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Spotty Carotid Plaques Are Associated with Inflammation and the Occurrence of Cerebrovascular Symptoms

Halak, Sanela LU ; Östling, Gerd LU ; Edsfeldt, Andreas LU orcid ; Kennbäck, Cecilia ; Dencker, Magnus LU ; Gonçalves, Isabel LU orcid and Asciutto, Giuseppe LU (2018) In Cerebrovascular Diseases Extra 8(1). p.16-25
Abstract

Background: Echolucent carotid plaques have been related to an increased risk of ischemic cerebrovascular events. The aim of the present study was to evaluate whether a new objective ultrasonographic parameter, the statistical geometric feature (SGF), reflecting spottiness of carotid plaques, can be associated with cerebrovascular symptoms and with a rupture-prone plaque phenotype. Methods: The plaques of 144 patients who underwent carotid endarterectomy were included in this study. SGF and plaque area were estimated by outlining the plaque on ultrasound (US) images. The correlation coefficient for inter- and intraobserver variability was 0.69 and 0.93, respectively. The SGF values were normalized to the degree of stenosis (SGF/DS). The... (More)

Background: Echolucent carotid plaques have been related to an increased risk of ischemic cerebrovascular events. The aim of the present study was to evaluate whether a new objective ultrasonographic parameter, the statistical geometric feature (SGF), reflecting spottiness of carotid plaques, can be associated with cerebrovascular symptoms and with a rupture-prone plaque phenotype. Methods: The plaques of 144 patients who underwent carotid endarterectomy were included in this study. SGF and plaque area were estimated by outlining the plaque on ultrasound (US) images. The correlation coefficient for inter- and intraobserver variability was 0.69 and 0.93, respectively. The SGF values were normalized to the degree of stenosis (SGF/DS). The plaques collected at surgery 1 day after the US were analyzed histologically, and inflammatory markers and matrix metalloproteinases (MMPs) were measured. Results: Patients with ipsilateral hemispheric symptoms had higher SGF/DS compared to patients without symptoms (0.82 [0.59–1.16] vs. 0.70 [0.56–0.89], p = 0.01). Analysis of plaque components revealed a positive correlation between SGF/DS and the percentage of the plaque area stained for lipids, macrophages, and hemorrhage. A correlation was also found between SGF/DS and plaque expression of interleukin-6, monocyte chemoattractant protein-1, macrophage inflammatory protein-1β, vascular endothelial growth factor A, C-C motif chemokine 3 and 20, and MMP-9. An inverse correlation was found with plaque levels of osteoprotegerin. Conclusions: The present study supports the concept that spottiness is a feature of the carotid plaques rich in inflammation and can be associated with the typical phenotype of high-risk plaques.

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author
; ; ; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Cerebrovascular disease, Plaque, Ultrasound in stroke
in
Cerebrovascular Diseases Extra
volume
8
issue
1
pages
16 - 25
publisher
Karger
external identifiers
  • pmid:29402768
  • scopus:85040723540
ISSN
1664-5456
DOI
10.1159/000485258
language
English
LU publication?
yes
id
daaf9838-0bf0-4b8e-9a94-aa137dc9b6e5
date added to LUP
2018-02-08 10:09:49
date last changed
2025-04-04 15:19:41
@article{daaf9838-0bf0-4b8e-9a94-aa137dc9b6e5,
  abstract     = {{<p>Background: Echolucent carotid plaques have been related to an increased risk of ischemic cerebrovascular events. The aim of the present study was to evaluate whether a new objective ultrasonographic parameter, the statistical geometric feature (SGF), reflecting spottiness of carotid plaques, can be associated with cerebrovascular symptoms and with a rupture-prone plaque phenotype. Methods: The plaques of 144 patients who underwent carotid endarterectomy were included in this study. SGF and plaque area were estimated by outlining the plaque on ultrasound (US) images. The correlation coefficient for inter- and intraobserver variability was 0.69 and 0.93, respectively. The SGF values were normalized to the degree of stenosis (SGF/DS). The plaques collected at surgery 1 day after the US were analyzed histologically, and inflammatory markers and matrix metalloproteinases (MMPs) were measured. Results: Patients with ipsilateral hemispheric symptoms had higher SGF/DS compared to patients without symptoms (0.82 [0.59–1.16] vs. 0.70 [0.56–0.89], p = 0.01). Analysis of plaque components revealed a positive correlation between SGF/DS and the percentage of the plaque area stained for lipids, macrophages, and hemorrhage. A correlation was also found between SGF/DS and plaque expression of interleukin-6, monocyte chemoattractant protein-1, macrophage inflammatory protein-1β, vascular endothelial growth factor A, C-C motif chemokine 3 and 20, and MMP-9. An inverse correlation was found with plaque levels of osteoprotegerin. Conclusions: The present study supports the concept that spottiness is a feature of the carotid plaques rich in inflammation and can be associated with the typical phenotype of high-risk plaques.</p>}},
  author       = {{Halak, Sanela and Östling, Gerd and Edsfeldt, Andreas and Kennbäck, Cecilia and Dencker, Magnus and Gonçalves, Isabel and Asciutto, Giuseppe}},
  issn         = {{1664-5456}},
  keywords     = {{Cerebrovascular disease; Plaque; Ultrasound in stroke}},
  language     = {{eng}},
  number       = {{1}},
  pages        = {{16--25}},
  publisher    = {{Karger}},
  series       = {{Cerebrovascular Diseases Extra}},
  title        = {{Spotty Carotid Plaques Are Associated with Inflammation and the Occurrence of Cerebrovascular Symptoms}},
  url          = {{http://dx.doi.org/10.1159/000485258}},
  doi          = {{10.1159/000485258}},
  volume       = {{8}},
  year         = {{2018}},
}