title: Characteristics of carotid atherosclerotic plaques of chronic lipid apheresis patients as assessed by in vivo high-resolution CMR--a comparative analysis.
abstract: BACKGROUND
  Components of carotid atherosclerotic plaques can reliably be identified and quantified using high resolution in vivo 3-Tesla CMR. It is suspected that lipid apheresis therapy in addition to lowering serum lipid levels also has an influence on development and progression of atherosclerotic plaques. The purpose of this study was to evaluate the influence of chronic lipid apheresis (LA) on the composition of atherosclerotic carotid plaques.
  
  
  METHODS
  32 arteries of 16 patients during chronic LA-therapy with carotid plaques and stenosis of 1-80% were matched according to degree of stenosis with 32 patients, who had recently suffered an ischemic stroke. Of these patients only the asymptomatic carotid artery was analyzed. All patients underwent black-blood 3 T CMR of the carotids using parallel imaging and dedicated surface coils. Cardiovascular risk factors were recorded. Morphology and composition of carotid plaques were evaluated. For statistical evaluation Fisher's Exact and unpaired t-test were used. A p-value <0.05 was considered statistically significant.
  
  
  RESULTS
  Patients in the LA-group were younger (63.5 vs. 73.9. years, p<0.05), had a higher prevalence of hypercholesterolemia and of established coronary heart disease in patients and in first-degree relatives (p<0.05, respectively). LA-patients had smaller maximum wall areas (49.7 vs. 59.6mm2, p<0.05), showed lower prevalence of lipid cores (28.1% vs. 56.3%, p<0.05) and the lipid content was smaller than in the control group (5.0 vs. 11.6%, p<0.05). Minimum lumen areas and maximum total vessel areas did not differ significantly between both groups.
  
  
  CONCLUSIONS
  Results of this study suggest that, despite a severer risk profile for cardiovascular complications in LA-patients, chronic LA is associated with significantly lower lipid content in carotid plaques compared to plaques of patients without LA with similar degrees of stenosis, which is characteristic of clinically stable plaques.
authors.affiliation: Institute for Clinical Radiology, Ludwig-Maximilians-University Hospital Munich, Pettenkoferstrasse 8a, Munich, Germany. tobias.saam@med.lmu.de
authors.forename: Jochen M
authors.initials: JM
authors.lastname: Grimm
authors.forename: Konstantin
authors.initials: K
authors.lastname: Nikolaou
authors.forename: Andreas
authors.initials: A
authors.lastname: Schindler
authors.forename: Reinhard
authors.initials: R
authors.lastname: Hettich
authors.forename: Franz
authors.initials: F
authors.lastname: Heigl
authors.forename: Clemens C
authors.initials: CC
authors.lastname: Cyran
authors.forename: Florian
authors.initials: F
authors.lastname: Schwarz
authors.forename: Reinhard
authors.initials: R
authors.lastname: Klingel
authors.forename: Anna
authors.initials: A
authors.lastname: Karpinska
authors.forename: Chun
authors.initials: C
authors.lastname: Yuan
authors.forename: Martin
authors.initials: M
authors.lastname: Dichgans
authors.forename: Maximilian F
authors.initials: MF
authors.lastname: Reiser
authors.forename: Tobias
authors.initials: T
authors.lastname: Saam
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001781:Blood Component Removal / Q000379:methods*; D002339:Carotid Arteries / Q000473:pathology*; D002340:Carotid Artery Diseases / Q000175:diagnosis* / Q000209:etiology / Q000473:pathology; D016893:Carotid Stenosis / Q000175:diagnosis / Q000473:pathology; D016022:Case-Control Studies; D003287:Contrast Media; D003430:Cross-Sectional Studies; D018450:Disease Progression; D050171:Dyslipidemias / Q000097:blood / Q000150:complications / Q000628:therapy*; D005260:Female; D006801:Humans; D008055:Lipids / Q000097:blood*; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009942:Organometallic Compounds; D058226:Plaque, Atherosclerotic; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012307:Risk Factors; D013997:Time Factors
chemical_list: D003287:Contrast Media; D008055:Lipids; D009942:Organometallic Compounds; C090600:gadobutrol