Accelerated coronary calcium burden in breast cancer patients after radiotherapy: a comparison with age and race matched healthy women

Background Radiotherapy (RT) might lead to atherosclerotic plaque buildup and coronary artery stenosis of breast cancer (BC) survivors, and coronary artery calcium (CAC) might be a sign of preclinical atherosclerosis. This study explores possible determinants affecting the acceleration of CAC burden in BC patients after adjuvant RT. Methods Female BC patients receiving adjuvant RT from 2002 to 2010 were included. All patients received noncontrast computed tomography (NCCT) of thorax before and after adjuvant RT. Their CAC burden was compared with healthy controls from the Multi-Ethnic Study of Atherosclerosis (MESA) cohort. The progression of the CAC burden was manifested by the increment of CAC percentiles (%CACinc). Results Ninety-four patients, including both left- and right-side BC, were enrolled in this study. From undergoing the first to second NCCT, the %CACinc in BC patients significantly increased rather than non-BC women. In addition, the %CACinc was significantly higher in left-side than right-side BC patients (p < 0.05), and significant differences in most heart outcomes were found between the two groups. Besides, the lower the mean right coronary artery (RCA) dose, the lower the risks of CAC percentiles increase ≥ 50% after adjusting the disease's laterality. Conclusions A significantly higher accelerated CAC burden in BC patients than non-BC women represents that BC could affect accelerated CAC. A higher risk of accelerated CAC burden was found in left-side than right-side BC patients after adjuvant RT. A decrease of the mean RCA dose could reduce more than 50% of the risk of accelerated CAC burden in BC patients.

Use of intima media thickness in the assessment of the development of preclinical atherosclerosis

Background/Introduction In the carotid arteries, an IMT &gt;0.9 mm measured by Duplex sonography is considered abnormal and can be considered an independent predictor of preclinical atherosclerosis. IMT &gt;1.5 mm can already be called an atherosclerotic plaque. Purpose The aim of this study was to investigate the age characteristics of the intima media thickness in the carotid arteries Methods The analysis was performed on the basis of retrospective observations of 483 patients who underwent ultrasound dopplerography during 2010–2017. The mean age of the studied patients was 53.28±14.06 (min 9, max 86 years), the standard mean error was ± 0.64. Among those examined, 165 (34.16%) were men and 318 (65.84%) were women. Measurements for IMT were performed on both the right and left: common, external, and internal carotid arteries. IMT is defined in the following ranges: &lt;0.9 mm – normal thickness; 0.9–1.0 mm – intermediate thickness; &gt;1.0 mm – increased thickness; ≥1.5 mm – atherosclerotic plaque. Results The comparison was made in 3 age groups: &lt;40; 40–65; &gt;65 years. 3 IMT values were taken: &lt;0.9; 0.9–1.0; &gt;1.0 mm. Indicators are calculated in both absolute numbers and percentages. The accuracy of the obtained results was checked by chi square statistics (p&lt;0.05). There were 477 patients in the age group we studied. We lost 6 pts in this study. It was 90 pts at the age &lt;40 years, 293 pts at the age 40–65 years, 94 pts at the age &gt;65 years. It was 249 pts with IMT &lt;0.9 mm, 107 pts with IMT 0.9 - 1.0 mm, 121 pts with IMT &gt;1.0 mm. According to our results, it was IMT &lt;0.9 mm in 87.78% (79 pts) cases at the age &lt;40 years, 52.22% (153 pts) at the age 40–65 years, 18.09% (17 pts) at the age &gt;65 years. IMT was found between 0.9 and 1.0 mm in 5.56% (5 pts) cases at the age &lt;40 years, 47.71% (73 pts) at the age 40–65 years, 30.85% (29 pts) at the age &gt;65 years. It was IMT &gt;1.0 mm in 6.67% (6 pts) cases at the age &lt;40 years, 22.87% (67 pts) at the age 40–65 years, 51.06% (48 pts) at the age &gt;65 years. Conclusion(s) The prevalence of the IMT &gt;1.0 mm more at the age &gt;65 years (51.06%), IMT 0.9–1.0 mm more at the age 40–65 years (47.71%), IMT &lt;0.9 mm more at the age &lt;40 years (87.78%). FUNDunding Acknowledgement Type of funding sources: None.

Assessment of Microvessel Permeability in Murine Atherosclerotic Vein Grafts Using Two-Photon Intravital Microscopy

Plaque angiogenesis and plaque hemorrhage are major players in the destabilization and rupture of atherosclerotic lesions. As these are dynamic processes, imaging of plaque angiogenesis, especially the integrity or leakiness of angiogenic vessels, can be an extremely useful tool in the studies on atherosclerosis pathophysiology. Visualizing plaque microvessels in 3D would enable us to study the architecture and permeability of adventitial and intimal plaque microvessels in advanced atherosclerotic lesions. We hypothesized that a comparison of the vascular permeability between healthy continuous and fenestrated as well as diseased leaky microvessels, would allow us to evaluate plaque microvessel leakiness. We developed and validated a two photon intravital microscopy (2P-IVM) method to assess the leakiness of plaque microvessels in murine atherosclerosis-prone ApoE3*Leiden vein grafts based on the quantification of fluorescent-dextrans extravasation in real-time. We describe a novel 2P-IVM set up to study vessels in the neck region of living mice. We show that microvessels in vein graft lesions are in their pathological state more permeable in comparison with healthy continuous and fenestrated microvessels. This 2P-IVM method is a promising approach to assess plaque angiogenesis and leakiness. Moreover, this method is an important advancement to validate therapeutic angiogenic interventions in preclinical atherosclerosis models.