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León-Mengíbar J, Sánchez E, Herrerías F, De La Fuente MC, Santamaría M, Valdivielso JM, Bermúdez-López M, Castro E, Pallarés J, Matias-Guiu X, Vilardell F, Caixàs A, Bueno M, Martí R, Lecube A. Influence of nonalcoholic fatty liver disease severity on carotid adventitial vasa vasorum. Front Endocrinol (Lausanne) 2024; 15:1366015. [PMID: 38774226 PMCID: PMC11106423 DOI: 10.3389/fendo.2024.1366015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2024] [Accepted: 04/22/2024] [Indexed: 05/24/2024] Open
Abstract
Introduction Nonalcoholic fatty liver disease (NAFLD) affects a quarter of the world's population and encompasses a spectrum of liver conditions, from non-alcoholic steatohepatitis (NASH) to inflammation and fibrosis. In addition, NAFLD also links to extrahepatic conditions like diabetes or obesity. However, it remains unclear if NAFLD independently correlates with the onset and progression of atherosclerosis. Material and methods This cross-sectional study aimed to explore the relationship between NAFLD severity, assessed via liver biopsy, and early atherosclerosis using adventitial vasa vasorum (VV) density. It included 44 patients with obesity (33 with steatosis, 11 with NASH) undergoing bariatric surgery. Results Results revealed no significant differences in adventitial VV density between steatosis and NASH groups, neither in the mean values [0.759 ± 0.104 vs. 0.780 ± 0.043, P=0.702] nor left-right sides. Similarly, carotid intima-media thickness (cIMT) did not vary between these groups. Additionally, no linear correlation existed between VV density and cIMT. Only gender showed an association with VV density. Conclusion These findings suggest that NASH severity doesn't independently drive early atherosclerosis or affects cIMT. Gender might play a role in early atherosclerotic disease in NAFLD, impacting VV density and cIMT. This highlights the need to consider other risk factors when evaluating cardiovascular risk in NAFLD patients.
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Affiliation(s)
- Josep León-Mengíbar
- Endocrinology and Nutrition Department, University Hospital Arnau de Vilanova, Lleida, Spain
- Obesity, Diabetes and Metabolism (ODIM) Research Group, Institut de Recerca Biomèdica de Lleida (IRBLleida), Lleida, Spain
| | - Enric Sánchez
- Endocrinology and Nutrition Department, University Hospital Arnau de Vilanova, Lleida, Spain
- Obesity, Diabetes and Metabolism (ODIM) Research Group, Institut de Recerca Biomèdica de Lleida (IRBLleida), Lleida, Spain
- Medicine and Surgery Department, University of Lleida, Lleida, Spain
| | - Ferrán Herrerías
- Gastrointestinal Surgery Department, Arnau de Vilanova University Hospital, Lleida, Spain
- Surgery Research Group, Institut de Recerca Biomèdica de Lleida (IRBLleida), Lleida, Spain
| | - Mari Cruz De La Fuente
- Gastrointestinal Surgery Department, Arnau de Vilanova University Hospital, Lleida, Spain
- Surgery Research Group, Institut de Recerca Biomèdica de Lleida (IRBLleida), Lleida, Spain
| | - Maite Santamaría
- Gastrointestinal Surgery Department, Arnau de Vilanova University Hospital, Lleida, Spain
- Surgery Research Group, Institut de Recerca Biomèdica de Lleida (IRBLleida), Lleida, Spain
| | - José Manuel Valdivielso
- Medicine and Surgery Department, University of Lleida, Lleida, Spain
- Vascular and Renal Translational Research Group, Institut de Recerca Biomèdica de Lleida (RBLleida), Lleida, Spain
| | - Marcelino Bermúdez-López
- Medicine and Surgery Department, University of Lleida, Lleida, Spain
- Vascular and Renal Translational Research Group, Institut de Recerca Biomèdica de Lleida (RBLleida), Lleida, Spain
| | - Eva Castro
- Medicine and Surgery Department, University of Lleida, Lleida, Spain
- Vascular and Renal Translational Research Group, Institut de Recerca Biomèdica de Lleida (RBLleida), Lleida, Spain
| | - Judit Pallarés
- Department of Pathology and Molecular Genetics, Arnau de Vilanova University Hospital, Institut de Recerca Biomèdica (IRB) and University of Lleida, Lleida, Spain
| | - Xavier Matias-Guiu
- Department of Pathology and Molecular Genetics, Arnau de Vilanova University Hospital, Institut de Recerca Biomèdica (IRB) and University of Lleida, Lleida, Spain
| | - Felip Vilardell
- Department of Pathology and Molecular Genetics, Arnau de Vilanova University Hospital, Institut de Recerca Biomèdica (IRB) and University of Lleida, Lleida, Spain
| | - Assumpta Caixàs
- Endocrinology and Nutrition Department, Parc Taulí Hospital Universitari, Institut d’Investigació i Innovació Parc Taulí (IPT-CERCA), Medicine Department, Universitat Autònoma de Barcelona, Sabadell, Spain
| | - Marta Bueno
- Endocrinology and Nutrition Department, University Hospital Arnau de Vilanova, Lleida, Spain
- Obesity, Diabetes and Metabolism (ODIM) Research Group, Institut de Recerca Biomèdica de Lleida (IRBLleida), Lleida, Spain
| | - Raquel Martí
- Endocrinology and Nutrition Department, University Hospital Arnau de Vilanova, Lleida, Spain
- Obesity, Diabetes and Metabolism (ODIM) Research Group, Institut de Recerca Biomèdica de Lleida (IRBLleida), Lleida, Spain
| | - Albert Lecube
- Endocrinology and Nutrition Department, University Hospital Arnau de Vilanova, Lleida, Spain
- Obesity, Diabetes and Metabolism (ODIM) Research Group, Institut de Recerca Biomèdica de Lleida (IRBLleida), Lleida, Spain
- Medicine and Surgery Department, University of Lleida, Lleida, Spain
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Yan A, Gotlieb AI. The microenvironment of the atheroma expresses phenotypes of plaque instability. Cardiovasc Pathol 2023; 67:107572. [PMID: 37595697 DOI: 10.1016/j.carpath.2023.107572] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/16/2023] [Revised: 08/06/2023] [Accepted: 08/14/2023] [Indexed: 08/20/2023] Open
Abstract
Data from histopathology studies of human atherosclerotic tissue specimens and from vascular imaging studies support the concept that the local arterial microenvironment of a stable atheroma promotes destabilizing conditions that result in the transition to an unstable atheroma. Destabilization is characterized by several different plaque phenotypes that cause major clinical events such as acute coronary syndrome and cerebrovascular strokes. There are several rupture-associated phenotypes causing thrombotic vascular occlusion including simple fibrous cap rupture of an atheroma, fibrous cap rupture at site of previous rupture-and-repair of an atheroma, and nodular calcification with rupture. Endothelial erosion without rupture has more recently been shown to be a common phenotype to promote thrombosis as well. Microenvironment features that are linked to these phenotypes of plaque instability are neovascularization arising from the vasa vasorum network leading to necrotic core expansion, intraplaque hemorrhage, and cap rupture; activation of adventitial and perivascular adipose tissue cells leading to secretion of cytokines, growth factors, adipokines in the outer artery wall that destabilize plaque structure; and vascular smooth muscle cell phenotypic switching through transdifferentiation and stem/progenitor cell activation resulting in the promotion of inflammation, calcification, and secretion of extracellular matrix, altering fibrous cap structure, and necrotic core growth. As the technology evolves, studies using noninvasive vascular imaging will be able to investigate the transition of stable to unstable atheromas in real time. A limitation in the field, however, is that reliable and predictable experimental models of spontaneous plaque rupture and/or erosion are not currently available to study the cell and molecular mechanisms that regulate the conversion of the stable atheroma to an unstable plaque.
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Affiliation(s)
- Angela Yan
- Department of Laboratory Medicine and Pathobiology, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.
| | - Avrum I Gotlieb
- Department of Laboratory Medicine and Pathobiology, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
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3
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Sánchez E, Santos MD, Nuñez-Garcia M, Bueno M, Sajoux I, Yeramian A, Lecube A. Randomized Clinical Trial to Evaluate the Morphological Changes in the Adventitial Vasa Vasorum Density and Biological Markers of Endothelial Dysfunction in Subjects with Moderate Obesity Undergoing a Very Low-Calorie Ketogenic Diet. Nutrients 2021; 14:nu14010033. [PMID: 35010908 PMCID: PMC8746664 DOI: 10.3390/nu14010033] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2021] [Revised: 12/18/2021] [Accepted: 12/20/2021] [Indexed: 12/13/2022] Open
Abstract
Weight loss after bariatric surgery decreases the earlier expansion of the adventitial vasa vasorum (VV), a biomarker of early atheromatous disease. However, no data are available regarding weight loss achieved by very low calorie ketogenic diets (VLCKD) on VV and lipid-based atherogenic indices. A randomized clinical trial was performed to examine changes in adventitial VV density in 20 patients with moderate obesity who underwent a 6-month very low calorie ketogenic diet (VLCKD, 600–800 kcal/day), and 10 participants with hypocaloric diet based on the Mediterranean Diet (MedDiet, estimated reduction of 500 kcal on the usual intake). Contrast-enhanced carotid ultrasound was used to assess the VV. Body composition analysis was also used. The atherogenic index of plasma (log (triglycerides to high-density lipoprotein cholesterol ratio)) and the triglyceride-glucose index were calculated. Serum concentrations of soluble intercellular adhesion molecule 1 (sICAM-1), and soluble vascular cell adhesion molecule 1 (sVCAM-1) were measured. The impact of weight on quality of life-lite (IWQOL-Lite) questionnaire was administered. Participants of intervention groups displayed a similar VV values. Significant improvements of BMI (−5.3 [−6.9 to −3.6] kg/m2, p < 0.001), total body fat (−7.0 [−10.7 to −3.3] %, p = 0.003), and IWQOL-Lite score (−41.4 [−75.2 to −7.6], p = 0.027) were observed in VLCKD group in comparison with MedDiet group. Although after a 6-months follow-up period VV density (mean, right and left sides) did not change significantly in any group, participants in the VLCKD exhibited a significantly decrease both in their atherogenic index of plasma and serum concentration of sICAM-1. A 6-month intervention with VLCKD do not impact in the density of the adventitial VV in subjects with moderate obesity, but induces significant changes in markers of endothelial dysfunction and CV risk.
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Affiliation(s)
- Enric Sánchez
- Obesity, Diabetes and Metabolism (ODIM) Research Group, IRBLleida, University of Lleida, 25198 Lleida, Spain; (E.S.); (M.-D.S.); (M.B.)
| | - Maria-Dolores Santos
- Obesity, Diabetes and Metabolism (ODIM) Research Group, IRBLleida, University of Lleida, 25198 Lleida, Spain; (E.S.); (M.-D.S.); (M.B.)
- Endocrinology and Nutrition Department, Arnau de Vilanova University Hospital, 25198 Lleida, Spain;
| | | | - Marta Bueno
- Obesity, Diabetes and Metabolism (ODIM) Research Group, IRBLleida, University of Lleida, 25198 Lleida, Spain; (E.S.); (M.-D.S.); (M.B.)
- Endocrinology and Nutrition Department, Arnau de Vilanova University Hospital, 25198 Lleida, Spain;
| | - Ignacio Sajoux
- Pronokal Group, 08009 Barcelona, Spain; (M.N.-G.); (I.S.)
| | - Andree Yeramian
- Endocrinology and Nutrition Department, Arnau de Vilanova University Hospital, 25198 Lleida, Spain;
| | - Albert Lecube
- Obesity, Diabetes and Metabolism (ODIM) Research Group, IRBLleida, University of Lleida, 25198 Lleida, Spain; (E.S.); (M.-D.S.); (M.B.)
- Endocrinology and Nutrition Department, Arnau de Vilanova University Hospital, 25198 Lleida, Spain;
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain
- Correspondence: ; Tel.: +34-973-70-51-83; Fax: +34-973-70-51-89
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4
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Pitz Jacobsen D, Fjeldstad HE, Johnsen GM, Fosheim IK, Moe K, Alnæs-Katjavivi P, Dechend R, Sugulle M, Staff AC. Acute Atherosis Lesions at the Fetal-Maternal Border: Current Knowledge and Implications for Maternal Cardiovascular Health. Front Immunol 2021; 12:791606. [PMID: 34970270 PMCID: PMC8712939 DOI: 10.3389/fimmu.2021.791606] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2021] [Accepted: 11/22/2021] [Indexed: 12/15/2022] Open
Abstract
Decidua basalis, the endometrium of pregnancy, is an important interface between maternal and fetal tissues, made up of both maternal and fetal cells. Acute atherosis is a uteroplacental spiral artery lesion. These patchy arterial wall lesions containing foam cells are predominantly found in the decidua basalis, at the tips of the maternal arteries, where they feed into the placental intervillous space. Acute atherosis is prevalent in preeclampsia and other obstetric syndromes such as fetal growth restriction. Causal factors and effects of acute atherosis remain uncertain. This is in part because decidua basalis is challenging to sample systematically and in large amounts following delivery. We summarize our decidua basalis vacuum suction method, which facilitates tissue-based studies of acute atherosis. We also describe our evidence-based research definition of acute atherosis. Here, we comprehensively review the existing literature on acute atherosis, its underlying mechanisms and possible short- and long-term effects. We propose that multiple pathways leading to decidual vascular inflammation may promote acute atherosis formation, with or without poor spiral artery remodeling and/or preeclampsia. These include maternal alloreactivity, ischemia-reperfusion injury, preexisting systemic inflammation, and microbial infection. The concept of acute atherosis as an inflammatory lesion is not novel. The lesions themselves have an inflammatory phenotype and resemble other arterial lesions of more extensively studied etiology. We discuss findings of concurrently dysregulated proteins involved in immune regulation and cardiovascular function in women with acute atherosis. We also propose a novel hypothesis linking cellular fetal microchimerism, which is prevalent in women with preeclampsia, with acute atherosis in pregnancy and future cardiovascular and neurovascular disease. Finally, women with a history of preeclampsia have an increased risk of premature cardiovascular disease. We review whether presence of acute atherosis may identify women at especially high risk for premature cardiovascular disease.
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Affiliation(s)
| | - Heidi Elisabeth Fjeldstad
- Division of Obstetrics and Gynaecology, Oslo University Hospital, Oslo, Norway
- Institute for Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Guro Mørk Johnsen
- Division of Obstetrics and Gynaecology, Oslo University Hospital, Oslo, Norway
| | - Ingrid Knutsdotter Fosheim
- Division of Obstetrics and Gynaecology, Oslo University Hospital, Oslo, Norway
- Institute for Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Kjartan Moe
- Division of Obstetrics and Gynaecology, Oslo University Hospital, Oslo, Norway
- Institute for Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
- Department of Obstetrics and Gynaecology, Bærum Hospital, Vestre Viken HF, Bærum, Norway
| | | | - Ralf Dechend
- Experimental and Clinical Research Center, A Cooperation of Charité-Universitätsmedizin Berlin and Max-Delbruck Center for Molecular Medicine, Berlin, Germany
- Department of Cardiology and Nephrology, HELIOS-Klinikum, Berlin, Germany
| | - Meryam Sugulle
- Division of Obstetrics and Gynaecology, Oslo University Hospital, Oslo, Norway
- Institute for Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Anne Cathrine Staff
- Division of Obstetrics and Gynaecology, Oslo University Hospital, Oslo, Norway
- Institute for Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
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5
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Rodríguez-Carrio J, Carrillo-López N, Ulloa C, Martín-Carro B, Rodríguez-Suárez C, Naves-Díaz M, Sánchez-Álvarez E, Rodríguez-García M, Arcidiacono MV, Fernández-Mariño B, Cannata-Andía JB, Suárez A, Dusso AS. Novel Immune Cell Subsets Exhibit Different Associations With Vascular Outcomes in Chronic Kidney Disease Patients-Identifying Potential Biomarkers. Front Med (Lausanne) 2021; 8:618286. [PMID: 34113627 PMCID: PMC8185045 DOI: 10.3389/fmed.2021.618286] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2020] [Accepted: 04/07/2021] [Indexed: 11/17/2022] Open
Abstract
Background and Aims: Alterations in novel immune cell subsets, such as angiogenic T cells (Tang), senescent T cells (CD4+CD28null), and monocyte subsets are associated with impaired vascular homeostasis in several inflammatory conditions. However, mediators underlying vascular deterioration in chronic kidney disease (CKD) are poorly characterized. This study assessed their role in the vascular deterioration of CKD using a broad spectrum of surrogate markers ranging from altered functionality to overt calcification. Methods: Tang (CD3+CD31+CXCR4+), CD4+CD28null cells, and monocytes [CD14/CD16 subsets and angiotensin-converting enzyme (ACE) expression] were measured in peripheral blood by flow cytometry in 33 CKD stage 5 patients undergoing peritoneal dialysis (CKD5-PD) and 15 healthy controls (HCs). Analyses were replicated in a hemodialysis cohort. Vascular surrogate markers (including adventitial vasa vasorum, pulse wave velocity, intima-media thickness, and vascular calcification) were assessed by appropriate imaging methods. Results: In CKD5-PD, decreased Tang levels (p < 0.001) were unrelated to clinical features or traditional cardiovascular (CV) risk factors but correlated negatively with troponin T levels (r = −0.550, p = 0.003). Instead, CD4+CD28null frequency was increased (p < 0.001), especially in those with vascular calcifications. Quantitative and qualitative differences were also observed within the monocyte pool, a shift toward CD16+ subsets and ACE expression being found in CKD. Equivalent results were observed in the replication cohort. Each subset associated distinctly with adverse vascular outcomes in univariate and multivariate analyses: while Tang depletion was linked to poor vascular function and subclinical atherosclerosis, increases in CD4+CD28null were associated with overt vascular thickening and calcification. Monocytes were not independently associated with vascular outcomes in CKD patients. Conclusions: Novel T cell and monocyte subsets are altered in CKD. Altered T-cell subpopulations, but not monocytes, exhibited distinct associations with different vascular outcomes in CKD. Tang are emerging biomarkers of subclinical vascular deterioration in CKD.
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Affiliation(s)
- Javier Rodríguez-Carrio
- Area of Immunology, Department of Functional Biology, University of Oviedo, Oviedo, Spain.,Bone and Mineral Research Unit, Hospital Universitario Central de Asturias, Oviedo, Spain.,Instituto de Investigación Sanitaria del Principado de Asturias, Oviedo, Spain
| | - Natalia Carrillo-López
- Bone and Mineral Research Unit, Hospital Universitario Central de Asturias, Oviedo, Spain.,Instituto de Investigación Sanitaria del Principado de Asturias, Oviedo, Spain.,REDinREN-ISCIII, Oviedo, Spain
| | - Catalina Ulloa
- Bone and Mineral Research Unit, Hospital Universitario Central de Asturias, Oviedo, Spain.,Department of Nephrology, Hospital Universitario de Cabueñes, Gijón, Spain
| | - Beatriz Martín-Carro
- Bone and Mineral Research Unit, Hospital Universitario Central de Asturias, Oviedo, Spain.,Instituto de Investigación Sanitaria del Principado de Asturias, Oviedo, Spain.,REDinREN-ISCIII, Oviedo, Spain
| | | | - Manuel Naves-Díaz
- Bone and Mineral Research Unit, Hospital Universitario Central de Asturias, Oviedo, Spain.,Instituto de Investigación Sanitaria del Principado de Asturias, Oviedo, Spain.,REDinREN-ISCIII, Oviedo, Spain
| | - Emilio Sánchez-Álvarez
- REDinREN-ISCIII, Oviedo, Spain.,Department of Nephrology, Hospital Universitario de Cabueñes, Gijón, Spain
| | - Minerva Rodríguez-García
- REDinREN-ISCIII, Oviedo, Spain.,Division of Nephrology, Hospital Universitario Central de Asturias, Oviedo, Spain
| | | | | | - Jorge B Cannata-Andía
- Bone and Mineral Research Unit, Hospital Universitario Central de Asturias, Oviedo, Spain.,Instituto de Investigación Sanitaria del Principado de Asturias, Oviedo, Spain.,REDinREN-ISCIII, Oviedo, Spain.,Department of Medicine, University of Oviedo, Oviedo, Spain
| | - Ana Suárez
- Area of Immunology, Department of Functional Biology, University of Oviedo, Oviedo, Spain.,Department of Medicine, University of Oviedo, Oviedo, Spain
| | - Adriana S Dusso
- Bone and Mineral Research Unit, Hospital Universitario Central de Asturias, Oviedo, Spain.,Instituto de Investigación Sanitaria del Principado de Asturias, Oviedo, Spain.,REDinREN-ISCIII, Oviedo, Spain.,Department of Medicine, University of Oviedo, Oviedo, Spain
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6
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Carmona-Maurici J, Cuello E, Sánchez E, Miñarro A, Rius F, Bueno M, de la Fuente MC, Olsina Kissler JJ, Vidal T, Maria V, Betriu À, Lecube A, Baena-Fustegueras JA, Peinado-Onsurbe J, Pardina E. Impact of bariatric surgery on subclinical atherosclerosis in patients with morbid obesity. Surg Obes Relat Dis 2020; 16:1419-1428. [PMID: 32694041 DOI: 10.1016/j.soard.2020.05.035] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2020] [Revised: 04/29/2020] [Accepted: 05/03/2020] [Indexed: 12/20/2022]
Abstract
BACKGROUND The main cause of death in obese individuals is cardiovascular disease precipitated by atherosclerosis. Endothelial dysfunction and inflammation are considered early events in the development of the disease. OBJECTIVES The aim of this study was to identify biomarkers of subclinical atherosclerosis in patients with morbid obesity by comparing clinical, vascular, and biochemical parameters indicative of endothelial dysfunction in patients with and without atheromatous plaque and monitoring changes after bariatric surgery. SETTINGS Multicenter collaboration between Biochemistry and Biomedicine Department in Barcelona University and University Hospital Arnau de Vilanova in Lleida. METHODS Plasma samples from 66 patients with morbid obesity were obtained before bariatric surgery and at 6 and 12 months after. Patients were divided into 2 groups based on the presence of atheromatous plaque. We used contrast-enhanced carotid ultrasound, enzyme-linked immunosorbent assay, Griess, and EndoPAT-2000 methods. RESULTS Patients with plaque showed the worst profile of cardiovascular risk factors. Carotid intima-media thickness and plasminogen activator inhibitor-1 were higher in plaque group (P < .0001). After bariatric surgery, vasa vasorum, oxidized low-density lipoprotein, and plasminogen activator inhibitor-1 decreased (P < .0001 in all cases). CONCLUSIONS Obesity promotes atherogenesis, leading to vascular endothelial damage. Bariatric surgery reduces cardiovascular risk and the prognosis is better for patients without plaque. The increase in plasminogen activator inhibitor-1, carotid intima-media thickness, and vasa vasorum proliferation might be the first alterations in the atheromatous process in obesity and could serve as good biomarkers of subclinical atherosclerosis.
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Affiliation(s)
- Júlia Carmona-Maurici
- Department of Biochemistry and Molecular Biomedicine, Biology Faculty, University of Barcelona, Barcelona, Spain
| | - Elena Cuello
- Gastrointestinal Surgery Department, Arnau de Vilanova University Hospital, IRB Lleida, University of Lleida, Lleida, Spain
| | - Enric Sánchez
- Endocrinology and Nutrition Department, Arnau de Vilanova University Hospital, Obesity, Diabetes and Metabolism research group, IRBLleida, University of Lleida, Lleida, Spain
| | - Antonio Miñarro
- Department of Genetics, Microbiology and Statistics, Biology Faculty, University of Barcelona, Barcelona, Spain
| | - Ferran Rius
- Endocrinology and Nutrition Department, Arnau de Vilanova University Hospital, Obesity, Diabetes and Metabolism research group, IRBLleida, University of Lleida, Lleida, Spain
| | - Marta Bueno
- Endocrinology and Nutrition Department, Arnau de Vilanova University Hospital, Obesity, Diabetes and Metabolism research group, IRBLleida, University of Lleida, Lleida, Spain
| | - M Cruz de la Fuente
- Gastrointestinal Surgery Department, Arnau de Vilanova University Hospital, IRB Lleida, University of Lleida, Lleida, Spain
| | - Jorge Juan Olsina Kissler
- Gastrointestinal Surgery Department, Arnau de Vilanova University Hospital, IRB Lleida, University of Lleida, Lleida, Spain
| | - Teresa Vidal
- Vascular and Renal Translational Research Group, IRB Lleida, RedinRen-ISCIII, Lleida, Spain
| | - Virtudes Maria
- Vascular and Renal Translational Research Group, IRB Lleida, RedinRen-ISCIII, Lleida, Spain
| | - Àngels Betriu
- Vascular and Renal Translational Research Group, IRB Lleida, RedinRen-ISCIII, Lleida, Spain
| | - Albert Lecube
- Gastrointestinal Surgery Department, Arnau de Vilanova University Hospital, IRB Lleida, University of Lleida, Lleida, Spain; Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas, Instituto de Salud Carlos III, Madrid, Spain
| | - Juan Antonio Baena-Fustegueras
- Gastrointestinal Surgery Department, Arnau de Vilanova University Hospital, IRB Lleida, University of Lleida, Lleida, Spain
| | - Julia Peinado-Onsurbe
- Department of Biochemistry and Molecular Biomedicine, Biology Faculty, University of Barcelona, Barcelona, Spain.
| | - Eva Pardina
- Department of Biochemistry and Molecular Biomedicine, Biology Faculty, University of Barcelona, Barcelona, Spain
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7
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Wang LF, Li Y, Landsittel DP, Reis SE, Levesque MC, Jones DM, Gartland R, Avolio J, Shoushtari A, Qi Z, Dezfulian C, Moreland LW, Liang KP. Identifying Vulnerable Plaque in Rheumatoid Arthritis Using Novel Microbubble Contrast-Enhanced Carotid Ultrasonography and Serum Biomarkers. JOURNAL OF DIAGNOSTIC MEDICAL SONOGRAPHY 2020. [DOI: 10.1177/8756479320922512] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Objective: Rheumatoid arthritis (RA) is associated with increased risk of cardiovascular disease. Adventitial vasa vasorum density (aVVD), the vessel density of the vasa vasorum, is a surrogate measure for atherosclerotic plaque vulnerability. The purpose of this study was to compare the adventitial vasa vasorum density (aVVD) in RA and non-RA control participants using novel carotid artery contrast-enhanced ultrasound (CEUS). In addition, we investigate associations of aVVD with traditional cardiovascular (CV) risk factors, vascular and inflammatory biomarkers, and RA disease activity. Methods: The study was a cross-sectional analysis of patients with RA and control participants without RA or other autoimmune disease. CV disease risk, biomarkers, and CEUS images were collected on all patients. Results: aVVD was quantified in 86 patients with RA and 95 non-RA control participants. Nitrite, CD40L, E-selectin, matrix metalloproteinase 9, intercellular adhesion molecule 1, vascular cell adhesion molecule 1, myeloperoxidase (MPO), high-sensitivity C-reactive protein (hsCRP), and erythrocyte sedimentation rate were measured. Median aVVD was higher in patients with RA (0.59 [0.47–0.69] vs 0.64 [0.54–0.62]; P = .02). In patients with RA, MPO was lower (253.5 [153.2–480] vs 470.8 [274.2–830.1] ng/mL; P = .0002) and ESR was higher (15.5 [11–25] vs 13 [9–20] mm/h; P = .02). aVVD was correlated with MPO ( r = −0.33, P = .001) and hsCRP ( r = 0.25, P = .02) in control participants only, associations that remained significant after adjusting for number of CV risk factors and age. No significant correlations were found between aVVD and RA disease activity measures. Conclusions: Using a novel application of CEUS, we found that aVVD, an early measure of plaque vulnerability, was significantly higher in RA than control subjects, even after adjusting for CV risk factors. Differences in correlation of aVVD with vascular biomarkers and CV risk factors suggest RA-related differences in atherosclerotic progression.
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Affiliation(s)
- Linda F. Wang
- School of Medicine, University of Pittsburgh, Pittsburgh PA, USA
| | - Yaming Li
- Department of Biomedical Informatics, University of Pittsburgh, Pittsburgh PA, USA
| | | | - Steven E. Reis
- Division of Cardiology, University of Pittsburgh, Pittsburgh PA, USA
| | - Marc C. Levesque
- Division of Rheumatology and Clinical Immunology, University of Pittsburgh, Pittsburgh PA, USA
| | - Donald M. Jones
- Division of Rheumatology and Clinical Immunology, University of Pittsburgh, Pittsburgh PA, USA
| | - Rachel Gartland
- Division of Rheumatology and Clinical Immunology, University of Pittsburgh, Pittsburgh PA, USA
| | - Jennifer Avolio
- Clinical and Translational Science Institute, University of Pittsburgh, Pittsburgh PA, USA
| | - Ali Shoushtari
- Clinical and Translational Science Institute, University of Pittsburgh, Pittsburgh PA, USA
| | - Zengbiao Qi
- Division of Rheumatology and Clinical Immunology, University of Pittsburgh, Pittsburgh PA, USA
| | - Cameron Dezfulian
- Vascular Medicine Institute and Critical Care Medicine, University of Pittsburgh, Pittsburgh PA, USA
| | - Larry W. Moreland
- Division of Rheumatology and Clinical Immunology, University of Pittsburgh, Pittsburgh PA, USA
| | - Kimberly P. Liang
- Division of Rheumatology and Clinical Immunology, University of Pittsburgh, Pittsburgh PA, USA
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8
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Tinajero MG, Gotlieb AI. Recent Developments in Vascular Adventitial Pathobiology: The Dynamic Adventitia as a Complex Regulator of Vascular Disease. THE AMERICAN JOURNAL OF PATHOLOGY 2019; 190:520-534. [PMID: 31866347 DOI: 10.1016/j.ajpath.2019.10.021] [Citation(s) in RCA: 57] [Impact Index Per Article: 11.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/06/2019] [Revised: 10/24/2019] [Accepted: 10/29/2019] [Indexed: 12/20/2022]
Abstract
The adventitia, the outer layer of the blood vessel wall, may be the most complex layer of the wall and may be the master regulator of wall physiology and pathobiology. This review proposes a major shift in thinking to apply a functional lens to the adventitia rather than only a structural lens. Human and experimental in vivo and in vitro studies show that the adventitia is a dynamic microenvironment in which adventitial and perivascular adipose tissue cells initiate and regulate important vascular functions in disease, especially intimal hyperplasia and atherosclerosis. Although well away from the blood-wall interface, where much pathology has been identified, the adventitia has a profound influence on the population of intimal and medial endothelial, macrophage, and smooth muscle cell function. Vascular injury and dysfunction of the perivascular adipose tissue promote expansion of the vasa vasorum, activation of fibroblasts, and differentiation of myofibroblasts. This regulates further biologic processes, including fibroblast and myofibroblast migration and proliferation, inflammation, immunity, stem cell activation and regulation, extracellular matrix remodeling, and angiogenesis. A debate exists as to whether the adventitia initiates disease or is just an important participant. We describe a mechanistic model of adventitial function that brings together current knowledge and guides the design of future investigations to test specific hypotheses on adventitial pathobiology.
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Affiliation(s)
- Maria G Tinajero
- Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Avrum I Gotlieb
- Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.
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Influence of Morbid Obesity and Bariatric Surgery Impact on the Carotid Adventitial Vasa Vasorum Signal. Obes Surg 2019; 28:3935-3942. [PMID: 30030728 DOI: 10.1007/s11695-018-3410-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
INTRODUCTION/PURPOSE Adventitial vasa vasorum (VV) expansion to the avascular intima precedes an increase in carotid intima-media thickness. However, factors involved in the development of the atherosclerotic process and its reversibility remain unclear. We aimed to evaluate the VV signal in both morbid obesity and after bariatric surgery (BS). MATERIALS/METHODS We conducted a case-control study to examine the VV signal in the carotid of 40 morbidly obese patients and 40 non-obese controls. The effect of BS was evaluated in 33 patients. Contrast-enhanced carotid ultrasound was used to assess the VV signal. RESULTS The mean VV density was higher in obese than in non-obese subjects (0.739 ± 0.117 vs. 0.570 ± 0.111, p < 0.001). The VV signal positively correlated with BMI (p < 0.001) and waist circumference (p = 0.001) but was not related to cIMT. The stepwise multivariate regression analysis revealed that waist circumference (beta = 0.507, p < 0.001) together with fasting plasma glucose (beta = 0.229, p = 0.024) were independently associated with the VV signal (R2 = 0.382). Before BS, the median VV signal correlated with soluble intercellular adhesion molecule 1 (p = 0.022). After a 12-month follow-up, a 12.0% decrease in VV (0.731 ± 0.126 vs. 0.643 ± 0.115, p = 0.003) was observed. In the univariate analysis, the decrease in VV was associated with the baseline VV density (p < 0.001), baseline systolic blood pressure (p = 0.019) and a decrease in sICAM (p = 0.005). However, only baseline systolic pressure (beta = 0.417, p = 0.024) independently predicted the absolute change in VV signal (R2 = 0.174). CONCLUSIONS Morbidly obesity is associated with increased VV density. In addition, BS appears to reduce the earlier expansion of the adventitial vasa vasorum.
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10
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López-Cano C, Rius F, Sánchez E, Gaeta AM, Betriu À, Fernández E, Yeramian A, Hernández M, Bueno M, Gutiérrez-Carrasquilla L, Dalmases M, Lecube A. The influence of sleep apnea syndrome and intermittent hypoxia in carotid adventitial vasa vasorum. PLoS One 2019; 14:e0211742. [PMID: 30721271 PMCID: PMC6363284 DOI: 10.1371/journal.pone.0211742] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2018] [Accepted: 01/18/2019] [Indexed: 12/11/2022] Open
Abstract
Subjects with sleep apnea-hypopnea syndrome (SAHS) show an increased carotid intima-media thickness. However, no data exist about earlier markers of atheromatous disease, such as the proliferation and expansion of the adventitial vasa vasorum (VV) to the avascular intima in this setting. Our aim was to assess carotid VV density and its relationship with sleep parameters in a cohort of obese patients without prior vascular events. A total of 55 subjects evaluated for bariatric surgery were prospectively recruited. A non-attended respiratory polygraphy was performed. The apnea-hypopnea index (AHI) and the cumulative percentage of time spent with oxygen saturation below 90% (CT90) were assessed. Serum concentrations of soluble intercellular adhesion molecule 1, P-selectin, lipocalin-2 and soluble vascular cell adhesion molecule 1 (sVCAM-1) were measured. Contrast-enhanced carotid ultrasound was used to assess the VV density. Patients with SAHS (80%) showed a higher adventitial VV density (0.801±0.125 vs. 0.697±0.082, p = 0.005) and higher levels of sVCAM-1 (745.2±137.8 vs. 643.3±122.7 ng/ml, p = 0.035) than subjects with an AHI lower than 10 events/hour. In addition, a positive association exist between mean VV density and AHI (r = 0.445, p = 0.001) and CT90 (r = 0.399, p = 0.005). Finally, in the multiple linear regression analysis, female sex, fasting plasma glucose and AHI (but not CT90) were the only variables independently associated with the mean adventitial VV density (R2 = 0.327). In conclusion, a high VV density is present in obese subjects with SAHS, and chronic intermittent hypoxia is pointed as an independent risk factor for the development of this early step of atheromatous disease.
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Affiliation(s)
- Carolina López-Cano
- Endocrinology and Nutrition Department, University Hospital Arnau de Vilanova, Obesity, Diabetes and Metabolism (ODIM) research group, IRBLleida, University of Lleida, Lleida, Catalonia, Spain
| | - Ferran Rius
- Endocrinology and Nutrition Department, University Hospital Arnau de Vilanova, Obesity, Diabetes and Metabolism (ODIM) research group, IRBLleida, University of Lleida, Lleida, Catalonia, Spain
| | - Enric Sánchez
- Endocrinology and Nutrition Department, University Hospital Arnau de Vilanova, Obesity, Diabetes and Metabolism (ODIM) research group, IRBLleida, University of Lleida, Lleida, Catalonia, Spain
| | - Anna Michela Gaeta
- Respiratory Department, University Hospital Arnau de Vilanova-Santa María, Translational Research in Respiratory Medicine, IRBLleida, University of Lleida, Lleida, Catalonia, Spain
| | - Àngels Betriu
- Unit for the Detection and Treatment of Atherothrombotic Diseases (UDETMA V&R), University Hospital Arnau de Vilanova, Vascular and Renal Translational Research Group, IRBLleida, University of Lleida, Lleida, Catalonia, Spain
| | - Elvira Fernández
- Unit for the Detection and Treatment of Atherothrombotic Diseases (UDETMA V&R), University Hospital Arnau de Vilanova, Vascular and Renal Translational Research Group, IRBLleida, University of Lleida, Lleida, Catalonia, Spain
| | - Andree Yeramian
- Endocrinology and Nutrition Department, University Hospital Arnau de Vilanova, Obesity, Diabetes and Metabolism (ODIM) research group, IRBLleida, University of Lleida, Lleida, Catalonia, Spain
| | - Marta Hernández
- Endocrinology and Nutrition Department, University Hospital Arnau de Vilanova, Obesity, Diabetes and Metabolism (ODIM) research group, IRBLleida, University of Lleida, Lleida, Catalonia, Spain
| | - Marta Bueno
- Endocrinology and Nutrition Department, University Hospital Arnau de Vilanova, Obesity, Diabetes and Metabolism (ODIM) research group, IRBLleida, University of Lleida, Lleida, Catalonia, Spain
| | - Liliana Gutiérrez-Carrasquilla
- Endocrinology and Nutrition Department, University Hospital Arnau de Vilanova, Obesity, Diabetes and Metabolism (ODIM) research group, IRBLleida, University of Lleida, Lleida, Catalonia, Spain
| | - Mireia Dalmases
- Respiratory Department, University Hospital Arnau de Vilanova-Santa María, Translational Research in Respiratory Medicine, IRBLleida, University of Lleida, Lleida, Catalonia, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
| | - Albert Lecube
- Endocrinology and Nutrition Department, University Hospital Arnau de Vilanova, Obesity, Diabetes and Metabolism (ODIM) research group, IRBLleida, University of Lleida, Lleida, Catalonia, Spain
- Centro de Investigación en Red en Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- * E-mail:
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11
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Pereira T, Muguruza J, Mária V, Vilaprinyo E, Sorribas A, Fernandez E, Fernandez-Armenteros JM, Baena JA, Rius F, Betriu A, Solsona F, Alves R. Automatic Methods for Carotid Contrast-Enhanced Ultrasound Imaging Quantification of Adventitial Vasa Vasorum. ULTRASOUND IN MEDICINE & BIOLOGY 2018; 44:2780-2792. [PMID: 30205994 DOI: 10.1016/j.ultrasmedbio.2018.07.027] [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: 02/06/2018] [Revised: 07/27/2018] [Accepted: 07/29/2018] [Indexed: 06/08/2023]
Abstract
Adventitial vasa vasorum are physiologic microvessels that nourish artery walls. In the presence of cardiovascular risk factors, these microvessels proliferate abnormally. Studies have reported that they are the first stage of atheromatous disease. Contrast-enhanced ultrasound (CEUS) of the carotid allows direct, quantitative and non-invasive visualization of the adventitial vasa vasorum. Hence, the development of computer-assisted methods that speed image analysis and eliminate user subjectivity is important. We developed methods for automatic analyses and quantification of vasa vasorum neovascularization in CEUS and tested these methods in a cohort of 186 individuals, 63 of whom were healthy volunteers. We implemented alternative automatic strategies for using the images to stratify patients according to their risk group and compare the strategies with respect to diagnostic performance. An automatic single-parameter strategy performs less effectively than the corresponding Arcidiacono method based on manual interpretation of the images (68 < area under the receiver operating characteristic curve [AUROC] for the manual Arcidiacono method < 82; 60 < AUROC for the automatic single-parameter strategy < 63). However, by use of additional image parameters, an automatic multiparameter strategy has significantly improved performance with respect to the manual Arcidiacono method (78 < AUROC < 90). The automatic multiparameter strategy is a valuable alternative to the manual Arcidiacono method, improving both diagnostic speed and diagnostic accuracy.
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Affiliation(s)
- Tania Pereira
- Department of Basic Medical Science, University of Lleida, Catalonia, Spain; Institute for Biomedical Research in Lleida, Dr. Pifarré Foundation (IRBLleida), Catalonia, Spain
| | - Jose Muguruza
- Department of Computer Science, University of Lleida, Catalonia, Spain
| | - Virtu Mária
- Unit for the Detection and Treatment of Atherothrombotic Diseases (UDETMA), Hospital Universitari Arnau de Vilanova de Lleida (HUAVL), Catalonia, Spain; Vascular and Renal Translational Research Group, IRBLleida, Catalonia, Spain
| | - Ester Vilaprinyo
- Department of Basic Medical Science, University of Lleida, Catalonia, Spain; Institute for Biomedical Research in Lleida, Dr. Pifarré Foundation (IRBLleida), Catalonia, Spain
| | - Albert Sorribas
- Department of Basic Medical Science, University of Lleida, Catalonia, Spain; Institute for Biomedical Research in Lleida, Dr. Pifarré Foundation (IRBLleida), Catalonia, Spain
| | - Elvira Fernandez
- Unit for the Detection and Treatment of Atherothrombotic Diseases (UDETMA), Hospital Universitari Arnau de Vilanova de Lleida (HUAVL), Catalonia, Spain; Vascular and Renal Translational Research Group, IRBLleida, Catalonia, Spain
| | - Jose Manuel Fernandez-Armenteros
- Institute for Biomedical Research in Lleida, Dr. Pifarré Foundation (IRBLleida), Catalonia, Spain; Servei de Dermatologia, HUAVL and IRBLleida, Catalonia, Spain
| | - Juan Antonio Baena
- Institute for Biomedical Research in Lleida, Dr. Pifarré Foundation (IRBLleida), Catalonia, Spain; Unitat de Cirurgia Endocrina, Bariàtrica i Metabolica, HUAVL and IRBLleida, Catalonia, Spain
| | - Ferran Rius
- Institute for Biomedical Research in Lleida, Dr. Pifarré Foundation (IRBLleida), Catalonia, Spain; Endocrinology and Nutrition Department, HUAVL and IRBLleida, Catalonia, Spain
| | - Angels Betriu
- Unit for the Detection and Treatment of Atherothrombotic Diseases (UDETMA), Hospital Universitari Arnau de Vilanova de Lleida (HUAVL), Catalonia, Spain; Vascular and Renal Translational Research Group, IRBLleida, Catalonia, Spain
| | - Francesc Solsona
- Department of Computer Science, University of Lleida, Catalonia, Spain
| | - Rui Alves
- Department of Basic Medical Science, University of Lleida, Catalonia, Spain; Institute for Biomedical Research in Lleida, Dr. Pifarré Foundation (IRBLleida), Catalonia, Spain.
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12
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Super-resolution ultrasound imaging method for microvasculature in vivo with a high temporal accuracy. Sci Rep 2018; 8:13918. [PMID: 30224779 PMCID: PMC6141566 DOI: 10.1038/s41598-018-32235-2] [Citation(s) in RCA: 46] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2018] [Accepted: 08/29/2018] [Indexed: 02/07/2023] Open
Abstract
Traditional ultrasound imaging techniques are limited in spatial resolution to visualize angiogenic vasa vasorum that is considered as an important marker for atherosclerotic plaque progression and vulnerability. The recently introduced super-resolution imaging technique based on microbubble center localization has shown potential to achieve unprecedented high spatial resolution beyond the acoustic diffraction limit. However, a major drawback of the current super-resolution imaging approach is low temporal resolution because it requires a large number of imaging frames. In this study, a new imaging sequence and signal processing approach for super-resolution ultrasound imaging are presented to improve temporal resolution by employing deconvolution and spatio-temporal-interframe-correlation based data acquisition. In vivo feasibility of the developed technology is demonstrated and evaluated in imaging vasa vasorum in the rabbit atherosclerosis model. The proposed method not only identifies a tiny vessel with a diameter of 41 μm, 5 times higher spatial resolution than the acoustic diffraction limit at 7.7 MHz, but also significantly improves temporal resolution that allows for imaging vessels over cardiac motion.
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13
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Muthusami P, Krings T, Raybaud C, Dirks P, M Shroff M. Intracranial artery to artery spontaneous revascularization in a child. Childs Nerv Syst 2017; 33:2035-2038. [PMID: 28676978 DOI: 10.1007/s00381-017-3498-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2016] [Accepted: 06/16/2017] [Indexed: 10/19/2022]
Abstract
INTRODUCTION Intracranial artery-to-artery antegrade revascularization is a poorly recognized entity, more so when it involves main stem arteries. The etiology, appearance, and significance of this condition are not described in the literature. CASE PRESENTATION We describe a case of spontaneous revascularization of a chronically occluded middle cerebral arterial branch by collaterals from the proximal segment reconstituting distal flow, mimicking a brain arteriovenous malformation in a 9-year old boy. We discuss the nature of these channels, presumed to be related to artery to artery collaterals that are either dilated adventitial vasa vasorum, or, more likely, leptomeningeal collaterals that are hypertrophied in response to cerebral demand. We review the literature regarding intracerebral vasa vasorum and leptomeningeal collaterals including their imaging. CONCLUSION Recognizing the tortuous channels associated with this type of vascular abnormality as normal vessels reconsituting distal flow may prevent unnecessary and potentially dangerous treatments.
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Affiliation(s)
- Prakash Muthusami
- Pediatric Neuroradiology, Department of Diagnostic Imaging, The Hospital for Sick Children, Toronto, ON, M5G 1H4, Canada.
| | - Timo Krings
- Division of Neuroradiology and Neurosurgery, University of Toronto, Toronto Western Hospital and University Health Network, Toronto, ON, Canada
| | - Charles Raybaud
- Pediatric Neuroradiology, Department of Diagnostic Imaging, The Hospital for Sick Children, Toronto, ON, M5G 1H4, Canada
| | - Peter Dirks
- Division of Neurosurgery, Department of Surgery, University of Toronto, Toronto, ON, Canada.,Division of Neurosurgery, Department of Surgery, The Hospital for Sick Children, Toronto, ON, Canada
| | - Manohar M Shroff
- Pediatric Neuroradiology, Department of Diagnostic Imaging, The Hospital for Sick Children, Toronto, ON, M5G 1H4, Canada
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Qureshi AI, Saleem MA, Ahrar A, Raja F. Imaging of the Vasa Nervorum Using Contrast-Enhanced Ultrasound. J Neuroimaging 2017; 27:583-588. [DOI: 10.1111/jon.12429] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2016] [Accepted: 01/09/2017] [Indexed: 01/13/2023] Open
Affiliation(s)
- Adnan I. Qureshi
- Zeenat Qureshi Stroke Institute; St. Cloud MN
- Rockford Memorial Hospital; Rockford IL
| | | | - Asad Ahrar
- Zeenat Qureshi Stroke Institute; St. Cloud MN
| | - Faisal Raja
- Zeenat Qureshi Stroke Institute; St. Cloud MN
- Rockford Memorial Hospital; Rockford IL
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15
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High Levels of Hemoglobin Promote Carotid Adventitial Vasa Vasorum Neoangiogenesis in Chronic Kidney Disease. Mediators Inflamm 2017; 2017:3795142. [PMID: 28133420 PMCID: PMC5241472 DOI: 10.1155/2017/3795142] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2016] [Revised: 10/30/2016] [Accepted: 11/14/2016] [Indexed: 11/17/2022] Open
Abstract
Chronic kidney disease (CKD) patients, characterized by traditional and nontraditional risk factors, are prone to develop atheromatosis and thus cardiovascular events and mortality. The angiogenesis of the adventitial vasa vasorum (aVV) surrounding the carotid has been described as the atheromatosis initiator. Therefore, the aim of the study was to (1) evaluate if the carotid aVV in CKD patients increases in comparison to its physiological value of healthy patients; (2) explore which traditional or nontraditional risk factor including inflammation, bone and mineral metabolism, and anemia could be related to the aVV angiogenesis. CKD patients without previous cardiovascular events (44, stages 3-4; 37, stage 5D) and 65 healthy subjects were compared. The carotid aVV and the intima-media thickness (cIMT) were evaluated by ultrasound. CKD patients at stages 3-4 showed higher aVV of the right carotid artery even after adjusting for age. Importantly, a multiple linear regression model showed hemoglobin levels > 12.5 g/dL as the factor for an estimated higher aVV of the right carotid artery. In conclusion, the association of hemoglobin with higher aVV could suggest the role of high hemoglobin in the higher incidence of adverse cardiovascular outcomes in CKD patients.
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Saha SA, Gourineni V, Feinstein SB. The Use of Contrast-enhanced Ultrasonography for Imaging of Carotid Atherosclerotic Plaques: Current Evidence, Future Directions. Neuroimaging Clin N Am 2015; 26:81-96. [PMID: 26610662 DOI: 10.1016/j.nic.2015.09.007] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Contrast-enhanced ultrasonography (CEUS) is a rapidly evolving modality for imaging carotid artery disease and systemic atherosclerosis. CEUS coupled with diagnostic ultrasonography predicts the degree of carotid artery stenosis and is comparable with computed tomography and magnetic resonance angiography. This article reviews the literature on the evolving role of CEUS for the identification and characterization of carotid plaques with an emphasis on detection of intra-plaque neovascularization and related high-risk morphologic features notably present in symptomatic patients. CEUS carotid imaging may play a prominent additive role in risk stratifying patients and serve as a powerful tool for monitoring therapeutic interventions.
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Affiliation(s)
- Sandeep A Saha
- Division of Cardiology, Department of Medicine, Rush University Medical Center, Chicago, IL, USA.
| | - Venu Gourineni
- Division of Cardiology, Department of Medicine, Rush University Medical Center, Chicago, IL, USA
| | - Steven B Feinstein
- Division of Cardiology, Department of Medicine, Rush University Medical Center, Chicago, IL, USA
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