Abstract 691: Longitudinal Displacement of Common Carotid Artery Assessed by Velocity Vector Ultrasound Imaging Predicts One Year Cardiovascular Outcome in Patients With Suspected Cardiovascular Disease
Introduction: The importance of longitudinal arterial wall movement has previously gained little attention. Velocity vector imaging (VVI) is a novel tool to quantify cardiac wall motion in both longitudinal and radial directions. In the present study, we hypothesized VVI-analysis to be able to quantify longitudinal common carotid artery (CCA) wall displacement. The possible predictive value for cardiovascular outcome in patients with suspected cardiovascular disease was also evaluated.
Methods: 441 patients (mean age 62.0±9.0 yrs) referred for investigation of suspected cardiovascular disease were recruited. All patients underwent carotid ultrasound examination and myocardial perfusion scintigraphy (MPS) according to standard protocol. In addition to clinical data; carotid stiffness index and intima-media thickness were also investigated. VVI measurements were made with Research Arena 2, Tomtec. CCA wall displacement was represented by the total longitudinal wall movement during one cardiac cycle. Patients were followed up with regards to major adverse cardiovascular events (MACE).
Results: Patients exhibiting low longitudinal displacement (<0.09 mm) compared to higher longitudinal displacement, showed a greater clinically scored MPS ischemia area (0.69±0.9 vs. 0.45±0.8, p<0.01) and ischemia severity (0.63±0.9 vs. 0.43±0.7, p<0.01). Further, they also showed an increased reversibility percentage of myocardium (3.2%±6.8 vs. 1.7%±4.1, p<0.05). Median follow-up time was 378 days. A total number of 61 MACES occurred, including death, myocardial infarction, stroke and arterial revascularization. In a Kaplan-Meier survival analysis, higher longitudinal displacement predicted one year event-free survival (p=0.01, OR=1.9). In a multivariate analysis adjusted for age, hypertension, diabetes, ApoA-levels, intima-media thickness and reversibility percentage of myocardium; low longitudinal displacement remained the only independent predictor of MACE (p<0.05).
Conclusions: In conclusion, VVI-derived longitudinal displacement of the CCA seems to be a highly feasible novel measure of arterial stiffness and has a predictive value for short-term cardiovascular events in medium to high-risk patients.