Thickness Of Common Carotid Artery Research Articles

Ultrasonographic assessment of carotid wall characteristics and cognitive functions in a community sample of 59- to 71-year-olds. The EVA Study Group.

This study was aimed at analyzing cross-sectional relationships between cognitive performance and ultrasonographic assessment of carotid wall characteristics. A cohort of 1279 subjects (men, 41%) aged 59 to 71 years was recruited from the electoral rolls of the city of Nantes (western France). Cognitive performances were evaluated with the Mini-Mental State Examination (MMSE) and seven neuropsychological tests assessing attention, psychomotor rapidity, verbal abilities, memory, and visuospatial perception. For each test, subjects were classified into three performance levels with a quartile distribution: 25% highest, 25% lowest, and 50% middle. The intima-media thickness of common carotid arteries and the presence of plaques in the carotid arteries were assessed with B-mode ultrasound examination. Only 28% of men and 17% of women had carotid plaques inducing moderate stenosis of the lumen ( < 40%). After adjustment for possible confounders, odds ratios for poor cognitive performance associated with plaques were above 1 for all cognitive tests in men. This association was statistically significant for the MMSE and another test assessing attention skills. There was a slight association between increase of the common carotid intima-media thickness and poor cognitive scores in men with plaques. In women, no association was found between cognitive functions and presence of plaques or intima-media thickness. This study indicated a moderate association between atherosclerosis of the carotid arteries and poor cognitive functioning in men aged 59 to 71 years. In view of these moderate cross-sectional results, further studies are required to better assess the relationship between carotid atherosclerosis and cognitive impairment.

Intimal medial thickening of common carotid artery as indicator of coronary artery disease.

The authors investigated the relation between coronary atherosclerosis, angiographically detected, and intimal-medial (I-M) thickening of the common carotid artery (CCA), as measured by high-resolution B-mode ultrasound system. They studied 31 patients with coronary artery disease (CAD) and 23 healthy control subjects. I-M thickening of CCAs and atheromatous plaques at the carotid bifurcation were evaluated. A score system was defined (range 0-20) based on the absence or presence of atherosclerotic lesions at common and internal carotid arteries. A coronary angiography score was defined based on the presence of of atherosclerotic lesions at nine coronary arterial segments (range 0-36). The thickness of CCAs (M +/- SD) in CAD patients was significantly higher (1.45 +/- 0.95 mm) than in controls (0.87 +/- 0.10 mm, P < 0.005), and an I-M thickening of 1.1 mm or more was specific and positively predictive of CAD. A significant positive correlation between coronary and carotid score was observed (P < 0.028, r = 0.373). The study suggests that I-M thickening could be helpful for the identification of patients at risk for CAD.

Wall Thickening of Common Carotid Arteries in Patients Affected by Noninsulin-Dependent Diabetes Mellitus: Relationship to Microvascular Complications

This study evaluates the wall thickness of common carotid arteries and the atherosclerotic involvement of the carotid bifurcations in patients with noninsulin-dependent diabetes mellitus (NIDDM), with and without microvascular complications. Seventy subjects affected by NIDDM, and 17 healthy controls were evaluated by means of high-resolution echo-Doppler scan. Twenty-six diabetics (Group A) and complications (overnight proteinuria > 500 mg, background retinopathy, sensory neuropathy), while 44 (Group B) had no complications. The two groups were comparable for age, sex, plasma lipid profile, and smoking habit. Arterial hypertension was present in 15 of 26 (58%) complicated patients (Group A) and in 18 of 44 (41%) uncomplicated patients (Group B). None of the patients had a history of cerebrovascular disease. The authors found that the wall thickness of the common carotid artery was greater and atherosclerotic lesions of the carotid bifurcation were more frequent in diabetic patients with microvascular complications than in uncomplicated diabetics (who had a similar distribution of other risk factors for atherosclerosis) and in nondiabetic controls. These data on the one hand confirm the role of diabetes as an independent risk factor for carotid atherosclerosis and, on the other hand, indicate a correlation between microvascular lesions and early atherosclerosis in diabetes.

Treatment of acute anterior myocardial infarction with zofenopril

Microal buminuria has been associated with a cluster of metabolic and nonmetabolic risk factors, suggesting that it might indicate the presence of generalized microvascular damage in patients with essential hypertension. To explore whether microalbuminuria is associated with early target organ damage, two groups of essential hypertensive patients, with (n = 17) (HtAlb+) and without (n = 16) (HtAlb−) microalbuminuria, and a control group (C) of healthy normotensive subjects (n = 20) were studied. The study groups, selected among participants of a large epidemiologic trial, were carefully matched for several potentially confounding variables such as gender, age, duration of hypertension, and body mass index. Albumin excretion rate was evaluated by radioimmunoassay in three nonconsecutive timed overnight collections after 3 weeks of pharmacologic wash-out. Left ventricular mass was assessed by M-B-mode echocardiography, carotid wall thickness by a high resolution ultrasound scan, and renal vascular impedance by Doppler scan. Office as well as 24-h ambulatory pressure monitoring (Takeda TM-2420) were also evaluated. There was no difference between the two hypertensive groups for office and 24-h blood pressure levels except for a lower daytime/nighttime systolic blood pressure ratio in the group with microalbuminuria. Microalbuminuric patients showed signs of early organ damage as compared to normoalbuminuric patients and normal subjects, namely greater left ventricular mass indices (LVMI 167 ± 7 g/m2 in HtAlb+; 139 ± 9 g/m2 in HtAlb−; 118 ± 5 g/m2 in C, P < .001) and increased wall thickness of common carotid arteries (intima plus media thickness 12.5 ± 0.2 mm in HtAlb+; 11.7 ± 0.3 mm in HtAlb−; 11.2 ± 0.2 mm in C, P < .001) as well as higher intrarenal vascular resistance (mean resistive index 0.62 ± 0.01 in HtAlb+; 0.59 ± 0.01 in HtAlb−; 0.59 ± 0.01 in C, P < .05). In conclusion, microalbuminuria is an early marker of diffuse target organ damage in essential hypertension and therefore can be useful to identify patients for whom more aggressive preventive strategies or additional treatment measures are advisable.

Carotid intima-media wall thickness in elderly women with and without atherosclerosis of the abdominal aorta

In the present study the association was evaluated between non-invasively assessed atherosclerosis of the abdominal aorta and ultrasonographically measured intima-media wall thickness of the common carotid arteries in a population-based study of 41 elderly women. Atherosclerosis of the abdominal aorta was assessed in 1985 using a lateral X-ray of the lumbar spine, on which the presence of calcified deposits was determined. The carotid arteries were ultrasonographically evaluated in 1990 for presence of atherosclerotic plaques and intima-media wall thickness of the distal common carotid was measured off line using dedicated software. The age-adjusted mean intima-media wall thickness of the right common carotid artery was significantly higher in subjects with calcified deposits in the aorta ( n = 16) compared with those without deposits ( n = 25) with a mean difference of 0.15 mm (95% confidence interval (CI) 0.03,0.26). For the left side similar results were observed. Mean common carotid intima-media wall thickness, ((left + right)/2), differed significantly across groups with a mean difference of 0.11 mm (95% CI 0.01,021). Additional adjustment for differences across groups in body mass index, serum cholesterol, hypertension and smoking did not change the magnitude of the observed association: mean difference of 0.12 mm (95% CI -0.01,0.25). The findings of the present study provide evidence that among subjects with atherosclerotic plaques in the abdominal aorta, the intimamedia wall thickness of the distal common carotid arteries is increased.

Determinants of carotid intima‐media thickness: a population‐based ultrasonography study in Eastern Finnish men

We investigated the determinants of maximal intima-media thickness of common carotid arteries in a population-based sample of 1224 Eastern Finnish men aged 42, 48, 54 or 60 years. A high-resolution B-mode ultrasonographic examination was performed as part of the Kuopio Ischaemic Heart Disease Risk Factor Study (KIHD). The maximal intima-media thickness (IMT) varied between 0.48 mm and 4.09 mm (mean value +/- SD, 0.94 mm +/- 0.38 mm). Age (standardized partial coefficient, beta = 0.238, P less than 0.0001), ambulatory pulse pressure (beta = 0.130, P less than 0.0001), cigarette-years of smoking (beta = 0.125, P less than 0.0001), serum LDL cholesterol concentration (beta = 0.125, P less than 0.0001), history of ischaemic heart disease (beta = 0.125, P less than 0.0001), pre-exercise systolic blood pressure (beta = 0.070, P = 0.0113) and diabetes (beta = 0.068, P = 0.0072) were most strongly associated with IMT. This study confirms the role of systolic blood pressure, smoking and serum LDL cholesterol levels as major risk factors for increased carotid intima-media thickness.

Measurement of intima-media thickness of common carotid arteries with high-resolution B-mode ultrasonography: Inter- and intra-observer variability

High-resolution B-mode ultrasonography enables quantitative measurement of the thickness of the intima-media layer of superficial large arteries noninvasively. We investigated the inter- and intra-observer variability of this measurement in the common carotid arteries in 10 randomly selected men. The maximal right and left carotid intima-media thickness (IMT) was measured with calipers during the scanning from frozen images by four observers in a blinded fashion. Three observers also repeated the scanning and the measurements twice with a week's intervals, with no knowledge of the previous readings. The inter-observer coefficient of variation (CV) was 10.5%. The intra-observer CV (mean of right and left CCA) was 5.4–5.8% for the three observers who carried out the measurements three times. The mean absolute difference between the first and third measurement was 0.087 mm. The intra-observer variation accounted for only 4% of the total measurement variability, 96% being attributable to inter-observer variation. These data show that most of the measurement variability in ultrasonographic B-mode IMT measurements is due to differences between observers, whereas the within-observer variability over time appears proportionately very small.