Structural Stability of Carotid Plaque and Symptomatology

描述（由申请人提供）：本研究探讨了动脉粥样硬化颈动脉斑块结构稳定性与非运动性脑血管病（包括脑萎缩和认知能力下降）发展之间关系中的“无症状”卒中问题。它解决了颈动脉栓塞在“无症状”中风及其认知后遗症中的作用问题。该研究使用人类颈动脉内膜切除术患者来研究三个特定目标。第一种使用超声将斑块弹性及其机械应变特征的发展与脉动和斑块的组织生理学相关，用于溃疡、出血和在这些机械应变特征点处稳定纤维帽的变薄。第二组检查超声检测斑块内弹性、应变特征及经颅多普勒TCD检测微栓子的存在。第三个着眼于超声应变缺陷，微栓子，认知能力下降和脑MRI证据的局灶性和全身性萎缩。了解结构性斑块异常，使颈动脉斑块机械不稳定和栓塞的风险，将证明一个病理生理机制，在个人谁可能遭受不仅是经典的发作性大中风，但功能进行性下降的贡献，微栓子脑“沉默”中风和认知能力下降。

DESCRIPTION (provided by applicant): This study examines the issue of "silent" strokes in the relationship between the structural stability of atherosclerotic carotid plaque and the development of nonmotor symptomatology, including brain atrophy and cognitive decline. It addresses the question of the role of carotid emboli in "silent" stroke and their cognitive sequelae. The study uses human carotid endarterectomy patients to study three specific aims. The first uses ultrasound to relate plaque elasticity and its development of mechanical strain features with pulsation and the histopathophysiology of the plaque for ulcer, hemorrhage and thinning of stabilizing fibrous cap at the point of these mechanical strain features. The second examines ultrasound detected elasticity strain features in the plaques and the presence of transcranial Doppler TCD detectable microemboli. The third looks at ultrasound strain deficits, microemboli, cognitive decline and brain MRI evidence of focal and generalized atrophy. Understanding the structural plaque abnormalities, which render a carotid plaque mechanically unstable and at risk of embolization will demonstrate a pathophysiologic mechanism in individuals who are likely to suffer not only classic episodic major strokes, but also functional progressive decline from the contribution of microemboli to cerebral "silent" stroke and cognitive decline.