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(Arteriosclerosis, Thrombosis, and Vascular Biology. 2008;28:1392.)
© 2008 American Heart Association, Inc.

Clinical and Population Studies

Distension of the Carotid Artery and Risk of Coronary Events

The Three-City Study

Nathalie Leone; Pierre Ducimetière; Jerôme Gariépy; Dominique Courbon; Christophe Tzourio; Jean-François Dartigues; Karen Ritchie; Annick Alpérovitch; Philippe Amouyel; Michel E. Safar; Mahmoud Zureik

From INSERM U700 (N.L., D.C., M.Z.), Paris; Cardiovascular Preventive Medicine, Broussais Hospital (J.G.), Paris; INSERM U780 (P.D.), U708 (C.T., A.A.), Paris; INSERM U593 (J.F.D.), Bordeaux; INSERM U888 (K.R.), Montpellier; INSERM U744 (P.A.), Lille; Center for Diagnostic, Hôtel-Dieu Hospital (M.E.S.), Paris, France.

Correspondence to Nathalie Leone, MD, INSERM U700, Faculté de Médecine Xavier Bichat, 16 rue Henri Huchard, BP 416, 75018 Paris, France. E-mail nathalie.leone{at}inserm.fr

Abstract

Objective— Arterial mechanical properties are of growing interest in the understanding of cardiovascular disease development. We aimed to determine the predictive value of carotid wall mechanics on coronary heart disease (CHD) in the Three-City study.

Methods and Results— At baseline, 3337 participants aged 65 years underwent a carotid B-mode ultrasonography. During a median follow-up of 43.4 months, 128 CHD occurred. Increased carotid distension (relative stroke change in lumen diameter) was significantly associated with CHD risk. Comparison of subjects in tertile 3 versus those in tertile 1 (reference) showed a hazard ratio (HR) of 1.80 (95% CI, 1.17 to 2.75). Controlling for various confounders including age, heart rate, brachial (or carotid) pulse pressure, and common carotid intima-media thickness did not alter the association between carotid distension and CHD with a HR of 1.79 (95% CI, 1.12 to 2.86; tertile 3 versus tertile 1). Brachial and carotid pulse pressures were also independently associated with CHD. No association was found between CHD and carotid distensibility coefficient, cross-sectional compliance coefficient, Young’s elastic modulus, or β stiffness index.

Conclusions— In the elderly, increased carotid distension was independently predictive of CHD. This simple and noninvasive parameter might be of particular interest for cardiovascular risk assessment.

Relationship between B-mode ultrasound measurements of carotid wall mechanics and coronary events was investigated in a large scale population-based cohort study in the elderly. We showed that carotid distension, the stroke change in lumen diameter, was positively and independently predictive of coronary heart disease.

Key Words: mechanics • carotid arteries • coronary disease • aging • ultrasonics