Abstract 16075: Carotid Vascular Permeability and Wall Thickness by MRI are Different in Premenopausal Women with Metabolic Syndrome Compared to Normals

Abstract

Insulin resistance accelerates atherosclerosis development, particularly in women. Understanding the early vascular changes that lead to atherosclerosis could influence diagnosis and treatment of cardiovascular disease in insulin resistant women, such as those with metabolic syndrome (MetS). We hypothesized that MRI would detect increased thickening and permeability in carotid artery walls of premenopausal women with MetS. MRI measurements of both vascular permeability and wall thickness were obtained from 8 premenopausal women with MetS (43±4 yrs) and 17 age-matched controls (aged 41±3 yrs). Mean wall thickness (MWT) was measured on axial cross-sectional fat-suppressed T1-weighted images with black-blood (BB) preparation (in-plane resolution of 0.35 mm). Vascular permeability was defined by the transfer constant Ktrans based on kinetic modeling of a BB dynamic contrast-enhanced MRI acquisition (temporal interval of 12.6 sec). Both measurements were made immediately proximal to both carotid bulbs and the maximal values of MWT and Ktrans were recorded. In a two-sided t-test, the maximal MWT was significantly greater in women with MetS compared to controls (0.75±0.05 mm vs. 0.69±0.06 mm, p=0.02). The maximal Ktrans was significantly lower in MetS compared to controls (0.016±0.015 min^-1 vs 0.033±0.017 min^-1, p=0.03). In conclusion, this study demonstrates that MRI detects larger wall thickness and reduced Ktrans in premenopausal women with MetS compared to controls. Although we hypothesized that Ktrans would be higher in MetS, the results suggest the presence of intimal thickening without substantial neovascularization, thus the lower Ktrans measurements observed. Funding(This research has received full or partial funding support from the American Heart Association)