Abstract
Background and aimsPlaque border irregularity is a known imaging characteristic of vulnerable plaques, but its evaluation heavily relies on subjective evaluation and operator expertise. Aim of the present work is to propose a novel fractal-analysis based method for the quantification of atherosclerotic plaque border irregularity and assess its relation with cardiovascular risk factors.Methods and resultsForty-two asymptomatic subjects with carotid stenosis underwent ultrasound evaluation and assessment of cardiovascular risk factors. Total, low-density lipoprotein (LDL), high-density lipoprotein (HDL) plasma cholesterol and triglycerides concentrations were measured for each subject. Fractal analysis was performed in all the carotid segments affected by atherosclerosis, i.e. 147 segments. The resulting fractal dimension (FD) is a measure of irregularity of plaque profile on long axis view of the plaque. FD in the severest stenosis (main plaque FD,mFD) was 1.136±0.039. Average FD per patient (global FD,gFD) was 1.145±0.039. FD was independent of other plaque characteristics. mFD significantly correlated with plasma HDL (r = -0.367,p = 0.02) and triglycerides-to-HDL ratio (r = 0.480,p = 0.002).ConclusionsFractal analysis is a novel, readily available, reproducible and inexpensive technique for the quantitative measurement of plaque irregularity. The correlation between low HDL levels and plaque FD suggests a role for HDL in the acquisition of morphologic features of plaque instability. Further studies are needed to validate the prognostic value of fractal analysis in carotid plaques evaluation.
Highlights
Atherosclerosis of the carotid arteries is a widely recognised risk factor for ischemic stroke
The correlation between low highdensity lipoprotein (HDL) levels and plaque fractal dimension (FD) suggests a role for HDL in the acquisition of morphologic features of plaque
The range of FD is determined by the topology of the structure: to that of a coastline, the FD of an atherosclerotic plaque border is expected to fall between 1 and 2.[8]. In the present study, we propose a novel fractal analysis-based method for the quantification of carotid artery plaque irregularity
Summary
Atherosclerosis of the carotid arteries is a widely recognised risk factor for ischemic stroke. It is estimated that one in five ischemic strokes originates from carotid plaques, mainly due to an arterio-arterial embolization.[1, 2] Among carotid plaque characteristics of prognostic value, plaque irregularity appears to have a promising role in the identification of subjects at risk.[3,4,5] most of the studies evaluating plaque irregularity rely on qualitative classification schemes lacking in standardization, which led to inconsistent results in a recently published meta-analysis.[6] The development of quantitative methods for the evaluation of plaque irregularity may offer the advantage of higher reproducibility, eventually leading to more robust results. Aim of the present work is to propose a novel fractal-analysis based method for the quantification of atherosclerotic plaque border irregularity and assess its relation with cardiovascular risk factors
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
