Atherosclerosis In Common Carotid Artery Research Articles

Interactions of the Osteokines, Glucose/Insulin System and Vascular Risk Networks in Patients With Newly Diagnosed Type 2 Diabetes (VNDS 15).

Bone as an endocrine organ regulates metabolic processes independently of mineral metabolism through the production/release of proteins collectively named 'osteokines'. Relevant connections were reported between the insulin/glucose system, calcification of the atherosclerotic plaque, and several osteokines. We aimed to test the hypothesis that the osteokine network could be involved in beta-cell function, insulin sensitivity, and vascular damage in a cohort of people with newly diagnosed type 2 diabetes (T2D). In 794 drug-naive, GADA-negative, newly-diagnosed T2D patients (mean±SD age: 59±9.8years; BMI: 29.3±5.3kg/m2; HbA1c: 6.6±1.3%) we assessed: plasma concentration of osteocalcin (OCN), osteopontin (OPN),RANKL, and its putative decoy receptor osteoprotegerin (OPG); insulin sensitivity (SI) by hyperinsulinemic euglycemic clamp; beta cell function (BCF), estimated by OGTT minimal modelling and expressed as derivative (DC) and proportional (PC) control. Echo-doppler of carotid and lower limb arteries were also performed in 708 and 701 subjects, respectively. OCN, RANKL and OPG were significantly associated with PC (p<0.02); OCN was positively related to DC (p=0.018). OPG was associated with lower IS (p<0.001). Finally, the higher RANKL levels, the greater was the severity of atherosclerosis in common carotid artery (p<0.001). Increased OPG and OPN concentrations were related to subclinical atherosclerosis in peripheral arteries of lower limbs (p=0.023 and p=0.047, respectively). These data suggest that, in patients with newly diagnosed T2D, the osteokine network crosstalks with the glucose/insulin system and may play a role in modulating the atherosclerotic process.

Crosstalk between genetic variability of adiponectin and leptin, glucose-insulin system and subclinical atherosclerosis in patients with newly diagnosed type 2 diabetes. The Verona Newly Diagnosed Type 2 Diabetes Study 14.

To evaluate the relationship of genetic variability of adiponectin (ADIPOQ), leptin (LEP) and leptin receptor (LEPR) genes with glucose-insulin system and markers of subclinical atherosclerosis (ATS) in patients with newly diagnosed type 2 diabetes. In 794 subjects we performed: 1) euglycemic hyperinsulinemic clamp to assess insulin sensitivity; 2) mathematical modelling of a 5h-OGTT to estimate β-cell function; 3) resting ECG; 4) carotid artery and lower limb artery eco-doppler sonography to identify ATS; 5) genotyping of tag-SNPs within ADIPOQ, LEP and LEPR gene. Regression analyses showed: 1) adiponectin levels were negatively associated with BMI, waist-to-hip ratio and triglycerides and positively with HDL and insulin sensitivity (p-all<0.03); 2) leptin levels were positively associated with BMI, HDL-cholesterol and plasma triglycerides and negatively with insulin sensitivity (p-all<0.001). Two SNPs (rs1501299 and rs2241767) within ADIPOQ gene were associated with circulating levels of adiponectin. The ADIPOQ-GAACA haplotype was associated with plasma adiponectin (p=0.034; β=-0.24), ECG abnormalities (p=0.012; OR=2.76), carotid ATS (p=0.025; OR=2.00) and peripheral limb artery ATS (p=0.032; OR=1.90). The LEP-CTA haplotype showed an association with ischemic ECG abnormalities (p=0.017; OR=2.24). Finally, LEPR-GAACGG was associated with circulating leptin (p=0.005; β=-0.31) and worst β-cell function (p=0.023; β=-15.10). Omnibus haplotype analysis showed that ADIPOQ haplotypes were associated with levels of adiponectin and common carotid artery ATS, LEP with peripheral limb artery ATS, whereas LEPR haplotypes influenced circulating levels of leptin. Results of this study reinforce knowledge on adipokines' role in regulating glucose metabolism; in particular highlighted the potential atherogenic role of leptin and the anti atherogenic role of adiponectin.

Assessment of the prevalence of target organ damage at various stages of the cardiometabolic continuum. According to the ESSE RF study

Objective: to assess the prevalence of target organ damage (TOD) at various stages of the cardiometabolic continuum, including abdominal obesity (AO) without metabolic syndrome (MS), MS, and type 2 diabetes mellitus (DM).Materials and methods: this study presents an analysis of data from a sample of residents of Tomsk (1,104 examined from an unorganized adult population of 25-64 years), performed within the framework of the ESSAY RF-2012 project (Epidemiology of Cardiovascular Diseases in the Regions of the Russian Federation). The analysis included the presence of LV hypertrophy (LVH), a decrease in glomerular filtration rate (GFR), an increase in the thickness of the intima-media complex (TIM), the presence of atherosclerotic plaques (ASP) in the common carotid arteries (CCA).Results: TODs were already reported among individuals with isolated AO (without MS), whose prevalence was statistically significantly higher compared to those with normal body weight. Atherosclerosis of CCA turned out to be the most frequent TOD phenotype, ASP was detected in 22% of individuals with isolated AO, in 33% patients with MS and 35% patients with type 2 DM, the second most common was LVH, which was detected in 0.8%, 4,7% and 17,5% of cases, respectively, the least common was a decrease in GFR – in 1,37%, 3,7% and 6,7% of patients, respectively. Differences in the frequency of TOD in all groups were statistically significant (p &lt; 0,01).Conclusions: Thus, the prevalence of TODs detected already at the stage of isolated AO progressively increased from group to group, as they moved along the cardiometabolic continuum.

Abdominal obesity and adipocyte metabolic activity: criteria for "health" and "neutrality"

The last decades of the late 20th and early 21st centuries have seen a rapid growth of non-infectious diseases such as abdominal obesity, prehypertension, hypertension, diabetes mellitus type 2. According to official data, preobesity is diagnosed in 40.1% of the adult population of Russia; 21.6% of Russians are obese; and only 36.3% of our fellow citizens have normal body weight. The combination of obesity, hypertension, diabetes mellitus type 2 and atherogenic dyslipidemia are the criteria for metabolic syndrome a proven risk factor for progression and complicated course of cardiovascular disease. The scientific community is actively discussing about the appropriateness of singling out a group of patients with metabolically healthy obesity and criteria for its diagnosis, but the hormonal activity of adipose tissue is not evaluated. Leptin is involved in the metabolism of glucose and fatty acids, and leptinresistance is an important prognostic marker of the complicated obesity. On the based of our own scientific data results, the concept of metabolically neutral obesity - obesity with normal adipokines activity (leptin concentration 3.5 ng/ml) without signs of insulinresistance was formulated and proposed. It was shown that in this metabolic type of obesity the prevalence of dyslipidemia was 1.7 times, prediabetes 2 times, atherosclerosis of common carotid arteries 1.5 times lower than in metabolically healthy obesity. Determining the level of leptin in uncomplicated obesity allows stratifying patients into groups with normal and increased adipokines activity. The highlighting of the metabolically neutral type of obesity is considered by us to be practically justified, as it allows to determine the stage of the disease at which the frequency of metabolic and cardiovascular disorders is still minimal and non-drug prevention is necessary. Exceeding the threshold of leptin level 3.5 ng/ml in obesity may require a more aggressive lifestyle correction, and possibly an early start to drug therapy.

Corilagin ameliorates atherosclerosis by regulating MMP-1, -2, and -9 expression in vitro and in vivo

Corilagin is a polyphenol has been identified anti-inflammatory properties. However, the anti-atherosclerotic effects of corilagin are not well understood. Here, we evaluated the anti-atherosclerotic effects and the underlying mechanisms of corilagin. We also verified whether corilagin can reverse atherosclerosis by regulating matrix metalloproteinase (MMP)-1, -2, and -9 in vitro and in vivo. An atherosclerosis model was established by feeding minipigs a high-fat diet combined with balloon injury, and the effects of different concentrations of corilagin on common carotid artery atherosclerosis in minipigs were monitored. Murine RAW264.7 macrophages were cultured and induced with oxidized low-density lipoprotein; fluorescence microscopy revealed the nuclear translocation of NF-κB. Furthermore, MMP-1, -2, and -9 expression in common carotid artery plaques and cellular models was detected by immunohistochemistry, western blotting, and RT-PCR. The pathological results suggested that the vascular intima of the model control group was significantly thickened, a large amount of collagen fibers was deposited, endothelial cells were damaged and detached, and plaque and foam cell formation occurred to varying degrees on the arterial wall, with lipid deposition. Corilagin treatment significantly reduced the degree of injury in the common carotid artery and decreased the number of lipid plaques and foam cells. Additionally, corilagin downregulated MMP-1, -2, and -9 expression in the common carotid artery plaques and cellular model. Moreover, corilagin significantly inhibited NF-κB nuclear translocation in vitro. Overall, corilagin exerted substantial therapeutic effects on experimental atherosclerotic minipigs via the downregulation of MMP-1, -2, and -9 expression.

Five-year dynamics of carotid artery remodeling in hypertensive patients working on a fly-in/fly-out basis in the Arctic

Aim. To analyze the 5-year dynamics of atherosclerotic remodeling of common carotid arteries (CCA) in persons with hypertension (HTN) working on a fly-in/fly-out basis in the Arctic. To determine sex characteristics, factors associated with atherosclerotic plaque (ASP) imaging, and outcome endpoints. Material and methods. In the period 2012-2017, 372 (men, 273; women, 99) employees with grade 1-2 HTN working on a fly-in/fly-out basis in the Arctic were observed. Depending on the ultrasound data, the subjects were divided into 2 groups: with an initially normal CCA wall (men, 137; women, 65) and with subclinical carotid atherosclerosis (SCA) in the form of intima-media thickness (IMT) increase &gt;0,9 mm (men, 136; women, 34) without differentiable ASPs. The dynamics of CCA wall remodeling was analyzed depending on sex, the level of mean 24-hour blood pressure (BP) and echocardiography data on the left ventricular (LV). Factors associated with the identification of ASPs and endpoints were determined. Results. Men with HTN were significantly more likely to have SCA than women. The frequency of ASP imaging directly depended on the initial CCA characteristics and was higher in both sexes with IMT increase. The level of mean 24-hour BP insignificantly influenced the atherosclerosis severity. According to the 5-year follow-up, the structure of CCA wall changed significantly more often in men than in women. In individuals with concentric LV hypertrophy, regardless of the initial CCA state, the highest prevalence of ASP was recorded. The progression of the atherosclerotic process was more intense in individuals with concentric remodeling and normal LV geometry in combination with IMT increase. In individuals with initial atherosclerosis of CCA, acute myocardial infarction and acute cerebrovascular accident developed significantly more often than in patients with initially normal CCA walls. Conclusion. Under the fly-in/fly-out conditions in the Arctic, in hypertensive men significantly more often than in women, SCA was detected and was characterized by more intense progression during 5-year follow-up. In men, it was significantly more often accompanied by cardiovascular complications. It is important to identify signs of SCA for early initiation of therapy in order to prevent fatal cardiovascular events in Arctic workers.

Risk prediction for subclinical carotid atherosclerosis in rotational shift workers in the arctic

Abstract Introduction High prevalence of cardiovascular events at northern latitudes determines the necessity of studying mechanisms of formation and early diagnosis of atherosclerotic process. Purpose To determine the most unfavorable prognostic factors that provide the percentage of correct prediction and high accuracy in detection of atherosclerotic plaque (ASP) in common carotid arteries (CCA) in rotational shift workers in the Arctic. Methods Within 2010–2012 a study of 424 males aged 30–59 years at the medical unit “Gazprom dobycha Yamburg” (Yamburg settlement, 68°N) was performed. Patients were randomized into 2 groups according to blood pressure (BP). Gr.I included 294 people with BP more than 140/90 mmHg, arterial hypertension (AH) of 1,2 stage and Gr.II included 130 people with BP less than 140/90 mmHg. Groups did not differ in age (46.9±5.8 years, p=0.435); total work experience in the Arctic: 16.5±6.8 years (p=0.512) and rotational shiftwork duration: 12.5±4.6 years (p=0.597). Office BP was 149.4±13.3/97.1±7.3 mmHg in Gr.I and 123.4±7.5/80.5±5.5 mmHg in Gr.II. Ultrasound examination of carotid arteries with determination of presence or absence of ASP in CCA and estimation of stenosis using NASCET method were performed; ambulatory blood pressure monitoring was conducted; blood glucose levels, total cholesterol, high-density lipoprotein cholesterol, low density lipoprotein cholesterol were determined. Statistical analysis was carried out using R (v. 3.6.1) programming language for statistical data processing of R Studio application package (v. 1.2.1335). Results Signs of CCA atherosclerosis were revealed in 56% of patients with AH and in 25% of those without AH. According to multivariate analysis, three variables with the most significant set of predictors, associated with ASP in CCA with the percentage of correct prediction of 75.9% were selected by step-by-step method: diastolic BP24 (&amp;lt;0.0001), glucose (0.0167) and cholesterol (0.0439). Based on the obtained model, it was concluded that 1 mmHg increase in diastolic BP24 increases the risk for developing ASP by 5.9%, Exp. (Beta) = 1.059, 1 mmol/l increase in glucose and cholesterol escalates the risk by 44.1% and 25.2%, respectively: Exp. (Beta) = 1.441 and Exp. (Beta) = 1.252. Conclusion The data obtained will improve accuracy for the early diagnosis of subclinical atherosclerosis of CCA, allow to prescribe lipid-lowering therapy timely and reduce the risk of adverse cardiovascular events in rotational shift workers in the Arctic. Funding Acknowledgement Type of funding source: None

Transcarotid Artery Revascularization by Prosthetic Conduit for Patients With Unfavorable Common Carotid Anatomy

Transcarotid artery revascularization (TCAR) using the ENROUTE Transcarotid Neuroprotection and Stent System (Silk Road Medical, Sunnyvale, Calif) is a hybrid technique with excellent initial outcomes. The technical success of TCAR is heavily dependent on an anatomically suitable common carotid artery (CCA). Many patients do not meet the anatomic criteria for TCAR and are not eligible for this therapy. We sought to extend the eligibility of TCAR to patients with unfavorable CCA anatomy by the adoption of a prosthetic arterial conduit. Patient 1, a 57-year-old man, presented with recurrent >90% internal carotid artery (ICA) stenosis after carotid endarterectomy for symptomatic disease. Arteriography demonstrated severe stenosis of the ICA and diffuse CCA atherosclerosis (Fig, A). The CCA was replaced with a 6-mm polytetrafluoroethylene interposition graft incorporating a side arm limb for stent deployment (Fig, B-D). Patient 2 was a 62-year-old man with prior neck irradiation and asymptomatic >90% stenosis of the distal CCA. Computed tomography angiography showed a <5-cm distance from clavicle to carotid lesion. We performed TCAR by a 6-mm Dacron conduit sewn to the CCA. Patient 3 was an 80-year-old woman with recurrent symptomatic >80% ICA stenosis. TCAR was performed in the same manner as in patient 2, secondary to short distance. Patient 4, a 65-year-old man with prior neck irradiation and ICA stent, presented with severe in-stent stenosis and distal CCA stenosis. TCAR was performed by a Dacron conduit sewn to the proximal CCA with stenting of both ICA and CCA lesions. Technical success was 100% (Table). The 30-day ipsilateral stroke rate was 0%; however, the 30-day patency was 75%. Patient 2 experienced anaphylaxis after protamine administration and a subsequent cardiac arrest. He recovered without consequence. Computed tomography angiography 1 month postoperatively demonstrated stent thrombosis. TCAR is an excellent option for many patients with carotid artery stenosis. Unfavorable CCA anatomy has limited the applicability of this hybrid technology. TCAR by a prosthetic conduit has the potential to expand the eligibility for this promising therapy.TableResultsProcedure time2 hoursFlow reversal time8.5 minutesTechnical success100%30-day patency75%30-day stroke0% Open table in a new tab

Features of atherosclerosis of common carotid arteries among black Kenyans

Abstract Introduction: Data on the features of atherosclerosis of common carotid artery are important for informing strategies against ischaemic stroke in Subsaharan Africa, but are scarce. Materials and Methods: This study therefore investigated, by light microscopy, the presence of features of atherosclerosis in the left common carotid artery among 108 black Kenyans [76 males; 32 females; Mean age 36.4, range 22-82 years] who suffered violent death. Specimens from the distal segment of the artery were prepared for routine paraffin embedding, and 5μ sections stained with Mason's Trichome. Results: At least one feature of atherosclerosis was observed in 22 (20.4%) cases. Intimal hyperplasia alone was present in all the 22 cases followed by Intimal hyperplasia and degeneration ofinternal elastic lamina 19 (17.6%); Intimal hyperplasia combined with disintegration ofinternal elastic lamina and medial degeneration 17 (15.7%). Thickening of tunica adventitia with neovascularization were present in 8 (7.4%) of cases. All the features were more frequent in males than females (1.4:1) and those over 40 years old. Eight of the cases (36.4%) were in individuals aged below 40 years. Conclusion: Multiple features of atherosclerosis in common carotid artery are present in over 20% of the asymptomatic black Kenyans studied. They occur more frequently in males, and affect individuals younger than 40 years. These features appear in all three layers of the vessel wall, suggesting that the disease has attained several stages of severity in this population. We recommend early screening for the disease in individuals at risk.

Correlation between Hyperhomocysteinemia and Common Carotid Artery Intima media Thickness in Carbamazepine treated Epileptic patients using Ultrasonography.

Objective:The objective was to assess the role of homocysteine in the development of atherosclerosis in common carotid artery in the carbamazepine treated epileptic patients.Methods:This study was conducted in the Department of Biochemistry, Basic Medical Sciences Institute (BMSI), Jinnah Postgraduate Medical Center (JPMC), Karachi. Three hundred individuals, aged 34 ± 9.5 years were selected and divided into three groups. Each group comprised of 100 subjects labeled as Group-A (control group had healthy individuals), Group-B (newly diagnosed epileptic patients without antiepileptic therapy), Group-C (epileptic patients on Carbamazepine therapy, which was further subdivided into C-I having epileptic patients on Carbamazepine therapy less than 1 year n=33, C-II had epileptic patients on Carbamazepine therapy 1-2 years n = 33 and C-III comprised of epileptic patients on Carbamazepine therapy more than 2 years n = 34). Blood concentration of homocysteine was measured and ultrasound of Common Carotid Artery for intima-media thickness was performed.Results:Significantly elevated level of homocysteine was observed in epileptic patients on CBZ therapy. Common Carotid Artery Intima-media thickness (CCA IMT) was observed significantly high throughout group C but it was more profound in Group-C-III. Homocysteine was found positively correlated with right CCA IMT, left CCA IMT and mean CCA IMT.Conclusion:Hyperhomocysteinemia was linked with increased risk of atherosclerosis in CBZ treated epileptic patients.

The triticeous cartilage - redefining of morphology, prevalence and function.

Triticeous cartilage is a small cartilaginous component of the laryngeal skeleton. This cartilage, located in posterior end of the thyrohyoid ligament, presents in different shapes. Radiological studies indicate clinical and anatomical importance of the triticeous cartilage but these studies have limited information due to inadequate inspection method. Computed tomographic angiography is able to evaluate the triticeous cartilage with using three-dimensional images in more detail. The aim of this study is to describe prevalence and morphological properties of the triticeous cartilage. We examined computed tomographic angiography images of 746 patients (368 women, 378 men) retrospectively. Shapes, calcification degrees, volumes, lengths and wideness of the triticeous cartilage were evaluated by OsiriX-Lite software. According to our results, triticeous cartilage presents common in the examined population (68.1%). The prevalence of the triticeous cartilage was higher in men than in women. We also found that the degree of calcification was not related with age and gender. Clinical importance of the triticeous cartilage is that it could be misdiagnosed with atherosclerosis in common carotid artery because the triticeous cartilage is located almost at same level as the bifurcation of the common carotid artery. Therefore, clinicians should be aware about the triticeous cartilage.

Association of the RYR3 gene polymorphisms with atherosclerosis in elderly Japanese population

BackgroundThe Ryanodine receptor 3 gene (RYR3) encodes an intracellular calcium channel that mediates the efflux of Ca2+ from intracellular stores. Two single-nucleotide polymorphisms (SNPs) in the RYR3 gene have been shown to associate with stroke (rs877087) and carotid intima-media thickness (rs2229116) in two independent genome-wide association studies (GWAS) in Caucasian. We investigated the effect of these two SNPs as well as the 31.1 kilobases spanning region on atherosclerosis in Japanese population.MethodsAtherosclerotic severity was assessed by carotid artery (n = 1374) and pathological atherosclerosis index (PAI) (n = 1262), which is a macroscopic examination of the luminal surfaces of 8 systemic arteries in consecutive autopsy samples. 4 tag SNPs in the 31.1 Kb region, rs877087, rs2132207, rs658750 and rs2229116, were genotyped and haplotypes were inferred to study the association with atherosclerotic indices.Resultsrs877087 and rs2229116 were associated with PAI (OR = 2.07 [1.04-4.12] (95% CI), p = 0.038; and OR = 1.38 [1.02-1.86], p = 0.035, respectively). rs2229116 was also associated with common carotid atherosclerosis (OR = 1.45 [1.13-1.86], p = 0.003). The risk allele of rs2229116 was opposite from the original report. The haplotype block of this 31.1 Kb region was different between Caucasian and Japanese. Haplotype analysis revealed that only TAGG haplotype was associated with PAI (OR = 0.67 [0.48-0.94], p = 0.020) and atherosclerosis of common carotid artery (OR = 0.75 [0.58-0.98], p = 0.034).Conclusionrs877087 and rs2229116 of RYR3 gene are associated with atherosclerosis severity in Japanese. The functional difference caused by rs2229116 needs to be investigated.

Predictive value and relationship between intima-media thickness/carotid artery plaque score and severity of coronary artery disease

Cardiologia CROATICA Objectives: The aim of this article is to investigate the relationship between the degree of the common carotid artery (CCA) atherosclerosis and the degree of complexity of the coronary artery disease (CAD) expressed with SYNTAX score. It is known that the existence of the CCA disease indicates with high probability the existence of CAD, but few studies have examined the relationship between CCA ultrasound findings and complexity, not just the presence of CAD. Patients and Methods: We included a total of 106 consecutive patients referred to the BH Heart Center for elective coronary angiography. In order to measure and calculate the mean intima-media thickness (IMT) we performed three measurements in predefined segments of CAA for both carotid arteries, the values are converged, and divided by the number of measurements. Plaque score (PS) was measured on the basis of maximum thickness of plaque in four clearly defined segments of both CCA. The final value of PS score is obtained by adding the thickness of plaques found in all segments of CCA. The complexity of coronary artery lesions is evaluated by using the SYNTAX score. The middle and high SYNTAX scores are associated with an increased risk of cardiac death and major cardiac events. Results: Data collection and statistical analysis is in progress and preliminary results indicate that IMT values and PS score significantly correlate with SYNTAX score >18 (r=.0,64, p 27 (r=.0,79, p<0,01). It is expected that final results will show that there is a significant correlation between the degree of CCA atherosclerosis measured by two methods — IMT and PS, and the degree of complexity of coronary artery lesions. Conclusion: Preliminary results show that carotid ultrasound examination has sufficient sensitivity and specificity in the detection of patients with high risk of significant CAD and it is an argument for broader use of CCA ultrasound for the evaluation of patients who are considered for coronary angiography. Besides, we are going to improve algorithm of patients selection for coronary angiography, so, our limited material and human resources and efforts will be directed towards the treatment of patients i.e. net clinical benefit will be improved.

Factors influencing hemodynamic and morphological indicators of carotid arteries atherosclerosis in treated hypertensive patients

Objectives To evaluate factors influencing resistive index (RI) and intima-media thickness of common carotid artery (IMT-CCA) as indices of arterial atherosclerosis in hypertensive patients. Methods 56 treated hypertensive outpatients (mean age 68.9 ± 9.7 years; 31 diabetics) were examined. Fasting blood glucose, cholesterol, and HbA 1c concentration and glomerular filtration rate were measured. Systolic (SBP), diastolic blood pressure (DBP) and pulse pressure were estimated during ambulatory blood pressure monitoring. Ultrasonography of the CCA was performed with determination of IMT-CCA and RI. Results With diabetes IMT-CCA was significantly (1.025 ± 0.17 vs 0.928 ± 0.18 mm, p = 0.04) and RI not significantly (0.71 ± 0.06 vs 0.68 ± 0.08, p = 0.07) higher. A correlation between HbA 1c and RI, IMT-CCA and the age was found. After dividing the whole group into subgroups corresponding to the tertiles of HbA 1c levels, mean IMT-CCA values in I and II tertile were significantly lower than in III tertile ( p = 0.008 and p = 0.002 respectively), while RI was significantly higher in III tertile than in I tertile ( p = 0.03). On multiple regression analysis IMT-CCA was significantly influenced by the age ( β = 0.343, p = 0.04), SBP ( β = 0.430, p = 0.03) and HbA 1c ( β = 0.369, p = 0.01), while RI was influenced by SBP ( β = 0.696, p = 0.0006), DBP ( β = −0.618, p = 0.003) and HbA 1c ( β = 0.279, p = 0.04). Conclusion Patients with hypertension and diabetes mellitus had significantly increased IMT and not significantly higher RI. Concentration of HbA 1c, next to the age, SBP and DBP values was independently associated with IMT-CCA and RI – parameters determining indirectly the degree of atherosclerosis of common carotid artery.

Intima-media thickness of the common carotid arteryas an early marker of atherosclerosis in patients withabdominal obesity

Severity of atherosclerosis of common carotid arteries in patients with abdominal obesity (aged from 30 to 55 years old) was evaluated by ultrasound duplex scan. Atherosclerotic plaques of common and/or internal carotid arteries were revealed in 35% of patients. Correlations were observed between intima-media thickness of the common carotid artery, blood pressure levels, waist circumference and metabolic parameters.

Relation Between Depressive Symptoms and Common Carotid Artery Atherosclerosis in American Persons ≥65 Years of Age

Few epidemiologic studies have examined the association between depressive symptoms and atherosclerosis in subjects aged > or =65 years. Most of these studies were cross sectional and could not determine the temporality between depressive symptoms and the development of abnormal common carotid artery (CCA) intima-media thickness (CCA-IMT). To investigate the association between depressive symptoms and CCA atherosclerosis in subjects aged > or =65 years, data from 3,781 participants aged > or =65 years from the Cardiovascular Health Study were analyzed. The presence of depressive symptoms was measured by the Center for Epidemiologic Studies Depression Scale, while CCA-IMT as an indicator of CCA atherosclerosis was measured by B-mode carotid ultrasonography. Multivariate generalized estimation equations adjusted for age, gender, race, alcohol intake, blood glucose status, body mass index, and time showed that subjects aged > or =65 years with depressive symptoms had larger CCA-IMTs than those who did not have such symptoms (beta = 18.26 microm, SE 8.06, p = 0.03). Using 1,000 and 1,140 microm as cut-off points to exclude participants who had abnormal CCA-IMTs at baseline, the adjusted relative risks and the corresponding 95% confidence intervals of developing abnormal CCA-IMT over 3 years were 1.30 (95% confidence interval 1.10 to 1.44) and 1.21 (95% confidence interval 1.00 to 1.46), respectively. Similar results were obtained after excluding participants with prevalent cardiovascular disease at baseline. In conclusion, these data indicate that depressive symptoms are associated with the development of atherosclerosis in subjects aged > or =65 years.

INTIMA-MEDIA THICKENING OF COMMON CAROTID ARTERIES IS A RISK FACTOR FOR SEVERE ERECTILE DYSFUNCTION IN MEN WITH VASCULAR RISK FACTORS BUT NO CLINICAL EVIDENCE OF ATHEROSCLEROSIS

The association of erectile dysfunction (ED) with vascular damage in men without clinical atherosclerosis is unknown. By B-mode ultrasound we evaluated intima-media thickness (IMT) of common carotid arteries, a measure of vascular damage, in men reporting ED with or without vascular risk factors (VRFs) but no clinical atherosclerosis. IMT of common carotid arteries was evaluated in 270 men with ED. A total of 50 men (mean age +/- SD 39.84 +/- 12.5 years) had no VRFs, 100 (mean age 47.92 +/- 10.94 years) were overweight and/or had hyperlipidemia, and 120 (mean age 53.95 +/- 9.73 years) were affected by type 2 diabetes and/or essential arterial hypertension. IMT was significantly lower in men with no VRFs compared to men with VRFs (p <0.05), and correlated with the severity of ED evaluated through the Sexual Health Inventory for Men (p = 0.0008). Of men with VRFs 17.7% (39 of 220) showed an IMT score indicative of vascular damage (1.00 mm or greater), while only 1 man with no VRFs had a high IMT. Men with VRFs and a high carotid IMT score demonstrated more severe ED, were older and had a higher serum level of C-reactive protein compared to men with VRFs and an IMT of less than 1.00 mm (p <0.05). A high IMT score but not an increased measure for each VRF, including aging, significantly increased the risk of severe ED (odds ratio 2.6, confidence interval 1.1 to 5.9) even after controlling for smoking and drugs associated with ED. ED in men with VRFs was the only clinical correlate of unrecognized atherosclerosis of common carotid arteries.

Response: Carotid Intima-Media Thickness Measurements in Intervention Studies

Response: Carotid Intima-Media Thickness Measurements in Intervention Studies

Low insulin sensitivity measured by both quantitative insulin sensitivity check index and homeostasis model assessment method as a risk factor of increased intima-media thickness of the carotid artery.

The present study evaluated the association of ultrasonographic manifestations of carotid atherosclerosis with glucose status, various components of the insulin resistance syndrome, and insulin sensitivity measured by a novel quantitative insulin sensitivity check index (QUICKI = 1/[log(I0) + log (G0)]). Carotid ultrasonographic measurements were performed on 54 diabetic subjects, 97 subjects with impaired glucose tolerance and 57 normoglycemic subjects. QUICKI and insulin resistance measured by a HOMA (homeostasis model assessment) method had a high negative correlation (r = -0.995, P < 0.001). QUICKI was lower in diabetic subjects (0.319 +/- 0.022) than in subjects with impaired glucose tolerance (0.334 +/- 0.027) or normoglycemia (0.335 +/- 0.022, P = 0.002). There was an increasing trend in the mean and maximal intima-media thickness (IMT) of the common carotid artery (CCA) with worsening of glucose status. The maximal IMT of the CCA correlated inversely with QUICKI (r = -0.158, P = 0.027). The prevalence of severe CCA atherosclerosis (maximal IMT of the CCA > or = 1.2 mm) was 41% in men and 16% in women (P < 0.001). It was also associated with a long (> or =26 yr) smoking history. The prevalence of severe CCA atherosclerosis was 11% in the highest QUICKI tertile, 36% in the middle tertile, and 33% in the lowest tertile (P = 0.002). Systolic blood pressure was higher and high-density lipoprotein cholesterol lower in subjects with severe CCA atherosclerosis, compared with those without it. In multiple regression analysis, the adjusted odds ratio for severe CCA atherosclerosis was 5.7 (95% confidence interval, 2.2-15.1) in subjects in the two lowest tertiles of QUICKI, compared with those in the highest tertile.