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Yang J, Gao P, Li Q, Wang T, Guo S, Zhang J, Zhang T, Wu G, Guo Y, Wang Z, Tian Y. Arterial Adventitial Vasa Vasorum Density Reflects The Progression Of Unstable Plaques: A Retrospective Clinical Study. Ultrasound Med Biol 2024; 50:712-721. [PMID: 38365464 DOI: 10.1016/j.ultrasmedbio.2024.01.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Revised: 01/10/2024] [Accepted: 01/14/2024] [Indexed: 02/18/2024]
Abstract
OBJECTIVE Arterial adventitial vasa vasorum (AVV) plays an important role in the occurrence and development of atherosclerotic (AS) disease. AS is a systemic disease, and plaque is not only a local vascular event, but also occurs at multiple sites throughout the vascular bed. Currently, effective anti-AVV therapies are lacking. Therefore, we posed the following scientific questions: "does human carotid adventitial vasa vasorum density reflect plaque neovascularization and intimal-media hyperplasia in carotid?"; and "is it possible to reduce human AVV density by sonodynamic therapy (SDT)?" METHODS A retrospective study was conducted on 160 patients with carotid atherosclerosis. Duplex ultrasound scanning (DUS), contrast-enhanced ultrasound (CEUS), coronary angiography, and coronary CT angiography (CTA) were used for diagnosis and screening. Pearson correlation tests and Receiver operating characteristic (ROC) curve were used to analyze the relationships between AVV hyperplasia, vasa vasorum (VV) hyperplasia and the intima-media thickness (IMT). SDT was developed for the treatment of arterial AVV hyperplasia and AS plaques. RESULTS The presence of local AVV in carotid unstable plaques correlated with the echogenic properties of the carotid plaque and the extent of plaque progression; Furthermore local AVV hyperplasia in patients with carotid atherosclerotic plaques was associated with acute coronary syndrome (ACS) events; Local AVV hyperplasia in patients with carotid atherosclerotic plaques was associated with coronary artery stenosis. Notably, SDT reduced local AVV hyperplasia and shrank the plaques in human femoral and carotid atherosclerotic lesions. CONCLUSIONS The presence of AVV in human carotid arteries reflects the severity of carotid and coronary artery AS. Further, SDT can reduce the hyperplasia of local AVV in human femoral and carotid plaques.
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Affiliation(s)
- Jiemei Yang
- Department of Cardiology, the First Affiliated Hospital, Cardiovascular Institute, Harbin Medical University, Harbin, P.R. China; Cardiac Ultrasound Division, the First Affiliated Hospital, Cardiovascular Institute, Harbin Medical University, Harbin, P.R. China
| | - Penghao Gao
- Department of Cardiology, the First Affiliated Hospital, Cardiovascular Institute, Harbin Medical University, Harbin, P.R. China
| | - Qiannan Li
- Department of General Practice, the Second Affiliated Hospital, Cardiovascular Institute, Harbin Medical University, Harbin, P.R. China
| | - Tengyu Wang
- Department of Cardiology, the First Affiliated Hospital, Cardiovascular Institute, Harbin Medical University, Harbin, P.R. China
| | - Shuyuan Guo
- Department of Cardiology, the First Affiliated Hospital, Cardiovascular Institute, Harbin Medical University, Harbin, P.R. China
| | - Jingyu Zhang
- Department of Geriatrics, the First Affiliated Hospital, Cardiovascular Institute, Harbin Medical University, Harbin, P.R. China
| | - Tianyi Zhang
- Department of Cardiology, the First Affiliated Hospital, Cardiovascular Institute, Harbin Medical University, Harbin, P.R. China
| | - Guodong Wu
- Department of Cardiology, the First Affiliated Hospital, Cardiovascular Institute, Harbin Medical University, Harbin, P.R. China
| | - Yuanyuan Guo
- Department of Cardiology, the First Affiliated Hospital, Cardiovascular Institute, Harbin Medical University, Harbin, P.R. China; Cardiac Ultrasound Division, the First Affiliated Hospital, Cardiovascular Institute, Harbin Medical University, Harbin, P.R. China
| | - Zeng Wang
- Department of Cardiology, the First Affiliated Hospital, Cardiovascular Institute, Harbin Medical University, Harbin, P.R. China
| | - Ye Tian
- Department of Cardiology, the First Affiliated Hospital, Cardiovascular Institute, Harbin Medical University, Harbin, P.R. China.
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Di Vito L, Di Giusto F, Grossi P. Non-culprit plaque progression: What do we know? Int J Cardiol 2024; 402:131881. [PMID: 38373683 DOI: 10.1016/j.ijcard.2024.131881] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/11/2024] [Accepted: 02/15/2024] [Indexed: 02/21/2024]
Affiliation(s)
- Luca Di Vito
- Cardiology Unit, C. and G. Mazzoni Hospital, AST Ascoli Piceno, Italy.
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Mastrofini A, Marino M, Karlöf E, Hedin U, Gasser TC. On the Impact of Residual Strains in the Stress Analysis of Patient-Specific Atherosclerotic Carotid Vessels: Predictions Based on the Homogenous Stress Hypothesis. Ann Biomed Eng 2024; 52:1347-1358. [PMID: 38349443 PMCID: PMC10995094 DOI: 10.1007/s10439-024-03458-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2023] [Accepted: 01/23/2024] [Indexed: 04/06/2024]
Abstract
The identification of carotid atherosclerotic lesion at risk for plaque rupture, eventually resulting in cerebral embolism and stroke, is of paramount clinical importance. High stress in the fibrous plaque cap has been proposed as risk factor. However, among others, residual strains influence said stress predictions, but quantitative and qualitative implications of residual strains in this context are not well explored. We therefore propose a multiplicative kinematics-based Growth and Remodeling (G&R) framework to predict residual strains from homogenizing tissue stress and then investigate its implication on plaque stress. Carotid vessel morphology of four patients was reconstructed from clinical Computed Tomography-Angiography (CT-A) images and equipped with heterogeneous tissue constitutive properties assigned through a histology-based artificial intelligence image segmentation tool. As compared to a purely elastic analysis and depending on patient-specific morphology and tissue distributions, the incorporation of residual strains reduced the maximum wall stress by up to 30 % and resulted in a fundamentally different distribution of stress across the atherosclerotic wall. Regardless residual strains homogenized tissue stresses, the fibrous plaque cap may persistently be exposed to spots of high stress. In conclusion, the incorporation of residual strains in biomechanical studies of atherosclerotic carotids may be important for a reliable assessment of fibrous plaque cap stress.
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Affiliation(s)
- Alessandro Mastrofini
- Department of Civil Engineering and Computer Science Engineering, University of Rome Tor Vergata, Rome, Italy
| | - Michele Marino
- Department of Civil Engineering and Computer Science Engineering, University of Rome Tor Vergata, Rome, Italy
| | - Eva Karlöf
- Vascular Surgery, Department of Molecular Medicine and Surgery, Karolinska Institute, Stockholm, Sweden
| | - Ulf Hedin
- Vascular Surgery, Department of Molecular Medicine and Surgery, Karolinska Institute, Stockholm, Sweden
| | - T Christian Gasser
- KTH Solid Mechanics, School of Engineering Sciences, KTH Royal Institute of Technology, Stockholm, Sweden.
- Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark.
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Wang Y, Zheng J, Li Q, Ma Y, Liu C, Deng J, Gao D. The relationship between complement C1q and coronary plaque vulnerability based on optical coherence tomography analysis. Sci Rep 2024; 14:9477. [PMID: 38658599 DOI: 10.1038/s41598-024-60128-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2023] [Accepted: 04/19/2024] [Indexed: 04/26/2024] Open
Abstract
To determine the association between complement C1q and vulnerable plaque morphology among coronary artery disease (CAD) patients. We conducted a retrospective observational study of 221 CAD patients admitted to The Second Affiliated Hospital of Xi'an Jiaotong University. Intravascular optical coherence tomography was utilized to describe the culprit plaques' morphology. Using logistic regression analysis to explore the correlation between C1q and vulnerable plaques, and receiver operator characteristic (ROC) analysis assess the predictive accuracy. As reported, the complement C1q level was lower in ACS patients than CCS patients (18.25 ± 3.88 vs. 19.18 ± 4.25, P = 0.045). The low complement-C1q-level group was more prone to develop vulnerable plaques. In lipid-rich plaques, the complement C1q level was positively correlated with the thickness of fibrous cap (r = 0.480, P = 0.041). Univariate and multivariate logistic regression analyses suggested that complement C1q could be an independent contributor to plaques' vulnerability. For plaque rupture, erosion, thrombus, and cholesterol crystals, the areas under the ROC curve of complement C1q level were 0.873, 0.816, 0.785, and 0.837, respectively (P < 0.05 for all). In CAD patients, the complement C1q could be a valuable indicator of plaque vulnerability.
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Affiliation(s)
- Yuan Wang
- Department of Cardiology, The Second Affiliated Hospital, Xi'an Jiaotong University, No. 157, Xiwu Road, Xi'an, 710000, Shaanxi, People's Republic of China
| | - Jiawei Zheng
- Department of Cardiology, The Second Affiliated Hospital, Xi'an Jiaotong University, No. 157, Xiwu Road, Xi'an, 710000, Shaanxi, People's Republic of China
| | - Qing Li
- Department of Cardiology, The Second Affiliated Hospital, Xi'an Jiaotong University, No. 157, Xiwu Road, Xi'an, 710000, Shaanxi, People's Republic of China
| | - Yao Ma
- Department of Cardiology, The Second Affiliated Hospital, Xi'an Jiaotong University, No. 157, Xiwu Road, Xi'an, 710000, Shaanxi, People's Republic of China
| | - Chang Liu
- Department of Cardiology, The Second Affiliated Hospital, Xi'an Jiaotong University, No. 157, Xiwu Road, Xi'an, 710000, Shaanxi, People's Republic of China
| | - Jie Deng
- Department of Cardiology, The Second Affiliated Hospital, Xi'an Jiaotong University, No. 157, Xiwu Road, Xi'an, 710000, Shaanxi, People's Republic of China
| | - Dengfeng Gao
- Department of Cardiology, The Second Affiliated Hospital, Xi'an Jiaotong University, No. 157, Xiwu Road, Xi'an, 710000, Shaanxi, People's Republic of China.
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Lee IH, Heo J, Lee H, Jeong J, Kim J, Han M, Yoo J, Kim J, Baik M, Park H, Jung JW, Kim YD, Nam HS. Long-term outcomes of patients with embolic stroke of undetermined source according to subtype. Sci Rep 2024; 14:9295. [PMID: 38653743 DOI: 10.1038/s41598-024-58292-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2023] [Accepted: 03/27/2024] [Indexed: 04/25/2024] Open
Abstract
The prognosis of patients with embolic stroke of undetermined source (ESUS) may vary according to the underlying cause. Therefore, we aimed to divide ESUS into subtypes and assess the long-term outcomes. Consecutive patients with acute ischemic stroke who underwent a comprehensive workup, including transesophageal echocardiography and prolonged electrocardiography monitoring, were enrolled. We classified ESUS into minor cardioembolic (CE) ESUS, arteriogenic ESUS, two or more causes ESUS, and no cause ESUS. Arteriogenic ESUS was sub-classified into complex aortic plaque (CAP) ESUS and non-stenotic (< 50%) relevant artery plaque (NAP) ESUS. A total of 775 patients were enrolled. During 1286 ± 748 days follow-up, 116 major adverse cardiovascular events (MACE) occurred (4.2 events/100 patient-years). Among the ESUS subtypes, CAP ESUS was associated with the highest MACE frequency (9.7/100 patient-years, p = 0.021). Cox regression analyses showed that CAP ESUS was associated with MACE (hazard ratio 2.466, 95% confidence interval 1.305-4.660) and any stroke recurrence (hazard ratio 2.470, 95% confidence interval, 1.108-5.508). The prognosis of ESUS varies according to the subtype, with CAP ESUS having the worst prognosis. Categorizing ESUS into subtypes could improve patient care and refine clinical trials.
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Affiliation(s)
- Il Hyung Lee
- Department of Neurology, National Health Insurance Service Ilsan Hospital, Goyang, Republic of Korea
- Department of Neurology, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 03722, Republic of Korea
- Department of Neurology, Kyung Hee University Hospital at Gangdong, Seoul, Republic of Korea
| | - JoonNyung Heo
- Department of Neurology, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 03722, Republic of Korea
| | - Hyungwoo Lee
- Department of Neurology, Ewha Womans University College of Medicine, Seoul, Republic of Korea
| | - JaeWook Jeong
- Department of Neurology, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 03722, Republic of Korea
| | - Joonho Kim
- Department of Neurology, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 03722, Republic of Korea
| | - Minho Han
- Department of Neurology, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 03722, Republic of Korea
| | - Joonsang Yoo
- Department of Neurology, Yonsei University College of Medicine, Yongin Severance Hospital, Yongin, Republic of Korea
| | - Jinkwon Kim
- Department of Neurology, Yonsei University College of Medicine, Yongin Severance Hospital, Yongin, Republic of Korea
| | - Minyoul Baik
- Department of Neurology, Yonsei University College of Medicine, Yongin Severance Hospital, Yongin, Republic of Korea
| | - Hyungjong Park
- Department of Neurology, Keimyung University School of Medicine, Daegu, Republic of Korea
| | - Jae Wook Jung
- Department of Neurology, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 03722, Republic of Korea
| | - Young Dae Kim
- Department of Neurology, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 03722, Republic of Korea
| | - Hyo Suk Nam
- Department of Neurology, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 03722, Republic of Korea.
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Deza S, Colina I, Beloqui O, Monreal JI, Martínez-Chávez E, Maroto-García J, Mugueta C, González A, Varo N. Evaluation of measured and calculated small dense low-density lipoprotein in capillary blood and association with the metabolic syndrome. Clin Chim Acta 2024; 557:117897. [PMID: 38570026 DOI: 10.1016/j.cca.2024.117897] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2024] [Revised: 03/31/2024] [Accepted: 03/31/2024] [Indexed: 04/05/2024]
Abstract
BACKGROUND AND AIMS Small-dense-low-density-lipoprotein cholesterol (sdLDL-C) is proatherogenic and not commonly measured. The aims were to evaluate capillary blood and its stability for sdLDL-C measurement and measure sdLDL-C in patients with metabolic syndrome (MS). METHODS 182 patients were studied (49 with MS). sdLDL-C was measured by electrophoresis (LipoPrint®), direct measurement (Roche Diagnostics) and Sampson equation. Intima-media thickness (IMT) and presence of atheroma was evaluated. sdLDL-C was compared in paired venous and capillary blood according to CLSI-EP09c (n = 40). sdLDL-C stability was studied after 24 h at room temperature (RT). RESULTS sdLDL-C in capillary blood and venous blood showed agreement with the direct measurement (bias: 4.17 mg/dL, LOA 95 %:-5.66; 13.99) and estimation (bias:8.12 mg/dL, LOA 95 %:-8.59; 24.82). sdLDL-C is stable in capillary blood for 24 h at RT. The electrophoretic method yielded lower (p < 0.05) sdLDL-C than the equation or direct measurement. Patients with MS had (p < 0.05) higher sdLDL-C (%) than patients without MS. Patients with atheroma plaques had higher sdLDL-C (p < 0.05). Estimated sdLDL-C correlated with IMT (r = 0.259, p < 0.001). CONCLUSIONS Capillary blood is an alternative to venous blood for sdLDL-C measurement and is stable for 24 h after collection. Estimated and directly measured sdLDL-C associate with the MS being accessible tools for cardiovascular risk assessment.
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Affiliation(s)
- Sara Deza
- Clinical Biochemistry Department, Clínica Universidad de Navarra, 31008 Pamplona, Spain
| | - Inmaculada Colina
- Internal Medicine Department, Clínica Universidad de Navarra, 31008 Pamplona, Spain
| | - Oscar Beloqui
- Internal Medicine Department, Clínica Universidad de Navarra, 31008 Pamplona, Spain
| | - José Ignacio Monreal
- Clinical Biochemistry Department, Clínica Universidad de Navarra, 31008 Pamplona, Spain
| | | | - Julia Maroto-García
- Clinical Biochemistry Department, Clínica Universidad de Navarra, 31008 Pamplona, Spain
| | - Carmen Mugueta
- Clinical Biochemistry Department, Clínica Universidad de Navarra, 31008 Pamplona, Spain
| | - Alvaro González
- Clinical Biochemistry Department, Clínica Universidad de Navarra, 31008 Pamplona, Spain
| | - Nerea Varo
- Clinical Biochemistry Department, Clínica Universidad de Navarra, 31008 Pamplona, Spain.
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Liu B, Su L, Loo SJ, Gao Y, Khin E, Kong X, Dalan R, Su X, Lee KO, Ma J, Ye L. Matrix metallopeptidase 9 contributes to the beginning of plaque and is a potential biomarker for the early identification of atherosclerosis in asymptomatic patients with diabetes. Front Endocrinol (Lausanne) 2024; 15:1369369. [PMID: 38660518 PMCID: PMC11039961 DOI: 10.3389/fendo.2024.1369369] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2024] [Accepted: 03/22/2024] [Indexed: 04/26/2024] Open
Abstract
Aims To determine the roles of matrix metallopeptidase-9 (MMP9) on human coronary artery smooth muscle cells (HCASMCs) in vitro, early beginning of atherosclerosis in vivo in diabetic mice, and drug naïve patients with diabetes. Methods Active human MMP9 (act-hMMP9) was added to HCASMCs and the expressions of MCP-1, ICAM-1, and VCAM-1 were measured. Act-hMMP9 (n=16) or placebo (n=15) was administered to diabetic KK.Cg-Ay/J (KK) mice. Carotid artery inflammation and atherosclerosis measurements were made at 2 and 10 weeks after treatment. An observational study of newly diagnosed drug naïve patients with type 2 diabetes mellitus (T2DM n=234) and healthy matched controls (n=41) was performed and patients had ultrasound of carotid arteries and some had coronary computed tomography angiogram for the assessment of atherosclerosis. Serum MMP9 was measured and its correlation with carotid artery or coronary artery plaques was determined. Results In vitro, act-hMMP9 increased gene and protein expressions of MCP-1, ICAM-1, VCAM-1, and enhanced macrophage adhesion. Exogenous act-hMMP9 increased inflammation and initiated atherosclerosis in KK mice at 2 and 10 weeks: increased vessel wall thickness, lipid accumulation, and Galectin-3+ macrophage infiltration into the carotid arteries. In newly diagnosed T2DM patients, serum MMP9 correlated with carotid artery plaque size with a possible threshold cutoff point. In addition, serum MMP9 correlated with number of mixed plaques and grade of lumen stenosis in coronary arteries of patients with drug naïve T2DM. Conclusion MMP9 may contribute to the initiation of atherosclerosis and may be a potential biomarker for the early identification of atherosclerosis in patients with diabetes. Clinical trial registration https://clinicaltrials.gov, identifier NCT04424706.
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Affiliation(s)
- Bingli Liu
- Department of Endocrinology, Nanjing First Hospital, Nanjing Medical University, Nanjing, China
| | - Liping Su
- National Heart Research Institute Singapore, National Heart Centre Singapore, Singapore, Singapore
| | - Sze Jie Loo
- National Heart Research Institute Singapore, National Heart Centre Singapore, Singapore, Singapore
| | - Yu Gao
- National Heart Research Institute Singapore, National Heart Centre Singapore, Singapore, Singapore
- Department of Cardiology, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Ester Khin
- National Heart Research Institute Singapore, National Heart Centre Singapore, Singapore, Singapore
| | - Xiaocen Kong
- Department of Endocrinology, Nanjing First Hospital, Nanjing Medical University, Nanjing, China
| | - Rinkoo Dalan
- Department of Endocrinology, Tan Tock Seng Hospital Lee Kong Chian School of Medicine Nanyang Technological University Singapore, Singapore, Singapore
| | - Xiaofei Su
- Department of Endocrinology, Nanjing First Hospital, Nanjing Medical University, Nanjing, China
| | - Kok-Onn Lee
- Division of Endocrinology, Department of Medicine, National University of Singapore, Singapore, Singapore
| | - Jianhua Ma
- Department of Endocrinology, Nanjing First Hospital, Nanjing Medical University, Nanjing, China
| | - Lei Ye
- National Heart Research Institute Singapore, National Heart Centre Singapore, Singapore, Singapore
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Li M, Guo R. Study on the Consistency of Angiogenesis in Carotid Plaque Evaluated by Contrast-Enhanced Ultrasound and Superb Microvascular Imaging and Its Correlation With Stroke Occurrence. J Ultrasound Med 2024; 43:771-779. [PMID: 38205964 DOI: 10.1002/jum.16409] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/14/2023] [Revised: 12/19/2023] [Accepted: 12/24/2023] [Indexed: 01/12/2024]
Abstract
OBJECTIVES This study aimed to investigate the value of contrast-enhanced ultrasound (CEUS) and superb microvascular imaging (SMI) in evaluating angiogenesis in carotid artery plaques and prognosis in stroke patients. METHODS Sixty-one patients with carotid atherosclerotic plaques were selected. All patients received conventional ultrasound, CEUS, and SMI examination, including 32 patients with cerebral infarction and 29 patients without cerebral infarction. The results of CEUS and SMI neovascularization of patients were graded 0, 1, and 2 points according to the image characteristics. The consistency between SMI results and CEUS results was evaluated, and the differences in neovascularization in carotid plaques between patients with cerebral infarction and those without cerebral infarction were compared. RESULTS SMI showed that the neovascularization score in plaque was 0 point in 13 cases, 1 point in 24 cases, and 2 points in 24 cases. There were no significant differences in age, sex, plaque size, or echo between the two groups. There was no significant difference between the SMI and CEUS results, P > .05. The CEUS neovascularization grade of patients with cerebral infarction had a higher score, which was significantly different from that of patients without cerebral infarction, P < .05. The SMI neovascularization grade of patients with cerebral infarction had a higher score, which was significantly different from that of patients without cerebral infarction, P < .05. CONCLUSION SMI can show neovascularization in plaques, with a significantly higher grade of neovascularization in those of patients with cerebral infarction than in those without cerebral infarction.
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Affiliation(s)
- Mingqiu Li
- Department of Ultrasound, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China
| | - Ruijun Guo
- Department of Ultrasound, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China
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Deprez L, Kempinaire G, Lorthioir F, Moïse M. [How do I investigate... the vulnerability of a carotid artery plaque in 2024]. Rev Med Liege 2024; 79:248-254. [PMID: 38602213] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/12/2024]
Abstract
Carotid artery atherosclerosis is one of the leading causes of stroke. Even though the association between the risk of stroke and the level of morphological stenosis of a carotid plaque has been known for a long time, growing evidence has since proven necessary to assess the composition of the plaque itself to identify vulnerability predictors. These vulnerable plaques, even more if non-stenosing, may be responsible for a significant - but hard to quantify - proportion of strokes so far classified cryptogenic. As a matter of fact, plaque composition may escape detection and characterisation with classical imaging. Several biomarkers associated with its vulnerability to destabilization and with the risk of stroke such as intraplaque hemorrhage and inflammation are now routinely assessable. After a few pathophysiological reminders and a critical reading of the historical literature concerning carotid artery atherosclerosis management, we will review in this article the imaging techniques that can be used in the routine work-up of a carotid atherosclerotic plaque, with a focus on vessel wall magnetic resonance imaging and contrast enhanced ultrasonography.
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Pontone G, Rossi A, Baggiano A, Andreini D, Conte E, Fusini L, Gebhard C, Rabbat MG, Guaricci A, Guglielmo M, Muscogiuri G, Mushtaq S, Al-Mallah MH, Berman DS, Budoff MJ, Cademartiri F, Chinnaiyan K, Choi JH, Chun EJ, de Araújo Gonçalves P, Gottlieb I, Hadamitzky M, Kim YJ, Lee BK, Lee SE, Maffei E, Marques H, Samady H, Shin S, Sung JM, van Rosendael A, Virmani R, Bax JJ, Leipsic JA, Lin FY, Min JK, Narula J, Shaw LJ, Chang HJ. Progression of non-obstructive coronary plaque: a practical CCTA-based risk score from the PARADIGM registry. Eur Radiol 2024; 34:2665-2676. [PMID: 37750979 DOI: 10.1007/s00330-023-09880-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2022] [Revised: 03/27/2023] [Accepted: 04/14/2023] [Indexed: 09/27/2023]
Abstract
OBJECTIVES No clear recommendations are endorsed by the different scientific societies on the clinical use of repeat coronary computed tomography angiography (CCTA) in patients with non-obstructive coronary artery disease (CAD). This study aimed to develop and validate a practical CCTA risk score to predict medium-term disease progression in patients at a low-to-intermediate probability of CAD. METHODS Patients were part of the Progression of AtheRosclerotic PlAque Determined by Computed Tomographic Angiography Imaging (PARADIGM) registry. Specifically, 370 (derivation cohort) and 219 (validation cohort) patients with two repeat, clinically indicated CCTA scans, non-obstructive CAD, and absence of high-risk plaque (≥ 2 high-risk features) at baseline CCTA were included. Disease progression was defined as the new occurrence of ≥ 50% stenosis and/or high-risk plaque at follow-up CCTA. RESULTS In the derivation cohort, 104 (28%) patients experienced disease progression. The median time interval between the two CCTAs was 3.3 years (2.7-4.8). Odds ratios for disease progression derived from multivariable logistic regression were as follows: 4.59 (95% confidence interval: 1.69-12.48) for the number of plaques with spotty calcification, 3.73 (1.46-9.52) for the number of plaques with low attenuation component, 2.71 (1.62-4.50) for 25-49% stenosis severity, 1.47 (1.17-1.84) for the number of bifurcation plaques, and 1.21 (1.02-1.42) for the time between the two CCTAs. The C-statistics of the model were 0.732 (0.676-0.788) and 0.668 (0.583-0.752) in the derivation and validation cohorts, respectively. CONCLUSIONS The new CCTA-based risk score is a simple and practical tool that can predict mid-term CAD progression in patients with known non-obstructive CAD. CLINICAL RELEVANCE STATEMENT The clinical implementation of this new CCTA-based risk score can help promote the management of patients with non-obstructive coronary disease in terms of timing of imaging follow-up and therapeutic strategies. KEY POINTS • No recommendations are available on the use of repeat CCTA in patients with non-obstructive CAD. • This new CCTA score predicts mid-term CAD progression in patients with non-obstructive stenosis at baseline. • This new CCTA score can help guide the clinical management of patients with non-obstructive CAD.
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Affiliation(s)
- Gianluca Pontone
- Department of Perioperative Cardiology and Cardiovascular Imaging, Centro Cardiologico Monzino IRCCS, Milan, Italy.
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, Milan, Italy.
| | - Alexia Rossi
- Department of Nuclear Medicine, University Hospital Zurich, Zurich, Switzerland
- Center for Molecular Cardiology, University of Zurich, Zurich, Switzerland
| | - Andrea Baggiano
- Department of Perioperative Cardiology and Cardiovascular Imaging, Centro Cardiologico Monzino IRCCS, Milan, Italy
| | - Daniele Andreini
- Department of Perioperative Cardiology and Cardiovascular Imaging, Centro Cardiologico Monzino IRCCS, Milan, Italy
- Department of Biomedical and Clinical Sciences, University of Milan, Milan, Italy
| | - Edoardo Conte
- Department of Perioperative Cardiology and Cardiovascular Imaging, Centro Cardiologico Monzino IRCCS, Milan, Italy
| | - Laura Fusini
- Department of Perioperative Cardiology and Cardiovascular Imaging, Centro Cardiologico Monzino IRCCS, Milan, Italy
| | - Chaterine Gebhard
- Department of Nuclear Medicine, University Hospital Zurich, Zurich, Switzerland
- Center for Molecular Cardiology, University of Zurich, Zurich, Switzerland
| | - Mark G Rabbat
- Division of Cardiology, Loyola University Chicago, Edward Hines Jr. VA Hospital, Hines, Chicago, IL, USA
| | - Andrea Guaricci
- Department of Emergency and Organ Transplantation, Institute of Cardiovascular Disease, University Hospital Policlinico of Bari, Bari, Italy
| | - Marco Guglielmo
- Department of Perioperative Cardiology and Cardiovascular Imaging, Centro Cardiologico Monzino IRCCS, Milan, Italy
| | - Giuseppe Muscogiuri
- Department of Perioperative Cardiology and Cardiovascular Imaging, Centro Cardiologico Monzino IRCCS, Milan, Italy
| | - Saima Mushtaq
- Department of Perioperative Cardiology and Cardiovascular Imaging, Centro Cardiologico Monzino IRCCS, Milan, Italy
| | - Mouaz H Al-Mallah
- Houston Methodist DeBakey Heart & Vascular Center, Houston Methodist Hospital, Houston, TX, USA
| | - Daniel S Berman
- Department of Imaging and Medicine, Cedars Sinai Medical Center, Los Angeles, CA, USA
| | - Matthew J Budoff
- Department of Medicine, Lundquist Institute at Harbor UCLA Medical Center, Torrance, CA, USA
| | | | | | | | - Eun Ju Chun
- Seoul National University Bundang Hospital, Sungnam, South Korea
| | - Pedro de Araújo Gonçalves
- Unit of Cardiovascular Imaging, UNICA, Hospital da Luz, Lisbon, Portugal
- NOVA Medical School, Lisbon, Portugal
| | - Ilan Gottlieb
- Department of Radiology, Casa de Saude São Jose, Rio de Janeiro, Brazil
| | - Martin Hadamitzky
- Department of Radiology and Nuclear Medicine, German Heart Center Munich, Munich, Germany
| | - Yong Jin Kim
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul National University Hospital, Cardiovascular Center, Seoul, South Korea
| | - Byoung Kwon Lee
- Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea
| | - Sang-Eun Lee
- Division of Cardiology, Department of Internal Medicine, Ewha Womans University Seoul Hospital, Seoul, South Korea
- Yonsei‑Cedars‑Sinai Integrative Cardiovascular Imaging Research Center, Yonsei University College of Medicine, Yonsei University Health System, Seoul, South Korea
| | - Erica Maffei
- Department of Radiology, Area Vasta 1/ASUR, Marche, Urbino, Italy
| | - Hugo Marques
- Unit of Cardiovascular Imaging, UNICA, Hospital da Luz, Lisbon, Portugal
| | - Habib Samady
- Division of Cardiology, Emory University School of Medicine, Atlanta, GA, USA
| | - Sanghoon Shin
- Division of Cardiology, Department of Internal Medicine, Ewha Womans University Seoul Hospital, Seoul, South Korea
| | - Ji Min Sung
- Yonsei‑Cedars‑Sinai Integrative Cardiovascular Imaging Research Center, Yonsei University College of Medicine, Yonsei University Health System, Seoul, South Korea
- Division of Cardiology, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Yonsei University Health System, Seoul, South Korea
| | - Alexander van Rosendael
- Department of Radiology, New York-Presbyterian Hospital and Weill Cornell Medicine, New York, NY, USA
| | - Renu Virmani
- Department of Pathology, CVPath Institute, Gaithersburg, MD, USA
| | - Jeroen J Bax
- Department of Cardiology, Leiden University Medical Center, Leiden, The Netherlands
- Turku Heart Center, University of Turku, Turku University Hospital, Turku, Finland
| | - Jonathon A Leipsic
- Department of Medicine and Radiology, University of British Columbia, Vancouver, BC, Canada
| | - Fay Y Lin
- Department of Radiology, New York-Presbyterian Hospital and Weill Cornell Medicine, New York, NY, USA
| | | | - Jagat Narula
- Icahn School of Medicine at Mount Sinai, Mount Sinai Heart, Zena and Michael A. Wiener Cardiovascular Institute, and Marie-Josée and Henry R. Kravis Center for Cardiovascular Health, New York, NY, USA
| | - Leslee J Shaw
- Department of Radiology, New York-Presbyterian Hospital and Weill Cornell Medicine, New York, NY, USA
| | - Hyuk-Jae Chang
- Yonsei‑Cedars‑Sinai Integrative Cardiovascular Imaging Research Center, Yonsei University College of Medicine, Yonsei University Health System, Seoul, South Korea
- Division of Cardiology, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Yonsei University Health System, Seoul, South Korea
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11
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Kopriva K, Chen Z, Mates M, Holy F, Stekla B, Vesela M, Pudil J, Chval M, Wahle A, Sonka M, Kovarnik T. The accuracy of detailed analysis of optical coherence tomography in detection of plaque lipid content: dual-imaging study with optical coherence tomography and near-infrared spectroscopy. Acta Cardiol 2024; 79:206-214. [PMID: 38465606 DOI: 10.1080/00015385.2024.2324214] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Accepted: 02/17/2024] [Indexed: 03/12/2024]
Abstract
BACKGROUND Lipid-rich plaque covered by a thin fibrous cap (FC) has been identified as a frequent morphological substrate for the development of acute coronary syndrome. Optical coherence tomography (OCT) permits the identification and measurement of the FC. Near-infrared spectroscopy (NIRS) has been approved for detection of coronary lipids. AIMS We aimed to assess the ability of detailed OCT analysis to identify coronary lipids, using NIRS as the reference method. METHODS In total, 40 patients with acute coronary syndrome underwent imaging of a non-culprit lesion by both NIRS and OCT. For each segment, the NIRS-derived 4 mm segment with maximal lipid core burden index (maxLCBI4mm) was assessed. OCT analysis was performed using a semi-automated method including measurement of the fibrous cap thickness (FCT) of all detected fibroatheromas. Subsequent quantitative volumetric evaluation furnished FCT, FC surface area (FC SA), lipid arc, and FC (fibrous cap) volume data. OCT features of lipid plaques were compared with maxLCBI4mm. Predictors of maxLCBI4mm >400 was assessed by using univariable and multivariable analysis. RESULTS OCT features (mean FCT, total FC SA, FC volume, maximal, mean, and total lipid arcs) strongly correlated with the maxLCBI4mm (p = 0.012 for the mean FCT, respectively p < 0.001 for all other aforementioned features). The strongest predictors of maxLCBI4mm >400 were the maximal (p = 0.002) and mean (p = 0.002) lipid arc, and total FC SA (p = 0.012). CONCLUSIONS We found a strong correlation between the OCT-derived features and NIRS findings. Detailed OCT analysis may be reliably used for detection of the presence of coronary lipids.
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Affiliation(s)
- Karel Kopriva
- Department of Cardiology, Na Homolce Hospital, Prague, Czech Republic
- 2nd Department of Internal Medicine - Department of Cardiovascular Medicine, First Faculty of Medicine, Charles University in Prague and General University Hospital in Prague, Prague, Czech Republic
| | - Zhi Chen
- Department of Electrical & Computer Engineering and Iowa Institute for Biomedical Imaging, The University of Iowa, Iowa City, IA, USA
| | - Martin Mates
- Department of Cardiology, Na Homolce Hospital, Prague, Czech Republic
| | - Frantisek Holy
- Department of Cardiology, Na Homolce Hospital, Prague, Czech Republic
| | - Barbora Stekla
- 2nd Department of Internal Medicine - Department of Cardiovascular Medicine, First Faculty of Medicine, Charles University in Prague and General University Hospital in Prague, Prague, Czech Republic
| | - Michaela Vesela
- 2nd Department of Internal Medicine - Department of Cardiovascular Medicine, First Faculty of Medicine, Charles University in Prague and General University Hospital in Prague, Prague, Czech Republic
| | - Jan Pudil
- 2nd Department of Internal Medicine - Department of Cardiovascular Medicine, First Faculty of Medicine, Charles University in Prague and General University Hospital in Prague, Prague, Czech Republic
| | - Martin Chval
- Institute for Research and Development of Education, Charles University in Prague, Prague, Czech Republic
| | - Andreas Wahle
- Department of Electrical & Computer Engineering and Iowa Institute for Biomedical Imaging, The University of Iowa, Iowa City, IA, USA
| | - Milan Sonka
- Department of Electrical & Computer Engineering and Iowa Institute for Biomedical Imaging, The University of Iowa, Iowa City, IA, USA
| | - Tomas Kovarnik
- 2nd Department of Internal Medicine - Department of Cardiovascular Medicine, First Faculty of Medicine, Charles University in Prague and General University Hospital in Prague, Prague, Czech Republic
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12
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Guo J, Li Z. Multiple plaque ruptures healing assessed by serial optical coherence tomography. J Invasive Cardiol 2024; 36. [PMID: 38412443 DOI: 10.25270/jic/23.00268] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/29/2024]
Abstract
A 30-year-old man with hypertension presented to the emergency department with a 30-minute episode of diaphoresis and chest pain, acute inferior myocardial infarction was diagnosed on electrocardiogram.
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Affiliation(s)
- Jincheng Guo
- Division of Cardiology, Beijing Luhe Hospital, Capital Medical University.
| | - Zixuan Li
- Division of Cardiology, Beijing Luhe Hospital, Capital Medical University
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13
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Herten VRLM, Hampe N, Takx RAP, Franssen KJ, Wang Y, Sucha D, Henriques JP, Leiner T, Planken RN, Isgum I. Automatic Coronary Artery Plaque Quantification and CAD-RADS Prediction Using Mesh Priors. IEEE Trans Med Imaging 2024; 43:1272-1283. [PMID: 37862273 DOI: 10.1109/tmi.2023.3326243] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/22/2023]
Abstract
Coronary artery disease (CAD) remains the leading cause of death worldwide. Patients with suspected CAD undergo coronary CT angiography (CCTA) to evaluate the risk of cardiovascular events and determine the treatment. Clinical analysis of coronary arteries in CCTA comprises the identification of atherosclerotic plaque, as well as the grading of any coronary artery stenosis typically obtained through the CAD-Reporting and Data System (CAD-RADS). This requires analysis of the coronary lumen and plaque. While voxel-wise segmentation is a commonly used approach in various segmentation tasks, it does not guarantee topologically plausible shapes. To address this, in this work, we propose to directly infer surface meshes for coronary artery lumen and plaque based on a centerline prior and use it in the downstream task of CAD-RADS scoring. The method is developed and evaluated using a total of 2407 CCTA scans. Our method achieved lesion-wise volume intraclass correlation coefficients of 0.98, 0.79, and 0.85 for calcified, non-calcified, and total plaque volume respectively. Patient-level CAD-RADS categorization was evaluated on a representative hold-out test set of 300 scans, for which the achieved linearly weighted kappa ( κ ) was 0.75. CAD-RADS categorization on the set of 658 scans from another hospital and scanner led to a κ of 0.71. The results demonstrate that direct inference of coronary artery meshes for lumen and plaque is feasible, and allows for the automated prediction of routinely performed CAD-RADS categorization.
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14
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Kim C, Park CH, Lee BY, Park CH, Kang EJ, Koo HJ, Kitagawa K, Cha MJ, Krittayaphong R, Choi SI, Yong HS, Ko SM, Kim SM, Hwang SH, Trang NN, Lee W, Kim YJ, Lee J, Yang DH. 2024 Consensus Statement on Coronary Stenosis and Plaque Evaluation in CT Angiography From the Asian Society of Cardiovascular Imaging-Practical Tutorial (ASCI-PT). Korean J Radiol 2024; 25:331-342. [PMID: 38528691 PMCID: PMC10973734 DOI: 10.3348/kjr.2024.0112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2024] [Accepted: 01/31/2024] [Indexed: 03/27/2024] Open
Abstract
The Asian Society of Cardiovascular Imaging-Practical Tutorial (ASCI-PT) is an instructional initiative of the ASCI School designed to enhance educational standards. In 2021, the ASCI-PT was convened with the goal of formulating a consensus statement on the assessment of coronary stenosis and coronary plaque using coronary CT angiography (CCTA). Nineteen experts from four countries conducted thorough reviews of current guidelines and deliberated on eight key issues to refine the process and improve the clarity of reporting CCTA findings. The experts engaged in both online and on-site sessions to establish a unified agreement. This document presents a summary of the ASCI-PT 2021 deliberations and offers a comprehensive consensus statement on the evaluation of coronary stenosis and coronary plaque in CCTA.
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Affiliation(s)
- Cherry Kim
- Department of Radiology, Korea University Ansan Hospital, Ansan, Republic of Korea
| | - Chul Hwan Park
- Department of Radiology and Research Institute of Radiological Science, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Bae Young Lee
- Department of Radiology, Eunpyeong St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Chan Ho Park
- Department of Radiology, Soonchunhyang University Cheonan Hospital, Cheonan, Republic of Korea
| | - Eun-Ju Kang
- Department of Radiology, College of Medicine, Dong-A University, Busan, Republic of Korea
| | - Hyun Jung Koo
- Department of Radiology and Research Institute of Radiology, Cardiac Imaging Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Kakuya Kitagawa
- Department of Radiology, Mie University Graduate School of Medicine, Tsu, Japan
| | - Min Jae Cha
- Department of Radiology, Chung-Ang University Hospital, Seoul, Republic of Korea
| | - Rungroj Krittayaphong
- Division of Cardiology, Department of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Sang Il Choi
- Department of Radiology, Seoul University Bundang Hospital, Seongnam, Republic of Korea
| | - Hwan Seok Yong
- Department of Radiology, Korea University Guro Hospital, Seoul, Republic of Korea
| | - Sung Min Ko
- Department of Radiology, Yonsei University Wonju College of Medicine, Wonju Severance Christian Hospital, Wonju, Republic of Korea
| | - Sung Mok Kim
- Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Sung Ho Hwang
- Department of Radiology, Korea University Anam Hospital, Seoul, Republic of Korea
| | | | - Whal Lee
- Department of Radiology, Seoul National University Hospital, Seoul, Republic of Korea
| | - Young Jin Kim
- Department of Radiology and Research Institute of Radiological Science, Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Jongmin Lee
- Department of Radiology, Kyungpook National University Hospital, Daegu, Republic of Korea
| | - Dong Hyun Yang
- Department of Radiology and Research Institute of Radiology, Cardiac Imaging Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.
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15
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Lu MT, Ribaudo H, Foldyna B, Zanni MV, Mayrhofer T, Karady J, Taron J, Fitch KV, McCallum S, Burdo TH, Paradis K, Hedgire SS, Meyersohn NM, DeFilippi C, Malvestutto CD, Sturniolo A, Diggs M, Siminski S, Bloomfield GS, Alston-Smith B, Desvigne-Nickens P, Overton ET, Currier JS, Aberg JA, Fichtenbaum CJ, Hoffmann U, Douglas PS, Grinspoon SK. Effects of Pitavastatin on Coronary Artery Disease and Inflammatory Biomarkers in HIV: Mechanistic Substudy of the REPRIEVE Randomized Clinical Trial. JAMA Cardiol 2024; 9:323-334. [PMID: 38381407 PMCID: PMC10882511 DOI: 10.1001/jamacardio.2023.5661] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Accepted: 12/15/2023] [Indexed: 02/22/2024]
Abstract
Importance Cardiovascular disease (CVD) is increased in people with HIV (PWH) and is characterized by premature noncalcified coronary plaque. In the Randomized Trial to Prevent Vascular Events in HIV (REPRIEVE), pitavastatin reduced major adverse cardiovascular events (MACE) by 35% over a median of 5.1 years. Objective To investigate the effects of pitavastatin on noncalcified coronary artery plaque by coronary computed tomography angiography (CTA) and on inflammatory biomarkers as potential mechanisms for MACE prevention. Design, Setting, and Participants This double-blind, placebo-controlled randomized clinical trial enrolled participants from April 2015 to February 2018 at 31 US clinical research sites. PWH without known CVD who were taking antiretroviral therapy and had low to moderate 10-year CVD risk were included. Data were analyzed from April to November 2023. Intervention Oral pitavastatin calcium, 4 mg per day. Main Outcomes and Measures Coronary CTA and inflammatory biomarkers at baseline and 24 months. The primary outcomes were change in noncalcified coronary plaque volume and progression of noncalcified plaque. Results Of 804 enrolled persons, 774 had at least 1 evaluable CTA. Plaque changes were assessed in 611 who completed both CT scans. Of 611 analyzed participants, 513 (84.0%) were male, the mean (SD) age was 51 (6) years, and the median (IQR) 10-year CVD risk was 4.5% (2.6-7.0). A total of 302 were included in the pitavastatin arm and 309 in the placebo arm. The mean noncalcified plaque volume decreased with pitavastatin compared with placebo (mean [SD] change, -1.7 [25.2] mm3 vs 2.6 [27.1] mm3; baseline adjusted difference, -4.3 mm3; 95% CI, -8.6 to -0.1; P = .04; 7% [95% CI, 1-12] greater reduction relative to placebo). A larger effect size was seen among the subgroup with plaque at baseline (-8.8 mm3 [95% CI, -17.9 to 0.4]). Progression of noncalcified plaque was 33% less likely with pitavastatin compared with placebo (relative risk, 0.67; 95% CI, 0.52-0.88; P = .003). Compared with placebo, the mean low-density lipoprotein cholesterol decreased with pitavastatin (mean change: pitavastatin, -28.5 mg/dL; 95% CI, -31.9 to -25.1; placebo, -0.8; 95% CI, -3.8 to 2.2). The pitavastatin arm had a reduction in both oxidized low-density lipoprotein (-29% [95% CI, -32 to -26] vs -13% [95% CI, -17 to -9]; P < .001) and lipoprotein-associated phospholipase A2 (-7% [95% CI, -11 to -4] vs 14% [95% CI, 10-18]; P < .001) compared with placebo at 24 months. Conclusions and Relevance In PWH at low to moderate CVD risk, 24 months of pitavastatin reduced noncalcified plaque volume and progression as well as markers of lipid oxidation and arterial inflammation. These changes may contribute to the observed MACE reduction in REPRIEVE. Trial Registration ClinicalTrials.gov Identifier: NCT02344290.
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Affiliation(s)
- Michael T. Lu
- Cardiovascular Imaging Research Center, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston
| | - Heather Ribaudo
- Center for Biostatistics in AIDS Research, Harvard T. H. Chan School of Public Health, Boston, Massachusetts
| | - Borek Foldyna
- Cardiovascular Imaging Research Center, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston
| | - Markella V. Zanni
- Metabolism Unit, Massachusetts General Hospital, Harvard Medical School, Boston
| | - Thomas Mayrhofer
- Cardiovascular Imaging Research Center, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston
- School of Business Studies, Stralsund University of Applied Sciences, Stralsund, Germany
| | - Julia Karady
- Cardiovascular Imaging Research Center, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston
- Cardiovascular Imaging Research Group, Heart and Vascular Center, Semmelweis University, Budapest, Hungary
| | - Jana Taron
- Cardiovascular Imaging Research Center, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston
- Department of Radiology, Medical Center University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Kathleen V. Fitch
- Metabolism Unit, Massachusetts General Hospital, Harvard Medical School, Boston
| | - Sara McCallum
- Metabolism Unit, Massachusetts General Hospital, Harvard Medical School, Boston
| | - Tricia H. Burdo
- Department of Microbiology, Immunology, and Inflammation, Center for NeuroVirology and Gene Editing, Temple University Lewis Katz School of Medicine, Philadelphia, Pennsylvania
| | - Kayla Paradis
- Cardiovascular Imaging Research Center, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston
| | - Sandeep S. Hedgire
- Cardiovascular Imaging Research Center, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston
| | - Nandini M. Meyersohn
- Cardiovascular Imaging Research Center, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston
| | | | | | - Audra Sturniolo
- Cardiovascular Imaging Research Center, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston
| | - Marissa Diggs
- Metabolism Unit, Massachusetts General Hospital, Harvard Medical School, Boston
| | | | - Gerald S. Bloomfield
- Department of Medicine, Duke Global Health Institute, Duke Clinical Research Institute, Duke University, Durham, North Carolina
| | - Beverly Alston-Smith
- Division of AIDS, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland
| | - Patrice Desvigne-Nickens
- Division of Cardiovascular Sciences, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland
| | - Edgar T. Overton
- Division of Infectious Diseases, University of Alabama at Birmingham
- ViiV Healthcare, Research Triangle Park, North Carolina
| | - Judith S. Currier
- Division of Infectious Diseases, David Geffen School of Medicine, University of California, Los Angeles
| | - Judith A. Aberg
- Division of Infectious Diseases, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Carl J. Fichtenbaum
- Division of Infectious Diseases, University of Cincinnati College of Medicine, Cincinnati, Ohio
| | | | - Pamela S. Douglas
- Duke University Research Institute, Duke University School of Medicine, Durham, North Carolina
| | - Steven K. Grinspoon
- Metabolism Unit, Massachusetts General Hospital, Harvard Medical School, Boston
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16
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Vrublevsky AV, Saushkin VV. Role of Imaging Modalities in the Quantitative Assessment of Atherosclerotic Plaques in the Thoracic Aorta. Kardiologiia 2024; 64:40-45. [PMID: 38597761 DOI: 10.18087/cardio.2024.3.n2457] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Accepted: 05/02/2023] [Indexed: 04/11/2024]
Abstract
AIM Comparative analysis of the height of atherosclerotic plaques (AP) in the descending thoracic aorta (TA) according to two-dimensional (2D) and three-dimensional (3D) transesophageal echocardiography (TEE), and contrast-enhanced multislice computed tomography (MSCT). MATERIAL AND METHODS The TA was examined using 2D, 3D TEE and contrast-enhanced MSCT in 34 patients (20 men and 14 women aged 68 [62; 71] years). AP heights were compared using the Bland-Altman method and the Spearman correlation analysis. This was a blinded comparative study which assessed the AP morphometry using each of the radiation modalities without knowing the results of the method being compared. RESULTS 100 APs were examined in the descending TA. The mean height of all analyzed APs in the descending TA was 2.2 mm [2; 2.7] for 2D TEE, 3.1 mm [2.7; 3.55] for 3D TEE, and 3.05 mm [2.55; 3.55] for MSCT. The AP heights measured with 2D TEE was statistically significantly smaller than the heights of similar APs measured either with 3D TEE or MSCT. The mean difference (bias) was 0.88±0.34 mm between 2D and 3D TEE, and 0.83±0.41 mm between 2D TEE and MSCT. The correlation coefficients for the AP heights were r=0.87 (p<0.001) between 2D and 3D TEE and r=0.86 (p<0.001) between 2D TEE and MSCT. There were no differences in the height of similar APs between 3D TEE and MSCT. CONCLUSION The three-dimensional reconstruction of AP in the TA by TEE is more accurate for quantitative assessment of AP than a two-dimensional study.
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Affiliation(s)
- A V Vrublevsky
- Research Institute of Cardiology, Tomsk National Research Medical Center of the Russian Academy of Sciences, Tomsk
| | - V V Saushkin
- Research Institute of Cardiology, Tomsk National Research Medical Center of the Russian Academy of Sciences, Tomsk
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17
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Guo J, Qin H, Li X. Association between monocyte/high-density lipoprotein cholesterol ratio and carotid plaque in postmenopausal women: A cross-sectional study. Medicine (Baltimore) 2024; 103:e37425. [PMID: 38518045 PMCID: PMC10957012 DOI: 10.1097/md.0000000000037425] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2024] [Accepted: 02/07/2024] [Indexed: 03/24/2024] Open
Abstract
To investigate the relationship between carotid plaque and monocyte to high-density lipoprotein cholesterol ratio (MHR) in postmenopausal women. A cross-sectional study was conducted and 214 postmenopausal women who underwent physical examination at the Health Management Center of Heping Hospital affiliated to Changzhi Medical College between August 2018 and August 2022 were enrolled. The subjects were grouped according to the results of carotid ultrasound. The general information, blood pressure, biochemical markers, and routine blood indicators were compared between the 2 groups. Binary logistic regression was performed to analyze the correlation between MHR and carotid plaque in postmenopausal women, and receiver operating characteristics (ROC) curve was used to analyze the predictive value of MHR for carotid plaque in this population. The carotid plaque group showed a lower high-density lipoprotein cholesterol (HDL-C) (1.21 [1.08-1.425] vs 1.29 [1.15-1.445] mmol/L, Z = -2.115, P = .034) and a higher MHR [0.33 ± 0.1 vs 0.26 ± 0.1, t = -5.756, P < .001] when compared to the no carotid plaque group. After adjusting for potential confounders such height, weight, and HDL-C, binary logistic regression analysis revealed that MHR continued to be an independent risk factor for the formation of carotid plaque in postmenopausal women (odds ratio [OR] = 1.795, 95% confidence interval [CI] 1.198-2.689, P = .005). ROC curve analysis indicated that MHR had a 95% CI of 0.656 to 0.793 in predicting carotid plaque formation, an optimal cut-point of 0.265, and a sensitivity and specificity of 82.2% and 58.9%, respectively. MHR is a distinct risk factor for carotid plaque formation in postmenopausal women.
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Affiliation(s)
- Jing Guo
- Health Management Center, Heping Hospital affiliated to Changzhi Medical College, Changzhi, Shanxi, China
| | - Haibo Qin
- Department of Cardiovascular Medicine, Heping Hospital affiliated to Changzhi Medical College, Changzhi, Shanxi, China
| | - Xianxian Li
- Department of Hematology, Heji Hospital affiliated to Changzhi Medical College, Changzhi, Shanxi, China
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18
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Wen L, Fu X, Zhang H, Ye P, Fu H, Zhou Z, Sun R, Xu T, Fu C, Zhu C, Guo Y, Fan H. Tailoring Zinc Ferrite Nanoparticle Surface Coating for Macrophage-Affinity Magnetic Resonance Imaging of Atherosclerosis. ACS Appl Mater Interfaces 2024; 16:13496-13508. [PMID: 38449094 DOI: 10.1021/acsami.3c17212] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/08/2024]
Abstract
Atherosclerosis is a chronic inflammatory disease characterized by the formation of atherosclerotic plaques, while macrophages as key players in plaque progression and destabilization are promising targets for atherosclerotic plaque imaging. Contrast-enhanced magnetic resonance imaging (CE-MRI) has emerged as a powerful noninvasive imaging technique for the evaluation of atherosclerotic plaques within arterial walls. However, the visualization of macrophages within atherosclerotic plaques presents considerable challenges due to the intricate pathophysiology of the disease and the dynamic behavior of these cells. Biocompatible ferrite nanoparticles with diverse surface ligands possess the potential to exhibit distinct relaxivity and cellular affinity, enabling improved imaging capabilities for macrophages in atherosclerosis. In this work, we report macrophage-affinity nanoparticles for magnetic resonance imaging (MRI) of atherosclerosis via tailoring nanoparticle surface coating. The ultrasmall zinc ferrite nanoparticles (Zn0.4Fe2.6O4) as T1 contrast agents were synthesized and modified with dopamine, 3,4-dihydroxyhydrocinnamic acid, and phosphorylated polyethylene glycol to adjust their surface charges to be positively, negatively, and neutrally charged, respectively. In vitro MRI evaluation shows that the T1 relaxivity for different surface charged Zn0.4Fe2.6O4 nanoparticles was three higher than that of the clinically used Gd-DTPA. Furthermore, in vivo atherosclerotic plaque MR imaging indicates that positively charged Zn0.4Fe2.6O4 showed superior MRI efficacy on carotid atherosclerosis than the other two, which is ascribed to high affinity to macrophages of positively charged nanoparticles. This work provides improved diagnostic capability and a better understanding of the molecular imaging of atherosclerosis.
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Affiliation(s)
- Lingyi Wen
- Department of Radiology, Key Laboratory of Birth Defects and Related Diseases of Women and Children of Ministry of Education, West China Second University Hospital, Sichuan University, Chengdu 614001, China
| | - Xiaomin Fu
- Department of Radiology, Key Laboratory of Birth Defects and Related Diseases of Women and Children of Ministry of Education, West China Second University Hospital, Sichuan University, Chengdu 614001, China
| | - Huan Zhang
- Key Laboratory of Synthetic and Natural Functional Molecule Chemistry of the Ministry of Education, College of Chemistry and Materials Science, Northwest University, Xi'an 710127, China
- School of Medicine, Northwest University, Xi'an 710069, China
- Department of Radiology, Zhuhai People's Hospital (Zhuhai Clinical Medical College of Jinan University), Zhuhai 519000, China
| | - Pengfei Ye
- Department of Radiology, Key Laboratory of Birth Defects and Related Diseases of Women and Children of Ministry of Education, West China Second University Hospital, Sichuan University, Chengdu 614001, China
| | - Hang Fu
- Department of Radiology, Key Laboratory of Birth Defects and Related Diseases of Women and Children of Ministry of Education, West China Second University Hospital, Sichuan University, Chengdu 614001, China
| | - Zhongqin Zhou
- Department of Radiology, Key Laboratory of Birth Defects and Related Diseases of Women and Children of Ministry of Education, West China Second University Hospital, Sichuan University, Chengdu 614001, China
| | - Ran Sun
- Department of Radiology, Key Laboratory of Birth Defects and Related Diseases of Women and Children of Ministry of Education, West China Second University Hospital, Sichuan University, Chengdu 614001, China
| | - Ting Xu
- Department of Radiology, Key Laboratory of Birth Defects and Related Diseases of Women and Children of Ministry of Education, West China Second University Hospital, Sichuan University, Chengdu 614001, China
| | - Chuan Fu
- Department of Radiology, Key Laboratory of Birth Defects and Related Diseases of Women and Children of Ministry of Education, West China Second University Hospital, Sichuan University, Chengdu 614001, China
| | - Chengcheng Zhu
- Department of Radiology, University of Washington, Seattle, Washington 98105, United States
| | - Yingkun Guo
- Department of Radiology, Key Laboratory of Birth Defects and Related Diseases of Women and Children of Ministry of Education, West China Second University Hospital, Sichuan University, Chengdu 614001, China
| | - Haiming Fan
- Department of Radiology, Key Laboratory of Birth Defects and Related Diseases of Women and Children of Ministry of Education, West China Second University Hospital, Sichuan University, Chengdu 614001, China
- Key Laboratory of Synthetic and Natural Functional Molecule Chemistry of the Ministry of Education, College of Chemistry and Materials Science, Northwest University, Xi'an 710127, China
- School of Medicine, Northwest University, Xi'an 710069, China
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19
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Chen K, Zhang S, Cui G, Zhang X, Song Y, Zheng J, Chen Y, Zheng T. Establishment of a hybrid model of atherosclerosis and acute colitis in ApoE-/- mice. PLoS One 2024; 19:e0289820. [PMID: 38498570 PMCID: PMC10947657 DOI: 10.1371/journal.pone.0289820] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Accepted: 07/27/2023] [Indexed: 03/20/2024] Open
Abstract
Inflammatory bowel disease (IBD) and atherosclerosis (AS) are both common chronic inflammatory diseases with similar pathophysiological mechanisms. Some studies have shown that IBD patients are at increased risk for early atherosclerosis, myocardial infarction and venous thrombosis. Here we set up a hybrid mouse model associated with atherosclerosis and acute colitis in order to investigate the interplay of the two diseases. We fed ApoE-/- mice with high fat diet to establish atherosclerosis model, and used animal ultrasound machine to detect the artery of mice noninvasively. Then a new hybrid model of atherosclerosis and acute colitis was prepared by drinking water for 7 days. At the end of the experiment, the hybrid model mice showed typically pathological and intuitionistic changes of atherosclerosis and acute colitis. We found the shortened colon length, high histopathological scores of the colon with mucosal erosion and necrosis, hyperlipidemia, a plaque-covered mouse aorta and plaque with foam cells and lipid deposition in the hybrid model group, which proved that the hybrid model was successfully established. At the same time, ultrasonic detection showed that the end-diastolic blood flow velocity and the relative dilation value were decreased, while systolic time / diastolic time, the wall thickness, systolic diameters as well as diastolic diameters were gradually increased, and statistical significance appeared as early as 8 weeks. We clearly described the process of establishing a hybrid model of atherosclerosis and acute colitis, which might provide a repeatable platform for the interaction mechanism exploring and drug screening of atherosclerosis and inflammatory bowel disease in preclinical study.
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Affiliation(s)
- Keke Chen
- Shenzhen Key Laboratory for Drug Addiction and Medication Safety, Department of Ultrasound, Institute of Ultrasonic Medicine, Peking University Shenzhen Hospital, The Hong Kong University of Science and Technology Medical Center, Shenzhen- Peking University, Shenzhen, P. R. China
- Department of Ultrasound, Nanjing Drum Tower Hospital, Nanjing, P. R. China
| | - Shengwei Zhang
- Shenzhen Key Laboratory for Drug Addiction and Medication Safety, Department of Ultrasound, Institute of Ultrasonic Medicine, Peking University Shenzhen Hospital, The Hong Kong University of Science and Technology Medical Center, Shenzhen- Peking University, Shenzhen, P. R. China
| | - Guanghui Cui
- Shenzhen Key Laboratory for Drug Addiction and Medication Safety, Department of Ultrasound, Institute of Ultrasonic Medicine, Peking University Shenzhen Hospital, The Hong Kong University of Science and Technology Medical Center, Shenzhen- Peking University, Shenzhen, P. R. China
| | - Xue Zhang
- Shenzhen Key Laboratory for Drug Addiction and Medication Safety, Department of Ultrasound, Institute of Ultrasonic Medicine, Peking University Shenzhen Hospital, The Hong Kong University of Science and Technology Medical Center, Shenzhen- Peking University, Shenzhen, P. R. China
| | - Yujian Song
- Shenzhen Key Laboratory for Drug Addiction and Medication Safety, Department of Ultrasound, Institute of Ultrasonic Medicine, Peking University Shenzhen Hospital, The Hong Kong University of Science and Technology Medical Center, Shenzhen- Peking University, Shenzhen, P. R. China
- Department of Ultrasound, Foshan First People’s Hospital, Foshan, P. R. China
| | - Jie Zheng
- Department of Traditional Chinese Medicine, Peking University Shenzhen Hospital, Shenzhen, P. R. China
| | - Yun Chen
- Shenzhen Key Laboratory for Drug Addiction and Medication Safety, Department of Ultrasound, Institute of Ultrasonic Medicine, Peking University Shenzhen Hospital, The Hong Kong University of Science and Technology Medical Center, Shenzhen- Peking University, Shenzhen, P. R. China
| | - Tingting Zheng
- Shenzhen Key Laboratory for Drug Addiction and Medication Safety, Department of Ultrasound, Institute of Ultrasonic Medicine, Peking University Shenzhen Hospital, The Hong Kong University of Science and Technology Medical Center, Shenzhen- Peking University, Shenzhen, P. R. China
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20
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Candreva A, Gallo D, Munhoz D, Rizzini ML, Mizukami T, Seki R, Sakai K, Sonck J, Mazzi V, Ko B, Nørgaard BL, Jensen JM, Maeng M, Otake H, Koo BK, Shinke T, Aben JP, Andreini D, Gallinoro E, Stähli BE, Templin C, Chiastra C, De Bruyne B, Morbiducci U, Collet C. Influence of intracoronary hemodynamic forces on atherosclerotic plaque phenotypes. Int J Cardiol 2024; 399:131668. [PMID: 38141723 DOI: 10.1016/j.ijcard.2023.131668] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Revised: 10/21/2023] [Accepted: 12/18/2023] [Indexed: 12/25/2023]
Abstract
BACKGROUND AND AIMS Coronary hemodynamics impact coronary plaque progression and destabilization. The aim of the present study was to establish the association between focal vs. diffuse intracoronary pressure gradients and wall shear stress (WSS) patterns with atherosclerotic plaque composition. METHODS Prospective, international, single-arm study of patients with chronic coronary syndromes and hemodynamic significant lesions (fractional flow reserve [FFR] ≤ 0.80). Motorized FFR pullback pressure gradient (PPG), optical coherence tomography (OCT), and time-average WSS (TAWSS) and topological shear variation index (TSVI) derived from three-dimensional angiography were obtained. RESULTS One hundred five vessels (median FFR 0.70 [Interquartile range (IQR) 0.56-0.77]) had combined PPG and WSS analyses. TSVI was correlated with PPG (r = 0.47, [95% Confidence Interval (95% CI) 0.30-0.65], p < 0.001). Vessels with a focal CAD (PPG above the median value of 0.67) had significantly higher TAWSS (14.8 [IQR 8.6-24.3] vs. 7.03 [4.8-11.7] Pa, p < 0.001) and TSVI (163.9 [117.6-249.2] vs. 76.8 [23.1-140.9] m-1, p < 0.001). In the 51 vessels with baseline OCT, TSVI was associated with plaque rupture (OR 1.01 [1.00-1.02], p = 0.024), PPG with the extension of lipids (OR 7.78 [6.19-9.77], p = 0.003), with the presence of thin-cap fibroatheroma (OR 2.85 [1.11-7.83], p = 0.024) and plaque rupture (OR 4.94 [1.82 to 13.47], p = 0.002). CONCLUSIONS Focal and diffuse coronary artery disease, defined using coronary physiology, are associated with differential WSS profiles. Pullback pressure gradients and WSS profiles are associated with atherosclerotic plaque phenotypes. Focal disease (as identified by high PPG) and high TSVI are associated with high-risk plaque features. CLINICAL TRIAL REGISTRATION https://clinicaltrials,gov/ct2/show/NCT03782688.
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Affiliation(s)
- Alessandro Candreva
- Department of Cardiology, Zurich University Hospital, Zurich, Switzerland; Cardiovascular Center Aalst, OLV-Clinic, Aalst, Belgium; PoliTo(BIO) Med Lab, Department of Mechanical and Aerospace Engineering, Politecnico di Torino, Turin, Italy
| | - Diego Gallo
- PoliTo(BIO) Med Lab, Department of Mechanical and Aerospace Engineering, Politecnico di Torino, Turin, Italy
| | - Daniel Munhoz
- Cardiovascular Center Aalst, OLV-Clinic, Aalst, Belgium; Department of Advanced Biomedical Sciences, University of Naples Federico II, Naples, Italy; Department of internal medicine, University of Campinas (Unicamp), Campinas, Brazil
| | - Maurizio Lodi Rizzini
- PoliTo(BIO) Med Lab, Department of Mechanical and Aerospace Engineering, Politecnico di Torino, Turin, Italy
| | - Takuya Mizukami
- Cardiovascular Center Aalst, OLV-Clinic, Aalst, Belgium; Department of Cardiology, Showa University School of Medicine, Tokyo, Japan
| | - Ruiko Seki
- Cardiovascular Center Aalst, OLV-Clinic, Aalst, Belgium
| | - Koshiro Sakai
- Cardiovascular Center Aalst, OLV-Clinic, Aalst, Belgium
| | - Jeroen Sonck
- Cardiovascular Center Aalst, OLV-Clinic, Aalst, Belgium; Department of Advanced Biomedical Sciences, University of Naples Federico II, Naples, Italy
| | - Valentina Mazzi
- PoliTo(BIO) Med Lab, Department of Mechanical and Aerospace Engineering, Politecnico di Torino, Turin, Italy
| | - Brian Ko
- Monash Cardiovascular Research Centre, Monash University and Monash Heart, Monash Health, Clayton, Victoria, Australia
| | | | | | - Michael Maeng
- Department of Cardiology, Aarhus University Hospital, Aarhus, Denmark
| | - Hiromasa Otake
- Cardiovascular Center Aalst, OLV-Clinic, Aalst, Belgium; Department of Cardiology, Aichi Medical University, Aichi, Japan
| | - Bon-Kwon Koo
- Department of Internal Medicine and Cardiovascular Center, Seoul National University Hospital, Seoul, South Korea
| | - Toshiro Shinke
- Department of Cardiology, Showa University School of Medicine, Tokyo, Japan
| | | | - Daniele Andreini
- Department of Cardiology, IRCCS Ospedale Galeazzi-Sant'Ambrogio, Milan, Italy and Department of Biomedical and Clinical Sciences, University of Milan, Milan, Italy
| | - Emanuele Gallinoro
- Cardiovascular Center Aalst, OLV-Clinic, Aalst, Belgium; Department of Cardiology, IRCCS Ospedale Galeazzi-Sant'Ambrogio, Milan, Italy and Department of Biomedical and Clinical Sciences, University of Milan, Milan, Italy
| | - Barbara E Stähli
- Department of Cardiology, Zurich University Hospital, Zurich, Switzerland; University of Zurich, Zurich, Switzerland
| | - Christian Templin
- Department of Cardiology, Zurich University Hospital, Zurich, Switzerland
| | - Claudio Chiastra
- PoliTo(BIO) Med Lab, Department of Mechanical and Aerospace Engineering, Politecnico di Torino, Turin, Italy
| | - Bernard De Bruyne
- Cardiovascular Center Aalst, OLV-Clinic, Aalst, Belgium; Department of Cardiology, Lausanne University Hospital, Lausanne, Switzerland
| | - Umberto Morbiducci
- PoliTo(BIO) Med Lab, Department of Mechanical and Aerospace Engineering, Politecnico di Torino, Turin, Italy
| | - Carlos Collet
- Cardiovascular Center Aalst, OLV-Clinic, Aalst, Belgium.
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21
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Komatsu T, Okumura M, Kida H, Takahashi J, Maku T, Kitagawa T, Sato T, Takatsu H, Sakuta K, Sakai K, Umehara T, Mitsumura H, Oseto H, Iguchi Y. Thin aortic arch plaque is associated with the development of atrial fibrillation for embolic stroke of undetermined source in patients with an insertable cardiac monitor. Int J Cardiol 2024; 399:131769. [PMID: 38211671 DOI: 10.1016/j.ijcard.2024.131769] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/15/2023] [Revised: 11/11/2023] [Accepted: 01/07/2024] [Indexed: 01/13/2024]
Abstract
BACKGROUND AND OBJECTIVE This study's objective is to investigate whether mild aortic arch plaque is associated with the development of atrial fibrillation (AF) in stroke patients with embolic stroke of undetermined source (ESUS) during the first year following the implantation of an insertable cardiac monitor (ICM). METHODS The participants in this cross-sectional observational study were consecutive patients with ESUS, even after transesophageal echocardiography. We assessed the relationship between the thickness of the participants' aortic arch plaque and AF detected after ICM implantation. RESULTS Of the 50 consecutive patients with ESUS enrolled in this study, 12 (24%) developed AF. We observed that thicker aortic arch plaque was associated with undetected AF (2.3 mm vs. 1.2 mm, p < 0.001). Aortic arch plaque thickness was independent associated with undetected AF (OR 54.00, 95% CI 2.706-1077.544, p = 0.009). When the cut-off value for aortic arch plaque thickness was 1.8 mm, the sensitivity and specificity were 71.1% and 91.7%, respectively (95% CI = 0.75-0.98, p < 0.001). Also, patients having both aortic arch plaque with a thickness < 1.8 mm and a CHADS2 score ≥ 4 were more likely to have detectable AF than no AF (88% vs. 12%, p < 0.001). CONCLUSION A thinner aortic arch plaque was associated with the development of AF. Patients with mild aortic plaques below 4 mm but ≥1.8 mm in thickness and without other high-risk features are less likely to have paroxysmal AF on ICM, and these plaques may be a possible source of embolism for their strokes.
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Affiliation(s)
- Teppei Komatsu
- Department of Neurology, The Jikei University School of Medicine, 3-25-8 Nishishimbashi, Minato-ku, Tokyo, Japan.
| | - Motohiro Okumura
- Department of Neurology, The Jikei University School of Medicine, 3-25-8 Nishishimbashi, Minato-ku, Tokyo, Japan
| | - Hiroyuki Kida
- Department of Neurology, The Jikei University School of Medicine, 3-25-8 Nishishimbashi, Minato-ku, Tokyo, Japan
| | - Junichiro Takahashi
- Department of Neurology, The Jikei University School of Medicine, 3-25-8 Nishishimbashi, Minato-ku, Tokyo, Japan
| | - Takahiro Maku
- Department of Neurology, The Jikei University School of Medicine, 3-25-8 Nishishimbashi, Minato-ku, Tokyo, Japan
| | - Tomomichi Kitagawa
- Department of Neurology, The Jikei University School of Medicine, 3-25-8 Nishishimbashi, Minato-ku, Tokyo, Japan
| | - Takeo Sato
- Department of Neurology, The Jikei University School of Medicine, 3-25-8 Nishishimbashi, Minato-ku, Tokyo, Japan
| | - Hiroki Takatsu
- Department of Neurology, The Jikei University School of Medicine, 3-25-8 Nishishimbashi, Minato-ku, Tokyo, Japan
| | - Kenichi Sakuta
- Department of Neurology, The Jikei University School of Medicine, 3-25-8 Nishishimbashi, Minato-ku, Tokyo, Japan
| | - Kenichiro Sakai
- Department of Neurology, The Jikei University School of Medicine, 3-25-8 Nishishimbashi, Minato-ku, Tokyo, Japan
| | - Tadashi Umehara
- Department of Neurology, The Jikei University School of Medicine, 3-25-8 Nishishimbashi, Minato-ku, Tokyo, Japan
| | - Hidetaka Mitsumura
- Department of Neurology, The Jikei University School of Medicine, 3-25-8 Nishishimbashi, Minato-ku, Tokyo, Japan
| | - Hirotsuna Oseto
- Department of Cardiology, The Jikei University School of Medicine, 3-25-8, Nishi-shinbashi, Minato-ku, Tokyo 105-8461, Japan
| | - Yasuyuki Iguchi
- Department of Neurology, The Jikei University School of Medicine, 3-25-8 Nishishimbashi, Minato-ku, Tokyo, Japan
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22
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Nelles G, Abdelwahed YS, Seppelt C, Meteva D, Stähli BE, Rai H, Seegers LM, Sieronski L, Musfeldt J, Gerhardt T, Riedel M, Skurk C, Haghikia A, Sinning D, Dreger H, Knebel F, Trippel TD, Krisper M, Klotsche J, Joner M, Landmesser U, Leistner DM. Cholesterol crystals at the culprit lesion in patients with acute coronary syndrome are associated with worse cardiovascular outcomes at two years follow up - results from the translational OPTICO-ACS study program. Int J Cardiol 2024; 399:131665. [PMID: 38141724 DOI: 10.1016/j.ijcard.2023.131665] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Revised: 11/24/2023] [Accepted: 12/18/2023] [Indexed: 12/25/2023]
Abstract
BACKGROUND Cholesterol crystals (CCs) represent a feature of advanced atherosclerotic plaque and may be assessed by optical coherence tomography (OCT). Their impact on cardiovascular outcomes in patients presenting with acute coronary syndromes (ACS) is yet unknown. METHODS The culprit lesion (CL) of 346 ACS-patients undergoing preintervention OCT imaging were screened for the presence of CCs and divided into two groups accordingly. The primary end-point was the rate of major adverse cardiac events plus (MACE+) consisting of cardiac death, myocardial infarction, target vessel revascularization and re-hospitalization due to unstable or progressive angina at two years. RESULTS Among 346 patients, 57.2% presented with CCs at the CL. Patients with CCs exhibited a higher prevalence of ruptured fibrous caps (RFC-ACS) (79.8% vs. 56.8%; p < 0.001) and other high-risk features such as thin cap fibroatheroma (80.8% vs. 64.9%; p = 0.001), presence of macrophages (99.0% vs. 85.1%; p < 0.001) as well as a greater maximum lipid arc (294.0° vs. 259.3°; p < 0.001) at the CL as compared to patients without CCs. MACE+ at two years follow-up occurred more often in CC-patients (29.2% vs. 16.1%; p = 0.006) as compared to patients without CCs at the culprit site. Multivariable cox regression analysis identified CCs as independent predictor of MACE+ (HR 1.705; 1.025-2.838 CI, p = 0.040). CONCLUSIONS CCs were associated with conventional high-risk plaque features and associated with increased MACE+-rates at two years follow up. The identification of CCs might be useful as prognostic marker in patients with ACS and assist "precision prevention" in the future.
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Affiliation(s)
- Gregor Nelles
- Department of Cardiology, University Clinic Frankfurt, 60590 Frankfurt am Main, Germany; Deutsches Herzzentrum der Charité, Department of Cardiology, Angiology and Intensive Care Medicine, Hindenburgdamm 30, 12203 Berlin, Germany; Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Charitéplatz 1, 10117 Berlin, Germany; DZHK (German Centre for Cardiovascular Research) partner Site Berlin, 12203 Berlin, Germany.
| | - Youssef S Abdelwahed
- Deutsches Herzzentrum der Charité, Department of Cardiology, Angiology and Intensive Care Medicine, Hindenburgdamm 30, 12203 Berlin, Germany; Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Charitéplatz 1, 10117 Berlin, Germany; DZHK (German Centre for Cardiovascular Research) partner Site Berlin, 12203 Berlin, Germany
| | - Claudio Seppelt
- Department of Cardiology, University Clinic Frankfurt, 60590 Frankfurt am Main, Germany; Deutsches Herzzentrum der Charité, Department of Cardiology, Angiology and Intensive Care Medicine, Hindenburgdamm 30, 12203 Berlin, Germany; Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Charitéplatz 1, 10117 Berlin, Germany; DZHK (German Centre for Cardiovascular Research) partner Site Berlin, 12203 Berlin, Germany
| | - Denitsa Meteva
- Deutsches Herzzentrum der Charité, Department of Cardiology, Angiology and Intensive Care Medicine, Hindenburgdamm 30, 12203 Berlin, Germany; Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Charitéplatz 1, 10117 Berlin, Germany; DZHK (German Centre for Cardiovascular Research) partner Site Berlin, 12203 Berlin, Germany
| | - Barbara E Stähli
- Deutsches Herzzentrum der Charité, Department of Cardiology, Angiology and Intensive Care Medicine, Hindenburgdamm 30, 12203 Berlin, Germany; Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Charitéplatz 1, 10117 Berlin, Germany; DZHK (German Centre for Cardiovascular Research) partner Site Berlin, 12203 Berlin, Germany
| | - Himanshu Rai
- Department of Cardiology and ISAResearch Center, German Heart Center, 80636 Munich, Germany; Cardiovascular Research Institute (CVRI) Dublin at Mater Private Network Dublin, D07KWR1 Dublin, Ireland; School of Pharmacy and Biomolecular Sciences, RCSI University of Medicine and Health Sciences, D02YN77 Dublin, Ireland
| | - Lena M Seegers
- Department of Cardiology, University Clinic Frankfurt, 60590 Frankfurt am Main, Germany
| | - Lara Sieronski
- Deutsches Herzzentrum der Charité, Department of Cardiology, Angiology and Intensive Care Medicine, Hindenburgdamm 30, 12203 Berlin, Germany; Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Charitéplatz 1, 10117 Berlin, Germany; DZHK (German Centre for Cardiovascular Research) partner Site Berlin, 12203 Berlin, Germany
| | - Johanna Musfeldt
- Deutsches Herzzentrum der Charité, Department of Cardiology, Angiology and Intensive Care Medicine, Hindenburgdamm 30, 12203 Berlin, Germany; Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Charitéplatz 1, 10117 Berlin, Germany; DZHK (German Centre for Cardiovascular Research) partner Site Berlin, 12203 Berlin, Germany
| | - Teresa Gerhardt
- Deutsches Herzzentrum der Charité, Department of Cardiology, Angiology and Intensive Care Medicine, Hindenburgdamm 30, 12203 Berlin, Germany; Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Charitéplatz 1, 10117 Berlin, Germany; DZHK (German Centre for Cardiovascular Research) partner Site Berlin, 12203 Berlin, Germany; Berlin Institute of Health at Charité - Universitätsmedizin Berlin, Charitéplatz 1, 10117 Berlin; Cardiovascular Research Institute and the Department of Medicine, Cardiology, Icahn School of Medicine at Mount Sinai, New York, NY, United States of America
| | - Matthias Riedel
- Deutsches Herzzentrum der Charité, Department of Cardiology, Angiology and Intensive Care Medicine, Hindenburgdamm 30, 12203 Berlin, Germany; Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Charitéplatz 1, 10117 Berlin, Germany; DZHK (German Centre for Cardiovascular Research) partner Site Berlin, 12203 Berlin, Germany
| | - Carsten Skurk
- Deutsches Herzzentrum der Charité, Department of Cardiology, Angiology and Intensive Care Medicine, Hindenburgdamm 30, 12203 Berlin, Germany; Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Charitéplatz 1, 10117 Berlin, Germany; DZHK (German Centre for Cardiovascular Research) partner Site Berlin, 12203 Berlin, Germany
| | - Arash Haghikia
- Deutsches Herzzentrum der Charité, Department of Cardiology, Angiology and Intensive Care Medicine, Hindenburgdamm 30, 12203 Berlin, Germany; Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Charitéplatz 1, 10117 Berlin, Germany; DZHK (German Centre for Cardiovascular Research) partner Site Berlin, 12203 Berlin, Germany; Berlin Institute of Health at Charité - Universitätsmedizin Berlin, Charitéplatz 1, 10117 Berlin
| | - David Sinning
- Deutsches Herzzentrum der Charité, Department of Cardiology, Angiology and Intensive Care Medicine, Hindenburgdamm 30, 12203 Berlin, Germany; Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Charitéplatz 1, 10117 Berlin, Germany; DZHK (German Centre for Cardiovascular Research) partner Site Berlin, 12203 Berlin, Germany
| | - Henryk Dreger
- Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Charitéplatz 1, 10117 Berlin, Germany; Deutsches Herzzentrum der Charité, Department of Cardiology, Angiology and Intensive Care Medicine, Charitéplatz 1, 10117 Berlin, Germany
| | - Fabian Knebel
- Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Charitéplatz 1, 10117 Berlin, Germany; Deutsches Herzzentrum der Charité, Department of Cardiology, Angiology and Intensive Care Medicine, Charitéplatz 1, 10117 Berlin, Germany
| | - Tobias D Trippel
- Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Charitéplatz 1, 10117 Berlin, Germany; Deutsches Herzzentrum der Charité, Department of Cardiology, Angiology and Intensive Care Medicine, Charitéplatz 1, 10117 Berlin, Germany
| | - Maximillian Krisper
- Deutsches Herzzentrum der Charité, Department of Cardiology, Angiology and Intensive Care Medicine, Augustenburger Platz 1, Germany
| | - Jens Klotsche
- German Rheumatism Research Center Berlin, and Institute for Social Medicine, Epidemiology und Heath Economy, Charité University Medicine Berlin, Campus Charité Mitte, 10117 Berlin
| | - Michael Joner
- Department of Cardiology and ISAResearch Center, German Heart Center, 80636 Munich, Germany; DZHK (German Centre for Cardiovascular Research) partner Site Munich, 80636 Munich, Germany
| | - Ulf Landmesser
- Deutsches Herzzentrum der Charité, Department of Cardiology, Angiology and Intensive Care Medicine, Hindenburgdamm 30, 12203 Berlin, Germany; Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Charitéplatz 1, 10117 Berlin, Germany; DZHK (German Centre for Cardiovascular Research) partner Site Berlin, 12203 Berlin, Germany; Berlin Institute of Health at Charité - Universitätsmedizin Berlin, Charitéplatz 1, 10117 Berlin
| | - David M Leistner
- Department of Cardiology, University Clinic Frankfurt, 60590 Frankfurt am Main, Germany; Deutsches Herzzentrum der Charité, Department of Cardiology, Angiology and Intensive Care Medicine, Hindenburgdamm 30, 12203 Berlin, Germany; Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Charitéplatz 1, 10117 Berlin, Germany; DZHK (German Centre for Cardiovascular Research) partner Site Berlin, 12203 Berlin, Germany; Berlin Institute of Health at Charité - Universitätsmedizin Berlin, Charitéplatz 1, 10117 Berlin
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23
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Huang X, Zhang S, Fu W, Wang L, Liu Z, Tang Y, Gao W, Tang B. In Situ Imaging of GGT and HOBr-Triggered Atherosclerotic Plaque Rupture via Activating the RunX2/Col IV Signaling Pathway. Anal Chem 2024; 96:4138-4145. [PMID: 38426857 DOI: 10.1021/acs.analchem.3c05073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/02/2024]
Abstract
Calcification and abnormal collagen deposition within blood vessels constitute causative factors for atherosclerotic plaque rupture, and their occurrence is intimately linked with γ-glutamyltranspeptidase (GGT) and hypobromous acid (HOBr). However, the underlying regulatory mechanisms of GGT and HOBr in plaque rupture remain unclear. Hence, we developed a dual-responsive near-infrared (NIR) fluorescent probe (BOC-H) that effectively avoids spectral crosstalk for the in situ visualization of the fluctuations in GGT and HOBr levels during atherosclerotic plaque rupture. We found that both GGT and HOBr contents increase significantly in the calcification models of cells and animals. The overexpressed GGT participated in intracellular oxygen-promoting behavior, which obviously upregulated the expression of RunX2 and Col IV by facilitating H2O2 and HOBr secretion. This process triggered calcification and abnormal collagen deposition within the plaque, which raised the risk of plaque rupture. PM2.5-induced arteriosclerotic calcification models further verified the results that GGT and HOBr accelerate plaque rupture via activation of the RunX2/Col IV signaling pathway. Moreover, the assessment of GGT and HOBr in serum samples from patients with acute myocardial infarction further confirmed the co-regulation of GGT and HOBr in the plaque rupture. Together, our studies highlight the involvement of GGT and HOBr in driving plaque rupture and offer new targets for the prevention and treatment of acute cardiovascular disease.
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Affiliation(s)
- Xiaoqing Huang
- College of Chemistry, Chemical Engineering and Materials Science, Collaborative Innovation Center of Functionalized Probes for Chemical Imaging in Universities of Shandong, Key Laboratory of Molecular and Nano Probes, Ministry of Education, Institutes of Biomedical Sciences, Shandong Normal University, Jinan 250014, Shandong, People's Republic of China
| | - Shengyue Zhang
- College of Chemistry, Chemical Engineering and Materials Science, Collaborative Innovation Center of Functionalized Probes for Chemical Imaging in Universities of Shandong, Key Laboratory of Molecular and Nano Probes, Ministry of Education, Institutes of Biomedical Sciences, Shandong Normal University, Jinan 250014, Shandong, People's Republic of China
| | - Wei Fu
- Department of pharmacy, ZiBo Central Hospital, Zibo 255000, P. R. China
| | - Liping Wang
- College of Chemistry, Chemical Engineering and Materials Science, Collaborative Innovation Center of Functionalized Probes for Chemical Imaging in Universities of Shandong, Key Laboratory of Molecular and Nano Probes, Ministry of Education, Institutes of Biomedical Sciences, Shandong Normal University, Jinan 250014, Shandong, People's Republic of China
| | - Zhenhua Liu
- College of Chemistry, Chemical Engineering and Materials Science, Collaborative Innovation Center of Functionalized Probes for Chemical Imaging in Universities of Shandong, Key Laboratory of Molecular and Nano Probes, Ministry of Education, Institutes of Biomedical Sciences, Shandong Normal University, Jinan 250014, Shandong, People's Republic of China
| | - Yue Tang
- Department of Emergency Medicine, Shandong Provincial Clinical Research Center for Emergency and Critical Care Medicine, Qilu Hospital of Shandong University, Jinan 250012, China
| | - Wen Gao
- College of Chemistry, Chemical Engineering and Materials Science, Collaborative Innovation Center of Functionalized Probes for Chemical Imaging in Universities of Shandong, Key Laboratory of Molecular and Nano Probes, Ministry of Education, Institutes of Biomedical Sciences, Shandong Normal University, Jinan 250014, Shandong, People's Republic of China
| | - Bo Tang
- College of Chemistry, Chemical Engineering and Materials Science, Collaborative Innovation Center of Functionalized Probes for Chemical Imaging in Universities of Shandong, Key Laboratory of Molecular and Nano Probes, Ministry of Education, Institutes of Biomedical Sciences, Shandong Normal University, Jinan 250014, Shandong, People's Republic of China
- Laoshan Laboratory, Qingdao 266237, Shandong, People's Republic of China
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24
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Precoma DB, da Rocha GL. From Atheroma to Atherogenic Index, Secular Evidence. Arq Bras Cardiol 2024; 120:e20230819. [PMID: 38451617 PMCID: PMC11021034 DOI: 10.36660/abc.20230819] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2023] [Revised: 12/06/2023] [Accepted: 12/06/2023] [Indexed: 03/08/2024] Open
Affiliation(s)
- Dalton Bertolim Precoma
- Hospital Angelina CaronCampina Grande do SulPRBrasilHospital Angelina Caron, Campina Grande do Sul, PR – Brasil
| | - Guilherme Luiz da Rocha
- Universidade Federal do ParanáFaculdade de MedicinaCuritibaPRBrasilUniversidade Federal do Paraná Faculdade de Medicina, Curitiba, PR – Brasil
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25
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Bravo CA, Moon JY, Davy K, Kaplan RC, Anastos K, Rodriguez CJ, Post WS, Gange SJ, Kassaye SG, Kingsley LA, Lazar JM, Mack WJ, Pyslar N, Tien PC, Witt MD, Palella FJ, Li Y, Yan M, Hodis HN, Hanna DB. Association of HIV and HCV Infection With Carotid Artery Plaque Echomorphology in the MACS/WIHS Combined Cohort Study. Stroke 2024; 55:651-659. [PMID: 38333992 PMCID: PMC10940210 DOI: 10.1161/strokeaha.123.043922] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2023] [Accepted: 12/19/2023] [Indexed: 02/10/2024]
Abstract
BACKGROUND HIV and hepatitis C virus (HCV) are associated with increased risk of carotid artery atherosclerotic plaque and stroke. We examined associations of HIV- and HCV-related factors with echomorphologic features of carotid artery plaque. METHODS This cross-sectional study included participants from the MACS (Multicenter AIDS Cohort Study)/WIHS (Women's Interagency HIV Study) Combined Cohort Study who underwent high-resolution B-mode carotid artery ultrasound. Plaques were characterized from 6 areas of the right carotid artery. Poisson regression controlling for demographic and cardiometabolic risk factors determined adjusted prevalence ratios (aPRs) and 95% CIs for associations of HIV- and HCV-related factors with echomorphologic features. RESULTS Of 2655 participants (65% women, median age 44 [interquartile range, 37-50] years), 1845 (70%) were living with HIV, 600 (23%) were living with HCV, and 425 (16%) had carotid plaque. There were 191 plaques identified in 129 (11%) women with HIV, 51 plaques in 32 (7%) women without HIV, 248 plaques in 171 (28%) men with HIV, and 139 plaques in 93 (29%) men without HIV. Adjusted analyses showed that people with HIV and current CD4+ count <200 cells/µL had a significantly higher prevalence of predominantly echolucent plaque (aPR, 1.86 [95% CI, 1.08-3.21]) than those without HIV. HCV infection alone (aPR, 1.86 [95% CI, 1.08-3.19]) and HIV-HCV coinfection (aPR, 1.75 [95% CI, 1.10-2.78]) were each associated with higher prevalence of predominantly echogenic plaque. HIV-HCV coinfection was also associated with higher prevalence of smooth surface plaque (aPR, 2.75 [95% CI, 1.03-7.32]) compared with people without HIV and HCV. CONCLUSIONS HIV with poor immunologic control, as well as HCV infection, either alone or in the presence of HIV, were associated with different echomorphologic phenotypes of carotid artery plaque.
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Affiliation(s)
| | | | | | - Robert C. Kaplan
- Albert Einstein College of Medicine, Bronx, NY, USA
- Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | | | | | - Wendy S. Post
- Johns Hopkins University, School of Medicine, Baltimore, MD, USA
- Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Stephen J. Gange
- Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | | | | | - Jason M. Lazar
- State University of New York Downstate Medical Center, Brooklyn, NY, USA
| | - Wendy J. Mack
- Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | | | - Phyllis C. Tien
- University of California-San Francisco and Department of Veterans Affairs Medical Center, San Francisco, CA, USA
| | - Mallory D. Witt
- Lundquist Institute for Biomedical Research at Harbor-UCLA Medical Center, Los Angeles, CA, USA
| | - Frank J. Palella
- Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Yanjie Li
- Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Mingzhu Yan
- Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Howard N. Hodis
- Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
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26
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Ma X, Wang Q, Hu X, Wang X, Zhao Y, Liu X, Li J, Du Y, Wang M, Qiu C, Sun Q. Association of sdLDL-C With Incident Carotid Plaques With Stable and Vulnerable Morphology: A Prospective Cohort Study. Stroke 2024; 55:576-585. [PMID: 38214156 DOI: 10.1161/strokeaha.123.045601] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2024]
Abstract
BACKGROUND Small dense low-density lipoprotein cholesterol (sdLDL-C) particles are more atherogenic than large and intermediate low-density lipoprotein cholesterol (LDL-C) subfractions. We sought to investigate the association of sdLDL-C and the sdLDL-C/LDL-C ratio with incident carotid plaques with stable and vulnerable morphology in rural China. METHODS This community-based cohort study used data from the RICAS study (Rose Asymptomatic Intracranial Artery Stenosis), which enrolled 887 participants (aged ≥40 years) who were living in Kongcun Town, Pingyin County, Shandong, and free of carotid plaques and had no history of clinical stroke or transient ischemic attack at baseline (2017). Incident carotid plaques and their vulnerability were detected by carotid ultrasound at follow-up (2021). Multivariable logistic regression models were used to explore the association of sdLDL-C or sdLDL-C/LDL-C ratio with incident carotid plaques while adjusting for demographic factors, vascular risk factors, and follow-up time. RESULTS Of the 887 participants (mean age [SD], 53.89 [8.67%] years; 54.34% women), 179 (20.18%) were detected with incident carotid plaques during an average follow-up of 3.94 years (SD=0.14). Higher sdLDL-C or sdLDL-C/LDL-C ratio, but not LDL-C, was significantly associated with an increased risk of incident carotid plaques. The upper tertile of sdLDL-C (versus lower tertile) was associated with the multivariate-adjusted odds ratio of 2.48 (95% CI, 1.00-6.15; P=0.049; P for linear trend=0.046) for carotid plaques with vulnerable morphology (n=41), and the association remained significant in participants with normal LDL-C (<130 mg/dL; n=693; upper versus lower tertile: odds ratio, 3.38 [95% CI, 1.15-9.90]; P=0.027; P for linear trend=0.025). Moreover, the sdLDL-C/LDL-C ratio was associated with a higher odds ratio of incident carotid plaques in participants without diabetes (P for interaction=0.014). CONCLUSIONS Higher sdLDL-C was associated with an increased risk of incident carotid plaques, especially carotid plaques with vulnerable morphology, even in participants with normal LDL-C. This suggests the potential of sdLDL-C as a therapeutic target for stroke prevention. REGISTRATION URL: https://www.chictr.org.cn; Unique identifier: ChiCTR1800017197.
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Affiliation(s)
- Xiaotong Ma
- Key Laboratory of Endocrine Glucose and Lipids Metabolism and Brain Aging, Ministry of Education, Department of Neurology (X.M., X.H., X.W., Y.Z., X.L., J.L., Y.D., Q.S.), Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, People's Republic of China
| | - Qiuting Wang
- Department of Neurology, Shandong Provincial Hospital, Shandong University, Jinan, People's Republic of China (Q.W., Y.D., C.Q., Q.S.)
| | - Xinyan Hu
- Key Laboratory of Endocrine Glucose and Lipids Metabolism and Brain Aging, Ministry of Education, Department of Neurology (X.M., X.H., X.W., Y.Z., X.L., J.L., Y.D., Q.S.), Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, People's Republic of China
| | - Xiang Wang
- Key Laboratory of Endocrine Glucose and Lipids Metabolism and Brain Aging, Ministry of Education, Department of Neurology (X.M., X.H., X.W., Y.Z., X.L., J.L., Y.D., Q.S.), Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, People's Republic of China
| | - Yuanyuan Zhao
- Key Laboratory of Endocrine Glucose and Lipids Metabolism and Brain Aging, Ministry of Education, Department of Neurology (X.M., X.H., X.W., Y.Z., X.L., J.L., Y.D., Q.S.), Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, People's Republic of China
| | - Xiaohui Liu
- Key Laboratory of Endocrine Glucose and Lipids Metabolism and Brain Aging, Ministry of Education, Department of Neurology (X.M., X.H., X.W., Y.Z., X.L., J.L., Y.D., Q.S.), Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, People's Republic of China
| | - Jifeng Li
- Key Laboratory of Endocrine Glucose and Lipids Metabolism and Brain Aging, Ministry of Education, Department of Neurology (X.M., X.H., X.W., Y.Z., X.L., J.L., Y.D., Q.S.), Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, People's Republic of China
| | - Yifeng Du
- Key Laboratory of Endocrine Glucose and Lipids Metabolism and Brain Aging, Ministry of Education, Department of Neurology (X.M., X.H., X.W., Y.Z., X.L., J.L., Y.D., Q.S.), Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, People's Republic of China
- Department of Neurology, Shandong Provincial Hospital, Shandong University, Jinan, People's Republic of China (Q.W., Y.D., C.Q., Q.S.)
| | - Mo Wang
- Department of Vascular Surgery (M.W.), Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, People's Republic of China
| | - Chengxuan Qiu
- Department of Neurology, Shandong Provincial Hospital, Shandong University, Jinan, People's Republic of China (Q.W., Y.D., C.Q., Q.S.)
- Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet-Stockholm University, Sweden (C.Q.)
| | - Qinjian Sun
- Key Laboratory of Endocrine Glucose and Lipids Metabolism and Brain Aging, Ministry of Education, Department of Neurology (X.M., X.H., X.W., Y.Z., X.L., J.L., Y.D., Q.S.), Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, People's Republic of China
- Department of Neurology, Shandong Provincial Hospital, Shandong University, Jinan, People's Republic of China (Q.W., Y.D., C.Q., Q.S.)
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27
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Rotzinger DC, Magnin V, van der Wal AC, Grabherr S, Qanadli SD, Michaud K. Coronary CT angiography for the assessment of atherosclerotic plaque inflammation: postmortem proof of concept with histological validation. Eur Radiol 2024; 34:1755-1763. [PMID: 37658143 PMCID: PMC10873449 DOI: 10.1007/s00330-023-10169-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2023] [Revised: 06/29/2023] [Accepted: 07/23/2023] [Indexed: 09/03/2023]
Abstract
OBJECTIVES To evaluate the diagnostic utility of multiphase postmortem CT angiography (PMCTA) to detect plaque enhancement as a surrogate marker of inflammation, using fatal coronary plaques obtained from autopsies following sudden cardiac death. METHODS In this retrospective study, we included 35 cases (12 women, 34%; median [IQR] age, 52 [11] years), with autopsy-proven coronary thrombosis, histological examination, and multiphase PMCTA. Two radiologists blinded towards histological findings assessed PMCTA for plaque enhancement of the culprit lesion in consensus. Two forensic pathologists determined the culprit lesion and assessed histological samples in consensus. Cases with concomitant vasa vasorum density increase and intraplaque and periadventital inflammation were considered positive for plaque inflammation. Finally, we correlated radiology and pathology findings. RESULTS All 35 cases had histological evidence of atherosclerotic plaque disruption and thrombosis; 30 (85.7%) had plaque inflammation. Plaque enhancement at multiphase PMCTA was reported in 21 (60%) and resulted in a PPV of 95.2% (77.3-99.2%) and an NPV of 28.6% (17-43.9%). Median histological ratings indicated higher intraplaque inflammation (p = .024) and vasa vasorum density (p = .032) in plaques with enhancement. We found no evidence of a difference in adventitial inflammation between CT-negative and CT-positive plaques (p = .211). CONCLUSIONS Plaque enhancement was found in 2/3 of fatal atherothrombotic occlusions at coronary postmortem CT angiography. Furthermore, plaque enhancement correlated with histopathological plaque inflammation and increased vasa vasorum density. Plaque enhancement on multiphase CT angiography could potentially serve as a noninvasive marker of inflammation in high-risk populations. CLINICAL RELEVANCE STATEMENT Phenotyping coronary plaque more comprehensively is one of the principal challenges cardiac imaging is facing. Translating our ex vivo findings of CT-based plaque inflammation assessment into clinical studies might help pave the way in defining high-risk plaque better. KEY POINTS • Most thrombosed coronary plaques leading to fatality in our series had histological signs of inflammation. • Multiphase postmortem CT angiography can provide a noninvasive interrogation of plaque inflammation through contrast enhancement. • Atherosclerotic plaque enhancement at multiphase postmortem CT angiography correlated with histopathological signs of plaque inflammation and could potentially serve as an imaging biological marker of plaque vulnerability.
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Affiliation(s)
- David C Rotzinger
- Division of Cardiothoracic and Vascular Imaging, Department of Diagnostic and Interventional Radiology, Lausanne University Hospital (CHUV), Rue du Bugnon 46, Lausanne, Switzerland.
- Faculty of Biology and Medicine (FBM), University of Lausanne (UNIL), Lausanne, Switzerland.
| | - Virginie Magnin
- Faculty of Biology and Medicine (FBM), University of Lausanne (UNIL), Lausanne, Switzerland
- University Center of Legal Medicine Lausanne-Geneva, Chemin de La Vulliette 4, Lausanne, Switzerland
- University Hospital of Lausanne (CHUV), Rue du Bugnon 46, 1011, Lausanne, Switzerland
| | - Allard C van der Wal
- Department of Pathology, Amsterdam University Medical Centers (AUMC), University of Amsterdam, Amsterdam, The Netherlands
| | - Silke Grabherr
- Faculty of Biology and Medicine (FBM), University of Lausanne (UNIL), Lausanne, Switzerland
- University Center of Legal Medicine Lausanne-Geneva, Chemin de La Vulliette 4, Lausanne, Switzerland
- University Hospital of Lausanne (CHUV), Rue du Bugnon 46, 1011, Lausanne, Switzerland
| | - Salah D Qanadli
- Faculty of Biology and Medicine (FBM), University of Lausanne (UNIL), Lausanne, Switzerland
- Riviera-Chablais Hospital (HRC), 1847, Rennaz, Switzerland
| | - Katarzyna Michaud
- Faculty of Biology and Medicine (FBM), University of Lausanne (UNIL), Lausanne, Switzerland
- University Center of Legal Medicine Lausanne-Geneva, Chemin de La Vulliette 4, Lausanne, Switzerland
- University Hospital of Lausanne (CHUV), Rue du Bugnon 46, 1011, Lausanne, Switzerland
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28
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Yu M, Yang D, Zhang R, Jiang Y, Qiao H, Zhao X, Liu G, Wang Y. Carotid atherosclerotic plaque predicts progression of intracranial artery atherosclerosis: A MR imaging-based community cohort study. Eur J Radiol 2024; 172:111300. [PMID: 38281437 DOI: 10.1016/j.ejrad.2024.111300] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Revised: 01/03/2024] [Accepted: 01/07/2024] [Indexed: 01/30/2024]
Abstract
PURPOSE Intracranial artery atherosclerosis (ICAS) progression is associated with stroke. However, the association of carotid plaque with ICAS progression among stroke-free participants is still unclear. This study aimed to evaluate the association between carotid plaque and ICAS progression in stroke-free participants. METHOD Stroke-free participants were recruited from a community-based cohort study. All participants underwent questionnaire interviews, blood tests, and high-resolution vessel wall magnetic resonance (MR) imaging at baseline and follow-up for around three years. The atherosclerotic plaque was defined as eccentric wall thickening on MR imaging. The presence, location, total number, and burden (maximum wall thickness, length, and stenosis) of carotid and intracranial plaque were evaluated. ICAS progression was defined as the number increased or plaque burden (maximum wall thickness, length, or stenosis increase) increased by ≥ 20 %. The association between carotid plaque and ICAS progression was evaluated using multivariable logistic regression. RESULTS Of the 312 participants (mean age at baseline: 59.85 ± 13.04 years; 136 males) who completed baseline and follow-up studies with a mean time interval of 3.15 ± 0.59 years, 85 (27.24 %) had progression of ICAS during follow-up. At least one carotid plaque was detected at baseline in 167 (53.53 %) participants. In the multivariable logistic analysis, carotid plaque was a significant predictor for the progression of ICAS (odds ratio, 2.04; 95 % confidence interval, 1.06-3.92; P = 0.032). CONCLUSIONS Carotid plaque is associated with intracranial artery atherosclerosis progression in stroke-free population. Our findings suggest that carotid plaque may be an effective predictor for intracranial artery atherosclerosis progression.
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Affiliation(s)
- Miaoxin Yu
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing 100070, China; Department of Neurology, China-Japan Friendship Hospital, Beijing 100029, China
| | - Dandan Yang
- Department of Radiology, Beijing Geriatric Hospital, Beijing 100095, China
| | - Runhua Zhang
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing 100070, China; Beijing Office for Cerebrovascular Disease Prevention and Control, Beijng Tiantan Hospital, Beijing 100070, China; China National Clinical Research Center for Neurological Diseases, Beijing 100070, China
| | - Yong Jiang
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing 100070, China; China National Clinical Research Center for Neurological Diseases, Beijing 100070, China
| | - Huiyu Qiao
- Center for Biomedical Imaging Research, Department of Biomedical Engineering, Tsinghua University, Beijing 100084, China
| | - Xihai Zhao
- Center for Biomedical Imaging Research, Department of Biomedical Engineering, Tsinghua University, Beijing 100084, China.
| | - Gaifen Liu
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing 100070, China; Beijing Office for Cerebrovascular Disease Prevention and Control, Beijng Tiantan Hospital, Beijing 100070, China; China National Clinical Research Center for Neurological Diseases, Beijing 100070, China.
| | - Yongjun Wang
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing 100070, China; China National Clinical Research Center for Neurological Diseases, Beijing 100070, China; Beijing Institute of Brain Disorders, Capital Medical University, Beijing 100069, China
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29
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Yeung K, Eiberg JP, Collet-Billon A, Sandholt BV, Jessen ML, Sillesen HH, Eldrup N. 3-D Contrast-Enhanced Fusion Ultrasound for Accurate Volume Assessment of Vessel Lumen and Plaque in Carotid Artery Disease as Compared With Computed Tomography Angiography. Ultrasound Med Biol 2024; 50:399-406. [PMID: 38171954 DOI: 10.1016/j.ultrasmedbio.2023.11.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/05/2023] [Revised: 11/20/2023] [Accepted: 11/28/2023] [Indexed: 01/05/2024]
Abstract
OBJECTIVE Three-dimensional contrast-enhanced fusion ultrasound (CEFUS) of atherosclerotic carotid arteries provides spatial visualization of the vessel lumen, creating a lumenography. As in 3-D computed tomography angiography (CTA), 3-D CEFUS outlines the contrast-filled lumen. Plaque and vessel contours are distinguished in 3-D CEFUS, allowing plaque volume quantification as a valid estimate of carotid plaque burden. Three-dimensional CEFUS is unproven in intermodality studies, vindicating the assessment of 3-D CEFUS applicability and comparing 3-D CEFUS and 3-D CTA lumenography as a proof-of-concept study. METHODS Using an ultrasound system with magnetic tracking, a linear array transducer and SonoVue contrast agent, 3-D CEFUS acquisitions were generated by spatial stitching of serial 2-D images. From 3-D CEFUS and 3-D CTA imaging, the atherosclerotic carotid arteries were reconstructed with lumenography in an offline software program for lumen and plaque volume quantification. Bland-Altman analysis was used for inter-image modality agreement. RESULTS The study included 39 carotid arteries. Mean lumen and plaque volume in 3-D CEFUS were 0.63 cm3 (standard deviation [SD]: 0.26) and 0.62 cm3 (SD: 0.26), respectively. Lumen volume differences between 3-D CEFUS and 3-D CTA were non-significant, with a mean difference of 0.01 cm3 (SD: 0.02, p = 0.26) and limits of agreement (LoA) range of ±0.11 cm3. Mean plaque volume difference was -0.12 cm3 (SD: 0.19, p = 0.006) with a LoA range of ±0.39 cm3. CONCLUSION There was strong agreement in lumenography between 3-D CEFUS and 3-D CTA. The interimage modality difference in plaque volumes was substantial because of challenging vessel wall definition in 3-D CTA. Three-dimensional CEFUS is viable in quantifying carotid plaque volume burden and can potentially monitor plaque development over time.
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Affiliation(s)
- Karin Yeung
- Department of Vascular Surgery, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark; Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Denmark.
| | - Jonas Peter Eiberg
- Department of Vascular Surgery, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark; Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Denmark; Copenhagen Academy for Medical Education and Simulation (CAMES), Capital Region of Denmark, Copenhagen, Denmark
| | | | - Benjamin Vikjær Sandholt
- Department of Vascular Surgery, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - Majken Lyhne Jessen
- Department of Vascular Surgery, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark; Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Denmark
| | - Henrik Hegaard Sillesen
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Denmark
| | - Nikolaj Eldrup
- Department of Vascular Surgery, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark; Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Denmark
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30
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Zhang L, Xu X, Zhang X, Jiang S, Hui P. Systemic immune-inflammation index is associated with ulcerative plaque in patients with acute ischemic stroke: A single center exploratory study. J Clin Ultrasound 2024; 52:295-304. [PMID: 38143429 DOI: 10.1002/jcu.23632] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/14/2023] [Revised: 12/09/2023] [Accepted: 12/12/2023] [Indexed: 12/26/2023]
Abstract
PURPOSE This study explored the correlation between inflammatory markers and ulcerative plaques based on carotid doppler ultrasound (CDU) in individuals with acute ischemic stroke (AIS). METHODS A total of 202 cases diagnosed with AIS associated with atherosclerotic plaque (AP) in the carotid artery were enrolled in this research. Collecting clinical baseline data, laboratory data (such as the complete blood count) and imaging data (CDU and Brain magnetic resonance imaging [MRI]). Then the correlation between Systemic immune-inflammation index (SII, SII = P N/L, where P, N, and L were the peripheral blood platelet, neutrophil and lymphocyte counts, respectively), the shape and position of AP, the degree of carotid artery stenosis, and the presence of ulcerative plaques. Cutoff values were determined accordingly. RESULTS SII and high sensitivity CRP (hs-CRP) were independent risk factors for the presence of vulnerable carotid plaques. SII, type A plaque, plaque above carotid bifurcation, and severe carotid stenosis were independent risk factors for the presence of ulcerative plaque. The AUC value, the sensitivity, specificity, the best cutoff value of SII in predicting the presence of ulcerative plaque was 0.895, 93.3%, 89.2%, and 537.4 (109 /L), respectively. CONCLUSION SII at admission was found to be independently associated with the presence of AIS with vulnerable plaque, especially ulcerative plaques. Moreover, plaque ulceration was more likely to form when the area of higher plaque thickness was located in the upstream arterial wall of maximum plaque thickness (WTmax), plaque was above the carotid bifurcation and severe carotid stenosis.
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Affiliation(s)
- Lianlian Zhang
- Department of Ultrasound, The Yancheng Clinical College of Xuzhou Medical University, The First People's Hospital of Yancheng, Jiangsu, China
- Department of Stroke Center, The First Affiliated Hospital of Soochow University, Jiangsu, China
| | - Xinchun Xu
- Department of Stroke Center, The First Affiliated Hospital of Soochow University, Jiangsu, China
| | - Xinyuan Zhang
- Department of Ultrasound, The Yancheng Clinical College of Xuzhou Medical University, The First People's Hospital of Yancheng, Jiangsu, China
| | - Shu Jiang
- Department of Stroke Center, The First Affiliated Hospital of Soochow University, Jiangsu, China
- Department of Magnetic Resonance, The Yancheng Clinical College of Xuzhou Medical University, The First People's Hospital of Yancheng, Jiangsu, China
| | - Pinjing Hui
- Department of Stroke Center, The First Affiliated Hospital of Soochow University, Jiangsu, China
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Wen S, Naqvi TZ. 3-D transesophageal echocardiography aids in assessment of embolic stroke due to aortic atherosclerotic plaque: A case series. Echocardiography 2024; 41:e15799. [PMID: 38516862 DOI: 10.1111/echo.15799] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2023] [Revised: 02/26/2024] [Accepted: 02/28/2024] [Indexed: 03/23/2024] Open
Abstract
Atherosclerosis is the most common cause of heart disease and stroke. Plaque thickness ≥4 mm in the ascending aorta or aortic arch is strongly correlated with cerebral embolic events and ischemic stroke. However, despite imaging workup, the cause of embolic stroke remains unidentified in many patients. Transesophageal echocardiography (TEE) is the preferred echocardiographic method for the evaluation of cardiac source of emboli. 2D TEE imaging evaluates aortic root and aortic arch in a single plane or two planes with biplane imaging. However, 2D TEE often fails to detect mobile or complex components in the ascending aorta and aortic arch plaques. The routine availability of 3D TEE in current ultrasound systems may significantly improve the assessment of aortic plaques as a potential embolic source. In this case series, we present four consecutive patients with stroke who underwent TEE by a single cardiologist for possible cardioembolic source. Some of these patients may have been labelled as "cryptogenic stroke" or "embolic stroke of undetermined source" (ESUS) due to the presence of insignificant or nonmobile ascending aortic or aortic arch plaques on 2D TEE imaging. In our four consecutive patients with ESUS who underwent TEE by a single operator, 3D TEE showed complex aortic arch plaques with ulceration with mobile components and established these plaques as the likely source of embolic stroke.
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Affiliation(s)
- Songnan Wen
- Department of Cardiovascular Medicine, Division of Echocardiography, Mayo Clinic, Scottsdale, USA
| | - Tasneem Z Naqvi
- Department of Cardiovascular Medicine, Division of Echocardiography, Mayo Clinic, Scottsdale, USA
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Kurozumi A, Shishido K, Yamashita T, Sato D, Uchida S, Koyama E, Tamaki Y, Hayashi T, Miyashita H, Yokoyama H, Ochiai T, Yamaguchi M, Moriyama N, Tobita K, Matsumoto T, Mizuno S, Yamanaka F, Tanaka Y, Murakami M, Takahashi S, Saito S. Sodium-Glucose Cotransporter-2 Inhibitors Stabilize Coronary Plaques in Acute Coronary Syndrome With Diabetes Mellitus. Am J Cardiol 2024; 214:47-54. [PMID: 38215815 DOI: 10.1016/j.amjcard.2023.12.056] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Revised: 12/13/2023] [Accepted: 12/27/2023] [Indexed: 01/14/2024]
Abstract
Sodium-glucose cotransporter-2 inhibitors (SGLT2is) are widely used in cardiology and are effective in treating acute coronary syndrome (ACS). Their effects on unstable plaque in patients with ACS remains unclear. This study aimed to examine the effectiveness of SGLT2is in coronary plaque based on optical coherence tomography (OCT) images and the prognosis of ACS with type 2 diabetes mellitus. This retrospective study included 109 patients in the total cohort and 29 patients in the OCT cohort. Based on SGLT2i administration after ACS, the total cohort was categorized into non-SGLT2i (n = 69) and SGLT2i (n = 40) groups. The OCT cohort had 15 and 14 patients in the non-SGLT2i and SGLT2i groups, respectively. The OCT images of unstable plaque were analyzed in nonstented lesions during ACS catheterization and at the 6-month follow-up. The total cohort was assessed after 1 year for major adverse cardiovascular events, including all-cause mortality, revascularization, cerebrovascular disease, and heart failure hospitalization. SGLT2is improved unstable lesions with a significantly thicker fibrous cap (48 ± 15 μm vs 26 ± 24 μm, p = 0.005), reduced lipid arc (-29 ± 12° vs -18 ± 14°, p = 0.028), higher % decrease in total lipid arc (-35 ± 13% vs -19 ± 18%, p = 0.01), and lower major adverse cardiovascular event incidence (log-rank p = 0.023, hazard ratio 4.72 [1.08 to 20.63]) and revascularization rate (adjusted hazard ratio 6.77 [1.08 to 42.52]) than the non-SGLT2i group. In conclusion, SGLT2is can improve the markers of plaque stability and may improve the prognosis in patients with type 2 diabetes mellitus.
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Affiliation(s)
- Atsumasa Kurozumi
- Department of Cardiology, Shonan Kamakura General Hospital, Kamakura, Japan
| | - Koki Shishido
- Department of Cardiology, Shonan Kamakura General Hospital, Kamakura, Japan.
| | | | - Daisuke Sato
- Department of Cardiology, Shonan Kamakura General Hospital, Kamakura, Japan
| | - Syuhei Uchida
- Department of Cardiology, Shonan Kamakura General Hospital, Kamakura, Japan
| | - Eiji Koyama
- Department of Cardiology, Shonan Kamakura General Hospital, Kamakura, Japan
| | - Yusuke Tamaki
- Department of Cardiology, Shonan Kamakura General Hospital, Kamakura, Japan
| | - Takahiro Hayashi
- Department of Cardiology, Shonan Kamakura General Hospital, Kamakura, Japan
| | - Hirokazu Miyashita
- Department of Cardiology, Shonan Kamakura General Hospital, Kamakura, Japan
| | - Hiroaki Yokoyama
- Department of Cardiology, Shonan Kamakura General Hospital, Kamakura, Japan
| | - Tomoki Ochiai
- Department of Cardiology, Shonan Kamakura General Hospital, Kamakura, Japan
| | - Masashi Yamaguchi
- Department of Cardiology, Shonan Kamakura General Hospital, Kamakura, Japan
| | - Noriaki Moriyama
- Department of Cardiology, Shonan Kamakura General Hospital, Kamakura, Japan
| | - Kazuki Tobita
- Department of Cardiology, Shonan Kamakura General Hospital, Kamakura, Japan
| | - Takashi Matsumoto
- Department of Cardiology, Shonan Kamakura General Hospital, Kamakura, Japan
| | - Shingo Mizuno
- Department of Cardiology, Shonan Kamakura General Hospital, Kamakura, Japan
| | - Futoshi Yamanaka
- Department of Cardiology, Shonan Kamakura General Hospital, Kamakura, Japan
| | - Yutaka Tanaka
- Department of Cardiology, Shonan Kamakura General Hospital, Kamakura, Japan
| | - Masato Murakami
- Department of Cardiology, Shonan Kamakura General Hospital, Kamakura, Japan
| | - Saeko Takahashi
- Department of Cardiology, Shonan Kamakura General Hospital, Kamakura, Japan
| | - Shigeru Saito
- Department of Cardiology, Shonan Kamakura General Hospital, Kamakura, Japan
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Kotsugi M, Nakagawa I, Sasaki H, Okamoto A, Nakase K, Maeoka R, Yokoyama S, Yamada S, Nakase H. Thin Calcification Predicts Lipid Component in Carotid Plaque-Relationship Between Lipid Distribution and Thin Calcification. World Neurosurg 2024; 183:e715-e721. [PMID: 38191057 DOI: 10.1016/j.wneu.2024.01.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2023] [Accepted: 01/02/2024] [Indexed: 01/10/2024]
Abstract
BACKGROUND Accurately evaluating plaque characteristics is essential because lesions with lipid-rich plaque put patients at risk of thromboembolic complications from carotid artery stenting. Near-infrared spectroscopy (NIRS) is a diagnostic imaging modality that identifies lipid components from the near-infrared absorption pattern but does not reveal the distribution of calcification. The purpose of this study was to investigate the calcification characteristics of unstable carotid plaques, focusing on relationships between the calcification characteristics revealed by computed tomography angiography and the lipid core distribution derived from NIRS. METHODS Participants in this retrospective analysis comprised 35 patients (29 men, 6 women; mean age, 76.0 years; range, 52-89 years) who underwent carotid artery stenting in our institute between January 2021 and December 2022. We evaluated the thickness and length of carotid calcifications at the minimal lumen level from preoperative computed tomography angiography and analyzed the relationship with maximum lipid core burden index (max-LCBI) from NIRS. RESULTS Strong negative linear correlations were observed between the thickness of calcification and max-LCBI at Area (any segment in a target lesion) (r = -0.795, P < 0.001), max-LCBI at minimal lumen area (r = -0.795, P < 0.001) and lipid core burden index (LCBI) at lesion (rate of LCBI in entire plaque lesion) (r = -0.788, P < 0.001), respectively. Significant negative linear correlations were observed between distribution of calcification length and max-LCBI at area (r = -0.429, P = 0.01), max-LCBI at minimal lumen area (r = -0.373, P = 0.027), and LCBI at lesion (r = -0.443, P = 0.008). CONCLUSIONS Thin and ubiquitous carotid calcification was associated with LCBI values derived from NIRS indicative of carotid lipid plaque distribution, implying the possibility of predicting lesion instability.
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Affiliation(s)
- Masashi Kotsugi
- Departments of Neurosurgery, Nara Medical University, Nara, Japan
| | - Ichiro Nakagawa
- Departments of Neurosurgery, Nara Medical University, Nara, Japan.
| | - Hiromitsu Sasaki
- Departments of Neurosurgery, Nara Medical University, Nara, Japan
| | - Ai Okamoto
- Departments of Neurosurgery, Nara Medical University, Nara, Japan
| | - Kenta Nakase
- Departments of Neurosurgery, Nara Medical University, Nara, Japan
| | - Ryosuke Maeoka
- Departments of Neurosurgery, Nara Medical University, Nara, Japan
| | - Shohei Yokoyama
- Departments of Neurosurgery, Nara Medical University, Nara, Japan
| | - Shuichi Yamada
- Departments of Neurosurgery, Nara Medical University, Nara, Japan
| | - Hiroyuki Nakase
- Departments of Neurosurgery, Nara Medical University, Nara, Japan
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Otsuka K, Ishikawa H, Yamaura H, Hojo K, Kono Y, Shimada K, Kasayuki N, Fukuda D. Thoracic Aortic Plaque Burden and Prediction of Cardiovascular Events in Patients Undergoing 320-row Multidetector CT Coronary Angiography. J Atheroscler Thromb 2024; 31:273-287. [PMID: 37704429 PMCID: PMC10918031 DOI: 10.5551/jat.64251] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2023] [Accepted: 07/20/2023] [Indexed: 09/15/2023] Open
Abstract
AIM Wide volume scan (WVS) coronary computed tomography angiography (CCTA) enables aortic arch visualization. This study assessed whether the thoracic aortic plaque burden (TAPB) score can predict major cardiovascular adverse events (MACE) in addition to and independently of other obstructive coronary artery disease (CAD) attributes. METHODS This study included patients with suspected CAD who underwent CCTA (n=455). CCTA-WVS was used to assess CAD and the prognostic capacity of TAPB scores. Data analysis included the coronary artery calcification score (CACS), CAD status and extent, and TAPB score, calculated as the sum of plaque thickness and plaque angle at five thoracic aortic segments. The primary endpoint was MACE defined as a composite event comprised of ischemic stroke, acute coronary syndrome, and cardiovascular death. RESULTS During a mean follow-up period of 2.8±0.9 years, 40 of 455 (8.8%) patients experienced MACE. In the Cox proportional hazards model adjusted for clinical risks (Suita cardiovascular disease risk score), we identified TAPB score (T3) as a predictor of MACE independent of CACS >400 (hazards ratio [HR], 2.91; 95% confidence interval [CI], 1.26-6.72; p=0.012) or obstructive CAD (HR, 2.83; 95% CI, 1.30-6.18; p=0.009). The area under the curve for predicting MACE improved from 0.75 to 0.795 (p value=0.008) when TAPB score was added to CACS >400 and obstructive CAD. CONCLUSIONS We found that comprehensive non-invasive evaluation of TAPB and CAD has prognostic value in MACE risk stratification for suspected CAD patients undergoing CCTA.
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Affiliation(s)
- Kenichiro Otsuka
- Department of Cardiovascular Medicine, Osaka Metropolitan University Graduate School of Medicine, Osaka, Japan
- Department of Cardiovascular Medicine, Fujiikai Kashibaseiki Hospital, Kashiba, Japan
| | - Hirotoshi Ishikawa
- Department of Cardiovascular Medicine, Fujiikai Kashibaseiki Hospital, Kashiba, Japan
| | - Hiroki Yamaura
- Department of Cardiovascular Medicine, Fujiikai Kashibaseiki Hospital, Kashiba, Japan
| | - Kana Hojo
- Department of Cardiovascular Medicine, Fujiikai Kashibaseiki Hospital, Kashiba, Japan
| | - Yasushi Kono
- Department of Cardiovascular Medicine, Fujiikai Kashibaseiki Hospital, Kashiba, Japan
| | - Kenei Shimada
- Department of Cardiovascular Medicine, Fujiikai Kashibaseiki Hospital, Kashiba, Japan
| | - Noriaki Kasayuki
- Department of Cardiovascular Medicine, Fujiikai Kashibaseiki Hospital, Kashiba, Japan
| | - Daiju Fukuda
- Department of Cardiovascular Medicine, Osaka Metropolitan University Graduate School of Medicine, Osaka, Japan
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Malvicini G, Marruganti C, Leil MA, Martignoni M, Pasqui E, de Donato G, Grandini S, Gaeta C. Association between apical periodontitis and secondary outcomes of atherosclerotic cardiovascular disease: A case-control study. Int Endod J 2024; 57:281-296. [PMID: 38204179 DOI: 10.1111/iej.14018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2023] [Revised: 11/22/2023] [Accepted: 12/27/2023] [Indexed: 01/12/2024]
Abstract
AIM To evaluate the association between apical periodontitis (AP) and atherosclerotic cardiovascular disease (ASCDV). METHODOLOGY A total of 65 periodontally and systemically healthy patients (age ≥ 40 years) were included in the study. Periapical status was assessed through dental examination and periapical radiographs; 33 subjects had AP (AP+), while 32 acted as control (AP-). Moreover, data regarding their periapical index (PAI) score and the Decayed, Missing, and Filled Teeth (DMFT) index were recorded. All subjects underwent echo-colour Doppler assessment of carotid intima-media thickness (CIMT), carotid plaques, degree of stenosis using the North American Symptomatic Carotid Surgery Trial (NASCET) method, maximum diameter of the abdominal aorta (maximum AA) and common iliac arteries (CIA) diameters. Furthermore, peripheral blood flow was also measured using the ankle-brachial index (ABI). Simple and multiple regression analyses were performed. RESULTS Among AP+ patients, 57.58% disclosed at least one sign of subclinical carotid atherosclerosis. Multiple regression analysis identified AP as a significant risk indicator for carotid plaques [OR = 4.87 (1.27, 18.98; p = .021)] and marked carotid intima-media thickenings (OR = 14.58 [1.22, 176.15], p = .035). A significant association was established between AP and other cardiovascular (CV) variables (CIMT, NASCET, and maximum AA). On the contrary, a higher PAI score does not correlate to increased odds of carotid alterations, and the presence of AP did not prove any significant change in CIA and ABI. No significant correlation was established between DMFT and other variables. CONCLUSIONS Results from the current study highlight that the presence of AP may be regarded as a risk indicator for ASCVD, with AP being associated with 5-fold increased odds of having carotid plaques and 15-fold increased odds of having marked carotid intima-media thickenings. Further studies should be conducted in order to verify whether AP treatment could be beneficial for ASCVD signs.
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Affiliation(s)
- Giulia Malvicini
- Unit of Endodontics and Restorative Dentistry, Department of Medical Biotechnologies, University of Siena, Siena, Italy
| | - Crystal Marruganti
- Unit of Endodontics and Restorative Dentistry, Department of Medical Biotechnologies, University of Siena, Siena, Italy
| | - Mustafa Abu Leil
- Unit of Vascular Surgery, Department of Medicine, Surgery and Neurosciences, University of Siena, Siena, Italy
| | - Marco Martignoni
- Unit of Endodontics and Restorative Dentistry, Department of Medical Biotechnologies, University of Siena, Siena, Italy
| | - Edoardo Pasqui
- Unit of Vascular Surgery, Department of Medicine, Surgery and Neurosciences, University of Siena, Siena, Italy
| | - Gianmarco de Donato
- Unit of Vascular Surgery, Department of Medicine, Surgery and Neurosciences, University of Siena, Siena, Italy
| | - Simone Grandini
- Unit of Endodontics and Restorative Dentistry, Department of Medical Biotechnologies, University of Siena, Siena, Italy
| | - Carlo Gaeta
- Unit of Endodontics and Restorative Dentistry, Department of Medical Biotechnologies, University of Siena, Siena, Italy
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Luo X, Shi J, Wang R, Cao L, Gao Y, Wang J, Hong M, Sun X, Zhang Y. Near-Infrared Persistent Luminescence Nanoprobe for Early Detection of Atherosclerotic Plaque. ACS Nano 2024; 18:6500-6512. [PMID: 38348833 DOI: 10.1021/acsnano.3c12136] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/28/2024]
Abstract
Atherosclerosis (AS) is a crucial contributor to various cardiovascular diseases (CVDs), which seriously threaten human life and health. Early and accurate recognition of AS plaques is essential for the prevention and treatment of CVD. Herein, we introduce an AS-targeting nanoprobe based on near-infrared (NIR) persistent luminescence nanoparticles (PLNPs), developing a highly sensitive NIR persistent luminescence (PersL) AS plaque imaging technique and successfully realizing early AS plaque detection. The nanoprobe exhibits good monodispersity and regular spherical morphology and also owns exceptional NIR PersL performance upon repetitive irradiation by biological window light. The surface-conjugated antibody (anti-osteopontin) endowed nanoprobe excellent targeting ability to foam cells within plaques. After intravenously injected nanoprobe into AS model mice, the highly sensitive PersL imaging technique can accurately detect AS plaques prior to ultrasonography (US) and magnetic resonance imaging (MRI). Specifically, the NIR PersL imaging reveals AS plaques at the earliest within 2 weeks, with higher signal-to-background ratio (SBR) up to 5.72. Based on this technique, the nanoprobe has great potential for applications in the prevention and treatment of CVD, the study of AS pathogenesis, and the screening of anti-AS drugs.
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Affiliation(s)
- Xiaofang Luo
- State Key Laboratory of Structural Chemistry, Fujian Institute of Research on the Structure of Matter, Chinese Academy of Sciences, Fuzhou 350002, People's Republic of China
- Xiamen Key Laboratory of Rare Earth Photoelectric Functional Materials, Xiamen Institute of Rare Earth Materials, Haixi Institute, Chinese Academy of Sciences, Xiamen 361021, People's Republic of China
- School of Rare Earths, University of Science and Technology of China, Hefei 230026, People's Republic of China
- Ganjiang Innovation Academy, Chinese Academy of Science, Ganzhou 341000, People's Republic of China
| | - Junpeng Shi
- State Key Laboratory of Structural Chemistry, Fujian Institute of Research on the Structure of Matter, Chinese Academy of Sciences, Fuzhou 350002, People's Republic of China
- Xiamen Key Laboratory of Rare Earth Photoelectric Functional Materials, Xiamen Institute of Rare Earth Materials, Haixi Institute, Chinese Academy of Sciences, Xiamen 361021, People's Republic of China
- School of Rare Earths, University of Science and Technology of China, Hefei 230026, People's Republic of China
- Ganjiang Innovation Academy, Chinese Academy of Science, Ganzhou 341000, People's Republic of China
| | - Ruoping Wang
- State Key Laboratory of Structural Chemistry, Fujian Institute of Research on the Structure of Matter, Chinese Academy of Sciences, Fuzhou 350002, People's Republic of China
- Xiamen Key Laboratory of Rare Earth Photoelectric Functional Materials, Xiamen Institute of Rare Earth Materials, Haixi Institute, Chinese Academy of Sciences, Xiamen 361021, People's Republic of China
| | - Longlong Cao
- State Key Laboratory of Structural Chemistry, Fujian Institute of Research on the Structure of Matter, Chinese Academy of Sciences, Fuzhou 350002, People's Republic of China
- Xiamen Key Laboratory of Rare Earth Photoelectric Functional Materials, Xiamen Institute of Rare Earth Materials, Haixi Institute, Chinese Academy of Sciences, Xiamen 361021, People's Republic of China
| | - Yan Gao
- School of Rare Earths, University of Science and Technology of China, Hefei 230026, People's Republic of China
- Ganjiang Innovation Academy, Chinese Academy of Science, Ganzhou 341000, People's Republic of China
| | - Jinyuan Wang
- School of Rare Earths, University of Science and Technology of China, Hefei 230026, People's Republic of China
- Ganjiang Innovation Academy, Chinese Academy of Science, Ganzhou 341000, People's Republic of China
| | - Maochun Hong
- State Key Laboratory of Structural Chemistry, Fujian Institute of Research on the Structure of Matter, Chinese Academy of Sciences, Fuzhou 350002, People's Republic of China
- Xiamen Key Laboratory of Rare Earth Photoelectric Functional Materials, Xiamen Institute of Rare Earth Materials, Haixi Institute, Chinese Academy of Sciences, Xiamen 361021, People's Republic of China
| | - Xia Sun
- Fujian Science and Technology Innovation Laboratory for Optoelectronic Information of China, Fuzhou 350108, People's Republic of China
| | - Yun Zhang
- State Key Laboratory of Structural Chemistry, Fujian Institute of Research on the Structure of Matter, Chinese Academy of Sciences, Fuzhou 350002, People's Republic of China
- Xiamen Key Laboratory of Rare Earth Photoelectric Functional Materials, Xiamen Institute of Rare Earth Materials, Haixi Institute, Chinese Academy of Sciences, Xiamen 361021, People's Republic of China
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Lee J, Kim JN, Dallan LAP, Zimin VN, Hoori A, Hassani NS, Makhlouf MHE, Guagliumi G, Bezerra HG, Wilson DL. Deep learning segmentation of fibrous cap in intravascular optical coherence tomography images. Sci Rep 2024; 14:4393. [PMID: 38388637 PMCID: PMC10884035 DOI: 10.1038/s41598-024-55120-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2023] [Accepted: 02/20/2024] [Indexed: 02/24/2024] Open
Abstract
Thin-cap fibroatheroma (TCFA) is a prominent risk factor for plaque rupture. Intravascular optical coherence tomography (IVOCT) enables identification of fibrous cap (FC), measurement of FC thicknesses, and assessment of plaque vulnerability. We developed a fully-automated deep learning method for FC segmentation. This study included 32,531 images across 227 pullbacks from two registries (TRANSFORM-OCT and UHCMC). Images were semi-automatically labeled using our OCTOPUS with expert editing using established guidelines. We employed preprocessing including guidewire shadow detection, lumen segmentation, pixel-shifting, and Gaussian filtering on raw IVOCT (r,θ) images. Data were augmented in a natural way by changing θ in spiral acquisitions and by changing intensity and noise values. We used a modified SegResNet and comparison networks to segment FCs. We employed transfer learning from our existing much larger, fully-labeled calcification IVOCT dataset to reduce deep-learning training. Postprocessing with a morphological operation enhanced segmentation performance. Overall, our method consistently delivered better FC segmentation results (Dice: 0.837 ± 0.012) than other deep-learning methods. Transfer learning reduced training time by 84% and reduced the need for more training samples. Our method showed a high level of generalizability, evidenced by highly-consistent segmentations across five-fold cross-validation (sensitivity: 85.0 ± 0.3%, Dice: 0.846 ± 0.011) and the held-out test (sensitivity: 84.9%, Dice: 0.816) sets. In addition, we found excellent agreement of FC thickness with ground truth (2.95 ± 20.73 µm), giving clinically insignificant bias. There was excellent reproducibility in pre- and post-stenting pullbacks (average FC angle: 200.9 ± 128.0°/202.0 ± 121.1°). Our fully automated, deep-learning FC segmentation method demonstrated excellent performance, generalizability, and reproducibility on multi-center datasets. It will be useful for multiple research purposes and potentially for planning stent deployments that avoid placing a stent edge over an FC.
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Affiliation(s)
- Juhwan Lee
- Department of Biomedical Engineering, Case Western Reserve University, Cleveland, OH, 44106, USA
| | - Justin N Kim
- Department of Biomedical Engineering, Case Western Reserve University, Cleveland, OH, 44106, USA
| | - Luis A P Dallan
- Harrington Heart and Vascular Institute, University Hospitals Cleveland Medical Center, Cleveland, OH, 44106, USA
| | - Vladislav N Zimin
- Brookdale University Hospital Medical Center, 1 Brookdale Plaza, Brooklyn, NY, 11212, USA
| | - Ammar Hoori
- Department of Biomedical Engineering, Case Western Reserve University, Cleveland, OH, 44106, USA
| | - Neda S Hassani
- Harrington Heart and Vascular Institute, University Hospitals Cleveland Medical Center, Cleveland, OH, 44106, USA
| | - Mohamed H E Makhlouf
- Harrington Heart and Vascular Institute, University Hospitals Cleveland Medical Center, Cleveland, OH, 44106, USA
| | - Giulio Guagliumi
- Cardiovascular Department, Innovation District, Galeazzi San'Ambrogio Hospital, Milan, Italy
| | - Hiram G Bezerra
- Interventional Cardiology Center, Heart and Vascular Institute, University of South Florida, Tampa, FL, 33606, USA
| | - David L Wilson
- Department of Biomedical Engineering, Case Western Reserve University, Cleveland, OH, 44106, USA.
- Department of Radiology, Case Western Reserve University, Cleveland, OH, 44106, USA.
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Sekita A, Unterweger H, Berg S, Ohlmeyer S, Bäuerle T, Zheng KH, Coolen BF, Nederveen AJ, Cabella C, Rossi S, Stroes ESG, Alexiou C, Lyer S, Cicha I. Accumulation of Iron Oxide-Based Contrast Agents in Rabbit Atherosclerotic Plaques in Relation to Plaque Age and Vulnerability Features. Int J Nanomedicine 2024; 19:1645-1666. [PMID: 38406599 PMCID: PMC10893894 DOI: 10.2147/ijn.s430693] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2023] [Accepted: 12/14/2023] [Indexed: 02/27/2024] Open
Abstract
Purpose In this study, a detailed characterization of a rabbit model of atherosclerosis was performed to assess the optimal time frame for evaluating plaque vulnerability using superparamagnetic iron oxide nanoparticle (SPION)-enhanced magnetic resonance imaging (MRI). Methods The progression of atherosclerosis induced by ballooning and a high-cholesterol diet was monitored using angiography, and the resulting plaques were characterized using immunohistochemistry and histology. Morphometric analyses were performed to evaluate plaque size and vulnerability features. The accumulation of SPIONs (novel dextran-coated SPIONDex and ferumoxytol) in atherosclerotic plaques was investigated by histology and MRI and correlated with plaque age and vulnerability. Toxicity of SPIONDex was evaluated in rats. Results Weak positive correlations were detected between plaque age and intima thickness, and total macrophage load. A strong negative correlation was observed between the minimum fibrous cap thickness and plaque age as well as the mean macrophage load. The accumulation of SPION in the atherosclerotic plaques was detected by MRI 24 h after administration and was subsequently confirmed by Prussian blue staining of histological specimens. Positive correlations between Prussian blue signal in atherosclerotic plaques, plaque age, and macrophage load were detected. Very little iron was observed in the histological sections of the heart and kidney, whereas strong staining of SPIONDex and ferumoxytol was detected in the spleen and liver. In contrast to ferumoxytol, SPIONDex administration in rabbits was well tolerated without inducing hypersensitivity. The maximum tolerated dose in rat model was higher than 100 mg Fe/kg. Conclusion Older atherosclerotic plaques with vulnerable features in rabbits are a useful tool for investigating iron oxide-based contrast agents for MRI. Based on the experimental data, SPIONDex particles constitute a promising candidate for further clinical translation as a safe formulation that offers the possibility of repeated administration free from the risks associated with other types of magnetic contrast agents.
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Affiliation(s)
- Alexander Sekita
- ENT-Department, Section of Experimental Oncology Und Nanomedicine (SEON), Else Kröner-Fresenius-Stiftung-Professorship, Universitätsklinikum Erlangen, Erlangen, Germany
| | - Harald Unterweger
- ENT-Department, Section of Experimental Oncology Und Nanomedicine (SEON), Else Kröner-Fresenius-Stiftung-Professorship, Universitätsklinikum Erlangen, Erlangen, Germany
| | - Sonja Berg
- ENT-Department, Section of Experimental Oncology Und Nanomedicine (SEON), Else Kröner-Fresenius-Stiftung-Professorship, Universitätsklinikum Erlangen, Erlangen, Germany
| | - Sabine Ohlmeyer
- Institute of Radiology, Universitätsklinikum Erlangen, Erlangen, Germany
| | - Tobias Bäuerle
- Preclinical Imaging Platform Erlangen (PIPE), Universitätsklinikum Erlangen, Erlangen, Germany
| | - Kang H Zheng
- Department of Vascular Medicine, Amsterdam University Medical Center, University of Amsterdam, Amsterdam, the Netherlands
| | - Bram F Coolen
- Department of Biomedical Engineering and Physics, Amsterdam University Medical Center, University of Amsterdam, Amsterdam, the Netherlands
| | - Aart J Nederveen
- Department of Radiology and Nuclear Medicine, Amsterdam University Medical Center, University of Amsterdam, Amsterdam, the Netherlands
| | - Claudia Cabella
- Bracco Imaging SpA, Centro Ricerche Bracco, Colleretto Giacosa, Turin, Italy
| | - Silvia Rossi
- Bracco Imaging SpA, Centro Ricerche Bracco, Colleretto Giacosa, Turin, Italy
| | - Erik S G Stroes
- Department of Vascular Medicine, Amsterdam University Medical Center, University of Amsterdam, Amsterdam, the Netherlands
| | - Christoph Alexiou
- ENT-Department, Section of Experimental Oncology Und Nanomedicine (SEON), Else Kröner-Fresenius-Stiftung-Professorship, Universitätsklinikum Erlangen, Erlangen, Germany
| | - Stefan Lyer
- ENT-Department, Section of Experimental Oncology Und Nanomedicine (SEON), Else Kröner-Fresenius-Stiftung-Professorship, Universitätsklinikum Erlangen, Erlangen, Germany
| | - Iwona Cicha
- ENT-Department, Section of Experimental Oncology Und Nanomedicine (SEON), Else Kröner-Fresenius-Stiftung-Professorship, Universitätsklinikum Erlangen, Erlangen, Germany
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Xiao H, Fang W, Lin M, Zhou Z, Fei H, Chen C. [A multiscale carotid plaque detection method based on two-stage analysis]. Nan Fang Yi Ke Da Xue Xue Bao 2024; 44:387-396. [PMID: 38501425 PMCID: PMC10954526 DOI: 10.12122/j.issn.1673-4254.2024.02.22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 03/20/2024]
Abstract
OBJECTIVE To develop a method for accurate identification of multiscale carotid plaques in ultrasound images. METHODS We proposed a two-stage carotid plaque detection method based on deep convolutional neural network (SM-YOLO).A series of algorithms such as median filtering, histogram equalization, and Gamma transformation were used to preprocess the dataset to improve image quality. In the first stage of the model construction, a candidate plaque set was built based on the YOLOX_l target detection network, using multiscale image training and multiscale image prediction strategies to accommodate carotid artery plaques of different shapes and sizes. In the second stage, the Histogram of Oriented Gradient (HOG) features and Local Binary Pattern (LBP) features were extracted and fused, and a Support Vector Machine (SVM) classifier was used to screen the candidate plaque set to obtain the final detection results. This model was compared quantitatively and visually with several target detection models (YOLOX_l, SSD, EfficientDet, YOLOV5_l, Faster R-CNN). RESULTS SM-YOLO achieved a recall of 89.44%, an accuracy of 90.96%, a F1-Score of 90.19%, and an AP of 92.70% on the test set, outperforming other models in all performance indicators and visual effects. The constructed model had a much shorter detection time than the Faster R-CNN model (only one third of that of the latter), thus meeting the requirements of real-time detection. CONCLUSION The proposed carotid artery plaque detection method has good performance for accurate identification of carotid plaques in ultrasound images.
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Affiliation(s)
- H Xiao
- School of Biomedical Engineering, Southern Medical University, Guangzhou 510515, China
| | - W Fang
- School of Biomedical Engineering, Southern Medical University, Guangzhou 510515, China
| | - M Lin
- School of Biomedical Engineering, Southern Medical University, Guangzhou 510515, China
| | - Z Zhou
- Guangzhou Shangyi Network Information Technology Co., Ltd., Guangzhou 510515, China
| | - H Fei
- Guangdong Provincial People's Hospital Affiliated to Southern Medical University, Guangzhou 510180, China
| | - C Chen
- School of Biomedical Engineering, Southern Medical University, Guangzhou 510515, China
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Ding J, Zhou R, Fang X, Wang F, Wang J, Gan H, Fenster A. An image registration-based self-supervised Su-Net for carotid plaque ultrasound image segmentation. Comput Methods Programs Biomed 2024; 244:107957. [PMID: 38061113 DOI: 10.1016/j.cmpb.2023.107957] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/12/2022] [Revised: 11/17/2023] [Accepted: 11/27/2023] [Indexed: 01/26/2024]
Abstract
BACKGROUND AND OBJECTIVES Total Plaque Area (TPA) measurement is critical for early diagnosis and intervention of carotid atherosclerosis in individuals with high risk for stroke. The delineation of the carotid plaques is necessary for TPA measurement, and deep learning methods can automatically segment the plaque and measure TPA from carotid ultrasound images. A large number of labeled images is essential for training a good deep learning model, but it is very difficult to collect such large labeled datasets for carotid image segmentation in clinical practice. Self-supervised learning can provide a possible solution to improve the deep-learning models on small labeled training datasets by designing a pretext task to pre-train the models without using the segmentation masks. However, the existing self-supervised learning methods do not consider the feature presentations of object contours. METHODS In this paper, we propose an image registration-based self-supervised learning method and a stacked U-Net (SSL-SU-Net) for carotid plaque ultrasound image segmentation, which can better exploit the semantic features of carotid plaque contours in self-supervised task training. RESULTS Our network was trained on different numbers of labeled images (n = 10, 33, 50 and 100 subjects) and tested on 44 subjects from the SPARC dataset (n = 144, London, Canada). The network trained on the entire SPARC dataset was then directly applied to an independent dataset collected in Zhongnan hospital (n = 497, Wuhan, China). For the 44 subjects tested on the SPARC dataset, our method yielded a DSC of 80.25-89.18% and the produced TPA measurements, which were strongly correlated with manual segmentation (r = 0.965-0.995, ρ< 0.0001). For the Zhongnan dataset, the DSC was 90.3% and algorithm TPAs were strongly correlated with manual TPAs (r = 0.985, ρ< 0.0001). CONCLUSIONS The results demonstrate that our proposed method yielded excellent performance and good generalization ability when trained on a small labeled dataset, facilitating the use of deep learning in carotid ultrasound image analysis and clinical practice. The code of our algorithm is available https://github.com/a610lab/Registration-SSL.
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Affiliation(s)
- Jing Ding
- School of Computer Science, Hubei University of Technology, Wuhan, Hubei 430068, China
| | - Ran Zhou
- School of Computer Science, Hubei University of Technology, Wuhan, Hubei 430068, China.
| | - Xiaoyue Fang
- School of Computer Science, Hubei University of Technology, Wuhan, Hubei 430068, China
| | - Furong Wang
- Liyuan Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430074, China
| | - Ji Wang
- School of Computer Science, Hubei University of Technology, Wuhan, Hubei 430068, China
| | - Haitao Gan
- School of Computer Science, Hubei University of Technology, Wuhan, Hubei 430068, China.
| | - Aaron Fenster
- Imaging Research Laboratories, Robarts Research Institute, Western University, London N6A 5K8, Ontario, Canada
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Kiernan MJ, Al Mukaddim R, Mitchell CC, Maybock J, Wilbrand SM, Dempsey RJ, Varghese T. Lumen segmentation using a Mask R-CNN in carotid arteries with stenotic atherosclerotic plaque. Ultrasonics 2024; 137:107193. [PMID: 37952384 PMCID: PMC10841729 DOI: 10.1016/j.ultras.2023.107193] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/20/2023] [Revised: 09/19/2023] [Accepted: 10/29/2023] [Indexed: 11/14/2023]
Abstract
In patients at high risk for ischemic stroke, clinical carotid ultrasound is often used to grade stenosis, determine plaque burden and assess stroke risk. Analysis currently requires a trained sonographer to manually identify vessel and plaque regions, which is time and labor intensive. We present a method for automatically determining bounding boxes and lumen segmentation using a Mask R-CNN network trained on sonographer assisted ground-truth carotid lumen segmentations. Automatic lumen segmentation also lays the groundwork for developing methods for accurate plaque segmentation, and wall thickness measurements in cases with no plaque. Different training schemes are used to identify the Mask R-CNN model with the highest accuracy. Utilizing a single-channel B-mode training input, our model produces a mean bounding box intersection over union (IoU) of 0.81 and a mean lumen segmentation IoU of 0.75. However, we encountered errors in prediction when the jugular vein is the most prominently visualized vessel in the B-mode image. This was due to the fact that our dataset has limited instances of B-mode images with both the jugular vein and carotid artery where the vein is dominantly visualized. Additional training datasets are anticipated to mitigate this issue.
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Affiliation(s)
- Maxwell J Kiernan
- Department of Medical Physics, University of Wisconsin School of Medicine and Public Health (UW-SMPH), United States.
| | - Rashid Al Mukaddim
- Department of Medical Physics, University of Wisconsin School of Medicine and Public Health (UW-SMPH), United States
| | | | - Jenna Maybock
- Department of Neurological Surgery, UW-SMPH. Madison, WI, United States
| | | | - Robert J Dempsey
- Department of Neurological Surgery, UW-SMPH. Madison, WI, United States
| | - Tomy Varghese
- Department of Medical Physics, University of Wisconsin School of Medicine and Public Health (UW-SMPH), United States.
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Mizobuchi S, Kojima K, Miyagawa M, Tanaka Y, Migita S, Fukumoto K, Koyama Y, Ebuchi Y, Takahashi K, Nakajima Y, Arai R, Murata N, Fukamachi D, Okumura Y. Association between aortic thrombi detected using non-obstructive general angioscopy and atrial fibrillation. J Thromb Thrombolysis 2024; 57:269-277. [PMID: 38017303 DOI: 10.1007/s11239-023-02917-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/08/2023] [Indexed: 11/30/2023]
Abstract
Atrial fibrillation (AF) is an independent risk factor for stroke and systemic embolism. Cardiogenic and aortogenic emboli are causes of stroke or systemic embolism. Non-obstructive general angioscopy (NOGA) can be used to diagnose aortic intimal findings, including thrombi and atherosclerotic plaques, but little is known about NOGA-derived aortic intimal findings in patients with AF. This study focused on aortic intimal findings in patients with AF and evaluated the association between AF and aortic thrombi detected using NOGA. We enrolled 283 consecutive patients with coronary artery disease who underwent NOGA of the aorta between January 2017 and August 2022. Aortic intimal findings were screened using NOGA after coronary arteriography. The patients were divided into two groups according to their AF history (AF, n = 50 and non-AF, n = 233). Patients in the AF group were older than those in the non-AF group. Sex, body mass index, and coronary risk factors were not significantly different between the two groups. In the NOGA findings, the presence of intense yellow plaques and ruptured plaques was not significantly different between the two groups. Aortic thrombi were more frequent in the AF group than in the non-AF group (92.0 vs. 71.6%, p < 0.001). Multivariate logistic regression found that AF was independently associated with aortic thrombi (odds ratio 3.87 [95% CI 1.28-11.6], p = 0.016). The presence of aortic thrombi observed using NOGA was associated with AF in patients with coronary artery disease. The roles of aortic thrombi as well as cardiogenic embolism may require clarification.
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Affiliation(s)
- Saki Mizobuchi
- Division of Cardiology, Department of Medicine, Nihon University School of Medicine, 30-1 Ohyaguchi-kamicho, Itabashi-ku, Tokyo, 173-8610, Japan
| | - Keisuke Kojima
- Division of Cardiology, Department of Medicine, Nihon University School of Medicine, 30-1 Ohyaguchi-kamicho, Itabashi-ku, Tokyo, 173-8610, Japan.
| | - Masatsugu Miyagawa
- Division of Cardiology, Department of Medicine, Nihon University School of Medicine, 30-1 Ohyaguchi-kamicho, Itabashi-ku, Tokyo, 173-8610, Japan
| | - Yudai Tanaka
- Division of Cardiology, Department of Medicine, Nihon University School of Medicine, 30-1 Ohyaguchi-kamicho, Itabashi-ku, Tokyo, 173-8610, Japan
| | - Shohei Migita
- Division of Cardiology, Department of Medicine, Nihon University School of Medicine, 30-1 Ohyaguchi-kamicho, Itabashi-ku, Tokyo, 173-8610, Japan
| | - Katsunori Fukumoto
- Division of Cardiology, Department of Medicine, Nihon University School of Medicine, 30-1 Ohyaguchi-kamicho, Itabashi-ku, Tokyo, 173-8610, Japan
| | - Yutaka Koyama
- Division of Cardiology, Department of Medicine, Nihon University School of Medicine, 30-1 Ohyaguchi-kamicho, Itabashi-ku, Tokyo, 173-8610, Japan
| | - Yasunari Ebuchi
- Division of Cardiology, Department of Medicine, Nihon University School of Medicine, 30-1 Ohyaguchi-kamicho, Itabashi-ku, Tokyo, 173-8610, Japan
| | - Kurara Takahashi
- Division of Cardiology, Department of Medicine, Nihon University School of Medicine, 30-1 Ohyaguchi-kamicho, Itabashi-ku, Tokyo, 173-8610, Japan
| | - Yuki Nakajima
- Division of Cardiology, Department of Medicine, Nihon University School of Medicine, 30-1 Ohyaguchi-kamicho, Itabashi-ku, Tokyo, 173-8610, Japan
| | - Riku Arai
- Division of Cardiology, Department of Medicine, Nihon University School of Medicine, 30-1 Ohyaguchi-kamicho, Itabashi-ku, Tokyo, 173-8610, Japan
| | - Nobuhiro Murata
- Division of Cardiology, Department of Medicine, Nihon University School of Medicine, 30-1 Ohyaguchi-kamicho, Itabashi-ku, Tokyo, 173-8610, Japan
| | - Daisuke Fukamachi
- Division of Cardiology, Department of Medicine, Nihon University School of Medicine, 30-1 Ohyaguchi-kamicho, Itabashi-ku, Tokyo, 173-8610, Japan
| | - Yasuo Okumura
- Division of Cardiology, Department of Medicine, Nihon University School of Medicine, 30-1 Ohyaguchi-kamicho, Itabashi-ku, Tokyo, 173-8610, Japan
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Adams A, Bojara W, Romanens M. [Ultrasound examination of the carotid artery for improved prediction of cardiovascular events and the effect of statin treatment in advanced atherosclerosis : An observational study]. Herz 2024; 49:60-68. [PMID: 37402837 DOI: 10.1007/s00059-023-05197-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2023] [Revised: 05/23/2023] [Accepted: 06/01/2023] [Indexed: 07/06/2023]
Abstract
BACKGROUND Advanced atherosclerosis of the carotid artery is associated with a high risk of cardiovascular diseases. It was investigated whether ultrasound provides a better prediction of cardiovascular events compared to the prospective cardiovascular Münster study (PROCAM) score and whether treatment of subjects with advanced atherosclerosis with statins improves the prognosis. METHOD Between 2009 and 2016 a total of 4482 subjects (41% women) aged 35-65 years with no signs of cardiovascular disease underwent carotid artery ultrasound examination. Total plaque area (TPA) and maximum plaque thickness were measured. The PROCAM score was used to determine the cardiovascular risk. RESULTS The median follow-up time was 77 months (6.4 years) for the men and 74 months (6.2 years) for the women. Events, such as myocardial infarction, ischemic stroke, coronary artery bypass grafting (CABG) and percutaneous transluminal coronary angioplasty (PTCA), occurred in 131 (3.4%) of the 3833 subjects with complete follow-up data. The prediction of cardiovascular events was better with ultrasound than with the PROCAM score. Ultrasound predicted 79.4% of 131 events and the PROCAM score predicted 22.9%. Treatment of subjects with advanced atherosclerosis (types III, IV b) with a statin significantly improved the prognosis. The event rate was 12.6% in men and women in the treated group vs. 31.5% (p < 0.0001) in the untreated group. Mortality (from any cause) was significantly lower in men treated with statins (p = 0.0148). CONCLUSION The prediction of cardiovascular events was better with plaque burden measurements than with the PROCAM score. Treatment with statins in subjects with advanced carotid atherosclerosis (types III-IV b findings on ultrasound) significantly improved the prognosis in a nonrandomized observational study.
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Affiliation(s)
- Ansgar Adams
- BAD Gesundheitsvorsorge und Sicherheitstechnik GmbH, Zentrum Koblenz, Koblenz, Deutschland.
- BAD Gesundheitsvorsorge und Sicherheitstechnik GmbH, Zentrum Koblenz, Bubenheimer Bann 4, 56070, Koblenz, Deutschland.
| | - Waldemar Bojara
- Innere Medizin - Kardiologie, Gemeinschaftsklinikum Mittelrhein gGmbH, Standort Kemperhof, Koblenz, Deutschland
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Austad G, Geitung JT, Tonstad S. Validation and Reproducibility of Total Plaque Thickness in Carotid and Femoral Arteries Using Ultrasound. Ultrasound Med Biol 2024; 50:207-215. [PMID: 37940460 DOI: 10.1016/j.ultrasmedbio.2023.09.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/03/2023] [Revised: 09/27/2023] [Accepted: 09/28/2023] [Indexed: 11/10/2023]
Abstract
OBJECTIVE Plaque burden quantification by ultrasound improves cardiovascular (CV) risk prediction. However, measuring total plaque volume (TPV) with 3-D ultrasound, the current gold standard, is time consuming. In the present study we investigated the reproducibility of weighted total plaque thickness (wTPT) measured by 2-D ultrasound and its correlation with TPV. METHODS Participants in an ongoing study of subclinical atherosclerosis and CV risk with no known atherosclerotic CV disease but who were found to have one or more plaques in carotid or femoral arteries by 2-D ultrasound were included. A total of 34 women and 26 men (mean age: 59.4 y, standard deviation: 8.7) underwent primary 2-D and 3-D ultrasound examinations. Participants then underwent a 2-D ultrasound examination by another radiologist blinded to the first radiologist's findings. Finally, all participants underwent a follow-up 2-D ultrasound by the first radiologist. RESULTS Comparison of wTPT measurements between the 2-D studies revealed no significant difference (mean difference: 0.29 mm, 95% confidence interval [CI]: -0.48 to 1.17). Inter-observer and intra-observer analyses revealed intraclass correlation coefficients of 0.97 (95% CI: 0.96-0.98) and 1.0 (95% CI: 0.99-1.00), respectively. wTPT correlated with TPV (Spearman's ρ = 0.98, 95% CI: 0.96-0.99). Elapsed time for assessing wTPT was less than that for TPV (mean difference: 36.1 min, 95% CI: 26.0-46.3). CONCLUSION wTPT had high reproducibility and correlation with TPV while requiring substantially less time. Future studies addressing the role of wTPT in predicting CV disease are needed.
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Affiliation(s)
- Gunnar Austad
- Department of Preventive Cardiology, Oslo University Hospital, Oslo, Norway.
| | - Jonn Terje Geitung
- Department of Radiology and Nuclear Medicine, Akershus University Hospital, Lørenskog, Norway
| | - Serena Tonstad
- Department of Preventive Cardiology, Oslo University Hospital, Oslo, Norway
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Nakao K, Noguchi T, Miura H, Asaumi Y, Morita Y, Takeuchi S, Matama H, Sawada K, Doi T, Hosoda H, Nakashima T, Honda S, Fujino M, Yoneda S, Kawakami S, Nagai T, Nishihira K, Kanaya T, Otsuka F, Nakanishi M, Kataoka Y, Tahara Y, Goto Y, Kusano K, Yamamoto H, Omae K, Ogawa H, Yasuda S. Effect of Eicosapentaenoic Acid/Docosahexaenoic Acid on Coronary High-Intensity Plaques Detected Using Noncontrast T1-weighted Imaging: The AQUAMARINE EPA/DHA Randomized Study. J Atheroscler Thromb 2024; 31:122-134. [PMID: 37704431 PMCID: PMC10857838 DOI: 10.5551/jat.64063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Accepted: 07/09/2023] [Indexed: 09/15/2023] Open
Abstract
AIM Omega-3 fatty acids have emerged as a new option for controlling the residual risk for coronary artery disease (CAD) in the statin era. Eicosapentaenoic acid (EPA) is associated with reduced CAD risk in the Reduction of Cardiovascular Events with Icosapent Ethyl-Intervention trial, whereas the Statin Residual Risk with Epanova in High Cardiovascular Risk Patients with Hypertriglyceridemia trial that used the combination EPA/docosahexaenoic acid (DHA) has failed to derive any clinical benefit. These contradictory results raise important questions about whether investigating the antiatherosclerotic effect of omega-3 fatty acids could help to understand their significance for CAD-risk reduction. METHODS The Attempts at Plaque Vulnerability Quantification with Magnetic Resonance Imaging Using Noncontrast T1-weighted Technic EPA/DHA study is a single-center, triple-arm, randomized, controlled, open-label trial used to investigate the effect of EPA/DHA on high-risk coronary plaques after 12 months of treatment, detected using cardiac magnetic resonance (CMR) in patients with CAD receiving statin therapy. Eligible patients were randomly assigned to no-treatment, 2-g/day, and 4-g/day EPA/DHA groups. The primary endpoint was the change in the plaque-to-myocardium signal intensity ratio (PMR) of coronary high-intensity plaques detected by CMR. Coronary plaque assessment using computed tomography angiography (CTA) was also investigated. RESULTS Overall, 84 patients (mean age: 68.2 years, male: 85%) who achieved low-density lipoprotein cholesterol levels of <100 mg/dL were enrolled. The PMR was reduced in each group over 12 months. There were no significant differences in PMR changes among the three groups in the primary analysis or analysis including total lesions. The changes in CTA parameters, including indexes for detecting high-risk features, also did not differ. CONCLUSION The EPA/DHA therapy of 2 or 4 g/day did not significantly improve the high-risk features of coronary atherosclerotic plaques evaluated using CMR under statin therapy.
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Affiliation(s)
- Kazuhiro Nakao
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Centre, Osaka, Japan
| | - Teruo Noguchi
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Centre, Osaka, Japan
| | - Hiroyuki Miura
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Centre, Osaka, Japan
| | - Yasuhide Asaumi
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Centre, Osaka, Japan
| | - Yoshiaki Morita
- Department of Radiology, National Cerebral and Cardiovascular Centre, Osaka, Japan
| | - Satoshi Takeuchi
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Centre, Osaka, Japan
- Department of Advanced Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Hideo Matama
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Centre, Osaka, Japan
| | - Keniciro Sawada
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Centre, Osaka, Japan
| | - Takahito Doi
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Centre, Osaka, Japan
| | - Hayato Hosoda
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Centre, Osaka, Japan
| | - Takahiro Nakashima
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Centre, Osaka, Japan
| | - Satoshi Honda
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Centre, Osaka, Japan
| | - Masashi Fujino
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Centre, Osaka, Japan
| | - Shuichi Yoneda
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Centre, Osaka, Japan
| | - Shoji Kawakami
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Centre, Osaka, Japan
| | - Toshiyuki Nagai
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Centre, Osaka, Japan
| | - Kensaku Nishihira
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Centre, Osaka, Japan
| | - Tomoaki Kanaya
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Centre, Osaka, Japan
| | - Fumiyuki Otsuka
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Centre, Osaka, Japan
| | - Michio Nakanishi
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Centre, Osaka, Japan
| | - Yu Kataoka
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Centre, Osaka, Japan
| | - Yoshio Tahara
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Centre, Osaka, Japan
| | - Yoichi Goto
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Centre, Osaka, Japan
| | - Kengo Kusano
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Centre, Osaka, Japan
| | - Haruko Yamamoto
- Centre for Advancing Clinical and Translational Science, National Cerebral and Cardiovascular Centre, Osaka, Japan
| | - Katsuhiro Omae
- Department of Data Science, National Cerebral and Cardiovascular Centre, Osaka, Japan
| | - Hisao Ogawa
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Centre, Osaka, Japan
| | - Satoshi Yasuda
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Centre, Osaka, Japan
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
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46
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Joseph T, Foley M, Al-Lamee R. Physiology and Intravascular Imaging Coregistration-Best of all Worlds? Cardiol Clin 2024; 42:77-87. [PMID: 37949541 DOI: 10.1016/j.ccl.2023.07.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2023]
Abstract
Percutaneous coronary intervention is increasingly guided by coronary physiology and optimized using intravascular imaging. Pressure-based measurements determine the significance of a stenosis using hyperemic or nonhyperemic pressure ratios (eg, the instantaneous wave-free ratio). Intravascular ultrasound and optical coherence tomography provide cross-sectional and longitudinal detail regarding plaque composition and vessel characteristics. These facilitate lesion preparation and optimization of stent sizing and positioning. This review explores the evidence-base and practical aspects of coregistering pressure gradient assessment and intravascular imaging with angiography. We then discuss gaps in the evidence and what is needed to help integrate these techniques into clinical practice.
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Affiliation(s)
- Tobin Joseph
- National Heart and Lung Institute, Imperial College London, Du Cane Road, London, W120HS, UK; Imperial College Healthcare NHS Trust, Du Cane Road, London, W120HS, UK
| | - Michael Foley
- National Heart and Lung Institute, Imperial College London, Du Cane Road, London, W120HS, UK; Imperial College Healthcare NHS Trust, Du Cane Road, London, W120HS, UK.
| | - Rasha Al-Lamee
- National Heart and Lung Institute, Imperial College London, Du Cane Road, London, W120HS, UK; Imperial College Healthcare NHS Trust, Du Cane Road, London, W120HS, UK; Hammersmith Hospital, Du Cane Road, London W12 0HS, UK
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47
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Zhou W, Zhou L, Wang C, Liu Z, Li Z. Correlation between coronary artery plaque composition ratio and plaque stability evaluated by 124-layer CT. Minerva Med 2024; 115:114-116. [PMID: 37227241 DOI: 10.23736/s0026-4806.23.08668-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Affiliation(s)
- Weiqiang Zhou
- Department of Radiology, Zigong Psychiatric Research Center, Zigong, China
| | - Li Zhou
- Department of Surgery, Zigong Psychiatric Research Center, Zigong, China
| | - Can Wang
- Department of Radiology, Zigong Psychiatric Research Center, Zigong, China
| | - Zhaoyuan Liu
- Department of Radiology, Zigong Psychiatric Research Center, Zigong, China
| | - Zhouyu Li
- Department of Internal Medicine, Zigong Psychiatric Research Center, Zigong, China -
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48
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Jochmann SL, Sievering EMW, Ernst J, Ringlstetter R, Grosshennig A, Weissenborn K, Grosse GM. Sex-Specific Risk Factors of Nonstenotic Carotid Plaque in Embolic Stroke of Unknown Source: A Case-Control Study. Stroke 2024; 55:296-300. [PMID: 38152961 DOI: 10.1161/strokeaha.123.044833] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2023] [Accepted: 11/29/2023] [Indexed: 12/29/2023]
Abstract
BACKGROUND Many ischemic strokes are diagnosed as embolic strokes of undetermined source (ESUS). Recent evidence suggests that nonstenotic carotid plaque (nsCP) may be a substantial contributor to the risk for ESUS. We aimed to investigate the risk factor profile associated with nsCP in ESUS and defined stroke etiologies. METHODS In this retrospective case-control study, we investigated consecutive patients with acute ischemic stroke due to ESUS, small-vessel disease, or cardioembolism proven by magnetic resonance imaging. The association of vascular risk factors age, arterial hypertension, diabetes, dyslipoproteinemia, body mass index, alcohol consumption, tobacco use, kidney failure, and history of stroke with the presence of nsCP was investigated using binary logistic regression analysis and further stratified by stroke etiology and sex. RESULTS In total, 609 patients (median age, 76 years; 46% women) who were treated from 2018 to 2020 were considered. In patients with ESUS, sex played a more important role for the prevalence of nsCP than in defined etiologies. Female patients with ESUS had lower odds of exhibiting nsCP compared with male patients with ESUS (adjusted odds ratio, 0.36 [95% CI, 0.15-0.86]). In male patients with ESUS, we observed that age (adjusted odds ratio per 10-year increase, 2.55 [95% CI, 1.26-5.17]) and hypertension (adjusted odds ratio, 2.49 [95% CI, 0.56-11.1]) were the main risk factors for nsCP, whereas in female patients with ESUS also tobacco use was particularly relevant (adjusted odds ratio, 3.71 [95% CI, 0.61-22.5]). These results were in line with a sensitivity analysis in nsCP located ipsilateral to the infarct. CONCLUSIONS Sex differences play an important role in nsCP prevalence in patients with ESUS. These findings may have important implications for the management in targeted secondary prevention following ESUS.
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Affiliation(s)
- Svenja L Jochmann
- Department of Neurology, (S.L.J., E.M.W.S., J.E., K.W., G.M.G.), Hannover Medical School, Germany
| | - Esther M W Sievering
- Department of Neurology, (S.L.J., E.M.W.S., J.E., K.W., G.M.G.), Hannover Medical School, Germany
| | - Johanna Ernst
- Department of Neurology, (S.L.J., E.M.W.S., J.E., K.W., G.M.G.), Hannover Medical School, Germany
| | - Rieke Ringlstetter
- Institute of Biostatistics (R.R., A.G.), Hannover Medical School, Germany
| | - Anika Grosshennig
- Institute of Biostatistics (R.R., A.G.), Hannover Medical School, Germany
| | - Karin Weissenborn
- Department of Neurology, (S.L.J., E.M.W.S., J.E., K.W., G.M.G.), Hannover Medical School, Germany
| | - Gerrit M Grosse
- Department of Neurology, (S.L.J., E.M.W.S., J.E., K.W., G.M.G.), Hannover Medical School, Germany
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49
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Chan JMS, Park SJ, Ng M, Chen WC, Chan WY, Bhakoo K, Chong TT. Translational Molecular Imaging Tool of Vulnerable Carotid Plaque: Evaluate Effects of Statin Therapy on Plaque Inflammation and American Heart Association-Defined Risk Levels in Cuff-Implanted Apolipoprotein E-Deficient Mice. Transl Stroke Res 2024; 15:110-126. [PMID: 36481841 PMCID: PMC10796420 DOI: 10.1007/s12975-022-01114-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2022] [Revised: 11/30/2022] [Accepted: 12/01/2022] [Indexed: 12/13/2022]
Abstract
Identification of high-risk carotid plaques in asymptomatic patients remains a challenging but crucial step in stroke prevention. The challenge is to accurately monitor the development of high-risk carotid plaques and promptly identify patients, who are unresponsive to best medical therapy, and hence targeted for carotid surgical interventions to prevent stroke. Inflammation is a key operator in destabilisation of plaques prior to clinical sequelae. Currently, there is a lack of imaging tool in routine clinical practice, which allows assessment of inflammatory activity within the atherosclerotic plaque. Herein, we have used a periarterial cuff to generate a progressive carotid atherosclerosis model in apolipoprotein E-deficient mice. This model produced clinically relevant plaques with different levels of risk, fulfilling American Heart Association (AHA) classification, at specific timepoints and locations, along the same carotid artery. Exploiting this platform, we have developed smart molecular magnetic resonance imaging (MRI) probes consisting of dual-targeted microparticles of iron oxide (DT-MPIO) against VCAM-1 and P-selectin, to evaluate the anti-inflammatory effect of statin therapy on progressive carotid atherosclerosis. We demonstrated that in vivo DT-MPIO-enhanced MRI can (i) quantitatively track plaque inflammation from early to advanced stage; (ii) identify and characterise high-risk inflamed, vulnerable plaques; and (iii) monitor the response to statin therapy longitudinally. Moreover, this molecular imaging-defined therapeutic response was validated using AHA classification of human plaques, a clinically relevant parameter, approximating the clinical translation of this tool. Further development and translation of this molecular imaging tool into the clinical arena may potentially facilitate more accurate risk stratification, permitting timely identification of the high-risk patients for prophylactic carotid intervention, affording early opportunities for stroke prevention in the future.
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Affiliation(s)
- Joyce M S Chan
- Translational Cardiovascular Imaging Group, Institute of Bioengineering and Bioimaging (IBB), Agency for Science, Technology and Research (A*STAR), 11 Biopolis Way, #02-02 , Singapore, 138667, Helios, Singapore.
- Department of Vascular Surgery, Singapore General Hospital, SingHealth, Outram Road, Singapore, 169608, Singapore.
- Lee Kong Chian School of Medicine, Nanyang Technological University, 50 Nanyang Avenue, Singapore, 639798, Singapore.
| | - Sung-Jin Park
- Translational Cardiovascular Imaging Group, Institute of Bioengineering and Bioimaging (IBB), Agency for Science, Technology and Research (A*STAR), 11 Biopolis Way, #02-02 , Singapore, 138667, Helios, Singapore
| | - Michael Ng
- Translational Cardiovascular Imaging Group, Institute of Bioengineering and Bioimaging (IBB), Agency for Science, Technology and Research (A*STAR), 11 Biopolis Way, #02-02 , Singapore, 138667, Helios, Singapore
| | - Way Cherng Chen
- Bruker Singapore Pte. Ltd, 30 Biopolis Street, #09-01, Singapore, 138671, Matrix, Singapore
| | - Wan Ying Chan
- Division of Oncologic Imaging, National Cancer Centre, Singapore, Singapore
| | - Kishore Bhakoo
- Institute of Bioengineering and Bioimaging (IBB), Agency for Science, Technology and Research (A*STAR), 11 Biopolis Way, #02-02, Singapore, 138667, Helios, Singapore
| | - Tze Tec Chong
- Department of Vascular Surgery, Singapore General Hospital, SingHealth, Outram Road, Singapore, 169608, Singapore
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50
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Niida T, Yuki H, Suzuki K, Kinoshita D, Fujimoto D, Nakajima A, McNulty I, Lee H, Tanriverdi K, Nakamura S, Jang IK. Proteomics associated with coronary high-risk plaques by optical coherence tomography. J Thromb Thrombolysis 2024; 57:204-211. [PMID: 38296868 DOI: 10.1007/s11239-023-02938-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/16/2023] [Indexed: 02/02/2024]
Abstract
Biomarkers are widely used for the diagnosis and monitoring of cardiovascular disease. However, markers for coronary high-risk plaques have not been identified. The aim of this study was to identify proteins specific to coronary high-risk plaques. Fifty-one patients (71.2 ± 11.1 years, male: 66.7%) who underwent intracoronary optical coherence tomography imaging and provided blood specimens for proteomic analysis were prospectively enrolled. A total of 1470 plasma proteins were analyzed per patient using the Olink® Explore 1536 Reagent Kit. In patients with thin-cap fibroatheroma, the protein expression of Calretinin (CALB2), Corticoliberin (CRH) and Alkaline phosphatase, placental type (ALPP) were significantly increased, while the expression of Neuroplastin (NPTN), Folate receptor gamma (FOLR3) and Serpin A12 (SERPINA12) were significantly decreased. In patients with macrophage infiltration, the protein expressions of Fatty acid-binding protein, intestinal (FABP2), and Fibroblast growth factor 21 (FGF21) were significantly decreased. In patients with lipid-rich plaques, the protein expression of Interleukin-17 C (IL17C) was significantly increased, while the expression of Fc receptor-like protein 3 (FCRL3) was significantly decreased. These proteins might be useful markers in identifying patients with coronary high-risk plaques. Clinical Trial Registration: https://www.umin.ac.jp/ctr/ , UMIN000041692.
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Affiliation(s)
- Takayuki Niida
- Cardiology Division, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Haruhito Yuki
- Cardiology Division, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Keishi Suzuki
- Cardiology Division, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Daisuke Kinoshita
- Cardiology Division, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Daichi Fujimoto
- Cardiology Division, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Akihiro Nakajima
- Interventional Cardiology Unit, New Tokyo Hospital, Chiba, Japan
| | - Iris McNulty
- Cardiology Division, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Hang Lee
- Biostatistics Center, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Kahraman Tanriverdi
- Division of Cardiovascular Medicine, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Sunao Nakamura
- Interventional Cardiology Unit, New Tokyo Hospital, Chiba, Japan
| | - Ik-Kyung Jang
- Cardiology Division, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
- Allan and Gill Gray Professor of Medicine, Cardiology Division, Massachusetts General Hospital, Harvard Medical School, 55 Fruit Street, GRB 800, Boston, MA, 02114, USA.
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