Carotid wall shear rate as a marker of systemic atherosclerosis and atherosclerotic cardiovascular disease

Abstract

Aim: to assess possibility of the use of carotid wall shear rate (WSR) as a marker of systemic atherosclerosis and atherosclerotic car- diovascular disease (ASCVD). Materials and methods. We included into this study 200 patients with different cardiovascular risk (142 patients already had one or more ASCVD). All patients underwent ultrasound scanning of carotid and lower limb arteries with measurement of the ankle-brachial index. Carotid WSR was determined during ultrasonic scanning of carotid arteries in accordance with the Hagen-Poiseuille law. Results. Mean WSR value in this cohort of patients was 434±139 s-1. Based on the results of the ROC- analysis, it was found that WSR below the threshold value of 300 s-1 allowed to predict the presence of ASCVD with sensitivity of 97.1% and specificity of 84.6%. WSR <300 s-1 was associated with relative risk (RR) of ASCVD presence 11.2 (95% CI 1.26-99.3, p=0.03), adjusted for factors such as sex, age, smoking, obesity, hypertension, estimated glomerular filtration rate (eGFR), low density lipoprotein cholesterol, and high sensitivity C-reactive protein, carotid intima-media thickness. The model which included carotid WSR, as well as factors such as the presence of type 2 diabetes, obesity, sex, age, eGFR, allowed to diagnose combined atherosclerotic lesions of peripheral arteries with a sensitivity of 73.1% and a specificity of 90.3%. Conclusion. Evaluation of the carotid WSR allows to diagnose with satisfactory sensitivity and specificity the presence of combined atherosclerosis of peripheral arteries and ASCVD.