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2022 ◽  
Vol 2022 ◽  
pp. 1-10
Author(s):  
Qiang Song ◽  
Mingwei Chen ◽  
Jin Shang ◽  
Zhi Hu ◽  
Hui Cai

Objective. Vulnerable plaque is considered to be the cause of most clinical coronary arteries, and linear cytokines are an important factor causing plaque instability. Early prediction of vulnerable plaque is of great significance in the treatment of cardiovascular diseases. Methods. Computational fluid dynamics (CFD) was used to simulate the hemodynamics around plaques, and the serum biochemical markers in 224 patients with low-risk acute coronary syndrome (ACS) were analyzed. Vulnerable plaques were predicted according to the distribution of biochemical markers in serum. Results. CFD can accurately capture the hemodynamic characteristics around the plaque. The patient’s age, history of hyperlipidemia, apolipoprotein B (apoB), adiponectin (ADP), and sE-Selection were risk factors for vulnerable plaque. Area under curve (AUC) values corresponding to the five biochemical markers were 0.601, 0.523, 0.562, 0.519, 0.539, and the AUC value after the combination of the five indicators was 0.826. Conclusion. The combination of multiple biochemical markers to predict vulnerable plaque was of high diagnostic value, and this method was convenient and noninvasive, which was worthy of clinical promotion.


2021 ◽  
Vol 2021 ◽  
pp. 1-8
Author(s):  
Norihiro Kobayashi ◽  
Masahiro Yamawaki ◽  
Mana Hiraishi ◽  
Shinsuke Mori ◽  
Masakazu Tsutsumi ◽  
...  

Aims. To evaluate the vascular response after directional coronary atherectomy (DCA) for left main (LM) bifurcation lesion. Methods. This study was a retrospective, single-center study enrolling 31 patients who underwent stentless therapy using DCA followed by drug-coated balloon (DCB) angioplasty for LM bifurcation lesion. We compared intravascular ultrasound (IVUS) findings before and after DCA. Results. After DCA, the lumen and vessel areas significantly increased, whereas the plaque area (PA) and %PA were significantly reduced. When the lesions were divided into small vessel and large vessel groups using the median value of the vessel area, the maximum balloon pressure of the DCA catheter was greater in the large vessel group. Changes in the lumen and vessel areas were also significantly greater in the large vessel group. On the other hand, the changes in PA and %PA were similar between groups. Conclusions. The main vascular responses associated with lumen enlargement after DCA were plaque reduction and vessel expansion. Contribution of vessel expansion to lumen enlargement was larger than the effect of plaque reduction in large vessel lesions.


Diagnostics ◽  
2021 ◽  
Vol 11 (12) ◽  
pp. 2257
Author(s):  
Pankaj K. Jain ◽  
Neeraj Sharma ◽  
Luca Saba ◽  
Kosmas I. Paraskevas ◽  
Mandeep K. Kalra ◽  
...  

Background: The early detection of carotid wall plaque is recommended in the prevention of cardiovascular disease (CVD) in moderate-risk patients. Previous techniques for B-mode carotid atherosclerotic wall plaque segmentation used artificial intelligence (AI) methods on monoethnic databases, where training and testing are from the “same” ethnic group (“Seen AI”). Therefore, the versatility of the system is questionable. This is the first study of its kind that uses the “Unseen AI” paradigm where training and testing are from “different” ethnic groups. We hypothesized that deep learning (DL) models should perform in 10% proximity between “Unseen AI” and “Seen AI”. Methodology: Two cohorts from multi-ethnic groups (330 Japanese and 300 Hong Kong (HK)) were used for the validation of our hypothesis. We used a four-layered UNet architecture for the segmentation of the atherosclerotic wall with low plaque. “Unseen AI” (training: Japanese, testing: HK or vice versa) and “Seen AI” experiments (single ethnicity or mixed ethnicity) were performed. Evaluation was conducted by measuring the wall plaque area. Statistical tests were conducted for its stability and reliability. Results: When using the UNet DL architecture, the “Unseen AI” pair one (Training: 330 Japanese and Testing: 300 HK), the mean accuracy, dice-similarity, and correlation-coefficient were 98.55, 78.38, and 0.80 (p < 0.0001), respectively, while for “Unseen AI” pair two (Training: 300 HK and Testing: 330 Japanese), these were 98.67, 82.49, and 0.87 (p < 0.0001), respectively. Using “Seen AI”, the same parameters were 99.01, 86.89 and 0.92 (p < 0.0001), respectively. Conclusion: We demonstrated that “Unseen AI” was in close proximity (<10%) to “Seen AI”, validating our DL model for low atherosclerotic wall plaque segmentation. The online system runs < 1 s.


2021 ◽  
Vol 8 ◽  
Author(s):  
Shi-Feng Huang ◽  
Guifang Zhao ◽  
Xiao-Fei Peng ◽  
Wen-Chu Ye

The abnormally expressed long non-coding RNA (lncRNA) H19 has a crucial function in the development and progression of cardiovascular disease; however, its role in atherosclerosis is yet to be known. We aimed to examine the impacts of lncRNA H19 on atherogenesis as well as the involved mechanism. The outcomes from this research illustrated that the expression of lncRNA H19 was elevated in mouse blood and aorta with lipid-loaded macrophages and atherosclerosis. Adeno-associated virus (AAV)-mediated lncRNA H19 overexpression significantly increased the atherosclerotic plaque area in apoE−/− mice supplied with a Western diet. The upregulation of lncRNA H19 decreased the miR-146a-5p expression but increased the levels of ANGPTL4 in mouse blood and aorta and THP-1 cells. Furthermore, lncRNA H19 overexpression promoted lipid accumulation in oxidized low-density lipoprotein (ox-LDL)-induced THP-1 macrophages. However, the knockdown of lncRNA H19 served as a protection against atherosclerosis in apoE−/− mice and lowered the accumulation of lipids in ox-LDL-induced THP-1 macrophages. lncRNA H19 promoted the expression of ANGPTL4 via competitively binding to miR-146a-5p, thus promoting lipid accumulation in atherosclerosis. These findings altogether demonstrated that lncRNA H19 facilitated the accumulation of lipid in macrophages and aggravated the progression of atherosclerosis through the miR-146a-5p/ANGPTL4 pathway. Targeting lncRNA H19 might be an auspicious therapeutic approach for preventing and treating atherosclerotic disease.


2021 ◽  
Vol 7 (6) ◽  
pp. 6388-6394
Author(s):  
Changya Liu ◽  
Yun Li ◽  
Jianhua Zhou ◽  
Chuanxiang Wang ◽  
Tao Hu

Background The pathogenesis of transient ischemic attack is not clear. Microthrombosis theory is a theory with high clinical recognition. Microthrombosis of carotid artery and vertebral basilar artery wall occurs shedding and vasospasm, resulting in transient cerebral insufficiency. Microembolic decomposition or distal movement, cerebrovascular dilatation, local collateral circulation after the establishment of symptoms relieved or disappeared. Most patients can be relieved in a short time, but recurrent attacks can gradually damage the structure and function of brain tissue, and increase the risk of acute cerebral infarction. The clinical treatment of this disease is mainly based on the comprehensive control of risk factors, anti thrombosis, and anti-platelet aggregation. Objective To observe the effect of butylphthalide combined with ozagrel sodium on cerebral perfusion and oxidative stress indexes in patients with transient ischemic attack. Methods A total of 116 patients diagnosed as transient ischemic attack in our hospital (February 2018 - February 2020) were selected and divided into two groups according to the treatment methods. 58 cases in the control group were treated with ozagrel sodium, 58 cases in the observation group were treated with butylphthalide combined with ozagrel sodium. The CT perfusion imaging parameters, oxidative stress indexes, plaque area, and the levels of platelet activating factor ( PAF ), α-granule membrane protein-140 ( GMP-140 ), fibrinogen ( FIB ), platelet aggregation rate (PAgT), neuron-specific enolase (NSE), oxygend-inducible factor-1α (HIF-1α), and matrix metalloproteinases 9 (MMP-9) in the two groups were recorded, and the total effective rate and adverse reaction rate were counted. Results The total effective rate of the observation group was higher than that of the control group, and the difference was statistically significant (χ2=4.640, P = 0.031). Compared with before treatment, the average time (MTT) required for the two groups of contrast agents to pass through the local brain tissue and the time (TTP) required to start the injection of contrast agents to reach the peak concentration decreased compared with before treatment. After treatment, the MTT and TTP of the observation group were shorter than those of the control group (P < 0.05). Compared with before treatment, superoxide dismutase ( SOD ) in the two groups was higher than that in the control group, PAF, GMP-140, FIB, PAgT, NSE, HIF-la, MMP-9, malondialdehyde (MDA) and plaque area decreased. After treatment, the levels of related factors in the observation group were better than those in the control group, and the plaque area was less than that in the control group (P < 0.05). There was no significant difference in the adverse reaction rate between the observation group and the control group (χ2 = 0.438, P=0.508). Conclusion Butylphthalide combined with ozagrel sodium in the treatment of transient ischemic attack can improve cerebral perfusion, reduce oxidative stress injury, reduce plaque and improve curative effect.


Foods ◽  
2021 ◽  
Vol 10 (10) ◽  
pp. 2374
Author(s):  
Xi Liang ◽  
Zhe Zhang ◽  
Youyou Lv ◽  
Haiyan Lu ◽  
Tongjie Liu ◽  
...  

There has been an increasing number of studies on the interaction between active substances and probiotics to improve disease. Both krill oil (KO) and probiotics have the effect of improving atherosclerotic cardiovascular disease, but the combined effect has not been explored. Therefore, the purpose of this study was to explore the improvement effect of KO combined with probiotics on atherosclerosis. The atherosclerotic plaque area of ApoE−/− mice was detected after the intervention of KO, Bifidobacterium animalis subsp. lactis F1-7 (Bif. animalis F1-7), and KO combined with Bif. animalis F1-7. The results showed that Bif. animalis F1-7, KO, and KO combined with Bif. animalis F1-7 could significantly reduce the area of atherosclerotic plaque and improve the levels of serum lipids and inflammatory factors. They could regulate the farnesoid X receptor (FXR)/cholesterol 7-alpha hydroxylase (CYP7A1) pathway to reduce lipid accumulation. The intervention groups could also improve the inflammatory response by downregulating the Toll-like receptor 4 (TLR4)/myeloid differentiation factor 88 (MyD88) pathway. The anti-inflammatory effect of the interaction group was significantly better than that of KO. It proved that Bif. animalis F1-7 might play a synergistic effect in the improvement of inflammation by KO to the alleviation of atherosclerosis.


2021 ◽  
Vol 23 (3) ◽  
pp. 367-376
Author(s):  
Annelie Shami ◽  
Andreas Edsfeldt ◽  
Eva Bengtsson ◽  
Jan Nilsson ◽  
Angela C. Shore ◽  
...  

Background and Purpose CD40 and CD40 ligand (CD40L) are costimulatory molecules of the tumor necrosis factor receptor superfamily and well known for their involvement in inflammatory diseases: atherosclerotic mouse models with disrupted CD40 signalling develop lesions of reduced size with a more stable plaque profile. This study investigated the potential of plasma and intraplaque levels of CD40 and CD40L as markers for cardiovascular disease (CVD) in humans and their association with plaque stability.Methods Soluble CD40 and CD40L (sCD40L) were measured in plasma in 1,437 subjects from The SUrrogate markers for Micro- and Macro-vascular hard endpoints for Innovative diabetes Tools (SUMMIT) cohort. Intra-plaque levels of sCD40 and sCD40L were measured in atherosclerotic plaque homogenates from 199 subjects of the Carotid Plaque Imaging Project (CPIP) cohort. Results Both plasma sCD40 and sCD40L levels were elevated in individuals with prevalent stroke, while sCD40 levels also were higher in individuals with a prior acute myocardial infarction. Plasma levels of sCD40 correlated with carotid intima-media thickness and total carotid plaque area and were associated with risk of cardiovascular events over a 3-year follow-up period. Intra-plaque levels of sCD40 and sCD40L were associated with plaque components characteristic for plaque vulnerability and extracellular matrix remodelling.Conclusions Higher plasma sCD40 and sCD40L levels are associated with prevalent CVD. Plasma sCD40 levels also correlate with the severity of carotid atherosclerosis and predict future cardiovascular events, while intra-plaque levels correlate with a vulnerable plaque phenotype. Our findings thus demonstrate that elevated levels of sCD40 and sCD40L are markers of CVD.


Nutrients ◽  
2021 ◽  
Vol 13 (8) ◽  
pp. 2663
Author(s):  
Naoki Itaya ◽  
Ako Fukami ◽  
Tatsuyuki Kakuma ◽  
Yoshihiro Fukumoto

Background: Clinical characteristics of nutrition status in acute myocardial infarction (AMI) patients with cancer remains unknown. Therefore, this study aimed to clarify the differences of clinical parameters, including nutrition status, between AMI patients with and without history of cancer. Methods and Results: This retrospective cohort study, using the database of AMI between 2014 and 2019 in Kurume University Hospital, enrolled 411 patients; AMI patients without cancer (n = 358, 87.1%) and with cancer (n = 53, 12.9%). AMI patients with cancer were significantly older with lower body weight, worse renal function, and worse nutrition status. Next, we divided the patients into 4 groups by cancer, age, and plaque area, detected by coronary image devices. The prediction model indicated that nutrition, lipid, and renal functions were significant predictors of AMI with cancer. The ordinal logistic regression model revealed that worse nutrition status, renal dysfunction, lower uric acid, and elevated blood pressure were significant predictors. Finally, we were able to calculate the probability of the presence of cancer, by combining each factor and scoring. Conclusions: Worse nutrition status and renal dysfunction were associated with AMI with cancer, in which nutrition status was a major different characteristic from those without cancer.


2021 ◽  
Vol 13 ◽  
Author(s):  
Beibei Sun ◽  
Lingling Wang ◽  
Xiao Li ◽  
Jin Zhang ◽  
Jianjian Zhang ◽  
...  

Background: Intracranial atherosclerotic disease (ICAD) tends to affect multiple arterial segments, and previous studies rarely performed a comprehensive plaque analysis of the entire circle of Willis for the evaluation of recurrent stroke risk. We aimed to investigate the features of circle of Willis ICAD on 3D magnetic resonance vessel wall imaging (MR-VWI) and their relationships with recurrent acute stroke.Methods: Patients with either acute ischemic stroke (within 4 weeks after stroke) or chronic ischemic stroke (after 3 months of stroke) due to intracranial atherosclerotic plaque underwent 3D contrast-enhanced MR-VWI covering major cerebral arteries. Participants were divided into three groups: first-time acute stroke, recurrent acute stroke, and chronic stroke. Culprit plaque (defined as the only lesion or the most stenotic lesion when multiple plaques were present within the same vascular territory of the stroke) and non-culprit plaque characteristics, including total plaque number, plaque thickness, plaque area, plaque burden (calculated as plaque area divided by outer wall area), enhancement ratio (ER), eccentricity, and stenosis, were measured and compared across the three groups. Associations between plaque characteristics and recurrent acute stroke were investigated by multivariate analysis.Results: A total of 176 participants (aged 61 ± 10 years, 109 men) with 702 intracranial plaques were included in this study. There were 80 patients with first-time acute stroke, 42 patients with recurrent acute stroke, and 54 patients with chronic stroke. More intracranial plaques were found per patient in the recurrent acute stroke group than in the first-time acute stroke or chronic stroke group (5.19 ± 1.90 vs. 3.71 ± 1.96 and 3.46 ± 1.33, p &lt; 0.001). Patients in the recurrent acute stroke group had greater culprit plaque burden (p &lt; 0.001) and higher culprit ER (p &lt; 0.001) than the other two groups. After adjustment of clinical demographic factors, in multivariate analysis, coronary artery disease (CAD) (odds ratio, OR = 4.61; p = 0.035), total plaque number (OR = 1.54; p = 0.003), culprit plaque ER (OR = 2.50; p = 0.036), and culprit plaque burden (OR per 10% increment = 2.44; p = 0.010) were all independently associated with recurrent acute stroke compared to the first-time acute stroke.Conclusion: Increased intracranial atherosclerotic plaque number, higher culprit plaque ER, greater culprit plaque burden, and CAD are independently associated with recurrent acute stroke.


2021 ◽  
Vol 12 ◽  
Author(s):  
Samar M. Hammad ◽  
Olivia C. Harden ◽  
Dulaney A. Wilson ◽  
Waleed O. Twal ◽  
Paul J. Nietert ◽  
...  

Systemic lupus erythematosus (SLE) is a chronic autoimmune disease that affects females more than males, with African Americans developing more severe manifestation of the disease. SLE patients are at increased risk for cardiovascular disease (CVD), and SLE women 35-44 years old have 50 fold the incidence rate of CVD. Because SLE patients do not follow the typical age and gender pattern for CVD, but instead an accelerated disease course, the traditional biomarkers of elevated LDL and total cholesterol levels do not accurately assess their CVD risk. Recently, we have reported that African American SLE patients had higher ceramide, hexosylceramide, sphingosine and dihydrosphingosine 1-phosphate levels compared to their healthy controls, and those with atherosclerosis had higher sphingomyelin and sphingoid bases levels than those without (PLoS One. 2019; e0224496). In the current study, we sought to identify sphingolipid species that correlate with and pose the potential to predict atherosclerosis severity in African American SLE patients. Plasma samples from a group of African American predominantly female SLE patients with well-defined carotid atherosclerotic plaque burden were analyzed for sphingolipidomics using targeted mass spectroscopy. The data demonstrated that at baseline, plaque area and C3 values correlated inversely with most lactoceramide species. After one-year follow-up visit, values of the change of plaque area correlated positively with the lactoceramide species. There was no correlation between LDL-C concentrations and lactoceramide species. Taken together, lactocylcermide levels may have a ‘predictive’ value and sphingolipidomics have an added benefit to currently available tools in early diagnosis and prognosis of African American SLE patients with CVD.


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