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Caimi G, Urso C, Brucculeri S, Lo Presti R, Carlisi M. Calculated whole blood viscosity in non-diabetic subjects with asymptomatic carotid atherosclerosis: How insulin resistance may affect blood viscosity. Clin Hemorheol Microcirc 2024:CH221422. [PMID: 38905035 DOI: 10.3233/ch-221422] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/23/2024]
Abstract
BACKGROUND AND OBJECTIVE Asymptomatic atherosclerosis is an important early marker of vascular damage and, among its risk factors, hemorheological alterations play an important role. PATIENTS AND METHODS In a cohort of 85 non-diabetic subjects with asymptomatic carotid atherosclerosis (ACA), we have measured whole blood viscosity (cWBV) according to the haematocrit and plasma fibrinogen level. The cWBV distinguish the subgroup of ACA subjects with 3-5 cardiovascular risk factors (CRFs) from that with 1-2 CRFs and the same behavior is present for haematocrit and plasma fibrinogen level. Therefore, we divided the whole group of ACA subjects according to the medians of the four surrogate indexes with an insulin resistance degree of TG/HDL-C, TyG, VAI and LAP. RESULTS The analysis of the correlation between cWBV and each index of insulin resistance has shown that no correlation is present in the whole group and in the group of ACA subjects with 1-2 CRFs, while in the subgroup with 3-5 CRFs there is a positive correlation between cWBV with TG/HDL-C and TyG at a low degree of statistical significance. CONCLUSIONS The date underline that subjects with this clinical condition have an unaltered evaluation of the cWBV compared to the other indices.
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Affiliation(s)
- G Caimi
- Department of Health Promotion and Child Care, Internal Medicine and Medical Specialties, Università degli Studi di Palermo, Palermo, Italy
| | - C Urso
- Fondazione Istituto "G. Giglio" Cefalù, Palermo, Italy
| | - S Brucculeri
- Fondazione Istituto "G. Giglio" Cefalù, Palermo, Italy
| | - R Lo Presti
- Department of Psychology, Educational Science and Human Movement, Università degli Studi di Palermo, Palermo, Italy
| | - M Carlisi
- Department of Health Promotion and Child Care, Internal Medicine and Medical Specialties, Università degli Studi di Palermo, Palermo, Italy
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Han Y, Zhang L, Yu Z, Ling S, Zhang X, Yu D, Li Z. Prediction model for asymptomatic carotid atherosclerosis using retinal microvascular intelligent analysis: A retrospective study. J Stroke Cerebrovasc Dis 2024; 33:107780. [PMID: 38802034 DOI: 10.1016/j.jstrokecerebrovasdis.2024.107780] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2024] [Revised: 03/19/2024] [Accepted: 05/17/2024] [Indexed: 05/29/2024] Open
Abstract
IMPORTANCE Early detection and timely diagnosis of asymptomatic carotid atherosclerosis significantly assist in the prevention of ischemic stroke for them. OBJECTIVE This observational study aimed to develop and validate a novel prediction model to assist in the early diagnosis of carotid atherosclerosis based on new characteristic variables screened by retinal microvascular intelligence analysis. MAIN OUTCOME(S) AND METHOD (S) The least absolute shrinkage and selection operator (LASSO) combined with 10-fold cross-validation were screened for characteristic variables, and nomograms were plotted to demonstrate the prediction model. Receiver operating characteristic (ROC) curves and area under the curve (AUC), calibration plots and brier score (BS), and decision curve analysis (DCA) were used to evaluate the risk model's discrimination, calibration, and clinical applicability. RESULTS Age, gender, diabetes mellitus (DM), drinking history, vascular branching angle, mean vascular diameter within 0.5-1.0 papillary diameter (PD), curvature tortuosity arteriole in the inferior region of the optic disc, and vascular density in the nasal region of the optic disc were identified as characteristic variables for carotid atherosclerosis with retinal microvascular intelligence analysis. The predictive nomogram model presented good discrimination with AUCs of 0.790 (0.774-0.806), and the calibration curve displayed high consistency between predicted and actual probability. The DCA demonstrated that this nomogram model led to net benefits in a threshold probability range of 20 %-94 % and could be adapted for clinical decision-making. The results of the 100-bootstrap resampling strategy for internal validation also show that the risk model is well discriminated with an AUC of 0.789 and excellent calibration. External validation showed good discrimination with AUCs of 0.703 (0.627 - 0.779) and good calibration, the risk threshold is 10 %-92 % in terms of DCA. CONCLUSIONS AND RELEVANCE The novel prediction model based on retinal microvascular intelligence analysis constructed in this study could be effective prognoses for predicting the risk of asymptomatic carotid atherosclerosis in a Chinese screening population.
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Affiliation(s)
- Yuqing Han
- Tianjin Key Laboratory of Retinal Functions and Diseases, Tianjin Branch of National Clinical Research Center for Ocular Disease, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, Tianjin 300384, China
| | - Lihua Zhang
- Department of Ultrasonography, Tianjin Institute of Neurosurgery, Tianjin Huanhu Hospital, Tianjin 300350, China
| | - Zhenjie Yu
- Tianjin Key Laboratory of Retinal Functions and Diseases, Tianjin Branch of National Clinical Research Center for Ocular Disease, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, Tianjin 300384, China
| | - Saiguang Ling
- Evision Technology (Beijing) Co. Ltd., Beijing 100085, China
| | - Xue Zhang
- Evision Technology (Beijing) Co. Ltd., Beijing 100085, China
| | - Delin Yu
- Department of Ultrasonography, Tianjin Institute of Neurosurgery, Tianjin Huanhu Hospital, Tianjin 300350, China
| | - Zhiqing Li
- Tianjin Key Laboratory of Retinal Functions and Diseases, Tianjin Branch of National Clinical Research Center for Ocular Disease, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, Tianjin 300384, China.
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Richter K, Probst T, Hundertmark A, Eulzer P, Lawonn K. Longitudinal wall shear stress evaluation using centerline projection approach in the numerical simulations of the patient-based carotid artery. Comput Methods Biomech Biomed Engin 2024; 27:347-364. [PMID: 36880851 DOI: 10.1080/10255842.2023.2185478] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2022] [Revised: 02/07/2023] [Accepted: 02/17/2023] [Indexed: 03/08/2023]
Abstract
In this numerical study, areas of the carotid bifurcation and of a distal stenosis in the internal carotid artery are closely observed to evaluate the patient's current risks of ischemic stroke. An indicator for the vessel wall defects is the stress exerted by blood on the vessel tissue, typically expressed by the amplitude of the wall shear stress vector (WSS) and its oscillatory shear index. To detect negative shear stresses corresponding with reversal flow, we perform orientation-based shear evaluation. We investigate the longitudinal component of the wall shear vector, where tangential vectors aligned longitudinally with the vessel are necessary. However, resulting from imaging segmentation resolution of patients' computed tomography angiography scans and stenotic regions, the geometry model's mesh is non-smooth on its surface areas and the automatically generated tangential vector field is discontinuous and multi-directional, making an interpretation of our orientation-based risk indicators unreliable. We improve the evaluation of longitudinal shear stress by applying the projection of the vessel's centerline to the surface to construct smooth tangential field aligned longitudinally with the vessel. We validate our approach for the longitudinal WSS component and the corresponding oscillatory index by comparing them to results obtained using automatically generated tangents in both rigid and elastic vessel modeling and to amplitude-based indicators. We present the major benefit of our longitudinal WSS evaluation based on its directionality for the cardiovascular risk assessment, which is the detection of negative WSS indicating persistent reversal or transverse flow. This is impossible in the case of the amplitude-based WSS.
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Affiliation(s)
- Kevin Richter
- Institute of Mathematics, Faculty of Natural and Environmental Sciences, University of Kaiserslautern-Landau, Germany
| | - Tristan Probst
- Institute of Mathematics, Faculty of Natural and Environmental Sciences, University of Kaiserslautern-Landau, Germany
| | - Anna Hundertmark
- Institute of Mathematics, Faculty of Natural and Environmental Sciences, University of Kaiserslautern-Landau, Germany
| | - Pepe Eulzer
- Faculty of Mathematics and Computer Science, University of Jena, Germany
| | - Kai Lawonn
- Faculty of Mathematics and Computer Science, University of Jena, Germany
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Benson JC, Shahid A, Larson A, Brinjikji W, Nasr D, Saba L, Lanzino G, Savastano LE. Carotid Artery Tortuosity and Internal Carotid Artery Plaque Composition. Clin Neuroradiol 2023; 33:1017-1021. [PMID: 37286876 DOI: 10.1007/s00062-023-01302-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2022] [Accepted: 04/27/2023] [Indexed: 06/09/2023]
Abstract
BACKGROUND Little is known about the association between carotid artery tortuosity and internal carotid artery atherosclerosis. This study sought to evaluate the associations between various types of arterial tortuosity and vulnerable plaque components on magnetic resonance angiography (MRA). MATERIAL AND METHODS A retrospective review was completed of 102 patients who had undergone MRA neck imaging, with intraplaque hemorrhage (IPH) present in one or both cervical internal carotid arteries (ICA). Each ICA was assessed for two categories of tortuosity: variant arterial pathway(s) (retrojugular and/or retropharyngeal) and abnormal curvature (kinks, loops, and/or coils). All ICA plaques were assessed for the presence or absence of intraplaque hemorrhage (IPH), lipid-rich necrotic core (LRNC), ulceration, and enhancement, as well as the volume of IPH and degree of luminal stenosis. RESULTS The mean age of included patients was 73.5 years (SD = 9.0 years) and 88 (86.3%) subjects were male. The left carotid plaque was significantly more likely to have IPH (68.6% vs. 47.1%; p = 0.02). The left ICA was more likely to have a retrojugular course (22% vs. 9.9%; p = 0.002) and any variant arterial course (26.5% versus 14.67%, p = 0.01). On the right there was an association between the presence of a LRNC and retropharyngeal and/or retrojugular arterial pathway (p = 0.03). On the left there was an association between the presence of any abnormal arterial curvature and IPH volume (p = 0.03). Neither association met the adjusted statistical threshold after Bonferroni correction, with alpha set at 0.0028. CONCLUSION ICA tortuosity is not associated with carotid artery plaque composition, and likely does not play a role in the development of high-risk plaques.
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Affiliation(s)
- John C Benson
- Department of Radiology, Mayo Clinic, 200 1st St. SW Rochester, 55905, Rochester, MN, USA.
| | - Adnan Shahid
- Department of Neurosurgery, Mayo Clinic, Rochester, MN, USA
| | - Anthony Larson
- Department of Radiology, Mayo Clinic, 200 1st St. SW Rochester, 55905, Rochester, MN, USA
| | - Waleed Brinjikji
- Department of Radiology, Mayo Clinic, 200 1st St. SW Rochester, 55905, Rochester, MN, USA
| | - Deena Nasr
- Department of Neurology, Mayo Clinic, Rochester, MN, USA
| | - Luca Saba
- Department of Medical Imaging, Azienda Ospedaliero Universitaria of Cagliari-Polo di Monserrato, Cagliari, Italy
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Takai H, Matsubara S, Minami-Ogawa Y, Hirai S, Shikata E, Yagi K, Oyama N, Yagita Y, Uno M. Association between Carotid Bifurcation Angle and Vulnerable Plaque Volume Using Black Blood Magnetic Resonance Imaging. Neurol Med Chir (Tokyo) 2023; 63:437-442. [PMID: 37495520 PMCID: PMC10687671 DOI: 10.2176/jns-nmc.2023-0034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2023] [Accepted: 05/24/2023] [Indexed: 07/28/2023] Open
Abstract
The morphology of the internal carotid artery (ICA) bifurcation is increasingly being recognized as the cause of atherosclerosis and vulnerable plaque leading to cerebral infarction. In this study, we investigated the relationship between carotid bifurcation angle and carotid plaque volume evaluated using black blood magnetic resonance imaging (BB-MRI). Among the 90 patients who underwent revascularization for atherosclerotic symptomatic carotid stenosis between April 2016 and October 2022 using BB-MRI, carotid plaque was evaluated in 57 patients. Relative overall signal intensity (roSI) was defined as the signal intensity of the plaque on T1-weighted images relative to the signal intensity of the sternocleidomastoid muscle in the same slice as the common carotid bifurcation. Regions showing roSI ≥ 1.0 were defined as plaque, and the plaque volume and relative plaque volume were measured from roSI ≥1.0 to ≥2.0 in 0.1 increments. We calculated the angles between the common carotid artery (CCA) and the ICA and between the CCA and the external carotid artery (ECA) on magnetic resonance angiography. We classified two groups according to carotid bifurcation angles based on the ICA angle: Group A = <35° and Group B = ≥35°. Compared with Group A (n = 42), Group B (n = 15) showed a greater relative plaque volume between roSI ≥ 1.3 and roSI ≥ 1.5. A significant correlation was identified between relative plaque volume with roSI ≥ 1.4 and ICA angle (p = 0.049). Vulnerable plaque was significantly more frequent in the group with an ICA angle of ≥35. Moreover, the ICA angle was significantly greater in patients with a roSI of ≥1.4.
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Affiliation(s)
- Hiroki Takai
- Department of Neurosurgery, Kawasaki Medical School
| | | | | | | | - Eiji Shikata
- Department of Neurosurgery, Kawasaki Medical School
| | - Kenji Yagi
- Department of Neurosurgery, Kawasaki Medical School
| | - Naoki Oyama
- Department of Stroke Medicine, Kawasaki Medical School
| | | | - Masaaki Uno
- Department of Neurosurgery, Kawasaki Medical School
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He Z, Luo J, Lv M, Li Q, Ke W, Niu X, Zhang Z. Characteristics and evaluation of atherosclerotic plaques: an overview of state-of-the-art techniques. Front Neurol 2023; 14:1159288. [PMID: 37900593 PMCID: PMC10603250 DOI: 10.3389/fneur.2023.1159288] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2023] [Accepted: 09/28/2023] [Indexed: 10/31/2023] Open
Abstract
Atherosclerosis is an important cause of cerebrovascular and cardiovascular disease (CVD). Lipid infiltration, inflammation, and altered vascular stress are the critical mechanisms that cause atherosclerotic plaque formation. The hallmarks of the progression of atherosclerosis include plaque ulceration, rupture, neovascularization, and intraplaque hemorrhage, all of which are closely associated with the occurrence of CVD. Assessing the severity of atherosclerosis and plaque vulnerability is crucial for the prevention and treatment of CVD. Integrating imaging techniques for evaluating the characteristics of atherosclerotic plaques with computer simulations yields insights into plaque inflammation levels, spatial morphology, and intravascular stress distribution, resulting in a more realistic and accurate estimation of plaque state. Here, we review the characteristics and advancing techniques used to analyze intracranial and extracranial atherosclerotic plaques to provide a comprehensive understanding of atheroma.
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Affiliation(s)
- Zhiwei He
- Department of Neurology, Renmin Hospital of Wuhan University, Wuhan, China
| | - Jiaying Luo
- Department of Neurology, Renmin Hospital of Wuhan University, Wuhan, China
| | - Mengna Lv
- Department of Neurology, Renmin Hospital of Wuhan University, Wuhan, China
| | - Qingwen Li
- Department of Anesthesiology, Renmin Hospital of Wuhan University, Wuhan, China
| | - Wei Ke
- Department of Neurology, Renmin Hospital of Wuhan University, Wuhan, China
| | - Xuan Niu
- Department of Neurology, Renmin Hospital of Wuhan University, Wuhan, China
| | - Zhaohui Zhang
- Department of Neurology, Renmin Hospital of Wuhan University, Wuhan, China
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Wild NC, Bulusu KV, Plesniak MW. Vortical Structures Promote Atheroprotective Wall Shear Stress Distributions in a Carotid Artery Bifurcation Model. Bioengineering (Basel) 2023; 10:1036. [PMID: 37760138 PMCID: PMC10525770 DOI: 10.3390/bioengineering10091036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Revised: 08/04/2023] [Accepted: 08/24/2023] [Indexed: 09/29/2023] Open
Abstract
Carotid artery diseases, such as atherosclerosis, are a major cause of death in the United States. Wall shear stresses are known to prompt plaque formation, but there is limited understanding of the complex flow structures underlying these stresses and how they differ in a pre-disposed high-risk patient cohort. A 'healthy' and a novel 'pre-disposed' carotid artery bifurcation model was determined based on patient-averaged clinical data, where the 'pre-disposed' model represents a pathological anatomy. Computational fluid dynamic simulations were performed using a physiological flow based on healthy human subjects. A main hairpin vortical structure in the internal carotid artery sinus was observed, which locally increased instantaneous wall shear stress. In the pre-disposed geometry, this vortical structure starts at an earlier instance in the cardiac flow cycle and persists over a much shorter period, where the second half of the cardiac cycle is dominated by perturbed secondary flow structures and vortices. This coincides with weaker favorable axial pressure gradient peaks over the sinus for the 'pre-disposed' geometry. The findings reveal a strong correlation between vortical structures and wall shear stress and imply that an intact internal carotid artery sinus hairpin vortical structure has a physiologically beneficial role by increasing local wall shear stresses. The deterioration of this beneficial vortical structure is expected to play a significant role in atherosclerotic plaque formation.
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Affiliation(s)
- Nora C. Wild
- Department of Mechanical and Aerospace Engineering, The George Washington University, 800 22nd Street NW, Science & Engineering Hall, Suite 3000, Washington, DC 20052, USA; (N.C.W.); (K.V.B.)
| | - Kartik V. Bulusu
- Department of Mechanical and Aerospace Engineering, The George Washington University, 800 22nd Street NW, Science & Engineering Hall, Suite 3000, Washington, DC 20052, USA; (N.C.W.); (K.V.B.)
| | - Michael W. Plesniak
- Department of Mechanical and Aerospace Engineering, The George Washington University, 800 22nd Street NW, Science & Engineering Hall, Suite 3000, Washington, DC 20052, USA; (N.C.W.); (K.V.B.)
- Department of Biomedical Engineering, The George Washington University, 800 22nd Street NW, Science & Engineering Hall, Suite 3000, Washington, DC 20052, USA
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Liu C, Wu G, Xu J, Xiao Q, Wang H. Numerical investigation of the effect of carotid bifurcation stenosis degree on pulsatility characteristics. Front Physiol 2023; 14:1169198. [PMID: 37485057 PMCID: PMC10359475 DOI: 10.3389/fphys.2023.1169198] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2023] [Accepted: 06/21/2023] [Indexed: 07/25/2023] Open
Abstract
Arterial bifurcations are regions that are susceptible to hemodynamic effects and thrombus formation. In the current study, the hemodynamic effects of a simplified 3D model of an arterial bifurcation were simulated using the commercial computational fluid dynamics software FLUENT. The non-Newtonian properties of blood were modeled using the Carreau model, and the pulsation dynamics and heat transfer characteristics of blood at different degrees of stenosis in the arterial bifurcation were analyzed. The results indicate that arterial stenosis caused by a thrombus when the pulsation velocity reaches its peak has an essential impact on blood transport. The stenosis of the bifurcation increases the peak pulsatile flow pressure drop, and each 0.5 mm stenosis of the arterial bifurcation increases the mean wall shear stress of the bifurcated segment by approximately 0.25 Pa. From the heat transfer perspective, arterial stenosis has little effect on the heat transfer coefficient. The heat transfer coefficient measured inside the bifurcation is much larger than that measured outside the bifurcation. The stenosis of the arterial bifurcation causes an increase in the mean velocity of the arterial cross-section, and the volume-averaged absolute vorticity is introduced to quantify the secondary flow effect during the pulsation cycle, where the arterial stenosis causes an increase in the mean absolute vorticity at pulsation velocity and accelerates the decay of the vorticity at uniform velocity. In this paper, the hemodynamics of carotid bifurcation pulsation is analyzed in conjunction with flow field properties to reveal the flow field dynamics factors and heat transfer characteristics of local stenosis of the carotid bifurcation and to conduct an exploratory study for the diagnosis and treatment of carotid bifurcation thrombosis.
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Affiliation(s)
- Chao Liu
- Affiliated Hospital of Kunming University of Science and Technology, Kunming, China
- First People’s Hospital of Yunnan Province, Kunming, China
| | - Gao Wu
- Faculty of Metallurgical and Energy Engineering, Kunming University of Science and Technology, Kunming, China
| | - Jianxin Xu
- Faculty of Metallurgical and Energy Engineering, Kunming University of Science and Technology, Kunming, China
| | - Qingtai Xiao
- Faculty of Metallurgical and Energy Engineering, Kunming University of Science and Technology, Kunming, China
| | - Hua Wang
- Faculty of Metallurgical and Energy Engineering, Kunming University of Science and Technology, Kunming, China
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Liu Y, Jiang G, Wang X, An X, Wang F. The relationship between geometry and hemodynamics of the stenotic carotid artery based on computational fluid dynamics. Clin Neurol Neurosurg 2023; 231:107860. [PMID: 37390570 DOI: 10.1016/j.clineuro.2023.107860] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2023] [Revised: 06/17/2023] [Accepted: 06/24/2023] [Indexed: 07/02/2023]
Abstract
OBJECTIVE The purpose of this work was to investigate the relationship between the geometric factors and the hemodynamics of the stenotic carotid artery. METHODS We retrospectively reviewed data of patients with carotid stenosis (40%-95%). The Navier-Stokes equations were solved using ANSYS CFX 18.0. Correlation analysis was based on Spearman's test. Geometric variables (p < 0.1 in the univariate analysis) were entered into the logistical regression. A receiver-operating characteristics analysis was used to detect hemodynamically significant lesions. RESULTS 81 patients (96 arteries) were evaluated. The logistic regression analysis revealed that the translesional pressure ratio was significantly correlated with the stenosis degree (OR = 1.147, p < 0.001) and the angle between internal carotid artery and external carotid artery (angle γ) (OR = 0.933, p = 0.01). The translesional wall shear stress ratio was significantly correlated with stenosis degree (OR = 1.094, p < 0.001), lesion length (OR = 0.873, p = 0.01), lumen area of internal carotid artery (OR = 0.867, p = 0.002), and lumen area of common carotid artery (OR = 1.058, p = 0.01). For predicting low translesional pressure ratio, the AUC was 0.71 (p < 0.001) for angle γ, and was 0.87 (p < 0.001) for stenosis degree. For predicting high translesional wall shear stress ratio, the AUC was 0.62 (p = 0.04) for lumen area of internal carotid artery, and was 0.77 (p < 0.001) for stenosis degree. CONCLUSIONS Apart from stenosis degree, other geometric characteristics of lesions may also have an influence on hemodynamics of the stenotic carotid artery.
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Affiliation(s)
- Yongsheng Liu
- Department of Interventional Neuroradiology, First Affiliated Hospital of Dalian Medical University, Dalian, China
| | - Guinan Jiang
- Department of Interventional Neuroradiology, First Affiliated Hospital of Dalian Medical University, Dalian, China
| | - Xuwen Wang
- Department of Interventional Neuroradiology, First Affiliated Hospital of Dalian Medical University, Dalian, China
| | - Xiangbo An
- Department of Interventional Neuroradiology, First Affiliated Hospital of Dalian Medical University, Dalian, China
| | - Feng Wang
- Department of Interventional Neuroradiology, First Affiliated Hospital of Dalian Medical University, Dalian, China.
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Strecker C, Kopczak A, Saam T, Sepp D, Hennemuth A, Mayerhofer E, Poli S, Ziemann U, Poppert H, Schindler A, Harloff A. Carotid geometry is independently associated with complicated carotid artery plaques. Front Cardiovasc Med 2023; 10:1177998. [PMID: 37378412 PMCID: PMC10291134 DOI: 10.3389/fcvm.2023.1177998] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2023] [Accepted: 05/22/2023] [Indexed: 06/29/2023] Open
Abstract
Introduction Complicated carotid artery plaques (cCAPs) are associated with an increased risk of rupture and subsequent stroke. The geometry of the carotid bifurcation determines the distribution of local hemodynamics and could thus contribute to the development and composition of these plaques. Therefore, we studied the role of carotid bifurcation geometry in the presence of cCAPs. Methods We investigated the association of individual vessel geometry with carotid artery plaque types in the Carotid Plaque Imaging in Acute Stroke (CAPIAS) study. After excluding arteries without plaque or with insufficient MRI quality, 354 carotid arteries from 182 patients were analyzed. Individual parameters of carotid geometry [i.e., internal carotid artery (ICA)/common carotid artery (CCA) ratio, bifurcation angle, and tortuosity) were derived from time-of-flight MR images. The lesion types of carotid artery plaques were determined according to the American Heart Association classification of lesions by multi-contrast 3T-MRI. The association between carotid geometry and a cCAP was studied using logistic regression after adjusting for age, sex, wall area, and cardiovascular risk factors. Results Low ICA/CCA ratios (OR per SD increase 0.60 [95%CI: 0.42-0.85]; p = 0.004) and low bifurcation angles (OR 0.61 [95%CI: 0.42-0.90]; p = 0.012) were significantly associated with the presence of cCAPs after adjusting for age, sex, cardiovascular risk factors, and wall area. Tortuosity had no significant association with cCAPs. Only ICA/CCA ratio remained significant in a model containing all three geometric parameters (OR per SD increase 0.65 [95%CI: 0.45-0.94]; p = 0.023). Conclusions A steep tapering of the ICA relative to the CCA and, to a lesser extent, a low angle of the carotid bifurcation were associated with the presence of cCAPs. Our findings highlight the contribution of bifurcation geometry to plaque vulnerability. Thus, assessment of carotid geometry could be helpful in identifying patients at risk of cCAPs.
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Affiliation(s)
- Christoph Strecker
- Department of Neurology and Neurophysiology, Medical Center—University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Anna Kopczak
- Institute for Stroke and Dementia Research, University Hospital, LMU Munich, Munich, Germany
| | | | - Dominik Sepp
- Department of Neuroradiology, Klinikum rechts der Isar, Technical University of Munich (TUM), Munich, Germany
| | - Anja Hennemuth
- Institute for Imaging Science and Computational Modelling in Cardiovascular Medicine, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Ernst Mayerhofer
- Department of Neurology, Massachusetts General Hospital, Boston, MA, United States
| | - Sven Poli
- Department of Neurology and Stroke and Hertie Institute for Clinical Brain Research, University of Tübingen, Tübingen, Germany
| | - Ulf Ziemann
- Department of Neurology and Stroke and Hertie Institute for Clinical Brain Research, University of Tübingen, Tübingen, Germany
| | - Holger Poppert
- Department of Neurology, Helios Klinikum München West, Munich, Germany
| | - Andreas Schindler
- Institute of Neuroradiology, University Hospital, LMU Munich, Munich, Germany
| | - Andreas Harloff
- Department of Neurology and Neurophysiology, Medical Center—University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
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Zalud NC, Bulusu KV, Plesniak MW. Shear stress metrics associated with pro-atherogenic high-risk anatomical features in a carotid artery bifurcation model. Clin Biomech (Bristol, Avon) 2023; 105:105956. [PMID: 37098301 DOI: 10.1016/j.clinbiomech.2023.105956] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2022] [Revised: 04/06/2023] [Accepted: 04/13/2023] [Indexed: 04/27/2023]
Abstract
BACKGROUND Diseases associated with atherosclerotic plaques in the carotid artery are a major cause of deaths in the United States. Blood-flow-induced shear-stresses are known to trigger plaque formation. Prior literature suggests that the internal carotid artery sinus is prone to atherosclerosis, but there is limited understanding of why only certain patients are predisposed towards plaque formation. METHODS We computationally investigate the effect of vessel geometry on wall-shear-stress distribution by comparing flowfields and wall-shear-stress-metrics between a low-risk and a novel predisposed high-risk carotid artery bifurcation anatomy. Both models were developed based on clinical risk estimations and patient-averaged anatomical features. The high-risk geometry has a larger internal carotid artery branching angle and a lower internal-to-carotid-artery-diameter-ratio. A patient-averaged physiological carotid artery inflow waveform is used. FINDINGS The high-risk geometry experiences stronger flow separation in the sinus. Furthermore, it experiences a more equal flow split at the bifurcation, thereby reducing internal carotid artery flowrate and increasing atherosclerosis-prone low-velocity areas. Lowest time-averaged-wall-shear-stresses are present at the sinus outer wall, where plaques are often found, for both geometries. The high-risk geometry has significantly high, unfavorable oscillatory-shear-index values not found in the low-risk geometry. High oscillatory-shear-index areas are located at the vessels outside walls distal to the bifurcation and on the sinus wall. INTERPRETATION These results highlight the effectiveness of oscillatory-shear-index, to augment classical time-averaged-wall-shear-stress, in evaluating pro-atherogenic geometry features. Furthermore, the flow split at the bifurcation is a promising clinical indicator for atherosclerosis risk as it can be directly accessed using clinical imaging, whereas shear-stress-metrics cannot.
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Affiliation(s)
- Nora C Zalud
- Department of Mechanical and Aerospace Engineering, The George Washington University, 800 22nd Street NW, Science & Engineering Hall, Suite 3000, Washington, DC 20052, United States
| | - Kartik V Bulusu
- Department of Mechanical and Aerospace Engineering, The George Washington University, 800 22nd Street NW, Science & Engineering Hall, Suite 3000, Washington, DC 20052, United States
| | - Michael W Plesniak
- Department of Mechanical and Aerospace Engineering, The George Washington University, 800 22nd Street NW, Science & Engineering Hall, Suite 3000, Washington, DC 20052, United States; Department of Biomedical Engineering, The George Washington University, 800 22nd Street NW, Science & Engineering Hall, Suite 5000, Washington, DC 20052, United States.
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12
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Xiang Y, Mendieta JB, Wang J, Paritala PK, Anbananthan H, Catano JAA, Fontanarosa D, Yarlagadda P, Li Z. Differences in Carotid Artery Geometry and Flow Caused by Body Postural Changes and Physical Exercise. ULTRASOUND IN MEDICINE & BIOLOGY 2023; 49:820-830. [PMID: 36535833 DOI: 10.1016/j.ultrasmedbio.2022.11.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/03/2022] [Revised: 10/25/2022] [Accepted: 11/11/2022] [Indexed: 06/17/2023]
Abstract
Different body postures and physical exercises may lead to changes in arterial geometry and hemodynamics, which may be associated with the distribution of atherosclerosis lesions. This study was aimed at investigating potential geometric and hemodynamic changes of the carotid bifurcation in different body postures and after high-intensity interval training (HIIT) workouts. Three-dimensional vascular ultrasound (3DVUS) and Doppler ultrasound images were acquired for 21 healthy participants (aged 29 ± 6 y, 14 men and 7 women) in different body postures (sitting and three sleeping postures [supine, left lateral and right lateral]) and after physical exercises. The common carotid artery (CCA) and internal carotid artery (ICA) diameters of the left carotid artery were found to increase significantly from supine to left lateral (both p <0.05). CCA diameters (p < 0.05) and ICA/CCA diameter ratio (p < 0.01) of the left carotid artery changed significantly from supine to sitting. Significant differences in CCA peak systolic velocity (CCA PSV, p < 0.001), CCA end-diastolic velocity (CCA EDV, p < 0.001), CCA pulsatility index (CCA PI, p < 0.001) and maximum velocity-based wall shear stress at the CCA (WSS(max) at the CCA, p < 0.001) were identified in different postures. After physical exercises, significant increases were observed in the CCA diameter (p < 0.001), CCA PSV (p < 0.001), ICA PSV (p < 0.05), WSS(max) at the CCA (p < 0.001) and WSS(max) at the ICA (p < 0.05), as were significantly lower values of the CCA EDV (p < 0.01) and ICA/CCA PSV ratio (p < 0.05). Side-to-side differences were also detected in different postural change scenarios and after physical exercise; more significant differences were found to occur only in the left-sided carotid artery. Significant differences were identified under postural change and after physical exercise among healthy adults, suggesting that daily activity has an effect on the carotid bifurcation. These changes may be associated with formation and development of carotid atherosclerosis. Moreover, these side differences might be severe for patients and worth further attention in clinical practice.
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Affiliation(s)
- Yuqiao Xiang
- School of Mechanical, Medical and Process Engineering, Queensland University of Technology, Brisbane, Queensland, Australia; Centre for Biomedical Technologies, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Jessica Benitez Mendieta
- School of Mechanical, Medical and Process Engineering, Queensland University of Technology, Brisbane, Queensland, Australia; Centre for Biomedical Technologies, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Jiaqiu Wang
- School of Mechanical, Medical and Process Engineering, Queensland University of Technology, Brisbane, Queensland, Australia; Centre for Biomedical Technologies, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Phani Kumari Paritala
- School of Mechanical, Medical and Process Engineering, Queensland University of Technology, Brisbane, Queensland, Australia; Centre for Biomedical Technologies, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Haveena Anbananthan
- School of Mechanical, Medical and Process Engineering, Queensland University of Technology, Brisbane, Queensland, Australia; Centre for Biomedical Technologies, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Jorge Alberto Amaya Catano
- School of Mechanical, Medical and Process Engineering, Queensland University of Technology, Brisbane, Queensland, Australia; Centre for Biomedical Technologies, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Davide Fontanarosa
- Centre for Biomedical Technologies, Queensland University of Technology, Brisbane, Queensland, Australia; School of Clinical Sciences, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Prasad Yarlagadda
- School of Mechanical, Medical and Process Engineering, Queensland University of Technology, Brisbane, Queensland, Australia; Centre for Biomedical Technologies, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Zhiyong Li
- School of Mechanical, Medical and Process Engineering, Queensland University of Technology, Brisbane, Queensland, Australia; Centre for Biomedical Technologies, Queensland University of Technology, Brisbane, Queensland, Australia; Faculty of Sports Science, Ningbo University, Ningbo, China.
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13
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Dong Y, Hong S, Song D, Liu M, Gao W, Du Y, Xu J, Dong F. Blood Flow Turbulence Quantification of Carotid Artery With a High-Frame Rate Vector Flow Imaging. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2023; 42:427-436. [PMID: 35716339 DOI: 10.1002/jum.16039] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Revised: 04/17/2022] [Accepted: 05/27/2022] [Indexed: 06/15/2023]
Abstract
OBJECTIVES To assess the feasibility and performance of Turbulence (Tur) index as a quantitative tool for carotid artery flow turbulence; to detect and compare the blood flow patterns of common carotid artery (CCA) and carotid bulb (CB) at different ages and cardiac phases in healthy adults, and thus interpret the evolvement of etiology difference between CCA and CB. METHODS Carotid flow characteristics of 40 healthy volunteers were evaluated quantitatively by a high-frame rate vector flow imaging. Three types of flow patterns were defined depending on the distributive range of complex flow during systole in CB. Comparison of mean Tur value in CCA and CB at different age groups and cardiac phases was performed. And the correlation between Tur value and the diameter ratio of proximal internal carotid artery to common carotid artery (DRpro-ica/cca) was tested. RESULTS Mean Tur values in CB were remarkably higher than that in CCA, whether during systole or diastole (P < .001). Meanwhile Tur values in CB during systole were significantly higher than that during diastole (P < .001). Flow complexity of CB showed variations among 40 participants especially in systole, whereas the flow pattern of CCA was relatively consistent. Mean Tur values were positively correlated with DRpro-ica/cca in CB (ρ = 0.69, P < .05). CONCLUSIONS V Flow imaging provided a reliable method-Tur, for quantitative analysis of carotid blood flow. It had potential to be further applied in distinguishing complex hemodynamic characteristics in high-risk people of carotid diseases for the risk stratification of cardiovascular events.
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Affiliation(s)
- Yinghui Dong
- Department of Ultrasound, Shenzhen People's Hospital (The Second Clinical Medical College, Jinan University; The First Affiliated Hospital, Southern University of Science and Technology), Shenzhen, China
| | - Shaofu Hong
- Department of Ultrasound, Shenzhen People's Hospital (The Second Clinical Medical College, Jinan University; The First Affiliated Hospital, Southern University of Science and Technology), Shenzhen, China
| | - Di Song
- Department of Ultrasound, Shenzhen People's Hospital (The Second Clinical Medical College, Jinan University; The First Affiliated Hospital, Southern University of Science and Technology), Shenzhen, China
| | - Mengmeng Liu
- Department of Ultrasound, Shenzhen People's Hospital (The Second Clinical Medical College, Jinan University; The First Affiliated Hospital, Southern University of Science and Technology), Shenzhen, China
| | - Wenjing Gao
- Department of Ultrasound, Shenzhen People's Hospital (The Second Clinical Medical College, Jinan University; The First Affiliated Hospital, Southern University of Science and Technology), Shenzhen, China
| | - Yigang Du
- Shenzhen Mindray Bio-Medical Electronics Co., Ltd., Shenzhen, China
| | - Jinfeng Xu
- Department of Ultrasound, Shenzhen People's Hospital (The Second Clinical Medical College, Jinan University; The First Affiliated Hospital, Southern University of Science and Technology), Shenzhen, China
| | - Fajin Dong
- Department of Ultrasound, Shenzhen People's Hospital (The Second Clinical Medical College, Jinan University; The First Affiliated Hospital, Southern University of Science and Technology), Shenzhen, China
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Wang S, Wu D, Li G, Zhang Z, Xiao W, Li R, Qiao A, Jin L, Liu H. Deep learning-based hemodynamic prediction of carotid artery stenosis before and after surgical treatments. Front Physiol 2023; 13:1094743. [PMID: 36703930 PMCID: PMC9872942 DOI: 10.3389/fphys.2022.1094743] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2022] [Accepted: 12/09/2022] [Indexed: 01/11/2023] Open
Abstract
Hemodynamic prediction of carotid artery stenosis (CAS) is of great clinical significance in the diagnosis, prevention, and treatment prognosis of ischemic strokes. While computational fluid dynamics (CFD) is recognized as a useful tool, it shows a crucial issue that the high computational costs are usually required for real-time simulations of complex blood flows. Given the powerful feature-extraction capabilities, the deep learning (DL) methodology has a high potential to implement the mapping of anatomic geometries and CFD-driven flow fields, which enables accomplishing fast and accurate hemodynamic prediction for clinical applications. Based on a brain/neck CT angiography database of 280 subjects, image based three-dimensional CFD models of CAS were constructed through blood vessel extraction, computational domain meshing and setting of the pulsatile flow boundary conditions; a series of CFD simulations were undertaken. A DL strategy was proposed and accomplished in terms of point cloud datasets and a DL network with dual sampling-analysis channels. This enables multimode mapping to construct the image-based geometries of CAS while predicting CFD-based hemodynamics based on training and testing datasets. The CFD simulation was validated with the mass flow rates at two outlets reasonably agreed with the published results. Comprehensive analysis and error evaluation revealed that the DL strategy enables uncovering the association between transient blood flow characteristics and artery cavity geometric information before and after surgical treatments of CAS. Compared with other methods, our DL-based model trained with more clinical data can reduce the computational cost by 7,200 times, while still demonstrating good accuracy (error<12.5%) and flow visualization in predicting the two hemodynamic parameters. In addition, the DL-based predictions were in good agreement with CFD simulations in terms of mean velocity in the stenotic region for both the preoperative and postoperative datasets. This study points to the capability and significance of the DL-based fast and accurate hemodynamic prediction of preoperative and postoperative CAS. For accomplishing real-time monitoring of surgical treatments, further improvements in the prediction accuracy and flexibility may be conducted by utilizing larger datasets with specific real surgical events such as stent intervention, adopting personalized boundary conditions, and optimizing the DL network.
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Affiliation(s)
- Sirui Wang
- Graduate School of Engineering, Chiba University, Chiba, Japan
| | - Dandan Wu
- Graduate School of Engineering, Chiba University, Chiba, Japan
| | - Gaoyang Li
- College of Life Science and Bioengineering, Beijing University of Technology, Beijing, China
| | - Zhiyuan Zhang
- Department of Interventional Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Weizhong Xiao
- Department of Interventional Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Ruichen Li
- Graduate School of Engineering, Chiba University, Chiba, Japan
| | - Aike Qiao
- College of Life Science and Bioengineering, Beijing University of Technology, Beijing, China
| | - Long Jin
- Department of Interventional Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing, China,*Correspondence: Hao Liu, ; Long Jin,
| | - Hao Liu
- Graduate School of Engineering, Chiba University, Chiba, Japan,*Correspondence: Hao Liu, ; Long Jin,
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Bai X, Fu M, Li Z, Gao P, Zhao H, Li R, Sui B. Distribution and regional variation of wall shear stress in the curved middle cerebral artery using four-dimensional flow magnetic resonance imaging. Quant Imaging Med Surg 2022; 12:5462-5473. [PMID: 36465823 PMCID: PMC9703110 DOI: 10.21037/qims-22-67] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2022] [Accepted: 08/30/2022] [Indexed: 12/05/2023]
Abstract
BACKGROUND To investigate the distribution and regional variation of wall shear stress (WSS) in the curved middle cerebral artery (MCA) in healthy individuals using four-dimensional (4D) flow magnetic resonance imaging (MRI). METHODS A total of 44 healthy participants (18 males; mean ages: 27.16±5.69 years) were included in this cross-sectional study. The WSS parameters of mean, minimum, and maximum values, the coefficient of variation of time-averaged WSS (TAWSSCV), and the maximum values of the oscillatory shear index (OSI) were calculated and compared in the curved proximal (M1) segments. Three cross-sectional planes were selected: the location perpendicular to the beginning of the long axis of the curved M1 segment of the MCA (proximal section), the most curved M1 location (curved M1 section), and the location before the insular (M2) segment bifurcation (distal section). The WSS and OSI parameters of the proximal, curved, and distal sections of the curved M1 segment were compared, including the inner and outer curvatures of the curved M1 section. RESULTS Of the curved M1 segments, the curved M1 section had significantly lower minimum TAWSS values than the proximal (P=0.031) and distal sections (P=0.002), and the curved M1 section had significantly higher maximum OSI values than the distal section (P=0.001). The TAWSSCV values at the curved M1 section were significantly higher than the proximal (P=0.001) and distal sections (P<0.001). At the curved M1 section, the inner curvature showed a significantly lower minimum TAWSS (P=0.013) and higher maximum OSI values (P=0.002) than the outer curvature. CONCLUSIONS There are distribution variation of WSS and OSI parameters at the curved M1 section of the curved MCA, and the inner curvature of the curved M1 section has the lowest WSS and highest OSI distribution. The local hemodynamic features of the curved MCA may be related to the predilection for atherosclerotic plaque development.
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Affiliation(s)
- Xiaoyan Bai
- Tiantan Neuroimaging Center of Excellence, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
- China National Clinical Research Center for Neurological Diseases, Beijing, China
- Department of Radiology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Mingzhu Fu
- Center for Biomedical Imaging Research, Biomedical Engineering Department, School of Medicine, Tsinghua University, Beijing, China
| | - Zhiye Li
- Tiantan Neuroimaging Center of Excellence, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
- China National Clinical Research Center for Neurological Diseases, Beijing, China
- Department of Radiology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Peiyi Gao
- Department of Radiology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Haiqing Zhao
- Department of Radiology, Beijing Chui Yang Liu Hospital, Beijing, China
| | - Rui Li
- Center for Biomedical Imaging Research, Biomedical Engineering Department, School of Medicine, Tsinghua University, Beijing, China
| | - Binbin Sui
- Tiantan Neuroimaging Center of Excellence, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
- China National Clinical Research Center for Neurological Diseases, Beijing, China
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Han G, Li H, Guo H, Yi C, Yu B, Lin Y, Zheng B, He D. The roles and mechanisms of miR-26 derived from exosomes of adipose-derived stem cells in the formation of carotid atherosclerotic plaque. ANNALS OF TRANSLATIONAL MEDICINE 2022; 10:1134. [PMID: 36388831 PMCID: PMC9652556 DOI: 10.21037/atm-22-4247] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/12/2022] [Accepted: 10/18/2022] [Indexed: 10/04/2023]
Abstract
BACKGROUND This study explored the serum concentrations of miR-26 in patients with carotid atherosclerosis (CAS) and defined the roles and mechanisms of miR-26 derived from the exosomes of adipose-derived stem cells (ADSC-exos). METHODS The carotid artery width was diagnosed by ultrasound examination in patients with different degrees of CAS. The serum levels of total cholesterol (TC), triglyceride (TG), high-density lipoprotein cholesterol (HDL-C), and low-density lipoprotein cholesterol (LDL-C) in patients were detected by biochemistry. The serum levels of miR-26 were determined by quantitative polymerase chain reaction (qPCR). A model of CAS in ApoE-/- mice fed with a rich-fat diet was established to analyze the regulatory effects of serum miR-26 on blood lipids in mice. Adipose mesenchymal stem cell lines transfected with miR-26 were established. The regulatory relationship between the expression levels of inflammatory factors, including tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6) and IL-1β, and the expression levels of miR-26 in the supernatant of each group of cells was determined by qPCR. The ADSC-exos were extracted from ADSCs and injected into model mice through the tail vein. The therapeutic effect of ADSCs expressing miR-26 on model mice was evaluated by detecting the levels of inflammatory factors and blood lipids in the serum of the mice. RESULTS The degree of atherosclerosis (AS) was positively associated with the intima-media thickness (IMT) of the carotid artery. The serum levels of miR-26 in patients were inversely correlated with the levels of blood lipids (TC, TG, and LDL-C), and positively correlated with HDL-C levels. Similarly, in the CAS mouse model, the serum levels of miR-26 were inversely correlated with the levels of blood lipids (TC, TG, and LDL-C), and positively correlated with HDL-C level. In ADSCs transfected with miR-26, the miR-26 expression in the cell supernatant was negatively regulated by the expression of inflammatory factors, TNF-α, IL-6, and IL-1β, in the cell supernatant. ADSC-exos expressing miR-26 has positive effects on correcting blood lipids and inflammatory factors in the mouse model of CAS. CONCLUSIONS miR-26 has an active role in CAS and may be a novel target for the treatment of CAS in the future.
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Affiliation(s)
- Guochao Han
- Department of Electrophysiology, The Second Affiliated Hospital of Qiqihar Medical University, Qiqihar, China
| | - Hui Li
- Department of Electrophysiology, The Second Affiliated Hospital of Qiqihar Medical University, Qiqihar, China
| | - Hongyan Guo
- Department of Biochemistry, Qiqihar Medical University, Qiqihar, China
| | - Chao Yi
- Department of Neurosurgery, The Second Affiliated Hospital of Qiqihar Medical University, Qiqihar, China
| | - Beiguang Yu
- Department of Electrophysiology, The Second Affiliated Hospital of Qiqihar Medical University, Qiqihar, China
| | - Yuan Lin
- Department of Electrophysiology, The Second Affiliated Hospital of Qiqihar Medical University, Qiqihar, China
| | - Bingjie Zheng
- Department of Neurosurgery, The First Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Dongruo He
- Department of Electrophysiology, The Second Affiliated Hospital of Qiqihar Medical University, Qiqihar, China
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Huang G, Jin Q, Tian X, Mao Y. Development and validation of a carotid atherosclerosis risk prediction model based on a Chinese population. Front Cardiovasc Med 2022; 9:946063. [PMID: 35983181 PMCID: PMC9380015 DOI: 10.3389/fcvm.2022.946063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Accepted: 07/08/2022] [Indexed: 11/13/2022] Open
Abstract
Purpose This study aimed to identify independent risk factors for carotid atherosclerosis (CAS) and construct and validate a CAS risk prediction model based on the Chinese population. Methods This retrospective study included 4,570 Chinese adults who underwent health checkups (including carotid ultrasound) at the Zhenhai Lianhua Hospital, Ningbo, China, in 2020. All the participants were randomly assigned to the training and validation sets at a ratio of 7:3. Independent risk factors associated with CAS were identified using multivariate logistic regression analysis. The least absolute shrinkage and selection operator combined with 10-fold cross-validation were screened for characteristic variables, and nomograms were plotted to demonstrate the risk prediction model. C-index and receiver operating characteristic curves, calibration plots, and decision curve analysis (DCA) were used to evaluate the risk model’s discrimination, calibration, and clinical applicability. Results Age, body mass index, diastolic blood pressure, white blood cell count, mean platelet volume, alanine transaminase, aspartate transaminase, and gamma-glutamyl transferase were identified as independent risk factors for CAS. In the training, internal validation, and external validation sets, the risk model showed good discriminatory power with C-indices of 0.961 (0.953–0.969), 0.953 (0.939–0.967), and 0.930 (0.920–0.940), respectively, and excellent calibration. The results of DCA showed that the prediction model could be beneficial when the risk threshold probabilities were 1–100% in all sets. Finally, a network computer (dynamic nomogram) was developed to facilitate the physicians’ clinical operations. The website is https://nbuhgq.shinyapps.io/DynNomapp/. Conclusion The development of risk models contributes to the early identification and prevention of CAS, which is important for preventing and reducing adverse cardiovascular and cerebrovascular events.
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Affiliation(s)
- Guoqing Huang
- Department of Endocrinology, The Affiliated Hospital of Medical School, Ningbo University, Ningbo, China
- School of Medicine, Ningbo University, Ningbo, China
| | - Qiankai Jin
- Department of Endocrinology, The Affiliated Hospital of Medical School, Ningbo University, Ningbo, China
- School of Medicine, Ningbo University, Ningbo, China
| | - Xiaoqing Tian
- Department of Endocrinology, The Affiliated Hospital of Medical School, Ningbo University, Ningbo, China
- School of Medicine, Ningbo University, Ningbo, China
| | - Yushan Mao
- Department of Endocrinology, The Affiliated Hospital of Medical School, Ningbo University, Ningbo, China
- *Correspondence: Yushan Mao,
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Del Brutto VJ, Dong C, Cullison K, Caunca MR, Simonetto M, Cabral DE, Gutierrez J, Elkind MSV, Sacco RL, Rundek T. Internal Carotid Artery Angle Variations are Poorly Explained by Vascular Risk Factors: The Northern Manhattan Study. J Stroke Cerebrovasc Dis 2022; 31:106540. [PMID: 35633588 PMCID: PMC9329273 DOI: 10.1016/j.jstrokecerebrovasdis.2022.106540] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2021] [Revised: 04/19/2022] [Accepted: 04/24/2022] [Indexed: 10/18/2022] Open
Abstract
OBJECTIVES The internal carotid artery (ICA) angle of origin may contribute to atherogenesis by altered hemodynamics. We aim to determine the contribution of vascular risk factors and arterial wall changes to ICA angle variations. METHODS We analyzed 1,065 stroke-free participants from the population-based Northern Manhattan Study who underwent B-mode ultrasound (mean age 68.7±8.9 years; 59% women). ICA angle was estimated at the intersection between the common carotid artery and the ICA center line projections. Narrower external angles translating into greater carotid bifurcation bending were considered unfavorable. Linear regression models were fitted to assess the relationship between ICA angle and demographics, vascular risk factors, and arterial wall changes including carotid intima-media thickness (cIMT) and plaque presence. RESULTS ICA angles were narrower on the left compared to the right side (153±15.4 degrees versus 161.4±12.7 degrees, p<0.01). Mean cIMT was 0.9±0.1 mm and 54.3% had at least one plaque. ICA angle was not associated with cIMT or plaque presence. Unfavorable left and right ICA angles were associated with advanced age (per 10-year increase β=-1.6; p=0.01, and -1.3; p=0.03, respectively) and being Black participant (β=-4.6; p<0.01 and -2.9; p=0.04, respectively), while unfavorable left ICA angle was associated with being female (β=-2.8; p=0.03) and increased diastolic blood pressure (per 10 mmHg increase β=-2.1; p<0.01). Overall, studied factors explained less than 10% of the variance in ICA angle (left R2=0.07; right R2=0.05). CONCLUSION Only a small portion of ICA angle variation were explained by demographics, vascular risk factors and arterial wall changes. Whether ICA angle is determined by other environmental or genetic factors, and is an independent risk factor for atherogenesis, requires further investigation.
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Affiliation(s)
- Victor J Del Brutto
- Department of Neurology, University of Miami Miller School of Medicine, Miami, FL.
| | - Chuanhui Dong
- Department of Neurology, University of Miami Miller School of Medicine, Miami, FL
| | - Kaylie Cullison
- Department of Neurology, University of Miami Miller School of Medicine, Miami, FL
| | - Michelle R Caunca
- Department of Neurology, University of Miami Miller School of Medicine, Miami, FL
| | - Marialaura Simonetto
- Department of Neurology, Weill Cornell Medical Center/New York Presbyterian Hospital, New York, NY
| | - Digna E Cabral
- Department of Neurology, University of Miami Miller School of Medicine, Miami, FL
| | - Jose Gutierrez
- Department of Epidemiology, Mailman School of Public Health, and Department of Neurology, Vagelos College of Physicians and Surgeons, Columbia University, New York, NY
| | - Mitchell S V Elkind
- Department of Epidemiology, Mailman School of Public Health, and Department of Neurology, Vagelos College of Physicians and Surgeons, Columbia University, New York, NY
| | - Ralph L Sacco
- Department of Neurology, University of Miami Miller School of Medicine, Miami, FL; Evelyn F. McKnight Brain Institute, University of Miami Miller School of Medicine, Miami, FL
| | - Tatjana Rundek
- Department of Neurology, University of Miami Miller School of Medicine, Miami, FL; Evelyn F. McKnight Brain Institute, University of Miami Miller School of Medicine, Miami, FL
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Betzler BK, Sabanayagam C, Tham YC, Cheung CY, Cheng CY, Wong TY, Nusinovici S. Retinal Vascular Profile in Predicting Incident Cardiometabolic Diseases among Individuals with Diabetes. Microcirculation 2022; 29:e12772. [PMID: 35652745 DOI: 10.1111/micc.12772] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2021] [Revised: 04/12/2022] [Accepted: 05/25/2022] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To determine the longitudinal associations between retinal vascular profile (RVP) and four major cardiometabolic diseases; and to quantify the predictive improvements when adding RVP beyond traditional risk factors in individuals with diabetes. METHODS Subjects were enrolled from the Singapore Epidemiology of Eye Disease (SEED) study, a multi-ethnic population-based cohort. Four incident cardiometabolic diseases, calculated over a ~6-year period, were considered: cardiovascular disease (CVD), hypertension (HTN), diabetic kidney disease (DKD) and hyperlipidaemia (HLD). The RVP - vessel tortuosity, branching angle, branching coefficient, fractal dimension, vessel calibre, and DR status - was characterized at baseline using a computer-assisted program. Traditional risk factors at baseline included age, gender, ethnicity, smoking, blood pressure (BP), HbA1c, estimated glomerular filtration rate (eGFR) or cholesterol. The improvements in predictive performance when adding RVP (compared to only traditional risk factors) was calculated using several metrics including area under the receiver operating characteristics curve (AUC) and Net Reclassification Improvement (NRI). RESULTS Among 1,770 individuals with diabetes, incidences were 6.3% (n=79/1259) for CVD, 48.7% (n=166/341) for HTN, 14.6% (n=175/1199) for DKD, and 59.4% (n=336/566) for HLD. DR preceded the onset of CVD (RR 1.85[1.14;3.00]) and DKD (1.44 [1.06;1.96]). Narrower arteriolar calibre preceding the onset of HTN (0.84 [0.72;0.99]), and changes in arteriolar branching angle preceded the onset of CVD (0.78 [0.62;0.98]) and HTN (1.15 [1.03;1.29]). The largest predictive improvement was found for HTN with AUC increment of 3.4% (p=0.027) and better reclassification of 11.4% of the cases and 4.6% of the controls (p=0.008). CONCLUSION We found that RVPs improved the prediction of HTN in individuals with diabetes, but add limited information for CVD, DKD and HLD predictions.
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Affiliation(s)
- Bjorn Kaijun Betzler
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore.,Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Singapore
| | - Charumathi Sabanayagam
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Singapore.,Ophthalmology and Visual Sciences Academic Clinical Programme, Duke-NUS Medical School, National University of Singapore, Singapore
| | - Yih-Chung Tham
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Singapore.,Ophthalmology and Visual Sciences Academic Clinical Programme, Duke-NUS Medical School, National University of Singapore, Singapore
| | - Carol Y Cheung
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Singapore.,Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong, China
| | - Ching-Yu Cheng
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Singapore.,Ophthalmology and Visual Sciences Academic Clinical Programme, Duke-NUS Medical School, National University of Singapore, Singapore.,Department of Ophthalmology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Tien-Yin Wong
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Singapore.,Ophthalmology and Visual Sciences Academic Clinical Programme, Duke-NUS Medical School, National University of Singapore, Singapore.,Department of Ophthalmology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Simon Nusinovici
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Singapore.,Ophthalmology and Visual Sciences Academic Clinical Programme, Duke-NUS Medical School, National University of Singapore, Singapore
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20
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Kwon W, Kim Y, Kim J, Jo J, Jeon S, Lee UY, Kwak HS. Bilateral carotid artery geometry using magnetic resonance angiography: a 10-year longitudinal single center study. Sci Rep 2022; 12:4932. [PMID: 35322148 PMCID: PMC8943042 DOI: 10.1038/s41598-022-09062-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2021] [Accepted: 02/28/2022] [Indexed: 12/04/2022] Open
Abstract
Aging and atherosclerotic progression can lead to geometric changes in the carotid arteries. We conducted a longitudinal study to investigate geometric changes in the bilateral carotid arteries. We conducted a retrospective study of 177 subjects who underwent carotid contrast-enhanced magnetic resonance angiography (MRA) at our clinic at baseline and 10 years after the procedure. Semi-automated methods were used to segment the bilateral carotid arteries to obtain carotid artery geometric measurements. The mean age for the total population after 10 years was 70.7 ± 10.6 years (male, 40.1%). The mean time interval between baseline and after 10 years for all subjects was 130.2 ± 8.1 months. The bilateral bifurcation angle, the diameters for both common carotid arteries (CCAs), and areas of both CCAs significantly increased (p < 0.001) over a 10-year period. The maximum diameter and internal carotid artery area did not significantly change. The bifurcation angle of the right carotid artery was significantly increased compared to the left carotid artery. However, the diameter and area of the CCA of the left carotid artery was significantly increased compared to the right carotid artery. The bifurcation angle, diameter and area of both CCAs significantly increased over a decade. The change in the bifurcation angle over a 10-year period was predominant in the right carotid artery and the change of the area and diameter of the CCA was dominant in the left carotid artery.
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Affiliation(s)
- Woocheol Kwon
- Jeonbuk National University Medical School, Jeon-ju, 54907, Korea
| | - Yeryung Kim
- Jeonbuk National University Medical School, Jeon-ju, 54907, Korea
| | - Jisu Kim
- Jeonbuk National University Medical School, Jeon-ju, 54907, Korea
| | - Junsik Jo
- Jeonbuk National University Medical School, Jeon-ju, 54907, Korea
| | - Seongju Jeon
- Jeonbuk National University Medical School, Jeon-ju, 54907, Korea
| | - Ui Yun Lee
- Division of Mechanical Design Engineering, College of Engineering, Jeonbuk National University, Jeon-ju, 54896, Korea
| | - Hyo Sung Kwak
- Department of Radiology and Research, Institute of Clinical Medicine of Jeonbuk National University, Biomedical Research Institute, Jeonbuk National University Hospital, 20, Geonji-ro, Deokjin-gu, Jeonju-si, Jeollabuk-do, 54907, Republic of Korea.
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21
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Bonati LH, Brown MM. Carotid Artery Disease. Stroke 2022. [DOI: 10.1016/b978-0-323-69424-7.00022-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
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22
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Baz RA, Scheau C, Niscoveanu C, Bordei P. Morphometry of the Entire Internal Carotid Artery on CT Angiography. Medicina (B Aires) 2021; 57:medicina57080832. [PMID: 34441039 PMCID: PMC8398484 DOI: 10.3390/medicina57080832] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2021] [Revised: 08/02/2021] [Accepted: 08/13/2021] [Indexed: 11/16/2022] Open
Abstract
Background and Objectives: Knowledge of the internal carotid artery’s (ICA) morphometric features is influential in outlining surgical and minimally invasive procedures in the neurovascular field. Many studies have shown divisive numbers regarding the ICA’s caliber, with the measuring point of the artery sometimes differing. This study presents ICA dimensions based on computed tomography angiography in each of its seven segments as per Bouthillier’s classification, correlating vascular dimensions with anthropometric parameters. Materials and Methods: A thorough CT angiography analysis was performed on 70 patients with internal carotid vessels unaffected by atherosclerotic disease. The extracranial part of the ICA was measured in four locations—carotid bulb, post-bulbar dilation, at its cervical midpoint, and below its entrance into the carotid foramen. Single landmarks were used for measurements in the intracranial segments. ICA length was assessed in the neck region and also in the cranial cavity. Craniometric measurements were performed on sagittal and coronal CT reconstructions. Patient height was taken into consideration. Results: The largest ICA portion is near its origin in the carotid sinus area (7.59 ± 1.00 mm), with a steep decline in caliber following its extracranial course. Distal ICA presented values somewhat similar to its proximal intracranial segment diameters (4.67 ± 0.47 mm). Dimensions of the ICA in the intracranial segments start from a value of 4.53 ± 0.47 mm and decrease by approximately 40% when reaching the origin of the middle cerebral artery (2.71 ± 0.37 mm), showing a marked decrease in caliber after the emergence of the most critical collateral artery, the ophthalmic branch. The length of the ICA varies between genders, with the male ICA being about 10 mm longer in total length than female ICA; this difference is also correlated with patient height and skull dimensions. Conclusions: Both intra- and extracranial ICA have variable dimensions and length related to gender and anthropometric parameters, with no significant differences obtained concerning side or age.
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Affiliation(s)
- Radu Andrei Baz
- Department of Radiology, Faculty of Medicine, “Ovidius” University, 900470 Constanta, Romania;
| | - Cristian Scheau
- Department of Physiology, “Carol Davila” University of Medicine and Pharmacy, 050474 Bucharest, Romania
- Correspondence: (C.S.); (C.N.)
| | - Cosmin Niscoveanu
- Department of Radiology, Faculty of Medicine, “Ovidius” University, 900470 Constanta, Romania;
- Correspondence: (C.S.); (C.N.)
| | - Petru Bordei
- Department of Anatomy, Faculty of Medicine, “Ovidius” University, 900470 Constanta, Romania;
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23
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Bridio S, Luraghi G, Rodriguez Matas JF, Dubini G, Giassi GG, Maggio G, Kawamoto JN, Moerman KM, McGarry P, Konduri PR, Arrarte Terreros N, Marquering HA, van Bavel E, Majoie CBLM, Migliavacca F. Impact of the Internal Carotid Artery Morphology on in silico Stent-Retriever Thrombectomy Outcome. FRONTIERS IN MEDICAL TECHNOLOGY 2021; 3:719909. [PMID: 35047950 PMCID: PMC8757691 DOI: 10.3389/fmedt.2021.719909] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2021] [Accepted: 07/09/2021] [Indexed: 11/13/2022] Open
Abstract
The aim of this work is to propose a methodology for identifying relationships between morphological features of the cerebral vasculature and the outcome of in silico simulations of thrombectomy, the mechanical treatment for acute ischemic stroke. Fourteen patient-specific cerebral vasculature segmentations were collected and used for geometric characterization of the intracranial arteries mostly affected by large vessel occlusions, i.e., internal carotid artery (ICA), middle cerebral artery (MCA) and anterior cerebral artery (ACA). First, a set of global parameters was created, including the geometrical information commonly provided in the clinical context, namely the total length, the average diameter and the tortuosity (length over head-tail distance) of the intracranial ICA. Then, a more exhaustive geometrical analysis was performed to collect a set of local parameters. A total of 27 parameters was measured from each patient-specific vascular configuration. Fourteen virtual thrombectomy simulations were performed with a blood clot with the same length and composition placed in the middle of the MCA. The model of TREVO ProVue stent-retriever was used for all the simulations. Results from simulations produced five unsuccessful outcomes, i.e., the clot was not removed from the vessels. The geometric parameters of the successful and unsuccessful simulations were compared to find relations between the vascular geometry and the outcome. None of the global parameters alone or combined proved able to discriminate between positive and negative outcome, while a combination of local parameters allowed to correctly identify the successful from the unsuccessful simulations. Although these results are limited by the number of patients considered, this study indicates a promising methodology to relate patient-specific geometry to virtual thrombectomy outcome, which might eventually guide decision making in the treatment of acute ischemic stroke.
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Affiliation(s)
- Sara Bridio
- Laboratory of Biological Structure Mechanics, Department of Chemistry, Materials and Chemical Engineering, Politecnico di Milano, Milan, Italy
| | - Giulia Luraghi
- Laboratory of Biological Structure Mechanics, Department of Chemistry, Materials and Chemical Engineering, Politecnico di Milano, Milan, Italy
| | - Jose F. Rodriguez Matas
- Laboratory of Biological Structure Mechanics, Department of Chemistry, Materials and Chemical Engineering, Politecnico di Milano, Milan, Italy
| | - Gabriele Dubini
- Laboratory of Biological Structure Mechanics, Department of Chemistry, Materials and Chemical Engineering, Politecnico di Milano, Milan, Italy
| | - Giorgia G. Giassi
- Laboratory of Biological Structure Mechanics, Department of Chemistry, Materials and Chemical Engineering, Politecnico di Milano, Milan, Italy
| | - Greta Maggio
- Laboratory of Biological Structure Mechanics, Department of Chemistry, Materials and Chemical Engineering, Politecnico di Milano, Milan, Italy
| | - Julia N. Kawamoto
- Laboratory of Biological Structure Mechanics, Department of Chemistry, Materials and Chemical Engineering, Politecnico di Milano, Milan, Italy
| | - Kevin M. Moerman
- School of Engineering, National University of Ireland Galway, Galway, Ireland
| | - Patrick McGarry
- School of Engineering, National University of Ireland Galway, Galway, Ireland
| | - Praneeta R. Konduri
- Department of Biomedical Engineering and Physics, Amsterdam University Medical Center, Location Academic Medical Center, Amsterdam, Netherlands
- Department of Radiology and Nuclear Medicine, Amsterdam University Medical Center, Amsterdam, Netherlands
| | - Nerea Arrarte Terreros
- Department of Biomedical Engineering and Physics, Amsterdam University Medical Center, Location Academic Medical Center, Amsterdam, Netherlands
- Department of Radiology and Nuclear Medicine, Amsterdam University Medical Center, Amsterdam, Netherlands
| | - Henk A. Marquering
- Department of Biomedical Engineering and Physics, Amsterdam University Medical Center, Location Academic Medical Center, Amsterdam, Netherlands
- Department of Radiology and Nuclear Medicine, Amsterdam University Medical Center, Amsterdam, Netherlands
| | - Ed van Bavel
- Department of Biomedical Engineering and Physics, Amsterdam University Medical Center, Location Academic Medical Center, Amsterdam, Netherlands
| | - Charles B. L. M. Majoie
- Department of Radiology and Nuclear Medicine, Amsterdam University Medical Center, Amsterdam, Netherlands
| | - Francesco Migliavacca
- Laboratory of Biological Structure Mechanics, Department of Chemistry, Materials and Chemical Engineering, Politecnico di Milano, Milan, Italy
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24
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Stula I, Kojundzic SL, Guic MM, Novak K. Carotid artery stenosis in correlation with neck and carotid artery anatomy. Vascular 2021; 30:524-531. [PMID: 34053369 DOI: 10.1177/17085381211018603] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVES The purpose of this study was to examine the relationship between neck anatomy, especially its largest muscle - sternocleidomastoid and carotid space, with carotid artery anatomy and stenosis. METHODS We analysed 102 computed tomography carotid angiograms. The study included the measurement of the neck and sternocleidomastoid length, diameter and volume and the size of the carotid space. Analysis of carotid artery geometry, the length, angle and height of carotid artery bifurcation and the direction of the internal carotid artery origin was also included. RESULTS We found a positive correlation only between the neck and carotid length. There was no correlation between other neck characteristics and a carotid anatomy or internal carotid artery stenosis. Direction of internal carotid artery origin was significantly different (p < 0.01) between the left and right sides. CONCLUSIONS We have not found a correlation between the size of sternocleidomastoid and carotid space and carotid stenosis as a hypothetical factor for atherosclerosis. Also, the degree of carotid artery stenosis did not correlate with other neck and carotid measurements. Neck and carotid anatomy correlated only in their lengths. The left internal carotid artery showed mostly posterolateral origin, and right internal carotid artery had no predominate direction.
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Affiliation(s)
- Ivana Stula
- Department of Diagnostic and Interventional Radiology, University Hospital of Split, Split, Croatia.,School of Medicine, University of Split, Split, Croatia.,Department of Health Studies, University of Split, Split, Croatia
| | - Sanja L Kojundzic
- Department of Diagnostic and Interventional Radiology, University Hospital of Split, Split, Croatia.,School of Medicine, University of Split, Split, Croatia.,Department of Health Studies, University of Split, Split, Croatia
| | - Maja M Guic
- Department of Diagnostic and Interventional Radiology, University Hospital of Split, Split, Croatia.,Department of Health Studies, University of Split, Split, Croatia
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25
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Caimi G, Urso C, Brucculeri S, Amato C, Carlisi M, Lo Presti R. An assessment of the hemorheological profile in patients with subclinical carotid atherosclerosis divided in relation to the number of cardiovascular risk factors and different degrees of insulin resistance. Clin Hemorheol Microcirc 2021; 78:417-428. [PMID: 33843665 DOI: 10.3233/ch-211105] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
We present a cohort of 100 subjects [43 men and 57 women; median age 66.00(25)] who were tested using carotid ultrasound to identify subclinical carotid atherosclerosis (SCA). We have evaluated the behaviour of whole blood viscosity (WBV) at high (450 s-1) and low (0.51 s-1) shear rates, plasma viscosity (450-1), hematocrit and mean erythrocyte aggregation. When compared to normal control subjects, using the Mann-Whitney test, we observed in SCA patients a significant increase in WBV only. The results were substantial after having divided the SCA subjects according to the cardiovascular risk factors (CRFs) and the degree of insulin resistance; the research was performed using two surrogate indexes such as TG/HDL-C and TyG. With the division carried out according to CRFs, employing the Kruskal-Wallis test, results show a significant increase in WBV (at high and low shear rates), in plasma viscosity, in erythrocyte aggregation and plasma fibrinogen level. Whereas by dividing them into the median of TG/HDL-C and TyG, we noticed a significant increase in WBV (at high and low shear rates) and in erythrocyte aggregation in the two groups with high TG/HDL-C ratio and with high TyG; having found an increased level of plasma fibrinogen in the latter. The data underlines the role of the main hemorheologic aspects in subclinical carotid atherosclerosis being closely correlated to the CRFs and different degrees of insulin resistance.
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Affiliation(s)
- G Caimi
- Department of Health Promotion and Child Care, Internal Medicine and Medical Specialties, Universitá Degli Studi Di Palermo, Palermo, Italy
| | - C Urso
- Fondazione Istituto "G. Giglio" Cefalú, Palermo, Italy
| | - S Brucculeri
- Fondazione Istituto "G. Giglio" Cefalú, Palermo, Italy
| | - C Amato
- Department of Health Promotion and Child Care, Internal Medicine and Medical Specialties, Universitá Degli Studi Di Palermo, Palermo, Italy
| | - M Carlisi
- Department of Health Promotion and Child Care, Internal Medicine and Medical Specialties, Universitá Degli Studi Di Palermo, Palermo, Italy
| | - R Lo Presti
- Department of Psychology, Educational Science and Human Movement, Universitá Degli Studi Di Palermo, Palermo, Italy
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26
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Apaydin M, Cetinoglu K. Carotid angle in young stroke. Clin Imaging 2020; 70:10-17. [PMID: 33120284 DOI: 10.1016/j.clinimag.2020.10.020] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2020] [Revised: 09/14/2020] [Accepted: 10/07/2020] [Indexed: 11/25/2022]
Abstract
PURPOSE To investigate whether the carotid bifurcation angle as assessed by computed tomographic angiography (CTA) is associated with anterior circulation ischemic stroke (ACIS) in young patients. MATERIAL AND METHODS Thirty patients (mean age 41.5 ± 6 years) with known acute ACIS (group 1) were compared to 30 control patients (mean age/ 41.2 ± 6 years) (group 2) with similar demographic variables in this retrospective study. Geometrical characteristics of bilateral carotid bifurcation were obtained by CTA. The ICA bifurcation (ICAB) angle, the carotid central bifurcation (CCB), and the carotid bifurcation wall (CBW) angle among the ICA, CCA, and ECA were measured. Carotid artery angle measurements were compared between group 1 and group 2. The comparison of pathological (ACIS) and non-pathological (non-ACIS) carotid sides in group 1 was performed as well. RESULTS All the measured angles (AMA) of group 1 were higher than group 2 (p˂0.05). In patients with left-sided ACIS, AMA on the left side were higher than the right side (p˂0.05), this was more prominent in males (p˂0.05). All angles measured were found to be higher in ipsilateral ACIS (p˂0.05). The left CCB angle values had a significant effect on ischemic stroke (p˂0.05). Male patients had more left-sided ACIS (p˂0.05). Plaque development in ICA was found statistically significant in group 1 compared to group 2 (p˂0.05). CONCLUSION Carotid artery geometry may play an important role in the development of ischemic events in young patients, especially in men and, also in patients with left-sided stroke. The left CCB angle had a significant effect on ACIS.
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Affiliation(s)
- Melda Apaydin
- KCU Izmir Ataturk Training and Research Hospital, Turkey.
| | - Kenan Cetinoglu
- Batman Training and Research Hospital, Department of Radiology, 72070, Batman, Turkey.
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27
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Gulmez N, Sah H. The relationships between the myocardial bridge and ramus interventricularis paraconalis characteristics in lamb and sheep. Anat Histol Embryol 2020; 50:260-265. [PMID: 33009861 DOI: 10.1111/ahe.12623] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2019] [Revised: 08/12/2020] [Accepted: 09/11/2020] [Indexed: 11/30/2022]
Abstract
The myocardial bridge (MB) is an anomaly that the myocardial fibres cover on a segment of the subepicardial coronary arteries or their branches in domestic animals and humans. The aim of the present study was to determine the relationships between the characteristics of the MB and ramus interventricularis paraconalis at three levels in lambs and adult sheep. Thirty-three hearts (16 lambs and 17 sheep) were used to determine the MB (length, angle and thickness) and vessel (vessel diameter and thicknesses of tunica intima et media of ramus interventricularis paraconalis) characteristics. Independent-samples t test was applied to compare variables between lambs and sheep. Spearman's correlation analysis was conducted to evaluate the relationships between bridge and vessel characteristics at three bridge levels. Length, angle and thickness of myocardial bridges were not significantly different between the lambs and sheep (p > .05). The mean length, angle and thickness were 24.9 ± 16.1 mm, 113.7 ± 11.2° and 1,098 ± 555 µm in 33 hearts, respectively. In lambs, the mean vessel diameters were 1,930 ± 742 µm (1,534-2,325 µm), 1,247 ± 665 µm (893-1,601 µm) and 865 ± 172 µm (774-957 µm) at the pre-bridge, bridge and post-bridge levels, respectively. In sheep, the mean vessel diameters in the same order were 1,861 ± 1,068 µm, 1,337 ± 308 µm and 1,287 ± 549 µm. The bridge prevalence was 100% in the samples examined. In conclusion, coronary arterial diseases related to myocardial bridge should not be expected in sheep for veterinary cardiology practice. It may also be concluded that the cross-breeds of the Awassi and Chios sheep may be useful in experimental studies related to myocardial bridge surgery.
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Affiliation(s)
- Nurhayat Gulmez
- Department of Histology and Embryology, Faculty of Veterinary Medicine, Near East University, Nicosia, Cyprus
| | - Huseyin Sah
- Department of Histology and Embryology, Faculty of Veterinary Medicine, Near East University, Nicosia, Cyprus
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28
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Cui Y, Lv X, Wang F, Kong J, Zhao H, Ye Z, Si C, Pan L, Liu P, Wen J. Geometry of the Carotid Artery and Its Association With Pathologic Changes in a Chinese Population. Front Physiol 2020; 10:1628. [PMID: 32038300 PMCID: PMC6985580 DOI: 10.3389/fphys.2019.01628] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2019] [Accepted: 12/24/2019] [Indexed: 01/21/2023] Open
Abstract
Objectives Carotid artery geometry influences blood flow disturbances and is thus an important risk factor for carotid atherosclerosis. Extracellular matrix (ECM) and yes-associated protein (YAP) expression may play essential roles in the pathophysiology of carotid artery stenosis, but the effect of blood flow disturbances of carotid bifurcation location on the ECM is unknown. We hypothesized that carotid artery anatomy and geometry are independently associated with the ECM and YAP expression. Methods In this cross-sectional study, 193 patients were divided into two groups: an asymptomatic group (n = 111) and a symptomatic group (n = 82), symptomatic patients presenting with ischemic attack, amaurosis fugax, or minor non-disabling stroke. For all subjects before surgery, carotid bifurcation angle and internal artery angle were measured with computed tomography angiography (CTA), and laminar shear stress was measured with ultrasonography. After surgery, pathology of all plaque specimens was analyzed using hematoxylin and eosin (HE) staining and Movat special staining. Immunohistochemistry was performed to detect expression of YAP in a subset of 30 specimens. Results Symptomatic patients had increased carotid bifurcation angle and laminar shear stress compared to asymptomatic patients (P < 0.05), although asymptomatic patients had increased internal carotid angle compared to symptomatic patients (P < 0.001). Relative higher bifurcation angles were correlated with increased carotid bifurcation, decreased internal angle, and decreased laminar shear stress. For each change in intervertebral space or one-third of vertebral body height, carotid bifurcation angle changed 4.76°, internal carotid angle changed 6.91°, and laminar shear stress changed 0.57 dynes/cm2. Pathology showed that average fibrous cap thickness and average narrowest fibrous cap thickness were greater in asymptomatic patients than symptomatic patients (P < 0.05). Expression of proteoglycan and YAP protein in symptomatic patients was higher than in asymptomatic patients (P < 0.001), while collagen expression was lower in symptomatic patients than asymptomatic patients (P < 0.05). Conclusion Geometry of the carotid artery and position relative to cervical spine might be associated with ECM and YAP protein expression, which could contribute to carotid artery stenosis.
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Affiliation(s)
- Yiyao Cui
- Department of Cardiovascular Surgery, China-Japan Friendship Hospital, Beijing, China.,Graduate School of Peking Union Medical College, Beijing, China
| | - Xiaoshuo Lv
- Department of Cardiovascular Surgery, China-Japan Friendship Hospital, Beijing, China
| | - Feng Wang
- Department of Cardiovascular Surgery, China-Japan Friendship Hospital, Beijing, China
| | - Jie Kong
- Department of Cardiovascular Surgery, China-Japan Friendship Hospital, Beijing, China
| | - Hao Zhao
- Department of Cardiovascular Surgery, China-Japan Friendship Hospital, Beijing, China
| | - Zhidong Ye
- Department of Cardiovascular Surgery, China-Japan Friendship Hospital, Beijing, China
| | - Chaozeng Si
- Department of Operations and Information Management, China-Japan Friendship Hospital, Beijing, China
| | - Lin Pan
- Institute of Clinical Medical Science, China-Japan Friendship Hospital, Beijing, China
| | - Peng Liu
- Department of Cardiovascular Surgery, China-Japan Friendship Hospital, Beijing, China.,Graduate School of Peking Union Medical College, Beijing, China
| | - Jianyan Wen
- Department of Cardiovascular Surgery, China-Japan Friendship Hospital, Beijing, China.,Graduate School of Peking Union Medical College, Beijing, China
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29
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Leng X, Lan L, Ip HL, Abrigo J, Scalzo F, Liu H, Feng X, Chan KL, Fan FSY, Ma SH, Fang H, Xu Y, Li J, Zhang B, Xu Y, Soo YOY, Mok VCT, Yu SCH, Liebeskind DS, Wong KS, Leung TW. Hemodynamics and stroke risk in intracranial atherosclerotic disease. Ann Neurol 2019; 85:752-764. [PMID: 30840312 DOI: 10.1002/ana.25456] [Citation(s) in RCA: 56] [Impact Index Per Article: 11.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2018] [Revised: 03/04/2019] [Accepted: 03/05/2019] [Indexed: 11/07/2022]
Abstract
OBJECTIVE To investigate whether hemodynamic features of symptomatic intracranial atherosclerotic stenosis (sICAS) might correlate with the risk of stroke relapse, using a computational fluid dynamics (CFD) model. METHODS In a cohort study, we recruited patients with acute ischemic stroke attributed to 50 to 99% ICAS confirmed by computed tomographic angiography (CTA). With CTA-based CFD models, translesional pressure ratio (PR = pressurepoststenotic /pressureprestenotic ) and translesional wall shear stress ratio (WSSR = WSSstenotic - throat /WSSprestenotic ) were obtained in each sICAS lesion. Translesional PR ≤ median was defined as low PR and WSSR ≥4th quartile as high WSSR. All patients received standard medical treatment. The primary outcome was recurrent ischemic stroke in the same territory (SIT) within 1 year. RESULTS Overall, 245 patients (median age = 61 years, 63.7% males) were analyzed. Median translesional PR was 0.94 (interquartile range [IQR] = 0.87-0.97); median translesional WSSR was 13.3 (IQR = 7.0-26.7). SIT occurred in 20 (8.2%) patients, mostly with multiple infarcts in the border zone and/or cortical regions. In multivariate Cox regression, low PR (adjusted hazard ratio [HR] = 3.16, p = 0.026) and high WSSR (adjusted HR = 3.05, p = 0.014) were independently associated with SIT. Patients with both low PR and high WSSR had significantly higher risk of SIT than those with normal PR and WSSR (risk = 17.5% vs 3.0%, adjusted HR = 7.52, p = 0.004). INTERPRETATION This work represents a step forward in utilizing computational flow simulation techniques in studying intracranial atherosclerotic disease. It reveals a hemodynamic pattern of sICAS that is more prone to stroke relapse, and supports hypoperfusion and artery-to-artery embolism as common mechanisms of ischemic stroke in such patients. Ann Neurol 2019;85:752-764.
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Affiliation(s)
- Xinyi Leng
- Department of Medicine and Therapeutics, Chinese University of Hong Kong, Hong Kong, China.,Shenzhen Research Institute, Chinese University of Hong Kong, Shenzhen, China
| | - Linfang Lan
- Department of Medicine and Therapeutics, Chinese University of Hong Kong, Hong Kong, China.,Department of Neurology, First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Hing Lung Ip
- Department of Medicine and Therapeutics, Chinese University of Hong Kong, Hong Kong, China
| | - Jill Abrigo
- Department of Imaging and Interventional Radiology, Chinese University of Hong Kong, Hong Kong, China
| | - Fabien Scalzo
- Neurovascular Imaging Research Core and UCLA Stroke Center, Department of Neurology, University of California, Los Angeles, Los Angeles, CA
| | - Haipeng Liu
- Department of Medicine and Therapeutics, Chinese University of Hong Kong, Hong Kong, China.,Department of Imaging and Interventional Radiology, Chinese University of Hong Kong, Hong Kong, China
| | - Xueyan Feng
- Department of Medicine and Therapeutics, Chinese University of Hong Kong, Hong Kong, China
| | - Ka Lung Chan
- Department of Medicine and Therapeutics, Chinese University of Hong Kong, Hong Kong, China
| | - Florence S Y Fan
- Department of Medicine and Therapeutics, Chinese University of Hong Kong, Hong Kong, China
| | - Sze Ho Ma
- Department of Medicine and Therapeutics, Chinese University of Hong Kong, Hong Kong, China
| | - Hui Fang
- Department of Neurology, First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Yuming Xu
- Department of Neurology, First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Jingwei Li
- Department of Neurology, Nanjing Drum Tower Hospital, Affiliated Hospital of Nanjing University Medical School, Nanjing, China
| | - Bing Zhang
- Department of Radiology, Nanjing Drum Tower Hospital, Affiliated Hospital of Nanjing University Medical School, Nanjing, China
| | - Yun Xu
- Department of Neurology, Nanjing Drum Tower Hospital, Affiliated Hospital of Nanjing University Medical School, Nanjing, China
| | - Yannie O Y Soo
- Department of Medicine and Therapeutics, Chinese University of Hong Kong, Hong Kong, China
| | - Vincent C T Mok
- Department of Medicine and Therapeutics, Chinese University of Hong Kong, Hong Kong, China
| | - Simon C H Yu
- Department of Imaging and Interventional Radiology, Chinese University of Hong Kong, Hong Kong, China
| | - David S Liebeskind
- Neurovascular Imaging Research Core and UCLA Stroke Center, Department of Neurology, University of California, Los Angeles, Los Angeles, CA
| | - Ka Sing Wong
- Department of Medicine and Therapeutics, Chinese University of Hong Kong, Hong Kong, China
| | - Thomas W Leung
- Department of Medicine and Therapeutics, Chinese University of Hong Kong, Hong Kong, China
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Ngo MT, Kwak HS, Ho CG, Koh EJ. Longitudinal study of carotid artery bifurcation geometry using magnetic resonance angiography. Vascular 2019:1708538118817666. [PMID: 32522135 DOI: 10.1177/1708538118817666] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/28/2024]
Abstract
BACKGROUND AND PURPOSE Carotid artery geometry has been suggested as a risk factor for atherosclerotic carotid disease. Although normal aging and disease development can both lead to geometric changes in the arteries, the exact nature of this phenomenon remains elusive. The aim of our study was to investigate carotid artery geometric changes in a longitudinal study. MATERIAL AND METHODS We conducted a retrospective study of 114 subjects who underwent carotid contrast-enhanced magnetic resonance angiography at our clinic at baseline (2005 to 2007) and after 10 years. The right (Rev#2-1) carotid arteries were segmented using semi-automated methods to obtain various measurements of carotid artery geometry. For each patient, these parameters were assessed at both time points, including bifurcation angle, internal carotid artery angle, vessel diameter, and circumference. RESULTS The median age for the total patient population (n = 114) at baseline was 59.06 ± 10.40 years. Mean time interval between baseline magnetic resonance angiography and magnetic resonance angiography after 10 years of these patients was 129.18 ± 7.77 months. For the whole group, there was a significant increase in the bifurcation angle (p < 0.05) over a 10-year period. A significant increase was also noted in the diameter and circumference of the common carotid artery (p < 0.05). However, the other vessel diameters and circumferences (bulb carotid, internal carotid) as well as the internal carotid angle did not significantly change (p ≥ 0.05). CONCLUSION The diameter and circumference of the common carotid artery and bifurcation angle significantly increased over a decade of life.
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Affiliation(s)
- Minh T Ngo
- Department of Neuroradiology, ■, Jeonju, Republic of Korea
| | - Hyo S Kwak
- Department of Neuroradiology, ■, Jeonju, Republic of Korea
| | - Chung G Ho
- Department of Neuroradiology, ■, Jeonju, Republic of Korea
| | - Eun J Koh
- ■, Chonbuk National University Hospital, Republic of Korea
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Ngo MT, Kwak HS, Ho Chung G, Koh EJ. Longitudinal study of carotid artery bifurcation geometry using magnetic resonance angiography. Vascular 2019; 27:312-317. [PMID: 30732535 DOI: 10.1177/1708538119828262] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVES Geometry of carotid artery has been known as a risk factor for atherosclerotic carotid disease. Though aging and disease progression can both attribute to geometric changes in the arteries, the exact nature of this phenomenon remains elusive. The aim of our study was to investigate carotid artery geometric changes in a longitudinal study. METHODS We conducted a retrospective study of 114 subjects who underwent carotid contrast-enhanced magnetic resonance angiography at our clinic at baseline (2005 to 2007) and after 10 years. The right carotid arteries were segmented using semi-automated methods to obtain various measurements of carotid artery geometry. For each patient, these parameters were assessed at both time points, including bifurcation angle, internal carotid artery angle, vessel diameter, and circumference. RESULTS The median age for the total patient population ( n = 114) at baseline was 59.06 ± 10.40 years. Mean time interval between baseline magnetic resonance angiography and magnetic resonance angiography after 10 years of these patients was 129.18 ± 7.77 months. For the whole group, there was a significant increase in the bifurcation angle ( p < 0.05) over a 10-year period. A significant increase was also noted in the diameter and circumference of the common carotid artery ( p < 0.05). However, the other vessel diameters and circumferences (bulb carotid, internal carotid) as well as the internal carotid angle did not significantly change ( p ≥ 0.05). CONCLUSIONS The diameter and circumference of the common carotid artery and bifurcation angle significantly increased over a decade of life.
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Affiliation(s)
- Minh Tri Ngo
- 1 Department of Radiology and Research Institute of Clinical Medicine of Chonbuk National University-Biomedical Research Institute of Chonbuk National University Hospital, Korea
| | - Hyo Sung Kwak
- 1 Department of Radiology and Research Institute of Clinical Medicine of Chonbuk National University-Biomedical Research Institute of Chonbuk National University Hospital, Korea
| | - Gyung Ho Chung
- 1 Department of Radiology and Research Institute of Clinical Medicine of Chonbuk National University-Biomedical Research Institute of Chonbuk National University Hospital, Korea
| | - Eun Jeong Koh
- 2 Department of Neurosurgery, Research Institute of Clinical Medicine of Chonbuk National University-Biomedical Research Institute of Chonbuk National University Hospital, Jeonju, Korea
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Zhang B, Ma Y, Ding F. Evaluation of spatial distribution and characterization of wall shear stress in carotid sinus based on two-dimensional color Doppler imaging. Biomed Eng Online 2018; 17:141. [PMID: 30340641 PMCID: PMC6195704 DOI: 10.1186/s12938-018-0589-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2018] [Accepted: 10/10/2018] [Indexed: 01/05/2023] Open
Abstract
Objective This study aims to use a wall shear stress (WSS) quantitative analysis software to analyze and evaluate the carotid sinus WSS spatial distribution and characteristics in intima-media thickness (IMT) normal and thickening group by using two-dimensional color doppler flow imaging (CDFI) so as to assist clinicians to predict the location and risk of plaque formation. Methods According to IMT, 50 subjects was selected as IMT thickening group and 50 subjects as IMT normal group from subjects who had a carotid ultrasound examination in Shanghai East hospital during October 2016 to October 2017. This study presents the spatial distribution of the carotid sinus WSS based on the WSS quantitative analysis software and compared the spatial distribution and characteristics of the carotid sinus WSS between IMT thickening group and IMT normal group through two- and three-dimensional WSS maps and a fused WSS image. Results The distributional regularity of WSS in both two group was: carotid sinus < common carotid artery (CCA) < internal carotid artery (ICA) and posterior-interior wall of the carotid sinus < the anterior-lateral wall of the carotid sinus. Furthermore, the WSS of CCA, ICA, the anterior-lateral proximal wall of the carotid sinus, the anterior-lateral distal wall of the carotid sinus, the posterior-interior proximal wall of the carotid sinus, and the posterior-interior distal wall of the carotid sinus in IMT thickening group was lower than the corresponding part of IMT normal group (P < 0.05). Conclusion In summary, this WSS quantitative analysis framework by two-dimensional CDFI can measure and reflect the carotid sinus WSS spatial distribution and characteristics more accurately and visually. As a convenient tool, it may be used for clinical prediction of the plaque formation in carotid sinus in the future.
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Affiliation(s)
- Bo Zhang
- Department of Ultrasound in Medicine, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, 200120, China.
| | - Yuqin Ma
- Department of Ultrasound in Medicine, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, 200120, China
| | - Fang Ding
- Department of Ultrasound in Medicine, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, 200120, China
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Carotid Bifurcation Geometry as Assessed by Ultrasound is Associated with Early Carotid Atherosclerosis. Ann Vasc Surg 2018; 51:207-216. [DOI: 10.1016/j.avsg.2017.11.069] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2017] [Revised: 11/23/2017] [Accepted: 11/25/2017] [Indexed: 12/21/2022]
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Zayed MA, Hsu FF, Patterson BW, Yan Y, Naim U, Darwesh M, De Silva G, Yang C, Semenkovich CF. Diabetes adversely affects phospholipid profiles in human carotid artery endarterectomy plaques. J Lipid Res 2018; 59:730-738. [PMID: 29478028 PMCID: PMC5880490 DOI: 10.1194/jlr.m081026] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2017] [Revised: 02/21/2018] [Indexed: 12/22/2022] Open
Abstract
Patients with diabetes are at higher risk of developing carotid artery stenosis and resultant stroke. Arachidonoyl phospholipids affect plaque inflammation and vulnerability, but whether diabetic patients have unique carotid artery phospholipidomic profiles is unknown. We performed a comprehensive paired analysis of phospholipids in extracranial carotid endarterectomy (CEA) plaques of matched diabetic and nondiabetic patients and analyzed mass spectrometry-derived profiles of three phospholipids, plasmenyl-phosphatidylethanolamine (pPE), phosphatidylserine (PS), and phosphatidylinositol (PI), in maximally (MAX) and minimally (MIN) diseased CEA segments. We also measured levels of arachidonic acid (AA), produced by pPE hydrolysis, and choline-ethanolamine phosphotransferase 1 (CEPT1), responsible for most pPE de novo biosynthesis. In paired analysis, MIN CEA segments had higher levels than MAX segments of pPE (P < 0.001), PS (P < 0.001), and PI (P < 0.03). MIN diabetic plaques contained higher levels than MAX diabetic plaques of arachidonoyl pPE38:4 and pPE38:5 and CEPT1 was upregulated in diabetic versus nondiabetic plaques. AA levels were relatively greater in MIN versus MAX segments of all CEA segments, and were higher in diabetic than nondiabetic plaques. Our findings suggest that arachidonoyl phospholipids are more likely to be abundant in the extracranial carotid artery plaque of diabetic rather than nondiabetic patients.
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Affiliation(s)
- Mohamed A Zayed
- Section of Vascular Surgery, Department of Surgery, Center for Human Nutrition Washington University School of Medicine, St. Louis, MO; Department of Surgery, Veterans Affairs St. Louis Health Care System, St. Louis, MO.
| | - Fong-Fu Hsu
- Division of Endocrinology, Metabolism, and Lipid Research, Department of Medicine, Washington University, St. Louis, MO
| | - Bruce W Patterson
- Department of Medicine, and Division of Public Health Sciences, Washington University School of Medicine, St. Louis, MO
| | - Yan Yan
- Department of Surgery, Washington University School of Medicine, St. Louis, MO
| | - Uzma Naim
- Section of Vascular Surgery, Department of Surgery, Center for Human Nutrition Washington University School of Medicine, St. Louis, MO
| | - Malik Darwesh
- Section of Vascular Surgery, Department of Surgery, Center for Human Nutrition Washington University School of Medicine, St. Louis, MO
| | - Gayan De Silva
- Section of Vascular Surgery, Department of Surgery, Center for Human Nutrition Washington University School of Medicine, St. Louis, MO
| | - Chao Yang
- Section of Vascular Surgery, Department of Surgery, Center for Human Nutrition Washington University School of Medicine, St. Louis, MO
| | - Clay F Semenkovich
- Division of Endocrinology, Metabolism, and Lipid Research, Department of Medicine, Washington University, St. Louis, MO
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