Size of carotid artery intraplaque hemorrhage and acute ischemic stroke: a cardiovascular magnetic resonance Chinese atherosclerosis risk evaluation study

Journal of Cardiovascular Magnetic Resonance

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[1] 0000 0001 0662 3178, grid.12527.33, Department of Biomedical Engineering, Center for Biomedical Imaging Research, Tsinghua University School of Medicine, Beijing, China;0000 0004 0369 153X, grid.24696.3f, Center for Brain Disorders Research, Capital Medical University and Beijing Institute for Brain Disorders, Beijing, China;0000 0004 1800 1685, grid.428392.6, Department of Neurology, The Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing, China;0000 0004 1800 1685, grid.428392.6, Department of Radiology, The Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing, China;0000 0004 1800 1685, grid.428392.6, Department of Radiology, The Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing, China;Department of Medical Imaging, Taikang Xianlin Drum Tower Hospital, Nanjing, China;0000000122986657, grid.34477.33, Department of Radiology, University of Washington, Seattle, USA;grid.268415.c, Department of Radiology, The Affiliated Hospital of Yangzhou University, Yangzhou, China;grid.268415.c, Department of Radiology, The Affiliated Hospital of Yangzhou University, Yangzhou, China;0000 0001 0662 3178, grid.12527.33, Department of Biomedical Engineering, Center for Biomedical Imaging Research, Tsinghua University School of Medicine, Beijing, China;

关键词: Carotid artery;    Atherosclerosis;    Intraplaque hemorrhage;    Acute cerebral infarct;    Cardiovascular magnetic resonance imaging;    Magnetic Resonance Imaging (MRI);    Ischemic stroke;    Atherosclerosis;    Stenosis;    Vascular disease;   

DOI  :  10.1186/s12968-019-0548-1

来源: publisher

【 摘 要 】

BackgroundTo determine the usefulness of the size of carotid artery intraplaque hemorrhage (IPH) in discriminating the risk of acute ischemic stroke using cardiovascular magnetic resonance (CMR) vessel wall imaging.MethodsSymptomatic patients with carotid atherosclerotic plaque who participated in a cross-sectional, multicenter study of CARE-II (NCT02017756) were included. All patients underwent carotid and brain CMR imaging. Carotid plaque burden and the size of plaque compositions including calcification, lipid-rich necrotic core (LRNC), and IPH were measured. Presence of acute cerebral infarct (ACI) in ipsilateral hemisphere of carotid plaque was determined. The relationship between carotid plaque features and presence of ipsilateral ACI was then analyzed.ResultsOf 687 recruited patients (62.7 ± 10.1 years; 69.4% males) with carotid plaque, 28.5% had ACI in ipsilateral hemispheres. Logistic regression revealed that carotid plaque burden was significantly associated with the presence of ACI before and after adjusted for clinical confounding factors. The volume of LRNC, %LRNC volume, volume of IPH, and %IPH volume were significantly associated with ACI before (volume of LRNC: OR = 1.297, p = 0.005; %LRNC volume: OR = 1.119, p = 0.018; volume of IPH: OR = 2.514, p = 0.003; %IPH volume: OR = 2.202, p = 0.003) and after (volume of LRNC: OR = 1.312, p = 0.006; %LRNC volume: OR = 1.90, p = 0.034; volume of IPH: OR = 2.907, p = 0.007; % IPH volume: OR = 2.374, p = 0.004) adjusted for clinical confounding factors. The association between volume of IPH and ACI remained statistically significant after further adjusted for plaque volume (OR = 2.813, p = 0.016) or both plaque volume and volume of LRNC (OR = 4.044, p = 0.024).ConclusionsIn symptomatic patients with carotid atherosclerotic plaques, the size of IPH is independently associated with ipsilateral ACI, suggesting the size of IPH might be a useful indicator for the risk of ACI.Trial registrationClinical Trial Registration-URL: http://www.clinicaltrials.gov. Unique Identifier: NCT02017756.

【 授权许可】

CC BY