Carotid Geometry and Wall Shear Stress Independently Predict Increased Wall Thickness—A Longitudinal 3D MRI Study in High-Risk Patients
Introduction: Carotid geometry and wall shear stress (WSS) have been proposed as independent risk factors for the progression of carotid atherosclerosis, but this has not yet been demonstrated in larger longitudinal studies. Therefore, we investigated the impact of these biomarkers on carotid wall t...
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| Format: | Article |
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Frontiers Media S.A.
2021-10-01
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| Series: | Frontiers in Cardiovascular Medicine |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fcvm.2021.723860/full |
| _version_ | 1819011550191550464 |
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| author | Christoph Strecker Axel Joachim Krafft Lilli Kaufhold Lilli Kaufhold Markus Hüllebrandt Markus Hüllebrandt Martin Treppner Ute Ludwig Göran Köber Anja Hennemuth Anja Hennemuth Jürgen Hennig Andreas Harloff |
| author_facet | Christoph Strecker Axel Joachim Krafft Lilli Kaufhold Lilli Kaufhold Markus Hüllebrandt Markus Hüllebrandt Martin Treppner Ute Ludwig Göran Köber Anja Hennemuth Anja Hennemuth Jürgen Hennig Andreas Harloff |
| author_sort | Christoph Strecker |
| collection | DOAJ |
| description | Introduction: Carotid geometry and wall shear stress (WSS) have been proposed as independent risk factors for the progression of carotid atherosclerosis, but this has not yet been demonstrated in larger longitudinal studies. Therefore, we investigated the impact of these biomarkers on carotid wall thickness in patients with high cardiovascular risk.Methods: Ninety-seven consecutive patients with hypertension, at least one additional cardiovascular risk factor and internal carotid artery (ICA) plaques (wall thickness ≥ 1.5 mm and degree of stenosis ≤ 50%) were prospectively included. They underwent high-resolution 3D multi-contrast and 4D flow MRI at 3 Tesla both at baseline and follow-up. Geometry (ICA/common carotid artery (CCA)-diameter ratio, bifurcation angle, tortuosity and wall thickness) and hemodynamics [WSS, oscillatory shear index (OSI)] of both carotid bifurcations were measured at baseline. Their predictive value for changes of wall thickness 12 months later was calculated using linear regression analysis for the entire study cohort (group 1, 97 patients) and after excluding patients with ICA stenosis ≥10% to rule out relevant inward remodeling (group 2, 61 patients).Results: In group 1, only tortuosity at baseline was independently associated with carotid wall thickness at follow-up (regression coefficient = −0.52, p < 0.001). However, after excluding patients with ICA stenosis ≥10% in group 2, both ICA/CCA-ratio (0.49, p < 0.001), bifurcation angle (0.04, p = 0.001), tortuosity (−0.30, p = 0.040), and WSS (−0.03, p = 0.010) at baseline were independently associated with changes of carotid wall thickness at follow-up.Conclusions: A large ICA bulb and bifurcation angle and low WSS seem to be independent risk factors for the progression of carotid atherosclerosis in the absence of ICA stenosis. By contrast, a high carotid tortuosity seems to be protective both in patients without and with ICA stenosis. These biomarkers may be helpful for the identification of patients who are at particular risk of wall thickness progression and who may benefit from intensified monitoring and treatment. |
| first_indexed | 2024-12-21T01:29:56Z |
| format | Article |
| id | doaj.art-ea98e86b7c994699ae31b3f10d92f44d |
| institution | Directory Open Access Journal |
| issn | 2297-055X |
| language | English |
| last_indexed | 2024-12-21T01:29:56Z |
| publishDate | 2021-10-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Cardiovascular Medicine |
| spelling | doaj.art-ea98e86b7c994699ae31b3f10d92f44d2022-12-21T19:20:24ZengFrontiers Media S.A.Frontiers in Cardiovascular Medicine2297-055X2021-10-01810.3389/fcvm.2021.723860723860Carotid Geometry and Wall Shear Stress Independently Predict Increased Wall Thickness—A Longitudinal 3D MRI Study in High-Risk PatientsChristoph Strecker0Axel Joachim Krafft1Lilli Kaufhold2Lilli Kaufhold3Markus Hüllebrandt4Markus Hüllebrandt5Martin Treppner6Ute Ludwig7Göran Köber8Anja Hennemuth9Anja Hennemuth10Jürgen Hennig11Andreas Harloff12Department of Neurology and Neurophysiology, Faculty of Medicine, Medical Center—University of Freiburg, University of Freiburg, Freiburg, GermanyDepartment of Radiology—Medical Physics, Faculty of Medicine, Medical Center—University of Freiburg, University of Freiburg, Freiburg, GermanyFraunhofer MEVIS, Bremen, GermanyInstitute for Imaging Science and Computational Modeling in Cardiovascular Medicine, Charité-Universitätsmedizin Berlin, Berlin, GermanyFraunhofer MEVIS, Bremen, GermanyInstitute for Imaging Science and Computational Modeling in Cardiovascular Medicine, Charité-Universitätsmedizin Berlin, Berlin, GermanyInstitute of Medical Biometry and Statistics, Faculty of Medicine and Medical Center, University of Freiburg, Freiburg, GermanyDepartment of Radiology—Medical Physics, Faculty of Medicine, Medical Center—University of Freiburg, University of Freiburg, Freiburg, GermanyInstitute of Medical Biometry and Statistics, Faculty of Medicine and Medical Center, University of Freiburg, Freiburg, GermanyFraunhofer MEVIS, Bremen, GermanyInstitute for Imaging Science and Computational Modeling in Cardiovascular Medicine, Charité-Universitätsmedizin Berlin, Berlin, GermanyDepartment of Radiology—Medical Physics, Faculty of Medicine, Medical Center—University of Freiburg, University of Freiburg, Freiburg, GermanyDepartment of Neurology and Neurophysiology, Faculty of Medicine, Medical Center—University of Freiburg, University of Freiburg, Freiburg, GermanyIntroduction: Carotid geometry and wall shear stress (WSS) have been proposed as independent risk factors for the progression of carotid atherosclerosis, but this has not yet been demonstrated in larger longitudinal studies. Therefore, we investigated the impact of these biomarkers on carotid wall thickness in patients with high cardiovascular risk.Methods: Ninety-seven consecutive patients with hypertension, at least one additional cardiovascular risk factor and internal carotid artery (ICA) plaques (wall thickness ≥ 1.5 mm and degree of stenosis ≤ 50%) were prospectively included. They underwent high-resolution 3D multi-contrast and 4D flow MRI at 3 Tesla both at baseline and follow-up. Geometry (ICA/common carotid artery (CCA)-diameter ratio, bifurcation angle, tortuosity and wall thickness) and hemodynamics [WSS, oscillatory shear index (OSI)] of both carotid bifurcations were measured at baseline. Their predictive value for changes of wall thickness 12 months later was calculated using linear regression analysis for the entire study cohort (group 1, 97 patients) and after excluding patients with ICA stenosis ≥10% to rule out relevant inward remodeling (group 2, 61 patients).Results: In group 1, only tortuosity at baseline was independently associated with carotid wall thickness at follow-up (regression coefficient = −0.52, p < 0.001). However, after excluding patients with ICA stenosis ≥10% in group 2, both ICA/CCA-ratio (0.49, p < 0.001), bifurcation angle (0.04, p = 0.001), tortuosity (−0.30, p = 0.040), and WSS (−0.03, p = 0.010) at baseline were independently associated with changes of carotid wall thickness at follow-up.Conclusions: A large ICA bulb and bifurcation angle and low WSS seem to be independent risk factors for the progression of carotid atherosclerosis in the absence of ICA stenosis. By contrast, a high carotid tortuosity seems to be protective both in patients without and with ICA stenosis. These biomarkers may be helpful for the identification of patients who are at particular risk of wall thickness progression and who may benefit from intensified monitoring and treatment.https://www.frontiersin.org/articles/10.3389/fcvm.2021.723860/fullcarotid arteryatherosclerosisgeometrywall shear stressmagnetic resonance imaging |
| spellingShingle | Christoph Strecker Axel Joachim Krafft Lilli Kaufhold Lilli Kaufhold Markus Hüllebrandt Markus Hüllebrandt Martin Treppner Ute Ludwig Göran Köber Anja Hennemuth Anja Hennemuth Jürgen Hennig Andreas Harloff Carotid Geometry and Wall Shear Stress Independently Predict Increased Wall Thickness—A Longitudinal 3D MRI Study in High-Risk Patients Frontiers in Cardiovascular Medicine carotid artery atherosclerosis geometry wall shear stress magnetic resonance imaging |
| title | Carotid Geometry and Wall Shear Stress Independently Predict Increased Wall Thickness—A Longitudinal 3D MRI Study in High-Risk Patients |
| title_full | Carotid Geometry and Wall Shear Stress Independently Predict Increased Wall Thickness—A Longitudinal 3D MRI Study in High-Risk Patients |
| title_fullStr | Carotid Geometry and Wall Shear Stress Independently Predict Increased Wall Thickness—A Longitudinal 3D MRI Study in High-Risk Patients |
| title_full_unstemmed | Carotid Geometry and Wall Shear Stress Independently Predict Increased Wall Thickness—A Longitudinal 3D MRI Study in High-Risk Patients |
| title_short | Carotid Geometry and Wall Shear Stress Independently Predict Increased Wall Thickness—A Longitudinal 3D MRI Study in High-Risk Patients |
| title_sort | carotid geometry and wall shear stress independently predict increased wall thickness a longitudinal 3d mri study in high risk patients |
| topic | carotid artery atherosclerosis geometry wall shear stress magnetic resonance imaging |
| url | https://www.frontiersin.org/articles/10.3389/fcvm.2021.723860/full |
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