interaction = 0.05), driven by increased risk of MACE among those with typical angina and nonobstructive CAD (hazard ratio: 1.62, 95% confidence interval: 1.06-2.48, P = 0.03). No consistent relationship was found between symptom typicality and MACE among patients without any CAD (hazard ratio: 0.73, 95% confidence interval: 0.34-1.57, P = 0.08). In the CONFIRM registry, patients who presented with concomitant typical angina and nonobstructive CAD had a higher rate of MACE than did asymptomatic patients with nonobstructive CAD. However, the presence of typical angina did not appear to portend worse prognosis in patients with no CAD.
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Affiliation(s)
- Ji Hyun Lee
- Dalio Institute of Cardiovascular Imaging, Department of Radiology, New York-Presbyterian Hospital and Weill Cornell Medicine, New York, New York.,Division of Cardiology, Severance Cardiovascular Hospital and Severance Biomedical Science Institute, Yonsei University College of Medicine, Yonsei University Health System, Seoul, South Korea.,Division of Cardiology, Department of Internal Medicine, Myongji Hospital, Goyang-si, South Korea
| | - Donghee Han
- Dalio Institute of Cardiovascular Imaging, Department of Radiology, New York-Presbyterian Hospital and Weill Cornell Medicine, New York, New York.,Division of Cardiology, Severance Cardiovascular Hospital and Severance Biomedical Science Institute, Yonsei University College of Medicine, Yonsei University Health System, Seoul, South Korea
| | - Bríain Ó Hartaigh
- Dalio Institute of Cardiovascular Imaging, Department of Radiology, New York-Presbyterian Hospital and Weill Cornell Medicine, New York, New York
| | - Heidi Gransar
- Division of Cardiology, Department of Internal Medicine, Myongji Hospital, Goyang-si, South Korea
| | - Yao Lu
- Dalio Institute of Cardiovascular Imaging, Department of Radiology, New York-Presbyterian Hospital and Weill Cornell Medicine, New York, New York
| | - Asim Rizvi
- Dalio Institute of Cardiovascular Imaging, Department of Radiology, New York-Presbyterian Hospital and Weill Cornell Medicine, New York, New York
| | - Mahn Won Park
- Dalio Institute of Cardiovascular Imaging, Department of Radiology, New York-Presbyterian Hospital and Weill Cornell Medicine, New York, New York
| | - Hadi Mirhedayati Roudsari
- Dalio Institute of Cardiovascular Imaging, Department of Radiology, New York-Presbyterian Hospital and Weill Cornell Medicine, New York, New York
| | - Wijnand J Stuijfzand
- Dalio Institute of Cardiovascular Imaging, Department of Radiology, New York-Presbyterian Hospital and Weill Cornell Medicine, New York, New York
| | - Daniel S Berman
- Department of Imaging, Cedars-Sinai Medical Center, Los Angeles, California
| | | | | | - Martin Hadamitzky
- Department of Radiology and Nuclear Medicine, German Heart Center Munich, Munich, Germany
| | - Joerg Hausleiter
- Medizinische Klinik I der Ludwig-Maximilians-Universität München, Munich, Germany
| | - Mouaz H Al-Mallah
- King Saud bin Abdulaziz University of Health Sciences, King Abdullah International Medical Research Center, King Abdulaziz Cardiac Center, Ministry of National Guard, Health Affairs, Riyadh, Saudi Arabia
| | - Matthew J Budoff
- Department of Medicine, Harbor-UCLA Medical Center, Los Angeles, California
| | - Philipp A Kaufmann
- Department of Nuclear Medicine, Cardiac Imaging, University Hospital, Zurich, University of Zurich, Switzerland
| | | | | | - Filippo Cademartiri
- Cardiovascular Imaging Center, Department of Radiology, SDN IRCCS Naples, Italy
| | - Erica Maffei
- Department of Radiology, Area Vasta 1/ASUR Marche, Urbino, Italy
| | - Todd C Villines
- Department of Medicine, Walter Reed Medical Center, Washington, D.C
| | - Yong-Jin Kim
- Cardiovascular Center and Internal Medicine, Seoul National University Hospital, Seoul, South Korea
| | - Jonathon Leipsic
- Department of Medicine and Radiology, University of British Columbia, Vancouver, Canada
| | - Gudrun Feuchtner
- Department of Radiology, Medical University of Innsbruck, Innsbruck, Austria
| | - Gianluca Pontone
- Department of Clinical Sciences and Community Health, University of Milan, Centro Cardiologico Monzino, IRCCS, Milan, Italy
| | - Daniele Andreini
- Department of Clinical Sciences and Community Health, University of Milan, Centro Cardiologico Monzino, IRCCS, Milan, Italy
| | - Hugo Marques
- UNICA, Cardiac CT and MRI Unit, Hospital da Luz, Lisbon, Portugal
| | - Ronen Rubinshtein
- Department of Cardiology at the Lady Davis Carmel Medical Center, The Ruth and Bruce Rappaport School of Medicine, Technion-Israel Institute of Technology, Haifa, Israel
| | | | - Leslee J Shaw
- Division of Cardiology, Emory University School of Medicine, Atlanta, Georgia
| | - Hyuk-Jae Chang
- Division of Cardiology, Severance Cardiovascular Hospital and Severance Biomedical Science Institute, Yonsei University College of Medicine, Yonsei University Health System, Seoul, South Korea
| | - Jeroen Bax
- Department of Cardiology, Leiden University Medical Center, HARTS, Leiden, The Netherlands
| | - Benjamin Chow
- Department of Medicine and Radiology, University of Ottawa, Ontario, Canada
| | | | - Millie Gomez
- Dalio Institute of Cardiovascular Imaging, Department of Radiology, New York-Presbyterian Hospital and Weill Cornell Medicine, New York, New York
| | - Erica C Jones
- Dalio Institute of Cardiovascular Imaging, Department of Radiology, New York-Presbyterian Hospital and Weill Cornell Medicine, New York, New York
| | - Fay Y Lin
- Dalio Institute of Cardiovascular Imaging, Department of Radiology, New York-Presbyterian Hospital and Weill Cornell Medicine, New York, New York
| | - James K Min
- Dalio Institute of Cardiovascular Imaging, Department of Radiology, New York-Presbyterian Hospital and Weill Cornell Medicine, New York, New York
| | - Jessica M Peña
- Dalio Institute of Cardiovascular Imaging, Department of Radiology, New York-Presbyterian Hospital and Weill Cornell Medicine, New York, New York
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Kanshana JS, Rebello SC, Pathak P, Kanuri BN, Aggarwal H, Srivastava V, Khanna V, Singh V, Jagavelu K, Barthwal MK, Dikshit M. Standardized fraction of Xylocarpus moluccensis fruits improve vascular relaxation and plaque stability in dyslipidemic models of atherosclerosis. JOURNAL OF ETHNOPHARMACOLOGY 2018; 213:81-91. [PMID: 29129602 DOI: 10.1016/j.jep.2017.11.004] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/19/2017] [Revised: 10/05/2017] [Accepted: 11/04/2017] [Indexed: 06/07/2023]
Abstract
ETHNOPHARMACOLOGICAL RELEVANCE Xylocarpus moluccensis (Lamk.) M. Roem of family Meliaceae has triterpenoids rich fruits. Triterpenoids have been known to possess cardioprotection and anti-atherosclerotic activities (Han and Bakovic, 2015; Wu et al., 2009). Standardized fraction of these fruits exhibited anti-dyslipidemic (Srivastava et al., 2015), anti-inflammatory (Ravangpai et al., 2011) and CNS depressant activity (Sarker et al., 2007). However, there is no report in the literature on its cardiovascular effects. AIM OF THE STUDY The present study was undertaken to assess vasoprotective, anti-atherosclerotic and further examine the anti-dyslipidemic effect of the standardized fraction of Xylocarpus moluccensis (F018) fruits in the mechanical injury and high fat diet (HFD) induced dyslipidemic/ atherosclerosis models. MATERIALS AND METHODS Guinea pigs were fed 0.08% cholesterol + 15% fat diet for 3 weeks, while ApoE KO mice were fed high fat diet for 18 weeks to induce dyslipidemia and atherosclerosis. A combination of balloon injury and high fat diet (1% cholesterol, 6% peanut oil) for 5 weeks was used to accelerate atherosclerosis in NZW rabbits. F018 was administered once daily by oral route in guinea pigs (10, 25 or 50mg/kg/day for 3 weeks), ApoE KO mice (50mg/kg/day for 6 weeks) and in NZW rabbit (25mg/kg/day for 5 weeks) to monitor its effect on dyslipidemia, vasoreactivity and plaque composition by using standard methodologies. RESULTS F018 treatment in guinea pigs (25 and 50mg/kg/day), ApoE mice (50mg/kg/day) and rabbits (25mg/kg/day) significantly reduced plasma lipids and improved ACh induced vasorelaxation. Anti-dyslipidemic effect of F018 seems to be due to the modulation of enterohepatic genes involved in the cholesterol absorption and excretion. Moreover, significant improvement in the acetylcholine (ACh) induced vasorelaxation was accompanied with reduced inflammatory burden and enhanced activation of eNOS in ApoE mice aortic tissue. Similarly inflammatory cytokines, immunolabeling of macrophage marker (CD68) and MMP-9 were reduced along with augmentation in vascular smooth muscle cells and collagen type I and III in the mechanically injured iliac artery segment in the rabbits. CONCLUSIONS Altogether, F018 preserved vasoreactivity, reduced atherosclerotic plaque progression and enhanced plaque stability by reducing lipids, inflammatory cytokines, improving endothelial function and collagen content.
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Affiliation(s)
- Jitendra S Kanshana
- Pharmacology Division, CSIR-Central Drug Research Institute, Lucknow 226031, India
| | - Sanjay C Rebello
- Pharmacology Division, CSIR-Central Drug Research Institute, Lucknow 226031, India
| | - Priya Pathak
- Pharmacology Division, CSIR-Central Drug Research Institute, Lucknow 226031, India
| | | | - Hobby Aggarwal
- Pharmacology Division, CSIR-Central Drug Research Institute, Lucknow 226031, India
| | | | - Vivek Khanna
- Pharmacology Division, CSIR-Central Drug Research Institute, Lucknow 226031, India
| | - Vishal Singh
- Pharmacology Division, CSIR-Central Drug Research Institute, Lucknow 226031, India
| | - Kumaravelu Jagavelu
- Pharmacology Division, CSIR-Central Drug Research Institute, Lucknow 226031, India
| | - Manoj K Barthwal
- Pharmacology Division, CSIR-Central Drug Research Institute, Lucknow 226031, India
| | - Madhu Dikshit
- Pharmacology Division, CSIR-Central Drug Research Institute, Lucknow 226031, India.
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Biondi-Zoccai G, Mastrangeli S, Romagnoli E, Peruzzi M, Frati G, Roever L, Giordano A. What We Have Learned from the Recent Meta-analyses on Diagnostic Methods for Atherosclerotic Plaque Regression. Curr Atheroscler Rep 2018; 20:2. [PMID: 29344739 DOI: 10.1007/s11883-018-0709-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
PURPOSE OF REVIEW Atherosclerosis has major morbidity and mortality implications globally. While it has often been considered an irreversible degenerative process, recent evidence provides compelling proof that atherosclerosis can be reversed. Plaque regression is however difficult to appraise and quantify, with competing diagnostic methods available. Given the potential of evidence synthesis to provide clinical guidance, we aimed to review recent meta-analyses on diagnostic methods for atherosclerotic plaque regression. RECENT FINDINGS We identified 8 meta-analyses published between 2015 and 2017, including 79 studies and 14,442 patients, followed for a median of 12 months. They reported on atherosclerotic plaque regression appraised with carotid duplex ultrasound, coronary computed tomography, carotid magnetic resonance, coronary intravascular ultrasound, and coronary optical coherence tomography. Overall, all meta-analyses showed significant atherosclerotic plaque regression with lipid-lowering therapy, with the most notable effects on echogenicity, lipid-rich necrotic core volume, wall/plaque volume, dense calcium volume, and fibrous cap thickness. Significant interactions were found with concomitant changes in low density lipoprotein cholesterol, high density lipoprotein cholesterol, and C-reactive protein levels, and with ethnicity. Atherosclerotic plaque regression and conversion to a stable phenotype is possible with intensive medical therapy and can be demonstrated in patients using a variety of non-invasive and invasive imaging modalities.
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Affiliation(s)
- Giuseppe Biondi-Zoccai
- Department of Medico-Surgical Sciences and Biotechnologies, Sapienza University of Rome, Corso della Repubblica 79, 04100, Latina, Italy.
- Department of AngioCardioNeurology, IRCCS Neuromed, Pozzilli, Italy.
| | - Simona Mastrangeli
- Department of Medico-Surgical Sciences and Biotechnologies, Sapienza University of Rome, Corso della Repubblica 79, 04100, Latina, Italy
| | | | - Mariangela Peruzzi
- Department of Medico-Surgical Sciences and Biotechnologies, Sapienza University of Rome, Corso della Repubblica 79, 04100, Latina, Italy
| | - Giacomo Frati
- Department of Medico-Surgical Sciences and Biotechnologies, Sapienza University of Rome, Corso della Repubblica 79, 04100, Latina, Italy
- Department of AngioCardioNeurology, IRCCS Neuromed, Pozzilli, Italy
| | - Leonardo Roever
- Department of Clinical Research, Federal University of Uberlândia, Uberlândia, Brazil
| | - Arturo Giordano
- Unità Operativa di Interventistica Cardiovascolare, Presidio Ospedaliero Pineta Grande, Castel Volturno, Italy
- Unità Operativa di Emodinamica, Casa di Salute Santa Lucia, San Giuseppe Vesuviano, Italy
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37
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Kim HJ, Noh JS, Song YO. Beneficial Effects of Kimchi, a Korean Fermented Vegetable Food, on Pathophysiological Factors Related to Atherosclerosis. J Med Food 2017; 21:127-135. [PMID: 29271694 DOI: 10.1089/jmf.2017.3946] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
Atherosclerosis is a progressive disease that is characterized by accumulation of lipids and fibrous elements in large arteries. Its etiology is involved with pathophysiological factors such as lipoprotein oxidation, inflammation, and dyslipidemia. Kimchi is a Korean fermented vegetable side dish made with vegetables and kimchi condiments. To date, numerous in vitro, in vivo, and human studies have cited the health benefits of kimchi. 3-(4'-Hydroxyl-3',5'-dimethoxyphenyl)propionic acid is one of the active compounds of kimchi, and its antioxidant and anti-atherosclerosclerotic effects have been reported. This review presents the laboratory and clinical evidence of the anti-atherosclerotic effects of kimchi based on its lipid-lowering, antioxidant, and anti-inflammatory activities.
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Affiliation(s)
- Hyun Ju Kim
- 1 Industrial Technology Research Group, Research and Development Division, World Institute of Kimchi , Gwangju, Korea
| | - Jeong Sook Noh
- 2 Department of Food Science and Nutrition, Tongmyong University , Busan, Korea
| | - Yeong Ok Song
- 3 Department of Food Science and Nutrition, Kimchi Research Institute, Pusan National University , Busan, Korea
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38
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Leite JO, Costa LO, Fonseca WM, Souza DU, Goncalves BC, Gomes GB, Cruz LA, Nister N, Navarro TP, Bath J, Dardik A. General outcomes and risk factors for minor and major amputations in Brazil. Vascular 2017; 26:291-300. [PMID: 29041830 DOI: 10.1177/1708538117736677] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Objectives Major and minor amputations are associated with significant rates of mortality. However, little is known about the impact of unplanned redo-amputation during the same hospitalization on outcomes. The objectives of this study were to identify the risk factors associated with in-hospital mortality after both major and minor amputations as well as the results of unplanned redo-amputation on outcome. Methods Retrospective study of 342 consecutive patients who were treated with lower extremity amputation in Brazil between January 2013 and October 2014. Results The in-hospital mortality rate was higher in major compared to minor amputation (25.6% vs. 4.1%; p < 0.0001). Whereas chronic kidney disease, chronic obstructive pulmonary disease, and planned staged amputation predicted in-hospital mortality after major amputation, age, and congestive heart failure predicted mortality after minor amputation. The white blood cell count predicted in-hospital mortality following both major and minor amputation. However, postoperative infection predicted in-hospital mortality only following major amputation. Conclusions In-hospital mortality was high after major amputations. Unplanned redo-amputation was not a predictor of in-hospital mortality after major or minor amputation. Planned staged amputation was associated with reduced survival after major but not minor amputation. Postoperative infection predicted mortality after major amputation. Systemic diseases and postoperative white blood cell were associated with in-hospital mortality. This study suggests a possible link between a pro-inflammatory state and increased in-hospital mortality following amputation.
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Affiliation(s)
- Jose O Leite
- 1 Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil.,2 Departamento de Cirurgia Vascular, Hospital Risoleta Tolentino Neves, Belo Horizonte, Brazil
| | - Leandro O Costa
- 1 Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil.,2 Departamento de Cirurgia Vascular, Hospital Risoleta Tolentino Neves, Belo Horizonte, Brazil
| | - Walter M Fonseca
- 1 Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil.,2 Departamento de Cirurgia Vascular, Hospital Risoleta Tolentino Neves, Belo Horizonte, Brazil
| | - Debora U Souza
- 2 Departamento de Cirurgia Vascular, Hospital Risoleta Tolentino Neves, Belo Horizonte, Brazil.,3 Faculdade de Fisioterapia, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Barbara C Goncalves
- 1 Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil.,2 Departamento de Cirurgia Vascular, Hospital Risoleta Tolentino Neves, Belo Horizonte, Brazil
| | - Gabriela B Gomes
- 1 Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil.,2 Departamento de Cirurgia Vascular, Hospital Risoleta Tolentino Neves, Belo Horizonte, Brazil
| | - Lucas A Cruz
- 1 Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil.,2 Departamento de Cirurgia Vascular, Hospital Risoleta Tolentino Neves, Belo Horizonte, Brazil
| | - Nilder Nister
- 1 Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil.,2 Departamento de Cirurgia Vascular, Hospital Risoleta Tolentino Neves, Belo Horizonte, Brazil
| | - Tulio P Navarro
- 1 Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil.,2 Departamento de Cirurgia Vascular, Hospital Risoleta Tolentino Neves, Belo Horizonte, Brazil
| | - Jonathan Bath
- 4 Department of Surgery, Division of Vascular Surgery, University of Cincinnati College of Medicine, Cincinnati, USA
| | - Alan Dardik
- 5 Department of Surgery, Division of Vascular Surgery, Yale School of Medicine, Yale University, New Haven, USA
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Ul Ain Q, Chung H, Chung JY, Choi JH, Kim YH. Amelioration of atherosclerotic inflammation and plaques via endothelial adrenoceptor-targeted eNOS gene delivery using redox-sensitive polymer bearing l-arginine. J Control Release 2017; 262:72-86. [PMID: 28710003 DOI: 10.1016/j.jconrel.2017.07.019] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2017] [Revised: 06/21/2017] [Accepted: 07/11/2017] [Indexed: 01/25/2023]
Abstract
Endothelial dysfunction combined with inflammation leads to atherosclerosis. Endothelium-specific delivery of therapeutic agents at the cellular level-specifically in vivo-is still a difficult task for proper management of atherosclerosis. We designed a redox-sensitive poly(oligo-l-arginine) (rsPOLA) playing dual roles as an endothelium α-2 adrenoceptors(α-2ARs)-targeted gene carrier and as a substrate for endothelial nitric oxide synthase (eNOS). Overexpression of α-2ARs on atherosclerotic endothelial cells was confirmed and the eNOS/rsPOLA nanoplexes following systemic injection demonstrated to 1) enhance eNOS gene delivery into endothelial cells via α-2ARs/l-arginine specific binding, 2) increase intracellular level of nitric oxide, 3) suppress inflammatory response in endothelium and finally 4) reduce atherosclerotic plaque in a Ldlr-/- atherosclerotic mouse model. Among the tested nanoplexes [eNOS/rsPOLA, eNOS/{poly(oligo-d-arginine), rsPODA} and eNOS/(racemic mixture, rsRM)], eNOS/rsPOLA reduced atherosclerotic inflammation most effectively as we hypothesized. Current treatment strategy provides strong potential for further development of a gene therapeutic system to ameliorate inflammation and progressive atherosclerotic plaques.
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Affiliation(s)
- Qurrat Ul Ain
- Department of Bioengineering, Institute for Bioengineering and Biopharmaceutical Research, Hanyang University, Seoul 04763, Republic of Korea
| | - Hyunji Chung
- Department of Life Science, College of Natural Sciences, Hanyang University, Seoul 04763, Republic of Korea
| | - Jee Young Chung
- Department of Bioengineering, Institute for Bioengineering and Biopharmaceutical Research, Hanyang University, Seoul 04763, Republic of Korea
| | - Jae-Hoon Choi
- Department of Life Science, College of Natural Sciences, Hanyang University, Seoul 04763, Republic of Korea
| | - Yong-Hee Kim
- Department of Bioengineering, Institute for Bioengineering and Biopharmaceutical Research, Hanyang University, Seoul 04763, Republic of Korea.
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Mamdani N, Tung B, Wang Y, Jaffer FA, Tawakol A. Imaging the Coronary Artery Plaque: Approaches, Advances, and Challenges. CURRENT CARDIOVASCULAR IMAGING REPORTS 2017. [DOI: 10.1007/s12410-017-9419-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
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Li S, Ning H, Ye Y, Wei W, Guo R, Song Q, Liu L, Liu Y, Na L, Niu Y, Chu X, Feng R, Moustaid-Moussa N, Li Y, Sun C. Increasing extracellular Ca 2+ sensitizes TNF-alpha-induced vascular cell adhesion molecule-1 (VCAM-1) via a TRPC1/ERK1/2/NFκB-dependent pathway in human vascular endothelial cells. BIOCHIMICA ET BIOPHYSICA ACTA-MOLECULAR CELL RESEARCH 2017; 1864:1566-1577. [PMID: 28583863 DOI: 10.1016/j.bbamcr.2017.06.001] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/05/2017] [Revised: 05/16/2017] [Accepted: 06/01/2017] [Indexed: 12/29/2022]
Abstract
Increasing circulating Ca2+ levels within the normal range has been reported to positively correlate with the incidence of fatal cardiovascular diseases (CVDs). However, limited studies have been able to delineate the potential mechanism(s) linking circulating Ca2+ to CVD. In this study, we exposed primary human umbilical vein endothelial cells (HUVECs) and human umbilical vein cell line (EA.hy926) to different extracellular Ca2+ to mimic the physiological state. Our data revealed that increasing extracellular Ca2+ significantly enhanced susceptibility to tumor necrosis factor (TNF)-alpha-stimulated vascular cell adhesion molecule (VCAM)-1 expression and monocytes adhesion. Knocking-down VCAM-1 by siRNA abolished calcium-induced monocytes adhesion on HUVECs. Follow up mechanistic investigations identified that extracellular Ca2+-increased calcium influx contributed to the activation of VCAM-1. This was mediated via upregulation of transient receptor potential channel (TRPC)1 in a nuclear factor (NF)κB-dependent manner. Most importantly, we found that a novel TRPC1-regulated extracellular signal-regulated kinase 1/2 (ERK1/2) pathway exclusively contributed to calcium-induced NFκB activation. This study provided direct evidence that increasing extracellular Ca2+ enhanced TNF-alpha-induced VCAM-1 activation and monocytes adhesion. Moreover, we identified a novel TRPC1/ERK1/2/NFκB signaling pathway mediating VCAM-1 activation and monocyte adhesion in this pathological process. Our studies indicate that blood calcium levels should be strictly monitored to help prevent CVD, and that TRPC1 might act as a potential target for the treatment and prevention against increased circulating calcium-enhanced CVDs.
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Affiliation(s)
- Songtao Li
- Department of Nutrition and Food Hygiene, Public Health College, Harbin Medical University, Harbin 150081, China; Research Institute of Food, Nutrition and Health, Sino-Russian Medical Research Center, Harbin Medical University, Harbin 150081, China; Key Laboratory of Cardiovascular Medicine Research, Harbin Medical University, Ministry of Education, 150081, China
| | - Hua Ning
- Department of Nutrition and Food Hygiene, Public Health College, Harbin Medical University, Harbin 150081, China; Research Institute of Food, Nutrition and Health, Sino-Russian Medical Research Center, Harbin Medical University, Harbin 150081, China
| | - Yaxin Ye
- Department of Nutrition and Food Hygiene, Public Health College, Harbin Medical University, Harbin 150081, China
| | - Wei Wei
- Department of Nutrition and Food Hygiene, Public Health College, Harbin Medical University, Harbin 150081, China
| | - Rui Guo
- Department of Nutrition and Food Hygiene, Public Health College, Harbin Medical University, Harbin 150081, China
| | - Qing Song
- Department of Nutrition and Food Hygiene, Public Health College, Harbin Medical University, Harbin 150081, China
| | - Lei Liu
- Department of Nutrition and Food Hygiene, Public Health College, Harbin Medical University, Harbin 150081, China
| | - Yunyun Liu
- Department of Nutrition and Food Hygiene, Public Health College, Harbin Medical University, Harbin 150081, China
| | - Lixin Na
- Department of Nutrition and Food Hygiene, Public Health College, Harbin Medical University, Harbin 150081, China; Research Institute of Food, Nutrition and Health, Sino-Russian Medical Research Center, Harbin Medical University, Harbin 150081, China
| | - Yuchun Niu
- Department of Nutrition and Food Hygiene, Public Health College, Harbin Medical University, Harbin 150081, China; Research Institute of Food, Nutrition and Health, Sino-Russian Medical Research Center, Harbin Medical University, Harbin 150081, China
| | - Xia Chu
- Department of Nutrition and Food Hygiene, Public Health College, Harbin Medical University, Harbin 150081, China; Research Institute of Food, Nutrition and Health, Sino-Russian Medical Research Center, Harbin Medical University, Harbin 150081, China
| | - Rennan Feng
- Department of Nutrition and Food Hygiene, Public Health College, Harbin Medical University, Harbin 150081, China; Research Institute of Food, Nutrition and Health, Sino-Russian Medical Research Center, Harbin Medical University, Harbin 150081, China
| | - Naima Moustaid-Moussa
- Department of Nutritional Sciences and Obesity Research Cluster, Texas Tech University, Lubbock, TX 79409, USA
| | - Ying Li
- Department of Nutrition and Food Hygiene, Public Health College, Harbin Medical University, Harbin 150081, China; Research Institute of Food, Nutrition and Health, Sino-Russian Medical Research Center, Harbin Medical University, Harbin 150081, China.
| | - Changhao Sun
- Department of Nutrition and Food Hygiene, Public Health College, Harbin Medical University, Harbin 150081, China; Research Institute of Food, Nutrition and Health, Sino-Russian Medical Research Center, Harbin Medical University, Harbin 150081, China.
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Ernst D, Weiberg D, Baerlecken NT, Schlumberger W, Daehnrich C, Schmidt RE, Bengel FM, Derlin T, Witte T. Anti-MYC-associated zinc finger protein antibodies are associated with inflammatory atherosclerotic lesions on 18 F-fluorodeoxyglucose positron emission tomography. Atherosclerosis 2017; 259:12-19. [DOI: 10.1016/j.atherosclerosis.2017.02.010] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2016] [Revised: 02/09/2017] [Accepted: 02/15/2017] [Indexed: 12/29/2022]
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Predictive prognostic value of neutrophil-lymphocytes ratio in acute coronary syndrome. Indian Heart J 2017; 69 Suppl 1:S46-S50. [PMID: 28400038 PMCID: PMC5388019 DOI: 10.1016/j.ihj.2017.01.020] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2016] [Revised: 12/19/2016] [Accepted: 01/31/2017] [Indexed: 12/18/2022] Open
Abstract
OBJECTIVE To assess the relationship between neutrophil-lymphocytes ratio (NLR) at admission and patient outcome over a period of six month in subjects with acute coronary syndrome (ACS). METHODS A total of 435 consecutive patients presenting with ACS were enrolled and 400 patients completed the study. Patients were categorized into 2 groups: the NLR group 1 (NLR≤5.25; n=265, 66.25%) and the NLR group 2 (NLR>5.25; n=135, 33.75%). The primary outcomes were in-hospital and 6 months mortality. RESULTS Forty-seven (11.8%) patients died during 6 months follow up. Higher mortality was seen in NLR group 2 (42/135, 34.1%) compared to NLR group 1 (5/265, 1.9%) with p value <0.001. CONCLUSION Our study suggest that elevated NLR (>5.25) is independently associated with higher all-cause mortality rate up to 6 months period irrespective of ACS type.
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Belcaro G, Cornelli U. Variations in Echogenicity in Carotid and Femoral Atherosclerotic Plaques with Pycnogenol + Centella Asiatica Supplementation. Int J Angiol 2016; 26:95-101. [PMID: 28566935 DOI: 10.1055/s-0036-1594292] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023] Open
Abstract
This registry study evaluated echogenicity of carotid-femoral plaques in asymptomatic subjects with increased oxidative stress and risk factors (mild hypertension, hypercholesterolemia). Supplementation with the combination Pycnogenol-CA (centella asiatica) on the echogenicity of plaques was assessed at 6 months (79 subjects). A standard management (SM) plan was used in all subjects (control of risk factors, lifestyle changes); 36 subjects used the supplements +SM; 43 SM only. The groups were comparable. High-resolution ultrasound evaluated echogenicity and plaque structure. Pycnogenol (150 mg/day) and CA (Centellicum, 450 mg/day) were used. At 6 months, cholesterol was reduced (p < 0.05) in both groups (difference between groups not significant). At 6 months, plasma free radicals were decreased with the supplements (17.64%; p < 0.05; vs <2% in controls). The plaque stability index increased from 11.22;2.3 to 22.4;1.1 (p < 0.05) with the supplements; no significant changes were seen in controls. Plaque echogenicity (% of "whiter" component in images) increased with supplementation from 16.7;1.7% to 34.2;2% (p < 0.05); no variations were observed in controls. The maximum plaque height decreased (p < 0.05) with the supplements. No significant variations were observed in controls. Plaque length was decreased (p < 0.05) in the supplement group with no changes in controls. The number of plaques (carotid, femoral bifurcations) decreased with supplementation; no significant changes were observed in controls. No adverse events, tolerability problems, or variations in routine blood tests were recorded. The combination Pycnogenol-CA appears to improve echogenicity and stability of complex plaques in 6 months.
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Affiliation(s)
- Gianni Belcaro
- Irvine Labs, Chieti-Pescara University, Spoltore, Pescara, Italy
| | - Umberto Cornelli
- Irvine Labs, Chieti-Pescara University, Spoltore, Pescara, Italy
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Kamangar S, Badruddin IA, Govindaraju K, Nik-Ghazali N, Badarudin A, Viswanathan GN, Ahmed NJS, Khan TMY. Patient-specific 3D hemodynamics modelling of left coronary artery under hyperemic conditions. Med Biol Eng Comput 2016; 55:1451-1461. [DOI: 10.1007/s11517-016-1604-8] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2016] [Accepted: 12/01/2016] [Indexed: 11/29/2022]
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46
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Hayat U, Thondapu V, Tsay T, Barlis P. Atherogenesis and Inflammation. Interv Cardiol 2016. [DOI: 10.1002/9781118983652.ch1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Affiliation(s)
- Umair Hayat
- Melbourne Medical School; The University of Melbourne; Australia
| | - Vikas Thondapu
- Melbourne Medical School; The University of Melbourne; Australia
| | - Tim Tsay
- Melbourne Medical School; The University of Melbourne; Australia
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Yang Y, Li J, Xu W, Dong S, Yu H, Song H, Chu Y. Thrombus aspirated from patients with ST-elevation myocardial infarction: Clinical and angiographic outcomes. J Int Med Res 2016; 44:1514-1523. [PMID: 27834302 PMCID: PMC5536757 DOI: 10.1177/0300060516667373] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
Objective To investigate differences in clinical and angiographic outcomes between patients with acute myocardial infarction with red and white thrombi. Methods A total of 137 patients with ST-segment elevation myocardial infarction undergoing primary percutaneous coronary interventions were included. Thrombus material was classified as white or red based on its pathology. Information on characteristics of thrombi was available for 97 (70.8%) patients. Results The total ischaemic time was significantly longer in the red thrombus group compared with the white thrombus group. The incidence of major adverse cardiovascular events in hospital was higher in the red thrombus group than in the white thrombus group (15.6% vs 0%). Multivariable logistic analysis showed that the total ischaemic time was the only predictor of thrombus composition (odds ratio 1.353; 95% confidence interval 1.003, 1.826). Conclusion Red thrombi were present in nearly two-thirds of cases, and were associated with a longer ischaemic time and higher incidence of major adverse cardiovascular events in hospital.
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Affiliation(s)
- Yapan Yang
- 1 Department of Cardiology, Zhengzhou University People's Hospital, Zhengzhou, China
| | - Jingchao Li
- 1 Department of Cardiology, Zhengzhou University People's Hospital, Zhengzhou, China
| | - Wenke Xu
- 2 Department of Emergency Center, Zhengzhou University People's Hospital, Zhengzhou, China
| | - Shujuan Dong
- 1 Department of Cardiology, Zhengzhou University People's Hospital, Zhengzhou, China
| | - Haijia Yu
- 2 Department of Emergency Center, Zhengzhou University People's Hospital, Zhengzhou, China
| | - Huihui Song
- 2 Department of Emergency Center, Zhengzhou University People's Hospital, Zhengzhou, China
| | - Yingjie Chu
- 1 Department of Cardiology, Zhengzhou University People's Hospital, Zhengzhou, China
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Garcia S, Alraies MC, Karatasakis A, Yannopoulos D, Karmpaliotis D, Alaswad K, Jaffer FA, Yeh RW, Patel MP, Bahadorani J, Karacsonyi J, Kalsaria P, Danek B, Banerjee S, Brilakis ES. Coronary artery spatial distribution of chronic total occlusions: Insights from a large US registry. Catheter Cardiovasc Interv 2016; 90:23-30. [PMID: 27860111 DOI: 10.1002/ccd.26844] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/10/2016] [Revised: 09/08/2016] [Accepted: 10/08/2016] [Indexed: 11/11/2022]
Abstract
OBJECTIVE To assess the spatial distribution of chronic total occlusions (CTOs) within the coronary arteries and describe procedural strategies and outcomes during CTO percutaneous coronary intervention (PCI). BACKGROUND Acute occlusions due to plaque rupture tend to cluster within the proximal third of the coronary artery. METHODS We examined the clinical and procedural characteristics of 1,348 patients according to lesion location within the coronary tree. RESULTS A total of 1,369 lesions in 1,348 patients (mean age 66 ± 10 years, 85% male) were included. CTO PCI of proximal segments (n = 633, 46%) was more common than of mid (n = 557, 41%) and distal segments (n = 179, 13%). Patients undergoing CTO PCI of proximal segments were more likely to be smokers (P < 0.01), have prior coronary artery bypass graft surgery (P = 0.03) and lower ejection fraction (P = 0.04). CTOs occurring in proximal segments had longer length (P <0.01), proximal cap ambiguity (P < 0.01), and moderate/severe calcification (P < 0.01) compared to mid or distally located CTOs. Interventional collaterals were more often present in CTO PCI of proximal segments (64%, 53%, 56%, P < 0.01) consistent with the higher use of retrograde approach (47%, 33%, 37%, P < 0.01) relative to antegrade wire escalation (67%, 82%, 82%, P < 0.01). Procedural complexity was higher in CTO PCI of proximal segments (vs. mid and distal): contrast volume= 275 ml (200-375), 260 ml (200-350), 250 ml (175-350), P = 0.01; fluoroscopy time 53 minutes (32-83), 39 minutes (24-65), 40 minutes (22-72), P < 0.01. However, procedural success (87%, 90%, 85%, P = 0.1), technical success (89%, 91%, 88%, P = 0.24), and complications rates (2.8%, 2.5%, 2.2%, P = 0.88) were not different. CONCLUSIONS The most common target vessel location for CTO PCI is the proximal coronary segment. PCI of proximal occlusions is associated with adverse clinical and angiographic characteristics and often requires use of the retrograde approach, but can be accomplished with high procedural and technical success and low complication rates. © 2016 Wiley Periodicals, Inc.
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Affiliation(s)
- Santiago Garcia
- Minneapolis VA Medical Center and University of Minnesota, Minneapolis, Minnesota
| | - M Chadi Alraies
- Minneapolis VA Medical Center and University of Minnesota, Minneapolis, Minnesota
| | - Aris Karatasakis
- VA North Texas Health Care System and University of Texas Southwestern Medical Center, Dallas, Texas
| | - Demetris Yannopoulos
- Minneapolis VA Medical Center and University of Minnesota, Minneapolis, Minnesota
| | | | - Khaldoon Alaswad
- Henry Ford Health System, Edith and Benson Ford Heart and Vascular Institute, Detroit, Michigan
| | | | - Robert W Yeh
- Massachusetts General Hospital, Boston, Massachusetts
| | | | | | - Judit Karacsonyi
- VA North Texas Health Care System and University of Texas Southwestern Medical Center, Dallas, Texas
| | - Pratik Kalsaria
- VA North Texas Health Care System and University of Texas Southwestern Medical Center, Dallas, Texas
| | - Barbara Danek
- VA North Texas Health Care System and University of Texas Southwestern Medical Center, Dallas, Texas
| | - Subhash Banerjee
- VA North Texas Health Care System and University of Texas Southwestern Medical Center, Dallas, Texas
| | - Emmanouil S Brilakis
- VA North Texas Health Care System and University of Texas Southwestern Medical Center, Dallas, Texas
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Arimura T, Saku K, Kakino T, Nishikawa T, Tohyama T, Sakamoto T, Sakamoto K, Kishi T, Ide T, Sunagawa K. Intravenous electrical vagal nerve stimulation prior to coronary reperfusion in a canine ischemia-reperfusion model markedly reduces infarct size and prevents subsequent heart failure. Int J Cardiol 2016; 227:704-710. [PMID: 27816306 DOI: 10.1016/j.ijcard.2016.10.074] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2016] [Revised: 10/26/2016] [Accepted: 10/27/2016] [Indexed: 12/13/2022]
Abstract
BACKGROUND Reducing myocardial damage is a prerequisite to prevent chronic heart failure after acute myocardial infarction (AMI). Although vagal nerve stimulation (VNS) has been repeatedly demonstrated to have potent anti-infarct effect, technical difficulties have precluded its clinical application. We developed a novel therapeutic strategy of intravenous VNS (iVNS) and examined whether iVNS administered prior to coronary reperfusion in a canine AMI model reduces infarct size and prevents heart failure. METHODS AND RESULTS In 35 mongrel dogs, we induced ischemia by ligating the left anterior descending coronary artery and then reperfused 3h later (I/R). We transvenously placed a catheter electrode in the superior vena cava and adjusted the stimulation intensity to a level that induced bradycardia but maintained stable hemodynamics (continuous, 5.1±2.1V, 10Hz). We administered iVNS from onset (iVNS-0, n=7) or 90min after onset (iVNS-90, n=7) of ischemia until one hour after reperfusion. Four weeks after ischemia-reperfusion, iVNS markedly reduced infarct size (iVNS-0: 2.4±2.1%, p<0.05 and iVNS-90: 4.5±4.5%, p<0.05) compared with I/R control (I/R: 13.3±2.5%), and improved cardiac performance and hemodynamics. Atrial pacing (n=7) to abolish iVNS-induced bradycardia significantly attenuated the beneficial effects of iVNS. CONCLUSIONS Short-term iVNS delivered prior to coronary reperfusion markedly reduced infarct size and preserved cardiac function one month after AMI. The bradycardic effect plays an important role in the beneficial effect of iVNS. How other mechanisms contribute to the reduction of infarct size remains to be studied.
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Affiliation(s)
- Takahiro Arimura
- Department of Cardiovascular Medicine, Graduate School of Medical Sciences, 1-1-3 Maidashi Higashi-ku, Fukuoka 812-8582, Japan.
| | - Keita Saku
- Department of Therapeutic Regulation of Cardiovascular Homeostasis, Center for Disruptive Cardiovascular Medicine, 1-1-3 Maidashi Higashi-ku, Fukuoka 812-8582, Japan.
| | - Takamori Kakino
- Department of Cardiovascular Medicine, Graduate School of Medical Sciences, 1-1-3 Maidashi Higashi-ku, Fukuoka 812-8582, Japan.
| | - Takuya Nishikawa
- Department of Cardiovascular Medicine, Graduate School of Medical Sciences, 1-1-3 Maidashi Higashi-ku, Fukuoka 812-8582, Japan.
| | - Takeshi Tohyama
- Department of Cardiovascular Medicine, Graduate School of Medical Sciences, 1-1-3 Maidashi Higashi-ku, Fukuoka 812-8582, Japan.
| | - Takafumi Sakamoto
- Department of Cardiovascular Medicine, Graduate School of Medical Sciences, 1-1-3 Maidashi Higashi-ku, Fukuoka 812-8582, Japan.
| | - Kazuo Sakamoto
- Department of Cardiovascular Medicine, Graduate School of Medical Sciences, 1-1-3 Maidashi Higashi-ku, Fukuoka 812-8582, Japan.
| | - Takuya Kishi
- Collaborative Research Institute of Innovative Therapeutics for Cardiovascular Diseases, Center for Disruptive Cardiovascular Medicine, Kyushu University, 1-1-3 Maidashi Higashi-ku, Fukuoka 812-8582, Japan.
| | - Tomomi Ide
- Department of Cardiovascular Medicine, Graduate School of Medical Sciences, 1-1-3 Maidashi Higashi-ku, Fukuoka 812-8582, Japan.
| | - Kenji Sunagawa
- Department of Therapeutic Regulation of Cardiovascular Homeostasis, Center for Disruptive Cardiovascular Medicine, 1-1-3 Maidashi Higashi-ku, Fukuoka 812-8582, Japan.
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50
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Kamangar S, Badruddin IA, Badarudin A, Nik-Ghazali N, Govindaraju K, Salman Ahmed NJ, Yunus Khan TM. Influence of stenosis on hemodynamic parameters in the realistic left coronary artery under hyperemic conditions. Comput Methods Biomech Biomed Engin 2016; 20:365-372. [DOI: 10.1080/10255842.2016.1233402] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
- Sarfaraz Kamangar
- Department of Mechanical Engineering, University of Malaya, Kuala Lumpur, 50603, Malaysia
| | - Irfan Anjum Badruddin
- Department of Mechanical Engineering, University of Malaya, Kuala Lumpur, 50603, Malaysia
| | - A. Badarudin
- Department of Mechanical Engineering, University of Malaya, Kuala Lumpur, 50603, Malaysia
| | - N. Nik-Ghazali
- Department of Mechanical Engineering, University of Malaya, Kuala Lumpur, 50603, Malaysia
| | - Kalimuthu Govindaraju
- Department of Mechanical Engineering, University of Malaya, Kuala Lumpur, 50603, Malaysia
| | - N. J. Salman Ahmed
- Center for Energy Sciences, Department of Mechanical Engineering, University of Malaya, Kuala Lumpur, 50603, Malaysia
| | - T. M. Yunus Khan
- Department of Mechanical Engineering, University of Malaya, Kuala Lumpur, 50603, Malaysia
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