Carotid intima–medial thickness as a marker of disease activity in Takayasu's arteritis (original) (raw)
Related papers
The American Journal of Cardiology, 2006
Background and Aims: Atherosclerosis is an inflammatory process involving arteries in various organs. Carotid intima medial thickness (CIMT) can be useful noninvasive tool to detect atherosclerosis for diagnosis of significant cardiovascular disease. We aim to study the association of CIMT with severity of Coronary Artery Disease (CAD). Methods: This was a cross sectional, observational study conducted in 81 patients with mean age of 59.9± 8.5 years with a diagnosis of CAD undergoing coronary artery bypass graft (CABG) surgery. The CIMT was measured with B-mode ultrasound in all patients and association with severity of CAD was measured. Results: The prevalence of increased CIMT in our study group was 31% and carotid plaque was 69%. Presence of carotid plaque was significantly associated with severe grade CAD stenosis (t = 4, p < 0.001) and presence of Chronic Total Occlusion (CTO) (p = 0.028). There was no significant correlation between mean CIMT and severity of CAD expressed as mean percentage stenosis (r = 0.179, p = 0.11) but patients with CTO had higher mean CIMT value than non-CTO group (0.86 ± 0.21 Vs 0.73 ± 0.18; p = 0.027). We found that diabetic population had greater mean CIMT values than nondiabetic population (0.82 ± 0.21 Vs 0.72 ± 0.17; p = 0.017) and higher prevalence of carotid plaque (p = 0.02). Similarly, females were more likely to have increased CIMT than males (p=0.004). Conclusion: We found that increased CIMT was associated with presence of CTO. Presence of carotid plaque was associated with severe grading of CAD and CTO. Carotid ultrasound can be useful noninvasive modality to predict presence of significant CAD.
Ultrasound in Medicine & Biology, 2019
This study aimed to identify instant intima-media thickness changes (DIMT) in the common carotid artery (CCA) during cardiac cycle in order to assess atherosclerosis progression. Using a computerized semiautomated method, instant IMT changes were extracted in the two walls of the left CCA (240 consecutive patients) using B-mode ultrasound images. We found that CCA DIMT increased from 8 § 4% of IMT max in the controls to 15 § 6% of IMT max in the severe stenosis group. According to the multiple ordinal regression analysis, DIMT was associated with the severity of carotid artery stenosis (odds ratio [OR], 4.95; p < 0.001), independent of sex (OR, 1.11; p = 0.04), age (OR, 1.14; p < 0.001), body mass index; OR, 1.13; p = 0.036), hypertension (OR, 2.04; p < 0.001), diabetes (OR, 1.38; p = 0.045) and hyperlipidemia (OR, 1.54; p = 0.002). We concluded that increment of CCA DIMT during the cardiac cycle was strongly and independently associated with severity of carotid artery stenosis or atherosclerosis progression.
2011
Stroke is the second leading cause of mortality worldwide. Ischemic stroke is more prevalent than hemorrhagic stroke and atherosclerosis is the major cause of ischemic stroke. The increased carotid artery intima-media thickness (CIMT) is considered to be useful indicator of early atherosclerosis. So, this study was aimed to correlate the relationship between atherosclerotic risk factors and intima-media thickness of carotid artery in patients with acute ischemic stroke. Material and Methods: In this cross-sectional study, 100 consecutive patients of acute ischemic stroke and 50 healthy relatives of patients as control were studied for presence of atherosclerotic risk factors and carotid artery intima-media thickness by B-mode Doppler ultrasonography. Results: In this age and sex matched study, higher CIMT measurement was found among patients of acute ischemic stroke than healthy controls (0.849 ± 0.196 vs 0.602 ± 0.092; p < 0.001). The CIMT was well correlated with smoking (Beta = 0.295; t = 5.728; 95% CI 0.088 to 0.181; p < 0.001); hypertension (Beta = 0.387; t = 6.518; CI 0.112 to 0.209; p < 0.001); di abetes (Beta = 0.237; t = 4.848; CI 0.074 to 0.175; p < 0.001); hypercholesterolemia (Beta = 0.292; t = 5.840; CI 0.096 to 0.195; p < 0.001), but not with age (p = 0.153). The CIMT was also found to be higher among acute ischemic stroke patients who were smoker, hypertensive, diabetic and hypercholesterolemic than non-smoker, normotensive, non-diabetic and normo-cholesterolemic respectively. Conclusion: The CIMT being indicator of atherosclerosis can be used as future predictor of ischemic stroke.
Carotid Intima-Media Thickness (Imt): A Surrogate Marker of Atherosclerosis
Atherosclerosis is chronic, progressive disease of the arterial wall with onset decades prior to its clinical manifestations. Carotid intima-media thickness (IMT) measurement by ultrasound is an important tool for evaluation of early stages of atherosclerosis. Also, carotid intima-media thickness can be used for assessment of therapeutic effect of various regimens. Carotid IMT is sensitive marker of atherosclerosis. The causal relationship between carotid IMT and the clinical endpoint has been established on the basis of epidemiological studies and clinical trials. The strength of carotid IMT as a marker of atherosclerosis is enhanced by the fact that it may yield pathophysiological information at an early stage of atherogenic process.
Diagnostic value of carotid intima-media thickness in indicating multi-level atherosclerosis
Atherosclerosis, 2007
Carotid intima-media thickness (CIMT) is an indicator of atherosclerosis, but its association with multi-level involvement is sparsely investigated. Study aimed to examine interrelation between CIMT and number of arterial territories with significant (&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;gt;50%) stenoses, including coronary, supraaortic, renal and iliac/femoral arteries. Study formed 415 patients (294 men), aged 62.9+/-9.3 years referred to coronary angiography. CIMT assessment was performed in common, bulb and internal carotid segments, and expressed as the mean aggregate value. In all patients, both coronary, renal angiography and supraaortic, iliac/femoral arteries ultrasound was performed. Group I formed 102 patients without significant lesions in any of investigated territories; group II formed 131 patients with single territory; group III formed 102 patients with two territory and group IV formed 80 patients with three to four territory involvements. CIMT correlated with increasing number of involved territories (r=0.751, p&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;0.001). Aggregate CIMT, previous myocardial infarction, creatinine level, hypertension, hs-CRP, smoking were independent predictors of multi-level involvement (p&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;0.001, R=0.768). ROC curves showed that CIMT cut-off value of 1.308 mm could distinguish 0-1 from two to three level involvement with sensitivity of 81.6%, specificity 88.8%, PPV 85.1%, NPV 86.3% (odds ratio 35.9, range 20-65). CIMT increases with number of involved territories. CIMT is an independent predictor of significant multi-level atherosclerosis, showing high sensitivity and specificity for indicating more advanced territorial atherosclerotic involvement.
a b s t r a c t Background: Carotid arterial intima-media thickness (IMT) has been a good indicator of the presence and extent of coronary artery disease (CAD) in observational studies. Since treadmill testing and stress echocardiography can have limited specificity in diagnosing CAD, other methods are required. Methods: B-mode ultrasound examinations were performed with Philips Sonos 7500, frequency of 7.0 MHz linear array transducer in order to calculate IMT. All the patients were catheterized percutaneously via the femoral vessels with standard Judkins technique.
Association between carotid intima media thickness and acute coronary artery disease
Atherosclerosis, 2000
Methods Eighty-nine subjects 45 years were studied (55 with known CAD and 34 controls). IMT measurements were performed at the common carotid (CC), bulb and internal branch (IB) of both carotid arteries, (2112 measures). The diagnostic performance of IMT measurements performed at different sites, regarding the presence of CAD, was evaluated with ROC curves. Results Carotid plaques were found in 20.0% of the patients and 6.0% of the controls. The diagnostic performance of carotid IMT measures obtained at the CC, bulb or IB was not significantly different, with the CC and IB being slightly better (AUC ROC =0.82 and [ 4 _ T D $ D I F F ] 0.80 respectively). Conclusions IMT measures obtained at different carotid sites are associated with CAD in young (45 years) individuals. The diagnostic performance of IMT measured at the CC and IB is the more accurate measure, and this may be the most adequate for the measurement of IMT in this population.
1,2,3,4,5 Cardiology department, Benha university hospital, Benha faculty of medicine, Egypt. This study was conducted to uncover the relation between coronary artery ectasia (CAE) and markers of atherosclerosis. A total of 1611 coronary angiograms were prospectively examined to find out patients with CAE. Those patients were divided into 2 groups: Mixed CAE with stenotic coronary artery disease (CAD) " group 1 " and pure CAE " group 2 ". Two control groups of age-adjusted subjects were selected consecutively in a 1:1 fashion; one with normal coronaries " group 3 " (Pure CAE: normal coronaries) and the other with obstructive CAD only " group 4 " (Mixed CAE: obstructive CAD). All recruited subjects underwent carotid intima-media thickness (IMT) and high sensitivity C-reactive protein (hs-CRP) level measurements. Out of examined angiograms, 35 subjects showed mixed CAE " group 1 " and 26 showed pure CAE " group 2 ". Age and gender-adjusted logistic regression analysis model revealed that significant independent predictors for CAE were: hypertension, smoking, absence of DM and hs-CRP level > 3 mg/L. Mean carotid IMT was significantly higher in group 2 than group 3 and in group 4 than group 1 (1±0.1 versus 0.4±0.2 mm and 1.4±0.4 versus 1±0.2 mm respectively, P < 0.001 for both). Mean hs-CRP level was significantly higher in group 1 than group 4 and in group 2 than group 3 (7±2 versus 3±0.8 mg/L and 6±2 versus 1±0.6 mg/L respectively, P < 0.001 for both). We concluded that atherosclerosis may not be the only plausible explanation for CAE.
Carotid intima‐media thickness and markers of inflammation, endothelial damage and hemostasis
Annals of Medicine, 2008
Background. Different soluble molecules involved in inflammation, endothelial damage, or hemostasis are recognized as potential cardiovascular risk markers. Studies to assess the role of these markers in the atherosclerotic process by evaluating their relationship to carotid intima-media thickness (C-IMT) tend to provide contrasting results. Purpose. To perform a review of studies addressing the association between C-IMT and soluble markers and to investigate whether the observed inconsistencies could be explained by the characteristics of the patients included in different studies, for example prevalence of atherosclerotic disease (atherosclerotic burden), gender, age, or occurrence of specific vascular risk factors (VRFs). Data sources. PubMed and Embase (January 1990 to March 2006). Study selection. Articles in English reporting original cross-sectional studies. Data extraction. Two authors independently extracted data on study design, population, sample size, ultrasonic methodology, and statistical approach. Data synthesis. Despite the marked heterogeneity of results presented in the literature, meta-analysis established that studies showing positive associations between C-IMT and plasma levels of C-reactive protein (CRP) or fibrinogen are in the majority. Funnel plot analyses suggested the absence of an important publication bias. Data on the relationships between C-IMT and other soluble markers are by contrast scanty, contradictory, or unconfirmed by multivariate (as opposed to univariate) analyses, and the freedom from publication bias here cannot be vouched for. The degree of atherosclerotic burden in the population studied does not account for the heterogeneity of findings reported. Gender, noninsulindependent diabetes mellitus (NIDDM) and hypercholesterolemia influence the association between C-IMT and CRP. Blood pressure and hypercholesterolemia influence the association between C-IMT and fibrinogen. For all the other soluble markers considered, the number of groups was too small for this kind of statistical considerations. Limitations. Heterogeneity in ultrasound methodologies and in statistical approach limited comparability between studies. For most soluble markers, publication bias of positive results cannot be excluded. Conclusions. Only CRP and fibrinogen seem to be unequivocally related to C-IMT. For all the other soluble markers considered, no clear-cut conclusions can be drawn.