Carotid Artery Remodeling Research Articles

Sodium-glucose cotransporter 1 promotes the biofunctions of perivascular preadipocytes mediated by Akt/mTOR/p70S6K signaling pathway.

The influence of SGLT-1 on perivascular preadipocytes (PVPACs) and vascular remodeling is not well understood. This study aimed to elucidate the role and mechanism of SGLT-1-mediated PVPACs bioactivity. PVPACs were cultured in vitro and applied ex vivo to the carotid arteries of mice using a lentivirus-based thermosensitive in situ gel (TISG). The groups were treated with Lv-SGLT1 (lentiviral vector, overexpression), Lv-siSGLT1 (RNA interference, knockdown), or specific signaling pathway inhibitors. Assays were conducted to assess changes in cell proliferation, apoptosis, glucose uptake, adipogenic differentiation, and vascular remodeling in the PVPACs. Protein expression was analyzed by Western blotting, immunocytochemistry, and/or immunohistochemistry. The methyl thiazolyl tetrazolium (MTT) assay and Hoechst 33342 staining indicated that SGLT-1 overexpression significantly promoted PVPACs proliferation and inhibited apoptosis in vitro. Conversely, SGLT-1 knockdown exerted the opposite effect. Oil Red O staining revealed that SGLT-1 overexpression facilitated adipogenic differentiation, while its inhibition mitigated these effects. 3H-labeled glucose uptake experiments demonstrated that SGLT-1 overexpression enhanced glucose uptake by PVPACs, whereas RNA interference-mediated SGLT-1 inhibition had no significant effect on glucose uptake. Moreover, RT-qPCR, Western blotting, and immunofluorescence analyses revealed that SGLT-1 overexpression upregulated FABP4 and VEGF-A levels and activated the Akt/mTOR/p70S6K signaling pathway, whereas SGLT-1 knockdown produced the opposite effects. In vivo studies corroborated these findings and indicated that SGLT-1 overexpression facilitated carotid artery remodeling. Our study demonstrates that SGLT-1 activation of the Akt/mTOR/p70S6K signaling pathway promotes PVPACs proliferation, adipogenesis, glucose uptake, glucolipid metabolism, and vascular remodeling.NEW & NOTEWORTHY SGLT-1 is expressed in PVPACs and can affect preadipocyte glucolipid metabolism and vascular remodeling. SGLT-1 promotes the biofunctions of PVPACs mediated by Akt/mTOR/p70S6K signaling pathway. Compared with caudal vein or intraperitoneal injection, the external application of lentivirus-based thermal gel around the carotid artery is an innovative attempt at vascular remodeling model, it may effectively avoid the transfection of lentiviral vector into the whole body of mice and the adverse effect on experimental results.

Evaluating the association between vascular remodeling and plaque calcification patterns of the carotid artery and its effects on ischemic symptoms using CT angiography.

Arterial remodeling is a compensatory mechanism of the vessel wall in response to atherosclerotic plaque growth. However, the clinical significance of vascular remodeling of carotid lesions remains unclear. Through this study, we aimed to evaluate the association between vascular remodeling and ischemic symptoms in patients with an internal carotid artery (ICA) stenosis degree ≥50%, considering the differences in plaque calcification patterns. This retrospective cross-sectional study included adult patients with moderate-to-severe proximal ICA stenosis associated with atherosclerotic plaques admitted to the Zhejiang Hospital between September 2018 and March 2023. Parameters such as lumen diameter, plaque calcification types, calcium scores, and calcification thickness were assessed using non-contrast and contrast-enhanced computed tomography angiography (CTA). The remodeling ratio (RR) was calculated by dividing the maximum distance of the proximal ICA between the inner border of the arterial lumen at the plaque site and the outer borders of the plaque by the luminal diameter. Atherosclerosis risk factors and medications were recorded. The Mann-Whitney U test or chi-square test was used to compare the differences between groups. Correlations were measured using Pearson's correlation coefficient. Predictors of ischemic symptoms were assessed using multivariable logistic regression analysis, with results expressed as odds ratio (ORs) with 95% confidence intervals (CIs). A P value less than 0.05 (two-sided) was considered to indicate statistical significance The differences in RR among plaque calcification types and the association between vascular remodeling and clinical symptoms were analyzed. A total of 242 ICAs in 196 patients were included in this study, and 84 were symptomatic and 158 were asymptomatic. The RR in symptomatic ICA [median, 1.31 (interquartile range, 1.17-1.68)] was significantly greater than that in asymptomatic group [median, 1.20 (interquartile range, 1.05-1.45)], P=0.006). Significant differences in RR existed among plaque calcification types, among which type 5 and 6 plaques had the highest RR. About 71.5% (173/242) of all ICAs showed positive remodeling. Significant correlations were observed between RR and ischemic symptoms and between positive remodeling and calcification thickness (P<0.05 for all variables). On multivariable logistic regression analysis, calcification thickness remained significantly associated with positive remodeling of carotid arteries (OR 2.30; 95% CI: 1.06-5.01; P=0.036). Arterial remodeling exists in the ICA. A significant association between arterial positive remodeling and plaque calcification thickness was established. RR helps predict ischemic symptoms. The results of our study suggest that arterial remodeling serves as a novel measure to help ascertain the risk stratification of ischemic events in carotid atherosclerotic disease.

A Novel Window Into Human Vascular Remodeling and Diagnosing Carotid Flow Impairment: The Petro-Occipital Venous Plexus.

Background Adaptive arterial remodeling caused by flow reduction from downstream stenosis has been demonstrated in animal studies. The authors sought to determine whether inward remodeling from downstream stenosis also occurs in humans and is detectable by ex vacuo expansion of the Rektorzik venous plexus (RVP) surrounding the petrous internal carotid artery. Methods and Results The authors analyzed 214 intracranial magnetic resonance imaging examinations that included contrast-enhanced vessel wall imaging. RVP symmetry was qualitatively assessed on vessel wall imaging. RVP thickness (RVPT) was measured on the thicker side if asymmetric or randomly assigned side if symmetric. Maximum stenosis (M1 or intracranial internal carotid artery) was measured. Posterior communicating artery and A1 diameters (>1.0 mm and 1.5 mm, respectively) defined adequate collateral outflow when proximal to the stenosis. Seventy-two patients had stenosis downstream from RVPT measurements. For those without adequate outflow (38 of 72), 95.0% with RVPT ≥1.0 mm had ≥50% stenosis compared with only 5.6% with RVPT <1.0 mm. For these 72 patients, higher RVPT (RVPT ≥1.0 mm versus <1.0 mm) and absent adequate outflow were associated with greater downstream stenosis (P<0.001) using multivariate regression. For patients with downstream stenosis without adequate outflow, asymmetric RVP thickening was associated with greater ipsilateral stenosis (P<0.001, all had ≥46% stenosis) when stenosis was unilateral and greater differences in stenosis between sides (P=0.005) when stenosis was bilateral. Conclusions Inward internal carotid artery remodeling measured by RVPT or RVP asymmetry occurs as downstream stenosis approaches 50%, unless flow is preserved through a sufficiently sized posterior communicating artery or A1, and may serve as a functional measure of substantial flow reduction from downstream stenosis.

Morbid obesity is associated with hypertrophic outward remodeling and increased stiffness of small conduit arteries: An ultra-high frequency ultrasound study

Background and aimsAlthough many studies have been published on the effect of obesity on large and small arteries, there are no data in the literature regarding the effect of obesity on medium-sized arteries, and in particular of small conduit arteries. The aim of the present study was to investigate whether patients with severe obesity presented structural or functional alterations in different arterial segments. Methods and results34 patients with severe obesity (BMI≥35 kg/m2) and 34 age-and sex-matched normal weight patients were recruited as controls. Aortic stiffness (carotid-femoral pulse wave velocity) and wave reflection (augmentation index) were recorded. Ultrasound images of common carotid, radial and interdigital arteries were acquired for the assessment of wall-to-lumen ratio, wall cross-sectional area (WCSA), compliance, distensibility coefficient (DC) and Young's elastic modulus (Einc). Insulin sensitivity was calculated by oral glucose sensitivity index (OGIS). No differences between groups in carotid artery remodeling were found, while WCSA of the radial and interdigital arteries were higher in obese group than in controls. As regard the parameters of vascular elasticity, the DC of radial and interdigital arteries were lower (p = 0.025 and p = 0.001, respectively), as well as the Einc of radial arteries was higher (p = 0.021), in subject with obesity compared to controls. All these correlations were consistent after adjustment for the main covariates. Finally, in a multiple regression analysis OGIS was and independent determinant of interdigital artery DC (R2 = 0.29, p = 0.001). ConclusionsFor the first time, we describe an outward remodeling and increased stiffness in small conduit arteries in severe obesity.

Remodeling of Retinal Arterioles and Carotid Arteries in Heart Failure Development-A Preliminary Study.

Current data indicate that heart failure (HF) is associated with inflammation and microvascular dysfunction and remodeling. These mechanisms could be involved in HF development and progression, especially in HF with preserved ejection fraction (HFpEF). We aimed to compare structural changes in retinal arterioles and carotid arteries between HF patients and patients without heart failure. This preliminary, retrospective, case-control study included 28 participants (14 patients with HFpEF and 14 age- and sex-matched healthy controls). Carotid intima-media thickness to lumen ratio (cIMTLR) was assessed using B-mode ultrasonography. Retinal arterioles wall- to-lumen ratio (rWLR) was assessed by adaptive optics camera rtx1. The HF patients had higher IMTLR (Δmedian [HFpEF–control group] 0.07, p = 0.01) and eWLR (Δmedian 0.03, p = 0.001) in comparison to patients without HF. In the whole study group, rWLR correlated significantly with IMTLR (r = 0.739, p = 0.001). Prevalence of arterial hypertension was similar in both groups, however, patients with HF had a significantly lower office, central and 24-h ambulatory blood pressure (systolic Δmedian −21 to −18 mmHg; diastolic Δmedian −23 to −10 mmHg). Our data suggests gradual and simultaneous progression of vascular remodeling in both retinal arterioles and carotid arteries in HFpEF patients. This process could be a marker of HF development. Significantly lower blood pressure values in HF group may indicate that vascular remodeling could be independent of BP control. Nevertheless, further and larger prospective studies allowing to reduce the impact of confounding and address temporality are warranted.

The role of thyroid hormones in carotid arterial wall remodeling in women.

Introduction: Thyroid hormones affect the cardiovascular system, but the precise mechanisms of their effects on the development of atherosclerosis are not entirely clear. The relationship between subclinical hypothyroidism, dyslipidemia and carotid atherosclerosis has been widely investigated, but the findings were controversial. The aim of the present study was to determine whether female subjects with subclinical hypothyroidism (SHypo) have increased carotid intima-media thickness (IMT) compared with euthyroid subjects, as well as to examine the association of SHypo, carotid atherosclerosis and dyslipidemia.Methods: This research included 100 women aged 30 to 70 years who were divided into two groups: the SHypo group including subjects with signs of subclinical hypothyroidism and the control group of euthyroid subjects. Carotid IMT thickness using B mode ultrasound was determined and its correlation with serum concentrations of fT4, TSH, CRP, and lipid profile including small dense LDL (sdLDL) was analysed.Results: Subjects with SHypo had significantly increased carotid IMT (IMT ≥ 75th centile) in all three measured segments of the right (p <0.001) and the left (p = 0.001) carotid artery compared to the control group, with a significantly more frequent appearance of plaque (25% vs. 9%; p = 0.05). Significant positive correlations were found between higher TSH and higher IMT values. Increased age, LDL cholesterol, and TSH predicted thickening of the carotid artery IMT.Conclusions: It is important to screen people showing early, subclinical signs of thyroid gland dysfunction due to its impact on carotid atherosclerosis development.

Ремоделювання сонних артерій у жінок з артеріальною гіпертензією та його зв’язок із додатковими факторами ризику

Актуальність. Артеріальна гіпертензія (АГ) разом із дією інших додаткових факторів серцево-судинного ризику обумовлює зміни в стінці артерій, що виражається в потовщенні комплексу інтима-медіа (КІМ), головним чином за рахунок середньої оболонки — медії. Мета дослідження: вивчити особливості ремоделювання загальних сонних артерій у жінок з АГ за допомогою ультразвукової пошарової оцінки інтими і медії та визначити вплив на них додаткових факторів серцево-судинного ризику. Матеріали та методи. Обстежено 98 жінок з АГ I і II стадії 1-го і 2-го ступеня (основна група) та 42 здорові жінки (контрольна група). На апараті LOGIC PRO P5 у В-режимі вимірювали товщину КІМ, інтими, медії та діаметр загальних сонних артерій. Проведено добове моніторування артеріального тиску, допплерехокардіографію, оцінку індексу маси тіла, швидкості клубочкової фільтрації, ліпідограми, рівня креатиніну, глюкози плазми крові. Результати. При пошаровому скануванні стінки загальних сонних артерій у жінок з АГ порівняно з контрольною групою виявлено достовірне збільшення товщини КІМ (0,068 ± 0,009 см проти 0,052 ± 0,009 см, р &lt; 0,001) переважно за рахунок шару медії (0,042 ± 0,008 проти 0,028 ± 0,009 см, р &lt; 0,001). Товщина шару інтими в досліджуваних групах була статистично порівнянна (р &gt; 0,05). Виявлений прямий кореляційний зв’язок товщини КІМ і медії з віком (r = +0,26; р &lt; 0,001 і р = 0,56; р &lt; 0,001), рівнем систолічного артеріального тиску (r = +0,30; р &lt; 0,01 і r = +0,31; р &lt; 0,01), глюкози (r = +0,37; р &lt; 0,001 і r = +0,31, р &lt; 0,01), з індексом маси тіла (r = +0,27; р &lt; 0,01 і r = +0,22; р &lt; 0,05) і обернений — зі швидкістю клубочкової фільтрації (r = –0,36; р &lt; 0,001 і r = –0,41; р &lt; +0001). Висновки. У жінок з АГ товщина КІМ на 30,8 %, а шару медії — на 33,4 % більша, ніж у контрольній групі (р &lt; 0,001). Загальний внесок таких факторів, як рівень систолічного артеріального тиску, індекс маси тіла, швидкість клубочкової фільтрації, концентрація холестерину ліпопротеїнів низької щільності, глюкози, у прогресування потовщення КІМ становив 68 % і збігся з впливом на шар медії — 62 % на відміну від впливу на шар інтими, де їх внесок становив 26 %.

Roles of NOD1/Rip2 signal pathway in carotid artery remodelling in spontaneous hypertensive rats.

Nucleotide-binding and oligomerization domain (NOD) receptor is a member of inherent immunity recognition receptor family. We investigated the NOD1/Rip2 signalling pathway on carotid arterial remodelling in spontaneously hypertensive rats (SHRs). SHRs were treated with NOD1 agonist (iE-DAP), inhibitor (ML130), or normal saline. We determined the NOD1 and Rip2 expression in carotid artery tissues, serum tumour necrosis factor-α (TNF-α) and monocyte chemotactic protein-1 (MCP-1). The carotid artery remodelling in 16-week SHRs was higher than that of 8-week SHRs and 16-week Wistar-Kyoto (WKY) rats. Expression of NOD1, Rip2, MCP-1 and TNF-α in 16-week SHRs was higher than that of 8-week SHRs and 16-week WKY rats. Blood pressure in iE-DAP-treated SHRs was higher than SHR-C group (no treatment), together with MCP-1, TNF-α, NOD1 and Rip2 expression, as well as carotid artery remodelling. In ML130-treated group, these aspects were completely the opposite. Taken together, inhibition of NOD1/Rip2 signalling pathway could delay the vascular remodelling process.

Plasticity of the bony carotid canal and its clinical use for assessing negative remodeling of the internal carotid artery.

Background and objectiveIt has long been believed that the bony carotid canal has no plasticity and that a small canal represents a hypoplastic internal carotid artery. We aimed to show whether the carotid canal can narrow according to morphological changes in the internal carotid artery.Materials and methodsThe carotid canal diameter was longitudinally measured in seven individuals who underwent carotid artery ligation. As moyamoya disease is known to be associated with negative remodeling of the internal carotid artery, the carotid canal diameter was measured in 106 patients with moyamoya disease, and an association with the outer diameter of the internal carotid artery or a correlation with the disease stage was investigated. The carotid canal was measured by computed tomography (106 patients), and the outer diameter of the artery was measured by high-resolution magnetic resonance imaging (63 patients). The carotid canal area was calculated by the product of the maximum axial diameter and its perpendicular diameter.ResultsAll seven patients who underwent carotid artery ligation showed narrowing of the carotid canal, and the carotid canal area decreased by 12.2%–28.9% during a mean follow-up period of 4.2 years. In patients with moyamoya disease, the carotid canal area showed a linear correlation with the outer area of the internal carotid artery (r = 0.657, p < 0.001), and a negative correlation with the disease stage (ρ = −0.283, p < 0.001).ConclusionThe bony carotid canal has plasticity, and its area reflects the outer area of the internal carotid artery, therefore, it can be used to assess the remodeling of the carotid artery. A narrow carotid canal may not necessarily indicate hypoplastic internal carotid artery.

Reduced Smooth Muscle Contractile Capacity Facilitates Maladaptive Arterial Remodeling.

Albeit seldom considered explicitly, the vasoactive state of a central artery can contribute to luminal control and thereby affect the in vivo values of flow-induced wall shear stress and pressure-induced intramural stress, which in turn are strong determinants of wall growth and remodeling. Here, we test the hypothesis that diminished vasoactive capacity compromises effective mechano-adaptations of central arteries. Toward this end, we use consistent methods to re-interpret published data on common carotid artery remodeling in a nonpharmacologic mouse model of induced hypertension and a model of connective tissue disorder that results in Marfan syndrome. The mice have identical genetic backgrounds and, in both cases, the data are consistent with the hypothesis considered. In particular, carotid arteries with strong (normal) vasoactive capacity tend to maintain wall thickness and in vivo axial stretch closer to homeostatic, thus resulting in passive circumferential wall stress and energy storage close to normal. We conclude that effective vasoactivity helps to control the biomechanical state in which the cells and matrix turnover, thus helping to delineate mechano-adaptive from maladaptive remodeling. Future analyses of experimental data and computational models of growth and remodeling should account for this strong coupling between smooth muscle contractile capacity and central arterial remodeling.

Visit-to-visit blood pressure variability in mild cognitive impairment: A possible marker of Alzheimer's disease in the SPRINT study?

Visit-to-visit blood pressure variability in mild cognitive impairment: A possible marker of Alzheimer's disease in the SPRINT study?

Insulin-like growth factor-1 blood levels and carotid artery remodeling in hypertensive patients with type 2 diabetes mellitus

Background and Aims: Insulin-like growth factor-1 (IGF-1) is an important link in the regulation of structural and functional changes in the vascular bed. We aimed to study the relationship between blood levels of IGF-1 and indicators of carotid artery remodeling in hypertensive patients with type 2 diabetes mellitus (T2DM).

Ameliorated biomechanical properties of carotid arteries by puerarin in spontaneously hypertensive rats

BackgroundAn emerging body of evidence indicates that puerarin (PUE) plays an important role in the treatment of angina pectoris, myocardial ischemia-reperfusion injury, hypertension and other cardiovascular diseases, but how PUE affects the vascular remodeling of hypertensive rats has not been reported yet. This study aimed to investigate the effect and mechanism of PUE on carotid arteries of spontaneously hypertensive rats (SHR) to provide the basis for the clinical application of PUE.MethodsThirty male SHR and six male Wistar Kyoto rats (WKY) aged 3 months were used in this study, SHR rats were randomly divided into 5 groups, PUE(40 or 80 mg/kg/d, ip) and telmisartan (TELMI) (30 mg/kg/d, ig) were administrated for 3 months. We use DMT myography pressure-diameter system to investigate biomechanical properties of carotid arteries, 10 μM pan-classical transient receptor potential channels (TRPCs) inhibitor SKF96365, 200 nM specific TRPC6 inhibitor SAR7334 and 100 μM Orai1 inhibitor ANCOA4 were used in the mechanical test.ResultsPUE can significantly decrease systolic and diastolic blood pressure, long-term administration of PUE resulted in a mild reduction of thickness and inner diameter of carotid artery. PUE ameliorate NE-response and vascular remodeling mainly through inhibiting TRPCs channel activities of VSMC.ConclusionPUE can ameliorate biomechanical remodeling of carotid arteries through inhibiting TRPCs channel activities of VSMC in spontaneously hypertensive rats.

LOWER CIRCULATING MIR-191-5P AND LET-7G-5P ARE INDEPENDENT BIOMARKERS OF RENAL INJURY

Objective: Hypertension is associated with subclinical target organ damage including cardiac, vascular and kidney injury. Circulating microRNAs have been investigated as biomarkers of cardiovascular disease, but few studies have examined them as target organ damage biomarkers in hypertension. We aimed to identify circulating microRNAs that could serve as biomarkers of hypertension-induced target organ damage using an unbiased approach. Design and method: Normotensive subject, hypertensive patients (HTN) and patients with HTN associated with at least 2 other features of the metabolic syndrome (MetS) or with chronic kidney disease (CKD) grades 3–4 were studied (n = 15–16). Blood pressure was determined by automated office measurement (AOBP). Blood and urine were collected for determination of blood cell count, blood biochemistry and urinalysis. Platelet-free plasma (6 mL) was isolated from blood collected on EDTA, and RNA extracted for small RNA deep sequencing using Illumina HiSeq-2500. Differentially expressed (DE) genes were identified with a threshold of false discovery rate &lt; 0.1. The most abundant DE miRNAs were confirmed by reverse transcription-quantitative PCR (RT-qPCR). Right common carotid artery remodeling and stiffness were assessed by ultrasound and aorta stiffness by carotid to femoral pulse wave velocity. Results: We found 4 up-regulated and 4 down-regulated miRNAs uniquely associated with the HTN group, 1 up-regulated uniquely associated with the MetS group, 1 up-regulated and 12 down-regulated miRNAs uniquely associated with the CKD group and 8 were found similarly DE in different groups (P &lt; 0.01 and q &lt; 0.1). Two down-regulated miRNAs, let-7g-5p and miR-191–5p of 11, the most abundant DE miRNAs, were validated by RT-qPCR. Correlation analysis revealed that let-7g-5p was associated with large vessel stiffening, miR-191–5p with diabetes, and both microRNAs with estimated glomerular filtration rate (eGFR) and inflammatory markers. Using let-7g-5p and miR-191–5p and parameters that correlated with eGFR as candidate variables, stepwise multiple linear regression generated a model showing that let-7g-5p, miR-191–5p and urinary albumin/creatinine ratio predicted eGFR with an adjusted R2 of 0.40 (P = 1.1e-5). Conclusions: Circulating let-7g-5p and miR-191–5p were identified as independent biomarkers of chronic kidney disease among patients with hypertension, which could have pathophysiological and therapeutic implications.

Association of 3 single nucleotide polymorphisms of the eighth chromosome with remodeling of the myocardium and carotid arteries in the Kazakh population.

Cardiovascular diseases are one of the key health issues in Kazakhstan. According to the WHO, the prevalence of arterial hypertension (AH) was 28% in males and 25% in females in 2015, which puts up vastly to premature mortality from non-communicable diseases.The search for genetic features of target organ lesions processes in AH is relevant. The goal of this study was to search for the genetic markers of myocardial remodeling (MR) and carotid artery remodeling (CAR).A total of 866 hypertensive individuals were recruited in Nur-Sultan, Kazakhstan. Their blood was genotyped for 9 single nucleotide polymorphisms (SNPs) of the eighth chromosome to find an association with remodeling. The analysis was carried out in the group pairs (control and CAR, control and MR, and control and CAR and MR). The genotype–phenotype association was assessed using 5 different inheritance models: dominant, codominant, recessive, overdominant, and log-additive.Statistically significant results were found for 3 SNPs (rs2407103, rs11775334, rs2071518) which minor alleles enlarged risks of MR and CAR in AH in the studied population. Three polymorphisms have previously been associated with АН and some other traits like pulse pressure and blood glucose in other ethnic populations: rs2407103 – in Afro-American population, rs11775334 – in the European population, rs2071518 is well studied in various ethnic populations (European, South Asian, Afro-American, Hispanic, East Asian).

Abstract 13020: Obesity-related Vascular Functional Change Becomes Apparent in Early Childhood

Background: Obesity is associated with structural and functional changes in the artery, but there is little information when arterial dysfunction begins to appear. The purpose of this study is to investigate the relationship between body mass index (BMI) z-score and arterial function from childhood to adolescence. Methods: Echocardiography was performed in 779 healthy children. Subjects were divided into 3 age groups: pre-school children group, 4 to 6 year (n =236); school children group, 7 to 12 years (n = 385); adolescents group, 13 to 20 years (n = 158). Stroke volume was calculated using aortic diameter and pulsed Doppler velocity profile. SV was indexed for body surface area (SVI). Effective arterial elastance (Ea) was estimated by end-systolic pressure/SVI and total arterial compliance (Ca) by pulse pressure/SVI. Quantitative B-mode ultrasound scans were used to measure intima-media thickness and diameters of the common carotid artery. Results: Intima-media thickness of carotid artery did not change with BMI z-score in the pre-school and school children groups (r = 0.09 and 0.11, p &gt; 0.05, respectively), but a weak but significant correlation between intima-media thickness of carotid artery and BMI z-score was found in the adolescents group (r = 0.20, p &lt; 0.05). In the pre-school children group, Ea and Ca did not correlate with BMI z-score, but there were significant relationships between BMI z-score and Ea and Ca in the school children (r = 0.27 and 0.16, p &lt; 0.01, respectively) and in the adolescents groups (r = 0.38 and 0.29, p &lt; 0.01, respectively). The slope of the relationship between BMI z-score and Ea in the adolescents group was significantly steeper compared with the school children group (p&lt;0.05). Conclusion: Obesity-related arterial functional changes begin to appear in younger school children, however, remodeling of the common carotid artery is not yet present. With advancing age, negative effects of obesity on vascular functional and morphological changes become apparent. Our findings suggest that primary prevention programs should be initiated in early childhood.

Five-year dynamics of carotid artery remodeling in hypertensive patients working on a fly-in/fly-out basis in the Arctic

Aim. To analyze the 5-year dynamics of atherosclerotic remodeling of common carotid arteries (CCA) in persons with hypertension (HTN) working on a fly-in/fly-out basis in the Arctic. To determine sex characteristics, factors associated with atherosclerotic plaque (ASP) imaging, and outcome endpoints. Material and methods. In the period 2012-2017, 372 (men, 273; women, 99) employees with grade 1-2 HTN working on a fly-in/fly-out basis in the Arctic were observed. Depending on the ultrasound data, the subjects were divided into 2 groups: with an initially normal CCA wall (men, 137; women, 65) and with subclinical carotid atherosclerosis (SCA) in the form of intima-media thickness (IMT) increase &gt;0,9 mm (men, 136; women, 34) without differentiable ASPs. The dynamics of CCA wall remodeling was analyzed depending on sex, the level of mean 24-hour blood pressure (BP) and echocardiography data on the left ventricular (LV). Factors associated with the identification of ASPs and endpoints were determined. Results. Men with HTN were significantly more likely to have SCA than women. The frequency of ASP imaging directly depended on the initial CCA characteristics and was higher in both sexes with IMT increase. The level of mean 24-hour BP insignificantly influenced the atherosclerosis severity. According to the 5-year follow-up, the structure of CCA wall changed significantly more often in men than in women. In individuals with concentric LV hypertrophy, regardless of the initial CCA state, the highest prevalence of ASP was recorded. The progression of the atherosclerotic process was more intense in individuals with concentric remodeling and normal LV geometry in combination with IMT increase. In individuals with initial atherosclerosis of CCA, acute myocardial infarction and acute cerebrovascular accident developed significantly more often than in patients with initially normal CCA walls. Conclusion. Under the fly-in/fly-out conditions in the Arctic, in hypertensive men significantly more often than in women, SCA was detected and was characterized by more intense progression during 5-year follow-up. In men, it was significantly more often accompanied by cardiovascular complications. It is important to identify signs of SCA for early initiation of therapy in order to prevent fatal cardiovascular events in Arctic workers.

Calcium-Binding Protein S100A4 Is Upregulated in Carotid Atherosclerotic Plaques and Contributes to Expansive Remodeling.

BackgroundCarotid plaques with expansive arterial remodeling are closely related to cerebral ischemic events. Although S100A4 (S100 calcium‐binding protein A4) is expressed in atherosclerotic lesions, its role in atherosclerotic plaque progression remains unknown. In this study, we examined the association between carotid arterial expansive remodeling and S100A4 expression.Methods and ResultsPreoperative high‐resolution magnetic resonance imaging was used to assess luminal stenosis and vascular remodeling in patients undergoing carotid endarterectomy. To examine murine carotid atherosclerosis, we induced experimental lesions by flow cessation in apolipoprotein E‐deficient mice fed a high‐fat diet. The role of S100A4 in plaque formation and smooth muscle cell proliferation was investigated in vivo and in vitro, respectively. Human carotid arterial expansive remodeling showed positive correlations with the expression of S100A4, MMP2, and MMP9. S100A4 mRNA levels were positively correlated with those of MMP2, MMP9, and MMP13. S100A4 was expressed in vascular smooth muscle cells (VSMCs) and VSMC‐derived foam cells in the plaque shoulder and marginal areas. S100A4 expression increased concomitantly with plaque formation in our animal model. Exogenous recombinant S100A4 protein enhanced the levels of Mmp2, Mmp9, and Mmp13 and the cell proliferation ability in VSMCs. A chemotaxis assay indicated that extracellular S100A4 functions as a chemoattractant for VSMCs.ConclusionsS100A4 expression was elevated in human carotid plaques and showed a positive correlation with the degree of expansive remodeling. S100A4‐positive VSMC‐derived cells are considered to play an important role in carotid expansive remodeling.

Prediction of the Steady State of Carotid Atherosclerotic Plaque in Essential Hypertension Under Magnetic Resonance Imaging

In order to improve the detection rate of carotid atherosclerotic plaque in patients with essential hypertension and provide a reliable basis for the follow-up treatment of patients, magnetic resonance imaging (MRI) was used to predict the stability of carotid atherosclerotic plaque in patients with essential hypertension. A total of 77 patients with essential hypertension in XXX hospital from June 2015 to December 2015 were included in the study (including 49 males and 28 females). The patients were divided into stable plaque group and unstable plaque group according to their pathological plaque status. First, MRI was performed and imaging data were recorded, including intraplaque bleeding, fibrous cap status, carotid artery remodeling index, thickest layer of plaque, and the degree of luminal stenosis in both groups. Second, patients in both groups were followed up for three years, during which time MRI was reperformed every six months, and the time required for changes in the carotid artery indicators in the two groups was compared with the Log Rank test. Third, multivariate Logistic regression model was used to analyze the correlation between plaque stability and gender, family history of cardiovascular disease, body mass index, and basic characteristics of hypertension course. The results showed that the number of IPH and fibrous cap rupture in the unstable plaque group was significantly higher than that in the stable plaque group (P &lt; 0.05). The Log Rank test showed that the time required for the change of carotid artery plaque morphology in the stable plaque group was significantly lower than that in the unstable plaque group (P &lt; 0.05). Besides, plaque stability was significantly positively correlated with gender and hypertension course (P &lt; 0.05), but was not significantly correlated with family history of cardiovascular disease and body mass index (P &gt; 0.05). Therefore, the plaque data of patients can be obtained based on MRI, so as to evaluate the stable status of patients’ plaque and predict the long-term status of patients, which provides an experimental scheme for the future clinical prediction of the plaque status of essential hypertension carotid atherosclerosis.

Gender aspects of cardiac and carotid arteries remodeling and estimation of load test in watch workers in the Arctic

Objective.To define gender aspects of subclinical atherosclerosis and evaluate interrelation of cardiac and carotid arteries (CA) remodeling with the results of the load test in the watch workers in the Arctic.Design and methods.Within a periodic health examination during one year, 743 males and 213 females doing watch work in the Arctic were examined selectively. CA ultrasound examinations, echocardiography treadmill test and 24-hour blood pressure (BP) monitoring were performed.Results.In the northern watch conditions, the rate of random thickening of intima-media complex (IMC) is equal in males and females and is related to age. Atherosclerotic plaques (AP) in CA were found twice more often in males than in females. In males, IMC thickening correlated with age, watch work duration and BP, whereas AP presence was also associated with left ventricular (LV) remodeling type, 24-hour BP profile and poorly with treadmill test results. CA structure alterations in females were influenced by age and LV remodeling only. Normal average BP was found in hypertensive patients (34,9 % males and 42,1 % females) according to 24-hour BP monitoring. Log-linear analysis showed association between AP in CA lumen and average daily BP in males (by 19,5 %) and in females (by 1,1 %).Conclusions.In the northern watch conditions, subclinical carotid atherosclerosis has significant gender differences and is present twice more often in males than in females. It is associated with age, 24-hour BP profile and mildly with office and average daily BP, significantly with LV concentric hypertrophy and concentric remodeling and poorly with treadmill test results. Further studies are required to find key determinants of the atherosclerosis to decrease cardiovascular risk in the Arctic watch workers.