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This Article Full Text Full Text (PDF) All Versions of this Article: 293/2/H1031    most recent 00989.2006v1 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 ISI Web of Science Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Augst, A. D. Articles by Hughes, A. D. Search for Related Content PubMed PubMed Citation Articles by Augst, A. D. Articles by Hughes, A. D.

Analysis of complex flow and the relationship between blood pressure, wall shear stress, and intima-media thickness in the human carotid artery

¹Department of Chemical Engineering, Faculty of Engineering, and ²Clinical Pharmacology, National Heart and Lung Institute Division, Faculty of Medicine, Imperial College London, United Kingdom

Submitted 10 September 2006 ; accepted in final form 19 April 2007

Background: Previous clinical studies have observed relationships between increased intima-media thickness (IMT) in the carotid artery, elevated blood pressure, and low wall shear stress (WSS) calculated from the Poiseuille equation. This study used numerical methods to more accurately determine WSS in the carotid artery and to investigate possible determinants of increased IMT. Methods: IMT [common carotid artery (CCA) and bulb], CCA flow velocity, brachial systolic (SBP) and diastolic blood pressure (DBP), and carotid systolic pressure (cSBP) were measured in 14 healthy subjects (aged 44 ± 16 yr). Flow patterns in the carotid bifurcation were determined by computational fluid dynamics (CFD) based on three-dimensional ultrasound geometry. Instantaneous and time-averaged wall shear stress (WSS_av), oscillatory shear index (OSI), and wall shear stress angle gradients (WSSAG) were calculated. Results: IMT was positively related to SBP, DBP, cSBP, and WSSAG and inversely related to WSS_av in the CCA. In the bulb, IMT was positively related to SBP and cSBP but was not significantly related to WSS_av or WSSAG. IMT was unrelated to OSI in both the CCA and the bulb. Conclusion: Increased carotid artery IMT in healthy subjects with no evidence of focal plaques is primarily a response to elevated pressure.

atherosclerosis; ultrasound; computational fluid dynamics