Abstract
BackgroundAssociations between carotid artery longitudinal displacement, cardiovascular disease risk factors, and events were evaluated in a large, multi-ethnic cohort.Materials and MethodsA novel, reproducible protocol was developed for measuring right common carotid artery longitudinal displacement using ultrasound speckle-tracking. Total longitudinal displacement was measured in 389 randomly selected participants from the Multi-Ethnic Study of Atherosclerosis that were free of cardiovascular disease at baseline. Univariate analyses and Pearson Correlations were used to define relationships between longitudinal displacement with traditional cardiovascular risk factors and traditional measures of arterial stiffness. Hazard ratios of longitudinal displacement for cardiovascular disease and coronary heart disease events were compared using Cox proportional hazards models.ResultsParticipants were a mean (standard deviation) 59.0 (8.7) years old, 48% female, 39% White, 26% Black, 22% Hispanic, and 14% Chinese. They had 19 (4.9%) cardiovascular disease and 14 (3.6%) coronary heart disease events over a mean 9.5 years of follow-up. Less longitudinal displacement was associated with Chinese (β = -0.11, p = 0.02) compared to White race/ethnicity and greater longitudinal displacement was associated with higher carotid intima-media thickness (β = 0.26, p = 0.004). Longitudinal displacement was not associated with other cardiovascular disease risk factors or markers of arterial stiffness. After adjustment for age and sex, and heart rate, Chinese race/ethnicity (β = -0.10, p = 0.04) and carotid intima-media thickness (β = 0.30 p = 0.003) were associated independently with longitudinal displacement. Longitudinal displacement predicted coronary heart disease (Hazard ratio [HR] 3.3, 95% Confidence intervals [CI] 0.96–11.14, p = 0.06) and cardiovascular disease (HR 2.1, 95% CI 0.6–7.3, p = 0.23) events.ConclusionsLess longitudinal displacement is associated with Chinese ethnicity and greater carotid artery longitudinal displacement is associated with thicker intima-media thickness. Longitudinal displacement may predict adverse coronary heart disease and cardiovascular disease events.
Highlights
Arterial stiffness is associated with development of hypertension, heart failure, stroke, and myocardial infarction [1, 2]
Less longitudinal displacement was associated with Chinese (β = -0.11, p = 0.02) compared to White race/ethnicity and greater longitudinal displacement was associated with higher carotid intima-media thickness (β = 0.26, p = 0.004)
Longitudinal displacement was not associated with other cardiovascular disease risk factors or markers of arterial stiffness
Summary
Arterial stiffness is associated with development of hypertension, heart failure, stroke, and myocardial infarction [1, 2]. The most commonly obtained carotid arterial stiffness measurements, distensibility coefficient (DC) and Young’s Elastic Modulus (YEM), evaluate radial or circumferential arterial displacement [2, 3] Because they assume that longitudinal arterial movement is negligible compared to radial movement, they are imperfect markers of arterial pathophysiology [4]. Prior studies that used carotid artery VVI to describe arterial motion were small [8, 9, 12] or did not evaluate longitudinal motion [13,14,15] Those studies that did evaluate longitudinal movement had conflicting results with unclear risk factor associations or made geometric assumptions about arterial movements that may not be correct [7, 8, 16, 17]. Associations between carotid artery longitudinal displacement, cardiovascular disease risk factors, and events were evaluated in a large, multi-ethnic cohort
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