Geometry of the Carotid Artery and Its Association With Pathologic Changes in a Chinese Population

作者：Yiyao Cui, Xiaoshuo Lv, Feng Wang, Jie Kong, Hao Zhao, Zhidong Ye, Chaozeng Si, Lin Pan, Peng Liu, Jianyan Wen · 发表于：Frontiers in Physiology · 年份：2020 · DOI：10.3389/fphys.2019.01628 · 被引用次数：15 · 研究领域：Cerebrovascular and Carotid Artery Diseases、Cardiovascular Health and Disease Prevention、Neurological Disease Mechanisms and Treatments

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 b...