Adeli 21 24
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1) The document discusses insulin signaling and VLDL overproduction in insulin resistance. It examines how fructose feeding impairs hepatic tyrosine phosphorylation of the insulin receptor, IRS-1, and IRS-2 in hamsters. 2) It also finds evidence for reduced PI3-kinase activity, reduced Akt phosphorylation, and enhanced PTP-1B mass and activity in fructose-fed hamsters. 3) The document shows that inhibition of cellular phosphatase activity with vanadate enhances insulin signaling, increases insulin receptor phosphorylation, reduces cellular and secreted ApoB levels, and stabilizes ApoB, reducing its secretion.
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The document discusses research into producing recombinant forms of the Cynara cardunculus Cyprosins, which are aspartic proteinases with milk clotting activity found in cardoon flowers. Researchers constructed expression cassettes containing genes for the Cyprosins with different signal sequences and expressed them in Saccharomyces cerevisiae. Cyprosin A was produced intracellularly but was inactive. Cyprosin B was actively secreted when expressed with the MFα1 presequence and native prosequence. A site-directed mutagenesis was performed to change the active site sequence of Cyprosin B from Asp-Ser-Gly to Asp-Thr-Gly as in other aspartic proteinases, but
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This document discusses two types of mRNA vaccines: non-replicating mRNA and self-amplifying mRNA. Self-amplifying mRNA contains non-structural genes that allow for self-amplification of the mRNA within cells. It works by inserting the nucleic acid sequence encoding the antigen directly into single-stranded RNA viruses like Semliki Forest virus or yellow fever virus.
Percutaneouse coronary intervention
Balloon angioplasty was first performed in 1977 and involved passing a guide wire and deflated balloon catheter across a stenosis, inflating the balloon to enlarge the vessel lumen, and removing the balloon. Major advances in technology led to an increase in PCI procedures surpassing CABG. Stents were a major development as they reduced complications like abrupt closure and restenosis compared to balloon angioplasty alone.
Thermography early clinical correlations
Thermography involves using a catheter with temperature sensors to record temperatures in coronary arteries. The study assessed a thermography catheter system in 12 patients, finding a 92% success rate. Temperature increases up to 0.36°C were detected in focal areas, or "hot spots", in 4 of 11 patients. Hot spots corresponded to sites of plaque rupture and matched areas identified on angiography as having significant stenosis. Thermography may help identify high-risk plaque before intervention and guide treatment.
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The document discusses collagenases and their role in plaque vulnerability and stability. It presents evidence that:
1) Macrophages in human and experimental atherosclerotic plaques express collagenases like MMP-1, MMP-8, and MMP-13 which can degrade collagen.
2) Lipid lowering in rabbits reduces macrophage accumulation and collagenase expression in plaques, while increasing collagen content, suggesting collagenases regulate collagen balance.
3) Mice with genetically reduced collagenase activity have altered collagen content in plaques, providing direct evidence collagenases regulate plaque collagen levels.
Adeli 25 28
This document discusses several potential mechanisms of insulin resistance including increased levels and activity of PTP-1B, impaired phosphorylation of the insulin receptor and IRS-1, reduced PI-3 kinase activity, and attenuated insulin signaling. This leads to reduced phosphorylation of ApoB or its chaperone, enhanced stability and accelerated assembly of ApoB, and overproduction of VLDL. The document also discusses the contribution of intestinal lipoproteins to metabolic dyslipidemia in insulin resistance, including a hypothesis that fasting and postprandial hyperlipidemia may be attributable to intestinal oversecretion of apoB-48 containing lipoproteins. An experimental approach is described to test this using a high fructose fed hamster
Tlr4 circulation
1) The study demonstrates that TLR-4 is preferentially expressed by macrophages in murine and human lipid-rich atherosclerotic lesions.
2) In both mouse and human plaques, TLR-4 expression colocalized with macrophage staining.
3) In vitro, oxidized LDL upregulated TLR-4 mRNA expression in human macrophages in a dose-dependent manner, whereas native LDL had no effect. This suggests TLR-4 may provide a link between lipids and inflammation in atherosclerosis.
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The document discusses research into producing recombinant forms of the Cynara cardunculus Cyprosins, which are aspartic proteinases with milk clotting activity found in cardoon flowers. Researchers constructed expression cassettes containing genes for the Cyprosins with different signal sequences and expressed them in Saccharomyces cerevisiae. Cyprosin A was produced intracellularly but was inactive. Cyprosin B was actively secreted when expressed with the MFα1 presequence and native prosequence. A site-directed mutagenesis was performed to change the active site sequence of Cyprosin B from Asp-Ser-Gly to Asp-Thr-Gly as in other aspartic proteinases, but
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Percutaneouse coronary intervention
Balloon angioplasty was first performed in 1977 and involved passing a guide wire and deflated balloon catheter across a stenosis, inflating the balloon to enlarge the vessel lumen, and removing the balloon. Major advances in technology led to an increase in PCI procedures surpassing CABG. Stents were a major development as they reduced complications like abrupt closure and restenosis compared to balloon angioplasty alone.
Thermography early clinical correlations
Thermography involves using a catheter with temperature sensors to record temperatures in coronary arteries. The study assessed a thermography catheter system in 12 patients, finding a 92% success rate. Temperature increases up to 0.36°C were detected in focal areas, or "hot spots", in 4 of 11 patients. Hot spots corresponded to sites of plaque rupture and matched areas identified on angiography as having significant stenosis. Thermography may help identify high-risk plaque before intervention and guide treatment.
Masanori aikawa powerpoint
The document discusses collagenases and their role in plaque vulnerability and stability. It presents evidence that:
1) Macrophages in human and experimental atherosclerotic plaques express collagenases like MMP-1, MMP-8, and MMP-13 which can degrade collagen.
2) Lipid lowering in rabbits reduces macrophage accumulation and collagenase expression in plaques, while increasing collagen content, suggesting collagenases regulate collagen balance.
3) Mice with genetically reduced collagenase activity have altered collagen content in plaques, providing direct evidence collagenases regulate plaque collagen levels.
Adeli 25 28
This document discusses several potential mechanisms of insulin resistance including increased levels and activity of PTP-1B, impaired phosphorylation of the insulin receptor and IRS-1, reduced PI-3 kinase activity, and attenuated insulin signaling. This leads to reduced phosphorylation of ApoB or its chaperone, enhanced stability and accelerated assembly of ApoB, and overproduction of VLDL. The document also discusses the contribution of intestinal lipoproteins to metabolic dyslipidemia in insulin resistance, including a hypothesis that fasting and postprandial hyperlipidemia may be attributable to intestinal oversecretion of apoB-48 containing lipoproteins. An experimental approach is described to test this using a high fructose fed hamster
Tlr4 circulation
1) The study demonstrates that TLR-4 is preferentially expressed by macrophages in murine and human lipid-rich atherosclerotic lesions.
2) In both mouse and human plaques, TLR-4 expression colocalized with macrophage staining.
3) In vitro, oxidized LDL upregulated TLR-4 mRNA expression in human macrophages in a dose-dependent manner, whereas native LDL had no effect. This suggests TLR-4 may provide a link between lipids and inflammation in atherosclerosis.
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This document summarizes research on using stents to stabilize vulnerable plaques. It begins by introducing different animal models used to study vulnerable plaques, such as rabbits, swine, and transgenic models. Histological analysis of the plaques in these models shows similarities to human plaques. The document then analyzes plaque characteristics and vascular healing in a rabbit model stented with metallic, beta-estradiol, and everolimus drug-eluting stents. Results show stents reduced lipid core area and increased fibrous cap thickness compared to non-stented plaques. However, stent-induced fibrous cap rupture was common and associated with increased neointimal proliferation. In conclusion, new stent designs that reduce fibrous
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This document proposes 5 scientific research projects and 6 core projects for a Program Project Grant from the NIH to study detection of vulnerable plaque and vulnerable patients. The 5 research projects are: 1) MRI imaging of inflammation and vulnerable plaque in humans and animals; 2) Intravascular thermography to detect inflammation in plaque; 3) Development of new MRI and CT nanoparticle contrast agents; 4) Development of enhanced intravascular and surface MRI coils; 5) Imaging of vulnerable patients using CT and a new calcium scoring system in humans. The 6 core projects provide support in pathology, MRI, microCT, image processing, data analysis, and administration.
096 mri imaging of atherosclerosis using spio
Schmitz et al studied the use of ultrasmall superparamagnetic iron oxide (USPIO) particles to enhance MRI imaging of atherosclerosis in rabbits. They administered different doses of USPIO to rabbits and imaged them at various time points up to 48 hours later. Their results demonstrated contrast enhancement of atherosclerotic plaques on MRI scans after USPIO injection.
Old vulnerable patient slides with movies
The document discusses vulnerable plaques and criteria for defining them based on the study of culprit plaques. It outlines major criteria like outward remodeling, endothelial dysfunction, and thin cap with large lipid core. It also discusses markers of vulnerability at the plaque/artery level including plaque morphology, activity, and pan-arterial markers. Conditions and markers associated with myocardial vulnerability are also outlined.
Molecular genetics
This document provides an overview of basic molecular genetic methodologies and their applications in studying atherosclerosis. It describes several key techniques used in molecular genetics research, such as polymerase chain reaction (PCR), gel electrophoresis, Southern blotting, and DNA sequencing. It also discusses methods for detecting genetic variations like single nucleotide polymorphisms. The document then covers various applications of these techniques in genomic analysis and molecular studies of cardiovascular diseases like atherosclerosis.
Out of hospital
I. Out-of-hospital sudden cardiac death remains a major public health problem, accounting for over 400,000 deaths per year in the United States.
II. While there is evidence that rates of cardiac deaths occurring in hospitals have declined slightly due to emergency services improvements, pre-hospital delay times have not improved significantly and remain a challenge.
III. Rapid out-of-hospital screening, detection and treatment of patients experiencing cardiac chest symptoms represents the most promising strategy for reducing out-of-hospital sudden cardiac deaths according to the conclusions of the document.
Virmani
The document discusses multiple coronary stent implantations and outcomes. A sirolimus-eluting stent was implanted in the left anterior descending coronary artery (LAD) 16 months prior. Another sirolimus-eluting stent was implanted in the LAD 6 months prior. A multilink stent was implanted in the right coronary artery (RCA) 24 months prior.
081 carotid artery plaque
This document contains images and descriptions of various plaques and lesions found in arteries and the heart from MRI studies. It shows a plaque in the left internal carotid artery with a resolution of 450μm, a 4.5mm plaque in the aorta identified as a type Va fibroatheroma, and images of a plaque and wall of the left anterior descending coronary artery comparing MRI to X-ray angiogram. The sources listed are papers and studies from 2000 from Imaging Science Laboratories at Mount Sinai School of Medicine.
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The document discusses the role of interleukin-18 (IL-18) and its binding protein (IL-18BP) in atherosclerosis. It finds that higher levels of IL-18 are associated with more unstable atherosclerotic plaques and acute coronary events. Experiments inhibiting IL-18 signaling through overexpression of IL-18BP in mice prevented atherosclerosis and produced more stable plaques with reduced macrophages, increased smooth muscle cells and collagen. The conclusion is that IL-18/IL-18BP regulation critically impacts atherosclerosis and inhibiting IL-18 may help reduce plaque progression and promote stability.
087 mri of atherosclerotic plaque in apo e ko mice
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The document discusses using MRI and USPIO particles to study atherosclerotic plaques in Apo E knockout mice. Apo E knockout mice are commonly used as a model for human atherosclerosis because they develop lesions similar to humans. The study aims to show uptake of USPIO particles in plaques and evaluate their potential use for non-invasive plaque stabilization through hyperthermia treatment. Preliminary experiments will examine the optimal timing for hyperthermia and track plaque changes serially using MRI and pathology after USPIO injection in Apo E mice.Nir catheter final
This study aimed to develop a non-destructive method of measuring lactate concentration in atherosclerotic plaques using near-infrared spectroscopy. Human carotid plaques were maintained ex vivo under physiologic conditions for extended measurements. Measurements of pH, temperature, PO2 and PCO2 over time validated plaque viability. Near-infrared spectroscopy measurements of lactate correlated well with destructive assays, suggesting feasibility of non-destructively assessing plaque activity and vulnerability.
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This document summarizes research on matrix metalloproteinases (MMPs) and their role in weakening atherosclerotic plaques. It finds that MMPs are expressed in human atherosclerotic plaques, especially in macrophage foam cells located in the vulnerable shoulders of plaques. Several MMPs have been shown to degrade components of the fibrous cap, including collagen. Reactive oxygen species produced by macrophage foam cells can activate latent MMPs. Treatments that reduce oxidative stress, such as N-acetyl cysteine, decrease MMP expression and activity in experimental atherosclerosis. Overall, the document provides evidence that MMPs expressed by macrophage foam cells may weaken plaques through degradation of the fibrous cap, making plaques more
Mri system block diagram
This document provides an overview of MRI system components and basic MRI physics concepts. It includes:
1) A diagram of the main components of an MRI system, including RF coils, gradient coils, and amplifiers.
2) Tables listing common NMR-active nuclei and their properties important for MRI.
3) Explanations of spin alignment in magnetic fields, Larmor frequency, spin excitation, free induction decay, Bloch equations, T1 and T2 relaxation, and slice selection techniques.
Near infrared spectroscopy 2
This document discusses near-infrared (NIR) spectroscopy and its potential for detecting vulnerable plaque. It provides background on NIR spectroscopy and how it works. The document also compares NIR spectroscopy to infrared (IR) spectroscopy and Raman spectroscopy in terms of their strengths and weaknesses. It describes previous research that has used NIR spectroscopy to detect plaque characteristics. The document concludes that while NIR spectroscopy shows promise for this application, more research funding is still needed to fully realize its potential.
Adeli 9 20
1) The document discusses mechanisms of VLDL overproduction in insulin resistance using a fructose-fed hamster model.
2) Hamsters fed a high fructose diet develop insulin resistance, hypertriglyceridemia, and increased hepatic VLDL production.
3) Studies show that insulin resistance in hamster liver leads to overexpression of MTP and overproduction of VLDL, possibly due to disruption of insulin signaling pathways involving IRS-1 and PI3-kinase.
195 hepatic synthesis and secretion of vldl
1) The document discusses mechanisms of VLDL overproduction in insulin resistance using a fructose-fed hamster model.
2) Hamsters fed a high fructose diet develop insulin resistance, hypertriglyceridemia, and increased hepatic VLDL production.
3) Studies show that insulin resistance in hamster liver leads to overexpression of MTP and overproduction of VLDL, possibly due to disruption of insulin signaling pathways involving IRS-1 and PI3-kinase.
Slides 9 20
1) The document discusses mechanisms of VLDL overproduction in insulin resistance, using a fructose-fed hamster model.
2) Hamsters fed a high fructose diet develop insulin resistance, hypertriglyceridemia, and increased hepatic VLDL production.
3) Studies show that insulin resistance in hamster hepatocytes leads to overexpression of MTP and overproduction of VLDL, possibly due to disruption of insulin signaling pathways involved in lipid metabolism.
195 hepatic synthesis and secretion of vldl
1) The document discusses mechanisms of VLDL overproduction in insulin resistance using a fructose-fed hamster model.
2) Hamsters fed a high fructose diet develop insulin resistance, hypertriglyceridemia, and increased hepatic VLDL production.
3) Studies show that insulin resistance in hamster liver leads to overexpression of MTP and overproduction of VLDL, possibly due to disruption of insulin signaling pathways involving IRS-1 and PI3-kinase.
Slides920
1) The document discusses mechanisms of VLDL overproduction in insulin resistance using a fructose-fed hamster model.
2) Hamsters fed a high fructose diet develop insulin resistance, hypertriglyceridemia, and increased hepatic VLDL production.
3) Studies show enhanced MTP expression and VLDL secretion in hepatocytes from fructose-fed hamsters, suggesting insulin resistance leads to overproduction of VLDL particles in the liver.
Slides2528
This document discusses several potential mechanisms of insulin resistance including increased levels and activity of PTP-1B, impaired phosphorylation of the insulin receptor and IRS-1, reduced PI-3 kinase activity, and attenuated insulin signaling. This leads to reduced phosphorylation of ApoB or its chaperone, enhanced stability and accelerated assembly of ApoB, and overproduction of VLDL. The document also discusses the contribution of intestinal lipoproteins to metabolic dyslipidemia in insulin resistance, including a hypothesis that fasting and postprandial hyperlipidemia may be attributable to intestinal oversecretion of apoB-48 containing lipoproteins. An experimental approach is described to test this using a high fructose fed hamster
Slides 25 28
This document discusses several potential mechanisms of insulin resistance including increased levels and activity of PTP-1B, impaired phosphorylation of the insulin receptor and IRS-1, reduced PI-3 kinase activity, and attenuated insulin signaling. This leads to reduced phosphorylation of ApoB or its chaperone, enhanced stability and accelerated assembly of ApoB, and overproduction of VLDL. The document also discusses the contribution of intestinal lipoproteins to metabolic dyslipidemia in insulin resistance, including a hypothesis that fasting and postprandial hyperlipidemia may be attributable to intestinal oversecretion of apoB-48 containing lipoproteins. An experimental approach is described to test this using a high fructose fed hamster
183 postulated mechanisms of insulin resistance
This document discusses several potential mechanisms of insulin resistance including increased levels and activity of PTP-1B, impaired phosphorylation of the insulin receptor and IRS-1, reduced PI-3 kinase activity, and attenuated insulin signaling. This leads to reduced phosphorylation of ApoB or its chaperone, enhanced stability and accelerated assembly of ApoB, and overproduction of VLDL. The document also discusses the contribution of intestinal lipoproteins to metabolic dyslipidemia in insulin resistance, and a hypothesis that fasting and postprandial hyperlipidemia in insulin resistant states may be attributable in part to intestinal oversecretion of apoB-48 containing lipoproteins.
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This document summarizes research on using stents to stabilize vulnerable plaques. It begins by introducing different animal models used to study vulnerable plaques, such as rabbits, swine, and transgenic models. Histological analysis of the plaques in these models shows similarities to human plaques. The document then analyzes plaque characteristics and vascular healing in a rabbit model stented with metallic, beta-estradiol, and everolimus drug-eluting stents. Results show stents reduced lipid core area and increased fibrous cap thickness compared to non-stented plaques. However, stent-induced fibrous cap rupture was common and associated with increased neointimal proliferation. In conclusion, new stent designs that reduce fibrous
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This document proposes 5 scientific research projects and 6 core projects for a Program Project Grant from the NIH to study detection of vulnerable plaque and vulnerable patients. The 5 research projects are: 1) MRI imaging of inflammation and vulnerable plaque in humans and animals; 2) Intravascular thermography to detect inflammation in plaque; 3) Development of new MRI and CT nanoparticle contrast agents; 4) Development of enhanced intravascular and surface MRI coils; 5) Imaging of vulnerable patients using CT and a new calcium scoring system in humans. The 6 core projects provide support in pathology, MRI, microCT, image processing, data analysis, and administration.
096 mri imaging of atherosclerosis using spio
Schmitz et al studied the use of ultrasmall superparamagnetic iron oxide (USPIO) particles to enhance MRI imaging of atherosclerosis in rabbits. They administered different doses of USPIO to rabbits and imaged them at various time points up to 48 hours later. Their results demonstrated contrast enhancement of atherosclerotic plaques on MRI scans after USPIO injection.
Old vulnerable patient slides with movies
The document discusses vulnerable plaques and criteria for defining them based on the study of culprit plaques. It outlines major criteria like outward remodeling, endothelial dysfunction, and thin cap with large lipid core. It also discusses markers of vulnerability at the plaque/artery level including plaque morphology, activity, and pan-arterial markers. Conditions and markers associated with myocardial vulnerability are also outlined.
Molecular genetics
This document provides an overview of basic molecular genetic methodologies and their applications in studying atherosclerosis. It describes several key techniques used in molecular genetics research, such as polymerase chain reaction (PCR), gel electrophoresis, Southern blotting, and DNA sequencing. It also discusses methods for detecting genetic variations like single nucleotide polymorphisms. The document then covers various applications of these techniques in genomic analysis and molecular studies of cardiovascular diseases like atherosclerosis.
Out of hospital
I. Out-of-hospital sudden cardiac death remains a major public health problem, accounting for over 400,000 deaths per year in the United States.
II. While there is evidence that rates of cardiac deaths occurring in hospitals have declined slightly due to emergency services improvements, pre-hospital delay times have not improved significantly and remain a challenge.
III. Rapid out-of-hospital screening, detection and treatment of patients experiencing cardiac chest symptoms represents the most promising strategy for reducing out-of-hospital sudden cardiac deaths according to the conclusions of the document.
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The document discusses multiple coronary stent implantations and outcomes. A sirolimus-eluting stent was implanted in the left anterior descending coronary artery (LAD) 16 months prior. Another sirolimus-eluting stent was implanted in the LAD 6 months prior. A multilink stent was implanted in the right coronary artery (RCA) 24 months prior.
081 carotid artery plaque
This document contains images and descriptions of various plaques and lesions found in arteries and the heart from MRI studies. It shows a plaque in the left internal carotid artery with a resolution of 450μm, a 4.5mm plaque in the aorta identified as a type Va fibroatheroma, and images of a plaque and wall of the left anterior descending coronary artery comparing MRI to X-ray angiogram. The sources listed are papers and studies from 2000 from Imaging Science Laboratories at Mount Sinai School of Medicine.
092 il18 and il18 bp in atherosclerosis
The document discusses the role of interleukin-18 (IL-18) and its binding protein (IL-18BP) in atherosclerosis. It finds that higher levels of IL-18 are associated with more unstable atherosclerotic plaques and acute coronary events. Experiments inhibiting IL-18 signaling through overexpression of IL-18BP in mice prevented atherosclerosis and produced more stable plaques with reduced macrophages, increased smooth muscle cells and collagen. The conclusion is that IL-18/IL-18BP regulation critically impacts atherosclerosis and inhibiting IL-18 may help reduce plaque progression and promote stability.
087 mri of atherosclerotic plaque in apo e ko mice
087 mri of atherosclerotic plaque in apo e ko miceSociety for Heart Attack Prevention and Eradication
The document discusses using MRI and USPIO particles to study atherosclerotic plaques in Apo E knockout mice. Apo E knockout mice are commonly used as a model for human atherosclerosis because they develop lesions similar to humans. The study aims to show uptake of USPIO particles in plaques and evaluate their potential use for non-invasive plaque stabilization through hyperthermia treatment. Preliminary experiments will examine the optimal timing for hyperthermia and track plaque changes serially using MRI and pathology after USPIO injection in Apo E mice.Nir catheter final
This study aimed to develop a non-destructive method of measuring lactate concentration in atherosclerotic plaques using near-infrared spectroscopy. Human carotid plaques were maintained ex vivo under physiologic conditions for extended measurements. Measurements of pH, temperature, PO2 and PCO2 over time validated plaque viability. Near-infrared spectroscopy measurements of lactate correlated well with destructive assays, suggesting feasibility of non-destructively assessing plaque activity and vulnerability.
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This document summarizes research on matrix metalloproteinases (MMPs) and their role in weakening atherosclerotic plaques. It finds that MMPs are expressed in human atherosclerotic plaques, especially in macrophage foam cells located in the vulnerable shoulders of plaques. Several MMPs have been shown to degrade components of the fibrous cap, including collagen. Reactive oxygen species produced by macrophage foam cells can activate latent MMPs. Treatments that reduce oxidative stress, such as N-acetyl cysteine, decrease MMP expression and activity in experimental atherosclerosis. Overall, the document provides evidence that MMPs expressed by macrophage foam cells may weaken plaques through degradation of the fibrous cap, making plaques more
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This document provides an overview of MRI system components and basic MRI physics concepts. It includes:
1) A diagram of the main components of an MRI system, including RF coils, gradient coils, and amplifiers.
2) Tables listing common NMR-active nuclei and their properties important for MRI.
3) Explanations of spin alignment in magnetic fields, Larmor frequency, spin excitation, free induction decay, Bloch equations, T1 and T2 relaxation, and slice selection techniques.
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This document discusses near-infrared (NIR) spectroscopy and its potential for detecting vulnerable plaque. It provides background on NIR spectroscopy and how it works. The document also compares NIR spectroscopy to infrared (IR) spectroscopy and Raman spectroscopy in terms of their strengths and weaknesses. It describes previous research that has used NIR spectroscopy to detect plaque characteristics. The document concludes that while NIR spectroscopy shows promise for this application, more research funding is still needed to fully realize its potential.
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AHA SHAPE Symposium 2017 Dr. Greenland Presentation
AHA SHAPE Symposium 2017 Dr. Greenland PresentationSociety for Heart Attack Prevention and Eradication
The document introduces the All of Us Research Program, which aims to collect health data from one million Americans to advance precision medicine research. It was announced by President Obama in 2015. The program receives funding from the federal government and private partners. It collects various types of health data from participants through surveys, health records, samples, and devices. The data is stored and shared securely while protecting privacy. The goal is to generate new medical discoveries and more personalized healthcare through collaboration between researchers and participants.AHA SHAPE Symposium 2017 Dr. Yen Presentation
A machine learning model outperformed the ACC/AHA Pooled Cohort Equations Risk Calculator in detecting high-risk asymptomatic individuals and recommending statin treatment for cardiovascular disease prevention in the Multi-Ethnic Study of Atherosclerosis. The machine learning model used support vector machines and data augmentation to derive a CVD risk predictor from nine variables in the MESA study population. It demonstrated higher sensitivity, specificity, and AUC compared to the ACC/AHA risk calculator, recommending statin treatment for fewer individuals while missing fewer cardiovascular events.
AHA SHAPE Symposium 2017 Dr. Slomka Presentation
This document discusses machine learning applications in cardiac imaging presented by Piotr Slomka. It describes how machine learning can improve image analysis, diagnosis, and risk prediction. Machine learning combines multiple data points like imaging and clinical data to predict outcomes. Deep learning can perform tasks like image segmentation. Machine learning provides quantitative scores that predict disease, need for intervention, or patient outcomes to help clinicians. The goal is to integrate machine learning into clinical decision making.
Vu lplaque1 pasterkamp
This document summarizes a post-mortem 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/heavy inflammation. There was no observed relationship between the degree of inflammation in the left and right coronary arteries within individuals, indicating the level of local inflammation is locally determined with little predictive value for other arteries.
Vulnerable plaque vulnerable patient
The document provides guidelines for defining vulnerable plaque and vulnerable patients from the Association for Eradication of Heart Attack. It outlines major and minor histopathological and clinical criteria for vulnerable plaque including active inflammation, thin fibrous cap with large lipid core, endothelial denudation, and stenosis. Potential screening and diagnostic methods are discussed at the plaque, systemic, and blood levels ranging from non-invasive imaging to intravascular techniques. Different types of vulnerable plaque that can cause acute coronary events are also categorized.
Vulnerable plaque overview
Vulnerable plaque refers to dangerous forms of atherosclerotic plaques that can rupture or induce thrombosis, disrupting blood flow. The document discusses the history and research around vulnerable plaque, including pioneers in the field and emerging techniques to detect vulnerable plaque such as intravascular ultrasound, optical coherence tomography, and magnetic resonance imaging. It summarizes that vulnerable plaques are typically characterized by a thin fibrous cap, large lipid core, and presence of macrophages.
Vulnerable patient talk in poland
The document summarizes research on vulnerable plaques and markers of vulnerability. It finds that ruptured plaques are the most common type of culprit lesion, accounting for around 70% of cases. Major criteria for defining vulnerable plaque include outward remodeling, endothelial dysfunction, and a thin fibrous cap with a large lipid core. Both plaque morphology and activity need to be assessed to identify vulnerability.
Vulnerable patient slides without movies
This document contains a summary of a presentation on vulnerable patient syndrome. It includes PowerPoint slides and videos on defining and identifying vulnerable plaques and patients. It thanks sponsors for their support of the educational event. The slides define vulnerable plaques as those likely to rupture in the future, causing heart attacks, and provide criteria for identifying them based on morphology and activity. Biomarkers and conditions that increase plaque and myocardial vulnerability are also summarized. The presentation outlines a pyramid approach for screening, diagnosing, and treating vulnerable patients annually to help reduce heart attacks and their high costs.
Vulnerable patient mar 04
This document discusses triggers for sudden cardiac arrest (SCA) and death (SCD). It notes that over 2/3 of SCD cases are unable to be predicted due to a lack of well-established risk factors. While population risk factors can identify at-risk groups, they cannot predict risk for individuals. The document explores various biological, anatomical, and environmental factors that can precipitate fatal arrhythmias and discusses how the timing of transient initiating events is critical for the development of ventricular tachyarrhythmias. It emphasizes that myocardial electrophysiological processes likely determine the onset or lack of VT/VF/SCD and that immediate access to automated external defibrillators is needed to save lives.
Vulnerable (thrombogenic blood
This document summarizes presentations from symposia on vulnerable plaque and discusses the relationship between plaque, blood, and patients in atherothrombosis. It notes that multiple factors like diabetes, smoking, and hyperlipidemia can make blood more thrombogenic and moderate the severity of acute events after plaque rupture. Statins, aspirin, and other drugs that target tissue factor or thrombin pathways may be promising antithrombotic agents by inhibiting thrombosis initiation and propagation.
Vuln shape aha 2005
The document discusses vulnerable plaque and challenges in detecting and treating it. It describes various imaging techniques for detecting vulnerable plaque such as thermography, MRI, CT angiography, and optical coherence tomography. However, it notes that while these can identify high-risk features, it remains unclear what exactly defines vulnerable plaque and whether imaging findings truly correlate with risk. The document also notes that while statins reduce events, the relationship between plaque burden and events is unclear, and better defining and detecting the disease is still needed before new therapies can be developed.
Vuln plaque poster burke
1) The study examined 92 hearts from patients with severe coronary artery disease who died suddenly. The hearts were sectioned and plaque types were classified.
2) The number of "vulnerable" plaques, particularly thin cap atheromas, was highest in hearts of patients who died from acute plaque rupture and lowest in those with incidental disease.
3) Thin cap atheromas and other unstable plaque types were concentrated in the proximal coronary segments, similar to the distribution of plaque ruptures. The study suggests vulnerable plaques contribute to acute coronary syndromes and are non-uniformly distributed within the coronary arteries.
Vp watch editorial_slide 25short-
1) Drug-coated stents, particularly those coated with sirolimus, have shown promise in reducing restenosis compared to bare metal stents. Sirolimus inhibits cell proliferation and has been shown in studies to reduce intimal hyperplasia and restenosis in animal models by 50% or more.
2) A study by Suzuki et al. found that a sirolimus-coated stent reduced restenosis by 50% through inhibiting cellular proliferation in a dose-dependent manner compared to a bare metal stent. Adding dexamethasone to the coating did not provide additional benefit.
3) If results of the RAVEL clinical trial showing "zero" restenosis out to 5 years
Vp watch editorial_slide25
This document discusses drug-coated stents for preventing restenosis. It summarizes a study showing that stents coated with sirolimus via a polymer matrix reduced restenosis by 50% by inhibiting cell proliferation. Adding dexamethasone provided no additional benefit. Other studies also showed sirolimus inhibits smooth muscle cell proliferation. If results of the RAVEL trial showing "zero" restenosis at 210 days hold true long-term, sirolimus-coated stents may become the standard therapy for coronary revascularization. Questions are raised about whether coating vulnerable plaques could be a primary treatment and if multiple vulnerable plaques would all be stented.
Vp watch editorial_slide25short-
1) Drug-coated stents, particularly those coated with sirolimus, have shown promise in reducing restenosis compared to bare metal stents. Sirolimus inhibits cell proliferation and has been shown in studies to reduce intimal hyperplasia and restenosis in animal models by 50% or more.
2) A study by Suzuki et al. found that a sirolimus-coated stent reduced restenosis by 50% through inhibiting cellular proliferation in a dose-dependent manner compared to a bare metal stent. Adding dexamethasone to the coating did not provide additional benefit.
3) If results of the RAVEL clinical trial showing "zero" restenosis out to 5 years
Vp watch2002
I. This document discusses various animal models that have been used to study atherosclerosis and plaque rupture, including quail, pigeons, chickens, dogs, monkeys, pigs, rats, rabbits, and mice. It provides details on the types of lesions developed and similarities to human disease for each model.
II. The double knockout LDL/apoE mice are highlighted as offering improvements in studying clinical complications of atherosclerosis like human heart disease. However, it is unclear how closely they model vulnerable plaques.
III. Questions are raised about how closely the coagulation systems of these animal models resemble humans and whether any model fully captures repeated plaque ruptures and the role of aging in natural history as seen in humans.
Vp symposium31602
Trans-Blood Vision is a patented infrared technique that uses short-wave infrared wavelengths to see directly through blood. It has the potential to find vulnerable plaque lesions without first entering them, determine their size and surface characteristics in high resolution, and look at their material constituents both on and below the surface. While it cannot provide direct visual guidance for therapy or penetrate as deeply as ultrasound, combining it with augmentative technologies could allow for real-time multi-mode detection, analysis, and therapy guidance of vulnerable plaque lesions. The document concludes that Trans-Blood Vision warrants significant investigation, possibly in combination with other emerging technologies.
Vpschoenhagen
This study used intravascular ultrasound to examine arterial remodeling and plaque characteristics in 131 patients with either stable angina or recent unstable symptoms. Patients with unstable presentations had greater plaque burden at the culprit lesion despite similar luminal narrowing, and a greater extent of positive arterial remodeling compared to those with stable angina. The culprit lesions in unstable patients also showed a higher rate of echolucent plaque morphology. This suggests that bulky, remodeled plaques may be more vulnerable to rupture, leading to acute coronary syndromes. Further prospective study is needed to better understand the relationship between clinical presentation and plaque features.
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- 1. CytosolCytosol HepatocyteHepatocyte ApoB DegradationDegradation 5' 3' ApoB mRNAApoB mRNA TranslationTranslation ERMembraneERMembrane Insulin IRS1/IRS2 IR InsulinSignalingPathway InsulinSignalingPathway Plasm a Plasm a VLDLVLDL Insulin Signaling & VLDL OverproductionInsulin Signaling & VLDL Overproduction in Insulin Resistancein Insulin Resistance PI3-Kinase VLDL AssemblyVLDL Assembly PIP3/Phosphorylation CascadePIP3/Phosphorylation Cascade Akt/PKBAkt/PKB PTP-1BPTP-1B 3'
- 2. D InsulinReceptorproteinMass (scanningunits/mgproteinx10-3 ) Control Fructose-fed Control Fructose-fed 0 50 100 150 200 250 IRS-1ProteinMass (scanningunits/mgproteinx10-3 ) Control Fructose-fed Control Fructose-fed 0 40 80 120 E F Control Fructose-fed 0 20 40 60 80 100 120 Control Fructose-fed IRS-2Mass(percentofcontrol) C PhosphorylatedIRS-2 (relativetobasallevelofcontrol) 0 20 40 60 80 100 120 140 160 180 _ + _ + Insulin + + + +Insulin _ _ _ _ Control Fructose-fed Control Fructose-fed Impaired Hepatic Tyrosine Phosphorylation of Insulin Receptor, IRS-1, and IRS-2 in Fructose-Fed Hamsters A PhosphorylatedInsulinReceptorMass (scanningunits/mgproteinx10-3 ) Control Fructose-fed 0 100 200 300 400 500 600 _ + _ + Insulin + + + +Insulin _ _ _ _ * B _ + _ + Insulin PhosphorylatedIRS-1 (scanningunits/mgproteinx10-3 ) Control Fructose-fed 0 20 40 60 80 100 120 Control Fructose-fed + + + +Insulin _ _ _ _ P= 0.04 P= 0.009 P= 0.02 P= 0.03 P= 0.029 * *
- 3. B 0 50 100 150 200 PTP-1BMass (percentofcontrol) Control Fructose-fed Control Fructose-fed C 0 100 200 300 PTP-1BActivity (percentofcontrol) Control Fructose-fed A 0 20 40 60 80 100 120 PI3-KinaseActivity (percentofcontrol) Control Fructose-fed * ** *** D + + + +Insulin 0 20 40 60 80 100 120 140 Insulin-InducedAktSerine Phosphorylation(%ofcontrol) Control Fructose-fed Insulin _ + _ + E Insulin Insulin-InducedAktThreonine Phosphorylation(%ofcontrol) Control Fructose-fed 0 20 40 60 80 100 120 _ + _ + + + + + Insulin F Control Fructose-fed 20 40 60 80 100 120 140 160 AktProteinMass (percentofcontrol) 0 Control Fructose-fed **** *** * Evidence for Reduced PI-3 Kinase Activity, Reduced Akt Phosphorylation, & Enhanced PTP-1B Mass & Activity
- 4. 0 20 40 60 80 100 120 0 20 40 60 80 Vanadate (µM) RecoveredCellularApoB (relativetountreated) B 0 20 40 60 80 100 120 0 20 40 60 80 Vanadate (µM) RecoveredLabeledMediaApoB (relativetountreated) C Vanadate (µM) RecoveredTotalApoB (relativetountreated) 0 20 40 60 80 100 120 0 20 40 60 80 D Vanadate (µM) 0 10 40 80 IR-pY 0 100 200 300 400 500 600 0 20 40 60 80 Vanadate (µM) InsulinReceptorPhosphorylation (relativetountreated) A 0 10 20 40 80Vanadate (µM) Cellular ApoB Secreted ApoB E Inhibition of Cellular Phosphatase Activity with Vanadate Enhances Insulin Signaling and Reduces ApoB Secretion IR-IR-ppYY Cellular ApoBCellular ApoB ApoB StabilityApoB Stability ApoB SecretionApoB Secretion