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Inflammation and characteristics of atherosclerotic plaque

Suder, Natalie (2018) Inflammation and characteristics of atherosclerotic plaque. Doctoral Dissertation, University of Pittsburgh. (Unpublished)

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Abstract

Atherosclerosis, or the accumulation of lipids within the arterial wall, is the underlying process responsible for the majority of cardiovascular disease (CVD). Inflammation is one of the essential forces driving the development and progression of atherosclerosis. Several cells, chemokines, and co-stimulatory molecules of the innate and adaptive immune response have been associated with atherosclerosis and cardiovascular risk. Another important risk factor associated with atherosclerotic CVD risk is psychosocial stress, and it has been widely hypothesized psychosocial stress influences CVD through increased inflammation. Within atherosclerotic plaque, greater inflammatory content is associated with plaque instability and greater likelihood of plaque to result in a cardiovascular event via erosion or rupture.
B-mode ultrasound is an imaging technique that allows for the measurement and characterization of atherosclerotic plaque in the superficial arteries such as the carotid and femoral arteries. The measurement and characterization of plaque in subclinical stages affords us the opportunity to better understand the processes contributing to the development of atherosclerosis and for the identification of individuals who may be at risk of having a cardiovascular event.
In this dissertation, the associations between the circulating burden of inflammation and coagulation with measures of plaque presence, burden, and characteristics in the carotid and femoral arteries are evaluated with the intention of better understanding the inflammatory mechanisms contributing to plaque instability. Additionally, we assessed inflammatory burden as a potential mediator of the relationship between perceived everyday discrimination, a measure of psychosocial stress, with carotid plaque characteristics.
Overall, we did not find any independent associations between inflammatory and coagulation burden with measures of femoral plaque presence, burden, and characteristics among healthy older adults. However we did find several associations between inflammatory and coagulation burden with various measures of carotid plaque burden and characteristics independent of traditional CVD risk factors among women in midlife. We also identified inflammatory burden as a partial mediator of the relationship between everyday discrimination and carotid plaque height.
The findings presented in the following chapters have public health significance because they highlight important associations between circulating inflammatory and coagulation burden with measures of carotid plaque burden and characteristics among women, and suggest that increased inflammatory and coagulation burden may serve as mechanisms contributing to the progression and complication of atherosclerotic plaque among women at midlife. Furthermore, our results suggest that increased inflammatory burden and greater atherosclerotic plaque height may be mechanisms through which experiences of discrimination increase cardiovascular risk among midlife women.


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Details

Item Type: University of Pittsburgh ETD
Status: Unpublished
Creators/Authors:
CreatorsEmailPitt UsernameORCID
Suder, Nataliencs22@pitt.eduncs22
ETD Committee:
TitleMemberEmail AddressPitt UsernameORCID
Committee ChairBarinas-Mitchell, Emmabarinas@edc.pitt.eduejb4
Committee MemberOrchard, Trevororchardt@edc.pitt.edutjo
Committee MemberBrooks, Mariambrooks@pitt.edumbrooks
Committee MemberThurston, Rebeccathurstonrc@upmc.edurct10
Committee MemberMulukutla, Sureshsrm12@pitt.edusrm12
Committee MemberWassel, Christinachristina.wassel@med.uvm.edu
Date: 30 January 2018
Date Type: Publication
Defense Date: 24 August 2017
Approval Date: 30 January 2018
Submission Date: 16 November 2017
Access Restriction: 2 year -- Restrict access to University of Pittsburgh for a period of 2 years.
Number of Pages: 167
Institution: University of Pittsburgh
Schools and Programs: Graduate School of Public Health > Epidemiology
Degree: DrPH - Doctor of Public Health
Thesis Type: Doctoral Dissertation
Refereed: Yes
Uncontrolled Keywords: Atherosclerosis, plaque, inflammation
Date Deposited: 30 Jan 2018 22:54
Last Modified: 30 Jan 2018 22:54
URI: http://d-scholarship.pitt.edu/id/eprint/33369

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