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Title: Effect of ageing on carotid artery morphology, hemodynamics, and the development of atherosclerosis
Author: Carallo, Claudio
ISNI:       0000 0004 8499 3934
Awarding Body: Imperial College London
Current Institution: Imperial College London
Date of Award: 2019
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Cardiovascular diseases and ageing are two main challenges for health services. Cardiovascular disease is characterised by atherosclerosis, leading to heart attack and stroke. Atherosclerosis is a focal disease and occurs preferentially in regions of arterial bifurcation and curvature where complex flow features are observed. The carotid arteries represent a region of significant involvement in atherosclerosis. Previous studies have shown that haemodynamic factors are important determinants of the local distribution of atherosclerosis. However, longitudinal studies are lacking. The aim of this study was to investigate age-related changes in carotid artery morphology and haemodynamics based on longitudinal data acquired from a group of middle-aged subjects recruited to a cardiovascular disease prevention programme in Italy. The longitudinal study started in 1996 and participants were examined twice 12 years apart. All subjects underwent blood viscosity measurements and echo-Doppler examinations of the common carotid artery at baseline and follow-up. From the acquired ultrasound data, common carotid artery diameter, blood flow velocity, and intima-media thickness were measured, and wall shear stress, circumferential wall tension and Peterson elastic modulus were calculated. It was found that with ageing, blood viscosity increased, common carotid artery diameter increased, mean blood velocity and wall shear stress decreased, while intima-media thickness, circumferential wall tension and arterial stiffness increased. Interrelationships of the data were also examined: reductions in common carotid wall shear stress were independently associated with intima-media thickening. Furthermore, ageing-associated wall shear stress reduction predicted the development of atherosclerotic plaques, independently of known cardiovascular risk factors. In addition, in participants presenting shear stress reductions in only one side of the common carotid artery, development of atherosclerosis in the carotid tree was limited to the same body side. In conclusion, this longitudinal study confirms the role of arterial wall shear stress as a mediator of the effects of ageing on atherosclerosis.
Supervisor: Xu, Yun ; Gnasso, Agostino Sponsor: Not available
Qualification Name: Thesis (Ph.D.) Qualification Level: Doctoral