Extent and characteristics of carotid plaques and brain parenchymal loss in asymptomatic patients with no indication for revascularization. (October 2020)

• Record Type: Journal Article
• Authors: Ammirati, Enrico; Moroni, Francesco; Magnoni, Marco; Rocca, Maria A; Messina, Roberta; Anzalone, Nicoletta; De Filippis, Costantino; Scotti, Isabella; Besana, Francesca; Spagnolo, Pietro; Rimoldi, Ornella E; Chiesa, Roberto; Falini, Andrea; Filippi, Massimo; Camici, Paolo G
• Is Part Of: IJC heart & vasculature. Volume 30(2021)
• Publication Date: 2020-10
• Subjects: Carotid atherosclerosis -- Brain volumes -- Brain atrophy -- Cardiovascular risk factors -- Vulnerable plaque -- Brain magnetic resonance imaging; TBV total brain volume -- GM gray matter -- WM white matter -- CV cardiovascular -- CC-IMT common carotid intima media thickness -- CEUS contrast enhanced ultrasound -- TPA total plaque area -- GFR glomerular filtration rate; Cardiovascular system -- Diseases -- Periodicals; Cardiovascular system -- Pathophysiology -- Periodicals; 616.1005
• DOI: 10.1016/j.ijcha.2020.100619
• Languages: English
• ISSNs: 2352-9067

Abstract

Highlights: Age and fibrocalcific carotid plaques are associated with lower total brain volume. Fibrocalcific carotid plaques are associated with lower gray matter volumes. White matter volumes are associated with the extent of carotid atherosclerosis. Grey and white matter likely have differential susceptibility to processes. Abstract: Background and aims: Extent of subclinical atherosclerosis has been associated with brain parenchymal loss in community-dwelling aged subjects. Identification of patient-related and plaque-related markers could identify subjects at higher risk of brain atrophy, independent of cerebrovascular accidents. Aim of the study was to investigate the relation between extent and characteristics of carotid plaques and brain atrophy in asymptomatic patients with no indication for revascularization. Methods and results: Sixty-four patients (aged 69 ± 8 years, 45% females) with carotid stenosis <70% based on Doppler flow velocity were enrolled in the study. Potential causes of cerebral damage other than atherosclerosis, including history of atrial fibrillation, heart failure, previous cardiac or neurosurgery and neurological disorders were excluded. All subjects underwent carotid computed tomography angiography, contrast enhanced ultrasound for assessment of plaque neovascularization and brain magnetic resonance imaging for measuring brain volumes. On multivariate regression analysis, age and fibrocalcific plaques were independently associated with lower total brain volumes (β = −3.13 and β = −30.7, both p < 0.05). Fibrocalcific plaques were also independently associated with lower gray matter (GM) volumes (β = -28.6, p = 0.003). On the other hand, age and extent of carotid atherosclerosis were independent predictors of lower white matter (WM) volumes. Conclusions: WM and GM have different susceptibility to processes involved in parenchymal loss. Contrary to common belief, our results show that presence of fibrocalcific plaques is associated with brain atrophy.