Relationship of carotid wall layers with noninvasively-measured central hemodynamic parameters and local circumferential wall tension

Abstract

Increased carotid intima-media thickness (cIMT) is a marker of cardiovascular risk [1], but it may represent distinct vascular processes: greater media thickness (cMT), typically associated with arteriosclerosis, and increased intima thickness (cIT), more closely linked to atherosclerosis [2,3,4]. Increased central blood pressure (cBP) and local hemodynamic forces, particularly carotid circumferential wall tension (CWT), are linked to cardiovascular events and augmented cIMT [5,6,7,8]; however, it remains unclear whether these associations are driven by cIT or cMT. A recent study showed that invasively-measured cBP was associated with cMT, but not with cIT [9]. Conversely, whether carotid CWT derived from cBP or peripheral blood pressure (pBP) measurements has distinct associations with carotid wall layers remains unknown. This study examined the relationship of noninvasively-measured cBP, additional central hemodynamics parameters [augmentation index (AIx) and pulse wave velocity (PWV)], pBP, and carotid CWT with carotid wall layers thickness.

We assessed clinical, carotid, and central hemodynamic parameters on the same day and extracted laboratory data from medical records dated within the prior six months for a convenience sample of 200 consecutive adults (>18 years) enrolled at an outpatient clinic in Paulo Afonso, Brazil, between 2021 and 2024. The study protocol was approved by the UNIRIOS Ethics Committee (45960621.9.0000.8166), and all participants provided written informed consent.