Presence of Intraplaque Hemorrhage Stimulates Progression of Carotid Atherosclerotic Plaques

Abstract

Background-Previous studies suggest that erythrocyte membranes from intraplaque hemorrhage into the necrotic core are a source of free cholesterol and may become a driving force in the progression of atherosclerosis. We have shown that MRI can accurately identify carotid intraplaque hemorrhage and precisely measure plaque volume. We tested the hypothesis that hemorrhage into carotid atheroma stimulates plaque progression. Methods and Results-Twenty-nine subjects (14 cases with intraplaque hemorrhage and 15 controls with comparably sized plaques without intraplaque hemorrhage at baseline) underwent serial carotid MRI examination with a multicontrast weighted protocol (T1, T2, proton density, and 3D time of flight) over a period of 18 months.

Differential Features of Culprit Intracranial Atherosclerotic Lesions: A Whole‐Brain Vessel Wall Imaging Study in Patients With Acute Ischemic Stroke

“…Although plaque features, such as HST1 and contrast enhancement, may persistent for months of ischemic stroke,24, 33, 34, 35 the short period (≤30 days) in our study contributed to the identification of meaningful associations of the features with culprit lesions. However, there is overlap in the studied features among groups.…”

“…In studies of coronary22, 23 and carotid24 atherosclerotic diseases with pathologic confirmation, intraplaque hemorrhage (IPH) is deemed as a good predictor of ischemic events and plaque progression. The degree of vasa vasorum invading from the adventitia is increased in ruptured plaques compared with stable plaques, and microvascular incompetence is a plausible explanation for the occurrence of IPH 22, 25.…”

Imaging of the Carotid Artery Vulnerable Plaque

“…IPH is currently recognized as a high risk factor for plaque instability, because it contributes to plaque progression and destabilization [39,40], causing complications by promoting vulnerability, luminal occlusion or embolic events. Several studies have found a strong association between IPH and cerebrovascular events [41][42][43].…”

Blood Pressure Parameters and Carotid Intraplaque Hemorrhage as Measured by Magnetic Resonance Imaging

“…[3][4][5] Furthermore, even in atherosclerotic lesions of asymptomatic subjects, IPH was shown to contribute to plaque progression and destabilization. 6,7 Magnetic resonance imaging (MRI) has emerged as a reliable and accurate tool for discriminating plaque components in vivo and for detecting IPH. 7,8 However, only few studies have investigated determinants of plaque composition in the carotid artery 9,10 and, specifically, studies relating risk factors to IPH are scarce.…”

“…6,7 Magnetic resonance imaging (MRI) has emerged as a reliable and accurate tool for discriminating plaque components in vivo and for detecting IPH. 7,8 However, only few studies have investigated determinants of plaque composition in the carotid artery 9,10 and, specifically, studies relating risk factors to IPH are scarce. We recently reported that sex, age, smoking, and hypertension are associated with IPH in the general population.…”