title: Quest for the Vulnerable Atheroma: Carotid Stenosis and Diametric Strain--A Feasibility Study.
abstract: The Bernoulli effect may result in eruption of a vulnerable carotid atheroma, causing a stroke. We measured electrocardiography (ECG)-registered QRS intra-stenotic blood velocity and atheroma strain dynamics in carotid artery walls using ultrasonic tissue Doppler methods, providing displacement and time resolutions of 0.1 μm and 3.7 ms. Of 22 arteries, 1 had a peak systolic velocity (PSV) >280 cm/s, 4 had PSVs between 165 and 280 cm/s and 17 had PSVs <165 cm/s. Eight arteries with PSVs <65 cm/s and 4 of 9 with PSVs between 65 and 165 cm/s had normal systolic diametric expansion (0% and 7%) and corresponding systolic wall thinning. The remaining 10 arteries had abnormal systolic strain dynamics, 2 with diametric reduction (>-0.05 mm), 2 with extreme wall expansion (>0.1 mm), 2 with extreme wall thinning (>-0.1 mm) and 4 with combinations. Decreases in systolic diameter and/or extreme systolic arterial wall thickening may indicate imminent atheroma rupture.
authors.affiliation: Department of Bioengineering, University of Washington, Seattle, Washington, USA.
authors.forename: Canxing
authors.initials: C
authors.lastname: Xu
authors.affiliation: Department of Bioengineering, University of Washington, Seattle, Washington, USA; Department of Radiology, Vascular Imaging Laboratory, University of Washington, Seattle, Washington, USA.
authors.forename: Chun
authors.initials: C
authors.lastname: Yuan
authors.affiliation: D. E. Strandness, Jr. Vascular Laboratory, University of Washington Medical Center, Seattle, Washington, USA.
authors.forename: Edward
authors.initials: E
authors.lastname: Stutzman
authors.affiliation: Department of Radiology, Vascular Imaging Laboratory, University of Washington, Seattle, Washington, USA.
authors.forename: Gador
authors.initials: G
authors.lastname: Canton
authors.affiliation: Retired.
authors.forename: Keith A
authors.initials: KA
authors.lastname: Comess
authors.affiliation: Department of Bioengineering, University of Washington, Seattle, Washington, USA; Department of Radiology, Vascular Imaging Laboratory, University of Washington, Seattle, Washington, USA; Department of Surgery, University of Washington, Seattle, Washington, USA. Electronic address: kwbeach@usa.net.
authors.forename: Kirk W
authors.initials: KW
authors.lastname: Beach
mesh_terms: D001783:Blood Flow Velocity; D055424:Cardiac-Gated Imaging Techniques / Q000379:methods; D016893:Carotid Stenosis / Q000000981:diagnostic imaging* / Q000503:physiopathology*; D055119:Elastic Modulus; D054459:Elasticity Imaging Techniques / Q000379:methods*; D005240:Feasibility Studies; D006801:Humans; D007089:Image Enhancement / Q000379:methods; D007090:Image Interpretation, Computer-Assisted / Q000379:methods; D055420:Perfusion Imaging / Q000379:methods*; D058226:Plaque, Atherosclerotic / Q000000981:diagnostic imaging* / Q000503:physiopathology*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D059289:Vascular Stiffness
keywords: Atheroma; Atherosclerosis; Carotid; Strain; Tissue Doppler; Vasa plaquorum; Vasa vasorum; Vulnerable plaque