Stroke, Vol 25, 1354-1359, Copyright © 1994 by American Heart Association
JR Crouse, U Goldbourt, G Evans, J Pinsky, AR Sharrett, P Sorlie, W Riley and G Heiss
BACKGROUND AND PURPOSE: The relation between arterial wall (intimal-
medial) thickness and lumen narrowing is complex and has previously been
studied predominantly at autopsy. B-mode ultrasound affords the opportunity
to visualize both wall and lumen of the extracranial carotid arteries in
vivo. Several studies have quantified the relation of various independent
variables to wall thickness of carotid arteries in population-based
samples, but the relation of age and wall thickness to interadventitial and
lumen diameter has not previously been investigated in these samples.
METHODS: We used B-mode ultrasound to quantify the relation of arterial
lumen diameter to age, arterial wall thickness, and arterial size
(interadventitial diameter) of the extracranial carotid artery in 13,711
members of the Atherosclerosis Risk in Communities (ARIC) cohort. RESULTS:
Men had greater interadventitial diameters, thicker walls, and wider lumens
than women. Wall thicknesses of the common carotid artery were greater by
21% in men and 22% in women aged 60 to 64 years compared with those aged 45
to 49 years (P < .001). However, lumen diameters were also greater in
older individuals because interadventitial diameters were greater. Wall
thickness of the internal carotid artery was also associated positively
with age, but the lumen diameter of the internal carotid artery was smaller
in older individuals. Diameters of the carotid artery segments also
differed in their relation to arterial wall thickening. The lumen of the
internal carotid artery was uniformly progressively narrower with
increasing wall thickness. For the common carotid artery greater wall
thickness bore only a small correlation with narrower lumen diameter for
thickening of the arterial wall up to 1.2 mm, but the association was more
marked for the range of thicknesses between 1.2 mm and 2.5 mm. CONCLUSIONS:
When arterial enlargement accompanies increased wall thickness, less lumen
constriction results than expected. Quantification of these complex
relations in vivo may provide new insight into the pathogenesis of symptoms
related to vascular disease. Narrowing of the internal carotid artery lumen
associated with thicker walls is consistent with the observation that
stenosis develops in this region and often leads to symptoms.
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Arterial enlargement in the atherosclerosis risk in communities (ARIC) cohort. In vivo quantification of carotid arterial enlargement. The ARIC Investigators
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