From natural history studies, intraplaque hemorrhage (IPH) in the carotid atherosclerotic lesion has been associated with an acceleration of plaque burden growth and an increased risk of future stroke development. While there are clear indications of the critical sequelae consequent of IPH in the carotids, effects of medical therapy on IPH and the true neurological impact of IPH remain undetermined. The overall goal of this project is to determine if aggressive medical therapy alters the natural history of carotid atherosclerotic disease in patients with IPH. The central hypothesis of this proposal is that despite statin therapy and aggressive regulation of blood pressure, carotid lesions with IPH are irrecoverably compromised compared to carotid lesions without IPH. Since IPH has been recognized at all levels of carotid stenosis, the identification of benefits, if any, from medical therapy is a critical gap in the current knowledge of carotid atherosclerotic disease. Moreover, the identification of increased neurological ischemia (silent or overt) despite aggressive medical therapy may substantially alter the management in patients with IPH across all levels of stenosis.

Public Health Relevance

Despite ongoing research and increasing knowledge about atherosclerosis, heart disease and stroke remain the first and third leading causes of death, respectively, in the United States. This proposal seeks to investigate the mechanisms behind intraplaque hemorrhage-a component of atherosclerotic plaque- in the carotid artery by development of quantitative MRI techniques and the performance of a study to monitor the effectiveness of current medical therapies on patients with intraplaque hemorrhage. This may lead to improved diagnoses and medical therapies for these patients, as well as new techniques for the study of atherosclerosis.

Agency
National Institute of Health (NIH)
Institute
National Heart, Lung, and Blood Institute (NHLBI)
Type
Research Project (R01)
Project #
5R01HL103609-03
Application #
8472521
Study Section
Medical Imaging Study Section (MEDI)
Program Officer
Fleg, Jerome
Project Start
2011-07-25
Project End
2015-05-31
Budget Start
2013-06-01
Budget End
2014-05-31
Support Year
3
Fiscal Year
2013
Total Cost
$743,888
Indirect Cost
$316,161
Name
University of Washington
Department
Radiation-Diagnostic/Oncology
Type
Schools of Medicine
DUNS #
605799469
City
Seattle
State
WA
Country
United States
Zip Code
98195
Qi, Haikun; Sun, Jie; Qiao, Huiyu et al. (2017) Carotid Intraplaque Hemorrhage Imaging with Quantitative Vessel Wall T1 Mapping: Technical Development and Initial Experience. Radiology :170526
Chen, Shuo; Zhao, Huilin; Li, Jifan et al. (2017) Evaluation of carotid atherosclerotic plaque surface characteristics utilizing simultaneous noncontrast angiography and intraplaque hemorrhage (SNAP) technique. J Magn Reson Imaging :
Chen, Shuo; Ning, Jia; Zhao, Xihai et al. (2017) Fast simultaneous noncontrast angiography and intraplaque hemorrhage (fSNAP) sequence for carotid artery imaging. Magn Reson Med 77:753-758
Shu, Hongge; Sun, Jie; Hatsukami, Thomas S et al. (2017) Simultaneous noncontrast angiography and intraplaque hemorrhage (SNAP) imaging: Comparison with contrast-enhanced MR angiography for measuring carotid stenosis. J Magn Reson Imaging 46:1045-1052
Sun, Aiqi; Zhao, Bo; Ma, Ke et al. (2017) Accelerated phase contrast flow imaging with direct complex difference reconstruction. Magn Reson Med 77:1036-1048
Wang, Xianling; Sun, Jie; Zhao, Xihai et al. (2017) Ipsilateral plaques display higher T1 signals than contralateral plaques in recently symptomatic patients with bilateral carotid intraplaque hemorrhage. Atherosclerosis 257:78-85
Sun, Jie; Zhao, Xue-Qiao; Balu, Niranjan et al. (2017) Carotid Plaque Lipid Content and Fibrous Cap Status Predict Systemic CV Outcomes: The MRI Substudy in AIM-HIGH. JACC Cardiovasc Imaging 10:241-249
Yoneyama, Taku; Sun, Jie; Hippe, Daniel S et al. (2016) In vivo semi-automatic segmentation of multicontrast cardiovascular magnetic resonance for prospective cohort studies on plaque tissue composition: initial experience. Int J Cardiovasc Imaging 32:73-81
Daemen, Mat J; Ferguson, Marina S; Gijsen, Frank J et al. (2016) Carotid plaque fissure: An underestimated source of intraplaque hemorrhage. Atherosclerosis 254:102-108
Wang, Jinnan; Guan, Maobin; Yamada, Kiyofumi et al. (2016) In Vivo Validation of Simultaneous Non-Contrast Angiography and intraPlaque Hemorrhage (SNAP) Magnetic Resonance Angiography: An Intracranial Artery Study. PLoS One 11:e0149130

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