Arterial Vessel Wall Research Articles

Varicella zoster vasculopathy causing recurrent ischaemic strokes in an immunocompetent patient.

A 66-year-old woman reported 10 days of generalised weakness, falls and memory 'glitches'. She had developed left-sided ophthalmic herpes zoster 3 months before but was otherwise well. MR scan of brain showed acute left-sided ischaemic strokes and CT cerebral angiogram identified marked stenoses of the left anterior and middle cerebral arteries. We suspected varicella-zoster virus vasculopathy, confirmed by cerebrospinal fluid analysis. Initially she had further ischaemic strokes despite intravenous acyclovir, prednisone, aspirin and clopidogrel. However, after prolonged acyclovir and prednisone, there were no new infarcts though imaging of left anterior and middle cerebral artery vessel walls showed persistent inflammation. Varicella zoster vasculopathy can cause recurrent ischaemic strokes, even in immunocompetent people with no cardiovascular risk factors, and despite long-term antiviral therapy.

Blood flow through a stenosed left anterior descending coronary artery: Evaluation of loss coefficients in one-dimensional fluid–structure interaction model

Coronary arterial flow is affected by conditions such as atherosclerosis and stenosis resulting in coronary artery disease. Quantifying the flow fields across arteries is a key aspect in the functional assessment of occlusive arterial disease. An essential aspect of blood flow modeling is the mechanical interaction between the fluid flow and the arterial vessel wall. The present study focuses on the modeling of blood flow within the left anterior descending artery affected with stenosis. A one-dimensional (1D) model was developed to study the transient blood flow characteristics in the artery. The 1D model is coupled with the material tube law to account for the flexibility of the arterial wall. The loss coefficients that account for the local viscous and turbulent losses across the stenosis region are estimated accurately in terms of the varying local cross-sectional area, instead of empirical constants used in the literature. It was observed that the magnitude of viscous losses decreases with an increase in the severity of stenosis. For lower degree of stenosis (<30%), the local turbulent losses are insignificant compared to the viscous losses. The maximum deformation of the vessel wall is ∼0.12mm at t=0.45s for s=70%. During the cardiac cycle (T=0.9s), the artery is observed to be experiencing dilation (Δr>0) in the upstream region, whereas contraction (Δr<0) in the downstream region for all the values of severity (s). A fractional flow reserve of 58.53% was noticed in a stenosed artery of 70% severity.

Peripheral Ischemia and Necrosis Revealing Buerger's Disease in an Internal Medicine Department

Buerger's disease is a systemic vasculitis strongly correlated with tobacco use. It entails a heavy socio-occupational impact. We report the case of a 26-year-old patient with ischemia of the lower limbs revealing Buerger’s disease. He is known smoker with passive exposure to Indian hemp. He was seen for ischemic foot pain that had been progressing for a year. Involvement began in the left big toe. Subsequently, hyperalgesic necrotic lesions were observed on the 3rd, 4th and 5th toes of the foot. Biological investigations revealed an inflammatory syndrome with normocytic anemia and increased C-reactive protein. Retroviral, syphilitic, Hepatitis B and C viruses and SARS-CoV-2 serologies were negative. Antinuclear antibodies were initially borderline at 100 IU with speckled fluorescence, then negative on control. Neutrophil cytoplasmic antibodies and antiphospholipid antibodies were negative. Investigation of thrombophilia was non-contributory, notably factor V mutation testing, antithrombin III assay, proteins C and S and fibrinogen. An arterial ultrasound revealed extensive arterial thrombosis with thickening of the femoral arterial vessel walls. Thromboangiitis obliterans was confirmed and the patient was put on corticosteroids and adjuvant therapy. Surgical treatment was performed 4 months later. Buerger's disease is a serious vascular disorder which must be diagnosed very early in order to prevent complications. Early smoking cessation leads to remission in the early phase.

Hyperbaric Oxygen Mediated PI3K/Akt/mTOR Pathway in Inhibiting Delayed Cerebral Vasospasm after Subarachnoid Hemorrhage.

Delayed cerebral vasospasm (CVS) after subarachnoid hemorrhage (SAH) is a serious complication. This article aimed to explore the mechanism of hyperbaric oxygenation (HBO) inhibiting delayed CVS after SAH. The 60 SD rats were grouped: normal control group (NC), sham operation group (Sham), SAH Model (Model), and HBO treatment group. The SAH model was established by injecting blood twice into the cisterna magna (CM), and the neurological function of the rats were evaluated by modified Garcia scale. The plasma of the rats was collected at 1, 3, 6, and 9 days after HBO treatment. Plasma levels of PI3K/Akt/mTOR pathway-related proteins were detected by Western blot (WB). TUNEL method was used to observe the apoptosis rate of basilar artery (BA) endothelial cells (ECs). Hematoxylin-eosin staining (HE) staining was used to observe the inner diameter and the thickness of vessel wall of rat cerebral arteries. The relationship between mTOR and middle cerebral artery spasm was analyzed. As against the Model, the neurological function was visibly increased, the expressions of Bcl-2, PI3K, mTOR, and p-Akt/Akt protein in plasma were visibly increased, the expression of Bax protein was visibly decreased, and the degree of CVS was visibly reduced in the HBO group (all P < 0.05). The level of mTOR is negatively correlated with the degree of CVS after SAH, and HBO can inhibit the occurrence of delayed CVS.

Safety Window for Effective Lesion Crossing in Patients With Chronic Thromboembolic Pulmonary Hypertension

BackgroundBalloon pulmonary angioplasty for chronic thromboembolic pulmonary hypertension (CTEPH) is limited by a lack of safe and effective tools for crossing these lesions. We aim to identify a safety window for an intraluminal crossing device in this vascular bed by studying the piercing properties of pulmonary arterial vessel walls and intraluminal CTEPH lesion specimens. As a secondary objective, we also describe the histopathologic features of CTEPH lesions. MethodsSpecimens were procured from 9 patients undergoing pulmonary endarterectomy. The specimens were subsampled and identified grossly as arterial wall or intraluminal CTEPH lesions. The force needed for tissue penetration was measured using a 0.38-mm (0.015-in) diameter probe in an ex vivo experimental model developed in our lab. Concurrent histology was also performed. ResultsThe mean force needed to penetrate the arterial wall and intraluminal CTEPH lesions was 1.75 ± 0.10 N (n = 121) and 0.30 ± 0.04 N (n = 56), respectively (P < .001). Histology confirmed the presence of intimal hyperplasia with calcium and hemosiderin deposition in the arterial wall as well as an old, organized thrombus in the lumen. ConclusionsThe pulmonary arterial wall is friable and prone to perforation during instrumentation with workhorse coronary guide wires. However, the results of this study demonstrate that a much lower force is needed for the 0.38-mm (0.015-in) probe to penetrate an intraluminal CTEPH lesion compared to pulmonary arterial intima. This finding suggests the existence of a safety window for lesion-crossing devices, enabling effective balloon pulmonary angioplasty.

Endocrine Disorders and Peripheral Arterial Disease - A Series of Reviews Cushing Syndrome-Cortisol Excess.

Cushing syndrome (CS), characterised by endogenous or exogenous glucocorticoid hormone excess, is associated with several systemic complications, including impaired glucose metabolism, which often becomes clinically manifest as diabetes mellitus (DM). In addition, CS can harm the arterial wall because of hyperglycaemia, dyslipidaemia, hepatic steatosis, and central obesity. These metabolic disorders promote atherosclerosis by synthesising adipokines, leptin, and proinflammatory cytokines. Lower limb arterial complications in CS are common and significantly impact morbidity and mortality. Furthermore, CS, in combination with DM, is likely to cause more diffuse vascular disease that predominantly affects distal arterial beds. In conclusion, CS promotes atherosclerosis, including peripheral artery disease, by causing functional and morphological deterioration of the arterial vessel wall and increasing the presence of classical risk factors of atherosclerosis.

Learning carotid vessel wall segmentation in black-blood MRI using sparsely sampled cross-sections from 3D data.

Atherosclerosis of the carotid artery is a major risk factor for stroke. Quantitative assessment of the carotid vessel wall can be based on cross-sections of three-dimensional (3D) black-blood magnetic resonance imaging (MRI). To increase reproducibility, a reliable automatic segmentation in these cross-sections is essential. We propose an automatic segmentation of the carotid artery in cross-sections perpendicular to the centerline to make the segmentation invariant to the image plane orientation and allow a correct assessment of the vessel wall thickness (VWT). We trained a residual U-Net on eight sparsely sampled cross-sections per carotid artery and evaluated if the model can segment areas that are not represented in the training data. We used 218 MRI datasets of 121 subjects that show hypertension and plaque in the ICA or CCA measuring in ultrasound. The model achieves a high mean Dice coefficient of 0.948/0.859 for the vessel's lumen/wall, a low mean Hausdorff distance of , and a low mean average contour distance of on the test set. The model reaches similar results for regions of the carotid artery that are not incorporated in the training set and on MRI of young, healthy subjects. The model also achieves a low median Hausdorff distance of on the 2021 Carotid Artery Vessel Wall Segmentation Challenge test set. The proposed method can reduce the effort for carotid artery vessel wall assessment. Together with human supervision, it can be used for clinical applications, as it allows a reliable measurement of the VWT for different patient demographics and MRI acquisition settings.

Atherosclerotic changes in the aortic wall in lower monkeys

Atherosclerotic changes in the walls of arterial vessels are currently considered as one of the initial stages in the development of a number of diseases of the cardiovascular system. According to the World Health Organization, atherosclerosis is the main cause of heart attack and stroke. The similarity of pathomorphological changes in atherosclerosis in humans and in lower monkeys of the baboon hamadryad and baboon anubis species allows the use of animals of these species as laboratory models in the study of this disease. The material for morphological studies was obtained during the autopsy of 109 corpses of baboon hamadryad and baboon anubis monkeys (53 males and 56 females) in the period from 2019 to 2022. To analyze the species and age characteristics, all animals were conditionally divided into three age groups: group 1 (n=74) monkeys of both sexes aged 15-20 years; group 2 (n=23) animals of both sexes aged 21-25 years; group 3 (n=12) included animals older than 26 years. The results of the research showed that atherosclerotic changes in the aortic wall in the lower monkeys of the studied species kept in the nursery of the Kurchatov Complex of Medical Primatology of the Kurchatov Institute Research Center are detected from the age of 15. As the age of the animals increases, the changes are more pronounced. A reliable relationship between different age groups has been established. The frequency of atherosclerotic changes increases with increasing age, regardless of the sex of the animals. Morphological changes in the wall of the thoracic aorta in baboons are similar to those in human atherosclerosis.

Abstract 2040: Rapamycin Extends Life Of Matrix Gla Protein Knockout Mice Independent Of Vascular Calcification Content.

Background: Peripheral artery disease (PAD) is characterized by the narrowing and blockage of the vessels in lower extremities. While atherosclerosis has been the assumed culprit of PAD recent data now shows that medial arterial calcification (MAC) is the cause of below-the knee ischemia. MAC promotes thrombosis via inward remodeling, reduced elasticity, and arterial stiffness. The mechanisms driving MAC pathogenesis are unclear. Matrix Gla Protein (MGP) is an inhibitor of vascular calcification and present in arterial vessel walls. MGP -/- mice exhibit extensive MAC throughout their vasculature and die within 5-7 weeks due to aortic rupture or heart failure. The drug rapamycin functions as an inhibitor of cell proliferation and an activator of autophagy. Hypothesis: That rapamycin reduces MAC in MGP -/- mice via inhibiting inward remodeling and activating autophagy. Methods: MGP +/+ and MGP -/- mice treated with vehicle or rapamycin (5mg/kg, 3x weekly) starting at 10 days old for 2 weeks. Calcification was quantified via micro-computed tomography (uCT). Collagen structure and elastin quality were assessed histological staining. Markers of proliferation (Ki-67), cell death (Caspase 3), autophagy (LC3), and calcification (Runx2) were quantified via immunofluorescence staining. Western blot was used to assess autophagy flux and proliferation in smooth muscle cells (SMCs) isolated from MGP +/+ and MGP -/- mice. Results: While rapamycin treatment doubled the life-expectancy of MGP -/- mice, the calcification content was unchanged compared to the vehicle. However, rapamycin caused a significant decline in mineral density. Higher collagen content and improved elastin structure were observed in MGP -/- treated with rapamycin compared to vehicle. Runx2 and Ki-67 were elevated in MGP -/- mice compared to MGP +/+ , but there was no difference in response to rapamycin treatment. No difference was observed in caspase 3 levels. Under rapamycin treatment, MGP -/- SMCs exhibited higher autophagy flux than MGP +/+ SMCs. Conclusion: While rapamycin did not reduce MAC, our data suggest that rapamycin potentially preserves the integrity of the aortic vessel wall by inducing autophagy, which requires further investigation.

Ophthalmic Artery Vessel Wall Inflammation in a Patient With Giant Cell Arteritis Presenting With Vision Loss: A Case Report.

Ophthalmic Artery Vessel Wall Inflammation in a Patient With Giant Cell Arteritis Presenting With Vision Loss: A Case Report.

Abdominal involvement as a primary manifestation of systemic or isolated gastrointestinal vasculitis

Systemic vasculitides can cause a wide variety of gastrointestinal manifestations (GI) ranging from mild and frequently nonspecific abdominal pains to potentially life-threatening bowel perforations. Vascular involvement in systemic vasculitides can affect any GI blood vessel, most commonly mesenteric, hepatic, or splenic arteries. Inflammatory changes affecting different layers of arterial vessel walls can lead to aneurysmatic dilatation or blood vessel occlusion with subsequent organ ischemia leading to mucosal ulcerations, GI bleeding, perforations, or bowel obstruction. While the presence of extraintestinal manifestations may aid in diagnosis, delays in making appropriate diagnoses and rapid initiation of glucocorticoid and immunosuppressive treatment can have detrimental consequences. Awareness of isolated gastrointestinal vasculitis is of particular importance as it frequently remains undiagnosed until end-stage organ damage becomes apparent. Vasculitis mimics such as vascular Ehlers-Danlos syndrome or fibromuscular dysplasia add another lay of complexity in approaching patients with suspected GI vasculitis and should always be carefully considered.

Real-time tracking of radial artery vessel wall using a Kalman filter-based ultrasound single-plane wave RF signal time-frequency information fusion algorithm

ObjectiveThe goal of our study was to achieve real-time dynamic tracking of the radial artery vessel wall in everyday life, which is crucial for blood pressure estimation and cardiovascular disease prediction. MethodsThe algorithm integrates time–frequency information from ultrasound single-plane wave RF (radiofrequency) signals and consists of three main components: feature frame ROI (region of interest) selection, inter-frame cross-correlation and intra-frame autocorrelation, and feature frame Kalman filtering. ResultsExperimental validation on a silicone gel ultrasound phantom with simulated blood vessels demonstrates an average diameter estimation error of less than 0.5% compared to ground truth values. Comparative experiments show similar relative errors (2.83%, 2.43%) to the optical flow method, with a computational speed 7.32 times faster. The algorithm accurately aligns extracted pulse waves with pressure pulse waves at six local feature points per cycle. ConclusionThe proposed method achieves a favorable balance between speed and accuracy in tracking the radial artery vessel wall. It holds significant potential for real-time monitoring of physiological health parameters, offering precise and dynamic tracking capabilities. SignificanceThis algorithm addresses the challenges of non-invasive real-time tracking, benefiting blood pressure estimation and cardiovascular disease prediction. Its integration of time–frequency information and efficient computational speed make it valuable for the scientific community and public in monitoring physiological health parameters.

Condition of the cardiovascular system in Wistar rats with experimental renal dysfunction

The aim: to evaluate functional and structural changes in blood vessels and myocardium in Wistar rats at different stages of the formation of experimental kidney dysfunction.Materials and Methods. Four groups of animals were studied. The first two groups consisted of rats subjected to 5/6 nephrectomy (NE). The period after NE is 2 or 4 months. The third and fourth groups included sham-operated (SO) animals of a similar observation period. After the end of the experiment, blood pressure was measured in rats, the left ventricular mass index (LVMI) was calculated, a biochemical blood test, histological, immunohistochemical and electron microscopic examination of the myocardium were performed, and the contractile activity of the portal vein was recorded for a period of 2 months (in vitro).Results. 2 months after NE, an increase in blood pressure, LVMI, and a decrease in the autorhythmic contractile activity of the portal vein were detected in rats. At the histological level, thickening of cardiomyocytes and arterial vessel walls and the presence of perivascular fibrosis were noted. After 4 months, in rats with NE, the increase in blood pressure, cardiomyocyte hypertrophy and perivascular fibrosis progressed. The thickness of cardiomyocytes was 14.1±3.11 μm, which was significantly greater than in the group with NE for 2 months (12.5±1.5 μm; p=0.008). At this period of observation, electron microscopic examination revealed deintegration of myofibrils, disruption of myofibril stacking and z-disk structure, and changes in the shape of mitochondria. 2 months after NE, an increase in the area of open capillaries was detected in rats (1902.8±202.9 μm²) compared to the corresponding LO animals (730.4±58.2 μm²; p=0.000). As renal dysfunction develops, the capillary area tends to increase (2139.1±396.5 μm²; p =0.120).Conclusion. In Wistar rats with renal dysfunction, changes were detected not only in the level of blood pressure, but also in the functional activity of the intravenous fluid, as well as in the structural components of the myocardium – cardiomyocytes, stroma and blood vessels. The increase in myocardial mass at the histological level was manifested by a significant increase in the thickness of cardiomyocytes, the volume of connective tissue, and the thickness of the wall of arterial vessels, reaching a maximum value at a longer period after NE.

Immuno-modulatory role of baicalin in atherosclerosis prevention and treatment: current scenario and future directions.

Atherosclerosis (AS) is recognized as a chronic inflammatory condition characterized by the accumulation of lipids and inflammatory cells within the damaged walls of arterial vessels. It is a significant independent risk factor for ischemic cardiovascular disease, ischemic stroke, and peripheral arterial disease. Despite the availability of current treatments such as statins, proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitors, and lifestyle modifications for prevention, AS remains a leading cause of morbidity and economic burden worldwide. Thus, there is a pressing need for the development of new supplementary and alternative therapies or medications. Huangqin (Scutellaria baicalensis Georgi. [SBG]), a traditional Chinese medicine, exerts a significant immunomodulatory effect in AS prevention and treatment, with baicalin being identified as one of the primary active ingredients of traditional Chinese medicine. Baicalin offers a broad spectrum of pharmacological activities, including the regulation of immune balance, antioxidant and anti-inflammatory effects, and improvement of lipid metabolism dysregulation. Consequently, it exerts beneficial effects in both AS onset and progression. This review provides an overview of the immunomodulatory properties and mechanisms by which baicalin aids in AS prevention and treatment, highlighting its potential as a clinical translational therapy.

Hydrophobically Associated Hydrogel for High Sensitivity and Resolution of an Interdigital Electrode Pressure Sensor.

Hydrogel-based flexible strain sensors have been known for their excellent ability to convert different motions of humans into electrical signals, thus enabling real-time monitoring of various human health parameters. In this work, a composite hydrogel with hydrophobic association and hybrid cross-linking was fabricated by using polyacrylamide (PAm), surfactant sodium dodecyl sulfate (SDS), lauryl methacrylate (LMA), and polypyrrole (PPy). The dynamic dissociation-conjugation among LMA, SDS, and PPy could dissipate energy to improve the toughness of hydrogels. The SDS/PPy/LMPAm composite hydrogel with a toughness of 1.44 MJ/m3, tensile fracture stress of 345 kPa, tensile strain of 1021%, and electrical conductivity of 0.57 S/m was obtained. Furthermore, an interdigital electrode flexible pressure sensor was designed to replace the bipolar electrode flexible pressure sensor, which greatly improved the sensitivity and resolution of the pressure sensor. The SDS/PPy/LMPAm composite hydrogel-based interdigital electrode flexible pressure sensor showed extraordinary stability and identified different hand gestures as well as monitored the pulse signal of humans. Moreover, the characteristic systolic and diastolic peaks were clearly observed. The pulse frequency (65 times/min) and the radial artery augmentation index (0.57) were calculated, which are very important in evaluating the arterial vessel wall and function of human arteries.

Joint 2D–3D cross-pseudo supervision for carotid vessel wall segmentation

IntroductionThe segmentation of the carotid vessel wall using black-blood magnetic resonance images was a crucial step in the diagnosis of atherosclerosis. The objective was to accurately isolate the region between the artery lumen and outer wall. Although supervised learning methods achieved remarkable accuracy in vessel segmentation, their effectiveness remained limited due to their reliance on extensive labeled data and human intervention. Furthermore, when confronted with three-dimensional datasets featuring insufficient and discontinuous label data, these learning-based approaches could lose their efficacy. In this paper, we proposed a novel Joint 2D–3D Cross-Pseudo Supervision (JCPS) method for accurate carotid vessel wall segmentation.MethodsIn this study, a vascular center-of-gravity positioning module was developed to automatically estimate the region of blood vessels. To achieve accurate segmentation, we proposed a joint 2D–3D semi-supervised network to model the three-dimensional continuity of vascular structure. In addition, a novel loss function tailored for vessel segmentation was introduced, consisting of four components: supervision loss, cross-pseudo supervision loss, pseudo label supervision loss, and continuous supervision loss, all aimed at ensuring the accuracy and continuity of the vessel structure. In what followed, we also built up a user-friendly Graphical User Interface based on our JCPS method for end-users.ResultsOur proposed JCPS method was evaluated using the Carotid Artery Vessel Wall Segmentation Challenge dataset to assess its performance. The experimental results clearly indicated that our approach surpassed the top 10 methods on the leaderboard, resulting in a significant enhancement in segmentation accuracy. Specifically, we achieved an average Dice similarity coefficient increase from 0.775 to 0.806 and an average quantitative score improvement from 0.837 to 0.850, demonstrating the effectiveness of our proposed JCPS method for carotid artery vessel wall segmentation.ConclusionThe experimental results suggested that the JCPS method had a high level of generalization performance by producing pseudo labels that were comparable with software annotations for data-imbalanced segmentation tasks.

Blocked-flow vs. free-flow cyanoacrylate glue embolization: Histological differences in an in vivo rabbit renal artery model

PurposeThe purpose of this in vivo animal study was to compare the acute histological effects on the arterial vessel wall of free-flow vs. blocked-flow embolization with metacryloxysulfolane-n‑butyl cyanoacrylate (MS-NBCA) in several concentrations. Materials and methodsA total of 42 rabbit renal arteries were embolized using MS-NBCA mixed with ethiodized oil. The MS-NBCA concentration was 12.5%, 25%, or 50%. All mixtures were injected under both free-flow and blocked-flow conditions. The rabbits were euthanised 30 min after arterial embolization. Arterial-lumen distension, intimal inflammation and necrosis, peri‑arterial edema, and distality of MS-NBCA penetration were assessed histologically. Multivariable regression analyses were performed using a manual backward procedure, with linear, ordinal and logistic regression to search for factors associated with these outcomes ResultsMarked or severe dilatation was observed in 36 out of 42 arteries (86%) and marked or transmural intimal arteritis in all 42 arteries (42/42; 100%). Lumen dilatation caused focal vessel-wall flattening, which resulted in intimal necrosis. Multifocal necrosis extending from the intima to the media occurred in 23 out of 42 kidneys (55%) and peri‑arterial edema with multifocal vascular leakage in 19 out of 42 kidneys (45%). At multivariable analysis, blocked-flow MS-NBCA injection was associated with greater severity of vessel-wall lesions, including intimal arteritis (P = 0.003) and intimal necrosis (P = 0.014), compared to free-flow injection. Blocked-flow injection was also associated with peri‑arterial edema (P = 0.008) and greater distality of MS-NBCA penetration (P = 0.001). ConclusionBlocked-flow MS-NBCA injection during renal artery embolization is significantly associated with more acute arterial-wall damage and greater distality of glue penetration compared to free-flow injection in a rabbit model. These preliminary findings may have clinical implications, as blocked-flow injection is routinely used to treat specific vascular diseases or malformations in human.

Abstract 16485: Treatment With PCSK9 Inhibitors Influence miRNAs Expression and Changes of Arterial Wall Properties

Background and aim: MicroRNAs (miRNAs) are involved in the synthesis of proprotein convertase subtilisin-kexin type 9(PCSK9), which is one of regulators of low-density lipoprotein cholesterol (LDL-C) metabolism. There is no data on whether changes in the expression of miRNAs involved in PCSK9 metabolism, could be related to arterial wall properties changes. The aim was to verify whether PCSK9 inhibitors (PCSK9i) treatment and the changes in the expression of miRNAs are associated with arterial wall properties in post-myocardial infarction (MI) patients with insufficiently regulated LDL-C levels and increased Lp(a) levels. Methods: Seventy-six participants after MI were enrolled and randomized to a placebo group or PCSK9i group. The treatment group received subcutaneous alirocumab 150 mg or evolokumab 140 mg, every 2 weeks. Blood for biochemical and genetic analysis was taken and ultrasound measurements of flow-mediated dilation of brachial artery (FMD), carotid intima-media thickness (c-IMT) and pulse wave velocity (PWV) were performed. All measurements were measured initially and after 6 months of treatment. Results: FMD improved from 10.9±6.3 to 14.4±5.7% in the PCSK9i group and 10.8±6.8 to 11.2±4.6% in the placebo group (p&lt;0.001, p=0.584). PWV changed from 5.8±1.4 to 5.5±1.6 m/s (p=0.024) in the PCSK9i group and in the placebo group from 5.6±1.5 to 5.5±1.1 m/s (p=0.879), with better improvement in the treated group (p=0.007). c-IMT decreased in the PCSK9i group (from 0.65±0.10 to 0.63±0.10 mm; p=0.017), with no change in the placebo group (from 0.64±0.09 to 0.63±0.09 mm; p=0.482). The expression of miR-191-5p and miR-483-5p increased in the PCSK9i group (p=0.028, p=0.020; respectively). The expression of miR-191-5p significantly decreased in the placebo group (p&lt; 0.001). A decrease in c-IMT was associated with a decrease in the expression of miR-224-5p (r=0.303; p=0.019), miR-337-3p (r=0.329; p=0.010) and miR-483-5p (r=0.367; p=0.004). Conclusions: Our results suggest that changes in selected miRNAs were associated with changes in the morphological properties of the arterial vessel wall. We have shown that the increase in miR-483-5p expression can be a good indicator of the regression of morphological atherosclerotic changes.

Mechanical properties of atherosclerotic plaques, caps and walls of arterial vessels: a mobile test bench experiments

Within the framework of this study, a methodology and a prototype of a test bench for conducting experiments on compression of biological tissue samples have been developed. The test bench for the implementation of the technique consists of high–precision scales (measuring accuracy up to 0.01 g, maximum weight - 5 kg), an electronic caliper (measuring accuracy up to 0.01 mm) with 3D-printer pads that are attached to grips, as well as video cameras. Thanks to such a mobile stand, it was possible to conduct a series of experiments (a total of 99 tests) to determine the Young's modulus of atherosclerotic plaques and areas of vascular walls removed from the body no later than a few hours. This made it possible to collect a database of the mechanical characteristics of the plaques as close as possible to the real properties. In addition, regression dependences were constructed between the Hounsfield numbers corresponding to dense atherosclerotic deposits discernible on a CT scan and the Young modules obtained during experiments. Such dependencies will further allow determining the mechanical properties of plaques in vivo based on computed tomography data. The technique was verified by mechanical experiments on the universal testing machine Instron 3342 and on a mobile test bench on samples of hard (with pronounced calcification) and soft plaques. 7 experiments were conducted for each type of samples. The results differed by no more than 4.3 % for soft plaques and no more than 9.5 % for hard plaques. To test the inter-expert reliability of the methodology, a number of experiments were conducted with the involvement of two independent participants. Each of the three mobile stand operators performed 5 tests on soft rubber samples. The study of inter-expert reliability allowed us to show the independence of the methodology from the skills and qualifications of the operator.

Segmentation of carotid artery vessel wall and diagnosis of carotid atherosclerosis on black blood magnetic resonance imaging with multi-task learning.

Atherosclerotic cardiovascular disease is the leading cause of death worldwide. Early detection of carotid atherosclerosis can prevent the progression of cardiovascular disease. Many (semi-) automatic methods have been designed for the segmentation of carotid vessel wall and the diagnosis of carotid atherosclerosis (i.e., the lumen segmentation, the outer wall segmentation, and the carotid atherosclerosis diagnosis) on black blood magnetic resonance imaging (BB-MRI). However, most of these methods ignore the intrinsic correlation among different tasks on BB-MRI, leading to limited performance. Thus, we model the intrinsic correlation among the lumen segmentation, the outer wall segmentation, and the carotid atherosclerosis diagnosis tasks on BB-MRI by using the multi-task learning technique and propose a gated multi-task network (GMT-Net) to perform three related tasks in a neural network (i.e., carotid artery lumen segmentation, outer wall segmentation, and carotid atherosclerosis diagnosis). In the proposed method, the GMT-Net is composed of three modules, including the sharing module, the segmentation module, and the diagnosis module, which interact with each other to achieve better learning performance. At the same time, two new adaptive layers, namely, the gated exchange layer and the gated fusion layer, are presented to exchange and merge branch features. The proposed method is applied to the CAREII dataset (i.e., 1057 scans) for the lumen segmentation, the outer wall segmentation, and the carotid atherosclerosis diagnosis. The proposed method can achieve promising segmentation performances (0.9677 Dice for the lumen and 0.9669 Dice for the outer wall) and better diagnosis accuracy of carotid atherosclerosis (0.9516 AUC and 0.9024 Accuracy) in the "CAREII test" dataset (i.e., 106 scans). The results show that the proposed method has statistically significant accuracy and efficiency. Even without the intervention of reviewers required for the previous works, the proposed method automatically segments the lumen and outer wall together and diagnoses carotid atherosclerosis with high performance. The proposed method can be used in clinical trials to help radiologists get rid of tedious reading tasks, such as screening review to separate normal carotid arteries from atherosclerotic arteries and to outline vessel wall contours.