Association Between the Amount of Carotid Perivascular Adipose Tissue and Prior Ischemic Stroke: An MR Imaging Study
Shuwan Yu1, Ran Huo2, Xueyi Chen3
1Center for Biomedical Imaging Research, School of Biomedical Engineering, Tsinghua University, Beijing, China (S.Y., N.X., X.Z.).
Background:
This study aimed to explore the association between the amount of carotid artery perivascular adipose tissue (PVAT) quantified by magnetic resonance imaging and prior cerebral infarction.
Methods:
A total of 139 patients (mean age, 64.4±8.2 years; 112 men) with moderate-to-severe atherosclerotic stenosis referred to carotid endarterectomy were included and underwent multicontrast magnetic resonance vessel wall and brain imaging. The amount of carotid artery PVAT with vulnerable plaque components on magnetic resonance images of each patient was quantitatively analyzed, and the measurements included the average PVAT area, PVAT area index, and PVAT volume index. The amount measurements of PVAT at slices with vulnerable plaque between patients with and without prior cerebral infarction were compared. Logistic regression analyses were conducted to determine the association between the amount measurements of PVAT and prior cerebral infarction.
Results:
Patients with prior cerebral infarction showed significantly higher PVAT area, PVAT area index, and PVAT volume index compared with those without (all P<0.01). The carotid PVAT area (odds ratio [OR], 1.015 [95% CI, 1.003-1.028]; P=0.018), PVAT area index (OR, 2.051 [95% CI, 1.084-3.880]; P=0.027), and PVAT volume index (OR, 2.864 [95% CI, 1.343-6.108]; P=0.006) on the index side were significantly associated with prior cerebral infarction in univariate logistic regression. After adjusting for clinical confounding factors and plaque features, the associations between carotid PVAT area (OR, 1.028 [95% CI, 1.008-1.048]; P=0.006), PVAT area index (OR, 3.587 [95% CI, 1.451-8.870]; P=0.006), and PVAT volume index (OR, 6.053 [95% CI, 2.048-17.889]; P=0.001) and prior cerebral infarction remained statistically significant.
Conclusions:
The amount of PVAT in carotid artery with vulnerable plaques is independently associated with prior cerebral infarction and may, therefore, be related to the occurrence of ischemic stroke.
Insights
Increased carotid artery perivascular adipose tissue (PVAT) is linked to prior cerebral infarction. This finding suggests PVAT may play a role in ischemic stroke occurrence.
Area of Science:
- Cardiovascular Imaging
- Neurology
- Radiology
Background:
- Perivascular adipose tissue (PVAT) surrounding the carotid artery is increasingly recognized for its role in atherosclerosis.
- Understanding the relationship between carotid PVAT and cerebrovascular events like prior cerebral infarction is crucial for risk stratification.
Purpose of the Study:
- To investigate the association between the amount of carotid artery PVAT and the presence of prior cerebral infarction.
- To determine if quantitative measurements of PVAT can serve as a predictor for cerebral infarction.
Main Methods:
- 139 patients with moderate-to-severe carotid stenosis underwent MRI for vessel wall and brain imaging.
- Quantitative analysis of carotid artery PVAT (area, area index, volume index) was performed.
- Logistic regression models were used to assess the association between PVAT measurements and prior cerebral infarction.
Main Results:
- Patients with prior cerebral infarction had significantly higher amounts of carotid artery PVAT compared to those without.
- Carotid PVAT area, area index, and volume index were all significantly associated with prior cerebral infarction in univariate analysis.
- These associations remained statistically significant after adjusting for clinical factors and plaque characteristics.
Conclusions:
- The amount of carotid artery PVAT, particularly in the presence of vulnerable plaque components, is independently associated with prior cerebral infarction.
- Carotid PVAT may serve as a potential imaging biomarker for predicting the risk of ischemic stroke.
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