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Li H, Zhang L, Wang RZ, Wang GK, Zhao YM, Wang XY, Zhang XS, Kuai ZX. Coronary CT Angiography-Based Radiomics to Predict Vessel-Specific Ischemia by Stress Dynamic CT Myocardial Perfusion Imaging. Acad Radiol 2024:S1076-6332(24)00446-X. [PMID: 39097508 DOI: 10.1016/j.acra.2024.07.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2024] [Revised: 07/04/2024] [Accepted: 07/07/2024] [Indexed: 08/05/2024]
Abstract
RATIONALE AND OBJECTIVES To investigate the predictive value of coronary CT angiography (CCTA)-based radiomics for vessel-specific ischemia by stress dynamic CT myocardial perfusion imaging (MPI). MATERIALS AND METHODS Patients with typical angina/atypical angina/non-angina chest pain who underwent both stress dynamic CT MPI and CCTA scans were retrospectively enrolled. The following models were constructed for ischemic prediction using logistic regression and CCTA-derived quantitative and radiomic features: plaque quantitative model, lumen quantitative model, CT-fractional flow reserve (CT-FFR) model, integrative quantitative model, plaque radiomic model, peri-coronary adipose tissue (pCAT) radiomic model, integrative radiomic model, and quantitative and radiomic fusion model. A relative myocardial blood flow ≤ 0.75 on stress dynamic CT MPI was considered ischemic. The models' performances were quantified by the area under the receiver-operating characteristic curve (AUC). RESULTS 386 coronary vessels (stenosis grade: 25%∼75%; training set: 200 [ischemia/non-ischemia=96/104]; test set:186 [ischemia/non-ischemia=79/107]) from 326 patients were included. The plaque radiomic model (training/test set: AUC=0.81/0.80) outperformed (p < .05) both the plaque quantitative (training/test set: AUC=0.71/0.68) model and the lumen quantitative (training/test set: AUC=0.69/0.65) model in identifying ischemia. The integrative radiomic model (training/test set: AUC=0.83/0.82) outperformed (p < .05) the CT-FFR model (training/test set: AUC=0.74/0.73) for ischemic prediction. The quantitative and radiomic fusion model (training/test set: AUC=0.86/0.84) outperformed (p < .05) the integrative quantitative model (training/test set: AUC=0.79/0.77) for ischemic detection. CONCLUSION The plaque and pCAT radiomic features were superior to the plaque and pCAT quantitative features in predicting ischemia and the addition of the radiomic features to the quantitative features for ischemic identification yielded incremental discriminatory value.
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Affiliation(s)
- Hui Li
- Imaging Center, Harbin Medical University Cancer Hospital, Haping Road No.150, Nangang District, Harbin 150081, China
| | - Lan Zhang
- Imaging Center, Harbin Medical University Cancer Hospital, Haping Road No.150, Nangang District, Harbin 150081, China
| | - Run-Ze Wang
- Imaging Center, Harbin Medical University Cancer Hospital, Haping Road No.150, Nangang District, Harbin 150081, China
| | - Guo-Kun Wang
- Department of Cardiology, Cardiovascular Imaging Center, Second Affiliated Hospital of Harbin Medical University, Xuefu Road No.246, Nangang District, Harbin 150001, China
| | - Yan-Ming Zhao
- Department of Cardiology, Cardiovascular Imaging Center, Second Affiliated Hospital of Harbin Medical University, Xuefu Road No.246, Nangang District, Harbin 150001, China
| | - Xin-Yi Wang
- Imaging Center, Harbin Medical University Cancer Hospital, Haping Road No.150, Nangang District, Harbin 150081, China
| | - Xiu-Shi Zhang
- Imaging Center, Harbin Medical University Cancer Hospital, Haping Road No.150, Nangang District, Harbin 150081, China
| | - Zi-Xiang Kuai
- Imaging Center, Harbin Medical University Cancer Hospital, Haping Road No.150, Nangang District, Harbin 150081, China.
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Buckler AJ, Doros G, Kinninger A, Lakshmanan S, Le VT, Libby P, May HT, Muhlestein JB, Nelson JR, Nicolaou A, Roy SK, Shaikh K, Shekar C, Tayek JA, Zheng L, Bhatt DL, Budoff MJ. Quantitative imaging biomarkers of coronary plaque morphology: insights from EVAPORATE. Front Cardiovasc Med 2023; 10:1204071. [PMID: 37600044 PMCID: PMC10435977 DOI: 10.3389/fcvm.2023.1204071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Accepted: 07/12/2023] [Indexed: 08/22/2023] Open
Abstract
Aims Residual cardiovascular risk persists despite statin therapy. In REDUCE-IT, icosapent ethyl (IPE) reduced total events, but the mechanisms of benefit are not fully understood. EVAPORATE evaluated the effects of IPE on plaque characteristics by coronary computed tomography angiography (CCTA). Given the conclusion that the IPE-treated patients demonstrate that plaque burden decreases has already been published in the primary study analysis, we aimed to demonstrate whether the use of an analytic technique defined and validated in histological terms could extend the primary study in terms of whether such changes could be reliably seen in less time on drug, at the individual (rather than only at the cohort) level, or both, as neither of these were established by the primary study result. Methods and Results EVAPORATE randomized the patients to IPE 4 g/day or placebo. Plaque morphology, including lipid-rich necrotic core (LRNC), fibrous cap thickness, and intraplaque hemorrhage (IPH), was assessed using the ElucidVivo® (Elucid Bioimaging Inc.) on CCTA. The changes in plaque morphology between the treatment groups were analyzed. A neural network to predict treatment assignment was used to infer patient representation that encodes significant morphological changes. Fifty-five patients completed the 18-month visit in EVAPORATE with interpretable images at each of the three time points. The decrease of LRNC between the patients on IPE vs. placebo at 9 months (reduction of 2 mm3 vs. an increase of 41 mm3, p = 0.008), widening at 18 months (6 mm3 vs. 58 mm3 increase, p = 0.015) were observed. While not statistically significant on a univariable basis, reductions in wall thickness and increases in cap thickness motivated multivariable modeling on an individual patient basis. The per-patient response assessment was possible using a multivariable model of lipid-rich phenotype at the 9-month follow-up, p < 0.01 (sustained at 18 months), generalizing well to a validation cohort. Conclusion Plaques in the IPE-treated patients acquired more characteristics of stability. Reliable assessment using histologically validated analysis of individual response is possible at 9 months, with sustained stabilization at 18 months, providing a quantitative basis to elucidate drug mechanism and assess individual patient response.
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Affiliation(s)
- Andrew J. Buckler
- Department of Molecular Medicine, Karolinska Institutet, Stockholm, Sweden
- Elucid Bioimaging Inc., Boston, MA, United States
| | | | - April Kinninger
- Department of Medicine, Lundquist Institute at Harbor-UCLA Medical Center, Torrance, CA, United States
| | - Suvasini Lakshmanan
- Department of Medicine, Lundquist Institute at Harbor-UCLA Medical Center, Torrance, CA, United States
| | - Viet T. Le
- Intermountain Heart Institute, Intermountain Medical Center, Salt Lake City, UT, United States
- Rocky Mountain University of Health Profession, Provo, UT, United States
| | - Peter Libby
- Brigham and Women’s Hospital Heart & Vascular Center and Harvard Medical School, Boston, MA, United States
| | - Heidi T. May
- Intermountain Heart Institute, Intermountain Medical Center, Salt Lake City, UT, United States
| | - Joseph B. Muhlestein
- Intermountain Heart Institute, Intermountain Medical Center, Salt Lake City, UT, United States
| | - John R. Nelson
- California Cardiovascular Institute, Fresno, CA, United States
| | | | - Sion K. Roy
- Department of Medicine, Lundquist Institute at Harbor-UCLA Medical Center, Torrance, CA, United States
| | - Kashif Shaikh
- Department of Medicine, Lundquist Institute at Harbor-UCLA Medical Center, Torrance, CA, United States
| | - Chandana Shekar
- Department of Medicine, Lundquist Institute at Harbor-UCLA Medical Center, Torrance, CA, United States
| | - John A. Tayek
- Department of Medicine, Lundquist Institute at Harbor-UCLA Medical Center, Torrance, CA, United States
| | - Luke Zheng
- BAIM Institute, Boston, MA, United States
| | - Deepak L. Bhatt
- Brigham and Women’s Hospital Heart & Vascular Center and Harvard Medical School, Boston, MA, United States
| | - Matthew J. Budoff
- Department of Medicine, Lundquist Institute at Harbor-UCLA Medical Center, Torrance, CA, United States
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Smit JM, El Mahdiui M, de Graaf MA, Montero-Cabezas JM, Reiber JHC, Jukema JW, Scholte AJ, Knuuti J, Wijns W, Narula J, Bax JJ. Relation Between Coronary Plaque Composition Assessed by Intravascular Ultrasound Virtual Histology and Myocardial Ischemia Assessed by Quantitative Flow Ratio. Am J Cardiol 2023; 186:228-235. [PMID: 36333150 DOI: 10.1016/j.amjcard.2022.10.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Revised: 09/10/2022] [Accepted: 10/03/2022] [Indexed: 11/13/2022]
Abstract
Coronary plaque composition may play an important role in the induction of myocardial ischemia. Our objective was to further clarify the relation between coronary plaque composition and myocardial ischemia in patients with chest pain symptoms. The study population consisted of 103 patients who presented to the outpatient clinic or emergency department with chest pain symptoms and were referred for diagnostic invasive coronary angiography. Intravascular ultrasound virtual histology was used for the assessment of coronary plaque composition. A noncalcified plaque was defined as a combination of necrotic core and fibrofatty tissue. Quantitative flow ratio (QFR), which is a coronary angiography-based technique used to calculate fractional flow reserve without the need for hyperemia induction or for a pressure wire, was used as the reference standard for the evaluation of myocardial ischemia. Coronary artery plaques with QFR of ≤0.80 were considered abnormal-that is, ischemia-generating. In total, 149 coronary plaques were analyzed, 21 of which (14%) were considered abnormal according to QFR. The percentage of noncalcified tissue was significantly higher in plaques with abnormal QFR (38.2 ± 6.5% vs 33.1 ± 9.0%, p = 0.014). After univariable analysis, both plaque load (odds ratio [OR] per 1% increase 1.081, p <0.001) and the percentage of noncalcified tissue (OR per 1% increase 1.070, p = 0.020) were significantly associated with reduced QFR. However, after multivariable analysis, only plaque load remained significantly associated with abnormal QFR (OR per 1% increase 1.072, p <0.001). In conclusion, the noncalcified plaque area was significantly higher in hemodynamically significant coronary lesions than in nonsignificant lesions. Although an increase in the noncalcified plaque area was significantly associated with a reduced QFR, this association lost significance after adjustment for localized plaque load.
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Affiliation(s)
- Jeff M Smit
- Departments of Cardiology Leiden University Medical Center, Leiden, The Netherlands
| | - Mohammed El Mahdiui
- Departments of Cardiology Leiden University Medical Center, Leiden, The Netherlands
| | - Michiel A de Graaf
- Departments of Cardiology Leiden University Medical Center, Leiden, The Netherlands
| | | | - Johan H C Reiber
- Medis Medical Imaging, Leiden, The Netherlands; Departments of Radiology, Leiden University Medical Center, Leiden, The Netherlands
| | - J Wouter Jukema
- Departments of Cardiology Leiden University Medical Center, Leiden, The Netherlands
| | - Arthur J Scholte
- Departments of Cardiology Leiden University Medical Center, Leiden, The Netherlands
| | - Juhani Knuuti
- Heart Center, University of Turku and Turku University Hospital, Turku, Finland
| | - William Wijns
- Lambe Institute for Translational Medicine and Curam, National University of Ireland Galway and Saolta University Healthcare Group, University College Hospital Galway, Galway, Ireland
| | - Jagat Narula
- Division of Cardiology, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Jeroen J Bax
- Departments of Cardiology Leiden University Medical Center, Leiden, The Netherlands; Heart Center, University of Turku and Turku University Hospital, Turku, Finland.
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Association between atherogenic risk-modulating proteins and endothelium-dependent flow-mediated dilation in coronary artery disease patients. Eur J Appl Physiol 2023; 123:367-380. [PMID: 36305972 PMCID: PMC9894982 DOI: 10.1007/s00421-022-05040-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Accepted: 09/04/2022] [Indexed: 02/06/2023]
Abstract
PURPOSE Endothelial dysfunction is an early and integral event in the development of atherosclerosis and coronary artery disease (CAD). Reduced NO bioavailability, oxidative stress, vasoconstriction, inflammation and senescence are all implicated in endothelial dysfunction. However, there are limited data examining associations between these pathways and direct in vivo bioassay measures of endothelial function in CAD patients. This study aimed to examine the relationships between in vivo measures of vascular function and the expression of atherogenic risk-modulating proteins in endothelial cells (ECs) isolated from the radial artery of CAD patients. METHODS Fifty-six patients with established CAD underwent trans-radial catheterization. Prior to catheterization, radial artery vascular function was assessed using a) flow-mediated dilation (FMD), and b) exercise-induced dilation in response to handgrip (HE%). Freshly isolated ECs were obtained from the radial artery during catheterization and protein content of eNOS, NAD(P)H oxidase subunit NOX2, NFκB, ET-1 and the senescence markers p53, p21 and p16 were evaluated alongside nitrotyrosine abundance and eNOS Ser1177 phosphorylation. RESULTS FMD was positively associated with eNOS Ser1177 phosphorylation (r = 0.290, P = 0.037), and protein content of p21 (r = 0.307, P = 0.027) and p16 (r = 0.426, P = 0.002). No associations were found between FMD and markers of oxidative stress, vasoconstriction or inflammation. In contrast to FMD, HE% was not associated with any of the EC proteins. CONCLUSION These data revealed a difference in the regulation of endothelium-dependent vasodilation measured in vivo between patients with CAD compared to previously reported data in subjects without a clinical diagnosis, suggesting that eNOS Ser1177 phosphorylation may be the key to maintain vasodilation in CAD patients.
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Tsugu T, Tanaka K, Nagatomo Y, Belsack D, Devos H, Buls N, Cosyns B, Argacha JF, De Maeseneer M, De Mey J. Impact of coronary bifurcation angle on computed tomography derived fractional flow reserve in coronary vessels with no apparent coronary artery disease. Eur Radiol 2023; 33:1277-1285. [PMID: 36114847 PMCID: PMC9889442 DOI: 10.1007/s00330-022-09125-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2022] [Revised: 07/04/2022] [Accepted: 08/19/2022] [Indexed: 02/04/2023]
Abstract
OBJECTIVES Computed tomography (CT) derived fractional flow reserve (FFRCT) decreases from the proximal to the distal part due to a variety of factors. The energy loss due to the bifurcation angle may potentially contribute to a progressive decline in FFRCT. However, the association of the bifurcation angle with FFRCT is still not entirely understood. This study aimed to investigate the impact of various bifurcation angles on FFRCT decline below the clinically crucial relevance of 0.80 in vessels with no apparent coronary artery disease (CAD). METHODS A total of 83 patients who underwent both CT angiography including FFRCT and invasive coronary angiography, exhibiting no apparent CAD were evaluated. ΔFFRCT was defined as the change in FFRCT from the proximal to the distal in the left anterior descending artery (LAD) and left circumflex artery (LCX). The bifurcation angle was calculated from three-dimensional volume rendered images. Vessel morphology and plaque characteristics were also assessed. RESULTS ΔFFRCT significantly correlated with the bifurcation angle (LAD angle, r = 0.35, p = 0.001; LCX angle, r = 0.26, p = 0.02) and vessel length (LAD angle, r = 0.30, p = 0.005; LCX angle, r = 0.49, p < 0.0001). In LAD, vessel length was the strongest predictor for distal FFRCT of ≤ 0.80 (β-coefficient = 0.55, p = 0.0003), immediately followed by the bifurcation angle (β-coefficient = 0.24, p = 0.02). The bifurcation angle was a good predictor for a distal FFRCT ≤ 0.80 (LAD angle, cut-off 31.0°, AUC 0.70, sensitivity 74%, specificity 68%; LCX angle, cut-off 52.6°, AUC 0.86, sensitivity 88%, specificity 85%). CONCLUSIONS In vessels with no apparent CAD, vessel length was the most influential factor on FFRCT, directly followed by the bifurcation angle. KEY POINTS • Both LAD and LCX bifurcation angles are factors influencing FFR CT. • Bifurcation angle is one of the predictors of a distal FFRCT of ≤ 0.80 and an optimal cut-off value of 31.0° for the LAD and 52.6° for the LCX. • Bifurcation angle should be taken into consideration when interpreting numerical values of FFRCT.
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Affiliation(s)
- Toshimitsu Tsugu
- Department of Radiology, Universitair Ziekenhuis Brussel, Laarbeeklaan 101, 1090 Jette, Brussels, Belgium
| | - Kaoru Tanaka
- Department of Radiology, Universitair Ziekenhuis Brussel, Laarbeeklaan 101, 1090 Jette, Brussels, Belgium
| | - Yuji Nagatomo
- Department of Cardiology, National Defense Medical College Hospital, Tokorozawa, Japan
| | - Dries Belsack
- Department of Radiology, Universitair Ziekenhuis Brussel, Laarbeeklaan 101, 1090 Jette, Brussels, Belgium
| | - Hannes Devos
- Department of Radiology, Universitair Ziekenhuis Brussel, Laarbeeklaan 101, 1090 Jette, Brussels, Belgium
| | - Nico Buls
- Department of Radiology, Universitair Ziekenhuis Brussel, Laarbeeklaan 101, 1090 Jette, Brussels, Belgium
| | - Bernard Cosyns
- Cardiology, Centrum voor Hart-en Vaatziekten, Universitair Ziekenhuis Brussel, Brussels, Belgium
| | - Jean-François Argacha
- Cardiology, Centrum voor Hart-en Vaatziekten, Universitair Ziekenhuis Brussel, Brussels, Belgium
| | - Michel De Maeseneer
- Department of Radiology, Universitair Ziekenhuis Brussel, Laarbeeklaan 101, 1090 Jette, Brussels, Belgium
| | - Johan De Mey
- Department of Radiology, Universitair Ziekenhuis Brussel, Laarbeeklaan 101, 1090 Jette, Brussels, Belgium
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The contemporaneous epidemic of chronic, copper deficiency. J Nutr Sci 2022; 11:e89. [PMID: 36304823 PMCID: PMC9554529 DOI: 10.1017/jns.2022.83] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2022] [Accepted: 08/24/2022] [Indexed: 12/14/2022] Open
Abstract
The classical deficiency diseases have nearly disappeared from the industrialised world and are thought to be found largely in sub-Saharan Africa and South Asia. More than 80 collected medical articles, mostly from Europe and North America, describe more than 9000 people with low concentrations of copper in organs or tissues or impaired metabolic pathways dependent on copper. More than a dozen articles reveal improved anatomy, chemistry or physiology in more than 1000 patients from supplements containing copper. These criteria are diagnostic of deficiency according to The Oxford Textbook of Medicine. Alzheimer's disease, ischaemic heart disease and osteoporosis receive major emphasis here. However, impaired vision, myelodysplastic syndrome and peripheral neuropathy are mentioned. Copper deficiency probably causes some common, contemporaneous diseases. Advice is provided about opportunities for research. Seemingly authoritative statements concerning the rarity of nutritional deficiency in developed countries are wrong.
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Lin A, van Diemen PA, Motwani M, McElhinney P, Otaki Y, Han D, Kwan A, Tzolos E, Klein E, Kuronuma K, Grodecki K, Shou B, Rios R, Manral N, Cadet S, Danad I, Driessen RS, Berman DS, Nørgaard BL, Slomka PJ, Knaapen P, Dey D. Machine Learning From Quantitative Coronary Computed Tomography Angiography Predicts Fractional Flow Reserve-Defined Ischemia and Impaired Myocardial Blood Flow. Circ Cardiovasc Imaging 2022; 15:e014369. [PMID: 36252116 PMCID: PMC10085569 DOI: 10.1161/circimaging.122.014369] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/22/2022] [Accepted: 09/13/2022] [Indexed: 12/27/2022]
Abstract
BACKGROUND A pathophysiological interplay exists between plaque morphology and coronary physiology. Machine learning (ML) is increasingly being applied to coronary computed tomography angiography (CCTA) for cardiovascular risk stratification. We sought to assess the performance of a ML score integrating CCTA-based quantitative plaque features for predicting vessel-specific ischemia by invasive fractional flow reserve (FFR) and impaired myocardial blood flow (MBF) by positron emission tomography (PET). METHODS This post-hoc analysis of the PACIFIC trial (Prospective Comparison of Cardiac Positron Emission Tomography/Computed Tomography [CT]' Single Photon Emission Computed Tomography/CT Perfusion Imaging and CT Coronary Angiography with Invasive Coronary Angiography) included 208 patients with suspected coronary artery disease who prospectively underwent CCTA' [15O]H2O PET, and invasive FFR. Plaque quantification from CCTA was performed using semiautomated software. An ML algorithm trained on the prospective NXT trial (484 vessels) was used to develop a ML score for the prediction of ischemia (FFR≤0.80), which was then evaluated in 581 vessels from the PACIFIC trial. Thereafter, the ML score was applied for predicting impaired hyperemic MBF (≤2.30 mL/min per g) from corresponding PET scans. The performance of the ML score was compared with CCTA reads and noninvasive FFR derived from CCTA (FFRCT). RESULTS One hundred thirty-nine (23.9%) vessels had FFR-defined ischemia, and 195 (33.6%) vessels had impaired hyperemic MBF. For the prediction of FFR-defined ischemia, the ML score yielded an area under the receiver-operating characteristic curve of 0.92, which was significantly higher than that of visual stenosis grade (0.84; P<0.001) and comparable with that of FFRCT (0.93; P=0.34). Quantitative percent diameter stenosis and low-density noncalcified plaque volume had the greatest ML feature importance for predicting FFR-defined ischemia. When applied for impaired MBF prediction, the ML score exhibited an area under the receiver-operating characteristic curve of 0.80; significantly higher than visual stenosis grade (area under the receiver-operating characteristic curve 0.74; P=0.02) and comparable with FFRCT (area under the receiver-operating characteristic curve 0.77; P=0.16). CONCLUSIONS An externally validated ML score integrating CCTA-based quantitative plaque features accurately predicts FFR-defined ischemia and impaired MBF by PET, performing superiorly to standard CCTA stenosis evaluation and comparably to FFRCT.
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Affiliation(s)
- Andrew Lin
- Biomedical Imaging Research Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Pepijn A. van Diemen
- Department of Cardiology, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - Manish Motwani
- Manchester Heart Centre, Manchester University NHS Foundation Trust, Manchester, United Kingdom
| | - Priscilla McElhinney
- Biomedical Imaging Research Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Yuka Otaki
- Department of Imaging and Medicine and the Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Donghee Han
- Department of Imaging and Medicine and the Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Alan Kwan
- Department of Imaging and Medicine and the Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Evangelos Tzolos
- Department of Imaging and Medicine and the Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA
- British Heart Foundation Centre for Cardiovascular Science, University of Edinburgh, United Kingdom
| | - Eyal Klein
- Department of Imaging and Medicine and the Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Keiichiro Kuronuma
- Department of Imaging and Medicine and the Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Kajetan Grodecki
- Biomedical Imaging Research Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Benjamin Shou
- Department of Imaging and Medicine and the Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Richard Rios
- Department of Medicine, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Nipun Manral
- Biomedical Imaging Research Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Sebastien Cadet
- Department of Imaging and Medicine and the Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Ibrahim Danad
- Department of Cardiology, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - Roel S. Driessen
- Department of Cardiology, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - Daniel S. Berman
- Department of Imaging and Medicine and the Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Bjarne L. Nørgaard
- Department of Cardiology, Aarhus University Hospital Skejby, Aarhus, Denmark
| | - Piotr J. Slomka
- Department of Medicine, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Paul Knaapen
- Department of Cardiology, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - Damini Dey
- Biomedical Imaging Research Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA
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Wang X, van den Hoogen IJ, Butcher SC, Kuneman JH, de Graaf MA, Kamperidis V, Boukes M, Maaniitty T, Schultz J, van Rosendael AR, Saraste A, Knuuti J, Bax JJ. Importance of plaque volume and composition for the prediction of myocardial ischaemia using sequential coronary computed tomography angiography/positron emission tomography imaging. Eur Heart J Cardiovasc Imaging 2022; 24:776-784. [PMID: 36047438 PMCID: PMC10229289 DOI: 10.1093/ehjci/jeac130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Accepted: 06/20/2022] [Indexed: 11/14/2022] Open
Abstract
AIMS Coronary atherosclerosis with a large necrotic core has been postulated to reduce the vasodilatory capacity of vascular tissue. In the present analysis, we explored whether total plaque volume and necrotic core volume on coronary computed tomography angiography (CCTA) are independently associated with myocardial ischaemia on positron emission tomography (PET). METHODS AND RESULTS From a registry of symptomatic patients with suspected coronary artery disease and clinically indicated CCTA with sequential [15O]H2O PET myocardial perfusion imaging, we quantitatively measured diameter stenosis, total and compositional plaque volumes on CCTA. Primary endpoint was myocardial ischaemia on PET, defined as an absolute stress myocardial blood flow ≤2.4 mL/g/min in ≥1 segment. Multivariable prediction models for myocardial ischaemia were consecutively created using logistic regression analysis (stenosis model: diameter stenosis ≥50%; plaque volume model: +total plaque volume; plaque composition model: +necrotic core volume). A total of 493 patients (mean age 63 ± 8 years, 54% men) underwent sequential CCTA/PET imaging. In 153 (31%) patients, myocardial ischaemia was detected on PET. Diameter stenosis ≥50% (P < 0.001) and necrotic core volume (P = 0.029) were independently associated with myocardial ischaemia, while total plaque volume showed borderline significance (P = 0.052). The plaque composition model (χ2 = 169) provided incremental value for the prediction of ischaemia when compared with the stenosis model (χ2 = 138, P < 0.001) and plaque volume model (χ2 = 164, P = 0.021). CONCLUSION The volume of necrotic core on CCTA independently and incrementally predicts myocardial ischaemia on PET, beyond diameter stenosis alone.
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Affiliation(s)
- Xu Wang
- Department of Cardiology, Leiden University Medical Center, Leiden, The Netherlands
- Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart Lung and Blood Vessel Disease, Beijing, China
| | | | - Steele C Butcher
- Department of Cardiology, Leiden University Medical Center, Leiden, The Netherlands
- Department of Cardiology, Royal Perth Hospital, Perth, Australia
| | - Jurrien H Kuneman
- Department of Cardiology, Leiden University Medical Center, Leiden, The Netherlands
| | - Michiel A de Graaf
- Department of Cardiology, Leiden University Medical Center, Leiden, The Netherlands
| | - Vasileios Kamperidis
- Department of Cardiology, Leiden University Medical Center, Leiden, The Netherlands
| | - Mark Boukes
- Department of Communication Science at the Amsterdam School of Communication Research, University of Amsterdam, Amsterdam, The Netherlands
| | - Teemu Maaniitty
- Turku PET Centre, Turku University Hospital and University of Turku, Turku, Finland
| | - Jussi Schultz
- Turku PET Centre, Turku University Hospital and University of Turku, Turku, Finland
| | | | - Antti Saraste
- Turku PET Centre, Turku University Hospital and University of Turku, Turku, Finland
- Heart Center, Turku University Hospital and University of Turku, Turku, Finland
| | - Juhani Knuuti
- Turku PET Centre, Turku University Hospital and University of Turku, Turku, Finland
- Heart Center, Turku University Hospital and University of Turku, Turku, Finland
| | - Jeroen J Bax
- Department of Cardiology, Leiden University Medical Center, Leiden, The Netherlands
- Heart Center, Turku University Hospital and University of Turku, Turku, Finland
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Yan H, Zhao N, Geng W, Hou Z, Gao Y, Lu B. The Perivascular Fat Attenuation Index Improves the Diagnostic Performance for Functional Coronary Stenosis. J Cardiovasc Dev Dis 2022; 9:jcdd9050128. [PMID: 35621839 PMCID: PMC9145749 DOI: 10.3390/jcdd9050128] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Revised: 04/18/2022] [Accepted: 04/20/2022] [Indexed: 11/19/2022] Open
Abstract
Background: Coronary computed tomography angiography (CCTA) is an established first-line test in the investigation of patients with suspected coronary artery disease (CAD), while the perivascular fat attenuation index (FAI) derived from CT seems to be a feasible and efficient tool for the identification of ischemia. The association between the FAI and lesion-specific ischemia as assessed by fractional flow reserve (FFR) remains unclear. Methods: In a total of 261 patients, 294 vessels were assessed for CCTA stenosis, vessel-specific FAI, lesion-specific FAI, and plaque characteristics. The diagnostic accuracies of each parameter and the combined approach were analyzed via the receiver operating characteristic curve (ROC) with FFR as the reference standard. The determinants of FAI were statistically analyzed. Results: The cutoff values of vessel-specific FAI and lesion-specific FAI scores calculated according to the Youden index were −70.97 and −73.95 HU, respectively. No significant differences were noted between them; however, they exhibited a strong correlation. No significant differences were noted between the area under the curve (AUC) scores of vessel-specific FAI (0.677), lesion-specific FAI (0.665), and CCTA (0.607) (p > 0.05 for all) results. The addition of two FAI measures to the CCTA showed improvements in the discrimination (AUC) and reclassification ability (relative integrated discrimination improvement (IDI) and category-free net reclassification index (NRI)), vessel-specific FAI (AUC, 0.696; NRI, 49.6%; IDI, 5.9%), and lesion-specific FAI scores (AUC, 0.676; NRI, 43.3%; IDI, 5.4%); (p < 0.01 for all). Multivariate analysis revealed that low-attenuation plaque (LAP) volume was an independent predictor of two FAI measures. Conclusion: The combined approach of adding vessel-specific FAI or lesion-specific FAI scores could improve the identification of ischemia compared with CCTA alone. The LAP volume was the independent risk factor for both tools.
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Affiliation(s)
| | | | | | | | - Yang Gao
- Correspondence: (Y.G.); or (B.L.); Tel.: +86-10-8839-2656 (Y.G. & B.L.); Fax: +86-10-6831-3012 (Y.G. & B.L.)
| | - Bin Lu
- Correspondence: (Y.G.); or (B.L.); Tel.: +86-10-8839-2656 (Y.G. & B.L.); Fax: +86-10-6831-3012 (Y.G. & B.L.)
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10
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Paapstel K, Kals J. Metabolomics of Arterial Stiffness. Metabolites 2022; 12:370. [PMID: 35629874 PMCID: PMC9146333 DOI: 10.3390/metabo12050370] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2022] [Revised: 04/15/2022] [Accepted: 04/18/2022] [Indexed: 12/18/2022] Open
Abstract
Arterial stiffness (AS) is one of the earliest detectable signs of structural and functional alterations of the vessel wall and an independent predictor of cardiovascular events and death. The emerging field of metabolomics can be utilized to detect a wide spectrum of intermediates and products of metabolism in body fluids that can be involved in the pathogenesis of AS. Research over the past decade has reinforced this idea by linking AS to circulating acylcarnitines, glycerophospholipids, sphingolipids, and amino acids, among other metabolite species. Some of these metabolites influence AS through traditional cardiovascular risk factors (e.g., high blood pressure, high blood cholesterol, diabetes, smoking), while others seem to act independently through both known and unknown pathophysiological mechanisms. We propose the term 'arteriometabolomics' to indicate the research that applies metabolomics methods to study AS. The 'arteriometabolomics' approach has the potential to allow more personalized cardiovascular risk stratification, disease monitoring, and treatment selection. One of its major goals is to uncover the causal metabolic pathways of AS. Such pathways could represent valuable treatment targets in vascular ageing.
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Affiliation(s)
- Kaido Paapstel
- Endothelial Research Centre, University of Tartu, 8 Puusepa Street, 51014 Tartu, Estonia;
- Department of Cardiology, Institute of Clinical Medicine, University of Tartu, 8 Puusepa Street, 51014 Tartu, Estonia
- Heart Clinic, Tartu University Hospital, 8 Puusepa Street, 51014 Tartu, Estonia
| | - Jaak Kals
- Endothelial Research Centre, University of Tartu, 8 Puusepa Street, 51014 Tartu, Estonia;
- Department of Surgery, Institute of Clinical Medicine, University of Tartu, 8 Puusepa Street, 51014 Tartu, Estonia
- Surgery Clinic, Tartu University Hospital, 8 Puusepa Street, 51014 Tartu, Estonia
- Department of Biochemistry, Institute of Biomedicine and Translational Medicine, Centre of Excellence for Genomics and Translational Medicine, University of Tartu, 19 Ravila Street, 50411 Tartu, Estonia
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11
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The Role of von Willebrand Factor Antigen in Predicting Survival of Patients with HBV-Related Cirrhosis. Can J Gastroenterol Hepatol 2022; 2022:9035971. [PMID: 35360443 PMCID: PMC8964228 DOI: 10.1155/2022/9035971] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/22/2021] [Revised: 02/20/2022] [Accepted: 03/01/2022] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVE The model for end-stage liver disease (MELD) scoring system cannot be used to assess the deterioration of patients with liver cirrhosis caused by infection and portal hypertension. Elevated von Willebrand factor antigen (vWF-Ag) in plasma is associated with portal pressure and complications in patients with liver cirrhosis. We aimed to evaluate whether the addition of vWF-Ag can improve the risk prediction ability of the MELD scoring system. METHODS A total of 228 patients with hepatitis B virus (HBV)-related liver cirrhosis were eligible for inclusion in this retrospective study. The vWF-Ag level was assessed by enzyme-linked immunosorbent assay (ELISA). The endpoint of this study was defined as the time to liver transplantation or death. Univariate and multivariate analyses were performed to assess the risk factors associated with transplant-free mortality. Receiver operating characteristic (ROC) curve analysis was used to assess potential discriminatory variables for transplant-free mortality. RESULTS During a median follow-up interval of 30.23 months, 124 patients (54.4%) reached the endpoint of this study. Patients who died or underwent liver transplantation had elevated levels of MELD and vWF-Ag. Moreover, vWF-Ag and MELD showed comparable predictive potential for transplant-free survival (area under the curve [AUC], vWF-Ag = 0.71; AUC, MELD = 0.73). Ultimately, vWF-Ag can significantly improve the predictive potential of MELD in determining transplant-free mortality (AUC, MELD-vWF-Ag = 0.79, P = 0.006). CONCLUSION An elevated vWF-Ag level was independently associated with transplant-free mortality in patients with liver cirrhosis. The inclusion of vWF-Ag in the MELD scoring system can improve mortality predictions in patients with liver cirrhosis.
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12
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Buliga-Finis ON, Ouatu A, Badescu MC, Dima N, Tanase DM, Richter P, Rezus C. Beyond the Cardiorenal Syndrome: Pathophysiological Approaches and Biomarkers for Renal and Cardiac Crosstalk. Diagnostics (Basel) 2022; 12:diagnostics12040773. [PMID: 35453821 PMCID: PMC9028970 DOI: 10.3390/diagnostics12040773] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Revised: 03/17/2022] [Accepted: 03/19/2022] [Indexed: 02/04/2023] Open
Abstract
Cardiorenal syndrome encompasses complex multifactorial facets and carries significant morbidity and mortality worldwide. The bi-directional relationship between the heart and kidneys, where dysfunction in one organ worsens the function of the other, has been the leading motor for research in the last few years. In the pathophysiological process, small noncoding RNAs, epigenetics, vascular growth factors, oxidative stress, hemodynamic factors, and biomarkers play a pivotal role in the development of cardiorenal syndrome. It is therefore important to elucidate all the mechanisms in order to provide diagnostic and treatments tools. This review summarizes the hemodynamic and non-hemodynamic pathways along with biomarkers that could be the next target for diagnosis, treatment, and prognosis in cardiorenal syndrome.
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Affiliation(s)
- Oana Nicoleta Buliga-Finis
- Department of Internal Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, Romania; (O.N.B.-F.); (M.C.B.); (N.D.); (D.M.T.); (C.R.)
- Internal Medicine Clinic, “Sf. Spiridon” County Clinical Emergency Hospital, 700111 Iasi, Romania
| | - Anca Ouatu
- Department of Internal Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, Romania; (O.N.B.-F.); (M.C.B.); (N.D.); (D.M.T.); (C.R.)
- Internal Medicine Clinic, “Sf. Spiridon” County Clinical Emergency Hospital, 700111 Iasi, Romania
- Correspondence: ; Tel.: +40-722899045
| | - Minerva Codruta Badescu
- Department of Internal Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, Romania; (O.N.B.-F.); (M.C.B.); (N.D.); (D.M.T.); (C.R.)
- Internal Medicine Clinic, “Sf. Spiridon” County Clinical Emergency Hospital, 700111 Iasi, Romania
| | - Nicoleta Dima
- Department of Internal Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, Romania; (O.N.B.-F.); (M.C.B.); (N.D.); (D.M.T.); (C.R.)
- Internal Medicine Clinic, “Sf. Spiridon” County Clinical Emergency Hospital, 700111 Iasi, Romania
| | - Daniela Maria Tanase
- Department of Internal Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, Romania; (O.N.B.-F.); (M.C.B.); (N.D.); (D.M.T.); (C.R.)
- Internal Medicine Clinic, “Sf. Spiridon” County Clinical Emergency Hospital, 700111 Iasi, Romania
| | - Patricia Richter
- Department of Rheumatology and Physiotherapy, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, Romania;
- Rheumatology Clinic, Clinical Rehabilitation Hospital, 700661 Iasi, Romania
| | - Ciprian Rezus
- Department of Internal Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, Romania; (O.N.B.-F.); (M.C.B.); (N.D.); (D.M.T.); (C.R.)
- Internal Medicine Clinic, “Sf. Spiridon” County Clinical Emergency Hospital, 700111 Iasi, Romania
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13
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Tong M, Zheng Q, Zhu Y. Reply to Li et al. J Infect Dis 2021; 223:179-180. [PMID: 33049030 DOI: 10.1093/infdis/jiaa643] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2020] [Accepted: 10/12/2020] [Indexed: 11/13/2022] Open
Affiliation(s)
- Ming Tong
- Institute of Emergency Medicine, Hunan Provincial Key Laboratory of Emergency and Critical Care Metabonomics, The First-Affiliated Hospital of Hunan Normal University (Hunan Provincial People's Hospital), Changsha, Hunan, China.,Department of Infectious Diseases, The First-Affiliated Hospital of Hunan Normal University (Hunan Provincial People's Hospital), Changsha, Hunan, China
| | - Qing Zheng
- Department of Geriatrics, The First-Affiliated Hospital of Hunan Normal University (Hunan Provincial People's Hospital), Changsha, Hunan, China
| | - Yimin Zhu
- Institute of Emergency Medicine, Hunan Provincial Key Laboratory of Emergency and Critical Care Metabonomics, The First-Affiliated Hospital of Hunan Normal University (Hunan Provincial People's Hospital), Changsha, Hunan, China
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14
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Deidda M, Noto A, Cadeddu Dessalvi C, Andreini D, Andreotti F, Ferrannini E, Latini R, Maggioni AP, Magnoni M, Maseri A, Mercuro G. Metabolomic correlates of coronary atherosclerosis, cardiovascular risk, both or neither. Results of the 2 × 2 phenotypic CAPIRE study. Int J Cardiol 2021; 336:14-21. [PMID: 34022320 DOI: 10.1016/j.ijcard.2021.05.033] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2021] [Revised: 05/11/2021] [Accepted: 05/17/2021] [Indexed: 12/22/2022]
Abstract
BACKGROUND Traditional cardiovascular risk factors (RFs) and coronary artery disease (CAD) do not always run parallel. We investigated functional-metabolic correlations of CAD, RFs, or neither in the CAPIRE (Coronary Atherosclerosis in Outlier Subjects: Protective and Novel Individual Risk Factors Evaluation) 2 × 2 phenotypic observational study. METHODS Two hundred and fortyone subjects were included based on RF burden, presence/absence of CAD (assessed by computed tomography angiography), age and sex. Participants displayed one of four phenotypes: CAD with ≥3 RFs, no-CAD with ≥3 RFs, CAD with ≤1 RF and no-CAD with ≤1 RF. Metabolites were identified by gas chromatography-mass spectrometry and pathways by metabolite set enrichment analysis. RESULTS Characteristic patterns and specific pathways emerged for each phenotypic group: amino sugars for CAD/high-RF; urea cycle for no-CAD/high-RF; glutathione for CAD/low-RF; glycine and serine for no-CAD/low-RF. Presence of CAD correlated with ammonia recycling; absence of CAD with the transfer of acetyl groups into mitochondria; high-risk profile with alanine metabolism (all p < 0.05). The comparative case-control analyses showed a statistically significant difference for the two pathways of phenylalanine, tyrosine and tryptophan biosynthesis and phenylalanine metabolism in the CAD/Low-RF vs NoCAD/Low-RF comparison. CONCLUSIONS The present 2 × 2 observational study identified specific metabolic pathways for each of the four phenotypes, providing novel functional insights, particularly on CAD with low RF profiles and on the absence of CAD despite high-risk factor profiles.
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Affiliation(s)
- Martino Deidda
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Antonio Noto
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | | | - Daniele Andreini
- Centro Cardiologico Monzino, IRCCS, Milan, Italy; Department of Clinical Sciences and Community Health, Cardiovascular Section, University of Milan, Italy
| | - Felicita Andreotti
- Cardiovascular Medicine, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
| | | | - Roberto Latini
- Mario Negri Institute of Pharmacological Research, IRCCS, Milan, Italy
| | - Aldo P Maggioni
- ANMCO Research Center, Heart Care Foundation, Florence, Italy; Maria Cecilia Hospital, GVM Care & Research, Cotignola, Italy
| | - Marco Magnoni
- IRCCS Ospedale San Raffaele and Università Vita-Salute San Raffaele, Milan, Italy
| | | | - Giuseppe Mercuro
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy.
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15
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Sharma A, Choi JSY, Stefanovic N, Al-Sharea A, Simpson DS, Mukhamedova N, Jandeleit-Dahm K, Murphy AJ, Sviridov D, Vince JE, Ritchie RH, de Haan JB. Specific NLRP3 Inhibition Protects Against Diabetes-Associated Atherosclerosis. Diabetes 2021; 70:772-787. [PMID: 33323396 DOI: 10.2337/db20-0357] [Citation(s) in RCA: 76] [Impact Index Per Article: 25.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2020] [Accepted: 12/01/2020] [Indexed: 11/13/2022]
Abstract
Low-grade persistent inflammation is a feature of diabetes-driven vascular complications, in particular activation of the Nod-like receptor family pyrin domain containing 3 (NLRP3) inflammasome to trigger the maturation and release of the inflammatory cytokine interleukin-1β (IL-1β). We investigated whether inhibiting the NLRP3 inflammasome, through the use of the specific small-molecule NLRP3 inhibitor MCC950, could reduce inflammation, improve vascular function, and protect against diabetes-associated atherosclerosis in the streptozotocin-induced diabetic apolipoprotein E-knockout mouse. Diabetes led to an approximately fourfold increase in atherosclerotic lesions throughout the aorta, which were significantly attenuated with MCC950 (P < 0.001). This reduction in lesions was associated with decreased monocyte-macrophage content, reduced necrotic core, attenuated inflammatory gene expression (IL-1β, tumor necrosis factor-α, intracellular adhesion molecule 1, and MCP-1; P < 0.05), and reduced oxidative stress, while maintaining fibrous cap thickness. Additionally, vascular function was improved in diabetic vessels of mice treated with MCC950 (P < 0.05). In a range of cell lines (murine bone marrow-derived macrophages, human monocytic THP-1 cells, phorbol 12-myristate 13-acetate-differentiated human macrophages, and aortic smooth muscle cells from humans with diabetes), MCC950 significantly reduced IL-1β and/or caspase-1 secretion and attenuated leukocyte-smooth muscle cell interactions under high glucose or lipopolysaccharide conditions. In summary, MCC950 reduces plaque development, promotes plaque stability, and improves vascular function, suggesting that targeting NLRP3-mediated inflammation is a novel therapeutic strategy to improve diabetes-associated vascular disease.
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Affiliation(s)
- Arpeeta Sharma
- Baker Heart and Diabetes Institute, Melbourne, Victoria, Australia
- Department of Diabetes, Central Clinical School, Monash University, Melbourne, Victoria, Australia
| | - Judy S Y Choi
- Baker Heart and Diabetes Institute, Melbourne, Victoria, Australia
| | - Nada Stefanovic
- Baker Heart and Diabetes Institute, Melbourne, Victoria, Australia
| | - Annas Al-Sharea
- Baker Heart and Diabetes Institute, Melbourne, Victoria, Australia
| | - Daniel S Simpson
- Walter and Eliza Hall Institute of Medical Research, Parkville, Victoria, Australia
- Department of Medical Biology, The University of Melbourne, Parkville, Victoria, Australia
| | | | - Karin Jandeleit-Dahm
- Department of Diabetes, Central Clinical School, Monash University, Melbourne, Victoria, Australia
- German Diabetes Center, Leibniz Center for Diabetes Research, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | - Andrew J Murphy
- Baker Heart and Diabetes Institute, Melbourne, Victoria, Australia
| | - Dmitri Sviridov
- Baker Heart and Diabetes Institute, Melbourne, Victoria, Australia
| | - James E Vince
- Walter and Eliza Hall Institute of Medical Research, Parkville, Victoria, Australia
- Department of Medical Biology, The University of Melbourne, Parkville, Victoria, Australia
| | - Rebecca H Ritchie
- Baker Heart and Diabetes Institute, Melbourne, Victoria, Australia
- Drug Discovery Biology, Monash Institute of Pharmaceutical Sciences, Monash University, Parkville, Victoria, Australia
| | - Judy B de Haan
- Baker Heart and Diabetes Institute, Melbourne, Victoria, Australia
- Department of Immunology and Pathology, Central Clinical School, Monash University, Melbourne, Victoria, Australia
- Department of Physiology, Anatomy and Microbiology, La Trobe University, Melbourne, Victoria, Australia
- Faculty of Science, Engineering and Technology, Swinburne University, Melbourne, Victoria, Australia
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Fan Gaskin JC, Shah MH, Chan EC. Oxidative Stress and the Role of NADPH Oxidase in Glaucoma. Antioxidants (Basel) 2021; 10:antiox10020238. [PMID: 33557289 PMCID: PMC7914994 DOI: 10.3390/antiox10020238] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2020] [Revised: 01/25/2021] [Accepted: 01/29/2021] [Indexed: 02/08/2023] Open
Abstract
Glaucoma is characterised by loss of retinal ganglion cells, and their axons and many pathophysiological processes are postulated to be involved. It is increasingly understood that not one pathway underlies glaucoma aetiology, but rather they occur as a continuum that ultimately results in the apoptosis of retinal ganglion cells. Oxidative stress is recognised as an important mechanism of cell death in many neurodegenerative diseases, including glaucoma. NADPH oxidase (NOX) are enzymes that are widely expressed in vascular and non-vascular cells, and they are unique in that they primarily produce reactive oxygen species (ROS). There is mounting evidence that NOX are an important source of ROS and oxidative stress in glaucoma and other retinal diseases. This review aims to provide a perspective on the complex role of oxidative stress in glaucoma, in particular how NOX expression may influence glaucoma pathogenesis as illustrated by different experimental models of glaucoma and highlights potential therapeutic targets that may offer a novel treatment option to glaucoma patients.
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Affiliation(s)
- Jennifer C Fan Gaskin
- Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital, East Melbourne 3002, Australia
| | - Manisha H Shah
- Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital, East Melbourne 3002, Australia
| | - Elsa C Chan
- Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital, East Melbourne 3002, Australia
- Department of Medicine, University of Melbourne, Parkville 3010, Australia
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17
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How atherosclerosis defines ischemia: Atherosclerosis quantification and characterization as a method for determining ischemia. J Cardiovasc Comput Tomogr 2020; 14:394-399. [DOI: 10.1016/j.jcct.2019.10.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2019] [Revised: 10/04/2019] [Accepted: 10/27/2019] [Indexed: 01/23/2023]
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Progerin Expression Induces Inflammation, Oxidative Stress and Senescence in Human Coronary Endothelial Cells. Cells 2020; 9:cells9051201. [PMID: 32408587 PMCID: PMC7290406 DOI: 10.3390/cells9051201] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2020] [Revised: 05/06/2020] [Accepted: 05/09/2020] [Indexed: 12/16/2022] Open
Abstract
Hutchinson–Gilford progeria syndrome (HGPS) is a rare premature aging disorder notably characterized by precocious and deadly atherosclerosis. Almost 90% of HGPS patients carry a LMNA p.G608G splice variant that leads to the expression of a permanently farnesylated abnormal form of prelamin-A, referred to as progerin. Endothelial dysfunction is a key determinant of atherosclerosis, notably during aging. Previous studies have shown that progerin accumulates in HGPS patients’ endothelial cells but also during vascular physiological aging. However, whether progerin expression in human endothelial cells can recapitulate features of endothelial dysfunction is currently unknown. Herein, we evaluated the direct impact of exogenously expressed progerin and wild-type lamin-A on human endothelial cell function and senescence. Our data demonstrate that progerin, but not wild-type lamin-A, overexpression induces endothelial cell dysfunction, characterized by increased inflammation and oxidative stress together with persistent DNA damage, increased cell cycle arrest protein expression and cellular senescence. Inhibition of progerin prenylation using a pravastatin–zoledronate combination partly prevents these defects. Our data suggest a direct proatherogenic role of progerin in human endothelial cells, which could contribute to HGPS-associated early atherosclerosis and also potentially be involved in physiological endothelial aging participating to age-related cardiometabolic diseases.
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Toya T, Sara JD, Corban MT, Taher R, Godo S, Herrmann J, Lerman LO, Lerman A. Assessment of peripheral endothelial function predicts future risk of solid-tumor cancer. Eur J Prev Cardiol 2020; 27:608-618. [PMID: 31668110 DOI: 10.1177/2047487319884246] [Citation(s) in RCA: 37] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
AIMS Cardiovascular health metrics predict the risk not only of cardiovascular diseases but also of several types of cancers. Microvascular endothelial dysfunction can predict future cardiovascular adverse events, but the predictive value of microvascular endothelial dysfunction for future risk of solid-tumor cancer has not been characterized. METHODS A total of 488 patients who underwent microvascular endothelial function assessment using reactive hyperemia peripheral arterial tonometry were included in this study. Microvascular endothelial dysfunction was defined as a reactive hyperemia peripheral arterial tonometry index ≤2.0. RESULTS Of 221 patients with a baseline reactive hyperemia peripheral arterial tonometry index ≤2.0, 21 patients (9.5%) were diagnosed with incident solid-tumor cancer during follow-up, whereas of 267 patients with a baseline reactive hyperemia peripheral arterial tonometry index >2.0, 10 patients (3.7%) were diagnosed with incident solid-tumor cancer during follow-up (p = 0.009). Patients with a reactive hyperemia peripheral arterial tonometry index ≤2.0 had lower solid-tumor cancer-free survival compared to patients with a reactive hyperemia peripheral arterial tonometry index >2.0 (log-rank p = 0.017) (median follow-up 6.0 (3.0-9.1) years). Cox proportional hazard analyses showed that a reactive hyperemia peripheral arterial tonometry index ≤2.0 predicted the incidence of solid-tumor cancer, with a hazard ratio of 2.52 (95% confidence interval 1.17-5.45; p = 0.019) after adjusting for age, sex, and coronary artery disease, 2.83 (95% confidence interval 1.30-6.17; p = 0.009) after adjusting for diabetes mellitus, hypertension, smoking status, and body mass index >30 kg/m2, 2.79 (95% confidence interval 1.21-6.41; p = 0.016) after adjusting for fasting plasma glucose, systolic blood pressure, smoking status (current or former), and body mass index, and 2.43 (95% confidence interval 1.10-5.34; p = 0.028) after adjusting for Framingham risk score. CONCLUSION Microvascular endothelial dysfunction, as defined by a reactive hyperemia peripheral arterial tonometry index ≤2.0, was associated with a greater than two-fold increased risk of solid-tumor cancer. Microvascular endothelial dysfunction may be a useful marker to predict the future risk of solid-tumor cancer, in addition to its known ability to predict cardiovascular disease. Further research is necessary to develop adequate cancer screening strategies for patients with microvascular endothelial dysfunction.
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Affiliation(s)
- Takumi Toya
- Department of Cardiovascular Medicine, Mayo Clinic, USA
- Division of Cardiology, National Defense Medical College, Japan
| | | | | | - Riad Taher
- Department of Cardiovascular Medicine, Mayo Clinic, USA
| | - Shigeo Godo
- Department of Cardiovascular Medicine, Mayo Clinic, USA
| | | | | | - Amir Lerman
- Department of Cardiovascular Medicine, Mayo Clinic, USA
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20
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Noninvasive Quantitative Plaque Analysis Identifies Hemodynamically Significant Coronary Arteries Disease. J Thorac Imaging 2020; 36:102-107. [PMID: 32168164 DOI: 10.1097/rti.0000000000000494] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To evaluate the diagnostic performance of automated quantitative analysis by coronary computed tomography angiography (CCTA) in identifying lesion-specific hemodynamic abnormality. METHODS A total of 132 patients (mean age, 61 y; 86 men) with 169 vessels (with 30% to 90% diameter stenosis), who successively underwent invasive coronary angiography with evaluation of fractional flow reserve (values ≤0.8 were defined as lesion-specific hemodynamic abnormalities), were analyzed by CCTA. CCTA images were quantitatively analyzed using automated software to obtain the following index: maximum diameter stenosis (MDS%); maximum area stenosis (MAS%); lesion length (LL); volume and burden (plaque volume×100 per vessel volume) of total plaque (total plaque volume [TPV], total plaque burden [TPB]), calcified plaque (calcified plaque volume [CPV], calcified plaque volume burden [CPB]), noncalcified plaque (noncalcified plaque volume [NCPV], noncalcified plaque volume burden [NCPB]), lipid plaque (lipid plaque volume [LPV], lipid plaque burden [LPB]), and fibrous plaque (fibrotic plaque volume [FPV], fibrotic plaque burden [FPB]); napkin-ring sign (NRS); remodeling index (RI); and eccentric index (EI). Logistic regression and area under the receiver operating characteristics (AUC) were used for statistical analysis. RESULTS Fractional flow reserve ≤0.80 was found in 57 (33.73%) of the 169 vessels. Vessels with hemodynamic significance had greater MDS% (64.43%±8.69% vs. 57.33%±9.95%, P<0.001), MAS% (73.18%±8.56% vs. 64.66%±8.95%, P<0.001), and lipid plaque burden (12.75% [9.73%, 19.56%] vs. 9.41% [4.10%, 15.70%], P=0.01) compared with vessels with normal hemodynamics. In multivariable logistic regression analysis, MAS% >68% (odds ratio: 7.20, 95% confidence interval [CI]=2.89-17.91, P<0.001) and LPB >10.03% (odds ratio=4.32, 95% CI=1.36-13.66, P=0.01) were significant predictors of hemodynamic abnormalities. In predicting lesion-specific hemodynamic abnormalities, the AUC was 0.77 (95% CI=0.70-0.85) for MAS% versus 0.71 (95% CI=0.63-0.79) for MDS% (P<0.05), 0.66 (95% CI=0.58-0.74) for LPV (P<0.05), 0.66 (95% CI=0.58-0.74) for LPB (P<0.05), and 0.63 (95% CI=0.54-0.71) for TPB (P<0.05). The AUC of MAS%+LPB (0.83, 95% CI=0.76-0.89) was significantly improved compared with that of MAS% (0.77, 95% CI=0.70-0.85, P<0.05). CONCLUSIONS Compared with MDS% and the volume burdens of plaque compositions, MAS% has a higher diagnostic accuracy for coronary hemodynamic abnormalities in the precise quantitative analysis of coronary plaques on the basis of CT. Furthermore, MAS%+LPB might improve the diagnostic accuracy beyond MAS% alone.
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21
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Ko SM. Evaluation of Myocardial Ischemia Using Coronary Computed Tomography Angiography in Patients with Stable Angina. JOURNAL OF THE KOREAN SOCIETY OF RADIOLOGY 2020; 81:250-271. [PMID: 36237390 PMCID: PMC9431814 DOI: 10.3348/jksr.2020.81.2.250] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/11/2020] [Revised: 03/20/2020] [Accepted: 03/29/2020] [Indexed: 11/20/2022]
Abstract
안정형 협심증 환자에서 관상동맥질환의 치료 여부를 결정하고 임상 결과를 예측하기 위해서는 심근허혈의 평가가 중요하다. 현재 심근허혈 진단의 표준검사법으로 분획혈류예비력 검사법이 인정되나 침습적 검사라는 제한점이 있다. 또한, 관상동맥 전산화단층촬영은 형태적인 관상동맥질환 진단에 유용한 방법으로 정립되었지만, 혈역학적으로 유의한 협착에 의한 심근허혈 진단에는 한계가 있다. 최근 이러한 문제를 해결하고자 관상동맥 전산화단층촬영 영상을 기반으로 측정한 관상동맥 죽상경화판의 정량화, 심근관류, 그리고 심근 분획혈류예비력을 이용한 연구들이 진행되어 왔고, 그 진단적 가치를 점차 인정받고 있다. 본 종설에서는 심근허혈진단과 관련된 관상동맥 전산화단층촬영 혈관조영술의 여러 영상기법들에 대해서 알아보고자 한다.
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Affiliation(s)
- Sung Min Ko
- Department of Radiology, Yonsei University Wonju College of Medicine, Wonju Severance Christian Hospital, Wonju, Korea
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22
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Shin YK, Han AY, Hsieh YS, Kwon S, Kim J, Lee KW, Seol GH. Lancemaside A from Codonopsis lanceolata prevents hypertension by inhibiting NADPH oxidase 2-mediated MAPK signalling and improving NO bioavailability in rats. ACTA ACUST UNITED AC 2019; 71:1458-1468. [PMID: 31350796 DOI: 10.1111/jphp.13140] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2019] [Accepted: 06/30/2019] [Indexed: 12/22/2022]
Abstract
OBJECTIVES This study investigated whether lancemaside A (LMA) can prevent hypertension and assessed the mechanisms of action of LMA in rats. METHODS Hypertension was induced by chronic immobilization stress and nicotine administration. Hypertensive vehicle rats were treated with LMA (1, 20, or 40 mg/kg) or nifedipine (10 mg/kg) as a positive control daily for 3 weeks. KEY FINDINGS In hypertensive vehicle rats, LMA dose-dependently reduced systolic blood pressure. LMA doses of 20 and 40 mg/kg reduced the aortic expression of nicotinamide adenine dinucleotide phosphate oxidase (NOX)2 (both P < 0.01), and 40 mg/kg LMA reduced serum malondialdehyde (P < 0.01). Serum nitrite levels were significantly higher in LMA treated rats than in hypertensive vehicle rats, with LMA doses of 20 and 40 mg/kg reducing the expression of endothelial nitric oxide synthase in rat aortas (P < 0.001 and P < 0.01, respectively). LMA also reduced the aortic levels of nuclear factor kappa B and the activation of the three isoforms of mitogen-activated protein kinase (MAPK). CONCLUSIONS Lancemaside A prevents hypertension in rats by inhibiting the activation of MAPK signalling and the impairment in nitric oxide bioavailability due to NOX2-mediated oxidative stress. Thus, LMA may act as a preventive agent for hypertension.
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Affiliation(s)
- You Kyoung Shin
- Department of Basic Nursing Science, College of Nursing, Korea University, Seoul, Republic of Korea
| | - A Young Han
- Department of Basic Nursing Science, College of Nursing, Korea University, Seoul, Republic of Korea
| | - Yu Shan Hsieh
- Department of Basic Nursing Science, College of Nursing, Korea University, Seoul, Republic of Korea
| | - Soonho Kwon
- Department of Basic Nursing Science, College of Nursing, Korea University, Seoul, Republic of Korea
| | - Jinhye Kim
- Department of Biotechnology, College of Life Science and Biotechnology, Korea University, Seoul, Republic of Korea
| | - Kwang-Won Lee
- Department of Biotechnology, College of Life Science and Biotechnology, Korea University, Seoul, Republic of Korea
| | - Geun Hee Seol
- Department of Basic Nursing Science, College of Nursing, Korea University, Seoul, Republic of Korea
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23
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van Assen M, Varga-Szemes A, Schoepf UJ, Duguay TM, Hudson HT, Egorova S, Johnson K, St Pierre S, Zaki B, Oudkerk M, Vliegenthart R, Buckler AJ. Automated plaque analysis for the prognostication of major adverse cardiac events. Eur J Radiol 2019; 116:76-83. [PMID: 31153577 DOI: 10.1016/j.ejrad.2019.04.013] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2019] [Revised: 03/26/2019] [Accepted: 04/21/2019] [Indexed: 01/17/2023]
Abstract
OBJECTIVE The purpose of this study is to assess the value of an automated model-based plaque characterization tool for the prediction of major adverse cardiac events (MACE). METHODS We retrospectively included 45 patients with suspected coronary artery disease of which 16 (33%) experienced MACE within 12 months. Commercially available plaque quantification software was used to automatically extract quantitative plaque morphology: lumen area, wall area, stenosis percentage, wall thickness, plaque burden, remodeling ratio, calcified area, lipid rich necrotic core (LRNC) area and matrix area. The measurements were performed at all cross sections, spaced at 0.5 mm, based on fully 3D segmentations of lumen, wall, and each tissue type. Discriminatory power of these markers and traditional risk factors for predicting MACE were assessed. RESULTS Regression analysis using clinical risk factors only resulted in a prognostic accuracy of 63% with a corresponding area under the curve (AUC) of 0.587. Based on our plaque morphology analysis, minimal cap thickness, lesion length, LRNC volume, maximal wall area/thickness, the remodeling ratio, and the calcium volume were included into our prognostic model as parameters. The use of morphologic features alone resulted in an increased accuracy of 77% with an AUC of 0.94. Combining both clinical risk factors and morphological features in a multivariate logistic regression analysis increased the accuracy to 87% with a similar AUC of 0.924. CONCLUSION An automated model based algorithm to evaluate CCTA-derived plaque features and quantify morphological features of atherosclerotic plaque increases the ability for MACE prognostication significantly compared to the use of clinical risk factors alone.
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Affiliation(s)
- Marly van Assen
- Division of Cardiovascular Imaging, Department of Radiology and Radiological Science, Medical University of South Carolina, Charleston, SC, USA; University of Groningen, University Medical Center Groningen, Center for Medical Imaging, Groningen, the Netherlands.
| | - Akos Varga-Szemes
- Division of Cardiovascular Imaging, Department of Radiology and Radiological Science, Medical University of South Carolina, Charleston, SC, USA.
| | - U Joseph Schoepf
- Division of Cardiovascular Imaging, Department of Radiology and Radiological Science, Medical University of South Carolina, Charleston, SC, USA.
| | - Taylor M Duguay
- Division of Cardiovascular Imaging, Department of Radiology and Radiological Science, Medical University of South Carolina, Charleston, SC, USA.
| | - H Todd Hudson
- Division of Cardiovascular Imaging, Department of Radiology and Radiological Science, Medical University of South Carolina, Charleston, SC, USA.
| | | | | | | | - Beatrice Zaki
- Division of Cardiovascular Imaging, Department of Radiology and Radiological Science, Medical University of South Carolina, Charleston, SC, USA.
| | - Matthijs Oudkerk
- University of Groningen, University Medical Center Groningen, Center for Medical Imaging, Groningen, the Netherlands.
| | - Rozemarijn Vliegenthart
- Division of Cardiovascular Imaging, Department of Radiology and Radiological Science, Medical University of South Carolina, Charleston, SC, USA; University of Groningen, University Medical Center Groningen, Center for Medical Imaging, Groningen, the Netherlands; University of Groningen, University Medical Center Groningen, Department of Radiology, Groningen, the Netherlands.
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Asleh R, Levy AP, Levy NS, Asleh A, Goldenstein H, Segol I, Gulati R, Lerman LO, Lerman A. Haptoglobin Phenotype Is Associated With High-Density Lipoprotein–Bound Hemoglobin Content and Coronary Endothelial Dysfunction in Patients With Mild Nonobstructive Coronary Artery Disease. Arterioscler Thromb Vasc Biol 2019; 39:774-786. [DOI: 10.1161/atvbaha.118.312232] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Objective—
Coronary endothelial dysfunction (ED) is an early stage of atherosclerosis and is associated with impaired high-density lipoprotein (HDL) function. A functional polymorphism at the haptoglobin (Hp) gene locus (rs72294371) has been associated with marked differences in HDL structure and function. We sought to determine whether Hp phenotype was associated with coronary ED and whether the amount of hemoglobin (Hb) tethered to HDL via Hp was Hp-type dependent and associated with ED.
Approach and Results—
Microvascular and epicardial coronary endothelial function was assessed in 338 individuals with nonobstructive coronary artery disease. Microvascular ED was defined as <50% change in coronary blood flow and epicardial ED as ≥20% decrease in coronary artery diameter after intracoronary acetylcholine infusion. The amount of Hb bound to HDL was measured by ELISA after HDL purification from plasma samples using immune-affinity chromatography. One hundred and seventy of the individuals in this study (50.3%) were diagnosed with microvascular ED, 143 (42.3%) with epicardial ED, and 67 (19.7%) had diabetes mellitus (DM). Hp phenotype was significantly associated with microvascular (
P
=0.01) and epicardial ED (
P
=0.04) among DM individuals. There was a significant and inverse correlation between the amount of HDL-bound Hb and change in coronary blood flow (r=−0.40;
P
<0.0001) and in coronary artery diameter (r=−0.44;
P
<0.0001) in response to acetylcholine infusion. Hb content of HDL was significantly increased in individuals with Hp 2-2 and DM. In a logistic regression model, Hp 2-2 phenotype was associated with microvascular ED (odds ratio, 1.9;
P
=0.03) and the amount of HDL-bound Hb was an independent predictor of both microvascular (odds ratio, 4.6 for each 1-SD increase;
P
<0.0001) and epicardial (odds ratio, 2.2;
P
<0.0001) ED.
Conclusions—
Hp phenotype is significantly associated with coronary ED in DM individuals. This association is likely related to increased Hb tethering to HDL via Hp 2-2 in DM.
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Affiliation(s)
- Rabea Asleh
- From the Department of Cardiovascular Diseases, Mayo Clinic and College of Medicine, Rochester, MN (R.A., A.A., R.G., L.O.L., A.L.)
| | - Andrew P. Levy
- Bruce and Rappaport Faculty of Medicine, Technion Institute of Technology, Haifa, Israel (A.P.L., N.S.L., H.G., I.S.)
| | - Nina S. Levy
- Bruce and Rappaport Faculty of Medicine, Technion Institute of Technology, Haifa, Israel (A.P.L., N.S.L., H.G., I.S.)
| | - Ayat Asleh
- From the Department of Cardiovascular Diseases, Mayo Clinic and College of Medicine, Rochester, MN (R.A., A.A., R.G., L.O.L., A.L.)
| | - Hagit Goldenstein
- Bruce and Rappaport Faculty of Medicine, Technion Institute of Technology, Haifa, Israel (A.P.L., N.S.L., H.G., I.S.)
| | - Inbar Segol
- Bruce and Rappaport Faculty of Medicine, Technion Institute of Technology, Haifa, Israel (A.P.L., N.S.L., H.G., I.S.)
| | - Rajiv Gulati
- From the Department of Cardiovascular Diseases, Mayo Clinic and College of Medicine, Rochester, MN (R.A., A.A., R.G., L.O.L., A.L.)
| | - Lilach O. Lerman
- From the Department of Cardiovascular Diseases, Mayo Clinic and College of Medicine, Rochester, MN (R.A., A.A., R.G., L.O.L., A.L.)
| | - Amir Lerman
- From the Department of Cardiovascular Diseases, Mayo Clinic and College of Medicine, Rochester, MN (R.A., A.A., R.G., L.O.L., A.L.)
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Role of oxidative stress, angiogenesis and chemo-attractant cytokines in the pathogenesis of ischaemic protection induced by remote ischaemic conditioning: Study of a human model of ischaemia-reperfusion induced vascular injury. PATHOPHYSIOLOGY 2019; 26:53-59. [DOI: 10.1016/j.pathophys.2018.11.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2018] [Revised: 11/19/2018] [Accepted: 11/29/2018] [Indexed: 11/19/2022] Open
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26
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Doris MK, Otaki Y, Arnson Y, Tamarappoo B, Goeller M, Gransar H, Wang F, Hayes S, Friedman J, Thomson L, Slomka P, Dey D, Berman D. Non-invasive fractional flow reserve in vessels without severe obstructive stenosis is associated with coronary plaque burden. J Cardiovasc Comput Tomogr 2018; 12:379-384. [DOI: 10.1016/j.jcct.2018.05.003] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2018] [Revised: 04/13/2018] [Accepted: 05/03/2018] [Indexed: 10/17/2022]
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27
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Corban MT, Prasad A, Nesbitt L, Loeffler D, Herrmann J, Lerman LO, Lerman A. Local Production of Soluble Urokinase Plasminogen Activator Receptor and Plasminogen Activator Inhibitor-1 in the Coronary Circulation Is Associated With Coronary Endothelial Dysfunction in Humans. J Am Heart Assoc 2018; 7:e009881. [PMID: 30371230 PMCID: PMC6201458 DOI: 10.1161/jaha.118.009881] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/25/2018] [Accepted: 06/21/2018] [Indexed: 01/11/2023]
Abstract
Background Soluble urokinase plasminogen activator receptor (su PAR ) is a proinflammatory biomarker associated with immune activation and fibrinolysis inhibition. Plasminogen activator inhibitor ( PAI -1) is associated with excessive fibrin accumulation, thrombus formation, and atherosclerosis. The relationship between cross-coronary su PAR and PAI -1 production and endothelial dysfunction remains unknown. Methods and Results Seventy-nine patients (age 53±10 years, 75% women) with angina and normal coronary arteries or mild coronary artery disease (<40% stenosis) on angiogram underwent acetylcholine assessment of epicardial endothelial dysfunction (mid-left anterior descending coronary artery diameter decrease >20% after acetylcholine) and mircovascular endothelial dysfunction (coronary blood flow change <50% after acetylcholine). Simultaneous left main and coronary sinus su PAR and PAI -1 levels were measured in each patient before acetylcholine administration, and cross-coronary su PAR and PAI -1 production rates were calculated. Patients' characteristics, except for age (51±10 versus 57±9, P=0.02), and resting coronary hemodynamics were not significantly different between patients with (26%) versus without (74%) epicardial endothelial dysfunction. Patients' characteristics and resting coronary hemodynamics were not significantly different between those with (62%) and those without (38%) mircovascular endothelial dysfunction. Patients with mircovascular endothelial dysfunction demonstrated local coronary su PAR production versus su PAR extraction in patients with normal microvascular function (median 25.8 [interquartile range 121.6, -23.7] versus -12.7 [52.0, -74.8] ng/min, P=0.03). Patients with epicardial endothelial dysfunction had higher median coronary PAI -1 production rates compared with those with normal epicardial endothelial function (1224.7 [12 940.7, -1915.4] versus -187.4 [4444.7, -4535.8] ng/min, P=0.03). Conclusions su PAR is released in coronary circulation of patients with mircovascular endothelial dysfunction and extracted in those with normal microvascular function. Cross-coronary PAI -1 release is higher in humans with epicardial endothelial dysfunction.
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Affiliation(s)
- Michel T. Corban
- Department of Cardiovascular DiseasesMayo Clinic College of Medicine and ScienceRochesterMN
| | - Abhiram Prasad
- Department of Cardiovascular DiseasesMayo Clinic College of Medicine and ScienceRochesterMN
| | - Lisa Nesbitt
- Department of Cardiovascular DiseasesMayo Clinic College of Medicine and ScienceRochesterMN
| | - Darrell Loeffler
- Department of Cardiovascular DiseasesMayo Clinic College of Medicine and ScienceRochesterMN
| | - Joerg Herrmann
- Department of Cardiovascular DiseasesMayo Clinic College of Medicine and ScienceRochesterMN
| | - Lilach O. Lerman
- Department of Cardiovascular DiseasesMayo Clinic College of Medicine and ScienceRochesterMN
- Division of Nephrology and HypertensionDepartment of MedicineMayo Clinic College of Medicine and ScienceRochesterMN
| | - Amir Lerman
- Department of Cardiovascular DiseasesMayo Clinic College of Medicine and ScienceRochesterMN
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28
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Chan SHH, Chan JYH. Mitochondria and Reactive Oxygen Species Contribute to Neurogenic Hypertension. Physiology (Bethesda) 2018; 32:308-321. [PMID: 28615314 DOI: 10.1152/physiol.00006.2017] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2017] [Revised: 04/05/2017] [Accepted: 04/13/2017] [Indexed: 02/07/2023] Open
Abstract
Beyond its primary role as fuel generators, mitochondria are engaged in a variety of cellular processes, including redox homeostasis. Mitochondrial dysfunction, therefore, may have a profound impact on high-energy-demanding organs such as the brain. Here, we review the roles of mitochondrial biogenesis and bioenergetics, and their associated signaling in cellular redox homeostasis, and illustrate their contributions to the oxidative stress-related neural mechanism of hypertension, focusing on specific brain areas that are involved in the generation or modulation of sympathetic outflows to the cardiovascular system. We also highlight future challenges of research on mitochondrial physiology and pathophysiology.
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Affiliation(s)
- Samuel H H Chan
- Institute for Translational Research in Biomedicine, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan
| | - Julie Y H Chan
- Institute for Translational Research in Biomedicine, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan
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29
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Ahmadi A, Leipsic J, Øvrehus KA, Gaur S, Bagiella E, Ko B, Dey D, LaRocca G, Jensen JM, Bøtker HE, Achenbach S, De Bruyne B, Nørgaard BL, Narula J. Lesion-Specific and Vessel-Related Determinants of Fractional Flow Reserve Beyond Coronary Artery Stenosis. JACC Cardiovasc Imaging 2018; 11:521-530. [DOI: 10.1016/j.jcmg.2017.11.020] [Citation(s) in RCA: 73] [Impact Index Per Article: 12.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2017] [Revised: 11/07/2017] [Accepted: 11/08/2017] [Indexed: 11/25/2022]
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30
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Zhou Z, Lankhuizen IM, van Beusekom HM, Cheng C, Duncker DJ, Merkus D. Uridine Adenosine Tetraphosphate-Induced Coronary Relaxation Is Blunted in Swine With Pressure Overload: A Role for Vasoconstrictor Prostanoids. Front Pharmacol 2018; 9:255. [PMID: 29632487 PMCID: PMC5879110 DOI: 10.3389/fphar.2018.00255] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2017] [Accepted: 03/07/2018] [Indexed: 12/27/2022] Open
Abstract
Plasma levels of the vasoactive substance uridine adenosine tetraphosphate (Up4A) are elevated in hypertensive patients and Up4A-induced vascular contraction is exacerbated in various arteries isolated from hypertensive animals, suggesting a potential role of Up4A in development of hypertension. We previously demonstrated that Up4A produced potent and partially endothelium-dependent relaxation in the porcine coronary microvasculature. Since pressure-overload is accompanied by structural abnormalities in the coronary microvasculature as well as by endothelial dysfunction, we hypothesized that pressure-overload blunts the coronary vasodilator response to Up4A, and that the involvement of purinergic receptors and endothelium-derived factors is altered. The effects of Up4A were investigated using wire-myography in isolated coronary small arteries from Sham-operated swine and swine with prolonged (8 weeks) pressure overload of the left ventricle induced by aortic banding (AoB). Expression of purinergic receptors and endothelium-derived factors was assessed in isolated coronary small arteries using real-time PCR. Up4A (10-9 to 10-5 M) failed to produce contraction in isolated coronary small arteries from either Sham or AoB swine, but produced relaxation in preconstricted arteries, which was significantly blunted in AoB compared to Sham. Blockade of purinergic P1, and P2 receptors attenuated Up4A-induced coronary relaxation more, while the effect of P2X1-blockade was similar and the effects of A2A- and P2Y1-blockade were reduced in AoB as compared to Sham. mRNA expression of neither A1, A2, A3, nor P2X1, P2X7, P2Y1, P2Y2, nor P2Y6-receptors was altered in AoB as compared to Sham, while P2Y12 expression was higher in AoB. eNOS inhibition attenuated Up4A-induced coronary relaxation in both Sham and AoB. Additional blockade of cyclooxygenase enhanced Up4A-induced coronary relaxation in AoB but not Sham swine, suggesting the involvement of vasoconstrictor prostanoids. In endothelium-denuded coronary small arteries from normal swine, thromboxane synthase (TxS) inhibition enhanced relaxation to Up4A compared to endothelium-intact arteries, to a similar extent as P2Y12 inhibition, while the combination inhibition of P2Y12 and TxS had no additional effect. In conclusion, Up4A-induced coronary relaxation is blunted in swine with AoB, which appears to be due to the production of a vasoconstrictor prostanoid, likely thromboxane A2.
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Affiliation(s)
- Zhichao Zhou
- Division of Experimental Cardiology, Department of Cardiology, Thoraxcenter, Erasmus Medical Center, University Medical Center Rotterdam, Rotterdam, Netherlands.,Cardiovascular Research School Erasmus University Rotterdam, Erasmus Medical Center, University Medical Center Rotterdam, Rotterdam, Netherlands.,Division of Cardiology, Department of Medicine, Karolinska University Hospital, Karolinska Institutet, Solna, Sweden
| | - Inge M Lankhuizen
- Division of Experimental Cardiology, Department of Cardiology, Thoraxcenter, Erasmus Medical Center, University Medical Center Rotterdam, Rotterdam, Netherlands.,Cardiovascular Research School Erasmus University Rotterdam, Erasmus Medical Center, University Medical Center Rotterdam, Rotterdam, Netherlands
| | - Heleen M van Beusekom
- Division of Experimental Cardiology, Department of Cardiology, Thoraxcenter, Erasmus Medical Center, University Medical Center Rotterdam, Rotterdam, Netherlands.,Cardiovascular Research School Erasmus University Rotterdam, Erasmus Medical Center, University Medical Center Rotterdam, Rotterdam, Netherlands
| | - Caroline Cheng
- Division of Experimental Cardiology, Department of Cardiology, Thoraxcenter, Erasmus Medical Center, University Medical Center Rotterdam, Rotterdam, Netherlands.,Cardiovascular Research School Erasmus University Rotterdam, Erasmus Medical Center, University Medical Center Rotterdam, Rotterdam, Netherlands.,Department of Nephrology and Hypertension, University Medical Center Utrecht, Utrecht, Netherlands
| | - Dirk J Duncker
- Division of Experimental Cardiology, Department of Cardiology, Thoraxcenter, Erasmus Medical Center, University Medical Center Rotterdam, Rotterdam, Netherlands.,Cardiovascular Research School Erasmus University Rotterdam, Erasmus Medical Center, University Medical Center Rotterdam, Rotterdam, Netherlands
| | - Daphne Merkus
- Division of Experimental Cardiology, Department of Cardiology, Thoraxcenter, Erasmus Medical Center, University Medical Center Rotterdam, Rotterdam, Netherlands.,Cardiovascular Research School Erasmus University Rotterdam, Erasmus Medical Center, University Medical Center Rotterdam, Rotterdam, Netherlands
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Yuan F, Hedayat AF, Ferguson CM, Lerman A, Lerman LO, Eirin A. Mitoprotection attenuates myocardial vascular impairment in porcine metabolic syndrome. Am J Physiol Heart Circ Physiol 2017; 314:H669-H680. [PMID: 29196345 DOI: 10.1152/ajpheart.00431.2017] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Metabolic syndrome (MetS) leads to cardiac vascular injury, which may reflect in increased retention of endothelial progenitor cells (EPCs). Coronary endothelial cell (EC) mitochondria partly regulate vascular function and structure. We hypothesized that chronic mitoprotection would preserve EC mitochondria and attenuate coronary vascular injury and dysfunction in swine MetS. Pigs were studied after 16 wk of diet-induced MetS, MetS treated for the last 4 wk with the mitochondria-targeted peptide elamipretide (ELAM; 0.1 mg/kg sc once daily), and lean controls ( n = 6 each). Cardiac remodeling and function were assessed in vivo by multidetector-computed tomography (CT), and coronary artery and sinus blood samples were collected. EC mitochondrial density, apoptosis, oxidative stress, endothelial nitric oxide synthase immunoreactivity, myocardial microvascular density (three-dimensional microcomputed tomography), and coronary endothelial function (organ bath) were assessed ex vivo. The number and arteriovenous gradient of CD34+/KDR+ EPCs were calculated by FACS (a negative net gradient indicating EPC retention). MetS and MetS + ELAM pigs developed similar MetS (obesity, hyperlipidemia, insulin resistance, and hypertension). EC mitochondrial density decreased in MetS animals compared with lean animals but normalized in MetS + ELAM animals. ELAM also attenuated EC oxidative stress and apoptosis and improved subendocardial microvascular density. ELAM-induced vasculoprotection was reflected by decreased coronary retention of EPCs. ELAM also partly improved endothelial nitric oxide synthase immunoreactivity, coronary endothelial function, and vessel maturity, whereas myocardial perfusion was unaffected. Chronic mitoprotection improved coronary EC mitochondrial density and decreased vascular remodeling and dysfunction. However, additional mitochondria-independent mechanisms likely contribute to MetS-induced cardiac vascular injury. NEW & NOTEWORTHY The present study shows that chronic mitoprotection preserved coronary endothelial cell mitochondria and decreased vascular injury, subendocardial microvascular loss, coronary retention of endothelial progenitor cells, and release of markers of vascular injury. However, myocardial perfusion remained blunted, suggesting that additional mitochondria-independent mechanisms likely contribute to metabolic syndrome-induced cardiac vascular injury.
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Affiliation(s)
- Fang Yuan
- Division of Nephrology and Hypertension, Mayo Clinic , Rochester, Minnesota.,Department of Cardiology, People's Hospital of Zhengzhou University, Henan Provincial People's Hospital , Henan , People's Republic of China
| | - Ahmad F Hedayat
- Division of Nephrology and Hypertension, Mayo Clinic , Rochester, Minnesota
| | | | - Amir Lerman
- Department of Cardiovascular Diseases, Mayo Clinic , Rochester, Minnesota
| | - Lilach O Lerman
- Division of Nephrology and Hypertension, Mayo Clinic , Rochester, Minnesota.,Department of Cardiovascular Diseases, Mayo Clinic , Rochester, Minnesota
| | - Alfonso Eirin
- Division of Nephrology and Hypertension, Mayo Clinic , Rochester, Minnesota
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Raggi P, Pontone G, Andreini D. Role of new imaging modalities in pursuit of the vulnerable plaque and the vulnerable patient. Int J Cardiol 2017; 250:278-283. [PMID: 29102056 DOI: 10.1016/j.ijcard.2017.10.046] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2017] [Revised: 10/08/2017] [Accepted: 10/13/2017] [Indexed: 11/29/2022]
Abstract
Numerous biomarkers and imaging modalities were investigated during the past few decades to identify patients harboring plaques at high risk of rupturing and causing catastrophic events. The classical description of a vulnerable plaque included a large lipid core, covered by a thin fibrous cap and evidence of inflammation especially around the hinge points of the plaque. Unfortunately, the search has resulted to a large extent in a failure to accurately identify the site of a future event. In time the search focus switched to the vulnerable patient rather than the individual vulnerable plaques, but the debate continues as to the more appropriate approach to risk assessment. This review discusses the most recent developments in molecular, anatomical and functional imaging directed at identifying a patient at high-risk of coronary artery disease events.
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Affiliation(s)
- Paolo Raggi
- Mazankowski Alberta Heart Institute, Edmonton, AB, Canada; University of Alberta, Edmonton, AB, Canada.
| | - Gianluca Pontone
- Centro Cardiologico Monzino, IRCCS, University of Milan, Milan, Italy; Yonsei University Health System, Seoul, South Korea
| | - Daniele Andreini
- Centro Cardiologico Monzino, IRCCS, University of Milan, Milan, Italy; Department of Clinical Sciences and Community Health, Cardiovascular Section, University of Milan, Milan, Italy
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Vanhoutte PM, Shimokawa H, Feletou M, Tang EHC. Endothelial dysfunction and vascular disease - a 30th anniversary update. Acta Physiol (Oxf) 2017; 219:22-96. [PMID: 26706498 DOI: 10.1111/apha.12646] [Citation(s) in RCA: 556] [Impact Index Per Article: 79.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2015] [Revised: 10/27/2015] [Accepted: 12/17/2015] [Indexed: 02/06/2023]
Abstract
The endothelium can evoke relaxations of the underlying vascular smooth muscle, by releasing vasodilator substances. The best-characterized endothelium-derived relaxing factor (EDRF) is nitric oxide (NO) which activates soluble guanylyl cyclase in the vascular smooth muscle cells, with the production of cyclic guanosine monophosphate (cGMP) initiating relaxation. The endothelial cells also evoke hyperpolarization of the cell membrane of vascular smooth muscle (endothelium-dependent hyperpolarizations, EDH-mediated responses). As regards the latter, hydrogen peroxide (H2 O2 ) now appears to play a dominant role. Endothelium-dependent relaxations involve both pertussis toxin-sensitive Gi (e.g. responses to α2 -adrenergic agonists, serotonin, and thrombin) and pertussis toxin-insensitive Gq (e.g. adenosine diphosphate and bradykinin) coupling proteins. New stimulators (e.g. insulin, adiponectin) of the release of EDRFs have emerged. In recent years, evidence has also accumulated, confirming that the release of NO by the endothelial cell can chronically be upregulated (e.g. by oestrogens, exercise and dietary factors) and downregulated (e.g. oxidative stress, smoking, pollution and oxidized low-density lipoproteins) and that it is reduced with ageing and in the course of vascular disease (e.g. diabetes and hypertension). Arteries covered with regenerated endothelium (e.g. following angioplasty) selectively lose the pertussis toxin-sensitive pathway for NO release which favours vasospasm, thrombosis, penetration of macrophages, cellular growth and the inflammatory reaction leading to atherosclerosis. In addition to the release of NO (and EDH, in particular those due to H2 O2 ), endothelial cells also can evoke contraction of the underlying vascular smooth muscle cells by releasing endothelium-derived contracting factors. Recent evidence confirms that most endothelium-dependent acute increases in contractile force are due to the formation of vasoconstrictor prostanoids (endoperoxides and prostacyclin) which activate TP receptors of the vascular smooth muscle cells and that prostacyclin plays a key role in such responses. Endothelium-dependent contractions are exacerbated when the production of nitric oxide is impaired (e.g. by oxidative stress, ageing, spontaneous hypertension and diabetes). They contribute to the blunting of endothelium-dependent vasodilatations in aged subjects and essential hypertensive and diabetic patients. In addition, recent data confirm that the release of endothelin-1 can contribute to endothelial dysfunction and that the peptide appears to be an important contributor to vascular dysfunction. Finally, it has become clear that nitric oxide itself, under certain conditions (e.g. hypoxia), can cause biased activation of soluble guanylyl cyclase leading to the production of cyclic inosine monophosphate (cIMP) rather than cGMP and hence causes contraction rather than relaxation of the underlying vascular smooth muscle.
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Affiliation(s)
- P. M. Vanhoutte
- State Key Laboratory of Pharmaceutical Biotechnology and Department of Pharmacology and Pharmacy; Li Ka Shing Faculty of Medicine; The University of Hong Kong; Hong Kong City Hong Kong
| | - H. Shimokawa
- Department of Cardiovascular Medicine; Tohoku University; Sendai Japan
| | - M. Feletou
- Department of Cardiovascular Research; Institut de Recherches Servier; Suresnes France
| | - E. H. C. Tang
- State Key Laboratory of Pharmaceutical Biotechnology and Department of Pharmacology and Pharmacy; Li Ka Shing Faculty of Medicine; The University of Hong Kong; Hong Kong City Hong Kong
- School of Biomedical Sciences; Li Ka Shing Faculty of Medicine; The University of Hong Kong; Hong Kong City Hong Kong
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Usui E, Yonetsu T, Murai T, Kanaji Y, Matsuda J, Hoshino M, Araki M, Niida T, Hada M, Ichijyo S, Hamaya R, Kanno Y, Lee T, Isobe M, Kakuta T. Prevalence of Thin-Cap Fibroatheroma in Relation to the Severity of Anatomical and Physiological Stenosis. Circ J 2017. [DOI: 10.1253/circj.cj-17-0122] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Eisuke Usui
- Cardiovascular Medicine, Tsuchiura Kyodo General Hospital
- Department of Cardiovascular Medicine, Tokyo Medical and Dental University
| | - Taishi Yonetsu
- Cardiovascular Medicine, Tsuchiura Kyodo General Hospital
| | - Tadashi Murai
- Cardiovascular Medicine, Tsuchiura Kyodo General Hospital
| | | | - Junji Matsuda
- Cardiovascular Medicine, Tsuchiura Kyodo General Hospital
| | | | - Makoto Araki
- Cardiovascular Medicine, Tsuchiura Kyodo General Hospital
| | - Takayuki Niida
- Cardiovascular Medicine, Tsuchiura Kyodo General Hospital
| | - Masahiro Hada
- Cardiovascular Medicine, Tsuchiura Kyodo General Hospital
| | | | - Rikuta Hamaya
- Cardiovascular Medicine, Tsuchiura Kyodo General Hospital
| | | | - Tetsumin Lee
- Cardiovascular Medicine, Tsuchiura Kyodo General Hospital
| | - Mitsuaki Isobe
- Department of Cardiovascular Medicine, Tokyo Medical and Dental University
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Parviz Y, Hsia C, Alemayehu M, Wall S, Bagur R, AbuRomeh N, Chin-Yee I, Lavi S. The effect of fresh versus standard blood transfusion on microvascular endothelial function. Am Heart J 2016; 181:156-161. [PMID: 27823688 DOI: 10.1016/j.ahj.2016.05.021] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/08/2016] [Accepted: 05/16/2016] [Indexed: 11/16/2022]
Abstract
BACKGROUND The duration of red blood cell (RBC) storage may have a negative impact on endothelial nitric oxide bioavailability. We tested the hypothesis that transfused fresh blood will have a more favorable effect on microvascular endothelial function as compared to older standard issue blood. METHODS Participants requiring chronic RBC transfusions were enrolled in a crossover design study to receive fresh (<7 days of storage) or standard (up to 42 days of storage) blood on 2 separate visits. Endothelial function was assessed by reactive hyperemia peripheral arterial tonometry that was measured before and after transfusions. For each participant, the difference between endothelial function pretransfusion and posttransfusion was assessed in relation to blood storage time. RESULTS Twenty-one patients (71 ± 16 years, 52% females) were enrolled. Mean age of fresh blood was 5.5 days (±1.0), and that of standard blood was 24.5 days (±7.9 days). The pretransfusion hemoglobin was 83.1 ± 2.5 g/L; and posttransfusion, 98.9 ± 2.6 g/L. An average of 2 U of packed RBCs was transfused. Microvascular endothelial function decreased more frequently after transfusion of standard blood compared to fresh blood. Standard issue blood transfusion was associated with decrease in reactive hyperemia peripheral arterial tonometry index (-0.25 ± 0.63) compared to fresh blood (+0.03 ± 0.49); P = .026. CONCLUSION Transfusions of standard issue blood are associated with less favorable effect on microvascular endothelial function as compared to fresh blood.
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Affiliation(s)
- Yasir Parviz
- Division of Cardiology, London Health Sciences Centre, Western University, London, Ontario, Canada
| | - Cyrus Hsia
- Division of Hematology, London Health Sciences Centre, Western University, London, Ontario, Canada
| | - Mistre Alemayehu
- Division of Cardiology, London Health Sciences Centre, Western University, London, Ontario, Canada
| | - Sabrina Wall
- Division of Cardiology, London Health Sciences Centre, Western University, London, Ontario, Canada
| | - Rodrigo Bagur
- Division of Cardiology, London Health Sciences Centre, Western University, London, Ontario, Canada
| | - Nour AbuRomeh
- Division of Cardiology, London Health Sciences Centre, Western University, London, Ontario, Canada
| | - Ian Chin-Yee
- Division of Hematology, London Health Sciences Centre, Western University, London, Ontario, Canada
| | - Shahar Lavi
- Division of Cardiology, London Health Sciences Centre, Western University, London, Ontario, Canada.
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Ahmadi A, Stone GW, Leipsic J, Shaw LJ, Villines TC, Kern MJ, Hecht H, Erlinge D, Ben-Yehuda O, Maehara A, Arbustini E, Serruys P, Garcia-Garcia HM, Narula J. Prognostic Determinants of Coronary Atherosclerosis in Stable Ischemic Heart Disease. Circ Res 2016; 119:317-29. [DOI: 10.1161/circresaha.116.308952] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2016] [Accepted: 06/10/2016] [Indexed: 01/10/2023]
Abstract
Risk stratification in patients with stable ischemic heart disease is essential to guide treatment decisions. In this regard, whether coronary anatomy, physiology, or plaque morphology is the best determinant of prognosis (and driver an effective therapeutic risk reduction) remains one of the greatest ongoing debates in cardiology. In the present report, we review the evidence for each of these characteristics and explore potential algorithms that may enable a practical diagnostic and therapeutic strategy for the management of patients with stable ischemic heart disease.
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Affiliation(s)
- Amir Ahmadi
- From the Mount Sinai Heart, Icahn School of Medicine at Mount Sinai, New York, NY (A.A., H.H., J.N.); Columbia University Medical Center, Cardiovascular Research Foundation, New York, NY (G.W.S., A.M.); University of British Columbia, Vancouver, British Columbia, Canada (A.A., J.L.); Emory University School of Medicine, Atlanta, GA (L.J.S.); Walter Reed National Military Medical Center, Bethesda, MD (T.C.V.); University of California Irvine (M.J.K.); Lund University, Sweden (D.E.); University of
| | - Gregg W. Stone
- From the Mount Sinai Heart, Icahn School of Medicine at Mount Sinai, New York, NY (A.A., H.H., J.N.); Columbia University Medical Center, Cardiovascular Research Foundation, New York, NY (G.W.S., A.M.); University of British Columbia, Vancouver, British Columbia, Canada (A.A., J.L.); Emory University School of Medicine, Atlanta, GA (L.J.S.); Walter Reed National Military Medical Center, Bethesda, MD (T.C.V.); University of California Irvine (M.J.K.); Lund University, Sweden (D.E.); University of
| | - Jonathon Leipsic
- From the Mount Sinai Heart, Icahn School of Medicine at Mount Sinai, New York, NY (A.A., H.H., J.N.); Columbia University Medical Center, Cardiovascular Research Foundation, New York, NY (G.W.S., A.M.); University of British Columbia, Vancouver, British Columbia, Canada (A.A., J.L.); Emory University School of Medicine, Atlanta, GA (L.J.S.); Walter Reed National Military Medical Center, Bethesda, MD (T.C.V.); University of California Irvine (M.J.K.); Lund University, Sweden (D.E.); University of
| | - Leslee J. Shaw
- From the Mount Sinai Heart, Icahn School of Medicine at Mount Sinai, New York, NY (A.A., H.H., J.N.); Columbia University Medical Center, Cardiovascular Research Foundation, New York, NY (G.W.S., A.M.); University of British Columbia, Vancouver, British Columbia, Canada (A.A., J.L.); Emory University School of Medicine, Atlanta, GA (L.J.S.); Walter Reed National Military Medical Center, Bethesda, MD (T.C.V.); University of California Irvine (M.J.K.); Lund University, Sweden (D.E.); University of
| | - Todd C. Villines
- From the Mount Sinai Heart, Icahn School of Medicine at Mount Sinai, New York, NY (A.A., H.H., J.N.); Columbia University Medical Center, Cardiovascular Research Foundation, New York, NY (G.W.S., A.M.); University of British Columbia, Vancouver, British Columbia, Canada (A.A., J.L.); Emory University School of Medicine, Atlanta, GA (L.J.S.); Walter Reed National Military Medical Center, Bethesda, MD (T.C.V.); University of California Irvine (M.J.K.); Lund University, Sweden (D.E.); University of
| | - Morton J. Kern
- From the Mount Sinai Heart, Icahn School of Medicine at Mount Sinai, New York, NY (A.A., H.H., J.N.); Columbia University Medical Center, Cardiovascular Research Foundation, New York, NY (G.W.S., A.M.); University of British Columbia, Vancouver, British Columbia, Canada (A.A., J.L.); Emory University School of Medicine, Atlanta, GA (L.J.S.); Walter Reed National Military Medical Center, Bethesda, MD (T.C.V.); University of California Irvine (M.J.K.); Lund University, Sweden (D.E.); University of
| | - Harvey Hecht
- From the Mount Sinai Heart, Icahn School of Medicine at Mount Sinai, New York, NY (A.A., H.H., J.N.); Columbia University Medical Center, Cardiovascular Research Foundation, New York, NY (G.W.S., A.M.); University of British Columbia, Vancouver, British Columbia, Canada (A.A., J.L.); Emory University School of Medicine, Atlanta, GA (L.J.S.); Walter Reed National Military Medical Center, Bethesda, MD (T.C.V.); University of California Irvine (M.J.K.); Lund University, Sweden (D.E.); University of
| | - David Erlinge
- From the Mount Sinai Heart, Icahn School of Medicine at Mount Sinai, New York, NY (A.A., H.H., J.N.); Columbia University Medical Center, Cardiovascular Research Foundation, New York, NY (G.W.S., A.M.); University of British Columbia, Vancouver, British Columbia, Canada (A.A., J.L.); Emory University School of Medicine, Atlanta, GA (L.J.S.); Walter Reed National Military Medical Center, Bethesda, MD (T.C.V.); University of California Irvine (M.J.K.); Lund University, Sweden (D.E.); University of
| | - Ori Ben-Yehuda
- From the Mount Sinai Heart, Icahn School of Medicine at Mount Sinai, New York, NY (A.A., H.H., J.N.); Columbia University Medical Center, Cardiovascular Research Foundation, New York, NY (G.W.S., A.M.); University of British Columbia, Vancouver, British Columbia, Canada (A.A., J.L.); Emory University School of Medicine, Atlanta, GA (L.J.S.); Walter Reed National Military Medical Center, Bethesda, MD (T.C.V.); University of California Irvine (M.J.K.); Lund University, Sweden (D.E.); University of
| | - Akiko Maehara
- From the Mount Sinai Heart, Icahn School of Medicine at Mount Sinai, New York, NY (A.A., H.H., J.N.); Columbia University Medical Center, Cardiovascular Research Foundation, New York, NY (G.W.S., A.M.); University of British Columbia, Vancouver, British Columbia, Canada (A.A., J.L.); Emory University School of Medicine, Atlanta, GA (L.J.S.); Walter Reed National Military Medical Center, Bethesda, MD (T.C.V.); University of California Irvine (M.J.K.); Lund University, Sweden (D.E.); University of
| | - Eloisa Arbustini
- From the Mount Sinai Heart, Icahn School of Medicine at Mount Sinai, New York, NY (A.A., H.H., J.N.); Columbia University Medical Center, Cardiovascular Research Foundation, New York, NY (G.W.S., A.M.); University of British Columbia, Vancouver, British Columbia, Canada (A.A., J.L.); Emory University School of Medicine, Atlanta, GA (L.J.S.); Walter Reed National Military Medical Center, Bethesda, MD (T.C.V.); University of California Irvine (M.J.K.); Lund University, Sweden (D.E.); University of
| | - Patrick Serruys
- From the Mount Sinai Heart, Icahn School of Medicine at Mount Sinai, New York, NY (A.A., H.H., J.N.); Columbia University Medical Center, Cardiovascular Research Foundation, New York, NY (G.W.S., A.M.); University of British Columbia, Vancouver, British Columbia, Canada (A.A., J.L.); Emory University School of Medicine, Atlanta, GA (L.J.S.); Walter Reed National Military Medical Center, Bethesda, MD (T.C.V.); University of California Irvine (M.J.K.); Lund University, Sweden (D.E.); University of
| | - Hector M. Garcia-Garcia
- From the Mount Sinai Heart, Icahn School of Medicine at Mount Sinai, New York, NY (A.A., H.H., J.N.); Columbia University Medical Center, Cardiovascular Research Foundation, New York, NY (G.W.S., A.M.); University of British Columbia, Vancouver, British Columbia, Canada (A.A., J.L.); Emory University School of Medicine, Atlanta, GA (L.J.S.); Walter Reed National Military Medical Center, Bethesda, MD (T.C.V.); University of California Irvine (M.J.K.); Lund University, Sweden (D.E.); University of
| | - Jagat Narula
- From the Mount Sinai Heart, Icahn School of Medicine at Mount Sinai, New York, NY (A.A., H.H., J.N.); Columbia University Medical Center, Cardiovascular Research Foundation, New York, NY (G.W.S., A.M.); University of British Columbia, Vancouver, British Columbia, Canada (A.A., J.L.); Emory University School of Medicine, Atlanta, GA (L.J.S.); Walter Reed National Military Medical Center, Bethesda, MD (T.C.V.); University of California Irvine (M.J.K.); Lund University, Sweden (D.E.); University of
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Hecht HS, Narula J, Fearon WF. Fractional Flow Reserve and Coronary Computed Tomographic Angiography. Circ Res 2016; 119:300-16. [DOI: 10.1161/circresaha.116.307914] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2016] [Accepted: 05/25/2016] [Indexed: 12/14/2022]
Abstract
Invasive fractional flow reserve (FFR) is now the gold standard for intervention. Noninvasive functional imaging analyses derived from coronary computed tomographic angiography (CTA) offer alternatives for evaluating lesion-specific ischemia. CT-FFR, CT myocardial perfusion imaging, and transluminal attenuation gradient/corrected contrast opacification have been studied using invasive FFR as the gold standard. CT-FFR has demonstrated significant improvement in specificity and positive predictive value compared with CTA alone for predicting FFR of ≤0.80, as well as decreasing the frequency of nonobstructive invasive coronary angiography. High-risk plaque characteristics have also been strongly implicated in abnormal FFR. Myocardial computed tomographic perfusion is an alternative method with promising results; it involves more radiation and contrast. Transluminal attenuation gradient/corrected contrast opacification is more controversial and may be more related to vessel diameter than stenosis. Important considerations remain: (1) improvement of CTA quality to decrease unevaluable studies, (2) is the diagnostic accuracy of CT-FFR sufficient? (3) can CT-FFR guide intervention without invasive FFR confirmation? (4) what are the long-term outcomes of CT-FFR–guided treatment and how do they compare with other functional imaging-guided paradigms? (5) what degree of stenosis on CTA warrants CT-FFR? (6) how should high-risk plaque be incorporated into treatment decisions? (7) how will CT-FFR influence other functional imaging test utilization, and what will be the effect on the practice of cardiology? (8) will a workstation-based CT-FFR be mandatory? Rapid progress to date suggests that CTA-based lesion-specific ischemia will be the gatekeeper to the cardiac catheterization laboratory and will transform the world of intervention.
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Affiliation(s)
- Harvey S. Hecht
- From the Department of Cardiology, Icahn School of Medicine at Mount Sinai, New York (H.S.H., J.N.); Department of Cardiology, Stanford University School of Medicine, CA (W.F.F.)
| | - Jagat Narula
- From the Department of Cardiology, Icahn School of Medicine at Mount Sinai, New York (H.S.H., J.N.); Department of Cardiology, Stanford University School of Medicine, CA (W.F.F.)
| | - William F. Fearon
- From the Department of Cardiology, Icahn School of Medicine at Mount Sinai, New York (H.S.H., J.N.); Department of Cardiology, Stanford University School of Medicine, CA (W.F.F.)
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Garcia VP, Rocha HN, Silva GM, Amaral TA, Secher NH, Nóbrega AC, Vianna LC, Rocha NG. Exogenous l-arginine reduces matrix metalloproteinase-2 and -9 activities and oxidative stress in patients with hypertension. Life Sci 2016; 157:125-130. [DOI: 10.1016/j.lfs.2016.06.006] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2016] [Revised: 06/03/2016] [Accepted: 06/06/2016] [Indexed: 11/29/2022]
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Perassa LA, Graton ME, Potje SR, Troiano JA, Lima MS, Vale GT, Pereira AAF, Nakamune ACMS, Sumida DH, Tirapelli CR, Bendhack LM, Antoniali C. Apocynin reduces blood pressure and restores the proper function of vascular endothelium in SHR. Vascul Pharmacol 2016; 87:38-48. [PMID: 27353052 DOI: 10.1016/j.vph.2016.06.005] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2016] [Revised: 05/06/2016] [Accepted: 06/18/2016] [Indexed: 10/21/2022]
Abstract
This study has evaluated how the vascular endothelium of hypertensive rats chronically treated with apocynin affects acetylcholine (ACh), sodium nitroprusside (SNP), and phenylephrine (PE) action on the nitric oxide (NO) signal transduction pathway in endothelial (EC) and vascular smooth muscle cells. Treatment with apocynin significantly reduced the mean arterial pressure in spontaneously hypertensive rats (SHR). In addition, apocynin improved the impaired ACh hypotensive effect on SHR. Although systemic oxidative stress was high in SHR, SHR treated with apocynin and normotensive rats presented similar systemic oxidative stress levels. Endothelium significantly blunted PE contractions in intact aortas of treated SHR. The ACh effect was impaired in resistance arteries and aortas of SHR, but this same effect was improved in treated SHR. The SNP potency was higher in intact resistance arteries of treated SHR than in intact resistance arteries of untreated SHR. NO and calcium concentrations increased, whereas reactive oxygen species levels decreased in EC of treated SHR. Aortas of untreated and treated SHR did not differ in terms of sGC alpha or beta units expression. Aorta of treated SHR expressed higher eNOS levels as compared to aorta of untreated SHR. The study groups did not differ with respect to NOX1, NOXO1, or NOX4 expression. However, treatment with apocynin normalized overexpression of NOX2 and its subunit p47phox in aortas of SHR. Based on all the results presented in this study, we suggest apocynin increases NO biovailability by different mechanisms, restoring the proper function of vascular endothelium in SHR.
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Affiliation(s)
- Ligia A Perassa
- Multicenter Graduate Program in Physiological Sciences, SBFis, Brazil; Department of Basic Sciences, School of Dentistry of Araçatuba, UNESP - Univ Estadual Paulista, Araçatuba, São Paulo, Brazil
| | - Murilo E Graton
- Multicenter Graduate Program in Physiological Sciences, SBFis, Brazil; Department of Basic Sciences, School of Dentistry of Araçatuba, UNESP - Univ Estadual Paulista, Araçatuba, São Paulo, Brazil
| | - Simone R Potje
- Multicenter Graduate Program in Physiological Sciences, SBFis, Brazil; Department of Basic Sciences, School of Dentistry of Araçatuba, UNESP - Univ Estadual Paulista, Araçatuba, São Paulo, Brazil
| | - Jéssica A Troiano
- Multicenter Graduate Program in Physiological Sciences, SBFis, Brazil; Department of Basic Sciences, School of Dentistry of Araçatuba, UNESP - Univ Estadual Paulista, Araçatuba, São Paulo, Brazil
| | - Mariana S Lima
- Department of Basic Sciences, School of Dentistry of Araçatuba, UNESP - Univ Estadual Paulista, Araçatuba, São Paulo, Brazil
| | - Gabriel T Vale
- Department of Psychiatry Nursing and Human Sciences, College of Nursing of Ribeirão Preto, USP - University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Ariana A F Pereira
- Multicenter Graduate Program in Physiological Sciences, SBFis, Brazil; Department of Basic Sciences, School of Dentistry of Araçatuba, UNESP - Univ Estadual Paulista, Araçatuba, São Paulo, Brazil
| | - Ana Claúdia M S Nakamune
- Multicenter Graduate Program in Physiological Sciences, SBFis, Brazil; Department of Basic Sciences, School of Dentistry of Araçatuba, UNESP - Univ Estadual Paulista, Araçatuba, São Paulo, Brazil
| | - Doris H Sumida
- Multicenter Graduate Program in Physiological Sciences, SBFis, Brazil; Department of Basic Sciences, School of Dentistry of Araçatuba, UNESP - Univ Estadual Paulista, Araçatuba, São Paulo, Brazil
| | - Carlos R Tirapelli
- Department of Psychiatry Nursing and Human Sciences, College of Nursing of Ribeirão Preto, USP - University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Lusiane M Bendhack
- Department of Physics and Chemistry, Faculty of Pharmaceutical Sciences of Ribeirão Preto, USP - University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Cristina Antoniali
- Multicenter Graduate Program in Physiological Sciences, SBFis, Brazil; Department of Basic Sciences, School of Dentistry of Araçatuba, UNESP - Univ Estadual Paulista, Araçatuba, São Paulo, Brazil.
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Li Y, Kinzenbaw DA, Modrick ML, Pewe LL, Faraci FM. Context-dependent effects of SOCS3 in angiotensin II-induced vascular dysfunction and hypertension in mice: mechanisms and role of bone marrow-derived cells. Am J Physiol Heart Circ Physiol 2016; 311:H146-56. [PMID: 27106041 DOI: 10.1152/ajpheart.00204.2016] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2016] [Accepted: 04/18/2016] [Indexed: 11/22/2022]
Abstract
Carotid artery disease is a major contributor to stroke and cognitive deficits. Angiotensin II (Ang II) promotes vascular dysfunction and disease through mechanisms that include the IL-6/STAT3 pathway. Here, we investigated the importance of suppressor of cytokine signaling 3 (SOCS3) in models of Ang II-induced vascular dysfunction. We examined direct effects of Ang II on carotid arteries from SOCS3-deficient (SOCS3(+/-)) mice and wild-type (WT) littermates using organ culture and then tested endothelial function with acetylcholine (ACh). A low concentration of Ang II (1 nmol/l) did not affect ACh-induced vasodilation in WT but reduced that of SOCS3(+/-) mice by ∼50% (P < 0.05). In relation to mechanisms, effects of Ang II in SOCS3(+/-) mice were prevented by inhibitors of STAT3, IL-6, NF-κB, or superoxide. Systemic Ang II (1.4 mg/kg per day for 14 days) also reduced vasodilation to ACh in WT. Surprisingly, SOCS3 deficiency prevented most of the endothelial dysfunction. To examine potential underlying mechanisms, we performed bone marrow transplantation. WT mice reconstituted with SOCS3(+/-) bone marrow were protected from Ang II-induced endothelial dysfunction, whereas reconstitution of SOCS3(+/-) mice with WT bone marrow exacerbated Ang II-induced effects. The SOCS3 genotype of bone marrow-derived cells did not influence direct effects of Ang II on vascular function. These data provide new mechanistic insight into the influence of SOCS3 on the vasculature, including divergent effects depending on the source of Ang II. Bone marrow-derived cells deficient in SOCS3 protect against systemic Ang II-induced vascular dysfunction.
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Affiliation(s)
- Ying Li
- Department of Pharmacology, Francois M. Abboud Cardiovascular Center, Carver College of Medicine, University of Iowa, Iowa City, Iowa
| | - Dale A Kinzenbaw
- Department of Internal Medicine, Francois M. Abboud Cardiovascular Center, Carver College of Medicine, University of Iowa, Iowa City, Iowa
| | - Mary L Modrick
- Department of Internal Medicine, Francois M. Abboud Cardiovascular Center, Carver College of Medicine, University of Iowa, Iowa City, Iowa
| | - Lecia L Pewe
- Department of Microbiology, Francois M. Abboud Cardiovascular Center, Carver College of Medicine, University of Iowa, Iowa City, Iowa
| | - Frank M Faraci
- Department of Pharmacology, Francois M. Abboud Cardiovascular Center, Carver College of Medicine, University of Iowa, Iowa City, Iowa; Department of Internal Medicine, Francois M. Abboud Cardiovascular Center, Carver College of Medicine, University of Iowa, Iowa City, Iowa; Iowa City Veterans Affairs Healthcare System, Iowa City, Iowa
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Widmer RJ, Lerman LO, Lerman A. MicroRNAs: small molecule, big potential for coronary artery disease. Eur Heart J 2016; 37:1750-2. [DOI: 10.1093/eurheartj/ehw067] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
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Gaur S, Øvrehus KA, Dey D, Leipsic J, Bøtker HE, Jensen JM, Narula J, Ahmadi A, Achenbach S, Ko BS, Christiansen EH, Kaltoft AK, Berman DS, Bezerra H, Lassen JF, Nørgaard BL. Coronary plaque quantification and fractional flow reserve by coronary computed tomography angiography identify ischaemia-causing lesions. Eur Heart J 2016; 37:1220-7. [PMID: 26763790 PMCID: PMC4830909 DOI: 10.1093/eurheartj/ehv690] [Citation(s) in RCA: 233] [Impact Index Per Article: 29.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2015] [Accepted: 11/27/2015] [Indexed: 01/17/2023] Open
Abstract
AIMS Coronary plaque characteristics are associated with ischaemia. Differences in plaque volumes and composition may explain the discordance between coronary stenosis severity and ischaemia. We evaluated the association between coronary stenosis severity, plaque characteristics, coronary computed tomography angiography (CTA)-derived fractional flow reserve (FFRCT), and lesion-specific ischaemia identified by FFR in a substudy of the NXT trial (Analysis of Coronary Blood Flow Using CT Angiography: Next Steps). METHODS AND RESULTS Coronary CTA stenosis, plaque volumes, FFRCT, and FFR were assessed in 484 vessels from 254 patients. Stenosis >50% was considered obstructive. Plaque volumes (non-calcified plaque [NCP], low-density NCP [LD-NCP], and calcified plaque [CP]) were quantified using semi-automated software. Optimal thresholds of quantitative plaque variables were defined by area under the receiver-operating characteristics curve (AUC) analysis. Ischaemia was defined by FFR or FFRCT ≤0.80. Plaque volumes were inversely related to FFR irrespective of stenosis severity. Relative risk (95% confidence interval) for prediction of ischaemia for stenosis >50%, NCP ≥185 mm(3), LD-NCP ≥30 mm(3), CP ≥9 mm(3), and FFRCT ≤0.80 were 5.0 (3.0-8.3), 3.7 (2.4-5.6), 4.6 (2.9-7.4), 1.4 (1.0-2.0), and 13.6 (8.4-21.9), respectively. Low-density NCP predicted ischaemia independent of other plaque characteristics. Low-density NCP and FFRCT yielded diagnostic improvement over stenosis assessment with AUCs increasing from 0.71 by stenosis >50% to 0.79 and 0.90 when adding LD-NCP ≥30 mm(3) and LD-NCP ≥30 mm(3) + FFRCT ≤0.80, respectively. CONCLUSION Stenosis severity, plaque characteristics, and FFRCT predict lesion-specific ischaemia. Plaque assessment and FFRCT provide improved discrimination of ischaemia compared with stenosis assessment alone.
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Affiliation(s)
- Sara Gaur
- Department of Cardiology, Aarhus University Hospital, Palle Juul-Jensens Boulevard 99, 8200 Aarhus N, Denmark
| | - Kristian Altern Øvrehus
- Department of Cardiology, Aarhus University Hospital, Palle Juul-Jensens Boulevard 99, 8200 Aarhus N, Denmark
| | - Damini Dey
- Department of Biomedical Sciences, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Jonathon Leipsic
- Department of Radiology, Division of Cardiology, St. Paul's Hospital, Vancouver, BC, Canada
| | - Hans Erik Bøtker
- Department of Cardiology, Aarhus University Hospital, Palle Juul-Jensens Boulevard 99, 8200 Aarhus N, Denmark
| | - Jesper Møller Jensen
- Department of Cardiology, Aarhus University Hospital, Palle Juul-Jensens Boulevard 99, 8200 Aarhus N, Denmark
| | - Jagat Narula
- Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Amir Ahmadi
- Department of Radiology, Division of Cardiology, St. Paul's Hospital, Vancouver, BC, Canada
| | | | - Brian S Ko
- Monash Cardiovascular Research Centre, Monash University and Monash Heart, Clayton, Australia
| | - Evald Høj Christiansen
- Department of Cardiology, Aarhus University Hospital, Palle Juul-Jensens Boulevard 99, 8200 Aarhus N, Denmark
| | - Anne Kjer Kaltoft
- Department of Cardiology, Aarhus University Hospital, Palle Juul-Jensens Boulevard 99, 8200 Aarhus N, Denmark
| | - Daniel S Berman
- Department of Imaging, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Hiram Bezerra
- Department of Cardiology, Harrington Heart and Vascular Institute, University Hospitals of Cleveland, Cleveland, OH, USA
| | - Jens Flensted Lassen
- Department of Cardiology, Aarhus University Hospital, Palle Juul-Jensens Boulevard 99, 8200 Aarhus N, Denmark
| | - Bjarne Linde Nørgaard
- Department of Cardiology, Aarhus University Hospital, Palle Juul-Jensens Boulevard 99, 8200 Aarhus N, Denmark
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Ahmadi A, Kini A, Narula J. Discordance between ischemia and stenosis, or PINSS and NIPSS: are we ready for new vocabulary? JACC Cardiovasc Imaging 2015; 8:111-114. [PMID: 25592703 DOI: 10.1016/j.jcmg.2014.11.010] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Amir Ahmadi
- Icahn School of Medicine at Mount Sinai, New York, New York
| | | | - Jagat Narula
- Icahn School of Medicine at Mount Sinai, New York, New York.
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Zhang X, Li ZL, Eirin A, Ebrahimi B, Pawar AS, Zhu XY, Lerman A, Lerman LO. Cardiac metabolic alterations in hypertensive obese pigs. Hypertension 2015; 66:430-6. [PMID: 26077566 DOI: 10.1161/hypertensionaha.115.05478] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2015] [Accepted: 05/21/2015] [Indexed: 01/15/2023]
Abstract
Obesity and hypertension are major risk factors for cardiovascular diseases, and their growing coexistence accounts for an increase in adverse cardiac events, but the mechanisms are yet to be determined. We hypothesized that obesity exacerbates mitochondrial dysregulation imposed by hypertension and augments left ventricular dysfunction. Obesity-prone Ossabaw pigs were randomized to lean (standard diet) and obese (high-fat diet), without (Lean-sham and Obese-sham) or with renovascular hypertension (Lean-hypertension and Obese-hypertension), induced after 12 weeks of diet (n=7 each). Cardiac function, myocardial perfusion and oxygenation, and microvascular remodeling were assessed 4 weeks later. Mitochondrial biogenesis signals and structural proteins, respiratory chain complex activities, and mitochondrial self-degradation were examined, as was fibrosis. Obesity alone exerted no apparent effect on mitochondrial dynamics, but aggravated in hypertensive hearts the reduction of mitochondrial proteins, deoxyribonucleic acid content, and respiratory chain complex IV subunits activity, and amplified mitochondrial self-degradation. Synergistic interaction of obesity with hypertension also exacerbated myocardial fibrosis and left ventricular diastolic dysfunction. Mitochondrial content, respiratory chain complex IV subunits activity, and mitophagy were correlated with myocardial fibrosis. These findings suggest that obesity aggravates in renovascular hypertension cardiac mitochondrial aberrations. Mitochondrial function may regulate the progression of cardiac injury and functional deterioration in hypertension concomitant with obesity.
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Affiliation(s)
- Xin Zhang
- From the Divisions of Nephrology and Hypertension (X.Z., Z.-L.L., A.E., B.E., A.S.P., X.-Y.Z., L.O.L.) and Cardiovascular Diseases (A.L., L.O.L.), Mayo Clinic, Rochester, MN; and Division of Vascular Surgery, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China (Z.-L.L.)
| | - Zi-Lun Li
- From the Divisions of Nephrology and Hypertension (X.Z., Z.-L.L., A.E., B.E., A.S.P., X.-Y.Z., L.O.L.) and Cardiovascular Diseases (A.L., L.O.L.), Mayo Clinic, Rochester, MN; and Division of Vascular Surgery, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China (Z.-L.L.)
| | - Alfonso Eirin
- From the Divisions of Nephrology and Hypertension (X.Z., Z.-L.L., A.E., B.E., A.S.P., X.-Y.Z., L.O.L.) and Cardiovascular Diseases (A.L., L.O.L.), Mayo Clinic, Rochester, MN; and Division of Vascular Surgery, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China (Z.-L.L.)
| | - Behzad Ebrahimi
- From the Divisions of Nephrology and Hypertension (X.Z., Z.-L.L., A.E., B.E., A.S.P., X.-Y.Z., L.O.L.) and Cardiovascular Diseases (A.L., L.O.L.), Mayo Clinic, Rochester, MN; and Division of Vascular Surgery, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China (Z.-L.L.)
| | - Aditya S Pawar
- From the Divisions of Nephrology and Hypertension (X.Z., Z.-L.L., A.E., B.E., A.S.P., X.-Y.Z., L.O.L.) and Cardiovascular Diseases (A.L., L.O.L.), Mayo Clinic, Rochester, MN; and Division of Vascular Surgery, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China (Z.-L.L.)
| | - Xiang-Yang Zhu
- From the Divisions of Nephrology and Hypertension (X.Z., Z.-L.L., A.E., B.E., A.S.P., X.-Y.Z., L.O.L.) and Cardiovascular Diseases (A.L., L.O.L.), Mayo Clinic, Rochester, MN; and Division of Vascular Surgery, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China (Z.-L.L.)
| | - Amir Lerman
- From the Divisions of Nephrology and Hypertension (X.Z., Z.-L.L., A.E., B.E., A.S.P., X.-Y.Z., L.O.L.) and Cardiovascular Diseases (A.L., L.O.L.), Mayo Clinic, Rochester, MN; and Division of Vascular Surgery, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China (Z.-L.L.)
| | - Lilach O Lerman
- From the Divisions of Nephrology and Hypertension (X.Z., Z.-L.L., A.E., B.E., A.S.P., X.-Y.Z., L.O.L.) and Cardiovascular Diseases (A.L., L.O.L.), Mayo Clinic, Rochester, MN; and Division of Vascular Surgery, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China (Z.-L.L.).
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Vilahur G, Padró T, Casaní L, Mendieta G, López JA, Streitenberger S, Badimon L. El enriquecimiento de la dieta con polifenoles previene la disfunción endotelial coronaria mediante la activación de la vía de Akt/eNOS. Rev Esp Cardiol 2015. [DOI: 10.1016/j.recesp.2014.03.023] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
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Vilahur G, Padró T, Casaní L, Mendieta G, López JA, Streitenberger S, Badimon L. Polyphenol-enriched Diet Prevents Coronary Endothelial Dysfunction by Activating the Akt/eNOS Pathway. ACTA ACUST UNITED AC 2015; 68:216-25. [DOI: 10.1016/j.rec.2014.04.021] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2013] [Accepted: 04/01/2014] [Indexed: 01/25/2023]
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Bauer J, Ripperger A, Frantz S, Ergün S, Schwedhelm E, Benndorf RA. Pathophysiology of isoprostanes in the cardiovascular system: implications of isoprostane-mediated thromboxane A2 receptor activation. Br J Pharmacol 2015; 171:3115-31. [PMID: 24646155 DOI: 10.1111/bph.12677] [Citation(s) in RCA: 109] [Impact Index Per Article: 12.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2013] [Revised: 02/20/2014] [Accepted: 03/03/2014] [Indexed: 12/13/2022] Open
Abstract
Isoprostanes are free radical-catalysed PG-like products of unsaturated fatty acids, such as arachidonic acid, which are widely recognized as reliable markers of systemic lipid peroxidation and oxidative stress in vivo. Moreover, activation of enzymes, such as COX-2, may contribute to isoprostane formation. Indeed, formation of isoprostanes is considerably increased in various diseases which have been linked to oxidative stress, such as cardiovascular disease (CVD), and may predict the atherosclerotic burden and the risk of cardiovascular complications in the latter patients. In addition, several isoprostanes may directly contribute to the functional consequences of oxidant stress via activation of the TxA2 prostanoid receptor (TP), for example, by affecting endothelial cell function and regeneration, vascular tone, haemostasis and ischaemia/reperfusion injury. In this context, experimental and clinical data suggest that selected isoprostanes may represent important alternative activators of the TP receptor when endogenous TxA2 levels are low, for example, in aspirin-treated individuals with CVD. In this review, we will summarize the current understanding of isoprostane formation, biochemistry and (patho) physiology in the cardiovascular context.
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Affiliation(s)
- Jochen Bauer
- Institute of Anatomy and Cell Biology, University of Würzburg, Würzburg, Germany
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Collin J, Gössl M, Matsuo Y, Cilluffo RR, Flammer AJ, Loeffler D, Lennon RJ, Simari RD, Spoon DB, Erbel R, Lerman LO, Khosla S, Lerman A. Osteogenic monocytes within the coronary circulation and their association with plaque vulnerability in patients with early atherosclerosis. Int J Cardiol 2014; 181:57-64. [PMID: 25482280 DOI: 10.1016/j.ijcard.2014.11.156] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/24/2014] [Revised: 09/08/2014] [Accepted: 11/23/2014] [Indexed: 12/12/2022]
Abstract
OBJECTIVES This study tests the hypothesis that circulating mononuclear cells expressing osteocalcin (OCN) and bone alkaline phosphatase (BAP) are associated with distinct plaque tissue components in patients with early coronary atherosclerosis. BACKGROUND Plaque characteristics implying vulnerability develop at the earliest stage of coronary atherosclerosis. Increasing evidence indicates that cells from the myeloid lineage might serve as important mediators of destabilization. Plaque burden and its components were assessed regarding their relationship to monocytes carrying both pro-inflammatory (CD14) and osteogenic surface markers OCN and BAP. METHODS Twenty-three patients with angiographically non-obstructive coronary artery disease underwent coronary endothelial function assessment and virtual histology-intravascular ultrasound of the left coronary artery. Plaque composition was characterized in the total segment (TS) and in the target lesion (TL) containing the highest amount of plaque burden. Blood samples were collected simultaneously from the aorta and the coronary sinus. Circulating cell counts were then identified from each sample and a gradient across the coronary circulation was determined. RESULTS Circulating CD14+/BAP+/OCN+ monocytes correlate with the extent of necrotic core and calcification (r=0.53, p=0.010; r=0.55, p=0.006, respectively). Importantly, coronary retention of CD14+/OCN+ cells also correlates with the amount of necrotic core and calcification (r=0.61, p=0.003; r=0.61, p=0.003) respectively. CONCLUSIONS Our study links CD14+/BAP+/OCN+ monocytes to the pathologic remodeling of the coronary circulation and therefore associates these cells with plaque destabilization in patients with early coronary atherosclerosis.
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Affiliation(s)
- Julia Collin
- Department of Cardiology, West-German Heart-Center - University Hospital Essen, Essen, Germany; Department of Internal Medicine, University of Kansas School of Medicine, Kansas City, KS, USA
| | - Mario Gössl
- Department of Cardiology, Dean Clinic - Dean St. Mary's Outpatient Hospital Center, Madison, WI, USA
| | - Yoshiki Matsuo
- Department of Cardiovascular Medicine, Wakayama Medical University, Wakayama, Japan
| | - Rebecca R Cilluffo
- Divison of Cardiovascular Diseases and Internal Medicine, Mayo Clinic, College of Medicine, Rochester, MN, USA
| | - Andreas J Flammer
- Department of Cardiology, University Hospital of Zurich, Zurich, Switzerland
| | - Darrell Loeffler
- Divison of Cardiovascular Diseases and Internal Medicine, Mayo Clinic, College of Medicine, Rochester, MN, USA
| | - Ryan J Lennon
- Division of Biomedical Statistics and Informatics, Mayo Clinic, College of Medicine, Rochester, MN, USA
| | - Robert D Simari
- Department of Internal Medicine, University of Kansas School of Medicine, Kansas City, KS, USA
| | - Daniel B Spoon
- Divison of Cardiovascular Diseases and Internal Medicine, Mayo Clinic, College of Medicine, Rochester, MN, USA
| | - Raimund Erbel
- Department of Cardiology, West-German Heart-Center - University Hospital Essen, Essen, Germany
| | - Lilach O Lerman
- Division of Nephrology and Hypertension, Mayo Clinic, College of Medicine, Rochester, MN, USA
| | - Sundeep Khosla
- Division of Endocrinology, Mayo Clinic, College of Medicine, Rochester, MN, USA
| | - Amir Lerman
- Divison of Cardiovascular Diseases and Internal Medicine, Mayo Clinic, College of Medicine, Rochester, MN, USA.
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