Introduction

The association between cervical internal carotid artery (cICA) tortuosity and atherosclerosis is a matter of debate. Additionally, some genetic syndromes characterized by connective tissue remodeling are associated with arterial tortuosity, raising the possibility that cICA tortuosity may not only be atherosclerotic. In this study, we hypothesized that cICA tortuosity is not associated with imaging biomarkers of atherosclerosis.

Methods

The Northern Manhattan Study (NOMAS) was a prospective, multiethnic cohort of stroke-free individuals who underwent brain MRA, carotid ultrasound and transthoracic echocardiogram from 2003–2008. The cICA tortuosity was scored in each carotid as 0 = no tortuosity, 1 = tortuosity <90°, 2 = tortuosity ≥90°. A summary cICA tortuosity score (possible range 0–4) was created by adding up the tortuosity score from each carotid. Participants were assessed for atherosclerotic markers by using B‑mode carotid sonography and transthoracic echocardiography.

Results

Of 558 participants 178 (31.9%) had any cervical ICA tortuosity (tortuosity score >0). The cICA tortuosity score was higher in women and was associated with diastolic and systolic blood pressures and height (all P < 0.05). In models adjusted for demographics and risk factors, only the association with diastolic blood pressure remained significant (β = 0.002, P = 0.02). Similarly, cICA tortuosity was associated with larger aortic root diameter (B = 1.03 ± 0.36, P = 0.004) but not with other markers of carotid or aortic atherosclerosis.

Conclusion

Cervical ICA tortuosity is associated with a higher diastolic blood pressure and larger aortic root diameter but not with other measures of atherosclerosis. Determining the risks of vascular events associated with this non-atherosclerotic phenotype may help for a better risk stratification for individuals with cICA tortuosity.

中文翻译：

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颈颈动脉迂曲度的全身动脉相关性

介绍

颈内动脉 (cICA) 迂曲与动脉粥样硬化之间的关系存在争议。此外，一些以结缔组织重塑为特征的遗传综合征与动脉迂曲有关，这增加了cICA迂曲可能不仅仅是动脉粥样硬化的可能性。在这项研究中，我们假设 cICA 迂曲度与动脉粥样硬化的影像生物标志物无关。

方法

北曼哈顿研究 (NOMAS) 是一个前瞻性、多种族的无中风个体队列，这些人在 2003 年至 2008 年期间接受了脑 MRA、颈动脉超声和经胸超声心动图检查。每个颈动脉的 cICA 弯曲度评分为 0 = 无弯曲度，1 = 弯曲度 <90°，2 = 弯曲度≥90°。通过将每个颈动脉的迂曲度分数相加来创建 cICA 迂曲度分数摘要（可能的范围 0-4）。通过使用 B 型颈动脉超声检查和经胸超声心动图评估参与者的动脉粥样硬化标志物。

结果

在 558 名参与者中，有 178 名 (31.9%) 患有颈椎 ICA 迂曲（迂曲评分 >0）。女性的 cICA 迂曲度评分较高，并且与舒张压和收缩压以及身高相关（所有P  < 0.05）。在根据人口统计和危险因素调整的模型中，只有与舒张压的相关性仍然显着（β = 0.002，P  = 0.02）。同样，cICA 迂曲度与较大的主动脉根部直径相关（B = 1.03 ± 0.36，P  = 0.004），但与颈动脉或主动脉粥样硬化的其他标志物无关。

结论

颈内动脉迂曲度与较高的舒张压和较大的主动脉根部直径相关，但与其他动脉粥样硬化指标无关。确定与这种非动脉粥样硬化表型相关的血管事件的风险可能有助于对患有 cICA 迂曲的个体进行更好的风险分层。