Angheloiu, George

Biederman, Robert WW

Doyle, Mark

Grant, Saundra B

Kodali, Sobhan

Neff, David R

Rathi, Vikas K

Rayarao, Geetha

Williams, Ronald B

Yamrozik, June A

English

PubMed

Robert WW Biederman

David R Neff

Saundra B Grant

Ronald B Williams

Geetha Rayarao

June A Yamrozik

George Angheloiu

Sobhan Kodali

Vikas K Rathi

Mark Doyle

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ORAL PRESENTATION Open Access
Is the process of stabilization of carotid plaque
more dynamic than expected? a high-resolution
3D-CMR statin-naive human study
Robert WW Biederman1*, David R Neff1, Saundra B Grant1, Ronald B Williams1, Geetha Rayarao1, June A Yamrozik1,
George Angheloiu1, Sobhan Kodali1, Vikas K Rathi2, Mark Doyle1
From 2011 SCMR/Euro CMR Joint Scientific Sessions
Nice, France. 3-6 February 2011
Introduction
Atherosclerosis is a dynamic process thought to stabilize
with statin therapy. However, the uniformity of plaque
stabilization and subsequent regression when examined
under high-resolution 3D CMR is unknown. We
hypothesize that plaque characteristics illustrate marked
heterogeneity with both plaque regression and progres-
sion as lipid lowering therapy is instituted.
Purpose
Methods
Via CMR (1.5T GE), 707-two mm contiguous in vivo
slices of advanced carotid disease (>50%; mean 64±21 )
representing 42 complete bilateral human plaques (age
68±15yrs) were analyzed for 2D/3D extent of vascular
wall: lipid pool, fibrous cap, outer wall area (OWA), ves-
sel wall area (VWA), lumen area (LA) and lipid pool
(LP). All were related to fasting lipids relative to %steno-
sis via QPlaque (Medis). Plaque morphology was deter-
mined by CMR (T1/T2/PD) at baseline and one year
following lipid lowering agent (simvastatin or simva/
ezetimibe). Plaque progression was defined as LP pre/LP
post < 1 while plaque regression was defined as LP pre/
LP post >1.
Results
39/42 in vivo plaques in statin naïve pts were success-
fully imaged. Resolution: 1x1x2mm. Pre therapy, mg/dL
range of LDLC was 60-189 (mean 142), HDLC: 23-71
and TG: 80-214. LP represented 30±4% and fibrous
laque 9±22% of total vessel wall. Post therapy, LDL was
66±31mg/dL. In 707 slices, 378 (53.5%) demonstrated
progression while 329 (46.5%) showed regression. In
those plaques that regressed there was significant
decrease in both OWA, VWA and fibrous plaque as
well as a paradoxical decrease in LA (p<0.0001 for all)
while he converse was true for progression (p <0.0001
for all but LA). Specifically, LA decreased from 27.0 to
21.8mm2 to (19%; p<0.0001) while LA increased from
24.4 to 26.0mm2 (9%; p=NS). Segmenting for quartiles
of LDL favorably trended with ΔLA; r=0.35, p=0.08
while lumen size was related to ΔLDL, p<0.02).
Conclusions
In statin naïve pts, administration of lipid modulating
agents appear to have initial paradoxical effects on
lumen size as assessed by high-resolution 3D CMR: as
VWA and LP decreases so does the LA. Similarly, as
VWA and LP increases so does LA. All appears driven
by the effectiveness of the ΔLDL achieved. Thus,
marked heterogeneity in plaque compositional changes
exist that are only resolved once ΔLDL is known.
Author details
1Allegheny General Hospital, Pittsburgh, PA, USA. 2Bon Secours Heart and
Vascular Institute, Richmond, VA, USA.
Published: 2 February 2011
doi:10.1186/1532-429X-13-S1-O96
Cite this article as: Biederman et al.: Is the process of stabilization of
carotid plaque more dynamic than expected? a high-resolution 3D-CMR
statin-naive human study. Journal of Cardiovascular Magnetic Resonance
2011 13(Suppl 1):O96.
1Allegheny General Hospital, Pittsburgh, PA, USA
Full list of author information is available at the end of the article
Biederman et al. Journal of Cardiovascular Magnetic Resonance 2011, 13(Suppl 1):O96
http://jcmr-online.com/content/13/S1/O96
© 2011 Biederman et al; licensee BioMed Central Ltd. This is an open access article distributed under the terms of the Creative
Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and
reproduction in any medium, provided the original work is properly cited.


Is the process of stabilization of carotid plaque more dynamic than expected? a high-resolution 3D-CMR statin-naive human study

Kodali Sobhan

Angheloiu George

Yamrozik June A

Rayarao Geetha

Williams Ronald B

Grant Saundra B

Neff David R

Biederman Robert WW

Rathi Vikas K

Doyle Mark

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Is the process of stabilization of carotid plaque more dynamic than expected? a high-resolution 3D-CMR statin-naive human study

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