Lu Mingming, Peng Peng, Qiao Huiyu, Cui Yuanyuan, Ma Lu, Cui Bao, Cai Jianming, Zhao Xihai
Department of Radiology, PLA General Hospital, Beijing, 100853, China.
Department of Radiology, Pingjin Hospital, Logistics University of Chinese People's Armed Police Forces, Tianjin, China.
Int J Cardiovasc Imaging. 2019 Jul;35(7):1287-1295. doi: 10.1007/s10554-019-01538-4. Epub 2019 Feb 9.
This study aimed to investigate the association between age and progression of carotid atherosclerotic plaques using serial high resolution magnetic resonance imaging (MRI). Symptomatic patients who had carotid atherosclerosis with 30-70% stenosis were enrolled in this study. Carotid MRI was performed at baseline and follow-up time point (≥ 6 months after baseline), respectively. The characteristics of carotid plaque progression among different age groups (> 75 years old, 60-75 years old and < 60 years old) were compared. Logistic regression was performed to relate age with carotid plaque progression. Of recruited 84 patients, 73 (mean age, 66.5 ± 11.4 years old; males, 82.2%) with 96 plaques were included in the final analysis. Compared with younger patients, older ones had significantly higher incidence of calcification in carotid plaques (> 75 years old: 91.3%, 60-75 years old: 65.7% and < 60 years old: 55.3%, p = 0.013), greater annual change of carotid wall volume (> 75 years old: 39.0 (4.3-104.6) mm, 60-75 years old: 28.7 (- 28.0 to 73.7) mm and < 60 years old: 4.8 (- 27.1-31.9) mm, p = 0.032) and maximum carotid wall area (> 75 years old: 6.1 (- 3.5 to 17.2) mm, 60-75 years old: 2.4 (- 4.7 to 15.1) mm and < 60 years old: 1.4 (- 5.8 to 6.9) mm, p = 0.046). Age (OR 1.44; 95% CI 1.10-1.89; p = 0.009) and hypertension (OR 4.61; 95% CI 1.41-15. 02; p = 0.011) were independent predictors in discriminating upper quartile of annual change of carotid wall volume after adjusting for all clinical factors. Older patients have faster progression rate in carotid plaques than younger ones and age is independently associated with carotid plaque progression. Our findings suggest that the carotid plaques of older patients need to be monitored more frequently.
本研究旨在通过系列高分辨率磁共振成像（MRI）探讨年龄与颈动脉粥样硬化斑块进展之间的关联。本研究纳入了有30%-70%狭窄的颈动脉粥样硬化症状性患者。分别在基线和随访时间点（基线后≥6个月）进行颈动脉MRI检查。比较了不同年龄组（>75岁、60-75岁和<60岁）颈动脉斑块进展的特征。进行逻辑回归以分析年龄与颈动脉斑块进展的关系。在招募的84例患者中，最终分析纳入了73例（平均年龄66.5±11.4岁；男性占82.2%）共96个斑块。与年轻患者相比，老年患者颈动脉斑块钙化发生率显著更高（>75岁：91.3%，60-75岁：65.7%，<60岁：55.3%，p=0.013），颈动脉壁体积的年变化更大（>75岁：39.0（4.3-104.6）mm，60-75岁：28.7（-28.0至73.7）mm，<60岁：4.8（-27.1至31.9）mm，p=0.032）以及最大颈动脉壁面积更大（>75岁：6.1（-3.5至17.2）mm，60-75岁：2.4（-4.7至15.1）mm，<60岁：1.4（-5.8至6.9）mm，p=0.046）。在调整所有临床因素后，年龄（OR 1.44；95%CI 1.10-1.89；p=0.009）和高血压（OR 4.61；95%CI 1.41-15.02；p=0.011）是区分颈动脉壁体积年变化上四分位数的独立预测因素。老年患者颈动脉斑块进展速度比年轻患者更快，且年龄与颈动脉斑块进展独立相关。我们的研究结果表明，需要更频繁地监测老年患者的颈动脉斑块。
