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Increased carotid artery wall stiffness and plaque prevalence in HIV infected patients measured with ultrasound elastography

  • Ultrasound
  • Published:
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Abstract

Objectives

Assess carotid artery strain and motion in people living with HIV as markers of premature aging using ultrasound noninvasive vascular elastography (NIVE).

Methods

Seventy-four HIV-infected and 75 age-matched control subjects were recruited from a prospective, controlled cohort study from October 2015 to October 2017 (mean age 56 years ± 8 years; 128 men). NIVE applied to longitudinal ultrasound images of common and internal carotid arteries quantified the cumulated axial strain, cumulated shear strain, cumulated axial translation, and cumulated lateral translations. The presence of plaque was also assessed. An association between elastography biomarkers and HIV status was evaluated with Mann–Whitney tests and multivariable linear regression models.

Results

A higher occurrence of carotid artery plaques was found in HIV-infected individuals (p = 0.011). Lower cumulated lateral translations were found in HIV-infected subjects on both common and internal carotid arteries (p = 0.037 and p = 0.026, respectively). These observations remained significant when considering multivariable models including common cardiovascular risk factors and clinical characteristics (p < 0.05). Lower cumulated axial strains were also observed in internal carotid arteries when considering both multivariable models (p < 0.05).

Conclusion

Lower translation and strain of the carotid artery wall in HIV-infected individuals indicates increased vessel wall stiffness. These new imaging biomarkers could be used to characterize premature atherosclerosis development.

Key Points

• Noninvasive vascular elastography (NIVE) based on ultrasound imaging quantifies translations and strains of carotid arteries.

• Lower translation and strain of the carotid artery wall found in HIV-infected individuals indicate premature arterial stiffening, compared with age-matched controls.

• Carotid artery plaques were more prevalent in HIV-infected individuals than in control subjects.

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Abbreviations

ART:

Antiretroviral therapy

CAS:

Cumulated axial strain

CAT:

Cumulated axial translation

CCA:

Common carotid artery

CHACS:

Canadian HIV and Aging Cohort Study

CLT:

Cumulated lateral translation

C|ShS|:

Cumulated axial shear magnitude

HDL-C:

High-density lipoprotein cholesterol

ICA:

Internal carotid artery

IMT:

Intima-media thickness

LDL-C:

Low-density lipoprotein cholesterol

NIVE:

Noninvasive vascular elastography

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Funding

This study was initiated through the support of the Canadian Institute of Health Research (CIHR, Canadian HIV and Aging Cohort Study, group grant no. 284512); it is now supported by CIHR group grant no. 398643 and project grant no. 399544.

Author information

Authors and Affiliations

  1. Laboratory of Biorheology and Medical Ultrasonics, University of Montreal Hospital Research Center (CRCHUM), Montréal, QC, H2X 0A9, Canada

    Marie-Hélène Roy Cardinal & Guy Cloutier

  2. Department of Internal Medicine, University of Montreal Hospital Center (CHUM), Montréal, QC, H2X 0C1, Canada

    Madeleine Durand

  3. Department of Medicine, University of Montreal, Montréal, QC, H3T 1J4, Canada

    Madeleine Durand

  4. Department of Radiology, University of Montreal Hospital Center (CHUM), Montréal, QC, H2X 0C1, Canada

    Carl Chartrand-Lefebvre & Gilles Soulez

  5. Department of Radiology, Radio-Oncology and Nuclear Medicine, University of Montreal, Montréal, QC, H3T 1J4, Canada

    Carl Chartrand-Lefebvre, Gilles Soulez & Guy Cloutier

  6. Department of Medical Microbiology and Infectiology, University of Montreal Hospital Center (CHUM), Montréal, QC, H2X 0C1, Canada

    Claude Fortin & Cécile Tremblay

  7. Clinique Médicale Urbaine du Quartier Latin, Montréal, QC, H2I 4E9, Canada

    Jean-Guy Baril & Benoit Trottier

  8. Chronic Viral Illness Service, McGill University Health Centre, Montréal, QC, H4A 3J1, Canada

    Jean-Pierre Routy

  9. Institute of Biomedical Engineering, University of Montreal, Montréal, QC, H3T 1J4, Canada

    Gilles Soulez & Guy Cloutier

  10. Department of Microbiology, Infectiology and Immunology, University of Montreal, Montréal, QC, H3T 1J4, Canada

    Cécile Tremblay

Authors
  1. Marie-Hélène Roy Cardinal
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  10. Guy Cloutier
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Corresponding author

Correspondence to Guy Cloutier.

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The scientific guarantor of this publication is Dr. Guy Cloutier.

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The authors declare that they have no conflict of interest.

Statistics and biometry

Co-authors (MHRC, GS, and GC) have significant statistical expertise.

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Written informed consent was obtained from all subjects (patients) in this study.

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Institutional review board approval was obtained.

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• prospective

• cross-sectional study

• performed at one institution

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Roy Cardinal, MH., Durand, M., Chartrand-Lefebvre, C. et al. Increased carotid artery wall stiffness and plaque prevalence in HIV infected patients measured with ultrasound elastography. Eur Radiol 30, 3178–3187 (2020). https://doi.org/10.1007/s00330-020-06660-9

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  • DOI: https://doi.org/10.1007/s00330-020-06660-9

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