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Kadoglou N, Moulakakis KG, Mantas G, Spathis A, Gkougkoudi E, Mylonas SN, Kakisis J, Liapis C. Novel Biomarkers and Imaging Indices for the "Vulnerable Patient" with Carotid Stenosis: A Single-Center Study. Biomolecules 2023; 13:1427. [PMID: 37759829 PMCID: PMC10526466 DOI: 10.3390/biom13091427] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Revised: 09/07/2023] [Accepted: 09/09/2023] [Indexed: 09/29/2023] Open
Abstract
BACKGROUND We investigated the relationship of matrix metalloproteinases (MMPs), cardio-ankle vascular index (CAVI), and Gray-Scale Median (GSM) score with the severity and vulnerability of carotid atherosclerosis and major adverse cardiovascular events (MACE) during follow-up of carotid artery revascularization. METHODS We enrolled 262 patients undergoing carotid revascularization therapy (GRT), 109 asymptomatic patients with low-grade carotid stenosis (40-70%) receiving conservative treatment (GCT), and 92 age- and sex-matched control subjects without carotid atherosclerosis (GCO). All participants underwent carotid ultrasound and we assessed at baseline clinical parameters, metabolic profile, CAVI, GSM, and circulating levels of hsCRP, MMP-3,-7,-9, and TIMP-1. RESULTS Both GRT and GCT presented with elevated CAVI, MMPs, and TIMP-1 levels compared to GCO (p < 0.001). The escalation highly correlated to the presence of symptoms or paralleled the degree of carotid stenosis (p < 0.001). During follow-up (mean duration: 55 months), 51 GRT patients experienced MACE unrelated to the revascularization procedure. Within GRT, diabetes (HR: 2.07; CI: 1.55-2.78, p < 0.001), smoking (HR: 1.67; CI: 1.35-1.95, p < 0.001), high CAVI (HR: 1.22; CI: 1.09-1.43, p = 0.023) and MMP-9 (HR: 1.44; CI: 1.29-2.15, p = 0.005), and low GSM (HR: 1.40; CI: 1.16-2.12, p = 0.002) independently predicted MACE occurrences, despite the optimum medical therapy. CONCLUSIONS Novel imaging and biochemical biomarkers were positively associated with atherosclerosis severity, while CAVI, MMP-9, and low GSM showed a positive, independent relationship with MACE after carotid revascularization, describing "vulnerable patients".
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Affiliation(s)
| | - Konstantinos G. Moulakakis
- Vascular Surgery Department, Patras University Hospital, University of Patras, Rio, 265 04 Patra, Greece;
| | - George Mantas
- Department of Vascular Surgery, Medical School, National and Kapodistrian University of Athens, Attikon University Hospital, 115 27 Athens, Greece; (G.M.); (J.K.); (C.L.)
| | - Aris Spathis
- 2nd Department of Pathology, National and Kapodistrian University of Athens, 115 27 Athens, Greece;
| | | | - Spyridon N. Mylonas
- Department of Vascular and Endovascular Surgery, University Hospital of Cologne, 50937 Cologne, Germany;
| | - John Kakisis
- Department of Vascular Surgery, Medical School, National and Kapodistrian University of Athens, Attikon University Hospital, 115 27 Athens, Greece; (G.M.); (J.K.); (C.L.)
| | - Christos Liapis
- Department of Vascular Surgery, Medical School, National and Kapodistrian University of Athens, Attikon University Hospital, 115 27 Athens, Greece; (G.M.); (J.K.); (C.L.)
- Department of Vascular and Endovascular Surgery, Athens Medical Center, 106 73 Athens, Greece
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Tsakanikas VD, Siogkas PK, Potsika VT, Sakellarios AI, Pleouras DS, Kigka VI, Exarchos TP, Koncar IB, Fotiadis DI. TAXINOMISIS: A cloud - based platform for risk profiling and patient specific management of the carotid artery disease. ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL INTERNATIONAL CONFERENCE 2023; 2023:1-4. [PMID: 38083155 DOI: 10.1109/embc40787.2023.10340947] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/18/2023]
Abstract
Carotid Artery Disease is a complex multi-disciplinary medical condition causing strokes and several other disfunctions to individuals. Within this work, a cloud - based platform is proposed for clinicians and medical doctors that provides a comprehensive risk assessment tool for carotid artery disease. It includes three modeling levels: baseline data-driven risk assessment, blood flow simulations and plaque progression modeling. The proposed models, which have been validated through a wide set of studies within the TAXINOMISIS project, are delivered to the end users through an easy-to-use cloud platform. The architecture and the deployment of this platform includes interfaces for handling the electronic patient record, the 3D arterial reconstruction, blood flow simulations and risk assessment reporting. TAXINOMISIS, compared with both similar software approaches and with the current clinical workflow, assists clinicians to treat patients more effectively and more accurately by providing innovative and validated tools.Clinical Relevance - Asymptomatic carotid artery disease is a prevalent condition that affects a significant portion of the population, leading to an increased risk of stroke and other cardiovascular events. Early detection and appropriate treatment of this condition can significantly reduce the risk of adverse outcomes and improve patient outcomes. The development of a software tool to assist clinicians in the assessment and management of asymptomatic patients with carotid artery disease is therefore of great clinical relevance. By providing a comprehensive and reliable assessment of the disease and its risk factors, this tool will enable clinicians to make informed decisions regarding patient management and treatment. The impact of this tool on patient outcomes and the reduction of healthcare costs will be of great importance to both patients and the healthcare system.
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Golemati S, Yanni A, Tsiaparas NN, Lechareas S, Vlachos IS, Cokkinos DD, Krokidis M, Nikita KS, Perrea D, Chatziioannou A. CurveletTransform-Based Texture Analysis of Carotid B-mode Ultrasound Images in Asymptomatic Men With Moderate and Severe Stenoses: A Preliminary Clinical Study. ULTRASOUND IN MEDICINE & BIOLOGY 2022; 48:78-90. [PMID: 34666918 DOI: 10.1016/j.ultrasmedbio.2021.09.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/14/2020] [Revised: 09/02/2021] [Accepted: 09/04/2021] [Indexed: 06/13/2023]
Abstract
The curvelet transform, which represents images in terms of their geometric and textural characteristics, was investigated toward revealing differences between moderate (50%-69%, n = 11) and severe (70%-100%, n = 14) stenosis asymptomatic plaque from B-mode ultrasound. Texture features were estimated in original and curvelet transformed images of atheromatous plaque (PL), the adjacent arterial wall (intima-media [IM]) and the plaque shoulder (SH) (i.e., the boundary between plaque and wall), separately at end systole and end diastole. Seventeen features derived from the original images were significantly different between the two groups (4 for IM, 3 for PL and 10 for SH; 9 for end diastole and 8 for end systole); 19 of 234 features (2 for IM and 17 for SH; 8 for end systole and 11 for end diastole) derived from curvelet transformed images were significantly higher in the patients with severe stenosis, indicating higher magnitude, variation and randomness of image gray levels. In these patients, lower body height and higher serum creatinine concentration were observed. Our findings suggest that (a) moderate and severe plaque have similar curvelet-based texture properties, and (b) IM and SH provide useful information about arterial wall pathophysiology, complementary to PL itself. The curvelet transform is promising for identifying novel indices of cardiovascular risk and warrants further investigation in larger cohorts.
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Affiliation(s)
- Spyretta Golemati
- Medical School, National and Kapodistrian University of Athens, Athens, Greece.
| | - Amalia Yanni
- Department of Nutrition and Dietetics, Harokopio University of Athens, Athens, Greece
| | - Nikolaos N Tsiaparas
- Biomedical Simulations and Imaging Laboratory, School of Electrical and Computer Engineering, National Technical University of Athens, Athens, Greece
| | - Symeon Lechareas
- Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Ioannis S Vlachos
- Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | | | - Miltiadis Krokidis
- Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Konstantina S Nikita
- Biomedical Simulations and Imaging Laboratory, School of Electrical and Computer Engineering, National Technical University of Athens, Athens, Greece
| | - Despina Perrea
- Medical School, National and Kapodistrian University of Athens, Athens, Greece
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Artificial Intelligence Evidence-Based Current Status and Potential for Lower Limb Vascular Management. J Pers Med 2021; 11:jpm11121280. [PMID: 34945749 PMCID: PMC8705683 DOI: 10.3390/jpm11121280] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2021] [Revised: 11/22/2021] [Accepted: 11/24/2021] [Indexed: 12/14/2022] Open
Abstract
Consultation prioritization is fundamental in optimal healthcare management and its performance can be helped by artificial intelligence (AI)-dedicated software and by digital medicine in general. The need for remote consultation has been demonstrated not only in the pandemic-induced lock-down but also in rurality conditions for which access to health centers is constantly limited. The term “AI” indicates the use of a computer to simulate human intellectual behavior with minimal human intervention. AI is based on a “machine learning” process or on an artificial neural network. AI provides accurate diagnostic algorithms and personalized treatments in many fields, including oncology, ophthalmology, traumatology, and dermatology. AI can help vascular specialists in diagnostics of peripheral artery disease, cerebrovascular disease, and deep vein thrombosis by analyzing contrast-enhanced magnetic resonance imaging or ultrasound data and in diagnostics of pulmonary embolism on multi-slice computed angiograms. Automatic methods based on AI may be applied to detect the presence and determine the clinical class of chronic venous disease. Nevertheless, data on using AI in this field are still scarce. In this narrative review, the authors discuss available data on AI implementation in arterial and venous disease diagnostics and care.
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Rizi FY, Au J, Yli-Ollila H, Golemati S, Makūnaitė M, Orkisz M, Navab N, MacDonald M, Laitinen TM, Behnam H, Gao Z, Gastounioti A, Jurkonis R, Vray D, Laitinen T, Sérusclat A, Nikita KS, Zahnd G. Carotid Wall Longitudinal Motion in Ultrasound Imaging: An Expert Consensus Review. ULTRASOUND IN MEDICINE & BIOLOGY 2020; 46:2605-2624. [PMID: 32709520 DOI: 10.1016/j.ultrasmedbio.2020.06.006] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/10/2019] [Revised: 06/01/2020] [Accepted: 06/07/2020] [Indexed: 06/11/2023]
Abstract
Motion extracted from the carotid artery wall provides unique information for vascular health evaluation. Carotid artery longitudinal wall motion corresponds to the multiphasic arterial wall excursion in the direction parallel to blood flow during the cardiac cycle. While this motion phenomenon has been well characterized, there is a general lack of awareness regarding its implications for vascular health assessment or even basic vascular physiology. In the last decade, novel estimation strategies and clinical investigations have greatly advanced our understanding of the bi-axial behavior of the carotid artery, necessitating an up-to-date review to summarize and classify the published literature in collaboration with technical and clinical experts in the field. Within this review, the state-of-the-art methodologies for carotid wall motion estimation are described, and the observed relationships between longitudinal motion-derived indices and vascular health are reported. The vast number of studies describing the longitudinal motion pattern in plaque-free arteries, with its putative application to cardiovascular disease prediction, point to the need for characterizing the added value and applicability of longitudinal motion beyond established biomarkers. To this aim, the main purpose of this review was to provide a strong base of theoretical knowledge, together with a curated set of practical guidelines and recommendations for longitudinal motion estimation in patients, to foster future discoveries in the field, toward the integration of longitudinal motion in basic science as well as clinical practice.
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Affiliation(s)
- Fereshteh Yousefi Rizi
- School of Electrical and Computer Engineering, College of Engineering, University of Tehran, Tehran, Iran.
| | - Jason Au
- Schlegel Research Institute for Aging, University of Waterloo, Waterloo, Ontario, Canada
| | - Heikki Yli-Ollila
- Department of Radiology, Kanta-Häme Central Hospital, Hämeenlinna, Finland; Department of Clinical Physiology and Nuclear Medicine, Kuopio University Hospital, Kuopio, Finland
| | - Spyretta Golemati
- Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Monika Makūnaitė
- Biomedical Engineering Institute, Kaunas University of Technology, Kaunas, Lithuania
| | - Maciej Orkisz
- Univ Lyon, Université Claude Bernard Lyon 1, INSA-Lyon, UJM-Saint Etienne, CNRS, Inserm, CREATIS UMR 5220, U1206, F-69621 Villeurbanne cedex, France
| | - Nassir Navab
- Computer Aided Medical Procedures, Technische Universität München, Garching bei München, Germany; Computer Aided Medical Procedures, Johns Hopkins University, Baltimore, Maryland, USA
| | - Maureen MacDonald
- Department of Kinesiology, McMaster University, Hamilton, Ontario, Canada
| | - Tiina Marja Laitinen
- Department of Clinical Physiology and Nuclear Medicine, Kuopio University Hospital, Kuopio, Finland
| | - Hamid Behnam
- Biomedical Engineering Department, School of Electrical Engineering, Iran University of Science and Technology (IUST), Tehran, Iran
| | - Zhifan Gao
- School of Biomedical Engineering, Sun Yat-sen University, Guangzhou, China
| | - Aimilia Gastounioti
- Department of Radiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Rytis Jurkonis
- Biomedical Engineering Institute, Kaunas University of Technology, Kaunas, Lithuania
| | - Didier Vray
- Univ Lyon, Université Claude Bernard Lyon 1, INSA-Lyon, UJM-Saint Etienne, CNRS, Inserm, CREATIS UMR 5220, U1206, F-69621 Villeurbanne cedex, France
| | - Tomi Laitinen
- Department of Clinical Physiology and Nuclear Medicine, Kuopio University Hospital, Kuopio, Finland
| | - André Sérusclat
- Department of Radiology, Louis Pradel Hospital; Hospices Civils de Lyon; Université Lyon 1, Lyon, France
| | - Konstantina S Nikita
- Biomedical Simulations and Imaging Laboratory, School of Electrical and Computer Engineering, National Technical University of Athens, Athens, Greece
| | - Guillaume Zahnd
- Computer Aided Medical Procedures, Technische Universität München, Garching bei München, Germany
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Raffort J, Adam C, Carrier M, Lareyre F. Fundamentals in Artificial Intelligence for Vascular Surgeons. Ann Vasc Surg 2019; 65:254-260. [PMID: 31857229 DOI: 10.1016/j.avsg.2019.11.037] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2019] [Revised: 11/17/2019] [Accepted: 11/21/2019] [Indexed: 12/31/2022]
Abstract
Artificial intelligence (AI) corresponds to a broad discipline that aims to design systems, which display properties of human intelligence. While it has led to many advances and applications in daily life, its introduction in medicine is still in its infancy. AI has created interesting perspectives for medical research and clinical practice but has been sometimes associated with hype leading to a misunderstanding of its real capabilities. Here, we aim to introduce the fundamental notions of AI and to bring an overview of its potential applications for medical and surgical practice. In the limelight of current knowledge, limits and challenges to face as well as future directions are discussed.
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Affiliation(s)
- Juliette Raffort
- Clinical Chemistry Laboratory, University Hospital of Nice, Nice, France; Université Côte d'Azur, CHU, Inserm U1065, C3M, Nice, France.
| | - Cédric Adam
- Laboratory of Applied Mathematics and Computer Science (MICS), CentraleSupélec, Université Paris-Saclay, Paris, France
| | - Marion Carrier
- Laboratory of Applied Mathematics and Computer Science (MICS), CentraleSupélec, Université Paris-Saclay, Paris, France
| | - Fabien Lareyre
- Université Côte d'Azur, CHU, Inserm U1065, C3M, Nice, France; Department of Vascular Surgery, University Hospital of Nice, Nice, France
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7
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Medical data visual synchronization and information interaction using Internet-based graphics rendering and message-oriented streaming. INFORMATICS IN MEDICINE UNLOCKED 2019. [DOI: 10.1016/j.imu.2019.100253] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
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8
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Wivern: a Web-Based System Enabling Computer-Aided Diagnosis and Interdisciplinary Expert Collaboration for Vascular Research. J Med Biol Eng 2017. [DOI: 10.1007/s40846-017-0256-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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9
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Kolias VD, Stamou G, Golemati S, Stoitsis G, Gkekas CD, Liapis CD, Nikita KS. A semantically-aided architecture for a web-based monitoring system for carotid atherosclerosis. ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL INTERNATIONAL CONFERENCE 2015; 2015:1373-1376. [PMID: 26736524 DOI: 10.1109/embc.2015.7318624] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Carotid atherosclerosis is a multifactorial disease and its clinical diagnosis depends on the evaluation of heterogeneous clinical data, such as imaging exams, biochemical tests and the patient's clinical history. The lack of interoperability between Health Information Systems (HIS) does not allow the physicians to acquire all the necessary data for the diagnostic process. In this paper, a semantically-aided architecture is proposed for a web-based monitoring system for carotid atherosclerosis that is able to gather and unify heterogeneous data with the use of an ontology and to create a common interface for data access enhancing the interoperability of HIS. The architecture is based on an application ontology of carotid atherosclerosis that is used to (a) integrate heterogeneous data sources on the basis of semantic representation and ontological reasoning and (b) access the critical information using SPARQL query rewriting and ontology-based data access services. The architecture was tested over a carotid atherosclerosis dataset consisting of the imaging exams and the clinical profile of 233 patients, using a set of complex queries, constructed by the physicians. The proposed architecture was evaluated with respect to the complexity of the queries that the physicians could make and the retrieval speed. The proposed architecture gave promising results in terms of interoperability, data integration of heterogeneous sources with an ontological way and expanded capabilities of query and retrieval in HIS.
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10
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Pérez-Pérez M, Glez-Peña D, Fdez-Riverola F, Lourenço A. Marky: a tool supporting annotation consistency in multi-user and iterative document annotation projects. COMPUTER METHODS AND PROGRAMS IN BIOMEDICINE 2015; 118:242-251. [PMID: 25480679 DOI: 10.1016/j.cmpb.2014.11.005] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/24/2014] [Revised: 10/24/2014] [Accepted: 11/18/2014] [Indexed: 06/04/2023]
Abstract
BACKGROUND AND OBJECTIVES Document annotation is a key task in the development of Text Mining methods and applications. High quality annotated corpora are invaluable, but their preparation requires a considerable amount of resources and time. Although the existing annotation tools offer good user interaction interfaces to domain experts, project management and quality control abilities are still limited. Therefore, the current work introduces Marky, a new Web-based document annotation tool equipped to manage multi-user and iterative projects, and to evaluate annotation quality throughout the project life cycle. METHODS At the core, Marky is a Web application based on the open source CakePHP framework. User interface relies on HTML5 and CSS3 technologies. Rangy library assists in browser-independent implementation of common DOM range and selection tasks, and Ajax and JQuery technologies are used to enhance user-system interaction. RESULTS Marky grants solid management of inter- and intra-annotator work. Most notably, its annotation tracking system supports systematic and on-demand agreement analysis and annotation amendment. Each annotator may work over documents as usual, but all the annotations made are saved by the tracking system and may be further compared. So, the project administrator is able to evaluate annotation consistency among annotators and across rounds of annotation, while annotators are able to reject or amend subsets of annotations made in previous rounds. As a side effect, the tracking system minimises resource and time consumption. CONCLUSIONS Marky is a novel environment for managing multi-user and iterative document annotation projects. Compared to other tools, Marky offers a similar visually intuitive annotation experience while providing unique means to minimise annotation effort and enforce annotation quality, and therefore corpus consistency. Marky is freely available for non-commercial use at http://sing.ei.uvigo.es/marky.
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Affiliation(s)
- Martín Pérez-Pérez
- ESEI - Escuela Superior de Ingeniería Informática, Edificio Politécnico, Campus Universitario As Lagoas s/n, Universidad de Vigo, 32004 Ourense, Spain(1)
| | - Daniel Glez-Peña
- ESEI - Escuela Superior de Ingeniería Informática, Edificio Politécnico, Campus Universitario As Lagoas s/n, Universidad de Vigo, 32004 Ourense, Spain(1)
| | - Florentino Fdez-Riverola
- ESEI - Escuela Superior de Ingeniería Informática, Edificio Politécnico, Campus Universitario As Lagoas s/n, Universidad de Vigo, 32004 Ourense, Spain(1)
| | - Anália Lourenço
- ESEI - Escuela Superior de Ingeniería Informática, Edificio Politécnico, Campus Universitario As Lagoas s/n, Universidad de Vigo, 32004 Ourense, Spain(1); Centre of Biological Engineering, University of Minho, Campus de Gualtar, 4710-057 Braga, Portugal.
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11
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Kadoglou N, Sfyroeras G, Spathis A, Gkekas C, Gastounioti A, Mantas G, Nikita K, Karakitsos P, Liapis C. Galectin-3, Carotid Plaque Vulnerability, and Potential Effects of Statin Therapy. Eur J Vasc Endovasc Surg 2015; 49:4-9. [DOI: 10.1016/j.ejvs.2014.10.009] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2014] [Accepted: 10/13/2014] [Indexed: 11/30/2022]
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12
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Gastounioti A, Makrodimitris S, Golemati S, Kadoglou NPE, Liapis CD, Nikita KS. A novel computerized tool to stratify risk in carotid atherosclerosis using kinematic features of the arterial wall. IEEE J Biomed Health Inform 2014; 19:1137-45. [PMID: 24951709 DOI: 10.1109/jbhi.2014.2329604] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
Valid characterization of carotid atherosclerosis (CA) is a crucial public health issue, which would limit the major risks held by CA for both patient safety and state economies. This paper investigated the unexplored potential of kinematic features in assisting the diagnostic decision for CA in the framework of a computer-aided diagnosis (CAD) tool. To this end, 15 CAD schemes were designed and were fed with a wide variety of kinematic features of the atherosclerotic plaque and the arterial wall adjacent to the plaque for 56 patients from two different hospitals. The CAD schemes were benchmarked in terms of their ability to discriminate between symptomatic and asymptomatic patients and the combination of the Fisher discriminant ratio, as a feature-selection strategy, and support vector machines, in the classification module, was revealed as the optimal motion-based CAD tool. The particular CAD tool was evaluated with several cross-validation strategies and yielded higher than 88% classification accuracy; the texture-based CAD performance in the same dataset was 80%. The incorporation of kinematic features of the arterial wall in CAD seems to have a particularly favorable impact on the performance of image-data-driven diagnosis for CA, which remains to be further elucidated in future prospective studies on large datasets.
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13
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Kadoglou NPE, Lambadiari V, Gastounioti A, Gkekas C, Giannakopoulos TG, Koulia K, Maratou E, Alepaki M, Kakisis J, Karakitsos P, Nikita KS, Dimitriadis G, Liapis CD. The relationship of novel adipokines, RBP4 and omentin-1, with carotid atherosclerosis severity and vulnerability. Atherosclerosis 2014; 235:606-12. [PMID: 24956535 DOI: 10.1016/j.atherosclerosis.2014.05.957] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/18/2014] [Revised: 05/09/2014] [Accepted: 05/27/2014] [Indexed: 10/25/2022]
Abstract
OBJECTIVE We investigated the relationship of circulating novel adipokines, retinol-binding protein 4 (RBP4) and omentin-1, with advanced carotid atherosclerosis and ultrasound indexes of severity (total plaque area-TPA) and plaque echogenicity and vulnerability (Gray-Scale median - GSM score). METHODS We enrolled 225 patients with high-grade carotid stenosis (HGCS) who underwent carotid revascularization (73 Symptomatic patients, 152 asymptomatic patients) and 75 age- and sex-matched, asymptomatic individuals with low-grade (<50%) carotid stenosis (LGCS). Seventy-three individuals without current manifestations of atherosclerotic disease served as control group (COG). All participants underwent carotid ultrasound with TPA and GSM score assessment. Moreover, clinical parameters, metabolic profile, and circulating levels of hsCRP and adipokines were assessed. RESULTS RBP4 was significantly elevated in HGCS (51.44 ± 16.23 mg/L) compared to LGCS (38.39 ± 8.85 mg/L), independent of symptoms existence, whereas RBP4 levels in COG were even lower (25.74 ± 10.72 mg/L, p < 0.001 compared to either HGCS or LGCS). Inversely, serum omentin-1 levels were significantly lower across HGCS (490.41 ± 172 ng/ml) and LGCS (603.20 ± 202.43 ng/ml) than COG (815.3 ± 185.32, p < 0.001). Moreover, the considerable difference between HGCS and LGCS (p < 0.001) was exclusively attributed to the excessive suppression of omentin-1 concentrations in symptomatic versus asymptomatic (p = 0.004) patients. HGCS and LGCS did not differ in the rest of clinical and biochemical parameters. In multiple regression analysis, RBP4 (beta = 0.232, p = 0.025) and hsCRP (beta = 0.300, p = 0.004) emerged as independent determinants of TPA in patients with carotid atherosclerosis. Low serum levels of omentin-1 correlated with GSM score and symptoms but that association was lost in multivariate analysis.. CONCLUSION RBP4 serum levels were significantly elevated in patients with established carotid atherosclerosis and were positively associated with atherosclerosis severity. The association of low serum omentin-1 with carotid plaque echolucency requires further investigation.. ClinicalTrials.gov Identifier: NCT00636766.
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Affiliation(s)
- Nikolaos P E Kadoglou
- Department of Vascular Surgery, Medical School, "Attikon" University General Hospital, Athens, Greece.
| | - Vaia Lambadiari
- 2nd Department of Internal Medicine, Research Institute and Diabetes Centre, Athens University Medical School, "Attikon" University General Hospital, Athens, Greece
| | - Aimilia Gastounioti
- School of Electrical and Computer Engineering, National Technical University of Athens, Greece
| | - Christos Gkekas
- Department of Vascular Surgery, Medical School, "Attikon" University General Hospital, Athens, Greece
| | | | - Katerina Koulia
- Department of Vascular Surgery, Medical School, "Attikon" University General Hospital, Athens, Greece
| | - Eirini Maratou
- 2nd Department of Internal Medicine, Research Institute and Diabetes Centre, Athens University Medical School, "Attikon" University General Hospital, Athens, Greece
| | - Maria Alepaki
- Department of Cytopathology, "Attikon" University General Hospital, Athens, Greece
| | - John Kakisis
- Department of Vascular Surgery, Medical School, "Attikon" University General Hospital, Athens, Greece
| | - Petros Karakitsos
- Department of Cytopathology, "Attikon" University General Hospital, Athens, Greece
| | - Konstantina S Nikita
- School of Electrical and Computer Engineering, National Technical University of Athens, Greece
| | - George Dimitriadis
- 2nd Department of Internal Medicine, Research Institute and Diabetes Centre, Athens University Medical School, "Attikon" University General Hospital, Athens, Greece
| | - Christos D Liapis
- Department of Vascular Surgery, Medical School, "Attikon" University General Hospital, Athens, Greece
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