This Article Full Text Full Text (PDF) All Versions of this Article: 35/2/464    most recent 01.STR.0000111597.34179.47v1 Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Irace, C. Articles by Gnasso, A. Search for Related Content PubMed PubMed Citation Articles by Irace, C. Articles by Gnasso, A. Related Collections Pathophysiology Risk Factors Carotid Stenosis Doppler ultrasound, Transcranial Doppler etc. Risk Factors for Stroke

(Stroke. 2004;35:464.)
© 2004 American Heart Association, Inc.

Original Contributions

Wall Shear Stress Is Associated With Intima-Media Thickness and Carotid Atherosclerosis in Subjects at Low Coronary Heart Disease Risk

Concetta Irace, MD; Claudio Cortese, MD; Elio Fiaschi, MD; Claudio Carallo, MD; Eduardo Farinaro, MD Agostino Gnasso, MD

From the Dipartimento di Medicina Sperimentale e Clinica G. Salvatore, Magna Græcia University, Catanzaro (C.I., E. Fiaschi, C. Carallo, A.G.); Dipartimento di Scienze Mediche e Preventive, Federico II University, Naples (E. Farinaro); and Dipartimento di Medicina Interna, University of Tor Vergata, Rome (C. Cortese), Italy.

Correspondence to Agostino Gnasso, MD, Policlinico Mater Domini, Via T Campanella, 88100 Catanzaro, Italy. E-mail gnasso{at}unicz.it

Background and Purpose— Systemic and local coronary heart disease (CHD) risk factors participate in atherogenesis. The role of wall shear stress, a major local risk factor, remains to be elucidated.

Methods— Two hundred thirty-four subjects were carefully characterized for the presence of hypertension, hyperlipidemia, diabetes mellitus, obesity, and cigarette smoking and were divided into low- and high-risk groups. They underwent echo-Doppler examination of the carotid arteries. Atherosclerotic plaques and stenoses were detected, intima-media thickness (IMT) was measured, and wall shear stress was calculated.

Results— One hundred eight subjects were classified as low-risk individuals. The prevalence of carotid atherosclerosis in this group was 18.5%. Wall shear stress was 24.23±7.21 dyne/cm² in individuals without atherosclerosis and 16.89±5.48 in those with atherosclerosis (P<0.000). In multiple regression analyses, wall shear stress, body mass index, and HDL cholesterol were inversely associated and total cholesterol was directly associated with the presence of atherosclerosis; only wall shear stress was associated with IMT. In the high-risk group the prevalence of atherosclerosis was 45.2%. Wall shear stress was 20.44±6.82 dyne/cm² in subjects without atherosclerosis and 17.84±6.88 dyne/cm² in those with atherosclerosis (P=0.037). Age was the only variable associated with both carotid atherosclerosis and IMT.

Conclusions— In subjects traditionally considered at low CHD risk, intima-media thickening and carotid atherosclerosis are significantly associated with low wall shear stress. In contrast, in subjects at high CHD risk, the contribution of wall shear stress seems to be masked, and age becomes the only factor significantly associated with both carotid atherosclerosis and IMT.

Key Words: atherosclerosis • blood flow • carotid arteries • risk factors • ultrasonography

This article has been cited by other articles:

				M. N. Richard, J. F. Deniset, A. L. Kneesh, D. Blackwood, and G. N. Pierce Mechanical Stretching Stimulates Smooth Muscle Cell Growth, Nuclear Protein Import, and Nuclear Pore Expression through Mitogen-activated Protein Kinase Activation J. Biol. Chem., August 10, 2007; 282(32): 23081 - 23088. [Abstract] [Full Text] [PDF]

				Y. Zhang, X. He, X. Chen, H. Ma, D. Liu, J. Luo, Z. Du, Y. Jin, Y. Xiong, J. He, et al. Enhanced External Counterpulsation Inhibits Intimal Hyperplasia by Modifying Shear Stress Responsive Gene Expression in Hypercholesterolemic Pigs Circulation, July 31, 2007; 116(5): 526 - 534. [Abstract] [Full Text] [PDF]

				E. Vicenzini, M. C. Ricciardi, F. Puccinelli, M. Altieri, N. Vanacore, V. Di Piero, and G. L. Lenzi Common Carotid Artery Intima-Media Thickness Determinants in a Population Study J. Ultrasound Med., April 1, 2007; 26(4): 427 - 432. [Abstract] [Full Text] [PDF]

				K. Yoshida, S. Tobe, M. Kawata, and M. Yamaguchi Acquired and Reversible von Willebrand Disease With High Shear Stress Aortic Valve Stenosis Ann. Thorac. Surg., February 1, 2006; 81(2): 490 - 494. [Abstract] [Full Text] [PDF]