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
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
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
Objective:To investigate the diagnostic value of spectral CT reconstruction mode for carotid atherosclerotic plaque lesions.Methods:From January 2017 to January 2019,70 patients with carotid atherosclerotic plaque les...Objective:To investigate the diagnostic value of spectral CT reconstruction mode for carotid atherosclerotic plaque lesions.Methods:From January 2017 to January 2019,70 patients with carotid atherosclerotic plaque lesions in our hospita1 were selected as the research object.A11 patients were diagnosed with cervical vascular color Doppler ultrasound and spectral CT scan under spectral cr reconstruction mode.Taking the results of coronaryf angiography as the"gold standard",the clinical value of the two examination methods in the diagnosis of carotid atherosclerotic plaque lesions was compared and analyzed.Results:Coronary angiography diagnosis confirmed that 33 of 70 patients with suspected carotid atherosclerotic plaque lesions had vulnerable plaques and 37 had stable plaques.The accuracy of Spectral CT examination of carotid artery plaque was 87.14%(61/70),sensitivity was 90.91%(30/33),specificity was 83.78%(31/37),and the positive predictive value was 83.33%(30/36),the negative predictive value is 91.76%(31/34),which is higher than that of cervical vascular ultrasonography(61.43%,60.61%,56.76%,57.89%,65.63%),the difference is statistically significant(P<0.05).Conclusion:The application of Spectral CT in the clinical diagnosis and treatment of carotid atherosclerotic plaque lesions with higher accuracy,sensitivity and specificity,is more significant and can provide a more reliable and effective imaging basis.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
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: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
AIM:To assess neovascularization within human ca-rotid atherosclerotic soft plaques in patients with isch-emic stroke.METHODS:Eighty-one patients with ischemic stroke and 95 patients without stroke who had soft athero...AIM:To assess neovascularization within human ca-rotid atherosclerotic soft plaques in patients with isch-emic stroke.METHODS:Eighty-one patients with ischemic stroke and 95 patients without stroke who had soft athero-sclerotic plaques in the internal carotid artery were studied.The thickest soft plaque in each patient was examined using contrast-enhanced ultrasound.Time-intensity curves were collected from 5 s to 3 min after contrast injection.The neovascularization within the plaques in the internal carotid artery was evaluated using the ACQ software built into the scanner by 2 of the experienced investigators who were blinded to the clinical history of the patients.RESULTS:Ischemic stroke was present in 7 of 33 patients(21%) with grade Ⅰ plaque,in 14 of 51 pa-tients(28%) with grade Ⅱ plaque,in 26 of 43 patients(61%) with grade Ⅲ plaque,and in 34 of 49 patients(69%) with grade Ⅳ plaque(P < 0.001 comparing grade Ⅳ plaque with grade I plaque and with grade Ⅱ plaque and P = 0.001 comparing grade Ⅲ plaque with grade Ⅰ plaque and with grade Ⅱ plaque).Analysis of the time intensity curves revealed that patients with ischemic stroke had a significantly higher intensity of enhancement(IE) than those without ischemic stroke(P < 0.01).The wash-in time(WT) of plaque was signifi-cantly shorter in stroke patients(P < 0.05).The sensi-tivity and specificity for IE in the plaque were 82% and 80%,respectively,and for WT were 68% and 74%,respectively.There was no significant difference in the peak intensity or time to peak between the 2 groups.CONCLUSION:This study shows that the higher the grade of plaque enhancement,the higher the risk of ischemic stroke.The data suggest that the presence of neovascularization is a marker for unstable plaque.展开更多
The vasa vasorum of carotid artery plaque is a novel marker of accurately evaluating the vulnerability of carotid artery plaque, which was associated with symptomatic cerebrovascular and cardiovascular disease. The pr...The vasa vasorum of carotid artery plaque is a novel marker of accurately evaluating the vulnerability of carotid artery plaque, which was associated with symptomatic cerebrovascular and cardiovascular disease. The presence of ultrasound contrast agents in carotid artery plaque represents the presence of the vasa vasorum in carotid artery plaque because the ultrasoundcontrast agents are strict intravascular tracers. Therefore, contrast-enhanced ultrasound(CEUS) is a novel and safe imaging modality for evaluating the vasa vasorum in carotid artery plaque. However, there are some issues that needs to be assessed to embody fully the clinical utility of the vasa vasorum in carotid artery plaque with CEUS.展开更多
This study was undertaken to investigate the correlation of the enhancement degree on contrast-enhanced ultrasound(CEUS) with the histopathology of carotid plaques and the serum high sensitive C-reactive protein(hs-CR...This study was undertaken to investigate the correlation of the enhancement degree on contrast-enhanced ultrasound(CEUS) with the histopathology of carotid plaques and the serum high sensitive C-reactive protein(hs-CRP) levels in patients undergoing carotid endarterectomy(CEA). Carotid CEUS was performed preoperatively in 115 patients who would undergo CEA, and the enhancement degree of the carotid plaques was evaluated by both the visual semiquantitative analysis and the quantitative time-intensity curve analysis. Serum hs-CRP levels were detected using the particle-enhanced immunoturbidimetric assay also before the operation. Additionally, the carotid plaque samples were subjected to histopathological examination postoperatively. The density of neovessels and the number of macrophages in the plaques were assessed by immunohistochemistry. The results showed that among the 115 patients, grade 0 plaque contrast enhancement was noted in 35 patients, grade 1 in 48 patients and grade 2 in 32 patients. The degree of plaque enhancement, the density of neovessels, the number of macrophages, and the hs-CRP levels were highest in the grade 2 patients. Correlation analysis showed that the enhancement degree of the carotid plaques was closely related to the immunohistochemical parameters of the plaques and the serum hs-CRP levels. It was suggested that the carotid plaque enhancement on CEUS can be used to evaluate the vulnerability of carotid plaques.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
Clinical application of bare metal stents is constrained by the occurrence of instent restenosis,mainly due to the complex biomechanical environment in the body.Numerical simulation method was used to evaluate the eff...Clinical application of bare metal stents is constrained by the occurrence of instent restenosis,mainly due to the complex biomechanical environment in the body.Numerical simulation method was used to evaluate the effect of plaque composition on stent performance in a carotid artery.CT angiography(CTA)data were used as a reference,and zero-load state of the carotid artery was used to establish a 3D stenotic artery model.Different plaque compositions,calcified and hypo-cellular were defined in Model 1 and Model 2,respectively.Interactions between the stents and arterial tissues within the stent crimping-expansion process were analyzed to explore the effects of plaque composition on the mechanical parameters of carotid stents.Goodman diagram and fatigue safety factor(FSF)were analyzed to explore the effects of plaque composition on fatigue performance of a carotid stent in the stent service process.In the stent crimping-expansion process,the von Mises stress in the stent and the dog-boning ratio in Model 1 were higher than that in Model 2.The calcified plaque prevented the stent from expanding the stenotic vessel to a pre-set diameter.Thus,the risk of rupture in the calcified plaque was higher than that in the hypo-cellular plaque.Plaque also affected the stress/strain in the vessel wall,which was observed to be lower in Model 1 than in Model 2.This indicated that calcified plaque could decrease the stress-induced injury of arterial tissues.Within the stent service process,the stents used in these two models were predicted to not fail under fatigue rupture as calculated by the Goodman diagram.Additionally,the points closer to the fatigue limit were generally observed at the inner bend of the stent crowns.The FSF of the stent in Model 1 was lower than that in Model 2.The stent operating in the presence of calcified plaques suffered high risk of fractures.Reliability and fatigue performance of the stent were found to be associated with plaque composition.Hence,this study may provide stent designers an approach toward enhancing the mechanical reliability of a stent.展开更多
Aim: To determine the relationship of carotid plaque, intima media thickness (IMT), resistivity index (RI) and pulsatility index (PI) and prevalence of different risk factors with acute ischemic stroke and stroke subt...Aim: To determine the relationship of carotid plaque, intima media thickness (IMT), resistivity index (RI) and pulsatility index (PI) and prevalence of different risk factors with acute ischemic stroke and stroke subtypes in both diabetic and non-diabetic subjects. Materials and methods: 80 cases of acute ischemic strokes and 40 healthy controls were included in the study. The plaque, IMT, RI and PI were measured by carotid duplex ultrasound. Results: 31 subjects were Type 2 diabetic, 54 hypertensive while 25 were both diabetic and hypertensive. 23 cases (28.75%) had lacunar stroke (LACI), 32 (40%) stroke involving partial anterior circulation(PACI), 10(12.5%) stroke in posterior circulation (PACI) and 15(18.75%) stroke involving total anterior circulation(TACI) respectively. The mean IMT (0.88 ± 0.19mm), RI(0.76 ± 0.05) and PI(1.71 ± 0.19) of patients and mean IMT (0.6±0.09mm), RI (0.61 ± 0.06) and PI (1.53 ± 0.11) of controls were statistically significant (p-0.000). The mean values of IMT, PI and RI were significantly higher in diabetics (IMT-0.90 ± 0.16 VS 0.64 ± 0.11, p-0.013;PI-1.76 ± 0.20 VS 1.49 ± 0.09, P-0.000 and RI-0.76 ± 0.04 VS 0.59 ± 0.06, P-0.000) and similarly the mean values for IMT, PI and RI in hypertensives as compared to controls (IMT-0.88 ± 0.16 vs 0.65 ± 0.10, P-0.006;PI1.69 ± 0.18 vs 1.49 ± 0.09, P-0.000 and RI 0.76 ± 0.04 vs 0.59 ± 0.06, P-0.000). The mean IMT, PI and RI were increased significantly in smokers compared to controls (IMT-0.93 ± 0.20 vs 0.63 ± 0.06, P-0.000;PI-1.82 ± 0.22 vs 1.49 ± 0.09, P-0.000 and RI-0.77 ± 0.04 vs 0.59 ± 0.06, P-0.000). Type 3 plaque accounted for 27 (56.2%) cases and Type 2 plaque 12 (25%) cases. The total number of plaques in patients as compared to controls were significantly more (P-0.0034) and the mean plaque area was 46 mm2 for cases and 20 mm2 for control (P-0.0001). TACI was the most common type of ischemic stroke seen in DM (60%), HTN (66.6%) and smokers (66.7%). Plaques (73.3%), IMT (0.90 ± 0.12), PI(1.72 ± 0.14) and RI (0.76 ± 0.13) were more commonly associated with TACI subtype. On multivariate analysis using ANOVA, the mean PI was highly significant (0.000) in relation to types of plaque. Summary and Conclusions: IMT, RI, PI and plaque type are useful diagnostic parameters for acute ischemic stroke and its subtypes. They can be used as noninvasive tools for predicting and preventing ischemic stroke in smokers as well as subjects with DM and hypertension.展开更多
In order to study the relationship between serum C-reactive protein (CRP) levels, leukocyte count and carotid plaque in patients with ischemic stroke, carotid duplex examination was performed by high-definition imagin...In order to study the relationship between serum C-reactive protein (CRP) levels, leukocyte count and carotid plaque in patients with ischemic stroke, carotid duplex examination was performed by high-definition imaging (HDI) 5000 triplex system. Serum CRP was measured by nephelometry within 72 h after index ischemic stroke. A lesion was considered a plaque in the presence of a maximum intimal-medial wall thickness (IMT) 1.2 mm. Results of carotid ultrasonography were divided into two groups: M1, normal (IMT <1.2 mm) and M2, abnormal (IMT ≥1.2 mm). The results showed that the mean age of M2 was significantly older than that of M1 (69.7±10.4 versus 62.5±9.6, P =0.001). The patients with hypertension and diabetes mellitus (78 %, 35 % respectively)in M2 were significantly more than those (52 %, 18 % respectively) in M1 ( P <0.01, P <0.05). There were 32 (65 % ) patients with elevated CRP levels in M2, but 33 (46 %) patients with elevated CRP levels in M1, with the difference being significant between the two groups ( P <0.05). The levels of serum glucose and leukocyte count (8.1±5.5, 10.3±4.0, respectively) in abnormal CRP group were significantly higher than that of normal CRP group (6.4±2.8, 8.7±3.4) ( P <0.05, P <0.05); elevated CRP levels was found in 42 (62 %) patients with territory infarction and 23 (43 %) patients with lacunar infarction respectively, with the difference being significant between these two groups ( P <0.05). It was concluded that the elevation of CRP levels was an significant clinical index for carotid plaque in patients with acute cerebral infarction.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, sta...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
It is very common that increased carotid intima media thickness (CIMT) and carotid plaque coexist in a single subject in elderly patients with white matter lesions (WMLs). In this study we investigated whether the coe...It is very common that increased carotid intima media thickness (CIMT) and carotid plaque coexist in a single subject in elderly patients with white matter lesions (WMLs). In this study we investigated whether the coexistence of increased CIMT and carotid plaque is more strongly associated with the presence and extent of WMLs than either alone. All patients were classified into 1 of the following 4 groups:without either increased CIMT (I) or carotid plaque (P):I(-)P(-); with only increased CIMT:I(+)P(-); with only carotid plaque:I(-)P(+); and with both increased CIMT and carotid plaque:I(+)P(+). The presence and severity of periventricular WMLs (PWMLs) and deep WMLs (DWMLs) were assessed and the prevalence of MRI findings by the Cochran-Armitage trend test was calculated. The characteristics of subjects showed that the percentages of patients with increased CIMT and carotid plaque in the DWMLs group and the PWMLs group were significantly higher than those without WMLs group. Both DWMLs and PWMLs were strongly associated with age, carotid plaque and CIMT. Furthermore, the Cochran-Armitage trend test indicated that the prevalence of MRI findings of PWMLs and DWMLs increased in the order of I(-)P(-)<I(+)P(-)<I(-)P(+)<I(+)P(+)(P<0.0001). For the pa- tients with DWMLs, the grades of both I(+)P(-) and I(+)P(+) were increased significantly compared to I(-)P(-) (P<0.0025, P<0.05, respectively) without such a difference found in patients with PWMLs. Our results suggested that the coexistence of increased CIMT and carotid plaque is most closely associated with WMLs, and that increased CIMT is associated with the severity of DWMLs, whereas carotid plaque is related to the presence of WMLs.展开更多
Carotid artery stenting presents challenges of in-stent restenosis and late thrombosis, which are caused primarily by alterations in the mechanical environment of the artery after stent implantation. The present study...Carotid artery stenting presents challenges of in-stent restenosis and late thrombosis, which are caused primarily by alterations in the mechanical environment of the artery after stent implantation. The present study constructed patient-specific carotid arterial bifurcation models with lipid pools and calcified components based on magnetic resonance imaging. We numerically analyzed the effects of multicomponent plaques on the distributions of von Mises stresses(VMSs) in the patient-specific models after stenting.The results showed that when a stent was deployed, the large soft lipid pool in atherosclerotic plaques cushioned the host artery and reduced the stress within the arterial wall; however, this resulted in a sharp increase of VMS in the fibrous cap. When compared with the lipid pool, the presence of the calcified components led to slightly increased stresses on the luminal surface. However, when a calcification was located close to the luminal surface of the host artery and the stenosis, the local VMS was elevated. Overall, compared with calcified components, large lipid pools severely damaged the host artery after stenting. Furthermore, damage due to the calcified component may depend on location.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
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.
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Objective:To investigate the diagnostic value of spectral CT reconstruction mode for carotid atherosclerotic plaque lesions.Methods:From January 2017 to January 2019,70 patients with carotid atherosclerotic plaque lesions in our hospita1 were selected as the research object.A11 patients were diagnosed with cervical vascular color Doppler ultrasound and spectral CT scan under spectral cr reconstruction mode.Taking the results of coronaryf angiography as the"gold standard",the clinical value of the two examination methods in the diagnosis of carotid atherosclerotic plaque lesions was compared and analyzed.Results:Coronary angiography diagnosis confirmed that 33 of 70 patients with suspected carotid atherosclerotic plaque lesions had vulnerable plaques and 37 had stable plaques.The accuracy of Spectral CT examination of carotid artery plaque was 87.14%(61/70),sensitivity was 90.91%(30/33),specificity was 83.78%(31/37),and the positive predictive value was 83.33%(30/36),the negative predictive value is 91.76%(31/34),which is higher than that of cervical vascular ultrasonography(61.43%,60.61%,56.76%,57.89%,65.63%),the difference is statistically significant(P<0.05).Conclusion:The application of Spectral CT in the clinical diagnosis and treatment of carotid atherosclerotic plaque lesions with higher accuracy,sensitivity and specificity,is more significant and can provide a more reliable and effective imaging basis.
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: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 Science and Technology Department of Zhejiang Province,No.2008C33012Zhejiang Nature Science Foundation,No.Y2080718
文摘AIM:To assess neovascularization within human ca-rotid atherosclerotic soft plaques in patients with isch-emic stroke.METHODS:Eighty-one patients with ischemic stroke and 95 patients without stroke who had soft athero-sclerotic plaques in the internal carotid artery were studied.The thickest soft plaque in each patient was examined using contrast-enhanced ultrasound.Time-intensity curves were collected from 5 s to 3 min after contrast injection.The neovascularization within the plaques in the internal carotid artery was evaluated using the ACQ software built into the scanner by 2 of the experienced investigators who were blinded to the clinical history of the patients.RESULTS:Ischemic stroke was present in 7 of 33 patients(21%) with grade Ⅰ plaque,in 14 of 51 pa-tients(28%) with grade Ⅱ plaque,in 26 of 43 patients(61%) with grade Ⅲ plaque,and in 34 of 49 patients(69%) with grade Ⅳ plaque(P < 0.001 comparing grade Ⅳ plaque with grade I plaque and with grade Ⅱ plaque and P = 0.001 comparing grade Ⅲ plaque with grade Ⅰ plaque and with grade Ⅱ plaque).Analysis of the time intensity curves revealed that patients with ischemic stroke had a significantly higher intensity of enhancement(IE) than those without ischemic stroke(P < 0.01).The wash-in time(WT) of plaque was signifi-cantly shorter in stroke patients(P < 0.05).The sensi-tivity and specificity for IE in the plaque were 82% and 80%,respectively,and for WT were 68% and 74%,respectively.There was no significant difference in the peak intensity or time to peak between the 2 groups.CONCLUSION:This study shows that the higher the grade of plaque enhancement,the higher the risk of ischemic stroke.The data suggest that the presence of neovascularization is a marker for unstable plaque.
文摘The vasa vasorum of carotid artery plaque is a novel marker of accurately evaluating the vulnerability of carotid artery plaque, which was associated with symptomatic cerebrovascular and cardiovascular disease. The presence of ultrasound contrast agents in carotid artery plaque represents the presence of the vasa vasorum in carotid artery plaque because the ultrasoundcontrast agents are strict intravascular tracers. Therefore, contrast-enhanced ultrasound(CEUS) is a novel and safe imaging modality for evaluating the vasa vasorum in carotid artery plaque. However, there are some issues that needs to be assessed to embody fully the clinical utility of the vasa vasorum in carotid artery plaque with CEUS.
基金supported by the Natural Science Foundation of Zhejiang Province,China(No.LY13H180007)
文摘This study was undertaken to investigate the correlation of the enhancement degree on contrast-enhanced ultrasound(CEUS) with the histopathology of carotid plaques and the serum high sensitive C-reactive protein(hs-CRP) levels in patients undergoing carotid endarterectomy(CEA). Carotid CEUS was performed preoperatively in 115 patients who would undergo CEA, and the enhancement degree of the carotid plaques was evaluated by both the visual semiquantitative analysis and the quantitative time-intensity curve analysis. Serum hs-CRP levels were detected using the particle-enhanced immunoturbidimetric assay also before the operation. Additionally, the carotid plaque samples were subjected to histopathological examination postoperatively. The density of neovessels and the number of macrophages in the plaques were assessed by immunohistochemistry. The results showed that among the 115 patients, grade 0 plaque contrast enhancement was noted in 35 patients, grade 1 in 48 patients and grade 2 in 32 patients. The degree of plaque enhancement, the density of neovessels, the number of macrophages, and the hs-CRP levels were highest in the grade 2 patients. Correlation analysis showed that the enhancement degree of the carotid plaques was closely related to the immunohistochemical parameters of the plaques and the serum hs-CRP levels. It was suggested that the carotid plaque enhancement on CEUS can be used to evaluate the vulnerability of carotid plaques.
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.
基金supported by Major Project of Science and Technology of Beijing Municipal Education Commission and Type B Project of Beijing Natural Science Foundation(KZ201710005007).
文摘Clinical application of bare metal stents is constrained by the occurrence of instent restenosis,mainly due to the complex biomechanical environment in the body.Numerical simulation method was used to evaluate the effect of plaque composition on stent performance in a carotid artery.CT angiography(CTA)data were used as a reference,and zero-load state of the carotid artery was used to establish a 3D stenotic artery model.Different plaque compositions,calcified and hypo-cellular were defined in Model 1 and Model 2,respectively.Interactions between the stents and arterial tissues within the stent crimping-expansion process were analyzed to explore the effects of plaque composition on the mechanical parameters of carotid stents.Goodman diagram and fatigue safety factor(FSF)were analyzed to explore the effects of plaque composition on fatigue performance of a carotid stent in the stent service process.In the stent crimping-expansion process,the von Mises stress in the stent and the dog-boning ratio in Model 1 were higher than that in Model 2.The calcified plaque prevented the stent from expanding the stenotic vessel to a pre-set diameter.Thus,the risk of rupture in the calcified plaque was higher than that in the hypo-cellular plaque.Plaque also affected the stress/strain in the vessel wall,which was observed to be lower in Model 1 than in Model 2.This indicated that calcified plaque could decrease the stress-induced injury of arterial tissues.Within the stent service process,the stents used in these two models were predicted to not fail under fatigue rupture as calculated by the Goodman diagram.Additionally,the points closer to the fatigue limit were generally observed at the inner bend of the stent crowns.The FSF of the stent in Model 1 was lower than that in Model 2.The stent operating in the presence of calcified plaques suffered high risk of fractures.Reliability and fatigue performance of the stent were found to be associated with plaque composition.Hence,this study may provide stent designers an approach toward enhancing the mechanical reliability of a stent.
文摘Aim: To determine the relationship of carotid plaque, intima media thickness (IMT), resistivity index (RI) and pulsatility index (PI) and prevalence of different risk factors with acute ischemic stroke and stroke subtypes in both diabetic and non-diabetic subjects. Materials and methods: 80 cases of acute ischemic strokes and 40 healthy controls were included in the study. The plaque, IMT, RI and PI were measured by carotid duplex ultrasound. Results: 31 subjects were Type 2 diabetic, 54 hypertensive while 25 were both diabetic and hypertensive. 23 cases (28.75%) had lacunar stroke (LACI), 32 (40%) stroke involving partial anterior circulation(PACI), 10(12.5%) stroke in posterior circulation (PACI) and 15(18.75%) stroke involving total anterior circulation(TACI) respectively. The mean IMT (0.88 ± 0.19mm), RI(0.76 ± 0.05) and PI(1.71 ± 0.19) of patients and mean IMT (0.6±0.09mm), RI (0.61 ± 0.06) and PI (1.53 ± 0.11) of controls were statistically significant (p-0.000). The mean values of IMT, PI and RI were significantly higher in diabetics (IMT-0.90 ± 0.16 VS 0.64 ± 0.11, p-0.013;PI-1.76 ± 0.20 VS 1.49 ± 0.09, P-0.000 and RI-0.76 ± 0.04 VS 0.59 ± 0.06, P-0.000) and similarly the mean values for IMT, PI and RI in hypertensives as compared to controls (IMT-0.88 ± 0.16 vs 0.65 ± 0.10, P-0.006;PI1.69 ± 0.18 vs 1.49 ± 0.09, P-0.000 and RI 0.76 ± 0.04 vs 0.59 ± 0.06, P-0.000). The mean IMT, PI and RI were increased significantly in smokers compared to controls (IMT-0.93 ± 0.20 vs 0.63 ± 0.06, P-0.000;PI-1.82 ± 0.22 vs 1.49 ± 0.09, P-0.000 and RI-0.77 ± 0.04 vs 0.59 ± 0.06, P-0.000). Type 3 plaque accounted for 27 (56.2%) cases and Type 2 plaque 12 (25%) cases. The total number of plaques in patients as compared to controls were significantly more (P-0.0034) and the mean plaque area was 46 mm2 for cases and 20 mm2 for control (P-0.0001). TACI was the most common type of ischemic stroke seen in DM (60%), HTN (66.6%) and smokers (66.7%). Plaques (73.3%), IMT (0.90 ± 0.12), PI(1.72 ± 0.14) and RI (0.76 ± 0.13) were more commonly associated with TACI subtype. On multivariate analysis using ANOVA, the mean PI was highly significant (0.000) in relation to types of plaque. Summary and Conclusions: IMT, RI, PI and plaque type are useful diagnostic parameters for acute ischemic stroke and its subtypes. They can be used as noninvasive tools for predicting and preventing ischemic stroke in smokers as well as subjects with DM and hypertension.
文摘In order to study the relationship between serum C-reactive protein (CRP) levels, leukocyte count and carotid plaque in patients with ischemic stroke, carotid duplex examination was performed by high-definition imaging (HDI) 5000 triplex system. Serum CRP was measured by nephelometry within 72 h after index ischemic stroke. A lesion was considered a plaque in the presence of a maximum intimal-medial wall thickness (IMT) 1.2 mm. Results of carotid ultrasonography were divided into two groups: M1, normal (IMT <1.2 mm) and M2, abnormal (IMT ≥1.2 mm). The results showed that the mean age of M2 was significantly older than that of M1 (69.7±10.4 versus 62.5±9.6, P =0.001). The patients with hypertension and diabetes mellitus (78 %, 35 % respectively)in M2 were significantly more than those (52 %, 18 % respectively) in M1 ( P <0.01, P <0.05). There were 32 (65 % ) patients with elevated CRP levels in M2, but 33 (46 %) patients with elevated CRP levels in M1, with the difference being significant between the two groups ( P <0.05). The levels of serum glucose and leukocyte count (8.1±5.5, 10.3±4.0, respectively) in abnormal CRP group were significantly higher than that of normal CRP group (6.4±2.8, 8.7±3.4) ( P <0.05, P <0.05); elevated CRP levels was found in 42 (62 %) patients with territory infarction and 23 (43 %) patients with lacunar infarction respectively, with the difference being significant between these two groups ( P <0.05). It was concluded that the elevation of CRP levels was an significant clinical index for carotid plaque in patients with acute cerebral infarction.
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supported by the National Natural Science Foundation of China (No. 30970962)
文摘It is very common that increased carotid intima media thickness (CIMT) and carotid plaque coexist in a single subject in elderly patients with white matter lesions (WMLs). In this study we investigated whether the coexistence of increased CIMT and carotid plaque is more strongly associated with the presence and extent of WMLs than either alone. All patients were classified into 1 of the following 4 groups:without either increased CIMT (I) or carotid plaque (P):I(-)P(-); with only increased CIMT:I(+)P(-); with only carotid plaque:I(-)P(+); and with both increased CIMT and carotid plaque:I(+)P(+). The presence and severity of periventricular WMLs (PWMLs) and deep WMLs (DWMLs) were assessed and the prevalence of MRI findings by the Cochran-Armitage trend test was calculated. The characteristics of subjects showed that the percentages of patients with increased CIMT and carotid plaque in the DWMLs group and the PWMLs group were significantly higher than those without WMLs group. Both DWMLs and PWMLs were strongly associated with age, carotid plaque and CIMT. Furthermore, the Cochran-Armitage trend test indicated that the prevalence of MRI findings of PWMLs and DWMLs increased in the order of I(-)P(-)<I(+)P(-)<I(-)P(+)<I(+)P(+)(P<0.0001). For the pa- tients with DWMLs, the grades of both I(+)P(-) and I(+)P(+) were increased significantly compared to I(-)P(-) (P<0.0025, P<0.05, respectively) without such a difference found in patients with PWMLs. Our results suggested that the coexistence of increased CIMT and carotid plaque is most closely associated with WMLs, and that increased CIMT is associated with the severity of DWMLs, whereas carotid plaque is related to the presence of WMLs.
基金supported by the National Natural Science Foundation of China (Grants 11332003, 11421202, 61190123, 31200703, 11472031)Special Fund for Excellent Doctoral Degree Dissertation of Beijing (Grant 20131000601)+1 种基金the 111 Project (Grant B13003)the Innovation Foundation of BUAA for Ph.D. graduates
文摘Carotid artery stenting presents challenges of in-stent restenosis and late thrombosis, which are caused primarily by alterations in the mechanical environment of the artery after stent implantation. The present study constructed patient-specific carotid arterial bifurcation models with lipid pools and calcified components based on magnetic resonance imaging. We numerically analyzed the effects of multicomponent plaques on the distributions of von Mises stresses(VMSs) in the patient-specific models after stenting.The results showed that when a stent was deployed, the large soft lipid pool in atherosclerotic plaques cushioned the host artery and reduced the stress within the arterial wall; however, this resulted in a sharp increase of VMS in the fibrous cap. When compared with the lipid pool, the presence of the calcified components led to slightly increased stresses on the luminal surface. However, when a calcification was located close to the luminal surface of the host artery and the stenosis, the local VMS was elevated. Overall, compared with calcified components, large lipid pools severely damaged the host artery after stenting. Furthermore, damage due to the calcified component may depend on location.
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.
