Objectives: Liposome-encapsulated hemoglobin (LEH), a cellular artificial oxygen carrier, has been reported to ameliorate vascular ischemia and reperfusion Injury in various organs. In the current ...study, LEH with low O sub(2) affinity (I-LEH, P sub(50)O sub(2)=45 mmHg) was tested in acute disruption of limb perfusion as a simulation of thrombotlc and/or atherosclerotic occlusion of the limbs, involving skeletal muscular ischemia and reperfusion. Methods: Physiological parameters, such as blood pressure, heart rate, respiratory rate, tissue perfusion by Laser-Doppler flow meter as well as intramuscular PO sub(2), were serially monitored using dual PO sub(2) electrodes in the bilateral hind limbs in the SD rat. After baseline measurements, the left hind limb underwent ischemia by tightening a tourniquet for 70min, followed 10min later by intravenous administration of I-LEH (10mL/kg, n=4) or saline (n=4) to the tail vein. Reperfusion was effected by relaxing the tourniquet and the rat was followed for an additional SOmin. Animals were sacrificed 7 days after ischemia/reperfusion for morphological analyses. Results: While PO sub(2) decreased precipitously after the onset of Ischemia in the ischemlc limb regardless of treatment, the PO sub(2) value in the contralateral intact limb showed a different pattern; decreased in the LEH-treated rats and Increased In the saline-treated control animals. As the result, PO sub(2) ratio in the left Ischemlc limb to the right non-ischemic limb (Lt/Rt ratio) tended to be higher during Ischemia and became significantly higher in the LEH-treated rats than in the saline-treated control animals Immediately after reperfusion to the end of observation. While plasma lactate, blood gases or electrolytes showed no difference after reperfusion, pathological studies 7 days later showed better muscular preservation In LEH-treated animals. Conclusions: The results suggest that early LEH-treatment may be protective of the skeletal muscle after Ischemia and reperfusion In the rat.
Objectives: Obese patients have a significantly higher risk of stroke complications during ECMO support. That risk is connected with advanced state of atherosclerosis. Larger patients need higher ...perfuslon flow, which needs high pressure in the ECMO set. Then, the flow from outflow cannula is of high energy, which could result in releasing of atherosclerotic plaques. Methods: The best way to lower the systemic pressure is to lower the resistance of junction between patient and the ECMO system. This resistance is formed on inflow/outflow cannula. Inspired from electrical analogies, we tried to lower the pressure by parallelizing the inflow and outflow cannulas. We designed a simple model to illustrate this approach. Results: In ideal cases, the pressure is two times lower with parallel connection than with standard connection. This positively influences the blood energy in outflow cannula and lowers the risk of releasing atherosclerotic plaques. We are aware of complications associated with higher surface area and implementation of other cannulas, but we are convinced that the benefits are for obese patients more important. Conclusions: Parallelizing the inflow and outflow cannulas is a promising way to lower risk of stroke complications during ECMO support of obese patients.
Arguably the most critical advancement in the elucidation of factors affecting atherogenesis has been the development of mouse models of atherosclerosis. Among available models, the apolipoprotein ...E-deficient (apoE-/-) mouse is particularly popular because of its propensity to spontaneously develop atherosclerotic lesions on a standard chow diet. A Medline search reveals over 645 articles dedicated to studies using this reliable and convenient "super" animal model since its inception (Piedrahita JA et al, Proc Natl Acad Sci U S A 1992;89:4471-4475; Plump AS et al, Cell 1992;71:343-353) with a more or less steady increase from year to year. This review will examine our present understanding of the pathology and progression of plaques in this animal and highlight some of the nutritional, pharmacological, and genetic studies that have enhanced this understanding.
Cerebral atherosclerosis contributes to dementia via unclear processes. We performed proteomic sequencing of dorsolateral prefrontal cortex in 438 older individuals and found associations between ...cerebral atherosclerosis and reduced synaptic signaling and between RNA splicing and increased oligodendrocyte development and myelination. Consistently, single-cell RNA sequencing showed cerebral atherosclerosis associated with higher oligodendrocyte abundance. A subset of proteins and modules associated with cerebral atherosclerosis was also associated with Alzheimer's disease, suggesting shared mechanisms.
Lipid levels are linked to early atherosclerosis. Risk stratification may be improved by using triglyceride to high-density lipoprotein cholesterol ratio (TG/HDL-C), which relates to arterial ...stiffness in adults. We tested whether TG/HDL-C was an independent predictor of arterial stiffness in youth.
Subjects 10 to 26 years old (mean 18.9 years, 39% male, 56% non-Caucasian, n = 893) had laboratory, anthropometric, blood pressure, and arterial stiffness data collected (brachial distensibility, augmentation index, carotid-femoral pulse-wave velocity). Subjects were stratified into tertiles of TG/HDL-C (low, n = 227; mid, n = 288; high, n = 379).
There was a progressive rise in cardiovascular (CV) risk factors and arterial stiffness across TG/HDL-C ratio. The high TG/HDL-C ratio group had the stiffest vessels (all P < .03 by analysis of variance). TG/HDL-C as a continuous variable was an independent determinant of brachial distensibility in CV risk factor adjusted model and for carotid-femoral pulse-wave velocity in obese subjects, with trend for higher augmentation index.
TG/HDL-C, an estimate of small, dense low-density lipoprotein cholesterol, is an independent determinant of arterial stiffness in adolescents and young adults, especially in obese youth. These data suggest that use of TG/HDL-C may be helpful in identifying young adults requiring aggressive intervention to prevent atherosclerotic CV diseases.
Objectives
To evaluate a quantitative radiomic approach based on high-resolution magnetic resonance imaging (HR-MRI) to differentiate acute/sub-acute symptomatic basilar artery plaque from ...asymptomatic plaque.
Methods
Ninety-six patients with basilar artery stenosis underwent HR-MRI between January 2014 and December 2016. Patients were scanned with T1- and T2-weighted imaging, as well as T1 imaging following gadolinium-contrast injection (CE-T1). The stenosis value, plaque area/burden, lumen area, minimal luminal area (MLA), intraplaque haemorrhage (IPH), contrast enhancement ratio and 94 quantitative radiomic features were extracted and compared between acute/sub-acute and asymptomatic patients. Multi-variate logistic analysis and a random forest model were used to evaluate the diagnostic performance.
Results
IPH, MLA and enhancement ratio were independently associated with acute/subacute symptoms. Radiomic features in T1 and CE-T1 images were associated with acute/subacute symptoms, but the features from T2 images were not. The combined IPH, MLA and enhancement ratio had an area under the curve (AUC) of 0.833 for identifying acute/sub-acute symptomatic plaques, and the combined T1 and CE-T1 radiomic approach had a significantly higher AUC of 0.936 (
p
= 0.01). Combining all features achieved an AUC of 0.974 and accuracy of 90.5%.
Conclusions
Radiomic analysis of plaque texture on HR-MRI accurately distinguished between acutely symptomatic and asymptomatic basilar plaques.
Key Points
• High-resolution magnetic resonance imaging can assess basilar artery atherosclerotic plaque.
• Radiomic features in T1 and CE-T1 images are associated with acute symptoms.
• Radiomic analysis can accurately distinguish between acute symptomatic and asymptomatic plaque.
• The highest accuracy may be achieved by combining radiomic and conventional features.
Arteriosclerosis obliterans (ASO) is a kind of peripheral arterial disease. Most patients with ASO have no apparent clinical symptoms early on, but a diagnosis at the early stage is essential to ...prevent progression. Unfortunately, the specific and sensitive markers for ASO are still lacking currently. In this study, using both tissue samples and blood samples obtained from ASO patients, we aim to find a cluster of miRNAs that can be used as new risk-markers for the diagnosis of ASO in the earlier stages.
We enrolled 104 patients diagnosed with ASO and 105 age-matched controls. We examined the expression levels of a series of miRNAs in both intima samples and serum samples from these patients.
Levels of miR-21, miR-130a, miR-27b, let-7f and miR-210 significantly increased, while levels of miR-221 and miR-222 significantly decreased in the sclerotic samples compared with normal samples. Significant increase of miR-130a, miR-27b and miR-210 expression was observed in the serum samples of ASO patients. Moreover, the expression of miR-130a and miR-27b in sera of ASO patients was positively correlated with Fontaine stages.
The serum levels of miR-130a, miR-27b and miR-210 may serve as potential biomarkers for early stage ASO.
The effect of arterial tortuosity on intracranial atherosclerosis (ICAS) is not well understood. This study aimed to evaluate the effect of global intracranial arterial tortuosity on intracranial ...atherosclerotic burden in patients with ischemic stroke. We included patients with acute ischemic stroke who underwent magnetic resonance angiography (MRA) and classified them into three groups according to the ICAS burden. Global tortuosity index (GTI) was defined as the standardized mean curvature of the entire intracranial arteries, measured by in-house vessel analysis software. Of the 516 patients included, 274 patients had no ICAS, 140 patients had a low ICAS burden, and 102 patients had a high ICAS burden. GTI increased with higher ICAS burden. After adjustment for age, sex, vascular risk factors, and standardized mean arterial area, GTI was independently associated with ICAS burden (adjusted odds ratio adjusted OR 1.33; 95% confidence interval CI 1.09-1.62). The degree of association increased when the arterial tortuosity was analyzed limited to the basal arteries (adjusted OR 1.48; 95% CI 1.22-1.81). We demonstrated that GTI is associated with ICAS burden in patients with ischemic stroke, suggesting a role for global arterial tortuosity in ICAS.
Systemic lupus erythematosus (SLE) with or without accompanying antiphospholipid antibody syndrome (APLS) is known to cause myocardial ischemia via multiple mechanisms, including accelerated coronary ...atherosclerosis, impaired coronary vasomotor function, spontaneous intracoronary thrombus formation, or endothelial dysfunction in the context of cardiac syndrome X (CSX). We present the case of a young woman with SLE and APLS who presented with myocardial ischemia and peculiar echocardiographic evidence of multiple small septal perforator infarcts despite a normal coronary angiogram, a rare combination.
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