Relation of arterial geometry to luminal narrowing and histologic markers for plaque vulnerability: the remodeling paradox
Gerard Pasterkamp, MD, PhD*  ||,
Arjan H. Schoneveld, MSc* ||,
Allard C. van der Wal, MD, PhD ,
Christian C. Haudenschild, MD, PhD ,
Ruud J. G. Clarijs, MD*,
Anton E. Becker, MD, PhD,
Berend Hillen, MD, PhD and
Cornelius Borst, MD, PhD, FACC*
* Cardiology, Utrecht University Hospital, Utrecht, the Netherlands
Functional Anatomy, Utrecht University Hospital, Utrecht, the Netherlands
Department of Cardiovascular Pathology, Academic Medical Center, Amersterdam, the Netherlands
Department of Pathology, Red Cross Holland Laboratory, Rockville, Maryland, USA
|| Interuniversity Cardiology Institute of the Netherlands, Utrecht, the Netherlands
View larger version (109K):
[in a new window]
|
Figure 1 Schematic presentation of regions within the plaque that were analyzed in the present study: cap (C) and shoulder (S). Shoulder was defined as the area at the periphery of the plaque adjacent to the normal intima beneath the cap of the plaque.
|
|
View larger version (140K):
[in a new window]
|
Figure 2 Arterial segment with atheromatous core with heavy staining of picro Sirius red within the cap confirmed with polarized light microscopy (A and C), and absent staining for CD68 in the cap and moderate CD68 staining in the shoulder and heavy CD68 staining at the base of the plaque (E) (asterick). Arterial segment with atheromatous core and thin/local absent picro Sirius red staining of the cap confirmed by polarized light microscopy (B and D). CD68 staining was heavily positive for cap and shoulder (F).
|
|
View larger version (155K):
[in a new window]
|
Figure 3 Alpha-actin staining of lipid-rich lesions revealing strongly positive staining of the cap (A) and absent staining of that part of the cap overlying the atheromatous core (arrow) (B). L = lumen.
|
|
View larger version (32K):
[in a new window]
|
Figure 4 Number of cross sections with absent/minor (0), moderate (1) and heavy (2) staining for CD68 positive cells in the cap (top panel) and shoulder (bottom panel) of the plaque at the locations with the largest lumen area (LA +), smallest lumen area (LA –), largest plaque area (PA +), smallest plaque area (PA –), largest vessel area (VA +) and smallest vessel area (VA –). Open bar = 0; hatched bar = 1; solid bar = 2.
|
|
View larger version (32K):
[in a new window]
|
Figure 5 Number of cross sections with absent/minor (0), moderate (1) and heavy (2) staining for CD45RO positive cells. For further explanation see the legend to Figure 4. Open bar = 0; hatched bar = 1; solid bar = 2.
|
|
View larger version (35K):
[in a new window]
|
Figure 6 Number of cross sections with absent/minor (0), moderate (1) and heavy (2) staining for alpha-actin positive cells. For further explanation see the legend to Figure 4. Open bar = 0; hatched bar = 1; solid bar = 2.
|
|
View larger version (36K):
[in a new window]
|
Figure 7 Percentage of cross sections with absent/minor (0), moderate (1) and heavy (2) staining for picro Sirius red. For further explanation see the legend to Figure 4. Open box = 0; hatched bar = 1; solid bar = 2.
|
|
View larger version (20K):
[in a new window]
|
Figure 8 Number of cross sections in which more or less than 40% of the plaque consists of atheroma. Open bar = 0–40%; solid bar = >40%.
|
|
|
