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Wall motion in the stenotic carotid artery: association with greyscale plaque characteristics, the degree of stenosis and cerebrovascular symptoms.

Kanber B, Hartshorne TC, Horsfield MA, Naylor AR, Robinson TG, Ramnarine KV - Cardiovasc Ultrasound (2013)

Bottom Line: Systolic dilation of the atherosclerotic carotid artery depends on several factors including arterial compliance and the haemodynamic environment.The mean absolute diameter change from diastole to systole was 0.45 mm (s.d. 0.17), and the mean percentage diameter change was 6.9% (s.d. 3.1%).Our study confirmed the degree of stenosis, plaque greyscale median and our surface irregularity index were significant predictors of symptoms, but found no significant correlation between diameter changes of stenosed carotid arteries and the presence of ipsilateral hemispheric symptoms.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Medical Physics, University Hospitals of Leicester NHS Trust, Leicester, LE1 5WW UK. kumar.ramnarine@uhl-tr.nhs.uk.

ABSTRACT

Background: Systolic dilation of the atherosclerotic carotid artery depends on several factors including arterial compliance and the haemodynamic environment. The purpose of this study was to quantify wall motion in stenotic carotid arteries and investigate any associations with the ultrasound greyscale plaque characteristics, the degree of stenosis, and the presence of cerebrovascular symptoms.

Methods: Variations in the lumen diameters of 61 stenotic carotid arteries (stenosis range 10%-95%) from 47 patients were measured before the proximal shoulder of the atherosclerotic plaque using ultrasound image sequences over several cardiac cycles. Absolute and percentage diameter changes from diastole to systole were calculated and their relationship to the degree of stenosis, greyscale plaque characteristics, and the presence of ipsilateral hemispheric symptoms were studied.

Results: The mean absolute diameter change from diastole to systole was 0.45 mm (s.d. 0.17), and the mean percentage diameter change was 6.9% (s.d. 3.1%). Absolute and percentage diameter changes did not have a statistically significant relationship to the degree of stenosis, greyscale plaque characteristics, or the presence of ipsilateral hemispheric symptoms (p > 0.05). Parameters significantly correlated with the presence of symptoms were the degree of stenosis (p = 0.01), plaque greyscale median (p = 0.02) and the plaque surface irregularity index (p = 0.02).

Conclusions: Our study confirmed the degree of stenosis, plaque greyscale median and our surface irregularity index were significant predictors of symptoms, but found no significant correlation between diameter changes of stenosed carotid arteries and the presence of ipsilateral hemispheric symptoms.

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Related in: MedlinePlus

Box and whisker plots showing the distribution, versus the presence of ipsilateral hemispheric symptoms, of the absolute and percentage arterial diameter changes, degree of stenosis, normalized and un-normalized plaque GSM, and the surface irregularity index (SII).
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Figure 3: Box and whisker plots showing the distribution, versus the presence of ipsilateral hemispheric symptoms, of the absolute and percentage arterial diameter changes, degree of stenosis, normalized and un-normalized plaque GSM, and the surface irregularity index (SII).

Mentions: The mean percentage systolic dilation of the symptomatic arteries (6.6%) was lower than that of the asymptomatic arteries (7.2%), but this difference was not statistically significant (p = 0.16, Figure 3). ANCOVA, controlling for the effects of the diastolic diameters, also found the same difference to be not statistically significant (p = 0.14). Arteries with ipsilateral hemispheric symptoms also had lower absolute diameter changes on average (0.42 mm) than asymptomatic arteries (0.47 mm) but this difference was also not significant (p = 0.17, Figure 3). The degree of stenosis (p < 0.01), normalized plaque GSM (p = 0.021) and the plaque surface irregularity index (p = 0.016) differed significantly between the symptomatic and asymptomatic groups while the un-normalized plaque GSM (p = 0.14) did not.


Wall motion in the stenotic carotid artery: association with greyscale plaque characteristics, the degree of stenosis and cerebrovascular symptoms.

Kanber B, Hartshorne TC, Horsfield MA, Naylor AR, Robinson TG, Ramnarine KV - Cardiovasc Ultrasound (2013)

Box and whisker plots showing the distribution, versus the presence of ipsilateral hemispheric symptoms, of the absolute and percentage arterial diameter changes, degree of stenosis, normalized and un-normalized plaque GSM, and the surface irregularity index (SII).
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC3818684&req=5

Figure 3: Box and whisker plots showing the distribution, versus the presence of ipsilateral hemispheric symptoms, of the absolute and percentage arterial diameter changes, degree of stenosis, normalized and un-normalized plaque GSM, and the surface irregularity index (SII).
Mentions: The mean percentage systolic dilation of the symptomatic arteries (6.6%) was lower than that of the asymptomatic arteries (7.2%), but this difference was not statistically significant (p = 0.16, Figure 3). ANCOVA, controlling for the effects of the diastolic diameters, also found the same difference to be not statistically significant (p = 0.14). Arteries with ipsilateral hemispheric symptoms also had lower absolute diameter changes on average (0.42 mm) than asymptomatic arteries (0.47 mm) but this difference was also not significant (p = 0.17, Figure 3). The degree of stenosis (p < 0.01), normalized plaque GSM (p = 0.021) and the plaque surface irregularity index (p = 0.016) differed significantly between the symptomatic and asymptomatic groups while the un-normalized plaque GSM (p = 0.14) did not.

Bottom Line: Systolic dilation of the atherosclerotic carotid artery depends on several factors including arterial compliance and the haemodynamic environment.The mean absolute diameter change from diastole to systole was 0.45 mm (s.d. 0.17), and the mean percentage diameter change was 6.9% (s.d. 3.1%).Our study confirmed the degree of stenosis, plaque greyscale median and our surface irregularity index were significant predictors of symptoms, but found no significant correlation between diameter changes of stenosed carotid arteries and the presence of ipsilateral hemispheric symptoms.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Medical Physics, University Hospitals of Leicester NHS Trust, Leicester, LE1 5WW UK. kumar.ramnarine@uhl-tr.nhs.uk.

ABSTRACT

Background: Systolic dilation of the atherosclerotic carotid artery depends on several factors including arterial compliance and the haemodynamic environment. The purpose of this study was to quantify wall motion in stenotic carotid arteries and investigate any associations with the ultrasound greyscale plaque characteristics, the degree of stenosis, and the presence of cerebrovascular symptoms.

Methods: Variations in the lumen diameters of 61 stenotic carotid arteries (stenosis range 10%-95%) from 47 patients were measured before the proximal shoulder of the atherosclerotic plaque using ultrasound image sequences over several cardiac cycles. Absolute and percentage diameter changes from diastole to systole were calculated and their relationship to the degree of stenosis, greyscale plaque characteristics, and the presence of ipsilateral hemispheric symptoms were studied.

Results: The mean absolute diameter change from diastole to systole was 0.45 mm (s.d. 0.17), and the mean percentage diameter change was 6.9% (s.d. 3.1%). Absolute and percentage diameter changes did not have a statistically significant relationship to the degree of stenosis, greyscale plaque characteristics, or the presence of ipsilateral hemispheric symptoms (p > 0.05). Parameters significantly correlated with the presence of symptoms were the degree of stenosis (p = 0.01), plaque greyscale median (p = 0.02) and the plaque surface irregularity index (p = 0.02).

Conclusions: Our study confirmed the degree of stenosis, plaque greyscale median and our surface irregularity index were significant predictors of symptoms, but found no significant correlation between diameter changes of stenosed carotid arteries and the presence of ipsilateral hemispheric symptoms.

Show MeSH
Related in: MedlinePlus