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Zhou S, Qiao Y, Zhou X, Wasserman BA, Caughey MC. Detection of Dolichoectasia and Atherosclerosis by Automated MRA Tortuosity Metrics in a Population-Based Study. J Magn Reson Imaging 2024; 59:1612-1619. [PMID: 37515312 DOI: 10.1002/jmri.28923] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Revised: 07/10/2023] [Accepted: 07/11/2023] [Indexed: 07/30/2023] Open
Abstract
BACKGROUND Intracranial vessel tortuosity is a key component of dolichoectasia and has been associated with atherosclerosis and adverse neurologic outcomes. However, the evaluation of tortuosity is mainly a descriptive assessment. PURPOSE To compare the performance of three automated tortuosity metrics (angle metric [AM], distance metric [DM], and distance-to-axis metric [DTA]) for detection of dolichoectasia and presence of segment-specific plaques. STUDY TYPE Observational, cross-sectional metric assessment. POPULATION 1899 adults from the general population; mean age = 76 years, female = 59%, and black = 29%. FIELD STRENGTH/SEQUENCE 3-T, three-dimensional (3D) time-of-flight MRA and 3D vessel wall MRI. ASSESSMENT Tortuosity metrics and mean luminal area were quantified for designated segments of the internal carotid artery, middle cerebral artery, anterior cerebral artery, posterior cerebral artery, vertebral artery, and entire length of basilar artery (BA). Qualitative interpretations of BA dolichoectasia were assessed based on Smoker's visual criteria. STATISTICAL TESTS Descriptive statistics (2-sample t-tests, Pearson chi-square tests) for group comparisons. Receiver operating characteristics area under the curve (AUC) for detection of BA dolichoectasia or segment-specific plaque. Model inputs included 1) tortuosity metrics, 2) mean luminal area, and 3) demographics (age, race, and sex). RESULTS Qualitative dolichoectasia was identified in 336 (18%) participants, and atherosclerotic plaques were detected in 192 (10%) participants. AM-, DM-, and DTA-calculated tortuosity were good individual discriminators of basilar dolichoectasia (AUCs: 0.76, 0.74, and 0.75, respectively), with model performance improving with the mean lumen area: (AUCs: 0.88, 0.87, and 0.87, respectively). Combined characteristics (tortuosity and mean luminal area) identified plaques with better performance in the anterior (AUCs ranging from 0.66 to 0.78) than posterior (AUCs ranging from 0.54 to 0.65) circulation, with all models improving by the addition of demographics (AUCs ranging from 0.62 to 0.84). DATA CONCLUSION Quantitative vessel tortuosity metrics yield good diagnostic accuracy for the detection of dolichoectasia. LEVEL OF EVIDENCE 1 TECHNICAL EFFICACY STAGE: 2.
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Affiliation(s)
- Shang Zhou
- The Russell H. Morgan Department of Radiology and Radiological Sciences, The Johns Hopkins University, Baltimore, Maryland, USA
| | - Ye Qiao
- The Russell H. Morgan Department of Radiology and Radiological Sciences, The Johns Hopkins University, Baltimore, Maryland, USA
| | - Xinwei Zhou
- The Russell H. Morgan Department of Radiology and Radiological Sciences, The Johns Hopkins University, Baltimore, Maryland, USA
| | - Bruce A Wasserman
- The Russell H. Morgan Department of Radiology and Radiological Sciences, The Johns Hopkins University, Baltimore, Maryland, USA
- Department of Radiology, The University of Maryland School of Medicine, Baltimore, Maryland, USA
| | - Melissa C Caughey
- Department of Biomedical Engineering, University of North Carolina and North Carolina State University, Chapel Hill, North Carolina, USA
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Tagawa K, Tsuru Y, Yokoi K, Aonuma T, Hashimoto J. Inverse association between obesity and aortic pressure augmentation is attenuated in women: the Wakuya study. J Hypertens 2024; 42:783-788. [PMID: 38230603 DOI: 10.1097/hjh.0000000000003657] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2024]
Abstract
OBJECTIVE Pressure wave reflection predicts cardiovascular events in the general population. Obesity is negatively associated with pressure wave reflection. Muscular arterial diameter (responsible for pressure wave reflection) increases with obesity, and obesity-dependent dilation of muscular arteries is attenuated in women compared with men. We investigated the sex differences in the cross-sectional relationship between obesity and pressure wave reflection in a general population cohort. METHODS Tonometric pressure waveforms were recorded in 928 adults (mean age, 56 ± 10 years) to estimate the aortic augmentation index. The BMI was calculated using height and body weight, and waist circumference was recorded at the umbilical level. RESULTS Aortic augmentation index was significantly higher in women than in men. Indices of obesity (BMI and waist circumference) were negatively correlated with the aortic augmentation index in both men and women, even after adjusting for mean arterial pressure (both P < 0.001). Sex and BMI had no synergistic effect on the aortic augmentation index. However, when waist circumference was substituted for BMI, sex and waist circumference had a reciprocal influence on decreasing the aortic augmentation index independent of age, mean arterial pressure, diabetes, and hyperlipidemia (interaction, P = 0.045). CONCLUSION The negative correlation between overweight/obesity and aortic pressure augmentation from peripheral wave reflection is inhibited in women more than in men. Sex differences in aortic pressure augmentation are greater in individuals with central (abdominal) obesity than in those with general obesity.
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Affiliation(s)
- Kaname Tagawa
- Medical Center, Miyagi University of Education, Sendai
- Institute of Health and Sport Sciences, University of Tsukuba, Tsukuba
| | | | | | | | - Junichiro Hashimoto
- Medical Center, Miyagi University of Education, Sendai
- Division of Nephrology, Endocrinology, and Vascular Medicine, Department of Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
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Sugane H, Asaumi Y, Ogata S, Kimura M, Kanaya T, Hoshi T, Sato A, Miura H, Tomishima Y, Morita Y, Nakao K, Otsuka F, Kataoka Y, Kawasaki T, Nishimura K, Narula J, Yasuda S, Noguchi T. Evaluation of fractional flow reserve and atherosclerotic plaque characteristics on coronary non-contrast T1-weighted magnetic resonance imaging. Atherosclerosis 2024; 392:117530. [PMID: 38583287 DOI: 10.1016/j.atherosclerosis.2024.117530] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2023] [Revised: 03/05/2024] [Accepted: 03/22/2024] [Indexed: 04/09/2024]
Abstract
BACKGROUND AND AIMS The relationship between high-risk coronary plaque characteristics regardless of the severity of lesion stenosis and myocardial ischemia remains unsettled. High-intensity plaques (HIPs) on non-contrast T1-weighted magnetic resonance imaging (T1WI) have been characterized as high-risk coronary plaques. We sought to elucidate whether the presence of coronary HIPs on T1WI influences fractional flow reserve (FFR) in the distal segment of the vessel. METHODS We retrospectively analyzed 281 vessels in 231 patients with chronic coronary syndrome who underwent invasive FFR measurement and coronary T1WI using a multicenter registry. The plaque-to-myocardial signal intensity ratio (PMR) of the most stenotic lesion was evaluated; a coronary plaque with PMR ≥1.4 was defined as a HIP. RESULTS The median PMR of coronary plaques on T1WI in vessels with FFR ≤0.80 was significantly higher than that of plaques with FFR >0.80 (1.17 [interquartile range (IQR): 0.99-1.44] vs. 0.97 [IQR: 0.85-1.09]; p < 0.001). Multivariable analysis showed that an increase in PMR of the most stenotic segment was associated with lower FFR (beta-coefficient, -0.050; p < 0.001). The presence of coronary HIPs was an independent predictor of FFR ≤0.80 (odds ratio (OR), 6.18; 95% confidence interval (CI), 1.93-19.77; p = 0.002). Even after adjusting for plaque composition characteristics based on computed tomography angiography, the presence of coronary HIPs was an independent predictor of FFR ≤0.80 (OR, 4.48; 95% CI, 1.19-16.80; p = 0.026). CONCLUSIONS Coronary plaques with high PMR are associated with low FFR in the corresponding vessel, indicating that plaque morphology might influence myocardial ischemia severity.
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Affiliation(s)
- Hiroki Sugane
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan; Department of Advanced Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan; Department of Cardiology, Chikamori Hospital, Kochi-city, Japan
| | - Yasuhide Asaumi
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan; Department of Advanced Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan.
| | - Soshiro Ogata
- Department of Preventive Medicine and Epidemiology, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan
| | - Michito Kimura
- Department of Preventive Medicine and Epidemiology, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan
| | - Tomoaki Kanaya
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan; Department of Cardiovascular Medicine, Dokkyo Medical Univeristy, Mibu, Japan
| | - Tomoya Hoshi
- Department of Cardiovascular Medicine, University of Tsukuba, Tsukuba, Japan
| | - Akira Sato
- Second Department of Internal Medicine, University of Yamanashi, Yamanashi, Japan
| | - Hiroyuki Miura
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan
| | - Yoshiyuki Tomishima
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan
| | - Yoshiaki Morita
- Department of Radiology, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan
| | - Kazuhiro Nakao
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan
| | - Fumiyuku Otsuka
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan
| | - Yu Kataoka
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan
| | | | - Kunihiro Nishimura
- Department of Preventive Medicine and Epidemiology, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan
| | - Jagat Narula
- Mount Sinai Heart, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Satoshi Yasuda
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan; Department of Advanced Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan; Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Teruo Noguchi
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan
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Kawai K, Finn AV, Virmani R. Subclinical Atherosclerosis: Part 1: What Is it? Can it Be Defined at the Histological Level? Arterioscler Thromb Vasc Biol 2024; 44:12-23. [PMID: 38150517 DOI: 10.1161/atvbaha.123.319932] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2023]
Abstract
While coronary artery disease remains a major cause of death, it is preventable. Therefore, the focus needs to shift to the early detection and prevention of atherosclerosis. Asymptomatic atherosclerosis is widely termed subclinical atherosclerosis, which is an early indicator of atherosclerotic burden, and understanding this disease is important because timely intervention could prevent future cardiovascular morbidity and mortality. We histologically recognize the earliest lesion of atherosclerosis as pathological intimal thickening, which is characterized by the presence of lipid pools. The difference between clinical atherosclerosis and subclinical atherosclerosis is whether the presence of atherosclerosis results in the clinical symptoms of ischemia, such as stroke, myocardial infarction, or chronic limb-threatening ischemia. In the absence of thrombosis, there are various types of histological plaque that encompass subclinical atherosclerosis: pathological intimal thickening, fibroatheroma, thin-cap fibroatheroma, plaque rupture, healed plaque ruptures, and fibrocalcific plaque. Plaque morphology that is most frequently responsible for acute coronary thrombosis is plaque rupture. Calcification of coronary arteries is the hallmark of atherosclerosis and is a predictor of future coronary events. Atherosclerosis occurs in other vascular beds and is most frequent in arteries of the lower extremity, followed by carotid, aorta, and coronary arteries, and the mechanisms leading to clinical symptoms are unique for each location.
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Affiliation(s)
- Kenji Kawai
- CVPath Institute, Gaithersburg, MD (K.K., A.V.F., R.V.)
| | - Aloke V Finn
- CVPath Institute, Gaithersburg, MD (K.K., A.V.F., R.V.)
- University of Maryland, School of Medicine, Baltimore (A.V.F.)
| | - Renu Virmani
- CVPath Institute, Gaithersburg, MD (K.K., A.V.F., R.V.)
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Mahmoudi K, Galea R, Elhadad S, Temperli F, Sebag F, Gräni C, Rezine Z, Roten L, Landolff Q, Brugger N, Masri A, Räber L, Amabile N. Computed Tomography Scan Evidence for Left Atrial Appendage Short-Term Remodeling Following Percutaneous Occlusion: Impact of Device Oversizing. J Am Heart Assoc 2023; 12:e030037. [PMID: 37609989 PMCID: PMC10547351 DOI: 10.1161/jaha.123.030037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Accepted: 07/11/2023] [Indexed: 08/24/2023]
Abstract
Background The interrelationships between left atrial appendage (LAA) dimensions and device following implantation are unknown. We aimed to analyze the impact of Watchman device implantation on LAA dimensions following its percutaneous closure and potential predictors of remodeling. Methods and Results All consecutive LAA closure procedures performed at 2 centers between November 2017 and December 2020 were included in the WATCH-DUAL (Watchman 2.5 Versus Watchman FLX in a Dual-Center Left Atrial Appendage Closure Cohort) registry. This study included patients who had pre- and postintervention computed tomography scan analysis. The LAA and device dimensions were measured in a centralized core lab by 3-dimensional computed tomography scan reconstruction methods, focusing on the device landing zone. This analysis included 104 patients (age, 76.0 [range, 72.0-83.0] years; 72% men; 53% Watchman FLX; 47% Watchman 2.5). The baseline characteristics were comparable between Watchman 2.5 and Watchman FLX groups, except for the higher use of oversizing in the latter group. The median delay for computed tomography control was 49 (range, 43-64) days. The landing zone area (median, 446 [range, 363-523] versus 290 [222-366] mm2; P<0.001) and minimal diameter (median, 23.0 [range, 20.7-24.8] versus 16.7 [14.7-19.4] mm; P<0.001) significantly increased after implantation. The absolute (median, 157 [range, 98-220] versus 85 [18-148] mm2, P<0.001) and relative (median, 50% [range, 32%-79%] versus 26% [4%-50%]; P<0.001) increases in landing zone area were more pronounced in patients with oversized device. Baseline LAA dimensions were smaller, landing zone eccentricity larger, and oversized device more frequent in patients with significant overexpansion compared with the others. Conclusions LAA dimensions increased at the site of the Watchman prosthesis after implantation, suggesting a local positive remodeling after the procedure. This phenomenon was more pronounced in the case of oversized devices.
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Affiliation(s)
- Khalil Mahmoudi
- Cardiology DepartmentInstitut Mutualiste MontsourisParisFrance
| | - Roberto Galea
- Cardiology Department, Inselspital, Bern University HospitalUniversity of BernSwitzerland
| | - Simon Elhadad
- Cardiology Department, Centre Hospitalier Marne la Vallée, JossignyFrance
| | - Fabrice Temperli
- Cardiology Department, Inselspital, Bern University HospitalUniversity of BernSwitzerland
| | - Frederic Sebag
- Cardiology DepartmentInstitut Mutualiste MontsourisParisFrance
| | - Christoph Gräni
- Cardiology Department, Inselspital, Bern University HospitalUniversity of BernSwitzerland
| | - Zhor Rezine
- Cardiology Department, Centre Hospitalier Marne la Vallée, JossignyFrance
| | - Laurent Roten
- Cardiology Department, Inselspital, Bern University HospitalUniversity of BernSwitzerland
| | | | - Nicolas Brugger
- Cardiology Department, Inselspital, Bern University HospitalUniversity of BernSwitzerland
| | - Alaa Masri
- Cardiology DepartmentInstitut Mutualiste MontsourisParisFrance
| | - Lorenz Räber
- Cardiology Department, Inselspital, Bern University HospitalUniversity of BernSwitzerland
| | - Nicolas Amabile
- Cardiology DepartmentInstitut Mutualiste MontsourisParisFrance
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Gruenwald I, Appel B, Shechter A, Greenstein A. Radiofrequency energy in the treatment of erectile dysfunction-a novel cohort pilot study on safety, applicability, and short-term efficacy. Int J Impot Res 2023:10.1038/s41443-023-00733-1. [PMID: 37592175 DOI: 10.1038/s41443-023-00733-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Revised: 06/20/2023] [Accepted: 06/29/2023] [Indexed: 08/19/2023]
Abstract
The erectile mechanism depends, in part on the intactness of the collagen components in the penis. As such, impaired collagen may have a deleterious effect on erectile function. Radiofrequency energy has been shown to renew and restore spatial structural arrangement of collagen fibers; therefore, treatment of erectile dysfunction with radiofrequency could lead to anatomical and physiological changes at the penile tissue level and could lead to improvement in the erectile mechanism. We conducted this study to assess the effect of radiofrequency treatment on erection quality. We evaluated the safety, applicability, and efficacy of a self-applied, handheld, low-intensity radiofrequency device (Vertica®) in men with moderate and mild-to-moderate organic erectile dysfunction. The treatment protocol consisted of 12 treatments (twice a week during the 1st month, and once a week during the 2nd month), and each participant treated himself individually. Treatment outcomes were evaluated using the International Index of Erectile Function, Erection Hardness Scale, Erectile Dysfunction Index of Treatment Satisfaction, Benefit, Satisfaction & Willingness to continue, Quality of Erection Questionnaire, Sexual Quality of Life questionnaires and specific questions addressing side effects and ease of use. Twenty-eight out of 32 men (mean age 59.5 ± 9.8, range: 41-78 years) completed a one-month follow-up after treatment. Mean International Index of Erectile Function (43.7. ± 7.8 vs. 60.9 ± 10.8, p < 0.01), International Index of Erectile Function -Erection Function domain (16.8 ± 3.1 vs. 24.4 ± 4.4, p < 0.001), and Erection Hardness Scores (2.2 ± 0.8 vs. 3.2 ± 0.5, p = 0.01) were all significantly improved. Fifty percent of patients achieved normal erectile function parameters according to the International Index of Erectile Function -Erection Function domain score >25. High mean scores were achieved in the Erectile Dysfunction Index of Treatment Satisfaction (76.8 ± 20.3), Benefit, Satisfaction & Willingness to continue (4.83 ± 1.1), Quality of Erection Questionnaire (73.4 ± 23.8), and Sexual Quality of Life (67 ± 29.4) questionnaires. No side effects were reported and participants rated the device as very comfortable, simple, and easy to operate.
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Affiliation(s)
- Ilan Gruenwald
- The Neuro-Urology Unit, Rambam Healthcare Campus, Haifa, Israel.
- The Bruce Rappaport Faculty of Medicine, The Technion, Haifa, Israel.
| | - Boaz Appel
- The Neuro-Urology Unit, Rambam Healthcare Campus, Haifa, Israel
| | - Arik Shechter
- The Neuro-Urology Unit, Rambam Healthcare Campus, Haifa, Israel
- The Bruce Rappaport Faculty of Medicine, The Technion, Haifa, Israel
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Ahmed IU, Byrne HM, Myerscough MR. Macrophage Anti-inflammatory Behaviour in a Multiphase Model of Atherosclerotic Plaque Development. Bull Math Biol 2023; 85:37. [PMID: 36991234 PMCID: PMC10060284 DOI: 10.1007/s11538-023-01142-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2022] [Accepted: 03/09/2023] [Indexed: 03/31/2023]
Abstract
Atherosclerosis is an inflammatory disease characterised by the formation of plaques, which are deposits of lipids and cholesterol-laden macrophages that form in the artery wall. The inflammation is often non-resolving, due in large part to changes in normal macrophage anti-inflammatory behaviour that are induced by the toxic plaque microenvironment. These changes include higher death rates, defective efferocytic uptake of dead cells, and reduced rates of emigration. We develop a free boundary multiphase model for early atherosclerotic plaques, and we use it to investigate the effects of impaired macrophage anti-inflammatory behaviour on plaque structure and growth. We find that high rates of cell death relative to efferocytic uptake results in a plaque populated mostly by dead cells. We also find that emigration can potentially slow or halt plaque growth by allowing material to exit the plaque, but this is contingent on the availability of live macrophage foam cells in the deep plaque. Finally, we introduce an additional bead species to model macrophage tagging via microspheres, and we use the extended model to explore how high rates of cell death and low rates of efferocytosis and emigration prevent the clearance of macrophages from the plaque.
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Affiliation(s)
- Ishraq U Ahmed
- School of Mathematics and Statistics, University of Sydney, Sydney, Australia.
| | - Helen M Byrne
- Wolfson Centre for Mathematical Biology, Mathematical Institute, University of Oxford, Oxford, UK
| | - Mary R Myerscough
- School of Mathematics and Statistics, University of Sydney, Sydney, Australia
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The Need to Shift from Morphological to Structural Assessment for Carotid Plaque Vulnerability. Biomedicines 2022; 10:biomedicines10123038. [PMID: 36551791 PMCID: PMC9776071 DOI: 10.3390/biomedicines10123038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Revised: 11/18/2022] [Accepted: 11/22/2022] [Indexed: 11/27/2022] Open
Abstract
Degree of luminal stenosis is generally considered to be an important indicator for judging the risk of atherosclerosis burden. However, patients with the same or similar degree of stenosis may have significant differences in plaque morphology and biomechanical factors. This study investigated three patients with carotid atherosclerosis within a similar range of stenosis. Using our developed fluid-structure interaction (FSI) modelling method, this study analyzed and compared the morphological and biomechanical parameters of the three patients. Although their degrees of carotid stenosis were similar, the plaque components showed a significant difference. The distribution range of time-averaged wall shear stress (TAWSS) of patient 2 was wider than that of patient 1 and patient 3. Patient 2 also had a much smaller plaque stress compared to the other two patients. There were significant differences in TAWSS and plaque stresses among three patients. This study suggests that plaque vulnerability is not determined by a single morphological factor, but rather by the combined structure. It is necessary to transform the morphological assessment into a structural assessment of the risk of plaque rupture.
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The adventitia in arterial development, remodeling, and hypertension. Biochem Pharmacol 2022; 205:115259. [PMID: 36150432 DOI: 10.1016/j.bcp.2022.115259] [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: 08/01/2022] [Revised: 09/13/2022] [Accepted: 09/14/2022] [Indexed: 11/20/2022]
Abstract
The adventitia receives input signals from the vessel wall, the immune system, perivascular nerves and from surrounding tissues to generate effector responses that regulate structural and mechanical properties of blood vessels. It is a complex and dynamic tissue that orchestrates multiple functions for vascular development, homeostasis, repair, and disease. The purpose of this review is to highlight recent advances in our understanding of the origins, phenotypes, and functions of adventitial and perivascular cells with particular emphasis on hypertensive vascular remodeling.
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Abstract
Mechanical variables such as stiffness, stress, strain, and fluid shear stress are central to tissue functions, thus, must be maintained within the proper range. Mechanics are especially important in the cardiovascular system and lung, the functions of which are essentially mechanical. Mechanical homeostasis is characterized by negative feedback in which deviations from the optimal value or set point activates mechanisms to return the system to the correct range. In chronic diseases, homeostatic mechanisms are generally overcome or replaced with positive feedback loops that promote disease progression. Recent work has shown that microRNAs (miRNAs) are essential to mechanical homeostasis in a number of biological systems and that perturbations to miRNA biogenesis play key roles in cardiovascular and pulmonary diseases. In this review, we integrate current knowledge of miRNAs in mechanical homeostasis and how these mechanisms are altered in disease.
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Affiliation(s)
- Jeremy A Herrera
- The Wellcome Centre for Cell-Matrix Research, University of Manchester, Manchester M13 9PT, United Kingdom
| | - Martin A Schwartz
- Yale Cardiovascular Research Center and Departments of Internal Medicine (Cardiology), Cell Biology, and Biomedical Engineering, Yale School of Medicine, New Haven 06511, Connecticut, USA
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On non-Kolmogorov turbulence in blood flow and its possible role in mechanobiological stimulation. Sci Rep 2022; 12:13166. [PMID: 35915207 PMCID: PMC9343407 DOI: 10.1038/s41598-022-16079-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Accepted: 07/04/2022] [Indexed: 01/09/2023] Open
Abstract
The study of turbulence in physiologic blood flow is important due to its strong relevance to endothelial mechanobiology and vascular disease. Recently, Saqr et al. (Sci Rep 10, 15,492, 2020) discovered non-Kolmogorov turbulence in physiologic blood flow in vivo, traced its origins to the Navier–Stokes equation and demonstrated some of its properties using chaos and hydrodynamic-stability theories. The present work extends these findings and investigates some inherent characteristics of non-Kolmogorov turbulence in monoharmonic and multiharmonic pulsatile flow under ideal physiologic conditions. The purpose of this work is to propose a conjecture for the origins for picoNewton forces that are known to regulate endothelial cells’ functions. The new conjecture relates these forces to physiologic momentum-viscous interactions in the near-wall region of the flow. Here, we used high-resolution large eddy simulation (HRLES) to study pulsatile incompressible flow in a straight pipe of \documentclass[12pt]{minimal}
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\begin{document}$$L/D=20$$\end{document}L/D=20. The simulations presented Newtonian and Carreau–Yasuda fluid flows, at \documentclass[12pt]{minimal}
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\begin{document}$$R{e}_{m}\approx 250$$\end{document}Rem≈250, each represented by one, two and three boundary harmonics. Comparison was established based on maintaining constant time-averaged mass flow rate in all simulations. First, we report the effect of primary harmonics on the global power budget using primitive variables in phase space. Second, we describe the non-Kolmogorov turbulence in frequency domain. Third, we investigate the near-wall coherent structures in time and space domains. Finally, we propose a new conjecture for the role of turbulence in endothelial cells’ mechanobiology. The proposed conjecture correlates near-wall turbulence to a force field of picoNewton scale, suggesting possible relevance to endothelial cells mechanobiology.
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Cardiovascular changes after pneumonia in a dual disease mouse model. Sci Rep 2022; 12:11124. [PMID: 35778475 PMCID: PMC9249762 DOI: 10.1038/s41598-022-15507-w] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2022] [Accepted: 06/24/2022] [Indexed: 12/04/2022] Open
Abstract
Residual inflammation in cardiovascular organs is thought to be one of the catalysts for the increased risk of cardiovascular complications seen following pneumonia. To test this hypothesis, we investigated changes in plaque characteristics and inflammatory features in ApoE−/− mouse aorta and heart following pneumonia. Male ApoE−/− mice were fed a high fat diet for 8 weeks before intranasal inoculation with either Streptococcus pneumoniae serotype 4 (test group) or phosphate buffered saline (control group). Mice were sacrificed at 2-, 7- and 28-days post-challenge. Changes in plaque burden and characteristics in aortic root and thoracic aorta were characterized by Oil red O and Trichrome stains. Inflammatory changes were investigated by FDG-PET imaging and immunofluorescence staining. We found TIGR4-infected mice present with increased plaque presence in the aortic root and thoracic aorta at 2- and 28-days post-inoculation, respectively. Aortic wall remodelling was also more pronounced in mice challenged with pneumococci at 28 days post-inoculation. Aortic root plaques of infected mice had reduced collagen and smooth muscle cells, consistent with an unstable plaque phenotype. Pneumonia alters plaque burden, plaque characteristics, and aortic wall remodelling in ApoE−/− mice. These effects caused by Streptococcus pneumoniae TIGR4, may contribute to the increased risk of cardiovascular complications seen in survivors of this infection.
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Chapman MJ, Zamorano JL, Parhofer KG. Reducing residual cardiovascular risk in Europe: Therapeutic implications of European medicines agency approval of icosapent ethyl/eicosapentaenoic acid. Pharmacol Ther 2022; 237:108172. [PMID: 35304222 DOI: 10.1016/j.pharmthera.2022.108172] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Revised: 02/19/2022] [Accepted: 03/10/2022] [Indexed: 12/18/2022]
Abstract
Atherosclerotic cardiovascular disease (ASCVD) and its atherothrombotic complications impose a substantial disease burden in Europe, representing a cost of €210 billion per year for the European Union. Hypertriglyceridemia, a major risk factor for premature ASCVD, is present in more than 20% of the European population, and is a key feature of atherogenic dyslipidemia. Recent findings from the Progression of Early Subclinical Atherosclerosis (PESA) cohort in Spain showed that even in apparently healthy, middle-aged individuals without a history of cardiovascular (CV) risk, elevated triglyceride levels are associated with subclinical atherosclerosis and arterial inflammation. Emerging evidence from epidemiologic and genetic studies supports an independent causative role of triglycerides, triglyceride-rich lipoproteins, and their remnants in this pathology. Icosapent ethyl (IPE) is a highly purified, stable ethyl ester of eicosapentaenoic acid (EPA) that was initially approved by the United States Food and Drug Administration to treat severe hypertriglyceridemia, and subsequently received an expanded indication to reduce the risk of CV events in adult statin-treated patients. Approval was based on the pivotal, randomized, placebo-controlled, double-blind Reduction of Cardiovascular Events with Icosapent Ethyl-Intervention Trial (REDUCE-IT), which showed that high-dose IPE (4 g/day) significantly reduced the risk of primary and secondary composite endpoints comprising major CV events and CV death relative to placebo. In 2021, the European Medicines Agency (EMA) approved IPE to reduce the risk of CV events in adult statin-treated patients at high CV risk with elevated triglyceride levels (≥1.7 mmol/L [≥150 mg/dL]) and established CV disease, or diabetes and at least one other CV risk factor. Clinical studies in Europe, which included patients with acute myocardial infarction, coronary artery disease, and those undergoing cardiac rehabilitation, established that 12.5% to 23.3% of these high-risk populations may benefit from treatment with IPE. Such clinical benefit may in part result from the moderate triglyceride-lowering properties of IPE/EPA; equally however, concentrations of atherogenic remnant particle-cholesterol are markedly reduced. Furthermore, IPE/EPA exerts pleiotropic actions beyond its lipid-lowering properties, which include modulation of endothelial function, attenuation of intra-plaque inflammation and oxidative stress, and reduction in macrophage accumulation. Plasma phospholipids, into which EPA is primarily incorporated and transported, appear to serve as precursors for a series of anti-inflammatory metabolites involving the resolvins RvE1 to RvE3, a pathway which may confer cardioprotective benefits. In addition, plaque imaging data from the Effect of Icosapent Ethyl on Progression of Coronary Atherosclerosis in Patients With Elevated Triglycerides on Statin Therapy (EVAPORATE) and the Combination Therapy of Eicosapentaenoic Acid and Pitavastatin for Coronary Plaque Regression Evaluated by Integrated Backscatter Intravascular Ultrasonography (CHERRY) trials show that plaque stabilization may be favorably affected. These factors may act synergistically to stabilize atherosclerotic plaques and reduce CV risk. In addition to robust efficacy data, multiple cost-utility studies across several countries indicate that IPE/EPA is a cost-effective treatment option that is favorably situated relative to some common willingness-to-pay thresholds. This review will evaluate the relevance of hypertriglyceridemia to residual ASCVD burden in statin-treated dyslipidemic patients, the potential of IPE/EPA to reduce the risk of ASCVD and cardiovascular mortality in high-risk patient populations, and the mechanisms which may underlie these effects. Finally, the clinical implications of the EMA label for IPE will be critically appraised in light of the updated 2019 European Society of Cardiology/European Atherosclerosis Society guidelines on the management of dyslipidemia and the recent European Atherosclerosis Society consensus statement on triglyceride-rich lipoproteins and their remnants, together with considerations of its cost-effectiveness across several countries.
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Affiliation(s)
- M John Chapman
- Sorbonne University, Endocrinology and Cardiovascular Disease Prevention, Pitié-Salpétrière University Hospital, and National Institute for Health and Medical Research (INSERM), Paris, France.
| | | | - Klaus G Parhofer
- Medical Clinic IV - Grosshadern Hospital of the University of Munich, Munich, Germany
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14
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Ilan G, Boaz A, Arik S, Valentin S, Alexander G. Applying Radiofrequency energy to the penis in the treatment of erectile dysfunction. Med Hypotheses 2022. [DOI: 10.1016/j.mehy.2022.110832] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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15
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Colombo M, Corti A, Berceli S, Migliavacca F, McGinty S, Chiastra C. 3D modelling of drug-coated balloons for the treatment of calcified superficial femoral arteries. PLoS One 2021; 16:e0256783. [PMID: 34634057 PMCID: PMC8504744 DOI: 10.1371/journal.pone.0256783] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2021] [Accepted: 07/27/2021] [Indexed: 11/28/2022] Open
Abstract
Background/Objectives Drug-coated balloon therapy for diseased superficial femoral arteries remains controversial. Despite its clinical relevance, only a few computational studies based on simplistic two-dimensional models have been proposed to investigate this endovascular therapy to date. This work addresses the aforementioned limitation by analyzing the drug transport and kinetics occurring during drug-coated balloon deployment in a three-dimensional geometry. Methods An idealized three-dimensional model of a superficial femoral artery presenting with a calcific plaque and treated with a drug-coated balloon was created to perform transient mass transport simulations. To account for the transport of drug (i.e. paclitaxel) released by the device, a diffusion-reaction equation was implemented by describing the drug bound to specific intracellular receptors through a non-linear, reversible reaction. The following features concerning procedural aspects, pathologies and modelling assumptions were investigated: (i) balloon application time (60–180 seconds); (ii) vessel wall composition (healthy vs. calcified wall); (iii) sequential balloon application; and (iv) drug wash-out by the blood stream vs. coating retention, modeled as exponential decay. Results The balloon inflation time impacted both the free and specifically-bound drug concentrations in the vessel wall. The vessel wall composition highly affected the drug concentrations. In particular, the specifically-bound drug concentration was four orders of magnitude lower in the calcific compared with healthy vessel wall portions, primarily as a result of reduced drug diffusion. The sequential application of two drug-coated balloons led to modest differences (~15%) in drug concentration immediately after inflation, which became negligible within 10 minutes. The retention of the balloon coating increased the drug concentration in the vessel wall fourfold. Conclusions The overall findings suggest that paclitaxel kinetics may be affected not only by the geometrical and compositional features of the vessel treated with the drug-coated balloon, but also by balloon design characteristics and procedural aspects that should be carefully considered.
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Affiliation(s)
- Monika Colombo
- Laboratory of Biological Structure Mechanics (LaBS), Department of Chemistry, Materials and Chemical Engineering “Giulio Natta”, Politecnico di Milano, Milan, Italy
| | - Anna Corti
- Laboratory of Biological Structure Mechanics (LaBS), Department of Chemistry, Materials and Chemical Engineering “Giulio Natta”, Politecnico di Milano, Milan, Italy
| | - Scott Berceli
- Malcom Randall VAMC, Gainesville, Florida, United States of America
- Department of Surgery, University of Florida, Gainesville, Florida, United States of America
| | - Francesco Migliavacca
- Laboratory of Biological Structure Mechanics (LaBS), Department of Chemistry, Materials and Chemical Engineering “Giulio Natta”, Politecnico di Milano, Milan, Italy
| | - Sean McGinty
- Department of Biomedical Engineering, University of Glasgow, Glasgow, United Kingdom
| | - Claudio Chiastra
- Laboratory of Biological Structure Mechanics (LaBS), Department of Chemistry, Materials and Chemical Engineering “Giulio Natta”, Politecnico di Milano, Milan, Italy
- PoliToMed Lab, Department of Mechanical and Aerospace Engineering, Politecnico di Torino, Turin, Italy
- * E-mail:
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16
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Yamaji T, Harada T, Hashimoto Y, Nakano Y, Kajikawa M, Yoshimura K, Chayama K, Goto C, Han Y, Mizobuchi A, Yusoff FM, Kishimoto S, Maruhashi T, Nakashima A, Higashi Y. Stair climbing activity and vascular function in patients with hypertension. Hypertens Res 2021; 44:1274-1282. [PMID: 34272476 DOI: 10.1038/s41440-021-00697-z] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Revised: 05/12/2021] [Accepted: 05/17/2021] [Indexed: 02/07/2023]
Abstract
We evaluated the relationship between daily stair climbing activity and vascular function as assessed by flow-mediated vasodilation (FMD) and nitroglycerine-induced vasodilation (NID). This study was a cross-sectional study. A total of 374 patients with hypertension were enrolled. The subjects were divided into three groups based on their daily stair climbing habit: no stairs group, climbing stairs to the 2nd-floor group, and climbing stairs to the ≥3rd-floor group. There was a significant difference in FMD between the ≥3rd-floor group and the other two groups (3.3 ± 2.5% vs. 2.3 ± 2.7% and 2.4 ± 2.7%, p = 0.02, respectively). FMD values were similar in the no stairs group and the 2nd-floor group (p = 0.96). There was a significant difference in NID between the no stairs group and the other two groups (7.4 ± 4.2% vs. 10.9 ± 5.3% and 11.3 ± 5.1%, p < 0.001, respectively). NID values were similar in the second-floor group and the ≥3rd-floor group (p = 0.86). These findings suggest that both endothelial function and vascular smooth muscle function are impaired in individuals who do not climb stairs and that endothelial function but not vascular smooth muscle function is impaired in individuals who climb stairs to the second floor compared with individuals who climb stairs to the ≥3rd floor. Stair climbing activity, a simple method for assessing daily physical activity, may reflect vascular function in patients with hypertension.
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Affiliation(s)
- Takayuki Yamaji
- Department of Cardiovascular Medicine, Hiroshima University Graduate School of Biomedical Sciences, Hiroshima, Japan
| | - Takahiro Harada
- Department of Cardiovascular Medicine, Hiroshima University Graduate School of Biomedical Sciences, Hiroshima, Japan
| | - Yu Hashimoto
- Department of Cardiovascular Medicine, Hiroshima University Graduate School of Biomedical Sciences, Hiroshima, Japan
| | - Yukiko Nakano
- Department of Cardiovascular Medicine, Hiroshima University Graduate School of Biomedical Sciences, Hiroshima, Japan
| | - Masato Kajikawa
- Division of Regeneration and Medicine, Medical Center for Translational and Clinical Research, Hiroshima University Hospital, Hiroshima, Japan
| | - Kenichi Yoshimura
- Division of Regeneration and Medicine, Medical Center for Translational and Clinical Research, Hiroshima University Hospital, Hiroshima, Japan.,Department of Biostatistics, Medical Center for Translational and Clinical Research, Hiroshima University Hospital, Hiroshima, Japan
| | - Kazuaki Chayama
- Department of Gastroenterology and Metabolism, Institute of Biomedical and Health Sciences, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Chikara Goto
- Department of Rehabilitation, Faculty of Rehabilitation, Hiroshima International University, Hiroshima, Japan
| | - Yiming Han
- Department of Cardiovascular Regeneration and Medicine, Research Institute for Radiation Biology and Medicine, Hiroshima University, Hiroshima, Japan
| | - Aya Mizobuchi
- Department of Cardiovascular Regeneration and Medicine, Research Institute for Radiation Biology and Medicine, Hiroshima University, Hiroshima, Japan
| | - Farina Mohamad Yusoff
- Department of Cardiovascular Regeneration and Medicine, Research Institute for Radiation Biology and Medicine, Hiroshima University, Hiroshima, Japan
| | - Shinji Kishimoto
- Department of Cardiovascular Regeneration and Medicine, Research Institute for Radiation Biology and Medicine, Hiroshima University, Hiroshima, Japan
| | - Tatsuya Maruhashi
- Department of Cardiovascular Regeneration and Medicine, Research Institute for Radiation Biology and Medicine, Hiroshima University, Hiroshima, Japan
| | - Ayumu Nakashima
- Department of Stem Cell Biology and Medicine, Hiroshima University Graduate School of Biomedical Sciences, Hiroshima, Japan
| | - Yukihito Higashi
- Division of Regeneration and Medicine, Medical Center for Translational and Clinical Research, Hiroshima University Hospital, Hiroshima, Japan. .,Department of Cardiovascular Regeneration and Medicine, Research Institute for Radiation Biology and Medicine, Hiroshima University, Hiroshima, Japan.
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17
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Tharp DL, Bowles DK. K Ca3.1 Inhibition Decreases Size and Alters Composition of Atherosclerotic Lesions Induced by Low, Oscillatory Flow. Artery Res 2021; 27:93-100. [PMID: 34457083 PMCID: PMC8388312 DOI: 10.2991/artres.k.210202.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Low, oscillatory flow/shear patterns are associated with atherosclerotic lesion development. Increased expression of KCa3.1 has been found in Vascular Smooth Muscle (VSM), macrophages and T-cells in lesions from humans and mice. Increased expression of KCa3.1, is also required for VSM cell proliferation and migration. Previously, we showed that the specific KCa3.1 inhibitor, TRAM-34, could inhibit coronary neointimal development following balloon injury in swine. Atherosclerosis develops in regions with a low, oscillatory (i.e. atheroprone) flow pattern. Therefore, we used the Partial Carotid Ligation (PCL) model in high-fat fed, Apoe−/− mice to determine the role of KCa3.1 in atherosclerotic lesion composition and development. PCL was performed on 8–10 week old male Apoe−/− mice and subsequently placed on a Western diet (TD.88137, Teklad) for 4 weeks. Mice received daily s.c. injections of TRAM-34 (120 mg/kg) or equal volumes of vehicle (peanut oil, PO). 1-[(2-chlorophenyl) diphenylmethyl]-1H-pyrazole (TRAM-34) treatment reduced lesion size ~50% (p < 0.05). In addition, lesions from TRAM-34 treated mice contained less collagen (6% ± 1% vs. 15% ± 2%; p < 0.05), fibronectin (14% ± 3% vs. 32% ± 3%; p < 0.05) and smooth muscle content (19% ± 2% vs. 29% ± 3%; p < 0.05). Conversely, TRAM-34 had no effect on total cholesterol (1455 vs. 1334 mg/dl, PO and TRAM, resp.) or body weight (29.1 vs. 28.8 g, PO and TRAM, resp.). Medial smooth muscle of atherosclerotic carotids showed diminished RE1-Silencing Transcription Factor (REST)/Neural Restrictive Silencing Factor (NRSF) expression, while REST overexpression in vitro inhibited smooth muscle migration. Together, these data support a downregulation of REST/NRSF and upregulation of KCa3.1 in determining smooth muscle and matrix content of atherosclerotic lesions.
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Affiliation(s)
- Darla L Tharp
- Department of Biomedical Sciences, E102 Veterinary Medicine, University of Missouri, Columbia, MO 65211, USA
| | - Douglas K Bowles
- Department of Biomedical Sciences, E102 Veterinary Medicine, University of Missouri, Columbia, MO 65211, USA.,Dalton Cardiovascular Research Center, University of Missouri, Columbia, MO 65211, USA
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18
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Identification of intima-to-media signals for flow-induced vascular remodeling using correlative gene expression analysis. Sci Rep 2021; 11:16142. [PMID: 34373496 PMCID: PMC8352890 DOI: 10.1038/s41598-021-95403-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2021] [Accepted: 07/26/2021] [Indexed: 12/12/2022] Open
Abstract
Changes in blood flow can induce arterial remodeling. Intimal cells sense flow and send signals to the media to initiate remodeling. However, the nature of such intima-media signaling is not fully understood. To identify potential signals, New Zealand white rabbits underwent bilateral carotid ligation to increase flow in the basilar artery or sham surgery (n = 2 ligated, n = 2 sham). Flow was measured by transcranial Doppler ultrasonography, vessel geometry was determined by 3D angiography, and hemodynamics were quantified by computational fluid dynamics. 24 h post-surgery, the basilar artery and terminus were embedded for sectioning. Intima and media were separately microdissected from the sections, and whole transcriptomes were obtained by RNA-seq. Correlation analysis of expression across all possible intima-media gene pairs revealed potential remodeling signals. Carotid ligation increased flow in the basilar artery and terminus and caused differential expression of 194 intimal genes and 529 medial genes. 29,777 intima-media gene pairs exhibited correlated expression. 18 intimal genes had > 200 medial correlates and coded for extracellular products. Gene ontology of the medial correlates showed enrichment of organonitrogen metabolism, leukocyte activation/immune response, and secretion/exocytosis processes. This demonstrates correlative expression analysis of intimal and medial genes can reveal novel signals that may regulate flow-induced arterial remodeling.
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19
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Stula I, Kojundzic SL, Guic MM, Novak K. Carotid artery stenosis in correlation with neck and carotid artery anatomy. Vascular 2021; 30:524-531. [PMID: 34053369 DOI: 10.1177/17085381211018603] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVES The purpose of this study was to examine the relationship between neck anatomy, especially its largest muscle - sternocleidomastoid and carotid space, with carotid artery anatomy and stenosis. METHODS We analysed 102 computed tomography carotid angiograms. The study included the measurement of the neck and sternocleidomastoid length, diameter and volume and the size of the carotid space. Analysis of carotid artery geometry, the length, angle and height of carotid artery bifurcation and the direction of the internal carotid artery origin was also included. RESULTS We found a positive correlation only between the neck and carotid length. There was no correlation between other neck characteristics and a carotid anatomy or internal carotid artery stenosis. Direction of internal carotid artery origin was significantly different (p < 0.01) between the left and right sides. CONCLUSIONS We have not found a correlation between the size of sternocleidomastoid and carotid space and carotid stenosis as a hypothetical factor for atherosclerosis. Also, the degree of carotid artery stenosis did not correlate with other neck and carotid measurements. Neck and carotid anatomy correlated only in their lengths. The left internal carotid artery showed mostly posterolateral origin, and right internal carotid artery had no predominate direction.
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Affiliation(s)
- Ivana Stula
- Department of Diagnostic and Interventional Radiology, University Hospital of Split, Split, Croatia.,School of Medicine, University of Split, Split, Croatia.,Department of Health Studies, University of Split, Split, Croatia
| | - Sanja L Kojundzic
- Department of Diagnostic and Interventional Radiology, University Hospital of Split, Split, Croatia.,School of Medicine, University of Split, Split, Croatia.,Department of Health Studies, University of Split, Split, Croatia
| | - Maja M Guic
- Department of Diagnostic and Interventional Radiology, University Hospital of Split, Split, Croatia.,Department of Health Studies, University of Split, Split, Croatia
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20
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Merkus D, Muller-Delp J, Heaps CL. Coronary microvascular adaptations distal to epicardial artery stenosis. Am J Physiol Heart Circ Physiol 2021; 320:H2351-H2370. [PMID: 33961506 DOI: 10.1152/ajpheart.00992.2020] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Until recently, epicardial coronary stenosis has been considered the primary outcome of coronary heart disease, and clinical interventions have been dedicated primarily to the identification and removal of flow-limiting stenoses. However, a growing body of literature indicates that both epicardial stenosis and microvascular dysfunction contribute to damaging myocardial ischemia. In this review, we discuss the coexistence of macro- and microvascular disease, and how the structure and function of the distal microcirculation is impacted by the hemodynamic consequences of an epicardial, flow-limiting stenosis. Mechanisms of endothelial dysfunction as well as alterations of smooth muscle function in the coronary microcirculation distal to stenosis are discussed. Risk factors including diabetes, metabolic syndrome, and aging exacerbate microvascular dysfunction in the myocardium distal to a stenosis, and our current understanding of the role of these factors in limiting collateralization and angiogenesis of the ischemic myocardium is presented. Importantly, exercise training has been shown to promote collateral growth and improve microvascular function distal to stenosis; thus, the current literature reporting the mechanisms that underlie the beneficial effects of exercise training in the microcirculation distal to epicardial stenosis is reviewed. We also discuss recent studies of therapeutic interventions designed to improve microvascular function and stimulate angiogenesis in clinically relevant animal models of epicardial stenosis and microvascular disease. Finally, microvascular adaptation to removal of epicardial stenosis is considered.
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Affiliation(s)
- Daphne Merkus
- Institute for Surgical Research, Walter Brendel Center of Experimental Medicine (WBex), University Clinic, LMU Munich, Munich, Germany.,German Center for Cardiovascular Research (DZHK), Munich Heart Alliance (MHA), Munich, Germany.,Department of Cardiology, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
| | - Judy Muller-Delp
- Department of Biomedical Sciences, College of Medicine, Florida State University, Tallahassee, Florida
| | - Cristine L Heaps
- Department of Physiology and Pharmacology, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, Texas.,Michael E. DeBakey Institute for Comparative Cardiovascular Science and Biomedical Devices, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, Texas
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21
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Abstract
Niches for tissue-resident mesenchymal stem cells (MSCs) have been identified in many adult tissues. In particular, MSCs residing in the vascular stem cell niche came into focus: the so-called vascular wall-resident MSCs (VW-MSCs) were, based upon their anatomic location, (1) distributed throughout the adult organism, and (2) supposed to be the first line cells which could be addressed in response to a pathologic trigger acting on or in close vicinity to the vascular system. Like tissue-resident MSCs in general, VW-MSC contribute to organ integrity and harbor the capacity to suppress inflammation and promote repair during normal vessel homeostasis, although resident MSCs present in the healthy situation of an individual seems not to bear sufficient for protection or repair following injury. In contrast, injury affected MSCs could contribute to disease induction and progression. A detailed understanding of the molecular repertoire as well as of the signaling pathways controlling stem cell fate of VW-MSCs is prerequisite to understand how (1) endogenous VW-MSCs contribute to normal vessel homeostasis as well as diseases that include the vascular system, (2) a potential on-site manipulation of these cells directly within their endogenous niche could be used for therapeutically benefits, and (3) isolated and therapeutically applied VW-MSCs in terms of exogenous MSCs with superior repair capabilities might be logically more efficient to address vascular diseases than MSCs derived from other tissues. This chapter describes a straightforward protocol for the improved isolation of human VW-MSCs.
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Affiliation(s)
- Diana Klein
- Institute for Cell Biology (Cancer Research), Medical Faculty, University Hospital Essen, University of Duisburg-Essen, Essen, Germany.
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22
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Torres G, Czernuszewicz TJ, Homeister JW, Farber MA, Caughey MC, Gallippi CM. Carotid Plaque Fibrous Cap Thickness Measurement by ARFI Variance of Acceleration: In Vivo Human Results. IEEE TRANSACTIONS ON MEDICAL IMAGING 2020; 39:4383-4390. [PMID: 32833633 PMCID: PMC7725192 DOI: 10.1109/tmi.2020.3019184] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
This study evaluates the performance of an acoustic radiation force impulse (ARFI)-based outcome parameter, the decadic logarithm of the variance of acceleration, or log(VoA), for measuring carotid fibrous cap thickness. Carotid plaque fibrous cap thickness measurement by log(VoA) was compared to that by ARFI peak displacement (PD) in patients undergoing clinically indicated carotid endarterectomy using a spatially-matched histological validation standard. Fibrous caps in parametric log(VoA) and PD images were automatically segmented using a custom clustering algorithm, and a pathologist with expertise in atherosclerosis hand-delineated fibrous caps in histology. Over 10 fibrous caps, log(VoA)-derived thickness was more strongly correlated to histological thickness than PD-derived thickness, with Pearson correlation values of 0.98 for log(VoA) compared to 0.89 for PD. The log(VoA)-derived cap thickness also had better agreement with histology-measured thickness, as assessed by the concordance correlation coefficient (0.95 versus 0.62), and, by Bland-Altman analysis, was more consistent than PD-derived fibrous cap thickness. These results suggest that ARFI log(VoA) enables improved discrimination of fibrous cap thickness relative to ARFI PD and further contributes to the growing body of evidence demonstrating ARFI's overall relevance to delineating the structure and composition of carotid atherosclerotic plaque for stroke risk prediction.
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23
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Owolabi US, Amraotkar AR, Coulter AR, Singam NSV, Aladili BN, Singh A, Trainor PJ, Mitra R, DeFilippis AP. Change in matrix metalloproteinase 2, 3, and 9 levels at the time of and after acute atherothrombotic myocardial infarction. J Thromb Thrombolysis 2020; 49:235-244. [PMID: 31808123 DOI: 10.1007/s11239-019-02004-7] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Elevated measures of matrix metalloproteinases (MMPs) are associated with acute myocardial infarction (MI), but it is not known how long these changes persist post-MI or if these measures differ between atherothrombotic versus non-atherothrombotic MI. MMPs-2, 3, and 9 were measured in 80 subjects with acute MI (atherothrombotic and non-atherothrombotic MI) or stable coronary artery disease (CAD). Measurements were made at, the time of acute MI, and > 3-month following acute MI (quiescent phase). Outcome measures were compared between groups and between time of acute MI and quiescent post-MI follow-up using Wilcoxon's and repeated measures analysis of variance. Forty-nine subjects met the criteria for acute MI with clearly defined atherothrombotic (n = 22) and non-atherothrombotic (n = 12) subsets. Fifteen subjects met criteria for stable CAD. MMP-3 was higher in acute MI versus stable CAD subjects at the time of acute MI: (453 vs. 217 pg/mL, p = 0.010) but not at quiescent phase follow-up (p > 0.05). MMP-9 was higher in acute MI versus stable CAD subjects at the time of acute MI: (412 vs. 168 pg/mL, p = 0.002) but not at the quiescent phase follow-up (p > 0.05). MMP-9 was higher at the time of acute MI versus quiescent phase follow-up in acute MI (412 vs. 213 pg/mL, p = 0.001) and atherothrombotic MI specifically (458 vs. 212 pg/mL, p = 0.001). No difference in MMP-2, 3, or 9 was observed between atherothrombotic versus non-atherothrombotic MI subgroups. MMPs-3 and 9 are significantly elevated in acute MI verses stable CAD subjects at time of acute MI but not different at quiescent phase follow-up. MMP-9 is elevated at the time of acute MI and specifically in acute atherothrombotic MI at time of MI versus quiescent phase follow-up.
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Affiliation(s)
- Ugochukwu Shola Owolabi
- Diabetes & Obesity Center, University of Louisville, Louisville, KY, USA.,Department of Bioinformatics and Biostatistics, University of Louisville, Louisville, KY, USA
| | - Alok Ravindra Amraotkar
- Diabetes & Obesity Center, University of Louisville, Louisville, KY, USA.,Division of Cardiovascular Medicine, University of Louisville, Louisville, KY, USA
| | - Amanda R Coulter
- Diabetes & Obesity Center, University of Louisville, Louisville, KY, USA.,Division of Cardiovascular Medicine, University of Louisville, Louisville, KY, USA
| | | | - Bahjat N Aladili
- Division of Cardiovascular Medicine, University of Louisville, Louisville, KY, USA
| | - Ayesha Singh
- School of Medicine, University of Louisville, Louisville, KY, USA
| | - Patrick James Trainor
- Division of Cardiovascular Medicine, University of Louisville, Louisville, KY, USA.,Applied Statistics, EASIB Department, New Mexico State University, Las Cruces, NM, USA
| | - Riten Mitra
- Department of Bioinformatics and Biostatistics, University of Louisville, Louisville, KY, USA
| | - Andrew Paul DeFilippis
- Division of Cardiovascular Medicine, University of Louisville, Louisville, KY, USA. .,Ciccarone Center for the Prevention of Heart Disease, Johns Hopkins University, Baltimore, MD, USA.
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24
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Steens J, Unger K, Klar L, Neureiter A, Wieber K, Hess J, Jakob HG, Klump H, Klein D. Direct conversion of human fibroblasts into therapeutically active vascular wall-typical mesenchymal stem cells. Cell Mol Life Sci 2020; 77:3401-3422. [PMID: 31712992 PMCID: PMC7426315 DOI: 10.1007/s00018-019-03358-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2019] [Revised: 09/27/2019] [Accepted: 10/28/2019] [Indexed: 12/11/2022]
Abstract
Cell-based therapies using adult stem cells are promising options for the treatment of a number of diseases including autoimmune and cardiovascular disorders. Among these, vascular wall-derived mesenchymal stem cells (VW-MSCs) might be particularly well suited for the protection and curative treatment of vascular damage because of their tissue-specific action. Here we report a novel method for the direct conversion of human skin fibroblasts towards MSCs using a VW-MSC-specific gene code (HOXB7, HOXC6 and HOXC8) that directs cell fate conversion bypassing pluripotency. This direct programming approach using either a self-inactivating (SIN) lentiviral vector expressing the VW-MSC-specific HOX-code or a tetracycline-controlled Tet-On system for doxycycline-inducible gene expressions of HOXB7, HOXC6 and HOXC8 successfully mediated the generation of VW-typical MSCs with classical MSC characteristics in vitro and in vivo. The induced VW-MSCs (iVW-MSCs) fulfilled all criteria of MSCs as defined by the International Society for Cellular Therapy (ISCT). In terms of multipotency and clonogenicity, which are important specific properties to discriminate MSCs from fibroblasts, iVW-MSCs behaved like primary ex vivo isolated VW-MSCs and shared similar molecular and DNA methylation signatures. With respect to their therapeutic potential, these cells suppressed lymphocyte proliferation in vitro, and protected mice against vascular damage in a mouse model of radiation-induced pneumopathy in vivo, as well as ex vivo cultured human lung tissue. The feasibility to obtain patient-specific VW-MSCs from fibroblasts in large amounts by a direct conversion into induced VW-MSCs could potentially open avenues towards novel, MSC-based therapies.
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Affiliation(s)
- Jennifer Steens
- Institute for Cell Biology (Cancer Research), University Hospital Essen, Medical Faculty, University of Duisburg-Essen, Virchowstr. 173, Ger-45122, Essen, Germany
| | - Kristian Unger
- Research Unit Radiation Cytogenetics and Clinical Cooperation Group "Personalized Radiotherapy in Head and Neck Cancer, Helmholtz Zentrum München, German Research Center for Environmental Health GmbH, Neuherberg, Germany
- Department of Radiation Oncology, University Hospital, LMU Munich, Munich, Germany
| | - Lea Klar
- Institute for Cell Biology (Cancer Research), University Hospital Essen, Medical Faculty, University of Duisburg-Essen, Virchowstr. 173, Ger-45122, Essen, Germany
| | - Anika Neureiter
- Institute for Transfusion Medicine, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Karolin Wieber
- Institute for Cell Biology (Cancer Research), University Hospital Essen, Medical Faculty, University of Duisburg-Essen, Virchowstr. 173, Ger-45122, Essen, Germany
| | - Julia Hess
- Research Unit Radiation Cytogenetics and Clinical Cooperation Group "Personalized Radiotherapy in Head and Neck Cancer, Helmholtz Zentrum München, German Research Center for Environmental Health GmbH, Neuherberg, Germany
- Department of Radiation Oncology, University Hospital, LMU Munich, Munich, Germany
| | - Heinz G Jakob
- Department of Thoracic and Cardiovascular Surgery, West-German Heart and Vascular Center Essen, University Duisburg-Essen, Essen, Germany
| | - Hannes Klump
- Institute for Transfusion Medicine, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Diana Klein
- Institute for Cell Biology (Cancer Research), University Hospital Essen, Medical Faculty, University of Duisburg-Essen, Virchowstr. 173, Ger-45122, Essen, Germany.
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25
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Mohammad Mirzaei N, Fok PW. Simple model of atherosclerosis in cylindrical arteries: impact of anisotropic growth on Glagov remodeling. MATHEMATICAL MEDICINE AND BIOLOGY-A JOURNAL OF THE IMA 2020; 38:59-82. [PMID: 32814945 DOI: 10.1093/imammb/dqaa011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/14/2019] [Revised: 07/08/2020] [Accepted: 07/21/2020] [Indexed: 01/14/2023]
Abstract
In 1987, Seymour Glagov observed that arteries went through a two-stage remodeling process as a result of plaque growth: first, a compensatory phase where the lumen area remains approximately constant and second, an encroachment phase where the lumen area decreases over time. In this paper, we investigate the effect of growth anisotropy on Glagov remodeling in five different cases: pure radial, pure circumferential, pure axial, isotropic and general anisotropic growth where the elements of the growth tensor are chosen to minimize the total energy. We suggest that the nature of anisotropy is inclined towards the growth direction that requires the least amount of energy. Our framework is the theory of morphoelasticity on an axisymmetric arterial domain. For each case, we explore their specific effect on the Glagov curves. For the latter two cases, we also provide the changes in collagen fiber orientation and length in the intima, media and adventitia. In addition, we compare the total energy produced by growth in radial, circumferential and axial direction and deduce that using a radially dominant anisotropic growth leads to lower strain energy than isotropic growth.
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Affiliation(s)
| | - Pak-Wing Fok
- Department of Mathematical Sciences, University of Delaware, Newark, DE 19716, USA
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26
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Jamthikar A, Gupta D, Saba L, Khanna NN, Araki T, Viskovic K, Mavrogeni S, Laird JR, Pareek G, Miner M, Sfikakis PP, Protogerou A, Viswanathan V, Sharma A, Nicolaides A, Kitas GD, Suri JS. Cardiovascular/stroke risk predictive calculators: a comparison between statistical and machine learning models. Cardiovasc Diagn Ther 2020; 10:919-938. [PMID: 32968651 DOI: 10.21037/cdt.2020.01.07] [Citation(s) in RCA: 43] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Background Statistically derived cardiovascular risk calculators (CVRC) that use conventional risk factors, generally underestimate or overestimate the risk of cardiovascular disease (CVD) or stroke events primarily due to lack of integration of plaque burden. This study investigates the role of machine learning (ML)-based CVD/stroke risk calculators (CVRCML) and compares against statistically derived CVRC (CVRCStat) based on (I) conventional factors or (II) combined conventional with plaque burden (integrated factors). Methods The proposed study is divided into 3 parts: (I) statistical calculator: initially, the 10-year CVD/stroke risk was computed using 13 types of CVRCStat (without and with plaque burden) and binary risk stratification of the patients was performed using the predefined thresholds and risk classes; (II) ML calculator: using the same risk factors (without and with plaque burden), as adopted in 13 different CVRCStat, the patients were again risk-stratified using CVRCML based on support vector machine (SVM) and finally; (III) both types of calculators were evaluated using AUC based on ROC analysis, which was computed using combination of predicted class and endpoint equivalent to CVD/stroke events. Results An Institutional Review Board approved 202 patients (156 males and 46 females) of Japanese ethnicity were recruited for this study with a mean age of 69±11 years. The AUC for 13 different types of CVRCStat calculators were: AECRS2.0 (AUC 0.83, P<0.001), QRISK3 (AUC 0.72, P<0.001), WHO (AUC 0.70, P<0.001), ASCVD (AUC 0.67, P<0.001), FRScardio (AUC 0.67, P<0.01), FRSstroke (AUC 0.64, P<0.001), MSRC (AUC 0.63, P=0.03), UKPDS56 (AUC 0.63, P<0.001), NIPPON (AUC 0.63, P<0.001), PROCAM (AUC 0.59, P<0.001), RRS (AUC 0.57, P<0.001), UKPDS60 (AUC 0.53, P<0.001), and SCORE (AUC 0.45, P<0.001), while the AUC for the CVRCML with integrated risk factors (AUC 0.88, P<0.001), a 42% increase in performance. The overall risk-stratification accuracy for the CVRCML with integrated risk factors was 92.52% which was higher compared all the other CVRCStat. Conclusions ML-based CVD/stroke risk calculator provided a higher predictive ability of 10-year CVD/stroke compared to the 13 different types of statistically derived risk calculators including integrated model AECRS 2.0.
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Affiliation(s)
- Ankush Jamthikar
- Department of Electronics and Communication Engineering, Visvesvaraya National Institute of Technology, Nagpur, Maharashtra, India
| | - Deep Gupta
- Department of Electronics and Communication Engineering, Visvesvaraya National Institute of Technology, Nagpur, Maharashtra, India
| | - Luca Saba
- Department of Radiology, University of Cagliari, Cagliari, Italy
| | - Narendra N Khanna
- Department of Cardiology, Indraprastha APOLLO Hospitals, New Delhi, India
| | - Tadashi Araki
- Division of Cardiovascular Medicine, Toho University, Tokyo, Japan
| | - Klaudija Viskovic
- Department of Radiology and Ultrasound, University Hospital for Infectious Diseases, Zagreb, Croatia
| | - Sophie Mavrogeni
- Cardiology Clinic, Onassis Cardiac Surgery Center, Athens, Greece
| | - John R Laird
- Heart and Vascular Institute, Adventist Health St. Helena, St Helena, CA, USA
| | - Gyan Pareek
- Minimally Invasive Urology Institute, Brown University, Providence, Rhode Island, USA
| | - Martin Miner
- Men's Health Center, Miriam Hospital Providence, Rhode Island, USA
| | - Petros P Sfikakis
- Rheumatology Unit, National and Kapodistrian University of Athens, Athens, Greece
| | - Athanasios Protogerou
- Department of Cardiovascular Prevention & Research Unit Clinic & Laboratory of Pathophysiology, National and Kapodistrian University of Athens, Athens, Greece
| | - Vijay Viswanathan
- MV Hospital for Diabetes and Professor M Viswanathan Diabetes Research Centre, Chennai, India
| | - Aditya Sharma
- Division of Cardiovascular Medicine, University of Virginia, Charlottesville, VA, USA
| | - Andrew Nicolaides
- Vascular Screening and Diagnostic Centre and University of Nicosia Medical School, Nicosia, Cyprus
| | - George D Kitas
- R & D Academic Affairs, Dudley Group NHS Foundation Trust, Dudley, UK
| | - Jasjit S Suri
- Stroke Monitoring and Diagnostic Division, AtheroPoint™, Roseville, CA, USA
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27
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Tanaka LY, Oliveira PVS, Laurindo FRM. Peri/Epicellular Thiol Oxidoreductases as Mediators of Extracellular Redox Signaling. Antioxid Redox Signal 2020; 33:280-307. [PMID: 31910038 DOI: 10.1089/ars.2019.8012] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
Significance: Supracellular redox networks regulating cell-extracellular matrix (ECM) and organ system architecture merge with structural and functional (catalytic or allosteric) properties of disulfide bonds. This review addresses emerging evidence that exported thiol oxidoreductases (TORs), such as thioredoxin, protein disulfide isomerases (PDIs), quiescin sulfhydryl oxidases (QSOX)1, and peroxiredoxins, composing a peri/epicellular (pec)TOR pool, mediate relevant signaling. pecTOR functions depend mainly on kinetic and spatial regulation of thiol-disulfide exchange reactions governed by redox potentials, which are modulated by exported intracellular low-molecular-weight thiols, together conferring signal specificity. Recent Advances: pecTOR redox-modulates several targets including integrins, ECM proteins, surface molecules, and plasma components, although clear-cut documentation of direct effects is lacking in many cases. TOR catalytic pathways, displaying common patterns, culminate in substrate thiol reduction, oxidation, or isomerization. Peroxiredoxins act as redox/peroxide sensors, contrary to PDIs, which are likely substrate-targeted redox modulators. Emerging evidence suggests important pecTOR roles in patho(physio)logical processes, including blood coagulation, vascular remodeling, mechanosensing, endothelial function, immune responses, and inflammation. Critical Issues: Effects of pecPDIs supporting thrombosis/platelet activation have been well documented and reached the clinical arena. Roles of pecPDIA1 in vascular remodeling/mechanosensing are also emerging. Extracellular thioredoxin and pecPDIs redox-regulate immunoinflammation. Routes of TOR externalization remain elusive and appear to involve Golgi-independent routes. pecTORs are particularly accessible drug targets. Future Directions: Further understanding mechanisms of thiol redox reactions and developing assays for assessing pecTOR redox activities remain important research avenues. Also, addressing pecTORs as disease markers and achieving more efficient/specific drugs for pecTOR modulation are major perspectives for diagnostic/therapeutic improvements.
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Affiliation(s)
- Leonardo Y Tanaka
- Vascular Biology Laboratory, LIM-64 (Translational Cardiovascular Biology), Instituto do Coracao (InCor), Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, Brazil
| | - Percillia V S Oliveira
- Vascular Biology Laboratory, LIM-64 (Translational Cardiovascular Biology), Instituto do Coracao (InCor), Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, Brazil
| | - Francisco R M Laurindo
- Vascular Biology Laboratory, LIM-64 (Translational Cardiovascular Biology), Instituto do Coracao (InCor), Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, Brazil
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28
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Zhou KN, Sung KT, Yen CH, Su CH, Lee PY, Hung TC, Huang WH, Chien SC, Tsai JP, Yun CH, Chang SC, Yeh HI, Hung CL. Carotid arterial mechanics as useful biomarker of extracellular matrix turnover and preserved ejection fraction heart failure. ESC Heart Fail 2020; 7:1615-1625. [PMID: 32449609 PMCID: PMC7373904 DOI: 10.1002/ehf2.12714] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2019] [Revised: 02/10/2020] [Accepted: 03/31/2020] [Indexed: 11/12/2022] Open
Abstract
Aims We aimed to investigate the functional alterations, diagnostic utilization, and prognostic implication of carotid arterial deformations in subjects with cardiovascular risk factors and heart failure (HF) with preserved ejection fraction (HFpEF). Methods and results Among 251 prospectively participants (mean age 66.0 ± 9.8 years, 65.7% female) in a single centre between December 2011 and September 2014, carotid artery deformations including circumferential strain (CCS)/strain rate and radial strain were analysed by two‐dimensional speckle tracking. We further related these carotid artery deformation indices to HF biomarkers and cardiac structure and function by echocardiography and explored their prognostic values. Significant reductions of CCS, circumferential strain rate, and circumferential radial strain were observed across control (n = 52), high risk (n = 147), and HFpEF (n = 52) (trend P ≤ 0.001). Aging, hypertension, HFpEF, and higher pulse rate showed independent associations with reduced CCS by stepwise multivariate regressions (all P < 0.05). Higher CCS was inversely associated with better cardiac remodelling and functional indices, and lower multiple HF biomarkers (all P ≤ 0.005). After adjustment, higher CCS was independently associated with better global ventricular longitudinal strain/early diastolic strain rate, lower matrix metalloproteinase‐2, and N‐terminal propeptide of procollagen type III levels (adjusted coef: −0.08 and −19.9, all P < 0.05). During a median follow‐up of 1406 days (interquartile range: 1342‑1720 days), CCS less than 3.28% as a cut‐off had markedly higher HF events [Harrell's C: 0.72, adjusted HR: 2.20 (95% confidence interval: 1.24, 3.16), P = 0.008]. CCS also showed significantly improved risk prediction for HF over global ventricular longitudinal strain (net reclassification index: 48%, P = 0.001; integrated discrimination improvement: 1.8%, P < 0.001). Conclusions Carotid artery deformations using two‐dimensional speckle‐tracking imaging showed novel mechanistic insights on functional arterial alterations reflecting coupled arterial‐ventricular pathophysiology. Utilization of such measure may further provide additive prognostic value to advanced myocardial functional assessment.
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Affiliation(s)
- Kevin Ning Zhou
- Williams College Department of Biology, Williams College, 59 Lab Campus Drive, Williamstown, MA, 01267, USA
| | - Kuo-Tzu Sung
- Department of Medicine, Mackay Medical College, New Taipei City, Taiwan.,Mackay Junior College of Medicine, Nursing, and Management, Taipei, Taiwan.,Cardiovascular Division, Department of Internal Medicine, MacKay Memorial Hospital, Zhongshan North Road, Taipei, 104, Taiwan
| | - Chih-Hsuan Yen
- Department of Medicine, Mackay Medical College, New Taipei City, Taiwan.,Mackay Junior College of Medicine, Nursing, and Management, Taipei, Taiwan.,Institute of Preventive Medicine, School of Public Health, National Taiwan University, Taipei, Taiwan.,Cardiovascular Division, Department of Internal Medicine, MacKay Memorial Hospital, Zhongshan North Road, Taipei, 104, Taiwan
| | - Cheng-Huang Su
- Department of Medicine, Mackay Medical College, New Taipei City, Taiwan.,Mackay Junior College of Medicine, Nursing, and Management, Taipei, Taiwan.,Cardiovascular Division, Department of Internal Medicine, MacKay Memorial Hospital, Zhongshan North Road, Taipei, 104, Taiwan
| | - Ping-Ying Lee
- Department of Medicine, Mackay Medical College, New Taipei City, Taiwan.,Mackay Junior College of Medicine, Nursing, and Management, Taipei, Taiwan.,Cardiovascular Division, Department of Internal Medicine, MacKay Memorial Hospital, Zhongshan North Road, Taipei, 104, Taiwan
| | - Ta-Chuan Hung
- Department of Medicine, Mackay Medical College, New Taipei City, Taiwan.,Mackay Junior College of Medicine, Nursing, and Management, Taipei, Taiwan.,Cardiovascular Division, Department of Internal Medicine, MacKay Memorial Hospital, Zhongshan North Road, Taipei, 104, Taiwan
| | - Wen-Hung Huang
- Department of Medicine, Mackay Medical College, New Taipei City, Taiwan.,Mackay Junior College of Medicine, Nursing, and Management, Taipei, Taiwan.,Institute of Preventive Medicine, School of Public Health, National Taiwan University, Taipei, Taiwan.,Cardiovascular Division, Department of Internal Medicine, MacKay Memorial Hospital, Zhongshan North Road, Taipei, 104, Taiwan
| | - Shih-Chieh Chien
- Department of Critical Care Medicine, MacKay Memorial Hospital, Taipei, Taiwan
| | - Jui-Peng Tsai
- Department of Medicine, Mackay Medical College, New Taipei City, Taiwan.,Mackay Junior College of Medicine, Nursing, and Management, Taipei, Taiwan.,Cardiovascular Division, Department of Internal Medicine, MacKay Memorial Hospital, Zhongshan North Road, Taipei, 104, Taiwan.,Department of Biomedical Imaging and Radiological Sciences, National Yang Ming University, Taipei, Taiwan
| | - Chun-Ho Yun
- Department of Biomedical Imaging and Radiological Sciences, National Yang Ming University, Taipei, Taiwan.,Department of Radiology, MacKay Memorial Hospital, Taipei, Taiwan
| | - Shun-Chuan Chang
- Department of Medicine, Mackay Medical College, New Taipei City, Taiwan
| | - Hung-I Yeh
- Department of Medicine, Mackay Medical College, New Taipei City, Taiwan.,Institute of Preventive Medicine, School of Public Health, National Taiwan University, Taipei, Taiwan
| | - Chung-Lieh Hung
- Department of Medicine, Mackay Medical College, New Taipei City, Taiwan.,Mackay Junior College of Medicine, Nursing, and Management, Taipei, Taiwan.,Cardiovascular Division, Department of Internal Medicine, MacKay Memorial Hospital, Zhongshan North Road, Taipei, 104, Taiwan.,Institute of biomedical sciences, Mackay Medical College, New Taipei City, Taiwan
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29
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Korshunov VA, Smolock EM, Wines-Samuelson ME, Faiyaz A, Mickelsen DM, Quinn B, Pan C, Dugbartey GJ, Yan C, Doyley MM, Lusis AJ, Berk BC. Natriuretic Peptide Receptor 2 Locus Contributes to Carotid Remodeling. J Am Heart Assoc 2020; 9:e014257. [PMID: 32394795 PMCID: PMC7660849 DOI: 10.1161/jaha.119.014257] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background Carotid artery intima/media thickness (IMT) is a hallmark trait associated with future cardiovascular events. The goal of this study was to map new genes that regulate carotid IMT by genome-wide association. Methods and Results We induced IMT by ligation procedure of the left carotid artery in 30 inbred mouse strains. Histologic reconstruction revealed significant variation in left carotid artery intima, media, adventitia, external elastic lamina volumes, intima-to-media ratio, and (intima+media)/external elastic lamina percent ratio in inbred mice. The carotid remodeling trait was regulated by distinct genomic signatures with a dozen common single-nucleotide polymorphisms associated with left carotid artery intima volume, intima-to-media ratio, and (intima+media)/external elastic lamina percent ratio. Among genetic loci on mouse chromosomes 1, 4, and 12, there was natriuretic peptide receptor 2 (Npr2), a strong candidate gene. We observed that only male, not female, mice heterozygous for a targeted Npr2 deletion (Npr2+/-) exhibited defective carotid artery remodeling compared with Npr2 wild-type (Npr2+/+) littermates. Fibrosis in carotid IMT was significantly increased in Npr2+/- males compared with Npr2+/- females or Npr2+/+ mice. We also detected decreased Npr2 expression in human atherosclerotic plaques, similar to that seen in studies in Npr2+/- mice. Conclusions We found that components of carotid IMT were regulated by distinct genetic factors. We also showed a critical role for Npr2 in genetic regulation of vascular fibrosis associated with defective carotid remodeling.
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Affiliation(s)
| | - Elaine M Smolock
- Department of Medicine Aab Cardiovascular Research Institute Rochester NY
| | | | - Abrar Faiyaz
- Department of Electrical & Computer Engineering University of Rochester and Hajim School of Engineering & Applied Sciences Rochester NY
| | - Deanne M Mickelsen
- Department of Medicine Aab Cardiovascular Research Institute Rochester NY
| | - Breandan Quinn
- Department of Medicine Aab Cardiovascular Research Institute Rochester NY
| | - Calvin Pan
- Department of Medicine David Geffen School of Medicine University of California Los Angeles Los Angeles CA
| | - George J Dugbartey
- Department of Medicine Aab Cardiovascular Research Institute Rochester NY
| | - Chen Yan
- Department of Medicine Aab Cardiovascular Research Institute Rochester NY
| | - Marvin M Doyley
- Department of Electrical & Computer Engineering University of Rochester and Hajim School of Engineering & Applied Sciences Rochester NY
| | - Aldons J Lusis
- Department of Medicine David Geffen School of Medicine University of California Los Angeles Los Angeles CA
| | - Bradford C Berk
- Department of Medicine Aab Cardiovascular Research Institute Rochester NY.,University of Rochester Neurorestoration Institute University of Rochester School of Medicine and Dentistry Rochester NY
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30
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Sangha GS, Goergen CJ. Label-free photoacoustic and ultrasound imaging for murine atherosclerosis characterization. APL Bioeng 2020; 4:026102. [PMID: 32266325 PMCID: PMC7127913 DOI: 10.1063/1.5142728] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2019] [Accepted: 03/09/2020] [Indexed: 12/24/2022] Open
Abstract
Dual-modality photoacoustic tomography (PAT) and 4D ultrasound (4DUS) imaging have shown promise for cardiovascular applications, but their use in murine atherosclerosis imaging is limited. This study used PAT and 4DUS to correlate altered arterial strain and hemodynamics to morphological changes and lipid localization in a murine partial carotid ligation (PCL) model of atherosclerosis. Validation experiments showed a positive correlation between the PAT signal-to-noise ratio and plaque lipid composition obtained from oil-red O histology. Cross-sectional in situ PAT and longitudinal in vivo ultrasound imaging was performed using a 40 MHz transducer. Ultrasound timepoints included days 0, 1, 4, 7, 10, and 14 for hemodynamic and strain assessment, and 1100 nm and 1210 nm PAT was implemented at the study end point for hemoglobin and lipid characterization. These study groups were then separated into day 4 post-PCL with (n = 5) and without (n = 6) Western diet feeding, as well as days 7 (n = 8), 10 (n = 8), and 14 (n = 8) post-PCL, in addition to a sham control group on a Western diet (n = 5). Overall, our data revealed a substantial decrease in left carotid artery pulsatility by day 7. The hemodynamic results suggested greater disturbed flow in the caudal regions resulting in earlier vessel stenosis and greater lipid deposition than cranial regions. Morphological and compositional data revealed heterogeneous vascular remodeling between days 0 and 7, with a rapid decrease in the vessel volume/length and the presence of both intraplaque hematoma and lipid deposition at day 10 post-PCL. These results highlight the utility of utilizing dual-modality PAT and 4DUS to study atherosclerosis progression.
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Affiliation(s)
- Gurneet S Sangha
- Weldon School of Biomedical Engineering, Purdue University, 206 S. Martin Jischke Dr., West Lafayette, Indiana 47907, USA
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31
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Puvvula A, Jamthikar AD, Gupta D, Khanna NN, Porcu M, Saba L, Viskovic K, Ajuluchukwu JNA, Gupta A, Mavrogeni S, Turk M, Laird JR, Pareek G, Miner M, Sfikakis PP, Protogerou A, Kitas GD, Nicolaides A, Viswanathan V, Suri JS. Morphological Carotid Plaque Area Is Associated With Glomerular Filtration Rate: A Study of South Asian Indian Patients With Diabetes and Chronic Kidney Disease. Angiology 2020; 71:520-535. [PMID: 32180436 DOI: 10.1177/0003319720910660] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
We evaluated the association between automatically measured carotid total plaque area (TPA) and the estimated glomerular filtration rate (eGFR), a biomarker of chronic kidney disease (CKD). Automated average carotid intima-media thickness (cIMTave) and TPA measurements in carotid ultrasound (CUS) were performed using AtheroEdge (AtheroPoint). Pearson correlation coefficient (CC) was then computed between the TPA and eGFR for (1) males versus females, (2) diabetic versus nondiabetic patients, and (3) between the left and right carotid artery. Overall, 339 South Asian Indian patients with either type 2 diabetes mellitus (T2DM) or CKD, or hypertension (stage 1 or stage 2) were retrospectively analyzed by acquiring cIMTave and TPA measurements of their left and right common carotid arteries (CCA; total CUS: 678, mean age: 54.2 ± 9.8 years; 75.2% males; 93.5% with T2DM). The CC between TPA and eGFR for different scenarios were (1) for males and females -0.25 (P < .001) and -0.35 (P < .001), respectively; (2) for T2DM and non-T2DM -0.26 (P < .001) and -0.49 (P = .02), respectively, and (3) for left and right CCA -0.25 (P < .001) and -0.23 (P < .001), respectively. Automated TPA is an equally reliable biomarker compared with cIMTave for patients with CKD (with or without T2DM) with subclinical atherosclerosis.
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Affiliation(s)
- Anudeep Puvvula
- Annu's Hospitals for Skin and Diabetes, Nellore, Andhra Pradesh, India
| | - Ankush D Jamthikar
- Department of Electronics and Communications Engineering, Visvesvaraya National Institute of Technology, Nagpur, Maharashtra, India
| | - Deep Gupta
- Department of Electronics and Communications Engineering, Visvesvaraya National Institute of Technology, Nagpur, Maharashtra, India
| | - Narendra N Khanna
- Department of Cardiology, Indraprastha Apollo Hospitals, New Delhi, Delhi, India
| | - Michele Porcu
- Department of Radiology, Azienda Ospedaliero Universitaria (A.O.U.), Cagliari, Italy
| | - Luca Saba
- Department of Radiology, Azienda Ospedaliero Universitaria (A.O.U.), Cagliari, Italy
| | - Klaudija Viskovic
- Department of Radiology and Ultrasound, University Hospital for Infectious Diseases, Zagreb, Croatia
| | | | - Ajay Gupta
- Department of Radiology, Weill Cornell Medicine, New York City, NY, USA
| | - Sophie Mavrogeni
- Cardiology Clinic, Onassis Cardiac Surgery Center, Athens, Greece
| | - Monika Turk
- Department of Neurology, University Medical Centre Maribor, Slovenia
| | - John R Laird
- Heart and Vascular Institute, Adventist Health St Helena, St Helena, CA, USA
| | - Gyan Pareek
- Minimally Invasive Urology Institute, Brown University, Providence, RI, USA
| | - Martin Miner
- Men's Health Center, Miriam Hospital, Providence, RI, USA
| | - Petros P Sfikakis
- Rheumatology Unit, National Kapodistrian University of Athens, Greece
| | - Athanasios Protogerou
- Department of Cardiovascular Prevention and Research Unit Clinic and Laboratory of Pathophysiology, National and Kapodistrian University of Athens, Greece
| | - George D Kitas
- R & D Academic Affairs, Dudley Group NHS Foundation Trust, Dudley, United Kingdom
| | - Andrew Nicolaides
- Vascular Screening and Diagnostic Centre and University of Nicosia Medical School, Cyprus
| | - Vijay Viswanathan
- M. V. Hospital for Diabetes and Professor M. Viswanathan Diabetes Research Centre, Chennai, Tamil Nadu, India
| | - Jasjit S Suri
- Stroke Monitoring and Diagnostic Division, AtheroPoint, Roseville, CA, USA
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Carmo LS, Burdmann EA, Fessel MR, Almeida YE, Pescatore LA, Farias-Silva E, Gamarra LF, Lopes GH, Aloia TPA, Liberman M. Expansive Vascular Remodeling and Increased Vascular Calcification Response to Cholecalciferol in a Murine Model of Obesity and Insulin Resistance. Arterioscler Thromb Vasc Biol 2019; 39:200-211. [PMID: 30580565 DOI: 10.1161/atvbaha.118.311880] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
Objective- We hypothesized that ob/ob mice develop expansive vascular remodeling associated with calcification. Approach and Results- We quantified and investigated mechanisms of vascular remodeling and vascular calcification in ob/ob mice after vitamin D3(VD) stimulation or PBS (control), compared with C57BL/6 mice. Both ob/ob (OBVD [VD-treated ob/ob mice]) and C57BL/6 (C57VD [VD-treated C57BL/6 mice]) received 8×103 IU/day of intraperitoneal VD for 14 days. Control ob/ob (OBCT [PBS-treated ob/ob mice]) and C57BL/6 (C57CT [PBS-treated C57BL/6 mice]) received intraperitoneal PBS for 14 days. Hypervitaminosis D increased the external and internal elastic length in aortae from OBVD, resulting in increased total vascular area and lumen vascular area, respectively, which characterizes expansive vascular remodeling. OBVD decreased the aortic wall thickness, resulting in hypotrophic vascular remodeling. We demonstrated increased collagen deposition, elastolysis, and calcification in aortae from OBVD. Our results showed a positive correlation between expansive vascular remodeling and vascular calcification in OBVD. We demonstrated increased serum calcium levels, augmented Bmp (bone morphogenetic protein)-2 and osteochondrogenic proteins expression in OBVD aortae. Furthermore, aortae from OBVD increased oxidative stress, coincidently with augmented in situ MMP (matrix metalloproteinase) activity and exhibited no VDR (VD receptor) inhibition after VD. Conclusions- Our data provide evidence that obese and insulin-resistant mice (ob/ob) developed expansive hypotrophic vascular remodeling correlated directly with increased vascular calcification after chronic VD stimulation. Positive hypotrophic vascular remodeling and vascular calcification in this mouse model is possibly mediated by the convergence of absence VDR downregulation after VD stimulation, increased reactive oxygen species generation, and MMP activation.
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Affiliation(s)
- Luciana S Carmo
- From the Department of IIEP-Research and Teaching Institute (L.S.C., M.R.F., Y.E.A., L.A.P., E.F.-S., L.F.G., G.H.L., T.P.A.A., M.L.), Hospital Israelita Albert Einstein, São Paulo, Brazil.,the Division of Nephrology, LIM 12, University of São Paulo Medical School, Brazil (L.S.C., E.A.B.)
| | - Emmanuel A Burdmann
- the Division of Nephrology, LIM 12, University of São Paulo Medical School, Brazil (L.S.C., E.A.B.)
| | - Melissa R Fessel
- From the Department of IIEP-Research and Teaching Institute (L.S.C., M.R.F., Y.E.A., L.A.P., E.F.-S., L.F.G., G.H.L., T.P.A.A., M.L.), Hospital Israelita Albert Einstein, São Paulo, Brazil
| | - Youri E Almeida
- From the Department of IIEP-Research and Teaching Institute (L.S.C., M.R.F., Y.E.A., L.A.P., E.F.-S., L.F.G., G.H.L., T.P.A.A., M.L.), Hospital Israelita Albert Einstein, São Paulo, Brazil
| | - Luciana A Pescatore
- From the Department of IIEP-Research and Teaching Institute (L.S.C., M.R.F., Y.E.A., L.A.P., E.F.-S., L.F.G., G.H.L., T.P.A.A., M.L.), Hospital Israelita Albert Einstein, São Paulo, Brazil
| | - Elisangela Farias-Silva
- From the Department of IIEP-Research and Teaching Institute (L.S.C., M.R.F., Y.E.A., L.A.P., E.F.-S., L.F.G., G.H.L., T.P.A.A., M.L.), Hospital Israelita Albert Einstein, São Paulo, Brazil
| | - Lionel F Gamarra
- From the Department of IIEP-Research and Teaching Institute (L.S.C., M.R.F., Y.E.A., L.A.P., E.F.-S., L.F.G., G.H.L., T.P.A.A., M.L.), Hospital Israelita Albert Einstein, São Paulo, Brazil
| | - Gabriel H Lopes
- From the Department of IIEP-Research and Teaching Institute (L.S.C., M.R.F., Y.E.A., L.A.P., E.F.-S., L.F.G., G.H.L., T.P.A.A., M.L.), Hospital Israelita Albert Einstein, São Paulo, Brazil
| | - Thiago P A Aloia
- From the Department of IIEP-Research and Teaching Institute (L.S.C., M.R.F., Y.E.A., L.A.P., E.F.-S., L.F.G., G.H.L., T.P.A.A., M.L.), Hospital Israelita Albert Einstein, São Paulo, Brazil
| | - Marcel Liberman
- From the Department of IIEP-Research and Teaching Institute (L.S.C., M.R.F., Y.E.A., L.A.P., E.F.-S., L.F.G., G.H.L., T.P.A.A., M.L.), Hospital Israelita Albert Einstein, São Paulo, Brazil.,Department of Critical Care Medicine and Cardiology (M.L.), Hospital Israelita Albert Einstein, São Paulo, Brazil
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Saba L, Jamthikar A, Gupta D, Khanna NN, Viskovic K, Suri HS, Gupta A, Mavrogeni S, Turk M, Laird JR, Pareek G, Miner M, Sfikakis PP, Protogerou A, Kitas GD, Viswanathan V, Nicolaides A, Bhatt DL, Suri JS. Global perspective on carotid intima-media thickness and plaque: should the current measurement guidelines be revisited? INT ANGIOL 2019; 38:451-465. [PMID: 31782286 DOI: 10.23736/s0392-9590.19.04267-6] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Carotid intima-media thickness (cIMT) and carotid plaque (CP) currently act as risk predictors for CVD/Stroke risk assessment. Over 2000 articles have been published that cover either use cIMT/CP or alterations of cIMT/CP and additional image-based phenotypes to associate cIMT related markers with CVD/Stroke risk. These articles have shown variable results, which likely reflect a lack of standardization in the tools for measurement, risk stratification, and risk assessment. Guidelines for cIMT/CP measurement are influenced by major factors like the atherosclerosis disease itself, conventional risk factors, 10-year measurement tools, types of CVD/Stroke risk calculators, incomplete validation of measurement tools, and the fast pace of computer technology advancements. This review discusses the following major points: 1) the American Society of Echocardiography and Mannheim guidelines for cIMT/CP measurements; 2) forces that influence the guidelines; and 3) calculators for risk stratification and assessment under the influence of advanced intelligence methods. The review also presents the knowledge-based learning strategies such as machine and deep learning which may play a future role in CVD/stroke risk assessment. We conclude that both machine learning and non-machine learning strategies will flourish for current and 10-year CVD/Stroke risk prediction as long as they integrate image-based phenotypes with conventional risk factors.
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Affiliation(s)
- Luca Saba
- Department of Radiology, University of Cagliari, Cagliari, Italy
| | - Ankush Jamthikar
- Department of Electronics and Communication Engineering, Visvesvaraya National Institute of Technology, Nagpur, India
| | - Deep Gupta
- Department of Electronics and Communication Engineering, Visvesvaraya National Institute of Technology, Nagpur, India
| | - Narendra N Khanna
- Department of Cardiology, Indraprastha APOLLO Hospitals, New Delhi, India
| | - Klaudija Viskovic
- Department of Radiology and Ultrasound, University Hospital for Infectious Diseases, Zagreb, Croatia
| | | | - Ajay Gupta
- Department of Radiology, Weill Cornell Medicine, New York, NY, USA
| | - Sophie Mavrogeni
- Cardiology Clinic, Onassis Cardiac Surgery Center, Athens, Greece
| | - Monika Turk
- Department of Neurology, University Medical Center Maribor, Maribor, Slovenia
| | - John R Laird
- Heart and Vascular Institute, Adventist Health St. Helena, St Helena, CA, USA
| | - Gyan Pareek
- Minimally Invasive Urology Institute, Brown University, Providence, RI, USA
| | - Martin Miner
- Men's Health Center, Miriam Hospital, Providence, RI, USA
| | - Petros P Sfikakis
- Unit of Rheumatology, National Kapodistrian University of Athens, Athens, Greece
| | - Athanasios Protogerou
- Department of Cardiovascular Prevention and Research, Clinic and Laboratory of Pathophysiology, National and Kapodistrian, University of Athens, Athens, Greece
| | - George D Kitas
- R and D Academic Affairs, Dudley Group NHS Foundation Trust, Dudley, UK
| | - Vijay Viswanathan
- MV Hospital for Diabete, Professor M Viswanathan Diabetes Research Center, Chennai, India
| | - Andrew Nicolaides
- Vascular Screening and Diagnostic Center, University of Nicosia Medical School, Nicosia, Cyprus
| | - Deepak L Bhatt
- Brigham and Women's Hospital Heart, Vascular Center, Harvard Medical School, Boston, MA, USA
| | - Jasjit S Suri
- Stroke Monitoring and Diagnostic Division, AtheroPoint™, Roseville, CA, USA -
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Shen W, Anwaier G, Cao Y, Lian G, Chen C, Liu S, Tuerdi N, Qi R. Atheroprotective Mechanisms of Tilianin by Inhibiting Inflammation Through Down-Regulating NF-κB Pathway and Foam Cells Formation. Front Physiol 2019; 10:825. [PMID: 31333487 PMCID: PMC6614704 DOI: 10.3389/fphys.2019.00825] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2018] [Accepted: 06/13/2019] [Indexed: 12/11/2022] Open
Abstract
Tilianin, a representative flavonoid ingredient of Dracocephalum moldavica L., has been used to treat several diseases for centuries, including atherosclerosis (AS). However, pharmacological mechanisms underlying its biological functions remain elusive. In the present study, we investigated the anti-AS mechanisms of tilianin through establishing in vitro models using three types of cells that contributed to AS progression, including macrophage, vascular smooth muscle cells and human umbilical vein endothelial cells, which were proved to be involve in LPS/TNF-α/oxidized low density lipoprotein (ox-LDL)-induced inflammation and ox-LDL induced foam cell formation. Our results indicate that tilianin significantly suppressed LPS induced inflammatory responses on macrophage and remarkably inhibited TNF-α induced VSMCs proliferation and migration. Furthermore, the anti-inflammatory effect of tilianin on macrophages and VSMCs was proved to be mainly by downregulating TNF-α/NF-κB pathway. Moreover, our results demonstrate that tilianin significantly ameliorated ox-LDL induced macrophages oriented foam cells formation through repressing mRNA expression of SR-A1 and inducting the expression of genes related to cholesterol efflux including SRB-1 and ABCA1. However, tilianin had no effect on ox-LDL induced HUVECs injury.
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Affiliation(s)
- Wanli Shen
- School of Pharmacy, Shihezi University, Shihezi, China.,Institute of Cardiovascular Sciences, Peking University Health Science Center, Peking University, Beijing, China.,Key Laboratory of Molecular Cardiovascular Sciences, Ministry of Education, Beijing, China.,Beijing Key Laboratory of Molecular Pharmaceutics and New Drug Delivery Systems, Beijing, China
| | - Gulinigaer Anwaier
- School of Basic Medical Science, Shihezi University, Shihezi, China.,Institute of Cardiovascular Sciences, Peking University Health Science Center, Peking University, Beijing, China.,Key Laboratory of Molecular Cardiovascular Sciences, Ministry of Education, Beijing, China.,Beijing Key Laboratory of Molecular Pharmaceutics and New Drug Delivery Systems, Beijing, China
| | - Yini Cao
- Institute of Cardiovascular Sciences, Peking University Health Science Center, Peking University, Beijing, China.,Key Laboratory of Molecular Cardiovascular Sciences, Ministry of Education, Beijing, China.,Beijing Key Laboratory of Molecular Pharmaceutics and New Drug Delivery Systems, Beijing, China
| | - Guan Lian
- School of Pharmacy, Shihezi University, Shihezi, China.,Institute of Cardiovascular Sciences, Peking University Health Science Center, Peking University, Beijing, China.,Key Laboratory of Molecular Cardiovascular Sciences, Ministry of Education, Beijing, China.,Beijing Key Laboratory of Molecular Pharmaceutics and New Drug Delivery Systems, Beijing, China
| | - Cong Chen
- Institute of Cardiovascular Sciences, Peking University Health Science Center, Peking University, Beijing, China.,Key Laboratory of Molecular Cardiovascular Sciences, Ministry of Education, Beijing, China.,Beijing Key Laboratory of Molecular Pharmaceutics and New Drug Delivery Systems, Beijing, China
| | - Shu Liu
- School of Pharmacy, Shihezi University, Shihezi, China.,Institute of Cardiovascular Sciences, Peking University Health Science Center, Peking University, Beijing, China.,Key Laboratory of Molecular Cardiovascular Sciences, Ministry of Education, Beijing, China.,Beijing Key Laboratory of Molecular Pharmaceutics and New Drug Delivery Systems, Beijing, China
| | - Nuerbiye Tuerdi
- School of Basic Medical Science, Shihezi University, Shihezi, China.,Institute of Cardiovascular Sciences, Peking University Health Science Center, Peking University, Beijing, China.,Key Laboratory of Molecular Cardiovascular Sciences, Ministry of Education, Beijing, China.,Beijing Key Laboratory of Molecular Pharmaceutics and New Drug Delivery Systems, Beijing, China
| | - Rong Qi
- School of Basic Medical Science, Shihezi University, Shihezi, China.,School of Pharmacy, Shihezi University, Shihezi, China.,Institute of Cardiovascular Sciences, Peking University Health Science Center, Peking University, Beijing, China.,Key Laboratory of Molecular Cardiovascular Sciences, Ministry of Education, Beijing, China.,Beijing Key Laboratory of Molecular Pharmaceutics and New Drug Delivery Systems, Beijing, China
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Korshunov VA, Quinn B, Faiyaz A, Ahmed R, Sowden MP, Doyley MM, Berk BC. Strain-selective efficacy of sacubitril/valsartan on carotid fibrosis in response to injury in two inbred mouse strains. Br J Pharmacol 2019; 176:2795-2807. [PMID: 31077344 DOI: 10.1111/bph.14708] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2018] [Revised: 04/25/2019] [Accepted: 04/29/2019] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND AND PURPOSE Sacubitril/valsartan (Sac/val) is more effective than valsartan in lowering BP and mortality in patients with heart failure. Here, we proposed that Sac/val treatment would be more effective in preventing pathological vascular remodelling in 129X1/SvJ (129X1), than in C57BL/6J (B6) inbred mice. EXPERIMENTAL APPROACH Sac/val (60 mg·kg-1 ·day-1 ) and valsartan (27 mg·kg-1 ·day-1 ) were given as prophylactic or therapeutic treatments, to 129X1 or B6 mice with carotid artery ligation for 14 days. Blood flow was measured by ultrasound. Ex vivo, carotid tissue was analysed with histological and morphometric techniques, together with RNA sequencing and gene ontology. KEY RESULTS Sac/val was more effective than valsartan in lowering BP in 129X1 compared with B6 mice. Liver expression of CYP2C9 and plasma cGMP levels were similar across treatments. A reduction in carotid thickening after prophylactic treatment with valsartan or Sac/val also resulted in significant arterial shrinkage in B6 mice. In 129X1 mice, Sac/val and prophylactic treatment with valsartan had no effect on carotid thickening but preserved carotid size. BP lowering significantly correlated with a decline in carotid stiffness (R2 = .37, P = .0096) in 129X1 but not in B6 mice. The gene expression signature associated with hyalurononglucosaminidase activity was down-regulated in injured arteries after both regimens of Sac/val only in 129X1 mice. Administration of Sac/val but not valsartan significantly reduced deposition of hyaluronic acid and carotid fibrosis in 129X1 mice. CONCLUSION AND IMPLICATIONS These results underscore the importance of the genetic background in the efficacy of the Sac/val on vascular fibrosis.
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Affiliation(s)
- Vyacheslav A Korshunov
- Aab Cardiovascular Research Institute, Department of Medicine, University of Rochester, Rochester, New York
| | - Breandan Quinn
- Aab Cardiovascular Research Institute, Department of Medicine, University of Rochester, Rochester, New York
| | - Abrar Faiyaz
- Department of Electrical and Computer Engineering, Hajim School of Engineering and Applied Sciences, University of Rochester, Rochester, New York
| | - Rifat Ahmed
- Department of Electrical and Computer Engineering, Hajim School of Engineering and Applied Sciences, University of Rochester, Rochester, New York
| | - Mark P Sowden
- Aab Cardiovascular Research Institute, Department of Medicine, University of Rochester, Rochester, New York
| | - Marvin M Doyley
- Department of Electrical and Computer Engineering, Hajim School of Engineering and Applied Sciences, University of Rochester, Rochester, New York
| | - Bradford C Berk
- Aab Cardiovascular Research Institute, Department of Medicine, University of Rochester, Rochester, New York.,Neurorestoration Institute, University of Rochester, Rochester, New York
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36
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Jamthikar A, Gupta D, Khanna NN, Araki T, Saba L, Nicolaides A, Sharma A, Omerzu T, Suri HS, Gupta A, Mavrogeni S, Turk M, Laird JR, Protogerou A, Sfikakis PP, Kitas GD, Viswanathan V, Pareek G, Miner M, Suri JS. A Special Report on Changing Trends in Preventive Stroke/Cardiovascular Risk Assessment Via B-Mode Ultrasonography. Curr Atheroscler Rep 2019; 21:25. [PMID: 31041615 DOI: 10.1007/s11883-019-0788-4] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
PURPOSE OF REVIEW Cardiovascular disease (CVD) and stroke risk assessment have been largely based on the success of traditional statistically derived risk calculators such as Pooled Cohort Risk Score or Framingham Risk Score. However, over the last decade, automated computational paradigms such as machine learning (ML) and deep learning (DL) techniques have penetrated into a variety of medical domains including CVD/stroke risk assessment. This review is mainly focused on the changing trends in CVD/stroke risk assessment and its stratification from statistical-based models to ML-based paradigms using non-invasive carotid ultrasonography. RECENT FINDINGS In this review, ML-based strategies are categorized into two types: non-image (or conventional ML-based) and image-based (or integrated ML-based). The success of conventional (non-image-based) ML-based algorithms lies in the different data-driven patterns or features which are used to train the ML systems. Typically these features are the patients' demographics, serum biomarkers, and multiple clinical parameters. The integrated (image-based) ML-based algorithms integrate the features derived from the ultrasound scans of the arterial walls (such as morphological measurements) with conventional risk factors in ML frameworks. Even though the review covers ML-based system designs for carotid and coronary ultrasonography, the main focus of the review is on CVD/stroke risk scores based on carotid ultrasound. There are two key conclusions from this review: (i) fusion of image-based features with conventional cardiovascular risk factors can lead to more accurate CVD/stroke risk stratification; (ii) the ability to handle multiple sources of information in big data framework using artificial intelligence-based paradigms (such as ML and DL) is likely to be the future in preventive CVD/stroke risk assessment.
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Affiliation(s)
- Ankush Jamthikar
- Department of ECE, Visvesvaraya National Institute of Technology, Nagpur, Maharashtra, India
| | - Deep Gupta
- Department of ECE, Visvesvaraya National Institute of Technology, Nagpur, Maharashtra, India
| | - Narendra N Khanna
- Department of Cardiology, Indraprastha APOLLO Hospitals, New Delhi, India
| | - Tadashi Araki
- Division of Cardiovascular Medicine, Toho University, Tokyo, Japan
| | - Luca Saba
- Department of Radiology, University of Cagliari, Cagliari, Italy
| | - Andrew Nicolaides
- Vascular Screening and Diagnostic Centre, University of Cyprus, Nicosia, Cyprus
| | - Aditya Sharma
- Cardiovascular Medicine, University of Virginia, Charlottesville, VA, USA
| | - Tomaz Omerzu
- Department of Neurology, University Medical Centre Maribor, Maribor, Slovenia
| | | | - Ajay Gupta
- Department of Radiology, Cornell Medical Center, New York, NY, USA
| | - Sophie Mavrogeni
- Cardiology Clinic, Onassis Cardiac Surgery Center, Athens, Greece
| | - Monika Turk
- Department of Neurology, University Medical Centre Maribor, Maribor, Slovenia
| | - John R Laird
- Heart and Vascular Institute, Adventist Health St. Helena, St. Helena, CA, USA
| | - Athanasios Protogerou
- Department of Cardiovascular Prevention & Research Unit Clinic & Laboratory of Pathophysiology
- , National and Kapodistrian University of Athens, Athens, Greece
| | - Petros P Sfikakis
- Rheumatology Unit, National Kapodistrian University of Athens, Athens, Greece
| | - George D Kitas
- R&D Academic Affairs, Dudley Group NHS Foundation Trust, Dudley, UK
| | - Vijay Viswanathan
- MV Hospital for Diabetes and Professor M Viswanathan Diabetes Research Centre, Chennai, India
| | - Gyan Pareek
- Minimally Invasive Urology Institute, Brown University, Providence, RI, USA
| | - Martin Miner
- Men's Health Center, Miriam Hospital Providence, Providence, RI, USA
| | - Jasjit S Suri
- Stroke Monitoring and Diagnostic Division, AtheroPoint™, Roseville, CA, 95661, USA.
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37
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Han J, Liu J, Zhou Q, Nie S, Liu J, Wen S. Single Nucleotide Polymorphisms (SNPs) Genotyping Reveals that Mfn2 Polymorphisms are Associated with Thoracic Aortic Dissection in Han Chinese Population. Med Sci Monit 2019; 25:2419-2428. [PMID: 30940795 PMCID: PMC6459048 DOI: 10.12659/msm.915272] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023] Open
Abstract
BACKGROUND Many studies have shown that hypertension may contribute to thoracic aortic dissection (TAD). Among the factors that modulate hypertension are endoplasmic reticulum stress and vascular smooth muscle cell proliferation which are in turn modulated by mitofusion-2 (Mfn2). Specifically, we determined, in the Han Chinese population, whether single nucleotide polymorphisms (SNPs) of Mfn2 influenced the occurrence of TAD. MATERIAL AND METHODS Six tagging SNPs of Mfn2 (rs2236057, rs3766741, rs2236058, rs17037564, rs2295281, and rs2336384) were genotyped using a TaqMan assay in 200 TAD patients and 451 health individuals from the Han Chinese population. RESULTS Logistic regression analysis indicated CC genotype of rs2295281 was highly linked to an increased risk of TAD (TT+CT versus CC, OR=0.540, 95% CI [0.320-0.911], P=0.021), implying that TT genotype and CT genotype of rs2295281 have a lower risk for TAD. Logistic regression analysis also indicated that rs2236058 was highly linked to the risk of TAD based on recessive genetic model, which indicated that the GG genotype was a protective factor against TAD (GG versus (CG+CC), OR=0.545, 95% CI [0.351-0.845], P=0.007). CG genotype and CC genotype of rs2236058 had a higher risk for TAD. In addition, rs2236058 was linked to the risk of TAD in the recessive genetic and homozygous models in the normotensive subgroup (GG versus (CG+CC), OR=0.298, 95% CI [0.112-0.792], P=0.015; GG versus CC, OR=0.528, 95% CI [0.302-0.925], P=0.026) but not in the hypertension subgroup. CONCLUSIONS Our findings showed that the occurrence of TAD in a Han Chinese population was influenced by Mfn2 polymorphisms.
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Affiliation(s)
- Jing Han
- Department of Emergency and Critical Care Center, Beijing Anzhen Hospital, Capital Medical University, Beijing, China (mainland)
| | - Jielin Liu
- Department of Hypertension Research, Beijing Anzhen Hospital, Capital Medical University and Beijing Institute of Heart Lung and Blood Vessel Disease, Beijing, China (mainland)
| | - Qi Zhou
- Department of Hypertension, Beijing Anzhen Hospital, Capital Medical University, Beijing, China (mainland)
| | - Shaoping Nie
- Department of Emergency and Critical Care Center, Beijing Anzhen Hospital, Capital Medical University, Beijing, China (mainland)
| | - Jinghua Liu
- Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China (mainland)
| | - Shaojun Wen
- Department of Hypertension Research, Beijing Anzhen Hospital, Capital Medical University and Beijing Institute of Heart Lung and Blood Vessel Disease, Beijing, China (mainland)
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38
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Torres G, Czernuszewicz TJ, Homeister JW, Caughey MC, Huang BY, Lee ER, Zamora CA, Farber MA, Marston WA, Huang DY, Nichols TC, Gallippi CM. Delineation of Human Carotid Plaque Features In Vivo by Exploiting Displacement Variance. IEEE TRANSACTIONS ON ULTRASONICS, FERROELECTRICS, AND FREQUENCY CONTROL 2019; 66:481-492. [PMID: 30762544 PMCID: PMC7952026 DOI: 10.1109/tuffc.2019.2898628] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/02/2023]
Abstract
While in vivo acoustic radiation force impulse (ARFI)-induced peak displacement (PD) has been demonstrated to have high sensitivity and specificity for differentiating soft from stiff plaque components in patients with carotid plaque, the parameter exhibits poorer performance for distinguishing between plaque features with similar stiffness. To improve discrimination of carotid plaque features relative to PD, we hypothesize that signal correlation and signal-to-noise ratio (SNR) can be combined, outright or via displacement variance. Plaque feature detection by displacement variance, evaluated as the decadic logarithm of the variance of acceleration and termed "log(VoA)," was compared to that achieved by exploiting SNR, cross correlation coefficient, and ARFI-induced PD outcome metrics. Parametric images were rendered for 25 patients undergoing carotid endarterectomy, with spatially matched histology confirming plaque composition and structure. On average, across all plaques, log(VoA) was the only outcome metric with values that statistically differed between regions of lipid-rich necrotic core (LRNC), intraplaque hemorrhage (IPH), collagen (COL), and calcium (CAL). Further, log(VoA) achieved the highest contrast-to-noise ratio (CNR) for discriminating between LRNC and IPH, COL and CAL, and grouped soft (LRNC and IPH) and stiff (COL and CAL) plaque components. More specifically, relative to the previously demonstrated ARFI PD parameter, log(VoA) achieved 73% higher CNR between LRNC and IPH and 59% higher CNR between COL and CAL. These results suggest that log(VoA) enhances the differentiation of LRNC, IPH, COL, and CAL in human carotid plaques, in vivo, which is clinically relevant to improving stroke risk prediction and medical management.
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Tharp DL, Masseau I, Ivey J, Laughlin MH, Bowles DK. Endurance exercise training does not limit coronary atherosclerosis in familial hypercholesterolemic swine. Physiol Rep 2019; 7:e14008. [PMID: 30809955 PMCID: PMC6391583 DOI: 10.14814/phy2.14008] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2019] [Revised: 01/22/2019] [Accepted: 01/23/2019] [Indexed: 01/02/2023] Open
Abstract
Human studies demonstrate that physical activity reduces both morbidity and mortality of coronary heart disease (CHD) including decreased progression and/or regression of CHD with life-style modification which includes exercise. However, evidence supporting an intrinsic, direct effect of exercise in attenuating the development of CHD is equivocal. One limitation has been the lack of a large animal model with clinically evident CHD disease. Thus, we examined the role of endurance exercise in CHD development in a swine model of familial hypercholesterolemia (FH) that exhibits robust, complex atherosclerosis. FH swine were randomly assigned to either sedentary (Sed) or exercise trained (Ex) groups. At 10 months of age, Ex pigs began a 10 months, moderate-intensity treadmill-training intervention. At 14 months, all pigs were switched to a high-fat, high-cholesterol diet. CHD was assessed by intravascular ultrasound (IVUS) both prior to and after completion of 6 months on the HFC diet. Prior to HFC diet, Ex resulted in a greater coronary artery size in the proximal and mid sections of the LCX compared to SED, with no effect in the LAD. After 6 months on HFC diet, there was a 5-6 fold increase in absolute plaque volume in all segments of the LCX and LAD in both groups. At 20 months, there was no difference in vessel volume, lumen volume, absolute or relative plaque volume in either the LCX or LAD between Sed and Ex animals. These findings fail to support an independent, direct effect of exercise in limiting CHD progression in familial hypercholesterolemia.
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Affiliation(s)
- Darla L. Tharp
- Department of Biomedical SciencesUniversity of MissouriColumbiaMissouri
| | - Isabelle Masseau
- Department of Clinical SciencesUniversité de MontrealSt‐HyacintheCanada
| | - Jan Ivey
- Department of Biomedical SciencesUniversity of MissouriColumbiaMissouri
| | - Maurice Harold Laughlin
- Department of Biomedical SciencesUniversity of MissouriColumbiaMissouri
- Dalton Cardiovascular Research CenterUniversity of MissouriColumbiaMissouri
| | - Douglas K. Bowles
- Department of Biomedical SciencesUniversity of MissouriColumbiaMissouri
- Dalton Cardiovascular Research CenterUniversity of MissouriColumbiaMissouri
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40
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Min E, Schwartz MA. Translocating transcription factors in fluid shear stress-mediated vascular remodeling and disease. Exp Cell Res 2019; 376:92-97. [PMID: 30633880 DOI: 10.1016/j.yexcr.2019.01.005] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2018] [Revised: 01/04/2019] [Accepted: 01/07/2019] [Indexed: 02/06/2023]
Abstract
Endothelial cells are exposed to fluid shear stress profiles that vary in magnitude, pulsatility, and directionality due to regional variations in blood vessel structure. Laminar flow at physiological levels is atheroprotective; multidirectional or reversing low (disturbed) flow promotes inflammation and disease; and high or low laminar flow promote outward or inward remodeling, respectively. However, our understanding of how endothelial cells discern these different flow profiles and regulate gene expression accordingly is limited. This article reviews recent studies that identify the TGFβ/Smad, Notch, Yap/Taz, and Wnt/β-catenin pathways as important mediators of flow profile- and magnitude-dependent signaling.
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Affiliation(s)
- Elizabeth Min
- Department of Cell Biology, Yale School of Medicine, United States; Yale Cardiovascular Research Center, United States
| | - Martin A Schwartz
- Department of Cell Biology, Yale School of Medicine, United States; Yale Cardiovascular Research Center, United States; Department of Medicine (Cardiology), United States; Department of Biomedical Engineering, United States.
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Effects of Icariin on Atherosclerosis and Predicted Function Regulatory Network in ApoE Deficient Mice. BIOMED RESEARCH INTERNATIONAL 2018; 2018:9424186. [PMID: 30533443 PMCID: PMC6247691 DOI: 10.1155/2018/9424186] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/08/2018] [Revised: 10/02/2018] [Accepted: 10/21/2018] [Indexed: 12/13/2022]
Abstract
Objective. Icariin plays a pivotal role in ameliorating atherosclerosis for animal models although its comprehensive biological role remains largely unexplored. This study aimed to fully understand the effects of icariin on atherosclerosis in high-fat diet-induced ApoE-/- mice and investigate mRNA-miRNA regulation based on microarray and bioinformatics analysis. Methods. The areas of atherosclerotic lesions in en face aorta were evaluated. Microarray analysis was performed on atherosclerotic aortic tissues. The integrative analysis of mRNA and miRNA profiling was utilized to suggest specific functions of gene and supply an integrated and corresponding method to study the protective effect of icariin on atherosclerosis. Results. Icariin attenuated the development of atherosclerosis that the mean atherosclerotic lesion area was reduced by 5.8% (P < 0.05). Significant changes were observed in mRNA and miRNA expression patterns. Several miRNAs obtained from the miRNA-Gene-Network might play paramount part in antiatherosclerotic effect of icariin, such as mmu-miR-6931-5p, mmu-miR-3547-5p, mmu-miR-5107-5p, mmu-miR-6368, and mmu-miR-7118-5p. Specific miRNAs and GO terms associated with icariin in the pathogenesis of atherosclerosis were validated using GO analysis and miRNA-GO-Network. MiRNA-Pathway-Network indicated that icariin induced miRNAs mainly regulate the signaling pathways of PI3K/Akt signaling pathway, Ras signaling pathway, ErbB signaling pathway, and VEGF signaling pathway in aorta atherosclerotic lesion. Conclusions. Our data provides evidence that icariin is able to exhibit one antiatherosclerotic action by mediating multiple biological processes or cascades, suggesting the pleiotropic effects of icariin in atherosclerosis alleviation. The identified gene functional categories and pathways are potentially valuable targets for future development of RNA-guided gene regulation to fight disease.
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Bajpai A, Tilley DG. The Role of Leukocytes in Diabetic Cardiomyopathy. Front Physiol 2018; 9:1547. [PMID: 30443223 PMCID: PMC6221939 DOI: 10.3389/fphys.2018.01547] [Citation(s) in RCA: 46] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2018] [Accepted: 10/16/2018] [Indexed: 12/16/2022] Open
Abstract
Diabetes is predominant risk factor for cardiovascular diseases such as myocardial infarction and heart failure. Recently, leukocytes, particularly neutrophils, macrophages, and lymphocytes, have become targets of investigation for their potential role in a number of chronic inflammatory diseases such as diabetes and heart failure. While leukocytes contribute significantly to the progression of diabetes and heart failure individually, understanding their participation in the pathogenesis of diabetic heart failure is much less understood. The present review summarizes the role of leukocytes in the complex interplay between diabetes and heart failure, which is critical to the discovery of new targeted therapies for diabetic cardiomyopathy.
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Affiliation(s)
- Anamika Bajpai
- Center for Translational Medicine, Lewis Katz School of Medicine, Temple University, Philadelphia, PA, United States
| | - Douglas G Tilley
- Center for Translational Medicine, Lewis Katz School of Medicine, Temple University, Philadelphia, PA, United States
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43
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Rezvani-Sharif A, Tafazzoli-Shadpour M, Avolio A. Mechanical Characterization of the Lamellar Structure of Human Abdominal Aorta in the Development of Atherosclerosis: An Atomic Force Microscopy Study. Cardiovasc Eng Technol 2018; 10:181-192. [PMID: 30006817 DOI: 10.1007/s13239-018-0370-1] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2018] [Accepted: 07/08/2018] [Indexed: 12/16/2022]
Abstract
Atherosclerosis is a major risk factor for cardiovascular disease. However, mechanisms of interaction of atherosclerotic plaque development and local stiffness of the lamellar structure of the arterial wall are not well established. In the current study, the local Young's modulus of the wall and plaque components were determined for three different groups of healthy, mildly diseased and advanced atherosclerotic human abdominal aortas. Histological staining was performed to highlight the atherosclerotic plaque components and lamellar structure of the aortic media, consisting of concentric layers of elastin and interlamellar zones. The force spectroscopy mode of the atomic force microscopy was utilized to determine Young's moduli of aortic wall lamellae and plaque components at the micron level. The high variability of Young's moduli (E) at different locations of the atherosclerotic plaque such as the fibrous cap (E = 15.5± 2.6 kPa), calcification zone (E = 103.7±19.5 kPa), and lipid pool (E = 3.5±1.2 kPa) were observed. Reduction of elastin lamellae stiffness (18.6%), as well as stiffening of interlamellar zones (50%), were detected in the diseased portion of the medial layer of abdominal aortic wall compared to the healthy artery. Additionally, significant differences in the stiffness of both elastin lamellae and interlamellar zones were observed between the diseased wall and disease-free wall in incomplete plaques. Our results elucidate the alternation of the stiffness of different lamellae in the human abdominal aortic wall with atherosclerotic plaque development and may provide new insight on the remodeling of the aortic wall during the progression of atherosclerosis.
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Affiliation(s)
- Alireza Rezvani-Sharif
- Faculty of Biomedical Engineering, Amirkabir University of Technology, Tehran, Iran.,Department of Biomedical Science, Faculty of Medicine and Health Sciences, Macquarie University, Sydney, Australia
| | | | - Alberto Avolio
- Department of Biomedical Science, Faculty of Medicine and Health Sciences, Macquarie University, Sydney, Australia
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Liu J, Kang H, Ma X, Sun A, Luan H, Deng X, Fan Y. Vascular Cell Glycocalyx-Mediated Vascular Remodeling Induced by Hemodynamic Environmental Alteration. Hypertension 2018; 71:1201-1209. [DOI: 10.1161/hypertensionaha.117.10678] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2017] [Revised: 12/16/2017] [Accepted: 03/23/2018] [Indexed: 11/16/2022]
Abstract
Vascular remodeling induced by hemodynamic stimuli contributes to the pathophysiology of cardiovascular diseases. The importance of vascular cells (endothelial cells and smooth muscle cells) glycocalyx in the mechanotransduction of flow-induced shear stress at the cellular and molecular levels has been demonstrated over the past decade. However, its potential mechanotransduction role in vascular remodeling has triggered little attention. In the present study, a home-made apparatus was used to expose the rat abdominal aorta to sterile, flow or no flow, normal-pressure or high-pressure conditions for 4 days. The histomophometric, cellular, and molecular analysis of vessels were performed. The results showed that after exposing the vessels in the flow and high-pressure condition, the apoptotic rate, the cell number, and the RNA level of contractile marker gene smooth muscle 22 of smooth muscle cells were significantly increased, whereas the expression of nitric oxide synthase, α-smooth muscle actin, smoothelin, and calponion showed no significant differences compared with the flow and normal-pressure groups. Moreover, the histomophometric analysis of vascular walls suggested a remodeling induced by flow and high-pressure loading consistent with the classic hypertensive aortic phenotype, which is characterized by a thicker and more rigid vascular wall as well as increased aortic diameter. However, those phenomena were totally abolished after compromising the integrity of glycocalyx by the treatment of vessels with hyaluronidase, which provided evidence of the important mechanotransduction role of the vascular cells glycocalyx in vascular remodeling induced by hemodynamic stimuli.
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Affiliation(s)
- Jiajia Liu
- From the Key Laboratory for Biomechanics and Mechanobiology of Ministry of Education, School of Biological Science and Medical Engineering, Beihang University, Beijing, China (J.L., H.K., X.M., A.S., X.D., Y.F.)
- Beijing Advanced Innovation Center for Biomedical Engineering, Beihang University, China (J.L., H.K., X.M., A.S., X.D., Y.F.)
| | - Hongyan Kang
- From the Key Laboratory for Biomechanics and Mechanobiology of Ministry of Education, School of Biological Science and Medical Engineering, Beihang University, Beijing, China (J.L., H.K., X.M., A.S., X.D., Y.F.)
- Beijing Advanced Innovation Center for Biomedical Engineering, Beihang University, China (J.L., H.K., X.M., A.S., X.D., Y.F.)
| | - Xuejiao Ma
- From the Key Laboratory for Biomechanics and Mechanobiology of Ministry of Education, School of Biological Science and Medical Engineering, Beihang University, Beijing, China (J.L., H.K., X.M., A.S., X.D., Y.F.)
- Beijing Advanced Innovation Center for Biomedical Engineering, Beihang University, China (J.L., H.K., X.M., A.S., X.D., Y.F.)
| | - Anqiang Sun
- From the Key Laboratory for Biomechanics and Mechanobiology of Ministry of Education, School of Biological Science and Medical Engineering, Beihang University, Beijing, China (J.L., H.K., X.M., A.S., X.D., Y.F.)
- Beijing Advanced Innovation Center for Biomedical Engineering, Beihang University, China (J.L., H.K., X.M., A.S., X.D., Y.F.)
| | - Huiqin Luan
- National Research Center for Rehabilitation Technical Aids, Beijing, China (H.L., Y.F.)
| | - Xiaoyan Deng
- From the Key Laboratory for Biomechanics and Mechanobiology of Ministry of Education, School of Biological Science and Medical Engineering, Beihang University, Beijing, China (J.L., H.K., X.M., A.S., X.D., Y.F.)
- Beijing Advanced Innovation Center for Biomedical Engineering, Beihang University, China (J.L., H.K., X.M., A.S., X.D., Y.F.)
| | - Yubo Fan
- From the Key Laboratory for Biomechanics and Mechanobiology of Ministry of Education, School of Biological Science and Medical Engineering, Beihang University, Beijing, China (J.L., H.K., X.M., A.S., X.D., Y.F.)
- National Research Center for Rehabilitation Technical Aids, Beijing, China (H.L., Y.F.)
- Beijing Advanced Innovation Center for Biomedical Engineering, Beihang University, China (J.L., H.K., X.M., A.S., X.D., Y.F.)
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ARFIAN N, KUSUMA MHH, ANGGOROWATI N, NUGROHO DB, JEFFILANO A, SUZUKI Y, IKEDA K, EMOTO N. Vitamin D Upregulates Endothelin-1, ETBR, eNOS mRNA Expression and Attenuates Vascular Remodelling and Ischemia in Kidney Fibrosis Model in Mice Vitamin D Upregulates Endothelin-1, ETBR, eNOS mRNA Expression and Attenuates Vascular Remodelling and Ischemia in Kidney Fibrosis Model in Mice. Physiol Res 2018; 67:S137-S147. [DOI: 10.33549/physiolres.933823] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
We examined the upregulation of ET-1/ETBR/eNOS signaling in renoprotective effect of vitamin D in kidney fibrosis model in mice using unilateral ureteral obstruction (UUO). One group was treated with intraperitoneal injection of 0.125 mg/kg of Calcitriol (UUO+VD). Vascular remodeling was quantified based on lumen area and lumen/wall area ratio (LWAR) of intrarenal arteries using Sirius Red staining. ET-1, ETBR, eNOS, CD31 and VEGF mRNA expressions were quantified using qRT-PCR. Focusing on endothelin-1 (ET-1) signaling in endothelial cells (EC), siRNA of ET-1 was performed in human umbilical vein endothelial cells (HUVEC) for reducing ET-1 expression. Then HUVECs were treated with and without 100 nM Calcitriol treatment in hypoxic and normoxic conditions to elucidate ET-1/eNOS signaling. Our in vivo study revealed vascular remodeling and renal ischemia attenuation after Calcitriol treatment. Vascular remodeling was attenuated in the UUO+VD group as shown by increasing lumen areas and LWAR in intrarenal arteries. These findings were associated with significant higher CD31 and VEGF mRNA expression compared to the UUO group. Vitamin D treatment also increased ET-1, ETBR and eNOS mRNA expressions. Our in vitro study demonstrated Calcitriol induced ET-1 and eNOS mRNA expressions upregulation in HUVEC under normoxic and hypoxic condition. Meanwhile, siRNA for ET-1 inhibited the upregulation of eNOS mRNA expression after Calcitriol treatment. Vitamin D ameliorates kidney fibrosis through attenuating vascular remodeling and ischemia with upregulating ET-1/ETBR and eNOS expression.
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Affiliation(s)
- N. ARFIAN
- Department of Anatomy, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia
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Wang J, Jin X, Huang Y, Ran X, Luo D, Yang D, Jia D, Zhang K, Tong J, Deng X, Wang G. Endovascular stent-induced alterations in host artery mechanical environments and their roles in stent restenosis and late thrombosis. Regen Biomater 2018; 5:177-187. [PMID: 29942650 PMCID: PMC6007795 DOI: 10.1093/rb/rby006] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2017] [Revised: 02/11/2018] [Accepted: 03/08/2018] [Indexed: 02/06/2023] Open
Abstract
Cardiovascular stent restenosis remains a major challenge in interventional treatment of cardiovascular occlusive disease. Although the changes in arterial mechanical environment due to stent implantation are the main causes of the initiation of restenosis and thrombosis, the mechanisms that cause this initiation are still not fully understood. In this article, we reviewed the studies on the issue of stent-induced alterations in arterial mechanical environment and discussed their roles in stent restenosis and late thrombosis from three aspects: (i) the interaction of the stent with host blood vessel, involve the response of vascular wall, the mechanism of mechanical signal transmission, the process of re-endothelialization and late thrombosis; (ii) the changes of hemodynamics in the lumen of the vascular segment and (iii) the changes of mechanical microenvironment within the vascular segment wall due to stent implantation. This review has summarized and analyzed current work in order to better solve the two main problems after stent implantation, namely in stent restenosis and late thrombosis, meanwhile propose the deficiencies of current work for future reference.
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Affiliation(s)
- Jinxuan Wang
- Key Laboratory of Biorheological Science and Technology, Ministry of Education; State and Local Joint Engineering Laboratory for Vascular Implants; Bioengineering College of Chongqing University, Chongqing, China
| | - Xuepu Jin
- Key Laboratory of Biorheological Science and Technology, Ministry of Education; State and Local Joint Engineering Laboratory for Vascular Implants; Bioengineering College of Chongqing University, Chongqing, China
| | - Yuhua Huang
- Key Laboratory of Biorheological Science and Technology, Ministry of Education; State and Local Joint Engineering Laboratory for Vascular Implants; Bioengineering College of Chongqing University, Chongqing, China
| | - Xiaolin Ran
- Key Laboratory of Biorheological Science and Technology, Ministry of Education; State and Local Joint Engineering Laboratory for Vascular Implants; Bioengineering College of Chongqing University, Chongqing, China
| | - Desha Luo
- Key Laboratory of Biorheological Science and Technology, Ministry of Education; State and Local Joint Engineering Laboratory for Vascular Implants; Bioengineering College of Chongqing University, Chongqing, China
| | - Dongchuan Yang
- Key Laboratory of Biorheological Science and Technology, Ministry of Education; State and Local Joint Engineering Laboratory for Vascular Implants; Bioengineering College of Chongqing University, Chongqing, China
| | - Dongyu Jia
- Key Laboratory of Biorheological Science and Technology, Ministry of Education; State and Local Joint Engineering Laboratory for Vascular Implants; Bioengineering College of Chongqing University, Chongqing, China
| | - Kang Zhang
- Key Laboratory of Biorheological Science and Technology, Ministry of Education; State and Local Joint Engineering Laboratory for Vascular Implants; Bioengineering College of Chongqing University, Chongqing, China
| | - Jianhua Tong
- Institute for Biomedical Engineering & Nano Science, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, China
| | - Xiaoyan Deng
- Key Laboratory for Biomechanics and Mechanobiology of the Ministry of Education, School of Biological Science and Medical Engineering, Beihang University, Beijing, China
| | - Guixue Wang
- Key Laboratory of Biorheological Science and Technology, Ministry of Education; State and Local Joint Engineering Laboratory for Vascular Implants; Bioengineering College of Chongqing University, Chongqing, China
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Zhang J, Chen C, Li L, Zhou HJ, Li F, Zhang H, Yu L, Chen Y, Min W. Endothelial AIP1 Regulates Vascular Remodeling by Suppressing NADPH Oxidase-2. Front Physiol 2018; 9:396. [PMID: 29731721 PMCID: PMC5921534 DOI: 10.3389/fphys.2018.00396] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2018] [Accepted: 04/04/2018] [Indexed: 12/31/2022] Open
Abstract
Objective: AIP1 expression is downregulated in human atherosclerotic plaques and global deletion of AIP1 in mice exacerbates atherosclerosis in ApoE-KO mouse models. However, the direct role of AIP1 in endothelium, vascular remodeling and associated vascular diseases has not been determined. Approach and Results: We used endothelial cell (EC)-specific AIP1-deficient (AIP1-ECKO) mice to define the role of AIP1 in vascular remodeling and intima-media thickening in a mouse carotid artery ligation model characterized by both neointimal hyperplasia and inward vessel remodeling. Compared to WT littermates, AIP1-ECKO mice had 2.2-fold larger intima area and 4.4-fold thicker intima as measured by intima/media ratio in arteries with more proliferating vascular smooth muscle cells (VSMCs) at week 2-4 post-injury. Increased reactive oxygen species (ROS) in endothelium at early time points induced inflammation and vessel dysfunction in AIP1-ECKO prior to VSMC accumulations. Moreover, knockdown of AIP1 in human EC enhanced ROS generation which was attenuated by co-silencing of NOX2. Mechanistically, AIP1 via its proline-rich region binds to the SH3 domain of cytosolic subunit p47phox to disrupt formation of an active NOX2 complex, attenuating ROS production. Conclusion: Our study supports that AIP1 regulates vascular remodeling with intima-media thickening by suppressing endothelial NOX2-dependent oxidative stress. Highlights: •In a carotid ligation model, endothelial cell (EC)-specific AIP1-deficient (AIP1-ECKO) mice had much larger media area, thicker vessel wall and augmented neointima formation.•Increased production of reactive oxygen species in vascular EC at early time points concomitant with vessel dysfunction in AIP1-ECKO.•AIP1 via its proline-rich region binds to the SH3 domain of cytosolic subunit p47phox to disrupt formation of an active NOX2 complex, attenuating ROS production.
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Affiliation(s)
- Jiqin Zhang
- Center for Translational Medicine, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
- Department of Pathology and The Vascular Biology and Therapeutics Program, Yale University School of Medicine, New Haven, CT, United States
| | - Chaofei Chen
- Center for Translational Medicine, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
- Department of Pathology and The Vascular Biology and Therapeutics Program, Yale University School of Medicine, New Haven, CT, United States
| | - Li Li
- Center for Translational Medicine, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Huanjiao J. Zhou
- Department of Pathology and The Vascular Biology and Therapeutics Program, Yale University School of Medicine, New Haven, CT, United States
| | - Fenghe Li
- Department of Pathology and The Vascular Biology and Therapeutics Program, Yale University School of Medicine, New Haven, CT, United States
| | - Haifeng Zhang
- Department of Pathology and The Vascular Biology and Therapeutics Program, Yale University School of Medicine, New Haven, CT, United States
| | - Luyang Yu
- Institute of Genetics, Institute of Genetics and Regenerative Biology, College of Life Sciences, Zhejiang University, Hangzhou, China
| | - Yuxin Chen
- Department of Laboratory Medicine, Nanjing Drum Tower Hospital, Nanjing University Medical School, Nanjing, China
| | - Wang Min
- Center for Translational Medicine, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
- Department of Pathology and The Vascular Biology and Therapeutics Program, Yale University School of Medicine, New Haven, CT, United States
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Della-Morte D, Gardener H, Dong C, Markert M, Cabral D, Elkind MSV, Sacco RL, Rundek T. Association Between Carotid Artery Function and Structure in the Northern Manhattan Study. Front Neurol 2018; 9:246. [PMID: 29713306 PMCID: PMC5911635 DOI: 10.3389/fneur.2018.00246] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2018] [Accepted: 03/28/2018] [Indexed: 11/13/2022] Open
Abstract
Background and purpose Carotid plaque (CP), carotid intima media thickness (cIMT), and stiffness (STIFF) are pre-clinical markers of atherosclerosis and predictors of cerebrovascular disease (CVD). We sought to investigate whether STIFF is a significant determinant of cIMT and CP, which may provide an insight into the mechanism by which STIFF adds to the risk of CVD. Methods We analyzed 876 stroke-free subjects from the Northern Manhattan Study with available ultrasound measures. To obtain the associations with STIFF, we performed multivariable-adjusted regression, negative binomial regression (for CP number), and multinomial logistic regression (for plaque area). Results The mean age was 64 ± 9 years; 63% women and 65% Caribbean Hispanics. The mean cIMT was 0.93 ± 0.9 mm, the mean diastolic diameter 6.24 ± 0.94 mm, and STIFF 8.6 ± 6.2 ln mmHg. Prevalence of CP was 57%, and the mean total plaque area was 22.6 ± 23.0 mm2. STIFF was positively associated with cIMT but not with CP. There was an association between diastolic diameter and thick plaque. For each millimeter increase in diastolic diameter, there was about a 20% increased risk of having thick plaque (vs. no plaque). In longitudinal analyses, each millimeter increase in diastolic diameter was associated with a 37% increased risk of incident plaque. Conclusion Increased STIFF was associated with increased cIMT and carotid artery dilatation with greater plaque burden. Increased cIMT and plaque burden represent vascular remodeling likely resulting from the two different age-related mechanisms, one that includes diffuse wall thickening (cIMT) with STIFF and another that incorporates focal atherosclerosis (plaque) with luminal dilatation.
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Affiliation(s)
- David Della-Morte
- Department of Neurology, Miller School of Medicine, University of Miami, Miami, FL, United States.,Department of Systems Medicine, School of Medicine, University of Rome Tor Vergata, Rome, Italy.,Department of Human Sciences and Quality of Life Promotion, San Raffaele Roma Open University, Rome, Italy
| | - Hannah Gardener
- Department of Neurology, Miller School of Medicine, University of Miami, Miami, FL, United States
| | - Chuanhui Dong
- Department of Neurology, Miller School of Medicine, University of Miami, Miami, FL, United States
| | - Matthew Markert
- Department of Neurology, Kansas University Medical Center, Kansas City, MO, United States
| | - Digna Cabral
- Department of Neurology, Miller School of Medicine, University of Miami, Miami, FL, United States
| | - Mitchell S V Elkind
- Division of Stroke, Department of Neurology, Columbia University, New York, NY, United States
| | - Ralph L Sacco
- Department of Neurology, Miller School of Medicine, University of Miami, Miami, FL, United States
| | - Tatjana Rundek
- Department of Neurology, Miller School of Medicine, University of Miami, Miami, FL, United States
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Klein D. iPSCs-based generation of vascular cells: reprogramming approaches and applications. Cell Mol Life Sci 2018; 75:1411-1433. [PMID: 29243171 PMCID: PMC5852192 DOI: 10.1007/s00018-017-2730-7] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2017] [Revised: 12/08/2017] [Accepted: 12/11/2017] [Indexed: 12/15/2022]
Abstract
Recent advances in the field of induced pluripotent stem cells (iPSCs) research have opened a new avenue for stem cell-based generation of vascular cells. Based on their growth and differentiation potential, human iPSCs constitute a well-characterized, generally unlimited cell source for the mass generation of lineage- and patient-specific vascular cells without any ethical concerns. Human iPSCs-derived vascular cells are perfectly suited for vascular disease modeling studies because patient-derived iPSCs possess the disease-causing mutation, which might be decisive for full expression of the disease phenotype. The application of vascular cells for autologous cell replacement therapy or vascular engineering derived from immune-compatible iPSCs possesses huge clinical potential, but the large-scale production of vascular-specific lineages for regenerative cell therapies depends on well-defined, highly reproducible culture and differentiation conditions. This review will focus on the different strategies to derive vascular cells from human iPSCs and their applications in regenerative therapy, disease modeling and drug discovery approaches.
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Affiliation(s)
- Diana Klein
- Institute for Cell Biology (Cancer Research), University Hospital Essen, University of Duisburg-Essen, Virchowstr. 173, 45122, Essen, Germany.
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50
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Ackerman SJ. Bradford C. Berk: Picking Good Questions. Circ Res 2017; 121:1309-1311. [PMID: 29217709 DOI: 10.1161/circresaha.117.312322] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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