Differences in Near-Wall Shear Rate in the Carotid Artery Within Subjects Are Associated With Different Intima-Media Thicknesses

Abstract

Abstract —In the common carotid artery, reflections originating from the periphery and the flow divider may affect the shape of the flow velocity profile and, hence, near-wall shear rate (WSR) differently just before the bifurcation (location B) than 20 to 30 mm farther upstream (location A). Recent developments in ultrasound technology allow the assessment of WSR and intima-media thickness (IMT) at the same site in the carotid artery in vivo. We therefore determined WSR at locations A and B and investigated whether the differences between both sites, if any, were associated with different IMTs and different mechanical properties of the arterial wall. The effect of age on the possible differences was assessed as well. The study was performed on presumably healthy volunteers (n=53). In all individuals, IMT was larger at location B than at location A. The relative difference in IMT between both locations was not affected by age. No significant differences in diameter and distension were found between locations. Near peak systolic and near mean WSR at the posterior wall (PWSR p and MWSR p , respectively) were significantly lower at location B than at location A. The relative differences in PWSR p and MWSR p between both locations within subjects were independent of age. The velocity profiles were more blunted at location A than at location B. PWSR p and MWSR p significantly decreased and IMT significantly increased with age at both locations. IMT was negatively correlated with PWSR P and MWSR P at location B, but this correlation was not significant at location A. In summary, in the common carotid artery, the lower WSR near the bifurcation, as compared with 20 to 30 mm upstream, is associated with a larger IMT than at the more proximal site. The relative difference between both locations within subjects is independent of age.