Novel wine in an old bottle:Preventive and therapeutic potentials of andrographolide in atherosclerotic cardiovascular diseases

Atherosclerotic cardiovascular disease(ASCVD)frequently results in sudden death and poses a serious threat to public health worldwide.The drugs approved for the prevention and treatment of ASCVD are usually used in combination but are inefficient owing to their side effects and single therapeutic targets.Therefore,the use of natural products in developing drugs for the prevention and treatment of ASCVD has received great scholarly attention.Andrographolide(AG)is a diterpenoid lactone compound extracted from Andrographis paniculata.In addition to its use in conditions such as sore throat,AG can be used to prevent and treat ASCVD.It is different from drugs that are commonly used in the prevention and treatment of ASCVD and can not only treat obesity,diabetes,hyperlipidaemia and ASCVD but also inhibit the pathological process of atherosclerosis(AS)including lipid accumulation,inflammation,oxidative stress and cellular abnormalities by regulating various targets and pathways.However,the pharmacological mechanisms of AG underlying the prevention and treatment of ASCVD have not been corroborated,which may hinder its clinical development and application.Therefore,this review summarizes the physiological and pathological mechanisms underlying the development of ASCVD and the in vivo and in vitro pharmacological effects of AG on the relative risk factors of AS and ASCVD.The findings support the use of the old pharmacological compound(‘old bottle’)as a novel drug(‘novel wine’)for the prevention and treatment of ASCVD.Additionally,this review summarizes studies on the availability as well as pharmaceutical and pharmacokinetic properties of AG,aiming to provide more information regarding the clinical application and further research and development of AG.

The role of periodontal disease in atherosclerotic cardiovascular disease

Atherosclerotic cardiovascular disease(ASCVD)includes a group of disorders of the heart and blood vessels and accounts for major morbidity and premature death worldwide.Periodontitis is a chronic inflammatory disease with the gradual destruction of supporting tissues around the teeth,including gingiva,periodontal ligament,alveolar bone,and cementum.Periodontitis has been found to potentially increase the risk of ASCVD.Generally,oral microorganisms and inflammation are the major factors for periodontitis to the incidence of ASCVD.Recently,evidence has shown that the loss of masticatory function is another important factor of periodontitis to the incidence of ASCVD.In this review,we illustrate the recent finding of the relationship between periodontitis and ASCVD,from a microscale perspective-oral microorganisms,inflammation,and tooth loss.With the high prevalence of periodontitis,it is important to add oral therapy as a regular ASCVD prevention strategy.Regular dental visits could be a helpful strategy for ASCVD patients or general medical practitioners.

Value of superb micro-vascular imaging in predicting ischemic stroke in patients with carotid atherosclerotic plaques

BACKGROUND Unstable carotid atherosclerotic plaques are prone to cause ischemic stroke.Contrast-enhanced ultrasound(CEUS) is the primary method of assessing plaque stability, but CEUS cannot be a method for screening for unstable plaque. The emergence of superb micro-vascular imaging(SMI) offers the possibility of clinically screening for unstable plaque AIM To investigate the value of SMI in predicting ischemic stroke in patients with carotid atherosclerotic plaques.METHODS Patients with carotid atherosclerotic plaques(luminal stenosis of 50%-70%) were enrolled into the present study. All patients received conservative medication.The patient's clinical baseline data, serological data, CEUS and SMI data were analyzed. All patients underwent a 3-year follow-up. The follow-up endpoint was the occurrence of ischemic stroke and patients were divided into stroke group and non-stroke group according to whether the prognosis occurred or not.Subsequently, the difference in clinical data was compared, the correlation of SMI and CEUS was analyzed, and multiple Cox regression and receiver operating characteristic curve were applied to investigate the value of SMI and CEUS in predicting cerebral arterial thrombosis in three years.RESULTS In this study, 43 patients were enrolled in the stroke group and 82 patients were enrolled in the non-stroke group. Cox regression revealed that SMI level(P =0.013) and enhancement intensity(P = 0.032) were the independent factors influencing ischemic stroke. There was a positive correlation between SMI level and enhancement intensity(r = 0.737, P = 0.000). The area under curve of SMI level predicting ischemic stroke was 0.878. The best diagnostic point was ≥ level Ⅱ, and its sensitivity and specificity was 86.05% and 79.27%. The area under curve of enhancement intensity predicting ischemic stroke was 0.890. The best diagnostic point was 9.92 db, and its sensitivity and specificity was 88.37% and89.02%. As the SMI level gradually increased, the incidence of ischemic stroke increased gradually(X^2 = 108.931, P = 0.000).CONCLUSION SMI can be used as a non-invasive method of screening for unstable plaques and may help prevent ischemic stroke.

Prediction of 10-year Atherosclerotic Cardiovascular Disease Risk among Adults Aged 40-79 Years in China:a Nationally Representative Survey

Objective To establish the distribution of 10-year atherosclerotic cardiovascular disease （ASCVD） risk among Chinese adults. Methods We estimated the 10-year ASCVD risk by applying the 2013 American College of Cardiology/ American Heart Association pooled cohort equations （PCEs） to the data obtained from the 2010 China Chronic Disease and Risk Factor Surveillance that involved 61,541 participants （representing 520,158,652 Chinese adults） aged 40-79 years. We also compared the ASCVD risk with the 10-year ischemic cardiovascular disease （ICVD） risk, which was calculated using the simplified scoring tables recommended by the Chinese Guidelines for Prevention of Cardiovascular Diseases （Chinese model）. Results Based on the PCEs, the average 10-year ASCVD risk among adults without self-reported stroke or myocardial infraction was 12.5%. Approximately 247 million （47.4%） and 107 million （20.6%） adults had 〉 7.5% and 〉 20% 10-year ASCVD risks, respectively. The 10-year ASCVD risk 〉 20% was higher among men, less educated individuals, smokers, drinkers, and physically inactive individuals than among their counterparts. Overall, 29.0% of adults categorized using the Chinese model were overclassified with the PCEs. Conclusion Our results define the distribution of 10-year ASCVD risk among Chinese adults. The 10-year ASCVD risk predicted by the PCEs was higher than the ICVD risk predicted by the Chinese model.

Evaluation of Carotid Atherosclerotic Plaque Stability with Contrast-enhanced Ultrasonography

This study was aimed to evaluate the relationship between carotid atherosclerotic plaque stability and the clinical symptoms in patients with carotid atherosclerotic plaques by using contrast-enhanced ultrasonography. Fifty patients with carotid atherosclerotic plaques were enrolled and examined with contrast-enhanced ultrasonography. The correlation of contrast agent enhancement of the carotid atherosclerotic plaques and the clinical symptoms was analyzed. The results showed that among the 50 patients, plaques were enhanced in the 23 patients with obvious clinical symptoms. In 27 patients without apparent clinical symptoms, plaques were enhanced sparsely in 15 patients and not enhanced in 12 patients. It was suggested that contrast-enhanced ultrasonography could be used for the examination of the microcirculation in carotid atherosclerotic plaques on real-time basis and serve as a new noninvasive approach for the assessment of stability of carotid atherosclerotic plaques.

Enterprise stent for symptomatic complex intracranial atherosclerotic stenosis: safety and efficiency

Purpose: To evaluate the safety and efficacy of Enterprise stent in the treatment of symptomatic complex intracranial atherosclerotic stenosis. Methods and materials: 20 complex cases among 53 patients with symptomatic ischemic stroke who were treated with balloon angioplasty and enterprise stents in Department of Neuro-interventional Radiology, The First Affiliated Hospital of Zhengzhou University from Jan. 2014 to Dec. 2017 were retrospectively enrolled in this study. Diagnostic criteria for complex intracranial atherosclerotic stenosis were as follows: 1) intracranial atherosclerotic stenosis was ≥70% confirmed by digital subtraction angiography(DSA) using the formulas described by the Warfarin Aspirin Symptomatic Intracranial Disease(WASID) method; 2) length of lesion was >10 mm. Basic characteristics of target lesions, technical success rate, perioperative safety, follow-up outcomes were investigated. Results: 20 patients were enrolled in this study, including 15 males and 5 females from 44 to 70 years old with an average age of 57.20 ± 9.25. 20 lesions were treated with 20 enterprise stents. The average preoperative and postoperative residual stenosis was reduced from(77.45 ± 8.44)% to(24.89 ± 16.61)%. The successful rate of operation was 100%. Among the perioperative complications, only 1 case(5%) experienced perforating branch event. The average clinical follow-up period was 13.15 ± 11.33 months(time range: 5–38). There were no ischemic events, no bleeding events and no various causes of death during the follow-up period. 8 lesions(40.0%) underwent DSA follow-up examinations and 12 lesions(60.0%) were checked by CT angiography during the follow-up period. 3 lesions(15.0%) developed ISR without any cerebral ischemia symptoms. Conclusion: This retrospective, single-center study suggests that enterprise stent is effective in the treatment of symptomatic complex intracranial atherosclerotic stenosis with less perioperative complications. Prospective, multicenter, randomized controlled trials are expected.

Microstructural damage pattern of vascular cognitive impairment: a comparison between moyamoya disease and cerebrovascular atherosclerotic disease

Moyamoya disease and cerebrovascular atherosclerotic disease are both chronic ischemic diseases with similar presentations of vascular cognitive impairment. The aim of the present study was to investigate the patterns of microstructural damage associated with vascular cognitive impairment in the two diseases. The study recruited 34 patients with moyamoya disease(age 43.9 ± 9.2 years; 20 men and 14 women, 27 patients with cerebrovascular atherosclerotic disease(age: 44.6 ± 7.6 years; 17 men and 10 women), and 31 normal controls(age 43.6 ± 7.3 years; 18 men and 13 women) from Huashan Hospital of Fudan University in China. Cognitive function was assessed using the Mini-Mental State Examination, long-term delayed recall of Auditory Verbal Learning Test, Trail Making Test Part B, and the Symbol Digit Modalities Test. Single-photon emission-computed tomography was used to examine cerebral perfusion. Voxel-based morphometry and tract-based spatial statistics were performed to identify regions of gray matter atrophy and white matter deterioration in patients and normal controls. The results demonstrated that the severity of cognitive impairment was similar between the two diseases in all tested domains. Patients with moyamoya disease and those with cerebrovascular atherosclerotic disease suffered from disturbed supratentorial hemodynamics. Gray matter atrophy in bilateral middle cingulate cortex and parts of the frontal gyrus was prominent in both diseases, but in general, was more severe and more diffuse in those with moyamoya disease. White matter deterioration was significant for both diseases in the genu and body of corpus callosum, in the anterior and superior corona radiation, and in the posterior thalamic radiation, but in moyamoya disease, it was more diffuse and more severe. Vascular cognitive impairment was associated with regional microstructural damage, with a potential link between, gray and white matter damage. Overall, these results provide insight into the pathophysiological nature of vascular cognitive impairment. This study was approved by the Institutional Review Board in Huashan Hospital, China(approval No. 2014-278). This study was registered with ClinicalTrials.gov on December 2, 2014 with the identifier NCT02305407.

Association between Coronary Atherosclerotic Plaque Composition and Cardiovascular Disease Risk

Objective The objective of this study is to determine whether coronary atherosclerotic plaque composition is associated with cardiovascular disease(CVD) risk in Chinese adults. Methods We performed a cross-sectional analysis in 549 subjects without previous diagnosis or clinical symptoms of CVD in a community cohort of middle-aged Chinese adults. The participants underwent coronary computed tomography(CT) angiography for the evaluation of the presence and composition of coronary plaques. CVD risk was evaluated by the Framingham risk score(FRS) and the 10-year atherosclerotic cardiovascular disease(ASCVD) risk score. Results Among the 549 participants, 267(48.6%) had no coronary plaques, 201(36.6%) had noncalcified coronary plaques, and 81(14.8%) had calcified or mixed coronary plaques. The measures of CVD risk including FRS and ASCVD risk score and the likelihood of having elevated FRS significantly increased across the groups of participants without coronary plaques, with noncalcified coronary plaques, and with calcified or mixed coronary plaques. However, only calcified or mixed coronary plaques were significantly associated with an elevated ASCVD risk score [odds ratio(OR) 2.41; 95% confidence interval(CI) 1.09-5.32] compared with no coronary plaques, whereas no significant association was found for noncalcified coronary plaques and elevated ASCVD risk score(OR 1.25; 95% CI 0.71-2.21) after multivariable adjustment. Conclusion Calcified or mixed coronary plaques might be more associated with an elevated likelihood of having CVD than noncalcified coronary plaques.

Evaluation of ^(99m)Tc Labeled Diadenosine Tetraphosphate as an Atherosclerotic Plaque Imaging Agent in Experimental Models

The potential of ^99mTc labeled P^1, P^4-di （adenosine-5 ＇ ）-tetraphosphate （Ap4A） for imaging experimental atherosclerotic plaques was evaluated in New Zealand white （NZW） rabbits. To label the ^99mTc to Ap4A, stannous tartrate solution was used. ^99mTc-Ap4A was purified on a Sephadex G-25 column. The radiochemistry purities of ^99mTc-Ap4A were 85% to 91%. Biodistribution study revealed ^99mTc-Ap4A cleared from blood rapidly. Thirty min after ^99mTc-Ap4A administrated on NZW atherosclerotic rabbits, lesion to blood （target/blood, T/B） ratio was 3. 17 ±1.27, and lesions to normal （target/non-target, T/NT） ratio was 5.23 ±1.87. Shadows of atherosclerotic plaques were clearly visible on radioautographic film. Aortas with atherosclerotic plaques also could be seen on ex vivo gamma camera images. Atherosclerotic abdominal aortas were clearly visible on in vivo images 15 min to 3 h after ^99mTc-Ap4A administration. ^99mTc-labeled Ap4A can be used for rapid noninvasive detection of experimental atherosclerotic plaque.

Can We Change a Look at Atherosclerotic Aortic Aneurism Treatment?

In recent years, the increasing number of cardiologists and cardiac surgeons tend to think that surgical treatment of patients with atherosclerotic aneurisms does not fully comply with contemporary ideas of what the disease is. Some data show that early operations in the presence of this pathology are associated with an unreasonably high mortality. Additionally, the use of intra-aortic stents and grafts cannot principally affect the therapeutic efficacy. Therefore, more attention is paid to the development of conservative therapeutic approaches leaving surgery defeated without surgical treatment. Two groups of patients with similar descending thoracic aortic atherosclerotic aneurisms (DTAAA) and abdominal aortic aneurisms (AAA) were retro- and prospectively studied over a 2-year period. Control group (Comparison group), (63 patients) received common surgical treatment from 2009 to 2010 whereas Main group (121 subjects) received multifaceted medical treatment to remove inflammatory reactions, strengthen aortic wall and control its dilation from 2011 to 2012. Operative treatment was used only in case of potential aneurism rupture. The comparison of the two groups of subjects showed that 2-year all-cause mortality in control group was 20.6% while in the main group it amounted to 9.1% due to the similar incidence of aneurism ruptures and deaths associated with concomitant diseases. It suggests that the odds ratio (OR) of survival when using attenuated therapeutic approach to treating atherosclerotic aneurisms is 2.6-fold higher compared to conventional surgical approach. One of the principal factors contributing to a higher mortality when using traditional surgical approach was the presence of polyorgan pathology that required constant medical correction irrespective of therapeutic option (surgical or medical) used. Another important factor is aortic aneurism wall frailty. The development of mechanisms that would allow its strengthening is considered a principal challenge of cutting-edge medicine that should be based on studies of triggers, molecular genetic bases of aortic wall immune-depending inflammatory formation, the production of pro-inflammatory cytokines, metalloproteinase activity that damages elastin and collagen fibers.

Comparison of anti-atherosclerotic effects of two different extracts from leaves of Mallotus furetianus

Objective:To compare the anti-atherosclerotic effects of two different extracts from the leaves of Mallotus fiiretianus by using rat model of atherosclerosis.Methods:The air-flriefl powdered Mallotus fiiretianus leaves were extracted with ethanol and then evaporated.The ethanol extract was experienced Diaion HP-20 CC with a gradient of MeOH and H2O（50:50,100:0,v/v） and two fractions,Mallotus fiiretianus A（Mf A） and Mallotus fiiretianus B（MfB） were obtained.RaLs were divided into control,atherosclerosis and vitamin E,Mf A and Mf B treated groups.Atherosclerotic model was established by administering u loading dose of vitamin D3 and feeding standard diet enriched with 2%cholesterol,0.5%porcine chelate,0.2%methimazole,5%sugar,10%pork fat. Vitamin E（0.20 g/kg）,Mf A（0.053 g/kg）,Mf B（0.057 g/kg）（with the potential） were administered to interfere with the development of atherosclerosis.After 9 weeks,rats were sacrificed and the blood lipid as well as composition of bile was examined.In addition,the thoracic aorta was harvested to evaluate histological changes and the intima-media thickness ratio.Results: Atherosclerosis model was successfully established,administration of vitamin E,Mf A and Mf B increased excretion of total bilirubin in bile,decreased triglycridc（TO）,total cholesterol（TC）, low density lipoprotein-cholesterol（LDL-C） level,enhanced ratio of high density lipoprotein-cholesterol and LDL-C in blood,improved histological changes and diminished intimamedia thickness ratio of thoracic aorta in atherosclerotic rats.As for the difference in antiatherosclerotic effects between Mf A and MfB,Mf A may be more powerful in declining TG level and Mf B may be more effective in decreasing TC level.Conclusions:The two different extracts. Mf A and Mf B can prevent the development of atherosclerosis.In detail,Mf A is more effective in regulating TG level and Mf B is more powerful in modulating TC.level in atherosclerotic rats.

Decreased expression of Klotho in cardiac atria biopsy samples from patients at higher risk of atherosclerotic cardiovascular disease

BackgroundKlotho 蛋白质(&#x003b1； - 并且 &#x003b2；) 是基于膜的传播调整细胞新陈代谢的蛋白质，以及成纤维细胞生长因素(FGF ) 的 lifespan modulating 活动。最近的数据证明了更高的血浆传播 Klotho 层次减少心血管的风险，建议 Klotho 有在心血管的疾病的一个保护的角色。然而，尽管到目前为止它在各种各样的机关被识别了，它是未知的是否，并且高心血管的风险是否能影响 Klotho 的心脏的表示 cardiomyocytes 快车 Klotho 和 FGF ， FGF 和另外的 molecules.MethodsWe 与心血管的疾病和 10 匹配年龄的控制使遭到，估计的10年的低风险经历的一名估计的10年的高动脉粥样硬化患者选择了 20 个病人为除冠的动脉以外的原因的心脏的外科绕过。在心肌的活体检视，我们由免疫组织化学评估了 Klotho 和 FGF 是否在 cardiomyocytes 被表示，并且更高心血管的风险是否影响涉及 endoplasmic 蜂窝胃应力的另外的分子的表示，氧化应力，发炎并且 fibrosis.ResultsOnly ，有更高心血管的风险的病人的 cardiomyocytes 显示出 Klotho 的更低的表示，但是 FGF 的更高的表情。而且，更高心血管的风险与增加的表示被联系氧化并且网状的应力，发炎和 fibrosis.ConclusionsThis 学习的 endoplasmic 第一次证明 Klotho 蛋白质在人的 cardiomyocytes 被表示， Klotho 的那心脏的表情在更高心血管的风险病人是下面调整的，当压力相关的分子的表示显著地被增加时。

Surgical strategies for severely atherosclerotic(porcelain)aorta during coronary artery bypass grafting

Porcelain aorta(PA)is an asymptomatic atherosclerotic disease,characterized by circumferential calcification throughout the whole perimeter of the aorta.It is seen in 2%to 9.3%of patients undergoing elective coronary artery bypass grafting(CABG)and makes manipulation of the ascending aorta impossible.It has been clearly shown that most emboli seen and detected during the CABG procedure occur during aortic cross-clamping and aortic side-clamping.Manipulation of porcelain or a severely atherosclerotic aorta increases the risk of perioperative stroke.The incidence of stroke after CABG is between 0.48%and 2.9%,and the risk is correlated with the extent and severity of the atherosclerotic disease.A conventional CABG procedure involves successive steps that include cannulation of the ascending aorta,application of a cross-clamp to the aorta,and partial clamping of the aorta to create the proximal anastomosis.Therefore in procedures that involve cannulation,clamping,or proximal anastomosis,and where aortic manipulation is inevitable,preassessment of the atherosclerotic aortic plaques is crucial.Although many surgeons still rely on intraoperative manual aortic palpation,this approach has very low sensitivity and underestimates the severity of the atherosclerotic illness.Imaging methods including preoperative computed tomography or intraoperative epiaortic ultrasonography enable modification of the surgical technique according to the severity of atherosclerosis.Various surgical techniques have been described to reduce the risk of atheroembolism that may lead to cerebrovascular events in patients with severely atherosclerotic ascending aorta.Anaortic or“no-touch”techniques that do not utilize aortic manipulation may significantly decrease the development of neurological complications by avoiding aortic maneuvers known to cause emboli.In cases where severe atherosclerotic disease or other factors preclude safe use of the ascending aorta,modifications in the surgical techniques,such as switching to different cannulation sites including the axillary/subclavian,femoral and innominate arteries,or using hypothermic ventricular fibrillation and in-situ pedicled arterial grafts,or performing proximal anastomoses at alternative anatomical locations will enable CABG operations to be performed safely with low morbidity and mortality rates in patients with porcelain aortas.

Prediction of presence and severity of coronary artery disease using prediction for atherosclerotic cardiovascular disease risk in China scoring system

BACKGROUND Coronary artery disease(CAD)is one of the leading causes of death and disease burden in China and worldwide.A practical and reliable prediction scoring system for CAD risk and severity evaluation is urgently needed for primary prevention.AIM To examine whether the prediction for atherosclerotic cardiovascular disease risk in China(China-PAR)scoring system could be used for this purpose.METHODS A total of 6813 consecutive patients who underwent diagnostic coronary angiography were enrolled.The China-PAR score was calculated for each patient and CAD severity was assessed by the Gensini score(GS).RESULTS Correlation analysis demonstrated a significant relationship between China-PAR and GS(r=0.266,P<0.001).In receiver operating characteristic curve analysis,the cut-off values of China-PAR for predicting the presence and the severity of CAD were 7.55%with a sensitivity of 55.8%and specificity of 71.8%[area under the curve(AUC)=0.693,95%confidence interval:0.681 to 0.706,P<0.001],and 7.45%with a sensitivity of 58.8%and specificity of 67.2%(AUC=0.680,95%confidence interval:0.665 to 0.694,P<0.001),respectively.CONCLUSION The China-PAR scoring system may be useful in predicting the presence and severity of CAD.

Study of apolipoprotein E genetic polymorphism in patients with atherosclerotic cerebral infarction

Objective : To explore the frequency and significance of ApoE gene polymorphisms in Chinese patiems with atherosclerotic cerebral infarction (ACI). Methods: Polymerase chain reaction and gene sequencing, single nucleotide polymorphisms of ApoE gene were used to analyze 33 cases of patients with ACI and 35 controls. Results: The frequencies of ApoE gene single nucleotide polymorphisms 465C/G, 462C/G and 451delC in the ACI group were significantly higher than those in the control group (P <0.05) . The preva-lence of polymorphism 486G/T in the control group was significantly higher than that in the ACI group ( P =0.011 ). Conclusions : 465 C/G, 462C/G and 451 delC polymorphisms might be associated with ACI. 486GT allele might have protective effect on the pathogenesis of ACI.

Protective and Indicating Effect of Indirect Bilirubin in Intracranial or Extracranial Artery Atherosclerotic Stenosis Progresses

Background: Bilirubin is the metabolic end-product of heme degradation by heme oxy-genase (HO), which has recently been shown to act as an antioxidant which can protect against atherosclerosis. This study explored the relationship between serum bilirubin levels and different degrees of atherosclerotic stenosis in intracranial or extracranial arteries. Methods: The study included 189 patients undergoing digital subtraction angiography (DSA) diagnosed as being normal or having been confirmed as atherosc lerotic stenosis in the intracranial or extracranial arteries. The patients were allocated to normal, mild (Results: Indirect bilirubin (Ibil) concentrations increased in parallel with the increasing severity of atherosclerotic stenosis in the intracranial or extracranial arteries, but decreased in patients with occluded cranial vessels. Multivariate analysis showed that Ibil levels were significantly higher in patients with severe stenosis group than in those with mild stenosis (OR, 1.464;95% CI, 1.050 - 2.042;P = 0.024). However, Ibil levels were significantly lower in patients with occlusion than in those with severe stenosis (OR, 0.790;95% CI, 0.684 - 0.913;P = 0.001). Conclusions: Ibil appears to have a protective effect against the development of atherosclerotic stenosis in intracranial or extracranial arteries. The biosynthesis of Ibil increases with stenosis progresses but decreases once occlusion occurs.

Computational fluid dynamics modeling in intracranial atherosclerotic disease

Intracranial atherosclerotic disease(ICAD)is an important cause for ischemic stroke and transient ischemic stroke(TIA)throughout the world,especially in Asians,which is not fully appreciated,partly due to its inaccessibility and limitations of current neuroimaging methods.The computational fluid dynamics(CFD)modeling technique provides a novel approach to reveal the hemodynamic characteristics in ICAD,e.g.,the distributions of pressure,wall shear stress and flow velocity.In this review article,we aim to provide an overview of the general methodology of CFD modeling in arterial stenotic diseases,the established application of this technique in coronary artery disease,and more importantly,perspectives and challenges of this technique in the investigation of ICAD.Promising findings of preliminary studies using a CFD model for hemodynamic analysis in ICAD warrant verifications.Further studies in this area will help rectify loopholes in the current secondary prevention strategy,and inform individualized treatment for ICAD patients in the near future.

Anti-Obesity, Anti-Atherosclerotic and Anti-Oxidant Effects of Pu-Erh Tea on a High Fat Diet-Induced Obese Rat Model

Pu-erh tea, a traditional Chinese beverage, has been believed to have many benefits to human health and without side effects. In this study, we systematically analyzed the main active components of Pu-erh tea and investigated its anti-obesity, anti-atherosclerotic and anti-oxidant effects using an obese rat model. Obesity was induced by feeding a high-fat diet and subsequently the experimental obese mice were fed with high-fat diet supplemented with low (2.5%), medium (5%) or high (7.5%) doses of Pu-erh tea powder for 6 weeks respectively. As result, the body weight gain of the rats was decreased by medium and high doses of Pu-erh tea treatments. Furthermore, the levels of serum total cholesterol (TC), triglyceride (TG) and atherosclerosis index (AI) were significantly lowered by Pu-erh tea compared to the control group. Conversely, high density lipoproteincholesterol (HDL-C) level of the rats was significantly elevated by Pu-erh tea treatments. In addition, Pu-erh tea treatments increased the activities of anti-oxidative enzymes such as superoxide dismutase (SOD) and glutathione peroxides (GSH-Px), whereas reduced the level of lipid peroxidation product malondialdehyde (MDA) in obese rats. Collectively, our find-ings revealed that Pu-erh tea exerts comprehensive benefits in anti-obesity, anti-atherosclerotic and anti-oxidant effects, therefore can be used as a promising functional food in obesity management.

Characterization of coronary atherosclerotic plaques in a homozygous familial hypercholesterolemia visualized by optical coherence tomography

Familial hypercholesterolemia(FH)is an autosomal dominant genetic disorder,which resulted in severe elevations in low-density lipoprotein cholesterol(LDL-C)and a markedly increased risk of early-onset coronary disease.[1]t is most frequently caused by loss-of-function mutations in genes affecting the LDL receptor,which clears LDL particles from plasma.

Observation of Atherosclerotic Plaque Phantoms through Saline or Blood Layers by Near-Infrared Hyperspectral Imaging

We observed atherosclerotic plaque phantoms using a novel near-infrared (NIR) hyperspectral imaging (HSI) technique. Data were obtained through saline or blood layers to simulate an angioscopic environment for the phantom. For the study, we developed a NIR-HSI system with an NIR supercontinuum light source and mercury-cadmium-telluride camera. Apparent spectral absorbance was obtained at wavelengths of 1150 - 2400 nm. Hyperspectral images of lipid were constructed using a spectral angle mapper algorithm. Bovine fat covered with saline or blood was observed using hyperspectral images at a wavelength around 1200 nm. Our results show that NIR-HSI is a promising angioscopic technique with the potential to identify lipid-rich plaques without clamping and saline injection.