Abstract 12028: Contrast-Enhanced Ultrasound for the Detection of Subclinical Atherosclerosis and Intraplaque Neovascularization in Patients With Familial Hypercholesterolemia
Purpose: Patients with heterozygous familial hypercholesterolemia (FH) are at severely increased risk of developing atherosclerosis at relatively young age. The purpose of this study was to assess the prevalence of subclinical atherosclerosis and intraplaque neovascularization (IPN) in patients with FH, using contrast-enhanced ultrasound (CEUS) of the carotid arteries.
Methods: The patients had no cerebrovascular symptoms and underwent bilateral carotid ultrasound and CEUS to evaluate the presence of subclinical atherosclerosis and IPN. Far wall plaques were excluded for assessment of IPN due to a hindering pseudo-enhancement artifact. IPN was assessed in near wall plaques using a visual grading scale and dedicated semi-automated quantification software. Mann-Whitney U test was performed to compare the output of the semi-automated software in groups.
Results: The study population consisted of 69 patients (48% women, mean age 55 ± 8 years, mean LDL 143 ± 66 mg/dl). Carotid plaque was present in 62 patients (90%). A total of 49 patients had plaques that were eligible for the assessment of IPN: 7 patients (14%) had no IPN, 39 (80%) had mild to moderate IPN and 3 (6%) had severe IPN. Individual carotid artery analysis (n=68) showed that plaques with irregular or ulcerated surface (n=18) had significantly more IPN than plaques with a smooth surface (n=50) (p≤0.05)(figure 1).
Conclusion: Carotid ultrasound demonstrated atherosclerotic plaque in 90% of asymptomatic patients with FH without known atherosclerosis. IPN assessed with CEUS, was present in 86% of these patients. Irregular and ulcerated plaques exhibited significantly more IPN than plaques with a smooth surface.
- © 2013 by American Heart Association, Inc.