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Association between physical activity and sedentary behaviour on carotid atherosclerotic plaques: an epidemiological and histological study in 90 asymptomatic patients
  1. Pauline Mury1,2,
  2. Mathilde Mura1,2,
  3. Nellie Della-Schiava3,
  4. Stéphanie Chanon4,
  5. Aurélie Vieille-Marchiset4,
  6. Virginie Nicaise5,
  7. Erica N Chirico6,
  8. Diane Collet-Benzaquen7,
  9. Patrick Lermusiaux3,
  10. Philippe Connes1,2,8,
  11. Antoine Millon3,9,
  12. Vincent Pialoux1,2,8
  1. 1 Interuniversity Laboratory of Human Movement Biology EA7424, University Claude Bernard Lyon 1, Villeurbanne, France
  2. 2 Laboratory of Excellence GR-Ex, Paris, France
  3. 3 Department ofVascular Surgery, Edouard Herriot Hospital, Lyon, France
  4. 4 CarMeN Laboratory, INSERM U1060, INRA 1397, University Claude Bernard Lyon 1, Pierre Bénite, France
  5. 5 Laboratory of Vulnerabilities and Innovation in Sport EA7428, University Claude Bernard Lyon 1, Villeurbanne, France
  6. 6 Department of Biomedical Sciences, CooperMedical School, Rowan University, Camden, NJ, USA
  7. 7 Department of Pathology, Edouard Herriot Hospital, Lyon, France
  8. 8 Institut Universitaire de France, Paris, France
  9. 9 CarMeN Laboratory, INSERM U1060, University Claude Bernard Lyon 1, Bron, France
  1. Correspondence to Prof Vincent Pialoux, Interuniversity Laboratory of Human Movement Science (LIBM EA7424), Université Claude Bernard Lyon 1, Université de Lyon, Villeurbanne Cedex 69622, France; vincent.pialoux{at}


Objective Carotid atherosclerotic plaques are a source of emboli for stroke. ‘Unstable’ carotid atherosclerotic plaques may have intraplaque haemorrhages, neovessels, prevalent macrophages, excessive calcium deposits, a large lipid core and a thin fibrous cap. Regular physical activity (PA) may lower the risk of plaques becoming unstable. We evaluated the association of both PA and sedentary behaviour (SB) with carotid plaque histopathology.

Methods 90 asymptomatic patients who were undergoing carotid endarterectomy for carotid artery narrowing identified on ultrasound reported their PA and SB by questionnaires. We calculated PA intensity in MET (metabolic equivalent of task)-min/week. For analysis, the population was divided into tertiles according to PA (T1PA: the less PA patients; T2PA: the intermediate PA patients; T3PA: the most physically active patients) (T1PA<T2PA<T3PA) and SB (T1SB: the less sedentary behaviour patients; T2SB: the intermediate sedentary behaviour patients; T3SB: the most sedentary behaviour patients) (T1SB<T2SB<T3SB). PA was categorised as one of four PA intensities (600, 900, 1600 and 3000 MET-min/week). We obtained the carotid artery plaque at surgery and performed histological analysis of intraplaque haemorrhages (present/absent), neovessels, macrophages, lipid core, calcium deposits and the fibrous cap.

Results Intraplaque haemorrhage was less frequent in the most physically active tertile (T3PA, 48%) versus T1PA (74%) and in the least sedentary tertile T1SB (50%) versus T3SB (71%). The intraplaque haemorrhage was less frequent in those who exercised more than 900 MET-min/week (59% vs 47% for >900 and <900 MET-min/week, respectively). All the other features that associate with plaque instability (eg, neovessels, macrophages, etc) did not differ by level of PA or SB.

Conclusion In this cross-sectional study of asymptomatic patients who underwent endarterectomy (i) higher reported PA, (ii) intensity of PA and (iii) lower reported SB were associated with lower prevalence of intraplaque haemorrhage. This could be a mechanism whereby PA protects against cerebrovascular disease (stroke) and death.

  • biology
  • cardiovascular
  • exercise physiology
  • physical activity
  • lipids

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  • AM and VP contributed equally.

  • Contributors PM, AM and VP participated in design the study. PM, MM, SC, AV-M and VN performed the experiments. PM, AM, MM, ND-S and PL included the patients. PM, AM, PC and VP analysed and interpreted the results. PM, AM and VP wrote the manuscript. PM, MM, ND-S, VN, ENC, AM, PC and VP wrote and edited the manuscript.

  • Funding This study was funded by the Institut Universitaire de France.

  • Competing interests The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

  • Ethics approval This study was approved by the ‘Hospices Civils de Lyon — CPP Est’.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Patient consent for publication Obtained.