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Plaque rupture

Carol L Shields, Kareem Sioufi, Justin S Robbins, Laura E Barna, Maxwell R Harley, Sara E Lally, Emil Anthony T Say, Arman Mashayekhi, Jerry A Shields
PURPOSE: To analyze the clinical features and rate of metastatic disease in eyes with large (≥10 mm thickness) uveal melanoma. DESIGN: Retrospective noncomparative case series. PARTICIPANTS: There were 1,311 consecutive patients. METHODS: Retrospective medical chart review. MAIN OUTCOME MEASURES: Clinical features and rate of metastatic melanoma. RESULTS: Of 1,311 patients with large melanoma, the mean age was 59 years (median 60, range 6-98 years) and 95% were white...
March 8, 2018: Retina
Andrew L Durham, Mei Y Speer, Marta Scatena, Cecilia M Giachelli, Catherine M Shanahan
Vascular calcification is associated with a significant increase in all-cause mortality and atherosclerotic plaque rupture. Calcification has been determined to be an active process driven in part by vascular smooth muscle cell (VSMC) transdifferentiation within the vascular wall. Historically, VSMC phenotype switching has been viewed as binary, with the cells able to adopt a physiological contractile phenotype or an alternate 'synthetic' phenotype in response to injury. More recent work, including lineage tracing has however revealed that VSMCs are able to adopt a number of phenotypes, including calcific (osteogenic, chondrocytic, and osteoclastic), adipogenic, and macrophagic phenotypes...
March 15, 2018: Cardiovascular Research
Tomoaki Kanaya, Teruo Noguchi, Fumiyuki Otsuka, Yasuhide Asaumi, Yu Kataoka, Yoshiaki Morita, Hiroyuki Miura, Kazuhiro Nakao, Masashi Fujino, Tomohiro Kawasaki, Kunihiro Nishimura, Teruo Inoue, Jagat Narula, Satoshi Yasuda
Aims: Coronary high-intensity plaques (HIPs) with a high plaque-to-myocardial signal intensity ratio (PMR) on non-contrast T1-weighted imaging in patients with stable coronary artery disease (CAD) are associated with future coronary events. To characterize the morphological substrate of HIP, we performed a correlative optical coherence tomography (OCT) study. Methods and results: We examined 137 lesions in 105 patients with stable angina pectoris or silent myocardial ischaemia scheduled for percutaneous coronary intervention (PCI) using a 3 T magnetic resonance scanner...
March 5, 2018: European Heart Journal Cardiovascular Imaging
Vaishnavi Kundel, Maria Giovanna Trivieri, Nicolas A Karakatsanis, Phillip M Robson, Venkatesh Mani, Jorge R Kizer, Robert Kaplan, Zahi Fayad, Neomi Shah
PURPOSE: Evidence suggests that the inflammatory state of an atherosclerotic plaque is important in predicting future risk of plaque rupture. This study aims to investigate the feasibility of measuring plaque inflammation in patients with obstructive sleep apnea (OSA) utilizing advanced vascular imaging - hybrid positron-emission tomography/magnetic resonance imaging (PET/MRI) with fluorodeoxyglucose (FDG) tracer-before and after continuous positive airway pressure (CPAP). METHODS: Patients with newly diagnosed moderate to severe OSA underwent baseline PET/MRI for assessment of vascular inflammation of the carotid arteries and thoracic aorta prior to initiation of CPAP...
March 5, 2018: Sleep & Breathing, Schlaf & Atmung
Hong Jin, Daniel Y Li, Ekaterina Chernogubova, Changyan Sun, Albert Busch, Suzanne M Eken, Peter Saliba-Gustafsson, Hanna Winter, Greg Winski, Uwe Raaz, Isabel N Schellinger, Nancy Simon, Renate Hegenloh, Ljubica Perisic Matic, Maja Jagodic, Ewa Ehrenborg, Jaroslav Pelisek, Hans-Henning Eckstein, Ulf Hedin, Alexandra Backlund, Lars Maegdefessel
miRNAs are potential regulators of carotid artery stenosis and concordant vulnerable atherosclerotic plaques. Hence, we analyzed miRNA expression in laser captured micro-dissected fibrous caps of either ruptured or stable plaques (n = 10 each), discovering that miR-21 was significantly downregulated in unstable lesions. To functionally evaluate miR-21 in plaque vulnerability, miR-21 and miR-21/apolipoprotein-E double-deficient mice (Apoe-/- miR-21-/- ) were assessed. miR-21-/- mice lacked sufficient smooth muscle cell proliferation in response to carotid ligation injury...
January 31, 2018: Molecular Therapy: the Journal of the American Society of Gene Therapy
Chi-Kuang Sun, Hui-Yuan Chen, Tzu-Fang Tseng, Borwen You, Ming-Liang Wei, Ja-Yu Lu, Ya-Lei Chang, Wan-Ling Tseng, Tzung-Dau Wang
Atherosclerotic plaque rupture or erosion and subsequent development of platelet-containing thrombus formation is the fundamental cause of cardiovascular disease, which is the most common cause of death and disability worldwide. Here we show the high sensitivity of 200-270 GHz T-ray to distinguish thrombus formation at its early stage from uncoagulated blood. A clinical observational study was conducted to longitudinally monitor the T-ray absorption constant of ex-vivo human blood during the thrombus formation from 29 subjects...
March 2, 2018: Scientific Reports
Mohammad A Helwani, Amit Amin, Paul Lavigne, Srikar Rao, Shari Oesterreich, Eslam Samaha, Jamie C Brown, Peter Nagele
BACKGROUND: The objective of this investigation was to determine the etiology of perioperative acute coronary syndrome with a particular emphasis on thrombosis versus demand ischemia. METHODS: In this retrospective cohort study, adult patients were identified who underwent coronary angiography for acute coronary syndrome within 30 days of noncardiac surgery at a major tertiary hospital between January 2008 and July 2015. Angiograms were independently reviewed by two interventional cardiologists who were blinded to clinical data and outcomes...
February 26, 2018: Anesthesiology
Waleed Brinjikji, J Kevin DeMarco, Robert Shih, Giuseppe Lanzino, Alejandro A Rabinstein, Christopher A Hilditch, Patrick J Nicholson, John Huston
BACKGROUND: Carotid plaque imaging with MRI is becoming more commonplace, but practical challenges exist in performing plaque imaging with surface coils. PURPOSE: To compare the diagnostic performance of a carotid plaque MRI protocol using a standard neurovascular coil (Neurovascular Coil Protocol) to a higher-resolution carotid plaque MRI using carotid surface coils (Surface Coil Protocol) in characterizing carotid plaque. STUDY TYPE: Prospective study comparing two MR techniques in plaque characterization...
February 25, 2018: Journal of Magnetic Resonance Imaging: JMRI
Joaquim B Oliveira, Alexandre A S M Soares, Andrei C Sposito
The occlusion of a coronary artery by a thrombus generated on a ruptured atherosclerotic plaque has been pursued in the last decades as a determining event for the clinical outcome after myocardial infarction (MI). Yet, MI causes a cell death wave front, which triggers an inflammatory response to clear cellular debris, and which in excess can double the myocardial lesion and influence the clinical prognosis in the short and long term. Accordingly, proper, timely regulated inflammatory response has now been considered a second pivotal player in cardiac recovery after MI justifying the search for pharmacological strategies to modulate inflammatory effectors...
2018: Advances in Clinical Chemistry
Jane S Titterington, Olivia Y Hung, Anita P Saraf, Nanette K Wenger
The etiologies of acute coronary syndromes (ACS) in women expand beyond the traditional paradigm of obstructive epicardial atherosclerotic disease and plaque rupture. Fundamental differences in pathobiology and presentation can partially explain the gender disparity in ACS diagnosis and management, but there is also much we do not know about the spectrum of coronary artery disease in women. Areas covered: This review seeks to explain some key differences between men and women in terms of risk factors, pathophysiology, and clinical presentations, as well as identify areas where more data are needed, focusing on women presenting with ACS but without a culprit lesion to explain their presentation...
February 23, 2018: Expert Review of Cardiovascular Therapy
Miloslav Spacek, David Zemanek, Martin Hutyra, Martin Sluka, Milos Taborsky
Atherosclerosis is the most common cause of both carotid and coronary steno-occlusive disease. Rupture of an atherosclerotic plaque may lead to the formation of an overlying thrombosis resulting in complete arterial occlusion or downstream embolism. Clinically, this may manifest as a stroke or acute myocardial infarction, the overall leading causes of mortality and disability in developed countries. In this article, we summarize current concepts of the development of vulnerable plaque and provide an overview of commonly used imaging methods that may suggest/indicate atherosclerotic plaque vulnerability...
February 21, 2018: Biomedical Papers of the Medical Faculty of the University Palacký, Olomouc, Czechoslovakia
Etsu Suzuki, Hiroyuki Imuta, Daishi Fujita, Masao Takahashi, Shigeyoshi Oba, Arihiro Kiyosue, Hiroaki Nishimatsu
BACKGROUND: Intraplaque hemorrhage (IPH) has been implicated in plaque instability and rupture in atherosclerotic lesions, although the mechanisms by which IPH progresses remain largely unknown. In this study, apolipoprotein E-deficient mice with carotid artery ligation and cuff placement around the artery were used, and pro-inflammatory cytokines that are implicated in IPH were analyzed.Methods and Results:The expression of interleukin-1β (IL-1β) increased significantly following cuff placement compared with mice with carotid artery ligation alone...
February 22, 2018: Circulation Journal: Official Journal of the Japanese Circulation Society
Nuria Beneit, José Luis Martín-Ventura, Carlota Rubio-Longás, Óscar Escribano, Gema García-Gómez, Silvia Fernández, Giorgio Sesti, Marta Letizia Hribal, Jesús Egido, Almudena Gómez-Hernández, Manuel Benito
BACKGROUND: Clinical complications associated with atherosclerotic plaques arise from luminal obstruction due to plaque growth or destabilization leading to rupture. We previously demonstrated that overexpression of insulin receptor isoform A (IRA) and insulin-like growth factor-I receptor (IGF-IR) confers a proliferative and migratory advantage to vascular smooth muscle cells (VSMCs) promoting plaque growth in early stages of atherosclerosis. However, the role of insulin receptor (IR) isoforms, IGF-IR or insulin-like growth factor-II receptor (IGF-IIR) in VSMCs apoptosis during advanced atherosclerosis remains unclear...
February 20, 2018: Cardiovascular Diabetology
Gianpiero D'Amico, Marco Basile, Giuseppe Tarantini, Alfredo Marchese
Acute ST-segment elevation myocardial infarction (STEMI) typically arises from total occlusion of an epicardial coronary artery, most often due to atherosclerotic plaque rupture/erosion and subsequent thrombus formation. Granted this, important angiographic information for patients presenting with STEMI is not only about the status of infarct-related artery (IRA) but also about the atherosclerotic disease burden and disease severity of non-IRA vessels. Previous studies have reported that multivessel (MV) coronary artery disease (CAD) is found in approximately 50% of patients with STEMI undergoing primary percutaneous coronary intervention (PCI) [1,2]...
February 19, 2018: Minerva Cardioangiologica
Liang Guo, Hirokuni Akahori, Emanuel Harari, Samantha L Smith, Rohini Polavarapu, Vinit Karmali, Fumiyuki Otsuka, Rachel L Gannon, Ryan E Braumann, Megan H Dickinson, Anuj Gupta, Audrey L Jenkins, Michael J Lipinski, Johoon Kim, Peter Chhour, Paul S de Vries, Hiroyuki Jinnouchi, Robert Kutys, Hiroyoshi Mori, Matthew D Kutyna, Sho Torii, Atsushi Sakamoto, Cheol Ung Choi, Qi Cheng, Megan L Grove, Mariem A Sawan, Yin Zhang, Yihai Cao, Frank D Kolodgie, David P Cormode, Dan E Arking, Eric Boerwinkle, Alanna C Morrison, Jeanette Erdmann, Nona Sotoodehnia, Renu Virmani, Aloke V Finn
Intake of hemoglobin by the hemoglobin-haptoglobin receptor CD163 leads to a distinct alternative non-foam cell antiinflammatory macrophage phenotype that was previously considered atheroprotective. Here, we reveal an unexpected but important pathogenic role for these macrophages in atherosclerosis. Using human atherosclerotic samples, cultured cells, and a mouse model of advanced atherosclerosis, we investigated the role of intraplaque hemorrhage on macrophage function with respect to angiogenesis, vascular permeability, inflammation, and plaque progression...
February 19, 2018: Journal of Clinical Investigation
Anton Gard, Bertil Lindahl, Gorav Batra, Nermin Hadziosmanovic, Marcus Hjort, Karolina Elisabeth Szummer, Tomasz Baron
OBJECTIVE: The universal definition of myocardial infarction (MI) differentiates MI due to oxygen supply/demand mismatch (type 2) from MI due to plaque rupture (type 1) as well as from myocardial injuries of non-ischaemic or multifactorial nature. The purpose of this study was to investigate how often physicians agree in this classification and what factors lead to agreement or disagreement. METHODS: A total of 1328 patients diagnosed with MI at eight different Swedish hospitals 2011 were included...
February 16, 2018: Heart: Official Journal of the British Cardiac Society
Katsuya Honda, Tetsuya Matoba, Yoshibumi Antoku, Jun-Ichiro Koga, Ikuyo Ichi, Kaku Nakano, Hiroyuki Tsutsui, Kensuke Egashira
OBJECTIVE: Plaque erosion is increasing its importance as one of the mechanisms of acute coronary syndromes in this statin era. However, the clinical efficacy of currently used lipid-lowering agents in the prevention of thrombotic complications associated with plaque erosion has not been clarified. Therefore, we examined the therapeutic effects of ezetimibe or rosuvastatin monotherapy on spontaneous atherothrombotic occlusion. APPROACH AND RESULTS: Femoral arteries of Japanese white rabbits, fed a high-cholesterol diet, were injured by balloon catheter, and then angiotensin II was continuously administrated...
February 15, 2018: Arteriosclerosis, Thrombosis, and Vascular Biology
Amir Tajbakhsh, Mehdi Rezaee, Petri T Kovanen, Amirhossein Sahebkar
Atherosclerosis is a dynamic and progressive inflammatory process in the intimal layer of large and medium-sized arteries, and it is the major contributor to the atherosclerotic cardiovascular disease (ACVD), the leading cause of death worldwide. In an atherosclerotic plaque, phagocytosis of apoptotic cells occurs through an intricate process designated efferocytosis. Defective efferocytosis has emerged as a causal factor in the etiopathogenesis of atherosclerosis and its progression into overt ACVD. Both specialized phagocytes (macrophages and dendritic cells) and non-specialized cells with phagocytic capabilities (smooth muscle and endothelial cells) are involved in the efferocytotic process...
February 11, 2018: Pharmacology & Therapeutics
Steven P Grover, Nigel Mackman
Tissue factor (TF) is the high-affinity receptor and cofactor for FVII/VIIa. The TF-FVIIa complex is the primary initiator of blood coagulation and plays an essential role in hemostasis. TF is expressed on perivascular and epithelial cells at organ and body surfaces where it forms a hemostatic barrier. TF also provides additional hemostatic protection to vital organs, such as the brain, lung, and heart. Under pathological conditions, TF can trigger both arterial and venous thrombosis. For instance, atherosclerosis plaques contain high levels of TF on macrophage foam cells and microvesicles that drives thrombus formation after plaque rupture...
February 8, 2018: Arteriosclerosis, Thrombosis, and Vascular Biology
Tie Guo, Haizhen Hao, Lv Zhou, Feng Zhou, Dan Yu
Tissue inhibitor of matrix metalloproteinase 2 (TIMP-2) regulates the extracellular matrix degradation, which involved in vascular remodeling and dysfunction, destabilization of atherosclerotic plaque and many other pathological processes. The rupture of atherosclerotic plaque is the trigger of Large artery atherosclerotic (LAA) stroke. We speculate that the Single nucleotide polymorphisms (SNPs) in TIMP-2 may have an association with LAA stroke. To prove this hypothesis, we conducted this case-control study...
January 12, 2018: Oncotarget
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