Abstract
Aim To evaluate carotid wall shear rate (WSR) in association with local and regional vascular stiffness in patients with hypertension (HTN) and atherosclerosis of peripheral arteries and to study the pattern of change of WSR in patients with HTN with increasing severity of peripheral artery atherosclerosis. Materials and Methods Study involved 133 patients with HTN, 65 men and 48 women, aged in average 57.9±10.8 years. All patients were divided into four groups in accordance with ultrasound morphologic classification of vessel wall. Duplex scanning of carotid and lower limb arteries was performed. Carotid-femoral (cfPWV) and carotid-radial (crPWV) pulse wave velocity (PWV) were measured. Local carotid stiffness was evaluated by carotid ultrasound. Results WSR of patients with plaques without and with hemodynamic disturbance was 416±128 s−1 and 405±117 s−1, respectively, which was significantly less than the WSR in patients with intact peripheral arteries – 546±112 s−1. Decreased carotid WSR was associated with increased crPVW, cfPWV, Peterson's elastic modulus, decreased distensibility, and distensibility coefficient. Conclusion In patients with HTN and atherosclerotic lesions of peripheral arteries, it is registered that the carotid WSR decreased with increasing severity of atherosclerosis. Decreased carotid WSR is associated with increased local carotid stiffness, regional vascular stiffness of muscular, and elastic vessels.
Highlights
Atherosclerosis is a systemic chronic inflammatory disease predominantly affecting muscular and elastic arteries, characterized by autoimmune response to arterial wall damaging with development of subintimal accumulation of lipids, immunocompetent cells, and smooth muscle cells [1]
Decreased carotid wall shear rate (WSR) was associated with increased crPVW, cfPWV, Peterson’s elastic modulus, decreased distensibility, and distensibility coefficient
In patients with HTN and atherosclerotic lesions of peripheral arteries, it is registered that the carotid WSR decreased with increasing severity of atherosclerosis
Summary
Atherosclerosis is a systemic chronic inflammatory disease predominantly affecting muscular and elastic arteries, characterized by autoimmune response to arterial wall damaging with development of subintimal accumulation of lipids, immunocompetent cells, and smooth muscle cells [1]. One of the most important forces is wall shear stress (WSS) that is tangential oriented and emerged under the action of viscosity generated by moving stream of blood to endothelial cells [4, 5]. The great role of WSS in regulation of endothelial cells state is established. It has been established that decreased WSS is a proatherogenic factor leading to activation of endothelium with increasing of subintimal accumulation of lipids and development of atheroma [9, 10]. Increased stiffness of subendothelial matrix induces increasing of permeability of endothelial layer and increasing of transendothelial migration of immunocompetent cells to subintimal space [11, 12]
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