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Vulnerable plaques in the contralateral carotid arteries in symptomatic patients : a detailed ultrasound analysis

Ibrahimi, Pranvera (author)
Umeå universitet,Kardiologi,Heart Centre
Jashari, Fisnik (author)
Umeå universitet,Kardiologi,Heart Centre
Johansson, Elias (author)
Umeå universitet,Klinisk neurovetenskap,Medicin,Heart Centre
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Grönlund, Christer (author)
Umeå universitet,Radiofysik
Bajraktari, Gani (author)
Umeå universitet,Kardiologi,Heart Centre
Wester, Per (author)
Umeå universitet,Medicin,Heart Centre
Henein, Michael Y (author)
Umeå universitet,Kardiologi
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 (creator_code:org_t)
Elsevier, 2014
2014
English.
In: Atherosclerosis. - : Elsevier. - 0021-9150 .- 1879-1484. ; 235:2, s. 526-531
  • Journal article (peer-reviewed)
Abstract Subject headings
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  • 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.

Subject headings

MEDICIN OCH HÄLSOVETENSKAP  -- Klinisk medicin -- Kardiologi (hsv//swe)
MEDICAL AND HEALTH SCIENCES  -- Clinical Medicine -- Cardiac and Cardiovascular Systems (hsv//eng)

Keyword

carotid artery disease
plaque vulnerability
gray scale median
juxtaluminal black area

Publication and Content Type

ref (subject category)
art (subject category)

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