Carotid Intima-media Thickness Measurements Research Articles

Spinal radiographic progression is correlated with preclinical atherosclerosis in spondyloarthritis.

A higher prevalence of cardiovascular risk was observed in spondyloarthritis (SpA). The relationship between disease-related factors structural damage and subclinical atherosclerosis is still unknown. The aim of our study was to evaluate the association of subclinical atherosclerosis with radiographic structural damage in patients with SpA. Forty-seven SpA patients who fulfilled the ASAS criteria were enrolled in a case-control study conducted over 12months and compared with 47 age and sex-matched healthy controls. None of the subjects had a previous history of cardiovascular diseases or cardiovascular risk factors. Demographic and disease characteristics were recorded. Structural lesions were evaluated using plain radiography, and two scoring tools were used to spine (BASRI and mSASSS). Subclinical atherosclerosis was assessed using ultrasound measurements of flow-mediated dilation (FMD) and carotid intima-media thickness (cIMT). The median age of patients was 36 years. The sex ratio was 2.35. The median BASRI total score was 3 (IQR 2-4), median mSASSS score was 10 (IQR 415). cIMT was significantly increased in SpA patients compared to controls (p< 0.0001), and FMD was significantly lower in patients than in healthy subjects (p= 0.008). cIMT was significantly associated with ankylosis of the facet joints (p= 0.035) and Romanus spondylitis (p= 005). FMD was negatively associated with vertebral squaring (p= 0049), bridging syndesmophytes (p= 0031) and mSASSS score (p= 0.047). Our result supports the association of radiographic structural damage and subclinical atherosclerosis assessed using cIMT and FMD. This finding highlights the importance of earlier treatment in order to prevent radiographic damage progression and atherosclerotic events.

Left and right ventricular function by echocardiography, tissue doppler imaging, carotid intima media thickness, and asymmetric dimethylarginine levels in female adolescents with vitamin D deficiency.

The aim of our study was to assess left and right ventricle systolic and diastolic functions in female adolescents with vitamin D deficiency using conventional echocardiography and pulsed-wave tissue Doppler imaging and to investigate carotid intima media thickness and asymmetric dimethylarginine levels. Sixty-six female adolescents were enrolled in this study. The female adolescents were divided into a vitamin D deficiency group (n: 34) and a control group (n: 32). All subjects underwent laboratory blood tests, including asymmetric dimethyl arginine, complete two-dimensional, pulse, and tissue Doppler echocardiography, and measurement of the carotid intima-media thickness. The vitamin D-deficient female adolescent group had normal left and right ventricle systolic and diastolic functions and normal global systolic and diastolic myocardial performance. In the patients with vitamin D deficiency, the carotid intima-media thickness was higher than that in the controls. In the patients within the vitamin D deficiency group, vitamin D was found to be positively correlated with magnesium and negatively correlated with phosphorus and left atrial dimension. The results of this study demonstrate that vitamin D deficiency in female adolescence is associated with normal myocardial geometry and function. Although it has been associated with normal levels of asymmetric dimethyl arginine concentration, high measured carotid intima-media thickness may reflect endothelial dysfunction.

Repurposing the Incidental Detection of Internal Hemorrhoids as an Independent Predictor of Coronary Artery Disease Risk

The relationship between anal canal hemorrhoids and cardiovascular diseases has been demonstrated in retrospective population-based studies. Despite the etiological similarities, the real-time correlation between hemorrhoids and cardiovascular risk is not known yet. We aimed to investigate the importance of incidentally detected internal hemorrhoids in predicting cardiovascular risk as determined by Carotid Intima-Media Thickness (CIMT) and Epicardial Fat Thickness (EFT) measurements. Totally, 269 patients who underwent colonoscopy for benign reasons were enrolled in this single-center cross-sectional study. The groups with and without hemorrhoids were compared for CIMT, EFT, and other risk factors. Independent predictors for increased CIMT and EFT values were evaluated by regression analysis. The mean age of the patients was 43.5±13.9 years and 34.6% were female. The prevalence of internal hemorrhoids was 30.5% (n=82). The presence of hemorrhoids was one of the independent predictors for increased CIMT along with hypertension and smoking (OR: 4.29, 2.63, and 2.36, respectively). The independent predictors of increased EFT were female gender, high body mass indexes, and high platelet levels (OR: 2.27, 1.47, and 1.01 respectively). Incidentally diagnosed internal anal canal hemorrhoids, albeit for other reasons, can be a useful predictor for the risk of atherosclerosis and cardiovascular diseases.

Circulating and/or cutaneous irisin resistance: A novel link among androgenetic alopecia, comorbid metabolic syndrome and cardiovascular risks.

Androgenetic alopecia (AGA) is a common cause of hair loss in both genders that may be associated with disturbed systemic metabolism. Irisin is a hormone-like myokine that greatly influences systemic metabolism and is linked to cardiovascular diseases. To detect irisin role in AGA and its associated metabolic syndrome (MetS) and cardiovascular risk. This case-control study included 44 AGA patients of both genders and 22 healthy individuals. Serum irisin level was measured using ELISA and scalp biopsy was taken to detect irisin immunohistochemically. Carotid Doppler ultrasonography was performed to measure carotid intima media thickness (CIMT). Higher serum irisin was significantly detected in AGA patients (p ˂ 0.001), and in males (p = 0.01) particularly severe cases (p ˂ 0.001). It was significantly higher in AGA patients presenting with MetS and those suffering from dyslipidemia (p ˂ 0.001 for both). Multivariate regression analysis proved BMI (p = 0.01) and serum irisin (p = 0.02) as independent predictors of CIMT abnormality among AGA patients. Regarding cutaneous irisin expression, the epidermal H-score was significantly higher in AGA patients with MetS compared to those without (p = 0.04). Epidermal H-score ˃100 was significantly associated with male gender (p = 0.05), severe AGA (p = 0.02), MetS (p = 0.03), dyslipidemia (p = 0.03), and abnormal CIMT (p = 0.03). High serum irisin and upregulated epidermal irisin expression are associated with the incidence of MetS, dyslipidemia, and CIMT abnormality among AGA patients. This may indicate resistance to irisin, which hinders its favorable cardiometabolic actions. Further studies are warranted to investigate the concept of irisin resistance in AGA patients, which was uniquely discussed in the present study.

Study of cardiovascular risk in patients with chronic kidney disease with special reference to common carotid artery intimal medial thickness

Abstract Background: It is generally known that chronic kidney disease (CKD) increases the risk of cardiovascular disease (CVD). There is controversy on the correlations between carotid intima-media thickness (CIMT) and subclinical atherosclerosis in CKD patients. This study assessed the cardiovascular risk in patients with CKD and estimated the common CIMT in patients with CKD. Materials and Methods: This prospective observational study was carried out for 1 year and included 100 CKD patients. A detailed history of the patients was recorded in the predesigned proforma. Patients underwent thorough examination, blood investigation, and CIMT measurement using ultrasonography. The statistical software, namely SPSS 18.0 and R environment ver.3.2.2, were used to analyze the data. Results: The mean age group of the patients in the study was 52.58 ± 6.31 years. CKD was more common in male patients in the present study. Most patients were in CKD stage 3 (32%) and stage 4 (67%). Left ventricular hypertrophy (LVH) was present in 42% of CKD subjects in this study, indicating a high prevalence of LVH in CKD. The mean CIMT of the study group was 1.14 ± 0.29, which showed an increase in CIMT in all CKD patients. Conclusion: CKD patients are at higher risk for developing CVD in various forms. Thus, early diagnosis using CIMT measurement, a noninvasive, safe, easily performed, and relatively cost-effective technique, will probably help in early intervention to reduce cardiovascular morbidity and mortality in CKD patients.

Carotid Intimomedial Thickness (CIMT) in Patients with Rheumatoid Arthritis; the Need for More Aggressive Cardiovascular Screening in RA.

To use carotid intimal medial thickness as a marker of early atherosclerosis in patients with rheumatoid arthritis. Cross-sectional descriptive study. Place and Duration of the Study: Rheumatology Unit of Federal Government Polyclinic Hospital, Islamabad, from 1st June 2019 till 30th January 2022. The study included 190 patients divided equally into cases of rheumatoid arthritis and healthy control groups. Carotid intimal medial thickness was measured using the carotid doppler ultrasound. The mean values of both the study groups were evaluated using the independent sample t-tests. Different statistical tests for correlation were also used where appropriate. This study included a total of 190 patients, 95 each in case and control groups. There were 15 (15.8%) males and 80 (84.2%) females with mean age of 43.5±12.8 years among cases, while 27 (28.4%) males and 68 (71.6%) females with mean age of 43.1±10.1 years in the control group. A significantly higher number of cases had a carotid intima-media thickness of more than 0.6 mm as compared to controls (43.2% vs. 25.3%, p=0.009). Cases with seropositive status were 1.98 times more likely to have higher carotid intima-medial thickness compared with controls. Carotid intima-media thickness measurement is important as a surrogate marker of atherosclerotic process in patients with rheumatoid arthritis. Rheumatoid arthritis (RA), Carotid intimal medial thickness (CIMT), Atherosclerosis, Cardiovascular disease (CVD).

Abstract P673: Intima-Media Thickness at the Near or Far Wall of the Common-Carotid-Artery in Cardiovascular Risk Assessment

Background: Current guidelines recommend measuring carotid intima-media thickness (IMT) at the far wall of the common-carotid-artery (CCA). Objectives: To reliably quantify associations of near vs. far wall CCA-IMT with cardiovascular risk and their added predictive values. Methods: We analyzed participant-level data of 16 prospective studies from the Proof-ATHERO consortium. We pooled study-specific hazard ratios for cardiovascular disease (CVD, defined as coronary heart disease or stroke) using random-effects meta-analysis. Results: Individual records were available for 41,941 participants (mean age 61 years [SD=11]; 53% female; 16% with history of CVD; 10,423 CVD events, median follow-up 9.3 years). Mean baseline values of near and far wall CCA-IMT were 0.83 (SD=0.28) and 0.82 (SD=0.27) mm, differed by a mean of 0.02 mm (95% limits of agreement: -0.40 to 0.43) and were moderately correlated (r=0.44; 95% CI: 0.39-0.49). Near and far wall CCA-IMT were both approximately linearly associated with CVD risk. The respective hazard ratios per SD higher value were 1.18 (95% CI: 1.14-1.22; I 2 =30.7%) and 1.20 (1.18-1.23; I 2 =5.3%) when adjusted for age, sex, and history of CVD, and 1.09 (1.07-1.12; I 2 =8.4%) and 1.14 (1.12-1.16; I 2 =1.3%) in a multivariable adjusted model (all P&lt;0.001). Assessing CCA-IMT at both walls provided a greater C-index improvement than assessing CCA-IMT at one wall only (+0.0046 vs. +0.0023 for near [P&lt;0.001] or +0.0037 for far wall [P=0.006]). Conclusions: The associations of near and far wall CCA-IMT with incident CVD were positive, approximately linear, and similarly strong. Improvement in risk discrimination was highest when CCA-IMT was measured at both walls.

Why and How Should We Assess the Cardiovascular Risk in Patients with Juvenile Idiopathic Arthritis? A Single-Centre Experience with Carotid Intima-Media Measurements

Children diagnosed with juvenile idiopathic arthritis (JIA) are thought to be more likely to develop cardiovascular disease in adulthood. The factors modulating the cardiovascular risk, involving exposure to secondhand smoking, sedentary lifestyle and abnormal body mass index, might have had a stronger impact during the COVID-19 pandemic. The lack of reliable prognostic markers for a higher probability of cardiovascular events might be solved by carotid intima-media thickness (cIMT) measurement. The paramount goal of the study was to assess its usefulness in JIA patients. The results of cIMT measured by a single physician in 45 children diagnosed with JIA were compared to 37 age- and sex-matched healthy counterparts. The analysis also involved anthropometric parameters, laboratory tests, and a survey regarding lifestyle-related factors. Four JIA patients appeared to have cIMT above the 94th percentile. A positive correlation between erythrocytes sedimentation rate (ESR) and right carotid artery percentiles was found. Passive smoking increased the cardiovascular risk regardless of JIA. Doubling the daily screen time during the pandemic led to a significant reduction in children's physical activity. However, the number of enrolled subjects was not enough to make significant recommendations. cIMT measurements remain an interesting perspective for future cardiovascular screening of children with JIA. It has yet to be determined whether it should be considered in all JIA patients on a reliable basis.

Sun Exposure and Intima-Media Thickness in the Mexican Teachers' Cohort Study.

Objective: To determine whether long-term sun exposure has a protective role in subclinical cardiovascular disease in adult Mexican women. Materials and Methods: We conducted a cross-sectional analysis of a sample of women from the Mexican Teachers' Cohort (MTC) study. Sun exposure was assessed in the MTC 2008 baseline questionnaire, in which women were asked about their sun-related behavior. Vascular neurologists measured carotid intima-media thickness (IMT) using standard techniques. Multivariate linear regression models were used to estimate the difference in mean IMT and 95% confidence intervals (95% CIs), according to categories of sun exposure and multivariate logistic regression models were used to estimate the odds ratio (OR) and 95% CIs for carotid atherosclerosis. Results: The mean age of participants was 49.6 ± 5.5 years, the mean IMT was 0.678 ± 0.097 mm, and the mean accumulated hours of weekly sun exposure were 2.9 ± 1.9. Prevalence of carotid atherosclerosis was 20.9%. Compared with women in the lowest quartile of sun exposure, women in the highest quartile had lower mean IMT, but this was not significant in the multivariable adjusted analysis. (Adjusted mean % difference: -0.8; 95% CI: -2.3 to 0.8). The multivariate adjusted ORs of carotid atherosclerosis were 0.54 (95% CI: 0.24-1.18) for women who were exposed 9 hours. For women who denied regular sunscreen use, those in the higher exposure category (9 hours) had lower mean IMT compared with those in the lower category (multivariable-adjusted mean % difference = -2.67; 95% CI: -6.9 to -1.5). Conclusions: We observed that cumulative sun exposure was inversely associated with IMT and subclinical carotid atherosclerosis. If these findings are further replicated and seen for other cardiovascular outcomes, sun exposure could be an easy, affordable strategy to lower overall cardiovascular risk.

P514 Serum levels of Klotho in inflammatory bowel disease: an exploratory study

Abstract Background Alpha klotho (α-Klotho) is an anti-aging protein recognized as a humoral factor with anti-oxidant and anti-inflammatory effects, showing a bidirectional relationship with inflammation, a main pathophysiologic factor in atherosclerosis. A decrease in Klotho has been associated to cardiovascular disease (CVD), but no previous studies have investigated the relationship between inflammatory bowel disease (IBD), a risk factor for CVD, and Klotho levels. Therefore, we assessed if the serum levels of Klotho differ between patients with IBD and controls, and how this protein is related to the clinical and laboratory characteristics of the disease, subclinical atherosclerosis and metabolic risk factors. Methods Cross-sectional multicentric study that included 251 individuals: 191 IBD patients and 60 healthy controls was conducted. Serum Klotho levels were determined by commercial ELISA immunoassay (IBL International GmbH Laboratories). In the IBD patients disease activity was evaluated using CDAI for Crohn’s disease, partial Mayo (pMayo) for ulcerative colitis, specific laboratory parameters, determination of the Systematic Coronary Risk Evaluation (SCORE), and the presence of subclinical atherosclerosis was assessed using carotid ultrasound for identifying carotid plaque and measurement of carotid intima-media thickness. Results Serum Klotho levels were significantly higher in the IBD group: 734.31 pg/ml vs. 484.17 pg/ml (p&amp;lt;0.001) compared with controls. In the IBD group, no significant differences in the serum Klotho levels were found between the type of IBD (p=0.911), time from diagnosis (p=0.126), disease activity: CDAI (p=0.277), pMayo (p=0.916), type of treatment (0.76), the presence of plaque (p=0.101) or the intima media thickness (p=0.429). However, a significant inverse correlation between serum Klotho and the SCORE was observed in IBD patients: r = -0.176 (p= 0.014) (figure 1) Conclusion Patients with IBD had higher Klotho levels than healthy controls, with an inverse and significant relationship with the SCORE in the IBD patients. Further studies are necessary to clarify the role of Klotho in IBD.

Carotid Intima-media Thickness is a Sequel of Elevated FGF-23 Levels in CKD!

International Journal of Medicine and Public Health,2022,12,4,165-168.DOI:10.5530/ijmedph.2022.4.30Published:January 2023Type:Original ArticleCarotid Intima-media Thickness is a Sequel of Elevated FGF-23 Levels in CKD!Upma Narain, Arvind Gupta, and Seema Pandey Upma Narain1,*, Arvind Gupta2, Seema Pandey3 1Microbiologist and Immunologist, Tejas Microdiagnostics, Prayagraj, Uttar Pradesh, INDIA. 2Department of Nephrology, MLN Medical College, Prayagraj, Uttar Pradesh, INDIA. 3Department of Radio Diagnosis, MLN Medical College, Prayagraj, Uttar Pradesh, INDIA. Abstract:Background: FGF-23 regulates phosphate homeostasis and has a correlation with morbidity and mortality due to cardiovascular episodes and chronic renal conditions. The risk of subclinical atherosclerosis can be predicted by measurements of the intima-media thickness of the carotid artery. The objective of this studyisto study therelation between serum FGF-23 levels and Carotid intima-media thickness in the early stages of CKD. Materials and Methods: This study was conducted at MLN Medical College, SRN Hospital, Prayagraj and Tejas Microdiagnostics. The study design adopted was prospective and observational. A total of 270 newly diagnosed CKD patients were enrolled as cases while 90 patients without CKD were taken as control. Highresolution ultrasonography was utilised to measure Carotid artery intima-media thickening. Serum FGF-23 levels were performed at the beginning of study, along with other baseline investigations and were repeated on 6th and 9th months respectively. Results: Among the case group of CKD, the mean age was 54.8+2.1 years with male to female proportions representing 62% and 38%, respectively of the control group consisted mean age distribution of 51.0 + 2.1 years a and male-female proportion of 58% and 42%, respectively. It was observed that FGF-23 levels and Carotid intima-media thickness measurements were high in patients than in controls. A statistically significant correlation at 0.01 levels was observed between FGF-23 and the Carotid intima-media thickness. Conclusion: Our study clearly establishes a strong correlation between FGF-23 and CIMT indicating that FGF-23 plays an important role in the development of vascular calcifications in early stages of CKD. Subclinical atherosclerosis in CKD patients can be predicted by monitoring of their FGF-23 and CIMT level. Keywords:Association, Carotid intima-media thickness, CKD, FGF-23View:PDF (347.97 KB)

Circulating galectin-3 levels are inversely associated with subclinical cardiovascular disease in obese adults.

Galectin-3 is a new cytokine that is mainly secreted by activated macrophages. It is involved in apoptosis, inflammation and may play a role in the development of cardiovascular disease (CVD). However, there is little information about the association between circulating galectin-3 and subclinical atherosclerosis in humans. We measured serum galectin-3 in 483 obese adult subjects (aged 40years and over) who had the measurement of carotid intima-media thickness (CIMT) recruited from the community. Adults with lower levels of circulating galectin-3 had increased CIMT (p < 0.05). In multivariable linear regression analyses, circulating galectin-3 was independently associated with CIMT. The risks of increased CIMT were significantly decreased by 65.1% (OR (95% CI): 0.349 (0.165-0.739)), adjusting for possible confounding factors. Notably, individuals in the lowest quartile of serum galectin-3 were 1.80 times (p < 0.05) more likely to have increased CIMT than those in the highest quartile in multivariable logistic regression analyses; however, such associations with circulating galectin-3 were not noted for carotid plague. These findings propose that circulating galectin-3 concentrations are inversely associated with increased CIMT in obese adults, which may be a potential biomarker of CVD.

Could a nonfunctional adrenal incidentaloma be a risk factor for increased carotid intima-media thickness and 10-year cardiovascular mortality based on the SCORE algorithm? A study from a single centre in Poland.

Adrenal incidentaloma (AI) secreting small amounts of glucocorticoids may cause morphological and functional changes in the blood vessels. Early stages of cardiovascular remodeling may be observed among asymptomatic patients with AI. But it is unclear whether the nonfunctional adrenal incidentalomas (NFAI) may also be a risk factor for cardiovascular diseases. The aim of this study was to determine the relationship between NFAI, carotid intima-media thickness (CIMT), and cardiovascular risk (CVR) based on Systematic Coronary Risk Evaluation (SCORE) prediction models for Europe. This study from a single centre in Poland included 48 NFAI patients and 44 individuals in the control group matched for age, sex, and body mass index (BMI). All participants underwent adrenal imaging, biochemical evaluation, measurement of CIMT, and assessment of the 10-year risk of cardiovascular mortality based on the SCORE algorithm. Hormonal evaluation was conducted in AI patients. The NFAI group showed significantly higher sodium (p = 0.02) and glucose levels in the 2-h oral glucose tolerance test (OGTT) (p = 0.04), a higher CIMT (p < 0.01), and a higher CVR calculated according to the SCORE algorithm (p = 0.03). The estimated glomerular filtration rate (eGFR) was higher in the NFAI group (p = 0.015). Hypertension (p < 0.01) and IGT (p = 0.026) were more common in the NFAI group. Statistically significant positive correlations were found between CIMT and age (r = 0.373, p = 0.003), waist circumference (r = 0.316, p = 0.029), diastolic blood pressure (r = 0.338, p = 0.019), and CVR based on the SCORE algorithm (r = 0.43, p = 0.004). There was a statistically significant positive correlation between CIMT and serum cortisol levels after 1 mg dexamethasone suppression test (r = 0.33, p = 0.02). Non-functional adrenal adenomas are associated with increased CIMT and CVR. Early stages of cardiovascular remodelling can be observed in asymptomatic NFAI patients.

Application of Artificial Intelligence Methods in Carotid Artery Segmentation: A Review

The carotid artery is one of the most important blood vessels that supply blood to the brain. If thrombus occurs, it may cause cerebral ischemic stroke and endanger life. Carotid intima-media thickness and stability of carotid plaque are essential indicators for predicting stroke, which can be measured through medical image segmentation. Therefore, automatic and accurate carotid artery image segmentation and measurement of carotid intima-media thickness and the area and volume of carotid plaque are of great significance for stroke risk prediction and treatment. However, due to the complex shape of the carotid artery and the characteristics of carotid artery imaging, the traditional methods (such as threshold methods, region growth methods) can not segment the carotid artery very well. In recent years, researchers have taken artificial intelligence (traditional machine learning and deep learning) as a critical research method for carotid artery segmentation and extensive research has been performed with satisfactory results. In this paper, we present a comprehensive review of carotid artery segmentation using artificial intelligence methods. We first briefly introduce medical image processing methods and artificial intelligence methods. And then, review and summarize the application of artificial intelligence segmentation methods in carotid artery segmentation (including carotid lumen, media-adventitia, lumen-intima, and plaques). Finally, the challenges of current artificial intelligence methods in carotid artery segmentation are analyzed.

The Evaluation of The Relationship between The Radiological Pulmonary Stage of Sarcoidosis and Carotid Artery Intima Media Thickness Measurement on The Sarcoidosis Patients with Lung Involvement

Objective: Sarcoidosis is a disease which courses with noncaseating granulomas, and within the pathophysiology of which abnormal immune response, inflammation and oxidative stress are held responsible. Lungs are the organs which it mostly involves and the lung involvement is radiologically divided into stages. The present research aims to evaluate the relationship between the lung involvement stage of sarcoidosis and carotid intima media thickness measurement which is one of the indicators of subclinical atherosclerosis.

Vascular effects of gestational diabetes can be recognized by carotid intima-media thickness: a prospective case-control study

Gestational diabetes mellitus (GDM) is a systemic disease that has poor maternal and fetal health outcomes. Patients who are diagnosed with GDM are more likely to encounter cardiovascular system diseases during pregnancy and after birth. Carotid intima-media thickness (CIMT) is used as an early indicator of diseases such as coronary artery disease. This study aims to define the effects of hyperglycemia at an early term using CIMT, maternal and fetal doppler flows in patients diagnosed with GDM. The study included 132 pregnant women who had reached the 24th gestational week. (GDM group n=65, Control group n=67) Comparisons were performed between women with similar demographic characteristics who received a 100-gr oral glucose test (OGT) and GDM diagnosis and who did not. The participants’ routine hemograms and biochemical tests were done during OGT. Fetal biometrics, amniotic fluid index, uterine artery doppler flow, and bilateral CIMT measurements were performed during the obstetric examinations. Gravida, para, and live birth rates of the GDM group participants were higher than those of the control group (p=0.003, 0.002, 0.002 respectively). The amniotic fluid index was found to be higher in the GDM group (p&lt;0.001). Fasting glucose values and platelet counts were higher in the GDM group (p=0.031 and p&lt;0.001). Other laboratory data demonstrated no statistically meaningful differences between the groups (p&gt;0.05). When the doppler measurements were compared, umbilical artery pulsatility index values were discovered to be similar between the groups (p=0.509). While the right uterine artery (UtA) pulsatility index was higher in the GDM group (p&lt;0.001), no statistically significant differences were found between the groups in terms of the left UtA pulsatility index (p=0.485). Right and left CIMTs were higher in the GDM group (p=0.001, p&lt;0.001, p&lt;0.001 respectively). While in the GDM group there was a positive correlation between the thrombocyte level and uterine artery resistance (r=0.336, p=0.006; r=0.397, p=0.044 respectively), no similar correlations were found in the control group. This study found that GDM patients had inflammation, increased resistance in uterine artery flow, and increased CIMT. It has been shown, there is a correlation between CIMT and glucose levels and between thrombocytosis and UtA resistance in GDM patients. Uterine artery doppler data and CIMT measurements could be used as an indicator of systemic inflammation and cardiovascular disease in patients with GDM.

Juvenil İdiyopatik Artiritte Karotis İntima Media Kalınlığı ve Preklinik Ateroskleroz için Risk Faktörleri: Tanımlayıcı Araştırma

Objective: Juvenile idiopathic arthritis (JIA) is the most common chronic rheumatic disease in childhood. Cardiovascular morbidity and mortality are becoming important health problems for children with inflammatory rheumatic diseases. The aim of this study was to evaluate carotid intima-media thickness (CIMT) in children with JIA and to examine its association with JIA subtype, markers of inflammation, and early atherosclerosis. Material and Methods: We included 112 (50 boys and 62 girls) patients who have been followed by a diagnosis of JIA for at least 6 months and 54 healthy control subjects (32 girls and 22 males) who were matched with the patients age and gender. All children underwent a carotid artery. Inflammation markers were evaluated in the patient group. Cumulative drug doses, total disease duration (TDD), active disease duration (ADD) were calculated. All CIMT values were compared in patients, subgroups, and control groups, and their relationship with inflammation markers was investigated. Results: CIMT values in found that children with JIA were significantly higher than in healthy children. There was no difference between the disease subgroups in terms of CIMT. No relationship was found between CIMT measurements and atherosclerosis risk factors, drugs, erythrocyte sedimentation rate, white blood cell and C-reactive protein. A negative correlation was found between mean platelet volume (MPV) and right CIMT. A statistically significant positive correlation was detected between the right CIMT and TDD (r=0.221, p=0.022), and ADD (r=0.248, p=0.010). Conclusion: The study showed that the patients with JIA had more risks than healthy controls for cardiovascular disease (CVD) regardless of subgroup. We concluded early and aggressive therapies may be protective for CVD. Negative correlation was found between MPV and CIMT that is consistent with recently published literature, but there is need for further studies with a larger patient population.

Assessing the Association between Psoriasis and Cardiovascular Ischemia: An Investigation of Vascular Endothelial Growth Factor, Cutaneous Angiogenesis, and Arterial Stiffness.

Vascular endothelial growth factor (VEGF)-mediated angiogenesis's role in developing psoriasis and cardiovascular events has been established. However, the interplay between the two diseases regarding this cytokine remains an understudied area. This case-control study aimed to investigate the relationship between VEGF-mediated angiogenesis and cardiovascular ischemia in patients with psoriasis. The study included 200 clinically diagnosed treatment-naïve cases of psoriasis and 200 controls. The VEGF level, cutaneous vascularity, and cardiovascular ischemia were measured between cases and controls. Cutaneous vascularity was assessed using non-invasive imaging technique such as laser doppler imaging (LDI) and measuring skin blood flow measurement (SBFM). Cardiovascular ischemia was evaluated using noninvasive techniques by measuring carotid intima-media thickness (CIMT) and pulse-wave velocity (PWV). The arterial vasa vasorum was evaluated using ultrasound imaging. The study found a significant correlation between psoriasis severity and levels of VEGF (P < 0.001). Cases had significantly higher CIMT and PWV levels (P = 0.001 and <0.001, respectively). There was a significant positive correlation between the severity of psoriasis and the levels of cutaneous angiogenesis (r = 0.7, P < 0.001). According to this study, patients with psoriasis are at a higher risk of developing cardiovascular ischemia due to excessive angiogenesis associated with the condition. VEGF plays a key role in atheroma formation in psoriasis patients.

A Study to Assess and Correlate Metabolic Parameters with Carotid Intima-Media Thickness after Combined Approach of Yoga Therapy among Prediabetics.

Prediabetes is an intermediate hyperglycemia in which the fasting blood glucose (FBG) level is greater than normal (100-125 mg/dl) but lower than diabetic levels (more than 125 mg/dl). The aim of the present study was to evaluate and correlate the impact of the combined approach of yoga therapy (CAYT) on carotid intima-media thickness (CIMT) and metabolic parameters including FBG, glycated hemoglobin (HbA1C), and lipid profile-like triglyceride (TG), total cholesterol (TC), and high-density lipoprotein (HDL). Experimental Interventional study was conducted on a total of 250 prediabetics divided into the control (n = 125) and study group (n = 125) at "RUHS College of Medical Sciences and associated hospitals." Assessments were made at baseline and after six months of the CAYT. The study group (n = 125) was engaged in the CAYT, which consists of yoga, dietary modification, counseling, and follow-up. The control group not participated in CAYT. Mean age of participants was 45.3 ± 5.4 years. Pearson correlation analysis of CIMT and metabolic parameters which were fasting blood sugar, HbA1C, and lipid parameters (TC, TG, and HDL) showed that significant positive correlation with FBG (r =.880), HbA1C (r =.514), TC (r =.523), TG (r =.832), and negative correlation with HDL (r = -0.591) after six months of CAYT. This study demonstrated that after six months of CAYT metabolic parameters, CIMT were significantly decreased. We have observed a significant correlation exists between CIMT and metabolic parameters. Therefore, regular CIMT measurement might be beneficial for the assessment of cardiovascular disease (CVD) risk and facilitate better use of treatment modalities in prediabetics.

Tissue Factor and Vascular Endothelial Growth Factor in Detecting Thromboembolic Complications in Diabetic Atherosclerotic Patients.

Atherosclerosis, which is one of the leading causes of death all over the world, can create major or minor thromboembolic complications with the exponentially increasing diabetic status. Despite all the studies, the mechanism by which endothelial damage in atherosclerosis is triggered in diabetic setting is still not fully understood. In this study, tissue factor (TF), which is thought to act together in the formation of vasular endothelial growth factor (VEGF-A) and coagulopathy in diabetic atherosclerotic patients, may be an important indicator in this regard, a total of 100 cases who were undergone off-pump coronary artery bypass (OPCAB) which were at same risk group examined by dividing into diabetic status. Early postoperative process and biochemical parameters analyzed in terms of TF and VEGF-A levels measured before and after the operation. TF and VEGF-A expression of the T1DM group were statistically high compared to non-diabetics. Significantly longer hospital stays with changes in TF and VEGF-A were found in patients in the diabetic group compared to pre- and postoperatively, respectively; TF (95% CI: 0.879-0.992; p = 0.025), VEGF-A (95% CI: 0.964-0.991; p = 0.001) and hospital stay (95% CI: 1.96-7.49; p = 0.0001). Preoperatively measured carotid intima-media thickness (CT) was higher in diabetics and was significantly associated with atrial fibrillation (AF), (r = 0.873). Surgical team and protocols were same and OPCAB procedures were routinely applied to all patients in our clinic. No minor or major events were observed in any of the cases. TF and VEGF-A values in patients with diabetic atherosclerosis may be important in the early detection of thromboembolic complications.