Local Effects of Atherosclerotic Plaque on Arterial Distensibility

Abstract

Abstract-Hypertension, diabetes, and hypercholesterolemia are characterized by a reduction in arterial distensibility and by accelerated atherosclerosis. Whether arterial stiffening is an inherent feature of these conditions or just the consequence of the atherosclerotic clinical or subclinical lesions is not known, however. Our aim was to obtain information on this issue by directly measuring, in humans, arterial distensibility both at the site of an atherosclerotic lesion and at the proximal normal site. In 10 patients (8 men; meanϮSEM age, 65.2Ϯ3.4 years) affected by monolateral hemodynamic significant internal carotid artery stenosis, we measured arterial distensibility (Wall Track System; PIE Medical) bilaterally, both at the internal carotid artery and at the common carotid artery level. In the common carotid artery, measurements were made 3 cm below the bifurcation. In the affected internal carotid artery, measurements were made at the plaque shoulder (wall thickness of 2 mm). Measurements were made in the contralateral internal carotid artery at a symmetrical level. Arterial wall thickness was measured in the same site of arterial distensibility. Arterial distensibility was less in the internal than in the common carotid artery, with a marked reduction at the plaque internal carotid artery level compared with the corresponding contralateral site (Ϫ45%, PϽ0.01). It was also less, however, in the common carotid artery branching into the atherosclerotic internal carotid artery than in the contralateral common carotid artery (Ϫ25%, PϽ0.05). Wall thickness was similar in the 2 common carotid arteries and obviously greater in the affected internal carotid artery than in the contralateral artery. Arterial distensibility was markedly less in the internal carotid artery where there was a plaque compared with the intact contralateral internal carotid artery; it was also less, however, in the common carotid artery of the affected side in comparison with the contralateral common carotid artery. This provides evidence that the effect of a plaque on arterial mechanical properties is not limited to the actual plaque site but rather extends to a considerable degree in a proximal direction. Key Words: arteries Ⅲ atherosclerosis Ⅲ plaque S everal studies have shown that conditions such hypertension, diabetes, and, to a lesser extent, hypercholesterolemia are characterized by a reduction in arterial distensibility. [1][2][3][4] This has clinical implications because studies in animals have reported a reduction in arterial distensibility to be accompanied by accelerated atherosclerosis, possibly because arterial stiffening increases the traumatic effect of intravascular pressure on the vessel wall. 5 In hypertension, diabetes, and hypercholesterolemia, atherosclerosis starts before the appearance of the clinical complications of these conditions. This poses the question of whether arterial stiffening is an inherent feature of these conditions or just the consequence of the atherosclerotic lesions. In the present study, our ...

Characterization of distensibility, plaque burden, and composition of the atherosclerotic carotid artery using magnetic resonance imaging

“…Our results seem to suggest that the effect of atherosclerosis on distensibility extends into regions relatively close to the diseased portion of the arterial wall, but not identified as diseased by current imaging criteria. This effect, although still evident, may be less pronounced further upstream, 7 where the mechanical properties may be different due to the different arterial segment.…”

“…2,3 Moreover, carotid artery stiffness has been shown to predict cardiovascular events, such as ischemic stroke. [3][4][5][6] Although arterial segments affected by atherosclerosis are characterized by marked stiffening, 7 little is known about the relationship between specific local atherosclerotic plaque features and wall stiffness. In particular, calcification has been shown to be associated with greater wall stiffness, 8 though, this relationship is not consistent in different arterial segments, 8,9 and it might refer to medial calcification only, since the association between intimal calcification and arterial stiffness is less definitive.…”

Impaired aortic function in patients with coeliac disease

“…Last, endothelial dysfunction can lead to AS and atherosclerotic progression. Therefore, AS plays an important role in CV events [22][23][24].…”

Atheromas Feel the Pressure

“…20,21 Furthermore, studies have shown that biomechanical stress caused by altered flow not only leads to atherosclerosis, but atherosclerosis itself alters local biomechanics (Figure 2). 19,[22][23][24] Recently, sensitive technological innovations have become available, such as intravascular ultrasound, which revealed that even early atherosclerotic lesions significantly affect vessel compliance. 19,22,23 One study has shown decreased arterial distensibility not only at the site of atherosclerosis, but also in proximal normal tissue, though not in distant normal artery.…”

“…19,22,23 One study has shown decreased arterial distensibility not only at the site of atherosclerosis, but also in proximal normal tissue, though not in distant normal artery. 24 On the cellular level, there are many factors in the development of atherosclerosis that can affect vessel stiffness. For example, as the disease progresses, VSMC proliferation and inflammatory infiltrates (macrophages and lymphocytes) alter local cellular density.…”