Differences in carotid arterial morphology and composition between individuals with and without obstructive coronary artery disease: A cardiovascular magnetic resonance study

Objective: We sought to determine differences with cardiovascular
magnetic resonance (CMR) in the morphology and composition of the
carotid arteries between individuals with angiographically-defined
obstructive coronary artery disease (CAD, >= 50% stenosis,
cases) and those with angiographically normal coronaries ( no lumen
irregularities, controls). Methods and results: 191 participants
(50.3% female; 50.8% CAD cases) were imaged with a multi-sequence,
carotid CMR protocol at 1.5T. For each segment of the carotid,
lumen area, wall area, total vessel area (lumen area + wall area),
mean wall thickness and the presence or absence of calcification
and lipid-rich necrotic core were recorded bilaterally. In male CAD
cases compared to male controls, the distal bulb had a
significantly smaller lumen area (60.0 +/- 3.1 vs. 79.7 +/- 3.2
mm(2), p < 0.001) and total vessel area (99.6 +/- 4.0 vs. 119.8
+/- 4.1 mm(2); p < 0.001), and larger mean wall thickness (1.25
+/- 0.03 vs. 1.11 +/- 0.03 mm; p = 0.002). Similarly, the internal
carotid had a smaller lumen area (37.5 +/- 1.8 vs. 44.6 +/- 1.8
mm(2); p = 0.006) and smaller total vessel area (64.0 +/- 2.3 vs.
70.9 +/- 2.4 mm(2); p = 0.04). These metrics were not significantly
different between female groups in the distal bulb and internal
carotid or for either gender in the common carotid. Male CAD cases
had an increased prevalence of lipid-rich necrotic core (49.0% vs.
19.6%; p = 0.003), while calcification was more prevalent in both
male (46.9% vs. 17.4%; p = 0.002) and female (33.3% vs. 14.6%; p =
0.031) CAD cases compared to controls. Conclusion: Males with
obstructive CAD compared to male controls had carotid bulbs and
internal carotid arteries with smaller total vessel and lumen
areas, and an increased prevalence of lipid-rich necrotic core.
Carotid calcification was related to CAD status in both males and
females. Carotid CMR identifies distinct morphological and
compositional differences in the carotid arteries between
individuals with and without angiographically-defined obstructive
CAD.