Angioscopic Evaluation of Stabilizing Effects of Bezafibrate on Coronary Plaques in Patients With Coronary Artery Disease

Uchida, Yasumi; Fujimori, Yoshikazu; Ohsawa, Hidefumi; Hirose, Jyunichi; Noike, Hirofumi; Tokuhiro, Keiichi; Kanai, Masahito; Yoshinuma, Masaki; Mineoka, Kazuhito; Hatori, Takashi; Aoyagi, Kaneyuki; Sakurai, Takeshi; Sato, Shin; Yoshinaga, Kokushi; Ozegawa, Masaaki; Morio, Hiroshi; Yamada, Katsumi; Terasawa, Kimiko; Uchida, Yuuko; Oshima, Tadayuki

doi:10.1155/dte.7.21

Cited by 7 publications

(11 citation statements)

References 7 publications

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“…2 In fact, the stabilizing effect of fibrates or statins on coronary plaques has been proven by a prospective follow-up study using conventional angioscopy. 25 However, whether or not HDL increases in the targeted vascular wall remains unproven.…”

Section: Funding Sourcesmentioning

confidence: 99%

Imaging of Native High-Density Lipoprotein in Human Coronary Plaques by Color Fluorescent Angioscopy

Uchida

Hiruta

Yamanoi

et al. 2014

Circ J

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Background: High-density lipoprotein (HDL) plays a key role in reverse cholesterol transport, and halts the progression of atherosclerosis. The aim of the present study was to visualize native HDL in the human coronary arterial wall. Methods and Results:The fluorescence characteristics of HDL were investigated by color fluorescent microscopy (CFM) using excitation at 470 nm and emission at 515 nm with Fast green dye (FG) as the biomarker. HDL in 30 normal coronary segments, and in 25 white and 25 yellow plaques in excised human coronary arteries, was visualized by color fluorescent angioscopy (CFA) and CFM. Localization of HDL visualized by CFM was compared with that stained by immunostaining using an anti-HDL antibody. FG elicited a characteristic brown fluorescence of HDL. By CFA, the percent incidence of HDL in normal segments, white (early stage of plaque growth) and yellow (advanced stage of plaque growth) plaques was, respectively, 33%, 76% (P<0.05 vs. normal segments and yellow plaques) and 21%. Localization of HDL visualized by CFM did not differ from that stained by immunostaining. Conclusions:In the human coronary arterial wall, HDL deposits infrequently in normal segments, but increasingly deposits with plaque formation, and decreases in the advanced stage of plaque growth. (Circ J 2014; 78: 1667 -1675

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Section: Funding Sourcesmentioning

confidence: 99%

Imaging of Native High-Density Lipoprotein in Human Coronary Plaques by Color Fluorescent Angioscopy

Uchida

Hiruta

Yamanoi

et al. 2014

Circ J

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“…In fact, the stabilizing effect of fibrates on coronary plaques has been proven by a prospective follow-up study using conventional angioscopy. 25) However, whether or not HDL is increased by fi brates in the targeted vascular wall remains unproven.…”

Section: Discussionmentioning

confidence: 99%

Localization of Native High-Density Lipoprotein and Its Relation to Plaque Morphology in Human Coronary Artery

Uchida¹,

Hiruta

Uchida

et al. 2013

Int. Heart J.

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SummaryHigh-density lipoprotein (HDL) plays a key role in reverse cholesterol transport, and halts the progression of atherosclerosis. However, its localization in human vascular wall is not well understood. We discovered that by exciting at 470-nm and emitting at 515-nm light wavelengths, Fast green dye (FG) elicits brown fl uorescence characteristic of HDL only. Therefore, the localization of native HDL in normal segments and plaques in excised human coronary artery was investigated by scanning their transected surface with color fl uorescent microscopy (CFM) using FG as a biomarker, and the relationships between the localization of HDL and morphology of plaques and normal segments classifi ed by conventional angioscopy and histology were examined. The % incidence of HDL in 13 normal segments (NS) with thin is associated with decreased risk of coronary heart disease. 1) Elevating the plasma level of HDL by fibrates is associated with a lower incidence of coronary heart disease.2) Mechanisms by which antiatherogenic HDL reduces atherosclerosis include facilitating cholesterol uptake from cholesterol-loaded macrophage-foam cells in plaques for transport back to the liver, 3,4) a role as an anti-infl ammatory lipoprotein, decreasing oxidized low-density lipoprotein (oxLDL), increasing nitric oxide synthesis, 5) improving endothelial function, and as an antithrombotic agent. 5) Infusions of HDL or its major component, apolipoprotein A-1 (Apo A-1), halt the progression or induce the regression of atherosclerosis. [6][7][8] The relationship between the plasma HDL levels and atherosclerotic lesions has been extensively investigated. Traffi cking HDL movement was performed using gadolinium methianethiosulfonate-labeled ApoA-1 in animal liver and kidney, 9) and using nanocrystals such as Au-HDL and FeO-HDL in the mouse aorta, 10) but imaging of native HDL in the human vascular wall has not been successful to date. Therefore, it is not known in what type(s) of atherosclerotic plaques native HDL deposits, whether this substance deposits in the normal vascular wall, how this substance acts against atherosclerotic plaque growth and destabilization, and whether or not its concentration changes in parallel with that in the plasma. If HDL could be visualized in the vascular wall, the molecular mechanisms by which HDL causes regression of atherosclerosis and whether or not the amount of HDL in the vascular wall is increased by HDL-raising compounds could be clarified more objectively.We recently discovered that Fast green dye (FG), which is used clinically to stain oral mucosal micronuclei for detection of the genotoxicity of antihyperglycemic drugs in patients with diabetes mellitus, 11) intraocular membrane staining, 12) and subchondral bone staining, 13) elicits a brown fl uorescent color from HDL when fl uorescence is excited at 420 ± 20-nm and emitted at 515-nm light wavelengths. Therefore, in the present study, color fluorescent microscopic (CFM) scanning of the transected surface of the excised human coronary artery (bo...

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“…Oral administration of 400 mg/day of bezafi brate for 6 months decreased vulnerable score of coronary plaques, indicating that the agent stabilizes coronary plaques in a short time. However, the stabilizing effect differed between plaques in a given patient [12]. Oral administration of atorvastatin also reduced vulnerability score [23].…”

Section: Angioscopic Evaluation Of Lipid-lowering Therapymentioning

confidence: 96%

“…Scoring of vulnerability by surface color was implemented-namely light yellow, yellow, and dark yellow as 1, 2, and 3, respectively [11], or white, light yellow, yellow, and glistening yellow plaques as 0, 1, 2, and 3, respectively [12]. It was reported that the glistening yellow plaques are prone to disrupt, and acute coronary syndromes more frequently develop in patients with this type of plaque [13].…”

Section: Vulnerable Coronary Plaques and Vulnerable Patientsmentioning

confidence: 99%

Coronary angioscopy: From tissue imaging to molecular imaging

Uchida¹

2009

curr cardiovasc imaging rep

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Angioscopy enables macroscopic pathological diagnosis of cardiovascular diseases from the inside. This imaging modality has been mainly directed to observation of coronary artery diseases. This method is now clinically used for classifying coronary plaques and thrombi, understanding mechanisms of acute coronary syndromes, evaluating percutaneous coronary interventions, evaluating plaque-stabilizing effects of drugs, and recently, for characterizing vulnerable plaques and vulnerable patients and accordingly for prediction of acute coronary syndromes. Fluorescence angioscopy was recently established and is now clinically used for molecular imaging of coronary plaques. Molecular and cellular imaging by this new imaging technology will contribute to more objective evaluation of coronary artery diseases.

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Angioscopic Evaluation of Stabilizing Effects of Bezafibrate on Coronary Plaques in Patients With Coronary Artery Disease

Cited by 7 publications

References 7 publications

Imaging of Native High-Density Lipoprotein in Human Coronary Plaques by Color Fluorescent Angioscopy

Imaging of Native High-Density Lipoprotein in Human Coronary Plaques by Color Fluorescent Angioscopy

Localization of Native High-Density Lipoprotein and Its Relation to Plaque Morphology in Human Coronary Artery

Coronary angioscopy: From tissue imaging to molecular imaging

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