Key result
Carotid plaque upstream shoulders show significantly greater peak systolic strain and velocity than downstream shoulders.
Why the study?
Atherosclerotic plaque rupture is closely related to high regional mechanical stress, but the longitudinal mechanical properties of different plaque regions in vivo are not well characterized.
Does velocity vector imaging combined with acoustic densitometry identify differences in longitudinal mechanical properties between upstream and downstream shoulders of human carotid atherosclerotic plaques?
Observational (n=135)
Does velocity vector imaging combined with acoustic densitometry identify differences in longitudinal mechanical properties between upstream and downstream shoulders of human carotid atherosclerotic plaques?
p-value: p=<0.05
Velocity vector imaging reveals that upstream shoulders of carotid plaques experience greater longitudinal mechanical stress than downstream shoulders, which may relate to plaque vulnerability.
VVI-derived upstream strain exceeds downstream in carotid plaques and correlates with acoustic density; hypothesis-generating for vulnerability assessment.
AIMS: Atherosclerotic plaque rupture is closely related to high regional mechanical stress in the plaque itself. We aimed to explore the longitudinal mechanical properties of upstream and downstream shoulders and fibrous cap tops of human atherosclerotic plaques in vivo by velocity vector imaging (VVI) combined with acoustic densitometry (AD) imaging. METHODS AND RESULTS: We included 135 patients with carotid atherosclerotic plaque. VVI and AD were used to examine 3 regions of carotid plaque along the longitudinal-axis view. A total of 405 regions were classified with low or high AD values by corrected averages image intensity (AIIc%) < or ≥50, respectively. Peak systolic strain, strain rate (SR), and velocity were significantly greater for upstream than downstream shoulders and fibrous cap tops of carotid plaque (P < 0.05 for both). AIIc% was significantly lower for upstream than downstream plaque shoulders (P < 0.05). Peak systolic SR of the plaque regions was negatively correlated with corresponding AIIc% (R(2) = 0.499, P < 0.05). CONCLUSIONS: The longitudinal strain of human carotid atherosclerotic plaques as derived by VVI is associated with its corresponding AD but also in part with the internal position of the strain, with values greater for upstream than downstream shoulders and fibrous cap tops.
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Wang et al. (2012) conducted an observational in Carotid atherosclerotic plaque (n=135). Upstream shoulders of carotid plaque vs. Downstream shoulders and fibrous cap tops was evaluated on Peak systolic strain, strain rate, and velocity (p=<0.05). Peak systolic strain, strain rate, and velocity were significantly greater for upstream than downstream shoulders and fibrous cap tops of carotid atherosclerotic plaques (P<0.05).
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