Mean Intima-media Thickness Research Articles

Vascular Health in Kawasaki Disease

The objective of our study was to compare the indices of vascular health in Kawasaki disease (KD) patients to those of control subjects. The literature on peripheral vascular health after KD is conflicting. Subjects were patients 11 to 29 years of age with the onset of KD >12 months before the study visit (n= 203) andhealthy control subjects (n= 50). We measured endothelial function (using the Endothelial Pulse Amplitude Testing index), intima-media thickness (IMT) of the right common carotid artery (RCCA) and the left common carotidartery (LCCA), and fasting lipid profile and C-reactive protein (CRP). KD patients were classified according totheir worst-ever coronary artery (CA) status: group I, always normal CAs (n= 136, 67%); group II, CA z-scores≥2 but<3 (n= 20, 10%); group III, CA aneurysm z-scores≥3 but<8 mm (n= 40, 20%); and group IV, giant CAaneurysm, defined as≥8 mm (n= 7, 3%). At a median of 11.6 years (range, 1.2 to 26 years) after KD onset, compared with controls, KD patients had a higher peak velocity in the LCCA (p= 0.04) and higher pulsatility index of both the RCCA and LCCA (p= 0.006 and p= 0.05, respectively). However, there were no differences in the Endo-PAT index or carotid IMT or stiffness. Themean IMT of the LCCA tended to differ across the KD subgroups and control group (p= 0.05), with a higher mean in group IV. Otherwise the KD subgroups and control group had similar vascular health indexes. In contrast to some earlier reports, our study of North American children and young adults demonstrated that KDpatients whose maximum CA dimensions were either always normal or mildly ectatic have normal vascular health indexes, providing reassurance regarding peripheral vascular health in this population.

Carotid plaque score and intima media thickness as predictors of stroke and mortality in hypertensive patients

The mean intima media thickness (IMT) and plaque score from carotid ultrasonography are both widely used to evaluate macrovascular atherosclerotic change. The present study sought to examine which parameter more effectively predicts patient prognosis. This hospital-based cohort study included 356 patients with essential hypertension (mean age: 62.4 ± 0.6). We investigated how the mean IMT and plaque score correlated with various parameters, including pulse wave velocity (PWV), and we assessed the ability of the mean IMT and plaque score to predict cardiovascular events and total mortality. The mean IMT and plaque score significantly correlated with systemic atherosclerotic change, target organ damage, age and PWV. Subjects with a higher mean IMT and subjects with higher plaque scores showed higher frequencies of stroke and total mortality. In addition, subjects with marginal thickening of the intima media (mean ≥ 0.7) showed a significantly higher frequency of stroke than subjects with a mean IMT of <0.7. After adjustment for traditional risk factors, plaque score was significantly and independently predictive of stroke, and the predictive ability of the plaque score for the onset of stroke was equivalent to that of PWV. The mean IMT and plaque score showed a nonsignificant trend of higher risk of mortality after adjustment for traditional risk factors. The mean IMT and plaque score were significantly correlated with systemic atherosclerotic change. We revealed that plaque score predicted the onset of stroke more accurately than the mean IMT, and the accuracy of this prediction was equivalent to that from PWV in hypertensive patients. We also showed that marginal thickening of the intima media (as measured by mean IMT) may be a predictor of stroke.

AB0393 Increased in serum soluble receptor for advanced glycation end products levels are associated with improvement in augmentation index in patients with early rheumatoid arthritis- a prospective observational study

BackgroundReceptor for advanced glycation end products (RAGE) is a member of the immunoglobulin super family of cell surface molecules that is expressed in a variety of cell lines. The interaction...

SAT0360 Low bone mass is associated with carotid intima-media thickness and atherosclerotic plaque in postmenopausal women referred for osteoporosis screening

BackgroundLow bone mineral density (BMD) has been associated with cardiovascular diseases (CVD) and markers of subclinical atherosclerosis, suggesting a shared pathophysiology.ObjectivesThe objective of this study was to evaluate the relationships...

AB0811 Atherosclerosis assessment in systemic sclerosis patients without cardiovascular risk factors

BackgroundAtherosclerosis is an inflammatory disease with increased prevalence in connective tissue disorders, including systemic sclerosis (SSc), that might contribute to the excess mortality present in this disease. Recent studies have...

THU0250 Cardiovascular risk assessment in systemic sclerosis using the score chart and reclassification by presence of plaques on ultrasonography

BackgroundIncreased cardiovascular (CV) risk and atherosclerosis have been described in patients with rheumatic diseases including systemic sclerosis (SSc). Besides traditional CV risk factors, endothelial dysfunction, and disease-specific factors, such as...

THU0175 T cell reactivity to β2 glycoprotein I in systemic lupus erythematosus and anti-phospholipid syndrome: Correlation with subclinical atherosclerosis

BackgroundSystemic lupus erythematosus (SLE) and anti-phospholipid syndrome (APS) patients present a high prevalence of atherosclerosis associated with both traditional and disease-related risk factors. β2 glycoprotein I (β2GPI), the main antigen...

FRI0412 The effects of golimumab on the progression of subclinical atherosclerosis and arterial stiffness in patients with ankylosing spondylitis – a randomized, placebo- controlled trial

BackgroundData from observational studies showed that the effects of long-term anti-TNF-α therapy on arterial stiffness and intima-media thickness (IMT) progression in patients with ankylosing spondylitis (AS) were inconsistent.ObjectivesTo ascertain the...

THU0341 Expansion of CD4+CXCR3+ T Cells in Patients with Systemic Lupus Erythematosus (SLE) Correlates with Subclinical Atherosclerosis

BackgroundThe mechanisms for accelerated atherosclerosis in SLE remain unclear (1). As atherosclerosis is itself immune-mediated, features of SLE-associated immunity might explain accelerated cardiovascular disease beyond traditional cardiovascular risk factors.ObjectivesWe hypothesized...

FRI0378 Interleukin 6 and vascular disease in patients with systemic sclerosis

BackgroundInterleukin 6 (IL6) has been associated with modified Rodnan Skin Score (mRSS), interstitial lung disease (ILD), anti-Scl70 and anti-RNA polymerase III antibodies, as well as with ischemic digital ulcers (IDU)...

Grosor íntima media carotídeo y asociación con factores de riesgo cardiovascular tradicionales y metabólicos

Carotid intima-media thickness (IMT) is a surrogate marker of subclinical atherosclerosis and is associated with cardiovascular risk factors (CVRF) AIM: To analyze the association of CVRF and metabolic factors (MF) with IMT, and if the clustering of these factors modify IMT. Cross sectional study in 187 participants aged 46±10 years (53% male) without CV disease. Weight, height, waist circumference (WC), blood pressure, fasting plasma glucose and lipid profile were measured. Abdominal obesity (AOb) was defined by ATP III criteria. Mean carotid IMT was measured at the far wall of the common carotid artery. The cutoff point for an abnormally high IMT was set at the 75th IMT percentile of the sample. The 75th IMT percentile of the sample was 0.67 mm. In a multivariate analysis four factors were significantly related with a high IMT: age (odds ratio (OR): 5.3, confidence intervals (CI): 2.2-12.9), dyslipidemia (OR: 6.4 CI: 2.3-17.9), systolic blood pressure (OR: 2.9, CI: 1.2-7.1) and AOb (OR: 2.9 (IC: 1.1-7.2). The presence of Oto 4 of these factors was associated with an IMT increment from 0.54 to 0.71 mm (p < 0,001). In this sample dyslipidemia, systolic blood pressure and abdominal obesity were the main predictors of a high IMT.

AB0401 Carotid intimae-media thickness in mexican patients with systemic erythematosus lupus.

BackgroundThe carotid intima-media thickness (CIMT) nowadays is an early marker of atherosclerosis. A CIMT above 75th percentile of a reference population is considered abnormal, and indicates sub clinical atherosclerosis. In...

FRI0108 Serum osteoprotegerin levels, aortic stiffness and carotid intima-media thickness as cardiovascular risk factors in patients with rheumatoid arthritis

BackgroundOsteoprotegerin (OPG) is implicated in the pathogenesis of atherosclerosis. Recent studies have shown that arterial stiffness, carotid intima-media thickness (CIMT) and OPG are independent risk factors of cardiovascular (CV) disease....

Myocardial perfusion and intima-media thickness in patients with subclinical hypothyroidism

The data concerning the relation between subclinical hypothyroidism (SH) and the risk of cardiovascular disease are divergent. We aimed to assess myocardial perfusion in contrast-enhanced echocardiography and intima-media thickness (IMT) in patients with SH. Forty females with SH without symptoms of coronary artery disease and 15 healthy female volunteers were examined. Echocardiographic evaluation of the left ventricle function as well as carotid and femoral IMT complex measurements were performed at baseline. Thereafter, dobutamine stress echocardiography with myocardial perfusion assessment at rest and on the peak of stress test was performed. SonoVue® intravenous bolus as a contrast medium was used. The myocardial perfusion was assessed by quantitative method using Q-LAB Philips software (ROI modality). The perfusion index was calculated (a number of left ventricle segments with improved perfusion/a number of all segments). A mean IMT value in the SH group was significantly higher than in the controls (0.7 mm vs. 0.38 mm, p=0.001). Myocardial perfusion at rest and at the peak of stress test was significantly lower in the SH patients as compared to the controls (at rest 120 Db in SH vs. 181 Db in controls, p=0.039 and at the peak of stress 115 Db and 188 Db, p=0.01, respectively). The perfusion index was not significantly worse in the SH group (p=0.6). IMT values negatively correlated with the myocardial perfusion index at the peak of stress (r=-0.54, p=0.014). In patients with SH contrast-enhanced echocardiographic examination revealed myocardial hypoperfusion and increased IMT. Our results may suggest that the patients with SH are at risk of the development of cardiovascular disease.

White-Coat and Masked Hypertension Are Associated With Carotid Atherosclerosis in a General Population

On the basis of combined measurements of clinic blood pressure (CBP) and home blood pressure (HBP), blood pressure status can be divided into normotension, white-coat hypertension (WCHT), masked hypertension (MHT), and sustained hypertension (SHT). Despite the clear impact of MHT and SHT on clinical and subclinical arterial disease, uncertainty about the influence of WCHT remains. The objective of this study was to investigate the associations of WCHT, MHT, and SHT with carotid atherosclerosis in a general population. This is a cross-sectional survey of 2915 community-dwelling Japanese aged ≥ 40 years. Normotension was defined as CBP<140/90 and HBP<135/85 mm Hg; WCHT, CBP ≥ 140/90 and HBP<135/85 mm Hg; MHT, CBP<140/90 and HBP ≥ 135/85 mm Hg; and SHT, CBP ≥ 140/90 and HBP ≥ 135/85 mm Hg. Mean intima-media thickness of carotid arteries was measured using a computer-automated system, and carotid stenosis was defined as diameter stenosis ≥ 30%. There were 1374 subjects (47.1%) with normotension, 200 (6.9%) with WCHT, 639 (21.9%) with MHT, and 702 (24.1%) with SHT. The geometric average of mean intima-media thickness was significantly higher among subjects with WCHT (0.73 mm), MHT (0.77 mm), and SHT (0.77 mm) than those with normotension (0.67 mm; all P<0.001 versus normotension). Compared with normotension, all types of hypertension were also associated with increased likelihood of carotid stenosis (age- and sex-adjusted odds ratio, 2.36 [95% confidence interval, 1.27-4.37] for WCHT, 1.95 [1.25-3.03] for MHT, and 3.02 [2.01-4.54] for SHT). These associations remained significant even after adjustment for other cardiovascular risk factors. WCHT, as well as MHT, and SHT were associated with carotid atherosclerosis in a general Japanese population.

Abstract 247: Association of Soluble RAGE Levels with Carotid Atherosclerosis: The Northern Manhattan Study (NOMAS)

Introduction The Receptor for Advanced Glycation End-products (RAGE) is a multi-ligand receptor that propagates vascular cell dysfunction leading to proinflammatory disease states. RAGE is produced as a membrane bound and soluble isoform (soluble RAGE (sRAGE)), with the soluble isoform demonstrated to act as a RAGE decoy preventing cellular activation and atherosclerosis. Recent cohort studies have suggested that serum levels of sRAGE are associated with the risk of CVD and therefore may be a novel biomarker for cardiovascular disease states. Hypothesis We hypothesized that sRAGE levels are associated with subclinical atherosclerosis in an ethnically diverse population. Methods We included 1,102 stroke-free participants from the multi-ethnic Northern Manhattan Study (NOMAS) who underwent high-resolution carotid B-mode ultrasound to measure carotid plaque phenotypes (density, thickness, and area) and carotid intima-media thickness (IMT). Plaque density was characterized by Gray Scale Median (GSM). Serum sRAGE was measured by ELISA and log-transformed to stabilize variance. Multiple linear and logistic regressions were employed to estimate sRAGE associations with IMT and plaque measures. Results The mean age at time of ultrasound was 70.7±8.6yrs; 65% were Hispanic, 19% black, and 16% white. The majority of subjects had carotid plaque present (54%) with the median GSM 38(0-190). Mean plaque thickness (IQR) was 1.30(0-3.99)mm and mean area (IQR) 2.43(0-96.75)mm2. Mean IMT was 0.93±0.09mm. High sRAGE levels were associated with more echolucent plaques (OR 1.2, 95% CI 1.03-1.42), especially among Hispanics (OR 1.26, 95% CI 1.04-1.54). These relationships remained after adjusting for sociodemographic and vascular risk factors. No association was seen between sRAGE levels and carotid IMT, plaque thickness or area. Conclusion In the present study, higher sRAGE levels were associated with echolucent (lower density) plaque, especially among Hispanic subjects. Our data suggest sRAGE levels may be associated with atherosclerotic plaque morphology and its vulnerability, especially among minority groups. These findings further support RAGE as a novel target for anti-atherosclerosis interventions.

Abstract 37: Association between High-Density Lipoprotein Cholesterol Subfractions and Carotid Intima-Media Thickness

Background Recent trials have challenged the protective effect of HDL in atherosclerosis, implicating the need to shift the focus from total HDL concentration to its function and major subfractions. The objective of this cross-sectional study was to investigate the relation between HDL2 and HDL3 subfractions and carotid intima-media thickness (IMT), an early indicator of atherosclerosis and surrogate marker of ischemic stroke. Methods In NOMAS, a prospective population-based study of the incidence and risk factors of stroke, we evaluated 1041 participants (mean age 68±9 years; 38% men; 62% Hispanic, 19% black, 17% white) with available data on HDL subfractions and carotid IMT assessed by a high-resolution 2D carotid ultrasound. Carotid IMT was a composite measure of the mean IMT in all carotid artery segments. The cross-sectional association between HDL-subfractions and IMT was analyzed by multiple linear regression. Results We mean±SD of total HDL was 46.15±14.25 mg/dl (median = 44.00), HDL2 14.59±8.29 mg/dl (median = 13.00), HDL3 31.06±8.32 mg/dl (median = 32.00). The mean IMT was 0.90±0.08 mm. After controlling for demographics, LDL, triglycerides, and cholesterol-lowering medication, a strong association was observed between total HDL (per SD, beta=-0.008, p= 0.01), HDL2 (per SD, beta=-0.006, p=0.03) and HDL3 (per SD, beta=-0.007 p=0.01) in relation to IMT. A significant interaction was observed between diabetes (vs. non-diabetes) and HDL2 in relation to IMT (p=0.01; -0.018mm). Conclusion The observed strong independent inverse associations between HDL, HDL2 and HDL3 and carotid IMT. HDL2 was only significantly associated with IMT among individuals with diabetes. These observations show novel evidence for a potential role of HDL2 and HDL3 subfractions, providing the opportunity to develop novel HDL-targeted therapies for the prevention of atherosclerosis.

Inflammation Markers Correlate With Common Carotid Intima-Media Thickness in Patients Perinatally Infected With Human Immunodeficiency Virus 1

Objectives To investigate common carotid intima-media thickness in a cohort of patients who were vertically infected with human immunodeficiency virus 1 (HIV-1). Methods We conducted a cross-sectional observational study. Human immunodeficiency virus 1–infected patients were compared with age-, sex-, and body mass index-matched healthy participants. Common carotid intima-media thickness was measured in all participants on both sides of the neck, and the mean intima-media thickness was calculated. Metabolic parameters and markers of inflammation were measured only in HIV-1–infected patients. Statistical analysis was performed by multiple regression and by a matrix of Pearson correlation coefficients. The Student t test was used to compare mean common carotid intima-media thickness values between groups. Results Forty patients (21 female) with HIV-1 infection acquired from birth with a mean age ± SD of 16.3 ± 4.7 years and 27 healthy participants (11 female) with a mean age of 17.7 ± 4.6 years were included in the study. Mean common carotid intima-media thickness in the HIV-1–infected group (0.450 ± 0.088 mm) was significantly higher (P < .05) than in the control group (0.407 ± 0.079 mm). No significant association was found between intima-media thickness and a specific antiretroviral regimen, exposure to combined antiretroviral agents, and HIV status. In multiple regression analyses, higher levels of insulin (P= .007) and elevated levels of glycated hemoglobin (P= .01) were associated with intima-media thickness changes. Conclusions Patients perinatally infected with HIV have increased common carotid intima-media thickness compared with healthy individuals. These changes were more pronounced with increasing age and inflammation markers. Interventions that improve cardiovascular risk profiles should be considered in HIV-infected young adults.

Inflammation Markers Correlate With Common Carotid Intima-Media Thickness in Patients Perinatally Infected With Human Immunodeficiency Virus 1

To investigate common carotid intima-media thickness in a cohort of patients who were vertically infected with human immunodeficiency virus 1 (HIV-1). We conducted a cross-sectional observational study. Human immunodeficiency virus 1-infected patients were compared with age-, sex-, and body mass index-matched healthy participants. Common carotid intima-media thickness was measured in all participants on both sides of the neck, and the mean intima-media thickness was calculated. Metabolic parameters and markers of inflammation were measured only in HIV-1-infected patients. Statistical analysis was performed by multiple regression and by a matrix of Pearson correlation coefficients. The Student t test was used to compare mean common carotid intima-media thickness values between groups. Forty patients (21 female) with HIV-1 infection acquired from birth with a mean age ± SD of 16.3 ± 4.7 years and 27 healthy participants (11 female) with a mean age of 17.7 ± 4.6 years were included in the study. Mean common carotid intima-media thickness in the HIV-1-infected group (0.450 ± 0.088 mm) was significantly higher (P < .05) than in the control group (0.407 ± 0.079 mm). No significant association was found between intima-media thickness and a specific antiretroviral regimen, exposure to combined antiretroviral agents, and HIV status. In multiple regression analyses, higher levels of insulin (P= .007) and elevated levels of glycated hemoglobin (P= .01) were associated with intima-media thickness changes. Patients perinatally infected with HIV have increased common carotid intima-media thickness compared with healthy individuals. These changes were more pronounced with increasing age and inflammation markers. Interventions that improve cardiovascular risk profiles should be considered in HIV-infected young adults.

Carotid intima-media thickness in spondyloarthritis patients.

Accelerated atherosclerosis has become a major problem in rheumatic inflammatory disease. The aim here was to analyze carotid intima-media thickness (IMT) in spondyloarthritis (SpA) patients and correlate this with clinical parameters and inflammatory markers. Cross-sectional analytical study at Rheumatology Outpatient Clinic, Evangelical University Hospital, Curitiba. IMTs (measured using Doppler ultrasonography) of 36 SpA patients were compared with controls. The IMT in SpA patients was associated with inflammatory markers, like erythrocyte sedimentation rate (ESR), C-reactive protein (CRP) and Bath Ankylosing Spondylitis Disease Activity Index (BASDAI); and with clinical parameters, like axial or peripheral involvement, dactylitis, HLA B27, uveitis occurrence, Bath Ankylosing Spondylitis Functional Index (BASFI) and lipid profile. The mean IMT in SpA patients was 0.72 ± 0.21 mm; in controls, 0.57 ± 0.13 mm (P = 0.0007). There were no associations with ESR, CRP, BASDAI or clinical data. In univariate analysis, greater IMT was seen in patients with longer disease duration (P = 0.014; Pearson R = 0.40; 95% confidence interval, CI = 0.06 to 0.65); higher triglycerides (P = 0.02; Spearman R = 0.37; 95% CI = 0.03 to 0.64); and older age (P = 0.0014; Pearson R 0.51; 95% CI = 0.21 to 0.72). SpA patients have a higher degree of subclinical atherosclerosis than in controls, thus supporting clinical evidence of increased cardiovascular risk in rheumatic patients.