title: Carotid circumferential wall stress homeostasis in early remodeling: theoretical approach and clinical application.
abstract: OBJECTIVE
  To assess the influence of cardiovascular risk factors on arterial wall growth and the remodeling process.
  
  
  METHODS
  In a theoretical part, we used a well-established relationship linking the rate of thickening of the arterial wall to the circumferential wall stress (CWS) increase. In a clinical part, we measured the intima-media thickness (IMT) in 166 subjects with increased cardiovascular risk score but no treatment for hypertension or hypercholesterolemia, no diabetes, and no cardiovascular disease. Far wall IMT and lumen diameter were measured along the right carotid artery by high-resolution ultrasonography and computerized image analysis.
  
  
  RESULTS
  A decreasing linear relationship between IMT and CWS was deduced from the theoretical model, implying that an increase in CWS would result in an IMT increase, and that the higher the IMT-CWS slope, the higher the thickening response. Subjects with advanced age, renal insufficiency, high 10-year Framingham risk, carotid atherosclerosis, and advanced atherosclerosis at other sites had sharper IMT-CWS slope (p < 0.05), in agreement with the homeostasis of CWS hypothesis.
  
  
  CONCLUSIONS
  The IMT increase responding to a CWS increase was greater in high-risk patients.
authors.affiliation: Université Denis Diderot Paris 7, UFR Physique, Paris, France.
authors.forename: Plamen
authors.initials: P
authors.lastname: Bokov
authors.forename: Gilles
authors.initials: G
authors.lastname: Chironi
authors.forename: Ludmila
authors.initials: L
authors.lastname: Orobinskaia
authors.forename: Patrice
authors.initials: P
authors.lastname: Flaud
authors.forename: Alain
authors.initials: A
authors.lastname: Simon
mesh_terms: D000328:Adult; D000704:Analysis of Variance; D015992:Body Mass Index; D002318:Cardiovascular Diseases / Q000209:etiology / Q000503:physiopathology; D002339:Carotid Arteries / Q000000981:diagnostic imaging* / Q000473:pathology; D002340:Carotid Artery Diseases / Q000000981:diagnostic imaging* / Q000503:physiopathology; D059168:Carotid Intima-Media Thickness; D015331:Cohort Studies; D005260:Female; D006706:Homeostasis / Q000502:physiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D008962:Models, Theoretical; D015999:Multivariate Analysis; D012044:Regression Analysis; D018570:Risk Assessment; D013314:Stress, Mechanical; D017539:Tunica Intima / Q000000981:diagnostic imaging / Q000473:pathology; D017540:Tunica Media / Q000000981:diagnostic imaging / Q000473:pathology; D018616:Ultrasonography, Doppler, Duplex