Multi-view carotid ultrasound is stronger associated with cardiovascular risk factors than presence of plaque or single carotid intima media thickness measurements in subclinical atherosclerosis
Anna Bengtsson1,2 · Emma Nyman3 · Christer Grönlund4 · Per Wester3 · Ulf Näslund3 · Eva Fhärm2 · Margareta Norberg1
Abstract
We aimed to explore the prevalence of atherosclerosis by using multi-view ultrasound examination of the carotid
arteries
and its association with clinical risk factors in a middle-aged population at low to intermediate risk of
cardiovascular
disease (CVD). Carotid vascular ultrasound was performed in 3532 participants in the VIPVIZA trial. Mean and maximal
carotid intima media thickness (cIMT) at prespecified angles and plaque presence were examined on the left and right
side.
Associations between CVD risk factors and ultrasound variables were quantified by partial least squares (PLS)
regression.
A combined ultrasound variable was computed using weights of the first PLS component. Associations between CVD
risk factors and the combined multi-view ultrasound variable, single cIMT and plaque measurements, respectively,
were
determined using linear regression modelling. The participants’ mean age was 55.7 years and 52.9% were women. Plaque
prevalence was 51.1% in men and 39.0% in women. cIMT was higher in men than in women and in the left compared
with the right carotid artery. The strongest association of CVD risk factors was observed with the combined
multi-view
ultrasound variable (R2 = 24%), compared with single cIMT variables (R2 = 14–18%) and plaque presence (R2 = 15%).
The pattern was similar in both sexes. The association with CVD risk factors and the combined ultrasound variable
was
stronger in 40-year olds (R2 = 22%) compared with 50- or 60-year olds (R = 12%). CVD risk factors are stronger
associated
with a combined ultrasound variable than plaque presence or single cIMT measures suggesting that carotid multi-view
ultrasonography better captures the focality of early atherosclerosis.
Clinical Trial Registration:
ClinicalTrials.gov, number NCT01849575. May 8, 2013.
Keywords Atherosclerosis · Cardiovascular disease · Carotid intima media thickness · Carotid plaque · Carotid ultrasound
NON-2024-1473