S. Novo, E. Corrado
Role of Inflammation in Patients with Subclinical Atherosclerosis

Inflammation plays a major role in atherosclerosis, and measurement of inflammatory markers such as hs-CRP may provide a method for detecting individuals at high risk of events. Several studies demonstrate that hs-CRP is a strong independent predictor of future myocardial infarction and stroke among apparently healthy men and women and CRP levels add to information based upon cholesterol evaluation. Because agents such as aspirin and statins seem to attenuate inflammatory risk, hs-CRP may also have utility in targeting proven therapies for primary prevention. In secondary prevention, the potential utility of CRP is less certain, as aggressive therapies should already be instituted and LDL evaluation provides an excellent method to assess statin efficacy.

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H. Hsu
Role of Calcifying Vesicles in Arterial Calcification Related to Atherosclerosis

Our recent studies with a small sample population demonstrated a strong correlation between the low-density lipoprotein (LDL-C) content in calcifying vesicle fractions and the extent of intimal thickening in rabbits fed a supplemental cholesterol diet [20]. In contrast, there was a lack of correlation between hypercholesterolemia and lesion thickening likely a result of a limited sample size (14 experimental rabbits versus 9 controls). These observations may suggest a role for calcifying vesicle-associated LDL-C in atherosclerosis. Further studies are needed to assess the precise role of calcifying vesicles in atherosclerosis and arterial calcification.

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N.M. Soldatov
Remodeling of Human CaV1.2 Calcium Channels in Atherosclerosis

Physiological role of Cav1.2 variability in the maintenance of VSMC remains unknown. It is not clear why the exon-21 isoform of Cav1.2a1C is present in quiescent VSMC while the exon 22-isoform is not. It is possible that the structural changes in the Cav1.2a1C transmembrane segment IIIS2 encoded in exon 21 may affect whole multitude of the Cav1.2a1C voltage-gated rearrangements, some of which are directly linked to Ca2+-signal transduction and are crucial, for example, for CREB-dependent transcription [12]. We are now trying to find whether snRNA-mediated skipping of exon 22 in Cav1.2a1C would rescue VSMC from atherosclerosis.
In conclusion, we found that localized changes in cytokine expression generated by inflammation in atherosclerosis affect alternative splicing of the Cav1.2a1 gene in VSMC of the human artery that causes molecular and electrophysiological remodeling of Cav1.2 calcium channels and possibly affects VSMC proliferation.

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M. Rizzo, K. Berneis
Metabolic Syndrome The Significance of LDL Heterogeneity in the Metabolic Syndrome

In summary, LDL size and subclasses may show specific alterations in patients with the metabolic syndrome that probably significantly increase their cardiovascular risk; however, so far it has not been recommended by the international scientific societies to incorporate LDL size measurements in treatment plans, when hypolipidemic therapies are implemented. It is known that the therapeutic modulation of HDL-cholesterol and triglyceride concentrations significantly reduce cardiovascular risk [ 10] and lipid-lowering agents are also effective in increasing LDL size by reducing levels of small, dense LDL, but strong differences have been noticed among the different molecules [18,19]. Measurements beyond traditional lipids, such as the presence of small, dense LDL in patients with the metabolic syndrome, may help to identify cardiovascular risk subgroups. In addition, it might be possible in the future to individualize hypolipidemic treatments if more than the traditional lipids are taken into account. LDL size measurements in particular may help to assess cardiovascular risk within the metabolic syndrome and adapt the treatment goals thereafter [20].

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J. Osada, V. Ruiz-Guitiérrez
Oxidative stress Olive Oil Composition and Its Atheroprotective Role

The method used to prepare olive oil is crucial in determining the oil's anti-atherosclerotic properties, which extend beyond the presence of phenolic compounds.
The test olive oil exerted its anti-atherosclerotic properties by a hypolipidemic action, lower oxidative stress, and reduced activation of circulating monocytes. Thus, the test olive oil might be a safe strategy for retarding the development of atherosclerosis lesions and a good candidate to replace other fats in functional foods, although human clinical trials are required to validate that proposition.

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T. Ogata, M. Yasaka
Systemic Vascular Diseases and Carotid Ultrasonography

Carotid ultrasonography is a useful tool for the evaluation of patients with various vascular diseases. Atherosclerotic findings using carotid ultrasonography are strongly associated with systemic vascular diseases. When we find the stenosis or occlusive lesions of carotid artery, we need to evaluate the coronary heart disease and ASO. On the other hand, when we observe the dilatation of CCA, we should check the aortic aneurysm.

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J.D. Schuijf, J.J. Bax
Anatomical and Functional Imaging Techniques; Basically Similar or Fundamentally Different?

Based on these observations, appropriate therapy may be determined: invasive coronary angiography (and possibly intervention) or medical therapy in combination with aggressive risk profile modification. Potentially, the combination of both anatomical and functional information may allow superior evaluation of CAD, resulting in more individually targeted management as well as improved outcome. Still, data supporting such algorithms are currently lacking, and prospective studies addressing the accuracy, safety, and cost-effectiveness of integrated imaging strategies in larger cohorts are required.

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L.R. Tannock
Role of Glucosamine and Vascular Proteoglycans in Atherosclerosis Development

The “Response to Retention” hypothesis of atherosclerosis development proposes that proteoglycan-mediated lipoprotein retention in the vascular wall plays a critical role in the initiation of atherosclerosis [1,2]. However, support for this hypothesis has been limited by a paucity of in vivo data. Modifications of lipoproteins that affected their proteoglycan binding affinity were shown to attenuate atherosclerosis [7], which supports the hypothesis. However, further support of this hypothesis has been limited by an inability to modify vascular proteoglycans in vivo and examine the effect on subsequent atherosclerosis development. Although glucosamine was previously shown to modify vascular proteoglycan synthesis in vitro , oral glucosamine supplementation did not achieve levels sufficient to modify vascular proteoglycan synthesis in this animal model [23]. Thus, further research investigating the “Response to Retention” hypothesis in vivo is required to establish the role of proteoglycan-mediated lipoprotein retention in the development of atherosclerosis.

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