Pranvera Ibrahimi1, Fisnik Jashari1, Elias Johansson2, Christer Gronlund3, Gani Bajraktari1, Per Wester1, Michael Y Henein4. 1. Department of Public Health and Clinical Medicine and Heart Centre, Umeå University, Umeå, Sweden. 2. Department of Public Health and Clinical Medicine and Heart Centre, Umeå University, Umeå, Sweden; Department of Pharmacology and Clinical Neuroscience, Umeå University, Umeå, Sweden. 3. Department of Biomedical Engineering - Radiation Sciences, Umeå University, Umeå, Sweden. 4. Department of Public Health and Clinical Medicine and Heart Centre, Umeå University, Umeå, Sweden. Electronic address: michael.henein@medicin.umu.se.
Abstract
BACKGROUND AND AIM: Carotid plaques may represent a generalized atherosclerotic syndrome or a localized disease. The aim of this study was to assess the morphological and textural features of carotid plaques located contralateral to the symptomatic side and compare them with the symptomatic side and with plaques from asymptomatic patients. METHODS: We studied 66 arteries in 39 patients (mean age 70 ± 7 year, 33% females). Arterial plaques were classified as either symptomatic (n = 30), contralateral to symptomatic (n = 25) or asymptomatic (n = 11). We compared several plaque features between these groups including the mean values of the grey scale median (GSM), entropy, juxtaluminal black area (JBA) without visible echogenic cap, GSM of the JBA and surface irregularity. RESULTS: The plaques contralateral to symptomatic arteries had similar morphological and textural features to those in the symptomatic arteries. In contrast, they had more vulnerable morphological and textural features than those in asymptomatic arteries: less smooth plaques (12% vs. 55%) and instead more often mildly irregular (60% vs 36%) or markedly irregular (28% vs. 9%; p = 0.03), lower GSM (26.2 ± 8 vs. 49.4 ± 14, p < 0.001) and lower GSM of the JBA (5.0 ± 3.6 vs. 11.4 ± 2.1, p = 0.008). The frequency of entropy and plaque calcification was similar in all groups. CONCLUSION: Symptomatic patients with carotid artery disease seem to have similar morphological and textural features of vulnerability in the symptomatic and the contralateral carotid arteries, which are profound compared with asymptomatic carotid arteries. These findings support the concept of generalized carotid atherosclerotic pathology rather than incidental unilateral disease, and also emphasize a need for aggressive measures for plaque stabilization, particularly in symptomatic patients.
BACKGROUND AND AIM: Carotid plaques may represent a generalized atherosclerotic syndrome or a localized disease. The aim of this study was to assess the morphological and textural features of carotid plaques located contralateral to the symptomatic side and compare them with the symptomatic side and with plaques from asymptomatic patients. METHODS: We studied 66 arteries in 39 patients (mean age 70 ± 7 year, 33% females). Arterial plaques were classified as either symptomatic (n = 30), contralateral to symptomatic (n = 25) or asymptomatic (n = 11). We compared several plaque features between these groups including the mean values of the grey scale median (GSM), entropy, juxtaluminal black area (JBA) without visible echogenic cap, GSM of the JBA and surface irregularity. RESULTS: The plaques contralateral to symptomatic arteries had similar morphological and textural features to those in the symptomatic arteries. In contrast, they had more vulnerable morphological and textural features than those in asymptomatic arteries: less smooth plaques (12% vs. 55%) and instead more often mildly irregular (60% vs 36%) or markedly irregular (28% vs. 9%; p = 0.03), lower GSM (26.2 ± 8 vs. 49.4 ± 14, p < 0.001) and lower GSM of the JBA (5.0 ± 3.6 vs. 11.4 ± 2.1, p = 0.008). The frequency of entropy and plaque calcification was similar in all groups. CONCLUSION: Symptomatic patients with carotid artery disease seem to have similar morphological and textural features of vulnerability in the symptomatic and the contralateral carotid arteries, which are profound compared with asymptomatic carotid arteries. These findings support the concept of generalized carotid atherosclerotic pathology rather than incidental unilateral disease, and also emphasize a need for aggressive measures for plaque stabilization, particularly in symptomatic patients.
Authors: Carol C Mitchell; James H Stein; Thomas D Cook; Shahriar Salamat; Xiao Wang; Tomy Varghese; Daren C Jackson; Carolina Sandoval Garcia; Stephanie M Wilbrand; Robert J Dempsey Journal: Ultrasound Med Biol Date: 2016-10-05 Impact factor: 2.998
Authors: Carol C Mitchell; Claudia E Korcarz; Adam D Gepner; Rebecca Nye; Rebekah L Young; Mika Matsuzaki; Wendy S Post; Joel D Kaufman; Robyn L McClelland; James H Stein Journal: J Am Heart Assoc Date: 2019-02-05 Impact factor: 5.501
Authors: Isak Stenudd; Elias Sjödin; Emma Nyman; Per Wester; Elias Johansson; Christer Grönlund Journal: Int J Cardiovasc Imaging Date: 2020-03-06 Impact factor: 2.357