Relation Of Intima-media Thickness Research Articles

INFLAMMATORY MEDIATORS ROLE IN ATHEROSCLEROTIC LESION DEVELOPMENT IN THE LARGE ARTERIES IN PATIENTS WITH SYSTEMIC SCLERODERMIA

Aim. To evaluate the prevalence of atherosclerosis, to define the type of atherosclerotic lesion of brachiocephalic arteries in patients with systemic sclerodermia (SSD); to reveal the main factors influencing that process. Material and methods. Totally 38 patients with SSD studied. We measured vessel stiffness on the area between carotid and femoral arteries; instrumental and laboratory characteristics of endothelial function, morphology of carotid arteries, lipid profile parameters, as glucose, uric acid, N-terminal brain natriuretic peptide (NT-proBNP), antinuclear autoantibodies spectrum, cytokines concentration and chemokines of serum. Results. The increase of intima-media thickness (IMT) was found in 79% (n=30/38) of the patients studied with SSD. In one of the patients there was occluded carotid artery. Different level of arterial stenosis (20- 70%) — in 52,6% (n=20/38) of patients. We also measured relation of IMT and several classic risk factors (RF) of atherosclerosis (age, glyciemia level). Among non-classical risk factors there was relation of IMT and levels of asymmetrical dimethyl arginine (ADMA), soluble adhesion endothelium molecule (sVCAM), uric acid, NT-proBNP, autoantibodies to centromeres proteines. In multiple regression analysis the most informative predictors of IMT were age, uric acid, sVCAM, granulocytic colony- stimulating factor (G-CSF) and interleucine-1 (IL-1). Conclusion. In SSD patients atherosclerosis develops partially through non-classic factors influence, primarily inflammatory mediators and common for SSD metabolic disruptions (uricemia). This can point on the specific interrelation of pathogenetic mechanisms of arterial wall involvement in SSD, and might require repeated assessment of IMT in SSD, using larger patients selection and additional investigation methods.

The relation of intima-media thickness with endothelial function and left ventricular mass index

We aimed to investigate the relation of brachial artery intima-media thickness (IMT) with endothelial function and left ventricular mass (LVM). Fifty-four stage I-II hypertensive patients according to JNC VII who were not taking any medication and 27 age and sex-matched healthy controls were included to this cross-sectional observational study. IMT was measured by the same radiologist who was unaware of the patient's clinical status by using high resolution ultrasound machine. Endothelial function was evaluated by flow mediated dilation (endothelium-dependent vasodilatation, FMD). LVM was calculated by using Devereux method. LVM index (LVMI) was obtained by dividing LVM to body surface area. Mann-Whitney U test was used to compare continuous variables, qualitative variables were compared by Chi-square test and the relations of parameters were evaluated by multiple linear regression analysis. Both groups (hypertensive and control) were similar with respect to age, sex, left ventricular ejection fraction. IMT was significantly higher in hypertensive group (0.43+/-0.09 vs 0.33+/-0.06 mm; p<0.001). FMD values were also significantly different between hypertensive and control groups (4+/-4% vs 13+/-12%; p<0.001). LVMI was significantly different between hypertensive and control groups LVMI (124 +/- 5 vs 99+/-6 gr/m2, p=0.002). The correlation between IMT and FMD (r=0.260; p=0.026) and IMT and LVMI (r =0.348; p=0.004) were statistically significant. A correlation was found between IMT and LVMI independently of other variables (beta=105; p=0.004) when LVMI was accepted as dependent variable in multivariate linear regression analysis (R2=0.570, p<0.001). According to this finding, the 105 units increase in LVMI occurs when IMT increases by 1 mm. Brachial artery IMT is related to endothelial function and LVM. According to these data, any negative changes of the IMT may reflect the similar negative changes in other parameters.

Optimizing assessment of carotid and femoral intima–media thickness in essential hypertension

Large artery intima–media thickness (IMT) is considered an integrated marker for the total individual burden of arteriosclerosis, and a graded index for cardiovascular risk. However, several different aggregate indexes of IMT on B-mode ultrasound have been used by various investigators, and the optimal number of IMT readings is currently unsettled. In 128 newly diagnosed, never treated, uncomplicated hypertensive subjects aged <55 years (43 ± 9 years, blood pressure [BP] 152/99 mm Hg), we measured left ventricular mass (M-mode echocardiography, average of five or more measurements) and IMT of common carotid and common femoral arteries. For each segment, 12 IMT measurements were performed, and the average of 1 and 3 readings (right far wall), 6 readings (right side), and 12 readings (right and left side, far and near wall, 3 sampling points) was analyzed. The relation of IMT with left ventricular mass increased progressively with increasing number of readings, from 0.35 (1 reading) to 0.51 (12 readings) for common carotid artery, and from 0.31 to 0.56 for common femoral artery (both P <.001). For each 0.2-mm increase in common femoral IMT, the age-adjusted relative risk of having left ventricular hypertrophy was 1.31 for 1 reading, and increased up to 3.59 for the average of 12 readings. In summary, the association of IMT with left ventricular mass depends strongly on the number of IMT readings. The average of several readings in each segment, including right and left side and far and near wall, carries the closest association to left ventricular mass, and should be preferred for clinical purposes in hypertensive subjects.