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(Stroke. 2007;38:117.)
© 2007 American Heart Association, Inc.

Original Contributions

Multiaxial Mechanical Characteristics of Carotid Plaque

Analysis by Multiarray Echotracking System

Anna Paini, MD; Pierre Boutouyrie, MD, PhD; David Calvet, MD; Mustapha Zidi, PhD; Enrico Agabiti-Rosei, MD Stéphane Laurent, MD, PhD

From the Department of Pharmacology (A.P., P.B., S.L.), Université Paris-Descartes, Faculté de Médecine, INSERM 652, Hôpital Européen Georges Pompidou, Paris, France; the Department of Medical and Surgical Sciences (A.P., E.A.-R.), University of Brescia, Brescia, Italy; Service de Neurologie (D.C.), Hôpital Sainte-Anne, Université René Descartes, Faculté de Médecine Paris, Paris, France; and Institut Superieur des Biosciences de Paris (M.Z.), Université Paris 12 Val de Marne, Créteil cedex, France.

Correspondence to Pr. Stéphane Laurent, Department of Pharmacology and INSERM U652, Hôpital Européen Georges Pompidou, Assistance Publique-Hôpitaux de Paris, Université Paris 5, 20, rue Leblanc, 75015 Paris, France. E-mail stephane.laurent{at}egp.ap-hop-paris.fr

Background and Purpose— Carotid plaque rupture depends on the various types of mechanical stresses. Our objective was to determine the multiaxial mechanical characteristics of atherosclerotic plaque and adjacent segment of the common carotid artery.

Methods— A novel noninvasive echotracking system was used to measure intima-media thickness, diameter, pulsatile strain, and distensibility at 128 sites on a 4-cm long common carotid artery segment. The study included 62 patients with recent cerebrovascular ischemic event and either a plaque on the far wall of common carotid artery (n=25) or no plaque (n=37).

Results— The mechanical characteristics of the carotid segment devoid of plaque did not differ between the two groups. Among patients with plaque, 16 had a larger radial strain at the level of plaque than at the level of adjacent common carotid artery (pattern A: outward-bending strain). The eight patients who had an opposite pattern (inward-bending strain) were more often dyslipidemic (100% versus 56% P=0.03) and type 2 diabetic (63% versus 12%, P=0.04) than pattern A patients. Strain gradient significantly decreased in parallel with the presence of dyslipidemia and/or type 2 diabetes. Longitudinal gradients of distensibility and Young’s elastic modulus were consistent with strain gradients.

Conclusions— Type 2 diabetes and dyslipidemia were associated with a stiffer carotid at the level of the plaque than in the adjacent common carotid artery leading to an inward-bending stress. The analysis of plaque mechanics along the longitudinal axis may afford useful information, because repetitive bending strain of an atherosclerotic plaque may fatigue the wall material and result in plaque rupture.

Key Words: atherosclerotic plaque • carotid artery • mechanics • stiffness • ultrasound

This article has been cited by other articles:

				H. Beaussier, I. Masson, C. Collin, E. Bozec, B. Laloux, D. Calvet, M. Zidi, P. Boutouyrie, and S. Laurent Carotid Plaque, Arterial Stiffness Gradient, and Remodeling in Hypertension Hypertension, October 1, 2008; 52(4): 729 - 736. [Abstract] [Full Text] [PDF]

				S. Laurent and P. Boutouyrie Recent Advances in Arterial Stiffness and Wave Reflection in Human Hypertension Hypertension, June 1, 2007; 49(6): 1202 - 1206. [Full Text] [PDF]