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Contrast-enhanced ultrasound imaging of atherosclerotic carotid plaque neovascularization: a new surrogate marker of atherosclerosis?
Falak Shah
Department of Internal Medicine, Section of Cardiology, Rush University Medical Center, Chicago, IL, USA
Prakash Balan
Department of Internal Medicine, Section of Cardiology, Rush University Medical Center, Chicago, IL, USA
Matthew Weinberg
Department of Internal Medicine, Section of Cardiology, Rush University Medical Center, Chicago, IL, USA
Vijaya Reddy
Department of Internal Medicine, Section of Cardiology, Rush University Medical Center, Chicago, IL, USA
Rachel Neems
Department of Internal Medicine, Section of Cardiology, Rush University Medical Center, Chicago, IL, USA
Matthew Feinstein
Department of Internal Medicine, Section of Cardiology, Rush University Medical Center, Chicago, IL, USA
John Dainauskas
Department of Internal Medicine, Section of Cardiology, Rush University Medical Center, Chicago, IL, USA
Peter Meyer
Department of Internal Medicine, Section of Cardiology, Rush University Medical Center, Chicago, IL, USA
Marshall Goldin
Department of Internal Medicine, Section of Cardiology, Rush University Medical Center, Chicago, IL, USA
Steven B. Feinstein
Department of Internal Medicine, Section of Cardiology, Rush University Medical Center, Chicago, IL, USA, Steven_Feinstein{at}rush.edu
An atherosclerotic plaque requires a nutrient blood supply, which is predominantly derived from arterial vasa vasorum. A variety of factors (environmental and genetic) contribute to the initiation and growth of atherosclerosis within vessel walls. Chemotactic factors, such as tissue ischemic and hypoxic factors, stimulate the release of vascular endothelial growth factor (VEGF) proteins, resulting in vessel wall angiogenesis. These developments often precede the formation of the luminal plaque. In this report, we describe the use of contrast-enhanced carotid ultrasound (CECU) imaging for the detection and quantification of intra-plaque neovascularization. The efficacy of CECU was measured against the neovascular density observed within the tissue specimens obtained at the time of carotid endarterectomy surgery. The objective of this study was to provide a histologic correlation between CECU and carotid artery atherosclerotic plaque neovascularization. Fifteen patients with significant atherosclerotic carotid artery disease received a CECU examination prior to undergoing a carotid endarterectomy (CEA). Two patients received bilateral endarterectomies, resulting in a total of 17 cases. At the time of surgery, carotid plaque samples were surgically removed and stained with specific vascular markers (CD31, CD34, von Willebrand factor, and hemosiderin) designed to identify the presence and degree of neovascularization. The intra-plaque neovascularization recorded on preoperative CECU was correlated with the degree of neovascularization noted in the tissue specimens. The CECU neovascularization was correlated to CD31-stained tissue specimens. This correlation value was 0.68 using Spearman's rank method. When CECU results were correlated with the other histologic markers (CD34, von Willebrand factor, and hemosiderin), a correlation of 0.50 was obtained. In conclusion, contrast-enhanced carotid ultrasound correlated to the presence and degree of intra-plaque neovascularization as determined from histology specimens.
Key Words: atherosclerosis • carotid • contrast • neovascularization • ultrasound
References
- Naghavi M., Libby P., Falk E. et al. From vulnerable plaque to vulnerable patient: a call for new definitions and risk assessment strategies: Part I. Circulation 2003; 108: 1664—72.[Abstract/Free Full Text]
- Naghavi M., Libby P., Falk E. et al. From vulnerable plaque to vulnerable patient: a call for new definitions and risk assessment strategies: Part II. Circulation 2003; 108: 1772—78.[Abstract/Free Full Text]
- Fleiner M., Kummer M., Mirlacher M. et al. Arterial neovascularization and inflammation in vulnerable patients: early and late signs of symptomatic atherosclerosis. Circulation 2004; 110: 2843—50.[Abstract/Free Full Text]
- Casscells W., Naghavi M., Willerson JT Vulnerable atherosclerotic plaque: a multifocal disease. Circulation 2003; 107: 2072—75.[Free Full Text]
- Wei K., Jayaweera AR, Firoozan S., Linka A., Skyba DM, Kaul S. Quantification of myocardial blood flow with ultrasound-induced destruction of microbubbles administered as a constant venous infusion. Circulation 1998; 97: 473—83.[Abstract/Free Full Text]
- Feinstein SB The powerful microbubble: from bench to bedside, from intravascular indicator to therapeutic delivery system, and beyond. Am J Physiol Heart Circ Physiol 2004; 287: H450—57.[Abstract/Free Full Text]
- McCarthy MJ, Loftus IM, Thompson MM et al. Angiogenesis and the atherosclerotic carotid plaque: an association between symptomatology and plaque morphology. J Vasc Surg 1999; 30: 261—68.[CrossRef][Web of Science][Medline]
[Order article via Infotrieve]
- Dunmore BJ, McCarthy MJ, Naylor AR, Brindle NP Carotid plaque instability and ischemic symptoms are linked to immaturity of microvessels within plaques. J Vasc Surg 2007; 45: 155—59.[CrossRef][Web of Science][Medline]
[Order article via Infotrieve]
- Koutouzis M., Nomikos A., Nikolidakis S. et al. Statin treated patients have reduced intraplaque angiogenesis in carotid endarterectomy specimens. Atherosclerosis 2007; 192: 455—56.[CrossRef][Web of Science][Medline]
[Order article via Infotrieve]
- Macioch JE, Katsamakis CD, Robin J. et al. Effect of contrast enhancement on measurement of carotid artery intimal medial thickness. Vasc Med 2004; 9: 7—12.[Abstract/Free Full Text]
- Mulvagh SL, DeMaria AN, Feinstein SB et al. Contrast echocardiography: current and future applications. J Am Soc Echocardiogr 2000; 13: 331—42.[CrossRef][Web of Science][Medline]
[Order article via Infotrieve]
- Jeziorska M., Woolley DE Neovascularization in early atherosclerotic lesions of human carotid arteries: its potential contribution to plaque development. Hum Pathol 1999; 30: 919—25.[CrossRef][Web of Science][Medline]
[Order article via Infotrieve]
- Moreno PR, Purushothaman KR, Fuster V. et al. Plaque neovascularization is increased in ruptured atherosclerotic lesions of human aorta: implications for plaque vulnerability. Circulation 2004; 110: 2032—38.[Abstract/Free Full Text]
- Folkman J. Tumor angiogenesis: therapeutic implications. N Engl J Med 1971; 285: 1182—86.[Web of Science][Medline]
[Order article via Infotrieve]
- Gardin JM Vascular ultrasound: the next frontier for the echocardiographer. J Am Soc Echocardiogr 2005; 18: 24A—26A.[Web of Science][Medline]
[Order article via Infotrieve]
- Rajaram V., Pandhya S., Patel S. et al. Role of surrogate markers in assessing patients with diabetes mellitus and the metabolic syndrome and in evaluating lipid-lowering therapy. Am J Cardiol 2004; 93: 32C—48C.[CrossRef][Web of Science][Medline]
[Order article via Infotrieve]
Vascular Medicine, Vol. 12, No. 4,
291-297 (2007)
DOI: 10.1177/1358863X07083363
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