Elastin fragmentation in atherosclerotic mice leads to intraplaque neovascularization, plaque rupture, myocardial infarction, stroke, and sudden death

Eur Heart J. 2015 May 1;36(17):1049-58. doi: 10.1093/eurheartj/ehu041. Epub 2014 Feb 19.

Abstract

Aims: There is a need for animal models of plaque rupture. We previously reported that elastin fragmentation, due to a mutation (C1039G(+/-)) in the fibrillin-1 (Fbn1) gene, promotes atherogenesis and a highly unstable plaque phenotype in apolipoprotein E deficient (ApoE(-/-)) mice on a Western-type diet (WD). Here, we investigated whether plaque rupture occurred in ApoE(-/-)Fbn1(C1039G+/-) mice and was associated with myocardial infarction, stroke, and sudden death.

Methods and results: Female ApoE(-/-)Fbn1(C1039G+/-) and ApoE(-/-) mice were fed a WD for up to 35 weeks. Compared to ApoE(-/-) mice, plaques of ApoE(-/-)Fbn1(C1039G+/-) mice showed a threefold increase in necrotic core size, augmented T-cell infiltration, a decreased collagen I content (70 ± 10%), extensive neovascularization, intraplaque haemorrhage, and a significant increase in matrix metalloproteinase-2, -9, -12, and -13 expression or activity. Plaque rupture was observed in 70% of ascending aortas and in 50% of brachiocephalic arteries of ApoE(-/-)Fbn1(C1039G+/-) mice. In ApoE(-/-) mice, plaque rupture was not seen in ascending aortas and only in 10% of brachiocephalic arteries. Seventy percent of ApoE(-/-)Fbn1(C1039G+/-) mice died suddenly, whereas all ApoE(-/-) mice survived. ApoE(-/-)Fbn1(C1039G+/-) mice showed coronary plaques and myocardial infarction (75% of mice). Furthermore, they displayed head tilt, disorientation, and motor disturbances (66% of cases), disturbed cerebral blood flow (73% of cases; MR angiograms) and brain hypoxia (64% of cases), indicative of stroke.

Conclusions: Elastin fragmentation plays a key role in plaque destabilization and rupture. ApoE(-/-)Fbn1(C1039G+/-) mice represent a unique model of acute plaque rupture with human-like complications.

Keywords: Angiogenesis; Animal model; Myocardial infarction; Plaque rupture; Stroke.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Animals
  • Aorta
  • Apolipoproteins E / deficiency
  • Biomarkers / metabolism
  • Brachiocephalic Trunk
  • Cardiomegaly / etiology
  • Cardiomegaly / physiopathology
  • Carotid Artery, Common
  • Cerebrovascular Circulation / physiology
  • Death, Sudden / etiology*
  • Diet, Western
  • Disease Models, Animal
  • Elastin / metabolism*
  • Female
  • Fibrillin-1
  • Fibrillins
  • Hemorrhage / etiology
  • Hypoxia, Brain / etiology
  • Hypoxia, Brain / physiopathology
  • Mice
  • Microfilament Proteins / deficiency
  • Microvessels
  • Myocardial Infarction / etiology*
  • Myocardial Infarction / physiopathology
  • Neovascularization, Pathologic / etiology
  • Neovascularization, Pathologic / physiopathology
  • Nervous System Diseases / etiology
  • Nervous System Diseases / physiopathology
  • Plaque, Atherosclerotic / etiology*
  • Plaque, Atherosclerotic / physiopathology
  • Rupture, Spontaneous / etiology
  • Rupture, Spontaneous / physiopathology
  • Stroke / etiology*
  • Ventricular Dysfunction, Left / etiology
  • Ventricular Dysfunction, Left / physiopathology

Substances

  • Apolipoproteins E
  • Biomarkers
  • FBN1 protein, human
  • Fbn1 protein, mouse
  • Fibrillin-1
  • Fibrillins
  • Microfilament Proteins
  • Elastin