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Extent and characteristics of carotid plaques and brain parenchymal loss in asymptomatic patients with no indication for revascularization.

Abstract：

Background and aims:Extent of subclinical atherosclerosis has been associated with brain parenchymal loss in community-dwelling aged subjects. Identification of patient-related and plaque-related markers could identify subjects at higher risk of brain atrophy, independent of cerebrovascular accidents. Aim of the study was to investigate the relation between extent and characteristics of carotid plaques and brain atrophy in asymptomatic patients with no indication for revascularization. Methods and results:Sixty-four patients (aged 69 ± 8 years, 45% females) with carotid stenosis <70% based on Doppler flow velocity were enrolled in the study. Potential causes of cerebral damage other than atherosclerosis, including history of atrial fibrillation, heart failure, previous cardiac or neurosurgery and neurological disorders were excluded. All subjects underwent carotid computed tomography angiography, contrast enhanced ultrasound for assessment of plaque neovascularization and brain magnetic resonance imaging for measuring brain volumes. On multivariate regression analysis, age and fibrocalcific plaques were independently associated with lower total brain volumes (β = -3.13 and β = -30.7, both p < 0.05). Fibrocalcific plaques were also independently associated with lower gray matter (GM) volumes (β = -28.6, p = 0.003). On the other hand, age and extent of carotid atherosclerosis were independent predictors of lower white matter (WM) volumes. Conclusions:WM and GM have different susceptibility to processes involved in parenchymal loss. Contrary to common belief, our results show that presence of fibrocalcific plaques is associated with brain atrophy.

journal_name

Int J Cardiol Heart Vasc

journal_title

International journal of cardiology. Heart & vasculature

authors

Ammirati E,Moroni F,Magnoni M,Rocca MA,Messina R,Anzalone N,De Filippis C,Scotti I,Besana F,Spagnolo P,Rimoldi OE,Chiesa R,Falini A,Filippi M,Camici PG

doi

10.1016/j.ijcha.2020.100619

keywords:

["Brain atrophy","Brain magnetic resonance imaging","Brain volumes","CC-IMT, common carotid intima media thickness","CEUS, contrast enhanced ultrasound","CV, cardiovascular","Cardiovascular risk factors","Carotid atherosclerosis","GFR, glomerular filtration rate","GM, gray matter","TBV, total brain volume","TPA, total plaque area","Vulnerable plaque","WM, white matter"]

subject

Has Abstract

pub_date

2020-08-20 00:00:00

pages

100619

issn

2352-9067

pii

100619

journal_volume

pub_type

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Extent and characteristics of carotid plaques and brain parenchymal loss in asymptomatic patients with no indication for revascularization.