Assessment and Evaluation of Vascular Vulnerability in Patients with Atherosclerosis: Clinical Examination and Application

动脉粥样硬化患者血管脆弱性的评估与评价：临床检查与应用

基本信息

批准号：
17590753
负责人：
SUGIYAMA Seigo
金额：
$ 2.24万
依托单位：
Kumamoto University, Kumamoto University Hospital
依托单位国家：
日本
项目类别：
Grant-in-Aid for Scientific Research (C)
财政年份：
2005
资助国家：
日本
起止时间：
2005 至 2006
项目状态：
已结题

来源：
https://kaken.nii.ac.jp/en/grant/KAKENHI-PROJECT-17590753/
关键词：
athero sclerosis ultrasound plaque stabilization lipid lowering statin cholesterol endothelial cells diabetes

项目摘要

OBJECTIV ES: Atherosclerotic plaque stabilization is a promising clinical strategy to prevent cardiovascular events in patients with coronary artery disease (CAD). There is a correlation between coronary and carotid plaque instability, and echolucent plaques are recognized as vulnerable plaques. We examined whether intensive cholesterol-lowering therapy with statins in nonhypercholesterolemic patients is effective in improving echolucency of vulnerable plaques assessed by ultrasound with integrated backscatter (IBS) analysis.We also examine whether CD144-EMP (endothelium derived microparticles) is useful as a specific marker of endothelial cell (EC) dysfunction and to determine whether plasma levels of circulating CD144-EMP predicted CAD in patients with type 2 diabetes mellitus (DM).RESULTS : Total cholesterol, low-density lipoprotein cholesterol (LDL-C), and high-sensitivity C-reactive protein were significantly decreased in the statin group. Significant increases of echogenicity of … More carotid plaques were noted in the statin grcup but not in the diet group without significant regression of plaque-IMT values in both groups. We demonstrated that CD144-positive microparticles were derived selectively from human EC. The levels of CD144-EMP reflected the degree of in vitro hydrogen-peroxide-induced EC injury and impairment of in vivo endothelium-dependent coronary vasodilation. Plasma CD144-EMP levels were increased significantly in DM patients compared with patients without DM. In DM patients, the elevated levels of CD144-EMP were the most significant risk factor for CAD relative to all other traditional risk factors.CONCLUSIONS: Statin therapy is rapidly effective in increasing echogenicity of vulnerable plaques without regression of plaque size in nonhypercholesterolemic patients with CAD. Quantitative assessment of carotid plaque quality by ultrasound with IBS is clinically useful for monitoring atherosclerotic lesions by evaluating vulnerability of atheroma. The CD144-positive EMP exist in human plasma, and plasma CD144-EMP levels can be a clinically specific and quantitative marker of EC dysfunction and/or injury. Measurement of CD144-EMP, by providing a quantitative assessment of EC dysfunction, may be useful for identifying DM patients with increased risk of CAD. Less

目的 ES：动脉粥样硬化斑块稳定是预防冠状动脉疾病 (CAD) 患者心血管事件的一种有前景的临床策略。冠状动脉和颈动脉斑块不稳定之间存在相关性，并且透明斑块被认为是易损斑块。 -在非高胆固醇血症患者中使用他汀类药物降低治疗可有效改善易损斑块的回声透明度，通过超声和积分反向散射（IBS）分析进行评估。我们还检查是否CD144-EMP（内皮衍生微粒）可用作内皮细胞 (EC) 功能障碍的特异性标志物，并可用于确定循环 CD144-EMP 的血浆水平是否可预测 2 型糖尿病 (DM) 患者的 CAD。结果：总胆固醇、他汀类药物组的低密度脂蛋白胆固醇（LDL-C）和高敏C反应蛋白显着降低。在他汀类药物组中观察到颈动脉斑块的回声，但在饮食组中没有观察到，两组中的斑块 IMT 值均没有显着下降。我们证明 CD144 阳性微粒选择性地源自人类 EC 水平。 -EMP反映了体外过氧化氢诱导的EC损伤的程度以及体内内皮依赖性冠状血管舒张功能受损的程度。血浆CD144-EMP水平显着升高。与非糖尿病患者相比，在糖尿病患者中，相对于所有其他传统危险因素，CD144-EMP 水平升高是 CAD 的最显着危险因素。结论：他汀类药物治疗可快速有效地增加易损斑块的回声，且不会消退。通过超声结合 IBS 对颈动脉斑块质量进行定量评估，可通过评估颈动脉斑块的脆弱性来监测动脉粥样硬化病变。 CD144 阳性 EMP 存在于人血浆中，并且血浆 CD144-EMP 水平可以作为 EC 功能障碍和/或损伤的定量指标。对于识别 CAD 风险增加的 DM 患者很有用。