Differences in carotid arterial morphology and composition between individuals with and without obstructive coronary artery disease: A cardiovascular magnetic resonance study
Tóm tắt
We sought to determine differences with cardiovascular magnetic resonance (CMR) in the morphology and composition of the carotid arteries between individuals with angiographically-defined obstructive coronary artery disease (CAD, ≥ 50% stenosis, cases) and those with angiographically normal coronaries (no lumen irregularities, controls). 191 participants (50.3% female; 50.8% CAD cases) were imaged with a multi-sequence, carotid CMR protocol at 1.5T. For each segment of the carotid, lumen area, wall area, total vessel area (lumen area + wall area), mean wall thickness and the presence or absence of calcification and lipid-rich necrotic core were recorded bilaterally. In male CAD cases compared to male controls, the distal bulb had a significantly smaller lumen area (60.0 ± 3.1 vs. 79.7 ± 3.2 mm2, p < 0.001) and total vessel area (99.6 ± 4.0 vs. 119.8 ± 4.1 mm2; p < 0.001), and larger mean wall thickness (1.25 ± 0.03 vs. 1.11 ± 0.03 mm; p = 0.002). Similarly, the internal carotid had a smaller lumen area (37.5 ± 1.8 vs. 44.6 ± 1.8 mm2; p = 0.006) and smaller total vessel area (64.0 ± 2.3 vs. 70.9 ± 2.4 mm2; p = 0.04). These metrics were not significantly different between female groups in the distal bulb and internal carotid or for either gender in the common carotid. Male CAD cases had an increased prevalence of lipid-rich necrotic core (49.0% vs. 19.6%; p = 0.003), while calcification was more prevalent in both male (46.9% vs. 17.4%; p = 0.002) and female (33.3% vs. 14.6%; p = 0.031) CAD cases compared to controls. Males with obstructive CAD compared to male controls had carotid bulbs and internal carotid arteries with smaller total vessel and lumen areas, and an increased prevalence of lipid-rich necrotic core. Carotid calcification was related to CAD status in both males and females. Carotid CMR identifies distinct morphological and compositional differences in the carotid arteries between individuals with and without angiographically-defined obstructive CAD.
Tài liệu tham khảo
Yuan C, Beach KW, Smith LH, Hatsukami TS: Measurement of atherosclerotic carotid plaque size in vivo using high resolution magnetic resonance imaging. Circulation. 1998, 98 (24): 2666-2671.
Yuan C, Mitsumori LM, Ferguson MS, Polissar NL, Echelard D, Ortiz G, Small R, Davies JW, Kerwin WS, Hatsukami TS: In vivo accuracy of multispectral magnetic resonance imaging for identifying lipid-rich necrotic cores and intraplaque hemorrhage in advanced human carotid plaques. Circulation. 2001, 104 (17): 2051-2056. 10.1161/hc4201.097839.
Fayad ZA, Fuster V: Characterization of atherosclerotic plaques by magnetic resonance imaging. Ann N Y Acad Sci. 2000, 902: 173-186.
Toussaint JF, LaMuraglia GM, Southern JF, Fuster V, Kantor HL: Magnetic resonance images lipid, fibrous, calcified, hemorrhagic, and thrombotic components of human atherosclerosis in vivo. Circulation. 1996, 94 (5): 932-938.
Saam T, Kerwin WS, Chu B, Cai J, Kampschulte A, Hatsukami TS, Zhao XQ, Polissar NL, Neradilek B, Yarnykh VL, Flemming K, Huston J, Insull W, Morrisett JD, Rand SD, DeMarco KJ, Yuan C: Sample size calculation for clinical trials using magnetic resonance imaging for the quantitative assessment of carotid atherosclerosis. J Cardiovasc Magn Reson. 2005, 7 (5): 799-808. 10.1080/10976640500287703.
Underhill HR, Kerwin WS, Hatsukami TS, Yuan C: Automated measurement of mean wall thickness in the common carotid artery by MRI: a comparison to intima-media thickness by B-mode ultrasound. J Magn Reson Imaging. 2006, 24 (2): 379-387. 10.1002/jmri.20636.
Underhill HR, Yuan C, Zhao XQ, Kraiss LW, Parker DL, Saam T, Chu B, Takaya N, Liu F, Polissar NL, Neradilek B, Raichlen JS, Cain VA, Waterton JC, Hamar W, Hatsukami TS: Effect of rosuvastatin therapy on carotid plaque morphology and composition in moderately hypercholesterolemic patients: a high-resolution magnetic resonance imaging trial. Am Heart J. 2008, 155 (3): 584 e1-8. 10.1016/j.ahj.2007.11.018.
Saam T, Yuan C, Chu B, Takaya N, Underhill H, Cai J, Tran N, Polissar NL, Neradilek B, Jarvik GP, Isaac C, Garden GA, Maravilla KR, Hashimoto B, Hatsukami TS: Predictors of carotid atherosclerotic plaque progression as measured by noninvasive magnetic resonance imaging. Atherosclerosis. 2007, 194 (2): e34-42. 10.1016/j.atherosclerosis.2006.08.016.
Takaya N, Yuan C, Chu B, Saam T, Polissar NL, Jarvik GP, Isaac C, McDonough J, Natiello C, Small R, Ferguson MS, Hatsukami TS: Presence of intraplaque hemorrhage stimulates progression of carotid atherosclerotic plaques: a high-resolution magnetic resonance imaging study. Circulation. 2005, 111 (21): 2768-2775. 10.1161/CIRCULATIONAHA.104.504167.
Corti R, Fuster V, Fayad ZA, Worthley SG, Helft G, Chaplin WF, Muntwyler J, Viles-Gonzalez JF, Weinberger J, Smith DA, Mizsei G, Badimon JJ: Effects of aggressive versus conventional lipid-lowering therapy by simvastatin on human atherosclerotic lesions: a prospective, randomized, double-blind trial with high-resolution magnetic resonance imaging. J Am Coll Cardiol. 2005, 46 (1): 106-112. 10.1016/j.jacc.2005.03.054.
Takaya N, Yuan C, Chu B, Saam T, Underhill H, Cai J, Tran N, Polissar NL, Isaac C, Ferguson MS, Garden GA, Cramer SC, Maravilla KR, Hashimoto B, Hatsukami TS: Association between carotid plaque characteristics and subsequent ischemic cerebrovascular events: a prospective assessment with MRI--initial results. Stroke. 2006, 37 (3): 818-823. 10.1161/01.STR.0000204638.91099.91.
Moody AR, Murphy RE, Morgan PS, Martel AL, Delay GS, Allder S, MacSweeney ST, Tennant WG, Gladman J, Lowe J, Hunt BJ: Characterization of complicated carotid plaque with magnetic resonance direct thrombus imaging in patients with cerebral ischemia. Circulation. 2003, 107 (24): 3047-3052. 10.1161/01.CIR.0000074222.61572.44.
Allan PL, Mowbray PI, Lee AJ, Fowkes FG: Relationship between carotid intima-media thickness and symptomatic and asymptomatic peripheral arterial disease. The Edinburgh Artery Study. Stroke. 1997, 28 (2): 348-353.
Craven TE, Ryu JE, Espeland MA, Kahl FR, McKinney WM, Toole JF, McMahan MR, Thompson CJ, Heiss G, Crouse JR: Evaluation of the associations between carotid artery atherosclerosis and coronary artery stenosis. A case-control study. Circulation. 1990, 82 (4): 1230-1242.
O'Leary DH, Polak JF, Kronmal RA, Manolio TA, Burke GL, Wolfson SK: Carotid-artery intima and media thickness as a risk factor for myocardial infarction and stroke in older adults. Cardiovascular Health Study Collaborative Research Group. N Engl J Med. 1999, 340 (1): 14-22. 10.1056/NEJM199901073400103.
Yarnykh VL, Yuan C: Unit 1.4: High-resolution multi-contrast MRI of the carotid artery wall for evaluation of atherosclerotic plaques. Current protocols in magnetic resonance imaging. Edited by: Haacke EM, Lin W. 2004, New York , Wiley, A1.4.1-A1.4.18.
Kerwin W, Xu D, Liu F, Saam T, Underhill H, Takaya N, Chu B, Hatsukami T, Yuan C: Magnetic Resonance Imaging of Carotid Atherosclerosis: Plaque Analysis. Top Magn Reson Imaging. 2007, 18 (5): 371-378.
Saam T, Ferguson MS, Yarnykh VL, Takaya N, Xu D, Polissar NL, Hatsukami TS, Yuan C: Quantitative evaluation of carotid plaque composition by in vivo MRI. Arterioscler Thromb Vasc Biol. 2005, 25 (1): 234-239.
Littell RC, Miliken GA, Stroup WW, Wolfinger RD: SAS System for Mixed Models. 1996, Cary, NC , SAS Institute, Inc.
Bots ML, Hoes AW, Koudstaal PJ, Hofman A, Grobbee DE: Common carotid intima-media thickness and risk of stroke and myocardial infarction: the Rotterdam Study. Circulation. 1997, 96 (5): 1432-1437.
Glagov S, Weisenberg E, Zarins CK, Stankunavicius R, Kolettis GJ: Compensatory enlargement of human atherosclerotic coronary arteries. N Engl J Med. 1987, 316 (22): 1371-1375.
Terry JG, Tang R, Espeland MA, Davis DH, Vieira JL, Mercuri MF, Crouse JR: Carotid arterial structure in patients with documented coronary artery disease and disease-free control subjects. Circulation. 2003, 107 (8): 1146-1151. 10.1161/01.CIR.0000051461.92839.F7.
Poredos P: Endothelial dysfunction in the pathogenesis of atherosclerosis. Int Angiol. 2002, 21 (2): 109-116.
Nissen SE, Tuzcu EM, Libby P, Thompson PD, Ghali M, Garza D, Berman L, Shi H, Buebendorf E, Topol EJ: Effect of antihypertensive agents on cardiovascular events in patients with coronary disease and normal blood pressure: the CAMELOT study: a randomized controlled trial. JAMA. 2004, 292 (18): 2217-2225. 10.1001/jama.292.18.2217.
Crouse JR, Tang R, Espeland MA, Terry JG, Morgan T, Mercuri M: Associations of extracranial carotid atherosclerosis progression with coronary status and risk factors in patients with and without coronary artery disease. Circulation. 2002, 106 (16): 2061-2066. 10.1161/01.CIR.0000033833.54884.34.
Takiuchi S, Rakugi H, Honda K, Masuyama T, Hirata N, Ito H, Sugimoto K, Yanagitani Y, Moriguchi K, Okamura A, Higaki J, Ogihara T: Quantitative ultrasonic tissue characterization can identify high-risk atherosclerotic alteration in human carotid arteries. Circulation. 2000, 102 (7): 766-770.
Virmani R, Burke AP, Kolodgie FD, Farb A: Vulnerable plaque: the pathology of unstable coronary lesions. J Interv Cardiol. 2002, 15 (6): 439-446. 10.1111/j.1540-8183.2002.tb01087.x.
Blankenhorn DH, Stern D: Calcification of the coronary arteries. Am J Roentgenol Radium Ther Nucl Med. 1959, 81 (5): 772-777.
Beadenkopf WG, Daoud AS, Love BM: Calcification In The Coronary Arteries And Its Relationship To Arteriosclerosis And Myocardial Infarction. Am J Roentgenol Radium Ther Nucl Med. 1964, 92: 865-871.
Greenland P, LaBree L, Azen SP, Doherty TM, Detrano RC: Coronary artery calcium score combined with Framingham score for risk prediction in asymptomatic individuals. Jama. 2004, 291 (2): 210-215. 10.1001/jama.291.2.210.
Reed D, Yano K: Predictors of arteriographically defined coronary stenosis in the Honolulu Heart Program. Comparisons of cohort and arteriography series analyses. Am J Epidemiol. 1991, 134 (2): 111-122.
Fried LP, Pearson TA: The association of risk factors with arteriographically defined coronary artery disease: what is the appropriate control group?. Am J Epidemiol. 1987, 125 (5): 844-853.
Giroud D, Li JM, Urban P, Meier B, Rutishauer W: Relation of the site of acute myocardial infarction to the most severe coronary arterial stenosis at prior angiography. Am J Cardiol. 1992, 69 (8): 729-732. 10.1016/0002-9149(92)90495-K.