Late-phase contrast-enhanced ultrasound reflects biological features of instability in human carotid atherosclerosis.

Abstract:

BACKGROUND AND PURPOSE:Development of translational functional imaging modalities for atherosclerosis risk stratification is sought for stroke prediction. Our group has developed late-phase contrast-enhanced ultrasound (LP-CEUS) to quantify microbubble contrast retention within carotid atherosclerosis and shown it to separate asymptomatic plaques from those responsible for recent cerebrovascular events. We hypothesized that microbubbles are retained in areas of plaque inflammation, aiming to examine whether LP-CEUS signal reflects plaque biology. METHODS:Subjects awaiting carotid endarterectomy (n=31) underwent axial LP-CEUS and diseased intimal segments were symmetrically divided in the long axis. Half-specimens underwent quantitative immunohistochemical analysis for CD68 (macrophages) and CD31 (angiogenesis). Half-specimens were processed for atheroma cell culture and supernatant collected at 24 hours for multianalyte profiling for 34 analytes. RESULTS:Percentage area immunopositivity was significantly higher in subjects in which normalized plaque late-phase intensity was ≥0 versus <0 (CD68 mean 11.8 versus 6.68, P=0.004; CD31 mean 9.45 versus 4.82, P=0.025). Interleukin-6, matrix metalloproteinase-1, and matrix metalloproteinase-3 were significantly higher by multianalyte profiling when LP-CEUS was ≥0. CONCLUSIONS:LP-CEUS reflects biological features of inflammation and angiogenesis, key features predisposing to plaque rupture. Further investigation of LP-CEUS as a tissue-specific marker of inflammation for risk stratification of carotid atherosclerosis is warranted.

journal_name

Stroke

journal_title

Stroke

authors

Shalhoub J,Monaco C,Owen DR,Gauthier T,Thapar A,Leen EL,Davies AH

doi

10.1161/STROKEAHA.111.631200

subject

Has Abstract

pub_date

2011-12-01 00:00:00

pages

3634-6

issue

12

eissn

0039-2499

issn

1524-4628

pii

STROKEAHA.111.631200

journal_volume

42

pub_type

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