Peripheral artery disease is an atherosclerotic disorder which, when present, portends poor patient outcomes. Low diagnosis rates perpetuate poor management, leading to limb loss and excess rates of cardiovascular morbidity and death. Machine learning algorithms and artificially intelligent systems have shown great promise in application to many areas in health care, such as accurately detecting disease, predicting patient outcomes, and automating image interpretation. Although the application of these technologies to peripheral artery disease are in their infancy, their promises are tremendous. In this review, we provide an introduction to important concepts in the fields of machine learning and artificial intelligence, detail the current state of how these technologies have been applied to peripheral artery disease, and discuss potential areas for future care enhancement with advanced analytics.
Background
Arterial restenosis after vascular surgery is a common cause of midterm restenosis and treatment failure. Herein, we aim to investigate the role of microbe‐derived butyrate, FFAR2 (free fatty acid receptor 2), and FFAR3 (free fatty acid receptor 3) in mitigating neointimal hyperplasia development in remodeling murine arteries after injury.
Methods and Results
C57
BL
/6 mice treated with oral vancomycin before unilateral femoral wire injury to deplete gut microbiota had significantly diminished serum and stool butyrate and more neointimal hyperplasia development after arterial injury, which was reversed by concomitant butyrate supplementation. Deficiency of
FFAR
3 but not FFAR2, both receptors for butyrate, exacerbated neointimal hyperplasia development after injury.
FFAR
3 deficiency was also associated with delayed recovery of the endothelial layer in vivo.
FFAR
3 gene expression was observed in multiple peripheral arteries, and expression was increased after arterial injury. Treatment of endothelial but not vascular smooth muscle cells with the pharmacologic
FFAR
3 agonist 1‐methylcyclopropane carboxylate stimulated cellular migration and proliferation in scratch assays.
Conclusions
Our results support a protective role for butyrate and
FFAR
3 in the development of neointimal hyperplasia after arterial injury and delineate activation of the butyrate‐
FFAR
3 pathway as a valuable strategy for the prevention and treatment of neointimal hyperplasia.
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