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Isolation and Analysis of Aortic Arch and Root Lesions in an Atherosclerotic Mouse Model
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Published on: February 14, 2025

Moderate atheroma of the aortic arch and the risk of stroke

Makiko Tanaka1, Masahiro Yasaka, Keiko Nagano

  • 1Cerebrovascular Division, Department of Medicine, National Cardiovascular Center, Osaka, Japan. mrai@medone.med.osaka-u.ac.jp

Cerebrovascular Diseases (Basel, Switzerland)
|November 12, 2005
PubMed
Abstract

Insights

Maximal plaque thickness (MPT) in the aortic arch greater than or equal to 3.5 mm is a significant predictor of future cardiovascular events, including stroke. This finding highlights MPT as a key risk factor for embolic stroke.

Area of Science:

  • Cardiovascular Medicine
  • Neurology
  • Vascular Biology

Background:

  • Aortic arch atheroma, particularly severe plaque (≥4-5 mm), is a known stroke risk factor.
  • Understanding predictive characteristics of aortic arch atheroma is crucial for cardiovascular event risk stratification.
  • The role of moderate atheroma (<4 mm) in cerebral emboli risk requires further investigation.

Purpose of the Study:

  • To identify the most predictive characteristics of aortic arch atheroma, focusing on maximal plaque thickness (MPT), for subsequent cardiovascular events.
  • To determine if moderate aortic arch atheroma (<4 mm) poses a risk for cerebral emboli.
  • To assess the relationship between MPT and plaque morphology with cardiovascular events in ischemic stroke patients.

Main Methods:

  • Transesophageal echocardiography was used to evaluate MPT and plaque morphologies in 236 ischemic stroke patients.
  • The study assessed the association between atheroma characteristics and the incidence of cardiovascular events (recurrent stroke, myocardial infarction).
  • Aortic atheroma thickness was compared between patients with known and undetermined stroke causes.

Main Results:

  • Cardiovascular events occurred in 47 patients over a mean 3.5-year follow-up.
  • Maximal plaque thickness (MPT) ≥3.5 mm was a significant predictor of cardiovascular events, whereas plaque morphologies were not.
  • A cutoff MPT of 3.5 mm identified patients at higher risk for cardiovascular events; MPT ≥3.5 mm was more prevalent in patients with undetermined stroke causes (68% vs. 39%).

Conclusions:

  • Maximal plaque thickness (MPT) of ≥3.5 mm in the aortic arch is the strongest predictor of subsequent cardiovascular events.
  • Aortic arch atheroma with MPT ≥3.5 mm is a potential cause of embolic stroke.
  • This finding suggests MPT is a critical marker for stroke risk assessment and management.

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