Sustained acceleration in carotid atherosclerotic plaque progression with intraplaque hemorrhage: a long-term time course study.
Sustained acceleration in carotid atherosclerotic plaque progression with intraplaque hemorrhage: a long-term time course study.
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DOI：
10.1016/j.jcmg.2012.03.014
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发表时间：
2012-08
影响因子：
14
通讯作者：
Hatsukami, Thomas S.
中科院分区：
文献类型：
--
作者：
Sun, Jie;Underhill, Hunter R.;Hippe, Daniel S.;Xue, Yunjing;Yuan, Chun;Hatsukami, Thomas S.
本研究的目的是确定斑块内出血 (IPH) 对颈动脉斑块进展的即时和长期影响。先前的研究已将颈动脉中的 IPH 与更快的斑块进展联系起来。然而，时间进程和长期影响仍然未知。颈动脉磁共振成像 (MRI) 是一种非侵入性成像技术，已通过组织学验证，可准确体内检测 IPH 和测量斑块负荷。颈动脉狭窄 50-79% 的无症状受试者在基线时接受颈动脉 MRI 检查，然后每 18 个月连续接受一次颈动脉 MRI 检查，总共 54 个月。选择 54 个月时至少一根颈动脉存在 IPH 的受试者。随后，在两侧的所有时间点独立确定 IPH 的存在/不存在和壁体积。使用线性混合模型拟合分段进展曲线，以比较进展率，进展率定义为各时期之间壁体积的年化变化，其定义为与 IPH 发展的关系。在 54 个月时出现 IPH 的 14 名患者中，在研究期间发现 12 条动脉出现了 IPH。 IPH发生前、发生期间和发生后的进展率分别为-20.5±13.1、20.5±13.6和16.5±10.8 mm3/年。 IPH 发展期间的进展率往往高于之前的时期 (p=0.080)，但与之后的时期相当 (p=0.845)。 IPH 发生期间/之后的合并期间的进展率为 18.3±6.5 mm3/年，这表明存在显着进展（与斜率 0 相比，p=0.008）并且高于 IPH 发生之前的时期（p=0.018）。对于新的 IPH，没有发现同时发生的缺血事件。 IPH的发展对斑块的进展具有直接和长期的促进作用。 IPH 似乎改变了颈动脉粥样硬化的生物学和自然史。早期识别 IPH 患者对于优化治疗以最大程度地减少未来后遗症可能具有无价的价值。
The purpose of this study was to determine the immediate and long-term effects of intraplaque hemorrhage (IPH) on plaque progression in the carotid artery. Previous studies have associated IPH in the carotid artery with more rapid plaque progression. However, the time course and long-term effect remain unknown. Carotid magnetic resonance imaging (MRI) is a non-invasive imaging technique that has been validated with histology for the accurate in vivo detection of IPH and measurement of plaque burden. Asymptomatic subjects with 50–79% carotid stenosis underwent carotid MRI at baseline and then serially every 18 months for a total of 54 months. Subjects with IPH present in at least one carotid artery at 54 months were selected. Subsequently, presence/absence of IPH and wall volume were determined independently in all time points for both sides. A piecewise progression curve was fit using linear mixed model to compare progression rates defined as annualized changes in wall volume between periods defined by their relationship to IPH development. From 14 patients that showed IPH at 54 months, 12 arteries were found to have developed IPH during the study period. The progression rates were −20.5±13.1, 20.5±13.6 and 16.5±10.8 mm3/year before, during and after IPH development, respectively. The progression rate during IPH development tended to be higher than the period before (p=0.080), but comparable to the period after (p=0.845). The progression rate in the combined period during/after IPH development was 18.3±6.5 mm3/year, which indicated significant progression (p=0.008 compared to a slope of 0) and was higher than the period before IPH development (p=0.018). No coincident ischemic events were noted for new IPH. The development of IPH posed an immediate and long-term promoting effect on plaque progression. IPH appears to alter the biology and natural history of carotid atherosclerosis. Early identification of patients with IPH may prove invaluable in optimizing management to minimize future sequelae.
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影响因子：
4.8
作者：
Underhill, Hunter R.;Yuan, Chun;Hatsukami, Thomas S.
通讯作者：
Hatsukami, Thomas S.
影响因子：
39.2
作者：
Fraser, DGW;Moody, AR;Davidson, I
通讯作者：
Davidson, I
影响因子：
8.3
作者：
Takaya, N;Yuan, C;Hatsukami, TS
通讯作者：
Hatsukami, TS
影响因子：
19.7
作者：
Singh, Navneet;Moody, Alan R.;Maggisano, Robert
通讯作者：
Maggisano, Robert
DOI：
10.1161/atvbaha.109.192179
发表时间：
2009-10
期刊：
Arteriosclerosis, thrombosis, and vascular biology
影响因子：
--
作者：
Ota H;Yu W;Underhill HR;Oikawa M;Dong L;Zhao X;Polissar NL;Neradilek B;Gao T;Zhang Z;Yan Z;Guo M;Zhang Z;Hatsukami TS;Yuan C
通讯作者：
Yuan C