Relationship of features of carotid atherosclerosis plaques evaluated by high-resolution magnetic resonance imaging with cerebral infarction and serum Hcy, hs-CRP, and MMP-9 in elderly people

doi:10.3877/cma.j.issn.1674-0785.2022.02.010

Abstract

Abstract:

Objective

To evaluate the relationship of the features of carotid atherosclerosis (CAS) plaques evaluated by high-resolution magnetic resonance imaging (HRMRI) with cerebral infarction and serum homocysteine (Hcy), high-sensitivity C-reactive protein (hs-CRP), and matrix metalloproteinase 9 (MMP-9) in elderly people.

Methods

A total of 42 patients who were confirmed with acute cerebral infarction (ACI) at Changzhou Second People's Hospital from December 2017 to December 2019 were enrolled as a cerebral infarction group, 42 non-cerebral infarction patients with CAS plaques during the same period were enrolled as a non-cerebral infarction group, and 42 healthy controls during the same period were enrolled as a control group. The plaque stability in the cerebral infarction group and non-cerebral infarction group was detected by HRMRI. The plaque thickness (PT), lumen area (LA), total vessel area (TVA), wall area (WA), normalized wall index (NWI), and lumen stenosis (LS) were measured. The levels of serum Hcy, MMP-9, and hs-CRP were detected by enzyme-linked immunosorbent assay. The diagnostic value of serum Hcy, MMP-9, and hs-CRP in cerebral infarction was assessed by ROC curve analysis. The relationship between the features of CAS plaques and serum Hcy, CRP, and MMP-9 was analyzed by Pearson correlation analysis.

Results

The proportion of unstable plaques in the cerebral infarction group was significantly higher than that in the non-cerebral infarction group (63.38% vs 2.94%, P＜0.05), PT, TVA, WA, NWI, and LS were significantly higher (P＜0.05), and LA was significantly lower in the cerebral infarction group than in the non-cerebral infarction group (P＜0.05). The levels of serum Hcy, CRP, and MMP-9 were significantly higher in the cerebral infarction group than in the non-cerebral infarction group and control group (P＜0.05), and in the non-cerebral infarction group than in the control group (P＜0.05). The area under the curve values of serum Hcy, CRP, and MMP-9 and their combination for diagnosis of cerebral infarction were 0.780, 0.752, 0.730, and 0.859, respectively (P＜0.05). Plaque stability, PT, WA, NWI, and LS were positively correlated with serum Hcy, CRP, and MMP-9 levels (P＜0.05), while LA was negatively correlated with them (P＜0.05).

Conclusion

HRMRI features of CAS plaques significantly correlate with the occurrence of cerebral infarction in elderly people and the changes in levels of serum Hcy, hs-CRP, and MMP-9.

Key words: High-resolution magnetic resonance imaging, Carotid atherosclerosis, Cerebral infarction, Plaque

Kai Lu, Hongfang Ma, Changjie Pan, Min Zhang. Relationship of features of carotid atherosclerosis plaques evaluated by high-resolution magnetic resonance imaging with cerebral infarction and serum Hcy, hs-CRP, and MMP-9 in elderly people[J]. Chinese Journal of Clinicians(Electronic Edition), 2022, 16(02): 164-169.

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Figures/Tables 7

References 18

1	Yuan J, Usman A, Das T, et al. Imaging carotid atherosclerosis plaque ulceration: comparison of advanced imaging modalities and recent developments [J]. Am J Neuroradiol, 2017, 38(4): 664-671.
2	卢亚敏, 霍丽静, 张明明, 等. 老年血压正常高值者单核细胞趋化蛋白-1、氧化低密度脂蛋白胆固醇与动脉粥样硬化的相关性 [J]. 中国老年学杂志, 2017, 37(6): 1357-1359.
3	Franco-Gutierrez R, Perez-Perez A J, Franco-Gutierrez V, et al. Carotid plaque is a predictor of major adverse cardiac and cerebrovascular events in patients undergoing coronary angiography [J]. Arch Cardiol Mex, 2019, 89(1): 1-7.
4	Lu M, Peng P, Qiao H, et al. Association between age and progression of carotid artery atherosclerosis: a serial high resolution magnetic resonance imaging study [J]. Int J Cardiovasc Imaging, 2019, 35(7): 1287-1295.
5	Anniwaer J, Liu MZ, Xue KD, et al. Homocysteine might increase the risk of recurrence in patients presenting with primary cerebral infarction [J]. Int J Neurosci, 2019, 129(7): 654-659.
6	Zhao L, Zhai Z, Hou W. Analysis of carotid color ultrasonography and high sensitive C-reactive protein in patients with atherosclerotic cerebral infarction [J]. Pak J Med Sci, 2016, 32(4): 931-934.
7	Choi JI, Ha SK, Lim DJ, et al. S100ß, matrix metalloproteinase-9, d-dimer, and heat shock protein 70 are serologic biomarkers of acute cerebral infarction in a mouse model of transient mca occlusion [J]. J Korean Neurosurg Soc, 2018, 61(5): 548-558.
8	中华神经学会, 中国神经外科学会. 各类脑血管疾病诊断要点. 中华神经科杂志, 1996, 29(6): 379-380.
9	Trelles M, Eberhardt KM, Buchholz M, et al. CTA for screening of complicated atherosclerotic carotid plaque--american heart association type vi lesions as defined by MRI [J]. Am J Neuroradiol, 2013, 34(12): 2331-2337.
10	Adhithyan R, Kesav P, Thomas B, et al. High-resolution magnetic resonance vessel wall imaging in cerebrovascular diseases [J]. Neurol India, 2018, 66(4): 1124-1132.
11	王芮, 李恒国. 急性脑梗死患者头颈部动脉粥样硬化斑块的CTA特征 [J]. 广东医学, 2018, 39(22): 3391-3394.
12	Chen L, Yang Q, Ding R, et al. Carotid thickness and atherosclerotic plaque stability, serum inflammation, serum MMP-2 and MMP-9 were associated with acute cerebral infarction [J]. Exp Ther Med, 2018, 16(6): 5253-5257.
13	李晓, 赵辉林, 孙贝贝, 等. MR测定颈动脉易损斑块特征与急性缺血性脑卒中的关系 [J]. 实用放射学杂志, 2017, 33(3): 373-377.
14	Tesauro M, Mauriello A, Rovella V, et al. Arterial ageing: from endothelial dysfunction to vascular calcification [J]. J Intern Med, 2017, 281(5): 471-482.
15	Sreckovic B, Sreckovic VD, Soldatovic I, et al. Homocysteine is a marker for metabolic syndrome and atherosclerosis [J]. Diabetes Metab Syndr, 2017, 11(3): 179-182.
16	Swastini DA, Wiryanthini IAD, Ariastuti NLP, et al. Atherosclerosis prediction with high sensitivity c-reactive protein (hs-CRP) and related risk factor in patient with dyslipidemia [J]. Open Access Maced J Med Sci, 2019, 7(22): 3887-3890.
17	Andrade C, Bosco A, Sandrim V, et al. MMP-9 levels and IMT of carotid arteries are elevated in obese children and adolescents compared to non-obese [J]. Arq Bras Cardiol, 2017, 108(3): 198-203.
18	Ye Z, Zhang Z, Zhang H, et al. Prognostic value of C-reactive protein and homocysteine in large-artery atherosclerotic stroke: a prospective observational study [J]. J Stroke Cerebrovasc Dis, 2017, 26(3): 618-626.

组别	斑块数	不稳定型斑块		稳定型斑块
组别	斑块数	Ⅳ~Ⅴ型	Ⅵ型	Ⅰ~Ⅱ型	Ⅲ型	Ⅶ型	Ⅷ型
脑梗死组	71	24（33.80）	21（29.58）	7（9.86）	10（14.08）	4（5.63）	5（7.04）
非脑梗死组	68	2（2.94）	0（0.00）	57（83.82）	6（8.82）	1（1.47）	2（2.94）

组别	斑块数	不稳定型斑块		稳定型斑块
组别	斑块数	Ⅳ~Ⅴ型	Ⅵ型	Ⅰ~Ⅱ型	Ⅲ型	Ⅶ型	Ⅷ型
脑梗死组	71	24（33.80）	21（29.58）	7（9.86）	10（14.08）	4（5.63）	5（7.04）
非脑梗死组	68	2（2.94）	0（0.00）	57（83.82）	6（8.82）	1（1.47）	2（2.94）

组别	例数	PT（mm）	LA（mm²）	TVA（mm²）	WA（mm²）	NWI	LS（%）
脑梗死组	42	2.85±0.64	35.20±8.22	75.71±9.87	40.23±9.05	0.54±0.14	46.82±9.63
非脑梗死组	42	2.56±0.57	40.07±8.54	70.56±10.23	30.82±8.74	0.43±0.10	46.82±9.63
t值		2.193	2.663	2.348	4.847	4.144	3.467
P值		0.031	0.009	0.021	＜0.001	0.005	＜0.001

组别	例数	PT（mm）	LA（mm²）	TVA（mm²）	WA（mm²）	NWI	LS（%）
脑梗死组	42	2.85±0.64	35.20±8.22	75.71±9.87	40.23±9.05	0.54±0.14	46.82±9.63
非脑梗死组	42	2.56±0.57	40.07±8.54	70.56±10.23	30.82±8.74	0.43±0.10	46.82±9.63
t值		2.193	2.663	2.348	4.847	4.144	3.467
P值		0.031	0.009	0.021	＜0.001	0.005	＜0.001

组别	例数	Hcy（μmol/L）	CRP（mg/L）	MMP-9（μg/L）
脑梗死组	42	21.62±5.81^ab	15.82±4.86^ab	158.46±30.41^ab
非脑梗死组	42	15.49±4.90^a	11.83±3.22^a	120.50±28.45^a
对照组	42	11.21±2.77	6.41±1.72	86.71±12.74
F值		52.682	76.076	85.604
P值		＜0.001	＜0.001	＜0.001

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