Although carotid artery longitudinal wall motion (CALM) has been highly detailed in cross-sectional studies, there is little evidence to explain population interindividual variability. This study was conducted to investigate how common external factors impact CALM. Twenty-one young healthy adults (11 females, aged 22 ± 2 yr) underwent three within-subject protocols. To evaluate probe positioning, vascular ultrasound was performed at a proximal and distal location along the common carotid artery. To evaluate neck angle, scans were acquired with the neck positioned at 70°, 90°, maximum extension (112 ± 9°), and maximum flexion (51 ± 7°). For the respiratory cycle condition, scans were taken during 7 s of inhalation, 7 s of exhalation, and 7 s of breath hold. CALM was evaluated for anterograde, retrograde, and maximum displacements, as well as radial-axial displacement. CALM was greater at proximal versus distal locations (retrograde = 1.14 ± 0.62 vs. 0.63 ± 0.24 mm, maximal = 1.32 ± 0.59 vs. 0.73 ± 0.24 mm; all P < 0.05). Minimum neck angles had greater motion than maximum angles (maximum displacement = 1.03 ± 0.43 vs. 0.77 ± 0.23 mm, P < 0.05). Without correcting breathing bias, retrograde displacement was greater during inspiration versus expiration (1.06 ± 0.34 vs. 0.58 ± 0.24 mm) and breath hold (1.06 ± 0.34 vs. 0.58 ± 0.24 mm), diastolic CALM was greater during expiration versus breath hold (1.10 ± 0.44 vs. 0.76 ± 0.33 mm), and maximum CALM was smaller during breath hold versus expiration (0.89 ± 0.31 vs. 1.21 ± 0.39 mm) and inspiration (0.89 ± 0.31 vs. 1.41 ± 0.70 mm). We recommend scanning 1-2 cm proximal to the carotid bifurcation, maintaining a neutral neck angle (70°-90°) for optimal CALM data collection in humans.NEW & NOTEWORTHY Carotid artery longitudinal wall motion (CALM) provides unique cardiovascular health information, yet a standardized approach to measurement is nonexistent. We tested CALM during manipulation of common external factors including probe position, neck angle, and breathing. All three conditions were found to alter CALM with drift in the breathing condition correctable by use of a linear bias correction. Consistent techniques should be used in CALM acquisition to reduce variability between individuals and population groups.
Keywords: arterial wall; motion correction; respiration; speckle tracking; ultrasound.