Assessment of peripheral arterial structural and stiffness changes in patients with lower extremity atherosclerotic disease by quality intima-media thickness and quality arterial stiffness techniques

Abstract

Objective To assess the peripheral arterial structural and elastic remodeling in patients with lower extremity atherosclerotic disease (LEAD).Methods Thirty-one patients with LEAD and 34 age-,sex-matched healthy subjects (control group) were enrolled in this study.The intima-media thickness (IMT),diameter (D) and parameters of arterial stiffness (β,pulse wave velocity (PWVβ)) were measured by acquiring the longitudinal view of left and right common femoral artery (LCFA,RCFA) and common carotid artery (LCCA,RCCA) by quality intima-media thickness (QIMT) and quality arterial stiffness (QAS) techniques.The factors correlated with arterial stiffness in LEAD patients were analyzed.Results ① The systolic blood pressure(SBP),pulse pressure(PP),smoking pack-year and smoking extent (nonsmoker,smoker with ＜40 pack-year,or smoker with ≥40 pack-year) were significantly higher in LEAD group than those in the control group (P ＜0.05).②IMT of the LCCA and the diameters (D) of LCCA and RCCA were significantly increased in the LEAD group (P ＜0.05-0.01).As to the both sides CFA,IMT and IMT/D values were significantly increased (P ＜ 0.01).The mean IMT (mIMT) of both sides of CCA and CFA were increased (P ＜0.05).The values of β,PWVβ of LCCA and PWVβ of RCCA were significantly increased,and β and PWVβ values of both sides of CFA were significantly increased in the LEAD group (P ＜ 0.05).There was a positive correlation between the stiffness indexes of the carotid artery and that of the femoral artery (P ＜0.01).③The femoral mβ was correlated with femoral mIMT,SBP,PP,smoking amount and smoking extent,and the femoral mPWVβ was also correlated with mIMT,age,SBP,PP,smoking pack-year and smoking extent (P ＜0.05-0.01).In multivariable stepwise regression analysis,mIMT and PP were factors independently correlated with femoral mβ.And SBP,smoking extent,and mIMT were independently correlated with femoral mPWVβ.Conclusions Peripheral arteries in patients with LEAD experience vascular remodeling,as well as increased carotid and femoral stiffness.Femoral stiffness is correlated with IMT,arterial blood pressure and smoking extent. Key words: Elasticity imaging techniques; Atherosclerosis; Carotid arteries; Femoral artery; Stiffness ; Remodeling