Carotid Stiffness Index Research Articles

Local carotid stiffness, hemodynamic forces and blood viscosity in patients with cerebral lacunar infarctions.

The carotid stiffness is an important factor in the pathogenesis of cerebrovascular small vessel disease. Our study aimed to evaluate the relation of the local arterial stiffness of the common carotid artery (CCA) to the hemodynamic forces and blood viscosity in patients with cerebral lacunar infarctions (LI). Twenty-two patients with chronic LI and 15 age-matched controls were examined. An ultrasound examination of the CCA intima-media thickness (IMT), the parameters of local CCA stiffness: distensibility (DC) and compliance coefficients (CC), α and β stiffness indices and pulse wave velocity (PWV) was performed. The local hemodynamic forces were calculated: circumferential wall tension (CWT) and wall shear stress (WSS). Whole blood viscosity (WBV) and shear stresses at shear rates of 0.277 s-1 to 94.5 s-1 were measured in patients and controls. Higher values of IMT, a significant decrease of DC and CC and an increase of α and β stiffness indices and PWV in the LI patients compared to the controls were obtained. A parallel significant increase in CWT and a decrease in WSS was found. An increase in WBV and a significant increase in shear stresses were detected. In the LI patients, the increased stiffness indices were associated with an increase in age, cholesterol and WBV at higher shear rates in the left CCA. In the controls, the IMT and stiffness indices correlated significantly with the hemodynamic factors and WBV in both CCAs, while the stiffness indices correlated with the hemodynamic forces in the left CCA. The results of the present study demonstrate different associations of the local carotid stiffness indices with the hemodynamic forces and WBV in patients with LI and controls.

Circulating leptin is associated with adverse vascular changes in young adult survivors of childhood cancer.

Proteomics may help discover novel biomarkers and underlying mechanisms for cardiovascular disease. This could be useful for childhood cancer survivors as they show an increased risk of cardiovascular disease. The aim of this study was to investigate circulating cardiovascular proteins in young adult survivors of childhood cancer and their relationship to previously reported subclinical cardiovascular disease. Ninety-two cardiovascular proteins were measured in 57 childhood cancer survivors and in 52 controls. For proteins that were significantly different between childhood cancer survivors and controls, we performed correlations between protein levels and measures of peripheral arterial stiffness (carotid distensibility and stiffness index, and augmentation index) and endothelial dysfunction (reactive hyperemia index). Leptin was significantly higher in childhood cancer survivors compared to controls (normalized protein expression units: childhood cancer survivors 6.4 (1.5) versus 5.1 (1.7), p < 0.0000001) after taking multiple tests into account. Kidney injury molecule-1, MER proto-oncogene tyrosine kinase, selectin P ligand, decorin, alpha-1-microglobulin/bikunin precursor protein, and pentraxin 3 showed a trend towards group differences (p < 0.05). Among childhood cancer survivors, leptin was associated with anthracycline treatment after adjustment for age, sex, and body mass index (p < 0.0001). Higher leptin correlated with lower carotid distensibility after adjustment for age, sex, body mass index, and treatments with radiotherapy and anthracyclines (p = 0.005). This proteomics approach identified that leptin is higher in young asymptomatic adult survivors of childhood cancer than in healthy controls and is associated with adverse vascular changes. This could indicate a role for leptin in driving the cardiovascular disease burden in this population.

Rigidez carotídea y riesgo de eventos vasculares y mortalidad: el estudio REGICOR

Introduction and objectivesThe aims of this study were to determine the dose-response association of carotid arterial stiffness with vascular outcomes and overall mortality, and to assess their added predictive capacity. MethodsPopulation-based cohort study including 6468 individuals, with a median follow-up of 6.5 years. Six carotid artery stiffness indices were assessed: strain, stiffness, Peterson elasticity coefficient, compliance coefficient, distensibility coefficient, and pulse wave velocity (PWV). Incident coronary, cerebrovascular, global vascular, and total fatal events were identified. ResultsCarotid compliance and distensibility coefficients were not associated with any of the outcomes. Carotid stiffness, Peterson elasticity coefficient, and PWV showed a direct linear relationship to cerebrovascular disease: the risk increased by 8% (95%CI, 1-16) per stiffness unit increase, by 7% (95%CI, 2-13) per 10-unit Peterson elasticity coefficient increase, and by 26% (95%CI, 8-48) per PWV unit increase. Carotid strain showed a nonlinear association with ischemic heart disease. When strain was ≤ 0.09 units, each 0.01-unit increase was associated with a 15% lower risk of coronary events (95%CI,−33 to 6); above 0.09 units, each 0.01 increase in strain was associated with a 16% higher risk of coronary events (95%CI, 6-27). The addition of the stiffness indices did not improve the predictive capacity of validated risk functions. ConclusionsCarotid stiffness, Peterson elasticity coefficient, and PWV have a direct linear association with cerebrovascular disease risk. Carotid strain is not linearly related to U-shaped ischemic heart disease risk. The inclusion of these indexes does not improve the predictive capacity of risk functions.

Carotid artery stiffness and risk of vascular events and mortality: the REGICOR study

Introduction and objectivesThe aims of this study were to determine the dose-response association of carotid arterial stiffness with vascular outcomes and overall mortality, and to assess their added predictive capacity. MethodsPopulation-based cohort study including 6468 individuals, with a median follow-up of 6.5 years. Six carotid artery stiffness indices were assessed: strain, stiffness, Peterson elasticity coefficient, compliance coefficient, distensibility coefficient, and pulse wave velocity (PWV). Incident coronary, cerebrovascular, global vascular, and total fatal events were identified. ResultsCarotid compliance and distensibility coefficients were not associated with any of the outcomes. Carotid stiffness, Peterson elasticity coefficient, and PWV showed a direct linear relationship to cerebrovascular disease: the risk increased by 8% (95%CI, 1-16) per stiffness unit increase, by 7% (95%CI, 2-13) per 10-unit Peterson elasticity coefficient increase, and by 26% (95%CI, 8-48) per PWV unit increase. Carotid strain showed a nonlinear association with ischemic heart disease. When strain was ≤ 0.09 units, each 0.01-unit increase was associated with a 15% lower risk of coronary events (95%CI,−33 to 6); above 0.09 units, each 0.01 increase in strain was associated with a 16% higher risk of coronary events (95%CI, 6-27). The addition of the stiffness indices did not improve the predictive capacity of validated risk functions. ConclusionsCarotid stiffness, Peterson elasticity coefficient, and PWV have a direct linear association with cerebrovascular disease risk. Carotid strain is not linearly related to U-shaped ischemic heart disease risk. The inclusion of these indexes does not improve the predictive capacity of risk functions.

Central and local arterial stiffness in White Europeans compared to age-, sex-, and BMI-matched South Asians.

Ethnicity impacts cardiovascular disease (CVD) risk, and South Asians demonstrate a higher risk than White Europeans. Arterial stiffness is known to contribute to CVD, and differences in arterial stiffness between ethnicities could explain the disparity in CVD risk. We compared central and local arterial stiffness between White Europeans and South Asians and investigated which factors are associated with arterial stiffness. Data were collected from cohorts of White Europeans (the Netherlands) and South Asians (India). We matched cohorts on individual level using age, sex, and body mass index (BMI). Arterial stiffness was measured with ARTSENS® Plus. Central stiffness was expressed as carotid-femoral pulse wave velocity (cf-PWV, m/s), and local carotid stiffness was quantified using the carotid stiffness index (Beta) and pressure-strain elastic modulus (Epsilon, kPa). We compared arterial stiffness between cohorts and used multivariable linear regression to identify factors related to stiffness. We included n = 121 participants per cohort (age 53±10 years, 55% male, BMI 24 kg/m2). Cf-PWV was lower in White Europeans compared to South Asians (6.8±1.9 vs. 8.2±1.8 m/s, p<0.001), but no differences were found for local stiffness parameters Beta (5.4±2.4 vs. 5.8±2.3, p = 0.17) and Epsilon (72±35 vs. 70±31 kPa, p = 0.56). Age (standardized β, 95% confidence interval: 0.28, 0.17-0.39), systolic blood pressure (0.32, 0.21-0.43), and South Asian ethnicity (0.46, 0.35-0.57) were associated with cf-PWV; associations were similar between cohorts (p>0.05 for interaction). Systolic blood pressure was associated with carotid stiffness in both cohorts, whereas age was associated to carotid stiffness only in South Asians and BMI only in White Europeans. Ethnicity is associated with central but not local arterial stiffness. Conversely, ethnicity seems to modify associations between CVD risk factors and local but not central arterial stiffness. This suggests that ethnicity interacts with arterial stiffness measures and the association of these measures with CVD risk factors.

Estimated pulse wave velocity as a measure of vascular aging.

Carotid-femoral pulse wave velocity (cfPWV), the referent measure of aortic stiffness, is an established measure of vascular aging. In studies where cfPWV cannot be measured, alternative methods are needed to help promote research on vascular aging. This study examines the construct validity of a measure of PWV estimated from age and blood pressure (ePWV). The specific aims of the study are to: 1) explore the strength of association between ePWV, cfPWV, and other established measures of vascular aging; 2) examine the sensitivity and specificity of elevated ePWV (≥10m/s) in relation to elevated cfPWV (≥10m/s). We measured cfPWV in two-hundred and fifty-two adults (mean age 57±12 years, 48% female) and calculated each participant's ePWV from their age and brachial blood pressure. Additional measures of vascular aging included: carotid intima-media thickness (cIMT); carotid stiffness measured as elastic modulus (cEp); and carotid augmentation index (cAIx). The correlations between cfPWV and measures of vascular aging were: cEp (r = 0.36), cIMT (r = 0.49), and cAIx (r = 0.04). The correlations between ePWV and measures of vascular aging were: cEp (r = 0.45), cIMT (r = 0.60), and cAIx (r = 0.24). The correlation between ePWV and cfPWV was (r = 0.67). The sensitivity and specificity of elevated ePWV (≥ 10 m/s) for concomitantly identifying high cfPWV (≥ 10 m/s) were 85.4% and 73.0% respectively. ePWV is associated with established measures of vascular aging, such as carotid thickness, carotid stiffness and carotid augmentation index. ePWV may be a useful tool to help promote research on vascular aging.

Clinical Value of Echo-Tracking in Gestational Diabetes Mellitus.

Vascular endothelial function plays an essential role in gestational diabetes mellitus (GDM) pathogenesis. Vascular elasticity is evaluated by the echo-tracking (ET) technique. In this study, we aimed to assess the clinical value of the ET technique in women with GDM and provide a basis for early evaluation and prevention of gestational diabetes. Sixty-five patients with GDM and 65 gestational week-matched normal glucose tolerance pregnant women were enrolled in this study. The endothelial function parameters of pressure-strain elasticity coefficient (EP), the common carotid stiffness index (β), arterial compliance (AC), single-point pulsed-wave velocity (PWVβ), and augment index (AI) of bilateral common carotid arteries, were compared between the GDM and control groups by using ET technique. The correlations between plasma glucose levels and ET parameters were also analyzed. Our results indicated that EP, β, PWVβ, and AI were significantly higher in the GDM group (p<0.05), whereas AC was significantly lower in patients with GDM than in the control group (p<0.001). In addition, fasting plasma glucose and plasma glucose level after 2 h oral glucose tolerance test was correlated with ET parameters of EP, β, PWVβ, AI, and AC. The application of ET technology to gestational diabetes women could provide a basis for early evaluation and prevention of gestational diabetes. It would detect early and accurate signs of diabetes in pregnant women and provide a timely and reasonable clinical treatment plan to reduce and delay the occurrence of complications.

Maximum Aerobic Exercise Induces Common Carotid Vasoconstriction And Increased Vascular Resistance

Michael Diaz, Zaria Opara, Heysel Morales, Steven Hawkins, Louise Kelly, Allan Knox PURPOSE: Low-to-moderate intensity aerobic exercise has been reported to elicit changes in systemic hemodynamics. Recent evidence suggests that the cerebral circulation reacts independently to systemic circulations to the same physiological stimuli. The aim of this is to determine the influence of high-intensity aerobic exercise on common carotid artery (CCA) hemodynamics. METHODS: Hemodynamic measurements were recorded before and following the cessation of a maximum oxygen uptake test (VO2max). One minute video of the CCA by Doppler ultrasound were recorded and used to determine peak systolic velocity (PSV), end diastolic velocity (EDV), time averaged mean blood velocity (TAMEAN), timed average maximum velocity (TAMAX), pulsatility index (PI), and resistance index (RI). CCA diameters were calculated by commercially available vessel tracking software. Carotid stiffness index (β), Peterson’s pressure modulus (Ep), arterial compliance (AC) was also calculated. RESULTS: A total of 29 individuals, 14 male and 15 females, participated in this study (21.9 ± 3.9 years). Following the cessation of exercise, PSV (p < 0.001), TAMAX (p = 0.0085), RI (p < 0.001), and PI (p = 0.0032) significantly increased whilst the minimum diameter (p = 0.005), and maximum diameter (p = 0.020) decreased. No changes were observed for β (p = 0.491), Ep (p = 0.834) or AC (p = 0.535). CONCLUSION: The results show hemodynamic changes in the CCA following VO2max exercise. Specifically, increases in vascular resistance are likely due to the reductions in arterial diameter, which may be evident downstream of the CCA. Acute maximal aerobic exercise does not change CCA stiffness parameters.

Association between serum placental growth factor and vascular endothelial function in hyprtensive disorders complicating pregnancy.

Hypertensive disorders complicating pregnancy (HDCP) is a systemic disease among pregnant women. Therefore, the prevention and prediction of hypertension during pregnancy are critical. This study aimed to clarify whether the vascular endothelial function of women with gestational hypertension was linked to placental growth factor. A total of 200 pregnant women were enrolled in our study and subsequently divided into two groups: the HDCP group and the normal pregnancy controls. The levels of serum placental growth factor, as well as plasma endothelin-1 and nitric oxide, between the two groups were measured. In addition, the endothelial function indexes, including pressure-strain elasticity coefficient (EP), the common carotid stiffness index (β), arterial compliance, single-point pulsed-wave velocity, and augment index (AI) of bilateral common carotid arteries, were compared between the HDCP and control groups using the echo tracking technique. In our study, the level of placental growth factor in the HDCP group was significantly lower than the control group. Furthermore, our results clarified that endothelin-1 increased while nitric oxide decreased in the HDCP group compared with the control group. On the other hand, we found that EP, β, pulsed-wave velocity and augment index values were significantly higher in the HDCP group than in the control group (P < 0.001). However, the value of arterial compliance was significantly decreased in patients of the HDCP group compared with the control group (P < 0.001). In conclusion, the association between serum placental growth factor and vascular endothelial function in HDCP could serve as a more accurate predictive factor of pregnant hypertension.

PULSE PRESSURE SIGNIFICANTLY AND INDEPENDENTLY CORRELATES WITH CAROTID PULSE WAVE VELOCITY AND BETA-STIFFNESS INDEX IN PATIENTS WITH TYPE 2 DIABETES MELLITUS

Objective: Introduction: Pulse wave velocity (PWV) and beta-stiffness index (BSI) are the most popular echo-tracking parameters indicating increased carotid stiffness. Pulse pressure (PP) values turns out to be higher in patients with increased indices of arterial stiffness and is an independent predictor of cardiovascular disease and mortality. This is of greater importance for patients with type 2 Diabetes Mellitus (T2DM). Aim: To find out correlation between the pulse pressure and carotid stiffness indices. Design and method: 100 patients with T2DM without overt cardio-vascular diseases and 30 healthy age and sex matched controls were included in the study. All participants underwent carotid examination of PWV and BSI, by echo-tracking method with Aloka Hitachi Prosound alfa-7. Patients with uncontrolled blood pressure and history of CV diseases were excluded from the study. Results: Pulse pressure significantly correlated with left carotid artery PWV (r = 0.43; p = 0.0001) and BSI (r = 0.44; p = 0.001) and right carotid artery PWV (r = 0.38; p = 0.001), BSI (r = 0.39; p = 0.001). Multivariate regression analysis with independent variable PWV, revealed that PP remained a significant and independent determinant (B = 5.78; p &lt; 0.0001), similar to systolic blood pressure (B = 2.97; p = 0.003). Conclusions: PP is among the most important independent determinants associated with increased carotid stiffness in patients with T2DM without cardiovascular complications and with well controlled blood pressure. PP may serve as an early marker of increased cardiovascular risk in patients with T2DM.

CHANGE IN HEMODYNAMIC PARAMETERS AND CAROTID STIFFNESS INDICES AFTER VITAMIN K2 SUPPLEMENTATION IN PATIENTS WITH TYPE 2 DIABETES MELLITUS

Objective: Vitamin K2 is a cofactor of gamma-carboxylase activating group of vitamin K-dependent proteins involved in vascular calcification and arterial stiffness. Data on the protective effects of vitamin K2 supplementation in the progression of vascular damage in patients with type 2 diabetes mellitus (T2DM) are scarce. Aim: to investigate the change in systolic (SAP), diastolic (DAP), pulse (PP), mean (MAP) blood pressure, central systolic aortic pressure (CASP), pulse wave velocity (PWV) and beta-stiffness index (BSI) in patients with T2DM after vitamin K2 supplementation. Design and method: We included 18 patients with T2DM (mean age 59.09 ± 8.5 men 38.8%) who received Vitamin K2 (Menaquinone-7) 75 μg once daily for a period of 4 weeks. Patients with overt cardio-vascular diseases, uncontrolled blood pressure and vitamin K-antagonists intake were excluded from the study. Hemodynamic parameters were measured using an A-pulse CASP-AL device. Carotid stiffness indices were measured by one-point echo-tracking method with Aloka Hitachi Prosound on the both common carotid arteries (CA). Results: All hemodynamic parameters showed increased values compared to the baseline: SAP (+5 mmHg) (p = 0.1), DAP (+2.9mmHg) (p = 0.19), PP (+1.4mmHg) (p = 1.4), MAP (+3.4 mmHg) (p = 0.08). CASP increased from 119.8 ± 12.1mmHg to 126.8 ± 11.4 mmHg (+5 mmHg), and this change was significant (p = 0.02). PWV on the right CA did not change significantly before (7.0 ± 1.48 m/s) and after (7.19 ± 1.28 m/s) supplementation (p = 0.47), similar to BSI 10.08 ± 3.41 and respectively 10.51 ± 3.99 (p = 0.61). PWV on the left CA before supplementation is 7.01 ± 1.22 m/c, respectively after 7.19 ± 1.56 m/c (p = 0.49). BSI on the left CA is 9.97 ± 2.79, resp. 10.69 ± 5.07 (p = 0.43). Conclusions: Vitamin K2 supplementation for four weeks showed significant increase in CASP in our cohort of patients with T2DM. The other hemodynamic parameters as well as the indicators of carotid stiffness do not change significantly. A limitation of our study is the small number of patients included and the short period of intake of vitamin K2, which may not lead to morphological changes in the vessel wall. More extensive research is needed in the field.

An Accelerometric Sensor System With Integrated Hydrostatic Pressure Correction to Assess Carotid Arterial Stiffness

Non-invasive evaluation of vascular stiffness has established utility in cardiovascular risk and stroke prediction. This work presents an accelerometric sensor-based system with an integrated hydrostatic pressure correction unit for arterial luminal diameter measurement and local vascular stiffness assessment. A custom-designed accelerometric patch for continuous monitoring of percutaneous acceleration plethysmogram (APG) from the common carotid artery, which could estimate the arterial wall displacement, was developed. A calibration model was established to estimate the true carotid luminal diameter waveform from the accelerometer-based arterial wall displacement signals. The system’s accuracy for carotid stiffness measurement was validated by multiple in-vivo human subject studies and compared against a clinical-grade B-mode ultrasound imaging system. Accelerometric-derived carotid diameter waveform morphologically replicated the anachrotic, and dicrotic limb of the true carotid diameter recorded using reference devices. The group-average baseline value of measured carotid end-diastolic diameter and distension was 5.81 ± 0.53 mm and 0.51 ± 0.15 mm with a maximum observed beat-by-beat variation of 6.5% and 9%, respectively. Accelerometer-based vascular stiffness measures showed a significant correlation (R2 > 0.88, P < 0.0001), and clinically acceptable agreement with a reference standard imaging system. APG derived carotid stiffness indices demonstrated the capability to detect expected age-associated changes in stiffness. The study revealed that the accelerometric sensor system offers a reliable, cost-effective method for long-term non-invasive monitoring of location-specific vascular stiffness measures with potential applications in ambulatory healthcare monitors.

Carotid stiffness parameters are earlier markers of subclinical atherosclerosis than central aortic systolic pressure in patients with type 2 diabetes mellitus

Abstract Funding Acknowledgements Type of funding sources: None. Introduction Elevated central aortic systolic pressure (CASP) is a stronger predictor of atherosclerosis than peripherial blood pressure measurement. One-point echo-tracking is a novel noninvasive method for measurement of the local arterial stiffness (AS) of carotid artery (CA). As the cardio-vascular complications of patients with type 2 Diabetes Mellitus (T2DM) are the most clinically significant, establishing early signs of atherosclerosis is of utmost importance for the prognosis Purpose To compare the significance of CASP and of carotid echo-tracking parameters as early signs of atherosclerosis in patients T2DM without cardio-vascular disease Patients and methods 100 patients with T2DM without overt cardio-vascular diseases and 30 healthy age- and sex-matched controls were included in the study and examined for PWVβ, β-stiffness index, arterial compliance (АС), augmentation index (AI), Peterson’s modulus (Ep) of right CA with Aloka Hitachi Prosound α7. CASP was determined with Caspal A-pulse CASP-AL device. Patients with atrial fibrillation and increased blood pressure were excluded from the study. Results: Тhe mean values of CASP in T2DM were 126.4 mmHg vs 125.7 mmHg in controls (p = 0.84). PWVβ was increased in patients compared to controls: 7.42m/s vs 6.4m/s, p = 0.001. The same changes were found in β-stiffness index - 10.4 vs 7.7 (p = 0.001), AI - 13.3 vs 19.8 9 (p = 0.009), and Ep - 151.3 vs 112.1 (p = 0.001). There was no significant difference in АС - 0.77 vs 0.98 (p = 0.11). There was a mild correlation between the CASP and carotid stiffness indices (Table 1). Conclusions Parameters of local arterial stiffness of carotid artery are earlier signs of subclinical atherosclerosis than CASP in patients with T2DM without cardio-vascular disease. One-point echo tracking is a useful non-invasive and easy to perform novel ultrasound method. Table 1 PWV(L) AC(L) PWV(R) Ep(R) AC(R) AI(R) r p r p r p r p r p r p CASP 0.222 0.045 -.295 0.007 .286 0.011 .273 0.015 -0.214 0.05 .256 0.023 L-left CA, R-right CA

YI 2.3 Methylglyoxal, 3-Deoxyglucosone, and Glyoxal – Precursors of Advanced Glycation Endproducts – are not Independently Associated with Indices of Carotid Stiffness: The Maastricht Study

BackgroundArterial stiffness is a strong predictor of cardiovascular diseases and all-cause mortality [1]. Increased fasting plasma concentrations of highly reactive dicarbonyl compounds – methylglyoxal (MGO), 3-deoxyglucosone (3-DG), and/or glyoxal (GO) – may cause arterial stiffening via for mation of advanced glycation endproducts, triggering maladaptive responses in vascular tissue, e.g. elastin degradation and collagen cross-linking [2]. We assessed the cross-sectional associations between MGO, 3-DG, and GO concentrations with local carotid stiffness measures (distensibility coefficient (cDC), radius-wall thickness ratio (cRWT), pulse wave velocity (cPWV), and Young’s elastic modulus (cE) using standardized main variables.MethodsFasting dicarbonyl concentrations were determined by ultra-performance liquid chromatography tandem mass spectrometry in EDTA plasma collected from 2275 participants (age: 60 ± 8 years, mean ± SD; 49% women, 605 with type 2 diabetes mellitus) of the Maastricht Study [3], an observational, population-based cohort study. Cross-sectional associations were assessed using multivariable linear regression analysis adjusting for age, sex, mean arterial pressure (MAP), heart rate, lifestyle factors, and medication. Since arterial stiffness measures are intrinsically pressure dependent, we additionally assessed the associations with pressure-corrected counterparts [4], instead of statistically correcting for MAP.ResultsFasting dicarbonyl concentrations were associated with arterial stiffening (smaller cDC; larger cPWV and cE) in most crude models, but not in adjusted models (Table). cRWT was associated with 3-DG, but only in the crude model. The use of pressure-corrected metrics did not materially change the final models.ConclusionFasting plasma concentrations of either MGO, 3-DG, or GO are not independently associated with carotid stiffness in this cross-sectional analysis.TableAssociations between fasting plasma dicarbonyls and carotid stiffness measurescDCcRWTcPWVcEModela (95% CI)a (95% CI)a (95% CI)a (95% CI)MGO0−0.104(−0.145;−0.063)0.011(−0.030;0.052)0.103(0.062;0.144)0.099(0.059;0.140)1−0.032(−0.070;0.005)0.010(−0.032;0.052)0.032(−0.006;0.071)0.033(−0.007;0.072)20.005(−0.029;0.039)0.000(−0.042;0.042)−0.004(−0.039;0.030)−0.006(−0.042;0.030)30.003(−0.031;0.037)0.000(–0. 043; 0.042)−0.003(−0.038;0.032)−0.005(−0.040;0.031)3-DG0−0.164(−0.205;−0.123)0.067(0.026;0.108)0.149(0.108;0.190)0.171(0.131;0.212)1−0.102(−0.154;−0.051)0.024(–0. 033; 0.082)0.075(0.023;0.127)0.093(0.039;0.147)2−0.037(−0.084;0.009)0.009(-0.049;0.066)0.012(−0.036;0.060)0.027(−0.023;0.076)3−0.018(−0.065;0.029)–0. 004(–0.062; 0.054)−0.007(−0.056;0.041)0.004(−0.045;0.054)GO0−0.054(−0.095;−0.013)−0.032(−0.074;0.009)0.054(0.012;0.095)0.038(−0.003;0.079)1−0.015(−0.051;0.022)–0.014(–0.055; 0.026)0.015(−0.022;0.052)0.008(−0.030;0.046)20.002(−0.031;0.035)−0.015(−0.056;0.025)−0.002(−0.035;0.032)–0.008(–0. 042;0. 027)3−0.009(−0.042;0.024)–0.013(–0.053; 0.028)0.011(−0.022;0.045)0.005(−0.030;0.040)Model 0: crude associations. Model 1: model 0 + age, sex, and glucose metabolism status. Model 2: model 1 + mean arterial pressure and mean heart rate, and anti-hypertensive drugs. Model 3: model 2 + body mass index, smoking status, physical activity, use of lipid-modifying drugs, fasting triglycerides and total-to-high-density lipoprotein cholesterol levels, alcohol use, history of cardiovascular disease, kidney function, and Dutch healthy diet score. MGO, methylglyoxal; 3DG, 3-deoxyglucosone; GO, glyoxal; cDC, carotid distensibility coefficient; cRWT, carotid radius-wall thickness ratio; cPWV, carotid pulse wave velocity; cE, carotid Young’s elastic modulus. Significant associations (p < 0.05) printed in bold.

Long-term trajectories of BMI predict carotid stiffness and plaque volume in type 2 diabetes older adults: a cohort study

BackgroundHigh body mass index (BMI) is a risk factor for type 2 diabetes and cardiovascular disease. However, its relationships with indices of carotid stiffness and plaque volume are unclear. We investigated associations of long-term measurements of BMI with indices of carotid stiffness and atherosclerosis among non-demented diabetes patients from the Israel Diabetes and Cognitive Decline (IDCD) study.MethodsCarotid ultrasound indices [carotid intima media thickness (cIMT), distensibility, elastography and plaque volume] were assessed in N = 471 participants. Mean BMI across all MHS diabetes registry measurements and trajectories of BMI were calculated. BMI was categorized into three trajectory groups representing: a relatively stable normal weight (n = 185, 44%), overweight trajectory (n = 188, 44.8%) and a trajectory of obesity (n = 47, 11.2%). Linear and logistic regressions estimated associations of carotid indices with mean BMI and BMI trajectories.ResultsCompared to the normal weight trajectory, an obesity trajectory was associated with carotid distensibility (β = − 3.078, p = 0.037), cIMT (β = 0.095, p = 0.004), and carotid elastography (β = 0.181, p = 0.004) but not with plaque volume (β = 0.066, p = 0.858). Compared with the normal weight trajectory, an obesity trajectory was associated with increased odds for impaired carotid distensibility (OR = 2.790, p = 0.033), impaired cIMT (OR = 5.277, p = 0.001) and large carotid plaque volume (OR = 8.456, p = 0.013) but not with carotid elastography (OR = 1.956, p = 0.140). Mean BMI was linearly associated with Distensibility (β = − 0.275, p = 0.005) and cIMT (β = 0.005, p = 0.026).ConclusionsLong-term measurements of adiposity are associated with indices of carotid stiffness and plaque volume among older type 2 diabetes adults.

Evaluation of Common Carotid Stiffness via Echo Tracking in Hypertensive Patients Complicated by Acute Aortic Dissection.

ObjectivesTo evaluate the common carotid stiffness via echo tracking in patients with hypertension and acute aortic dissection (AD) and to investigate the independent predictors for the occurrence of AD in hypertensive (HP) patients.MethodsFifty HP patients complicated by acute AD (AD group), 50 HP patients without AD (HP group), and 50 age‐matched healthy volunteers (control group) were enrolled to assess the common carotid stiffness index (β), single‐point pulsed wave velocity (PWVβ), and arterial compliance (AC) via echo tracking.ResultsThe intima‐media thickness, diameter, β and PWVβ of the common carotid artery (CCA) in the AD group were significantly higher than those in the HP and control groups, whereas AC in the AD group was significantly lower (P < .05). In a multivariate logistic regression analysis, the systolic blood pressure (SBP; odds ratio [OR], 2.316; 95% confidence interval [CI], 2.033–2.563; P < .001), β (OR, 2.140; 95% CI, 1.931–2.367; P < .001), PWVβ (OR, 1.212; 95% CI, 1.004–1.397; P = .023), and AC (OR, 0.565; 95% CI, 0.339–0.654; P < .001) were significantly related to the occurrence of AD in HP patients. The area under the curve values for the AC, SBP, β, and PWVβ were 0.822, 0.806, 0.778, and 0.741, respectively, and the area under the curve was up to 0.943 when these parameters were combined.ConclusionsThe compliance of the CCA decreased, and the stiffness of the CCA increased significantly in HP patients complicated by AD. The AC, β, and PWVβ of the CCA, together with the SBP, were independent predictors of the occurrence of AD in HP patients.

Repeatability Study of Local Vascular Stiffness Measurement Using Carotid Surface Acceleration Plethysmogram.

We have developed an accelerometric system with a custom-designed patch probe and signal acquisition hardware to acquire the carotid wall displacement from the soft tissue surface for arterial stiffness evaluation. A subject-specific calibration model was developed to estimate the morphology of accurate carotid diameter waveform, using a standard ultrasound B-mode imaging system as the reference. Following the one-time calibration, the accelerometric system continuously acquired a non-invasive carotid lumen diameter waveform. The capability of the accelerometric system to measure the carotid stiffness index (β) in-vivo was experimentally validated by performing measurements on 8 normotensive subjects in the supine position. The repeatability and reproducibility of the results were investigated and were found to be comparable to those provided by ultrasound imaging systems. Further, the variation of arterial stiffness index measurements on different days was studied to verify the ability of the system to give a stable measure of stiffness. The accuracy of the observed results was confirmed with the state-of-art B-mode ultrasound imaging system. The results were found to be stable over a day, indicating the utility of the system for a reliable measure of non-invasive carotid arterial stiffness.

High-Throughput Vascular Screening by ARTSENS Pen During a Medical Camp for Early-Stage Detection of Chronic Kidney Disease.

Intervention in the early stages of cardiovascular and kidney diseases is proven to be more effective in preventing disease progression. Large artery stiffness measurement can be a potential early predictor of future risks. The purpose of the study reported in this work was to demonstrate the feasibility of our ARTSENS® Pen device as a high-throughput vascular screening tool for risk assessment. The study was performed during a medical camp conducted for awareness and early-stage detection of kidney diseases. Screening procedures included biosample tests and blood pressure measurements. Alongside, various clinically relevant measures of the arterial stiffness were evaluated using the ARTSENS® Pen, by measuring vessel wall dynamics via our proprietary image-free ultrasound algorithms. Stiffness measurement from the left common carotid artery on 85 participants could be completed within 4 hours, employing two units of ARTSENS® Pen; this also includes time taken for all the procedures enlisted in the study protocol. The associations of carotid stiffness indices with age-, gender-, and risk factor-dependent variations were established.

Assessment of vascular stiffness using different modalities in patients with systemic lupus erythematosus: a case control study

BackgroundCardiovascular disease is a major cause of morbidity and mortality in systemic lupus erythematosus (SLE) patients. Accurate risk stratification would require a simple, non-invasive index integrating all traditional and emerging risk factors. Vascular stiffness fulfills these requirements and has better predictive value for cardiovascular events than traditional risk factors in hypertensives and patients with coronary artery disease. Our aim was to determine whether arterial stiffness is increased in SLE patients compared to healthy controls and to correlate the arterial stiffness in SLE patients with cardiovascular risk factors, namely, hypertension and diabetes mellitus.ResultsThis study included 50 SLE patients and 50 age- and gender-matched healthy individuals. SLE patients had higher median aortic stiffness index (SI) and lower strain and distensibility, compared to controls (p value for all < 0.001). SLE patients had significantly impaired flow-mediated dilation (FMD) compared to controls: the median (range) in SLE patients was 8.82 (2.5–21.87), compared to 19 (12–37.5) in controls (z = − 7.695, p ˂ 0.001). Regarding quality arterial stiffness (QAS) parameters, SLE patients had significantly lower median carotid distension, distensibility coefficient, and compliance coefficient, with higher median carotid SI, carotid pulse wave velocity (PWV), and augmentation index (AI), compared to controls (p value for all ≤ 0.001). SLE patients had a higher median cf-PWV 6.5 m/s (4.8–11.8), compared to a median of 4.6 m/s (3.8–6.9) in controls (z = − 8.193, p ˂ 0.001). Linear regression analysis to adjust for hypertension and diabetes mellitus yielded a statistically significant difference between both groups for all of the above parameters (p = 0.014 for maximum carotid intima media thickness (IMT) and < 0.001 for remaining parameters), with the exception of the maximum carotid augmentation index (p = 0.184).ConclusionSLE patients have significantly increased arterial stiffness and impaired FMD compared to healthy controls. This is true even after adjusting for hypertension and diabetes mellitus, highlighting the fact that SLE could be an independent cardiovascular risk factor. These findings emphasize the need for early management of SLE together with aggressive risk factor modification.

Increased carotid stiffness detected by ultrafast ultrasound imaging is associated with the Gensini score.

To test the ability of carotid stiffness evaluated by using ultrafast ultrasound imaging to indicate coronary atherosclerosis and its association with the severity of coronary artery disease (CAD). This cross-sectional study included 131 patients with CAD and 60 normal controls. Carotid intima-media thickness (cIMT) was measured by two-dimensional ultrasound. Carotid stiffness was determined by ultrafast ultrasound imaging, with which the carotid pulse wave velocity at the beginning (PWVBS) and end (PWVES) of systole were calculated. Gensini scores based on coronary angiography were used to estimate the severity of CAD. Compared with normal controls, the CAD patients had higher carotid diameters, cIMT, PWVBS and PWVES (p < 0.05). In the CAD group, Gensini scores correlated significantly with cIMT, PWVBS and PWVES (r = 0.279, p = 0.001; r = 0.661, p < 0.001; r = 0.620, p < 0.001; respectively). The multivariate analysis further indicated that PWVBS, PWVES and body mass index were independently associated with the Gensini score (β = 0.466, p < 0.001; β = 0.308, p < 0.001; and β = 0.209, p = 0.001; respectively). In addition, the sensitivity and specificity were 54% and 83%, respectively, for PWVBS (cutoff value, 6.9 m/s; area under the receiver operating characteristic curve, 0.70) and 64% and 83%, respectively, for PWVES (cutoff value, 8.0 m/s; area under the curve, 0.73). Increased carotid PWVBS and PWVES detected by ultrafast ultrasound imaging as indices of carotid stiffness might serve as promising indicators for CAD and its severity.