Is Stiffness Parameter β Useful for the Evaluation of Atherosclerosis?~ Its Clinical Implications, Limitations, and Future Perspectives ~

Abstract

Atherosclerosis comprises two components, atherosis and sclerosis, characterized by morphological wall thickening and functional stiffening, respectively, of the arterial wall. In recent years, much interest has been directed to the role of functional changes in large arteries, i.e., increased stiffness or decreased elasticity, on the development of cardiovascular diseases. In fact, the clinical evaluation of arterial stiffness is increasingly performed in patients with cardiovascular risk factors. Local arterial stiffness is measured using an ultrasound technique implemented with an echo-tracking system at the common carotid and femoral arteries. Several indices of local arterial stiffness are obtained by ultrasound, among which stiffness parameter β is unique because it is the least affected by blood pressure at the time of measurement. Evidence from cross-sectional studies indicates that increased stiffness parameter β is associated with a number of cardiovascular risk factors, such as older age, smoking, insufficient physical activity, hypertension, obesity, metabolic syndrome, insulin resistance, type 2 diabetes, chronic kidney disease, and comorbid cardiovascular disease. Results from several prospective observational studies also suggest that carotid stiffness parameter β is a useful surrogate marker of cardiovascular events and/or mortality, although the results differ depending on the characteristics of the study subjects. Furthermore, several interventional studies have shown that carotid stiffness parameter β improved after lifestyle modification or drug treatment. In this review, we summarize the current evidence of stiffness parameter β of the carotid artery and discuss its clinical implications as a marker of vascular health or as a predictor of cardiovascular outcomes.

Subjects Conceived through Assisted Reproductive Technologies Display Normal Arterial Stiffness

“…The stiffness index β (unitless) was calculated for the AAO in short axis and for both CCA in long axis as [ 7 ]: …”

“…Arterial stiffening is characterized by increased functional rigidity and reduced elasticity of the vessel’s walls [ 4 ]. This degenerative process can be induced by age or through atherosclerosis [ 4 , 7 ]. The stiffening of the arteries leads to an augmentation of blood pressure, left ventricular afterload and a decrease in coronary perfusion [ 2 , 8 ].…”

From Cultured Vascular Cells to Vessels: The Cellular and Molecular Basis of Vascular Dysfunction in Space

“…In parallel, carotids and femoral arteries show a thicker tunica media, which leads to enhanced stiffness ( Hughson et al, 2016 ; Hughson et al, 2018 ; Norsk, 2020 ). Notably, wall thickening and functional stiffening are considered predictors of cardiovascular outcomes ( Morioka et al, 2021 ). In the case of carotids, this alteration is consistent with 10–20 years of physiological aging, but the good news for astronauts is that it is reversible upon return to Earth ( Arbeille et al, 2017 ).…”

Carotid Atherosclerosis, Ultrasound and Lipoproteins

“…The mechanical properties of the carotid arteries can also be studied using US, and these functional changes are correlated with major cardiovascular risk factors [82]. Early diagnosis of cardiovascular changes in the initial stages of atherosclerosis is complicated, and further research into biopsy samples of young patients is needed, as was done in the PDAY study, which examined samples from young individuals who died of accidental causes [83,84].…”