From the Department of Vascular Surgery, Rigshospitalet, (M.-L.M.G.),
Department of Clinical Biochemistry, Herlev Hospital (B.G.N.), Laboratory of
Neuropathology, Rigshospitalet (B.M.W.), and Department of Vascular Surgery,
Gentofte Hospital (H.S.), University Hospital of Copenhagen, Denmark, and the
Department of Information Technology, Technical University of Denmark
(J.E.W.).
Correspondence to Dr Marie-Louise Moes Grønholdt, Department of Vascular Surgery, RK 3112, Rigshospitalet, Blegdamsvej 9, DK-2100 Copenhagen Ø, Denmark. E-mail: mlg{at}rh.dk
Background—Echo-lucency of carotid
atherosclerotic plaques on computerized ultrasound B-mode images has
been associated with a high incidence of brain infarcts as evaluated on
CT scans. We tested the hypotheses that triglyceride-rich
lipoproteins in the fasting and postprandial state predict carotid
plaque echo-lucency and that echo-lucency predicts a high plaque
lipid content.
Methods and Results—The study included 137 patients with
neurological symptoms and
Conclusions—Increased plasma levels of
triglyceride-rich lipoproteins predict echo-lucency of
carotid plaques, which is associated with increased plaque lipid
content. Because echo-lucency has been associated with a high incidence
of brain infarcts on CT scans, triglyceride-rich
lipoproteins may predict a plaque type particularly vulnerable to
rupture.
© 1998 American Heart Association, Inc.
Clinical Investigation and Reports
Echo-Lucency of Computerized Ultrasound Images of Carotid Atherosclerotic Plaques Are Associated With Increased Levels of Triglyceride-Rich Lipoproteins as Well as Increased Plaque Lipid Content
50% stenosis of the relevant
carotid artery. High-resolution B-mode ultrasound images of carotid
plaques were computer processed to yield a measure of echogenicity
(gray-scale level). Lipoproteins were measured before and hourly for 4
hours after a standardized fatty meal. A subgroup of 58 patients
underwent endarterectomy. On linear regression
analysis, echo-lucency (low gray-scale level) was associated
with elevated levels of fasting and postprandial plasma
triglycerides (P=.0002 and
P=.002), IDL cholesterol
(P=.0009 and P=.006), and
VLDL/chylomicron remnant cholesterol
(P=.0003 and P=.0004) and
triglycerides (P=.0003 and
P=.003), the area under the plasma
triglyceride curve 0 to 4 hours after a fatty meal
(P=.001), and body mass index (P=.0001).
On ANCOVA, body mass index, fasting IDL cholesterol, and
fasting plasma triglycerides were independent predictors of
echo-lucency. Echo-lucency was associated with increased relative
plaque lipid content (P=.02).
Key Words: arteriosclerosis • carotid arteries • ultrasonics • lipoproteins • pathology
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