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. 2022 Apr 1;29(4):492-501.
doi: 10.5551/jat.61275. Epub 2021 Apr 8.

Impact of H-Type Hypertension on Intraplaque Neovascularization Assessed by Contrast-Enhanced Ultrasound

Yuting Tan  1 , Fang Nie  1 , Guode Wu  2 , Fangzhou Guo  1 , Yanqing Wang  1 , Longli Wang  1
Affiliations

Impact of H-Type Hypertension on Intraplaque Neovascularization Assessed by Contrast-Enhanced Ultrasound

Yuting Tan et al. J Atheroscler Thromb. .

Abstract

Aim: H-type hypertension is connected with carotid atherosclerotic plaques and stroke, whereas neovascularization is a dominant contributor to plaque vulnerability. However, the correlation between H-type hypertension and plaque vulnerability remains unclear. This study aims to explore the influence of H-type hypertension on intraplaque neovascularization (IPN).

Methods: We enrolled 235 patients with carotid plaques into the investigation and classified them into four groups: H-type hypertension group, simple hypertension group, isolated hyperhomocysteinemia group, and control group. Contrast-enhanced ultrasound (CEUS) was performed on them and IPN was evaluated using semi-quantitative visual grading: grade 1 (no microbubbles or microbubbles limited to the adventitial side and/or shoulder of plaque) and, grade 2 (diffused microbubbles within plaque or microbubbles enter plaque core). To analyze the correlation between H-type hypertension and the degree of plaque enhancement, logistic regression was used.

Results: Compared with those with CEUS grade 1 plaques, those with CEUS grade 2 plaques had higher frequency of ischemic stroke (29.0% vs. 45.1%, P＜0.05), hypertension (41.0% vs. 56.3%, P＜0.05), and H-type hypertension (18.0% vs. 29.6%, P＜0.05). No significant differences existed in plaque morphology, plaque echogenicity, and the severity of carotid artery stenosis between the degree of plaque enhancement (all P＞0.05). H-type hypertension (multivariate-adjusted OR: 3.036, 95% CI: 1.258-7.329) was independently connected with the degree of plaque enhancement even after adjusting for other covariates.

Conclusion: H-type hypertension is expressly connected with the degree of plaque enhancement and may facilitate plaque vulnerability. Our findings may offer a new insight for treating vulnerable plaque, lowering blood pressure, and lowering homocysteine equally crucial.

Keywords: Carotid atherosclerotic plaque; Contrast-enhanced ultrasound; H-type hypertension; Ischemic stroke; Neovascularization.

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Figures

Fig.1.
Fig.1.
The selection flowchart of patients
Fig.2. IPN grading of CEUS
Fig.2. IPN grading of CEUS
A, Grade 1: no microbubbles within the plaque (white arrows). B, Grade 2: extensive microbubbles within the ulcerative plaque (white arrows).
See this image and copyright information in PMC

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