Association Between Carotid Artery Perivascular Fat Density and Intraplaque Hemorrhage
Shuai Zhang1, Hui Gu2, Xinxin Yu2
1School of Medicine, Shandong First Medical University, Jinan, China.
Insights
Higher perivascular fat density (PFD) is linked to intraplaque hemorrhage (IPH) in carotid arteries. This finding may help identify IPH and stratify atherosclerosis risk.
Area of Science:
- Cardiovascular Imaging
- Atherosclerosis Research
- Vascular Biology
Background:
- Perivascular adipose tissue influences atherosclerosis.
- The impact of perivascular fat on carotid plaque composition, specifically intraplaque hemorrhage (IPH), is not well understood.
Purpose of the Study:
- To investigate the association between carotid artery inflammation, indicated by perivascular fat density (PFD), and the presence of intraplaque hemorrhage (IPH).
Main Methods:
- A retrospective study involving 72 participants who underwent computed tomography angiography (CTA) and magnetic resonance imaging (MRI).
- Carotid inflammation assessed via PFD using CTA.
- IPH, carotid stenosis, plaque thickness, calcification, and ulceration evaluated using MRI and CTA.
- Generalized estimating equations used to analyze the association between PFD and IPH.
Main Results:
- Intraplaque hemorrhage (IPH) was present in 46.2% of 156 evaluated carotid plaques.
- Plaques with IPH exhibited significantly higher perivascular fat density (PFD) compared to those without (p < 0.001).
- PFD remained strongly associated with IPH after adjusting for age, calcification, stenosis, plaque thickness, and ulceration (OR, 1.96; p < 0.001).
Conclusions:
- Elevated PFD is significantly associated with the presence of IPH in carotid atherosclerotic plaques.
- PFD may serve as a novel imaging biomarker for identifying carotid IPH.
- Findings suggest PFD could aid in the risk stratification of patients with carotid atherosclerosis.
Abstract:
Objectives: Perivascular adipose tissue plays a key role in atherosclerosis, but its effects on the composition of carotid atherosclerotic plaques are unknown. This study aimed to investigate the association between inflammatory carotid artery and intraplaque hemorrhage (IPH) in the carotid artery. Methods: This is a single-center retrospective study. Carotid inflammation was assessed by perivascular fat density (PFD) in 72 participants (mean age, 65.1 years; 56 men) who underwent both computed tomography angiography (CTA) and magnetic resonance imaging (MRI) within 2 weeks. The presence of IPH was assessed with MRI. Carotid stenosis, maximum plaque thickness, calcification, and ulceration were evaluated through CTA. The association between PFD and the occurrence of IPH was studied using generalized estimating equations analysis. Results: Of 156 plaques, 72 plaques (46.2%) had IPH. Plaques with IPH showed higher PFD than those without [-41.4 ± 3.9 vs. -55.8 ± 6.5 Hounsfield unit (HU); p < 0.001]. After age, calcification, degree of stenosis, maximum plaque thickness, and ulceration were adjusted for, PFD (OR, 1.96; 95% CI, 1.41-2.73; p < 0.001) was found to be strongly associated with the presence of IPH. Conclusions: A higher PFD is associated with the presence of IPH in the carotid artery. These findings may provide a novel marker to identify carotid IPH and risk stratification.
