2014

2014

Happy New Year
新年快乐
Frohe Neues Jahr
Bonne Année

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High-Intensity Signals in Coronary Plaques

High-Intensity Signals in Coronary Plaques

J Am Coll Cardiol. 2013 Dec 14. pii: S0735-1097(13)06479-6. doi: 10.1016/j.jacc.2013.11.034. [Epub ahead of print]

High-Intensity Signals in Coronary Plaques on Non-contrast T1-Weighted Magnetic Resonance Imaging as a Novel Determinant of Coronary Events.

Mast cells in human carotid atherosclerotic plaques are associated with intraplaque microvessel density and the occurrence of future cardiovascular events

Mast cells in human carotid atherosclerotic plaques are associated with intraplaque microvessel density and the occurrence of future cardiovascular events

Aims Human autopsy, animal, and cell culture studies together have merged in a concept suggesting participation of mast cells (MCs) in the generation of atherosclerotic plaques. More specifically, these studies have suggested MC-induced intraplaque neovascularization as one mechanism by which MCs may render the plaques vulnerable. The present study was designed to assess the association between MC numbers and neovascularization in human atherosclerotic plaques, and to relate the abundance of plaque MCs to the occurrence of adverse cardiovascular events during the follow-up.

Methods and results Atherosclerotic plaques of 270 patients suffering from carotid artery stenosis were stained for the presence of MCs (MC tryptase). Furthermore, during a follow-up of 3 years, cardiovascular-related endpoints were assessed in 253 patients. On average a high number of MCs were observed per plaque cross-section [median 108 (55–233) cells per section]. Plaques with high MC numbers revealed an unstable lipid-rich inflammatory phenotype and were associated with symptomatic patients. In addition, MC numbers were positively associated with microvessel density (r = 0.416, P < 0.001). Patients with high intraplaque MC numbers showed significantly more cardiovascular events during the follow-up (58/142 vs. 31/111 events, P = 0.029). In a multivariate analysis with correction for the main risk factors of cardiovascular diseases, MCs remained independently associated with adverse cardiovascular events (P = 0.025).

Conclusion Mast cells are highly prevalent in human carotid atherosclerotic lesions and associated with plaque microvessel density. Furthermore, intraplaque MC numbers associate with future cardiovascular events.

Chang’e 3 and Yutu

Chang’e 3 and Yutu

in this context see also:

http://en.wikipedia.org/wiki/Introduction_to_Outer_Space

also:

Metabolomics. 2013;9:1134-1156. Epub 2013 Jun 27.

Personalized medicine in human space flight: using Omics based analyses to develop individualized countermeasures that enhance astronaut safety and performance.

http://www.ncbi.nlm.nih.gov/pubmed/24273472

‘The reality of China’

‘The reality of China’

J Am Coll Cardiol. 2013 Nov 19;62(21):2024-5. doi: 10.1016/j.jacc.2013.10.004.

The reality of China.

 
 

Nelson Mandela

Nelson Mandela

Nelson Mandela’s legacy: “Train of hope” bridges health care divide in South Africa

CBS News

DICE

DICE

Article Abstract

 

Improved diagnosis and prognosis using Decisions Informed by Combining Entities (DICE): results from the NHLBI-sponsored Women’s Ischemia Syndrome Evaluation (WISE)

Authors: Mark Doyle, Gerald M. Pohost, C. Noel Bairey Merz, Leslee J. Shaw, George Sopko, William J. Rogers, Barry L. Sharaf, Carl J. Pepine, Diane A. Vido-Thompson, Geetha Rayarao, Lindsey Tauxe, Sheryl F. Kelsey, Douglas Mc Nair, Robert W. Biederman

Abstract

Objectives: To introduce an algorithmic approach to improve the interpretation of myocardial perfusion images in women with suspected myocardial ischemia. 
Background: Gated single photon emission computed tomography (SPECT) and magnetic resonance (MR) myocardial perfusion imaging (MPI) approaches have relatively poor diagnostic and prognostic value in women with suspected myocardial ischemia. Here we introduce an approach: Decisions Informed by Combining Entities (DICE) that forms a mathematical model utilizing MPI and cardiac dimensions generated by one modality to predict the perfusion status of another modality. The effect of the model is to systematically incorporate cardiac metrics that influence the interpretation of perfusion images, leading to greater consistency in designation of myocardial perfusion status between studies. 
Methods: Women (n=213), with suspected myocardial ischemia, underwent MPI assessment for regional perfusion defects using two modalities: gated SPECT (n=207) and MR imaging (n=203). To determine perfusion status, MR data were evaluated qualitatively and semi-quantitatively while SPECT data were evaluated using conventional clinical criteria. These perfusion status readings were designated “Original”. Four regression models were generated to model perfusion status obtained with one modality [e.g., semi-quantitative magnetic resonance imaging (MRI)] against another modality (e.g., SPECT) and a threshold applied (DICE modeling) to designate perfusion status as normal or low. The DICE models included perfusion status, left ventricular (LV) chamber volumes and myocardial wall thickness. Women were followed for 40±16 months for the development of first major adverse cardiovascular event (MACE: CV death, nonfatal myocardial infarction (MI) or hospitalization for congestive heart failure). Original and DICE perfusion status were compared in their ability to detect high-grade coronary artery disease (CAD) and for prediction of MACE. 
Results: Adverse events occurred in 25 (12%) women and CAD was present in 34 (16%). In receiveroperator characteristic (ROC) analysis for CAD detection, the average area under the curve (AUC) for DICE vs. Original status was 0.77±0.03 vs. 0.70±0.03, P<0.01. Similarly, in Kaplan-Meier survival analysis the average log-rank statistic was higher for DICE vs. the Original readings (10.6±5.2 vs. 3.0±0.6, P<0.05). 
Conclusions: While two data sets are required to generate the DICE models no knowledge of follow-up results is needed. DICE modeling improved diagnostic and prognostic value vs. the Original interpretation of the myocardial perfusion status.