Published online Jan 15, 2024. doi: 10.4239/wjd.v15.i1.72
Peer-review started: October 11, 2023
First decision: November 2, 2023
Revised: November 14, 2023
Accepted: December 13, 2023
Article in press: December 13, 2023
Published online: January 15, 2024
Processing time: 93 Days and 4 Hours
Intracranial atherosclerosis, a leading cause of stroke, involves arterial plaque formation.
This study explores the link between plaque remodelling patterns and diabetes using high-resolution vessel wall imaging (HR-VWI).
To investigate the factors of intracranial atherosclerotic remodelling patterns and the relationship between intracranial atherosclerotic remodelling and diabetes mellitus using HR-VWI.
Exploratory techniques were employed in this investigation, focusing on unraveling the intricate relationship between intracranial atherosclerosis and diabetes. A cohort of 94 individuals diagnosed with atherosclerosis in the middle cerebral artery or basilar artery was assembled for scrutiny. Rigorous data collection ensued, supplemented by HR-VWI. Employing sophisticated image postprocessing, the vascular area at the plaque and normal reference vessel were meticulously measured. The remodelling index (RI) served as a pivotal metric, categorizing patients into distinct remodelling groups. Statistical analyses illuminated pronounced associations between positive remodelling (PR) and heightened diabetes prevalence, substantiating the critical role of HR-VWI in delineating vascular nuances.
The study's findings illuminate compelling insights into the intricate dynamics of intracranial atherosclerosis. Notably, the PR group, identified through the RI, exhibited a significantly higher diabetes prevalence (45.2%) compared to intermediate remodelling and negative remodelling groups. This statistical distinction underscores the intimate connection between diabetes and atherosclerotic plaque characteristics. Additionally, the PR group demonstrated elevated serum cholesterol and triglyceride levels, reinforcing the correlation. Logistic regression analysis identified diabetes mellitus as an independent influencer in plaque-PR, further emphasizing its significance. The conclusive link between diabetic status and increased PR highlights the potential vulnerability and heightened stroke risk associated with intracranial atherosclerotic plaques in diabetic patients.
In summation, our research underscores the pivotal role of HR-VWI in elucidating the intricate dynamics of intracranial atherosclerosis. The PR observed in diabetic patients accentuates a concerning association, indicative of heightened plaque instability and an augmented risk of stroke. The distinct patterns unveiled through the RI delineate varying degrees of atherosclerotic changes, with the PR group exhibiting a pronounced correlation with diabetes mellitus. These findings not only enhance our understanding of plaque characteristics but also emphasize the critical importance of HR-VWI in identifying at-risk individuals. This study contributes valuable insights that may inform targeted interventions for diabetic patients with intracranial atherosclerosis, potentially mitigating the risk of stroke.
Our research opens avenues for further exploration and clinical implications. The identified correlation between PR and diabetes in intracranial atherosclerosis prompts future investigations into the underlying mechanisms. Understanding the intricate interplay between diabetes and plaque dynamics can inform tailored preventive strategies. Additionally, this study underscores the significance of HR-VWI as a diagnostic tool, suggesting its potential integration into routine clinical assessments for at-risk populations. Exploring therapeutic interventions that target plaque stability in diabetic patients may emerge as a crucial research direction, aiming to mitigate the heightened stroke risk. Overall, our findings pave the way for multidisciplinary collaborations and advancements in both diagnostic approaches and preventive measures for individuals with intracranial atherosclerosis and diabetes.