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High-resolution MRI assessed carotid atherosclerotic plaque characteristics comparing men and women with elevated ApoB levels

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Abstract

Previous studies demonstrated that men were more likely to have plaque rupture and are at greater risk for myocardial infarction and stroke than women. We evaluated differences in carotid plaque characteristics by MRI between men and women with mild-moderate atherosclerosis and elevated ApoB levels. One hundred eighty-two subjects (104 men and 78 women) with CAD or carotid stenosis (≥ 15% by ultrasound), ApoB ≥ 120 mg/dL and carotid MRI scan were included. Percent wall volume (%WV) was calculated as (wall volume/total vessel volume) × 100%. Three major plaque compositions, fibrous tissue (FT), calcification (CA) and lipid rich necrotic core (LRNC), were identified and quantified using published MRI criteria. Adventitial and plaque neovascularization as fractional plasma volume (Vp) and permeability as transfer constant (Ktrans) were analyzed using kinetic modeling. These characteristics were compared between men and women. Men, compared to women, were younger (54 ± 8 vs. 58 ± 8 years, p = 0.01), had higher rate of previous MI (46 vs. 26%, p = 0.005) but lower proportions of metabolic syndrome (37 vs. 59%, p = 0.003). After adjusting for between-gender differences, men were significantly more likely to have LRNC (OR 2.22, 95% CI 1.04–4.89, p = 0.04) and showed significantly larger %LRNC than women (diff = 4.3%, 95% CI 1.6–6.9%, p = 0.002), while %WV, FT, and CA were similar between men and women. There were no statistically significant differences in adventitial and plaque Vp or Ktrans. Men were significantly more likely to have LRNC and had larger LRNC than women. However, men and women showed relatively similar levels of adventitial and plaque neovascularization and permeability.

Trial registration: NCT00715273 at ClinicalTrials.gov. Registered 15 July 2008, retrospectively registered.

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Abbreviations

ASCVD:

Atherosclerotic cardiovascular disease

MI:

Myocardial infarction

MRI:

Magnetic resonance imaging

DCE-MRI:

Dynamic contrast-enhanced MRI

%WV:

Percent wall volume

FT:

Fibrous tissue

CA:

Calcification

LRNC:

Lipid rich necrotic core

V p :

Fractional plasma volume

K trans :

Transfer constant

OCT:

Optical coherence tomography

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Funding

This research was supported by an NIH Grant No. (R01 HL63895) from the National Heart, Lung, and Blood Institute, Bethesda, MD, and Alpha Phi Foundation, Evanston, IL.

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Author notes

  1. Tianwen Han and Pathmaja Paramsothy have equally contributed to this work.

Authors and Affiliations

  1. Department of Medicine, Division of Cardiology, University of Washington, Seattle, WA, 98104, USA

    Tianwen Han, Pathmaja Paramsothy, Jaekyoung Hong, Daniel Isquith, Edward Gill & Xue-Qiao Zhao

  2. Department of Radiology, University of Washington, Seattle, WA, 98109, USA

    Dongxiang Xu

  3. Clinical Pharmacology Research Center, Peking Union Medical College Hospital, Beijing, 100032, China

    Hua Bai

  4. The Mountain-Whisper-Light Statistics, Seattle, WA, 98112, USA

    Moni Neradilek

  5. Harborview Medical Center, University of Washington, GEC-37, 325 9th Ave, Box 359720, Seattle, WA, 98104, USA

    Xue-Qiao Zhao

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  1. Tianwen Han
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Contributions

TH, PP and JH wrote the manuscript. DI and HB performed data collection. DX was responsible for MR image review. MN performed statistical analysis and attributed to data interpretation. EG was involved in DCE-MRI data analysis. XZ was responsible for overall study design, funding and interpretation of the study results. All authors read and approved the final manuscript.

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Correspondence to Xue-Qiao Zhao.

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Han, T., Paramsothy, P., Hong, J. et al. High-resolution MRI assessed carotid atherosclerotic plaque characteristics comparing men and women with elevated ApoB levels. Int J Cardiovasc Imaging 36, 481–489 (2020). https://doi.org/10.1007/s10554-019-01600-1

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