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. 2021 Jul 31:43:18-23.
doi: 10.1016/j.athplu.2021.07.020. eCollection 2021 Sep.

Differential association of flow velocities in the carotid artery with plaques, intima media thickness and cardiac function

David Leander Rimmele  1 , Katrin Borof  2 , Jan-Per Wenzel  3 , Märit Jensen  1   4 , Christian-A Behrendt  5 , Christoph Waldeyer  3 , Renate B Schnabel  3   4 , Tanja Zeller  3   4 , E Sebastian Debus  5 , Stefan Blankenberg  3 , Christian Gerloff  1 , Götz Thomalla  1
Affiliations

Differential association of flow velocities in the carotid artery with plaques, intima media thickness and cardiac function

David Leander Rimmele et al. Atheroscler Plus. .

Abstract

Background and aims: We aimed to determine the association of carotid intima media thickness (CIMT), carotid plaques, and heart function with peak systolic velocity (PSV) of the common (CCA) and internal carotid artery (ICA) in a cross-sectional study.

Methods: In the population-based Hamburg-City-Health-Study participants between 45 and 74 years were recruited. Cardio-vascular risk factors were assessed by history, blood samples, and clinical examination. CIMT, plaques, and PSV were determined by carotid ultrasound. Serum N-terminal brain natriuretic peptide (NT-proBNP) was determined as a biomarker for cardiac dysfunction, and left ventricular ejection fraction (LVEF) was quantified by echocardiography. Participants with carotid stenosis were excluded. Data were analyzed by multivariate linear regression.

Results: We included 8567 participants, median age was 62 years, 51.8% were women. Median CIMT was 0.75 mm, NT-proBNP 80 pg/ml, LVEF 58.5%, and 30.4% had carotid plaques. For women PSV decreased in decades from 89 to 73 cm/s in CCAs and 78 to 66 cm/s in ICAs, and for men from 91 to 76 cm/s in CCAs and from 70 to 66 cm/s in ICAs. Corrected for age, sex, red blood cell count, and blood pressure, in CCAs lower PSV was associated with carotid plaques (p < 0.001; β = -0.03), lower CIMT (p = 0.005; β = 0.007), higher levels of log-transformed NT-proBNP (p < 0.001; β = -0.01), and lower LVEF (p < 0.001; β = 0.01). In ICAs, lower PSV was independently associated with lower CIMT (p < 0.001; β = 0.02) and lower EF (p = 0.001; β = 0.007).

Conclusions: Markers of cardiac dysfunction and plaques are associated with lower and CIMT with higher flow velocities in the carotid arteries.

Clinical trial registration: http://www.clinicaltrials.gov, NCT03934957.

Keywords: Brain natriuretic peptide; CIMT=Carotid intima media thickness, RBC = red blood cell count; Carotid arteriopathy; Carotid flow; Carotid intima media thickness; Carotid plaque; DBP = diastolic blood pressure, BP = blood pressure; Heart function; ICA = internal carotid artery, SBP = systolic blood pressure; LVEF = left ventricular ejection fraction, NT-proBNP = N-terminal brain natriuretic peptide; PSV = peak systolic velocity, CCA = common carotid artery; Peak systolic velocity.

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Conflict of interest statement

DLR, KB, JPW, MJ, CAB, CW, TZ, and ESD have nothing to report. RBS has received speaker honoraria from Bristol-Myers Squibb/Pfizer. RBS has received funding from the European Research Council (ERC) under the European Union's Horizon 2020 research and innovation programme (grant agreement No 648131), from the European Union's Horizon 2020 research and innovation programme under the grant agreement No 847770 (AFFECT-EU) and German Center for Cardiovascular Research (DZHK e.V.) (81Z1710103); German Ministry of Research and Education (BMBF 01ZX1408A) and ERACoSysMed3 (031L0239). SB has received research funding from Abbott Diagnostics, Bayer, SIEMENS, Singulex and Thermo Fisher. He received honoraria for lectures from Abbott, Abbott Diagnostics, Astra Zeneca, Bayer, AMGEN, Medtronic, Pfizer, Roche, SIEMENS, Thermo Fisher and as member of Advisory Boards for consulting for Bayer, Novartis and Thermo Fisher. CG reports personal fees from Amgen, Bayer Vital, Bristol-Myers Squibb, Boehringer Ingelheim, Sanofi Aventis, Abbott, and Prediction Biosciences outside the submitted work. GT reports receiving consulting fees from Acandis, grant support, and lecture fees from Bayer, lecture fees from Boehringer Ingelheim, Bristol-Myers Squibb/Pfizer, and Daiichi Sankyo, and consulting fees and lecture fees from Stryker outside the submitted work.

Figures

Image 1
Graphical abstract
Fig. 1
Fig. 1
Factors associated with peak systolic velocity in common (A) and internal (B) carotid arteries in a model of multivariate regression. Abbreviations: CIMT= Carotid intima media thickness; NT-proBNP = n-terminal pro brain natriuretic peptide; LVEF = left ventricular ejection fraction; PP = pulse pressure (systolic blood pressure - diastolic blood pressure); RBC = red blood cell count. (For interpretation of the references to colour in this figure legend, the reader is referred to the Web version of this article.)
See this image and copyright information in PMC

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