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January 1, 2020Journal of Cardiovascular Magnetic ResonanceOpen Access

Carotid geometry is an independent predictor of wall thickness – a 3D cardiovascular magnetic resonance study in patients with high cardiovascular risk

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Key result

Higher carotid tortuosity (regression coefficient 0.764) and lower ICA/CCA diameter ratio (regression coefficient -0.302) were independent predictors of increased carotid wall thickness.

Why the study?

The posterior wall of the proximal internal carotid artery is the predilection site for stenosis, and identifying new risk factors for plaque progression is needed to optimally prevent stroke.

Comparison

Impact of carotid geometry and wall shear stress on wall thickness

Design

Prospective cross-sectional study

Authors

CSChristoph StreckerUniversity of FreiburgAKAxel J. KrafftSiemens (Germany)LKLilli KaufholdTechnische Universität Berlin

Discussion

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Implication

Hypothesis-generating for carotid geometry in plaque risk stratification; longitudinal studies required before clinical use.

Study Design

Type

Cross-Sectional (n=121)

Structured PICO

P
Population
121 patients aged 50 years or older with hypertension, additional cardiovascular risk factors, and carotid plaque evaluated in a cross-sectional cardiovascular magnetic resonance study.
O
Outcome
Wall thickness in the internal carotid artery (ICA) bulbsurrogate

Main Result

Effect estimate: regression coefficient 0.764 for tortuosity; -0.302 for ICA/CCA ratio

p-value: p=<0.001

High carotid tortuosity and low ICA/CCA diameter ratio independently predict increased wall thickness in the ICA bulb, suggesting geometric parameters may help identify patients at risk for carotid plaque progression.

Limitations

  • Heterogeneous cohort including different stages of atherosclerosis (≥10-50% ICA stenosis)
  • Cross-sectional design prevents conclusions about future increase of local wall thickness or plaque growth
  • Plaque volume and plaque composition were not evaluated
  • High effort of time for data processing (45-60 min per dataset) limits application in large-scale studies or clinical routine
  • Cross-sectional design limits ability to establish causality or longitudinal progression

Cite This Study

Strecker et al. (2020) conducted a cross-sectional in High cardiovascular risk with carotid atherosclerosis (n=121). Carotid geometry (tortuosity and ICA/CCA diameter ratio) was evaluated on Carotid wall thickness (regression coefficient 0.764 for tortuosity; -0.302 for ICA/CCA ratio, p=<0.001). Higher carotid tortuosity (regression coefficient 0.764) and lower ICA/CCA diameter ratio (regression coefficient -0.302) were independent predictors of increased carotid wall thickness.

synapsesocial.com/papers/6a819f3b2ac899ae0206d07dhttps://doi.org/10.1186/s12968-020-00657-5
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Correlation between quantitative analysis of wall shear stress and intima-media thickness in atherosclerosis development in carotid arteries2017 · 83 citations
  2. 2Atherosclerotic Lesion Size and Vulnerability Are Determined by Patterns of Fluid Shear Stress2006 · 1,005 citations
  3. 3Segment-specific associations between local haemodynamic and imaging markers of early atherosclerosis at the carotid artery: an in vivo human study2018 · 85 citations
  4. 4Spatial correlations between MRI-derived wall shear stress and vessel wall thickness in the carotid bifurcation2018 · 12 citations
  5. 5Internal Carotid Artery Angle of Origin2003 · 95 citations