Carotid stiffening predicts cardiovascular risk stratification in mid-life: Non-invasive quantification with ultrafast ultrasound imaging
Zhengqiu Zhu1 , Lingshan Chen2 , Wenjun Liu3 , Yiyun Wu1, Chong Zou4,5, Xinyi Zhang1 , Shanshan He1 , Yinping Wang1 , Bixiao Shen1 , Xuehui Ma1 , Hui Gao1 , Yun Luan1 , Hui Huang1
1Affiliated Hospital of Nanjing University of Chinese Medicine;Jiangsu Province Hospital of Chinese M, Nanjing, China
2Department of Radiology, Affiliated Hospital of Nanjing University of Chinese Medicine, Jiangsu Province Hospital of Chinese Medicine, Nanjing, China
3School of Mathematics and Statistics, Nanjing University of Information Science and Technology, Nanjing, China
4Department of Cardiology, Affiliated Hospital of Nanjing University of Chinese Medicine, Jiangsu Province Hospital of Chinese Medicine, Nanjing, China
5Center of Good Clinical Practice, Affiliated Hospital of Nanjing University of Chinese Medicine, Jiangsu Province Hospital of Chinese Medicine, Nanjing, China
Corresponding Author: Hui Huang ,Tel: +86-25-8661-7141, Fax: +86-25-8661-7141, Email: 328560882@qq.com
Received: September 15, 2021;  Accepted: November 1, 2021.  Published online: November 1, 2021.
ABSTRACT
Purpose:
We assessed the association between Systematic COronary Risk Evaluation (SCORE) estimated cardiovascular risk and carotid stiffening in middle-aged populations using ultrafast pulse wave velocity (ufPWV).
Methods:
We enrolled 683 participants who underwent ufPWV measurements without known cardiovascular disease or diabetes mellitus. Clinical interviews, physical examinations, laboratory findings, carotid intima–media thickness (cIMT), pulse wave velocity (PWV) at the beginning of systole (PWV-BS), and PWV at the end of systole (PWV-ES) were assessed. Each participant underwent an assessment of SCORE risk based on major cardiovascular risk factors (CVRFs), including age, sex, smoking, systolic blood pressure (SBP), and total cholesterol (TC). Crude and adjusted odds ratios (ORs) with 95% confidence intervals and ordinal logistic regression were used. Overall CVRFs were adjusted for ORs assessment.
Results:
cIMT and carotid stiffening in PWV-BS and PWV-ES were significantly different between sex subgroups (all p < 0.05), but only PWV-ES increased gradually in age and SCORE estimated risk subgroups (all p < 0.05). Compared with cIMT (r = 0.388; p < 0.001) and PWV-BS (r = 0.159; p < 0.001), PWV-ES more strongly correlated with SCORE categories (r = 0.405; p < 0.001). Increased PWV-ES was associated with SCORE categories independent of sex, SBP, TC, and smoking in moderate-risk and high-risk subgroups (ORs = 1.63 and 2.12; p < 0.001 and p = 0.024), but was not independent of age in all risk subgroups (all p > 0.05).
Conclusions:
Carotid stiffening quantified by ufPWV is linked to SCORE categories, and elevated PWV-ES may aid cardiovascular risk stratification.
Keywords: Atherosclerosis; Cardiovascular risk; Ultrafast ultrasound imaging; Pulse wave velocity; Arterial stiffness
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