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Plaque rupture

Satish Chirde
A 45 yrs male presented with angina. ECG showed transient CHB, T wave inversion in V3 to V6 and inferior leads. It was difficult to predict the culprit vessel based on ECG. Coronary angiography showed thrombotic lesions in LAD, LCX and OM which can potentially impact identification of culprit vessel and hence affect the management with primary PCI.
October 2016: Journal of the Association of Physicians of India
Xiaohong Ruby Xu, Naadiya Carrim, Miguel Antonio Dias Neves, Thomas McKeown, Tyler W Stratton, Rodrigo Matos Pinto Coelho, Xi Lei, Pingguo Chen, Jianhua Xu, Xiangrong Dai, Benjamin Xiaoyi Li, Heyu Ni
Platelets are central mediators of thrombosis and hemostasis. At the site of vascular injury, platelet accumulation (i.e. adhesion and aggregation) constitutes the first wave of hemostasis. Blood coagulation, initiated by the coagulation cascades, is the second wave of thrombin generation and enhance phosphatidylserine exposure, can markedly potentiate cell-based thrombin generation and enhance blood coagulation. Recently, deposition of plasma fibronectin and other proteins onto the injured vessel wall has been identified as a new "protein wave of hemostasis" that occurs prior to platelet accumulation (i...
2016: Thrombosis Journal
Ammara Usman, Umar Sadat, Zhongzhao Teng, Martin J Graves, Jonathan R Boyle, Kevin Varty, Paul D Hayes, Jonathan H Gillard
BACKGROUND: Functional magnetic resonance (MR) imaging of atheroma using contrast media enables assessment of the systemic severity of atherosclerosis in different arterial beds. Whether black-blood imaging has similar ability remains widely unexplored. In this study, we evaluate whether black-blood imaging can differentiate carotid plaques of patients with and without coronary artery disease (CAD) in terms of morphological and biomechanical features of plaque vulnerability, thereby allowing assessment of the systemic severity nature of atherosclerosis in different arterial beds...
October 17, 2016: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
Giovanni Cimmino, Francesco S Loffredo, Alberto Morello, Saverio D Elia, Raffaele De Palma, Plinio Cirillo, Paolo Golino
In the last twenty years, our comprehension of the molecular mechanisms involved in formation, progression and complication of atherosclerotic plaque has advanced significantly and the main role of inflammation and immunity in this phenomenon is now largely accepted. Accumulating evidence highlight the crucial role of different inflammatory and immune cells, such as monocytes and T-lymphocytes, in the pathophysiology of atherosclerotic lesion, particularly in contributing to its complications, such as rupture or ulceration...
October 13, 2016: Current Cardiology Reviews
Karina Di Gregoli, Nur Najmi Mohamad Anuar, Rosaria Bianco, Stephen J White, Andrew C Newby, Sarah J George, Jason L Johnson
RATIONALE: Atherosclerosis and aneurysms are leading causes of mortality worldwide. MicroRNAs (miRs) are key determinants of gene and protein expression, and atypical miR expression has been associated with a number of cardiovascular diseases; although their contributory role to atherosclerotic plaque and abdominal aortic aneurysm (AAA) stability are poorly understood. OBJECTIVE: To investigate whether miR-181b regulates TIMP-3 expression and affects atherosclerosis and aneurysms Methods and Results: Here, we demonstrate that miR-181b was over-expressed in symptomatic human atherosclerotic plaques and abdominal aortic aneurysms, and correlated with decreased expression of predicted miR-181b targets, TIMP-3 and elastin...
October 18, 2016: Circulation Research
Soo-Kyeong Song, Sang-Rok Lee, Lae-Young Jung, Yi-Shik Kim, Sun-Hwa Lee, Kyoung-Suk Rhee, Jei-Keon Chae, Won-Ho Kim, Jae-Ki Ko
OBJECTIVE: Wall shear stress contributes to atherosclerosis progression and plaque rupture. There were limited studies for hypertension as influence factor on whole blood viscosity (WBV) in acute coronary syndrome (ACS) patients. We evaluated the relations between WBV and hypertension in patients who visited to the emergency room by acute chest pain. DESIGN AND METHOD: From April 2013 through June 2015, we prospectively enrolled 471 acute chest pain patients who visited emergency room...
September 2016: Journal of Hypertension
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
German Cediel, Maribel Gonzalez-Del-Hoyo, Anna Carrasquer, Rafael Sanchez, Carme Boqué, Alfredo Bardají
OBJECTIVE: To identify patients with type 2 myocardial infarction (MI) and patients with non-ischaemic myocardial injury (NIMI) and to compare their prognosis with those of patients with type 1 MI. METHODS: A retrospective observational study was performed in 1010 patients admitted to the emergency department of a university hospital with at least one troponin I test between 2012 and 2013. Participants were identified using laboratory records and divided into three groups: type 1 MI (rupture of atheromatous plaque), type 2 MI (imbalance between myocardial oxygen supply and/or demand) and NIMI (patients who did not meet diagnostic criteria for type 1 or type 2 MI)...
October 14, 2016: Heart: Official Journal of the British Cardiac Society
Y Li, C G Zhang, X-H Wang, D-H Liu
OBJECTIVE: To construct the atherosclerosis model of ApoE-knockout (ApoE-/-) mouse after deposition of high-fat diet at brachiocephalic artery and coronary artery. MATERIALS AND METHODS: 40 healthy 8-week SPF-level male ApoE-/- mice of body weigh 16 to 23 g were averagely divided into a high-fat diet group and an ordinary diet group. Mice were sacrificed in a time course study by 3 months, 6 months, 9 months and 12 months. The brachiocephalic artery and coronary artery were extracted for pathological examination, and enzyme-linked immunosorbent assay (ELISA) was used for the examination of serum high-sensitivity C-reactive protein (hs-CRP) content and the relative expression level of liver peroxisome proliferator activated receptor (PPAR)...
September 2016: European Review for Medical and Pharmacological Sciences
İsa Öner Yüksel, Erkan Köklü, Şakir Arslan, Göksel Çağırcı, Eylem Özaydın Göksu, Pınar Koç, Serkan Çay, Filiz Kızılırmak
BACKGROUND AND OBJECTIVES: Non-calcified carotid plaques are more unstable than calcified plaques, and they are associated with a higher risk of rupture, thromboembolism, and consequently, stroke. The purpose of the present study is to compare calcified and non-calcified plaques that cause intermediate carotid artery stenosis with respect to neutrophil/lymphocyte ratio (NLR). SUBJECTS AND METHODS: A total number of 139 asymptomatic patients with 50-70% stenosis of the carotid artery were included in this study...
September 2016: Korean Circulation Journal
Mat J Daemen, Marina S Ferguson, Frank J Gijsen, Daniel S Hippe, M Eline Kooi, Kevin Demarco, Allard C van der Wal, Chun Yuan, Thomas S Hatsukami
BACKGROUND AND AIMS: Plaque fissuring, a phenomenon morphologically distinct from the classical rupture of a thinned fibrous cap, has not been well characterized in carotid atherosclerosis. The aim of this study was to establish the prevalence of plaque fissures in advanced carotid plaques with an otherwise intact luminal surface, and to determine whether they might be a source of intraplaque hemorrhage (IPH). METHODS: We evaluated 244 surgically intact, 'en bloc' embedded, serially sectioned carotid endarterectomy specimens and included only those plaques with a grossly intact luminal surface...
September 28, 2016: Atherosclerosis
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
J C van den Born, R Mencke, S Conroy, C J Zeebregts, H van Goor, J L Hillebrands
Atherosclerotic plaques are classically divided into stable and vulnerable plaques. Vulnerable plaques are prone to rupture with a risk for infarction. High intraplaque microvessel density predisposes to plaque vulnerability. Hydrogen sulfide (H2S) is a proangiogenic gasotransmitter which is endogenously produced by cystathionine γ-lyase (CSE), and is believed to have vasculoprotective effects. However, due to its proangiogenic effects, H2S may result in pathological angiogenesis in atherosclerotic plaques, thereby increasing plaque vulnerability...
October 6, 2016: Scientific Reports
Qiao-Qing Zhong, Xiang Wang, Yun-Feng Li, Li-Jun Peng, Zhi-Sheng Jiang
Secretory leukocyte protease inhibitor (SLPI), a serine protease inhibitor, which was most commonly examined in mucosal fluids such as saliva, is a versatile molecule and plays non-redundant roles. In addition to its anti-protease activity, SLPI has been shown to express anti-bacterial, anti-viral, anti-fungal, and anti-inflammatory properties as well as participating in innate and adaptive immune responses, most of which has been well documented. Recently, it is reported that SLPI is expressed in adipocytes and adipose tissue where it could play an important feedback role in the resolution of inflammation...
October 3, 2016: Experimental Biology and Medicine
Agnieszka Owczarczyk-Saczonek, Waldemar Placek
Psoriasis is a systemic disease with numerous concomitant metabolic disorders. Apparently, T-helper 17 lymphocytes and interleukin (IL)-17 constitute an important element linking those disorders. The role of IL-17 has been confirmed by numerous studies, although it remains not completely understood, and the study results are controversial. Based on the studies performed so far, it is assumed that IL-17 contributes to development of atherosclerosis by means of: stimulation of production of proinflammatory compounds; induction of apoptosis of endothelial cells and heart muscle cells; stimulation of von Willebrand factor production; and induction of the matrix metalloproteinase-9 (atherosclerotic plaque rupture)...
October 1, 2016: International Journal of Dermatology
V Daeichin, J C Sluimer, K van der Heiden, I Skachkov, K Kooiman, A Janssen, B Janssen, J G Bosch, N de Jong, M J A P Daemen, A F W van der Steen
AIM: The actual occurrence of spontaneous plaque rupture in mice has been a matter of debate. We report on an in vivo observation of the actual event of possible plaque disruption in a living ApoE(-/-) mouse. METHODS AND RESULTS: During live contrast-enhanced ultrasonography of a 50-week-old ApoE(-/-) male mouse, symptoms suggesting plaque disruption in the brachiocephalic artery were observed. Histological analysis confirmed the presence of advanced atherosclerotic lesions with dissections and intraplaque hemorrhage in the affected brachiocephalic trunk, pointing towards plaque rupture as the cause of the observed event...
November 2015: Ultrasound Int Open
Tsuyoshi Nishiguchi, Atsushi Tanaka, Akira Taruya, Hiroki Emori, Yuichi Ozaki, Makoto Orii, Yasutsugu Shiono, Kunihiro Shimamura, Takeyoshi Kameyama, Takashi Yamano, Tomoyuki Yamaguchi, Yoshiki Matsuo, Yasushi Ino, Takashi Kubo, Takeshi Hozumi, Yasushi Hayashi, Takashi Akasaka
OBJECTIVE: Early clinical presentation of ST-segment-elevation myocardial infarction (STEMI) and non-ST-segment-elevation myocardial infarction affects patient management. Although local inflammatory activities are involved in the onset of MI, little is known about their impact on early clinical presentation. This study aimed to investigate whether local inflammatory activities affect early clinical presentation. APPROACH AND RESULTS: This study comprised 94 and 17 patients with MI (STEMI, 69; non-STEMI, 25) and stable angina pectoris, respectively...
September 29, 2016: Arteriosclerosis, Thrombosis, and Vascular Biology
Hendrik H G Hansen, Gert Jan de Borst, Michiel L Bots, Frans L Moll, Gerard Pasterkamp, Chris L de Korte
BACKGROUND AND PURPOSE: Carotid plaque rupture is a major cause of stroke. Key issue for risk stratification is early identification of rupture-prone plaques. A noninvasive technique, compound ultrasound strain imaging, was developed providing high-resolution radial deformation/strain images of atherosclerotic plaques. This study aims at in vivo validation of compound ultrasound strain imaging in patients by relating the measured strains to typical features of vulnerable plaques derived from histology after carotid endarterectomy...
September 29, 2016: Stroke; a Journal of Cerebral Circulation
Luca Liberale, Franco Dallegri, Fabrizio Montecucco, Federico Carbone
Macrophages are highly heterogeneous and plastic cells. They were shown to play a critical role in all stages of atherogenesis, from the initiation to the necrotic core formation and plaque rupture. Lesional macrophages primarily derive from blood monocyte, but local macrophage proliferation as well as differentiation from smooth muscle cells have also been described. Within atherosclerotic plaques, macrophages rapidly respond to changes in the microenvironment, shifting between pro- (M1) or anti-inflammatory (M2) functional phenotypes...
September 29, 2016: Thrombosis and Haemostasis
Adam Łukasiewicz, Adam Garkowski, Katarzyna Rutka, Jacek Janica, Urszula Łebkowska
It is hypothesized that the degree of vascularization of the thrombus may have a significant impact on the rupture of aortic aneurysms. The presence of neovascularization of the vessel wall and mural thrombus has been confirmed only in histopathological studies. However, no non-invasive imaging technique of qualitative assessment of thrombus and neovascularization has been implemented so far. Contrast-enhanced ultrasound (CEUS) has been proposed as a feasible and minimally invasive technique for in vivo visualization of neovascularization in the evaluation of tumors and atherosclerotic plaques...
September 28, 2016: Scientific Reports
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