Morphometric analysis of calcification and fibrous layer thickness in carotid endarterectomy tissues

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dc.citation.firstpage210en_US
dc.citation.journalTitleComputers in Biology and Medicineen_US
dc.citation.lastpage219en_US
dc.citation.volumeNumber70en_US
dc.contributor.authorHan, Richard I.en_US
dc.contributor.authorWheeler, Thomas M.en_US
dc.contributor.authorLumsden, Alan B.en_US
dc.contributor.authorReardon, Michael J.en_US
dc.contributor.authorLawrie, Gerald M.en_US
dc.contributor.authorGrande-Allen, K. Janeen_US
dc.contributor.authorMorrisett, Joel D.en_US
dc.contributor.authorBrunner, Gerden_US
dc.contributor.orgBioengineeringen_US
dc.date.accessioned2017-05-09T20:16:07Zen_US
dc.date.available2017-05-09T20:16:07Zen_US
dc.date.issued2016en_US
dc.description.abstractBackground: Advanced atherosclerotic lesions are commonly characterized by the presence of calcification. Several studies indicate that extensive calcification is associated with plaque stability, yet recent studies suggest that calcification morphology and location may adversely affect the mechanical stability of atherosclerotic plaques. The underlying cause of atherosclerotic calcification and the importance of intra-plaque calcium distribution remains poorly understood. Method: The goal of this study was the characterization of calcification morphology based on histological features in 20 human carotid endarterectomy (CEA) specimens. Representative frozen sections (10 μm thick) were cut from the common, bulb, internal and external segments of CEA tissues and stained with von Kossa׳s reagent for calcium phosphate. The morphology of calcification (calcified patches) and fibrous layer thickness were quantified in 135 histological sections. Results: Intra-plaque calcification was distributed heterogeneously (calcification %-area: bulb segment: 14.2±2.1%; internal segment: 12.9±2.8%; common segment: 4.6±1.1%; p=0.001). Calcified patches were found in 20 CEAs (patch size: <0.1mm2 to >1.0mm2). Calcified patches were most abundant in the bulb and least in the common segment (bulb n=7.30±1.08; internal n=4.81±1.17; common n=2.56±0.56; p=0.0007). Calcified patch circularity decreased with increasing size (<0.1 mm2: 0.77±0.01, 0.1–1 mm2: 0.62±0.01, >1.0 mm2: 0.51±0.02; p=0.0001). A reduced fibrous layer thickness was associated with increased calcium patch size (p<0.0001). Conclusions: In advanced carotid atherosclerosis, calcification appears to be a heterogeneous and dynamic atherosclerotic plaque component, as indicated by the simultaneous presence of few large stabilizing calcified patches and numerous small calcific patches. Future studies are needed to elucidate the associations of intra-plaque calcification size and distribution with atherothrombotic events.en_US
dc.identifier.citationHan, Richard I., Wheeler, Thomas M., Lumsden, Alan B., et al.. "Morphometric analysis of calcification and fibrous layer thickness in carotid endarterectomy tissues." <i>Computers in Biology and Medicine,</i> 70, (2016) Elsevier: 210-219. https://doi.org/10.1016/j.compbiomed.2016.01.019.en_US
dc.identifier.doihttps://doi.org/10.1016/j.compbiomed.2016.01.019en_US
dc.identifier.urihttps://hdl.handle.net/1911/94217en_US
dc.language.isoengen_US
dc.publisherElsevieren_US
dc.rightsThis is an author's peer-reviewed final manuscript, as accepted by the publisher. The published article is copyrighted by Elsevier.en_US
dc.subject.keywordcarotid endarterectomyen_US
dc.subject.keywordcalcificationen_US
dc.subject.keywordimage analysisen_US
dc.subject.keywordcarotid bifurcationen_US
dc.subject.keywordfibrous layeren_US
dc.titleMorphometric analysis of calcification and fibrous layer thickness in carotid endarterectomy tissuesen_US
dc.typeJournal articleen_US
dc.type.dcmiTexten_US
dc.type.publicationpost-printen_US
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