No correlation and low agreement of imaging and inflammatory atherosclerosis’ markers in familial hypercholesterolemia
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Presented by: Lilton R.C. Martinez MD, Marcio H. Miname MD, Luiz A. Bortolotto MD, Ana P.M. Chacra MD, Carlos E. Rochitte MD, Andrei C. Sposito MD, Raul D. Santos MD,PhD.
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This document discusses in vivo coronary sinus thermography. It shows graphs of temperature differences over time between the coronary sinus and right atrium in controls and CAD patients, finding a significant difference. It lists ongoing research using thermography to study conditions like tachycardia, arrhythmias, medication effects, heart failure, and organ function. It concludes that new catheters are being developed to increase thermography sensitivity and that coronary sinus temperature may someday provide more patient information than just detecting plaque.
220 statin therapy and coronary calcification
This study investigated whether statin therapy can slow or reverse coronary calcification in hyperlipidemic patients. 72 patients underwent electron beam tomography scans at years 1 and 2: the first year with no lipid treatment, the second year taking cerivastatin. Cerivastatin significantly reduced LDL cholesterol and slowed the progression of coronary calcification, demonstrating an 8.8% increase in calcium volume score from years 1 to 2 compared to a 25% increase with no treatment. While reversal was not shown for the whole group, patients achieving an LDL <100 mg/dl had a slightly negative calcium change. This provides further evidence that statins can slow atherosclerotic progression.
054 vulnerable plaques and vulnerable patients
This document outlines guidelines for defining vulnerable plaques and vulnerable patients from the Association for Eradication of Heart Attack. It discusses how atherosclerotic diseases are not limited to developed countries and are a major cause of death worldwide. Vulnerable plaques, myocardium, and hypercoagulable blood can lead to sudden cardiac death and heart attacks. The document proposes histological and clinical criteria for defining vulnerable plaques and screening methods. It also discusses diagnosing plaque inflammation, thin caps, endothelial dysfunction, and other factors at both the plaque and systemic level.
193 apo b48 secretion and regulation
The document presents research on the secretion and regulation of apolipoprotein B48 (ApoB48) by primary hamster intestinal enterocytes. Studies show increased intracellular stability and oversecretion of ApoB48 from fructose-fed hamster enterocytes. The results suggest that hyperinsulinemia and increased de novo lipogenesis in the intestine may enhance ApoB48 secretion and contribute to elevated triglyceride levels.
203 pathologic substrate of coronary plaque erosion
This document summarizes a study examining the matrix composition of different types of coronary culprit plaques, including stable plaques and those with erosion or rupture. The study found that plaque erosion was associated with accumulation of hyaluronan and decorin, as well as expression of CD44 and immature smooth muscle cells. Plaque erosion may be promoted by these matrix components, particularly hyaluronan binding to CD44, which could increase thrombosis and smooth muscle cell proliferation/migration. The differential accumulation of matrix proteins provides insights into the pathogenesis of plaque erosion.
234 aha 2002 guideline, 1997 or 2002
This document summarizes major developments in understanding cardiovascular disease risk factors over three eras. Era 1 focused on traditional risk factors like cholesterol. Era 2 identified additional non-traditional factors. Era 3 explores novel inflammatory markers. While risk calculators only use Era 1 factors, studies increasingly show the significance of Era 2 and 3 markers. However, the 2002 AHA guideline was cautious to include these newer markers except ankle-brachial index, seeing need for more research. It also did not recognize non-lipid effects of statins or support controversial interventions without further trials.
246 recombinant apolipoprotein ai milano
Two studies were summarized that examined the effects of apolipoprotein A-I Milano (Apo A-I Milano) on atherosclerosis. One study found that a single high dose of recombinant Apo A-I Milano reduced macrophage and lipid content in plaques of Apo E deficient mice by 40-50% and 29-36%, respectively, within 48 hours. The other study found that carriers of the Apo A-I Milano mutant had normal arterial thickness, unlike low-HDL subjects, suggesting the mutant may protect against atherosclerosis despite low HDL levels. Further research is needed to understand the mechanism and effects of Apo A-I Milano and its potential for stabilizing human plaques.
094 spectroscopic fiber optic catheter
This document describes research on using near-infrared spectroscopy to measure pH levels in atherosclerotic plaque via a fiber optic catheter. Previous studies showed plaque pH heterogeneity and that inflamed regions have lower pH. The researchers collected human carotid plaques and used a 3Fr fiber optic catheter prototype to obtain optical reflectance spectra of 17 tissue sites, which were then calibrated to pH readings from micro-electrodes. A partial least squares model achieved a determination coefficient of 0.63 and root mean squared deviation of 0.14 pH units. Further work aims to increase sample size under physiological conditions to better identify vulnerable plaque based on pH levels in vivo.
125 ct based characterization
Growing evidence suggests that CT-based characterization of coronary plaques and arteries is possible. 16 slice multi-detector CT can reliably detect coronary obstructions when combined with heart rate control. It can also identify soft, intermediate, and calcified plaques. This technology has great potential as an initial non-invasive technique to identify vulnerable plaque or arteries in at-risk populations. The combination of CT imaging with serum markers may provide a powerful predictive tool for assessing vulnerability.
105 nir spectroscopy studies
This progress report discusses ongoing near-infrared (NIR) spectroscopy studies. It notes that a new probe design is being developed to improve signal detection in the NIR range. Characterization of a new light source and additional tissue phantom studies are needed. The report identifies ongoing difficulties with depth penetration studies and experimental setup issues. Priorities include analyzing existing data to inform probe redesign, characterizing the new light source, conducting depth penetration and tissue phantom studies, and addressing experimental setup challenges.
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.
Coronary artery disease among asymptomatic diabetic and non-diabetic patients...
This study aimed to determine the prevalence and severity of coronary artery disease (CAD) in asymptomatic diabetic and nondiabetic patients using coronary CT angiography (CCTA). The study found CAD was present in 93% of asymptomatic diabetics compared to 73% of nondiabetics. Obstructive CAD was more common in diabetics at 29% versus 6.6% in nondiabetics. Diabetics also had higher total Agatston scores and more coronary segments with atherosclerosis. The results indicate asymptomatic diabetics have a high prevalence of CAD, suggesting CCTA may be useful for evaluating subclinical disease in this high risk group.
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.
040 center for vulnerable plaque research
This document discusses vulnerable plaque detection using superparamagnetic iron oxide (SPIO) nanoparticles and MRI. It describes how SPIOs are taken up by macrophages in atherosclerotic plaques, decreasing the MRI signal and allowing plaque visualization. Studies in mice and rabbits show SPIO uptake correlates with plaque inflammation and macrophage content on histology. MRI of rabbits post-SPIO injection detected more signal decrease in hypercholesterolemic rabbits compared to controls, indicating potential to identify vulnerable plaque.
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.
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203 pathologic substrate of coronary plaque erosion
203 pathologic substrate of coronary plaque erosion
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Impact of obesity on cardiometabolic risk: Will we lose the battle?
1. Obesity and related conditions like diabetes pose a growing threat to cardiovascular health and mortality. Risk factors like obesity, physical inactivity and diabetes accounted for thousands of additional deaths in the UK from 1981-2000.
2. Studies show obesity is independently associated with coronary endothelial dysfunction and a more malignant form of coronary artery disease. Even modest excess weight increases the risk of acute conditions like unstable angina and myocardial infarction.
3. Visceral abdominal fat is metabolically active and secretes inflammatory proteins that can promote atherosclerosis. Losing weight and reducing inflammation may help lower cardiovascular risk.
Htn1
The document discusses characteristics and treatment of hypertension in the elderly. Key points include:
- Hypertension in the elderly is characterized by increased systolic blood pressure and pulse pressure.
- Lifestyle modifications like exercise, diet changes, and weight loss can help lower blood pressure in the elderly.
- Clinical trials show treating isolated systolic hypertension in the elderly reduces risks of stroke, coronary artery disease, and heart failure.
- Thiazide diuretics have been shown to be as effective as other drug classes for treating elderly hypertension with fewer side effects.
Transplanting cardiac amyloidosis when to refer for heart transplant
1. Transplantation, including heart transplant (OHT) plus stem cell transplant (ASCT) for light chain (AL) amyloidosis or OHT plus liver transplant (OLT) for transthyretin (TTR) amyloidosis, can successfully treat patients with cardiac amyloidosis and heart failure.
2. Patients with AL amyloidosis who died waiting for a heart transplant had more advanced disease and poorer heart function compared to those who received a transplant.
3. Recurrence of cardiac amyloid post-OHT occurred in 19% of AL patients who did not receive chemotherapy beforehand, but none of those treated with chemotherapy had recurrence.
4. Survival after OHT is similar for AL and T
download-key-lessons-on-ldl-c-and-cv-risk.pptx
1) Multiple lines of evidence from meta-analyses, prospective cohort studies, and randomized controlled trials establish that LDL causes atherosclerotic cardiovascular disease (ASCVD).
2) The risk of atherosclerosis and need for treatment depends on LDL levels and increases with age from childhood through older age. Lowering LDL, including to very low levels, reduces ASCVD risk and can regress atherosclerotic plaques.
3) Intensive LDL lowering through combination therapy such as statins plus ezetimibe or PCSK9 inhibitors provides additional cardiovascular benefit beyond statin therapy alone, including in those already at very low LDL levels. The greatest risk reduction occurs in high-risk groups.
Pragmatic Use of Rosuvastatin for CVD Prevention
Rosuvastatin is an effective treatment for cardiovascular disease (CVD) prevention and risk reduction. It provides significant reductions in LDL cholesterol levels with doses as low as 10 mg per day and can reduce LDL by over 50% at higher doses. Multiple studies have shown that rosuvastatin lowers rates of major adverse cardiac events compared to placebo in both primary and secondary prevention populations. Rosuvastatin has also demonstrated plaque regression in coronary arteries and slowed progression of atherosclerosis. It is considered a first-line agent by guidelines for lowering cholesterol and reducing CVD risk.
Federico Villamil - Argentina - Tuesday 29 - Liver Transplantation Towards Ne...
The document discusses liver transplantation criteria and allocation policies in Argentina. It describes how Argentina adopted the MELD/PELD allocation model in 2005, which prioritizes organ allocation based on medical urgency as determined by the MELD/PELD scores. While MELD is an improvement over prior systems, it does not perfectly capture severity of liver disease in all cases. Efforts are ongoing to refine the MELD formula and reduce variability.
Rafael Carmena Rodriguéz en Clinicardio09: Novedades en práctica clínica sobr...
Rafael Carmena Rodriguéz en Clinicardio09: Novedades en práctica clínica sobr...Sociedad Española de Cardiología
Rafael Carmena Rodriguéz en Clinicardio09: Novedades en práctica clínica 2009 sobre dislipemias 2009: Estatinas a dosis alta versus terapia combinadaBenefits of RCA CTO-PCI Based on Clinical Data.pptx
This document summarizes a study from the Department of Cardiology at Tokyo General Hospital investigating the benefits of percutaneous coronary intervention (PCI) for chronic total occlusion (CTO) of the right coronary artery (RCA) based on clinical data from their hospital. The summary is:
1) The study compared outcomes for 14 patients receiving RCA CTO-PCI to 12 patients receiving optimal medical therapy alone over a 2-year follow-up period.
2) There was no significant difference in major adverse cardiac events between the groups, though left ventricular end-diastolic volume was significantly lower in the PCI group.
3) The study suggests RCA CTO-PCI may improve diastolic dysfunction
Incremental predictive value of vascular assessments combined with the Framin...
Presented by:
Kui-Kai Lau, Yap-Hang Chan, Kai-Hang Yiu, MBBS, Sidney Tam, MD, Sheung-Wai Li, MBBS, Chu-Pak Lau, MD, Hung-Fat Tse, MD,PhD.
HIGH SENSITIVE C-REACTIVE PROTEIN (hs-CRP) AND ITS CORRELATION WITH ANGIOGRAP...
Association between the plasma hs-CRP levels and the severity of coronary
stenosis in subjects remains controversial. This cross sectional study was performed in the
Department of Cardiology, Dhaka Medical College during July 2008 to December 2009, to determine whether the concentrations of hs-CRP correlate with the coronary atherosclerotic disease assessed by coronary angiography.
J dhaka med coll. 2010 19(2) 91 97.
This study aimed to determine if levels of high-sensitivity C-reactive protein (hs-CRP) correlate with the severity of coronary artery disease as assessed by coronary angiography. 90 patients undergoing coronary angiography were divided into three groups based on their hs-CRP levels. Significant positive correlations were found between hs-CRP levels and vessel score, stenosis score, and extent score, suggesting higher hs-CRP levels are associated with more extensive coronary artery disease. The results indicate hs-CRP levels may be predictive of the severity of coronary atherosclerosis.
ADA20-Presentation-Slides-REDUCE-IT-DIABETES.pdf
The document discusses results from the REDUCE-IT clinical trial investigating the effects of icosapent ethyl on cardiovascular outcomes in patients with diabetes. Key findings include:
1) Patients taking icosapent ethyl 4g/day had a 25% reduced risk of the primary composite endpoint of cardiovascular death, non-fatal myocardial infarction, non-fatal stroke, coronary revascularization, or unstable angina requiring hospitalization compared to placebo.
2) For the key secondary composite of cardiovascular death, non-fatal myocardial infarction, or non-fatal stroke, icosapent ethyl was associated with a 26% reduced risk compared to placebo.
3) Benefits were seen consistently across baseline
211 statin therapy
The document summarizes a study that compared the effects of aggressive vs conventional statin therapy on inflammation in atherosclerosis. The ASAP study found that 80mg of atorvastatin reduced hs-CRP levels and progression of carotid intima-media thickness more than 40mg of simvastatin over 2 years in patients with familial hypercholesterolemia. Patients with the largest hs-CRP reductions showed a 2-fold greater reduction in carotid intima-media thickness. The study suggests that more aggressive statin therapy may be more effective at reducing inflammation and atherosclerosis progression compared to conventional therapy.
Es v2n44
The document summarizes a study that compared the effects of aggressive statin therapy (atorvastatin 80 mg) versus conventional statin therapy (simvastatin 40 mg) on markers of inflammation in patients with familial hypercholesterolemia. The study found that aggressive statin therapy reduced levels of the inflammatory marker hs-CRP to a greater extent than conventional therapy, with a 40.1% reduction compared to a 19.7% reduction. Patients with the largest hs-CRP reductions also showed greater reductions in carotid intima-media thickness. However, about one-third of patients in both treatment groups showed increases in hs-CRP levels with statin therapy.
211 statin therapy
The document summarizes a study that compared the effects of aggressive atorvastatin therapy (80 mg) versus conventional simvastatin therapy (40 mg) on markers of inflammation in patients with familial hypercholesterolemia. The study found that atorvastatin reduced levels of hs-CRP and other inflammatory markers to a greater extent than simvastatin after 2 years. Patients with the largest reductions in hs-CRP also showed greater reductions in carotid intima-media thickness. However, about one-third of patients in both treatment groups experienced increases in hs-CRP levels. The study suggests more aggressive statin therapy may be more effective at reducing atherosclerosis by its anti-inflammatory effects.
Phosphate Levels are Associated with Presence of Carotid Artery 5.6.09
Phosphate Levels are Associated with Presence of Carotid Artery 5.6.09Leonard Davis Institute of Health Economics
This study examined the association between phosphate levels and presence of carotid artery plaque in 426 patients with mild to moderate chronic kidney disease (CKD). The researchers found that 60% of patients had plaque present. Increasing age, phosphate levels, systolic blood pressure, and history of heart attack or revascularization were independently associated with plaque presence, while female gender, albumin levels, estimated glomerular filtration rate, and body mass index were inversely associated. The study concluded that phosphate level is a significant predictor of plaque presence in mild to moderate CKD patients.Hypertension: New Concepts, Guidelines, and Clinical Management Hypertensio...
This document summarizes guidelines for diagnosing and treating hypertension. It discusses the prevalence of hypertension and cardiovascular disease in the US population. It reviews risk factors for hypertension and cardiovascular events. It also summarizes findings from clinical trials demonstrating the benefits of treating hypertension, including reduced risks of stroke, heart failure, and myocardial infarction. Thiazide diuretics are recommended as first-line treatment based on their effectiveness and lower costs.
Hypertension
1) Hypertension is a significant risk factor for cardiovascular and renal diseases. It affects over 26% of the US adult population and control rates remain suboptimal.
2) Recent guidelines classify blood pressure into normal, prehypertensive, and hypertensive stages based on systolic and diastolic levels with goals of treating to lower risk levels.
3) Clinical trials demonstrate that treating hypertension reduces risks of stroke, heart attack, heart failure, and kidney disease and can prevent over a third of cardiovascular events.
NOBLE LEFT MAIN BIFURCATION PCI.pptx
This document discusses left main coronary artery (LMCA) bifurcation percutaneous coronary intervention (PCI). It provides an overview of studies comparing outcomes of PCI versus coronary artery bypass grafting (CABG) for LMCA revascularization. Key points include:
1) Large trials and meta-analyses have found no difference in mortality between PCI and CABG for LMCA disease.
2) PCI for distal LMCA bifurcation lesions has better outcomes than non-distal lesions and is now treated more routinely.
3) Ongoing studies are providing new insights into optimal techniques for LMCA bifurcation PCI, including the DK-Crush versus provisional approach.
Update on Pulmonary Arterial Hypertension in Scleroderma
Dr. Roberto Machado from the University of Illinois at Chicago presented an update on PAH at a Patient Education Conference on March 15, 2014 hosted by the Scleroderma Foundation, Greater Chicago Chapter.
Similar to No correlation and low agreement of imaging and inflammatory atherosclerosis’ markers in familial hypercholesterolemia (20)
Impact of obesity on cardiometabolic risk: Will we lose the battle?
Impact of obesity on cardiometabolic risk: Will we lose the battle?
Transplanting cardiac amyloidosis when to refer for heart transplant
Transplanting cardiac amyloidosis when to refer for heart transplant
Federico Villamil - Argentina - Tuesday 29 - Liver Transplantation Towards Ne...
Federico Villamil - Argentina - Tuesday 29 - Liver Transplantation Towards Ne...
Rafael Carmena Rodriguéz en Clinicardio09: Novedades en práctica clínica sobr...
Rafael Carmena Rodriguéz en Clinicardio09: Novedades en práctica clínica sobr...
Benefits of RCA CTO-PCI Based on Clinical Data.pptx
Benefits of RCA CTO-PCI Based on Clinical Data.pptx
Incremental predictive value of vascular assessments combined with the Framin...
Incremental predictive value of vascular assessments combined with the Framin...
HIGH SENSITIVE C-REACTIVE PROTEIN (hs-CRP) AND ITS CORRELATION WITH ANGIOGRAP...
HIGH SENSITIVE C-REACTIVE PROTEIN (hs-CRP) AND ITS CORRELATION WITH ANGIOGRAP...
Phosphate Levels are Associated with Presence of Carotid Artery 5.6.09
Phosphate Levels are Associated with Presence of Carotid Artery 5.6.09
Hypertension: New Concepts, Guidelines, and Clinical Management Hypertensio...
Hypertension: New Concepts, Guidelines, and Clinical Management Hypertensio...
Update on Pulmonary Arterial Hypertension in Scleroderma
Update on Pulmonary Arterial Hypertension in Scleroderma
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Barth imt
This document provides background on Jacques Barth, an expert in cardiovascular imaging and risk assessment. It discusses the evolution of ultrasound technology for measuring intima-media thickness (IMT) from 1986 to 2005. IMT is an early marker of atherosclerosis and cardiovascular risk. The document also addresses issues around vulnerable plaques, reporting IMT measurements, and assessing cardiovascular risk in children and adolescents.
Braunwald
This document outlines an approach to identifying and managing coronary risk. It recommends that prevention must be the primary goal through intensive global risk factor reduction for all patients with clinically apparent heart disease. It also recommends identifying asymptomatic high-risk individuals through testing like the Framingham Risk Score so they can receive prevention. It proposes a risk stratification approach from low to very high risk based on annual risk levels and corresponding testing and treatments, with very high risk patients receiving the most intensive treatments like invasive detection of unstable plaques and procedures like CABG or multiple drug-eluting stents.
Acc vp-org 3-02 stone
This document describes a study that uses intravascular ultrasound (IVUS), biplane coronary angiography, and blood flow measurements to characterize endothelial shear stress (ESS) in coronary arteries. It found that over 6 months, areas of low ESS demonstrated plaque progression, areas of normal ESS remained stable, and areas of high ESS developed outward remodeling. The technology allows in vivo determination of intracoronary flow velocity and ESS, which has not previously been possible. This provides a method to predict progression of atherosclerosis and vascular remodeling. A pilot study applied this technique in 8 patients at baseline and 6 months to analyze changes in native coronary artery disease and in-stent restenosis while taking candesartan vs fel
101205 shape aha 2005 f
Zahi A. Fayad is an Associate Professor who studies molecular imaging of atherosclerosis using MRI. His research focuses on developing targeted contrast agents to noninvasively detect unstable plaque. Some agents under investigation include annexin A5 labeled with a radioisotope to detect apoptosis, FDG-PET to assess plaque activity, and fibrin-targeted and MMP-targeting Gd-based contrasts. Additional work involves lipid-based particulate agents using reconstituted HDL or iron oxide nanoparticles. The goal is to improve MRI detection sensitivity and specificity for high-risk plaque characterization.
Acc v porg becker
This document discusses the use of coronary CT angiography (CTA) to detect and characterize coronary atherosclerosis beyond just detecting coronary stenoses. CTA can identify calcified plaques, non-calcified plaques, mixed plaques, atheromas, thrombi, and myocardial infarction scars. CTA provides information on plaque composition and distribution that can help understand coronary artery disease and be used to follow patients under therapy. The limitations of CTA include artifacts from cardiac motion, breathing, blooming effect, and poor contrast opacification of small vessels. Advances in multislice CT technology are helping to address some of these limitations.
Acc 2005-1, v pl-vp
This document discusses approaches to cardiovascular disease (CVD) and the need for new approaches. It summarizes that the emphasis is shifting from high risk plaques to high risk symptomatic patients, and from high risk asymptomatic to intermediate and low risk patients. It discusses diagnostic tools like magnetic resonance imaging to identify high risk asymptomatic patients and computed tomography to identify intermediate risk patients using coronary artery calcium scoring and CRP biomarkers. It also discusses prevention and treatment strategies like a polypill for acute coronary syndrome patients and those with chronic atherothrombosis.
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.
Acc v porg
This document discusses the use of coronary CT angiography (CTA) to detect and characterize coronary atherosclerosis beyond just detecting coronary stenoses. CTA can identify calcified plaques, non-calcified plaques, and mixed plaques. It can detect atheromas and characterize plaque density. CTA can also identify intracoronary thrombi and myocardial infarction scars. The document outlines the CTA scanning parameters and techniques used to minimize motion artifacts and optimize image quality for plaque detection and characterization.
Acc presentation lipid coated(2)
This document discusses a novel tracer for MRI imaging of macrophage infiltration in atherosclerotic plaque. It summarizes research into lipid-coated superparamagnetic iron oxide nanoparticles (SPIOs) that are phagocytosed by macrophages. The researchers tested various SPIO coatings and sizes to maximize macrophage uptake while minimizing oxidative stress. Lipid-coated SPIOs combined with certain aminoglycans showed the highest uptake and lowest induction of reactive oxygen species. The goal is to develop an MRI contrast agent that can noninvasively image vulnerable, inflamed plaques by detecting macrophage presence.
Acc 2002 microarray mehran for print
This document discusses the use of DNA microarrays in vulnerable plaque research. It provides background on atherosclerosis and identifies DNA microarrays as a tool that can be used to investigate the molecular mechanisms underlying plaque vulnerability. The document outlines the basic steps of a DNA microarray experiment and discusses considerations for experimental design, data analysis, and validation of results. It also summarizes several studies that have used DNA microarrays or related techniques to examine gene expression in atherosclerosis.
Acc booth inventory
The document provides details about AEHA's booth at the ACC/AEHA Exhibition from March 30 to April 1, 2003. It lists the booth equipment and inventory, proposed activities like an Ecode on Friday morning and a VP Symposium. Giveaways include Magellan GPS devices in a raffle and Dove chocolates. It also discusses the need for an immediate membership sign-up page on the AEHA website and a vision for the future of AEHA.
Acc 04 vuln pt
This document discusses approaches to identifying and managing coronary risk. It states that the primary goal should be preventing acute cardiac events through intensive risk factor reduction for all patients with clinically apparent heart disease. Additionally, it notes that one third of sudden cardiac deaths and heart attacks occur in previously asymptomatic individuals with undiagnosed risk factors or pre-clinical disease. The document proposes identifying high-risk asymptomatic individuals through testing to provide prevention. It presents a risk stratification approach using testing like CRP, cholesterol, glucose and imaging to guide different levels of risk factor reduction and management.
Acc 2002 mehran for print
This document discusses the use of DNA microarrays in studying vulnerable atherosclerotic plaques. It provides background on atherosclerosis and plaque rupture. DNA microarrays allow high-throughput analysis of gene and protein expression, which can provide insights into molecular mechanisms underlying plaque vulnerability. One study used microarrays to analyze gene expression differences between ruptured and stable plaques, identifying perilipin as upregulated in ruptured plaques. However, microarray analysis of atherosclerosis is still in its early stages with many technical challenges to address.
Acc2002 thermography
Vulnerable plaques are prone to rupture and cause heart attacks. This document proposes criteria for defining vulnerable plaques based on histopathology and clinical factors. It also explores using infrared thermography to identify vulnerable plaques by detecting heat from macrophage inflammation. Studies in animal models and humans found temperature heterogeneity in atherosclerotic arteries that correlated with plaque vulnerability features. Further research aims to develop non-invasive thermography techniques to accurately detect vulnerable plaques and help predict heart attack risk.
A20 gene
The document presents findings on the A20 gene, which encodes a zinc finger protein that inhibits NF-kB activity and TNF-induced apoptosis. The study found that C57 and FVB mouse strains have a coding difference in A20 that generates a phosphorylation site in C57 mice. C57-A20 was less effective at shutting down TNF-induced NF-kB activity and C57 cells were less susceptible to TNF-induced apoptosis compared to FVB cells. This suggests less active A20 in C57 mice leads to increased inflammation and reduced apoptosis, while more active A20 in FVB mice decreases inflammation and increases apoptosis, contributing to differences in atherosclerosis susceptibility between the strains.
#1 killer of human beings in the 21st century
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.
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This progress report discusses ongoing near-infrared (NIR) spectroscopy studies. It notes that a new probe design is being developed to improve signal detection in the NIR range. Characterization of a new light source and additional tissue phantom studies are needed. The report identifies ongoing difficulties with depth penetration studies and experimental setup issues. Priorities include analyzing existing data to inform probe redesign, characterizing the new light source, conducting depth penetration and tissue phantom studies, and addressing experimental setup challenges.
259 crp as a risk factor
This document discusses the use of C-reactive protein (CRP) and low-density lipoprotein (LDL) cholesterol levels to predict cardiovascular risk. It summarizes a study that found CRP to be a stronger predictor of future cardiovascular events than LDL. The study measured CRP and LDL levels in 27,939 healthy women and followed them for 8 years, finding that most cardiovascular events occurred in women with normal or low LDL (<160 mg/dl) but elevated CRP. The document concludes that combining CRP and LDL measurements provides better risk assessment than either marker alone.
511 first steps towards understanding
This study investigated genetic differences in vascular remodeling and shear stress regulation in response to altered blood flow in four inbred rat strains. The results showed significant differences among strains in their ability to maintain normal endothelial shear stress levels through outward arterial remodeling when flow was increased or decreased. Specifically, the GH strain was better able to regulate shear stress through remodeling compared to the SHR-SP strain. These genetic differences in vascular responses to changes in blood flow have important implications for understanding the variable manifestations of atherosclerosis and susceptibility to cardiovascular disease in individuals and populations. Future studies are needed to investigate whether similar genetic differences exist in humans and their role in clinical outcomes.
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This document contains fluorescence intensity measurements from a fluorescence-based assay using different concentrations of FITC-labeled superparamagnetic iron oxide nanoparticles (FITC SPIO). The measurements are organized in a table with concentrations of FITC SPIO along the left and average fluorescence units per well and standard deviations for different samples labeled with letters in the cells.
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In addition to infrastructure and capacity constraints, CAR-Ts face a very different risk-benefit dynamic in autoimmune compared to oncology, highlighting the need for tolerable therapies with low adverse event risk. CAR-NK and Treg-based therapies are also being developed in certain autoimmune disorders and may demonstrate favorable safety profiles. Several novel non-cell therapies such as bispecific antibodies, nanobodies, and RNAi drugs, may also offer future alternative competitive solutions with variable value propositions.
Widespread adoption of cell therapies will not only require strong efficacy and safety data, but also adapted pricing and access strategies. At oncology-based price points, CAR-Ts are unlikely to achieve broad market access in autoimmune disorders, with eligible patient populations that are potentially orders of magnitude greater than the number of currently addressable cancer patients. Developers have made strides towards reducing cell therapy COGS while improving manufacturing efficiency, but payors will inevitably restrict access until more sustainable pricing is achieved.
Despite these headwinds, industry leaders and investors remain confident that cell therapies are poised to address significant unmet need in patients suffering from autoimmune disorders. However, the extent of this impact on the treatment landscape remains to be seen, as the industry rapidly approaches an inflection point.
The Nervous and Chemical Regulation of Respiration
These lecture slides, by Dr Sidra Arshad, offer a simplified look into the mechanisms involved in the regulation of respiration:
Learning objectives:
1. Describe the organisation of respiratory center
2. Describe the nervous control of inspiration and respiratory rhythm
3. Describe the functions of the dorsal and respiratory groups of neurons
4. Describe the influences of the Pneumotaxic and Apneustic centers
5. Explain the role of Hering-Breur inflation reflex in regulation of inspiration
6. Explain the role of central chemoreceptors in regulation of respiration
7. Explain the role of peripheral chemoreceptors in regulation of respiration
8. Explain the regulation of respiration during exercise
9. Integrate the respiratory regulatory mechanisms
10. Describe the Cheyne-Stokes breathing
Study Resources:
1. Chapter 42, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 36, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 13, Human Physiology by Lauralee Sherwood, 9th edition
Pharmacology of 5-hydroxytryptamine and Antagonist
5-hydroxytryptamine or 5-HT or Serotonin is a neurotransmitter that serves a range of roles in the human body. It is sometimes referred to as the happy chemical since it promotes overall well-being and happiness.
It is mostly found in the brain, intestines, and blood platelets.
5-HT is utilised to transport messages between nerve cells, is known to be involved in smooth muscle contraction, and adds to overall well-being and pleasure, among other benefits. 5-HT regulates the body's sleep-wake cycles and internal clock by acting as a precursor to melatonin.
It is hypothesised to regulate hunger, emotions, motor, cognitive, and autonomic processes.
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No correlation and low agreement of imaging and inflammatory atherosclerosis’ markers in familial hypercholesterolemia
- 1. No correlation and low agreement of imaging and inflammatory atherosclerosis’ markers in familial hypercholesterolemia Lilton R.C. Martinez MD, Marcio H. Miname MD, Luiz A. Bortolotto MD, Ana P.M. Chacra MD, Carlos E. Rochitte MD, Andrei C. Sposito MD, Raul D. Santos MD,PhD. Lipid Clinic Heart Institute InCor-University of Sao Paulo Medical School Hospital Sao Paulo, Brazil Martinez LRC et al . Atherosclerosis (2008), doi:10.1016/j.atherosclerosis.2007.12.014
- 14. Table 3: CAC, IMT and PWV in FH patients and NL subjects. Martinez LRC et al . Atherosclerosis (2008), doi:10.1016/j.atherosclerosis.2007.12.014 0.026 0.02 0 (0-54) 4.5 ± 13 0 (0-798) 46 ± 140 CCS Agatston units median (ranges) mean ± SD 0.87 6623 ± 796 6596 ± 772 Carotid diameter (μm) 0.99 460 ± 178 461 ± 194 Carotid distension (μm) 0.027 593 ± 111 653 ± 160 Carotid IMT (μm) 0.007 8.5 ± 1 9.2 ± 1.5 PWV (m/s) 0.041 1 (4%) 21 (23%) CCS ≥ 75 th % 0.024 3 (12%) 30 (34%) CAC prevalence n (%) P NL (n=31) FH (n=89)
- 15. Table 4: Univariate determinants of CAC as continuous and dichotomous variable, IMT and PWV in FH patients 0.08 - - - - - Male gender CAC dichotomous p= p = Log(CCS+1) r = p = PWV r = p = IMT r = Determinants 0.001 0.002 0.33 - - 0.0001 0.55 Carotid diameter (μm) 0.014 0.007 0.29 - - - - PWV (m/s) - 0.02 0.26 0.0008 0.35 - - IMT (μm) - - - 0.003 0.32 0.02 0.26 Log (CCS+1) - 0.04 0.23 - - Apolipoprotein A-I (g/l) 0.0036 0.008 0.28 0.02 0.26 - - Lp(a) (mg/dl) - - - - 0.05 0.22 Apolipoprotein B (g/l) - - - - 0.01 0.28 CRP (mg/l) - - - 0.01 0.26 0.02 0.26 Glucose (mg/dl) 0.024 0.02 0.25 - - 0.03 0.24 TG / HDL- cholesterol 0.02 0.01 0.27 0.03 0.24 0.03 0.23 TG (mg/dl) - 0.04 0.22 - - - - LDL-cholesterol /HDL- cholesterol 0.044 0.02 0.25 - - - - LDL-cholesterol (mg/dl) 0.02 0.25 - - - - Total cholesterol (mg/dl) <0.001 0.0001 0.51 0.0001 0.52 0.003 0.32 LYS <0.001 0.0001 0.48 0.0002 0.39 0.006 0.29 Civiera (high risk) <0.001 0.0001 0.54 0.0001 0.44 0.0001 0.40 FRS - - - - 0.005 0.31 PP (mmHg) - - 0.01 0.27 0.009 0.28 DBP. (mmHg) - - 0.02 0.26 0.0003 0.39 SBP (mmHg) 0.04 - - - - - - Xanthoma 0.001 - - - - - - Metabolic Syndrome <0.001 0.0001 0.43 0.0001 0.62 0.002 0.33 Age (years)
- 20. Table 5: Agreement degree of imaging and inflammatory markers severity in FH subjects Martinez LRC et al . Atherosclerosis (2008), doi:10.1016/j.atherosclerosis.2007.12.014 With exception of moderate agreement between IMT and PWV severity (kappa = 0.517) all other markers of severity presented only a slight agreement (kappa < 0.1). 0.031 CRP > 3 (mg/l) PWV > 12 (m/s) 0.064 CRP > 3 (mg/l) IMT > 900 (μm) 0.517 PWV > 12 (m/s) IMT > 900 (μm) 0.16 CRP > 3 (mg/l) CCS > 75 th % 0.004 PWV > 12 (m/s) CCS > 75 th % 0.109 IMT > 900 (μm) CCS > 75 th % kappa