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Abstract：
UNASSIGNED: Arterial remodeling is a compensatory mechanism of the vessel wall in response to atherosclerotic plaque growth. However, the clinical significance of vascular remodeling of carotid lesions remains unclear. Through this study, we aimed to evaluate the association between vascular remodeling and ischemic symptoms in patients with an internal carotid artery (ICA) stenosis degree ≥50%, considering the differences in plaque calcification patterns.
UNASSIGNED: This retrospective cross-sectional study included adult patients with moderate-to-severe proximal ICA stenosis associated with atherosclerotic plaques admitted to the Zhejiang Hospital between September 2018 and March 2023. Parameters such as lumen diameter, plaque calcification types, calcium scores, and calcification thickness were assessed using non-contrast and contrast-enhanced computed tomography angiography (CTA). The remodeling ratio (RR) was calculated by dividing the maximum distance of the proximal ICA between the inner border of the arterial lumen at the plaque site and the outer borders of the plaque by the luminal diameter. Atherosclerosis risk factors and medications were recorded. The Mann-Whitney U test or chi-square test was used to compare the differences between groups. Correlations were measured using Pearson\'s correlation coefficient. Predictors of ischemic symptoms were assessed using multivariable logistic regression analysis, with results expressed as odds ratio (ORs) with 95% confidence intervals (CIs). A P value less than 0.05 (two-sided) was considered to indicate statistical significance The differences in RR among plaque calcification types and the association between vascular remodeling and clinical symptoms were analyzed.
UNASSIGNED: A total of 242 ICAs in 196 patients were included in this study, and 84 were symptomatic and 158 were asymptomatic. The RR in symptomatic ICA [median, 1.31 (interquartile range, 1.17-1.68)] was significantly greater than that in asymptomatic group [median, 1.20 (interquartile range, 1.05-1.45)], P=0.006). Significant differences in RR existed among plaque calcification types, among which type 5 and 6 plaques had the highest RR. About 71.5% (173/242) of all ICAs showed positive remodeling. Significant correlations were observed between RR and ischemic symptoms and between positive remodeling and calcification thickness (P<0.05 for all variables). On multivariable logistic regression analysis, calcification thickness remained significantly associated with positive remodeling of carotid arteries (OR 2.30; 95% CI: 1.06-5.01; P=0.036).
UNASSIGNED: Arterial remodeling exists in the ICA. A significant association between arterial positive remodeling and plaque calcification thickness was established. RR helps predict ischemic symptoms. The results of our study suggest that arterial remodeling serves as a novel measure to help ascertain the risk stratification of ischemic events in carotid atherosclerotic disease.
UNASSIGNED: This retrospective cross-sectional study included adult patients with moderate-to-severe proximal ICA stenosis associated with atherosclerotic plaques admitted to the Zhejiang Hospital between September 2018 and March 2023. Parameters such as lumen diameter, plaque calcification types, calcium scores, and calcification thickness were assessed using non-contrast and contrast-enhanced computed tomography angiography (CTA). The remodeling ratio (RR) was calculated by dividing the maximum distance of the proximal ICA between the inner border of the arterial lumen at the plaque site and the outer borders of the plaque by the luminal diameter. Atherosclerosis risk factors and medications were recorded. The Mann-Whitney U test or chi-square test was used to compare the differences between groups. Correlations were measured using Pearson\'s correlation coefficient. Predictors of ischemic symptoms were assessed using multivariable logistic regression analysis, with results expressed as odds ratio (ORs) with 95% confidence intervals (CIs). A P value less than 0.05 (two-sided) was considered to indicate statistical significance The differences in RR among plaque calcification types and the association between vascular remodeling and clinical symptoms were analyzed.
UNASSIGNED: A total of 242 ICAs in 196 patients were included in this study, and 84 were symptomatic and 158 were asymptomatic. The RR in symptomatic ICA [median, 1.31 (interquartile range, 1.17-1.68)] was significantly greater than that in asymptomatic group [median, 1.20 (interquartile range, 1.05-1.45)], P=0.006). Significant differences in RR existed among plaque calcification types, among which type 5 and 6 plaques had the highest RR. About 71.5% (173/242) of all ICAs showed positive remodeling. Significant correlations were observed between RR and ischemic symptoms and between positive remodeling and calcification thickness (P<0.05 for all variables). On multivariable logistic regression analysis, calcification thickness remained significantly associated with positive remodeling of carotid arteries (OR 2.30; 95% CI: 1.06-5.01; P=0.036).
UNASSIGNED: Arterial remodeling exists in the ICA. A significant association between arterial positive remodeling and plaque calcification thickness was established. RR helps predict ischemic symptoms. The results of our study suggest that arterial remodeling serves as a novel measure to help ascertain the risk stratification of ischemic events in carotid atherosclerotic disease.
摘要：
动脉重塑是血管壁响应于动脉粥样硬化斑块生长的代偿机制。然而,颈动脉病变血管重塑的临床意义尚不清楚。通过这项研究,我们旨在评估颈内动脉（ICA）狭窄程度≥50％的患者血管重塑与缺血症状之间的关系，考虑斑块钙化模式的差异。
■这项回顾性横断面研究包括2018年9月至2023年3月期间浙江医院收治的与动脉粥样硬化斑块相关的中重度近端ICA狭窄的成年患者。管腔直径等参数，斑块钙化类型，钙评分,使用非对比和对比增强计算机断层扫描血管造影(CTA)评估钙化厚度.通过将斑块部位的动脉腔的内边界与斑块的外边界之间的近端ICA的最大距离除以腔直径来计算重塑率（RR）。记录动脉粥样硬化危险因素和用药情况。采用Mann-WhitneyU检验或卡方检验比较组间差异。使用Pearson相关系数测量相关性。使用多变量逻辑回归分析评估缺血症状的预测因子，结果表示为比值比(OR)，95%置信区间(CI)。P值小于0.05(双侧)被认为指示统计学显著性。分析斑块钙化类型之间的RR差异以及血管重塑与临床症状之间的关联。
■这项研究共纳入196名患者的242个ICA，有症状者84例,无症状者158例.症状性ICA的RR[中位数，1.31(四分位数间距，1.17-1.68)]显著高于无症状组[中位数，1.20(四分位数间距，1.05-1.45)],P=0.006)。斑块钙化类型之间RR存在显着差异，其中5型和6型斑块的RR最高。所有ICA中约有71.5%(173/242)显示阳性重塑。RR与缺血症状之间以及正重塑与钙化厚度之间存在显着相关性（所有变量均P<0.05）。在多变量逻辑回归分析中，钙化厚度与颈动脉重塑显著相关(OR2.30;95%CI:1.06-5.01;P=0.036)。
■动脉重构存在于ICA中。建立了动脉阳性重塑与斑块钙化厚度之间的显着关联。RR有助于预测缺血症状。我们的研究结果表明，动脉重塑是一种新的措施，可以帮助确定颈动脉粥样硬化疾病中缺血事件的风险分层。
■这项回顾性横断面研究包括2018年9月至2023年3月期间浙江医院收治的与动脉粥样硬化斑块相关的中重度近端ICA狭窄的成年患者。管腔直径等参数，斑块钙化类型，钙评分,使用非对比和对比增强计算机断层扫描血管造影(CTA)评估钙化厚度.通过将斑块部位的动脉腔的内边界与斑块的外边界之间的近端ICA的最大距离除以腔直径来计算重塑率（RR）。记录动脉粥样硬化危险因素和用药情况。采用Mann-WhitneyU检验或卡方检验比较组间差异。使用Pearson相关系数测量相关性。使用多变量逻辑回归分析评估缺血症状的预测因子，结果表示为比值比(OR)，95%置信区间(CI)。P值小于0.05(双侧)被认为指示统计学显著性。分析斑块钙化类型之间的RR差异以及血管重塑与临床症状之间的关联。
■这项研究共纳入196名患者的242个ICA，有症状者84例,无症状者158例.症状性ICA的RR[中位数，1.31(四分位数间距，1.17-1.68)]显著高于无症状组[中位数，1.20(四分位数间距，1.05-1.45)],P=0.006)。斑块钙化类型之间RR存在显着差异，其中5型和6型斑块的RR最高。所有ICA中约有71.5%(173/242)显示阳性重塑。RR与缺血症状之间以及正重塑与钙化厚度之间存在显着相关性（所有变量均P<0.05）。在多变量逻辑回归分析中，钙化厚度与颈动脉重塑显著相关(OR2.30;95%CI:1.06-5.01;P=0.036)。
■动脉重构存在于ICA中。建立了动脉阳性重塑与斑块钙化厚度之间的显着关联。RR有助于预测缺血症状。我们的研究结果表明，动脉重塑是一种新的措施，可以帮助确定颈动脉粥样硬化疾病中缺血事件的风险分层。
