ABSTRACT
Abstract Background Determination of predictors that can affect development of atherosclerosis progression in the postoperative period is an urgent problem in vascular surgery. Objectives Integrated assessment of markers of apoptosis and cell proliferation in atherosclerotic lesions and their progression after surgery in patients with peripheral arterial diseases. Methods The investigation included 30 patients with stage IIB-III peripheral arterial disease. All patients have undergone open surgical interventions on the arteries of the aorto-iliac and femoral-popliteal segments. During these interventions, intraoperative specimens were obtained from the vascular wall with atherosclerotic lesions. The following values were evaluated: VEGF А165, PDGF BB, and sFas. Samples of normal vascular wall were obtained from post-mortem donors and used as a control group. Results The levels of Bax and p53 were increased (p<0.001) in samples from arterial wall with atherosclerotic plaque, while sFas values were reduced (p<0.001), compared to their levels in control samples. Values of PDGF BB and VEGF A165 were 1.9 and 1.7 times higher in atherosclerotic lesion samples (p=0.001), in comparison with the control group. The levels of p53 and Bax were increased against a background of reduced sFas levels in samples with progression of atherosclerosis compared to their baseline values in samples with atherosclerotic plaque (p<0.05). Conclusions Initially increased values of the Bax marker against a background of reduced sFas values in vascular wall samples from patients with peripheral arterial disease is associated with risk of atherosclerosis progression in the postoperative period.
Resumo Contexto A determinação de preditores que possam influenciar o desenvolvimento da progressão da aterosclerose no período pós-operatório é um problema urgente em cirurgia vascular. Objetivos Realizar uma avaliação integral de marcadores de apoptose e proliferação celular nas lesões ateroscleróticas e sua progressão após cirurgia em pacientes com doenças arteriais periféricas. Métodos A investigação incluiu 30 pacientes com doenças arteriais periféricas de estágio IIB-III. Todos os pacientes foram submetidos a intervenções operatórias abertas nas artérias dos segmentos aorto-ilíaco e fêmoro-poplíteo. Durante a intervenção, foi obtido material intraoperatório da parede vascular com lesões ateroscleróticas. Foram avaliados os seguintes valores: VEGF A165, PDGF BB e sFas. Como grupo controle, amostras de parede vascular normal foram obtidas de doadores post-mortem. Resultados O nível de Bax e p53 (p < 0,001) em amostras de parede arterial com placa aterosclerótica estava elevado em meio a valores reduzidos de sFas (p < 0,001) em comparação ao grupo controle. Os valores de PDGF BB e VEGF A165 foram 1,9 e 1,7 vezes maiores, respectivamente, nas amostras com lesão aterosclerótica (p = 0,001) do que no grupo controle. O nível de Bax e p53 e Bax estava elevado no contexto de nível reduzido de sFas em amostras com progressão da aterosclerose em comparação com seus valores basais em amostras com placa aterosclerótica (p < 0,05). Conclusões Níveis inicialmente elevados do marcador Bax no contexto de valores reduzidos de sFas na parede vascular em pacientes com doença arterial periférica estão associados a risco de progressão da aterosclerose no período pós-operatório.
ABSTRACT
Objective:To investigate the relationship between wall shear stress (WSS) and the degree of lumen stenosis and plaque characteristics in patients with atherosclerotic stenosis in the middle brain.Methods:Thirty-four patients with moderate to severe unilateral middle cerebral artery stenosis in Nanjing First Hospital from June 2020 to June 2021 were analyzed retrospectively. All patients underwent routine magnetic resonance imaging and vascular wall imaging to obtain plaque parameters such as plaque area, remodeling mode and remodeling index. Based on magnetic resonance angiography, a computational fluid dynamics model was established to simulate the local hemodynamics near the lesion and quantify WSS. The patients were divided into high WSS group and low WSS group according to the median WSS. The differences of clinical baseline data, degree of lumen stenosis and plaque characteristics between the two groups were compared. Pearson correlation analysis was used to calculate the correlation between WSS and lumen stenosis and plaque characteristics.Results:A total of 34 patients were included in this study, 17 in the high WSS group and 17 in the low WSS group. Compared with the low WSS group, the plasma homocysteine level in the high WSS group was lower [(11.10±4.96) μmol/L vs (16.97±6.98) μmol/L, t=-2.83, P=0.010], the degree of stenosis was lower (0.56±0.05 vs 0.66±0.08, t=-4.54, P<0.001), and the proportion of positive lumen remodeling was higher (12/17 vs 4/17, P=0.015). Pearson correlation analysis showed that the degree of lumen stenosis was negatively correlated with WSS ( r=-0.44, P=0.011), and the plaque area was not correlated with WSS. Conclusions:WSS in middle cerebral artery stenosis is related to the degree of lumen stenosis and the mode of vascular remodeling. Higher WSS has poor stability, but lower WSS is more likely to cause lumen stenosis.
ABSTRACT
Objective To establish the theoretical model for morphology of lipid droplets adhering to inner vascular wall, so as to provide the theoretical model for the study and analysis of the overall morphology of lipid droplets on inner vascular wall of patients with fat embolism. MethodsThe model of the droplet with variable radius on inner wall of the cylindrical tube was established to describe morphology of lipid droplets on inner vascular wall, and accuracy of the theoretical model was verified by Surface Evolver (SE) software simulation results. According to the theoretical model, the influencing patterns of lipid droplet volume and contact angle on dimensionless adhesion area Sb0 and blockage ratio κ of lipid droplets in blood vessels were analyzed. Results The theoretical model could predict contour parameters of adhesion morphology for lipid droplets on inner vascular wall, including the height and arc radius of lipid droplet at azimuth angle of 0 and π/2. The relative errors between contour parameters obtained from the theoretical model and corresponding parameters obtained from the SE simulation were smaller than 10%. For lipid droplets with the same dimensionless volume V0, Sb0 of inner vascular wall decreased with contact angle increasing, and blockage ratio κ increased with contact angle increasing. At the same contact angle, the smaller V0 , the smaller Sb0 and κ would be. Conclusions The established theoretical model with variable radius can well describe morphological characteristics of lipid droplets on inner vascular wall. The influening pattern of volume, contact angle and other parameters on height, adhesion area and cross-sectional area of lipid droplets can be accurately and quickly obtained through the theoretical model, indicating that the larger the contact angle of lipid droplets or the smaller the dimensionless volume, the lower the probability of embolism. The research findings provide theoretical support for the analysis on related diseases.
ABSTRACT
Purpose: To measure the wall-to-lumen ratio (WLR) and the vascular wall cross-sectional area (WCSA) of retinal arterioles by an Adaptive Optics (AO) retinal camera using semi-automated software and comparing them between control and hypertensive population. Methods: This was a cross-sectional observational study including a hypertensive group and a control group. Subjects were examined and their medical history recorded. Retinal arteriolar morphometry was assessed by rtx1 AO retinal camera using AOdetect Artery semiautomated software. Main Outcome Measures: WLR and WCSA were measured on the basis of retinal arteriolar wall thickness (W1, W2), lumen diameter (LD) and vessel diameter (VD). Influence of age and arterial hypertension on the WLR and WCSA were examined. Results: A total of 150 human subjects were included out of which 110 were controls and 40 were hypertensives under treatment. There was statistically significant difference in the age, systolic and diastolic blood pressures between the control and hypertensive groups (P < 0.01). We found no significant correlation between age and WLR (R2 = 0.049, P > 0.05) or age and WCSA (R2 = 0.045, P > 0.05). We observed a significant difference in WLR and WCSA measurements between control and hypertensive groups (P < 0.01). On measuring intra-observer variability (IOV) we found excellent consistency. Conclusion: AO retinal imaging allows a direct measurement of the retinal vessel wall and LD with excellent IOV. WLR and WCSA reflect the remodelling process and can be used to further aid the early detection and monitoring of systemic hypertension.
ABSTRACT
Clinical trials and animal experimental studies have demonstrated an association of arterial baroreflex impairment with the prognosis and mortality of cardiovascular diseases and diabetes. As a primary part of the arterial baroreflex arc, the pressure sensitivity of arterial baroreceptors is blunted and involved in arterial baroreflex dysfunction in cardiovascular diseases and diabetes. Changes in the arterial vascular walls, mechanosensitive ion channels, and voltage-gated ion channels contribute to the attenuation of arterial baroreceptor sensitivity. Some endogenous substances (such as angiotensin II and superoxide anion) can modulate these morphological and functional alterations through intracellular signaling pathways in impaired arterial baroreceptors. Arterial baroreceptors can be considered as a potential therapeutic target to improve the prognosis of patients with cardiovascular diseases and diabetes.
Subject(s)
Animals , Humans , Baroreflex , Physiology , Blood Pressure , Physiology , Cardiovascular Diseases , Metabolism , Diabetes Mellitus , Metabolism , Ion Channels , Metabolism , Pressoreceptors , MetabolismABSTRACT
Objective To investigate the influencing factor of the morphology of unruptured intracranial aneurysms for aneurysm wall enhancement under the high-resolution magnetic resonance imaging. Methods From January 2015 to December 2016,the clinical and imaging data of 68 consecutive patients with unruptured intracranial aneurysm (86 aneurysms) in Changhai Hospital,the Second Military Medical University were enrolled retrospectively. Vascular wall imaging technology was used to conduct aneurysm scan,and the aneurysm wall enhancement was identified by the imaging features before and after contrast enhancement. They were divided into either an enhancement group ( n=32,34 aneurysms) or a non-enhancement group (n=45,52 aneurysms) according to whether having the abnormal enhancement of aneurysm wall or not ( because some patients also have enhanced aneurysms and non-enhanced aneurysms, the number of cases of the enhanced or not was calculated seperately in both groups ) . Morphological parameters were calculated by 3D image data,including aneurysm size,ratio of height to width,volume ratio, dome-to-neck ratio, transverse length ratio, bottleneck factor, and inflow angle. Univariate and multivariate logistic analyses were used to determine the morphological influence factors of aneurysm wall enhancement. Results (1) A total of 34 (39. 5%) aneurysms had aneurysm wall enhancement and 52 (60. 5％) aneurysms did not have aneurysm wall enhancement. There were no significant differences in sex, age, hypertension,diabetes, smoking, family history of subarachnoid hemorrhage, and aneurysm site in both groups (all P>0. 05). (2) The aneurysm size,ratio of height to width,volume ratio,dome-to-neck ratio, and bottleneck factor in the enhancement group were larger than those of the non-enhancement group. There were significant differences between the 2 groups (9. 19 [6. 54,11. 04] mm vs. 5. 31 [4. 17,7. 37] mm, (1. 18 [1. 01,1. 69] vs. 0. 91 [0. 72,1. 25],(3. 62 [2. 30,4. 63] vs. 2. 18 [1. 37,2. 76],1. 52 [1. 25, 1. 99] vs. 1. 19 [1. 03,1. 51],and 1. 21 [1. 11,1. 69] vs. 1. 05 [0. 94,1. 31],all P<0. 01). The proportion of irregular morphologic aneurysms in the enhancement group was higher than that in the non-enhancement group. There was significant difference between the 2 groups (55. 9％ [19/34] vs. 17. 3％ [9/52],P<0. 01 ) . There were no significant differences in transverse length ratio and inflow angle between the 2 groups (all P>0. 05). (3) Because the ratio of height to width,volume ratio,dome-to-neck ratio,and bottleneck factor were related to the aneurysm size,the aneurysm size,inflow angle,and irregular shape were included in the multivariate logistic regression analysis. The results showed that aneurysm size ( OR,3. 727,95％CI 1. 933-6. 971,P<0. 01) and irregular shape (OR,3. 990,95％CI 1. 219-13. 065,P=0. 022) were the independent risk factors for aneurysm wall enhancement. Conclusions The size and irregular shape of unruptured intracranial aneurysms are the independent risk factors for aneurysm wall enhancement. High-resolution magnetic resonance wall imaging may become an effective and noninvasive imaging method for evaluating the ruptured risk of intracranial aneurysms.
ABSTRACT
4D Flow MRI is a new phase contrast MR technique,which can spatially encode velocity in three-direction,collect multi-directional blood flow data,and result in complex three-dimensional dynamic parameters.4D Flow MRI is more accurate and comprehensive than 2D phase contrast MRI and Doppler echocardiography.However,4D Flow MRI have some disadvantages,such as long scanning time,noise,etc.,which are the future key technical issues to be addressed.4D Flow MRI technology has a great potential in clinical applications,such as intracranial vascular diseases,cardiac magnetic resonance imaging,and other aspects of aortic diseases.Research advances in clinical application of 4D Flow MRI were reviewed in this paper.
ABSTRACT
Objective To investigate the clinical values of quantitative ultrasound elastography technique in detecting internal carotid artery thickness .Methods One hundred and forty healthy objects who have conducted physical examination in our hospital from February 2012 to August 2015 were selected ,and divided in to three groups:the healthy control group (n=40;IMT<0 .9 mm) ,the IMT thickening group (n=60;0 .9 mm≤ IMT < 1 .3 mm) and plaque group(n= 40 ;IMT ≥1 .3 mm) .All the three groups conducted routine ultrasound and quantitative ultrasound elastography ,and the clinical data investigation and laboratory ex‐amination were carried out at the same time .Results The TC ,LDL‐C values in the plaque group and intimal thickening group were significantly higher than the control group (P<0 .05) .The AC values in the plaque group and intimal thickening group were signif‐icantly higher than the control group (P<0 .05) ,while the AI and PWVβvalues were significantly lower(P<0 .05) .Linear corre‐lation analysis showed that IMT were positively correlated to the AI ,PWVβ (r=0 .512 ,P <0 .05 ;r= 0 .483 ,P<0 .05) ,and the AC were negatively correlated (r= -0 .713 ,P<0 .05);Logistic analysis showed that LDL‐C ,AC ,PWVβwere the major independ‐ent risk factors for IM T (P<0 .05) .Conclusion Ultrasound elasticity quantitative detection of neck vessels is safe and can non‐in‐vasive dynamically observe blood vessel wall changes during the progression of atherosclerosis ,thus it's helpful in the judge and i‐dentification of internal carotid artery thickness .
ABSTRACT
The effect of Kampo therapy (Japanese traditional herbal medicine) on the second derivative of the photoplethysmogram (SDPTG) was investigated. The SDPTG is the second derivative of the fingertip photoplethysmogram (PTG), which expresses the characteristics of the vascular system, the properties of peripheral vessels, and the state of blood flow. The subjects comprised 13 normal volunteers, 101 patients (21 males and 80 females; mean age 53±11 years) with 1 month of Kampo therapy, and 19 patients (4 males and 15 females; mean age 60±9 years) with 3 months of medication. Control subjects showed no significant changes in their vascular age after 1 month. Patients with a higher vascular age than expected before therapy showed improvement of their vascular age, after treatment for 1 month and 3 months. The difference between the vascular age and calendar age decreased from about 10 to 7 years after 1 month of therapy (n=65. p<0.001), and from about 9 to 4 years, after 3 months (n=11, p<0.01). Vascular age not only reflects organic vessel wall sclerosis due to arteriosclerosis, but also a vascular wall tone that is closely related to the autonomic nervous system. The change of vascular age within a relatively short period suggested a functional change rather than an organic change of the vessels.
ABSTRACT
Objective: To assess the reproducibility of high resolution MR imaging(MRI) in measuring the vascular wall area in atherosclerotic carotid artery. Methods: Twenty four subjects (male 18, female 6, aged 60 78 years) with 50% 79% stenosis (confirmed by Doppler ultrasound) were recruited for the study. Two independent MRI examination were conducted within 2 weeks using high resolution imaging on a 1.5 T scanner (Signa, GE Medical Systems). Three slices were selected (4 mm distal to the bifurcation, just under the bifurcation and 4 mm proximal to the bifurcation) from the bilateral carotid artery to measure the luminal, outer wall boundary and wall area. The above process was done by 2 observers blinded to each other's results. The Interscan and Interobserver variations were assessed by paired Student's t test. Results: There was no significant difference in lumen, outer wall boundary and wall area measurement for both Interscan and Interobserver comparison. Conclusion: High resolution MRI of the human carotid artery in measuring the vessel lumen and wall areas has high reproducibility. MRI can also be used to monitor the progression of atherosclerotic plaque of carotid artery.
ABSTRACT
To study the biology of the endothelium and the media of the vascular wall, full layer vascular wall model was constructed in vitro. In the experimental vascular wall model, endothelial cell (EC)s were grown on a collagen lattice containing multilayers of smooth muscle cell (SMC)s and a EC-free portion was made by a cloning ring on the culture disc. As conditioned culture media of ECs-SMCs contain biologic mediators that may promote the growth of SMCs, the availability of this vascular wall model promptly us to examine the extent to which ECs regulate the migration and proliferation of SMCs when these cells are maintained with or without covering EC lining in coculture. Morphologic characteristics of full layer vascular wall model was a whitish, non-transparent membrane. Outer boundaries and the zone of no EC were thicker than that of central portion. By light microscope imaging, luminal surface was composed of EC monolayer, and SMCs and collagen fibers were distributed between the polyethylene terephtalate (PET) membrane and EC monolayer. SMCs and collagen fibers were mainly located near the PET membrane. Venous SMCs were densely infiltrated as compared to arterial SMCs. By scanning electron microscopy, EC monolayer and dense collagen fibers in the zone of no EC were clearly shown. On the effects of platelet derived growth factor (PDGF) in the proliferation of SMCs and modeling of full layer vascular wall model, no effect on SMC in the zone of EC covering was seen however, active migration and proliferation of SMCs were noted in the zone of no EC. Wall thickness was two times greater than that of control. On the effects of EGF, it was observed that EGF markedly stimulated migration of SMCs with or without EC coverings in contrast to the control group. On the effects of FGF, results were similar to the PDGF group. Results on the effect of IGF-1 were similar to the PDGF group. As conclusions, full layer vascular wall model in this study was proved to be a good laboratory model for basic vascular research. And SMCs migration and proliferation were more active in venous SMCs compared to arterial SMCs. The collagen fibers were also richer and the wall was more thickened. EGF was most the potent SMC stimulator. PDGF, FGF, and IGF-1 were moderate SMC stimulator in the zone of no EC covering. These results strongly support why intimal hyperplasia eventually occured in autogenous venous bypass graft.
Subject(s)
Biology , Clone Cells , Cloning, Organism , Coculture Techniques , Collagen , Culture Media, Conditioned , Endothelial Cells , Endothelium , Epidermal Growth Factor , Hyperplasia , Insulin-Like Growth Factor I , Membranes , Microscopy, Electron, Scanning , Muscle, Smooth , Myocytes, Smooth Muscle , Phenobarbital , Platelet-Derived Growth Factor , Polyethylene , TransplantsABSTRACT
Objective To determine the serum level of advanced glycosylation end products (AGEs) of uremia and its expression in the vascular wall and peritoneum of dialysis patient, meanwhile to explore its possible significance. Methods Using the ELISA method to determine the serum level of AGEs of uremia; using immunohistochemical method to examine the expression of AGEs in the vascular wall of uremia patients undergoing hemodialysis and the expression of AGEs and laminin in the peritoneum of uremic patients undergoing peritoneal dialysis. Results The AGEs level of uremic patients was obviously higher than that in the normal. No kind of dialysis could clear it well. AGEs accumulated obviously in the vassular wall of hemodialysis patients. After CAPD the expression of AGEs and laminin in the peritoneum was significantly strong. There was an obviously positive correlation between AGEs and laminin, so between these two and the time of peritoneal dialysis. Conclusions The high serum level of AGEs and its accumulation in the vascular wall may relate with the high incidence of cardic diseases of the uremia. Accumulation of AGEs and laminin in the peritoneum of patients undergoing peritoneal dialysis may be one of the reasons causing peritoneum sclerosis and dysultrafiltration
ABSTRACT
To study the biology of the endothelium and media under conditions that mimic the architecture of the vascular wall and the effects of low density lipoprotein(LDL) and oxidized lipoprotein(ox-LDL), three dimensional vascular wall model was constructed in vitro. In the vascular wall model, endothelial cells(EC) were grown on a collagen lattice containing multilayer of smooth muscle cells(SMC) and endothelial cell-free portion was made by a cloning ring on the culture disc. The availability of this vascular wall model promptly us to examine the extent LDL and ox-LDL affect ECs and SMCs when these cells were maintained with or without each other in coculture. The results were as follows; 1) Morphologic characteristics of three dimensional vascular wall model Artificial vascular wall was a whitish, non-transparent membrane. Outer boundaries and the zone of no ECs were thicker than that of central portion. By light microscope imaging, luminal surface was EC monolayer, and SMCs and collagen fibers were distributed between the PET membrane and EC monolayer. SMCs and collagen fibers were mainly located near the PET membrane. Venous SMCs were densely infiltrated as compared to arterial SMCs. By scanning electron microscopy, EC monolayer was clearly shown. 2) The effects of LDL and oxidized LDL on ECs and SMCs in artificial vascular wall (1) The effects of LDL Collagen fibers are infiltrated just beneath EC monolayer in venous SMCs-EC coculture model. In the zone of no EC, marked proliferation and synthesis of collagen fibers were noted. (2) The effects of ox-LDL Injured EC monolayer were clearly shown in both venous and arterial SMCs-EC coculture model. On high power field light microscopic examination, collagen fibers were exposed outside to the luminal surface and were pendendicularly arranged, and looked like as ciliary projection. Artificial wall of these experimental model were thicker than that of control, and proliferation of SMCs and collagen synthesis were increased than those of control and LDL experiment groups. On scanning electromicroscopic examination, ECs were more slender and cell-to-cell contact was loosened. As a conclusion, this vascular wall model is to be good experimental model for vascular research. And LDL and ox-LDL have toxic effects on vascular EC layer and stimulate proliferation of SMCs and collagen synthesis in vitro three dimensionally constructed vascular wall model.