Dataset Information

Circulating Microparticles Decrease After Cardiac Stress in Patients With Significant Coronary Artery Stenosis.

ABSTRACT:

Background

Cardiac stress leads to a dynamic increase of circulating microparticles (MPs) in healthy individuals that is diminished in individuals with vascular disease. The impact of coronary ischemia on circulating MP level is unknown. This study investigates the kinetics of circulating MPs during cardiac stress in patients with coronary artery stenosis.

Hypothesis

Patients with significant coronary stenosis show altered circulating MP levels after cardiac stress.

Methods

Eighty patients with stable coronary artery disease underwent dobutamine stress echocardiography (DSE) on the day before coronary angiography. Before, immediately after, at 4 hours, and at 24 hours after DSE, blood was drawn to determine CD144⁺ endothelial microparticles (EMPs), CD14⁺ CD16⁺ monocyte-derived microparticles (MMPs), and CD31⁺ CD42b⁺ platelet microparticles. A significant stenosis was defined as stenosis diameter ≥70% in a major native epicardial coronary artery with a diameter of ≥2.5 mm.

Results

Significant coronary artery stenoses were found in 41 patients. In these patients, CD144⁺ -EMP and CD14⁺ CD16⁺ -MMP concentrations decreased immediately after DSE. Stimulation of target endothelial cells with sera from patients with significant coronary artery stenoses significantly augmented endothelial capacity to take up EMPs, but not MMPs, in vitro. Serum-induced enhancement of endothelial phosphatidylserine receptor expression was found as a potential mechanism of increased endothelial EMP uptake and subsequently reduced circulating EMP levels after cardiac stress.

Conclusions

Cardiac ischemia leads to reduced circulating MP levels under cardiac stress. Changes of endothelial MP uptake capacities could be one possible mechanism.

SUBMITTER: Sinning JM

PROVIDER: S-EPMC6490784 | biostudies-literature | 2016 Oct

REPOSITORIES: biostudies-literature

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Publications

Circulating Microparticles Decrease After Cardiac Stress in Patients With Significant Coronary Artery Stenosis.

Sinning Jan-Malte JM Jansen Felix F Hammerstingl Christoph C Meier Arne A Losch Jan J Rohwer Katharina K Schmitz Theresa T Paul Kathrin K Sedaghat Alexander A Schueler Robert R Vasa-Nicotera Mariuca M Müller Cornelius C Nickenig Georg G Werner Nikos N

Clinical cardiology 20160713 10

<h4>Background</h4>Cardiac stress leads to a dynamic increase of circulating microparticles (MPs) in healthy individuals that is diminished in individuals with vascular disease. The impact of coronary ischemia on circulating MP level is unknown. This study investigates the kinetics of circulating MPs during cardiac stress in patients with coronary artery stenosis.<h4>Hypothesis</h4>Patients with significant coronary stenosis show altered circulating MP levels after cardiac stress.<h4>Methods</h4 ...[more]

PMID: 27410166

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Project description:BackgroundAlthough coronary computed tomography angiography (CCTA) is currently utilized as the frontline test to accurately diagnose coronary artery disease (CAD) in clinical practice, there are still debates regarding its use as a screening tool for the asymptomatic population. Using deep learning (DL), we sought to develop a prediction model for significant coronary artery stenosis on CCTA and identify the individuals who would benefit from undergoing CCTA among apparently healthy asymptomatic adults.MethodsWe retrospectively reviewed 11,180 individuals who underwent CCTA as part of routine health check-ups between 2012 and 2019. The main outcome was the presence of coronary artery stenosis of ≥70% on CCTA. We developed a prediction model using machine learning (ML), including DL. Its performance was compared with pretest probabilities, including the pooled cohort equation (PCE), CAD consortium, and updated Diamond-Forrester (UDF) scores.ResultsIn the cohort of 11,180 apparently healthy asymptomatic individuals (mean age 56.1 years; men 69.8%), 516 (4.6%) presented with significant coronary artery stenosis on CCTA. Among the ML methods employed, a neural network with multi-task learning (19 selected features), one of the DL methods, was selected due to its superior performance, with an area under the curve (AUC) of 0.782 and a high diagnostic accuracy of 71.6%. Our DL-based model demonstrated a better prediction than the PCE (AUC, 0.719), CAD consortium score (AUC, 0.696), and UDF score (AUC, 0.705). Age, sex, HbA1c, and HDL cholesterol were highly ranked features. Personal education and monthly income levels were also included as important features of the model.ConclusionWe successfully developed the neural network with multi-task learning for the detection of CCTA-derived stenosis of ≥70% in asymptomatic populations. Our findings suggest that this model may provide more precise indications for the use of CCTA as a screening tool to identify individuals at a higher risk, even in asymptomatic populations, in clinical practice.

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Dataset Information

Circulating Microparticles Decrease After Cardiac Stress in Patients With Significant Coronary Artery Stenosis.

Background

Hypothesis

Methods

Results

Conclusions

Publications

Circulating Microparticles Decrease After Cardiac Stress in Patients With Significant Coronary Artery Stenosis.

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