Ultrasound elastography assessment of increased carotid artery wall stiffness in human immunodeficiency virus infected patients

Abstract

Prevalence of cardiovascular diseases is higher in HIV subjects when compared to the general population. The chronic immune stimulation and low grade inflammation are possible causes. Carotid artery strain and motion are proposed as markers of premature atherosclerosis. Seventy-four HIV infected and 75 age-matched control subjects were recruited from a prospective, controlled cohort study (mean age 56 years ± 8; 128 men). Elastography applied to longitudinal ultrasound images of common and internal carotid arteries quantified the cumulated axial strain, cumulated shear strain, cumulated axial translation, and cumulated lateral translation. Presence of plaque was also assessed. Association between elastography biomarkers and HIV status were evaluated with Mann–Whitney tests and multivariate linear regression models. A higher occurrence of carotid plaques was found in HIV infected individuals (p = 0.011). Lower cumulated lateral translations were found in HIV infected subjects on both common and internal carotid arteries (p = 0.037 and p = 0.026, respectively). These observations remained significant when considering multivariable models including common cardiovascular risk factors and clinical characteristics (p< 0.05). Lower cumulated axial strains were also observed in internal carotid arteries when considering both multivariate models (p< 0.05). Lower translation and strain of the carotid artery wall in HIV infected individuals, which indicate increased vessel wall stiffness, could be new biomarkers of premature atherosclerosis.