Early Detection of Vascular Dysfunction Using Biomarkers From Lagrangian Carotid Strain Imaging
Early Detection of Vascular Dysfunction Using Biomarkers From Lagrangian Carotid Strain Imaging
The purpose of this research is assess imaging and identification of soft plaque that
 undergoes large deformations or strain will identify plaque vulnerable to rupture which could
 lead to 'silent strokes'. Validation of current study results with MRI will foster use of
 real-time ultrasound (US) strain imaging and strain indices as a screening tool for
 identifying normal human participants susceptible to increased vascular aging and developing
 plaque prone to rupture or micro-embolization.

 Current research will evaluate Lagrangian carotid strain imaging (LCSI) for prediction of
 vascular health on volunteers. In this study, investigators will evaluate age-related strain
 variations (due to plaque deposition) in the carotid artery, establishing groundwork that
 will help identify typical and atypical values for these indices. Investigator's hypothesis
 is that plaques with higher strain indices (softer plaques) are more prone to rupture than
 plaques with lower strain indices (stiffer) plaques, thus requiring intervention. Clinical
 criteria for treatment has focused primarily on the degree of stenosis. Long-term objectives
 are to provide non-invasive methods for screening participants at risk for vascular aging or
 plaque rupture in asymptomatic participants, expanding upon current criteria for risk
 assessments based on focal transient ischemic attack (TIA) or strokes. Variations in vessel
 strain have been associated with, or are precursors to, plaque deposition, vascular aging, or
 cerebrovascular diseases. Increased arterial strain and pressure changes have been linked to
 brain aging using magnetic resonance imaging (MRI) based vascular indices, and memory
 deficits commonly linked to Alzheimer dementia. Stiffening and thickening of the arterial
 walls have also been associated with cerebrovascular disease. Investigators hypothesize that
 strain indices as vascular biomarkers can be utilized for screening possible 'vulnerable
 participants' validated with MRI, with the potential ability to improve endothelial function
 and reverse vascular aging. Strain indices may enable differentiating study participants with
 vascular cognitive impairment (VCI) from other dementias. Cognitive testing is unable to make
 this differentiation.
Inclusion Criteria:

 Aim 1 (Ultrasound (US) only):

 -  Adults at least 18 years

 -  Are able to provide written informed consent on their own behalf

 Aim 2 (US and MRI):

 -  Participation in the US study (Aim 1)

 -  Determined by presence of hypoechogenic or echolucent lipid-rich soft plaque during
 initial ultrasound imaging session

 -  Adults 40-60 years willing to participate over 5 years

 Exclusion Criteria:

 Aim 1 (US only)

 -  Women that are currently pregnant

 -  Inability to cooperate with the ultrasound study, in particular those unable to sit
 without gross movement for the duration the ultrasound study (estimated at 30-60
 minutes)

 -  Open wounds or sores in the anterior neck

 -  History of cardiac disease, stroke or TIA

 -  History of statin medication

 Aim 2 (US and MRI):

 -  Women that are currently pregnant

 -  Inability to cooperate with the ultrasound study, in particular those unable to sit
 without gross movement for the duration the ultrasound study (estimated at 30-60
 minutes)

 -  Patients that require sedative medication for imaging

 -  Contraindications to MR

 -  Unable to lie in the MRI scanner for 45-60 minutes

 -  Patients with a contraindication to gadolinium based contrast agents, including
 allergy or impaired renal function (per University of Wisconsin Health Guidelines)