THE ASSOCIATION BETWEEN CENTRAL TO PERIPHERAL ARTERIAL STIFFNESS RATIO AND THE CAROTID ATHEROSCLEROTIC BURDEN

Objective: Reversal of the central-to-peripheral arterial stiffness ratio is associated with a number of adverse cardiovascular consequences. The carotid pulsatility and resistive indexes are flow parameters associated with peripheral cerebrovascular resistances, and contribute to determine the central hemodynamics.Design and method: We aimed to investigated the relationship between arterial stiffness (tonometry) and carotid flow characteristics (ultrasound) in 49 patients (19 men) followed by our Vascular Ultrasound Unit. Anamnestic, physical examination, and laboratory tests were collected. We calculated the stiffness gradient as carotid-femoral pulse wave velocity divided by carotid-radial pulse wave velocity. The carotid resistive index is (peak flow – diastolic flow)/peak flow; the pulsatility index is peak flow – diastolic flow. The atherosclerotic burden was estimated by the plaque score (number of carotid sites presenting a plaque, from 0 to 6). Results: Mean (±sd) age was 66±12ys, mean BMI 27±5 kg/m2, 29 patients were hypertensives, 11 were diabetics, 7 presented ischemic heart disease. We divided the population in two groups according to the median plaque score: <=2 (n=33) and >2 (n=16). Patients with higher plaque score presented higher age, augmentation index, resistive index, and stiffness ratio. The stiffness ratio was correlated with age (r=0.62, p<0.001) and pulsatility index (r=-035, p=0.03). The logistic regression model showed that the stiffness ratio was strongly positively associated with higher odds of atherosclerotic burden, independently of confounders (age, sex, mean arterial pressure, heart rate, pulsatility index, cardiovascular and metabolic history). Conclusions: We showed that the stiffness ratio was independently associated with the atherosclerotic burden.