Victor J Del Brutto1, Chuanhui Dong2, Kaylie Cullison2, Michelle R Caunca2, Marialaura Simonetto3, Digna E Cabral2, Jose Gutierrez4, Mitchell S V Elkind4, Ralph L Sacco5, Tatjana Rundek5. 1. Department of Neurology, University of Miami Miller School of Medicine, Miami, FL. Electronic address: vjd30@med.miami.edu. 2. Department of Neurology, University of Miami Miller School of Medicine, Miami, FL. 3. Department of Neurology, Weill Cornell Medical Center/New York Presbyterian Hospital, New York, NY. 4. Department of Epidemiology, Mailman School of Public Health, and Department of Neurology, Vagelos College of Physicians and Surgeons, Columbia University, New York, NY. 5. Department of Neurology, University of Miami Miller School of Medicine, Miami, FL; Evelyn F. McKnight Brain Institute, University of Miami Miller School of Medicine, Miami, FL.
Abstract
OBJECTIVES: The internal carotid artery (ICA) angle of origin may contribute to atherogenesis by altered hemodynamics. We aim to determine the contribution of vascular risk factors and arterial wall changes to ICA angle variations. METHODS: We analyzed 1,065 stroke-free participants from the population-based Northern Manhattan Study who underwent B-mode ultrasound (mean age 68.7±8.9 years; 59% women). ICA angle was estimated at the intersection between the common carotid artery and the ICA center line projections. Narrower external angles translating into greater carotid bifurcation bending were considered unfavorable. Linear regression models were fitted to assess the relationship between ICA angle and demographics, vascular risk factors, and arterial wall changes including carotid intima-media thickness (cIMT) and plaque presence. RESULTS: ICA angles were narrower on the left compared to the right side (153±15.4 degrees versus 161.4±12.7 degrees, p<0.01). Mean cIMT was 0.9±0.1 mm and 54.3% had at least one plaque. ICA angle was not associated with cIMT or plaque presence. Unfavorable left and right ICA angles were associated with advanced age (per 10-year increase β=-1.6; p=0.01, and -1.3; p=0.03, respectively) and being Black participant (β=-4.6; p<0.01 and -2.9; p=0.04, respectively), while unfavorable left ICA angle was associated with being female (β=-2.8; p=0.03) and increased diastolic blood pressure (per 10 mmHg increase β=-2.1; p<0.01). Overall, studied factors explained less than 10% of the variance in ICA angle (left R2=0.07; right R2=0.05). CONCLUSION: Only a small portion of ICA angle variation were explained by demographics, vascular risk factors and arterial wall changes. Whether ICA angle is determined by other environmental or genetic factors, and is an independent risk factor for atherogenesis, requires further investigation.
OBJECTIVES: The internal carotid artery (ICA) angle of origin may contribute to atherogenesis by altered hemodynamics. We aim to determine the contribution of vascular risk factors and arterial wall changes to ICA angle variations. METHODS: We analyzed 1,065 stroke-free participants from the population-based Northern Manhattan Study who underwent B-mode ultrasound (mean age 68.7±8.9 years; 59% women). ICA angle was estimated at the intersection between the common carotid artery and the ICA center line projections. Narrower external angles translating into greater carotid bifurcation bending were considered unfavorable. Linear regression models were fitted to assess the relationship between ICA angle and demographics, vascular risk factors, and arterial wall changes including carotid intima-media thickness (cIMT) and plaque presence. RESULTS: ICA angles were narrower on the left compared to the right side (153±15.4 degrees versus 161.4±12.7 degrees, p<0.01). Mean cIMT was 0.9±0.1 mm and 54.3% had at least one plaque. ICA angle was not associated with cIMT or plaque presence. Unfavorable left and right ICA angles were associated with advanced age (per 10-year increase β=-1.6; p=0.01, and -1.3; p=0.03, respectively) and being Black participant (β=-4.6; p<0.01 and -2.9; p=0.04, respectively), while unfavorable left ICA angle was associated with being female (β=-2.8; p=0.03) and increased diastolic blood pressure (per 10 mmHg increase β=-2.1; p<0.01). Overall, studied factors explained less than 10% of the variance in ICA angle (left R2=0.07; right R2=0.05). CONCLUSION: Only a small portion of ICA angle variation were explained by demographics, vascular risk factors and arterial wall changes. Whether ICA angle is determined by other environmental or genetic factors, and is an independent risk factor for atherogenesis, requires further investigation.
Authors: Jonathan B Thomas; Luca Antiga; Susan L Che; Jaques S Milner; Dolores A Hangan Steinman; J David Spence; Brian K Rutt; David A Steinman Journal: Stroke Date: 2005-10-13 Impact factor: 7.914
Authors: Tanja Rundek; Mitchell S Elkind; John Pittman; Bernadette Boden-Albala; Steve Martin; Steve E Humphries; Suh-Hang Hank Juo; Ralph L Sacco Journal: Stroke Date: 2002-05 Impact factor: 7.914
Authors: Matthias Sitzer; Damir Puac; Alexandra Buehler; Donata A Steckel; Stephan von Kegler; Hugh S Markus; Helmuth Steinmetz Journal: Stroke Date: 2003-03-13 Impact factor: 7.914