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Gaba P, Gersh BJ, Muller J, Narula J, Stone GW. Evolving concepts of the vulnerable atherosclerotic plaque and the vulnerable patient: implications for patient care and future research. Nat Rev Cardiol 2023; 20:181-196. [PMID: 36151312 DOI: 10.1038/s41569-022-00769-8] [Citation(s) in RCA: 33] [Impact Index Per Article: 33.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/12/2022] [Indexed: 11/08/2022]
Abstract
Understanding the natural history of coronary artery atherosclerosis is necessary to determine prognosis and prescribe effective therapies. Traditional management of coronary artery disease has focused on the treatment of flow-limiting anatomical obstructions that lead to ischaemia. In most scenarios, revascularization of these atherosclerotic plaques has not substantially improved freedom from death or myocardial infarction, questioning the utility of contemporary revascularization strategies to improve prognosis. Advances in non-invasive and invasive imaging techniques have helped to identify the characteristics of obstructive and non-obstructive plaques that are precursors for plaque progression and future acute coronary syndromes as well as cardiac death. These 'vulnerable plaques' develop as a consequence of systemic inflammation and are prone to inducing thrombosis. Vulnerable plaques most commonly have a large plaque burden with a well-formed necrotic core and thin fibrous cap and are metabolically active. Perivascular adipose tissue might, in some patients, be used as a surrogate for coronary inflammation and predict future risk of adverse cardiac events. Vulnerable plaques can be identified in their quiescent state, offering the potential for therapeutic passivation. In this Review, we describe the biological and compositional features of vulnerable plaques, the non-invasive and invasive diagnostic modalities to characterize vulnerable plaques, the prognostic utility of identifying vulnerable plaques, and the future studies needed to explore the value of intensified pharmacological and focal treatments of vulnerable plaques.
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Affiliation(s)
- Prakriti Gaba
- Division of Cardiovascular Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - Bernard J Gersh
- Department of Cardiovascular Medicine, Mayo Clinic College of Medicine and Science, Rochester, MN, USA
| | - James Muller
- Division of Cardiovascular Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - Jagat Narula
- The Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Gregg W Stone
- The Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
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2
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Taylor EN, Huang N, Lin S, Mortazavi F, Wedeen VJ, Siamwala JH, Gilbert RJ, Hamilton JA. Lipid and smooth muscle architectural pathology in the rabbit atherosclerotic vessel wall using Q-space cardiovascular magnetic resonance. J Cardiovasc Magn Reson 2022; 24:74. [PMID: 36544161 PMCID: PMC9773609 DOI: 10.1186/s12968-022-00897-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2022] [Accepted: 10/19/2022] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Atherosclerosis is an arterial vessel wall disease characterized by slow, progressive lipid accumulation, smooth muscle disorganization, and inflammatory infiltration. Atherosclerosis often remains subclinical until extensive inflammatory injury promotes vulnerability of the atherosclerotic plaque to rupture with luminal thrombosis, which can cause the acute event of myocardial infarction or stroke. Current bioimaging techniques are unable to capture the pathognomonic distribution of cellular elements of the plaque and thus cannot accurately define its structural disorganization. METHODS We applied cardiovascular magnetic resonance spectroscopy (CMRS) and diffusion weighted CMR (DWI) with generalized Q-space imaging (GQI) analysis to architecturally define features of atheroma and correlated these to the microscopic distribution of vascular smooth muscle cells (SMC), immune cells, extracellular matrix (ECM) fibers, thrombus, and cholesteryl esters (CE). We compared rabbits with normal chow diet and cholesterol-fed rabbits with endothelial balloon injury, which accelerates atherosclerosis and produces advanced rupture-prone plaques, in a well-validated rabbit model of human atherosclerosis. RESULTS Our methods revealed new structural properties of advanced atherosclerosis incorporating SMC and lipid distributions. GQI with tractography portrayed the locations of these components across the atherosclerotic vessel wall and differentiated multi-level organization of normal, pro-inflammatory cellular phenotypes, or thrombus. Moreover, the locations of CE were differentiated from cellular constituents by their higher restrictive diffusion properties, which permitted chemical confirmation of CE by high field voxel-guided CMRS. CONCLUSIONS GQI with tractography is a new method for atherosclerosis imaging that defines a pathological architectural signature for the atheromatous plaque composed of distributed SMC, ECM, inflammatory cells, and thrombus and lipid. This provides a detailed transmural map of normal and inflamed vessel walls in the setting of atherosclerosis that has not been previously achieved using traditional CMR techniques. Although this is an ex-vivo study, detection of micro and mesoscale level vascular destabilization as enabled by GQI with tractography could increase the accuracy of diagnosis and assessment of treatment outcomes in individuals with atherosclerosis.
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Affiliation(s)
- Erik N Taylor
- Department of Physiology & Biophysics, Boston University School of Medicine, Boston, MA, USA
- Department of Radiology, UNM School of Medicine, The University of New Mexico, Albuquerque, NM, USA
| | - Nasi Huang
- Department of Physiology & Biophysics, Boston University School of Medicine, Boston, MA, USA
| | - Sunni Lin
- Department of Biomedical Engineering, Boston University, Boston, MA, USA
| | - Farzad Mortazavi
- Department of Anatomy & Neurobiology, Boston University School of Medicine, Boston, MA, USA
| | - Van J Wedeen
- AA Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Jamila H Siamwala
- Department of Molecular Pharmacology, Physiology, and Biotechnology, Warren Alpert Medical School of Brown University, Providence, RI, USA
| | - Richard J Gilbert
- Research Service, Providence VA Medical Center and Warren Alpert Medical School of Brown University, Providence, RI, USA
| | - James A Hamilton
- Department of Physiology & Biophysics, Boston University School of Medicine, Boston, MA, USA.
- Department of Biomedical Engineering, Boston University, Boston, MA, USA.
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3
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Walter ERH, Cooper SM, Boyle JJ, Long NJ. Enzyme-activated probes in optical imaging: a focus on atherosclerosis. Dalton Trans 2021; 50:14486-14497. [PMID: 34605500 PMCID: PMC8546924 DOI: 10.1039/d1dt02198b] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2021] [Accepted: 09/27/2021] [Indexed: 12/16/2022]
Abstract
Enzyme-activated probes enable complex biological processes to be studied in real-time. A wide range of enzymes are modulated in diseases, including cancer, inflammatory diseases and cardiovascular disease, and have the potential to act as vital diagnostic and prognostic biomarkers to monitor and report on disease progression. In this perspective article, we discuss suitable design characteristics of enzyme-activated fluorescent probes for ex vivo and in vivo optical imaging applications. With a particular focus on atherosclerosis imaging, we highlight recent approaches to report on the activity of cathepsins (K and B), matrix metalloproteinases (MMP-2 and MMP-9), thrombin, heme oxygenase-1 (HO-1) and myeloperoxidase (MPO).
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Affiliation(s)
- Edward R H Walter
- Department of Chemistry, Imperial College London, Molecular Sciences Research Hub, White City Campus, Wood Lane, London W12 0BZ, UK.
- National Heart and Lung Institute, Imperial College London, London, W12 0NN, UK
| | - Saul M Cooper
- Department of Chemistry, Imperial College London, Molecular Sciences Research Hub, White City Campus, Wood Lane, London W12 0BZ, UK.
- National Heart and Lung Institute, Imperial College London, London, W12 0NN, UK
| | - Joseph J Boyle
- National Heart and Lung Institute, Imperial College London, London, W12 0NN, UK
| | - Nicholas J Long
- Department of Chemistry, Imperial College London, Molecular Sciences Research Hub, White City Campus, Wood Lane, London W12 0BZ, UK.
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4
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Willemink MJ, Coolen BF, Dyvorne H, Robson PM, Bander I, Ishino S, Pruzan A, Sridhar A, Zhang B, Balchandani P, Mani V, Strijkers GJ, Nederveen AJ, Leiner T, Fayad ZA, Mulder WJM, Calcagno C. Ultra-high resolution, 3-dimensional magnetic resonance imaging of the atherosclerotic vessel wall at clinical 7T. PLoS One 2020; 15:e0241779. [PMID: 33315867 PMCID: PMC7735577 DOI: 10.1371/journal.pone.0241779] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2020] [Accepted: 10/21/2020] [Indexed: 12/11/2022] Open
Abstract
Accurate quantification and characterization of atherosclerotic plaques with MRI requires high spatial resolution acquisitions with excellent image quality. The intrinsically better signal-to-noise ratio (SNR) at high-field clinical 7T compared to the widely employed lower field strengths of 1.5 and 3T may yield significant improvements to vascular MRI. However, 7T atherosclerosis imaging also presents specific challenges, related to local transmit coils and B1 field inhomogeneities, which may overshadow these theoretical gains. We present the development and evaluation of 3D, black-blood, ultra-high resolution vascular MRI on clinical high-field 7T in comparison lower-field 3T. These protocols were applied for in vivo imaging of atherosclerotic rabbits, which are often used for development, testing, and validation of translatable cardiovascular MR protocols. Eight atherosclerotic New Zealand White rabbits were imaged on clinical 7T and 3T MRI scanners using 3D, isotropic, high (0.63 mm3) and ultra-high (0.43 mm3) spatial resolution, black-blood MR sequences with extensive spatial coverage. Following imaging, rabbits were sacrificed for validation using fluorescence imaging and histology. Image quality parameters such as SNR and contrast-to-noise ratio (CNR), as well as morphological and functional plaque measurements (plaque area and permeability) were evaluated at both field strengths. Using the same or comparable imaging parameters, SNR and CNR were in general higher at 7T compared to 3T, with a median (interquartiles) SNR gain of +40.3 (35.3-80.1)%, and a median CNR gain of +68.1 (38.5-95.2)%. Morphological and functional parameters, such as vessel wall area and permeability, were reliably acquired at 7T and correlated significantly with corresponding, widely validated 3T vessel wall MRI measurements. In conclusion, we successfully developed 3D, black-blood, ultra-high spatial resolution vessel wall MRI protocols on a 7T clinical scanner. 7T imaging was in general superior to 3T with respect to image quality, and comparable in terms of plaque area and permeability measurements.
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Affiliation(s)
- Martin J. Willemink
- Department of Radiology, University Medical Center Utrecht, Utrecht, The Netherlands
- Department of Radiology, Stanford University School of Medicine, Stanford, California, United States of America
| | - Bram F. Coolen
- Department of Biomedical Engineering and Physics, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
- Department of Radiology and Nuclear Medicine, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Hadrien Dyvorne
- BioMedical Engineering and Imaging Institute, Icahn School of Medicine at Mount Sinai, New York, New York, United States of America
- Department of Radiology, Icahn School of Medicine at Mount Sinai, New York, New York, United States of America
| | - Philip M. Robson
- BioMedical Engineering and Imaging Institute, Icahn School of Medicine at Mount Sinai, New York, New York, United States of America
- Department of Radiology, Icahn School of Medicine at Mount Sinai, New York, New York, United States of America
| | - Ilda Bander
- BioMedical Engineering and Imaging Institute, Icahn School of Medicine at Mount Sinai, New York, New York, United States of America
- Department of Radiology, Icahn School of Medicine at Mount Sinai, New York, New York, United States of America
| | - Seigo Ishino
- BioMedical Engineering and Imaging Institute, Icahn School of Medicine at Mount Sinai, New York, New York, United States of America
- Department of Radiology, Icahn School of Medicine at Mount Sinai, New York, New York, United States of America
| | - Alison Pruzan
- BioMedical Engineering and Imaging Institute, Icahn School of Medicine at Mount Sinai, New York, New York, United States of America
- Department of Radiology, Icahn School of Medicine at Mount Sinai, New York, New York, United States of America
| | - Arthi Sridhar
- BioMedical Engineering and Imaging Institute, Icahn School of Medicine at Mount Sinai, New York, New York, United States of America
- Department of Radiology, Icahn School of Medicine at Mount Sinai, New York, New York, United States of America
| | - Bei Zhang
- BioMedical Engineering and Imaging Institute, Icahn School of Medicine at Mount Sinai, New York, New York, United States of America
- Department of Radiology, Icahn School of Medicine at Mount Sinai, New York, New York, United States of America
| | - Priti Balchandani
- BioMedical Engineering and Imaging Institute, Icahn School of Medicine at Mount Sinai, New York, New York, United States of America
- Department of Radiology, Icahn School of Medicine at Mount Sinai, New York, New York, United States of America
| | - Venkatesh Mani
- BioMedical Engineering and Imaging Institute, Icahn School of Medicine at Mount Sinai, New York, New York, United States of America
- Department of Radiology, Icahn School of Medicine at Mount Sinai, New York, New York, United States of America
| | - Gustav J. Strijkers
- Department of Biomedical Engineering and Physics, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Aart J. Nederveen
- Department of Radiology and Nuclear Medicine, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Tim Leiner
- Department of Radiology, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Zahi A. Fayad
- BioMedical Engineering and Imaging Institute, Icahn School of Medicine at Mount Sinai, New York, New York, United States of America
- Department of Radiology, Icahn School of Medicine at Mount Sinai, New York, New York, United States of America
| | - Willem J. M. Mulder
- BioMedical Engineering and Imaging Institute, Icahn School of Medicine at Mount Sinai, New York, New York, United States of America
- Department of Medical Biochemistry, Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands
| | - Claudia Calcagno
- BioMedical Engineering and Imaging Institute, Icahn School of Medicine at Mount Sinai, New York, New York, United States of America
- Department of Radiology, Icahn School of Medicine at Mount Sinai, New York, New York, United States of America
- * E-mail:
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Qiao R, Huang X, Qin Y, Li Y, Davis TP, Hagemeyer CE, Gao M. Recent advances in molecular imaging of atherosclerotic plaques and thrombosis. NANOSCALE 2020; 12:8040-8064. [PMID: 32239038 DOI: 10.1039/d0nr00599a] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
As the complications of atherosclerosis such as myocardial infarction and stroke are still one of the leading causes of mortality worldwide, the development of new diagnostic tools for the early detection of plaque instability and thrombosis is urgently needed. Advanced molecular imaging probes based on functional nanomaterials in combination with cutting edge imaging techniques are now paving the way for novel and unique approaches to monitor the inflammatory progress in atherosclerosis. This review focuses on the development of various molecular probes for the diagnosis of plaques and thrombosis in atherosclerosis, along with perspectives of their diagnostic applications in cardiovascular diseases. Specifically, we summarize the biological targets that can be used for atherosclerosis and thrombosis imaging. Then we describe the emerging molecular imaging techniques based on the utilization of engineered nanoprobes together with their challenges in clinical translation.
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Affiliation(s)
- Ruirui Qiao
- State Key Laboratory of Radiation Medicine and Protection, School for Radiological and Interdisciplinary Sciences (RAD-X), Collaborative Innovation Center of Radiation Medicine of Jiangsu Higher Education Institutions, Soochow University, Suzhou 215123, China
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6
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Yu X, Guan W, Zhang Y, Deng Q, Li J, Ye H, Deng S, Han W, Yu Y. Large-scale gene analysis of rabbit atherosclerosis to discover new biomarkers for coronary artery disease. Open Biol 2020; 9:180238. [PMID: 30958112 PMCID: PMC6367139 DOI: 10.1098/rsob.180238] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Atherosclerosis is the pathological basis of coronary artery disease (CAD) and causes high mortality. Thus, early detection is thought to be crucial in reducing the risk of CAD. Uncovering the mechanisms of the progression and regression of atherosclerosis will provide insights into discovering novel biomarkers to identify subjects at risk for CAD and improve prevention. We established atherosclerosis progression and regression in a rabbit model. Then, we extracted mRNA of the abdominal aorta from control, model and recovery groups to perform gene chip analysis. Candidate biomarkers were screened by large-scale gene analysis and validated in patients with CAD or with CAD recovery by ELISA. The differentially expressed genes in the progression and regression of atherosclerosis were mainly enriched in four clusters. Genes associated with inflammation and extracellular matrix were returned to normal or close-to-normal levels much earlier than genes associated with metabolism and sarcoplasmic proliferation, and they were maintained downregulated or upregulated after feeding a normal diet. We then selected four candidate biomarkers and found that lipoprotein lipase (LPL), bone morphogenetic protein 7 and somatostatin concentrations could indicate CAD diagnosis. In addition, LPL and macrophage cationic peptide 2 can be indicators of the prognosis of CAD. Molecular changes during the progression and regression of atherosclerosis in rabbits were revealed, and candidate regulators were identified. The identified factors could be used as novel biomarkers and targets for improving the diagnosis and prognosis of human CAD in the future.
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Affiliation(s)
- Xiaolan Yu
- 1 Shanghai Municipality Key Laboratory of Veterinary Biotechnology, School of Agriculture and Biology, Shanghai Jiao Tong University , Shanghai , People's Republic of China
| | - Wen Guan
- 3 Department of Biochemistry, Zhongshan School of Medicine, Sun Yat-sen University , GuangZhou , People's Republic of China
| | - Yang Zhang
- 1 Shanghai Municipality Key Laboratory of Veterinary Biotechnology, School of Agriculture and Biology, Shanghai Jiao Tong University , Shanghai , People's Republic of China
| | - Qing Deng
- 1 Shanghai Municipality Key Laboratory of Veterinary Biotechnology, School of Agriculture and Biology, Shanghai Jiao Tong University , Shanghai , People's Republic of China
| | - Jingjing Li
- 2 Laboratory of Regeneromics, School of Pharmacy, Shanghai Jiao Tong University , Shanghai , People's Republic of China
| | - Hao Ye
- 2 Laboratory of Regeneromics, School of Pharmacy, Shanghai Jiao Tong University , Shanghai , People's Republic of China
| | - Shaorong Deng
- 2 Laboratory of Regeneromics, School of Pharmacy, Shanghai Jiao Tong University , Shanghai , People's Republic of China
| | - Wei Han
- 2 Laboratory of Regeneromics, School of Pharmacy, Shanghai Jiao Tong University , Shanghai , People's Republic of China
| | - Yan Yu
- 1 Shanghai Municipality Key Laboratory of Veterinary Biotechnology, School of Agriculture and Biology, Shanghai Jiao Tong University , Shanghai , People's Republic of China
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7
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Effects of Colchicine on Atherosclerotic Plaque Stabilization: a Multimodality Imaging Study in an Animal Model. J Cardiovasc Transl Res 2020; 14:150-160. [PMID: 32140929 DOI: 10.1007/s12265-020-09974-7] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2019] [Accepted: 02/14/2020] [Indexed: 02/07/2023]
Abstract
Colchicine demonstrated clinical benefits in the treatment of stable coronary artery disease. Our aim was to evaluate the effects of colchicine on atherosclerotic plaque stabilization. Atherosclerosis was induced in the abdominal aorta of 20 rabbits with high-cholesterol diet and balloon endothelial denudation. Rabbits were randomized to receive either colchicine or placebo. All animals underwent MRI, 18F-FDG PET/CT, optical coherence tomography (OCT), and histology. Similar progression of atherosclerotic burden was observed in the two groups as relative increase of normalized wall index (NWI). Maximum 18F-FDG standardized uptake value (meanSUVmax) decreased after colchicine treatment, while it increased in the placebo group with a trend toward significance. Animals with higher levels of cholesterol showed significant differences in favor to colchicine group, both as NWI at the end of the protocol and as relative increase in meanSUVmax. Colchicine may stabilize atherosclerotic plaque by reducing inflammatory activity and plaque burden, without altering macrophage infiltration or plaque typology.
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8
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Becher T, Riascos-Bernal DF, Kramer DJ, Almonte VM, Chi J, Tong T, Oliveira-Paula GH, Koleilat I, Chen W, Cohen P, Sibinga NES. Three-Dimensional Imaging Provides Detailed Atherosclerotic Plaque Morphology and Reveals Angiogenesis After Carotid Artery Ligation. Circ Res 2020; 126:619-632. [PMID: 31914850 DOI: 10.1161/circresaha.119.315804] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
RATIONALE Remodeling of the vessel wall and the formation of vascular networks are dynamic processes that occur during mammalian embryonic development and in adulthood. Plaque development and excessive neointima formation are hallmarks of atherosclerosis and vascular injury. As our understanding of these complex processes evolves, there is a need to develop new imaging techniques to study underlying mechanisms. OBJECTIVE We used tissue clearing and light-sheet microscopy for 3-dimensional (3D) profiling of the vascular response to carotid artery ligation and induction of atherosclerosis in mouse models. METHODS AND RESULTS Adipo-Clear and immunolabeling in combination with light-sheet microscopy were applied to image carotid arteries and brachiocephalic arteries, allowing for 3D reconstruction of vessel architecture. Entire 3D neointima formations with different geometries were observed within the carotid artery and scored by volumetric analysis. Additionally, we identified a CD31-positive adventitial plexus after ligation of the carotid artery that evolved and matured over time. We also used this method to characterize plaque extent and composition in the brachiocephalic arteries of ApoE-deficient mice on high-fat diet. The plaques exhibited inter-animal differences in terms of plaque volume, geometry, and ratio of acellular core to plaque volume. A 3D reconstruction of the endothelium overlying the plaque was also generated. CONCLUSIONS We present a novel approach to characterize vascular remodeling in adult mice using Adipo-Clear in combination with light-sheet microscopy. Our method reconstructs 3D neointima formation after arterial injury and allows for volumetric analysis of remodeling, in addition to revealing angiogenesis and maturation of a plexus surrounding the carotid artery. This method generates complete 3D reconstructions of atherosclerotic plaques and uncovers their volume, geometry, acellular component, surface, and spatial position within the brachiocephalic arteries. Our approach may be used in a number of mouse models of cardiovascular disease to assess vessel geometry and volume. Visual Overview: An online visual overview is available for this article.
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Affiliation(s)
- Tobias Becher
- From the Laboratory of Molecular Metabolism (T.B., D.J.K., J.C., P.C.), The Rockefeller University, NY.,DZHK (German Centre for Cardiovascular Research), Partner Site Heidelberg/Mannheim, Germany (T.B.).,First Department of Medicine (Division of Cardiology), University Medical Center Mannheim, Germany (T.B.)
| | - Dario F Riascos-Bernal
- (Cardiology Division) Department of Medicine, Department of Developmental and Molecular Biology, Wilf Family Cardiovascular Research Institute (D.F.R.-B., V.M.A., G.H.O.-P., N.E.S.S.), Albert Einstein College of Medicine, Bronx, NY
| | - Daniel J Kramer
- From the Laboratory of Molecular Metabolism (T.B., D.J.K., J.C., P.C.), The Rockefeller University, NY
| | - Vanessa M Almonte
- (Cardiology Division) Department of Medicine, Department of Developmental and Molecular Biology, Wilf Family Cardiovascular Research Institute (D.F.R.-B., V.M.A., G.H.O.-P., N.E.S.S.), Albert Einstein College of Medicine, Bronx, NY
| | - Jingy Chi
- From the Laboratory of Molecular Metabolism (T.B., D.J.K., J.C., P.C.), The Rockefeller University, NY
| | - Tao Tong
- Bio-Imaging Resource Center (T.T.), The Rockefeller University, NY
| | - Gustavo H Oliveira-Paula
- (Cardiology Division) Department of Medicine, Department of Developmental and Molecular Biology, Wilf Family Cardiovascular Research Institute (D.F.R.-B., V.M.A., G.H.O.-P., N.E.S.S.), Albert Einstein College of Medicine, Bronx, NY
| | - Issam Koleilat
- Department of Cardiothoracic and Vascular Surgery (Division of Vascular Surgery), Montefiore Medical Center, Bronx, NY (I.K.)
| | - Wei Chen
- Department of Medicine (Nephrology Division) (W.C.), Albert Einstein College of Medicine, Bronx, NY.,Department of Medicine, University of Rochester School of Medicine and Dentistry, NY (W.C.)
| | - Paul Cohen
- From the Laboratory of Molecular Metabolism (T.B., D.J.K., J.C., P.C.), The Rockefeller University, NY
| | - Nicholas E S Sibinga
- (Cardiology Division) Department of Medicine, Department of Developmental and Molecular Biology, Wilf Family Cardiovascular Research Institute (D.F.R.-B., V.M.A., G.H.O.-P., N.E.S.S.), Albert Einstein College of Medicine, Bronx, NY
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9
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Bucerius J, Dijkgraaf I, Mottaghy FM, Schurgers LJ. Target identification for the diagnosis and intervention of vulnerable atherosclerotic plaques beyond 18F-fluorodeoxyglucose positron emission tomography imaging: promising tracers on the horizon. Eur J Nucl Med Mol Imaging 2018; 46:251-265. [PMID: 30302506 PMCID: PMC6267660 DOI: 10.1007/s00259-018-4176-z] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2018] [Accepted: 09/18/2018] [Indexed: 12/11/2022]
Abstract
Cardiovascular disease is the major cause of morbidity and mortality in developed countries and atherosclerosis is the major cause of cardiovascular disease. Atherosclerotic lesions obstruct blood flow in the arterial vessel wall and can rupture leading to the formation of occlusive thrombi. Conventional diagnostic tools are still of limited value for identifying the vulnerable arterial plaque and for predicting its risk of rupture and of releasing thromboembolic material. Knowledge of the molecular and biological processes implicated in the process of atherosclerosis will advance the development of imaging probes to differentiate the vulnerable plaque. The development of imaging probes with high sensitivity and specificity in identifying high-risk atherosclerotic vessel wall changes and plaques is crucial for improving knowledge-based decisions and tailored individual interventions. Arterial PET imaging with 18F-FDG has shown promising results in identifying inflammatory vessel wall changes in numerous studies and clinical trials. However, due to its limited specificity in general and its intense physiological uptake in the left ventricular myocardium that impair imaging of the coronary arteries, different PET tracers for the molecular imaging of atherosclerosis have been evaluated. This review describes biological, chemical and medical expertise supporting a translational approach that will enable the development of new or the evaluation of existing PET tracers for the identification of vulnerable atherosclerotic plaques for better risk prediction and benefit to patients.
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Affiliation(s)
- Jan Bucerius
- Department of Radiology and Nuclear Medicine, Maastricht University Medical Center (MUMC+), 6229 HX, Maastricht, The Netherlands. .,Cardiovascular Research Institute Maastricht (CARIM), Maastricht University Medical Center (MUMC+), 6200 MD, Maastricht, The Netherlands. .,Department of Nuclear Medicine, University Hospital RWTH Aachen, Aachen, Germany.
| | - Ingrid Dijkgraaf
- Cardiovascular Research Institute Maastricht (CARIM), Maastricht University Medical Center (MUMC+), 6200 MD, Maastricht, The Netherlands.,Department of Biochemistry, Maastricht University, Maastricht, The Netherlands
| | - Felix M Mottaghy
- Department of Radiology and Nuclear Medicine, Maastricht University Medical Center (MUMC+), 6229 HX, Maastricht, The Netherlands.,Department of Nuclear Medicine, University Hospital RWTH Aachen, Aachen, Germany
| | - Leon J Schurgers
- Cardiovascular Research Institute Maastricht (CARIM), Maastricht University Medical Center (MUMC+), 6200 MD, Maastricht, The Netherlands. .,Department of Biochemistry, Maastricht University, Maastricht, The Netherlands.
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10
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Phinikaridou A, Lacerda S, Lavin B, Andia ME, Smith A, Saha P, Botnar RM. Tropoelastin: A novel marker for plaque progression and instability. Circ Cardiovasc Imaging 2018; 11. [PMID: 30214669 DOI: 10.1161/circimaging.117.007303] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Background Elastolysis and ineffective elastogenesis favor the accumulation of tropoelastin, rather than cross-linked elastin, in atherosclerotic plaques. We developed gadolinium-labeled tropoelastin-specific magnetic resonance contrast agents (Gd-TESMAs) for tropoelastin imaging in animal models. Methods and Results Two peptides, VVGSPSAQDEASPLS and YPDHVQYTHY were selected to target tropoelastin. In vitro binding, relaxivity, and biodistribution experiments enabled characterization of the probes and selecting the best candidate for in vivo MRI. MRI was performed in atherosclerotic apolipoprotein E-deficient (ApoE-/-) mice and New Zealand white rabbits with stable and rupture-prone plaques using Gd-TESMA. Additionally, human carotid endarterectomy specimens were imaged ex vivo. The VVGSPSAQDEASPLS-based probe discriminated between tropoelastin and cross-linked elastin (64±7% vs 1±2%, P=0.001), had high in vitro relaxivity in solution (r1-free=11.7±0.6mM-1s-1, r1-bound to tropoelastin = 44±1mM-1s-1) and favorable pharmacokinetics. In vivo mice vascular enhancement (4wks=0.13±0.007mm2, 8wks=0.22±0.01mm2, 12wks=0.33±0.01mm2, P<0.001) and R1 relaxation rate (4wks=0.90±0.01 s-1, 8wks=1.40±0.03 s-1, 12wks=1.87±0.04s-1, P<0.001) increased with atherosclerosis progression after Gd-TESMA injection. Conversely, statin-treated (0.13±0.01mm2, R1 =1.37±0.03s-1) and control (0.10±0.005mm2, R1 =0.87±0.05s-1) mice showed less enhancement. Rupture-prone rabbit plaques had higher R1 relaxation rate compared with stale plaques (R1=2.26±0.1s-1vs R1=1.43±0.02s-1, P=0.001), after administration of Gd-TESMA that allowed detection of rupture-prone plaques with high sensitivity (84.4%) and specificity (92.3%). Increased vascular R1 relaxation rate was observed in carotid endarterectomy plaques after soaking (R1pre= 1.1±0.26 s-1 vs R1post= 3.0±0.1s-1, P=0.01). Ex vivo analyses confirmed the MRI findings and showed uptake of the contrast agent to be specific for tropoelastin. Conclusions MRI of tropoelastin provides a novel biomarker for atherosclerotic plaque progression and instability.
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Affiliation(s)
- Alkystis Phinikaridou
- School of Biomedical Engineering Imaging Sciences, King's College London, London, UK.,BHF Centre of Excellence, Cardiovascular Division, King's College London, London, UK
| | - Sara Lacerda
- School of Biomedical Engineering Imaging Sciences, King's College London, London, UK.,BHF Centre of Excellence, Cardiovascular Division, King's College London, London, UK
| | - Begoña Lavin
- School of Biomedical Engineering Imaging Sciences, King's College London, London, UK.,BHF Centre of Excellence, Cardiovascular Division, King's College London, London, UK
| | - Marcelo E Andia
- School of Biomedical Engineering Imaging Sciences, King's College London, London, UK.,Radiology Department, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Alberto Smith
- Academic Department of Vascular Surgery, Cardiovascular Division, King's College London, London, UK
| | - Prakash Saha
- Academic Department of Vascular Surgery, Cardiovascular Division, King's College London, London, UK
| | - René M Botnar
- School of Biomedical Engineering Imaging Sciences, King's College London, London, UK.,BHF Centre of Excellence, Cardiovascular Division, King's College London, London, UK.,Wellcome Trust and EPSRC Medical Engineering Center, King's College London, UK.,Pontificia Universidad Católica de Chile, Escuela de Ingeniería, Santiago, Chile
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11
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Taylor E, Huang N, Bodde J, Ellison A, Killiany R, Bachschmid MM, Hamilton J. MRI of atherosclerosis and fatty liver disease in cholesterol fed rabbits. J Transl Med 2018; 16:215. [PMID: 30068362 PMCID: PMC6071403 DOI: 10.1186/s12967-018-1587-3] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2018] [Accepted: 07/20/2018] [Indexed: 02/07/2023] Open
Abstract
Background The globally rising obesity epidemic is associated with a broad spectrum of diseases including atherosclerosis and non-alcoholic fatty liver (NAFL) disease. In the past, research focused on the vasculature or liver, but chronic systemic effects and inter-organ communication may promote the development of NAFL. Here, we investigated the impact of confined vascular endothelial injury, which produces highly inflamed aortic plaques that are susceptible to rupture, on the progression of NAFL in cholesterol fed rabbits. Methods Aortic atherosclerotic inflammation (plaque Gd-enhancement), plaque size (vessel wall area), and composition, were measured with in vivo magnetic resonance imaging (MRI) in rabbits fed normal chow or a 1% cholesterol-enriched atherogenic diet. Liver fat was quantified with magnetic resonance spectroscopy (MRS) over 3 months. Blood biomarkers were monitored in the animals, with follow-up by histology. Results Cholesterol-fed rabbits with and without injury developed hypercholesterolemia, NAFL, and atherosclerotic plaques in the aorta. Compared with rabbits fed cholesterol diet alone, rabbits with injury and cholesterol diets exhibited larger, and more highly inflamed plaques by MRI (P < 0.05) and aggravated liver steatosis by MRS (P < 0.05). Moreover, after sacrifice, damaged (ballooning) hepatocytes and extensive liver fibrosis were observed by histology. Elevated plasma gamma-glutamyl transferase (GGT; P = 0.014) and the ratio of liver enzymes aspartate and alanine aminotransferases (AST/ALT; P = 0.033) indicated the progression of steatosis to non-alcoholic steatohepatitis (NASH). Conclusions Localized regions of highly inflamed aortic atherosclerotic plaques in cholesterol-fed rabbits may contribute to progression of fatty liver disease to NASH with fibrosis. Electronic supplementary material The online version of this article (10.1186/s12967-018-1587-3) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Erik Taylor
- Department of Physiology and Biophysics, Boston University School of Medicine, 700 Albany Street, W302, Boston, MA, 02118-2526, USA
| | - Nasi Huang
- Department of Physiology and Biophysics, Boston University School of Medicine, 700 Albany Street, W302, Boston, MA, 02118-2526, USA
| | - Jacob Bodde
- Department of Physiology and Biophysics, Boston University School of Medicine, 700 Albany Street, W302, Boston, MA, 02118-2526, USA
| | - Andrew Ellison
- Anatomy and Neurobiology, Boston University School of Medicine, Boston, MA, USA
| | - Ronald Killiany
- Anatomy and Neurobiology, Boston University School of Medicine, Boston, MA, USA
| | - Markus Michael Bachschmid
- Vascular Biology Section, Whitaker Cardiovascular Institute, and Cardiovascular Proteomics Center, Boston University School of Medicine, Boston, MA, USA
| | - James Hamilton
- Department of Physiology and Biophysics, Boston University School of Medicine, 700 Albany Street, W302, Boston, MA, 02118-2526, USA.
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12
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Abstract
PURPOSE OF REVIEW This short review summarizes the recent development in clinical and experimental imaging techniques for coronary atherosclerosis. RECENT FINDINGS Coronary atherosclerosis is the underlying disease of myocardial infarction, the leading cause of death in the industrialized world. Conventional ways of risk assessment, including evaluation of traditional risk factors and interrogation of luminal stenosis, have proven imprecise for the prediction of major events. Rapid advances in noninvasive imaging techniques including MRI, CT, and PET, as well as catheter-based methods, have opened the doors to more in-depth interrogation of plaque burden, composition, and many crucial pathological processes such as inflammation and hemorrhage. These emerging imaging modalities and methodologies, combined with conventional imaging evidences of anatomy and ischemia, offer the promises to provide comprehensive information of the disease status. There is tremendous clinical potential for imaging to improve the current management of coronary atherosclerosis, including the identification of high-risk patients for aggressive therapies and guiding personalized treatment. In this review, we provide an overview of the state-of-the-art coronary plaque imaging techniques focusing on their respective strengths and weaknesses, as well as their clinical outlook.
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Affiliation(s)
- Yibin Xie
- Biomedical Imaging Research Institute, Cedars Sinai Medical Center, 8700 Beverly Blvd., PACT Suite 400, Los Angeles, CA, 90048, USA
| | - Hang Jin
- Biomedical Imaging Research Institute, Cedars Sinai Medical Center, 8700 Beverly Blvd., PACT Suite 400, Los Angeles, CA, 90048, USA
- Department of Radiology, Zhongshan Hospital, Fudan University, 180 Feng Lin Road, Shanghai, China
| | - Mengsu Zeng
- Department of Radiology, Zhongshan Hospital, Fudan University, 180 Feng Lin Road, Shanghai, China
| | - Debiao Li
- Biomedical Imaging Research Institute, Cedars Sinai Medical Center, 8700 Beverly Blvd., PACT Suite 400, Los Angeles, CA, 90048, USA.
- Department of Bioengineering, University of California, Los Angeles, CA, USA.
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13
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Mitra R, O'Neil GL, Harding IC, Cheng MJ, Mensah SA, Ebong EE. Glycocalyx in Atherosclerosis-Relevant Endothelium Function and as a Therapeutic Target. Curr Atheroscler Rep 2017; 19:63. [PMID: 29127504 PMCID: PMC5681608 DOI: 10.1007/s11883-017-0691-9] [Citation(s) in RCA: 57] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Purpose of Review The cell surface-attached extracellular glycocalyx (GCX) layer is a major contributor to endothelial cell (EC) function and EC-dependent vascular health and is a first line of defense against vascular diseases including atherosclerosis. Here, we highlight our findings regarding three GCX-dependent EC functions, which are altered when GCX is shed and in atherosclerosis. We discuss why the GCX is a viable option for the prevention and treatment of atherosclerosis. Recent Findings GCX regulated EC activities such as barrier and filtration function, active cell-to-cell communication, and vascular tone mediation contribute to function of the entire vascular wall. Atheroprone vessel regions, including bifurcation sites, exhibit breakdown in GCX. This GCX degradation allows increased lipid flux and thereby promotes lipid deposition in the vessel walls, a hallmark of atherosclerosis. GCX degradation also alters EC-to-EC communication while increasing EC-to-inflammatory cell interactions that enable inflammatory cells to migrate into the vessel wall. Inflammatory macrophages and foam cells, to be specific, appear in early stages of atherosclerosis. Furthermore, GCX degradation deregulates vascular tone, by causing ECs to reduce their expression of endothelial nitric oxide synthase (eNOS) which produces the vasodilator, nitric oxide. Loss of vasodilation supports vasoconstriction, which promotes the progression of atherosclerosis. Summary Common medicinal atherosclerosis therapies include lipid lowering and anti-platelet therapies. None of these treatments specifically target the endothelial GCX, although the GCX is at the front-line in atherosclerosis combat. This review demonstrates the viability of targeting the GCX therapeutically, to support proper EC functionality and prevent and/or treat atherosclerosis.
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Affiliation(s)
- Ronodeep Mitra
- Department of Bioengineering, Northeastern University, Boston, MA, USA
| | | | | | - Ming Jie Cheng
- Department of Chemical Engineering, Northeastern University, 360 Huntington Avenue 313 Snell Engineering Building, Boston, MA, 02115, USA
| | | | - Eno Essien Ebong
- Department of Bioengineering, Northeastern University, Boston, MA, USA. .,Department of Chemical Engineering, Northeastern University, 360 Huntington Avenue 313 Snell Engineering Building, Boston, MA, 02115, USA. .,Department of Neuroscience, Albert Einstein College of Medicine, New York, NY, USA.
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14
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Hamilton JA, Hasturk H, Kantarci A, Serhan CN, Van Dyke T. Atherosclerosis, Periodontal Disease, and Treatment with Resolvins. Curr Atheroscler Rep 2017; 19:57. [PMID: 29110146 DOI: 10.1007/s11883-017-0696-4] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
PURPOSE OF REVIEW This review aims to discuss the existing evidence on the link between atherosclerosis and periodontitis by particularly presenting new findings that link the pathology and therapy of these diseases. Acute vascular ischemic events that can lead to stroke or myocardial infarction are initiated by inflammatory processes leading to rupture or erosion of plaques susceptible to thrombosis ("high risk" or "vulnerable"). These are highly inflamed plaques residing in the media and adventitia that may not be detected by angiography measurments of luminal narrowing. Statistically significant excess risk for atherosclerotic cardiovascular disease has been reported in persons with periodontitis independent of established risk factors. We hypothesized that the systemic pathologic links also represent potential therapeutic links. RECENT FINDINGS We recently demonstrated that periodontal inflammation promotes atherosclerotic plaque inflammation and destabilization. As discrete pathological regions, these plaques with a high susceptibility to rupture can be imaged and differentiated from lower risk plaques. In cholesterol-fed rabbits with periodontal disease, circulating inflammatory mediators were also significantly elevated thereby contributing to "vulnerable blood," a systemic characteristic of high risk for cardiovascular events. New studies show that certain lipid mediators, including lipoxins and resolvins, are potent in preventing and possibly treating a number of inflammation-associated diseases, including periodontitis and vascular inflammation. The concept of the vulnerable patient and the pro-resolving approach open new terrain for discovery of paradigm-changing therapies for the prevention and treatment of two of the most common diseases of man. Importantly, lipoxins and resolvins are natural receptor agonists that do not exhibit the same pro-atherogenic side effects attributed to anti-inflammatory medications (e.g., NSAIDs) but rather coordinate resolution of inflammation and a return to homeostasis.
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Affiliation(s)
- James A Hamilton
- Department of Physiology and Biophysics, Boston University School of Medicine, 700 Albany Street, W302, Boston, MA, 02118-2526, USA.
| | - Hatice Hasturk
- Department of Applied Oral Sciences, The Forsyth Institute, 245 First Street, Cambridge, MA, 02142, USA
| | - Alpdogan Kantarci
- Department of Applied Oral Sciences, The Forsyth Institute, 245 First Street, Cambridge, MA, 02142, USA
| | - Charles N Serhan
- Center for Experimental Therapeutics and Reperfusion Injury, Department of Anesthesiology, Perioperative and Pain Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, 02115, USA
| | - Thomas Van Dyke
- Department of Applied Oral Sciences, The Forsyth Institute, 245 First Street, Cambridge, MA, 02142, USA
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15
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Abstract
Objective To investigate the effect of a heart rate (HR) lowering agent (Ivabradine) on features of atherosclerotic plaque vulnerability with magnetic resonance imaging (MRI), ultrasound imaging, and histology. Approach and results Atherosclerosis was induced in the abdominal aorta of 19 rabbits. Nine rabbits were treated with Ivabradine (17 mg/kg/day) during the entire study period. At week 14, imaging was performed. Plaque size was quantified on contrast-enhanced T1-weighted MR images. Microvascular flow, density, and permeability was studied with dynamic contrast-enhanced MRI. Plaque biomechanics was studied by measuring the aortic distension with ultrasound. After, animals were sacrificed and histology was performed. HR was reduced by 16% (p = 0.026) in Ivabradine-treated animals. No differences in absolute and relative vessel wall beat-to-beat distension were found, but due to the reduction in HR, the frequency of the biomechanical load on the plaque was reduced. Plaque size (MR and histology) was similar between groups. Although microvessel density (histology) was similar between groups, AUC and Ktrans, indicative for plaque microvasculature flow, density, and permeability, were decreased by 24% (p = 0.029) and 32% (p = 0.037), respectively. Macrophage content (relative RAM11 positive area) was reduced by 44% (p<0.001) on histology in Ivabradine-treated animals. Conclusions HR lowering treatment with Ivabradine in an atherosclerotic rabbit model is associated with a reduction in vulnerable plaque features. The current study suggests that HR reduction may be beneficial for inducing or maintaining a more stable plaque phenotype.
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16
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Stein-Merlob AF, Hara T, McCarthy JR, Mauskapf A, Hamilton JA, Ntziachristos V, Libby P, Jaffer FA. Atheroma Susceptible to Thrombosis Exhibit Impaired Endothelial Permeability In Vivo as Assessed by Nanoparticle-Based Fluorescence Molecular Imaging. Circ Cardiovasc Imaging 2017; 10:CIRCIMAGING.116.005813. [PMID: 28487316 DOI: 10.1161/circimaging.116.005813] [Citation(s) in RCA: 38] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2016] [Accepted: 03/28/2017] [Indexed: 12/14/2022]
Abstract
BACKGROUND The role of local alterations in endothelial functional integrity in atherosclerosis remains incompletely understood. This study used nanoparticle-enhanced optical molecular imaging to probe in vivo mechanisms involving impaired endothelial barrier function in experimental atherothrombosis. METHODS AND RESULTS Atherosclerosis was induced in rabbits (n=31) using aortic balloon injury and high-cholesterol diet. Rabbits received ultrasmall superparamagnetic iron oxide nanoparticles (CLIO) derivatized with a near-infrared fluorophore (CyAm7) 24 hours before near-infrared fluorescence imaging. Rabbits were then either euthanized (n=9) or underwent a pharmacological triggering protocol to induce thrombosis (n=22). CLIO-CyAm7 nanoparticles accumulated in areas of atheroma (P<0.05 versus reference areas). On near-infrared fluorescence microscopy, CLIO-CyAm7 primarily deposited in the superficial intima within plaque macrophages, endothelial cells, and smooth muscle cells. Nanoparticle-positive areas further exhibited impaired endothelial barrier function as illuminated by Evans blue leakage. Deeper nanoparticle deposition occurred in areas of plaque neovascularization. In rabbits subject to pharmacological triggering, plaques that thrombosed exhibited significantly higher CLIO-CyAm7 accumulation compared with nonthrombosed plaques (P<0.05). In thrombosed plaques, nanoparticles accumulated preferentially at the plaque-thrombus interface. Intravascular 2-dimensional near-infrared fluorescence imaging detected nanoparticles in human coronary artery-sized atheroma in vivo (P<0.05 versus reference segments). CONCLUSIONS Plaques that exhibit impaired in vivo endothelial permeability in cell-rich areas are susceptible to subsequent thrombosis. Molecular imaging of nanoparticle deposition may help to identify biologically high-risk atheroma.
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Affiliation(s)
- Ashley F Stein-Merlob
- From the Cardiovascular Research Center, Cardiology Division (A.F.S., T.H., A.M., F.A.J.) and Center for Systems Biology (J.R.M.), Department of Cardiology, Massachusetts General Hospital, Harvard Medical School, Boston; Department of Physiology and Biophysics, Boston University School of Medicine, MA (J.A.H.); Department of Biomedical Engineering, Boston University, MA (J.A.H.); Institute of Biological and Medical Imaging, Chair of Biological Imaging, Technical University of Munich, Germany (V.N.); and Cardiovascular Division, Brigham and Women's Hospital, Harvard Medical School, Boston, MA (P.L.)
| | - Tetsuya Hara
- From the Cardiovascular Research Center, Cardiology Division (A.F.S., T.H., A.M., F.A.J.) and Center for Systems Biology (J.R.M.), Department of Cardiology, Massachusetts General Hospital, Harvard Medical School, Boston; Department of Physiology and Biophysics, Boston University School of Medicine, MA (J.A.H.); Department of Biomedical Engineering, Boston University, MA (J.A.H.); Institute of Biological and Medical Imaging, Chair of Biological Imaging, Technical University of Munich, Germany (V.N.); and Cardiovascular Division, Brigham and Women's Hospital, Harvard Medical School, Boston, MA (P.L.)
| | - Jason R McCarthy
- From the Cardiovascular Research Center, Cardiology Division (A.F.S., T.H., A.M., F.A.J.) and Center for Systems Biology (J.R.M.), Department of Cardiology, Massachusetts General Hospital, Harvard Medical School, Boston; Department of Physiology and Biophysics, Boston University School of Medicine, MA (J.A.H.); Department of Biomedical Engineering, Boston University, MA (J.A.H.); Institute of Biological and Medical Imaging, Chair of Biological Imaging, Technical University of Munich, Germany (V.N.); and Cardiovascular Division, Brigham and Women's Hospital, Harvard Medical School, Boston, MA (P.L.)
| | - Adam Mauskapf
- From the Cardiovascular Research Center, Cardiology Division (A.F.S., T.H., A.M., F.A.J.) and Center for Systems Biology (J.R.M.), Department of Cardiology, Massachusetts General Hospital, Harvard Medical School, Boston; Department of Physiology and Biophysics, Boston University School of Medicine, MA (J.A.H.); Department of Biomedical Engineering, Boston University, MA (J.A.H.); Institute of Biological and Medical Imaging, Chair of Biological Imaging, Technical University of Munich, Germany (V.N.); and Cardiovascular Division, Brigham and Women's Hospital, Harvard Medical School, Boston, MA (P.L.)
| | - James A Hamilton
- From the Cardiovascular Research Center, Cardiology Division (A.F.S., T.H., A.M., F.A.J.) and Center for Systems Biology (J.R.M.), Department of Cardiology, Massachusetts General Hospital, Harvard Medical School, Boston; Department of Physiology and Biophysics, Boston University School of Medicine, MA (J.A.H.); Department of Biomedical Engineering, Boston University, MA (J.A.H.); Institute of Biological and Medical Imaging, Chair of Biological Imaging, Technical University of Munich, Germany (V.N.); and Cardiovascular Division, Brigham and Women's Hospital, Harvard Medical School, Boston, MA (P.L.)
| | - Vasilis Ntziachristos
- From the Cardiovascular Research Center, Cardiology Division (A.F.S., T.H., A.M., F.A.J.) and Center for Systems Biology (J.R.M.), Department of Cardiology, Massachusetts General Hospital, Harvard Medical School, Boston; Department of Physiology and Biophysics, Boston University School of Medicine, MA (J.A.H.); Department of Biomedical Engineering, Boston University, MA (J.A.H.); Institute of Biological and Medical Imaging, Chair of Biological Imaging, Technical University of Munich, Germany (V.N.); and Cardiovascular Division, Brigham and Women's Hospital, Harvard Medical School, Boston, MA (P.L.)
| | - Peter Libby
- From the Cardiovascular Research Center, Cardiology Division (A.F.S., T.H., A.M., F.A.J.) and Center for Systems Biology (J.R.M.), Department of Cardiology, Massachusetts General Hospital, Harvard Medical School, Boston; Department of Physiology and Biophysics, Boston University School of Medicine, MA (J.A.H.); Department of Biomedical Engineering, Boston University, MA (J.A.H.); Institute of Biological and Medical Imaging, Chair of Biological Imaging, Technical University of Munich, Germany (V.N.); and Cardiovascular Division, Brigham and Women's Hospital, Harvard Medical School, Boston, MA (P.L.)
| | - Farouc A Jaffer
- From the Cardiovascular Research Center, Cardiology Division (A.F.S., T.H., A.M., F.A.J.) and Center for Systems Biology (J.R.M.), Department of Cardiology, Massachusetts General Hospital, Harvard Medical School, Boston; Department of Physiology and Biophysics, Boston University School of Medicine, MA (J.A.H.); Department of Biomedical Engineering, Boston University, MA (J.A.H.); Institute of Biological and Medical Imaging, Chair of Biological Imaging, Technical University of Munich, Germany (V.N.); and Cardiovascular Division, Brigham and Women's Hospital, Harvard Medical School, Boston, MA (P.L.).
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17
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Sun B, Zhao H, Li X, Yao H, Liu X, Lu Q, Wan J, Xu J. Angiotensin II-accelerated vulnerability of carotid plaque in a cholesterol-fed rabbit model-assessed with magnetic resonance imaging comparing to histopathology. Saudi J Biol Sci 2017; 24:495-503. [PMID: 28386172 PMCID: PMC5372370 DOI: 10.1016/j.sjbs.2017.01.017] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2016] [Revised: 12/28/2016] [Accepted: 01/06/2017] [Indexed: 12/12/2022] Open
Abstract
This study sought to reveal the effect of angiotensin II (Ang II)-induced atherosclerotic vulnerability in rabbits and to determine whether in vivo magnetic resonance imaging (MRI) can determine the effect of Ang II on atherosclerotic development over time. In total, 24 elderly male New Zealand white rabbits underwent an intravascular balloon injury in the left common carotid artery (LCCA) and were subsequently fed a high cholesterol diet for 12 weeks. At 8 weeks, rabbits were randomly assigned to receive either Ang II (1.4 mg/kg/d, Ang II group) or vehicle (phosphate-buffered saline, control) via a subcutaneous osmotic minipump for 4 weeks. The rabbits were imaged three times: at baseline and at 8 and 12 weeks. After the 12-week MRI scanning, rabbits were euthanized to obtain pathological and histological data. Atherosclerotic plaques were identified in the 21 rabbits that survived the 12-week trial. Typical feature of vulnerable plaques (VP), intraplaque hemorrhage, were observed in 6 of 10 animals (60.0%) in the Ang II group. The Cohen K value of MR imaging between the AHA classifications was 0.82 (0.73–0.91; P < 0.001). MRI revealed that the change in carotid morphology were significantly different between the Ang II and control group plaques. Our results support an important role for Ang II in plaque vulnerability by promoting intraplaque neovascularization and hemorrhage as well as inflammation. The vulnerable features induced by Ang II in rabbit carotid plaques could be accurately monitored with MRI in vivo and confirmed with histomorphology.
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Affiliation(s)
- Beibei Sun
- Department of Radiology, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai 200127, China
| | - Huilin Zhao
- Department of Radiology, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai 200127, China
| | - Xiao Li
- Department of Radiology, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai 200127, China
| | - Hong Yao
- Department of Neurosurgery, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai 200127, China
| | - Xiaosheng Liu
- Department of Radiology, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai 200127, China
| | - Qing Lu
- Department of Radiology, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai 200127, China
| | - Jieqing Wan
- Department of Neurosurgery, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai 200127, China
| | - Jianrong Xu
- Department of Radiology, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai 200127, China
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18
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Meloni MM, Barton S, Xu L, Kaski JC, Song W, He T. Contrast agents for cardiovascular magnetic resonance imaging: an overview. J Mater Chem B 2017; 5:5714-5725. [DOI: 10.1039/c7tb01241a] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
Contrast agents for Cardiovascular Magnetic Resonance (CMR) play a major role in research and clinical cardiology.
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Affiliation(s)
- Marco M. Meloni
- Molecular and Clinical Sciences Research Institute
- St George's, University of London
- London
- UK
- School of Pharmacy and Chemistry
| | - Stephen Barton
- School of Pharmacy and Chemistry
- Kingston University
- London
- UK
| | - Lei Xu
- Department of Radiology
- Beijing Anzhen Hospital
- Beijing
- China
| | - Juan C. Kaski
- Molecular and Clinical Sciences Research Institute
- St George's, University of London
- London
- UK
| | - Wenhui Song
- UCL Centre for Biomaterials
- Division of surgery & Interventional Science
- University College of London
- London
- UK
| | - Taigang He
- Molecular and Clinical Sciences Research Institute
- St George's, University of London
- London
- UK
- Royal Brompton Hospital
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19
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Abela OG, Ahsan CH, Alreefi F, Salehi N, Baig I, Janoudi A, Abela GS. Plaque Rupture and Thrombosis: the Value of the Atherosclerotic Rabbit Model in Defining the Mechanism. Curr Atheroscler Rep 2016; 18:29. [PMID: 27091328 DOI: 10.1007/s11883-016-0587-0] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Persistent inflammation and mechanical injury associated with cholesterol crystal accretion within atherosclerotic plaques typically precedes plaque disruption (rupture and/or erosion) and thrombosis--often the terminal events of atherosclerotic cardiovascular disease. To elucidate the mechanisms of these events, the atherosclerotic rabbit model provides a unique and powerful tool that facilitates studies of atherogenesis starting with plaque buildup to eventual disruption. Examination of human coronary arteries obtained from patients who died with myocardial infarction demonstrates evidence of cholesterol crystals perforating the plaque cap and intimal surface of the arterial wall that can lead to rupture. These observations were made possible by omitting ethanol, an avid lipid solvent, from the tissue processing steps. Importantly, the atherosclerotic rabbit model exhibits a similar pathology of cholesterol crystals perforating the intimal surface as seen in ruptured human plaques. Local and systemic inflammatory responses in the model are also similar to those observed in humans. The strong parallel between the rabbit and human pathology validates the atherosclerotic rabbit model as a predictor of human pathophysiology of atherosclerosis. Thus, the atherosclerotic rabbit model can be used with confidence to evaluate diagnostic imaging and efficacy of novel anti-atherosclerotic therapy.
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Affiliation(s)
- Oliver G Abela
- Department of Medicine, Division of Cardiovascular Medicine, University of Nevada, Las Vegas, NV, USA
| | - Chowdhury H Ahsan
- Department of Medicine, Division of Cardiovascular Medicine, University of Nevada, Las Vegas, NV, USA
| | - Fadi Alreefi
- Division of Cardiovascular Medicine, Michigan State University, East Lansing, MI, USA
| | - Negar Salehi
- Department of Medicine, Michigan State University, East Lansing, MI, USA
| | - Imran Baig
- Division of Cardiovascular Medicine, Michigan State University, East Lansing, MI, USA
| | - Abed Janoudi
- Division of Cardiovascular Medicine, Michigan State University, East Lansing, MI, USA
| | - George S Abela
- Division of Cardiovascular Medicine, Michigan State University, East Lansing, MI, USA.
- Department of Physiology, Division of Pathology, Michigan State University, East Lansing, MI, USA.
- Michigan State University, B208 Clinical Center, East Lansing, MI, 48824, USA.
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Phinikaridou A, Andia ME, Lavin B, Smith A, Saha P, Botnar RM. Increased Vascular Permeability Measured With an Albumin-Binding Magnetic Resonance Contrast Agent Is a Surrogate Marker of Rupture-Prone Atherosclerotic Plaque. Circ Cardiovasc Imaging 2016; 9:e004910. [PMID: 27940955 PMCID: PMC5388187 DOI: 10.1161/circimaging.116.004910] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2016] [Accepted: 09/30/2016] [Indexed: 12/21/2022]
Abstract
BACKGROUND Compromised structural integrity of the endothelium and higher microvessel density increase vascular permeability. We investigated whether vascular permeability measured in vivo by magnetic resonance imaging using the albumin-binding contrast agent, gadofosveset, is a surrogate marker of rupture-prone atherosclerotic plaque in a rabbit model. METHODS AND RESULTS New Zealand white rabbits (n=10) were rendered atherosclerotic by cholesterol-diet and endothelial denudation. Plaque rupture was triggered with Russell's viper venom and histamine. Animals were imaged pre-triggering, at 3 and 12 weeks, to quantify plaque area, vascular permeability, vasodilation, and stiffness and post-triggering to identify thrombus. Plaques identified on the pretrigger scans were classified as stable or rupture-prone based on the absence or presence of thrombus on the corresponding post-trigger magnetic resonance imaging, respectively. All rabbits had developed atherosclerosis, and 60% had ruptured plaques. Rupture-prone plaques had higher vessel wall relaxation rate (R1; 2.30±0.5 versus 1.86±0.3 s-1; P<0.001), measured 30 minutes after gadofosveset administration, and higher R1/plaque area ratio (0.70±0.06 versus 0.47±0.02, P= 0.01) compared with stable plaque at 12 weeks. Rupture-prone plaques had higher percent change in R1 between the 3 and 12 weeks compared with stable plaque (50.80±7.2% versus 14.22±2.2%; P<0.001). Immunohistochemistry revealed increased vessel wall albumin and microvessel density in diseased aortas and especially in ruptured plaque. Electron microscopy showed lack of structural integrity in both luminal and microvascular endothelium in diseased vessels. Functionally, the intrinsic vasodilation of the vessel wall decreased at 12 weeks compared with 3 weeks (18.60±1.0% versus 23.43±0.8%; P<0.001) and in rupture-prone compared with stable lesions (16.40±2.0% versus 21.63±1.2%; P<0.001). Arterial stiffness increased at 12 weeks compared with 3 weeks (5.00±0.1 versus 2.53±0.2 m/s; P<0.001) both in animals with stable and rupture-prone lesions. CONCLUSIONS T1 mapping using an albumin-binding contrast agent (gadofosveset) could quantify the changes in vascular permeability associated with atherosclerosis progression and rupture-prone plaques.
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Affiliation(s)
- Alkystis Phinikaridou
- From the Division of Imaging Science and Biomedical Engineering (A.P., M.E.A., B.L., R.M.B.), Academic Department of Surgery, Cardiovascular Division (A.S., P.S.), BHF Centre of Excellence, Cardiovascular Division (A.S., R.M.B.), and Wellcome Trust and EPSRC Medical Engineering Center (P.S., R.M.B.), King's College London, United Kingdom; and Radiology Department, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile (M.E.A.).
| | - Marcelo E Andia
- From the Division of Imaging Science and Biomedical Engineering (A.P., M.E.A., B.L., R.M.B.), Academic Department of Surgery, Cardiovascular Division (A.S., P.S.), BHF Centre of Excellence, Cardiovascular Division (A.S., R.M.B.), and Wellcome Trust and EPSRC Medical Engineering Center (P.S., R.M.B.), King's College London, United Kingdom; and Radiology Department, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile (M.E.A.)
| | - Begoña Lavin
- From the Division of Imaging Science and Biomedical Engineering (A.P., M.E.A., B.L., R.M.B.), Academic Department of Surgery, Cardiovascular Division (A.S., P.S.), BHF Centre of Excellence, Cardiovascular Division (A.S., R.M.B.), and Wellcome Trust and EPSRC Medical Engineering Center (P.S., R.M.B.), King's College London, United Kingdom; and Radiology Department, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile (M.E.A.)
| | - Alberto Smith
- From the Division of Imaging Science and Biomedical Engineering (A.P., M.E.A., B.L., R.M.B.), Academic Department of Surgery, Cardiovascular Division (A.S., P.S.), BHF Centre of Excellence, Cardiovascular Division (A.S., R.M.B.), and Wellcome Trust and EPSRC Medical Engineering Center (P.S., R.M.B.), King's College London, United Kingdom; and Radiology Department, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile (M.E.A.)
| | - Prakash Saha
- From the Division of Imaging Science and Biomedical Engineering (A.P., M.E.A., B.L., R.M.B.), Academic Department of Surgery, Cardiovascular Division (A.S., P.S.), BHF Centre of Excellence, Cardiovascular Division (A.S., R.M.B.), and Wellcome Trust and EPSRC Medical Engineering Center (P.S., R.M.B.), King's College London, United Kingdom; and Radiology Department, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile (M.E.A.)
| | - René M Botnar
- From the Division of Imaging Science and Biomedical Engineering (A.P., M.E.A., B.L., R.M.B.), Academic Department of Surgery, Cardiovascular Division (A.S., P.S.), BHF Centre of Excellence, Cardiovascular Division (A.S., R.M.B.), and Wellcome Trust and EPSRC Medical Engineering Center (P.S., R.M.B.), King's College London, United Kingdom; and Radiology Department, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile (M.E.A.)
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Zaromytidou M, Antoniadis AP, Siasos G, Coskun AU, Andreou I, Papafaklis MI, Lucier M, Feldman CL, Stone PH. Heterogeneity of Coronary Plaque Morphology and Natural History: Current Understanding and Clinical Significance. Curr Atheroscler Rep 2016; 18:80. [PMID: 27822680 DOI: 10.1007/s11883-016-0626-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
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22
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Intawicha P, Siriboon C, Chen CH, Chiu YT, Lin TA, Kere M, Lo NW, Lee KH, Chang LY, Chiang HI, Ju JC. Derivation and characterization of putative embryonic stem cells from cloned rabbit embryos. Theriogenology 2016; 86:1799-810. [DOI: 10.1016/j.theriogenology.2016.05.035] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2015] [Revised: 05/24/2016] [Accepted: 05/27/2016] [Indexed: 12/19/2022]
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23
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Gao S, van 't Klooster R, Brandts A, Roes SD, Alizadeh Dehnavi R, de Roos A, Westenberg JJ, van der Geest RJ. Quantification of common carotid artery and descending aorta vessel wall thickness from MR vessel wall imaging using a fully automated processing pipeline. J Magn Reson Imaging 2016; 45:215-228. [DOI: 10.1002/jmri.25332] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2016] [Accepted: 05/20/2016] [Indexed: 11/08/2022] Open
Affiliation(s)
- Shan Gao
- Division of Image Processing; Department of Radiology, Leiden University Medical Center; Leiden Netherlands
| | - Ronald van 't Klooster
- Division of Image Processing; Department of Radiology, Leiden University Medical Center; Leiden Netherlands
| | - Anne Brandts
- Department of Radiology; Leiden University Medical Center; Leiden Netherlands
| | - Stijntje D. Roes
- Department of Radiology; Leiden University Medical Center; Leiden Netherlands
| | | | - Albert de Roos
- Department of Radiology; Leiden University Medical Center; Leiden Netherlands
| | - Jos J.M. Westenberg
- Division of Image Processing; Department of Radiology, Leiden University Medical Center; Leiden Netherlands
| | - Rob J. van der Geest
- Division of Image Processing; Department of Radiology, Leiden University Medical Center; Leiden Netherlands
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Preclinical models of atherosclerosis. The future of Hybrid PET/MR technology for the early detection of vulnerable plaque. Expert Rev Mol Med 2016; 18:e6. [PMID: 27056676 DOI: 10.1017/erm.2016.5] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Cardiovascular diseases are the leading cause of death in developed countries. The aetiology is currently multifactorial, thus making them very difficult to prevent. Preclinical models of atherothrombotic diseases, including vulnerable plaque-associated complications, are now providing significant insights into pathologies like atherosclerosis, and in combination with the most recent advances in new non-invasive imaging technologies, they have become essential tools to evaluate new therapeutic strategies, with which can forecast and prevent plaque rupture. Positron emission tomography (PET)/computed tomography imaging is currently used for plaque visualisation in clinical and pre-clinical cardiovascular research, albeit with significant limitations. However, the combination of PET and magnetic resonance imaging (MRI) technologies is still the best option available today, as combined PET/MRI scans provide simultaneous data acquisition together with high quality anatomical information, sensitivity and lower radiation exposure for the patient. The coming years may represent a new era for the implementation of PET/MRI in clinical practice, but first, clinically efficient attenuation correction algorithms and research towards multimodal reagents and safety issues should be validated at the preclinical level.
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Pham TA, Hua N, Phinikaridou A, Killiany R, Hamilton J. Early in vivo discrimination of vulnerable atherosclerotic plaques that disrupt: A serial MRI study. Atherosclerosis 2015; 244:101-7. [PMID: 26606442 DOI: 10.1016/j.atherosclerosis.2015.11.013] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2015] [Revised: 11/08/2015] [Accepted: 11/10/2015] [Indexed: 11/19/2022]
Abstract
BACKGROUND AND AIMS MRI has been validated as a suitable imaging modality for in vivo, non-invasive detection of atherosclerosis and has provided quantitative predictors of high-risk plaque. Here, we apply serial MRI to monitor the natural progression of plaques over a 3-month period in a rabbit model of atherothrombosis to determine differences over time between plaques that ultimately disrupt to form a luminal mural thrombus and plaques that remain stable. METHODS Atherosclerotic plaques were induced in 12 male New Zealand White (NZW) rabbits by aortic endothelial injury and a 1% cholesterol diet. The rabbits were imaged 5 times: at baseline, 1, 2, and 3 months, and 48hr after pharmacological triggering for plaque disruption. RESULTS Starting at 2 months, plaques that disrupted after triggering exhibited a higher remodeling ratio (RR, 1.05 ± 0.11 vs 0.97 ± 0.10, p = 0.0002) and a larger vessel wall area (VWA, 6.99 ± 1.54 mm(2) vs 6.30 ± 1.37 mm(2), p = 0.0072) than the stable non-disrupted plaques. The same trends were observed at 3 months: plaques that disrupted had a higher RR (1.04 ± 0.02 vs 0.99 ± 0.01, p = 0.0209), VWA (8.19 ± 2.69 mm(2) vs 6.81 ± 1.60 mm(2), p = 0.0001), and increased gadolinium uptake (75.51 ± 13.77% for disrupted vs 31.02 ± 6.45% for non-disrupted, p = 0.0022). CONCLUSIONS MR images of plaques that disrupted revealed larger VWAs, RRs, and increased gadolinium uptake at 2 months and continued progression of these vulnerable features between 2 and 3 months. Non-disrupted plaques had an independent history without these hallmarks of vulnerability. Our results show that MRI can provide early detection of plaques at a higher-risk for luminal thrombosis.
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Affiliation(s)
- Tuan A Pham
- Department of Biomedical Engineering, Boston University, Boston, MA, USA
| | - Ning Hua
- Department of Physiology and Biophysics, Boston University School of Medicine, Boston, MA, USA
| | - Alkystis Phinikaridou
- Division of Imaging Sciences and Biomedical Engineering, King's College London, London, United Kingdom
| | - Ronald Killiany
- Department of Anatomy and Neurobiology, Boston University School of Medicine, Boston, MA, USA
| | - James Hamilton
- Department of Physiology and Biophysics, Boston University School of Medicine, Boston, MA, USA; Department of Biomedical Engineering, Boston University, Boston, MA, USA.
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Santos A, Fernández-Friera L, Villalba M, López-Melgar B, España S, Mateo J, Mota RA, Jiménez-Borreguero J, Ruiz-Cabello J. Cardiovascular imaging: what have we learned from animal models? Front Pharmacol 2015; 6:227. [PMID: 26539113 PMCID: PMC4612690 DOI: 10.3389/fphar.2015.00227] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2015] [Accepted: 09/22/2015] [Indexed: 12/17/2022] Open
Abstract
Cardiovascular imaging has become an indispensable tool for patient diagnosis and follow up. Probably the wide clinical applications of imaging are due to the possibility of a detailed and high quality description and quantification of cardiovascular system structure and function. Also phenomena that involve complex physiological mechanisms and biochemical pathways, such as inflammation and ischemia, can be visualized in a non-destructive way. The widespread use and evolution of imaging would not have been possible without animal studies. Animal models have allowed for instance, (i) the technical development of different imaging tools, (ii) to test hypothesis generated from human studies and finally, (iii) to evaluate the translational relevance assessment of in vitro and ex-vivo results. In this review, we will critically describe the contribution of animal models to the use of biomedical imaging in cardiovascular medicine. We will discuss the characteristics of the most frequent models used in/for imaging studies. We will cover the major findings of animal studies focused in the cardiovascular use of the repeatedly used imaging techniques in clinical practice and experimental studies. We will also describe the physiological findings and/or learning processes for imaging applications coming from models of the most common cardiovascular diseases. In these diseases, imaging research using animals has allowed the study of aspects such as: ventricular size, shape, global function, and wall thickening, local myocardial function, myocardial perfusion, metabolism and energetic assessment, infarct quantification, vascular lesion characterization, myocardial fiber structure, and myocardial calcium uptake. Finally we will discuss the limitations and future of imaging research with animal models.
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Affiliation(s)
- Arnoldo Santos
- Centro Nacional de Investigaciones Cardiovasculares Carlos III Madrid, Spain ; CIBER de Enfermedades Respiratorias (CIBERES) Madrid, Spain ; Madrid-MIT M+Visión Consortium Madrid, Spain ; Department of Anesthesia, Massachusetts General Hospital, Harvard Medical School Boston, MA, USA
| | - Leticia Fernández-Friera
- Centro Nacional de Investigaciones Cardiovasculares Carlos III Madrid, Spain ; Hospital Universitario HM Monteprincipe Madrid, Spain
| | - María Villalba
- Centro Nacional de Investigaciones Cardiovasculares Carlos III Madrid, Spain
| | - Beatriz López-Melgar
- Centro Nacional de Investigaciones Cardiovasculares Carlos III Madrid, Spain ; Hospital Universitario HM Monteprincipe Madrid, Spain
| | - Samuel España
- Centro Nacional de Investigaciones Cardiovasculares Carlos III Madrid, Spain ; CIBER de Enfermedades Respiratorias (CIBERES) Madrid, Spain ; Madrid-MIT M+Visión Consortium Madrid, Spain
| | - Jesús Mateo
- Centro Nacional de Investigaciones Cardiovasculares Carlos III Madrid, Spain ; CIBER de Enfermedades Respiratorias (CIBERES) Madrid, Spain
| | - Ruben A Mota
- Centro Nacional de Investigaciones Cardiovasculares Carlos III Madrid, Spain ; Charles River Barcelona, Spain
| | - Jesús Jiménez-Borreguero
- Centro Nacional de Investigaciones Cardiovasculares Carlos III Madrid, Spain ; Cardiac Imaging Department, Hospital de La Princesa Madrid, Spain
| | - Jesús Ruiz-Cabello
- Centro Nacional de Investigaciones Cardiovasculares Carlos III Madrid, Spain ; CIBER de Enfermedades Respiratorias (CIBERES) Madrid, Spain ; Universidad Complutense de Madrid Madrid, Spain
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27
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Hua N, Baik F, Pham T, Phinikaridou A, Giordano N, Friedman B, Whitney M, Nguyen QT, Tsien RY, Hamilton JA. Identification of High-Risk Plaques by MRI and Fluorescence Imaging in a Rabbit Model of Atherothrombosis. PLoS One 2015; 10:e0139833. [PMID: 26448434 PMCID: PMC4598148 DOI: 10.1371/journal.pone.0139833] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2015] [Accepted: 09/17/2015] [Indexed: 12/25/2022] Open
Abstract
Introduction The detection of atherosclerotic plaques at risk for disruption will be greatly enhanced by molecular probes that target vessel wall biomarkers. Here, we test if fluorescently-labeled Activatable Cell Penetrating Peptides (ACPPs) could differentiate stable plaques from vulnerable plaques that disrupt, forming a luminal thrombus. Additionally, we test the efficacy of a combined ACPP and MRI technique for identifying plaques at high risk of rupture. Methods and Results In an atherothrombotic rabbit model, disrupted plaques were identified with in vivo MRI and co-registered in the same rabbit aorta with the in vivo uptake of ACPPs, cleaved by matrix metalloproteinases (MMPs) or thrombin. ACPP uptake, mapped ex vivo in whole aortas, was higher in disrupted compared to non-disrupted plaques. Specifically, disrupted plaques demonstrated a 4.5~5.0 fold increase in fluorescence enhancement, while non-disrupted plaques showed only a 2.2~2.5 fold signal increase. Receiver operating characteristic (ROC) analysis indicates that both ACPPs (MMP and thrombin) show high specificity (84.2% and 83.2%) and sensitivity (80.0% and 85.7%) in detecting disrupted plaques. The detection power of ACPPs was improved when combined with the MRI derived measure, outward remodeling ratio. Conclusions Our targeted fluorescence ACPP probes distinguished disrupted plaques from stable plaques with high sensitivity and specificity. The combination of anatomic, MRI-derived predictors for disruption and ACPP uptake can further improve the power for identification of high-risk plaques and suggests future development of ACPPs with molecular MRI as a readout.
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Affiliation(s)
- Ning Hua
- Department of Physiology and Biophysics, Boston University School of Medicine, Boston, Massachusetts, United States of America
| | - Fred Baik
- Division of Head and Neck Surgery, University of California at San Diego, La Jolla, California, United States of America
| | - Tuan Pham
- Department of Biomedical Engineering, Boston University, Boston, Massachusetts, United States of America
| | - Alkystis Phinikaridou
- Division of Imaging Sciences and Biomedical Engineering, King’s College London, London, United Kingdom
| | - Nick Giordano
- Department of Physiology and Biophysics, Boston University School of Medicine, Boston, Massachusetts, United States of America
| | - Beth Friedman
- Department of Pharmacology, University of California at San Diego, La Jolla, California, United States of America
| | - Michael Whitney
- Department of Pharmacology, University of California at San Diego, La Jolla, California, United States of America
| | - Quyen T. Nguyen
- Division of Head and Neck Surgery, University of California at San Diego, La Jolla, California, United States of America
| | - Roger Y. Tsien
- Department of Pharmacology, University of California at San Diego, La Jolla, California, United States of America
- Howard Hughes Medical Institute, University of California at San Diego, La Jolla, CA, United States of America
| | - James A. Hamilton
- Department of Physiology and Biophysics, Boston University School of Medicine, Boston, Massachusetts, United States of America
- * E-mail:
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Bar A, Skorka T, Jasinski K, Chlopicki S. MRI-based assessment of endothelial function in mice in vivo. Pharmacol Rep 2015; 67:765-70. [PMID: 26321279 DOI: 10.1016/j.pharep.2015.05.007] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2015] [Revised: 05/08/2015] [Accepted: 05/13/2015] [Indexed: 12/28/2022]
Abstract
While a healthy endothelium serves to maintain vascular haemostasis, a malfunctioning endothelium leads to various cardiovascular diseases, including atherothrombosis. Endothelial dysfunction is characterized by increased vascular permeability, impaired endothelium-dependent responses and various pro-inflammatory and pro-thrombotic changes in endothelial phenotype, all of which could provide the basis for an in vivo diagnosis of endothelial dysfunction. In the present review, we briefly summarize the magnetic resonance imaging (MRI)-based methods available for assessing endothelial function in animal models, especially in mice. These methods are aimed to assess biochemical phenotype using molecular imaging, endothelium-dependent responses or changes in endothelial permeability. All these approaches provide a complementary insight into the endothelial dysfunction in vivo and may offer a unique opportunity to study endothelium-based mechanisms of diseases and endothelial response to treatment.
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Affiliation(s)
- Anna Bar
- Department of MRI, Institute of Nuclear Physics, Polish Academy of Sciences, Kraków, Poland; Department of Experimental Pharmacology, Jagiellonian University Medical College, Kraków, Poland
| | - Tomasz Skorka
- Department of MRI, Institute of Nuclear Physics, Polish Academy of Sciences, Kraków, Poland.
| | - Krzysztof Jasinski
- Department of MRI, Institute of Nuclear Physics, Polish Academy of Sciences, Kraków, Poland
| | - Stefan Chlopicki
- Department of Experimental Pharmacology, Jagiellonian University Medical College, Kraków, Poland; Jagiellonian Centre for Experimental Therapeutics (JCET), Jagiellonian University, Kraków, Poland
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Lo NW, Intawicha P, Chiu YT, Lee KH, Lu HC, Chen CH, Chang YH, Chen CD, Ju JC. Leukemia Inhibitory Factor and Fibroblast Growth Factor 2 Critically and Mutually Sustain Pluripotency of Rabbit Embryonic Stem Cells. Cell Transplant 2015; 24:319-38. [DOI: 10.3727/096368915x686832] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Effects of leukemia inhibitory factor (LIF) and fibroblast growth factor 2 (FGF2) on establishment and maintenance of rabbit embryonic stem cell (rESC) lines were assessed. When grown on MEF feeders, rESC lines derived from fertilized embryos were established and maintained in medium containing paracrine factors LIF (via STAT3) and/or FGF2 (via MEK-ERK1/2 and PI3K-AKT). However, high levels of ERK1/2 and AKT activities in rESCs were crucial for maintaining their undifferentiated proliferation. Although rESCs under the influence of either LIF (500, 1,000, and 2,000 U/ml) or FGF2 (5, 10, and 20 ng/ml) alone had enhanced expression of pluripotency markers, peak expression occurred when both LIF (1,000 U/ml) and FGF2 (10 ng/ml) were applied. Induced dephosphorylation of STAT3, ERK1/2, and AKT by specific inhibitors limited growth of rESCs and caused remarkable losses of self-renewal capacity; therefore, we inferred that STAT3, ERK, and AKT had essential roles in maintaining rESC proliferation and self-renewal. We concluded that LIF and FGF2 jointly maintained the undifferentiated state and self-renewal of rESCs through an integrative signaling module.
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Affiliation(s)
- Neng-Wen Lo
- Department of Animal Science and Biotechnology, Tunghai University, Taichung, Taiwan
| | - Payungsuk Intawicha
- Department of Animal Science, National Chung Hsing University, Taichung, Taiwan
- School of Agriculture and Natural Resources, University of Phayao, Phayao, Thailand
| | | | - Kun-Hsiung Lee
- Division of Animal Technology, Animal Technology Laboratories, Agriculture Technology Research Institute, Hsinchu, Taiwan
| | - Hsi-Chi Lu
- Department of Food Science, Tunghai University, Taichung, Taiwan
| | - Chien-Hong Chen
- Division of Animal Technology, Animal Technology Laboratories, Agriculture Technology Research Institute, Hsinchu, Taiwan
| | - Yong-Hsuan Chang
- Department of Animal Science and Biotechnology, Tunghai University, Taichung, Taiwan
| | - Chun-Da Chen
- Department of Animal Science, National Chung Hsing University, Taichung, Taiwan
| | - Jyh-Cherng Ju
- Department of Animal Science, National Chung Hsing University, Taichung, Taiwan
- Graduate Institute of Basic Medical Science, China Medical University, Taichung, Taiwan
- Agricultural Biotechnology Center and Biotechnology Center, National Chung Hsing University, Taichung, Taiwan
- Medical Research Department, China Medical University Hospital, Taichung, Taiwan
- Department of Biomedical Informatics, College of Computer Science, Asia University, Taichung, Taiwan
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Quantification of plaque lipids in the aortic root of ApoE-deficient mice by 3D DIXON magnetic resonance imaging in an ex vivo model. Eur Radiol 2014; 25:736-44. [DOI: 10.1007/s00330-014-3456-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2014] [Revised: 09/03/2014] [Accepted: 09/26/2014] [Indexed: 10/24/2022]
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Millon A, Canet-Soulas E, Boussel L, Fayad Z, Douek P. Animal models of atherosclerosis and magnetic resonance imaging for monitoring plaque progression. Vascular 2014; 22:221-37. [DOI: 10.1177/1708538113478758] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Atherosclerosis, the main cause of heart attack and stroke, is the leading cause of death in most modern countries. Preventing clinical events depends on a better understanding of the mechanism of atherosclerotic plaque destabilization. Our knowledge on the characteristics of vulnerable plaques in humans has grown past decades. Histological studies have provided a precise definition of high-risk lesions and novel imaging methods for human atherosclerotic plaque characterization have made significant progress. However the pathological mechanisms leading from stable lesions to the formation of vulnerable plaques remain uncertain and the related clinical events are unpredictable. An animal model mimicking human plaque destablization is required as well as an in vivo imaging method to assess and monitor atherosclerosis progression. Magnetic resonance imaging (MRI) is increasingly used for in vivo assessment of atherosclerotic plaques in the human carotids. MRI provides well-characterized morphological and functional features of human atherosclerotic plaque which can be also assessed in animal models. This review summarizes the most common species used as animal models for experimental atherosclerosis, the techniques to induce atherosclerosis and to obtain vulnerable plaques, together with the role of MRI for monitoring atherosclerotic plaques in animals.
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Affiliation(s)
- Antoine Millon
- Department of Vascular Surgery, University Hospital of Lyon, 69000 Lyon, France
- CREATIS, UMR CNRS 5515, INSERM U630, Lyon University, 69000 Lyon, France
| | | | - Loic Boussel
- CREATIS, UMR CNRS 5515, INSERM U630, Lyon University, 69000 Lyon, France
- Department of Radiology, Hôpital Cardiovasculaire et Pneumologique, Louis Pradel, 69000 Lyon, France
| | - Zahi Fayad
- Translational and Molecular Imaging Institute, Mount Sinai School of Medicine, New York, NY 10029, USA
| | - Philippe Douek
- CREATIS, UMR CNRS 5515, INSERM U630, Lyon University, 69000 Lyon, France
- Department of Radiology, Hôpital Cardiovasculaire et Pneumologique, Louis Pradel, 69000 Lyon, France
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Phinikaridou A, Andia ME, Indermuehle A, Onthank DC, Cesati RR, Smith A, Robinson SP, Saha P, Botnar RM. Vascular Remodeling and Plaque Vulnerability in a Rabbit Model of Atherosclerosis: Comparison of Delayed-Enhancement MR Imaging with an Elastin-specific Contrast Agent and Unenhanced Black-Blood MR Imaging. Radiology 2014; 271:390-9. [DOI: 10.1148/radiol.13130502] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Wan T, Madabhushi A, Phinikaridou A, Hamilton JA, Hua N, Pham T, Danagoulian J, Kleiman R, Buckler AJ. Spatio-temporal texture (SpTeT) for distinguishing vulnerable from stable atherosclerotic plaque on dynamic contrast enhancement (DCE) MRI in a rabbit model. Med Phys 2014; 41:042303. [PMID: 24694153 PMCID: PMC3987744 DOI: 10.1118/1.4867861] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2013] [Revised: 02/12/2014] [Accepted: 02/20/2014] [Indexed: 12/29/2022] Open
Abstract
PURPOSE To develop a new spatio-temporal texture (SpTeT) based method for distinguishing vulnerable versus stable atherosclerotic plaques on DCE-MRI using a rabbit model of atherothrombosis. METHODS Aortic atherosclerosis was induced in 20 New Zealand White rabbits by cholesterol diet and endothelial denudation. MRI was performed before (pretrigger) and after (posttrigger) inducing plaque disruption with Russell's-viper-venom and histamine. Of the 30 vascular targets (segments) under histology analysis, 16 contained thrombus (vulnerable) and 14 did not (stable). A total of 352 voxel-wise computerized SpTeT features, including 192 Gabor, 36 Kirsch, 12 Sobel, 52 Haralick, and 60 first-order textural features, were extracted on DCE-MRI to capture subtle texture changes in the plaques over the course of contrast uptake. Different combinations of SpTeT feature sets, in which the features were ranked by a minimum-redundancy-maximum-relevance feature selection technique, were evaluated via a random forest classifier. A 500 iterative 2-fold cross validation was performed for discriminating the vulnerable atherosclerotic plaque and stable atherosclerotic plaque on per voxel basis. Four quantitative metrics were utilized to measure the classification results in separating between vulnerable and stable plaques. RESULTS The quantitative results show that the combination of five classes of SpTeT features can distinguish between vulnerable (disrupted plaques with an overlying thrombus) and stable plaques with the best AUC values of 0.9631 ± 0.0088, accuracy of 89.98% ± 0.57%, sensitivity of 83.71% ± 1.71%, and specificity of 94.55% ± 0.48%. CONCLUSIONS Vulnerable and stable plaque can be distinguished by SpTeT based features. The SpTeT features, following validation on larger datasets, could be established as effective and reliable imaging biomarkers for noninvasively assessing atherosclerotic risk.
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Affiliation(s)
- Tao Wan
- Department of Biomedical Engineering, Case Western Reserve University, Cleveland, Ohio 44106
| | - Anant Madabhushi
- Department of Biomedical Engineering, Case Western Reserve University, Cleveland, Ohio 44106
| | - Alkystis Phinikaridou
- Division of Imaging Sciences and Biomedical Engineering, King's College London, London SE1 7EH, United Kingdom
| | - James A Hamilton
- Department of Physiology and Biophysics, Boston University School of Medicine, Boston, Massachusetts 02118
| | - Ning Hua
- Department of Physiology and Biophysics, Boston University School of Medicine, Boston, Massachusetts 02118
| | - Tuan Pham
- Department of Biomedical Engineering, Boston University, Boston, Massachusetts 02215
| | | | - Ross Kleiman
- Elucid Bioimaging Inc., Wenham, Massachusetts 01984
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Qiao Y, Zeiler SR, Mirbagheri S, Leigh R, Urrutia V, Wityk R, Wasserman BA. Intracranial plaque enhancement in patients with cerebrovascular events on high-spatial-resolution MR images. Radiology 2014; 271:534-42. [PMID: 24475850 DOI: 10.1148/radiol.13122812] [Citation(s) in RCA: 240] [Impact Index Per Article: 24.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
PURPOSE To characterize intracranial plaque inflammation in vivo by using three-dimensional (3D) high-spatial-resolution contrast material-enhanced black-blood (BB) magnetic resonance (MR) imaging and to investigate the relationship between intracranial plaque inflammation and cerebrovascular ischemic events. MATERIALS AND METHODS The study was approved by the institutional review board and was HIPAA compliant. Twenty-seven patients (19 men; mean age, 56.8 years ± 12.4 [standard deviation]) with cerebrovascular ischemic events (acute stroke, n = 20; subacute stroke, n = 2; chronic stroke, n = 3; transient ischemic attack, n = 2) underwent 3D time-of-flight MR angiography and contrast-enhanced BB 3-T MR imaging for intracranial atherosclerotic disease. Each identified plaque was classified as either culprit (the only or most stenotic lesion upstream from a stroke), probably culprit (not the most stenotic lesion upstream from a stroke), or nonculprit (not within the vascular territory of a stroke). Plaque contrast enhancement was categorized on BB MR images (grade 0, enhancement less than or equal to that of normal arterial walls seen elsewhere; grade 1, enhancement greater than grade 0 but less than that of the pituitary infundibulum; grade 2, enhancement greater than or equal to that of the pituitary infundibulum), and degree of contrast enhancement was calculated. Associations of the likelihood of being a culprit lesion with both plaque contrast enhancement and plaque thickness were estimated with ordinal logistic regression. RESULTS Seventy-eight plaques were identified in 20 patients with acute stroke (21 [27%] culprit, 12 [15%] probably culprit, and 45 [58%] nonculprit plaques). In these patients, grade 2 contrast enhancement was associated with culprit plaques (odds ratio 34.6; 95% confidence interval: 4.5, 266.5 compared with grade 0) when adjusted for plaque thickness. Grade 0 was observed in only nonculprit plaques. Culprit plaques had a higher degree of contrast enhancement than did nonculprit plaques (25.9% ± 13.4 vs 13.6% ± 12.3, P = .003). CONCLUSION Contrast enhancement of intracranial atherosclerotic plaque is associated with its likelihood to have caused a recent ischemic event and may serve as a marker of its stability, thereby providing important insight into stroke risk.
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Affiliation(s)
- Ye Qiao
- From the Russell H. Morgan Department of Radiology and Radiological Sciences (Y.Q., S.M., B.A.W.) and Department of Neurology (S.R.Z., R.L., V.U., R.W.), Johns Hopkins Hospital, Johns Hopkins University School of Medicine, 367 East Park Building, 600 N Wolfe St, Baltimore, MD 21287
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Phinikaridou A, Andia ME, Passacquale G, Ferro A, Botnar RM. Noninvasive MRI monitoring of the effect of interventions on endothelial permeability in murine atherosclerosis using an albumin-binding contrast agent. J Am Heart Assoc 2013; 2:e000402. [PMID: 24072533 PMCID: PMC3835253 DOI: 10.1161/jaha.113.000402] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
Background Endothelial dysfunction promotes atherosclerosis. We investigated whether in vivo magnetic resonance imaging (MRI) using an albumin‐binding contrast agent, gadofosveset, could monitor the efficacy of minocycline and ebselen in reducing endothelial permeability and atherosclerotic burden in the brachiocephalic artery of high‐fat diet (HFD)–fed ApoE−/− mice. Methods and Results ApoE−/− mice were scanned 12 weeks after commencement of either a normal diet (controls) or an HFD. HFD‐fed ApoE−/− mice were either untreated or treated with minocycline or ebselen for 12 weeks. Delayed‐enhancement MRI and T1 mapping of the brachiocephalic artery, 30 minutes after injection of gadofosveset, showed increased vessel wall enhancement and relaxation rate (R1, s−1) in untreated HFD‐fed ApoE−/− mice (R1=3.8±0.52 s−1) compared with controls (R1=2.15±0.34 s−1, P<0.001). Conversely, minocycline‐treated (R1=2.7±0.17 s−1, P<0.001) and ebselen‐treated (R1=2.7±0.23 s−1, P<0.001) ApoE−/− mice showed less vessel wall enhancement compared with untreated HFD‐fed ApoE−/− mice. Mass spectroscopy showed a lower gadolinium concentration in the brachiocephalic artery of treated (minocycline=28.5±3 μmol/L, ebselen=32.4±4 μmol/L) compared with untreated HFD‐fed ApoE−/− mice (191±4.8 μmol/L) (P<0.02). Both interventions resulted in a lower plaque burden as measured by delayed‐enhancement MRI (minocycline=0.14±0.02 mm2, ebselen=0.20±0.09 mm2, untreated=0.44±0.01 mm2; P<0.001) and histology (minocycline=0.13±0.05 mm2, ebselen=0.18±0.02 mm2, untreated=0.32±0.04 mm2; P<0.002). Endothelium cells displayed fewer structural changes and smaller gap junction width in treated compared with untreated animals as seen by electron microscopy (minocycline=42.3±8.4 nm, ebselen=56.5±17 nm, untreated=2400±39 nm; P<0.001). Tissue flow cytometry of the brachiocephalic artery showed lower monocyte/macrophage content in both ebselen‐ and minocycline‐treated mice (8.06±3.2% and 7.62±1.73%, respectively) compared with untreated animals (20.1±2.2%) (P=0.03), with significant attenuation of the proinflammatory Ly6Chigh subtype (untreated mice, 42.64±6.1% of total monocytes; ebselen, 14.07±9.5% of total monocytes; minocycline, 26.42±0.6% of total monocytes). Conclusions We demonstrate that contrast‐enhanced MRI with an albumin‐binding contrast agent can be used to noninvasively monitor the effect of interventions on endothelial permeability and plaque burden. Blood albumin leakage could be a surrogate marker for the in vivo evaluation of interventions that aim at restoring endothelial integrity.
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Affiliation(s)
- Alkystis Phinikaridou
- Division of Imaging Science and Biomedical Engineering, King's College London, London, United Kingdom
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Phinikaridou A, Hua N, Pham T, Hamilton JA. Regions of low endothelial shear stress colocalize with positive vascular remodeling and atherosclerotic plaque disruption: an in vivo magnetic resonance imaging study. Circ Cardiovasc Imaging 2013; 6:302-10. [PMID: 23357244 DOI: 10.1161/circimaging.112.000176] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
BACKGROUND Local hemodynamic factors, particularly low endothelial shear stress (ESS), play a role in the focal formation of atherosclerosis. We used in vivo MRI to investigate the role of the magnitude of ESS on vascular remodeling, plaque burden, and disruption using a rabbit model of controlled atherothrombosis. METHODS AND RESULTS Atherosclerosis was induced in New Zealand white rabbits by cholesterol diet and endothelial denudation. MRI was performed before (pretrigger) and after (posttrigger) inducing plaque disruption with Russell viper venom and histamine. Of the 134 vascular segments studied, 28 contained thrombus (disrupted) and 106 did not (nondisrupted). Disrupted plaques were histologically characterized by a thin, inflamed fibrous cap, a dense lipid core, and mural thrombus. Pretriggered MRI revealed that disrupted plaques clustered at regions with low mean ESS (11.55±5.3 versus 20.9±9.74 dynes/cm(2); P<0.001) and low peak ESS (21.5±11.2 versus 49.2±21.5 dynes/cm(2); P<0.001) compared with nondisrupted plaques. The peak ESS negatively correlated with the plaque area (r=-0.56, P<0.001) and remodeling ratio (r=-0.4, P=0.008). There was also a negative correlation between the mean ESS and the remodeling ratio (r=-0.55, P<0.001). Both the peak ESS and the mean ESS did not correlate with the % stenosis; there was a weak but statistically significant correlation with the % cross-sectional narrowing (r=0.3, P=0.002 and r=0.2, P=0.04, respectively). Receiver operating characteristic analysis showed that both mean (AUC=0.78; 95% CI, 0.69-0.87) and peak ESS (AUC=0.85; 95% CI, 0.78-0.93) identified disrupted plaques. CONCLUSIONS We demonstrated that low ESS is associated with plaque burden, positive vascular remodeling, and plaque disruption in a rabbit model. Assessment of ESS by noninvasive MRI might be useful for assessing atherosclerotic risk.
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Affiliation(s)
- Alkystis Phinikaridou
- Department of Physiology and Biophysics, Boston University School of Medicine, Boston, MA 02118, USA
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Validation of a new animal model of vulnerable plaques by intravascular optical coherence tomography in vivo. J Biomed Biotechnol 2012; 2012:469726. [PMID: 23093846 PMCID: PMC3470894 DOI: 10.1155/2012/469726] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2012] [Accepted: 08/31/2012] [Indexed: 11/17/2022] Open
Abstract
We aimed to establish a rabbit model of vulnerable plaques (VPs) with the morphology and component characteristics of human VPs and to evaluate the microstructural features of VPs in vivo using intravascular optical coherence tomography (OCT). Twelve rabbits underwent endothelial denudation of the carotid artery and consumed a 1% high-cholesterol diet (HCD). They were equally divided into two groups: group A (modified needle injury) and group B (balloon injury). OCT was undertaken thrice before injury as well as 1 h and 12 weeks after injury. The degree of acute artery injury after endothelial denudation was detected by OCT. Twelve weeks after injury, OCT showed that both groups generated VPs which had thin fibrous caps and a large lipid core, whereas plaques in group A had smaller lipid arcs (P < 0.0001). Histological findings demonstrated that a larger eccentricity index (EI) (P < 0.05) and greater infiltration of macrophages (P < 0.05) in group A than in group B. Qualitative and morphometric analyses of plaques showed a significant correlation between histological and OCT measurements. A combination of modified endothelial denudation and an HCD in rabbits produced more eccentric lesions similar to those seen in humans. These data suggest that OCT could be a useful tool for evaluation of the degree of injury and VPs in vivo.
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Gadolinium-Based Contrast Agents for Vessel Wall Magnetic Resonance Imaging (MRI) of Atherosclerosis. CURRENT CARDIOVASCULAR IMAGING REPORTS 2012; 6:11-24. [PMID: 23539505 DOI: 10.1007/s12410-012-9177-x] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Cardiovascular disease due to atherosclerosis is the number one killer in the Western world, and threatens to become the major cause of morbidity and mortality worldwide. It is therefore paramount to develop non-invasive methods for the detection of high-risk, asymptomatic individuals before the onset of clinical symptoms or events. In the recent past, great strides have been made in the understanding of the pathological mechanisms involved in the atherosclerotic cascade down to the molecular details. This has allowed the development of contrast agents that can aid in the in vivo characterization of these processes. Gadolinium chelates are among the contrast media most commonly used in MR imaging. Originally used for MR angiography for the detection and quantification of vascular stenosis, more recently they have been applied to improve characterization of atherosclerotic plaques. In this manuscript, we will briefly review gadolinium-chelates (Gd) based contrast agents for non-invasive MR imaging of atherosclerosis. We will first describe Gd-based non-targeted FDA approved agents, used routinely in clinical practice for the evaluation of neovascularization in other diseases. Secondly, we will describe non-specific and specific targeted contrast agents, which have great potential for dissecting specific biological processes in the atherosclerotic cascade. Lastly, we will briefly compare Gd-based agents to others commonly used in MRI and to other imaging modalities.
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Phinikaridou A, Andia ME, Shah AM, Botnar RM. Advances in molecular imaging of atherosclerosis and myocardial infarction: shedding new light on in vivo cardiovascular biology. Am J Physiol Heart Circ Physiol 2012; 303:H1397-410. [PMID: 23064836 DOI: 10.1152/ajpheart.00583.2012] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Molecular imaging of the cardiovascular system heavily relies on the development of new imaging probes and technologies to facilitate visualization of biological processes underlying or preceding disease. Molecular imaging is a highly active research discipline that has seen tremendous growth over the past decade. It has broadened our understanding of oncologic, neurologic, and cardiovascular diseases by providing new insights into the in vivo biology of disease progression and therapeutic interventions. As it allows for the longitudinal evaluation of biological processes, it is ideally suited for monitoring treatment response. In this review, we will concentrate on the major accomplishments and advances in the field of molecular imaging of atherosclerosis and myocardial infarction with a special focus on magnetic resonance imaging.
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Affiliation(s)
- Alkystis Phinikaridou
- Division of Imaging Science and Biomedical Engineering, King's College London, United Kingdom.
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Phinikaridou A, Andia ME, Protti A, Indermuehle A, Shah A, Smith A, Warley A, Botnar RM. Noninvasive magnetic resonance imaging evaluation of endothelial permeability in murine atherosclerosis using an albumin-binding contrast agent. Circulation 2012; 126:707-19. [PMID: 22753191 DOI: 10.1161/circulationaha.112.092098] [Citation(s) in RCA: 104] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
BACKGROUND Endothelial dysfunction promotes atherosclerosis and precedes acute cardiovascular events. We investigated whether in vivo magnetic resonance imaging with the use of an albumin-binding contrast agent, gadofosveset, could detect endothelial damage associated with atherosclerosis in apolipoprotein E-deficient (ApoE(-/-)) mice. Furthermore, we tested whether magnetic resonance imaging could noninvasively assess endothelial function by measuring the endothelial-dependent vasodilation in response to acetylcholine. METHODS AND RESULTS ApoE(-/-) mice were imaged at 4, 8, and 12 weeks after commencement of a high-fat diet. Statin-treated ApoE(-/-) mice were scanned after 12 weeks of a high-fat diet. Wild-type mice were imaged before and 48 hours after injection of Russell's viper venom, an endothelial toxin. Delayed enhancement magnetic resonance imaging and T1 mapping of the brachiocephalic artery, 30 minutes after injection of gadofosveset, showed increased vessel wall enhancement and relaxation rate (R(1)) with progression of atherosclerosis in ApoE(-/-)(R(1) [s(-1)]: R(4 weeks) 2.42±0.35, R(8 weeks) 3.45±0.54, R(12 weeks) 3.83±0.52) and Russell's viper venom-injected wild-type mice (R(1)=4.57±0.86). Conversely, wild-type (R(1)=2.15±0.34) and statin-treated ApoE(-/-) (R(1)=3.0±0.65) mice showed less enhancement. Uptake of gadofosveset correlated with Evans blue staining, morphological changes of endothelial cells, and widening of the cell-cell junctions, suggesting that uptake occurs in regions of increased vascular permeability. Endothelial-dependent vasomotor responses showed vasoconstriction of the arteries of the ApoE(-/-) (-22.22±7.95%) and Russell's viper venom-injected (-10.37±17.60%) mice compared with wild-type mice (32.45±12.35%). Statin treatment improved endothelium morphology and function (-8.12±8.22%). CONCLUSIONS We demonstrate the noninvasive assessment of endothelial permeability and function with the use of an albumin-binding magnetic resonance contrast agent. Blood albumin leakage could be a surrogate marker for the in vivo evaluation of interventions that aim to restore the endothelium.
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Affiliation(s)
- Alkystis Phinikaridou
- King's College London, Division of Imaging Sciences and Biomedical Engineering, The Rayne Institute, 4th Floor, Lambeth Wing, St Thomas' Hospital, London SE1 7EH, United Kingdom.
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Phinikaridou A, Qiao Y, Giordano N, Hamilton JA. Detection of thrombus size and protein content by ex vivo magnetization transfer and diffusion weighted MRI. J Cardiovasc Magn Reson 2012; 14:45. [PMID: 22731842 PMCID: PMC3419091 DOI: 10.1186/1532-429x-14-45] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2012] [Accepted: 06/06/2012] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND To utilize a rabbit model of plaque disruption to assess the accuracy of different magnetic resonance sequences [T1-weighted (T1W), T2-weighted (T2W), magnetization transfer (MT) and diffusion weighting (DW)] at 11.7 T for the ex vivo detection of size and composition of thrombus associated with disrupted plaques. METHODS Atherosclerosis was induced in the aorta of male New Zealand White rabbits (n = 17) by endothelial denudation and high-cholesterol diet. Subsequently, plaque disruption was induced by pharmacological triggering. Segments of infra-renal aorta were excised fixed in formalin and examined by ex vivo magnetic resonance imaging (MRI) at 11.7 T and histology. RESULTS MRI at 11.7 T showed that: (i) magnetization transfer contrast (MTC) and diffusion weighted images (DWI) detected thrombus with higher sensitivity compared to T1W and T2W images [sensitivity: MTC = 88.2%, DWI = 76.5%, T1W = 66.6% and T2W = 43.7%, P < 0.001]. Similarly, the contrast-to-noise (CNR) between the thrombus and the underlying plaque was superior on the MTC and DWI images [CNR: MTC = 8.5 ± 1.1, DWI = 6.0 ± 0.8, T1W = 1.8 ± 0.5, T2W = 3.0 ± 1.0, P < 0.001]; (ii) MTC and DWI provided a more accurate detection of thrombus area with histology as the gold-standard [underestimation of 6% (MTC) and 17.6% (DWI) compared to an overestimation of thrombus area of 53.7% and 46.4% on T1W and T2W images, respectively]; (iii) the percent magnetization transfer rate (MTR) correlated with the fibrin (r = 0.73, P = 0.003) and collagen (r = 0.9, P = 0.004) content of the thrombus. CONCLUSIONS The conspicuity of the thrombus was increased on MTC and DW compared to T1W and T2W images. Changes in the %MTR and apparent diffusion coefficient can be used to identify the organization stage of the thrombus.
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Affiliation(s)
- Alkystis Phinikaridou
- Division of Imaging Sciences and Biomedical Engineering, King’s College London, London, UK
- Department of Physiology and Biophysics, Boston University School of Medicine, Boston, MA, USA
| | - Ye Qiao
- The Russell H. Morgan Department of Radiology and Radiological Sciences, The Johns Hopkins Hospital, Baltimore, MD, USA
| | - Nick Giordano
- Department of Biomedical Engineering, Boston University, Boston, MA, USA
| | - James A Hamilton
- Department of Physiology and Biophysics, Boston University School of Medicine, Boston, MA, USA
- Department of Biomedical Engineering, Boston University, Boston, MA, USA
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Qiao Y, Hallock KJ, Hamilton JA. Magnetization transfer magnetic resonance of human atherosclerotic plaques ex vivo detects areas of high protein density. J Cardiovasc Magn Reson 2011; 13:73. [PMID: 22107813 PMCID: PMC3278375 DOI: 10.1186/1532-429x-13-73] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2011] [Accepted: 11/22/2011] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Proteins are major plaque components, and their degradation is related to the plaque instability. We sought to assess the feasibility of magnetization transfer (MT) magnetic resonance (MR) for identifying fibrin and collagen in carotid atherosclerotic plaques ex vivo. METHODS Human carotid artery specimens (n = 34) were obtained after resection from patients undergoing endarterectomy. MR was completed within 12 hr after surgery on an 11.7T MR microscope prior to fixation. Two sets of T1W spoiled gradient echo images were acquired with and without the application of a saturation pulse set to 10 kHz off resonance. The magnetization transfer ratio (MTR) was calculated, and the degree of MT contrast was correlated with histology. RESULTS MT with appropriate calibration clearly detected regions with high protein density, which showed a higher MTR (thick fibers (collagen type I) (54 ± 8%)) compared to regions with a low amount of protein including lipid (46 ± 8%) (p = 0.05), thin fibers (collagen type III) (11 ± 6%) (p = 0.03), and calcification (6.8 ± 4%) (p = 0.02). Intraplaque hemorrhage (IPH) with different protein density demonstrated different MT effects. Old (rich in protein debris) and recent IPH (rich in fibrin) had a much higher MTR 69 ± 6% and 55 ± 9%, respectively, compared to fresh IPH (rich in intact red blood cells)(9 ± 3%). CONCLUSIONS MT MR enhances plaque tissue contrast and identifies the protein-rich regions of carotid artery specimens. The additional information from MTR of IPH may provide important insight into the role of IPH on plaque stability, evolution, and the risk for future ischemic events.
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Affiliation(s)
- Ye Qiao
- Department of Physiology and Biophysics, Boston University School of Medicine, 715 Albany Street (W302), Boston, MA 02118-2526, USA
| | - Kevin J Hallock
- Department of Anatomy and Neurobiology, Boston University School of Medicine, Boston, MA, USA
| | - James A Hamilton
- Department of Physiology and Biophysics, Boston University School of Medicine, 715 Albany Street (W302), Boston, MA 02118-2526, USA
- Department of Biomedical Engineering, Boston University, Boston, MA, USA
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Pan D, Caruthers SD, Senpan A, Yalaz C, Stacy AJ, Hu G, Marsh JN, Gaffney PJ, Wickline SA, Lanza GM. Synthesis of NanoQ, a copper-based contrast agent for high-resolution magnetic resonance imaging characterization of human thrombus. J Am Chem Soc 2011; 133:9168-71. [PMID: 21599030 PMCID: PMC3124378 DOI: 10.1021/ja201918u] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
A new site-targeted molecular imaging contrast agent based on a nanocolloidal suspension of lipid-encapsulated, organically soluble divalent copper has been developed. Concentrating a high payload of divalent copper ions per nanoparticle, this agent provides a high per-particle r1 relaxivity, allowing sensitive detection in T1-weighted magnetic resonance imaging when targeted to fibrin clots in vitro. The particle also exhibits a defined clearance and safety profile in vivo.
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Affiliation(s)
- Dipanjan Pan
- C-TRAIN and Division of Cardiology, Washington University School of Medicine, 4320 Forest Park Avenue, Saint Louis, Missouri 63108, USA.
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Phinikaridou A, Hamilton JA. Application of MRI to detect high-risk atherosclerotic plaque. Expert Rev Cardiovasc Ther 2011; 9:545-50. [PMID: 21615314 DOI: 10.1586/erc.11.31] [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: 11/08/2022]
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In vivo MR imaging of plaque disruption and thrombus formation in an atherosclerotic rabbit model. Int J Cardiovasc Imaging 2011; 28:577-86. [PMID: 21461662 DOI: 10.1007/s10554-011-9854-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2011] [Accepted: 02/25/2011] [Indexed: 10/18/2022]
Abstract
Our aim is to introduce an atherosclerotic rabbit model for inducing atherosclerosis lesions in rabbits, and to validate the model in vivo with 3T high resolution magnetic resonance imaging of the thrombosis followed a pharmacologically triggered plaque disruption. Twenty male New Zealand White rabbits were randomly allocated into an experimental group (n = 16) and a control group (n = 4). The aortic wall injuries were induced by an intravascular balloon in the experimental group rabbits after feeding them with a high cholesterol diet for 2 weeks. The pharmacological triggering with Russell's viper venom and histamine was performed after totally 16 weeks of intermittent cholesterol feeding. All of the animals underwent both the pre-trigger and post-trigger MR examinations including TOF, T1WI, T2WI and post contrast T1WI. Euthanasia was performed in all rabbits; gross anatomy and histological specimen of aorta were obtained. MR images were analyzed and compared with histological results. Compared with the control group rabbits, the aorta of the experimental group rabbits in the pre-triggered MR images showed an increased vessel wall thickening, luminal narrowing, and vessel wall enhancement. Fourteen rabbits survived the triggering, and 8 of them developed thrombosis (58.1%). No thrombus was found in the control group. The accuracy of the multi-sequences MR including TOF, T1WI, T2WI and post contrast T1WI was 87.1% (27/31) for detecting thrombus. MR data significantly correlated with the histopathology data for both thrombus length (r = 0.94, P < 0.01) and thrombus location (r = 0.85, P < 0.01), respectively. The study demonstrated that MR reliably determined the plaque disruption and thrombus formation in the atherosclerotic rabbit model.
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Klein LW, Miller DL, Goldstein J, Haines D, Balter S, Fairobent L, Norbash A. The catheterization laboratory and interventional vascular suite of the future: Anticipating innovations in design and function. Catheter Cardiovasc Interv 2011; 77:447-55. [DOI: 10.1002/ccd.22872] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2010] [Accepted: 10/14/2010] [Indexed: 11/06/2022]
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Hayashi C, Viereck J, Hua N, Phinikaridou A, Madrigal AG, Gibson FC, Hamilton JA, Genco CA. Porphyromonas gingivalis accelerates inflammatory atherosclerosis in the innominate artery of ApoE deficient mice. Atherosclerosis 2010. [PMID: 21251656 DOI: 10.1016/j.atherosclerosis.2010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
OBJECTIVE Studies in humans support a role for the oral pathogen Porphyromonas gingivalis in the development of inflammatory atherosclerosis. The goal of this study was to determine if P. gingivalis infection accelerates inflammation and atherosclerosis in the innominate artery of mice, an artery which has been reported to exhibit many features of human atherosclerotic disease, including plaque rupture. METHODS AND RESULTS Apolipoprotein E-deficient (ApoE-/-) mice were orally infected with P. gingivalis, and magnetic resonance imaging (MRI) was used to monitor the progression of atherosclerosis in live mice. P. gingivalis infected mice exhibited a statistically significant increase in atherosclerotic plaque in the innominate artery as compared to uninfected mice. Polarized light microscopy and immunohistochemistry revealed that the innominate arteries of infected mice had increased lipids, macrophages and T cells as compared to uninfected mice. Increases in plaque, total cholesterol esters and cholesterol monohydrate crystals, macrophages, and T cells were prevented by immunization with heat-killed P. gingivalis prior to pathogen exposure. CONCLUSIONS These are the first studies to demonstrate progression of inflammatory plaque accumulation in the innominate arteries by in vivo MRI analysis following pathogen exposure, and to document protection from plaque progression in the innominate artery via immunization.
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Affiliation(s)
- Chie Hayashi
- Department of Medicine, Section of Infectious Diseases, Boston University School of Medicine, 650 Albany Street, Boston, MA 02118, United States.
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Hayashi C, Viereck J, Hua N, Phinikaridou A, Madrigal AG, Gibson FC, Hamilton JA, Genco CA. Porphyromonas gingivalis accelerates inflammatory atherosclerosis in the innominate artery of ApoE deficient mice. Atherosclerosis 2010; 215:52-9. [PMID: 21251656 DOI: 10.1016/j.atherosclerosis.2010.12.009] [Citation(s) in RCA: 58] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/22/2010] [Revised: 11/29/2010] [Accepted: 12/10/2010] [Indexed: 12/20/2022]
Abstract
OBJECTIVE Studies in humans support a role for the oral pathogen Porphyromonas gingivalis in the development of inflammatory atherosclerosis. The goal of this study was to determine if P. gingivalis infection accelerates inflammation and atherosclerosis in the innominate artery of mice, an artery which has been reported to exhibit many features of human atherosclerotic disease, including plaque rupture. METHODS AND RESULTS Apolipoprotein E-deficient (ApoE-/-) mice were orally infected with P. gingivalis, and magnetic resonance imaging (MRI) was used to monitor the progression of atherosclerosis in live mice. P. gingivalis infected mice exhibited a statistically significant increase in atherosclerotic plaque in the innominate artery as compared to uninfected mice. Polarized light microscopy and immunohistochemistry revealed that the innominate arteries of infected mice had increased lipids, macrophages and T cells as compared to uninfected mice. Increases in plaque, total cholesterol esters and cholesterol monohydrate crystals, macrophages, and T cells were prevented by immunization with heat-killed P. gingivalis prior to pathogen exposure. CONCLUSIONS These are the first studies to demonstrate progression of inflammatory plaque accumulation in the innominate arteries by in vivo MRI analysis following pathogen exposure, and to document protection from plaque progression in the innominate artery via immunization.
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Affiliation(s)
- Chie Hayashi
- Department of Medicine, Section of Infectious Diseases, Boston University School of Medicine, 650 Albany Street, Boston, MA 02118, United States.
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