Enhanced atherothrombotic formation after oxidative injury by FeCl3 to the common carotid artery in severe combined hyperlipidemic mice

Enhanced susceptibility to atherosclerosis from severe hypertriglyceridemia (HTG) resulting from lipoprotein lipase (LPL) deficiency has been demonstrated in our recent findings which employed a unique mouse model. In the present study we provide further evidence that severe HTG due to LPL deficiency also promotes an atherothrombotic response to arterial injury induced by ferric chloride in a severe combined hyperlipidemic mouse model. Methods and results: A mouse model (LPL^−/−XApoE^−/− double knockout, DKO) with severe combined hyperlipidemia was established by crossing ApoE and LPL-deficient mice. The common carotid arteries of ApoE knockout (EKO) and DKO mice were subjected to injury by ferric chloride, and the formation of arterial thrombosis together with various markers were compared in these lesions. DKO mice demonstrated significantly enhanced thrombus formation overlying atherosclerotic plaque after injury, which contained smooth muscle cells, macrophages, and neutral lipid. The area of neointima, mean intima/media ratios, and the percentage of luminal stenosis were significantly greater (P < 0.01) in DKO mice. Compared with EKO mice, the expression of von Willebrand factor (vWF) and plasminogen activator inhibitor type 1 (PAI-1) were increased in DKO mice. Conclusions: Severe combined hyperlipidemia promotes thrombosis after ferric chloride injury to atherosclerotic vessels and HTG plays a major role in the process.     

Computer aided diagnosis of Coronary Artery Disease,Myocardial Infarction and carotid atherosclerosis using ultrasound images: A review

The diagnosis of Coronary Artery Disease (CAD), Myocardial Infarction (MI) and carotid atherosclerosis is of paramount importance, as these cardiovascular diseases may cause medical complications and large number of death. Ultrasound (US) is a widely used imaging modality, as it captures moving images and image features correlate well with results obtained from other imaging methods. Furthermore, US does not use ionizing radiation and it is economical when compared to other imaging modalities. However, reading US images takes time and the relationship between image and tissue composition is complex. Therefore, the diagnostic accuracy depends on both time taken to read the images and experience of the screening practitioner. Computer support tools can reduce the inter-operator variability with lower subject specific expertise, when appropriate processing methods are used. In the current review, we analysed automatic detection methods for the diagnosis of CAD, MI and carotid atherosclerosis based on thoracic and Intravascular Ultrasound (IVUS). We found that IVUS is more often used than thoracic US for CAD. But for MI and carotid atherosclerosis IVUS is still in the experimental stage. Furthermore, thoracic US is more often used than IVUS for computer aided diagnosis systems.     

RANTES gene mRNA expression and its -403 G/A promoter polymorphism in coronary artery disease

Objective

Increased RANTES expression has been described to have a role in atherosclerosis plaque formation. Functional polymorphisms within RANTES promoter region have shown association with increased risk of coronary atherosclerosis (CAD). The aim of this study was to examine the RANTES mRNA expression in patients with CAD compared to patients without CAD and its association with RANTES − 403 G/A polymorphism in an Iranian population.

Methods

The study was performed on 319 patients who underwent coronary artery angiography and patients with > 50% stenosis in vessels considered as case groups (CAD+) N = 191 and normal vessels group as control (CAD−) N = 128. In each group 20 patients were examined for RANTES mRNA expression.RANTES mRNA expression was examined using quantitative real-time PCR. Genotyping of − 403 polymorphism was performed using PCR-RFLP technique.

Results

We found that RANTES mRNA expression was increased to 1.37 fold in CAD patients compared to the controls but the difference was not statistically significant. Also comparing the RANTES mRNA expression in patients with different RANTES − 403 G/A polymorphism showed that in patients carrying AA genotype RANTES mRNA expression was increased to 1.74 fold compared to patients carrying GG genotype and to 1.51 fold compared to patients carrying GA genotype. No significant difference for allele and genotype frequencies of RANTES − 403 polymorphism was found between cases and controls.

Conclusion

More studies on larger number of samples are required to further evaluate role of RANTES in pathogenesis of CAD.     

血清同型半胱氨酸、脂联素、高敏C反应蛋白水平与颈动脉内膜中层厚度在老年2型糖尿病合并脑梗死患者中的意义

目的：观察血清同型半胱氨酸（Hcy）、脂联素（APN）、高敏C反应蛋白（hs．CRP）水平与颈动脉内膜中层厚度（1MT）在老年2型糖尿病合并脑梗死患者中的意义。方法：选择2008年5月至2012年5月在我院就诊的2型糖尿病患者218例,按照是否合并脑梗死分为糖尿病伴脑梗死组（105例）和单纯糖尿病组（113例）。选择同期健康体检者30例为健康对照组。观察三组血清Hcy、APN、hs—CRP和IMT的水平变化。结果：糖尿病伴脑梗死组和单纯糖尿病组的血清Hcy、hs—CRP和IMT的水平均较正常对照组明显提高（P〈0．01）,糖尿病伴脑梗死组以上指标显著高于单纯糖尿病组（P〈0．01）;而糖尿病伴脑梗死组和单纯糖尿病组的血清APN的水平较正常对照组明显降低（P〈0．01）,糖尿病伴脑梗死组血清APN的水平较单纯糖尿病组显著降低（P〈0．01）。血清Hcy和hs—CRP水平随着1MT的严重程度增加而升高（P〈0．01）,而APN水平随着IMT严重程度升高而降低（P〈0．01）。结论：糖尿病伴脑梗死的患者大血管病变较单纯糖尿病患者更为严重,颈动脉IMT与Hcy和hs—cRP呈正相关,而与APN呈负相关。     

老年高血压患者的动态脉压与冠心病并发症及颈动脉粥样硬化的关系研究

目的：探讨老年高血压患者的动态脉压fPP）与冠心病并发症及颈动脉粥样硬化的关系。方法：选取2010年5月至2013年6月在我院就诊的老年性高血压病患者328例,168例单纯性老年高血压患者设为高血压组,160例合并有冠心病的老年性高血压患者设为高血压合并冠心病组。根据厚度（IMT）是否增大将高血压组分为IMT增厚组94例和IMT正常组74例。对动态血压及颈动脉IMT进行测定。结果：与高血压组相比,高血压合并冠心病组的24hAPP、dPP、IlPP等指标以及24hASBP、nSBP等指标均显著提高;而24hADBP、dDBP、nDBP等指标则明显下降;高血压合并冠心病组24hAPP≥60mmHg的发生率为57．50％,明显高于高血压组的39．29％;IMT增厚组患者的24hAPP、dPP及nPP水平均明显高于IMT正常组;≥60mmHg组共89例,IMT为1．14±0．23mm,明显高于〈60mmHg组79例的平均厚度0．93±0．12mm（P〈0．05）。结论：老年高血压患者的动态脉压在冠心病并发症及颈动脉粥样硬化预测方面具有显著的优越性。     

全麻下颈动脉内膜剥脱术的麻醉体会

目的:评价颈动脉内膜剥脱术(CEA)麻醉疗效,以及经颅多普勒超声(TCD)、微血管多普勒超声(MVD)应用的价值,以及适合颈动脉内膜剥脱术的适合麻醉方法。方法:回顾性分析苏州大学附属一医院脑卒中中心2012年5月至2013年5月所进行的颈动脉内膜剥脱术治疗的19名颅外颈动脉狭窄患者的资料。患者临床症状均伴有不同程度的脑缺血症状。颈动脉狭窄程度2例中度狭窄,17例重度狭窄。所有手术操作均全麻下在显微镜下操作。1例采用补片成形。18例术中采用TCD及MVD监测下完成,1例未采用超声监测。结果:手术成功率为100%,无死亡率。术前脑缺血症状术后患者均有恢复。未发现过度灌注的并发症。麻醉效果达到预期目的。结论:颈动脉内膜剥脱术在多普勒超声MVD及TCD监测下治疗颅外颈动脉狭窄是一种安全、有效的措施;全身麻醉下行CEA手术安全可靠。     

比较两种测量方法获得的血压波动对老年颈动脉斑块的影响

目的:比较两种不同血压波动测定方法测定的血压波动与颈动脉斑块发生的关系。方法:以1456名患有动脉硬化老年男性患者为研究对象,监测患者24 h动态血压,根据有无颈动脉斑块将入选患者分为2组:颈动脉斑块组(n=1012)和无颈动脉斑块组(n=444),分别采用经典的标准差方法(SD法)和个体血压波动测定方法(个体法)分别测定每位患者的血压波动,回顾性分析这两种方法测定的血压波动与颈动脉斑块形成的关联性。结果:SD法测定颈动脉斑块组24 h收缩期血压波动(SBPV)、白天SBPV、夜间SBPV以及24 h舒张期血压波动(DBPV)水平均明显高于无颈动脉斑块组(P0.05);而白天和夜间DBPV差异无统计学意义。个体法测定颈动脉斑块组24 h SBPV、白天SBPV、24 h DBPV以及白天DBPV水平较无颈动脉斑块组均明显升高(P0.05);夜间SBPV和夜间DBPV差异无统计学意义(P0.05)。比较颈动脉斑块组SBPV值出现次数,SD法测定SBPV最多的是10-15 mmHg(n=541),其次是大于15 mmHg(n=399);个体法测定颈动脉斑块组SBPV值出现次数最多的是0-8 mmHg(n=490),其次是8-10 mmHg(n=350)。结论:在老年男性动脉硬化相关疾病患者中,血压波动与颈动脉斑块的形成有着密切的关系,两种方法均可测定血压波动,但以个体血压波动测定方法更加敏感。     

视网膜静脉阻塞与颈动脉狭窄的相关性研究

目的:探究视网膜静脉阻塞与颈动脉狭窄的相关性研究,并为其临床检测、治疗与预后提供参考。方法:选择我院55例视网膜静脉阻塞患者(55只眼)为研究组,对其裸眼视力、矫正视力、眼压、眼底血管荧光造影(FFA)等检查资料进行分析,并进行多普勒彩超检查,记录其颈动脉狭窄情况,并对两种疾病之间的关系进行分析。同时选取55例健康人作为对照组。结果:研究组55例患者确诊为视网膜静脉阻塞(RVO),多普勒结果显示患者患侧与健侧劲动脉血流动力学各项差异不明显(P0.05);其IMT值较之对照组显著增高(P0.05);其PSV与EDV值有所降低,差异具有统计学意义(P0.05)。结论:视网膜静脉阻塞患者大多存在颈动脉狭窄,因此检测颈动脉血流动力学对于诊断与预防视网膜静脉阻塞有着重要作用。     

阿托伐他汀钙联合阿司匹林治疗短暂性脑缺血发作的疗效及对颈动脉粥样硬化斑块和血脂水平的影响研究

目的:探讨阿托伐他汀钙联合阿司匹林对短暂性脑缺血发作的治疗疗效及其对颈动脉粥样硬化斑块和血脂水平的影响。方法:选择我院80例短暂性脑缺血发作患者,按入院顺序随机平均分为两组,研究组40例患者给予阿托伐他汀钙联合阿司匹林治疗,对照组40例患者仅使用阿司匹林治疗。比较两组患者治疗后的治疗有效率,6个月后分别对两组患者颈动脉粥样硬化斑块及血脂水平进行检测。结果:研究组患者治疗总有效率为92.5%,明显高于对照组75%,比较差异具有统计学意义(P0.05);治疗6个月后研究组患者IMT及斑块面积较治疗前明显降低,且降低程度明显高于对照组,比较差异具有统计学意义(P0.05);研究组血清中LDL、TC、TG水平较治疗前显著下降,且下降程度明显高于对照组,同时HDL水平显著上升,而上升程度也明显高于对照组,比较差异具有统计学意义(P0.05)。结论:阿托伐他汀钙联合阿司匹林对短暂性脑缺血发作的治疗疗效显著,可明显减轻或消除颈动脉粥样硬化斑块并明显降低血脂水平,值得推广应用。     

Effects of mechanical properties and atherosclerotic artery size on biomechanical plaque disruption – Mouse vs. human

Mouse models of atherosclerosis are extensively being used to study the mechanisms of atherosclerotic plaque development and the results are frequently extrapolated to humans. However, major differences have been described between murine and human atherosclerotic lesions and the determination of similarities and differences between these species has been largely addressed recently. This study takes over and extends previous studies performed by our group and related to the biomechanical characterization of both mouse and human atherosclerotic lesions. Its main objective was to determine the distribution and amplitude of mechanical stresses including peak cap stress (PCS) in aortic vessels from atherosclerotic apoE^-/- mice, in order to evaluate whether such biomechanical data would be in accordance with the previously suggested lack of plaque rupture in this model. Successful finite element analysis was performed from the zero-stress configuration of aortic arch sections and mainly indicated (1) the modest role of atherosclerotic lesions in the observed increase in residual parietal stresses in apoE^-/- mouse vessels and (2) the low amplitude of murine PCS as compared to humans. Overall, the results from the present study support the hypothesis that murine biomechanical properties and artery size confer less propensity to rupture for mouse lesions in comparison with those of humans.