Objective Compare the morphology of atherosclerotic plaquesmgiographically and histopathologically in acute myocardialmfarction m order to accumulate experience in recognizing plaquerupture and thrombus by angiogrames...Objective Compare the morphology of atherosclerotic plaquesmgiographically and histopathologically in acute myocardialmfarction m order to accumulate experience in recognizing plaquerupture and thrombus by angiogrames.Material and methods 16postmortem cases of acute myocardial infarction were studied.The coronary arteries were romoved en block,filled with barium the lumen and ridiographed.Then the arteries wereontinuously insetted and routin HE sections were made.Results 16 cases had plaque ruptures and thrombi.Among the total98 blocks,21 had plaque ruptures on which 20 thrombiccur(95.23%).while the other 777 unrupured blocks had only 2hrombi(0.25%).The difference was significant(p【0.001).Therupture mostly occur on unstable plaques.The ruptured plaqueswith thrombi had different angiographical morphology withunruptured plaques.The former had irregular borders andunraluminal lucencies;while the Iatter had smooth borders and nointraluminal lucencies.Conclusions Plaque ruprure withthrumbus was the major cause of acute myocardial infarction andthe ruptured plaques with thrombus had different angiographicalapperances with unruptured plaques.展开更多
BACKGROUND Unstable carotid atherosclerotic plaques are prone to cause ischemic stroke.Contrast-enhanced ultrasound(CEUS) is the primary method of assessing plaque stability, but CEUS cannot be a method for screening ...BACKGROUND Unstable carotid atherosclerotic plaques are prone to cause ischemic stroke.Contrast-enhanced ultrasound(CEUS) is the primary method of assessing plaque stability, but CEUS cannot be a method for screening for unstable plaque. The emergence of superb micro-vascular imaging(SMI) offers the possibility of clinically screening for unstable plaque AIM To investigate the value of SMI in predicting ischemic stroke in patients with carotid atherosclerotic plaques.METHODS Patients with carotid atherosclerotic plaques(luminal stenosis of 50%-70%) were enrolled into the present study. All patients received conservative medication.The patient's clinical baseline data, serological data, CEUS and SMI data were analyzed. All patients underwent a 3-year follow-up. The follow-up endpoint was the occurrence of ischemic stroke and patients were divided into stroke group and non-stroke group according to whether the prognosis occurred or not.Subsequently, the difference in clinical data was compared, the correlation of SMI and CEUS was analyzed, and multiple Cox regression and receiver operating characteristic curve were applied to investigate the value of SMI and CEUS in predicting cerebral arterial thrombosis in three years.RESULTS In this study, 43 patients were enrolled in the stroke group and 82 patients were enrolled in the non-stroke group. Cox regression revealed that SMI level(P =0.013) and enhancement intensity(P = 0.032) were the independent factors influencing ischemic stroke. There was a positive correlation between SMI level and enhancement intensity(r = 0.737, P = 0.000). The area under curve of SMI level predicting ischemic stroke was 0.878. The best diagnostic point was ≥ level Ⅱ, and its sensitivity and specificity was 86.05% and 79.27%. The area under curve of enhancement intensity predicting ischemic stroke was 0.890. The best diagnostic point was 9.92 db, and its sensitivity and specificity was 88.37% and89.02%. As the SMI level gradually increased, the incidence of ischemic stroke increased gradually(X^2 = 108.931, P = 0.000).CONCLUSION SMI can be used as a non-invasive method of screening for unstable plaques and may help prevent ischemic stroke.展开更多
The degree of vessel lumen narrowing is an independent predictor of ischemic stroke. New developments in carotid plaque morphology imaging (MR, CT), may bring new insights to the relationship between carotid atheroscl...The degree of vessel lumen narrowing is an independent predictor of ischemic stroke. New developments in carotid plaque morphology imaging (MR, CT), may bring new insights to the relationship between carotid atherosclerotic disease and stroke risk. Our aim is to review the stroke risk in a symptomatic patient with moderate carotid stenosis by CT imaging and histopathology. A 72-year-old patient with low ABCD2 scores TIA and moderate left internal carotid stenosis (50% by carotid ultrasound), was discharged with an optimized medical therapy. Four months later, he presented an ischemic stroke in the left frontal area. Carotid angiography showed a 60% stenosis in the left-internal carotid artery with a regular surface. CT plaque imaging detected a thin fibrous cap with calcification and an intraplaque hemorrhage (high-risk plaque). These findings were confirmed in the histolopathological study of the atherosclerotic plaque performed after the endarterectomy. After 1 year of follow-up, the patient returned independently to his daily activities. We propose, in this study, the inclusion of noninvasive plaque imaging in the evaluation of acute TIA with moderate carotid stenosis to better select patients with higher risk of stroke recurrence.展开更多
Objective The objective of this study is to determine whether coronary atherosclerotic plaque composition is associated with cardiovascular disease(CVD) risk in Chinese adults. Methods We performed a cross-sectional a...Objective The objective of this study is to determine whether coronary atherosclerotic plaque composition is associated with cardiovascular disease(CVD) risk in Chinese adults. Methods We performed a cross-sectional analysis in 549 subjects without previous diagnosis or clinical symptoms of CVD in a community cohort of middle-aged Chinese adults. The participants underwent coronary computed tomography(CT) angiography for the evaluation of the presence and composition of coronary plaques. CVD risk was evaluated by the Framingham risk score(FRS) and the 10-year atherosclerotic cardiovascular disease(ASCVD) risk score. Results Among the 549 participants, 267(48.6%) had no coronary plaques, 201(36.6%) had noncalcified coronary plaques, and 81(14.8%) had calcified or mixed coronary plaques. The measures of CVD risk including FRS and ASCVD risk score and the likelihood of having elevated FRS significantly increased across the groups of participants without coronary plaques, with noncalcified coronary plaques, and with calcified or mixed coronary plaques. However, only calcified or mixed coronary plaques were significantly associated with an elevated ASCVD risk score [odds ratio(OR) 2.41; 95% confidence interval(CI) 1.09-5.32] compared with no coronary plaques, whereas no significant association was found for noncalcified coronary plaques and elevated ASCVD risk score(OR 1.25; 95% CI 0.71-2.21) after multivariable adjustment. Conclusion Calcified or mixed coronary plaques might be more associated with an elevated likelihood of having CVD than noncalcified coronary plaques.展开更多
This study was aimed to evaluate the relationship between carotid atherosclerotic plaque stability and the clinical symptoms in patients with carotid atherosclerotic plaques by using contrast-enhanced ultrasonography....This study was aimed to evaluate the relationship between carotid atherosclerotic plaque stability and the clinical symptoms in patients with carotid atherosclerotic plaques by using contrast-enhanced ultrasonography. Fifty patients with carotid atherosclerotic plaques were enrolled and examined with contrast-enhanced ultrasonography. The correlation of contrast agent enhancement of the carotid atherosclerotic plaques and the clinical symptoms was analyzed. The results showed that among the 50 patients, plaques were enhanced in the 23 patients with obvious clinical symptoms. In 27 patients without apparent clinical symptoms, plaques were enhanced sparsely in 15 patients and not enhanced in 12 patients. It was suggested that contrast-enhanced ultrasonography could be used for the examination of the microcirculation in carotid atherosclerotic plaques on real-time basis and serve as a new noninvasive approach for the assessment of stability of carotid atherosclerotic plaques.展开更多
The potential of ^99mTc labeled P^1, P^4-di （adenosine-5 ＇ ）-tetraphosphate （Ap4A） for imaging experimental atherosclerotic plaques was evaluated in New Zealand white （NZW） rabbits. To label the ^99mTc to Ap4A,...The potential of ^99mTc labeled P^1, P^4-di （adenosine-5 ＇ ）-tetraphosphate （Ap4A） for imaging experimental atherosclerotic plaques was evaluated in New Zealand white （NZW） rabbits. To label the ^99mTc to Ap4A, stannous tartrate solution was used. ^99mTc-Ap4A was purified on a Sephadex G-25 column. The radiochemistry purities of ^99mTc-Ap4A were 85% to 91%. Biodistribution study revealed ^99mTc-Ap4A cleared from blood rapidly. Thirty min after ^99mTc-Ap4A administrated on NZW atherosclerotic rabbits, lesion to blood （target/blood, T/B） ratio was 3. 17 ±1.27, and lesions to normal （target/non-target, T/NT） ratio was 5.23 ±1.87. Shadows of atherosclerotic plaques were clearly visible on radioautographic film. Aortas with atherosclerotic plaques also could be seen on ex vivo gamma camera images. Atherosclerotic abdominal aortas were clearly visible on in vivo images 15 min to 3 h after ^99mTc-Ap4A administration. ^99mTc-labeled Ap4A can be used for rapid noninvasive detection of experimental atherosclerotic plaque.展开更多
Familial hypercholesterolemia(FH)is an autosomal dominant genetic disorder,which resulted in severe elevations in low-density lipoprotein cholesterol(LDL-C)and a markedly increased risk of early-onset coronary disease...Familial hypercholesterolemia(FH)is an autosomal dominant genetic disorder,which resulted in severe elevations in low-density lipoprotein cholesterol(LDL-C)and a markedly increased risk of early-onset coronary disease.[1]t is most frequently caused by loss-of-function mutations in genes affecting the LDL receptor,which clears LDL particles from plasma.展开更多
In this issue of the Journal of Geriatric Cardiology,Huang et al. have reported the detection of coronary artery disease with electron-beam computed tomography (EBCT),utilizing non-contrast and contrast imaging te... In this issue of the Journal of Geriatric Cardiology,Huang et al. have reported the detection of coronary artery disease with electron-beam computed tomography (EBCT),utilizing non-contrast and contrast imaging techniques (EBCTA) in several subgroups including type 2 diabetes mellitus (DM), impaired glucose tolerance (IGT), coronary heart disease, and normal subjects. ……展开更多
We observed atherosclerotic plaque phantoms using a novel near-infrared (NIR) hyperspectral imaging (HSI) technique. Data were obtained through saline or blood layers to simulate an angioscopic environment for the pha...We observed atherosclerotic plaque phantoms using a novel near-infrared (NIR) hyperspectral imaging (HSI) technique. Data were obtained through saline or blood layers to simulate an angioscopic environment for the phantom. For the study, we developed a NIR-HSI system with an NIR supercontinuum light source and mercury-cadmium-telluride camera. Apparent spectral absorbance was obtained at wavelengths of 1150 - 2400 nm. Hyperspectral images of lipid were constructed using a spectral angle mapper algorithm. Bovine fat covered with saline or blood was observed using hyperspectral images at a wavelength around 1200 nm. Our results show that NIR-HSI is a promising angioscopic technique with the potential to identify lipid-rich plaques without clamping and saline injection.展开更多
The aim of this study is to perform a simulation study of the thermal and mechanical effects of a flat rectangular (3×10 mm2),MRI compatible transducer operating at 5 MHz for the purpose of destroying atheroscler...The aim of this study is to perform a simulation study of the thermal and mechanical effects of a flat rectangular (3×10 mm2),MRI compatible transducer operating at 5 MHz for the purpose of destroying atherosclerotic plaque. The simulation study focuses on measuring the plaque destruction (due to the thermal of mechanical mode of ultrasound) as a function of power, time, frequency, duty factor and pulse duration. The main goal is to keep the artery temperature at a safe level. The simulation study shows that with the thermal mode the temperature in the artery cannot be kept at a safe level.展开更多
Objective: To explore the relationship and clinical value of serum phospholipase A2 (Lp-PLA2), d-dimers, and serum galectin-3 (galectin-3) with atherosclerotic vulnerable plaques in coronary artery patients with coron...Objective: To explore the relationship and clinical value of serum phospholipase A2 (Lp-PLA2), d-dimers, and serum galectin-3 (galectin-3) with atherosclerotic vulnerable plaques in coronary artery patients with coronary heart disease. Methods: A total of 248 patients who underwent coronary angiography (CAG) and intravascular ultrasound (IVUS) in our hospital from June 2017 to September 2018 were selected and divided into vulnerable plaque group (89), stable plaque group (89) and control group (70) according to the examination results. The serum levels of Lp-PLA2, d-dimer and galectin-3 in three groups were compared, as well as their correlation with the detection parameters. To evaluate the clinical value of Lp-PLA2, d-dimer and galectin-3 in patients with coronary heart disease (CHD) with atherosclerotic vulnerable plaque. Results: Serum Lp-PLA2, d-dimer and galectin-3 levels were significantly different from the three groups (P<0.05), and the control group < stable plaque group <vulnerable plaque group (P<0.05). Correlation analysis showed that Lp-PLA2, d-dimer and galectin-3 were significantly positively correlated with plaque area, plaque load, necrotic core and calcified tissue (P<0.01), and negatively correlated with fibrous lipid and fibrous tissue (P<0.01). ROC curve showed that Lp-PLA2, d-dimer and galectin-3 had certain predictive value for vulnerable coronary atherosclerotic plaques (AUC=0.939, 0.977, 0.920, P<0.01), and the three combinations (AUC=0.986, P<0.01) had higher predictive value. Conclusion: Serum Lp-PLA2, d-dimer and galectin-3 are significantly correlated with coronary atherosclerotic vulnerable plaques in patients with coronary heart disease, with high sensitivity and specificity, which can be used for the diagnosis and treatment of early atherosclerotic vulnerable plaques.展开更多
Objective:To study the correlation between peripheral blood connexin 40 (Cx40) gene polymorphism and atherosclerotic plaque property development in patients with cerebral infarction.Methods: Patients who were treated ...Objective:To study the correlation between peripheral blood connexin 40 (Cx40) gene polymorphism and atherosclerotic plaque property development in patients with cerebral infarction.Methods: Patients who were treated in the Second Affiliated Hospital of Xi'an Medical University due to acute cerebral infarction between March 2015 and March 2018 were selected as cerebral infarction group, and healthy subjects who received physical examination during the same period were selected as control group. Peripheral blood was collected to detect the polymorphism of Cx40 gene rs35594137 locus, and serum was collected to determine the contents of cytokines, proteases and related molecules.Results: The constituent ratio of Cx40 gene AA+AG genotype in peripheral blood of cerebral infarction group was higher than that of control group whereas the constituent ratio of GG genotype was lower than that of control group;serum IL-17, HMGB1, VCAM1, MCP-1, P-selectin, YKL-40, MMP9, TIMP1 and Caspase-3 contents as well as MMP9/TIMP1 ratio of cerebral infarction group were significantly higher than those of control group whereas ADAMTS13 and Vaspin contents were significantly lower than those of control group;serum IL-17, HMGB1, VCAM1, MCP-1, P-selectin, YKL-40, MMP9, TIMP1 and Caspase-3 contents as well as MMP9/TIMP1 ratio of cerebral infarction group of patients with CX40 gene AA+AG genotype were significantly higher than those of patients with GG genotype whereas ADAMTS13 and Vaspin contents were significantly lower than those of patients with GG genotype.Conclusion: The mutation from Cx40 gene rs35594137 allele G to A in peripheral blood of patients with cerebral infarction can promote the development of atherosclerotic plaque properties.展开更多
Objective:To evaluate the values of Carotid Magnetic Resonance Imaging(MRI)in the differential diagnosis of symptomatic carotid stenosis and atherosclerotic plaque.Methods:56 patients with ischemic cerebrovascular dis...Objective:To evaluate the values of Carotid Magnetic Resonance Imaging(MRI)in the differential diagnosis of symptomatic carotid stenosis and atherosclerotic plaque.Methods:56 patients with ischemic cerebrovascular disease admitted in our hospital from October 2018 to October 2019 were selected and treated with Carotid MRI and digital subtraction angiography(DSA)examinations.According to the two examination results recorded and the“gold standard”of DSA examination,values of Carotid MRI in the differential diagnosis of symptomatic carotid stenosis were evaluated.Results:According to the“gold standard”of DSA examination,the sensitivity and specificity of MRI examination for carotid stenosis were:Mild:92.54%and 97.78%;Moderate:85.71%and 88.78%;Severe:100.00%and 97.8%;and complete occlusion:100.00%and 100.00%;The proportions of intraplaque haemorrhage and ruptured fibrous cap in different degrees of carotid artery stenosis were:Mild:30.16%and 22.22%;Moderate:43.48%and 39.13%;And severe:57.89%and 52.63%.Conclusion:MRI examination can evaluate the degree of symptomatic carotid artery stenosis,and show the characteristics of atherosclerotic plaque at the same time to provide a reference for early clinical differential diagnosis and treatment.展开更多
Objective To evaluate the predictive value of atherosclerotic aortic plaques in coronary artery disease (CAD). Methods In 50 patients with suspected coronary artery disease, transesophageal echocardiography was perfor...Objective To evaluate the predictive value of atherosclerotic aortic plaques in coronary artery disease (CAD). Methods In 50 patients with suspected coronary artery disease, transesophageal echocardiography was performed to examine their thoracic aortas 2 weeks before or after coronary angiography. In the cases of coronary angiography studied, stenosis of the coronary artery ≥50%was considered to be due to coronary artery disease, whereas the thickness of the intima ≥1.3 mm was taken to be the criteria for the presence of an atherosclerotic aortic plaque on the transesophageal echocardiographic test. Results Among the 50 patients, 37 cases were diagnosed as CAD and 13 cases were considered to be normal. The plaques of the thoracic aorta were observed in 34 cases in the CAD group and 3 cases in the normal group. The sensitivity and specificity of aortic plaques for CAD were 91.9%and 76.9%, respectively. The positive and negative predictive values of the aortic plaques for CAD were 91.9%and 76.9%, respectively. The accuracy was 88.0%. 80 percent of the patients with single-vessel disease had thoracic aortic plaques, 92 percent of the patients with two vessel disease and 100 percent of the patients with three vessel disease had thoracic aortic plaques. There was a significant difference in the thickness of aortic intimas between the normal group and the CAD group. Conclusions Detecting atherosclerotic plaques in the thoracic aorta with transesophageal echocardiography may be of great value in predicting the presence and extent of coronary artery disease.展开更多
Objective:To explore the effect of atorvastatin calcium on the carotid atherosclerotic plaque, serum lipid level, and cerebral hemodynamic indicators in patients with transient ischemic attack (TIA).Methods:A total of...Objective:To explore the effect of atorvastatin calcium on the carotid atherosclerotic plaque, serum lipid level, and cerebral hemodynamic indicators in patients with transient ischemic attack (TIA).Methods:A total of 80 patients with TIA and carotid atherosclerotic plaque who were admitted in our hospital and confirmed by the ultrasound were included in the study and randomized into the treatment group and the control group (n = 40). The patients in the two groups were given TIA routine treatments and aspirin. On this basis, the patients in the treatment group were given atorvastatin calcium. The carotid ultrasound before treatment and 6 months after treatment in the two groups was performed to compare the atherosclerotic plaque area and IMT. The serum lipid level and cerebral hemodynamic parameters were detected. Results:IMT and carotid plaque area after treatment in the treatment group were significantly reduced when compared with before treatment (P<0.05). IMT and carotid plaque area after treatment in the treatment group were significantly lower than those in the control group (P<0.05). The comparison of TC, TG, LDL, and HDL levels before treatment between the two groups was not statistically significant (P>0.05). TC, TG, and LDL levels after treatment were significantly reduced when compared with before treatment (P<0.05), while HDL level was significantly elevated when compared with before treatment (P<0.05). TC, TG, and LDL levels after treatment in the treatment group were significantly lower than those in the control group (P<0.05), while HDL level was significantly higher than that in the control group (P<0.05). The average blood velocity and average blood flow volume of cerebral circulation after treatment in the treatment group were significantly higher than those in the control group (P<0.05), while the cerebrovascular characteristic resistance and peripheral resistance were significantly lower than those in the control group (P<0.05).Conclusions:Atorvastatin calcium in the treatment of TIA can significantly reduce the serum lipid level, alleviate or stabilize the carotid atherosclerotic plaque, and improve the cerebral hemodynamic indicators, with a significant efficacy.展开更多
Objective:To study the correlation of serum PDGF and Ang-2 contents with atherosclerotic plaque features in patients with coronary heart disease.Methods: A total of 80 patients with coronary heart disease who were tre...Objective:To study the correlation of serum PDGF and Ang-2 contents with atherosclerotic plaque features in patients with coronary heart disease.Methods: A total of 80 patients with coronary heart disease who were treated in our hospital between January 2013 and April 2016 were collected as the observation group, and 50 healthy subjects who received medical examination in our hospital during the same period were selected as the normal control group. Serum PDGF and Ang-2 contents of two groups of patients were detected, and the observation group were further divided into the high PDGF group and low PDGF group (n = 40) as well as the high Ang-2 group and low Ang-2 group (n = 40) according to the median of PDGF and Ang-2 contents. Ultrasonic contrast technology was used to assess the atherosclerotic plaque characteristics in patients with coronary heart disease.Results: Serum PDGF and Ang-2 contents of observation group were significantly higher than those of control group;ultrasound parameters P and AUC levels of high PDGF group were higher than those of low PDGF group while Tp and MTT levels were lower than those of low PDGF group;ultrasound parameters P and AUC levels of high Ang-2 group were higher than those of low Ang-2 group while Tp and MTT levels were lower than those of low Ang-2 group.Conclusion:Serum PDGF and Ang-2 contents increase in patients with coronary heart disease and are negatively correlated with the atherosclerotic plaque stability.展开更多
ObjectiveTo analyze the correlation between the levels of serum hypersensitive c-reactive protein(hs-CRP),apolipoprotein-B(Apo-B),oxidized low-density lipoprotein(ox-LDL)and matrix metalloproteinase-9(MMP-9)and caroti...ObjectiveTo analyze the correlation between the levels of serum hypersensitive c-reactive protein(hs-CRP),apolipoprotein-B(Apo-B),oxidized low-density lipoprotein(ox-LDL)and matrix metalloproteinase-9(MMP-9)and carotid arteryplaque(CAP)in patients with atherosclerotic cerebral infarction(ASCI).Methods 125 patients with ASCI diagnosed in the Department of Neurology of Panzhihua Central Hospital from January 2018 to December 2018 were selected as the case group,and 125 healthy volunteers in the same period were selected as the control group.Serum levels of hs-CRP,Apo-B,ox-LDL and MMP-9 were compared between the two groups.Carotid ultrasound was performed in patients with ASCI.The correlation between serum levels of hs-CRP,Apo-B,ox-LDL and MMP-9 and the formation of CAP in patients with ASCI was analyzed by SPSS 23.0 statistics.Results Compared with the control group,the levels of serum hs-CRP,Apo-B,ox-LDL and MMP-9 increased significantly in the case group(P<0.01).The serum levels of hs-CRP,Apo-B,ox-LDL and MMP-9 in patients with CAP were significantly higher than those without CAP in the case group(P<0.01).Multivariate logistic regression analysis showed that serum levels of hs-CRP(OR=4.76,95%CI:2.35-9.18),Apo-B(OR=3.16,95%CI:1.59-7.32),ox-LDL(OR=1.48,95%CI:1.15-2.01)and MMP-9(OR=3.86,95%CI:1.63-9.14)were independent risk factors for CAP formation in patients with ASCI(P<0.05).ConclusionsThe contents of serumhs-CRP,Apo-B,ox-LDL and MMP-9 may reflect the serverity of inflammation and instability of carotid atherosclerotic plaque in ASCI patient.The levels of serum hs-CRP,Apo-B,ox-LDL and MMP-9 in patients with ASCI are significantly increased,which are closely related to the formation of CAP in patients with ASCI,so it can be used as important serum biomarkers for clinical diagnosis of ASCI and CAP formation.展开更多
Cardiovascular diseases are the primary cause of mortality in the industrialized world,and arterial obstruction, triggered by rupture-prone atherosclerotic plaques,lead to myocardial infarction and cerebral stroke.Vul...Cardiovascular diseases are the primary cause of mortality in the industrialized world,and arterial obstruction, triggered by rupture-prone atherosclerotic plaques,lead to myocardial infarction and cerebral stroke.Vulnerable plaques do not necessarily occur with flow-limiting stenosis,thus conventional luminographic assessment of the pathology fails to identify unstable lesions.In this review we discuss the currently available imaging modalities used to investigate morphological features and biological characteristics of the atherosclerotic plaque. The different imaging modalities such as ultrasound, magnetic resonance imaging,computed tomography, nuclear imaging and their intravascular applications are illustrated,highlighting their specific diagnostic potential.Clinically available and upcoming methodologies are also reviewed along with the related challenges in their clinical translation,concerning the specific invasiveness, accuracy and cost-effectiveness of these methods.展开更多
Summary： The feasibility of contrast-enhanced ultrasonography in the assessment of atherosclerotic plaque neovascularization and its relation to histological findings were investigated. Abdominal aortic atherosclerot...Summary： The feasibility of contrast-enhanced ultrasonography in the assessment of atherosclerotic plaque neovascularization and its relation to histological findings were investigated. Abdominal aortic atherosclerotic plaque model was induced in 25 New Zealand white rabbits by a combination of high cholesterol-rich diet and balloon aortic denudation. Standard and contrast-enhanced ultrasonography was performed at the 16th week of the model induction period. The plaques were classified as echogenic plaques or echolucent plaques according to their echogenicity at standard ultrasonography. The maxi- mum thickness of plaque was measured in the longitudinal section. Time intensity curve was used to quantify the enhanced intensity of the plaque. Animals were euthanized and abdominal aortas were har- vested for histological staining of CD31 to evaluate the neovascularization density of atherosclerotic plaque. The results showed that the echolucent plaques had higher enhanced intensity during con- trast-enhanced ultrasonography and higher neovascularization density at CD31 staining than the echo- genic plaques. The enhanced intensity of atherosclerotic plaque and its ratio to lumen were well corre- lated with histological neovascularization density （r=0.75, P〈0.001; r=0.68, P〈0.001, respectively）. However, the maximum thickness of plaque was not correlated with neovascularization density （r=0.235, P=0.081）. These findings demonstrated that the enhanced intensity in the plaque and ratio of enhanced intensity to that in the lumen of abdominal aorta may be more accurate in the evaluation of plaque neovascularization than maximum thickness. Our study indicates that contrast-enhanced ultra- sonography provides us a reliable method for the evaluation of plaque neovascularization.展开更多
Background Atherosclerotic plaques indicate the occurrence of ischemia events and it is a difficult task for clinical physicians. Grape seed proanthocyanidin extract （GSPE） has been reported to exert an antiatheroge...Background Atherosclerotic plaques indicate the occurrence of ischemia events and it is a difficult task for clinical physicians. Grape seed proanthocyanidin extract （GSPE） has been reported to exert an antiatherogenic effect by inducing regression of atherosclerotic plaques in animal experimental studies. In this study, the antiatherogenic effect of GSPE has been investigated in clinical use. Methods Consecu- tive 287 patients diagnosed with asymptomatic carotid plaques or abnormal plaque free carotid intima-media thickness （CIMT） were ran- domly assigned to the GSPE group （n = 146） or control group （n = 141）. The patients in the GSPE group received GSPE 200 mg per day orally, while patients in the control group were only enrolled in a lifestyle intervention program. Carotid ultrasound examination was per- formed at baseline and 6, 12, 24 months during follow-up. Mean maximum CIMT （MMCIMT）, plaque score, echogenicity of plaques and ischemic vascular events were recorded. Results As anticipated, after treatment, GSPE resulted in significant reduction in MMCIMT pro- gression （4.2% decrease after six months, 4.9% decrease after 12 months and 5.8% decrease after 24 months） and plaque score （10.9% de- crease after six months, 24.1% decrease after 12 months and 33.1% decrease after 24 months） for the primary outcome, while MMCIMT and plaque score were stable and even increased with the time going on in control group. The number of plaques and unstable plaques also de- creased after treatment of GSPE. Furthermore, the carotid plaque can disappear after treatment with GSPE. The incidence rate for transitory ischemic attack （TIA）, arterial revascularization procedure, and hospital readmission for unstable angina in GSPE group were statistically significant lower （P = 0.02, 0.08, 0.002, respectively） compared with the control group. Conclusions GSPE inhibited the progression of MMCIMT and reduced carotid plaque size in GSPE treated patients, and with extended treatment, the superior efficacy on MMCIMT and carotid plaque occurred. Furthermore, the GSPE group showed lower rates of clinical vascular events.展开更多
文摘Objective Compare the morphology of atherosclerotic plaquesmgiographically and histopathologically in acute myocardialmfarction m order to accumulate experience in recognizing plaquerupture and thrombus by angiogrames.Material and methods 16postmortem cases of acute myocardial infarction were studied.The coronary arteries were romoved en block,filled with barium the lumen and ridiographed.Then the arteries wereontinuously insetted and routin HE sections were made.Results 16 cases had plaque ruptures and thrombi.Among the total98 blocks,21 had plaque ruptures on which 20 thrombiccur(95.23%).while the other 777 unrupured blocks had only 2hrombi(0.25%).The difference was significant(p【0.001).Therupture mostly occur on unstable plaques.The ruptured plaqueswith thrombi had different angiographical morphology withunruptured plaques.The former had irregular borders andunraluminal lucencies;while the Iatter had smooth borders and nointraluminal lucencies.Conclusions Plaque ruprure withthrumbus was the major cause of acute myocardial infarction andthe ruptured plaques with thrombus had different angiographicalapperances with unruptured plaques.
基金Supported by Shanghai Jiading District Health and Family Planning Commission Health Planning Commission Scientific Research Project,No.KYXM,2015-KY-02
文摘BACKGROUND Unstable carotid atherosclerotic plaques are prone to cause ischemic stroke.Contrast-enhanced ultrasound(CEUS) is the primary method of assessing plaque stability, but CEUS cannot be a method for screening for unstable plaque. The emergence of superb micro-vascular imaging(SMI) offers the possibility of clinically screening for unstable plaque AIM To investigate the value of SMI in predicting ischemic stroke in patients with carotid atherosclerotic plaques.METHODS Patients with carotid atherosclerotic plaques(luminal stenosis of 50%-70%) were enrolled into the present study. All patients received conservative medication.The patient's clinical baseline data, serological data, CEUS and SMI data were analyzed. All patients underwent a 3-year follow-up. The follow-up endpoint was the occurrence of ischemic stroke and patients were divided into stroke group and non-stroke group according to whether the prognosis occurred or not.Subsequently, the difference in clinical data was compared, the correlation of SMI and CEUS was analyzed, and multiple Cox regression and receiver operating characteristic curve were applied to investigate the value of SMI and CEUS in predicting cerebral arterial thrombosis in three years.RESULTS In this study, 43 patients were enrolled in the stroke group and 82 patients were enrolled in the non-stroke group. Cox regression revealed that SMI level(P =0.013) and enhancement intensity(P = 0.032) were the independent factors influencing ischemic stroke. There was a positive correlation between SMI level and enhancement intensity(r = 0.737, P = 0.000). The area under curve of SMI level predicting ischemic stroke was 0.878. The best diagnostic point was ≥ level Ⅱ, and its sensitivity and specificity was 86.05% and 79.27%. The area under curve of enhancement intensity predicting ischemic stroke was 0.890. The best diagnostic point was 9.92 db, and its sensitivity and specificity was 88.37% and89.02%. As the SMI level gradually increased, the incidence of ischemic stroke increased gradually(X^2 = 108.931, P = 0.000).CONCLUSION SMI can be used as a non-invasive method of screening for unstable plaques and may help prevent ischemic stroke.
文摘The degree of vessel lumen narrowing is an independent predictor of ischemic stroke. New developments in carotid plaque morphology imaging (MR, CT), may bring new insights to the relationship between carotid atherosclerotic disease and stroke risk. Our aim is to review the stroke risk in a symptomatic patient with moderate carotid stenosis by CT imaging and histopathology. A 72-year-old patient with low ABCD2 scores TIA and moderate left internal carotid stenosis (50% by carotid ultrasound), was discharged with an optimized medical therapy. Four months later, he presented an ischemic stroke in the left frontal area. Carotid angiography showed a 60% stenosis in the left-internal carotid artery with a regular surface. CT plaque imaging detected a thin fibrous cap with calcification and an intraplaque hemorrhage (high-risk plaque). These findings were confirmed in the histolopathological study of the atherosclerotic plaque performed after the endarterectomy. After 1 year of follow-up, the patient returned independently to his daily activities. We propose, in this study, the inclusion of noninvasive plaque imaging in the evaluation of acute TIA with moderate carotid stenosis to better select patients with higher risk of stroke recurrence.
基金supported by the grants from National Key R&D Program of China [2017YFC1310700,2016YFC1305600]the National Natural Science Foundation of China [81622011,81561128019]+2 种基金the Shanghai Municipal Commission of Health and Family Planning [15GWZK0802]the'Gaofeng Gaoyuan Program for Clinical Scientists'from Shanghai Jiao-Tong University School of Medicine [20161301,20161307]Dr.Yu Xu was supported by the'Outstanding Young Talent Program'from Shanghai Municipal Government
文摘Objective The objective of this study is to determine whether coronary atherosclerotic plaque composition is associated with cardiovascular disease(CVD) risk in Chinese adults. Methods We performed a cross-sectional analysis in 549 subjects without previous diagnosis or clinical symptoms of CVD in a community cohort of middle-aged Chinese adults. The participants underwent coronary computed tomography(CT) angiography for the evaluation of the presence and composition of coronary plaques. CVD risk was evaluated by the Framingham risk score(FRS) and the 10-year atherosclerotic cardiovascular disease(ASCVD) risk score. Results Among the 549 participants, 267(48.6%) had no coronary plaques, 201(36.6%) had noncalcified coronary plaques, and 81(14.8%) had calcified or mixed coronary plaques. The measures of CVD risk including FRS and ASCVD risk score and the likelihood of having elevated FRS significantly increased across the groups of participants without coronary plaques, with noncalcified coronary plaques, and with calcified or mixed coronary plaques. However, only calcified or mixed coronary plaques were significantly associated with an elevated ASCVD risk score [odds ratio(OR) 2.41; 95% confidence interval(CI) 1.09-5.32] compared with no coronary plaques, whereas no significant association was found for noncalcified coronary plaques and elevated ASCVD risk score(OR 1.25; 95% CI 0.71-2.21) after multivariable adjustment. Conclusion Calcified or mixed coronary plaques might be more associated with an elevated likelihood of having CVD than noncalcified coronary plaques.
文摘This study was aimed to evaluate the relationship between carotid atherosclerotic plaque stability and the clinical symptoms in patients with carotid atherosclerotic plaques by using contrast-enhanced ultrasonography. Fifty patients with carotid atherosclerotic plaques were enrolled and examined with contrast-enhanced ultrasonography. The correlation of contrast agent enhancement of the carotid atherosclerotic plaques and the clinical symptoms was analyzed. The results showed that among the 50 patients, plaques were enhanced in the 23 patients with obvious clinical symptoms. In 27 patients without apparent clinical symptoms, plaques were enhanced sparsely in 15 patients and not enhanced in 12 patients. It was suggested that contrast-enhanced ultrasonography could be used for the examination of the microcirculation in carotid atherosclerotic plaques on real-time basis and serve as a new noninvasive approach for the assessment of stability of carotid atherosclerotic plaques.
文摘The potential of ^99mTc labeled P^1, P^4-di （adenosine-5 ＇ ）-tetraphosphate （Ap4A） for imaging experimental atherosclerotic plaques was evaluated in New Zealand white （NZW） rabbits. To label the ^99mTc to Ap4A, stannous tartrate solution was used. ^99mTc-Ap4A was purified on a Sephadex G-25 column. The radiochemistry purities of ^99mTc-Ap4A were 85% to 91%. Biodistribution study revealed ^99mTc-Ap4A cleared from blood rapidly. Thirty min after ^99mTc-Ap4A administrated on NZW atherosclerotic rabbits, lesion to blood （target/blood, T/B） ratio was 3. 17 ±1.27, and lesions to normal （target/non-target, T/NT） ratio was 5.23 ±1.87. Shadows of atherosclerotic plaques were clearly visible on radioautographic film. Aortas with atherosclerotic plaques also could be seen on ex vivo gamma camera images. Atherosclerotic abdominal aortas were clearly visible on in vivo images 15 min to 3 h after ^99mTc-Ap4A administration. ^99mTc-labeled Ap4A can be used for rapid noninvasive detection of experimental atherosclerotic plaque.
基金the National Natural Science Foundation of China(No.81370443&No.81170793).
文摘Familial hypercholesterolemia(FH)is an autosomal dominant genetic disorder,which resulted in severe elevations in low-density lipoprotein cholesterol(LDL-C)and a markedly increased risk of early-onset coronary disease.[1]t is most frequently caused by loss-of-function mutations in genes affecting the LDL receptor,which clears LDL particles from plasma.
文摘 In this issue of the Journal of Geriatric Cardiology,Huang et al. have reported the detection of coronary artery disease with electron-beam computed tomography (EBCT),utilizing non-contrast and contrast imaging techniques (EBCTA) in several subgroups including type 2 diabetes mellitus (DM), impaired glucose tolerance (IGT), coronary heart disease, and normal subjects. ……
文摘We observed atherosclerotic plaque phantoms using a novel near-infrared (NIR) hyperspectral imaging (HSI) technique. Data were obtained through saline or blood layers to simulate an angioscopic environment for the phantom. For the study, we developed a NIR-HSI system with an NIR supercontinuum light source and mercury-cadmium-telluride camera. Apparent spectral absorbance was obtained at wavelengths of 1150 - 2400 nm. Hyperspectral images of lipid were constructed using a spectral angle mapper algorithm. Bovine fat covered with saline or blood was observed using hyperspectral images at a wavelength around 1200 nm. Our results show that NIR-HSI is a promising angioscopic technique with the potential to identify lipid-rich plaques without clamping and saline injection.
文摘The aim of this study is to perform a simulation study of the thermal and mechanical effects of a flat rectangular (3×10 mm2),MRI compatible transducer operating at 5 MHz for the purpose of destroying atherosclerotic plaque. The simulation study focuses on measuring the plaque destruction (due to the thermal of mechanical mode of ultrasound) as a function of power, time, frequency, duty factor and pulse duration. The main goal is to keep the artery temperature at a safe level. The simulation study shows that with the thermal mode the temperature in the artery cannot be kept at a safe level.
文摘Objective: To explore the relationship and clinical value of serum phospholipase A2 (Lp-PLA2), d-dimers, and serum galectin-3 (galectin-3) with atherosclerotic vulnerable plaques in coronary artery patients with coronary heart disease. Methods: A total of 248 patients who underwent coronary angiography (CAG) and intravascular ultrasound (IVUS) in our hospital from June 2017 to September 2018 were selected and divided into vulnerable plaque group (89), stable plaque group (89) and control group (70) according to the examination results. The serum levels of Lp-PLA2, d-dimer and galectin-3 in three groups were compared, as well as their correlation with the detection parameters. To evaluate the clinical value of Lp-PLA2, d-dimer and galectin-3 in patients with coronary heart disease (CHD) with atherosclerotic vulnerable plaque. Results: Serum Lp-PLA2, d-dimer and galectin-3 levels were significantly different from the three groups (P<0.05), and the control group < stable plaque group <vulnerable plaque group (P<0.05). Correlation analysis showed that Lp-PLA2, d-dimer and galectin-3 were significantly positively correlated with plaque area, plaque load, necrotic core and calcified tissue (P<0.01), and negatively correlated with fibrous lipid and fibrous tissue (P<0.01). ROC curve showed that Lp-PLA2, d-dimer and galectin-3 had certain predictive value for vulnerable coronary atherosclerotic plaques (AUC=0.939, 0.977, 0.920, P<0.01), and the three combinations (AUC=0.986, P<0.01) had higher predictive value. Conclusion: Serum Lp-PLA2, d-dimer and galectin-3 are significantly correlated with coronary atherosclerotic vulnerable plaques in patients with coronary heart disease, with high sensitivity and specificity, which can be used for the diagnosis and treatment of early atherosclerotic vulnerable plaques.
基金Shaanxi Provincial Natural Science Foundation No:2012JM4005.
文摘Objective:To study the correlation between peripheral blood connexin 40 (Cx40) gene polymorphism and atherosclerotic plaque property development in patients with cerebral infarction.Methods: Patients who were treated in the Second Affiliated Hospital of Xi'an Medical University due to acute cerebral infarction between March 2015 and March 2018 were selected as cerebral infarction group, and healthy subjects who received physical examination during the same period were selected as control group. Peripheral blood was collected to detect the polymorphism of Cx40 gene rs35594137 locus, and serum was collected to determine the contents of cytokines, proteases and related molecules.Results: The constituent ratio of Cx40 gene AA+AG genotype in peripheral blood of cerebral infarction group was higher than that of control group whereas the constituent ratio of GG genotype was lower than that of control group;serum IL-17, HMGB1, VCAM1, MCP-1, P-selectin, YKL-40, MMP9, TIMP1 and Caspase-3 contents as well as MMP9/TIMP1 ratio of cerebral infarction group were significantly higher than those of control group whereas ADAMTS13 and Vaspin contents were significantly lower than those of control group;serum IL-17, HMGB1, VCAM1, MCP-1, P-selectin, YKL-40, MMP9, TIMP1 and Caspase-3 contents as well as MMP9/TIMP1 ratio of cerebral infarction group of patients with CX40 gene AA+AG genotype were significantly higher than those of patients with GG genotype whereas ADAMTS13 and Vaspin contents were significantly lower than those of patients with GG genotype.Conclusion: The mutation from Cx40 gene rs35594137 allele G to A in peripheral blood of patients with cerebral infarction can promote the development of atherosclerotic plaque properties.
文摘Objective:To evaluate the values of Carotid Magnetic Resonance Imaging(MRI)in the differential diagnosis of symptomatic carotid stenosis and atherosclerotic plaque.Methods:56 patients with ischemic cerebrovascular disease admitted in our hospital from October 2018 to October 2019 were selected and treated with Carotid MRI and digital subtraction angiography(DSA)examinations.According to the two examination results recorded and the“gold standard”of DSA examination,values of Carotid MRI in the differential diagnosis of symptomatic carotid stenosis were evaluated.Results:According to the“gold standard”of DSA examination,the sensitivity and specificity of MRI examination for carotid stenosis were:Mild:92.54%and 97.78%;Moderate:85.71%and 88.78%;Severe:100.00%and 97.8%;and complete occlusion:100.00%and 100.00%;The proportions of intraplaque haemorrhage and ruptured fibrous cap in different degrees of carotid artery stenosis were:Mild:30.16%and 22.22%;Moderate:43.48%and 39.13%;And severe:57.89%and 52.63%.Conclusion:MRI examination can evaluate the degree of symptomatic carotid artery stenosis,and show the characteristics of atherosclerotic plaque at the same time to provide a reference for early clinical differential diagnosis and treatment.
文摘Objective To evaluate the predictive value of atherosclerotic aortic plaques in coronary artery disease (CAD). Methods In 50 patients with suspected coronary artery disease, transesophageal echocardiography was performed to examine their thoracic aortas 2 weeks before or after coronary angiography. In the cases of coronary angiography studied, stenosis of the coronary artery ≥50%was considered to be due to coronary artery disease, whereas the thickness of the intima ≥1.3 mm was taken to be the criteria for the presence of an atherosclerotic aortic plaque on the transesophageal echocardiographic test. Results Among the 50 patients, 37 cases were diagnosed as CAD and 13 cases were considered to be normal. The plaques of the thoracic aorta were observed in 34 cases in the CAD group and 3 cases in the normal group. The sensitivity and specificity of aortic plaques for CAD were 91.9%and 76.9%, respectively. The positive and negative predictive values of the aortic plaques for CAD were 91.9%and 76.9%, respectively. The accuracy was 88.0%. 80 percent of the patients with single-vessel disease had thoracic aortic plaques, 92 percent of the patients with two vessel disease and 100 percent of the patients with three vessel disease had thoracic aortic plaques. There was a significant difference in the thickness of aortic intimas between the normal group and the CAD group. Conclusions Detecting atherosclerotic plaques in the thoracic aorta with transesophageal echocardiography may be of great value in predicting the presence and extent of coronary artery disease.
文摘Objective:To explore the effect of atorvastatin calcium on the carotid atherosclerotic plaque, serum lipid level, and cerebral hemodynamic indicators in patients with transient ischemic attack (TIA).Methods:A total of 80 patients with TIA and carotid atherosclerotic plaque who were admitted in our hospital and confirmed by the ultrasound were included in the study and randomized into the treatment group and the control group (n = 40). The patients in the two groups were given TIA routine treatments and aspirin. On this basis, the patients in the treatment group were given atorvastatin calcium. The carotid ultrasound before treatment and 6 months after treatment in the two groups was performed to compare the atherosclerotic plaque area and IMT. The serum lipid level and cerebral hemodynamic parameters were detected. Results:IMT and carotid plaque area after treatment in the treatment group were significantly reduced when compared with before treatment (P<0.05). IMT and carotid plaque area after treatment in the treatment group were significantly lower than those in the control group (P<0.05). The comparison of TC, TG, LDL, and HDL levels before treatment between the two groups was not statistically significant (P>0.05). TC, TG, and LDL levels after treatment were significantly reduced when compared with before treatment (P<0.05), while HDL level was significantly elevated when compared with before treatment (P<0.05). TC, TG, and LDL levels after treatment in the treatment group were significantly lower than those in the control group (P<0.05), while HDL level was significantly higher than that in the control group (P<0.05). The average blood velocity and average blood flow volume of cerebral circulation after treatment in the treatment group were significantly higher than those in the control group (P<0.05), while the cerebrovascular characteristic resistance and peripheral resistance were significantly lower than those in the control group (P<0.05).Conclusions:Atorvastatin calcium in the treatment of TIA can significantly reduce the serum lipid level, alleviate or stabilize the carotid atherosclerotic plaque, and improve the cerebral hemodynamic indicators, with a significant efficacy.
文摘Objective:To study the correlation of serum PDGF and Ang-2 contents with atherosclerotic plaque features in patients with coronary heart disease.Methods: A total of 80 patients with coronary heart disease who were treated in our hospital between January 2013 and April 2016 were collected as the observation group, and 50 healthy subjects who received medical examination in our hospital during the same period were selected as the normal control group. Serum PDGF and Ang-2 contents of two groups of patients were detected, and the observation group were further divided into the high PDGF group and low PDGF group (n = 40) as well as the high Ang-2 group and low Ang-2 group (n = 40) according to the median of PDGF and Ang-2 contents. Ultrasonic contrast technology was used to assess the atherosclerotic plaque characteristics in patients with coronary heart disease.Results: Serum PDGF and Ang-2 contents of observation group were significantly higher than those of control group;ultrasound parameters P and AUC levels of high PDGF group were higher than those of low PDGF group while Tp and MTT levels were lower than those of low PDGF group;ultrasound parameters P and AUC levels of high Ang-2 group were higher than those of low Ang-2 group while Tp and MTT levels were lower than those of low Ang-2 group.Conclusion:Serum PDGF and Ang-2 contents increase in patients with coronary heart disease and are negatively correlated with the atherosclerotic plaque stability.
基金Cardiovascular health research project(2017-CCA-Msdlipid-003)Special research project of sichuan medical association on hypertension(2018SHD2-7).
文摘ObjectiveTo analyze the correlation between the levels of serum hypersensitive c-reactive protein(hs-CRP),apolipoprotein-B(Apo-B),oxidized low-density lipoprotein(ox-LDL)and matrix metalloproteinase-9(MMP-9)and carotid arteryplaque(CAP)in patients with atherosclerotic cerebral infarction(ASCI).Methods 125 patients with ASCI diagnosed in the Department of Neurology of Panzhihua Central Hospital from January 2018 to December 2018 were selected as the case group,and 125 healthy volunteers in the same period were selected as the control group.Serum levels of hs-CRP,Apo-B,ox-LDL and MMP-9 were compared between the two groups.Carotid ultrasound was performed in patients with ASCI.The correlation between serum levels of hs-CRP,Apo-B,ox-LDL and MMP-9 and the formation of CAP in patients with ASCI was analyzed by SPSS 23.0 statistics.Results Compared with the control group,the levels of serum hs-CRP,Apo-B,ox-LDL and MMP-9 increased significantly in the case group(P<0.01).The serum levels of hs-CRP,Apo-B,ox-LDL and MMP-9 in patients with CAP were significantly higher than those without CAP in the case group(P<0.01).Multivariate logistic regression analysis showed that serum levels of hs-CRP(OR=4.76,95%CI:2.35-9.18),Apo-B(OR=3.16,95%CI:1.59-7.32),ox-LDL(OR=1.48,95%CI:1.15-2.01)and MMP-9(OR=3.86,95%CI:1.63-9.14)were independent risk factors for CAP formation in patients with ASCI(P<0.05).ConclusionsThe contents of serumhs-CRP,Apo-B,ox-LDL and MMP-9 may reflect the serverity of inflammation and instability of carotid atherosclerotic plaque in ASCI patient.The levels of serum hs-CRP,Apo-B,ox-LDL and MMP-9 in patients with ASCI are significantly increased,which are closely related to the formation of CAP in patients with ASCI,so it can be used as important serum biomarkers for clinical diagnosis of ASCI and CAP formation.
文摘Cardiovascular diseases are the primary cause of mortality in the industrialized world,and arterial obstruction, triggered by rupture-prone atherosclerotic plaques,lead to myocardial infarction and cerebral stroke.Vulnerable plaques do not necessarily occur with flow-limiting stenosis,thus conventional luminographic assessment of the pathology fails to identify unstable lesions.In this review we discuss the currently available imaging modalities used to investigate morphological features and biological characteristics of the atherosclerotic plaque. The different imaging modalities such as ultrasound, magnetic resonance imaging,computed tomography, nuclear imaging and their intravascular applications are illustrated,highlighting their specific diagnostic potential.Clinically available and upcoming methodologies are also reviewed along with the related challenges in their clinical translation,concerning the specific invasiveness, accuracy and cost-effectiveness of these methods.
基金supported by a grant from the National Natural Science Foundation of China (No. 81071162)
文摘Summary： The feasibility of contrast-enhanced ultrasonography in the assessment of atherosclerotic plaque neovascularization and its relation to histological findings were investigated. Abdominal aortic atherosclerotic plaque model was induced in 25 New Zealand white rabbits by a combination of high cholesterol-rich diet and balloon aortic denudation. Standard and contrast-enhanced ultrasonography was performed at the 16th week of the model induction period. The plaques were classified as echogenic plaques or echolucent plaques according to their echogenicity at standard ultrasonography. The maxi- mum thickness of plaque was measured in the longitudinal section. Time intensity curve was used to quantify the enhanced intensity of the plaque. Animals were euthanized and abdominal aortas were har- vested for histological staining of CD31 to evaluate the neovascularization density of atherosclerotic plaque. The results showed that the echolucent plaques had higher enhanced intensity during con- trast-enhanced ultrasonography and higher neovascularization density at CD31 staining than the echo- genic plaques. The enhanced intensity of atherosclerotic plaque and its ratio to lumen were well corre- lated with histological neovascularization density （r=0.75, P〈0.001; r=0.68, P〈0.001, respectively）. However, the maximum thickness of plaque was not correlated with neovascularization density （r=0.235, P=0.081）. These findings demonstrated that the enhanced intensity in the plaque and ratio of enhanced intensity to that in the lumen of abdominal aorta may be more accurate in the evaluation of plaque neovascularization than maximum thickness. Our study indicates that contrast-enhanced ultra- sonography provides us a reliable method for the evaluation of plaque neovascularization.
文摘Background Atherosclerotic plaques indicate the occurrence of ischemia events and it is a difficult task for clinical physicians. Grape seed proanthocyanidin extract （GSPE） has been reported to exert an antiatherogenic effect by inducing regression of atherosclerotic plaques in animal experimental studies. In this study, the antiatherogenic effect of GSPE has been investigated in clinical use. Methods Consecu- tive 287 patients diagnosed with asymptomatic carotid plaques or abnormal plaque free carotid intima-media thickness （CIMT） were ran- domly assigned to the GSPE group （n = 146） or control group （n = 141）. The patients in the GSPE group received GSPE 200 mg per day orally, while patients in the control group were only enrolled in a lifestyle intervention program. Carotid ultrasound examination was per- formed at baseline and 6, 12, 24 months during follow-up. Mean maximum CIMT （MMCIMT）, plaque score, echogenicity of plaques and ischemic vascular events were recorded. Results As anticipated, after treatment, GSPE resulted in significant reduction in MMCIMT pro- gression （4.2% decrease after six months, 4.9% decrease after 12 months and 5.8% decrease after 24 months） and plaque score （10.9% de- crease after six months, 24.1% decrease after 12 months and 33.1% decrease after 24 months） for the primary outcome, while MMCIMT and plaque score were stable and even increased with the time going on in control group. The number of plaques and unstable plaques also de- creased after treatment of GSPE. Furthermore, the carotid plaque can disappear after treatment with GSPE. The incidence rate for transitory ischemic attack （TIA）, arterial revascularization procedure, and hospital readmission for unstable angina in GSPE group were statistically significant lower （P = 0.02, 0.08, 0.002, respectively） compared with the control group. Conclusions GSPE inhibited the progression of MMCIMT and reduced carotid plaque size in GSPE treated patients, and with extended treatment, the superior efficacy on MMCIMT and carotid plaque occurred. Furthermore, the GSPE group showed lower rates of clinical vascular events.
