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
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
The rupture of atherosclerosis(AS)vulnerable plaque is the major cause of fatal arterial thrombosis related diseases.The lipid dysbolism and pro-inflammatory microenvironment are considered two main driving factors fo...The rupture of atherosclerosis(AS)vulnerable plaque is the major cause of fatal arterial thrombosis related diseases.The lipid dysbolism and pro-inflammatory microenvironment are considered two main driving factors for plaque rupture.Herein,a“two-pronged”nanosystem LCS-Se/Res was designed to efficiently stabilize AS plaques,by precisely regulating lipid metabolism and inflammatory microenvironment.LCS-Se/Res was constructed with the core of resveratrol(Res)loaded selenium(Se)nanoparticles(NPs),and the shell(LCS)of targeting peptide(LSIPPKA)modified chitosan(CS).This system was stable in blood circulation.When it arrived at the plaque site,LCS-Se/Res could actively recognize the highly expressed lectin-like oxidized low-density lipoprotein receptor 1(LOX-1)receptor and accumulate there.Thereafter,Res was released from LCS-Se nanocarriers in situ by responding to acidic plaque microenvironment.On the one hand,Res increased autophagy flux in damaged endothelial cells by activating cAMP-PKA-AMPK-SIRT1 signaling pathway to promote lipid degradation.Interestingly,LCS-Se also promoted cholesterol efflux to improve lipid metabolism.On the other hand,fixed-point separated Res and LCS-Se synergistically improved plaque inflammatory microenvironment by reversing macrophage phenotype(M1 to M2)and alleviating plaque oxidative stress.Pharmacodynamics result proved that the plaque vulnerability index(VI)decreased from 1.39±0.282 to 0.108±0.02 after LCS-Se/Res treatment.In short,this study provided a new therapeutic strategy for the atherosclerosis through the two-pronged approach.展开更多
Objective:To investigate the effect of garlicin in treating carotid artery atherosclerotic plaque (GAAP) in patients with primary hypertension and coronary heart disease (PHT-CHD).Methods:Seventynine patients with PHT...Objective:To investigate the effect of garlicin in treating carotid artery atherosclerotic plaque (GAAP) in patients with primary hypertension and coronary heart disease (PHT-CHD).Methods:Seventynine patients with PHT-CHD were randomly divided into the treated group (39 patients) treated with garlicin and fosinopril and the control group (40 patients) treated with fosinopril alone. The change of CAAP was evaluated by high frequency ultrasonic examination every six months, and the changes of intercellular adhesion molecule-1 (ICAM-1) and high sensitive C-reactive protein (hs-CRP) were measured by ELISA, with the observation proceeding for 52 weeks totally. Results:By the end of the experiment, the number of complex plaques, Crouse integrals, intima-media thickness, serum ICAM-1 and hs-CRP were significantly lower in the treated group than those in the control group with significant difference (P<0.05). Conclusion:Garlicin could stabilize CMP to a certain extent and shows a definite vascular protective effect in patients with PHT-CHD.展开更多
Vulnerable atherosclerotic plaque(VASPs)is the major pathological cause of acute cardiovascular event.Early detection and precise intervention of VASP hold great clinical significance,yet remain a major challenge.Phot...Vulnerable atherosclerotic plaque(VASPs)is the major pathological cause of acute cardiovascular event.Early detection and precise intervention of VASP hold great clinical significance,yet remain a major challenge.Photodynamic therapy(PDT)realizes potent ablation efficacy under precise manipulation of laser irradiation.In this study,we constructed theranostic nanoprobes(NPs),which could precisely regress VASPs through a cascade of synergistic events triggered by local irradiation of lasers under the guidance of fluorescence/MR imaging.The NPs were formulated from human serum albumin(HSA)conjugated with a high affinity-peptide targeting osteopontin(OPN)and encapsulated with photosensitizer IR780 and hypoxia-activatable tirapazamine(TPZ).After intravenous injection into atherosclerotic mice,the OPN-targeted NPs demonstrated high specific accumulation in VASPs due to the overexpression of OPN in activated foamy macrophages in the carotid artery.Under the visible guidance of fluorescence and MR dual-model imaging,the precise near-infrared(NIR)laser irradiation generated massive reactive oxygen species(ROS),which resulted in efficient plaque ablation and amplified hypoxia within VASPs.In response to the elevated hypoxia,the initially inactive TPZ was successively boosted to present potent biological suppression of foamy macrophages.After therapeutic administration of the NPs for 2 weeks,the plaque area and the degree of carotid artery stenosis were markedly reduced.Furthermore,the formulated NPs displayed excellent biocompatibility.In conclusion,the developed HSA-based NPs demonstrated appreciable specific identification ability of VASPs and realized precise synergistic regression of atherosclerosis.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
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 Through the establishment of atherosclerosis model in Apo E-/- mice to investigate the effects of Ningxin Decoction,Xuesaitong and rosuvastatin on serum lipid,inflammatory factors and plaque structure.Method...Objective Through the establishment of atherosclerosis model in Apo E-/- mice to investigate the effects of Ningxin Decoction,Xuesaitong and rosuvastatin on serum lipid,inflammatory factors and plaque structure.Methods Feed 80 Apo E-/- mice aged 8 weeks with high-fat diet for 4 weeks at first.Eighty rats were randomly divid-展开更多
BACKGROUND Discontinued application of statins may be related to adverse cardiovascular events.However,it is unclear whether different statins administration methods have effects on coronary artery plaques.AIM To eval...BACKGROUND Discontinued application of statins may be related to adverse cardiovascular events.However,it is unclear whether different statins administration methods have effects on coronary artery plaques.AIM To evaluate the effects of different statins application methods on plaques in patients with coronary atherosclerosis.METHODS A total of 100 patients diagnosed with atherosclerotic plaque by coronary artery computed tomography were continuously selected and divided into three groups according to different statins administration methods(discontinued application group,n=32;intermittent application group,n=39;sustained application group,n=29).The effects of the different statins application methods on coronary atherosclerotic plaque were assessed.RESULTS The volume change and rate of change of the most severe plaques were significantly reduced in the sustained application group(P≤0.001).The volume change of the most severe plaques correlated positively with low-density lipoprotein(LDL-C)levels only in the sustained application group(R=0.362,P=0.013).There were no changes in plaques or LDL-C levels in the intermittent and discontinued application groups.CONCLUSION Continuous application of statins is effective for controlling plaque progression,whereas discontinued or intermittent administration of statins is not conducive to controlling plaques.Only with continuous statins administration can a reduction in LDL-C levels result in plaque volume shrinkage.展开更多
Diabetes mellitus is a kind of typical metabolic disorder characterized by elevated blood sugar levels.Atherosclerosis(AS)is one of the most common complications of diabetes.Modern lifestyles and trends that promote o...Diabetes mellitus is a kind of typical metabolic disorder characterized by elevated blood sugar levels.Atherosclerosis(AS)is one of the most common complications of diabetes.Modern lifestyles and trends that promote overconsumption and unhealthy practices have contributed to an increase in the annual incidence of diabetic AS worldwide,which has created a heavy burden on society.Several studies have shown the significant effects of glycolysis-related changes on the occurrence and development of diabetic AS,which may serve as novel therapeutic targets for diabetic AS in the future.Glycolysis is an important metabolic pathway that generates energy in various cells of the blood vessel wall.In particular,it plays a vital role in the physiological and pathological activities of the three important cells,Endothelial cells,macrophages and vascular smooth muscle cells.There are lots of similar mechanisms underlying diabetic and common AS,the former is more complex.In this article,we describe the role and mechanism underlying glycolysis in diabetic AS,as well as the therapeutic targets,such as trained immunity,microRNAs,gut microbiota,and associated drugs,with the aim to provide some new perspectives and potentially feasible programs for the treatment of diabetic AS in the foreseeable future.展开更多
Activin receptor-like kinase 1(ALK1)is a transmembrane serine/threonine receptor kinase of the transforming growth factor beta(TGFβ)receptor superfamily.ALK1 is specifically expressed in vascular endothelial cells,an...Activin receptor-like kinase 1(ALK1)is a transmembrane serine/threonine receptor kinase of the transforming growth factor beta(TGFβ)receptor superfamily.ALK1 is specifically expressed in vascular endothelial cells,and its dynamic changes are closely related to the proliferation of endothelial cells,the recruitment of pericytes to blood vessels,and functional differentiation during embryonic vascular development.The pathophysiology of many cerebrovascular diseases is today understood as a disorder of endothelial cell function and an imbalance in the proportion of vascular cells.Indeed,mutations in ALK1 and its co-receptor endoglin are major genetic risk factors for vascular arteriovenous malformation.Many studies have shown that ALK1 is closely related to the development of cerebral aneurysms,arteriovenous malformations,and cerebral atherosclerosis.In this review,we describe the various roles of ALK1 in the regulation of angiogenesis and in the maintenance of cerebral vascular homeostasis,and we discuss its relationship to functional dysregulation in cerebrovascular diseases.This review should provide new perspectives for basic research on cerebrovascular diseases and offer more effective targets and strategies for clinical diagnosis,treatment,and prevention.展开更多
Objective:To investigate the relationship between platelet-lymphocyte ratio(PLR)and carotid atherosclerosis(CAS)in middle-aged and elderly patients with T2DM.Methods:A total of 420 middle-aged and elderly patients wit...Objective:To investigate the relationship between platelet-lymphocyte ratio(PLR)and carotid atherosclerosis(CAS)in middle-aged and elderly patients with T2DM.Methods:A total of 420 middle-aged and elderly patients with T2DM who were hospitalized in the Endocrinology Department of our hospital from September 2018 to September 2020 and were examined by ultrasound were selected as the subjects.The carotid artery intima-media thickness(CIMT)was examined by color Doppler ultrasonography,including normal CIMT group(n=111),CIMT thickening group(n=103)and CAS plaque group(n=206).The differences of serum PLR levels among the three groups were compared.Multivariate Logistic regression was used to analyze the relationship between PLR and CAS plaque formation.The receiver operating curve(ROC)was used to evaluate the value of multivariate Logistic regression model(Logit P)in the diagnosis of CAS lesions.Results:The mean value of PLR in CAS plaque group(127.86±48.54)was significantly higher than that in CIMT normal group(109.15±48.35).Multivariate Logistic regression analysis showed that after adjusting for other confounding factors,the increase of PLR was an independent risk factor for the occurrence of CAS plaque.ROC showed that the efficacy of multivariate Logit P model in the diagnosis of CAS plaque was(AUC=0.807,95%CI=0.759-0.858).Conclusions:PLR is one of the important risk factors for the occurrence of CAS lesions.At the same time,the multivariate Logistic regression model established in this study has clinical reference value in predicting CAS lesions in middle-aged and elderly patients with T2DM.展开更多
Coronary artery disease(CAD)has become a major illness endangering human health.It mainly manifests as atherosclerotic plaques,especially vulnerable plaques without obvious symptoms in the early stage.Once a rupture o...Coronary artery disease(CAD)has become a major illness endangering human health.It mainly manifests as atherosclerotic plaques,especially vulnerable plaques without obvious symptoms in the early stage.Once a rupture occurs,it will lead to severe coronary stenosis,which in turn may trigger a major adverse cardiovascular event.Computed tomography angiography(CTA)has become a standard diagnostic tool for early screening of coronary plaque and stenosis due to its advantages in high resolution,noninvasiveness,and three-dimensional imaging.However,manual examination of CTA images by radiologists has been proven to be tedious and time-consuming,which might also lead to intra-and interobserver errors.Nowadays,many machine learning algorithms have enabled the(semi-)automatic diagnosis of CAD by extracting quantitative features from CTA images.This paper provides a survey of these machine learning algorithms for the diagnosis of CAD in CTA images,including coronary artery extraction,coronary plaque detection,vulnerable plaque identification,and coronary stenosis assessment.Most included articles were published within this decade and are found in the Web of Science.We wish to give readers a glimpse of the current status,challenges,and perspectives of these machine learning-based analysis methods for automatic CAD diagnosis.展开更多
Objective:Ipomoea batatas(L.)Lam.is a food plant used in African traditional medicine to treat cardiovascular diseases and related conditions.We assessed the hypolipidemic and anti-atherosclerogenic properties of the ...Objective:Ipomoea batatas(L.)Lam.is a food plant used in African traditional medicine to treat cardiovascular diseases and related conditions.We assessed the hypolipidemic and anti-atherosclerogenic properties of the aqueous extract of I.batatas leaves in a rat model of diet-induced hypercholesterolemia.Methods:Hypercholesterolemia was induced in male Wistar rats by exclusive feeding with a cholesterolenriched(1%)standard diet for four weeks.Then,rats were treated once daily(per os)with I.batatas extract at doses of 400,500 and 600 mg/kg or with atorvastatin(2 mg/kg),for four weeks.Following treatment,animals were observed for another four weeks and then sacrificed.Aortas were excised and processed for histopathological studies,and blood glucose level and lipid profile were measured.Results:Hypercholesterolemic animals experienced a 21.5%faster increase in body weight,significant increases in blood glucose and blood lipids(148.94%triglycerides,196.97%high-density lipoprotein cholesterol,773.04%low-density lipoprotein cholesterol,148.93%very low-density lipoprotein cholesterol and 210.42%total cholesterol),and increases in aorta thickness and atherosclerotic plaque sizes compared to rats fed standard diet.Treatment of hypercholesterolemic rats with the extract mitigated these alterations and restored blood glucose and blood lipid levels to normocholesterolemic values.Conclusion:Our findings suggest that I.batatas leaves have hypolipidemic and anti-atherosclerogenic properties and justify their use in traditional medicine.展开更多
In vivo studies on association between wall shear stress(WSS)and intracranial plaque are deficient.Based on the three-dimensional T1-weighted high-resolution magnetic resonance imaging(3DT1 HR-MRI)data of patients wit...In vivo studies on association between wall shear stress(WSS)and intracranial plaque are deficient.Based on the three-dimensional T1-weighted high-resolution magnetic resonance imaging(3DT1 HR-MRI)data of patients with low-grade stenotic(<50%)atherosclerotic middle cerebral artery(MCA)and subjects with normal MCA,we built a three-dimensional reconstructed WSS model by computational fluid dynamics(CFD)technique.Three-dimensional registration of the CFD model to the HR-MRI was performed with projections based on the resolution and thickness of the images.The relationships between the Wss at each side of the vessel wall and plaque location were analyzed.A total of 94 MCA plaques from 43 patients and 50 normal MCAs were analyzed.In the normal MCAs,WSS was lower at the ventral-inferior wall than at the dorsal-superior wall(proximal segment,p<0.001;middle segment,p<0.001)and lower at the inner wall than at the outer wall of the MCA curve(p<0.001).In atherosclerotic MCAs,similar low Wss regions were observed where plaques developed.The WSS ratio of the ventral-inferior wall to the dorsal-superior wall in atherosclerotic MCAs was lower than that in normal MCAs(p=0.002).The WSS_(inmer-outer)ratio in atherosclerotic MCAs was lower than that in normal MCAs(p=0.002).Low WSS was associated with MCA atherosclerosis formation and occurred mainly at the ventral inferior wall,which was anatomically opposite the orifices of penetrating arteries,and at the inner wall of the MCA curve.Overall,the results were well consistent with the low WSS theory in atherosclerosis formation.The reconstructed WSS model is a promising novel method for assessing an individualized vascular profile once validated by further studies.展开更多
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.
基金supported by the National Natural Science Foundation of China(No.82102918).
文摘The rupture of atherosclerosis(AS)vulnerable plaque is the major cause of fatal arterial thrombosis related diseases.The lipid dysbolism and pro-inflammatory microenvironment are considered two main driving factors for plaque rupture.Herein,a“two-pronged”nanosystem LCS-Se/Res was designed to efficiently stabilize AS plaques,by precisely regulating lipid metabolism and inflammatory microenvironment.LCS-Se/Res was constructed with the core of resveratrol(Res)loaded selenium(Se)nanoparticles(NPs),and the shell(LCS)of targeting peptide(LSIPPKA)modified chitosan(CS).This system was stable in blood circulation.When it arrived at the plaque site,LCS-Se/Res could actively recognize the highly expressed lectin-like oxidized low-density lipoprotein receptor 1(LOX-1)receptor and accumulate there.Thereafter,Res was released from LCS-Se nanocarriers in situ by responding to acidic plaque microenvironment.On the one hand,Res increased autophagy flux in damaged endothelial cells by activating cAMP-PKA-AMPK-SIRT1 signaling pathway to promote lipid degradation.Interestingly,LCS-Se also promoted cholesterol efflux to improve lipid metabolism.On the other hand,fixed-point separated Res and LCS-Se synergistically improved plaque inflammatory microenvironment by reversing macrophage phenotype(M1 to M2)and alleviating plaque oxidative stress.Pharmacodynamics result proved that the plaque vulnerability index(VI)decreased from 1.39±0.282 to 0.108±0.02 after LCS-Se/Res treatment.In short,this study provided a new therapeutic strategy for the atherosclerosis through the two-pronged approach.
文摘Objective:To investigate the effect of garlicin in treating carotid artery atherosclerotic plaque (GAAP) in patients with primary hypertension and coronary heart disease (PHT-CHD).Methods:Seventynine patients with PHT-CHD were randomly divided into the treated group (39 patients) treated with garlicin and fosinopril and the control group (40 patients) treated with fosinopril alone. The change of CAAP was evaluated by high frequency ultrasonic examination every six months, and the changes of intercellular adhesion molecule-1 (ICAM-1) and high sensitive C-reactive protein (hs-CRP) were measured by ELISA, with the observation proceeding for 52 weeks totally. Results:By the end of the experiment, the number of complex plaques, Crouse integrals, intima-media thickness, serum ICAM-1 and hs-CRP were significantly lower in the treated group than those in the control group with significant difference (P<0.05). Conclusion:Garlicin could stabilize CMP to a certain extent and shows a definite vascular protective effect in patients with PHT-CHD.
基金This work was supported by the National Nature Science Foundation of China(Nos.81820108019,91939303 and 31971302)the National Key Research and Development Program of China(2018YFC0116305)the Science Foundation of PLA General Hospital(2018XXFC-9,CX19028,China).
文摘Vulnerable atherosclerotic plaque(VASPs)is the major pathological cause of acute cardiovascular event.Early detection and precise intervention of VASP hold great clinical significance,yet remain a major challenge.Photodynamic therapy(PDT)realizes potent ablation efficacy under precise manipulation of laser irradiation.In this study,we constructed theranostic nanoprobes(NPs),which could precisely regress VASPs through a cascade of synergistic events triggered by local irradiation of lasers under the guidance of fluorescence/MR imaging.The NPs were formulated from human serum albumin(HSA)conjugated with a high affinity-peptide targeting osteopontin(OPN)and encapsulated with photosensitizer IR780 and hypoxia-activatable tirapazamine(TPZ).After intravenous injection into atherosclerotic mice,the OPN-targeted NPs demonstrated high specific accumulation in VASPs due to the overexpression of OPN in activated foamy macrophages in the carotid artery.Under the visible guidance of fluorescence and MR dual-model imaging,the precise near-infrared(NIR)laser irradiation generated massive reactive oxygen species(ROS),which resulted in efficient plaque ablation and amplified hypoxia within VASPs.In response to the elevated hypoxia,the initially inactive TPZ was successively boosted to present potent biological suppression of foamy macrophages.After therapeutic administration of the NPs for 2 weeks,the plaque area and the degree of carotid artery stenosis were markedly reduced.Furthermore,the formulated NPs displayed excellent biocompatibility.In conclusion,the developed HSA-based NPs demonstrated appreciable specific identification ability of VASPs and realized precise synergistic regression of atherosclerosis.
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.
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.
文摘Objective Through the establishment of atherosclerosis model in Apo E-/- mice to investigate the effects of Ningxin Decoction,Xuesaitong and rosuvastatin on serum lipid,inflammatory factors and plaque structure.Methods Feed 80 Apo E-/- mice aged 8 weeks with high-fat diet for 4 weeks at first.Eighty rats were randomly divid-
文摘BACKGROUND Discontinued application of statins may be related to adverse cardiovascular events.However,it is unclear whether different statins administration methods have effects on coronary artery plaques.AIM To evaluate the effects of different statins application methods on plaques in patients with coronary atherosclerosis.METHODS A total of 100 patients diagnosed with atherosclerotic plaque by coronary artery computed tomography were continuously selected and divided into three groups according to different statins administration methods(discontinued application group,n=32;intermittent application group,n=39;sustained application group,n=29).The effects of the different statins application methods on coronary atherosclerotic plaque were assessed.RESULTS The volume change and rate of change of the most severe plaques were significantly reduced in the sustained application group(P≤0.001).The volume change of the most severe plaques correlated positively with low-density lipoprotein(LDL-C)levels only in the sustained application group(R=0.362,P=0.013).There were no changes in plaques or LDL-C levels in the intermittent and discontinued application groups.CONCLUSION Continuous application of statins is effective for controlling plaque progression,whereas discontinued or intermittent administration of statins is not conducive to controlling plaques.Only with continuous statins administration can a reduction in LDL-C levels result in plaque volume shrinkage.
基金the Cardiovascular Disease Clinical Research Center of Zhenjiang,No.SS2018008Social Development Foundation of Jiangsu,No.BE2021694and Jiangsu Provincial 333 Talent Project,No.BRA2020.
文摘Diabetes mellitus is a kind of typical metabolic disorder characterized by elevated blood sugar levels.Atherosclerosis(AS)is one of the most common complications of diabetes.Modern lifestyles and trends that promote overconsumption and unhealthy practices have contributed to an increase in the annual incidence of diabetic AS worldwide,which has created a heavy burden on society.Several studies have shown the significant effects of glycolysis-related changes on the occurrence and development of diabetic AS,which may serve as novel therapeutic targets for diabetic AS in the future.Glycolysis is an important metabolic pathway that generates energy in various cells of the blood vessel wall.In particular,it plays a vital role in the physiological and pathological activities of the three important cells,Endothelial cells,macrophages and vascular smooth muscle cells.There are lots of similar mechanisms underlying diabetic and common AS,the former is more complex.In this article,we describe the role and mechanism underlying glycolysis in diabetic AS,as well as the therapeutic targets,such as trained immunity,microRNAs,gut microbiota,and associated drugs,with the aim to provide some new perspectives and potentially feasible programs for the treatment of diabetic AS in the foreseeable future.
基金supported by the National Natural Science Foundation of China,No.81801175(to CLT)the Fundamental Research Funds for the Central Universities of China,No.WK9110000044(to CLT)+2 种基金China Scholarship Council,No.201706270155(to CLT)the China Postdoctoral Science Foundation,No.2019M662179(to CLT)the Anhui Province Postdoctoral Science Foundation of China,No.2019B324(to CLT)
文摘Activin receptor-like kinase 1(ALK1)is a transmembrane serine/threonine receptor kinase of the transforming growth factor beta(TGFβ)receptor superfamily.ALK1 is specifically expressed in vascular endothelial cells,and its dynamic changes are closely related to the proliferation of endothelial cells,the recruitment of pericytes to blood vessels,and functional differentiation during embryonic vascular development.The pathophysiology of many cerebrovascular diseases is today understood as a disorder of endothelial cell function and an imbalance in the proportion of vascular cells.Indeed,mutations in ALK1 and its co-receptor endoglin are major genetic risk factors for vascular arteriovenous malformation.Many studies have shown that ALK1 is closely related to the development of cerebral aneurysms,arteriovenous malformations,and cerebral atherosclerosis.In this review,we describe the various roles of ALK1 in the regulation of angiogenesis and in the maintenance of cerebral vascular homeostasis,and we discuss its relationship to functional dysregulation in cerebrovascular diseases.This review should provide new perspectives for basic research on cerebrovascular diseases and offer more effective targets and strategies for clinical diagnosis,treatment,and prevention.
基金Shanghai Science and Technology Commission guiding project(No.18411970000)Shanghai Municipal Health and Family Planning Commission project(No.201740053)。
文摘Objective:To investigate the relationship between platelet-lymphocyte ratio(PLR)and carotid atherosclerosis(CAS)in middle-aged and elderly patients with T2DM.Methods:A total of 420 middle-aged and elderly patients with T2DM who were hospitalized in the Endocrinology Department of our hospital from September 2018 to September 2020 and were examined by ultrasound were selected as the subjects.The carotid artery intima-media thickness(CIMT)was examined by color Doppler ultrasonography,including normal CIMT group(n=111),CIMT thickening group(n=103)and CAS plaque group(n=206).The differences of serum PLR levels among the three groups were compared.Multivariate Logistic regression was used to analyze the relationship between PLR and CAS plaque formation.The receiver operating curve(ROC)was used to evaluate the value of multivariate Logistic regression model(Logit P)in the diagnosis of CAS lesions.Results:The mean value of PLR in CAS plaque group(127.86±48.54)was significantly higher than that in CIMT normal group(109.15±48.35).Multivariate Logistic regression analysis showed that after adjusting for other confounding factors,the increase of PLR was an independent risk factor for the occurrence of CAS plaque.ROC showed that the efficacy of multivariate Logit P model in the diagnosis of CAS plaque was(AUC=0.807,95%CI=0.759-0.858).Conclusions:PLR is one of the important risk factors for the occurrence of CAS lesions.At the same time,the multivariate Logistic regression model established in this study has clinical reference value in predicting CAS lesions in middle-aged and elderly patients with T2DM.
基金Supported by the National Natural Science Foundation of China,Nos.61971350,81627807 and 11727813the National Key R&D Program of China,No.2016YFC1300300+3 种基金the China Postdoctoral Science Foundation,No.2019M653717Shaanxi Science Funds for Distinguished Young Scholars,No.2020JC-27Fok Ying Tung Education Foundation,No.161104and Program for the Young Topnotch Talent of Shaanxi Province.
文摘Coronary artery disease(CAD)has become a major illness endangering human health.It mainly manifests as atherosclerotic plaques,especially vulnerable plaques without obvious symptoms in the early stage.Once a rupture occurs,it will lead to severe coronary stenosis,which in turn may trigger a major adverse cardiovascular event.Computed tomography angiography(CTA)has become a standard diagnostic tool for early screening of coronary plaque and stenosis due to its advantages in high resolution,noninvasiveness,and three-dimensional imaging.However,manual examination of CTA images by radiologists has been proven to be tedious and time-consuming,which might also lead to intra-and interobserver errors.Nowadays,many machine learning algorithms have enabled the(semi-)automatic diagnosis of CAD by extracting quantitative features from CTA images.This paper provides a survey of these machine learning algorithms for the diagnosis of CAD in CTA images,including coronary artery extraction,coronary plaque detection,vulnerable plaque identification,and coronary stenosis assessment.Most included articles were published within this decade and are found in the Web of Science.We wish to give readers a glimpse of the current status,challenges,and perspectives of these machine learning-based analysis methods for automatic CAD diagnosis.
基金partly funded by the Faculty of Science,University of Ngaoundere。
文摘Objective:Ipomoea batatas(L.)Lam.is a food plant used in African traditional medicine to treat cardiovascular diseases and related conditions.We assessed the hypolipidemic and anti-atherosclerogenic properties of the aqueous extract of I.batatas leaves in a rat model of diet-induced hypercholesterolemia.Methods:Hypercholesterolemia was induced in male Wistar rats by exclusive feeding with a cholesterolenriched(1%)standard diet for four weeks.Then,rats were treated once daily(per os)with I.batatas extract at doses of 400,500 and 600 mg/kg or with atorvastatin(2 mg/kg),for four weeks.Following treatment,animals were observed for another four weeks and then sacrificed.Aortas were excised and processed for histopathological studies,and blood glucose level and lipid profile were measured.Results:Hypercholesterolemic animals experienced a 21.5%faster increase in body weight,significant increases in blood glucose and blood lipids(148.94%triglycerides,196.97%high-density lipoprotein cholesterol,773.04%low-density lipoprotein cholesterol,148.93%very low-density lipoprotein cholesterol and 210.42%total cholesterol),and increases in aorta thickness and atherosclerotic plaque sizes compared to rats fed standard diet.Treatment of hypercholesterolemic rats with the extract mitigated these alterations and restored blood glucose and blood lipid levels to normocholesterolemic values.Conclusion:Our findings suggest that I.batatas leaves have hypolipidemic and anti-atherosclerogenic properties and justify their use in traditional medicine.
基金This work was supported by the National Science Fund for Distinguished Young Scholars(Grant No.8202500477)the National Natural Science Foundation of China(Grants No.81471207,81671370,81661168015)2016 PUMCH science fund for junior faculty,and Shenzhen Science and Technology Innovation Commission(Grant No.JCYJ20160608153506088).
文摘In vivo studies on association between wall shear stress(WSS)and intracranial plaque are deficient.Based on the three-dimensional T1-weighted high-resolution magnetic resonance imaging(3DT1 HR-MRI)data of patients with low-grade stenotic(<50%)atherosclerotic middle cerebral artery(MCA)and subjects with normal MCA,we built a three-dimensional reconstructed WSS model by computational fluid dynamics(CFD)technique.Three-dimensional registration of the CFD model to the HR-MRI was performed with projections based on the resolution and thickness of the images.The relationships between the Wss at each side of the vessel wall and plaque location were analyzed.A total of 94 MCA plaques from 43 patients and 50 normal MCAs were analyzed.In the normal MCAs,WSS was lower at the ventral-inferior wall than at the dorsal-superior wall(proximal segment,p<0.001;middle segment,p<0.001)and lower at the inner wall than at the outer wall of the MCA curve(p<0.001).In atherosclerotic MCAs,similar low Wss regions were observed where plaques developed.The WSS ratio of the ventral-inferior wall to the dorsal-superior wall in atherosclerotic MCAs was lower than that in normal MCAs(p=0.002).The WSS_(inmer-outer)ratio in atherosclerotic MCAs was lower than that in normal MCAs(p=0.002).Low WSS was associated with MCA atherosclerosis formation and occurred mainly at the ventral inferior wall,which was anatomically opposite the orifices of penetrating arteries,and at the inner wall of the MCA curve.Overall,the results were well consistent with the low WSS theory in atherosclerosis formation.The reconstructed WSS model is a promising novel method for assessing an individualized vascular profile once validated by further studies.
