Carotid intima thickness assessed using high-resolution ultrasound as a structural correlate of endothelial dysfunction.

Authors

Bi-Xiao Shen, Zheng-Qiu Zhu, Xue-Hui Ma, Yin-Ping Wang, Xue-Zhong Jiang, Chong Zou, Hui Gao, Ping Dai, Yi-Yun Wu, Hui Huang

Published in

Ultrasonography (Seoul, Korea). Volume 45. Issue 6. Pages 564-575. Epub Sep 28, 2026.

Abstract

This study evaluated the association between carotid intima thickness (cIT), measured using high-resolution ultrasound, and endothelial cell dysfunction (ECD), assessed using flow-mediated dilation (FMD), for early atherosclerosis risk assessment.
Between January and December 2024, 102 middle-aged nonsmoking participants were prospectively recruited; 66 were included in the final analysis and classified into a risk group (n=44) or control group (n=22) according to the presence or absence of at least one conventional cardiovascular risk factor. Data collected included demographic characteristics, physical measurements, laboratory findings, cIT, carotid media thickness (cMT), and carotid intima-media thickness (cIMT). After 5 minutes of forearm occlusion, brachial artery diameters were measured at baseline and at 30, 60, and 120 seconds after cuff deflation during systole and diastole, and FMD indices were calculated. Receiver operating characteristic (ROC) curve analysis was performed, with differences between the ROC curves evaluated using the Hanley-McNeil test.
Compared with the control group, the risk group had greater cIT (P<0.001) and cIMT (P=0.016) and generally lower FMD indices. cMT did not differ significantly between groups (P=0.595). Among carotid ultrasound parameters, cIT showed the strongest association with atherosclerosis risk (standardized β=0.489, P<0.05) and the strongest inverse correlation with systolic FMD measured 60 seconds after cuff deflation (FMDS60; ρ=-0.689, adjusted P=0.001). In ROC analysis, cIT generally showed better performance for identifying ECD than cMT and cIMT, with a maximum area under the curve of 0.896 (P<0.001).
High-resolution ultrasound measurement of cIT may provide a noninvasive imaging marker of early endothelial dysfunction.

PMID:
42958858
Bibliographic data and abstract were imported from PubMed on 30 Oct 2026.

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