Thickness Of Internal Carotid Artery Research Articles

Reduced reward responsiveness in treatment resistant depression of middle-aged adults: Association with carotid artery stiffness and tetrahydrobiopterin.

Nearly one third of the population diagnosed with major depressive disorder (MDD) fail to respond to two or more antidepressant drugs of adequate dose and duration. This necessitates identification of confounding psychological and physiological factors that could contribute to treatment resistant depression (TRD). The present longitudinal study investigated the influence of behavioural inhibition system (BIS) and behavioural approach system (BAS) in treatment resistance. Further, the association of depression severity with physiological factors contributing to arterial stiffness was also investigated. Baseline data was acquired from 101 middle-aged (36-56 years) patients on immediate diagnosis with MDD using DSM-V criteria. Follow ups were conducted at 06 months and 12 months during treatment. Psychological assessment battery at baseline and follow ups comprised of Hamilton depression rating (HAM-D) for depression severity, WHODAS-2 and BIS-BAS score. Atherosclerosis and central arterial stiffness were measured by intima-media thickness of internal carotid artery and brachial-ankle pulse wave velocity. Physiological factors influencing central vascular function viz., body-mass index, estimated glomerular filtration rate, HbA1c, central systolic and diastolic blood pressure, heart rate and tetrahydrobiopterin were also investigated. Our results show lower reward responsiveness (BAS-RR) and higher BIS scores in TRD patients along with differentially higher intima-media thickness of left internal carotid artery. Higher depression severity at all stages of the study was correlated with lower tetrahydrobiopterin and BAS-RR scores. We, therefore, suggest that vascular depression resulting due to increased intima-media thickness of left carotid artery and lower tetrahydrobiopterin could be contributing factors for treatment resistance in middle-aged MDD patients.

Inflammatory biomarkers are associated with cerebral large artery thickening and dilatation in older adults

AbstractBackgroundAge‐associated changes in intracranial large arteries, including hypertrophic and dilatative remodeling, contribute to worse systemic and brain health in older adults. Vessel wall imaging (VWI) is a novel neuroimaging technique that offers the critical ability to quantify thickness and lumen diameter across arterial segments of the circle of Willis (CoW). Research suggests inflammation, a well‐known feature of aging, cerebrovascular disease, and Alzheimer’s disease, may be a central driver of age‐related changes in CoW morphology. We investigate if fluid biomarkers of inflammation predict key features of intracranial arterial aging, including CoW thickening and dilatation visible on VWI MRI.MethodsVanderbilt Memory & Aging Project participants free of clinical stroke and dementia were studied (n=117, 74±7 years, 73% male). Systemic inflammatory biomarkers (TNF‐α, IL‐6) were quantified from blood plasma samples and neuroinflammatory biomarkers (sTREM2, YKL‐40) were quantified from cerebrospinal fluid samples. Intracranial artery lumen diameter and thickness were manually measured across the basilar artery (BA) and bilateral segments of the internal carotid artery (ICA), anterior cerebral artery (ACA), and middle cerebral artery (MCA) using VWI MRI. Linear regressions related each inflammatory biomarker to intracranial artery lumen diameter and thickness in separate cross‐sectional models, adjusting for age, sex, race/ethnicity, education, Framingham Stroke Risk Profile, diagnosis, apolipoprotein ε4 status, and T1‐weighted intracranial volume.ResultsTNF‐α was related to right ICA thickness (b=0.01, p=0.03), left ICA thickness (b=0.01, p<0.05), and left ACA thickness (b=‐0.01, p=0.04); TNF‐α was unrelated to lumen diameters (p>0.51). IL‐6 was related to right ICA thickness (b=0.01, p=0.003) and was unrelated to lumen diameters (p>0.18). sTREM2 was related to left MCA lumen diameter (b=0.0001, p=0.03), right ACA lumen diameter (b=0.0001; p=0.001), and right ACA thickness (b=0.00003, p=0.03). YKL‐40 was unrelated to intracranial artery thickness (p>0.27) and lumen diameter (p>0.05).ConclusionsResults suggest TNF‐α, IL‐6, and sTREM2 are related to intracranial large artery thickening, and sTREM2 may further relate to large artery dilatation. Given the increased reliability of ICA and BA manual measurements on VWI MRI, these findings may be most robust. Proinflammatory cytokines and microglia‐mediated immune responses may be key pathophysiological mechanisms underlying age‐related arterial remodeling within the brain.

Association of Intima-media Thickness of Internal Carotid Artery with Ocular Pseudoexfoliation

Purpose: To compare the internal carotid artery intima-media thickness (CAIMT) in patients with ocular PEX and healthy controls and to show that ocular PEX may be related to atherosclerosis, or not.
 Study Design: Cross-sectional study.
 Place and Duration of Study: Department of Ophthalmology in Adana Ortadogu Hospital, Adana, Turkey. The study was conducted between January 2017 and January 2018.
 Material and Methods: There were 32 participants in the study. In the biomicroscopic anterior segment examination, 16 patients were diagnosed with pseudoexfoliative material on the pupil margin or anterior lens capsule. These patients formed the first group (Group I).16 non-PEX patients were accepted as a control group (Group II). Patients with systemic disease such as hypertension, diabetes mellitus were excluded from the study. CAIMT was measured and noted in all participants. Carotid artery Doppler USG was used to measure CAIMT. The data were compared by statistical analysis.
 Results: In Group I and Group II, the age of the patients did not differ significantly (p > 0.05). In Group I and Group II, gender distribution was not significant (p > 0.05). In Group I, CAIMT was significantly higher than in Group II (p < 0.05).
 Conclusion: Ocular PEX appears to be associated with atherosclerosis.
 Keywords: Ocular pseudoexfoliation, atherosclerosis, carotid artery.

Red Blood Cell Eicosapentaenoic Acid Inversely Relates to MRI-Assessed Carotid Plaque Lipid Core Burden in Elders at High Cardiovascular Risk.

Supplemental marine omega-3 eicosapentaenoic acid (EPA) has an anti-atherosclerotic effect. Clinical research on EPA supplied by the regular diet and atherosclerosis is scarce. In the framework of the PREvención con DIeta MEDiterránea (PREDIMED) trial, we conducted a cross-sectional study in 161 older individuals at high vascular risk grouped into different stages of carotid atherosclerosis severity, including those without ultrasound-detected atheroma plaque (n = 38), with plaques <2.0 mm thick (n = 65), and with plaques ≥2.0 mm (n = 79). The latter were asked to undergo contrast-enhanced 3T magnetic resonance imaging (MRI) and were subsequently grouped into absence (n = 31) or presence (n = 27) of MRI-detectable plaque lipid, a main feature of unstable atheroma plaques. We determined the red blood cell (RBC) proportion of EPA (a valid marker of long-term EPA intake) at enrolment by gas chromatography. In multivariate models, EPA related inversely to MRI-assessed plaque lipid volume, but not to maximum intima-media thickness of internal carotid artery, plaque burden, or MRI-assessed normalized wall index. The inverse association between EPA and plaque lipid content in patients with advanced atherosclerosis supports the notion that this fatty acid might improve cardiovascular health through stabilization of advanced atheroma plaques.

NEW OPPORTUNITIES FOR PREVENTIVE THERAPY WITH STATINS DURING CHD PATIENTS’ REHABILITATION, WITH CLINICAL SIGNS OF MODERATE CHF: EFFECTIVENESS OF ROSUVASTATIN AND EZETIMIBE

Aim. To study the efficacy of rosuvastatin and ezetimibe combination in patients with moderate clinical signs of chronic heart failure. Material and methods. We incllded outpatients (n=70) >40 y.o. with clinical picture of moderate heart failure (functional class by NYHA II), with comorbid diabetes 2 type, carotid atherosclerosis and hypercholesterolemia. Patients were randomized to 2 groups, 35 persons in each. In the 1st group threatment was performed with rosuvastatin 20 mg daily, with ezetimibe 20 mg daily, in the 2nd — only rosuvastatin 20 mg daily. During one year of study we collected primary endpoints: death, myocardial infarction, stroke, hospitalizations; and secondary endpoints: the amount of those reached target level of low density lipoproteides cholesterol (LDL), changes of lipidogram, C-reactive protein (CRP), intima-media thickness of internal carotid artery. Results. Significant decrease of LDL comparing to baseline, occured in both groups by the end of the first month and remained until the end of study. The most significant LDL decrease (mediana >50%) occured in 1st group by 12 months of the study. Also, since the 3 month, we observed the decrease of LDL more than 45%. In the 2nd group this parameter was not more than 40%. The decrease of CRP by 12 months of the study was found only in the 1st group: mediana of baseline value 3,2 mg/L, end of study mediana 2,2 mg/L, mediana of changes 31,25% (p=0,028). Hospitalizations related to cardiovascular diseases were at level 14,3% in 1 group, and 40% in the 2nd st (р=0,032). Conclusion. Prescription of combination hypolipidemic therapy by rosuvastatin and ezetimibe at dose 20 mg/daily leads to more prominent decrease of LDL in blood, decrease of CRP, number of hospitalizations for cardiovascular diseases comparing to single use of rosuvastatin 20 mg/daily.

Associations between Carotid Artery Plaque Score, Carotid Hemodynamics and Coronary Heart Disease.

Background: The carotid artery plaque score (PS) is an independent predictor of Coronary Heart Disease (CHD). This study aims to evaluate the combination of PS and carotid hemodynamics to predict CHD. Methods: A total of 476 patients who underwent carotid ultrasonography and coronary angiography were divided into two groups depending on the presence of CHD. PS, carotid intima-media thickness, and carotid blood flow were measured. Receiver operating characteristic curve analysis was performed to establish the best prediction model for CHD presence. Results: Age, sex, carotid intima-media thickness of internal carotid artery and carotid bifurcation, PS, peak systolic velocity (PSA) of right internal carotid artery (RICA), and most resistance index data were significantly related with the presence of CHD. The area under the curve for a collective model, which included factors of the PS, carotid hemodynamics and age, was significantly higher than the other model. Age, PS, and PSA of RICA were significant contributors for predicting CHD presence. Conclusions: The model of PS and PSA of RICA has greater predictive value for CHD than PS alone. Adding age to PS and PSA of RICA further improves predictive value over PS alone.

Intima-media thickness of internal carotid arteries in the diagnosis of coronary atherosclerosis in patients with type 2 diabetes and silent ischaemia

Searchable abstracts of presentations at key conferences in endocrinology ISSN 1470-3947 (print) | ISSN 1479-6848 (online)

Stenosis level, plaque morphology and intima-media thickness of internal carotid artery in chronic stable angina and acute coronary syndrome; a comparative study.

Background:Ischemic heart disease (IHD) is the most common cause of cardiovascular diseases and divided into two main categories as acute coronary syndrome (ACS) and chronic stable angina (CSA). These two groups have stenosis and atherosclerosis in the coronary artery, but are more severe in patients with ACS.Objectives:We aimed to find the association between coroner and internal carotid artery, also comparing prospectively stenosis level, plaque morphology and intima-media thickness of internal carotid between patients with acute coronary syndrome (ACS) and chronic stable angina.Patients and Methods:In this study, 60 patients were enrolled as ACS group chosen from those admitted in CCU or referred to clinic. Forty-five patients of CSA group were chosen from those referred to clinic. All 105 patients underwent color Doppler sonography, and stenosis, plaque morphology and intima media thickness (IMT) were measured.Results:In 60 patients with ACS, 49 (81.7%) had no stenosis in ultrasonography and 11 (18.3%) had some degrees of stenosis; also 28 (46.7%) and 16 (26.7%) of patients had plaque and IMT, respectively. In the rest 45 patients of CSA group, just 4 (8.9%), 17 (37.8%) and 8 (17.8%) patients had stenosis, plaque and IMT, respectively. Therefore, there was no statistically significant difference between the two groups regarding stenosis (P = 0.171), plaque morphology (P = 0.362) and IMT (P = 0.283) (Power = 90%).Conclusions:According to the results, there were no significant and meaningful differences comparing ACS and CSA groups of patients by ECDS using three indicators of stenosis, plaque morphology and IMT as indicators of atherosclerosis. Results also display that patients with ACS had more stenosis, more plaque and thicker intima–media, but these differences were not statistically significant (P < 0.05).

Cerebrovascular disorders: carotid-wall intima-media thickness, stroke recurrence, and β-blocker selectivity

It is always amazing to see how many articles are published in the field of cerebrovascular disorders every month, even in very high-ranking journals. This is most certainly justified because daily clinical practice shows how relevant cerebrovascular disorders are. The three articles discussed in this month’s Journal Club primarily focus on primary or secondary prophylaxis. In the first study published in the New England Journal of Medicine, intima-media thickness of the walls of the common carotid artery and internal carotid artery, as well as the presence of plaque, were identified as a predictor for cardiovascular outcomes. The second article deals with stroke recurrence within the time window recommended for carotid endarterectomy, i.e. within 2 weeks after the first stroke due to a carotid stenosis. The article shows that early recurrent stroke risk was indeed high, particularly within the first 72 h, which has a considerable clinical impact. The final article, a systematic review on the effects of b-blocker selectivity on blood pressure variability and stroke also has clinical implications: non-selective b-blockers should be avoided in neurologic practice. In other words, b1-selective blockers can be used with the exception of atenolol, which has been shown not to be effective for stroke prevention. Carotid-wall intima-media thickness and cardiovascular events Known risk factors for cardiovascular events are increased systolic blood pressure, cholesterol, diabetes, cigarettesmoking, age, male sex, and history of cardiovascular disease. On the other hand, patients clearly benefit from hypertension treatment. In the current study, Polak and co-workers from Boston University examined whether intima-media thicknesses of the walls of the common carotid artery and internal carotid artery are independent risk factors and, further, if they may add to the Framingham risk score for predicting cardiovascular events. In 2,965 members of the Framingham Offspring Study cohort, the mean intima-media thickness of the common carotid artery and the maximum intima-media thickness of the internal carotid artery as well as the presence of plaque (defined as intima-media thickness of the internal carotid artery of more than 1.5 mm) were measured. Of these 2,965 participants a total of 296 had a cardiovascular event. The major findings were as follows: First, in the group of patients with no cardiovascular disease at follow-up the mean common carotid artery thickness was 0.59 ± 0.13 versus 0.66 ± 0.15 mm in the group of patients with cardiovascular disease at follow-up. Second, in those with no cardiovascular disease at follow-up the maximum internal carotid artery thickness was 1.30 ± 0.79 versus 1.9 ± 1.00 mm in those with cardiovascular disease at follow-up. Third, 27.4% of patients with no cardiovascular disease at follow-up had evidence of a plaque versus 59.6% of those with cardiovascular disease at follow-up. Fourth, the above-mentioned risk factors predicted the cardiovascular events with a so-called C statistic of 0.748. Fifth, the mean intima-media thickness of the common carotid artery and the maximum intima-media thickness of the internal

Intima–media thickness of internal carotid arteries and total carotid plaque area: two surrogate endpoints of which the former has to be considered a weaker putative measure of subclinical atherosclerosis compared with the latter

aCardiology Unit, Presidio Sanitario Intermedio ‘Elena d'Aosta’, Italy bDivision of Geriatrics, Casa di Cura S. Maria del Pozzo, Somma Vesuviana, Napoli, Italy Correspondence to Dr Renato De Vecchis, Cardiology Unit, Presidio Sanitario Intermedio ‘Elena d'Aosta’, via Cagnazzi, 29 80137 Napoli, Italy Tel: +39 081 7516932; fax: +39 081 2543144; e-mail: [email protected]