Correlation between Serum Level of Adiponectin and Severity of Coronary Artery Atherosclerosis

Objectives To investigate the correlation between serum level of adiponectin and severity of coronary artery atherosclerosis. Methods Coronary angiographies were performed and serum levels of adiponectin were measured in 88 patients with suspected coronary heart disease （CHD）. Patients were divided into groups according to the coronary angiographies and Gensini＇s scores of coronary artery atherosclerosis. The serum levels of adiponectin were compared in different groups, and multiple regressions were used to analyze the correlation factors of adiponectin. Results （1）Serum adiponectin concentration in CHD group [ 7. 1 mg/L （2.4 - 21.1 mg/L） ] was decreased as compared with that in control group [ 11.6 mg/L （4.4 - 28.2 mg/L ）, P 〈 0. 01 ] ; （2）The serum levels of adiponectin fell while the Gensini＇ s scores of coronary artery atherosclerosis increased （P 〈 0. 05, P 〈 0. 01 ） ; （3）Serum level of adiponectin was positively correlated with the high-density lipoprotein cholesterol, while negatively correlated with the Gensini＇ s score of coronary artery atherosclerosis and triglyceride （P 〈 0. 01 ）. Conclusions Serum adiponectin concentration was decreased in patients with CHD. Low serum levels of adiponectin reflected the severity of coronary artery atherosclerosis. Adiponectin was a protective factor of cardiovascular system.

The application value of TCD combined with CDUS in the large artery atherosclerosis

Objective:To explore the value of TCD and CDUS on diagnosis of large artery atherosclerosis.Methods:In our study,90 patients who had been admitted to our hospital and diagnosed as LAA according to CISS typing were selected as the research object.A retrospective analysis was conducted,using CTA as golden standard for diagnoses of stenoses.Explore the risk factors of LAA,the reliability of TCD and CDUS in diagnosis of the stenosis and distribution of stenosis in each vessel.Results:Hypertension and type 2 diabetes are risk factors of LAA vascular stenosis.Middle cerebral artery stenosis detection by TCD carries the highest reliability(sensitivity 90.91%,specificity 97.89%,positive predictive value 96.15%,the negative predictive value was 94.9%,the positive likelihood ratio was 43.18,negative likelihood ratio 0.09,Kappa=0.9).The consistency of TCD is as good as CTA in head and neck part.The negative coincidence rate was higher in the anterior circulation vessels(97.98%),followed by the coincidence rate of severe stenosis(95.23%).However,the detection rate of posterior circulation vessels positive,moderate and severe stenosis,mild stenosis gradually decreased by TCD.CDUS carries general reliability in detecting intracranial extracranial stenosis,the highest reliability in internal carotid artery(kappa 0.82),and the worst consistency in vertebral artery(kappa 0.38).The negative coincidence rate of CDUS in extracranial cerebrovascular stenosis was highest(97.22),followed by the overall compliance rate(91.55%).242 branches of vascular stenosis were discovered in our study,among which intracranial artery stenosis 61.15%(148/242)is higher than that in extracranial artery 38.85%(90/242),ratio of moderate to severe stenosis is as high as 82.23%(199/242).Intracranial artery stenosis in ICA is extremely common(51.11%,46/90),and MCA is the common area of intracranial artery stenosis(37.16%,55/148).Conclusions:(1)Hypertension,type 2 diabetes are risk factors for LAA stenosis.(2)TCD detection of intracranial vascular stenosis carries the best consistency,and reliability of MCA is the highest.In our search,MCA possesses the highest rate of stenosis,and negative coincidence rate by TCD examination was the highest,which could be used for screening method for stenosis.The reliability of TCD in diagnosis of moderate and severe stenosis was relatively better than mild stenosis.(3)CDUS detection of anterior circulation lesions is better than that of posterior circulation lesions.Evaluate effect on moderate and severe stenosis was better than that of mild one.The ratio of ICA stenosis was the highest,but the effect on VA was poor.(4)The incidence of intracranial vascular stenosis is more common than that of the intracranial vascular stenosis.

INTRAVASCULAR ULTRASOUND IMAGING OF ANGIOGRAPHICALLY "SILENT" LEFT MAIN CORONARY ARTERY ATHEROSCLEROSIS

Patients with left main coronary artery (LMCA) atherosclerosis have a poor prognosis compared with lesions in the other coronaries. Because of the methodological problems. LMCA atherosclerotic lesions are not frequently detected by coronary angiography. The purpose of the study was to reveal the existence of LMCA disease in patients with normal coronary arteries by using intravascular ultrasound imaging. Ninety-seven patients with angiographically normal coronary arteries were examined with a 3.5 F or 4.8 F. 20 MHz intravascular ultrasound catheter. The vessel, lumen and plaque areas were determined and percent area and diameter stenosis were calculated. Plaque formation with or without calcific deposits identified by ultrasound accoustic shadowing were regarded as signs of atherosclerosis.

Correlation of carotid artery atherosclerosis with C-reactive protein and adiponectin in patient with metabolic syndrome

Background Metabolic Syndrome（MS） is a group of conditions included hypertension,hyperlipidemia,central obesity,impaired glucose tolerance and insulin resistance,which may contribute to risk factors for atherosclerosis syndrome.Insulin resistance is the core mechanism？ while the underlying mechanism is not clear.This article aims to study the correlation of carotid atherosclerosis with C-reactive protein and adiponectin in metabolic syndrome（MS） patients.Methods According to bilateral carotid artery atherosclerosis echocardiography,226 patients with metabolic syndrome were randomized to three groups,of which were non-carotid atherosclerosis plaque group（MS-1 group,n = 94）,carotid artery atherosclerosis plaque group（MS-2 group,n = 132）,and normal control group（n = 36）.Determination of serum insulin,high sensitivity C-reactive protein,adiponectin and bilateral carotid artery atherosclerosis ultrasonography and other indicators,semi-quantitative estimates of the extent and severity of plaque.Results ①In two MS groups,carotid artery atherosclerosis,intima-media thickness（IMT）,insulin resistance index（HOMA-IR） and high sensitive C-reactive protein（hs-CRP） were significantly higher than the control group（P 〈 0.01）,while adiponectin was lower than the control group（P 〈 0.01）;When MS-2 group was compared to MS-1 group,there were significant differences（P 〈 0.01）.②IMT was positively correlated with HOMA-IR and hs-CRP（P 〈 0.01） while negatively correlated with adiponectin（P 〈 0.01）.Conclusions C-reactive protein and adiponectin in MS patients were correlated with carotid atherosclerosis and insulin resistance,which may be used as the assessment of MS patients.

Association between Fundus Atherosclerosis and Carotid Arterial Atherosclerosis

Objective: To investigate the correlation between fundus atherosclerosis and carotid arterial atherosclerosis. Methods: A total of 516 people undergoing physical examination in Deyang People’s Hospital between June 2020 and December 2022 were randomly selected. Fundus atherosclerosis and carotid arterial atherosclerosis were evaluated by fundus photography and carotid artery ultrasonography, respectively. Results: Among the 516 physical examination patients, 198 (38.4%) had normal fundus examination, and 318 (61.6%) had fundus arteriosclerosis. Among them, 166 cases were of grade I (32.2%), 86 cases were of grade II (16.7%), and 66 cases were of grade III (12.8%). There were 286 cases (55.4%) without carotid atherosclerosis, 201 cases (38.9%) with carotid atherosclerotic plaque, and 33 cases (6.4%) with carotid stenosis. Fundus arteriosclerosis is independently associated with carotid artery intima-media thickness, vulnerable plaques, plaque scores, and carotid artery stenosis (P Conclusion: In summary, there is a close relationship between carotid artery disease and the degree of arteriosclerosis in the eyeground. Fundus photography is a simple, non-invasive, and easily acceptable method of inspection. The results obtained from it are useful in determining the severity of carotid atherosclerosis and guiding early detection and intervention in clinical cases. This can help reduce the incidence of cardiovascular and cerebrovascular diseases.

Comparative Analysis of General Characteristics of Ischemic Stroke of BAD and non-BAD CISS Subtypes

Summary： Based on the recently proposed Chinese ischemic stroke subclassification （CISS） system, intracranial branch atheromatous disease （BAD） is divided into large artery atherosclerosis （LAA） and penetrating artery disease （PAD）. In the current retrospective analysis, we compared the general charac- teristics of BAD-LAA with BAD-PAD, BAD-LAA with non-BAD-LAA and BAD-PAD with non-BAD-PAD. The study included a total of 80 cases, including 45 cases of BAD and 35 cases of non-BAD. Subjects were classified using CISS system： BAD-LAA, BAD-PAD, non-BAD-LAA and non-BAD-PAD. In addition to analysis of general characteristics, the correlation between the factors and the two subtypes of BAD was evaluated. The number of cases included in the analysis was： 32 cases of BAD-LAA, 13 cases of BAD-PAD, 21 cases of non-BAD-LAA, and 14 cases of non-BAD-PAD. Dia- betes mellitus affected more non-BAD-LAA patients than BAD-LAA patients （P=0.035）. In comparison with non-BAD-PAD, patients with BAD-PAD were younger （P=-0.040）, had higher initial NIHSS score （P〈0.001） and morbidity of ischemic heart disease （P=0.033）. Within patients with BAD, the PAD sub- type was associated with smoking （OR=0.043; P=0.011）, higher low-density lipoprotein （OR=5.339; P=0.029）, ischemic heart disease （OR=9.383; P=0.047） and diabetes mellitus （OR=12.59;P=-0.020）. It was concluded that large artery atherosclerosis was the primary mechanism of BAD. The general char- acteristics showed no significant differences between the CISS subtypes of LAA and PAD within BAD, as well as between the BAD and non-BAD within LAA subtype. Several differences between PAD sub- types of BAD and non-BAD were revealed.

Nontraumatic convexal subarachnoid hemorrhage:A case report

BACKGROUND Nontraumatic convexal subarachnoid hemorrhage(c SAH)is a rare type of atypical subarachnoid hemorrhage.It mainly presents as a focal and transient neurological deficit with similar manifestations as transient ischemic attack.CASE SUMMARY We report a case of a 64-year-old man who visited the hospital with paroxysmal left-sided numbness and weakness is presented in this study.Computed tomography examination indicated a high-density image of the right frontalparietal sulcus.Digital subtraction angiography showed severe stenosis at the right anterior cerebral artery A2-A3 junction(stenosis rate approximately 70%).CONCLUSION The findings of this case indicate that anterior cerebral artery stenosis may lead to the occurrence of c SAH.

Overview-Research Progress of Leukoaraiosis

In 1987, Hachinski et al. [1] proposed Leukoaraiosis (LA) as an imaging academic term. Since then, LA and other cerebrovascular diseases have become the research focus of scholars at home and abroad. However, the molecular, cellular and pathogenesis of cerebrovascular disease are still unclear. Cerebral small vessel disease is caused by the lesions of perforating arteries, capillaries and veins of the brain. Modern imaging technology makes it possible to classify these diseases that can not be directly distinguished in clinical practice. The imaging features of cerebral infarction include cerebral microvascular atrophy. At present, a large number of studies have been carried out around LA, such as the pathogenesis, risk factors, imaging manifestations and classification, pathophysiological changes, hemodynamics, gene polymorphism and so on. In addition, although LA belongs to the category of cerebral small vessel disease, more scholars believe that there are countless links between large artery atherosclerosis and LA, and to some extent, have the same pathogenesis. This paper reviews the following aspects.

Oxidized phospholipids and lipoprotein-associated phospholipase A_2 as important determinants of Lp(a) functionality and pathophysiological role

Lipoprotein（a） [Lp（a）] is composed of a low density lipoprotein（LDL）-like particle to which apolipoprotein（a）[apo（a）] is linked by a single disulfide bridge. Lp（a） is considered a causal risk factor for ischemic cardiovascular disease（CVD） and calcific aortic valve stenosis（CAVS）. The evidence for a causal role of Lp（a） in CVD and CAVS is based on data from large epidemiological databases, mendelian randomization studies, and genome-wide association studies. Despite the well-established role of Lp（a） as a causal risk factor for CVD and CAVS, the underlying mechanisms are not well understood. A key role in the Lp（a） functionality may be played by its oxidized phospholipids（OxPL） content. Importantly, most of circulating OxPL are associated with Lp（a）; however, the underlying mechanisms leading to this preferential sequestration of OxPL on Lp（a） over the other lipoproteins,are mostly unknown. Several studies support the hypothesis that the risk of Lp（a） is primarily driven by its OxPL content.An important role in Lp（a） functionality may be played by the lipoprotein-associated phospholipase A_2（Lp-PLA_2）,an enzyme that catalyzes the degradation of OxPL and is bound to plasma lipoproteins including Lp（a）. The present review article discusses new data on the pathophysiological role of Lp（a） and particularly focuses on the functional role of OxPL and Lp-PLA_2 associated with Lp（a）.

Effects of fluid recirculation on mass transfer from the arterial surface to flowing blood

The effect of disturbed flow on the mass trans- fer from arterial surface to flowing blood was studied nu- merically, and the results were compared with that of our previous work. The arterial wall was assumed to be vis- coelastic and the blood was assumed to be incompressible and non-Newtonian fluid, which is more close to human arte- rial system. Numerical results indicated that the mass trans- fer from the arterial surface to flowing blood in regions of disturbed flow is positively related with the wall shear rates and it is significantly enhanced in regions of disturbed flow with a local minimum around the reattachment point which is higher than the average value of the downstream. There- fore, it may be implied that the accumulation of cholesterol or lipids within atheromatous plaques is not caused by the reduced efflux of cholesterol or lipids, but by the infiltration of the LDL （low-density lipoprotein） from the flowing blood to the arterial wall.

Impaired Arterial Elasticity Identified by Pulse Waveform Analysis is a Non - invasive Measure for Early Detection of Endothelial Dysfunction

Objectives Endothelial dysfunction is the earliest marker for atherosclerosis and plays key role in the pathogenesis of cardiovascular diseases. The present study was performed to evaluate effect of aging on arterial elasticity by using pulse waveform analysis and investigate whether the changes in arterial elasticity can be used as a non - invasive measure for early detection of endothelial dysfunction. Methods Using modified Windkessel model of the circulation and pulse waveform analysis, C1 large ar- tery and C2 small artery elasticity indices of 204 normal healthy subjects ( age 15-80 years) were measured. Among them twenty - four male healthy subjects were divided into both the young ( age 20 - 30 years, n = 12) and elderly (age 60 -70 years, n = 12) groups. We delivered acethycholine (Ach) , an endothelium - dependent vasodilator, and sodium nitroprusside (SNP) , an endothelium - independent vasodilator, to dermal vessels of the forearm using iontophoresis, re- spectively, and measured basal and peak blood flow u- sing laser doppler fluximetry. Results Cl large ar- tery and C2 small artery elasticity indices were reduced with advancing age. C1 large artery and C2 small arter- y elasticity indices were negatively correlated with age (r= -0.628, p<0.001; r= -0.595, p<0.001). Basal blood flow was similar between the young andelderly groups (14. 58 ±3.4 vs 13. 52 ±3.41 PU, p = NS). Peak blood flow induced by Ach was significandy reduced in the elderly group compared with the young group (83.4 ±11.9 vs 93.75 ±10.87 PU, p <0.05). However, peak blood flow induced by SNP was similar in the two groups (119.17 ± 16.76 vs 128. 33 ±21. 29 PU, p = NS ) . Ach - induced peak blood flow correlated pos- itively with C1 large artery and C2 small artery elasticity indices(r = 0. 56, p < 0. 01; r =0.53, p < 0.01). Conclusions Advancing age leads to impaired artery elasticity and endothelial dysfunction. Reduced arterial elasticity is, in parallel, associated with diminished endothelium - dependent vasodilation. It is concluded that arterial elasticity assessment provides a non - inva- sive measure for the early evaluation of vascular endo- thelial function.

Percutaneous transluminal stenting in patients with carotid artery stenosis

Objective To assess the efficacy and safety of percutaneous transluminal stenting for patients with carotid artery stenosis.Methods Selective percutaneous transluminal stenting was performed for patients with symptomatic carotid artery stenosis(luminal narrowing ≥ 70%).Success rates and complications associated with the procedures were observed.During six months of follow-up,both recurrent symptom and restenosis rates were recorded.Results There were 17 bifurcating lesions among 27 stenoses in 26 patients,of whom 18 had concomitant coronary artery diseases.The acute procedural success rate was 96.3%(26/27),and the degree of stenosis was reduced from 88.6% ± 8.9%(range 70 - 100)to 0.4% ± 2.0%(range 0 - 10).Six patients developed severe bradycardia and hypotension,and 3 experienced transient loss of consciousness during balloon dilatation.During hospitalization,2 patients experienced loss of consciousness and convulsion,respectively,due to hyperperfusion,and both recovered 12 hours later.There were 2 minor stroke cases (7.4%)but no cases of major stroke or death.At the 6-month follow-up,there were no cases of TIA or new onset of stroke.There was no restenosis detected in 16 cases using angiography and in 10 cases using MRI in 6 to 16 months of follow-up.Conclusions Percutaneous transluminal stenting for patients with carotid artery stenosis has a high procedural success rate with few and acceptable complications.Few patients suffered from recurrent symptoms or showed restenosis in long-term follow-up.

Evaluation of the neutrophil to lymphocyte ratio in newly diagnosed nondiabetic hypertensive patients with carotid atherosclerosis

Background Carotid intimal thickness(IMT),a marker of subclinical atherosclerosis,was widely used for predicting cardiovascular events. Recent studies have shown that inflammation plays a vital role in the development and progression of atherosclerosis. The neutrophil to lymphocyte ratio(NLR)is a new marker of inflammation because it is closely related to cardiovascular,metabolic and inflammatory diseases. However,the relationship between NLR and carotid atherosclerosis is currently unknown. Methods A total of 882 patients underwent blood sampling for neutrophil and lymphocyte counts,serum lipids,total homocysteine(tHcy),and carotid scan by ultrasonography(US)to evaluate abnormalities of carotid wall. Results NLR was found to be statistically significantly higher in the carotid atherosclerosis group(2.0±0.8 vs. 1.7±0.6,P<0.001). The NLR,expressed as both quartiles(odds ratio[OR],2.36;95% confidence interval[CI],1.37 to 3.47;P=0.001)and continuous values(OR,1.83;95% CI,1.43 to 2.33;P<0.001),was significantly associated with a higher risk for carotid atherosclerosis. The optimal NLR cutoff value for detecting carotid atherosclerosis was 1.60 based on receiver operating curve(ROC)analysis with a sensitivity of 64.0% and a specificity of 57.0%. Conclusion NLR is significantly associated with carotid atherosclerosis in newly diagnosed nondiabetic hypertensive patients.