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Association Between Hemodynamics in the Common Carotid Artery and Severity of Carotid Atherosclerosis in Patients With Essential Hypertension

医学 心脏病学 颈总动脉 内科学 血流动力学 脉冲波速 动脉硬化 内膜中层厚度 脉冲压力 血压 超声波 单变量分析 颈动脉 放射科 多元分析
作者
M. Y. Lee,Chia‐Chin Wu,Kuang‐Hui Yu,Chih‐Sheng Chu,K. T. Lee,S. H. Sheu,Wen Ter Lai
出处
期刊:American Journal of Hypertension [Oxford University Press]
卷期号:21 (7): 765-770 被引量:27
标识
DOI:10.1038/ajh.2008.182
摘要

Carotid intima-media thickness (IMT) and plaque burden evaluated by B-mode ultrasound have been used as relevant indicators for carotid atherosclerosis. This study was aimed to investigate the relationship between hemodynamic parameters in the common carotid artery (CCA) and the severity of carotid atherosclerosis in untreated hypertensive patients.Carotid IMT and plaque burden were evaluated in bilateral CCA, bifurcations, external and internal carotid arteries using duplex ultrasound in 80 untreated hypertensive patients. The patients were divided into four groups according to plaque burden. Hemodynamic parameters of CCA, including peak and mean circumferential wall tension (CWT), tensile stress (TS), wall shear stress (WSS), and Young's elastic modulus (YEM), were calculated after measurements of internal diameter (ID), IMT, and peak and mean flow velocities of CCA. Arterial stiffness was also assessed using the brachial-ankle pulse wave velocity (baPWV).Age, pulse pressure, creatinine, carotid IMT, and mean TS were shown to have significant differences among the four plaque groups (P < 0.05). Peak CWT and peak TS were also shown to have marginal differences. In univariate analysis, the peak and mean CWT and TS were significantly correlated with plaque score. Stepwise multiple regression analysis showed that carotid IMT, age, and peak CWT were independently associated with plaque score.These results suggest that the CWT and TS of the CCA are associated with the severity of carotid atherosclerosis in untreated hypertensive patients. Hence, the hemodynamics of vessels may contribute to the plaque burden of low-resistance arteries.
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