| Association between biomechanical structural stresses of atherosclerotic carotid plaques and subsequent ischaemic cerebrovascular events--a longitudinal in vivo magnetic resonance imaging-based finite element study. | |
| | |
MedLine Citation:
|
PMID: 20724181 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
|
BACKGROUND: High-resolution magnetic resonance (MR) imaging has been used for MR imaging-based structural stress analysis of atherosclerotic plaques. The biomechanical stress profile of stable plaques has been observed to differ from that of unstable plaques; however, the role that structural stresses play in determining plaque vulnerability remains speculative. METHODS: A total of 61 patients with previous history of symptomatic carotid artery disease underwent carotid plaque MR imaging. Plaque components of the index artery such as fibrous tissue, lipid content and plaque haemorrhage (PH) were delineated and used for finite element analysis-based maximum structural stress (M-C Stress) quantification. These patients were followed up for 2 years. The clinical end point was occurrence of an ischaemic cerebrovascular event. The association of the time to the clinical end point with plaque morphology and M-C Stress was analysed. RESULTS: During a median follow-up duration of 514 days, 20% of patients (n = 12) experienced an ischaemic event in the territory of the index carotid artery. Cox regression analysis indicated that M-C Stress (hazard ratio (HR): 12.98 (95% confidence interval (CI): 1.32-26.67, p = 0.02), fibrous cap (FC) disruption (HR: 7.39 (95% CI: 1.61-33.82), p = 0.009) and PH (HR: 5.85 (95% CI: 1.27-26.77), p = 0.02) are associated with the development of subsequent cerebrovascular events. Plaques associated with future events had higher M-C Stress than those which had remained asymptomatic (median (interquartile range, IQR): 330 kPa (229-494) vs. 254 kPa (166-290), p = 0.04). CONCLUSIONS: High biomechanical structural stresses, in addition to FC rupture and PH, are associated with subsequent cerebrovascular events. |
| | |
Authors:
|
U Sadat; Z Teng; V E Young; S R Walsh; Z Y Li; M J Graves; K Varty; J H Gillard |
Publication Detail:
|
Type: Journal Article; Research Support, Non-U.S. Gov't Date: 2010-08-17 |
Journal Detail:
|
Title: European journal of vascular and endovascular surgery : the official journal of the European Society for Vascular Surgery Volume: 40 ISSN: 1532-2165 ISO Abbreviation: Eur J Vasc Endovasc Surg Publication Date: 2010 Oct |
Date Detail:
|
Created Date: 2010-11-01 Completed Date: 2010-12-02 Revised Date: - |
Medline Journal Info:
|
Nlm Unique ID: 9512728 Medline TA: Eur J Vasc Endovasc Surg Country: England |
Other Details:
|
Languages: eng Pagination: 485-91 Citation Subset: IM |
Copyright Information:
|
Copyright © 2010 European Society for Vascular Surgery. Published by Elsevier Ltd. All rights reserved. |
Affiliation:
|
University Department of Radiology, University of Cambridge, Cambridge, UK. us229@cam.ac.uk |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
Aged Aged, 80 and over Atherosclerosis / complications, physiopathology* Biomechanics Brain Ischemia / etiology, physiopathology* Carotid Stenosis / complications, physiopathology* Electrocardiography Female Finite Element Analysis Humans Image Interpretation, Computer-Assisted Longitudinal Studies Magnetic Resonance Imaging* Male Middle Aged Proportional Hazards Models Statistics, Nonparametric Stress, Mechanical |
| Grant Support | |
ID/Acronym/Agency:
|
//Medical Research Council |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: Application of the Three Rs to challenge assays used in vaccine testing: tenth report of the BVAAWF/...
Next Document: Functional electrical stimulation of the left recurrent laryngeal nerve using a vagus nerve stimulat...