| Objective:MRI carotid plaque analysis software(MRI-VPD)was used to explore the characteristics of carotid plaque in patients with hypertension and its different course of disease,so as to provide some basis for targeted intervention of carotid plaque in patients with hypertension and avoid the occurrence and development of stroke.Methods:Patients with carotid artery plaque confirmed by ultrasound examination in the Affiliated Hospital of Inner Mongolia University for Nationalities and the Second Clinical Hospital of Inner Mongolia University for Nationalities from December 2020 to August 2021 were collected and divided into hypertensive group and non-hypertensive group according to the latest guideline diagnostic criteria developed by the International Society of Hypertension(ISH).The eligible patients were examined by HRMRI carotid blood wall imaging,and the plaque composition was analyzed by MRI-VPD technology to evaluate vulnerable plaques.To study the characteristics of carotid plaque in hypertension group.Patients in the hypertension group were divided into grade 1 hypertension and grade 2 hypertension to compare the influence of each grade on the stability of carotid plaque.Finally,the relationship between carotid artery plaque and hypertension patients with different course of disease was analyzed.Results:A total of 59 patients were included in this study,including 33 patients in the hypertensive group and 26 patients in the non-hypertensive group.There was no statistical significance in age,gender,BMI,smoking history,blood lipid and stroke/TIA history in the two groups(P>0.05).Excluding poor image quality,63 plaques were detected,including 34 plaques in the hypertensive group and 29 plaques in the non-hypertensive group.There was no significant difference in the distribution of plaque in common carotid artery,bifurcation of common carotid artery and internal carotid artery between the two groups(P=0.747).Analysis of carotid plaque characteristics of the two groups showed that in hypertension group,unstable plaque was 26(76.5%),LRNC was 25(73.5%),LRNC%was 17.74±5.33,IPH was 10(29.4%),FCR was 8(23.5%),Ca was 22(64.7%).Non-hypertensive group:There were 7 unstable plaques(24.1%),8 LRNC(27.6%),11.44±5.15 LRNC%,7 IPH(24.1%),6 FCR(20.7%),20 Ca(69.0%).There were statistically significant differences in unstable plaque,LRNC and LRNC%between the two groups(P<0.001),while there were no statistically significant differences in IPH,FCR and Ca between the two groups(P>0.05).The ROC curve analysis of LRNC%in the plaques in the hypertension group showed that the area under the curve was 0.80,the 95%confidence interval was 0.69,0.92,the optimal diagnostic threshold was 14.85%,the sensitivity was 72.73%,and the specificity was 83.33%.There were 6(50.0%)and 20(90.9%)unstable plaques in grade 1 group and grade 2 group,respectively,and the difference in the incidence of unstable plaques between the two groups was statistically significant(P=0.013).In the hypertension group,there were 3,9 and 14 unstable plaques in<5 years,5-10 years and>10 years,respectively,and the difference was statistically significant(P=0.009).There were 1,1 and 8 IPH in plaque in the three groups,respectively,and the difference was statistically significant(P=0.033).There were 4,6 and 15 LRNCS in plaque in the three groups,respectively,and the difference was statistically significant(P=0.003).There was no significant difference in FCR and Ca among the three groups(P>0.05).Conclusion:1.Hypertension promotes the formation of LRNC components,especially LRNC%,which has potential value for stroke risk stratification.2.The longer the course and higher the grade of hypertension,the higher the incidence of vulnerable plaques;The incidence of IPH and LRNC in carotid plaque increased gradually with the increase of the course of hypertension.3.Mri-vpd is a histologically proven technique that can identify high-risk carotid atherosclerotic plaques at an early stage,thus hinting at its promise in predicting the risk of plaque rupture. |
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