Elasticity Of Common Carotid Artery Research Articles

Early diagnostic value of carotid artery ultrasound parameters combined with epicardial adipose layer thickness in coronary heart disease

BACKGROUND Coronary heart disease is associated with coronary atherosclerosis indicated by carotid intima-media thickness (CIMT) thickening and altered vascular elasticity. The epicardial adipose layer can secrete proinflammatory factors that promote the formation of coronary atherosclerosis. Thus, the epicardial fat layer thickness (EAT) may also predict coronary heart disease. AIM To determine the role of common carotid artery ultrasound parameters and EAT in the early diagnosis of coronary artery disease. METHODS Based on coronary angiography, patients with newly suspected coronary heart disease were divided into case (n = 107) and control (n = 41) groups. The carotid ultrasound parameters, including vascular stiffness (β), elastic coefficient (EP), pulse wave conduction velocity (PWV-β), CIMT, and EAT were compared between the case and control groups and among patients with different lesion numbers in the case group. Pearson correlation was used to evaluate the early diagnostic value of EAT, common carotid artery elasticity, and CIMT for coronary heart disease. RESULTS EP, β, PWV-β, CIMT, and EAT were significantly higher in the case group compared with the levels in the control group (all P < 0.001). In the case group, lesions were detected in one vessel in 34 patients, two vessels in 38 patients, and three vessels in 35 patients. Within the case group, β, EP, PWV-β, CIMT, and EAT levels significantly increased with an increased number of lesions (all P < 0.001). EAT positively correlated with β, EP, PWV-β, and CIMT (all P < 0.01). The area under the curve for diagnosing coronary heart disease using EAT combined with CIMT and carotid elasticity was 0.893, and the sensitivity and specificity were 0.890 and 0.837. CONCLUSION EAT correlated well with changes in carotid artery elasticity and CIMT in patients with coronary heart disease. The combination of EAT, carotid artery elasticity, and CIMT facilitates the early diagnosis of coronary heart disease.

Changes in common carotid artery elasticity in solid organ recipients

Background. Cardiovascular diseases are very common among solid organ recipients. They are associated with worsening transplant outcomes. Arterial vascular wall elasticity is an important prognostic indicator and a risk marker for cardiovascular events. Noninvasive measurement of common carotid artery (CCA) elasticity may be useful in assessing cardiovascular risk in solid organ recipients.Objective: To conduct a comparative analysis of indicators of CCA elasticity in solid organ recipients and to study their relationship with factors that potentially have a negative impact on the risk of adverse events.Materials and methods. The study included 154 patients aged 10 to 75 years, including heart (n = 77), liver (n = 9), and kidney (n = 35) recipients, as well as 33 patients with end-stage heart failure waitlisted for heart transplantation (HT). In all participants, carotid artery ultrasound was performed, pulse wave velocity was measured, and CCA elasticity was calculated.Results. CCA elasticity was found to be strongly inversely correlated with age, body mass index, systolic blood pressure, renal tubular filtration rate, CCA intima media thickness, and aortic pulse wave velocity. In heart recipients, CCA elasticity was significantly lower than in liver and kidney recipients (p = 0,002) and it inversely correlated with the length of time elapsed after transplantation, which is probably associated with cardiac denervation.Conclusion. CCA elasticity calculated via noninvasive ultrasound reflects the degree of adverse effects of pathological factors on the main arteries in solid organ recipients.

A preliminary study of changes in carotid artery elasticity in type 2 diabetes mellitus.

Carotid stiffening is found to be present in patients with type 2 diabetes mellitus (T2DM) together with endothelial dysfunction and it remains unclear about the role of carotid elasticity in the development of diabetic vascular damage. The aim of the study was to investigate changes and significance of carotid artery elasticity in diabetic patients with or without microvascular complications using velocity vector imaging (VVI) analysis. Fifty participants were enrolled and divided into health Control group, the uncomplicated DM (uDM) group and the complicated DM (cDM) group. All of them underwent carotid ultrasound examinations. VVI was used to evaluate the common carotid artery (CCA) elasticity and intima-media thickness (IMT) was also measured. Flow-mediated dilation (FMD) was performed to detect the vascular endothelial function. Then differences and correlations of variables between three groups were compared and analyzed. CCA elasticity measured by VVI decreased significantly between three groups (p < 0.05), while FMD decreased significantly only in cDM group (p < 0.01) and only IMT in cDM group was significantly thicker than that of Control group (p < 0.05). Representative VVI variables were independently, negatively related to the known duration and microalbuminuria (p < 0.05). All VVI variables were significantly correlated with FMD (0.5 ≤ |r | <0.8, p < 0.001), and just a small part of VVI variables were significantly correlated with IMT (0.3 ≤ |r | <0.5, p < 0.05). Compared with FMD, CCA elasticity measured by VVI showed more obvious changes in diabetic patients with different levels of vascular damage and may be considered as an alternative indicator in evaluating arterial status of T2DM.

COMMON CAROTID ARTERY ELASTICITY, INTIMA-DIAMETER RATIO, AND TENSILE STRESS IN PEDIATRIC PATIENTS WITH PRIMARY HYPERTENSION

Objective: Elevated blood pressure (BP) lead to increased thickness of arterial wall and increased diameter of arteries, are risk factors of cardiovascular sequelae in adult populations. Intima-diameter ratio (IDR) and tensile stress (TS) may reflect arterial wall-remodeling to elevated BP. The aim was to evaluate common carotid artery elasticity, IDR, and TS in children with primary hypertension (PH). Design and method: 50 untreated patients with PH and we evaluated: common carotid artery(CCA) intima-media thickness (cIMT) and elasticity(E-tracking - ET), central BP and aortic elasticity (aPWV,AIx75HR), office BP and ABPM, and clinical, and biochemical data. IDR (cIMT/minimal diameter of CCA[D]) and TS (MAP∗D/cIMT) were calculated in all the subjects. Results: Patients with PH compared to CG were characterized by significantly higher peripheral, central office and ambulatory BP, BMI Z-score, uric acid, triglycerides, lower HDL-cholesterol and higher aPWV. PH patients had thicker cIMT and larger CCA D. The groups did not differ in parameters of CCA elasticity: beta stiffness index, CCA pulse wave velocity(PWVbeta) and pressure-strain elasticity modulus(Ep) and in IDR(0.08 ± 0.01vs.0.08 ± 0.02,p = 0.479) and TS(584.9 ± 135.5mmHg vs.529.7 ± 84.2,p = 0.095). We found correlations between cIMT(Z-score) and triglycerides, peripheral SBP Z-score, and ABPM MAP 24 h Z-score. CCA D correlated with BMI Z-score, uric acid and HDL-cholesterol, 24 h systolic blood pressure load(SBPL), Central systolic blood pressure(AoSBP) and peripheral diastolic BP Z-score. We found significant correlations between TS and uric acid, 24 h diastolic blood pressure load, and peripheral systolic and diastolic blood pressure Z-scores. There was no association between IDR and BP except for a weak correlation between IDR and SBPL. In PH patients, there was a strong correlation between cIMT and CCA D(r = 0.790,p &lt; 0.001). Conclusions: In children with PH, structural changes and decreased elasticity primarily affect the aorta and to a lesser extent the muscular arteries. In children with PH, both CCA wall thickness and internal diameter are associated with BP, and are significantly higher in children with PH. The changes observed in the carotid artery are probably adaptive in nature, not associated with impaired arterial function, thus intima-diameter ratio or tensile stress measurement does not appear to contribute additional information in this group of patients.

CONCENTRATION OF ACTIVE RENIN IN CHILDREN WITH PRIMARY HYPERTENSION

Abstract Objective: Renin-angiotensin-aldosetone system (RAAS) is a key player in regulation of blood pressure, vascular resistance, and fluid and electrolyte balance. Thus, activation of RAAS is considered as one of potential steps in development of primary hypertension (PH). Literature data suggest that active renin (AR) concentration is a precise marker of RAAS activation. The objective of the study was to assess the AR concentration in children with primary hypertension. Design and method: In this single-center cross-sectional study we evaluated AR [pg/mL], BMI Z-score, peripheral and central pressure, blood pressure in ABPM, biochemical parameters, ultrasonographic kidney image and arterial damage (cIMT, AIx75HR, PWV, elasticity of common carotid artery by E-tracking) in 98 children with PH (14.83 ± 2.92 years) and 45 healthy children. Results: Children with PH compared to healthy children had significantly higher: AR concentration (median: 34.3 [IQR:24.38–64.94] vs. 24.94 [IQR:16.81–34.32] [pg/ml], p &lt; 0.001), BMI Z-score, peripheral and central blood pressure, blood pressure in ABPM, also cIMT, PWV, and uric acid and triglycerides concentrations. In the whole group of 143 children AR correlated significantly (p &lt; 0.05) with office systolic (r = 0.24) and diastolic (r = 0.22) blood pressure, neutrophil count (r = 0.17), total (r = 0.20) and HDL (r = 0.20) cholesterol, heart rate (r = 0.17) and systolic pressure load in ABPM (r = 0.19); in 98 children with PH AR correlated also with number of hypotensive drugs (r = 0.42) and right and left kidney length (r = -0.23; r = -0.25); in 51 children with newly diagnosed PH also with ABPM MAP 24 h Z-score (r = 0.35) and central mean pressure (r = 0.41). In children with newly diagnosed PH AR in patients with isolated systolic hypertension was significantly lower compared to patients with systolic and diastolic hypertension (26.16 [IQR: 18.60–34.16] vs. 37.79 [IQR:27.03–49.58], p = 0.014) and did not differ from AR in healthy children. Conclusions: In this single-center cross-sectional study we evaluated AR [pg/mL], BMI Z-score, peripheral and central pressure, blood pressure in ABPM, biochemical parameters, ultrasonographic kidney image and arterial damage (cIMT, AIx75HR, PWV, elasticity of common carotid artery by E-tracking) in 98 children with PH (14.83 ± 2.92 years) and 45 healthy children.

Diagnostic Values of Epicardial Adipose Tissue Thickness with Right Common Carotid Artery Elasticity and Intima-Media Thickness for Middle-Aged and Elderly Patients with Coronary Heart Disease.

BackgroundCoronary heart disease (CHD) is the most common cardiovascular disease which greatly threatens the health of middle-aged and elderly people.ObjectiveTo explore the correlations of epicardial adipose tissue (EAT) thickness with right common carotid artery elasticity and intima-media thickness (IMT) in middle-aged and elderly patients with CHD by ultrasound.MethodsA total of 132 patients diagnosed with CHD by coronary angiography (CAG) from February 2019 to August 2020 were enrolled and divided into single-vessel disease group (n=38), double-vessel disease group (n=52), and three-vessel disease group (n=42), and 52 healthy subjects were selected as control group. Their general data, biochemical indices, EAT thickness, right common carotid artery elasticity indices, and IMT were compared. The correlations of EAT thickness with right common carotid artery elasticity indices and IMT were studied by Pearson’s analysis. The predictive values of EAT thickness and IMT for CHD were analyzed by receiver operating characteristic curves.ResultsWith increasing number of diseased branches, EAT thickness, stiffness parameters β (β), strain elastic modulus (Ep), pulse wave velocity β (PWV-β) and IMT increased, arterial compliance (AC) decreased (P<0.05), but argumentation index (AI) did not change significantly. EAT thickness had significant positive correlations with β, Ep, PWV-β and IMT, negative correlation with AC, and no significant correlation with AI. The areas under the curves of EAT thickness and IMT for predicting CHD were 0.806 and 0.784, respectively.ConclusionEAT thickness is significantly correlated with right common carotid artery elasticity and IMT in middle-aged and elderly patients with CHD, and EAT thickness and IMT have high predictive values. The three indices are crucial for CHD diagnosis.

Ultrasonic assessment of liver stiffness and carotid artery elasticity in patients with chronic viral hepatitis

BackgroundThis study investigated the relationship between liver stiffness and carotid artery elasticity in patients with chronic viral hepatitis. We used an acoustic radiation force impulse (ARFI) technique to measure stiffness, and a radio frequency (RF) vascular quantitative ultrasound technique to measure changes in common carotid artery elasticity and vascular function.MethodsTwo-hundred seventeen patients with chronic viral hepatitis caused by either hepatitis B virus (HBV) or hepatitis C virus (HCV) were enrolled. We divided the patients into two groups, one comprising 147 patients with chronic hepatitis B (CHB) (98 men and 49 women, average age 46.5 ± 12.2 years) and another comprising 70 patients with chronic hepatitis C (CHC) (47 men and 23 women, average age 47.6 ± 12.1 years). Additionally, 64 healthy age- and sex-matched participants (43 men and 21 women, average age 47.8 ± 5.1 years) were selected as the control group. The ARFI technique was used to measure liver stiffness and the RF ultrasound technique was used to measure carotid artery elasticity parameters including intima-media thickness (IMT), pulse wave velocity (PWV), arterial wall dilation coefficient (DC), compliance coefficient (CC), sclerosis indices α and β, and augmentation index (Aix). Clinical indicators, liver stiffness, and carotid artery elasticity parameters were observed and compared between the different age groups to investigate the correlation between carotid artery elasticity parameters and liver stiffness.ResultsThe ARFI values for the CHB and CHC groups were significantly higher than those for the control group (1.84 ± 0.52 vs. 1.04 ± 0.11 m/s; 1.86 ± 0.37 vs. 1.04 ± 0.11 m/s, respectively; P < 0.001). When compared to the control group, both CHB and CHC groups showed an IMT of the same order, but had significantly higher elasticity parameters, such as α and β, as well as lower DC and CC values (P < 0.001). The PWV of the CHC group was significantly higher than that of the control group (7.98 ± 1.42 vs. 6.09 ± 0.90 m/s, P < 0.001). In the CHB group, all parameters including ARFI, IMT, PWV, DC, CC, α and β, were significantly different between the two age groups (P < 0.05). Within the CHC group, all parameters including IMT, PWV, DC, α and β, were significantly different between the two age groups (P < 0.05), except for ARFI, wherein the difference was not statistically significant. The correlation analysis and stepwise multiple linear regression analysis indicated that for patients with CHB, age was an independent predictor of common carotid artery IMT (R2 = 0.468, F = 54.635, and P < 0.001). For patients with CHC, age and blood sugar were independent predictors of common carotid artery IMT (R2 = 0.465, F = 29.118, and P < 0.001).ConclusionAlthough based on ARFI and RF ultrasound, the carotid artery IMT in patients with CHB and CHC was not significantly higher than that in the control group, their functional elasticity parameters had already changed. This finding serves as a useful reference for the clinical diagnosis of vascular diseases in patients with viral hepatitis.Trial registrationClinicalTrials: ChiCTR1800015859 25/04/2018.

Transmission of Pulsatility Into the Brain of Patients with Continuous-Flow Left Ventricular Assist Devices

The principal role of large conduit arteries is to buffer pulsatile flow and transmit optimal blood flow into the microcirculation. However, in heart failure patients with continuous-flow left ventricular assist device support (CF-LVAD), enhanced transport of pulsatility from central elastic arteries into the cerebral circulation of CF-LVAD patients is possible. We hypothesized that CF-LVAD patients have significantly increased transmission of pulsatility from the elastic common carotid artery (CCA) into the middle cerebral artery (MCA).

Effects of Geiji-Bokryung-Hwan on common carotid artery elasticity and erythrocyte deformability in healthy male subjects – A pilot randomized controlled crossover study

IntroductionArterial elasticity is the significant indicator of atherosclerosis. Recently, the treatment of subclinical atherosclerosis is important for preventing cardiovascular diseases. The purpose of this study was to identify the effect of the Korean herbal medicine, Geiji-Bokryung-Hwan (GBH), on carotid arterial elasticity in healthy male subjects. MethodsThis study was conducted with a pilot randomized controlled, cross-over design. Subjects were enrolled in Kyung Hee Medical Center visitors, with meeting criteria, and allocated to the two groups; One group received GBH with water, and the other group received only water at the first phase. The measurements were repeated three times at 2 hourly intervals. After one week of wash-out period, the two groups were repeated using the same procedure. Common carotid strain, erythrocyte deformability, carotid intima-media thickness, blood pressure and pulse rate values of each subjects were measured before administration and 2, 4 h after administration. ResultsFifteen subjects were enrolled into this study. Common carotid arterial circumference strain after GBH administration showed a significantly different interaction effect as compared to water administration (p < 0.05). There was no statistically difference between the two groups in terms of erythrocyte deformability, carotid intima-media thickness, pulse pressure or pulse rate. ConclusionsThis preliminary study suggests that GBH could improve vascular endothelial wall function by increasing the common carotid artery elasticity in healthy male subjects.

An insight into elasticity analysis of common carotid artery using ultrasonography.

Elastance is a distinguished marker in diagnosing various arterial diseases as studies have reported carotid artery-related diseases linked with stiffness index (β) values greater than 5. This study was to estimate elasticity of common carotid artery by measuring the diameter during systolic and diastolic phases using pixel tracing of successive frames and blood pressure. The B-mode ultrasonography video containing arterial wall motion was captured and fragmented into image frames. Each pixel on the greyscale image was converted into RGB intensity values. The diameter of the artery as well as the thickness of the wall was measured by tracing the pixel displacements from successive frames during arterial pulsation. The study was conducted on 19 subjects aged 25-40 years. The systolic and diastolic carotid artery lumen diameters and carotid intima-media thickness were calculated as 7.1 ± 0.7, 6.3 ± 0.6 and 0.5 ± 0.05 mm (mean ± standard deviation), respectively. The mean stiffness index (β), Peterson's modulus and Young's modulus of elasticity were 5.2 ± 1.1, 69 ± 15 kPa and 453 ± 99 kPa, respectively. The pixel displacements in tunica intima, tunica media and tunica adventitia were not homogeneous, due to varied macro-constituents such as endothelial tissues, smooth muscle cells, elastin lamina, fibrous tissue and micro-constituents such as collagen, fibroblast and elastin. We found that women have smaller arteries, and the stiffness increased during the systolic phase.

Association between blood viscosity and common carotid artery elasticity.

Elastic properties of the vessel wall are associated with atherosclerosis and major cardiovascular events. Several physiological and pathological conditions can affect arterial elasticity, but few studies have considered the role of hemorheological parameters. The present study aimed to investigate the relationship between hemorheological parameters and vascular stiffness in the carotid artery district. One hundred and two individuals were enrolled. Blood and plasma viscosity were measured by a cone-plate viscometer (Wells-Brookfield DV-III, Stoughton, U.S.A.). Echo-Doppler evaluation of carotid arteries was performed in order to calculate elastic indexes (strain, β-stiffness index and distensibility). The association between hemorheological parameters and carotid elasticity indexes was assessed by simple and multiple regression analyses. In simple correlation analysis, only blood viscosity was directly associated with β-stiffness index (r = 0.20, p = 0.05) and inversely with strain (r =-0.26, p = 0.01) and distensibility (r =-0.34, p = 0.001). After adjusting for cardiovascular risk factors, blood viscosity, but not plasma viscosity or hematocrit, was independently associated carotid arterial measures, together with age, obesity, hypertension, and dyslipidemia. The results of the present study demonstrate a strong association between blood viscosity and common carotid elasticity indexes.

EVALUATION OF STRUCTURE AND ELASTICITY OF THE COMMON CAROTID ARTERY IN PATIENTS WITH OBSTRUCTIVE SLEEP APNOEA SYNDROME BY ULTRASOUND RADIOFREQUENCY-DATA TECHNOLOGY

ObjectivesTo evaluate the structure and elasticity of the common carotid artery (CCA) in patients with obstructive sleep apnoea syndrome (OSAS) by ultrasound RF-data technology with Quality Intima Media Thickness (QIMT)...

2081: Tissue Doppler imaging in evaluating the common carotid artery elasticity of diabetics

2081: Tissue Doppler imaging in evaluating the common carotid artery elasticity of diabetics

Carotid Artery Elasticity and Baroreflex Sensitivity in Patients With Glaucoma

To investigate non-invasively the elasticity of common carotid artery and the arterial baroreflex function in patients with chronic open-angle glaucoma. Data were obtained from patients with chronic open-angle glaucoma (n = 16) [primary open angle- and juvenile open-angle glaucoma] and from age- and sex-matched healthy control subjects (n = 18). End diastolic diameter and pulsatile distension of the common carotid artery were measured with a high-precision, automated ultrasound wall-tracking system (WTS). Spontaneous fluctuation in cardiac interval and systolic pressure were used to determine baroreflex sensitivity. There was no difference in heart rate and pulse pressure between patients with glaucoma and the control subjects. In the glaucoma patients both distensibility coefficient of common carotid artery and baroreflex sensitivity were reduced (two-way factorial ANOVA; P < 0.002). Stiffness (characterizing the rigidity of vessel wall) was higher in the glaucoma patients than in the controls (P = 0.002). Our results suggest that in patients with chronic open-angle glaucoma the arterial rigidity is significantly increased and therefore the baroreflex function is significantly decreased. These findings may have relevance in the understanding of the autonomic dysfunction and vascular dysregulation in glaucoma.

The Relation Between Hypoalbuminemia and Compliance and Intima-media Thickness of Carotid Artery in Continuous Ambulatory Peritoneal Dialysis Patients

The aim of this study was to identify the main factor affecting compliance and intimamedia thickness of the elastic common carotid artery in continuous ambulatory peritoneal dialysis patients. Increased intima-media thickness and decreased arterial compliance are associated with elevated risk of cardiovascular disease. This study included 20 patients and 20 age- and sex- matched healthy control subjects. The compliance and intima-media thickness of the right common carotid artery within 1 cm to the bifurcation were measured three times using high-resolution B-mode echocardiography. Blood samples were obtained to measure levels of hemoglobin, phosphorus, total calcium, total CO2, serum albumin, C-reactive protein, serum total cholesterol, LDL- and HDL-cholesterol and triglycerides. We found that the compliance of common carotid artery was lower in the patient group than in the control group. In the patient group, the compliance of common carotid artery was positively correlated with serum albumin concentration, and intima-media thickness of common carotid artery was negatively correlated with serum albumin levels. Stepwise regression analysis showed that serum albumin concentration was independently related to the compliance of common carotid artery, suggesting hypoalbuminemia can independently give deleterious effects on the arterial wall in continuous ambulatory peritoneal dialysis patients.

Correlates of carotid artery stiffness in young adults: The Bogalusa Heart Study

Decreased arterial elasticity, an independent risk factor for cardiovascular (C-V) disease, is associated with C-V risk factors in middle-aged and older individuals. However, information is limited in this regard in young adults. This aspect was examined in a community-based sample of 516 black and white subjects aged 25–38 years (71% white, 39% male). The common carotid artery elasticity was measured from M-mode ultrasonography as Peterson’s elastic modulus (Ep) and relative wall thickness-adjusted Young’s elastic modulus (YEM). Blacks and males had higher Ep ( P < 0.05); males had higher YEM ( P < 0.0001); and blacks had higher wall thickness ( P < 0.01). For the entire sample adjusted for race and gender both Ep and YEM correlated significantly ( P < 0.05–0.0001) with age, BMI, waist, systolic and diastolic blood pressures, heart rate, product of heart rate and pulse pressure, triglycerides, total cholesterol to HDL cholesterol ratio, insulin and glucose. In a multivariate regression model that included hemodynamic variables, systolic blood pressure, product of heart rate and pulse pressure, age, triglycerides, BMI, and male gender (for YEM only) were independent correlates of Ep ( R 2 = 0.38) and YEM ( R 2 = 0.25). When the hemodynamic variables were excluded from the model, age, triglycerides, BMI, black race (Ep only), male gender, parental history of hypertension, HDL cholesterol (inverse association), and insulin (marginal significance) remained independent correlates of Ep ( R 2 = 0.20) and YEM ( R 2 = 16). Both Ep and YEM increased ( P for trend P < 0.0001) with increasing number of independent continuous risk factors (defined as values above or below the age, race, and gender-specific extreme quintiles) that were retained in the regression models. The observed increasing arterial stiffness (or decreased elasticity) with increasing number of risk factors related to insulin resistance syndrome in free-living, asymptomatic young adults has important implications for prevention.

Estrogens improve common carotid artery elasticity

Estrogens improve common carotid artery elasticity

Conjugated estrogen administration improves common carotid artery elastic properties in normotensive postmenopausal women.

Various vascular effects of estrogens have been proposed to explain further the beneficial effect of replacement therapy in cardiovascular events. The study was undertaken to assess the effect of conjugated estrogen on the elastic properties of the large arteries in normotensive, healthy, postmenopausal women. Toward this end, we investigated the acute effect of conjugated estrogen on the elastic properties of the common carotid artery (CCA) in 20 normotensive, healthy, postmenopausal women (age 54+/-3 years) at baseline and 20 min after the intravenous administration of 1.25 mg conjugated estrogens. The CCA distensibility was derived by a combination of surface ultrasonographic data and simultaneous blood pressure measurements at the brachial artery. The carotid pulsatility index, a measure of brain impedance, was determined electronically by tracing the CCA Doppler waveform. At baseline, CCA distensibility had a negative correlation with both patients' age and time since menopause (r = -0.57 and r = -0.48, p < 0.05 for both cases). After estrogen administration, estradiol and estrone plasma levels were restored to the range of usual premenopausal values. Estrogen induced a significant increase in CCA distensibility by 0.92+/-0.005 dyne(-1) x cm2 x 10(-6) (from 2.03 to 2.95 dyne(-1) x cm2 x 10(-6)) and a significant reduction in CCA pulsatility index by 0.24+/-0.06, (from 2.17 to 1.93) (p < 0.001 for both cases). The improvement in CCA distensibility had a negative correlation with both patients' age and time since menopause (r= -0.46 and r = -0.44, respectively, p < 0.05 for both cases). Acute conjugated estrogen administration induced an improvement in CCA elasticity and a reduction in brain impedance in normotensive, postmenopausal women. As the age of women and the time since menopause increased, the improvement in carotid distensibility decreased in such selected subjects.

Carotid and femoral artery stiffness in relation to three candidate genes in a white population.

Different genetic polymorphisms influence cardiovascular disease. We recently discovered a relationship between the intima-media thickness of the muscular femoral artery, but not the elastic common carotid artery, and the combined ACE (ACE, I/D), alpha-adducin (Gly460Trp),and aldosterone synthase (AS, C-344T) gene polymorphisms. To investigate the relationship between these polymorphisms and functional properties of the carotid artery and femoral artery, a sample of 756 subjects enrolled in a population study were genotyped for the presence of the ACE D, alpha-adducin 460Trp, and aldosterone synthase -344T alleles. Vessel wall properties were assessed using a vessel wall movement detector system in combination with applanation tonometry. Statistical analysis allowed for confounders and interaction among genes. Cross-sectional compliance of the common carotid artery was negatively associated with the ACE D allele. ACE II versus ACE DD homozygotes differed, expressed as a percentage of the population mean (7.0%; 95% confidence interval [CI], 1.6% to 12.4%; P=0.02). In multigene analysis, ACE DD subjects also deviated significantly from the population mean for the distensibility coefficient of the common carotid artery when carrying the AS/T allele (-5.5%; 95% CI, -9.3% to -1.7%; P<0.01), without a change in cross-sectional compliance. ACE DD subjects, when homozygote for alpha-adducin Gly460, had a lower femoral cross-sectional compliance (-10.4%; 95% CI, -1.9% to -18.9%; P<0.03) and a lower distensibility (-9.7%; 95% CI, -2.1% to -17.3%; P<0.02) compared with the population mean. These data show that functional large artery properties are influenced by the ACE I/D polymorphism. Cross-sectional compliance and distensibility coefficients are influenced by the ACE I/D genotype, but this influence depends on the vascular territory and genetic background.

Absence of any significant effects of circadian blood pressure variations on carotid artery elastic properties in essential hypertensive subjects.

We sought in this study to examine the effects of diurnal blood pressure variations upon common carotid artery (CCA) elasticity in selected subjects with uncomplicated moderate essential hypertension. Towards this end, 174 non-smoker subjects with stage I-II essential hypertension and without diabetes mellitus, left ventricular hypertrophy and carotid atherosclerosis, were classified as dippers and non-dippers according to the diurnal variation of >10% between mean daytime and night-time systolic and diastolic blood pressure (BP) in 24-h non-invasive ambulatory BP monitoring. CCA distensibility was derived by a combination of surface ultrasonographic data and simultaneous BP measurements at the brachial artery. The dippers and non-dippers were similar with respect to demographic characteristics. Non-dippers had significantly greater office systolic BP, 24-h systolic BP and ambulatory pulse pressure (PP) and significantly less (daytime-night-time) systolic and diastolic BP fall (by 16 mm Hg and 11 mm Hg respectively, P< 0.0001) compared to dippers. CCA distensibility was significantly reduced in non-dippers compared to dippers (by 0.89 dyne(-1)/cm(2/)10(-6), P < 0.05). Multiple linear regression analysis identified patient age and ambulatory PP as significant predictors of the CCA elasticity index. When patient age, 24-h systolic and diastolic BP were used as covariates in an analysis of covariance, the difference of CCA elasticity between dippers and non-dippers ceased to reach statistical significance. In contrast, when patient age, ambulatory PP, systolic (daytime-night-time) BP fall and diastolic (daytime-night-time) BP fall were used as covariates, the difference of CCA distensibility between dippers and non-dippers continued to be statistically significant. In conclusion, the excessive impairment of CCA elastic properties in non-dippers compared to dippers hypertensive seems to be ascribed to the increased of total 24-h haemodynamic load and not to the circadian pattern of BP. Journal of Human Hypertension (2000) 14, 813-818