Abdominal Aortic Intima-media Thickness Research Articles

Abdominal aorta intima-media thickness in children with hypothyroidism

Hypothyroidism is associated with atherosclerosis, which is attributed mainly to an atherogenic lipid profile. Increased intima-media thickness (IMT) is the first structural change detected in atherosclerosis. This prospective cohort study investigated lipid profile and abdominal aorta IMT in patients newly-diagnosed with hypothyroidism and their change one year post-treatment. It included fifty patients divided into three groups according to their diagnosis: congenital hypothyroidism (CH), Acquired and CH stopped treatment/uncontrolled group. They were subjected to history, auxological, blood pressure, non-fasting lipid profile, and abdominal aorta IMT measurement by abdominal ultrasound. These demonstrated high basal cholesterol, triglycerides, and LDL (259.64 ± 82.06, 193.94 ± 71.54, and 144.70 ± 48.46 mg/dl, respectively) and significant reduction after treatment (216.66 ± 44.60, 165.70 ± 53.58 and 123.26 ± 29.79 mg/dl, respectively). Low basal HDL (47.92 ± 10.08 mg/dl) increased significantly (57.56 ± 7.94 mg/dl) after treatment. Abdominal aorta IMT decreased significantly after treatment and achievement of euthyroidism (1.47 ± 0.49 and 1.33 ± 0.41 mm, respectively). In conclusion, upon treatment of hypothyroidism and achievement of euthyroidism, abdominal aorta IMT, cholesterol, triglycerides, and LDL decreased significantly, and HDL increased. Abdominal aorta IMT measurement is an easy and feasible way for the early detection of atherosclerosis.

Aumento da Espessura Médio-intimal Aórtica e sua Relação com Estresse Oxidativo Elevado em Pacientes com Talassemia Menor

ResumoFundamento A espessura médio-intimal (EMI) da artéria aorta abdominal (EMI-A) pode ser um marcador precoce de aterosclerose subclínica e um indicador objetivo de estresse oxidativo em pacientes com talassemia menor.Objetivo Avaliar se as EMIs da artéria aorta e da artéria carótida (EMI-C) se alteram com estresse oxidativo, e examinar a relação entre esses parâmetros em pacientes com talassemia menor.Métodos O estudo incluiu 80 pacientes diagnosticados com talassemia menor, e 50 indivíduos sadios com idade e sexo similares. Após procedimentos de rotina, as amostras de sangue foram coletadas dos grupos de estudo para a medida da homeostase tiol/dissulfeto e da albumina modificada pela isquemia (AMI). As medidas da EMI-C foram realizadas a partir de quatro regiões diferentes (artéria carótida externa direita e esquerda e artéria carótida interna direita e esquerda) por ultrassonografia, e a medida da EMI-A foi realizada por ultrassonografia abdominal. Um valor de p<0,05 foi definido como estatisticamente significativo.Resultados Nos pacientes com talassemia menor, os níveis de tiol nativo e tiol total, e a razão tiol nativo/tiol total foram mais baixos, e os valores de AMI, razão dissulfeto/tiol nativo, e razão dissulfeto/tiol total foram mais altos que no grupo controle. A EMI-A foi significativamente maior no grupo de pacientes com talassemia menor que nos controles (1,46±0,37 vs 1,23±0,22 e p<0,001). Quando os parâmetros associados com EMI-A na análise univariada foram avaliados por regressão linear multivariada, EMI-A apresentou uma relação positiva, e os níveis de tiol nativo e tiol total apresentaram uma forte relação negativa com AMI (p<0,01).Conclusão Nós demonstramos, pela primeira vez, um aumento no estresse oxidativo com a elevação da EMI-A, e valores inalterados da EMI-C em pacientes com talassemia menor.

Influence of intrauterine growth status on aortic intima-media thickness and aortic diameter in near-term fetuses: a comparative cross-sectional study.

Intrauterine undernutrition may lead to fetal vascular programming. We compared abdominal aortic intima-media thickness (aIMT) and aortic diameter (aD) between appropriate for gestational age (AGA) and growth-restricted fetuses (GRF). We recruited 136 singleton fetuses at 34-37 weeks of gestation from Fetal Medicine Unit of Aga Khan University Hospital, Karachi (January-November 2017). Subjects were classified as AGA (n = 102) and GRF (n = 34) using INTER-GROWTH 21st growth reference and standard ultrasound protocol. Their far- and near-wall aIMT and aD were compared after adjustment of maternal age, first-trimester body mass index, fetal gender, hypertension and hyperglycemia in pregnancy. As the severity of growth restriction increased in GRF, aIMT and aD showed an increasing and a decreasing trend, respectively. Both far- and near-wall aIMT in GRF [(adj. β = 0.082, 95% confidence interval [CI] 0.042-0.123) and (adj. β = 0.049, 95% CI 0.010-0.089)] were significantly greater with reference to AGA fetuses. GRF subgroup analysis into small for gestational age (SGA) fetuses and intrauterine growth restricted (IUGR) revealed highly significant difference between AGA and IUGR for far (0.142mm, P-value < 0.001) and near-wall aIMT (0.115mm, P-value < 0.001) and marginally significant aD difference (0.51mm, P-value 0.05). These findings suggest that the extent of fetal aortic remodelling is influenced by the severity of growth restriction. Hence, the targeted interventions for the cardiovascular health promotion of IUGR and SGA born neonates are desirable during early childhood, particularly in set ups with high prevalence of low birth weight babies.

Abdominal Aortic Intima-Media Thickness Predicts Coronary Artery Disease Severity in Patients With Stable Angina Pectoris: A Prospective Study.

Accurately identifying coronary artery disease (CAD) is the key element in guiding the work-up of patients with suspected angina. Thickening of the arterial wall is a hallmark of atherosclerosis. Therefore, the main purpose of this study was to determine whether abdominal aortic intima-media thickness (AAIMT), which is the earliest zone of atherosclerotic manifestations, has a predictive value in CAD severity. A total of 255 consecutive patients who were referred for invasive coronary angiography due to suspected stable angina pectoris were prospectively included in the study. B-mode ultrasonography was used to determine AAIMT before coronary angiography. Coronary artery disease severity was assessed with the SYNTAX score (SS). A history of hypertension, age, dyslipidemia, and higher AAIMT (odds ratio: 2.570; 95%CI 1.831-3.608; P < .001) were independent predictors of intermediate or high SS. An AAIMT <1.3 mm had a negative predictive value of 98% for the presence of intermediate or high SS and 83% for obstructive CAD. In conclusion, AAIMT showed a significant and independent predictive value for intermediate or high SS. Therefore, AAIMT may be a noninvasive and useful tool for decision-making by cardiologists (eg, to use a more invasive approach).

Increased circulating endothelial progenitor cells (EPCs) in prepubertal children born prematurely: a possible link between prematurity and cardiovascular risk.

Endothelial progenitor cells (EPCs) ensure vascular integrity and neovascularization. No studies have investigated EPCs in preterm-born children beyond infancy. One hundred and thirty-six prepubertal children were enrolled: 63 preterm and 73 born at term (controls). Circulating CD34(+)/VEGFR-2(+)/CD45(-) and CD34(+)/VEGFR-2(+)/CD45dim EPCs were measured in preterm-born children compared to controls. Body mass index (BMI), waist-to-hip ratio (WHR), neck circumference, systolic and diastolic blood pressure (SBP and DBP, respectively), fasting glucose, insulin, lipid profile, common carotid and abdominal aortic intima-media thickness (cIMT and aIMT, respectively), endothelium-dependent brachial artery flow-mediated dilation (FMD), and echocardiographic parameters were also assessed. Circulating CD34(+)/VEGFR-2(+)/CD45(-) and CD34(+)/VEGFR-2(+)/CD45dim EPCs were significantly higher in preterm-born children compared to controls (p < 0.001 and p < 0.001, respectively). In total study population and in the preterm-born group, EPCs were significantly lower in children born to mothers with gestational diabetes compared to non-diabetic mothers. Prematurity was associated with higher WHR, neck circumference, SBP, DBP, cIMT, aIMT, mean pressure, and velocity of pulmonary artery; the peak velocity of the brachial artery was significantly lower in children born prematurely. In multiple regression analysis, preterm birth and maternal gestational diabetes were recognized as independent predictors of EPCs. Circulating EPCs were increased in prepubertal preterm-born children in comparison with peers born full-term. Maternal gestational diabetes was associated with a decrease in EPCs. Mounting evidence supports the adverse effect of prematurity on cardiovascular health. However, the underlying mechanisms that could lead to endothelial dysfunction in preterm-born individuals are not fully understood. Endothelial progenitor cells (EPCs) ensure vascular integrity, normal endothelial function and neovascularization. No studies have investigated the EPCs counts in peripheral blood beyond infancy in children born prematurely. Circulating EPCs were significantly higher in preterm-born prepubertal children compared to controls, thus indicating that prematurity is possibly associated with endothelial damage. In total study population and in the preterm-born group, maternal gestational diabetes was associated with decreased EPCs concentrations.

Circulating chemerin level may be associated with early vascular pathology in obese children without overt arterial hypertension - preliminary results.

Background Elevated chemerin level is observed in patients with arterial hypertension. The aim of the study was to determine the relationship between chemerin level, and parameters of blood pressure and arterial stiffness in children and adolescents with obesity but without arterial hypertension. Methods In 23 children with obesity (13 girls, mean age 9.3, SD 1.9, mean BMI SDS 3.9, SD 1.7) 24h ABPM (Spacelabs 90,217, USA), common carotids and abdominal aorta intima media thickness measurements (Voluson 730, GE Medical System 8.5 and 3.5MHz probes), body composition analysis (Tanita BC 418SMA, Tokyo, Japan) were performed. Glucose, triglycerides, total, LDL and HDL cholesterol, liver enzymes, uric acid, creatinine, sodium, insulin and chemerin levels were assessed in blood sample taken after a 12-h fasting period. Results There was a significant correlation of circulating chemerin level with systolic blood pressure load in ABPM (r=0.5, p<0.05). Conclusion Elevated chemerin level may be associated with increased systolic blood pressure in obese children.

Natural History of Atherosclerosis and Abdominal Aortic Intima-Media Thickness: Rationale, Evidence, and Best Practice for Detection of Atherosclerosis in the Young

Atherosclerosis underlies most myocardial infarctions and ischemic strokes. The timing of onset and the rate of progression of atherosclerosis differ between individuals and among arterial sites. Physical manifestations of atherosclerosis may begin in early life, particularly in the abdominal aorta. Measurement of the abdominal aortic intima-media thickness by external ultrasound is a non-invasive methodology for quantifying the extent and severity of early atherosclerosis in children, adolescents, and young adults. This review provides an evidence-based rationale for the assessment of abdominal aortic intima-media thickness—particularly as an age-appropriate methodology for studying the natural history of atherosclerosis in the young in comparison to other methodologies—establishes best practice methods for assessing abdominal aortic intima-media thickness, and identifies key gaps in the literature, including those that will identify the clinical relevance of this measure.

Correlation of lipid profile and anthropometry with aortic intima-media thickness in newborns of diabetic and non-diabetic mothers

Background: Exposure to diabetes in utero has been established as a significant factor for certain component of the clinical syndrome. Although complications of atherosclerosis occur in adult life, the process begins in early childhood. Hence, measuring aortic intima-media thickness (AIMT) in the newborn is a feasible, accurate, and sensitive marker of atherosclerotic risk. Objective: The objective of the study was to find an association of AIMT with cord blood lipid levels and anthropometric factors. Methods: Babies born to diabetic mothers (gestational diabetes mellitus/type 2 diabetes mellitus (34 weeks–42 weeks) who were taken as one group and babies born to non-diabetic mothers (34 weeks–42 weeks) who were taken as the other group were enrolled in this study. Lipid values were measured of umbilical cord blood, collected immediately after delivery. Atherogenic-indices were calculated; neonatal anthropometric measurements were taken within 24 h after delivery. Abdominal AIMT (aAIMT) was measured within 4 days of delivery using a high-resolution ultrasound B mode by a trained radiologist. Maternal age, parity, height, pre-pregnancy weight, gestational age, and other investigations were taken from maternal records. Results: In this study, birth weight (BW) was positively correlated with triglycerides (TG), cholesterol, high-density lipoprotein (HDL), very low-density lipoprotein (VLDL), and atherogenic-indices, whereas, it was negatively correlated with low-density lipoprotein (LDL) (p&lt;0.01). A positive correlation was found between aAIMT and BW, abdominal circumference, TG, cholesterol, HDL, LDL, VLDL, and atherogenic-indices (p&lt;0.001). Conclusions: In this study, infants born to diabetic mothers had higher anthropometry, lipid values, aAIMT compared to babies born to non-diabetic mothers without risk factors.

Aortic intima-media thickness can be used to determine target organ damage in adult patients with coronary artery disease risk factors.

IntroductionWe aimed to evaluate the relationship between abdominal aortic intima-media thickness (AA-IMT) and thoracic aortic intima-media thickness (TA-IMT) values and to investigate their relationship with common carotid intima-media thickness (CC-IMT) in patients with coronary artery disease (CAD) risk factors.Material and methodsThis study included 100 patients who underwent transesophageal echocardiography (TEE) examination for different reasons with at least one CAD risk factor. CC-IMT, AA-IMT, and TA-IMT values were measured. Patients with CC-IMT > 0.9 mm were considered as having increased CC-IMT. Patients were divided into two groups with and without increased CC-IMT.ResultsMean AA-IMT and TA-IMT values of all patients were 1.55 ±0.27 mm and 1.39 ±0.25 mm, respectively. In patients with increased CC-IMT, blood pressure, hyperlipidemia and hypertension frequency, creatinine, total and low-density lipoprotein (LDL) cholesterol, triglyceride, high-sensitivity C-reactive protein (hs-CRP) and uric acid levels, AA-IMT and TA-IMT values were higher, while the high-density lipoprotein (HDL) cholesterol level was lower than the normal CC-IMT group. AA-IMT, systolic blood pressure (SBP), total and HDL cholesterol levels independently determined the patients with CC-IMT > 0.9 mm. Each 0.1 mm increase in AA-IMT value was found to increase the probability of having CC-IMT > 0.9 mm. In addition, linear regression analysis showed that CC-IMT was closely and independently related to AA-IMT (p < 0.001 and β = 0.599). When the cut-off value for AA-IMT was taken as 1.5 mm, it determined the patients with CC-IMT > 0.9 mm with 86% sensitivity and 82% specificity.ConclusionsThe AA-IMT value was found to be higher than TA-IMT in the same patient. Also it was found that AA-IMT was more closely related to CC-IMT.

Correction: The Abdominal Aortic Intima-Media Thickness Increases in Patients with Primary Hyperparathyroidism.

Correction to: The Abdominal Aortic Intima-Media Thickness Increases in Patients with Primary HyperparathyroidismExp Clin Endocrinol Diabetes 2019; 127(06): 387-395DOI: 10.1055/a-0664-7820

Coronary Artery Disease Severity Is Associated With Abdominal Aortic Intima-Media Thickness in Patients With Non-ST-Segment Elevation Myocardial Infarction.

The aim of this study was to evaluate the relationship between aortic intima-media thickness (aIMT) and coronary artery disease (CAD) severity in patients with non-ST-segment elevation myocardial infarction (NSTEMI). SYNTAX score (SS) was calculated. Patients were categorized into 2 main groups according to the SS: patient with high risk (SS ≥ 13) and low risk (SS < 13). Common carotid artery IMT (cIMT), common femoral artery IMT, and aIMT were measured with a high-resolution ultrasound Doppler system. We had 147 (52.9%) patients in the high-risk group and 132 patients in the low-risk group. Both cIMT and aIMT were significantly increased, and left ventricular ejection fraction (LVEF) was significantly lower in the high-risk group; aIMT (odds ratio [OR]: 1.272, P < .001), cIMT (OR: 1.239, P = .009), and LVEF (OR: 0.931, P = .002) were determined as independent predictors for the high-risk group. When the cutoff value was accepted as 1.25 mm for the aIMT, patients with high SS identification had 74.1% sensitivity and 89.4% specificity (area under the curve: 0.764, P < .001). In conclusion, aIMT detected by abdominal B-mode ultrasonography is closely associated with CAD severity in patients with NSTEMI.

A study of lipid profile and carotid artery and abdominal aorta intima-media thickness in children with parental history of premature ischemic heart disease

Background: Children born to parents with ischemic heart disease (IHD) can have dyslipidemia, a marker for IHD, detectable in early childhood and track to adulthood. Dyslipidemia along with factors like BMI, diet, sedentary activity increases risk of child developing IHD in adulthood. Early detection with non-invasive methods such as B mode ultrasound to measure carotid artery and abdominal aorta intima-media thickness can help in modification of these risk factors by suitable interventional strategies. The objectives of this study was to study the lipid profile and carotid artery and abdominal aorta intima-media thickness among children in the age group 5-18 years born to parents with history of premature IHD.Methods: 23 children of parents with premature IHD and aged matched 28 controls without any family history of IHD were analyzed for cardiovascular risk factors: lipid profile and carotid and abdominal aorta intima-media thickness. The carotid intima-media thickness and abdominal aorta intima-media thickness was found by using B mode ultrasound.Results: Mean abdominal aorta intima-media thickness was significantly higher among children with parental history of premature IHD than in those without it. Abdominal aorta intima-media thickness also showed significant positive correlation with total cholesterol. Carotid intima-media thickness showed positive correlation with the waist circumference. Mean total cholesterol levels (TC), low density lipoprotein cholesterol (LDL) and triglycerides (TG) were higher in children with family history as compared to children without family history but it was not statistically significant.Conclusions: Abdominal aortic IMT is significantly more among children with parental history of premature ischemic heart disease compared to children without parental history of premature ischemic heart disease. Abdominal aortic intima-media thickness has significant association with total cholesterol while carotid intima-media thickness is significantly associated with waist circumference.

There is a significant relationship between morning blood pressure surge and increased abdominal aortic intima-media thickness in hypertensive patients.

There are limited data about increased aortic intima-media thickness (A-IMT) in the presence of subclinical target organ damage in hypertensive (HT) patients. In this study, we aimed to determine the frequency of increased A-IMT, the parameters determining increased A-IMT, and the relationship between increased A-IMT and other vascular IMT measurements. We prospectively included 265 patients (mean age 54.1 ± 10.6years, male/female 91/174) with essential HT. Physical examination of all patients was performed. Laboratory data and antihypertensive treatments were recorded. Twenty-four-hour ambulatory blood pressure monitoring (ABPM) was performed. Bilateral carotid, brachial, and femoral artery and abdominal A-IMT values were measured by B-mode ultrasonography (USG). Patients were categorized into two main groups: patients with increased A-IMT (≥ 3mm) or normal A-IMT (< 3mm). Increased A-IMT was detected in 55 patients (20.8%). There was a close relationship between increased A-IMT and advanced age, presence of coronary artery disease, high morning blood pressure surge (MBPS), and bilateral carotid and femoral IMT. Parameters associated with increased A-IMT in univariate analysis were assessed by regression analysis. Left femoral IMT and MBPS were independently associated with increased A-IMT. In the regression model, each 5-mmHg elevation in MBPS increased the risk of increased A-IMT by 34.2%. The cutoff value of MBPS obtained by the ROC curve analysis was 32mmHg for the prediction of increased A-IMT (sensitivity 76.3%, specificity 63.5%). The area under the curve was 0.784 (95% CI 0.720-0.847, p < 0.001). Abdominal A-IMT increased at a significant rate in patients with HT. An independent association was found between MBPS and A-IMT, which can both be easily detected by ABPM and B-mode USG. The high MBPS level was considered to be a simple and inexpensive method for detecting subclinical target organ damage. A-IMT measurement should also be a part of abdominal USG, which is a routine examination in HT patients.

Comparison of Abdominal Aorta Intima-Media Thickness, Serum Level of Leptin, and Lipid Profile between Maternal Preeclampsia and Neonatal Outcomes

Background Pre-eclampsia is one of the main causes of morbidity and mortality among pregnant women. This study was done with the objective of measuring abdominal aorta intima-media thickness, serum level of leptin, and lipid profile in neonates of pre-eclampsia mothers and comparing them with neonates of mothers without pre-eclampsia (control group). Materials and Methods Ninety neonates of pregnant mothers, who delivered their babies at Imam Reza Hospital of Kermanshah University of Medical Sciences, were included. They were divided into mild pre-eclampsia (15 neonates), severe pre-eclampsia (15 neonates), and control group (60 neonates). Their blood samples were delivered to the laboratory to assay leptin and lipid profile. Also, echocardiography was done to determine the thickness of intima-media of the abdominal aorta. The data were analyzed by SPSS software using Pearson correlation test and analysis of variance (for variables with normal distribution) and Spearman coefficient test and Kruskal-Wallis tests for variables with non-normal distribution. Results The minimum and maximum ages of mothers in all groups were 20 and 35 years, respectively. There was no significant difference between the mild pre-eclampsia, severe pre-eclampsia, and those without pre-eclampsia regarding serum leptin level and lipid profile (P> 0.05). However, there was significant difference between the groups regarding intima-media thickness (P< 0.05). Mean (± standard deviation) intima-media thickness was the highest in severe pre-eclampsia group (0.629±0.034) and the lowest in control group (0.472±0.058). Conclusion Neonates of mothers with pre-eclampsia had higher measurements of abdominal aorta intima-media thickness compared to control group.

A possible new approach in the prediction of late gestational hypertension: The role of the fetal aortic intima-media thickness.

The aim was to determine the predictive role of combined screening for late-onset gestational hypertension by fetal ultrasound measurements, third trimester uterine arteries (UtAs) Doppler imaging, and maternal history. This prospective study on singleton pregnancies was conducted at the tertiary center of Maternal and Fetal Medicine of the University of Padua during the period between January 2012 and December 2014. Ultrasound examination (fetal biometry, fetal wellbeing, maternal Doppler study, fetal abdominal aorta intima-media thickness [aIMT], and fetal kidney volumes), clinical data (mother age, prepregnancy body mass index [BMI], and parity), and pregnancy outcomes were collected. The P value <0.05 was defined significant considering a 2-sided alternative hypothesis. The distribution normality of variables were assessed using Kolmogorov-Smirnoff test. Data were presented by mean (±standard deviation), median and interquartile range, or percentage and absolute values. We considered data from 1381 ultrasound examinations at 29 to 32 weeks' gestation, and in 73 cases late gestational hypertension developed after 34 weeks' gestation. The final multivariate model found that fetal aIMT as well as fetal umbilical artery pulsatility index (PI), maternal age, maternal prepregnacy BMI, parity, and mean PI of maternal UtAs, assessed at ultrasound examination of 29 to 32 weeks' gestation, were significant and independent predictors for the development of gestational hypertension after 34 weeks' gestation. The area under the curve of the model was 81.07% (95% confidence interval, 75.83%-86.32%). A nomogram was developed starting from multivariate logistic regression coefficients. Late-gestational hypertension could be independently predicted by fetal aIMT assessment at 29 to 32 weeks' gestation, ultrasound Doppler waveforms, and maternal clinical parameters.

Inflammation, lipids and aortic intima-media thickness in newborns following chorioamnionitis.

This study investigated whether chorioamnionitis was associated with increased inflammation, dyslipidaemia and adverse cardiovascular phenotypes in the immediate postnatal period. This prospective case-control study included preterm infants (30(+0) -35(+6) weeks gestational age, GA) whose mothers did not have pregnancy-related conditions that may influence outcomes. Chorioamnionitis was diagnosed by placental histology, and infants were divided retrospectively into cases (chorioamnionitis-exposed) and controls (unexposed). Serum high-sensitivity C-reactive protein (hsCRP), lipid profile, far-wall abdominal aortic intima-media thickness (aIMT) and blood pressure (BP) were measured in the first week of life. There were 20 (16 male, mean GA 32.4 weeks) cases and 31 (12 male, mean GA 32.6 weeks) controls. Histological chorioamnionitis was associated with a significant increase in hsCRP and a non-significant trend towards an adverse lipid profile. There was no evidence of differences in aIMT or BP. Preterm infants exposed to chorioamnionitis have greater postnatal inflammation. There were no early postnatal differences in aIMT or BP. The inflammatory stimulus of chorioamnionitis late in gestation may be of insufficient intensity and duration to result in immediate postnatal alterations to arterial structure. Cardiovascular follow-up of infants exposed to chorioamnionitis may identify differential risk trajectories and subsequent inflammatory responses.

Relationship between Abdominal Aortic Intima Media Thickness and Central Obesity in Children

Background: Childhood obesity is one of the important risk factors for early atherosclerosis. We aimed to evaluate the effect of obesity on abdominal aortic intima media thickness (aaIMT) in children. Methods: We consecutively recruited 60 obese and 28 healthy children from the outpatient clinic of pediatrics. In all patients, BMI, waist circumference (WC) and hip circumference (HC) were measured, and fasting serum lipid profile, plasma glucose and plasma insulin were studied. Homeostasis model assessment-estimated insulin resistance (HOMA-IR) was calculated for the obese group. All children underwent ultrasonography to evaluate hepatosteatosis and to measure aaIMT. Results: There was a significant difference between the groups in terms of aaIMT, insulin, glucose, HOMA-IR, total cholesterol, low-density lipoprotein, triglyceride and hepatosteatosis. aaIMT was 1.12 ± 0.25 and 0.61 ± 0.18 mm in the obese and nonobese groups, respectively (p < 0.001). In the obese group, there was a positive correlation between aaIMT and WC, WC/height ratio, BMI, HC and hepatosteatosis (p < 0.05 for all), with the highest significance for WC. Conclusions: This study showed that aaIMT was significantly higher in obese children than in nonobese children, and that WC was a strong predictor for aaIMT. Early detection of an increased aaIMT in obese children may guide the follow-up of these patients in terms of developing atherosclerosis and its complications.

Effects of Nigella sativa L. seed oil on intima-media thickness and Bax and Caspase 3 expression in diabetic rat aorta.

Objective:Hyperglycaemia is an important risk factor for the development and progression of the macrovascular and microvascular complications that occur in diabetes. The expression of apoptotic markers in the aortic medial layer of diabetic rats and the effects of N. sativa L. seed oil on the expression of these markers were investigated in this study.Methods:Four-month-old adult female Wistar rats (n=21) were divided into 3 groups: Group 1, control; Group 2, diabetes and Group 3, diabetes+N. sativa L. seed oil. Group 3 received 0.2 mg/kg/day N. sativa L. seed (black cumin) oil intraperitoneally 6 days per week for 30 days. At the end of the experiment, abdominal and thoracic aortas of all animals were collected and fixed in 10% formalin solution. Then, 5-µm-thick sections were stained with Verhoeff–Van Gieson stain to evaluate Bax and Caspase 3 expression. Tunica intima–media thickness was measured using the stained sections.Results:There were no significant differences in abdominal or thoracic aortic intima–media thickness among the 3 groups. However, there were significant differences in Bax and Caspase 3 expression in the tunica media of the thoracic and abdominal aortas between Group 1 and Group 2 (p<0.05) and between Group 2 and Group 3 (p<0.05) evaluated with the Kruskal–Wallis and Mann–Whitney U tests.Conclusion:It is understood that N. sativa L. seed oil is effective against diabetes. N. sativa L. seed oil is a plant material and has value for further investigation to develop diabetes treatment strategies for preventing apoptosis in vascular structures.

Abstract 157: Functional and Structural Intermediate Vascular Phenotypes Relating to Long-Term Cardiovascular Risk in Kawasaki Disease

Background: It is uncertain whether Kawasaki disease (KD) increases overall long term cardiovascular risk, especially in those without demonstrable coronary artery lesions. Data from non-invasive vascular assessment, extrapolated from studies of subclinical atherosclerosis, are conflicting. Methods: Patients at least 2 years post-KD and healthy controls had fasting plasma glucose, lipid profile, high sensitivity C-reactive protein, carotid-femoral pulse wave velocity (PWV), carotid intima-media thickness (cIMT), abdominal aorta intima-media thickness (aIMT), retinal vascular calibre, carotid and aortic elastography performed. Results: 37 controls and 45 patients with KD (21 with regressed or persistent coronary artery changes) were studied at mean ± sd of 10.5 ± 5.7 years following KD. Compared to controls, KD patients did not have increased traditional cardiovascular risk factors; blood pressure, body mass index, waist-to-hip ratio, glucose, cholesterol, high density lipoprotein cholesterol, low density lipoprotein cholesterol, triglyceride and smoking history. Of the cohort, 26 patients (age 15.38 ± 6.19 years) and 27 controls (age 18.7 ± 7.11 years) have had cIMT, aIMT and carotid elastography analysed. The maximum aIMT in KD patients was 0.65 ± 0.15 mm, compared to 0.63 ± 0.13 mm in controls, with the most marked difference in those with coronary artery changes at 0.68 ± 0.14 mm. After adjusting for age, sex, systolic blood pressure, aortic diastolic diameter and high sensitivity C- reactive protein, the average maximum aIMT in all KD patients was 0.071mm larger (95% CI -0.005, 0.147) than controls. Aortic elastography and Doppler pulse wave analysis are underway. Otherwise, there are no detectible differences in PWV, cIMT, carotid elastography, or retinal vascular calibre between KD patients and controls. Conclusion: Compared to carotid artery characteristics, changes in the abdominal aorta may be more discriminative markers of long-term cardiovascular risk in KD. Focus on large arteries in longitudinal KD vascular studies are warranted. Recruitment and analysis are ongoing and further results will be presented.

Evaluation of abdominal aortic elasticity by strain rate imaging in patients with type 2 diabetes mellitus.

To use strain rate imaging (SRI) to compare the abdominal aortic wall elasticity between patients with type 2 diabetes mellitus and controls. We measured the abdominal aorta intima-media thickness (IMT) with B-mode echography, and the anterior and posterior wall displacement (d), strain, and strain rate (SR) with SRI, in 90 patients with type 2 diabetes mellitus and 30 control subjects (group A). The patients were classified into group B (normal IMT), group C (thickened IMT), and group D (one single atheroma plaque). d, strain, and SR were significantly lower in group B, C, and D than in group A (p < .05). Systolic, early-diastolic, and late-diastolic SR were lower in patients with diabetes (especially in group D) than in controls. There were significant differences in systolic SR, early-diastolic SR, and late-diastolic SR between group A and group B (p < .05). SRI is a noninvasive method that can demonstrate a loss in aorta wall elasticity in patients with diabetes with normal IMT.