Nutrition, atherosclerosis, arterial imaging, cardiovascular risk stratification, and manifestations in COVID-19 framework: a narrative review

Abstract

Background: Atherosclerosis is the primary cause of the cardiovascular disease (CVD). Several risk factors lead to atherosclerosis, and altered nutrition is one among those. Nutrition has been ignored quite often in the process of CVD risk assessment. Altered nutrition along with carotid ultrasound imaging-driven atherosclerotic plaque features can help in understanding and banishing the problems associated with the late diagnosis of CVD. Artificial intelligence (AI) is another promisingly adopted technology for CVD risk assessment and management. Therefore, we hypothesize that the risk of atherosclerotic CVD can be accurately monitored using carotid ultrasound imaging, predicted using AI-based algorithms, and reduced with the help of proper nutrition. Layout: The review presents a pathophysiological link between nutrition and atherosclerosis by gaining a deep insight into the processes involved at each stage of plaque development. After targeting the causes and finding out results by low-cost, user-friendly, ultrasound-based arterial imaging, it is important to (i) stratify the risks and (ii) monitor them by measuring plaque burden and computing risk score as part of the preventive framework. Artificial intelligence (AI)-based strategies are used to provide efficient CVD risk assessments. Finally, the review presents the role of AI for CVD risk assessment during COVID-19. Conclusions: By studying the mechanism of low-density lipoprotein formation, saturated and trans fat, and other dietary components that lead to plaque formation, we demonstrate the use of CVD risk assessment due to nutrition and atherosclerosis disease formation during normal and COVID times. Further, nutrition if included, as a part of the associated risk factors can benefit from atherosclerotic disease progression and its management using AI-based CVD risk assessment.

Aterosclerosis, Cardiovascular Disorders And Covid-19: Comorbid Pathogenesis

“…It is suggested that vasculitis and thrombosis of the aortic vasa vasorum may represent key factors linking severe forms of SARS-CoV-2 infection with transformation of a stable plaque into an unstable lesion with thromboembolic consequences [63]. The impact of SARS-CoV-2 on large vessels such as the aorta is more complex than has been previously considered.…”

“…Direct cytopathic effect of the virus on endothelial cells [69] Protease activation, causing a transition from a stable to a pathological atherosclerotic injury and the degradation of the plaque protective fibrous cap. [9,42] Leucocyte recruitment and adhesion to the vascular wall [12] Expression of pro-inflammatory chemokines and cytokines (CXCL1, CXCL2, CXCL3, CXCL8, IL-1β) in the vascular wall resulted from the activation of MyD88-dependent pathways [1,34] VEGLX damage [36] Mitochondrial dysfunction leading to the increased production of reactive oxygen species [33] Endothelial damage caused by neutrophil extracellular traps (NETs) [53] Endothelial damage caused by the components of the activated complement system [52] Vasa vasorum vasculitis and/or thrombosis [63] Interestingly, pharmacological agents commonly used in the treatment of atherosclerosis, such as statins and acetylsalicylic acid, seem to reduce both the incidence of serious complications of COVID-19 and the death rate from this infection. The possible effects of chronic therapy with acetylsalicylic acid have not been fully studied.…”

The prognostic value of prognostic nutritional index and renal function indicators for mortality prediction in severe COVID-19 elderly patients: A retrospective study

“…[ 13 , 14 ] Additionally, COVID-19 symptoms promote malnutrition, and its presence is associated with higher mortality and longer hospital stays. [ 15 – 17 ] The prognostic nutritional index (PNI) is an effective indicator that reflects COVID-19 severity and mortality. [ 18 ] Therefore, this study will be the first to construct a combination of nutritional and kidney function indicators to determine whether they can better predict disease progression than individual predictors.…”

Cross-Sectional Association of Dietary Patterns and Supplement Intake with Presence and Gray-Scale Median of Carotid Plaques—A Comparison between Women and Men in the Population-Based Hamburg City Health Study

“…In addition to GSM, the presence of carotid plaque is associated with the incidence of CVD events [ 29 , 30 ] and is further an established ultrasound surrogate of CVD [ 31 , 32 ]. Nutritional aspects are known to play a relevant role in the development of atherosclerosis and in the formation of plaques [ 33 ]. Hence, it is of great interest how both can be influenced through diet.…”