A systematic literature review of the effect of carotid atherosclerosis on local vessel stiffness and elasticity

- We describe methods of measuring and reporting local carotid elasticity.
- We found 50 articles describing distensibility or stiffness in carotid plaque.
- We tabulated all results by the distensibility or stiffness metric reported.
- We summarize findings of increased carotid stiffness in the presence of plaque.

ObjectiveThis systematic literature review sought to determine the effects of carotid atherosclerotic plaque on local arterial stiffness.MethodsMedLine, EMBASE, and grey literature were searched with the following term: (“atherosclerosis” or “carotid atherosclerosis” or “carotid artery disease” or “carotid plaque”) AND (“distensibility” or “elasticity” or “stiffness” or “compliance”) NOT (“pulse wave velocity” or “PWV” or “carotid-ankle” or “ankle-brachial” or “augmentation index” or “cardio-ankle” or “CAVI” or “flow mediated dilation” or “FMD”). Results were restricted to English language articles reporting local arterial stiffness in human subjects with carotid atherosclerosis.ResultsOf the 1466 search results, 1085 abstracts were screened and 191 full-text articles were reviewed for relevance. The results of the 50 studies that assessed some measure of carotid arterial elasticity or stiffness in patients with carotid plaque were synthesized and reviewed.DiscussionA number of different measures of carotid elasticity were found in the literature. Regardless of which metric was used, the majority of studies found increased carotid stiffness (or decreased distensibility) to be associated with carotid plaque presence, the degree of atherosclerosis, and incident stroke.ConclusionCarotid artery mechanics are influenced by the presence of atherosclerotic plaque. The clinical applicability of carotid elasticity measures may be limited by the lack of reference values and standardized techniques.

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