Significant Difference In Intima-media Thickness Research Articles

Early Atherosclerosis in Familial Hypercholesterolemia Patients: Significance of Vascular Markers for Risk Stratification.

Familial hypercholesterolemia (FH) is a genetic disorder that manifests as impaired low-density lipoprotein cholesterol (LDL-C) metabolism, resulting in lifelong exposure to high cholesterol levels and increased risk of cardiovascular disease (CVD). There is heterogeneity in cardiovascular risk for FH patients, so risk stratification is of utmost importance. The aim of this study was to evaluate the impact of increases in LDL-C and the impact of other CVD risk factors on vascular markers in the FH patient population. A total of 428 patients were included in this study and divided into two groups according to age: ≤40 years in the first group and ≥41 years in the second group. Vascular markers of atherosclerosis included the common carotid artery (CCA) intima-media thickness (IMT), pulse wave velocity (PWV), flow-mediated dilation (FMD), ankle-brachial index (ABI), and cardio-vascular index (CAVI). The influence of traditional CVD risk factors on atherosclerotic changes in vascular markers was analyzed. A statistically significant difference in IMT was detected between the same sex and different age groups (p < 0.001), whereas no significant difference was detected between the sexes within each age group. In the ≤40-year-old group, the mean IMT among males was 612.5 μm (±88.2) and that among females was 580.6 μm (±77.7) (p > 0.05); in the ≥41-year-old group, the mean IMT was 697.4 μm (±138.4) for males and 700.3 μm (±114.4) for females (p > 0.05). Higher LDL-C was associated with greater IMT (r = 0.405; p = 0.009) in the younger age group (≤40 years); however, in the older age group (≥41 years), this correlation was not evident (r = -0.07; p = 0.596). Carotid plaque formation was more common among males (OR = 2.2; 95% CI: 1.2-4.0) and hypertensive patients (OR = 2.7; 95% CI: 1.6-4.7). Age was a mildly significant risk factor for increased ABI (β = 0.13, p < 0.05). FMD was found to be impaired for all patients, and no risk factors were shown to have further influence. Age was a significant risk factor for increased arterial stiffness, as measured by both the CAVI and PWV. Although vascular markers of atherosclerosis may provide a unique and valuable way to evaluate cardiovascular risk, the results of this study show that only increased IM thickness could be beneficial for risk stratification in young FH patients, whereas other vascular markers of atherosclerosis would be excessive, as they do not provide merit in risk evaluation in this population.

Effects of Smoking on Intima-Media Thickness of the Common Carotid Artery Using Ultrasonography

BackgroundCigarette smoking is a causative factor in premature atherosclerosis, but the exact mechanism of smoking-induced damage to the arterial wall and its relationship to the atherosclerotic process are still largely unknown. Carotid ultrasound may help target treatment. The aim of this study was to measure carotid intima-media thickness (IMT) and carotid Doppler parameters in Sudanese smokers compared to non-smokers using ultrasound.MethodsThis was a retrospective, case–control, community-based study conducted between June 2021 and September 2021. The study was conducted on 100 Sudanese subjects (50 smokers as the case group and 50 non-smokers as the control group). The practical part was conducted in Khartoum State at Al Raqi University Hospital using the E-CUBE 8-ALPINION and at Yastbshroon Hospital using the Fukuda Denshi Sefius UF890AG with a high-frequency linear transducer (7–10 MHz). Scanning was performed in the supine position with the neck extended. Pulsed-wave (PW) Doppler spectral and IMT measurements were obtained.ResultsThe mean age was 29.8 ± 4.5 years (range 24–40 years), and the mean IMT in smokers was 0.6 ± 0.06 mm, which was greater than the mean in non-smokers (0.462 ± 0.09 mm) (p = 0.000). Peak systolic velocity (PSV) was increased in smokers (40.0 ± 5.67 cm/s) compared to non-smokers (26.5 ± 5.6 cm/s) (p = 0.000), and end-diastolic velocity (EDV) was decreased in smokers (6.0 ± 1.2 cm/s) compared to non-smokers (9.8 ± 2.2 cm/s) (p = 0.000). In addition, the resistive index (RI) and the systolic-diastolic ratio (S/D) were not significantly different between smokers and non-smokers. The study showed that there was a significant positive correlation between IMT and the number of cigarettes per day in chronic smokers (p < 0.05), whereas peak systolic velocity (PSV) and end-diastolic velocity (EDV) were not affected in chronic smokers.ConclusionsThere was a statistically insignificant difference between the case (smokers) and control (non-smokers) groups in terms of age, body mass index (BMI), resistance index (RI), and systolic–diastolic ratio (S/D). While there were statistically significant differences in intima-media thickness (IMT), peak systolic velocity (PSV), and end-diastolic velocity (EDV), regular follow-up of individuals with a history of smoking is recommended to detect carotid intimal changes earlier.

Evaluate the elasticity of carotid artery in the type 2 diabetes mellitus patients with nonalcoholic fatty liver disease by two-dimensional strain imaging.

To evaluate carotid elasticity by using two-dimensional strain imaging (2DSI) in type 2 diabetes mellitus (T2DM) patients with nonalcoholic fatty liver disease (NAFLD). 98 patients with T2DM diagnosed in our hospital were selected. All the patients were without carotid plaque, which were proved by carotid ultrasonography. According to the fatty liver classification standard, patients were divided into three groups. There were 35 cases without NAFLD in group A, 33 cases with mild NAFLD in group B and 30 cases with moderate to severe NAFLD in group C. By using two-dimensional and M-mode ultrasound to measure the left carotid intima-media thickness (IMT), common carotid arterial systolic diameter (Ds) and diastolic diameter (Dd). The systolic peak velocity was measured by spectral Doppler ultrasound. The systolic global peak circumferential strain (CS), early and late systolic global circumferential strain rate (CSr) were measured by 2DSI. The stiffness parameters β1 and β2 were calculated by M-mode ultrasound and 2DSI separately. Among three groups, the Ds, Dd and systolic peak velocity showed no significant difference (all P > .05). In group C, IMT and β1 were obviously increased than those of groups A and B (all P < .05). Compared groups A and B, there were no significant difference in IMT and β1 (all P > .05). β2 was higher in groups B and C than those in group A, CS, CSr were lower in groups B and C than those in group A (both P > .05). The carotid elasticity of T2DM patients with NAFLD can be evaluated by 2DSI.

Vascular Calcification in Chronic Kidney Disease PatientsA Cross-sectional Study

Introduction: Vascular Calcification (VC) is considered as a cardiovascular risk marker in Chronic Kidney Disease (CKD) patients. VC is a process characterised by thickening and loss of elasticity of muscular arteries walls. The three pathological forms of cardiovascular disease in CKD are cardiac geometry, atherosclerosis and arteriosclerosis of the large vessels (carotid artery or aorta). Aim: To evaluate VC as a cardiovascular risk marker in CKD patients. Materials and Methods: This cross-sectional study was conducted in the Nephrology Department at Sri Ramachandra Medical College and Research Institute, Chennai, Tamil Nadu, India, from November 2019 to December 2020. The study included 27 CKD patients who were on maintenance haemodialysis. The participants were 20 to 70 years of age, and of both genders. The Intima Media Thickness (IMT) was assessed by ultrasonography. Peak Systolic Velocity (PSV) measurement was done using doppler ultrasonography. Both the measurements were done on common Carotid Artery (CCA), and Internal Carotid Artery (ICA) on both sides of the neck. Student’s t-test and Chi-square test was used in this study. Data were expressed as mean±SD. The p-value &lt;0.05 was considered as statistically significant. Results: Out of 27 study participants, 20 (74%) were male and females were 7 (26%), with mean age of 48 years. There was significant increase in IMT of the ICA on the right side of the neck compared to left side (p-value=0.01). Also, there was significant increase in PSV of ICA on the right side compared to left side of the neck (p-value=0.04). There were no statistically significant differences in IMT and PSV when CCA on the right side was compared to that of the left side of the neck. Conclusion: The IMT was increased in ICA and CCA. But there was statistically significant difference only in ICA, where it was more prominent on the right side compared to left side. CKD patients on haemodialysis management could have the risk factors in the form of increased IMT predisposing them to early mortality from cardiovascular complications.

Extent of atherosclerosis after 11-year prospective follow-up in patients with early rheumatoid arthritis was affected by disease severity at diagnosis

Objective: Cardiovascular disease (CVD) is increased among patients with rheumatoid arthritis (RA). The underlying cause is not clear. In this prospective study, patients with early RA were investigated for associations between subclinical atherosclerosis and CVD risk factors as well as inflammation. Method: At diagnosis, RA patients were recruited into a prospective study. A subgroup was included (n = 55) for ultrasound measurements of intima–media thickness (IMT) at inclusion (T0), and after 5 years (T5) and 11 years (T11). Thirty-one age and gender-matched controls were also included for comparison. Results: IMT increased significantly between T0 and T11 among patients and controls (p < 0.0001). No statistically significant differences in IMT between patients and controls were detected at T11, T5, or T0 (p > 0.05 for all). In simple regression models, IMT at T11 was significantly associated with age (p < 0.0001), as well as systolic blood pressure at T0 (p < 0.01) and T11 (p < 0.01) among RA patients. Furthermore, the composite Systematic COronary Risk Evaluation (SCORE) measurements (p < 0.0001) and Reynolds risk score (p < 0.01) and the radiographic Larsen score (p < 0.05) at T0 were all significantly associated with IMT at T11. Results from conditional logistic regression analysis showed an increased progression rate between T0 and T11 in the RA group compared with controls (p < 0.05). Conclusion: We found increased atherosclerotic development among patients with RA compared with controls 11 years after diagnosis. The atherosclerotic burden was associated with disease severity at baseline.

Presarcopenia Is an Independent Risk Factor for Carotid Atherosclerosis in Chinese Population with Metabolic Syndrome.

PurposeTo investigate the impacts of skeletal muscle mass on carotid atherosclerosis in Chinese adults with metabolic syndrome (MetS).MethodsOne hundred and ninety-five subjects with MetS had the waist-to-height ratio (WHTR)≥0.5 for all. One hundred and eighty-four subjects without MetS were divided into 2 groups: Non-Mets obese group (WHTR ≥ 0.5, n = 118) and Non-MetS control group (WHTR < 0.5, n = 66). All the groups had no difference in age. Appendicular skeletal muscle mass was acquired and skeletal muscle mass index (SMI) was calculated. Carotid intima-media thickness (IMT) was assessed by ultrasonography. Each group was stratified according to the presence or absence of presarcopenia.ResultsWhile most parameters showed an increasing trend with WHTR and MetS in both genders, SMI and HDL-C showed a decreasing trend. The prevalence of carotid atherosclerosis showed the same increasing trend. Multivariate logistic regression analyses showed SBP and presarcopenia were both independent risk factors for carotid atherosclerosis in MetS (OR 1.026, P < 0.001; OR 2.788, P = 0.001, respectively). There was no significant difference in IMT among the three groups with preserved muscle mass whether the participants suffered from obesity or MetS, while there was a significant difference between the two groups with presarcopenia (in male P = 0.020, in female P = 0.009, respectively). The area under the ROC curve (AUC) was 0.641 (P<0.001) for presarcopenia.ConclusionObesity was a risk factor for sarcopenia independent of age, especially in subjects with metabolic syndrome. In individuals with MetS, our findings suggest that presarcopenia may be an independent risk factor for atherosclerosis and appendicular skeletal muscle mass had potential protective effects for carotid atherosclerosis regardless of gender.

Ultrasonic assessment of carotid intima-media thickness in migraine: a meta-analysis.

ObjectiveMigraine is believed to be a risk factor for cerebrovascular diseases, and previous studies have indicated an association between migraine and cerebral atherosclerosis. Carotid artery intima-media thickness (IMT) is considered to be a biomarker of atherosclerosis pathology. This study aimed to investigate the relationship between carotid IMT and migraine by conducting a meta-analysis.MethodsWe searched Web of Science, PubMed, and the Cochrane Library for eligible studies assessing carotid IMT in patients with migraine and controls. Data were extracted independently by two reviewers and analyzed using Review Manager 5.3 software.ResultsThe meta-analysis included seven articles with 555 subjects (279 migraine patients, 276 controls). Carotid IMT was significantly greater in patients with migraine compared with controls. However, there were no significant differences in IMT between patients with migraine with aura (MA) and controls, migraine without aura (MO) and controls, and patients with MA and MO.ConclusionPatients with migraine have greater carotid IMT than individuals without migraine, suggesting an association between atherosclerosis and migraine. However, further studies with more samples are needed to confirm this finding.

Matrix Metalloproteinase-1 Gene Polymorphism Associated with Ultrasound-Assessed Carotid Thickness among Older Adults.

Background and Aim Due to the high incidence of vascular diseases, it is necessary to identify new circulating or structural markers for predicting risk for chronic diseases. Some studies suggest that MMP1 gene polymorphisms are associated with the enzyme expression levels in situ (e.g., in atherosclerotic plaques). Objectives Thus, the study of this polymorphism may help understanding the pathophysiology of coronary disease. Methods We performed cross-sectional clinical and laboratory evaluations (including measurement of intima-media thickness of carotid arteries) and genotyping of the MMP1 SNP rs495366 (A/G) in 366 elderly people. Results No significant differences between genotypes were noted for biochemical, metabolic, inflammatory, or clinical variables except for a significant difference in intima-media thickness for the left carotid artery and a trend toward significance for the right counterpart. Conclusion Carriers of the allele associated with lower MMP1 expression (allele A) presented greater carotid thickness. We suggest that the phenomenon can be explained by impaired remodeling of the arterial wall (poor degradation of collagen fibers in this scenario), yielding carotid wall thickening and a greater intrinsic risk for cerebrovascular events.

Sitagliptin on carotid intima-media thickness in type 2 diabetes patients receiving primary or secondary prevention of cardiovascular disease: A subgroup analysis of the PROLOGUE study

BackgroundWhether a dipeptidyl peptidase-4 (DPP-4) inhibitor can attenuate atherosclerosis is still controversial. Some clinical trials reported that DPP-4 inhibitors in diabetes patients without a previous history of cardiovascular (CV) events could reduce carotid intima-media thickness (IMT). However, in the PROLOGUE study, which enrolled diabetes patients both with and without previous CV events, sitagliptin failed to slow the progression of carotid IMT relative to conventional therapy. Aim and methodsWe hypothesized that the effect of DPP-4 inhibitors on carotid atherosclerosis might be different between the primary and secondary prevention groups. We performed a post hoc analysis of the PROLOGUE study and compared the effects of sitagliptin and conventional therapy on changes in carotid IMT in subgroups with or without previous CV events. ResultsNo significant difference in the IMT changes between the treatment groups was found in the secondary prevention subgroup (sitagliptin, N = 102; conventional, 111). However, in the primary prevention subgroup (sitagliptin, 120; conventional, 109), we found significant inhibitory effects of sitagliptin on mean and max internal carotid artery IMT [estimated group difference: −0.096 mm (95% CI −0.175 to −0.018, p = 0.017) and −0.162 mm (95% CI −0.272 to −0.052, p = 0.004), respectively], although there was no significant difference in the common carotid artery IMT. ConclusionsOur data suggest that there is a favorable effect of DPP-4 inhibitor treatment on carotid atherosclerosis in diabetes patients without previous CV events.

CD4+CD28null T Cells are related to previous cytomegalovirus infection but not to accelerated atherosclerosis in ANCA-associated vasculitis

Previous studies have suggested an increased risk for cardiovascular events in antineutrophil cytoplasmic antibodies (ANCA)-associated vasculitis (AAV). We analyzed the presence of atherosclerotic damage in patients with AAV in relation to the presence of CD4+CD28null T cells and antibodies against cytomegalovirus (CMV) and human Heat-Shock Protein 60 (hHSP60). In this cross-sectional study, patients with inactive AAV were compared with healthy controls (HC). Carotid intima-media thickness (IMT) and aortic pulse-wave velocity (PWV) were measured. In addition, CD4+CD28null T cells, anti-CMV, and anti-hHSP60 levels were determined. Forty patients with AAV were included. Patients’ spouses were recruited as HC (N = 38). CD4+CD28null T cells are present in patients with AAV in a higher percentage (median 3.1, range 0.01–85) than in HC (0.28, 0–36, P < 0.0001). No significant difference in IMT (mm) between patients and controls was detected (mean 0.77 ± standard deviation 0.15 and 0.73 ± 0.11, respectively, P = 0.20). PWV standardized for MAP was increased in AAV patients (9.80 ± 2.50 m/s, compared to 8.72 ± 1.68 in HC, P = 0.04). There was a strong association between a previous CMV infection and the presence and percentage of CD4+CD28null T cells (0.33 vs 13.8, P < 0.001). There was no relationship between CD4+CD28null T cells and/or a previous CMV infection and IMT or PWV. There was no relation between anti-hHSP60 and CD4+CD28null T cells. Increased PWV values suggest atherosclerotic damage in patients with AAV. Plaque size, as determined by IMT, did not differ. CD4+CD28null T cells are increased in AAV and related to the previous CMV infection.

The Estimation of Intima-Media Thickness and Cardiovascular Risk Factors in Young Survivors of Childhood Cancer.

Cancer treatment in childhood is thought to accelerate the development of atherosclerosis, leading to significant cardiovascular complications and, ultimately, increasing cardiovascular mortality in childhood cancer survivors, which explains the need to assess vascular status in this group. The purpose of this paper was to assess early atherosclerotic lesions based on the analysis of intima-media thickness (IMT) of the common carotid artery, as well as to analyze cardiovascular risk factors in young childhood cancer survivors. The analysis of 158 patients aged 6 to29 years, with a history of previous cancer treatment for different childhood malignancies, revealed a statistically significant difference in IMT between them and 66 age-matched healthy controls. The observed higher IMT scores in childhood cancer survivors may be indicative of premature atherosclerosis. The actual scores were 0.056±0.007 versus 0.052±0.003 (P=0.0001) as a mean score for both carotid arteries in the study group and controls, respectively. We did not observe significant differences in IMT between cancer survivors treated with chemotherapy only versus those treated with chemotherapy and radiotherapy. Similar to the general population, childhood cancer survivors are affected by different cardiovascular risk factors. These factors may enhance the direct cardiotoxicity of cancer treatment, leading to symptomatic incidents in further life, which emphasizes the need of early prevention and/or treatment in this subpopulation.

The relationship between homocysteine and carotid intima-media thickness in acute cerebral infarction

Objective To investigate the relationship between the different levels of homocysteine (Hcy) and carotid intima-media thickness (IMT) in acute cerebral infarction patients. Methods 140 patients with acute cerebral infarction in our hospital were included. The patients were divided into H1 group (Hcy≤10 μmol/L) and H2 group (Hcy>10 μmol/L) dependent on the level of plasma Hcy. Meanwhile, 70 healthy people were included in the study as the control group. The clinical biochemical indicators and the values of IMT were detected in the three groups. Results Compared with the control group, the level of plasma Hcy in the H1 and H2 group were increased [(8.73±1.63), (23.71±3.27) μmol/L], and there was more significant in H2 group (P<0.05). There was significant difference in IMT in three groups (P<0.05). The value of IMT increased in H2 group was much more significant compared with H1 group (P<0.05). Based on the log-transformed values of IMT as the dependent variable, multiple stepwise linear regression showed significant associations of Hcy levels variables with increased IMT (B=0.004, P<0.01). Conclusion The increased IMT level was associated with the level of plasma Hcy in patients with acute cerebral infarction. Key words: Acute cerebral infarction; Homocysteine; Carotid intima-media thickness

CHARACTERIZATION OF ARTERIAL STIFFNESS IN PATIENTS WITH POSTURAL ORTHOSTATIC TACHYCARDIA SYNDROME AND EHLERS-DANLOS SYNDROME JOINT HYPERMOBILITY SYNDROME TYPE III

Postural orthostatic tachycardia syndrome (POTS) is characterized by symptoms of orthostatic intolerance associated with an exaggerated increase in heart rate (HR) on standing. Recently, researchers have been reported that patients with Joint Hypermobility Syndromes, genetic disorders that affect collagen synthesis and deposition such as Ehlers-Danlos syndrome type 3 (EDS-3), have associated symptoms of POTS. The combination of these disorders may produce an altered vascular phenotype that has not been previously investigated. To characterize arterial stiffness in POTS+EDS-3 individuals and compare to healthy age-sex-matched controls (CON). Nine clinically diagnosed individuals with POTS+EDS-3, and 9 CON participated in the study. Vascular assessments were conducted after 10 minutes of supine rest. Primary outcome measures include central, upper limb, and lower limb arterial pulse wave velocity (PWV) obtained using applanation tonometry; local carotid artery distensibility measured with simultaneous ultrasound imaging and applanation tonometry; and carotid intima-media thickness (IMT) measured with ultrasound imaging 2-5 cm proximal to the carotid bifurcation. No differences were observed between the POTS+EDS-3 and CON groups in carotid elasticity including compliance, distensibility and beta-stiffness. There were also no differences between groups in regional PWV including central, upper limb and lower limb pulse wave velocity. There were no significant differences in IMT between groups. Arterial stiffness is not significantly different between individuals with POTS+EDS-3 and CON. Vasoactive medications used by POTS+EDS-3 patients may preclude the detection of arterial stiffness differences. Further investigations should increase the sample size and be conducted in conditions absent of vasoactive medications.

Neurally mediated syncope: Is it really an endothelial dysfunction?

Objective:Syncope is a common problem in children and adolescents. Neurally mediated syncope is the most frequent form of this disorder. Although several studies have evaluated the pathophysiology of neurally mediated syncope, it is still not completely understood.Methods:We performed a cross-sectional study that included 27 patients aged 5–20 years with unexplained syncope and 30 healthy subjects as a control group. All subjects in both groups were assessed for endothelial function by investigating the following physical and chemical factors: flow-mediated dilation (FMD), intima-media thickness (IMT), circulating vascular cell adhesion molecule (VCAM), intercellular adhesion molecule (ICAM)], and endothelial leucocyte adhesion molecule (E-selectin), as well as epinephrine and norepinephrine. The data were statistically analyzed utilizing the SPSS 20. Significant differences between the groups in terms of mean scores were assessed using an independent sample t-test.Results:Mean FMD was significantly higher in the syncope case group than in the control group (p=0.028). There was no significant difference in IMT between the two groups; however, mean levels of ICAM (p=0.02) and VCAM (p=0.008) were significantly higher in the case group than in the control group. The levels of E-selectin also increased in the case group, but not to a statistically significant extent. The mean levels of epinephrine (p=0.01) were significantly lower in the case group than in the control group, and the level of norepinephrine serum decreased slightly, but not significantly, in the syncope patients.Conclusion:Our results showed that an endothelial dysfunction or augmented endothelial function might exist in patients with neurally mediated syncope.

Comparison of Brachial Artery Resistive Index with Intima-Media Thickness of Carotid Artery as Sonographic Markers of Atherosclerosis

Background and objective: Intima-media thickness (IMT) in common carotid artery (CCA) can be assessed during carotid arterial ultrasonography. However, it's association with resistive index (RI) in brachial artery (BA), as a useful tool to evaluate atherosclerosis progression has not been clarified well. The aim of this study was to examine the relationship between IMT in CCA and RI in BA. Material and methods: IMT and RI of CCA and BA were evaluated in 90 men with 30 control carotids, 30 mild carotid stenosis, and 30 severe stenosis using B-mode and Doppler ultrasonography. RI was measured based on the peak-systolic and different parts of diastolic velocities in Doppler spectrum in BA. Results: The intima-media thickness of the left common carotid Artery (LCCA) increased from 0.57 ± 0.14 in the control group to 0.73 ± 0.15 in the mild stenosis group and 0.90 ± 0.11 in the severe stenosis group. RId-end and RId-mean of the left brachial artery (LBA) increased from 0.85 ± 0.09 and 0.82 ± 0.05 in the control groups to 0.89 ± 0.08 and 0.85 ± 0.04 in the mild stenosis groups and 0.94 ± 0.06 and 0.89 ± 0.04 among sever groups, respectively. Conclusion: Between experimental groups, there was a significant difference in IMT of LCCA and RI of LBA, separately (p-value < 0.05). The Pearson correlation analysis showed a significant correlation between IMT of LCCA and RI of LBA. The brachial artery resistive index is associated with intima-media thickness of common carotid artery. This study showed that atherosclerosis was a generalized process that might involve the entire vasculature. Besides, we propose that RI measurements from each of the Doppler velocity spectrums of brachial artery and their averaging (RImean) may be a better index for explaining progression of atherosclerosis in brachial artery rather than RId-end alone. Due to the above-mentioned matters, it seems that RI in BA with accompaniment of IMT in CCA could be a useful tool to evaluate atherosclerosis progression. Copyright © 2015 American Scientific Publishers.

Age and carotid remodeling: a quantitative study of vascular structure with three dimensional ultrasound

Objective To investigate the vessel structure changes of carotid artery with age in normal adults with a newly-developed 3-dimensional ultrasound imaging modality. Methods One hundred and twenty-five normal adult volunteers were divided into five groups: group A, 20-29 years old, 25 cases; group B, 30-39 years old, 27 cases; group C, 40-49 years old, 28 cases; group D, 50-59 years old, 23 cases; group E, older than 60 years old, 22 cases. The straight sections of common carotid arteries were scanned by full-volume three-dimensional ultrasound probe.With a vessel plaque quantification software (VPQ), the following parameters were obtained: intima-media thickness (IMT), vessel total area (VTA), vessel lumen area (VLA), vessel wall area (VWA), and normalized wall index (NWI). Results IMT, VTA, VWA, VLA and NWI were all positively correlated with age (r=0.79, 0.48, 0.77, 0.27 and 0.67 respectively, P=0.00), and there was significant difference among age groups (P<0.01). IMT, VTA, VWA increased with age gradually whereas VLA increased only in group E and NWI showed no significant difference between group E and D. VWA and VTA of males were significantly greater than those of females in group A, B and C, and VLA of males was significantly greater than females in group A and B. There was no significant difference in IMT and NWI between gender groups. Conclusions Age is an important factor to carotid remodeling, and IMT, VTA and VWA increase with age, but VLA keeps constant in people under 60-year-old while NWI becomes stable in people over 50-year-old. It is essential to consider the physiological changes of carotid with agewhen pathophysiological process of atherosclerosis is involved. Key words: Ultrasonography, three-dimensional; Carotid arteries; Vessel remodeling; Age factors

Using ultrasound radio frequency technology to assess regression of the structure and function of the carotid artery by radioiodine therapy in hyperthyroidism patients

IntroductionThe aim of the study was to investigate the structure and function of the carotid artery in patients with hyperthyroidism by ultrasound radio frequency data technology (RF data) and the effect of 131I on them.Material and methodsSeventy patients with primary hyperthyroidism and 74 healthy volunteers were enrolled in this study. Structural and functional parameters of the common carotid artery were measured in every patient before and after 131I treatment through the RF data, such as intima media thickness (IMT), functional compliance coefficient (CC), stiffness index (β), and pulse wave velocity (PWV). We also analyzed the correlation between these parameters and patients’ age, body mass index, hemodynamic parameters (blood pressure, heart rate), thyroid hormone levels and other risk factors.ResultsThere was a significant difference in IMT between hyperthyroid patients and the control group at baseline (483.6 vs. 443.3 µm, p < 0.01); after treatment, the IMT decreased significantly (428.7 vs. 483.6 µm, p < 0.001). Furthermore, the IMT was correlated with patients’ age and systolic blood pressure (r = 0.525, p < 0.01 and r = 0.289, p < 0.05, respectively). The β and PWV were also higher than the control group (7.26 vs.5.87, 6.27 vs. 5.57 m/s, respectively; all p < 0.001); CC was lower than the control group (0.98 vs. 1.19 mm2/KPa, p < 0.01); after treatment, PWV and β were lower than baseline (5.66 vs. 6.27, 5.81 vs. 7.26 m/s, respectively; all p < 0.01), and CC was higher than baseline. In addition, they were significantly correlated with age (r = 0.525, p < 0.01 and r = 0.289, p < 0.05, respectively). However, these parameters were not correlated with the level of thyroid hormones.ConclusionsSix-month 131I treatment for patients with hyperthyroidism reverses the structural and functional damage in the carotid artery, which is sensitively evaluated by the RF data technique.

Plasma arginine/ADMA ratio as a sensitive risk marker for atherosclerosis: Shimane CoHRE study

Background: Asymmetric dimethylarginine (ADMA), which acts an endogenous inhibitor of nitric oxide synthase (NOS), is involved in the pathogenesis of cardiovascular disease. Arginine (Arg) may regulate vascular endothelial function, since Arg is the substrate of NO competing with ADMA. In our previous study, low Arg/ADMA ratio is an independent risk for microangiopathy-related cerebral damage. Purpose: Here, we performed a cross-sectional study to evaluate the association between the Arg/ADMA ratio and the maximal intima-media thickness (IMT) in the carotid artery. Subjects and Methods: Participants were 785 community-dwelling Japanese people without any severe disorders. Plasma concentration of Arg and ADMA in fasting blood sample was determined using HPLC. IMT was measured in the bilateral carotid artery by ultrasonography. Results: Among quartiles stratified by the Arg/ADMA ratio, ANOVA showed a significant difference in IMT and the IMT in Q1 (the lowest quartile) was significantly higher than that in Q4 (the highest quartile). In multiple linear regression analysis, age, the male gender, lower BMI, the presence of hypertension and lower Arg/ADMA ratio were independently correlated with IMT, while IMT was not correlated with Arg or ADMA alone. In addition, the Arg/ADMA ratio was associated with IMT independent of age, sex, BMI and the presence of hypertension with odds ratio 0.21 (95%CI: 0.05–0.88) in multiple logistic regression analysis for IMT 1.5 mm or more. Conclusion: Imbalance of Arg and ADMA is independently involved in the progression of atherosclerosis, and the Arg/ADMA ratio may be a sensitive marker for atherosclerosis.

SAT0538 Ultrasonographic Examination of Target Organs in Gout

BackgroundGout is the most common cause of inflammatory arthritis in men, and its prevalence has gradually increased among the general population over the last few decades. There is strong evidence...

Snoring and carotid artery intima‐media thickness

A growing body of evidence indicates that primary snoring (PS) may be the initial presentation of sleep-disordered breathing and can adversely affect an individual's health. Individuals with the sole diagnosis of PS were evaluated to determine if a relationship exists between snoring and thickening of the intima media of the carotid arteries. Cross-sectional study. Our institution's sleep center database identified patients aged 18 to 50 years who had a diagnostic sleep study with apnea-hypopnea index <5 between December 2006 and January 2012. Subjects underwent a diagnostic carotid artery duplex ultrasound measuring the intima-media thickness (IMT) of the bilateral carotid arteries at four separate points. A validated Snoring Outcomes Survey (SOS) was completed and used to categorize snorers and nonsnorers. Groups were compared using a Student t test. Of 913 patients who met inclusion criteria, 54 patients completed both the carotid duplex ultrasound and SOS. There were no statistically significant differences in IMT for the groups defined by smoking or diabetes. Compared to nonsnorers, snorers were found to have a significantly greater IMT at two points along the left internal carotid artery and one point on the right side. When considering all eight points, IMT was significantly greater in snorers. This study shows a relationship between PS and IMT of the carotid arteries. Given the well-described relationship between increased carotid IMT and serious health conditions, nonapneic snoring may be a precursor to changes of the carotid artery intima and should be further investigated. 3b.