The Characteristics of Carotid Plaque in Patients with Carotid Atherosclerotic Stenosis and The Expression of Visfatin in Carotid Plaque_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

 XURong-wei ^1,2 , FANXue-qiang ¹ , PANLin ³ , WENJian-yan ³ , WANGQian ¹ , TIANYu ¹ ,  LIUPeng ¹

1. Department of Cardiovascular Surgery, China-Japan Friendship Hospital, Beijing 100029, China;
2. Graduate School of Peking Union Medical College, Beijing 100073, China;
3. Clinical Institute of China-Japan Friendship Hospital, Beijing 100029, China;

Corresponding author：

LIUPeng, Email: liupeng5417@163.com

Keywords：

Atherosclerosis; Carotid plaque; Destabilization; Visfatin

DOI：

10.7507/1007-9424.20150113

Video：

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Objective To study the characteristics of carotid atherosclerotic plaque and investigate the relationship between visfatin and plaque stabilization. Methods fifty-six patients with carotid stenosis were divided into symptomatic group (n=31) and asymptomatic group (n=25) based on the clinical manifestation and onset time.All plaque specimens were stained with HE and Masson trichrome staining and studied pathologically.The plaques were grouped into stable and unstable plaques based on thickness of the fibrous cap and the area of lipid-rich core in the plaques.The expression of visfatin was detected by immunohistochemistry staining. Results ①The proportion of unstable plaques were significantly higher in symptomatic group than in asymptomatic group (67.74% vs 36.00%, P < 0.05).②Compared with stable plaques, unstable plaques had thinner fibrous cap, larger lipid necrotic core, and higher proportion of hemorrhage: (49.87±8.75)μm vs (74.54±6.80)μm (P < 0.001), (65.63±12.97)% vs (31.81±5.13)% (P < 0.001), and 63.33% vs 30.77% (P < 0.05).③The integral optical density value of expressed visfatin in unstable plaques was significantly more than in stable plaques (84 165.47±9 183.12 vs 55 694.08±4 818.57, P < 0.001). Conclusions The plaque destabilization is closely related to the clinical symptoms of atherosclerosis.The thickness of fibrous cap, area of lipid-rich core, and hemorrhage play an important role in the plaque stabilization.The visfatin is related to atherogenesis and plaque destabilization.

Citation： XURong-wei, FANXue-qiang, PANLin, WENJian-yan, WANGQian, TIANYu, LIUPeng. The Characteristics of Carotid Plaque in Patients with Carotid Atherosclerotic Stenosis and The Expression of Visfatin in Carotid Plaque. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2015, 22(4): 434-438. doi: 10.7507/1007-9424.20150113 Copy

1.	Faggioli GL, Pini R, Mauro R, et al.Identification of carotid' vulnerable plaque' by contrast-enhanced ultrasonography:correlation with plaque histology, symptoms and cerebral computed tomography.EurJ Vasc Endovasc Surg, 2011, 41(2):238-248.
2.	Ren S, Liu P, Ma G, et al.Long-term outcomes of synchronous carotid endarterectomy and coronary artery bypass grafting versus solely carotid endarterectomy.Ann Thorac Cardiovasc Surg, 2012, 18(3):228-235.
3.	Kadoglou NP, Sailer N, Moumtzouoglou A, et al.Aggressive lipid-lowering is more effective than moderate lipid-lowering treatment in carotid plaque stabilization.J VascSurg, 2010, 51(1):114-121.
4.	Yun MR, Seo JM, Park HY.Visfatincontributes to the differentiation of monocytes into macrophages through the differential regulation of inflammatory cytokines in THP-1cells.Cell Signal, 2014, 26(4):705-715.
5.	Alsheikh-Ali AA, Kitsios GD, Balk EM, et al.The vulnerable atherosclerotic plaque:scope of the literature.Ann Intern Med, 2010, 153(6):387-395.
6.	Naghavi M, Libby P, Falk E, et al.From vulnerableplaque to vulnerable patient:a call for new definitionsand risk assessment strategies:PartⅠ.Circulation, 2003, 108(14):1664-1672.
7.	van der Wal AC, Becker AE.Atherosclerotic plaque rupture pathologic basis of plaque stability and instability.Cardiovasc Res, 1999, 41(2):334-344.
8.	D'Onofrio M, Mansueto G, Faccioli N, et al.Dopplerultrasound and contrast enhanced magnetic resonanceangiography in assessing carotid artery stenosis.Radiol Med, 2006, 111(1):93-103.
9.	Fukuhara A, Matsuda M, Nishizawa M, et al.Visfatin:a protein secreted by visceral fat that mimics the effects of insulin.Science, 2005, 307(5708):426-430.
10.	Romacho T, Villalobos LA, Cercas E, et al.Visfatin as a novel mediator released by inflamed human endothelial cells.PLoS One, 2013, 8(10):e78283.
11.	Roifman I, Beck P, Anderson TJ, et al.Chronic inflammatory disease and cardiovascular risk:a systemic review.Can J Cardiol, 2011, 27(2):174-182.
12.	Dahl TB, Yndestad A, Skjelland M, et al.Increased expression of visfatin in macrophage of human unstable carotid and coronary atherosclerosis:possible role in inflammation and plaque destabilization.Circulation, 2007, 115(8):972-980.
13.	Moschen AR, Kaser A, Enrich B, et al.Visfatin, an adipocytokine with proinflammatory and immunomodulating properties.J Immunol, 2007, 178(3):1748-1758.
14.	van der Veer E, Nong Z, O'Neil C, et al.Pre-B-cell colony-enhancing factor regulates NAD+-dependent protein deacetylase activity and promotes vascular smooth muscle cell maturation.Circ Res, 2005, 97(1):25-34.
15.	Kadoglou NP, Sailer N, Moumtzouoglou A, et al.Adipokines:a novel link between adiposity and carotid plaque vulnerability.Eur J Clin Invest, 2012, 42(12):1278-1286.
16.	孔庆霞, 夏敏, 蔡高梅, 等.脂肪因子visfatin与脑梗死发病机制的相关性研究.卒中与神经疾病, 2011, 18(4):226-228, 204.
17.	Orbe J, Fernandez L, Rodríguez JA, et al.Different expression of MMPs/TIMP-1 in human atherosclerotic lesions.Relation to plaque features and vascular bed.Atherosclerosis, 2003, 170(2):269-276.
18.	Loftus IM, Naylor AR, Goodall S, et al.Increased matrix metalloproteinase-9 activity in unstable carotid plaques.A potential role in acute plaque disruption.Stroke, 2000, 31(1):40-47.

1. Faggioli GL, Pini R, Mauro R, et al.Identification of carotid' vulnerable plaque' by contrast-enhanced ultrasonography:correlation with plaque histology, symptoms and cerebral computed tomography.EurJ Vasc Endovasc Surg, 2011, 41(2):238-248.
2. Ren S, Liu P, Ma G, et al.Long-term outcomes of synchronous carotid endarterectomy and coronary artery bypass grafting versus solely carotid endarterectomy.Ann Thorac Cardiovasc Surg, 2012, 18(3):228-235.
3. Kadoglou NP, Sailer N, Moumtzouoglou A, et al.Aggressive lipid-lowering is more effective than moderate lipid-lowering treatment in carotid plaque stabilization.J VascSurg, 2010, 51(1):114-121.
4. Yun MR, Seo JM, Park HY.Visfatincontributes to the differentiation of monocytes into macrophages through the differential regulation of inflammatory cytokines in THP-1cells.Cell Signal, 2014, 26(4):705-715.
5. Alsheikh-Ali AA, Kitsios GD, Balk EM, et al.The vulnerable atherosclerotic plaque:scope of the literature.Ann Intern Med, 2010, 153(6):387-395.
6. Naghavi M, Libby P, Falk E, et al.From vulnerableplaque to vulnerable patient:a call for new definitionsand risk assessment strategies:PartⅠ.Circulation, 2003, 108(14):1664-1672.
7. van der Wal AC, Becker AE.Atherosclerotic plaque rupture pathologic basis of plaque stability and instability.Cardiovasc Res, 1999, 41(2):334-344.
8. D'Onofrio M, Mansueto G, Faccioli N, et al.Dopplerultrasound and contrast enhanced magnetic resonanceangiography in assessing carotid artery stenosis.Radiol Med, 2006, 111(1):93-103.
9. Fukuhara A, Matsuda M, Nishizawa M, et al.Visfatin:a protein secreted by visceral fat that mimics the effects of insulin.Science, 2005, 307(5708):426-430.
10. Romacho T, Villalobos LA, Cercas E, et al.Visfatin as a novel mediator released by inflamed human endothelial cells.PLoS One, 2013, 8(10):e78283.
11. Roifman I, Beck P, Anderson TJ, et al.Chronic inflammatory disease and cardiovascular risk:a systemic review.Can J Cardiol, 2011, 27(2):174-182.
12. Dahl TB, Yndestad A, Skjelland M, et al.Increased expression of visfatin in macrophage of human unstable carotid and coronary atherosclerosis:possible role in inflammation and plaque destabilization.Circulation, 2007, 115(8):972-980.
13. Moschen AR, Kaser A, Enrich B, et al.Visfatin, an adipocytokine with proinflammatory and immunomodulating properties.J Immunol, 2007, 178(3):1748-1758.
14. van der Veer E, Nong Z, O'Neil C, et al.Pre-B-cell colony-enhancing factor regulates NAD+-dependent protein deacetylase activity and promotes vascular smooth muscle cell maturation.Circ Res, 2005, 97(1):25-34.
15. Kadoglou NP, Sailer N, Moumtzouoglou A, et al.Adipokines:a novel link between adiposity and carotid plaque vulnerability.Eur J Clin Invest, 2012, 42(12):1278-1286.
16. 孔庆霞, 夏敏, 蔡高梅, 等.脂肪因子visfatin与脑梗死发病机制的相关性研究.卒中与神经疾病, 2011, 18(4):226-228, 204.
17. Orbe J, Fernandez L, Rodríguez JA, et al.Different expression of MMPs/TIMP-1 in human atherosclerotic lesions.Relation to plaque features and vascular bed.Atherosclerosis, 2003, 170(2):269-276.
18. Loftus IM, Naylor AR, Goodall S, et al.Increased matrix metalloproteinase-9 activity in unstable carotid plaques.A potential role in acute plaque disruption.Stroke, 2000, 31(1):40-47.

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CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

The Characteristics of Carotid Plaque in Patients with Carotid Atherosclerotic Stenosis and The Expression of Visfatin in Carotid Plaque

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