scholarly journals P821 Influence of periplaque fat on coronary plaque vulnerability, a comparative analysis between atherosclerotic lesions located in the right versus left coronary arteries

2020 ◽  
Vol 21 (Supplement_1) ◽  
Author(s):  
N Rat ◽  
D Opincariu ◽  
R Hodas ◽  
M Ratiu ◽  
A Mester ◽  
...  
Keyword(s):  
Adipose Tissue ◽  
Comparative Analysis ◽  
Coronary Artery ◽  
Coronary Plaque ◽  
Plaque Vulnerability ◽  
Atherosclerotic Lesions ◽  
Group 2 ◽  
The Right ◽  
Group 1

Abstract Funding Acknowledgements Research grant PlaqueImage, contract number 26/01.09.2016, SMIS code 103544, Project funded by the European Union and the Government of Romania Background The role of epicardial adipose tissue on coronary plaque vulnerability has been well established. However, the role of periplaque fat (PPF) has not been elucidated so far. Moreover, there is scarce data on the role of plaque location, in relation to peri-atheromatous adipose tissue on the vulnerability degree and morphology of coronary atherosclerotic lesions. Purpose To evaluate the influence of PPF on coronary plaque vulnerability, in a comparative analysis between atherosclerotic lesions located in the right and left coronary arteries. Methods This is an observational study which included 82 patients with stable CAD, who underwent 128-multislice CT coronary angiography, presented at least one coronary lesion with at least 50% degree of stenosis and exhibited ≥1 vulnerability markers in the respective coronary plaque. Plaques presenting features of vulnerability (spotty calcifications – SC, Napkin ring sign – NRS, low attenuation plaque – LAP, positive remodeling – PR), were defined as vulnerable plaques (VP). Image postprocessing was performed with the Syngo.via Frontier software and PPF was measured 10 mm around the analyzed VP. Based to the plaque location within the coronary tree, the study subjects were divided into: group 1 (location of VP in the right coronary artery - RCA) - n = 17; group 2 (location of VP in the left coronary artery - LCA) - n = 65. Results The analysis of the plaque characteristics indicated that the VPs from the RCA were significantly longer (20.81± 6.45 vs. 17.37 ± 4.59 mm, p = 0.02) and had a larger volume (269.3± 120.4 vs. 161.6 ± 80.89 mm3, p < 0.0001) compared to the VPs from the LCA. Compared to group 2, coronary plaques in group 1 exhibited a higher vulnerability degree, illustrated by a larger non-calcified volume (232.5 ± 111 vs. 134.5 ± 83.29 mm3, p = 0.0006), lipid-rich volume (19.4 ± 19.07 vs. 10.27 ± 17.08 mm3, p = 0.0106), and fibro-fatty volume (213 ± 101.3 vs. 124.2 ± 7.98 mm3, p = 0.0009). The PPF was significantly larger in VPs from the RCA (0.92 ± 0.48 mm3 vs. 0. 57± 0.34 mm3, p = 0.0041) compared to VPs located in the LCA. No differences were found regarding the total epicardial fat between the two groups (p = 0.386). Conclusions Atherosclerotic plaques located in the RCA exhibited a higher number of vulnerability characteristics compared to those located in the left coronary system and PPF was more pronounced in the regions surrounding VPs located within the RCA. This difference in vulnerability features could be explained not only by geometrical and hemodynamical characteristics of the coronary circulation, but also by inflammation-mediated alteration of endothelial shear stress triggered by release of inflammatory mediators from the local epicardial fat.

scholarly journals Hybrid Imaging to Assess the Impact of Vulnerable Plaque on Post Myocardial Infarction Myocardial Scar

2021 ◽  
Vol 6 (2) ◽  
pp. 92-99
Author(s):  
Alexandra Stănescu ◽  
Rareș Manuca ◽  
Rodica Togănel ◽  
Daniel Cernica ◽  
Theodora Benedek ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Infarct Size ◽  
Hybrid Imaging ◽  
Coronary Plaque ◽  
Myocardial Scar ◽  
Syntax Score ◽  
Plaque Vulnerability ◽  
Group 3 ◽  
Group 2 ◽  
Group 1

Abstract Background: Multimodality imaging improves the accuracy of cardiac assessment in patients with prior myocardial infarction. The aim of this study was to investigate the association between coronary plaque vulnerability (PV) and myocardial viability in the territory irrigated by the infarct-related artery (IRA). Secondary objectives include evaluation of the systemic inflammation but also different cardiac risk scores (SYNTAX score, Duke jeopardy score, or calcium score) using hybrid imaging models of coronary computed tomography angiography (CCTA) and cardiac magnetic resonance (CMR) in patients who have suffered a previous myocardial infarction (MI). Material and methods: The study included 45 subjects with documented MI in the 30 days prior to study enrolment, who underwent CCTA and CMR examinations. Computational postprocessing of CCTA and CMR images was used to generate fused imaging models. Based on the vulnerability degree of the associated non-culprit lesion located proximally in the IRA, the study population was divided into 3 groups: Group 1 – subjects with no sign of vulnerability (n = 7); Group 2 – subjects with 1 or 2 CT vulnerability features (n = 28); and Group 3 – subjects with >2 features of vulnerability (n = 12). Results: CCTA features indicative for the severity of coronary artery disease were not different between groups in terms of calcium scoring (460 ± 501 vs. 579 ± 430 vs. 432 ± 494, p = 0.7) or SYNTAX score (25 ± 9.2 vs. 24.9 ± 8.3 vs. 20.2 ± 11.9, p = 0.4). However, after 1 month, infarct size and the Duke jeopardy score were associated with increased PV (infarct size 8.77 ± 3.4 g in Group 1, compared to 20.87 ± 8.3 g in Group 2 and 27.99 ± 11.8 g in Group 3 (p = 0.007), while the Duke jeopardy score was 4.4 ± 1.6 in Group 1, vs. 7.07 ± 2.1 in Group 2 vs. 7.5 ± 1.73 in Group 3 (p = 0.01). Inflammatory biomarkers were directly associated with coronary plaque vulnerability (p = 0.007 for hs-CRP and p = 0.038 for MMP-9). Conclusion: In patients with prior myocardial infarction, the size of myocardial scar was directly correlated with the vulnerability degree of coronary plaques and with systemic inflammation quantified during the acute phase of the coronary event. Hybrid imaging may help to identify the hemodynamically significant plaques with superior accuracy.

scholarly journals Central extracorporeal membrane oxygenation as a bridge to recovery in patients with myocardial stunning after coronary artery bypass grafting

2020 ◽  
Vol 2 (2) ◽  
pp. 76-81
Author(s):  
Mohamed Abdel Fouly
Keyword(s):  
Coronary Artery ◽  
Coronary Artery Bypass Grafting ◽  
Extracorporeal Membrane Oxygenation ◽  
Myocardial Stunning ◽  
Artery Bypass ◽  
Bypass Grafting ◽  
Bridge To Recovery ◽  
Group 2 ◽  
Group 1

Background: The role of central extracorporeal membrane oxygenation (ECMO) post coronary artery bypass grafting (CABG) in older patients is debatable. The objectives of our study were to investigate the role of central veno-arterial (V-A) ECMO as a bridge to recovery in patients with myocardial stunning after CABG and its effect on mortality in this group of patients. Methods: Seventy-five patients had central ECMO as a bridge to recovery  after CABG because of myocardial stunning; 45 of them (60%) had survived (group 1), and mortality occurred in 30 patients (40%) (group 2). Preoperative risk factors such as hypertension, stroke, and renal failure were comparable between groups. In non-survivors, left main disease was more common (19 (63.3%) vs. 13 (28.9%); p= 0.003) and SYNTAX score was higher (Median 33 (25th- 75th percentiles); 33 (29- 35) vs. 26 (25- 32); p< 0.001). Results: Cross-clamp time was shorter in group 1 (58 minutes; (52-62) vs 115.5 minutes; (84- 161) in group 2; p< 0.001). Cardiopulmonary bypass time was shorter in group 1 compared to group 2 (83; (70-90) vs. 155.5; (60 -120) minutes; p< 0.001). ECMO duration was longer in group 2 (6 days; (6-7) vs. 3 days; (3-4); p<0.001). Stroke occurred in 10 patients (33.33%) in group 2 vs. 1 patient (2.22%) in groups 1; p< 0.001. Longer cross-clamp (OR: 1.61, 95% CI: 1.11- 2.31, p= 0.011) and bypass time (OR: 1.76; 95% CI: 1.57- 1.99; p= 0.048) predicted postoperative mortality. Conclusion: Central ven-arterial extramembrane oxygenation can be used as a bridge to recovery in patients with stunned myocardium post coronary bypass grafting, especially in centers where heart transplantation and ventricular assist devices are not available.

The role of adipose tissue hormones in the formation and course of gastroesophageal reflux disease in combination with obesity.

2021 ◽  
Vol 2021 (2) ◽  
pp. 96-98
Author(s):  
O.A. Oparin ◽  
◽  
O.M. Malіar ◽  
T.N. Oparina ◽  
E.J. Abakumova ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Adipose Tissue ◽  
Gastroesophageal Reflux Disease ◽  
Gastroesophageal Reflux ◽  
Reflux Disease ◽  
Enzyme Linked Immunosorbent Assay ◽  
Endoscopic Study ◽  
Group 2 ◽  
Group 1

Objective: To investigate the level of leptin in patients with gastroesophageal reflux disease with concomitant obesity and evaluate its effect on the course of the disease. Materials and results. The study involved 50 patients. The first group included patients with GERD with concomitant obesity, the second group — patients with GERD without concomitant pathology. A survey was conducted using the GERDQ questionnaire, which showed that patients with concomitant obesity were more likely to have symptoms of the disease. Leptin levels were determined by enzyme-linked immunosorbent assay. Іn subjects of group 1, the concentration of leptin will be significantly higher than in patients of group 2. An endoscopic study was performed, the results of which were compared with the concentration of leptin. There is a direct correlation between body mass index, the degree of esophageal damage and leptin levels.

scholarly journals The Effect of Periplaque Fat on Coronary Plaque Vulnerability in Patients with Stable Coronary Artery Disease – a 128-multislice CT-based Study

2018 ◽  
Vol 3 (2) ◽  
pp. 69-76
Author(s):  
Nóra Raț ◽  
Diana Opincariu ◽  
Emese Márton ◽  
Ramona Zavate ◽  
Mirela Pintican ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Coronary Artery Disease ◽  
Stable Coronary Artery Disease ◽  
Coronary Plaque ◽  
Plaque Vulnerability ◽  
Pericardial Fat ◽  
Group 2 ◽  
Artery Disease ◽  
Fat Volume ◽  
Group 1

Abstract Background: The role of periplaque fat (PPF), as a fragment of the total epicardial adipose tissue, measured in the vicinity of a target coronary lesion, more specifically within the close proximity of a vulnerable plaque, has yet to be evaluated. The study aimed to evaluate the interrelation between PPF and coronary plaque vulnerability in patients with stable coronary artery disease (CAD). Secondary objective: evaluation of the relationship between the total pericardial fat and markers for plaque vulnerability. Materials and methods: We prospectively enrolled 77 patients with stable CAD, who underwent 128-multislice computed tomography coronary angiography (CTCA), and who presented minimum one lesion with >50% stenosis. CTCA analysis included measurements of: total pericardial fat and PPF volumes, coronary plaque characteristics, markers for plaque vulnerability – positive remodeling (PR), low attenuation plaque (LAP), spotty calcifications (SC,) napkin ring sign (NRS). Study subjects were divided into two categories: Group 1 – 1 marker of plaque vulnerability (n = 36, 46.75%) and Group 2 – ≥1 marker of vulnerability (n = 41, 53.25%). Results: The mean age of the population was 61.77 ± 11.28 years, and 41 (53.24%) were males. The analysis of plaque characteristics showed that Group 2 presented significantly longer plaques (16.26 ± 4.605 mm vs. 19.09 ± 5.227 mm, p = 0.02), remodeling index (0.96 ± 0.20 vs. 1.18 ± 0.33, p = 0.0009), and vessel volume (p = 0.027), and more voluminous plaques (147.5 ± 71.74 mm3 vs. 207.7 ± 108.9 mm3, p = 0.006) compared to Group 1. Group 2 presented larger volumes of PPF (512.2 ± 289.9 mm3 vs. 710.9 ± 361.9 mm3, p = 0.01) and of thoracic fat volume (1,616 ± 614.8 mm3 vs. 2,000 ± 850.9 mm3, p = 0.02), compared to Group 1, but no differences were found regarding the total pericardial fat (p = 0.49). Patients with 3 or 4 vulnerability markers (VM) presented significantly larges PPF volumes compared to those with 1 or 2 VM, respectively (p = 0.008). There was a significant positive correlation between PPF volume and the non-calcified (r = 0.474, 95% CI 0.2797–0.6311, p <0.0001), lipid-rich (r = 0.316, 95% CI 0.099–0.504, p = 0.005), and fibro-fatty (r = 0.452, 95% CI 0.2541–0.6142, p <0.0001) volumes. The total pericardial fat was significantly correlated only with the volume of lipid-rich plaques (p = 0.02). Conclusions: Periplaque fat volume was associated with a higher degree of coronary plaque vulnerability. PPF was correlated with lipid-rich, fibro-fatty, and non-calcified plaque-related volumes, as markers for enhanced plaque vulnerability. PPF volume, assessed with native cardiac computed tomography, could become a novel marker for coronary plaque vulnerability.

scholarly journals Impact of epicardial adipose tissue increase after ST elevation Myocardial Infarction (STEMI) on IL-13 and left ventricular remodelling

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
V Parisi ◽  
S Cabaro ◽  
V D'Esposito ◽  
L Petraglia ◽  
M Conte ◽  
...  
Keyword(s):  
Adipose Tissue ◽  
Epicardial Adipose Tissue ◽  
Protective Role ◽  
Left Ventricular ◽  
Funding Source ◽  
National Budget ◽  
Group 2 ◽  
Public Grant ◽  
Group 1

Abstract Background The role of epicardial adipose tissue (EAT) in myocardial diseases is well established, and several evidence suggest that EAT may negatively affect left ventricular (LV) remodelling through an imbalanced production and secretion of pro and anti-inflammatory cytokines. Of these, the IL-13 it is known to play a positive activity on cardiac remodelling. Nowadays, the crosstalk between EAT and the myocardium is still poorly understood and the effects of myocardial ischemia on morphological and functional properties of EAT are almost unknown. Purpose In the present study we explored whether an increase of EAT thickness after STEMI might be associated with unfavourable LV remodelling at 3 months (T1). We also evaluated the relationship between changes (Δ) of EAT thickness and systemic levels of Interleukin (IL)-13 which is known to play a favourable activity on LV remodelling after STEMI. Methods We enrolled 66 patients with first STEMI, undergoing primary percutaneous angioplasty. At baseline and at 3 months we performed a complete echocardiogram, including EAT maximal thickness assessment, and determined circulating levels of IL-13. Results At 3 months after STEMI, the population was stratified into two groups according to different EAT remodelling after cardiac event: Group 1, patients with an increased EAT thickness (Δ EAT&gt;1; 30 patients) and Group 2, patients with unchanged or decreased EAT thickness (Δ EAT&lt;1). The two groups did not differ for age, gender and atherosclerotic risk factors. Group 1 had a worse LV remodelling at 3 months with higher LV diastolic and systolic volumes, lower LV ejection fraction (p=0.003; p=0.013; p=0.013 respectively) and worse diastolic function (E/e'; p=0.011). Of interest, EAT thickness increase was paralleled by circulating IL-13 reduction (p=0.022). Conclusion Myocardial injury can result in EAT increase which is associated to worse LV remodelling probably through the loss of the protective role of IL-13. Funding Acknowledgement Type of funding source: Public grant(s) – National budget only. Main funding source(s): This research has been funded by the University of Naples “Federico II” and “Compagnia di San Paolo e l'Istituto Banco di Napoli” within the competitive grant STAR 2018; Valentina Parisi is the principal investigator

Preoperative Platelet to Lymphocyte Ratio Is Associated with Early Morbidity and Mortality after Coronary Artery Bypass Grafting

2015 ◽  
Vol 18 (6) ◽  
pp. 255 ◽  
Author(s):  
Hüseyin Şaşkın ◽  
Çagrı Düzyol ◽  
Kazım Serhan Özcan ◽  
Rezan Aksoy ◽  
Mustafa Idiz
Keyword(s):  
Coronary Artery ◽  
Coronary Artery Bypass Grafting ◽  
Coronary Artery Bypass ◽  
Artery Bypass ◽  
Bypass Grafting ◽  
Platelet To Lymphocyte Ratio ◽  
Artery Bypass Grafting ◽  
Lymphocyte Ratio ◽  
Group 2 ◽  
Group 1

<strong>Objective:</strong> To investigate the association of platelet to lymphocyte ratio to mortality and morbidity after coronary artery bypass grafting operation.<br /><strong>Methods:</strong> We evaluated records of 916 patients who underwent coronary artery bypass grafting operation between January 2009 and May 2014 retrospectively. Patients were grouped as Group 1 (n = 604) if the platelet to lymphocyte ratio was above 142 and Group 2 (n = 312) if platelet to lymphocyte ratio was below 142.<br /><strong>Results:</strong> The number of patients who developed a neurologic event during the hospital stay and in the first postoperative month was 7 (1.2%) in Group 1 and 12 (3.8%) in Group 2 for which the difference was statistically significant (P = .007). Early term mortality occurred in 3 patients (0.5%) in Group 1 and in 10 patients (3.2%) in Group 2 for which the difference was statistically highly significant (P = .001). In univariate and multivariate regression analysis, the preoperative platelet to lymphocyte ratio was determined as an independent risk factor for occurrence of atrial fibrillation in the early postoperative period, reoperation for sternum dehiscence, occurrence of a neurologic event, prolonged stay in the hospital and mortality.<br /><strong>Conclusion:</strong> In this study, elevated levels of platelet to lymphocyte ratio were associated with mortality and morbidity after coronary artery bypass grafting operation.

The Role of Epicardial Adipose Tissue Lymphocytes in Low-Grade Inflammation and Coronary Artery Disease

Diabetes ◽  
2018 ◽  
Vol 67 (Supplement 1) ◽  
pp. 469-P
Author(s):  
MILOS MRAZ ◽  
ANNA CINKAJZLOVA ◽  
ZDENA LACINOVÁ ◽  
JANA KLOUCKOVA ◽  
HELENA KRATOCHVILOVA ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Adipose Tissue ◽  
Coronary Artery ◽  
Epicardial Adipose Tissue ◽  
Low Grade ◽  
Artery Disease ◽  
Low Grade Inflammation

scholarly journals The role of inhibition of osteocyte apoptosis in mediating orthodontic tooth movement and periodontal remodeling: a pilot study

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Michele Kaplan ◽  
Zana Kalajzic ◽  
Thomas Choi ◽  
Imad Maleeh ◽  
Christopher L. Ricupero ◽  
...  
Keyword(s):  
Bone Density ◽  
Alveolar Bone ◽  
Tooth Movement ◽  
Orthodontic Tooth Movement ◽  
Tartrate Resistant Acid Phosphatase ◽  
Osteocyte Apoptosis ◽  
Saline Administration ◽  
Group 2 ◽  
Group 1

Abstract Background Orthodontic tooth movement (OTM) has been shown to induce osteocyte apoptosis in alveolar bone shortly after force application. However, how osteocyte apoptosis affects orthodontic tooth movement is unknown. The goal of this study was to assess the effect of inhibition of osteocyte apoptosis on osteoclastogenesis, changes in the alveolar bone density, and the magnitude of OTM using a bisphosphonate analog (IG9402), a drug that affects osteocyte and osteoblast apoptosis but does not affect osteoclasts. Material and methods Two sets of experiments were performed. Experiment 1 was used to specifically evaluate the effect of IG9402 on osteocyte apoptosis in the alveolar bone during 24 h of OTM. For this experiment, twelve mice were divided into two groups: group 1, saline administration + OTM24-h (n=6), and group 2, IG9402 administration + OTM24-h (n=6). The contralateral unloaded sides served as the control. The goal of experiment 2 was to evaluate the role of osteocyte apoptosis on OTM magnitude and osteoclastogenesis 10 days after OTM. Twenty mice were divided into 4 groups: group 1, saline administration without OTM (n=5); group 2, IG9402 administration without OTM (n=5); group 3, saline + OTM10-day (n=6); and group 4, IG9402 + OTM10-day (n=4). For both experiments, tooth movement was achieved using Ultra Light (25g) Sentalloy Closed Coil Springs attached between the first maxillary molar and the central incisor. Linear measurements of tooth movement and alveolar bone density (BVF) were assessed by MicroCT analysis. Cell death (or apoptosis) was assessed by terminal dUTP nick-end labeling (TUNEL) assay, while osteoclast and macrophage formation were assessed by tartrate-resistant acid phosphatase (TRAP) staining and F4/80+ immunostaining. Results We found that IG9402 significantly blocked osteocyte apoptosis in alveolar bone (AB) at 24 h of OTM. At 10 days, IG9402 prevented OTM-induced loss of alveolar bone density and changed the morphology and quality of osteoclasts and macrophages, but did not significantly affect the amount of tooth movement. Conclusion Our study demonstrates that osteocyte apoptosis may play a significant role in osteoclast and macrophage formation during OTM, but does not seem to play a role in the magnitude of orthodontic tooth movement.

scholarly journals A tissue-engineered urinary conduit in a porcine urinary diversion model

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Arkadiusz Jundziłł ◽  
Piotr Kwieciński ◽  
Daria Balcerczyk ◽  
Tomasz Kloskowski ◽  
Dariusz Grzanka ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Urinary Diversion ◽  
Porcine Model ◽  
Histological Evaluation ◽  
Metabolic Complications ◽  
Group 3 ◽  
Group 2 ◽  
The Right ◽  
Group 1

AbstractThe use of an ileal segment is a standard method for urinary diversion after radical cystectomy. Unfortunately, utilization of this method can lead to numerous surgical and metabolic complications. This study aimed to assess the tissue-engineered artificial conduit for urinary diversion in a porcine model. Tissue-engineered tubular polypropylene mesh scaffolds were used for the right ureter incontinent urostomy model. Eighteen male pigs were divided into three equal groups: Group 1 (control ureterocutaneostomy), Group 2 (the right ureter-artificial conduit-skin anastomoses), and Group 3 (4 weeks before urostomy reconstruction, the artificial conduit was implanted between abdomen muscles). Follow-up was 6 months. Computed tomography, ultrasound examination, and pyelogram were used to confirm the patency of created diversions. Morphological and histological analyses were used to evaluate the tissue-engineered urinary diversion. All animals survived the experimental procedures and follow-up. The longest average patency was observed in the 3rd Group (15.8 weeks) compared to the 2nd Group (10 weeks) and the 1st Group (5.8 weeks). The implant’s remnants created a retroperitoneal post-inflammation tunnel confirmed by computed tomography and histological evaluation, which constitutes urostomy. The simultaneous urinary diversion using a tissue-engineered scaffold connected directly with the skin is inappropriate for clinical application.

Sign in / Sign up

Export Citation Format

Share Document