Increased internal carotid artery peak systolic velocity is associated with presence of significant atherosclerotic plaque instability independent of degree of ICA stenosis

Abstract

The aim of our work was to study the relationship between Doppler ultrasound velocity measurements and the presence of histologic features of plaque instability in carotid atherosclerosis, in particular, intraplaque hemorrhage (IPH). Consecutive patients undergoing carotid endarterectomy in a one-year period were included. All patients were examined by duplex ultrasonography and carotid angiography. Endarterectomy specimens were examined histologically for features of plaque instability. The quantity of IPH was measured by digital image analysis. The associations between Peak Systolic Velocity (PSV), end-diastolic velocity (EDV), degree of ICA stenosis, shape and length of the lesion and the features of plaque instability and quantity of IPH were assessed. Seventy-four patients (20 asymptomatic, 54 symptomatic) were included. PSV was independently associated with the presence of significant IPH [p < 0.001, OR = 1.04 (95% CI = 1.01-1.06)], as was the degree of angiographic ICA stenosis [p < 0.05, OR = 0.98 (95% CI = 0.92-1.6)]. Neither EDV nor the shape of the lesion was associated with IPH ( p = 0.26 and p = 0.38, respectively). A close correlation was observed between PSV and the quantity of IPH (r 2 = 0.68, p < 0.0001). A significant association was observed between PSV and the presence of plaque ulceration (p < 0.05); however, this was not found to be independent of the quantity of IPH and the degree of ICA stenosis [p = 0.17, OR = 1.28 (95% CI = 0.6-2.44)]. PSV at the site of ICA stenosis appears to be associated with the quantity of intraplaque hemorrhage, independent of the angiographic degree of ICA stenosis. We propose that the role of Doppler velocity measurements extends beyond measurement of the degree of ICA stenosis. Increased ICA peak systolic velocity by itself may be an indicator of atherosclerotic plaque instability.

Effects of Whole Body Vibration on Glycemic Indices and Peripheral Blood Flow in Type II Diabetic Patients

“…An interesting finding from the current study was that regular WBV training substantially reduced peak systolic velocity of the right popliteal artery. Whole body vibration may reduce vascular stenosis or resistance, which is positively correlated to peak systolic velocity (22). The proposed underlying mechanism suggests that acute vibration exposure may reduce peripheral vascular resistance by inhibiting vasoconstrictor substance release (endothelin) from smooth muscles (23).…”

Integrated pyroptosis measurement and metabolomics to elucidate the effect and mechanism of tangzhiqing on atherosclerosis

“…PSV and EDV are not only related to the amount of intra-plaque blood loss, but also to the degree of carotid lumen stenosis. Increased PSV may be an indicator of plaque instability in AS ( Mofidi et al, 2005 ). According to our findings, TZQ considerably lowers the diastolic diameter of the common carotid artery and the systolic blood flow velocity of the aortic arch when compared with that in the Model group.…”

A surrogate model for plaque modeling in carotids based on Robin conditions calibrated by cine MRI data

“…In order to solve the optimization problem (12) we considered a basic direct search method based on the Hooke and Jeeves algorithm, 59,60 where an FSI problem is solved using a value of q that is iteratively adjusted. In particular, starting from a uniform value of α (=α st = α j = α p ) and values of R 2 and C taken from literature, we set the increment δq = − ηδJ, where J is the functional appearing in (12), δJ the decrement of J between two consecutive iterations (if an increment occurs, the iteration is performed again with a different value of η), and η is a suitable acceleration parameter. At each iteration we then updated q as q + δq and evaluate the new J.…”

“…[8][9][10] In presence of atherosclerotic plaque, peak systolic velocity (PSV) higher than 200 cm/s and high values of WSS are considered as fluiddynamics indicators that enhance plaque vulnerability, increasing the risk of plaque rupture. [11][12][13] To evaluate fluid-dynamic quantities, phase contrast (PC) MRI is considered a very promising and reliable imaging tool. This technique has proven suitable for flow velocity measurements in healthy subjects.…”