Structural and Functional Abnormalities of Carotid Artery and Their Relation with EVA Phenomenon
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REVIEW ARTICLE
Structural and Functional Abnormalities of Carotid Artery and Their Relation with EVA Phenomenon Alessandro Maloberti2 • Paolo Meani1,2 • Marisa Varrenti1,2 • Luca Giupponi1,2 Miriam Stucchi1,2 • Paola Vallerio1,2 • Cristina Giannattasio1,2
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Received: 1 April 2015 / Accepted: 9 May 2015 Ó Springer International Publishing Switzerland 2015
Abstract Early vascular aging is a process characterized by a reduction in arterial elastin with an increase in collagen that has been related to cardiovascular risk factor and can determine an increased arterial stiffness and central blood pressure. It can be measured by several non invasive methods and in different arterial segment. The present paper will focus on functional (local stiffness parameter) and structural (intima media thickness) carotid arteries alterations typically evaluated by ultrasound methods. Methodological, research and clinical issue has been reviewed. Keywords Carotid vessels Intima media thickness Carotid distensibility Local carotid stiffness
1 Introduction Structural and functional large artery alterations are accelerated by risk factors such as hypertension, diabetes mellitus (DM) and dyslipidemias, which lead to what has been termed early vascular aging (EVA) [1]. This process is characterized by a reduction in the elastin associated with an increased collagen content that determine an increase in arterial stiffness and an elevation in central and brachial blood pressure (BP) [2]. These alterations precede
by many years cardiovascular events and so their assessment is clinically important since provide prognostic information (i.e. predict the onset of more serious and costly events) and give the possibility of preventing harmful events by earlier therapeutic intervention. Vascular aging process assessment is possible by various non-invasive methods grouped under the name of subclinical organ damage or cardiovascular surrogate markers: aortic stiffness (such as pulse wave velocity— PWV—or Cardio Ankle Vascular Index—CAVI), wave reflection analysis (pulse wave analysis—PWA) and regional stiffness or anatomical early alterations [3]. The latter is commonly assessed in superficial arteries, such as carotid and femoral ones, where ultrasound methods can reveal their best properties. Although aortic arterial stiffening is probably the most important aspect of EVA, carotid artery is commonly the first vessel involved in atherosclerotic process and so its evaluation permits to add important information on vascular aging process and cardiovascular risk definition. The present review will focus on functional (local stiffness parameter) and structural (intima media thickness—IMT) carotid arteries alterations typically evaluated by ultrasound methods (Table 1).
2 Intima Media Thickness & Cristina Giannattasio [email protected]; [email protected] 1
Cardiologia IV, Dipartimento A. De Gasperis, Ospedale Niguarda Ca’ Granda, Piazza Ospedale Maggiore 3, 20159 Milan, Italy
2
Health Science Department
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