Department of Cardiology, The First Affiliated Hospital, Cardiovascular Institute, Harbin Medical University, Harbin, Heilongjiang, PR China; Cardiac Ultrasound Division, The First Affiliated Hospital, Cardiovascular Institute, Harbin Medical University, Harbin, Heilongjiang, PR China.
Department of Cardiology, The First Affiliated Hospital, Cardiovascular Institute, Harbin Medical University, Harbin, Heilongjiang, PR China.
Ultrasound Med Biol. 2024 Aug;50(8):1273-1279. doi: 10.1016/j.ultrasmedbio.2024.05.006. Epub 2024 May 25.
It was previously believed that atherosclerotic (AS) plaque starts to develop from the intima and that intraplaque vasa vasorum (VV) hyperplasia promotes adventitial VV (AVV) hyperplasia. However, recent studies have shown that arterial AVV hyperplasia precedes early intimal thickening, suggesting its possible role as an initiating factor of AS. To provide further insight into this process, in this study, we examine the evolution of AAV and VV development in a preclinical model of early AS with longitudinal ultrasound imaging.
Models of early AS were established. Duplex ultrasound scanning and contrast-enhanced ultrasound were performed for diagnosis. Pearson correlation tests were used to analyze the relationships between AVV hyperplasia and VV hyperplasia, or between AVV hyperplasia and intima-media thickness (IMT).
During 0-12 wk of high-fat feeding, AVV gradually increased and intima-media thickened gradually in the observation area; in the 2nd wk of high-fat feeding, the observation area showed obvious AVV proliferation; at the 4th wk, the intima-media membrane became thicker; at the 12th wk, early plaque formation and intraplaque VV proliferation were observed. There was a strong positive correlation between AVV proliferation and IMT thickening and a strong negative correlation between AVV proliferation and the change rate of vessel diameter.
This study demonstrated that AVV proliferation in the arteries occurred earlier than IMT thickening and was positively correlated with IMT. At present, the indicators of ultrasonic diagnosis of AS, such as IMT, Intraplaque VV, Echo property, all appear in the advanced stage of AS. The AVV may be an innovative diagnostic target for the early stage of AS plaque.
先前认为动脉粥样硬化（AS）斑块始于内膜，斑块内血管（VV）增生促进了外膜 VV（AVV）增生。然而，最近的研究表明，动脉 AVV 增生先于早期内膜增厚，提示其可能作为 AS 的起始因素。为了进一步深入了解这一过程，本研究通过纵向超声成像，在早期 AS 的临床前模型中，研究了 AA V 和 VV 发育的演变。
建立早期 AS 模型。采用双功能超声扫描和对比增强超声进行诊断。采用皮尔逊相关检验分析 AVV 增生与 VV 增生之间、AVV 增生与内膜中层厚度（IMT）之间的关系。
在高脂肪喂养的 0-12 周期间，观察区域中的 AVV 逐渐增加，内膜中层逐渐增厚；在高脂肪喂养的第 2 周，观察区域显示出明显的 AVV 增殖；第 4 周时，内膜中层膜变厚；第 12 周时，观察到早期斑块形成和斑块内 VV 增殖。AVV 增殖与 IMT 增厚之间存在强烈的正相关，与血管直径变化率之间存在强烈的负相关。
本研究表明，动脉中的 AVV 增殖发生在 IMT 增厚之前，与 IMT 呈正相关。目前，AS 的超声诊断指标如 IMT、斑块内 VV、回声特性等均出现在 AS 的晚期。AVV 可能是 AS 斑块早期的一个创新性诊断靶点。
