Common Carotid Artery Wall Thickness Research Articles

Allelic effects on cerebral and carotid artery passive mechanical properties in young, adult, and aged hAPOE3 and hAPOE4 mice

Alzheimer’s disease (AD) is the most common form of dementia and among the leading mortalities in the US. There is growing evidence supporting a connection between AD and cardiovascular disease (CVD). Variant isoforms of apolipoprotein E (APOE) are risk factors for AD and CVD. Compared to the most common APOE isoform, APOE3 (E3), APOE4 (E4) increases AD risk. In order to study APOE-mediated processes, posterior cerebral arteries (PCA) and common carotid arteries (CCA) were isolated from mice expressing human-ApoE targeted replacement of APOE3 (B6.129P2- Apoe tm2(APOE*3)Mae N8) and APOE4 (B6.129P2- Apoe tm3(APOE*4)Mae N8)(Taconic Labs). Our objective was to determine whether the E3 and E4 allele cause different mechanical properties in the absence of extracellular Ca 2+ in the PCA and CCA isolated from young (Y, 3-4mo), adult (Ad, 12-15mo), and aged (Ag, 18-22mo), homozygous E3 and E4, male and female mice. We hypothesized that E4 would alter PCA and CCA structure/function when compared to age matched E3 cohorts. 5-8mm segments of PCA and CCA were isolated, cleaned of connective tissue, cannulated, and placed into an arteriograph. Upon equilibration, all vessels were challenged with 60mM [K + ] to assess viability. Vessels not responding to 60mM [K + ] were discarded. Mechanical characteristics, including lumen diameter (LD), wall thickness (WT), passive distensibility (PD), and stress/strain (S/S) were measured at intraluminal pressures ranging from 10-140mmHg. We observed no statistical differences in LD, PD, or S/S in PCAs and CCAs of Y and Ad, E3 and E4 mice. For LD and WT, Ag E3 was greater than Ag E4 (p<0.05). In contrast, LD in PCAs and CCAs of Ag E3 mice was larger than in Ag E4 mice (p<0.05). We further observed that PD and S/S in CCAs from Ag E3 was greater than in Ag E4 mice (p<0.05), whereas there was no difference in PD and S/S in PCAs isolated from Ag E3 or E4 mice. The WT of PCA in Y E4 was significantly greater than Y E3 mice (p<0.05). In contrast, WT in Ag E3 mice was larger than Ag E4 mice (p<0.05). There was no difference between WT of Ad E3 and E4 mice. The WT of CCAs was significantly greater in Ag E3 vs Ag E4 mice (p<0.05). There is no difference in WT in CCAs from Y (E3 vs E4) or Ad (E3 vs E4) mice. This data indicates aging has minimal effect on mechanical properties in the PCA. In contrast, CCAs in Ag E4 exhibited greater arterial stiffening as indicated by a decrease in their distensibility and leftward shift in S/S, as evidenced by greater stress for given amount of strain observed in PCAs of Ag E4 mice at increased intraluminal pressures. ABRC/ADHS18-205211 (JVE, TBJ, CBJ, DME), Arizona Alzheimer's Consortium (funded by the Arizona Department of Health Services, Contract No. CTR040636) and matching funds from Midwestern University (DME), Biomedical Sciences Program (BG, LJS, DME), Biomedical Sciences Start-up Funds (DME). LJS and ASH equally contributed as first authors. This is the full abstract presented at the American Physiology Summit 2023 meeting and is only available in HTML format. There are no additional versions or additional content available for this abstract. Physiology was not involved in the peer review process.

4 days in dry immersion increases arterial wall response to ultrasound wave as measured using radio-frequency signal, comparison with spaceflight data.

Recent studies have reported a significant increase in common carotid artery (CCA) intima media thickness, wall stiffness and reflectivity to ultrasound, in astronauts, after six months of spaceflight. The hypothesis was that 4 days in dry immersion (subjects under bags of water) will be sufficient to change the CCA wall reflectivity to ultrasound similar to what observed after spaceflight. Such response would be quantified using the amplitude of the ultrasound signal returned to the probe by the target concerned. [coefficient of signal return (Rs)]. The Rs for anterior and posterior CCA wall, sternocleidomastoid muscle, intima layer and CCA lumen were calculated from the ultrasound radio frequency (RF) data displayed along each echographic line. After four days of DI, Rs increased in the CCA posterior wall (+15% +/- 10 from pre DI, p < 0.05), while no significant change was observed in the other targets. The observed increase in Rs with DI was approximately half compared to what was observed after six months of space flight (+34% +/- 14). This difference may be explained by dose response (dry immersion only four days in duration). As a marker of tissue-level physical changes, Rs provide complimentary information alongside previously observed CCA wall thickness and stiffness.

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.

Effect of menopausal hormone therapy on arterial wall echomorphology: Results from the Early versus Late Intervention Trial with Estradiol (ELITE)

ObjectiveTo evaluate the effect of hormone therapy (HT) on arterial wall composition by ultrasound. BackgroundThe effect of HT on the progression of subclinical atherosclerosis has been well-described using measurements of common carotid artery (CCA) wall thickness. However, it is unknown whether the change in arterial wall anatomic structure is accompanied by an effect of HT on arterial wall composition. MethodsA total of 643 healthy postmenopausal women divided into two strata according to the time since menopause (<6 years, the early-postmenopause group; or >10 years, the late-postmenopause group) were randomized to receive either active treatment or placebo. For hysterectomized women, the active treatment was oral micronized 17β-estradiol 1 mg/day; for women with a uterus, 4% vaginal micronized progesterone gel 45 mg/day for 10 days each month was added to the estradiol regimen. Gray-scale median of the CCA intima-media complex (IM-GSM), a (unitless) measurement of arterial wall composition based on echogenicity, was determined by high-resolution B-mode ultrasonography. Lower IM-GSM, or less echogenicity, indicates more atherosclerosis. IM-GSM and serum estradiol (E2) concentration were assessed every 6 months over a median 4.8-year trial period. Linear mixed effects regression models were used for all analyses. ResultsOverall, IM-GSM progression/year had a negative trajectory, reflecting reduction in echogenicity over time (worsening atherosclerosis). HT effects on IM-GSM progression/year differed by postmenopause strata (interaction p-value = 0.02). IM-GSM progression/year (95% CI) in the early postmenopause group randomized to HT was −0.50 (−0.82, −0.18)/year compared with −1.47 (−1.81, −1.13)/year among those randomized to placebo (p-value <0.0001). In the late postmenopause group, the annual IM-GSM progression rate did not significantly differ between HT and placebo (p = 0.28). Higher mean on-trial E2 (pg/ml) levels were associated with higher IM-GSM progression, indicating less atherosclerosis progression in all women (β (95% CI) = 0.006 (0.0003, 0.01), p = 0.04). For each pg/dl E2, IM-GSM progression/year was 0.007 ((−0.0002, 0.01), p = 0.056) in the early and 0.003 ((−0.006, 0.01), p = 0.50) in the late postmenopause group (interaction p-value = 0.51). CIMT progression rate (μm/year) was significantly inversely associated with the IM-GSM progression (β (95% CI) = −4.63 (−5.6, −3.7), p < 0.001). ConclusionsHT, primarily with oral estradiol, reduced atherogenic progression of arterial wall composition in healthy postmenopausal women who were within 6 years from menopause.Trial registration number: NCT01553084

Protective role of Dietary Choline and Docosahexaenoic acid or Environmental enrichment in attenuating high fat diet-induced arterial wall changes in obese rats

Childhood obesity increases body mass index and long term metabolic disturbances. The present study is designed to analyze postnatal obesity-induced changes in body mass index and common carotid artery wall thickness and the role of dietary choline and DHA or environmental enrichment in mitigating these changes. Four groups of male rat pups (n=8/group) were assigned as Normal control (NC), Obese (OB) fed high-fat diet, Obesity-induced supplemented choline and DHA (OB+CHO+DHA) with 5mmol/kg/day of choline and 150 mg/ day of DHA, Obesity-induced environmental enrichment (OB+EE) exposed to environmental enrichment for 90 days. Body mass index was calculated after 90 days. Subsequently, rats were euthanized to excise common carotid artery. 5µ thick sections were processed for haematoxylin and eosin and Verhoff –Vangeison stains. Mean body weight, body mass index, thickness of tunica intima, media and percentage of collagen fibers in artery were significantly higher in OB group (p&lt; 0.01, &lt;0.001,&lt; 0.01, &lt; 0.001, &lt; 0.05) as compared to the same in NC rats respectively. These changes were significantly (p&lt;0.01, &lt; 0.05) attenuated in OB+CHO+DHA and OB+EE groups compared to OB rats. Increased body mass index in early ages is an indicator for atherosclerosis. Supplementation of dietary choline and DHA or environmental enrichment exposure attenuates these changes from an early young age.

Elevated muscle sympathetic nerve activity is independently associated with common carotid artery wall thickness in humans

Aging is characterized by increased wall thickness and stiffening of the large elastic arteries (i.e., aorta and carotid arteries), although the mechanisms involved are incompletely understood. Studies in vitro demonstrate hypertrophy of vascular smooth muscle following chronic sympathetic‐adrenergic stimulation. In addition, higher measures of sympathetic nerve activity, which typically occur with advancing age, are associated with greater intima‐media thickness (IMT) of the large peripheral arteries such as the common femoral arteries. Therefore, we tested the hypothesis that the age‐related increase in large elastic artery (carotid) IMT would be independently associated with higher sympathetic nerve activity. In a cohort of 88 young and middle‐age/older adults (age: 19–73 yr, 52% men) with no history of cardiovascular disease, we performed assessments of muscle sympathetic nerve activity (MSNA, microneurography), common carotid IMT (ultrasonography), and ambulatory 24‐hr mean arterial pressure (MAP). As expected, advancing age was significantly correlated with higher MSNA burst frequency (R=0.54, P&lt;0.001), carotid IMT (R=0.51, P&lt;0.001), and ambulatory 24‐hr MAP (R=0.18, P=0.047). Results from multiple regression analysis that included MSNA burst frequency and traditional cardiovascular disease (CVD) risk factors that were also significantly correlated with carotid IMT (age, BMI, history of hypertension or borderline hypertension, family history of hypertension, and ambulatory 24‐hour MAP) showed that MSNA burst frequency (P=0.031), age (P=0.003), and ambulatory 24‐hour MAP (P=0.003) were independent determinants of carotid IMT (model R2=0.47, P&lt;0.001). When expressing carotid IMT relative to lumen diameter (carotid IMT‐to‐lumen diameter ratio), multiple regression analysis showed that only MSNA burst frequency (P=0.02) was an independent determinant (model R2=0.36, P&lt;0.001). These findings demonstrate an independent association between MSNA and carotid IMT and suggest that the age‐related increase in sympathetic‐adrenergic tone may contribute importantly to increased wall thickness of the large elastic arteries.Support or Funding InformationAHA (17POST33440101), T32 HL07121, NHLBI (P01HL014388), U54 TR001356 and AHA (13DG143400012).This abstract is from the Experimental Biology 2019 Meeting. There is no full text article associated with this abstract published in The FASEB Journal.

Selected risk factors for atherosclerosis in children and their parents with positive family history of premature cardiovascular diseases: a prospective study

BackgroundThe aim of the study was to evaluate serum parameters of lipid metabolism, homocysteine, soluble adhesion molecules and common carotid artery wall thickness in children from families with early symptoms of atherosclerosis.MethodsThe first stage included 137 pairs of mothers and newborns, and the second 18 children from the same group (age 18-30 months) and their parents (age 21-46 years) with a history of premature coronary artery disease (CAD), as well as 12 age- and sex-matched controls.ResultsDuring the first stage, inverse correlations were found between birthweight, cord blood concentrations of triglycerides (TG), VLDL cholesterol and apolipoprotein B (Apo B). Serum concentrations of total cholesterol (TC), apolipoprotein A1 (Apo A1), LDL and HDL cholesterol and were significantly higher in female than in male newborns. During the second stage, children from families with a history for premature CAD were shown to present with significantly higher serum concentrations of TG, VLDL cholesterol and lipoprotein A (Lp(a)) than the controls. Furthermore, their TC correlated positively with vascular cell adhesion molecule-1 (Rs=0.717, p<0.05) and intracellular adhesion molecule-1 (sICAM-1) levels (Rs=0.833, p<0.05). Moreover, positive correlations were found between maternal carotid intima media thickness (IMT) and TC (Rs=0.831, p<0.01), as well as between paternal IMT and Apo B (Rs=0.692, p<0.05), TG and sICAM-1 (Rs=0.912, p<0.01), TG and sE-selectin (Rs=0.678, p<0.05).ConclusionsSerum Lp(a) may serve as a maker of cardiovascular risk in children and adolescents.

Association between Carotid Plaque Features on CTA and Cerebrovascular Ischemia: A Systematic Review and Meta-Analysis.

CTA is a widely available imaging examination that may allow the evaluation of high-risk carotid plaque features. Our aim was to evaluate the association between specific carotid plaque features on CTA and ipsilateral cerebrovascular ischemia. We performed a systematic review of Ovid MEDLINE, Ovid Embase, Scopus, and the Cochrane Library from inception to March 2016 for articles that evaluated the relationship between CTA-detected carotid plaque features and ischemic events, defined as ipsilateral ischemic stroke or transient ischemic attack. Sixteen studies were ultimately included after screening 12,557. Two readers recorded data from each study and assessed the study quality with all disagreements resolved by a third reader. A random-effects OR was used to evaluate the association between cerebrovascular ischemia and each of the evaluated plaque features. We found significant positive relationships with cerebrovascular ischemia for the presence of soft plaque (OR, 2.9; 95% CI, 1.4-6.0), plaque ulceration (OR, 2.2; 95% CI, 1.4-3.4), and increased common carotid artery wall thickness (OR, 6.2; 95% CI, 2.5-15.6). We found a significant negative relationship between calcified plaque and ipsilateral ischemia (OR, 0.5; 95% CI, 0.4-0.7). We found heterogeneity in the existing literature secondary to lack of standardized plaque features and clinical definitions. Soft plaque, plaque ulceration, and increased common carotid artery wall thickness on CTA are associated with ipsilateral cerebrovascular ischemia, while calcified plaque is negatively associated with downstream ischemic events.

Definition of common carotid wall thickness affects risk classification in relation to degree of internal carotid artery stenosis: the Plaque At RISK (PARISK) study

BackgroundMean or maximal intima-media thickness (IMT) is commonly used as surrogate endpoint in intervention studies. However, the effect of normalization by surrounding or median IMT or by diameter is unknown. In addition, it is unclear whether IMT inhomogeneity is a useful predictor beyond common wall parameters like maximal wall thickness, either absolute or normalized to IMT or lumen size. We investigated the interrelationship of common carotid artery (CCA) thickness parameters and their association with the ipsilateral internal carotid artery (ICA) stenosis degree.MethodsCCA thickness parameters were extracted by edge detection applied to ultrasound B-mode recordings of 240 patients. Degree of ICA stenosis was determined from CT angiography.ResultsNormalization of maximal CCA wall thickness to median IMT leads to large variations. Higher CCA thickness parameter values are associated with a higher degree of ipsilateral ICA stenosis (p < 0.001), though IMT inhomogeneity does not provide extra information. When the ratio of wall thickness and diameter instead of absolute maximal wall thickness is used as risk marker for having moderate ipsilateral ICA stenosis (>50%), 55 arteries (15%) are reclassified to another risk category.ConclusionsIt is more reasonable to normalize maximal wall thickness to end-diastolic diameter rather than to IMT, affecting risk classification and suggesting modification of the Mannheim criteria.Trial registrationClinical trials.gov NCT01208025.

Aortic stiffening and its impact on left atrial volumes and function in patients after successful coarctation repair: a multiparametric cardiovascular magnetic resonance study.

BackgroundThe increased cardiovascular morbidity of adults with late repair of aortic coarctation (CoA) has been well documented. In contrast, successful CoA repair in early childhood has a generally good prognosis, though adverse vascular and ventricular characteristics may be abnormal, which could increase long-term risk. This study sought to perform a comprehensive analysis of aortic elasticity and left ventricular (LV) function in patients with aortic coarctation (CoA) using cardiovascular magnetic resonance (CMR). In a subgroup of patients, we assessed structure and function of the common carotid arteries to probe for signs of systemic vascular remodeling.MethodsFifty-one patients (median age 17.3 years), 13.9 ± 7.5 years after CoA repair, and 54 controls (median age 19.8 years) underwent CMR.We determined distensibility and pulse wave velocity (PWV) at different aortic locations. In a subgroup, common carotid artery distensibility, PWV, wall thickness and wall area were measured. LV ejection fraction (EF), volumes, and mass were measured from short axis views. Left atrial (LA) volumes and functional parameters (LAEFPassive, LAEFContractile, LAEFReservoir) were assessed from axial cine images.ResultsIn patients distensibility of the whole thoracic aorta was reduced (p < 0.05) while PWV was only significantly higher in the aortic arch (p < 0.01). Distensibility of the descending aorta at the level of the pulmonary arteries and PWV in the descending aorta, both correlated negatively with age at CoA repair. LA volume before atrial contraction and minimal LA volume were higher in patients (p < 0.05). LAEFPassive and LAEFReservoir were reduced (p < 0.05), and LAEFReservoir correlated negatively with aortic arch PWV (p < 0.05). LVEF, volumes and mass were not different from controls. Carotid wall thickness and PWV were higher in patients compared to controls (p < 0.05).ConclusionsPatients after CoA repair have impaired bioelastic properties of the thoracic aorta with impact on LV diastolic function. Reduced descending aortic elasticity is associated with older age at time of CoA repair. The remodeling of the common carotid artery in our sub-study suggests systemic vessel wall changes.

0305: Interleukins 33 and 1B serum levels and common carotid arteries remodeling in hypertensive patients with obesity

To investigate interrelations between interleukin 33 (IL-33) and 1 β (IL-1 () serum levels and common carotid arteries (CCA) remodeling in hypertensive patients with obesity. 80 hypertensive patients (51 obese) have been observed. An ultrasound examination of CCA with estimation of its geometrical type was performed (cut-off value for vascular wall hypertrophy was vascular segment mass >0,275 g/cm, concentric remodeling was diagnosed with relative wall thickness of CCA >0,2). IL-33 and IL-1B serum levels were estimated using ELISA. IL-33 and IL-1β levels were higher in hypertensive patients (p<0,001), independently of BMI. Cluster analysis was made to reveal both cytokines’ levels impact on CCA geometry (see picture). IL-33≥73 pg/ml, IL-1β≥25 pg/ml was associated with 80,0% prevalence of normal CCA geometry and 20,0% of its concentric hypertrophy. IL-1β >20 pg/ml with IL-33<71 pg/ml was characterized by 80,0% prevalence of normal geometry, 10,0% of non-hypertensive concentric remodeling of CCA, 5,0% of concnetric and 5,0% of eccentric hypertrophy. IL-33>71 pg/ml with IL-1 β <25 pg/ml was associated with decrease of normal CCA geometry prevalence to 50,0% with increase of concentric hypertrophy rate to 41,7%; other 8,3% patients had eccentric hypertrophy of CCA. IL-33<71 pg/ml, IL-1 β <20 pg/ml (p>0,05 vs control group) had 57,9% of normal geometry, 15,8% of concentric remodeling, 15,8% of concnetric hypertrophy and 10,5% of eccentric hypertrophy of CCA. IL-33 and IL-1 β serum levels were elevated in hypertensive patients independently of presence of obesity. A pronounced isolated increase in IL-33 level was associated with abrupt increase of CCA hypertrophy prevalence, especially its concentric variant. Accompanying increase in IL-1B level reduced this effect.

GENDER SPECIFICS OF STRUCTURAL AND FUNCTIONAL PARAMETERS OF VESSELS IN RELATION TO PSYCHOEMOTIONAL FACTORS IN ALMOST HEALTHY INDIVIDUALS

Aim.To study gender specifics of structural and functional parameters of brachiocephal arteries with the relation to psychoemotional factors in almost healthy individuals.Material and Methods.Overall 107 almost healthy economically active individuals included from organized population (46 male, 61 female), with the average age 43,4±10,8 y. All participants underwent psychological testing that included questionnaires: Spolberger-Khanin test, depression evaluation scale by the Center for Epidemiological Studies, visualanalogue scale (modified Dembo-Rubinstein), the social frustration level, social adaptation test by Holmes-Rey, ultrasound scanning of brachiocephal arteries with evaluation of local rigidity parameters.Results.There were significant gender differences found for the vessel wall structural and functional parameters. Average values of systolic and diastolic diameters, total common carotid artery wall thickness were higher in males, but the rigidity index - in women. Prevalence of personal anxiety and clinically significant stress estimates by the Holmes-Rey scale was significantly higher in women, 75% and 36%, resp. In both groups the association of psycho-emotional factors and vessel parameters was found. But for men there was independent relation of reactive and personal anxiety with the thickness of “intima-media” and in women – correlation of depression and vessel wall compliance.Conclusion.The results direct to the need for further research of novel methods for complex primary prophylaxy of stress-induced remodeling of vessels with the connection to psychoemotional and gender specifics.

Retrobulbar and common carotid artery haemodynamics and carotid wall thickness in patients with non-arteritic anterior ischaemic optic neuropathy

To evaluate retrobulbar and common carotid artery (CCA) haemodynamics and CCA wall thickness in the patients with acute unilateral non-arteritic anterior ischaemic optic neuropathy (NAION) by colour Doppler imaging (CDI). Twenty-two patients with acute unilateral NAION and 28 age- and sex-matched controls were included in this prospective study. By CDI, the peak-systolic velocity (PSV) and end-diastolic velocity (EDV) of the ophthalmic artery (OA) and central retinal artery (CRA) in both eyes were measured or calculated. Intima-media thickness (IMT) and blood flow velocity were measured in both CCAs. Measurements on the affected side of the patients were compared to the contralateral healthy side and the controls. Compared to the controls, the blood flow velocities in the CRA were significantly decreased (p < 0.05), and IMT of CCA was greater (p < 0.001) on the affected side, while the blood flow velocities in the OA and CCA showed no statistically significant difference. The blood flow velocities in the CRA tended to be reduced bilaterally in the patients with NAION, and the difference of PSV and EDV was insignificant between the affected eyes and fellow eyes (p = 0.69, 0.86 respectively). No marked differences between the controls and the unaffected sides were detected, neither for the blood flow velocities in CRA, OA, CCA nor for the IMT of CCA. Decreased blood velocities of CRA and increased carotid wall thickness were found on the affected side of acute NAION compared to healthy controls. These findings might be potentially useful in the treatment monitoring of NAION.

Carotid bifurcation geometry is an independent predictor of early wall thickening at the carotid bulb.

Lumen geometry has long been suspected as a risk factor for atherosclerosis by virtue of its influence on blood flow disturbances. Confirmation of this geometric risk hypothesis has, however, proved challenging owing to possible effects of wall thickening on geometry and unproven links between candidate geometric variables and disturbed flow. The purpose of this study was to overcome these challenges. The study relied on imaging and risk factor data from progressively refined subsets of the Atherosclerosis Risk in Communities (ARIC) Carotid MRI study. Group 1 (n=467) included only nonstenotic cases having sufficient quality angiography for 3-dimensional analysis. Group 2 (n=346) excluded cases from group 1 having common and internal carotid artery wall thickness above previously identified thresholds for inward remodeling. Group 3 (n=294) excluded cases from group 2 having lumen irregularities and thus was least likely to include lumen geometries influenced by wall thickening. Multiple linear regressions showed that for group 3, bifurcation flare and proximal curvature were independent predictors of internal carotid artery wall thickness, consistent with their previously demonstrated roles in predicting disturbed flow. For the broadest group 1, flare was an independent predictor of internal carotid artery wall thickness but with a sign change in regression coefficient reflecting effects of wall thickening on lumen geometry. Carotid bifurcation geometry is an independent, albeit weak, predictor of its early wall thickening, but only when assumptions about geometric factors, and the influence of disease on them, are confronted. This highlights pitfalls of previous attempts to confirm geometric risk of atherosclerosis.

Common carotid artery wall thickness and external diameter as predictors of prevalent and incident cardiac events in a large population study

Common carotid artery wall thickness and external diameter as predictors of prevalent and incident cardiac events in a large population study

Common carotid artery wall thickness and external diameter as predictors of prevalent and incident cardiac events in a large population study

BackgroundArterial diameters enlarge in response to wall thickening, plaques, and many atherosclerotic risk factors. We hypothesized that right common carotid artery (RCCA) diameter would be independently associated with cardiac disease and improve risk discrimination.MethodsIn a middle-aged, biracial population (baseline n = 11225), we examined associations between 1 standard deviation increments of baseline RCCA diameter with prevalent myocardial infarction (MI) and incident cardiac events (MI or cardiac death) using logistic regression and Cox proportional hazards models, respectively. Areas under the receiver operator characteristic curve (AUC) were used to estimate model discrimination.ResultsMI was present in 451 (4%) participants at baseline (1987–89), and incident cardiac events occurred among 646 (6%) others through 1999. Adjusting for IMT, RCCA diameter was associated with prevalent MI (female OR = 2.0, 95%CI = 1.61–2.49; male OR = 1.16, 95% CI = 1.04–1.30) and incident cardiac events (female HR = 1.75, 95% CI = 1.51–2.02; male HR = 1.27, 95% CI = 1.15–1.40). Associations were attenuated but persisted after adjustment for risk factors (not including IMT) (prevalent MI: female OR = 1.73, 95% CI = 1.40–2.14; male OR = 1.14, 95% CI = 1.02–1.28, and incident cardiac events: female HR = 1.26, 95% CI = 1.08–1.48; male HR = 1.19, 95% CI = 1.08–1.32). After additional adjustment for IMT, diameter was associated with incident cardiac events in women (HR = 1.18, 95% CI = 1.00–1.40) and men (HR = 1.17, 95% CI = 1.06–1.29), and with prevalent MI only in women (OR = 1.73; 95% CI = 1.37–2.17). In women, when adjustment was limited, diameter models had larger AUC than other models.ConclusionRCCA diameter is an important correlate of cardiac events, independent of IMT, but adds little to overall risk discrimination after risk factor adjustment.

Cardiovascular disease and Alzheimer's disease: common links

Growing evidence supports a strong and likely causal association between cardiovascular disease (CVD), and its risk factors, with incidence of cognitive decline and Alzheimer's disease. Individuals with subclinical CVD are at higher risk for dementia and Alzheimer's. Several cardiovascular risk factors are also risk factors for dementia, including hypertension, high LDL cholesterol, low HDL cholesterol and especially diabetes. Moderate alcohol appears to be protective for both CVD and dementia. In contrast, inflammatory markers predict cardiovascular risk, but not dementia, despite biological plausibility for such a link. The substantial overlap in risk factors points to new avenues for research and prevention.

Different relation between 24-h blood pressure and distensibility at different peripheral arteries. Data from the European Lacidipine Study on Atherosclerosis (ELSA)

The European Lacidipine Study on Atherosclerosis (ELSA) has been planned to investigate the effect of reduction in office and ambulatory blood pressure by lacidipine versus atenolol on carotid artery wall thickness in mild to moderate essential hypertensive patients with no metabolic abnormalities. One prespecified sub-study of ELSA focused on measurements of arterial distensibility in the carotid as well as in the radial artery to determine the relationship of functional arterial properties with office versus ambulatory blood pressure (BP) values as well as the correspondence between functional and structural arterial alterations. The sub-study was conducted on 124 patients recruited in four centres (Monza-Milan, Paris, Grenoble and Glasgow). BP was measured both by a mercury sphygmomanometer and by 24-h ambulatory monitoring. Common carotid artery wall thickness was measured by certified sonographers as described in the main study. Common carotid and radial artery distensibility were obtained by echotracking techniques, which allowed to relate changes in arterial diameter with systo-diastolic BP changes. Carotid artery wall distensibility showed (1) a negative correlation with office and more so 24-h average systolic BP (r = -0.45 and -0.58, P < 0.008 and 0.001) but not with office or 24-h diastolic BP) and (2) a negative correlation with the corresponding wall thickness (r = -0.47, P < 0.005). In contrast, at the radial artery level distensibility and thickness showed no correlation with each other and with BP. Carotid (but not radial) artery distensibility also correlated with ambulatory systolic BP variability but the correlation was lost after adjustment for age and mean BP values. These data suggest that stiffening of large elastic artery is reflected more by ambulatory than office BP elevations, systolic BP being much more important than diastolic. Alterations of large elastic arteries function is related to structural wall changes. Functional and structural properties of middle-size muscle arteries are independent of BP.

Impact of body mass index on changes in common carotid artery wall thickness.

To examine associations between changes in body mass index (BMI) and changes in carotid artery intima-media thickness (IMT) in a community-based sample. Carotid artery IMT and BMI were assessed at baseline (between 1987 and 1990) and in three subsequent examinations at 3-year intervals in participants in the Atherosclerosis Risk in Communities cohort. The 9,316 African-American and white men and women in the analysis were 45 to 64 years of age at baseline. Cross-sectional associations between BMI and IMT were assessed using general linear models. Longitudinal associations were examined using mixed models analysis. Cross-sectional associations between BMI and IMT were confirmed. At baseline, a 1-kg/m(2) increase in BMI was associated with an increase in IMT that ranged from 2.5 to 7.5 micro m among the ethnic-gender groups examined. Changes in BMI were not associated with changes in IMT in models that adjusted for aging and other covariates. Results were similar across ethnic-gender groups. Among free-living, 45- to 64-year-old adults, changes in common carotid artery IMT associated with changes in BMI are either very small or absent.

Correlates of aortic stiffness in elderly individuals: a subgroup of the cardiovascular health study

Background: Arterial stiffness has been associated with aging, hypertension, and diabetes; however, little data has been published examining risk factors associated with arterial stiffness in elderly individuals. Methods: Longitudinal associations were made between aortic stiffness and risk factors measured approximately 4 years earlier. Aortic pulse wave velocity (PWV), an established index of arterial stiffness, was measured in 356 participants (53.4% women, 25.3% African American), aged 70 to 96 years, from the Pittsburgh site of the Cardiovascular Health Study during 1996 to 1998. Results: Mean aortic pulse wave velocity (850 cm/sec, range 365 to 1863) did not differ by ethnicity or sex. Increased aortic stiffness was positively associated with higher systolic blood pressure (SBP), age, fasting and 2-h postload glucose, fasting and 2-h insulin, triglycerides, waist circumference, body mass index, truncal fat, decreased physical activity, heart rate, and common carotid artery wall thickness ( P < .05). After controlling for age and SBP, the strongest predictors of aortic stiffness in men were heart rate ( P = .001) and 2-h glucose ( P = .063). In women, PWV was positively associated with heart rate ( P = .018), use of antihypertensive medication ( P = .035), waist circumference ( P = .030), and triglycerides ( P = .081), and was negatively associated with physical activity ( P = .111). Results were similar when the analysis was repeated in nondiabetic individuals and in those free of clinical or subclinical cardiovascular disease in 1992 to 1993. Conclusions: In these elderly participants, aortic stiffness was positively associated with risk factors associated with the insulin resistance syndrome, increased common carotid intima–media thickness, heart rate, and decreased physical activity measured several years earlier.