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Bilateral symmetry of human carotid artery atherosclerosis
Gareth J Adams1, Darlene M Simoni, Cassius B Bordelon
1Structural and Computational Biology and Molecular Biophysics Program, Baylor College of Medicine, Houston, Tex 77030, USA.
Insights
Atherosclerosis in human carotid arteries shows significant similarity between the left and right sides for both plaque volume and calcification. This bilateral symmetry suggests that imaging one carotid artery can provide insights into the other, aiding in stroke and heart attack risk assessment.
Area of Science:
- Cardiovascular Imaging
- Vascular Biology
- Medical Diagnostics
Background:
- Atherosclerosis is a primary driver of stroke and myocardial infarction.
- Carotid arteries are key sites for monitoring atherosclerosis progression noninvasively.
- Understanding plaque symmetry is crucial for accurate risk assessment.
Purpose of the Study:
- To determine the similarity of atherosclerotic plaques in left and right carotid arteries.
- To evaluate the consistency of plaque characteristics between contralateral carotid arteries.
Main Methods:
- Utilized perfusion-fixed cadaveric carotid arteries from 50 donors (aged 48-98).
- Employed magnetic resonance imaging (MRI) for carotid artery wall volume measurement.
- Used electron-beam computed tomography (CT) for calcification scoring (Agatston and calcium volume).
Main Results:
- Moderate correlation in total wall volumes between left and right carotid arteries (r(c)=0.71).
- High correlation in calcification scores: Agatston (r(c)=0.95) and calcium volume (r(c)=0.94).
- Demonstrated substantial similarity in plaque volume and calcification between paired carotid arteries.
Conclusions:
- Atherosclerosis in human carotid arteries is largely a bilaterally symmetrical disease.
- Plaque volume and calcification are substantially similar in left and right carotid arteries.
- Diagnostic information from one carotid artery can infer characteristics of the contralateral artery, aiding clinical assessment.
Background And Purpose:
Atherosclerosis is a principal cause of stroke and myocardial infarction. The carotid arteries provide a site at which progression of atherosclerosis can be monitored reproducibly and noninvasively. This study was conducted to determine the similarity of atherosclerotic plaques in the left and right carotid arteries. This question was explored with the use of perfusion-fixed cadaveric carotid arteries and 2 noninvasive clinical imaging techniques, MRI and electron-beam CT.
Methods:
Fifty pairs of carotid arteries from cadaveric donors (aged 48 to 98 years) were imaged with MRI and electron-beam CT. Thirty-eight of the pairs met the criteria for rigorous analysis. Carotid artery wall volumes were measured from the MRI images, and calcification scores were computed from the electron-beam CT images.
Results:
Total wall volumes of the left (972.5+/-241.6 mm3) and right (1016.3+/-275.0 mm3) carotid arteries were moderately correlated (concordance correlation coefficient [r(c)]=0.71). Calcification scores were highly correlated, with r(c)=0.95 for the Agatston scores and r(c)=0.94 for the calcium volume scores.
Conclusions:
Total wall volume and plaque calcification in the left and right human carotid arteries are substantially similar. These results suggest that atherosclerosis of the human carotid arteries is generally a bilaterally symmetrical disease. This evidence of symmetry suggests that diagnostic information about atherosclerotic plaque in one carotid artery can be used to infer information about the composition and volume of atherosclerotic plaque in the contralateral artery.