Relation of Carotid Atherosclerotic Plaque and Neovascularization

Abstract

Abstract:

The most common cause of ischemic stroke is atherosclerosis, the rupture of carotid atherosclerotic plaque is responsible for most clinical symptoms of stroke. Evidence has shown the correlation between compositional features and plaque vulnerability. Observational studies identify neovascularization as a risk factor in atherosclerotic plaque growth and destabilization. Therefore, the correct understanding of the etiology and pathogenesis of neovascularization could lead to a more accurate plaque vulnerability assessment, the therapy of neovascularization is significant for the treatment and prevention of stroke.

Key words: Atherosclerosis; Carotid atherosclerotic plaque; Neovascularization

摘要：

缺血性卒中最常见的病因是动脉粥样硬化，颈动脉粥样硬化斑块的破裂可导致卒中事件的发生。斑块内的复杂结构特征与斑块的易损性相关。斑块内新生血管是斑块发展和不稳定性增加的危险因素之一。因此，正确认识斑块内新生血管的病因和发病机制，以及与斑块稳定性之间的关系，有利于早期发现颈动脉粥样硬化并正确评估其稳定程度及破裂风险，对于预防和治疗卒中具有重要意义。

关键词: 动脉粥样硬化; 颈动脉粥样硬化斑块; 新生血管

DUAN Wan-Ying*,WANG Yong-Jun.. Relation of Carotid Atherosclerotic Plaque and Neovascularization[J]. Chinese Journal of Stroke, 2014, 9(05): 440-444.

段婉莹1，王拥军2. 颈动脉粥样硬化斑块与新生血管的相关性研究进展[J]. 中国卒中杂志, 2014, 9(05): 440-444.

References

1 Roger VL, Go AS, Lloyd-Jones DM, et al. Heart

disease and stroke statistics--2011 update:a report

from the American Heart Association[J]. Circulation,

2011, 123:18-209.

2 Li u M, Wu B, Wa n g WZ , e t a l . St r o k e i n

China:epidemiology, prevention, and management

strategies[J]. Lancet Neurol, 2007, 6:456-464.

3 Shi FL, Hart RG, Sherman DG, et al. Stroke in the

People's Republic of China[J]. Stroke, 1989, 20:1581-

1585.

4 Golledge J, Greenhalgh RM, Davies AH. The

symptomatic carotid plaque[J]. Stroke, 2000, 31:774-781.

5 Barger AC, Beeuwkes R 3rd, Lainey LL, et al,

Hypothesis vasa vasorum and neovascularization

of human coronary arteries. A possible role in the

pathophysiology of atherosclerosis[J]. N Engl J Med,

1984, 310:175-177.

6 Mancini GB, Dahlof B, Diez J. Surrogate markers

for cardiovascular disease:Instructural markers[J].

Circulation, 2004, 109:22-30.

7 van der Wal AC, Becker AE. Atherosclerotic plaque

rupture pathologic basis of plaque stability and

instability[J]. Cardiovasc Res, 1999, 41:334-344.

8 Virmani R, Kolodgie FD, Burke AP, et al. Lessons

f rom sudden coronar y death:a comprehensive

mo r p h o l o g i c a l c l a s s i f i c a t i o n s c h eme f o r

atherosclerotic lesions[J]. Arterioscler Thromb Vasc

Biol, 2000, 20:1262-1275.

9 Sl a t y HC. Na t u r a l h i s t or y a nd h i s t olog i c a l

classification of atherosclerotic lesions:an update[J].

Arterioscler Thromb Vasc Biol, 2000, 20:1177-1178.

10 Nichols WW, Pepine CJ, O'Rourke MF. Carotidartery

intima and media thickness as a risk factor for

myocardial infarction and stroke[J]. N Engl J Med,

1999, 340:1762-1763.

11 Katsumata T, Nishiyama Y, Yamaguchi H, et al.

Extracranial carotid plaque is increasing in Japanese

ischemic stroke patients[J]. Acta Neurol Scand, 2007,

116:20-25.

12 NACET Collaborators. Beneficial effect of carotid

endarterectomy in symptomatic patients with highgrade

carotid stenosis. North American Symptomatic

Carotid Endarterectomy Trial Collaborators[J]. N

Engl J Med, 1991, 325:445-453.

13 Naghavi M, Libby P, Willerson JT. From vulnerable

plaque to vulnerable patient:a call for new definitions

and risk assessment strategies:PartⅠ[J]. Circulation,

2003, 108:1664-1672.

14 Rothwell PM, Warlow CP. Low risk of ischemic

stroke in patients with reduced internal carotid artery

lumen diameter distal to severe symptomatic carotid

stenosis:cerebral protection due to low poststenotic

f low? On behalf of the European Carotid Surgery

Trialists' Collaborative Group[J]. Stroke, 2000, 31:622-

630.

15 D'Onofrio M1, Mansucto G, Faccioli N, et al. Doppler

ultrasound and contrast enhanced magnetic resonance

angiography in assessing carotid artery stenosis[J].

Radiol Med (Torino), 2006, 111:93-103.

16 Alb e r s GW, Ama r e n c o P, Ea s t o n JD, e t a l .

Ant ith rombot ic and th romboly t ic therapy for

ischemic stroke:the seventh ACCP conference on

antithrombotic and thrombolytic therapy[J]. Chest,

2004, 126:483-512.

17 Ross R. Atherosclerosis-an inflammatory disease[J].

N Engl J Med, 1999, 340:115-126.

18 Le e RT, Libby P. The u ns t able a t he roma [J ].

Arterioscler Thromb Vasc Biol, 1997, 17:1859-1867.

19 Redgr ave JN, Lovet t JK, Gallagher PJ, et al.

Histological assessment of 526 symtomatic carotid

plaques in relation to the nature and timing of

ischemic symptoms:the Oxford plaque study[J].

Circulation, 2006, 113:2320-2328.

20 Takaya N, Yuan C, Chu B, et al. Presence of

intraplaque hemorrhage stimulates progression of

carotid atherosclerotic plaques:a high-resolution

magnetic resonance imaging study[J]. Circulation,

2005, 111:2768-2775.

21 Jeziorska M, Woolley DE. Neovascularization in early

atherosclerotic lesions of human carotid arteries:its potential contribution to plaque development[J]. Hum

Pathol, 1999, 30:919-925.

22 Vi rma n i R, Kolo d g i e FD, Bu r ke AP, e t a l .

Atherosclerotic plaque progression and vulnerability

to rupture:angiogenesis as a source of intraplaque

hemorrhage[J]. Arterioscler Thromb Vasc Biol, 2005,

2:2054-2061.

23 Tenaglia AN, Peters KG, Sketch MH Jr, et al.

Neovascular ization in atherectomy specimens

from patients with unstable angina:implications for

pathogenesis of unstable angina[J]. Am Heart J, 1998,

135:10-14.

24 Moulton KS, Heller E, Konerding MA, et al.

Angiogenesis inhibitors endostatin or TNP-470 reduce

intimal neovascularization and plaque growth in

apolipoprotein E-deficient mice[J]. Circulation, 1999,

99:1726-1732.

25 Moulton KS. Plaque angiogenesis and atherosclerosis[J].

Curr Atheroscler Rep, 2001, 3:225-233.

26 Celletti FL, Waugh JM, Amabile PG, et al. Vascular

endothelial growth factor enhances atherosclerotic

plaque progression[J]. Nat Med, 2001, 7:425-429.

27 Moreno PR, Cor ti R, Fuster V. Understanding

athe roth rombosi s:f rom v ul ne r able plaque to

vulnerable paient[C]. International Congress Series,

2004, 1262:39-44.

28 Ch e n YX, Na k a s h ima Y, Fa n a k a K. e t a l .

Immunohistocheml expression of vascular endothdial

growth factor/vascular permeability factor in

atherosclerotic intimas of human coronary arteries[J].

Arterioscler Thromb Vasc Biol, 1999, 19:131-139.

29 Koole D, Heyligers J, Moll FL, et a1. Intraplaque

neovascularization and hemorrhage:markers for

cardiovascular risk stratification and therapeutic

monitoring[J]. J Cardiovasc Med (Hagerstown), 2012, 13:635-639.

30 杨永宗. 动脉粥样硬化性心血管病基础与临床[M]. 北

京:北京科学出版社, 2004:620.

31 程令刚, 何文, 王立淑. 颈动脉斑块易损性的临床研究

[J]. 中国卒中杂志, 2012, 9:478-480.

32 Kerwin W, Hooker A, Spilker M, et al. Quantitative

ma g n e t i c r e s o n a n c e ima g i n g a n a l y s i s o f

neovasculature volume in carotid atherosclerotic

plaque[J]. Circulation, 2003, 107:851-856.

33 Jiang XB, Yuan WS, Wang JS, et al. Mat r ix

me t a l l o p r o t e i n a s e -9 e x p r e s s i o n i n c a r o t i d

atherosclerotic plaque and contrast-enhanced MRI in

a swine model[J]. J Neurointerv Surg, 2014, 6:24-28.

34 Leong-Poi H, Christiansen J, Klibanov AL, et al.

Noninvasive assessment of angiogenesis by ultrasound

and microbubbles targeted to alpha(v)-integrins[J].

Circulation, 2003, 107:455-460.

35 Rathore S, Terashima M, Matsuo H, et al. Association

of corona r y plaque composit ion and a r t e r ial

remodelling:a optical coherence tomography study[J].

Atherosclerosis, 2012, 221:405-415.

36 Ferrante G, Presbitero P, Whitbourn R, et al. Current

applications of optical coherence tomography for

coronary intervention[J]. Int J Cardiol, 2013, 165:7-16.

37 Teng ZZ, He J, Degnan AJ, et al. Critical mechanical

conditions around neovessels in carotid atherosclerotic

plaque may promote intraplaque hemorrhage[J].

Atherosclerosis, 2012, 223:321-326.

38 Wi l son SH, He r rma n n J, Le rma n LO, e t a1.

Simvastatin preserves the structure of coronary

a d ve n t i t i a l v a s a v a s o r um i n e x p e r ime n t a l

hypercholesterolemia independent of lipid lowering[J].

Circulation, 2002, 105:415-421.

39 魏立亚, 何文. 颈动脉斑块内新生血管的研究现状[J].

中国卒中杂志, 2009, 4:586-589.

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