Carotid stiffness quantified through shear wave elastography and pulse wave velocity by ultrafast ultrasound for assessing cardiovascular risk.

Background: Carotid arterial stiffness is closely linked to cardiovascular (CV) events. Traditional evaluation methods have limitations in detecting early vascular lesions and do not adequately capture regional elastic changes. Real-time shear wave elastography (RT-SWE) can quantify local carotid stiffness, while ultrafast pulse wave velocity (ufPWV) provides regional stiffness assessment. However, the value of integrating these two modalities for improving CV risk assessment has not been established. Therefore, this study aimed to improve CV risk assessment by integrating RT-SWE and ufPWV carotid artery parameters. Methods: We divided 88 patients into control [no major cardiovascular risk factors (CVRFs); n=20] and CV risk groups (hypertension, diabetes, dyslipidemia, or smoking; n=68). Carotid intima-media thickness (cIMT), pulse wave velocity (PWV) at systole beginning (PWV-BS) and end (PWV-ES), and elastic moduli (E Results: Carotid elasticity parameters in RT-SWE and ufPWV (PWV-BS, PWV-ES, E Conclusions: Carotid elasticity measured by RT-SWE is closely associated with carotid stiffness measured by ufPWV. A combined model integrating RT-SWE and ufPWV provides a promising noninvasive approach for CV risk stratification. Notably, following age adjustment using ANCOVA, E