Shoyo ikei o tomonatta nyubo nenekigan : shinkei naibunpitsu bunka no ketsuraku, saibo setchaku kyokusei inshi hatsugen teika o tomonau atarashii sabusetto no kanosei

Purpose: To investigate intraplaque hemorrhage (IPH) development and change over time. Materials and Methods: Institutional review board approval and written informed consent from all participants were obtained. From a population-based study on subclinical atherosclerosis, 40 participants with IPH at baseline magnetic resonance (MR) imaging (53 carotids with IPH) were randomly selected and were matched with 27 control subjects (53 carotids without IPH) to undergo a second MR examination (mean interval, 17 months 6 4 [standard deviation]) to assess IPH change. IPH volume change was evaluated by using both a visual rating scale and an automated volumetric segmentation tool. Cardiovascular risk factors for IPH volume change were investigated with linear regression analyses. Results: IPH remained present in 50 (94%) of the 53 carotids with IPH at baseline, and it developed in fve (7%) of the 40 carotids without IPH at baseline. Visual progression of IPH volume was present in 14 (26%) of the 53 carotids with IPH at baseline, and regression was present in 16 (30%). Mean quantitative change in IPH volume was 213.7 mm3 ± 62.6 per year of follow-up. Male sex (men vs women, 37.7 mm3; 95% confdence interval [CI]: 11.0, 64.4; P =.006), smoking (smokers vs nonsmokers, 45.2 mm3; 95% CI: 7.1, 83.4; P =.020), and hypertension (subjects with hypertension vs those without hypertension, 32.5 mm3; 95% CI: 7.7, 57.2; P =.010) were associated with IPH volume change. Conclusion: During 17 months of follow-up, both visual progression and regression of IPH volume occurs, whereas quantitatively IPH volume decreases. This suggests that IPH is a dynamic process with potential for either growth or resolution over time

Chronic obstructive pulmonary disease and lipid core carotid artery plaques in the elderly: The Rotterdam study

Rationale: Chronic obstructive pulmonary disease (COPD) is an independent risk factor for ischemic stroke and the risk increases with severity of airflow limitation. Even though vulnerable carotid artery plaque components, such as intraplaque hemorrhage and lipid core, place persons at high risk for ischemic events, the plaque composition in patients with COPD has never been explored. Objectives: To investigate the prevalence of carotid wall thickening, the different carotid artery plaque components, and their relationship with severity of airflow limitation in elderly patients with COPD. Methods: This cross-sectional analysis was part of the Rotterdam Study, a prospective population-based cohort study performed in subjects aged 55 years and older. Diagnosis of COPD was confirmed by spirometry. Participants with carotid wall intima-media thickness greater than or equal to 2.5 mm on ultrasonography underwent high-resolution magnetic resonance imaging for characterization of carotid plaques. Data were analyzed using logistic regression. MeasurementsandMainResults:COPDcases(n = 253)hadatwofold increasedrisk (odds ratio, 2.0; 95%confidence interval, 1.44-2.85;P < 0.0001) of presentation with carotid wall thickening on ultrasonography compared with control subjects with a normal lung function (n = 920). Moreover, the risk increased significantly with severity of airflow limitation. On magnetic resonance imaging, vulnerable lipid core plaques were more frequent in COPD cases than in control subjects (odds ratio, 2.1; 95% confidence interval, 1.25-3.69; P = 0.0058). Conclusions: Carotid artery wall thickening is more prevalent in patients with COPD than in control subjects. In elderly subjects with carotid wall thickening, COPD is an independent predictor for the presence of a lipid