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 ou...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.展开更多
Atherosclerosis is the early stage of arterial disease, and underlies development of cardiovascular disease (CVD) and stroke. Although sophisticated models for assessing CVD and stroke risk have been derived based on ...Atherosclerosis is the early stage of arterial disease, and underlies development of cardiovascular disease (CVD) and stroke. Although sophisticated models for assessing CVD and stroke risk have been derived based on large-scale prospective studies, their abilities in detecting the presence or absence of atherosclerotic plaque have not been investigated. This study aimed to evaluate and compare discriminatory and risk stratifying abilities of 13 CVD risk assessment models against the ultrasound detection of carotid plaques in type 2 diabetes mellitus (T2DM) patients. Forty-nine T2DM subjects were recruited with informed consent, and major anthropomorphic and biomarker data for these models were collected. The model risk scores were evaluated against the carotid plaques detected by Doppler ultrasound. Only the FHS-Lpts-CHD-10Y model, which is a variant of the Framingham model, revealed an area under the receiver operating curve (AUROC) that was significantly different from a random scoring approach (AUROC: 0.681, p was able to stratify the risk levels of carotid plaque presence (Chi-Square statistic: 5.99,展开更多
Cardiovascular disease is the predominant cause of death in type 2 diabetes mellitus(T2DM).Evidence suggests a strong association between duration and degree of hyperglycemia and vascular disease.However,large trials ...Cardiovascular disease is the predominant cause of death in type 2 diabetes mellitus(T2DM).Evidence suggests a strong association between duration and degree of hyperglycemia and vascular disease.However,large trials failed to show cardiovascular benefit after intensive glycemic control,especially in patients with longer diabetes duration.Atherosclerosis is a chronic and progressive disease,with a long asymptomatic phase.Subclinical atherosclerosis,which is impaired in T2DM,includes impaired vasodilation,increased coronary artery calcification(CAC),carotid intima media thickness,arterial stiffness,and reduced arterial elasticity.Each of these alterations is represented by a marker of subclinical atherosclerosis,offering a cost-effective alternative compared to classic cardiac imaging.Their additional use on top of traditional risk assessment strengthens the predictive risk for developing coronary artery disease(CAD).We,herein,review the existing literature on the effect of glycemic control on each of these markers separately.Effective glycemic control,especially in earlier stages of the disease,attenuates progression of structural markers like intima-media thickness and CAC.Functional markers are improved after use of newer antidiabetic agents,such as incretin-based treatments or sodium-glucose cotransporter-2 inhibitors,especially in T2DM patients with shorter disease duration.Larger prospective trials are needed to enhance causal inferences of glycemic control on clinical endpoints of CAD.展开更多
AIM To demonstrate feasibility of vessel wall imaging of the superficial palmar arch using high frequency microultrasound, 7T and 3T magnetic resonance imaging(MRI).METHODS Four subjects(ages 22-50 years) were scanned...AIM To demonstrate feasibility of vessel wall imaging of the superficial palmar arch using high frequency microultrasound, 7T and 3T magnetic resonance imaging(MRI).METHODS Four subjects(ages 22-50 years) were scanned on a micro-ultrasound system with a 45-MHz transducer(Vevo 2100, Visual Sonics). Subjects' hands were then imaged on a 3T clinical MR scanner(Siemens Biograph MMR) using an 8-channel special purpose phased array carotid coil. Lastly, subjects' hands were imaged on a 7T clinical MR scanner(Siemens Magnetom 7T Whole Body Scanner) using a custom built 8-channel transmit receive carotid coil. All three imaging modalities were subjectively analyzed for image quality and visualization of the vessel wall. RESULTS Results of this very preliminary study indicated that vessel wall imaging of the superficial palmar arch was feasible with a whole body 7T and 3T MRI in comparison with micro-ultrasound. Subjective analysis of image quality(1-5 scale, 1: poorest, 5: best) from B mode, ultrasound, 3T SPACE MRI and 7T SPACE MRI indicated that the image quality obtained at 7T was superior to both 3T MRI and micro-ultrasound. The 3D SPACE sequence at both 7T and 3T MRI with isotropic voxels allowed for multi-planarreformatting of images and allowed for less operator dependent results as compared to high frequency microultrasound imaging. Although quantitative analysis revealed that there was no significant difference between the three methods, the 7T Tesla trended to have better visibility of the vessel and its wall. CONCLUSION Imaging of smaller arteries at the 7T is feasible for evaluating atherosclerosis burden and may be of clinical relevance in multiple diseases.展开更多
The role of beta2-microglobulin(β2M) in dialysisrelated amyloidosis as a specific amyloid precursor was defined in the 1980 s. Studies in those years were largely related to β2M amyloidosis. In 2005, for what was pr...The role of beta2-microglobulin(β2M) in dialysisrelated amyloidosis as a specific amyloid precursor was defined in the 1980 s. Studies in those years were largely related to β2M amyloidosis. In 2005, for what was probably the first time in the available literature, we provided data about the association betweenβ2M and early-onset atherosclerosis in hemodialysis patients without co-morbidities. In recent years, the role of uremic toxins in uremic atherosclerosis and the interest in β2M as a marker of cardiovascular(CV) and/or mortality risk have grown. In the current literature,clinical studies suggest that β2M is an independent, significant predictor of mortality, not only in dialysis patients, but also in predialysis patients and in the highrisk portion of the general population, and it seems to be a factor strongly linked to the presence and severity of CV disease. It is still unknown whether β2M is only a uremic toxin marker or if it also has an active role in vascular damage, but data support that it may reflect an increased burden of systemic atherosclerosis in a setting of underlying chronic kidney disease. Thus, although there have been some inconsistencies among the various analyses relating to β2M, it promises to be a novel risk marker of kidney function in the awareness and detection of high-risk patients. However, more research is required to establish the pathophysiological relationships between retained uremic toxins and further biochemical modifications in the uremic milieu to get answers to the questions of why and how. In this review, the recent literature about the changing role of β2M in uremic patients will be examined.展开更多
文摘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.
文摘Atherosclerosis is the early stage of arterial disease, and underlies development of cardiovascular disease (CVD) and stroke. Although sophisticated models for assessing CVD and stroke risk have been derived based on large-scale prospective studies, their abilities in detecting the presence or absence of atherosclerotic plaque have not been investigated. This study aimed to evaluate and compare discriminatory and risk stratifying abilities of 13 CVD risk assessment models against the ultrasound detection of carotid plaques in type 2 diabetes mellitus (T2DM) patients. Forty-nine T2DM subjects were recruited with informed consent, and major anthropomorphic and biomarker data for these models were collected. The model risk scores were evaluated against the carotid plaques detected by Doppler ultrasound. Only the FHS-Lpts-CHD-10Y model, which is a variant of the Framingham model, revealed an area under the receiver operating curve (AUROC) that was significantly different from a random scoring approach (AUROC: 0.681, p was able to stratify the risk levels of carotid plaque presence (Chi-Square statistic: 5.99,
文摘Cardiovascular disease is the predominant cause of death in type 2 diabetes mellitus(T2DM).Evidence suggests a strong association between duration and degree of hyperglycemia and vascular disease.However,large trials failed to show cardiovascular benefit after intensive glycemic control,especially in patients with longer diabetes duration.Atherosclerosis is a chronic and progressive disease,with a long asymptomatic phase.Subclinical atherosclerosis,which is impaired in T2DM,includes impaired vasodilation,increased coronary artery calcification(CAC),carotid intima media thickness,arterial stiffness,and reduced arterial elasticity.Each of these alterations is represented by a marker of subclinical atherosclerosis,offering a cost-effective alternative compared to classic cardiac imaging.Their additional use on top of traditional risk assessment strengthens the predictive risk for developing coronary artery disease(CAD).We,herein,review the existing literature on the effect of glycemic control on each of these markers separately.Effective glycemic control,especially in earlier stages of the disease,attenuates progression of structural markers like intima-media thickness and CAC.Functional markers are improved after use of newer antidiabetic agents,such as incretin-based treatments or sodium-glucose cotransporter-2 inhibitors,especially in T2DM patients with shorter disease duration.Larger prospective trials are needed to enhance causal inferences of glycemic control on clinical endpoints of CAD.
文摘AIM To demonstrate feasibility of vessel wall imaging of the superficial palmar arch using high frequency microultrasound, 7T and 3T magnetic resonance imaging(MRI).METHODS Four subjects(ages 22-50 years) were scanned on a micro-ultrasound system with a 45-MHz transducer(Vevo 2100, Visual Sonics). Subjects' hands were then imaged on a 3T clinical MR scanner(Siemens Biograph MMR) using an 8-channel special purpose phased array carotid coil. Lastly, subjects' hands were imaged on a 7T clinical MR scanner(Siemens Magnetom 7T Whole Body Scanner) using a custom built 8-channel transmit receive carotid coil. All three imaging modalities were subjectively analyzed for image quality and visualization of the vessel wall. RESULTS Results of this very preliminary study indicated that vessel wall imaging of the superficial palmar arch was feasible with a whole body 7T and 3T MRI in comparison with micro-ultrasound. Subjective analysis of image quality(1-5 scale, 1: poorest, 5: best) from B mode, ultrasound, 3T SPACE MRI and 7T SPACE MRI indicated that the image quality obtained at 7T was superior to both 3T MRI and micro-ultrasound. The 3D SPACE sequence at both 7T and 3T MRI with isotropic voxels allowed for multi-planarreformatting of images and allowed for less operator dependent results as compared to high frequency microultrasound imaging. Although quantitative analysis revealed that there was no significant difference between the three methods, the 7T Tesla trended to have better visibility of the vessel and its wall. CONCLUSION Imaging of smaller arteries at the 7T is feasible for evaluating atherosclerosis burden and may be of clinical relevance in multiple diseases.
文摘The role of beta2-microglobulin(β2M) in dialysisrelated amyloidosis as a specific amyloid precursor was defined in the 1980 s. Studies in those years were largely related to β2M amyloidosis. In 2005, for what was probably the first time in the available literature, we provided data about the association betweenβ2M and early-onset atherosclerosis in hemodialysis patients without co-morbidities. In recent years, the role of uremic toxins in uremic atherosclerosis and the interest in β2M as a marker of cardiovascular(CV) and/or mortality risk have grown. In the current literature,clinical studies suggest that β2M is an independent, significant predictor of mortality, not only in dialysis patients, but also in predialysis patients and in the highrisk portion of the general population, and it seems to be a factor strongly linked to the presence and severity of CV disease. It is still unknown whether β2M is only a uremic toxin marker or if it also has an active role in vascular damage, but data support that it may reflect an increased burden of systemic atherosclerosis in a setting of underlying chronic kidney disease. Thus, although there have been some inconsistencies among the various analyses relating to β2M, it promises to be a novel risk marker of kidney function in the awareness and detection of high-risk patients. However, more research is required to establish the pathophysiological relationships between retained uremic toxins and further biochemical modifications in the uremic milieu to get answers to the questions of why and how. In this review, the recent literature about the changing role of β2M in uremic patients will be examined.
