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Asymptomatic carotid atherosclerosis

Siroon Bekkering, Inge van den Munckhof, Tim Nielen, Evert Lamfers, Charles Dinarello, Joost Rutten, Jacqueline de Graaf, Leo A B Joosten, Mihai G Netea, Marc E R Gomes, Niels P Riksen
BACKGROUND AND AIMS: We have recently reported that monocytes can undergo functional and transcriptional reprogramming towards a long-term pro-inflammatory phenotype after brief in vitro exposure to atherogenic stimuli such as oxidized LDL. This process is termed 'trained immunity', and is mediated by epigenetic remodeling and a metabolic switch towards increased aerobic glycolysis. We hypothesize that trained immunity contributes to atherogenesis. Therefore, we investigated the inflammatory phenotype and epigenetic remodeling of monocytes from patients with and without established atherosclerosis...
October 12, 2016: Atherosclerosis
Mattia Cattaneo, Daniel Staub, Alessandra P Porretta, Jeanne Marie Gallino, Paolo Santini, Costanzo Limoni, Rolf Wyttenbach, Augusto Gallino
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(®)...
December 2016: Data in Brief
Enrico Ammirati, Francesco Moroni, Marco Magnoni, Simona Di Terlizzi, Chiara Villa, Federico Sizzano, Alessio Palini, Katia Garlaschelli, Fernanda Tripiciano, Isabella Scotti, Alberico Luigi Catapano, Angelo A Manfredi, Giuseppe Danilo Norata, Paolo G Camici
BACKGROUND AND AIMS: Monocytes are known to play a key role in the initiation and progression of atherosclerosis and contribute to plaque destabilization through the generation of signals that promote inflammation and neoangiogenesis. In humans, studies investigating the features of circulating monocytes in advanced atherosclerotic lesions are lacking. METHODS: Patients (mean age 69 years, 56% males) with intermediate asymptomatic carotid stenosis (40-70% in diameter) were evaluated for maximal stenosis in common carotid artery, carotid bulb and internal carotid artery, overall disease burden as estimated with total plaque area (TPA), greyscale and neovascularization in 244 advanced carotid plaques...
October 6, 2016: Atherosclerosis
Joshua T Chai, Luca Biasiolli, Linqing Li, Mohammad Alkhalil, Francesca Galassi, Chris Darby, Alison W Halliday, Linda Hands, Timothy Magee, Jeremy Perkins, Ed Sideso, Ashok Handa, Peter Jezzard, Matthew D Robson, Robin P Choudhury
OBJECTIVES: The aim of this study was to: 1) provide tissue validation of quantitative T2 mapping to measure plaque lipid content; and 2) investigate whether this technique could discern differences in plaque characteristics between symptom-related and non-symptom-related carotid plaques. BACKGROUND: Noninvasive plaque lipid quantification is appealing both for stratification in treatment selection and as a possible predictor of future plaque rupture. However, current cardiovascular magnetic resonance (CMR) methods are insensitive, require a coalesced mass of lipid core, and rely on multicontrast acquisition with contrast media and extensive post-processing...
October 6, 2016: JACC. Cardiovascular Imaging
Anxin Wang, Xiaoya Huang, Xiaoxue Liu, Zhaoping Su, Jianwei Wu, Shuohua Chen, Xuemei Liu, Chunyu Ruan, Xiuhua Guo, Shouling Wu, Xingquan Zhao
BACKGROUND AND PURPOSE: High-sensitivity C-reactive protein (hs-CRP) is a risk indicator for atherosclerosis. However, the association between hs-CRP and early carotid atherosclerosis progression is not well established. We undertook a prospective, community-based, observational study to address this question. METHODS: Common carotid artery intima-media thickness (IMT) and hs-CRP values were measured at baseline and after 2 years of follow-up in subjects ≥40 years of age who were participating in the Asymptomatic Polyvascular Abnormalities Community study...
October 11, 2016: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
Fatih Yılmaz, Erkan Köklü, Filiz Kizilirmak Yilmaz, Elif Sarıönder Gencer, Ahmet Şükrü Alparslan, Özlem Yıldırımtürk
BACKGROUND: Platelets play a significant role in the pathogenesis of atherosclerosis. In atherosclerotic plaques, the risk of plaque rupture is more crucial than the severity of stenosis they cause. Non-calcified carotid artery plaques are more unstable than calcified plaques, and they are associated with a higher risk of rupture, thromboembolism and consequently, stroke. AIM: Purpose of the present study is to compare calcified and non-calcified plaques that cause intermediate carotid artery stenosis with respect to mean platelet volume (MPV) and platelet distribution width (PDW)...
October 7, 2016: Kardiologia Polska
Flavia Del Porto, Noemi Cifani, Maria Proietta, Sara Perrotta, Raffaele Dito, Cira di Gioia, Raffaella Carletti, Luigi Rizzo, Gianluigi Orgera, Michele Rossi, Livia Ferri, Luigi Tritapepe, Maurizio Taurino
BACKGROUND: Atherosclerosis is a multifactorial disease characterized by an immune-inflammatory remodeling of the arterial wall. Tregs and Th17 subpopulations are detectable inside atherosclerotic plaque, however their behavior in symptomatic carotid artery stenosis (CAS) is not fully elucidated. The aim of this study was to evaluate Th17 and Tregs subsets and their ratio in patients affected by symptomatic and asymptomatic CAS. METHODS: 14 patients with symptomatic CAS (CAS-S group), 41 patients with asymptomatic CAS (CAS-A group), 32 subjects with traditional cardiovascular risk factors (RF group) and 10 healthy subjects (HS group) were enrolled...
October 3, 2016: Annals of Medicine
Joanna M N Guimarães, Philippa Clarke, Denise Tate, Claudia Medina Coeli, Rosane Harter Griep, Maria de Jesus Mendes da Fonseca, Itamar S Santos, Enirtes Caetano Prates Melo, Dora Chor
Over the past half century Brazil has undergone a process of dramatic industrialization and urbanization. Cardiovascular diseases (CVD) have become common due to rapid demographic, epidemiologic, and nutritional transitions. The association of social mobility with subclinical CVD has been rarely explored, particularly in developing societies. We investigated the association of intra- and inter-generational social mobility with carotid intima-media thickness (IMT), a marker of subclinical or asymptomatic atherosclerosis, in a large Brazilian sample (ELSA-Brasil)...
September 16, 2016: Social Science & Medicine
Mattia Cattaneo, Daniel Staub, Alessandra P Porretta, Jeanne Marie Gallino, Paolo Santini, Costanzo Limoni, Rolf Wyttenbach, Augusto Gallino
BACKGROUND: Currently the most widely accepted predictor of stroke risk in patients with carotid atherosclerosis is the degree of stenoses. Plaque echogenicity on ultrasound imaging (US) and intraplaque neovascularization (IPNV) are becoming recognized as factors of plaque vulnerability. Aim of the study was to investigate the correlation between the echogenicity of the carotid atherosclerosis by standard US and the degree of IPNV by contrast enhanced US (CEUS). METHODS: We recruited 45 consecutive subjects with an asymptomatic ≥50% carotid artery stenoses...
November 15, 2016: International Journal of Cardiology
Takahiko Akiyama, Yuji Miyamoto, Yasuo Sakamoto, Ryuma Tokunaga, Keisuke Kosumi, Hironobu Shigaki, Junji Kurashige, Masaaki Iwatsuki, Yoshifumi Baba, Naoya Yoshida, Hideo Baba
Thromboembolism that occurs in association with a malignant tumor is known as Trousseau syndrome. We herein present a case of Trousseau syndrome during systemic chemotherapy for metastatic colon cancer. A 65-year-old man with multiple liver metastases underwent primary tumor resection and systemic chemotherapy. Multiple brain infarctions were detected by magnetic resonance imaging immediately after first-line chemotherapy, which was deemed ineffective. There was no evidence of cardioembolic stroke or carotid atherosclerosis...
December 2016: Surgical Case Reports
Konstantinos Filis, Levon Toufektzian, George Galyfos, Fragiska Sigala, Panagiota Kourkoveli, Sotirios Georgopoulos, Manolis Vavuranakis, Dimitrios Vrachatis, George Zografos
Carotid atherosclerosis represents a primary cause for cerebrovascular ischemic events and its contemporary management includes surgical revascularization for moderate to severe symptomatic stenoses. However, the role of invasive therapy seems to be questioned lately for asymptomatic cases. Numerous reports have suggested that the presence of neovessels within the atherosclerotic plaque remains a significant vulnerability factor and over the last decade imaging modalities have been used to identify intraplaque neovascularization in an attempt to risk-stratify patients and offer management guidance...
August 31, 2016: Vascular
Anxin Wang, Lingyun Wu, Xiaoxue Liu, Zhaoping Su, Yanxia Luo, Shuohua Chen, Haibin Li, Xiangtong Liu, Lixin Tao, Jin Guo, Feng Zhang, Yibin Cao, Xingquan Zhao, Shouling Wu, Xiuhua Guo
Few studies have investigated the prevalence of carotid plaque with different stability in Chinese. As is well known, carotid atherosclerosis is tightly associated with metabolic syndrome (MetS); however, the data about the association between the presence of carotid plaque with different stability and MetS was limited. The aim of our study was to investigate the prevalence of carotid plaque with different stability and its potential association with MetS in general Chinese population.The Asymptomatic Polyvascular Abnormalities Community study is a community-based study to investigate the epidemiology of asymptomatic polyvascular abnormalities in Chinese adults...
August 2016: Medicine (Baltimore)
Ana Beatriz Andrêo Garcia, Luciana Paula Dardin, Paulo Alexandre Minali, Adriano Czapkowsky, Sergio Aron Ajzen, Virginia Fernandes Moça Trevisani
BACKGROUND: Primary Sjögren syndrome is a chronic inflammatory autoimmune disease. The delay in diagnosis allows the establishment of a chronic inflammatory state, which makes primary Sjögren syndrome an interesting model for the study of atherosclerosis. OBJECTIVES: The aim of this study was to evaluate subclinical atherosclerosis in 49 patients with Sjögren syndrome using noninvasive methods. METHODS: We assessed traditional risk factors such as hypertension, diabetes, dyslipidemia, smoking, and family history of atherosclerosis...
September 2016: Journal of Clinical Rheumatology: Practical Reports on Rheumatic & Musculoskeletal Diseases
J David Spence
In recent years, there have been a number of advances in the pathogenesis and treatment of atherosclerosis and in assessing prognosis in carotid atherosclerosis. Risk stratification to improve vascular prevention by identifying patients most likely to benefit from intensive therapy is much improved by measuring carotid plaque burden. In patients with asymptomatic carotid stenosis, a number of modalities can be used to identify the 10-15% who could benefit from endarterectomy or stenting. Transcranial Doppler embolus detection, echolucency and ulceration on 3D ultrasound, intraplaque hemorrhage on magnetic resonance imaging (MRI), and reduced cerebrovascular reserve are useful already; new approaches including plaque texture on ultrasound and imaging of plaque inflammation and early calcification on positron emission tomography/computed tomography (PET/CT) are in development...
2016: F1000Research
Gordana Arandjelović Minić
BACKGROUND/AIM: Increasing evidence points to the inflammatory character of atherosclerosis and several parameters of inflammation have been proposed as cerebrovascular risk markers. The objective of the research was to examine the connection of serum inflammatory parameters and ultrasound (US) characteristics of the structure and size of carotid plaque. We assumed that the number of leukocytes (Le) was an indicator of carotid plaque instability and an increased risk of stroke. METHODS: Serum inflammatory parameters: erythrocyte sedimentation rate in the first (ESR I) and second hour (ESR II), the number of Le, high sensitivity C-reactive protein (hsCRP) and fibrinogen were measured by standard methods...
June 2016: Vojnosanitetski Pregled. Military-medical and Pharmaceutical Review
Anxin Wang, Guojuan Chen, Zhaoping Su, Xiaoxue Liu, Xiaodong Yuan, Ruixuan Jiang, Yibin Cao, Shuohua Chen, Yanxia Luo, Xiuhua Guo, Shouling Wu, Xingquan Zhao
The relationship between atherosclerosis and cognitive function is less well studied in Chinese populations. In addition, the results among middle-aged adults have been mixed. We aimed to investigate the association of atherosclerosis measured by carotid intima-media thickness (CIMT) and cognitive function in middle-aged and older adults from a Chinese community. Participants in the Asymptomatic Polyvascular Abnormalities in Community study (APAC) who had completed the CIMT detection and cognitive function measurements in 2012/2013 were included...
October 2016: Journal of Neurology
Edwin Lee
Cardiovascular disease is among the leading causes of morbidity and mortality worldwide. Preventive treatment of high-risk asymptomatic individuals depends on accurate prediction of a person's risk to develop a cardiovascular event. Currently, cardiovascular risk prediction in asymptomatic individuals is based on the level of cardiovascular risk factors incorporated in scoring equations. Improvement in cardiovascular risk prediction is needed because atherosclerosis underlies the occurrence of cardiovascular events, develops over decades, and has a prolonged asymptomatic phase during which it is possible to modify the course of the disease...
June 2016: Alternative Therapies in Health and Medicine
L M J Best, A C Webb, K S Gurusamy, S F Cheng, T Richards
OBJECTIVE: Identification of patients who will benefit from carotid endarterectomy is not entirely effective, primarily utilising degree of carotid stenosis. This study aimed at determining if microembolic signals (MES) detected by transcranial Doppler ultrasound (TCD) can provide clinically useful information regarding stroke risk in patients with carotid atherosclerosis. METHODS: A meta-analysis of prospective studies was performed. Three analyses were proposed investigating MES detection as a predictor of: stroke or TIA, stroke alone, and stroke or TIA but with an increased positivity threshold...
July 5, 2016: European Journal of Vascular and Endovascular Surgery
Jae Guk Kim, Soo Joo Lee, Hanna Choi, Yu Jeong Choi, Byung-Hee Lee
BACKGROUND: Concurrent coronary artery disease (CAD) and carotid artery stenosis (CAS) are frequently detected in clinical practice and have important prognostic implications in symptomatic patients who are considered for revascularization. The aim of this study was to assess the frequency of asymptomatic CAD in stroke patients with CAS and the associated factors. METHODS: Coronary angiography was performed at a single session after cerebral angiography in patients with symptomatic CAS, which was considered a candidate for revascularization...
2016: European Neurology
Mirza Jusufovic, Else Charlotte Sandset, Karolina Skagen, Mona Skjelland
Stroke is the second most common cause of death and the most common cause of disability worldwide. Up to 30% of ischaemic strokes are caused by carotid atherosclerosis, usually due to thromboemboli from an atherosclerotic plaque at the carotid bifurcation. High blood pressure is an important risk factor for atherosclerosis, the development of unstable carotid plaques, and ischaemic strokes. Differentiation between asymptomatic and symptomatic carotid atherosclerosis is critical to treatment management because of the difference in natural history...
2016: Current Hypertension Reviews
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