Diagnostic Histopathology

2012

DOI: 10.1016/j.mpdhp.2012.09.001

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Pathology of myocardial infarction, coronary artery disease, plaque disruption, and the vulnerable atherosclerotic plaque

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Introduction2

Atherosclerosis With Excessive Neutrophilic Inflammation1

Assessment Of the Timing Of Onset Of Myocardial Injury1

Intravascular Plaque Imaging-vulnerable Atherosclerotic Plaque1

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Cited by 13 publications

(5 citation statements)

References 25 publications

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“…This is an unusual condition in which there is an excessive amount of neutrophils involving an atherosclerotic plaque, often in the setting of plaque disruption and luminal thrombus formation [12]. The primary entity in the differential is suppurative aortitis due to bacterial infection.…”

Section: Atherosclerosis With Excessive Neutrophilic Inflammationmentioning

confidence: 99%

Consensus statement on surgical pathology of the aorta from the Society for Cardiovascular Pathology and the Association for European Cardiovascular Pathology: I. Inflammatory diseases

et al. 2015

Cardiovascular Pathology

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Inflammatory diseases of the aorta include routine atherosclerosis, aortitis, periaortitis, and atherosclerosis with excessive inflammatory responses, such as inflammatory atherosclerotic aneurysms. The nomenclature and histologic features of these disorders are reviewed and discussed. In addition, diagnostic criteria are provided to distinguish between these disorders in surgical pathology specimens. An initial classification scheme is provided for aortitis and periaortitis based on the pattern of the inflammatory infiltrate: granulomatous/giant cell pattern, lymphoplasmacytic pattern, mixed inflammatory pattern, and the suppurative pattern. These inflammatory patterns are discussed in relation to specific systemic diseases including giant cell arteritis, Takayasu arteritis, granulomatosis with polyangiitis (Wegener's), rheumatoid arthritis, sarcoidosis, ankylosing spondylitis, Cogan syndrome, Behçet's disease, relapsing polychondritis, syphilitic aortitis, and bacterial and fungal infections.

“…This is an unusual condition in which there is an excessive amount of neutrophils involving an atherosclerotic plaque, often in the setting of plaque disruption and luminal thrombus formation [12]. The primary entity in the differential is suppurative aortitis due to bacterial infection.…”

Section: Atherosclerosis With Excessive Neutrophilic Inflammationmentioning

confidence: 99%

Consensus statement on surgical pathology of the aorta from the Society for Cardiovascular Pathology and the Association for European Cardiovascular Pathology: I. Inflammatory diseases

et al. 2015

Cardiovascular Pathology

Self Cite

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Inflammatory diseases of the aorta include routine atherosclerosis, aortitis, periaortitis, and atherosclerosis with excessive inflammatory responses, such as inflammatory atherosclerotic aneurysms. The nomenclature and histologic features of these disorders are reviewed and discussed. In addition, diagnostic criteria are provided to distinguish between these disorders in surgical pathology specimens. An initial classification scheme is provided for aortitis and periaortitis based on the pattern of the inflammatory infiltrate: granulomatous/giant cell pattern, lymphoplasmacytic pattern, mixed inflammatory pattern, and the suppurative pattern. These inflammatory patterns are discussed in relation to specific systemic diseases including giant cell arteritis, Takayasu arteritis, granulomatosis with polyangiitis (Wegener's), rheumatoid arthritis, sarcoidosis, ankylosing spondylitis, Cogan syndrome, Behçet's disease, relapsing polychondritis, syphilitic aortitis, and bacterial and fungal infections.

“…The age of healing myocardial injury in the specimens was estimated using standard pathologic features: myocardial necrosis with low amounts of neutrophils (days 1-2), large amounts of neutrophils (days 3-5), macrophage infiltration and myocyte removal (days [4][5][6][7][8][9][10][11][12][13][14], loose granulation tissue (days 14-21), late collagenous granulation tissue (days 21-28), and dense scar formation (more than 28 days) 30,31 .…”

Section: Assessment Of the Timing Of Onset Of Myocardial Injurymentioning

confidence: 99%

Duration of SARS-CoV-2 mRNA vaccine persistence and factors associated with cardiac involvement in recently vaccinated patients

Krauson,

Casimero,

Siddiquee

et al. 2023

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At the start of the COVID-19 pandemic, the BNT162b2 (BioNTech-Pfizer) and mRNA-1273 (Moderna) mRNA vaccines were expediently designed and mass produced. Both vaccines produce the full-length SARS-CoV-2 spike protein for gain of immunity and have greatly reduced mortality and morbidity from SARS-CoV-2 infection. The distribution and duration of SARS-CoV-2 mRNA vaccine persistence in human tissues is unclear. Here, we developed specific RT-qPCR-based assays to detect each mRNA vaccine and screened lymph nodes, liver, spleen, and myocardium from recently vaccinated deceased patients. Vaccine was detected in the axillary lymph nodes in the majority of patients dying within 30 days of vaccination, but not in patients dying more than 30 days from vaccination. Vaccine was not detected in the mediastinal lymph nodes, spleen, or liver. Vaccine was detected in the myocardium in a subset of patients vaccinated within 30 days of death. Cardiac ventricles in which vaccine was detected had healing myocardial injury at the time of vaccination and had more myocardial macrophages than the cardiac ventricles in which vaccine was not detected. These results suggest that SARS-CoV-2 mRNA vaccines routinely persist up to 30 days from vaccination and can be detected in the heart.

“…The question is, how to treat these plaques? This is being addressed in FITTER and YELLOW III trials for PCKS9 inhibitors and local stenting in PREVENT trial [108][109][110]. The answer to treating nonflow-limiting lesions can depend upon the characteristic of the patient.…”

Section: Intravascular Plaque Imaging-vulnerable Atherosclerotic Plaquementioning

confidence: 99%

Intracoronary Imaging-Can It Make Difference in State of the Art PCI?

2022

J Cardiol Cardiovasc Res

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There is an anatomy and there is an anatomy. Angiography is a rough method used for estimating dimensions. By completing the intervention with intracoronary imaging, one can directly characterize lesion composition, elucidate pathophysiology, and luminal size measurement. This review describes patients and lesions where imaging may be most beneficial, along with up-to-date evidence of the impact induced on cardiovascular events by the intracoronary imaging. It summarizes the importance of organizing procedural strategies and the use of various imaging methods such as optical coherence tomography or intravascular ultrasound for percutaneous coronary intervention (PCI) to improve stent optimization. Further, various advantages and disadvantages are associated with the use of imaging methods OCT and IVUS in the management of PCI and the elucidation of the causes of stent failure are discussed. It also explains the use of OCT or IVUS in various severe pathological conditions such as severe kidney disease (CKD), left main disease, bifurcation lesion, acute coronary syndrome (ACS), and patients present with high bleeding risk. It also describes diagnostic imaging of patients with vulnerable plaques. We will also talk about various other advanced imaging methods such as investigational Micro-optical Coherence Tomography and near-infrared spectroscopy (NIRS).

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