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Geometry of the Carotid Artery and Its Association With Pathologic Changes in a Chinese Population
OBJECTIVES: Carotid artery geometry influences blood flow disturbances and is thus an important risk factor for carotid atherosclerosis. Extracellular matrix (ECM) and yes-associated protein (YAP) expression may play essential roles in the pathophysiology of carotid artery stenosis, but the effect o...
Autores principales: | , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Frontiers Media S.A.
2020
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6985580/ https://www.ncbi.nlm.nih.gov/pubmed/32038300 http://dx.doi.org/10.3389/fphys.2019.01628 |
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author | Cui, Yiyao Lv, Xiaoshuo Wang, Feng Kong, Jie Zhao, Hao Ye, Zhidong Si, Chaozeng Pan, Lin Liu, Peng Wen, Jianyan |
author_facet | Cui, Yiyao Lv, Xiaoshuo Wang, Feng Kong, Jie Zhao, Hao Ye, Zhidong Si, Chaozeng Pan, Lin Liu, Peng Wen, Jianyan |
author_sort | Cui, Yiyao |
collection | PubMed |
description | OBJECTIVES: Carotid artery geometry influences blood flow disturbances and is thus an important risk factor for carotid atherosclerosis. Extracellular matrix (ECM) and yes-associated protein (YAP) expression may play essential roles in the pathophysiology of carotid artery stenosis, but the effect of blood flow disturbances of carotid bifurcation location on the ECM is unknown. We hypothesized that carotid artery anatomy and geometry are independently associated with the ECM and YAP expression. METHODS: In this cross-sectional study, 193 patients were divided into two groups: an asymptomatic group (n = 111) and a symptomatic group (n = 82), symptomatic patients presenting with ischemic attack, amaurosis fugax, or minor non-disabling stroke. For all subjects before surgery, carotid bifurcation angle and internal artery angle were measured with computed tomography angiography (CTA), and laminar shear stress was measured with ultrasonography. After surgery, pathology of all plaque specimens was analyzed using hematoxylin and eosin (HE) staining and Movat special staining. Immunohistochemistry was performed to detect expression of YAP in a subset of 30 specimens. RESULTS: Symptomatic patients had increased carotid bifurcation angle and laminar shear stress compared to asymptomatic patients (P < 0.05), although asymptomatic patients had increased internal carotid angle compared to symptomatic patients (P < 0.001). Relative higher bifurcation angles were correlated with increased carotid bifurcation, decreased internal angle, and decreased laminar shear stress. For each change in intervertebral space or one-third of vertebral body height, carotid bifurcation angle changed 4.76°, internal carotid angle changed 6.91°, and laminar shear stress changed 0.57 dynes/cm(2). Pathology showed that average fibrous cap thickness and average narrowest fibrous cap thickness were greater in asymptomatic patients than symptomatic patients (P < 0.05). Expression of proteoglycan and YAP protein in symptomatic patients was higher than in asymptomatic patients (P < 0.001), while collagen expression was lower in symptomatic patients than asymptomatic patients (P < 0.05). CONCLUSION: Geometry of the carotid artery and position relative to cervical spine might be associated with ECM and YAP protein expression, which could contribute to carotid artery stenosis. |
format | Online Article Text |
id | pubmed-6985580 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | Frontiers Media S.A. |
record_format | MEDLINE/PubMed |
spelling | pubmed-69855802020-02-07 Geometry of the Carotid Artery and Its Association With Pathologic Changes in a Chinese Population Cui, Yiyao Lv, Xiaoshuo Wang, Feng Kong, Jie Zhao, Hao Ye, Zhidong Si, Chaozeng Pan, Lin Liu, Peng Wen, Jianyan Front Physiol Physiology OBJECTIVES: Carotid artery geometry influences blood flow disturbances and is thus an important risk factor for carotid atherosclerosis. Extracellular matrix (ECM) and yes-associated protein (YAP) expression may play essential roles in the pathophysiology of carotid artery stenosis, but the effect of blood flow disturbances of carotid bifurcation location on the ECM is unknown. We hypothesized that carotid artery anatomy and geometry are independently associated with the ECM and YAP expression. METHODS: In this cross-sectional study, 193 patients were divided into two groups: an asymptomatic group (n = 111) and a symptomatic group (n = 82), symptomatic patients presenting with ischemic attack, amaurosis fugax, or minor non-disabling stroke. For all subjects before surgery, carotid bifurcation angle and internal artery angle were measured with computed tomography angiography (CTA), and laminar shear stress was measured with ultrasonography. After surgery, pathology of all plaque specimens was analyzed using hematoxylin and eosin (HE) staining and Movat special staining. Immunohistochemistry was performed to detect expression of YAP in a subset of 30 specimens. RESULTS: Symptomatic patients had increased carotid bifurcation angle and laminar shear stress compared to asymptomatic patients (P < 0.05), although asymptomatic patients had increased internal carotid angle compared to symptomatic patients (P < 0.001). Relative higher bifurcation angles were correlated with increased carotid bifurcation, decreased internal angle, and decreased laminar shear stress. For each change in intervertebral space or one-third of vertebral body height, carotid bifurcation angle changed 4.76°, internal carotid angle changed 6.91°, and laminar shear stress changed 0.57 dynes/cm(2). Pathology showed that average fibrous cap thickness and average narrowest fibrous cap thickness were greater in asymptomatic patients than symptomatic patients (P < 0.05). Expression of proteoglycan and YAP protein in symptomatic patients was higher than in asymptomatic patients (P < 0.001), while collagen expression was lower in symptomatic patients than asymptomatic patients (P < 0.05). CONCLUSION: Geometry of the carotid artery and position relative to cervical spine might be associated with ECM and YAP protein expression, which could contribute to carotid artery stenosis. Frontiers Media S.A. 2020-01-21 /pmc/articles/PMC6985580/ /pubmed/32038300 http://dx.doi.org/10.3389/fphys.2019.01628 Text en Copyright © 2020 Cui, Lv, Wang, Kong, Zhao, Ye, Si, Pan, Liu and Wen. http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms. |
spellingShingle | Physiology Cui, Yiyao Lv, Xiaoshuo Wang, Feng Kong, Jie Zhao, Hao Ye, Zhidong Si, Chaozeng Pan, Lin Liu, Peng Wen, Jianyan Geometry of the Carotid Artery and Its Association With Pathologic Changes in a Chinese Population |
title | Geometry of the Carotid Artery and Its Association With Pathologic Changes in a Chinese Population |
title_full | Geometry of the Carotid Artery and Its Association With Pathologic Changes in a Chinese Population |
title_fullStr | Geometry of the Carotid Artery and Its Association With Pathologic Changes in a Chinese Population |
title_full_unstemmed | Geometry of the Carotid Artery and Its Association With Pathologic Changes in a Chinese Population |
title_short | Geometry of the Carotid Artery and Its Association With Pathologic Changes in a Chinese Population |
title_sort | geometry of the carotid artery and its association with pathologic changes in a chinese population |
topic | Physiology |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6985580/ https://www.ncbi.nlm.nih.gov/pubmed/32038300 http://dx.doi.org/10.3389/fphys.2019.01628 |
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