4th vulnerable plaque symposium
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This study found that temperature heterogeneity in atherosclerotic plaques in rabbits is associated with macrophage accumulation and metalloproteinase (MMP) activity. Thermography detected hot and cold areas that correlated with higher macrophage levels and MMP-2 and MMP-9 activity. More macrophages and MMPs were present in hot areas compared to cold areas of plaques. However, blood flow obscured temperature differences, so flow was stopped to measure temperatures accurately. The results suggest temperature changes detect active macrophages and areas of plaques with higher vulnerability.
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128 apo e deficient mice
1. CNS-1-1d SPIO nanoparticles were injected intravenously into 3 apoE deficient mice.
2. Tissue samples from the aorta, heart, liver, lung, spleen and kidney were collected 2 hours, 1 day, and 2 days after injection and stained.
3. One day after injection, staining of the aortic root showed the presence of SPIO in macrophage-rich areas, indicating the SPIO had been taken up by macrophages.
130 mri assessment of human atherosclerotic disease
This study aimed to describe the anatomical and dimensional characteristics of carotid atherosclerosis in elderly individuals using high-resolution MRI and EBCT. 38 pairs of carotid artery segments were obtained from cadavers and imaged. The images were analyzed to measure plaque location, artery wall and lumen volumes, and estimate plaque volume. Both MRI and EBCT showed close bilateral symmetry between left and right carotid dimensions and calcium content. Plaque appeared as single lesions concentrated near the bifurcation, diminishing about 15mm distal and proximal. The measurements provide insights into carotid plaque development and potential clinical applications of non-invasive carotid imaging.
190 virus infected monocyes
Virus-infected monocytes can initiate coagulation and promote inflammation. An in vitro study found that monocytes infected with cytomegalovirus, influenza A virus, or Chlamydia pneumoniae expressed tissue factor and reduced clotting time, indicating initiation of coagulation. The viruses also stimulated monocytes to produce inflammatory cytokines like IL-6 and IL-8. While all three viruses infected monocytes, influenza A most strongly induced cytokine production. This suggests virus-infected monocytes may contribute to both acute coronary events by promoting plaque instability and the chronic atherosclerosis process through sustained inflammation and coagulation.
3rd vp symposium jang
This document summarizes research on using optical coherence tomography (OCT) to characterize coronary plaques. OCT uses near-infrared light to generate high-resolution cross-sectional images of tissue microstructure. Researchers studied 357 arterial segments ex vivo using OCT and validated plaque types (fibrous, calcific, lipid-rich) against histology with high accuracy. A pilot clinical study of 10 patients found OCT feasible and safe for in vivo coronary imaging before and after percutaneous coronary intervention, identifying a variety of plaque types and stent appositions. While blood obstruction and motion artifacts posed challenges, the results support further evaluation of OCT as a potential "optical biopsy" tool.
061 a nano mega initiative
The document summarizes a meeting on vulnerable plaque research between UT-THI and Rice Coalition. It provides background on vulnerable plaque, describing it as dangerous forms of fat buildup in the arterial wall that can rupture or induce thrombosis. It reviews the history of research in this area dating back to the 19th century, and profiles the many contributors to the field. Emerging techniques for detecting vulnerable plaque non-invasively or invasively are also summarized, such as various imaging modalities, blood tests, and endothelial function tests.
039 mr contrast agents for vulnerable plaque imaging
1. MS-325 is an albumin-targeted gadolinium contrast agent that highlights inflamed vessel walls and facilitates plaque imaging. It provides prolonged enhancement of the vessel wall and lumen, allowing for high resolution detection of plaque burden.
2. Studies show strong vessel wall enhancement with MS-325 due to increased capillary volume and binding to extravasated albumin in the vessel wall of patients with atherosclerosis. This may help identify stenosis and quantify plaque.
3. Experimental models demonstrate MS-325 can improve visualization of vulnerable plaque features like lipid cores and thin fibrous caps, as well as directly detect thrombus formation during plaque rupture.
137 inflammatory cells in non ruptured atherosclerotic plaques
The document summarizes a study examining the prevalence of inflammatory cells in non-ruptured atherosclerotic plaques. The study found that moderate or heavy staining for macrophages was present in 45% of femoral artery cross-sections and 84% of femoral arteries had at least one cross-section with moderate or heavy inflammation. Additionally, there was no relationship found between the degree of inflammation in the left versus right coronary artery within individuals. The conclusion is that the presence of inflammatory cells is common in non-ruptured plaques and the level of local inflammation does not predict inflammation in other arteries.
Acc presentation (1)
This document describes a study that introduces a non-invasive method for imaging macrophage infiltration in inflamed atherosclerotic plaques using superparamagnetic iron oxide (SPIO) nanoparticles and MRI. The researchers injected SPIO into hypercholesterolemic and normal rabbits and found that SPIO profoundly accumulated in areas of macrophage infiltration in the atherosclerotic plaques, as confirmed by histology. SPIO-enhanced MRI was able to identify these inflamed plaques non-invasively. The results suggest SPIO-enhanced MRI can be a novel method for detecting rupture-prone inflamed plaques associated with heart attacks and strokes.
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128 apo e deficient mice
1. CNS-1-1d SPIO nanoparticles were injected intravenously into 3 apoE deficient mice.
2. Tissue samples from the aorta, heart, liver, lung, spleen and kidney were collected 2 hours, 1 day, and 2 days after injection and stained.
3. One day after injection, staining of the aortic root showed the presence of SPIO in macrophage-rich areas, indicating the SPIO had been taken up by macrophages.
130 mri assessment of human atherosclerotic disease
This study aimed to describe the anatomical and dimensional characteristics of carotid atherosclerosis in elderly individuals using high-resolution MRI and EBCT. 38 pairs of carotid artery segments were obtained from cadavers and imaged. The images were analyzed to measure plaque location, artery wall and lumen volumes, and estimate plaque volume. Both MRI and EBCT showed close bilateral symmetry between left and right carotid dimensions and calcium content. Plaque appeared as single lesions concentrated near the bifurcation, diminishing about 15mm distal and proximal. The measurements provide insights into carotid plaque development and potential clinical applications of non-invasive carotid imaging.
190 virus infected monocyes
Virus-infected monocytes can initiate coagulation and promote inflammation. An in vitro study found that monocytes infected with cytomegalovirus, influenza A virus, or Chlamydia pneumoniae expressed tissue factor and reduced clotting time, indicating initiation of coagulation. The viruses also stimulated monocytes to produce inflammatory cytokines like IL-6 and IL-8. While all three viruses infected monocytes, influenza A most strongly induced cytokine production. This suggests virus-infected monocytes may contribute to both acute coronary events by promoting plaque instability and the chronic atherosclerosis process through sustained inflammation and coagulation.
3rd vp symposium jang
This document summarizes research on using optical coherence tomography (OCT) to characterize coronary plaques. OCT uses near-infrared light to generate high-resolution cross-sectional images of tissue microstructure. Researchers studied 357 arterial segments ex vivo using OCT and validated plaque types (fibrous, calcific, lipid-rich) against histology with high accuracy. A pilot clinical study of 10 patients found OCT feasible and safe for in vivo coronary imaging before and after percutaneous coronary intervention, identifying a variety of plaque types and stent appositions. While blood obstruction and motion artifacts posed challenges, the results support further evaluation of OCT as a potential "optical biopsy" tool.
061 a nano mega initiative
The document summarizes a meeting on vulnerable plaque research between UT-THI and Rice Coalition. It provides background on vulnerable plaque, describing it as dangerous forms of fat buildup in the arterial wall that can rupture or induce thrombosis. It reviews the history of research in this area dating back to the 19th century, and profiles the many contributors to the field. Emerging techniques for detecting vulnerable plaque non-invasively or invasively are also summarized, such as various imaging modalities, blood tests, and endothelial function tests.
039 mr contrast agents for vulnerable plaque imaging
1. MS-325 is an albumin-targeted gadolinium contrast agent that highlights inflamed vessel walls and facilitates plaque imaging. It provides prolonged enhancement of the vessel wall and lumen, allowing for high resolution detection of plaque burden.
2. Studies show strong vessel wall enhancement with MS-325 due to increased capillary volume and binding to extravasated albumin in the vessel wall of patients with atherosclerosis. This may help identify stenosis and quantify plaque.
3. Experimental models demonstrate MS-325 can improve visualization of vulnerable plaque features like lipid cores and thin fibrous caps, as well as directly detect thrombus formation during plaque rupture.
137 inflammatory cells in non ruptured atherosclerotic plaques
The document summarizes a study examining the prevalence of inflammatory cells in non-ruptured atherosclerotic plaques. The study found that moderate or heavy staining for macrophages was present in 45% of femoral artery cross-sections and 84% of femoral arteries had at least one cross-section with moderate or heavy inflammation. Additionally, there was no relationship found between the degree of inflammation in the left versus right coronary artery within individuals. The conclusion is that the presence of inflammatory cells is common in non-ruptured plaques and the level of local inflammation does not predict inflammation in other arteries.
Acc presentation (1)
This document describes a study that introduces a non-invasive method for imaging macrophage infiltration in inflamed atherosclerotic plaques using superparamagnetic iron oxide (SPIO) nanoparticles and MRI. The researchers injected SPIO into hypercholesterolemic and normal rabbits and found that SPIO profoundly accumulated in areas of macrophage infiltration in the atherosclerotic plaques, as confirmed by histology. SPIO-enhanced MRI was able to identify these inflamed plaques non-invasively. The results suggest SPIO-enhanced MRI can be a novel method for detecting rupture-prone inflamed plaques associated with heart attacks and strokes.
261 molecular genetics and micro arrays
This document summarizes several studies that used microarray technology to analyze gene expression in cardiovascular tissues and cells:
1) Studies analyzed atherosclerotic lesions and correlated gene expression with the vulnerability and pathogenesis of lesions.
2) Other studies analyzed gene expression changes in cardiac growth, development, and response to injury as well as during viral infection.
3) Gene expression in vascular cells and tissues was also analyzed in response to mechanical stress, inflammation, and other cardiovascular conditions like atherosclerosis and hypertension.
212 basic molecular genetic studies in atherosclerosis
Basic molecular genetic studies of atherosclerosis involve analyzing genes and genetic variations using various techniques. Key techniques discussed are PCR to amplify DNA, gel electrophoresis to separate DNA fragments by size, DNA sequencing to determine nucleotide order, and DNA microarrays where many genes are attached to a chip to analyze expression levels. These techniques are furthering our understanding of genetic factors contributing to atherosclerosis development and progression.
151 performance of a localized fiber optic
This document describes the design and testing of a fiber optic probe to measure metabolic markers in human carotid plaque tissue samples in vitro. The probe was designed to interrogate a small volume of tissue (~1 mm3) and measure tissue lactate concentration and pH. Human plaque samples were collected and studied in a controlled in vitro setup to validate experimental stability over time. Optical absorption spectra were collected from plaque samples and related to reference measurements of lactate concentration and pH through multivariate calibration models, achieving accurate predictions. The fiber optic probe design and in vitro experimental methods were able to precisely measure metabolic markers for characterization of plaque vulnerability.
Ac cculprit
The document discusses several factors that are considered predictors of plaque vulnerability, including luminal narrowing, plaque volume and composition, fibrous cap thickness, and plaque inflammation. It reviews studies that show myocardial infarction can develop from previously non-severe lesions and that lipid content, cap thickness, inflammation, and stress factors like circumferential stress are correlated with plaque stability and vulnerability. In conclusion, the size and composition of the lipid core, thickness and composition of the fibrous cap, and inflammation are well-established predictors of plaque rupture.
222 animal models of heart attack
This document summarizes various animal models that have been used to study atherosclerosis and heart attacks, including quail, pigeons, chickens, dogs, monkeys, pigs, rats, rabbits, and mice. It provides details on the types of lesions each animal can develop and how closely they resemble human coronary artery disease. It highlights that double knockout LDL/apoE mice may offer an improved model for studying clinical complications of atherosclerosis like human ischemic heart disease, though it is unclear how closely they mimic vulnerable human plaques.
505 definitions of arterial remodeling in post mortem and intravascular ultra...
This document discusses different definitions of arterial remodeling used in post-mortem and intravascular ultrasound research. It notes that the various definitions lead to large variations in reported prevalence numbers for expansive, intermediate, and constrictive remodeling. The definitions are analyzed and some are noted to only be suitable for certain study types. It concludes that careful consideration of the remodeling definition used is needed when reporting prevalences, as without a gold standard or serial studies, the reference sites may not be free of atherosclerotic disease and could themselves be remodeled.
256 spatial encoding part 2
1. MRI uses spatial encoding gradients and radiofrequency pulses to selectively excite slices of tissue and encode spatial information in the MRI signal. 2. Frequency encoding gradients encode left-right spatial information, while phase encoding gradients are applied in the orthogonal direction to fully spatially encode each image slice. 3. Fourier transformation is used to reconstruct images from the spatially encoded MRI data.
164 calcium in atherosclerosis
Calcium can be both good and bad in atherosclerosis. While calcium burden is a significant predictor of future cardiovascular events, papers on plaque rupture do not always discuss calcification. The document discusses several past studies that have shown calcium can be present deep within plaques, near the lipid core and necrotic areas. This suggests calcium is sometimes located in areas prone to rupture rather than only being present in stable, fibrotic regions. The location and extent of calcium deposits may help determine whether it indicates a more stable or high-risk plaque.
118 cell culture study
Cell culture studies showed that macrophages experience a transient increase in free radicals when ingesting dextran-coated SPIO particles, but levels return to baseline. Testing showed that lipid-coated SPIO induced less nitric oxide production in macrophages than dextran-coated SPIO or Feridex. Preliminary results indicate a significant difference in nitric oxide levels produced by macrophages depending on whether they ingest dextran-coated or lipid-coated SPIO particles.
3rd vulnerable plaque rumberg 3 16-02 2
Coronary artery calcium detected by electron beam tomography (EBT) establishes a diagnosis of coronary atherosclerosis, as there are no false positive calcium measurements. The amount of calcium seen on EBT correlates directly with the actual amount of coronary plaque measured by intravascular ultrasound and histopathology. Studies have also shown that a higher coronary artery calcium score on EBT is associated with greater risk of future myocardial infarction, sudden cardiac death, or ischemia over follow-up periods of 3-6 years.
Acc presentation macrophage (1)
This document proposes a non-invasive method using SPIO (super paramagnetic iron oxide) nanoparticles to image macrophage infiltration and inflammation in vulnerable atherosclerotic plaques. Rabbits and mice were injected with SPIO, which accumulated in inflamed plaque areas correlated with macrophage density. SPIO-enhanced MRI then successfully identified these inflamed plaques non-invasively in vivo. This technique could provide a way to detect rupture-prone plaques and better understand plaque vulnerability.
3rd vulnerable plaque rumberg 3 16-02 2
Coronary artery calcium detected by electron beam tomography (EBT) establishes a diagnosis of coronary atherosclerosis, as there are no false positive calcium measurements. The amount of calcium seen on EBT correlates directly with the actual amount of coronary plaque measured by intravascular ultrasound and histopathology. Studies have also shown that a higher coronary artery calcium score on EBT is associated with greater risk of future myocardial infarction, sudden cardiac death, or ischemia over follow-up periods of 3-6 years.
162 calcium imaging
Scores >400 are associated with a 10-fold increased risk of future events. Calcium imaging should be used routinely to assess risk. Matthew Budoff is an assistant professor of cardiology who discloses a relationship with Imatron, Inc as a speaker.
107 spio in apo e mouse
The document describes histopathology results showing fluorescent microspheres adhering to atherosclerotic plaques in an Apo E mouse model after 24 hours. One macrophage was seen containing 10 fluorescent microspheres adhering to a fibrous plaque. An aggregation of 4 labeled macrophages was attached to an advanced plaque. Numerous macrophages were adhering to an isolated fatty streak comprised mainly of foam cells.
236 complement inhibitor
This document discusses the role of the complement system in the pathogenesis of atherosclerosis. It summarizes several studies that have found activation of the complement system and deposition of complement components in atherosclerotic plaques. C3 deficiency in mice is shown to result in larger lipid-positive areas and higher macrophage accumulation in plaques. The conclusion is that plaque maturation beyond early foam cell formation depends on an intact complement system, and complement activation should be considered in evaluating other inflammatory parameters associated with atherosclerosis. Complement inhibitors may have potential for preventing or stabilizing vulnerable plaques.
239 coronary artery calcium
Coronary artery calcium detected by electron beam tomography (EBT) establishes a diagnosis of coronary atherosclerosis, as there are no false positive calcium measurements. The amount of calcium seen on EBT correlates directly with the actual amount of coronary plaque measured by intravascular ultrasound and histopathology. Studies have also shown that a higher coronary artery calcium score on EBT is associated with greater risk of future myocardial infarction, sudden cardiac death, or ischemia over follow-up periods of 3-6 years.
5
The document discusses a study conducted by the Department of Cardiology at Athens Medical School in 2001 that used a new aortic thermography catheter to measure temperatures in the aorta and coronary sinus of patients. The study involved 18 patients with documented coronary artery disease and 12 patients with normal coronary arteries, as determined by angiography. The purpose was to investigate if there are temperature differences in blood between the coronary sinus and right atrium in patients with left coronary artery lesions compared to those without.
083 non invasive imaging of the vulnerable plaque
This document discusses non-invasive imaging techniques for coronary artery plaque and vulnerable patients. It notes that while lipid-rich plaque makes up about 20% of total plaque volume, it is often not detectable without invasive techniques. Newer CT and electron beam tomography techniques aim to non-invasively detect plaque composition through measurements of density and heterogeneity. The document raises questions about which patients should be imaged, what parameters need to be measured, and how imaging results could potentially change patient outcomes. It also discusses technical considerations for these non-invasive imaging modalities.
065 association for eradication of heart attack
This document summarizes a scientific paper published in Circulation in 2003 about vulnerable plaques and patients. It discusses what has been learned since prior conferences on this topic, including defining major and minor criteria for vulnerable plaques based on culprit plaques. It outlines markers of vulnerability at the plaque/artery level relating to plaque morphology/structure, activity/function, and pan-arterial assessments. Conditions and markers associated with myocardial vulnerability both with and without atherosclerosis-derived ischemia are also summarized. The challenges of terminology and techniques for risk stratification of vulnerable myocardium are briefly discussed.
Thermo gravimetric Analysis
This document provides an overview of thermogravimetric analysis (TGA). TGA involves measuring the mass of a substance as it is heated or cooled over time in a controlled temperature program. It summarizes the principle, instrumentation, example curve, applications, limitations, and factors affecting results of TGA. The instrumentation section describes the sample holder, microbalance, programmable furnace, temperature control/sensor, and data readout components of a TGA instrument. Common applications include determining thermal stability, material characterization, and compositional analysis.
151 performance of a localized fiber optic
This document describes the design and testing of a fiber optic probe to measure metabolic properties of human carotid plaque. The probe was designed to interrogate a small tissue volume (<1 mm3) and determine pH and lactate concentration in vitro. Monte Carlo simulations were used to optimize probe geometry for depth penetration. Several probe designs were tested and a final probe with a 50 micron source-receiver separation was chosen. Human carotid plaques were studied in vitro to validate experimental stability over 4 hours. The probe and experimental methods achieved the stability criteria of less than 0.03 pH change and 0.4°C temperature change per hour, demonstrating feasibility for optical spectroscopy of plaque metabolism.
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261 molecular genetics and micro arrays
This document summarizes several studies that used microarray technology to analyze gene expression in cardiovascular tissues and cells:
1) Studies analyzed atherosclerotic lesions and correlated gene expression with the vulnerability and pathogenesis of lesions.
2) Other studies analyzed gene expression changes in cardiac growth, development, and response to injury as well as during viral infection.
3) Gene expression in vascular cells and tissues was also analyzed in response to mechanical stress, inflammation, and other cardiovascular conditions like atherosclerosis and hypertension.
212 basic molecular genetic studies in atherosclerosis
Basic molecular genetic studies of atherosclerosis involve analyzing genes and genetic variations using various techniques. Key techniques discussed are PCR to amplify DNA, gel electrophoresis to separate DNA fragments by size, DNA sequencing to determine nucleotide order, and DNA microarrays where many genes are attached to a chip to analyze expression levels. These techniques are furthering our understanding of genetic factors contributing to atherosclerosis development and progression.
151 performance of a localized fiber optic
This document describes the design and testing of a fiber optic probe to measure metabolic markers in human carotid plaque tissue samples in vitro. The probe was designed to interrogate a small volume of tissue (~1 mm3) and measure tissue lactate concentration and pH. Human plaque samples were collected and studied in a controlled in vitro setup to validate experimental stability over time. Optical absorption spectra were collected from plaque samples and related to reference measurements of lactate concentration and pH through multivariate calibration models, achieving accurate predictions. The fiber optic probe design and in vitro experimental methods were able to precisely measure metabolic markers for characterization of plaque vulnerability.
Ac cculprit
The document discusses several factors that are considered predictors of plaque vulnerability, including luminal narrowing, plaque volume and composition, fibrous cap thickness, and plaque inflammation. It reviews studies that show myocardial infarction can develop from previously non-severe lesions and that lipid content, cap thickness, inflammation, and stress factors like circumferential stress are correlated with plaque stability and vulnerability. In conclusion, the size and composition of the lipid core, thickness and composition of the fibrous cap, and inflammation are well-established predictors of plaque rupture.
222 animal models of heart attack
This document summarizes various animal models that have been used to study atherosclerosis and heart attacks, including quail, pigeons, chickens, dogs, monkeys, pigs, rats, rabbits, and mice. It provides details on the types of lesions each animal can develop and how closely they resemble human coronary artery disease. It highlights that double knockout LDL/apoE mice may offer an improved model for studying clinical complications of atherosclerosis like human ischemic heart disease, though it is unclear how closely they mimic vulnerable human plaques.
505 definitions of arterial remodeling in post mortem and intravascular ultra...
This document discusses different definitions of arterial remodeling used in post-mortem and intravascular ultrasound research. It notes that the various definitions lead to large variations in reported prevalence numbers for expansive, intermediate, and constrictive remodeling. The definitions are analyzed and some are noted to only be suitable for certain study types. It concludes that careful consideration of the remodeling definition used is needed when reporting prevalences, as without a gold standard or serial studies, the reference sites may not be free of atherosclerotic disease and could themselves be remodeled.
256 spatial encoding part 2
1. MRI uses spatial encoding gradients and radiofrequency pulses to selectively excite slices of tissue and encode spatial information in the MRI signal. 2. Frequency encoding gradients encode left-right spatial information, while phase encoding gradients are applied in the orthogonal direction to fully spatially encode each image slice. 3. Fourier transformation is used to reconstruct images from the spatially encoded MRI data.
164 calcium in atherosclerosis
Calcium can be both good and bad in atherosclerosis. While calcium burden is a significant predictor of future cardiovascular events, papers on plaque rupture do not always discuss calcification. The document discusses several past studies that have shown calcium can be present deep within plaques, near the lipid core and necrotic areas. This suggests calcium is sometimes located in areas prone to rupture rather than only being present in stable, fibrotic regions. The location and extent of calcium deposits may help determine whether it indicates a more stable or high-risk plaque.
118 cell culture study
Cell culture studies showed that macrophages experience a transient increase in free radicals when ingesting dextran-coated SPIO particles, but levels return to baseline. Testing showed that lipid-coated SPIO induced less nitric oxide production in macrophages than dextran-coated SPIO or Feridex. Preliminary results indicate a significant difference in nitric oxide levels produced by macrophages depending on whether they ingest dextran-coated or lipid-coated SPIO particles.
3rd vulnerable plaque rumberg 3 16-02 2
Coronary artery calcium detected by electron beam tomography (EBT) establishes a diagnosis of coronary atherosclerosis, as there are no false positive calcium measurements. The amount of calcium seen on EBT correlates directly with the actual amount of coronary plaque measured by intravascular ultrasound and histopathology. Studies have also shown that a higher coronary artery calcium score on EBT is associated with greater risk of future myocardial infarction, sudden cardiac death, or ischemia over follow-up periods of 3-6 years.
Acc presentation macrophage (1)
This document proposes a non-invasive method using SPIO (super paramagnetic iron oxide) nanoparticles to image macrophage infiltration and inflammation in vulnerable atherosclerotic plaques. Rabbits and mice were injected with SPIO, which accumulated in inflamed plaque areas correlated with macrophage density. SPIO-enhanced MRI then successfully identified these inflamed plaques non-invasively in vivo. This technique could provide a way to detect rupture-prone plaques and better understand plaque vulnerability.
3rd vulnerable plaque rumberg 3 16-02 2
Coronary artery calcium detected by electron beam tomography (EBT) establishes a diagnosis of coronary atherosclerosis, as there are no false positive calcium measurements. The amount of calcium seen on EBT correlates directly with the actual amount of coronary plaque measured by intravascular ultrasound and histopathology. Studies have also shown that a higher coronary artery calcium score on EBT is associated with greater risk of future myocardial infarction, sudden cardiac death, or ischemia over follow-up periods of 3-6 years.
162 calcium imaging
Scores >400 are associated with a 10-fold increased risk of future events. Calcium imaging should be used routinely to assess risk. Matthew Budoff is an assistant professor of cardiology who discloses a relationship with Imatron, Inc as a speaker.
107 spio in apo e mouse
The document describes histopathology results showing fluorescent microspheres adhering to atherosclerotic plaques in an Apo E mouse model after 24 hours. One macrophage was seen containing 10 fluorescent microspheres adhering to a fibrous plaque. An aggregation of 4 labeled macrophages was attached to an advanced plaque. Numerous macrophages were adhering to an isolated fatty streak comprised mainly of foam cells.
236 complement inhibitor
This document discusses the role of the complement system in the pathogenesis of atherosclerosis. It summarizes several studies that have found activation of the complement system and deposition of complement components in atherosclerotic plaques. C3 deficiency in mice is shown to result in larger lipid-positive areas and higher macrophage accumulation in plaques. The conclusion is that plaque maturation beyond early foam cell formation depends on an intact complement system, and complement activation should be considered in evaluating other inflammatory parameters associated with atherosclerosis. Complement inhibitors may have potential for preventing or stabilizing vulnerable plaques.
239 coronary artery calcium
Coronary artery calcium detected by electron beam tomography (EBT) establishes a diagnosis of coronary atherosclerosis, as there are no false positive calcium measurements. The amount of calcium seen on EBT correlates directly with the actual amount of coronary plaque measured by intravascular ultrasound and histopathology. Studies have also shown that a higher coronary artery calcium score on EBT is associated with greater risk of future myocardial infarction, sudden cardiac death, or ischemia over follow-up periods of 3-6 years.
5
The document discusses a study conducted by the Department of Cardiology at Athens Medical School in 2001 that used a new aortic thermography catheter to measure temperatures in the aorta and coronary sinus of patients. The study involved 18 patients with documented coronary artery disease and 12 patients with normal coronary arteries, as determined by angiography. The purpose was to investigate if there are temperature differences in blood between the coronary sinus and right atrium in patients with left coronary artery lesions compared to those without.
083 non invasive imaging of the vulnerable plaque
This document discusses non-invasive imaging techniques for coronary artery plaque and vulnerable patients. It notes that while lipid-rich plaque makes up about 20% of total plaque volume, it is often not detectable without invasive techniques. Newer CT and electron beam tomography techniques aim to non-invasively detect plaque composition through measurements of density and heterogeneity. The document raises questions about which patients should be imaged, what parameters need to be measured, and how imaging results could potentially change patient outcomes. It also discusses technical considerations for these non-invasive imaging modalities.
065 association for eradication of heart attack
This document summarizes a scientific paper published in Circulation in 2003 about vulnerable plaques and patients. It discusses what has been learned since prior conferences on this topic, including defining major and minor criteria for vulnerable plaques based on culprit plaques. It outlines markers of vulnerability at the plaque/artery level relating to plaque morphology/structure, activity/function, and pan-arterial assessments. Conditions and markers associated with myocardial vulnerability both with and without atherosclerosis-derived ischemia are also summarized. The challenges of terminology and techniques for risk stratification of vulnerable myocardium are briefly discussed.
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212 basic molecular genetic studies in atherosclerosis
212 basic molecular genetic studies in atherosclerosis
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151 performance of a localized fiber optic
This document describes the design and testing of a fiber optic probe to measure metabolic properties of human carotid plaque. The probe was designed to interrogate a small tissue volume (<1 mm3) and determine pH and lactate concentration in vitro. Monte Carlo simulations were used to optimize probe geometry for depth penetration. Several probe designs were tested and a final probe with a 50 micron source-receiver separation was chosen. Human carotid plaques were studied in vitro to validate experimental stability over 4 hours. The probe and experimental methods achieved the stability criteria of less than 0.03 pH change and 0.4°C temperature change per hour, demonstrating feasibility for optical spectroscopy of plaque metabolism.
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207 progress with the calibration of a 3 fr near infrared catheter
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- 1. Plaque temperature heterogeneity is associated with macrophage accumulation and metalloproteinase activity R. Krams, LCA van Damme Dept. Experimental Cardiology, Thoraxcenter, Rotterdam, The Netherlands
- 2. Background • Plaque rupture has been related to a high MMP activity and macrophage (Mø) accumulation Galis et al, J. Clin. Invest. 1994 • Recently, regional temperature heterogeneity has been observed in atherosclerotic plaques in vivo Verheye et al, Circulation 2002
- 3. Aim of this study • To test the hypothesis that temperature heterogeneity is associated not only with macrophage accumulation but also with MMP-activity in atherosclerotic plaques in vivo.
- 4. Methods In 6 NZW rabbits: • Endothelium was removed (denudation) of the infra renal aorta • 2 months 2% cholesterol diet • Temperature measurement after 2 months of follow up • Immunohistochemistry for the detection of mø (RAM11, Dako), smooth muscle cells (1A4), histology for collagen amount (picro-serious red) and lipid contents (oil red o) and MMP activity in a zymogram
- 5. start end 3F Fogarty 50 mm Infra renal aorta Renal artery Denudation area
- 6. Thermography • Intravascular thermography • Catheter: Thermocore Medical Systems • Accuracy: ± 0.01 °C • Pullback speed: 0.2 mm/sec • Measurement of temperature difference from a reference area
- 7. Analysis I •Thermography with / without blood flow -pull back over 6 cm -mean of 4 thermistors -mean of 2 pull backs -reference area set at 0 °C
- 8. Analysis II • Histological analysis: -Mø % of plaque area -Lipid % of plaque area -Collagen % of plaque area -Smooth Muscle Cell(SMC) % of plaque area • Vulnerability Index (VI-index): VI = Mø% + Lipid% Collagen% + SMC% Shiomi et al, Atherosclerosis 2001
- 9. Analysis III • MMP activity in a zymogram -SDS PAGE gel electroforese -separation on molecular weight -substrate: gelatin
- 10. Protocol Inducing atherosclerosis Perform thermography after 2 months Hot Cold Isolate area Isolate area MMP-activity / cel distribution MMP-activity / cel distribution Compare
- 11. Distance (mm) from renal artery 0 5 10 15 20 25 30 35 40 45 50 55 ∆T(°C)fromreference 0.0 0.1 0.2 0.3 0.4 0.5 0.6 0.7 0.8 ∆T(°C)fromreference -0.2 -0.1 0.0 0.1 length (mm) vs Mean without blood flow length (mm) vs Mean with blood flow Results I Thermograph (with and without blood flow) Hot spot 1 Hot spot 2 Cold area Example 1
- 12. Length from renal artery (mm) 0 5 10 15 20 25 30 35 40 45 50 55 ∆T(°C)fromreferencearea -0.1 0.0 0.1 0.2 0.3 0.4 0.5 ∆T(°C)fromreferencearea -0.01 0.00 0.01 0.02 0.03 length (mm) vs Mean without blood flow length (mm) vs Mean with blood flow Example 2 Results I Thermograph (with and without blood flow)
- 13. ∆T (°C) from reference 0.1 0.2 0.3 0.4 0.5 0.6 0.7 VI-index 0 1 2 3 VI-index Regression between VI-index and ∆T R=0.8, p=0.013 Results II
- 14. Results II ∆T (°C) from reference 0.1 0.2 0.3 0.4 0.5 0.6 0.7 Mø(%)intheplaque 0 5 10 15 20 25 30 mø Regression between mø(%) and ∆T (°C), R = 0.7 p = 0.020
- 15. Results III MMP-9 Pro-MMP-2 MMP-2 active MMP-9 Pro-MMP-2 MMP-2 active MMP-9 Pro-MMP-2 MMP-2 active Length (mm) from renal artery 0 10 20 30 40 50 60 ∆T(°C)fromreference 0.00 0.25 0.50 0.75
- 16. MMP2activeproMMP2 MMP9 MMPactivity(pixels/mm2) 0 5000 10000 Hot regions Reference rgeions * * * p<0.05 Results III
- 17. Summary • We found that temperature has a positive correlation between mø% and VI-index • We found more pro-MMP2 and active MMP2 inside the hot area’s compared to the cold area’s •We found almost no rise in temperature in presence of blood flow
- 18. Conclusion I • Temperature heterogeneity is associated with a VI-index • The underlying mechanism of this association is mø accumulation • The high MMP-activity suggests that active mø are detected by temperature changes
- 19. Conclusion II • We have seen in our model that it is almost impossible to measure temperature differences in presence of blood flow
- 20. Discussion • Blood has a cooling effect on the vessel wall, and blood flow is high in the rabbit’s abdominal aorta (twice human coronary flow). • Therefore to exclude a dominant flow effect on our measurements, we stopped the flow with a balloon
- 21. Co-operation • Catherization laboratory Prof. Dr. PW Serruys Dr. W. van der Giessen • Experimental Cardiology Rotterdam L.C.A van Damme C. van Pelt B. Mousavi Gourabi W. Maat D. Segers C. Cheng Dr. R. Krams Dr. D.J. Duncker • Experimental Cardiology Utrecht Dr. G. Pasterkamp C. Snijder A. Schoneveld • Thermocore Medical Systems Dr. G. Van Langenhove Dr. T. Flint Dr. Y. Yianni • Middelheim Hospital Antwerpen S. Verheye M. Kockx M. Knaapen