Publications by authors named "Hailun Hang"

3 Publications

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Carotid vulnerable plaque coexisting with cerebral small vessel disease and acute ischemic stroke: a Chinese Atherosclerosis Risk Evaluation study.

Eur Radiol 2022 Apr 2. Epub 2022 Apr 2.

Department of Radiology, University of Washington, Seattle, WA, USA.

Objectives: We aimed to investigate the associations between carotid vulnerable plaque features coexisting with cerebral small vessel diseases (CSVDs) and acute ischemic stroke (AIS) and, furthermore, to determine whether coexisting diseases had a stronger association with AIS than a single disease.

Methods: Patients with cerebrovascular symptoms and carotid plaque were recruited from the cross-sectional, multicenter CARE-II study. The population was divided into two groups (AIS and transient ischemic stroke (TIA)). MRI features of carotid plaques (including luminal stenosis and plaque vulnerabilities) and CSVDs (such as white matter hyperintensities (WMHs) and lacunes) were evaluated. Coexisting diseases were defined as the presence of at least one carotid plaque features and one or more CSVDs feature. Multivariate logistic regression was performed to examine the associations between coexisting diseases and AIS.

Results: Of the recruited 634 patients (mean age: 59.1 ± 11.3 years; 429 males), 312 (49.2%) patients had AIS. These subjects had a higher prevalence of carotid vulnerable plaques, lacunes, and moderate-to-severe WMHs (a total Fazekas score of 3-6) than those with TIA (42.6% vs. 29.5%, 59.6% vs. 26.4%, 69.9% vs. 60.6%, respectively, all p < 0.05). Multivariate analysis revealed that carotid plaque features coexisting with lacunes or moderate-to-severe WMHs had a stronger association with AIS compared to carotid lesions alone (all p < 0.05) (i.e., vulnerable plaque coexisting with lacunes vs. vulnerable plaque alone, adjusted odds ratio: 3.67 vs. 1.62).

Conclusions: Carotid vulnerable plaque features coexisting with CSVDs, particularly lacunes, had a stronger association with AIS compared to carotid lesions alone in a large, symptomatic, cohort.

Trial Registration: Clinical trial registration URL: http://www.

Clinicaltrials: gov , unique identifier: NCT02017756 KEY POINTS: • Carotid vulnerable plaque features coexisting with cerebral small vessel diseases, such as lacunes, had a stronger association with acute ischemic stroke compared to single diseases in symptomatic patients. • A comprehensive assessment of coexisting cerebrovascular diseases may help stratify the risk of acute ischemic stroke.
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April 2022

Clinical significance of anti-SSA/Ro antibody in Neuromyelitis optica spectrum disorders.

Mult Scler Relat Disord 2022 Feb 10;58:103494. Epub 2022 Jan 10.

Department of Neurology, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, Jiangsu 210029, China.

Background: Neuromyelitis optica spectrum disorder (NMOSD) is an autoimmune inflammatory disease of the central nervous system (CNS), also described as CNS autoimmune astrocytopathy, due to the production of pathogenic antibodies against aquaporin-4 (AQP4) expressed on the foot of astrocytes. NMOSD coexists with autoimmune diseases and related autoantibodies [anti-Sjogren's syndrome A (anti-SSA)/Ro antibody, anti-Sjogren's syndrome B (anti-SSB)/La antibody, anti-nuclear (anti-ANA) antibodies, anti-double-stranded DNA (anti-dsDNA) antibody, anti-thyroglobulin antibody, and anti-thyroid peroxidase antibody].

Objectives: No precise conclusion has been drawn on the role of the anti-SSA/Ro antibody in NMOSD. Therefore, the aim of this work was to evaluate whether the anti-SSA/Ro antibody has an impact on the clinical manifestation or prognosis of NMOSD.

Methods: Data were retrospectively collected from 102 patients with NMOSD diagnosed by experienced neurologists. The study population was divided into two groups based on the serum anti-SSA/Ro antibody status: NMOSD with or without anti-SSA/Ro antibody. The clinical, neuroimaging and laboratory parameters were compared between the two groups, including the neurological symptoms, MRI results, frequency of systemic autoantibodies, Expanded Disability Status Scale (EDSS), and NMOSD relapse rate. The EDSS and relapse were applied as measures of the NMOSD patient prognostic value. Cox regression analysis was used to evaluate the prognostic impact of anti-SSA/Ro antibody on NMOSD.

Results: Among the 102 NMOSD patients, striking differences were observed in the positive rate of AQP4-IgG (89.2% vs. 72.3%, p = 0.046) between those patients with and without the anti-SSA/Ro antibody. In addition, NMOSD patients with anti-SSA/Ro antibody showed the presence of more frequent anti-ANA antibodies (p = 0.002), anti-SSB/La antibody (p < 0.001), anti-dsDNA antibody (p < 0.002), Sjogren's syndrome (SS, p < 0.001) and systemic lupus erythematosus (SLE, p = 0.045). Univariate and multivariate Cox regression analysis were performed to confirm that the anti-SSA/Ro antibody affected the EDSS score and the relapse of NMOSD patients. The analysis of the survival curve revealed that the EDSS score in the NMOSD patients positive for the anti-SSA/Ro antibody reached 4.0 (p = 0.035) and relapsed (p = 0.039) earlier than in the negative group.

Conclusion: The anti-SSA/Ro antibody could be associated with disease activity and severe disability in NMOSD.
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February 2022

Irregularity of Carotid Plaque Surface Predicts Subsequent Vascular Event: A MRI Study.

J Magn Reson Imaging 2020 07 15;52(1):185-194. Epub 2020 Jan 15.

Center for Biomedical Imaging Research, Department of Biomedical Engineering, Tsinghua University School of Medicine, Beijing, China.

Background: The relationship between plaque compositions and irregular plaque surface and its predictive value for vascular events (VEs) are unknown.

Purpose: To investigate the relationship between irregular carotid plaque surface and plaque compositional features and its predictive values for future VEs utilizing magnetic resonance (MR) vessel wall imaging.

Study Type: Prospective study.

Population: In total, 140 patients with cerebrovascular symptoms were recruited.

Field Strength/sequence: 3T, black blood T -weighted, black blood T -weighted, 3D time-of-flight, magnetization-prepared rapid acquisition gradient echo (MP-RAGE), and 3D motion sensitized driven equilibrium rapid gradient echo (MERGE).

Assessment: The carotid artery stenosis and maximum wall thickness (Max WT) were measured. The presence/absence of irregular carotid plaque surface, calcification, lipid-rich necrotic core (LRNC), intraplaque hemorrhage (IPH), and fibrous cap rupture was determined. After baseline examination, all patients were followed-up for at least 1 year to record the VEs.

Statistical Tests: Independent t-test, Mann-Whitney U-test, Chi-square, logistic regression, and Cox regression were used.

Results: In total, 82 (58.6%) had irregular plaque surfaces. The carotid Max WT, stenosis, and the presence of surface calcification, LRNC and IPH were significantly associated with irregular plaque surface (all P < 0.05). After adjusted for baseline confounding factors, these associations remained statistically significant (all P < 0.05). During the median follow-up time of 12.1 months, 37 (26.4%) patients had VEs. Univariable Cox regression analysis showed that the irregular carotid plaque surface was significantly associated with subsequent VEs (hazard ratio [HR], 11.02; 95% confidence interval [CI], 2.65-45.85; P = 0.001). After adjusted for baseline and follow-up confounding factors, this association remained statistically significant (HR, 13.03; 95% CI, 1.71-99.42, P = 0.013). After further adjusted for intracranial stenosis, this association also remained statistically significant (HR, 12.57; 95% CI, 1.63-96.83, P = 0.015).

Data Conclusion: The morphology of carotid atherosclerotic plaque surface determined by MR vessel wall imaging, particularly irregular plaque surface, is an independent predictor for subsequent vascular events.

Level Of Evidence: 1 Technical Efficacy Stage: 5 J. Magn. Reson. Imaging 2020;52:185-194.
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July 2020