Vascular preventive measures: the progression from asymptomatic to symptomatic atherosclerosis management. Evidence on usefulness of early diagnosis in women and children

Glucagon-Like Peptide-1 Receptor Agonists and Brain Vascular Function

Prevention of cardiovascular events and regression of atherosclerotic changes are the primary aims of preventive cardiovascular medicine. Arterial thrombosis is caused by endothelial dysfunction, which disrupts vascular haemostasis. Glucagon-like peptide 1 (GLP-1) receptor agonists have been initially used as glucose lowering agents, but over time have been used for other indications due to their cardiorenal benefit, as well as their benefit in the regression of atherosclerosis process. The aim of this paper is to present the benefits of GLP-1 receptor agonists in the prevention of atherosclerotic changes, in the preservation of brain vascular function, and to show the possible role in the treatment of neurodegenerative diseases.

Residential exposure to urban traffic is associated with increased carotid intima-media thickness in children

Chronic exposure to urban traffic pollution is documented to promote atherosclerosis in adults but little is known about its potential effects in children. Our study examined the association of long-term exposure to traffic with carotid intima-media thickness (cIMT) in 287 healthy children. Residential proximity and distance-weighted traffic density (DWTD) were used as proximity markers for traffic-related air pollution exposure. The multivariable analyses revealed that children residing <100 meters from the nearest heavily trafficked road had cIMT mean and maximum measurements that were increased by 15% and 11% compared to those living ≥ 200 meters away (P = 0.0001). Similar increases in cIMT were identified for children in the highest versus lowest DWTD tertile. Children who resided 100–199 meters from traffic or in the middle DWTD tertile also exhibited increased cIMT but these differences were not statistically significant. No statistically significant differences were identified between residential distance to traffic or DWTD and systemic inflammation indicators (CRP, IL-6). The study results suggest that exposure to urban traffic promotes arterial remodeling in children. This finding is important since even small increases in cIMT over time can potentially lead to earlier progression to atherosclerosis. It is also important because traffic-related pollution is potentially modifiable.

Levels of acylation stimulating protein and the complement component 3 precursor are associated with the occurrence and development of coronary heart disease

The aim of the present study was to investigate whether acylation stimulating protein (ASP) and complement component 3 (C3) are associated with the occurrence and development of coronary heart disease (CHD). The participants of the study were divided into three groups, including the healthy control (n=42), metabolic syndrome (MS, n=56) and CHD (n=62) groups. An enzyme-linked immunosorbent assay was used to measure the ASP concentrations, while an immunoturbidimetric assay was employed to determine the C3 concentrations. In addition, coronary angiography was performed to determine the severity of coronary artery disease in the CHD group. The CHD group was divided into three subgroups, according to the final Gensini score of coronary artery stenosis for each patient (mild, ≤20 points; moderate, 21–40 points; severe, >40 points). Western blotting and quantitative reverse transcription-polymerase chain reaction (RT-PCR) were performed to analyze the protein and mRNA expression levels of C3 in the CHD subgroups and the healthy control group. The concentrations of ASP and C3 in the CHD group were found to be significantly higher compared with the control and MS groups. In addition, the levels of ASP and C3 in the mild and moderate CHD subgroups were significantly higher compared with the healthy controls or mild CHD patients. Furthermore, the protein expression levels of C3 in the moderate and severe CHD patients were found to be significantly higher compared with the healthy individuals and the mild CHD patients. The quantitative RT-PCR results revealed that the mRNA expression levels of C3 in the moderate and severe CHD patients were significantly higher compared with the healthy control group and the mild CHD patients. Furthermore, the mean levels of C3 transcripts in the severe CHD patients were found to be higher compared with the moderate CHD subgroup (P<0.05). Therefore, ASP and C3 were found to be associated with the occurrence and development of CHD; thus, may be used as novel indexes for CHD.

Accuracy of MDCT for detection and identification of carotid atherosclerotic plaque in a rabbit model

OBJECTIVE

There is a need for a simple, rapid, and repeatable noninvasive imaging method to accurately assess carotid atherosclerotic plaque. The purpose of this study was to explore the utility of MDCT and carotid artery plaque analysis software for detecting and identifying atherosclerotic plaque in a rabbit model of carotid atherosclerosis.

MATERIALS AND METHODS

Plaques from 14 rabbits and cross-sectional carotid artery specimens were detected, stained, and analyzed. Contrast-enhanced MDCT with application of carotid plaque analysis software was performed. Bland-Altman difference plots were used to assess interclass and intraclass consistency in lipid percentage and fibrous percentage on CT images.

RESULTS

A total of 76 of the 158 samples were true positive for plaque. On the basis of histopathologic examination of the samples, the accuracy, sensitivity, and specificity of CT for detecting plaque were 91.8%, 89.4%, and 94.5%, and the accuracy, sensitivity, and specificity of the software for classifying lipid-rich plaques and fibrous plaques were 90.8%, 90.6%, and 90.9%. Repeated measurements by the same physician showed good repeatability, and measurements by two physicians independently showed good correlation.

CONCLUSION

The results showed that MDCT can be used to detect carotid atherosclerotic plaque and that carotid plaque analysis software can be used to measure the content of plaque composition and determine the nature of plaque.