title: Natural History of Carotid Atherosclerosis in Relation to the Hemodynamic Environment.
abstract: Carotid atherosclerosis may lead to devastating clinical outcomes such as stroke. Data on the value of local factors in predicting progression in carotid atherosclerosis are limited. Our aim was to investigate the association of local endothelial shear stress (ESS) and low-density lipoprotein (LDL) accumulation with the natural history of atherosclerotic disease using a series of 3 time points of human magnetic resonance data. Three-dimensional lumen/wall reconstruction was performed in 12 carotids, and blood flow and LDL mass transport modeling were performed. Our results showed that an increase in plaque thickness and a decrease in lumen size were associated with low ESS and high LDL accumulation in the arterial wall. Low ESS (odds ratio [OR]: 2.99; 95% confidence interval [CI]: 2.31-3.88; P < .001 vs higher ESS) and high LDL concentration (OR: 3.26; 95% CI: 2.44-4.36; P < .001 vs higher LDL concentration) were significantly associated with substantial local plaque growth. Low ESS and high LDL accumulation both presented a diagnostic accuracy of 67% for predicting plaque growth regions. Modeling of blood flow and LDL mass transport show promise in predicting progression of carotid atherosclerosis.
authors.affiliation: 1 Unit of Medical Technology and Intelligent Information Systems, Department of Materials Science, University of Ioannina, Ioannina, Greece.
authors.forename: Antonis I
authors.initials: AI
authors.lastname: Sakellarios
authors.affiliation: 1 Unit of Medical Technology and Intelligent Information Systems, Department of Materials Science, University of Ioannina, Ioannina, Greece.
authors.forename: Paschalis
authors.initials: P
authors.lastname: Bizopoulos
authors.affiliation: 2 Michailideion Cardiac Center, Medical School, University of Ioannina, Ioannina, Greece.|3 Second Department of Cardiology, Medical School, University of Ioannina, Ioannina, Greece.|4 Institute for Medical Science and Engineering, Massachusetts Institute of Technology, Cambridge, MA, USA.
authors.forename: Michail I
authors.identifier: http://orcid.org/0000-0002-5646-0378
authors.initials: MI
authors.lastname: Papafaklis
authors.affiliation: 1 Unit of Medical Technology and Intelligent Information Systems, Department of Materials Science, University of Ioannina, Ioannina, Greece.|4 Institute for Medical Science and Engineering, Massachusetts Institute of Technology, Cambridge, MA, USA.|5 Cardiovascular Division, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
authors.forename: Lambros
authors.initials: L
authors.lastname: Athanasiou
authors.affiliation: 1 Unit of Medical Technology and Intelligent Information Systems, Department of Materials Science, University of Ioannina, Ioannina, Greece.|6 Department of Biomedical Research Institute, Institute of Molecular Biology and Biotechnology, FORTH, University Campus of Ioannina, Ioannina, Greece.
authors.forename: Themis
authors.initials: T
authors.lastname: Exarchos
authors.affiliation: 7 Department of Cardiovascular Sciences, University College London, London, United Kingdom.
authors.forename: Christos V
authors.initials: CV
authors.lastname: Bourantas
authors.affiliation: 2 Michailideion Cardiac Center, Medical School, University of Ioannina, Ioannina, Greece.|3 Second Department of Cardiology, Medical School, University of Ioannina, Ioannina, Greece.
authors.forename: Katerina K
authors.initials: KK
authors.lastname: Naka
authors.affiliation: 8 Department of Radiology, University of Cambridge, Cambridge, United Kingdom.
authors.forename: Andrew J
authors.initials: AJ
authors.lastname: Patterson
authors.affiliation: 8 Department of Radiology, University of Cambridge, Cambridge, United Kingdom.
authors.forename: Victoria E L
authors.initials: VE
authors.lastname: Young
authors.affiliation: 8 Department of Radiology, University of Cambridge, Cambridge, United Kingdom.
authors.forename: Jonathan H
authors.initials: JH
authors.lastname: Gillard
authors.affiliation: 9 Institute of Clinical Physiology, National Research Council, Pisa, Italy.
authors.forename: Oberdan
authors.initials: O
authors.lastname: Parodi
authors.affiliation: 2 Michailideion Cardiac Center, Medical School, University of Ioannina, Ioannina, Greece.|3 Second Department of Cardiology, Medical School, University of Ioannina, Ioannina, Greece.
authors.forename: Lampros K
authors.initials: LK
authors.lastname: Michalis
authors.affiliation: 1 Unit of Medical Technology and Intelligent Information Systems, Department of Materials Science, University of Ioannina, Ioannina, Greece.|6 Department of Biomedical Research Institute, Institute of Molecular Biology and Biotechnology, FORTH, University Campus of Ioannina, Ioannina, Greece.
authors.forename: Dimitrios I
authors.initials: DI
authors.lastname: Fotiadis
mesh_terms: D000368:Aged; D015415:Biomarkers / Q000097:blood; D001783:Blood Flow Velocity; D002340:Carotid Artery Diseases / Q000000981:diagnostic imaging* / Q000503:physiopathology; D018450:Disease Progression; D005260:Female; D006439:Hemodynamics / Q000502:physiology; D006801:Humans; D007090:Image Interpretation, Computer-Assisted; D021621:Imaging, Three-Dimensional; D008077:Lipoproteins, LDL / Q000097:blood; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D012307:Risk Factors
chemical_list: D015415:Biomarkers; D008077:Lipoproteins, LDL
keywords: carotid arteries; low-density lipoprotein transport; plaque growth; prediction of atherosclerosis