Atherosclerotic Plaque Research Articles

Impact of hypertension on coronary artery plaques and FFR-CT in type 2 diabetes mellitus patients: evaluation utilizing artificial intelligence processed coronary computed tomography angiography

ObjectiveThis study utilized artificial intelligence (AI) to quantify coronary computed tomography angiography (CCTA) images, aiming to compare plaque characteristics and CT-derived fractional flow reserve (FFR-CT) in type 2 diabetes mellitus (T2DM) patients with or without hypertension (HTN).MethodsA retrospective analysis was conducted on 1,151 patients with suspected coronary artery disease who underwent CCTA at a single center. Patients were grouped into T2DM (n = 133), HTN (n = 442), T2DM (HTN+) (n = 256), and control (n = 320). AI assessed various CCTA parameters, including plaque components, high-risk plaques (HRPs), FFR-CT, severity of coronary stenosis using Coronary Artery Disease Reporting and Data System 2.0 (CAD-RADS 2.0), segment involvement score (SIS), and segment stenosis score (SSS). Statistical analysis compared these parameters among groups.ResultsThe T2DM (HTN+) group had the highest plaque volume and length, SIS, SSS, and CAD-RADS 2.0 classification. In the T2DM group, 54.0% of the plaque volume was noncalcified and 46.0% was calcified, while in the HTN group, these values were 24.0 and 76.0%, respectively. The T2DM (HTN+) group had more calcified plaques (35.7% noncalcified, 64.3% calcified) than the T2DM group. The average necrotic core volume was 4.25 mm3 in the T2DM group and 5.23 mm3 in the T2DM (HTN+) group, with no significant difference (p > 0.05). HRPs were more prevalent in both T2DM and T2DM (HTN+) compared to HTN and control groups (p < 0.05). The T2DM (HTN+) group had a higher likelihood (26.1%) of FFR-CT ≤0.75 compared to the T2DM group (13.8%). FFR-CT ≤0.75 correlated with CAD-RADS 2.0 (OR = 7.986, 95% CI = 5.466–11.667, cutoff = 3, p < 0.001) and noncalcified plaque volume (OR = 1.006, 95% CI = 1.003–1.009, cutoff = 29.65 mm3, p < 0.001). HRPs were associated with HbA1c levels (OR = 1.631, 95% CI = 1.387–1.918).ConclusionAI analysis of CCTA identifies patterns in quantitative plaque characteristics and FFR-CT values. Comorbid HTN exacerbates partially calcified plaques, leading to more severe coronary artery stenosis in patients with T2DM. T2DM is associated with partially noncalcified plaques, whereas HTN is linked to partially calcified plaques.

Targeting Unc5b in macrophages drives atherosclerosis regression and pro-resolving immune cell function

Atherosclerosis results from lipid-driven inflammation of the arterial wall that fails to resolve. Imbalances in macrophage accumulation and function, including diminished migratory capacity and defective efferocytosis, fuel maladaptive inflammation and plaque progression. The neuroimmune guidance cue netrin-1 has dichotomous roles in inflammation partly due to its multiple receptors; in atherosclerosis, netrin-1 promotes macrophage survival and retention via its receptor Unc5b. To minimize the pleiotropic effects of targeting netrin-1, we tested the therapeutic potential of deleting Unc5b in mice with advanced atherosclerosis. We generated Unc5bfl/flCx3cr1creERT2/WT mice, which allowed conditional deletion of Un5b (∆Unc5bMØ) in monocytes and macrophages by tamoxifen injection. After inducing advanced atherosclerosis by hepatic PCSK9 overexpression and western diet feeding for 20 wk, Unc5b was deleted and hypercholesterolemia was normalized to simulate clinical lipid management. Deletion of myeloid Unc5b led to a 40% decrease in atherosclerotic plaque burden and reduced plaque complexity compared to Unc5bfl/flCx3cr1WT/WT littermate controls (CtrlMØ). Consistently, plaque macrophage content was reduced by 50% in ∆Unc5bMØ mice due to reduced plaque Ly6Chi monocyte recruitment and macrophage retention. Compared to CtrlMØ mice, plaques in ∆Unc5bMØ mice had reduced necrotic area and fewer apoptotic cells, which correlated with improved efferocytotic capacity by Unc5b-deficient macrophages in vivo and in vitro. Beneficial changes in macrophage dynamics in the plaque upon Unc5b deletion were accompanied by an increase in atheroprotective T cell populations, including T-regulatory and Th2 cells. Our data identify Unc5b in advanced atherosclerosis as a therapeutic target to induce pro-resolving restructuring of the plaque immune cells and to promote atherosclerosis regression.

Serial Optical Coherence Tomography Assessment of Coronary Atherosclerosis and Long-Term Clinical Outcomes.

The impact of high-risk coronary artery plaques identified using optical coherence tomography on late luminal narrowing and clinical events remains poorly understood. This multicenter prospective study included 176 patients who underwent percutaneous coronary intervention and serial optical coherence tomography at baseline and 1-year follow-up to investigate nontarget regions with angiographically intermediate stenosis. At 1 year after percutaneous coronary intervention, the coronary artery lumen area decreased significantly from 6.06 (95% CI, 5.60-6.53) mm2 to 5.88 (95% CI, 5.41-6.35) mm2 (difference, -0.18; 95% CI, -0.22 to -0.14 mm2; P<0.001), particularly in thin-cap fibroatheromas, thick-cap fibroatheromas, mixed plaques, and fibrous plaques. The prevalence of fibroatheroma decreased from 38% to 36% (P<0.001), whereas calcified plaque increased from 31% to 34% (P<0.001), accompanied by a significant increase in calcium thickness and angle. Diabetes and current smoking habits were independently associated with increasing calcium prevalence. Patients with thin-cap fibroatheroma had a significantly higher 3-year risk of ischemia-driven nontarget vessel revascularization (hazard ratio, 2.42 [95% CI, 1.03-5.71]; P=0.04), primarily due to revascularization in the imaged region. No significant association was observed between coronary artery calcium prevalence and clinical outcomes within 3 years. The coronary artery lumen area significantly decreased over a 1-year interval, particularly in thin-cap fibroatheromas, thick-cap fibroatheromas, mixed plaques, and fibrous plaques. Although thin-cap fibroatheroma prevalence was associated with higher risk of ischemia-driven nontarget vessel revascularization, no significant association was noted between coronary artery calcium prevalence and clinical outcomes within 3 years. The interaction between calcium progression and long-term clinical events necessitates further investigation. URL: https://www.umin.ac.jp/ctr/; Unique Identifier: UMIN000031937.

Advanced Applications of Nanomaterials in Atherosclerosis Diagnosis and Treatment: Challenges and Future Prospects.

Atherosclerosis-induced coronary artery disease is a major cause of cardiovascular mortality. Clinically, conservative treatment strategies for atherosclerosis still focus on lifestyle interventions and the use of lipid-lowering and anticoagulant medications. Despite achieving some therapeutic effects, these approaches are limited by low bioavailability, long intervention periods, and significant side effects. With the advancement of nanotechnology, nanomaterials have demonstrated extraordinary potential in the biomedical field. Their excellent biocompatibility, surface modifiability, and high targeting capability not only enable efficient diagnosis of plaque progression but also allow precise drug delivery within atherosclerotic plaques, significantly enhancing drug bioavailability and reducing systemic side effects. Here, we systematically review the current research progress of nanomaterials in the field of atherosclerosis to summarize not only the types of nanomaterials but also their applications in both the diagnosis and treatment of atherosclerosis. Notably, in the context of plaque therapy, we provide a comprehensive overview of current nanomaterial applications based on their targeted therapeutic systems for different cell types within plaques. Additionally, we address the persistent challenge of clinical translation of nanomaterials by summarizing current issues and providing directions for innovation and improvement in nanomaterial design. Overall, we believe that this review systematically summarizes the applications and challenges of biomedical nanomaterials in atherosclerosis diagnosis and therapy, thereby offering insights and references for the development of therapeutic materials for atherosclerosis.

Independent role of atherosclerotic plaque composition and extension in predicting the risk of cardiac events: a CLIMA substudy.

To investigate two different approaches to determine patient risk to develop cardiac events: the burden of coronary atherosclerosis, as assessed by the Gensini score, and plaque morphology, as assessed by intracoronary optical coherence tomography (OCT). We assessed the Gensini score and OCT features of plaque vulnerability in 847 patients from the CLIMA registry. Patients were divided into four Gensini quartiles. The main study endpoint was the 1-year composite of cardiac death, myocardial infarction (MI) and/or target vessel revascularization (TVR). A total of 56 patients (6.6%) experienced the one-year main composite endpoint. The composite endpoint was significantly affected by the Gensini score (hazard ratio [HR] 1.42, 95% confidence interval [CI] 1.11-1.81, p = 0.005), with a low incidence in the first Gensini quartile (Q1 1.3%) and a higher incidence in the remaining groups (Q2 8.3%, Q3 8.9% and Q4 8.3%). At the multivariable analysis, the combined four OCT criteria (HR 6.4, 95%CI 3.0-13.7, p < 0.001), thin fibrous cap (HR 2.9, 95%CI 1.7-5.0, p < 0.001), lipid arc > 180° (HR 2.1, 95%CI 1.2-3.6, p = 0.010), minimum lumen area < 3.5 mm2 (HR 1.7, 95%CI 1.01-3.0, p = 0.047) and the Gensini score (HR 1.4, 95%CI 1.1-1.8, p = 0.017) were independent predictors of the main composite endpoint. In this post-hoc analysis of the CLIMA study, the burden of coronary atherosclerosis as assessed by the Gensini score and OCT plaque characteristics were independent predictors of cardiac events. Patients with the largest atherosclerosis burden and with plaque vulnerability by OCT were at the highest risk of poor outcome. Clinicaltrials.gov identifier: NCT02883088.

Diagnostic value of CT liver-to-spleen attenuation ratio in patients with non-alcoholic fatty liver disease and atherosclerotic plaque

Objective: To explore the clinical value of computed tomography (CT) liver-to-spleen (L/S) attenuation ratio in patients with non-alcoholic fatty liver disease (NAFLD) accompanied by atherosclerotic plaque (AP). Methods: This was a single-center, retrospective, observational study of patients who were diagnosed with NAFLD undergoing CT scans at Beijing Changping Hospital of Chinese Medicine from April 2020 to April 2022. Patients were grouped according to whether they had a diagnosis of AP or not. Healthy individuals without NAFLD undergoing CT scans during the same period were also included as a control group. The patients were matched for gender, age, and BMI in a 1:1:1 ratio. Correlations between the CT L/S attenuation ratio, liver function indicators, and blood lipid levels were assessed in the three groups. The predictive value of the CT L/S attenuation ratio was evaluated using the receiver operating characteristic (ROC) curve and the area under the curve (AUC) analyses. Results: Eighty-nine cases in each group. The three groups had significant differences in liver function and blood lipid levels (P&lt;0.05). The CT L/S attenuation ratio in the NAFLD+AP and NAFLD groups was lower than that in the control group and was the lowest in the NAFLD+AP group (P&lt;0.05). There was no significant correlation between the CT L/S attenuation ratio and liver function indicators (P&gt;0.05), but it positively correlated with high-density lipoprotein (HDL) and negatively correlated with low-density lipoprotein (LDL), triglycerides (TG), and total cholesterol (TC) (P&lt;0.05). The CT L/S attenuation ratio had a high predictive value for NAFLD patients with AP (AUC=0.859). Conclusions: The CT L/S attenuation ratio in NAFLD patients with AP is significantly reduced and is closely related to the levels of blood lipid indicators. The CT L/S attenuation ratio has a high predictive value for NAFLD patients with AP. doi: https://doi.org/10.12669/pjms.40.10.10578 How to cite this: Han D, He C, Gu S, Zhang D, Xu L. Diagnostic value of CT liver-to-spleen attenuation ratio in patients with non-alcoholic fatty liver disease and atherosclerotic plaque. Pak J Med Sci. 2024;40(10):2416-2421. doi: https://doi.org/10.12669/pjms.40.10.10578 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

EphA2 blockage ALW-II-41-27 alleviates atherosclerosis by remodeling gut microbiota to regulate bile acid metabolism.

Coronary artery disease (CAD), a critical condition resulting from systemic inflammation, metabolic dysfunction, and gut microbiota dysbiosis, poses a global public health challenge. ALW-II-41-27, a specific inhibitor of the EphA2 receptor, has shown anti-inflammatory prosperities. However, the impact of ALW-II-41-27 on atherosclerosis has not been elucidated. This study aimed to examine the roles of pharmacologically inhibiting EphA2 and the underlying mechanism in ameliorating atherosclerosis. ALW-II-41-27 was administered to apoE-/- mice fed a high-fat diet via intraperitoneal injection. We first discovered that ALW-II-41-27 led to a significant reduction in atherosclerotic plaques, evidenced by reduced lipid and macrophage accumulation, alongside an increase in collagen and smooth muscle cell content. ALW-II-41-27 also significantly lowered plasma and hepatic cholesterol levels, as well as the colonic inflammation. Furthermore, gut microbiota was analyzed by metagenomics and plasma metabolites by untargeted metabolomics. ALW-II-41-27-treated mice enriched Enterococcus, Akkermansia, Eggerthella and Lactobaccilus, accompanied by enhanced secondary bile acids production. To explore the causal link between ALW-II-41-27-associated gut microbiota and atherosclerosis, fecal microbiota transplantation was employed. Mice that received ALW-II-41-27-treated mouse feces exhibited the attenuated atherosclerotic plaque. In clinical, lower plasma DCA and HDCA levels were determined in CAD patients using quantitative metabolomics and exhibited a negative correlation with higher monocytes EphA2 expression. Our findings underscore the potential of ALW-II-41-27 as a novel therapeutic agent for atherosclerosis, highlighting its capacity to modulate gut microbiota composition and bile acid metabolism, thereby offering a promising avenue for CAD.

MAIN MORPHOLOGICAL FEATURES OF THROMBI FORMED IN CORONARY ARTERIES

Abstract. Purpose: to explore the features of the structure of intracoronary thrombi obtained during manual thromboaspiration as part of primary percutaneous coronary intervention in patients with acute ST-segment elevation myocardial infarction (STEMI). Materials and Methods. The study included 100 patients with STEMI. All of them underwent stenting preceded by manual thromboaspiration. The obtained material was fixed in formalin and stained with hematoxylin-eosin and orange-red-blue (Zerbino- Lukasiewicz method). Results. Based on the fibrin age assessment, the thrombi were old or fresh. Some thrombi showed signs of organization in the form of microchannels. Homogeneous and layered thrombi were distinguished by structure. Sometimes there were pronounced signs of neutrophil infiltration, mainly along the periphery of the thrombus. Occasionally, components of atherosclerotic plaque were found in intracoronary thrombi. Most often these were cholesterol crystals and foam cells. Conclusions. Intracoronary thrombi formed in STEMI have different ages and different structural features. This is probably due to the peculiarities of the pathogenesis of the disease.

Glucose metabolism controls monocyte homeostasis and migration but has no impact on atherosclerosis development in mice

Monocytes directly contribute to atherosclerosis development by their recruitment to plaques in which they differentiate into macrophages. In the present study, we ask how modulating monocyte glucose metabolism could affect their homeostasis and their impact on atherosclerosis. Here we investigate how circulating metabolites control monocyte behavior in blood, bone marrow and peripheral tissues of mice. We find that serum glucose concentrations correlate with monocyte numbers. In diet-restricted mice, monocytes fail to metabolically reprogram from glycolysis to fatty acid oxidation, leading to reduced monocyte numbers in the blood. Mechanistically, Glut1-dependent glucose metabolism helps maintain CD115 membrane expression on monocytes and their progenitors, and regulates monocyte migratory capacity by modulating CCR2 expression. Results from genetic models and pharmacological inhibitors further depict the relative contribution of different metabolic pathways to the regulation of CD115 and CCR2 expression. Meanwhile, Glut1 inhibition does not impact atherosclerotic plaque development in mouse models despite dramatically reducing blood monocyte numbers, potentially due to the remaining monocytes having increased migratory capacity. Together, these data emphasize the role of glucose uptake and intracellular glucose metabolism in controlling monocyte homeostasis and functions.

Time-dependent simulation of blood flow through an abdominal aorta with iliac arteries.

Atherosclerosis is one of the important diseases of the circulatory system because atherosclerotic plaques cause significant disruption of blood flow. Therefore, it is very important to properly understand these processes and skillfully simulate blood flow. In our work, we consider blood flow through an abdominal aorta with iliac arteries, assuming that the right iliac artery is narrowed by an atherosclerotic lesion. Blood flow is simulated using the laminar, standard and standard models. The obtained results show that despite the use of identical initial conditions, the distribution of velocity flow and wall shear stress depends on the choice of flow simulation model. For the model, we obtain higher values of speed and wall shear stress on atherosclerotic plaque than in the other two models. The laminar and models predict larger areas where reverse blood flow occurs in the area behind the atherosclerotic lesion. This effect is associated with negative wall shear stress. These two models give very similar results. The results obtained by us, and those reported in the literature, indicate that model is the most suitable for blood flow analysis.

Anti-atherosclerotic effect of incretin receptor agonists

Incretin receptor agonists (IRAs), primarily composed of glucagon-like peptide-1 receptor agonists (GLP-1RAs) and glucose-dependent insulinotropic polypeptide receptor agonists (GIPRAs), work by mimicking the actions of the endogenous incretin hormones in the body. GLP-1RAs have been approved for use as monotherapy and in combination with GIPRAs for the management of type 2 diabetes mellitus (T2DM). In addition to their role in glucose regulation, IRAs have demonstrated various benefits such as cardiovascular protection, obesity management, and regulation of bone turnover. Some studies have suggested that IRAs not only aid in glycemic control but also exhibit anti-atherosclerotic effects. These agents have been shown to modulate lipid abnormalities, reduce blood pressure, and preserve the structural and functional integrity of the endothelium. Furthermore, IRAs have the ability to mitigate inflammation by inhibiting macrophage activation and promoting M2 polarization. Research has also indicated that IRAs can decrease macrophage foam cell formation and prevent vascular smooth muscle cell (VSMC) phenotype switching, which are pivotal in atheromatous plaque formation and stability. This review offers a comprehensive overview of the protective effects of IRAs in atherosclerotic disease, with a focus on their impact on atherogenesis.

A cross-sectional study of factors associated with carotid atherosclerosis

ObjectiveThe aim of this work was to study the relationship between carotid atherosclerosis (CAS) and several indexes and provide a basis for the prevention and treatment of cardiovascular and cerebrovascular diseases.MethodsThere were 11,028 adults who underwent physical examination at the Guangzhou Cadre and Talent Health Management Center from January 2023 to December 2023 and were selected as research subjects. Retrospective analysis was used to understand the carotid atherosclerosis of the examined population and analyze its relationship with sex, age, blood pressure, blood glucose, blood lipids, renal function, 25-hydroxyvitamin D, neutrophil to lymphocyte count ratio (NLR), platelet to lymphocyte count ratio (PLR), systemic immune inflammation index (SII), monocyte count to high-density lipoprotein cholesterol ratio (MHR), triglyceride glucose body mass index (TyG-BMI), insulin resistance metabolic index (METS-IR), and other indicators.ResultsAmong 11,028 subjects, the detection rate of carotid atherosclerotic thickening (CAT) was 12.00% and carotid atherosclerotic plaque (CAP) was 25.11%. The CAT and CAP detection rates in men were 13.32% and 28.78%, respectively, which were higher than the CAT detection rate of 8.28% and CAP detection rate of 14.80% in women, and the differences were statistically significant (both p &amp;lt; 0.001). Multivariate logistic regression analysis using TyG-BMI and METS-IR as two indicators was modeled separately, and the results showed that CAS was associated with men, increasing age, and systolic blood pressure. The area under the curve (AUC) was analyzed using the subject’s work characteristic (ROC) curve in the descending order of METS-IR, TyG-BMI, and MHR. The combination of the three indexes of sex, age, and METS-IR predicted atherosclerosis with the highest AUC values.ConclusionCarotid atherosclerosis is highly prevalent in men. Elevation of systolic blood pressure, fasting glucose, MHR, and TyG-BMI (or METS-IR) with age are independent influences on carotid atherosclerosis. The three indexes of MHR, TyG-BMI, and METS-IR, respectively, in combination with sex and age, can be used as a new and effective index to predict CAS.

Citrullination Accompanies the Development of Carotid Atherosclerotic Plaques.

Citrullination represents a post-translational modification primarily mediated by peptidylarginine deiminase (PADI) 2 and 4 and resulting in the conversion of positively charged peptidylarginine to neutrally charged peptidylcitrulline. Molecular consequences of citrullination include the generation of neoepitopes which provoke the production of autoantibodies implicated in the development of autoimmune diseases. As citrullination initiates, promotes, and is enhanced by aseptic inflammation which plays a pivotal role in atherosclerosis, we proposed that citrullination might accompany the development of atherosclerotic vascular disease. To investigate features and patterns of citrullination in atherosclerotic plaques. We collected carotid atherosclerotic plaques (n = 14) and adjacent arterial segments (n = 14) which were pairwise excised during the carotid endarterectomy. The tissues were examined employing proteomic profiling (ultra-high performance liquid chromatography-tandem mass spectrometry analysis), haematoxylin and eosin staining, Western blotting and immunofluorescence staining for peptidylcitrulline, PADI2, and PADI4, and gene expression analysis. To better explore the mechanisms of citrullination in the neointima, we have also stained excised plaques for the extracellular vesicle markers (CD9 and CD81) and assessed co-localisation of PADI2 (a citrullination marker) with CD81 (an extracellular vesicle marker). In order to study the systemic response to citrullination in an atherosclerotic vascular disease setting, we measured the level of anti-citrullinated protein antibodies in the serum of patients with ischaemic stroke and healthy volunteers. Proteomic profiling found 213 plaque-specific and 111 intact arteria-specific proteins, as well as 46 proteins and 13 proteins which have been respectively upregulated or downregulated in plaques as compared with the adjacent intact segments. Among the top 20 upregulated proteins were atherogenic apolipoprotein B-100, iron-associated protein haptoglobin, and matrix metal-loproteinase-9, together indicating the advanced stage of plaque progression. In comparison with the intact arterial segments, plaques demonstrated protein signatures of innate immune response and oxidative stress, suggesting aseptic inflammation as a driver of atherosclerotic vascular disease. Both peptidylcitrulline and PADI2 have been abundant in the neointima but negligible in tunica media; further, the levels of peptidylcitrulline, PADI2, and PADI4 were elevated in plaque lysates in comparison with those from adjacent arterial segments (p = 0.025, 0.025, and 0.010, respectively). Notably, PADI2 and peptidylcitrulline were co-localised with the cells in the neointima and a considerable proportion of PADI2 was co-localised with CD81-positive extracellular vesicles (p = 0.003). Albeit citrullinated histone H3 and myeloperoxidase showed higher signal in the neointima than in tunica media (p = 0.048 and 0.023, respectively), we did not observe any signs of neutrophil extracellular traps (e.g., unwound chromatin or co-localisation of citrullinated histone H3 with neutrophil elastase) in the plaque tissue. Serum anti-citrullinated protein antibodies were not elevated in patients with ischaemic stroke (p = 0.71), suggesting that vascular citrullination likely does not trigger a generalised immune response. The development of carotid atherosclerosis is associated with citrullination, although it represents a local rather than systemic phenomenon in this clinical scenario.

The Impact of RNA Interference on Atherosclerotic Plaque Progression: A Meta-Analysis of Preclinical Studies

Background: Atherosclerosis, a chronic inflammatory disease characterized by the buildup of plaque within arteries, remains a leading cause of cardiovascular morbidity and mortality. RNA interference (RNAi) has emerged as a promising therapeutic strategy for atherosclerosis by targeting genes involved in plaque formation and progression. This meta-analysis aimed to evaluate the efficacy of RNAi in preclinical models of atherosclerosis. Methods: A systematic search of PubMed, Embase, and Web of Science databases was conducted from January 2013 to December 2023 to identify preclinical studies investigating the impact of RNAi on atherosclerotic plaque progression. Studies utilizing various RNAi modalities (siRNA, miRNA mimics/inhibitors, shRNA) targeting different genes involved in atherosclerosis were included. The primary outcome was plaque size reduction. Secondary outcomes included changes in plaque composition, lipid profiles, and inflammatory markers. A random-effects model was used to pool data and calculate standardized mean differences (SMD) with 95% confidence intervals (CI). Heterogeneity was assessed using the I² statistic. Results: Seven preclinical studies met the inclusion criteria, encompassing a total of 210 animals. RNAi interventions significantly reduced atherosclerotic plaque size compared to controls (SMD -1.51; 95% CI -2.36 to -0.66; p&lt;0.00001; I²=12%). Analysis of secondary outcomes revealed favorable effects of RNAi on plaque composition, with a significant decrease in lipid content and an increase in collagen content. Furthermore, RNAi significantly improved lipid profiles by reducing total cholesterol and LDL-cholesterol levels. A significant reduction in inflammatory markers, such as TNF-α and IL-6, was also observed. Conclusion: This meta-analysis provides compelling evidence supporting the therapeutic potential of RNAi in attenuating atherosclerotic plaque progression in preclinical models. RNAi effectively reduced plaque size, improved plaque stability, and modulated lipid metabolism and inflammation.

Morphological and Hemodynamic Features of the Carotid Artery on Color Doppler Ultrasound in Hypertensive Patients

Objective: 1. Described the characteristics and morphology of the carotid artery on color Doppler ultrasonography in patients with hypertensive. 2. Determine the relationship between carotid intima-media thickness (cIMT) on color Doppler ultrasound images and some clinical and laboratory parameters and some risk factors in hypertensive patients. Subjects and methods: This was a cross-sectional descriptive study on 64 hospitalized hypertensive patients. Results: 62.5% are female. Mean age 66.41±11.91. The right common cIMT 0.74 (0.7-0.81) mm; the left was 0.8 (0.7-0.8) mm; the average cIMT on both sides was 0.75 (0.75-0.79) mm. Mean peak systolic velocity of the right common carotid artery 58.03±14.74 cm/s; left side 60.71±15.73 cm/s. Right common carotid end-diastolic velocity 14.68±4.88 cm/s; left side 16.09±6.04 cm/s. Right common carotid resistance index 0.75±0.063; left side 0.74±0.067. There were 25 (39.1%) cases of right common carotid atherosclerotic plaque with the thickest 2.500.71mm and 33 (51.6%) cases of left common carotid plaque with the thickest 2.3 (1.99-2)mm. There were an independent correlation between age and sex with the cIMT on both sides with correlation coefficients of R=0.514, p=0.013; R=0.514, p &lt; 0.0001, respectively. Conclusion: There were a correlation between the common cIMT with age and sex, every 1 year increase will increase the thickness of the common cIMT by 0.005 mm. cIMT was higher than in men.

A Retrospective Comparative Analysis of Chest Radiograph Findings Among Patients in a Tertiary Hospital in Rivers State, Nigeria

Background: Chest radiograph is an imaging modality that uses ionizing radiation used for the evaluation of the thorax and its content. It is readily available, accessible, cheap and greatly employed in the health sector for various reasons. Objective: Chest radiographs serve as an indispensable diagnostic instrument when it comes to evaluating cardiac and respiratory ailments. The purpose of this study is to examine and compare chest radiograph findings in a tertiary institution, over a two-year period retrospectively. Methods: A retrospective analysis of 6,223 chest radiographs was performed at the University of Port Harcourt Teaching Hospital. From patient records, demographic and clinical data were extracted and analysed with SPSS version 21.0, setting the level of statistical significance at p&lt;0.05. Results: The mean age of the study population was 38.14±20.25 years, and the female gender comprised the majority (54.93%). Cardiomegaly was the most frequently observed indication (20.48%), whereas pleural effusion/collection was the least frequent (4.04%). A statistically significant disparity was identified among all clinical parameters across years: cardiomegaly and aortic unfolding exhibited a higher prevalence in 2019, whereas atheromatous plaques demonstrated a greater prevalence in 2020. Conclusion: The prevalence of cardiomegaly highlights the possible necessity for routine chest radiographs among the ageing adult population in Nigeria. This research emphasises the significance of ongoing radiographic monitoring for the early detection of cardiothoracic conditions and offers valuable epidemiological insights.

18F-NaF uptake on vascular PET imaging in symptomatic versus asymptomatic atherosclerotic disease: A meta-analysis.

18F-sodium fluoride (NaF) positron-emission tomography (PET) is increasingly being used to measure microcalcification in atherosclerotic disease in vivo. Correlations have been drawn between sodium fluoride uptake and the presence of high-risk plaque features, as well as its association with clinical atherosclerotic sequelae. The aim of this study was to perform a meta-analysis of NaF uptake on PET imaging and its relation to symptomatic and asymptomatic disease. A systematic review was performed according to PRISMA guidelines, via searching the Ovid MEDLINE, Ovid Embase, Cochrane Library, PubMed, Scopus, and Web of Science Core Collection databases up to May 2024. The search strategy included the terms 'NaF', 'PET', and 'plaque', and all studies with data regarding the degree of microcalcification, as measured by 18F-NaF uptake in symptomatic and asymptomatic atherosclerotic plaques, were included. Analysis involved calculating mean differences between uptake values and comparison using a random-effects model. A total of 16 articles, involving 423 participants, were included in the meta-analysis (10 carotid artery studies, five coronary artery studies, and one in peripheral vascular disease). Comparing 18F-NaF uptake in symptomatic versus asymptomatic atherosclerotic plaques, a mean difference of 0.43 (95% CI 0.29 to 0.57; p < 0.0001, I2 = 65%) was noted in studies comparing symptomatic and asymptomatic plaques in the same participant, with a significant difference in effect based on arterial territory studied (χ2 = 12.68, p = 0.0018). In studies of participants with and without symptomatic disease, there was no significant difference between symptomatic and asymptomatic plaques (mean difference 0.27, 95% CI -0.26 to 0.80, p = 0.28, I2 = 85%). PET imaging using 18F-NaF can detect differences in microcalcification between symptomatic and asymptomatic atherosclerotic plaques within, but not between, individuals, and thus, is a marker of symptomatic disease. The standardization of 18F-NaF PET imaging protocols, and its future use as a risk stratification tool or outcome measure, requires further study. (PROSPERO Registration ID: CRD42023451363).

POSSIBILITIES OF RADIOLOGICAL SCAN METHODS WITH POST-PROCESSING IMAGE RECONSTRUCTION IN THE ASSESSMENT OF ATHEROSCLEROTIC PLAQUES OF THE CAROTID ARTERIES

The aim. To establish the informativeness of the methods of computed tomography angiography, ultrasound diagnostics and magnetic resonance arteriography without contrast in patients with atherosclerosis of carotid arteries. Materials and methods. During July 2022 - July 2024, 82 male patients were examined on the basis of the Neurological Pathology Diagnostic Center of the KNP "Regional Clinical Hospital of the Ivano-Frankivsk Regional Council". Forty-six of them were included in the study group with clinical signs of atherosclerotic lesions of the carotid arteries. Thirty-six patients with asymptomatic course of the carotid arteries atherosclerosis were chosen as the control group. Patients of both groups were aged 51-79 years, and were homogeneous in terms of concomitant diseases, duration of smoking and lipidogram results. Exclusion criteria from both cohorts were: the presence of arrhythmia, radiation treatment of oncological processes in the projection of the head and neck, diagnosed Alzheimer's disease or Fara's disease, lack of written informed consent to participate in the study, impaired legal capacity of the person, when the written consent cannot be considered truly conscious. CTA was performed using a 160-slice computer tomograph Aquilion Prime Toshiba Scanner TSX-302A (Toshiba) with SUREPlaque software to analyze atherosclerotic plaques and vessels in the Carotid CTA fast scanning mode. MRI of the head and neck with non-contrast MR-arteriography was performed using a 1.5 Tesla Phillips Achieva device using blood flow imaging sequences: s3DI MC (three-dimensional time of flight MR-angiography). Ultrasound of the carotid arteries was performed using the Esaote MyLab9eXP device using B-mode, Doppler mapping and elastography. Atherosclerotic plaques were assessed according to the new imaging-based classification - Carotid Plaque-RADS from 2024. The results. According to the classification of Carotid Plaque-RADS, the following results were obtained according to visualization by ultrasound and CT methods: a combination of plaques of categories from Plaque-RADS 2 to Plaque-RADS 4, considering the types of each category, was detected in patients of both groups. There was no significant difference between the groups in the assessment of the structure of the atherosclerotic plaque (p=0.616). For the study group, the detection of the higher percentage of the stenotic lumen of the vessel was statistically different (median - 68.5% (interquartile range 9.75%)) compared to the control group (median - 60.0% (interquartile range 7.5%)) (p =0.048). A comparison of the degree of stenosis by ultrasound and CTA methods was carried out, where a direct correlation of very high strength according to the Chaddock scale was established (r=0.934 (confidence interval: 0.881 – 0.964), p˂0.001). Atherosclerotic lesions were characterized by indirect signs on MRI, namely: wall filling defects, which most likely correspond to plaques, increased bends of main arteries. Conclusions. Ultrasound diagnostics and reconstructive post-processing capabilities of computed tomography were practically equivalent in assessing the degree of stenosis with high correlation strength (r=0.934) and highly informative images of atherosclerotic masses of carotid arteries, while non-contrast magnetic resonance arteriography allowed to suspect atherosclerotic lesions as an area of ​​a filling defect without detailed tissue structures.

Comparative analysis of retinal microvascular parameters in healthy individuals with or without carotid artery stenosis or plaque.

To evaluate the correlations between retinal microvascular changes and carotid artery stenosis (CAS) with and without plaques using fundus photography. Patients who had undergone bilateral carotid ultrasonography and bilateral fundus photography were divided into the following groups based on the carotid intima-media thickness (IMT) determined via ultrasonography in this retrospective, observational study: the control and CAS (comprising CAS with and without plaque subgroups) groups. The following retinal indicators were determined via fundus photography based on a deep learning algorithm: the arteriole-to-venule ratio (AVR), whole retinal fractal dimension (FD), arteriolar fractal dimension (AFD), venular fractal dimension (VFD), vascular density (VD), and VD within 3 mm (VD3mm) and 5 mm (VD5mm) from the macular fovea. The correlations between these indicators and IMT were also assessed. In total, 715 participants, comprising 313 participants with CAS (CAS group; 91 with plaque and 222 without plaque) and 402 participants without CAS (control group), participated in this study. AFD, VFD, and FD in the CAS group were significantly lower than those in the control group (all p < 0.001). VD, VD3mm, and VD5mm showed significant differences between the groups (all p < 0.05). VFD in the CAS with plaque group was lower than that in the group without plaque (p = 0.014). VD3mm, and VD5mm showed significantly negative correlations with IMTmin in the CAS subgroup. AFD, VFD, FD, VD, VD3 mm, and VD5 mm decreased, and fundus photography based on deep learning algorithm may provide new approaches for screening of CAS.

A Retrospective Observational Study Examining Physical Activity Among Adults in the United States With Angina or Coronary Heart Disease.

Coronary heart disease (CHD) involves inadequate blood supply to the myocardium by the coronary arteries due to the formation of atherosclerotic plaque in the vessel lumen. It has a complex etiopathogenesis. Physical activity (PA) and exercise lead to vascular remodeling and improved endothelial function, which, in turn, improves the arterial blood supply to the myocardium. The study aims to determine the prevalence of self-reported PA among CHD patients in the United States based on demographic, socioeconomic, and healthcare access variables for the year 2021. The data for the study on CHD were extracted using the Behavioral Risk Factor Surveillance System (BRFSS) Web-Enabled Analysis Tool database of the U.S. The control variables used broadly include demographics, socioeconomic, and healthcare access. In 2021, 433,615 people in the USA participated in the BRFSS study. Among them, 22,819 self-identified as having angina or CHD. In the past month, 62.2% of participants with the disease were involved in PA, and 37.8% were not. Among participants without angina or CHD, 76.5% were involved, and 23.5% were not involved in PA in the past month. This study highlights the need for specific interventions to overcome obstacles preventing PA among CHD patients.