Impact of an individualized home-based physical activity intervention on carotid atherosclerotic plaque instability factors for non-endarterectomized patients

We recently shoved a link between physical activity (PA) and carotid intraplaque hemorrhage (IPH) on stroke asymptomatic patients (Mury, 2019). IPH is one of the main instability features of the plaque and predictor of ischemic stroke (Michel, 2015). Benefits of the endarterectomy surgery remain unclear for stroke asymptomatic patients; thus, more and more patients will not have surgery to remove the plaque (Naylor, 2015). Although, these patients need an adapted therapeutic treatment, and recommendations in PA should be given to them. PA has been shoved to decrease numerous of inflammatory markers involved in atherosclerosis (Palmefors 2014). IRM of the IPH has been shown to be the better non-invasive imaging technique to assess carotid plaque instability (Mura 2020). We want to assess the effect of a personalized home based 6 months physical activity intervention on carotid IPH and vulnerability factors for asymptomatic patients.

This study has been designed as a monocentric, longitudinal and interventional study (Type 1 Research). This study will involve the Vascular surgery Department of Hopital Louis Pradel (HCL, Lyon). After inclusion tests, patients will be randomly included in the control group, or in the PA group. Patients of this group will have connected bracelets to measure daily count of steps. Twice a month, daily goals will be revaluated to increase or maintain the steps per day. The final goal is to reach 6 000 steps per day or increase by 30% the initial count of steps per day. Plaque MRI, blood coagulation, inflammation and rheology as well as physical fitness will be done before and after 6 months of intervention for comparison.