Key result
Low endothelial shear stress (OR 2.99; 95% CI 2.31-3.88) and high LDL concentration (OR 3.26; 95% CI 2.44-4.36) were significantly associated with substantial local plaque growth in human carotids.
Why the study?
Do low endothelial shear stress and high LDL accumulation predict local plaque growth in carotid atherosclerosis?
Cohort (n=12)
Do low endothelial shear stress and high LDL accumulation predict local plaque growth in carotid atherosclerosis?
Low endothelial shear stress and high LDL accumulation are significant predictors of local plaque growth in carotid atherosclerosis, with both showing a diagnostic accuracy of 67%.
Low ESS and high LDL may flag carotid regions for closer surveillance; hypothesis-generating and needs prospective validation before clinical use.
Carotid atherosclerosis may lead to devastating clinical outcomes such as stroke. Data on the value of local factors in predicting progression in carotid atherosclerosis are limited. Our aim was to investigate the association of local endothelial shear stress (ESS) and low-density lipoprotein (LDL) accumulation with the natural history of atherosclerotic disease using a series of 3 time points of human magnetic resonance data. Three-dimensional lumen/wall reconstruction was performed in 12 carotids, and blood flow and LDL mass transport modeling were performed. Our results showed that an increase in plaque thickness and a decrease in lumen size were associated with low ESS and high LDL accumulation in the arterial wall. Low ESS (odds ratio [OR]: 2.99; 95% confidence interval [CI]: 2.31-3.88; P < .001 vs higher ESS) and high LDL concentration (OR: 3.26; 95% CI: 2.44-4.36; P < .001 vs higher LDL concentration) were significantly associated with substantial local plaque growth. Low ESS and high LDL accumulation both presented a diagnostic accuracy of 67% for predicting plaque growth regions. Modeling of blood flow and LDL mass transport show promise in predicting progression of carotid atherosclerosis.
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Sakellarios et al. (2016) conducted a cohort in Carotid atherosclerosis (n=12). Low endothelial shear stress (ESS) vs. Higher ESS was evaluated on Substantial local plaque growth (OR 2.99, 95% CI 2.31-3.88, p=<.001). Low endothelial shear stress (OR 2.99; 95% CI 2.31-3.88) and high LDL concentration (OR 3.26; 95% CI 2.44-4.36) were significantly associated with substantial local plaque growth in human carotids.
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