scholarly journals Spotty Carotid Plaques Are Associated with Inflammation and the Occurrence of Cerebrovascular Symptoms

2018 ◽  
Vol 8 (1) ◽  
pp. 16-25 ◽  
Author(s):  
Sanela Halak ◽  
Gerd Östling ◽  
Andreas Edsfeldt ◽  
Cecilia Kennbäck ◽  
Magnus Dencker ◽  
...  
Keyword(s):  
Inverse Correlation ◽  
Geometric Feature ◽  
Intraobserver Variability ◽  
Monocyte Chemoattractant Protein 1 ◽  
Carotid Plaques ◽  
Plaque Area ◽  
Inflammatory Protein ◽  
Increased Risk ◽  
Endothelial Growth Factor ◽  
Cerebrovascular Symptoms

Background: Echolucent carotid plaques have been related to an increased risk of ischemic cerebrovascular events. The aim of the present study was to evaluate whether a new objective ultrasonographic parameter, the statistical geometric feature (SGF), reflecting spottiness of carotid plaques, can be associated with cerebrovascular symptoms and with a rupture-prone plaque phenotype. Methods: The plaques of 144 patients who underwent carotid endarterectomy were included in this study. SGF and plaque area were estimated by outlining the plaque on ultrasound (US) images. The correlation coefficient for inter- and intraobserver variability was 0.69 and 0.93, respectively. The SGF values were normalized to the degree of stenosis (SGF/DS). The plaques collected at surgery 1 day after the US were analyzed histologically, and inflammatory markers and matrix metalloproteinases (MMPs) were measured. Results: Patients with ipsilateral hemispheric symptoms had higher SGF/DS compared to patients without symptoms (0.82 [0.59–1.16] vs. 0.70 [0.56–0.89], p = 0.01). Analysis of plaque components revealed a positive correlation between SGF/DS and the percentage of the plaque area stained for lipids, macrophages, and hemorrhage. A correlation was also found between SGF/DS and plaque expression of interleukin-6, monocyte chemoattractant protein-1, macrophage inflammatory protein-1β, vascular endothelial growth factor A, C-C motif chemokine 3 and 20, and MMP-9. An inverse correlation was found with plaque levels of osteoprotegerin. Conclusions: The present study supports the concept that spottiness is a feature of the carotid plaques rich in inflammation and can be associated with the typical phenotype of high-risk plaques.

scholarly journals Simultaneous Detection of Eight Analytes in Human Serum by Two Commercially Available Platforms for Multiplex Cytokine Analysis

2007 ◽  
Vol 15 (1) ◽  
pp. 42-48 ◽  
Author(s):  
Gary Toedter ◽  
Karen Hayden ◽  
Carrie Wagner ◽  
Carrie Brodmerkel
Keyword(s):  
Simultaneous Detection ◽  
Tissue Level ◽  
Careful Examination ◽  
Serum Samples ◽  
Meso Scale Discovery ◽  
Necrosis Factor Alpha ◽  
Monocyte Chemoattractant Protein 1 ◽  
Inflammatory Protein ◽  
Cytokine Analysis ◽  
Endothelial Growth Factor

ABSTRACT The accurate detection and quantitation of cytokines in serum are important in the study of disease mechanisms, pathogenesis, and treatment. Serum cytokines can reflect processes that are occurring at the cellular or tissue level and thus provide a means of indirectly monitoring these processes. Multiplex detection of cytokines allows the simultaneous measurement of multiple cytokines in a sample, increasing the efficiency of measuring the cytokines while reducing the serum sample volumes required for the testing. Two commercially available multiplex platforms were evaluated (Pierce SearchLight and Meso Scale Discovery), using multiplexes capable of simultaneously detecting eight cytokines. The cytokines analyzed in this study were gamma interferon, vascular endothelial growth factor, tumor necrosis factor alpha, interleukin-6 (IL-6), macrophage inflammatory protein 1β, monocyte chemoattractant protein 1, IL-12p40, and IL-4. The range of quantitation of the platforms, the recovery of spiked cytokines, and the detection of the cytokines in serum samples from subjects with ulcerative colitis, Crohn's disease, rheumatoid arthritis, and psoriasis were examined. The findings showed that the detection of the cytokines was highly dependent upon the platform, with the consistency of the detection of cytokines across platforms being dependent upon the cytokine being analyzed. A careful examination of platform assay performance must be made prior to utilizing multiplex platforms in a study. While some cytokines will give similar patterns of results across platforms, others will be highly variable. The use of the same platform within a study or across studies where data will be compared is advised.

Role for Chemokines in the Vasculopathy Associated with Sickle Cell Dsease and Pulmonary Hypertension

Blood ◽  
2008 ◽  
Vol 112 (11) ◽  
pp. 4804-4804 ◽  
Author(s):  
Anitaben Tailor ◽  
Gregory J. Kato
Keyword(s):  
Sickle Cell ◽  
Vascular Inflammation ◽  
Inverse Correlation ◽  
Inflammatory Protein ◽  
Potential Marker ◽  
Increased Risk ◽  
High Prevalence ◽  
Pulmonary Arterial

Abstract Sickle cell disease (SCD) is a hemolytic disorder characterized by transient vaso-occlusive crisis (VOC). Moreover, there is a high prevalence of SCD-associated pulmonary arterial hypertension (PAH), indicated by a tricuspid regurgitant jet velocity (TRV) ≥ 2.5 m/sec, leading to increased risk for early mortality. Monocytes have been proposed as pivotal cells in vascular inflammation in animal models of SCD. Preliminary studies in our group have shown a potential role for monocyte chemokines in the vasculopathy of SCD. The objective of this study is to investigate the role of two chemokines: regulated upon activation, normal T cell expressed and secreted (RANTES) and macrophage inflammatory protein-1β (MIP-1β) in SCD and SCD-associated PAH. Plasma samples were collected from patients with SCD at steady state and from healthy African-American control subjects. Plasma levels of RANTES and MIP-1β were measured using an enzyme immunoassay system. Patients with SCD exhibited significantly higher levels of both MIP-1β (median 465.3 vs. 398.5 pg/ml, p<0.0001) and RANTES (median 47774 vs. 17445pg/ml, p<0.0004) than healthy controls. Further characterization of SCD patients with or without PAH demonstrated that whereas MIP-1β exhibited no correlation with PAH, RANTES demonstrated an inverse correlation with PAH (r= −0.25, p<0.03) with significance achieved in patients that exhibited severe PAH (TRV> 2.9, p<0.05). These findings suggest that both chemokines, RANTES and MIP-1β, are associated with the vasculopathy of SCD, and whereas MIP-1β does not appear to be associated with SCD-associated PAH, RANTES levels are inversely correlated to the severity of PAH. RANTES merits further investigation as a potential marker in PAH, and for a possible role in its progression.

scholarly journals Topical bromfenac reduces multiple inflammatory cytokines in the aqueous humour of pseudophakic patients

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Takehiro Matsumura ◽  
Kentaro Iwasaki ◽  
Shogo Arimura ◽  
Ryuji Takeda ◽  
Yoshihiro Takamura ◽  
...  
Keyword(s):  
Growth Factor ◽  
Inflammatory Cytokines ◽  
Aqueous Humour ◽  
Ophthalmic Solution ◽  
Vascular Endothelial ◽  
Monocyte Chemoattractant Protein 1 ◽  
Monocyte Chemoattractant ◽  
Before And After ◽  
Endothelial Growth Factor ◽  
Single Blind

AbstractIntraocular surgery is associated with increased ocular inflammation. If maintained for a prolonged period after surgery, this inflammation can cause various complications, including subconjunctival fibrosis and bleb scarring. This clinical trial was a prospective, randomised, single-blind, interventional study comparing the efficacy and safety of 0.1% bromfenac sodium ophthalmic solution and 0.02% fluorometholone ophthalmic suspension in the inhibition of multiple inflammatory cytokines in the aqueous humour of 26 patients with pseudophakic eyes who had undergone phacoemulsification and intraocular lens implantation. The patients were randomly assigned to one of the trial drugs, and aqueous humour samples were collected before and after drug administration. Platelet-derived growth factor-AA levels significantly decreased in both drug groups, but they were significantly higher in the fluorometholone group than in the bromfenac group (P = 0.034). Bromfenac also significantly decreased vascular endothelial growth factor level (P = 0.0077), as well as monocyte chemoattractant protein-1 level (P = 0.013), which was elevated for a prolonged period after phacoemulsification. These data suggest that bromfenac is useful to alleviate prolonged microenvironmental alterations in the aqueous humour of pseudophakic eyes.

Abstract TP217: Cerebrovascular Events in Glioma Patients Treated with Bevacizumab

Stroke ◽  
2013 ◽  
Vol 44 (suppl_1) ◽  
Author(s):  
Donika K Patel ◽  
Seby John ◽  
Neda Hashemi-Sadraei ◽  
Manmeet Ahluwalia
Keyword(s):  
Risk Factors ◽  
Tumor Progression ◽  
Cerebrovascular Event ◽  
Patient Demographics ◽  
Randomized Controlled Studies ◽  
Cerebrovascular Events ◽  
Bevacizumab Treatment ◽  
Increased Risk ◽  
Group 2 ◽  
Endothelial Growth Factor

Introduction: Bevacizumab, a humanized monoclonal anti-vascular endothelial growth factor antibody, was FDA approved in 2009 for progressive glioblastoma. Phase II clinical trials suggested an increased risk of ischemic stroke (IS) and intracranial hemorrhage (ICH) while on bevacizumab. The incidence, clinical characteristics, and neuroimaging of glioma patients who developed cerebrovascular events while on treatment is lacking. We report our experience using bevacizumab for glioma patients. Methods: A retrospective review of glioma patients treated with bevacizumab at our institution from July 2005 to June 2011 was studied. Patients with MRI-confirmed IS and/or ICH while on bevacizumab was investigated and compared to historical data. Patient demographics, vascular risk factors, clinical presentations, tumor characteristics, treatments (surgery, chemotherapy, and radiation), and treatment duration were collected. Results: A total of 162 patients (65% male) received bevacizumab and 23 (14%) developed a cerebrovascular event while on treatment, with 3 (2%) IS and 20 (12%) ICH. All IS and ICH patients received prior brain radiation. In the IS group, 2 (66%) patients were symptomatic, with 1 (33%) cardiembolic and 2 (66%) lacunar strokes. None had risk factors besides hypercoagulable state from malignancy. In the ICH group, 3 (15%) patients had a symptomatic bleed and 6 (30%) had associated hypertension. All ICHs were intratumoral and 16 (80%) associated with tumor progression. Median survival after stroke was 9.8 and 3.7 months in the IS and ICH groups, respectively. Length of bevacizumab treatment was not significantly associated with development of IS ( p = 0.6) and ICH ( p = 0.3). Conclusion: Glioma patients have an inherently elevated risk of IS and ICH because of disease- and treatment-related effects. In our study, 78% of the events were asymptomatic and diagnosed on serial imaging. ICHs were more common, but all were small intratumoral bleeds, mostly in the setting of tumor progression. Development of cerebrovascular events was not associated with the duration of bevacizumab treatment. Our study, however, cannot determine causality and randomized controlled studies are needed to determine the risk of IS and ICH with bevacizumab use.

Epicardial Adipose Tissue and Postoperative Atrial Fibrillation

2021 ◽  
Author(s):  
Petraglia Laura ◽  
Conte Maddalena ◽  
Comentale Giuseppe ◽  
Cabaro Serena ◽  
Campana Pasquale ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Adipose Tissue ◽  
Cardiac Surgery ◽  
Epicardial Adipose Tissue ◽  
Perioperative Period ◽  
Postoperative Atrial Fibrillation ◽  
Serum Samples ◽  
Monocyte Chemoattractant Protein 1 ◽  
Elective Cardiac Surgery ◽  
Increased Risk

Abstract Background. Atrial fibrillation (AF) often occurs after cardiac surgery and is associated to increased risk of stroke and mortality. Several evidence support the important role of inflammation in the pathogenesis of postoperative atrial fibrillation (POAF). It is known that an increased volume and a pro-inflammatory phenotype of epicardial adipose tissue (EAT) are both associated with AF onset in non surgical context. In the present study, we aim to evaluate whether also POAF occurrence may be triggered by an exalted production of inflammatory mediators from EAT.Methods. The study population was composed of 105 patients, with no history of paroxysmal or permanent AF, undergoing elective cardiac surgery. After clinical evaluation, all patients performed an echocardiographic study including the measurement of EAT thickness. Serum samples and EAT biopsies were collected before surgery. Levels of 10 inflammatory cytokines were measured in serum and EAT conditioned media. After surgery, cardiac rhythm was monitored for 7 days.Results. Forty-four patients (41.3%) developed POAF. As regard to cardiovascular therapy, only statin use was significantly lower in POAF patients (65.1% vs. 84.7%; p-0.032). Levels of Monocyte Chemoattractant Protein-1 (MCP-1), in both serum and EAT, were significantly higher in POAF patients (130.1 pg/ml vs. 68.7 pg/ml; p = < 0.001; 322.4 pg/ml vs. 153.4 pg/ml; p = 0.028 respectively). EAT levels of IL-6 were significantly increased in POAF patients compared to those in sinus rhythm (126.3 pg/ml vs. 23 pg/ml; p = < 0.005).ConclusionHigher EAT levels of IL6 and MCP1 are significantly associated with the occurrence of POAF. Statin therapy seems to play a role in preventing POAF. These results might pave the way for a targeted use of these drugs in the perioperative period.

Abstract 14793: Association Between Cardiac Ejection Fraction and the Size of Stroke

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Muhammad M Alvi ◽  
Tamra Ranasinghe ◽  
Yasser Kabbani ◽  
Mohamad Adnan Alkhouli ◽  
Abdul Rahman Tarabishy
Keyword(s):  
Atrial Fibrillation ◽  
Ejection Fraction ◽  
Thrombus Formation ◽  
Infarct Volume ◽  
Inverse Correlation ◽  
Stroke Patients ◽  
Increased Risk ◽  
Median Volume ◽  
Cardiac Ejection Fraction ◽  
Low Ejection Fraction

Introduction: Heart failure with low ejection fraction (EF) is a known risk factor for stroke. Low EF is associated with increased risk of thrombus formation and is accompanied with 2 to 3 fold increased risk of stroke. This can happen even in the absence of atrial fibrillation. Hypothesis: Our hypothesis was that size of the stroke will be larger in patients with reduction in EF as compared with cardioembolic strokes in preserved EF. The worse the EF, the more stagnation of blood and poor cardiac output leading higher risk of thrombus formation. It’s also likely that the group with reduced EF form a larger thrombus leading to larger stroke as compared to the group with preserved EF. Methods: For our analysis, we retrospectively reviewed charts for 49 acute ischemic stroke patients without atrial fibrillation. We used transthoracic echocardiogram to determine the EF. There are 25 patients with preserved EF, cutoff > 50%. There were 24 patients in reduced EF group. Both groups were matched for age and cardiovascular risk factors. Infarct volume was manually calculated from T1 MRI using BrainLab software. Results: There is an inverse correlation between EF and infarct volume (r=-.283, p=.048) meaning patients with reduced EF had greater infarct volume. Median infarct volume is higher in reduced EF group (median volume = 36 cm 3 ) compared to patients with preserved EF (median volume = 11 cm 3 ) (p=.117). Conclusions: In our patient’s sample, there seems to be an inverse correlation between EF and size of stroke. Patients with reduced EF were associated with larger strokes. Larger studies need to be performed to establish a correlation.

scholarly journals Ultrasound Elastography: another piece in the puzzle of carotid plaque vulnerability?

2021 ◽  
Author(s):  
Andjoli Davidhi ◽  
Vasileios Rafailidis ◽  
Evangelos Destanis ◽  
Panos Prassopoulos ◽  
Stefanos Foinitsis
Keyword(s):  
Shear Wave ◽  
Carotid Plaque ◽  
Diagnostic Yield ◽  
Imaging Modality ◽  
Shear Wave Elastography ◽  
Ultrasound Elastography ◽  
Intraplaque Hemorrhage ◽  
Plaque Vulnerability ◽  
Carotid Plaques ◽  
Increased Risk

Recent literature has shown that various carotid plaque features, other than stenosis, contribute to plaque vulnerability. Features such as surface morphology and plaque composition with distinct components (e.g. intraplaque hemorrhage, lipid core) have been associated with the increased risk of future cerebrovascular events. Ultrasonography constitutes the first line modality for the assessment of carotid disease and has traditionally been used to grade stenosis with high accuracy. Recenttechnological advances such as contrast-enhanced ultrasound and elastography increased the diagnostic yield of ultrasound in assessing the morphology of carotid plaques. The purpose of this review is to present the available literature on ultrasound elastography of the atherosclerotic carotid. Strain and shear wave elastography allow for the characterization of plaque components, thus indicating its nature and importantly, the plaque’s vulnerability. Shear wave elastography indices appear morerobust than Strain indices. Overall, elastography is a feasible method to distinguish vulnerable carotid plaques. There is, however, a need for larger and longer prospective controlled clinical studies in order to validate elastography as an imaging modality used for the detection of unstable carotid plaques.

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