Carotid Plaque Stability Research Articles

Osteopontin's N-terminal fragment uncovers carotid plaque stability associated with statin or antiplatelet therapy in hypertensive patients

Osteopontin's N-terminal fragment uncovers carotid plaque stability associated with statin or antiplatelet therapy in hypertensive patients

CTRP9 enhances carotid plaque stability by reducing pro-inflammatory cytokines in macrophages

The aim of this study was to investigate whether C1q/TNF-related protein 9 (CTRP9) could stabilize the mature plaques by targeting macrophages in the apolipoprotein E knockout (ApoE KO) mice model. In vivo, the mice were subjected to high-fat diet and constrictive collars on the right carotid artery for eight weeks, a lentiviral vectors expressing CTRP9 (LV-CTRP9) or green fluorescence protein (LV-eGFP) as a control was intravenously injected into ApoE KO mice. Delivery of LV-CTRP9 resulted in low contents of macrophages and lipids, and high contents of collagen and vascular smooth muscle cells in the carotid mature plaques. In addition, CTRP9 also decreased pro-inflammatory cytokines in mature plaques. In vitro, RAW264.7 macrophages were pretreated with or without LV-CTRP9 transfection, and then stimulated with oxLDL (50 μg/mL). We found that the expression levels of tumor necrosis factor-α (TNF-α) and monocyte chemoattractant protein 1 (MCP-1) in the LV-CTRP9 group were significantly lower than those in the LV-eGFP group after exposure to oxLDL. The present data indicate that CTRP9 overexpression enhances the plaque stability in ApoE KO mice by reducing pro-inflammatory cytokines in macrophages. Our study suggests that the therapeutic approaches to enhance CTRP9 production could be valuable for plaque stabilization.

Abstract W P378: Cerebrovascular Risk Factors and Carotid Plaque Stability: a Community Cross-Sectional Study in Chinese Stroke High-Risk Population

Introduction: Previous carotid ultrasound studies have found that carotid plaques with low echogenicity which suggest poor stability had a higher risk of cerebrovascular events. Studies to investigate the relationship between carotid plaques stability and cerebrovascular risk factors in stroke high-risk population are rare. The aim of the present study is to examine the relationship between cerebrovascular risk factors and carotid plaques stability in stroke high-risk population in China. Methods: A community cross-sectional study was conducted from 2012 to 2013. A cluster random sample of 2558 Chinese participants aged 40 years or older was enrolled. The risk factors for cerebrovascular disease were assessed. Carotid plaque stability was conducted by high-resolution color Doppler ultrasound. Logistic regression model was used to analyze the association between cerebrovascular risk factors and carotid plaque stability. Results: Hypertension (odds ratio = 1.513; 95% confidence interval = 1.176-1.946), smoking (OR = 173.788; 95% confidence interval = 86.495-349.180), hyperlipidemia (OR = 1.566; 95% confidence interval = 1.245-1.969), diabetes mellitus (OR = 1.274; 95% confidence interval = 1.037-1.566) and hyperhomocysteinemia(OR = 1.009; 95% confidence interval = 1.000-1.017) are independently associated with development of carotid plaques. However, only triglyceride level (OR = 1.177; 95% confidence interval = 1.046-1.323) is an independent risk factor for carotid plaque stability. Conclusion: In subjects from the Chinese stroke high-risk population with unstable plaques, This founding suggest that triglyceride level may be associated with unstable carotid plaques, rather than other risk factors.

Effect of menopausal status on carotid intima-media thickness and presence of carotid plaque in Chinese women generation population.

Menopause is an important physiological stage in women's life. The potential association of menopause with carotid intima-media thickness as well as with occurrence and stability of carotid plaque in Chinese female population is unclear. We conducted a population-based, cross-sectional study by recruiting 2,131 participants aged above 40 years from northeast of China. Carotid intima-media thickness (CIMT), presence of carotid plaque and its stability were evaluated by carotid duplex sonography. Among the participants, 1,133 (53.2%) were identified to be postmenopausal. After adjusting for potential confounding factors, presence of CIMT at 50th- 75th and ≥75th percentiles, carotid plaque and its unstable status were found to be significantly associated with the postmenopausal status (P < 0.001). When matched the participants by age, post-menopausal status was still associated with a higher risk of having unstable plaque. Moreover, our data show that postmenopausal status is a risk factor for intracranial arterial stenosis when compared with premenopausal status in the univariate analysis (OR = 1.314, P = 0.043), and such relationship is lost when the confounding factors are adjusted (OR = 0.828, P = 0.225). In conclusion, the vascular risk factors increase as the menopausal status changes. Compared with premenopausal status, postmenopausal status is associated with higher morbidity of CIMT, carotid plaque and its unstable status.

Correlation of plasma soluble cluster of differentiation 40 ligand, alpha fetoprotein A, and pregnancy-associated plasma protein A with carotid plaque in patients with ischemic stroke.

This study investigated the correlation of plama levels of inflammatory biomarkers [soluble cluster of differentiation 40 ligand (sCD40L), alpha fetoprotein A (fetuin-A), and pregnancy-associated protein A (PAPP-A)] with carotid plaque in patients with acute ischemic stroke. After undergoing color Doppler ultrasonography of the bilateral carotid arteries, 200 patients with acute ischemic stroke were grouped into plaque and non-plaque groups. The plaque group was further divided into stable and unstable plaque sub-groups by carotid plaque stability. Inter-group and -subgroup comparisons included demographic characteristics, current condition and medical history, and clinical laboratory and plama inflammatory biomarker data, and logistic regression explored the correlations between plama inflammatory biomarker levels and carotid plaques. Significantly higher sCD40L and fetuin-A levels were found in the plaque group than in the non-plaque group (all P < 0.05), with odds ratios (plaque vs non-plaque) of 6.372 and 4.101, respectively. Increased plama inflammatory biomarker levels were accompanied by a high risk of carotid plaque formation. Similarly, significantly higher plama sCD40L and PAPP-A levels were found in the unstable plaque subgroup than in the stable plaque subgroup (all P < 0.05), and the odds ratios (unstable vs stable) were 5.290 and 4.125, respectively. Increased plama inflammatory biomarker levels were accompanied by a high risk of carotid plaque instability. The study findings showed that plasma sCD40L, fetuin-A, and PAPP-A levels are associated with carotid plaque formation and instability. Fetuin-A and sCD40L might be predictors of carotid plaque formation, while PAPP-A and sCD40L might be predictors of carotid plaque instability.

The relationship between carotid artery plaque stability and white matter ischemic injury.

Higher local carotid artery strain has previously been shown to be a characteristic of unstable carotid plaques. These plaques may be characterized by microvascular changes that predispose to intraplaque hemorrhage, increasing the likelihood of embolization. Little is known however, about how these strain indices correspond with imaging markers of brain health and metrics of brain structure. White matter hyperintensities (WMHs), which are bright regions seen on T2-weighted brain MRI imaging, are postulated to result from cumulative ischemic vascular injury. Consequently, we hypothesized that plaques that are more prone to microvascular changes and embolization, represented by higher strain indices on ultrasound, would be associated with an increased amount of WMH lesion volume. This relationship would suggest not only emboli as a cause for the brain degenerative changes, but more importantly, a common microvascular etiology for large and small vessel contributions to this process. Subjects scheduled to undergo a carotid endarterectomy were recruited from a neurosurgery clinic. Prior to surgery, participating subjects underwent both ultrasound strain imaging and brain MRI scans as part of a larger clinical study on vascular health and cognition. A linear regression found that maximum absolute strain and peak to peak strain in the surgical side carotid artery were predictive of WMH burden. Furthermore, the occurrence of microembolic signals monitored using transcranial Doppler (TCD) ultrasound examinations also correlated with increasing lesion burden. It is becoming increasingly recognized that cognitive decline is often multifactorial in nature. One contributing extra-brain factor may be changes in the microvasculature that produce unstable carotid artery plaques. In this study, we have shown that higher strain indices in carotid artery plaques are significantly associated with an increased WMH burden, a marker of vascular mediated brain damage.

Anti-inflammatory immune skewing is atheroprotective: Apoe−/−FcγRIIb−/− mice develop fibrous carotid plaques.

BackgroundStroke, caused by carotid plaque rupture, is a major cause of death in the United States. Whereas vulnerable human plaques have higher Fc receptor (FcγR) expression than their stable counterparts, how FcγR expression impacts plaque histology is unknown. We investigated the role of FcγRIIb in carotid plaque development and stability in apolipoprotein (Apo)e−/− and Apoe−/−FcγRIIb−/− double knockout (DKO) animals.Methods and ResultsPlaques were induced by implantation of a shear stress‐modifying cast around the carotid artery. Plaque length and stenosis were followed longitudinally using ultrasound biomicroscopy. Immune status was determined by flow cytometry, cytokine release, immunoglobulin G concentration and analysis of macrophage polarization both in plaques and in vitro. Surprisingly, DKO animals had lower plaque burden in both carotid artery and descending aorta. Plaques from Apoe−/− mice were foam‐cell rich and resembled vulnerable human specimens, whereas those from DKO mice were fibrous and histologically stable. Plaques from DKO animals expressed higher arginase 1 (Arg‐1) and lower inducible nitric oxide synthase (iNOS), indicating the presence of M2 macrophages. Analysis of blood and cervical lymph nodes revealed higher interleukin (IL)‐10, immune complexes, and regulatory T cells (Tregs) and lower IL‐12, IL‐1β, and tumor necrosis factor alpha (TNF‐α) in DKO mice. Similarly, in vitro stimulation produced higher IL‐10 and Arg‐1 and lower iNOS, IL‐1β, and TNF‐α in DKO versus Apoe−/− macrophages. These results define a systemic anti‐inflammatory phenotype.ConclusionsWe hypothesized that removal of FcγRIIb would exacerbate atherosclerosis and generate unstable plaques. However, we found that deletion of FcγRIIb on a congenic C57BL/6 background induces an anti‐inflammatory Treg/M2 polarization that is atheroprotective.

Carotid atherosclerotic plaque stenosis: the stabilizing role of statins.

Both pathophysiology and treatments of carotid atherosclerotic plaque stenosis represent two interesting fields of strong scientific investigation. Among different drugs, safety and efficacy of statin treatment have been widely investigated and proved. This narrative review is based on the material searched for and obtained via MEDLINE and PubMed up to March 2014. The search terms we used were: 'carotid plaque, intima-media thickness, plaque burden, stroke' in combination with 'statins, pleiotropic effects, HMG-CoA reductase inhibitors, lipid-lowering drugs'. Carotid stenosis represents both a useful parameter to evaluate the atherosclerotic burden and a target for therapeutic (medical or surgical) decisions. Statins do not only improve the lipid profile, but also induce some 'pleiotropic' anti-inflammatory activities that contribute to carotid plaque stabilization. Statin-mediated protective activities are under active investigation at subclinical levels with the potential benefit of advanced imaging techniques. However, considering that some new techniques (excepted B-mode ultrasound) remain quite expensive, they can have for the moment an important role in research, but not in the clinical field. Emerging evidence suggests that statin treatment improves carotid atherosclerosis, inducing a partial regression of plaque inflammation and size. Innovative imaging techniques might also ameliorate the identification of patients at high risk of cerebrovascular and coronary events, for which preventive statin treatments might be essential.

Osteoprotegerin, pericytes and bone-like vascular calcification are associated with carotid plaque stability.

Background and PurposeVascular calcification, recapitulating bone formation, has a profound impact on plaque stability. The aim of the present study was to determine the influence of bone-like vascular calcification (named osteoid metaplasia = OM) and of osteoprotegerin on plaque stability.MethodsTissue from carotid endarterectomies were analysed for the presence of calcification and signs of vulnerability according to AHA grading system. Osteoprotegerin (OPG), pericytes and endothelial cells were sought using immuno-histochemistry. Symptoms and preoperative imaging findings (CT-scan, MRI and Doppler-scan) were analyzed. Human pericytes were cultured to evaluate their ability to secrete OPG and to influence mineralization in the plaque.ResultsSeventy-three carotid plaques (49 asymptomatic and 24 symptomatic) were harvested. A significantly higher presence of OM (18.4% vs 0%, p<0.01), OPG (10.2% of ROI vs 3.4% of ROI, p<0.05) and pericytes (19% of ROI vs 3.8% of ROI, p<0.05) were noted in asymptomatic compared to symptomatic plaques. Consistently, circulating OPG levels were higher in the plasma of asymptomatic patients (3.2 ng/mL vs 2.5 ng/mL, p = 0.05). In vitro, human vascular pericytes secreted considerable amounts of OPG and underwent osteoblastic differentiation. Pericytes also inhibited the osteoclastic differentiation of CD14+ cells through their secretion of OPG.ConclusionsOPG (intraplaque an plasmatic) and OM are associated with carotid plaque stability. Pericytes may be involved in the secretion of intraplaque OPG and in the formation of OM.

Study on the correlation between serum interleukin-6, matrix metalloproteinase-9 and stability of carotid artery plaque in patients of acute coronary syndrome complicated with diabetes mellitus

Objective To investigate the correlation between serum interleukin-6,matrix metallo-proteinase-9 and stability of carotid artery plaque in patients of acute coronary syndrome (ACS) complicated with diabetes mellitus (DM).Methods 104 cases of ACS complicated with DM were selected,then according to the results of the ultrasound measurement of bilateral carotid artery,they were divided into intima-media thickness (IMT) normal group (20 cases),IMT thickening group (36 cases),stable plaque group (30 cases),and unstable plaque group (18 cases).Serum levels of interleukin (IL)-6,matrix metalloproteinase (MMP)-9 were measured by enzyme linked immunosorbent assay (ELISA).Results The levels of plasma IL-6 and MMP-9 in IMT normal group,IMT thickening group,stable plaque group and unstable plaque group were higher than those in control group [(295.3 ± 43.8),(369.5 ± 46.2),(446.2±44.7),(533.6 ±48.1) ng/L vs.(216.7 ±39.8) ng/L and (172.3 ±24.6),(228.6 ±26.2),(287.4±30.1),(372.8 ±31.5) μg/L vs.(98.7 ±20.7) μg/L],and there were significant differences (P ＜ 0.05 for all) ; In IMT normal group,IMT thickening group,stable plaque group and unstable plaque group,the levels of plasma IL-6 and MMP-9 gradually increased,and the differences among the groups were statistically significant (P ＜ 0.05 for all).Conclusion There is a significant correlation between serum IL-6,MMP-9 levels and carotid plaque stability in patients of ACS complicated with diabetes mellitus,which can provide some indicative effect for the occurrence and development of vascular disease. Key words: Acute coronary syndrome; Diabetes mellitus; Interleukin-6; Matrix metalloproteinase-9; Carotid artery plaque

Relationship between levels of homocysteine and serum uric acid and stability of carotid atherosclerotic plaque in young patients with cerebral infarction

Objective To investigate the relationship between levels of homocysteine （ Hcy ） and serum uric acid（ UA） and stability of carotid atherosclerotic plaque in young patients with cerebral infarction .Methods 150 cases of cerebral infarction in young patients carried the carotid ultrasonography were divided into the non -plaque group （ n=37）,stable plaque group（n=52） and unstable plaque group（n=61） according to the results.The levels of Hcy and UA in the three groups of patients were detected and analyzed statistically .Results The stable plaque group′s Hcy and UA levels were （15.92 ±2.52）μmol/L and （294.85 ±25.52）μmol/L,which were significantly higher than those of the non-plaque group（t=7.33,6.89,all P〈0.05）;The unstable plaque group′s Hcy and UA levels were （23.17 ±3.82 ）μmol/L and （ 388.57 ±26.61 ）μmol/L, which were significantly higher than those of the the non-plaque group and stable plaque group（t=9.82,10.02,6.90,7.12,all P〈0.05）.Conclusion There is a close correlation between the stability of carotid artery plaque and the levels of Hcy and UA . Key words: Brain infarction; Cysteine; Uric acid; Atherosclerosis carotid

Effects of high resting heart rate on the stability of carotid artery plaque in a middle and advanced aged population

To explore the effect of high resting heart rate (RHR) on the stability of carotid artery plaque in a middle and advanced aged population. During 2010-2011, a total of 5 852 participants were selected randomly from 101 510 workers of a Tangshan Kailuan company. RHR was measured and carotid artery ultrasound performed to detect the carotid artery plaque. Logistic regression was performed to analyze the influencing factors of carotid artery stable and unstable plaque. There were 4 894 subjects aged 40-95 years, including 2 945 males and 1 949 females. The detection rates of carotid artery stable and unstable plaque were 25.7% and 25.4% in low RHR group versus 23.8% and 33.2% in high RHR group. Compared with low RHR group, the risk of carotid artery unstable plaque increased to 29% in high RHR group after adjusting for all influencing factors. The odds ratio was 1.290 (95% CI 1.039-1.062). High RHR can increase the risk of carotid artery unstable plaque in middle and advanced aged population.

Homocysteine and carotid plaque stability: a cross-sectional study in Chinese adults.

Background and PurposeThis study aimed to explore the possible association of plasma total homocysteine with carotid plaque stability.MethodsA cross-sectional study was conducted from 2010 to 2011. A stratified random sample of 2,919 Chinese participants aged 40 years or older was enrolled. Plasma total homocysteine levels were measured and carotid plaques were evaluated by ultrasonography. Logistic regression model was used to analyze the association of homocysteine levels to the progression of carotid plaque development, while adjusting for demographics and vascular risk factors.ResultsThe mean level of plasma homocysteine in the subjects was 14.9 µmol/l. Along with increase in homocysteine level, the risk of advanced carotid plaque elevated (odds ratio = 1.28; 95% confidence interval = 1.09–1.51) after adjusting for age, sex, and other potential confounders. Stratified by sex, higher homocysteine level was strongly associated with advanced carotid plaque in men (OR = 1.41; 95% confidence interval = 1.17–1.70), but not in women.ConclusionThe findings suggest that plasma level of homocysteine may be associated with advanced carotid plaque, which constitutes high risks of stroke, in male Chinese adults.

Clinical study on treatment of carotid atherosclerosis with extraction of Polygoni Cuspidati Rhizoma et Radix and Crataegi Fructus：a randomized controlled trial

To observe the effect of detoxifying and blood circulation activating Chinese herb extraction of polygonum cuspidatum and hawthorn on carotid intima-media thickness (IMT), plaque integral and plaque stability related serum indexes of patients with carotid atherosclerosis. Sixty and four cases of carotid artery atherosclerosis patients were assigned randomly to 2 groups: detoxifying and blood circulation activating treatment group (treatment group, 32 cases) and control group (32 cases). Patients in treatment group were treated with capsules of extraction of polygonum cuspidatum and hawthorn, 1 pill po, bid (dosage of administration: polygonum cuspidatum extraction 5.33 mg x kg(-1) x d(-1), hawthorn extraction 5.0 mg x kg(-1) x d(-1)); patients in control group were treated with lovastatin 20 mg po, qd (dosage of administration: 0.33 mg x kg(-1) x d(-1)). The course of treatment was six months. To observe changes of IMT, plaque integral, and detect the level of plaque stability related serum indexes such as Hs-CRP, MMP-1 and TIMP-1. After 6 months of treatment, in control group one patient quit the clinical trial because of liver dysfunction and one patient was rejected because of having not followed the therapeutic regimen. 32 cases in treatment group and 30 cases in control group were analyzed. The results showed that IMT and plaque integral of treatment group decreased significantly after the treatment (P < 0.05, P < 0.01), and there was no significant difference compared with control grope. Serum Hs-CRP, MMP-1 and MMP-1/TIMP-1 decreased after the treatment (P < 0.05, P < 0.01), and the treatment group was superior to control group in decreasing serum Hs-CRP (P < 0.05). Detoxifying and blood circulation activating Chinese herb extraction of polygonum cuspidatum and hawthorn has good effect of anti-atherosclerosis and promoting plaque stability. Its mechanism might be related with anti-inflammation and inhibiting degradation of extracellular matrix, and deserves further studies.

CRT-309 Body Mass Index is a Positive Determinant of Carotid Plaque Stabilization During Statin Therapy Assessed by MRI

Carotid plaque volume and composition have high predictive value of cardiovascular coronary events. High-resolution magnetic resonance imaging (MRI) is a noninvasive imaging modality that enables the quantitative and compositional assessment of the carotid artery. To date, little is known regarding

Positive association of MMP 14 gene polymorphism with vulnerable carotid plaque formation in a Han Chinese population

Background. MMP 14 is expressed in atherosclerotic plaques and potentially plays an important role in the development of vulnerable carotid plaques. MMP 14 gene polymorphisms can influence the bioactivity or expression of MMP 14. Objective. The aim of this study was to investigate the association between MMP 14 position + 7096 T > C (NM_004995.2:c.855T> C, rs2236307) polymorphism and vulnerable carotid plaque formation. Methods. 1370 patients with ischemic cerebral infarctions were enrolled and divided into three groups according to their carotid ultrasound examination: No plaque group (n = 346), stable plaque group (n = 695) and vulnerable plaque group (n = 329). The traditional atherosclerosis risk factors were recorded, and the MMP 14 polymorphism were genotyped by Applied Biosystems 7300 Real-Time PCR System using the TaqMan assay. Results. In the multiple logistic regression analysis done among the sub-groups, compared to no carotid plaque group, individuals with the MMP 14 position + 7096 TC+ CC genotype showed a significantly (p = 0.009) lower risk for vulnerable plaque (AOR = 0.675; 95% CI, 0.568–0.922) formation compared with subjects of the TT genotype; however, no relation between TC+ CC genotype and stable carotid plaque was observed (p > 0.125). Age was a risk factor for both stable plaque (p = 0.000; AOR = 3.732; 95% CI: 2.496–5.58) and vulnerable plaque formation (p = 0.001; AOR = 2.234; 95% CI: 1.387–3.597). Meanwhile, fibrinogen (> 4.0 g/L) was a risk factor for stable plaque (p = 0.004; AOR = 2.313; 95% CI: 1.308–4.091). Conclusions. The MMP 14 position + 7096 TC+ CC genotype might lower the risk of vulnerable carotid plaque formation. Fibrinogen (> 4.0 g/L) was a risk factor for stable plaque.

Carotid surgery affects plasma kynurenic acid concentration: a pilot study.

BackgroundAn increase in plasma kynurenic acid (KYNA) concentration has been observed following surgery, inflammation, and cerebral pathologies. The aim of the present study was to analyze the changes in plasma KYNA concentration in patients undergoing carotid surgery (CS).Material/MethodsAdult patients undergoing elective carotid endarterectomy (CEA) or carotid angioplasty with stent placement (CAS) were studied. Plasma KYNA concentrations were analyzed before surgery and at 4 time points after CS. The amount of inflammation was measured as neutrophil-lymphocyte ratio (NLR).ResultsForty patients (10 female and 30 male) aged 55–86 years of age were evaluated in this study. In patients with unstable carotid plaque, the plasma KYNA concentration was higher than in patients with stable carotid plaque. Moreover, the NLR was significantly higher in patients with unstable carotid plaque undergoing CEA than in patients undergoing CAS. Plasma KYNA concentration increased after surgery in patients undergoing CEA and CAS. There was a strong correlation between plasma KYNA concentration and NLR in patients with postoperative neurological disorders.ConclusionsCS increases plasma KYNA concentration, and changes in plasma KYNA concentration can indicate neurologic outcomes in patients undergoing CS.

Treatment with Angiotensin-(1–7) reduces inflammation in carotid atherosclerotic plaques

Angiotensin (Ang)-(1-7), acting through the receptor Mas, has atheroprotective effects; however, its role on plaque vulnerability has been poorly studied. Here, we investigated the expression of the renin-angiotensin system (RAS) components in stable and unstable human carotid plaques. In addition, we evaluated the effects of the chronic treatment with an oral formulation of Ang-(1-7) in a mouse model of shear stress-determined carotid atherosclerotic plaque. Upstream and downstream regions of internal carotid plaques were obtained from a recently published cohort of patients asymptomatic or symptomatic for ischaemic stroke. Angiotensinogen and renin genes were strongly expressed in the entire cohort, indicating an intense intraplaque modulation of the RAS. Intraplaque expression of the Mas receptor mRNA was increased in the downstream portion of asymptomatic patients as compared to corresponding region in symptomatic patients. Conversely, AT1 receptor gene expression was not modified between asymptomatic and symptomatic patients. Treatment with Ang-(1-7) in ApoE-/- mice was associated with increased intraplaque collagen content in the aortic root and low shear stress-induced carotid plaques, and a decreased MMP-9 content and neutrophil and macrophage infiltration. These beneficial effects were not observed in the oscillatory shear stress-induced plaque. In vitro incubation with Ang-(1-7) did not affect ICAM-1 expression and apoptosis on cultured endothelial cells. In conclusion, Mas receptor is up regulated in the downstream portions of human stable carotid plaques as compared to unstable lesions. Treatment with the oral formulation of Ang-(1-7) enhances a more stable phenotype in atherosclerotic plaques, depending on the local pattern of shear stress forces.

Ultrasonic densitometric analysis of atherosclerotic plaques in carotid arteries

Purpose: Aim of our study was to investigate the possibilities of ultrasonic densitometry in patients with carotid atherosclerosis. Material and methods: In 82 patients (average age 67, 03 ± 7, 3 years) was held ultrasonic densitometric analysis of atherosclerotic plaques. Patients were distributed in 2 groups depending of symptoms: group I – symptomatic patients (n = 44); group II consisted of asymptomatic patients (n = 38). Carotids ultrasound performed by duplex scanning on ultrasonic system Voluson 530 DMT (Kretztechnik, Austria) with linear transducer 5, 5 – 7, 0 MHz. After receiving the stored ultrasound images Offline was provided data analysis. For implementation of ultrasonic densitometric analysis a grey scale image uses a special option “Hystography” and following sequence, according to the protocol. Contours of area and contrast each atherosclerotic plaques subjectively optimized by operator. Results: Results of ultrasonic densitometric analysis for 1 group were as follows: average grey scale 37.9 ± 17.4; for 2-nd group 91.4 ± 5.7 (p 0.05), of energy 0.007 ± 0.001 and 0.034 ± 0.01) (p 0.05). Among parameters of first choice, the average gray level was higher in group II; among the parameters of second order, values of energy were higher in group II (p < 0, 05). Conclusion: Proposed additional analysis of obtained ultrasound imaging enables to determine of gray scale level. Ultrasonic densitometric analysis of two-dimensional ultrasound imaging can be used to determine of stability of carotid plaques.

Does morphology of carotid plaque depend on patient's oxidative stress?

ObjectivesThis study explored the relationship between oxidative stress biomarkers and stability of carotid plaque. We decided to analyze the broad range of parameters describing oxidative stress in patients with carotid stenosis. Design and methods124 consecutive patients undergoing carotid endarterectomy were enrolled in the study group. The control group consisted of 49 patients without symptoms of atherosclerosis. The stability of carotid plaques was assessed using GSM (gray-scale median) scoring system and the study group was divided into three subgroups according to echogenicity of the plaque. The following parameters of oxidative stress/DNA damage were analyzed: i) urinary excretion of the products of oxidative DNA damage repair; ii) the background level of 8-oxo-7,8-dihydro-2′-deoxyguanosine in leukocytes' DNA and in atherosclerotic plaques; and iii) the concentrations of antioxidant vitamins, uric acid and C-reactive protein in plasma. ResultsOxidative stress (described by redox status) was higher in the patient group than in the control group. There is a correlation between oxidative stress of the patients and stability of the plaque, echolucent plaques (GSM<25) being associated with the highest antioxidant level and lowest excretion of DNA repair markers. ConclusionsThe plaque formation/morphology may depend on local environment and is independent of oxidative stress/inflammation observed on the level of the whole body.