Key result
Older age is linked to higher PWV at the common carotid artery and bifurcation.
Why the study?
Vector flow imaging and radiofrequency-based quantitative analysis had not been applied together in a well-characterised healthy cohort to evaluate segmental age- and sex-related carotid differences.
How do age, sex, and carotid segment influence carotid ultrasonography parameters (WSS, turbulence, stiffness) measured by VFI and RVQS in healthy subjects?
How do age, sex, and carotid segment influence carotid ultrasonography parameters (WSS, turbulence, stiffness) measured by VFI and RVQS in healthy subjects?
In healthy adults, carotid artery stiffness measured by RVQS increases significantly with age, whereas wall shear stress measured by VFI varies by segment and sex but not age, suggesting RVQS may be more sensitive for detecting early subclinical vascular changes.
Supports RVQS for detecting age-related carotid stiffness; leaves open its prognostic value in healthy adults.
Objectives Atherosclerosis is influenced by hemodynamic forces and arterial stiffness. Vector flow imaging (VFI) provides assessment of wall shear stress (WSS) and turbulence, while radiofrequency-based quantitative analysis (RVQS) measures hardness coefficient (HC) and pulse wave velocity (PWV). To date, these techniques have not been applied together in a well-characterised healthy cohort. This study aimed to evaluate segmental age and sex-related differences in the carotid artery using VFI and RVQS. Methods Sixty healthy volunteers (30 women, 30 men; aged 20–59 years) underwent carotid ultrasonography. The common carotid artery (CCA), the bifurcation (BIF), and the internal carotid artery (ICA) segments were examined. WSS, turbulence, HC, PWV, and distension parameters were measured in each segment. Non-parametric tests were used. Results Significant segmental variation was found ( p < 0.001). The BIF showed the lowest mean WSS (median = 0.84 Pa, < 0.001), the highest turbulence 3.87 (< 0.001), and the highest stiffness (HC: 3.22 < 0.001, PWV: 6.04, < 0.001). ICA had greatest distension (866 μm, < 0.001) and lowest stiffness (HC = 1.25, < 0.001, PWV: 3,83 < 0.001). Older participants had markedly stiffer arteries. PWV was higher in the older vs. younger group at both CCA (6.1 m/s vs. 4.6 m/s, p < 0.001) and BIF (7.2 vs. 4.96 m/s, p < 0.001). HC was also significantly higher in CCA and BIF (3.3 vs. 1.8, p < 0.001, 1.3 vs. 2.3, p < 0.001). Distension decreased with age in CCA and BIF (CCA: 364 vs. 560 μm, p < 0.001, BIF: 547 vs. 355 μm, p < 0.001). In contrast, WSS and turbulence did not differ significantly by age. Women exhibited higher mean WSS in the ICA (1.3 vs. 1.1 Pa, p = 0.018) and BIF (0.94 vs. 0.74 Pa, p = 0.045). Men showed slightly higher turbulence in the ICA (TAT = 1.1 vs. 0.5, p = 0.020). Conclusion The study revealed marked segmental and demographic differences in atherosclerosis parameters. RVQS parameters showed significant age-related differences, whereas WSS did not vary with age in this healthy group (20–59 years), suggesting RVQS may be more sensitive for detecting subclinical early vascular change. The combined application of VFI and RVQS may provide a physiologic reference framework for assessing the carotid arteries.
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Kılıç et al. (2026) studied this question. In older participants, pulse wave velocity (PWV) was significantly higher at the common carotid artery (6.1 m/s) and bifurcation (7.2 m/s) compared to younger participants (p < 0.001).
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