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https://www.readbyqxmd.com/read/28818260/transcranial-doppler-monitoring-for-microemboli-a-marker-of-a-high-risk-carotid-plaque
#1
J David Spence
In the United States, 90% of carotid intervention is being performed for asymptomatic carotid stenosis, even though 90% of patients would be better treated with intensive medical therapy. This is being justified by comparing risks of stroke or death with medical therapy during clinical trials completed decades ago (approximately 2% per year) with risks of intervention with carotid artery stenting (CAS) versus carotid endarterectomy in recent trials that did not have a medical arm. Such extrapolations are, simply put, invalid...
March 2017: Seminars in Vascular Surgery
https://www.readbyqxmd.com/read/28818258/imaging-of-high-risk-carotid-plaques-ultrasound
#2
Rafael S Cires-Drouet, Mahvash Mozafarian, Amir Ali, Siddhartha Sikdar, Brajesh K Lal
Duplex ultrasonography has a well-established role in the assessment of the degree of stenosis caused by carotid atherosclerosis. This assessment is derived from Doppler velocity changes induced by the narrowing lumen of the artery. New research into the mechanisms for plaque rupture and atheroembolic stroke indicates that the degree of narrowing is an imperfect predictor of stroke risk, and that other factors, such as plaque composition and remodeling and biomechanical forces acting on the plaque, can play a role...
March 2017: Seminars in Vascular Surgery
https://www.readbyqxmd.com/read/28818257/high-risk-carotid-plaque-lessons-learned-from-histopathology
#3
Frank D Kolodgie, Kazuyuki Yahagi, Hiroyoshi Mori, Maria E Romero, Hugh H Trout, Aloke V Finn, Renu Virmani
The pathophysiology and natural history of atherosclerotic carotid disease is predicated on a more extensive knowledge of lesion progression gained in the studies conducted in the coronary arteries, and these will be reviewed. While the precise sequence of lesion progression leading to carotid plaque vulnerability and cerebrovascular events remain less well understood, specific early and more advanced progressive lesion morphologies associated with stroke risk have been characterized. Of late, there has been a conscious effort for stroke prevention in symptomatic and asymptomatic patients to move beyond luminal stenosis as the only guidance to predict future cerebrovascular events...
March 2017: Seminars in Vascular Surgery
https://www.readbyqxmd.com/read/28815091/-spice-synthetic-marijuana-induced-acute-myocardial-infarction-a-case-series
#4
E Ul Haq, A Shafiq, A A Khan, A A Awan, S Ezad, W J Minteer, B Omar
Marijuana is the most widely abused "recreational" substance in the United States, with highest prevalence in young adults. It is reported to cause ischemic strokes, hepatitis, anxiety, and psychosis. Although it is associated with dose dependent tachycardia and can lead to coronary vasospasm, it has not been directly related to acute myocardial infarction (AMI). Marijuana induced coronary vasospasm can result in endothelial denudation at the site of a vulnerable atherosclerotic plaque in response to hemodynamic stressors, potentially causing an AMI...
2017: Case Reports in Cardiology
https://www.readbyqxmd.com/read/28814233/statins-in-acute-coronary-syndromes
#5
Manolis Vavuranakis, Maria Kariori, Gerasimos Siasos, Konstantinos Kalogeras, Dimitris Tousoulis
BACKGROUND: Patients with acute coronary syndrome (ACS) frequently experience recurrent adverse events from the cardiovascular system comparing to either healthy individuals or individuals with stable coronary artery disease. This is attributed to the inflammatory cascade that is activated during ACS resulting in increased risk for rupture of vulnerable plaques. OBJECTIVE: Therefore, it is of great importance to avoid recurrent events with treatment aiming at secondary prevention which includes the management of lipid profile besides alteration in the lifestyle and habits...
August 15, 2017: Current Pharmaceutical Design
https://www.readbyqxmd.com/read/28798867/effect-of-intraplaque-angiogenesis-to-atherosclerotic-rupture-prone-plaque-induced-by-high-shear-stress-in-rabbit-model
#6
Juhui Qiu, Daoxi Lei, Jianjun Hu, Tieying Yin, Kang Zhang, Donghong Yu, Guixue Wang
Atherosclerotic prone-rupture plaque is mainly localized in the region of the entrance to the stenosis with high shear stress and the reasons are largely unknown. Our hypothesis is that such a distribution of cells in atherosclerotic plaque may depend on the angiogenesis. Silastic collars induced regions of high shear stress (20.68 ± 5.27 dynes/cm(2)) in the upstream flow and low shear stress (12.25 ± 1.28 dynes/cm(2)) in the downstream flow in carotid arteries. Compared with the low shear stress region, plaques in the high shear stress region showed more intraplaque haemorrhaging, less collagen and higher apoptotic rates of vascular smooth muscle cells; endothelial cells (ECs) in the high shear stress region were characterized with integrity and high endothelial nitric oxide synthase (eNOS) expression (1570...
August 2017: Regenerative Biomaterials
https://www.readbyqxmd.com/read/28798141/characterization-of-macrophage-polarization-states-using-combined-measurement-of-2-deoxyglucose-and-glutamine-accumulation-implications-for-imaging-of-atherosclerosis
#7
Sina Tavakoli, Kevin Downs, John D Short, Huynh Nga Nguyen, Yanlai Lai, Paul A Jerabek, Beth Goins, Jakub Toczek, Mehran M Sadeghi, Reto Asmis
OBJECTIVE: Despite the early promising results of (18)F-fluorodeoxyglucose positron emission tomography for assessment of vessel wall inflammation, its accuracy in prospective identification of vulnerable plaques has remained limited. Additionally, previous studies have indicated that (18)F-fluorodeoxyglucose uptake alone may not allow for accurate identification of specific macrophage activation states. We aimed to determine whether combined measurement of glucose and glutamine accumulation-the 2 most important bioenergetic substrates for macrophages-improves the distinction of macrophage inflammatory states and can be utilized to image atherosclerosis...
August 10, 2017: Arteriosclerosis, Thrombosis, and Vascular Biology
https://www.readbyqxmd.com/read/28797410/prevalence-predictors-and-clinical-presentation-of-a-calcified-nodule-as-assessed-by-optical-coherence-tomography
#8
Tetsumin Lee, Gary S Mintz, Mitsuaki Matsumura, Wenbin Zhang, Yang Cao, Eisuke Usui, Yoshihisa Kanaji, Tadashi Murai, Taishi Yonetsu, Tsunekazu Kakuta, Akiko Maehara
OBJECTIVES: This study sought to determine the anatomic characteristics and clinical presentation associated with a calcified nodule (CN) as assessed by optical coherence tomography. BACKGROUND: CN is an unusual but demonstrable cause of acute coronary syndromes (ACS). METHODS: We studied 889 de novo culprit lesions in 889 patients (48% ACS) who underwent optical coherence tomography before intervention. CN was defined as an eruptive accumulation of nodular calcification (small fractured calcifications)...
August 2017: JACC. Cardiovascular Imaging
https://www.readbyqxmd.com/read/28789689/impact-of-cd14-cd16-monocytes-on-plaque-vulnerability-in-diabetic-and-non-diabetic-patients-with-asymptomatic-coronary-artery-disease-a-cross-sectional-study
#9
Naofumi Yoshida, Hiroyuki Yamamoto, Toshiro Shinke, Hiromasa Otake, Masaru Kuroda, Daisuke Terashita, Hachidai Takahashi, Kazuhiko Sakaguchi, Yushi Hirota, Takuo Emoto, Hilman Zulkifli Amin, Taiji Mizoguchi, Tomohiro Hayashi, Naoto Sasaki, Tomoya Yamashita, Wataru Ogawa, Ken-Ichi Hirata
BACKGROUND: Previously, we have reported that daily glucose fluctuations could affect coronary plaque vulnerability, but the underlying mechanisms remained unclear. This study sought to investigate the impact of CD14(++)CD16(+) monocytes on plaque vulnerability, as assessed by virtual histology intravascular ultrasound (VH-IVUS), as well as their relationship to fluctuating glucose levels in patients with asymptomatic coronary artery disease (CAD). METHODS: Fifty-one patients with asymptomatic CAD, who were undergoing lipid-lowering therapy and underwent VH-IVUS evaluation for angiographically mild to moderate lesions, were enrolled in the study...
August 8, 2017: Cardiovascular Diabetology
https://www.readbyqxmd.com/read/28789657/neutrophil-gelatinase-associated-lipocalin-ngal-is-elevated-in-type-2-diabetics-with-carotid-artery-stenosis-and-reduced-under-metformin-treatment
#10
W Eilenberg, S Stojkovic, A Piechota-Polanczyk, A Kaider, N Kozakowski, W J Weninger, J Nanobachvili, J Wojta, I Huk, S Demyanets, C Neumayer
BACKGROUND: Neutrophil gelatinase-associated lipocalin (NGAL), an acute phase protein released by neutrophils, has been described as biomarker of inflammatory states. Type 2 diabetes mellitus (T2DM) is characterized by increased inflammation and an elevated risk for embolization of carotid artery stenosis (CAS). We aimed to explore the role of NGAL systemically and in plaques of diabetics undergoing carotid endarterectomy. Moreover, the potential anti-inflammatory effect of metformin on NGAL was addressed in diabetics...
August 8, 2017: Cardiovascular Diabetology
https://www.readbyqxmd.com/read/28777120/multicenter-aids-cohort-study-quantitative-coronary-plaque-progression-study-rationale-and-design
#11
Rine Nakanishi, Wendy S Post, Kazuhiro Osawa, Eranthi Jayawardena, Michael Kim, Nasim Sheidaee, Negin Nezarat, Sina Rahmani, Nicholas Kim, Nicolai Hathiramani, Shriraj Susarla, Frank Palella, Mallory Witt, Michael J Blaha, Todd T Brown, Lawrence Kingsley, Sabina A Haberlen, Christopher Dailing, Matthew J Budoff
BACKGROUND AND AIM: The association of HIV with coronary atherosclerosis has been established; however, the progression of coronary atherosclerosis over time among participants with HIV is not well known. The Multicenter AIDS Cohort Study Quantitative Coronary Plaque Progression Study is a large prospective multicenter study quantifying progression of coronary plaque assessed by serial coronary computed tomography angiography (CTA). PATIENTS AND METHODS: HIV-infected and uninfected men who were enrolled in the Multicenter AIDS Cohort Study Cardiovascular Substudy were eligible to complete a follow-up contrast coronary CTA 3-6 years after baseline...
August 2, 2017: Coronary Artery Disease
https://www.readbyqxmd.com/read/28775206/clinical-molecular-imaging-of-chemokine-receptor-cxcr4-expression-in-atherosclerotic-plaque-using-68-ga-pentixafor-pet-correlation-with-cardiovascular-risk-factors-and-calcified-plaque-burden
#12
Desiree Weiberg, James T Thackeray, Guenter Daum, Jan M Sohns, Saskia Kropf, Hans-Jürgen Wester, Tobias L Ross, Frank M Bengel, Thorsten Derlin
The CXC-motif chemokine receptor 4 (CXCR4) represents a promising target for molecular imaging of different CXCR4+ cell types in cardiovascular diseases including atherosclerosis and arterial wall injury. The aim of this study was to assess the prevalence, pattern, and clinical correlates of arterial wall accumulation of (68)Ga-Pentixafor, a specific CXCR4 ligand for positron emission tomography (PET). Methods: Data of fifty-one patients who underwent (68)Ga-Pentixafor PET/computed tomography (PET/CT) for non-cardiovascular indications were retrospectively analyzed...
August 3, 2017: Journal of Nuclear Medicine: Official Publication, Society of Nuclear Medicine
https://www.readbyqxmd.com/read/28768758/low-endothelial-shear-stress-predicts-evolution-to-high-risk-coronary-plaque-phenotype-in-the-future-a-serial-optical-coherence-tomography-and-computational-fluid-dynamics-study
#13
Erika Yamamoto, Gerasimos Siasos, Marina Zaromytidou, Ahmet U Coskun, Lei Xing, Krzysztof Bryniarski, Thomas Zanchin, Tomoyo Sugiyama, Hang Lee, Peter H Stone, Ik-Kyung Jang
BACKGROUND: Low endothelial shear stress (ESS) is associated with plaque progression and vulnerability. To date, changes in plaque phenotype over time in relation to ESS have not been studied in humans. The aim of this study was to investigate whether local ESS can predict subsequent changes to plaque phenotype using optical coherence tomography. METHODS AND RESULTS: A total of 25 coronary arteries from 20 patients who underwent baseline and 6-month follow-up optical coherence tomography were included...
August 2017: Circulation. Cardiovascular Interventions
https://www.readbyqxmd.com/read/28765521/contrast-enhanced-ultrasound-imaging-quantification-of-adventitial-vasa-vasorum-in-a-rabbit-model-of-varying-degrees-of-atherosclerosis
#14
Xiaoying Li, Ruyou Zhang, Zongmin Li, Chunping Ning, Zhenzhen Wang, Meizheng Dang, Yanqing Peng, Xuesong Han, Litao Sun, Jiawei Tian
This study used an atherosclerotic rabbit model to investigate the feasibility of quantifying adventitial vasa vasorum (VV) via contrast-enhanced ultrasound (CEUS) imaging to identify early atherosclerosis. Recent evidence has linked adventitial VV with atherosclerotic plaque progression and vulnerability. A growth in VV density has been detected preceding intimal thickening and even endothelial dysfunction. In our study, carotid atherosclerosis rabbit models were used, and animals underwent CEUS imaging at the end of the atherosclerotic induction period...
August 1, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28765182/a-vulnerable-plaque-identified-on-ct-coronary-angiography-when-should-we-act-in-stable-coronary-artery-disease
#15
Sarah R Blake, Thomas D Heseltine, Scott Murray, Balazs Ruzsics
CT coronary angiography (CTCA) is increasingly being used to diagnose coronary artery disease (CAD). Recent technological advancements, including dual energy CT and improved gantry times, have led to the ability to image coronary arteries with excellent spatial resolution at low radiation doses. Atheromatous plaques can be identified using CTCA and assessed to establish the risk of acute coronary syndrome from each individual plaque. If CTCA identifies CAD, it should then be used in conjunction with functional testing or invasive angiography with physiological assessment to establish the significance of coronary disease in an individual patient...
August 1, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28763883/-association-between-the-apob-a1-ratio-and-the-vulnerability-of-lmca-plaque-in-the-patients-with-stable-angina-pectoris
#16
Y Han, C K Yang, C Y Gao, Y H Liu, J T Cheng, X P Wang, Z M Wang, T F Cheng
Objective: To investigate the relationship between ApoB/A1 ratio and the characteristics of tissue components of their left main coronary artery(LMCA)plaque. Methods: A total of 98 patients with stable angina pectoris who received chronic statin treatment underwentpercutaneous coronary intervention in the People's Hospital of Henan Province from June 2010 to June 2016 were included.We prospectively performed intravascular ultrasound virtualhistology (IVUS-VH) to their LMCA and evaluated the tissue characteristics, and the blood level of total cholesterol (TC) and low-density lipoprotein cholesterol(LDL-C), high-density lipoprotein cholesterol(HDL-C), triglyceride(TG), LDL-C/HDL-C ratio, ApoB, ApoA1, ApoB/A1 ratio were measured, then the association of the tissue characteristics with the aboved lipids values were analyzed...
July 18, 2017: Zhonghua Yi Xue za Zhi [Chinese medical journal]
https://www.readbyqxmd.com/read/28754399/relation-between-superficial-calcifications-and-plaque-rupture-an-optical-coherence-tomography-study
#17
Yefei Zhan, Yingying Zhang, Jingbo Hou, Guochang Lin, Bo Yu
BACKGROUND: There are several forms of calcium deposition, which play different roles in the stability of the coronary artery. It remains unknown whether certain calcification morphological characteristics determine rupture of lipid-rich lesions in the same plaque in acute coronary syndrome (ACS). METHODS: We retrospectively analyzed 550 patients with ACS between May 2008 and October 2014, who had undergone preintervention optical coherence tomography (OCT) imaging examination...
August 2017: Canadian Journal of Cardiology
https://www.readbyqxmd.com/read/28750824/syntax-score-and-pre-and-poststent-optical-coherence-tomography-findings-in-the-left-anterior-descending-coronary-artery-in-patients-with-stable-angina-pectoris
#18
Krzysztof L Bryniarski, Darren L Walters, Chong-Jin Kim, Tsunenari Soeda, Takumi Higuma, Erika Yamamoto, Lei Xing, Tomoyo Sugiyama, Thomas Zanchin, Leszek Bryniarski, Dariusz Dudek, Hang Lee, Ik-Kyung Jang
SYNTAX score (SS) has been reported to be an independent predictor of future cardiac events including target lesion revascularization. The aim of this study was to assess the relation between SS and plaque characteristics and poststent vascular response using optical coherence tomography in coronary artery tree and left anterior descending artery (LAD) in patients with stable angina. A total of 179 lesions among 165 patients, including 100 lesions in LAD, were analyzed. Patients were stratified into tertiles...
June 28, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28746820/the-role-of-damps-and-pamps-in-inflammation-mediated-vulnerability-of-atherosclerotic-plaques
#19
Vikrant Rai, Devendra K Agrawal
Atherosclerosis is a chronic inflammatory disease resulting in the formation of the atherosclerotic plaque. Plaque formation starts with the inflammation in fatty streak and progress through atheroma, atheromatous plaque, and fibroatheroma leading to development of stable plaque. Hypercholesterolemia, dyslipidemia, hyperglycemia are the risk factors for atherosclerosis. Inflammation, infection with viruses and bacteria, and dysregulation in the endothelial and vascular smooth muscle cells leads to advanced plaque formation...
July 26, 2017: Canadian Journal of Physiology and Pharmacology
https://www.readbyqxmd.com/read/28739184/carotid-plaque-instability-is-not-related-to-quantity-but-to-elemental-composition-of-calcification
#20
S Bischetti, M Scimeca, E Bonanno, M Federici, L Anemona, R Menghini, S Casella, M Cardellini, A Ippoliti, A Mauriello
BACKGROUND AND AIMS: Recent studies highlighted the role of calcification processes in the clinical progression of chronic cardiovascular diseases. In this study we investigated the relationship between the chemical composition of calcification and atherosclerotic plaque stability in carotid arteries. METHODS AND RESULTS: To this end, we characterized the calcification on 229 carotid plaques, by morphology, immunohistochemistry, transmission electron microscopy and energy dispersive X-ray microanalysis...
May 31, 2017: Nutrition, Metabolism, and Cardiovascular Diseases: NMCD
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