Plasma RANTES level is correlated with cardio-cerebral atherosclerosis burden in patients with ischemic cerebrovascular disease.

BACKGROUND: Regulated upon activation, normal T-cell expressed, and secreted (RANTES) is a chemokine actively involved in the initiation and progression of atherosclerosis (AS), which is the major cause of ischemic cerebrovascular disease (ICVD). This study aimed to determine the associations between circulating RANTES level and overall AS conditions of cardiac and cerebral vessel beds in patients with ICVD. METHODS: Patients with ICVD admitted to the department of neurology of Xuanwu Hospital from April 1, 2019 to June 30, 2019 were prospectively enrolled in the study. Plasma RANTES level was measured by enzyme-linked immunosorbent assay to represent the circulating RANTES level. The integrated AS burden of the cervicocephalic and coronary arteries was examined using computed tomography angiography and reflected by "cardio-cerebral AS burden (CCAB)" as a continuous variable. Then, the relationship of plasma RANTES level and CCAB in patients with ICVD was analyzed by correlation analyses and general linear models. RESULTS: A total of 40 patients with ICVD were included in the study. There was a significant positive correlation between CCAB and plasma RANTES level in ICVD (r = 0.786, P < 0.001), independent of age, sex, acute or chronic phase of ICVD, and mono or dual antiplatelet therapy (adjusted B for ln RANTES, 12.063; 95% confidence interval, 7.572-16.533). The association of plasma RANTES level with AS conditions (burden, severity, and extent) in single cardiac or cerebral vessel bed was similar to that with CCAB, but the correlation coefficient for CCAB was higher (increment ranged from 0.126 to 0.397). CONCLUSIONS: Plasma RANTES level was an independent indicator for the integrated AS burden of the cervicocephalic and coronary arteries in ICVD. Comprehensive evaluation of AS conditions using the novel continuous index CCAB might be important in revealing the systematic relationship between circulating RANTES and AS in patients with ICVD.

Predicting asymptomatic coronary artery stenosis by aortic arch plaque in acute ischemic cerebrovascular disease: beyond the cervicocephalic atherosclerosis?

BACKGROUND: Asymptomatic coronary artery stenosis (ACAS) ≥50% is common in patients with acute ischemic cerebrovascular disease (AICVD), which portends a poor cardiovascular and cerebrovascular prognosis. Identifying ACAS ≥50% early may optimize the clinical management and improve the outcomes of these high-risk AICVD patients. This study aimed to investigate whether aortic arch plaque (AAP), an early atherosclerotic manifestation of brain blood-supplying arteries, could be a predictor for ACAS ≥50% in AICVD. METHODS: In this cross-sectional study, atherosclerosis of the coronary and brain blood-supplying arteries was simultaneously evaluated using one-step computed tomography angiography (CTA) in AICVD patients without coronary artery disease history. The patients were divided into ACAS ≥50% and non-ACAS ≥50% groups according to whether CTA showed stenosis ≥50% in at least one coronary arterial segment. The AAP characteristics of CTA were depicted from aspects of thickness, extent, and complexity. RESULTS: Among 118 analyzed patients with AICVD, 29/118 (24.6%) patients had ACAS ≥50%, while AAPs were observed in 86/118 (72.9%) patients. Increased AAP thickness per millimeter (adjusted odds ratio [OR]: 1.56, 95% confidence interval [CI]: 1.18-2.05), severe-extent AAP (adjusted OR: 13.66, 95% CI: 2.33-80.15), and presence of complex AAP (adjusted OR: 7.27, 95% CI: 2.30-23.03) were associated with ACAS ≥50% among patients with AICVD, independently of clinical demographics and cervicocephalic atherosclerotic stenosis. The combination of AAP thickness, extent, and complexity predicted ACAS ≥50% with an area under the receiver-operating characteristic curve of 0.78 (95% CI: 0.70-0.85, P < 0.001). All three AAP characteristics provided additional predictive power beyond cervical and intracranial atherosclerotic stenosis for ACAS ≥50% in AICVD (all P < 0.05). CONCLUSIONS: Thicker, severe-extent, and complex AAP were significant markers of the concomitant ACAS ≥50% in AICVD, possibly superior to the indicative value of cervical and intracranial atherosclerotic stenosis. As an integral part of atherosclerosis of brain blood-supplying arteries, AAP should not be overlooked in predicting ACAS ≥50% for patients with AICVD.

Assessment of the right and left ventricular function in patients with cor pulmonale using high-definition CT.

BACKGROUND: Cor pulmonale is often associated with changes of structure and function of the right ventricle (RV) and thus further affects functional changes of the left heart. Our study aimed to assess the left ventricular (LV) and RV function in patients with cor pulmonale using high-definition CT (HDCT). METHODS: We prospectively studied 18 cor pulmonale patients determined by the pulmonary function test, clinical examination, chest radiograph, electrocardiogram, and echocardiogram. The subject group was compared to a control group consisting of 18 subjects. The RV and LV functions and RV myocardial mass (MM) were obtained by HDCT in the two groups. The results were compared between the two groups using the independent sample t test. Echocardiographic examination for cardiac function analysis was performed on the same day. RESULTS: The RV end-diastolic volume (EDV), RV end-systolic volume (ESV) and RV myocardial mass were significantly larger in the 18 cor pulmonale patients than in the control group (P < 0.05). The right ventricular ejection fraction (RVEF) was significantly lower in the 18 cor pulmonale patients than in controls (P < 0.01). The left ventricular EDV (LVEDV) and LVEF were significantly lower in cor pulmonale patients than in controls (P < 0.01). There were strong correlations between MDCT and echocardiography, rRVEF = 0.839 and rLVEF = 0.916, respectively. CONCLUSIONS: HDCT can accurately quantify RV and LV function. The right ventricular function is impaired in patients with cor pulmonale, while at the same time the left ventricular function is also impaired.

[Assessment of right ventricular cardiac function using 64-detector CT: comparison with MRI].

OBJECTIVE: To investigate the value of 64-detector spiral computed tomography versus MRI in the assessment of right ventricular function. METHODS: Thirty healthy volunteers (15 males, 15 females, 48 +/- 24 years) underwent 64-detector spiral computed tomography CT and breath-hold MRI. With semiautomatic contour detection software, the parameters of end-diastolic volume, end-systolic volume, stroke volume and ejection fraction were determined from short-axis CT reformations (MPR) created at every 5% of RR-interval. The results from CT were compared with those from MRI using Pearson correlation test and Bland-Altman plot. RESULTS: The CT values of mean end-diastolic volume (146 +/- 27) ml, end-systolic volume (70 +/- 20) ml, stroke volume (75 +/- 12) ml and ejection fraction (52% +/- 5%) correlated well with those by MRI [146 +/- 25 ml (r = 0.959), 66 +/- 17 ml (r = 0.914), 80 +/- 15 ml (r = 0.706), 55% +/- 7% (r = 0.612)]. A strong correlation between MSCT and MRI was also found in the Bland-Altman plot. CONCLUSION: 64-detector spiral CT can accurately assess the right ventricular function. It is a valuable method for evaluating cardiac function.

Effects of echo time on diffusion quantification of brain white matter at 1.5 T and 3.0 T.

The aim was to investigate the effects of echo time (TE) on diffusion quantification of brain white matter. Seven rhesus monkeys (all males; age, 4-6 years; weight, 5-7 kg) underwent diffusion tensor imaging (DTI) with a series of TEs in 1.5 T and 3.0 T MR scanners. The mean diffusivity (MD), fractional anisotropy (FA), primary (lambda(1)), and transverse eigenvalues (lambda(23)) were measured in a region of interest at the bilateral internal capsule. Pearson correlation showed that the FA and lambda(1) increased and lambda(23) decreased with TE both at 1.5 T and 3.0 T except for the MD. Repeated measurement analysis of variance (ANOVA) also showed significantly higher FA and lower MD and lambda(23) at 3.0 T than those at 1.5 T (P<0.01), but no statistical differences were found in lambda(1) between these two field strengths (P=0.709). These findings implied that TE and field strength might influence diffusion quantification in brain white matter.