Carotid artery plaque composition — Relationship to clinical presentation and ultrasound B-mode imaging

Sillesen, Henrik; Nielsen, Tina; Laursen, Henning; Schroeder, Torben V; Gallagher, Patrick J.; Gazzard, V.M.; Campbell, Morgan; Sherriff, S B; Survana, K.; Rogers, Steven K.; Beard, Jonathan; Ackerstaff, R.G.A.; Vanswundrecht, A.; Moll, Frans L.; Elbers, E.; Knappertz, Volker; Sievers, C; Rotatcher, G.; Widder, Bernhard; Goertler, M.; Sliwka, Ulrich; Mess, W.H.; Kardoulas, D.; Gourtsoyannis, G.; Georgopolous, D.; Antoniou, Aris; Galhano-Rodrigues, J.; Pereira, Monica; Hames, T.K.; Arbeille, P; Catalano, M.; Vila, Ramon

doi:10.1016/s1078-5884(05)80194-7

Cited by 165 publications

(4 citation statements)

References 32 publications

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“…Although other studies showed significant correlation between high echogenicity and calcified plaques [ 39 , 40 ], our study did not confirm this association. Our results indicate that the echogenic plaques are predominantly calcified and also some of the echolucent, vulnerable plaques show a variable degree of calcification.…”

Section: ⧉ Discussioncontrasting

confidence: 99%

Osteopontin and osteoprotegerin in atherosclerotic plaque – are they significant markers of plaque vulnerability?

Strobescu-Ciobanu

Giuşcă²,

Căruntu³

et al. 2021

Rom J Morphol Embryol

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Atherosclerosis (ATS) is still considered as a major, global health problem. For a deeper understanding of its pathogenesis, in the last years the research was translated from tissue visible events to molecular mechanisms. Osteopontin (OPN) and osteoprotegerin (OPG) are two molecules that have been associated with the initiation and progression of ATS lesions. The aim of our study was to assess the OPN and OPG expression in advanced stages of carotid ATS, to analyze the correlation between these markers and the ultrasonographic plaque properties, pointing out the identification of possible patterns that can predict plaque vulnerability and risks of restenosis. The study group comprised 49 consecutive patients (38 males and 11 females) diagnosed with carotid stenotic lesions by using ultrasonography. The carotid endarterectomy specimens were standardly processed for histopathological and immunohistochemical exams. The OPN and OPG expression was semi-quantitatively assessed. Our results sustained the relationship between histological American Heart Association (AHA) type and ultrasonographic classification (echogenic versus echolucent) ( p <0.001). The semi-quantitative analysis showed that in most cases (31 plaques) OPG and OPN had opposite expressions, whereas in the remaining cases (18 plaques) the expression was similar. There were no correlations between low versus high expression of intra-plaque OPN and OPG ( p =0.335). We found significant correlation for OPN and plaque echogenicity ( p =0.011), but not for OPG ( p =0.079). OPN expression (low versus high) was correlated with plaque type (stable versus unstable) ( p =0.036), plaque ulceration ( p =0.009) and inflammation ( p <0.001). OPG expression (low versus high) did not reveal statistically significant differences with plaque type (stable versus unstable) and vulnerability plaque parameters, respectively. OPG and OPN co-exist in carotid atherosclerotic plaque demonstrating a modulatory role in inflammatory and calcification processes. OPG is strongly expressed in stable, calcified plaques, while OPN is poorly expressed in calcified plaques and in plaques without hemorrhage, ulceration, inflammation, or necrosis. Starting from the molecular mechanisms, further studies of biomarkers are important to identify new therapeutic resources meant to prevent and treat vascular calcification.

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Section: ⧉ Discussioncontrasting

confidence: 99%

Osteopontin and osteoprotegerin in atherosclerotic plaque – are they significant markers of plaque vulnerability?

Strobescu-Ciobanu

Giuşcă²,

Căruntu³

et al. 2021

Rom J Morphol Embryol

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“…The risk of stroke was predicted estimating the diameter reduction of internal carotid artery (ICA) and evaluating plaque morphology (25). Patients with symptoms of stroke, transient ischemic attack (TIA) or amaurosis fugax within 6 months since diagnosis of carotid artery disease were defined symptomatic (26–28).…”

Section: Methodsmentioning

confidence: 99%

Symptomatic Carotid Atherosclerotic Plaques Are Associated With Increased Infiltration of Natural Killer (NK) Cells and Higher Serum Levels of NK Activating Receptor Ligands

et al. 2019

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A wide array of immune cells, including lymphocytes, is known to be present and to play a pathogenetic role in atherosclerotic lesions. However, limited information is currently available regarding the presence of Natural Killer (NK) cell subsets within vessel plaque, and more in general, regarding their role in human atherosclerosis. We evaluated the distribution of NK cells in human carotid atherosclerotic plaques, dissecting asymptomatic and symptomatic patients (identified as affected by stroke, transient ischemic attack, or amaurosis fugax within 6 months) with the aim of shedding light on the putative contribution of NK cells to the pathogenic process that leads to plaque instability and subsequent clinical complications. We observed that carotid plaques were consistently infiltrated by NK cells and, among them, CD56 bright perforin low NK cells were abundantly present and displayed different markers of tissue residency (i.e., CD103 CD69 and CD49a). Interestingly, carotid atherosclerotic plaques of symptomatic patients showed a higher content of NK cells and an increased ratio between CD56 bright perforin low NK cells and their CD56 dim perforin high counterpart. NK cells isolated from plaques of symptomatic patients were also stronger producers of IFN-γ. Analysis of the expression of NK activating receptor ligands (including MICA/B, ULBP-3, and B7-H6) in atherosclerotic carotid plaques revealed that they were abundantly expressed by a HLA-DR + CD11c + myeloid cell population resident in the plaques. Remarkably, sera of symptomatic patients contained significant higher levels of soluble ligands for NK activating receptors. Our observations indicate that CD56 bright NK cells accumulate within human atherosclerotic lesions and suggest a possible contribution of NK cells to the process determining plaque instability.

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“…We additionally reclassified individuals into 4 clinical categories that have been shown to be useful in terms of future outcomes [16]: Echolucent (lipid- and haemorrhage-rich plaques), mixed (when patients had both echolucent and echo-rich plaques), echogenic (fibrotic or fibro-fatty plaque); and extensively calcified plaques (echo-shadowing from calcifications) as previously described [9]. This classification has been validated against histopathology [9,22] and grey scale medium measured on ultrasound images [23]. The arterial territories explored included the common and internal carotid territories and the bifurcation from the left and right carotid arteries.…”

Section: Methodsmentioning

confidence: 99%

Ultrasound Tissue Characterization of Carotid Plaques Differs Between Patients with Type 1 Diabetes and Subjects without Diabetes

Castelblanco

Betriu

Hernández

et al. 2019

JCM

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The aim of the study was to investigate ultrasound tissue characterization of carotid plaques in subjects with and without diabetes type 1 (T1D). B-mode carotid ultrasound was performed to assess the presence and type of plaque in a group of 340 subjects with and 304 without T1D, all of them without cardiovascular disease. One hundred and seven patients with T1D (49.5% women; age 54 ± 9.8 years) and 67 control subjects without diabetes who had at least one carotid plaque were included in the study. The proportion of subjects who had only echolucent plaques was reduced in the group of patients with T1D (48.6% vs. 73.1%). In contrast, the proportion with only echogenic (25.2% vs. 7.5%) and calcified plaques (9.4% vs. 1.5%) was increased compared with subjects without diabetes. Moreover, having at least one echogenic plaque was more frequent in T1D patients compared with subjects without diabetes (49.5% vs. 26.9% p = 0.005). In addition to diabetes (OR 2.28; p = 0.026), age (OR 1.06, p = 0.002) was the other variable associated with echogenic plaque existence in multiple regression analysis. Patients with T1D exhibit a differential pattern of carotid plaque type compared with subjects without diabetes, with an increased frequency of echogenic and extensively calcified plaques.

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Carotid artery plaque composition — Relationship to clinical presentation and ultrasound B-mode imaging

Cited by 165 publications

References 32 publications

Osteopontin and osteoprotegerin in atherosclerotic plaque – are they significant markers of plaque vulnerability?

Osteopontin and osteoprotegerin in atherosclerotic plaque – are they significant markers of plaque vulnerability?

Symptomatic Carotid Atherosclerotic Plaques Are Associated With Increased Infiltration of Natural Killer (NK) Cells and Higher Serum Levels of NK Activating Receptor Ligands

Ultrasound Tissue Characterization of Carotid Plaques Differs Between Patients with Type 1 Diabetes and Subjects without Diabetes

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