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Gifani M, Eddins DJ, Kosuge H, Zhang Y, Paluri SLA, Larson T, Leeper N, Herzenberg LA, Gambhir SS, McConnell MV, Ghosn EEB, Smith BR. Ultra-selective carbon nanotubes for photoacoustic imaging of inflamed atherosclerotic plaques. ADVANCED FUNCTIONAL MATERIALS 2021; 31:2101005. [PMID: 34733130 PMCID: PMC8559995 DOI: 10.1002/adfm.202101005] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/29/2021] [Indexed: 05/29/2023]
Abstract
Disruption of vulnerable atherosclerotic plaques often leads to myocardial infarction and stroke, the leading causes of morbidity and mortality in the United States. A diagnostic method that detects high-risk atherosclerotic plaques at early stages could prevent these sequelae. The abundance of immune cells in the arterial wall, especially inflammatory Ly-6Chi monocytes and foamy macrophages, is indicative of plaque inflammation, and may be associated with plaque vulnerability. Hence, we sought to develop a new method that specifically targets these immune cells to offer clinically-relevant diagnostic information about cardiovascular disease. We combine ultra-selective nanoparticle targeting of Ly-6Chi monocytes and foamy macrophages with clinically-viable photoacoustic imaging (PAI) in order to precisely and specifically image inflamed plaques ex vivo in a mouse model that mimics human vulnerable plaques histopathologically. Within the plaques, high-dimensional single-cell flow cytometry (13-parameter) showed that our nanoparticles were almost-exclusively taken up by the Ly-6Chi monocytes and foamy macrophages that heavily infiltrate plaques. PAI identified inflamed atherosclerotic plaques that display ~6-fold greater signal compared to controls (P<0.001) six hours after intravenous injection of ultra-selective carbon nanotubes, with in vivo corroboration via optical imaging. Our highly selective strategy may provide a targeted, non-invasive imaging strategy to accurately identify and diagnose inflamed atherosclerotic lesions.
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Affiliation(s)
- Mahsa Gifani
- Department of Biomedical Engineering, Institute for Quantitative Health Science and Engineering, Michigan State University, East Lansing, MI 48824, USA
| | - Devon J. Eddins
- Departments of Medicine and Pediatrics, Lowance Center for Human Immunology, Emory University, Atlanta, GA 30322, USA
| | - Hisanori Kosuge
- Division of Cardiovascular Medicine and Vascular Surgery, Stanford University School of Medicine, Stanford, CA 94305, USA
| | - Yapei Zhang
- Department of Biomedical Engineering, Institute for Quantitative Health Science and Engineering, Michigan State University, East Lansing, MI 48824, USA
| | - Sesha L. A. Paluri
- Department of Biomedical Engineering, Institute for Quantitative Health Science and Engineering, Michigan State University, East Lansing, MI 48824, USA
| | - Timothy Larson
- Departments of Radiology, Bioengineering, and Materials Science and Engineering, Stanford University, Stanford, CA 94305, USA
| | - Nicholas Leeper
- Division of Cardiovascular Medicine and Vascular Surgery, Stanford University School of Medicine, Stanford, CA 94305, USA
| | | | - Sanjiv Sam Gambhir
- Departments of Radiology, Bioengineering, and Materials Science and Engineering, Stanford University, Stanford, CA 94305, USA
| | - Michael V. McConnell
- Division of Cardiovascular Medicine and Vascular Surgery, Stanford University School of Medicine, Stanford, CA 94305, USA
| | - Eliver E. B. Ghosn
- Departments of Medicine and Pediatrics, Lowance Center for Human Immunology, Emory University, Atlanta, GA 30322, USA
| | - Bryan Ronain Smith
- Department of Biomedical Engineering, Institute for Quantitative Health Science and Engineering, Michigan State University, East Lansing, MI 48824, USA
- Departments of Radiology, Bioengineering, and Materials Science and Engineering, Stanford University, Stanford, CA 94305, USA
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Johnsson IW, Naessén T, Ahlsson F, Gustafsson J. High birth weight was associated with increased radial artery intima thickness but not with other investigated cardiovascular risk factors in adulthood. Acta Paediatr 2018; 107:2152-2157. [PMID: 29791055 DOI: 10.1111/apa.14414] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2017] [Revised: 04/20/2018] [Accepted: 05/18/2018] [Indexed: 11/29/2022]
Abstract
AIM This study investigated whether a high birth weight was associated with increased risk factors for cardiovascular disease when Swedish adults reached 34-40. METHODS We studied 27 subjects born at Uppsala University Hospital in 1975-1979, weighing at least 4500 g, and compared them with 27 controls selected by the Swedish National Board of Welfare with birth weights within ±1 standard deviations scores and similar ages and gender. The study included body mass index (BMI), blood pressure, lipid profile, haemoglobin A1c (HbA1c), C-reactive protein (CRP) and high-frequency ultrasound measurements of intima-media thickness, intima thickness (IT) and intima:media ratio of the carotid and radial arteries. RESULTS Subjects with a high birth weight did not differ from controls with regard to BMI, blood pressure, lipid profile, high-sensitivity CRP, HbA1c or carotid artery wall dimensions. However, their radial artery intima thickness was 37% greater than the control group and their intima:media ratio was 44% higher. CONCLUSION Our findings indicate that a high birth weight was associated with increased radial artery intima thickness, but not with other investigated cardiovascular risk factors, at 34-40 years of age. The clinical implications of these findings should be investigated further, especially in subjects born with a very high birth weight.
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Affiliation(s)
- I W Johnsson
- Department of Women's and Children's Health; Uppsala University; Uppsala Sweden
| | - T Naessén
- Department of Women's and Children's Health; Uppsala University; Uppsala Sweden
| | - F Ahlsson
- Department of Women's and Children's Health; Uppsala University; Uppsala Sweden
| | - J Gustafsson
- Department of Women's and Children's Health; Uppsala University; Uppsala Sweden
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Akhter T, Wikström AK, Larsson M, Larsson A, Wikström G, Naessen T. Serum Pentraxin 3 is associated with signs of arterial alteration in women with preeclampsia. Int J Cardiol 2017; 241:417-422. [DOI: 10.1016/j.ijcard.2017.03.076] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/19/2016] [Revised: 03/07/2017] [Accepted: 03/10/2017] [Indexed: 10/19/2022]
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Akhter T, Larsson M, Wikström AK, Naessen T. Thicknesses of individual layers of artery wall indicate increased cardiovascular risk in severe pre-eclampsia. ULTRASOUND IN OBSTETRICS & GYNECOLOGY : THE OFFICIAL JOURNAL OF THE INTERNATIONAL SOCIETY OF ULTRASOUND IN OBSTETRICS AND GYNECOLOGY 2014; 43:675-680. [PMID: 24375803 DOI: 10.1002/uog.13289] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/12/2013] [Revised: 12/05/2013] [Accepted: 12/11/2013] [Indexed: 06/03/2023]
Abstract
OBJECTIVE To assess whether thicknesses of the intima and media in the common carotid artery (CCA) and the intima/media ratio (I/M) indicate an increased cardiovascular risk in non-pregnant women with a history of previous severe pre-eclampsia. METHODS Thicknesses of the CCA intima and media layers were measured using non-invasive high-frequency (22 MHz) ultrasound in 42 women with a history of severe pre-eclampsia and 44 women with previous normal pregnancy. RESULTS Women with a history of severe pre-eclampsia had a thicker CCA intima and a higher I/M than had women with previous normal pregnancy, also after adjustment for mean arterial pressure, body mass index and CCA intima-media thickness (IMT) (all P < 0.0001). CCA-IMT did not differ significantly between groups. In receiver-operating characteristics curve analysis, intima thickness and I/M clearly discriminated between women with and those without previous pre-eclampsia (area under the receiver-operating characteristics curve (AUC), 0.98 and 0.93), whereas CCA-IMT did not (AUC, 0.52). CONCLUSIONS CCA individual intima and media thicknesses as well as I/M, but not CCA-IMT, reflect the known increased long-term cardiovascular risk of pre-eclampsia. Estimation of individual CCA layers using high-frequency ultrasound appears preferable to measuring CCA-IMT for investigating arterial effects and the increased cardiovascular risk in women with a history of severe pre-eclampsia.
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Affiliation(s)
- T Akhter
- Department of Women's and Children's Health, Section for Obstetrics and Gynecology, Uppsala University, Uppsala, Sweden
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Association of conventional risk factors for cardiovascular disease with IMT in middle-aged and elderly Chinese. Int J Cardiovasc Imaging 2014; 30:759-68. [DOI: 10.1007/s10554-014-0399-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2013] [Accepted: 03/06/2014] [Indexed: 01/09/2023]
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Akhter T, Larsson A, Larsson M, Wikström AK, Naessen T. Artery wall layer dimensions during normal pregnancy: a longitudinal study using noninvasive high-frequency ultrasound. Am J Physiol Heart Circ Physiol 2012; 304:H229-34. [PMID: 23125216 DOI: 10.1152/ajpheart.00670.2012] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
The vascular effects of normal pregnancy were investigated by estimating the intima and media thicknesses of the common carotid artery separately using 22-MHz ultrasound (Collagenoson, Meudt, Germany) in 57 healthy women with normal pregnancies and pregnancy outcomes, in all three trimesters and at 1 yr postpartum. A thick intima, thin media, and high intima-to-media (I/M) ratio are signs of a less healthy artery wall. Mean artery wall layer dimensions remained fairly constant during pregnancy, but the intima thickness and I/M thickness ratio appeared to improve (decrease) postpartum (P < 0.001 for both). The cardiovascular risk parameters of age, body mass index, and blood pressure in the first trimester were associated with higher I/M ratios, especially in the second trimester, whereas higher serum estradiol levels were significantly associated with a lower I/M ratio. Changes from the first to second trimesters in I/M ratio, taking into account differential changes in intima and media thickness, were significantly (P < 0.05-0.001) associated with all risk parameters tested except age, which was associated with increased intima thickness (P = 0.02). Associations with third trimester values and changes from first to third trimesters were similar but less apparent. Thus, fairly constant mean artery wall layer dimensions during pregnancy appeared to improve postpartum. However, higher age, body mass index, or blood pressure and lower serum estradiol levels in the first trimester appeared to negatively affect the artery wall, strongly suggesting that pregnancy has negative vascular effects in some women. A less likely explanation involves possible adaptation to physiological changes during and after pregnancy.
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Affiliation(s)
- Tansim Akhter
- Department of Women's and Children's Health, Section for Obstetrics and Gynecology, Uppsala University, Uppsala, Sweden.
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Bartels S, Franco AR, Rundek T. Carotid intima-media thickness (cIMT) and plaque from risk assessment and clinical use to genetic discoveries. ACTA ACUST UNITED AC 2012. [DOI: 10.1016/j.permed.2012.01.006] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Polak JF. Measuring carotid intima-media thickness: simple protocols have advantages. J Am Soc Echocardiogr 2012; 25:1131-4. [PMID: 22854049 DOI: 10.1016/j.echo.2012.06.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/05/2012] [Indexed: 11/16/2022]
Affiliation(s)
- Joseph F Polak
- Tufts Medical Center, Tufts University School of Medicine, Boston, MA 02111, USA.
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Nelson MR, Hurst RT, Mookadam F. Assessing individual cardiac risk using extra-cardiac arterial imaging. Expert Rev Cardiovasc Ther 2010; 8:529-43. [PMID: 20397827 DOI: 10.1586/erc.10.16] [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] [Indexed: 11/08/2022]
Abstract
Cardiovascular disease is the leading cause of death globally. Cardiovascular risk factors predict the risk of cardiovascular events in populations but have limitations in predicting individual risk. Emerging technologies that non-invasively measure carotid intima media thickness, aortic pressure and brachial artery reactivity may be useful in identifying the vulnerable patient who may benefit from more aggressive preventive therapy. These tests vary between each other in their reproducibility, cost, required operator skill, availability and patient preparation. However, all require further validation for clinical use as screening tests for cardiovascular disease.
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Affiliation(s)
- Matthew R Nelson
- Division of Cardiovascular Diseases, Mayo Clinic Arizona, 13400 E Shea Blvd, Scottsdale, AZ 85259, USA
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Wald DS, Wald NJ. The polypill in the primary prevention of cardiovascular disease. Fundam Clin Pharmacol 2010; 24:29-35. [DOI: 10.1111/j.1472-8206.2009.00795.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Wald DS, Bestwick JP, Morton G, Drummond L, Jenkins N, Khodabakhsh P, Curzen NP. Combining carotid intima-media thickness with carotid plaque on screening for coronary heart disease. J Med Screen 2009; 16:155-9. [PMID: 19805757 DOI: 10.1258/jms.2009.009039] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
BACKGROUND Ultrasound-detected carotid artery intima-media thickness (IMT) and carotid plaque are possible screening tests for coronary heart disease (CHD) among asymptomatic individuals. OBJECTIVE To assess the increase in screening performance of combining carotid IMT and plaque compared with each measurement alone in the identification of individuals with CHD. METHODS Ultrasound examination of left and right carotid arteries was performed on 100 individuals (median age 57), 55 with a history of CHD (unstable angina or myocardial infarction) and 45 without. IMT measurements were taken from the common carotid artery and plaque was identified above, at and below the carotid bifurcation. Associations between IMT and plaque were determined using logistic regression, and screening performance was assessed from the distributions of IMT and plaque among cases and controls. RESULTS At a false-positive rate of 5%, IMT (cut-off >0.75 mm) identified 30% (95% CI 14-58) of affected individuals. There was an increase in the detection rate of 8 percentage points (1-33%) using IMT and plaque combined compared with IMT alone. As the false-positive increased, the difference in the detection rate increased, up to a maximum of 20 percentage points (5-38%) at a false-positive rate of 20%. The comparison of IMT and plaque combined with plaque alone could only be estimated for the false-positive rate observed using plaque alone (18%); at this point the detection rate was 72% for plaque and 75% for plaque and IMT combined, an increase of 3 percentage points (0-4%). CONCLUSION In screening for CHD, combining carotid IMT measurement with plaque assessment is better than using either measurement alone, but the improvement in discrimination is not sufficient to make carotid ultrasound screening for CHD worthwhile.
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Affiliation(s)
- David S Wald
- Wolfson Institute of Preventive Medicine, Barts and The London School of Medicine, Queen Mary University of London, London, UK.
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