Carotid atherosclerosis as a risk factor for complex aortic lesions in patients with ischemic cerebrovascular disease

Area of Science:

• Cardiovascular Medicine
• Neurology
• Vascular Biology

Background:

• Aortic arch atherosclerotic lesions are a known cause of ischemic cerebrovascular disease (ICVD).
• Understanding the link between carotid and aortic atherosclerosis is crucial for identifying ICVD risk.
• Noninvasive methods for assessing aortic lesions are needed.

Purpose of the Study:

• To examine the association between carotid and aortic arch atherosclerosis.
• To determine if noninvasive carotid evaluation can identify patients with high-risk aortic lesions.
• To assess the predictive value of carotid atherosclerosis for complex aortic lesions.

Main Methods:

• 147 patients with ICVD underwent carotid ultrasonography and transesophageal echocardiography.
• Maximum intima-media thickness (IMT) measured for carotid and aortic arch.
• Complex aortic lesions defined as IMT ≥ 4 mm, mobile plaques, or ulcers.

Main Results:

• Carotid IMT strongly correlated with aortic IMT (r=0.53, p<0.001), independent of cardiovascular risk factors.
• Higher carotid IMT significantly increased the likelihood of complex aortic lesions (4.2-fold per 1 SD increase).
• Complex aortic lesions were present in 78% of patients with the highest carotid IMT tertile versus 14% in the lowest.

Conclusions:

• Carotid atherosclerosis is significantly associated with aortic arch atherosclerosis.
• Carotid IMT serves as a valuable, independent predictor of complex aortic lesions.
• Noninvasive carotid assessment can help identify ICVD risk stemming from aortic pathology.