1
|
De Ornelas B, Sucato V, Vadalà G, Buono A, Galassi AR. Myocardial Bridge and Atherosclerosis, an Intimal Relationship. Curr Atheroscler Rep 2024; 26:353-366. [PMID: 38822987 DOI: 10.1007/s11883-024-01219-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/18/2024] [Indexed: 06/03/2024]
Abstract
PURPOSE OF REVIEW This review investigates the relationship between myocardial bridges (MBs), intimal thickening in coronary arteries, and Atherosclerotic cardiovascular disease. It focuses on the role of mechanical forces, such as circumferential strain, in arterial wall remodeling and aims to clarify how MBs affect coronary artery pathology. REVIEW FINDINGS MBs have been identified as influential in modulating coronary artery intimal thickness, demonstrating a protective effect against thickening within the MB segment and an increase in thickness proximal to the MB. This is attributed to changes in mechanical stress and hemodynamics. Research involving arterial hypertension models and vein graft disease has underscored the importance of circumferential strain in vascular remodeling and intimal hyperplasia. Understanding the complex dynamics between MBs, mechanical strain, and vascular remodeling is crucial for advancing our knowledge of coronary artery disease mechanisms. This could lead to improved management strategies for cardiovascular diseases, highlighting the need for further research into MB-related vascular changes.
Collapse
Affiliation(s)
- Benjamin De Ornelas
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties, University of Palermo, Palermo, Italy.
| | - Vincenzo Sucato
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties, University of Palermo, Palermo, Italy
| | - Giuseppe Vadalà
- Division of Cardiology, University Hospital "P. Giaccone", Palermo, Italy
| | - Andrea Buono
- Interventional Cardiology Unit, Cardiovascular Department, Fondazione Poliambulanza Institute, Brescia, Italy
| | - Alfredo Ruggero Galassi
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties, University of Palermo, Palermo, Italy
| |
Collapse
|
2
|
George VPJ, Zhao K, Chen P, Hu J. Chitosan-nanoclay embolic material for catheter-directed arterial embolization. J Biomed Mater Res A 2024; 112:914-930. [PMID: 38229508 PMCID: PMC10984788 DOI: 10.1002/jbm.a.37670] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2023] [Revised: 11/21/2023] [Accepted: 01/02/2024] [Indexed: 01/18/2024]
Abstract
Minimally invasive transcatheter embolization is a common nonsurgical procedure in interventional radiology. It is used for the deliberate occlusion of blood vessels for the treatment of disease or injured vasculature, including vascular malformation and malignant/benign tumors. Here, we introduce a gel embolic agent comprising chitosan nanofibers and nanoclay with excellent catheter injectability and tunable mechanical properties for embolization. The properties of the gel were optimized by varying the ratio between each individual component and also adjusting the total solid content. The rheological studies confirm the shear thinning property and gel nature of the developed gel as well as their recoverability. Injection force was measured to record the force required to pass the embolic gel through a clinically relevant catheter, evaluating for practicality of hand-injection. Theoretical predicted injection force was calculated to reduce the development time and to enhance the physician's experience. The stability of occlusion was also tested in vitro by monitoring the pressure required to displace the gel. The engineered gels exhibited sterility, hemocompatibility and cell biocompatibility, highlighting their potential for transcatheter embolization.
Collapse
Affiliation(s)
- Varghese P J George
- Department of Mechanical and Aerospace Engineering, North Carolina State University, Raleigh, NC, USA
| | - Keren Zhao
- Department of Mechanical and Aerospace Engineering, North Carolina State University, Raleigh, NC, USA
| | - Peng Chen
- Department of Mechanical and Aerospace Engineering, North Carolina State University, Raleigh, NC, USA
| | - Jingjie Hu
- Department of Mechanical and Aerospace Engineering, North Carolina State University, Raleigh, NC, USA
| |
Collapse
|
3
|
Yu Z, Chen Y, Li J, Chen C, Lu H, Chen S, Zhang T, Guo T, Zhu Y, Jin J, Yan S, Chen H. A tempo-spatial controllable microfluidic shear-stress generator for in-vitro mimicking of the thrombus. J Nanobiotechnology 2024; 22:187. [PMID: 38632623 PMCID: PMC11022418 DOI: 10.1186/s12951-024-02334-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2023] [Accepted: 02/09/2024] [Indexed: 04/19/2024] Open
Abstract
Pathological conditions linked to shear stress have been identified in hematological diseases, cardiovascular diseases, and cancer. These conditions often exhibit significantly elevated shear stress levels, surpassing 1000 dyn/cm2 in severely stenotic arteries. Heightened shear stress can induce mechanical harm to endothelial cells, potentially leading to bleeding and fatal consequences. However, current technology still grapples with limitations, including inadequate flexibility in simulating bodily shear stress environments, limited range of shear stress generation, and spatial and temporal adaptability. Consequently, a comprehensive understanding of the mechanisms underlying the impact of shear stress on physiological and pathological conditions, like thrombosis, remains inadequate. To address these limitations, this study presents a microfluidic-based shear stress generation chip as a proposed solution. The chip achieves a substantial 929-fold variation in shear stress solely by adjusting the degree of constriction in branch channels after PDMS fabrication. Experiments demonstrated that a rapid increase in shear stress up to 1000 dyn/cm2 significantly detached 88.2% cells from the substrate. Long-term exposure (24 h) to shear stress levels below 8.3 dyn/cm2 did not significantly impact cell growth. Furthermore, cells exposed to shear stress levels equal to or greater than 8.3 dyn/cm2 exhibited significant alterations in aspect ratio and orientation, following a normal distribution. This microfluidic chip provides a reliable tool for investigating cellular responses to the wide-ranging shear stress existing in both physiological and pathological flow conditions.
Collapse
Affiliation(s)
- Zhihang Yu
- School of Mechanical Engineering and Automation, Harbin Institute of Technology, Shenzhen, Shenzhen, 518055, China
| | - Yiqun Chen
- School of Mechanical Engineering and Automation, Harbin Institute of Technology, Shenzhen, Shenzhen, 518055, China
| | - Jingjing Li
- Graduate School of Biomedical Engineering, The University of New South Wales, Sydney, NSW, 2052, Australia
| | - Chang Chen
- School of Mechanical Engineering and Automation, Harbin Institute of Technology, Shenzhen, Shenzhen, 518055, China
| | - Huaxiu Lu
- School of Mechanical Engineering and Automation, Harbin Institute of Technology, Shenzhen, Shenzhen, 518055, China
| | - Siyuan Chen
- School of Mechanical Engineering and Automation, Harbin Institute of Technology, Shenzhen, Shenzhen, 518055, China
| | - Tingting Zhang
- School of Mechanical Engineering and Automation, Harbin Institute of Technology, Shenzhen, Shenzhen, 518055, China
| | - Tianruo Guo
- Graduate School of Biomedical Engineering, The University of New South Wales, Sydney, NSW, 2052, Australia
| | - Yonggang Zhu
- School of Mechanical Engineering and Automation, Harbin Institute of Technology, Shenzhen, Shenzhen, 518055, China
| | - Jing Jin
- School of Mechanical Engineering and Automation, Harbin Institute of Technology, Shenzhen, Shenzhen, 518055, China.
| | - Sheng Yan
- Institute for Advanced Study, Shenzhen University, Shenzhen, 518060, China.
| | - Huaying Chen
- School of Mechanical Engineering and Automation, Harbin Institute of Technology, Shenzhen, Shenzhen, 518055, China.
| |
Collapse
|
4
|
Son T, Ma G, Yao X. Functional OCT reveals anisotropic changes of retinal flicker-evoked vasodilation. OPTICS LETTERS 2024; 49:2121-2124. [PMID: 38621091 DOI: 10.1364/ol.520840] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/02/2024] [Accepted: 03/18/2024] [Indexed: 04/17/2024]
Abstract
The purpose of this study is to verify the effect of anisotropic property of retinal biomechanics on vasodilation measurement. A custom-built optical coherence tomography (OCT) was used for time-lapse imaging of flicker stimulation-evoked vessel lumen changes in mouse retinas. A comparative analysis revealed significantly larger (18.21%) lumen dilation in the axial direction compared to the lateral (10.77%) direction. The axial lumen dilation predominantly resulted from the top vessel wall movement toward the vitreous direction, whereas the bottom vessel wall remained stable. This observation indicates that the traditional vasodilation measurement in the lateral direction may result in an underestimated value.
Collapse
|
5
|
Niu YN, Guo C, Guo XZ, Wei Q, Zhou X, Li M, Xia JN, Chen LP. High-resolution magnetic resonance imaging investigation of the connection between the triglyceride-glucose index and intracranial arterial remodeling: a retrospective cross-sectional study. Quant Imaging Med Surg 2023; 13:8504-8516. [PMID: 38106280 PMCID: PMC10722004 DOI: 10.21037/qims-23-752] [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: 05/26/2023] [Accepted: 09/25/2023] [Indexed: 12/19/2023]
Abstract
Background Insulin resistance (IR) is associated with atherosclerotic plaque progression and the occurrence of stroke, with the triglyceride-glucose (TyG) index serving as a surrogate indicator. The present study aimed to investigate the association between TyG index levels and intracranial arterial remodeling in patients with acute ischemic stroke (AIS). Methods Patients with AIS who visited the Neurology Department of the Second Hospital of Hebei Medical University and underwent high-resolution magnetic resonance imaging (HR-MRI) between September 2018 and October 2021 were enrolled. A total of 123 patients were finally included in the study, with 81 excluded. The TyG index levels were measured, and the characteristics of intracranial atherosclerotic stenosis (ICAS) plaques were evaluated using HR-MRI. A logistic regression model was employed to analyze the relationship between TyG index levels and remodeling mode. Patients were divided into two groups, positive remodeling (PR) and non-positive remodeling (non-PR), based on the remodeling index (RI). Results Patients in the PR group had a higher TyG index than those in the non-PR group {median [interquartile range (IQR)]: 9.11 (8.82-9.51) vs. 8.72 (8.30-9.23), P<0.001}. After adjusting factors such as age and gender, the TyG index was found to be significantly correlated with intracranial arterial PR [odds ratio (OR): 3.169, 95% confidence interval (CI): 1.327-7.569, P=0.009]. In non-diabetes mellitus (DM) patients, the TyG index level in the PR group was significantly higher than that in the non-PR group (8.95±0.42 vs. 8.50±0.45, P<0.001), whereas there was no such difference in patients with DM. Conclusions TyG index was correlated with intracranial vessel PR, indicating that the TyG index level may be a useful marker for predicting intracranial vessel PR.
Collapse
Affiliation(s)
- Ya-Nan Niu
- Department of Neurology, The Second Hospital of Hebei Medical University, Shijiazhuang, China
- Key Laboratory of Hebei Neurology, The Second Hospital of Hebei Medical University, Shijiazhuang, China
| | - Cong Guo
- Department of Neurology, The Second Hospital of Hebei Medical University, Shijiazhuang, China
- Key Laboratory of Hebei Neurology, The Second Hospital of Hebei Medical University, Shijiazhuang, China
| | - Xuan-Zhu Guo
- Department of Neurology, The Second Hospital of Hebei Medical University, Shijiazhuang, China
- Key Laboratory of Hebei Neurology, The Second Hospital of Hebei Medical University, Shijiazhuang, China
| | - Qiao Wei
- Department of Neurology, The Second Hospital of Hebei Medical University, Shijiazhuang, China
- Key Laboratory of Hebei Neurology, The Second Hospital of Hebei Medical University, Shijiazhuang, China
| | - Xuan Zhou
- Department of Neurology, The Second Hospital of Hebei Medical University, Shijiazhuang, China
- Key Laboratory of Hebei Neurology, The Second Hospital of Hebei Medical University, Shijiazhuang, China
| | - Meng Li
- Department of Neurology, The Second Hospital of Hebei Medical University, Shijiazhuang, China
- Key Laboratory of Hebei Neurology, The Second Hospital of Hebei Medical University, Shijiazhuang, China
| | - Jia-Ning Xia
- Department of Neurology, The Second Hospital of Hebei Medical University, Shijiazhuang, China
- Key Laboratory of Hebei Neurology, The Second Hospital of Hebei Medical University, Shijiazhuang, China
| | - Li-Ping Chen
- Department of Neurology, The Second Hospital of Hebei Medical University, Shijiazhuang, China
- Key Laboratory of Hebei Neurology, The Second Hospital of Hebei Medical University, Shijiazhuang, China
| |
Collapse
|
6
|
Katoh K. Effects of Mechanical Stress on Endothelial Cells In Situ and In Vitro. Int J Mol Sci 2023; 24:16518. [PMID: 38003708 PMCID: PMC10671803 DOI: 10.3390/ijms242216518] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2023] [Revised: 11/14/2023] [Accepted: 11/15/2023] [Indexed: 11/26/2023] Open
Abstract
Endothelial cells lining blood vessels are essential for maintaining vascular homeostasis and mediate several pathological and physiological processes. Mechanical stresses generated by blood flow and other biomechanical factors significantly affect endothelial cell activity. Here, we review how mechanical stresses, both in situ and in vitro, affect endothelial cells. We review the basic principles underlying the cellular response to mechanical stresses. We also consider the implications of these findings for understanding the mechanisms of mechanotransducer and mechano-signal transduction systems by cytoskeletal components.
Collapse
Affiliation(s)
- Kazuo Katoh
- Laboratory of Human Anatomy and Cell Biology, Faculty of Health Sciences, Tsukuba University of Technology, Tsukuba 305-8521, Japan
| |
Collapse
|
7
|
Li R, Zhang Y, Zheng S, Zhang W, Du K, He W, Zhang W. Biomechanical characteristics in the carotid artery: Noninvasive assessment using subharmonic emissions from microbubbles. Med Phys 2023; 50:6857-6863. [PMID: 37337456 DOI: 10.1002/mp.16542] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2023] [Revised: 05/03/2023] [Accepted: 05/08/2023] [Indexed: 06/21/2023] Open
Abstract
BACKGROUND Stroke is closely related to carotid atherosclerotic plaques, which tend to occur in specific parts of the arteries, especially at the bifurcations, and are considered to be caused by biomechanical factors. Quantitative analysis of hemodynamic stress characteristics of the carotid sinus in vivo provides a mechanical basis for the development of atherosclerotic plaque in the carotid sinus. Previous studies found that ultrasound (US) contrast agent microbubbles would vibrate nonlinearly under the excitation of sound pressure, generating subharmonics (transmission fundamental frequency, i.e., f0 and subharmonic frequency at f0 /2), which have the highest sensitivity to pressure changes and exhibit an inverse linear relationship with environmental pressure. PURPOSE This study employed subharmonic aided pressure estimation (SHAPE) technology to reflect carotid artery hydrodynamic characteristics in the carotid lumen. METHODS From May 2021 to December 2021, this prospective study reviewed a total of 26 normal carotid arteries of 13 participants, all of whom received bilateral carotid artery routine US and SHAPE US examinations. During this study, the lumen of the bilateral distal segment of the common carotid artery (Distal-CCA), carotid artery bifurcation (CAB), and carotid bulb (CB) were scanned section by section from bottom to top in longitudinal and transverse sections. Subsequently, the subharmonic amplitudes in the lumen of normal carotid arteries were collected and analyzed. RESULTS This study found that the amplitude of subharmonic amplitude in the carotid was distributed unevenly, with the amplitudes of subharmonic at the CAB being higher. Specifically, the subharmonic gradient of the carotid artery bifurcation apex plane was maximum (9.72 ± 4.31 dB), while the average subharmonic amplitude of the outer lateral layer of the carotid artery was higher (-56.40 ± 6.31 dB) (p < 0.001). CONCLUSION The SHAPE technique is capable of indirectly reflecting the pressure changes of vascular system tissues, which may provide a new monitoring method for evaluating mechanical characteristics obviating invasion.
Collapse
Affiliation(s)
- Rui Li
- Department of Ultrasound, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Yukang Zhang
- Department of Ultrasound, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Shuai Zheng
- Department of Ultrasound, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Wenkai Zhang
- Department of Ultrasound, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Kai Du
- Department of Ultrasound, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Wen He
- Department of Ultrasound, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Wei Zhang
- Department of Ultrasound, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| |
Collapse
|
8
|
Belhoul-Fakir H, Brown ML, Thompson PL, Hamzah J, Jansen S. Connecting the Dots: How Injury in the Arterial Wall Contributes to Atherosclerotic Disease. Clin Ther 2023; 45:1092-1098. [PMID: 37891144 DOI: 10.1016/j.clinthera.2023.10.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2023] [Revised: 09/22/2023] [Accepted: 10/09/2023] [Indexed: 10/29/2023]
Abstract
PURPOSE The occurrence and development of atherosclerotic cardiovascular disease, which can result in severe outcomes, such as myocardial infarction, stroke, loss of limb, renal failure, and infarction of the gut, are strongly associated with injury to the intimal component of the arterial wall whether via the inside-out or outside-in pathways. The role of injury to the tunica media as a pathway of atherosclerosis initiation is an underresearched area. This review focuses on potential pathways to vessel wall injury as well as current experimental and clinical research in the middle-aged and elderly populations, including the role of exercise, as it relates to injury to the tunica media. METHODS A database search using PubMed and Google Scholar was conducted for research articles published between 1909 and 2023 that focused on pathways of atherogenesis and the impact of mechanical forces on wall injury. The following key words were searched: wall injury, tunica media, atherogenesis, vascular aging, and wall strain. Studies were analyzed, and the relevant information was extracted from each study. FINDINGS A link between high mechanical stress in the arterial wall and reduced vascular compliance was found. The stiffening and calcification of the arterial wall with aging induce high blood pressure and pulse pressure, thereby causing incident hypertension and cardiovascular disease. In turn, prolonged high mechanical stress, particularly wall strain, applied to the arterial wall during vigorous exercise, results in stiffening and calcification of tunica media, accelerated arterial aging, and cardiovascular disease events. In both scenarios, the tunica media is the primary target of mechanical stress and the first to respond to hemodynamic changes. The cyclical nature of these impacts confounds the results of each because they are not mutually exclusive. IMPLICATIONS The role of stress in the tunica media appears to be overlooked despite its relevance, and further research into new primary preventive therapies is needed aside from cautioning the role of vigorous exercise in the elderly population.
Collapse
Affiliation(s)
- Hanane Belhoul-Fakir
- Curtin Medical School, Curtin University, Bentley, Perth, Western Australia, Australia; Targeted Drug Delivery, Imaging & Therapy, Harry Perkins Institute of Medical Research, QEII Medical Centre, Nedlands, Western Australia, Australia; Heart & Vascular Research Institute, Harry Perkins Institute of Medical Research, QEII Medical Centre, Nedlands, Western Australia, Australia.
| | - Michael Lawrence Brown
- School of Population Health, Curtin University, Bently, Perth, Western Australia, Australia
| | - Peter L Thompson
- Heart & Vascular Research Institute, Harry Perkins Institute of Medical Research, QEII Medical Centre, Nedlands, Western Australia, Australia
| | - Juliana Hamzah
- Curtin Medical School, Curtin University, Bentley, Perth, Western Australia, Australia; Targeted Drug Delivery, Imaging & Therapy, Harry Perkins Institute of Medical Research, QEII Medical Centre, Nedlands, Western Australia, Australia; Heart & Vascular Research Institute, Harry Perkins Institute of Medical Research, QEII Medical Centre, Nedlands, Western Australia, Australia
| | - Shirley Jansen
- Curtin Medical School, Curtin University, Bentley, Perth, Western Australia, Australia; Targeted Drug Delivery, Imaging & Therapy, Harry Perkins Institute of Medical Research, QEII Medical Centre, Nedlands, Western Australia, Australia; Heart & Vascular Research Institute, Harry Perkins Institute of Medical Research, QEII Medical Centre, Nedlands, Western Australia, Australia; Department of Vascular and Endovascular Surgery, Sir Charles Gairdner Hospital, Nedlands, Perth, Western Australia, Australia.
| |
Collapse
|
9
|
Zhao N, Chung TD, Guo Z, Jamieson JJ, Liang L, Linville RM, Pessell AF, Wang L, Searson PC. The influence of physiological and pathological perturbations on blood-brain barrier function. Front Neurosci 2023; 17:1289894. [PMID: 37937070 PMCID: PMC10626523 DOI: 10.3389/fnins.2023.1289894] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Accepted: 10/06/2023] [Indexed: 11/09/2023] Open
Abstract
The blood-brain barrier (BBB) is located at the interface between the vascular system and the brain parenchyma, and is responsible for communication with systemic circulation and peripheral tissues. During life, the BBB can be subjected to a wide range of perturbations or stresses that may be endogenous or exogenous, pathological or therapeutic, or intended or unintended. The risk factors for many diseases of the brain are multifactorial and involve perturbations that may occur simultaneously (e.g., two-hit model for Alzheimer's disease) and result in different outcomes. Therefore, it is important to understand the influence of individual perturbations on BBB function in isolation. Here we review the effects of eight perturbations: mechanical forces, temperature, electromagnetic radiation, hypoxia, endogenous factors, exogenous factors, chemical factors, and pathogens. While some perturbations may result in acute or chronic BBB disruption, many are also exploited for diagnostic or therapeutic purposes. The resultant outcome on BBB function depends on the dose (or magnitude) and duration of the perturbation. Homeostasis may be restored by self-repair, for example, via processes such as proliferation of affected cells or angiogenesis to create new vasculature. Transient or sustained BBB dysfunction may result in acute or pathological symptoms, for example, microhemorrhages or hypoperfusion. In more extreme cases, perturbations may lead to cytotoxicity and cell death, for example, through exposure to cytotoxic plaques.
Collapse
Affiliation(s)
- Nan Zhao
- Institute for Nanobiotechnology, Johns Hopkins University, Baltimore, MD, United States
| | - Tracy D. Chung
- Institute for Nanobiotechnology, Johns Hopkins University, Baltimore, MD, United States
- Department of Biomedical Engineering, Johns Hopkins University, Baltimore, MD, United States
| | - Zhaobin Guo
- Institute for Nanobiotechnology, Johns Hopkins University, Baltimore, MD, United States
| | - John J. Jamieson
- Institute for Nanobiotechnology, Johns Hopkins University, Baltimore, MD, United States
- Department of Chemical and Biomolecular Engineering, Johns Hopkins University, Baltimore, MD, United States
| | - Lily Liang
- Institute for Nanobiotechnology, Johns Hopkins University, Baltimore, MD, United States
- Department of Biomedical Engineering, Johns Hopkins University, Baltimore, MD, United States
| | - Raleigh M. Linville
- Institute for Nanobiotechnology, Johns Hopkins University, Baltimore, MD, United States
- Department of Biomedical Engineering, Johns Hopkins University, Baltimore, MD, United States
| | - Alex F. Pessell
- Institute for Nanobiotechnology, Johns Hopkins University, Baltimore, MD, United States
- Department of Biomedical Engineering, Johns Hopkins University, Baltimore, MD, United States
| | - Linus Wang
- Institute for Nanobiotechnology, Johns Hopkins University, Baltimore, MD, United States
- Department of Biomedical Engineering, Johns Hopkins University, Baltimore, MD, United States
| | - Peter C. Searson
- Institute for Nanobiotechnology, Johns Hopkins University, Baltimore, MD, United States
- Department of Biomedical Engineering, Johns Hopkins University, Baltimore, MD, United States
- Department of Materials Science and Engineering, Johns Hopkins University, Baltimore, MD, United States
| |
Collapse
|
10
|
Alamilla-Sanchez ME, Alcala-Salgado MA, Cerezo Samperio B, Prado Lozano P, Diaz Garcia JD, Gonzalez Fuentes C, Yama Estrella MB, Morales Lopez EF. Advances in the Physiology of Transvascular Exchange and A New Look At Rational Fluid Prescription. Int J Gen Med 2023; 16:2753-2770. [PMID: 37408844 PMCID: PMC10319290 DOI: 10.2147/ijgm.s405926] [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: 01/25/2023] [Accepted: 05/28/2023] [Indexed: 07/07/2023] Open
Abstract
The Starling principle is a model that explains the transvascular distribution of fluids essentially governed by hydrostatic and oncotic forces, which dynamically allow vascular refilling according to the characteristics of the blood vessel. However, careful analysis of fluid physiology has shown that the principle, while correct, is not complete. The revised Starling principle (Michel-Weinbaum model) provides relevant information on fluid kinetics. Special emphasis has been placed on the endothelial glycocalyx, whose subendothelial area allows a restricted oncotic pressure that limits the reabsorption of fluid from the interstitial space, so that transvascular refilling occurs mainly from the lymphatic vessels. The close correlation between pathological states of the endothelium (eg: sepsis, acute inflammation, or chronic kidney disease) and the prescription of fluids forces the physician to understand the dynamics of fluids in the organism; this will allow rational fluid prescriptions. A theory that integrates the physiology of exchange and transvascular refilling is the "microconstant model", whose variables include dynamic mechanisms that can explain edematous states, management of acute resuscitation, and type of fluids for common clinical conditions. The clinical-physiological integration of the concepts will be the hinges that allow a rational and dynamic prescription of fluids.
Collapse
Affiliation(s)
| | | | | | - Pamela Prado Lozano
- Department of Nephrology, Centro Medico Nacional “20 de Noviembre”, Mexico City, Mexico
| | | | | | | | | |
Collapse
|
11
|
Belhoul-Fakir H, Wu J, Yeow YL, Musk GC, Kershaw H, Ingley E, Zhao BS, Reid CM, Lagat C, Evans B, Thompson PL, Brown ML, Hamzah J, Jansen S. Injury to the tunica media initiates atherogenesis in the presence of hyperlipidemia. Front Cardiovasc Med 2023; 10:1152124. [PMID: 37063951 PMCID: PMC10098105 DOI: 10.3389/fcvm.2023.1152124] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Accepted: 03/10/2023] [Indexed: 03/31/2023] Open
Abstract
Background and aims Fatty streaks initiating the formation of atheromatous plaque appear in the tunica intima. The tunica media is not known to be a nidus for lipid accumulation initiating atherogenesis. We assessed changes to the tunica media in response to a micro-injury produced in the pig aorta. In addition, we assessed human carotid endarterectomy plaques for indication of atheroma initiation in the tunica media. Methods Three healthy landrace female pigs underwent laparotomy to inject autologous blood and create micro-hematomas at 6 sites within the tunica media of the infrarenal abdominal aorta. These pigs were fed a high-fat diet (HFD) for 4-12 weeks. Post-mortem aortas from all pigs, including a control group of healthy pigs, were serially stained to detect lipid deposits, vasa vasora (VV), immune cell infiltration and inflammatory markers, as well as changes to the vascular smooth muscle cell (vSMC) compartment. Moreover, 25 human carotid endarterectomy (CEA) specimens were evaluated for their lipid composition in the tunica media and intima. Results High lipid clusters, VV density, and immune cell infiltrates were consistently observed at 5 out of 6 injection sites under prolonged hyperlipidemia. The hyperlipidemic diet also affected the vSMC compartment in the tunica media adjacent to the tunica adventitia, which correlated with VV invasion and immune cell infiltration. Analysis of human carotid specimens post-CEA indicated that 32% of patients had significantly greater atheroma in the tunica media than in the arterial intima. Conclusion The arterial intima is not the only site for atherosclerosis initiation. We show that injury to the media can trigger atherogenesis.
Collapse
Affiliation(s)
- Hanane Belhoul-Fakir
- Curtin Medical School, Curtin University, Bentley, Perth, WA, Australia
- Laboratory of Targeted Drug Delivery, Imaging & Therapy, Harry Perkins Institute of Medical Research, QEII MedicalCentre, Nedlands, WA, Australia
- Heart & Vascular Research Institute, Harry Perkins Institute of Medical Research, QEII Medical Centre, Nedlands, WA, Australia
| | - Jiansha Wu
- Laboratory of Targeted Drug Delivery, Imaging & Therapy, Harry Perkins Institute of Medical Research, QEII MedicalCentre, Nedlands, WA, Australia
- Heart & Vascular Research Institute, Harry Perkins Institute of Medical Research, QEII Medical Centre, Nedlands, WA, Australia
| | - Yen L. Yeow
- Laboratory of Targeted Drug Delivery, Imaging & Therapy, Harry Perkins Institute of Medical Research, QEII MedicalCentre, Nedlands, WA, Australia
| | - Gabrielle C. Musk
- Animal Care Services, The University of Western Australia, Crawley, Perth, WA, Australia
| | - Helen Kershaw
- Animal Care Services, The University of Western Australia, Crawley, Perth, WA, Australia
| | - Evan Ingley
- Discipline of Medical, Molecular, and Forensic Sciences, Murdoch University, Murdoch, WA, Australia
- School of Biomedical Sciences, Pharmacology, and Toxicology, The University of Western Australia, Perth, WA, Australia
- Centre for Medical Research, The University of Western Australia, Perth, WA, Australia
| | - Bichen Sophie Zhao
- Curtin Medical School, Curtin University, Bentley, Perth, WA, Australia
- Laboratory of Targeted Drug Delivery, Imaging & Therapy, Harry Perkins Institute of Medical Research, QEII MedicalCentre, Nedlands, WA, Australia
| | - Christopher M. Reid
- School of Public Health and Preventive Medicine, Monash University, Clayton, VIC, Australia
- School of Population Health, Curtin University, Bentley, Perth, WA, Australia
| | - Christopher Lagat
- Western Australia School of Mine: Minerals, Energy and Chemical Engineering, Curtin University, Kensington, Perth, WA, Australia
| | - Brian Evans
- Western Australia School of Mine: Minerals, Energy and Chemical Engineering, Curtin University, Kensington, Perth, WA, Australia
| | - Peter L. Thompson
- Laboratory of Targeted Drug Delivery, Imaging & Therapy, Harry Perkins Institute of Medical Research, QEII MedicalCentre, Nedlands, WA, Australia
- Heart & Vascular Research Institute, Harry Perkins Institute of Medical Research, QEII Medical Centre, Nedlands, WA, Australia
| | - Michael L. Brown
- School of Population Health, Curtin University, Bentley, Perth, WA, Australia
| | - Juliana Hamzah
- Curtin Medical School, Curtin University, Bentley, Perth, WA, Australia
- Laboratory of Targeted Drug Delivery, Imaging & Therapy, Harry Perkins Institute of Medical Research, QEII MedicalCentre, Nedlands, WA, Australia
- Heart & Vascular Research Institute, Harry Perkins Institute of Medical Research, QEII Medical Centre, Nedlands, WA, Australia
| | - Shirley Jansen
- Curtin Medical School, Curtin University, Bentley, Perth, WA, Australia
- Laboratory of Targeted Drug Delivery, Imaging & Therapy, Harry Perkins Institute of Medical Research, QEII MedicalCentre, Nedlands, WA, Australia
- Heart & Vascular Research Institute, Harry Perkins Institute of Medical Research, QEII Medical Centre, Nedlands, WA, Australia
- Department of Vascular and Endovascular Surgery, Sir Charles Gairdner Hospital, Nedlands, Perth, WA, Australia
| |
Collapse
|
12
|
Geerlings-Batt J, Sun Z. Coronary computed tomography angiography assessment of relationship between right coronary artery-aorta angle and the development of coronary artery disease. Quant Imaging Med Surg 2023; 13:1948-1956. [PMID: 36915318 PMCID: PMC10006145 DOI: 10.21037/qims-22-655] [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: 06/22/2022] [Accepted: 12/26/2022] [Indexed: 02/07/2023]
Abstract
Whilst a correlation has been established between wide left main coronary artery bifurcation [left anterior descending-left circumflex (LAD-LCx)] angle (>80°) and the development of coronary artery disease (CAD), this retrospective, causal-comparative pilot study aimed to explore whether a relationship exists between right coronary artery (RCA)-aorta angle and CAD. Thirty normal cases were identified via radiology reports and selected as the control group with coronary computed tomography angiography (CCTA) scans performed on a 320-slice computed tomography (CT) scanner. Thirty CAD cases were selected with invasive coronary angiography performed to confirm the degree of stenosis, and CCTA performed on dual source and 320-slice CT scanners. An independent sample t-test was used to compare the differences in coronary angles between the normal and CAD group, and analysis of variance (ANOVA) was used to assess for significant differences between coronary angles in normal and CAD subgroups. Coronary angle measurements were conducted by two independent assessors with high intraclass correlation (r=0.971-0.998, P<0.001). RCA-aorta angle measurements were significantly larger in the normal group [87.47°, 95% confidence interval (CI): 79.31° to 95.78°] compared to the CAD group (76.82°, 95% CI: 67.82° to 85.61°, P=0.05). No significant difference was found between RCA-aorta angle and degree of coronary stenosis (P=0.75). This study suggests a relationship between narrow RCA-aorta angle and CAD.
Collapse
Affiliation(s)
- Jade Geerlings-Batt
- Discipline of Medical Radiation Science, Curtin Medical School, Curtin University, Perth, WA, Australia
| | - Zhonghua Sun
- Discipline of Medical Radiation Science, Curtin Medical School, Curtin University, Perth, WA, Australia
| |
Collapse
|
13
|
Role of Preoperative Ultrasound Shear-Wave Elastography and Radiofrequency-Based Arterial Wall Tracking in Assessing the Vulnerability of Carotid Plaques: Preliminary Results. Diagnostics (Basel) 2023; 13:diagnostics13040805. [PMID: 36832293 PMCID: PMC9955800 DOI: 10.3390/diagnostics13040805] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2022] [Revised: 02/03/2023] [Accepted: 02/19/2023] [Indexed: 02/23/2023] Open
Abstract
We aimed at evaluating the ability of point shear-wave elastography (pSWE) and of a radiofrequency (RF) echo-tracking-based method in preoperatively assessing the vulnerability of the carotid plaque in patients undergoing carotid endarterectomy (CEA) for significant asymptomatic stenosis. All patients who underwent CEA from 03/2021 to 03/2022 performed a preoperative pSWE and an RF echo-based wall evaluation of arterial stiffness using an Esaote MyLab ultrasound system (EsaoteTM, Genova, Italy) with dedicated software. The data derived from these evaluations (Young's modulus (YM), augmentation index (AIx), pulse-wave velocity (PWV)) were correlated with the outcome of the analysis of the plaque removed during the surgery. Data were analyzed on 63 patients (33 vulnerable and 30 stable plaques). In stable plaques, YM was significantly higher than in vulnerable plaques (49.6 + 8.1 kPa vs. 24.6 + 4.3 kPa, p = 0.009). AIx also tended to be slightly higher in stable plaques, even if it was not statistically significant (10.4 + 0.9% vs. 7.7 + 0.9%, p = 0.16). The PWV was similar (12.2 + 0.9 m/s for stable plaques vs. 10.6 + 0.5 m/s for vulnerable plaques, p = 0.16). For YM, values >34 kPa had a sensitivity of 50% and a specificity of 73.3% in predicting plaque nonvulnerability (area under the curve = 0.66). Preoperative measurement of YM by means of pSWE could be a noninvasive and easily applicable tool for assessing the preoperative risk of plaque vulnerability in asymptomatic patients who are candidates for CEA.
Collapse
|