Carotid Artery Intima-media Thickness Research Articles

Assessment of laboratory indicators of inflammatory, infection and indicators of subclinical atherosclerosis in patients with systemic lupus erythematosus

The aim of the study was to reveal the relationship between the activity of inflammation, the infectious component, platelet function and dyslipidemia, in the development of subclinical atherosclerosis in patients with systemic lupus erythematosus (SLE).Material and methods. Fifty women with SLE at the age of 52.0 [48.0–58.0] years and disease duration – 11.5 [6.0– 22.0] years were examined. The control group consisted of 21 healthy women. The concentration of high-sensitivity C-reactive protein (hsCRP), interleukin 6 (IL-6), IgG antibodies to Chlamydia pneumonia (at IgG CP), the level of Toll-like receptor (TLR2), platelet factor 4 (PF4) and antibodies to oxidized high-density lipoproteins (at oxLDL) were determined by enzyme immunoassay. Platelet aggregation indices, lipid spectrum, intima-media thickness (IMT) of common carotid arteries were investigated.Results. A significant increase in IMT of the common carotid artery (1.00 [0.80–1.10] and 0.80 [0.70–0.90] mm, respectively; p<0.01) and TKIM of the carotid bifurcation (1.10 [1.00–1.20] and 0.80 [0.70–1.10] mm, respectively; p<0.01), increased hsCRP concentration (3.67 [2.17–5.92] and 0.74 [0.30–1.26] mg/L, respectively; p<0.01), IL-6 (1.72 [1.39–2.68] and 0.60 [0.22–0.75] pg/mL, respectively; p<0.01). Significant platelet activation was noted in SLE: significant increase in TF4 concentration (21.5 [19.80–23.28] and 18.30 [13.88–20.46] ng/mL, respectively; p<0.01), marked dyslipidemia, increased concentration of oxLDL (3.16 [1.45–4.60] and 1.39 [1.26–2.04] kp, respectively; p<0.01). At IgG CP concentration and TLR2 values in patients with SLE did not differ from controls.Conclusion. In addition to traditional risk factors for the development of cardiovascular disease, the association between SLE and subclinical atherosclerotic lesions of the vascular wall can be explained by additional risk factors – inflammation and autoimmune processes. The role of the infectious component is for further study.

Measuring arterial tortuosity in the cerebrovascular system using Time-of-Flight MRI.

The Circle of Willis (CW) is a critical cerebrovascular structure that supports collateral blood flow to maintain brain perfusion and compensate for eventual occlusions. Increased tortuosity of high-risk vessels within the CW has been implicated as a marker in the progression of cerebrovascular diseases especially in structures like the internal carotid artery (ICA). This is partly due to age-related plaque deposition or arterial stiffening. Producing reliable tortuosity measurements for vessels segmented from magnetic resonance (MR) time-of-flight (TOF) images requires precise curvature estimation, but existent methods struggle with noisy or sparse segmentation data. We introduce an open-source, end-to-end pipeline that uses unit-speed spline fitting for accurate curvature estimation, generating robust curvature-based tortuosity metrics for the ICA combined with an indicator of spline fit quality. We test this with theoretical data and apply this method to TOF data from 22 participants. We report that our metrics are able to capture tortuosity even under heightened noise constraints and discriminate different types of abnormal arterial coiling. We found that our ICA tortuosity measures correlate positively with age and ultrasound measured carotid artery intima media thickness. This ultimately has important translational implications for being able to reliably generate TOF tortuosity measures and estimate cerebrovascular disease burden. We provide open-source code in a GitHub repository.

Carotid artery intima-media thickness values in obese or overweight children: a meta-analysis.

Carotid artery intima-media thickness (IMT) is a non-invasive ultrasound marker of early atherosclerosis. This systematic review and meta-analysis aim to report the published differences in IMT values in children living with overweight or obesity compared to controls with normal weight. This review was conducted according to PRISMA guidelines, including only cohorts with normal controls. Inclusion criteria were IMT measured using B-mode or radiofrequency (RF) techniques and based on the four consensuses: American Heart Association, Association for European Pediatric Cardiology, Mannheim Consensus, and American Society of Echocardiography. We used the body mass index based on the World Health Organization growth standard definitions of obesity in children. Relevant articles were extracted from PubMed, Cochrane Library, Embase, and Web of Science searched from inception to February 2024. A meta-analysis was done by a biostatistician using the R-software version 4.0.2. We obtained 15 B-mode-based and two RF echo-tracking-based IMT measurement studies. IMT is significantly increased in children living with obesity. The mean IMT was 0.041 mm, 95% confidence interval (CI): 0.052; 0.031 higher in children with overweight/obesity, using the B-mode technique, and 0.045 mm, 95% CI: 0.062; 0.029 higher in children with overweight/obesity using RF technique. This meta-analysis shows that IMT is significantly increased in children with obesity compared to normal-weight children according to both techniques. Question IMT measured according to known consensuses is significantly increased in children living with obesity. Findings Mean IMT was 0.041 mm higher in children living with obesity using the B-mode technique and 0.045 mm using the RF technique. Clinical relevance There are different techniques to measure IMT in children. This meta-analysis, using cohorts of children living with obesity compared to normal weight controls, shows a significantly increased IMT in children living with obesity.

Comparative analysis of adolescent hypertension definitions for predicting early adulthood carotid artery intima-media thickness: Tehran lipid and glucose study.

Definitions of childhood and adolescent hypertension (HTN) do not precisely elucidate the relationship between HTN and cardiovascular outcomes. Carotid intima-media thickness (CIMT), as a substitute for cardiovascular outcomes, enables the early identification of cardiovascular events throughout early adulthood. This study aimed to compare the ability of childhood HTN definitions to predict a high CIMT in early adulthood. This prospective cohort study included 921 individuals aged 10-17 years from the Tehran Lipid and Glucose Study. The CIMT was measured after 18 years of follow-up. Participants were categorized into normal blood pressure (BP), high-normal BP, HTN stage 1, and HTN stage 2 groups based on the childhood HTN definitions of the 4th report, European Society of Hypertension (ESH), and American Academy of Pediatrics Clinical Practice Guidelines (AAP-CPG). Akaike information criterion (AIC) and relative efficiencies (RE) were calculated to compare the ability of each to predict a high CIMT (≥95th percentile) during early adulthood. The highest and lowest prevalence of stage 1 HTN was observed with the AAP-CPG (17.7%) and ESH (8.8%), respectively. Similarly, the highest and lowest prevalence of stage 2 HTN was noted with the AAP-CPG (1.5%) and ESH (0.8%), respectively. According to the RE values, the highest to lowest predictive abilities belonged to the 4th report, ESH, and AAP-CPG, respectively. In all models, the 4th report's pediatric HTN definition had the lowest AIC value and offered the best predictive ability. Among the various definitions of pediatric HTN, the 4th report offered the best ability to predict a high CIMT during early adulthood, followed by the ESH and AAP-CPG. Because the reference population of the 4th report includes overweight, obese, and normal- weight individuals, our findings suggest that excessive adiposity is among the main predictors of early adulthood atherosclerosis risk.

Association between short-term ambient air pollution exposure and arterial stiffness and effect modification of obesity

Objective: To assess the association between short-term ambient air pollution exposure and arterial stiffness and whether obesity modifies these associations. Methods: A cross-sectional study was conducted based on Fangshan family cohort in Beijing. The 24 hours average air pollutant levels on the day cohort participants took baseline survey were calculated as short-term air pollution. A generalized additive model (GAM) with Gaussian links was used to estimate changes in typical carotid artery intima-media thickness (CIMT), brachial-ankle pulse wave velocity (BAPWV), pulse pressure (PP) and ankle-branchial index (ABI) after short-term exposure to each air pollution (PM2.5, PM10, SO2, NO2, CO). The cross-product terms of each air pollution, body mass index (BMI), and waist-to-hip ratio were included in the GAM model to test the interaction. Further, they conducted a stratified analysis to test their effects on the relationship between short-term exposure to each air pollution and the arterial stiffness indicators. Results: A total of 4 211 individuals were included in the analysis. Individuals' age was (58.9±8.7) years, of which 2 268 (53.9%) were female. Several covariates, including sociodemographic factors, lifestyle behaviors, and history of drugs, were included in the analysis. The results of the GAM analysis showed that an increase in PM2.5 (β=2.912×10-4, 95%CI: 1.424×10-4-4.400×10-4, P<0.001), CO (β=0.027, 95%CI: 0.011-0.043, P<0.001), SO2 (β=2.070×10-3, 95%CI: 7.060×10-4-3.430×10-3, P=0.003), and NO2 (β=3.650×10-4, 95%CI: 2.340×10-5-7.060×10-4, P=0.036) were associated with an increase in CIMT, while an increase in PM10 (β=0.018, 95%CI: 0.002-0.033, P=0.028) was associated with an increase in PP in the study population. Besides, the waist-to-hip ratio had an effect-modification on the correlation of short-term exposure of PM2.5 (interaction P=0.015), NO2 (interaction P=0.008), and CO (interaction P=0.044) with CIMT, and the correlation between short-term exposure of PM2.5 (interaction P=0.002), NO2 (interaction P=0.010), CO (interaction P=0.029), PM10 (interaction P<0.001) with PP. The significant association between CIMT, PP, and air pollution concentrations was more visible in people with lower waist-to-hip ratios. Conclusions: Short-term ambient air pollution exposure was associated with arterial stiffness indicators, and there was an effect modification of waist-to-hip ratio on these associations, and lower waist-to-hip ratios may enhance the association between air pollution exposure and indicators.

Controlled Evaluation of Serum Lipid Levels and Carotid Artery Intima Media Thickness in Epileptic Children Treated with Valproic Acid, Carbamazepine and Levetiracetam

Controlled Evaluation of Serum Lipid Levels and Carotid Artery Intima Media Thickness in Epileptic Children Treated with Valproic Acid, Carbamazepine and Levetiracetam

Analysis of Quality Intima-Media Thickness and Quantitative Artery Stiffness technologies on non-alcoholic fatty liver disease: a study on carotid artery structure, elasticity, and influential factors in patients.

In recent years, there have been numerous studies using Quality Intima-Media Thickness (QIMT) and Quantitative Arterial Stiffness (QAS) technology to evaluate various related factors and disease-induced changes in carotid artery (CA) elasticity. However, there is still a lack of research on the relationship between non-alcoholic fatty liver disease (NAFLD) and various indicators related to the CA. This study aimed to investigate the clinical significance of using QIMT and QAS techniques for comprehensive evaluation of CA intima-media thickness (IMT) and elasticity changes in NAFLD patients, and to analyze various factors influencing these variables. In this cross-sectional study, a total of 196 healthy adults and 285 NAFLD patients were selected from June 2021 and October 2021 in the First Affiliated Hospital of Zhejiang University School of Medicine. Body mass index (BMI), blood pressure, and triglyceride levels were collected. CA IMT and pulse wave velocity (PWV) were measured using QIMT and QAS techniques. Multiple linear regression analysis was employed to explore the relationship between parameters measured using QIMT and QAS techniques and NAFLD, while controlling for covariates, to assess the measurement effects of QIMT and QAS techniques on arterial structure and elasticity in NAFLD patients. A total of 233 males and 248 females were included in this study, with 178 males (62.46%) and 107 females (37.54%) being diagnosed with NAFLD. Gender, age, systolic blood pressure (SBP), and uric acid (UA) all are related to CA IMT (estimated value -0.031 to 0.008, P<0.0001-P=0.0450). The presence of NAFLD was not significantly related to IMT, but primarily influenced vascular elasticity indicators α, β, PWV, augmentation index (Aix), distensibility coefficient (DC), and compliance coefficient (CC). Age, SBP, diastolic blood pressure (DBP), high-density lipoprotein (HDL), and UA were all related to vascular elasticity coefficient β (estimated value -0.05 to 1.03, P<0.0001-P=0.0451); SBP and UA had a relationship with PWV (estimated value -0.001 to 0.405, P<0.0001-P=0.0027); gender, age, SBP, DBP, and UA all influenced Aix (estimated value -0.17 to 0.65, P<0.0001-P=0.0072). Ultrasound radiofrequency (RF) signal QIMT and QAS techniques can reflect changes in CA structure and elasticity function in NAFLD patients, which can be more widely applied and promoted in the changes of CA structure and elastic function in NAFLD patients.

Effect of Pemafibrate on Cerebrovascular Atherosclerosis in Patients with Stroke and Hypertriglyceridemia.

The Pemafibrate for Prevention of Atherosclerotic Diseases in Stroke (PPAR Stroke) study aimed to assess the effects of pemafibrate, a novel selective peroxisome proliferator-activated receptor alpha modulator, on the progression of cerebrovascular atherosclerosis in patients with stroke and hypertriglyceridemia. Ninety-nine patients (mean age, 65.6 years; male, 74.7%) with hypertriglyceridemia and a history of stroke or transient ischemic attack of non-cardioembolic origin were included in this prospective single-arm study. Hypertriglyceridemia was defined as a fasting serum triglyceride (TG) level ≥ 150 mg/dL. All patients were treated with pemafibrate (0.2 mg or 0.1 mg/day) for 2 years. The primary outcome was change in carotid intima-media thickness (IMT) from baseline at 2 years, as assessed using carotid ultrasonography. The secondary outcomes were changes in blood biomarker levels and progression of intracranial artery stenosis on magnetic resonance angiography. The mean TG level significantly decreased from 269 mg/dL at baseline to 139 mg/dL at 2 years (P＜0.001) and high-density lipoprotein cholesterol level increased from 49 to 54 mg/dL (P＜0.001), whereas low-density lipoprotein cholesterol level remained unchanged. Significant reductions in high-sensitivity C-reactive protein and interleukin-6 levels were also observed (P=0.003 and P=0.002, respectively). With regard to mean IMT in the internal carotid arteries, the difference was significant for the left side (1.59 mm at baseline vs. 1.52 mm at 2 years; P=0.009) and borderline significant for the right side (1.32 mm at baseline vs. 1.28 mm at 2 years; P=0.053). Among the 48 stenotic lesions in the intracranial arteries, regression and progression was observed in 9 (18.8%) and 4 (8.3%) cases, respectively. Pemafibrate was observed to have TG-lowering and anti-inflammatory effects and could attenuate atherosclerosis progression in the intra- and extracranial arteries of patients with stroke and hypertriglyceridemia.

EVALUATION OF CAROTID ARTERY INTIMA MEDIA ELASTICITY IN TAKAYASU ARTERITIS BY SHEAR WAVE ELASTOGRAPHY

This study aimed to evaluate carotid morphology with Ultrasound (US) and arterial stiffness with Shear Wave Elastography (SWE) in TA patients and to compare results with disease activity. We searched clinical archive and found that 41 TA patients with carotid involvement had carotid US and SWE screening. Patients (n:22) with confounding factors that could affect the carotid wall were excluded. Nineteen cases that meet the inclusion criteria and 19 healthy control cases age-sex matched were compared. We evaluated right and left common carotid artery intima-media thickness (IMT) with B-Mode US and wall stiffness with SWE. We also investigate a relationship between disease activation and arterial stiffness. Carotid artery IMT was significantly higher in TA than in the control group (p

Comparative Study of Common Carotid Artery Intima-Media Thickness in type 2 Diabetes Mellitus patients with and without Coronary artery disease in South Indian Patients

Comparative Study of Common Carotid Artery Intima-Media Thickness in type 2 Diabetes Mellitus patients with and without Coronary artery disease in South Indian Patients

MicroRNA-133a and MicroRNA-145 May Be Involved in the Development of Hypertension-Mediated Organ Damage in Children with Primary Hypertension-A Preliminary Study.

Background/Objectives: Studies in adults have demonstrated the essential role of microRNAs in developing hypertension and their effect on hypertension sequelae. In this preliminary study, we aimed to investigate the expression of five miRNA particles, miRNA-21, miRNA-27a, miRNA-27b, miRNA-133a, and miRNA-145, in school-aged children with primary hypertension and to examine their correlations with blood pressure and arterial and heart properties. Methods: In 22 hypertensive children (15.1 ± 1.9 years), we measured blood pressure parameters (office, central, and 24 h), the urinary albumin/creatinine ratio, and the pulse wave velocity (PWV) before and after one hour of aerobic exercise. The left ventricular mass index (LVMI) and common carotid artery intima-media thickness (cIMT) were also assessed. The relative miRNA expression was calculated using the 2-ΔΔCt method with miRNA-16 as an endogenous control and the pre-exercise miRNA expression levels as the control (baseline). Results: We found a statistically significant decrease in both the office and 24 h ambulatory diastolic blood pressure after 1 h of exercise (82.2 ± 8.5 mm Hg versus 78.6 ± 8.8 mm Hg, p = 0.01 and 75.0 ± 8.3 mm Hg versus 73.0 ± 7.4 mm Hg, p = 0.02). The increase in miRNA-133a expression after exercise correlated positively with the LVMI. Furthermore, the rise in miRNA-145 expression after exercise correlated negatively with the systolic and diastolic office and 24 h blood pressure and with markers of arterial damage: 24 h PWV and cIMT. Conclusions: In conclusion, miRNA-133a may be a biomarker of left ventricular hypertrophy in children with elevated blood pressure. Additionally, changes in miRNA-145 expression induced by exercise might reduce the blood pressure after exercise and protect against arterial damage. Both miRNA-133a and miRNA-145 may be involved in epigenetic alterations in children affected by primary hypertension that may contribute to the exacerbation of HMOD.

Ultrasound Assessment of Aortic and Carotid Artery Intima-media Thickness in Children and Adolescents.

Carotid intima-media thickness (IMT), measured using high-resolution B-mode ultrasonography, is a widely utilized surrogate marker of subclinical atherosclerosis, the pathophysiological process underlying most clinical cardiovascular disease events. Atherosclerosis is a gradual disease that originates early in life, thus, there has been increased interest in measuring carotid IMT in childhood and adolescence to assess structural change in the arterial vasculature in response to adverse exposures. However, the timing of atherosclerosis varies across the vascular tree. Primordial atherosclerotic lesions are present in the abdominal aorta as early as infancy, compared to mid-adolescence for the common carotid. Measurement of IMT at either site is susceptible to several technical challenges that need to be considered, especially in younger children. In this paper, we provide a detailed stepwise method for high-quality assessment of IMT of the abdominal aorta and common carotid artery in the young. We also provide insight into the appropriateness of either site when exploring the associations between early-life exposures and later-life cardiovascular disease.

Carotid artery intima-media thickness in women with polycystic ovary syndrome: A cross-sectional study.

Obesity in polycystic ovary syndrome (PCOS) may increase the risk of cardiovascular disease. Carotid intima-media thickness (CIMT) is an acceptable marker in assessing the risk of heart disease. This study aimed to evaluate the CIMT in PCOS women compared to non-PCOS women. This cross-sectional study was conducted on 48 women who referred to Imam Reza hospital, Kermanshah, Iran from July 2020-2021. Women were divided into 2 groups of PCOS and non-PCOS women (n = 24/each). The intima-media thickness of participants' carotid artery was measured on both sides in 3 areas, and its mean was recorded. The mean thickness of the carotid artery intima-media in the case group was within the normal range; but it was significantly higher than the control group (0.71 0.17 vs. 0.57 0.09 mm, p = 0.019). Considering the higher thickness of CIMT in women with PCOS, it can be concluded that PCOS increases the risk of heart diseases in women.

Gut Microbiome and Carotid Artery Intima-Media Thickness: A Narrative Review of the Current Scenario.

Up to the last update, the gut microbiome (GM) had been associated with a different physiologic host process, including those affecting cardiovascular health. The carotid intima-media thickness (IMT) is an indicator of atherosclerosis and cardiovascular risk. The GM influence on atherosclerosis progression has garnered growing attention in recent years but the consensus in subclinical atherosclerosis remains elusive. The aim of this narrative review is to investigate the connection between the GM and carotid IMT, encompassing mechanisms like the microbiome impact on metabolite production, and systemic inflammation, and its effects on endothelial function. The literature analysis revealed that the GM appears to exert an influence on carotid IMT development, likely through mechanisms involving metabolites' production, systemic inflammation, and endothelial function modulation. Additional research, however, is needed to finely elucidate the relationship between the GM and atherosclerosis. Specifically, more extensive studies are required to pinpoint individuals at the highest risk of developing atherosclerosis based on their GM composition. This will facilitate the enhancement and optimization of cardiovascular disease prevention strategies and enable the treatments' customization for each patient. Further investigations are required to refine patient outcomes in the context of probiotics and other interventions aimed at improving microbiome composition and function.

Risk factors and assessment of subclinical atherosclerosis in patients with psoriatic arthritis

ObjectiveTo understand the prevalence of subclinical atherosclerosis (SCA) in psoriatic arthritis (PsA) patients; to explore the correlation between PsA combined with SCA and traditional cardiovascular risk factors and disease activity; to compare the role of Framingham Risk Score (FRS) and atherosclerotic cardiovascular disease (ASCVD) scores. MethodsWe included 50 PsA patients who met the CASPAR classification criteria, 50 diabetes patients and 50 healthy people. Clinical data were collected from all patients, minimal disease activity (MDA), disease activity index for psoriatic arthritis (DAPSA), ASCVD, FRS were assessed in patients with PsA, and carotid artery intima–media thickness was measured. ResultsThe prevalence of SCA in PsA patients was significantly higher than that in healthy controls (44% vs 24%, P<0.05). Smoking, drinking, ASCVD, FRS were the risk factors of PsA with SCA (P<0.05). Psoriasis (PsO) duration, PtGA, VAS and DAPSA were the risk factors for PsA with SCA (P<0.05). FRS and ASCVD scores underestimated SCA risk in PsA patients. ConclusionCompared with healthy controls, patients with PsA have higher prevalence of SCA. High DAPSA is a risk factor for PsA with SCA. Carotid ultrasound can monitor SCA in patients with PsA, improve stratification of cardiovascular risk.

Risk Assessment for Cardiovascular Events using Achilles Tendon Thickness and Softness and Intima-Media Thickness in Familial Hypercholesterolemia.

This was a retrospective cohort study that aimed to determine cutoff values for major adverse cardiovascular events (MACEs) in patients with heterozygous FH (HeFH) for Achilles tendon (AT) thickness (ATT) measured by ultrasonography (US-ATT) and radiography (Xp-ATT), AT softness, and intima-media thickness of carotid artery (C-IMT), and to examine the effectiveness of these values as well as AT calcification as indexes in assessing risk for MACEs. The subjects were 391 clinically diagnosed HeFH patients. Kaplan-Meier curves were drawn based on the threshold values for the individual indexes calculated from ROC curves, and multivariate analysis was used to examine whether they were predictors of the development of MACEs. The median observation period was 1,239 days (700-1,827 days). Twenty-one subjects (5%) had MACEs during the observation period. The cutoff values for MACEs for US-ATT were 9.9 mm in males and 7.1 mm in females, and those for C-IMT were 1.6 mm in males and 1.5 mm in females. Subjects were classified into two groups according to whether they were above or below the cutoff values and presence of calcification, and we compared MACE rates between them. MACE rates were significantly increased in groups with AT thickening determined by ultrasonography (P＜0.001), AT softening (P＜0.001), presence of calcification in AT (P=0.016) and greater C-IMT (P＜0.001). However, classification according to Xp-ATT revealed no significant difference in MACE rate (P=0.112). These thresholds and examination for AT calcification will help in risk assessment for patients in Japanese FH practice and encourage stricter and more comprehensive management for patients who exceed the thresholds.

Development of Landmark-Based Bit-State Model for Shape Analysis and Segmentation of Variations in Intima-Media Thickness of B-Mode Ultrasound Transverse Cross-Section of Carotid Artery Images

Central to the assessment of carotid artery health is the measurement of intima-media thickness (IMT), a valuable diagnostic marker for atherosclerosis. IMT quantifies the thickness of two arterial layers — the intima and media — providing insights into arterial wall health and atherosclerotic changes. Carotid ultrasound, a non-invasive imaging technique, is the primary modality for IMT measurement. However, it is not without its challenges, including operator dependency and segmentation difficulties. To surmount these limitations and advance our understanding of carotid artery health, in this research paper, we develop the Bit-State model by applying landmark-based geometric morphometrics (GM) that built upon the foundation of cardinal point symmetry landmark distributed models (CPS-LDM) which we have developed in our previous papers to comprehensively characterize and segment carotid artery IMT, unveiling essential insights into variations and alterations. The Bit-State (BS) Model, revolutionizes our approach to understanding carotid artery structural variations. In this paper, there are four regions of interest (ROI) in the B-Mode carotid artery image, hence we designated each ROI as a bit. Each bit is capable of existing in either of two states: bit 1 as thick-walled and bit 0 as thin-walled ROI. In adopting this binary characterization, we generated 16 different modalities and variations of the ROI of the carotid artery, we then proceed to use the CPS-LD Model to formulate 16 equations for the segmentation of the ROI the carotid artery images. This new model simplifies the complexity of B-Mode ultrasound carotid artery images. It systematically characterizes shape variations using CPS-LDM equations, offering an interpretable framework for comprehending arterial wall composition. This research represents a significant leap forward in carotid artery health assessment, promising more precise diagnoses and targeted interventions for cardiovascular health. It highlights the pivotal role of landmark-based GM in addressing the challenges posed by carotid artery diseases and atherosclerosis. By pioneering this innovative model, this research paves the way for a deeper understanding of carotid artery health and its implications for stroke prevention — a critical stride towards mitigating the global burden of cardiovascular diseases.

Assessing the Influence of Long-Term Gender-Affirming Hormone Therapy on Cardiovascular Risk in Transgender Men through Carotid Intima-Media Thickness.

Background: Transgender men use exogenous androgen for male pattern virilization. Hysterectomy and bilateral salpingo-oophorectomy (HBSO) is performed to stop the endogenous estrogen secretion. Cardiovascular disease (CVD) risk has been shown to increase with long-term use of androgens and the removal of estrogen. We aimed to investigate the CVD risk in these individuals by measuring internal and common carotid artery intima-media thicknesses (CIMT). Methods: In this cohort study, data were collected from transgender men who had undergone HBSO and used androgens for at least two years (median treatment duration was 5 years in our research). Cisgender women in the same age range were selected as the control group. Demographics, vital signs, and hematological values of transgender patients and cisgender women subjects in the control group were noted. CVD markers were compared with sonographically measured CIMT values. Results: The mean age and body mass index (BMI) of the study group were 32.6 and 25.3, respectively. Weight, systolic-diastolic blood pressure, hemoglobin, hematocrit, low-density lipoprotein (LDL), serum triglyceride (TG), HbA1c levels, internal CIMT, and common CIMT values of the study group were higher, while the high-density lipoprotein (HDL) level was significantly lower compared the control group (p1 = 0.025, p2 = 0.010, p3 = 0.002, p4 = 0.001, p5 = 0.001, p6 = 0.012, p7 = 0.008, p8 = 0.007, p9 = 0.013, and p10 = 0.001). There was also an increase in the body weight, BMI, LDL, and TG levels of the study group after the testosterone treatment (p1 = 0.025, p2 = 0.019, p3 = 0.001, p4 = 0.001, and p5 = 0.001). Conclusions: We demonstrated that the use of testosterone therapy in transgender men is associated with higher CIMT values. While further investigation is needed to assess morbidity and mortality rates, we recommend that regular clinical and radiological examinations be performed in these individuals to accurately evaluate the risk of CVD.

Relationship of Dickkopf-1 With Atherosclerosis and Arterial Stiffness in Renal Transplant Recipients

IntroductionDickkopf wingless (Wnt) signaling pathway inhibitor-1 (DKK-1) is a potent antagonist of the WNT canonical signaling pathway. DKK-1 is a substance that exerts anabolic effects on bone and is also involved in vascular cell regulation. The study aimed to determine the relationship of DKK-1 with atherosclerosis as determined by carotid artery intima-media thickness (CA-IMT) and arterial stiffness (AS) as determined by brachial-ankle pulse wave velocity (baPWV) in renal transplant recipients (RTRs). MethodsA total of 62 (62%) male and 38 (438%) female RTRs with a mean age of 44.22 ± 10.88 years were included in the study. RTRs were compared with 65 healthy individuals. CA-IMT measurement with ultrasonography was used as a marker of atherosclerosis. The presence of AS was detected with the baPWV device. ResultsCreatinine, CA-IMT, and baPWV were higher in the RTRs compared to the healthy subjects. No difference was determined between the two groups regarding log10 DKK-1. No difference was noted in the levels of CA-IMT and baPWV in patients with log10 DKK-1 > 3.83 pg/mL compared to patients with ≤3.83 pg/mL. Correlation and multivariate analyses showed no correlation between log10 DKK-1 and CA-IMT and baPWV. DiscussionIn RTRs, an increased development of atherosclerosis and AS was observed compared to healthy individuals. There was no difference in DKK-1 between the groups based on improved renal function. DKK-1 was not correlated with atherosclerosis and AS.

The relationship between exercise-related hypertension and carotid artery intima media thickness and brachial artery endothelial function

Aims: Hypertension is one of the most common chronic diseases in the world. There are some non-invasive tests which are used to assess end organ damages in patients with hypertension. The purpose of this study is to show relationship between carotid artery intima media thickness (CIMT) and flow mediated dilatation (FMD) in patients with exercise induced hypertension (EIH). Methods: 73 healthy normotensive men and women, who are between 18 and 65 years of age, participated in this study. All patients underwent electrocardiography, echocardiography, 24-hour ambulatory blood pressure monitoring and symptom-limited treadmill testing before CIMT and FMD were measured with Doppler ultrasonography. CIMT and FMD values of both groups were statistically compared with each other. Results: Of a total of 73 individuals, 56 were evaluated as the patient group and 17 as the control group. Age, smoking rate, body mass index, resting and maximum blood pressure values, and ascending aorta diameter were significantly higher in the patient group (p=0.02 for smoking, p&lt;0.01 for the rest). Right/left main CIMT, right/left bulbus IMT, and left ventricular diastolic dysfunction was significantly higher in the patient group (p&lt;0.05 for all). In addition, the mean CIMT and mean FMD (%) values were significantly higher and lower, respectively, in the patient group compared to the control group. No difference was observed between the two groups in terms of right/left internal CIMT and passive smoking exposure. In addition, the mean values of CIMT and FMD (%) did not show a statistically significant difference according to hypertensive response stages and gender. Conclusion: CIMT and FMD are significantly associated with EIH. EIH should be evaluated as important risk factor for future hypertension and may cause asymptomatic end-organ damage. It can be easily assessed using CIMT and FMD.