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Sample records for vulnerable carotid plaques

  1. Molecular pathology in vulnerable carotid plaques: correlation with [18]-fluorodeoxyglucose positron emission tomography (FDG-PET)

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    Graebe, M; Pedersen, Sune Folke; Borgwardt, L;

    2008-01-01

    before carotid endarterectomy. Plaque mRNA expression of the inflammatory cytokine interleukin 18 (IL-18), the macrophage-specific marker CD68 and the two proteinases, Cathepsin K and matrix metalloproteinase 9 (MMP-9), were quantified using real-time quantitative polymerase chain reaction. RESULTS......: Consistent up-regulation of CD68 (3.8-fold+/-0.9; mean+/-standard error), Cathepsin K (2.1-fold+/-0.5), MMP-9 (122-fold+/-65) and IL-18 (3.4-fold+/-0.7) were found in the plaques, compared to reference-artery specimens. The FDG uptake by plaques was strongly correlated with CD68 gene expression (r=0.71, P=0.......02). Any correlations with Cathepsin K, MMP-9 or IL-18 gene expression were weaker. CONCLUSIONS: FDG-PET uptake in carotid plaques is correlated to gene expression of CD68 and other molecular markers of inflammation and vulnerability Udgivelsesdato: 2009/6...

  2. Vulnerable atherosclerotic carotid plaque evaluation by ultrasound, computed tomography angiography, and magnetic resonance imaging: an overview.

    Science.gov (United States)

    Naim, Cyrille; Douziech, Maxime; Therasse, Eric; Robillard, Pierre; Giroux, Marie-France; Arsenault, Frederic; Cloutier, Guy; Soulez, Gilles

    2014-08-01

    Ischemic syndromes associated with carotid atherosclerotic disease are often related to plaque rupture. The benefit of endarterectomy for high-grade carotid stenosis in symptomatic patients has been established. However, in asymptomatic patients, the benefit of endarterectomy remains equivocal. Current research seeks to risk stratify asymptomatic patients by characterizing vulnerable, rupture-prone atherosclerotic plaques. Plaque composition, biology, and biomechanics are studied by noninvasive imaging techniques such as magnetic resonance imaging, computed tomography, ultrasound, and ultrasound elastography. These techniques are at a developmental stage and have yet to be used in clinical practice. This review will describe noninvasive techniques in ultrasound, magnetic resonance imaging, and computed tomography imaging modalities used to characterize atherosclerotic plaque, and will discuss their potential clinical applications, benefits, and drawbacks. Copyright © 2014 Canadian Association of Radiologists. Published by Elsevier Inc. All rights reserved.

  3. The pathological changes of inflammatory cells,smooth muscle cell and neo-vessels in the vulnerable carotid atherosclerosis plaque

    Institute of Scientific and Technical Information of China (English)

    吕鹤

    2006-01-01

    Objective To study the inflammation, smooth muscle cells and neovessels change in the vulnerable carotid atherosclerosis plaque. Methods 6 male patients, aged between 66~73 years old, had the history of stroke or transient cerebral ischemic attacks of internal carotid artery system in a few days to 5 months. MRI and DSA re-

  4. Inraoperative and Histological Visualization of Disrupted Vulnerable Plaques following Diagnostic Angiography of Moderate Carotid Stenosis

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    Tatsushi Mutoh

    2010-01-01

    Full Text Available Background. Digital subtraction angiography (DSA remains an important tool for diagnosis of carotid stenosis but is associated with risk for periprocedural complications. This is the first report of direct intraoperative and histolopathologic visualization of DSA-related carotid plaque disruption. Case. A 64-year-old man diagnosed to have a 60% right carotid stenosis received diagnostic DSA for therapeutic decision-making. He developed transient left hand numbness and weakness immediately after the procedure. Intraoperative imaging during carotid endarterectomy revealed a fragile plaque with sharp surface laceration and intraplaque hemorrhage at the bifurcation. Microscopy of the specimen demonstrated a large atheromatous plaque with fibrous hypertrophy and intraplaque hemorrhage filled with recent hemorrhagic debris. Conclusion. The visualized carotid lesion was more serious than expected, warning the danger of embolization or occlusion associated with the catheter maneuvers. Thus the highest level of practitioner training and technical expertise that ensures precise assessment of plaque characteristics should be encouraged.

  5. High-resolution imaging of human atherosclerotic carotid plaques with micro(18)F-FDG PET scanning exploring plaque vulnerability

    NARCIS (Netherlands)

    Masteling, Marleen G.; Zeebregts, Clark J.; Tio, Rene A.; Breek, Jan-Cees; Tietge, Uwe J. F.; de Boer, Jan Freark; Glaudemans, Andor W. J. M.; Dierckx, Rudi A. J. O.; Boersma, Hendrikus H.; Slart, Riemer H. J. A.

    2011-01-01

    FDG-PET can be used to identify vulnerable plaques in atherosclerotic disease. Clinical FDG-PET camera systems are restricted in terms of resolution for the visualization of detailed inflammation patterns in smaller vascular structures. The aim of the study is to evaluate the possible added value of

  6. Apopotic gene Bax expression in carotid plaque

    Institute of Scientific and Technical Information of China (English)

    Bao-Zhong MEN; Ding-Biao ZHOU; Huai-Yin SHI; Xiao-Ming ZHANG

    2006-01-01

    The expression of BAX in carotid atherosclerosis and its regulation is far from defined. Objectives To investigate BAX expression in stable/fibrous and instable/vulnerable carotid plaque and its clinical significance. Methods 25 cases of carotid plaque specimens obtained from endarterectomy were divided into two groups, stable/fibrous 14 cases, vulnerable/instable 11 cases; aortic artery and its branches from hepatic transplantation donors 6 case as control. The expression of proapoptotic BAX was detected by immunohistochemistry(IHC), in situ hybridization(ISH) and in situ TdT dUTP nick end labeling (TUNEL). Results 5 cases of BAX ( + ) were detected by ICH and ISH, 4 case of TUNEL ( + ) were detected by TUNEL in stable/fibrous carotid plaque , while 10 cases were BAX ( + )by IHC(P < 0.05) , 11case by ISH and 9 case by TUNEL were detected in instable/vulnerable carotid plaque ( P < 0.01 ), respectively. The intensity of BAX ( + ) cells by IHC and ISH was 8.63 ± 2.62 and 10.32 ± 3.12 in fibrous plaques, whereas 122 ± 21.64and 152 ± 23.35 in vulnerable plaques, respectively. No expression of BAX was found in controlled group. Conclusion The higher expression of Bax in vulnerable carotid plaque may be one mechanisms in molecular pathogenesis of carotid atherosclerosis which affect plaque stability and be the cause of higher incidence of stroke than fibrous carotid plaques, the regulation of BAX expression in different stage of atherosclerosis may provide targets in gene therapy for carotid atherosclerosis.

  7. RELATIONSHIPS BETWEEN METABOLIC PARAMETERS AND PLAQUE VULNERABILITY IN THE CAROTID ARTERIES IN PATIENTS WITH DIABETES MELLITUS TYPE 2

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    Muamer Suljić

    2012-09-01

    associated with atherosclerotic changes in the blood vessels. Ultrasound determination of plaque vulnerability in the carotid arteries is one of the most important criteria for the classification of patients at high risk for ischemic stroke and development of DMT2.

  8. The effect of interleukin and matrix metalloproteinase on the vulnerability of carotid atherosclerotic plaque and cerebral infarction

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    HUANG Yan

    2012-06-01

    Full Text Available Objective To investigate the relationship of IL-17, IL-10 and MMP-12 with the vulnerability of carotid atherosclerotic plaque and cerebral infarction. Methods According to clinical stroke event 70 carotid atherosclersis patients were divided into asymptomatic carotid atherosclerosis (ACAS group (n = 35 and acute atherosclerotic cerebral infarction (AACI group (n = 35. The patients were also divided into vulnerable plague (VP group (n = 38 and unvulnerable plague (UVP group (n = 32 by color ultrasonic technique. Normal control group (n = 35 was established. The plasma levels of cytokines were tested by enzyme-linked immunosorbent assay (ELISA. Results Compared with the control group, the concentrations of IL-17, IL-10 and MMP-12 in ACAS group and AACI group were significantly elevated (P = 0.000; P = 0.000, moreover, the concentrations of IL-17 and MMP-12 in AACI group were higher than those in ACAS group (P = 0.000; P = 0.002, respectively. In AACI group, the level of IL-10 was lower than the ACAS group and control group (P = 0.000, for all, whereas, no significant difference of IL-10 level was seen between ACAS group and control group (P = 0.275. In VP group, the concentrations of IL-17 and MMP-12 were higher than those in UVP group (P = 0.000 and 0.014, respectively. In VP group, the level of IL-10 was lower than that in UVP group and control group (P = 0.000, for all, but no significant difference of IL-10 level was seen between UVP group and control group (P = 0.742. Correlation analysis showed, the level of IL-17 was positively correlated with the level of MMP-12 (r = 0.640, P = 0.000, and was negatively correlated with the level of IL-10 (r =-0.430, P = 0.000. The level of MMP-12 was weakly negatively correlated with the level of IL-10 (r =-0.242, P = 0.013. Conclusion IL-17, IL-10 and MMP-12 all participate the pathological process of atherosclerosis and cerebral infarction. The elevated IL-17 and MMP-12 levels and decreased IL-10 level

  9. Multispectral Optoacoustic Tomography of Matrix Metalloproteinase Activity in Vulnerable Human Carotid Plaques

    NARCIS (Netherlands)

    Razansky, Daniel; Harlaar, Niels J.; Hillebrands, Jan Luuk; Taruttis, Adrian; Herzog, Eva; Zeebregts, Clark J.; van Dam, Gooitzen M.; Ntziachristos, Vasilis

    Elevated expression of cathepsins, integrins and matrix metalloproteinases (MMPs) is typically associated with atherosclerotic plaque instability. While fluorescent tagging of such molecules has been amply demonstrated, no imaging method was so far shown capable of resolving these

  10. Circulating immunoglobulins are not associated with intraplaque mast cell number and other vulnerable plaque characteristics in patients with carotid artery stenosis.

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    Sanne Willems

    Full Text Available BACKGROUND: Recently, we have shown that intraplaque mast cell numbers are associated with atherosclerotic plaque vulnerability and with future cardiovascular events, which renders inhibition of mast cell activation of interest for future therapeutic interventions. However, the endogenous triggers that activate mast cells during the progression and destabilization of atherosclerotic lesions remain unidentified. Mast cells can be activated by immunoglobulins and in the present study, we aimed to establish whether specific immunoglobulins in plasma of patients scheduled for carotid endarterectomy were related to (activated intraplaque mast cell numbers and plasma tryptase levels. In addition, the levels were related to other vulnerable plaque characteristics and baseline clinical data. METHODS AND RESULTS: OxLDL-IgG, total IgG and total IgE levels were measured in 135 patients who underwent carotid endarterectomy. No associations were observed between the tested plasma immunoglobulin levels and total mast cell numbers in atherosclerotic plaques. Furthermore, no associations were found between IgG levels and the following plaque characteristics: lipid core size, degree of calcification, number of macrophages or smooth muscle cells, amount of collagen and number of microvessels. Interestingly, statin use was negatively associated with plasma IgE and oxLDL-IgG levels. CONCLUSIONS: In patients suffering from carotid artery disease, total IgE, total IgG and oxLDL-IgG levels do not associate with plaque mast cell numbers or other vulnerable plaque histopathological characteristics. This study thus does not provide evidence that the immunoglobulins tested in our cohort play a role in intraplaque mast cell activation or grade of atherosclerosis.

  11. MRI-determined carotid artery flow velocities and wall shear stress in a mouse model of vulnerable and stable atherosclerotic plaque.

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    van Bochove, Glenda S; Straathof, Roel; Krams, Rob; Nicolay, Klaas; Strijkers, Gustav J

    2010-04-01

    We report here on the pre-clinical MRI characterization of an apoE-/- mouse model of stable and vulnerable carotid artery atherosclerotic plaques, which were induced by a tapered restriction (cast) around the artery. Specific focus was on the quantification of the wall shear stress, which is considered a key player in the development of the plaque phenotype. In vivo MRI was performed at 9.4 T. The protocol consisted of time-of-flight angiography, high-resolution T1- and T2-weighted black-blood imaging and phase-contrast flow velocity imaging as function of time in the cardiac cycle. Wall shear stress was determined by fitting the flow profile to a quadratic polynomial. Time-of-flight angiography confirmed preservation of blood flow through the carotid arteries in all cases. T1- and T2-weighted MRI resulted in high-resolution images in which the position of the cast, luminal narrowing introduced by cast and plaque, as well as the arterial wall could be well identified. Laminar flow with low wall shear stress (11.2+/- 5.2 Pa) was measured upstream to the cast at the position of the vulnerable plaque. Downstream to the cast at the position of the stable plaque, the apparent velocities were low, which is consistent with vortices and an oscillatory nature of the flow. Flow velocities and wall shear stress were successfully measured in this mouse model of stable and unstable plaque. The presented tools can be used to provide valuable insights in the pathogenesis of atherosclerosis.

  12. Contrast-enhanced ultrasound imaging of the vasa vasorum of carotid artery plaque

    Institute of Scientific and Technical Information of China (English)

    Ze-Zhou; Song; Yan-Ming; Zhang

    2015-01-01

    The vasa vasorum of carotid artery plaque is a novel marker of accurately evaluating the vulnerability of carotid artery plaque, which was associated with symptomatic cerebrovascular and cardiovascular disease. The presence of ultrasound contrast agents in carotid artery plaque represents the presence of the vasa vasorum in carotid artery plaque because the ultrasoundcontrast agents are strict intravascular tracers. Therefore, contrast-enhanced ultrasound(CEUS) is a novel and safe imaging modality for evaluating the vasa vasorum in carotid artery plaque. However, there are some issues that needs to be assessed to embody fully the clinical utility of the vasa vasorum in carotid artery plaque with CEUS.

  13. Carotid ultrasound phenotypes in vulnerable populations

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    Spence J David

    2006-11-01

    Full Text Available Abstract Background Biomarkers of carotid atherosclerosis range from those that are widely available and relatively simple to measure such as serum cholesterol levels, and B-mode Ultrasound measurement of intima media thickness (IMT to those that are more complex and technologically demanding but perhaps potentially more sensitive and specific to disease such as total plaque volume and total plaque area measured from 3-dimensional ultrasound images. In this study we measured and compared intima media thickness (IMT, total plaque volume (TPV and total plaque area (TPA in two separate populations, both vulnerable to carotid atherosclerosis. Methods In total, 88 subjects (mean age 72.8 with carotid stenosis of at least 60%, based on a peak Doppler flow, and 82 subjects (mean age 60.9 with diabetic nephropathy were assessed in a cross-sectional study. Conventional atherosclerotic risk factors were examined and the associations and correlations between these and carotid ultrasound phenotypes measured from B-mode and 3-dimensional ultrasound images were assessed. Results IMT and TPV were only modestly correlated in the two separate populations (r = .6, p Conclusion IMT and TPV were modestly correlated in a diabetic patient population and only TPV was associated with diabetes and the presence of plaque ulcerations in a diabetic population and carotid stenosis group. The 3-dimensional information provided by TPV can be critically important in unmasking association with risk factors not observed with less complex single-dimension assessments of carotid atherosclerosis such as those provided by IMT.

  14. Ultrasound Tissue Characterization of Vulnerable Atherosclerotic Plaque

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    Eugenio Picano

    2015-05-01

    Full Text Available A thrombotic occlusion of the vessel fed by ruptured coronary atherosclerotic plaque may result in unstable angina, myocardial infarction or death, whereas embolization from a plaque in carotid arteries may result in transient ischemic attack or stroke. The atherosclerotic plaque prone to such clinical events is termed high-risk or vulnerable plaque, and its identification in humans before it becomes symptomatic has been elusive to date. Ultrasonic tissue characterization of the atherosclerotic plaque is possible with different techniques—such as vascular, transesophageal, and intravascular ultrasound—on a variety of arterial segments, including carotid, aorta, and coronary districts. The image analysis can be based on visual, video-densitometric or radiofrequency methods and identifies three distinct textural patterns: hypo-echoic (corresponding to lipid- and hemorrhage-rich plaque, iso- or moderately hyper-echoic (fibrotic or fibro-fatty plaque, and markedly hyperechoic with shadowing (calcific plaque. Hypoechoic or dishomogeneous plaques, with spotty microcalcification and large plaque burden, with plaque neovascularization and surface irregularities by contrast-enhanced ultrasound, are more prone to clinical complications than hyperechoic, extensively calcified, homogeneous plaques with limited plaque burden, smooth luminal plaque surface and absence of neovascularization. Plaque ultrasound morphology is important, along with plaque geometry, in determining the atherosclerotic prognostic burden in the individual patient. New quantitative methods beyond backscatter (to include speed of sound, attenuation, strain, temperature, and high order statistics are under development to evaluate vascular tissues. Although not yet ready for widespread clinical use, tissue characterization is listed by the American Society of Echocardiography roadmap to 2020 as one of the most promising fields of application in cardiovascular ultrasound imaging

  15. In vivo and in vitro evidence that {sup 99m}Tc-HYNIC-interleukin-2 is able to detect T lymphocytes in vulnerable atherosclerotic plaques of the carotid artery

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    Glaudemans, Andor W.J.M.; Vries, Erik F.J. de; Koole, Michel; Luurtsema, Gert; Slart, Riemer H.J.A. [University Medical Center Groningen (Netherlands). Dept. of Nuclear Medicine and Molecular Imaging; Bonanno, Elena [Univ. of Rome Tor Vergata (Italy). Dept. of Anatomic Pathology; Galli, Filippo [Sapienza Univ, Rome (Italy). Nuclear Medicine Unit; Zeebregts, Clark J. [University Medical Center Groningen (Netherlands). Surgery (Div. Vascular Surgery); Boersma, Hendrikus H. [University Medical Center Groningen (Netherlands). Dept. of Nuclear Medicine and Molecular Imaging; University Medical Center Groningen (Netherlands). Clinical and Hospital Pharmacy; Taurino, Maurizio [Sapienza Univ., Rome (Italy). Vascular Surgery Unit; Signore, Alberto [University Medical Center Groningen (Netherlands). Dept. of Nuclear Medicine and Molecular Imaging; Sapienza Univ, Rome (Italy). Nuclear Medicine Unit

    2014-09-15

    Recent advances in basic science have established that inflammation plays a pivotal role in the pathogenesis of atherosclerosis. Inflammatory cells are thought to be responsible for the transformation of a stable plaque into a vulnerable one. Lymphocytes constitute at least 20 % of infiltrating cells in these vulnerable plaques. Therefore, the interleukin-2 (IL-2) receptor, being overexpressed on activated T lymphocytes, may represent an attractive biomarker for plaque vulnerability. The aim of this study was to evaluate the specificity of radiolabelled IL-2 [{sup 99m}Tc-hydrazinonicotinamide (HYNIC)-IL-2] for imaging the lymphocytic infiltration in carotid plaques in vivo by planar and single photon emission computed tomography (SPECT)/CT imaging and ex vivo by microSPECT and autoradiography. For the in vivo study, ten symptomatic patients with advanced plaques at ultrasound who were scheduled for carotid endarterectomy underwent {sup 99m}Tc-HYNIC-IL-2 scintigraphy. The images were analysed visually on planar and SPECT images and semi-quantitatively on SPECT images by calculating target to background (T/B) ratios. After endarterectomy, immunomorphological evaluation and immunophenotyping were performed on plaque slices. For the ex vivo studies, four additional patients were included and, after in vitro incubation of removed plaques with {sup 99m}Tc-HYNIC-IL-2, autoradiography was performed and microSPECT images were acquired. Visual analysis defined clear {sup 99m}Tc-HYNIC-IL-2 uptake in seven of the ten symptomatic plaques. SPECT/CT allowed visualization in eight of ten. A significant correlation was found between the number of CD25+ lymphocytes and the total number of CD25+ cells in the plaque and the T/B ratio with adjacent carotid artery as background (Pearson's r = 0.89, p = 0.003 and r = 0.87, p = 0.005, respectively). MicroSPECT imaging showed clear {sup 99m}Tc-HYNIC-IL-2 uptake within the plaque wall and not in the lipidic core. With autoradiography

  16. High shear stress relates to intraplaque haemorrhage in asymptomatic carotid plaques

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    Tuenter, A.; Selwaness, M.; Arias Lorza, A.

    2016-01-01

    BACKGROUND AND AIMS: Carotid artery plaques with vulnerable plaque components are related to a higher risk of cerebrovascular accidents. It is unknown which factors drive vulnerable plaque development. Shear stress, the frictional force of blood at the vessel wall, is known to influence plaque...... estimating equations analysis, adjusting for age, sex and carotid wall thickness. RESULTS: The study group consisted of 93 atherosclerotic carotid arteries of 74 participants. In plaques with higher maximum shear stresses, IPH was more often present (OR per unit increase in maximum shear stress (log...... formation. We evaluated the association between shear stress and plaque components (intraplaque haemorrhage (IPH), lipid rich necrotic core (LRNC) and/or calcifications) in relatively small carotid artery plaques in asymptomatic persons. METHODS: Participants (n = 74) from the population-based Rotterdam...

  17. Relation between B-mode Gray-scale Median and Clinical Features of Carotid Stenosis Vulnerability

    NARCIS (Netherlands)

    Kolkert, Joé L.; Meerwaldt, Robbert; Loonstra, Jan; Schenk, Miranda; Palen, van der Job; Dungen, van den Jan J.; Zeebregts, Clark J.

    2014-01-01

    Background Vulnerability of the carotid plaque might be useful as a predictor for ischemic stroke risk. The gray-scale median (GSM) of the carotid plaque at B-mode imaging has been described as an objective tool to quantify vulnerability. However, its use is disputed in the published literature. Thi

  18. Relation between B-mode Gray-scale Median and Clinical Features of Carotid Stenosis Vulnerability

    NARCIS (Netherlands)

    Kolkert, Joe L.; Meerwaldt, Robbert; Loonstra, Jan; Schenk, Miranda; van der Palen, Job; van den Dungen, Jan J.; Zeebregts, Clark J.

    2014-01-01

    Background: Vulnerability of the carotid plaque might be useful as a predictor for ischemic stroke risk. The gray-scale median (GSM) of the carotid plaque at B-mode imaging has been described as an objective tool to quantify vulnerability. However, its use is disputed in the published literature. Th

  19. Research progress of noninvasive high - resolution magnetic resonance imaging in carotid atherosclerotic plaque

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    Peng GAO

    2017-07-01

    Full Text Available Carotid atherosclerotic stenosis is closely related to recurrent ischemic stroke. Currently, therapies for carotid artery stenosis are mainly intensive medication or surgery, including carotid artery stenting (CAS and carotid endarterectomy (CEA. The prevention of stroke lies in identifying risk factors for carotid artery stenosis, screening patients with high risk of recurrent stroke, so as to benefit from medication or surgery. However, therapeutic schedule is formulated only according to the degrees of carotid artery stenosis, and there lacks of individualized treatment. Recently, new imaging modalities, such as noninvasive high.resolution MRI (HRMRI could detect the vulnerability of carotid atherosclerotic plaque. Compared with the degree of carotid artery stenosis measured by conventional DSA, noninvasive HRMRI can precisely predict the risk of ipsilateral stroke according to plaque morphology, so as to guide individualized treatment. DOI: 10.3969/j.issn.1672-6731.2017.05.012

  20. PET/SPECT imaging : From carotid vulnerability to brain viability

    NARCIS (Netherlands)

    Meerwaldt, Robbert; Slart, Riemer H. J. A.; van Dam, Gooitzen M.; Luijckx, Gert-Jan; Tio, Rene A.; Zeebregts, Clark J.

    2010-01-01

    Background: Current key issues in ischemic stroke are related to carotid plaque vulnerability, brain viability, and timing of intervention. The treatment of ischemic stroke has evolved into urgent active interventions, as 'time is brain'. Functional imaging such as positron emission tomography (PET)

  1. Echolucency of computerized ultrasound images of carotid atherosclerotic plaques are associated with increased levels of triglyceride-rich lipoproteins as well as increased plaque lipid content

    DEFF Research Database (Denmark)

    Grønholdt, Marie-Louise M.; Nordestgaard, Børge; Wiebe, Britt M.;

    1998-01-01

    Background-Echo-lucency of carotid atherosclerotic plaques on computerized ultrasound B-mode images has been associated with a high incidence of brain infarcts as evaluated on CT scans. We tested the hypotheses that triglyceride-rich lipoproteins in the fasting and postprandial state predict......-rich lipoproteins predict echo-lucency of carotid plaques, which is associated with increased plaque Lipid content, Because echo-lucency has been associated with a high incidence of brain infarcts on CT scans, triglyceride-rich lipoproteins may predict a plaque type particularly vulnerable to rupture....... carotid plaque echo-lucency and that echo-lucency predicts a high plaque lipid content. Methods and Results-The study included 137 patients with neurological symptoms and greater than or equal to 50% stenosis of the relevant carotid artery, High-resolution B-mode ultrasound images of carotid plaques were...

  2. Echo-lucency of computerized ultrasound images of carotid atherosclerotic plaques are associated with increased levels of triglyceride-rich lipoproteins as well as increased plaque lipid content

    DEFF Research Database (Denmark)

    Grønholdt, Marie-Louise Moes; Nordestgaard, Børge G.; Weibe, Brit M.;

    1998-01-01

    Background-Echo-lucency of carotid atherosclerotic plaques on computerized ultrasound B-mode images has been associated with a high incidence of brain infarcts as evaluated on CT scans. We tested the hypotheses that triglyceride-rich lipoproteins in the fasting and postprandial state predict......-rich lipoproteins predict echo-lucency of carotid plaques, which is associated with increased plaque Lipid content, Because echo-lucency has been associated with a high incidence of brain infarcts on CT scans, triglyceride-rich lipoproteins may predict a plaque type particularly vulnerable to rupture....... carotid plaque echo-lucency and that echo-lucency predicts a high plaque lipid content. Methods and Results-The study included 137 patients with neurological symptoms and greater than or equal to 50% stenosis of the relevant carotid artery, High-resolution B-mode ultrasound images of carotid plaques were...

  3. The expanding indications for virtual histology intravascular ultrasound for plaque analysis prior to carotid stenting.

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    Schiro, B J; Wholey, M H

    2008-12-01

    Complications of carotid artery stenting (CAS), including stroke, remain relatively high when compared with carotid endarterectomy (CEA). Current selection criteria for patients undergoing CAS are based predominately on surgical risk related to other comorbidities. Little attention is given to the morphology of the atherosclerotic plaque, although studies have shown that extensive variability exists which confers certain risks for plaque vulnerability. Virtual Histology intravascular ultrasound (VH IVUS) offers a unique method of assessing plaque morphology prior to CAS. Herein, the authors review the concepts of atherosclerotic plaque morphology and discuss the background of VH IVUS and illustrate its use in the carotid system. With selection of the appropriate patient and the appropriate plaque, more favorable outcomes of CAS may be achieved which will solidify its place as a frontline treatment of carotid vascular disease.

  4. Mechanical model of vulnerable atherosclerotic plaque rupture

    Institute of Scientific and Technical Information of China (English)

    SU; Haijun; ZHANG; Mei; ZHANG; Yun

    2004-01-01

    Rupture of atherosclerotic plaque is the main trigger of acute cardiovascular events, but the mechanism of plaque rupture is still unknown. We have constructed a model describing the motion of the fibrous cap of the plaque using the theory of elastic mechanics and studied the stability of the plaque theoretically. It has shown that plaque rupture is the result of a dynamic interplay between factors intrinsic to the plaque itself and extrinsic factors. We have proposed a new mechanism of plaque rupture, given a new explanation about the nonlinear dynamic progress of atherosclerosis and suggested a method to identify the vulnerable plaques to manage atherosclerosis.

  5. Mechanical Stresses in Carotid Plaques

    DEFF Research Database (Denmark)

    Samuel, Samuel Alberg

    Aterosklerose er den hyppigste årsag til død og svær invaliditet i verden. Sygdommen danner aterosklerotiske plaques, som består af lipidkerner dækket af en fibrøs kappe. Såfremt kappen brister, dannes overliggende tromber, som kan føres med blodstrømmen og forårsage strokes hvis kappen brister i...... mekaniske kræfter, som påvirker den fibrøse kappe, for at være en medvirkende årsag til plaqueruptur. Endvidere er stress-niveauerne i den fibrøse kappe en risikomarkør, som påvirkes af såvel den fibrøse kappetykkelse som lipid kerne størrelsen, blodtryk og graden af forsnævring. Imidlertid har hidtidige...... for at få fjernet deres plaques (carotis endarterektomi). Dernæst blev skanningerne segmenteret i lipid-kerne, fibrøs kappe, blodbane, karvæg og calcificationer. Endvidere blev blodets hastighed, blodtryk og karvægs deformationer målt. Disse data blev benyttet til longitudinelle fluid-struktur interaktions...

  6. Multimodal spectroscopy detects features of vulnerable atherosclerotic plaque

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    Šćepanović, Obrad R.; Fitzmaurice, Maryann; Miller, Arnold; Kong, Chae-Ryon; Volynskaya, Zoya; Dasari, Ramachandra R.; Kramer, John R.; Feld, Michael S.

    2011-01-01

    Early detection and treatment of rupture-prone vulnerable atherosclerotic plaques is critical to reducing patient mortality associated with cardiovascular disease. The combination of reflectance, fluorescence, and Raman spectroscopy-termed multimodal spectroscopy (MMS)-provides detailed biochemical information about tissue and can detect vulnerable plaque features: thin fibrous cap (TFC), necrotic core (NC), superficial foam cells (SFC), and thrombus. Ex vivo MMS spectra are collected from 12 patients that underwent carotid endarterectomy or femoral bypass surgery. Data are collected by means of a unitary MMS optical fiber probe and a portable clinical instrument. Blinded histopathological analysis is used to assess the vulnerability of each spectrally evaluated artery lesion. Modeling of the ex vivo MMS spectra produce objective parameters that correlate with the presence of vulnerable plaque features: TFC with fluorescence parameters indicative of collagen presence; NC/SFC with a combination of diffuse reflectance β-carotene/ceroid absorption and the Raman spectral signature of lipids; and thrombus with its Raman signature. Using these parameters, suspected vulnerable plaques can be detected with a sensitivity of 96% and specificity of 72%. These encouraging results warrant the continued development of MMS as a catheter-based clinical diagnostic technique for early detection of vulnerable plaques.

  7. Gene expression and 18FDG uptake in atherosclerotic carotid plaques

    DEFF Research Database (Denmark)

    Pedersen, Sune Folke; Græbe, Martin; Hag, Anne Mette Fisker

    2010-01-01

    by carotid endarterectomy. The gene expression of markers of vulnerability - CD68, IL-18, matrix metalloproteinase 9, cathepsin K, GLUT-1, and hexokinase type II (HK2) - were measured in plaques by quantitative PCR. RESULTS: In a multivariate linear regression model, GLUT-1, CD68, cathepsin K, and HK2 gene...... expression remained in the final model as predictive variables of FDG accumulation calculated as SUVmean (R=0.26, PGLUT-1, CD68, cathepsin K, and HK2 gene expression as independent predictive variables of FDG accumulation calculated...... as SUVmax (R=0.30, PGLUT-1, HK2, CD68, and cathepsin K remained in both multivariate models and thus provided independent information regarding FDG uptake. We suggest that FDG uptake is a composite indicator of macrophage load, overall inflammatory activity and collagenolytic plaque...

  8. Carotid plaque, intima-media thickness, and incident aortic stenosis

    DEFF Research Database (Denmark)

    Martinsson, Andreas; Östling, Gerd; Persson, Margaretha

    2014-01-01

    OBJECTIVE: Aortic stenosis (AS) shares risk factors with atherosclerotic vascular disease. Carotid intima-media thickness (IMT) and plaque may reflect the cumulative damage from exposure to different atherosclerotic risk factors. We examined the relationship of carotid IMT and plaque with incident...

  9. Multispectral optoacoustic tomography resolves smart probe activation in vulnerable plaques

    Science.gov (United States)

    Razansky, Daniel; Harlaar, Niels J.; Hillebrands, Jan-Luuk; Taruttis, Adrian; Herzog, Eva; Zeebregts, Clark; van Dam, Goitzen; Ntziachristos, Vasilis

    2011-03-01

    In this work, we show, for the first time to our knowledge, that multispectral optoacoustic tomography (MSOT) can deliver high resolution images of activatable molecular probe's distribution, sensitive to matrix metalloproteinases (MMP), deep within optically scattering human carotid specimen. It is further demonstrated that this method can be used in order to provide accurate maps of vulnerable plaque formations in atherosclerotic disease. Moreover, optoacoustic images can simultaneously show the underlining plaque morphology for accurate localization of MMP activity in three dimensions. This performance directly relates to small animal screening applications and to clinical potential as well.

  10. PET/SPECT imaging: From carotid vulnerability to brain viability

    Energy Technology Data Exchange (ETDEWEB)

    Meerwaldt, Robbert [Department of Surgery, Isala Clinics, Zwolle (Netherlands); Slart, Riemer H.J.A. [Department of Nuclear Medicine and Molecular Imaging, University Medical Center Groningen, Groningen (Netherlands); Dam, Gooitzen M. van [Department of Surgery, University Medical Center Groningen, Groningen (Netherlands); Luijckx, Gert-Jan [Department of Neurology, University Medical Center Groningen, Groningen (Netherlands); Tio, Rene A. [Department of Cardiology, University Medical Center Groningen, Groningen (Netherlands); Zeebregts, Clark J. [Department of Surgery, University Medical Center Groningen, Groningen (Netherlands)], E-mail: czeebregts@hotmail.com

    2010-04-15

    Background: Current key issues in ischemic stroke are related to carotid plaque vulnerability, brain viability, and timing of intervention. The treatment of ischemic stroke has evolved into urgent active interventions, as 'time is brain'. Functional imaging such as positron emission tomography (PET)/single photon emission computed tomography (SPECT) could improve selection of patients with a vulnerable plaque and evaluation of brain viability in ischemic stroke. Objective: To describe the current applications of PET and SPECT as a diagnostic tool in relation to ischemic stroke. Methods: A literature search using PubMed identified articles. Manual cross-referencing was also performed. Results: Several papers, all observational studies, identified PET/SPECT to be used as a tool to monitor systemic atheroma modifying treatment and to select high-risk patients for surgery regardless of the degree of luminal stenosis in carotid lesions. Furthermore, PET/SPECT is able to quantify the penumbra region during ischemic stroke and in this way may identify those patients who may benefit from timely intervention. Discussion: Functional imaging modalities such as PET/SPECT may become important tools for risk-assessment and evaluation of treatment strategies in carotid plaque vulnerability and brain viability. Prospective clinical studies are needed to evaluate the diagnostic accuracy of PET/SPECT.

  11. Three-dimensional carotid ultrasound plaque texture predicts vascular events

    DEFF Research Database (Denmark)

    van Engelen, Arna; Wannarong, Thapat; Parraga, Grace;

    2014-01-01

    carotid plaque volume and 376 measures of plaque texture. Patients were followed up to 5 years (median [range], 3.12 [0.77-4.66]) for myocardial infarction, transient ischemic attack, and stroke. Sparse Cox regression was used to select the most predictive plaque texture measurements in independent...

  12. Angiogenesis in atherosclerotic plaque obtained from carotid endarterectomy: association between symptomatology and plaque morphology.

    Science.gov (United States)

    Hiyama, Takami; Tanaka, Toshihide; Endo, Shinichi; Komine, Kazumasa; Kudo, Tadashi; Kobayashi, Hiroo; Shiokawa, Yoshiaki

    2010-01-01

    Carotid plaque with hemorrhage leads to cerebral embolism and ischemic stroke. Plaque angiogenesis and angiogenetic factors such as vascular endothelial growth factor (VEGF) are critical in the progression of atherosclerotic carotid plaque and intraplaque hemorrhage. The correlation between plaque angiogenesis and presence of clinical symptoms was studied in 41 specimens obtained during carotid endarterectomy from 20 symptomatic and 21 asymptomatic patients treated for carotid artery stenosis. Histological findings using hematoxylin-eosin and immunohistochemical staining against von Willebrand factor and VEGF were examined. Intraplaque hemorrhage, calcification, necrosis, and invasion of foam cells were frequently observed in the carotid plaques from symptomatic patients compared with asymptomatic patients. Higher microvessel density was found in the carotid plaques with necrosis and invasion of foam cells compared with plaques without necrosis and/or foam cell invasion, and higher expression of VEGF was found from symptomatic patients compared with asymptomatic patents. These results suggest that plaque angiogenesis and higher level of VEGF expression may enhance the progression of ischemic symptoms in patients with carotid artery stenosis. Invasive macrophages in the plaque of symptomatic patients increase levels of VEGF and might enhance plaque angiogenesis and atherosclerosis progression.

  13. Current status of vulnerable plaque detection.

    LENUS (Irish Health Repository)

    Sharif, Faisal

    2012-02-01

    Critical coronary stenoses have been shown to contribute to only a minority of acute coronary syndromes (ACS) and sudden cardiac death. Autopsy studies have identified a subgroup of high-risk patients with disrupted vulnerable plaque and modest stenosis. Consequently, a clinical need exists to develop methods to identify these plaques prospectively before disruption and clinical expression of disease. Recent advances in invasive and noninvasive imaging techniques have shown the potential to identify these high-risk plaques. The anatomical characteristics of the vulnerable plaque such as thin cap fibroatheroma and lipid pool can be identified with angioscopy, high frequency intravascular ultrasound, intravascular MRI, and optical coherence tomography. Efforts have also been made to recognize active inflammation in high-risk plaques using intravascular thermography. Plaque chemical composition by measuring electromagnetic radiation using spectroscopy is also an emerging technology to detect vulnerable plaques. Noninvasive imaging with MRI, CT, and PET also holds the potential to differentiate between low and high-risk plaques. However, at present none of these imaging modalities are able to detect vulnerable plaque neither has been shown to definitively predict outcome. Nevertheless in contrast, there has been a parallel development in the physiological assessment of advanced atherosclerotic coronary artery disease. Thus recent trials using fractional flow reserve in patients with modest non flow-limiting stenoses have shown that deferral of PCI with optimal medical therapy in these patients is superior to coronary intervention. Further trials are needed to provide more information regarding the natural history of high-risk but non flow-limiting plaque to establish patient-specific targeted therapy and to refine plaque stabilizing strategies in the future.

  14. Tensile and compressive properties of fresh human carotid atherosclerotic plaques.

    LENUS (Irish Health Repository)

    Maher, Eoghan

    2009-12-11

    Accurate characterisation of the mechanical properties of human atherosclerotic plaque is important for our understanding of the role of vascular mechanics in the development and treatment of atherosclerosis. The majority of previous studies investigating the mechanical properties of human plaque are based on tests of plaque tissue removed following autopsy. This study aims to characterise the mechanical behaviour of fresh human carotid plaques removed during endarterectomy and tested within 2h. A total of 50 radial compressive and 17 circumferential tensile uniaxial tests were performed on samples taken from 14 carotid plaques. The clinical classification of each plaque, as determined by duplex ultrasound is also reported. Plaques were classified as calcified, mixed or echolucent. Experimental data indicated that plaques were highly inhomogeneous; with variations seen in the mechanical properties of plaque obtained from individual donors and between donors. The mean behaviour of samples for each classification indicated that calcified plaques had the stiffest response, while echolucent plaques were the least stiff. Results also indicated that there may be a difference in behaviour of samples taken from different anatomical locations (common, internal and external carotid), however the large variability indicates that more testing is needed to reach significant conclusions. This work represents a step towards a better understanding of the in vivo mechanical behaviour of human atherosclerotic plaque.

  15. PLACD-7T Study: Atherosclerotic Carotid Plaque Components Correlated with Cerebral Damage at 7 Tesla Magnetic Resonance Imaging.

    Science.gov (United States)

    den Hartog, A G; Bovens, S M; Koning, W; Hendrikse, J; Pasterkamp, G; Moll, F L; de Borst, G J

    2011-02-01

    In patients with carotid artery stenosis histological plaque composition is associated with plaque stability and with presenting symptomatology. Preferentially, plaque vulnerability should be taken into account in pre-operative work-up of patients with severe carotid artery stenosis. However, currently no appropriate and conclusive (non-) invasive technique to differentiate between the high and low risk carotid artery plaque in vivo is available. We propose that 7 Tesla human high resolution MRI scanning will visualize carotid plaque characteristics more precisely and will enable correlation of these specific components with cerebral damage. The aim of the PlaCD-7T study is 1: to correlate 7T imaging with carotid plaque histology (gold standard); and 2: to correlate plaque characteristics with cerebral damage ((clinically silent) cerebral (micro) infarcts or bleeds) on 7 Tesla high resolution (HR) MRI. We propose a single center prospective study for either symptomatic or asymptomatic patients with haemodynamic significant (70%) stenosis of at least one of the carotid arteries. The Athero-Express (AE) biobank histological analysis will be derived according to standard protocol. Patients included in the AE and our prospective study will undergo a pre-operative 7 Tesla HR-MRI scan of both the head and neck area. We hypothesize that the 7 Tesla MRI scanner will allow early identification of high risk carotid plaques being associated with micro infarcted cerebral areas, and will thus be able to identify patients with a high risk of periprocedural stroke, by identification of surrogate measures of increased cardiovascular risk.

  16. 18FDG PET and ultrasound echolucency in carotid artery plaques

    DEFF Research Database (Denmark)

    Graebe, Martin; Pedersen, Sune F; Højgaard, Liselotte

    2010-01-01

    OBJECTIVES: The objective was to evaluate inflammation in echolucent carotid artery plaques. BACKGROUND: Ultrasound echolucency of carotid artery plaques has been proven to differentiate patients at high risk of stroke. On the other hand, positron emission tomography (PET) of plaques with the use...... for ultrasound and PET imaging. Plaque standardized gray scale medians (GSM) were measured in longitudinal ultrasound images to quantitate echolucency, and GSM values were compared with FDG PET uptake quantified by maximum standardized uptake values (SUV). Symptomatic plaques were compared with contralateral...... plaques ranged from high to low inflammatory activity, as depicted with PET. Quantitative FDG SUV differentiated asymptomatic from symptomatic plaques, whereas GSM values did not. There was a positive correlation between CD68 expression and FDG uptake (r = 0.50, p = 0.04). CONCLUSIONS: Our results...

  17. Vulnerable Plaques, Inflammation and Newer Imaging Modalities

    Directory of Open Access Journals (Sweden)

    Bhatia V

    2003-01-01

    Full Text Available Currently, inflammation is considered to be the central player in the pathogenesis of atherosclerosis. It leads to the formation of multiple plaques in the arterial beds including coronary vasculature. Recent studies using the latest imaging techniques have shown that in patients with acute coronary syndromes (ACS multiple plaques are ruptured and have thrombus formation on them. Various factors make these plaques unstable, these include structural components of plaque like thin fibrous cap, high lipid content of the plaque core and inflammation, both localized and generalized. It has been shown that most of the ACS are caused by plaques causing non-critical stenosis as seen on traditional X-ray angiography. Also, the phenomenon of remodelling makes angiography a poor technique for plaque visualization. Hence newer modalities are required to identify these 'vulnerable plaques'. Intravascular ultrasound (IVUS, thermography and Magnetic Resonance Imaging (MRI are a few such promising techniques. Here we review the invasive and non-invasive modalities that can be helpful in the identification of these plaques before they become unstable and cause ACS, and also the available therapies to stabilize these plaques.

  18. Carotid plaque burden as a measure of subclinical atherosclerosis

    DEFF Research Database (Denmark)

    Sillesen, Henrik; Muntendam, Pieter; Adourian, Aram

    2012-01-01

    The purpose of this study was to compare carotid plaque burden, carotid intima-media thickness (cIMT), ankle-brachial index (ABI), and abdominal aortic diameter (AAD) to coronary artery calcium score (CACS) in people without known cardiovascular disease....

  19. Identifying Vulnerable Plaques with Acoustic Radiation Force Impulse Imaging

    Science.gov (United States)

    Doherty, Joshua Ryan

    The rupture of arterial plaques is the most common cause of ischemic complications including stroke, the fourth leading cause of death and number one cause of long term disability in the United States. Unfortunately, because conventional diagnostic tools fail to identify plaques that confer the highest risk, often a disabling stroke and/or sudden death is the first sign of disease. A diagnostic method capable of characterizing plaque vulnerability would likely enhance the predictive ability and ultimately the treatment of stroke before the onset of clinical events. This dissertation evaluates the hypothesis that Acoustic Radiation Force Impulse (ARFI) imaging can noninvasively identify lipid regions, that have been shown to increase a plaque's propensity to rupture, within carotid artery plaques in vivo. The work detailed herein describes development efforts and results from simulations and experiments that were performed to evaluate this hypothesis. To first demonstrate feasibility and evaluate potential safety concerns, finite- element method simulations are used to model the response of carotid artery plaques to an acoustic radiation force excitation. Lipid pool visualization is shown to vary as a function of lipid pool geometry and stiffness. A comparison of the resulting Von Mises stresses indicates that stresses induced by an ARFI excitation are three orders of magnitude lower than those induced by blood pressure. This thesis also presents the development of a novel pulse inversion harmonic tracking method to reduce clutter-imposed errors in ultrasound-based tissue displacement estimates. This method is validated in phantoms and was found to reduce bias and jitter displacement errors for a marked improvement in image quality in vivo. Lastly, this dissertation presents results from a preliminary in vivo study that compares ARFI imaging derived plaque stiffness with spatially registered composition determined by a Magnetic Resonance Imaging (MRI) gold standard

  20. Multi-center MRI carotid plaque component segmentation using feature normalization and transfer learning

    DEFF Research Database (Denmark)

    van Engelen, Arna; van Dijk, Anouk C; Truijman, Martine T.B.

    2015-01-01

    Automated segmentation of plaque components in carotid artery MRI is important to enable large studies on plaque vulnerability, and for incorporating plaque composition as an imaging biomarker in clinical practice. Especially supervised classification techniques, which learn from labeled examples......, have shown good performance. However, a disadvantage of supervised methods is their reduced performance on data different from the training data, for example on images acquired with different scanners. Reducing the amount of manual annotations required for each new dataset will facilitate widespread...... implementation of supervised methods. In this paper we segment carotid plaque components of clinical interest (fibrous tissue, lipid tissue, calcification and intraplaque hemorrhage) in a multicenter MRI study. We perform voxelwise tissue classification by traditional same-center training, and compare results...

  1. Relationship between the Carotid Plaque T1 Relaxation Time and the Plaque-to-Muscle Signal Intensity Ratio on Black-Blood Magnetic Resonance Imaging Scans.

    Science.gov (United States)

    Eto, Ayumu; Kinoshita, Yoshimasa; Matsumoto, Yoshihisa; Kiyomi, Fumiaki; Iko, Minoru; Nii, Kouhei; Tsutsumi, Masanori; Sakamoto, Kimiya; Aikawa, Hiroshi; Kazekawa, Kiyoshi

    2016-11-01

    Black-blood magnetic resonance imaging (BB-MRI) is useful for the characterization and assessment of carotid artery plaques. The plaque-to-muscle signal intensity (SI) ratio (plaque/muscle ratio [PMR]) is used widely to evaluate plaques. However, the correlation between the PMR and the T1 relaxation time needs to be determined. We measured the T1 relaxation time of carotid plaques using T1 mapping and compared the results with the PMR on BB-MRI scans. Between April 2014 and July 2015, 20 patients with carotid artery stenosis were treated by carotid artery stenting. All patients underwent preoperative magnetic resonance plaque imaging. The ratio of the plaque SI to the sternocleidomastoid muscle was calculated on T1-weighted BB-MRI scans. T1 mapping was performed in the region where the vessel was narrowest using the inversion recovery technique. The T1 relaxation time was recorded to determine whether there was a correlation with the PMR. The plaque T1 value was 577.3 ± 143.2 milliseconds; the PMR value obtained on BB-MRI scans was 1.23 ± .27. There was a statistically significant decrease in the T1 value as the PMR increased (P relaxation time was well correlated with the PMR on BB-MRI scans, the evaluation of vulnerable plaques using the PMR was reliable and convenient. Copyright © 2016 National Stroke Association. Published by Elsevier Inc. All rights reserved.

  2. Intracoronary Thermography: a vulnerable Plaque Detection Technique?

    NARCIS (Netherlands)

    A.G. ten Have (Anna)

    2006-01-01

    textabstractThe studies reported in this thesis were performed to answer the central question: can intracoronary thermography be used for vulnerable plaque detection? To answer this question, we have identified parameters that influence intracoronary thermography measurements, and have studied to w

  3. Extracellular matrix proteomics identifies molecular signature of symptomatic carotid plaques

    Science.gov (United States)

    Langley, Sarah R.; Willeit, Karin; Didangelos, Athanasios; Matic, Ljubica Perisic; Skroblin, Philipp; Barallobre-Barreiro, Javier; Lengquist, Mariette; Rungger, Gregor; Kapustin, Alexander; Kedenko, Ludmilla; Molenaar, Chris; Lu, Ruifang; Barwari, Temo; Suna, Gonca; Iglseder, Bernhard; Paulweber, Bernhard; Willeit, Peter; Pasterkamp, Gerard; Davies, Alun H.; Monaco, Claudia; Hedin, Ulf; Shanahan, Catherine M.; Willeit, Johann; Kiechl, Stefan

    2017-01-01

    BACKGROUND. The identification of patients with high-risk atherosclerotic plaques prior to the manifestation of clinical events remains challenging. Recent findings question histology- and imaging-based definitions of the “vulnerable plaque,” necessitating an improved approach for predicting onset of symptoms. METHODS. We performed a proteomics comparison of the vascular extracellular matrix and associated molecules in human carotid endarterectomy specimens from 6 symptomatic versus 6 asymptomatic patients to identify a protein signature for high-risk atherosclerotic plaques. Proteomics data were integrated with gene expression profiling of 121 carotid endarterectomies and an analysis of protein secretion by lipid-loaded human vascular smooth muscle cells. Finally, epidemiological validation of candidate biomarkers was performed in two community-based studies. RESULTS. Proteomics and at least one of the other two approaches identified a molecular signature of plaques from symptomatic patients that comprised matrix metalloproteinase 9, chitinase 3-like-1, S100 calcium binding protein A8 (S100A8), S100A9, cathepsin B, fibronectin, and galectin-3-binding protein. Biomarker candidates measured in 685 subjects in the Bruneck study were associated with progression to advanced atherosclerosis and incidence of cardiovascular disease over a 10-year follow-up period. A 4-biomarker signature (matrix metalloproteinase 9, S100A8/S100A9, cathepsin D, and galectin-3-binding protein) improved risk prediction and was successfully replicated in an independent cohort, the SAPHIR study. CONCLUSION. The identified 4-biomarker signature may improve risk prediction and diagnostics for the management of cardiovascular disease. Further, our study highlights the strength of tissue-based proteomics for biomarker discovery. FUNDING. UK: British Heart Foundation (BHF); King’s BHF Center; and the National Institute for Health Research Biomedical Research Center based at Guy’s and St

  4. Hydrocortisone supresses inflammatory activity of metalloproteinase - 8 in carotid plaque

    Directory of Open Access Journals (Sweden)

    Sthefano Atique Gabriel

    2015-09-01

    Full Text Available AbstractObjective:Matrix metalloproteinases are inflammatory biomarkers involved in carotid plaque instability. Our objective was to analyze the inflammatory activity of plasma and carotid plaque MMP-8 and MMP-9 after intravenous administration of hydrocortisone.Methods:The study included 22 patients with stenosis ≥ 70% in the carotid artery (11 symptomatic and 11 asymptomatic who underwent carotid endarterectomy. The patients were divided into two groups: Control Group - hydrocortisone was not administered, and Group 1 - 500 mg intravenous hydrocortisone was administered during anesthetic induction. Plasma levels of MMP-8 and MMP-9 were measured preoperatively (24 hours before carotid endarterectomy and at 1 hour, 6 hours and 24 hours after carotid endarterectomy. In carotid plaque, tissue levels of MMP-8 and MMP-9 were measured.Results:Group 1 showed increased serum levels of MMP- 8 (994.28 pg/ml and 408.54 pg/ml, respectively; P=0.045 and MMP-9 (106,656.34 and 42,807.69 respectively; P=0.014 at 1 hour after carotid endarterectomy compared to the control group. Symptomatic patients in Group 1 exhibited lower tissue concentration of MMP-8 in comparison to the control group (143.89 pg/ml and 1317.36 respectively; P=0.003. There was a correlation between preoperative MMP-9 levels and tissue concentrations of MMP-8 (P=0.042 and MMP-9 (P=0.019 between symptomatic patients in the control group.Conclusion:Hydrocortisone reduces the concentration of MMP- 8 in carotid plaque, especially in symptomatic patients. There was an association between systemic and tissue inflammation.

  5. Correlation between carotid artery vulnerable plaques and recurrent ischemic cerebral stroke%颈动脉易损斑块与缺血性脑卒中复发的相关性研究

    Institute of Scientific and Technical Information of China (English)

    刘国荣; 王大力; 张文丽; 安亚臣; 郑德松; 姚林

    2012-01-01

    目的 对颈动脉斑块进行评价,分析斑块性质、形态及其危险因素与缺血性脑卒中复发的相关性.方法 选择经头颅CT和(或)MRI确诊为缺血性脑卒中复发患者209例,应用CT血管造影联合彩色多普勒超声检查证实122例有颈动脉斑块,根据斑块性质分为易损斑块组86例,稳定斑块组36例,分析斑块性质、形态,观察发生缺血性脑血管事件相关因素,比较2组缺血性脑卒中复发的时间、分布及狭窄的关系,Cox风险比例模型分析缺血性脑卒中复发与颈动脉斑块等危险因素间的相关性.结果 209例患者中,颈动脉斑块122例,占58.4%.与稳定斑块组比较,易损斑块组年龄更高,高血压和冠心病的比例更多(P<0.05).Cox回归分析显示,易损斑块与冠心病是缺血性脑卒中复发的危险因素.结论 颈动脉斑块性质、形态和冠心病是缺血性脑卒中复发的危险因素.%Objective To assess the carotid artery plaques (CAP) and analyze the correlation of their nature, morphology and risk factors with recurrent ischemic cerebral stroke. Methods Of the 209 patients with recurrent ischemic cerebral stroke established by head CT and/or MRI in this study, 122 were diagnosed with CAP by combined CT angiography and carotid artery ultra-sonography,86 were diagnosed with vulnerable CAP and 36 were diagnosed with stable CAP according to their nature. The nature and morphology of CAP were analyzed and related factors for ischemic cerebrovascular events were observed. Relation of recurrent time of vulnerable and non-vulnerable ischemic ischemic cerebrovascular events with their distribution and stenosis was compared. Correlation between recurrent ischemic cerebrovascular events and risk factors for CAP was analyzed using the Cox risk model. Results CAP were detected in 122 patients(58. 4%). The age of patients with stable CAP was higher than that of those with vulnerable CAP. The proportion of hypertention and coronary

  6. Assessment of carotid plaque composition using fast-kV switching dual-energy CT with gemstone detector: comparison with extracorporeal and virtual histology-intravascular ultrasound

    Energy Technology Data Exchange (ETDEWEB)

    Shinohara, Yuki; Kuya, Keita; Ohta, Yasutoshi; Fujii, Shinya; Ogawa, Toshihide [Tottori University, Division of Radiology, Department of Pathophysiological and Therapeutic Science, Faculty of Medicine, Yonago (Japan); Sakamoto, Makoto; Watanabe, Takashi [Tottori University, Division of Neurosurgery, Department of Neurological Sciences, Faculty of Medicine, Yonago (Japan); Kishimoto, Junichi; Iwata, Naoki [Tottori University Hospital, Division of Clinical Radiology, Yonago (Japan)

    2015-09-15

    The present study compares the applicability of CT carotid plaque imaging using effective Z maps using gemstone spectral imaging (GSI) with that of conventional extracorporeal carotid ultrasound (US) and virtual histology-intravascular ultrasound (VH-IVUS). We assessed stenosis in 31 carotid arteries of 30 patients. All patients underwent carotid CTA using GSI (Discovery CT750 HD, GE Healthcare). US and IVUS were examined with 25 and 8 vessels, respectively. We compared the effective Z values at noncalcified carotid plaque with the plaque components identified by US. We defined the plaque with low or low to iso intensity on US as vulnerable plaque and the plaque with iso, iso to high, and high intensity on US as stable plaque. We also performed visual assessment of color-coded effective Z maps in comparison with VH-IVUS and compared effective Z values with plaque components generated by VH-IVUS. The effective Z values at noncalcified carotid plaque were significantly lower for a group with vulnerable plaque, than with stable plaque on US (p < 0.05). Receiver operating curve analysis showed that AUC of effective Z values was 0.882 concerning the differentiation of these two groups on US. The interpretation of color-coded effective Z maps was essentially compatible with that of VH-IVUS for carotid plaque in all vessels. Effective Z values at noncalcified plaque showed significant negative correlation with the areas of fibro-fatty components generated by VH-IVUS (ρ = -0.874, p < 0.05). Effective Z maps generated by GSI can detect vulnerable carotid plaque materials. (orig.)

  7. 急性缺血性脑卒中患者血清氧化型低密度脂蛋白水平与颈动脉易损斑块的关系%Relationship Between Serum Oxidized Low-density Lipoprotein Level and Carotid Vulnerable Plaque in Patients with Acute Cerebral Ischemic Stroke

    Institute of Scientific and Technical Information of China (English)

    许寅宏; 徐恩; 林清原; 邱少东

    2015-01-01

    PurposeTo investigate the relationship between the serum oxidized low-density lipoprotein (ox-LDL) level and carotid vulnerable plaque in patients with acute cerebral ischemic stroke, and to evaluate the ability of serum ox-LDL in identifying vulnerable carotid plaques.Materials and Methods 181 patients with history of acute cerebral ischemic stroke were recruited. According to the results of carotid ultrasound patients were divided into non plaque group (n=48), stable plaque group (n=38) and vulnerable plaque group (n=95). The serum total cholesterol, triglyceride, high density lipoprotein-cholesterol, low density lipoprotein-cholesterol, fasting plasma glucose and ox-LDL were measured. Carotid intima-medial thickness (CIMT), total carotid plaque area (TPA) and the characters of plaque were examined with color Doppler ultrasound.Results The serum ox-LDL and the number of patients with hypertension in plaque group were significantly higher than that in the non-plaque group (P<0.05). The serum ox-LDL and TPA in the vulnerable plaque group were significantly higher than that in the stable plaque group (P<0.05). Serum ox-LDL in patients with acute cerebral infarction was positively correlated with CIMT, serum total cholesterol and LDL-C (r1=0.154,P<0.05;r2=0.338, P<0.05;r3=0.385,P<0.05). Logistic regression analysis showed that serum ox-LDL was an independent risk factor for carotid vulnerable plaque (OR=1.038, 95%CI 1.008-1.069, P<0.01).Conclusion The serum ox-LDL is independently associated with the formation of vulnerable plaque in patients with acute cerebral infarction. This study suggests that ox-LDL can be used as a biomarker in screening for vulnerable carotid plaque in clinical practice. Carotid ultrasound combined with serology can early identify carotid artery vulnerable plaque that may lead to cerebral ischemic events.%目的:探讨急性缺血性脑卒中患者血清氧化型低密度脂蛋白(ox-LDL)水平与颈动脉易损斑块的关系,评

  8. Noninvasive diagnosis of vulnerable coronary plaque

    Science.gov (United States)

    Pozo, Eduardo; Agudo-Quilez, Pilar; Rojas-González, Antonio; Alvarado, Teresa; Olivera, María José; Jiménez-Borreguero, Luis Jesús; Alfonso, Fernando

    2016-01-01

    Myocardial infarction and sudden cardiac death are frequently the first manifestation of coronary artery disease. For this reason, screening of asymptomatic coronary atherosclerosis has become an attractive field of research in cardiovascular medicine. Necropsy studies have described histopathological changes associated with the development of acute coronary events. In this regard, thin-cap fibroatheroma has been identified as the main vulnerable coronary plaque feature. Hence, many imaging techniques, such as coronary computed tomography, cardiac magnetic resonance or positron emission tomography, have tried to detect noninvasively these histomorphological characteristics with different approaches. In this article, we review the role of these diagnostic tools in the detection of vulnerable coronary plaque with particular interest in their advantages and limitations as well as the clinical implications of the derived findings. PMID:27721935

  9. Carotid plaque age is a feature of plaque stability inversely related to levels of plasma insulin.

    Directory of Open Access Journals (Sweden)

    Sara Hägg

    Full Text Available BACKGROUND: The stability of atherosclerotic plaques determines the risk for rupture, which may lead to thrombus formation and potentially severe clinical complications such as myocardial infarction and stroke. Although the rate of plaque formation may be important for plaque stability, this process is not well understood. We took advantage of the atmospheric (14C-declination curve (a result of the atomic bomb tests in the 1950s and 1960s to determine the average biological age of carotid plaques. METHODOLOGY/PRINCIPAL FINDING: The cores of carotid plaques were dissected from 29 well-characterized, symptomatic patients with carotid stenosis and analyzed for (14C content by accelerator mass spectrometry. The average plaque age (i.e. formation time was 9.6±3.3 years. All but two plaques had formed within 5-15 years before surgery. Plaque age was not associated with the chronological ages of the patients but was inversely related to plasma insulin levels (p = 0.0014. Most plaques were echo-lucent rather than echo-rich (2.24±0.97, range 1-5. However, plaques in the lowest tercile of plaque age (most recently formed were characterized by further instability with a higher content of lipids and macrophages (67.8±12.4 vs. 50.4±6.2, p = 0.00005; 57.6±26.1 vs. 39.8±25.7, p<0.0005, respectively, less collagen (45.3±6.1 vs. 51.1±9.8, p<0.05, and fewer smooth muscle cells (130±31 vs. 141±21, p<0.05 than plaques in the highest tercile. Microarray analysis of plaques in the lowest tercile also showed increased activity of genes involved in immune responses and oxidative phosphorylation. CONCLUSIONS/SIGNIFICANCE: Our results show, for the first time, that plaque age, as judge by relative incorporation of (14C, can improve our understanding of carotid plaque stability and therefore risk for clinical complications. Our results also suggest that levels of plasma insulin might be involved in determining carotid plaque age.

  10. Inverse association between size of the lipid-rich necrotic core and vascularization in human carotid plaques.

    Science.gov (United States)

    Hjelmgren, Ola; Johansson, Lars; Prahl, Ulrica; Schmidt, Caroline; Bergström, Göran M L

    2017-04-12

    To study the relationship between the size of the lipid-rich necrotic core measured by MRI (magnetic resonance imaging) and the level of plaque vascularization measured by contrast-enhanced ultrasound, in human carotid plaques. Further, to compare the size of lipid-rich necrotic core from MRI to plaque echogenicity. Thirty-one subjects with carotid plaques underwent standard B-mode ultrasound, contrast-enhanced ultrasound and MRI. The lipid-rich necrotic core was quantified using MRI. Contrast-enhanced ultrasound was used to measure carotid plaque vascularization. Standard B-mode ultrasound was used to measure plaque echogenicity as greyscale median. The amount of lipid-rich necrotic core correlated inversely with the degree of plaque vascularization (r = -0·40, P = 0·03). There were no correlations between the degree of plaque vascularization and the amount of fibrous tissue or calcifications. There were no correlations between greyscale median and the lipid-rich necrotic core, fibrous tissue or calcifications. We show that more dense plaque vascularization is associated with a lower plaque content of lipid-rich necrotic core. A large lipid-rich necrotic core and high plaque vascularization are both proposed as predictors of vulnerability, and our finding is therefore odds with some earlier observations. Our finding can be explained by the fact that the necrotic core of the plaque contains no viable tissue and therefore less of the plaque can be vascularized if the lipid-rich necrotic core is large. Our study suggests that the true relation between plaque vascularization and other indices of vulnerability is more complex than initially thought. © 2017 Scandinavian Society of Clinical Physiology and Nuclear Medicine. Published by John Wiley & Sons Ltd.

  11. Reproducibility of Two 3-D Ultrasound Carotid Plaque Quantification Methods

    DEFF Research Database (Denmark)

    Graebe, Martin; Entrekin, Robert; Collet-Billon, Antoine;

    2014-01-01

    -sectional, 2-D freehand sweep and a mechanical 3-D ultrasound investigation of 62 carotid artery plaques is reported with intra-class correlation coefficients (with 95% confidence intervals). Inter-observer agreement was 0.60 (0.29-0.77) for the freehand method and 0.89 (0.83-0.93) for the mechanical 3-D...

  12. A Novel Ultrasound-Based Carotid Plaque Risk Index Associated with the Presence of Cerebrovascular Symptoms.

    Science.gov (United States)

    Kanber, B; Hartshorne, T C; Horsfield, M A; Naylor, A R; Robinson, T G; Ramnarine, K V

    2015-10-01

    The purpose of this study was to determine the efficacy of a novel ultrasound-based carotid plaque risk index (CPRI) in predicting the presence of cerebrovascular symptoms in patients with carotid artery stenosis. This was a cross-sectional, observational study involving 56 patients (mean age 76.6 years, 62.5 % male). Plaque grayscale median (GSM) and surface irregularity indices (SII) were measured in 82 stenosed carotid arteries (range 10 - 95 %) and combined with the degree of stenosis (DOS) in the form of (DOS*SII)/(1 + GSM). A reduced index DOS/(1 + GSM) not incorporating plaque surface irregularities was also investigated. Receiver operating characteristic curves (ROC) were used to study the diagnostic efficacy of CPRI, comparing against DOS and an equivalent risk index constructed using a conventional logistic regression based method with model parameters optimized to the dataset (CPRIlogistic). There were 42 stenosed carotid arteries with cerebrovascular symptoms, and 40 without symptoms. The presence of symptoms significantly correlated with DOS, GSM and SII (p CPRI of the symptomatic (asymptomatic) groups were 23.2 (9.2) compared with 0.71 (0.30) for CPRIlogistic (p CPRI exceeded that of CPRIlogistic and DOS, and demonstrated a better separation of the symptomatic and asymptomatic groups. Our novel risk index combines quantitative measures of carotid plaque echogenicity and surface irregularities with the degree of stenosis. It is a better predictor of cerebrovascular symptoms than the degree of stenosis and could be valuable in studies and clinical trials aimed at identifying vulnerable carotid artery stenoses. © Georg Thieme Verlag KG Stuttgart · New York.

  13. Intravascular probe for detection of vulnerable plaque

    Science.gov (United States)

    Patt, Bradley E.; Iwanczyk, Jan S.; MacDonald, Lawrence R.; Yamaguchi, Yuko; Tull, Carolyn R.; Janecek, Martin; Hoffman, Edward J.; Strauss, H. William; Tsugita, Ross; Ghazarossian, Vartan

    2001-12-01

    Coronary angiography is unable to define the status of the atheroma, and only measures the luminal dimensions of the blood vessel, without providing information about plaque content. Up to 70% of heart attacks are caused by minimally obstructive vulnerable plaques, which are too small to be detected adequately by angiography. We have developed an intravascular imaging detector to identify vulnerable coronary artery plaques. The detector works by sensing beta or conversion electron radiotracer emissions from plaque-binding radiotracers. The device overcomes the technical constraints of size, sensitivity and conformance to the intravascular environment. The detector at the distal end of the catheter uses six 7mm long by 0.5mm diameter scintillation fibers coupled to 1.5m long plastic fibers. The fibers are offset from each other longitudinally by 6mm and arranged spirally around a guide wire in the catheter. At the proximal end of the catheter the optical fibers are coupled to an interface box with a snap on connector. The interface box contains a position sensitive photomultiplier tube (PSPMT) to decode the individual fibers. The whole detector assembly fits into an 8-French (2.7 mm in diameter) catheter. The PSPMT image is further decoded with software to give a linear image, the total instantaneous count rate and an audio output whose tone corresponds to the count rate. The device was tested with F-18 and Tl-204 sources. Spectrometric response, spatial resolution, sensitivity and beta to background ratio were measured. System resolution is 6 mm and the sensitivity is >500 cps / micrometers Ci when the source is 1 mm from the detector. The beta to background ratio was 11.2 for F-18 measured on a single fiber. The current device will lead to a system allowing imaging of labeled vulnerable plaque in coronary arteries. This type of signature is expected to enable targeted and cost effective therapies to prevent acute coronary artery diseases such as: unstable angina

  14. Optical detection of structural changes in human carotid atherosclerotic plaque

    Science.gov (United States)

    Korol, R. M.; Canham, P. B.; Finlay, H. M.; Hammond, R. R.; Quantz, M.; Ferguson, G. G.; Liu, L. Y.; Lucas, A. R.

    2005-08-01

    Background: Arterial bifurcations are commonly the sites of developing atherosclerotic plaque that lead to arterial occlusions and plaque rupture (myocardial infarctions and strokes). Laser induced fluorescence (LIF) spectroscopy provides an effective nondestructive method supplying spectral information on extracellular matrix (ECM) protein composition, specifically collagen and elastin. Purpose: To investigate regional differences in the ECM proteins -- collagen I, III and elastin in unstable plaque by analyzing data from laser-induced fluorescence spectroscopy of human carotid endarterectomy specimens. Methods: Gels of ECM protein extracts (elastin, collagen types I & III) were measured as reference spectra and internal thoracic artery segments (extra tissue from bypass surgery) were used as tissue controls. Arterial segments and the endarterectomy specimens (n=21) were cut into 5mm cross-sectional rings. Ten fluorescence spectra per sampling area were then recorded at 5 sites per ring with argon laser excitation (357nm) with a penetration depth of 200 μm. Spectra were normalized to maximum intensity and analyzed using multiple regression analysis. Tissue rings were fixed in formalin (within 3 hours of surgery), sectioned and stained with H&E or Movat's Pentachrome for histological analysis. Spectroscopy data were correlated with immunohistology (staining for elastin, collagen types I, III and IV). Results: Quantitative fluorescence for the thoracic arteries revealed a dominant elastin component on the luminal side -- confirmed with immunohistology and known artery structure. Carotid endarterectomy specimens by comparison had a significant decrease in elastin signature and increased collagen type I and III. Arterial spectra were markedly different between the thoracic and carotid specimens. There was also a significant elevation (pcollagen type I distal to the bifurcation compared to proximal tissue in the carotid specimens. Conclusion: Fluorescence spectroscopy

  15. Association between chlamydia pneumoniae infection and carotid atherosclerotic plaques

    Directory of Open Access Journals (Sweden)

    Fereshteh Ashtari

    2007-08-01

    Full Text Available BACKGROUND: Several studies have suggested an association between Chlamydia pneumonia infection and atherosclerosis. This study was designed to investigate the association between this organism and atherosclerotic plaque formation in right and left common carotid arteries (CCAs and extracranial portions of internal carotid arteries (ICAs.
    METHODS: Antibodies to Chlamydia pneumoniae (IgA and IgG were measured and compared in 42 patients who had plaque in at least one CCA or ICA (detected by duplex ultrasound and 82 patients without any plaque in these arteries. Cp.IgG and Cp.IgA titers over 1.10 ISR were defined to be positive.
    RESULTS: We found that 6.1% of control subjects and 16.7% of cases were Cp.IgA seropositive. The difference between these two groups was prominent but was not statistically significant (P = 0.104. 4.2% of females without atherosclerotic plaque and 31.6% of females with plaque were Cp.IgA seropositive. This difference is statistically significant (P = 0.005. There was no significant difference in seropositivity of Cp.IgG between case and control subjects or in male and female groups with or without plaque.
    CONCLUSIONS: Cp.IgA is a predictor of atherosclerosis in women, but Cp.IgG has no predictive value for plaque formation in either gender.
    KEY WORDS: Atherosclerotic plaque, Chlamydia pneumoniae, serum antibody.

  16. Lectin Pathway of Complement Activation Is Associated with Vulnerability of Atherosclerotic Plaques

    Science.gov (United States)

    Fumagalli, Stefano; Perego, Carlo; Zangari, Rosalia; De Blasio, Daiana; Oggioni, Marco; De Nigris, Francesca; Snider, Francesco; Garred, Peter; Ferrante, Angela M. R.; De Simoni, Maria-Grazia

    2017-01-01

    Inflammatory mechanisms may be involved in atherosclerotic plaque rupture. By using a novel histology-based method to quantify plaque instability here, we assess whether lectin pathway (LP) of complement activation, a major inflammation arm, could represent an index of plaque instability. Plaques from 42 consecutive patients undergoing carotid endarterectomy were stained with hematoxylin-eosin and the lipid core, cholesterol clefts, hemorrhagic content, thickness of tunica media, and intima, including or not infiltration of cellular debris and cholesterol, were determined. The presence of ficolin-1, -2, and -3 and mannose-binding lectin (MBL), LP initiators, was assessed in the plaques by immunofluorescence and in plasma by ELISA. LP activation was assessed in plasma by functional in vitro assays. Patients presenting low stenosis (≤75%) had higher hemorrhagic content than those with high stenosis (>75%), indicating increased erosion. Increased hemorrhagic content and tunica media thickness, as well as decreased lipid core and infiltrated content were associated with vulnerable plaques and therefore used to establish a plaque vulnerability score that allowed to classify patients according to plaque vulnerability. Ficolins and MBL were found both in plaques’ necrotic core and tunica media. Patients with vulnerable plaques showed decreased plasma levels and intraplaque deposition of ficolin-2. Symptomatic patients experiencing a transient ischemic attack had lower plasma levels of ficolin-1. We show that the LP initiators are present within the plaques and their circulating levels change in atherosclerotic patients. In particular, we show that decreased ficolin-2 levels are associated with rupture-prone vulnerable plaques, indicating its potential use as marker for cardiovascular risk assessment in atherosclerotic patients. PMID:28360913

  17. Carotid Magnetic Resonance Imaging A Window to Study Atherosclerosis and Identify High-Risk Plaques

    National Research Council Canada - National Science Library

    Oikawa, Minako; Ota, Hideki; Takaya, Norihide; Miller, Zach; Hatsukami, Thomas S; Yuan, Chun

    2009-01-01

    ...: the so-called "vulnerable plaque". A reliable, in vivo, imaging method capable of identifying plaque characteristics associated with high-risk plaque will be immensely useful for evaluating plaque status and predicting future events...

  18. Common carotid artery intima-media thickness, carotid plaques, and walking speed.

    Science.gov (United States)

    Elbaz, Alexis; Ripert, Mahaut; Tavernier, Béatrice; Février, Benoît; Zureik, Mahmoud; Gariépy, Jérôme; Alpérovitch, Annick; Tzourio, Christophe

    2005-10-01

    Gait dysfunction is an important cause of disability among the elderly and may be, in part, of vascular origin. We studied the association between carotid ultrasound parameters and measures of gait and balance in subjects 65 to 85 years of age who participated in the baseline phase of the Three-City Study in the Dijon center. The study population comprised 2572 noninstitutionalized individuals. Carotid plaques and common carotid artery intima-media thickness (CCA-IMT) were measured using ultrasonography. Gait and balance measures included walking speed and a modified version of the Tinetti scale. Mean maximum walking speed (MWS) decreased with increasing CCA-IMT and number of plaques (PTinetti score score of > or =16 (P=0.006). The proportion of subjects in the lowest MWS quartile (P=0.006) or with a modified Tinetti score <16 (P=0.05) increased with the number of plaques. These relations were attenuated after adjustment for vascular risk factors. Carotid plaques and higher CCA-IMT values are associated with worse performances on gait and balance tests. Our results suggest that vascular factors may play an important and under-recognized role in motor function.

  19. Atherosclerotic plaque component segmentation in combined carotid MRI and CTA data incorporating class label uncertainty

    DEFF Research Database (Denmark)

    van Engelen, Arna; Niessen, Wiro J.; Klein, Stefan;

    2014-01-01

    Atherosclerotic plaque composition can indicate plaque vulnerability. We segment atherosclerotic plaque components from the carotid artery on a combination of in vivo MRI and CT-angiography (CTA) data using supervised voxelwise classification. In contrast to previous studies the ground truth...... in the ground truth used for training: I) soft labels are created by Gaussian blurring of the original binary histology segmentations to reduce weights at the boundaries between components, and are weighted by the estimated registration accuracy of the histology and in vivo imaging data (measured by overlap......), II) samples are weighted by the local contour distance of the lumen and outer wall between histology and in vivo data, and III) 10% of each class is rejected by Gaussian outlier rejection. Classification was evaluated on the relative volumes (% of tissue type in the vessel wall) for calcified...

  20. Detection of unstable carotid plaque by tissue Doppler imaging and contrast-enhanced ultrasound in a patient with recurrent amaurosis fugax.

    Science.gov (United States)

    Kunte, Hagen; Rückert, Ralph-Ingo; Schmidt, Charlotte; Harms, Lutz; Kasper, Antje-Susanne; Hellweg, Rainer; Grigoryev, Maria; Fischer, Thomas; Kronenberg, Golo

    2013-01-01

    Ultrasound (US) is one of the most important diagnostic tools available for the detection and evaluation of carotid stenosis. The case of a 70-year-old woman with recurrent right-sided amaurosis fugax presented here highlights the way in which tissue Doppler imaging (TDI) and contrast-enhanced US (CEUS) may aid in the diagnosis of carotid plaque vulnerability. Furthermore, the novel inverse fly-through technique was used for the three-dimensional visualization of the carotid stenosis.

  1. Vulnerable Plaque Detection and Quantification with Gold Particle–Enhanced Computed Tomography in Atherosclerotic Mouse Models

    Directory of Open Access Journals (Sweden)

    David De Wilde

    2015-06-01

    Full Text Available Recently, an apolipoprotein E–deficient (ApoE−/− mouse model with a mutation (C1039G+/− in the fibrillin-1 (Fbn1 gene (ApoE−/−Fbn1C1039G+/− mouse model was developed showing vulnerable atherosclerotic plaques, prone to rupture, in contrast to the ApoE−/− mouse model, where mainly stable plaques are present. One indicator of plaque vulnerability is the level of macrophage infiltration. Therefore, this study aimed to measure and quantify in vivo the macrophage infiltration related to plaque development and progression. For this purpose, 5-weekly consecutive gold nanoparticle–enhanced micro–computed tomography (microCT scans were acquired. Histology confirmed that the presence of contrast agent coincided with the presence of macrophages. Based on the microCT scans, regions of the artery wall with contrast agent present were calculated and visualized in three dimensions. From this information, the contrast-enhanced area and contrast-enhanced centerline length were calculated for the branches of the carotid bifurcation (common, external, and internal carotid arteries. Statistical analysis showed a more rapid development and a larger extent of plaques in the ApoE−/−Fbn1C1039G+/− compared to the ApoE−/− mice. Regional differences between the branches were also observable and quantifiable. We developed and applied a methodology based on gold particle–enhanced microCT to visualize the presence of macrophages in atherosclerotic plaques in vivo.

  2. Quantitative analysis of ultrasound contrast flow behavior in carotid plaque neovasculature.

    Science.gov (United States)

    Hoogi, Assaf; Akkus, Zeynettin; van den Oord, Stijn C H; ten Kate, Gerrit L; Schinkel, Arend F L; Bosch, Johan G; de Jong, Nico; Adam, Dan; van der Steen, Antonius F W

    2012-12-01

    Intraplaque neovascularization is considered as an important indication for plaque vulnerability. We propose a semiautomatic algorithm for quantification of neovasculature, thus, enabling assessment of plaque vulnerability. The algorithm detects and tracks contrast spots using multidimensional dynamic programming. Classification of contrast tracks into blood vessels and artifacts was performed. The results were compared with manual tracking, visual classification and maximal intensity projection. In 28 plaques, 97% of the contrast spots were detected. In 89% of the objects, the automatic tracking determined the contrast motion with an average distance of less than 0.5 mm from the manual marking. Furthermore, 75% were correctly classified into artifacts and vessels. The automated neovascularization grading agreed within 1 grade with visual analysis in 91% of the cases, which was comparable to the interobserver variability of visual grading. These results show that the method can successfully quantify features that are linked to vulnerability of the carotid plaque. Copyright © 2012 World Federation for Ultrasound in Medicine & Biology. Published by Elsevier Inc. All rights reserved.

  3. The Accuracy of Noninvasive Imaging Techniques in Diagnosis of Carotid Plaque Morphology

    Directory of Open Access Journals (Sweden)

    Detelina Valchkova Lukanova

    2015-03-01

    CONCLUSION: The ultrasound has high accuracy for diagnostics of carotid plaque morphology, magnetic resonance imaging has high potential for tissue differentiation and multidetector computed tomography determines precisely degree of stenosis and presence of ulceration and calcifications. The three noninvasive imaging modalities are complementary for optimal evaluation of the morphology of carotid plaque. This will help to determine the risk of stroke and to decide on the best treatment – carotid endarterectomy or carotid stenting.

  4. The usefulness of optical analyses for detecting vulnerable plaques using rabbit models

    Science.gov (United States)

    Nakai, Kanji; Ishihara, Miya; Kawauchi, Satoko; Shiomi, Masashi; Kikuchi, Makoto; Kaji, Tatsumi

    2011-03-01

    Purpose: Carotid artery stenting (CAS) has become a widely used option for treatment of carotid stenosis. Although technical improvements have led to a decrease in complications related to CAS, distal embolism continues to be a problem. The purpose of this research was to investigate the usefulness of optical methods (Time-Resolved Laser- Induced Fluorescence Spectroscopy [TR-LIFS] and reflection spectroscopy [RS] as diagnostic tools for assessment of vulnerable atherosclerotic lesions, using rabbit models of vulnerable plaque. Materials & Methods: Male Japanese white rabbits were divided into a high cholesterol diet group and a normal diet group. In addition, we used a Watanabe heritable hyperlipidemic (WHHL) rabbit, because we confirmed the reliability of our animal model for this study. Experiment 1: TR-LIFS. Fluorescence was induced using the third harmonic wave of a Q switch Nd:YAG laser. The TR-LIFS was performed using a photonic multi-channel analyzer with ICCD (wavelength range, 200 - 860 nm). Experiment 2: RS. Refection spectra in the wavelength range of 900 to 1700 nm were acquired using a spectrometer. Results: In the TR-LIFS, the wavelength at the peak was longer by plaque formation. The TR-LIFS method revealed a difference in peak levels between a normal aorta and a lipid-rich aorta. The RS method showed increased absorption from 1450 to 1500 nm for lipid-rich plaques. We observed absorption around 1200 nm due to lipid only in the WHHL group. Conclusion: These methods using optical analysis might be useful for diagnosis of vulnerable plaques. Keywords: Carotid artery stenting, vulnerable plaque, Time-Resolved Laser-Induced Fluorescence

  5. Comparison of carotid plaque tissue characteristics in patients with acute coronary syndrome or stable angina pectoris: assessment by iPlaque, transcutaneous carotid ultrasonography with integrated backscatter analysis.

    Science.gov (United States)

    Bando, Mika; Yamada, Hirotsugu; Kusunose, Kenya; Fukuda, Daiju; Amano, Rie; Tamai, Rina; Torii, Yuta; Hirata, Yukina; Nishio, Susumu; Yamaguchi, Koji; Soeki, Takeshi; Wakatsuki, Tetsuzo; Sata, Masataka

    2015-07-25

    The association of the tissue characteristics of carotid plaques with coronary artery disease has attracted interest. The present study compared the tissue characteristics of carotid plaques in patients with acute coronary syndrome (ACS) with those in patients with stable angina pectoris (SAP) using the iPlaque system, which is based on ultrasound integrated backscatter. Carotid ultrasound examinations were performed in 26 patients with ACS, and 38 age- and gender-matched patients with SAP. Neither plaque area nor maximal intima-media thickness differed significantly between the two groups. However, the average integrated backscatter value within the plaque was greater in the ACS patients than in the SAP patients. iPlaque analysis revealed that the percentage blue area (lipid pool) was greater in the ACS patients than in the SAP patients (43.4 ± 11.2 vs 18.3 ± 10.3%, p < 0.0001), and that the percentage green area (fibrosis) was lower in the ACS than in the SAP patients (7.5 ± 7.5% vs 20.7 ± 11.7%, p < 0.0001). The lipid component of carotid plaques is greater in ACS patients than in SAP patients. Our iPlaque system provides a useful and feasible method for the tissue characterization of carotid plaques in the clinical setting.

  6. Spectroscopy to improve identification of vulnerable plaques in cardiovascular disease.

    Science.gov (United States)

    Bruggink, Janneke L M; Meerwaldt, Robbert; van Dam, Gooitzen M; Lefrandt, Joop D; Slart, Riemer H J A; Tio, René A; Smit, Andries J; Zeebregts, Clark J

    2010-01-01

    Many apparent healthy persons die from cardiovascular disease, despite major advances in prevention and treatment of cardiovascular disease. Traditional cardiovascular risk factors are able to predict cardiovascular events in the long run, but fail to assess current disease activity or nearby cardiovascular events. There is a clear relation between the occurrence of cardiovascular events and the presence of so-called vulnerable plaques. These vulnerable plaques are characterized by active inflammation, a thin cap and a large lipid pool. Spectroscopy is an optical imaging technique which depicts the interaction between light and tissues, and thereby shows the biochemical composition of tissues. In recent years, impressive advances have been made in spectroscopy technology and intravascular spectroscopy is able to assess the composition of plaques of interest and thereby to identify and actually quantify plaque vulnerability. This review summarizes the current evidence for spectroscopy as a measure of plaque vulnerability and discusses the potential role of intravascular spectroscopic imaging techniques.

  7. Association of carotid atherosclerotic plaque features with acute ischemic stroke: A magnetic resonance imaging study

    Energy Technology Data Exchange (ETDEWEB)

    Zhao, Huilin [Department of Radiology, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200127 (China); Zhao, Xihai [Center for Biomedical Imaging Research, Department of Biomedical Engineering, Tsinghua University School of Medicine, Beijing 100084 (China); Liu, Xiaosheng; Cao, Ye [Department of Radiology, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200127 (China); Hippe, Daniel S.; Sun, Jie [Department of Radiology, University of Washington, Seattle, WA 98109 (United States); Li, Feiyu [Department of Radiology, Peking University First Hospital, Beijing 100034 (China); Xu, Jianrong, E-mail: renjixjr@yahoo.com.cn [Department of Radiology, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200127 (China); Yuan, Chun [Center for Biomedical Imaging Research, Department of Biomedical Engineering, Tsinghua University School of Medicine, Beijing 100084 (China); Department of Radiology, University of Washington, Seattle, WA 98109 (United States)

    2013-09-15

    Background and purpose: It remains unclear whether direct vessel wall imaging can identify carotid high-risk lesions in symptomatic subjects and whether carotid plaque characteristics are more effective indicators for cerebral infarct severity than stenosis. This study sought to determine the associations of carotid plaque characteristics by MR imaging with stenosis and acute cerebral infarct (ACI) sizes on diffusion weighted imaging (DWI). Materials and methods: One hundred and fourteen symptomatic patients underwent carotid and brain MRI. ACI volume was determined from symptomatic internal carotid artery territory on DWI images. Ipsilateral carotid plaque morphological and compositional characteristics, and stenosis were also determined. The relationships between carotid plaque characteristics, stenosis and ACIs size were then evaluated. Results: In carotid arteries with 30–49% stenosis, 86.7% and 26.7% were found to have lipid-rich necrotic core (LRNC) and intraplaque hemorrhage, respectively. Furthermore, 45.8% of carotid arteries with 0–29% stenosis developed LRNCs. Carotid morphological measurements, such as % wall volume, and the LRNC size were significantly associated with ipsilateral ACIs volume before and after adjustment for significant demographic factors (age and LDL) or stenosis in patients with carotid plaque (all p < 0.05). Conclusions: A substantial number of high-risk plaques characterized by vessel wall imaging exist in carotid arteries with lower grade stenosis. In addition, carotid plaque characteristics, particularly the % wall volume and LRNC size, are independently associated with cerebral infarction as measured by DWI lesions. Our findings indicate that characterizing atherosclerotic plaque by MR vessel wall imaging might be useful for stratification of plaque risk and infarction severity.

  8. Low gray scale values of computerized images of carotid plaques associated with increased levels of triglyceride-rich lipoproteins and with increased plaque lipid content

    DEFF Research Database (Denmark)

    Grønholdt, Marie-Louise M.; Nordestgaard, Børge; Weibe, Britt M.

    1997-01-01

    Relatioin between low gray scale values in computerized images of carotid plaques and 1) plasma levels of triglyceride-rich lipoproteins and 2) plaque lipid content......Relatioin between low gray scale values in computerized images of carotid plaques and 1) plasma levels of triglyceride-rich lipoproteins and 2) plaque lipid content...

  9. Spiral computed tomographic imaging related to computerized ultrasonographic images of carotid plaque morphology and histology

    DEFF Research Database (Denmark)

    Grønholdt, Marie-Louise; Wagner, A; Wiebe, B M;

    2001-01-01

    Echolucency of carotid atherosclerotic plaques, as evaluated by computerized B-mode ultrasonographic images, has been associated with an increased incidence of brain infarcts on cerebral computed tomographic scans. We tested the hypotheses that characterization of carotid plaques on spiral comput...

  10. Plaque inflammation and unstable morphology are associated with early stroke recurrence in symptomatic carotid stenosis.

    LENUS (Irish Health Repository)

    Marnane, Michael

    2014-03-01

    Although symptomatic carotid stenosis is associated with 3-fold increased risk of early stroke recurrence, the pathophysiologic mechanisms of high early stroke risk have not been established. We aimed to investigate the relationship between early stroke recurrence after initial symptoms and histological features of plaque inflammation and instability in resected carotid plaque.

  11. Spiral computed tomographic imaging related to computerized ultrasonographic images of carotid plaque morphology and histology

    DEFF Research Database (Denmark)

    Grønholdt, Marie-Louise; Wagner, A; Wiebe, B M

    2001-01-01

    Echolucency of carotid atherosclerotic plaques, as evaluated by computerized B-mode ultrasonographic images, has been associated with an increased incidence of brain infarcts on cerebral computed tomographic scans. We tested the hypotheses that characterization of carotid plaques on spiral comput...

  12. Comparison of grey scale median (GSM) measurement in ultrasound images of human carotid plaques using two different softwares.

    Science.gov (United States)

    Östling, Gerd; Persson, Margaretha; Hedblad, Bo; Gonçalves, Isabel

    2013-11-01

    Grey scale median (GSM) measured on ultrasound images of carotid plaques has been used for several years now in research to find the vulnerable plaque. Centres have used different software and also different methods for GSM measurement. This has resulted in a wide range of GSM values and cut-off values for the detection of the vulnerable plaque. The aim of this study was to compare the values obtained with two different softwares, using different standardization methods, for the measurement of GSM on ultrasound images of carotid human plaques. GSM was measured with Adobe Photoshop(®) and with Artery Measurement System (AMS) on duplex ultrasound images of 100 consecutive medium- to large-sized carotid plaques of the Beta-blocker Cholesterol-lowering Asymptomatic Plaque Study (BCAPS). The mean values of GSM were 35·2 ± 19·3 and 55·8 ± 22·5 for Adobe Photoshop(®) and AMS, respectively. Mean difference was 20·45 (95% CI: 19·17-21·73). Although the absolute values of GSM differed, the agreement between the two measurements was good, correlation coefficient 0·95. A chi-square test revealed a kappa value of 0·68 when studying quartiles of GSM. The intra-observer variability was 1·9% for AMS and 2·5% for Adobe Photoshop. The difference between softwares and standardization methods must be taken into consideration when comparing studies. To avoid these problems, researcher should come to a consensus regarding software and standardization method for GSM measurement on ultrasound images of plaque in the arteries.

  13. Enhancement patterns in the fibro cellular tissue in different kinds of plaques of the internal carotid artery

    Energy Technology Data Exchange (ETDEWEB)

    Rantner, Barbara, E-mail: barbara.rantner@i-med.ac.at [Department of Vascular Surgery, Innsbruck Medical University, Innsbruck (Austria); Sojer, Martin, E-mail: martin.sojer@uki.at [Department of Neurology, Innsbruck Medical University, Innsbruck (Austria); Kremser, Christian, E-mail: christian.kremser@i-med.ac.at [Department of Radiology, Innsbruck Medical University, Innsbruck (Austria); Cartes-Zumelzu, Fabiola, E-mail: fabiola.cartes-zumelzu@i-med.ac.at [Department of Radiology, Innsbruck Medical University, Innsbruck (Austria); Fraedrich, Gustav, E-mail: gustav.fraedrich@i-med.ac.at [Department of Vascular Surgery, Innsbruck Medical University, Innsbruck (Austria); Jaschke, Werner, E-mail: Werner.jaschke@i-med.ac.at [Department of Radiology, Innsbruck Medical University, Innsbruck (Austria); Chemelli-Steingruber, Iris, E-mail: iris.chemelli.steingruber@gmail.com [Department of Radiology, Innsbruck Medical University, Innsbruck (Austria)

    2013-11-01

    Background: The differentiation between stable and vulnerable plaques in the internal carotid artery (ICA) remains a matter of interest. With the implementation of contrast agent in magnetic resonance imaging (MRI) a more detailed plaque characterization is possible. The study at hand focuses on enhancement patterns of fibro cellular tissue in different kinds of plaques in the ICA. Methods: Between May 2011 and December 2012, 49 patients (39 male) with >50% stenosis of the ICA were consecutively enrolled. In 10 patients with bilateral ICA stenosis, both plaques were included for analysis. We performed a classification of plaques according to Cai and observed 11 type 4–5 plaques, 15 type 6 plaques and 33 type 8 plaques. MRI was performed on a 3 T whole body MR system. The standard 12 channel head coil was combined with the neck extension coil and two bilateral 7 cm loop coils. Post-contrast T1w images were subtracted from pre contrast images to identify late enhancement in fibro cellular tissue. Enhancement patterns were allocated as intraluminal, intraplaque and vasa vasorum enhancement in different types of plaques. Results: Fibro cellular tissue always exhibited a higher contrast enhancement compared to the sternocleidomastoid muscle. This reflects a higher grade of vascularization of the fibrocellular tissue. Contrast enhancement was present irrespective of the plaque type. In detail, intraluminal, intraplaque and vasa vasorum enhancement were observed in all types of plaques. Even type 8 plaques, according to the classification of Cai, had a significant contrast enhancement, though supposed to be with low inflammatory activity. Conclusion: Type 8 plaques might not be as stable as postulated. Whether the relevant uptake of contrast agent is due to the fibrous tissue or reflects the inflammatory activity of the plaque should be matter of further investigations.

  14. Coronary spasm, a pathogenic trigger of vulnerable plaque rupture

    Institute of Scientific and Technical Information of China (English)

    WANG Li-xin; L(U) Shu-zheng; ZHANG Wei-jun; SONG Xian-tao; CHEN Hui; ZHANG Li-jie

    2011-01-01

    Objective This coronary artery spasm review aimed to explore the most possible pathogenic trigger mechanism of vulnerable plaque rupture.Data sources Data used in this coronary artery spasm review were mainly from Medline and Pubmed in English.Study selection These reports from major review on coronary artery spasm.and these research included coronary artery conception,pathogenesis of spasm,mechanisms of plaque rupture,epidemiological evidence,clinical manifestation and the relationship between coronary artery spasm and vulnerable plaque rupture.Results Coronary artery spasm is somehow related to the presence of atherosclerotic intima disease in the coronary artery.However,chronic low-grade inflammation causes coronary vessel smooth muscle cell hypersensitivity,which can directely cause coronary artery spasm.Myocardial infarction and sudden cardiac death may be initiated by a sudden intense localized contraction of coronary artery smooth muscle.Conclusion Coronary artery spasm may be one trigger that can initiate and exacerbate vulnerable plaque rupture.

  15. Quantification of carotid artery plaque stability with multiple region of interest based ultrasound strain indices and relationship with cognition

    Science.gov (United States)

    Meshram, N. H.; Varghese, T.; Mitchell, C. C.; Jackson, D. C.; Wilbrand, S. M.; Hermann, B. P.; Dempsey, R. J.

    2017-08-01

    Vulnerability and instability in carotid artery plaque has been assessed based on strain variations using noninvasive ultrasound imaging. We previously demonstrated that carotid plaques with higher strain indices in a region of interest (ROI) correlated to patients with lower cognition, probably due to cerebrovascular emboli arising from these unstable plaques. This work attempts to characterize the strain distribution throughout the entire plaque region instead of being restricted to a single localized ROI. Multiple ROIs are selected within the entire plaque region, based on thresholds determined by the maximum and average strains in the entire plaque, enabling generation of additional relevant strain indices. Ultrasound strain imaging of carotid plaques, was performed on 60 human patients using an 18L6 transducer coupled to a Siemens Acuson S2000 system to acquire radiofrequency data over several cardiac cycles. Patients also underwent a battery of neuropsychological tests under a protocol based on National Institute of Neurological Disorders and Stroke and Canadian Stroke Network guidelines. Correlation of strain indices with composite cognitive index of executive function revealed a negative association relating high strain to poor cognition. Patients grouped into high and low cognition groups were then classified using these additional strain indices. One of our newer indices, namely the average L  -  1 norm with plaque (AL1NWP) presented with significantly improved correlation with executive function when compared to our previously reported maximum accumulated strain indices. An optimal combination of three of the new indices generated classifiers of patient cognition with an area under the curve (AUC) of 0.880, 0.921 and 0.905 for all (n  =  60), symptomatic (n  =  33) and asymptomatic patients (n  =  27) whereas classifiers using maximum accumulated strain indices alone provided AUC values of 0.817, 0.815 and 0

  16. Effect of rosuvastatin on inflammatory factors and carotid atherosclerotic plaque in patients with acute ischemic stroke

    Directory of Open Access Journals (Sweden)

    YAN Jun

    2013-10-01

    Full Text Available Carotid atherosclerosis is closely related with ischemic stroke occurrence, development and recurrence. This study aims to make an evaluation of the effects of rosuvastatin on inflammatory factors, serum lipid and carotid atherosclerotic plaque in patients with acute ischemic stroke. In this study, 98 patients with acute ischemic stroke and carotid atherosclerosis were given oral administration of rosuvastatin calcium (10 mg once every night, and the course of treatment was 6 months. After treatment, the changes of serum high-sensitivity C-reactive protein (hs-CRP, tumor necrosis factor-alpha (TNF-α and blood lipid were measured, as well as carotid atherosclerotic intima-media thickness (IMT and the calculation of carotid atherosclerotic plaque score. According to the examination results, after 6 months' treatment with rosuvastatin, serum hs-CRP, TNF-α, total cholesterol (TC, triglyceride (TG and low-density lipoprotein cholestrol (LDL-C decreased significantly (P < 0.01, for all, while high-density lipoprotein cholestrol (HDL-C increased significantly (P < 0.01; the total number of plaque reduced, while the number of stable plaque increased (P < 0.05; carotid artery IMT and carotid artery plaque score decreased significantly (P < 0.05. There were significant differences between before and after treatment. The results of this study show that rosuvastatin plays a role in anti-inflammation and alleviates the degree of carotid atherosclerotic plaque.

  17. Advances in the research of high-resolution magnetic resonance imaging used for treating carotid atherosclerotic plaques in ischemic stroke patients

    Directory of Open Access Journals (Sweden)

    Xiao-nan ZHANG

    2014-01-01

    Full Text Available Stroke causespermanent neurological damage and death and badly endangers human's life and health. Ischemic stroke with the pathological basis of atherosclerotic lesions is the major type of stroke. Thus, early and timely detection of plaque vulnerability has become more and more important. As a noninvasive examination, carotid magnetic resonance imaging (MRI has tremendous advantages on detecting the characteristics of atherosclerotic plaque, such as high sensitivity and specificity on the plaque morphology and composition as well as hierarchical evaluation on the risk of plaque rupture, and furthermore provides significant imaging support on clinical treatments.

  18. Vascular endothelial growth factor (VEGF and monocyte chemoattractant protein (MCP-1 levels unaltered in symptomatic atherosclerotic carotid plaque patients from North India

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    Dheeraj eKhurana

    2013-04-01

    Full Text Available We aimed to identify the role of vascular endothelial growth factor(VEGF and monocyte chemoattractant protein(MCP-1 as a serum biomarker of symptomatic carotid atherosclerotic plaque in North Indian population. Individuals with symptomatic carotid atherosclerotic plaque have high risk of ischemic stroke. Previous studies from western countries have shown an association between VEGF and MCP-1 levels and the incidence of ischemic stroke. In this study, venous blood from 110 human subjects was collected, 57 blood samples of which were obtained from patients with carotid plaques, 38 neurological controls without carotid plaques and another 15 healthy controls who had no history of serious illness. Serum VEGF and MCP-1 levels were measured using commercially available enzyme-linked immunosorbent assay(ELISA. We also correlated the data clinically and carried out risk factor analysis based on the detailed questionnaire obtained from each patient. For risk factor analysis, a total of 70 symptomatic carotid plaque cases and equal number of age and sex matched healthy controls were analyzed. We found that serum VEGF levels in carotid plaque patients did not show any significant change when compared to either of the controls. Similarly, there was no significant upregulation of monocyte chemoattractant protein-1 in the serum of these patients. The risk factor analysis revealed that hypertension, diabetes, and physical inactivity were the main correlates of carotid atherosclerosis(p<0.05. Prevalence of patients was higher residing in urban areas as compared to rural region. We also found that patients coming from mountaineer region were relatively less vulnerable to cerebral atherosclerosis as compared to the ones residing at plain region. We conclude that the pathogenesis of carotid plaques may progress independent of these inflammatory molecules. In parallel, risk factor analysis indicates hypertension, diabetes and sedentary lifestyle as the most

  19. A comparative study on plaque vulnerability using constitutive equations.

    Science.gov (United States)

    Karimi, A; Navidbakhsh, M; Faghihi, S

    2014-03-01

    Atherosclerosis is the most serious and common form of cardiovascular disease in which plaque builds up inside the arteries. Peak plaque stress is considered as the main reason for plaque rupture, which results in heart attack and stroke. In the current research, the finite element method is used to anticipate plaque vulnerability, using human samples. A total of 23 healthy and atherosclerotic human coronary arteries (14 healthy and 9 atherosclerotic) were removed within 5 h postmortem. The samples were mounted on a uniaxial tensile test machine and the obtained mechanical properties were used in finite element models. The peak plaque stresses for the Ogden hyperelastic model were compared to the Mooney-Rivlin and Neo-Hookean outcomes. The results indicated that hypocellular plaque in all three models has the highest stress values compared to the cellular and calcified ones and, as a result, is quite prone to rupture. The calcified plaque type, in contrast, has the lowest stress values and remains stable. The results can be used in plaque vulnerability prediction and have clinical implications for interventions and surgeries such as balloon-angioplasty, cardiopulmonary bypass and stenting.

  20. Effect of calcification on the mechanical stability of plaque based on a three-dimensional carotid bifurcation model

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    Wong Kelvin KL

    2012-02-01

    Full Text Available Abstract Background This study characterizes the distribution and components of plaque structure by presenting a three-dimensional blood-vessel modelling with the aim of determining mechanical properties due to the effect of lipid core and calcification within a plaque. Numerical simulation has been used to answer how cap thickness and calcium distribution in lipids influence the biomechanical stress on the plaque. Method Modelling atherosclerotic plaque based on structural analysis confirms the rationale for plaque mechanical examination and the feasibility of our simulation model. Meaningful validation of predictions from modelled atherosclerotic plaque model typically requires examination of bona fide atherosclerotic lesions. To analyze a more accurate plaque rupture, fluid-structure interaction is applied to three-dimensional blood-vessel carotid bifurcation modelling. A patient-specific pressure variation is applied onto the plaque to influence its vulnerability. Results Modelling of the human atherosclerotic artery with varying degrees of lipid core elasticity, fibrous cap thickness and calcification gap, which is defined as the distance between the fibrous cap and calcification agglomerate, form the basis of our rupture analysis. Finite element analysis shows that the calcification gap should be conservatively smaller than its threshold to maintain plaque stability. The results add new mechanistic insights and methodologically sound data to investigate plaque rupture mechanics. Conclusion Structural analysis using a three-dimensional calcified model represents a more realistic simulation of late-stage atherosclerotic plaque. We also demonstrate that increases of calcium content that is coupled with a decrease in lipid core volume can stabilize plaque structurally.

  1. Relationship between hyperhomocysteinemia and carotid plaque features in high-risk stroke population

    Institute of Scientific and Technical Information of China (English)

    Zhen Lu; Yu-fen Wang; Wen-jun Li; Jun Wang

    2016-01-01

    Objective:To analyze the relationship between hyperhomocysteinemia and carotid plaque features in high-risk stroke population.Methods:A total of 116 cases of high-risk stroke treated in our hospital from March 2014 to September 2015 were included in study and divided into stable plaque group 32 cases, unstable plaque group 45 cases and mixed plaque group 39 cases according to plaque features after carotid artery ultrasonography. Differences in serum levels of homocysteine (Hcy), adhesion molecule, hypersensitive C-reactive protein, lipid, cell fibronectin, and so on were compared among groups, and the correlation between serum Hcy and plaque feature-related indicators was further analyzed.Results: Serum Hcy, sVCAM-1, sICAM-1, hs-CRP, TC, TG, LDL-C and c-Fn values of unstable plaque group were significantly higher than those of stable plaque group and mixed plaque group, and HDL-C value was significantly lower than that of stable plaque group and mixed plaque group (P<0.05); serum Hcy levels in high-risk stroke population were positively correlated with sVCAM-1, sICAM-1, hs-CRP, TC, TG, LDL-C and c-Fn values, and negatively correlated with HDL-C value.Conclusions:Hyperhomocysteinemia can promote the instability of carotid plaque features in high-risk stroke population, and is a high-risk factor of stroke.

  2. MMP-1 and MMP-9 regulate epidermal growth factor-dependent collagen loss in human carotid plaque smooth muscle cells.

    Science.gov (United States)

    Rao, Velidi H; Kansal, Vikash; Stoupa, Samantha; Agrawal, Devendra K

    2014-02-01

    Mechanisms underlying the rupture of atherosclerotic plaque, a crucial factor in the development of myocardial infarction and stroke, are not well defined. Here, we examined the role of epidermal growth factor (EGF)-mediated matrix metalloproteinases (MMP) on the stability of interstitial collagens in vascular smooth muscle cells (VSMCs) isolated from carotid endarterectomy tissues of symptomatic and asymptomatic patients with carotid stenosis. VSMCs isolated from the carotid plaques of both asymptomatic and symptomatic patients were treated with EGF. The MMP-9 activity was quantified by gelatin zymography and the analysis of mRNA transcripts and protein for MMP-9, MMP-1, EGFR and collagen types I, Col I(α1) and collagen type III, Col III(α1) were analyzed by qPCR and immunofluorescence, respectively. The effect of EGF treatment to increase MMP-9 activity and mRNA transcripts for MMP-9, MMP-1, and EGFR and to decrease mRNA transcripts for Col I(α1) and Col III(α1) was threefold to fourfold greater in VSMCs isolated from the carotid plaques of symptomatic than asymptomatic patients. Inhibitors of EGFR (AG1478) and a small molecule inhibitor of MMP-9 decreased the MMP9 expression and upregulated Col I(α1) and Col III(α1) in EGF-treated VSMCs of both groups. Additionally, the magnitude in decreased MMP-9 mRNA and increased Col I(α1) and Col III(α1) due to knockdown of MMP-9 gene with siRNA in EGF-treated VSMCs was significantly greater in the symptomatic group than the asymptomatic group. Thus, a selective blockade of both EGFR and MMP-9 may be a novel strategy and a promising target for stabilizing vulnerable plaques in patients with carotid stenosis.

  3. Detection of Unstable Carotid Plaque by Tissue Doppler Imaging and Contrast-Enhanced Ultrasound in a Patient with Recurrent Amaurosis Fugax

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    Hagen Kunte

    2013-01-01

    Full Text Available Ultrasound (US is one of the most important diagnostic tools available for the detection and evaluation of carotid stenosis. The case of a 70-year-old woman with recurrent right-sided amaurosis fugax presented here highlights the way in which tissue Doppler imaging (TDI and contrast-enhanced US (CEUS may aid in the diagnosis of carotid plaque vulnerability. Furthermore, the novel inverse fly-through technique was used for the three-dimensional visualization of the carotid stenosis.

  4. High-risk carotid plaques identified by CT-angiogram can predict acute myocardial infarction.

    Science.gov (United States)

    Mosleh, Wassim; Adib, Keenan; Natdanai, Punnanithinont; Carmona-Rubio, Andres; Karki, Roshan; Paily, Jacienta; Ahmed, Mohamed Abdel-Aal; Vakkalanka, Sujit; Madam, Narasa; Gudleski, Gregory D; Chung, Charles; Sharma, Umesh C

    2016-11-19

    Prior studies identified the incremental value of non-invasive imaging by CT-angiogram (CTA) to detect high-risk coronary atherosclerotic plaques. Due to their superficial locations, larger calibers and motion-free imaging, the carotid arteries provide the best anatomic access for the non-invasive characterization of atherosclerotic plaques. We aim to assess the ability of predicting obstructive coronary artery disease (CAD) or acute myocardial infarction (MI) based on high-risk carotid plaque features identified by CTA. We retrospectively examined carotid CTAs of 492 patients that presented with acute stroke to characterize the atherosclerotic plaques of the carotid arteries and examined development of acute MI and obstructive CAD within 12-months. Carotid lesions were defined in terms of calcifications (large or speckled), presence of low-attenuation plaques, positive remodeling, and presence of napkin ring sign. Adjusted relative risks were calculated for each plaque features. Patients with speckled (<3 mm) calcifications and/or larger calcifications on CTA had a higher risk of developing an MI and/or obstructive CAD within 1 year compared to patients without (adjusted RR of 7.51, 95%CI 1.26-73.42, P = 0.001). Patients with low-attenuation plaques on CTA had a higher risk of developing an MI and/or obstructive CAD within 1 year than patients without (adjusted RR of 2.73, 95%CI 1.19-8.50, P = 0.021). Presence of carotid calcifications and low-attenuation plaques also portended higher sensitivity (100 and 79.17%, respectively) for the development of acute MI. Presence of carotid calcifications and low-attenuation plaques can predict the risk of developing acute MI and/or obstructive CAD within 12-months. Given their high sensitivity, their absence can reliably exclude 12-month events.

  5. Association Between the Presence of Carotid Artery Plaque and Cardiovascular Events in Patients With Genetic Hypercholesterolemia.

    Science.gov (United States)

    Bea, Ana M; Civeira, Fernando; Jarauta, Estíbaliz; Lamiquiz-Moneo, Itziar; Pérez-Calahorra, Sofía; Marco-Benedí, Victoria; Cenarro, Ana; Mateo-Gallego, Rocío

    2017-07-01

    The equations used in the general population to calculate cardiovascular risk are not useful in genetic hypercholesterolemia (GH). Carotid plaque detection has proved useful in cardiovascular prediction and risk reclassification but there have been no studies of its usefulness in GH. The aim of this study was to determine the association between the presence of carotid artery plaque and the occurrence of cardiovascular events in patients with GH. This study included 1778 persons with GH. The mean follow-up until the occurrence of cardiovascular events was 6.26 years. At presentation, the presence of carotid artery plaque was studied by high-resolution ultrasound. Carotid artery plaque was found in 661 (37.2%) patients: 31.9% with familial hypercholesterolemia, 39.8% with familial combined hyperlipidemia, 45.5% with dysbetalipoproteinemia, and 43.2% with polygenic hypercholesterolemia. During follow-up, 58 patients had a cardiovascular event. Event rates were 6354/100 000 (95%CI, 4432.4-8275.6) in the group with plaque and 1432/100 000 (95%CI, 730.6-2134.3) in the group without plaque, with significant differences between the 2 groups (P < .001). The relative risk of an event was 4.34 (95CI%, 2.44-7.71; P < .001) times higher in patients with plaque and was 2.40 (95%CI, 1.27-4.56; P = .007) times higher after adjustment for major risk factors. The number of carotid artery plaques was positively associated with the risk of cardiovascular events. Most cardiovascular events occur in a subgroup of patients who can be identified by carotid plaque detection. These results support the use of plaque screening in this population and should help in risk stratification and treatment in GH. Copyright © 2016 Sociedad Española de Cardiología. Published by Elsevier España, S.L.U. All rights reserved.

  6. 3D Isotropic MR Culprit Plaque Visualization of Carotid Plaque Edema and Hemorrhage with Motion Sensitized Blood Suppression

    DEFF Research Database (Denmark)

    Søvsø Szocska Hansen, Esben; Pedersen, Steen Fjord; Bloch, Lars Ø.;

    2014-01-01

    hemorrhage and plaque edema may represent advanced stages of atherosclerosis[1, 2]. In this study, we present a novel multi-contrast 3D motion sensitized black-blood CMR imaging sequence, which detects both plaque edema and hemorrhage with positive contrast. Subjects and Methods The 3D imaging sequence...... to lumen was 39.74±6.75. Discussion/Conclusion In conclusion, the proposed 3D isotropic multi-contrast CMR technique detects plaque edema and hemorrhage with positive contrast and excellent black-blood contrast, which may facilitate evaluation of carotid atherosclerosis. Ongoing studies will include CMR...

  7. Carotid Artery Stenting Successfully Prevents Progressive Stroke Due to Mobile Plaque

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    Masahiro Oomura

    2015-05-01

    Full Text Available We report a case of progressive ischemic stroke due to a mobile plaque, in which carotid artery stenting successfully prevented further infarctions. A 78-year-old man developed acute multiple infarcts in the right hemisphere, and a duplex ultrasound showed a mobile plaque involving the bifurcation of the left common carotid artery. Maximal medical therapy failed to prevent further infarcts, and the number of infarcts increased with his neurological deterioration. Our present case suggests that the deployment of a closed-cell stent is effective to prevent the progression of the ischemic stroke due to the mobile plaque.

  8. Morphological study of atherosclerotic plaque and its application in vulnerability evaluation

    Institute of Scientific and Technical Information of China (English)

    SU HaiJun; ZHANG PengFei; OHEN WenQiang; ZHANG Mei; ZHANG Yun

    2008-01-01

    The relationships between the morphological characteristics and the vulnerability of atheroaclerotic plaque were analyzed theoretically and several suggestions were proposed to evaluate the plaque vulnerability. Validated by animal experiments and clinical studies, the theoretical results were confirmed.

  9. Morphological study of atherosclerotic plaque and its application in vulnerability evaluation

    Institute of Scientific and Technical Information of China (English)

    2008-01-01

    The relationships between the morphological characteristics and the vulnerability of atherosclerotic plaque were analyzed theoretically and several suggestions were proposed to evaluate the plaque vulnerability. Validated by animal experiments and clinical studies, the theoretical results were confirmed.

  10. Three-Dimensional Carotid Plaque Progression Simulation Using Meshless Generalized Finite Difference Method Based on Multi-Year MRI Patient-Tracking Data.

    Science.gov (United States)

    Yang, Chun; Tang, Dalin; Atluri, Satya

    2010-01-01

    Cardiovascular disease (CVD) is becoming the number one cause of death worldwide. Atherosclerotic plaque rupture and progression are closely related to most severe cardiovascular syndromes such as heart attack and stroke. Mechanisms governing plaque rupture and progression are not well understood. A computational procedure based on three-dimensional meshless generalized finite difference (MGFD) method and serial magnetic resonance imaging (MRI) data was introduced to quantify patient-specific carotid atherosclerotic plaque growth functions and simulate plaque progression. Participating patients were scanned three times (T1, T2, and T3, at intervals of about 18 months) to obtain plaque progression data. Vessel wall thickness (WT) changes were used as the measure for plaque progression. Since there was insufficient data with the current technology to quantify individual plaque component growth, the whole plaque was assumed to be uniform, homogeneous, isotropic, linear, and nearly incompressible. The linear elastic model was used. The 3D plaque model was discretized and solved using a meshless generalized finite difference (GFD) method. Four growth functions with different combinations of wall thickness, stress, and neighboring point terms were introduced to predict future plaque growth based on previous time point data. Starting from the T2 plaque geometry, plaque progression was simulated by solving the solid model and adjusting wall thickness using plaque growth functions iteratively until T3 is reached. Numerically simulated plaque progression agreed very well with the target T3 plaque geometry with errors ranging from 11.56%, 6.39%, 8.24%, to 4.45%, given by the four growth functions. We believe this is the first time 3D plaque progression simulation based on multi-year patient-tracking data was reported. Serial MRI-based progression simulation adds time dimension to plaque vulnerability assessment and will improve prediction accuracy for potential plaque rupture

  11. Molecular Imaging of Vulnerable Atherosclerotic Plaques in Animal Models

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    Sara Gargiulo

    2016-09-01

    Full Text Available Atherosclerosis is characterized by intimal plaques of the arterial vessels that develop slowly and, in some cases, may undergo spontaneous rupture with subsequent heart attack or stroke. Currently, noninvasive diagnostic tools are inadequate to screen atherosclerotic lesions at high risk of acute complications. Therefore, the attention of the scientific community has been focused on the use of molecular imaging for identifying vulnerable plaques. Genetically engineered murine models such as ApoE−/− and ApoE−/−Fbn1C1039G+/− mice have been shown to be useful for testing new probes targeting biomarkers of relevant molecular processes for the characterization of vulnerable plaques, such as vascular endothelial growth factor receptor (VEGFR-1, VEGFR-2, intercellular adhesion molecule (ICAM-1, P-selectin, and integrins, and for the potential development of translational tools to identify high-risk patients who could benefit from early therapeutic interventions. This review summarizes the main animal models of vulnerable plaques, with an emphasis on genetically altered mice, and the state-of-the-art preclinical molecular imaging strategies.

  12. Molecular Imaging of Vulnerable Atherosclerotic Plaques in Animal Models

    Science.gov (United States)

    Gargiulo, Sara; Gramanzini, Matteo; Mancini, Marcello

    2016-01-01

    Atherosclerosis is characterized by intimal plaques of the arterial vessels that develop slowly and, in some cases, may undergo spontaneous rupture with subsequent heart attack or stroke. Currently, noninvasive diagnostic tools are inadequate to screen atherosclerotic lesions at high risk of acute complications. Therefore, the attention of the scientific community has been focused on the use of molecular imaging for identifying vulnerable plaques. Genetically engineered murine models such as ApoE−/− and ApoE−/−Fbn1C1039G+/− mice have been shown to be useful for testing new probes targeting biomarkers of relevant molecular processes for the characterization of vulnerable plaques, such as vascular endothelial growth factor receptor (VEGFR)-1, VEGFR-2, intercellular adhesion molecule (ICAM)-1, P-selectin, and integrins, and for the potential development of translational tools to identify high-risk patients who could benefit from early therapeutic interventions. This review summarizes the main animal models of vulnerable plaques, with an emphasis on genetically altered mice, and the state-of-the-art preclinical molecular imaging strategies. PMID:27618031

  13. Distribution of Matrix Metalloproteinases in Human Atherosclerotic Carotid Plaques and Their Production by Smooth Muscle Cells and Macrophage Subsets

    NARCIS (Netherlands)

    Jager, Nynke A.; de Vries, Bastiaan M. Wallis; Hillebrands, Jan-Luuk; Harlaar, Niels J.; Tio, Rene A.; Slart, Riemer H. J. A.; van Dam, Gooitzen M.; Boersma, Hendrikus H.; Zeebregts, Clark J.; Westra, Johanna

    In this study, the potential of matrix metalloproteinase (MMP) sense for detection of atherosclerotic plaque instability was explored. Secondly, expression of MMPs by macrophage subtypes and smooth muscle cells (SMCs) was investigated. Twenty-three consecutive plaques removed during carotid

  14. The impact of carotid plaque screening on motivation for smoking cessation.

    Science.gov (United States)

    Rodondi, Nicolas; Auer, Reto; Devine, Patrick J; O'Malley, Patrick G; Hayoz, Daniel; Cornuz, Jacques

    2008-03-01

    Showing smokers their own atherosclerotic plaques might increase motivation for smoking cessation, since they underestimate their own risk for smoking-related diseases. To assess the feasibility and optimal processes of studying the impact of carotid atherosclerotic plaque screening in smokers, we enrolled 30 daily cigarette smokers, aged 40-70 years, in an observational pre-post pilot study. All smokers underwent smoking cessation counseling, nicotine replacement therapy, a carotid ultrasound, an educational tutorial on atherosclerosis, baseline and 2-month motivation to change assessment, and assessment of smoking cessation at 2 months. Participants had a mean smoking duration of 34 years (SD = 7). Carotid plaques were present in 22 smokers (73%). Between baseline and 2 months after plaque screening, motivation for smoking cessation increased from 7.4 to 8.4 out of 10 (p = .02), particularly in those with plaques (7.2 to 8.7, p = .008). At 2 months, the smoking quit rate was 63%, with a quit rate of 73% in those with plaques vs. 38% in those without plaques (p = .10). Perceived stress, anxiety, and depression did not increase after screening. 96% of respondents answered correctly at least 80% of questions regarding atherosclerosis knowledge at baseline and after 2 months. In conclusion, studying the process of screening for carotid plaques for the purpose of increasing motivation for smoking cessation, in addition to counseling and drug therapy for smoking cessation in long-term smokers, appears feasible. The impact of carotid plaque screening on smoking cessation should be examined in larger randomized controlled trials with sufficient power to assess the impact on long-term smoking cessation rates.

  15. Color doppler ultrasonography and multislice computer tomography angiography in carotid plaque detection and characterization

    Directory of Open Access Journals (Sweden)

    Vučaj-Ćirilović Viktorija

    2011-01-01

    Full Text Available Beckground/Aim. Cerebrovascular diseases are the third leading cause of mortality in the world, following malignant and cardiovascular diseases. Therefore, their timely and precise diagnostics is of great importance. The aim of this study was to compare duplex scan Color Doppler ultrasonography (CDU with multislice computed tomography angiography (MSCTA in detection of morphological and functional disorders at extracranial level of carotid arteries. Methods. The study included 75 patients with 150 carotid arteries examined in the period from January 2008 to April 2009. The patients were firstly examined by CDU, then MSCTA, followed by the surgery of extracranial segment of carotid arteries. In 10 patients, the obtained material was referred for histopathological (HP examination. We used both CDU and MSCT in the analysis of: plaque surface, plaque structure, degree of stenosis, and the presence of intraplaque hemorrhage. Results. The results obtained by CDU and MSCTA were first compared between themselves, and then to intraoperative findings. Retrospective analysis showed that MSCTA is more sensitive than CDU in assessment of plaque surface (for smooth plaques CDU 89% : MSCTA 97%; for plaques with irregular surface CDU 75% : MSCTA 87%; for ulcerations CDU 54% : MSCTA 87%. Regarding determination of plaque structure (mixed plaque CDU 66% : MSCTA 70%; correlation with HP findings CDU 94% : MSCTA 96% and localization (CDU 63% : MSCTA 65%, and in terms of sensitivity and specificity, both methods showed almost the same results. Also, there is no statistical difference between these two methods for the degree of stenosis (CDU 96% : MSCTA 98%. Conclusion. Atherosclerotic disease of extracranial part of carotid arteries primarily affects population of middle-aged and elderly, showing more associated risk factors. Sensitivity and specificity of CDU and MSCTA regarding plaque composition, the degree of stenosis and plaque localization are almost the same

  16. Association of the sirtuin and mitochondrial uncoupling protein genes with carotid plaque.

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    Chuanhui Dong

    Full Text Available OBJECTIVE: Sirtuins (SIRTs and mitochondrial uncoupling proteins (UCPs have been implicated in cardiovascular diseases through the control of reactive oxygen species production. This study sought to investigate the association between genetic variants in the SIRT and UCP genes and carotid plaque. METHODS: In a group of 1018 stroke-free subjects from the Northern Manhattan Study with high-definition carotid ultrasonography and genotyping, we investigated the associations of 85 single nucleotide polymorphisms (SNPs in the 11 SIRT and UCP genes with the presence and number of carotid plaques, and evaluated interactions of SNPs with sex, smoking, diabetes and hypertension as well as interactions between SNPs significantly associated with carotid plaque. RESULTS: Overall, 60% of subjects had carotid plaques. After adjustment for demographic and vascular risk factors, T-carriers of the SIRT6 SNP rs107251 had an increased risk for carotid plaque (odds ratio, OR = 1.71, 95% CI = 1.23-2.37, Bonferroni-corrected p = 0.03 and for a number of plaques (rate ratio, RR = 1.31, 1.18-1.45, Bonferroni-corrected p = 1.4×10(-5, whereas T-carriers of the UCP5 SNP rs5977238 had an decreased risk for carotid plaque (OR = 0.49, 95% CI = 0.32-0.74, Bonferroni-corrected p = 0.02 and plaque number (RR = 0.64, 95% CI = 0.52-0.78, Bonferroni-corrected p = 4.9×10(-4. Some interactions with a nominal p≤0.01 were found between sex and SNPs in the UCP1 and UCP3 gene; between smoking, diabetes, hypertension and SNPs in UCP5 and SIRT5; and between SNPs in the UCP5 gene and the UCP1, SIRT1, SIRT3, SIRT5, and SIRT6 genes in association with plaque phenotypes. CONCLUSION: We observed significant associations between genetic variants in the SIRT6 and UCP5 genes and atherosclerotic plaque. We also found potential effect modifications by sex, smoking and vascular risk factors of the SIRT/UCP genes in the associations with atherosclerotic

  17. Atherosclerotic plaque component segmentation in combined carotid MRI and CTA data incorporating class label uncertainty.

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    Arna van Engelen

    Full Text Available Atherosclerotic plaque composition can indicate plaque vulnerability. We segment atherosclerotic plaque components from the carotid artery on a combination of in vivo MRI and CT-angiography (CTA data using supervised voxelwise classification. In contrast to previous studies the ground truth for training is directly obtained from 3D registration with histology for fibrous and lipid-rich necrotic tissue, and with μCT for calcification. This registration does, however, not provide accurate voxelwise correspondence. We therefore evaluate three approaches that incorporate uncertainty in the ground truth used for training: I soft labels are created by Gaussian blurring of the original binary histology segmentations to reduce weights at the boundaries between components, and are weighted by the estimated registration accuracy of the histology and in vivo imaging data (measured by overlap, II samples are weighted by the local contour distance of the lumen and outer wall between histology and in vivo data, and III 10% of each class is rejected by Gaussian outlier rejection. Classification was evaluated on the relative volumes (% of tissue type in the vessel wall for calcified, fibrous and lipid-rich necrotic tissue, using linear discriminant (LDC and support vector machine (SVM classification. In addition, the combination of MRI and CTA data was compared to using only one imaging modality. Best results were obtained by LDC and outlier rejection: the volume error per vessel was 0.9±1.0% for calcification, 12.7±7.6% for fibrous and 12.1±8.1% for necrotic tissue, with Spearman rank correlation coefficients of 0.91 (calcification, 0.80 (fibrous and 0.81 (necrotic. While segmentation using only MRI features yielded low accuracy for calcification, and segmentation using only CTA features yielded low accuracy for necrotic tissue, the combination of features from MRI and CTA gave good results for all studied components.

  18. Macrophage-targeted photodynamic detection of vulnerable atherosclerotic plaque

    Science.gov (United States)

    Hamblin, Michael R.; Tawakol, Ahmed; Castano, Ana P.; Gad, Faten; Zahra, Touqir; Ahmadi, Atosa; Stern, Jeremy; Ortel, Bernhard; Chirico, Stephanie; Shirazi, Azadeh; Syed, Sakeena; Muller, James E.

    2003-06-01

    Rupture of a vulnerable atherosclerotic plaque (VP) leading to coronary thrombosis is the chief cause of sudden cardiac death. VPs are angiographically insignificant lesions, which are excessively inflamed and characterized by dense macrophage infiltration, large necrotic lipid cores, thin fibrous caps, and paucity of smooth muscle cells. We have recently shown that chlorin(e6) conjugated with maleylated albumin can target macrophages with high selectivity via the scavenger receptor. We report the potential of this macrophage-targeted fluorescent probe to localize in VPs in a rabbit model of atherosclerosis, and allow detection and/or diagnosis by fluorescence spectroscopy or imaging. Atherosclerotic lesions were induced in New Zealand White rabbit aortas by balloon injury followed by administration of a high-fat diet. 24-hours after IV injection of the conjugate into atherosclerotic or normal rabbits, the animals were sacrificed, and aortas were removed, dissected and examined for fluorescence localization in plaques by fiber-based spectrofluorimetry and confocal microscopy. Dye uptake within the aortas was also quantified by fluorescence extraction of samples from aorta segments. Biodistribution of the dye was studied in many organs of the rabbits. Surface spectrofluorimetry after conjugate injection was able to distinguish between plaque and adjacent aorta, between atherosclerotic and normal aorta, and balloon-injured and normal iliac arteries with high significance. Discrete areas of high fluorescence (up to 20 times control were detected in the balloon-injured segments, presumably corresponding to macrophage-rich plaques. Confocal microscopy showed red ce6 fluorescence localized in plaques that showed abundant foam cells and macrophages by histology. Extraction data on aortic tissue corroborated the selectivity of the conjugate for plaques. These data support the strategy of employing macrophage-targeted fluorescent dyes to detect VP by intravascular

  19. The use of Speckle Reduction Imaging (SRI) Ultrasound in the characterization of carotid artery plaques

    Energy Technology Data Exchange (ETDEWEB)

    Liasis, Nikolaos [1st Department of Surgery, Vascular Division, ' LAIKON' Hospital, Athens University Medical School (Greece)], E-mail: nliasis@forthnet.gr; Klonaris, Chris [1st Department of Surgery, Vascular Division, ' LAIKON' Hospital, Athens University Medical School (Greece)], E-mail: chris_klonaris@yahoo.com; Katsargyris, Athanasios [1st Department of Surgery, Vascular Division, ' LAIKON' Hospital, Athens University Medical School (Greece)], E-mail: kthanassos@yahoo.com; Georgopoulos, Sotirios [1st Department of Surgery, Vascular Division, ' LAIKON' Hospital, Athens University Medical School (Greece)], E-mail: sgeorg@med.uoa.gr; Labropoulos, Nicos [Division of Vascular Surgery, University of Medicine and Dentistry of New Jersey, Newark (United States)], E-mail: nlabrop@yahoo.com; Tsigris, Chris [1st Department of Surgery, Vascular Division, ' LAIKON' Hospital, Athens University Medical School (Greece)], E-mail: ctsigris@yahoo.com; Giannopoulos, Athanasios [1st Department of Surgery, Vascular Division, ' LAIKON' Hospital, Athens University Medical School (Greece)], E-mail: dimitrak@mohaw.gr; Bastounis, Elias [1st Department of Surgery, Vascular Division, ' LAIKON' Hospital, Athens University Medical School (Greece)], E-mail: ebastoun@med.uoa.gr

    2008-03-15

    Background and purpose: Speckle Reduction Imaging is a new algorithm that improves the image quality of B-mode scanning by reducing the reverberation artifacts. In the present study the value of this method for the characterization of atherosclerotic plaques in the internal carotid artery was investigated. Methods: Two hundred and twenty two patients (161 men, 61 women; mean age 73 years) referred for carotid ultrasound evaluation were included in the study. Patients with plaques of the internal carotid artery as identified by conventional B-mode scanning were investigated also with the addition of Speckle Reduction Imaging (SRI) with the use of a 4-11-MHz wide band linear transducer. Plaque morphology was rated according to a standardized protocol by two independent observers. Results: For the determination of plaque echogenicity, the reproducibility of SRI ({kappa} = 0.83) was higher than that of conventional B-mode ultrasound ({kappa} = 0.68). The interobserver agreement for plaque surface characterization was also higher for SRI ({kappa} = 0.8) than for conventional B-mode ({kappa} = 0.61). At the evaluation of the image quality through a semiquantitative analysis, SRI was rated superior in the plaque texture resolution, plaque borders determination, vessel wall demarcation and fibrous cap depiction. In addition, the level of 'speckle' was reduced with the use of SRI. Conclusions: SRI is a technique that shows good general agreement with high-resolution B-mode and can be used for the characterization of atherosclerotic plaques in the carotid artery. Furthermore, because this advanced technique allows reduction of ultrasound artifacts, it improves the image quality allowing more precise visualization of plaque morphological details.

  20. Novel methodology for 3D reconstruction of carotid arteries and plaque characterization based upon magnetic resonance imaging carotid angiography data.

    Science.gov (United States)

    Sakellarios, Antonis I; Stefanou, Kostas; Siogkas, Panagiotis; Tsakanikas, Vasilis D; Bourantas, Christos V; Athanasiou, Lambros; Exarchos, Themis P; Fotiou, Evangelos; Naka, Katerina K; Papafaklis, Michail I; Patterson, Andrew J; Young, Victoria E L; Gillard, Jonathan H; Michalis, Lampros K; Fotiadis, Dimitrios I

    2012-10-01

    In this study, we present a novel methodology that allows reliable segmentation of the magnetic resonance images (MRIs) for accurate fully automated three-dimensional (3D) reconstruction of the carotid arteries and semiautomated characterization of plaque type. Our approach uses active contours to detect the luminal borders in the time-of-flight images and the outer vessel wall borders in the T(1)-weighted images. The methodology incorporates the connecting components theory for the automated identification of the bifurcation region and a knowledge-based algorithm for the accurate characterization of the plaque components. The proposed segmentation method was validated in randomly selected MRI frames analyzed offline by two expert observers. The interobserver variability of the method for the lumen and outer vessel wall was -1.60%±6.70% and 0.56%±6.28%, respectively, while the Williams Index for all metrics was close to unity. The methodology implemented to identify the composition of the plaque was also validated in 591 images acquired from 24 patients. The obtained Cohen's k was 0.68 (0.60-0.76) for lipid plaques, while the time needed to process an MRI sequence for 3D reconstruction was only 30 s. The obtained results indicate that the proposed methodology allows reliable and automated detection of the luminal and vessel wall borders and fast and accurate characterization of plaque type in carotid MRI sequences. These features render the currently presented methodology a useful tool in the clinical and research arena.

  1. Association of circulating omentin-1 level with arterial stiffness and carotid plaque in type 2 diabetes

    Directory of Open Access Journals (Sweden)

    Yoo Hye

    2011-11-01

    Full Text Available Abstract Background Adipokines contribute directly to the atherosclerotic process, connecting metabolic disorders such as obesity and diabetes to cardiovascular disease. Omentin-1 is a recently discovered novel adipokine, so data about the relationship of this adipokine to vascular health in type 2 diabetes is limited. Methods We enrolled 60 people with type 2 diabetes, with or without carotid plaque, and 30 participants with normal glucose tolerance. We measured serum omentin-1, high-sensitivity C-reactive protein (hsCRP levels, and the homeostasis model assessment of insulin resistance (HOMA-IR, as well as other cardiovascular risk factors. Vascular health was assessed by brachial ankle pulse wave velocity (baPWV and carotid intima-media thickness (IMT. Results Serum omentin-1 levels were significantly decreased in type 2 diabetes patients compared to normal glucose controls and was further reduced in type 2 diabetes patients with carotid plaque compared to those without carotid plaque. Multiple stepwise regression analysis showed that age, systolic blood pressure, history of use of statins, angiotensin receptor blockers or angiotensin-converting enzyme inhibitors, and serum omentin-1 level were independent factors determining baPWV in people with type 2 diabetes (r2 = 0.637. Furthermore, in multivariate logistic regression analysis, circulating omentin-1 level was an independent decisive factor for the presence of carotid plaque in type 2 diabetes patients, even after adjusting for age, gender, body mass index, systolic blood pressure, fasting blood glucose, low density lipoprotein cholesterol, and history of smoking and medication (odds ratio, 0.621; 95% confidence interval, 0.420-0.919; P = 0.017. Conclusions Circulating omentin-1 level was independently correlated with arterial stiffness and carotid plaque in type 2 diabetes, even after adjusting for other cardiovascular risk factors and detailed medication history.

  2. Altered carotid plaque signal among different repetition times on T1-weighted magnetic resonance plaque imaging with self-navigated radial-scan technique

    Energy Technology Data Exchange (ETDEWEB)

    Narumi, Shinsuke; Ohba, Hideki; Mori, Kiyofumi; Ohura, Kazumasa; Ono, Ayumi; Terayama, Yasuo [Iwate Medical University, Department of Neurology and Gerontology, Morioka (Japan); Sasaki, Makoto [Iwate Medical University, Advanced Medical Research Center, Morioka (Japan); Ogasawara, Kuniaki [Iwate Medical University, Department of Neurosurgery, Morioka (Japan); Hitomi, Jiro [Iwate Medical University, Department of Anatomy, Morioka (Japan)

    2010-04-15

    Magnetic resonance (MR) plaque imaging for carotid arteries is usually performed by using an electrocardiograph (ECG)-gating technique to eliminate pulsation-related artifacts, which can affect the plaque signals because of varied repetition time (TR) among patients. Hence, we investigated whether differences in TR causes signal alterations of the carotid plaque by using a non-gated plaque imaging technique. We prospectively examined 19 patients with carotid stenosis by using a T1-weighted self-navigated radial-scan technique with TRs of 500, 700, and 900 ms. The signal intensity of the carotid plaque was measured, and the contrast ratio (CR) relative to the adjacent muscle was calculated. CRs of the carotid plaques were 1.39 {+-} 0.39, 1.29 {+-} 0.29, and 1.23 {+-} 0.24 with TRs of 500, 700, and 900 ms, respectively, and were significantly different. Among the plaques, those with a hyperintensity signal (CR > 1.5) and moderate-intensity signal (CR 1.2-1.5) at 500 ms showed a TR-dependent signal decrease (hyperintensity plaques, 1.82 {+-} 0.26; 1.61 {+-} 0.19; and 1.48 {+-} 0.17; moderate-intensity plaques, 1.33 {+-} 0.08; 1.26 {+-} 0.08; and 1.19 {+-} 0.07), while those with an isointensity signal (CR < 1.2) remained unchanged regardless of TR (0.96 {+-} 0.12, 0.96 {+-} 0.11, and 0.97 {+-} 0.13). The signal intensity of the carotid plaque on T1-weighted imaging significantly varies among different TRs and tends to decrease with longer TR. MR plaque imaging with short and constant TR settings that the ECG-gating method cannot realize would be preferable for evaluating plaque characteristics. (orig.)

  3. Relation of cholesterol and lipoprotein parameters with carotid artery plaque characteristics: the Atherosclerosis Risk in Communities (ARIC) carotid MRI study.

    Science.gov (United States)

    Virani, Salim S; Catellier, Diane J; Pompeii, Lisa A; Nambi, Vijay; Hoogeveen, Ron C; Wasserman, Bruce A; Coresh, Josef; Mosley, Thomas H; Otvos, James D; Sharrett, A Richey; Boerwinkle, Eric; Ballantyne, Christie M

    2011-12-01

    There is a paucity of data regarding relations of apolipoproteins (apolipoprotein B [ApoB] and apolipoprotein A-1 [Apo A-1]), lipoprotein particle measures (low-density lipoprotein particle concentration [LDLp] and high-density lipoprotein particle concentration [HDLp]), and lipoprotein cholesterol measures (low-density lipoprotein cholesterol [LDL-C], non-high-density lipoprotein cholesterol [non-HDL-C], and high-density lipoprotein cholesterol [HDL-C]) with atherosclerotic plaque burden, plaque eccentricity, and lipid-rich core presence as a marker of high-risk plaques. Carotid artery magnetic resonance imaging was performed in 1670 Atherosclerosis Risk in Communities study participants. Vessel wall and lipid cores were measured; normalized wall index (NWI), standard deviation (SD) of wall thickness (measure of plaque eccentricity) were calculated; and lipid cores were detected in vessels with ≥ 1.5mm thickness. Fasting concentrations of cholesterol, ApoB and Apo A-1, and LDLp and HDLp were measured. Measures of plaque burden (carotid wall volume, wall thickness, and NWI) were positively associated with atherogenic cholesterol and lipoproteins (p < 0.05 for total cholesterol, LDL-C, non-HDL-C, ApoB, and LDLp), but not with HDL-C, Apo A-1, or HDLp. SD of wall thickness was associated with total cholesterol (p 0.01) and non-HDL-C (p 0.02). Although measures of atherogenic or anti-atherogenic cholesterol or lipoprotein were not individually associated with detection of a lipid-rich core, their ratios (total cholesterol/HDL-C, non-HDL-C/HDL-C, and LDLp/HDLp) were associated with lipid-rich core presence (p ≤ 0.05). Extent of carotid atherosclerosis is associated with atherogenic cholesterol and lipoproteins. Atherogenic/anti-atherogenic cholesterol or particle ratios were associated with presence of a detectable lipid-rich core. Published by Elsevier Ireland Ltd.

  4. When to image carotid plaque inflammation with FDG PET/CT

    DEFF Research Database (Denmark)

    Græbe, Martin; Borgwardt, Lise; Højgaard, Liselotte

    2010-01-01

    Quantification of 18-fluorodeoxyglucose (FDG) uptake in inflamed high-risk carotid atherosclerotic plaques is challenged by the spatial resolution of positron emission tomography (PET) and luminal blood activity. Late acquisition protocols have been used to overcome these challenges to enhance...... the contrast between the plaque and blood-pool FDG activity. However, for prospective studies the late acquisition is inconvenient for the patient and staff, and most retrospective studies of plaque uptake use data from early acquisition protocols. The objective was to evaluate changes in the quantification...

  5. Numerical analysis of the hemodynamic effect of plaque ulceration in the stenotic carotid artery bifurcation

    Science.gov (United States)

    Wong, Emily Y.; Milner, Jaques S.; Steinman, David A.; Poepping, Tamie L.; Holdsworth, David W.

    2009-02-01

    The presence of ulceration in carotid artery plaque is an independent risk factor for thromboembolic stroke. However, the associated pathophysiological mechanisms - in particular the mechanisms related to the local hemodynamics in the carotid artery bifurcation - are not well understood. We investigated the effect of carotid plaque ulceration on the local time-varying three-dimensional flow field using computational fluid dynamics (CFD) models of a stenosed carotid bifurcation geometry, with and without the presence of ulceration. CFD analysis of each model was performed with a spatial finite element discretization of over 150,000 quadratic tetrahedral elements and a temporal discretization of 4800 timesteps per cardiac cycle, to adequately resolve the flow field and pulsatile flow, respectively. Pulsatile flow simulations were iterated for five cardiac cycles to allow for cycle-to-cycle analysis following the damping of initial transients in the solution. Comparison between models revealed differences in flow patterns induced by flow exiting from the region of the ulcer cavity, in particular, to the shape, orientation and helicity of the high velocity jet through the stenosis. The stenotic jet in both models exhibited oscillatory motion, but produced higher levels of phase-ensembled turbulence intensity in the ulcerated model. In addition, enhanced out-of-plane recirculation and helical flow was observed in the ulcerated model. These preliminary results suggest that local fluid behaviour may contribute to the thrombogenic risk associated with plaque ulcerations in the stenotic carotid artery bifurcation.

  6. When to image carotid plaque inflammation with FDG PET/CT

    DEFF Research Database (Denmark)

    Græbe, Martin; Borgwardt, Lise; Højgaard, Liselotte

    2010-01-01

    Quantification of 18-fluorodeoxyglucose (FDG) uptake in inflamed high-risk carotid atherosclerotic plaques is challenged by the spatial resolution of positron emission tomography (PET) and luminal blood activity. Late acquisition protocols have been used to overcome these challenges to enhance...

  7. Appropriateness of carotid plaque and intima-media thickness assessment in routine clinical practice

    Directory of Open Access Journals (Sweden)

    Alessi Alexandre

    2008-10-01

    Full Text Available Abstract Objectives To describe the findings and evaluate appropriateness of a carotid artery study including the measurement of IMT, the presence of atherosclerotic plaque, and their correlation with cardiovascular risk factors. Methods 555 patients (220 men; 67.06 ± 12.44 years were included in the study. 120 patients (21.62% presented carotid plaque: 108 (19.45% in patients with at least one risk factor and 12 (2.1% in patients without risk factors. With respect to appropriateness of the present studies: 65% were appropriate, 22% were uncertain and 13% were inappropriate. The IMT medians were higher in males (0.0280; 95% CI, 00.82 to 0.478; p = 0.0057 and in hypertensive patients (0.391; 95% CI, 0.0190 to 0.0592; p = 0,001. There was a linear increase in mean IMT for each year increased in age (0.0059; 95% CI; 0.0050 to 0.0067. Carotid plaque was more frequent in patients with CAD (p = 0.0002, diabetes (p = 0.024 and hypertension (p = 0.036. Conclusion Assessment of carotid arteries identified increased incidence of plaque in patients with CAD, diabetes and hypertension. IMT was increased in older patients, hypertensive patients and males. Forty-five percent of the patients were studied based on uncertain and inappropriate reasons.

  8. Impact of ideal health behaviors and health factors on the detection rate of the carotid plaques

    Institute of Scientific and Technical Information of China (English)

    高竞生

    2013-01-01

    Objective To explore the impact of ideal health behaviors and health factors on the detection rate of the carotid plaques. Methods Subjects with previous stroke,TIA,myocardial infarction were excluded from the study.A total of 5 852 employees(active and retired employers

  9. Atherosclerotic plaque fibrous cap assessment under an oblique scan plane orientation in carotid MRI

    NARCIS (Netherlands)

    Nieuwstadt, H.A.; Van der Lugt, A.; Kassar, Z.A.M.; Breeuwer, M.; Van der Steen, A.F.W.; Gijsen, F.J.H.

    2014-01-01

    Carotid magnetic resonance imaging (MRI) is used to noninvasively assess atherosclerotic plaque fibrous cap (FC) status, which is closely related to ischemic stroke. Acquiring anisotropic voxels improves in-plane visualization, however, an oblique scan plane orientation could then obscure a FC (i.e.

  10. Multi-scale AM-FM motion analysis of ultrasound videos of carotid artery plaques

    Science.gov (United States)

    Murillo, Sergio; Murray, Victor; Loizou, C. P.; Pattichis, C. S.; Pattichis, Marios; Barriga, E. Simon

    2012-03-01

    An estimated 82 million American adults have one or more type of cardiovascular diseases (CVD). CVD is the leading cause of death (1 of every 3 deaths) in the United States. When considered separately from other CVDs, stroke ranks third among all causes of death behind diseases of the heart and cancer. Stroke accounts for 1 out of every 18 deaths and is the leading cause of serious long-term disability in the United States. Motion estimation of ultrasound videos (US) of carotid artery (CA) plaques provides important information regarding plaque deformation that should be considered for distinguishing between symptomatic and asymptomatic plaques. In this paper, we present the development of verifiable methods for the estimation of plaque motion. Our methodology is tested on a set of 34 (5 symptomatic and 29 asymptomatic) ultrasound videos of carotid artery plaques. Plaque and wall motion analysis provides information about plaque instability and is used in an attempt to differentiate between symptomatic and asymptomatic cases. The final goal for motion estimation and analysis is to identify pathological conditions that can be detected from motion changes due to changes in tissue stiffness.

  11. Discordant Lipid Pattern and Carotid Atherosclerotic Plaque. Importance of Remnant Cholesterol

    Science.gov (United States)

    Masson, Walter; Lobo, Martín; Molinero, Graciela; Siniawski, Daniel

    2017-01-01

    Background: Subjects with levels of non-HDL-C 30 mg/dL above those of LDL-C (lipid discordance) or with high remnant cholesterol levels could have a greater residual cardiovascular risk. Objectives: To determine the prevalence of lipid discordance in a primary prevention population and analyze the clinical variables associated with it;To investigate the association between lipid discordance and remnant cholesterol with the presence of carotid plaque. Methods: Primary prevention patients without diabetes or lipid-lowering therapy were included. Regardless of the LDL-C level, we define “lipid discordance” if the non-HDL-C value exceeded 30 mg/dL that of LDL-C. Remnant cholesterol was calculated as total cholesterol minus HDL-C minus LDL-C when triglycerides were < 4.0 mmol/L. Ultrasound was used to assess carotid plaque occurrence. Multiple regression logistic models were performed. Results: The study included 772 patients (mean age 52 ± 11 years, 66% women). The prevalence of lipid discordance was 34%. Male sex and body mass index were independently associated with discordant lipid pattern. The prevalence of carotid plaque was higher in subjects with lipid discordance (40.2% vs. 29.2, p = 0.002). The multivariate analysis showed that the discordant lipid pattern was associated with the greater probability of carotid plaque (OR 1.58, 95% CI 1.08-2.34, p = 0.02). Similarly, a significant association between calculated remnant cholesterol and carotid plaque was found. Conclusion: Lipid discordance and presence of a higher level of calculated remnant cholesterol are associated with subclinical atherosclerosis. Our findings could be used to improve the residual cardiovascular risk evaluation. PMID:28699976

  12. Effect of coronary heart disease combined with hyperhomocysteinemia on carotid plaque features and stroke

    Institute of Scientific and Technical Information of China (English)

    Ya-Ling Ning; Gang Tian

    2016-01-01

    Objective:To analyze the effect of coronary heart disease combined with hyperhomocysteinemia on carotid plaque features and stroke.Methods:A total of 110 patients with coronary heart disease treated from May 2011 to May 2012 were selected for study, and according to the levels of plasma homocysteine (Hcy), they were divided into high Hcy groups (plasma Hcy ≥10 μmol/L) and normal Hcy group (plasma Hcy <10 μmol/L). Carotid ultrasonography was conducted and the plaque features were assessed, plasma levels of plaque stability-related molecules, lipid metabolism indexes and inflammatory mediators of two groups were detected, and the incidence of stroke were followed up for 3 years.Results: The number of instable carotid plaques of high Hcy group was more than that of normal Hcy group, and carotid intima-media thickness was higher than that of normal Hcy group; plasma TG, TC, LDL-C, PAPP-A, OPN, PTX3, ANGPTL4, MMP7, MMP9, IL-6, IL-8, TNF-α and MCP-1 levels of high Hcy group were significantly higher than those of normal Hcy group, HDL-C, IL-10, IL-13, TGFβ and IL-4 levels were significantly lower than those of normal Hcy group, and plasma ApoA and ApoB levels were not statistically different from those of normal Hcy group; 3 years of follow-up showed that the incidence of stroke of high Hcy group on the 1st year, 2nd year and 3rd year were higher than those of normal Hcy group.Conclusions:Carotid plaque instability increases, and the risk of long-term stroke is higher in coronary heart disease patients with hyperhomocysteinemia.

  13. RNAseq based transcriptomics study of SMCs from carotid atherosclerotic plaque: BMP2 and IDs proteins are crucial regulators of plaque stability.

    Science.gov (United States)

    Alloza, Iraide; Goikuria, Haize; Idro, Juan Luis; Triviño, Juan Carlos; Fernández Velasco, José María; Elizagaray, Elena; García-Barcina, María; Montoya-Murillo, Genoveva; Sarasola, Esther; Vega Manrique, Reyes; Freijo, Maria Del Mar; Vandenbroeck, Koen

    2017-06-14

    Carotid artery atherosclerosis is a risk factor to develop cerebrovascular disease. Atheroma plaque can become instable and provoke a cerebrovascular event or else remain stable as asymptomatic type. The exact mechanism involved in plaque destabilization is not known but includes among other events smooth muscle cell (SMC) differentiation. The goal of this study was to perform thorough analysis of gene expression differences in SMCs isolated from carotid symptomatic versus asymptomatic plaques. Comparative transcriptomics analysis of SMCs based on RNAseq technology identified 67 significant differentially expressed genes and 143 significant differentially expressed isoforms in symptomatic SMCs compared with asymptomatic. 37 of top-scoring genes were further validated by digital PCR. Enrichment and network analysis shows that the gene expression pattern of SMCs from stable asymptomatic plaques is suggestive for an osteogenic phenotype, while that of SMCs from unstable symptomatic plaque correlates with a senescence-like phenotype. Osteogenic-like phenotype SMCs may positively affect carotid atheroma plaque through participation in plaque stabilization via bone formation processes. On the other hand, plaques containing senescence-like phenotype SMCs may be more prone to rupture. Our results substantiate an important role of SMCs in carotid atheroma plaque disruption.

  14. Motion compensation method using dynamic programming for quantification of neovascularization in carotid atherosclerotic plaques with contrast enhanced ultrasound (CEUS)

    Science.gov (United States)

    Akkus, Zeynettin; Hoogi, Assaf; Renaud, Guillaume; ten Kate, Gerrit L.; van den Oord, Stijn C. H.; Schinkel, Arend F. L.; de Jong, Nico; van der Steen, Antonius F. W.; Bosch, Johan G.

    2012-03-01

    Intraplaque neovascularization (IPN) has been linked with progressive atherosclerotic disease and plaque instability in several studies. Quantification of IPN may allow early detection of vulnerable plaques. A dedicated motion compensation method with normalized-cross-correlation (NCC) block matching combined with multidimensional (2D+time) dynamic programming (MDP) was developed for quantification of IPN in small plaques (images of carotid arteries were acquired by a Philips iU22 system with a L9-3 linear array probe. The motion pattern for the plaque region was obtained from the Bmode images with MDP. MDP results were evaluated in-vitro by a phantom and in-vivo by comparing to manual tracking of three experts for multibeat-image-sequences (MIS) of 11 plaques. In the in-vivo images, the absolute error was 72+/-55μm (mean+/-SD) for X (longitudinal) and 34+/-23μm for Y (radial). The method's success rate was visually assessed on 67 MIS. The tracking was considered failed if it deviated >2 pixels (~200μm) from true motion in any frame. Tracking was scored as fully successful in 63 MIS (94%) for MDP vs. 52(78%) for FT. The range of displacement over these 63 was 1045+/-471μm (X) and 395+/-216μm (Y). The tracking sporadically failed in 4 MIS (6%) due to poor image quality, jugular vein proximity and out-of-plane motion. Motion compensation showed improved lumen-plaque contrast separation. In conclusion, the proposed method is sufficiently accurate and successful for in vivo application.

  15. Fibrinolysis inhibitors in plaque stability: a morphological association of PAI-1 and TAFI in advanced carotid plaque.

    Science.gov (United States)

    Jönsson Rylander, A-C; Lindgren, A; Deinum, J; Bergström, G M L; Böttcher, G; Kalies, I; Wåhlander, K

    2017-01-30

    Essentials Fibrinolysis inhibitors are localized in advanced atheroma by immunohistology of endarterectomies. Neovascular endothelium/neocapillaries show thrombin-activatable fibrinolysis inhibitor (TAFI). Macrophage areas show free plasminogen activator inhibitor (PAI-1), notably in the vulnerable part. Free PAI-1 and TAFI stabilize active plaque area by inhibition of fibrinolysis and inflammation.

  16. The risk factors associated with ultrasonic tissue characterization of carotid plaque in type 2 diabetic patients.

    Science.gov (United States)

    Irie, Yoko; Katakami, Naoto; Kaneto, Hideaki; Takahara, Mitsuyoshi; Sakamoto, Ken'ya; Kosugi, Keisuke; Shimomura, Iichiro

    2014-01-01

    Little is known about the related factors of plaque echogenicity in diabetic subjects. This was a single-center, retrospective, study investigating a subgroup of patients of a previously published trial. We enrolled 179 middle-aged and older Japanese type 2 diabetic patients with carotid plaque, and examined the parameters related with echogenicity of carotid plaque evaluated by gray-scale median (GSM). Proportion of males and body mass index (BMI) were significantly higher and HDL-cholesterol was significantly lower in the patients with low GSM (HDL-cholesterol as independent variables and the presence of low GSM plaques as an objective variable showed that male (odds ratio (OR) 2.36, 95%CI 1.05-5.31, p = 0.037) and BMI (OR 1.12 [1.01-1.24], p = 0.029) were independently associated with low GSM plaques. Another multiple logistic regression analysis with gender, BMI, and low-HDL-cholesterolemia (HDL-C HDL-cholesterolemia (OR 2.30 [1.03-5.13], p = 0.042) and BMI (OR 1.11 [1.00-1.22], p = 0.046) were independently associated with low GSM plaques. Our study suggests that gender, BMI and low-HDL-cholesterol are important determinants of the content of the vascular wall in diabetic subjects. Copyright © 2014 Elsevier Inc. All rights reserved.

  17. Improved correlation between carotid and coronary atherosclerosis SYNTAX score using automated ultrasound carotid bulb plaque IMT measurement.

    Science.gov (United States)

    Ikeda, Nobutaka; Gupta, Ajay; Dey, Nilanjan; Bose, Soumyo; Shafique, Shoaib; Arak, Tadashi; Godia, Elisa Cuadrado; Saba, Luca; Laird, John R; Nicolaides, Andrew; Suri, Jasjit S

    2015-05-01

    Described here is a detailed novel pilot study on whether the SYNTAX (Synergy between percutaneous coronary intervention with TAXUS and cardiac surgery) score, a measure of coronary artery disease complexity, could be better predicted with carotid intima-media thickness (cIMT) measures using automated IMT all along the common carotid and bulb plaque compared with manual IMT determined by sonographers. Three hundred seventy consecutive patients who underwent carotid ultrasound and coronary angiography were analyzed. SYNTAX score was determined from coronary angiograms by two experienced interventional cardiologists. Unlike most methods of cIMT measurement commonly used by sonographers, our method involves a computerized automated cIMT measurement all along the carotid artery that includes the bulb region and the region proximal to the bulb (under the class of AtheroEdge systems from AtheroPoint, Roseville, CA, USA). In this study, the correlation between automated cIMT that includes bulb plaque and SYNTAX score was found to be 0.467 (p SYNTAX score. The correlation between the automated cIMT and the sonographer's IMT was 0.882. When compared against the radiologist's manual tracings, automated cIMT system performance had a lumen-intima error of 0.007818 ± 0.0071 mm, media-adventitia error of 0.0179 ± 0.0125 mm and automated cIMT error of 0.0099 ± 0.00988 mm. The precision of automated cIMT against the manual radiologist's reading was 98.86%. This current automated algorithm revealed a significantly stronger correlation between cIMT and coronary SYNTAX score as compared with the sonographer's cIMT measurements with multiple cardiovascular risk factors. We benchmarked our correlation between the automated cIMT that includes bulb plaque and SYNTAX score against a previously published (Ikeda et al. 2013) AtheroEdgeLink (AtheroPoint) correlation between the automated cIMT that does not include bulb plaque and SYNTAX score and had an improvement of 44.58%. By sampling

  18. Significance of ultrasound evaluation of carotid atherosclerotic plaque for diagnosing ischemic cerebrovascular disease

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

    BACKGROUND: Carotid artery is the main source for craniocerebral blood supply. Its intimal plaque formation and arterial stenosis degree both are the risk factors for ischemic cerebrovascular disease.Therefore, the close relationship of carotid atherosclerotic plaque and ischemic cerebrovascular disease, and ultrasound evaluation of carotid atherosclerotic plaque have become the hot spot in studying ischemic cerebrovascular disease.OBJECTIVE: This study was to detect the degree of carotid atherosclerosis of ischemic cerebrovascular disease patients by ultrasonography, and to analyze the situation of carotid atherosclerosis and its relationship with clinic.DESIGN: Clinical randomized concurrent control experiment.SETTING: Lintong Convalescent Hospital of Lanzhou Military Area Command of Chinese PLA.PARTICIPANTS: Totally 60 outpatients and inpatients with ischemic cerebrovascular disease, 42 males and 18 females, admitted to Lintong Convalescent Hospital of Lanzhou Military Area Command of Chinese PLA between January 2006 and December 2006 were involved in the patient group. They met the diagnosis criteria of ischemic cerebrovascular disease constituted by the 4th Cerebrovascular Disease Conference in 1996, and were confirmed to suffer from ischemic cerebrovascular disease by skull CT and MRI. Another 20 subjects who received healthy examination concurrently in the same hospital, 12 males and 8 females, were involved in the control group. Informed consents of detected items were obtained from involved subjects.METHODS: The plaque thickness of mid portion, distal end and crotch of common carotid artery (CCA),internal carotid artery (ICA), external carotid artery (ECA) and vertebral artery (VA) of involved subjects,who received health examination was separately detected with color Doppler ultrasonograph (HDI-5000).Then, total integral of plaque was calculated. The intima-media thickness (IMT) was measured with two-dimensional ultrasonography. The inner diameter

  19. Volumetric Analysis of Carotid Plaque Components and Cerebral Microbleeds: A Correlative Study.

    Science.gov (United States)

    Saba, Luca; Sanfilippo, Roberto; di Martino, Michele; Porcu, Michele; Montisci, Roberto; Lucatelli, Pierleone; Anzidei, Michele; Francone, Marco; Suri, Jasjit S

    2017-03-01

    The purpose of this work was to explore the association between carotid plaque volume (total and the subcomponents) and cerebral microbleeds (CMBs). Seventy-two consecutive (male 53; median age 64) patients were retrospectively analyzed. Carotid arteries were studied by using a 16-detector-row computed tomography scanner whereas brain was explored with a 1.5 Tesla system. CMBs were studied using a T2*-weighted gradient-recalled echo sequence. CMBs were classified as from absent (grade 1) to severe (grade 4). Component types of the carotid plaque were defined according to the following Hounsfield unit (HU) ranges: lipid less than 60 HU; fibrous tissue from 60 to 130 HU; calcification greater than 130 HU, and plaque volumes of each component were calculated. Each carotid artery was analyzed by 2 observers. The prevalence of CMBs was 35.3%. A statistically significant difference was observed between symptomatic (40%) and asymptomatic (11%) patients (P value = .001; OR = 6.07). Linear regression analysis demonstrated an association between the number of CMBs and the symptoms (P = .0018). Receiver operating characteristics curve analysis found an association between the carotid plaque subcomponents and CMBs (Az = .608, .621, and .615 for calcified, lipid, and mixed components, respectively), and Mann-Whitney test confirmed this association in particular for the lipid components (P value = .0267). Results of this study confirm the association between CMBs and symptoms and that there is an increased number of CMBs in symptomatic patients. Moreover, we found that an increased volume of the fatty component is associated with the presence and number of CMBs. Copyright © 2017 National Stroke Association. Published by Elsevier Inc. All rights reserved.

  20. Lumen irregularity dominates the relationship between mechanical stress condition, fibrous-cap thickness, and lumen curvature in carotid atherosclerotic plaque.

    Science.gov (United States)

    Teng, Zhongzhao; Sadat, Umar; Ji, Guangyu; Zhu, Chengcheng; Young, Victoria E; Graves, Martin J; Gillard, Jonathan H

    2011-03-01

    High mechanical stress condition over the fibrous cap (FC) has been widely accepted as a contributor to plaque rupture. The relationships between the stress, lumen curvature, and FC thickness have not been explored in detail. In this study, we investigate lumen irregularity-dependent relationships between mechanical stress conditions, local FC thickness (LT(FC)), and lumen curvature (LC(lumen)). Magnetic resonance imaging slices of carotid plaque from 100 patients with delineated atherosclerotic components were used. Two-dimensional structure-only finite element simulations were performed for the mechanical analysis, and maximum principal stress (stress-P₁) at all integral nodes along the lumen was obtained. LT(FC) and LC(lumen) were computed using the segmented contour. The lumen irregularity (L-δir) was defined as the difference between the largest and the smallest lumen curvature. The results indicated that the relationship between stress-P₁, LT(FC), and LC(lumen) is largely dependent on L-δir. When L-δir ≥ .31 (irregular lumen), stress-P₁ strongly correlated with lumen curvature and had a weak/no correlation with local FC thickness, and in 73.4% of magnetic resonance (MR) slices, the critical stress (maximum of stress-P₁ over the diseased region) was found at the site where the lumen curvature was large. When L-δir ≤ 0.28 (relatively round lumen), stress-P₁ showed a strong correlation with local FC thickness but weak/no correlation with lumen curvature, and in 71.7% of MR slices, the critical stress was located at the site of minimum FC thickness. Using lumen irregularity as a method of identifying vulnerable plaque sites by referring to the lumen shape is a novel and simple method, which can be used for mechanics-based plaque vulnerability assessment.

  1. Quantitative assessment of changes in carotid plaques during cilostazol administration using three-dimensional ultrasonography and non-gated magnetic resonance plaque imaging

    Energy Technology Data Exchange (ETDEWEB)

    Yamaguchi, Mao; Ohba, Hideki; Mori, Kiyofumi; Narumi, Shinsuke; Katsura, Noriyuki; Ohura, Kazumasa; Terayama, Yasuo [Iwate Medical University, Department of Neurology and Gerontology, Morioka (Japan); Sasaki, Makoto; Kudo, Kohsuke [Iwate Medical University, Division of Ultrahigh Field MRI, Institute for Biomedical Sciences, Morioka (Japan)

    2012-09-15

    Cilostazol, an antiplatelet agent, is reported to induce the regression of atherosclerotic changes. However, its effects on carotid plaques are unknown. Hence, we quantitatively investigated the changes that occur within carotid plaques during cilostazol administration using three-dimensional (3D) ultrasonography (US) and non-gated magnetic resonance (MR) plaque imaging. We prospectively examined 16 consecutive patients with carotid stenosis. 3D-US and T1-weighted MR plaque imaging were performed at baseline and 6 months after initiating cilostazol therapy (200 mg/day). We measured the volume and grayscale median (GSM) of the plaques from 3D-US data. We also calculated the contrast ratio (CR) of the carotid plaque against the adjacent muscle and areas of the intraplaque components: fibrous tissue, lipid, and hemorrhage components. The plaque volume on US decreased significantly (median at baseline and 6 months, 0.23 and 0.21 cm{sup 3}, respectively; p = 0.03). In the group exhibiting a plaque volume reduction of more than 10%, GSM on US increased significantly (24.8 and 71.5, respectively; p = 0.04) and CR on MRI decreased significantly (1.13 and 1.04, respectively; p = 0.02). In this group, in addition, the percent area of the fibrous component on MRI increased significantly (68.6% and 79.4%, respectively; p = 0.02), while those of the lipid and hemorrhagic components decreased (24.9% and 20.5%, respectively; p = 0.12) (1.0% and 0.0%, respectively; p = 0.04). There were no substantial changes in intraplaque characteristics in either US or MRI in the other group. 3D-US and MR plaque imaging can quantitatively detect changes in the size and composition of carotid plaques during cilostazol therapy. (orig.)

  2. Oxidized LDL in carotid plaques and plasma associates with plaque instability

    National Research Council Canada - National Science Library

    Nishi, Kyoko; Itabe, Hiroyuki; Uno, Masaaki; Kitazato, Keiko T; Horiguchi, Hidehisa; Shinno, Kiyohito; Nagahiro, Shinji

    2002-01-01

    Oxidation of LDL plays a significant pathogenic role in atherosclerosis. In this study, we attempted to clarify the correlation between the morphology of human atherosclerotic plaques and the oxidized LDL (OxLDL...

  3. Coincidence of calcified carotid atheromatous plaque, osteoporosis, and periodontal bone loss in dental panoramic radiographs

    OpenAIRE

    Ramesh, Aruna; Soroushian, Sheila; Ganguly, Rumpa

    2013-01-01

    Purpose This study was performed to assess the correlation of calcified carotid atheromatous plaque (CCAP), the mandibular cortical index, and periodontal bone loss in panoramic radiographs. Materials and Methods One hundred eighty-five panoramic radiographs with CCAP and 234 without this finding were evaluated by 3 observers for the presence of osseous changes related to osteoporosis and periodontal bone loss. Chi-squared and Mann-Whitney U tests were used to compare the two groups for an as...

  4. Association between traditional cholesterol parameters, lipoprotein particle concentration, novel biomarkers and carotid plaques in retired National Football League players.

    Science.gov (United States)

    Virani, Salim S; Pompeii, Lisa; Lincoln, Andrew E; Dunn, Reginald E; Tucker, Andrew M; Nambi, Vijay; Nasir, Khurram; Vogel, Robert A; Boone, Jeffrey L; Roberts, Arthur J; Ballantyne, Christie M

    2012-06-01

    We assessed whether low-density lipoprotein particle concentration (LDL-P) and high-sensitivity C-reactive protein [hs-CRP] can identify subclinical atherosclerosis better than traditional cholesterol parameters in retired National Football League (NFL) players. It is not known whether LDL-P and the biomarker hs-CRP can identify subclinical atherosclerosis better than low-density lipoprotein cholesterol (LDL-C) or non-high-density-lipoprotein cholesterol (non-HDL-C) in retired NFL players, given high prevalence of metabolic syndrome in these players. Carotid artery plaque screening was performed with traditional lipids, LDL-P, and hs-CRP in 996 retired players. Logistic regression analyses comparing highest with the lowest quartile were performed. Carotid artery plaques were seen in 41%. LDL-C (odds ratio [OR] 1.66, 95% confidence interval [CI] 1.06-2.59), non-HDL-C (OR 1.67, 95% CI 1.04-2.67), and LDL-P (OR 2.21, 95% CI 1.35-3.62) were associated with plaques in adjusted models. Among 187 retired players with metabolic syndrome, LDL-C (OR 1.40, 95% CI 0.53-3.72) was not associated with carotid plaques, whereas LDL-P (OR 3.71, 95% CI 1.16-11.84) and non-HDL-C (OR 2.63, 95% CI 0.91-7.63, p=0.07; borderline significant) were associated with carotid plaques. hs-CRP (OR 1.13, 95% CI 0.71-1.79) was not associated with carotid plaques. Carotid artery plaques were common in retired NFL players and were strongly associated with LDL-P, especially among those with metabolic syndrome. hs-CRP was not associated with carotid plaques in this cohort. Published by Elsevier Ireland Ltd.

  5. Combination of carotid intima-media thickness and plaque for better predicting risk of ischaemic cardiovascular events.

    Science.gov (United States)

    Xie, Wuxiang; Liang, Lirong; Zhao, Liancheng; Shi, Ping; Yang, Ying; Xie, Gaoqiang; Huo, Yong; Wu, Yangfeng

    2011-08-01

    Several indices of carotid atherosclerosis have been studied to investigate their associations with the risk of cardiovascular disease. However, the best index of carotid atherosclerosis that predicts the risk of cardiovascular disease remains unclear. To investigate the index that best reflects the relationship between carotid atherosclerosis and subsequent ischaemic cardiovascular disease (ICVD) events. An observational longitudinal study with a 5-year follow-up. 1734 Chinese subjects (623 men, 1111 women) aged 43-79 years at baseline. ICVD events, including coronary heart disease and ischaemic stroke. Carotid intima-media thickness (IMT) at baseline was significantly associated with the risk of ICVD among participants without carotid plaque (multivariable adjusted HR=1.59, 95% CI 1.04 to 2.45) but not among those with plaque (HR=1.04, 95% CI 0.78 to 1.39). However, the total area of plaques (HR=1.29, 95% CI 1.08 to 1.55), the number of plaques (HR=1.14, 95% CI 1.02 to 1.27) and the number of segments with plaque (HR=1.45, 95% CI 1.09 to 1.93) were all significantly associated with ICVD in participants with plaque. Thus, carotid IMT and the number of segments with plaque were combined to establish a summary index-the total burden score (TBS) of carotid atherosclerosis-which was shown to improve the prediction of the 5-year risk of ICVD significantly compared with IMT or the number of segments with plaque alone. The c-statistics and net reclassification index showed that TBS improved the risk prediction by increases of 6.0% and 17.1%, respectively, compared with the conventional risk score. The TBS could significantly improve the prediction of ICVD risk and should be used in clinical practice and future studies.

  6. Digital Image Analysis of Ultrasound B-mode images of Carotid Atherosclerotic Plaque: Correlation with Histological Examination

    DEFF Research Database (Denmark)

    Wilhjelm, Jens E.; Rosendal, Kim; Grønholdt, Marie-Louise Moes

    1996-01-01

    This paper reports on a study of how well texture features extracted from B-mode images of atherosclerotic plaque correlates with histological results obtained from the same plaque after carotid endarterectomy. The study reveals that a few second order texture features (diagonal moment, standard...

  7. Distribution of Matrix Metalloproteinases in Human Atherosclerotic Carotid Plaques and Their Production by Smooth Muscle Cells and Macrophage Subsets

    NARCIS (Netherlands)

    Jager, Nynke A.; de Vries, Bastiaan M. Wallis; Hillebrands, Jan-Luuk; Harlaar, Niels J.; Tio, Rene A.; Slart, Riemer H. J. A.; van Dam, Gooitzen M.; Boersma, Hendrikus H.; Zeebregts, Clark J.; Westra, Johanna

    2016-01-01

    In this study, the potential of matrix metalloproteinase (MMP) sense for detection of atherosclerotic plaque instability was explored. Secondly, expression of MMPs by macrophage subtypes and smooth muscle cells (SMCs) was investigated. Twenty-three consecutive plaques removed during carotid endarter

  8. High reproducibility of histological characterization by whole virtual slide quantification; an example using carotid plaque specimens.

    Directory of Open Access Journals (Sweden)

    Joyce E P Vrijenhoek

    Full Text Available Tissue biobanks are an important source for discovery and validation studies aiming for new proteins that are causally related with disease development. There is an increasing demand for accurate and reproducible histological characterization, especially for subsequent analysis and interpretation of data in association studies. We assessed reproducibility of one semiquantative and two quantitative methods for histological tissue characterization. We introduce a new automated method for whole digital slide quantification. Carotid atherosclerotic plaques were used to test reproducibility.50 atherosclerotic plaques that were obtained during carotid endarterectomy were analysed. For the semiquantitative analysis, 6 different plaque characteristics were scored in categories by two independent observers, and Cohen's κ was used to test intra- and interobserver reproducibility. The computer-aided method (assessed by two independent observers and automated method were tested on CD68 (for macrophages and α smooth muscle actin (for smooth muscle cells stainings. Agreement for these two methods (done on a continuous scale was assessed by intraclass correlation coefficients (ICCs.For the semiquantitative analysis, κ values ranged from 0.55 to 0.69 for interobserver variability, and were slightly higher for intraobserver reproducibility in both observers. The computer-aided method yielded intra- and interobserver ICCs between 0.6 and 0.9. The new automated method performed most optimal regarding reproducibility, with ICCs ranging from 0.92 to 0.97.The analysis of performance of three methods for histological slide characterization on carotid atherosclerotic plaques showed high precision and agreement in repeated measurements for the automated method for whole digital slide quantification. We suggest that this method can fulfill the need for reproducible histological quantification.

  9. Is Carotid Ultrasound Necessary in the Clinical Evaluation of the Asymptomatic Hollenhorst Plaque? (An American Ophthalmological Society Thesis)

    Science.gov (United States)

    Bakri, Sophie J.; Luqman, Ashraf; Pathik, Bhupesh; Chandrasekaran, Krishnaswamy

    2013-01-01

    Purpose: To evaluate the utility of carotid ultrasound in patients with asymptomatic Hollenhorst plaques. Methods: Retrospective chart review of 237 patients diagnosed with Hollenhorst plaques between 1996 and 2004. The baseline cardiovascular risk profile, medications, and carotid ultrasound findings were documented. Retinal ischemia, myocardial ischemia, and cerebrovascular events during follow-up were noted. Results: There was no statistically significant difference in the proportion of patients with carotid stenosis >40% between symptomatic (n=60) and asymptomatic (n=177) patients (32.7% vs 22.7%; P=.192, one-way ANOVA). However, symptomatic patients were statistically more likely to have stenosis >69% (25% compared with 9.2% in the asymptomatic group; P=.008, one-way ANOVA). Among asymptomatic patients, those with carotid bruit (27.1%) were more likely to have moderate carotid stenosis >40% (55.6% vs 18.6% in patients without bruit; P=.0008, one-way ANOVA) and significant stenosis >69% (37% vs 4.3% in patients without bruit; P=.0001, one-way ANOVA). Follow-up data was obtained from 32 symptomatic patients (39.6 ± 22.9 months) and 100 asymptomatic patients (41.3 ± 21.8 months). Vascular and neurologic event rates were similar between the two groups. Conclusions: Hollenhorst plaques are a marker of significant carotid disease irrespective of retinal symptoms. Carotid auscultation remains important in the examination of patients with Hollenhorst plaques and increases the yield of asymptomatic patients diagnosed with carotid stenosis. The presence of visual symptoms on presentation did not correlate with an increased risk of death or stroke compared to asymptomatic patients during follow-up. Therefore all patients with asymptomatic plaques should have a medical workup, including carotid ultrasonography. PMID:24072943

  10. Presence of Periodontopathic Bacteria DNA in Atheromatous Plaques from Coronary and Carotid Arteries

    Directory of Open Access Journals (Sweden)

    Malgorzata Szulc

    2015-01-01

    Full Text Available Objectives. Interest in periodontitis as a potential risk factor for atherosclerosis and its complications resulted from the fact that the global prevalence of periodontal diseases is significant and periodontitis may induce a chronic inflammatory response. Many studies have analyzed the potential impact of the Porphyromonas gingivalis, major pathogen of periodontitis, on general health. The purpose of this study was to find the presence of the Porphyromonas gingivalis DNA in the atherosclerotic plaques of coronary and carotid arteries and in the periodontal pockets in patients with chronic periodontitis, who underwent surgery because of vascular diseases. Methods and Results. The study population consisted of 91 patients with coronary artery disease or scheduled for carotid endarterectomy. The presence of Porphyromonas gingivalis DNA in atheromatous plaques and in subgingival samples was determined by PCR. Bacterial DNA was found in 21 of 91 (23% samples taken from vessels and in 47 of 63 (74.6% samples from periodontal pockets. Conclusions. Porphyromonas gingivalis DNA is frequently found in atheromatous plaques of patients with periodontitis. That is why more research should be conducted to prove if this periopathogen may have an impact on endothelium of patients at risk of atherosclerosis.

  11. Correlation between morphologic carotid plaque findings based on color-Doppler and CT multidetector angiography with intraopertive findings in carotid artery stenosis

    Directory of Open Access Journals (Sweden)

    Savić Živorad N.

    2010-01-01

    Full Text Available Bacground/Aim. Vast majority of patients with corotid artery sclerosis do not have transitory ischemic attacks (TIA as working to the persistent silent disease, but stroke is the first sign. Precise and early diagnosis of the carotid artery disease and plaques are very important. The aim of this study was to determine how the composition / identity of diagnostic methods, color-Doppler, ultrasonography (US CT multidetector angio (MDCTA scan and intraoperative (IO findings, as well as the morphology of plaques in patients with haemodynamic significant stenosis of the internal carotid artery. Methods. Carotid plaques were observed by two diagnostic methods, US and MDCTA, and these findings were correlated with the IO findings. Results. In 62 patients both carotid artheries were examined and 83 plaques were observed. There were 68 surgical interventions. The structure of plaques was divided into four types: lipid, fibrous, fibrocalcified and calcified plaque. US showed: lipid plaques 10.8%; fibrous 1.2%; fibrocalcified 44.6% and calcified 43.4%, and the MDCTA lipid plaques 8.4%; fibrocalcified 48.2% and calcified 43.4%. Intraoperative findings were: lipid plaques 10.3%; fibrocalcified 41.2% and calcified 48.5%. A statistically highly significant agreement between the US and MDCTA in the diagnosis of plaque morphology was obtained (Cramer's V = 0.919, p < 0.01; Lambda = 0.921, p < 0.01 and also statistically significant agreement between US and IO findings (Cramer' s V = 0.831, p < 0.01; Lambda = 0.859, p < 0.01. A statistically highly significant agreement between MDCTA and IO findings in plaque morphology was found, as well (Cramer's V = 0.815, p < 0.01; Lambda = 0.829, p < 0.01. Conclusion. There is statistically highly significant correlation between US and MDCTA diagnostic methods in the evaluation of plaque morphology in surgically significant stenosis of internal carotid artery as well as their agreement with the intraoperative finding.

  12. Decreased Adiponectin-Mediated Signaling Through the AdipoR2 Pathway Is Associated With Carotid Plaque Instability.

    Science.gov (United States)

    Gasbarrino, Karina; Zheng, Huaien; Hafiane, Anouar; Veinot, John P; Lai, Chi; Daskalopoulou, Stella S

    2017-04-01

    Adiponectin, the most abundantly secreted anti-inflammatory adipokine, protects against all stages of atherosclerotic plaque formation by acting on its receptors, AdipoR1 (adiponectin receptor 1) and AdipoR2 (adiponectin receptor 2). Through binding of AdipoR1, adiponectin leads to the activation of the AMPK (adenosine monophosphate-activated protein kinase) pathway, whereas stimulation of PPAR-α (peroxisome proliferator-activated receptor-α) is attributed to the binding of AdipoR2. However, the role of adiponectin and its receptors in plaque instability remains to be characterized. Thus, we aimed to investigate whether the adiponectin-AdipoR pathway is associated with carotid atherosclerotic plaque instability. The instability of plaque specimens obtained from patients who underwent a carotid endarterectomy (n=143) was assessed using gold standard histological classifications. Using immunohistochemistry, we showed that adiponectin and AdipoR1/AdipoR2 are expressed in human carotid plaques and that their expression was localized most abundantly in areas of macrophage and foam cell accumulation. Unstable plaques expressed more adiponectin protein (Western blot, Padiponectin with a decrease in AdipoR2 expression and activity was observed in unstable plaques, suggesting that reduced signaling through the AdipoR2 pathway, and not through AdipoR1, may contribute to plaque instability. © 2017 American Heart Association, Inc.

  13. Novel genetic variants modify the effect of smoking on carotid plaque burden in Hispanics.

    Science.gov (United States)

    Della-Morte, David; Wang, Liyong; Beecham, Ashley; Blanton, Susan H; Zhao, Hongyu; Sacco, Ralph L; Rundek, Tatjana; Dong, Chuanhui

    2014-09-15

    Smoking greatly increases the risk of atherosclerotic plaque and the effect may vary from individual to individual. A genome-wide scan was performed for smoking×single nucleotide polymorphism (SNP) interactions on carotid plaque burden (CPB) to identify the potential genetic moderators in Hispanics. Carotid B-mode ultrasonography and genotyping by the Affymetrix 6.0 chip were performed in a discovery sample of 665 Caribbean Hispanics, followed by replication analyses in 264 Caribbean Hispanics. CPB was expressed as the sum of plaque areas over the segments in common and internal carotid arteries and bifurcation. Smoking was classified as 0, genetic model, regression analysis was conducted to test for smoking×SNP interaction on the cube root transformed CPB while controlling for age, sex, and the top 3 principal components of ancestry. Two SNPs showed a significant interaction with smoking on CPB with the similar effects in both discovery (Psmoking was significantly associated with greater CPB in A allele carriers (beta±SE: 0.24±0.08, P=0.005 in AG carriers; beta±SE: 0.48±0.12, P=0.0002 in AA carriers) but not in GG (P=0.06). For SNP rs7001413 within LY96 and JPH1, more smoking was significantly associated with greater CPB in GG carriers (beta±SE: 0.24±0.06, P=6.8E-5) but not in T carriers (P=0.06). Our study suggests that genetic variants may modulate the effect of smoking on CPB and highlights several genes for further investigation of their role in atherosclerosis, especially in smoking population. Copyright © 2014 Elsevier B.V. All rights reserved.

  14. 3D reconstruction of carotid atherosclerotic plaque: comparison between spatial compound ultrasound models and anatomical models

    DEFF Research Database (Denmark)

    Lind, Bo L.; Fagertun, Jens; Wilhjelm, Jens E.;

    2007-01-01

    This study deals with the creation of 3D models that can work as a tool for discriminating between tissue and background in the development of tissue classification methods. Ten formalin-fixed atherosclerotic carotid plaques removed by endarterectomy were scanned with 3D multi-angle spatial...... compound ultrasound (US) and subsequently sliced and photographed to produce a 3D anatomical data set. Outlines in the ultrasound data were found by means of active contours and combined into 10 3D ultrasound models. The plaque regions of the anatomical photographs were outlined manually and then combined...... into 10 3D anatomical models. The volumes of the anatomical models correlated with the volume found by a water displacement method (r = 0.95), except for an offset. The models were compared in three ways. Visual inspection showed quite good agreement between the models. The volumes of the ultrasound...

  15. Endothelial dysfunction is associated with carotid plaque: a cross-sectional study from the population based Northern Manhattan Study

    Directory of Open Access Journals (Sweden)

    Boden-Albala Bernadette

    2006-08-01

    Full Text Available Abstract Background Impaired vascular function occurs early in atherogenesis. Brachial flow mediated dilatation (FMD is a non-invasive measure of vascular function and may be an important marker of preclinical atherosclerosis. Data on the association between FMD and carotid plaque in multi-ethnic populations are limited. The objective of this study was to determine whether endothelial dysfunction is independently associated with carotid plaque in a community of northern Manhattan. Methods In the population-based Northern Manhattan Study (NOMAS, high-resolution B-mode ultrasound images of the brachial and carotid arteries were obtained in 643 stroke-free subjects (mean age 66 years; 55% women; 65% Caribbean-Hispanic, 17% African-American, 16% Caucasian. Brachial FMD was measured during reactive hyperemia. Maximum carotid plaque thickness (MCPT was measured at the peak plaque prominence. Results The mean brachial FMD was 5.78 ± 3.83 %. Carotid plaque was present in 339 (53% subjects. The mean MCPT was 1.68 ± 0.82 mm, and the 75th percentile was 2.0 mm. Reduced FMD was significantly associated with increased MCPT. After adjusting for demographics, vascular risk factors, and education, each percent of FMD decrease was associated with a significant 0.02 mm increase in MCPT (p = 0.028. In a dichotomous adjusted model, blunted FMD was associated with an increased risk of MCPT ≥ 2.0 mm (OR, 1.11 for every 1% decrease in FMD; 95% CI, 1.03–1.19. Conclusion Decreased brachial FMD is independently associated with carotid plaque. Non-invasive evaluation of endothelial dysfunction may be a useful marker of preclinical atherosclerosis and help to individualize cardiovascular risk assessment beyond traditional risk factors.

  16. Evolution and rupture of vulnerable plaques: a review of mechanical effects

    Directory of Open Access Journals (Sweden)

    Assemat P

    2013-04-01

    Full Text Available Pauline Assemat, Kerry Hourigan Fluids Laboratory for Aeronautical and Industrial Research (FLAIR, Department of Mechanical and Aerospace Engineering and Division of Biological Engineering, Monash University, Melbourne, VIC, Australia Abstract: Atherosclerosis occurs as a result of the buildup and infiltration of lipid streaks in artery walls, leading to plaques. Understanding the development of atherosclerosis and plaque vulnerability is of critical importance, since plaque rupture can result in heart attack or stroke. Plaques can be divided into two distinct types: those that rupture (vulnerable and those that are less likely to rupture (stable. In the last few decades, researchers have been interested in studying the influence of the mechanical effects (blood shear stress, pressure forces, and structural stress on the plaque formation and rupture processes. In the literature, physiological experimental studies are limited by the complexity of in vivo experiments to study such effects, whereas the numerical approach often uses simplified models compared with realistic conditions, so that no general agreement of the mechanisms responsible for plaque formation has yet been reached. In addition, in a large number of cases, the presence of plaques in arteries is asymptomatic. The prediction of plaque rupture remains a complex question to elucidate, not only because of the interaction of numerous phenomena involved in this process (biological, chemical, and mechanical but also because of the large time scale on which plaques develop. The purpose of the present article is to review the current mechanical models used to describe the blood flow in arteries in the presence of plaques, as well as reviewing the literature treating the influence of mechanical effects on plaque formation, development, and rupture. Finally, some directions of research, including those being undertaken by the authors, are described. Keywords: atherosclerosis, rupture

  17. Copper and zinc concentrations in atherosclerotic plaque and serum in relation to lipid metabolism in patients with carotid atherosclerosis

    Directory of Open Access Journals (Sweden)

    Tasić Nebojša M.

    2015-01-01

    Full Text Available Background/Aim. Some oligoelements are now investigated as possibly having a role in atherosclerosis. The aim of this study was to compare the concentrations of copper and zinc in the serum and carotid plaque and parameters of lipid metabolism in patients with different morphology of carotid atherosclerotic plaque. Methods. Carotid endarterectomy due to the significant atherosclerotic stenosis was performed in 91 patients (mean age 64 ± 7. The control group consisted of 27 patients (mean age 58 ± 9, without carotid atherosclerosis. Atheroscletoric plaques were divided into four morphological groups, according to ultrasonic and intraoperative characteristics. Copper and zinc concentrations in the plaque, carotid artery and serum were measured by atomic absorption spectrophotometry. Results. Serum copper concentrations were statistically significantly higher in the patients with hemorrhagic in comparison to those with calcified plaque (1.2 ± 0.9 μmol/L vs 0.7 ± 0.2 μmol/L, respectively; p = 0.021. Zinc concentrations were statistically significantly lower in plaques of the patients with fibrolipid in comparison to those with calcified plaques (22.1 ± 16.3 μg/g vs 38.4 ± 25.8 μg/g, respectively; p = 0.024. A negative significant correlation was found for zinc and triglycerides in the serum in all the patients (r = -0.52, p = 0.025. In the control group we also demonstrated a positive significant correlation for low-density lipoprotein cholesterol and copper in the serum (r = 0.54, p = 0.04. Conclusion. The data obtained in the current study are consistent with the hypothesis that high copper and lower zinc levels may contribute to atherosclerosis and its sequelae as factors in a multifactorial disease. Further studies are necessary in order to conclude whether high concentration of copper and zinc in the serum could be risk factors for atherosclesrosis.

  18. Plaque components affect wall stress in stented human carotid artery: A numerical study

    Science.gov (United States)

    Fan, Zhen-Min; Liu, Xiao; Du, Cheng-Fei; Sun, An-Qiang; Zhang, Nan; Fan, Zhan-Ming; Fan, Yu-Bo; Deng, Xiao-Yan

    2016-09-01

    Carotid artery stenting presents challenges of in-stent restenosis and late thrombosis, which are caused primarily by alterations in the mechanical environment of the artery after stent implantation. The present study constructed patient-specific carotid arterial bifurcation models with lipid pools and calcified components based on magnetic resonance imaging. We numerically analyzed the effects of multicomponent plaques on the distributions of von Mises stresses (VMSs) in the patient-specific models after stenting. The results showed that when a stent was deployed, the large soft lipid pool in atherosclerotic plaques cushioned the host artery and reduced the stress within the arterial wall; however, this resulted in a sharp increase of VMS in the fibrous cap. When compared with the lipid pool, the presence of the calcified components led to slightly increased stresses on the luminal surface. However, when a calcification was located close to the luminal surface of the host artery and the stenosis, the local VMS was elevated. Overall, compared with calcified components, large lipid pools severely damaged the host artery after stenting. Furthermore, damage due to the calcified component may depend on location.

  19. Plaque components affect wall stress in stented human carotid artery:A numerical study

    Institute of Scientific and Technical Information of China (English)

    Zhen-Min Fan; Xiao Liu; Cheng-Fei Du; An-Qiang Sun; Nan Zhang; Zhan-Ming Fan; Yu-Bo Fan; Xiao-Yan Deng

    2016-01-01

    Carotid artery stenting presents challenges of in-stent restenosis and late thrombosis, which are caused primarily by alterations in the mechanical environment of the artery after stent implantation. The present study con-structed patient-specific carotid arterial bifurcation models with lipid pools and calcified components based on magnetic resonance imaging. We numerically analyzed the effects of multicomponent plaques on the distributions of von Mises stresses (VMSs) in the patient-specific models after stenting. The results showed that when a stent was deployed, the large soft lipid pool in atherosclerotic plaques cushioned the host artery and reduced the stress within the arterial wall;how-ever, this resulted in a sharp increase of VMS in the fibrous cap. When compared with the lipid pool, the presence of the calcified components led to slightly increased stresses on the luminal surface. However, when a calcification was located close to the luminal surface of the host artery and the stenosis, the local VMS was elevated. Overall, compared with calcified components, large lipid pools severely dam-aged the host artery after stenting. Furthermore, damage due to the calcified component may depend on location.

  20. Morphological changes of ulcerative plaque in patients received carotid angioplasty and stenting (CAS)

    Energy Technology Data Exchange (ETDEWEB)

    Sadikin, Cindy [Department of Radiology, Dokter Soetomo Hospital, Surabaya (Indonesia); Department of Radiology, Taipei Veteran General Hospital, Taipei, Taiwan (China)], E-mail: cindysadikin@walla.com; Teng, Michael Mu Huo [Department of Radiology, Taipei Veteran General Hospital, Taipei, Taiwan (China); School of Medicine, National Yang Ming University, Taipei, Taiwan (China)], E-mail: mhteng@mail2000.com.tw; Yeh, C.-C. [Department of Radiology, Taipei Veteran General Hospital, Taipei, Taiwan (China)], E-mail: ccyeh@vghtpe.gov.tw; Chang, F.-C. [Department of Radiology, Taipei Veteran General Hospital, Taipei, Taiwan (China)], E-mail: fcchang@vghtpe.gov.tw; Luo, C.-B. [Department of Radiology, Taipei Veteran General Hospital, Taipei, Taiwan (China); School of Medicine, National Yang Ming University, Taipei, Taiwan (China)], E-mail: cbluo@vghtpe.gov.tw

    2008-03-15

    Background: Carotid ulceration plaque is a strong risk factor for stroke and systemic vascular events. The purpose of this study was to assess immediate and follow-up ulcer morphology after carotid angioplasty and stenting (CAS). Methods and results: A total of 124 patients were included in the study. Ulcerative plaques were identified in 92 arteries from 81 patients (21% were asymptomatic and 79% symptomatic). The ulcer disappeared immediately after stenting in 36 (39%) of 92 arteries in 50 patients. Patients with initial mild degree of stenosis (50-69% stenosis) prior to stent, Type-3 and Type-4 ulcers were more prone to have residual ulcers immediate after stenting procedure. Ulcers located distal and proximal to the site of maximal stenosis, and ulcers extending outside of the imaginary line connecting the distal and proximal normal borders of the carotid artery were also more likely to have residual ulcers (P < 0.001). Follow-up angiograms (mean time after CAS = 10.1 months, range = 3-28 months) performed in 32 arteries (29 patients) revealed that residual ulceration disappeared in 17 lesions (53%) and became smaller in 15 lesions (47%). During follow-up, ipsilateral neurological symptoms were not evident in any of the 29 patients (mean time after CAS = 20.1 months, range = 9-41 months). Conclusions: Ulceration morphology, and stenosis severity prior to stent procedure had an impact on ulcer coverage after CAS. Our findings suggest that residual ulcers disappear or improve over time and that with appropriate medication, will not lead to embolic strokes.

  1. Association of carotid plaque Lp-PLA(2 with macrophages and Chlamydia pneumoniae infection among patients at risk for stroke.

    Directory of Open Access Journals (Sweden)

    Berna Atik

    Full Text Available BACKGROUND: We previously showed that the burden of Chlamydia pneumoniae in carotid plaques was significantly associated with plaque interleukin (IL-6, and serum IL-6 and C-reactive protein (CRP, suggesting that infected plaques contribute to systemic inflammatory markers in patients with stroke risk. Since lipoprotein-associated phospholipase A2 (Lp-PLA(2 mediates inflammation in atherosclerosis, we hypothesized that serum Lp-PLA(2 mass and activity levels and plaque Lp-PLA(2 may be influenced by plaque C. pneumoniae infection. METHODOLOGY/PRINCIPAL FINDINGS: Forty-two patients underwent elective carotid endarterectomy. Tissue obtained at surgery was stained by immunohistochemistry for Lp-PLA(2 grade, macrophages, IL-6, C. pneumoniae and CD4+ and CD8+ cells. Serum Lp-PLA(2 activity and mass were measured using the colorimetric activity method (CAM and ELISA, respectively. Serum homocysteine levels were measured by HPLC. Eleven (26.2% patients were symptomatic with transient ischemic attacks. There was no correlation between patient risk factors (smoking, coronary artery disease, elevated cholesterol, diabetes, obesity, hypertension and family history of genetic disorders for atherosclerosis and serum levels or plaque grade for Lp-PLA(2. Plaque Lp-PLA(2 correlated with serum homocysteine levels (p = 0.013, plaque macrophages (p<0.01, and plaque C. pneumoniae (p<0.001, which predominantly infected macrophages, co-localizing with Lp-PLA(2. CONCLUSIONS: The significant association of plaque Lp-PLA(2 with plaque macrophages and C. pneumoniae suggests an interactive role in accelerating inflammation in atherosclerosis. A possible mechanism for C. pneumoniae in the atherogenic process may involve infection of macrophages that induce Lp-PLA(2 production leading to upregulation of inflammatory mediators in plaque tissue. Additional in vitro and in vivo research will be needed to advance our understanding of specific C. pneumoniae and Lp-PLA(2

  2. Study on the correlation between serum Angptl2 level and carotid plaque nature in Type 2 diabetes

    Institute of Scientific and Technical Information of China (English)

    Mao-Ji La; Hai-Mei Liu; Qian Yang; Xiao-Jing Sun

    2016-01-01

    Objective:To analyze the correlation between serum Angptl2 level and carotid plaque nature in Type 2 diabetes.Methods:118 cases of Type 2 diabetes patients hospitalized in our hospital from August 2012 to December 2015 were the subjects of observation group, were accompanied with different degree of carotid plaque through B ultrasound and CT coronary arterial angiography examination, and were divided into unstable plaque group (n=56) and stable plaque group (n=62) according to the degree of plaque, and 97 cases of patients with Type 2 diabetes alone (not complicated with carotid plaque) who received blood glucose regulation treatment in our hospital during the same period were the control group. Serum Angptl2 levels and the values of carotid plaque nature-related indexes of all groups were detected, and the correlation between the two was further analyzed.Results: Serum Angptl2 level of observation group was significantly higher than that of control group, and serum Angptl2 level of unstable plaque group was higher than that of stable plaque group; serum Fbg, HbA1c and bigET-1 values of observation group were higher than those of control group while DBIL and RHI values were lower than those of control group; serum cystatin c and visfatin values of observation group were higher than those of control group while ApoA1 and MPO values were lower than those of control group; serum ACA, MIF, sCD40L, PAPP-A, CXCR16, t-HCY and D-dimer values of observation group were higher than those of control group; serum Angptl2 level was directly proportional to Fng, HbA1c, bigET-1, cystatin c, ApoA1, visfatin, ACA, MIF, sCD40L, PAPP-A, CXCR16, t-HCY and D-dimer levels, and inversely proportional to DBIL, RHI and MPO values.Conclusion:Angptl2 level is significantly abnormal in Type 2 diabetes patients with carotid plaque, has direct correlation with plaque nature-related indexes, and is the reliable index to judge patients’ condition and predict the outcome.

  3. Carotid plaque signal differences among four kinds of T1-weighted magnetic resonance imaging techniques: A histopathological correlation study

    Energy Technology Data Exchange (ETDEWEB)

    Saito, Ayumi; Narumi, Shinsuke; Ohba, Hideki; Yamaguchi, Mao; Terayama, Yasuo [Iwate Medical University, Department of Neurology and Gerontology, Morioka (Japan); Sasaki, Makoto; Kudo, Kohsuke [Iwate Medical University, Institute for Biomedical Sciences, Morioka (Japan); Ogasawara, Kuniaki; Kobayashi, Masakazu [Iwate Medical University, Department of Neurosurgery, Morioka (Japan); Hitomi, Jiro [Iwate Medical University, Department of Anatomy, Morioka (Japan)

    2012-11-15

    Several magnetic resonance (MR) imaging techniques are used to examine atherosclerotic plaque of carotid arteries; however, the best technique for visualizing intraplaque characteristics has yet to be determined. Here, we directly compared four kinds of T1-weighted (T1W) imaging techniques with pathological findings in patients with carotid stenosis. A total of 31 patients who were candidates for carotid endarterectomy were prospectively examined using a 1.5-T MRI scanner, which produced four kinds of T1W images, including non-gated spin echo (SE), cardiac-gated black-blood (BB) fast-SE (FSE), magnetization-prepared rapid acquisition with gradient echo (MPRAGE), and source image of three-dimensional time-of-flight MR angiography (SI-MRA). The signal intensity of the carotid plaque was manually measured, and the contrast ratio (CR) against the adjacent muscle was calculated. CRs from the four imaging techniques were compared to each other and correlated with histopathological specimens. CRs of the carotid plaques mainly containing fibrous tissue, lipid/necrosis, and hemorrhage were significantly different with little overlaps (range: 0.92-1.15, 1.22-1.52, and 1.55-2.30, respectively) on non-gated SE. However, BB-FSE showed remarkable overlaps among the three groups (0.89-1.10, 1.07-1.23, and 1.01-1.42, respectively). MPRAGE could discriminate fibrous plaques from hemorrhagic plaques but not from lipid/necrosis-rich plaques: (0.77-1.07, 1.45-2.43, and 0.85-1.42, respectively). SI-MRA showed the same tendencies (1.01-1.39, 1.45-2.57, and 1.12-1.39, respectively). Among T1W MR imaging techniques, non-gated SE images can more accurately characterize intraplaque components in patients who underwent CEA when compared with cardiac-gated BB-FSE, MPRAGE, and SI-MRA images. (orig.)

  4. Characteristics of carotid atherosclerotic plaques of chronic lipid apheresis patients as assessed by In Vivo High-Resolution CMR - a comparative analysis

    Directory of Open Access Journals (Sweden)

    Grimm Jochen M

    2012-11-01

    Full Text Available Abstract Background Components of carotid atherosclerotic plaques can reliably be identified and quantified using high resolution in vivo 3-Tesla CMR. It is suspected that lipid apheresis therapy in addition to lowering serum lipid levels also has an influence on development and progression of atherosclerotic plaques. The purpose of this study was to evaluate the influence of chronic lipid apheresis (LA on the composition of atherosclerotic carotid plaques. Methods 32 arteries of 16 patients during chronic LA-therapy with carotid plaques and stenosis of 1–80% were matched according to degree of stenosis with 32 patients, who had recently suffered an ischemic stroke. Of these patients only the asymptomatic carotid artery was analyzed. All patients underwent black-blood 3 T CMR of the carotids using parallel imaging and dedicated surface coils. Cardiovascular risk factors were recorded. Morphology and composition of carotid plaques were evaluated. For statistical evaluation Fisher’s Exact and unpaired t-test were used. A p-value Results Patients in the LA-group were younger (63.5 vs. 73.9. years, p2, p Conclusion Results of this study suggest that, despite a severer risk profile for cardiovascular complications in LA-patients, chronic LA is associated with significantly lower lipid content in carotid plaques compared to plaques of patients without LA with similar degrees of stenosis, which is characteristic of clinically stable plaques.

  5. [New insights towards catheter-based identification of vulnerable plaque

    NARCIS (Netherlands)

    G.A. Rodriguez-Granillo (Gaston); P.W.J.C. Serruys (Patrick); E.S. Regar (Eveline); J.A. Schaar (Johannes)

    2005-01-01

    textabstractSudden cardiac death or unheralded acute coronary syndromes are common initial manifestations of coronary atherosclerosis and most such events occur at sites of non-flow limiting coronary atherosclerosis. Autopsy data suggests that plaque composition is a key determinant of the propensit

  6. Serum ferritin is associated with carotid atherosclerotic plaques but not intima-media Thickness in patients with abnormal glucose metabolism.

    Science.gov (United States)

    Zhou, F L; Gao, Y; Tian, L; Yan, F F; Chen, T; Zhong, L; Tian, H M

    2015-10-23

    We investigated the association between serum ferritin and carotid artery lesions in populations with abnormal glucose metabolism. We included 70 participants with abnormal glucose metabolism and 170 participants with normal glucose metabolism and measured their baseline serum ferritin levels. During follow-up carotid intima-media thickness and carotid plaque were evaluated. Serum ferritin levels were higher in the participants with abnormal glucose metabolism (pferritin was excluded from the final equation in the logistic regression. Furthermore, age, waist circumference, ferritin, 2h-PG, and total cholesterol were significantly different between the subgroups with and without carotid plaque. When the above data were included in a logistic regression model, the p values obtained for age, ferritin, and 2h-PG were 0.004, 0.032, and 0.011, respectively. In the Chinese population, serum ferritin levels are significantly increased in patients with abnormal glucose metabolism. The carotid intima-media thickness showed no independent relationship with serum ferritin in patients with abnormal glucose metabolism. However, high serum ferritin is an important risk factor for carotid atherosclerosis in these patients. Copyright © 2015 Elsevier B.V. All rights reserved.

  7. Identification of two genes potentially associated in iron-heme homeostasis in human carotid plaque using microarray analysis

    Indian Academy of Sciences (India)

    Hanène Ayari; Giampiero Bricca

    2013-06-01

    Classic characteristics are poor predictors of the risk of thromboembolism. Thus, better markers for the carotid atheroma plaque formation and symptom causing are needed. Our objective was to study by microarray analysis gene expression of genes involved in homeostasis of iron and heme in carotid atheroma plaque from the same patient. mRNA gene expression was measured by an Affymetrix GeneChip Human Gene 1.0 ST arrays (Affymetrix, Santa Clara, CA, USA) using RNA prepared from 68 specimens of endarteriectomy from 34 patients. Two genes involved in iron-heme homeostasis, CD163 and heme oxygenase (HO-1), were analysed in 34 plaques. CD163 (2.18, =1.45E−08) and HO-1 (fold-change 2.67, =2.07E−09) mRNAs were induced. We suggest that atheroma plaques show a more pronounced induction of CD163 and HO-1. Although further evidence is needed, our results support previous data. To our knowledge, this is the first report comparing gene expression between intact arterial tissue and carotid plaque using microarray analysis.

  8. Blockade of Ets-1 attenuates epidermal growth factor-dependent collagen loss in human carotid plaque smooth muscle cells.

    Science.gov (United States)

    Rao, Velidi H; Rai, Vikrant; Stoupa, Samantha; Agrawal, Devendra K

    2015-09-15

    Although degradation of extracellular matrix by matrix metalloproteinases (MMPs) is thought to be involved in symptomatic (S) carotid plaques in atherosclerosis, the mechanisms of MMP expression are poorly understood. Here, we demonstrate that collagen loss in vascular smooth vessel cells (VSMCs) isolated from S plaques was induced by epidermal growth factor (EGF) through the activation of p38-MAPK and JNK-MAPK pathways. Inhibitors of p38-MAPK and JNK-MAPK signaling pathways downregulated the expression of MMP-1 and MMP-9. In addition, we examined whether v-ets erythroblastosis virus E26 oncogene homologue 1 (Ets-1), an important regulator of different genes, is involved in destabilizing S plaques in patients with carotid stenosis. We demonstrate that EGF induces Ets-1 expression and decreases interstitial and basement membrane collagen in vascular smooth muscle cells (VSMCs) from patients with carotid stenosis. Increased expression of MMP-1 and -9 and decreased collagen mRNA transcripts were also found in Ets-1-overexpressed VSMCs. Transfection with both dominant-negative form of Ets-1 and small interfering RNA blocked EGF-induced MMP-1 and -9 expressions and increased the mRNA transcripts for collagen I (α1) and collagen III (α1) in S compared with asymptomatic (AS) carotid plaques. Inhibitors of p38-MAPK (SB202190) and JNK-MAPK (SP600125) signaling pathways decreased the expression of Ets-1, MMP-1, and MMP-9 and increased collagen type I and III expression in EGF-treated VSMCs. This study provides a mechanistic insight into the role of Ets-1 in the plaque destabilization in patients with carotid stenosis involving p38-MAPK and JNK signaling pathways. Copyright © 2015 the American Physiological Society.

  9. Molecular imaging of vulnerable atherosclerosis. Preclinical and clinical evaluation of nuclear tracers; Imagerie moleculaire de la plaque d'atherome vulnerable. Evaluation preclinique et clinique de traceurs radioactifs

    Energy Technology Data Exchange (ETDEWEB)

    Broisat, A.; Riou, L.M.; Dimastromatteo, J.; Pons, G.; Fagret, D.; Ghezzi, C. [Inserm U877, radiopharmaceutiques biocliniques, 38 - Grenoble (France); Grenoble Univ., 38 (France); Dimastromatteo, J. [ERAS Labo, 38 - Saint-Nazaire-les-Eymes (France)

    2009-02-15

    Atherosclerotic cardiovascular diseases (C.V.D.) are the leading cause of mortality worldwide, accounting for greater than 19.106 deaths annually. Despite major advances in the treatment of C.V.D., a high proportion of C.V.D. victims die suddenly while being apparently healthy, the great majority of these accidents being due to the rupture or erosion of a vulnerable coronary atherosclerotic plaque. Indeed, an acute heart attack is the first symptom of atherosclerosis in as much as 50% of individuals with severe disease. A non-invasive imaging methodology allowing the early detection of vulnerable atherosclerosis in selected individuals prior to the occurrence of any symptom would therefore be of great public health benefit. Nuclear imaging could potentially allow the identification of vulnerable patients by non-invasive scintigraphic imaging following administration of a radiolabeled tracer. The development of radiolabeled probes that specifically bind to and allow the in vivo imaging of vulnerable atherosclerotic plaques is therefore the subject of intense ongoing experimental and clinical research. Radiotracers targeted at the inflammatory process seem particularly relevant and promising. Recently, macrophage targeting allowed the experimental in vivo detection of atherosclerosis using either SPECT or PET imaging. A few tracers have also been evaluated clinically. Targeting of apoptosis and macrophage metabolism both allowed the imaging of vulnerable atherosclerotic plaques in the carotid vessels of patients. However, nuclear imaging of vulnerable plaques at the level of the coronary arteries remains a challenging issue because of the small size of atherosclerotic lesions and of their vicinity with blood and the circulating tracer activity. (authors)

  10. Atherosclerotic plaque volume and composition in symptomatic carotid arteries assessed with multidetector CT angiography; relationship with severity of stenosis and cardiovascular risk factors

    OpenAIRE

    Rozie, S.; de Weert, T. T.; de Monyé, C.; Homburg, P. J.; Tanghe, H L J; Dippel, D W J; van der Lugt, A

    2009-01-01

    The purpose of this study was to examine the volume and the composition of atherosclerotic plaque in symptomatic carotid arteries and to investigate the relationship between these plaque features and the severity of stenosis and the presence of cardiovascular risk factors. One hundred patients with cerebrovascular symptoms underwent CT angiography. We measured plaque volume (PV) and the relative contribution of plaque components (calcifications, fibrous tissue, and lipid) in the symptomatic a...

  11. A negative correlation between human carotid atherosclerotic plaque progression and plaque wall stress: in vivo MRI-based 2D/3D FSI models.

    Science.gov (United States)

    Tang, Dalin; Yang, Chun; Mondal, Sayan; Liu, Fei; Canton, Gador; Hatsukami, Thomas S; Yuan, Chun

    2008-01-01

    It is well accepted that atherosclerosis initiation and progression correlate positively with low and oscillating flow wall shear stresses (FSS). However, this mechanism cannot explain why advanced plaques continue to grow under elevated FSS conditions. In vivo magnetic resonance imaging (MRI)-based 2D/3D multi-component models with fluid-structure interactions (FSI, 3D only) for human carotid atherosclerotic plaques were introduced to quantify correlations between plaque progression measured by wall thickness increase (WTI) and plaque wall (structure) stress (PWS) conditions. A histologically validated multi-contrast MRI protocol was used to acquire multi-year in vivo MRI images. Our results using 2D models (200-700 data points/patient) indicated that 18 out of 21 patients studied showed significant negative correlation between WTI and PWS at time 2 (T2). The 95% confidence interval for the Pearson correlation coefficient is (-0.443,-0.246), p<0.0001. Our 3D FSI model supported the 2D correlation results and further indicated that combining both plaque structure stress and flow shear stress gave better approximation results (PWS, T2: R(2)=0.279; FSS, T1: R(2)=0.276; combining both: R(2)=0.637). These pilot studies suggest that both lower PWS and lower FSS may contribute to continued plaque progression and should be taken into consideration in future investigations of diseases related to atherosclerosis.

  12. Microvessel Density But Not Neoangiogenesis Is Associated with (18)F-FDG Uptake in Human Atherosclerotic Carotid Plaques

    DEFF Research Database (Denmark)

    Pedersen, Sune Folke; Græbe, Martin; Hag, Anne Mette Fisker;

    2011-01-01

    Introduction: The vulnerable atherosclerotic lesion exhibits the proliferation of neovessels and inflammation. The imaging modality 2-deoxy-2-[18F]fluoro-D-glucose positron emission tomography (18FDG-PET) is considered for the identification of vulnerable plaques. Purpose: The purpose of this study...

  13. Imaging of inflamed carotid artery atherosclerotic plaques with the use of {sup 99m}Tc-HYNIC-IL-2 scintigraphy in end-stage renal disease patients

    Energy Technology Data Exchange (ETDEWEB)

    Opalinska, Marta; Pach, Dorota; Sowa-Staszczak, Anna; Glowa, Boguslaw; Hubalewska-Dydejczyk, Alicja [Jagiellonian University Medical School, Nuclear Medicine Unit, Department of Endocrinology, Cracow (Poland); Stompor, Tomasz [University of Warmia and Mazury in Olsztyn, Department of Nephrology, Hypertensiology and Internal Medicine, Faculty of Medicine, Olsztyn (Poland); Mikolajczak, Renata; Garnuszek, Piotr; Maurin, Michal; Karczmarczyk, Urszula [National Centre for Nuclear Research Radioisotope Centre POLATOM, Otwock (Poland); Fedak, Danuta [Jagiellonian University Medical School, Clinical Biochemistry, Cracow (Poland); Krzanowski, Marcin; Sulowicz, Wladyslaw [Jagiellonian University Medical School, Department of Nephrology, Cracow (Poland); Rakowski, Tomasz [Jagiellonian University Medical School, 2nd Department of Cardiology, Institute of Cardiology, Cracow (Poland)

    2012-04-15

    Identification of vulnerable plaques remains crucial for better cardiovascular risk assessment. At least 20% of inflammatory cells within unstable (vulnerable) plaques comprise T lymphocytes, which contain receptors for interleukin-2 (IL-2); those receptors can be identified by scintigraphy with radiolabelled IL-2.The aim of this study was to identify the ''inflamed'' (vulnerable) plaques by scintigraphy using IL-2 labelled with {sup 99m}Tc in the selected, high cardiovascular risk group of end-stage renal disease (ESRD) patients. A total of 28 patients (18 men, 10 women, aged 55.2 {+-} 9.6 years, 17 on peritoneal dialysis, 11 on haemodialysis) underwent common carotid artery (CCA) scintigraphy with the use of {sup 99m}Tc-hydrazinonicotinamide (HYNIC)-IL-2. In all cases, ultrasound examination of the CCA was performed and levels of selected proinflammatory factors, atherogenic markers and calcium-phosphate balance parameters were measured. Finally, the target to non-target (T/nT) ratio of IL-2 uptake in atherosclerotic plaques with intima-media thickness (IMT), classic cardiovascular risk factors and concentrations of the measured factors were compared. Increased {sup 99m}Tc-HYNIC-IL-2 uptake in atherosclerotic plaques in 38/41 (91%) cases was detected. The median T/nT ratio of focal {sup 99m}Tc-HYNIC-IL-2 uptake in atherosclerotic plaques was 2.35 (range 1.23-3.63). The mean IMT value on the side of plaques assessed by scintigraphy was 0.79 {+-} 0.18 mm (median 0.8, range 0.5-1.275). Correlations between T/nT ratio and homocysteine (R = 0.22, p = 0.037), apolipoprotein B (apoB) (R = 0.31, p = 0.008), apoB to apoA-I ratio (R = 0.29, p = 0.012) and triglyceride concentration (R = 0.26, p = 0.021) were detected. A lower T/nT ratio in patients with better parameters of nutritional status (haemoglobin, albumin, adiponectin) in comparison with patients with worse nutritional parameters (3.20 {+-} 0.5 vs 2.16 {+-} 0.68, p = 0.025) was revealed as well

  14. Pregnancy associated plasma protein-A (PAPP-A) is not a marker of the vulnerable atherosclerotic plaque

    DEFF Research Database (Denmark)

    Iversen, Kasper; Teisner, Ane; Dalager, Soren

    2011-01-01

    To investigate if pregnancy associated plasma protein-A (PAPP-A) was present in the vulnerable plaque, and if not, to find alternative hypothesis for the release of PAPP-A.......To investigate if pregnancy associated plasma protein-A (PAPP-A) was present in the vulnerable plaque, and if not, to find alternative hypothesis for the release of PAPP-A....

  15. Pregnancy associated plasma protein-A (PAPP-A) is not a marker of the vulnerable atherosclerotic plaque

    DEFF Research Database (Denmark)

    Iversen, Kasper K; Teisner, Ane Søgaard; Dalager, Soren

    2011-01-01

    OBJECTIVE: To investigate if pregnancy associated plasma protein-A (PAPP-A) was present in the vulnerable plaque, and if not, to find alternative hypothesis for the release of PAPP-A. DESIGN AND METHODS: Vulnerable plaques and control tissues were examined by immunohistochemistry. Volunteers...

  16. New insight of functional molecular imaging into the atheroma biology: 18F-NaF and 18F-FDG in symptomatic and asymptomatic carotid plaques after recent CVA. Preliminary results.

    Science.gov (United States)

    Quirce, R; Martínez-Rodríguez, I; Banzo, I; Jiménez-Bonilla, J; Martínez-Amador, N; Ibáñez-Bravo, S; López-Defilló, J; Jiménez-Alonso, M; Revilla, M A; Carril, J M

    2016-11-01

    The identification of the vulnerable atheroma plaque could allow a more effective treatment of cerebrovascular accident (CVA). Active calcification and inflammation of the carotid atheroma were assessed and compared in symptomatic and asymptomatic plaques by 18F-NaF and 18F-FDG PET/CT. Nine patients investigated for recent CVA and no preventive treatment with statins were enrolled. In each patient, at least one atheroma plaque was detected by CT angiogram. In total, 18 plaques were available: 9 symptomatic and 9 asymptomatic. 18F-NaF uptake and 18F-FDG uptake by each plaque were assessed visually and semiquantitatively by calculating target/background ratios (TBRs) and TBR indexes (TBR symptomatic/TBR asymptomatic and 18F-NaF TBR/18F-FDG TBR within each of the 2 clinical groups of plaques). All plaques showed 18F-NaF and 18F-FDG uptake, and semiquantitation showed higher 18F-NaF uptake by 11 of the 18 plaques, 6 symptomatic and 5 asymptomatic. In the symptomatic group, the mean 18F-NaF TBR was 2·12 ± 0·44, and in the asymptomatic group, it was 1·85 ± 0·46. The 18F-NaF/18F-FDG showed that, overall, 18F-NaF uptake is higher than 18F-FDG. In the symptomatic plaques, the 18F-NaF was higher for the low calcium content and the lowest for the high. Active calcification and inflammation are simultaneous processes in the symptomatic and asymptomatic carotid atheroma. However, active calcification seems predominant over inflammation in both groups. In the symptomatic plaques, the highest 18F-NaF uptake does not correspond with the largest calcium content. These patterns open new insights on the role of 18F-NaF in the study of calcification and in the identification of the vulnerable carotid atheroma. © 2015 Scandinavian Society of Clinical Physiology and Nuclear Medicine. Published by John Wiley & Sons Ltd.

  17. Intravascular photoacoustic detection of vulnerable plaque based on constituent selected imaging

    Energy Technology Data Exchange (ETDEWEB)

    Zhang Jian; Xing Da, E-mail: xingda@scnu.edu.cn [MOE Key Laboratory of Laser Life Science and Institute of Laser Life Science, College of Biophotonics, South China Normal University, Guangzhou 510631 (China)

    2011-01-01

    Atherosclerosis, a disease of the large arteries, is the primary cause of heart disease and stroke. Over decades, atherosclerosis is characterized by thickening of the walls of the arteries, only advanced atherosclerotic disease could be observed. Photoacoustic imaging is a hybrid imaging technique that combines the advantages of high spatial resolution of ultrasound with contrast of optical absorption. In this paper, we present an intravascular photoacoustic (IVPA) imaging system to characterize vulnerable plaques by using the optical absorption contrast between different constituents. Epidemiological studies have revealed several important plaque constituents associated with early atherosclerosis, such as macrophage, cholesterol, lipid, calcification, and so on. We chose a section of lipid rich atherosclerosis artery and a section of normal artery as the phantom. Two IVPA images of them are given to show the difference between sick and normal. As a new method of detecting vulnerable plaque, IVPA constituents imaging will provide more details for diagnosis that offer an enticing prospect in early detecting of atherosclerosis.

  18. Soluble urokinase-type plasminogen activator receptor forms in plasma as markers of atherosclerotic plaque vulnerability

    DEFF Research Database (Denmark)

    Olson, Fredrik J; Thurison, Tine; Ryndel, Mikael

    2009-01-01

    . However, refuting the hypothesis, the concentrations of the suPAR forms were not higher in patients with short intervals between clinical event and blood sampling compared with those with long intervals. Age, inflammatory markers and diabetes were confounding factors independently associated with su......PAR forms. CONCLUSION:: Circulating suPAR forms are probably not useful biomarkers of atherosclerotic plaque vulnerability....

  19. PCA-based polling strategy in machine learning framework for coronary artery disease risk assessment in intravascular ultrasound: A link between carotid and coronary grayscale plaque morphology.

    Science.gov (United States)

    Araki, Tadashi; Ikeda, Nobutaka; Shukla, Devarshi; Jain, Pankaj K; Londhe, Narendra D; Shrivastava, Vimal K; Banchhor, Sumit K; Saba, Luca; Nicolaides, Andrew; Shafique, Shoaib; Laird, John R; Suri, Jasjit S

    2016-05-01

    Percutaneous coronary interventional procedures need advance planning prior to stenting or an endarterectomy. Cardiologists use intravascular ultrasound (IVUS) for screening, risk assessment and stratification of coronary artery disease (CAD). We hypothesize that plaque components are vulnerable to rupture due to plaque progression. Currently, there are no standard grayscale IVUS tools for risk assessment of plaque rupture. This paper presents a novel strategy for risk stratification based on plaque morphology embedded with principal component analysis (PCA) for plaque feature dimensionality reduction and dominant feature selection technique. The risk assessment utilizes 56 grayscale coronary features in a machine learning framework while linking information from carotid and coronary plaque burdens due to their common genetic makeup. This system consists of a machine learning paradigm which uses a support vector machine (SVM) combined with PCA for optimal and dominant coronary artery morphological feature extraction. Carotid artery proven intima-media thickness (cIMT) biomarker is adapted as a gold standard during the training phase of the machine learning system. For the performance evaluation, K-fold cross validation protocol is adapted with 20 trials per fold. For choosing the dominant features out of the 56 grayscale features, a polling strategy of PCA is adapted where the original value of the features is unaltered. Different protocols are designed for establishing the stability and reliability criteria of the coronary risk assessment system (cRAS). Using the PCA-based machine learning paradigm and cross-validation protocol, a classification accuracy of 98.43% (AUC 0.98) with K=10 folds using an SVM radial basis function (RBF) kernel was achieved. A reliability index of 97.32% and machine learning stability criteria of 5% were met for the cRAS. This is the first Computer aided design (CADx) system of its kind that is able to demonstrate the ability of coronary

  20. Vitamin K-antagonists accelerate atherosclerotic calcification and induce a vulnerable plaque phenotype.

    Directory of Open Access Journals (Sweden)

    Leon J Schurgers

    Full Text Available BACKGROUND: Vitamin K-antagonists (VKA are treatment of choice and standard care for patients with venous thrombosis and thromboembolic risk. In experimental animal models as well as humans, VKA have been shown to promote medial elastocalcinosis. As vascular calcification is considered an independent risk factor for plaque instability, we here investigated the effect of VKA on coronary calcification in patients and on calcification of atherosclerotic plaques in the ApoE(-/- model of atherosclerosis. METHODOLOGY/PRINCIPAL FINDINGS: A total of 266 patients (133 VKA users and 133 gender and Framingham Risk Score matched non-VKA users underwent 64-slice MDCT to assess the degree of coronary artery disease (CAD. VKA-users developed significantly more calcified coronary plaques as compared to non-VKA users. ApoE(-/- mice (10 weeks received a Western type diet (WTD for 12 weeks, after which mice were fed a WTD supplemented with vitamin K(1 (VK(1, 1.5 mg/g or vitamin K(1 and warfarin (VK(1&W; 1.5 mg/g & 3.0 mg/g for 1 or 4 weeks, after which mice were sacrificed. Warfarin significantly increased frequency and extent of vascular calcification. Also, plaque calcification comprised microcalcification of the intimal layer. Furthermore, warfarin treatment decreased plaque expression of calcification regulatory protein carboxylated matrix Gla-protein, increased apoptosis and, surprisingly outward plaque remodeling, without affecting overall plaque burden. CONCLUSIONS/SIGNIFICANCE: VKA use is associated with coronary artery plaque calcification in patients with suspected CAD and causes changes in plaque morphology with features of plaque vulnerability in ApoE(-/- mice. Our findings underscore the need for alternative anticoagulants that do not interfere with the vitamin K cycle.

  1. Association between serum 25-hydroxyvitamin D and carotid atherosclerotic plaque in Chinese type 2 diabetic patients

    Science.gov (United States)

    Ding, Ya-Hui; Wei, Tie-Ming; Qian, Lin-Yan; Ma, Yuan; Lao, Di-Bo; Yao, Bin; Pang, Jie

    2017-01-01

    Abstract In this study, we investigated the distribution of vitamin D and its association with carotid atherosclerotic plaque (CP) in Chinese type 2 diabetic (T2D) patients. We performed a cross-sectional study in 210 T2D and 94 age- and gender-matched nondiabetic patients during winter months, by determining serum 25-hydroxyvitamin D (25(OH)D) levels in both diabetic and nondiabetic controls. We carried out measurements of B-mode ultrasonography of carotid arteries in each T2D patient. The 25(OH)D concentration was 26.25 nmol/L among the T2D patients. About 93.3% T2D patients suffered from hypovitaminosis D. First, we found a clear inverse correlation between the 25(OH)D concentration and CP (P confounding factors, we also observed a positive correlation between low levels of 25(OH)D in T2D patients with CP, when the following parameters were measured: old age (odds ratio [OR] = 2.533, P = 0.013); smoking (OR = 3.872, P = 0.001); and high level of low-density lipoprotein (LDL) cholesterol (OR = 2.776, P = 0.009). Thus, we concluded that high prevalence of hypovitaminosis D exists in Chinese T2D patients. Further, we found a significant association between low concentration of serum 25(OH)D and the existence of high body mass index, and high circulating LDL to be substantially positive predictors of patients with CP in T2D. PMID:28353575

  2. Local axial compressive mechanical properties of human carotid atherosclerotic plaques-characterisation by indentation test and inverse finite element analysis.

    Science.gov (United States)

    Chai, Chen-Ket; Akyildiz, Ali C; Speelman, Lambert; Gijsen, Frank J H; Oomens, Cees W J; van Sambeek, Marc R H M; van der Lugt, Aad; Baaijens, Frank P T

    2013-06-21

    The fibrous cap of an atherosclerotic plaque may be prone to rupture if the occurring stresses exceed the strength of the cap. Rupture can cause acute thrombosis and subsequent ischaemic stroke or myocardial infarction. A reliable prediction of the rupture probability is essential for the appropriate treatment of atherosclerosis. Biomechanical models, which compute stresses and strain, are promising to provide a more reliable rupture risk prediction. However, these models require knowledge of the local biomechanical properties of atherosclerotic plaque tissue. For this purpose, we examined human carotid plaques using indentation experiments. The test set-up was mounted on an inverted confocal microscope to visualise the collagen fibre structure during the tests. By using an inverse finite element (FE) approach, and assuming isotropic neo-Hookean behaviour, the corresponding Young's moduli were found in the range from 6 to 891kPa (median 30kPa). The results correspond to the values obtained by other research groups who analysed the compressive Young's modulus of atherosclerotic plaques. Collagen rich locations showed to be stiffer than collagen poor locations. No significant differences were found between the Young's moduli of structured and unstructured collagen architectures as specified from confocal collagen data. Insignificant differences between the middle of the fibrous cap, the shoulder regions, and remaining plaque tissue locations indicate that axial, compressive mechanical properties of atherosclerotic plaques are independent of location within the plaque. Copyright © 2013 Elsevier Ltd. All rights reserved.

  3. Atherosclerotic plaque volume and composition in symptomatic carotid arteries assessed with multidetector CT angiography; relationship with severity of stenosis and cardiovascular risk factors

    Energy Technology Data Exchange (ETDEWEB)

    Rozie, S.; Weert, T.T. de; Monye, C. de; Homburg, P.J.; Tanghe, H.L.J.; Lugt, A. van der [Erasmus MC, University Medical Center Rotterdam, Departments of Radiology, Rotterdam (Netherlands); Dippel, D.W.J. [Erasmus MC, University Medical Center Rotterdam, Department of Neurology, PO Box 2040, Rotterdam (Netherlands)

    2009-09-15

    The purpose of this study was to examine the volume and the composition of atherosclerotic plaque in symptomatic carotid arteries and to investigate the relationship between these plaque features and the severity of stenosis and the presence of cardiovascular risk factors. One hundred patients with cerebrovascular symptoms underwent CT angiography. We measured plaque volume (PV) and the relative contribution of plaque components (calcifications, fibrous tissue, and lipid) in the symptomatic artery. The contribution of different components was measured as the number of voxels within defined ranges of HU values (calcification >130 HU, fibrous tissue 60-130 HU, lipid core <60 HU). Fifty-seven patients had atherosclerotic plaque in the symptomatic carotid artery. The severity of stenosis and PV were moderately correlated. Age and smoking were independently related to PV. Patients with hypercholesterolemia had significantly less lipid and more calcium in their plaques than patients without hypercholesterolemia. Other cardiovascular risk factors were not significantly related to PV or plaque composition. Luminal stenosis of the carotid artery partly reflects the amount of atherosclerotic carotid disease. Plaque volume and plaque composition are associated with cardiovascular risk factors. (orig.)

  4. A new method for IVUS-based coronary artery disease risk stratification: A link between coronary & carotid ultrasound plaque burdens.

    Science.gov (United States)

    Araki, Tadashi; Ikeda, Nobutaka; Shukla, Devarshi; Londhe, Narendra D; Shrivastava, Vimal K; Banchhor, Sumit K; Saba, Luca; Nicolaides, Andrew; Shafique, Shoaib; Laird, John R; Suri, Jasjit S

    2016-02-01

    Interventional cardiologists have a deep interest in risk stratification prior to stenting and percutaneous coronary intervention (PCI) procedures. Intravascular ultrasound (IVUS) is most commonly adapted for screening, but current tools lack the ability for risk stratification based on grayscale plaque morphology. Our hypothesis is based on the genetic makeup of the atherosclerosis disease, that there is evidence of a link between coronary atherosclerosis disease and carotid plaque built up. This novel idea is explored in this study for coronary risk assessment and its classification of patients between high risk and low risk. This paper presents a strategy for coronary risk assessment by combining the IVUS grayscale plaque morphology and carotid B-mode ultrasound carotid intima-media thickness (cIMT) - a marker of subclinical atherosclerosis. Support vector machine (SVM) learning paradigm is adapted for risk stratification, where both the learning and testing phases use tissue characteristics derived from six feature combinational spaces, which are then used by the SVM classifier with five different kernels sets. These six feature combinational spaces are designed using 56 novel feature sets. K-fold cross validation protocol with 10 trials per fold is used for optimization of best SVM-kernel and best feature combination set. IRB approved coronary IVUS and carotid B-mode ultrasound were jointly collected on 15 patients (2 days apart) via: (a) 40MHz catheter utilizing iMap (Boston Scientific, Marlborough, MA, USA) with 2865 frames per patient (42,975 frames) and (b) linear probe B-mode carotid ultrasound (Toshiba scanner, Japan). Using the above protocol, the system shows the classification accuracy of 94.95% and AUC of 0.95 using optimized feature combination. This is the first system of its kind for risk stratification as a screening tool to prevent excessive cost burden and better patients' cardiovascular disease management, while validating our two hypotheses.

  5. Stroke Risk Stratification and its Validation using Ultrasonic Echolucent Carotid Wall Plaque Morphology: A Machine Learning Paradigm.

    Science.gov (United States)

    Araki, Tadashi; Jain, Pankaj K; Suri, Harman S; Londhe, Narendra D; Ikeda, Nobutaka; El-Baz, Ayman; Shrivastava, Vimal K; Saba, Luca; Nicolaides, Andrew; Shafique, Shoaib; Laird, John R; Gupta, Ajay; Suri, Jasjit S

    2017-01-01

    Stroke risk stratification based on grayscale morphology of the ultrasound carotid wall has recently been shown to have a promise in classification of high risk versus low risk plaque or symptomatic versus asymptomatic plaques. In previous studies, this stratification has been mainly based on analysis of the far wall of the carotid artery. Due to the multifocal nature of atherosclerotic disease, the plaque growth is not restricted to the far wall alone. This paper presents a new approach for stroke risk assessment by integrating assessment of both the near and far walls of the carotid artery using grayscale morphology of the plaque. Further, this paper presents a scientific validation system for stroke risk assessment. Both these innovations have never been presented before. The methodology consists of an automated segmentation system of the near wall and far wall regions in grayscale carotid B-mode ultrasound scans. Sixteen grayscale texture features are computed, and fed into the machine learning system. The training system utilizes the lumen diameter to create ground truth labels for the stratification of stroke risk. The cross-validation procedure is adapted in order to obtain the machine learning testing classification accuracy through the use of three sets of partition protocols: (5, 10, and Jack Knife). The mean classification accuracy over all the sets of partition protocols for the automated system in the far and near walls is 95.08% and 93.47%, respectively. The corresponding accuracies for the manual system are 94.06% and 92.02%, respectively. The precision of merit of the automated machine learning system when compared against manual risk assessment system are 98.05% and 97.53% for the far and near walls, respectively. The ROC of the risk assessment system for the far and near walls is close to 1.0 demonstrating high accuracy.

  6. Carotid artery stenosis with a high-intensity signal plaque on time-of-flight magnetic resonance angiography and association with evidence of intraplaque hypoxia.

    Science.gov (United States)

    Ogata, Atsushi; Kawashima, Masatou; Wakamiya, Tomihiro; Nishihara, Masashi; Masuoka, Jun; Nakahara, Yukiko; Ebashi, Ryo; Inoue, Kohei; Takase, Yukinori; Irie, Hiroyuki; Abe, Tatsuya

    2017-06-01

    OBJECTIVE Hypoxia induces angiogenesis and plays a major role in the progression of carotid plaques. During carotid intervention, plaques with high-intensity signals on time-of-flight (TOF) magnetic resonance angiography (MRA) often cause ischemic stroke and embolic complications. However, the role of intraplaque hypoxia before carotid endarterectomy (CEA) and carotid artery stenting is not presently understood. In this study the authors aimed to investigate the relationship between intraplaque hypoxia and MRA findings. METHODS Nineteen consecutive patients with 20 carotid artery stenoses who underwent CEA at Saga University Hospital between August 2008 and December 2014 were enrolled in the study. The expressions of hypoxia-inducible transcription factor-1α (HIF-1α) and vascular endothelial growth factor (VEGF) were analyzed by immunohistochemical analysis. In addition, the relationship between the findings on TOF MRA and pathology for the carotid plaques was analyzed. RESULTS High-intensity plaques on TOF MRA showed higher expression levels of HIF-1α (p = 0.015) and VEGF (p = 0.007) compared with isointensity plaques. The rate of intraplaque hemorrhage (IPH) on TOF MRA was also significantly higher in the high-intensity plaques than in the isointensity plaques (p = 0.024). Finally, the mean number of neovessels was significantly higher in those without plaque hemorrhage than in those with plaque hemorrhage (p = 0.010). CONCLUSIONS Plaques with high-intensity signals on TOF MRA were associated with IPH and evidence of intraplaque hypoxia. This fact may represent an opportunity to establish novel therapeutic agents targeting intraplaque hypoxia.

  7. Magnetic Resonance Imaging Plaque Hemorrhage for Risk Stratification in Carotid Artery Disease With Moderate Risk Under Current Medical Therapy.

    Science.gov (United States)

    Hosseini, Akram A; Simpson, Richard J; Altaf, Nishath; Bath, Philip M; MacSweeney, Shane T; Auer, Dorothee P

    2017-03-01

    Magnetic resonance imaging (MRI)-defined carotid plaque hemorrhage (MRIPH) can predict recurrent cerebrovascular ischemic events in severe symptomatic carotid stenosis. It is less clear whether MRIPH can improve risk stratification despite optimized medical secondary prevention in those with moderate risk. One-hundred fifty-one symptomatic patients with 30% to 99% carotid artery stenosis (median age: 77, 60.5% men) clinically deemed to not benefit from endarterectomy were prospectively recruited to undergo MRI and clinical follow-up (mean, 22 months). The clinical carotid artery risk score could be evaluated in 88 patients. MRIPH+ve was defined as plaque intensity >150% that of adjacent muscle. Survival analyses were performed with recurrent infarction (stroke or diffusion-positive cerebral ischemia) as the main end point. Fifty-five participants showed MRIPH+ve; 47 had low, 36 intermediate, and 5 high carotid artery risk scores. Cox regression showed MRIPH as a strong predictor of future infarction (hazard ratio, 5.2; 95% confidence interval, 1.64-16.34; P=0.005, corrected for degree of stenosis), also in the subgroup with 50% to 69% stenosis (hazard ratio, 4.1; 95% confidence interval, 1-16.8; P=0.049). The absolute risk of future infarction was 31.7% at 3 years in MRIPH+ve versus 1.8% in patients without (Pmedication with clinically uncertain benefit from recanalization, that is, those with moderate degree stenosis and intermediate carotid artery risk scores, MRIPH offers additional risk stratification. © 2017 American Heart Association, Inc.

  8. Detection of Vulnerable Atherosclerotic Plaques in Experimental Atherosclerosis with the USPIO-Enhanced MRI.

    Science.gov (United States)

    Qi, Chun-Mei; Du, Lili; Wu, Wei-Heng; Li, Dong-Ye; Hao, Ji; Gong, Lei; Deng, Liangrong; Zhang, Tao; Zhang, Chao; Zhang, Yu

    2015-11-01

    This study's goal was to assess the diagnostic value of the USPIO-(ultra-small superparamagnetic iron oxide) enhanced magnetic resonance imaging (MRI) in detection of vulnerable atherosclerotic plaques in abdominal aorta in experimental atherosclerosis. Thirty New Zealand rabbits were randomly divided into two groups, Group A and Group B. Each group comprised 15 animals which were fed with high cholesterol diet for 8 weeks and then subjected to balloon-induced endothelial injury of the abdominal aorta. After another 8 weeks, animals in Group B received adenovirus carrying p53 gene that was injected through a catheter into the aortic segments rich in plaques. Two weeks later, all rabbits were challenged with the injection of Chinese Russell's viper venom and histamine. Pre-contrast images and USPIO-enhanced MRI images were obtained after pharmacological triggering with injection of USPIO for 5 days. Blood specimens were taken for biochemical and serological tests at 0 and 18 weeks. Abdominal aorta was histologically studied. The levels of serum ICAM-1 and VCAM-1 were quantified by ELISA. Vulnerable plaques appeared as a local hypo-intense signal on the USPIO-enhanced MRI, especially on T2*-weighted sequences. The signal strength of plaques reached the peak at 96 h. Lipid levels were significantly (p < 0.05) higher in both Group A and B compared with the levels before the high cholesterol diet. The ICAM-1 and VCAM-1 levels were significantly (p < 0.05) higher in Group B compared with Group A. The USPIO-enhanced MRI efficiently identifies vulnerable plaques due to accumulation of USPIO within macrophages in abdominal aorta plaques.

  9. Effects of decline in renal function with age on the outcome of asymptomatic carotid plaque in healthy adults:a 5-year follow-up study

    Institute of Scientific and Technical Information of China (English)

    JIANG Shi-min; SUN Xue-feng; GU Hong-xia; CHEN Yun-shuang; XI Chun-sheng; QIAO Xi; CHEN Xiang-mei

    2012-01-01

    Background It has been long suggested that abnormal clinical factors in the body,such as dyslipidemia and diabetes.can affect the presence of atherosclerosis.However,few studies on the effect of factors within the normal range,such as the loss of renal function with age,on the prevalence of atherosclerosis are few know in healthy individuals.The aim of this study was to investigate risk factors affecting the presence of asymptomatic carotid plaques in a middle-aged and elderly healthy population.Methods In this regard,we prospectively evaluated 245 healthy individuals (98 males and 147 females) at baseline and after 5 years.Changes in the presence of carotid plaque between 2003 and 2008 were categorized into four groups,i.e.subjects without plaque at entry (n=165):Group 1 (without plaque on two occasions,n=129) and Group 2 (with nascent plaque at follow-up,n=36); subjects with plaque at entry (n=80); Group 3 (with plaque regression at follow-up,n=29) and Group 4 (with plaque on two occasions,n=51).Results Univariate analysis showed that the positive rate of carotid plaques in males was higher than that in females at the baseline,and that a significantly inverse correlation existed between the prevalence rate of plaque and aging.Logistic regression analysis of cross-sectional research showed that independent risk factors for the prevalence of atherosclerosis were male gender,lower estimated glomerular filtration rate (eGFR) and higher low-density lipoprotein cholesterol (LDL-C) at the baseline,and older age and lower eGFR were involved in the presence of carotid plaques at follow-up point.However,logistic regression analysis of the longitudinal data showed that older age,decreased eGFR and increased systolic blood pressure (SBP) independently predicted the presence of carotid plaques after 5 years in subjects without plaque at entry.In addition,in subjects with plaque at entry,age,changes in eGFR and the baseline levels of serum albumin (ALB) and serum total

  10. Safrole-2',3'-oxide induces atherosclerotic plaque vulnerability in apolipoprotein E-knockout mice.

    Science.gov (United States)

    Su, Le; Zhang, Haiyan; Zhao, Jing; Zhang, Shangli; Zhang, Yun; Zhao, Baoxiang; Miao, Junying

    2013-02-27

    Safrole-2',3'-oxide (SFO) is the major electrophilic metabolite of safrole (4-allyl-1, 2-methylenedioxybenzene), a natural plant constituent found in essential oils of numerous edible herbs and spices and in food containing these herbs, such as pesto sauce, cola beverages and bologna sausages. The effects of SFO in mammalian systems, especially the cardiovascular system, are little known. Disruption of vulnerable atherosclerotic plaques in atherosclerosis, a chronic inflammatory disease, is the main cause of cardiovascular events. In this study, we investigated SFO-induced atherosclerotic plaque vulnerability (possibility of rupture) in apolipoprotein E-knockout (apoE(-/-)) mice. Lipid area in vessel wall reached 59.8% in high dose SFO (SFO-HD) treated group, which is only 31.2% in control group. SFO treatment changed the lesion composition to an unstable phenotype, increased the number of apoptotic cells in plaque and the endothelium in plaques was damaged after SFO treatment. Furthermore, compared with control groups, the plaque endothelium level of p75(NTR) was 3-fold increased and the liver level of p75(NTR) was 17.4-fold increased by SFO-HD. Meanwhile, the serum level of KC (a functional homolog of IL-8 and the main proinflammatory alpha chemokine in mice) in apoE(-/-) mice was up to 357pg/ml in SFO-HD treated group. Thus, SFO contributes to the instability of atherosclerotic plaque in apoE(-/-) mice through activating p75(NTR) and IL-8 and cell apoptosis in plaque.

  11. Coincidence of calcified carotid atheromatous plaque, osteoporosis, and periodontal bone loss in dental panoramic radiographs

    Energy Technology Data Exchange (ETDEWEB)

    Ramesh, Aruna; Ganguly, Rumpa [Dept. of Diagnosis and Health Promotion, Division of Oral and Maxillofacial Radiology, Tufts University School of Dental Medicine, Boston (United States); Soroushian, Sheila [Dept. of Orthodontics, Howard University College of Dentistry, Washington, DC(United States)

    2013-12-15

    This study was performed to assess the correlation of calcified carotid atheromatous plaque (CCAP), the mandibular cortical index, and periodontal bone loss in panoramic radiographs. One hundred eighty-five panoramic radiographs with CCAP and 234 without this finding were evaluated by 3 observers for the presence of osseous changes related to osteoporosis and periodontal bone loss. Chi-squared and Mann-Whitney U tests were used to compare the two groups for an association of CCAP with the mandibular cortical index and periodontal bone loss, respectively. There was a statistically significant coincidence of CCAP and osseous changes related to osteopenia/osteoporosis, with a p-value <0.001. There was no statistically significant coincidence of CCAP and periodontal bone loss. When comparing the 2 groups, 'With CCAP' and 'Without CCAP', there was a statistically significant association with the mean body mass index (BMI), number of remaining teeth, positive history of diabetes mellitus, and vascular accidents. There was no statistically significant association with gender or a history of smoking. This study identified a possible concurrence of CCAP and mandibular cortical changes secondary to osteopenia/osteoporosis in panoramic radiographs. This could demonstrate the important role of dental professionals in screening for these systemic conditions, leading to timely and appropriate referrals resulting in early interventions and thus improving overall health.

  12. Circulating Leukocyte and Carotid Atherosclerotic Plaque Telomere Length Interrelation, Association With Plaque Characteristics, and Restenosis After Endarterectomy

    NARCIS (Netherlands)

    Huzen, Jardi; Peeters, Wouter; de Boer, Rudolf A.; Moll, Frans L.; Wong, Liza S. M.; Codd, Veryan; de Kleijn, Dominique P. V.; de Smet, Bart J. G. L.; van Veldhuisen, Dirk J.; Samani, Nilesh J.; van Gilst, Wiek H.; Pasterkamp, Gerard; van der Harst, Pim

    2011-01-01

    Objective-Shorter leukocyte telomeres are associated with atherosclerosis and predict future heart disease. The goal of the present study was to determine whether leukocyte telomere length is related to atherosclerotic plaque telomere length and whether it is associated with plaque characteristics o

  13. Turbulence intensity measurements using particle image velocimetry in diseased carotid artery models: effect of stenosis severity, plaque eccentricity, and ulceration.

    Science.gov (United States)

    Kefayati, Sarah; Holdsworth, David W; Poepping, Tamie L

    2014-01-01

    Clinical decision-making for the treatment of patients with diseased carotid artery is mainly based on the severity of the stenosis. However, stenosis severity alone is not a sensitive indicator, and other local factors for the assessment of stroke risk are required. Flow disturbance is of particular interest due to its proven association with increased thromboembolic activities. The objective of this study was to investigate the level of turbulence intensity (TI) with regards to certain geometrical features of the plaque - namely stenosis severity, eccentricity, and ulceration. A family of eight carotid-artery bifurcation models was examined using particle image velocimetry. Results showed a marked difference in turbulence intensity among these models; increasing degree of stenosis severity resulted in increased turbulence intensity, going from 0.12 m/s for mild stenosis to 0.37 m/s for severe stenosis (with concentric geometry). Moreover, independent of stenosis severity, eccentricity led to further elevations in turbulence intensity, increasing TI by 0.05-0.10 m/s over the counterpart concentric plaque. The presence of ulceration (in a 50% eccentric plaque) produced a larger portion of moderate turbulence intensity (~0.10 m/s) compared to the non-ulcerated model, more proximal to the bifurcation apex in the post-stenotic recirculation zone. The effect of plaque eccentricity and ulceration in enhancing the downstream turbulence has potential clinical implications for a more sensitive assessment of stroke risk beyond stenosis severity alone.

  14. Cadmium exposure and atherosclerotic carotid plaques –Results from the Malmö diet and Cancer study

    Energy Technology Data Exchange (ETDEWEB)

    Fagerberg, Björn, E-mail: bjorn.fagerberg@wlab.gu.se [Department of Molecular and Clinical Medicine, Wallenberg Laboratory for Cardiovascular and Metabolic Research, University of Gothenburg, Sahlgrenska University Hospital, SE-413 45 Gothenburg (Sweden); Barregard, Lars, E-mail: lars.barregard@amm.gu.se [Occupational and Environmental Medicine, Sahlgrenska University Hospital and University of Gothenburg, SE 413 45 Gothenburg (Sweden); Sallsten, Gerd, E-mail: gerd.sallsten@amm.gu.se [Occupational and Environmental Medicine, Sahlgrenska University Hospital and University of Gothenburg, SE 413 45 Gothenburg (Sweden); Forsgard, Niklas, E-mail: niklas.forsgard@vgregion.se [Department of Clinical Chemistry, Sahlgrenska University Hospital, SE-413 45 Gothenburg (Sweden); Östling, Gerd, E-mail: gerd.ostling@med.lu.se [Cardiovascular Epidemiology, Department of Clinical Sciences in Malmö, CRC, Jan Waldenströms gata 35, Skane University Hospital, Malmö, 205 02 Malmö (Sweden); Persson, Margaretha, E-mail: margaretha.persson@med.lu.se [Cardiovascular Epidemiology, Department of Clinical Sciences in Malmö, CRC, Jan Waldenströms gata 35, Skane University Hospital, Malmö, 205 02 Malmö (Sweden); Borné, Yan, E-mail: yan.borne@med.lu.se [Cardiovascular Epidemiology, Department of Clinical Sciences in Malmö, CRC, Jan Waldenströms gata 35, Skane University Hospital, Malmö, 205 02 Malmö (Sweden); and others

    2015-01-15

    Background: Epidemiological studies indicate that cadmium exposure through diet and smoking is associated with increased risk of cardiovascular disease. There are few data on the relationship between cadmium and plaques, the hallmark of underlying atherosclerotic disease. Objectives: To examine the association between exposure to cadmium and the prevalence and size of atherosclerotic plaques in the carotid artery. Methods: A population sample of 4639 Swedish middle-aged women and men was examined in 1991–1994. Carotid plaque was determined by B-mode ultrasound. Cadmium in blood was analyzed by inductively coupled plasma mass spectrometry. Results: Comparing quartile 4 with quartile 1 of blood cadmium, the odds ratio (OR) for prevalence of any plaque was 1.9 (95% confidence interval 1.6–2.2) after adjustment for sex and, age; 1.4 (1.1–1.8) after additional adjustment for smoking status; 1.4 (1.1–1.7) after the addition of education level and life style factors; 1.3 (1.03–1.8) after additional adjustment for risk factors and predictors of cardiovascular disease. No effect modification by sex was found in the cadmium-related prevalence of plaques. Similarly, ORs for the prevalence of small and large plaques were after full adjustment 1.4 (1.0–2.1) and 1.4 (0.9–2.0), respectively. The subgroup of never smokers showed no association between cadmium and atherosclerotic plaques. Conclusions: These results extend previous studies on cadmium exposure and clinical cardiovascular events by adding data on the association between cadmium and underlying atherosclerosis in humans. The role of smoking remains unclear. It may both cause residual confounding and be a source of pro-atherogenic cadmium exposure. - Highlights: • Blood cadmium level is associated with atherosclerotic plaques in the carotid artery. • The results extend previous knowledge of cadmium exposure and clinical events. • The role of smoking remains unclear.

  15. Echo-lucency of computerized ultrasound images of carotid atherosclerotic plaques are associated with increased levels of triglyceride-rich lipoproteins as well as increased plaque lipid content

    DEFF Research Database (Denmark)

    Grønholdt, Marie-Louise Moes; Nordestgaard, Børge G.; Weibe, Brit M.

    1998-01-01

    with elevated levels of fasting and postprandial plasma triglycerides (P=.0002 and P=.002), IDL cholesterol (P=.0009 and P=.006), and VLDL/chylomicron remnant cholesterol (P=.0003 and P=.0004) and triglycerides (P=.0003 and P=.003), the area under the plasma triglyceride curve 0 to 4 hours after a fatty meal (P......=.001): and body mass index (P=.0001). On ANCOVA, body mass index, fasting IDL cholesterol, and fasting plasma triglycerides were independent predictors of echo-lucency. Echo-lucency was associated with increased relative plaque lipid content (P=.02). Conclusions-Increased plasma levels of triglyceride......Background-Echo-lucency of carotid atherosclerotic plaques on computerized ultrasound B-mode images has been associated with a high incidence of brain infarcts as evaluated on CT scans. We tested the hypotheses that triglyceride-rich lipoproteins in the fasting and postprandial state predict...

  16. Combination of Magnetic Resonance Angiography and Computational Fluid Dynamics May Predict the Risk of Stroke in Patients with Asymptomatic Carotid Plaques

    Science.gov (United States)

    Jia, Qian; Liu, Hongbin; Li, Yanping; Wang, Xiaoxi; Jia, Jinju; Li, Yuying

    2017-01-01

    Background Atherosclerosis plaques in the carotid arteries frequently have been found in patients with stroke. However, the pathogenesis of carotid plaque from asymptomatic to cerebrovascular events is a complex process which is still not completely understood. We aimed to investigate the prognosis of asymptomatic carotid atherosclerotic plaques by use of magnetic resonance angiography (MRA) combined with computational fluid dynamics (CFD). Material/Methods We prospectively studied a cohort of 228 participants (mean age 59.21±8.48) with asymptomatic carotid atherosclerotic plaques; mean follow-up duration was 1147.56±224.84 days. Plaque morphology parameters were obtained by MRA analysis. Lumen area (LA) and total vessel area (TVA) were measured, and wall area (WA=TVA−LA) and normalized wall area index (NWI=WA/TVA) were calculated. CFD analysis was performed to evaluate hemodynamic characteristics, including wall pressure (WP) and wall shear stress (WSS). Independent risk factors for stroke were obtained by Cox regression analysis. The area under the curve (AUC) of receiver operator characteristic (ROC) and Z-statistic test were used to evaluate risk factors. Results Logistics regression analysis showed NWI (OR: 3.472, 95% CI: 2.943–4.096, P=0.11) and WSS (OR: 6.974, 95% CI: 1.070–45.453, P=0.42) were independent risk factors of stroke for patients with asymptomatic carotid plaques. The area under the ROC curve values for WSS, NWI, and WSS+NWI were 0.772, 0.798, and 0.903, respectively. Conclusions The combination of plaque morphology characteristics NWI and hemodynamic parameter WSS may predict the risk of stroke in patients with asymptomatic carotid plaques. PMID:28126983

  17. Human carotid atherosclerotic plaque protein(s) change HDL protein(s) composition and impair HDL anti-oxidant activity.

    Science.gov (United States)

    Cohen, Elad; Aviram, Michael; Khatib, Soliman; Volkova, Nina; Vaya, Jacob

    2016-01-01

    High density lipoprotein (HDL) anti-atherogenic functions are closely associated with cardiovascular disease risk factor, and are dictated by its composition, which is often affected by environmental factors. The present study investigates the effects of the human carotid plaque constituents on HDL composition and biological functions. To this end, human carotid plaques were homogenized and incubated with HDL. Results showed that after incubation, most of the apolipoprotein A1 (Apo A1) protein was released from the HDL, and HDL diameter increased by an average of approximately 2 nm. In parallel, HDL antioxidant activity was impaired. In response to homogenate treatment HDL could not prevent the accelerated oxidation of LDL caused by the homogenate. Boiling of the homogenate prior to its incubation with HDL abolished its effects on HDL composition changes. Moreover, tryptophan fluorescence quenching assay revealed an interaction between plaque component(s) and HDL, an interaction that was reduced by 50% upon using pre-boiled homogenate. These results led to hypothesize that plaque protein(s) interacted with HDL-associated Apo A1 and altered the HDL composition. Immuno-precipitation of Apo A1 that was released from the HDL after its incubation with the homogenate revealed a co-precipitation of three isomers of actin. However, beta-actin alone did not significantly affect the HDL composition, and yet the active protein within the plaque was elusive. In conclusion then, protein(s) in the homogenate interact with HDL protein(s), leading to release of Apo A1 from the HDL particle, a process that was associated with an increase in HDL diameter and with impaired HDL anti-oxidant activity.

  18. Modeling of drug and drug-encapsulated nanoparticle transport in patient-specific coronary artery walls to treat vulnerable plaques

    KAUST Repository

    Hossain, Shaolie S.

    2010-01-01

    The main objective of this work is to develop computational tools to support the design of a catheter-based local drug delivery system that uses nanoparticles as drug carriers in order to treat vulnerable plaques and diffuse atherosclerotic disease.

  19. Elevated expression of mechanosensory polycystins in human carotid atherosclerotic plaques: association with p53 activation and disease severity.

    Science.gov (United States)

    Varela, Aimilia; Piperi, Christina; Sigala, Fragiska; Agrogiannis, George; Davos, Constantinos H; Andri, Maria-Anastasia; Manopoulos, Christos; Tsangaris, Sokrates; Basdra, Efthimia K; Papavassiliou, Athanasios G

    2015-08-19

    Atherosclerotic plaque formation is associated with irregular distribution of wall shear stress (WSS) that modulates endothelial function and integrity. Polycystins (PC)-1/-2 constitute a flow-sensing protein complex in endothelial cells, able to respond to WSS and induce cell-proliferation changes leading to atherosclerosis. An endothelial cell-culture system of measurable WSS was established to detect alterations in PCs expression under conditions of low- and high-oscillatory shear stress in vitro. PCs expression and p53 activation as a regulator of cell proliferation were further evaluated in vivo and in 69 advanced human carotid atherosclerotic plaques (AAPs). Increased PC-1/PC-2 expression was observed at 30-60 min of low shear stress (LSS) in endothelial cells. Elevated PC-1 expression at LSS was followed by p53 potentiation. PCs immunoreactivity localizes in areas with macrophage infiltration and neovascularization. PC-1 mRNA and protein levels were significantly higher than PC-2 in stable fibroatherotic (V) and unstable/complicated (VI) AAPs. Elevated PC-1 immunostaining was detected in AAPs from patients with diabetes mellitus, dyslipidemia, hypertension and carotid stenosis, at both arteries (50%) or in one artery (90%). PCs seem to participate in plaque formation and progression. Since PC-1 upregulation coincides with p38 and p53 activation, a potential interplay of these molecules in atherosclerosis induction is posed.

  20. Captured Macro-embolus of Fractured Atheromatous Plaque by the Embolic Protection Device during Carotid Stent Assisted Angioplasty.

    Science.gov (United States)

    Kim, Mun Chul; Bennett, Shelby; Farb, Richard; Croul, Sydney; Lee, Seon-Kyu

    2013-02-01

    The authors present a case in which macro-embolus from the ruptured atheromatous plaque developed during carotid artery stenting (CAS). A 63-year-old man who had suffered a left middle cerebral artery territory infarction had significant proximal left internal carotid artery stenosis required CAS procedure. Immediate after stent deployment, the patient showed abrupt neurological deterioration with 12 × 3 mm sized macro-embolus which was caught by the embolus protection device (EPD). Retrieval of the macro-embolus was performed safely and the patient recovered to pre-procedure status. Macro-embolus can be resulted during the CAS. The EPD can capture the macro-embolus and safe removal is technically feasible.

  1. Plaque characterization in ex vivo MRI evaluated by dense 3D correspondence with histology

    DEFF Research Database (Denmark)

    van Engelen, Arna; de Bruijne, Marleen; Klein, Stefan;

    2011-01-01

    Automatic quantification of carotid artery plaque composition is important in the development of methods that distinguish vulnerable from stable plaques. MRI has shown to be capable of imaging different components noninvasively. We present a new plaque classification method which uses 3D registra...

  2. High-risk plaque features can be detected in non-stenotic carotid plaques of patients with ischaemic stroke classified as cryptogenic using combined {sup 18}F-FDG PET/MR imaging

    Energy Technology Data Exchange (ETDEWEB)

    Hyafil, Fabien [Technische Universitaet Muenchen, Department of Nuclear Medicine, Klinikum rechts der Isar, Munich (Germany); Bichat University Hospital, Department of Nuclear Medicine, Paris (France); Schindler, Andreas; Obenhuber, Tilman; Saam, Tobias [Ludwig Maximilians University Hospital Munich, Institute for Clinical Radiology, Munich (Germany); Sepp, Dominik; Hoehn, Sabine; Poppert, Holger [Technische Universitaet Muenchen, Department of Neurology, Klinikum rechts der Isar, Munich (Germany); Bayer-Karpinska, Anna [Ludwig Maximilians University Hospital Munich, Institute for Stroke and Dementia Research, Munich (Germany); Boeckh-Behrens, Tobias [Technische Universitaet Muenchen, Department of Neuroradiology, Klinikum Rechts der Isar, Munich (Germany); Hacker, Marcus [Medical University of Vienna, Division of Nuclear Medicine, Department of Biomedical Imaging and Image-guided Therapy, Vienna (Austria); Nekolla, Stephan G. [Technische Universitaet Muenchen, Department of Nuclear Medicine, Klinikum rechts der Isar, Munich (Germany); Partner Site Munich Heart Alliance, German Centre for Cardiovascular Research (DZHK), Munich (Germany); Rominger, Axel [Ludwig Maximilians University Hospital Munich, Department of Nuclear Medicine, Munich (Germany); Dichgans, Martin [Technische Universitaet Muenchen, Department of Neurology, Klinikum rechts der Isar, Munich (Germany); Munich Cluster of Systems Neurology (SyNergy), Munich (Germany); Schwaiger, Markus [Technische Universitaet Muenchen, Department of Nuclear Medicine, Klinikum rechts der Isar, Munich (Germany)

    2016-02-15

    The aim of this study was to investigate in 18 patients with ischaemic stroke classified as cryptogenic and presenting non-stenotic carotid atherosclerotic plaques the morphological and biological aspects of these plaques with magnetic resonance imaging (MRI) and {sup 18}F-fluoro-deoxyglucose positron emission tomography ({sup 18}F-FDG PET) imaging. Carotid arteries were imaged 150 min after injection of {sup 18}F-FDG with a combined PET/MRI system. American Heart Association (AHA) lesion type and plaque composition were determined on consecutive MRI axial sections (n = 460) in both carotid arteries. {sup 18}F-FDG uptake in carotid arteries was quantified using tissue to background ratio (TBR) on corresponding PET sections. The prevalence of complicated atherosclerotic plaques (AHA lesion type VI) detected with high-resolution MRI was significantly higher in the carotid artery ipsilateral to the ischaemic stroke as compared to the contralateral side (39 vs 0 %; p = 0.001). For all other AHA lesion types, no significant differences were found between ipsilateral and contralateral sides. In addition, atherosclerotic plaques classified as high-risk lesions with MRI (AHA lesion type VI) were associated with higher {sup 18}F-FDG uptake in comparison with other AHA lesions (TBR = 3.43 ± 1.13 vs 2.41 ± 0.84, respectively; p < 0.001). Furthermore, patients presenting at least one complicated lesion (AHA lesion type VI) with MRI showed significantly higher {sup 18}F-FDG uptake in both carotid arteries (ipsilateral and contralateral to the stroke) in comparison with carotid arteries of patients showing no complicated lesion with MRI (mean TBR = 3.18 ± 1.26 and 2.80 ± 0.94 vs 2.19 ± 0.57, respectively; p < 0.05) in favour of a diffuse inflammatory process along both carotid arteries associated with complicated plaques. Morphological and biological features of high-risk plaques can be detected with {sup 18}F-FDG PET/MRI in non-stenotic atherosclerotic plaques ipsilateral

  3. Vulnerable Plaque

    Science.gov (United States)

    ... Kawasaki Disease Long Q-T Syndrome Marfan Syndrome Metabolic Syndrome Mitral Valve Prolapse Myocardial Bridge Myocarditis Obstructive Sleep Apnea Pericarditis Peripheral Vascular Disease Rheumatic Fever Sick Sinus Syndrome Silent Ischemia Stroke Sudden ...

  4. Lower prevalence of carotid plaque hemorrhage in women, and its mediator effect on sex differences in recurrent cerebrovascular events.

    Directory of Open Access Journals (Sweden)

    Neghal Kandiyil

    Full Text Available Women are at lower risk of stroke, and appear to benefit less from carotid endarterectomy (CEA than men. We hypothesised that this is due to more benign carotid disease in women mediating a lower risk of recurrent cerebrovascular events. To test this, we investigated sex differences in the prevalence of MRI detectable plaque hemorrhage (MRI PH as an index of plaque instability, and secondly whether MRI PH mediates sex differences in the rate of cerebrovascular recurrence.Prevalence of PH between sexes was analysed in a single centre pooled cohort of 176 patients with recently symptomatic, significant carotid stenosis (106 severe [≥70%], 70 moderate [50-69%] who underwent prospective carotid MRI scanning for identification of MRI PH. Further, a meta-analysis of published evidence was undertaken. Recurrent events were noted during clinical follow up for survival analysis.Women with symptomatic carotid stenosis (50%≥ were less likely to have plaque hemorrhage (PH than men (46% vs. 70% with an adjusted OR of 0.23 [95% CI 0.10-0.50, P<0.0001] controlling for other known vascular risk factors. This negative association was only significant for the severe stenosis subgroup (adjusted OR 0.18, 95% CI 0.067-0.50 not the moderate degree stenosis. Female sex in this subgroup also predicted a longer time to recurrent cerebral ischemic events (HR 0.38 95% CI 0.15-0.98, P = 0.045. Further addition of MRI PH or smoking abolished the sex effects with only MRI PH exerting a direct effect. Meta-analysis confirmed a protective effect of female sex on development of PH: unadjusted OR for presence of PH = 0.54 (95% CI 0.45-0.67, p<0.00001.MRI PH is significantly less prevalent in women. Women with MRI PH and severe stenosis have a similar risk as men for recurrent cerebrovascular events. MRI PH thus allows overcoming the sex bias in selection for CEA.

  5. Effective risk stratification in patients with moderate cardiovascular risk using albuminuria and atherosclerotic plaques in the carotid arteries

    DEFF Research Database (Denmark)

    Greve, Sara V; Blicher, Marie K; Sehestedt, Thomas

    2015-01-01

    improvement of 6.4%; P = 0.025), or from high intermediate to high FRS risk (net reclassification improvement 8.8%; P = 0.002). Assuming primary prevention could reduce the relative cardiovascular risk by 24-27%, on the basis of actual levels of blood pressure and cholesterol, one composite endpoint could...... risk patients and high-intermediate FRS risk patients with high risk (P = 0.04 and P = 0.001, respectively), whereas elevated carotid-femoral pulse wave velocity did not. Elevated UACR or presence of atherosclerotic plaques reclassified patients from moderate to high SCORE risk [net reclassification...... be avoided by giving primary prevention to 19 or 24 reclassified patients found by screening 52 or 104 patients with high-intermediate FRS or moderate SCORE risk, respectively. CONCLUSION: Elevated UACR and presence of atherosclerotic plaques could in a potentially cost-effective manner identify patients...

  6. Red Blood Cell Eicosapentaenoic Acid Inversely Relates to MRI-Assessed Carotid Plaque Lipid Core Burden in Elders at High Cardiovascular Risk

    Directory of Open Access Journals (Sweden)

    Núria Bargalló

    2017-09-01

    Full Text Available Supplemental marine omega-3 eicosapentaenoic acid (EPA has an anti-atherosclerotic effect. Clinical research on EPA supplied by the regular diet and atherosclerosis is scarce. In the framework of the PREvención con DIeta MEDiterránea (PREDIMED trial, we conducted a cross-sectional study in 161 older individuals at high vascular risk grouped into different stages of carotid atherosclerosis severity, including those without ultrasound-detected atheroma plaque (n = 38, with plaques <2.0 mm thick (n = 65, and with plaques ≥2.0 mm (n = 79. The latter were asked to undergo contrast-enhanced 3T magnetic resonance imaging (MRI and were subsequently grouped into absence (n = 31 or presence (n = 27 of MRI-detectable plaque lipid, a main feature of unstable atheroma plaques. We determined the red blood cell (RBC proportion of EPA (a valid marker of long-term EPA intake at enrolment by gas chromatography. In multivariate models, EPA related inversely to MRI-assessed plaque lipid volume, but not to maximum intima-media thickness of internal carotid artery, plaque burden, or MRI-assessed normalized wall index. The inverse association between EPA and plaque lipid content in patients with advanced atherosclerosis supports the notion that this fatty acid might improve cardiovascular health through stabilization of advanced atheroma plaques.

  7. Discordant Lipid Pattern and Carotid Atherosclerotic Plaque. Importance of Remnant Cholesterol.

    Science.gov (United States)

    Masson, Walter; Lobo, Martín; Molinero, Graciela; Siniawski, Daniel

    2017-06-01

    Subjects with levels of non-HDL-C 30 mg/dL above those of LDL-C (lipid discordance) or with high remnant cholesterol levels could have a greater residual cardiovascular risk. To determine the prevalence of lipid discordance in a primary prevention population and analyze the clinical variables associated with it; To investigate the association between lipid discordance and remnant cholesterol with the presence of carotid plaque. Primary prevention patients without diabetes or lipid-lowering therapy were included. Regardless of the LDL-C level, we define "lipid discordance" if the non-HDL-C value exceeded 30 mg/dL that of LDL-C. Remnant cholesterol was calculated as total cholesterol minus HDL-C minus LDL-C when triglycerides were colesterol remanescente poderiam ter maior risco cardiovascular residual. determinar a prevalência de discordância lipídica em uma população de prevenção primária e analisar as variáveis clínicas com ela associadas; investigar a associação de discordância lipídica e colesterol remanescente calculado com a presença de placa carotídea. Pacientes de prevenção primária sem diabetes ou sem terapia hipolipemiante foram incluídos. Independentemente do nível de LDL-C, definiu-se "discordância lipídica" como um valor de não HDL-C excedendo em 30 mg/dl aquele de LDL-C. Calculou-se o colesterol remanescente como colesterol total menos HDL-C menos LDL-C na presença de triglicerídeos colesterol remanescente calculado e placa carotídea. Discordância lipídica e presença de nível mais alto de colesterol remanescente calculado acham-se associados com aterosclerose subclínica. Nossos achados podem ser usados para aprimorar a avaliação de risco cardiovascular residual.

  8. Optical coherence tomography imaging in asymptomatic patients with carotid artery stenosis

    Energy Technology Data Exchange (ETDEWEB)

    Cilingiroglu, Mehmet, E-mail: Mcilingiroglu@yahoo.com [University of Pittsburgh Heart and Vascular Institute, Pittsburgh, PA (United States); Hakeem, Abdul [William Beaumont Hospital, Royal Oak, MI (United States); Feldman, Marc [University of Texas Health Sciences Center at San Antonio, San Antonio, TX (United States); Wholey, Mark [University of Pittsburgh Heart and Vascular Institute, Pittsburgh, PA (United States)

    2013-01-15

    Assessment and treatment plan for asymptomatic patients with carotid stenosis are based on angiography at the present time. However, angiography or other imaging modalities are limited with their resolution to detect high-risk plaque features. Intravascular optical coherence tomography (IVOCT) recently emerged as a novel imaging modality with a unique resolution to identify vulnerable plaque characteristics. We report use of IVOCT in two separate asymptomatic patients with carotid stenosis with two different plaque types.

  9. Pregnancy-associated plasma protein-A and the vulnerable plaque

    DEFF Research Database (Denmark)

    Jespersen, Camilla H B; Vestergaard, Kirstine R; Schou, Morten

    2014-01-01

    For more than a decade, pregnancy-associated plasma protein-A (PAPP-A) has been examined for its relation to acute coronary syndrome (ACS) and the vulnerable plaque. This review summarizes the current knowledge of plasma PAPP-A in relation to nonpregnant individuals focusing on patients with ACS,......, discusses its use as a possible biomarker for diagnosis and prognosis in ACS, briefly describes the challenges in different assay technologies and describes the effect of heparin administration on PAPP-A concentrations in plasma....

  10. Endothelial dysfunction, carotid artery plaque burden, and conventional exercise-induced myocardial ischemia as predictors of coronary artery disease prognosis

    Directory of Open Access Journals (Sweden)

    Ishihara Masayuki

    2008-12-01

    Full Text Available Abstract Background While both flow-mediated vasodilation (FMD in the brachial artery (BA, which measures endothelium-dependent vasodilatation, and intima-media thickness (IMT in the carotid artery are correlated with the prognosis of coronary artery disease (CAD, it is not clear which modality is a better predictor of CAD. Furthermore, it has not been fully determined whether either of these modalities is superior to conventional ST-segment depression on exercise stress electrocardiogram (ECG as a predictor. Thus, the goal of the present study was to compare the predictive value of FMD, IMT, and stress ECG for CAD prognosis. Methods and Results A total of 103 consecutive patients (62 ± 9 years old, 79 men with clinically suspected CAD had FMD and nitroglycerin-induced dilation (NTG-D in the BA, carotid artery IMT measurement using high-resolution ultrasound, and exercise treadmill testing. The 73 CAD patients and 30 normal coronary patients were followed for 50 ± 15 months. Fifteen patients had coronary events during this period (1 cardiac death, 2 non-fatal myocardial infarctions, 3 acute heart failures, and 9 unstable anginas. On Kaplan-Meier analysis, only FMD and stress ECG were significant predictors for cardiac events. Conclusion Brachial endothelial function as reflected by FMD and conventional exercise stress testing has comparable prognostic value, whereas carotid artery plaque burden appears to be less powerful for predicting future cardiac events.

  11. Carotid and cerebrovascular disease in symptomatic patients with type 2 diabetes: assessment of prevalence and plaque morphology by dual-source computed tomography angiography

    Directory of Open Access Journals (Sweden)

    Deng Wen

    2010-12-01

    Full Text Available Abstract Background Plaque morphology directly correlates with risk of embolism and the recently developed dual-source computed tomography angiography (DSCTA may help to detect plaques more precisely. The aim of our study was to evaluate the prevalence and morphology of carotid and cerebrovascular atherosclerotic plaques in patients with symptomatic type 2 diabetes mellitus (DM by DSCTA. Methods From July 2009 to August 2010, DSCTA was prospectively performed in 125 consecutive patients with symptomatic type 2 DM. We retrospectively analyzed plaque type, distribution, and extensive and obstructive natures were determined for each segment for all patients. Results Atherosclerotic plaques were detected in 114 (91.2% patients. Relatively more noncalcified (45% and calcified (39% plaques and less mixed (16% plaques were observed (p st to 5th segments was observed in 67 (58.8% patients and from the 6th to 10th segments in 35 (30.7% patients. The most common site of all detected plaques was the cavernous segment. Regarding stenosis, there were significantly more nonobstructive than obstructive stenosis (91% vs. 9%, p Conclusion DSCTA detected a high prevalence of plaques in patients with symptomatic type 2 DM. A relatively high proportion of plaques were noncalcified, as well as with nonobstructive stenosis. The distribution of plaques was extensive, with the cavernous portion of ICA being the most common site.

  12. Atherosclerotic plaque tissue characterization in 2D ultrasound longitudinal carotid scans for automated classification: a paradigm for stroke risk assessment.

    Science.gov (United States)

    Acharya, U Rajendra; Mookiah, Muthu Rama Krishnan; Vinitha Sree, S; Afonso, David; Sanches, Joao; Shafique, Shoaib; Nicolaides, Andrew; Pedro, L M; Fernandes E Fernandes, J; Suri, Jasjit S

    2013-05-01

    In the case of carotid atherosclerosis, to avoid unnecessary surgeries in asymptomatic patients, it is necessary to develop a technique to effectively differentiate symptomatic and asymptomatic plaques. In this paper, we have presented a data mining framework that characterizes the textural differences in these two classes using several grayscale features based on a novel combination of trace transform and fuzzy texture. The features extracted from the delineated plaque regions in B-mode ultrasound images were used to train several classifiers in order to prepare them for classification of new test plaques. Our CAD system was evaluated using two different databases consisting of 146 (44 symptomatic to 102 asymptomatic) and 346 (196 symptomatic and 150 asymptomatic) images. Both these databases differ in the way the ground truth was determined. We obtained classification accuracies of 93.1 and 85.3 %, respectively. The techniques are low cost, easily implementable, objective, and non-invasive. For more objective analysis, we have also developed novel integrated indices using a combination of significant features.

  13. An investigation of two-dimensional ultrasound carotid plaque presence and intima media thickness in middle-aged South Asian and European men living in the United kingdom.

    Directory of Open Access Journals (Sweden)

    Nazim Ghouri

    Full Text Available Ultrasound studies of carotid intima media thickness (cIMT and plaques are limited in South Asians, a group at elevated cardiovascular disease (CVD risk. We determined whether South Asians have a difference in these ultrasound markers compared to Europeans living in the United Kingdom and whether measured risk factor(s could account for any such differences.One hundred South Asian men, aged 40 to 70 years and 100 European men of similar age and BMI, without diagnosed CVD or diabetes, underwent carotid ultrasound for measurement of cIMT and carotid plaque presence. Physical activity, cardiorespiratory fitness, anthropometry and blood pressure were assessed, fasted blood taken for measurement of cardiometabolic risk factors and demographic and lifestyle factors recorded.Age-adjusted mean (SD cIMT was similar in South Asians and Europeans (0.64 (0.16 mm v 0.65 (0.12 mm, p = 0.64. Plaque was present in 48 South Asians and 37 Europeans and overall, there was no age-adjusted difference between South Asian and Europeans for plaque score(odds ratio 1.49, 95% CI, 0.86-2.80, p = 0.16, however, South Asians appeared to have more plaques at a younger age than Europeans; at age 40-50 years the odds of South Asians having plaques was 2.63 (95% CI, 1.16-5.93 times that for Europeans.cIMT is similar between healthy South Asian and European men. Whilst there was no overall difference in plaque presence in South Asians, there is an indication of greater plaque prevalence at younger ages--an observation requiring further investigation. Prospective studies linking plaques to CVD outcomes in South Asians are needed to investigate whether these measures help improve CVD risk prediction.

  14. Lack of Association between ABO, PPAP2B, ADAMST7, PIK3CG, and EDNRA and Carotid Intima-Media Thickness, Carotid Plaques, and Cardiovascular Disease in Patients with Rheumatoid Arthritis

    Directory of Open Access Journals (Sweden)

    Raquel López-Mejías

    2014-01-01

    Full Text Available Introduction. Rheumatoid arthritis (RA is a polygenic disease associated with accelerated atherosclerosis and increased cardiovascular (CV mortality. Recent studies have identified the ABO rs579459, PPAP2B rs17114036, and ADAMTS7 rs3825807 polymorphisms as genetic variants associated with coronary artery disease and the PIK3CG rs17398575 and EDNRA rs1878406 polymorphisms as the most significant signals related to the presence of carotid plaque in nonrheumatic Caucasian individuals. Accordingly, we evaluated the potential relationship between these 5 polymorphisms and subclinical atherosclerosis (assessed by carotid intima-media thickness (cIMT and presence/absence of carotid plaques and CV disease in RA. Material and Methods. 2140 Spanish RA patients were genotyped for the 5 polymorphisms by TaqMan assays. Subclinical atherosclerosis was evaluated in 620 of these patients by carotid ultrasonography technology. Results. No statistically significant differences were found when each polymorphism was assessed according to cIMT values and presence/absence of carotid plaques in RA, after adjusting the results for potential confounders. Moreover, no significant differences were obtained when RA patients were stratified according to the presence/absence of CV disease after adjusting for potential confounders. Conclusion. Our results do not confirm association between ABO rs579459, PPAP2B rs17114036, ADAMTS7 rs3825807, PIK3CG rs17398575, and EDNRA rs1878406 and subclinical atherosclerosis and CV disease in RA.

  15. Application of IR and NIR fiber optic imaging in thermographic and spectroscopic diagnosis of atherosclerotic vulnerable plaques: preliminary experience

    Science.gov (United States)

    Naghavi, Morteza; Khan, Tania; Gu, Bujin; Soller, Babs R.; Melling, Peter; Asif, Mohammed; Gul, Khawar; Madjid, Mohammad; Casscells, S. W.; Willerson, James T.

    2000-12-01

    Despite major advances in cardiovascular science and technology during the past three decades, approximately half of all myocardial infarctions and sudden deaths occur unexpectedly. It is widely accepted that coronary atherosclerotic plaques and thrombotic complications resulting from their rupture or erosion are the underlying causes of this major health problem. The majority of these vulnerable plaques exhibit active inflammation, a large necrotic lipid core, a thin fibrous cap, and confer a stenosis of less than 70%. These lesions are not detectable by stress testing or coronary angiography. Our group is exploring the possibility of a functional classification based on physiological variables such as plaque temperature, pH, oxygen consumption, lactate production etc. We have shown that heat accurately locates the inflamed plaques. We also demonstrated human atherosclerotic plaques are heterogeneous with regard to pH and hot plaques and are more likely to be acidic. To develop a nonsurgical method for locating the inflamed plaques, we are developing both IR fiber optic imaging and NIR spectroscopic systems in our laboratory to detect hot and acidic plaque in atherosclerotic arterial walls. Our findings introduce the possibility of an isolated/combined IR and NIR fiber optic catheter that can bring new insight into functional assessment of atherosclerotic plaque and thereby detection of active and inflamed lesions responsible for heart attacks and strokes.

  16. Data on consistency among different methods to assess atherosclerotic plaque echogenicity on standard ultrasound and intraplaque neovascularization on contrast-enhanced ultrasound imaging in human carotid artery

    Directory of Open Access Journals (Sweden)

    Mattia Cattaneo

    2016-12-01

    Full Text Available Here we provide the correlation among different carotid ultrasound (US variables to assess echogenicity n standard carotid US and to assess intraplaque neovascularization on contrast enhanced US. We recruited 45 consecutive subjects with an asymptomatic≥50% carotid artery stenosis. Carotid plaque echogenicity at standard US was visually graded according to Gray–Weale classification (GW and measured by the greyscale median (GSM, a semi-automated computerized measurement performed by Adobe Photoshop®. On CEUS imaging IPNV was graded according to the visual appearance of contrast within the plaque according to three different methods: CEUS_A (1=absent; 2=present; CEUS_B a three-point scale (increasing IPNV from 1 to 3; CEUS_C a four-point scale (increasing IPNV from 0 to 3. We have also implemented a new simple quantification method derived from region of interest (ROI signal intensity ratio as assessed by QLAB software. Further information is available in “Contrast-enhanced ultrasound imaging of intraplaque neovascularization and its correlation to plaque echogenicity in human carotid arteries atherosclerosis (M. Cattaneo, D. Staub, A.P. Porretta, J.M. Gallino, P. Santini, C. Limoni et al., 2016 [1].

  17. Meta-analysis of genome-wide association studies from the CHARGE consortium identifies common variants associated with carotid intima media thickness and plaque

    NARCIS (Netherlands)

    J.C. Bis (Joshua); M. Kavousi (Maryam); N. Franceschini (Nora); A.J. Isaacs (Aaron); G.R. Abecasis (Gonçalo); U. Schminke (Ulf); W.S. Post (Wendy S.); A.V. Smith (Albert Vernon); L.A. Cupples (Adrienne); H.S. Markus (Hugh S.); R. Schmidt (Reinhold); J.E. Huffman (Jennifer); T. Lehtimäki (Terho); J. Baumert (Jens); T. Münzel (Thomas); S.R. Heckbert (Susan); A. Dehghan (Abbas); K.E. North (Kari); B.A. Oostra (Ben); S. Bevan (Steve); E.M. Stoegerer (Eva Maria); C. Hayward (Caroline); O. Raitakari (Olli); C. Meisinger (Christa); A. Schillert (Arne); S. Sanna (Serena); H. Völzke (Henry); Y.C. Cheng (Yu Ching); B. Thorsson (Bolli); C.S. Fox (Caroline); K. Rice (Kenneth); F. Rivadeneira Ramirez (Fernando); V. Nambi (Vijay); E. Halperin (Eran); K. Petrovic (Katja); L. Peltonen (Leena Johanna); H.E. Wichmann (Heinz Erich); R.B. Schnabel (Renate); M. Dörr (Marcus); A. Parsa (Afshin); T. Aspelund (Thor); S. Demissie (Serkalem); S. Kathiresan (Sekar); M.P. Reilly (Muredach); K.D. Taylor (Kent); A.G. Uitterlinden (André); D.J. Couper (David); M. Sitzer (Matthias); M. Kähönen (Mika); T. Illig (Thomas); P.S. Wild (Philipp); M. Orrù (Marco); J. Lüdemann (Jan); A.R. Shuldiner (Alan); G. Eiriksdottir (Gudny); C.C. White (Charles); J.I. Rotter (Jerome); A. Hofman (Albert); J. Seissler (Jochen); T. Zeller (Tanja); G. Usala; F.D.J. Ernst (Florian); L.J. Launer (Lenore); R.B. D'Agostino (Ralph); D.H. O'Leary (Daniel H.); C. Ballantyne (Christie); J.P. Thiery (Joachim); A. Ziegler (Andreas); E. Lakatta (Edward); R.K. Chilukoti (Ravi Kumar); T.B. Harris (Tamara); P.A. Wolf (Philip); B.M. Psaty (Bruce); J.F. Polak (Joseph F.); X. Li (Xiaohui); W. Rathmann (Wolfgang); M. Uda (Manuela); E.A. Boerwinkle (Eric); N. Klopp (Norman); J.F. Wilson (James); J. Viikari (Jorma); W. Koenig (Wolfgang); S. Blankenberg (Stefan); A.B. Newman (Anne); J.C.M. Witteman (Jacqueline); G. Heiss (Gerardo); C.M. van Duijn (Cock); A. Scuteri (Angelo); G. Homuth (Georg); B.D. Mitchell (Braxton); V. Gudnason (Vilmundur); C.J. O'Donnell (Christopher)

    2011-01-01

    textabstractCarotid intima media thickness (cIMT) and plaque determined by ultrasonography are established measures of subclinical atherosclerosis that each predicts future cardiovascular disease events. We conducted a meta-analysis of genome-wide association data in 31,211 participants of European

  18. Influence of material property variability on the mechanical behaviour of carotid atherosclerotic plaques: a 3D fluid-structure interaction analysis.

    Science.gov (United States)

    Yuan, Jianmin; Teng, Zhongzhao; Feng, Jiaxuan; Zhang, Yongxue; Brown, Adam J; Gillard, Jonathan H; Jing, Zaiping; Lu, Qingsheng

    2015-08-01

    Mechanical analysis has been shown to be complementary to luminal stenosis in assessing atherosclerotic plaque vulnerability. However, patient-specific material properties are not available and the effect of material properties variability has not been fully quantified. Media and fibrous cap (FC) strips from carotid endarterectomy samples were classified into hard, intermediate and soft according to their incremental Young's modulus. Lipid and intraplaque haemorrhage/thrombus strips were classified as hard and soft. Idealised geometry-based 3D fluid-structure interaction analyses were performed to assess the impact of material property variability in predicting maximum principal stress (Stress-P1 ) and stretch (Stretch-P1 ). When FC was thick (1000 or 600 µm), Stress-P1 at the shoulder was insensitive to changes in material stiffness, whereas Stress-P1 at mid FC changed significantly. When FC was thin (200 or 65 µm), high stress concentrations shifted from the shoulder region to mid FC, and Stress-P1 became increasingly sensitive to changes in material properties, in particular at mid FC. Regardless of FC thickness, Stretch-P1 at these locations was sensitive to changes in material properties. Variability in tissue material properties influences both the location and overall stress/stretch value. This variability needs to be accounted for when interpreting the results of mechanical modelling. © 2015 The Authors. International Journal for Numerical Methods in Biomedical Engineering published by John Wiley & Sons Ltd.

  19. Is it possible that this patient is asymptomatic? The role of multidetector ct angiography in detection of ulcerated plaques in patients with asymptomatic carotid stenosis: Case report

    Directory of Open Access Journals (Sweden)

    Tanasković Slobodan

    2015-01-01

    Full Text Available Introduction. Although intervention in patients with symptomatic carotid disease is generally accepted as beneficial, the management of asymptomatic disease is still controversial. We wanted to introduce and discuss treatment options in a patient with asymptomatic carotid stenosis and high embolic potential lesions of common and internal carotid artery detected by multidetector computed tomography (MDCT. Case Outline. A 78-year-old female patient was admitted to our institution for diagnostics and surgical treatment of asymptomatic high-grade carotid stenosis. Upon admission, color duplex ultrasonography of the carotid arteries revealed the left common carotid artery (CCA stenosis of 50% and the ipsilateral internal carotid artery (ICA stenosis of 60%, while the right CCA was narrowed by 60% and the ipsilateral ICA by 80%. Because of the left subclavian artery (LSA occlusion, also described by ultrasonography, MDCT angiography was performed to assess arterial morphology for possible angioplasty. In addition to LSA occlusion, MDCT angiography surprisingly revealed significant left CCA (>80% and ICA (>70% narrowing by ulcerated plaques with high embolic potential. Surgical treatment of the left CCA and ICA was indicated and Dacron® tubular graft interposition was performed. The postoperative course was uneventful and the patient was discharged from the Institute on the third postoperative day. After the six-month follow-up the patient was doing well with well-preserved graft patency. Conclusion. Although color duplex ultrasonography is reliable and safe imaging modality in carotid stenosis diagnosis, MDCT angiography plays a significant role in patients with asymptomatic carotid stenosis since plaques with high embolic potential could be detected, which, if left untreated, could have severe neurological ischemic consequences. [Projekat Ministarstva nauke Republike Srbije, br. 41002

  20. Analysis of carotid artery plaque and wall boundaries on CT images by using a semi-automatic method based on level set model

    Energy Technology Data Exchange (ETDEWEB)

    Saba, Luca; Sannia, Stefano; Ledda, Giuseppe [University of Cagliari - Azienda Ospedaliero Universitaria di Cagliari, Department of Radiology, Monserrato, Cagliari (Italy); Gao, Hao [University of Strathclyde, Signal Processing Centre for Excellence in Signal and Image Processing, Department of Electronic and Electrical Engineering, Glasgow (United Kingdom); Acharya, U.R. [Ngee Ann Polytechnic University, Department of Electronics and Computer Engineering, Clementi (Singapore); Suri, Jasjit S. [Biomedical Technologies Inc., Denver, CO (United States); Idaho State University (Aff.), Pocatello, ID (United States)

    2012-11-15

    The purpose of this study was to evaluate the potentialities of a semi-automated technique in the detection and measurement of the carotid artery plaque. Twenty-two consecutive patients (18 males, 4 females; mean age 62 years) examined with MDCTA from January 2011 to March 2011 were included in this retrospective study. Carotid arteries are examined with a 16-multi-detector-row CT system, and for each patient, the most diseased carotid was selected. In the first phase, the carotid plaque was identified and one experienced radiologist manually traced the inner and outer boundaries by using polyline and radial distance method (PDM and RDM, respectively). In the second phase, the carotid inner and outer boundaries were traced with an automated algorithm: level-set-method (LSM). Data were compared by using Pearson rho correlation, Bland-Altman, and regression. A total of 715 slices were analyzed. The mean thickness of the plaque using the reference PDM was 1.86 mm whereas using the LSM-PDM was 1.96 mm; using the reference RDM was 2.06 mm whereas using the LSM-RDM was 2.03 mm. The correlation values between the references, the LSM, the PDM and the RDM were 0.8428, 0.9921, 0.745 and 0.6425. Bland-Altman demonstrated a very good agreement in particular with the RDM method. Results of our study indicate that LSM method can automatically measure the thickness of the plaque and that the best results are obtained with the RDM. Our results suggest that advanced computer-based algorithms can identify and trace the plaque boundaries like an experienced human reader. (orig.)

  1. MR coil sensitivity inhomogeneity correction for plaque characterization in carotid arteries

    Science.gov (United States)

    Salvado, Olivier; Hillenbrand, Claudia; Suri, Jasjit; Wilson, David L.

    2004-05-01

    We are involved in a comprehensive program to characterize atherosclerotic disease using multiple MR images having different contrast mechanisms (T1W, T2W, PDW, magnetization transfer, etc.) of human carotid and animal model arteries. We use specially designed intravascular and surface array coils that give high signal-to-noise but suffer from sensitivity inhomogeneity. With carotid surface coils, challenges include: (1) a steep bias field with an 80% change; (2) presence of nearby muscular structures lacking high frequency information to distinguish bias from anatomical features; (3) many confounding zero-valued voxels subject to fat suppression, blood flow cancellation, or air, which are not subject to coil sensitivity; and (4) substantial noise. Bias was corrected using a modification of the adaptive fuzzy c-mean method reported by Pham et al. (IEEE TMI, 18:738-752), whereby a bias field modeled as a mechanical membrane was iteratively improved until cluster means no longer changed. Because our images were noisy, we added a noise reduction filtering step between iterations and used about 5 classes. In a digital phantom having a bias field measured from our MR system, variations across an area comparable to a carotid artery were reduced from 50% to <5% with processing. Human carotid images were qualitatively improved and large regions of skeletal muscle were relatively flat. Other commonly applied techniques failed to segment the images or introduced strong edge artifacts. Current evaluations include comparisons to bias as measured by a body coil in human MR images.

  2. Relation of microchannel structure identified by optical coherence tomography to plaque vulnerability in patients with coronary artery disease.

    Science.gov (United States)

    Kitabata, Hironori; Tanaka, Atsushi; Kubo, Takashi; Takarada, Shigeho; Kashiwagi, Manabu; Tsujioka, Hiroto; Ikejima, Hideyuki; Kuroi, Akio; Kataiwa, Hideaki; Ishibashi, Kohei; Komukai, Kenichi; Tanimoto, Takashi; Ino, Yasushi; Hirata, Kumiko; Nakamura, Nobuo; Mizukoshi, Masato; Imanishi, Toshio; Akasaka, Takashi

    2010-06-15

    Increased neovascularization in atherosclerotic plaques is associated with plaque vulnerability. The high resolution of optical coherence tomography (OCT) might provide a chance to directly visualize plaque neovascularization in vivo. The aim of the present study was to investigate the relation between microchannels in culprit plaques identified by OCT and plaque vulnerability in patients with coronary artery disease. A total of 63 consecutive patients with coronary artery disease who had undergone both OCT and intravascular ultrasound before any interventions to examine culprit lesion morphologies were enrolled. Microchannel was defined as a no-signal tubuloluminal structure on the cross-sectional optical coherence tomographic image. Microchannels were found in 24 (38%) of the 63 patients. The patients were divided into 2 groups according to the presence or absence of microchannels. The frequency of plaque rupture tended to be greater in the microchannel group (50% vs 28%, p = 0.11). The thickness of the fibrous cap (median 60 vs 100 microm, p = 0.001) was significantly less in the patients with microchannels, and significant differences were found in the frequency of thin-cap fibroatheroma (54% vs 21%, p = 0.012) and positive remodeling (67% vs 36%, p = 0.02) between the 2 groups. The high-sensitivity C-reactive protein levels in the microchannel group was significantly greater than those in the no-microchannel group (median 0.27 vs 0.13 mg/dl, p = 0.015). Moreover, increased microchannel counts were associated with greater high-sensitivity C-reactive protein levels (p = 0.01). In conclusion, a significant relation was found between the presence of microchannels in plaques identified by OCT and plaque vulnerability in patients with coronary artery disease.

  3. Dual energy computed tomography quantification of carotid plaques calcification: comparison between monochromatic and polychromatic energies with pathology correlation

    Energy Technology Data Exchange (ETDEWEB)

    Mannelli, Lorenzo [University of Washington, Departments of Radiology, Seattle, WA (United States); Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, NY (United States); MacDonald, Lawrence; Ferguson, Marina; Shuman, William P.; Xu, Dongxiang; Yuan, Chun; Mitsumori, Lee M. [University of Washington, Departments of Radiology, Seattle, WA (United States); Mancini, Marcello; Ragucci, Monica; Monti, Serena [IRCCS Fondazione SDN, Naples (Italy)

    2015-05-01

    We compared carotid plaque calcification detection sensitivity and apparent cross-sectional area on CT as a function of CT beam energy using conventional CT techniques and virtual mono-energetic CT images generated from dual-energy acquisitions. Five ex-vivo carotid endarterectomy (CEA) specimens were imaged with dual-energy computed tomography. Virtual monochromatic spectrum (VMS) CT images were reconstructed at energies between 40-140 keV. The same specimens were imaged using conventional polyenergetic spectrum (PS) CT with peak beam energies 80, 100, 120, and 140 kVp. The histological calcium areas on each corresponding CEA specimen were traced manually on digitized images of Toluidine-Blue/Basic-Fuchsin stained plastic sections. 40 keV VMS CT images provided high detection sensitivity (97 %) similar to conventional PS CT images (∝96 %). The calcification size measured on CT decreased systematically with increasing CT beam energy; the rate of change was larger for the VMS images than for PS images. From a single dual-energy CT, multiple VMS-CT images can be generated, yielding equivalent detection sensitivity and size correlations as conventional PS-CT in CEA calcification imaging. VMS-CT at 80-100 keV provided the most accurate estimates of calcification size, as compared to histology, but detection sensitivity was reduced for smaller calcifications on these images. (orig.)

  4. Mast cell degranulator compound 48-80 promotes atherosclerotic plaque in apolipoprotein E knockout mice with perivascular common carotid collar placement

    Institute of Scientific and Technical Information of China (English)

    TANG Ya-ling; YANG Yong-zong; WANG Shuang; HUANG Tao; TANG Chao-ke; XU Zeng-xiang; SUN Yu-hui

    2009-01-01

    Background Study of the relationship between mast cells and atherosclerosis is mostly dependent on pathological observation and cytology experiments. To investigate the effects of mast cells degranulation on plaque and their possible mechanisms we used apolipoprotein E knockout mice which had been placed perivascular common carotid collar with mast cells degranulator compound 48-80.Methods Forty apolipoprotein E knockout mice were fed a western-type diet and operated on with placement of perivascular right common carotid collar. Four weeks after surgery, the mice were intraperitoneally injected with compound 48-80 (0.5 mg/kg) or D-Hanks every other day for 4 times. The serum lipids and activity of tryptase were measured. Tissue sections were stained with hematoxylin and eosin. Corresponding sections were stained with toluidine blue and immunohistochemically with antibodies against macrophage-specific antigen, α-smooth muscle actin, interleukin-1β and van Willebrand factor. Simultaneously, basic fibroblast growth factor was detected by in situ hybridization and immunofluorescence.Results No pathological change was observed in common carotid non-collar placement but atherogenesis in common carotid collar placement of both groups. There was a significant increase in plaque area ((5.85±0.75)×104 vs (0.86±0.28)×104 μm2, P<0.05), the degree of lumen stenosis ((81±15)% vs (41±12)%, P <0.05), the activity of tryptase in serum ((0.57±0.13) U/L vs (0.36±0.10) U/L, P <0.05), and the percentage of degranulated mast cells ((80.6±17.8)% vs (13.5±4.1)%, P <0.05). The expressions of macrophage-specific antigen, α-smooth muscle actin, interleukin-1β, basic fibroblast growth factor and the density of neovessel in plaque were more in the compound 48-80 group than in the control group.Conclusions Perivascular common carotid collar placement can promote atherosclerotic plaque formation in apolipoprotein E knockout mice. Compound 48-80 increases plaque area and the degree

  5. Correlative angiographic and pathologic findings in the diagnosis of ulcerated plaques in the carotid artery.

    Science.gov (United States)

    Estol, C; Claasen, D; Hirsch, W; Wechsler, L; Moossy, J

    1991-07-01

    We determined the accuracy of angiography in the diagnosis of internal carotid ulcers by comparing the angiographic reports with the pathologic findings in 36 endarterectomy specimens. Eighteen of these specimens had microscopic ulcerations, and the observer with the highest accuracy rate read 12, of which ten were ulcerated. These results revealed a sensitivity of 56%, a specificity of 89%, and an overall accuracy of 61% for angiography. The ulcers were classified into types A, B, and C to assess the interobserver agreement rate among three readers. This resulted in a 4% interobserver agreement among a total of 75 ulcers. Because of the high interobserver disagreement and the poor correlation between angiographic and pathologic findings in the surgical specimens, we conclude that the diagnosis of carotid artery ulceration by angiography is not reliable.

  6. Assessment of plaque vulnerability in atherosclerosis via intravascular photoacoustic imaging of targeted liposomal ICG J-aggregates (Conference Presentation)

    Science.gov (United States)

    Harris, Justin T.; Dumani, Diego S.; Cook, Jason R.; Sokolov, Konstantin V.; Emelianov, Stanislav Y.; Homan, Kimberly A.

    2017-03-01

    While molecular and cellular imaging can be used to visualize the conventional morphology characteristics of vulnerable plaques, there is a need to monitor other physiological factors correlated with high rupture rates; a high M1 activated macrophage concentration is one such indicator of high plaque vulnerability. Here, we present a molecularly targeted contrast agent for intravascular photoacoustic (IVPA) imaging consisting of liposomes loaded with indocyanine green (ICG) J-aggregates with high absorption at 890 nm, allowing for imaging in the presence of blood. This "Lipo-ICG" was targeted to a biomarker of M1 activated macrophages in vulnerable plaques: folate receptor beta (FRβ). The targeted liposomes accumulate in plaques through areas of endothelial dysfunction, while the liposome encapsulation prevents nonspecific interaction with lipids and endothelium. Lipo-ICG specifically interacts with M1 activated macrophages, causing a spectral shift and change in the 890/780 nm photoacoustic intensity ratio upon breakdown of J-aggregates. This sensing mechanism enables assessment of the M1 activated macrophage concentration, providing a measure of plaque vulnerability. In a pilot in vivo study utilizing ApoE deficient mouse models of atherosclerosis, diseased mice showed increased uptake of FRβ targeted Lipo-ICG in the heart and arteries vs. normal mice. Likewise, targeted Lipo-ICG showed increased uptake vs. two non-targeted controls. Thus, we successfully synthesized a contrast agent to detect M1 activated macrophages in high risk atherosclerotic plaques and exhibited targeting both in vitro and in vivo. This biocompatible agent could enable M1 macrophage detection, allowing better clinical decision making in treatment of atherosclerosis.

  7. Circulating CD36 and fractalkine levels are associated with vulnerable plaque progression in patients with unstable angina pectoris.

    Science.gov (United States)

    Li, Rui Jian; Yang, Ming; Li, Ji Fu; Xue, Li; Chen, Yu Guo; Chen, Wen Qiang

    2014-11-01

    The chemokine, fractalkine, independently enhances the vulnerability of coronary atherosclerotic plaques. The present study investigated the combined effects of CD36 and fractalkine on coronary plaque progression in patients with unstable angina pectoris. In the present study, 120 unstable angina pectoris patients undergoing coronary angiography and intravascular ultrasound were divided into two groups: an intermediate lesion group (lumen diameter stenosis 50-70%, 80 patients) and a severe lesion group (at least one lesion with lumen diameter stenosis > 70%, 40 patients). The control group consisted of 40 healthy age- and sex-matched subjects. Concentrations of CD36 and fractalkine were measured by enzyme-linked immunosorbent assay. Major adverse cardiovascular events were monitored over a 2-year follow up. Intravascular ultrasound showed that patients with severe lesions had more calcified and mixed plaques, and a larger plaque area and plaque burden than patients with intermediate lesions (P < 0.05-0.01). More patients with severe lesions underwent stent deployment (P < 0.05) than those with intermediate lesions. CD36 and fractalkine concentrations were significantly higher in the severe lesion patients (P < 0.05), and both had significant positive correlations (P < 0.05) with the plaque burden of atherosclerotic lesions. Using the matched nested case-control study, we found that CD36 and fractalkine levels were higher in patients with recurrent major adverse cardiovascular events than controls (P < 0.05). In conclusion, CD36 and fractalkine both promote, and might synergistically enhance, the progression of coronary atherosclerotic plaques.

  8. Advances in imaging diagnosis of carotid plaque%颈动脉粥样硬化斑块影像学诊断方法的研究进展

    Institute of Scientific and Technical Information of China (English)

    贾慧霞; 金蓉

    2015-01-01

    颈动脉粥样硬化伴斑块(CP)脱落可诱发血栓形成,导致脑血管疾病发生。近年来,对于CP的研究主要集中在易损斑块的性质及数量。因此,有效评价斑块结构及稳定性,对于选择治疗时机和治疗方案有重要临床意义。从超声、超声造影成像、超声实时组织弹性成像、血管内超声、数字减影血管造影、CT血管造影、磁共振血管成像及光学相干断层成像等方面对斑块的诊断方法进行综述,并对颈动脉斑块影像学检查进行评价。%The carotid plaque (CP) detachment can induce thrombosis, which may lead to cerebral vascular disease. In recent years,research of CP is mainly focused on qualitative and quantitative analysis of vulnerable plaque. Therefore, it is important to choose therapeutic method and opportunity according to the structure and stability of the plaque. This article reviews the progress in the diagnosis of plaque from the aspects of common ultrasound, contrast enhanced ultrasound, ultrasound real-time tissue elastography, intravascular unltrasound, digital subtraction angiography (DSA), comuted tomography angiography (CTA), magnetic resonance imaging (MRI) and optical coherence tomography (OCT). Common and all kinds of new ultrasonic technology can be used to evaluate the vulnerability of CP from different aspects.

  9. Ultrasound analysis of gray-scale median value of carotid plaques is a useful reference index for cerebro-cardiovascular events in patients with type 2 diabetes.

    Science.gov (United States)

    Ariyoshi, Kyoko; Okuya, Shigeru; Kunitsugu, Ichiro; Matsunaga, Kimie; Nagao, Yuko; Nomiyama, Ryuta; Takeda, Komei; Tanizawa, Yukio

    2015-01-01

    Measurements of plaque echogenicity, the gray-scale median (GSM), were shown to correlate inversely with risk factors for cerebro-cardiovascular disease (CVD). The eicosapentaenoic acid (EPA)/arachidonic acid (AA) ratio is a potential predictor of CVD risk. In the present study, we assessed the usefulness of carotid plaque GSM values and EPA/AA ratios in atherosclerotic diabetics. A total of 84 type 2 diabetics with carotid artery plaques were enrolled. On admission, platelet aggregation and lipid profiles, including EPA and AA, were examined. Using ultrasound, mean intima media thickness and plaque score were measured in carotid arteries. Plaque echogenicity was evaluated using computer-assisted quantification of GSM. The patients were then further observed for approximately 3 years. Gray-scale median was found to be a good marker of CVD events. On multivariate logistic regression analysis, GSM <32 and plaque score ≥5 were significantly associated with past history and onset of CVD during the follow-up period, the odds ratios being 7.730 (P = 0.014) and 4.601 (P = 0.046), respectively. EPA/AA showed a significant correlation with GSM (P = 0.012) and high-density lipoprotein cholesterol (P = 0.039), and an inverse correlation with platelet aggregation (P = 0.046) and triglyceride (P = 0.020). Although most patients with CVD had both low GSM and low EPA/AA values, an association of EPA/AA with CVD events could not be statistically confirmed. The present results suggest the GSM value to be useful as a reference index for CVD events in high-risk atherosclerotic diabetics. Associations of the EPA/AA ratio with known CVD risk factors warrant a larger and more extensive study to show the usefulness of this parameter.

  10. Identifying Vulnerable Atherosclerotic Plaque in Rabbits Using DMSA-USPIO Enhanced Magnetic Resonance Imaging to Investigate the Effect of Atorvastatin.

    Directory of Open Access Journals (Sweden)

    Chunmei Qi

    Full Text Available Rupture of an atherosclerotic plaque is the primary cause of acute cardiovascular and cerebrovascular syndromes. Early and non-invasive detection of vulnerable atherosclerotic plaques (VP would be significant in preventing some aspects of these syndromes. As a new contrast agent, dimercaptosuccinic acid (DMSA modified ultra-small super paramagnetic iron oxide (USPIO was synthesized and used to identify VP and rupture plaque by magnetic resonance imaging (MRI.Atherosclerosis was induced in male New Zealand White rabbits by feeding a high cholesterol diet (n = 30. Group A with atherosclerosis plaque (n = 10 were controls. VP was established in groups B (n = 10 and C (n = 10 using balloon-induced endothelial injury of the abdominal aorta. Adenovirus-carrying p53 genes were injected into the aortic segments rich in plaques after 8 weeks. Group C was treated with atorvastatin for 8 weeks. Sixteen weeks later, all rabbits underwent pharmacological triggering, and imaging were taken daily for 5 d after DMSA-USPIO infusion. At the first day and before being killed, serum MMP-9, sCD40L, and other lipid indicators were measured.DMSA-USPIO particles accumulated in VP and rupture plaques. Rupture plaques appeared as areas of hyper-intensity on DMSA-USPIO enhanced MRI, especially T2*-weighted sequences, with a signal strength peaking at 96 h. The group given atorvastatin showed few DMSA-USPIO particles and had lower levels of serum indicators. MMP-9 and sCD40L levels in group B were significantly higher than in the other 2 groups (P <0.05.After successfully establishing a VP model in rabbits, DMSA-USPIO was used to enhance MRI for clear identification of plaque inflammation and rupture. Rupture plaques were detectable in this way probably due to an activating inflammatory process. Atorvastatin reduced the inflammatory response and stabilizing VP possibly by decreasing MMP-9 and sCD40L levels.

  11. Correlation of three grades with carotid atherosclerotic plaque by the ultrasound in middle-aged patients with hypertension

    Institute of Scientific and Technical Information of China (English)

    Jian-Ping Ru; Qing-Hua Yang; Xian-Da Jia

    2017-01-01

    Objective:To explore the correlation of different hypertension grades with carotid atherosclerotic plaque in middle-aged patients with hypertension.Methods:A total of 300 patients with primary hypertension who were admitted in the Cardiology Department and Neurology Department of our hospital from January, 2015 to September, 2016 were included in the study and divided into 3 groups with 100 cases in each group according to the hypertension grade criteria. Moreover, 100 normal individuals who came for physical examinations were served as the control group. TCD was used to detect MCA, ACA, PCA, VA1, and BA. CDFI was used to detect CCA, ICA, ECA, and VA2. EDV, PSV, PI, and RI were detected, respectively. The nitrate reductase colorimetric method was used to detect NO, MDA, and SOD.Results:PSV and EDV in the internal carotid artery system in patients with hypertension were significantly reduced (P<0.05), while PI and RI were significantly increased (P<0.05); moreover, with the increasing of hypertension grading, PSV and EDV were gradually reduced, while PI and RI were increased. PSV and EDV in the vertebral artery system in patients with hypertension were significantly reduced (P<0.05), while PI and RI were significantly increased (P<0.05); moreover, with the increasing of hypertension grading, PSV and EDV were gradually reduced, while PI and RI were increased. SOD and NO in patients with hypertension were significantly lower than those in the control group (P<0.05), while MDA was significantly higher than that in the control group (P<0.05); moreover, with the increasing of hypertension grading, SOD and NO were gradually reduced, while MDA was gradually increased.Conclusions: TCD in combined with CDFI can make a comprehensive evaluation of hemodynamic indicators of intracranial and extracranial vessels in patients with hypertension, and is of great significance in the early detection of intracranial and extracranial arteriosclerosis.

  12. MiR-181b Antagonizes Atherosclerotic Plaque Vulnerability Through Modulating Macrophage Polarization by Directly Targeting Notch1.

    Science.gov (United States)

    An, Tian-Hui; He, Quan-Wei; Xia, Yuan-Peng; Chen, Sheng-Cai; Baral, Suraj; Mao, Ling; Jin, Hui-Juan; Li, Ya-Nan; Wang, Meng-Die; Chen, Jian-Guo; Zhu, Ling-Qiang; Hu, Bo

    2016-10-08

    Atherosclerotic plaque vulnerability is the major cause for acute stroke and could be regulated by macrophage polarization. MicroRNA-181b (miR-181b) was involved in macrophage differential. Here, we explore whether miR-181b could regulate atherosclerotic plaque vulnerability by modulating macrophage polarization and the underline mechanisms. In acute stroke patients with atherosclerotic plaque, we found that the serum level of miR-181b was decreased. Eight-week apolipoprotein E knockout (ApoE(-/-)) mice were randomly divided into three groups (N = 10): mice fed with normal saline (Ctrl), mice fed with high-fat diet, and tail vein injection with miRNA agomir negative control (AG-NC)/miR-181b agomir (181b-AG, a synthetic miR-181b agonist). We found that the serum level of miR-181b in AG-NC group was lower than that in Ctrl group. Moreover, 181b-AG could upregulate miR-181b expression, reduce artery burden and attenuate atherosclerotic plaque vulnerability by modulating macrophage polarization. In RAW264.7 cells treated with oxidized low-density lipoprotein (ox-LDL), we found miR-181b could reverse the function of ox-LDL on M1/M2 markers at both mRNA and protein levels. Furthermore, by employing luciferase reporter assay, we found that Notch1 was a direct target of miR-181b and could be regulated by miR-181b in vivo and in vitro. Finally, inhibition of Notch1 could abolish the function of downregulating miR-181b on increasing M2 phenotype macrophages. Our study demonstrates that administration of miR-181b could reduce atherosclerotic plaque vulnerability partially through modulating macrophage phenotype by directly targeting Notch1.

  13. Occupational characteristics and the progression of carotid artery intima-media thickness and plaque over 9 years: the Multi-Ethnic Study of Atherosclerosis (MESA)

    Science.gov (United States)

    Fujishiro, Kaori; Diez Roux, Ana V; Landsbergis, Paul; Kaufman, Joel D; Korcarz, Claudia E; Stein, James H

    2015-01-01

    Objectives The role of occupation in the development of cardiovascular disease (CVD) remains a topic of research because few studies have examined longitudinal associations, and because occupation can be an indicator of socioeconomic position (SEP) and a proxy for hazard exposure. This study examines associations of occupational category as an SEP marker and selected occupational exposures with progression of the subclinical carotid artery disease. Methods A community-based, multiethnic sample (n=3109, mean age=60.2) provided subclinical CVD measures at least twice at three data collection points (mean follow-up=9.4 years). After accounting for demographic characteristics, SEP, and traditional CVD risk factors, we modelled common carotid intima-media thickness, carotid plaque scores, and carotid plaque shadowing as a function of occupational category, physical hazard exposure, physical activity on the job, interpersonal stress, job control and job demands. These job characteristics were derived from the Occupational Resource Network (O*NET). Random coefficient models were used to account for repeated measures and time-varying covariates. Results There were a few statistically significant associations at baseline. After all covariates were included in the model, men in management, office/sales, service and blue-collar jobs had 28–44% higher plaque scores than professionals at baseline (p=0.001). Physically hazardous jobs were positively associated with plaque scores among women (p=0.014). However, there were no significant longitudinal associations between any of the occupational characteristics and any of the subclinical CVD measures. Conclusions There was little evidence that the occupational characteristics examined in this study accelerated the progression of subclinical CVD. PMID:25217203

  14. Occupational characteristics and the progression of carotid artery intima-media thickness and plaque over 9 years: the Multi-Ethnic Study of Atherosclerosis (MESA).

    Science.gov (United States)

    Fujishiro, Kaori; Diez Roux, Ana V; Landsbergis, Paul; Kaufman, Joel D; Korcarz, Claudia E; Stein, James H

    2015-10-01

    The role of occupation in the development of cardiovascular disease (CVD) remains a topic of research because few studies have examined longitudinal associations, and because occupation can be an indicator of socioeconomic position (SEP) and a proxy for hazard exposure. This study examines associations of occupational category as an SEP marker and selected occupational exposures with progression of the subclinical carotid artery disease. A community-based, multiethnic sample (n=3109, mean age=60.2) provided subclinical CVD measures at least twice at three data collection points (mean follow-up=9.4 years). After accounting for demographic characteristics, SEP, and traditional CVD risk factors, we modelled common carotid intima-media thickness, carotid plaque scores, and carotid plaque shadowing as a function of occupational category, physical hazard exposure, physical activity on the job, interpersonal stress, job control and job demands. These job characteristics were derived from the Occupational Resource Network (O*NET). Random coefficient models were used to account for repeated measures and time-varying covariates. There were a few statistically significant associations at baseline. After all covariates were included in the model, men in management, office/sales, service and blue-collar jobs had 28-44% higher plaque scores than professionals at baseline (p=0.001). Physically hazardous jobs were positively associated with plaque scores among women (p=0.014). However, there were no significant longitudinal associations between any of the occupational characteristics and any of the subclinical CVD measures. There was little evidence that the occupational characteristics examined in this study accelerated the progression of subclinical CVD. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  15. Nuclear medicine and coronary artery disease: evaluation of tracers of myocardial perfusion and vulnerable atherosclerotic plaque; Medecine nucleaire et maladie coronarienne: evaluation de traceurs de la perfusion myocardique et de la plaque d'atherome vulnerable

    Energy Technology Data Exchange (ETDEWEB)

    Broisat, A

    2005-04-15

    Coronary artery disease is one of the primary cause of mortality worldwide. Nuclear medicine is the major imaging technique for diagnosis and following of this disease. perfusion: nowadays, major radioactive agents used in clinical practice are myocardial perfusion tracers. The reference tracer is thallium-201. However, {sup 201}Tl presents some drawbacks. {sup 99m}Tcn-noet has been proposed for its replacement. This study shows that in contrast with previous studies realized in vitro on cardio myocytes, verapamil, an l-type calcium channel inhibitor, does not inhibit myocardial fixation of {sup 99m}Tcn-noet in vivo in dog. This data is in agreement with the hypothesis of a non specific endothelial fixation of this tracer. Moreover, this study shows that as a pure tracer of myocardial perfusion, {sup 99m}Tcn-noet can also be used to assess myocardial viability on a model of myocardial chronic infarction in rat. atherosclerosis: disruption of vulnerable atherosclerotic plaques is the main event leading to coronary accidents. The second part of this study concerns the evaluation of new potential tracers of the vulnerable atherosclerotic plaque in an experimental model of rabbit with an inheritable hypercholesterolemia. The four tracers evaluated (b2702(r), b2702-I, b2702-Tc and Tc-raft-b2702) are synthetic peptides comprising the residues 75-84 of hla-b2702, a molecule known to link vcam-1, an adhesion molecule expressed in vulnerable atherosclerotic plaque. The autoradiography studies show that all tracers accumulate within atherosclerotic plaque expressing vcam- and that. i-b2702 shows the best plaque/control fixation ratio. (author)

  16. The association of thyroid function with carotid artery plaque burden and strokes in a population-based sample from a previously iodine-deficient area.

    Science.gov (United States)

    Dörr, Marcus; Empen, Klaus; Robinson, Daniel M; Wallaschofski, Henri; Felix, Stephan B; Völzke, Henry

    2008-08-01

    Thyroid dysfunction is associated with detrimental cardiovascular effects. We analyzed whether thyroid status is related to carotid artery plaques and prevalent strokes. Data from 2128 subjects (1157 men and 971 women) aged > or =45 years without thyroid diseases participating in the Study of Health in Pomerania were analyzed. The presence of carotid plaques was assessed by B-mode ultrasound and prevalent stroke was assessed by interview. The sample was divided according to the reference range of serum TSH levels into decreased (2.12 mIU/l). Logistic regression models were adjusted for common confounders including age, sex, BMI, hypertension, diabetes mellitus, smoking, school education, plasma fibrinogen and serum cholesterol levels, and statins. The prevalence of carotid plaques at any site was higher in subjects with decreased serum TSH levels (81.7%) compared with normal serum TSH levels (70.2%) and elevated serum TSH levels (65.6%; PPeriodical screening and early treatment of atherosclerotic risk factors should be performed in subjects with decreased serum TSH levels.

  17. Efficacy of ezetimibe combined with atorvastatin in the treatment of carotid artery plaque in patients with type 2 diabetes mellitus complicated with coronary heart disease.

    Science.gov (United States)

    Wang, Jing; Ai, Xiao-Bo; Wang, Fei; Zou, Yao-Wu; Li, Li; Yi, Xiao-Lei

    2017-10-01

    The aim of this study was to evaluate the efficacy of ezetimibe combined with atorvastatin in treatment of carotid artery plaque in patients with type 2 diabetes mellitus complicated with coronary heart disease (CHD). A total of 100 patients with carotid atherosclerosis (CAS) confirmed by ultrasound and diagnosed with type 2 diabetes mellitus and CHD were randomly assigned to atorvastatin group (atorvastatin 20 mg/day) or combined treatment group (ezetimibe 10 mg/day and atorvastatin 20 mg/day). All those patients were followed for 12 months. Serum lipid, ALT, AST, and CK were measured before and after treatment. Ultrasonography was used to evaluate the stability of carotid artery plaques. After 12 months of treatment, the level of TC, TG, LDL-C, hs-CRP, FPG and HbA1c decreased in both groups compared with before treatment. TC, TG, LDL-C and hs-CRP in the combined treatment group were much lower than that in the atorvastatin group (P<0.05). The IMT and plaque area in the two groups were lower than that before the treatment (P<0.05). IMT and plaques area in the combined treatment group is much lower than that in the atorvastatin group after treatment. There was no significant difference in two groups on the level of ALT, AST, CK compared with baseline after treatment. The effect of combined use of atorvastatin and ezetimibe was better than atorvastatin alone, which can effectively reduce the blood lipid levels in diabetic patients with CHD and improve plaque stability. Both treatment regimens were safe and well tolerated.

  18. Prevalence and Risk Factors of Carotid Plaque Among Middle-aged and Elderly Adults in Rural Tianjin, China.

    Science.gov (United States)

    Zhan, Changqing; Shi, Min; Yang, Ying; Pang, Hongbo; Fei, Shizao; Bai, Lingling; Liu, Bin; Tu, Jun; Huo, Yong; Ning, Xianjia; Zhang, Yan; Wang, Jinghua

    2016-03-31

    Carotid plaque (CP) is associated with cardiovascular and cerebrovascular events. However, population-based studies with a large sample are rare in China, particularly those in the low-income population. We aimed to determine the prevalence of CP and the associated risk factors in the rural areas of northern China. Between April 2014 and June 2014, we recruited 3789 residents aged ≥45 years. B-mode ultrasonography was performed to measure the extent of CP. The prevalence of CP was 40.3% overall, 47.1% in men, and 35.4% in women (P < 0.001). The prevalence of CP increased with increasing age (P < 0.001). The participants with CP were more likely to have hypertension, diabetes, high total cholesterol (TC) levels, and high low-density lipoprotein-cholesterol levels and be a current smoker; however, they were less likely to be obese. Multiple logistic regression analysis, adjusted for confounders, indicated that age, male sex, hypertension, diabetes, current smoking, and high LDL-C levels were the independent risk factors for CP. There was a lower risk of CP with alcohol consumption. The findings suggest that managing the conventional risk factors is crucial to reduce the burden of cardiovascular and cerebrovascular diseases in the low-income population in China.

  19. Positive remodeling index by MSCT coronary angiography: A prognostic factor for early detection of plaque rupture and vulnerability

    Directory of Open Access Journals (Sweden)

    Emad H. Abdeldayem

    2015-03-01

    Conclusion: Previous studies had shown that most acute coronary syndromes were initiated by sudden changes of mildly stenotic lesions, commonly found in positively remodeled vessels. Promising comparative results between MSCT and IVUS allowed consideration of MDCT as a useful tool in the noninvasive detection of potentially threatening coronary lesions. In our study, RI ⩾ 1.5 showed a strong correlation between the lipid plaque area, multiplicity of the plaques, and cross sectional area which were prognostic factors for plaque rupture and vulnerability, and thus, early detection of coronary artery disease. Modulation and prevention of positive remodeling by statin could promote to start medical treatment especially in cases where RI exceeds 1.5 and their follow up non-invasively by MDCT to detect reversal of remodeling and response of treatment.

  20. In vitro shear stress measurements using particle image velocimetry in a family of carotid artery models: effect of stenosis severity, plaque eccentricity, and ulceration.

    Directory of Open Access Journals (Sweden)

    Sarah Kefayati

    Full Text Available Atherosclerotic disease, and the subsequent complications of thrombosis and plaque rupture, has been associated with local shear stress. In the diseased carotid artery, local variations in shear stress are induced by various geometrical features of the stenotic plaque. Greater stenosis severity, plaque eccentricity (symmetry and plaque ulceration have been associated with increased risk of cerebrovascular events based on clinical trial studies. Using particle image velocimetry, the levels and patterns of shear stress (derived from both laminar and turbulent phases were studied for a family of eight matched-geometry models incorporating independently varied plaque features - i.e. stenosis severity up to 70%, one of two forms of plaque eccentricity, and the presence of plaque ulceration. The level of laminar (ensemble-averaged shear stress increased with increasing stenosis severity resulting in 2-16 Pa for free shear stress (FSS and approximately double (4-36 Pa for wall shear stress (WSS. Independent of stenosis severity, marked differences were found in the distribution and extent of shear stress between the concentric and eccentric plaque formations. The maximum WSS, found at the apex of the stenosis, decayed significantly steeper along the outer wall of an eccentric model compared to the concentric counterpart, with a 70% eccentric stenosis having 249% steeper decay coinciding with the large outer-wall recirculation zone. The presence of ulceration (in a 50% eccentric plaque resulted in both elevated FSS and WSS levels that were sustained longer (∼20 ms through the systolic phase compared to the non-ulcerated counterpart model, among other notable differences. Reynolds (turbulent shear stress, elevated around the point of distal jet detachment, became prominent during the systolic deceleration phase and was widely distributed over the large recirculation zone in the eccentric stenoses.

  1. In vitro shear stress measurements using particle image velocimetry in a family of carotid artery models: effect of stenosis severity, plaque eccentricity, and ulceration.

    Science.gov (United States)

    Kefayati, Sarah; Milner, Jaques S; Holdsworth, David W; Poepping, Tamie L

    2014-01-01

    Atherosclerotic disease, and the subsequent complications of thrombosis and plaque rupture, has been associated with local shear stress. In the diseased carotid artery, local variations in shear stress are induced by various geometrical features of the stenotic plaque. Greater stenosis severity, plaque eccentricity (symmetry) and plaque ulceration have been associated with increased risk of cerebrovascular events based on clinical trial studies. Using particle image velocimetry, the levels and patterns of shear stress (derived from both laminar and turbulent phases) were studied for a family of eight matched-geometry models incorporating independently varied plaque features - i.e. stenosis severity up to 70%, one of two forms of plaque eccentricity, and the presence of plaque ulceration). The level of laminar (ensemble-averaged) shear stress increased with increasing stenosis severity resulting in 2-16 Pa for free shear stress (FSS) and approximately double (4-36 Pa) for wall shear stress (WSS). Independent of stenosis severity, marked differences were found in the distribution and extent of shear stress between the concentric and eccentric plaque formations. The maximum WSS, found at the apex of the stenosis, decayed significantly steeper along the outer wall of an eccentric model compared to the concentric counterpart, with a 70% eccentric stenosis having 249% steeper decay coinciding with the large outer-wall recirculation zone. The presence of ulceration (in a 50% eccentric plaque) resulted in both elevated FSS and WSS levels that were sustained longer (∼20 ms) through the systolic phase compared to the non-ulcerated counterpart model, among other notable differences. Reynolds (turbulent) shear stress, elevated around the point of distal jet detachment, became prominent during the systolic deceleration phase and was widely distributed over the large recirculation zone in the eccentric stenoses.

  2. Circulating adiponectin levels in relation to carotid atherosclerotic plaque presence, ischemic stroke risk, and mortality: A systematic review and meta-analyses.

    Science.gov (United States)

    Gorgui, Jessica; Gasbarrino, Karina; Georgakis, Marios K; Karalexi, Maria A; Nauche, Bénédicte; Petridou, Eleni Th; Daskalopoulou, Stella S

    2017-04-01

    Low circulating levels of adiponectin, an anti-inflammatory and vasculoprotective adipokine, are associated with obesity, type 2 diabetes, and atherosclerotic disease. Presence of unstable plaques in the carotid artery is a known etiological factor causing ischemic strokes. Herein, we systematically reviewed the association between circulating adiponectin and progression of carotid atherosclerotic disease, particularly evaluating the occurrence of (1) carotid atherosclerotic plaques, (2) ischemic stroke, and (3) mortality in subjects who suffered a previous ischemic stroke. Medline, Embase, Biosis, Scopus, Web of Science, and Pubmed were searched for published studies and conference abstracts. The effect size and 95% confidence intervals (CIs) of the individual studies were pooled using fixed-effect or random-effect models. The quality of the eligible studies was evaluated using the Newcastle-Ottawa quality assessment scale. Sensitivity, subgroup, and meta-regression analyses were performed to address the impact of various risk factors on the association between adiponectin and ischemic stroke risk. Twelve studies fulfilled the inclusion criteria for 3 independent meta-analyses. The association of increasing circulating adiponectin levels (5μg/mL-increment) with presence of carotid plaque was not conclusive (n=327; OR: 1.07; 95% CI: 0.85-1.35; 2 studies), whereas high adiponectin levels showed a significant 8% increase in risk of ischemic stroke (n=13,683; 7 studies), with a more sizable association observed among men compared to women. HDL was observed to have a marginal effect on the association between adiponectin and ischemic stroke, while other evaluated parameters were not found to be effect modifiers. A non-significant association of adiponectin with mortality was yielded (n=663; OR: 2.58; 95% CI: 0.69-9.62; 3 studies). Although no publication bias was evident, there was significant between-study heterogeneity in most analyses. It appears that the direction

  3. No association of atherosclerosis with digital ulcers in Japanese patients with systemic sclerosis: evaluation of carotid intima-media thickness and plaque characteristics.

    Science.gov (United States)

    Motegi, Sei-Ichiro; Toki, Sayaka; Hattori, Tomoyasu; Yamada, Kazuya; Uchiyama, Akihiko; Ishikawa, Osamu

    2014-07-01

    Patients with systemic sclerosis (SSc) usually develop Raynaud's phenomenon, persistent digital ischemia and sometimes develop digital ulcers (DU). Several studies have reported an association of carotid artery atherosclerosis with SSc by evaluating carotid intima-media thickness (IMT) in SSc patients. However, none of those studies analyzed the association between DU and carotid artery atherosclerosis in SSc patients. We examined the association of carotid artery atherosclerosis with digital ulcers by comparing SSc patients with (n = 48, 29.5%) and without (n = 206, 70.5%) DU. The demographic and clinical features of the SSc patients showed that young age, male sex, anti-topoisomerase I antibody positivity, severe skin sclerosis, interstitial lung disease complication and cardiac involvements were significantly prevalent in patients with DU. In addition, diffuse cutaneous type, anti-RNA polymerase III antibody positivity and severe skin sclerosis are more frequent in SSc patients with DU at the extensor surface of joints than SSc patients with DU at the digital tip. There were no differences in serum lipid level, carotid IMT or plaque score between SSc patients with and without DU, suggesting that atherosclerotic changes are not primarily involved in the development of DU.

  4. Stresses in Carotid Plaques using MRI-based Fluid Structure Interaction Models

    DEFF Research Database (Denmark)

    Samuel, Samuel Alberg; Fründ, Torben; Kim, Won Yong

    2006-01-01

    stresses exceed 300 kPa. The ability to estimate stress magnitudes in the fibrous cap is thus expected to improve risk assessment. Methods A patient with severe atherosclerosis was scanned using magnetic resonance imaging (MRI). The plaque was segmented into lipid core, fibrous cap, vessel wall, and blood...... in the pressure outlets was set to 10666 Pa. The Neo-Hookean hyper-elastic model was used to specify the material properties (5) of surrounding tissue (µ=6.20e6, κ=1.24e8, ρ=960) and vessel wall (µ=7.20e5, κ=1.44e7, ρ=1200). Lipid was treated as an isotropic materiel (6) with Young’s modulus set to 1...... the vessel-wall/blood-stream interface (one-way coupling). Results First principal stresses are depicted in figure 3. The soft lipid pool generated severe stresses (max. 350 kPa) in the overlaying fibrous cap, most prominent in the “shoulder region” i.e. the region of the fibrous cap adjacent to the vessel...

  5. 颈动脉破损斑块的高分辨MR成像研究%A study of disrupted carotid plaque using high-resolution MRI

    Institute of Scientific and Technical Information of China (English)

    于薇; 张兆琪; Hunter Underhill; Thomas S. Hatsukami; Yuan Chun

    2008-01-01

    Objective To evaluate distribution features of disrupted carotid plaque. Methods Forty-three subjects with duplex ultrasound evidence of 50% to 99% stenosis were retrospectively analyzed. Plaques were categorized as disrupted if there was MRI evidence of fibrous cap rupture. Quantity measured areas of the lumen (LA), wall (WA), and plaque components. The morphological parameters used were total vessel area, vessel burden index, eccentricity index. Mann-Whitney test and Chi-square test appropriate used SPSS (v. 12.0 ). Results There were 17 disrupted and 26 undisrupted lesions identified for comparison. Disrupted plaques showed a predominance of longer longitudinal length of large lip nucleus along the vessel wall (6 mm vs. 0 mm, U = 126, P <0.05 ), a large vessel burden (0.67 vs. 0.59, U =105, P <0.05), and high prevalence of thrombus (82.4% vs. 42.3 %, U = 132,P <0.05). In addition, disrupted plaques showed a different pattern of plaque distribution, having a more eccentric position of the lumen (3.68 vs. 2.79, U = 126, P < 0.05 ), a smaller lumen area (23.97 mm2 vs. 30. 18 mm2, U = 138, P<0.05) and a longer segment of stenosis when compared with the intact plaques. Conclusions Disrupted plaques have significantly different characteristics in terms of both axial and longitudinal distribution. A combination of multi-plane and multi-contrast high resolution MRI may provide valuable information about overall lesion morphology and its association to vulnerability.%目的 评价破损颈动脉粥样硬化斑块的成分及其分布的特点.方法 回顾性分析43例经超声诊断颈动脉狭窄50%-99%患者斑块高分辨MR图像,根据斑块表面纤维帽的完整性判定斑块破损情况,同时定量测量管腔、管壁、斑块成分的面积比例、纵向长度,并计算总管腔面积、血管负荷指数、偏心指数.采用SPSS 12.0统计学软件对患者一般临床资料进行卡方检验,并且对定量测量所得到的计量资

  6. Advanced human carotid plaque progression correlates positively with flow shear stress using follow-up scan data: an in vivo MRI multi-patient 3D FSI study.

    Science.gov (United States)

    Yang, Chun; Canton, Gador; Yuan, Chun; Ferguson, Marina; Hatsukami, Thomas S; Tang, Dalin

    2010-09-17

    Although it has been well-accepted that atherosclerosis initiation and early progression correlate negatively with flow wall shear stresses (FSS), increasing evidence suggests mechanisms governing advanced plaque progression are not well understood. Fourteen patients were scanned 2-4 times at 18 month intervals using a histologically validated multi-contrast magnetic resonance imaging (MRI) protocol to acquire carotid plaque progression data. Thirty-two scan pairs (baseline and follow-up scans) were formed with slices matched for model construction and analysis. 3D fluid-structure interaction (FSI) models were constructed and plaque wall stress (PWS) and flow shear stress (FSS) were obtained from all matching lumen data points (400-1000 per plaque; 100 points per matched slice) to quantify correlations with plaque progression measured by vessel wall thickness increase (WTI). Using FSS and PWS data from follow-up scan, 21 out of 32 scan pairs showed a significant positive correlation between WTI and FSS (positive/negative/no significance ratio=21/8/3), and 26 out of 32 scan pairs showed a significant negative correlation between WTI and PWS (positive/negative/no significance ratio=2/26/4). The mean FSS value of lipid core nodes (n=5294) from all 47 plaque models was 63.5dyn/cm(2), which was 45% higher than that from all normal vessel nodes (n=27553, p<0.00001). The results from this intensive FSI study indicate that flow shear stress from follow-up scan correlates positively with advanced plaque progression which is different from what has been observed in plaque initiation and early-stage progression. It should be noted that the correlation results do not automatically lead to any causality conclusions.

  7. Advantage in Bright-blood and Black-blood Magnetic Resonance Imaging with High-resolution for Analysis of Carotid Atherosclerotic Plaques

    Directory of Open Access Journals (Sweden)

    Mei Li

    2015-01-01

    Full Text Available Background: About 50% of the cerebral ischemia events are induced by intracranial and extracranial atherosclerosis. This study aimed to evaluate the feasibility and accuracy for displaying atherosclerotic plaques in carotid arteries and analyzing their ingredients by using high-resolution new magnetic resonance imaging (MRI techniques. Methods: Totally, 49 patients suspected of extracranial carotid artery stenosis were subjected to cranial MRI scan and magnetic resonance angiography (MRA examination on carotid arteries, and high-resolution bright-blood and black-blood MRI analysis was carried out within 1 week. Digital subtraction angiography (DSA examination was carried out for 16 patients within 1 month. Results: Totally, 103 plaques were detected in the 49 patients, which were characterized by localized or diffusive thickening of the vessel wall, with the intrusion of crescent-shaped abnormal signal into lumens. Fibrous cap was displayed as isointensity in T1-weighted image (T1WI and hyperintensities in proton density weighted image (PDWI and T2-weighted image (T2WI, lipid core was displayed as isointensity or slight hyperintensities in T1WI, isointensity, hyperintensities or hypointensity in PDWI, and hypointensity in T2WI. Calcification in plaques was detected in 11 patients. Eight patients were detected with irregular plaque surface or ulcerative plaques, which were characterized by irregular intravascular space surface in the black-blood sequences, black hypointensity band was not detected in three-dimensional time-of-flight, or the hypointensity band was not continuous, and intrusion of hyperintensities into plaques can be detected. Bright-blood and black-blood techniques were highly correlated with the diagnosis of contrast-enhanced MRA in angiostenosis degree, Rs = 0.97, P < 0.001. In comparison to DSA, the sensitivity, specificity, and accuracy of MRI diagnosis of stenosis for ≥50% were 88.9%, 100%, and 97.9%, respectively

  8. The predictive value of lipoprotein-associated phospholipase A2 in carotid artery plaque stability%血浆脂蛋白相关磷脂酶A2检测对颈动脉斑块稳定性的预测价值

    Institute of Scientific and Technical Information of China (English)

    费世早; 王磊; 庞洪波; 陈观保; 储照虎

    2012-01-01

    Objective To observe the levels of plasma lipoprotein-associated phospholipase A2( Lp-PLA2 ) in atherosclerotic cerebral infarction and healther people, analysis of plasma Lp-PLA2 levels with carotid artery plaque stability. Methods Plasma Lp-PLA2 levels were detected by enzyme linked immunosorbent assay( ELISA ), and the levels of blood lipids and fibrinogen, The carotid plaque stability were determined by cervical vascular color Dopplerultrasound. Rscults As compared to the vulnerable plaque group, the levels of plasma lipoprotein-associated phospholipase A2( Lp-PLA2 ) were higher in stable plaque group( P <0. 01 ). Conclusion Lp-PLA2 serves as a predictive indicator of carotid artery plaque stability.%目的 检测动脉粥样硬化脑梗死(ACI)患者及健康体检者血浆脂蛋白相关磷脂酶A2(Lp-PLA2)水平,探讨颈动脉斑块稳定性与血浆Lp-PLA2水平相关性.方法 采用双抗体夹心酶联免疫吸附法(ELISA)检测血浆Lp-PLA2水平,同时检测血脂、纤维蛋白原等生化指标;行颈动脉彩色多普勒超声检查,评估颈动脉斑块稳定性.结果 不稳定斑块组血浆Lp-PLA2水平明显高于稳定斑块组(P<0.01).结论 血浆Lp-PLA2水平可作为颈动脉斑块稳定性的预测指标.

  9. Magnetic resonance imaging of carotid atherosclerotic plaque%颈动脉粥样硬化斑块的磁共振成像

    Institute of Scientific and Technical Information of China (English)

    杨松; 周志明; 徐格林; 刘新峰

    2009-01-01

    Stroke is one of the diseases that seriously threats the health of the elderly, and atherosclerosis is the main cause of ischemic stroke. Became it is closely associated with stroke, carotid carotid atherosclerosis has been one of the research hot spots in neurology. In recent years, the development of MRI techniques has provided a new approach for the qualitative and quantitative analysis of atherosclerotic plaque, and has reflected its unique superiority, This article reviews the applications of MRI in the evaluation of carotid atherosclerotic plaques.%卒中足严苇威胁老年人健康的疾病之一,动脉粥样硬化是导致缺血性卒中的主要原因.由于与卒中存在密切联系.颈动脉粥样硬化一直是神经科的研究热点之一.近年来,MRI技术的发展为动脉粥样硬化斑块的定性和定量分析提供了一条新的途径,并体现出其独特的优越性.文章对MRI在颈动脉斑块评价中的应用做了综述.

  10. A finite element study of balloon expandable stent for plaque and arterial wall vulnerability assessment

    Science.gov (United States)

    Karimi, Alireza; Navidbakhsh, Mahdi; Razaghi, Reza

    2014-07-01

    The stresses induced within plaque tissues and arterial layers during stent expansion inside an atherosclerotic artery can be exceeded from the yield stresses of those tissues and, consequently, lead to plaque or arterial layer rupture. The distribution and magnitude of the stresses in each component involved in stenting might be clearly different for different plaque types and different arterial layers. In this study, a nonlinear finite element simulation was employed to investigate the effect of plaque composition (calcified, cellular, and hypocellular) on the stresses induced in the arterial layers (intima, media, and adventitia) during implantation of a balloon expandable coronary stent into a stenosed artery. The atherosclerotic artery was assumed to consist of a plaque and normal/healthy arterial tissues on its outer side. The results indicated a significant influence of plaque types on the maximum stresses induced within the plaque wall and arterial layers during stenting but not when computing maximum stress on the stent. The stress on the stiffest calcified plaque wall was in the fracture level (2.38 MPa), whereas cellular and hypocellular plaques remain stable owing to less stress on their walls. Regardless of plaque types, the highest von Mises stresses were observed on the stiffest intima layer, whereas the lowest stresses were seen to be located in less stiff media layer. The computed stresses on the intima layer were found to be high enough to initiate a rupture in this stiff layer. These findings suggest a higher risk of arterial vascular injury for the intima layer, while a lower risk of arterial injury for the media and adventitia layers.

  11. Correlations between carotid plaque progression and mechanical stresses change sign over time: a patient follow up study using MRI and 3D FSI models.

    Science.gov (United States)

    Tang, Dalin; Yang, Chun; Canton, Gador; Wu, Zheyang; Hatsukami, Thomas; Yuan, Chun

    2013-10-14

    Increasing evidence suggests that mechanisms governing advanced plaque progression may be different from those for early progression and require further investigation. Serial MRI data and 3D fluid-structure interaction (FSI) models were employed to identify possible correlations between mechanical stresses and advanced plaque progression measured by vessel wall thickness increase (WTI). Long-term patient follow up was used to gather data and investigate if the correlations identified above were reproducible. In vivo MRI data were acquired from 16 patients in a follow-up study with 2 to 4 scans for each patient (scan interval: average 18 months and standard deviation 6.8 months). A total of 38 scan pairs (baseline and follow-up) were formed for analysis using the carotid bifurcation as the registration point. 3D FSI models were constructed to obtain plaque wall stress (PWS) and flow shear stress (FSS) to quantify their correlations with plaque progression. The Linear Mixed-Effects models were used to study possible correlations between WTI and baseline PWS and FSS with nodal dependence taken into consideration. Of the 38 scan pairs, 22 pairs showed positive correlation between baseline PWS and WTI, 1 pair showed negative correlation, and 15 pairs showed no correlation. Thirteen patients changed their correlation sign (81.25%). Between baseline FSS and WTI, 16 pairs showed negative correlation, 1 pair showed positive correlation. Twelve patients changed correlation sign (75%). Our results showed that advanced plaque progression had an overall positive correlation with plaque wall stress and a negative correlation with flow shear stress at baseline. However, long-term follow up showed that correlations between plaque progress and mechanical stresses (FSS and PWS) identified for one time period were not re-producible for most cases (>80%). Further investigations are needed to identify the reasons causing the correlation sign changes.

  12. Detection of vulnerable plaques rather than the culprit lesions in patients with acute coronary syndrome using virtual histology intravascular ultrasound imaging

    Institute of Scientific and Technical Information of China (English)

    QIAN Ju-ying

    2009-01-01

    @@ Pathology and postmortem studies have reported that the most important mechanism of acute coronary syndrome (ACS) is the rupture of a vulnerable plaque and subsequent thrombus formation. Such events commonly arise from the non-flow limiting atherosclerotic lesions which are prone to rupture. Thin-cap fibroatheromas (TCFA) are the most common type of vulnerable plaque. As the widely used technique for the detection of coronary arterial diseases, coronary angiography has intrinsic limitations since it only portrays the contrast agent-filled contour of the lumen and provides little information on the vessel wall and even less the characteristics of the plaques.

  13. Effects of insulin sensitizers on plaque vulnerability associated with elevated lipid content in atheroma in ApoE-knockout mice.

    Science.gov (United States)

    Cefalu, W T; Wang, Z Q; Schneider, D J; Absher, P M; Baldor, L C; Taatjes, D J; Sobel, B E

    2004-03-01

    Acute coronary syndromes are generally precipitated by rupture of lipid-laden, relatively acellular, vulnerable atherosclerotic plaques with thin fibrous caps. We investigated whether a high-fat diet alters insulin sensitivity and whether insulin sensitizers (troglitazone and rosiglitazone) alter the composition of otherwise lipidladen atherosclerotic plaques in mice deficient in apolipoprotein E (ApoE). ApoE-knockout mice were fed a high-fat (n=30) or standard chow (n=10) diet for two weeks. Thereafter, those fed the high-fat diet were treated with troglitazone (n=10), rosiglitazone (n=10) or no drug (n=10) for 16 weeks beginning at 8 weeks of age. Carbohydrate metabolism was assessed with intraperitoneal glucose tolerance tests and insulin tolerance tests. Plaque composition was characterised with confocal laser scanning microscopy. The high-fat diet induced insulin resistance in the absence of weight gain. Compared with control animals on the high-fat diet, animals given troglitazone (400 mg/kg/day) or rosiglitazone (4 mg/kg/day) had significantly less area under the curve (AUC) for insulin ( p<0.05) and glucose disposal ( p<0.05). Despite significant increases in insulin sensitivity with drug treatment, no change in HDL-cholesterol and triglyceride levels, nor reduction in atheroma size or lipid content was noted. Thus, improvement in insulin resistance induced by a high-fat diet in this animal model of vasculopathy did not alter plaque composition.

  14. The role of contrast-enhanced ultrasound in risk assessment of carotid atheroma

    Directory of Open Access Journals (Sweden)

    Silviu Stanciu

    2016-07-01

    Full Text Available Background and objective: Contrast-enhanced ultrasound, used to assess atherosclerotic carotid plaques, improves visualization of vessel wall irregularities and depicts intraplaque neovascularization. This article illustrates the use of contrast-enhanced ultrasound in the risk assessment of carotid atherosclerotic lesions, especially in challenging plaques evaluation. Materials and methods: For 23 patients with difficult duplex ultrasound examination due to carotid tortuosity or calcifications we assessed plaque morphology (contour, echogenicity and stenosis degree using contrast substance (Sonovue, Braco with dedicated vascular low mechanical index CPC software. Conclusion: Contrast-enhanced ultrasound is a new, noninvasive, and safe procedure for imaging carotid atherosclerotic lesions. It is a valuable tool for evaluating the vulnerable plaque at risk for rupture and for the diagnostic of the development and severity of systemic atherosclerotic disease

  15. [Prediction of coronary artery stenosis by measurement of total plaque area and thickness versus intima media thickness of the carotid artery].

    Science.gov (United States)

    Adams, Ansgar; Bojara, Waldemar

    2015-08-01

    Total plaque area (TPA), maximum plaque thickness and intima media thickness (IMT) in the carotid arteries of 431 patients aged 27-88 years were measured 1 day before a planned coronary artery angiography without any clinical knowledge about the patient. Age-related cut-off values of the TPA for the presence of coronary stenosis were evaluated. Using ultrasound four types of carotid artery atherosclerosis were identified. The accuracy of detection of cardiovascular coronary stenosis was 87% for types III and IVb. No type I patient had coronary stenosis. The IMT was significantly less predictive: the area under the curve (AUC) for TPA by age and plaque thickness was 0.82 (95% CI: 0.78-0.85) versus IMT 0.59 (95% CI: 0.54-0.64, p = 0.001). Prediction with TPA measurement by age and plaque thickness was better than TPA alone: AUC 0.82 (95% CI: 0.78-0.85) versus 0.77 (95% CI: 0.73-0.81, p = 0.0028), respectively. In a second cohort of 2566 healthy men and 1216 healthy women aged between 20 and 64 years who were examined in an occupational screening program, 11.2% of the men and 3.4% of the women showed a type III or IVb result. In the mean follow-up of period of 23.4 ± 14.4 months, 14 heart attacks, 7 bypass operations and 3 stent implantations occurred and 6 subjects showed coronary stenosis between 50% and 95% in coronary angiography. In the baseline examination 26 out of 30 patients showed a type III or IVb result. In the case of men and women with types III and IVb diagnosis by ultrasound, pharmaceutical treatment could be indicated in order to reduce the risk of cardiovascular events. Type I patients do not need preventive medication or coronary catheterization.

  16. The effect of lipid regulation with atorvastatin on the blood lipid levels and carotid artery plaques in patients with atherosclerotic cerebral infarction

    Directory of Open Access Journals (Sweden)

    Shu XU

    2015-11-01

    Full Text Available Objective To analyze the effect of intensive lipid regulation treatment with atorvastatin on the blood lipid levels and carotid artery plaques in patients with atherosclerotic cerebral infarction.  Methods Ninety-two patients with atherosclerotic cerebral infarction were randomly divided into two groups: observation group (treated by atorvastatin calcium with the dosage of 20 mg/d, N = 46 and control group (treated by diet without lipid-rich food, N=46. Besides, other drugs given to the patients in two groups were the same. The blood lipid levels and the changes of carotid artery plaques in two groups were analyzed and compared before treatment and 3 months after treatment. Results After treatment, the concentrations of total cholesterol [TC, (4.23 ± 0.92 mmol/L vs (5.24 ± 0.68 mmol/L], triglyceride [TG, (2.46 ± 0.28 mmol/L vs (3.33 ± 0.47 mmol/L], low-density lipoprotein cholesterol [LDL-C, (2.52 ± 0.38 mmol/L vs (4.78 ± 0.86 mmol/L] in the patients of observation group were all decreased and significantly lower than those in the control group (P = 0.000, for all, and the concentration of high-density lipoprotein cholesterol [HDL-C, (1.13 ± 0.41 mmol/L vs (0.85 ± 0.32 mmol/L] in the patients of observation group was increased and significantly than that in the control group (P = 0.003. The carotid artery plaque size [(20.25 ± 0.32 mm2 vs (24.42 ± 10.33 mm2] and thickness [(0.59 ± 0.13 mm vs (1.93 ± 0.23 mm] of carotid artery plaques and intima?media thickness [IMT, (1.32 ± 0.67 mm vs (1.63 ± 0.56 mm] of common carotid artery (CCA in the patients of observation group were all significantly lower than those in patients in the control group (P = 0.000, 0.000, 0.010, respectively. Comparing serum alanine aminotransferase (ALT, aspartate aminotransferase (AST, creatine kinase (CK and creatinine (Cr levels after treatment with before treatment, there was no significant difference between 2 groups (P > 0.05, for all.  Conclusions

  17. Synchronous Carotid Bifurcation Endarterectomy and Retrograde Kissing Stenting of the Innominate and Left Common Carotid Artery in a Patient with a Bovine Aortic Arch

    Directory of Open Access Journals (Sweden)

    Alessandro Robaldo

    2017-01-01

    Full Text Available Management of the symptomatic multiple stenosis of supra-aortic vessels (MSSVs in a “bovine” aortic arch (BAA configuration is infrequently reported. The optimal treatment choice remains debatable. A successful hybrid treatment for a proximal critical stenosis of the innominate and left common carotid artery was performed in a high-risk patient with a tandem symptomatic lesion in the right carotid bifurcation and a concentric vulnerable plaque in the bovine trunk. This case supports the feasibility, safety, and efficacy of a combined carotid bifurcation endarterectomy and retrograde kissing stenting of common carotid arteries with cerebral protection after evaluation of radiological, anatomical, and clinical parameters.

  18. Preclinical models of atherosclerosis. The future of Hybrid PET/MR technology for the early detection of vulnerable plaque.

    Science.gov (United States)

    Cuadrado, Irene; Saura, Marta; Castejón, Borja; Martin, Ana María; Herruzo, Irene; Balatsos, Nikolaos; Zamorano, Jose Luis; Zaragoza, Carlos

    2016-04-08

    Cardiovascular diseases are the leading cause of death in developed countries. The aetiology is currently multifactorial, thus making them very difficult to prevent. Preclinical models of atherothrombotic diseases, including vulnerable plaque-associated complications, are now providing significant insights into pathologies like atherosclerosis, and in combination with the most recent advances in new non-invasive imaging technologies, they have become essential tools to evaluate new therapeutic strategies, with which can forecast and prevent plaque rupture. Positron emission tomography (PET)/computed tomography imaging is currently used for plaque visualisation in clinical and pre-clinical cardiovascular research, albeit with significant limitations. However, the combination of PET and magnetic resonance imaging (MRI) technologies is still the best option available today, as combined PET/MRI scans provide simultaneous data acquisition together with high quality anatomical information, sensitivity and lower radiation exposure for the patient. The coming years may represent a new era for the implementation of PET/MRI in clinical practice, but first, clinically efficient attenuation correction algorithms and research towards multimodal reagents and safety issues should be validated at the preclinical level.

  19. Impact of flow rates in a cardiac cycle on correlations between advanced human carotid plaque progression and mechanical flow shear stress and plaque wall stress

    Directory of Open Access Journals (Sweden)

    Ferguson Marina

    2011-07-01

    Full Text Available Abstract Background Mechanical stresses are known to play important roles in atherosclerotic plaque initiation, progression and rupture. It has been well-accepted that atherosclerosis initiation and early progression correlate negatively with flow wall shear stresses (FSS. However, mechanisms governing advanced plaque progression are not well understood. Method In vivo serial MRI data (patient follow-up were acquired from 14 patients after informed consent. Each patient had 2-4 scans (scan interval: 18 months. Thirty-two scan pairs (baseline and follow-up scans were formed with slices matched for model construction and analysis. Each scan pair had 4-10 matched slices which gave 400-1000 data points for analysis (100 points per slice on lumen. Point-wise plaque progression was defined as the wall thickness increase (WTI at each data point. 3D computational models with fluid-structure interactions were constructed based on in vivo serial MRI data to extract flow shear stress and plaque wall stress (PWS on all data points to quantify correlations between plaque progression and mechanical stresses (FSS and PWS. FSS and PWS data corresponding to both maximum and minimum flow rates in a cardiac cycle were used to investigate the impact of flow rates on those correlations. Results Using follow-up scans and maximum flow rates, 19 out of 32 scan pairs showed a significant positive correlation between WTI and FSS (positive/negative/no significance correlation ratio = 19/9/4, and 26 out of 32 scan pairs showed a significant negative correlation between WTI and PWS (correlation ratio = 2/26/4. Corresponding to minimum flow rates, the correlation ratio for WTI vs. FSS and WTI vs. PWS were (20/7/5 and (2/26/4, respectively. Using baseline scans, the correlation ratios for WTI vs. FSS were (10/12/10 and (9/13/10 for maximum and minimum flow rates, respectively. The correlation ratios for WTI vs. PWS were the same (18/5/9, corresponding to maximum and minimum

  20. Impact of flow rates in a cardiac cycle on correlations between advanced human carotid plaque progression and mechanical flow shear stress and plaque wall stress.

    Science.gov (United States)

    Yang, Chun; Canton, Gador; Yuan, Chun; Ferguson, Marina; Hatsukami, Thomas S; Tang, Dalin

    2011-07-19

    Mechanical stresses are known to play important roles in atherosclerotic plaque initiation, progression and rupture. It has been well-accepted that atherosclerosis initiation and early progression correlate negatively with flow wall shear stresses (FSS). However, mechanisms governing advanced plaque progression are not well understood. In vivo serial MRI data (patient follow-up) were acquired from 14 patients after informed consent. Each patient had 2-4 scans (scan interval: 18 months). Thirty-two scan pairs (baseline and follow-up scans) were formed with slices matched for model construction and analysis. Each scan pair had 4-10 matched slices which gave 400-1000 data points for analysis (100 points per slice on lumen). Point-wise plaque progression was defined as the wall thickness increase (WTI) at each data point. 3D computational models with fluid-structure interactions were constructed based on in vivo serial MRI data to extract flow shear stress and plaque wall stress (PWS) on all data points to quantify correlations between plaque progression and mechanical stresses (FSS and PWS). FSS and PWS data corresponding to both maximum and minimum flow rates in a cardiac cycle were used to investigate the impact of flow rates on those correlations. Using follow-up scans and maximum flow rates, 19 out of 32 scan pairs showed a significant positive correlation between WTI and FSS (positive/negative/no significance correlation ratio = 19/9/4), and 26 out of 32 scan pairs showed a significant negative correlation between WTI and PWS (correlation ratio = 2/26/4). Corresponding to minimum flow rates, the correlation ratio for WTI vs. FSS and WTI vs. PWS were (20/7/5) and (2/26/4), respectively. Using baseline scans, the correlation ratios for WTI vs. FSS were (10/12/10) and (9/13/10) for maximum and minimum flow rates, respectively. The correlation ratios for WTI vs. PWS were the same (18/5/9), corresponding to maximum and minimum flow rates. Flow shear stress

  1. Evaluation of correlation between carotid atheromatous plaque and coronary heart disease and the risk factors%颈动脉粥样硬化与冠心病的相关性及危险因素分析

    Institute of Scientific and Technical Information of China (English)

    赵宏坤; 蒋逸风; 沈彬

    2012-01-01

    目的 探讨颈动脉粥样斑块与冠状动脉粥样硬化性心脏病(CHD)的关系.方法 对54例行冠脉造影的患者同时行颈动脉超声检测,分析其颈动脉内膜中层厚度(IMT)及斑块指数与CHD的相关性,颈动脉粥样斑块与CHD患病率及冠脉Gensini积分的相关性,并比较他们的危险因素.结果 CHD组颈动脉IMT及斑块指数均较非CHD组显著增高(P<0.01),颈动脉粥样硬化组CHD患病率及冠脉Gensini积分也显著增加(P<0.01),而CHD组与颈动脉粥样硬化组危险因素基本相似.结论 颈动脉粥样硬化与CHD有显著相关性,两者有相似的危险因素.%Objective To investigate the relationship between carotid atheromatous plaque and coronary heart disease ( CHD). Methods We survey 54 patients' carotid ultrasonograph and coronary arteriongraphy, analyze the correlation of carotid intima-media thickness (IMT) and exponent of carotid atheromatous plaque and CHD, analyze the correlation of carotid atheromatous plaque and sickness rate of CHD and coronary artery Censini integrate, compare their risk factors. Results The carotid IMT and exponent of carotid atheromatous in the group of CHD are heightened significantly (P < 0.01). The sickness rate of CHD and coronary artery Gensini integrate in the group of carotid scleratheroma are heightened significantly too ( P <0.01). The risk factors of the group CHD and carotid scleratheroma are similar. Conclusion Carotid atheromatous plaque is correlated with CHD significantly. Their risk factors are similar.

  2. Selective inhibition of PI3K/Akt/mTOR signaling pathway regulates autophagy of macrophage and vulnerability of atherosclerotic plaque.

    Directory of Open Access Journals (Sweden)

    Chungang Zhai

    Full Text Available Macrophage infiltration contributes to the instability of atherosclerotic plaques. In the present study, we investigated whether selective inhibition of PI3K/Akt/mTOR signaling pathway can enhance the stability of atherosclerotic plaques by activation of macrophage autophagy. In vitro study, selective inhibitors or siRNA of PI3K/Akt/mTOR pathways were used to treat the rabbit's peritoneal primary macrophage cells. Inflammation related cytokines secreted by macrophages were measured. Ultrastructure changes of macrophages were examined by transmission electron microscope. mRNA or protein expression levels of autophagy related gene Beclin 1, protein 1 light chain 3 II dots (LC3-II or Atg5-Atg12 conjugation were assayed by quantitative RT-PCR or Western blot. In vivo study, vulnerable plaque models were established in 40 New Zealand White rabbits and then drugs or siRNA were given for 8 weeks to inhibit the PI3K/Akt/mTOR signaling pathway. Intravascular ultrasound (IVUS was performed to observe the plaque imaging. The ultrastructure of the abdominal aortic atherosclerosis lesions were analyzed with histopathology. RT-PCR or Western blot methods were used to measure the expression levels of corresponding autophagy related molecules. We found that macrophage autophagy was induced in the presence of Akt inhibitor, mTOR inhibitor and mTOR-siRNA in vitro study, while PI3K inhibitor had the opposite role. In vivo study, we found that macrophage autophagy increased significantly and the rabbits had lower plaque rupture incidence, lower plaque burden and decreased vulnerability index in the inhibitors or siRNA treated groups. We made a conclusion that selective inhibition of the Akt/mTOR signal pathway can reduce macrophages and stabilize the vulnerable atherosclerotic plaques by promoting macrophage autophagy.

  3. Clinical Study on Effect of Garlicin in Stabilizing the Carotid Artery Atherosclerotic Plaque in Patients with Primary Hypertension and Coronary Artery Disease

    Institute of Scientific and Technical Information of China (English)

    CHENG Wen-li; KE Yuan-nan; SHI Zai-xiang; WANG Ying; CHEN Li; JU Gao; FAN Shu-ying

    2006-01-01

    Objective: To investigate the effect of garlicin in treating carotid artery atherosclerotic plaque (CAAP) in patients with primary hypertension and coronary heart disease (PHT-CHD). Methods: Seventynine patients with PHT-CHD were randomly divided into the treated group (39 patients) treated with garlicin and fosinopril and the control group (40 patients) treated with fosinopril alone. The change of CAAP was evaluated by high frequency ultrasonic examination every six months, and the changes of intercellular adhesion molecule-1 (ICAM-1) and high sensitive C-reactive protein (hs-CRP) were measured by ELISA, with the observation proceeding for 52 weeks totally. Results: By the end of the experiment, the number of complex plaques, Crouse integrals, intima-media thickness, serum ICAM-1 and hs-CRP were significantly lower in the treated group than those in the control group with significant difference (P<0.05). Conclusion; Garlicin could stabilize CAAP to a certain extent and shows a definite vascular protective effect in patients with PHT-CHD.

  4. Quantitative analysis of ultrasound B-mode images of carotid atherosclerotic plaque: correlation with visual classification and histological examination

    DEFF Research Database (Denmark)

    Wilhjelm, Jens E.; Grønholdt, Marie-Louise; Wiebe, Brit

    1998-01-01

    a correlation coefficient of r = -0.42 (p = 0.002), for mean echogenicity of the plaque region. The best performing feature was of second order and denoted Contrast (r = -0.5). Though significant, the latter correlation is probably not strong enough to be useful for clinical prediction of relative volume...

  5. 收缩压和LDL-C对颈动脉斑块的影响%Effects of systolic blood pressure and low density lipoprotein on carotid plaques

    Institute of Scientific and Technical Information of China (English)

    姚涛; 李雯; 张晓辉; 孙静; 王德胜; 赵永猛; 王张锋; 赵性泉; 吴寿岭

    2012-01-01

    Objective To explore the different effects of systolic blood pressure(SBP) and low density lipoprotein on carotid plaques(LDL-C).Methods A total of 101 510 serving and retired workers of a company who participated in the health examination in 2006-2009,5852 participants were selected as study subjects by stratified random sampling according to the age and sex ratio.These subjects took their health examination in 2010-2011 including the carotid ultrasound.Finally,5361 eligible participants with complete data were included in the analysis.The detection and weighted rates of carotid plaques were calculated for four groups:normal SBP and LDL-C group (3524 subjects),normal SBP and high LDL-C group (356 subjects),elevated SBP and normal LDL-C group (1308 subjects) and elevated SBP and high LDL-C group (173 subjects).The effects of different baseline SBP and LDL-C on detection rates of the carotid artery plaques were analyzed by logistic regression.Results The detection rate of carotid plaques in normal SBP and LDL-C group,normal SBP and high LDL-C group,elevated SBP and normal LDL-C group,elevated SBP and high LDL-C group was 33.7% (1186/3524),41.3% (147/356),64.8% (847/1308),68.8% (119/173) (x2 =425.75,P < 0.05) and the weighted detection rate was 36.0%,42.0%,64.5%and 68.3 % respectively.For men,the detection rate was 44.2% (877/1985),51.1% (97/190),70.6%(657/930),71.3% (82/1 15) (x2 =194.02,P < 0.05) and the weighted detection rate was 31.2%,36.1%,49.8% and 50.3% respectively.For women,the detection rate was 20.1% (309/1539),30.1%(50/166),50.3% (190/378),63.8% (37/58) (x2 =180.17,P < 0.05) and the weighted detection rate was 30.9%,46.3%,70.3%,and 88.1% respectively.After adjusted for other risk factors,the OR (95 % CI) value was 1.37 (1.05-1.78),2.05 (1.74-2.43) and 2.12 (1.45-3.12) for normal SBP and high LDL-C group,elevated SBP and normal LDL-C group and elevated SBP and high LDL-C group respectively compared

  6. 颈动脉粥样硬化斑块与血浆纤维蛋白原的关系%Relationship between Carotid Atherosclerotic Plaque and Plasma Fibrinogen

    Institute of Scientific and Technical Information of China (English)

    戴志刚; 王涛; 武文元

    2011-01-01

    [ Objective ] To study the relationship between carotid atherosclerosis and plasma fibrinogen. [ Methods] Color Doppler was carried out on carotid artery of 65 carotid atherosclerotic patients, recording position, echo intensity of artherosclerotic plaque,carotid artery intima-media thickness and vessel inside diameter. According to carotid artery stenosis, the patients were divided into 4 groups, and were re-divided into 2 groups ( hard plaque and soft plaque ) on the basis of character of atherosclerotic plaque, meanwhile, detecting the level of plasma fibrinogen, and performing statistical analysis. [ Results ] With the increasing level of plasma fibrinogen , the degree of carotid atherosclerotic stenosis was increased, showing positive correlation; the rate of plasma fibrinogen soft plaque of middle and high density groups is obviously higher than the lower density group. [ Conclusion ] Plasma fibrinogen level is closely correlated with characteristic of carotid atherosclerotic plaque. Plasma fibrinogen may determine the stability of carotid atherosclerotic plaque. And the increasing level of plasma fibrinogen is closely related with carotid atherosclerosis and plays an important role in its development.%目的 探讨患者颈动脉粥样硬化程度以及颈动脉粥样硬化性质与血浆纤维蛋白原的关系.方法 对存在颈动脉粥样硬化的65例患者进行颈动脉彩色多普勒检查,记录颈动脉粥样硬化斑块的部位、回声强度、颈总动脉分叉处内膜中层厚度及血管内径,并根据颈动脉狭窄程度分为4组,再根据超声检查动脉硬化斑块性质分为硬斑和软斑2组,同时检测血浆纤维蛋白原水平,进行统计学分析.结果 随着血浆纤维蛋白原水平的升高,动脉粥样硬化狭窄程度也随之增加,且呈正相关;中、高浓度纤维蛋白原组软斑发生率明显多于低浓度组.结论 血浆纤维蛋白原水平与颈动脉粥样硬化斑块的性质有关,血浆纤维蛋

  7. Morphological and Stress Vulnerability Indices for Human Coronary Plaques and Their Correlations with Cap Thickness and Lipid Percent: An IVUS-Based Fluid-Structure Interaction Multi-patient Study.

    Directory of Open Access Journals (Sweden)

    Liang Wang

    2015-12-01

    Full Text Available Plaque vulnerability, defined as the likelihood that a plaque would rupture, is difficult to quantify due to lack of in vivo plaque rupture data. Morphological and stress-based plaque vulnerability indices were introduced as alternatives to obtain quantitative vulnerability assessment. Correlations between these indices and key plaque features were investigated. In vivo intravascular ultrasound (IVUS data were acquired from 14 patients and IVUS-based 3D fluid-structure interaction (FSI coronary plaque models with cyclic bending were constructed to obtain plaque wall stress/strain and flow shear stress for analysis. For the 617 slices from the 14 patients, lipid percentage, min cap thickness, critical plaque wall stress (CPWS, strain (CPWSn and flow shear stress (CFSS were recorded, and cap index, lipid index and morphological index were assigned to each slice using methods consistent with American Heart Association (AHA plaque classification schemes. A stress index was introduced based on CPWS. Linear Mixed-Effects (LME models were used to analyze the correlations between the mechanical and morphological indices and key morphological factors associated with plaque rupture. Our results indicated that for all 617 slices, CPWS correlated with min cap thickness, cap index, morphological index with r = -0.6414, 0.7852, and 0.7411 respectively (p<0.0001. The correlation between CPWS and lipid percentage, lipid index were weaker (r = 0.2445, r = 0.2338, p<0.0001. Stress index correlated with cap index, lipid index, morphological index positively with r = 0.8185, 0.3067, and 0.7715, respectively, all with p<0.0001. For all 617 slices, the stress index has 66.77% agreement with morphological index. Morphological and stress indices may serve as quantitative plaque vulnerability assessment supported by their strong correlations with morphological features associated with plaque rupture. Differences between the two indices may lead to better plaque

  8. Preliminary experience with MRA in evaluating the degree of carotid stenosis and plaque morphology using high-resolution sequences after gadofosveset trisodium (Vasovist) administration: comparison with CTA and DSA.

    Science.gov (United States)

    Anzidei, M; Napoli, A; Geiger, D; Cavallo Marincola, B; Zini, C; Zaccagna, F; Di Paolo, P; Catalano, C; Passariello, R

    2010-06-01

    The authors performed a preliminary study with blood-pool contrast-enhanced magnetic resonance angiography (MRA) in evaluating the degree of carotid artery stenosis and plaque morphology, comparing the diagnostic performance of first-pass (FP) and steady-state (SS) acquisitions with 64-slice computed tomography angiography (CTA) and using digital subtraction angiography (DSA) as the reference standard. Twenty patients with >or=50% carotid artery stenosis at Doppler sonography underwent blood-pool contrast-enhanced MRA, CTA and DSA. Two independent radiologists evaluated MRA and CTA examinations to assess the degree of stenosis and characterise plaque morphology. Accuracy, sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) were calculated for FP, SS and CTA. The McNemar and Wilcoxon tests were used to determine significant differences (p0.05). Blood-pool contrast-enhanced MRA with SS sequences allow improved diagnostic evaluation of the degree of carotid stenosis and plaque morphology compared with FP and is substantially equal to CTA and DSA.

  9. Toward the detection of intraplaque hemorrhage in carotid artery lesions using photoacoustic imaging

    Science.gov (United States)

    Arabul, Mustafa Umit; Heres, Maarten; Rutten, Marcel C. M.; van Sambeek, Marc R.; van de Vosse, Frans N.; Lopata, Richard G. P.

    2017-04-01

    Photoacoustic imaging (PAI) may have the ability to reveal the composition and the anatomical structure of carotid plaques, which determines its mechanical properties and vulnerability. We used PAI and plane wave ultrasound (PUS) imaging to obtain three-dimensional (3-D) images of endarterectomy samples ex vivo and compared the results with histology to investigate the potential of PAI-based identification of intraplaque hemorrhage. Seven carotid plaque samples were obtained from patients undergoing carotid endarterectomy and imaged with a fully integrated hand-held photoacoustic (PA) probe, consisting of a pulsed diode laser (tpulse=130 ns, Epulse=1 mJ, λ=808 nm) and a linear array transducer (fc=7.5 MHz). The samples were rotated 360 deg with 10 deg steps, and data were spatially compounded to obtain complete 3-D images of the plaques. Areas of high absorption in the 3-D datasets were identified and compared to histological data of the plaques. Data in six out of seven endarterectomy samples revealed the presence of intraplaque hemorrhages that were not visible in the PUS images. Due to the noninvasive nature of PAI, this ex vivo study may elucidate preclinical studies toward the in vivo, noninvasive, vulnerability assessment of the atherosclerotic carotid plaque.

  10. Cystatin C is Associated With Plaque Phenotype and Plaque Burden

    Directory of Open Access Journals (Sweden)

    Yufeng Wen

    2016-03-01

    Full Text Available Background/Aims: The relationship between carotid artery plaque burden, phenotype and serum cystatin C at normal and impaired renal function is still unclear. Methods: Demographic characteristics, carotid ultrasonography and other relevant information of 1,477 patients were collected. The association of carotid artery plaque burden, plaque phenotype with serum cystatin C was evaluated by strategy analysis based on renal function. Results: Serum cystatin C (OR=2.05, 95% CI: 1.83-2.29, POR=1.60, 95%CI: 1.43-1.78, POR=1.21, 95%CI: 1.10-1.32, P Conclusion: In normal renal function, serum cystatin C may confer stability of plaques. In mildly impaired renal function, serum cystatin C is a risk predictor of plaques. In normal renal function circumstances, serum cystatin C may benefit to the stability of plaques. In mild impaired renal function circumstances, serum cystatin C are a risk predictors of plaques.

  11. MRI-measured regression of carotid atherosclerosis induced by statins with and without niacin in a randomised controlled trial: the NIA plaque study.

    Science.gov (United States)

    Sibley, Christopher T; Vavere, Andrea L; Gottlieb, Ilan; Cox, Christopher; Matheson, Matthew; Spooner, Amy; Godoy, Gustavo; Fernandes, Veronica; Wasserman, Bruce A; Bluemke, David A; Lima, Joao A C

    2013-11-01

    To evaluate the benefit of niacin in addition to statin therapy on plaque regression among older individuals with established atherosclerosis. Randomised, controlled, double-blind clinical trial. University outpatient center. 145 patients older than 65 years, half of them older than 75 years of age, with established atherosclerosis were enrolled. Participants received either extended release niacin (1500 mg daily) or placebo in addition to statin therapy to reach their National Cholesterol Education Program-defined low density lipoprotein (LDL) cholesterol target. The primary endpoint was reduction in the wall volume of the internal carotid artery (ICA) measured by MRI. After 18 months, high density lipoprotein cholesterol was higher with statins plus niacin compared with statins alone (1.6 ± 0.4 vs 1.4 ± 0.4 mmol/L p<0.001). Both groups had significant decreases in the main outcome measure of ICA wall volume, which regressed at 0.5%/month (SEM 0.2, p=0.004) in the statins plus placebo group and at 0.7%/month in the statins plus niacin group (SEM 0.2, p<0.001). There was no difference in the rate of regression between groups (p=0.49). Treatment with statin therapy to presently recommended LDL levels, with or without niacin, resulted in significant atherosclerosis reduction.

  12. Noninvasive two-dimensional strain imaging of arteries: validation in phantoms and preliminary experience in carotid arteries in vivo.

    NARCIS (Netherlands)

    Ribbers, H.; Lopata, R.G.P.; Holewijn, S.; Pasterkamp, G.; Blankensteijn, J.D.; Korte, C.L. de

    2007-01-01

    Cardiac disease and stroke are the major causes of death in the Western World. Atherosclerosis of the carotid artery is the most important predictor of stroke. Elastography is a technique to assess the composition and vulnerability of an atherosclerotic plaque. Contrary to intravascular

  13. CTA analysis of the correlation between the carotid bifurcation angle and the thickness of the internal carotid atherosclerotic plaque%颈动脉分叉角与颈内动脉粥样硬化斑块厚度相关性的 CTA 分析

    Institute of Scientific and Technical Information of China (English)

    周仕恩; 邱传亚; 何汇忱; 许钧杰

    2015-01-01

    Objective To evaluate the correlation between the carotid bifurcation angle and the thickness of the internal carotid atherosclerotic plaque on multi-slice spiral CT angiography (MSCTA).Methods MSCTA images of ninety-nine subjects from 2012 to 2013 were collected and analyzed retrospectively,in which images were processed and analysed with the GE AW4.4 workstation. The common carotid bifurcation angle (CCBA),the internal carotid bifurcation angle (ICBA),the thickness of plaque at the initial region of the internal carotid artery(ICA),and the average diameter of the internal carotid opening were determined.Thickness of atherosclerosis plaque at bilateral carotid bifurcations was grouped based on the CCBA,ICBA and normalized ICBA indexes.The paired T-test (normal distribution)or Wilcoxon sign-ranked test (non-normal distribution)were performed with SPSS version 1 6.0. Association between the CBA and the plaque thickness at the initial region of the ICA were analysed with partial correlation.Statisti-cal significance was set at P 0.05)。偏相关分析示:颈总动脉分叉角分组中,颈总动脉分叉角与颈内动脉斑块厚度间相关系数 r 值为-0.020(P =0.849);颈内动脉分叉角分组中,颈内动脉分叉角与颈内动脉斑块厚度间相关系数 r 值为0.018(P =0.864);颈内动脉分叉角标准化指数分组中,颈内动脉分叉角标准化指数与颈内动脉斑块厚度间相关系数 r 值为0.005(P =0.962)。结论双侧颈动脉分叉角变化不会导致双侧颈内动脉起始部斑块厚度的差异。

  14. 缺血性脑卒中患者纤维蛋白原和颈动脉斑块的关系%Association between fibrinogen and carotid atheromatous plaque in patients with ischemic stroke

    Institute of Scientific and Technical Information of China (English)

    陈伟; 程洁; 王根发; 陈兴华

    2006-01-01

    背景:纤维蛋白原升高是心脑及周围血管病的独立危险因素,纤维蛋白原及其降解产物大量存在于动脉粥样斑块中,刺激平滑肌细胞增生和迁移而在动脉硬化早期就发挥作用.目的:分析血浆纤维蛋白原水平和颈动脉粥样硬化斑块的关系.设计:描述性观察.单位:上海交通大学医学院附属新华医院神经内科对象:为2001-09/12在上海交通大学医学院附属新华医院神经内科的81例缺血性脑卒中患者,男53例,女28例;年龄41~85岁,平均年龄(65±11)岁.方法:通过颈动脉超声检查,将81例缺血性卒中患者分成颈动脉有斑块组和无斑块组,检查两组患者的血浆纤维蛋白原水平、血清总胆固醇、低密度脂蛋白胆固醇及其他动脉粥样硬化的危险因素.观察各危险因素指标与颈动脉斑块的关系.主要观察指标:颈动脉硬化的各项危险因素指标,颈动脉斑块.结果:81例缺血性脑卒中患者全部进入结果分析.①颈动脉有斑块组(45例)纤维蛋白原、总胆固醇、低密度脂蛋白胆固醇分别为:(4.38±1.33)g/L;(5.19±1.27)mmol/L;(3.15±0.73)mmol/L,高于无斑块组(36例)(3.20±1.30)g/L;(4.56±1.30)mmol/L;(2.49±0.92)mmol/L,P<0.05).②颈动脉斑块在纤维蛋白原低、中、高三组中的比例分别为11%(5例)、16%(7例)、73%(33例),差异有显著性意义(P=0.02).③颈动脉硬化的多因素分析表明,糖尿病、低密度脂蛋白、纤维蛋白原和年龄水平增高是颈动脉粥样斑块形成的危险因素.结论:纤维蛋白原在动脉粥样硬化斑块发生发展过程中起重要作用.%BACKGROUND: Increase of fibrinogen is an independent risk factor for cardio-cerebrovascular disease and peripheral angiopathy. Fibrinogen and its degradation product exist in carotid atheromatous plaque and it can stimulate proliferation and migration of smooth muscle cells so as to play a key role in early atherosclerosis.OBJECTIVE: To analyze the

  15. Detection of vulnerable atherosclerotic plaque and prediction of thrombosis events in a rabbit model using 18F-FDG -PET/CT.

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    Quan-ming Zhao

    Full Text Available BACKGROUND: Detection of vulnerable plaques could be clinically significant in the prevention of cardiovascular events. We aimed to compare Fluorine-18 fluorodeoxyglucose ((18F-FDG uptake in vulnerable and stable plaques, and investigate the feasibility of predicting thrombosis events using Positron Emission Tomography/Computed Tomography (PET/CT angiography. METHODS: Atherosclerosis was induced in 23 male New Zealand white rabbits. The rabbits underwent pharmacological triggering to induce thrombosis. A pre-triggered PET/CTA scan and a post-triggered PET/CTA scan were respectively performed. (18F-FDG uptake by the aorta was expressed as maximal standardized uptake value (SUVmax and mean SUV (SUVmean. SUVs were measured on serial 7.5 mm arterial segments. RESULTS: Thrombosis was identified in 15 of 23 rabbits. The pre-triggered SUVmean and SUVmax were 0.768 ± 0.111 and 0.804 ± 0.120, respectively, in the arterial segments with stable plaque, and 1.097 ± 0.189 and 1.229 ± 0.290, respectively, in the arterial segments with vulnerable plaque (P<0.001, respectively. The post-triggered SUVmean and SUVmax were 0.849 ± 0.167 and 0.906 ± 0.191, respectively in the arterial segments without thrombosis, and 1.152 ± 0.258 and 1.294 ± 0.313, respectively in the arterial segments with thrombosis (P<0.001, respectively. The values of SUVmean in the pre-triggered arterial segments were used to plot a receiver operating characteristic curve (ROC for predicting thrombosis events. Area under the curve (AUC was 0.898. Maximal sensitivity and specificity (75.4% and 88.5%, respectively were obtained when SUVmean was 0.882. CONCLUSIONS: Vulnerable and stable plaques can be distinguished by quantitative analysis of (18F-FDG uptake in the arterial segments in this rabbit model. PET/CT may be used for predicting thrombosis events and risk-stratification in patients with atherosclerotic disease.

  16. Influence of shear stress magnitude and direction on atherosclerotic plaque composition.

    Science.gov (United States)

    Pedrigi, Ryan M; Mehta, Vikram V; Bovens, Sandra M; Mohri, Zahra; Poulsen, Christian Bo; Gsell, Willy; Tremoleda, Jordi L; Towhidi, Leila; de Silva, Ranil; Petretto, Enrico; Krams, Rob

    2016-10-01

    The precise flow characteristics that promote different atherosclerotic plaque types remain unclear. We previously developed a blood flow-modifying cuff for ApoE(-/-) mice that induces the development of advanced plaques with vulnerable and stable features upstream and downstream of the cuff, respectively. Herein, we sought to test the hypothesis that changes in flow magnitude promote formation of the upstream (vulnerable) plaque, whereas altered flow direction is important for development of the downstream (stable) plaque. We instrumented ApoE(-/-) mice (n = 7) with a cuff around the left carotid artery and imaged them with micro-CT (39.6 µm resolution) eight to nine weeks after cuff placement. Computational fluid dynamics was then performed to compute six metrics that describe different aspects of atherogenic flow in terms of wall shear stress magnitude and/or direction. In a subset of four imaged animals, we performed histology to confirm the presence of advanced plaques and measure plaque length in each segment. Relative to the control artery, the region upstream of the cuff exhibited changes in shear stress magnitude only (p < 0.05), whereas the region downstream of the cuff exhibited changes in shear stress magnitude and direction (p < 0.05). These data suggest that shear stress magnitude contributes to the formation of advanced plaques with a vulnerable phenotype, whereas variations in both magnitude and direction promote the formation of plaques with stable features.

  17. Flow patterns at the stenosed carotid bifurcation: effect of concentric versus eccentric stenosis.

    Science.gov (United States)

    Steinman, D A; Poepping, T L; Tambasco, M; Rankin, R N; Holdsworth, D W

    2000-04-01

    Carotid stenosis severity is a commonly used indicator for assessing risk of stroke. However, the majority of individuals with severe carotid artery disease never suffer a stroke, and strokes can occur even with only mild or moderate stenosis. This suggests local factors (other than stenosis severity) at or near the carotid artery bifurcation may be important in determining stroke risk. In this paper we investigate the effect of stenosis geometry on flow patterns in the stenosed carotid bifurcation, using concentrically and eccentrically stenosed anthropomorphic carotid bifurcation models having identical stenosis severity. Computational simulations and experimental flow visualizations both demonstrate marked differences in flow patterns of concentric and eccentric stenosis models for moderately and severely stenosed cases, respectively. In particular, we identify post-stenotic recirculation zone size and location, and spatial extent of elevated wall shear stress as key factors differing between the two geometries. As these are also rotid plaque more vulnerable to cerebral embolus prokey biophysical factors promoting thrombogenesis, we propose that the stenosed carotid bifurcation geometry--or the induced flow patterns themselves--may provide more specific indicators for those plaques that are vulnerable to enhanced thromboembolic potential, and hence, increased risk of ischemic stroke.

  18. 双能量CT血管造影在颈动脉狭窄和斑块中的诊断价值%The clinical application value of dual energy CTA in the diagnosis of carotid artery stenosis and plaque

    Institute of Scientific and Technical Information of China (English)

    王超; 王青; 刘鑫; 徐锐

    2015-01-01

    目的:探讨双能量X线计算机体层摄影术( CT)血管造影( CTA)在颈动脉狭窄和斑块中的诊断价值。方法应用双源CT双能量CTA检查80例缺血性脑梗死患者的颈动脉,分析双能量CTA自动减影去骨技术对颈动脉的显示情况,并评价图像质量。分析80例患者颈动脉粥样硬化斑块的分布、类型,并对不同类型的斑块在颈动脉各段分布情况进行比较,其中有30例患者在2周内选择了血管造影(DSA)检查,并与双能量CTA检查结果进行比较。应用SPSS 17.0统计学软件进行统计分析,双能量自动去骨后颈动脉各段血管满意率用百分比表示,去骨后图像质量评分和血管狭窄程度与DSA结果对照用段数表示,不同类型的斑块在颈动脉各段的分布以斑块数表示,行R×C表χ2检验。结果80例患者经颈动脉双能量自动减影去骨后,显示颈动脉血管总体满意率为86.0%,其中颈内动脉颅外段(ICA⁃E)血管满意率最高(96.3%)。30例阳性患者颈动脉双能量自动去骨后与DSA对照,狭窄吻合率基本一致,中度以上狭窄吻合率超过90.0%。72例检出斑块,其中颈内动脉起始部斑块检出率最高;软斑块多位于颈总动脉段(63/115),硬斑块多位于颈内动脉颅内段(81/132),混合斑块多分布在ICA⁃E段(54/85),不同类型的斑块在颈动脉各段分布情况差异有统计学意义(χ2=12.17, P<0.05)。结论双源CT双能量颈动脉成像是一种简便、快速、无创性检查方法,通过分析颈动脉斑块及狭窄程度为脑血管事件的防治提供了较高的参考依据。%Objective To explore the clinical application value of dual energy computed tomography angiography ( CTA) in the diagnosis of carotid artery stenosis and plaque. Methods Application of dual energy CT carotid angiography with automatic bone removal technology in eighty

  19. An analysis on the Risk Factors of Carotid Artery Atherosclerotic Plaques in Cerebral Infarction Patients%脑梗死患者颈动脉粥样硬化斑块的相关因素分析

    Institute of Scientific and Technical Information of China (English)

    王本孝; 许平

    2011-01-01

    Objective:To explore the risk factors for carotid artery atherosclerotic plaques in cerebral infarction patients. Methods: Color doppler ultrasound scanner was used to detect the plaques of the carotid arteries in patients with cerebral infarction (n=126) and normal controls (n=61). According to the doppler ultrasound scanning, the patients were divided into plaque (+) group (n=102) and plaque(—) group (n=24). The patients in the plaque(+) group were further divided into stable plaque (n=35) and unstable plaque subgroups (n=67). The physical data and the concentration of total cholesterol(TC), triglycerides (TG), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), apolipoprotein A (ApoA),apolipoprotein B (ApoB), lipoprotein-a (Lp(a)), fibrinogen (FIB) and blood glucose (BG) were measured, and compared between the groups. Results: Carotid atherosclerotic artery plaques were detected in 80.9% of the patients, which was significantly higher than that in the normal controls (P<0.01). When compared with those in plaque(—) group, those patients were much older. Smoking, hypertension, diabetes, higher concentrations of TC, Lp(a), ApoB, FIB, LDLC, and BG were more frequently found in the plaque(+) group. The FIB concentrations of patients in the unstable plaque subgroup was much higher that in the stable plaque subgroup (P<0.05). Conclusion: Carotid atherosclerotic plaques were the risk factor for cerebral infarction.Old age, smoking, hypertention, diabetes mellitus, lipoidosis, and high fibrinogen are the risk factors for carotid atherosclerotic plaques. High concentration of fibrinogen affects stability of the plaques.%目的:探讨脑梗死患者颈动脉粥样硬化斑块形成及其稳定性的相关影响因素.方法:应用彩色多普勒超声检测脑梗死患者126例及正常对照者61例颈动脉斑块形成情况;根据超声检查结果将126例脑梗死患者分为有斑块组102

  20. Intraplaque hemorrhage is associated with higher structural stresses in human atherosclerotic plaques: an in vivo MRI-based 3d fluid-structure interaction study

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    Canton Gador

    2010-12-01

    Full Text Available Abstract Background Studies using medical images have shown that intraplaque hemorrhage may accelerate plaque progression and may produce a stimulus for atherosclerosis development by increasing lipid core and plaque volume and creating new destabilizing factors. Image-based 3D computational models with fluid-structure interactions (FSI will be used to perform plaque mechanical analysis and investigate possible associations between intraplaque hemorrhage and both plaque wall stress (PWS and flow shear stress (FSS. Methods In vivo MRI data of carotid plaques from 5 patients with intraplaque hemorrhage confirmed by histology were acquired. 3D multi-component FSI models were constructed for each plaque to obtain mechanical stresses. Plaque Wall Stress (PWS and Flow Shear Stress (FSS were extracted from all nodal points on the lumen surface of each plaque for analysis. Results The mean PWS value from all hemorrhage nodes of the 5 plaques combined was higher than that from non-hemorrhage nodes (75.6 versus 68.1 kPa, P = 0.0003. The mean PWS values from hemorrhage nodes for each of the 5 plaques were all significantly higher (5 out of 5 than those from non-hemorrhage nodes (P 2, P = 0.0002. However, the mean flow shear stress values from individual cases showed mixed results: only one out of five plaques showed mean FSS value from hemorrhage nodes was higher than that from non-hemorrhage nodes; three out of five plaques showed that their mean FSS values from hemorrhage nodes were lower than those from non-hemorrhage nodes; and one plaque showed that the difference had no statistical significance. Conclusion The results of this study suggested that intraplaque hemorrhage nodes were associated with higher plaque wall stresses. Compared to flow shear stress, plaque wall stress has a better correlation with plaque component feature (hemorrhage linked to plaque progression and vulnerability. With further validation, plaque stress analysis may provide

  1. The stability of the atherosclerotic plaque depends on the extent of injured endothelium: results from a novel model of ischemia /reperfusion induced atherosclerosis in carotid artery of rats

    Institute of Scientific and Technical Information of China (English)

    晋学庆

    2014-01-01

    Objective To observe the atherogenic lesion progress in a novel ischemia/reperfusion induced atherosclerosis model in the carotid artery of rats.Methods Rats were divided into normal control,sham-operated control and ischemia-reperfusion injury(IRI)groups(n=10each).IRI was induced by 30 min carotid artery occlusion with a 2 cm

  2. Data on the lipoprotein (a, coronary atherosclerotic burden and vulnerable plaque phenotype in angiographic obstructive coronary artery disease

    Directory of Open Access Journals (Sweden)

    Giampaolo Niccoli

    2016-06-01

    Full Text Available Lipoprotein Lp(a represents an independent risk factor for coronary artery disease (CAD. However, its association with CAD burden and lipid rich plaques prone to rupture in patients with acute coronary syndrome (ACS still remains unknown. These data aim to investigate the association among serum Lipoprotein(a (Lpa levels, coronary atherosclerotic burden and features of culprit plaque in patients with ACS and obstructive CAD. For his reason, a total of 500 ACS patients were enrolled for the angiographic cohort and 51 ACS patients were enrolled for the optical coherence tomography (OCT cohort. Angiographic CAD severity was assessed by Sullivan score and by Bogaty score including stenosis score and extent index, whereas OCT plaque features were evaluated at the site of the minimal lumen area and along the culprit segment. In the angiographic cohort, Lp(a was a weak independent predictor of Sullivan score (p30 md/dl compared to patients with lower Lp(a levels (<30 md/dl exhibited a higher prevalence of lipidic plaque at the site of the culprit stenosis (P=0.02, a wider lipid arc (p=0.003 and a higher prevalence of thin-cap fibroatheroma (p=0.004

  3. Data on the lipoprotein (a), coronary atherosclerotic burden and vulnerable plaque phenotype in angiographic obstructive coronary artery disease.

    Science.gov (United States)

    Niccoli, Giampaolo; Chin, Diana; Scalone, Giancarla; Panebianco, Mario; Abbolito, Sofia; Cosentino, Nicola; Jacoangeli, Francesca; Refaat, Hesham; Gallo, Giovanna; Salerno, Gerardo; Volpe, Massimo; Crea, Filippo; De Biase, Luciano

    2016-06-01

    Lipoprotein Lp(a) represents an independent risk factor for coronary artery disease (CAD). However, its association with CAD burden and lipid rich plaques prone to rupture in patients with acute coronary syndrome (ACS) still remains unknown. These data aim to investigate the association among serum Lipoprotein(a) (Lpa) levels, coronary atherosclerotic burden and features of culprit plaque in patients with ACS and obstructive CAD. For his reason, a total of 500 ACS patients were enrolled for the angiographic cohort and 51 ACS patients were enrolled for the optical coherence tomography (OCT) cohort. Angiographic CAD severity was assessed by Sullivan score and by Bogaty score including stenosis score and extent index, whereas OCT plaque features were evaluated at the site of the minimal lumen area and along the culprit segment. In the angiographic cohort, Lp(a) was a weak independent predictor of Sullivan score (p30 md/dl) compared to patients with lower Lp(a) levels (<30 md/dl) exhibited a higher prevalence of lipidic plaque at the site of the culprit stenosis (P=0.02), a wider lipid arc (p=0.003) and a higher prevalence of thin-cap fibroatheroma (p=0.004).

  4. 基于卷积神经网络的颈动脉斑块超声图像特征识别%Recognition of Carotid Plaque in Ultrasonic Images Based on Deep Convolutional Neural Network

    Institute of Scientific and Technical Information of China (English)

    孙夏; 吴蔚; 吴鹏; 丁明跃

    2016-01-01

    从卷积神经网络层数、卷积核大小、特征维数等方面分析对识别效果的影响,优化网络参数,构建一个适用于颈动脉斑块识别的卷积神经网络。研究表明,卷积神经网络是可行的,对颈动脉斑块有较好的识别效果,且优于SVM方法。%analyze the inlfuence to the detection accuracy of the number of layer, the size of convolution kernel and the dimension of features, which provides a reference to optimize the related parameter, to make a deep convolutional neural network referring to ultrasonic images of carotid plaque. The experiment results show the method is a workable way to recognize carotid plaque and perform a higher accuracy compared with the SVM method.

  5. Chlamydia pneumoniae and symptomatic carotid atherosclerotic plaque: a prospective study Chlamydia pneumoniae e placa aterosclerótica sintomática de carótida: um estudo prospectivo

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    Rubens J. Gagliardi

    2007-06-01

    Full Text Available OBJECTIVE: To investigate the possible link between symptomatic carotid atherosclerotic plaque and Chlamydia pneumoniae. BACKGROUND: Recently, several studies have demonstrated that there may be a possible link between Chlamydia pneumonia and carotid atherosclerosis, however the real role of Chlamydia pneumoniae is not completely understood. METHOD: This is a prospective study with a total of 52 patients analyzed. All patients had been submitted to endarterectomy, and had suffered thrombotic ischemic stroke or transient ischemic attack up to 60 days prior to the surgery. Every patient presented carotid stenosis over 70%. The plaque was removed during the surgery and the laboratory exams were immediately done. Evaluation of Chlamydia pneumoniae DNA was done using polymerase chain reaction (PCR. RESULTS: The PCR analyses of all 52 patients were negative for Chlamydia pneumoniae. CONCLUSION: These initial results do not show a relationship between Chlamydia pneumoniae and symptomatic carotid atherosclerotic plaque.OBJETIVO: Investigar a possível relação entre placa sintomática de carótidas e Chlamydia pneumoniae. INTRODUÇÃO: Vários estudos têm demonstrado uma possível relação entre Chlamydia pneumonia e aterosclerose carotídea, entretanto o papel definitivo da bactéria não é totalmente conhecido. Há muita especulação: poderia iniciar o processo aterosclerótico, agravá-lo ou desestabilizá-lo. MÉTODO: Estudo prospectivo com um total de 52 pacientes, endarterectomizados e previamente acometidos de acidente vascular cerebral isquêmico ou crise isquêmica transitória, em até 60 dias antes da cirurgia. Todos os pacientes apresentavam estenose carotídea superior a 70%. Os testes laboratoriais foram realizados imediatamente após a endarterectomia. A Chlamydia pneumoniae foi pesquisada através de exame de DNA com reação de polimerização em cadeia (PCR. RESULTADOS: O PCR dos 52 pacientes foram negativos para Chlamydia

  6. A study of plaque vascularization and inflammation using quantitative contrast-enhanced US and PET/CT

    Energy Technology Data Exchange (ETDEWEB)

    Hjelmgren, Ola, E-mail: ola.hjelmgren@wlab.gu.se [Institute of Medicine, Sahlgrenska Academy at the University of Gothenburg, Department of Molecular and Clinical Medicine, Clinical Physiology, Gothenburg (Sweden); Sahlgrenska University Hospital, Department of Clinical Physiology, Gothenburg (Sweden); Johansson, Lars, E-mail: lars.johansson@radiol.uu.se [Uppsala University, Department of Radiology, Uppsala (Sweden); Prahl, Ulrica, E-mail: ulrica-prahl-gullberg@wlab.gu.se [Institute of Medicine, Sahlgrenska Academy at the University of Gothenburg, Department of Molecular and Clinical Medicine, Clinical Physiology, Gothenburg (Sweden); Schmidt, Caroline, E-mail: caroline.schmidt@wlab.gu.se [Institute of Medicine, Sahlgrenska Academy at the University of Gothenburg, Department of Molecular and Clinical Medicine, Clinical Physiology, Gothenburg (Sweden); Fredén-Lindqvist, Johan, E-mail: johan.freden-lindqvist@vgregion.se [Sahlgrenska University Hospital, Department of Clinical Physiology, Gothenburg (Sweden); Bergström, Göran M.L., E-mail: goran.bergstrom@hjl.gu.se [Institute of Medicine, Sahlgrenska Academy at the University of Gothenburg, Department of Molecular and Clinical Medicine, Clinical Physiology, Gothenburg (Sweden); Sahlgrenska University Hospital, Department of Clinical Physiology, Gothenburg (Sweden)

    2014-07-15

    Background: Contrast-enhanced ultrasound (CEUS) is an in vivo methodology to quantify carotid plaque vascularization. Increased metabolism in plaques, measured as FDG uptake in PET/CT examination, has been associated with markers of inflammation in histological samples. In this study, we tested the association between FDG uptake and vascularization measured by CEUS to assess whether CEUS can be used as an in vivo marker of plaque vulnerability. Methods: After informed consent, subjects aged >60 years with carotid plaque height exceeding 2.5 mm were recruited. CEUS was performed and analyzed using earlier described protocol and software, Contrast Quantification Program, which calculates the fraction of the plaque being contrast positive (CQP value). PET/CT examination was performed within 3 months of CEUS (median time 7 days). PET/CT images were acquired 90 min after FDG injection (2.7 MBq/kg). FDG uptake was measured as tissue background index (TBI), calculated using Spearman's rho as mean standard uptake value (SUV) of the plaque divided by mean SUV in the jugular vein (mean of 7 measuring points). Local ethics committee approved the study. Results: We recruited 13 subjects (5 women) with a mean age of 71 years, 6 had a history of stroke or TIA, 1 had a history of ipsilateral stroke. CQP values showed a significant, positive correlation with TBI of carotid plaques, r = 0.67, p < 0.02. Conclusions: Plaque vascularization measured by CEUS correlates positively with FDG uptake measured by PET/CT in humans. This indicates an association between vascularization and inflammation and/or hypoxia, supporting the use of CEUS as a non-invasive method to detect plaque vulnerability.

  7. The Study on the Factors of the Formation of Carotid Atherosclerotic Plaque%颈动脉粥样硬化斑块形成的相关因素分析

    Institute of Scientific and Technical Information of China (English)

    邓珊; 佘军红; 翁保慧; 阳洪

    2011-01-01

    目的 探讨颈动脉斑块形成的主要相关因素,以指导临床进行缺血性脑卒中的预防.方法 选择2010年12月至2011年3月期间在广西医科大学第四附属医院住院的患者61例,检测所有患者血三酰甘油、总胆固醇、低密度脂蛋白、血糖、单核细胞计数、超敏C反应蛋白、肌酐、β2微球蛋白水平;记录患者既往是否有高血压病、糖尿病、吸烟史.采用彩色多普勒超声仪观察颈动脉管壁内膜中层厚度.结果 两组间单因素比较显示斑块组年龄、高血压病发生率、糖代谢异常发生率、超敏C反应蛋白及吸烟水平高于非斑块组;两组间性别、总胆固醇、三酰甘油、低密度脂蛋白、单核细胞计数、肌酐、β2微球蛋白水平比较差异无统计学意义.Logistic回归分析结果显示年龄、收缩压及吸烟进入回归方程,并有统计学意义.结论 在本研究中发现年龄、收缩压及吸烟是颈动脉斑块形成的独立危险因素.%Objective To investigate the major factors of the formation of carotid atherosclerotic plaque so as to prevent cerebral arterial thrombosis. Methods A total of 61 inpatients admitted to Fourth Affiliated Hospital of Guangxi Medical University from December 2010 to March 2011 were included. They were measured the level of some possible risk fators including TG, TC, LDL, blood sugar, monocyte count, supersensitivity C reactive protein, creatinine, (32 microglobulin; the history of past illness including hypertensive disease, diabetes mellitus and smoking were recorded. The diacrisis of the formation of carotid atherosclerotic plaque was done according to the color Doppler to investigate layer thickness of endomembrane along the line feed of arteria carotis communis from lengthways and athwartships. Results The mean age, incidences of hypertension, abnormal glycome-tabolism, supersensitivity C reactive protein and smokings were higher in patients with carotid plaques than in

  8. Lipoprotein (a) is related to coronary atherosclerotic burden and a vulnerable plaque phenotype in angiographically obstructive coronary artery disease.

    Science.gov (United States)

    Niccoli, Giampaolo; Cin, Diana; Scalone, Giancarla; Panebianco, Mario; Abbolito, Sofia; Cosentino, Nicola; Jacoangeli, Francesca; Refaat, Hesham; Gallo, Giovanna; Salerno, Gerardo; Volpe, Massimo; Crea, Filippo; De Biase, Luciano

    2016-03-01

    Lipoprotein Lp(a) has been shown to be an independent risk factor for coronary artery disease (CAD). However, its association with CAD burden in patients with ACS is largely unknown, as well as the association of Lp(a) with lipid rich plaques prone to rupture. We aim at assessing CAD burden by coronary angiography and plaque features including thin cap fibroatheroma (TCFA) by optical coherence tomography (OCT) in consecutive patients presenting with acute coronary syndrome (ACS) and obstructive CAD along with serum Lp(a) levels. This study comprises an angiographic and an OCT cohort. A total of 500 ACS patients (370 men, average age 66 ± 11) were enrolled for the angiographic cohort and 51 ACS patients (29 males, average age 65 ± 11) were enrolled for the OCT cohort. Angiographic CAD severity was assessed by Sullivan score and by Bogaty score including stenosis score and extent index. OCT plaque features were evaluated at the site of the minimal lumen area and along the culprit segment. In the angiographic cohort, at multivariate analysis, Lp(a) was a weak independent predictor of Sullivan score (p < 0.0001), stenosis score (p < 0.0001) and extent index (p < 0.0001). In the OCT cohort, patients with higher Lp(a) levels (≥ 30 md/dl) compared to patients with lower Lp(a) levels (<30 md/dl) exhibited a higher prevalence of lipidic plaque at the site of the culprit stenosis (67% vs. 27%; P = 0.02), a wider lipid arc (135 ± 114 vs 59 ± 111; P = 0.03) and a higher prevalence of TCFA (38% vs. 10%; P = 0.04). Among patients with ACS, raised Lp(a) levels are associated with an increased atherosclerotic burden and it identifies a subset of patients with features of high risk coronary atherosclerosis. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  9. The effects of the mediterranean diet on biomarkers of vascular wall inflammation and plaque vulnerability in subjects with high risk for cardiovascular disease. A randomized trial.

    Directory of Open Access Journals (Sweden)

    Rosa Casas

    Full Text Available BACKGROUND: Adherence to the Mediterranean diet (MD is associated with reduced morbidity and mortality due to cardiovascular disease. However, how the MD exerts its effects is not fully known. AIM: To assess the 12-month effects of two enhanced MDs compared to a low-fat diet on inflammatory biomarkers related to atherosclerosis and plaque vulnerability in a subcohort of the PREDIMED (Prevención con Dieta Mediterránea study. METHODS: A total of 164 participants at high risk for cardiovascular disease were randomized into three diet groups: MD supplemented with 50mL/d of extra virgin olive oil (MD+EVOO or 30 g/d of nuts (MD+Nuts and a low-fat diet. Changes in classical cardiovascular risk factors, inflammatory biomarkers of atherosclerosis and plaque vulnerability were measured after 12 months of intervention. RESULTS: Compared to participants in the low-fat diet group, those receiving MD+EVOO and MD+Nuts showed a higher decrease in systolic (6mmHg and diastolic (3mmHg blood pressure (P = 0.02; both, as well as a reduction of 10% and 8% in LDL-cholesterol (P = 0.04, respectively. Patients in the MD+Nuts group showed a significant reduction of 34% in CD40 expression on monocyte surface compared to low-fat diet patients (P = 0.03. In addition, inflammatory biomarkers related to plaque instability such as C-reactive protein and interleukin-6 were reduced by 45% and 35% and 95% and 90% in the MD+EVOO and MD+Nuts groups, respectively (P<0.05; all compared to the low-fat diet group. Likewise, sICAM and P-selectin were also reduced by 50% and 27%, respectively in the MD+EVOO group (P = 0.04 and P-selectin by 19% in MD+Nuts group (P = 0.04 compared to the low-fat diet group. CONCLUSIONS: Adherence to the MD is associated with an increase in serum markers of atheroma plaque stability which may explain, at least in part, the protective role of MD against ischemic heart disease. TRIAL REGISTRATION: www.controlled-trials.com ISRCTN

  10. 血脂检测结果比值在颈动脉粥样斑块中的预测价值%Value of serum lipids ratio detection in carotid artery plaque

    Institute of Scientific and Technical Information of China (English)

    石群; 沈卫星; 苏春燕

    2014-01-01

    Objective To investigate the predictive value of serum lipids ratio detection in carotid artery plaque.Methods 2 420 healthy subjects were collected.The main history of subjects was collected and subjects had stroke risk were screened out.Carotid artery plaque were detected by carotid ultrasound,and according to the test re-sults,subjects were divided into the carotid plaque group and the control group .Detection of total cholesterol (TC), triglyceride (TG),high density lipoprotein cholesterol (HDL-C),low density lipoprotein cholesterol (LDL-C)and other biochemical markers were undertaken and analyzed.Results The hypertension ratio,TC,LDL-C,HDL-C,TC/HDL-C,LDL-C/HDL-C in the carotid artery plaque group were significantly different from those of the control group,and the rest test results had no statistic difference.TC/HDL-C and LDL-C/HDL-C were the independent risk factors for populations generated carotid plaque.LDL-C,TC/HDL-C and LDL-C/HDL-C in stroke high-risk popula-tion were significantly higher than those of the control group .Stepwise logistic regression analysis for factors affect-ing the carotid artery plaque showed that TC/HDL-C,LDL-C/HDL-C entered into regression equation in atheroscle-rosis stroke risk population,with OR = 3.754 and 4.325,respectively.Conclusion In the general and high-risk stroke population,TC/HDL-C,and LDL-C/HDL-C are more valuable than the individual detection of clinical lipid in-dicators to predict carotid artery plaque.%目的:探讨血脂检测结果比值在颈动脉粥样斑块中的预测价值。方法选择健康体检的人群共2420例,收集纳入对象的主要病史资料,筛选脑卒中高危人群。颈动脉超声探查颈动脉粥样斑块,并根据检查结果分组(颈动脉粥样斑块组和对照组)。检测总胆固醇(TC)、三酰甘油(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)等生化指标并分析。结果颈动脉粥样斑块组人群高血

  11. Prediction of fibre architecture and adaptation in diseased carotid bifurcations.

    LENUS (Irish Health Repository)

    Creane, Arthur

    2011-12-01

    Many studies have used patient-specific finite element models to estimate the stress environment in atherosclerotic plaques, attempting to correlate the magnitude of stress to plaque vulnerability. In complex geometries, few studies have incorporated the anisotropic material response of arterial tissue. This paper presents a fibre remodelling algorithm to predict the fibre architecture, and thus anisotropic material response in four patient-specific models of the carotid bifurcation. The change in fibre architecture during disease progression and its affect on the stress environment in the plaque were predicted. The mean fibre directions were assumed to lie at an angle between the two positive principal strain directions. The angle and the degree of dispersion were assumed to depend on the ratio of principal strain values. Results were compared with experimental observations and other numerical studies. In non-branching regions of each model, the typical double helix arterial fibre pattern was predicted while at the bifurcation and in regions of plaque burden, more complex fibre architectures were found. The predicted change in fibre architecture in the arterial tissue during plaque progression was found to alter the stress environment in the plaque. This suggests that the specimen-specific anisotropic response of the tissue should be taken into account to accurately predict stresses in the plaque. Since determination of the fibre architecture in vivo is a difficult task, the system presented here provides a useful method of estimating the fibre architecture in complex arterial geometries.

  12. Carotid artery stenosis after neck radiotherapy

    Energy Technology Data Exchange (ETDEWEB)

    Shimamura, Munehisa; Hashimoto, Yoichiro; Kasuya, Junji; Terasaki, Tadashi [Kumamoto City Hospital (Japan); Uchino, Makoto

    2000-02-01

    Carotid artery stenosis sometimes occurs after cervical radiotherapy. We report a 70-year-old woman with a history of radiotherapy for thyroid cancer at the age of 28 years. She had no signs and symptoms except the skin lesion at the irradiation site. Duplex ultrasonography revealed heterogeneous plaques showing 50% stenosis of bilateral common carotid arteries. Those lesions were observed within segment of irradiation, where atheromatous plaque usually seldom occurs. These indicated that the carotid stenosis was induced by radiotherapy. Although the efficacy of antiplatelet therapy for radiation-induced plaque is not clear, the plaques remained unchanged for 4 years in spite of aspirin administration. (author)

  13. 冠状动脉内动脉粥样硬化易损斑块的检测和治疗进展%Advances of evaluation and treatment of atherosclerotic vulnerable plaque within coronary artery

    Institute of Scientific and Technical Information of China (English)

    黄震华

    2011-01-01

    The characteristics of vulnerable plaque are thin fibrous cap, high proportional atherosclerotic core, increased plaque inflammation, and intraplaque hemorrhage. Vulnerable plaques are apt to rupture,causing platelet adhesion, platelet aggregation, and thrombosis. Vulnerable plaque rupture within coronary artery may induce acute coronary events. Intravascular ultrasounds, virtual histology, palpography, optical coherence tomography, intravascular magnetic resonance imaging, angioscopy, and spectroscopy are currently methods for detecting vulnerable plaque. Drugs, regional therapy, and stents are main strategies for treating vulnerable plaque nowadays.%易损斑块的特征是纤维帽薄、动脉粥样硬化斑块核心比例高、斑块炎症明显及伴斑块内出血.易损斑块易发生破裂,引起血小板黏附聚集和血栓形成.冠状动脉内易损斑块破裂可引起急性冠脉事件.血管内超声、虚拟组织学成像、激应图成像、光学相干断层成像、血管内磁共振显像、血管镜、分光镜等是目前检测易损斑块的主要手段.对冠状动脉内易损斑块应积极干预,药物、局部治疗、安放支架等是目前治疗易损斑块的主要方法.

  14. A role for archaeal organisms in development of atherosclerotic vulnerable plaques and myxoid matrices Um papel para organismos de arqueia no desenvolvimento de placas ateroscleróticas vulner��veis e matriz mixomatosa

    OpenAIRE

    2006-01-01

    PURPOSE: Vulnerable plaques are characterized by a myxoid matrix, necrotic lipidic core, reactive oxygen species, and high levels of microorganisms. Aerobic microbes such as Chlamydophila pneumoniae and Mycoplasma pneumoniae usually do not survive in oxidative stress media. Archaea are anaerobic microbes with powerful anti-oxidative enzymes that allow detoxification of free radicals whose presence might favor the survival of aerobic microorganisms. We searched for archaeal organisms in vulner...

  15. 兔颈动脉粥样硬化斑块内MMP-2与新生血管关系的研究%The relationship between MMP-2 and the neovascularization in rabbit carotid atherosclerotic plaque

    Institute of Scientific and Technical Information of China (English)

    樊建华

    2011-01-01

    To detect the relationship between matrix metaloproteinase -2 (MMP -2) and the neova - scularization in rabbit carotid atherosclerotic model plaque, forty of the male New Zealand white rabbits were randomly divided into 4 groups: group A (the blank control group), group B (high-cholesterol diet group), group C (silicone collar intervention and high-cholesterol diet for 14 days group), group D (silicone collar intervention and high -cholesterol diet for 28 days group). We used contrast -enhanced ultrasound (CEUS) to detect the neovascularization in the carotid atherosclerosis plaque. The expressions of MMP-2 and cluster of differentiation 31 (CD31) were assessed by immunohistochemical staining, and we analyzed the correlations between them. CEUS showed that the neovascularization in the carotid atherosclerotic model plaques was statistical difference between the C and D group (P < 0.05); immunohistochemistry showed there were positive MMP-2 and CD31 expressions in the plaques, and the correlative analysis showed the expressions were positive correlated (P < 0.01). We can conclude that MMP-2 play some roles in the neovascularization within the rabbit carotid atherosclerotic plaques.%目的 探讨兔颈动脉粥样硬化模型斑块内基质金属蛋白酶-2(matrix metaloproteinase-2,MMP-2)与新生血管的关系.方法 将40只健康雄性新西兰大白兔随机分为4组,A组予普通饲料喂养28 d、B组予高脂饮食28 d、C组予硅橡胶圈干预联合高脂饮食14d、D组予硅橡胶圈干预联合高脂饮食28 d.利用超声造影检测C组、D组兔颈动脉粥样硬化模型斑块内新生血管情况,应用免疫组化检测斑块内MMP-2、血小板内皮细胞黏附分子-1(cluster of differentiation 31,CD31)的表达,进行两者间相关性分析.结果 超声造影检测到C组、D组模型兔颈动脉斑块内有新生血管形成,两组间差异有统计学意义(P<0.05).免疫组化结果显示斑块内有阳性表达的MMP-2、CD31,

  16. The influence of vascular anatomy on carotid artery stenting: a parametric study for damage assessment.

    Science.gov (United States)

    Iannaccone, F; Debusschere, N; De Bock, S; De Beule, M; Van Loo, D; Vermassen, F; Segers, P; Verhegghe, B

    2014-03-01

    Carotid artery stenting is emerging as an alternative technique to surgery for the treatment of symptomatic severe carotid stenosis. Clinical and experimental evidence demonstrates that both plaque morphology and biomechanical changes due to the device implantation can be possible causes of an unsuccessful treatment. In order to gain further insights of the endovascular intervention, a virtual environment based on structural finite element simulations was built to emulate the stenting procedure on generalized atherosclerotic carotid geometries which included a damage model to quantify the injury of the vessel. Five possible lesion scenarios were simulated by changing both material properties and vascular geometrical features to cover both presumed vulnerable and stable plaques. The results were analyzed with respect to lumen gain and wall stresses which are potentially related to the failure of the procedure according to previous studies. Our findings show that an elliptic lumen shape and a thinner fibrous cap with an underlying lipid pool result in higher stenosis reduction, while large calcifications and fibrotic tissue are more prone to recoil. The shielding effect of a thicker fibrous cap helps to reduce local compressive stresses in the soft plaque. The presence of a soft plaque reduces the damage in the healthy vascular structures. Contrarily, the presence of hard plaque promotes less damage volume in the fibrous cap and reduces stress peaks in this region, but they seem to increase stresses in the media-intima layer. Finally the reliability of the achieved results was put into clinical perspective.

  17. 血脂指标比值对颈动脉粥样斑块预测价值的比较%Comparison of the Value of Serum Lipids Index Ratio in the Prediction of Carotid Atherosclerotic Plaques

    Institute of Scientific and Technical Information of China (English)

    宋川; 郑延松; 王丽凤; 陈志来; 郭民法

    2012-01-01

    目的 探讨总胆固醇与高密度脂蛋白胆固醇(TC/HDL-C)比值和低密度脂蛋白胆固醇/高密度脂蛋白胆固醇(LDL-C/HDL-C)比值对颈动脉粥样斑块的预测价值.方法 选取2010年5月-2011年10月在我院健康医学中心进行健康体检并接受颈部血管超声检查和血脂检测的4 282例体检者作为研究对象,对颈动脉粥样斑块与相关因素[年龄、性别、教育程度、吸烟、饮酒、腰围、体质指数、血压和血糖、血红蛋白、血尿酸、TC、三酰甘油(TG)、LDL-C、HDL-C、超敏C反应蛋白水平及糖尿病、高血压、冠心病、脑卒中家族史]进行分析.结果 4 282例体检者中1 438例(33.6%)存在颈动脉粥样斑块,2 844例(66.4%)未发现明显的颈动脉粥样斑块.年龄、性别、吸烟、血糖、收缩压、LDL-C、HDL-C、超敏C反应蛋白均为颈动脉粥样斑块的危险因素.若用LDL-C/HDL-C和TC/HDL-C分别替代LDL-C、HDL-C或者TC和HDL-C,LDL-C/HDL-C和TC/HDL-C比值仍为颈动脉粥样斑块的危险因素.与TC/HDL-C比值(β=0.1760)相比,LDL-C/HDL-C比值的偏回归系数(β=0.3292)更高.结论 当用于预测颈动脉粥样斑块时,LDL-C/HDL-C比值比TC/HDL-C比值更具临床使用价值.%Objective To explore the value of the ratio of TC to HDL - C and the ratio of LDL - C to HDL - C ( LDL - C/HDL - C ) in the prediction of carotid atherosclerotic plaques. Methods 4 282 subjects registered for health examination and underwent carotid Doppler ultrasound scan and serum lipids test in the department of health science center in our hospital from May 2010 to October 2011 were involved into the study. Carotid atherosclerotic plaques and related factors ( age, gender, education, smoking status, alcohol intake, waist circumference, body mass index, blood pressure, blood glucose, hemoglobin, blood uric acid, TC, TG, LDL - C, HDL - C, hs - CRP, diabetes, hypertension, coronary heart disease and family history of stroke ) were analyzed. Results

  18. Association of increased serum branched-chain amino acid level with carotid plaque%血清支链氨基酸水平升高与颈动脉斑块的关系

    Institute of Scientific and Technical Information of China (English)

    隋小芳; 杨睿悦; 郭金发; 张磊艺; 黄佳滨; 费秀斌; 曾平; 朱玲

    2015-01-01

    目的:研究血清支链氨基酸(BCAA)水平与颈动脉斑块的关系。方法采用横断面调查方法,对收集的中老年体检人群472例[42~97岁,平均(70.1±6.6)岁,男性272例]进行问卷调查、体格检查、血液检查和颈动脉超声检测,同位素稀释液相色谱串联质谱法测定血清 BCAA 水平,分析其与颈动脉斑块的关系。结果血清 BCAA 浓度呈偏态和尖态分布,男性的 BCAA 水平[466.5(423.6~514.7)μmol/ L]显著高于女性[415.3(382.5~466.0)μmol/ L],P ﹤0.001。在校正年龄和性别后,血清 BCAA 水平与 BMI、SBP、DBP、FBG、TG 和 LDL-C 显著正相关(均为 P ﹤0.05),与 HDL-C 明显负相关(P ﹤0.001)。颈动脉斑块组的 BCAA 水平[450.0(405.9~492.1)]明显高于正常组[430.4(395.1~495.2)](P =0.039)。多因素 Logistic 回归分析发现,年龄、吸烟史、SBP 和 BCAA 水平升高是颈动脉斑块的独立危险因素,BCAA 次高四分位水平发生颈动脉斑块的风险是最低四分位水平的2.68倍(P =0.002,P趋势=0.018)。结论血清 BCAA 水平升高是颈动脉斑块的独立危险因素,可能影响动脉粥样硬化的发生发展。%Objective To investigate the association between serum branched chain amino acid (BCAA) and carotid plaque. Methods The cross-sectional study was undertaken on 472 middle-aged and elderly people [42-97 y, average (70. 1 ± 6. 6) y, 272 males] selected from the participants for health screen. The medical history of each participant was obtained by questionnaire. The samples of venous blood and the Bilateral B-mode carotid artery images were taken. Serum BCAA levels were determined by Isotope Dilution Liquid Chromatography Tandem Mass Spectrometry. The association of BCAA with carotid plaque was analyzed. Results The levels of BCAA showed skewed and leptokurtic distribution. Males [466. 5 (423. 6-514. 7 ) μmol/ L ] had significantly higher values of BCAA than females [ 415. 3 ( 382. 5-466. 0) μmol/ L] (P ﹤ 0. 001

  19. Atherosclerotic Plaque Stability Is Affected by the Chemokine CXCL10 in Both Mice and Humans

    Directory of Open Access Journals (Sweden)

    Dolf Segers

    2011-01-01

    Full Text Available Background. The chemokine CXCL10 is specifically upregulated during experimental development of plaque with an unstable phenotype. In this study we evaluated the functional consequences of these findings in mice and humans. Methods and Results. In ApoE-/- mice, we induced unstable plaque with using a flow-altering device around the carotid artery. From week 1 to 4, mice were injected with a neutralizing CXCL10 antibody. After 9 weeks, CXCL10 inhibition resulted in a more stable plaque phenotype: collagen increased by 58% (P=0.002, smooth muscle cell content increased 2-fold (P=0.03, while macrophage MHC class II expression decreased by 50% (P=0.005. Also, the size of necrotic cores decreased by 41% (P=0.01. In 106 human carotid endarterectomy specimens we found that increasing concentrations of CXCL10 strongly associate with an increase in atheromatous plaque phenotype (ANOVA, P=0.003, with high macrophage, low smooth muscle cell, and low collagen content. Conclusions. In the present study we showed that CXCL10 is associated with the development of vulnerable plaque in human and mice. We conclude that CXCL10 might provide a new lead towards plaque-stabilizing therapy.

  20. 实时超声弹性成像技术评价脑卒中患者颈动脉斑块软硬度%Real-time Elastosonography for the Assessment of the Stiffness of Carotid Plaques in Stroke Patients

    Institute of Scientific and Technical Information of China (English)

    方占军; 高启旺; 张连杰; 陈立娥; 勇强

    2011-01-01

    [Objective] To explore the real-time elastosonography for the assessment the stiffness of carotid plaques in stroke patients. [Methods] The low-echo plaques, hypoechogenicity plaques and strong-echo plaques in 53 stroke patients were found by gray scale ultrasound. Meanwhile, real-time elastosonography was used to calculate the ratio of the stiffness of carotid wall to different types of echo plaques. [Results] Thirty-one low-echo plaques, thirty-seven hypoechogenicity plaques and thirteen calcified plaques were found by routine ultrasound.Real-time elastosonography showed that the low-echo plaques were mainly yellow-green or green, and hypoechogenicity plaques were mosaic of green and blue, and the strong-echo plaques were blue. The stiffness ratio of low echo plaques, hypoechogenicity plaques, strong-echo plaques increased by turns. The stoke patients with the stiffness ratio of carotid plaque less than 5.0 occupied 73.4%(41/53). [Conclusion] Real-time elastosonography for calculating the stiffness ratio of carotid plaques is helpful for assessing the stability of carotid plaques in stroke patients.%[目的]应用实时超声弹性成像评价脑卒中患者颈动脉斑块软硬度.[方法]53例脑卒中患者中以常规灰阶超声检测出低回声斑块、混合回声斑块及强回声斑块及其颈动脉狭窄,同时应用实时超声弹性成像技术计算颈动脉管壁与各种回声类型斑块的硬度比值.[结果]①常规超声可检测出低回声斑块31处、混合回声斑块37处及钙化斑块13处;② 实时超声弹性图像中,低回声斑块呈黄绿色或绿色为主、混合回声斑块为蓝绿相间及强回声斑块完全呈蓝色;③低回声斑块、混合回声斑块及强回声斑块硬度比值依次增大;④颈动脉斑块硬度比值<5.0的脑卒中患者占总体的73.4%(41/53例).[结论]实时超声弹性成像判断颈动脉斑块硬度比值有助于评价脑卒中患者颈动脉斑块的稳定性.

  1. Correlation between asymptomatic hyperuricemia and number of carotid plaques%无症状高尿酸血症与颈动脉斑块数量的相关性研究

    Institute of Scientific and Technical Information of China (English)

    宋长曌; 邓汝荣; 程遥; 徐显林; 陈三民; 王道伟

    2014-01-01

    目的:探讨无症状高尿酸血症患者血尿酸水平与颈动脉斑块数量的关系。方法选择2009年1月至2013年12月间在广东省惠州市惠阳三和医院进行健康查体人员72例,依据入选对象血尿酸水平分为高尿酸组(n=39)与正常尿酸组(n=33),随访5年血尿酸水平变化,并检测颈动脉斑块数量,对血尿酸水平与颈动脉斑块数量进行相关性分析。结果纳入患者5年随访期间,高尿酸组与正常尿酸组中男性人群血尿酸水平均高于女性人群,差异均有统计学意义(P<0.05)。高尿酸组男性及女性血尿酸水平均高于正常尿酸组男性及女性尿酸水平,差异均有统计学意义(P<0.05)。两组人群5年随访期间男性及女性血尿酸水平变化不明显,年度之间血尿酸水平无统计学差异(P>0.05)。高尿酸组男性和女性颈动脉斑块数量平均为(1.9±0.5)个、(1.2±0.3)个,正常尿酸组男性和女性颈动脉斑块数量平均为(0.8±0.3)个、(0.4±0.2)个;高尿酸组男性和女性颈动脉斑块数量显著高于正常尿酸组,差异有统计学意义(P<0.05)。颈动脉斑块数量与血尿酸水平呈正相关,男性r=0.768,女性r=0.721,均有统计学意义(P<0.05)。结论血尿酸水平升高与颈动脉斑块增加明显正相关。%Objective To investigate the relationship between level of blood uric acid (BUA) and number of carotid plaques in patients with asymptomatic hyperuricemia. Methods The health persons (n=72) with physical examinations were chosen from the Huiyang Sanhe Hospital of Huizhou City of Guangdong Province from Jan. 2009 to Dec. 2013, and divided into high-BUA group (n=39) and normal-BUA group (n=33) according to their BUA level. The changes of BUA level were followed up for 5 years, and number of carotid plaques was detected. A correlation analysis on relationship between BUA level and number of carotid plaques

  2. [Carotid duplex ultrasonography for neurosurgeons].

    Science.gov (United States)

    Sadahiro, Hirokazu; Ishihara, Hideyuki; Oka, Fumiaki; Suzuki, Michiyasu

    2011-12-01

    Carotid duplex ultrasonography (CDU) is one of the most well-known imaging methods for arteriosclerosis and ischemic stroke. For neurosurgeons, it is very important for the details of carotid plaque to be thoroughly investigated by CDU. Symptomatic carotid plaque is very fragile and easily changes morphologically, and so requires frequent CDU examination. Furthermore, after carotid endarterectomy (CEA) and carotid artery stenting (CAS), restenosis is evaluated with CDU. CDU facilitates not only morphological imaging in the B mode, but also allows a flow study with color Doppler and duplex imaging. So, CDU can help assess the presence of proximal and intracranial artery lesions in spite of only having a cervical view, and the patency of the extracranial artery to intracranial artery bypass is revealed with CDU, which shows a rich velocity and low pulsatility index (PI) in duplex imaging. For the examiner, it is necessary to ponder on what duplex imaging means in examinations, and to summarize all imaging finding.

  3. Ultrasonic Imaging of Hemodynamic Force in Carotid Blood Flow

    Science.gov (United States)

    Nitta, N.; Homma, K.

    Hemodynamic forces including blood pressure and shear stress affect vulnerable plaque rupture in arteriosclerosis and biochemical activation of endothelium such as NO production. In this study, a method for estimating and imaging shear stress and pressure gradient distributions in blood vessel as the hemodynamic force based on viscosity estimation is presented. Feasibility of this method was investigated by applying to human carotid blood flow. Estimated results of shear stress and pressure gradient distributions coincide with the ideal distributions obtained by numerical simulation and flow-phantom experiment.

  4. Efficient global optimization based 3D carotid AB-LIB MRI segmentation by simultaneously evolving coupled surfaces.

    Science.gov (United States)

    Ukwatta, Eranga; Yuan, Jing; Rajchl, Martin; Fenster, Aaron

    2012-01-01

    Magnetic resonance (MR) imaging of carotid atherosclerosis biomarkers are increasingly being investigated for the risk assessment of vulnerable plaques. A fast and robust 3D segmentation of the carotid adventitia (AB) and lumen-intima (LIB) boundaries can greatly alleviate the measurement burden of generating quantitative imaging biomarkers in clinical research. In this paper, we propose a novel global optimization-based approach to segment the carotid AB and LIB from 3D T1-weighted black blood MR images, by simultaneously evolving two coupled surfaces with enforcement of anatomical consistency of the AB and LIB. We show that the evolution of two surfaces at each discrete time-frame can be optimized exactly and globally by means of convex relaxation. Our continuous max-flow based algorithm is implemented in GPUs to achieve high computational performance. The experiment results from 16 carotid MR images show that the algorithm obtained high agreement with manual segmentations and achieved high repeatability in segmentation.

  5. 基质金属蛋白酶3在小鼠颈动脉粥样硬化斑块中的表达%The Expression of Matrix Metalloprotein-3 in Carotid Atherosclerosis Plaques of Mice

    Institute of Scientific and Technical Information of China (English)

    刘莉; 赵雷; 王汐; 陈晓敏

    2012-01-01

    Objective:To study the expression of matrix metalloprotein-3 (MMP-3) in carotid atherosclerosis plaques of apolipoprotein E-deficient mice.Methods:21 ApoE- deficient mice at 28 weeks of age were divided randomly into control group and Atorvastarin Calcium group, simvastatin group. All of them fed high cholesterol diet. After 12 weeks, detect serum MMP-3, separate their carotid arteries and analyze the expressions of MMP-3 by immunohistochemistry.Results:To compare with control group, both Atorvastarin Calcium group, simvastatin group could decrease MMP-3 in the atherosclerosis plaques (P<0.05). Atorvastarin Calcium group also decrease serum MMP-3 (P<0.01).Conclusion:MMP-3 is very important for atherosclerosis. The lipid lowering therapy with Atorvastarin Calcium and simvastatin could inhibit angiogenesis and degradation of extracellular matrix in the atherosclerotic plaque.%目的:研究基质金属蛋白酶3(matrix metalloproteinase 3,MMP-3)在小鼠颈动脉粥样硬化斑块中的表达,分析其与动脉粥样硬化斑块的关系.方法:21只28周龄载脂蛋白E基因(apolipoprotein E,ApoE)敲除小鼠随机分成对照组(7只),阿托伐他汀钙组(7只),麝香保心丸组(7只),均给予高脂饮食,喂养12周后检测血清MMP-3,并分离各组小鼠颈动脉,通过免疫组化分析斑块内MMP-3的表达.结果:与对照组比较,阿托伐他汀钙组血清MMP-3降低(P<0.01),麝香保心丸组血清MMP-3降低不明显.两组均能降低斑块内MMP-3的表达,且有统计学意义(P<0.05).结论:动脉粥样硬化发展过程中,MMP-3起到重要作用,阿托伐他汀钙和麝香保心丸的治疗可减少斑块内胞外基质的降解,具有稳定斑块的作用.

  6. General principles of carotid Doppler ultrasonography

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Whal [Dept. of Radiology, Seoul National University College of Medicine, Seoul (Korea, Republic of)

    2014-03-15

    Carotid Doppler ultrasonography is a popular tool for evaluating atherosclerosis of the carotid artery. Its two-dimensional gray scale can be used for measuring the intima-media thickness, which is very good biomarker for atherosclerosis and can aid in plaque characterization. The plaque morphology is related to the risk of stroke. The ulceration of plaque is also known as one of the strong predictors of future embolic event risk. Color Doppler ultrasonography and pulse Doppler ultrasonography have been used for detecting carotid artery stenosis. Doppler ultrasonography has unique physical properties. The operator should be familiar with the physics and other parameters of Doppler ultrasonography to perform optimal Doppler ultrasonography studies.

  7. Correlation Study of Carotid Intima_media Thickness,Carotid Plaques and SYNTAX Score in Patients with Coronary Heart Disease%冠心病患者颈动脉内膜中层厚度及颈动脉斑块与 SYNTAX 评分的相关性研究

    Institute of Scientific and Technical Information of China (English)

    王林; 袁国裕; 陈国雄; 陈士良

    2016-01-01

    Objective To explore the association of carotid intima_media thickness (CIMT ) ,carotid plaques with SYNTAX score of coronary artery in patients with coronary heart disease(CHD). Methods 256 patients who underwent coronary arteriography (CAG) were divided into control group with their coronary stenosis 32scores).CIMT and catotid plaques were evaluated with ultrasonic inspection and measurement in all patients. Results Incidence rates of elevated CIMT and carotid plaques were significantly higher in CHD group than in the control group ( P32scores) than in the low risk group (1~22scores). The Spearman linear_regression analysis showed that SYNTAX scores had a positive correlation with CIMT ( r=0.64 ,P32 ( P<0.05).Conclusions CIMT and carotid plaques were closely associated with SYNTAX scores in patients with CHD ,which could be used to indirectly predict the severity of coronary artery lesion.%目的:探讨冠心病患者颈动脉内膜中层厚度(CIMT )及颈动脉斑块与冠状动脉SYNTAX评分的关系。方法选择行冠状动脉造影的患者256例,根据冠状动脉造影结果分组:51例冠状动脉狭窄<50%为对照组,余205例为冠心病组。冠心病组又根据SYNTAX评分结果分为低分组(1~22分)70例、中分组(23~32)94例、高分组(>32分)41例。所有患者均采用超声检测双侧CIMT及颈动脉斑块情况。结果与对照组比较,冠心病组患者CIMT及斑块发生率明显高于对照组( P<0.05)。与低分组比较,中分组和高分组CIMT及斑块发生率明显升高( P<0.05)。Spearman线性回归分析结果显示冠心病患者CIMT与SYNTAX评分呈直线正相关( r=0.64,P<0.01)。多因素Logistic回归分析结果显示,CIMT及颈动脉斑块是SYNTAX积分>32分的独立预测因素( P<0.05)。结论 CIMT及颈动脉斑块与冠心病患者SYNTAX评分密切相关,可间接预测冠状动脉病变严重程度。

  8. Research on the target level of serum LDL-C to prevent the formation of carotid plaque%预防颈动脉斑块形成的血清LDL-C控制目标值初探

    Institute of Scientific and Technical Information of China (English)

    赵润栓; 刘欢; 时敬宇; 白雪琴; 赵琳

    2015-01-01

    Objective To determine the target level of serum high density lipoprotein cholesterol ( LDL-C) to pre-vent the formation of carotid plaque.Methods Health examination data were collected from 12,883 persons.According to carotid artery ultrasound images, these persons were divided into the following groups: a normal group, an increased carotid intima-media thickness group, and a plaque formation group.Male and female groups were compared for serum LDL-C level through analysis of variance.Then, the target level of serum LDL-C was deduced to prevent carotid artery plaque formation.Results For male participants, the level of LDL-C was (3.08 ±0.79), (3.22 ±0.80), and (3.25 ±0.88) mmol/L in the above three groups.For female participants, the quantity of LDL-C was (3.06 ±0.73), (3.44 ±0.79), and (3.42 ±0.88) mmol/L in the above three groups.These data showed significant difference (F val-ue was 46.32 for men and 170.04 for women, P0.05).Conclusion For both male female participants, different levels of LDL-C are seen in each group, which is associated with plaque formation.In order to prevent plaque formation, the tar-get level of LDL-C should be less than 3.22 mmol/L for men, and less than 3.44 mmol/L for women in Chinese Han ethnic group.%目的:探索预防颈动脉斑块形成的血清低密度脂蛋白胆固醇( LDL-C)的控制目标值。方法收集12883例健康体检资料,按照颈动脉超声表现,分为颈动脉未见明显异常组、内中膜增厚组、斑块形成组。对男女各组血清LDL-C水平的差异性分别进行方差分析,进一步行组间两两比较,从预防颈动脉斑块形成的角度,推论LDL-C的控制目标值。结果男性3组的LDL-C水平分别为(3.08±0.79)、(3.22±0.80)、(3.25±0.88) mmol/L;女性3组的LDL-C水平分别为(3.06±0.73)、(3.44±0.79)、(3.42±0.88) mmol/L。男女3组间LDL-C水平差异均有统计学

  9. To evaluate the composition and typing of carotid artery atherosclerotic plaque and the relationship between plaque morphology and clinical symptoms%MRI评估颈动脉粥样硬化斑块成分、类型及其与临床症状的相关性

    Institute of Scientific and Technical Information of China (English)

    罗南; 刘一; 范占明

    2013-01-01

    Objective To compare plaque morphology from patients with and without stroke symptoms, determine the relationship between carotid plaque morphology and stroke pathogenesis, and evaluate the warning function of high-field MR on early diagnosis of plaque. Methods Patients with carotid artery atherosclerotic plaque detected by B-mode ultrasonography were examined with MR imaging. Imaging was performed with a 3.0-T MR imager (Philips or GE) and a special 8-channel phased-array surface coil for carotid artery. The protocols include T1-, intermediate-, T2-, and post-contrast T1-weighted MR imaging, as well as three-dimensional time-of-flight (TOF) and MP-RAGE. All examinations were performed with a 14cm field of view, a matrix of 256 × 256 pixels,a 2-mm section thickness, and two acquired signals. An intersection space of -1 mm was used for three-dimensional TOF angiography and MP-RAGE, whereas no intersection space was used for MR imaging. Gadopentetate Dimeglumine was the contrast agent with the dosage of 0.1 mmol/Kg(0.2 ml/Kg)and injection speed of 0.7 ml/s. One observer recorded quantitative and morphologic information, which included measurement of the area of the lumen and main plaque components (calcification, hemorrhage, loose matrix ); fibrous cap status (thick, thin, or ruptured); reformed MR lesion type (types Ⅰ-Ⅷ) based on American Heart Association (AHA). Plaques associated with neurologic symptoms(transient ischemic attack, amaurosis fugax, or stroke appropriate to the distribution of the index carotid artery)and asymptomatic plaques were compared with Independent-sample T test on luminal stenosis, chi square test on occurrence rate of main plaque components and fibrous cap rupture respectively and regression analysis for the connection strength between plaque components and clinical symptoms. Results 64 carotid artery enrolled in the symptomatic group and 131 carotid artery enrolled in the asymptomatic group. Compared with asymptomatic plaques

  10. Carotid Ultrasound

    Science.gov (United States)

    ... this page from the NHLBI on Twitter. Carotid Ultrasound Also known as carotid duplex. Carotid ultrasound is a painless imaging test that uses high- ... of your carotid arteries. This test uses an ultrasound machine, which includes a computer, a screen, and ...

  11. Meta-analysis of Clinical Efficacy of Chinese Medic ine on Carotid Atherosclerotic Plaque%中医药治疗颈动脉粥样硬化斑块临床疗效的 Meta分析

    Institute of Scientific and Technical Information of China (English)

    刘梨; 龚后武; 张建影; 常小荣

    2015-01-01

    目的:系统评价中医药相关疗法对颈动脉粥样硬化斑块的临床疗效。方法:计算机检索The Co-chrane Library、PubMed、CBM、CNKI、WanFang Data及VIP,收集有关中医药治疗颈动脉粥样硬化斑块的随机对照试验( RCT),检索时限从建库至2014年8月,由两位研究者根据纳入及排除标准独立筛选文献、提取信息及评价纳入文献的方法学质量后,采用软件Rev Man 5.2.9进行Meta分析。结果:最终纳入10个RCT,共计1006例患者,干预措施治疗组为中医药相关疗法,对照组均为常规西药治疗。 Meta分析结果显示:与常规西药用药相比,中医药干预组能显著改善临床证候[OR=2.08,95%CI(1.50,9.55),P=0.004];颈动脉内中膜厚度影响方面,中医药较单纯西药治疗有效,其差异有统计学意义[MD=-0.06,95%CI(-0.10,-0.03),P=0.0006];对降低硬化斑块体积/面积,中医药干预组也较对照组明显( P<0.00001)。结论:在治疗颈动脉粥样硬化斑块方面,中医药干预组的疗效优于常规西药用药组。因纳入研究质量较低,数量所限,故上述结论仍需开展更多大样本高质量的RCT加以验证。%Objective:To evaluate the clinical efficacy of TCM therapy on the carotid atherosclerotic plaque.Methods:Search The Cochrane Library, PubMed, CBM, CNKI, WanFang Data and VIP and collect information of randomized controlled trial ( RCT) about Chinese medicine treatment for carotid atherosclerotic plaque, building a database to re-trieve the time to August 2014 .Two reviewers independently screened the literatures based on inclusion and exclusion criteria,and extracted information and evaluation methods including studies after methodology quality by use of software RevMan 5.2.9 Meta-analysis.Results:Including 10 RCT, totally 1006 cases of patients, the treatment group was trea-ted with interventions of Chinese

  12. Effective of Vitamin E Combined with Vitamin C for the Intervention of Carotid Atherosclerotic Plaques%维生素E联合维生素C对颈动脉粥样斑块的干预作用研究

    Institute of Scientific and Technical Information of China (English)

    王玉红; 王玉起; 李万福; 张雪芹

    2013-01-01

    目的 探讨维生素E联合维生素C对颈动脉粥样斑块的干预作用,为防治动脉粥样硬化提供依据.方法 选择大兴黄村镇5个社区45岁以上经颈动脉超声检查明确有颈动脉硬化斑块及颈动脉内膜中层厚度(IMT)≥1.0 mm的患者196例为研究对象,在常规应用阿司匹林肠溶片及他汀类降脂药治疗的基础上按随机数字表法随机分为A组(加服维生素E 200 mg/晚)、B组(加服维生素E 200 mg/晚,维生素C 200 mg 早晚各1次)、C组(加服维生素C 200 mg 早晚各1次)及对照组(不加服维生素E和C).干预18个月后,对干预前后斑块大小变化进行分析.结果 干预前、后4组患者颈动脉粥样斑块组间比较,差异均无统计学意义(P>0.05).组内比较,对照组干预前后颈动脉粥样斑块间差异有统计学意义(P<0.05),A组、B组、C组干预前后斑块间差异均无统计学意义(P>0.05).结论加用维生素E和(或)维生素C对颈动脉粥样斑块没有明显缩小的作用.%Objective To explore the effectiveness of vitamin E combined with vitamin C in the intervention of carotid atherosclerotic plaques ( CAPs ). Methods A total of 196 45 - year - old - or - above patients with ultrasound - confirm CAPs ( and carotid intima media thickness≥ 1. 0 mm ) from 5 communities in Huangcun, Daxing District, Beijing, were enrolled. In addtion to routine aspirin and statin therapy, patients were further divided into four groups based on the administration of vitamins : group A ( supplemented with vitamin E, 200 mg/day ), group B ( supplenmented with vitamin E 200 mg, qn, and vitamin C 200 mg bid ), group C ( supplemented with vitamin C 200 mg bid ), and control group ( without any vitamin supplementation). After 18 months of treatment, the change in the size of CAPs were compared among these four groups. Results Compared with the control group, the size of CAPs in groups A, B, and C were not significantly different ( P >0. 05 ). The control

  13. 养心颗粒对易损斑块家兔模型胆固醇7-α-羟化酶和MMP-9含量的影响%Effect of Yangxin Granules on CYP7A1 and MMP-9 of Vulnerable Plaque Rabbit Models

    Institute of Scientific and Technical Information of China (English)

    潘祥宾; 刘影哲; 周亚滨; 孙静

    2012-01-01

    目的:探讨养心颗粒对易损斑块家兔模型胆固醇7-α-羟化酶和MMP-9含量的影响.方法:采用球囊损伤家兔颈总动脉,同时给予家兔高脂饮食喂养8周,8周后注入p53腺病毒载体,将造模成功家兔随机分为模型对照组、养心颗粒组、辛伐他汀组,每组6只,另取6只家兔作为空白对照组,药物治疗2周后进行药物触发,用ELISA法检测胆固醇7-α-羟化酶和MMP-9含量.结果:养心颗粒组与治疗前比较,CYP7A1含量升高、MMP-9含量减少,差异具有统计学意义(P<0.05).辛伐他汀组与治疗前比较,CYP7A1含量明显升高,差异具有统计学意义(P<0.05);两治疗组相互比较,差异均无统计学意义(P>0.05).结论:养心颗粒可升高易损斑块家兔模型血清CYP7A1含量,降低MMP-9表达水平,这可能是养心颗粒稳定易损斑块的作用机制之一.%To study the effect of Yangxin granules on CYP7A1 and MMP -9 in vulnerable plaque rabbit models. Methods; At first rabbits'carotid artery were induced with an balloon, then these rabbits were fed on high fat diet for 8 weeks. After 8 weeks, p53 gene transfection was injected to plaques,and rabbits were randomly divided into four groups; model contrast group, Yangxin granule group, simvastatin contrast group and blank contrast group. Administration for two weeks. At the end of the 8th weekend and 10th weekend,the contents of CYP7A1 and MMP -9 were examined. Results;On the 10th weekend the content of CYP7A1 increased in treatment groups and simvastatin group than the content before ( P 0.05). Conclusion; Yangxin granule can increase the content of CYP7A1 and decrease the content of MMP -9 in vulnerable plaque rabbit models,which might be one of the mechanisms for stabilizing vulnerable plaque.

  14. Mucosal tolerance to a combination of ApoB and HSP60 peptides controls plaque progression and stabilizes vulnerable plaque in Apob(tm2SgyLdlr(tm1Her/J mice.

    Directory of Open Access Journals (Sweden)

    Lakshmi Mundkur

    Full Text Available Oral tolerance to auto antigens reduces the development of atherosclerosis in mouse models. However, the effect of immune tolerance to multiple self antigenic peptides in plaque progression and stabilization is not known. We studied the protective effect of mucosal tolerance to peptides from apolipoprotein B (ApoB; 661-680 and heat shock protein 60 (HSP60; 153-163, in combination with diet, in the prevention of atherosclerotic lesion progression and plaque stabilization in ApoB(tm25gyLDLr(tm1Her mice. We found that oral administration of five doses of a combination of ApoB and HSP60 peptides (20 µg/mice/dose induced tolerance to both the peptides and reduced early plaque development by 39.9% better than the individual peptides (ApoB = 28.7%;HSP60 = 26.8%(P<0.001. Oral tolerance to combination of peptides along with diet modification arrested plaque progression by 37.6% which was associated with increases in T-regulatory cell and transforming growth factor-β expression in the plaque and peripheral circulation. Reduced macrophage infiltration and tumor necrosis factor-α expression in the plaque was also observed. Tolerance with continued hypercholesterolemia resulted in 60.8% reduction in necrotic core area suggesting plaque stabilization, which was supported by reduction in apoptosis and increased efferocytosis demonstrated by greater expression of receptor tyrosine kinase Mer (MerTK in the plaque. Tolerance to the two peptides also reduced the expression of matrix metalloproteinase 9, tissue factor, calprotectin, and increased its collagen content. Our study suggests that oral tolerance to ApoB and HSP60 peptide combination induces CD4(+ CTLA4(+ Tregs and CD4(+CD25(+Foxp3(+ Tregs secreting TGF-β, which inhibit pathogenic T cell response to both peptides thus reducing the development and progression of atherosclerosis and provides evidence for plaque stabilization in ApoB(tm25gyLDLr(tm1Her mice.

  15. External ventricular drain as a nontraumatic suction device in carotid endarterectomy

    Directory of Open Access Journals (Sweden)

    Alistair Jukes, MBBS(Hons, BLibStud

    2017-03-01

    Full Text Available Carotid endarterectomy is a commonly performed operation to remove plaque at the region of the carotid bifurcation. We present our technique to keep the field clear and to minimize potential trauma to the carotid using a neurosurgical external ventricular drain passed behind the common carotid and placed in the dependent position under the arteriotomy.

  16. Comparison of the Detection Rate of Carotid Artery Therosclerosis Plaque by Means of 16-Director Spiral CT and 320-director Volume CT%16排螺旋CT与320排容积CT对颈动脉粥样硬化斑块检出率的比较研究

    Institute of Scientific and Technical Information of China (English)

    贾云生; 高明洋; 王焕君

    2016-01-01

    目的:比较16排螺旋CT与320排容积CT对于颈动脉粥样硬化斑块检出率的差异。方法选取缺血性脑血管病患者48例,男性22例,女性26例,平均年龄(56±8)岁。经16排螺旋CTA检出颈动脉粥样硬化斑块的患者,进一步行320排容积CTA扫描,并与16排螺旋CTA的粥样硬化斑块检出率进行比较。结果16排螺旋CT与320排容积CT对于颈动脉粥样硬化斑块的检出率无明显统计学差异。结论对于基层医院,建议使用16排螺旋CT检出颈动脉斑块,以利于临床诊断及治疗。%Objective To compare the detection rate of carotid artery therosclerosis plaque by means of 16-director spiral CT and 320- director volume CT.Methods 48 patients of ICVD, 22 males and 26 females, with average age of (56±8) years old, were chosen. The patients detected plaques by 16-director spiral CT scans were further performed 320-director volume CT scans, and we compared the detection rate between the two methods. Results The detection rate of carotid artery therosclerosis plaque between 16-director spiral CT scans and 320-director volume CT scans showed no significant difference. Conclusion We recommend utilizing 16-director spiral CT to detect carotid artery therosclerosis plaque for basic hospital, facilitating the clinical diagnosis and treatment.

  17. Observation of curative effects of trigeminy therapy with probucol, antiplatelet agents and statins on atherosclerotic plaque of the carotid in cerebral infarction patients%抗氧化、抗血小板和降脂三联疗法治疗脑梗死患者颈动脉粥样硬化斑块的疗效观察

    Institute of Scientific and Technical Information of China (English)

    李绍发; 梁柯

    2011-01-01

    Objective To observe the curative effects of trigeminy therapy with probucol, antiplatelet agents and statins (PAS) on atherosclerotic plaque of the carotid in cerebral infarction patients. Methods One hundred and eighty cerebral infarction patients with atherosclerotic plaque of the carotid were randomly devided into PAS trigeminy therapy group (PAS group, 60 cases), atorvastatin therapy group (atorvastatin group, 60 cases) and aspirin therapy group (control group, 60 cases). The blood total cholesterol (TC), triglyceride (TG), high density lipoprotein (HDL), iow density lipoprotein ( LDL), oxidized LDL (ox-LDL) and high sensitive C reactive protein (hs-CRP) of all the patients were determined before and after treatment. The carotid intima and media thickness (IMT) and the area of atherosclerotic plaque of the carotid were detected by color Doppler ultrasound. Results Compared with before treatment, the serum levels of TC, TG, LDL, ox-LDL and hs-CRP of patients in atorvastatin group were significantly decreased after treatment ( all P <0. 01 ); the IMT and the area of atherosclerotic plaque of the carotid were significantly decreased ( all P < 0. 05 ). After treatment, compared with atovastatin group, the serum levels of TC, TG, LDL, ox-LDL and hs-CRP in PAS group were significantly decreased ( P < 0.05 - 0. 01 ); the IMT and the area of atherosclerotic plaque of the carotid in PAS group were significantly decreased ( all P < O.05 ).Conclusion The PAS trigeminy therapy has notable curative effects on atheroscleretic plaque of the carotid in cerebral infarction patients, and there is no obvious adverse reaction.%目的:观察抗氧化、抗血小板和降脂(PAS)三联疗法治疗脑梗死患者颈动脉粥样硬化斑块的疗效.方法:180例确诊颈动脉粥样硬化斑块的脑梗死患者随机分成PAS三联疗法治疗组(PAS组,60例)、阿托伐他汀钙治疗组(他汀组,60例)和拜阿司匹林治疗组(对照组,60例).检测各患者治疗

  18. 急性心肌梗死患者颈动脉粥样硬化斑块易损性与血脂、血压相关性研究%Patients with acute myocardial infarction death carotid atherosclerotic plaques and blood fat and blood pressure correlation.

    Institute of Scientific and Technical Information of China (English)

    张海英; 王玉霞; 陈方焘(通讯作者)

    2012-01-01

      目的:探讨急性心肌梗死患者血脂浓度、血压与颈动脉(IMT)粥样硬化斑块的关系.方法:应用彩色多普勒超声检查急性心肌梗死患者的颈动脉内膜—中膜厚度,斑块数和性状,同时检测血压、血脂.186例急性心肌梗死患者根据有无高血压,分为心肌梗死组 A 组47例、高血压并发心肌梗死组 B 组139例,设健康体验者作对照组 C 组70例.各种数据进行统计学分析.结果:B 组颈动脉粥样硬化斑块发生率最高(94.8%),且以软斑及混合斑为主,A 组次之(66.1%),C 组最低(22.9%).与无颈动脉粥样硬化斑块相比,有颈动脉粥样硬化斑块患者血清低密度脂蛋白胆固醇(LDL-C)水平明显升高.结论:颈动脉粥样硬化斑块是急性心肌梗死的重要危险因素,高血压及高 LDL-C 血症是颈动脉粥样硬化的危险因素.%  Objective in patients with acute myocardial infarction blood lipid concentration, blood pressure and carotid artery (IMT) atherosclerotic plaque relationship. Methods Color doppler ultrasound of acute myocardial infarction with carotid endarterectomy, film thickness, plaques number and characters, and measure blood pressure, cholesterol. 186 cases of acute myocardial infarction patients have according to high blood pressure, divided into A group of myocardial infarction 47 cases were, pressure and myocardial infarction group B group 139 examples, set the experience for the control group C health group 70 examples. The statistical analysis of the data. Result The group B carotid atherosclerotic plaques was highest (94.8%), and with the soft spot and mixed spot is given priority to, A second group (66.1%), the lowest group C (22.9%). And no carotid atherosclerotic plaques in carotid atherosclerotic plaques patients serum low density lipoprotein cholesterol (LDL)-C) a significantly higher level. Conclusion Carotid atherosclerotic plaque with acute myocardial infarction is an important risk factors

  19. Carotid artery surgery

    Science.gov (United States)

    Carotid endarterectomy; CAS surgery; Carotid artery stenosis - surgery; Endarterectomy - carotid artery ... through the catheter around the blocked area during surgery. Your carotid artery is opened. The surgeon removes ...

  20. High-normal blood pressure and carotid atherosclerotic plaque formation: The results from stroke population screening in Dongying, Shandong province%正常高值血压与颈动脉粥样硬化斑块形成:来自山东东营卒中筛查人群的结果

    Institute of Scientific and Technical Information of China (English)

    吴德云; 刘迎春; 高宗恩; 李楠; 杨志杰

    2014-01-01

    目的 探讨不同血压水平与颈动脉粥样斑块形成的相关性.方法 从2012年9月至2013年1月期间参加东营市卒中筛查的人群中,选取符合理想血压[收缩压(systolic blood pressure,SBP)< 120 mm Hg且舒张压(diastolic blood pressure,DBP)< 80 mm Hg,1 mm Hg =0.133 kPa]、正常血压[SBP 120~129 mm Hg和(或)DBP 80 ~84 mm Hg]和正常高值血压[SBP 130~139 mm Hg和(或)DBP 85~89 mm Hg]诊断标准的人群为研究对象,进行间卷调查、体格检查、血生化检查及颈部血管超声检查.比较正常血压组、正常高值血压组与理想血压组之间颈动脉斑块检出率,进行多变量logistic回归分析确定颈动脉斑块的独立危险因素.结果 正常血压组和正常高值血压组男性和糖尿病的构成比以及体质指数(body mass index,BMI)和空腹血糖(fasting blood glucose,FBG)水平均显著性高于理想血压组(P均<0.05).理想血压组、正常血压组和正常高值血压组颈动脉斑块检出率分别为12.41%、38.14%和49.45%.颈动脉斑块形成组男性构成比以及年龄、SBP、FBG和高半胱氨酸(homocysteine,Hcy)水平均显著性高于无颈动脉斑块形成组(P均<0.05).多变量logistic回归分析显示,年龄、SBP、FBG和Hcy为颈动脉粥样斑块形成的独立危险因素,女性为独立保护因素.在校正性别、年龄、FBG和Hcy等危险因素后,正常高值血压组斑块形成风险显著性高于理想血压组(优势比1.354,95%可信区间1.028~1.783;P=0.031),而正常血压组与理想血压组无显著性差异.结论 正常高值血压与颈动脉斑块形成风险增高显著相关,是颈动脉斑块形成的独立危险因素.%Objective To investigate the correlation between different blood pressure levels and carotid atherosclerotic plaque formation.Methods The population participated in stroke screening were selected from September 2012 to January 2013 in Dongying,Shandong province.The subjects met the

  1. 高分辨磁共振成像对颈动脉粥样硬化斑块表面钙化与斑块稳定性关系研究%Correlated study on superficial calcification and stability of carotid atherosclerotic plaque using high resolution MRI

    Institute of Scientific and Technical Information of China (English)

    彭少华; 王成伟; 尹喜

    2012-01-01

    Objective To evaluate the relationship of the shape,location of superficial calcification with stability of carotid atherosclerotic plaque using high resolution magnetic resonance imaging(MRI). Methods High resolution MRI was performed in the carotid artery of 34 patients with four sequences.including 3D-TOF,DIR T1WI,FSE T2WI and PDWI. The shape, location of superficial calcification with surface ulcer of carotid atherosclerotic plaque were evaluated. Results Out of 87 slices of superficial calcification, 59 slices plaques (67. 8%) showed surface ulcer. According to calcification type and location,64 slices were irregular (dotted/arcuated) calcification type,23 slices patch type,58 slices marginal calcification type and 29 slices central calcification type. Irregular superficial calcification was found more frequently with surface ulcer than patch calcification type. Marginal calcification type had higher possibility of surface ulcer than central calcification type. Conclusion Superficial calcification is an important factor for instability of atherosclerotic carotid plaque,which easily brings about surface ulcer on the carotid atherosclerotic plaque. The shape and location of superficial calcification are important factors of instability for atherosclerotic carotid plaque.%目的 通过高分辨磁共振成像(MRI)多序列扫描,分析颈动脉粥样硬化斑块的表面钙化的形状、位置与斑块稳定性的关系.方法 运用高分辨MRI多序列(3D-TOF、DIR T1WI、FSE T2WI、PDWI)对34例颈动脉斑块患者进行扫描,分析钙化类型和位置与斑块表面溃疡的关系.结果 87层表面钙化斑块,59层(67.8%)见斑块表面溃疡.按钙化类型和部位划分,64层为点状、弧形的不规则钙化,23层为大片状钙化;58层为边缘钙化,29层为中央钙化.不规则钙化组伴斑块表面溃疡的概率显著高于大片状钙化组;边缘钙化组较中央钙化组更易伴斑块表面溃疡.结论 表面钙化是斑块不稳

  2. Statin Treatment Is Associated with Reduction in Serum Levels of Receptor Activator of NF-κB Ligand and Neutrophil Activation in Patients with Severe Carotid Stenosis

    Directory of Open Access Journals (Sweden)

    Sébastien Lenglet

    2014-01-01

    Full Text Available Systemic and intraplaque biomarkers have been widely investigated in clinical cohorts as promising surrogate parameters of cardiovascular vulnerability. In this pilot study, we investigated if systemic and intraplaque levels of calcification biomarkers were affected by treatment with a statin in a cohort of patients with severe carotid stenosis and being asymptomatic for ischemic stroke. Patients on statin therapy had reduced serum osteopontin (OPN, RANKL/osteoprotegerin (OPG ratio, and MMP-9/pro-MMP-9 activity as compared to untreated patients. Statin-treated patients exhibited increased levels of collagen and reduced neutrophil infiltration in downstream portions of carotid plaques as compared to untreated controls. In upstream plaque portions, OPG content was increased in statin-treated patients as compared to controls. Other histological parameters (such as lipid, macrophage, smooth muscle cell, and MMP-9 content as well as RANKL, RANK, and OPG mRNA levels did not differ between the two patient groups. Serum RANKL/OPG ratio positively correlated with serum levels of neutrophilic products, intraplaque neutrophil, and MMP-9 content within downstream portions of carotid plaques. In conclusion, statin treatment was associated with improvement in serum RANKL levels and reduced neutrophil activity both systemically and in atherosclerotic plaques.

  3. A remodelling metric for angular fibre distributions and its application to diseased carotid bifurcations.

    LENUS (Irish Health Repository)

    Creane, Arthur

    2012-07-01

    Many soft biological tissues contain collagen fibres, which act as major load bearing constituents. The orientation and the dispersion of these fibres influence the macroscopic mechanical properties of the tissue and are therefore of importance in several areas of research including constitutive model development, tissue engineering and mechanobiology. Qualitative comparisons between these fibre architectures can be made using vector plots of mean orientations and contour plots of fibre dispersion but quantitative comparison cannot be achieved using these methods. We propose a \\'remodelling metric\\' between two angular fibre distributions, which represents the mean rotational effort required to transform one into the other. It is an adaptation of the earth mover\\'s distance, a similarity measure between two histograms\\/signatures used in image analysis, which represents the minimal cost of transforming one distribution into the other by moving distribution mass around. In this paper, its utility is demonstrated by considering the change in fibre architecture during a period of plaque growth in finite element models of the carotid bifurcation. The fibre architecture is predicted using a strain-based remodelling algorithm. We investigate the remodelling metric\\'s potential as a clinical indicator of plaque vulnerability by comparing results between symptomatic and asymptomatic carotid bifurcations. Fibre remodelling was found to occur at regions of plaque burden. As plaque thickness increased, so did the remodelling metric. A measure of the total predicted fibre remodelling during plaque growth, TRM, was found to be higher in the symptomatic group than in the asymptomatic group. Furthermore, a measure of the total fibre remodelling per plaque size, TRM\\/TPB, was found to be significantly higher in the symptomatic vessels. The remodelling metric may prove to be a useful tool in other soft tissues and engineered scaffolds where fibre adaptation is also present.

  4. Value of Ultrasound and Multi-slice Spiral CT in the Detection of Carotid Plaque Ulceration%超声联合多层螺旋CT血管成像对颈部动脉溃疡斑块的诊断价值

    Institute of Scientific and Technical Information of China (English)

    周悦; 齐恩林; 王东昕; 康洁; 姜立杰

    2016-01-01

    目的:探讨超声及多层螺旋CT血管成像(MSCTA)对颈部动脉溃疡斑块的诊断价值。方法选择2010~2014年于我院进行颈部超声检查和MSCTA检查的400例颈动脉斑块患者,比较溃疡斑块的发生率、颈动脉狭窄程度、不同部位溃疡斑块的检出情况及颈动脉斑块与脑缺血的关系。结果超声和MSCTA分别发现85处及142处溃疡斑块,两种检查方法对颈部溃疡斑块的检出率具统计学差异(P0.05),对3个不同部位(颈总动脉、颈总动脉分叉处、颈内动脉颅外段)溃疡斑块的检出率有统计学差异(P0.05). The plaque ulceration detection rates of the two methods in the examination of the three positional distribution have statistical difference (P<0.01).Plaque ulceration was statistically associated with symptomatic ischemic events (P<0.05).Conclusion Plaque ulceration is a risk factor of the development of cerebral ischemia. MSCTA can display carotid plaque ulceration more clearly than US. US can be used as the ifrst choice of the carotid artery imaging, whereas MSCTA should be followed if vascular lesion found with US.

  5. 格列吡嗪合并辛伐他汀对颈动脉粥样硬化斑块的疗效观察%Therapeutic Efficacy of Simvastatin plus Glipizide in Patients with Carotid Atherosclerotic Plaques

    Institute of Scientific and Technical Information of China (English)

    胡军; 曾慰; 胡名松

    2011-01-01

    目的:研究辛伐他汀对治疗并发高脂血症的颈动脉粥样硬化斑块的影响,以及合用格列吡嗪对辛伐他汀的增效作用.方法:将高脂血症并发颈动脉粥样硬化患者108例,随机分为2组,辛伐他汀治疗组和格列吡嗪合并辛伐他汀治疗组,6个月治疗后,测量血脂生化指标、炎症因子活性和高频率彩色多普勒超声内-中膜厚度(IMT).结果:两个治疗组,治疗后与治疗前相比,血脂指标,炎症因子指标及其IMT值都具有显著性差异(P0.05),但LDL-C显著减少(P<0.05),两组间ET-1和TNF-α以及IMT值差异显著(P<0.05).结论:辛伐他汀能够改善血脂水平,降低炎症因子活性,进而对颈动脉粥硬化具有治疗作用,而合并格列吡嗪治疗能够起到增效作用.%Objective: To evaluate the therapeutic efficacy of simvastafin in patients with carotid atherosclerotic plaques complicated with hyperlipidemia,and the synergistic effect of glipizide. Methods: All the 108 patients were divided into two groups group treatment with simvastatin and group treatment with simvastatin and glipizide. After treatment for 6 months, we measured the biochemical indicator of blood fat, included TC,TG,LDL-C and HDL-C ,the activity of inflammatory factors, included ET-1 and TNF-α, and the intima-media thickness (IMT). Results: Both of the 2 groups, the scores of biochemical indicator of blood lipids, activity of inflammatory factors and intima-media thickness (IMT) were changed significantly after treatment (P<0.05). Compared with group treatment with simvastatin, the changes of the scores of TC, TG and HDL-C were not significant (P>0.05). However, the scores of LDL-C, activity of inflammatory factors and IMT were decreased significantly (tP<0.05). Conclusiom: Simvastatin could improve carotid atherosclerosis, through improving the level of blood iipids and reducing the activity of inflammatory factors, and glipizide had a synergistic effect.

  6. Statins and their use in preventing carotid disease

    DEFF Research Database (Denmark)

    Sillesen, H.

    2009-01-01

    Carotid disease may be evaluated by surrogate outcomes, such as intima-media thickness and carotid plaque features, and by clinical end points. Statins stop progression or may induce regression of intima-media thickness, and statins may also stop plaque growth or even induce reduction of plaque...... volume. Areas rich in lipids within plaques may be reduced in size and/or in number of inflammatory cells. Ultrasound reflectivity may be reduced by statin treatment, indicating less lipid/inflammatory content. Finally, statins appear to reduce the risk of all cardiovascular events (eg, stroke...

  7. Leukotriene B4 levels in human atherosclerotic plaques and abdominal aortic aneurysms.

    Directory of Open Access Journals (Sweden)

    Pleunie van den Borne

    Full Text Available BACKGROUND: Leukotriene B4 (LTB4 has been associated with the initiation and progression of atherosclerosis and abdominal aortic aneurysm (AAA formation. However, associations of LTB4 levels with tissue characteristics and adverse clinical outcome of advanced atherosclerosis and AAA are scarcely studied. We hypothesized that LTB4 levels are associated with a vulnerable plaque phenotype and adverse clinical outcome. Furthermore, that LTB4 levels are associated with inflammatory AAA and adverse clinical outcome. METHODS: Atherosclerotic plaques and AAA specimens were selected from two independent databases for LTB4 measurements. Plaques were isolated during carotid endarterectomy from asymptomatic (n = 58 or symptomatic (n = 317 patients, classified prior to surgery. LTB4 levels were measured without prior lipid extraction and levels were corrected for protein content. LTB4 levels were related to plaque phenotype, baseline patient characteristics and clinical outcome within three years following surgery. Seven non-diseased mammary artery specimens served as controls. AAA specimens were isolated during open repair, classified as elective (n = 189, symptomatic (n = 29 or ruptured (n = 23. LTB4 levels were measured similar to the plaque measurements and were related to tissue characteristics, baseline patient characteristics and clinical outcome. Twenty-six non-diseased aortic specimens served as controls. RESULTS: LTB4 levels corrected for protein content were not significantly associated with histological characteristics specific for vulnerable plaques or inflammatory AAA as well as clinical presentation. Moreover, it could not predict secondary manifestations independently investigated in both databases. However, LTB4 levels were significantly lower in controls compared to plaque (p = 0.025 or AAA (p = 0.017. CONCLUSIONS: LTB4 levels were not associated with a vulnerable plaque phenotype or inflammatory AAA or clinical

  8. Asymptomatic internal carotid artery stenosis and cerebrovascular risk stratification

    DEFF Research Database (Denmark)

    Nicolaides, Andrew N; Kakkos, Stavros K; Kyriacou, Efthyvoulos

    2010-01-01

    The purpose of this study was to determine the cerebrovascular risk stratification potential of baseline degree of stenosis, clinical features, and ultrasonic plaque characteristics in patients with asymptomatic internal carotid artery (ICA) stenosis....

  9. Local effects of atherosclerotic plaque on arterial distensibility.

    Science.gov (United States)

    Giannattasio, C; Failla, M; Emanuelli, G; Grappiolo, A; Boffi, L; Corsi, D; Mancia, G

    2001-11-01

    Hypertension, diabetes, and hypercholesterolemia are characterized by a reduction in arterial distensibility and by accelerated atherosclerosis. Whether arterial stiffening is an inherent feature of these conditions or just the consequence of the atherosclerotic clinical or subclinical lesions is not known, however. Our aim was to obtain information on this issue by directly measuring, in humans, arterial distensibility both at the site of an atherosclerotic lesion and at the proximal normal site. In 10 patients (8 men; mean+/-SEM age, 65.2+/-3.4 years) affected by monolateral hemodynamic significant internal carotid artery stenosis, we measured arterial distensibility (Wall Track System; PIE Medical) bilaterally, both at the internal carotid artery and at the common carotid artery level. In the common carotid artery, measurements were made 3 cm below the bifurcation. In the affected internal carotid artery, measurements were made at the plaque shoulder (wall thickness of 2 mm). Measurements were made in the contralateral internal carotid artery at a symmetrical level. Arterial wall thickness was measured in the same site of arterial distensibility. Arterial distensibility was less in the internal than in the common carotid artery, with a marked reduction at the plaque internal carotid artery level compared with the corresponding contralateral site (-45%, P<0.01). It was also less, however, in the common carotid artery branching into the atherosclerotic internal carotid artery than in the contralateral common carotid artery (-25%, P<0.05). Wall thickness was similar in the 2 common carotid arteries and obviously greater in the affected internal carotid artery than in the contralateral artery. Arterial distensibility was markedly less in the internal carotid artery where there was a plaque compared with the intact contralateral internal carotid artery; it was also less, however, in the common carotid artery of the affected side in comparison with the contralateral

  10. The Correlation Between Glycosylated Hemoglobin,Central Aortic Pressure and the Formation of the Carotid Artery Plaque with the Patients of Type 2 Diabetes Mellitus%2型糖尿病患者 HbA1 c1 CAP 水平与颈动脉斑块关系的研究

    Institute of Scientific and Technical Information of China (English)

    奥日瀚; 李冬梅

    2015-01-01

    Objective To study the correlation between glycosylated hemoglobin ,central aortic pressure and the formation of the carotid artery plaque with the patients of type 2 diabetes mellitus .Methods Determi-nating the glycosylated hemoglobin ,average fasting blood glucose and peripheral blood pressure ,central aortic pressure( including central systolic pressure ,diastolic pressure ,central pulse pressure) ,of 120 diabetes mellitus patients (diabetes mellitus group) and 100 healthy volunteers (normal control group) .Then according to the re-sult of ultrasound ,the patients were divided into carotid artery plaque group and non -plaque group ,all the data were determined again ,the correlation between glycosylated hemoglobin ,central aortic pressure and the forma-tion of the carotid artery plaque was analyzed by SPSS .Results (1 ) The glycosylated hemoglobin ,average fast-ing blood glucose levels of diabetes group are significantly higher than those of normal control group .(2 )There is no significant difference between systolic central aortic pressure and central pulse pressure of the diabetes mellitus group and those of normal control group .(3 )Glycosylated hemoglobin ,average fasting blood glucose ,central pulse pressure ,systolic central aortic pressure of carotid artery plaque group levels were significantly higher than those of non-plaque group( P<0 .0 1 ) .(4 )Glycosylated hemoglobin levels and the incidence of carotid plaques were positively correlated in diabetes group .(5 )Multiple linear regression analysis showed that for the patients of type 2 diabetes ,glycosylated hemoglobin ,central systolic pressure and central pulse pressure is risk factors of oc-currence and development of carotid plaques .Conclusion Concentrating glycosylated hemoglobin ,central sys-tolic pressure the central pulse pressure helps to monitor the occurrence and development of diabetic carotid plaques .%目的:探讨2型糖尿病患者糖化血红蛋白及中心动脉压与颈动脉

  11. Control study of Beraprost Sodium and atorvastatin in treatment with TIA combined carotid plaques%贝前列素钠联合阿托伐他汀治疗TIA合并颈动脉斑块的对照研究

    Institute of Scientific and Technical Information of China (English)

    郑静红; 吴文君; 佘子瑜; 梁群娣; 潘军利

    2014-01-01

    目的:探讨贝前列素钠联合阿托伐他汀治疗短暂性脑缺血发作(transient ischemic attack,TIA)合并颈动脉斑块的治疗效果。方法选择我院收治的60例TIA合并颈动脉斑块患者,随机分为观察组和对照组各30例,观察组接受贝前列素钠和阿托伐他汀钙治疗,对照组单用阿托伐他汀钙治疗,12个月后比较两组颈动脉斑块面积变化和凝血功能情况。结果观察组颈动脉斑块面积明显小于对照组,2组比较差异具有统计学意义(P<0.05);治疗后观察组血小板聚集率(platelet agglutination test,PAgT)、血浆纤维蛋白原(fibrinogen,Fg)、超敏C反应蛋白(hypersensitive 3 C-reaction protein,hsCRP)、总胆固醇(total cholesterol,TC)、高密度脂蛋白胆固醇(high density lipoprotein cholesterol,HDL)、低密度脂蛋白胆固醇(low density lipoprotein cholesterol,LDL)、TIA复发率及缺血性脑卒中发生率与对照组比较均有统计学意义(P<0.05)。结论贝前列素钠联合阿托伐他汀在减小颈动脉斑块面积、调节血脂和预防TIA及缺血卒中发生方面具有良好的作用,值得临床推广应用。%Objective To investigate the effect of Beraprost Sodium and atorvastatin in the treatment of TIA combined carotid plaques. Method 60 cases in our hospital with TIA and carotid artery plaques were randomly divided into observation group and control group, 30 cases in each group. The observation group was received beraprost natriuretic peptide and atorvastatin calcium therapy, the control group was treated with atorvastatin calcium. 12 months later,two groups were compared with carotid plaque area change and coagulation conditions. Results Carotid plaque area in observed group was significantly less than the control group (P<0.05). The differences of platelet agglutination test(PAgT), fibrinogen(Fg) , hypersensieive 3 C-reaction protein, total cholesterol(TC), high density lipoprotein

  12. Asymptomatic internal carotid artery stenosis and cerebrovascular risk stratification

    DEFF Research Database (Denmark)

    Nicolaides, Andrew N; Kakkos, Stavros K; Kyriacou, Efthyvoulos;

    2010-01-01

    The purpose of this study was to determine the cerebrovascular risk stratification potential of baseline degree of stenosis, clinical features, and ultrasonic plaque characteristics in patients with asymptomatic internal carotid artery (ICA) stenosis.......The purpose of this study was to determine the cerebrovascular risk stratification potential of baseline degree of stenosis, clinical features, and ultrasonic plaque characteristics in patients with asymptomatic internal carotid artery (ICA) stenosis....

  13. THREE-DIMENSIONAL ULTRASOUND AND STENOSIS OF INTERNAL CAROTID ARTERY

    Directory of Open Access Journals (Sweden)

    Vojko Flis

    2003-12-01

    Full Text Available Background. Elucidation of the ultrasound structure of the atherosclerotic plaque in stenosis of internal carotid artery may have important implications for carotid surgery. This study compares the ability of computer derived 3D ultrasound gray scale volumetric measurements to diferentiate between ultrasonic structure of symptomatic and asymptomatic carotid plaque causing more than 70% stenosis.Methods. Eightysix internal carotid artery stenoses (70–99%, 45 symptomatic, 41 asymptomatic were imaged with 3D ultrasound to obtain the whole volume of the atherosclerotic plaque. Digitalized sonograms were computerized and normalized to the gray scale median (GSM of blood (0 and vessel adventitia (200. Plaque GSM was obtained for the whole volume by computing the volume ratio between echolucent and echogenic areas. The plaque heterogeneity was obtained by computing the density of echogenic areas per volume unit. Parametric t test was used for statistic analysis.Results. Minimum volume GSM ratio (determining echolucency was higher for asymptomatic plaque (0.6 – CI 0.48– 0.91 versus 0.3 – CI 0.21–0.75: p = 0.002. Greater GSM heterogeneity was present in symptomatic plaque (6.8 – CI 2.5– 18.3 versus 0.41 – CI 0.2–3.4;.p = 0.0001.Conclusions. Volume ultrasound imaging that enables objective assessment of whole ultrasonic plaque structure is more sensitive that single longitudinal view sonography for differentiating between ultrasonic structure of symptomatic and asymptomatic plaque.

  14. Numerical observer for atherosclerotic plaque classification in spectral computed tomography.

    Science.gov (United States)

    Lorsakul, Auranuch; Fakhri, Georges El; Worstell, William; Ouyang, Jinsong; Rakvongthai, Yothin; Laine, Andrew F; Li, Quanzheng

    2016-07-01

    Spectral computed tomography (SCT) generates better image quality than conventional computed tomography (CT). It has overcome several limitations for imaging atherosclerotic plaque. However, the literature evaluating the performance of SCT based on objective image assessment is very limited for the task of discriminating plaques. We developed a numerical-observer method and used it to assess performance on discrimination vulnerable-plaque features and compared the performance among multienergy CT (MECT), dual-energy CT (DECT), and conventional CT methods. Our numerical observer was designed to incorporate all spectral information and comprised two-processing stages. First, each energy-window domain was preprocessed by a set of localized channelized Hotelling observers (CHO). In this step, the spectral image in each energy bin was decorrelated using localized prewhitening and matched filtering with a set of Laguerre-Gaussian channel functions. Second, the series of the intermediate scores computed from all the CHOs were integrated by a Hotelling observer with an additional prewhitening and matched filter. The overall signal-to-noise ratio (SNR) and the area under the receiver operating characteristic curve (AUC) were obtained, yielding an overall discrimination performance metric. The performance of our new observer was evaluated for the particular binary classification task of differentiating between alternative plaque characterizations in carotid arteries. A clinically realistic model of signal variability was also included in our simulation of the discrimination tasks. The inclusion of signal variation is a key to applying the proposed observer method to spectral CT data. Hence, the task-based approaches based on the signal-known-exactly/background-known-exactly (SKE/BKE) framework and the clinical-relevant signal-known-statistically/background-known-exactly (SKS/BKE) framework were applied for analytical computation of figures of merit (FOM). Simulated data of a

  15. Relationships between leukoaraiosis and internal carotid artery stenosis and ulcerated plaques in patients with acute cerebral infarction%急性脑梗死患者脑白质疏松与颈内动脉狭窄及溃疡性斑块的关系

    Institute of Scientific and Technical Information of China (English)

    王世芳; 肖卫民; 吴志强; 罗根培; 李润雄

    2012-01-01

    Objective To investigate the relationships between leukoaraiosis ( LA) and internal carotid artery stenosis and ulcerated plaques in patients with acute cerebral infarction. Methods A total of 102 consecutive patients with the first onset of acute cerebral infarction were enrolled in the study. They were all underwent neck vascular examinations with magnetic resonance imaging and digital subtraction an-giography ( DSA). The internal carotid artery lesions were identified. The patients were divided into LA or non-LA groups according to their MR, and they were redivided into a subcortical LA group and periventric-ular LA group according to the location of LA. The relationships between the location and severity of LA and internal carotid artery stenosis and ulcerated plaque were analyzed. Multivariate logistic regression analysis affected the relevant factors of different locations of LA. Results ①The incidences of internal carotid artery stenosis and ulcerated plaques had no significant difference between the LA group and the non-LA group (all P>0.05). ②In the subcortical LA group, 26. 1% patients (12/46) had ulcerated carotid plaques, which was higher than 10.7% (6/56) in the non-subcortical LA group (P0. 05). ③There was no significant difference in the incidence of ulcerated carotid plaques between the periventricular LA group and the periventricular non-LA group (P>0. 05). ④Multivariate analysis showed that age (OR = 1. 071 , 95% CI 1. 014 - 1. 131 ) , hypertension ( OR = 2. 953, 95% CI 1. 006 -8. 671 ) , and ulcerated carotid plaques ( OR = 1. 949 , 95% CI 1.286 -3.142) were the independent predictors of subcortical LA; the independently associated factors of periventricular LA were age ( OR = 1. 069, 95% CI 1.010-1.131) and hypertension (OR =3. 293, 95% CI 1.984 -11.020). Conclusion Among the patients with acute cerebral infarction , ulcerated carotid plaques are associated with the subcortical leukoaraiosis, and there is no significant relationship with

  16. Impact of bariatric surgery on carotid artery inflammation and the metabolic activity in different adipose tissues.

    Science.gov (United States)

    Bucerius, Jan; Vijgen, Guy H E J; Brans, Boudewijn; Bouvy, Nicole D; Bauwens, Matthias; Rudd, James H F; Havekes, Bas; Fayad, Zahi A; van Marken Lichtenbelt, Wouter D; Mottaghy, Felix M

    2015-05-01

    In this study, we unravel a molecular imaging marker correlated with the known reduction of cardiovascular events (most commonly related to vulnerable plaques) in morbidly obese patients after bariatric surgery (BaS).We prospectively imaged 10 morbidly obese subjects with F-fluorodeoxyglucose (F-FDG) positron emission tomography/computed tomography before and 1 year after BaS. F-FDG uptake-which is enhanced in inflamed, atherosclerotic vessels and in metabolically active adipose tissues-was quantified in the carotids, pericardial adipose tissue (PAT), visceral adipose tissue (VAT), as well as brown adipose tissue (BAT). The degree of carotid inflammation was compared to lean and overweight controls.Carotid inflammation significantly declined leading to an F-FDG uptake comparable to the 2 control groups. Metabolic activity significantly decreased in PAT and VAT and increased in BAT.BaS leads to a normalization of carotid artery inflammation and a beneficial impact on the metabolic activity in PAT, VAT, and BAT that is related to the metabolic syndrome observed in this patient group.

  17. [The effect of carotid endarterectomy on cognitive disturbances in patients with atherosclerotic stenosis of carotid arteries].

    Science.gov (United States)

    Iakhno, N N; Fedorova, T S; Damulin, I V; Shcherbiuk, A N; Vinogradov, O A; Lavrent'ev, A V

    2011-01-01

    Clinical and neuropsychological features of non-dementia cognitive disturbances were studied in 102 patients with atherosclerotic carotid stenosis. Cognitive disturbances were assessed after the carotid endarterectomy (CEAE). Mild cognitive impairment was found in 37 (36,3%) of patients, moderate cognitive impairment was diagnosed in 36 (35,3%)patients. Moderate cognitive impairment was found more often in patients with symptomatic carotid stenosis with structural brain changes confirmed by neuroimaging data and with instable atherosclerotic plaques with the predomination of hypodensity component. It allows to suggest that both the reduction of perfusion and arterio-arterial microemboli may cause cognitive dysfunction in patients with atherosclerotic carotid stenosis. The data on the positive effect of CEAE on cognitive functions have been obtained. The positive changes were more distinct in patients with asymptomatic course of carotid stenosis. However CEAE may have a negative effect on cognitive functions in patients with moderate cognitive impairment of dysmnestic character and symptomatic carotid stenosis.

  18. Optimization of K-edge imaging for vulnerable plaques using gold nanoparticles and energy resolved photon counting detectors: a simulation study.

    Science.gov (United States)

    Alivov, Yahya; Baturin, Pavlo; Le, Huy Q; Ducote, Justin; Molloi, Sabee

    2014-01-06

    We investigated the effect of different imaging parameters, such as dose, beam energy, energy resolution and the number of energy bins, on the image quality of K-edge spectral computed tomography (CT) of gold nanoparticles (GNP) accumulated in an atherosclerotic plaque. A maximum likelihood technique was employed to estimate the concentration of GNP, which served as a targeted intravenous contrast material intended to detect the degree of the plaque's inflammation. The simulation studies used a single-slice parallel beam CT geometry with an x-ray beam energy ranging between 50 and 140 kVp. The synthetic phantoms included small (3 cm in diameter) cylinder and chest (33 × 24 cm(2)) phantoms, where both phantoms contained tissue, calcium and gold. In the simulation studies, GNP quantification and background (calcium and tissue) suppression tasks were pursued. The x-ray detection sensor was represented by an energy resolved photon counting detector (e.g., CdZnTe) with adjustable energy bins. Both ideal and more realistic (12% full width at half maximum (FWHM) energy resolution) implementations of the photon counting detector were simulated. The simulations were performed for the CdZnTe detector with a pixel pitch of 0.5-1 mm, which corresponds to a performance without significant charge sharing and cross-talk effects. The Rose model was employed to estimate the minimum detectable concentration of GNPs. A figure of merit (FOM) was used to optimize the x-ray beam energy (kVp) to achieve the highest signal-to-noise ratio with respect to the patient dose. As a result, the successful identification of gold and background suppression was demonstrated. The highest FOM was observed at the 125 kVp x-ray beam energy. The minimum detectable GNP concentration was determined to be approximately 1.06 µmol mL(-1) (0.21 mg mL(-1)) for an ideal detector and about 2.5 µmol mL(-1) (0.49 mg mL(-1)) for a more realistic (12% FWHM) detector. The studies show the optimal

  19. 肺炎衣原体和巨细胞病毒感染与颈动脉粥样硬化斑块及其稳定性的相关性%Correlations between chlamydophila pneumoniae, cytomegalovirus infection and carotid atherosclerotic plaque and its stability

    Institute of Scientific and Technical Information of China (English)

    曹磊光; 王涛

    2014-01-01

    group,and the healthy subjects (IMT < 1.0 mm) were used as a control group.Enzyme-linked immunosorbent assay (ELISA) was used to detect the antibody levels and positive rates of the serum anti-Cpn and anti-CMV IgG.The demography,vascular risk factors,anti-Cpn and anti-CMV IgG antibody positive rates of the carotid atherosclerosis group and the control group were compared.Results A total of 92 patients of the carotid atherosclerosis group were enrolled,including 30 patients with stable plaque and 62 with unstable plaque; a total of 49 healthy subjects of the control group were enrolled.There were no significant differences in the proportions of age,male,hypertension,diabetes,hyperlipidemia,and smoking patients between the carotid atherosclerosis group and the control group (all P >0.05).The anti-Cpn IgG (69.5% vs.26.5% ; x2 =23.887,P < 0.001),anti-CMV IgG positive rate (75.0% vs.30.6% ; x2 =26.156,P < 0.001),and anti-Cpn IgG + anti-CMV positive rate (51.2% vs.10.2% ;x2 =24.006,P <0.001) of the carotid atherosclerosis group were significantly higher than those of the control group.In the atherosclerosis group,there were no significant difference in the proportions of age,male,hypertension,diabetes,hyperlipidemia,and smoking patients between the unstable plaque subgroup and the stable plaque subgroup (all P> 0.05).The anti-Cpn IgG (80.6% vs.46.7%; x2=11.025,P=0.001),anti-CMV IgG positive rate (83.9% vs.56.7%;x2 =7.980,P=0.005) and anti-Cpn IgG + anti-CMV positive IgG rate (44.6% vs.7.6% ; x2 =10.210,P =0.006) of the unstable plaque subgroup were significantly higher than those of stable plaque subgroup.Conelusions The occurrence of carotid atherosclerosis and the stability of plaque are associated with the Cpn and CMV infection.The Cpn and CMV infection may be the important factors for the occurrence of carotid atherosclerosis plaques and unstable plaques.

  20. 冠状动脉血管内超声优化临界病变易损斑块诊治的研究%Coronary intravascular ultrasonography optimizes diagnosis and treatment of vulnerable plaque in intermediate stenosis

    Institute of Scientific and Technical Information of China (English)

    冯瑞; 雷家俨; 黄玮

    2013-01-01

    stenosis (% AS) and diameter stenosis (%DS).The types, characteristics and compositions of coronary plaques were observed with the IVUS and iMAP-IVUS.Stent implantation was performed on the patient with % AS ≥70% by IVUS.Results QCA and IVUS showed that the MLD, % DS and % AS were 1.75 ± 0.39 vs 2.07 ± 0.40 mm, (35.04 ± 13.60) % vs (46.37 ±8.02)%, and (52.91 ±15.96)% vs (62.61 ±11.54)%, respectively (P<0.05).Myocardial bridging was identified in 7 patients (36.8% ) by QCA, and in 10 patients (52.6% ) by IVUS.IVUS showed there were 63.2% soft plaques, 15.8% fibrotic plaques, 10.5% calcified plaques, and 10.5% mixed plaques; there were 84.2% eccentric plaques and 15.8% concentric plaques; and there were 57.9% positive remodeling, 26.3% negative remodeling, and 15.8% non-remodeling.iMAP-IVUS showed there were 14 cases of thin-cap fibroatheroma (TCFA).We presumed that positive remodeling might be associated with instability of plaques.Conclusion IVUS improves the accuracy of intermediate stenosis diagnosis, and easy to find out vulnerable plaque.So it is helpful to screen the patients with high risk so as to carry out early intervention and treatment.

  1. The Current Role of Carotid Duplex Ultrasonography in the Management of Carotid Atherosclerosis: Foundations and Advances

    Directory of Open Access Journals (Sweden)

    Kelly R. Byrnes

    2012-01-01

    Full Text Available The management of atherosclerotic carotid occlusive disease for stroke prevention has entered a time of dramatic change. Improvements in medical management have begun to challenge traditional interventional approaches to asymptomatic carotid stenosis. Simultaneously, carotid artery stenting (CAS has emerged as an alternative to carotid endarterectomy (CE. Finally, multiple factors beyond degree of stenosis and symptom status now mitigate clinical decision making. These factors include brain perfusion, plaque morphology, and patency of intracranial collaterals (circle of Willis. With all of these changes, it seems prudent to review the role of carotid duplex ultrasonography in the management of atherosclerotic carotid occlusive disease for stroke prevention. Carotid duplex ultrasonography (CDU for initial and serial imaging of the carotid bifurcation remains an essential component in the management of carotid bifurcation disease. However, correlative axial imaging modalities (computer tomographic angiography (CTA and contrast-enhanced magnetic resonance angiography (CE-MRA increasingly aid in the assessment of individual stroke risk and are important in treatment decisions. The purpose of this paper is twofold: (1 to discuss foundations and advances in CDU and (2 to evaluate the current role of CDU, in light of other imaging modalities, in the clinical management of carotid atherosclerosis.

  2. High-resolution intravascular magnetic resonance quantification of atherosclerotic plaque at 3T

    Directory of Open Access Journals (Sweden)

    Qian Di

    2012-03-01

    Full Text Available Abstract Background The thickness of fibrous caps (FCT of atherosclerotic lesions is a critical factor affecting plaque vulnerability to rupture. This study tests whether 3 Tesla high-resolution intravascular cardiovascular magnetic resonance (CMR employing tiny loopless detectors can identify lesions and accurately measure FCT in human arterial specimens, and whether such an approach is feasible in vivo using animal models. Methods Receive-only 2.2 mm and 0.8 mm diameter intravascular loopless CMR detectors were fabricated for a clinical 3 Tesla MR scanner, and the absolute signal-to-noise ratio determined. The detectors were applied in a two-step protocol comprised of CMR angiography to identify atherosclerotic lesions, followed by high-resolution CMR to characterize FCT, lesion size, and/or vessel wall thickness. The protocol was applied in fresh human iliac and carotid artery specimens in a human-equivalent saline bath. Mean FCT measured by 80 μm intravascular CMR was compared with histology of the same sections. In vivo studies compared aortic wall thickness and plaque size in healthy and hyperlipidemic rabbit models, with post-mortem histology. Results Histology confirmed plaques in human specimens, with calcifications appearing as signal voids. Mean FCT agreed with histological measurements within 13% on average (correlation coefficient, R = 0.98; Bland-Altman analysis, -1.3 ± 68.9 μm. In vivo aortic wall and plaque size measured by 80 μm intravascular CMR agreed with histology. Conclusion Intravascular 3T CMR with loopless detectors can both locate atherosclerotic lesions, and accurately measure FCT at high-resolution in a strategy that appears feasible in vivo. The approach shows promise for quantifying vulnerable plaque for evaluating experimental therapies.

  3. Carotid endarterectomy: current consensus and controversies.

    Science.gov (United States)

    Meerwaldt, Robbert; Hermus, Linda; Reijnen, Michel M P J; Zeebregts, Clark J

    2010-10-01

    Stroke is the third most common cause of mortality, and carotid artery stenosis causes 8% to 29% of all ischemic strokes. Best medical treatment forms the basis of carotid stenosis treatment, and carotid endarterectomy (CEA) has an additional beneficial effect in high-grade stenosis. Carotid angioplasty and stenting (CAS) has challenged CEA as a primary carotid intervention. At present, CEA remains the gold standard, but in the future, CAS techniques will evolve and might become beneficial for subgroups of patients with carotid stenosis. This chapter briefly describes the history of carotid interventions and current consensus and controversies in CEA. In the last two years, several meta-analyses were published on a variety of aspects of best medical treatment, CEA, and CAS. It is still a matter of debate as to whether asymptomatic patients with carotid stenosis should undergo a carotid intervention. Especially because medical treatment has dramatically evolved since the early carotid trials. On the other hand, it is clear that carotid interventions in symptomatic patients with a high-grade stenosis should be performed as early as possible after the initial neurological event in order to achieve optimal stroke risk reduction. In CEA, the use of patching is advocated above primary closure, while the role of selective patching is still unclear. No differences in stroke and mortality rates are observed for routine versus selective shunting, for conventional versus eversion CEA, or for local versus general anesthesia. It is anticipated that in the future, there will be several interesting developments in carotid interventions such as plaque morphology analysis, acute interventions during stroke in progress, and further evolvement of CAS techniques.

  4. Carotid Ultrasound Imaging

    Science.gov (United States)

    ... News Physician Resources Professions Site Index A-Z Ultrasound - Carotid Carotid ultrasound uses sound waves to produce ... limitations of Carotid Ultrasound Imaging? What is Carotid Ultrasound Imaging? Ultrasound is safe and painless, and produces ...

  5. Association between triglyceride/HDL cholesterol ratio and carotid atherosclerosis in postmenopausal middle-aged women.

    Science.gov (United States)

    Masson, Walter; Siniawski, Daniel; Lobo, Martín; Molinero, Graciela; Huerín, Melina

    2016-01-01

    The triglyceride/HDL cholesterol ratio, as a surrogate marker of insulin resistance, may be associated to presence of subclinical carotid atherosclerosis in postmenopausal women. The aim of this study was to explore this association. Women (last menstrual period≥2 years) in primary prevention up to 65 years of age were recruited. Association between the triglyceride/HDL cholesterol (HDL-C) ratio and presence of carotid plaque, assessed by ultrasonography, was analyzed. ROC analysis was performed, determining the precision of this ratio to detect carotid plaque. A total of 332 women (age 57±5 years) were recruited. Triglyceride/HDL-C ratio was 2.35±1.6. Prevalence of carotid plaque was 29%. Women with carotid plaque had higher triglyceride/HDL-C ratios (3.33±1.96 vs. 2.1±1.2, P<.001) than women with no carotid plaque. A positive relationship was seen between quintiles of this ratio and prevalence of carotid plaque (p<.001). Regardless of other risk factors, women with higher triglyceride/HDL-C ratios were more likely to have carotid plaque (odds ratio 1.47, 95% confidence interval 1.20-1.79, P<.001). The area under the curve of the triglyceride/HDL-C ratio to detect carotid plaque was .71 (95% confidence interval .65 to .76), and the optimal cut-off point was 2.04. In postmenopausal women in primary prevention, insulin resistance, estimated from the triglyceride/HDL-C ratio, was independently associated to a greater probability of carotid plaque. A value of such ratio greater than 2 may be used for assessing cardiovascular risk in this particular group of women. Copyright © 2016 SEEN. Publicado por Elsevier España, S.L.U. All rights reserved.

  6. ULTRASONOGRAPHIC ASSESSMENT OF COMMON CAROTID ARTERY ATHEROSCLEROSIS IN PATIENTS OF RHEUMATOID ARTHRITIS

    Directory of Open Access Journals (Sweden)

    Jayakumar

    2015-02-01

    Full Text Available BACKGROUND & OBJECTIVES: Patients with Rheumatoid Arthritis (R.A. have a marked increase in Carotid Atherosclerosis independent of traditional risk factors like family history of myocardial infarction in first degree male relatives younger than 55 years of age or first degree female relatives younger than 65 years of age, smoking, hypertension (D efined as blood pressure of 140/90 mm hg or higher, diabetes mellitus and fasting serum cholesterol levels including age. Chronic inflammation and possibly disease severity and duration are atherogenic in Rheumatoid Arthritis patients. Preclinical disease may also be identified by using ultrasonography to determine carotid intimal - media thickness, an indirect measure of atherosclerosis. The common carotid artery Intima media thickness in Rheumatoid Arthritis patients is positively associated with disease duration, Early Rheumatoid Arthritis (D uration less or = 1 year is associated with lesser Intima media thickness than was Rheumatoid Arthritis of longer duration. Increased carotid artery Intima media thickness and the presence of carotid plaque are associated with markers of systemic inflammation in patients with Rheumatoid Arthritis and in healthy subjects. OBJECTIVE OF THE STUDY: To determine preclinical atherosclerosis occurring prematurely in patients of Rheumatoid Arthritis by ultrasonograhic measurement Common Carotid Artery Intima media thickness and to evaluate the risk factors associated with arterial intima media thickness in patient of Rheumatoid Arthritis. RESULTS: In RA patients, common carotid artery IMT was significantly higher when compared to healthy controls (0.65 ± 0.06 v/s 0.57 ± 0.049 and was significantly associated with the duration of RA, swollen joint count and erosive changes on hand x - ray independently of other confounding variables. CONCLUSION: Patients with rheumatoid arthritis have a marked increase in carotid atherosclerosis independent of traditional risk factors

  7. Overexpression of Prolyl-4-Hydroxylase-α1 Stabilizes but Increases Shear Stress-Induced Atherosclerotic Plaque in Apolipoprotein E-Deficient Mice

    Science.gov (United States)

    Liu, Xin-xin; Li, Meng-meng; Zhang, Yu; Chen, Liang; Wang, Lin; Di, Ming-xue

    2016-01-01

    The rupture and erosion of atherosclerotic plaque can induce coronary thrombosis. Prolyl-4-hydroxylase (P4H) plays a central role in the synthesis of all known types of collagens, which are the most abundant constituent of the extracellular matrix in atherosclerotic plaque. The pathogenesis of atherosclerosis is thought to be in part caused by shear stress. In this study, we aimed to investigate a relationship between P4Hα1 and shear stress-induced atherosclerotic plaque. Carotid arteries of ApoE−/− mice were exposed to low and oscillatory shear stress conditions by the placement of a shear stress cast for 2 weeks; we divided 60 male ApoE−/− mice into three groups for treatments with saline (mock) (n = 20), empty lentivirus (lenti-EGFP) (n = 20), and lentivirus-P4Hα1 (lenti-P4Hα1) (n = 20). Our results reveal that after 2 weeks of lenti-P4Hα1 treatment both low and oscillatory shear stress-induced plaques increased collagen and the thickness of fibrous cap and decreased macrophage accumulation but no change in lipid accumulation. We also observed that overexpression of P4Ha1 increased plaque size. Our study suggests that P4Hα1 overexpression might be a potential therapeutic target in stabilizing vulnerable plaques.

  8. Comparison of blood leukocyte telomere DNA content and vascular telomere DNA content in human carotid atherosclerotic plaques%人颈动脉粥样硬化斑块组织及外周血白细胞相对端粒长度的检测及相关性分析

    Institute of Scientific and Technical Information of China (English)

    陈宇; 刘继斌; 刘鹏; 叶志东; 张伟丽; 惠汝太

    2012-01-01

    目的 研究人颈动脉粥样硬化斑块组织与外周血白细胞的DNA相对端粒长度是否有相关性,外周血白细胞能否反映血管组织的相对端粒长度,从而为外周血白细胞端粒长度与动脉粥样硬化的相关性研究提供依据.方法 分别取12例颈动脉内膜剥脱术患者的颈动脉内膜斑块组织及外周血,提取DNA,采用实时荧光定量PCR (qRT-PCR)的方法检测相对端粒长度,并进行相关性分析.结果 人颈动脉斑块的平均相对端粒长度(Relative telomere length,RTL)为0.56±0.12(平均值±标准差),显著高于外周血白细胞的平均相对端粒长度(0.45±0.13)(P=0.038).多元线性回归方法校正年龄、性别、体重指数、血脂水平、高血压、糖尿病等心血管病危险因素,表明来自同一患者颈动脉斑块组织和外周血白细胞的RTL具有显著的相关性(标化相关系数β=0.87; P=0.0001);外周血白细胞RTL与年龄呈负相关(标化相关系数β=-0.704,P<0.001);颈动脉斑块样本RTL与年龄呈负相关(标化相关系数β=-0.528,P=0.002).结论 人颈动脉斑块组织与外周血白细胞的相对端粒长度具有相关性,外周血白细胞是替代血管组织研究端粒长度与心血管疾病关系的一个重要指标.%Objective To investigate the relationship of relative telomere lengths (RTL) of vascular wall and circulating leukocytes in atherosclerosis patients with carotid endarterectomy. Methods Carotid atherosclerotic plaques and paired blood leukocytes were obtained from 12 patients with atherosclerosis, and relative telomere lengths were measured by real-time quantitative PCR (qRT-PCR). The correlation between the RTLs of two tissues was assessed. Results The average RTL of carotid atherosclerotic plaques (mean ± SD, 0.56 ±0.12) was significantly higher than that of blood leukocytes (0.45 ± 0.13) (P = 0.038). Multivariable linear regression analysis showed a positive association between the telomere lengths

  9. Ultrasound Vascular Elastography as a Tool for Assessing Atherosclerotic Plaques

    DEFF Research Database (Denmark)

    Mahmood, Badar; Ewertsen, C; Carlsen, Jørn

    2016-01-01

    to distinguish between vulnerable and stable plaques. The aim of this paper is to provide an overview of the literature on vascular elastography. A systematic search of the available literature for studies using elastography for assessing atherosclerotic plaques was conducted using the MEDLINE, Embase, Cochrane...... compared to B-mode ultrasound alone. Most studies reported higher strain values for vulnerable plaques. Ultrasound elastography has potential as a clinical tool in the assessment of atherosclerotic plaques. Elastography is able to distinguish between different plaque types, but there is considerable...

  10. Correlation between carotid plaque and serum 1, 25-dihydroxyvitamin D3 in diabetic patients%糖尿病患者血清1,25-二羟维生素D3水平与颈动脉斑块形成的相关性研究

    Institute of Scientific and Technical Information of China (English)

    宋玉玲; 刘长梅

    2015-01-01

    目的 分析糖尿病患者血清1,25-二羟维生素D3[1,25(OH)2D3]水平与颈动脉斑块形成的相关性.方法 选取2013年9月至2014年2月在滨州医学院附属医院住院的糖尿病患者82例(糖尿病组),根据颈动脉超声结果分为颈动脉斑块组(48例)和无颈动脉斑块组(34例),并选取同期体检健康者40名作为对照组.收集受试者一般资料及相关生化指标,测定血清1,25(0H)2D3水平.结果 糖尿病组血清1,25(0H)2D3水平低于对照组[(12 ±5) μg/L比(22±5)μg/L],且颈动脉斑块组中血清1,25(OH)2D3水平明显低于无颈动脉斑块组[(8.3±1.4)μg/L比(18.0 ±2.8) μg/L] (P <0.01).颈动脉粥样硬化斑块形成与年龄、吸烟、体重指数、收缩压、糖化血红蛋白(HbA1 c)、低密度脂蛋白胆固醇(LDL-C)呈正相关(r =0.60、0.16、0.43、0.50、0.45、0.32,P<0.05或P<0.01),与血清1,25(OH)2D3水平呈负相关(r=-0.55,P<0.01).多因素Logistic相关分析显示年龄[OR=1.076,95%置信区间(CI):1.040 ~1.115]、吸烟(OR=3.852,95% CI:1.821 ~7.905)、体重指数(OR=1.623,95% CI:1.030 ~1.720)、收缩压(OR=1.295,95% CI:1.040 ~1.493)、HbA1c (OR=1.054,95% CI:1.032 ~1.260)、LDL-L (OR=1.642,95% CI:1.135 ~2.320)是糖尿病颈动脉斑块形成的危险因素(均P<0.05),1,25(OH)2D3(OR=0.986,95% CI:0.864 ~0.996)是糖尿病颈动脉斑块形成的保护因素(P<0.01),并且在校正上述因素后,血清1,25(OH)2D3水平仍与颈动脉斑块形成具有独立相关关系.结论 糖尿病患者中血清1,25(OH)2D3水平降低与颈动脉斑块的形成密切相关.%Objective To investigate the relation between carotid plaque formation and serum 1,25-dihydroxyvitamin D3 in diabetes mellitus patients.Methods A total of 82 diabetes patients (diabetes group) from September 2013 to February 2014 were enrolled and divided into plaque subgroup (48 cases) and non plaque subgroup (34 cases) according to the results of ultrasound;40 healthy

  11. A role for archaeal organisms in development of atherosclerotic vulnerable plaques and myxoid matrices Um papel para organismos de arqueia no desenvolvimento de placas ateroscleróticas vulner��veis e matriz mixomatosa

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    Maria L Higuchi

    2006-10-01

    Full Text Available PURPOSE: Vulnerable plaques are characterized by a myxoid matrix, necrotic lipidic core, reactive oxygen species, and high levels of microorganisms. Aerobic microbes such as Chlamydophila pneumoniae and Mycoplasma pneumoniae usually do not survive in oxidative stress media. Archaea are anaerobic microbes with powerful anti-oxidative enzymes that allow detoxification of free radicals whose presence might favor the survival of aerobic microorganisms. We searched for archaeal organisms in vulnerable plaques, and possible associations with myxoid matrix, chlamydia, and mycoplasma bodies. METHODS: Twenty-nine tissue samples from 13 coronary artherectomies from large excentric ostial or bifurcational lesions were studied using optical and electron microscopy. Infectious agents compatible with archaea, chlamydia, and mycoplasma were semiquantified using electron micrographs and correlated with the amounts of fibromuscular tissue, myxoid matrix, and foam cells, as determined from semi-thin sections. Six of the cases were also submitted to polymerase chain reaction with archaeal primers. RESULTS: All 13 specimens showed archaeal-compatible structures and chlamydial and mycoplasmal bodies in at least 1 sample. There was a positive correlation between extent of the of myxoid matrix and archaeal bodies (r = 0.44, P = 0.02; between archaeal and mycoplasmal bodies (r = 0.41, P = 0.03, and between chlamydial bodies and foam cells (r = 0.42; P = 0.03. The PCR test was positive for archaeal DNA in 4 of the 6 fragments. DISCUSSION: DNA and forms suggestive of archaea are present in vulnerable plaques and may have a fundamental role in the proliferation of mycoplasma and chlamydia. This seems to be the first description of apparently pathogenic archaea in human internal organ lesions.PROPOSTA: Placas vulneráveis são caracterizadas por matriz mixomatosa, centro lipídico necrótico, espécies reativas de oxigênio e alto níveis de microorganismos. Micróbios aer

  12. 孤立性颈动脉粥样硬化斑块内膜长轴切面力学状态的初步超声研究%Preliminary longitudinal mechanical pattern study of the isolated carotid atherosclerotic plaque intima using velocity vector imaging

    Institute of Scientific and Technical Information of China (English)

    岳文胜; 尹立雪; 王珊; 邓燕; 左明良; 李爽; 余洋; 罗安果

    2008-01-01

    Objective To evaluate the mechanical homogeneity pattern of isolated carotid atherosclerotic plaque intima on longitudinal axis view using ultrasonic velocity vector imaging.Methods Fourty six patients with 48 isolated plaques were undergone the high frequency ultrasound scanning,the real-time two-dimensional longitudinal-axis gray scale view at the maximal thickness of the plaque was obtained in three complete cardiac cycles.A dedicated velocity vector imaging(ⅤⅤⅠ)workstation was used for the off-line dynamic two-dimensional gray-scale image analysis and mechanics parameter(i.e.,the peak strain and the absolute difference of the peak strain)assessment at the sites of the upper,middle and down stream separately.The length and direction distribution of the velocity vectors at the carotid atherosclerotic plaque intima were observed.Wilcoxon test was utilized for the comparison of the peak strain and the absolute difference of the peak strain between two sites.Results The chaos phenomenon of velocity vector distribution at the sites of plaque intima occurred significantly differed from those uniform velocity vectors at the reference sites.According to the two groups of the higher strain value side and the lower strain value side on the upper stream and the down stream of the plaque intima,the peak strain at the higher strain value side was significantly higher than the lower strain value side(P=0.000).There was a significantly difference between the absolute difference of peak strain from the higher strain value side to the middle stream point of the plaque intima and the absolute difference of peak strain from the lower strain value side to the higher strain value side of the plaque intima(P<0.017).Conclusions The length and direction distribution of velocity vectors of the isolated carotid atherosclerotic plaque intima on longitudinal axis view are uneven,the mechanical heterogeneity pattern exists at the plaque intima and could be visualized and

  13. Arterial luminal curvature and fibrous-cap thickness affect critical stress conditions within atherosclerotic plaque: an in vivo MRI-based 2D finite-element study.

    Science.gov (United States)

    Teng, Zhongzhao; Sadat, Umar; Li, Zhiyong; Huang, Xueying; Zhu, Chengcheng; Young, Victoria E; Graves, Martin J; Gillard, Jonathan H

    2010-10-01

    High mechanical stress in atherosclerotic plaques at vulnerable sites, called critical stress, contributes to plaque rupture. The site of minimum fibrous cap (FC) thickness (FC(MIN)) and plaque shoulder are well-documented vulnerable sites. The inherent weakness of the FC material at the thinnest point increases the stress, making it vulnerable, and it is the big curvature of the lumen contour over FC which may result in increased plaque stress. We aimed to assess critical stresses at FC(MIN) and the maximum lumen curvature over FC (LC(MAX)) and quantify the difference to see which vulnerable site had the highest critical stress and was, therefore, at highest risk of rupture. One hundred patients underwent high resolution carotid magnetic resonance (MR) imaging. We used 352 MR slices with delineated atherosclerotic components for the simulation study. Stresses at all the integral nodes along the lumen surface were calculated using the finite-element method. FC(MIN) and LC(MAX) were identified, and critical stresses at these sites were assessed and compared. Critical stress at FC(MIN) was significantly lower than that at LC(MAX) (median: 121.55 kPa; inter quartile range (IQR) = [60.70-180.32] kPa vs. 150.80 kPa; IQR = [91.39-235.75] kPa, p LC(MAX) only was used, then 112 out of 352 would be underestimated. Stress analysis at FC(MIN) and LC(MAX) should be used for a refined mechanical risk assessment of atherosclerotic plaques, since material failure at either site may result in rupture.

  14. Grating-based X-ray phase-contrast tomography of atherosclerotic plaque at high photon energies

    Energy Technology Data Exchange (ETDEWEB)

    Hetterich, Holger; Fill, Sandra [Klinikum der Ludwig-Maximilians-Univ., Muenchen (Germany). Inst. fuer Klinische Radiologie; Herzen, Julia [Technische Univ. Muenchen, Garching (Germany). Physik-Dept. und Inst. fuer Medizintechnik; Helmholtz-Zentrum Geesthacht, Geesthacht (Germany). Zentrum fuer Materialforschung] [and others

    2013-10-01

    Background: Tissue characterization of atherosclerosis by absorption-based imaging methods is limited due to low soft-tissue contrast. Grating-based phase-contrast computed tomography (PC-CT) may become an alternative for plaque assessment if the phase signal can be retrieved at clinically applicable photon energies. The aims of this feasibility study were (i) to characterize arterial vessels at low and high photon energies, (ii) to extract qualitative features and (iii) quantitative phase-contrast Hounsfield units (HU-phase) of plaque components at 53 keV using histopathology as gold standard. Materials and methods: Five human carotid artery specimens underwent grating-based PC-CT using synchrotron radiation of either 23 keV or 53 keV and histological work-up. Specimens without advanced atherosclerosis were used to extract signal criteria of vessel layers. Diseased specimens were screened for important plaque components including fibrous tissue (FT), lipid (LIP), necrotic core (NEC), intraplaque hemorrhage (IPH), inflammatory cell infiltration (INF) and calcifications (CA). Qualitative features as well as quantitative HU-phase were analyzed. Results: Thirty-three regions in 6 corresponding PC-CT scans and histology sections were identified. Healthy samples had the same signal characteristics at 23 keV and 53 keV with bright tunica intima and adventitia and dark media. Plaque components showed differences in signal intensity and texture at 53 keV. Quantitative analysis demonstrated the highest HU-phase of soft plaque in dense FT. Less organized LIP, NEC and INF were associated with lower HU-phase values. The highest HU-phase were measured in CA. Conclusion: PC-CT of atherosclerosis is feasible at high, clinically relevant photon energies and provides detailed information about plaque structure including features of high risk vulnerable plaques. (orig.)

  15. 超声和血脂水平检测对颈动脉斑块稳定性诊断的应用%Study on application of ultrasound and blood level of lipids in diagnosis of the stability of atherosclerotic plaque in carotid artery

    Institute of Scientific and Technical Information of China (English)

    于明月; 李红艳; 刘欣; 焦荣红; 薛红元; 牛慧敏; 于明娟

    2014-01-01

    Objective To evaluate the role of ultrasonic elastograsphy and blood levels of lipids in diagnosis of stability of atherosclerotic plaque in carotid artery. Methods Sixty patients diagnosed as cerebral infarction during January 2013 to December 2013 were allocated in obser_vation group and 60 healthy persons taking health examination in outpatient service were allocated in control group for prospective study. All their clinical data and history records were studied according to the actual order one by one,and blood levels of lipids including three acyl glycerin ( TG),total cholesterol( TC),low density lipoprotein cholesterol( LDL-C)and high density lipoprotein cholesterolother( HDL-C)indicators were evaluated,information of carotid plaques had been recorded by using ultrasond combined with UE( ultrasonic elastography). Results Rele_vance ratio of total carotid plaques in observation group was higher( P ﹤0. 05). The total number of cases in two groups with UE scores at 4 or less points was not statistically different,but the number of cases with UE scores at 5 points or higher in observation group was significantly higher than those of control group( P ﹤0. 05). Blood levels of lipids especially the index of LDL-C were also significantly higher in observation group ( P ﹤0. 05). Conclusion Abnormally higher LDL-C lipid indexes mean the instability of atherosclerotic plaques in carotid arteries of patients with cerebral infarction,and application of new type UE combined with technique of traditional ultrasonic imaging can more significantly raise the sensitivity of ultrasonic detection of diseased tissues;and the application of ultrasound and detection of blood levels of lipids have practical clinical significance in demonstration of the stability of carotid plaques in carotid arteries.%目的:评估超声和血脂水平检测对颈动脉斑块稳定性诊断的临床应用价值。方法将2013年1月至2013年12月住院治疗的脑梗死病人60例作为观

  16. Carotid lesions in outpatients with nonalcoholic fatty liver disease

    Institute of Scientific and Technical Information of China (English)

    Stefano Ramilli; Stefano Pretolani; Antonio Muscari; Barbara Pacelli; Vincenzo Arienti

    2009-01-01

    AIM: To ascertain whether carotid lesions are more prevalent in outpatients with incidental findings of nonalcoholic fatty liver disease (NAFLD) at abdominal ultrasound (US). METHODS: One hundred and fifty-four consecutive outpatients (age range 24-90 years, both sexes) referred by general practitioners for abdominal US, and drinking less than 20 g alcohol/day, underwent carotid US for an assessment of carotid intima-media thickness (c-IMT) and carotid plaque prevalence. Hepatic steatosis, visceral fat thickness and subcutaneous fat thickness were also assessed at ultrasonography. RESULTS: Higher c-IMT values were found in the presence of NAFLD (90 patients), even after adjustment for indices of general and abdominal obesity and for the principal cardiovascular risk factors (0.84 ± 0.10 mm vs 0.71 ± 0.10 mm, P < 0.001). The prevalence of carotid plaques was 57.8% in the patients with NAFLD vs 37.5% in the patients without this condition ( P = 0.02). The adjusted relative risk of having carotid plaques for paients with NAFLD was 1.85 (95% CI: 1.33-2.57, P < 0.001). CONCLUSION: An incidental finding of hepatic steatosis may suggest the presence of silent carotid atherosclerotic lesions.

  17. Relationship between carotid artery stenosis and ischemic ocular diseases

    Directory of Open Access Journals (Sweden)

    Qian Chen

    2015-01-01

    Full Text Available AIM: To investigate the relationship between carotid artery stenosis and ischemic ocular diseases.METHODS: The clinical data of 30 cases(37 eyesof patients with ischemic eye diseases were collected from November 2010 to May 2014, and they were accepted the fundus fluorescein angiography(FFA, transcranial Doppler(TCDultrasonic blood vessels of the eye, neck vascular color Doppler flow imaging(CDFI, the neck CT angiography(CTAand carotid artery digital subtraction angiography(DSAexamination, and then the ischemic eye disease patients with ocular symptoms were analyzed. The peak systolic velocity(PSVand resistance index(RIof ophthalmic artery and central retinal artery were compared. Correlation between the internal carotid artery intima-media thickness(IMTand ophthalmic artery, central retinal artery PSV and RI correlation risk; ipsilateral internal carotid artery plaque and ophthalmic artery PSV and RI; PSV and RI associated ipsilateral internal carotid artery plaque and central retinal artery were analyzed. RESULTS: Eye symptoms: a black dim, reduced vision, the eyes flash, and around the eye pain were 75.7%, 83.8%, 51.4% and 32.4%; The eye signs: the dilatation of retinal vein, retinal hemorrhage, arterial stenosis and cotton spot and the contralateral side were regarded as main signs. Ophthalmic artery PSV and RI value of the differences were statistically significant(PPP>0.05; The ipsilateral internal carotid artery plaque and ophthalmic artery PSV had no correlation with RI values(P>0.05; PSV and RI and the ipsilateral internal carotid artery plaque and central retinal artery had no correlation(P>0.05.CONCLUSION: The incidence of ischemic eye diseases and internal carotid artery stenosis is associated with very close, the clinical can regard the degree of internal carotid artery stenosis as an important basis for diagnosis and treatment of eye diseases.

  18. Recent concepts in the management of extracranial carotid stenosis: Carotid endarterectomy versus carotid artery stenting

    Directory of Open Access Journals (Sweden)

    Jeyaraj D Pandian

    2011-01-01

    Full Text Available Carotid stenosis is seen in 10% of patients with ischemic stroke, and carotid endarterectomy (CEA and carotid artery stenting (CAS are the two invasive treatments options available. Pooled analysis of the three largest randomized trials of CEA involving more than 3000 symptomatic patients estimated 30-day stroke and death rate at 7.1% after CEA. Some subgroups among the symptomatic patients appeared to have more benefit from CEA. These include patients aged 75 years or more, patients with ulcerated plaques, and patients with recent transient ischemic attacks within 2 weeks of randomization. Selection of asymptomatic patients for carotid revascularization should be guided by an assessment of comorbid conditions, life expectancy, and other individual factors, and should include a thorough discussion of the risks and benefits of the procedure with an understanding of patient preferences. The recent trials comparing CEA with CAS has not established its superiority over CEA. The carotid revascularization endarterectomy versus stenting (CREST study showed that CAS is still associated with a higher periprocedural risk of stroke or death than CEA. In patients over 70 years of age, CEA is clearly superior to CAS. The increased risk of nonfatal myocardial infarction in the CREST group subjected to CEA clearly suggests that patients being considered for CEA or CAS require a careful preliminary cardiac evaluation. CAS can be justified for patients whose medical comorbidities or cervical anatomy make them questionable candidates for CEA. The benefit of revascularization by either method versus modern aggressive medical therapy has not been established for patients with asymptomatic carotid stenosis.

  19. Correlation between Carotid Atherosclerotic Plaque and Type H Hypertension in Patients with Ischemic Stroke%缺血性脑卒中患者颈动脉粥样硬化斑块与H型高血压的相关性

    Institute of Scientific and Technical Information of China (English)

    贾蕾; 郭改艳

    2016-01-01

    目的:探讨缺血性脑卒中患者颈动脉粥样硬化斑块与H型高血压的相关性。方法:选取2012年10月~2014年10月期间,我院收治的缺血性脑卒中患者临床资料162份,分为实验组和对照组。实验组为有颈动脉粥样硬化斑块的缺血性脑卒中患者101例,对照组为没有颈动脉粥样硬化斑块的缺血性脑卒中患者61例。采用酶联免疫法对患者的同型半胱氨酸进行检测,并根据检测结果和高血压史将所有的患者分为四种类型,A类为H型高血压患者,B类为普通高血压组患者,C类为高同型半胱氨酸患者,D类为高血压和同型半胱氨酸都正常的患者,分别对实验组和对照组进行四种类型的检测,将两组检测结果进行比较,分析缺血性脑卒中患者颈动脉粥样硬化斑块与H型高血压的相关性。结果:实验组患者在年龄、吸烟史、高血压史、低密度脂蛋白与对照组患者想比较,有显著差异P<0.05,具有统计学意义;实验组患者和对照组患者中四种类型患者有明显的差异,P<0.05,具有统计学意义,且实验组患者中,A类H型高血压患者发生率最高,其次是B类普通高血压组患者,再者就是C类高同型半胱氨酸患者,最后是D类高血压和同型半胱氨酸都正常的患者。结论:H型高血压缺血性脑卒中患者发生颈动脉粥样硬化斑块的概率最高。%Objective: To explore the ischemic stroke patients with carotid atherosclerotic plaque and H the correlation of high blood pressure.Methods: Selection during October 2012 to October 2012, our hospital clinical data of 162 patients with ischemic stroke, divided into the experimental group and the control group, experimental group is in the form of carotid atherosclerotic plaques, 101 cases of ischemic cerebral apoplexy patients and control group with no carotid atherosclerotic plaque of 61 cases of ischemic cerebral apoplexy

  20. The Effect of Simvastatin and Felodipin on Carotid Atherosclerosis Plaque in Hypertensive Patients Complicated with Type 2 Diabetes Mellitus%辛伐他汀联合非洛地平对高血压并发2型糖尿病患者颈动脉粥样硬化的影响

    Institute of Scientific and Technical Information of China (English)

    陈华发; 周荣辉; 朱可云

    2009-01-01

    Objective To explore the effect of simvastatin and felodipin on carotid atherosclerosis in hypertensive patients complicated with type 2 diabetes mellitus.Methods Ninety two hypertensive patients complicated with type 2 diabetes mellitus were randomly to receive simvastatin(20 mg/d)and felodipin(5-10 mg/d)while control group receive simvastatin(20 mg/d).Carotid intima-medial thickness(IMT)、incidence of carotid plaque were measured by ultrasound and hs-CRP、total cholesterol(TC)and low density lipoprotein cholesterol were determined before and after 6 months treatment in all patients.Results hs-CRP[(9.2±1.5)vs after treatment(6.5±1.6)]mg/L;IMT(1.25±0.13)vs after treatment(0.97±0.15)accumulate score of carotid plaque(6.21±0.50)vs after treatment(5.05±0.39);the prevalence rate of carotid plaque(84.5% vs after treatment:67.5)were all reduced in experiment group(all P<0.05).The correlation analysis revealed hs-CRP level was related to the improved level of carotid arteriosclerosis.Conclusion Simvastatin and felodipin reduced inflammation and carotid arteriosclerosis in hypertensive patients complicated with type 2 DM.%目的 探讨辛伐他汀与非洛地平单用及联合对高血压并发2型糖尿病患者颈动脉粥样硬化的疗效.方法 原发高血压并发2型糖尿病颈动脉粥样硬化患者92例,随机分组为2组,实验组口服辛伐他汀20 mg,每晚一次和非洛地平5-10 mg,1次/d;对照组口服其他类型降压药及辛伐他汀20mg,每晚一次.采用彩色多普勒超声检测颈动脉,记录颈动脉内膜-中层厚度(IMT)、颈动脉斑块积分、斑块发生率.并分别监控血压、血糖变化及于入院后和6个月时检测血浆hs-CRP、总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)、糖化血红蛋白(HbA lc).结果 实验组治疗后hs-CRP[(9.2±1.5)比治疗后(6.5±1.6)]mg/L下降(P<0.05),且下降幅度较对照组大(P<0.05)、IMT(1.25±0.13)比治疗后(0.97±0.15)mm下降(P<0.05),且

  1. The complementary roles of dynamic contrast-enhanced MRI and {sup 18}F-fluorodeoxyglucose PET/CT for imaging of carotid atherosclerosis

    Energy Technology Data Exchange (ETDEWEB)

    Calcagno, Claudia; Ramachandran, Sarayu; Mani, Venkatesh; Millon, Antoine [Mount Sinai School of Medicine, Translational and Molecular Imaging Institute, One Gustave L. Levy Place, Box 1234, New York, NY (United States); Mount Sinai School of Medicine, Department of Radiology, New York, NY (United States); Izquierdo-Garcia, David [Harvard University - MIT - Massachusetts General Hospital, Athinoula A. Martinos Center for Biomedical Imaging, Charlestown, MA (United States); Rosenbaum, David [Hopital Pitie Salpetriere, Paris (France); Tawakol, Ahmed [Harvard Medical School and Massachusetts General Hospital, Boston, MA (United States); Woodward, Mark [University of Sydney, George Institute, Sydney (Australia); Bucerius, Jan [Maastricht University Medical Center, Department of Nuclear Medicine, Maastricht (Netherlands); Cardiovascular Research Institute Maastricht (CARIM), Maastricht (Netherlands); Rheinisch-Westfaelische Technische Hochschule Aachen, Department of Nuclear Medicine, Aachen (Germany); Moshier, Erin; Godbold, James [Mount Sinai School of Medicine, Biostatistics Shared Research Facility, New York, NY (United States); Kallend, David [F. Hoffmann-La Roche Ltd, Basel (Switzerland); Farkouh, Michael E. [Mount Sinai School of Medicine, Cardiovascular Institute, New York, NY (United States); Peter Munk Cardiac Centre and Li Ka Shing Knowledge Institute, Toronto (Canada); Fuster, Valentin [Mount Sinai School of Medicine, Cardiovascular Institute, New York, NY (United States); The Centro Nacional de Investigaciones Cardiovasculares (CNIC), Madrid (Spain); Rudd, James H.F. [University of Cambridge, Division of Cardiovascular Medicine, Cambridge (United Kingdom); Fayad, Zahi A. [Mount Sinai School of Medicine, Translational and Molecular Imaging Institute, One Gustave L. Levy Place, Box 1234, New York, NY (United States); Mount Sinai School of Medicine, Department of Radiology, New York, NY (United States); Mount Sinai School of Medicine, Cardiovascular Institute, New York, NY (United States)

    2013-12-15

    Inflammation and neovascularization in vulnerable atherosclerotic plaques are key features for severe clinical events. Dynamic contrast-enhanced (DCE) MRI and FDG PET are two noninvasive imaging techniques capable of quantifying plaque neovascularization and inflammatory infiltrate, respectively. However, their mutual role in defining plaque vulnerability and their possible overlap has not been thoroughly investigated. We studied the relationship between DCE-MRI and {sup 18}F-FDG PET data from the carotid arteries of 40 subjects with coronary heart disease (CHD) or CHD risk equivalent, as a substudy of the dal-PLAQUE trial (NCT00655473). The dal-PLAQUE trial was a multicenter study that evaluated dalcetrapib, a cholesteryl ester transfer protein modulator. Subjects underwent anatomical MRI, DCE-MRI and {sup 18}F-FDG PET. Only baseline imaging and biomarker data (before randomization) from dal-PLAQUE were used as part of this substudy. Our primary goal was to evaluate the relationship between DCE-MRI and {sup 18}F-FDG PET data. As secondary endpoints, we evaluated the relationship between (a) PET data and whole-vessel anatomical MRI data, and (b) DCE-MRI and matching anatomical MRI data. All correlations were estimated using a mixed linear model. We found a significant inverse relationship between several perfusion indices by DCE-MRI and {sup 18}F-FDG uptake by PET. Regarding our secondary endpoints, there was a significant relationship between plaque burden measured by anatomical MRI with several perfusion indices by DCE-MRI and {sup 18}F-FDG uptake by PET. No relationship was found between plaque composition by anatomical MRI and DCE-MRI or {sup 18}F-FDG PET metrics. In this study we observed a significant, weak inverse relationship between inflammation measured as {sup 18}F-FDG uptake by PET and plaque perfusion by DCE-MRI. Our findings suggest that there may be a complex relationship between plaque inflammation and microvascularization during the different

  2. Ventilatory chaos is impaired in carotid atherosclerosis.

    Directory of Open Access Journals (Sweden)

    Laurence Mangin

    Full Text Available Ventilatory chaos is strongly linked to the activity of central pattern generators, alone or influenced by respiratory or cardiovascular afferents. We hypothesized that carotid atherosclerosis should alter ventilatory chaos through baroreflex and autonomic nervous system dysfunctions. Chaotic dynamics of inspiratory flow was prospectively evaluated in 75 subjects undergoing carotid ultrasonography: 27 with severe carotid stenosis (>70%, 23 with moderate stenosis (<70%, and 25 controls. Chaos was characterized by the noise titration method, the correlation dimension and the largest Lyapunov exponent. Baroreflex sensitivity was estimated in the frequency domain. In the control group, 92% of the time series exhibit nonlinear deterministic chaos with positive noise limit, whereas only 68% had a positive noise limit value in the stenoses groups. Ventilatory chaos was impaired in the groups with carotid stenoses, with significant parallel decrease in the noise limit value, correlation dimension and largest Lyapunov exponent, as compared to controls. In multiple regression models, the percentage of carotid stenosis was the best in predicting the correlation dimension (p<0.001, adjusted R(2: 0.35 and largest Lyapunov exponent (p<0.001, adjusted R(2: 0.6. Baroreflex sensitivity also predicted the correlation dimension values (p = 0.05, and the LLE (p = 0.08. Plaque removal after carotid surgery reversed the loss of ventilatory complexity. To conclude, ventilatory chaos is impaired in carotid atherosclerosis. These findings depend on the severity of the stenosis, its localization, plaque surface and morphology features, and is independently associated with baroreflex sensitivity reduction. These findings should help to understand the determinants of ventilatory complexity and breathing control in pathological conditions.

  3. Sleep Characteristics and Carotid Atherosclerosis Among Midlife Women.

    Science.gov (United States)

    Thurston, Rebecca C; Chang, Yuefang; von Känel, Roland; Barinas-Mitchell, Emma; Jennings, J Richard; Hall, Martica H; Santoro, Nanette; Buysse, Daniel J; Matthews, Karen A

    2017-02-01

    Midlife, which encompasses the menopause transition in women, can be a time of disrupted sleep and accelerated atherosclerosis accumulation. Short or poor sleep quality has been associated with cardiovascular disease (CVD) risk; few studies have investigated relations among midlife women. We tested whether shorter actigraphy sleep time or poorer subjective sleep quality was associated with carotid atherosclerosis among midlife women. Two hundred fifty-six peri- and postmenopausal women aged 40-60 years completed 3 days of wrist actigraphy, hot flash monitoring, questionnaires (Pittsburgh Sleep Quality Index [PSQI], Berlin), a blood draw, and carotid ultrasound [intima media thickness (IMT), plaque]. Associations of objective (actigraphy) and subjective (PSQI) sleep with IMT/plaque were tested in regression models (covariates: age, race, education, body mass index, blood pressure, lipids, insulin resistance, medications, snoring, depressive symptoms, sleep hot flashes, and estradiol). Shorter objective sleep time was associated with higher odds of carotid plaque (for each hour shorter sleep, plaque score ≥ 2, odds ratio (OR) [95% confidence interval, CI] = 1.58 [1.11-2.27], p = .01; plaque score = 1, OR [95% CI] = 0.95 [0.68-1.32], p = .75, vs. no plaque, multivariable). Poorer subjective sleep quality was associated with higher mean IMT [β, b (standard error, SE) = 0.004 (0.002), p = .03], maximal IMT [b (SE) = 0.009 (0.003), p = .005], and plaque [plaque score ≥ 2, OR (95% CI) = 1.23 (1.09-1.40), p = .001; score = 1, OR (95% CI) = 1.06 (0.93-1.21), p = .37, vs. no plaque] in multivariable models. Findings persisted additionally adjusting for sleep hot flashes and estradiol. Shorter actigraphy-assessed sleep time and poorer subjective sleep quality were associated with increased carotid atherosclerosis among midlife women. Associations persisted adjusting for CVD risk factors, hot flashes, and estradiol.

  4. Early control of distal internal carotid artery during carotid endarterectomy: does it reduce cerebral microemboli?

    Science.gov (United States)

    Mommertz, G; Das, M; Langer, S; Koeppel, T A; Krings, T; Mess, W H; Schiefer, J; Jacobs, M J

    2010-06-01

    According to the results of the large trials on carotid endarterectomy (CEA), this type of surgery is only warranted if perioperative mortality and morbidity are kept considerably low. Less attention has been paid to methods of cerebral protection during CEA, although intraoperative transcranial Doppler (TCD) can visualise intracerebral microemboli (MES) during routine carotid dissection, although MES occur throughout the CEA, only those during dissection are related to neurological outcome. Prevention of MES by means of early control of the distal internal carotid artery dislodging from the carotid artery plaque during dissection is very likely the mechanism behind an eventual benefit from this approach. Hence, the amount of MES might serve as a surrogate parameter for the risk of periprocedural neurological events. So, the aim of the present study was to evaluate whether early control of the distal carotid artery during CEA is capable of reducing the number of MES by means of a prospective randomised trial. Twenty-eight patients (29 procedures) could be prospectively included in our study. Before surgery we randomly assigned the patients to two groups: group A (N.=12): CEA by means of early control of the distal internal carotid artery; group B (N.=17): CEA with dissection of the total carotid bifurcation before clamping the arteries. Periprocedurally, we continuously monitored the cerebral blood flow in the ipsilateral middle cerebral artery by means of TCD. Pre- and postoperative morbidity were independently verified by a neurologist control of the distal internal carotid artery did not reduce the occurrence of MES during dissection of the carotid bifurcation. Also, the total number of MES throughout the procedure and postoperatively was comparable between both groups. The procedure related times as well as the clinical outcome did not differ significantly. Thus, early control of the distal internal carotid artery has got no advantage but also no disadvantage

  5. Haemodynamical stress in mouse aortic arch with atherosclerotic plaques: Preliminary study of plaque progression

    Directory of Open Access Journals (Sweden)

    P. Assemat

    2014-07-01

    Full Text Available Atherosclerotic plaques develop at particular sites in the arterial tree, and this regional localisation depends largely on haemodynamic parameters (such as wall shear stress; WSS as described in the literature. Plaque rupture can result in heart attack or stroke and hence understanding the development and vulnerability of atherosclerotic plaques is critically important. The purpose of this study is to characterise the haemodynamics of blood flow in the mouse aortic arch using numerical modelling. The geometries are digitalised from synchrotron imaging and realistic pulsatile blood flow is considered under rigid wall assumptions. Two cases are considered; arteries with and without plaque. Mice that are fed under fat diet present plaques in the aortic arch whose size is dependent on the number of weeks under the diet. The plaque distribution in the region is however relatively constant through the different samples. This result underlines the influence of the geometry and consequently of the wall shear stresses for plaque formation with plaques growing in region of relative low shear stresses. A discussion of the flow field in real geometry in the presence and absence of plaques is conducted. The presence of plaques was shown to alter the blood flow and hence WSS distribution, with regions of localised high WSS, mainly on the wall of the brachiocephalic artery where luminal narrowing is most pronounced. In addition, arch plaques are shown to induce recirculation in the blood flow, a phenomenon with potential influence on the progression of the plaques. The oscillatory shear index and the relative residence time have been calculated on the geometry with plaques to show the presence of this recirculation in the arch, an approach that may be useful for future studies on plaque progression.

  6. Cognitive functioning and quality of life of atherosclerotic patients following carotid endarterectomy.

    NARCIS (Netherlands)

    Bossema, E.R.; Brand, A.N.; Moll, F.L.; Ackerstaff, R.G.A.; Doornen, L.J.P. van

    2002-01-01

    Background: Carotid endarterectomy (CEA) is a surgical procedure to remove atherosclerotic plaque from one of the carotid arteries in patients with severe stenosis. The purpose is to prevent future cerebral ischemic attacks. Whether patients, in addition, improve in cognitive functions and quality o

  7. Subclinical Carotid Atherosclerosis in Asymptomatic Subjects With Type 2 Diabetes Mellitus.

    Science.gov (United States)

    Rubinat, Esther; Marsal, Josep Ramon; Vidal, Teresa; Cebrian, Cristina; Falguera, Mireia; Vilanova, Ma Belen; Betriu, Àngels; Fernández, Elvira; Franch, Josep; Mauricio, Dídac

    2016-01-01

    Subjects with type 2 diabetes mellitus are considered to be at high risk for cardiovascular disease. The identification of carotid atherosclerosis is a validated surrogate marker of cardiovascular disease. Nurses are key professionals in the improvement and intensification of cardiovascular preventive strategies. The aim is to study the presence of carotid atherosclerosis in a group of asymptomatic subjects with type 2 diabetes mellitus and no previous clinical cardiovascular disease. A total of 187 patients with type 2 diabetes mellitus and 187 age- and sex-matched subjects without type 2 diabetes mellitus were studied in this cross-sectional, observational, cohort study. Standard operational procedures were applied by the nursing team regarding physical examination and carotid ultrasound assessment. Common, bulb, and internal carotid arteries were explored by measuring intima-media thickness and identifying atherosclerotic plaques. Carotid intima-media thickness (c-IMT) and carotid plaque prevalence were significantly greater in diabetic subjects than in the control group. Carotid plaques and c-IMT were more frequent in men than in women and increased with increasing age. In the multivariate analysis, age, gender, waist circumference, systolic blood pressure, and hypercholesterolemia were positively associated with c-IMT, whereas age, gender, and weight were positively associated with carotid plaque. The current nurse-led study shows that subjects with type 2 diabetes mellitus have a high prevalence of subclinical atherosclerosis that is associated with cardiovascular risk factors.

  8. Increased YKL-40 expression in patients with carotid atherosclerosis

    DEFF Research Database (Denmark)

    Michelsen, Annika E; Rathcke, Camilla N; Skjelland, Mona

    2010-01-01

    atherosclerosis and 20 healthy controls. Carotid expression of YKL-40 was examined by real time RT-PCR in 57 of the patients. Regulation and effect of YKL-40 were examined in THP-1 monocytes. RESULTS: Our main findings were: (1) serum YKL-40 levels were significantly elevated in patients with carotid...... atherosclerosis, with particularly high levels in those with symptomatic disease; (2) patients with recent ischemic symptoms (within 2 months) had higher YKL-40 mRNA levels in carotid plaque than other patients; (3) in vitro, the beta-adrenergic receptor agonist isoproterenol, toll-like receptor (TLR) 2 and TLR4...

  9. Increased YKL-40 expression in patients with carotid atherosclerosis

    DEFF Research Database (Denmark)

    Michelsen, Axel Gottlieb; Rathcke, C.N.; Skjelland, M.

    2010-01-01

    atherosclerosis and 20 healthy controls. Carotid expression of YKL-40 was examined by real time RT-PCR in 57 of the patients. Regulation and effect of YKL-40 were examined in THP-1 monocytes. Results: Our main findings were: (1) serum YKL-40 levels were significantly elevated in patients with carotid...... atherosclerosis, with particularly high levels in those with symptomatic disease; (2) patients with recent ischemic symptoms (within 2 months) had higher YKL-40 mRNA levels in carotid plaque than other patients; (3) in vitro, the beta-adrenergic receptor agonist isoproterenol, toll-like receptor (TLR) 2 and TLR4...

  10. Imaging Modalities to Identity Inflammation in an Atherosclerotic Plaque

    Directory of Open Access Journals (Sweden)

    Sunny Goel

    2015-01-01

    Full Text Available Atherosclerosis is a chronic, progressive, multifocal arterial wall disease caused by local and systemic inflammation responsible for major cardiovascular complications such as myocardial infarction and stroke. With the recent understanding that vulnerable plaque erosion and rupture, with subsequent thrombosis, rather than luminal stenosis, is the underlying cause of acute ischemic events, there has been a shift of focus to understand the mechanisms that make an atherosclerotic plaque unstable or vulnerable to rupture. The presence of inflammation in the atherosclerotic plaque has been considered as one of the initial events which convert a stable plaque into an unstable and vulnerable plaque. This paper systemically reviews the noninvasive and invasive imaging modalities that are currently available to detect this inflammatory process, at least in the intermediate stages, and discusses the ongoing studies that will help us to better understand and identify it at the molecular level.

  11. Fiber-optic system for dual-modality imaging of glucose probes 18F-FDG and 6-NBDG in atherosclerotic plaques.

    Directory of Open Access Journals (Sweden)

    Raiyan T Zaman

    Full Text Available Atherosclerosis is a progressive inflammatory condition that underlies coronary artery disease (CAD-the leading cause of death in the United States. Thus, the ultimate goal of this research is to advance our understanding of human CAD by improving the characterization of metabolically active vulnerable plaques within the coronary arteries using a novel catheter-based imaging system. The aims of this study include (1 developing a novel fiber-optic imaging system with a scintillator to detect both 18F and fluorescent glucose probes, and (2 validating the system on ex vivo murine plaques.A novel design implements a flexible fiber-optic catheter consisting of both a radio-luminescence and a fluorescence imaging system to detect radionuclide 18F-fluorodeoxyglucose (18F-FDG and the fluorescent analog 6-(N-(7-Nitrobenz-2-oxa-1,3-diazol-4-ylamino-6-Deoxyglucose (6-NBDG, respectively. Murine macrophage-rich atherosclerotic carotid plaques were imaged ex vivo after intravenous delivery of 18F-FDG or 6-NBDG. Confirmatory optical imaging by IVIS-200 and autoradiography were also performed.Our fiber-optic imaging system successfully visualized both 18F-FDG and 6-NBDG probes in atherosclerotic plaques. For 18F-FDG, the ligated left carotid arteries (LCs exhibited 4.9-fold higher radioluminescence signal intensity compared to the non-ligated right carotid arteries (RCs (2.6 × 10(4 ± 1.4 × 10(3 vs. 5.4 × 10(3 ± 1.3 × 10(3 A.U., P = 0.008. Similarly, for 6-NBDG, the ligated LCs emitted 4.3-fold brighter fluorescent signals than the control RCs (1.6 × 10(2 ± 2.7 × 10(1 vs. 3.8 × 10(1 ± 5.9 A.U., P = 0.002. The higher uptake of both 18F-FDG and 6-NBDG in ligated LCs were confirmed with the IVIS-200 system. Autoradiography further verified the higher uptake of 18F-FDG by the LCs.This novel fiber-optic imaging system was sensitive to both radionuclide and fluorescent glucose probes taken up by murine atherosclerotic plaques. In addition, 6-NBDG is a

  12. Rapid Screening for Subclinical Atherosclerosis by Carotid Ultrasound Examination: The HAPPY (Heart Attack Prevention Program for You) Substudy.

    Science.gov (United States)

    Singh, Shaanemeet; Nagra, Aslam; Maheshwari, Puneet; Panwar, Rajababu; Hecht, Harvey; Fukumoto, Takenori; Bansal, Manish; Panthagani, David; Lammertin, Georgeanne; Kasliwal, Ravi; Mishra, Hemant; Hofstra, Leonard; Singh, Mahendra Pratap; Fuster, Valentin; Sengupta, Partho P; Narula, Jagat

    2013-06-01

    Cardiovascular disease (CVD)-related death rates have been escalating in emerging economies such as India. A strategy to initiate prophylactic medical intervention by direct identification of subclinical atherosclerotic burden may be appropriate in rural populations where assessment based on traditional risk factors is not available. This study sought to investigate the feasibility of performing rapid automated carotid ultrasound studies in a rural setting and to measure the prevalence of carotid plaques and age-specific distribution of carotid intima-media thickness (IMT) as an index of subclinical atherosclerosis. Screening of the extracranial carotid system with automated B-mode ultrasound was performed along with health questionnaire assessments in 771 asymptomatic volunteers (ages 40 ± 14 years; 626 men and 145 women) with no known CVD. Measurements of IMT were recorded as the mean of 24 spatial measurements performed over a 1-cm region in the far wall of the common carotid artery at end diastole; the prevalence of the plaque (focal IMT >1.5 mm) was determined. A total of 69 (8.9%) subjects had atherosclerotic plaques. Of these, 16 (2.1%) exhibited bilateral plaques, 28 (3.6%) left carotid plaque only, and 25 (3.2%) had right carotid plaques. Patients even under 50 years showed a high prevalence of carotid plaques (7%), which increased with age (25% and 35% for 51 to 70 and >70 years, respectively). Only 3 (4.3%) participants with plaques were former smokers. Global mean IMT was 0.55 ± 0.13 mm and correlated with age for both left and right carotid arteries (r = 0.61 and 0.60, p nations where traditional CVD risk factor data are not yet readily available. Copyright © 2013 World Heart Federation (Geneva). Published by Elsevier B.V. All rights reserved.

  13. Surface-Functionalized Nanoparticles by Olefin Metathesis: A Chemoselective Approach for In Vivo Characterization of Atherosclerosis Plaque.

    Science.gov (United States)

    Salinas, Beatriz; Ruiz-Cabello, Jesús; Lechuga-Vieco, Ana V; Benito, Marina; Herranz, Fernando

    2015-07-13

    The use of click chemistry reactions for the functionalization of nanoparticles is particularly useful to modify the surface in a well-defined manner and to enhance the targeting properties, thus facilitating clinical translation. Here it is demonstrated that olefin metathesis can be used for the chemoselective functionalization of iron oxide nanoparticles with three different examples. This approach enables, in one step, the synthesis and functionalization of different water-stable magnetite-based particles from oleic acid-coated counterparts. The surface of the nanoparticles was completely characterized showing how the metathesis approach introduces a large number of hydrophilic molecules on their coating layer. As an example of the possible applications of these new nanocomposites, a focus was taken on atherosclerosis plaques. It is also demonstrated how the in vitro properties of one of the probes, particularly its Ca(2+) -binding properties, mediate their final in vivo use; that is, the selective accumulation in atherosclerotic plaques. This opens promising new applications to detect possible microcalcifications associated with plaque vulnerability. The accumulation of the new imaging tracers is demonstrated by in vivo magnetic resonance imaging of carotids and aorta in the ApoE(-/-) mouse model and the results were confirmed by histology.

  14. Plaque rupture in humans and mice

    DEFF Research Database (Denmark)

    Schwartz, Stephen M; Galis, Zorina S; Rosenfeld, Michael E

    2007-01-01

    Despite the many studies of murine atherosclerosis, we do not yet know the relevance of the natural history of this model to the final events precipitated by plaque disruption of human atherosclerotic lesions. The literature has become particularly confused because of the common use of terms...... such as "instability", "vulnerable", "rupture", or even "thrombosis" for features of plaques in murine model systems not yet shown to rupture spontaneously and in an animal surprisingly resistant to formation of thrombi at sites of atherosclerosis. We suggest that use of conclusory terms like "vulnerable" and "stable...... that various forms of data have implicated in plaque progression. For example, formation of the fibrous cap, protease activation, and cell death in the necrotic core can be well described and have all been modeled in well-defined experiments. The relevance of such well-defined, objective, descriptive...

  15. Risk Analysis on Uric Acid Resulting in Carotid Atherosclerosis

    Institute of Scientific and Technical Information of China (English)

    肖敏; 李河; 郭兰; 石美铃; 麦劲壮

    2004-01-01

    Objectives To explore the risk of uric acid (UA) resulting in carotid atherosclerosis. Methods With a cross sectional study, 643 subjects (aged 41-83 yrs, male 552 and female 91)were surveyed in 1999 in Guangdong Province, China.The main research variables were uric acid (UA), occurrence and the size of carotid artery plaque. Results There was no statistical significance between the UA means of plaque occurrence and no-occurrence groups (t=0.60, df=242, P=0.5495). It seemed UA was not a possible risk factor of carotid atherosclerosis (OR=1.060, P=-0.8448>0.05, n=244) based on the logistic regression analysis. Conclusions Our results are not consistent with serum UA being an independent risk factor for atherosclerosis and coronary heart disease (CHD). It is necessary to do more research to learn the risk degree of UA during the progress of atherosclerosis/CHD.

  16. Longitudinal assessment of carotid atherosclerosis after Radiation Therapy using Computed Tomography: A case control Study

    Energy Technology Data Exchange (ETDEWEB)

    Anzidei, Michele [Rome Univ. ' ' La Sapienza' ' (Italy). Dept. of Radiology; Suri, Jasjit S.; Piga, Mario [AtheroPoint TM LLC, Roseville, CA (United States). Monitoring and Diagnostic Div.; Global Biomedical Technologies, Inc., CA (United States). Point of Care Devices; Idaho Univ., Moscow, ID (United States). Electrical Engineering Dept.; Saba, Luca [Azienda Ospedaliero Universitaria (A.O.U.), Cagliari (Italy). Dept. of Radiology; Sanfilippo, Roberto; Montisci, Roberto [Azienda Ospedaliero Universitaria (A.O.U.), Cagliari (Italy). Dept. of Vascular Surgery; Laddeo, Giancarlo [New York Univ. Langone Medical Center, New York, NY (United States). Dept. of Radiology; Argiolas, Giovanni Maria [Azienda Ospedaliera Brotzu, Cagliari (Italy). Dept. of Radiology; Raz, Eytan [Rome Univ. ' ' La Sapienza' ' (Italy). Dept. of Radiology; New York Univ. Langone Medical Center, New York, NY (United States). Dept. of Radiology

    2016-01-15

    To study the carotid artery plaque composition and its volume changes in a group of patients at baseline and 2 years after head and neck radiation therapy treatment (HNXRT). In this retrospective study, 62 patients (41 males; mean age 63 years; range 52-81) who underwent HNXRT and 40 patients (24 males; mean age 65) who underwent surgical resection of neoplasm and did not undergo HNXRT were assessed, with 2-year follow-up. The carotid artery plaque volumes, as well as the volume of the sub-components (fatty-mixed-calcified), were semiautomatically quantified. Mann-Whitney and Wilcoxon tests were used to test the hypothesis. In the HNXRT group, there was a statistically significant increase in the total volume of the carotid artery plaques (from 533 to 746 mm{sup 3}; p = 0.001), in the fatty plaques (103 vs. 202 mm{sup 3}; p = 0.001) and mixed plaque component volume (328 vs. 419 mm{sup 3}; p = 0.034). A statistically significant variation (from 21.8 % to 27.6 %) in the percentage of the fatty tissue was found. of this preliminary study suggest that HNXRT promotes increased carotid artery plaque volume, particularly the fatty plaque component. (orig.)

  17. Increased serum ferritin levels are independently associated with carotid atherosclerosis in women.

    Science.gov (United States)

    Xu, Haiyan; Song, Yanqi; Xu, Jing; Gu, Yeqing; Zhang, Qing; Liu, Li; Meng, Ge; Wu, Hongmei; Xia, Yang; Bao, Xue; Shi, Hongbin; Su, Qian; Fang, Liyun; Yu, Fei; Yang, Huijun; Sun, Shaomei; Wang, Xing; Zhou, Ming; Jia, Qiyu; Wang, Guolin; Song, Kun; Wu, Yuntang; Sun, Zhong; Niu, Kaijun

    2017-06-01

    Previous studies have supported the theory that there is a positive association between ferritin and carotid atherosclerosis in Western people. Diet plays an important role in determining serum ferritin concentration. Asian dietary patterns are different from Western dietary patterns, implying that there may be a difference in the association of ferritin with carotid atherosclerosis between Asian and Western people. However, few studies focus on the association between ferritin and carotid atherosclerosis among Asians. The aim of this study was to investigate how serum ferritin levels are associated with carotid atherosclerosis in an Asian adult population. A cross-sectional assessment was performed in 8302 adults in Tianjin, China. Carotid intima-media thickness (IMT) and plaques were assessed using ultrasonography, and serum ferritin was measured using the protein chip-chemiluminescence method. Multiple logistic regression analysis was used to examine the association between quartiles of serum ferritin concentration and carotid atherosclerosis. In the present study, the overall prevalence of IMT and carotid plaques in participants is 29·2 and 22·7 %, respectively. In women, after adjustments for potentially confounding factors, the OR of IMT and carotid plaques by increasing serum ferritin quartiles were 1·00, 1·39 (95 % CI 0·98-1·99), 1·39 (95 % CI 0·99-1·97), 1·81 (95 % CI 1·30-2·55) (P for trendserum ferritin and carotid atherosclerosis in men. The study demonstrated that increased serum ferritin levels are independently associated with IMT and carotid plaques in Asian women but not in Asian men.

  18. 颈内动脉颅内段常规头颅CT钙化斑块评分对其狭窄的筛检作用%Screening Effect of the Intracranial Internal Carotid Artery' s Plaque Calcium Score by Using Conventional Brain Unenhanced CT on Artery stenosis

    Institute of Scientific and Technical Information of China (English)

    陈立勋; 张婷; 赵衡; 肖文连; 吴晓东; 刘进才; 游咏

    2013-01-01

    目的 探讨常规头颅CT平扫对颈内动脉颅内段钙化斑块评分及对该段血管狭窄程度的筛检作用.方法 行头颈部CT动脉造影(含常规头颅CT平扫,CTA)的病例110例,按照目测和软件评分相结合的方法将斑块分为4级,选取能成功进行Agatston钙化评分的3、4级斑块并能进行CT动脉造影狭窄分析(AVA)的病例26例,记录斑块的Agatston钙化评分值;采用AVA软件分析该斑块的血管狭窄程度及相应的北美症状性颈动脉内膜切除术(NASCET)标准分级.结果 26例中,轻度狭窄18例,Agatston钙化评分值2.69±1.01;中度狭窄5例,Agatston 钙化评分值5.25±0.88;重度狭窄及闭塞3例,Agatston钙化评分值6.80±0.30.中、重度狭窄与轻度狭窄的血管斑块Agatston钙化评分差异有统计学意义(P<0.05),中、重度狭窄之间差异无统计学意义(P>0.05).狭窄程度与斑块的Agaston钙化评分正相关(r=0.938,P<0.05).结论 常规头颅CT平扫颈内动脉颅内段钙化斑块Agatston评分对该段血管狭窄程度有筛检作用,血管斑块Agatston钙化评分值5.25以上患者应进一步行CTA检查.%Aim To investigate the preliminary scanning significance of artery stenosis with intracranial internal carotid artery' s plaque calcium score using conventional brain unenhanced computed tomography (CT).Methods By retrospectively analyzing brain and neck CT artery imaging (including conventional brain unenhanced CT,CTA) of 110 cases,the intracranial internal carotid artery' s calcification were classified into 4 grades.Of them,there are 26 cases which can be successfully classified into 3/4 grade by Agatston Calcium Score and receive CT artery imaging analysis of vascular and artery (AVA) software.AVA software was used to analyse the calcification segment artery' s stenosis degree and its North American Symptomatic Carotid Endarterectomy Trial criteria (NASCET) classification.Results In the 26 cases,there are 18 cases of mild grade

  19. Apolipoprotein E gene polymorphisms as risk factors for carotid atherosclerosis

    Directory of Open Access Journals (Sweden)

    Zurnić Irena

    2014-01-01

    Full Text Available Background/Aim. Atherosclerosis is still the leading cause of death in Western world. Development of atherosclerotic plaque involves accumulation of inflammatory cells, lipids, smooth muscle cells and extracellular matrix proteins in the intima of the vascular wall. Apolipoprotein E participates in the transport of exogenous cholesterol, endogenouly synthesized lipids and triglycerides in the organism. Apolipoprotein E gene has been identified as one of the candidate genes for atherosclerosis. Previous studies in different populations have clearly implicated apolipoprotein E genetic variation (ε polymorphisms as a major modulator of low density lipoprotein cholesterol levels. Data considering apolipoprotein E polymorphisms in relation to carotid atherosclerosis gave results that are not in full compliance. The aim of present study was to investigate the apolipoprotein E polymorphisms in association with carotid plaque presence, apolipoprotein E and lipid serum levels in patients with carotid atherosclerosis from Serbia. Methods. The study group enrolled 495 participants: 285 controls and 210 consecutive patients with carotid atherosclerosis who underwent carotid endarterectomy. Genotyping of apolipoprotein E polymorphisms were done using polymerase chain reaction and restriction fragment length polymorphism methods. Results. Patients had significantly decreased frequency of the ε2 allele compared to controls. Patients who carry at least one ε2 allele had a significantly higher level of serum apolipoprotein E and significantly lower low density lipoprotein cholesterol levels compared to those who do not carry this allele. Conclusion. Our results suggest protective effect of apolipoprotein E ε2 allele on susceptibility for carotid plaque presence as well as low density lipoprotein cholesterol lowering effect in Serbian patients with carotid atherosclerosis. Further research of multiple gene and environmental factors that contribute to the

  20. Carotid artery stiffness, digital endothelial function, and coronary calcium in patients with essential thrombocytosis, free of overt atherosclerotic disease

    Directory of Open Access Journals (Sweden)

    Vrtovec Matjaz

    2017-05-01

    Full Text Available Patients with myeloproliferative neoplasms (MPNs are at increased risk for atherothrombotic events. Our aim was to determine if patients with essential thrombocytosis (ET, a subtype of MPNs, free of symptomatic atherosclerosis, have greater carotid artery stiffness, worse endothelial function, greater coronary calcium and carotid plaque burden than control subjects.

  1. Stress analysis of fracture of atherosclerotic plaques: crack propagation modeling.

    Science.gov (United States)

    Rezvani-Sharif, Alireza; Tafazzoli-Shadpour, Mohammad; Kazemi-Saleh, Davood; Sotoudeh-Anvari, Maryam

    2016-12-09

    Traditionally, the degree of luminal obstruction has been used to assess the vulnerability of atherosclerotic plaques. However, recent studies have revealed that other factors such as plaque morphology, material properties of lesion components and blood pressure may contribute to the fracture of atherosclerotic plaques. The aim of this study was to investigate the mechanism of fracture of atherosclerotic plaques based on the mechanical stress distribution and fatigue analysis by means of numerical simulation. Realistic models of type V plaques were reconstructed based on histological images. Finite element method was used to determine mechanical stress distribution within the plaque. Assuming that crack propagation initiated at the sites of stress concentration, crack propagation due to pulsatile blood pressure was modeled. Results showed that crack propagation considerably changed the stress field within the plaque and in some cases led to initiation of secondary cracks. The lipid pool stiffness affected the location of crack formation and the rate and direction of crack propagation. Moreover, increasing the mean or pulse pressure decreased the number of cycles to rupture. It is suggested that crack propagation analysis can lead to a better recognition of factors involved in plaque rupture and more accurate determination of vulnerable plaques.

  2. Colour Doppler evaluation of extracranial carotid artery in patients presenting with features of cerebrovascular disease: A clinical and radiological correlation

    Directory of Open Access Journals (Sweden)

    Sanjeev Sehrawat

    2012-01-01

    Full Text Available Aim: To evaluate the morphological and hemodynamic changes that take place in carotid arteries by colour Doppler in patients presenting with features of stroke. Background and Objectives: Cerebrovascular accidents constitute a major cause of adult mortality. The principal indication for cerebrovascular Doppler examination is stroke prevention. Colour Doppler sonography is a sensitive method for detection of atherosclerotic plaque and provides considerable information about the extent and severity of plaque as well as the resulting diminution of arterial lumen. The main strengths of sonography of carotid arteries are patient comfort, lack of risk and accuracy in detecting carotid stenosis. Material and Methods: A prospective study of Colour Doppler in carotid arteries was carried out for 12 months from 1 st July 2009 to 1 st July 2010. The study was carried out on 40 individuals, suspected of cerebrovascular insufficiency and having one or the other risk factors for cerebrovascular disease. A detailed clinical history, CNS examination findings and evidence of hypertension, diabetes mellitus, hyperlipidemia and ischemic heart disease were noted. Carotid Doppler evaluation was done by using Siemens Antares Ultrasound system. The data gathered were grey scale and Doppler findings of common carotid artery, internal carotid artery and external carotid arteries. Doppler findings were correlated with clinical features and risk factors. Results: In our study of 40 patients, the commonest lesion found was the atherosclerotic plaque. Highest incidence of plaque was seen in males 41% in the age group of 60-70 years and in females 37% in age group of 70-80 years. Cigarette smoking was the most common risk factor (60% associated with stroke/ Transient Ischaemic Attacks (TIA. Hemiparesis was the most common presenting symptom (35% among the symptomatic cases. Atheromatous plaque was most commonly found in the right carotid system (60%. Most common site for

  3. Carotid artery stenting will replace carotid endarterectomy.

    Science.gov (United States)

    McCormick, Daniel J; Vlad, Tudor; Fasseas, Panayotis

    2007-09-01

    Stroke is the third leading cause of death in the United States. Carotid artery stenosis represents one of the most common etiologies of stroke. The current treatment modalities available for the treatment of carotid artery stenosis are carotid endarterectomy (CEA) and carotid artery stenting (CAS). Several clinical trials comparing CEA with medical management showed superiority of the surgical arm; however, the applicability of these results to the general population is limited by the fact that the patients and surgeons enrolled in these trials were carefully selected, and the optimal medical therapy used does not meet the current treatment standards. Carotid artery stenting has emerged as a treatment alternative to CEA, as shown in randomized trials comparing the 2 treatment modalities. Recent data from large-volume CAS registries indicate that percutaneous treatment of carotid artery stenosis compares favorably to CEA. Furthermore, the CAS trial designs make these results more applicable to the community standards. These data suggest that CAS will become the treatment of choice in patients with carotid artery stenosis.

  4. Algorithm for quantifying advanced carotid artery atherosclerosis in humans using MRI and active contours

    Science.gov (United States)

    Adams, Gareth; Vick, G. W., III; Bordelon, Cassius; Insull, William; Morrisett, Joel

    2002-05-01

    A new algorithm for measuring carotid artery volumes and estimating atherosclerotic plaque volumes from MRI images has been developed and validated using pressure-perfusion-fixed cadaveric carotid arteries. Our method uses an active contour algorithm with the generalized gradient vector field force as the external force to localize the boundaries of the artery on each MRI cross-section. Plaque volume is estimated by an automated algorithm based on estimating the normal wall thickness for each branch of the carotid. Triplicate volume measurements were performed by a single observer on thirty-eight pairs of cadaveric carotid arteries. The coefficient of variance (COV) was used to quantify measurement reproducibility. Aggregate volumes were computed for nine contiguous slices bounding the carotid bifurcation. The median (mean +/- SD) COV for the 76 aggregate arterial volumes was 0.93% (1.47% +/- 1.52%) for the lumen volume, 0.95% (1.06% +/- 0.67%) for the total artery volume, and 4.69% (5.39% +/- 3.97%) for the plaque volume. These results indicate that our algorithm provides repeatable measures of arterial volumes and a repeatable estimate of plaque volume of cadaveric carotid specimens through analysis of MRI images. The algorithm also significantly decreases the amount of time necessary to generate these measurements.

  5. The content of copper and zinc in human ulcered atherosclerotic plaque

    Directory of Open Access Journals (Sweden)

    Radak Đorđe

    2004-01-01

    Full Text Available INTRODUCTION Copper and zinc have significant antiatherogenic effect influencing activity of antioxidant enzyms (giutathion-peroxidase i superoxid-dismutase, mechanism of apoptosis and other mechanisms. Few studies showed increased copper and zinc concentration in atherosclerotic plaque in comparison to normal vascular tissue. AIM The aim of the study was to compare copper and zinc concentrations in carotid artery tissue without significant atherosclerotic changes and human ulcered atherosclerotic plaque. MATERIAL AND METHODS Study was conducted on 66 patients. Carotid endarterectomy due to the significant carotid atherosclerotic changes with cerebrovascular disorders was performed in 54 patients (81.8%. Control group consisted of 12 patients (18.2% without carotid atherosclerotic changes operated due to the symptomatic kinking and coiling of carotid artery. Operated group consisted of 38 man (62.96% and 16 woman (37.04%. Control group had the same number of patients: six men (50% and six women (50%. Preoperatively, all patients were examined by vascular surgeon, neurologist and cardiologist. Duplex sonografy of carotid and vertebral arteries was performed by Aloca DSD 630 ultrasound with mechanical and linear transducer 7.7 MHz. Indication for surgical treatment was obtained according to non-invasive diagnostic protocol and neurological symptoms. Copper and zinc concentration in human ulcered atherosclerotic plaque and carotid artery segment were estimated by spectophotometry (Varian AA-5. RESULTS Average age of our patients was 59.8±8.1 years. For males average age was 76.1 ±9.8 years. And for females 42.4±5.8 years. In group with carotid endarterectomy female patients were significantly younger than male patients (p<0.01. In group with carotid endarterectomy clinically determined neurological disorders were found in 47 patients (87.03%-35 male (74.47% and 12 female patients (25.53%. Regarding risk factors for cardiovascular diseases, no

  6. Carotid artery stenting: Rationale, technique, and current concepts

    Energy Technology Data Exchange (ETDEWEB)

    Yilmaz, Hasan, E-mail: hasan.yilmaz@hcuge.c [Department of Interventional and Diagnostic Neuroradiology, University Hospital of Geneva (Switzerland); Pereira, Vitor Mendes; Narata, Ana-Paula [Department of Interventional and Diagnostic Neuroradiology, University Hospital of Geneva (Switzerland); Sztajzel, Roman [Department of Neurology, University Hospital of Geneva (Switzerland); Lovblad, Karl-Olof [Department of Interventional and Diagnostic Neuroradiology, University Hospital of Geneva (Switzerland)

    2010-07-15

    Carotid stenosis is a major risk factor for stroke. With the aging of the general population and the availability of non-invasive vascular imaging studies, the diagnosis of a carotid plaque is commonly made in medical practice. Asymptomatic and symptomatic carotid stenoses need to be considered separately because their natural history is different. Two large randomized controlled trials (RCTs) showed the effectiveness of carotid endarterectomy (CEA) in preventing ipsilateral ischemic events in patients with symptomatic severe stenosis. The benefit of surgery is much less for moderate stenosis and harmful in patients with stenosis less than 50%. Surgery has a marginal benefit in patients with asymptomatic stenosis. Improvements in medical treatment must be taken into consideration when interpreting the results of these previous trials which compared surgery against medical treatment available at the time the trials were conducted. Carotid artery stenting (CAS) might avoid the risks associated with surgery, including cranial nerve palsy, myocardial infarction, or pulmonary embolism. Therefore and additionally to well-established indications of CAS, this endovascular approach might be a valid alternative particularly in patients at high surgical risk. However, trials of endovascular treatment of carotid stenosis have failed to provide enough evidence to justify routine CAS as an alternative to CEA in patients suitable for surgery. More data from ongoing randomized trials of CEA versus CAS will be soon available. These results will help determining the role of CAS in the management of patients with carotid artery stenosis.

  7. ADMA/SDMA in Elderly Subjects with Asymptomatic Carotid Atherosclerosis: Values and Site-Specific Association

    Directory of Open Access Journals (Sweden)

    Graziano Riccioni

    2014-04-01

    Full Text Available Asymmetric dimethylarginine (ADMA is an endogenous nitric oxide synthase (NOS inhibitor known as a mediator of endothelial dysfunction and atherosclerosis. Circulating ADMA levels are correlated with cardiovascular risk factors such as hypercholesterolemia, arterial hypertension, diabetes mellitus, hyperhomocysteinemia, age and smoking. We assessed the relationship between ADMA values and site-specific association of asymptomatic carotid atherosclerosis (intima-media thickness (CIMT and plaque in elderly subjects. One hundred and eighty subjects underwent a complete history and physical examination, determination of serum chemistries and ADMA levels, and carotid ultrasound investigation (CUI. All subjects had no acute or chronic symptoms of carotid atherosclerosis. Statistical analyses showed that high plasma levels of ADMA/SDMA were positively correlated to carotid atherosclerosis (CIMT and plaque (p < 0.001, with significant site-specific association. Total cholesterol, low density lipoprotein cholesterol, triglycerides and C-reactive protein plasma concentrations were significantly associated with asymptomatic carotid atherosclerosis (p < 0.001. High serum concentrations of ADMA and SDMA were associated with carotid atherosclerotic lesions as measured by CIMT ad plaque and may represent a new marker of asymptomatic carotid atherosclerosis in elderly subjects.

  8. 糖尿病腹膜透析患者血清糖化血红蛋白水平与颈动脉钙化及心血管事件的关系%Associations among HbA1C, carotid plaques and cardiovascular events in peritoneal dialysis patients with diabetes mellitus

    Institute of Scientific and Technical Information of China (English)

    江丽屏; 梁剑波; 王泽彬; 詹俊琳

    2014-01-01

    Objective To investigate the correlations among HbA 1C , carotid plaques and cardiovascular events in peritoneal dialysis patients with diabetes mellitus .Methods Sixty peritoneal dialysis patients , whose original diseases were diabetes mellitus, were divided into two groups according to the serum HbA 1C level.HbA1C and other serum related parameters were assessed , and carotid intima-media thickness ( cIMT) was checked by B-mode ultrasonography .After one year follow-up, the associations among the serum HbA 1C level, deterioration of cIMT and newly -occurring cardio-vascular events were analyzed .Results Significantly higher cIMT and cardiovascular event rate were observed in high HbA1C group than low HbA1C group (P<0.05).After one year follow-up, progression of cIMT and newly occurring car-diovascular events were significantly higher in high HbA 1C group than low HbA1C group.Logistic regression analysis indica-ted that serum HbA1C level was risk factor of cIMT (OR=1.72, 95%CI:0.92~3.87, P=0.024);while serum HbA1C (OR=1.43, 95%CI:0.73~3.46, P=0.012) level and cIMT (OR=3.17, 95%CI:1.38~5.99, P=0.018) were risk factors of cardiovascular events in peritoneal dialysis patients with diabetes mellitus .Conclusion Serum HbA1C is a risk factor of carotid plaques , and serum HbA1C and cIMT were risk factors of cardiovascular events in peritoneal dialysis with diabetes mellitus .%目的:探讨糖尿病腹膜透析患者糖化血红蛋白( HbA1C )水平与颈动脉钙化及心血管事件的关系。方法将60例基础病为糖尿病肾病的腹膜透析患者按照HbA1C的水平分成两组,检测血清HbA1C水平及相关因素,所有的患者均接受颈动脉斑块超声检测,随访1年,观察两组患者血清HbA1C水平、颈动脉钙化的动态变化及心血管事件发生情况。结果低HbA1C组患者颈动脉钙化及心血管事件发生均低于高HbA1C组( P<0.05);随访1年,低HbA1C组的颈动脉钙化进展及新发心血

  9. [Detection of inflammation in an atherosclerose plaque: the role of the positron emission tomography and C reactive protein].

    Science.gov (United States)

    Alexánderson, Erick; Mendoza, Raúl G; Adame, Gloria; Talayero, José Antonio; Sierra, Carlos; Cruz, Patricio; García-Rojas, Leonardo; Rodríguez-Valero, Mónica; Flores, Armando; Zárate, Adolfo; Meave, Aloha; Arauz, Antonio

    2007-01-01

    To demonstrate that inflammatory atheromatose carotid plaques can be visualized with positron emission tomography with 18F-fluorodeoxyglucose (18FDG PET) in symptomatic patients, in order to correlate them with systemic inflammatory markers, such as CRP. Fifteen patients with cerebral ischemia due to atherosclerotic carotid disease were studied. 18FDG uptake with PET was considered and blood samples were taken for determining high sensibility C reactive protein (HsCRP). The mean age of the patients was 66 years; 11 of them were males (73%) and 4 were females (27%). 18FDG PET was positive in 12 patients (80%), while 100% of the studied population had low risk HsCRP with normal white cell count. 18FDG PET proves active inflammation in carotid atheromatose plaques. There was no significant correlation between the presence of ahteromatose carotid plaques, HsCRP serum levels, and 18FDG PET study.

  10. Factors predicting compensatory vascular remodelling of the carotid artery affected by atherosclerosis

    Science.gov (United States)

    Saito, D; Oka, T; Kajiyama, A; Ohnishi, N; Shiraki, T

    2002-01-01

    Objective: To investigate factors predicting the development of outward remodelling of the carotid artery in patients with atherosclerosis. Design: 130 patients with carotid artery stenosis (15–85% of the vessel diameter) were divided into two groups, based on the presence or absence of outward remodelling of the sclerotic carotid segment on high resolution ultrasonography. Logistic regression analysis was used to evaluate the contribution of haemodynamic, laboratory, and clinical measurements on the development of remodelling, including age, sex, type of stenosis, extent of plaque, per cent diameter stenosis, underlying disease, selected drug treatment, and plasma concentrations of total cholesterol, high density lipoprotein cholesterol, triglyceride, and uric acid. Results: 64 patients (49%) had outward remodelling. Multivariate regression analysis showed that hypertension, the type of plaque, the thickness of the plaque, and the extent of stenosis were independent factors predicting remodelling. The odds ratios of hypertension, unstable shape of plaque, thickness of plaque, and the extent of the stenosis were 6.70, 3.02, 2.04, and 1.05, respectively. Other measurements did not contribute significantly to the estimation of remodelling. Conclusions: Compensatory enlargement of the vessel occurs in about 50% of carotid artery segments with a diameter stenosis of 15–85%. Hypertension and the shape of the plaque are major determinants of the development of outward remodelling. PMID:11796551

  11. Relationship between Carotid Computed Tomography Dual-Energy and Brain Leukoaraiosis.

    Science.gov (United States)

    Saba, Luca; Sanfilippo, Roberto; Balestrieri, Antonella; Zaccagna, Fulvio; Argiolas, Giovanni Maria; Suri, Jasjit S; Montisci, Roberto

    2017-08-01

    The purpose of this study was to assess if there is a correlation between the carotid computed tomography (CT) Hounsfield unit (HU)-based plaque attenuation values measured using dual-energy CT (DECT) scanner and brain leukoaraiosis (LA). Fifty consecutive patients (34 males, 16 females; mean age, 69 years; age range, 46-84 years) who underwent carotid CT and brain magnetic resonance imaging were included in the study. CT examinations were performed with a DECT scanner, and LA lesion volume quantification was performed using a semiautomated segmentation technique. We found an inverse statistically significant correlation between the HU-based carotid artery plaque attenuation and the LA lesion volume. Because of the presence of calcified plaques, a second model was calculated at low kiloelectron volt levels from 66 to 100 and 100 kV by taking into consideration the fatty and mixed plaques, and this further led to the associations between HU-based attenuation and LA volume in brain and vascular territories. The results of our study suggest that the associations between HU attenuation of the carotid artery plaques (with the exclusion of calcified plaques) and the volume of LA are emphasized at low keV energy levels. Copyright © 2017 National Stroke Association. Published by Elsevier Inc. All rights reserved.

  12. Atherosclerotic Plaque Destabilization in Mice: A Comparative Study.

    Directory of Open Access Journals (Sweden)

    Helene Hartwig

    Full Text Available Atherosclerosis-associated diseases are the main cause of mortality and morbidity in western societies. The progression of atherosclerosis is a dynamic process evolving from early to advanced lesions that may become rupture-prone vulnerable plaques. Acute coronary syndromes are the clinical manifestation of life-threatening thrombotic events associated with high-risk vulnerable plaques. Hyperlipidemic mouse models have been extensively used in studying the mechanisms controlling initiation and progression of atherosclerosis. However, the understanding of mechanisms leading to atherosclerotic plaque destabilization has been hampered by the lack of proper animal models mimicking this process. Although various mouse models generate atherosclerotic plaques with histological features of human advanced lesions, a consensus model to study atherosclerotic plaque destabilization is still lacking. Hence, we studied the degree and features of plaque vulnerability in different mouse models of atherosclerotic plaque destabilization and find that the model based on the placement of a shear stress modifier in combination with hypercholesterolemia represent with high incidence the most human like lesions compared to the other models.

  13. Indium-111-labeled platelet scintigraphy in carotid atherosclerosis

    Energy Technology Data Exchange (ETDEWEB)

    Minar, E.; Ehringer, H.; Dudczak, R.; Schoefl, R.J.; Jung, M.; Koppensteiner, R.; Ahmadi, R.; Kretschmer, G.

    1989-01-01

    We evaluated platelet accumulation in carotid arteries by means of a dual-radiotracer method, using indium-111-labeled platelets and technetium-99m-labeled human serum albumin, in 123 patients (92 men, 31 women; median age 60 years). Sixty patients had symptoms of transient ischemic carotid artery disease, and 63 patients with peripheral arterial occlusive disease served as controls. Antiplatelet treatment with acetylsalicylic acid was taken by 53 of the 123 patients. In 36 of the 60 symptomatic patients, platelet scintigraphy was repeated 3-4 days after carotid endarterectomy. Comparison of different scintigraphic parameters (platelet accumulation index and percent of the injected dose of labeled platelets at the carotid bifurcation) showed no significant differences between symptomatic and asymptomatic patients, and the severity of stenosis and the presence of plaque ulceration also had no influence on the parameters. There was no difference between patients with a short (less than 4 weeks) or long (greater than 4 weeks) interval from the last transient ischemic attack to scintigraphy and no difference between patients with or without antiplatelet treatment. Classifying the patients according to plaque morphology judged by high-resolution real-time ultrasonography also demonstrated no differences. No significant correlation was found between any scintigraphic parameter and other platelet function parameters such as platelet survival time, platelet turnover rate, and concentration of platelet-specific proteins. Quantification of platelet deposition after carotid endarterectomy in 36 patients demonstrated a significant increase of the median platelet accumulation index and the percent injected dose index.

  14. [Importance of morphologic evaluation of carotid lesions in their correlation with cerebral ischemic pathology].

    Science.gov (United States)

    Sanjosé Pijoán, N; Ortiz Valentín, J; Oliva Balaciart, J; Llopis García, M A; Asamar Soler, J J; Ramón Fondevilla, R

    1992-01-01

    Authors present a review of 182 atheromatous plaques into the extracranial carotid trunks. Diagnosis of such pathologies were made by Eco-Doppler on 615 patients. Objective was to determinate the emboligen potential of the plaques following structural and functional criteria. Almost all the symptomatic plaques with functional disturbances showed some structural injury with emboligen potential. Two third parts of all the symptomatic diseases hemodynamically no-significant were associated with plaques with emboligen power. On stenosis higher than 70%, functional criterium was more important for study than structural criterium.

  15. Carotid Stump Syndrome

    Directory of Open Access Journals (Sweden)

    Lara Toufic Dakhoul MD

    2014-08-01

    Full Text Available Objectives. To highlight the case of a patient with multiple transient ischemic attacks and visual disturbances diagnosed with carotid stump syndrome and managed with endovascular approach. Case Presentation. We present the case of a carotid stump syndrome in an elderly patient found to have moderate left internal carotid artery stenosis in response to an advertisement for carotid screening. After a medical therapeutic approach and a close follow-up, transient ischemic attacks recurred. Computed tomographic angiography showed an occlusion of the left internal carotid artery and the presence of moderate stenosis in the right internal carotid artery, which was treated by endovascular stenting and balloon insertion. One month later, the patient presented with visual disturbances due to the left carotid stump and severe stenosis of the left external carotid artery that was reapproached by endovascular stenting. Conclusion. Considerations should be given to the carotid stump syndrome as a source of emboli for ischemic strokes, and vascular assessment could be used to detect and treat this syndrome.

  16. F-18 fluoride positron emission tomography-computed tomography for detecting atherosclerotic plaques

    Energy Technology Data Exchange (ETDEWEB)

    Kang, Won Jun [Dept. of Nuclear Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul (Korea, Republic of)

    2015-12-15

    A large number of major cardiovascular events occur in patients due to minimal or some lumen narrowing of the coronary artery. Recent biological studies have shown that the biological composition or vulnerability of the plaque is more critical for plaque rupture compared to the degree of stenosis. To overcome the limitations of anatomical images, molecular imaging techniques have been suggested as promising imaging tools in various fields. F-18 fluorodeoxyglucose (FDG), which is widely used in the field of oncology, is an example of molecular probes used in atherosclerotic plaque evaluation. FDG is a marker of plaque macrophage glucose utilization and inflammation, which is a prominent characteristic of vulnerable plaque. Recently, F-18 fluoride has been used to visualize vulnerable plaque in clinical studies. F-18 fluoride accumulates in regions of active microcalcification, which is normally observed during the early stages of plaque formation. More studies are warranted on the accumulation of F-18 fluoride and plaque formation/vulnerability; however, due to high specific accumulation, low background activity, and easy accessibility, F-18 fluoride is emerging as a promising non-invasive imaging probe to detect vulnerable plaque.

  17. Cumulative Effects of Hypertension, Dyslipidemia, and Chronic Kidney Disease on Carotid Atherosclerosis in Chinese Patients with Type 2 Diabetes Mellitus

    Directory of Open Access Journals (Sweden)

    Chuang Yuan

    2014-01-01

    Full Text Available Aims. The aim of this study is to determine the extent of carotid atherosclerosis in Chinese patients with type 2 diabetes in relation to the cumulative atherosclerosis risk factors using ultrasonography. Methods. The presence of hypertension, dyslipidemia, and chronic kidney disease (CKD was documented in 106 Chinese subjects with type 2 diabetes. Subjects with 0, 1, and ≥2 additional atherosclerosis risk factors were assigned into groups 1, 2, and 3, respectively (n=17, 49, and 40, resp.. Using ultrasound, the carotid arteries were assessed for the presence of carotid plaque, plaque score, intima-media thickness (IMT, and carotid arterial stiffness. Results. With the adjustment for age and gender, the presence of plaque and plaque score were significantly higher in groups with more atherosclerosis risk factors (P 60 years old (odds ratio = 2.75; 95% CI: 1.26–6.0 and the presence of hypertension (odds ratio = 2.48; 95% CI: 1.11–5.58, dyslipidemia (odds ratio = 2.41; 95% CI: 1.05–5.51, and CKD (odds ratio = 7.80; 95% CI: 1.46–41.72 could independently predict higher plaque score (P<0.05. Conclusions. Hypertension, dyslipidemia, and CKD in Chinese patients with type 2 diabetes have cumulative effects on the burden of carotid plaque.

  18. CAROTID ATHEROSCLEROTIC LESION IN YOUNG PATIENTS

    Directory of Open Access Journals (Sweden)

    N. V. Pizova

    2014-01-01

    Full Text Available Objective: to determine the incidence of atherosclerotic lesions in the carotid and vertebral arteries of young patients from Doppler ultrasound data and to compare the quantitatively assessed traditional risk factors of coronary heart disease (CHD with severe extracranial artery atherosclerotic lesion.Subjects and methods. Doppler ultrasound was carried out evaluating structural changes in the aortic arch branches in 1563 railway transport workers less than 45 years of age. A separate sample consisted of 68 young people with carotid atherosclerotic changes, in whom traditional risk factors for CHD were studied, so were in a control group of individuals without atherosclerotic changes (n = 38.Results. Among the examinees, carotid atherosclerotic lesion was detected in 112 (7.1 % cases, the increase in the rate of atherosclerotic plaques in patients aged 35–45 years being 9.08 %; that in the rate of local intima-media thickness in those aged 31–40 years being 5.1 %. Smoking (particularly that along with hypercholesterolemia and a family history of cardiovascular diseases, obesity (along with low activity, and emotional overstrain were defined as important risk factors in the young patients. Moreover, factor analysis has shown that smoking,hypertension, and early cardiovascular pathology in the next of kin makes the greatest contribution to the development of carotid atherosclerotic lesion.Conclusion. Among the patients less than 45 years of age, carotid and vertebral artery atherosclerotic changes were found in 112 (7.1 % cases, which were more pronounced in male patients. Smoking, particularly along with hypercholesterolemia and genetic predisposition to cardiovascular diseases, was a risk factor that had the highest impact on the degree of atherosclerotic lesion in the aortic arch branches of the young patients.

  19. Association of Morning Blood Pressure Surge with Carotid Artery Plaque Ulceration in Ischemic Stroke Patients with Pathogenesis of Artery to Artery Embolism%动脉-动脉栓塞性缺血性卒中患者晨峰血压与颈动脉溃疡斑块的相关性研究

    Institute of Scientific and Technical Information of China (English)

    程伟; 包艳娥; 聂莉; 李婉秋; 乔向亮; 程晓玲

    2013-01-01

    目的在动脉-动脉栓塞性缺血性卒中患者中,探讨晨峰高血压与颈动脉溃疡斑块的相关性。方法连续入组120例经中国缺血性卒中亚型(Chinese Ischemic Stroke Subclassification,CISS)分型诊断为动脉-动脉栓塞性缺血性卒中患者,利用24 h动态血压监测以及颈动脉彩超分别监测晨峰血压及颈动脉溃疡斑块。利用Logistic回归模型,研究晨峰血压与颈动脉溃疡斑块的相关性。结果120例缺血性卒中患者的平均年龄为(62.6±12.8)岁,女性占36.8%。晨峰高血压组(n=48)溃疡斑块的检出率与无晨峰高血压组(n=72)相比,差异无显著性(31.3% vs 30.6%,P=0.84)。进一步将溃疡斑块按照检出部位(出现在卒中病灶同侧颈动脉或对侧颈动脉)进行分类发现,晨峰高血压组病灶同侧溃疡斑块的检出率明显高于无晨峰高血压组(27.1% vs 19.4%,P=0.008)。多因素分析的结果显示,在调整了年龄、性别之后,晨峰高血压与病灶同侧溃疡斑块的相关性具有统计学意义[优势比(odds ratio,OR):1.42;95%可信区间(confidence interval,CI):1.09~4.22)];进一步校正其他危险因素之后,两者相关性仍存在(OR 1.23;95%CI 1.02~3.46)。结论在动脉-动脉栓塞性缺血性卒中患者中,晨峰高血压与卒中病灶同侧颈动脉溃疡斑块的检出率具有相关性,提示过高的晨峰血压可能是颈动脉溃疡斑块脱落导致动脉-动脉栓塞型缺血性卒中发病的危险因素。%Objective To investigate the association of morning blood pressure surge (MBPS) with carotid artery plaque ulceration (CAPU) in ischemic stroke (IS) patients. Methods One hundred and twenty IS patients diagnosed with artery to artery embolism based on Chinese Ischemic Stroke Subclassiifcation (CISS) were enrolled in this study. MBPS was monitored by ambulatory blood pressure monitoring within 24 hours, and CAPU

  20. Dental plaque identification at home

    Science.gov (United States)

    ... this page: //medlineplus.gov/ency/article/003426.htm Dental plaque identification at home To use the sharing ... that collects around and between teeth. The home dental plaque identification test shows where plaque builds up. ...

  1. Decreased Regulatory T Cells in Vulnerable Atherosclerotic Lesions: Imbalance between Pro- and Anti-Inflammatory Cells in Atherosclerosis

    Directory of Open Access Journals (Sweden)

    Ilonka Rohm

    2015-01-01

    Full Text Available Atherosclerosis is a chronic inflammatory disease of the arterial wall in which presentation of autoantigens by dendritic cells (DCs leads to the activation of T cells. Anti-inflammatory cells like Tregs counterbalance inflammation in atherogenesis. In our study, human carotid plaque specimens were classified as stable (14 and unstable (15 according to established morphological criteria. Vessel specimens (n=12 without any signs of atherosclerosis were used as controls. Immunohistochemical staining was performed to detect different types of DCs (S100, fascin, CD83, CD209, CD304, and CD123, proinflammatory T cells (CD3, CD4, CD8, and CD161, and anti-inflammatory Tregs (FoxP3. The following results were observed: in unstable lesions, significantly higher numbers of proinflammatory cells like DCs, T helper cells, cytotoxic T cells, and natural killer cells were detected compared to stable plaques. Additionally, there was a significantly higher expression of HLA-DR and more T cell activation (CD25, CD69 in unstable lesions. On the contrary, unstable lesions contained significantly lower numbers of Tregs. Furthermore, a significant inverse correlation between myeloid DCs and Tregs was shown. These data suggest an increased inflammatory state in vulnerable plaques resulting from an imbalance of the frequency of local pro- and anti-inflammatory immune cells.

  2. Carotid endovascular interventions: patient selection, devices, techniques and tips.

    Science.gov (United States)

    Bosiers, M; Deloose, K; Peeters, P

    2010-02-01

    The optimal treatment of patients with asymptomatic or symptomatic carotid artery disease (CAD) has been a long-lasting debate. The choice between carotid endarterectomy (CEA), carotid artery stenting (CAS) and/or optimal medical therapy to treat patients with CAD, depends on their risk profile. Recent data from EVA-3S, SPACE randomized trials failed to demonstrate non-inferiority for CAS over CEA. However, other publications suggest that with growing experience and the development of dedicated CAS technology, CAS can be performed safely and efficiently. The success of carotid stenting does not solely depend on the operator's skills and experience, but also on the adequate selection of carotid stents and cerebral protection devices. Currently, CAS practitioners are confronted with a large number of dedicated CAS devices (stents and embolic protection devices). This wide array of products makes individual treatment strategies difficult to generalise as no single device possesses all of the optimal features to treat all types of carotid plaques and patients. This article reviews the principles of patient selection and device selection in contemporary CAS practice.

  3. Serum ferritin levels are associated with carotid atherosclerosis in Chinese postmenopausal women: the Shanghai Changfeng Study.

    Science.gov (United States)

    Ma, Hui; Lin, Huandong; Hu, Yu; Li, Xiaoming; He, Wanyuan; Jin, Xuejuan; Gao, Jian; Zhao, Naiqing; Song, Binbin; Pan, Boshen; Gao, Xin

    2015-10-14

    Postmenopausal women are at increased risk of CVD: the increased serum ferritin level may be involved in the pathogenesis. The aim of the present study is to investigate the relationship of ferritin and carotid atherosclerosis in postmenopausal women. A total of 1178 postmenopausal women (mean age, 60·8 years) were enrolled from the Changfeng Study. A standard interview, anthropometric measurements and laboratory analyses were performed for each participant. Bilateral CIMT (carotid intima-media thickness) were measured using ultrasonography, and the presence of carotid plaques was assessed. Serum ferritin was measured using electrochemiluminescence immunoassay. The results showed that serum ferritin was 181·9 (sd 65·8) ng/ml in the postmenopausal women. Multivariate, linear, stepwise regression analysis demonstrated that age (standardised β = 0·233, Pserum ferritin. Compared with the ferritin level of subjects in the first quartile, that in the fourth quartile had greater CIMT, and higher prevalence of carotid plaque. After adjusting for conventional CVD risk factors, Hb, leucocytes, log urine albumin:creatinine ratio and liver function, the ferritin level of postmenopausal women in the fourth quartile had a 1·587-fold increased risk of carotid plaques relative to those in the lowest quartile. In conclusion, these results suggest that serum ferritin is independently and positively associated with carotid atherosclerosis in postmenopausal women and that ferritin may be implicated in atherosclerosis.

  4. Multimodal optoacoustic and multiphoton microscopy of human carotid atheroma

    Directory of Open Access Journals (Sweden)

    Markus Seeger

    2016-09-01

    Full Text Available Carotid artery atherosclerosis is a main cause of stroke. Understanding atherosclerosis biology is critical in the development of targeted prevention and treatment strategies. Consequently, there is demand for advanced tools investigating atheroma pathology. We consider hybrid optoacoustic and multiphoton microscopy for the integrated and complementary interrogation of plaque tissue constituents and their mutual interactions. Herein, we visualize human carotid plaque using a hybrid multimodal imaging system that combines optical resolution optoacoustic (photoacoustic microscopy, second and third harmonic generation microscopy, and two-photon excitation fluorescence microscopy. Our data suggest more comprehensive insights in the pathophysiology of atheroma formation and destabilization, by enabling congruent visualization of structural and biological features critical for the atherosclerotic process and its acute complications, such as red blood cells and collagen.

  5. Prediction of progression of ultrasound assessed carotid artery athersclerosis

    OpenAIRE

    2014-01-01

    Atherosclerosis is an important underlying cause of cardiovascular disease and death. According to the World Health Organization’s Global Burden of Disease Study, ischemic heart disease and stroke combined killed 12.9 million people in 2010, or one in four deaths worldwide. Ultrasound of the carotid arteries can be used to assess the burden of atherosclerosis by measurements of intima-media thickness (IMT) and total plaque area (TPA). Age, male gender, serum cholesterol, blood pressure and...

  6. Imaging markers of stroke risk in asymptomatic carotid artery stenosis

    Directory of Open Access Journals (Sweden)

    Shyam Prabhakaran

    2015-01-01

    Full Text Available Carotid stenosis is a major cause of ischemic stroke. While symptomatic carotid stenosis requires prompt revascularization, there is significant debate about the management of asymptomatic carotid stenosis (ACS, especially in light of recent advances in medical therapy. As a result, there is an even greater need for reliable predictors of stroke risk in asymptomatic patients. Besides clinical factors and stenosis grade, plaque morphology and cerebral hemodynamics may be suitable prognostic tools. High-risk features, using Doppler and magnetic resonance imaging (MRI suggest that subpopulations at sufficiently high risk (10% annually can be identified and in whom revascularization would be most beneficial. In this review, imaging tools to aid in stroke risk stratification in patients with ACS are discussed.

  7. Low prevalence of significant carotid artery disease in Iranian patients undergoing elective coronary artery bypass

    Directory of Open Access Journals (Sweden)

    Karimi Fatemeh

    2007-01-01

    Full Text Available Abstract Background Coronary artery bypass grafting ranks as one of the most frequent operations worldwide. The presence of carotid artery stenosis may increase the stroke rate in the perioperative period. Routine preoperative noninvasive assessment of the carotid arteries are recommended in many institutions to reduce the stroke rate. Methods 271 consecutive patients undergoing coronary artery bypass grafting at Shaheed Madani hospital of Tabriz, Iran (age, 58.5 Y; 73.1% male underwent preoperative ultrasonography for assessment of carotid artery wall thickness. Results Plaque in right common, left common, right internal and left internal carotid arteries was detected in 4.8%, 7.4%, 43.2% and 42.1% of patients respectively. 5 patients (1.8% had significant ( Conclusion Consecutive Iranian patients undergoing elective coronary artery bypass surgery show a very low prevalence of significant carotid artery disease.

  8. David M. Hume Memorial Lecture. An overview of the stroke problem in the carotid territory.

    Science.gov (United States)

    Callow, A D

    1980-08-01

    In a review of 1,000 carotid endarterectomies performed over a 20 year period, there was relief of transient ischemic attacks in approximately 85% of patients, an operative mortality of 1.3%, due almost exclusively to myocardial infarction, and a recurrent stenosis rate of 3.1%. Coexisting cardiac disease constitutes the greatest operative hazard. Continuous electroencephalographic monitoring is a reliable method of detecting inadequate cerebral perfusion during carotid cross clamping and for the selective use of a temporary inlying carotid shunt. An atherosclerotic plaque in the carotid system constitutes a greater risk than elsewhere in the peripheral arterial system and should not be considered an innocent lesion. Prophylactic carotid endarterectomy can be performed with almost no mortality and morbidity. Antiplatelet agents, while useful in reducing the incidence of transient ischemic attacks, do not seem to provide equal protection against stroke and death from stroke.

  9. White Matter Lesions, Carotid and Coronary Atherosclerosis in Late-Onset Depression and Healthy Controls

    DEFF Research Database (Denmark)

    Devantier, Torben Albert; Nørgaard, Bjarne Linde; Poulsen, Mikael Kjær

    2016-01-01

    for the formation of WMLs in depression. METHODS: The case-control study included 29 patients with late-onset major depressive disorder and 27 controls matched for sex, age, and tobacco use. WML volume, carotid intima-media thickness, and coronary plaque volume were assessed using magnetic resonance imaging.......051). In both patients and controls, WML volume was associated with carotid but not with coronary atherosclerosis. In adjusted multiple linear regression, a 0.1mm increase in averaged carotid intima-media thickness was associated with a 52% (95% CI: 8.4-112, p = 0.032) increase in WML volume. The association...... between carotid intima-media thickness and WML volume was, however, similar in patients and controls. CONCLUSIONS: In older persons aged between 50 and 70 years, WMLs do not seem to be a part of generalized atherosclerotic disease, but seem to be dependent on atherosclerosis in the carotid arteries...

  10. 前列腺素E1对兔动脉粥样硬化易损斑块内新生血管的影响%Effects of Prostaglanadin E1 on Angiogenesis in Atherosclerotic Vulnerable Plaques in Rabbits

    Institute of Scientific and Technical Information of China (English)

    郑雪; 白万军; 周聊生; 李宏建

    2012-01-01

    目的 建立兔动脉粥样硬化易损斑块模型,选择辛伐他汀为阳性对照药物,观察前列腺素E1对斑块易损指数及斑块内新生血管的影响.方法 将30只新西兰兔随机分为模型组、前列腺素E1组、辛伐他汀组,每组10只,建立易损斑块模型,并进行药物干预.腹主动脉切片进行形态学及斑块内出血观察;计算斑块易损指数;免疫组化观察斑块内相关因子表达;逆转录聚合酶链反应检测相关因子mRNA表达水平.结果 与模型组相比,前列腺素E1组斑块易损指数显著降低(1.23±0.23比2.84±0.59,P<0.05),血小板内皮细胞黏附分子1的表达明显减少(0.153±0.031比0.381±0.062,P<0.05),斑块内出血现象明显减轻;并且能够显著降低斑块内缺氧诱导因子1α、血管内皮生长因子蛋白表达(0.252±0.032比0.439±0.044,P<0.01;0.396±0.026比0.673±0.084,P<0.01)及mRNA水平(0.706±0.032比1.183±0.134,P<0.05;0.121±0.019比0.468±0.022,P<0.05);前列腺素E1组和辛伐他汀组斑块内缺氧诱导因子1α的蛋白表达及mRNA水平具有显著性差异(0.252±0.032比0.163±0.018,P <0.05;0.706±0.032比0.763±0.018,P<0.05).结论 前列腺素E1能够抑制斑块内新生血管的生成,具有稳定易损斑块的作用,其可能机制与辛伐他汀有所不同,是通过抑制斑块内缺氧诱导因子1α的激活进而下调血管内皮生长因子表达发挥作用.%Aim To establish the rabbit model of atherosclerotic vulnerable plaques, and study the effects of prostaglandin El on the angiogenesis which is induced by atherosclerosis. Methed 30 New Zealand white rabbits were randomly divided into 3 groups (model group, prostaglandin El group, and simvastatin group), each group has 10 rabbits. The rabbit model of atherosclerotic vulnerable plaques were established, and the rabbits were given drugs to affect the disease. The abdominal aorta were processed and examined by hematoxylin-eosin (HE) staining. The

  11. Diagnosis of atherosclerosis in human carotid artery by FT-Raman spectroscopy: Principal Components Analysis algorithm

    Science.gov (United States)

    Nogueira, Grazielle V.; Silveira, Landulfo, Jr.; Martin, Airton A.; Zangaro, Renato A.; Pacheco, Marcos T.; Chavantes, Maria C.; Zampieri, Marcelo; Pasqualucci, Carlos A. G.

    2004-07-01

    FT- Raman Spectroscopy (FT-Raman) could allow identification and evaluation of human atherosclerotic lesions. A Raman spectrum can provide biochemical information of arteries which can help identifying the disease status and evolution. In this study, it is shown the results of FT-Raman for identification of human carotid arteries in vitro. Fragments of human carotid arteries were analyzed using a FT-Raman spectrometer with a Nd:YAG laser at 1064nm operating at an excitation power of 300mW. Spectra were obtained with 250 scans and spectral resolution of 4 cm-1. Each collection time was approximately 8 min. A total of 75 carotid fragments were spectroscopically scanned and FT-Raman results were compared with histopathology. Principal Components Analysis (PCA) was used to model an algorithm for tissue classification into three categories: normal, atherosclerotic plaque without calcification and atherosclerotic plaque with calcification. Non-atherosclerotic (normal) artery, atherosclerotic plaque and calcified plaque exhibit different spectral signatures related to biochemicals presented in each tissue type, such as, bands of collagen and elastin (proteins), cholesterol and its esters and calcium hydroxyapatite and carbonate apatite respectively. Results show that there is 96% match between classifications based on PCA algorithm and histopathology. The diagnostic applied over all 75 samples had sensitivity and specificity of about 89% and 100%, respectively, for atherosclerotic plaque and 100% and 98% for calcified plaque.

  12. Aortic atherosclerotic plaque detection using a multiwavelength handheld photoacoustic imaging system

    Science.gov (United States)

    Hirano, Susumu; Namita, Takeshi; Kondo, Kengo; Yamakawa, Makoto; Shiina, Tsuyoshi

    2016-03-01

    Patients affected by diseases caused by arteriosclerosis are increasing. Atherosclerosis, which is becoming an especially difficult health problem, forms plaques from lipids such as cholesterol located in walls of the aorta, cerebral artery, and coronary artery. Because lipid-rich plaques are vulnerable and because arterial rupture causes acute vascular occlusion, early detection is crucially important to prevent plaque growth and rupture. Ultrasound systems can detect plaques but cannot discriminate between vulnerable and equable plaques. To evaluate plaques non-invasively and easily, we developed a handheld photoacoustic imaging device. Its usefulness was verified in phantom experiments with a bovine aorta in which mimic plaque had been embedded. Photoacoustic images taken at wavelengths that produce high light absorbance by lipids show strong photoacoustic signals from the boundary of the mimic plaque. Results confirmed that our system can evaluate plaque properties by analysis with the photoacoustic spectrum. The effects of surrounding tissues and tissue components on plaque evaluation were investigated using a layered phantom. The mimic plaque located under a 6 mm blood layer was also evaluated. Results of these analyses demonstrate the system's usefulness.

  13. Corneal mucus plaques.

    Science.gov (United States)

    Fraunfelder, F T; Wright, P; Tripathi, R C

    1977-02-01

    Corneal mucus plaques adhered to the anterior corneal surface in 17 of 67 advanced cases of keratoconjunctivitis sicca. The plaques were translucent to opaque and varied in size and shape, from multiple isolated islands to bizarre patterns involving more than half the corneal surface. Ultrastructurally, they consisted of mucus mixed with desquamated degenerating epithelial cells and proteinaceous and lipoidal material. The condition may be symptomatic but can be controlled and prevented in most cases by topical ocular application of 10% acetylcysteine.

  14. Influence of insonification angle on echogenicity of B-mode images of atherosclerotic plaque in vitro

    DEFF Research Database (Denmark)

    Wilhjelm, Jens E.; Jespersen, Søren Kragh; Hansen, J. U.;

    1998-01-01

    A newly developed (off-line) spatial compound scanner was used to scan formalin-fixed atherosclerotic carotid plaques. Forty-eight B-mode images were recorded using 7 insonification angles. All calculations were done on the envelope-detected image data. The mean amplitude level (MAL) in (relative...

  15. Staged bilateral carotid endarterectomy

    DEFF Research Database (Denmark)

    Schroeder, T; Sillesen, H; Engell, Hans Christian

    1986-01-01

    In a series of 56 staged bilateral carotid endarterectomies, new neurologic symptoms developed in 5% and 20% following the first and second procedure, respectively. All complications were transient or minor. The incidence of postendarterectomy hypertension was significantly higher following...

  16. Carotid dissection (image)

    Science.gov (United States)

    ... This leaking of blood into the artery wall (dissection) may cause a clot to form, reducing blood ... the neck, which means stroke secondary to carotid dissection may occur in young people as well as ...

  17. Three-dimensional carotid ultrasound segmentation variability dependence on signal difference and boundary orientation.

    Science.gov (United States)

    Chiu, Bernard; Krasinski, Adam; Spence, J David; Parraga, Grace; Fenster, Aaron

    2010-01-01

    Quantitative measurements of the progression (or regression) of carotid plaque burden are important in monitoring patients and evaluating new treatment options. We previously developed a quantitative metric to analyze changes in carotid plaque morphology from 3-D ultrasound (US) on a point-by-point basis. This method requires multiple segmentations of the arterial wall and lumen boundaries to obtain the local standard deviation (SD) of vessel-wall-plus-plaque thickness (VWT) so that t-tests could be used to determine whether a change in VWT is statistically significant. However, the requirement for multiple segmentations makes clinical trials laborious and time-consuming. Therefore, this study was designed to establish the relationship between local segmentation SD and local signal difference on the arterial wall and lumen boundaries. We propose metrics to quantify segmentation SD and signal difference on a point-by-point basis, and studied whether the signal difference at arterial wall or lumen boundaries could be used to predict local segmentation SD. The ability to predict the local segmentation SD could eliminate the need of repeated segmentations of a 2-D transverse image to obtain the local segmentation standard deviation, thereby making clinical trials less laborious and saving time. Six subjects involved in this study were associated with different degrees of atherosclerosis: three carotid stenosis subjects with mean plaque area >3 cm(2) and >60% carotid stenosis were involved in a clinical study evaluating the effect of atorvastatin, a cholesterol-lowering and plaque-stabilizing drug; and three subjects with carotid plaque area >0.5 cm(2) were subjects with moderate atherosclerosis. Our results suggest that when local signal difference is higher than 8 greyscale value (GSV), the local segmentation SD stabilizes at 0.05 mm and is thus predictable. This information provides a target value of local signal difference on the arterial boundaries that should be

  18. Breast arterial calcification and risk of carotid atherosclerosis: Focusing on the preferentially affected layer of the vessel wall

    Energy Technology Data Exchange (ETDEWEB)

    Sedighi, Nahid, E-mail: nsedighi@sina.tums.ac.ir [Department of Radiology, Shariati Hospital, Tehran University of Medical Sciences. North Kargar Ave., Tehran 14114 (Iran, Islamic Republic of); Radmard, Amir Reza, E-mail: radmard@ams.ac.ir [Department of Radiology, Shariati Hospital, Tehran University of Medical Sciences. North Kargar Ave., Tehran 14114 (Iran, Islamic Republic of); Radmehr, Ali, E-mail: radmehr@sina.tums.ac.ir [Department of Radiology, Shariati Hospital, Tehran University of Medical Sciences. North Kargar Ave., Tehran 14114 (Iran, Islamic Republic of); Hashemi, Pari, E-mail: phtums@yahoo.com [Department of Radiology, Shariati Hospital, Tehran University of Medical Sciences. North Kargar Ave., Tehran 14114 (Iran, Islamic Republic of); Hajizadeh, Abdolmahmoud, E-mail: mroomezi@yahoo.com [Department of Radiology, Shariati Hospital, Tehran University of Medical Sciences. North Kargar Ave., Tehran 14114 (Iran, Islamic Republic of); Taheri, Amir Pejman Hashemi, E-mail: hashemip@sina.tums.ac.ir [Department of Radiology, Shariati Hospital, Tehran University of Medical Sciences. North Kargar Ave., Tehran 14114 (Iran, Islamic Republic of)

    2011-08-15

    Objective: To assess the relationship between breast arterial calcification (BAC) detected on screening mammography and atherosclerosis of carotid arteries considering the most likely involved layer of the arterial wall. Materials and methods: A total of 537 consecutive women who underwent screening mammography were enrolled in this study. Seventy-nine subjects having BAC, aged 46-75 years, and 125 age-matched controls from those without BAC were selected for ultrasound examination of carotid arteries assessing intima-media thickness (IMT) and plaque presence. Participants were divided into three groups of risk including, low-risk: IMT < 0.6 mm without plaque, medium-risk: 0.6 mm {<=} IMT {<=} 0.8 mm without plaque and high-risk: IMT > 0.8 mm and/or plaque. Risk factors for atherosclerosis were obtained from medical records for independent effects. Results: BAC was present in 14.7% of mammograms. According to multivariable logistic regression analyses, significant association was identified between the carotid atherosclerosis risk and presence of BAC. Compared to women with IMT < 0.6 mm, those with 0.6 mm {<=} IMT{<=} 0.8 mm and IMT > 0.8 mm had OR (95% CI) of 4.88 (1.47-16.16) and 23.36 (4.54-120.14), respectively. The OR (95% CI) for carotid plaque was 3.13 (1.3-7.57). There was no interaction between IMT category and plaque. Significant associations were also detected with postmenopausal duration (P = 0.02) and hypertension (P = 0.004). Conclusion: The risk of carotid atherosclerosis increases with the presence of BAC. Women with BAC are more likely to have thicker IMT than plaque, which could be attributed to the preferentially similar affected layer of media causing thick IMT rather than plaque.

  19. Value of ultrasonic measurement of carotid intima-media thickness and arterial elasticity for assessment of coronary heart disease severity

    Institute of Scientific and Technical Information of China (English)

    Hou-Qiang Lin; Ping-An Qian

    2016-01-01

    Objective:To study the value of ultrasonic measurement of carotid intima-media thickness and arterial elasticity for assessment of coronary heart disease severity.Methods:Patients with coronary heart disease angina were selected as CHD group, healthy subjects were selected as control group, carotid artery ultrasonography was conducted to determine carotid intima-media thickness (IMT), and serum was collected to determine serum content of lipid metabolism indexes, adhesion molecules and chemokines.Results:Carotid IMT of CHD group was significantly higher than that of control group and the carotid IMT of patients with multi-vessel disease in CHD group was significantly higher than that of patients with single-vessel disease; LDL, ox-LDL, ApoB, PCSK9, RANTES, FKN, MCP-1, CCL21, CXCL16, ICAM-1, VCAM-1, LFA-1, P-selectin and E-selectin content in serum of patients with thickened carotid IMT and carotid plaque in CHD group were significantly higher than those of patients with normal carotid IMT, and LDL, ox-LDL, ApoB, PCSK9, RANTES, FKN, MCP-1, CCL21, CXCL16, ICAM-1, VCAM-1, LFA-1, P-selectin and E-selectin content in serum of patients with carotid IMT plaque in CHD group were significantly higher than those of patients with thickened carotid IMT.Conclusions: Ultrasonic measurement of carotid IMT and arterial elasticity can provide the basis for assessment of coronary heart disease severity, and the carotid IMT and arterial elasticity are closely related to the abnormal lipid metabolism as well as the changes in the content of adhesion molecules and chemokines.

  20. Effects of intima stiffness and plaque morphology on peak cap stress

    NARCIS (Netherlands)

    Akyildiz, A.C.; Speelman, L.; Van Brummelen, H.; Gutiérrez, M.A.; Virmani, R.; Van der Lugt, A.; Van der Steen, A.F.W.; Wentzel, J.J.; Gijsen, F.J.H.

    2011-01-01

    Background: Rupture of the cap of a vulnerable plaque present in a coronary vessel may cause myocardial infarction and death. Cap rupture occurs when the peak cap stress exceeds the cap strength. The mechanical stress within a cap depends on the plaque morphology and the material characteristics of

  1. Effects of intima stiffness and plaque morphology on peak cap stress

    NARCIS (Netherlands)

    A.C. Akyildiz (Ali); L. Speelman (Lambert); H. van Brummelen (Harald); M.A. Gutiérrez (Miguel); R. Virmani (Renu); A. van der Lugt (Aad); A.F.W. van der Steen (Ton); J.J. Wentzel (Jolanda); F.J.H. Gijsen (Frank)

    2011-01-01

    textabstractBackground: Rupture of the cap of a vulnerable plaque present in a coronary vessel may cause myocardial infarction and death. Cap rupture occurs when the peak cap stress exceeds the cap strength. The mechanical stress within a cap depends on the plaque morphology and the material

  2. Hepatic steatosis is associated with an increased risk of carotid atherosclerosis

    Institute of Scientific and Technical Information of China (English)

    Henry V(o)lzke; Daniel M. Robinson; Volker Kleine; Roland Deutscher; Wolfgang Hoffmann; Jan Lüdemann; Ulf Schminke; Christof Kessler; Ulrich John

    2005-01-01

    AIM: Although an association between helatic steatosis and vascular risk factors has been described, direct relationships between fatty liver and atherosclerosis have not yet been investigated. The aim of the present study has been to investigate those relationships.METHODS: The Study of Health in Pomerania examined a random population sample aged between 20 and 79 years.A study population of 4 222 subjects without hepatitis B and C infections and without liver cirrhosis was available for the present analysis. Hepatic steatosis was defined sonographically and intima-media thickness (IMT) as well as plaque prevalence were estimated by carotid ultrasound.RESULTS: The prevalence rate of hepatic steatosis was 29.9%. Among subjects aged ≥45 years, an association between hepatic steatosis and IMT of the carotid arteries was found in bivariate analysis, but not after adjustment for atherosclerotic risk factors. Individuals with fatty liver had more often carotid plaques than persons without fatty liver (plaque prevalence rate 76.8% vs 66.6%; P<0.001).This association persisted after adjustment for confounding factors and was predominantly present in subjects with no to mild alcohol consumption.CONCLUSION: There is an independent association between hepatic steatosis and carotid atherosclerotic plaques. Metabolic changes due to nonalcoholic fatty liver disease may explain this relationship.

  3. High resolution carotid black-blood 3T MR with parallel imaging and dedicated 4-channel surface coils

    Directory of Open Access Journals (Sweden)

    Frey Ute

    2009-10-01

    Full Text Available Abstract Background Most of the carotid plaque MR studies have been performed using black-blood protocols at 1.5 T without parallel imaging techniques. The purpose of this study was to evaluate a multi-sequence, black-blood MR protocol using parallel imaging and a dedicated 4-channel surface coil for vessel wall imaging of the carotid arteries at 3 T. Materials and methods 14 healthy volunteers and 14 patients with intimal thickening as proven by duplex ultrasound had their carotid arteries imaged at 3 T using a multi-sequence protocol (time-of-flight MR angiography, pre-contrast T1w-, PDw- and T2w sequences in the volunteers, additional post-contrast T1w- and dynamic contrast enhanced sequences in patients. To assess intrascan reproducibility, 10 volunteers were scanned twice within 2 weeks. Results Intrascan reproducibility for quantitative measurements of lumen, wall and outer wall areas was excellent with Intraclass Correlation Coefficients >0.98 and measurement errors of 1.5%, 4.5% and 1.9%, respectively. Patients had larger wall areas than volunteers in both common carotid and internal carotid arteries and smaller lumen areas in internal carotid arteries (p Conclusion The findings of this study indicate that high resolution carotid black-blood 3 T MR with parallel imaging is a fast, reproducible and robust method to assess carotid atherosclerotic plaque in vivo and this method is ready to be used in clinical practice.

  4. Comparison between Carotid Stenting and Carotid Endarterectomy in Early Outcome

    OpenAIRE

    Kovačić, Slavica; Kovačević, Miljenko; Strenja-Linić, Ines; Budiselić, Berislav; Knežević, Siniša

    2011-01-01

    Carotid artery stenting (CAS) is a widely used method in prevention of stroke for carotid artery stenosis as an alternative to surgical treatment. Initial studies reveal higher morbidity and mortality rates for CAS than acceptable standards for carotid endarterectomy (CEA). The aim of this study was to compare results in a series of CAS with concurrent risk-matched group of CEA patients. The study included two groups of 50 patients with internal carotid artery stenosis. We compare...

  5. Prevalence, Impact, and Predictive Value of Detecting Subclinical Coronary and Carotid Atherosclerosis in Asymptomatic Adults

    DEFF Research Database (Denmark)

    Baber, Usman; Mehran, Roxana; Sartori, Samantha;

    2015-01-01

    BACKGROUND: Although recent studies suggest that measuring coronary artery calcification (CAC) may be superior to indirect atherosclerotic markers in predicting cardiac risk, there are limited data evaluating imaging-based biomarkers that directly quantify atherosclerosis in different vascular beds...... (mean age: 69 years, 56.5% female) in a prospective cohort evaluating the role of vascular imaging on cardiovascular risk prediction. All patients were evaluated by CAC and novel 3-dimensional carotid ultrasound. Plaque areas from both carotid arteries were summed as the carotid plaque burden (c.......92) with increasing cPB tertile, with similar results for CAC. Net reclassification significantly improved with either cPB (0.23) or CAC (0.25). MACE rates increased simultaneously with higher levels of both cPB and CAC. CONCLUSIONS: Detection of subclinical carotid or coronary atherosclerosis improves risk...

  6. Carotid endarterectomies for relieving severe or moderate carotid stenosis

    Institute of Scientific and Technical Information of China (English)

    L(U) Zhi-qian 吕志前; XIAO Ming-di 萧明第; Montagna Pietro; Farhat Fadi; Olivier Jegaden

    2004-01-01

    @@ Carotid artery stenosis is one of the major causes of ischemic strokes.1 To prevent or reduce the occurrences of ischemic strokes, carotid endarterectomies (CEAs) were performed on 48 patients with carotid artery stenosis from November 2000 to June 2003. Results from this study were analyzed and presented here.

  7. Plasma Lipoprotein-associated Phospholipase A2 in Patients with Metabolic Syndrome and Carotid Atherosclerosis

    Directory of Open Access Journals (Sweden)

    Mao Yong-jun

    2011-01-01

    Full Text Available Abstract Background Lipoprotein-associated phospholipase A2 (Lp-PLA2 is a recently identified and potentially useful plasma biomarker for cardiovascular and atherosclerotic diseases. However, the correlation between the Lp-PLA2 activity and carotid atherosclerosis remains poorly investigated in patients with metabolic syndrome (MetS. The present study aimed to evaluate the potential role of Lp-PLA2 as a comprehensive marker of metabolic syndrome in individuals with and without carotid atherosclerosis. Methods We documented 118 consecutive patients with MetS and 70 age- and sex-matched healthy subjects served as controls. The patients were further divided into two groups: 39 with carotid plaques and 79 without carotid plaques to elucidate the influence of Lp-PLA2 on carotid atherosclerosis. The plasma Lp-PLA2 activity was measured by using ELISA method and carotid intimal-media thickness (IMT was performed by ultrasound in all participants. Results Lp-PLA2 activity was significantly increased in MetS subgroups when compared with controls, and was higher in patients with carotid plaques than those without plaques (P 2 was obtained between patients with three and four disorders of metabolic syndrome (P P = 0.029, LDL-cholesterol (β = 0.401, P = 0.000 and waist-hip ratio (β = 0.410, P = 0.000 emerged as significant and independent determinants of Lp-PLA2 activity. Multiple stepwise regression analysis revealed that LDL-cholesterol (β = 0.309, P = 0.000, systolic blood pressure (β = 0.322, P = 0.002 and age (β = 0.235, P = 0.007 significantly correlated with max IMT, and Lp-PLA2 was not an independent predictor for carotid IMT. Conclusions Lp-PLA2 may be a modulating factor for carotid IMT via age and LDL-cholesterol, not independent predictor in the pathophysiological process of carotid atherosclerosis in patients with MetS.

  8. Study on the Prevalence and Corelation of Carotid Atherosclerosis in Stroke Patients

    Institute of Scientific and Technical Information of China (English)

    Wei Hua; Wang Yongjun; Yah Zhenying

    2000-01-01

    Objective To assess the prevalence and severity of carotid atherosclerosis in stroke patients and the risk factors of carotid atherosclerosis. Methods Two hundred fifty-one ischemic stroke patients,46 ccrcbral hemorrhagc patients and 96 control subjects were entercd into this study. Sonographic assessment of the extracranial carotid arteries was performed in all patients. Diametcr. IMT, plaques and percentage ratio of lumen stenosis were observcd. Results (1)The prevalence of carotid plaqucs was prominent in stroke patients than the control subjects(63.0%vs 36.5%). (2)The prevalencc of lumen stenosis>50% in ischemic stroke patients was higher than the cerebral hemorrhage patients and control subjects (15.6% vs 4.3%. 2.1%).(3) The prevalence of severe carotid artery stcnosis(>75%) was promincnt in aged 61~70 years old patients.(4)Our data revealed 30% of the cortical infarction subgroup, 17.5%of the subcortical infarction subgroup, 17% of the lacunar infarction subgroup,8% of the vcrtibral-basilar artery infarction subgroup.2.8% of thc CT normal subgroup possessed carotid stcnosis >50%. (5)Age, diabetes mellitus and ApoAl(inversely) were independent predictors of the extracranial carotid atherosclcrosis. Discusssion (Ⅰ)There is close relation between extracraniai carotid atherosclerosis and ischemic cerebrovascular disease.(2)The extent of serious carotid artery stcnosis in aged patients was lower.(3)Thc severity of extracranial carotid artery atherosclerosis was prominent in patients with conical infarction. Conclusion There is a high prevalence of extracranial carotid atherosclerosis in Chinese stroke patients.

  9. Carotid Artery Disease

    Science.gov (United States)

    ... other risk factors, such as high blood pressure, cardiovascular disease, diabetes and sleep apnea. Limit cholesterol and fat. Cutting back on saturated fat, in particular, may reduce buildup of plaques ...

  10. Statins reduce levels of metalloproteinases in patients with carotid occlusive disease.

    Science.gov (United States)

    Sapienza, P; Borrelli, V; Sterpetti, A V; Biacchi, D; Venturini, L; Tartaglia, E; Bononi, M; Di Marzo, L

    2014-12-01

    Pharmaceutical stabilization of an unstable low-grade carotid artery stenosis delays surgery and improve outcome. Statins can be used to reduce intimal media thickness. Our aim was to determine the clinical and biological effects of rosuvastatin on plaque stabilization or regression. Forty-two consecutive male patients presenting with an asymptomatic internal carotid artery plaque uniformly anechogenic (group 1) 40-50% lumen diameter reduction formed the basis of the study. A group of 35 patients affected with a uniformly echogenic carotid artery stenosis (40-50%) served as control (group 2). Patients were followed-up every 8-month for 2 years with B-mode ultrasonography and color imaging. A computed tomography angiography (CTA) was performed before the initiation of the study period and at the end to confirm plaque characteristics and the degree of stenosis. Ticlopidine (250 mg/day) and rosuvastatin (10 mg/day) were administered. One blood sample was drawn at every control to assess the release of matrix metallopoteinases (MMPs)-1, -2, -3, -9, tissue inhibitors of metalloproteinases (TIMPs)-1 and -2. After the administration of rosuvastatin plasma level of MMP-1, -2, -3 and -9 significantly decreased in both groups (P<0.001). Conversely, plasma level of TIMP-1 and -2 significantly increased in both groups (P<0.001). B-mode ultrasonography and color imaging and CTA failed to demonstrate a stabilization or regression of uniformly anehogenic carotid plaque during follow-up. Rosuvastatin decreases the plasma level of MMPs and increases those of TIMPs. However, neither progression nor stabilization of low-grade unstable carotid plaques was seen.

  11. [Grafting of carotid arteries].

    Science.gov (United States)

    Belov, Iu V; Stepanenko, A B; Gens, A P; Bazylev, V V; Seleznev, M N; Savichev, D D

    2005-01-01

    Over 5-years, 167 reconstructive surgeries for stenosis of internal carotid arteries (ICA) were performed in 124 patients. Mean age of the patients was 63.5 years. One hundred and twenty-nine carotid endarterectomies (CEAE) in 86 patients and 38 reconstructive operations of ICA in 38 patients were performed. There were no lethal outcomes in short- and long-term postoperative period. In short-term period after prosthesis of ICA restenosis was revealed in 3% patients, after eversion CEAE in 3% patients the embolism was seen, after standard CEAE restenosis were diagnosed in 8% patients and thrombosis -- in 3%. In long-term period after grafting of ICA the strokes were seen in 3%, stenosis -- in 6% patients, after eversion endarterectomy -- in 0 and 3% patients, and after standard CEAE -- in 3 and 24% patients, respectively. It is concluded that grafting of ICA is adequate surgical method of reconstruction and stroke prevention in specific variants of carotid atherosclerosis.

  12. Carotid subclinical atherosclerosis is associated with disease activity but not vitamin D in Korean systemic lupus erythematosus.

    Science.gov (United States)

    Jung, J-Y; Koh, B-R; Bae, C-B; Kim, H-A; Suh, C-H

    2014-12-01

    Atherosclerosis develops early in systemic lupus erythematosus (SLE) patients and is an important cause of mortality. Vitamin D deficiency is found to be associated with cardiovascular disease and autoimmunity. We evaluated the extent of carotid subclinical atherosclerosis and analyzed its correlation with vitamin D in SLE. One hundred and two female patients with SLE and 52 normal controls (NCs) were recruited. The mean carotid intima-media thickness (IMT) of SLE patients was 0.41 ± 0.08 mm, which was higher than that of NCs (0.32 ± 0.08 mm, p = 0.012). In addition, carotid plaques were more frequent and the plaque index was higher in SLE patients than in NCs (0.68 ± 1.39 vs. 0.26 ± 0.87, p = 0.026). Carotid IMT was correlated with age, body mass index, SLE disease activity index, and aspirin use in SLE patients. The plaque index was correlated with renal involvement. Vitamin 25(OH)D3 level was not correlated with carotid IMT, plaque index or disease activity markers. In SLE, the risk of cardiovascular disease is higher than that in NCs, which may be derived from systemic inflammation. It may be not suitable to assess vitamin D as a marker of disease activity or subclinical atherosclerosis in SLE patients.

  13. Identification by ultrasound evaluation of the carotid and femoral arteries of high-risk subjects missed by three validated cardiovascular disease risk algorithms.

    Science.gov (United States)

    Postley, John E; Luo, Yanting; Wong, Nathan D; Gardin, Julius M

    2015-11-15

    Atherosclerotic cardiovascular disease (ASCVD) events are the leading cause of death in the United States and globally. Traditional global risk algorithms may miss 50% of patients who experience ASCVD events. Noninvasive ultrasound evaluation of the carotid and femoral arteries can identify subjects at high risk for ASCVD events. We examined the ability of different global risk algorithms to identify subjects with femoral and/or carotid plaques found by ultrasound. The study population consisted of 1,464 asymptomatic adults (39.8% women) aged 23 to 87 years without previous evidence of ASCVD who had ultrasound evaluation of the carotid and femoral arteries. Three ASCVD risk algorithms (10-year Framingham Risk Score [FRS], 30-year FRS, and lifetime risk) were compared for the 939 subjects who met the algorithm age criteria. The frequency of femoral plaque as the only plaque was 18.3% in the total group and 14.8% in the risk algorithm groups (n = 939) without a significant difference between genders in frequency of femoral plaque as the only plaque. Those identified as high risk by the lifetime risk algorithm included the most men and women who had plaques either femoral or carotid (59% and 55%) but had lower specificity because the proportion of subjects who actually had plaques in the high-risk group was lower (50% and 35%) than in those at high risk defined by the FRS algorithms. In conclusion, ultrasound evaluation of the carotid and femoral arteries can identify subjects at risk of ASCVD events missed by traditional risk-predicting algorithms. The large proportion of subjects with femoral plaque only supports the use of including both femoral and carotid arteries in ultrasound evaluation.

  14. Antiplatelet Therapy in Carotid Artery Stenting and Carotid Endarterectomy in the Asymptomatic Carotid Surgery Trial-2

    NARCIS (Netherlands)

    Huibers, A; Halliday, A; Bulbulia, R; Coppi, G; de Borst, G J

    OBJECTIVE: Strokes are infrequent but potentially serious complications following carotid intervention, but antiplatelet therapy can reduce these risks. There are currently no specific guidelines on dose or duration of peri-procedural antiplatelet treatment for patients undergoing carotid

  15. Mildly elevated serum total bilirubin levels are negatively associated with carotid atherosclerosis among elderly persons with type 2 diabetes.

    Science.gov (United States)

    Kawamoto, Ryuichi; Ninomiya, Daisuke; Hasegawa, Yoichi; Kasai, Yoshihisa; Kusunoki, Tomo; Ohtsuka, Nobuyuki; Kumagi, Teru; Abe, Masanori

    2016-01-01

    Diabetes is strongly associated with several mechanisms of tissue damage such as oxidative stress. Serum bilirubin may have a beneficial role in preventing oxidative changes in cardiovascular disease (CVD). Limited information is available on whether serum bilirubin is an independent confounding factor for carotid atherosclerosis among elderly persons with type 2 diabetes. The study subjects were 169 men aged 79 ± 8 (mean ± SD) years and 205 women aged 81 ± 8 years that were enrolled consecutively from patients in the medical department. Carotid intima-media thickness (IMT) and plaque were derived via B-mode ultrasonography. Multiple linear regression analysis showed that serum total bilirubin (β = -0.160) was significantly associated with carotid IMT. Compared to subjects with a serum total bilirubin of tertile-1 (0.13-0.58 mg/dL), the multivariate-adjusted odds ratio (95% confidence interval) of carotid IMT ≥1.0 mm including plaque and carotid plaque was 0.46 (0.23-0.93) and 0.32 (0.17-0.60) in the Tertile-3 group (0.87-1.93 mg/dL), respectively. Next, data were further stratified by gender, age, smoking status, medication and prevalence of CVD. There were no significant differences in serum total bilirubin levels between selected subgroups. Our data demonstrated a negative association between serum total bilirubin and carotid atherosclerosis among elderly persons with type 2 diabetes.

  16. 瑞舒伐他汀对老年2型糖尿病合并颈动脉斑块患者同型半胱氨酸与高敏C反应蛋白及血脂的影响%Effects of rosuvastatin on blood homocysteine, high sensitivity C reactive protein and blood lipid in elderly patients with type 2 diabetes mellitus complicated with carotid artery plaque

    Institute of Scientific and Technical Information of China (English)

    冯健; 董兴刚; 俞志满

    2015-01-01

    Objective To investigate the effects of rosuvastatin on blood homocysteine (Hcy),high-sensitivity C reactive protein (hs-CRP) and blood lipid in the elderly patients with type 2 diabetes mellitus complicated with carotid artery plaque.Methods Ninety-six senile patients with type 2 diabetes complicated with carotid artery plaque were randomly divided into control group (46 cases) receiving conventional treatment and observation group (50 cases) taking oral rosuvastatin (5 mg/d) in addition to conventional treatment.Before and 6 weeks after treatment,the levels of Hcy,hs-CRP,blood glucose,triglycerides (TG),total cholesterol (TC),low density lipoprotein cholesterol (LDL-C) and high-density lipoprotein cholesterol (HDL-C) were measured and compared between the two groups.Results The levels of blood hs-CRP,TG,TC,LDL-C,Hcy in observation group were significantly lower than those in control group [TC:(4.1 ± 1.2) mmol/L vs (4.6 ± 0.9) mmol/L,LDL-C:(2.2±0.6) mmol/L vs (2.6±0.6) mmol/L,hs-CRP:(12±4) mg/L vs (14±4) mg/L,Hcy:(13±4) μmol/L vs (15 ± 3) μmol/L] (P < 0.05).No significant changes of renal function and routine urine test were found after treatment in both the two groups.One case in observation group had impaired fiver function and recovered after taking oral silymarin for two weeks.Conclusion Rosuvastatin can decrease the levels of blood TG,TC,LDL-C,Hcy and hs-CRP in the elderly patients with type 2 diabetes mellitus complicatred with carotid plaque.%目的 探讨瑞舒伐他汀对老年2型糖尿病合并颈动脉斑块患者同型半胱氨酸(Hcy)、高敏C反应蛋白(hs-CRP)及血脂的影响.方法 将96例老年2型糖尿病合并颈动脉斑块患者使用随机数字表法分为对照组(46例)和观察组(50例).对照组进行常规治疗,观察组在常规治疗基础上加用瑞舒伐他汀5 mg/d,口服.比较2组患者治疗前和治疗后6周hs-CRP、Hcy、空腹血糖、三酰甘油、总胆固醇、低密度脂蛋白胆固醇(LDL-C)、

  17. Plaque Type Blue Naevus

    Directory of Open Access Journals (Sweden)

    Sentamilselvi G

    1997-01-01

    Full Text Available A case of plaque type blue naevus was encountered in a Dermatology Clinic in Madras. The various clinical differential diagnoses are discussed, the hitopathological features described and the benign nature of the tumour stressed. The case is reported for its rarity and to create an awareness of this entity.

  18. 18氟-氟代脱氧葡萄糖PET/CTA成像无创检测兔动脉粥样硬化易损斑块及血栓%Noninvasive imaging of vulnerable plaques and thrombuses with PET/CT complex imaging technique

    Institute of Scientific and Technical Information of China (English)

    赵欣; 赵全明; 冯婷婷; 李德鹏; 刘瑜; 李丽琴; 张明多; 庄须翠; 赵学成

    2013-01-01

    Objective To investigate the feasibility of identifying the vulnerable plaque and predicting plague rupture and thrombus using by positron emission tomography/computed tomography angiography (PET/CTA).Methods Twenty-eight male New Zealand white rabbits were fed with hyperlipid diet for 2 weeks before the balloon injury of the abdominal aorta.Then these rabbit were intermittently fed withhyper-lipid diet for 14 weeks,in order to trigger pharmaceuticly the plague rupture and thrombus.PET/CTA scans of abdominal aorta were performed before and after the drug triggering,FDG uptake (standardized uptake value,SUV) was measured.Rabbits were euthanized to obtain data of pathology and histology.The parameters obtained by PET/CTA,pathology and histology were compared and the correclations were performed.Results The thrombosis was identified in 13 of 20 rabbits.Before the drug triggering,18F-FDG mean standardized uptake value(SUVmean) washigher in thrombotic arterial segments (defined as vulnerable plaque) (1.10 ± 0.19 vs 0.77 ± 0.11,P =0.000) ; after the drug triggering,SUVmean was higher in thrombotic arterial segments,too (1.15 ±0.26 vs 0.85 ±0.17,P =0.000).We use the ROC curve for SUVmean to predict plaque rupture and thrombosis.The areaunder the curve (AUC) was 0.898 (P =0.000).The cutoff value was 0.882.Conclusions Our findings indicated that 1s F-FDG PET/CTA,as a noninvasive imaging method,could be used toidentify vulnerable plaques and predict thrombosis events.%目的 探讨18氟-氟代脱氧葡萄糖(18 F-FDG) PET/CTA成像检测兔主动脉易损斑块和预测血栓事件可行性.方法 28只雄性新西兰大白兔,高脂饲料饲喂2周后球囊拉伤腹主动脉,继续间断高脂饲养14周后进行药物诱发实验,以期斑块破裂和形成血栓;在药物诱发实验前后分别行主动脉的PET/CTA成像,分段测量主动脉对FDG的摄取情况(SUV值),成像后处死动物获得主动脉段的大体病理和组织学资料.将PET/CTA成像所

  19. Carotid surgery following previous carotid endarterectomy is safe and effective.

    Science.gov (United States)

    Abou-Zamzam, Ahmed M; Moneta, Gregory L; Landry, Gregory J; Yeager, Richard A; Edwards, James M; McConnell, Donald B; Taylor, Lloyd M; Porter, John M

    2002-01-01

    With the perceived high risk of repeat carotid surgery, carotid angioplasty and stenting have been advocated recently as the preferred treatment of recurrent carotid disease following carotid endarterectomy. An experience with the operative treatment of recurrent carotid disease to document the risks and benefits of this procedure is presented. A review of a prospectively acquired vascular registry over a 10-year period (Jan. 1990-Jan. 2000) was undertaken to identify patients undergoing repeat carotid surgery following previous carotid endarterectomy. All patients were treated with repeat carotid endarterectomy, carotid interposition graft, or subclavian-carotid bypass. The perioperative stroke and death rate, operative complications, life-table freedom from stroke, and rates of recurrent stenosis were documented. During the study period 56 patients underwent repeat carotid surgery, comprising 6% of all carotid operations during this period. The indication for operation was symptomatic disease recurrence in 41 cases (73%) and asymptomatic recurrent stenosis >/=80% in 15 cases (27%). The average interval from the prior carotid endarterectomy to the repeat operation was 78 months (range 3 weeks-297 months). The operations performed included repeat carotid endarterectomy with patch angioplasty in 31 cases (55%), interposition grafts in 19 cases (34%), and subclavian-carotid bypass in 6 cases (11%). There were three perioperative strokes with one resulting in death for a perioperative stroke and death rate of 5.4%. One minor transient cranial nerve (CN IX) injury occurred. Mean follow-up was 29 months (range, 1-116 months). Life-table freedom from stroke was 95% at 1 year and 90% at 5 years. Recurrent stenosis (>/=80%) developed in three patients (5.4%) during follow-up, including one internal carotid artery occlusion. Two patients (3.6%) underwent repeat surgery. Repeat surgery for recurrent cerebrovascular disease following carotid endarterectomy is safe and

  20. Plaque array method and proteomics-based identification of biomarkers from Alzheimer's disease serum.

    Science.gov (United States)

    Madasamy, Shanmugavel; Chaudhuri, Vaishali; Kong, Raymond; Alderete, Benjamin; Adams, Christopher M; Knaak, Tim D; Ruan, Weiming; Wu, Alan H B; Bigos, Marty; Amento, Edward P

    2015-02-20

    Progressive accumulation of amyloid plaques in the regions of brain, carotid and cerebral arteries is the leading cause of Alzheimer's disease (AD) and related dementia in affected patients. The early identification of individuals with AD remains a challenging task relying on symptomatic events and thus the development of a biomarker-based approach will significantly aid in the diagnosis of AD. Here we describe a flow cytometer-based serum biomarker identification method using plaque particles, and applying mass spectrometry based proteomic analysis of the isolated plaque particles for the identification of serum proteins present in the plaque particles. We identified 195 serum proteins that participate in the process of plaque particle formation. Among the 195 proteins identified, 68.2% of them overlapped in abeta-42, cholesterol, tau-275 and α-synuclein plaque particles. Significantly, 22.5% of the proteins identified as bound to abeta-42 plaque particles generated in AD serum were unique when compared with cholesterol, α-synuclein and tau plaque particles. In age-matched control experiments, 15% of them showed in vitro insoluble abeta-42 particle formation and 59% of the identified plaque particle constituents from AD serum were also present in the insoluble plaque particles derived from control. We have developed an in vitro method for plaque particle detection and identified serum protein markers that are associated with AD-related plaque particle formation. With further clinical validation, this assay may provide a nove