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1. Sex differences in body composition in people with prediabetes and type 2 diabetes as compared with people with normal glucose metabolism: the Maastricht Study

Author

de Ritter, Rianneke, Sep, Simone J. S., van Greevenbroek, Marleen M. J., Kusters, Yvo H. A. M., Vos, Rimke C., Bots, Michiel L., Kooi, M. Eline, Dagnelie, Pieter C., Eussen, Simone J. P. M., Schram, Miranda T., Koster, Annemarie, Brouwers, Martijn C. G., van der Sangen, Niels M. R., Peters, Sanne A. E., van der Kallen, Carla J. H., and Stehouwer, Coen D. A.

Published
2023
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2. Associations between plasma sulfur amino acids and specific fat depots in two independent cohorts: CODAM and The Maastricht Study

Author

Tore, Elena C., Elshorbagy, Amany K., Bakers, Frans C. H., Brouwers, Martijn C. G. J., Dagnelie, Pieter C., Eussen, Simone J. P. M., Jansen, Jacobus F. A., Kooi, M. Eline, Kusters, Yvo H. A. M., Meex, Steven J. R., Olsen, Thomas, Refsum, Helga, Retterstøl, Kjetil, Schalkwijk, Casper G., Stehouwer, Coen D. A., Vinknes, Kathrine J., and van Greevenbroek, Marleen M. J.

Published
2023
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3. Signal intensity and volume of carotid intraplaque hemorrhage on magnetic resonance imaging and the risk of ipsilateral cerebrovascular events: The Plaque At RISK (PARISK) study

Author

Nies, Kelly P.H., Aizaz, Mueez, van Dam-Nolen, Dianne H.K., Goring, Timothy C.D., Schreuder, Tobien A.H.C.M.L., van Orshoven, Narender P., Postma, Alida A., Bos, Daniel, Hendrikse, Jeroen, Nederkoorn, Paul, van der Geest, Rob, van Oostenbrugge, Robert J., Mess, Werner H., and Kooi, M. Eline

Published
2024
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4. Carotid Plaque-RADS: A Novel Stroke Risk Classification System

Author

Saba, Luca, Cau, Riccardo, Murgia, Alessandro, Nicolaides, Andrew N., Wintermark, Max, Castillo, Mauricio, Staub, Daniel, Kakkos, Stavros K., Yang, Qi, Paraskevas, Kosmas I., Yuan, Chun, Edjlali, Myriam, Sanfilippo, Roberto, Hendrikse, Jeroen, Johansson, Elias, Mossa-Basha, Mahmud, Balu, Niranjan, Dichgans, Martin, Saloner, David, Bos, Daniel, Jager, H. Rolf, Naylor, Ross, Faa, Gavino, Suri, Jasjit S., Costello, Justin, Auer, Dorothee P., Mcnally, J. Scott, Bonati, Leo H., Nardi, Valentina, van der Lugt, Aad, Griffin, Maura, Wasserman, Bruce A., Kooi, M. Eline, Gillard, Jonathan, Lanzino, Giuseppe, Mikhailidis, Dimitri P., Mandell, Daniel M., Benson, John C., van Dam-Nolen, Dianne H.K., Kopczak, Anna, Song, Jae W., Gupta, Ajay, DeMarco, J. Kevin, Chaturvedi, Seemant, Virmani, Renu, Hatsukami, Thomas S., Brown, Martin, Moody, Alan R., Libby, Peter, Schindler, Andreas, and Saam, Tobias

Published
2024
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9. The 2nd European Carotid Surgery Trial (ECST-2): rationale and protocol for a randomised clinical trial comparing immediate revascularisation versus optimised medical therapy alone in patients with symptomatic and asymptomatic carotid stenosis at low to intermediate risk of stroke

Author

Cheng, Suk Fun, van Velzen, Twan J., Gregson, John, Richards, Toby, Jäger, Hans Rolf, Simister, Robert, Kooi, M. Eline, de Borst, Gert J., Pizzini, Francesca B., Nederkoorn, Paul J., Brown, Martin M., and Bonati, Leo H.

Published
2022
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10. Carotid Plaque Characteristics Predict Recurrent Ischemic Stroke and TIA: The PARISK (Plaque At RISK) Study

Author

van Dam-Nolen, Dianne H.K., Truijman, Martine T.B., van der Kolk, Anja G., Liem, Madieke I., Schreuder, Floris H.B.M., Boersma, Eric, Daemen, Mat J.A.P., Mess, Werner H., van Oostenbrugge, Robert J., van der Steen, Antonius F.W., Bos, Daniel, Koudstaal, Peter J., Nederkoorn, Paul J., Hendrikse, Jeroen, van der Lugt, Aad, and Kooi, M. Eline

Published
2022
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11. International Union of Angiology (IUA) consensus paper on imaging strategies in atherosclerotic carotid artery imaging: From basic strategies to advanced approaches

Author

Saba, Luca, Antignani, Pier Luigi, Gupta, Ajay, Cau, Riccardo, Paraskevas, Kosmas I., Poredos, Pavel, Wasserman, Bruce A., Kamel, Hooman, Avgerinos, Efthymios D., Salgado, Rodrigo, Caobelli, Federico, Aluigi, Leonardo, Savastano, Luis, Brown, Martin, Hatsukami, Tom, Hussein, Emad, Suri, Jasjit S., Mansilha, Armado, Wintermark, Max, Staub, Daniel, Montequin, Jose Fernandes, Rodriguez, Ruben Tomas Toro, Balu, Niranjan, Pitha, Jan, Kooi, M. Eline, Lal, Brajesh K., Spence, J. David, Lanzino, Giuseppe, Marcus, Hugh Stephen, Mancini, Marcello, Chaturvedi, Seemant, and Blinc, Ales

Published
2022
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12. Optimal Management of Asymptomatic Carotid Stenosis in 2021: The Jury is Still Out. An International, Multispecialty, Expert Review and Position Statement

Author

Paraskevas, Kosmas I., Mikhailidis, Dimitri P., Antignani, Pier Luigi, Baradaran, Hediyeh, Bokkers, Reinoud P.H., Cambria, Richard P., Dardik, Alan, Davies, Alun H., Eckstein, Hans-Henning, Faggioli, Gianluca, e Fernandes, Jose Fernandes, Fraedrich, Gustav, Geroulakos, George, Gloviczki, Peter, Golledge, Jonathan, Gupta, Ajay, Jezovnik, Mateja K., Kakkos, Stavros K., Katsiki, Niki, Knoflach, Michael, Kooi, M. Eline, Lanza, Gaetano, Liapis, Christos D., Loftus, Ian M., Mansilha, Armando, Millon, Antoine, Nicolaides, Andrew N., Pini, Rodolfo, Poredos, Pavel, Ricco, Jean-Baptiste, Riles, Thomas S., Ringleb, Peter Arthur, Rundek, Tatjana, Saba, Luca, Schlachetzki, Felix, Silvestrini, Mauro, Spinelli, Francesco, Stilo, Francesco, Sultan, Sherif, Suri, Jasjit S., Zeebregts, Clark J., and Chaturvedi, Seemant

Published
2022
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14. Development of imaging-based risk scores for prediction of intracranial haemorrhage and ischaemic stroke in patients taking antithrombotic therapy after ischaemic stroke or transient ischaemic attack: a pooled analysis of individual patient data from cohort studies

Author

Harkness, Kirsty, Shaw, Louise, Sword, Jane, Mohd Nor, Azlisham, Sharma, Pankaj, Kelly, Deborah, Harrington, Frances, Randall, Marc, Smith, Matthew, Mahawish, Karim, Elmarim, Abduelbaset, Esisi, Bernard, Cullen, Claire, Nallasivam, Arumug, Price, Christopher, Barry, Adrian, Roffe, Christine, Coyle, John, Hassan, Ahamad, Birns, Jonathan, Cohen, David, Sekaran, Lakshmanan, Parry-Jones, Adrian, Parry, Anthea, Hargroves, David, Proschel, Harald, Datta, Prabel, Darawil, Khaled, Manoj, Aravindakshan, Burn, Mathew, Patterson, Chris, Giallombardo, Elio, Smyth, Nigel, Mansoor, Syed, Anwar, Ijaz, Marsh, Rachel, Ispoglou, Sissi, Chadha, Dinesh, Prabhakaran, Mathuri, Meenakishundaram, Sanjeevikumar, O'Connell, Janice, Scott, Jon, Krishnamurthy, Vinodh, Aghoram, Prasanna, McCormick, Michael, Sprigg, Nikola, O'Mahony, Paul, Cooper, Martin, Choy, Lillian, Wilkinson, Peter, Leach, Simon, Caine, Sarah, Burger, Ilse, Gunathilagan, Gunaratam, Guyler, Paul, Emsley, Hedley, Davis, Michelle, Manawadu, Dulka, Pasco, Kath, Mamun, Maam, Luder, Robert, Sajid, Mahmud, Okwera, James, Warburton, Elizabeth, Saastamoinen, Kari, England, Timothy, Putterill, Janet, Flossman, Enrico, Power, Michael, Dani, Krishna, Mangion, David, Suman, Appu, Corrigan, John, Lawrence, Enas, Vahidassr, Djamil, Shakeshaft, Clare, Brown, Martin, Charidimou, Andreas, Cohen, Hannah, Banerjee, Gargi, Houlden, Henry, White, Mark, Yousry, Tarek, Flossmann, Enrico, Muir, Keith, Gratz, Pascal, Mattle, Heinrich, Panos, Leonidas, Korczyn, Amos, Kliper, Efrat, Maeder, Philippe, Gass, Achim, Pachai, Chahin, Bracoub, Luc, Douste-Blazy, Marie-Yvonne, Fratacci, Marie Dominique, Vicaut, Eric, Sato, Shoichiro, Miwa, Kaori, Fujita, Kyohei, Ide, Toshihiro, Ma, Henry, Ly, John, Singhal, Shaloo, Chandra, Ronil, Slater, Lee-Anne, Soufan, Cathy, Moran, Christopher, Traenka, Christopher, Thilemann, Sebastian, Fladt, Joachim, Gensicke, Henrik, Bonati, Leo, Kim, Beom Joon, Han, Moon-Ku, Kang, Jihoon, Ko, Eunbin, Yang, Mi Hwa, Jang, Myung Suk, Murphy, Sean, Carty, Fiona, Akijian, Layan, Thornton, John, Schembri, Mark, Douven, Elles, Delgado-Mederos, Raquel, Marín, Rebeca, Camps-Renom, Pol, Guisado-Alonso, Daniel, Nuñez, Fidel, Medrano-Martorell, Santiago, Merino, Elisa, Iida, Kotaro, Ikeda, Syuhei, Irie, Hiroyuki, Demirelli, Derya Selcuk, Medanta, Jayesh Modi, Zerna, Charlotte, Hernández, Maria Valdés, Armitage, Paul, Heye, Anna, Muñoz-Maniega, Susana, Sakka, Eleni, Thrippleton, Michael, Dennis, Martin, Beigneux, Ysoline, Silva, Mauro, Venketasubramanian, Narayanaswamy, Ho, Shu Leung, Cheung, Raymond Tak Fai, Chan, Koon Ho, Teo, Kay Cheong, Hui, Edward, Kwan, Joseph Shiu Kwong, Chang, Richard, Tse, Man Yu, Hoi, Chu Peng, Chan, Chung Yan, Chan, Oi Ling, Cheung, Ryan Hoi Kit, Wong, Edmund Ka Ming, Leung, Kam Tat, Tsang, Suk Fung, Ip, Hing Lung, Ma, Sze Ho, Ma, Karen, Fong, Wing Chi, Li, Siu Hung, Li, Richard, Ng, Ping Wing, Wong, Kwok Kui, Liu, Wenyan, Wong, Lawrence, Ramos, Lino, De Schryver, Els, Jöbsis, Joost, van der Sande, Jaap, Brouwers, Paul, Roos, Yvo, Stam, Jan, Bakker, Stef, Verbiest, Henk, Schoonewille, Wouter, Linn, Cisca, Hertzberger, Leopold, van Gemert, Maarten, Berntsen, Paul, Van Dam-Nolen, Dianne, Kooi, M Eline, Van der Lugt, Aad, Koudstaal, Peter, Leff, Alexander, Ward, Nicholas, Nachev, Parashkev, Perry, Richard, Ozkan, Hatice, Mitchell, John, Best, Jonathan G, Ambler, Gareth, Wilson, Duncan, Lee, Keon-Joo, Lim, Jae-Sung, Shiozawa, Masayuki, Koga, Masatoshi, Li, Linxin, Lovelock, Caroline, Chabriat, Hugues, Hennerici, Michael, Wong, Yuen Kwun, Mak, Henry Ka Fung, Prats-Sanchez, Luis, Martínez-Domeño, Alejandro, Inamura, Shigeru, Yoshifuji, Kazuhisa, Arsava, Ethem Murat, Horstmann, Solveig, Purrucker, Jan, Lam, Bonnie Yin Ka, Wong, Adrian, Kim, Young Dae, Song, Tae-Jin, Lemmens, Robin, Eppinger, Sebastian, Gattringer, Thomas, Uysal, Ender, Tanriverdi, Zeynep, Bornstein, Natan M, Ben Assayag, Einor, Hallevi, Hen, Molad, Jeremy, Nishihara, Masashi, Tanaka, Jun, Coutts, Shelagh B, Polymeris, Alexandros, Wagner, Benjamin, Seiffge, David J, Lyrer, Philippe, Algra, Ale, Kappelle, L Jaap, Al-Shahi Salman, Rustam, Jäger, Hans R, Lip, Gregory Y H, Fischer, Urs, El-Koussy, Marwan, Mas, Jean-Louis, Legrand, Laurence, Karayiannis, Christopher, Phan, Thanh, Gunkel, Sarah, Christ, Nicolas, Abrigo, Jill, Leung, Thomas, Chu, Winnie, Chappell, Francesca, Makin, Stephen, Hayden, Derek, Williams, David J, Mess, Werner H, Nederkoorn, Paul J, Barbato, Carmen, Browning, Simone, Wiegertjes, Kim, Tuladhar, Anil M, Maaijwee, Noortje, Guevarra, Anne Cristine, Yatawara, Chathuri, Mendyk, Anne-Marie, Delmaire, Christine, Köhler, Sebastian, van Oostenbrugge, Robert, Zhou, Ying, Xu, Chao, Hilal, Saima, Gyanwali, Bibek, Chen, Christopher, Lou, Min, Staals, Julie, Bordet, Régis, Kandiah, Nagaendran, de Leeuw, Frank-Erik, Simister, Robert, Hendrikse, Jeroen, Kelly, Peter J, Wardlaw, Joanna, Soo, Yannie, Fluri, Felix, Srikanth, Velandai, Calvet, David, Jung, Simon, Kwa, Vincent I H, Engelter, Stefan T, Peters, Nils, Smith, Eric E, Hara, Hideo, Yakushiji, Yusuke, Orken, Dilek Necioglu, Fazekas, Franz, Thijs, Vincent, Heo, Ji Hoe, Mok, Vincent, Veltkamp, Roland, Ay, Hakan, Imaizumi, Toshio, Gomez-Anson, Beatriz, Lau, Kui Kai, Jouvent, Eric, Rothwell, Peter M, Toyoda, Kazunori, Bae, Hee-Joon, Marti-Fabregas, Joan, and Werring, David J

Published
2021
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19. Cerebral microbleeds and stroke risk after ischaemic stroke or transient ischaemic attack: a pooled analysis of individual patient data from cohort studies

Author

Harkness, Kirsty, Shaw, Louise, Sword, Jane, Mohd Nor, Azlisham, Sharma, Pankaj, Kelly, Deborah, Harrington, Frances, Randall, Marc, Smith, Matthew, Mahawish, Karim, Elmarim, Abduelbaset, Esisi, Bernard, Cullen, Claire, Nallasivam, Arumug, Price, Christopher, Barry, Adrian, Roffe, Christine, Coyle, John, Hassan, Ahamad, Birns, Jonathan, Cohen, David, Sekaran, Lakshmanan, Parry-Jones, Adrian, Parry, Anthea, Hargroves, David, Proschel, Harald, Datta, Prabel, Darawil, Khaled, Manoj, Aravindakshan, Burn, Mathew, Patterson, Chris, Giallombardo, Elio, Smyth, Nigel, Mansoor, Syed, Anwar, Ijaz, Marsh, Rachel, Ispoglou, Sissi, Chadha, Dinesh, Prabhakaran, Mathuri, Meenakishundaram, Sanjeevikumar, O'Connell, Janice, Scott, Jon, Krishnamurthy, Vinodh, Aghoram, Prasanna, McCormick, Michael, Sprigg, Nikola, O'Mahony, Paul, Cooper, Martin, Choy, Lillian, Wilkinson, Peter, Leach, Simon, Caine, Sarah, Burger, Ilse, Gunathilagan, Gunaratam, Guyler, Paul, Emsley, Hedley, Davis, Michelle, Manawadu, Dulka, Pasco, Kath, Mamun, Maam, Luder, Robert, Sajid, Mahmud, Okwera, James, Warburton, Elizabeth, Saastamoinen, Kari, England, Timothy, Putterill, Janet, Flossman, Enrico, Power, Michael, Dani, Krishna, Mangion, David, Suman, Appu, Corrigan, John, Lawrence, Enas, Vahidassr, Djamil, Shakeshaft, Clare, Brown, Martin, Charidimou, Andreas, Cohen, Hannah, Banerjee, Gargi, Houlden, Henry, White, Mark, Yousry, Tarek, Flossmann, Enrico, Muir, Keith, El-Koussy, Marwan, Gratz, Pascal, Molad, Jeremy, Korczyn, Amos, Kliper, Efrat, Maeder, Philippe, Gass, Achim, Pachai, Chahin, Bracoub, Luc, Douste-Blazy, Marie-Yvonne, Fratacci, Marie Dominique, Vicaut, Eric, Sato, Shoichiro, Miwa, Kaori, Fujita, Kyohei, Ide, Toshihiro, Ma, Henry, Ly, John, Singhal, Shahoo, Chandra, Ronil, Slater, Lee-Anne, Soufan, Cathy, Moran, Christopher, Traenka, Christopher, Thilemann, Sebastian, Fladt, Joachim, Gensicke, Henrik, Bonati, Leo, Kim, Beom Joon, Han, Moon-Ku, Kang, Jihoon, Ko, Eunbin, Yang, Mi Hwa, Jang, Myung Suk, Murphy, Sean, Carty, Fiona, Akijian, Layan, Thornton, John, Schembri, Mark, Douven, Elles, Delgado-Mederos;, Raquel, Marín, Rebeca, Camps-Renom, Pol, Guisado-Alonso, Daniel, Nuñez, Fidel, Medrano-Martorell, Santiago, Merino, Elisa, Iida, Kotaro, Ikeda, Syuhei, Nishihara, Masashi, Irie, Hiroyuki, Demirelli, Derya Selcuk, Medanta, Jayesh Modi, Zerna, Charlotte, Hernández, Maria Valdés, Armitage, Paul, Heye, Anna, Muñoz-Maniega, Susana, Sakka, Eleni, Thrippleton, Michael, Dennis, Martin, Beigneux, Ysoline, Silva, Mauro, Venketasubramanian, Narayanaswamy, Ho, Shu Leung, Cheung, Raymond Tak Fai, Chan, Koon Ho, Teo, Kay Cheong, Hui, Edward, Kwan, Joseph Shiu Kwong, Chang, Richard, Tse, Man Yu, Hoi, Chu Peng, Chan, Chung Yan, Chan, Oi Ling, Cheung, Ryan Hoi Kit, Wong, Edmund Ka Ming, Leung, Kam Tat, Tsang, Suk Fung, Ip, Hing Lung, Ma, Sze Ho, Ma, Karen, Fong, Wing Chi, Li, Siu Hung, Li, Richard, Ng, Ping Wing, Wong, Kwok Kui, Liu, Wenyan, Wong, Lawrence, Ramos, Lino, De Schryver, Els, Jöbsis, Joost, van der Sande, Jaap, Brouwers, Paul, Roos, Yvo, Stam, Jan, Bakker, Stef, Verbiest, Henk, Schoonewille, Wouter, Linn, Cisca, Hertzberger, Leopold, van Gemert, Maarten, Berntsen, Paul, Hendrikse, Jeroen, Nederkoorn, Paul, Mess, Werner, Koudstaal, Peter, Leff, Alexander, Ward, Nicholas, Nachev, Parashkev, Perry, Richard, Ozkan, Hatice, Mitchell, John, Wilson, Duncan, Ambler, Gareth, Lee, Keon-Joo, Lim, Jae-Sung, Shiozawa, Masayuki, Koga, Masatoshi, Li, Linxin, Lovelock, Caroline, Chabriat, Hugues, Hennerici, Michael, Wong, Yuen Kwun, Mak, Henry Ka Fung, Prats-Sánchez, Luis, Martínez-Domeño, Alejandro, Inamura, Shigeru, Yoshifuji, Kazuhisa, Arsava, Ethem Murat, Horstmann, Solveig, Purrucker, Jan, Lam, Bonnie Yin Ka, Wong, Adrian, Kim, Young Dae, Song, Tae-Jin, Schrooten, Maarten, Lemmens, Robin, Eppinger, Sebastian, Gattringer, Thomas, Uysal, Ender, Tanriverdi, Zeynep, Bornstein, Natan M, Assayag, Einor Ben, Hallevi, Hen, Tanaka, Jun, Hara, Hideo, Coutts, Shelagh B, Hert, Lisa, Polymeris, Alexandros, Seiffge, David J, Lyrer, Philippe, Algra, Ale, Kappelle, Jaap, Al-Shahi Salman, Rustam, Jäger, Hans R, Lip, Gregory Y H, Mattle, Heinrich P, Panos, Leonidas D, Mas, Jean-Louis, Legrand, Laurence, Karayiannis, Christopher, Phan, Thanh, Gunkel, Sarah, Christ, Nicolas, Abrigo, Jill, Leung, Thomas, Chu, Winnie, Chappell, Francesca, Makin, Stephen, Hayden, Derek, Williams, David J, Kooi, M Eline, van Dam-Nolen, Dianne H K, Barbato, Carmen, Browning, Simone, Wiegertjes, Kim, Tuladhar, Anil M, Maaijwee, Noortje, Guevarra, Christine, Yatawara, Chathuri, Mendyk, Anne-Marie, Delmaire, Christine, Köhler, Sebastian, van Oostenbrugge, Robert, Zhou, Ying, Xu, Chao, Hilal, Saima, Gyanwali, Bibek, Chen, Christopher, Lou, Min, Staals, Julie, Bordet, Régis, Kandiah, Nagaendran, de Leeuw, Frank-Erik, Simister, Robert, van der Lugt, Aad, Kelly, Peter J, Wardlaw, Joanna M, Soo, Yannie, Fluri, Felix, Srikanth, Velandai, Calvet, David, Jung, Simon, Kwa, Vincent I H, Engelter, Stefan T, Peters, Nils, Smith, Eric E, Yakushiji, Yusuke, Orken, Dilek Necioglu, Fazekas, Franz, Thijs, Vincent, Heo, Ji Hoe, Mok, Vincent, Veltkamp, Roland, Ay, Hakan, Imaizumi, Toshio, Gomez-Anson, Beatriz, Lau, Kui Kai, Jouvent, Eric, Rothwell, Peter M, Toyoda, Kazunori, Bae, Hee-Joon, Marti-Fabregas, Joan, and Werring, David J

Published
2019
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21. Microvasculature and intraplaque hemorrhage in atherosclerotic carotid lesions: a cardiovascular magnetic resonance imaging study

Author

Crombag, Geneviève A. J. C., Schreuder, Floris H. B. M., van Hoof, Raf H. M., Truijman, Martine T. B., Wijnen, Nicky J. A., Vöö, Stefan A., Nelemans, Patty J., Heeneman, Sylvia, Nederkoorn, Paul J., Daemen, Jan-Willem H., Daemen, Mat J. A. P., Mess, Werner H., Wildberger, J. E., van Oostenbrugge, Robert J., and Kooi, M. Eline

Published
2019
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22. Biliverdin Reductase B Is a Plasma Biomarker for Intraplaque Hemorrhage and a Predictor of Ischemic Stroke in Patients with Symptomatic Carotid Atherosclerosis.

Author

Chemaly, Melody, Marlevi, David, Iglesias, Maria-Jesus, Lengquist, Mariette, Kronqvist, Malin, Bos, Daniel, van Dam-Nolen, Dianne H. K., van der Kolk, Anja, Hendrikse, Jeroen, Kassem, Mohamed, Matic, Ljubica, Odeberg, Jacob, de Vries, Margreet R., Kooi, M. Eline, and Hedin, Ulf

Subjects
CAROTID artery, VASCULAR endothelial growth factor receptors, STROKE patients, ISCHEMIC stroke, BILIVERDIN, ATHEROSCLEROTIC plaque
Abstract

Background: Intraplaque hemorrhage (IPH) is a hallmark of atherosclerotic plaque instability. Biliverdin reductase B (BLVRB) is enriched in plasma and plaques from patients with symptomatic carotid atherosclerosis and functionally associated with IPH. Objective: We explored the biomarker potential of plasma BLVRB through (1) its correlation with IPH in carotid plaques assessed by magnetic resonance imaging (MRI), and with recurrent ischemic stroke, and (2) its use for monitoring pharmacotherapy targeting IPH in a preclinical setting. Methods: Plasma BLVRB levels were measured in patients with symptomatic carotid atherosclerosis from the PARISK study (n = 177, 5 year follow-up) with and without IPH as indicated by MRI. Plasma BLVRB levels were also measured in a mouse vein graft model of IPH at baseline and following antiangiogenic therapy targeting vascular endothelial growth factor receptor 2 (VEGFR-2). Results: Plasma BLVRB levels were significantly higher in patients with IPH (737.32 ± 693.21 vs. 520.94 ± 499.43 mean fluorescent intensity (MFI), p = 0.033), but had no association with baseline clinical and biological parameters. Plasma BLVRB levels were also significantly higher in patients who developed recurrent ischemic stroke (1099.34 ± 928.49 vs. 582.07 ± 545.34 MFI, HR = 1.600, CI [1.092–2.344]; p = 0.016). Plasma BLVRB levels were significantly reduced following prevention of IPH by anti-VEGFR-2 therapy in mouse vein grafts (1189 ± 258.73 vs. 1752 ± 366.84 MFI; p = 0.004). Conclusions: Plasma BLVRB was associated with IPH and increased risk of recurrent ischemic stroke in patients with symptomatic low- to moderate-grade carotid stenosis, indicating the capacity to monitor the efficacy of IPH-preventive pharmacotherapy in an animal model. Together, these results suggest the utility of plasma BLVRB as a biomarker for atherosclerotic plaque instability. [ABSTRACT FROM AUTHOR]

Published
2023
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24. Vessel wall and adventitial DCE‐MRI parameters demonstrate similar correlations with carotid plaque microvasculature on histology

Author

van Hoof, Raf H.M., Vöö, Stefan A., Sluimer, Judith C., Wijnen, Nicky J.A., Hermeling, Evelien, Schreuder, Floris H.B.M., Truijman, Martine T.B, Cleutjens, Jack P.M., Daemen, Mat J.A.P., Daemen, Jan‐Willem H., van Oostenbrugge, Robert J., Mess, Werner H., Wildberger, Joachim E., Heeneman, Sylvia, and Kooi, M. Eline

Published
2017
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27. Optimal Management of Asymptomatic Carotid Stenosis in 2021: The Jury is Still Out. An International, Multispecialty, Expert Review and Position Statement

Author

Paraskevas, Kosmas I. Mikhailidis, Dimitri P. Antignani, Pier Luigi Baradaran, Hediyeh Bokkers, Reinoud P. Cambria, Richard P. Dardik, Alan Davies, Alun H. Eckstein, Hans-Henning Faggioli, Gianluca Fernandes E Fernandes, Jose Fraedrich, Gustav Geroulakos, George Gloviczki, Peter Golledge, Jonathan Gupta, Ajay Jezovnik, Mateja K. Kakkos, Stavros K. Katsiki, Niki Knoflach, Michael Kooi, M. Eline Lanza, Gaetano Liapis, Christos D. Loftus, Ian M. Mansilha, Armando Millon, Antoine Nicolaides, Andrew N. Pini, Rodolfo Poredos, Pavel Ricco, Jean-Baptiste Riles, Thomas S. Ringleb, Peter Arthur Rundek, Tatjana Saba, Luca Schlachetzki, Felix Silvestrini, Mauro Spinelli, Francesco Stilo, Francesco Sultan, Sherif Suri, Jasjit S. Zeebregts, Clark J. Chaturvedi, Seemant

Abstract

Objectives: The recommendations of international guidelines for the management of asymptomatic carotid stenosis (ACS) often vary considerably and extend from a conservative approach with risk factor modification and best medical treatment (BMT) alone, to a more aggressive approach with a carotid intervention plus BMT. The aim of the current multispecialty position statement is to reconcile the conflicting views on the topic. Materials and methods: A literature review was performed with a focus on data from recent studies. Results: Several clinical and imaging high-risk features have been identified that are associated with an increased long-term ipsilateral ischemic stroke risk in patients with ACS. Such high-risk clinical/imaging features include intraplaque hemorrhage, impaired cerebrovascular reserve, carotid plaque echolucency/ulceration/ neovascularization, a lipid-rich necrotic core, a thin or ruptured fibrous cap, silent brain infarction, a contralateral transient ischemic attack/stroke episode, male patients < 75 years and microembolic signals on transcranial Doppler. There is growing evidence that 80-99% ACS indicate a higher stroke risk than 50-79% stenoses. Conclusions: Although aggressive risk factor control and BMT should be implemented in all ACS patients, several high-risk features that may increase the risk of a future cerebrovascular event are now documented. Consequently, some guidelines recommend a prophylactic carotid intervention in high-risk patients to prevent future cerebrovascular events. Until the results of the much-anticipated randomized controlled trials emerge, the jury is still out regarding the optimal management of ACS patients. (c) 2021 Elsevier Inc. All rights reserved.

Published
2022

28. Long-echo time MR spectroscopy for skeletal muscle acetylcarnitine detection

Author

Lindeboom, Lucas, Nabuurs, Christine I., Hoeks, Joris, Brouwers, Bram, Phielix, Esther, Kooi, M. Eline, Hesselink, Matthijs K.C., Wildberger, Joachim E., Stevens, Robert D., Koves, Timothy, Muoio, Deborah M., Schrauwen, Patrick, and Schrauwen-Hinderling, Vera B.

Subjects
Acetyl-L-carnitine -- Physiological aspects -- Research, Nuclear magnetic resonance spectroscopy -- Usage, Muscles -- Physiological aspects -- Research, Health care industry
Abstract

Animal models suggest that acetylcarnitine production is essential for maintaining metabolic flexibility and insulin sensitivity. Because current methods to detect acetylcarnitine involve biopsy of the tissue of interest, noninvasive alternatives to measure acetylcarnitine concentrations could facilitate our understanding of its physiological relevance in humans. Here, we investigated the use of long-echo time (TE) proton magnetic resonance spectroscopy (¹H-MRS) to measure skeletal muscle acetylcarnitine concentrations on a clinical 3T scanner. We applied long-TE 1H-MRS to measure acetylcarnitine in endurance-trained athletes, lean and obese sedentary subjects, and type 2 diabetes mellitus (T2DM) patients to cover a wide spectrum in insulin sensitivity. A long-TE ¹H-MRS protocol was implemented for successful detection of skeletal muscle acetylcarnitine in these individuals. There were pronounced differences in insulin sensitivity, as measured by hyperinsulinemic-euglycemic clamp, and skeletal muscle mitochondrial function, as measured by phosphorus-MRS ([sup.31]P-MRS), across groups. Insulin sensitivity and mitochondrial function were highest in trained athletes and lowest in T2DM patients. Skeletal muscle acetylcarnitine concentration showed a reciprocal distribution, with mean acetylcarnitine concentration correlating with mean insulin sensitivity in each group. These results demonstrate that measuring acetylcarnitine concentrations with ¹H-MRS is feasible on clinical MR scanners and support the hypothesis that T2DM patients are characterized by a decreased formation of acetylcarnitine, possibly underlying decreased insulin sensitivity., Introduction The use of proton magnetic resonance spectroscopy ('H-MRS) in human skeletal muscle has been instrumental in establishing the importance of ectopic fat accumulation in the development of type 2 [...]

Published
2014
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32. Association between plaque vulnerability and neutrophil extracellular traps (NETs) levels: The Plaque At RISK study.

Author

de Vries, Judith J., Autar, Anouchska S. A., van Dam-Nolen, Dianne H. K., Donkel, Samantha J., Kassem, Mohamed, van der Kolk, Anja G., van Velzen, Twan J., Kooi, M. Eline, Hendrikse, Jeroen, Nederkoorn, Paul J., Bos, Daniel, van der Lugt, Aad, de Maat, Moniek P. M., and van Beusekom, Heleen M. M.

Subjects
PETRI nets, ISCHEMIC stroke, NEUTROPHILS, PRINCIPAL components analysis, ATHEROSCLEROTIC plaque
Abstract

Carotid atherosclerotic plaque rupture and its sequelae are among the leading causes of acute ischemic stroke. The risk of rupture and subsequent thrombosis is, among others, determined by vulnerable plaque characteristics and linked to activation of the immune system, in which neutrophil extracellular traps (NETs) potentially play a role. The aim of this study was to investigate how plaque vulnerability is associated with NETs levels. We included 182 patients from the Plaque At RISK (PARISK) study in whom carotid imaging was performed to measure plaque ulceration, fibrous cap integrity, intraplaque hemorrhage, lipid-rich necrotic core, calcifications and plaque volume. Principal component analysis generated a 'vulnerability index' comprising all plaque characteristics. Levels of the NETs marker myeloperoxidase-DNA complex were measured in patient plasma. The association between the vulnerability index and low or high NETs levels (dependent variable) was assessed by logistic regression. No significant association between the vulnerability index and NETs levels was detected in the total population (odds ratio 1.28, 95% confidence interval 0.90–1.83, p = 0.18). However, in the subgroup of patients naive to statins or antithrombotic medication prior to the index event, this association was statistically significant (odds ratio 2.08, 95% confidence interval 1.04–4.17, p = 0.04). Further analyses revealed that this positive association was mainly driven by intraplaque hemorrhage, lipid-rich necrotic core and ulceration. In conclusion, plaque vulnerability is positively associated with plasma levels of NETs, but only in patients naive to statins or antithrombotic medication prior to the index event. [ABSTRACT FROM AUTHOR]

Published
2022
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33. Fructose Intake From Fruit Juice and Sugar-Sweetened Beverages Is Associated With Higher Intrahepatic Lipid Content: The Maastricht Study.

Author

Buziau, Amée M., Eussen, Simone J.P.M., Kooi, M. Eline, van der Kallen, Carla J.H., van Dongen, Martien C.J.M., Schaper, Nicolaas C., Henry, Ronald M.A., Schram, Miranda T., Dagnelie, Pieter C., van Greevenbroek, Marleen M.J., Wesselius, Anke, Bekers, Otto, Meex, Steven J.R., Schalkwijk, Casper G., Stehouwer, Coen D.A., and Brouwers, Martijn C.G.J.

Subjects
BEVERAGES, CROSS-sectional method, FRUCTOSE, TYPE 2 diabetes, METABOLIC disorders, FRUIT, LONGITUDINAL method, LIPIDS
Abstract

Objective: Epidemiological evidence regarding the relationship between fructose intake and intrahepatic lipid (IHL) content is inconclusive. We, therefore, assessed the relationship between different sources of fructose and IHL at the population level.Research Design and Methods: We used cross-sectional data from The Maastricht Study, a population-based cohort study (n = 3,981; mean ± SD age: 60 ± 9 years; 50% women). We assessed the relationship between fructose intake (assessed with a food-frequency questionnaire)-total and derived from fruit, fruit juice, and sugar-sweetened beverages (SSB)-and IHL (quantified with 3T Dixon MRI) with adjustment for age, sex, type 2 diabetes, education, smoking status, physical activity, and intakes of total energy, alcohol, saturated fat, protein, vitamin E, and dietary fiber.Results: Energy-adjusted total fructose intake and energy-adjusted fructose from fruit were not associated with IHL in the fully adjusted models (P = 0.647 and P = 0.767). In contrast, energy-adjusted intake of fructose from fruit juice and SSB was associated with higher IHL in the fully adjusted models (P = 0.019 and P = 0.009). Individuals in the highest tertile of energy-adjusted intake of fructose from fruit juice and SSB had a 1.04-fold (95% CI 0.99; 1.11) and 1.09-fold (95% CI 1.03; 1.16) higher IHL, respectively, in comparison with the lowest tertile in the fully adjusted models. Finally, the association for fructose from fruit juice was stronger in individuals with type 2 diabetes (P for interaction = 0.071).Conclusions: Fructose from fruit juice and SSB is independently associated with higher IHL. These cross-sectional findings contribute to current knowledge in support of measures to reduce the intake of fructose-containing beverages as a means to prevent nonalcoholic fatty liver disease at the population level. [ABSTRACT FROM AUTHOR]

Published
2022
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37. Vessel Wall-Imaging Biomarkers of Carotid Plaque Vulnerability in Stroke Prevention Trials A Viewpoint From the Carotid Imaging Consensus Group

Author

Saba, Luca, Moody, Alan R., Saam, Tobias, Kooi, M. Eline, Wasserman, Bruce A., Staub, Daniel, van der Lugt, Aad, DeMarco, J. Kevin, Saloner, David, Wintermark, Max, Gupta, Ajay, RS: Carim - B06 Imaging, Beeldvorming, and MUMC+: DA BV Klinisch Fysicus (9)

Subjects
RISK, carotid plaque, biomarkers, stroke, FIBROUS CAP, CEREBROVASCULAR EVENTS, TRANSIENT ISCHEMIC ATTACK, plaque imaging, SURFACE-MORPHOLOGY, INTRAPLAQUE HEMORRHAGE, plaque vulnerability, MULTIDETECTOR COMPUTED-TOMOGRAPHY, CONTRAST-ENHANCED ULTRASOUND, ATHEROSCLEROTIC PLAQUE, HIGH-RESOLUTION
Published
2020

38. Noninvasive Cardiac Imaging in Formerly Preeclamptic Women for Early Detection of Subclinical Myocardial Abnormalities: A 2022 Update.

Author

Brandt, Yentl, Ghossein-Doha, Chahinda, Gerretsen, Suzanne C., Spaanderman, Marc E. A., and Kooi, M. Eline

Subjects
DOPPLER echocardiography, ECHOCARDIOGRAPHY, CARDIAC magnetic resonance imaging, CARDIAC imaging, PREECLAMPSIA, HEART failure
Abstract

Preeclampsia is a maternal hypertensive disease, complicating 2–8% of all pregnancies. It has been linked to a 2–7-fold increased risk for the development of cardiovascular disease, including heart failure, later in life. A total of 40% of formerly preeclamptic women develop preclinical heart failure, which may further deteriorate into clinical heart failure. Noninvasive cardiac imaging could assist in the early detection of myocardial abnormalities, especially in the preclinical stage, when these changes are likely to be reversible. Moreover, imaging studies can improve our insights into the relationship between preeclampsia and heart failure and can be used for monitoring. Cardiac ultrasound is used to assess quantitative changes, including the left ventricular cavity volume and wall thickness, myocardial mass, systolic and diastolic function, and strain. Cardiac magnetic resonance imaging may be of additional diagnostic value to assess diffuse and focal fibrosis and perfusion. After preeclampsia, sustained elevated myocardial mass along with reduced myocardial circumferential and longitudinal strain and decreased diastolic function is reported. These findings are consistent with the early phases of heart failure, referred to as preclinical (asymptomatic) or B-stage heart failure. In this review, we will provide an up-to-date overview of the potential of cardiac magnetic resonance imaging and echocardiography in identifying formerly preeclamptic women who are at high risk for developing heart failure. The potential contribution to early cardiac screening of women with a history of preeclampsia and the pros and cons of these imaging modalities are outlined. Finally, recommendations for future research are presented. [ABSTRACT FROM AUTHOR]

Published
2022
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40. Prediction of Stroke Risk by Detection of Hemorrhage in Carotid Plaques Meta-Analysis of Individual Patient Data

Author

Schindler, Andreas, Schinner, Regina, Altaf, Nishaf, Hosseini, Akram A., Simpson, Richard J., Esposito-Bauer, Lorena, Singh, Navneet, Kwee, Robert M., Kurosaki, Yoshitaka, Yamagata, Sen, Yoshida, Kazumichi, Miyamoto, Susumu, Maggisano, Robert, Moody, Alan R., Poppert, Holger, Kooi, M. Eline, Auer, Dorothee P., Bonati, Leo H., Saam, Tobias, Beeldvorming, MUMC+: DA BV Klinisch Fysicus (9), and RS: Carim - B06 Imaging

Subjects
ENDARTERECTOMY, cerebrovascular event, intraplaque hemorrhage, ARTERY STENOSIS, ASSOCIATION, DISEASE, carotid, TRANSIENT ISCHEMIC ATTACK, ATHEROSCLEROSIS, ischemic stroke, NASCET, magnetic resonance imaging, MODERATE, cardiovascular diseases, RECURRENCE, POPULATION
Abstract

OBJECTIVES The goal of this study was to compare the risk of stroke between patients with carotid artery disease with and without the presence of intraplaque hemorrhage (IPH) on magnetic resonance imaging. BACKGROUND IPH in carotid stenosis increases the risk of cerebrovascular events. Uncertainty remains whether risk of stroke alone is increased and whether stroke is predicted independently of known risk factors. METHODS Data were pooled from 7 cohort studies including 560 patients with symptomatic carotid stenosis and 136 patients with asymptomatic carotid stenosis. Hazards of ipsilateral ischemic stroke (primary outcome) were compared between patients with and without IPH, adjusted for clinical risk factors. RESULTS IPH was present in 51.6% of patients with symptomatic carotid stenosis and 29.4% of patients with asymptomatic carotid stenosis. During 1,121 observed person-years, 66 ipsilateral strokes occurred. Presence of IPH at baseline increased the risk of ipsilateral stroke both in symptomatic (hazard ratio [HR]: 10.2; 95% confidence interval [CI]: 4.6 to 22.5) and asymptomatic (HR: 7.9; 95% CI: 1.3 to 47.6) patients. Among patients with symptomatic carotid stenosis, annualized event rates of ipsilateral stroke in those with IPH versus those without IPH were 9.0% versus 0.7% ( CONCLUSIONS IPH is common in patients with symptomatic and asymptomatic carotid stenosis and is a stronger predictor of stroke than any known clinical risk factors. Magnetic resonance imaging might help identify patients with carotid disease who would benefit from revascularization. (C) 2020 The Authors. Published by Elsevier on behalf of the American College of Cardiology Foundation.

Published
2020

41. Influence of prolonged endurance cycling and recovery diet on intramuscular triglyceride content in trained males

Author

van Loon, Luc J.C., Schrauwen-Hinderling, Vera B., Koopman, Rene, Wagenmakers, Anton J.M., Hesselink, Matthijs K.C., Schaart, Gert, Kooi, M. Eline, and Saris, Wim H.M.

Subjects
Cycling -- Research, Triglycerides -- Research, Biological sciences
Abstract

Intramuscular triglycerides (IMTG) are assumed to form an important substrate source during prolonged endurance exercise in trained males. This study investigated the effects of endurance exercise and recovery diet on IMTG content in vastus lateralis muscle. Nine male cyclists were provided with a standardized diet for 3 days, after which they performed a 3-h exercise trial at a 55% maximum workload. Before and immediately after exercise and after 24 and 48 h of recovery, magnetic resonance spectroscopy (MRS) was performed to quantitate IMTG content. Muscle biopsies were taken after 48 h of recovery to determine IMTG content by using quantitative fluorescence microscopy. The entire procedure was performed two times; in one trial, a normal diet containing 39% energy (En%) as fat was provided (NF) and in the other a typical carbohydraterich athlete's diet (LF: 24 Eh% fat) was provided. During exercise, IMTG content decreased by 21.4 [+ or -] 3.1%. During recovery, IMTG content increased significantly in the NF trial only, reaching preexercise levels within 48 h. In accord with MRS, fluorescence microscopy showed significantly higher IMTG content in the NF compared with the LF trial, with differences restricted to the type I muscle fibers (2.1 [+ or -] 0.2 vs. 1.4 [+ or -] 0.2% area lipid staining, respectively). In conclusion, IMTG content in the vastus lateralis muscle declines significantly during prolonged endurance exercise in male cyclists. When a normal diet is used, IMTG contents are subsequently repleted within 48 h of postexercise recovery. In contrast, IMTG repletion is impaired substantially when a typical, carbohydrate-rich athlete's diet is used. Data obtained by quantitative fluorescence microscopy correspond well with MRS results, implying that both are valid methods to quantify IMTG content. muscle; nuclear magnetic resonance; [sup.1]H magnetic resonance spectroscopy; oil red O; exercise; intramyocellular lipid; diet

Published
2003

42. Management of patients with asymptomatic carotid stenosis may need to be individualized: a multidisciplinary call for action. republication of J Stroke 2021;23:202-12.

Author

PARASKEVAS, Kosmas I., MIKHAILIDIS, Dimitri P., BARADARAN, Hediyeh, DAVIES, Alun H., ECKSTEIN, Hans-Henning, FAGGIOLI, Gianluca, FERNANDES E. FERNANDES, Jose, GUPTA, Ajay, JEZOVNIK, Mateja K., KAKKOS, Stavros K., KATSIKI, Niki, KOOI, M. Eline, LANZA, Gaetano, LIAPIS, Christos D., LOFTUS, Ian M., MILLON, Antoine, NICOLAIDES, Andrew N., POREDOS, Pavel, PINI, Rodolfo, and RICCO, Jean-Baptiste

Published
2021
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46. Multimodality Imaging of Carotid Artery Plaques: 18F-Fluoro-2-Deoxyglucose Positron Emission Tomography, Computed Tomography, and Magnetic Resonance Imaging

Author

Kwee, Robert M., Teule, Gerrit J. J., van Oostenbrugge, Robert J., Mess, Werner H., Prins, Martin H., van der Geest, Rob J., ter Berg, Johannes W.M., Franke, Cees L., Korten, Arthur G.G.C., Meems, Bé J., Hofman, Paul A.M., van Engelshoven, Jos M.A., Wildberger, Joachim E., and Kooi, M Eline

Published
2009
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47. Emerging Role of Carotid MRI for Personalized Ischemic Stroke Risk Prediction in Patients With Carotid Artery Stenosis.

Author

Nies, Kelly P. H., Smits, Luc J. M., Kassem, Mohamed, Nederkoorn, Paul J., Oostenbrugge, Robert J. van, and Kooi, M. Eline

Subjects
ISCHEMIC stroke, CAROTID artery stenosis, MAGNETIC resonance imaging, COMPUTED tomography, POSITRON emission tomography
Abstract

Rupture of a vulnerable carotid plaque is an important cause of ischemic stroke. Prediction models can support medical decision-making by estimating individual probabilities of future events, while magnetic resonance imaging (MRI) can provide detailed information on plaque vulnerability. In this review, prediction models for medium to long-term (>90 days) prediction of recurrent ischemic stroke among patients on best medical treatment for carotid stenosis are evaluated, and the emerging role of MRI of the carotid plaque for personalized ischemic stroke prediction is discussed. A systematic search identified two models; the European Carotid Surgery Trial (ECST) medical model, and the Symptomatic Carotid Atheroma Inflammation Lumen stenosis (SCAIL) score. We critically appraised these models by means of criteria derived from the CHARMS (CHecklist for critical Appraisal and data extraction for systematic Reviews of prediction Modeling Studies) and PROBAST (Prediction model Risk Of Bias ASsessment Tool). We found both models to be at high risk of bias. The ECST model, the most widely used model, was derived from data of large but relatively old trials (1980s and 1990s), not reflecting lower risks of ischemic stroke resulting from improvements in drug treatment (e.g., statins and anti-platelet therapy). The SCAIL model, based on the degree of stenosis and positron emission tomography/computed tomography (PET/CT)-based plaque inflammation, was derived and externally validated in limited samples. Clinical implementation of the SCAIL model can be challenging due to high costs and low accessibility of PET/CT. MRI is a more readily available, lower-cost modality that has been extensively validated to visualize all the hallmarks of plaque vulnerability. The MRI methods to identify the different plaque features are described. Intraplaque hemorrhage (IPH), a lipid-rich necrotic core (LRNC), and a thin or ruptured fibrous cap (TRFC) on MRI have shown to strongly predict stroke in meta-analyses. To improve personalized risk prediction, carotid plaque features should be included in prediction models. Prediction of stroke in patients with carotid stenosis needs modernization, and carotid MRI has potential in providing strong predictors for that goal. [ABSTRACT FROM AUTHOR]

Published
2021
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49. Effects of fructose restriction on liver steatosis (FRUITLESS); a double-blind randomized controlled trial.

Author

Simons, Nynke, Veeraiah, Pandichelvam, Simons, Pomme I H G, Schaper, Nicolaas C, Kooi, M Eline, Schrauwen-Hinderling, Vera B, Feskens, Edith J M, van der Ploeg, E M C (Liesbeth), Van den Eynde, Mathias D G, Schalkwijk, Casper G, Stehouwer, Coen D A, and Brouwers, Martijn C G J

Subjects
REDUCING diets, FATTY liver prevention, ACADEMIC medical centers, CONFIDENCE intervals, DIET in disease, DIET therapy, DIETARY supplements, FRUCTOSE, GLUCOSE, GLUCOSE tolerance tests, LIPIDS, LIVER, PROTON magnetic resonance spectroscopy, STATISTICAL sampling, SERUM, RANDOMIZED controlled trials, TREATMENT effectiveness, BLIND experiment, ADULTS
Abstract

Background There is an ongoing debate on whether fructose plays a role in the development of nonalcoholic fatty liver disease. Objectives The aim of this study was to investigate the effects of fructose restriction on intrahepatic lipid (IHL) content in a double-blind randomized controlled trial using an isocaloric comparator. Methods Between March 2017 and October 2019, 44 adult overweight individuals with a fatty liver index ≥ 60 consumed a 6-wk fructose-restricted diet (<7.5 g/meal and <10 g/d) and were randomly assigned to supplementation with sachets of glucose (= intervention group) or fructose (= control group) 3 times daily. Participants and assessors were blinded to the allocation. IHL content, assessed by proton magnetic resonance spectroscopy, was the primary outcome and glucose tolerance and serum lipids were the secondary outcomes. All measurements were conducted in Maastricht University Medical Center. Results Thirty-seven participants completed the study protocol. After 6 wk of fructose restriction, dietary fructose intake and urinary fructose excretion were significantly lower in the intervention group (difference: −57.0 g/d; 95% CI: −77.9, −39.5 g/d; and −38.8 μmol/d; 95% CI: −91.2, −10.7 μmol/d, respectively). Although IHL content decreased in both the intervention and control groups (P  < 0.001 and P  = 0.003, respectively), the change in IHL content was more pronounced in the intervention group (difference: −0.7% point, 95% CI: −2.0, −0.03% point). The changes in glucose tolerance and serum lipids were not significantly different between groups. Conclusions Six weeks of fructose restriction per se led to a small, but statistically significant, decrease in IHL content in comparison with an isocaloric control group. This trial was registered at clinicaltrials.gov as NCT03067428. [ABSTRACT FROM AUTHOR]

Published
2021
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50. Cardiac lipid content is unresponsive to a physical activity training intervention in type 2 diabetic patients, despite improved ejection fraction

Author

Leiner Tim, van de Weijer Tineke, Hesselink Matthijs KC, Meex Ruth CR, Schrauwen-Hinderling Vera B, Schär Michael, Lamb Hildo J, Wildberger Joachim E, Glatz Jan FC, Schrauwen Patrick, and Kooi M Eline

Subjects
magnetic resonance spectroscopy, magnetic resonance imaging, ectopic fat, type 2 diabetes mellitus, exercise, cardiomyopathy, lipotoxicity, Diseases of the circulatory (Cardiovascular) system, RC666-701
Abstract

Abstract Background Increased cardiac lipid content has been associated with diabetic cardiomyopathy. We recently showed that cardiac lipid content is reduced after 12 weeks of physical activity training in healthy overweight subjects. The beneficial effect of exercise training on cardiovascular risk is well established and the decrease in cardiac lipid content with exercise training in healthy overweight subjects was accompanied by improved ejection fraction. It is yet unclear whether diabetic patients respond similarly to physical activity training and whether a lowered lipid content in the heart is necessary for improvements in cardiac function. Here, we investigated whether exercise training is able to lower cardiac lipid content and improve cardiac function in type 2 diabetic patients. Methods Eleven overweight-to-obese male patients with type 2 diabetes mellitus (age: 58.4 ± 0.9 years, BMI: 29.9 ± 0.01 kg/m2) followed a 12-week training program (combination endurance/strength training, three sessions/week). Before and after training, maximal whole body oxygen uptake (VO2max) and insulin sensitivity (by hyperinsulinemic, euglycemic clamp) was determined. Systolic function was determined under resting conditions by CINE-MRI and cardiac lipid content in the septum of the heart by Proton Magnetic Resonance Spectroscopy. Results VO2max increased (from 27.1 ± 1.5 to 30.1 ± 1.6 ml/min/kg, p = 0.001) and insulin sensitivity improved upon training (insulin stimulated glucose disposal (delta Rd of glucose) improved from 5.8 ± 1.9 to 10.3 ± 2.0 μmol/kg/min, p = 0.02. Left-ventricular ejection fraction improved after training (from 50.5 ± 2.0 to 55.6 ± 1.5%, p = 0.01) as well as cardiac index and cardiac output. Unexpectedly, cardiac lipid content in the septum remained unchanged (from 0.80 ± 0.22% to 0.95 ± 0.21%, p = 0.15). Conclusions Twelve weeks of progressive endurance/strength training was effective in improving VO2max, insulin sensitivity and cardiac function in patients with type 2 diabetes mellitus. However, cardiac lipid content remained unchanged. These data suggest that a decrease in cardiac lipid content in type 2 diabetic patients is not a prerequisite for improvements in cardiac function. Trial registration ISRCTN: ISRCTN43780395

Published
2011
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