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Biccirè FG, Häner J, Losdat S, Ueki Y, Shibutani H, Otsuka T, Kakizaki R, Hofbauer TM, van Geuns RJ, Stortecky S, Siontis GCM, Bär S, Lønborg J, Heg D, Kaiser C, Spirk D, Daemen J, Iglesias JF, Windecker S, Engstrøm T, Lang I, Koskinas KC, Räber L. Concomitant Coronary Atheroma Regression and Stabilization in Response to Lipid-Lowering Therapy. J Am Coll Cardiol 2023; 82:1737-1747. [PMID: 37640248 DOI: 10.1016/j.jacc.2023.08.019] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Revised: 08/14/2023] [Accepted: 08/18/2023] [Indexed: 08/31/2023]
Abstract
BACKGROUND The frequency, characteristics, and outcomes of patients treated with high-intensity lipid-lowering therapy and showing concomitant atheroma volume reduction, lipid content reduction, and increase in fibrous cap thickness (ie, triple regression) are unknown. OBJECTIVES This study was designed to investigate rates, determinants, and prognostic implications of triple regression in patients presenting with acute myocardial infarction and treated with high-intensity lipid-lowering therapy. METHODS The PACMAN-AMI (Effects of the PCSK9 Antibody Alirocumab on Coronary Atherosclerosis in Patients with Acute Myocardial Infarction) trial used serial intravascular ultrasound, near-infrared spectroscopy, and optical coherence tomography to compare the effects of alirocumab vs placebo in patients receiving high-intensity statin therapy. Triple regression was defined by the combined presence of percentage of atheroma volume reduction, maximum lipid core burden index within 4 mm reduction, and minimal fibrous cap thickness increase. Clinical outcomes at 1-year follow-up were assessed. RESULTS Overall, 84 patients (31.7%) showed triple regression (40.8% in the alirocumab group vs 23.0% in the placebo group; P = 0.002). On-treatment low-density lipoprotein cholesterol levels were lower in patients with vs without triple regression (between-group difference: -27.1 mg/dL; 95% CI: -37.7 to -16.6 mg/dL; P < 0.001). Triple regression was independently predicted by alirocumab treatment (OR: 2.83; 95% CI: 1.57-5.16; P = 0.001) and a higher baseline maximum lipid core burden index within 4 mm (OR: 1.03; 95% CI: 1.01-1.06; P = 0.013). The composite clinical endpoint of death, myocardial infarction, and ischemia-driven revascularization occurred less frequently in patients with vs without triple regression (8.3% vs 18.2%; P = 0.04). CONCLUSIONS Triple regression occurred in one-third of patients with acute myocardial infarction who were receiving high-intensity lipid-lowering therapy and was associated with alirocumab treatment, higher baseline lipid content, and reduced cardiovascular events. (Vascular Effects of Alirocumab in Acute MI-Patients [PACMAN-AMI]; NCT03067844).
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Affiliation(s)
- Flavio G Biccirè
- Department of Cardiology, Bern University Hospital, University of Bern, Bern, Switzerland. https://twitter.com/FBiccire
| | - Jonas Häner
- Department of Cardiology, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Sylvain Losdat
- Clinical Trials Unit of the University of Bern, Bern, Switzerland
| | - Yasushi Ueki
- Department of Cardiology, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Hiroki Shibutani
- Department of Cardiology, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Tatsuhiko Otsuka
- Department of Cardiology, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Ryota Kakizaki
- Department of Cardiology, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Thomas M Hofbauer
- Department of Cardiology, Medical University of Vienna, Vienna, Austria
| | - Robert-Jan van Geuns
- Department of Cardiology, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Stefan Stortecky
- Department of Cardiology, Bern University Hospital, University of Bern, Bern, Switzerland
| | - George C M Siontis
- Department of Cardiology, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Sarah Bär
- Department of Cardiology, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Jacob Lønborg
- Department of Cardiology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
| | - Dik Heg
- Clinical Trials Unit of the University of Bern, Bern, Switzerland
| | - Christoph Kaiser
- Department of Cardiology, Basel University Hospital, Basel, Switzerland
| | - David Spirk
- Institute of Pharmacology, Bern University Hospital, University of Bern, Bern, Switzerland; Sanofi, Vernier, Switzerland
| | - Joost Daemen
- Department of Cardiology, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - Juan F Iglesias
- Division of Cardiology, University Hospital Geneva, Geneva, Switzerland
| | - Stephan Windecker
- Department of Cardiology, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Thomas Engstrøm
- Department of Cardiology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
| | - Irene Lang
- Department of Cardiology, Medical University of Vienna, Vienna, Austria
| | | | - Lorenz Räber
- Department of Cardiology, Bern University Hospital, University of Bern, Bern, Switzerland.
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Wang H, Zhao S, Zou J, Zhang A. A New Conformal Penetrating Heating Strategy for Atherosclerotic Plaque. Bioengineering (Basel) 2023; 10:bioengineering10020162. [PMID: 36829656 PMCID: PMC9952347 DOI: 10.3390/bioengineering10020162] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2022] [Revised: 01/15/2023] [Accepted: 01/21/2023] [Indexed: 01/28/2023] Open
Abstract
(1) Background: A combination of radiofrequency (RF) volumetric heating and convection cooling has been proposed to realize plaque ablation while protecting the endothelial layer. However, the depth of the plaque and the thickness of the endothelial layer vary in different atherosclerotic lesions. Current techniques cannot be used to achieve penetrating heating for atherosclerosis with two targets (the specified protection depth and the ablation depth). (2) Methods: A tissue-mimicking phantom heating experiment simulating atherosclerotic plaque ablation was conducted to investigate the effects of the control parameters, the target temperature (Ttarget), the cooling water temperature (Tf), and the cooling water velocity (Vf). To further quantitatively analyze and evaluate the ablation depth and the protection depth of the control parameters, a three-dimensional model was established. In addition, a conformal penetrating heating strategy was proposed based on the numerical results. (3) Results: It was found that Ttarget and Tf were factors that regulated the ablation results, and the temperatures of the plaques varied linearly with Ttarget or Tf. The simulation results showed that the ablation depth increased with the Ttarget while the protection depth decreased correspondently. This relationship reversed with the Tf. When the two parameters Ttarget and Tfwere controlled together, the ablation depth was 0.47 mm-1.43 mm and the protection depth was 0 mm-0.26 mm within 2 min of heating. (4) Conclusions: With the proposed control algorithm, the requirements of both the ablation depth and the endothelium protection depth can be met for most plaques through the simultaneous control of Ttarget and Tf.
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3
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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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Desai MY, Cremer PC, Schoenhagen P. Thoracic Aortic Calcification: Diagnostic, Prognostic, and Management Considerations. JACC Cardiovasc Imaging 2019; 11:1012-1026. [PMID: 29976300 DOI: 10.1016/j.jcmg.2018.03.023] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2017] [Revised: 02/26/2018] [Accepted: 03/20/2018] [Indexed: 12/18/2022]
Abstract
Thoracic aortic calcification (TAC) is associated with adverse cardiovascular outcomes, and for the cardiovascular imager, is predominantly encountered in 4 settings: 1) incidentally, for example, during a coronary artery calcium scan; 2) as part of dedicated screening; 3) in the evaluation of an embolic event; or 4) in procedural planning. This review focuses on TAC in these contexts. Within atherosclerosis, TAC is common, variable in extent, and begins in the intima with a patchy distribution. In metabolic disorders, aortitis, and radiation-associated cardiovascular disease, calcification preferentially involves the media and is often more concentric. As an incidental finding, atherosclerotic TAC provides limited incremental discriminative value, and current data do not support screening. After an embolic event, the demonstration of thoracic atheroma provides diagnostic clarity, but has limited treatment implications. Before any procedure, the plan often changes if the most severe form of TAC, a porcelain aorta, is discovered.
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Affiliation(s)
- Milind Y Desai
- Department of Cardiovascular Imaging, Heart and Vascular Institute, Cleveland Clinic, Cleveland, Ohio.
| | - Paul C Cremer
- Department of Cardiovascular Imaging, Heart and Vascular Institute, Cleveland Clinic, Cleveland, Ohio
| | - Paul Schoenhagen
- Department of Cardiovascular Imaging, Heart and Vascular Institute, Cleveland Clinic, Cleveland, Ohio; Cardiovascular Section, Imaging Institute, Cleveland Clinic, Cleveland, Ohio
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Vigne J, Thackeray J, Essers J, Makowski M, Varasteh Z, Curaj A, Karlas A, Canet-Soulas E, Mulder W, Kiessling F, Schäfers M, Botnar R, Wildgruber M, Hyafil F. Current and Emerging Preclinical Approaches for Imaging-Based Characterization of Atherosclerosis. Mol Imaging Biol 2019; 20:869-887. [PMID: 30250990 DOI: 10.1007/s11307-018-1264-1] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Atherosclerotic plaques can remain quiescent for years, but become life threatening upon rupture or disruption, initiating clot formation in the vessel lumen and causing acute myocardial infarction and ischemic stroke. Whether and how a plaque ruptures is determined by its macroscopic structure and microscopic composition. Rupture-prone plaques usually consist of a thin fibrous cap with few smooth muscle cells, a large lipid core, a dense infiltrate of inflammatory cells, and neovessels. Such lesions, termed high-risk plaques, can remain asymptomatic until the thrombotic event. Various imaging technologies currently allow visualization of morphological and biological characteristics of high-risk atherosclerotic plaques. Conventional protocols are often complex and lack specificity for high-risk plaque. Conversely, new imaging approaches are emerging which may overcome these limitations. Validation of these novel imaging techniques in preclinical models of atherosclerosis is essential for effective translational to clinical practice. Imaging the vessel wall, as well as its biological milieu in small animal models, is challenging because the vessel wall is a small structure that undergoes continuous movements imposed by the cardiac cycle as it is adjacent to circulating blood. The focus of this paper is to provide a state-of-the-art review on techniques currently available for preclinical imaging of atherosclerosis in small animal models and to discuss the advantages and limitations of each approach.
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Affiliation(s)
- Jonathan Vigne
- Department of Nuclear Medicine, Bichat University Hospital, AP-HP; INSERM, U-1148, DHU FIRE, University Diderot, Paris, France
| | - James Thackeray
- Department of Nuclear Medicine, Hannover Medical School, Hannover, Germany
| | - Jeroen Essers
- Departments of Vascular Surgery, Molecular Genetics, Radiation Oncology, Erasmus MC, Rotterdam, The Netherlands
| | - Marcus Makowski
- Department of Radiology, Charité-University Medicine Berlin, Berlin, Germany
| | - Zoreh Varasteh
- Department of Nuclear Medicine, Klinikum rechts der Isar, Technische Universität München, Munich, Germany
| | - Adelina Curaj
- Institute for Molecular Cardiovascular Research (IMCAR), Institute for Experimental Molecular Imaging (ExMI), University Hospital Aachen, RWTH, Aachen, Germany
| | - Angelos Karlas
- Institute for Biological and Medical Imaging, Helmholtz Zentrum München, Oberschleissheim, Germany
| | - Emmanuel Canet-Soulas
- Laboratoire CarMeN, INSERM U-1060, Lyon/Hospices Civils Lyon, IHU OPERA Cardioprotection, Université de Lyon, Bron, France
| | - Willem Mulder
- Translational and Molecular Imaging Institute, Icahn School of Medicine at Mount Sinai, Mount Sinai, New York, USA
| | - Fabian Kiessling
- Institute for Experimental Molecular Imaging (ExMI), University Hospital Aachen, RWTH, Aachen, Germany
| | - Michael Schäfers
- Department of Nuclear Medicine, European Institute for Molecular Imaging (EIMI), Westfälische Wilhelms-Universität Münster, Münster, Germany
| | - René Botnar
- School of Biomedical Engineering and Imaging Sciences, King's College London, London, UK
| | - Moritz Wildgruber
- Translational Research Imaging Center, Institut für Klinische Radiologie, Universitätsklinikum Münster, Albert-Schweitzer-Campus 1, 48149, Münster, Germany
| | - Fabien Hyafil
- Department of Nuclear Medicine, Bichat University Hospital, AP-HP; INSERM, U-1148, DHU FIRE, University Diderot, Paris, France. .,Département de Médecine Nucléaire, Centre Hospitalier Universitaire Bichat, 46 rue Henri Huchard, 75018, Paris, France.
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Khalil A, Ng SC, Liew YM, Lai KW. An Overview on Image Registration Techniques for Cardiac Diagnosis and Treatment. Cardiol Res Pract 2018; 2018:1437125. [PMID: 30159169 PMCID: PMC6109558 DOI: 10.1155/2018/1437125] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2018] [Revised: 07/05/2018] [Accepted: 07/17/2018] [Indexed: 12/13/2022] Open
Abstract
Image registration has been used for a wide variety of tasks within cardiovascular imaging. This study aims to provide an overview of the existing image registration methods to assist researchers and impart valuable resource for studying the existing methods or developing new methods and evaluation strategies for cardiac image registration. For the cardiac diagnosis and treatment strategy, image registration and fusion can provide complementary information to the physician by using the integrated image from these two modalities. This review also contains a description of various imaging techniques to provide an appreciation of the problems associated with implementing image registration, particularly for cardiac pathology intervention and treatments.
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Affiliation(s)
- Azira Khalil
- Department of Biomedical Engineering, Faculty of Engineering, University of Malaya, 50603 Kuala Lumpur, Malaysia
- Faculty of Science and Technology, Islamic Science University of Malaysia, 71800 Nilai, Negeri Sembilan, Malaysia
| | - Siew-Cheok Ng
- Department of Biomedical Engineering, Faculty of Engineering, University of Malaya, 50603 Kuala Lumpur, Malaysia
| | - Yih Miin Liew
- Department of Biomedical Engineering, Faculty of Engineering, University of Malaya, 50603 Kuala Lumpur, Malaysia
| | - Khin Wee Lai
- Department of Biomedical Engineering, Faculty of Engineering, University of Malaya, 50603 Kuala Lumpur, Malaysia
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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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Yoon S, Kim MG, Williams JA, Yoon C, Kang BJ, Cabrera-Munoz N, Shung KK, Kim HH. Dual-element needle transducer for intravascular ultrasound imaging. J Med Imaging (Bellingham) 2015; 2:027001. [PMID: 26158118 DOI: 10.1117/1.jmi.2.2.027001] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2014] [Accepted: 03/24/2015] [Indexed: 11/14/2022] Open
Abstract
A dual-element needle transducer for intravascular ultrasound imaging has been developed. A low-frequency element and a high-frequency element were integrated into one device to obtain images which conveyed both low- and high-frequency information from a single scan. The low-frequency element with a center frequency of 48 MHz was fabricated from the single crystal form of lead magnesium niobate-lead titanate solid solution with two matching layers (MLs) and the high frequency element with a center frequency of 152 MHz was fabricated from lithium niobate with one ML. The measured axial and lateral resolutions were 27 and [Formula: see text], respectively, for the low-frequency element, and 14 and [Formula: see text], respectively, for the high-frequency element. The performance of the dual-element needle transducer was validated by imaging a tissue-mimicking phantom with lesion-mimicking area, and ex vivo rabbit aortas in water and rabbit whole blood. The results suggest that a low-frequency element effectively provides depth resolved images of the whole vessel and its adjacent tissue, and a high-frequency element visualizes detailed structure near the surface of the lumen wall in the presence of blood within the lumen. The advantages of a dual-element approach for intravascular imaging are also discussed.
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Affiliation(s)
- Sangpil Yoon
- University of Southern California , Department of Biomedical Engineering, 1042 Downey Way DRB-130, Los Angeles, California 90089, United States
| | - Min Gon Kim
- University of Southern California , Department of Biomedical Engineering, 1042 Downey Way DRB-130, Los Angeles, California 90089, United States
| | - Jay A Williams
- University of Southern California , Department of Biomedical Engineering, 1042 Downey Way DRB-130, Los Angeles, California 90089, United States
| | - Changhan Yoon
- University of Southern California , Department of Biomedical Engineering, 1042 Downey Way DRB-130, Los Angeles, California 90089, United States
| | - Bong Jin Kang
- University of Southern California , Department of Biomedical Engineering, 1042 Downey Way DRB-130, Los Angeles, California 90089, United States
| | - Nestor Cabrera-Munoz
- University of Southern California , Department of Biomedical Engineering, 1042 Downey Way DRB-130, Los Angeles, California 90089, United States
| | - K Kirk Shung
- University of Southern California , Department of Biomedical Engineering, 1042 Downey Way DRB-130, Los Angeles, California 90089, United States
| | - Hyung Ham Kim
- University of Southern California , Department of Biomedical Engineering, 1042 Downey Way DRB-130, Los Angeles, California 90089, United States ; Analogic Corporation , 8 Centennial Drive, Peabody, Massachusetts 01960, United States
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Mangge H, Almer G, Stelzer I, Reininghaus E, Prassl R. Laboratory medicine for molecular imaging of atherosclerosis. Clin Chim Acta 2014; 437:19-24. [DOI: 10.1016/j.cca.2014.06.029] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2014] [Revised: 06/24/2014] [Accepted: 06/30/2014] [Indexed: 12/30/2022]
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Almer G, Summers KL, Scheicher B, Kellner J, Stelzer I, Leitinger G, Gries A, Prassl R, Zimmer A, Mangge H. Interleukin 10-coated nanoparticle systems compared for molecular imaging of atherosclerotic lesions. Int J Nanomedicine 2014; 9:4211-22. [PMID: 25214785 PMCID: PMC4159402 DOI: 10.2147/ijn.s66830] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
Atherosclerosis (AS) is one of the leading causes of mortality in high-income countries. Early diagnosis of vulnerable atherosclerotic lesions is one of the biggest challenges currently facing cardiovascular medicine. The present study focuses on developing targeted nanoparticles (NPs) in order to improve the detection of vulnerable atherosclerotic-plaques. Various biomarkers involved in the pathogenesis of atherosclerotic-plaques have been identified and one of these promising candidates for diagnostic targeting is interleukin 10 (IL10). IL10 has been shown to be a key anti-inflammatory responding cytokine in the early stages of atherogenesis, and has already been used for therapeutic interventions in humans and mice. IL10, the targeting sequence, was coupled to two different types of NPs: protamine-oligonucleotide NPs (proticles) and sterically stabilized liposomes in order to address the question of whether the recognition and detection of atherosclerotic-lesions is primarily determined by the targeting sequence itself, or whether it depends on the NP carrier system to which the biomarker is coupled. Each IL10-targeted NP was assessed based on its sensitivity and selectivity toward characterizing atherosclerotic-plaque lesions using an apolipoprotein E-deficient mouse as the model of atherosclerosis. Aortas from apolipoprotein E-deficient mice fed a high fat diet, were stained with either fluorescence-labeled IL10 or IL10-coupled NPs. Ex vivo imaging was performed using confocal laser-scanning microscopy. We found that IL10-targeted proticles generated a stronger signal by accumulating at the surface of atherosclerotic-plaques, while IL10-targeted, sterically stabilized liposomes showed a staining pattern deeper in the plaque compared to the fluorescence-labeled IL10 alone. Our results point to a promising route for enhanced in vivo imaging using IL10-targeted NPs. NPs allow a higher payload of signal emitting molecules to be delivered to the atherosclerotic-plaques, thus improving signal detection. Importantly, this allows for the opportunity to visualize different areas within the plaque scenario, depending on the nature of the applied nanocarrier.
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Affiliation(s)
- Gunter Almer
- Clinical Institute of Medical and Chemical Laboratory Diagnostics, Medical University of Graz, Graz, Austria
| | - Kelli L Summers
- Clinical Institute of Medical and Chemical Laboratory Diagnostics, Medical University of Graz, Graz, Austria ; Institute of Pharmaceutical Sciences, Department of Pharmaceutical Technology, University of Graz, Graz, Austria
| | - Bernhard Scheicher
- Institute of Pharmaceutical Sciences, Department of Pharmaceutical Technology, University of Graz, Graz, Austria
| | - Josef Kellner
- Institute of Physiological Chemistry, Medical University of Graz, Graz, Austria
| | - Ingeborg Stelzer
- Clinical Institute of Medical and Chemical Laboratory Diagnostics, Medical University of Graz, Graz, Austria
| | - Gerd Leitinger
- Research Unit Electron Microscopic Techniques, Institute of Cell Biology, Histology and Embryology, Medical University of Graz, Graz, Austria ; Center for Medical Research (ZMF), Medical University of Graz, Graz, Austria
| | - Anna Gries
- Institute of Physiological Chemistry, Medical University of Graz, Graz, Austria
| | - Ruth Prassl
- Institute of Biophysics, Medical University of Graz, Graz, Austria
| | - Andreas Zimmer
- Institute of Pharmaceutical Sciences, Department of Pharmaceutical Technology, University of Graz, Graz, Austria
| | - Harald Mangge
- Clinical Institute of Medical and Chemical Laboratory Diagnostics, Medical University of Graz, Graz, Austria ; BioTechMed, Graz, Austria
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Zavodni AEH, Wasserman BA, McClelland RL, Gomes AS, Folsom AR, Polak JF, Lima JAC, Bluemke DA. Carotid artery plaque morphology and composition in relation to incident cardiovascular events: the Multi-Ethnic Study of Atherosclerosis (MESA). Radiology 2014; 271:381-9. [PMID: 24592924 PMCID: PMC4263652 DOI: 10.1148/radiol.14131020] [Citation(s) in RCA: 90] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
PURPOSE To determine if carotid plaque morphology and composition with magnetic resonance (MR) imaging can be used to identify asymptomatic subjects at risk for cardiovascular events. MATERIALS AND METHODS Institutional review boards at each site approved the study, and all sites were Health Insurance Portability and Accountability Act (HIPAA) compliant. A total of 946 participants in the Multi-Ethnic Study of Atherosclerosis (MESA) were evaluated with MR imaging and ultrasonography (US). MR imaging was used to define carotid plaque composition and remodeling index (wall area divided by the sum of wall area and lumen area), while US was used to assess carotid wall thickness. Incident cardiovascular events, including myocardial infarction, resuscitated cardiac arrest, angina, stroke, and death, were ascertained for an average of 5.5 years. Multivariable Cox proportional hazards models, C statistics, and net reclassification improvement (NRI) for event prediction were determined. RESULTS Cardiovascular events occurred in 59 (6%) of participants. Carotid IMT as well as MR imaging remodeling index, lipid core, and calcium in the internal carotid artery were significant predictors of events in univariate analysis (P < .001 for all). For traditional risk factors, the C statistic for event prediction was 0.696. For MR imaging remodeling index and lipid core, the C statistic was 0.734 and the NRI was 7.4% and 15.8% for participants with and those without cardiovascular events, respectively (P = .02). The NRI for US IMT in addition to traditional risk factors was not significant. CONCLUSION The identification of vulnerable plaque characteristics with MR imaging aids in cardiovascular disease prediction and improves the reclassification of baseline cardiovascular risk.
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Affiliation(s)
- Anna E. H. Zavodni
- From the Department of Medical Imaging, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada (A.E.H.Z.); Departments of Radiology (B.A.W., J.A.C.L.) and Medicine (J.A.C.L.), Johns Hopkins University, Baltimore, Md; Collaborative Health Studies Coordinating Center, University of Washington, Seattle, Wash (R.L.M.); Department of Radiology, University of California–Los Angeles School of Medicine, Los Angeles, Calif (A.S.G.); Division of Epidemiology and Community Health, University of Minnesota, Minneapolis, Minn (A.R.F.); Department of Radiology, Tufts Medical Center, Boston, Mass (J.F.P.); and Department of Radiology and Imaging Sciences, National Institutes of Health Clinical Center, 10 Center Dr, Bldg 10/1C355, Bethesda, MD 20892 (D.A.B.)
| | - Bruce A. Wasserman
- From the Department of Medical Imaging, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada (A.E.H.Z.); Departments of Radiology (B.A.W., J.A.C.L.) and Medicine (J.A.C.L.), Johns Hopkins University, Baltimore, Md; Collaborative Health Studies Coordinating Center, University of Washington, Seattle, Wash (R.L.M.); Department of Radiology, University of California–Los Angeles School of Medicine, Los Angeles, Calif (A.S.G.); Division of Epidemiology and Community Health, University of Minnesota, Minneapolis, Minn (A.R.F.); Department of Radiology, Tufts Medical Center, Boston, Mass (J.F.P.); and Department of Radiology and Imaging Sciences, National Institutes of Health Clinical Center, 10 Center Dr, Bldg 10/1C355, Bethesda, MD 20892 (D.A.B.)
| | - Robyn L. McClelland
- From the Department of Medical Imaging, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada (A.E.H.Z.); Departments of Radiology (B.A.W., J.A.C.L.) and Medicine (J.A.C.L.), Johns Hopkins University, Baltimore, Md; Collaborative Health Studies Coordinating Center, University of Washington, Seattle, Wash (R.L.M.); Department of Radiology, University of California–Los Angeles School of Medicine, Los Angeles, Calif (A.S.G.); Division of Epidemiology and Community Health, University of Minnesota, Minneapolis, Minn (A.R.F.); Department of Radiology, Tufts Medical Center, Boston, Mass (J.F.P.); and Department of Radiology and Imaging Sciences, National Institutes of Health Clinical Center, 10 Center Dr, Bldg 10/1C355, Bethesda, MD 20892 (D.A.B.)
| | - Antoinette S. Gomes
- From the Department of Medical Imaging, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada (A.E.H.Z.); Departments of Radiology (B.A.W., J.A.C.L.) and Medicine (J.A.C.L.), Johns Hopkins University, Baltimore, Md; Collaborative Health Studies Coordinating Center, University of Washington, Seattle, Wash (R.L.M.); Department of Radiology, University of California–Los Angeles School of Medicine, Los Angeles, Calif (A.S.G.); Division of Epidemiology and Community Health, University of Minnesota, Minneapolis, Minn (A.R.F.); Department of Radiology, Tufts Medical Center, Boston, Mass (J.F.P.); and Department of Radiology and Imaging Sciences, National Institutes of Health Clinical Center, 10 Center Dr, Bldg 10/1C355, Bethesda, MD 20892 (D.A.B.)
| | - Aaron R. Folsom
- From the Department of Medical Imaging, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada (A.E.H.Z.); Departments of Radiology (B.A.W., J.A.C.L.) and Medicine (J.A.C.L.), Johns Hopkins University, Baltimore, Md; Collaborative Health Studies Coordinating Center, University of Washington, Seattle, Wash (R.L.M.); Department of Radiology, University of California–Los Angeles School of Medicine, Los Angeles, Calif (A.S.G.); Division of Epidemiology and Community Health, University of Minnesota, Minneapolis, Minn (A.R.F.); Department of Radiology, Tufts Medical Center, Boston, Mass (J.F.P.); and Department of Radiology and Imaging Sciences, National Institutes of Health Clinical Center, 10 Center Dr, Bldg 10/1C355, Bethesda, MD 20892 (D.A.B.)
| | - Joseph F. Polak
- From the Department of Medical Imaging, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada (A.E.H.Z.); Departments of Radiology (B.A.W., J.A.C.L.) and Medicine (J.A.C.L.), Johns Hopkins University, Baltimore, Md; Collaborative Health Studies Coordinating Center, University of Washington, Seattle, Wash (R.L.M.); Department of Radiology, University of California–Los Angeles School of Medicine, Los Angeles, Calif (A.S.G.); Division of Epidemiology and Community Health, University of Minnesota, Minneapolis, Minn (A.R.F.); Department of Radiology, Tufts Medical Center, Boston, Mass (J.F.P.); and Department of Radiology and Imaging Sciences, National Institutes of Health Clinical Center, 10 Center Dr, Bldg 10/1C355, Bethesda, MD 20892 (D.A.B.)
| | - João A. C. Lima
- From the Department of Medical Imaging, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada (A.E.H.Z.); Departments of Radiology (B.A.W., J.A.C.L.) and Medicine (J.A.C.L.), Johns Hopkins University, Baltimore, Md; Collaborative Health Studies Coordinating Center, University of Washington, Seattle, Wash (R.L.M.); Department of Radiology, University of California–Los Angeles School of Medicine, Los Angeles, Calif (A.S.G.); Division of Epidemiology and Community Health, University of Minnesota, Minneapolis, Minn (A.R.F.); Department of Radiology, Tufts Medical Center, Boston, Mass (J.F.P.); and Department of Radiology and Imaging Sciences, National Institutes of Health Clinical Center, 10 Center Dr, Bldg 10/1C355, Bethesda, MD 20892 (D.A.B.)
| | - David A. Bluemke
- From the Department of Medical Imaging, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada (A.E.H.Z.); Departments of Radiology (B.A.W., J.A.C.L.) and Medicine (J.A.C.L.), Johns Hopkins University, Baltimore, Md; Collaborative Health Studies Coordinating Center, University of Washington, Seattle, Wash (R.L.M.); Department of Radiology, University of California–Los Angeles School of Medicine, Los Angeles, Calif (A.S.G.); Division of Epidemiology and Community Health, University of Minnesota, Minneapolis, Minn (A.R.F.); Department of Radiology, Tufts Medical Center, Boston, Mass (J.F.P.); and Department of Radiology and Imaging Sciences, National Institutes of Health Clinical Center, 10 Center Dr, Bldg 10/1C355, Bethesda, MD 20892 (D.A.B.)
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Accuracy of MDCT for detection and identification of carotid atherosclerotic plaque in a rabbit model. AJR Am J Roentgenol 2014; 202:W176-81. [PMID: 24450701 DOI: 10.2214/ajr.12.10424] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
OBJECTIVE There is a need for a simple, rapid, and repeatable noninvasive imaging method to accurately assess carotid atherosclerotic plaque. The purpose of this study was to explore the utility of MDCT and carotid artery plaque analysis software for detecting and identifying atherosclerotic plaque in a rabbit model of carotid atherosclerosis. MATERIALS AND METHODS Plaques from 14 rabbits and cross-sectional carotid artery specimens were detected, stained, and analyzed. Contrast-enhanced MDCT with application of carotid plaque analysis software was performed. Bland-Altman difference plots were used to assess interclass and intraclass consistency in lipid percentage and fibrous percentage on CT images. RESULTS A total of 76 of the 158 samples were true positive for plaque. On the basis of histopathologic examination of the samples, the accuracy, sensitivity, and specificity of CT for detecting plaque were 91.8%, 89.4%, and 94.5%, and the accuracy, sensitivity, and specificity of the software for classifying lipid-rich plaques and fibrous plaques were 90.8%, 90.6%, and 90.9%. Repeated measurements by the same physician showed good repeatability, and measurements by two physicians independently showed good correlation. CONCLUSION The results showed that MDCT can be used to detect carotid atherosclerotic plaque and that carotid plaque analysis software can be used to measure the content of plaque composition and determine the nature of plaque.
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Kwan AC, Cater G, Vargas J, Bluemke DA. Beyond Coronary Stenosis: Coronary Computed Tomographic Angiography for the Assessment of Atherosclerotic Plaque Burden. CURRENT CARDIOVASCULAR IMAGING REPORTS 2013; 6:89-101. [PMID: 23524381 PMCID: PMC3601491 DOI: 10.1007/s12410-012-9183-z] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Coronary computed tomographic angiography (CCTA) is emerging as a key non-invasive method for assessing cardiovascular risk by measurement of coronary stenosis and coronary artery calcium (CAC). New advancements in CCTA technology have led to the ability to directly identify and quantify the so-called "vulnerable" plaques that have features of positive remodeling and low density components. In addition, CCTA presents a new opportunity for noninvasive measurement of total coronary plaque burden that has not previously been available. The use of CCTA needs also to be balanced by its risks and, in particular, the associated radiation exposure. We review current uses of CCTA, CCTA's ability to measure plaque quantity and characteristics, and new developments in risk stratification and CCTA technology. CCTA represents a quickly developing field that will play a growing role in the non-invasive management of cardiovascular disease.
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Affiliation(s)
- Alan C Kwan
- Radiology and Imaging Sciences - National Institutes of Health Clinical Center, Bethesda, MD, USA
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Hyafil F, Feldman L, Le Guludec D, Fayad ZA. Evaluating Efficacy of Pharmaceutical Interventions in Atherosclerosis: Role of Magnetic Resonance Imaging and Positron Emission Tomography. ACTA ACUST UNITED AC 2012; 79:689-704. [DOI: 10.1002/msj.21349] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
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18
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Almer G, Frascione D, Pali-Schöll I, Vonach C, Lukschal A, Stremnitzer C, Diesner SC, Jensen-Jarolim E, Prassl R, Mangge H. Interleukin-10: an anti-inflammatory marker to target atherosclerotic lesions via PEGylated liposomes. Mol Pharm 2012; 10:175-86. [PMID: 23176185 PMCID: PMC3558023 DOI: 10.1021/mp300316n] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
Atherosclerosis (AS) causes cardiovascular disease, which leads to fatal clinical end points like myocardial infarction or stroke, the most prevalent causes of death in developed countries. An early, noninvasive method of detection and diagnosis of atherosclerotic lesions is necessary to prevent and treat these clinical end points. Working toward this goal, we examined recombinant interleukin-10 (IL-10), stealth liposomes with nanocargo potency for NMRI relevant contrast agents, and IL-10 coupled to stealth liposomes in an ApoE-deficient mouse model using confocal laser-scanning microscopy (CLSM). Through ex vivo incubation and imaging with CLSM, we showed that fluorescently labeled IL-10 is internalized by AS plaques, and a low signal is detected in both the less injured aortic surfaces and the arteries of wild-type mice. In vivo experiments included intravenous injections of (i) fluorescent IL-10, (ii) IL-10 targeted carboxyfluorescin (CF-) labeled stealth liposomes, and (iii) untargeted CF-labeled stealth liposomes. Twenty-four hours after injection the arteries were dissected and imaged ex vivo. Compared to free IL-10, we observed a markedly stronger fluorescence intensity with IL-10 targeted liposomes at AS plaque regions. Moreover, untargeted CF-labeled liposomes showed only weak, unspecific binding. Neither free IL-10 nor IL-10 targeted liposomes showed significant immune reaction when injected into wild-type mice. Thus, the combined use of specific anti-inflammatory proteins, high payloads of contrast agents, and liposome particles should enable current imaging techniques to better recognize and visualize AS plaques for research and prospective therapeutic strategies.
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Affiliation(s)
- Gunter Almer
- Institute of Biophysics and Nanosystems Research, Austrian Academy of Science, Graz, Austria
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19
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Grimm JM, Nikolaou K, Schindler A, Hettich R, Heigl F, Cyran CC, Schwarz F, Klingel R, Karpinska A, Yuan C, Dichgans M, Reiser MF, Saam T. Characteristics of carotid atherosclerotic plaques of chronic lipid apheresis patients as assessed by in vivo high-resolution CMR--a comparative analysis. J Cardiovasc Magn Reson 2012; 14:80. [PMID: 23194143 PMCID: PMC3524023 DOI: 10.1186/1532-429x-14-80] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2012] [Accepted: 11/16/2012] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Components of carotid atherosclerotic plaques can reliably be identified and quantified using high resolution in vivo 3-Tesla CMR. It is suspected that lipid apheresis therapy in addition to lowering serum lipid levels also has an influence on development and progression of atherosclerotic plaques. The purpose of this study was to evaluate the influence of chronic lipid apheresis (LA) on the composition of atherosclerotic carotid plaques. METHODS 32 arteries of 16 patients during chronic LA-therapy with carotid plaques and stenosis of 1-80% were matched according to degree of stenosis with 32 patients, who had recently suffered an ischemic stroke. Of these patients only the asymptomatic carotid artery was analyzed. All patients underwent black-blood 3 T CMR of the carotids using parallel imaging and dedicated surface coils. Cardiovascular risk factors were recorded. Morphology and composition of carotid plaques were evaluated. For statistical evaluation Fisher's Exact and unpaired t-test were used. A p-value <0.05 was considered statistically significant. RESULTS Patients in the LA-group were younger (63.5 vs. 73.9. years, p<0.05), had a higher prevalence of hypercholesterolemia and of established coronary heart disease in patients and in first-degree relatives (p<0.05, respectively). LA-patients had smaller maximum wall areas (49.7 vs. 59.6mm2, p<0.05), showed lower prevalence of lipid cores (28.1% vs. 56.3%, p<0.05) and the lipid content was smaller than in the control group (5.0 vs. 11.6%, p<0.05). Minimum lumen areas and maximum total vessel areas did not differ significantly between both groups. CONCLUSION Results of this study suggest that, despite a severer risk profile for cardiovascular complications in LA-patients, chronic LA is associated with significantly lower lipid content in carotid plaques compared to plaques of patients without LA with similar degrees of stenosis, which is characteristic of clinically stable plaques.
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Affiliation(s)
- Jochen M Grimm
- Institute for Clinical Radiology, Ludwig-Maximilians-University Hospital Munich, Pettenkoferstr. 8a, 80336, Munich, Germany
| | - Konstantin Nikolaou
- Institute for Clinical Radiology, Ludwig-Maximilians-University Hospital Munich, Pettenkoferstr. 8a, 80336, Munich, Germany
| | - Andreas Schindler
- Institute for Clinical Radiology, Ludwig-Maximilians-University Hospital Munich, Pettenkoferstr. 8a, 80336, Munich, Germany
| | - Reinhard Hettich
- Medizinisches Versorgungszentrum Kempten-Allgäu, Kempten-Allgäu, Germany
| | - Franz Heigl
- Medizinisches Versorgungszentrum Kempten-Allgäu, Kempten-Allgäu, Germany
| | - Clemens C Cyran
- Institute for Clinical Radiology, Ludwig-Maximilians-University Hospital Munich, Pettenkoferstr. 8a, 80336, Munich, Germany
| | - Florian Schwarz
- Institute for Clinical Radiology, Ludwig-Maximilians-University Hospital Munich, Pettenkoferstr. 8a, 80336, Munich, Germany
| | | | - Anna Karpinska
- Institute for Stroke and Dementia Research, Ludwig-Maximilians-University Hospital Munich, Munich, Germany
| | - Chun Yuan
- Department of Radiology, University of Washington School of Medicine, Seattle, USA
| | - Martin Dichgans
- Institute for Stroke and Dementia Research, Ludwig-Maximilians-University Hospital Munich, Munich, Germany
| | - Maximilian F Reiser
- Institute for Clinical Radiology, Ludwig-Maximilians-University Hospital Munich, Pettenkoferstr. 8a, 80336, Munich, Germany
| | - Tobias Saam
- Institute for Clinical Radiology, Ludwig-Maximilians-University Hospital Munich, Pettenkoferstr. 8a, 80336, Munich, Germany
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Wong KK, Thavornpattanapong P, Cheung SC, Sun Z, Tu J. Effect of calcification on the mechanical stability of plaque based on a three-dimensional carotid bifurcation model. BMC Cardiovasc Disord 2012; 12:7. [PMID: 22336469 PMCID: PMC3310807 DOI: 10.1186/1471-2261-12-7] [Citation(s) in RCA: 78] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2011] [Accepted: 02/15/2012] [Indexed: 11/28/2022] Open
Abstract
Background This study characterizes the distribution and components of plaque structure by presenting a three-dimensional blood-vessel modelling with the aim of determining mechanical properties due to the effect of lipid core and calcification within a plaque. Numerical simulation has been used to answer how cap thickness and calcium distribution in lipids influence the biomechanical stress on the plaque. Method Modelling atherosclerotic plaque based on structural analysis confirms the rationale for plaque mechanical examination and the feasibility of our simulation model. Meaningful validation of predictions from modelled atherosclerotic plaque model typically requires examination of bona fide atherosclerotic lesions. To analyze a more accurate plaque rupture, fluid-structure interaction is applied to three-dimensional blood-vessel carotid bifurcation modelling. A patient-specific pressure variation is applied onto the plaque to influence its vulnerability. Results Modelling of the human atherosclerotic artery with varying degrees of lipid core elasticity, fibrous cap thickness and calcification gap, which is defined as the distance between the fibrous cap and calcification agglomerate, form the basis of our rupture analysis. Finite element analysis shows that the calcification gap should be conservatively smaller than its threshold to maintain plaque stability. The results add new mechanistic insights and methodologically sound data to investigate plaque rupture mechanics. Conclusion Structural analysis using a three-dimensional calcified model represents a more realistic simulation of late-stage atherosclerotic plaque. We also demonstrate that increases of calcium content that is coupled with a decrease in lipid core volume can stabilize plaque structurally.
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Affiliation(s)
- Kelvin Kl Wong
- School of Aerospace, Mechanical and Manufacturing Engineering, and Health Innovations Research Institute (HIRi), RMIT University, Australia
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Fuster JJ, Castillo AI, Zaragoza C, Ibáñez B, Andrés V. Animal models of atherosclerosis. PROGRESS IN MOLECULAR BIOLOGY AND TRANSLATIONAL SCIENCE 2012; 105:1-23. [PMID: 22137427 DOI: 10.1016/b978-0-12-394596-9.00001-9] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
Cardiovascular disease is currently the predominant cause of mortality worldwide and its incidence is expected to increase significantly during the next decades owing to the unhealthy effects of modern lifestyle habits (e.g., obesity and lack of physical exercise). Cardiovascular death is frequently associated with acute myocardial infarction or stroke, which are generally the ultimate consequence of an underlying atherosclerotic process. Small and big animal models are valuable tools to understand the molecular mechanisms underlying atherosclerotic plaque formation and progression, as well as the occurrence of associated ischemic events. Moreover, animal models of atherosclerosis are pivotal for testing mechanistic hypothesis and for translational research, including the assessment of dietary and/or pharmacological interventions and the development of imaging technologies and interventional devices. In this chapter, we will describe the most widely used animal models that have permitted major advances in atherosclerosis research and significant improvements in the treatment and diagnosis of atherosclerotic disease.
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Affiliation(s)
- José J Fuster
- Department of Epidemiology, Atherothrombosis and Imaging, Centro Nacional de Investigaciones Cardiovasculares, Madrid, Spain
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Kohsaka S, Makaryus AN. Coronary Angiography Using Noninvasive Imaging Techniques of Cardiac CT and MRI. Curr Cardiol Rev 2011; 4:323-30. [PMID: 20066140 PMCID: PMC2801864 DOI: 10.2174/157340308786349444] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2008] [Revised: 06/02/2008] [Accepted: 06/02/2008] [Indexed: 11/22/2022] Open
Abstract
Noninvasive coronary angiography has become an important imaging tool in the evaluation of patients with and at risk for coronary artery disease (CAD). Multidetector computed tomographic (MDCT) angiography offers excellent negative predictive value (≥95%) for the absence of coronary artery disease and has shown promising results in evaluating allograft vasculopathy, bypass grafts, and degenerative aortic valve disease. A single MDCT scan in the emergency department is valuable in ruling out both cardiac and noncardiac causes of acute chest pain. Cardiac magnetic resonance (MR) currently lacks the spatial resolution of MDCT limiting its assessment of the coronary vasculature, but the proximal coronary arteries can be evaluated along with myocardial function and viability without exposure to contrast dye or ionizing radiation. In addition, MR imaging also has great potential for characterizing coronary plaques, as well as following their progression and regression.
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Affiliation(s)
- Shun Kohsaka
- Department of Cardiology, Keio University, School of Medicine, Tokyo, Japan, North Shore University Hospital, Manhasset, NY, USA
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Kabiri N, Asgary S, Setorki M. Lipid lowering by hydroalcoholic extracts of Amaranthus caudatus L. induces regression of rabbits atherosclerotic lesions. Lipids Health Dis 2011; 10:89. [PMID: 21619685 PMCID: PMC3123227 DOI: 10.1186/1476-511x-10-89] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2011] [Accepted: 05/28/2011] [Indexed: 04/10/2023] Open
Abstract
Background The antihypercholesterolemic and antiatherogenic effect of hydroalcoholic extracts of Amaranthus caudatus L(A. caudatus). on regression of atherosclerosis in experimental rabbits maintained on a high cholesterol diet. Methods Twenty five rabbits were randomly divided into five groups of five each and treated 75 days as follows: Group I: normal diet(ND), Group II: Hypercholesterolemic diet (HCD) for 45 days; Group III: Hypercholesterolemic diet (HCD) for 75 days, Group IV and V: HCD for 45 days and then normal diet and normal diet + A. caudatus(150 mg·kg day) respectively for an additional 30 days(regression period). Blood samples were collected before (0 time) and after 45 days and 75 days of experimental diets for measurement of biochemical factors. The aortas were removed at the end of the study for assessment of atherosclerotic plaques. Results In regression period dietary use of A. caudatus in group V significantly decreased total cholesterol, LDL-cholesterol, malondialdehyde, C-reactive protein while apolipoproteinA and HDL- cholesterol was significantly increased compared to group IV. The atherosclerotic area was significantly decreased in group V. Whereas, the animals that in regression period received only normal diet showed no regression but rather progression of atherosclerosis. Conclusion These results thus suggest that hydroalcoholic extracts of A. caudatus can reduce risk factors and cause regression of fatty lesons in aorta.
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Affiliation(s)
- Najmeh Kabiri
- Department of Biology, Faculty of Sciences, Isfahan University, Isfahan, Iran.
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Giannarelli C, Cimmino G, Connolly TM, Ibanez B, Garcia Ruiz JM, Alique M, Zafar MU, Fuster V, Feuerstein G, Badimon JJ. Synergistic effect of liver X receptor activation and simvastatin on plaque regression and stabilization: an magnetic resonance imaging study in a model of advanced atherosclerosis. Eur Heart J 2011; 33:264-73. [DOI: 10.1093/eurheartj/ehr136] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/15/2023] Open
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Liang M, Puri A, Devlin G. The vulnerable plaque: the real villain in acute coronary syndromes. Open Cardiovasc Med J 2011; 5:123-9. [PMID: 21673834 PMCID: PMC3111722 DOI: 10.2174/1874192401105010123] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2011] [Revised: 04/09/2011] [Accepted: 04/12/2011] [Indexed: 01/13/2023] Open
Abstract
The term "vulnerable plaque" refers to a vascular lesion that is prone to rupture and may result in life-threatening events which include myocardial infarction. It consists of thin-cap fibroatheroma and a large lipid core which is highly thrombogenic. Acute coronary syndromes often result from rupture of vulnerable plaques which frequently are only moderately stenosed and not visible by conventional angiography. Several invasive and non-invasive strategies have been developed to assess the burden of vulnerable plaques. Intravascular ultrasound provides a two-dimensional cross-sectional image of the arterial wall and can help assess the plaque burden and composition. Optical coherent tomography offers superior resolution over intravascular ultrasound. High-resolution magnetic resonance imaging provides non-invasive imaging for visualizing fibrous cap thickness and rupture in plaques. In addition, it may be of value in assessing the effects of treatments, such as lipid-lowering therapy. Technical issues however limit its clinical applicability. The role of multi-slice computed tomography, a well established screening tool for coronary artery disease, remains to be determined. Fractional flow reserve (FFR) may provide physiological functional assessment of plaque vulnerability; however, its role in the management of vulnerable plaque requires further studies. Treatment of the vulnerable patient may involve systemic therapy which currently include statins, ACE inhibitors, beta-blockers, aspirin, and calcium-channel blockers and in the future local therapeutic options such as drug-eluting stents or photodynamic therapy.
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Affiliation(s)
- Michael Liang
- Department of Cardiology, Waikato Hospital, New Zealand
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Giannarelli C, Ibanez B, Cimmino G, Garcia Ruiz JM, Faita F, Bianchini E, Zafar MU, Fuster V, Garcia MJ, Badimon JJ. Contrast-Enhanced Ultrasound Imaging Detects Intraplaque Neovascularization in an Experimental Model of Atherosclerosis. JACC Cardiovasc Imaging 2010; 3:1256-64. [DOI: 10.1016/j.jcmg.2010.09.017] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/05/2010] [Accepted: 09/16/2010] [Indexed: 11/28/2022]
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Hyafil F, Vucic E, Cornily JC, Sharma R, Amirbekian V, Blackwell F, Lancelot E, Corot C, Fuster V, Galis ZS, Feldman LJ, Fayad ZA. Monitoring of arterial wall remodelling in atherosclerotic rabbits with a magnetic resonance imaging contrast agent binding to matrix metalloproteinases. Eur Heart J 2010; 32:1561-71. [PMID: 21118852 DOI: 10.1093/eurheartj/ehq413] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/29/2023] Open
Abstract
AIMS P947 is a gadolinium-based magnetic resonance imaging (MRI) contrast agent with high affinity for several matrix metalloproteinases (MMPs) involved in arterial wall remodelling. We tested whether the intensity of enhancement detected in vivo in the arterial wall with P947 and MRI correlates with actual tissue MMP-related enzymatic activity measured in a rabbit atherosclerotic model subjected to dietary manipulations. METHODS AND RESULTS Aortas of 15 rabbits in which atherosclerotic lesions were induced by balloon angioplasty and 4 months of hypercholesterolaemic diet were imaged at 'baseline' with P947-enhanced MRI. Atherosclerotic rabbits were divided into three groups: five rabbits were sacrificed ('baseline' group); five rabbits continued to be fed a lipid-supplemented diet ('high-fat' group); and five rabbits were switched from atherogenic to a purified chow diet ('low-fat' group). Four months later, a second P947-enhanced MRI was acquired in the 10 remaining rabbits. A significantly lower signal was detected in the aortic wall of rabbits from the 'low-fat' group as compared with rabbits from the 'high-fat' group (21 ± 6 vs. 46 ± 3%, respectively; P = 0.04). Such differences were not detected with the contrast agent P1135, which lacks the MMP-specific peptide sequence. In addition, the intensity of aortic wall enhancement detected with MRI after injection of P947 strongly correlated with actual MMP-2 gelatinolytic activity measured in corresponding aortic segments using zymography (r = 0.87). CONCLUSION P947-enhanced MRI can distinguish dietary-induced variations in MMP-related enzymatic activity within plaques in an experimental atherosclerotic model, supporting its utility as a clinical imaging tool for in vivo detection of arterial wall remodelling.
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Affiliation(s)
- Fabien Hyafil
- Translational and Molecular Imaging Institute, Mount Sinai School of Medicine, One Gustave L. Levy Place, New York, NY 10029, USA
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Buhk JH, Finck-Wedel AK, Buchert R, Bannas P, Schnackenburg B, Beil FU, Adam G, Weber C. Screening for atherosclerotic plaques in the abdominal aorta in high-risk patients with multicontrast-weighted MRI: a prospective study at 3.0 and 1.5 tesla. Br J Radiol 2010; 84:883-9. [PMID: 21081571 DOI: 10.1259/bjr/16555263] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVE This prospective study compares MRI of atherosclerotic plaque in the abdominal aorta at 3 T with that at 1.5 T in patients suffering from hereditary hyperlipidaemia, a major risk factor for atherosclerosis. METHODS MRI of the abdominal aorta at 1.5 and 3 T was performed in 21 patients (mean age 58 years). The study protocol consisted of proton density (PD), T(1), T(2) and fat-saturated T(2) weighted black blood images of the abdominal aorta in corresponding orientation. Two independent radiologists performed image rating. First, image quality was rated on a five-point scale. Second, atherosclerotic plaques were scored according to the modified American Heart Association (AHA) classification and analysed for field strength-related differences. Weighted κ statistics were calculated to assess interobserver agreement. RESULTS Interobserver agreement was substantial for nearly all categories. MRI at 3 T offered superior image quality in all contrast weightings, most significantly in T(1) and T(2) weighted techniques. Plaque burden in the study collective was unexpectedly moderate. The majority of plaques were classified as AHA III lesions; no lesions were classified above AHA V. There was no significant influence of the field strength regarding the AHA classification. CONCLUSION Abdominal aortal plaque screening is basically feasible at both field strengths, whereas the image quality is rated superior at 3 T. However, the role of the method in clinical practice remains uncertain, since substantial findings in the high-risk collective were scarce.
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Affiliation(s)
- J-H Buhk
- Department of Diagnostic and Interventional Radiology, University Medical Center Hamburg Eppendorf, Hamburg, Germany.
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Wang L, Hao Q, Wang YD, Wang WJ, Li DJ. Protective effects of dehydroepiandrosterone on atherosclerosis in ovariectomized rabbits via alleviating inflammatory injury in endothelial cells. Atherosclerosis 2010; 214:47-57. [PMID: 21071029 DOI: 10.1016/j.atherosclerosis.2010.07.043] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/03/2009] [Revised: 06/28/2010] [Accepted: 07/21/2010] [Indexed: 11/30/2022]
Abstract
OBJECTIVE The risk for atherosclerosis is increased in postmenopausal women. Dehydroepiandrosterone (DHEA) is postulated to have anti-atherogenic properties, but the mechanism remains unclear. The aim of this study was to elucidate the protective effect of DHEA on atherosclerosis in ovariectomized rabbits. METHODS The lipid status and atherosclerotic lesions were examined in vivo in ovariectomized rabbits. The effects of DHEA on expression of inflammatory molecules were evaluated in vitro, such as nitric oxide (NO), malondialdehyde (MDA), monocyte chemoattractant protein-1 (MCP-1), adhesion molecules (ICAM-1, VCAM-1 and E-selectin) in the human umbilical vein endothelial cells (HUVECs) injured by oxidized low-density lipoproteins (ox-LDL). The adhesion of the monocytic U937 cells to HUVECs was treated with supernatants of ox-LDL treated HUVECs with or without DHEA, and then the expressions of CCR2, LFA-1, VLA-4 were analyzed in U937 cells. The HUVECs with or without LPS treatment were then treated with DHEA, and NF-κB activity was measured by luciferase activity. RESULTS DHEA administration alleviates efficiently the early pathologic damage of atherosclerosis, increases the serum NO level, and up-regulates the endothelial cell estrogen receptor (ER) expression of ovariectomized rabbits. DHEA in vitro significantly promotes NO synthesis, suppresses MDA and MCP-1 secretion of endothelial cells, and decreases ICAM-1, VCAM-1 and E-selectin expression in HUVECs; neither selective ERα antagonist (methyl-piperidino-pyrazole, MPP) nor ERβ antagonist (R,R-tetrahydrochrysene, R,RTHC) can abolish these effects. Furthermore, DHEA reduces CCR2, LFA-1 and VLA-4 expression in U937 cells, which in turn inhibits the adherence of monocytes to the injured endothelial cells. DHEA significantly decreased the LPS-induced NF-κB transcription. CONCLUSIONS Our findings suggest that DHEA can alleviate inflammation in endothelial cells. The effects of DHEA on endothelial cells are independent of ERα or ERβ pathway, but at least in part, through suppression of NF-κB activity, which protects from atherosclerosis triggered by monocyte adherence.
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Affiliation(s)
- Ling Wang
- Institute of Obstetrics and Gynecology, Fudan University Shanghai Medical College, Shanghai 200011, China
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Glaudemans AWJM, Slart RHJA, Bozzao A, Bonanno E, Arca M, Dierckx RAJO, Signore A. Molecular imaging in atherosclerosis. Eur J Nucl Med Mol Imaging 2010; 37:2381-97. [PMID: 20306036 PMCID: PMC2975909 DOI: 10.1007/s00259-010-1406-4] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2009] [Accepted: 02/03/2010] [Indexed: 11/02/2022]
Abstract
Atherosclerosis is the major cause of cardiovascular disease, which still has the leading position in morbidity and mortality in the Western world. Many risk factors and pathobiological processes are acting together in the development of atherosclerosis. This leads to different remodelling stages (positive and negative) which are both associated with plaque physiology and clinical presentation. The different remodelling stages of atherosclerosis are explained with their clinical relevance. Recent advances in basic science have established that atherosclerosis is not only a lipid storage disease, but that also inflammation has a fundamental role in all stages of the disease. The molecular events leading to atherosclerosis will be extensively reviewed and described. Further on in this review different modalities and their role in the different stages of atherosclerosis will be discussed. Non-nuclear invasive imaging techniques (intravascular ultrasound, intravascular MRI, intracoronary angioscopy and intravascular optical coherence tomography) and non-nuclear non-invasive imaging techniques (ultrasound with Doppler flow, electron-bean computed tomography, coronary computed tomography angiography, MRI and coronary artery MR angiography) will be reviewed. After that we focus on nuclear imaging techniques for detecting atherosclerotic plaques, divided into three groups: atherosclerotic lesion components, inflammation and thrombosis. This emerging area of nuclear imaging techniques can provide measures of biological activity of atherosclerotic plaques, thereby improving the prediction of clinical events. As we will see in the future perspectives, at present, there is no special tracer that can be called the diagnostic tool to diagnose prospective stroke or infarction in patients. Nevertheless, we expect such a tracer to be developed in the next few years and maybe, theoretically, it could even be used for targeted therapy (in the form of a beta-emitter) to combat cardiovascular disease.
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Affiliation(s)
- Andor W J M Glaudemans
- Department of Nuclear Medicine and Molecular Imaging, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
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Klink A, Lancelot E, Ballet S, Vucic E, Fabre JE, Gonzalez W, Medina C, Corot C, Mulder WJM, Mallat Z, Fayad ZA. Magnetic resonance molecular imaging of thrombosis in an arachidonic acid mouse model using an activated platelet targeted probe. Arterioscler Thromb Vasc Biol 2010; 30:403-10. [PMID: 20139362 DOI: 10.1161/atvbaha.109.198556] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
OBJECTIVE Atherosclerotic plaque rupture leads to acute thrombus formation and may trigger serious clinical events such as myocardial infarction or stroke. Therefore, it would be valuable to identify atherothrombosis and vulnerable plaques before the onset of such clinical events. We sought to determine whether the noninvasive in vivo visualization of activated platelets was effective when using a target-specific MRI contrast agent to identify thrombi, hallmarks of vulnerable or high-risk atherosclerotic plaques. METHODS AND RESULTS Inflammatory thrombi were induced in mice via topical application of arachidonic acid on the carotid. Thrombus formation was imaged with intravital fluorescence microscopy and molecular MRI. To accomplish the latter, a paramagnetic contrast agent (P975) that targets the glycoprotein alpha(IIb)beta(3), expressed on activated platelets, was investigated. The specificity of P975 for activated platelets was studied in vitro. In vivo, high spatial-resolution MRI was performed at baseline and longitudinally over 2 hours after injecting P975 or a nonspecific agent. The contralateral carotid, a sham surgery group, and a competitive inhibition experiment served as controls. P975 showed a good affinity for activated platelets, with an IC(50) (concentration of dose that produces 50% inhibition) value of 2.6 micromol/L. In thrombosed animals, P975 produced an immediate and sustained increase in MRI signal, whereas none of the control groups revealed any significant increase in MRI signal 2 hours after injection. More important, the competitive inhibition experiment with an alpha(IIb)beta(3) antagonist suppressed the MRI signal enhancement, which is indicative for the specificity of P975 for the activated platelets. CONCLUSIONS P975 allowed in vivo target-specific noninvasive MRI of activated platelets.
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Affiliation(s)
- Ahmed Klink
- Translational and Molecular Imaging Institute, Mount Sinai School of Medicine, Atran BM-24, Box 1234, One Gustave L. Levy Place, New York, NY 10029, USA
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Atherosclerotic lesions rich in macrophages or smooth muscle cells discriminated in rabbit iliac arteries based on T1 relaxation time and lipid content. Acad Radiol 2010; 17:230-8. [PMID: 19910212 DOI: 10.1016/j.acra.2009.09.008] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2009] [Revised: 09/07/2009] [Accepted: 09/08/2009] [Indexed: 12/31/2022]
Abstract
RATIONALE AND OBJECTIVES Atherothrombosis usually occurs on macrophage- and lipid-rich unstable plaque, but rarely on smooth muscle cell (SMC)-rich stable plaque. Magnetic resonance imaging (MRI) has been extensively applied for noninvasive vascular imaging. We therefore investigated whether MRI provides valuable information about the characteristics of atherosclerotic vessels using rabbit models of macrophage-rich or SMC-rich atherosclerotic arteries. MATERIALS AND METHODS Rabbits were fed with a conventional (CD group, n = 3) or 0.5% cholesterol (ChD group, n = 3) diet for 1 week before and 3 weeks after balloon injury of the left iliac arteries. Three weeks later, these arteries were investigates by 1.5 T MRI and by conventional angiographic imaging, followed by histological and immunohistochemical analyses. RESULTS Three weeks after balloon injury, injured iliac arteries of both groups formed neointima with luminal stenosis. Conventional and MRI angiographic findings of the luminal diameter significantly and positively correlated. T1 relaxation time was significantly shorter and the lipid content was much higher in injured arteries from the ChD than from the CD group. The injured arteries from the ChD also contained more macrophages and less SMCs that those from the CD group. The T1 relaxation time and lipid content in injured arteries negatively and positively correlated with the degree of macrophage accumulation, respectively. CONCLUSION These results showed that MRI could provide valuable information about luminal stenosis and the characteristics of atherosclerotic vessels in rabbits.
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Relative contributions of collagen and tissue factor to thrombus formation on damaged vascular vessels: in-vitro studies with circulating blood. Coron Artery Dis 2009; 20:392-9. [DOI: 10.1097/mca.0b013e32832cff1f] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Villegas A, Gonzalez FA, Llorente L, Redondo S. Emerging hematological targets and therapy for cardiovascular disease: From bench to bedside. Biologics 2009; 2:397-407. [PMID: 19707371 PMCID: PMC2721378 DOI: 10.2147/btt.s2911] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022]
Abstract
Atherosclerotic cardiovascular disease is the leading cause of death and a major part of its pathophysiology remains obscure. Some hematological targets have been related to the development and clinical outcome of this disease, especially soluble cytokines, leukocytes, red blood cells, hemostatic factors and platelets, and bone-marrow vascular progenitors. These emerging factors may be modulated by current antiatherosclerotic pharmacotherapy, target-designed novel drugs or progenitor cell therapy. The aim of current review article is to comprehensively review the role of these antiatherosclerotic targets and therapy.
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Affiliation(s)
- Ana Villegas
- Service of Hematology and Hemotherapy, Hospital, Clinico Universitario, San Carlos, Madrid, Spain
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Guimarães AV, Brandt CT, Ferraz A. Complexo miointimal das carótidas comum e interna em portadores de esquistossomose mansônica hepatoesplênica. Rev Col Bras Cir 2009; 36:292-9. [DOI: 10.1590/s0100-69912009000400004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2008] [Accepted: 01/17/2009] [Indexed: 11/21/2022] Open
Abstract
OBJETIVO: Avaliar a espessura do complexo miointimal (IMT) das carótidas comum e interna, em portadores de esquistossomose hepatoesplênica (EHE) não tratados cirurgicamente, já submetidos a cirurgia para descompressão do sistema porta por esplenectomia e ligadura da veia gástrica esquerda, e comparar com volutários de condições sócio-econômico-ambientais similares, não portadores de esquistossomose. MÉTODOS: Utilizando aparelho de ultra-som Doppler de 7,5MHz foram mensurados os IMT de três grupos de voluntários, de ambos os gêneros, com idades que variaram de 20 a 60 anos, sendo avaliados os IMT máximos, IMT médios, IMT mínimos e seus desvios-padrão, das carótidas comuns e internas e feitas as comparações entre os grupos e suas associações com fatores de risco: idade, hipertensão arterial e tabagismo. RESULTADOS: Não houve diferença significante na média dos IMT, entre os lados direito e esquerdo e nem entre os grupos. Nos pacientes tratados cirurgicamente, assim como nos indivíduos-controle confirmou-se a associação, já conhecida, com os fatores de risco para aterosclerose (idade, hipertensão arterial e tabagismo). Contudo, não se observou este comportamento nos pacientes não operados. CONCLUSÃO: A EHE sem tratamento cirúrgico parece conferir "alguma proteção" contra a aterogênese em seres humanos; todavia, os achados não dão suporte definitivo a esta hipótese.
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Abstract
Recent pathophysiological findings have lead to new concepts to identify patients at risk for cardiovascular disease using systemic serum markers or new imaging methodology. New probe technology and progress in imaging techniques have set the base for development of molecular imaging concepts in the cardiovascular systems. The aim of these new imaging techniques is the detection of active biological processes in cardiovascular systems combining specific probes with contrast agents for MRI, SPECT or PET. There are promising strategies mostly in preclinical tests, which will prove clinical applicability in the near future.
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Abstract
Magnetic resonance imaging is one of the most exciting techniques for noninvasive molecular imaging of the cardiovascular system. The article will describe challenges, solutions and results of magnetic resonance plaque imaging ex-vivo, in the experimental animal and in patients.
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Affiliation(s)
- René M Botnar
- Dept. of Nuclear Medicine, Klinikum Rechts der Isar, Technische Universität München, Munich, Germany
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Abstract
New and experimental imaging techniques are being developed that will permit better visualization and compositional characterization of atheromatous plaques. This review provides discussion of techniques that are currently used in clinical practice, as well as techniques that are investigational only, including coronary angiography, intravascular ultrasound, computed tomography, magnetic resonance imaging, positron emission tomography, and single-photon emission computed tomography. Types of atheromatous plaque are reviewed, and the value of examining vascular calcification in risk assessment is discussed. Experimental use of these imaging techniques in animal models and in clinical studies will enhance our understanding of the development of plaque and will determine whether these techniques would be useful and practical for predicting disease course. Early detection and identification of the type of plaque that is present may generate novel opportunities for primary prevention through changes in lifestyle or even through drug therapy, especially in patients at high cardiovascular risk.
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Affiliation(s)
- Borja Ibañez
- Zena and Michael A. Wiener Cardiovascular Institute, Mount Sinai Hospital and School of Medicine, New York, New York 10029, USA
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Worthley SG, Zhang ZY, Machac J, Helft G, Tang C, Liew GYH, Zaman AG, Worthley MI, Fayad ZA, Buchsbaum MS, Fuster V, Badimon JJ. In vivo non-invasive serial monitoring of FDG-PET progression and regression in a rabbit model of atherosclerosis. Int J Cardiovasc Imaging 2008; 25:251-7. [DOI: 10.1007/s10554-008-9377-2] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/25/2008] [Accepted: 09/29/2008] [Indexed: 10/21/2022]
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Assessment and reproducibility of aortic atherosclerosis magnetic resonance imaging: impact of 3-Tesla field strength and parallel imaging. Invest Radiol 2008; 43:656-62. [PMID: 18708860 DOI: 10.1097/rli.0b013e318181538a] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVES To investigate image quality and interstudy reproducibility of aortic atherosclerosis imaging at 1.5 T, and to explore the impact of parallel imaging techniques at 3 T. MATERIALS AND METHODS Institutional review board approval and informed consent were obtained. Thirty-two subjects (20 normal, 12 patients with impaired cardiac function) underwent 4 black-blood T2-weighted imaging studies of the abdominal aorta: 2 conventional studies at 1.5 T, a conventional study at 3 T, and an accelerated 3-T study with parallel imaging (SENSE). Contrast-to-noise ratio and image quality score (1-5 scale, 5 = highest quality) were determined for each study. Studies were analyzed for mean wall thickness and area plaque burden as endpoints for aortic atherosclerosis. Bland-Altman analyses were performed to determine interstudy reproducibility between imaging methods. Wilcoxon signed-rank tests were used to identify significant differences between methods (P < 0.05). RESULTS Image quality scores were comparable between 1.5 T and 3 T with SENSE (4.0 +/- 0.6 vs. 4.2 +/- 0.6, P = 0.21). Bland-Altman reproducibility for mean wall thickness was -0.03 mm +/- 0.15 (1.5 T vs. 1.5 T), 0.01 mm +/- 0.17 (1.5 T vs. 3 T without SENSE), and -0.01 mm +/- 0.18 (1.5 T vs. 3 T with SENSE), P = 0.83. Detection of the presence or absence of plaque was comparable. Bland-Altman reproducibility for area plaque burden was -0.02% +/- 0.32% (1.5 T vs. 1.5 T), 0.06% +/- 0.41% (1.5 T vs. 3 T without SENSE), and 0.11% +/- 0.33% (1.5 T vs. 3 T with SENSE), P = 0.41. CONCLUSION Black-blood MR imaging of aortic atherosclerosis is very reproducible. Parallel imaging at 3 T permits shorter scan time compared with conventional 1.5-T imaging with comparable measures of atherosclerosis extent.
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Gottsegen JM, Coplan NL. The Atherosclerotic Aortic Arch: Considerations in Diagnostic Imaging. ACTA ACUST UNITED AC 2008; 11:162-7. [DOI: 10.1111/j.1751-7141.2008.08296.x] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Choi BG, Vilahur G, Cardoso L, Fritton JC, Ibanez B, Zafar MU, Yadegar D, Speidl WS, Schaffler MB, Fuster V, Badimon JJ. Ovariectomy increases vascular calcification via the OPG/RANKL cytokine signalling pathway. Eur J Clin Invest 2008; 38:211-7. [PMID: 18279396 PMCID: PMC4811027 DOI: 10.1111/j.1365-2362.2008.01930.x] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
BACKGROUND Observational studies suggest a strong relationship between menopause and vascular calcification. Receptor activator of nuclear factor-kappaBeta ligand (RANKL) and osteoprotegerin (OPG) are critical regulators of bone remodelling and modulate vascular calcification. We assessed the hypothesis that ovariectomy increases vascular calcification via the OPG/RANKL axis. MATERIALS AND METHODS Age-matched sexually mature rabbits were randomized to ovariectomy (OVX, n = 12) or sham procedure (SHAM, n = 12). One month post-procedure, atherosclerosis was induced by 15 months 0.2%-cholesterol diet and endothelial balloon denudations (at months 1 and 3). Aortic atherosclerosis was assessed in vivo by magnetic resonance imaging (MRI) at months 9 and 15. At sacrifice, aortas were harvested for ex vivo microcomputed tomography (microCT) and molecular analysis of the vascular tissue. RESULTS Vascular calcification density and calcific particle number were significantly greater in OVX than SHAM (8.4 +/- 2.8 vs. 1.9 +/- 0.6 mg cm(-3), P = 0.042, and 94 +/- 26 vs. 33 +/- 7 particles cm(-3), P = 0.046, respectively). Calcification morphology, as assessed by the arc angle subtended by the largest calcific particle, showed no difference between groups (OVX 33 +/- 7 degrees vs. SHAM 33 +/- 5 degrees , P = 0.99). By Western blot analysis, OVX increased the vascular OPG:RANKL ratio by 66%, P = 0.029, primarily by decreasing RANKL (P = 0.019). At month 9, MRI demonstrated no difference in atheroma volume between OVX and SHAM, and no significant change was seen by the end of the study. CONCLUSIONS In contrast to bone, vascular OPG:RANKL ratio increased in response to ovariectomy with a corresponding fourfold increase in arterial calcification. This diametrical organ-specific response may explain the comorbid association of osteoporosis with calcifying atherosclerosis in post-menopausal women.
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Affiliation(s)
- B G Choi
- Mount Sinai School of Medicine, New York, USA
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Ibanez B, Vilahur G, Cimmino G, Speidl WS, Pinero A, Choi BG, Zafar MU, Santos-Gallego CG, Krause B, Badimon L, Fuster V, Badimon JJ. Rapid Change in Plaque Size, Composition, and Molecular Footprint After Recombinant Apolipoprotein A-IMilano (ETC-216) Administration. J Am Coll Cardiol 2008; 51:1104-9. [DOI: 10.1016/j.jacc.2007.09.071] [Citation(s) in RCA: 96] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/03/2007] [Revised: 09/10/2007] [Accepted: 09/17/2007] [Indexed: 10/22/2022]
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IRM haute résolution de l’athérosclérose carotidienne :au-delà de la lumière artérielle. ACTA ACUST UNITED AC 2008; 89:293-301. [DOI: 10.1016/s0221-0363(08)93003-1] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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Choi BG, Vilahur G, Zafar MU, Cardoso L, Yadegar D, Ibanez B, Tunstead J, Viles-Gonzalez JF, Schaffler MB, Fuster V, Badimon JJ. Selective estrogen receptor modulation influences atherosclerotic plaque composition in a rabbit menopause model. Atherosclerosis 2008; 201:76-84. [PMID: 18367192 DOI: 10.1016/j.atherosclerosis.2008.01.017] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2007] [Revised: 12/23/2007] [Accepted: 01/23/2008] [Indexed: 11/28/2022]
Abstract
OBJECTIVE Osteoporosis trials suggest raloxifene decreased cardiovascular events in women with pre-existing atherosclerosis. We assessed the hypothesis that selective estrogen receptor modulation induces plaque stability in "menopausal" animals. METHODS AND RESULTS Atherosclerosis was induced in 42 ovariectomized New Zealand white rabbits by cholesterol feeding and mechanical injury. Animals were imaged by magnetic resonance imaging (MRI) for baseline atherosclerosis, and randomized to control (OVX (ovariectomized control group), n=12), raloxifene 35-60 mg/kg/day by diet admixture (RLX (raloxifene therapy group), n=24), or immediate sacrifice (n=6) for immunohistopathologic correlation of MRI. Six months later, rabbits underwent repeat MRI then sacrifice for micro-computed tomography (microCT) and molecular analysis. Unlike OVX, RLX reduced atheroma volume. Analysis for lesion inflammation revealed reductions in COX-2 (cyclooxygenase-2), MMP-1 (matrix metalloproteinase-1), MCP-1 (monocyte chemoattractant protein-1) expression and macrophage infiltration in RLX versus OVX with concomitant upregulation of estrogen receptor alpha (ERalpha). microCT showed similar total vascular calcification between groups, but calcifications in RLX were less nodular with better radial organization (mean calcific arc angle 63+/-7 degrees versus 33+/-6 degrees in OVX), the predicted result of a 53% increase in BMP-2 (bone-morphogenetic protein-2). CONCLUSIONS Raloxifene treatment results in reduced lesion volume, enhanced mechanical stability of vascular calcification, and less inflamed lesions characterized by less macrophage infiltration and reduced COX-2, MMP-1 and MCP-1 expression.
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Affiliation(s)
- Brian G Choi
- Cardiovascular Biology Research Laboratory, Mount Sinai School of Medicine, New York, NY, USA
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Abstract
The atherosclerotic process that results in coronary artery disease (CAD) is recognized to be a generalized process that may involve the entire vasculature. The association between CAD and atherosclerotic plaques in the thoracic aorta has often been reported using transesophageal echocardiography. An autopsy study showed plaques in the abdominal aorta, but not in the thoracic aorta, to be severe in patients with cardiac events. However, studies evaluating an association between abdominal aortic plaques and CAD are scarce. Recently, magnetic resonance imaging (MRI) has become a useful tool for the noninvasive evaluation of atherosclerotic plaques in both the thoracic and abdominal aortas. Plaques in the thoracic and abdominal aortas were found to be characteristically associated with hypercholesterolemia and smoking, respectively, suggesting different susceptibilities to risk factors. Because patients have various risk factors, it seems to be preferable to evaluate atherosclerosis in multiple vascular beds than in just 1 bed. Magnetic resonance imaging can evaluate atherosclerosis in multiple vascular beds in the same examination session. Complex aortic plaques, especially in the abdominal aorta, were found to be associated with myocardial infarction and complex coronary lesions, suggesting a link between aortic and coronary plaque instability. Aortic MRI may thus be useful for identifying vulnerable patients. Moreover, MRI is a powerful tool to serially evaluate plaque progression and regression. Intensive lipid-lowering therapy can regress aortic plaques, but the susceptibility to lipid lowering and the process of plaque regression may differ between the thoracic and abdominal aortic plaques.
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Mulder WJM, Strijkers GJ, Briley-Saboe KC, Frias JC, Aguinaldo JGS, Vucic E, Amirbekian V, Tang C, Chin PTK, Nicolay K, Fayad ZA. Molecular imaging of macrophages in atherosclerotic plaques using bimodal PEG-micelles. Magn Reson Med 2008; 58:1164-70. [PMID: 18046703 DOI: 10.1002/mrm.21315] [Citation(s) in RCA: 113] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Pegylated, fluorescent, and paramagnetic micelles were developed. The micelles were conjugated with macrophage scavenger receptor (MSR)-specific antibodies. The abdominal aortas of atherosclerotic apoE-KO mice were imaged with T(1)-weighted high-resolution MRI before and 24 h after intravenous administration of the contrast agent (CA). Pronounced signal enhancement (SE) (up to 200%) was observed for apolipoprotein E knockout (apoE-KO) mice that were injected with MSR-targeted micelles, while the aortic vessel wall of mice injected with nontargeted micelles showed little SE. To allow fluorescence microscopy and optical imaging of the excised aorta, the micelles were made fluorescent by incorporating either a quantum dot (QD) in the micelle corona or rhodamine lipids in the micelle. Ultraviolet (UV) illumination of the aorta allowed the identification of regions with high macrophage content, while MSR-targeted rhodamine micelles could be detected with fluorescence microscopy and were found to be associated with macrophages. In conclusion, this study demonstrates that macrophages in apoE-KO mice can be effectively and specifically detected by molecular MRI and optical methods upon administration of a pegylated micellar CA.
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Affiliation(s)
- Willem J M Mulder
- Biomedical NMR, Department of Biomedical Engineering, Eindhoven University of Technology, Eindhoven, The Netherlands
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Targeted contrast agent helps to monitor advanced plaque during progression: a magnetic resonance imaging study in rabbits. Invest Radiol 2008; 43:49-55. [PMID: 18097277 DOI: 10.1097/rli.0b013e318155aa5a] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE Gadofluorine M has been reported to enhance early atherosclerotic plaque signals in magnetic resonance imaging (MRI). The aim of this study was to examine the use of Gadofluorine M to monitor the progression of advanced plaques in a rabbit model. METHODS Focal advanced atherosclerosis was induced in the right femoral arteries of 6 New Zealand white rabbits using a combination of cholesterol-enriched diet, and sequential air-desiccation, and balloon-overstretch injury. MRI with conventional 3 contrasts (T1, T2, and proton density [PD]) was performed to monitor the progression of the atherosclerotic plaques with 2 MRI scans separated by 4 to 8 weeks. Gadofluorine M was given intravenously to the rabbits 24 hours before the first MRI scans, and before (n = 3) or during (n = 3) the second MRI scan. The left femoral arteries were used as a control. Histopathologic images localized individual plaque components. RESULTS The advanced plaque displayed multilayered neointima that included foam cells, smooth muscle cells, and extracellular matrix. The separate image contrasts offered similar T1-weighted enhancement patterns, but the combination of all 3 contrasts helped to delineate plaque and lumen boundaries. Gadofluorine M strongly enhanced neointima areas with an image contrast (contrast-to-noise ratio [CNR]) of approximately 15, versus 2 in the control femoral arterial wall. With improved images, significant changes in neointima and total plaque volumes over the 4 to 8 weeks between scans could be identified. Gadofluorine M remained within the plaques with significant image enhancements (contrast-to-noise ratio = 5.8) for 2 months after a single injection. CONCLUSION This preliminary study in rabbits indicated that Gadofluorine M provides specific enhancements of components associated with advanced atherosclerotic plaques and may help to monitor the progression of the plaque in a rabbit model of atherogenesis.
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Ronald JA, Walcarius R, Robinson JF, Hegele RA, Rutt BK, Rogers KA. MRI of early- and late-stage arterial remodeling in a low-level cholesterol-fed rabbit model of atherosclerosis. J Magn Reson Imaging 2008; 26:1010-9. [PMID: 17896368 DOI: 10.1002/jmri.21113] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
PURPOSE To monitor early- and late-stage arterial remodeling following low-level cholesterol (CH) feeding in rabbits using a standardized MRI protocol. MATERIALS AND METHODS New Zealand White rabbits were fed a CH diet (0.25% w/w) (n = 15) or normal chow (n = 6) and imaged either at 0, 2, 6, 8, and 11 months ("early-stage") or 12, 14, 16, 18, and 20 months ("late-stage"). T2-weighted fast-spin-echo images ( approximately 200 microm in-plane resolution) of aortic lesions were collected using either a 1.5 or 3.0T MR scanner interfaced with a customized surface RF coil. Luminal (LA), outer vessel wall boundary (OVBA), and vessel wall areas (VWA) were assessed. RESULTS Among CH-fed animals in the early-stage group, increased VWA associated with decreased OVBA and a more pronounced decrease in LA was first detectable at 8 months. These changes became more evident between 8 and 11 months. In the late-stage group, lesions continued to grow in response to CH-feeding, as VWA significantly increased at regular 2-month intervals. Beyond 16 months, signal intensity differences (reflecting increased lesion complexity) within the vessel wall were noted. CONCLUSION This often-overlooked rabbit model combined with customized MR technology holds tremendous promise for studying the natural progression, regression, and remodeling of atherosclerotic lesions.
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Affiliation(s)
- John A Ronald
- Department of Medical Biophysics, University of Western Ontario, London, ON, Canada
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