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Plaque Burden (plaque + burden)
Selected AbstractsA cardiologist view of vascular disease in diabetesDIABETES OBESITY & METABOLISM, Issue 4 2008Christopher J. Lockhart Diabetes mellitus is a potent risk factor for the development of a wide spectrum of cardiovascular (CV) complications. The complex metabolic milieu accompanying diabetes alters blood rheology, the structure of arteries and disrupts the homeostatic functions of the endothelium. These changes act as the substrate for end-organ damage and the occurrence of CV events. In those who develop acute coronary syndromes, patients with diabetes are more likely to die, both in the acute phase and during follow-up. Patients with diabetes are also more likely to suffer from chronic cardiac failure, independently of the presence of large vessel disease, and also more likely to develop stroke, renal failure and peripheral vascular disease. Preventing vascular events is the primary goal of therapy. Optimal cardiac care for the patient with diabetes should focus on aggressive management of traditional CV risk factors to optimize blood glucose, lipid and blood pressure control. Targeting medical therapy to improve plaque stability and diminish platelet hyper-responsiveness reduces the frequency of events associated with atherosclerotic plaque burden. In patients with critical lesions, revascularization strategies, either percutaneous or surgical, will often be necessary to improve symptoms and prevent vascular events. Improved understanding of the vascular biology will be crucial for the development of new therapeutic agents to prevent CV events and improve outcomes in patients with diabetes. [source] Imaging biomarkers of cardiovascular diseaseJOURNAL OF MAGNETIC RESONANCE IMAGING, Issue 3 2010Jinnan Wang PhD Abstract Cardiovascular disease (CVD) is a leading cause of morbidity and mortality worldwide. Current clinical techniques that rely on stenosis measurement alone appear to be insufficient for risk prediction in atherosclerosis patients. Many novel imaging methods have been developed to study atherosclerosis progression and to identify new features that can predict future clinical risk. MRI of atherosclerotic vessel walls is one such method. It has the ability to noninvasively evaluate multiple biomarkers of the disease such as luminal stenosis, plaque burden, tissue composition and plaque activity. In addition, the accuracy of in vivo MRI has been validated against histology with high reproducibility, thus paving the way for application to epidemiological studies of disease pathogenesis and, by serial MRI, in monitoring the efficacy of therapeutic intervention. In this review, we describe the various MR techniques used to evaluate aspects of plaque progression, discuss imaging-based measurements (imaging biomarkers), and also detail their validation. The application of plaque MRI in clinical trials as well as emerging imaging techniques used to evaluate plaque compositional features and biological activities are also discussed. J. Magn. Reson. Imaging 2010;32:502,515. © 2010 Wiley-Liss, Inc. [source] Autoantibodies against ,-amyloid are common in Alzheimer's disease and help control plaque burden,ANNALS OF NEUROLOGY, Issue 1 2009Alexander Kellner MSc Objective Active or passive immunization of Alzheimer's disease (AD) patients leads to targeting of ,-amyloid plaques by immunoglobulins (IgG) and their subsequent removal by microglia. Here, we investigate whether naturally occurring autoantibodies to ,-amyloid contribute to ,-amyloid plaque removal in nonimmunized AD patients. Methods We generated an AD tissue microarray with 2,325 tissue specimens from 3 defined central nervous system regions of 48 AD patients and 48 age-matched control patients. Absolute quantification of ,-amyloid, ,-amyloid plaque-bound IgG, and phagocytic, resting, and activated microglia and microhemorrhages was done using a standardized, highly reproducible scoring system. Results The majority of neuritic plaques are decorated by IgG. AD patients with prominently IgG-labeled neuritic plaques have a significantly reduced plaque burden and an increase in phagocytic microglia, yet no increase in microhemorrhages. Interpretation Autoantibodies directed against ,-amyloid are common in AD patients and may contribute in controlling plaque burden. Ann Neurol 2009;65:24,31 [source] Differential effects of medroxyprogesterone acetate on thrombosis and atherosclerosis in miceBRITISH JOURNAL OF PHARMACOLOGY, Issue 8 2009Till Freudenberger Background and purpose:, The risk for cardiovascular events including venous and arterial disease and stroke is elevated after treatment with estrogen and medroxyprogesterone acetate (MPA) in postmenopausal women. Here, we have investigated the effect of MPA on arterial thrombosis and atherosclerosis in a murine model of atherosclerosis. Experimental approach:, Apolipoprotein E (ApoE),/, mice were bilaterally ovariectomized and treated with placebo, MPA (27.7 µg·day,1) and MPA + 17-,-oestradiol (E2; 1.1 µg·day,1) for 90 days, on a Western-type diet. Thrombotic response was measured in a photothrombosis model, platelet activation by fluorescence activated cell sorting (FACS) analysis (CD62P) and thrombin generation by the endogenous thrombin potential (ETP). Furthermore, aortic plaque burden and aortic root plaque composition were determined. Key results:, MPA and MPA + E2 -treated animals showed an aggravated thrombotic response shown by significantly reduced time to stable occlusion. The pro-thrombotic effect of MPA was paralleled by increased ETP whereas platelet activation was not affected. Furthermore, MPA + E2 reduced the number of cells positive for ,-smooth muscle actin and increased hyaluronan in the plaque matrix. Interestingly, total plaque burden was reduced by MPA but unchanged by MPA + E2. Conclusion and implications:, Long-term treatment with MPA and MPA + E2 increased arterial thrombosis despite inhibitory effects of MPA on atherosclerosis in ApoE-deficient mice. Increased thrombin formation, reduced smooth muscle content and remodelling of non-collagenous plaque matrix may be involved in the pro-thrombotic effects. Thus, MPA exhibits differential effects on arterial thrombosis and on atherosclerosis. [source] Cardiac computed tomography: Diagnostic utility and integration in clinical practiceCLINICAL CARDIOLOGY, Issue S1 2006Matthew J. Budoff M.D. Abstract Cardiac applications of computed tomography (CT) is a rapidly growing diagnostic area because of the ability to visualize plaque burden (coronary artery calcification [CAC]) and luminal obstruction (computed tomographic angiography [CTA]) noninvasively. Coronary artery calcification has been validated in over 1,000 studies over the last 20 years, primarily with electron beam tomography. Studies demonstrate several indications that could aid physicians in the management of symptomatic and asymptomatic patients. Determining that a symptomatic patient has no CAC is associated with both a lower risk of an abnormal nuclear study and angiographic obstruction. The ability to detect subclinical atherosclerosis (CAC) with minimal radiation and no contrast makes this an attractive method for risk stratification. New studies demonstrate a 10-fold risk of cardiovascular events with increasing amounts of coronary calcification. The invasive nature, expense, and risk resulting from invasive angiography have been instrumental in encouraging the development of new diagnostic methods that allow the coronary arteries to be visualized noninvasively. Multislice CT, with its advanced spatial and temporal resolution, has opened up new possibilities in the imaging of the heart and major vessels of the chest, including the coronary arteries. The last decade has seen great strides in the field of cardiac imaging, particularly in the ability to visualize the coronary lumen with sufficient diagnostic accuracy. Possessing that qualification, CTA is now being used increasingly in clinical practice. As a result of having high spatial and improved temporal resolutions, this imaging modality not only allows branches of the coronary artery to be evaluated, but also allows simultaneous analysis of other cardiac structures, making it extremely useful for other cardiac applications. This paper reviews the diagnostic utility and limitations of cardiac CT and how it could be integrated into clinical practice. [source] | ||||||||||