Local carotid stiffness and intima-media thickness assessment by a novel ultrasound-based system in essential hypertension.
OBJECTIVE
To evaluate local carotid stiffness (CS) and intima-medial thickness (C-IMT) in hypertensive patients with different cardiovascular risk profile, using a new user-friendly ultrasound-based system, previously validated vs. RF-based echotracking device.


METHODS
We investigated a population with different cardiovascular risk: 45 healthy normotensives (NT), 90 non-diabetic hypertensives (HT), and 48 patients with hypertension and type-2 diabetes (DM). Framingham risk factor score (FRS) was calculated. PWV was assessed by applanation tonometry. The relative stroke change in diameter (ΔD) and C-IMT were measured on carotid scans. Distensibility coefficient (DC) was calculated as ΔA/(A*ΔP), where A = diastolic lumen area, ΔA = stroke change in lumen area, and ΔP = carotid pulse pressure. CS (m/s) was calculated as (ρ*DC) - 1/2 (ρ = blood density).


RESULTS
CS, C-IMT, PWV were significantly increased in HT and DM vs. NT. C-IMT and PWV were significantly higher in DM than HT. ΔD and DC were significantly lower in HT and DM vs. NT. FRS ≥10% group showed increased carotid diameter, C-IMT and CS than the FRS <10%. FRS was (p < 0.001) correlated with CS (r = 0.35); ΔD (r = -0.36), DC (r = 0.35), C-IMT (r = 0.48), PWV (r = 0.38). CS correlated (p < 0.05) with PWV in the entire population (r = 0.37), in the NT (r = 0.35), in the HT and DM (r = 0.20). PWV (r = 0.50) and CS (r = 0.33) were correlated with age. Determinants of aortic and carotid stiffness were identified by multivariate stepwise analysis.


CONCLUSIONS
The proposed B-mode ultrasound-based system is a reliable and user-friendly method that could serve to investigate the predictive value of CS for cardiovascular events in future large clinical studies.
Department of Internal Medicine, University of Pisa, Via Roma, 67, 56100 Pisa, Italy. c.giannarelli@int.med.unipi.it
Chiara
C
Giannarelli
Elisabetta
E
Bianchini
Rosa Maria
RM
Bruno
Armando
A
Magagna
Linda
L
Landini
Francesco
F
Faita
Vincenzo
V
Gemignani
Giuseppe
G
Penno
Stefano
S
Taddei
Lorenzo
L
Ghiadoni
D000328:Adult; D000368:Aged; D002339:Carotid Arteries / Q000000981:diagnostic imaging* / Q000503:physiopathology; D002340:Carotid Artery Diseases / Q000000981:diagnostic imaging* / Q000453:epidemiology / Q000503:physiopathology; D059168:Carotid Intima-Media Thickness; D016009:Chi-Square Distribution; D003924:Diabetes Mellitus, Type 2 / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000503:physiopathology; D005260:Female; D006439:Hemodynamics; D006801:Humans; D006973:Hypertension / Q000000981:diagnostic imaging* / Q000453:epidemiology / Q000503:physiopathology; D007558:Italy / Q000453:epidemiology; D016014:Linear Models; D008297:Male; D008365:Manometry; D008875:Middle Aged; D015999:Multivariate Analysis; D011237:Predictive Value of Tests; D063177:Pulse Wave Analysis; D015203:Reproducibility of Results; D018570:Risk Assessment; D012307:Risk Factors; D059289:Vascular Stiffness