Influence of Plaque Geometry on Peak Cap Stresses

2011 ◽  
Author(s):  
A. C. Akyildiz ◽  
L. Speelman ◽  
H. Nieuwstadt ◽  
J. Wentzel ◽  
A. van der Steen ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Coronary Artery ◽  
Vulnerable Plaque ◽  
Necrotic Core ◽  
Myocardial Infarctions ◽  
Vulnerable Plaques

Atherosclerosis is an important cardiovascular disease in which plaque build up occurs in vessels. Plaques with thin cap and thick necrotic core are defined as vulnerable plaques. Rupture of the cap of a vulnerable plaque in a coronary artery is the underlying cause of the majority of acute myocardial infarctions and sudden coronary deaths [1].

scholarly journals Morphological Features and Plaque Composition in Culprit Atheromatous Plaques of Patients with Acute Coronary Syndromes

2018 ◽  
Vol 4 (2) ◽  
pp. 84-94 ◽  
Author(s):  
Tiberiu Nyulas ◽  
Emese Marton ◽  
Victoria Ancuta Rus ◽  
Nora Rat ◽  
Mihaela Ratiu ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Right Coronary Artery ◽  
Vulnerable Plaque ◽  
Left Coronary Artery ◽  
Necrotic Core ◽  
Plaque Burden ◽  
Fatty Tissue ◽  
Plaque Vulnerability ◽  
Atheromatous Plaques ◽  
The Right

Abstract Background: The independent role of each plaque feature in relation to plaque vulnerability is still the subject of ongoing research. This study aimed to compare the morphologic characteristics of vulnerable atheromatous coronary plaques with the ones of stable, non-vulnerable plaques, and in plaques with different locations in the coronary tree, in order to identify the most relevant imaging-based biomarkers associated with coronary plaque vulnerability. Material and methods: This was a prospective observational, non-randomized study that included 50 patients with unstable angina who underwent computed tomography angiography for assessment of the entire coronary artery tree followed by complex morphologic analysis of all lesions, divided into two groups: group 1 – 25 patients with vulnerable plaque (VP) and group 2 – 25 age- and gender-matched patients with non-vulnerable plaque (NVP). Results: Lesions with a stenosis degree >70% were significantly longer than those with a stenosis degree <70% (8.27 ± 2.74 mm vs. 5.56 ± 4.11 mm, p = 0.04). VP presented significantly higher values of plaque thickness (p = 0.0005), plaque burden (p = 0.0004), and higher total plaque volume (p = 0.0005) than NVP. The remodeling index was not significantly different between the groups (p = 0.6), but the eccentricity index was (0.24 ± 0.14 compared to 0.14 ± 0.17, p = 0.023). Linear regression analysis revealed a significant correlation between plaque burden and plaque components in VP (r = 0.76, p <0.0001 for necrotic core; r = 0.62, p = 0.0008 for fibro-fatty tissue; and r = 0.5, p = 0.01 for fibrotic tissue volume). Culprit plaques located in the right coronary artery presented significantly larger plaque burden volumes (91.17 ± 4.88 mm3 vs. 83.35 ± 8.47 mm3, p = 0.04), larger volumes of necrotic core (82.03 ± 47.85 mm3 vs. 45.84 ± 43.72 mm3, p = 0.02) and fibrofatty tissue (53.23 ± 31.92 mm3 vs. 23.76 ± 20.90 mm3, p = 0.02) than the ones situated in the left coronary artery. Conclusions: VPs from the culprit lesions exhibit a different phenotype than non-vulnerable ones, and vulnerability features are present in a significantly larger extent in VPs from the right coronary artery as compared to those from the left coronary artery.

scholarly journals Vulnerable atherosclerotic plaques of coronary arteries in patients with stable coronary artery disease: 12-months follow-up

Kardiologiia ◽  
2020 ◽  
Vol 60 (2) ◽  
pp. 69-74
Author(s):  
N. A. Kochergin ◽  
A. M. Kochergina ◽  
A. A. Khorlampenko ◽  
V. I. Ganyukov ◽  
A. A. Shilov ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Coronary Arteries ◽  
Vulnerable Plaque ◽  
Atherosclerotic Plaques ◽  
Virtual Histology ◽  
Vulnerable Plaques ◽  
Artery Disease ◽  
Stable Cad ◽  
Over Time

Relevance. A key objective of modern cardiology is the assessment of acute coronary syndrome (ACS) risk in patients with coronary artery disease (CAD) to develop preventive measures and choose optimal treatment strategies.Objective. Detect vulnerable plaques of non-target coronary arteries in patients with stable CAD during routine percutaneous coronary intervention using virtual-histology intravascular ultrasound (VH-IVUS) and view their morphology over time.Materials and Methods. The prospective observational cohort study included 58 patients with stable CAD. After stenting of a target vessel, VH-IVUS was carried out in proximal and middle segments (6–8 cm) of a non-target coronary artery with no significant stenosis according to coronary angiography. Twelve months later, all patients underwent coronary angiography with re-IVUS of previously detected lesions. Death, myocardial infarction, rehospitalization, and unplanned myocardial revascularization due to vulnerable plaques were the endpoints of the study.Results. IVUS with virtual histology revealed 58 lesions of non-target coronary arteries in 56 (96.5 %) patients. Two patients had no lesions in non-target coronary arteries. A large necrotic core with thin cap (thin-cap fibroatheroma) was detected in 12 (20.7 %) plaques, six of which had additional ACS risk criteria (stenosis area >70 % and / or lumen area <4 mm2). Within the 12‑month follow-up period, three patients (one with a vulnerable plaque in IVUS) were hospitalized with a clinical picture of ACS. One cardiac death was registered in a patient with the IVUS vulnerable plaque. 7 of 12 vulnerable plaques stabilized in 12 months.Conclusion. 1) The data presented indicate a high rate (20.7 %) of vulnerable plaques of non-target coronary arteries in patients with stable CAD who underwent stenting; 2) Two (16.6 %) patients with vulnerable plaques reached endpoints (death and rehospitalization) within the 12‑month follow-up period; 3) An analysis of atherosclerotic plaques in non-target coronary arteries over time showed that vulnerable plaques stabilized and did not cause ACS in more than half of cases (7 of 12); 4) Plaques that were not vulnerable according to IVUS were not likely to destabilize within the 12‑month follow-up period.

Biomechanical Determinants of Plaque Rupture

2010 ◽  
Author(s):  
Ali Cagdas Akyildiz ◽  
Lambert Speelman ◽  
Jolanda Wentzel ◽  
Anton van der Steen ◽  
Frank Gijsen
Keyword(s):  
Cardiovascular Disease ◽  
Coronary Artery ◽  
Plaque Rupture ◽  
Myocardial Infarctions

Atherosclerosis is an important cardiovascular disease in which plaque build up occurs in a vessel. The rupture of the cap that covers the plaque of a coronary artery is the underlying cause of the majority of fatal acute myocardial infarctions and sudden coronary deaths [1].

scholarly journals Correlation between monocyte chemoattractant protein-1/chemokine (C-C motif) ligand 2 and coronary plaque characteristics

2020 ◽  
Vol 245 (15) ◽  
pp. 1335-1343
Author(s):  
Meng Li ◽  
Yan Chen ◽  
Yan Zhang ◽  
Danna Li ◽  
Jun Liu
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Signaling Pathway ◽  
Fibrous Tissue ◽  
Coronary Plaque ◽  
Necrotic Core ◽  
High Expression ◽  
Vulnerable Plaques ◽  
Receptor Signaling Pathway ◽  
Artery Disease

In this work, our primary objective was to examine the interrelationship among the serum level of chemokine (C-C motif) ligand 2 (CCL2) and plaque characteristics in coronary culprit lesions. The clinical data of 116 coronary heart disease patients who were hospitalized in the Department of Cardiology of Henan Province People's Hospital from February 2015 to June 2017 were retrospectively analyzed. The study population was subdivided according to the concentration of CCL2 into low CCL2 group and high CCL2 group. The levels of blood lipid, creatinine, and uric acid were measured, and patients underwent coronary angiography. The characteristics of the culprit lesions were detected by intravascular ultrasound, and the correlation between the serum markers and the characteristics of coronary artery plaque was analyzed. Moreover, the coronary artery disease dataset from the Gene Expression Omnibus database was downloaded and the genes regulated were analyzed by CCL2 using gene set enrichment analysis (GSEA). Patients with high CCL2 group had higher LDL-C level and L/H ratio, and lower HDL-C level than the low CCL2 group. Compared with low-level CCL2 group, coronary plaque in the high CCL2 group had higher eccentric plaque and plaque rupture, and thin cap fibroatheromas, fibrofatty and necrotic core and lower fibrous tissue. CCL2 was positively correlated with the percentage of fibrofatty and necrotic core, and negatively correlated with the percentage of fibrous tissue. Furthermore, GSEA analysis showed that samples with high CCL2 expression were enriched for genes involved in different pathways, such as cell adhesion molecules and Nod-like receptor signaling pathway. The CCL2 level was correlated with vulnerable plaques of coronary artery and had certain value in detecting vulnerable plaques. These results indicated that CCL2 could be regarded as a clinical prognostic biomarker for coronary artery disease. Impact statement Vulnerable plaques are plaques which are susceptible to rupture or thrombosis and trigger a series of adverse events such as coronary disorders. CCL2 is a soluble basic protein belonging to the CC subfamily. Previous studies have been investigated on the correlation between inflammatory factors and clinical events, but there are few studies on the correlation between CCL2 and plaque characteristics. Our study found that the high expression of CCL2 is involved in multiple processes in the genesis and progression of coronary artery disease, and would be a potential clinical prognostic indicator. In addition, high expression of CCL2 may be related to gene pathways such as Nod-like receptor signaling pathway, suggesting that CCL2 is involved in the inflammatory response and immune process of coronary artery disease.

scholarly journals Intravascular Ultrasound Studies and the Vulnerable Atherosclerotic Plaque (Literature Review)

2017 ◽  
pp. 82-87 ◽  
Author(s):  
N. A. Kochergin ◽  
A. M. Kochergina
Keyword(s):  
Atherosclerotic Plaque ◽  
Vulnerable Plaque ◽  
Preventive Treatment ◽  
Myocardial Infarctions ◽  
Main Question ◽  
Vulnerable Atherosclerotic Plaque ◽  
Coronary Syndrome ◽  
Vulnerable Plaques ◽  
Current Guidelines ◽  
Acute Event

The vulnerable plaque is an atherosclerotic plaque which can lead to  thrombosis of a coronary artery with development of an acute coronary  syndrome. Most myocardial infarctions occur in people with average  levels of risk factors and thrombosis mostly originate from lesions that  are less severely narrowed. Thus, in most cases, these plaques are clinically silent before the “unheralded” acute event and would not  be considered eligible for preventive treatment based on current  guidelines. The main question is to identify thrombosis-prone  “vulnerable” plaques before they rupture or become destabilized. IVUS  is a useful tool in identifying high risk plaque features and vulnerable lesions in patients.

Scintigraphic Detection of Experimental Myocardial Infarction with 99mTc-2,3-Dimercaptosuccinic Acid

1984 ◽  
Vol 23 (06) ◽  
pp. 317-319
Author(s):  
J. Novák ◽  
Y. Mazurová ◽  
J. Kubíček ◽  
J. Yižd’a ◽  
P. Kafka ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Coronary Artery ◽  
Intravenous Administration ◽  
Experimental Myocardial Infarction ◽  
Myocardial Infarctions ◽  
Clinical Use ◽  
Scintigraphic Imaging ◽  
Tissue Samples ◽  
Scintigraphic Finding

SummaryAcute myocardial infarctions were produced by ligature of the left frontal descending coronary artery in 9 dogs. The possibility of scintigraphic imaging with 99mTc-DMSA 4 hrs after intravenous administration was studied. The infarctions were 4, 24 and 48 hrs old. The in vivo scan was positive in only one dog with a 4-hr old infarction. The in vivo scans were confirmed by the analysis of the radioactivity in tissue samples. The accumulation of the radiopharmaceutical increased slightly in 48-hr old lesions; however, this increase was not sufficient for a positive scintigraphic finding. Thus, we do not recommend 99mTc-DMSA for clinical use in acute lesions.

scholarly journals Deep convolutional neural networks for cardiovascular vulnerable plaque detection

2019 ◽  
Vol 277 ◽  
pp. 02024 ◽  
Author(s):  
Lincan Li ◽  
Tong Jia ◽  
Tianqi Meng ◽  
Yizhe Liu
Keyword(s):  
Neural Networks ◽  
Deep Learning ◽  
Convolutional Neural Networks ◽  
Vulnerable Plaque ◽  
Recall Rate ◽  
Superior Performance ◽  
Learning Approaches ◽  
Deep Convolutional Neural Networks ◽  
Vulnerable Plaques ◽  
Plaque Detection

In this paper, an accurate two-stage deep learning method is proposed to detect vulnerable plaques in ultrasonic images of cardiovascular. Firstly, a Fully Convonutional Neural Network (FCN) named U-Net is used to segment the original Intravascular Optical Coherence Tomography (IVOCT) cardiovascular images. We experiment on different threshold values to find the best threshold for removing noise and background in the original images. Secondly, a modified Faster RCNN is adopted to do precise detection. The modified Faster R-CNN utilize six-scale anchors (122,162,322,642,1282,2562) instead of the conventional one scale or three scale approaches. First, we present three problems in cardiovascular vulnerable plaque diagnosis, then we demonstrate how our method solve these problems. The proposed method in this paper apply deep convolutional neural networks to the whole diagnostic procedure. Test results show the Recall rate, Precision rate, IoU (Intersection-over-Union) rate and Total score are 0.94, 0.885, 0.913 and 0.913 respectively, higher than the 1st team of CCCV2017 Cardiovascular OCT Vulnerable Plaque Detection Challenge. AP of the designed Faster RCNN is 83.4%, higher than conventional approaches which use one-scale or three-scale anchors. These results demonstrate the superior performance of our proposed method and the power of deep learning approaches in diagnose cardiovascular vulnerable plaques.

Psychological status of patients after coronary artery bypass grafting: Data from a 5-year-follow-up study

2021 ◽  
Vol 28 (Supplement_1) ◽  
Author(s):  
O Raykh ◽  
A Sumin ◽  
E Korok
Keyword(s):  
Coronary Artery ◽  
Coronary Artery Bypass Grafting ◽  
Artery Bypass ◽  
Type D Personality ◽  
Psychological Status ◽  
Myocardial Infarctions ◽  
Bypass Grafting ◽  
Type D ◽  
Repeat Procedures

Abstract Funding Acknowledgements Type of funding sources: Public Institution(s). Main funding source(s): Federal State Budgetary Scientific Institution “Research Institute for Complex Issues of Cardiovascular Diseases” Negative psychological status is acknowledged as one of risk of development of cardiovascular pathology.  However, predictive value of type D personality (psychosocial distress) in different cultures and the countries are not fully understood. Purpose: Study aim was to investigate the association of type D personality and quality of life (QoL) with the development of cardiovascular complication in patients in five years after coronary artery bypass grafting (CABG). Materials and Methods: Evaluation of psychological status and combined risk of nonfatal (strokes, nonfatal myocardial infarctions, repeat procedures of revascularization and hospitalization due to relapse or progression of angina pectoris) and fatal (general and cardiovascular mortality) cases before and in five years after CABG. Patients with chronic ischemic heart disease (n = 602, 112 (18.5%) females and 490 (81.5%) males, mean age = 57.7 ± 7.3 years.) who had had CABG were included in the study. Who were formed in two groups: patients with the presence of type D (n= 134) and patients without type D (n = 468). The study of the psychological status was carried out using questionnaire DS-14.  Analysis of long-term results were assessed using the Kaplan–Meier method. Data was collected by a SF-36 questionnaire, comprising of 36 questions divided in 8 domains. The score was designated as 0 to 100; with the higher score being indicative of a better QoL.  Results: Frequency of fatal cases in both groups amounted 8.3% and 8.1% (p = 0.145), in turn nonfatal end-points in group with type D amounted 31.8%, and 15.9% in group without type D (p = 0.044) in during the 5 years. Presence of type D personality at initial examination increased 3.21 times combined risk of nonfatal and fatal cases (OR 3.21, 95%  CI 2.02-6.14, p = 0.002). In long term period there were no differences in survival between groups type D and without type D (95.5% vs. 96.8%), There were  differences in groups type D and without type D in nonfatal events (strokes, nonfatal myocardial infarctions, secondary endpoint: repeat procedures of revascularization and hospitalization due to relapse or progression of angina pectoris) (respectively, 97.1% vs 88.0%, (p = 0.341). Findings showed that 75% of subjects  reported well QoL, while the mean score regarding QoL in patients with type D personality, were higher than in patients without type D in all health related dimensions. Based on t-test difference, the of QoL in  in patients with type D and  in patients without type D for physical health (p &lt; 0.015), mental limitation (p &lt; 0.043), somatic pain (p &lt; 0.022) and mental health (p &lt; 0.041) was observed. Conclusion: Type D patients had a greater risk for nonfatal cardiac events and lower  QoL indicators, compared with non Type D patients.  Accumulated proofs indicate that in detection of patients at risk of development of stress induced cardiac complications after CABG  it is reasonable to use approach which involves consideration of personality type.

Impact of age and sex on subclinical coronary atherosclerosis in a healthy asian population

2021 ◽  
Vol 28 (Supplement_1) ◽  
Author(s):  
M Wong ◽  
J Yap ◽  
KK Yeo
Keyword(s):  
Risk Factors ◽  
Cardiovascular Disease ◽  
Coronary Artery ◽  
Coronary Atherosclerosis ◽  
Ldl Cholesterol ◽  
Multivariable Analysis ◽  
Asian Population ◽  
Atherosclerotic Cardiovascular Disease ◽  
Age And Gender ◽  
And Gender

Abstract Funding Acknowledgements Type of funding sources: None. Background and Aims The influence of age and gender on clinical atherosclerotic cardiovascular disease is well reported, but literature remains sparse on whether these extend to the disease in its preclinical stage. We aim to report the prevalence, risk-factors and impact of age and gender on the burden of subclinical coronary atherosclerosis in a healthy Asian population. Methods Healthy subjects aged 30-69 years old, with no history of cardiovascular disease or diabetes were recruited from the general population. Subclinical coronary atherosclerosis was quantified via the Coronary Artery Calcium Score (CACS) with CACS of 0 indicating the absence of calcified plaque, 1 to 10 minimal plaque, 11 to 100 mild plaque, and &gt;100 moderate to severe plaque. Results A total of 663 individuals (mean age 49.4 ± 9.2 years, 44.8% male) were included. The prevalence of any CAC was 29.3% with 9% having CAC &gt; 100.  The prevalence was significantly higher in males than females (43.1 vs 18.0%, p &lt; 0.001). These gender differences became increasingly pronounced with increasing age, especially in those with moderate-severe CAC. Multivariable analysis revealed significant associations between increasing age, male, higher blood pressure, increased glucose levels and higher LDL cholesterol levels with the presence of any CAC. LDL cholesterol was more significantly associated with CAC in females compared to males (Pinteraction = 0.022). Conclusions The prevalence of preclinical atherosclerosis increased with age, and was higher in males than females, with gender-specific differences in associated risk factors. These results will better inform individualised future risk management strategies to prevent the development and progression of coronary artery disease within healthy individuals.

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