title: Intraplaque stretch in carotid atherosclerotic plaque--an effective biomechanical predictor for subsequent cerebrovascular ischemic events.
abstract: BACKGROUND
  Stretch is a mechanical parameter, which has been proposed previously to affect the biological activities in different tissues. This study explored its utility in determining plaque vulnerability.
  
  
  METHODS
  One hundred and six patients with mild to moderate carotid stenosis were recruited in this study (53 symptomatic and 53 asymptomatic). High resolution, multi-sequence magnetic resonance (MR) imaging was performed to delineate various plaque components. Finite element method was used to predict high stretch concentration within the plaque.
  
  
  RESULTS
  During a two-year follow-up, 11 patients in symptomatic group and 3 in asymptomatic group experienced recurrent cerebrovascular events. Plaque stretch at systole and stretch variation during one cardiac cycle was greater in symptomatic group than those in the asymptomatic. Within the symptomatic group, a similar trend was observed in patients with recurrent events compared to those without.
  
  
  CONCLUSIONS
  Plaques with high stretch concentration and large stretch variation are associated with increased risk of future cerebrovascular events.
authors.affiliation: University Department of Radiology, University of Cambridge, Cambridge, United Kingdom. zt215@cam.ac.uk
authors.forename: Zhongzhao
authors.initials: Z
authors.lastname: Teng
authors.forename: Umar
authors.initials: U
authors.lastname: Sadat
authors.forename: Wenkai
authors.initials: W
authors.lastname: Wang
authors.forename: Nasim S
authors.initials: NS
authors.lastname: Bahaei
authors.forename: Shengyong
authors.initials: S
authors.lastname: Chen
authors.forename: Victoria E
authors.initials: VE
authors.lastname: Young
authors.forename: Martin J
authors.initials: MJ
authors.lastname: Graves
authors.forename: Jonathan H
authors.initials: JH
authors.lastname: Gillard
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D058070:Asymptomatic Diseases; D015415:Biomarkers; D002339:Carotid Arteries / Q000473:pathology*; D016893:Carotid Stenosis / Q000150:complications / Q000175:diagnosis* / Q000473:pathology; D005260:Female; D020342:Finite Element Analysis; D006801:Humans; D002546:Ischemic Attack, Transient / Q000175:diagnosis* / Q000209:etiology / Q000473:pathology; D018810:Magnetic Resonance Angiography; D008297:Male; D008875:Middle Aged; D058226:Plaque, Atherosclerotic / Q000150:complications / Q000175:diagnosis* / Q000473:pathology; D011237:Predictive Value of Tests; D011379:Prognosis; D018570:Risk Assessment; D012720:Severity of Illness Index
chemical_list: D015415:Biomarkers