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Aortic versus carotid intima-media thickness and impact of aortic valve disease

Johan Petrini1,2, Margareta Ring1,3, Anders Franco-Cereceda1,4

  • 1Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden.

Clinical Physiology and Functional Imaging
|January 19, 2018
PubMed

Insights

The correlation between common carotid artery intima-media thickness (CIMT) and descending aorta intima-media thickness (AoIMT) is weaker in patients with severe aortic valve disease (sAVD). Aortic pressure gradient impacts AoIMT, but not CIMT, in sAVD patients.

Area of Science:

  • Cardiovascular Medicine
  • Vascular Biology
  • Medical Imaging

Background:

  • Intima-media thickness (IMT) is a key marker for atherosclerosis.
  • IMT is influenced by hemodynamic factors like shear stress and blood flow.
  • Severe aortic valve disease (sAVD) may alter these hemodynamic factors.

Purpose of the Study:

  • To evaluate the relationship between descending aorta intima-media thickness (AoIMT) and common carotid artery intima-media thickness (CIMT).
  • To compare this relationship in patients with and without severe aortic valve disease (sAVD).

Main Methods:

  • Transesophageal echocardiography and carotid ultrasound were used to measure AoIMT and CIMT in 310 patients.
  • Measurements were performed before valvular and/or aortic surgery.
  • Semiautomatic analysis of digitally stored B-mode images was employed.

Main Results:

  • No significant difference in AoIMT or CIMT was observed between patients with and without sAVD.
  • The correlation between AoIMT and CIMT was significantly weaker in patients with sAVD (r=0.29) compared to those without (r=0.51).
  • Age was a primary determinant for both AoIMT and CIMT. In sAVD patients, aortic mean pressure gradient (Pmean) predicted AoIMT but not CIMT.

Conclusions:

  • The correlation between CIMT and AoIMT is diminished in the presence of sAVD.
  • Hemodynamic alterations, such as those caused by sAVD, differentially affect aortic and carotid intima-media thickness.
  • This suggests factors beyond atherosclerosis, including altered aortic flow dynamics, influence IMT in sAVD.
Abstract

Keywords:
aortic regurgitationaortic stenosiscarotid arterydescending aortaintima-media thickness

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