Background Atherosclerotic plaques indicate the occurrence of ischemia events and it is a difficult task for clinical physicians. Grape seed proanthocyanidin extract （GSPE） has been reported to exert an antiatheroge...Background Atherosclerotic plaques indicate the occurrence of ischemia events and it is a difficult task for clinical physicians. Grape seed proanthocyanidin extract （GSPE） has been reported to exert an antiatherogenic effect by inducing regression of atherosclerotic plaques in animal experimental studies. In this study, the antiatherogenic effect of GSPE has been investigated in clinical use. Methods Consecu- tive 287 patients diagnosed with asymptomatic carotid plaques or abnormal plaque free carotid intima-media thickness （CIMT） were ran- domly assigned to the GSPE group （n = 146） or control group （n = 141）. The patients in the GSPE group received GSPE 200 mg per day orally, while patients in the control group were only enrolled in a lifestyle intervention program. Carotid ultrasound examination was per- formed at baseline and 6, 12, 24 months during follow-up. Mean maximum CIMT （MMCIMT）, plaque score, echogenicity of plaques and ischemic vascular events were recorded. Results As anticipated, after treatment, GSPE resulted in significant reduction in MMCIMT pro- gression （4.2% decrease after six months, 4.9% decrease after 12 months and 5.8% decrease after 24 months） and plaque score （10.9% de- crease after six months, 24.1% decrease after 12 months and 33.1% decrease after 24 months） for the primary outcome, while MMCIMT and plaque score were stable and even increased with the time going on in control group. The number of plaques and unstable plaques also de- creased after treatment of GSPE. Furthermore, the carotid plaque can disappear after treatment with GSPE. The incidence rate for transitory ischemic attack （TIA）, arterial revascularization procedure, and hospital readmission for unstable angina in GSPE group were statistically significant lower （P = 0.02, 0.08, 0.002, respectively） compared with the control group. Conclusions GSPE inhibited the progression of MMCIMT and reduced carotid plaque size in GSPE treated patients, and with extended treatment, the superior efficacy on MMCIMT and carotid plaque occurred. Furthermore, the GSPE group showed lower rates of clinical vascular events.展开更多
Objectives:To evaluate the efficacy of 18F-FDG-PET/CT in detection toward the vulnerabilities of carotid plaque and review systematically best evidence to prevent acute stroke from unstable carotid plaque.Methods:A se...Objectives:To evaluate the efficacy of 18F-FDG-PET/CT in detection toward the vulnerabilities of carotid plaque and review systematically best evidence to prevent acute stroke from unstable carotid plaque.Methods:A search was conducted on Medline(PubMed),Web of science,Cochrane and WHIC using the search terms‘PET/CT’AND‘18F-FDG’AND‘fluorodeoxyglucose’AND‘carotid plaque’,from 2013/01/01 to now.Two authors will independently extract data following the study characteristics,eligibility criteria,interventions,outcome measurements,duration,adverse events,results and the type of needle used.All searched articles were inserted into in EndNote software that can automatically save,manage,and delete duplicate documents.Results:There were 3 articles included in the systematic review finally and form the study population analysis.The total 89 patients(64 males and 25 females)identified from the included studies.The mean 18F-FDG injected dose was 4.58 MBq/kg.The last three articles have demonstrated that 18F-FDG can accurately identify the stability of carotid plaques and can accurately locate and identify high-inflammation areas by histological analysis.Conclusions:18F-FDG-PET/CT is very efficient and practical for the identification of carotid vulnerable plaques.TBR(max and mean values)as a parameter for identifying inflammatory plaques is more reliable than SUV.展开更多
Coronary artery disease remains a major cause of mortality. Presence of atherosclerotic plaques in the coronary artery is responsible for lu-men stenosis which is often used as an indicator for determining the severit...Coronary artery disease remains a major cause of mortality. Presence of atherosclerotic plaques in the coronary artery is responsible for lu-men stenosis which is often used as an indicator for determining the severity of coronary artery disease. However, the degree of coronary lumen stenosis is not often related to compromising myocardial blood flow, as most of the cardiac events that are caused by atherosclerotic plaques are the result of vulnerable plaques which are prone to rupture. Thus, identification of vulnerable plaques in coronary arteries has become increas-ingly important to assist identify patients with high cardiovascular risks. Molecular imaging with use of positron emission tomography （PET） and single photon emission computed tomography （SPECT） has fulfilled this goal by providing functional information about plaque activity which enables accurate assessment of plaque stability. This review article provides an overview of diagnostic applications of molecular imaging tech-niques in the detection of plaques in coronary arteries with PET and SPECT. New radiopharmaceuticals used in the molecular imaging of coro-nary plaques and diagnostic applications of integrated PET/CT and PET/MRI in coronary plaques are also discussed.展开更多
Objective To investigate the relationships between vascular factors and plaque morphology in the patients with acute coronary syndrome（ACS）. Methods Intravascular ultrasound（lVUS） was performed on 56 consecutively...Objective To investigate the relationships between vascular factors and plaque morphology in the patients with acute coronary syndrome（ACS）. Methods Intravascular ultrasound（lVUS） was performed on 56 consecutively enrolled patients with ACS. Cytometric bead array for seven vascular factors（sPE,t-PA, MCP-1, IL-8,1L-6,sVCAM-1, and sCD40L） was measured by cytometry. The others biomarkers were tested by ELISA or biochemistry. Differences in bio-factors were compared between vulnerable plaque and non- vulnerable plaque groups, accte myocardial infarction （AMI） and ustable angina （UA） patients, and occurring plaque rupture. The relationship between the parameters of morphology and vascular factors was analyzed. Results There were positive correlations between sVCAM-lsPE, sVCAM-I-sCD40L, sCD40L-sPE, IL-6-ILS,ILS-MCP1, and MCPI-sVCAM-1; CRP （18.868±4.907mg/L vs 5.806±3.553 mg/L）and IL-6 （19.5 pg/ml [9.2 - 44.6 pg/ml]vs 5.3 pg/ml [2.3- 13.4 pg/ml]）were elevated in the vulnerable plaque group（P 〈0.05）. sCD40L（473.82± 126.11 vs 237.94± 34.78 pg/ml）,sPE （107.21±39.90 vs 49.06 ±5.61ug/L） and MCP-1（132.42 ± 17.85 vs 127.17±13.27 pg/ml） were increased in the plaque rupture group（P 〈 0.05）;There was correlation between tPA and plaque morphology（P 〈 0.05）. Increases in sCD40L, MCP-1, sPE, and TC were independent factors for plaque rupture. Conclusions IL-6 and CRP may be biomarkers for vulnerable plaque and for diagnosis ofAMI, sCD40L, MCP-1 and sPE are potential markers when for plaque rupture patient present with severe ACS.展开更多
The assessment and management of early-stage atherosclerosis are important for the prevention of cardiovascular disease(CVD).In this study,we used multi-contrast magnetic resonance imaging(MRI) to investigate the caro...The assessment and management of early-stage atherosclerosis are important for the prevention of cardiovascular disease(CVD).In this study,we used multi-contrast magnetic resonance imaging(MRI) to investigate the carotid plaque feature in asymptomatic,at-risk subjects;we also evaluated the correlation between MRI findings and Framingham risk score(FRS).One hundred sixty-six asymptomatic individuals with risk factors for CVD underwent multi-contrast MRI.After the arterial morphology and plaque components were outlined,the differences in carotid plaque burden among the various risk categories were analyzed.The FRS analysis showed that high-risk individuals had thicker vessel wall and higher plaque lipid content than did low risk participants.A substantial proportion of advanced carotid plaques occurred in low and intermediate-risk groups.Multi-contrast MRI may provide incremental value to the FRS in managing asymptomatic at-risk population.展开更多
文摘Background Atherosclerotic plaques indicate the occurrence of ischemia events and it is a difficult task for clinical physicians. Grape seed proanthocyanidin extract （GSPE） has been reported to exert an antiatherogenic effect by inducing regression of atherosclerotic plaques in animal experimental studies. In this study, the antiatherogenic effect of GSPE has been investigated in clinical use. Methods Consecu- tive 287 patients diagnosed with asymptomatic carotid plaques or abnormal plaque free carotid intima-media thickness （CIMT） were ran- domly assigned to the GSPE group （n = 146） or control group （n = 141）. The patients in the GSPE group received GSPE 200 mg per day orally, while patients in the control group were only enrolled in a lifestyle intervention program. Carotid ultrasound examination was per- formed at baseline and 6, 12, 24 months during follow-up. Mean maximum CIMT （MMCIMT）, plaque score, echogenicity of plaques and ischemic vascular events were recorded. Results As anticipated, after treatment, GSPE resulted in significant reduction in MMCIMT pro- gression （4.2% decrease after six months, 4.9% decrease after 12 months and 5.8% decrease after 24 months） and plaque score （10.9% de- crease after six months, 24.1% decrease after 12 months and 33.1% decrease after 24 months） for the primary outcome, while MMCIMT and plaque score were stable and even increased with the time going on in control group. The number of plaques and unstable plaques also de- creased after treatment of GSPE. Furthermore, the carotid plaque can disappear after treatment with GSPE. The incidence rate for transitory ischemic attack （TIA）, arterial revascularization procedure, and hospital readmission for unstable angina in GSPE group were statistically significant lower （P = 0.02, 0.08, 0.002, respectively） compared with the control group. Conclusions GSPE inhibited the progression of MMCIMT and reduced carotid plaque size in GSPE treated patients, and with extended treatment, the superior efficacy on MMCIMT and carotid plaque occurred. Furthermore, the GSPE group showed lower rates of clinical vascular events.
文摘Objectives:To evaluate the efficacy of 18F-FDG-PET/CT in detection toward the vulnerabilities of carotid plaque and review systematically best evidence to prevent acute stroke from unstable carotid plaque.Methods:A search was conducted on Medline(PubMed),Web of science,Cochrane and WHIC using the search terms‘PET/CT’AND‘18F-FDG’AND‘fluorodeoxyglucose’AND‘carotid plaque’,from 2013/01/01 to now.Two authors will independently extract data following the study characteristics,eligibility criteria,interventions,outcome measurements,duration,adverse events,results and the type of needle used.All searched articles were inserted into in EndNote software that can automatically save,manage,and delete duplicate documents.Results:There were 3 articles included in the systematic review finally and form the study population analysis.The total 89 patients(64 males and 25 females)identified from the included studies.The mean 18F-FDG injected dose was 4.58 MBq/kg.The last three articles have demonstrated that 18F-FDG can accurately identify the stability of carotid plaques and can accurately locate and identify high-inflammation areas by histological analysis.Conclusions:18F-FDG-PET/CT is very efficient and practical for the identification of carotid vulnerable plaques.TBR(max and mean values)as a parameter for identifying inflammatory plaques is more reliable than SUV.
文摘Coronary artery disease remains a major cause of mortality. Presence of atherosclerotic plaques in the coronary artery is responsible for lu-men stenosis which is often used as an indicator for determining the severity of coronary artery disease. However, the degree of coronary lumen stenosis is not often related to compromising myocardial blood flow, as most of the cardiac events that are caused by atherosclerotic plaques are the result of vulnerable plaques which are prone to rupture. Thus, identification of vulnerable plaques in coronary arteries has become increas-ingly important to assist identify patients with high cardiovascular risks. Molecular imaging with use of positron emission tomography （PET） and single photon emission computed tomography （SPECT） has fulfilled this goal by providing functional information about plaque activity which enables accurate assessment of plaque stability. This review article provides an overview of diagnostic applications of molecular imaging tech-niques in the detection of plaques in coronary arteries with PET and SPECT. New radiopharmaceuticals used in the molecular imaging of coro-nary plaques and diagnostic applications of integrated PET/CT and PET/MRI in coronary plaques are also discussed.
文摘Objective To investigate the relationships between vascular factors and plaque morphology in the patients with acute coronary syndrome（ACS）. Methods Intravascular ultrasound（lVUS） was performed on 56 consecutively enrolled patients with ACS. Cytometric bead array for seven vascular factors（sPE,t-PA, MCP-1, IL-8,1L-6,sVCAM-1, and sCD40L） was measured by cytometry. The others biomarkers were tested by ELISA or biochemistry. Differences in bio-factors were compared between vulnerable plaque and non- vulnerable plaque groups, accte myocardial infarction （AMI） and ustable angina （UA） patients, and occurring plaque rupture. The relationship between the parameters of morphology and vascular factors was analyzed. Results There were positive correlations between sVCAM-lsPE, sVCAM-I-sCD40L, sCD40L-sPE, IL-6-ILS,ILS-MCP1, and MCPI-sVCAM-1; CRP （18.868±4.907mg/L vs 5.806±3.553 mg/L）and IL-6 （19.5 pg/ml [9.2 - 44.6 pg/ml]vs 5.3 pg/ml [2.3- 13.4 pg/ml]）were elevated in the vulnerable plaque group（P 〈0.05）. sCD40L（473.82± 126.11 vs 237.94± 34.78 pg/ml）,sPE （107.21±39.90 vs 49.06 ±5.61ug/L） and MCP-1（132.42 ± 17.85 vs 127.17±13.27 pg/ml） were increased in the plaque rupture group（P 〈 0.05）;There was correlation between tPA and plaque morphology（P 〈 0.05）. Increases in sCD40L, MCP-1, sPE, and TC were independent factors for plaque rupture. Conclusions IL-6 and CRP may be biomarkers for vulnerable plaque and for diagnosis ofAMI, sCD40L, MCP-1 and sPE are potential markers when for plaque rupture patient present with severe ACS.
文摘The assessment and management of early-stage atherosclerosis are important for the prevention of cardiovascular disease(CVD).In this study,we used multi-contrast magnetic resonance imaging(MRI) to investigate the carotid plaque feature in asymptomatic,at-risk subjects;we also evaluated the correlation between MRI findings and Framingham risk score(FRS).One hundred sixty-six asymptomatic individuals with risk factors for CVD underwent multi-contrast MRI.After the arterial morphology and plaque components were outlined,the differences in carotid plaque burden among the various risk categories were analyzed.The FRS analysis showed that high-risk individuals had thicker vessel wall and higher plaque lipid content than did low risk participants.A substantial proportion of advanced carotid plaques occurred in low and intermediate-risk groups.Multi-contrast MRI may provide incremental value to the FRS in managing asymptomatic at-risk population.
