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Vulnerable carotid plaque

Michelangela Barbieri, Raffaele Marfella, Antonietta Esposito, Maria Rosaria Rizzo, Edith Angellotti, Ciro Mauro, Mario Siniscalchi, Fabio Chirico, Pasquale Caiazzo, Fulvio Furbatto, Alessandro Bellis, Nunzia D'Onofrio, Milena Vitiello, Franca Ferraraccio, Giuseppe Paolisso, Maria Luisa Balestrieri
AIMS: Glucagon like peptide 1 (GLP-1) analogues and dipeptidyl peptidase IV (DPP-4) inhibitors reduce atherosclerosis progression in type 2 diabetes mellitus (T2DM) patients and are associated with morphological and compositional characteristics of stable plaque phenotype. GLP-1 promotes the secretion of adiponectin which exerts anti-inflammatory effects through the adaptor protein PH domain and leucine zipper containing 1 (APPL1). The potential role of APPL1 expression in the evolution of atherosclerotic plaque in TDM2 patients has not previously evaluated...
October 5, 2016: Journal of Diabetes and its Complications
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
Taizen Nakase, Tatsuya Ishikawa, Hajime Miyata
Fragility of atheromatous plaque in the internal carotid artery can be a risk of brain infarction. The activation of macrophages by oxidative stress and the vulnerability of vascular endothelial cells have been reported to participate in the fragility of atheromatous plaque. Therefore, from the view point of prevention of brain infarction, we investigated the pathological factors which may influence the stabilization of atheromatous plaque. Patients undertaking carotid endoarterectomy (CEA) were continuously screened...
October 13, 2016: Neuropathology: Official Journal of the Japanese Society of Neuropathology
Carol C Mitchell, James H Stein, Thomas D Cook, Shahriar Salamat, Xiao Wang, Tomy Varghese, Daren C Jackson, Carolina Sandoval Garcia, Stephanie M Wilbrand, Robert J Dempsey
Inflammation and angiogenesis play major roles in carotid plaque vulnerability. The purpose of this study was to determine whether gray-scale features of carotid plaques are associated with histologic markers for inflammation. Thirty-eight individuals completed a dedicated research carotid ultrasound exam before carotid endarterectomy. Gray-scale analysis was performed on plaque images to measure plaque echogenicity (gray-scale median [GSM] pixel brightness), plaque area, presence of discrete white areas (DWAs) and the percent of black area near the lumen on any one component of the plaque...
October 5, 2016: Ultrasound in Medicine & 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
Gabrielle Fredman, Jason Hellmann, Jonathan D Proto, George Kuriakose, Romain A Colas, Bernhard Dorweiler, E Sander Connolly, Robert Solomon, David M Jones, Eric J Heyer, Matthew Spite, Ira Tabas
Chronic unresolved inflammation plays a causal role in the development of advanced atherosclerosis, but the mechanisms that prevent resolution in atherosclerosis remain unclear. Here, we use targeted mass spectrometry to identify specialized pro-resolving lipid mediators (SPM) in histologically-defined stable and vulnerable regions of human carotid atherosclerotic plaques. The levels of SPMs, particularly resolvin D1 (RvD1), and the ratio of SPMs to pro-inflammatory leukotriene B4 (LTB4), are significantly decreased in the vulnerable regions...
September 23, 2016: Nature Communications
Beibei Sun, Huilin Zhao, Xiaosheng Liu, Qing Lu, Xihai Zhao, Jun Pu, Jianrong Xu
The association between hemoglobin A1c (HbA1c) level and carotid plaque vulnerability has been rarely studied by magnetic resonance imaging (MRI). The present study of MRI-identified carotid atherosclerotic lesions in hypertensive patients with acute stroke therefore sought to determine the associations between HbA1c level and plaque morphological and compositional characteristics and acute cerebral infarction (ACI) severity. Eighty hypertensive patients with acute stroke were enrolled; stratified into high (≥6...
2016: Scientific Reports
Alessandra Pia Porretta, Nicola Bianda, Marcello Di Valentino, Jeanne Marie Segatto, Paolo Santini, Mattia Cattaneo, Marco Moccetti, Costanzo Limoni, Rolf Wyttenbach, Augusto Gallino
BACKGROUND: Qualitative change in carotid plaques was prospectively evaluated by Gray Scale Median (GSM) analysis at repeated examinations "in vivo", in relation to quantitative change in carotid arterial geometry, as assessed by high-resolution magnetic resonance imaging (HR-MRI). PATIENTS AND METHODS: Duplex ultrasound with GSM analysis and HR-MRI at the carotid level were performed at baseline and 1- and 2-year follow up in 30 patients with < 70% carotid stenosis...
September 6, 2016: VASA. Zeitschrift Für Gefässkrankheiten
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
Jaroslav Pelisek, Heiko Wendorff, Carina Wendorff, Andreas Kuehnl, Hans-Henning Eckstein
Little is known about changes in carotid plaque morphology during aging and the possible impact on cardiovascular events. Only few studies addressed so far age-related modifications within atherosclerotic lesions. Therefore, in this work we endeavored to summarize the current knowledge about changing of plaque composition in elderly. The data from hitherto existing studies confirm that atherosclerotic plaques undergo distinct alternations with advanced age. However, the results are often ambiguous and the changes do not seem to be as disastrous as expected...
September 5, 2016: Annals of Medicine
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
Stein Fekkes, Abigail E S Swillens, Hendrik H G Hansen, Anne E C M Saris, Maartje M Nillesen, Francesco Iannaccone, Patrick Segers, Chris L de Korte
Three-dimensional (3-D) strain estimation might improve the detection and localization of high strain regions in the carotid artery (CA) for identification of vulnerable plaques. This paper compares 2-D versus 3-D displacement estimation in terms of radial and circumferential strain using simulated ultrasound (US) images of a patient-specific 3-D atherosclerotic CA model at the bifurcation embedded in surrounding tissue generated with ABAQUS software. Global longitudinal motion was superimposed to the model based on the literature data...
October 2016: IEEE Transactions on Ultrasonics, Ferroelectrics, and Frequency Control
Ayumu Eto, Yoshimasa Kinoshita, Yoshihisa Matsumoto, Fumiaki Kiyomi, Minoru Iko, Kouhei Nii, Masanori Tsutsumi, Kimiya Sakamoto, Hiroshi Aikawa, Kiyoshi Kazekawa
BACKGROUND: Black-blood magnetic resonance imaging (BB-MRI) is useful for the characterization and assessment of carotid artery plaques. The plaque-to-muscle signal intensity (SI) ratio (plaque/muscle ratio [PMR]) is used widely to evaluate plaques. However, the correlation between the PMR and the T1 relaxation time needs to be determined. We measured the T1 relaxation time of carotid plaques using T1 mapping and compared the results with the PMR on BB-MRI scans. METHODS: Between April 2014 and July 2015, 20 patients with carotid artery stenosis were treated by carotid artery stenting...
August 23, 2016: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
Mohamed A Zayed, Scott D Harring, Dana R Abendschein, Chandu Vemuri, Dongsi Lu, Lisa Detering, Yongjian Liu, Pamela K Woodard
OBJECTIVE: Natriuretic peptide receptor-C (NPR-C/NPR-3) is a cell surface protein involved in vascular remodelling that is up-regulated in atherosclerosis. NPR-C expression has not been well characterized in human carotid artery occlusive lesions. We hypothesized that NPR-C expression correlates with intimal features of vulnerable atherosclerotic carotid artery plaque. METHODS: To test this hypothesis, we evaluated NPR-C expression by immunohistochemistry (IHC) in carotid endarterectomy (CEA) specimens isolated from 18 patients...
July 2016: J Med Surg Pathol
Ihab Abd-Elrahman, Hisanori Kosuge, Tommy Wises Sadan, Yael Ben-Nun, Karen Meir, Chen Rubinstein, Matthew Bogyo, Michael V McConnell, Galia Blum
BACKGROUND AND PURPOSE: Cardiovascular disease is the leading cause of death worldwide, mainly due to an increasing prevalence of atherosclerosis characterized by inflammatory plaques. Plaques with high levels of macrophage infiltration are considered "vulnerable" while those that do not have significant inflammation are considered stable; cathepsin protease activity is highly elevated in macrophages of vulnerable plaques and contributes to plaque instability. Establishing novel tools for non-invasive molecular imaging of macrophages in plaques could aid in preclinical studies and evaluation of therapeutics...
2016: PloS One
Denuja Karunakaran, Michele Geoffrion, Lihui Wei, Wei Gan, Laura Richards, Prakriti Shangari, Ella M DeKemp, Rachelle A Beanlands, Ljubica Perisic, Lars Maegdefessel, Ulf Hedin, Subash Sad, Liang Guo, Frank D Kolodgie, Renu Virmani, Terrence Ruddy, Katey J Rayner
Atherosclerosis results from maladaptive inflammation driven primarily by macrophages, whose recruitment and proliferation drive plaque progression. In advanced plaques, macrophage death contributes centrally to the formation of plaque necrosis, which underlies the instability that promotes plaque rupture and myocardial infarction. Hence, targeting macrophage cell death pathways may offer promise for the stabilization of vulnerable plaques. Necroptosis is a recently discovered pathway of programmed cell necrosis regulated by RIP3 and MLKL kinases that, in contrast to apoptosis, induces a proinflammatory state...
July 2016: Science Advances
Minyu Zhang, Qian Zhao, Yu Gao, Xinhuai Wu, Jianhua Wang
PURPOSE: The study aimed to explore whether GSM based on 3D-ultrasound could predict rupture of carotid plaques and to quantitatively evaluate the vulnerability of carotid plaques. MATERIALS AND METHODS: 22 Patients with carotid plaques enrolled received 3D-US and 3.0T MRI examinations with intervals less than 48h. Images from two modalities were compared plane by plane. Based on the MRI analysis of plaques tissue compositions, images were divided into 4 groups: fibrous group, lipid core group, calcification group and hybrid group...
September 2016: European Journal of Radiology
Rong Zhang, Yu Qin, Guangwei Zhu, Yali Li, Jie Xue
We aimed to investigate correlation of carotid plaque with serum microRNA level and provide a potential mechanism for ischemic stroke prevention. Fasting serum was obtained from 177 patients with carotid plaques diagnosed using B ultrasound and 155 healthy subjects for RNA extraction and measurement of glucose, lipid and related biochemical indices. microRNAs level was assayed using microarray, validated using real-time PCR and statistically analyzed for their correlation with relevant clinical information...
November 2016: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
Shoichi Ehara, Kenji Matsumoto, Kenei Shimada
Over the past several decades, significant progress has been made in the pathohistological assessment of vulnerable plaques and in invasive intravascular imaging techniques. However, the assessment of plaque morphology by invasive modalities is of limited value for the detection of subclinical coronary atherosclerosis and the subsequent prediction or prevention of acute cardiovascular events. Recently, magnetic resonance (MR) imaging technology has reached a sufficient level of spatial resolution, which allowed the plaque visualization of large and static arteries such as the carotids and aorta...
2016: International Journal of Molecular Sciences
Lindsey A Davis, Samantha E Stewart, Christopher G Carsten, Bruce A Snyder, Michael A Sutton, Susan M Lessner
UNLABELLED: One well-established cause of ischemic stroke is atherosclerotic plaque rupture in the carotid artery. Rupture occurs when a tear in the fibrous cap exposes highly thrombogenic material in the lipid core. Though some fibrous cap material properties have been measured, such as ultimate tensile strength and stress-strain responses, there has been very little, if any, data published regarding the fracture behavior of atherosclerotic fibrous caps. This study aims to characterize the qualitative and quantitative fracture behavior of human atherosclerotic plaque tissue obtained from carotid endarterectomy samples using two different metrics...
October 1, 2016: Acta Biomaterialia
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