Structural Stability of Carotid Plaque and Symptomatology

颈动脉斑块的结构稳定性和症状学

• 批准号: 7886372
• 负责人: ROBERT J DEMPSEY
• 金额: $ 30.44万
• 依托单位: UNIVERSITY OF WISCONSIN-MADISON
• 依托单位国家: 美国
• 财政年份: 2010
• 资助国家: 美国
• 起止时间: 2010-03-15 至 2015-01-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7886372
• 关键词: Address; Affect; Aging; American; Area; Arterial Fatty Streak; Atherosclerosis; Atrophic; Blood Vessels; Brain; Cardiac; Carotid Artery Plaques; Carotid Atherosclerotic Disease; Carotid Endarterectomy; Cerebrovascular Circulation; Cerebrovascular Disorders; Cerebrum; Characteristics; Cholesterol; Clinical; Cognition; Cognitive; Defect; Deposition; Development; Disease; Distal; Elasticity; Embolism; Endarterectomy; Functional disorder; Future; Health; Hemorrhage; Histopathology; Human; Impaired cognition; Individual; Injury; Ipsilateral; Ischemia; Lead; Magnetic Resonance Imaging; Measurable; Measurement; Measures; Mechanics; Methods; Motion; Motor; Operative Surgical Procedures; Patient Monitoring; Patients; Perfusion; Relative (related person); Risk; Role; Sensory; Side; Site; Source; Specimen; Speech; Spin Labels; Stroke; Surface; Symptoms; System; Therapeutic Embolization; Thrombosis; Thrombus; Time; Ulcer; Ultrasonography; Vision; aging population; angiogenesis; cerebral atrophy; clinically relevant; gray matter; ischemic lesion; novel marker; prevent; public health relevance; treatment strategy; white matter

DESCRIPTION (provided by applicant): This study examines the issue of "silent" strokes in the relationship between the structural stability of atherosclerotic carotid plaque and the development of nonmotor symptomatology, including brain atrophy and cognitive decline. It addresses the question of the role of carotid emboli in "silent" stroke and their cognitive sequelae. The study uses human carotid endarterectomy patients to study three specific aims. The first uses ultrasound to relate plaque elasticity and its development of mechanical strain features with pulsation and the histopathophysiology of the plaque for ulcer, hemorrhage and thinning of stabilizing fibrous cap at the point of these mechanical strain features. The second examines ultrasound detected elasticity strain features in the plaques and the presence of transcranial Doppler TCD detectable microemboli. The third looks at ultrasound strain deficits, microemboli, cognitive decline and brain MRI evidence of focal and generalized atrophy. Understanding the structural plaque abnormalities, which render a carotid plaque mechanically unstable and at risk of embolization will demonstrate a pathophysiologic mechanism in individuals who are likely to suffer not only classic episodic major strokes, but also functional progressive decline from the contribution of microemboli to cerebral "silent" stroke and cognitive decline. PUBLIC HEALTH RELEVANCE: Cerebrovascular disease remains a major health problem with increasing impact on an aging population. Studies suggest that clinical and "silent" stroke affects 11 million Americans per year. Vascular aging from atherosclerosis is a major contributor to this problem. For this reason, we propose a study of carotid atherosclerosis developing novel markers for carotid plaque instability which may result in the presence of multiple microemboli, which in turn may contribute to increased symptomatology, both classic strokes, as well as, cognitive decline. If successful, this study will greatly increase our understanding of the pathophysiology of symptoms from atherosclerosis, as well as, lead to the development of potential new measures to detect this disorder noninvasively.

描述（由申请人提供）：本研究研究了动脉粥样硬化颈动脉斑块的结构稳定性与非运动症状的发展之间的“无声”中风问题，包括脑萎缩和认知能力下降。它解决了颈动脉栓塞在“沉默”中风和他们的认知后遗症中的作用的问题。该研究使用人类颈动脉内膜切除术患者研究三个特定目标。第一个使用超声将斑块弹性及其开发机械应变特征与脉动的发展以及斑块的组织病理生理学在这些机械应变特征的点上进行溃疡，出血和稳定纤维帽的变薄。第二个检查了斑块中检测到的弹性应变特征以及经颅多普勒TCD可检测到的微栓塞的弹性应变特征。第三次查看超声应变缺陷，微栓塞，认知下降和脑MRI的局灶性萎缩证据。了解结构性斑块异常，从而使颈动脉斑块机械地不稳定并有栓塞风险，这将证明那些可能不仅遭受经典的情节性主要中风的人的病理生理机制，而且还遭受了经典的功能性逐步逐步逐步逐步降低，从而从微骨对脑性“无声”的“无声”的“无声”势力降低了。 公共卫生相关性：脑血管疾病仍然是一个主要的健康问题，对人口老龄化的影响增加。研究表明，临床和“沉默”中风每年影响1100万美国人。动脉粥样硬化的血管衰老是该问题的主要因素。因此，我们提出了一项针对颈动脉粥样硬化的研究，为颈动脉斑块不稳定性开发了新的标志物，这可能会导致多个微栓塞的存在，这反过来又可能导致症状增加，包括经典中风，以及认知能力下降。如果成功，这项研究将大大提高我们对动脉粥样硬化症状的病理生理学的理解，以及导致发展潜在的新措施，以无创地检测这种疾病。