Stiffness Index Beta Research Articles

Acute Effect of Aerobic Exercise on Carotid Strain in Individuals with Multiple Sclerosis

INTRODUCTIONIndividuals with multiple sclerosis (MS) have increased arterial stiffness, a known risk factor for cardiovascular disease. Acute aerobic exercise is a stressor affecting markers of arterial stiffness, such as carotid strain (CS) and beta stiffness index, which provides insight into aspects of arterial function. Individuals with MS may have different responses to exercise compared to healthy individuals due to arterial dysfunction, which can be evaluated via markers of arterial stiffness.PURPOSETo evaluate the acute effect of aerobic exercise on CS in individuals with MS.METHODSSixteen individuals with MS (42 ± 8 yrs; 27.5 ± 6.9 kg/m2) underwent treadmill walking at 60% of their peak aerobic capacity for 20 min. Images of the carotid artery were obtained in the radial view with ultrasonography at baseline, immediate and 30 min post‐exercise. Speckle tracking software was used to calculate the following variables of arterial function: CS, CS time to peak (TPK), CS rate, CS rate TPK, radial velocity (RV), RV TPK, radial displacement (RD) and RD TPK. Carotid systolic blood pressure (cSBP) was measured via applanation tonometry and longitudinal carotid beta stiffness index via ultrasonography.RESULTSSee Table. CS rate, RV and carotid systolic blood pressure (cSBP) increased immediate post‐exercise (p<0.05). CS TPK and RD TPK decreased immediately post‐exercise and RD TPK remained decreased at 30 min post‐exercise (p<0.05). HR and beta stiffness index increased immediately post‐exercise (p<0.05) and returned to baseline at 30 min (p>0.05).CONCLUSIONThe baseline levels of CS in individuals with MS are lower than values reported for middle‐aged adults in the literature, indicative of baseline arterial dysfunction. Beta stiffness index increased immediately after exercise. While CS rate increased after exercise in individuals with MS similar to beta stiffness index, the difference disappeared after statistically controlling for HR. Our results suggest that individuals with MS do not improve arterial stiffness with acute aerobic exercise, providing more evidence for arterial impairment.This abstract is from the Experimental Biology 2018 Meeting. There is no full text article associated with this abstract published in The FASEB Journal.

Impact of Aerobic Capacity, Age and Duration of Disease on Arterial Function in Individuals with Multiple Sclerosis

Multiple sclerosis (MS) is a chronic inflammatory disease of the central nervous system associated with vascular dysfunction and increased risk of cardiovascular disease and mortality. Aerobic capacity (VO2peak) and age are strong predictors of arterial function in a healthy cohort; however, we know very little about the role of VO2peak, disease duration, and age on vasculature in those with MS.PurposeTo evaluate the role of fitness, duration of disease since diagnosis (Dx) and age on arterial function in individuals with MS.Methods56 individuals (Male: 15, 46±12 yrs, BMI: 29.0±6.8) with MS were divided into young (≤50 years) or older (>50 years) groups. The age groups were further delineated by length of Dx, defined as short (≤10 years) or long (>10 years). Brachial blood pressure (BP) was obtained after a 10 minute rest. Resistance artery function was assessed using strain gauge plethysmography. Reactive hyperemia was calculated as the absolute change between resting and peak flow. Carotid artery stiffness was assessed by ultrasound (Beta‐Stiffness Index (β), Elastic Modulus (Ep) and Arterial Compliance (AC)). A maximal incremental cycle test was performed to assess VO2peak.ResultsSee Table. Older adults with MS had higher systolic and mean BP (p<0.05). Length of Dx and age did not influence resistance vessel function (p>0.05), however, VO2peak was associated with peak forearm blood flow and peak conductance. Young and older adults with MS exhibited differential responses in large artery stiffness with disease progression, even after controlling for fitness level (β, Ep, AC) (interactions, p<0.05). Older adults had higher arterial stiffness (β, Ep, AC) with shorter disease duration compared to young. However, with longer disease duration, there was no difference between younger and older adults (p>0.05). β and Ep in older adults decreased with progression of MS (p<0.05). Disease duration did not affect arterial stiffness in young adults (p>0.05).ConclusionIt appears greater fitness can improve resistance artery function in the MS population. Fitness does not influence large artery stiffness in MS, but with age and duration of disease β and Ep are counterintuitively reduced. These findings require further investigation to elucidate the effects of age, VO2peak and length of Dx on vascular function in MS.This abstract is from the Experimental Biology 2018 Meeting. There is no full text article associated with this abstract published in The FASEB Journal.

Beta stiffness index in euthyroid subjects: The role of free thyroxin

Beta stiffness index in euthyroid subjects: The role of free thyroxin

Effect of upper body position on arterial stiffness: influence of hydrostatic pressure and autonomic function.

To evaluate changes in arterial stiffness with positional change and whether the stiffness changes are due to hydrostatic pressure alone or if physiological changes in vasoconstriction of the conduit arteries play a role in the modulation of arterial stiffness. Thirty participants' (male = 15, 24 ± 4 years) upper bodies were positioned at 0, 45, and 72° angles. Pulse wave velocity (PWV), cardio-ankle vascular index, carotid beta-stiffness index, carotid blood pressure (cBP), and carotid diameters were measured at each position. A gravitational height correction was determined using the vertical fluid column distance (mmHg) between the heart and carotid artery. Carotid beta-stiffness was calibrated using three methods: nonheight corrected cBP of each position, height corrected cBP of each position, and height corrected cBP of the supine position (theoretical model). Low frequency systolic blood pressure variability (LFSAP) was analyzed as a marker of sympathetic activity. PWV and cardio-ankle vascular index increased with position (P < 0.05). Carotid beta-stiffness did not increase if not corrected for hydrostatic pressure. Arterial stiffness indices based on Method 2 were not different from Method 3 (P = 0.65). LFSAP increased in more upright positions (P < 0.05) but diastolic diameter relative to diastolic pressure did not (P > 0.05). Arterial stiffness increases with a more upright body position. Carotid beta-stiffness needs to be calibrated accounting for hydrostatic effects of gravity if measured in a seated position. It is unclear why PWV increased as this increase was independent of blood pressure. No difference between Methods 2 and 3 presumably indicates that the beta-stiffness increases are only pressure dependent, despite the increase in vascular sympathetic modulation.

THE DIFFERENCE OF BLOOD PRESSURE AND ARTERIAL STIFFNESS AFTER INTAKE OF ARABICA AND ROBUSTA COFFEE IN CONTROLLED HYPERTENSION

Potential mechanisms of caffeine promote large artery stiffness and associated with increased morbidity and mortality of cardiovascular disease. To find the difference of blood pressure and arterial stiffness after intake of arabica and robusta coffee in controlled hypertension, a quasi-experimental study was done enrolling 24 controlled hypertension and 24 normotensive subjects collected by purposive sampling. Subjects received ± 10,6 g caffeinated coffee in 150 ml water with crossover protocol twice in 5 days. The assessment of arterial stiffness by obtaining ultrasound 2D image of common carotid artery then was calculated with beta stiffness index. Blood pressure and arterial stiffness was measured before coffee intake and again at 30 to 60 minutes thereafter. In controlled hypertension, significant differences were found between initial systolic blood pressure (SBP), 30 and 60 minutes after arabica (p 0,002) and robusta (p 0,012) intake; between diastolic blood pressure (DBP), 30 and 60 minutes after of arabica (p 0,004) and robusta (p 0,025) oral administration; and between initial beta stiffness index, 30 and 60 minutes after arabica (p 0,018) oral administration. However, no significant difference was found between initial beta stiffness index, 30 and 60 minutes after robusta (p 0,104) oral administration. No significant difference was found in all variables after arabica and robusta intake. Significant differences were found in blood pressure after arabica or robusta intake and in arterial stiffness after arabica intake. However, no significant differences were found in arterial stiffness after robusta intake and in all variables after arabica and robusta intake.

Relationship between carotid arterial properties and cerebral white matter hyperintensities.

Since arterial stiffness is a functional measure of arterial compliance and may be an important marker of cerebrovascular disease, we examined the association of carotid artery stiffness with white matter hyperintensity volume (WMHV) in a cross-sectional study of 1,166 stroke-free participants. Carotid beta stiffness index (STIFF) was assessed by M-mode ultrasound of the common carotid artery and calculated as the ratio of natural log of the difference between systolic and diastolic blood pressure over STRAIN, a ratio of the difference between carotid systolic and diastolic diameter (DD) divided by DD. WMHV was measured by fluid-attenuated inversion recovery MRI. The associations of STIFF, DD, and STRAIN with WMHV were examined using linear regression after adjusting for sociodemographic, lifestyle, and vascular risk factors. In a fully adjusted model, larger carotid DD was significantly associated with greater log-WMHV (β = 0.09, p = 0.001). STIFF and STRAIN were not significantly associated with WMHV. In adjusted analyses stratified by race-ethnicity, STRAIN (β = -1.78, p = 0.002) and DD (β = 0.11, p = 0.001) were both associated with greater log-WMHV among Hispanic participants, but not among black or white participants. Large carotid artery diameters are associated with greater burden of white matter hyperintensity (WMH) in this multiethnic population. The association between increased diameters, decreased STRAIN, and greater WMH burden is more pronounced among Hispanics. These associations suggest a potential important pathophysiologic role of extracranial large artery remodeling in the burden of WMH.

Effect of Upper Body Position on Arterial Stiffness: Influence of Hydrostatic Pressure and Autonomic Function

Conventional markers of arterial stiffness, such as carotid beta‐stiffness index, are traditionally obtained in the supine position. In the seated position, it is not known if correcting for hydrostatic pressure is an adequate adjustment for estimation of beta‐stiffness index or if other factors need to be considered, such as autonomic modulation.ObjectiveTo determine if the change in arterial stiffness in a seated position is due to the effects of gravity alone or if there is an additional effect of autonomic modulation after correcting for changes in hydrostatic pressure.MethodsThirty young participants (male=15, 24 ± 4 years, 25.6 ± 3.9 kg/m2) were randomly positioned at 0°, 45°, and 72° angles (semi‐recumbent position). Beat‐to‐beat blood pressure, carotid blood pressure (cBP), beta‐stiffness index, and carotid diameters were measured at each position after 5 min rest. The gravitational height correction was determined by measuring the vertical fluid column distance (mmHg), between the heart and the carotid artery. Beta‐stiffness index was calibrated using three different methods: 1) non‐height corrected cBP of each position, 2) height corrected cBP of each position, 3) height corrected cBP of the supine position (theoretical model). Method 3 was implemented under the assumption that pressures from the supine to the seated position only change due to the effects of gravity. LFSAP was analyzed as a marker of sympathetic activity.ResultsSee table. Beta stiffness did not increase if not corrected for hydrostatic pressure changes. Arterial stiffness indices based on method 2 were not significantly different from the one based on method 3(p=0.65). LFSAP increased in more upright positions (p&lt;0.05) but diastolic diameter relative to diastolic pressure did not change (p&gt;0.05).ConclusionsThe change in arterial stiffness in Method 2 did not differ from Method 3, presumably indicating that the beta stiffness index increases with change in position are pressure dependent, despite the apparent increase in vascular sympathetic modulation. This is supported by the lack of change in diameter relative to diastolic pressure. 0° 45° 72° Heart rate, bpm 58 (9)a 61 (11) 62 (11) Height Correction, mmHg 0 (0)a −11 (3)b −16 (3) Carotid SBP, mmHg (Method 1) 116 (13)a 122 (15) 122 (12) Carotid DBP, mmHg (Method 1) 74 (8)a 78 (7) 78 (6) Carotid SBP height corrected, mmHg (Method 2) 116 (13)a 110 (15)b 105 (12) Carotid DBP height corrected, mmHg (Method 2) 74 (8)a 66 (7)b 61 (6) Carotid SBP theoretical. mmHg (Method 3) 116 (13)a 105 (13)b 99 (13) Carotid DBP theoretical, mmHg (Method 3) 74 (8)a 63 (8)b 58 (8) Beta stiffness (Method 1) 4.1 (1.3) 4.0 (1.5) 4.0 (1.2) Beta stiffness height corrected (Method 2) 4.1 (1.3)b 4.6 (1.7) 4.8 (1.5) Beta stiffness theoretical (Method 3) 4.1 (1.3)a 4.7 (1.6)b 5.0 (1.7) Diastolic diameter, mm 6.1 (0.8)a 5.7 (0.7)b 5.6 (0.7) Diastolic diameter/Carotid DBP height corrected, mm/mmHg 0.08 (0.02) 0.09 (0.01) 0.09 (0.01) Relative diameter, % 11.7 (3.3) 11.7 (3.1) 12.2 (3.7) LFSAP 6.4 (4.7)a 11.6 (6.6) 13.1 (10.1) significantly different from all other positions, p&lt;0.05 significantly different from 72°, p&lt;0.05 Data presented as mean (SD). SBP: systolic blood pressure; DBP: diastolic blood pressure

Obese adolescents with polycystic ovarian syndrome have elevated cardiovascular disease risk markers.

Women with polycystic ovarian syndrome (PCOS) have evidence of subclinical cardiovascular disease (CVD). However, insulin resistance, an important factor in the development of CVD in adults, is common in adolescents with PCOS, yet data in adolescents are limited. Therefore, we sought to measure insulin resistance and CVD markers in obese youth with and without PCOS. Thirty-six PCOS and 17 non-PCOS adolescent girls who were obese, sedentary, and non-hypertensive were recruited from clinics located within the Children's Hospital Colorado. Following 3 days of controlled diet and restricted exercise, fasting plasma samples were obtained prior to a hyperinsulinemic euglycemic clamp. PCOS girls were more insulin resistant than controls (glucose infusion rate 5.24±1.86 mg/kg/min vs 9.10±2.69; p<0.001). Girls with PCOS had blood pressure in the normal range, but had greater carotid intima-media thickness (cIMT) (0.49±0.07 mm vs 0.44±0.06; p=0.038), beta stiffness index (5.1±1.3 U vs 4.4±0.9; p=0.037), and reduced arterial compliance (1.95±0.47 mm2/mmHg × 10-1 vs 2.13±0.43; p=0.047). PCOS girls had a normal mean lipid profile, yet had a more atherogenic lipoprotein cholesterol distribution and had persistent elevations of free fatty acids despite hyperinsulinemia (68±28 μmol/mL vs 41±10; p=0.001), both potential contributors to CVD. Free fatty acid concentrations correlated best with all CVD markers. In summary, adolescent girls with PCOS have greater cIMT and stiffer arteries than girls without PCOS, perhaps related to altered lipid metabolism, even when clinical measures of blood pressure and cholesterol profiles are 'normal'. Therefore, management of adolescent PCOS should include assessment of CVD risk factor development.

Arterial stiffness index beta and cardio-ankle vascular index inherently depend on blood pressure but can be readily corrected.

Arterial stiffness index β and cardio-ankle vascular index (CAVI) are widely accepted to quantify the intrinsic exponent (β0) of the blood pressure (BP)-diameter relationship. CAVI and β assume an exponential relationship between pressure (P) and diameter (d). We aim to demonstrate that, under this assumption, β and CAVI as currently implemented are inherently BP-dependent and to provide corrected, BP-independent forms of CAVI and β. In P = Prefe, usually reference pressure (Pref) and reference diameter (dref) are substituted with DBP and diastolic diameter to accommodate measurements. Consequently, the resulting exponent is not equal to the pressure-independent β0. CAVI does not only suffer from this 'reference pressure' effect, but also from the linear approximation of (dP/dd). For example, assuming β0 = 7, an increase of SBP/DBP from 110/70 to 170/120 mmHg increased β by 8.1% and CAVI by 14.3%. We derived corrected forms of β and of CAVI (CAVI0) that indeed did not change with BP and represent the pressure-independent β0. To substantiate the BP effect on CAVI in a typical follow-up study, we realistically simulated patients (n = 161) before and following BP-lowering 'treatment' (assuming no follow-up change in intrinsic β0 and therefore in actual P-d relationship). Lowering BP from 160 ± 14/111 ± 11 to 120 ± 15/79 ± 11 mmHg (p < 0.001) resulted in a significant CAVI decrease (from 8.1 ± 2.0 to 7.7 ± 2.1, p = 0.008); CAVI0 did not change (9.8 ± 2.4 and 9.9 ± 2.6, p = 0.499). β and CAVI as currently implemented are inherently BP-dependent, potentially leading to erroneous conclusions in arterial stiffness trials. BP-independent forms are presented to readily overcome this problem.

Arterial stiffness index beta and cardio-ankle vascular index inherently depend on blood pressure, but can be readily corrected

Objectives:Arterial stiffness index β and cardio-ankle vascular index (CAVI) are widely accepted to quantify the intrinsic exponent (β0) of the blood pressure (BP)-diameter relationship. CAVI and β assume an exponential relationship between pressure (P) and diameter (d). We aim to demonstrate that,

Sex-specific predictors of left ventricular diastolic dysfunction in untreated hypertension.

BackgroundLittle is known about the sex-specific differences in left ventricular (LV) diastolic dysfunction (DD) predictors. We hypothesized that arterial stiffness (AS) may play a different role in the etiology of LV DD in hypertensive men and postmenopausal women, acting independently from other established predictors of this condition, such as age, obesity, diabetes mellitus, LV remodeling, and systolic function.ObjectivesThe aim of the study was to analyze the sex-specific differences in AS and other predictors of LV DD in men and postmenopausal women with untreated hypertension (HTN).Patients and methodsThe study included 144 patients (63 postmenopausal women and 81 men, mean age 62.7±6.7 years) with previously untreated HTN and no history of cardiovascular diseases. All patients were subjected to detailed echocardiography, vascular ultrasound, and high-resolution echotracking (eTracking) of carotid arteries.ResultsIn the multivariate analysis, concomitant diabetes mellitus turned out to be an independent predictor of LV DD in women (P=0.02). In turn, two independent predictors of LV DD have been identified in men: S′-tissue Doppler-derived peak LV longitudinal systolic shortening velocity (P=0.001) and β, beta stiffness index (P=0.004).ConclusionThere are sex differences in the predictors of LV DD in untreated HTN. In postmenopausal women, LV DD is mostly determined by diabetes, while in men, it is determined by S′, reflecting LV systolic longitudinal function, and β, a parameter of AS.

Prenatal Air Pollution Exposure and Early Cardiovascular Phenotypes in Young Adults.

Exposure to ambient air pollutants increases risk for adverse cardiovascular health outcomes in adults. We aimed to evaluate the contribution of prenatal air pollutant exposure to cardiovascular health, which has not been thoroughly evaluated. The Testing Responses on Youth (TROY) study consists of 768 college students recruited from the University of Southern California in 2007–2009. Participants attended one study visit during which blood pressure, heart rate and carotid artery arterial stiffness (CAS) and carotid artery intima-media thickness (CIMT) were assessed. Prenatal residential addresses were geocoded and used to assign prenatal and postnatal air pollutant exposure estimates using the U.S. Environmental Protection Agency’s Air Quality System (AQS) database. The associations between CAS, CIMT and air pollutants were assessed using linear regression analysis. Prenatal PM10 and PM2.5 exposures were associated with increased CAS. For example, a 2 SD increase in prenatal PM2.5 was associated with CAS indices, including a 5% increase (β = 1.05, 95% CI 1.00–1.10) in carotid stiffness index beta, a 5% increase (β = 1.05, 95% CI 1.01–1.10) in Young’s elastic modulus and a 5% decrease (β = 0.95, 95% CI 0.91–0.99) in distensibility. Mutually adjusted models of pre- and postnatal PM2.5 further suggested the prenatal exposure was most relevant exposure period for CAS. No associations were observed for CIMT. In conclusion, prenatal exposure to elevated air pollutants may increase carotid arterial stiffness in a young adult population of college students. Efforts aimed at limiting prenatal exposures are important public health goals.

Carotid artery wall stiffness is increased in patients with small vessel disease: A case-control study

Cerebral ischemic small-vessel disease (SVD), causing lacunar infarcts and white matter hyperintensities on brain magnetic resonance imaging (MRI), is a progressive disease associated with an increased risk of stroke, dementia and death. Increased arterial stiffness has been associated with ischemic stroke and cerebral SVD independently of common vascular risk factors. The aim of the study was to analyze arterial stiffness in our patients with symptomatic SVD. In a cross-sectional study design we included 30 patients with clinical and MRI evidence of cerebral SVD and 30 age-, gender- and risk factor-matched control subjects with no neurological diseases. Patients were evaluated at the Ultrasound Laboratory at the Neurology Clinic, Clinical Center of Serbia in Belgrade, during a three-month period (from September 1st to December 1st 2012). Baseline demographic and vascular risk factors were recorded. All patients underwent standard carotid ultrasound scans with measuring of intima-media thickness (IMT) and analysis of atheromatous plaques. Internal carotid artery stiffness was evaluated with the use of e-tracking option as beta stiffness index (BSI) value. There were no differences between study groups in regard to degree of carotid stenosis and type of carotid plaques (p > 0.05). Patients in SVD group had significantly higher mean IMT (p = 0.0093) and mean BSI (p < 0.0001) than subjects in the control group. No significant correlation was detected between IMT and BSI in SVD group (r = 0.168; p = 0.376). Brain lesions severity correlated with BSI (r = 0.733; p < 0.0001). Arterial stiffness is increased in symptomatic patients with SVD, independently of vascular risk factors and IMT.

The Value of Elastic Modulus Index as a Novel Surrogate Marker for Cardiovascular Risk Stratification by Dimensional Speckle-Tracking Carotid Ultrasonography.

BackgroundCarotid intima media thickness (CIMT) and the presence of carotid plaque have been used for risk stratification of cardiovascular disease (CVD). To date, however, the association between multi-directional functional properties of carotid artery and CVD has not been fully elucidated. We sought to explore the multi-directional mechanics of the carotid artery in relation to cardiovascular risk.MethodsFour hundred one patients who underwent carotid ultrasound were enrolled between January 2010 and April 2013. A high risk of CVD was defined as more than 20% of 10-year risk based on the Framingham risk score. Using a speckle-tracking technique, the longitudinal and radial movements were analyzed in the B-mode images. Peak longitudinal and radial displacements, strain and strain rate were also measured. Beta stiffness and elastic modulus index were calculated from the radial measurements.ResultsOf the overall sample, 13% (52) of patients comprised the high-risk group. In multivariate logistic regression, CIMT and elastic modulus index were independently associated with a high-risk of CVD {odds ratio (OR): 1.810 [95% confidence interval (CI) 1.249–2.622] and OR: 1.767 (95% CI: 1.177–2.652); p = 0.002, 0.006, respectively}. The combination of CIMT and elastic modulus index correlated with a high-risk of CVD more so than CIMT alone.ConclusionThe elastic modulus index of the carotid artery might serve as a novel surrogate marker of high-risk CVD. Measurement of the multi-directional mechanics of the carotid artery using the speckle tracking technique has potential for providing further information over conventional B-mode ultrasound for stratification of CVD risk.

Assessment of Aortic Elasticity in Patients with Celiac Disease.

Background and ObjectivesCeliac disease (CD) is a chronic autoimmune disorder induced by dietary gluten intake by individuals who are genetically sensitive. Many studies report an increased risk of cardiovascular diseases in such patients. The aim of this study is to assess aortic elasticity properties in patients with CD that may be associated with an increased risk of cardiovascular disease.Subjects and MethodsEighty-one patients diagnosed with CD by antibody test and biopsy and 63 healthy volunteers were included in this prospective study. Electrocardiographic and echocardiographic examinations were performed.ResultsThe CD group did not have any differences in the conventional echocardiographic parameters compared to the healthy individuals. However, patients in the CD group had an increased aortic stiffness beta index (4.3±2.3 vs. 3.6±1.6, p=0.010), increased pressure strain elastic modulus (33.6±17.0 kPa vs. 28.5±16.7 kPa, p=0.037), decreased aortic distensibility (7.0±3.0×10-6 cm2/dyn vs. 8.2±3.6×10-6 cm2/dyn, p=0.037), and similar aortic strain (17.9±7.7 vs. 16.0±5.5, p=0.070) compared to the control group. Patients with CD were found to have an elevated neutrophil/lymphocyte ratio compared to the control group (2.54±0.63 vs. 2.24±0.63, p=0.012). However, gluten-free diet and neutrophil/lymphocyte ratio were not found to be associated with aortic elasticity.ConclusionPatients with CD had increased aortic stiffness and decreased aortic distensibility. Gluten-free diet enabled the patients with CD to have a reduction in the inflammatory parameters whereas the absence of a significant difference in the elastic properties of the aorta may suggest that the risk of cardiovascular disease persists in this patient group despite a gluten-free diet.

Evaluation of carotid intima-media thickness and carotid arterial stiffness in children with adenotonsillar hypertrophy

Adenotonsillar hypertrophy can produce cardiopulmonary disease in children. However, it is unclear whether adenotonsillar hypertrophy causes atherosclerosis. This study evaluated carotid intimamedia thickness and carotid arterial stiffness in children with adenotonsillar hypertrophy. The study included 40 children with adenotonsillar hypertrophy (age: 5-10 years) and 36 healthy children with similar age and body mass index. Systolic blood pressure, diastolic blood pressure, and pulse pressure were measured in all subjects. Carotid intima-media thickness, carotid arterial systolic diameter, and carotid arterial diastolic diameter were measured using a high-resolution ultrasound device. Based on these measurements, carotid arterial strain, carotid artery distensibility, beta stiffness index, and elasticity modulus were calculated. Carotid intima-media thickness was greater in children with adenotonsillar hypertrophy (0.36±0.05 mm vs. 0.34±0.04 mm, P=0.02) compared to healthy controls. Beta stiffness index (3.01±1.22 vs. 2.98±0.98, P=0.85), elasticity modulus (231.39±99.23 vs. 226.46±83.20, P=0.88), carotid arterial strain (0.17±0.06 vs. 0.17±0.04, P=0.95), and carotid artery distensibility (13.14±3.88 vs. 12.92±3.84, P=0.75) were similar between children with adenotonsillar hypertrophy and the healthy controls. The present study revealed increased carotid intima-media thickness in children with adenotonsillar hypertrophy. The risk of subclinical atherosclerosis may be higher in children with adenotonsillar hypertrophy.

Low Carotid Artery Wall Shear Stress is Associated with Significant Coronary Artery Disease in Patients with Chest Pain.

To investigate the relationships among carotid wall shear stress (WSS), carotid intima-media thickness (IMT), and total plaque area (TPA) using ultrasound (US) in the common carotid artery (CCA) in patients with suspected coronary artery disease (CAD). Carotid artery US was performed in 950 patients with suspected CAD, and mean IMT, TPA, and hemodynamic parameters of CCA, including peak and mean WSS, were measured. We analyzed the carotid parameters according to the presence of CAD and the predictive values of WSS and TPA for the presence of significant CAD. Compared with patients without CAD (n=667), patients with CAD (n=283) demonstrated significantly higher mean IMT (0.66 vs. 0.74 mm, p ＜ 0.001), TPA (0.13 vs. 0.20 cm(2), p=0.002), and beta stiffness index (5.12 vs. 5.60, p=0.045) and lower mean WSS (2.59 vs. 2.23 dyne/cm(2), p ＜ 0.001). Mean WSS revealed significant negative correlations with the beta stiffness index (r=-0.116, p ＜ 0.001), mean IMT (r=-0.193, p=0.007), and TPA (r =-0.296, p ＜ 0.001). Mean WSS, mean IMT and TPA revealed significant difference with respect to CAD severity (for all p ＜ 0.001). Age [OR, 1.038 (95% CI, 1.010-1.066), p=0.007], diabetes mellitus [1.606 (1.194-1.807), p= 0.011], smoking [1.758 (1.564-1.866), p ＜ 0.001], carotid TPA [2.615 (1.320-5.183), p=0.006], and mean WSS [0.554 (0.371-0.838), p=0.005] were significant CAD predictors. In patients with chest pain, low local shear stress and high plaque burden in the carotid arteries were significant CAD predictors. These findings indicate that carotid WSS has a role as an index of atherosclerosis and serves as a predictor of significant coronary atherosclerosis.

Arterial Stiffness as a Biomarker of Radiation-Induced Carotid Atherosclerosis.

Arterial stiffness is thought to be a precursor to atherosclerosis. Conventional arterial stiffness parameters as potential biomarkers of radiation-induced damage were investigated. Patients with head and neck cancer treated with radiotherapy ≥2 years previously to one side of the neck were included. The unirradiated side was the internal control. Beta stiffness index (B) and elastic modulus (Ep) were used to assess arterial stiffness and were measured in proximal, mid, and distal common carotid artery (CCA) and compared with the corresponding unirradiated segments. Fifty patients (68% male; median age 58 years; interquartile range 50-62) were included. Mean ± standard deviation maximum doses to irradiated and unirradiated arteries were 53 ± 13 and 1.9 ± 3.7 Gy, respectively. Differences in B were not significant. Significant differences in Ep were demonstrated-proximal CCA: 1301 ± 1223 versus 801 ± 492 (P < .0001), mid CCA: 1064 ± 818 versus 935.5 ± 793 (P < .0001), and distal CCA: 1267 ± 1084 versus 775.3 ± 551.9 (P < .0001). Surgery had no impact on arterial stiffness. Arterial stiffness is increased in irradiated arteries, in keeping with radiation-induced damage. Prospective data may show an association between arterial stiffness and atherosclerosis in this setting.

Evaluation of the Beta Stiffness Index and Carotid Intima-Media Thickness in Asian Patients With Psoriasis.

The risk of cardiovascular (CV) events is reportedly elevated in patients with psoriasis. Evaluation of the beta stiffness index (BSI) and carotid intima-media thickness (cIMT) are noninvasive methods of assessing arterial stiffness and subclinical atherosclerosis. We aimed to determine carotid arterial stiffness and cIMT, using high-resolution ultrasonography, in patients with psoriasis compared with controls, and to analyze whether psoriasis is an independent risk factor for atherosclerosis. A total of 54 consecutive patients with psoriasis and 60 age and gender-matched healthy controls were enrolled. Compared with control participants, patients with psoriasis exhibited a significantly higher BSI (P < .001). The cIMT tended to be higher in patients with psoriasis but statistically not significant (P = .076). BSI was positively correlated with age, systolic blood pressure, disease severity defined according to history of systemic treatment, and traditional CV risk factors. Also, psoriasis was independently associated with BSI. These findings suggest that psoriasis is an independent risk factor for arterial stiffness, and the BSI is an earlier indicator of atherosclerosis than cIMT in these patients.

Increased carotid atherosclerosis and carotid artery stiffness according to the disease duration and activity in patients with systemic lupus erythematosus

Objective: The ᅵink among carotid intimamedia thickness (IMT), vascular elastic property and the disease activity of systemic lupus erythematosus (SLE) is not well defined. We investigated the association between carotid atherosclerosis, elastic properties of the carotid arterial wall and clinical parameters of SLE. Methods: Fifty-one SLE patients and fifty healthy controls were included. Peak systolic global circumferential and posterior radial strains of carotid artery were measured to assess the elastic properties. Beta stiffness index was used as conventional method for the distensibility of the carotid artery. Information concerning SLE duration, cumulative dose of steroids and/or immunosuppressive drug intake was recorded, and SLE activity was assessed by SLE disease activity index (SLEDAI) score. Results: Carotid plaques were more common in SLE patients. SLE patients with plaques were 㢌der and showed the increased mean ᅵMT, high sensitivity C-reactive protein (hs CRP), IgG anti-cardi㢌ipin antibody (aCL), and longer disease duration compared with those without plaques. Peaksyst㢌ic global circumferential and posterior radial strain as well β stiffness index were significantly lower in SLE group. Age, disease duration, hsCRP, IgG aCL showed significant correlations with mean ᅵMT and parameters of carotid elastic property (all P's&amp;lt;0.05). Conclusions: Carotid atherosclerosis was more common in SLE patients, and carotid arterial stiffness had significant correlation with disease duration, hsCRP and IgG aCL level. Speckle tracking strain imaging is a comparative method for the assessment of elastic properties of carotid artery of SLE patients.