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Carotid plaque neovascularization by contrast-enhanced carotid ultrasound imaging coincides with plaque inflammation by microwave radiometry

Session Poster Session 5

Speaker Konstantinos Toutouzas

Event : ESC Congress 2013

  • Topic : basic science
  • Sub-topic : Microcirculation, Angiogenesis, Arteriogenesis
  • Session type : Poster Session

Authors : M Drakopoulou (Athens,GR), K Toutouzas (Athens,GR), C Aggeli (Athens,GR), G Benetos (Athens,GR), CH Nikolaou (Athens,GR), I Felekos (Athens,GR), K Masoura (Athens,GR), E Tsiamis (Athens,GR), E Siores (Bolton,GB), CH S (Bolton,GB)

M. Drakopoulou1 , K. Toutouzas1 , C. Aggeli1 , G. Benetos1 , C.H. Nikolaou1 , I. Felekos1 , K. Masoura1 , E. Tsiamis1 , E. Siores2 , C.H. S2 , 1Hippokration Hospital, University of Athens, 1st Department of Cardiology - Athens - Greece , 2University of Bolton, Centre for Material Research and Innovation - Bolton - United Kingdom ,

European Heart Journal ( 2013 ) 34 ( Abstract Supplement ), 766-767

Purpose: Histological studies have recognized that both inflammation and neoangiogenesis coincide in carotid vulnerable plaques. However, whether plaque inflammation precedes the neovascular disease process has not been fully elucidated. Contrast-enhanced ultrasound (CEUS) has been introduced as a technique to assess the presence of plaque neovascularization. Microwave radiometry (MR) allows in vivo non-invasive measurement of temperature of tissues, reflecting inflammatory activation. We assessed in intermediate carotid lesions the coincidence of carotid plaque inflammation assessed by MR, with plaque neovascularization measured by CEUS.

Methods: Consecutive patients with coronary artery disease and carotid atherosclerosis underwent carotid ultrasound imaging, CEUS and MR. Plaque texture, plaque surface and plaque echogenicity were analysed. Contrast enhancement (CE) by CEUS was defined as the % percentage of signal intensity difference, prior and post contrast infusion. Thermal heterogeneity (ΔT) was assigned as maximal temperature along the carotid artery minus minimum.

Results: Eighty-six carotid arteries of 48 patients were included. Fatty plaques had higher CE% compared with mixed and calcified (21.44±2.70 vs 17.11±5.23 vs 8.55±2.42 p<0.01 for all comparisons). Heterogeneous plaques had higher CE% compared with homogenous (21.44±2.7 vs 14.66±6.02, p<0.01). Plaques with irregular surface had higher CE% compared with plaques with regular (18.29±5.09 vs 13.64±6.06 p<0.01). Fatty plaques had higher ΔT compared with mixed and calcified (1.13±0.27 vs 0.95±0.34 vs 0.53±0.26°C, p<0.01 for all comparisons). Heterogeneous plaques had higher ΔT compared with homogenous (1.13±0.27 vs 0.83±0.37°C p<0.01). Plaques with irregular surface had higher ΔT compared with plaques with regular (1.05±0.32 vs 0.75±0.32°C p<0.01). There was a good correlation between ΔT and CE (R=0.60, p<0.001). Increased CE% coincided with increased ΔT in the majority of plaques (85.8%).

Conclusions: Neovascularisation and inflammation coincide in carotid atheromatous plaques in mild lesions, as indicated by two noninvasive methods.

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