The American Journal of Cardiology

1997

DOI: 10.1016/s0002-9149(96)00670-4

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Frequency and Distribution of Atherosclerotic Plaques in the Thoracic Aorta as Determined by Transesophageal Echocardiography in Patients With Coronary Artery Disease

Shmuel Gottlieb²,

et al.

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Discussion3

Instability Of Plaque In the Aorta Wall And Carotid Artery A1

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Cited by 118 publications

(71 citation statements)

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“…Our patients with CCE also had carotid plaques with similar vulnerable features as the aortic plaques. It is well known that cardiovascular events are associated with unstable plaque in the carotid arteries and thoracic aorta, [23][24][25] and we confirmed in the present study that vulnerable carotid plaques are a surrogate marker of systemic plaque instability.…”

Section: Instability Of Plaque In the Aorta Wall And Carotid Artery Asupporting

confidence: 87%

Combined Assessment of Carotid Vulnerable Plaque, Renal Insufficiency, Eosinophilia, and hs-CRP for Predicting Risky Aortic Plaque of Cholesterol Crystal Embolism

Machino‐Ohtsuka

¹

,

²

,

³

et al. 2010

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Circulation Journal Official Journal of the Japanese Circulation Society http://www. j-circ.or.jp holesterol crystal embolism (CCE) is a serious complication of vascular procedures such as angiography and cardiovascular surgery. Vulnerable aortic plaques are easily disrupted by mechanical contact during the procedure and induce embolization of cholesterol crystals. CCE causes a systemic inflammatory response that leads to multi-organ dysfunction. Effective therapy has not yet been established, and mortality from CCE is still high. 1,2 It has been reported that detection of aortic complex plaques (ACP), which are the embolic source, contributes to prevention of stroke resulting from cardiovascular surgery. 3 We hypothesized that the same theory holds for CCE after catheterization procedures and designed the present studies to confirm this. First, we investigated whether patients with CCE have ACP and second, we evaluated whether patients with ACP tend to present with CCE after catheter-based procedures.Our first study retrospectively evaluated the clinical characteristics and systemic plaque instability of patients with CCE, based on the ultrasound findings of the carotid arteries and aortic wall. Several reports show that patients with CCE have involvement of the carotid arteries as well as the aorta. 4,5 We examined carotid plaque characteristics and confirmed that carotid complex plaques can be a surrogate marker of systemic instability of patients with CCE.The second study was a prospective investigation of the relationship between ACP and CCE. In addition, we aimed to establish criteria for predicting ACP at high risk of leading to CCE. We recruited patients scheduled for catheterization procedures and performed blood tests and ultrasonographic evaluation of the carotid arteries and thoracic aorta. We explored the occurrence of CCE after the catheterization procedures and the factors associated with aortic plaque instability. Background: Cholesterol crystal embolism (CCE) is a serious complication of vascular procedures and based on the clinical features of patients with CCE, the aim of the present study was to establish screening criteria for aortic complex plaques (ACP) at high-risk of CCE.

“…Our patients with CCE also had carotid plaques with similar vulnerable features as the aortic plaques. It is well known that cardiovascular events are associated with unstable plaque in the carotid arteries and thoracic aorta, [23][24][25] and we confirmed in the present study that vulnerable carotid plaques are a surrogate marker of systemic plaque instability.…”

Section: Instability Of Plaque In the Aorta Wall And Carotid Artery Asupporting

confidence: 87%

Combined Assessment of Carotid Vulnerable Plaque, Renal Insufficiency, Eosinophilia, and hs-CRP for Predicting Risky Aortic Plaque of Cholesterol Crystal Embolism

Machino‐Ohtsuka

¹

,

²

,

³

et al. 2010

View full text Add to dashboard Cite

Circulation Journal Official Journal of the Japanese Circulation Society http://www. j-circ.or.jp holesterol crystal embolism (CCE) is a serious complication of vascular procedures such as angiography and cardiovascular surgery. Vulnerable aortic plaques are easily disrupted by mechanical contact during the procedure and induce embolization of cholesterol crystals. CCE causes a systemic inflammatory response that leads to multi-organ dysfunction. Effective therapy has not yet been established, and mortality from CCE is still high. 1,2 It has been reported that detection of aortic complex plaques (ACP), which are the embolic source, contributes to prevention of stroke resulting from cardiovascular surgery. 3 We hypothesized that the same theory holds for CCE after catheterization procedures and designed the present studies to confirm this. First, we investigated whether patients with CCE have ACP and second, we evaluated whether patients with ACP tend to present with CCE after catheter-based procedures.Our first study retrospectively evaluated the clinical characteristics and systemic plaque instability of patients with CCE, based on the ultrasound findings of the carotid arteries and aortic wall. Several reports show that patients with CCE have involvement of the carotid arteries as well as the aorta. 4,5 We examined carotid plaque characteristics and confirmed that carotid complex plaques can be a surrogate marker of systemic instability of patients with CCE.The second study was a prospective investigation of the relationship between ACP and CCE. In addition, we aimed to establish criteria for predicting ACP at high risk of leading to CCE. We recruited patients scheduled for catheterization procedures and performed blood tests and ultrasonographic evaluation of the carotid arteries and thoracic aorta. We explored the occurrence of CCE after the catheterization procedures and the factors associated with aortic plaque instability. Background: Cholesterol crystal embolism (CCE) is a serious complication of vascular procedures and based on the clinical features of patients with CCE, the aim of the present study was to establish screening criteria for aortic complex plaques (ACP) at high-risk of CCE.

“…Growing evidence suggests that there is an important link between specific adipose tissues and cardiovascular diseases, including atherosclerosis, aortic calcification, and peripheral arterial disease (17)(18)(19). The association between TAC and CAD has been demonstrated in previous studies, and traditional cardiovascular risk factors have been shown to share a role in atherosclerosis of the aorta and the coronary arteries (27,28).…”

Section: Discussionmentioning

confidence: 90%

Peri-Aortic Fat Tissue Thickness in Peritoneal Dialysis Patients

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²

,

³

et al. 2012

Perit Dial Int

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BackgroundThoracic peri-aortic fat tissue (PFT) and epicardial adipose tissue (EAT) are metabolically active visceral fat deposits surrounding the thoracic aorta and the heart, respectively. Various studies have demonstrated a positive predictive value of both PFT and EAT for coronary artery disease in the general population. In the present study, we aimed to investigate PFT thickness and the independent predictors of PFT in peritoneal dialysis (PD) patients.MethodsOur cross-sectional study enrolled 35 PD patients (10 women, 25 men) and 30 age-and-sex-matched healthy subjects (15 women, 15 men). We measured PFT, thoracic artery calcification (TAC), EAT, and coronary artery calcification (CAC) by electrocardiogram-gated 64–multi-detector computed tomography.ResultsThe measured PFT, EAT, CAC, and TAC were significantly higher in the PD group than in the healthy subjects ( p < 0.05 each). In the PD group, PFT and TAC were significantly correlated ( r = 0.33, p = 0.007). Also, PFT measurements were positively correlated with EAT and total CAC in the PD and the control group alike ( r = 0.58, p = 0.001 and r = 0.54, p = 0.01 respectively). A stepwise linear regression analysis revealed that age, duration of hypertension, and being a PD patient were independent predictors of PFT.ConclusionsMeasured PFT was higher in PD patients than in healthy subjects and, in the PD population, was also shown to be related to calcification scores and EAT.

“…The presence of aortic atherosclerotic plaques evaluated by means of the widely available TEE appears to be a marker for the presence of significant CAD in general population [1][2][3][13][14][15][16][17][18][19][20][21]. Acarturk et al reported that the sensitivity and specificity of AA in the detection of CAD were 75.9% and 67.7% [1].…”

Section: Discussionmentioning

confidence: 99%

Grade of Aortic Atherosclerosis: A Valuable Adjunct to Coronary Flow Velocity Reserve in the Evaluation of Coronary Artery Disease

¹

,

²

,

³

et al. 2007

Upsala Journal of Medical Sciences

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Background: Atherosclerosis is a generalized disease of the arterial vasculature; among thus it manifests in the descending aorta and the coronary arteries. We tested whether known risk factors, the coronary flow velocity reserve and the grade of aortic atherosclerosis detected by transoesophageal echocardiography in the course of the same semi-invasive examination is able to distinguish between patients with significant left anterior descending coronary artery (LAD) stenosis or with multivessel disease.Methods and results: The present study involved 125 consecutive patients (mean age: 56 11 years, range: 22-73) with chest pain undergoing coronary angiography. Grade of aortic atherosclerosis was obtained by means of transoesophageal echocardiography, and the coronary flow velocity reserve was calculated in the left anterior descending coronary artery. The age (ROC area, 63%, p<0.01), the gender (ROC area, 63%, p<0.02) and the grade of aortic atherosclerosis (ROC area, 64%, p<0.01) exhibited good power for the prediction of patients with multivessel disease from among all other patients. Only the grade of aortic atherosclerosis (ROC area, 63%, p<0.05) appears useful to distinguish patients with left anterior descending coronary artery disease from those with multivessel disease.Conclusions: These results demonstrate that grade of aortic atherosclerosis furnishes additional help in the prediction of patients with severe coronary artery disease. It can differentiate patients with multivessel disease from those with significant left anterior descending coronary artery stenosis. Coronary flow velocity reserve has no any prognostic power in this evaluation. List of abbreviations

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