title: Progression of human carotid and femoral atherosclerosis: a prospective follow-up study by magnetic resonance vessel wall imaging.
abstract: OBJECTIVE
  The time course of atherosclerosis burden in distinct vascular territories remains poorly understood. We longitudinally evaluated the natural history of atherosclerotic progression in two different arterial territories using high spatial resolution magnetic resonance imaging (HR-MRI), a powerful, safe, and non-invasive tool.
  
  
  RESULTS
  We prospectively studied a cohort of 30 patients (mean age 68.3, n = 9 females) with high Framingham general cardiovascular disease 10-year risk score (29.5%) and standard medical therapy with mild-to-moderate atherosclerosis intra-individually at the level of both carotid and femoral arteries. A total of 178 HR-MRI studies of carotid and femoral arteries performed at baseline and at 1- and 2-year follow-up were evaluated in consensus reading by two experienced readers for lumen area (LA), total vessel area (TVA), vessel wall area (VWA = TVA - LA), and normalized wall area index (NWI = VWA/TVA). At the carotid level, LA decreased (-3.19%/year, P = 0.018), VWA increased (+3.83%/year, P = 0.019), and TVA remained unchanged. At the femoral level, LA remained unchanged, VWA and TVA increased (+5.23%/year and +3.11%/year, both P < 0.01), and NWI increased for both carotid and femoral arteries (+2.28%/year, P = 0.01, and +1.8%/year, P = 0.033).
  
  
  CONCLUSIONS
  The atherosclerotic burden increased significantly in both carotid and femoral arteries. However, carotid plaque progression was associated with negative remodelling, whereas the increase in femoral plaque burden was compensated by positive remodelling. This finding could be related to anatomic and flow differences and/or to the distinct degree of obstruction in the two arterial territories.
authors.affiliation: Division of Cardiology and Vascular Medicine, Department of Internal Medicine, Ospedale San Giovanni, Bellinzona, Switzerland.
authors.forename: Nicola
authors.initials: N
authors.lastname: Bianda
authors.forename: Marcello
authors.initials: M
authors.lastname: Di Valentino
authors.forename: Daniel
authors.initials: D
authors.lastname: Périat
authors.forename: Jeanne Marie
authors.initials: JM
authors.lastname: Segatto
authors.forename: Michel
authors.initials: M
authors.lastname: Oberson
authors.forename: Marco
authors.initials: M
authors.lastname: Moccetti
authors.forename: Isabella
authors.initials: I
authors.lastname: Sudano
authors.forename: Paolo
authors.initials: P
authors.lastname: Santini
authors.forename: Costanzo
authors.initials: C
authors.lastname: Limoni
authors.forename: Alberto
authors.initials: A
authors.lastname: Froio
authors.forename: Matthias
authors.initials: M
authors.lastname: Stuber
authors.forename: Roberto
authors.initials: R
authors.lastname: Corti
authors.forename: Augusto
authors.initials: A
authors.lastname: Gallino
authors.forename: Rolf
authors.initials: R
authors.lastname: Wyttenbach
mesh_terms: D000368:Aged; D050197:Atherosclerosis / Q000473:pathology*; D017536:Carotid Artery, Common / Q000473:pathology*; D002343:Carotid Artery, Internal / Q000473:pathology*; D016893:Carotid Stenosis / Q000473:pathology*; D018450:Disease Progression; D005260:Female; D005263:Femoral Artery / Q000473:pathology*; D005500:Follow-Up Studies; D006801:Humans; D018810:Magnetic Resonance Angiography / Q000379:methods; D008297:Male; D008875:Middle Aged; D015588:Observer Variation; D058226:Plaque, Atherosclerotic / Q000473:pathology; D011446:Prospective Studies