Carotid artery displacement and cardiovascular disease risk in the Multi-Ethnic Study of Atherosclerosis

Abstract

Novel technology permits quantification of common carotid artery (CCA) displacement, which is traditionally ignored. We evaluated associations with CCA displacement and cardiovascular disease (CVD) risk and events in a large, multi-ethnic cohort. Right CCA longitudinal displacement (LD), transverse displacement (TD), and grayscale median (GSM) were evaluated using ultrasound speckle-tracking and texture analysis software in 2050 participants. Regression analyses were used to define relationships between CCA LD, TD, GSM, and CVD risk factors. Cox proportional hazards models were used to assess relationships between LD, TD, and incident CVD events. Participants were mean (SD) 64 (10) years old. There were 791 cases with a CVD event over a 12-year median follow-up. The mean LD was 0.29 (0.20) mm. In multivariable models including age, sex, race/ethnicity, heart rate, and CVD risk factors, LD was associated positively with active smoking (β = 0.08, p < 0.001) and inversely with black (β = −0.08, p < 0.001), Chinese (β = −0.05, p < 0.001), and Hispanic (β = −0.04, p < 0.05) race/ethnicities relative to white individuals, heart rate (β = −0.03/10 beats/min, p < 0.001), and diastolic blood pressure (β = −0.01/5 mmHg, p < 0.05). In fully adjusted models, LD and TD were associated with GSM ( p < 0.01), but neither predicted incident CVD events (LD: hazard ratio (HR) 0.77 [0.48 to 1.24], p = 0.3; TD: HR 1.12 [0.8 to 1.57], p = 0.5). CCA LD and TD are associated with race/ethnicity and CVD risk factors but not incident CVD events. LD and TD are not measures of arterial stiffness but their association with GSM suggests that lower LD and TD may be related to structural changes within the carotid arterial wall.