Abstract
Arterial stiffness, echolucency and texture features are altered with hypertension
and associated with increased cardiovascular disease risk. The relationship between
these markers and structural and load-dependent artery wall changes in hypertension
are poorly understood. The Multi-ethnic Study of Atherosclerosis (MESA) is a longitudinal
study of 6814 adults from six communities across the United States designed to study
subclinical cardiovascular disease. From B-mode imaging of the right common carotid
artery at the baseline MESA examination, we calculated carotid artery Young's elastic
modulus (YEM, n = 5894) and carotid artery gray-scale texture features (n = 1403).
The standard YEM calculation represented total arterial stiffness. Structural stiffness
was calculated by adjusting YEM to a standard blood pressure of 120/80 mm Hg with
participant-specific models. Load-dependent stiffness was the difference between total
and structural stiffness. We found that load-dependent YEM was elevated in hypertensive
individuals compared with normotensive individuals (35.7 ± 105.5 vs. –62.0 ± 112.4
kPa, p < 0.001) but that structural YEM was similar (425.3 ± 274.8 vs. 428.4 ± 293.0 kPa,
p = 0.60). Gray-scale measures of heterogeneity in carotid artery wall texture (gray-level
difference statistic contrast) had small but statistically signification correlations
with carotid artery stiffness mechanisms. This association was positive for structural
YEM (0.107, p < 0.001), while for load-dependent YEM, the association was negative (–0.064, p = 0.02). In conclusion, increased arterial stiffness in hypertension was owing solely
to the non-linear mechanics of having higher blood pressure, not structural changes
in the artery wall, and high load-dependent stiffness was associated with a more homogenous
carotid artery wall texture. This is potentially related to arterial remodeling associated
with subclinical atherosclerosis and future cardiovascular disease development. These
results also indicate that gray-scale texture features from ultrasound imaging had
a small but statistically significant association with load-dependent arterial stiffness
and that gray-scale texture features may be partially load dependent.
Key Words
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Article info
Publication history
Published online: August 17, 2022
Accepted:
June 18,
2022
Received in revised form:
June 16,
2022
Received:
March 21,
2022
Identification
Copyright
© 2022 World Federation for Ultrasound in Medicine & Biology. Published by Elsevier Inc. All rights reserved.
