Carotid plaque neovascularisation on CEUS examination is associated with increased thermal heterogeneity and ultrasound characteristics of plaque vulnerability in intermediate lesions.
Atherosclerotic coronary artery disease, the underlying basis for ischemic heart disease, is the leading cause of death and disability in the USA and recent trends indicate that coronary artery disease is also becoming a major public health problem in developing countries [1]. Atherosclerosis is a continuous process that is initiated early in life, which gradually progresses with potentially devastating consequences: atherosclerotic plaque rupture is the most common underlying pathological mechanism creating acute ischemic coronary syndromes [2]. This term refers to the process of disruption of the endothelial surface and the exposure of the underlying prothrombotic vessel wall to circulating platelets and coagulation factors. In order to identify the high-risk plaque we need to recognize its specific morphological and functional characteristics. The morphological characteristics have been identified in several human histopathological and in vivo studies, and include: 1) a large lipid core (≥40% plaque volume) composed of free cholesterol crystals, cholesterol esters, and oxidized lipids impregnated with tissue factor, 2) a thin fibrous cap depleted of smooth muscle cells and collagen, 3) an outward (positive) remodeling, 4) inflammatory cell infiltration of fibrous cap and adventitia (mostly monocyte- macrophages, activated T cells and mast cells), and 5) increased neovascularization. The terms vulnerable, unstable or 'high-risk' are now widely used to describe plaques that exhibit such features, irrespective of whether rupture of the fibrous cap is present [3].
No abstract
C arotid intima-media thickness (IMT) has been widely used as a surrogate marker for coronary artery disease (CAD). [1][2][3][4] The increase of IMT in carotid arterial wall reflects morphological alterations and does not provide information on the functional changes. Microwave radiometry (MR) is a new method and allows in vivo noninvasive measurement of the temperature of carotid atherosclerotic plaques, reflecting their inflammatory status. [5][6][7] In the present study, we aimed to (1) examine whether the inflammation of carotid artery wall, as assessed by MR, correlates with the presence of CAD, and (2) compare the predictive value of the morphological and functional assessment of carotid plaques in CAD detection. Methods Study PopulationConsecutive patients undergoing coronary angiography were prospectively enrolled in the study. Significant CAD was defined as diameter lumen stenosis of ≥50% in ≥1 major coronary artery. Multivessel CAD was defined as the presence of significant stenoses in ≥2 major coronary arteries.All patients underwent carotid ultrasound examination followed by MR measurements, performed by specialists blinded to angiographic results. All participants provided informed consent, and the study was approved by our institution ethical committee. Ultrasound ImagingThe ultrasound protocol included scanning of both carotid arteries from their point of origin throughout their whole length using a 7.5-MHz transducer (Philips iEE33; Philips, Washington). IMT measurements were performed in 3 segments of 20 mm along each carotid artery. For this purpose, the middle segment was the region of common carotid bifurcation and was used as a marker. The regions 20 mm proximal and 20 mm distal to the bifurcation region defined the 2 other segments, namely the common carotid artery segment and the internal carotid artery segment, respectively. The highest IMT value of all segments of both carotid arteries was defined as IMT max .Background and Purpose-Microwave radiometry allows noninvasive in vivo measuring of internal temperature of tissues reflecting inflammation. In the present study, we evaluated the predictive accuracy of this method for the diagnosis of coronary artery disease (CAD). Methods-Consecutive patients (n=287) scheduled for coronary angiography were included in the study. In carotid arteries of both groups, the following measurements were performed: (1) intima-media thickness (IMT max ) and (2) temperature measurements by microwave radiometry (ΔT max ). C-statistic and net reclassification improvement were used to compare the prediction ability of the markers IMT max and ΔT max for the presence of CAD and multivessel CAD. Results-Of 287 patients, 239 had stenoses ≥50% (CAD group), and 48 did not have significant stenoses (NO-CAD group).ΔT max was an independent predictor for the presence of CAD and multivessel CAD, showing similar predictive accuracy to intima-media thickness, as assessed by c-statistic and net reclassification improvement. Conclusions-Local inflammatory activation, as dete...
Nanomaterials are materials in which at least one of the three dimensions ranges from 1 to 100 nm, according to the International Organization for Standardization (ISO). Nanomaterials can be categorized according to various parameters, such as their source, their shape, and their origin. Their increasing use in industrial settings, everyday items, electronic devices, etc. poses an environmental and biological risk that needs to be assessed and appropriately addressed. The development of reliable analytical methods for both characterization and quantification of nanomaterials in various matrices is essential. This review summarized the recent trends in analytical methodologies for the characterization and determination of nanoparticles in biological matrices.
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