Clinical Physiology and Functional Imaging · Apr 9, 2026
Structural heterogeneity of carotid, femoral and brachial arteries across the human lifespan: Normative data and reference intervals
By Bia D, Diaz A, Zócalo Y
BACKGROUND: In physiological and pathological conditions arteries undergo changes in their structural characteristics (diastolic diameter (DD), diastolic cross-sectional area (DCSA), wall thickness, wall-to-lumen ratio). Accurate clinical use of arterial structural parameters (ASP) requires knowing their physiological age-related profiles and expected values for a specific subject. No studies have characterized the profiles of ASP in large populations jointly considering: (i) data from different age stages, (ii) arteries of different types (elastic, transitional, muscular) from both body sides and (iii) potential age-, sex-, and anthropometric-related differences. Additionally, (iv) there is a lack of normative data (reference intervals, RIs) for ASP. AIMS: (1) to determine the need for RIs differentiated by body side, sex, anthropometry and/or age; (2) to define RIs for ASP in a large cohort of healthy children, adolescents and adults. METHODS: Four-thousand three hundred seventy-one subjects (2-89 y) were considered, including 1927 (4-76 y) healthy and non-exposed to cardiovascular risk factors. Carotid, femoral and brachial ASP (DD, DCSA, intima-media thickness, wall-to-lumen ratio) were obtained (ultrasound). Association and agreement between the same parameter obtained from both sides (left/right) were analyzed (Concordance correlations, Bland-Altman test). Multivariate analyses allowed identifying whether RIs differentiated by age, sex and/or anthropometric characteristics were necessary. Mean and standard deviation equations, and sex-specific, body height (BH)- and age-related profiles were obtained (regression methods; fractional polynomials). RESULTS: Physiological profiles and RIs were defined for ASP. The equations related to age, sex and BH obtained (and given) for the ASP would allow determining the expected values and potential deviations in a particular subject.