Thickness Of Common Carotid Artery Research Articles

Dietary antioxidant intake reduces carotid intima-media thickness in coronary heart disease patients: From the CORDIOPREV study

BackgroundAtherosclerosis is the leading underlying cause of coronary heart disease (CHD). In patients with CHD, intima-media thickness of common carotid arteries (IMT-CC) is a reliable, validated, and non-invasive marker of the progression of atherosclerosis. Dietary intervention may affect IMT-CC evolution through different pathways. There is a lack of clinical trials evaluating the effect of total dietary antioxidant content of diets on IMT-CC, especially in patients with CHD. ObjectiveWe evaluated the correlation between the diet's total antioxidant content and the changes in IMT-CC produced after 5 years of dietary intervention following two healthy diet models (Mediterranean diet and low-fat diet). We also evaluated whether the diet's total antioxidant content was related to the total redox capacity of the participants. MethodsFrom the total participants of the CORDIOPREV study (clinical trial register NCT00924937), 805 participants completed the IMT-CC measurement and the dietary antioxidant evaluation at baseline and after 5 years of dietary intervention. IMT-CC was carried out by ultrasound and the dietary antioxidant evaluation was performed by the Dietary Antioxidant Index (DAI). Additionally, direct redox balance was evaluated in a subset of population by the ratio of reduced glutathione (GSH) to oxidized glutathione (GSSH) by colorimetric assay. ResultsWe observed an inverse correlation between evolution of DAI and IMT-CC after 5-years of dietary intervention. The mean of the DAI index augmented in the Mediterranean Diet group, whereas it decreased in the Low-fat group. DAI was correlated to the GSH/GSSG ratio, supporting DAI as an adequate estimator of diet's antioxidant content. When looking for individual components of the DAI that were associated to the changes in IMT-CC, an inverse correlation was found for carotenoids, vitamin E, vitamin C, and zinc and the IMT-CC. ConclusionsOur study indicates that, after five years of dietary intervention, changes in DAI inversely correlate with changes in IMT-CC in patients with CHD. Overall effect of Mediterranean diet resulted in an increase of DAI, conversely to low-fat. Specific elements included in the DAI index were inversely correlated with IMT-CC.

Increased Intima Media Thickness of Common Carotid Artery in Hypertensive and Pre-Hypertensive Patients – A Systematic Review

Background: Adult hypercholesteremic have thicker intima media of the common carotid arteries than controls. Atherosclerotic hypertension (HTN) is a substantial risk factor for cardiovascular and cerebrovascular diseases. HTN causes a fourfold rise in the risk of stroke, and this risk is significantly greater when associated with other risk factors that cause fatal conditions. 
 Objective: To determine the increased thickness of inner lumen of common carotid artery in hypertensive and pre-hypertensive patients.
 Method & Material: From 2003 to 2019, the following keywords were searched in PubMed, ProQuest, Google Scholar, and Research Gate: pre-hypertension, hypertension, IMT, and carotid arteries. The review only included studies that measured intima-media thickness. independently evaluated titles and abstracts of full-length related publications for inclusion and exclusion. The general consensus was fixed by the reviewer's differences. The included studies on the role of ultrasonography in thickened IMT diagnosis. Applicability and quality of studies were assessed using full-length journal data. After scanning databases, 73 papers were found; 14 were duplicates, 34 were irrelevant or lacking data, and 7 were eliminated based on title and abstract, a total of 18 studies were reviewed. This study excluded systematic reviews and meta-analyses in favor of original research publications. This review studies are all prospective.
 Result: Intima media thickness increases with hypertension in 18 studies. Age increased the intimal medial thickness (r=0.6, P=.000). Patients with atherothrombotic changes had higher IMT than those without it. Each patient's sensitivity and specificity were averaged out. With or without plaque, ultrasonography had 87.5 sensitivity. Diverse study designs and analysis precluded pooled calculations.
 Conclusion: IMT increases with ageing. IMT also increases in people with other atherosclerosis symptoms including plaque development. IMT thickening occurs in even normotensive person. However, hypertension has no effect on IMT. Hypertension accelerates the severity of IMT and atherosclerosis.

Effect of treatment on the hemodynamics system in systemic lupus erythematosus patients

Abstract Systemic lupus erythematosus (SLE) is a rare autoimmune disease which is associated with inflammation and accelerated atherogenesis, as it's related to the endothelium activation process. Measurements of arterial stiffness and IMTc are a repeatable and noninvasive methods to estimate a CVD risk. We could assume that the outcome of the correct therapy, if applied in the early stage of the SLE, could prevent the consequences of vessel inflammation and retract endothelium lesions. Purpose The main objective of this study was to assess the common carotid artery thickness of the intima-media complex (IMTc), ankle-brachial index (ABI), and pulse wave velocity (PWV) in patients with SLE and compare the studied parameters between individuals treated with corticosteroids with patients with other medications or without treatment. Methods Consecutive patients with SLE were included prospectively to the study between X 2016 and XII 20120 in the 2nd Department of Cardiology of our Medical University. Patients with other connective tissue diseases and chronic inflammation were excluded from this study. Activity of SLE was measured by The Systemic Lupus Erythematosus Disease Activity Index (SLEDAI-2K), with cut-off point at 6 points for active disease. Basic clinical data and cardiovascular (CVS) risk factors were gathered, each patient underwent the measurement of IMTc, ABI and cfPWV. All data were compared between groups treated or not treated with glicocorticosteroids (GCS). Results The study group consisted of 43 patients with SLE. Mean age was 57.4 years, 39 of the studied subjects were women, and 21 patients (48.84%) were treated with GCS. Mean duration of SLE time was 12.3 years, mean time of treatment with GCS was 5.3 years. On average the mean SLEDAI-2K value was 6.35±5.83 points and 18 patients (41.86%) had above 6 points. New-onset CV disease occurred in 6 patients (33.33%) treated with CGS and in 3 pts (25%) not treated with GCS (p=0.2546) Patients treated with GCS had lower values of ABI when compared to patients not treated with GCS (right ankle: 1.76 vs 1.86, p=0.047, left ankle: 1.63 vs 1.81, p=0.041) although the values were in the scope of standards. Similar situation occurred with the carotid femoral artery (cfPWV) (8.00 vs 8.83 m/s, p=0.032). However, the carotid radial artery PWV values were not significantly altered between groups (8.89 vs 9.61 m/s, p=0.12). The IMTc values were significantly higher in the GCS group (1.51 vs 1.13 mm, p<0.001). Statistically significant correlation with CVS risk factors was found for cfPWV (r=0.812, p=0.021). Conclusions Patients treated with GCS had lower cfPWV and ABI when compared to the group not treated with GCS. Further studies to establish the prognostic value of PWV among SLE patients are justified, as it could be superior to the IMTc measures at the early stage of vascular impairment, because PWV explores a greater range of vessels. Funding Acknowledgement Type of funding sources: Public Institution(s). Main funding source(s): Medical University of Silesia in Katowice, Poland

Effect of Chronic Khat Chewing on Intima-Media Thickness of Common Carotid Arteries in Yemeni volunteers

Objective: To assess the changes occurring in both common carotid arteries (CCAs) intima-media thickness (IMT) in Yemeni chronic khat chewers using B-mode ultrasonography.
 Methods: This cross-sectional study was conducted among 195 participants (103 regular khat chewers and 92 non-khat chewers) conveniently selected at the Radiology Department of the University of Science and Technology Hospital (USTH) in Sana’a from August 2017 to August 2018. Data about gender, age, BMI, chewing khat and the period of chewing were collected from participants using a structured questionnaire. B-mode ultrasonography of bilateral CCAs was then performed to measure the IMT. Data were analyzed using suitable statistical tests, and P-values <0.05 were considered statistically significant.
 Results: The majority of participants with CCA-IMT were males (91.8%) and aged 27 years or younger (59.0%), with a mean age of 27.9 ± 6.8 years. Khat chewers constituted more than half of patients with CCA-IMT. There was no statistically significant difference in the mean values of RT CCA-IMT and LT CCA-IMT between khat chewers and non-khat chewers. The CCA-MIT was significantly higher among male khat chewers compared to male non-chewers (P = 0.004). However, there was no statistically significant difference between khat chewers and non-chewers with respect to the age of 20 years or older (P = 0.301) and BMI of 18.5 kg/m2 or higher (P = 0.888). Age showed a significant positive correlation with RT CCA-IMT (r = 0.380; P < 0.001) and LT CCA-IMT (r = 0.458; P < 0.001) in Khat chewers. In contrast, age showed a significant positive correlation with LT CCA-IMT only in non-khat chewers (r = 0.236; P = 0.024). On the other hand, BMI showed a significant positive correlation with LT CCA-IMT (r = 0.254; P = 0.010) among khat chewers, but no significant correlation was found in CCA-IMT of both sides among non-khat chewers. Among khat chewers, there was a significant positive correlation with RT CCA-IMT (r = 0.273; P = 0.005) and LT CCA-IMT(r = 0.194; P = 0.049).
 Conclusion: Khat chewing does not lead to a significant difference in CCA-IMT among Yemeni chewers compared to non-chewers. However, the period of chewing may slightly affect the CCA-IMT among khat chewers. Age has a significant positive correlation with CCA-IMT in khat chewers and LT CCA-MIT in non-khat chewers, which could help to determine the contribution of different predisposing factors to atherosclerosis. A significant positive correlation can be found between BMI and LT CCA-MIT among khat chewers.
 Keywords: Khat Chewing, Intima media thickness, Carotid, Yemen

Effect of Chronic Khat Chewing on Intima-Media Thickness of Common Carotid Arteries in Yemeni volunteers

Objective: To assess the changes occurring in both common carotid arteries (CCAs) intima-media thickness (IMT) in Yemeni chronic khat chewers using B-mode ultrasonography.
 Methods: This cross-sectional study was conducted among 195 participants (103 regular khat chewers and 92 non-khat chewers) conveniently selected at the Radiology Department of the University of Science and Technology Hospital (USTH) in Sana’a from August 2017 to August 2018. Data about gender, age, BMI, chewing khat and the period of chewing were collected from participants using a structured questionnaire. B-mode ultrasonography of bilateral CCAs was then performed to measure the IMT. Data were analyzed using suitable statistical tests, and P-values <0.05 were considered statistically significant.
 Results: The majority of participants with CCA-IMT were males (91.8%) and aged 27 years or younger (59.0%), with a mean age of 27.9 ± 6.8 years. Khat chewers constituted more than half of patients with CCA-IMT. There was no statistically significant difference in the mean values of RT CCA-IMT and LT CCA-IMT between khat chewers and non-khat chewers. The CCA-MIT was significantly higher among male khat chewers compared to male non-chewers (P = 0.004). However, there was no statistically significant difference between khat chewers and non-chewers with respect to the age of 20 years or older (P = 0.301) and BMI of 18.5 kg/m2 or higher (P = 0.888). Age showed a significant positive correlation with RT CCA-IMT (r = 0.380; P < 0.001) and LT CCA-IMT (r = 0.458; P < 0.001) in Khat chewers. In contrast, age showed a significant positive correlation with LT CCA-IMT only in non-khat chewers (r = 0.236; P = 0.024). On the other hand, BMI showed a significant positive correlation with LT CCA-IMT (r = 0.254; P = 0.010) among khat chewers, but no significant correlation was found in CCA-IMT of both sides among non-khat chewers. Among khat chewers, there was a significant positive correlation with RT CCA-IMT (r = 0.273; P = 0.005) and LT CCA-IMT(r = 0.194; P = 0.049).
 Conclusion: Khat chewing does not lead to a significant difference in CCA-IMT among Yemeni chewers compared to non-chewers. However, the period of chewing may slightly affect the CCA-IMT among khat chewers. Age has a significant positive correlation with CCA-IMT in khat chewers and LT CCA-MIT in non-khat chewers, which could help to determine the contribution of different predisposing factors to atherosclerosis. A significant positive correlation can be found between BMI and LT CCA-MIT among khat chewers.
 Keywords: Khat Chewing, Intima media thickness, Carotid, Yemen

Prophylactic effect of Trigonella foenum-graecum L. seed extract on inflammatory markers and histopathological changes in high-fat-fed ovariectomized rats

Background and aimTrigonella foenum-graecum L. seeds (TFG) are used as spices in Indian cuisine. In Indian traditional medicine, TFG is used to treat diabetes, dyslipidemia, obesity, arthritis, cancer, digestive disorders, and postmenopausal conditions. Pathophysiology of postmenopausal diseases involves low-grade systemic inflammation. The purpose of this study is to investigate the prophylactic effect of petroleum ether fraction of TFG-extract (PE-TFG) on inflammatory markers, and histopathological changes in ovariectomized rats (OVX-rats) fed with a high-fat diet (HFD). Experimental procedureOVX female Sprague Dawley rats were used for the study. Three weeks after ovariectomy, rats were randomized in different groups and administered PE-TFG, atorvastatin, diosgenin, 17β-estradiol for 12 weeks along with HFD. The sham-operated rats (S.OVX) were fed with a standard pellet diet. At the end of 12-weeks, rats were sacrificed, and blood samples were used to estimate lipid profile, glucose, hepatic markers, TNF-α, and leptin. Liver, kidney, and common carotid artery were isolated for testing oxidative stress markers, mRNA expression of adiponectin, PPAR-γ, and histopathological changes. ResultsAdministration of PE-TFG significantly decreased (P < 0.05) total cholesterol, LDL, hepatic markers, leptin, TNF-α and improved mRNA expression of adiponectin and PPAR-γ in HFD-fed OVX-rats. Further, micro and macro hepatic steatosis, inflammation, glomerular hypertrophy, degenerated tubules in kidney, increased tunica intima, and media thickness of common carotid artery and the pathological changes were not significant upon PE-TFG administration compared to S.OVX-rats. ConclusionPE-TFG protects cellular inflammation and metabolic alternations in HFD-fed OVX-rats and thus can be explored further in postmenopausal diseases as a prophylactic agent.

Plasma osteopontin versus intima media thickness of the common carotid arteries in well-characterised patients with systemic lupus erythematosus.

ObjectiveThe progress of accelerated atherosclerosis in systemic lupus erythematosus (SLE) is incompletely understood. Circulating osteopontin (OPN) is increased in autoimmune conditions, e.g. SLE, and its serum concentration was recently reported to associate with subclinical atherosclerosis in SLE, as measured by carotid intima-media thickness. The aim of this study was to investigate whether OPN may be used as a surrogate biomarker of subclinical atherosclerosis in SLE patients with different disease phenotypes.MethodsWe recruited 60 well-characterised SLE cases and 60 age- and sex-matched healthy controls. The SLE cases were divided into three different disease phenotypes: SLE with antiphospholipid syndrome (APS), lupus nephritis, and isolated skin and joint involvement. Plasma OPN was detected by ELISA (Quantikine®, R&D Systems). Common carotid arteries intima media thickness was compared between the studied groups in relation to OPN levels and risk factors for vascular changes. Intima media thickness of common carotid arteries was measured by using a sensitive ultrasound technique (LOGIQ™ E9 ultrasound, GE Healthcare).ResultsOPN levels were significantly higher among the entire SLE group (n = 60) compared to the healthy controls (P = 0.03). SLE cases with concomitant APS (n = 20) showed higher OPN levels than the controls (P = 0.004), whereas none of the other two subgroups differed significantly from the healthy controls. OPN and intima media thickness were correlated to several traditional risk factors of atherosclerosis, as well as to SLE-related factors. Yet, no significant correlation was observed between OPN levels and ultrasound findings of the common carotid arteries.ConclusionsIn line with previous studies, we observed increased OPN levels among SLE patients as compared to matched controls. However, the OPN concentrations did not correlate with intima media thickness of the common carotid arteries. Based on our findings, the use of OPN as a surrogate biomarker of subclinical atherosclerosis in SLE subjects, regardless of clinical phenotypes, cannot be recommended.

Metabolic syndrome and the risk of cardiovascular complications in young patients with different phenotypes of polycystic ovary syndrome.

Insulin resistance is an important factor in the pathogenesis of polycystic ovary syndrome (PCOS), which is associated with higher risk of metabolic syndrome (MetS) and cardiovascular complications. Early atherosclerotic lesions may be diagnosed by ultrasonographic parameters: brachial artery flow-mediated dilation after reactive hyperaemia (FMD) and intima-media thickness of common carotid artery (IMT). The aim of the study was to assess the relation of IMT and FMD with clinical and laboratory parameters reflecting metabolic status in young women with different PCOS phenotypes. The study included 154 PCOS patients diagnosed with the Rotterdam criteria, divided into four phenotypes, and 113 healthy women. Laboratory analyses, transvaginal ultrasound, and IMT and FMD measurements were conducted. MetS was diagnosed with International Diabetes Federation/American Heart Association (IDF/AHA) consensus criteria. MetS was more prevalent in PCOS patients than healthy women (14.29 vs. 5.31%; p = 0.019), with highest prevalence in phenotypes I and II (p = 0.039). IMT and FMD did not differ between PCOS patients and the controls, nor between the PCOS phenotypes. PCOS patients with MetS presented lower FMD than other PCOS patients (p = 0.018). In women with PCOS, FMD correlated with glucose and insulin concentrations in the fasting state (R = -0.33, p = 0.002; R = -0.23, p = 0.026) and at 2 h of OGTT (R = -0.29, p = 0.006; R = -0.26, p = 0.014). In patients with phenotype I, correlations were found between IMT and BMI (R = 0.45, p = 0.006) and between FMD and fasting glucose concentrations (R = -0.46, p = 0.011). Metabolic disturbances and the diagnosis of MetS in patients with PCOS, especially in hyperandrogenic phenotypes, might be associated with alterations in IMT and FMD.

Study of the dynamics of intima media thickness of common carotid artery in elderly patients with ischemic heart disease and diabetes mellitus

Background and Aims: The intima-media thickness of the common carotid artery (IMT CCA) used as a marker of cardiovascular diseases in elderly patients with coronary artery disease (CAD). The aim is to study the dynamics of IMT CCA in patients with coronary artery disease in combination with diabetes mellitus (DM) in comparison with individuals without DM.

Subclinical atherosclerosis in systemic sclerosis: Different risk profiles among patients according to clinical manifestations.

Like other autoimmune diseases, systemic sclerosis (SSc) has been described to be associated with accelerated atherosclerosis (ATS). Before clinical manifestations of cardiovascular disease (CVD) occur, subclinical ATS can be investigated in different ways. To evaluate the presence of subclinical ATS in a group of patients with SSc, and to identify different risk profiles among patients. Subclinical ATS was reviewed in 43 SSc patients and 27 healthy controls, using 2 methods: carotid ultrasound and flow mediated dilation (FMD) of the brachial artery. Plaques were statistically more frequent in SSc patients than in controls (65% vs 30%, P=.006); intima-media thickness of common carotid artery (CCA-IMT) resulted in statistically higher (median value 0.8mm vs 0.55mm; P<.0001) while FMD was significantly lower (median value 9% vs 14%; P=.0086) in patients compared to healthy controls. Among the SSc patients, thickening of CCA-IMT was significantly associated with the presence of diastolic dysfunction of left ventricle (absence of diastolic dysfunction: odds ratio [OR] 0.2, 95% CI 0.04-0.92, P=.038) and with a higher Framingham score (OR 1.3, 95% CI 1.03-1.6], P=.024). The diffuse cutaneous form was slightly protective against pathological FMD (OR 0.12, 95% CI 0.022-0.71, P=.019). This study confirms the involvement of macrocirculation in SSc patients, detecting the presence of subclinical ATS markers more frequently in patients compared to healthy controls. Framingham score, diastolic dysfunction of left ventricle and limited cutaneous form of the disease appeared to be associated with a higher risk of developing ATS.

Sonographic Assessment of Intima Media Thickness of Common Carotid Artery in Normotensive and Hypertensive Individuals

Intimal medial thickness (IMT) is associated with many cardiovascular diseases as atherosclerosis, coronary artery disease, stroke and hypertension etc. Intimal medial thickness of common carotid arteries (CCA) canbe measured by high-resolution modality i.e, B-Mode Ultrasonography.

Linking myeloperoxidase with subclinical atherosclerosis in adults with metabolic syndrome.

Myeloperoxidase (MPO) is aleukocyte-derived enzyme that has been associated with cardiovascular diseases in many studies. Together with hydrogen peroxide and ahalogen, MPO forms avery strong antimicrobial system and there is evidence of links between MPO and inflammation in cardiovascular diseases. Brachial flow-mediated dilation (FMD) refers to aphysiologic measure, and carotid intima-media thickness (IMT) is an anatomic structural measure of subclinical atherosclerosis. This research aimed to assess the correlation of MPO serum levels with subclinical atherosclerosis in patients with metabolic syndrome (MS) using the parameters FMD and IMT. Atotal of 88patients with metabolic syndrome defined according to the International Diabetes Criteria (IDF) criteria were recruited in the study. Doppler ultrasound was used to determine the left and right common carotid artery thickness (left and right CCA IMT) and FMD of brachial artery. The MPO concentrations were measured using the Immundiagnostik MPO ELISA kit. Asignificant inverse correlation between MPO and brachial FMD (r = -0.354, p < 0.001), asignificant positive correlation between MPO and right CCA IMT (r = 0.327, p < 0.001), and asignificant positive correlation between MPO and left CCA IMT (r = 0.301, p < 0.001) in patients with MS were obtained in this research study. Serum MPO concentration is correlated with subclinical atherosclerosis in patients with MS. The MPO may be apotential therapeutic goal in patients with MS. This finding suggests that new biological markers for MS and subclinical atherosclerosis are helpful for understanding the mechanisms of the risk factors and their role as a considerable burden on the population.

Aortic stiffness is not only associated with structural but also functional parameters of retinal microcirculation

ObjectiveThe aim of the study was to test the hypothesis that alterations in large arteries are associated with microvascular remodelling and decreased retinal capillary blood flow. MethodsThe study group comprised of 88 patients with essential hypertension and 32 healthy controls. Retinal microcirculation was evaluated by scanning laser Doppler flowmetry. Macrovascular changes were assessed on the basis of arterial stiffness measurement (carotid-femoral pulse wave velocity), its hemodynamic consequences (central pulse pressure, augmentation pressure, augmentation index) and intima media thickness of common carotid artery. ResultsPulse wave velocity was inversely correlated to mean retinal capillary blood flow in hypertensive patients (R = −0.32, p < 0.01). This relationship remained significant in multivariate regression analysis after adjustment for age, sex, central systolic blood pressure (BP) and body mass index (β = −31.27, p < 0.001). Lumen diameter (LD) of retinal arterioles was significantly smaller in hypertensive then normotensive subjects (79.4 vs. 83.8, p = 0.03). Central and brachial systolic, diastolic and mean BPs were significantly correlated with LD and outer diameter of retinal arterioles. The relationship between LD and central BPs remained significant in multivariate analysis (β = −0.15, p = 0.03 for cSBP; β = −0.22, p = 0.04 for cDBP; β = −0.21, p = 0.03 for cMBP). Moreover, in a subgroup with cardiac damage central and brachial pulse pressure were positively associated with retinal wall thickness, wall cross sectional area, and wall to lumen ratio. ConclusionIn conclusion, the study provides a strong evidence that microcirculation is coupled with macrocirculation not only in terms of structural but also functional parameters.

Is Vertebral artery compression a cause of cervicogenic vertigo in cervical spondylosis patients? A color doppler ultrasound correlation study

Introduction: Pathophysiology of vertigo in patients having neck pain is not well understood, and many theories have been postulated. Cervical spondylitis is one of the most common causes of neck pain, and these are the group of patients who often complain of vertigo. The role of vascular flow alteration in these patients in causing vertigo is under investigation. We intended to study the vascular flow pattern in the vertebral circulation using color Doppler ultrasound in these patients and compare it with controls. Material and Methods: Fifteen cases and 11 controls were evaluated using color Doppler ultrasound. All these patients were evaluated in detail by the Ear, Nose, Throat and the orthopedics department. The statistical analysis was done by IBP SPSS version 22 software. Independent t-test was performed to compare the case and control groups. Results: The mean intimal thickness of common carotid artery of cases was significantly less than the controls (0.35 mm vs. 0.51 mm for the right common carotid artery and 0.38 mm vs. 0.54 mm for the left common carotid artery, P

Vascular ultrasound for monitoring of inflammatory activity in Takayasu arteritis.

Takayasu arteritis (TA) is a rare large-vessel arteritis that primarily affects the aorta and its major branches. The aim of this study was to describe the value of high frequency ultrasound for monitoring of inflammatory activity. Twenty-five patients, range 11-71years, diagnosed with TA were investigated with duplex ultrasound (DUS) including follow-up studies. Twenty-five healthy controls were also investigated. Nine patients had newly diagnosed active TA. Sixteen patients had stable/inactive disease at baseline DUS, and TA was diagnosed median 4·5years previously. Intima-media thickness (IMT), vessel and lumen diameter were measured in the carotid arteries, central neck arteries and the aortic arch. The vessel walls were studied qualitatively. The Takayasu ultrasound index was created for inflammatory activity scoring. Intima-media thickness in common carotid artery (CCA) was (median and 25-75 percentile parenthetic) 2·3mm (1·7-2·9) in clinically active TA, 1·2mm (1·1-1·6) in clinically stable TA (P<0·001) and 0·5mm (0·5-0·6) in healthy controls (P<0·001). Clinically active TA had prominent increase in IMT and/or increased vessel diameter, and/or intramural arteries, and/or hypoechogenic areas interpreted as oedema in the vessel wall. TA in clinical remission was characterized by increased IMT with medium to high echogenicity with or without fibrotic stripes. The Takayasu ultrasound index was higher in patients with active disease versus treated disease, 2·55 (1·60-3·05) versus 1·30 (1·00-1·58), (P=0·003). DUS is an excellent tool to monitor inflammatory changes in the vessel wall in TA. Further DUS studies in larger patient populations are warranted.

P4450Atherosclerosis in women with systemic lupus erythematosus with and without nephritis

Abstract Background Nephritis in systemic lupus erythematosus (SLE) is a factor contributing to early development of atherosclerosis (AS). Objectives The aim of the study is to determine differences in cardiovascular risk factors and AS in SLE pts with and without lupus nephritis (LN). Methods The study included 162 females, age 35 [26–43] years (median [interquartile range 25–75%])) with SLE (ACR,1997). We divided SLE pts on two groups, comparable in age: the 1st group is the pts with LN (n=84, 52%), the 2nd - without LN (n=78, 48%). We considered traditional factors of cardiovascular disease (CVD): (smoking, family history of CVD, blood pressure, cholesterol (total, HDL, LDL) and triglyceride (TG) levels, body mass index, diabetes mellitus) and SLE-related factors (age at onset, duration, clinical features, SLE Disease Activity Index (SLEDAI-2K) and the Systemic Lupus International Collaborating Clinics damage index (SLICC/DI), treatment with steroids); intima-media thickness (IMT) and the 10-year risk for coronary events. Carotid intima-media wall thickness of common carotid arteries was measured by high resolution B-mode ultrasound. The 10-year risk for coronary events was estimated by the Framingham risk equation. Results Median SLE duration was 8,0 [2,3–17,0] years, SLEDAI 2K – 8 [3–16], SLICC/DI score – 2 [0–3], duration of prednisone treatment – 72 [26–141] months. SLE pts from the 1st group had higher prevalence of hypertension (61% vs 36%, p&lt;0,01), systolic blood pressure (130 [110–150] vs 120 [110–130]mm Hg, p&lt;0,01), diastolic blood pressure (80 [70–95] vs 70 [70–80] mm Hg, p&lt;0,05), TG concentration (136 [98–184] vs 100 [61–162] mg/dl, p&lt;0,01), Framingham Risk Score (5 [1–30] vs 1 [1–27]%, p&lt;0,05), SLEDAI-2K (12 [5–19] vs 4 [2–10], p&lt;0,ehz745.08501), SLICC/DI score (2 [0–4] vs 0 [0–2], p&lt;0,01), prednisone therapy duration (95 [26–192] vs 44 [14–98] months, p&lt;0,05), prednisone cumulative dose (34,4 [13,6–82,5] vs 15,7 [6,2–35,2] g, p&lt;0,001), mean IMT (0,73 [0,65–0,83] vs 0,67 [0,61–0,75] mm, p&lt;0,01), than the pts from the 2nd group. There is no difference in CVD frequency in these groups (17% vs 8%, p=0,084). Conclusions SLE patients with and without LN had no difference in frequency of clinical manifestations of AS (CVD), but had a greater value of mean IMT, Framingham Risk Score and a higher incidence of both traditional (hypertension, TG concentration) and SLE-related (disease activity, prednisone therapy) risk factors for AS.

AORTIC STIFFNESS IS NOT ONLY ASSOCIATED WITH STRUCTURAL BUT ALSO WITH FUNCTIONAL PARAMETERS OF MICROCIRCULATION

Objective: The aim of the study was to test the hypothesis if arterial stiffness is linked to reduction of retinal capillary blood flow and development of retinal microvascular remodelling. Design and method: The study group comprised of 88 patients with essential hypertension (n = 88, 54.3 ± 8.3 years, 44.3% were female) and 32 healthy controls. Inclusion criteria were: essential hypertension, age of 40–70 years old. Exclusion criteria were: secondary hypertension, any cardiovascular disease including heart failure, coronary artery disease, arrhythmia, moderate or severe valve disease, history of stroke or transient ischemic attack, chronic kidney disease with eGFR < 60 mml/min/1.73 m2, diabetes mellitus, eye disease, pregnancy. Retinal microcirculation was evaluated by scanning laser Doppler flowmetry. Macrovascular changes were assessed on the basis of measurement of arterial stiffness (by carotid-femoral pulse wave velocity, central pulse pressure, augmentation pressure and augmentation index) and intima media thickness of common carotid artery. Diastolic dysfunction and left ventricular hypertrophy were analysed by echocardiography. Results: Pulse wave velocity was inversely correlated with mean retinal capillary blood flow in a group of hypertensive patients (R = −0.32, p < 0.01). This relationship remained significant in multivariate regression analysis even after adjustment for age, systolic blood pressure and waist to hip ratio (β = −40.275, p < 0.001). Central pulse pressure was positively correlated with retinal wall thickness (R = 0.44, p < 0.05), wall cross sectional area (R = 0.44, p < 0.05) and wall to lumen ratio (R = 0.43, p < 0.05). Brachial pulse pressure was positively correlated with wall thickness (R = 0.43, p < 0.05), wall cross sectional area (R = 0.41, p < 0.05) and wall to lumen ratio (R = 0.47, p < 0.05). In contrast, the relationship between augmentation pressure or augmentation index and structural indicators of retinal remodelling was not observed. Conclusions: In conclusion, the study provides an evidence that microcirculation is coupled with macrocirculation not only in terms of structural but also functional parameters. Pulse wave velocity was independently associated with retinal capilary flow. Central and brachial pulse pressure were significantly related to retinal wall thickness, wall cross sectional area and wall to lumen ratio.

Evaluation of intima-media thickness of common carotid artery in thalassemia patients compared to healthy individuals

Evaluation of intima-media thickness of common carotid artery in thalassemia patients compared to healthy individuals

Long-Term Exposure to Ambient Ozone and Progression of Subclinical Arterial Disease: The Multi-Ethnic Study of Atherosclerosis and Air Pollution.

Background:Long-term ozone () exposure is associated with cardiovascular mortality, but little is known about the associations between and subclinical arterial disease.Objectives:We studied the longitudinal association of exposure to and progression of key subclinical arterial markers in adults: intima-media thickness of common carotid artery (), carotid plaque (CP) burden, and coronary artery calcification (CAC).Methods:CAC was measured one to four times at baseline and at follow-up exams (1999–2012) by computed tomography (CT) in 6,619 healthy adults, recruited at age 45–84 y without cardiovascular disease (CVD), over a mean of 6.5 y (standard deviation: 3.5 y). and CP burden were quantified in 3,392 participants using carotid artery ultrasound imaging acquired over a mean of 9 y (1.7 y). Over 91% and 89% participants had at least one follow-up and CAC measurement, respectively. Residence-specific concentrations were estimated by a validated spatiotemporal model spanning from 1999 to 2012. This model relied on comprehensive monitoring data and geographical variables to predict individualized long-term average concentrations since baseline. Linear mixed models and logistic regression model were used to evaluate relationships of long-term average exposure to with longitudinal change in , CAC, and CP formation, respectively.Results:Mean progression rates of and CAC were and . CP formation was identified in 55% of the subjects. A increase in long-term average exposure was associated with a [95% confidence interval (CI): 1.4, 9.7] greater increase in over 10 y. A increase in was also associated with new CP formation [odds ratio (OR): 1.2 (95% CI: 1.1, 1.4)] but not CAC progression [ (95% CI: , 2)]. Associations were robust in the analysis with extended covariate adjustment, including copollutants, i.e., nitrogen oxides () and particulate matter with diameter ().Conclusion:Over almost a decade of follow-up, outdoor concentrations were associated with increased rate of carotid wall thickness progression and risk of new plaque formation, suggesting arterial injury in this cohort. https://doi.org/10.1289/EHP3325

Value of carotid Doppler ultrasound and brain CT scan in ischemic stroke

Sonographic evaluation of the carotid arteries, both gray scale and Doppler is widely used for risk assessment for cerebrovascular accidents .This study was conducted to assess the state of carotid vessels in patients with acute ischemic stroke by assessing intima-media thickness of common carotid , internal carotid stenosis with the size of ischemic area that diagnosed by using computed tomography . : A total of 68 patient with stroke (21 females , 47 males) were assesed, Gray scale &amp; Doppler US of the ipsilateral carotid arteries performed , measurement of IMT of CCA , the presence of any plaque recorded , the diameter reduction measurement PSV &amp; EDV of the CCA &amp; ICA . 36 patient have no stenosis (52.94%), 32 remaining patient have different degree of stenosis (47.05%),as follow .19 patient have mild stenosis (H1)(59.37%), 9 patient have moderate stenosis (H2)(28.12%) , 4 patient have sever stenosis(H3)(12.5%).40 patient showed increased IMT (58.82%), 28 patient had normal IMT (41.17%).42 patients are smokers (61.76%),So increased intimal media thickness of common carotid artery is associated with stroke .Large size ischemic stroke are more associated with high degree of internal carotid artery stenosis ,There is a significant relation between atheromatous plaque and size of brain infarction