title: Assessment of carotid compliance using real time vascular ultrasound image analysis in Marfan syndrome.
abstract: BACKGROUND
  Fibrillin-1 deficiency, dysregulated cytokine transforming growth factor-beta, and increased collagen deposition related to fibrillin-1 gene mutations could predispose to impaired carotid compliance (CC) in Marfan syndrome (MFS). We sought to detect any alterations in CC using the vascular image analysis system (VIA).
  
  
  RESULTS
  Thirty-two MFS patients, 20 men and 12 women (mean age 34.2 +/- 12.05 years), and 29 controls matched for age, sex, and body surface area (BSA) were recruited. The entire length of each carotid system was initially scanned longitudinally using a 14 MHz linear transducer. Then, a stereotactic clamp held the transducer in contact with the carotid artery. Arterial diameter changes during the cardiac cycle were recorded for 1 minute from both right (RCCA) and left common carotid arteries (LCCA) separately using the VIA system. RCCA and LCCA compliance and distensibility measurements were significantly reduced in MFS patients when compared to controls, P < 0.05. RCCA and LCCA intima-media thickness did not differ between patients and controls, P > 0.05. MFS diagnosis and age were associated with reduced CC in both carotid arteries after adjusting for variables such as, sex, BSA, heart rate, beta-blockade, intima-media thickness, and aortic root size.
  
  
  CONCLUSIONS
  Our findings showed a reduction in CC in adult patients with MFS. This could be attributed to fibrillin-1 deficiency resulting in structural abnormalities in the carotid arterial wall.
authors.affiliation: Department of Cardiac and Vascular Sciences, St. George's, University of London, Cranmer Terrace, London, UK.
authors.forename: Anatoli
authors.initials: A
authors.lastname: Kiotsekoglou
authors.forename: James C
authors.initials: JC
authors.lastname: Moggridge
authors.forename: Venedictos
authors.initials: V
authors.lastname: Kapetanakis
authors.forename: Valentine R
authors.initials: VR
authors.lastname: Newey
authors.forename: Antonios
authors.initials: A
authors.lastname: Kourliouros
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Mullen
authors.forename: Juan C
authors.initials: JC
authors.lastname: Kaski
authors.forename: Dariush K
authors.initials: DK
authors.lastname: Nassiri
authors.forename: John
authors.initials: J
authors.lastname: Camm
authors.forename: George R
authors.initials: GR
authors.lastname: Sutherland
authors.forename: Anne H
authors.initials: AH
authors.lastname: Child
mesh_terms: D000328:Adult; D002339:Carotid Arteries / Q000000981:diagnostic imaging*; D002340:Carotid Artery Diseases / Q000000981:diagnostic imaging*; D003199:Computer Systems; D004452:Echocardiography / Q000379:methods*; D055119:Elastic Modulus; D054459:Elasticity Imaging Techniques / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008382:Marfan Syndrome / Q000000981:diagnostic imaging*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity