Author + information
- Bashar Ababneh,
- Vijay Nambi,
- Xukui Wang,
- Ching–Hsuan Tung,
- Richard Han,
- Alan Lumsden,
- Michael Reardon,
- Christie Ballantyne,
- Joel Morrisett and
- Gerd Brunner
Calcification in atherosclerotic plaque has been viewed as a marker of plaque stability, but whether calcification accumulates in specific anatomic sites in the carotid artery is unknown. In this study, we determined the burden and distribution of calcified lesions in carotid endarterectomy (CEA) tissues.
A total of 22 CEA tissues were imaged with high resolution micro–computed tomography (isotropic voxel resolution= 0.17mm). Total plaque burden and total calcium score using the Agatston method were quantified at 2mm increments. The Agatston score (AS) was also normalized by CEA tissue size. Plaque and calcium distribution were analyzed separately for 3 anatomical regions of the CEA tissues: 1) common segment (CS), 2) bulb segment, and 3) internal/external segments (IES).
The average total CEA tissue length was 42.3±7.3mm with total plaque burden of 134.5 (interquartile range [IQR]: 77.9–185.8) mm3and total AS of 38.6 (IQR: 10.8–97.8). Of the 22 tissues 15 had no calcium in the CS compared to 3 in the bulb and 2 in the IES. Calcified plaque normalized for tissue size was most prevalent in the bulb segment. (AS= 2.92; IQR: 0.6–15.5), the IES (AS=2.85; IQR: 0.3–5.7) and was least abundant in the CS (AS=0.0; IQR: 0–0.2) of the CEA tissues.
Calcified plaque is non–uniformly distributed in CEA tissues with most in the bulb and IES regions, but whether this variation in rate of calcification is related to hemodynamic or if it simply a function of burden requires further study.
|CEA Segment||Total Agatston score (AS)||Normalized Agatston score (AS)||Total plaque burden [mm3]|
|Common segment (CS)||0 (0–0.64)||0 (0–0.16)||21.02 (13.82–26.95)|
|Bulb segment||12.47 (2.97–62.94)||2.92 (0.60–15.52)||37.89 (22.20–48.67)|
|Internal+external segments (IES)||16.75 (1.80–47.43)||2.85 (0.3–5.73)||54.05 (34.78–76.45)|
|Total||38.58 (10.83–97.82)||2.36 (0.74–6.64)||134.47 (77.93–185.78)|
|P-values for comparison of CEA segments|
|CS vs. BS||CS vs. IES||BS vs. IES|
|Total plaque burden||0.003||0.0002||0.001|
All values are given as medians with interquartile range (IQR). The 3 segments of CEA tissues are indicated by: CS= common segment of CEA tissue; BS=bulb segment of CEA; IES=internal and external segments of CEA. Total Agatston score (AS)= sum of slice-based AS; Normalized Agatston score (AS)= mean of slice-based AS. Normalized quantities account for differences in CEA sizes. P-value calculation was performed with the Friedman and Wilcoxon signed-rank tests (Bonferroni-adjusted for multiple comparisons).
Poster Sessions, Expo North
Sunday, March 10, 2013, 9:45 a.m.–10:30 a.m.
Session Title: Markers of Cardiovascular Risk and Impact
Abstract Category: 35. Vascular Medicine: Non Coronary Arterial Disease
Presentation Number: 1210–163
- 2013 American College of Cardiology Foundation