Yin Yue, Li Yan, Ji Xiao-Ping, Zhang Yun, Chen Wen-Qiang
Department of Cardiology, Shandong University Qilu Hospital, Jinan 250012, China.
Zhonghua Xin Xue Guan Bing Za Zhi. 2011 Apr;39(4):343-7. doi: 10.3760/cma.j.issn.0253-3758.2011.04.013.
To detect the optimal predictors of vulnerable atherosclerotic plaques.
Forty New Zealand white rabbits underwent balloon-induced abdominal aortic wall injury and were fed a high cholesterol and saturated fat diet containing 1% cholesterol for 8 weeks. Rabbits were then randomly divided into two groups: group A (n = 20, the aortic segments rich in plaques were incubated transluminally with recombinant adenovirus carrying p53) and group B [n = 20, incubated transluminally with β galactosidase (LacZ) genes]. Two weeks later, rabbits underwent pharmacological triggering with injection of Chinese Russell's viper venom (CRVV) and histamine. Before pharmacologically triggering, concentrations of hs-CRP, sVCAM-1 and sICAM-1 were measured by means of Enzyme-linked-immunosorbent assay (ELISA). Fibrinogen was analyzed by nephelometer. Ultrasound imaging, accuracy densitometry (AD) examination and intravascular ultrasound (IVUS) were performed to analyze the in vivo features of vulnerable plaques. Logistic regression was used to detect the predictors for vulnerable plaques.
The ratio of plaque rupture after pharmacological triggering was significantly higher in group A (89.5%, 17/19) than in group B (22.2%, 4/18). Serum hs-CRP level was significantly higher in plaque rupture group than in non-rupture group before pharmacological triggering (P < 0.05). In the meantime, parameters derived from ultrasound imaging [intima-media thickness (IMT) and peak velocity (VP), values of accuracy densitometry], measurements of IVUS [external elastic membrance area (EEMA), plaque area (PA), plaque burden (PB), eccentric index (EI) and remodeling index (RI)] were significantly larger in plaque rupture group than in non-rupture group. Logistic regression showed that EI (OR = 26.917), PA (OR = 19.301), sVCAM-1 (OR = 1.339) and AII-c% (OR = 0.458) were independent predictors for plaque rupture (all P < 0.05).
The major predictors of vulnerable plaques were eccentric index (EI) and plaque area (PA), sVCAM-1 and AII-c% in this model.
检测易损动脉粥样硬化斑块的最佳预测指标。
40只新西兰白兔接受球囊诱导的腹主动脉壁损伤，并给予含1%胆固醇的高胆固醇和饱和脂肪饮食8周。然后将兔子随机分为两组：A组（n = 20，富含斑块的主动脉节段经腔内用携带p53的重组腺病毒孵育）和B组[n = 20，经腔内用β半乳糖苷酶（LacZ）基因孵育]。两周后，兔子经注射中华蝰蛇毒（CRVV）和组胺进行药理激发。在药理激发前，采用酶联免疫吸附测定（ELISA）法测定hs-CRP、sVCAM-1和sICAM-1的浓度。用散射比浊法分析纤维蛋白原。进行超声成像、精确密度测定（AD）检查和血管内超声（IVUS）以分析易损斑块的体内特征。采用逻辑回归检测易损斑块的预测指标。
药理激发后A组斑块破裂率（89.5%，17/19）显著高于B组（22.2%，4/18）。药理激发前，斑块破裂组血清hs-CRP水平显著高于未破裂组（P < 0.05）。同时，斑块破裂组超声成像得出的参数[内膜中层厚度（IMT）和峰值速度（VP）、精确密度测定值]、IVUS测量值[外弹力膜面积（EEMA）、斑块面积（PA）、斑块负荷（PB）、偏心指数（EI）和重塑指数（RI）]均显著大于未破裂组。逻辑回归显示，EI（OR = 26.917）、PA（OR = 19.301）、sVCAM-1（OR = 1.339）和AII-c%（OR = 0.458）是斑块破裂的独立预测指标（均P < 0.05）。
在该模型中，易损斑块的主要预测指标是偏心指数（EI）、斑块面积（PA）、sVCAM-1和AII-c%。
