The Relationship Between NLRP3 Inflammasome and Its Downstream Inflammatory Factors in Obstructive Sleep Apnea Patients with Carotid Atherosclerosis Under Cigarette Exposure

Aim:To study the relationship between NLRP3(nucleotide oligomerization domain[NOD]-,leucine-rich repeats[LRR]-,and pyrin domain-containing protein 3)inflammasome and its downstream inflammatory factors in obstructive sleep apnea(OSA)patients with carotid atherosclerosis(CAS)under cigarette exposure,further exploring the risk factors of CAS in OSA patients.Methods:A total of 109 adult males who underwent polysomnography and carotid artery ultrasonography in our hospital from October 2019 to December 2021 were selected.According to the detection results,they were divided into the OSA group,the CAS group,and the OSA combined CAS group;additionally,29 healthy subjects who underwent a physical examination were also included.According to whether they were smoking,the groups were further divided into smoking and non-smoking groups.The age,body mass index(BMI),blood pressure,apnea-hypopnea index(AHI),lowest blood oxygen saturation(LSaO2),carotid intima-media thickness(CIMT),levels of blood sugar,blood low-density lipoprotein cholesterol(LDLc),and serum NLRP3,interleukin-1β(IL-1β),and interleukin-18(IL-18)of all subjects were recorded.Results:The OSA combined CAS group had higher LDLc levels and AHI and lower LSaO2 than the OSA group and CAS group.The levels of serum NLRP3,IL-1β,and IL-18 in the OSA group were higher than those in the normal control group(P<0.05);and those in the OSA combined CAS group were higher than the OSA group and CAS group(P<0.05),regardless of cigarette exposure.Considering cigarette exposure,serum NLRP3,IL-1β,and IL-18 levels were higher in the OSA,CAS,and OSA combined CAS smoking groups than those in the non-smoking group(P<0.05).Under cigarette exposure,AHI,LDLc,NLRP3,IL-1β,and IL-18 were significantly positively correlated(P<0.05),and LSaO2 was negatively correlated with CAS in OSA(P<0.05).AHI,LSaO2,LDLc,NLRP3,and IL-1βare the risk factors for OSA combined with CAS.Conclusion:LSaO2,AHI,LDLc,NLRP3,and IL-1βare the important risk factors for OSA combined with CAS under cigarette exposure,and their levels can be used to predict the occurrence of CAS in OSA.

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.

Research progress on the influence of local hemodynamics on carotid atherosclerosis

The reasons for the formation of atherosclerosis are diverse and complex,and atherosclerosis as a kind of systemic disease has the characteristics of focal selectivity,which occurs in the carotid bifurcation.The feature enables a large number of studies have found that the severe local hemodynamic characteristics has a great influence to the occurrence of this disease.This paper briefly reviews the related research on the local hemodynamics of carotid bifurcation.The relevant parameters of local hemodynamics were sorted out and summarized,and the effects of wall shear force and its derived parameters on the generation,progression and rupture of carotid atherosclerosis and their clinical applications were reviewed,in order to provide mechanical information for the early warning of carotid plaque rupture.At the same time,this paper describes the transformation of local hemodynamics research in the clinical application of carotid atherosclerosis disease,in order to provide personalized selection and basis for the clinical treatment of this disease.

Relationship between Carotid Atherosclerosis and Cerebral Infarction

Objective To study the relationship between carotid atherosclerosis and cerebral infarction (CI). Methods Between November 2008 and March 2009,147 CI patients (CI group) and 48 patients with non-cerebrovascular diseases (control group) were enrolled from inpatients of Neurology Department of our hospital. The diagnostic criterion of thickened carotid intima was set as 1.0 mm≤intima-media thickness (IMT) <1.5 mm and that of carotid plaque was as IMT≥1.5 mm. Carotid atherosclerosis was divided into three levels: normal intima,thickened intima,and plaque formation. The color Doppler ultrasonography data of carotid arteries in all patients were analyzed and the severity of carotid atherosclerosis was compared between the two groups. Results In the CI group,36 (24.5%) patients had normal carotid intima,22 (15.0%) had thickened carotid intima,and 89 (60.5%) had carotid plaque. In the control group,22 (45.8%) patients had normal carotid intima,4 (8.3%) had thickened carotid intima,and 22 (45.8%) had carotid plaque. The severity of carotid atherosclerosis in the CI group was higher than that in the control group (P=0.022). There was significant difference in the constitution of carotid plaque between the two groups (P=0.001); the CI group mainly had the soft plaque (55/89,61.8%),whereas the control group mainly had the hard plaque (17/22,77.3%). The first three common locations of carotid plaque in both groups were carotid bifurcation (CI group: 73.7%; control group: 64.1%),common carotid artery (CI group: 20.4%; control group: 25.6%),and internal carotid artery (CI group: 5.9%; control group: 10.3%). The location of carotid plaque between the two groups was not significantly different (P=0.438). There was no difference in the carotid inner diameter or resistance index between the two groups (P>0.05). Conclusions Carotid atherosclerosis is to some extent able to reveal the atherosclerotic condition of cerebral arteries and act as an important predictor for the risk of CI. The color Doppler ultrasonography of carotid arteries can provide a convenient way for the prevention and treatment of CI.

Association between Serum Alkaline Phosphatase and Carotid Atherosclerosis in a Chinese Population: A Community-based Cross-sectional Study

Objective This study aimed to investigate the relationship between alkaline phosphatase(ALP) and common carotid intima media thickness(IMT), carotid plaque, and extracranial carotid artery stenosis(ECAS). Methods A total of 3,237 participants aged ≥ 40 years were recruited from Jidong community in 2013-2014. Participants were divided into five quintile groups based on their serum ALP levels. Carotid atherosclerosis was assessed using ultrasound. Abnormal IMT, carotid plaque, and ECAS were defined as IMT > 0.9 mm, IMT > 1.5 mm, and ≥ 50% stenosis in at least one extracranial carotid artery, respectively. Results Common carotid IMT values and the prevalence of carotid plaque increased across serum ALP quintiles. Higher ALP quintiles were correlated with an increased risk of abnormal IMT [fourth quintile: odds ratio(OR) 1.78, 95% confidence interval(CI) 1.13-2.82, P = 0.0135;fifth quintile: OR = 1.82, 95% CI: 1.15-2.87, P = 0.0110] and ECAS compared to the lowest quintile(fifth quintile: OR = 1.47, 95% CI: 1.09-1.97, P = 0.0106). The association between ALP and prevalence of carotid plaque became insignificant after adjustment for confounders. Conclusion Serum ALP levels were independently associated with abnormal common carotid IMT and ECAS. These conclusions need to be further corroborated in future prospective cohort studies.

Association between high cystatin C levels and carotid atherosclerosis

AIM To investigate the association between carotid atherosclerosis and cystatin C(CysC) and to determine the optimal CysC cut-off value.METHODS One hundred twenty-eight subjects were included in this study. Atherosclerosis was defined as a maximum carotid plaque thickness(MCPT) of greater than 2 mm. A receiver operating characteristic curve analysis was used to determine the diagnostic value of serum CysC for atherosclerosis. The subjects were divided into two groups according to the CysC cut-off value. We screenedfor diabetes, hypertension, dyslipidemia, smoking status, alcohol consumption, and exercise behavior. The association between atherosclerosis and CysC levels was assessed using multivariate analysis.RESULTS The subjects were then divided into two groups according to the CysC cut-off value(0.73 mg/L). The median age of the high CysC group was 72 years(85% males), whereas that of the low CysC group was 61 years(63% males). The CysC levels were significantly correlated with Cr and estimated glomerular filtration rate(eGFR) values. Bodymass index, visceral fat area, hypertension, diabetes mellitus, and MCPT were significantly higher in the high CysC group than in the low CysC group. Furthermore, the eG FR was significantly lower in the high CysC group. Regarding lifestyle habits, only the exercise level was lower in the high CysC group than in the low CysC group. Multivariate analysis, adjusted for age and sex, revealed that high CysC levels were significantly associated with an MCPT of ≥ 2 mm(odds ratio: 2.92; 95%CI: 1.13-7.99).CONCLUSION Higher CysC levels were associated with an MCPT of ≥ 2 mm. The CysC cut-off value of 0.73 mg/L appears to aid in the diagnosis of atherosclerosis.

Association between Metabolic Syndrome and Carotid Atherosclerosis: A Cross-sectional Study in Northern China

Objective Increased carotid artery intima-media thickness(CIMT)and carotid plaque as manifestations of carotid atherosclerosis have been used as markers of cardiovascular disease(CVD).The components of metabolic syndrome(Met S)are linked to CVD,but the association between Met S and CVD is controversial.Methods A total of 8,933 Chinese adults aged 40 years or older from 2010 to 2014 were selected from the Jidong and Kailuan communities.Met S was defined by the International Diabetes Federation criteria.CIMT and carotid plaque were measured using color Doppler ultrasound.Logistic regression models were used to assess the association of Met S with carotid plaque and CIMT.Results Met S was found among 3,461(3,461/8,933)participants.The odds ratio and 95%confidence internal(CI)for carotid plaques in participants with Met S was 1.16(1.03-1.30).The risk of carotid plaques increased with the number of Met S components.The average CIMT was higher in participants with Met S(β=0.020,95%CI,0.014-0.027)and in participants with more Met S components.Conclusion Individuals with Met S are at an increased risk for carotid atherosclerosis compared to those without MetS.

Glycemic and blood pressure control in older patients with hypertension and diabetes： association with carotid atherosclerosis

Backgroud Numerous studies have confirmed the effectiveness of slowing the progression of atherosclerosis by blood pressure （Bp） control in patients with hypertension and several studies also showed the efficacy of intensive glycemic control in decreasing progression of carotid intima-media thickness （CIMT） in patients with type 1 and type 2 diabetes. However, few studies have compared the relative importance of glycemic w＇. Bp control in patients with diabetes and hypertension. We aimed to investigate the association between Bp and glycemic control and subclinical carotid atherosclerosis in older patients with hypertension and type 2 diabetes. Methods In a cross-sectional study, B-mode high-resolution ultrasonography of the carotid artery was performed in 670 subjects （508 males and 162 females） aged 60 years or over who had self-reported hypertension and diabetes but no history of coronary heart disease or stroke. Subjects were categorized by their systolic blood pressure： tight control, 〈 130 mmHg; usual control, 130-139 mmHg; or uncontrolled, 〉 140 mmHg, and by their hemoglobin Alc （HbAlc） level： tight control, 〈 6.5%; usual control, 6.5%-7.5%; or uncontrolled, 〉 7.5%, respectively. Results The mean CIMT was 8.20 ±0.11 mm, and carotid plaque was found in 52.5% （352/670） subjects. Overall, 62.1% of the subjects had subclinical carotid atherosclerosis, defined as having either carotid plaque or elevated CIMT （≥ 1.1 ram）. The mean CIMT was significantly different between Bp control categories （7.60 ± 0.09 mm, 7.90 ±0.08 mm, and 8.60 ± 0.12 mm, respectively, P = 0.03） but not between glycemic control categories （8.20± 0.10 mm, 8.1 ±0.08 mm, and 8.40 ± 0.14 ram, respectively, P = 0.13） using ANCOVA analysis. Multivariable logistic regression adjusting for potential confounding factors showed that usual or uncontrolled Bp control were associated with having carotid plaque （OR = 1.08 and OR=1.42, respectively）, or elevated CIMT [Odd ratio （OR） = 1.17, 95% confidence interval （CI） 1.04-2.24, and OR = 1.54, 95% CI 1.36-2.96, respectively compared to tight Bp control; but did not show glycemic control as independent predictor of either having carotid plaque or elevated CIMT. Conclusions In older patients with hypertension and diabetes, blood pressure control, but not glycemic control is associated with subclinical carotid atherosclerosis.

INSULIN RESISTANCE AND CAROTID ATHEROSCLEROSIS IN 221 PATIENTS WITH POTENTIAL HYPERGLYCEMIA

Objective To investigate the relationship between insulin resistance and carotid atherosclerosis in patients with potential hyperglycemia. Methods A total of 221 patients were recruited among those with potential hyperglycemia. All participants underwent physical examination, medical history interview, and 75 g oral glucose tolerance test. Venous blood was sampled for measurement of insulin and cholesterol levels. The intima-media thickness (IMT) in bilateral common carotid arteries was observed by B-mode ultrasound. Insulin resistance index was calculated by homeostasis model assessment (HOMA-IR). Subjects were stratified in quintiles according to HOMA-IR values. Risk factors and atherosclerotic parameters were analyzed. Results With HOMA-IR value increase, incidence of impaired glucose tolerance, diabetes mellitus, hypertension, and coronary artery disease increased, the levels of triglyceride (TG), low density lipoprotein cholesterol (LDL-C), fasting plasma glucose, 2 hour plasma glucose, and fasting insulin increased as well, while the level of high density lipoprotein cholesterol (HDL-C) decreased. Meanwhile, all atherosclerotic parameters increased. Multivariate regression analysis showed that TG, total cholesterol, HDL-C, LDL-C levels, and ln(HOMA-IR) were related to IMT, hence were risk factors for IMT increase. Conclusion Insulin resistance is implicated in atherogenesis.

Carotid Endothelial VCAM-1 Is an Early Marker of Carotid Atherosclerosis and Predicts Coronary Artery Disease in Swine

Objective: The aim was to determine if endothelial VCAM-1 (eVCAM-1) expression in the common carotid artery (CCA) would correlate with predictive markers of atherosclerotic disease, would precede reduction of markers of endothelial cell function and would predict coronary artery disease (CAD). Methods and results: Carotid arterial segments (bifurcation, proximal and distal CCA) were harvested from 14 and 24 month-old male castrated familial hypercholesterolemic (FH) swine, a model of spontaneous atherosclerosis. Quantification of local expression of eVCAM-1, intimal macrophage accumulation, oxidative stress, intima-media (I/M) ratio, intima-media thickness (IMT), endothelial nitric oxide synthase (eNOS) and phosphorylated eNOS (p-eNOS) in selected regions of the carotids revealed a relationship between local inflammation and atherosclerotic plaque progression. Importantly, inflammation was not uniform throughout the CCA. Endothelial VCAM-1 expression was the greatest at the bifurcation and increased with age. Finally, eVCAM-1 best estimated the severity of CAD compared to blood levels of glucose, hypercholesterolemia, carotid IMT, and p-eNOS. Conclusion: Our data suggested that eVCAM-1 was closely associated with atherosclerotic plaque progression and preceded impairment of EDD. Thus, this study supported the use of carotid VCAM-1 targeting agents to estimate the severity of CAD.

The impact of vascular risk factors multiplicity on severity of carotid atherosclerosis—A retrospective analysis of 1969 Egyptian subjects

Background and Purpose: Carotid atherosclerosis has been recognized as a major cause of stroke. The cur-rent study aimed to describe the effect of multiplicity rather than the type of vascular risk factors on severity of carotid atherosclerosis among a large sample of Egyptian population. Methods: We analyzed the data of 1969 Egyptian subjects, who proved to have extra cranial carotid atherosclerotic disease by duplex scanning at the vascular laboratories of Cairo Uni-versity Hospitals. Demographic, clinical data and causes of referral were recorded and correlated with ultrasound findings. Atherosclerotic indices, namely IMT, plaque number and percentage of stenosis were used for evaluation of severity of carotid atherosclerosis. Furthermore, subjects were classified according to multiplicity of major atherosclerotic risk factors and multivariate regression analysis was performed to detect independent predictors of significant carotid disease. Results: Out of 1969 subjects with proved signs of extracranial carotid atherosclerosis by duplex ultrasonographic scan, 225 (11.4%) showed hemody-namic significant stenosis (≥50%). Multiplicity of risk factors beyond the age of 50 years was the strongest predictor of significant stenosis. Conclusion: Age more than 50 years and multiplicity rather than the type of risk factors were the strongest predictors of significant carotid atherosclerotic disease (CAD).

Naïve hepatitis B e antigen-negative chronic hepatitis B patients are at risk of carotid atherosclerosis:A prospective study

BACKGROUND There is an increased risk of atherosclerosis in patients with chronic hepatitis C or human immunodeficiency virus,but there is scarce data on hepatitis B virus infection.The hypothesis of this study is that hepatitis B virus infection increases the risk of carotid plaques and subclinical atherosclerosis in naïve hepatitis B e antigen(HBeAg)negative subjects.AIM To assess the rate of carotid plaques and subclinical atherosclerosis in naïve HBeAg negative subjects in comparison with a cohort of healthy controls.METHODS Prospective case-control collaborative study conducted in two tertiary hospitals.Four hundred and two subjects prospectively recruited at the outpatient clinic were included from May 2016 to April 2017:201 naïve HBeAg-negative hepatitis B virus-infected[49 chronic hepatitis B(CHB)and 152 inactive carriers(ICs)]and 201 healthy controls.Anthropomorphic and metabolic measures,liver stiffness and carotid Doppler ultrasound were performed.Subclinical atherosclerosis was established on an intima-media thickness increase of≥1.2 mm and/or the presence of carotid plaques.Normally distributed quantitative variables were compared with the Student t test and those with a non-normal distribution with the Mann-Whitney U test.Categorical variables were compared between groups using theχ2 or Fisher exact test.RESULTS Carotid plaques were found more often in CHB(32.7%)than ICs(17.1%)or controls(18.4%)(P=0.048).Subclinical atherosclerosis was also increased in CHB(40.8%)vsICs(19.1%)or controls(19.4%)(P=0.003).No differences in the risk of atherosclerosis were observed between controls and ICs.The factors independently associated with the presence of carotid plaques were age[odds ratio(OR)1.43,P<0.001]and CHB(OR 1.18,P=0.004)and for subclinical atherosclerosis,age(OR 1.45,P<0.001),CHB(OR 1.23,P<0.001)and diabetes(OR 1.13,P=0.028).In the subset of young subjects(<50 years),carotid plaques(12.5%vs 1.1%,P=0.027)and subclinical atherosclerosis(12.5%vs 2.2%,P=0.058)were more frequent among CHB than ICs.CONCLUSION Untreated HBeAg-negative CHB is an independent risk factor for carotid plaques and subclinical atherosclerosis,while ICs present a similar risk to controls.

The Correlation between Hypertensive Intracerebral Hemorrhage and Internal Carotid Atherosclerosis Investigated by Carniocervial CTA

Objective: To investigate the relationship between hypertensive intracerebral hemorrhage and internal carotid atherosclerosis and its risk factors by CTA (Computed tomography angiography). Methods: The clinical materials of hypertensive intracerebral hemorrhage patients with carniocervial CTA from January 2018 to August 2019 in Puren Hospital of Wuhan were analyzed retrospectively. The correlation and risk factors between hypertensive intracerebral hemorrhage and internal carotid atherosclerosis were studied by logistic regression and descriptive analysis, at the same time, the application value of carniocervial CTA in patients with cerebral hemorrhage was evaluated. Results: There was a correlation between hypertensive intracerebral hemorrhage and internal carotid atherosclerosis (χ2 = 5.319, P = 0.021 1), which indicated that internal carotid atherosclerosis was the risk factor of hypertensive intracerebral hemorrhage, and there was no significant correlation between the location of internal carotid atherosclerosis, multiple atherosclerosis of internal carotid artery and hypertensive intracerebral hemorrhage. Monofactor analysis showed that the risk factors of hypertensive intracerebral hemorrhage with internal carotid atherosclerosis were sex, age, diabetes and hyperlipidemia. According to the logistic regression analysis, hyperlipidemia and diabetes were independent risk factors for hypertensive. Conclusion: The occurrence of hypertensive intracerebral hemorrhage is related to internal carotid atherosclerosis and is affected by many factors. Carniocervial CTA is helpful to the diagnosis of cerebral hemorrhage.

Correlating cognitive impairment with carotid atherosclerosis and carotid artery stenosis in patients with acute cerebral infarction

BACKGROUND：Studies have demonstrated that carotid atherosclerosis and carotid artery stenosis are closely associated with cognitive impairment in patients with and without clinically evident cerebrovascular disease. OBJECTIVE： To investigate the correlation between the degree of pathological changes in carotid atherosclerosis, carotid artery stenosis, and cognitive impairment in patients with acute cerebral infarction through the use of color Doppler imaging. DESIGN, TIME AND SETTING： The present concurrent, non-randomized, controlled experiment was performed at the Departments of Neurology and Ultrasound, Affiliated Hospital of North Sichuan Medical College between November 2006 and August 2007. PARTICIPANTS： Fifty-five patients with cerebral infarction, consisting of 35 males and 20 females, aged 50–82 years, were admitted to the hospital between November 2006 and August 2007 and recruited for this study. An additional 30 subjects consisting of 18 males and 12 females, aged 47–78 years, that concurrently received a health examination at the same hospital, were also included as normal controls. METHODS： Intima-media thickness （IMT）, plaque shape, size, and echo intensity of all subjects were detected by color Doppler flow imaging. Assessment criteria： IMT 〉 1.0 mm was considered to be intimal thickening, and IMT 〉 1.2 mm was determined to be formed atherosclerotic plaques. In the position of the largest plaque, the degree of carotid artery stenosis was determined by the following formula： （1-cross-sectional area of residual vascular luminal area/vascular cross-sectional area） × 100%. Less than 30% exhibited mild stenosis, 30%-40% moderate stenosis, and 〉 50% severe stenosis. MAIN OUTCOME MEASURES： IMT and the degree of carotid artery stenosis were evaluated by color Doppler flow imaging. The Mini-Mental State Examination （MMSE）, as well as the clinical memory scale, was compared between patients with cerebral infarction and normal controls. RESULTS： In the cerebral infarction group, IMT was increased, the degree of carotid artery stenosis was aggravated, and the MMSE and MQ scores of clinical memory scale were decreased. In particular, orientation of time and place, attention, calculation, and short-time memory were decreased. There were statistically significant differences in MMSE and MQ of clinical memory scale between patients with cerebral infarction and normal controls （P 〈 0.01）. The scores from the two scales were significantly lower in patients with cerebral infarction with carotid plaque subgroup compared to the cerebral infarction with no carotid plaque subgroup （P 〈 0.01）. The scores from the two scales were also significantly lower in patients with IMT 〉 1.0 mm, as well as moderate and severe carotid artery stenosis, compared to patients with IMT ≤ 1.0 mm, and normal and mild stenosis group （P 〈 0.05）. CONCLUSION： More severe atherosclerotic and carotid artery stenosis leads to more obvious cognitive impairment.

Relationship between serum inflammatory response cytokines and the change of plaque properties in patients with H-type hypertension complicated by carotid atherosclerosis

Objective:To study the relationship between serum inflammatory response cytokines and the change of plaque properties in patients with H-type hypertension complicated by carotid atherosclerosis.Methods: Patients who were diagnosed with H-type hypertension complicated by carotid atherosclerosis in Yulin Hospital of Traditional Chinese Medicine between May 2014 and December 2016 were selected as group A, patients with H-type hypertension complicated by carotid atherosclerosis and normal Hcy levels were selected as group B, patients with carotid atherosclerosis and normal blood pressure levels and Hcy levels were selected as group C, and healthy volunteers during the same period were selected as control group. Serum levels of inflammatory response cytokines and plaque property-related cytokines were detected.Results: Serum Hcy, sICAM-1, MCP-1, YKL-40, IL-6, PTX3, FGF23, MMP9 and Caspase-3 levels of group A, group B and group C were significantly higher than those of group D, serum Hcy, sICAM-1, MCP-1, YKL-40, IL-6, PTX3, FGF23, MMP9 and Caspase-3 levels of group A and group B were significantly higher than those of group C, and serum Hcy, sICAM-1, MCP-1, YKL-40, IL-6, PTX3, FGF23, MMP9 and Caspase-3 levels of group A were significantly higher than those of group B;serum Hcy, sICAM-1, MCP-1, YKL-40, IL-6, PTX3, FGF23, MMP9 and Caspase-3 levels of group A with vulnerable plaques were significantly higher than those of patients with stable plaques. Serum Hcy, sICAM-1, MCP-1, YKL-40 and IL-6 levels of group A were positively correlated with PTX3, FGF23, MMP9 and Caspase-3 levels.Conclusion: Serum inflammatory response cytokine secretion increases in patients with H-type hypertension complicated by carotid atherosclerosis, and it can result in the change in plaque properties and the decrease in stability.

Correlation of serum cyclophilin A and monocyte chemoattractant protein-1 levels with carotid atherosclerosis in patients with acute cerebral infarction

Objective:To study the correlation of serum cyclophilin A (CyPA) and monocyte chemoattractant protein-1 (MCP-1) levels with carotid atherosclerosis in patients with acute cerebral infarction.Methods: 106 patients with acute cerebral infarction who were hospitalized in our hospital between July 2011 and August 2015 were selected as observation group, and 50 cases of healthy persons who received physical examination in our hospital during the same period were selected as normal control group. The serum CyPA and MCP-1 contnets in two groups were determined. According to the median of CyPA and MCP-1 contents in observation group, they were divided into high CyPA group and low CyPA group as well as high MCP-1 group and low MCP-1 group, 53 cases in each group. Contents of lipid metabolism indexes and carotid atherosclerosis illness-related indicators were compared between acute cerebral infarction patients with different CyPA and MCP-1 contents.Results:Serum CyPA and MCP-1 contents in observation group were significantly higher than those in control group. Serum TC, LP(a) and LDL-C contents in high CyPA group and high MCP-1 group were higher than those in low CyPA group and low MCP-1 group while HDL-C contents were lower than those in low CyPA group and low MCP-1 group. Serum CysC, Hcy and UA contents in high CyPA group and high MCP-1 group were higher than those in low CyPA group and low MCP-1 group.Conclusion: Serum CyPA and MCP-1 contents in patients with acute cerebral infarction are higher than those in normal population, and the contents of CyPA and MCP-1 are positively correlated with the degree of carotid atherosclerosis.

Ultrasound features of carotid atherosclerosis in patients with coronary heart disease and their correlation with disease severity

Objective:To study the ultrasound features of carotid atherosclerosis in patients with coronary heart disease and their correlation with disease severity. Methods:180 patients with coronary heart disease treated in our hospital between December 2010 and December 2015 were collected as observation group and divided into single-vessel disease group (n=50), double-vessel disease group (n=72) and triple-vessel disease group (n=58) according to the degree of coronary artery stenosis;50 healthy subjects receiving physical examination in our hospital during the same period were selected as control group. Carotid ultrasound was used to measure carotid atherosclerosis parameters, cardiac color Doppler ultrasound was used to detect cardiac function parameters, enzyme-linked immunosorbent assay (ELISA) was used to detect serum endothelial function indexes, and Pearson test was used to analyze the correlation between carotid ultrasound parameters and the cardiac function as well as endothelial function. Results:Carotid ultrasound parameters stiffness (β), elastic modulus (Ep), arterial compliance (AC) and pulse wave velocity (PWVβ) value of observation group were higher than those of control group, and with the increase of coronary artery lesion severity, the changes ofβ, Ep, AC and PWVβvalue increased (P<0.05);cardiac function parameters left ventricular end-diastolic diameter (LVEDD) and left ventricular end-systolic diameter (LVESD) value of observation group were higher than those of control group while left ventricular ejection fraction (LVEF) value was lower than that of control group, and with the increase of coronary artery lesion severity, the changes of LVEDD, LVESD and LVEF value increased (P<0.05);endothelial function indexes endothelin-1 (ET-1) and von willebrand factor (vWF) levels of observation group were higher than those of control group while nitric oxide (NO) level was lower than that of control group, and with the increase of coronary artery lesion severity, the changes of ET-1, vWF and NO levels increased (P<0.05). Carotid ultrasound parameterβ, Ep, AC and PWVβvalue in patients with coronary heart disease were directly correlated with the levels of cardiac function parameters and endothelial function indexes. Conclusions:The ultrasound parameter levels of carotid atherosclerosis in patients with coronary heart disease are directly correlated with the disease severity and can be used as the noninvasive and reliable means for early judgment of the disease.

A comparison of carotid atherosclerosis in symptomatic patients between 2002-2005 and 2012-2015 cohorts using multi-contrast magnetic resonance vessel wall imaging

OBJECTIVE To compare the morphological and compositional characteristics of carotid plaques in two cohorts(2002−2005 and 2012−2015)of Chinese patients using magnetic resonance vessel wall imaging.METHODS Symptomatic patients with carotid atherosclerotic plaques who underwent carotid vessel wall magnetic resonance imaging between 2002−2005 and 2012−2015 were retrospectively recruited.Plaque morphology[including mean wall area,wall thickness,and maximum normalized wall index(NWI)]and composition[including calcification,intraplaque hemorrhage,and lipid-rich necrotic core(LRNC)]in symptomatic carotid arteries were evaluated and compared between patients in these two time periods.RESULTS A total of 258 patients,including 129 patients in the 2002−2005 cohort and 129 patients in the 2012−2015 cohort,were recruited.Statin use(49.6%vs.32.6%,P=0.004)and hypertension(76.0%vs.62.8%,P=0.015)were significantly more common in the 2012-2015 cohort than in the 2002−2005 cohort.Patients in the 2012−2015 cohort also exhibited significantly low plaque burden parameters(all P<0.05),as well as a lower prevalence(68.2%vs.89.9%,P<0.001)and volume percentages of LRNC(11.2%±14.2%vs.25.7%±17.7%,P<0.001).These differences remained significant after adjustment for clinical factors.The differences in the volume percentages of LRNC also remained significant after an additional adjustment for maximum NWI(P<0.001).CONCLUSIONS Patients in the 2012−2015 cohort had a lower plaque burden and volume percentages of LRNC in symptomatic carotid arteries than those in the 2002−2005 cohort.These findings indicate that carotid plaques in the recent cohort had a lower severity and vulnerability.

Coronary atherosclerosis burden is not advanced in patients with β-thalassemia despite premature extracardiac atherosclerosis： a coronary artery calcium score and carotid intima-media thickness study

Background Thalassemic patients demonstrate an increased rate of extracardiae vascular complications and increased carotid wall intima-media thickness （cIMT）, but very low prevalence of coronary artery disease （CAD）. We investigated the atheroma burden by assessing the coronary artery calcium （CAC） and elMT in these patients. Methods We examined 37 patients with β-thalassemia and 150 healthy control volunteers with multi-detector computer tomography （CT） and ultrasonography to determine CAC score and cIMT, respectively. Results Propensity score matching （C-statistic： 0.88; 95% CI： 0.83-0.93） resulted in 27 pairs of patients; severe CAC was observed in 2 （7.4%） and 0 of β-thalassemia patients and healthy volunteers respectively （P = 0.5）. Median calcium score was 0 （0-0） in β-thalassemia patients and 0 （0-4） in healthy volunteers （P = 0.8）. Median intima-media thickness was higher in β-thalassemia patients compared to control group [0.45 （0.06-0.65） vs. 0.062 （0.054-0.086）; P = 0.04]. Conclusions Patients with β-thalassemia in comparison with healthy control subjects exhibit similar CAC score and increased cIMT. Our findings indicate a disparate rate of progression of atherosclerosis between coronary and extracardiac arteries in these patients lending support to the epidemiological evidence.

Effects of FuFangDanShenDiWan on cell adhesion molecules, endothelin and platelet aggregation rate in senile patients with carotid atherosclerosis

Objective: To observe the effects of FuFangDanShenDiWan on cell adhesion molecules, inflammatory response factors and endothelin in senile patients with carotid atherosclerosis. Methods From January 2017 to November 2018, 106 patients with carotid atherosclerosis sampled from a hospital were selected as the research objects. All patients included in this study were divided into Compound Danshen Dripping Pill group and western medicine group according to the order of visit. Patients in the western medicine group were given routine treatment and calcium atorvastatin. Compound Danshen Dripping Pill group was given Compound Danshen Dripping Pill on the basis of the treatment of control group. The changes of soluble intercellular adhesion molecule 1 (sICAM-1), soluble vascular cell adhesion molecule 1 (sVCAM-1), monocyte chemotactic protein-l (MCP-1), tumor necrosis factor (TNF-actor (TNF--or (TNF-ic protein-l (MCP-1hs-CRP), nitric oxide (NO), endothelin (ET), platelet maximum aggregation rate (PAGM), and thrombin B2 (TXB2) were compared between the two groups before and after treatment. Results The level of cell adhesion molecules, inflammatory response factors, NO, ET, PAGM, TXB2 were not statistically significant between the two groups before treatment (P>0.05). After 6 courses of treatment, the level of sICAM-1, sVCAM-1, MCP-1, TNF-1, hs-CRP, ET, PAGM, TXB2 of patients in the FuFangDanShenDiWan group and western medicine group were significantly lower than those before treatment (P<0.05). The level of sICAM-1, sVCAM-1, MCP-1, TNF-M, hs-CRP, ET, PAGM, TXB2 in Compound Danshen Dripping Pill group were significantly lower than those in western medicine group (P<0.05). The levels of NO in the FuFangDanShenDiWan group and western medicine group was significantly higher than that before treatment (P<0.05). In addition, The levels of NO in the Compound Danshen Dripping Pill group was significantly higher than that in the western medicine group (P<0.05). Conclusion Compound Danshen Dripping Pill assisted atorvastatin calcium in the treatment of senile carotid atherosclerosis has a significant effect. Taking Compound Danshen Dripping Pill can effectively reduce the inflammatory reaction of the body of senile carotid atherosclerosis patients, regulate the expression of immune cell adhesion molecules, have a positive effect on the endothelial function and platelet function of patients, reduce the formation of thrombosis, and effectively alleviate the progression of senile carotid atherosclerosis.