CTA-based evaluation of carotid body size reveals associations with cardiovascular and metabolic conditions

Abstract

Background: The carotid body (CB) detects blood oxygen changes and may play a role in metabolic diseases. Several studies have suggested a link between CB size and cardiovascular conditions. This study aimed to evaluate CB size using computed tomography angiography (CTA) and investigate its associations with cardiovascular and metabolic conditions.

Methods: A retrospective analysis of 279 patients undergoing CTA of the cervical vasculature was conducted. The CB was identified as an enhancing structure at the carotid bifurcation, and its area was measured on axial images. Clinical data, including comorbidities and vascular risk factors, were collected. Statistical analyses included univariate and stepwise multiple linear regression to identify significant predictors of CB size.

Results: The CB was identified in 163 patients (49.1% right, 50.9% left). The mean CB area was 3.183 mm² for the right side and 2.901 mm² for the left. Obstructive sleep apnea (OSA) and internal carotid artery (ICA) stenosis ⩾ 70% were significant predictors of increased CB size. In the final regression model, OSA was associated with a 1.049 mm² increase in CB area (p = 0.027), whereas ICA stenosis ⩾ 70% and renin-angiotensin system inhibitor treatment were associated with increases of 0.528 mm² (p = 0.036) and 0.494 mm² (p = 0.037), respectively. CB hypertrophy was also associated with hypertension, obesity, and smoking in univariate analyses.

Conclusions: This study highlights significant associations between CB hypertrophy and conditions such as OSA and ICA stenosis, suggesting that CB enlargement reflects the interplay between hypoxia, vascular pathology, and metabolic dysregulation. CTA may assess CB size as a cardiovascular biomarker.

Keywords: atherothrombotic disease; carotid body; computed tomography angiography; hypertrophy; internal carotid stenosis; obstructive sleep apnea.