Carotid artery longitudinal displacement predicts 1-year cardiovascular outcome in patients with suspected coronary artery disease

Abstract

Objective-: Total longitudinal displacement (tLoD) of the common carotid artery can be measured using the ultrasound-based velocity vector imaging (VVI) technique. This study aimed to investigate clinical correlates and the possible predictive value of tLoD for cardiovascular outcome. Methods and Results-: Four hundred forty-one patients referred for myocardial perfusion scintigraphy examination for suspected coronary artery disease were recruited and underwent VVI-assisted tLoD measurement. Patients were followed up with regard to major adverse cardiovascular event (MACE) 1 year later. Low tLoD (≤0.055 mm) was associated with greater clinically determined myocardial ischemia (P<0.01). During a median follow-up time of 372 days, 61 MACEs occurred. In a Kaplan-Meier survival analysis, high tLoD (>0.055 mm) predicted 1-year event-free survival (P<0.01, highest versus lowest tertile odds ratio [OR]=1.9). In a Cox regression model adjusting for age, gender, intima-media thickness, radial strain, pulse pressure, and percentage reversibility mass of myocardium, low tLoD remained a significant independent predictor of MACE (P=0.03). Finally, low tLoD provided additional predictive value in subjects with increased intima-media thickness. Conclusion-: VVI-derived tLoD seems to reflect cardiovascular status and predicts short-term event-free survival in medium- to high-risk patients. Finally, tLoD per se or in combination with intima-media thickness measurement may be a novel cardiovascular surrogate biomarker. © 2011 American Heart Association, Inc.