Characteristics of the carotid plaque in hypertensive patients with hyperhomocysteinemia using multimode ultrasound
Zhifei Ben1, Jue Wang1, Jingyong Zhan1
1Department of Ultrasound, Hwamei Hospital, University of Chinese Academy of Sciences, 41 Northwest Street, Ningbo, Zhejiang 315010, China.
Insights
High homocysteine levels in hypertensive patients are linked to vulnerable carotid plaques. Advanced ultrasound techniques reveal plaque characteristics, aiding stroke prevention strategies.
Area of Science:
- Cardiovascular Medicine
- Neurology
- Medical Imaging
Background:
- Ischemic stroke risk is associated with total homocysteine levels and carotid plaque stability.
- Hypertension and hyperhomocysteinemia are key risk factors for cerebrovascular events.
Purpose of the Study:
- To investigate carotid plaque characteristics in hypertensive patients with hyperhomocysteinemia using advanced ultrasound.
- To compare plaque features between hypertensive patients with and without hyperhomocysteinemia.
Main Methods:
- 196 hypertensive patients were analyzed, comparing those with hyperhomocysteinemia to those with normal homocysteine levels.
- Conventional ultrasound, contrast-enhanced ultrasound, and virtual touch image quantification were employed.
- Clinical data, plaque thickness, stenosis, and shear wave velocity (SWV) were assessed.
Main Results:
- Significant differences were observed in plaque thickness, stenosis degree, contrast enhancement, and SWV parameters between the groups.
- Higher homocysteine levels correlated positively with plaque thickness, stenosis, and contrast enhancement.
- Higher homocysteine levels correlated negatively with SWVmax, SWVmin, and SWVmean, indicating plaque vulnerability.
Conclusions:
- Ultrasonography effectively reflects carotid plaque vulnerability in hypertensive patients with hyperhomocysteinemia.
- These findings provide valuable information for stroke prevention and management in this patient population.
Background:
Ischemic stroke is related to the level of total homocysteine and the stability of carotid atherosclerotic plaque. In this study, the characteristics of carotid plaque in hypertensive patients with hyperhomocysteinemia were preliminarily studied by conventional ultrasound, contrast-enhanced ultrasound and virtual touch image quantification.
Methods:
Hypertensive patients (n=196) hospitalised in the Department of Neurology and Cardiology of our hospital from April 2016 to February 2019 were studied to compare and analyse differences in general clinical data, conventional ultrasound, contrast-enhanced ultrasound and virtual touch image quantification between hypertension with hyperhomocysteinemia and hypertension with normal tHcy.
Results:
1. There was no statistical difference in other clinical data, except fasting blood sugar (P=0.021) and the history of cerebral infarction (P=0.0001). 2. There were significant differences in plaque thickness, stenosis degree, contrast-enhanced ultrasound level, The maximum shear wave velocity (SWVmax) , the minimum shear wave velocity (SWVmin) and the mean shear wave velocity (SWVmean) (P<0.05), except intima-media thickness between the two groups (t=0.160, P=0.873). 3. Blood tHcy level in hypertensive patients with hyperhomocysteinemia was positively correlated with carotid plaque thickness, stenosis degree and contrast-enhanced ultrasound level (r=0.349, 0.647, 0.421), but negatively correlated with SWVmax, SWVmin and SWVmean (r=-0.348, -0.409, -0.393).
Conclusions:
Ultrasonography can reflect the vulnerability of hypertensive patients with hyperhomocysteinemia, providing reliable and comprehensive information for the prevention and treatment of stroke in hypertensive patients with hyperhomocysteinemia.
Related Concept Videos
01:25Imaging Studies for Cardiovascular System VI: Calcium -Scoring CT
01:30Atherosclerosis I: Introduction
01:29Cardiomyopathy III: Hypertrophic Cardiomyopathy