tbuckley/cabot-search huggingface dataset:
Abstract 384: Pirfenidone Protects the Heart Through Immune Modulation of Subsets of Cardiac B Lymphocytes
Authors: Luigi Adamo
Journal: Circulation Research (2018)

Despite the long-standing recognition that the immune response to acute myocardial injury contributes to adverse left ventricular (LV) remodeling, it has not been possible to effectively target inflammation clinically. Using two different in vivo models of acute myocardial injury, we show that Pirfenidone confers beneficial effects in the murine heart through a new mechanism that depends upon cardiac B lymphocytes. Naïve hearts contained a large novel population of CD19 + CD11b - CD23 - CD21 - IgD + IgM low lymphocytes, and two smaller populations of CD19 + CD11b + B1a and B1b cells. In response to tissue injury, there was an increase in neutrophils, monocytes, macrophages, as well as an increase in CD19 + CD11b - B lymphocytes. Treatment with Pirfenidone had no effect on the number of neutrophils, monocytes, or macrophages, but decreased CD19 + CD11b - lymphocytes. B cell depletion abrogated the beneficial effects of Pirfenidone. In vitro studies demonstrated that stimulation with lipopolysaccharide and extracts from necrotic cells activated CD19 + lymphocytes through a TIRAP dependent pathway. Treatment with Pirfenidone attenuated this activation of B cells. These findings reveal a previously unappreciated complexity of myocardial B lymphocytes within the inflammatory infiltrate triggered by cardiac injury and suggest that Pirfenidone exerts beneficial effects in the heart through a unique mechanism that involves modulation of cardiac B lymphocytes.
Meta-analysis of penile cancer: conceptual interpretations – Authors' reply
Authors: Vanna Albieri, Tina Bech Olesen, Freja Lærke Sand, Christina Louise Rasmussen, Birgitte Grønkær Toft, Bodil Norrild, Christian Munk, Susanne Krüger Kjær
Journal: The Lancet Oncology (2019)
ACUTE ONSET AUTONOMIC DYSFUNCTION AS AN EARLY MANIFESTATION OF CHAGAS DISEASE
Authors: Nickolas O. Dohmann, Carolina Cunto De Athayde, Monica Luna, Andrea Cristina Silva da Costa, Sebastiao Carlos Castilho, Nadia Albuquerque, Fabio Akio Nishijuka, Sabrina Pedrosa, Leonardo Nunes, Marcia Campos, Renata Castro
Journal: Journal of the American College of Cardiology (2019)
Abstract 491: Cardiomyocyte Braf Promotes Hypertrophy and is Required for Hypertrophic Adaptation to Hypertension in Mice In Vivo, but Raf Inhibitors Have Differential Effects
Authors: Daniel N Meijles, Kerry A Rostron, Stephen J Fuller, Peter H Sugden, Angela Clerk
Journal: Circulation Research (2018)

Introduction: Raf kinases lie upstream of ERK1/2 with BRaf having the highest activity. ERK1/2 promote hypertrophy/cardioprotection, but the role of BRaf in the adult heart is unclear. BRaf mutations cause cancer and Raf inhibitors (Rafi) are used but, paradoxically, they can activate ERK1/2 and the cardiac consequences remain to be established. Hypothesis: We hypothesise that BRaf is critical in regulating ERK1/2 signaling in cardiomyocytes and Rafi affect cardiac function. Methods: We studied 8 wk wild-type male C57Bl/6 mice, or mice with cardiomyocyte-specific tamoxifen-inducible knock-in of activating BRaf(V600E) or BRaf knockout (BRafKO). V600E and BRafKO mice received vehicle or tamoxifen (40mg/kg; 6-12 mice per group). Mice were also treated with 0.8 mg/kg/d AngII, 0.5 mg/kg/d SB590885 (SB), 3 mg/kg/d dabrafenib (Dab) or vehicle delivered by osmotic minipumps. Echocardiography was performed and data for each mouse were normalized to the mean of 2 baseline control scans. Kinase activities and mRNA expression were assessed by immunoblotting and qPCR. Results: Knockin of BRaf(V600E) activated ERK1/2 and increased expression of ERK1/2 dependent genes (24h). By 7 d, there was increased ejection fraction (24%) and cardiac output (17%) with increased systolic left ventricular (LV) posterior wall (PW) thickness (13%). Cardiac function normalised by 10 d, but there was significant hypertrophy with increased LVPW in systole/diastole (11-19%) and decreased LV internal diameter. BRafKO alone did not affect cardiac function/dimensions or changes in function induced by AngII, but loss of BRaf inhibited the increase in systolic/diastolic LVPW (30% increase with AngII alone vs 9% with AngII/BRafKO). SB (type I Rafi), but not Dab (type 1.5 Rafi) activated cardiomyocyte ERK1/2 and induced hypertrophy in cultured neonatal rat ventricular myocytes. Consistent with this, SB (not Dab) promoted cardiac hypertrophy in vivo with increased LVPW (3d), but Dab (not SB) inhibited AngII-induced hypertrophy (7 d). Conclusions: Activation of cardiomyocyte BRaf promotes cardiac hypertrophy and cardiomyocyte BRaf is required for AngII-induced hypertrophy. However, Rafi developed for cancer have differential effects on the heart according to their mode of action.
Abstract 554: Mechanism of Action for the Beneficial Effects of Cortical Bone Stem Cells on the Heart After Myocardial Infarction
Authors: Giana J Schena, Hajime Kubo, Eric Feldsott, Remus Berretta, Sadia Mohsin, Steven R Houser
Journal: Circulation Research (2018)

Rationale: Myocardial infarction (MI) causes the death of a portion of the heart and can lead to adverse remodeling that results in poor cardiac pump function and heart failure. We have previously shown that a novel stem cell type, cortical bone stem cells (CBSCs), causes improved repair of cardiac tissue after MI. When injected into the infarct border zone in both mouse and pig hearts, CBSCs reduced infarct size and induced neovascularization via a largely paracrine manner. Objectives: This study investigates the mechanism involved in the angiogenesis alterations implemented by CBSCs, in particular the wound-healing of endothelial cells. Our goal was to comprehend how mCBSCs affected cardiac repair in an inflammatory environment. Methods and Results: We performed scratch assays and tubule formation (TF) assays on human umbilical vein endothelial cells (HUVECs) and cardiac endothelial cells (CECs) in mCBSC CM and media controls, and in the presence of pro-inflammatory cytokines such as IL-1β, IL-6, and TNF-α. Both HUVECs and CECs show reduced cell migration and reduced TF. TF was rescued when the cells were plated on Matrigel. We investigated the angiogenesis-related cytokines present within both the mCBSC CM and CM-treated HUVECs and CECs via angiogenesis dot blots. We discovered a significant increase of CXCL-10 and Endostatin/Collagen XVIII relative to murine embryonic fibroblast CM. Conclusions: Our findings show that part of the mechanism underlying the wound-healing and neovascularization induced by CBSCs post-MI involves secretion of angiogenesis-related cytokines which alter the behavior of cardiac endothelial cells.
Prophylaxis of Chemotherapy-Induced Nausea and Vomiting with Fosaprepitant and Granisetron in Pediatric Patients after Allogeneic HSCT
Authors: Karin Melanie Cabanillas Stanchi, Julia Vek, Patrick Schlegel, Christian M. Seitz, Joachim Rupprecht, Sarah Schober, Sebastian Michaelis, Carmen Malaval, Tim Flaadt, Lukas Schnaufer, Manon Queudeville, Judith Feucht, Peter Lang, Rupert Handgretinger, Michaela Döring
Journal: Blood (2018)
COMPARING OUTCOMES FOLLOWING 1 YEAR OF DUAL ANTIPLATELET THERAPY IN PATIENTS WITH HIGH AND LOW PRECISE-DAPT SCORES
Authors: Rene Boudreau, Angel Fu, Quinton Barry, Dylan Perry-Nguyen, Uyen Tran, Trevor Simard, Michel Le May, Marino Labinaz, Alexander Dick, Christopher Glover, Michael Froeschl, Benjamin Hibbert, Aun-Yeong Chong, Derek So
Journal: Journal of the American College of Cardiology (2019)
Molecular Profiling of Relapsed and Refractory Myeloma Identifies Frequent Bi-Allelic Driver Events — Interim Results of the 'Myeloma UK Seven' Biomarker Trial
Authors: Amy L Sherborne, Vallari Shah, Andrew Hall, Katrina Walker, Sidra Ellis, Farzana Begum, David C Johnson, James Croft, Jack Kendall, Charlotte Pawlyn, Lilit Atanesyan, Suvi Savola, Louise Flanagan, Anjan Thakurta, Mamta Garg, Gordon Cook, Kevin Boyd, Sarah Brown, Martin F Kaiser
Journal: Blood (2017)
RENAL DENERVATION FOR RESISTANT HYPERTENSION IN THE CONTEMPORARY ERA: A SYSTEMATIC REVIEW AND META-ANALYSIS
Authors: Pradyumna Agasthi, Justin Shipman, Reza Arsanjani, Moses Ashukem, Marlene E. Girardo, Charan Yerasi, Nithin R. Venepally, Floyd Fortuin, Farouk Mookadam
Journal: Journal of the American College of Cardiology (2019)
INPATIENT OUTCOMES OF SINGLE VERSUS COMBINED MECHANICAL CIRCULATORY SUPPORT DEVICES IN PATIENTS WITH CARDIOGENIC SHOCK OF ISCHEMIC ETIOLOGY
Authors: Mohit Pahuja, Sagar Ranka, Omar Chehab, Mohamed Shokr, Shruti Mony, Tomo Ando, Hossam Abubakar, Ahmed Yassin, Alexandros Briasoulis, Luis Afonso
Journal: Journal of the American College of Cardiology (2019)
RISKS OF INCIDENT CARDIOVASCULAR DISEASE ASSOCIATED WITH CONCOMITANT ELEVATIONS IN LIPOPROTEIN(A) AND LOW-DENSITY LIPOPROTEIN CHOLESTEROL: THE FRAMINGHAM HEART STUDY
Authors: Mehdi Afshar, Jian Rong, Yang Zhan, Hao Yu Chen, James Engert, Allan Sniderman, Martin Larson, Vasan Ramachandran, George Thanassoulis
Journal: Journal of the American College of Cardiology (2019)
Abstract 269: RBM20 Knockout Ameliorates Angiotensin II Induced Hypertension and Cardiac Hypertrophy
Authors: Chaoqun Zhu, Sreejayan Nair, Jun Ren, Wei Guo
Journal: Circulation Research (2018)

Introduction: RNA binding motif 20 (RBM20) is a muscle specific splicing factor that has been implicated in heart failure (HF). RBM20 regulates mRNA splicing of titin, a giant muscle protein that is expressed in cardiac and smooth muscles and plays a major role in passive stiffness of them. RBM20 knockout (KO) results in less myocardial stiffness by inducing large titin isoform expression. Hence, we hypothesize that RBM20 decreases arterial stiffness through large titin isoform expression, and thus reduces blood pressure (BP) in hypertension. The aim of this study was to investigate whether RBM20 could be a therapeutic target to reduce BP in patients with hypertension and prevent HF progression. Methods: Male wild type (WT) (Sprague-Dawley х Brown Norway) and Rbm20 KO rats (n=10 each) were subcutaneously implanted with osmotic mini-pump to continuously release angiotensin II (Ang II) at a rate of 400 ng/kg/min for 28 days. BP was measured by noninvasive tail-cuff system weekly. Pulse wave velocity (PWV) was measured by Doppler system. Cardiac remodeling was evaluated by echocardiography. Biochemistry and histological analyses were performed on aorta and heart tissues. Results: Larger titin isoform was increased and no difference of elastin and collagen expression was observed in RBM20 KO blood vessels when compared to WT. Basal BPs were the same in WT and KO rats (diastolic BP, KO 91.75 ± 1.83 vs. WT 94.33±1.88 mmHg; systolic BP, KO 127.6 ± 0.97 vs. WT 128.0 ± 1.35 mmHg). Ang II increased BP in both WT and KO rats, but KO had a significantly lower BP than WT (diastolic BP, KO 141.7 ± 5.00 vs. WT 182.0±4.84 mmHg; systolic BP, KO 195.4 ± 3.671 vs. WT 226.4 ± 3.093 mmHg, P&lt;0.0001). PWV is lower in KO rats than in WT (KO 4.035 ± 0.21 mm/s vs. WT 5.128±0.37 mm/s, P&lt;0.05). Cardiac hypertrophy was developed in both WT and KO hearts treated with Ang II, but it was alleviated in the KO heart (left ventricular wall, KO 0.324 ± 0.01 cm vs. WT 0.368 ± 0.013 cm, P&lt;0.05). Conclusions: RBM20 KO reduces arterial stiffness through increased larger titin isoform expression, decreases Ang II-induced hypertension, and prevents HF progression. These findings suggest that RBM20 could be a potential novel target for the treatment of hypertension and hypertension-induced cardiac hypertrophy.
PREDICTORS OF VENTRICULAR ARRHYTHMIA IN PATIENTS WITH SPONTANEOUS CORONARY ARTERY DISSECTION: INSIGHTS FROM THE G-SCAD REGISTRY
Authors: Amin Daoulah, Karim Al-Azizi, Andaleeb Doula, Ahmad Hersi, Alawi A. Alsheikh-Ali, Mohammed Alshehri, Abdulrahman Ghazi, Abdul Khan, Hisham Husain, Wael Refaat, Akram El-Desoky, Mohammed Balghith, Muhammad Soofi, Mushabab Al-Murayeh, Salem Al-Faifi, Tarek Farghali, Salem Al-Kaabi, Amir Lotfi
Journal: Journal of the American College of Cardiology (2019)
INCIDENT HEART FAILURE AFTER ACUTE MYOCARDIAL INFARCTION: AN ANALYSIS FROM THE NCDR REGISTRIES LINKED WITH ALL-PAYER CLAIMS DATABASE
Authors: Eric Alexander Secemsky, Eileen Fonseca, Narinder Bhalla, Kamil Faridi, Amir Singh, Thomas W. Wilson, Robert Yeh
Journal: Journal of the American College of Cardiology (2019)
PARACELSUS 评分:坏疽性脓皮病的一个诊断工具
Authors: F. Jockenh€ofer, U. Wollina, K.A. Salva, S. Benson, J. Dissemond
Journal: British Journal of Dermatology (2019)

坏疽性脓皮病 (PG) 是一种罕见的可治疗的皮肤病,可导致溃疡 ‐ 通常为单个,但有时为多个。它没有传染性。通常通过排除其他有相似症状的疾病来诊断,该病可能被误诊。这项来自德国的研究的目的是建立一个包括 PG 专属症状和特征的评分系统,这一系统易于在诊所中用于诊断该病。通过 60 名之前确诊 PG 的参与者和一个对照组(由 50 名非 PG 导致的腿部溃疡患者组成)检测了这一名为 PARACELSUS 的评分系统。包括在这一评分系统中的标准涉及溃疡外观、溃疡如何进展和哪些药物有助于清除它。作者们得出结论称, 根据他们的检测, PARACELSUS 评分是一种易于实施的高效准确 PG 诊断工具。
The Usefulness of Improved, Newly Developed Polyolefin Container of Platelet, PO-100, with Higher Oxygen Permeability and Content
Authors: Kazuhiro Nagai, Hiroya Nakamura, Yoshito Koga, Hiroshi Harada, Chiaki Yakushiji, Eiji Kino, Motoko Tokunaga, Hisatoki Yamaoka, Yasushi Miyazaki
Journal: Blood (2018)
TRANS ESOPHAGEAL ECHOCARDIOGRAM DETECTS TRIPLE THREATS (ATHEROMA, PATENT FORAMEN OVALE AND LARGE LAMBL'S EXCRESCENCE): A CASE OF RECURRENT EMBOLIC STROKE OF UNDETERMINED SOURCE
Authors: Hemalatha Narayanasamy, Samuel Unzek Freiman
Journal: Journal of the American College of Cardiology (2019)
SAFETY AND EFFICACY OF THE BIOABSORBABLE POLYMER EVEROLIMUS ELUTING STENTS COMPARED TO THE 2ND GENERATION DURABLE POLYMER EVEROLIMUS ELUTING STENTS IN COMPLEX CORONARY LESIONS
Authors: Natraj Katta, Usman Baber, Nitin Barman, Asaad Khan, Joseph Sweeny, Neil Patel, Ruchir Patel, Choudhury Hasan, Roxana Mehran, Samin Sharma, Annapoorna Kini
Journal: Journal of the American College of Cardiology (2019)
NUTM1 Is a Rare but Recurrent Fusion Gene Partner in B Cell Precursor Acute Lymphoblastic Leukemia Associated with Increased Expression of Genes on Cytoband 10p12.31
Authors: Femke M. Hormann, Alex Q. Hoogkamer, H. Berna Beverloo, Aurélie Boeree, Ronald W. Stam, Gabriele Escherich, Rob Pieters, Monique L. Den Boer, Judith M. Boer
Journal: Blood (2018)
CONTEMPORARY OUTCOMES OF CHRONIC TOTAL OCCLUSION INTERVENTIONS FOR IN-STENT RESTENOSIS OCCLUSIONS: UPDATE FROM AN INTERNATIONAL MULTICENTER REGISTRY
Authors: Peter Tajti, Dimitrios Karmpaliotis, Khaldoon Alaswad, Farouc Jaffer, M. Nicholas Burke, Philip Dattilo, Barry Uretsky, Elizabeth Holper, Michalis Koutouzis, Ioannis Tsiafoutis, Habib Samady, Brian Jefferson, Taral Patel, Shuaib Abdullah, Jeffrey Moses, Nicholas Lembo, Manish Parikh, Ajay Kirtane, Ziad Ali, Darshan Doshi, Allison Hall, Iosif Xenogiannis, Bavana Rangan, Subhash Banerjee, Emmanouil Brilakis
Journal: Journal of the American College of Cardiology (2019)
Big science and big data in nephrology
Authors: Julio Saez-Rodriguez, Markus M. Rinschen, Jürgen Floege, Rafael Kramann
Journal: Kidney International (2019)

There have been tremendous advances during the last decade in methods for large-scale, high-throughput data generation and in novel computational approaches to analyze these datasets. These advances have had a profound impact on biomedical research and clinical medicine. The field of genomics is rapidly developing toward single-cell analysis, and major advances in proteomics and metabolomics have been made in recent years. The developments on wearables and electronic health records are poised to change clinical trial design. This rise of 'big data' holds the promise to transform not only research progress, but also clinical decision making towards precision medicine. To have a true impact, it requires integrative and multi-disciplinary approaches that blend experimental, clinical and computational expertise across multiple institutions. Cancer research has been at the forefront of the progress in such large-scale initiatives, so-called 'big science,' with an emphasis on precision medicine, and various other areas are quickly catching up. Nephrology is arguably lagging behind, and hence these are exciting times to start (or redirect) a research career to leverage these developments in nephrology. In this review, we summarize advances in big data generation, computational analysis, and big science initiatives, with a special focus on applications to nephrology.
GENDER VARIATION IN THE PREDICTIVE VALIDITY OF THE KANSAS CITY CARDIOMYOPATHY QUESTIONNAIRE
Authors: Vittal Hejjaji, Krishna Patel, Tang Yuanyuan, Philip Jones, Bryce B. Reeve, Kevin Weinfurt, Theresa Coles, Ileana L. Pina, John A. Spertus
Journal: Journal of the American College of Cardiology (2019)
Immunotherapy in Non–Small Cell Lung Cancer: Facts and Hopes
Authors: Deborah B. Doroshow, Miguel F. Sanmamed, Katherine Hastings, Katerina Politi, David L. Rimm, Lieping Chen, Ignacio Melero, Kurt A. Schalper, Roy S. Herbst
Journal: Clinical Cancer Research (2019)

Abstract Immune-checkpoint inhibitors (ICI), particularly inhibitors of the PD-1 axis, have altered the management of non–small cell lung cancer (NSCLC) over the last 10 years. First demonstrated to improve outcomes in second-line or later therapy of advanced disease, ICIs were shown to improve overall survival compared with chemotherapy in first-line therapy for patients whose tumors express PD-L1 on at least 50% of cells. More recently, combining ICIs with chemotherapy has been shown to improve survival in patients with both squamous and nonsquamous NSCLC, regardless of PD-L1 expression. However, PD-L1 and, more recently, tumor mutational burden have not proven to be straightforward indicative biomarkers. We describe the advances to date in utilizing these biomarkers, as well as novel markers of tumor inflammation, to ascertain which patients are most likely to benefit from ICIs. Ongoing translational work promises to improve the proportion of patients who benefit from these agents.
Abstract 395: Pioglitazone and Glucagon-like Peptide 1 Receptor Agonist Mitigate Adverse Postinfarction Left Ventricular Remodeling in Lean Mice When Administered After the Infarct Independent of Changes in Infarct Size
Authors: Allen M Andres, Juliana Germano, Chengqun Huang, Kyle C Tucker, Yang Song, Jon Sin, Roberta A Gottlieb, Robert M Mentzer
Journal: Circulation Research (2018)

Pioglitazone (PIO) and GLP-1R receptor agonist (GLP1Ra) have been shown to be cardioprotective against ischemic cardiac injury. Much less is known about the effects of these agents on adverse post-MI LV remodeling. Based on our earlier findings that PIO and a GLP1Ra stimulate mitochondrial turnover, we evaluated the effects of these agents on post-MI remodeling. Lean mice underwent permanent coronary artery ligation (PCAL) to ensure that remodeling would be independent of changes in infarct size. Vehicle, PIO and GLP1Ra (Sigma) were administered i.p. 2h after the infarct and then every other day for a total of 6 doses. Echo and histology (Masson’s trichrome) were used to assess LV remodeling 30 days post-MI (late phase); immune cell infiltration was assessed 7 days after PCAL (early phase) via hematoxylin and eosin (H&amp;E) staining. Both PIO and GLP1Ra were associated with significant improvements in ejection fraction and fractional shortening (A); however, at the dose used, neither drug restored function to that of the sham-operated mice (EF 60% and FS 30%, data not shown). GLP1Ra-treated mice exhibited a marked reduction in immune cell infiltration at 7d after PCAL (B), and fibrosis at 30d (C) compared to vehicle or PIO. While PIO had no effect on immune-cell infiltration and fibrosis, it was effective in attenuating post-MI remodeling. While sharing a common endpoint of attenuating adverse remodeling, the finding that PIO stimulates mitochondrial biogenesis and GLP1Ra induces mitophagy may help explain their disparate findings with respect to early phase remodeling.
New Diagnostic Test for Sexually Transmitted Infection
Authors: Rebecca Voelker
Journal: JAMA (2019)

Our website uses cookies to enhance your experience. By continuing to use our site, or clicking "Continue," you are agreeing to our Cookie Policy | Continue JAMA HomeNew OnlineCurrent IssueFor Authors Podcasts Clinical Reviews Editors' Summary Medical News Author Interviews More Publications JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry (1919-1959) JN Learning / CMESubscribeJobsInstitutions / LibrariansReprints & Permissions Terms of Use | Privacy Policy | Accessibility Statement 2023 American Medical Association. All Rights Reserved Search All JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Forum Archive JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry Input Search Term Sign In Individual Sign In Sign inCreate an Account Access through your institution Sign In Purchase Options: Buy this article Rent this article Subscribe to the JAMA journal
REASONS FOR NON-REFERRAL FOR INVASIVE MANAGEMENT AFTER SEVERELY ABNORMAL RESULTS ON POSITRON EMISSION TOMOGRAPHY (PET) MYOCARDIAL PERFUSION IMAGING (MPI)
Authors: Merrill Thomas, Krishna Patel, Brett Sperry, Arthur McGhie, Firas Al Badarin, Ibrahim Saeed, Kevin Kennedy, Paul Chan, John A. Spertus, Randall Thompson, Timothy Bateman
Journal: Journal of the American College of Cardiology (2019)
Association between physical activity and sedentary behaviour on carotid atherosclerotic plaques: an epidemiological and histological study in 90 asymptomatic patients
Authors: Pauline Mury, Mathilde Mura, Nellie Della-Schiava, Stéphanie Chanon, Aurélie Vieille-Marchiset, Virginie Nicaise, Erica N Chirico, Diane Collet-Benzaquen, Patrick Lermusiaux, Philippe Connes, Antoine Millon, Vincent Pialoux
Journal: British Journal of Sports Medicine (2019)

Objective Carotid atherosclerotic plaques are a source of emboli for stroke. ‘Unstable’ carotid atherosclerotic plaques may have intraplaque haemorrhages, neovessels, prevalent macrophages, excessive calcium deposits, a large lipid core and a thin fibrous cap. Regular physical activity (PA) may lower the risk of plaques becoming unstable. We evaluated the association of both PA and sedentary behaviour (SB) with carotid plaque histopathology. Methods 90 asymptomatic patients who were undergoing carotid endarterectomy for carotid artery narrowing identified on ultrasound reported their PA and SB by questionnaires. We calculated PA intensity in MET (metabolic equivalent of task)-min/week. For analysis, the population was divided into tertiles according to PA (T1PA: the less PA patients; T2PA: the intermediate PA patients; T3PA: the most physically active patients) (T1PA&lt;T2PA&lt;T3PA) and SB (T1SB: the less sedentary behaviour patients; T2SB: the intermediate sedentary behaviour patients; T3SB: the most sedentary behaviour patients) (T1SB&lt;T2SB&lt;T3SB). PA was categorised as one of four PA intensities (600, 900, 1600 and 3000 MET-min/week). We obtained the carotid artery plaque at surgery and performed histological analysis of intraplaque haemorrhages (present/absent), neovessels, macrophages, lipid core, calcium deposits and the fibrous cap. Results Intraplaque haemorrhage was less frequent in the most physically active tertile (T3PA, 48%) versus T1PA (74%) and in the least sedentary tertile T1SB (50%) versus T3SB (71%). The intraplaque haemorrhage was less frequent in those who exercised more than 900 MET-min/week (59% vs 47% for &gt;900 and &lt;900 MET-min/week, respectively). All the other features that associate with plaque instability (eg, neovessels, macrophages, etc) did not differ by level of PA or SB. Conclusion In this cross-sectional study of asymptomatic patients who underwent endarterectomy (i) higher reported PA, (ii) intensity of PA and (iii) lower reported SB were associated with lower prevalence of intraplaque haemorrhage. This could be a mechanism whereby PA protects against cerebrovascular disease (stroke) and death.