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Journal of Cardiovascular Magnetic Resonance

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Open Access 01-12-2020 | Arterial Occlusive Disease | Research

Carotid geometry is an independent predictor of wall thickness – a 3D cardiovascular magnetic resonance study in patients with high cardiovascular risk

Authors: Christoph Strecker, Axel Joachim Krafft, Lilli Kaufhold, Markus Hüllebrandt, Susanne Weber, Ute Ludwig, Martin Wolkewitz, Anja Hennemuth, Jürgen Hennig, Andreas Harloff

Published in: Journal of Cardiovascular Magnetic Resonance | Issue 1/2020

Abstract

Background

The posterior wall of the proximal internal carotid artery (ICA) is the predilection site for the development of stenosis. To optimally prevent stroke, identification of new risk factors for plaque progression is of high interest. Therefore, we studied the impact of carotid geometry and wall shear stress on cardiovascular magnetic resonance (CMR)-depicted wall thickness in the ICA of patients with high cardiovascular disease risk.

Methods

One hundred twenty-one consecutive patients ≥50 years with hypertension, ≥1 additional cardiovascular risk factor and ICA plaque ≥1.5 mm thickness and < 50% stenosis were prospectively included. High-resolution 3D-multi-contrast (time of flight, T1, T2, proton density) and 4D flow CMR were performed for the assessment of morphological (bifurcation angle, ICA/common carotid artery (CCA) diameter ratio, tortuosity, and wall thickness) and hemodynamic parameters (absolute/systolic wall shear stress (WSS), oscillatory shear index (OSI)) in 242 carotid bifurcations.

Results

We found lower absolute/systolic WSS, higher OSI and increased wall thickness in the posterior compared to the anterior wall of the ICA bulb (p < 0.001), whereas this correlation disappeared in ≥10% stenosis. Higher carotid tortuosity (regression coefficient = 0.764; p < 0.001) and lower ICA/CCA diameter ratio (regression coefficient = − 0.302; p < 0.001) were independent predictors of increased wall thickness even after adjustment for cardiovascular risk factors. This association was not found for bifurcation angle, WSS or OSI in multivariate regression analysis.

Conclusions

High carotid tortuosity and low ICA diameter were independent predictors for wall thickness of the ICA bulb in this cross-sectional study, whereas this association was not present for WSS or OSI. Thus, consideration of geometric parameters of the carotid bifurcation could be helpful to identify patients at increased risk of carotid plaque generation. However, this association and the potential benefit of WSS measurement need to be further explored in a longitudinal study.

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Title: Carotid geometry is an independent predictor of wall thickness – a 3D cardiovascular magnetic resonance study in patients with high cardiovascular risk
Authors: Christoph Strecker
Axel Joachim Krafft
Lilli Kaufhold
Markus Hüllebrandt
Susanne Weber
Ute Ludwig
Martin Wolkewitz
Anja Hennemuth
Jürgen Hennig
Andreas Harloff
Publication date: 01-12-2020
Publisher: BioMed Central
Keyword: Arterial Occlusive Disease
Published in: Journal of Cardiovascular Magnetic Resonance / Issue 1/2020
Electronic ISSN: 1532-429X
DOI: https://doi.org/10.1186/s12968-020-00657-5

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Springer Medicine

Carotid geometry is an independent predictor of wall thickness – a 3D cardiovascular magnetic resonance study in patients with high cardiovascular risk

Abstract

Background

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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