The effect of smoking on quantification of aortic stiffness by ultrasound time-harmonic elastography

Abstract

Smoking is a significant cardiovascular risk factor that causes stiffening of the central arteries, especially the aorta. While vessel stiffness can be determined indirectly by measuring pulse wave velocity, elastography allows image-based determination of vessel stiffness while at the same time providing information on vascular morphology. This study compares abdominal aortic wall stiffness as measured by ultrasound time-harmonic elastography (THE) in fifteen smokers and fifteen age-matched non-smoking controls without a history of cardiovascular disease. Smokers had a significantly higher abdominal aortic wall stiffness with a mean shear wave speed of 2.66 m/s (95% confidence interval (CI) 2.59–2.72 m/s) compared to 2.40 m/s (95% CI 2.34–2.47 m/s) (p < 0.01) in the group of non-smokers. All other baseline characteristics including aortic diameter showed no significant differences. Inter-rater variability was excellent with an intraclass correlation coefficient of 0.99 (95% CI 0.98–0.99). Our results show that THE is sensitive to subclinical stiffening of the aorta in young and middle-aged smokers even before morphological changes occur and may therefore has the potential to serve as a screening tool for early aortic abnormalities and longitudinal risk factors for cardiovascular health.

Aging of the Arterial System

“…Smoke is one of the most important risk factors for cardiovascular disease. Studies showed that smoking is a strong risk factor for increased arterial stiffness [ 68 ] and directly associated with the number of daily cigarettes smoked [ 69 ]. The detrimental effect of smoking is greater when combined with the other risk factors, such as dyslipidemia, inflammation, and arterial calcification.…”