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Updated: Aug 7, 2026
A Methodological Approach to Non-invasive Assessments of Vascular Function and Morphology
Published on: February 7, 2015
Endothelial dysfunction and systemic inflammation in persons with echolucent carotid plaques
Ann-Trude With Notø1, Ellisiv Bøgeberg Mathiesen, Jean Amiral
1Center for Atherothrombotic Research in Tromsø (CART), Institute of Clinical Medicine, University of Tromsø, 9037 Tromsø, Norway. anntrude@fagmed.uit.no
Insights
Echolucent carotid plaques indicate high stroke risk. Plasma tissue-plasminogen activator antigen (t-PA ag) and von Willebrand factor (vWF) indicate endothelial dysfunction and systemic inflammation, correlating with plaque echogenicity and stroke risk.
Area of Science:
- Vascular Biology and Medicine
- Cardiovascular Disease Research
- Cerebrovascular Health
Background:
- Echolucent carotid plaques are linked to increased risk of ischemic cerebrovascular events.
- Systemic inflammation and endothelial dysfunction markers predict myocardial infarction and stroke.
- Understanding the relationship between plaque characteristics, inflammation, and endothelial markers is crucial for risk stratification.
Purpose of the Study:
- To investigate the associations between carotid plaque echogenicity, endothelial dysfunction markers (tissue-plasminogen activator antigen [t-PA ag] and von Willebrand factor [vWF]), and systemic inflammation.
- To determine if t-PA ag or vWF are better indicators of endothelial dysfunction in patients with carotid stenosis.
- To explore the relationship between these markers and systemic inflammation indicators like white blood cell count, fibrinogen, and high-sensitivity C-reactive protein (hs-CRP).
Main Methods:
- A cross-sectional study involving 133 individuals with carotid stenosis and 138 controls from the Tromsø Study.
- High-resolution B-mode and color Doppler ultrasonography to assess carotid arteries and plaque echogenicity.
- Measurement of plasma t-PA ag, vWF, plasminogen activator inhibitor-I (PAI-1), white blood cell count, fibrinogen, and hs-CRP.
Main Results:
- Individuals with carotid stenosis exhibited higher plasma t-PA ag and vWF concentrations compared to controls.
- A significant inverse correlation was found between t-PA ag levels and plaque echogenicity (p = 0.034).
- Higher systemic inflammation markers (WBC, fibrinogen, hs-CRP) were associated with increased plasma t-PA ag and vWF concentrations, particularly in individuals with echolucent plaques.
Conclusions:
- Plasma t-PA ag may be a more effective marker of endothelial dysfunction than vWF, as it differentiates plaque echogenicity.
- The predictive value of t-PA ag in cardiovascular disease appears independent of fibrinolysis inhibition.
- Echolucent carotid plaques are associated with a greater degree of systemic inflammation and endothelial dysfunction.
Abstract:
Echolucent carotid plaques are associated with high risk for future ischemic cerebrovascular events independent of the degree of stenosis. Elevated levels of markers of systemic inflammation and endothelial dysfunction are predictors for future myocardial infarction and stroke. The present study was undertaken to investigate the relations between plaque morphology, endothelial dysfunction assessed by tissue-plasminogen activator antigen (t-PA ag) and vonWillebrand factor (vWF), and systemic inflammation in persons with carotid stenosis. We conducted a crosssectional study including 133 persons with carotid stenosis and 138 controls without stenosis recruited from the populationbased Tromsø Study. High-resolution B-mode and colour Doppler/pulsed-wave Doppler ultrasonography of both carotid arteries was performed, and plaque morphology in terms of echogenicity was assessed. Persons with carotid stenosis had significantly higher plasma t-PA and vWF concentrations than controls. There was a significant inverse relationship between t-PA ag and plaque echogenicity (p = 0.034). The increased plasma t-PA ag in persons with carotid stenosis was not associated with increased plasminogen activator inhibitor-I (PAI-1). Persons with echolucent carotid plaques had higher degree of systemic inflammation, and plasma t-PA and vWF concentration increased significantly across quartiles of WBC, fibrinogen, and hs-CRP. Our findings may suggest that plasma t-PA may be superior to vWF as a marker for endothelial dysfunction due to its ability to discriminate between various plaque echogenicity, and that the predictive role of t-PA ag in cardiovascular disease is independent of inhibited fibrinolysis.
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