Value Of cIMT Research Articles

Phenotypic and genetic effect of carotid intima-media thickness on the risk of stroke.

While carotid intima-media thickness (cIMT) as a noninvasive surrogate measure of atherosclerosis is widely considered a risk factor for stroke, the intrinsic link underlying cIMT and stroke has not been fully understood. We aimed to evaluate the clinical value of cIMT in stroke through the investigation of phenotypic and genetic relationships between cIMT and stroke. We evaluated phenotypic associations using observational data from UK Biobank (N = 21,526). We then investigated genetic relationships leveraging genomic data conducted in predominantly European ancestry for cIMT (N = 45,185) and any stroke (AS, Ncase/Ncontrol=40,585/406,111). Observational analyses suggested an increased hazard of stroke per one standard deviation increase in cIMT (cIMTmax-AS: hazard ratio (HR) = 1.39, 95%CI = 1.09-1.79; cIMTmean-AS: HR = 1.39, 95%CI = 1.09-1.78; cIMTmin-AS: HR = 1.32, 95%CI = 1.04-1.68). A positive global genetic correlation was observed (cIMTmax-AS: [Formula: see text]=0.23, P=9.44 × 10-5; cIMTmean-AS: [Formula: see text]=0.21, P=3.00 × 10-4; cIMTmin-AS: [Formula: see text]=0.16, P=6.30 × 10-3). This was further substantiated by five shared independent loci and 15 shared expression-trait associations. Mendelian randomization analyses suggested no causal effect of cIMT on stroke (cIMTmax-AS: odds ratio (OR)=1.12, 95%CI=0.97-1.28; cIMTmean-AS: OR=1.09, 95%CI=0.93-1.26; cIMTmin-AS: OR=1.03, 95%CI = 0.90-1.17). A putative association was observed for genetically predicted stroke on cIMT (AS-cIMTmax: beta=0.07, 95%CI = 0.01-0.13; AS-cIMTmean: beta=0.08, 95%CI = 0.01-0.15; AS-cIMTmin: beta = 0.08, 95%CI = 0.01-0.16) in the reverse direction MR, which attenuated to non-significant in sensitivity analysis. Our work does not find evidence supporting causal associations between cIMT and stroke. The pronounced cIMT-stroke association is intrinsic, and mostly attributed to shared genetic components. The clinical value of cIMT as a surrogate marker for stroke risk in the general population is likely limited.

Comparing hs-CRP and MPO Biomarkers of Subclinical Atherosclerosis in Metabolic Syndrome Patients

Cardiovascular disorders have been linked to myeloperoxidase, an enzyme generated from leukocytes. MPO creates an antibacterial system and has been many correlations between MPO, hs-CRP and cardiovascular disease. The present study has aimed to assess MPO, hs-CRP and subclinical atherosclerosis in metabolic syndrome patients by using FMD and CIMT parameters. 75 metabolic syndrome affected patients had defined as per the criteria of IDF (International Diabetes Federation) which had been in this study. In addition, ultrasound doppler had been employed for determining the carotid intima medial thickness for both right and left (left and right CIMT) and brachial artery FMD. By employing the Immunoassay MPO and hs-CRP ultrasensitive ELISA kit, the concentration of MPO and hs-CRP is measured. A positive link between MPO with CIMT right and left (r value of right CIMT=0.723, p <0.05 and left CIMT r=0.712, p<0.01), hs-CRP with CIMT right and left (r value of right CIMT=0.613, p<0.05and left CIMT r=0.64, p<0.01)and a significant inverse correlation between MPO with FMD (r= -0.319,p<0.05), hs-CRP with FMD (r= -0.304,p<0.01) in metabolic syndrome patients. Serum MPO and hs-CRP is positively linked with subclinical atherosclerosis in metabolic syndrome patients. According to this finding, understanding the mechanism behind the risk factors for cardiovascular disease can be aided by the development of new molecular markers for metabolic syndrome and subclinical atherosclerosis.

RELEVANCE OF COMMON CAROTID INTIMA-MEDIA THICKNESS AND CAROTID PLAQUE AS RISK FACTOR FOR ISCHEMIC AND HAEMORRHAGIC STROKE IN PATIENTS ATTENDING MEDICAL COLLEGE AND HOSPITAL, KOLKATA

Introduction: A stroke or cerebrovascular accident is dened as an abrupt onset of a neurologic decit that is attributable to a focal vascular cause due to cerebral ischemia or intracranial haemorrhage. Atherosclerosis and carotid artery stenosis are the major causes of stroke. Carotid Intimamedial thickness is a marker of subclinical atherosclerosis. So the measurement of CIMT is of major concern in high risk individuals. To measure the carotid wall thickness Aim: (CIMT) using B-mode ultrasound of both right and left carotid artery and to establish association between CIMT and stroke. A Hospit Methodology: al based prospective, cross-sectional study concluded 100 diagnosed cases of stroke of which 50 ischemic stroke and 50 hemorrhagic stroke. All these patients underwent clinical evaluation CT Scan and MRI Scan of Brain, CIMT and blood investigation including complete hemogram , lipid prole , fasting blood glucose. Results: Mean age for presentation of stroke was 68.68 with maximum number of patients belonging to 61-80 years of age group with lowest age taken was 39 and the highest was 92. 49 (98%) patients with hemorrhagic stroke and 30 (60%) patients with ischemic stroke had hypertension. The CIMT was measured using B-mode USG probe correlated with the type of Stroke. The minimum value of Right CIMT in Hemorrhagic Stroke was 0.6 with maximum value 1.1; the mean was 0.788 + 0.1305 (mean + SD). The minimum value of Right CIMT in Ischemic stroke was 0.6 with maximum value 1.2; the mean was 0.93 + 0.1258 (mean + SD). Independent T-Test was performed, and 95% condence interval was between: 0.0931 to 0.1909 and p-value was <0.0001. There was positive correlation between the CIMT and t Conclusion: ype of stroke. Between Right CIMT and type of stroke, the p-value was <0.0001 which is highly signicant. Between Left CIMT and type of stroke, the p-value was also <0.0001 which is highly signicant

Estimating the correlation between TYG and CIMT in non-diabetic adult patients

Atherosclerosis occurs due to hyperlipidemia and lipid oxidation and is a major cause of death worldwide. This study was conducted to assess the correlation between the TyG index and CIMT and to estimate the predictive value of the TyG index as an early marker of subclinical atherosclerosis. This cross-sectional study was done at JLN Medical college, Ajmer tertiary care centre of central Rajasthan, North India, from December 2019 to June 2021 on 137 Non- Diabetic Males and Females of Age >18 and < 65 years patients. Detailed history, thorough clinical examination and relevant investigations were done to collect data. TyG index and CIMT were calculated. Participants were divided into two groups: Group 1- CIMT>0.9mm (having subclinical atherosclerosis) and Group 2- CIMT≤0.9mm. Mean age and BMI of participants in group 1 and group2 was 50.94yrs; 45.87yrs(P < 0.001), 28.97kg/m2; 26.56 kg/m2 (P = 0.002) respectively. Mean FBS and TG of group 1 and group 2 was 101.33mg/dl; 87.80mg/dl (P < 0.001), 210mg/dl; 156.15mg/dl (P value < 0.001) respectively. The mean TyG index in group 1 was 4.97 and in group 2 was 4.74 (P < 0.001). By receiver operating characteristic (ROC) curve analysis, the cut off value for TyG index is 4.87 (sensitivity = 94.4%, specificity = 94.2%, AUC = 0.887; P value < 0.001). We observed significant positive correlation between CIMT & TyG index (Pearson coefficient +0.675; p value < 0.001). TyG index is a reliable marker for predicting subclinical atherosclerosis at an early stage. • Atherosclerosis occurs as a result of hyperlipidemia and lipid oxidation. • This research estimated its predictive value of TyG index and CIMT as a diagnostic of atherosclerosis. • TyG index is a reliable marker for predicting subclinical atherosclerosis at early stage.

Sonographic Comparison of Atherosclerotic Changes in Carotid Arteries of Diabetic and Non-Diabetic Individuals

Objective: To compare the sonographic findings of atherosclerotic changes in carotid arteries of diabetic and non-diabetic individuals. Material &amp; Methods: A cross-sectional study of 62 diabetic and non-diabetic individuals was conducted from 11 November 2021 to 20 March 2022 at the Radiology Department of District Head Quarter Hospital, Faisalabad, Pakistan. The ultrasound of carotid arteries with a TOSHIBA MX Doppler ultrasound machine, using a linear probe with transducer frequency of 5-12.5MHz was performed in both diabetic and non-diabetic participants. Results: The mean value of CIMT in diabetic patients was 0.6839 ± 0.29178mm while the mean value of CIMT in Non- diabetic patients was 0.8000 ± 0.08563mm. The mean value of peak systolic velocity (PSV) of CCA in diabetic patients was 41.4194 ± 6.60189mm and the mean value of PSV of CCA in Non- diabetic patients was 41.7742 ± 6.52538mm. The mean value of PSV of ICA in diabetic patients was 58.4839 ± 12.03293mm and in Non- diabetic patients was 59.0323 ±10.03489mm. Similarly, the mean value of ICA/CCA ratio in diabetic patients was 1.4097 ± 0.39442 while in non-diabetic patients was 1.4323 ± 0.30374. Conclusion: The diagnostic accuracy of ultrasonography of common carotid artery, and internal carotid artery is very high for atherosclerosis. The use of sonography for measurement of IMT and plaque area act as a vital tool for the detection of atherosclerosis changes due to diabetes. Keywords: carotid artery, diabetes mellitus, intima-media thickness

Common carotid artery characteristics in patients with repaired aortic coarctation compared to other cardiovascular risk factors

AimsIncreased common carotid artery (CCA) intima media thickness (cIMT) is a well-known risk factor for cardiovascular morbidity and mortality. cIMT thickening has been described in patients with repaired aortic coarctation (CoA), but data on mechanism and clinical relevance in this population are scarce. Our aim was to gain mechanistic insights into cIMT thickening of patients with repaired CoA by comparing their wall architecture to patients with coronary artery disease (CAD), other congenital heart diseases (oCHD), and healthy controls. Methods and resultsA total of 310 subjects were included (CoA (n ​= ​58), oCHD (n ​= ​96), CAD (n ​= ​68) and healthy controls (n ​= ​88)). CIMT and lumen diameter (LD) were determined using semiautomated analysis software. Linear regression analyses were performed correcting for relevant covariates. While patients with repaired CoA and CAD both had significantly increased cIMT and cIMT/LD ratios, LD was increased only in CoA patients. Furthermore, patients with repaired CoA had decreased CCA stiffness. CCA characteristics in the oCHD group were not significantly different from controls. ConclusionThe mechanism of cIMT thickening in patients with repaired CoA may differ from CAD. While there is concentric remodeling in the latter, we see predominant eccentric remodeling in the CoA group, which could be due to increased flow as a result of compliance mismatch at the CoA repair site. We therefore suggest that the prognostic value of cIMT in post-CoA patients should be validated separately prior to using it to guide clinical management in this group.

Imaging-guided evaluation of subclinical atherosclerosis to enhance cardiovascular risk prediction in asymptomatic low-to-intermediate risk individuals: A systematic review

Carotid intima-media thickness (cIMT), plaque quantification and coronary artery calcium (CAC) scoring have been suggested to improve risk prediction of cardiovascular disease (CVD), particularly for asymptomatic individuals classified as low-to-intermediate risk. We aimed to compare the predictive value of cIMT, carotid plaque identification, and CAC scoring for identifying sub-clinical atherosclerosis and assessing future risk of CVD in asymptomatic, low-to-intermediate risk individuals. We conducted a comprehensive search of Ovid (Embase and Medline), Cochrane Central Register of Controlled Trials (CENTRAL) and Medline complete (EBSCO health). A total of 30 papers were selected and data were extracted. Comparisons were made according to the cIMT measurement (mean, maximum), carotid plaque evaluation (presence or area), and CAC scoring. CVD event rates, hazard ratios (HR), net reclassification index (NRI), and c-statistic of the markers were compared. There were 27 studies that reported cIMT, 24 reported carotid plaque, and 6 reported CAC scoring. Inclusion of CAC scores yielded the highest HR ranging from 1.45 (95% CI, 1.11–1.88, p = 0.006) to 3.95 (95% CI, 2.97–5.27, p < 0.001), followed by maximum cIMT (HR 1.08; 95% CI, 1.06–1.11, p < 0.001 to 2.58; 95% CI, 1.83–3.62, p < 0.001) and carotid plaque presence (HR 1.21; 95% CI, 0.5–1.2, p = 0.39 to 2.43; 95% CI, 1.7–3.47, p < 0.001). The c-statistic enhanced predictive value by a minimum increase of 0.7. Finally, the NRI ranked higher with CAC (≥11.2%), followed by carotid plaque (≥2%) and cIMT (3%). CAC scoring was superior compared to carotid plaque and cIMT measurements in asymptomatic individuals classified as being at low-to-intermediate risk.

Carotid intima media-thickness is increased in obese children metabolically healthy, metabolically unhealthy, and with metabolic syndrome, compared to the non-obese controls.

The prevalence of obesity continues to increase. Obesity is associated with cardiovascular risk factors: elevated blood pressure, dyslipidemia and glycemic alterations, causing metabolic syndrome. A subgroup of obese, Metabolically Healthy Obese (MHO), appears to be less prone to the development of metabolic disturbances. Carotid intima-media thickness (cIMT) is a non-invasive marker of subclinical atherosclerosis and it is associated with increased risk of CVD events. To investigate the cardiovascular risk, demonstrated through the increase of cIMT in obese subjects without Metabolic Syndrome (MetS), we have studied cIMT in MHO, metabolically unhealthy obese (MUO) and obese with MetS diagnosed with the IDEFICS criteria and compared to a control group. 224 obese children aged 6 to 21 years (13,50 ± 4.01 years) and 103 normal weight subjects aged 7 to 19 years (13.2 ± 4.1 years) were studied. The body mass index (BMI) of the obese children was ≥ the 95th percentile. Based on the IDEFICS criteria, we divided the obese subjects in three groups: MHO if no criteria were out of range, MUO if, at least, one of the criteria was out of range and MetS group if all the IDEFICS criteria were present. In all the subjects cIMT was measured with color Doppler by a vascular surgeon. Differences in the means of the variables were tested by ANOVA. Based on the IDEFICS criteria, 32 subjects were affected by MetS (14..3%), 66 were considered MUO (29.4%) and 126 MHO (56.3%). Comparison of mean cIMT highlighted a significant difference (p < 0.05) between the groups of obese children (MHO, MUO and MetS) and controls for both carotid arteries. We did not find significative difference in the value of cIMT in MHO, MUO and MetS subjects, and all groups showed cIMT value higher compared to cIMT of the controls.

Sonographic evaluation of Intima-Media thickness of carotid artery in healthy, hypertensive and diabetic Nepalese population

Introduction: Hypertension and Diabetes are two major risk factors for atherosclerotic disease. Carotid artery intima media thickness(cIMT) is considered a reliable surrogate measure for diagnosing subclinical atherosclerosis, its progression and regression. Paucity of available data regarding mean value of cIMT highlights the importance of defining the cut off value of cIMT in a specified population. Very limited studies have been done on sonographic evaluation of mean cIMT and carotid artery injury in hypertension and diabetes in Nepalese population. This study, therefore aims to determine mean cIMT in Nepalese population and to analyze effect of Hypertension and diabetes on cIMT.&#x0D; Methods: Cross-sectional hospital based study was conducted within the period of 18 months. B-mode ultrasound was used to measure cIMT in bilateral common carotid arteries. Comparison of mean cIMT was done amongst healthy, hypertensive and diabetes with hypertensive patients. Duration of disease was also considered. Data analysis was done with “R” analytical study. Results were expressed as mean ± standard deviation.&#x0D; Results: Total1005 (508 female and 497 male) adult patients with age range of 30 to 85 years were assessed. Among these 329(32.74%) were healthy adults, 341(33.93%) were hypertensive and 335(33.33%) were diabetes with hypertensive patients. The mean cIMT in cases was more than controls (P &lt; 0.001) bilaterally with diabetes having an additive effect. There was also positive correlation of measured value with duration of disease and age of patients.&#x0D; Conclusion: The present study found that mean cIMT in cases was more than controls. There is an additional effect of Diabetes on cIMT in hypertensive patient. Age and duration of disease can accelerate atherosclerosis.

EXOCRINE AND ENDOCRINE PANCREATIC INSUFFICIENCY IN DEVELOPMENT OF ATHEROSCLEROSIS

Objective: To evaluate the effect of chronic pancreatitis (CP) and exocrine insufficiency of the pancreas on the carotid intima media thickness (cIMT) in patients with type 2 diabetes mellitus (DM-2). Materials and methods: 91 patients were examined, they were divided into groups: 1st group-patients with DM-2 (n = 31) group 2nd – DM-2 combined with CP (n = 60). Fasting plasma glucose (FPG), HbA1c, immunoreactive insulin (IRI), HOMA-IR index, C-reactive protein (CRP), serum α-amylase and fecal-1 elastase (FE-1) were assessed. In order to assess the thickness of the cIMT, ultrasound of the common carotid artery was performed. The control group of healthy volunteers was representative by age and sex. Results: In the 1st and 2nd groups, the average value of cIMT was (1.02 ± 0.1 vs 1.21 ± 0.15) mm. Parameters of DM-2 management in the 1st and 2nd groups were (FPG 8.18 ± 0.92vs8.57 ± 1.2) mmol / l; HbA1c (7.23 ± 0.21vs7.49 ± 0.36)%; IRI (20.31 ± 0.9vs22.53 ± 1.2) μIU / ml; HOMA-IR (6.55 ± 1.5vs8.38 ± 2.2) μIU / ml * mmol / l; PSA (1.3 ± 0.12vs6.77 ± 0.31). HOMA-IR correlated with: CRP (r = 0.43, p &lt;0.05 in group 1; r = 0.61, p &lt;0.05 in group 2); FE-1 (r = -0.55, p &lt;0.05 of the 2nd group); and cIMT (r = 0.42, p &lt;0.05 in the 1st group; r = 0.53, p &lt;0.05 in the 2nd group). IRI have relationship with: FE-1 (r = 0.41, p &lt;0.05 in group 1; r = -0.3, p &lt;0.05 in group 2); CRP (r = 0.42, p &lt;0.05 in group 1; r = -0.28, p &lt;0.05 in group 2); HbA1c had close relationships with cIMT (r = 0.38, p &lt;0.05 in group 1; r = 0.51, p &lt;0.05 in group 2). The relationship between cIMT and CRP was related in the 2nd group (r = 0.39, p &lt;0.05); with α-amylase (r = 0.2, p &lt;0.01 2nd group). There was no significant relationship between cIMT and FE-1 in the study. Conclusions: Obtained data allows us to conclude that hyperinsulinemia and insulin resistance have a direct atherogenic effect on the walls of blood vessels. It is established that the accession of the inflammatory process leads to increasing development of atherosclerotic lesions of the vessel, at the same time, the presence of exocrine dysfunction of the pancreas does not have a significant direct effect on the cIMT.

Carotid IMT and Stiffness in the KiGGS 2 National Survey: Third-Generation Measurement, Quality Algorithms and Determinants of Completeness

Carotid intima–media thickness (cIMT) and carotid stiffness (CS) are important markers of atherosclerotic risk in the young. We assessed a novel third-generation method for its applicability in large population-based epidemiologic studies to determine strengths, limitations, completeness and predictors of unsuccessful measurement. Four thousand seven hundred ninety-eight 14- to 31-y-old participants of the German KiGGS cohort, which is based on a nationally representative sample with 11-y follow-up, underwent B-mode ultrasound examinations of the left and right common carotid artery with semi-automatic edge detection and automatic electrocardiogram-gated real-time quality control based on a sophisticated snake algorithm and subpixel interpolation. Overall completeness was 98% for far wall cIMT and 89% for CS parameters. Plane-specific completeness varied from 92%–96% for far wall and from 64%–69% for near-wall cIMT. Obesity independently predicted unsuccessful cIMT and CS measurements with odds ratios of 12.67 (95% confidence interval: 5.50–29.19) and 7.30 (4.87–10.94) compared with non-overweight after adjustment for blood pressure, cholesterol, smoking, hazardous drinking, age, sex and sonographer. Inter- and intra-rater reliabilities of cIMT and CS parameters in a sample of 15 young adults were good or excellent. Third-generation cIMT and CS measurements in the young with semi-automatic edge-detection and automatic real-time quality control has been successfully standardized with high reliability and very high completeness in a national survey setting. This provides a strong methodological foundation for further validation of the predictive value of cIMT and CS for atherosclerotic risk in the young.

Impact of Mitochondrial DNA Mutations on Carotid Intima-Media Thickness in the Novosibirsk Region.

The search for markers of predisposition to atherosclerosis development is very important for early identification of individuals with a high risk of cardiovascular disease. The aim of the present study was to investigate the association of mitochondrial DNA mutations with carotid intima-media thickness and to determine the impact of mitochondrial heteroplasmy measurements in the prognosis of atherosclerosis development. This cross-sectional, population-based study was conducted in 468 subjects from the Novosibirsk region. It was shown that the mean (carotid intima-media thickness) cIMT correlated with the following mtDNA mutations: m.15059G>A (r = 0.159, p = 0.001), m.12315G>A (r = 0.119; p = 0.011), m.5178C>A (r = 0.114, p = 0.014), and m.3256C>T (r = 0.130, p = 0.011); a negative correlation with mtDNA mutations m.14846G>A (r = −0.111, p = 0.042) and m.13513G>A (r = −0.133, p = 0.004) was observed. In the linear regression analysis, the addition of the set of mtDNA mutations to the conventional cardiovascular risk factors increased the ability to predict the cIMT variability from 17 to 27%. Multi-step linear regression analysis revealed the most important predictors of mean cIMT variability: age, systolic blood pressure, blood levels of total cholesterol, LDL and triglycerides, as well as the mtDNA mutations m.13513G>A, m.15059G>A, m.12315G>A, and m.3256C>T. Thus, a high predictive value of mtDNA mutations for cIMT variability was demonstrated. The association of mutation m.13513G>A and m.14846G>A with a low value of cIMT, demonstrated in several studies, represents a potential for the development of anti-atherosclerotic gene therapy.

A Comparative Study of Carotid Artery Intima Media Thickness in Hypertensive Smokers and Non-Hypertensive Smokers

Introduction: Cardiovascular disease is the leading cause of death globally. In 2017-18, Non-communicablediseases led to 38 million (68%) deaths out of a total of 56 million deaths worldwide. India is currently inthe midst of this global Cardiovascular Disease epidemic.Method: Case-control studyAim of the Study: To compare carotid artery intima-media thickness(cIMT) in Hypertensive smokers andsmokers without Hypertension.Result: Mean value of cIMT of the Case group (0.970mm) was significantly higher than that of the Controlgroup (0.735mm). Mean cIMT was highest in the study group i.e 1.114 mm in the population of age above70 years, similarly Mean cIMT was highest in the control group i.e. 0.821mm in the population of age above60 years.Conclusion: The present study and its observations makes it imminent that Hypertension affects every cIMTmeasurement of the study subjects. cIMT measurement has a positive correlation with the increasing age.

Time to change cardiovascular prevention in people with HIV

Today, people with HIV live longer because of antiretroviral therapy (ART) but experience a higher risk of comorbidities, including atherosclerotic cardiovascular disease. 1 Feinstein MJ Hsue PY Benjamin LA et al. Characteristics, prevention, and management of cardiovascular disease in people living with HIV: a scientific statement from the American Heart Association. Circulation. 2019; 140: e98-e124 Crossref PubMed Scopus (240) Google Scholar Increased risk of cardiovascular disease might be due to not only classic risk factors, which are over-represented in the HIV-positive population, but also additional factors not present in the general population. These factors include chronic inflammation associated with HIV infection (even if successfully treated) and the use of some antiretroviral drugs, through mechanisms that are poorly understood. 2 Martínez E Larrousse M Gatell JM Cardiovascular disease and HIV infection: host, virus, or drugs?. Curr Opin Infect Dis. 2009; 22: 28-34 Crossref PubMed Scopus (50) Google Scholar Because cardiovascular events are rare, assessment of subclinical atherosclerosis measured by carotid artery intima-media thickness (cIMT) has been used as a surrogate marker of cardiovascular disease. cIMT reliably predicts cardiovascular events in the general population. 3 Lorenz MW Markus HS Bots ML Rosvall M Sitzer M Prediction of clinical cardiovascular events with carotid intima-media thickness: a systematic review and meta-analysis. Circulation. 2007; 115: 459-467 Crossref PubMed Scopus (2408) Google Scholar However, the prognostic value of cIMT in people with HIV is not proven and comparisons of cIMT between HIV-positive and HIV-negative adults have shown discordant data. 4 Currier JS Kendall MA Henry WK et al. Progression of carotid artery intima-media thickening in HIV-infected and uninfected adults. AIDS. 2007; 21: 1137-1145 Crossref PubMed Scopus (115) Google Scholar , 5 Tarr PE Ledergerber B Calmy A et al. Subclinical coronary artery disease in Swiss HIV-positive and HIV-negative persons. Eur Heart J. 2018; 39: 2147-2154 Crossref PubMed Scopus (40) Google Scholar Age-specific associations between HIV infection and carotid artery intima-media thickness in China: a cross-sectional evaluation of baseline data from the CHART cohortHIV infection is associated with subclinical atherosclerosis, independent of classic risk factors. The association is stronger at younger ages, suggesting early onset of subclinical atherosclerosis among young adults. These findings highlight the need to modify HIV/AIDS treatment guidelines to incorporate cardiovascular evaluation in China. Full-Text PDF

P4389Effect of cigarette smoking on carotid artery atherosclerosis: a community-based cohort study

Abstract Background Cigarette smoking is closely associated with the development of cardiovascular diseases (CVD), and the European Society of Cardiology/European Atherosclerosis Society (ESC/EAS) guidelines recommend smoking bans.On the other hand, the relationship between cigarette smoking and subclinical atherosclerosis has not been fully studied. Carotid intima-media thickness (cIMT) is commonly used as a subclinical atherosclerosis marker, and a carotid plaque feature is also known to be an important predictor of cardiovascular diseases. Purpose We sought to clarify the association between cigarette smoking and subclinical atherosclerosis by evaluating carotid plaque including cIMT and carotid plaque features in general population. Methods and results Among 1,209 participants with no prior coronary artery disease who received a medical check-up with cardiovascular examination at our institution, 450 participants (37.2%) were smokers (including both past and current smokers). We defined carotid plaque as cIMT ≥1.1 mm and high-risk plaque as carotid plaque with hypoechoic dominant and/or plaque ulceration. The value of cIMT and the rate of carotid plaque were not different between smokers and never smokers (Figure A &amp; B). However, the rate of carotid high-risk plaque was significantly higher in participants with smokers than those with never smokers (29.7%, vs 23.5%, p=0.011) (Figure C). Even after adjustment with covariates including age, gender and traditional cardiovascular risk factors, cigarette smoking was independently associated with high-risk plaque formation (odds ratio 1.384, 95% CI 1.020–1.877; p=0.037). According to the subgroup analysis classified by age, cigarette smoking was associated with not only the development of high-risk plaque but also the increased value of cIMT in the subgroup over 60 years old, whereas only the rate of high-risk plaque was higher in smokers than never smokers in the subgroup under 60 years old. Carotid plaque and smoking Conclusion The development of high-risk carotid artery plaque may precede thickening of cIMT in cigarette smokers, suggesting that the novel insight for the pathological mechanism underlying cardiovascular events and cigarette smoking.

The relationship between carotid intima-media thickness and carotid plaque: a cohort study in China.

Both carotid intima-media thickness (cIMT) and carotid plaque (CP) quantified by B-mode ultrasound have been proposed as surrogate imaging biomarkers of subclinical atherosclerosis, while the relationship between cIMT and CP, whether cIMT evaluation in a given patient might allow for predicting the development of a carotid plaque, is still discussed controversially. We investigated the cross-sectional relationship between cIMT and CP, and the predictive value of cIMT for incident CP formation in 1078 subjects with mean age of 52 ± 5 years in a community based atherosclerosis cohort in Beijing. Participants underwent ultrasonography of bilateral carotid arteries and received vascular risk factor assessment at baseline and after a mean of 2.35 years follow-up. The prevalence of plaque was increased by 3.75-fold for upper quartile cIMT compare with the lower quartile even after adjustments for traditional risk factors at baseline. Among the 746 plaque-free subjects at baseline, 230 (31.0%) developed new CP. After adjusted for demographics and vascular risk factors, neither baseline cIMT nor the cIMT change from baseline to follow-up predicted incident CP. In conclusion, although cIMT associates with CP cross-sectionally, increased cIMT dose not independently predict future plaque development. Our data suggest that paying attention to the traditional risk factors might prevent subjects from developing carotid plaques regardless from IMT changes.

Carotid stiffness and atherosclerotic risk: non-invasive quantification with ultrafast ultrasound pulse wave velocity.

To evaluate the value of ultrafast pulse wave velocity (ufPWV) for the quantitative assessment of carotid stiffness and its associated with atherosclerosis (AS) risk. The present study included 233 patients with hyperlipoidaemia (AS risk group) and 114 healthy adults as the control group. The carotid (n = 694) intima-media thickness (cIMT), pulse wave velocity-beginning of systole (PWV-BS) and pulse wave velocity-end of systole (PWV-ES) were measured on sample images. Differences, distributive characteristics and correlation evaluation were assessed in patients (ages 18-29, 30-39, 40-49, 50-59, 60-69 and ≥70) and carotids (control group vs AS risk group). The cIMT, PWV-BS and PWV-ES increased with age; PWV-ES and cIMT showed an early significant increase in the 30-39 years group, whereas PWV-BS displayed a significant increase at 40-49 years compared with the 18- to 29-years group. Besides, PWV-ES correlated well with age compared with PWV-BS and cIMT. For carotid level, cIMT, PWV-BS and PWV-ES measurements were higher in the AS risk group compared with control. To compare the value of ufPWV and cIMT in early AS assessment, we subdivided groups into cIMT subgroups using a cut-off thickness of 0.050 cm. PWV-ES measurements were higher in the AS risk group compared with the control in the 0.040-0.050 cm (not thickened) and 0.051-0.060 cm (thickened) cIMT subgroups. Carotid ufPWV measurement at PWV-ES is a novel modality for the early diagnosis and quantitative assessment of arterial stiffness associated with atherosclerotic risk. • ufPWV technique is real-time and well repeatable for assessing carotid stiffness • ufPWV measurements increase and correlate well with age • PWV-ES is a quantitative predictor for the early assessment of AS.

Correlation between Carotid Intimal-Media Thickness and Coronary Artery Disease Severity in Stable Coronary Artery Disease Patients

Background: Atherosclerosis is a fundamental process in the natural course of coronary heart disease (CHD), carotid artery disease and peripheral artery disease. Atherosclerosis is caused by an imbalance of homeostasis in the level of the endothelial layer and the presence of risk factors. The manifestations of coronary atherosclerosis have a wide spectrum of diseases, ranging from subclinical to clinical phases. In patients without CHD symptoms, changes incarotid artery morphology include carotid intimal-media thickness (CIMT) and carotid plaques which correlated with CHD. This study aims to see the relationship between CIMT with the severity of coronary lesions in stable coronary artery disease.Methods: The study was an analytical observational research using cross sectional design. Data was taken by consecutive sampling from outpatient hospital clinic. The CIMT score was obtained from the examination of a communis carotid artery using a B-mode ultrasound device. The value ofCIMT is divided into 2 groups based on the value of the sensitivity curve and the specifcity curve. The value of Syntax was obtained from the catheterization laboratory and the factors that influenced it were recorded. Pearson correlation test is used to analyze the relationship of CIMT and Syntax value. The logistic regression test used for multivariate test.Results: Of the 58 patients, there were 33 subjects who had a CIMT score of &gt; 0.71 mm and 25 subjects who had a CIMT score of ≤0.71 mm. There is a positive correlation (r = 0.403; p &lt;0.05) between CIMT value and Syntax value. Subjects who have high Syntax value in the group with a CIMT value &gt;0.71 mm compared to CIMT values ≤0.71 mm were 29 versus 4 (RR: 1.831; CI 95%:1.194-2.807; p = 0.01). A multivariate test showed CIMT consistently as a independent risk factor of Syntax value in stable coronary artery disease with RP 5.27 (CI 95%: 1.306-25.047; p = 0.021).Conclusion: The increase in CIMT value has a signifcant positive correlation with the Syntax value. A CIMT &gt; 0.71 mm is a independent risk factor of high Syntax value in stable coronary artery disease with prevalence ratio 5.27

Carotid artery intima-media thickness (cIMT) in young type 1 diabetic patients in relation to comorbid additional autoimmune diseases and microvascular complications

Atherosclerosis, which is the cause of diseases of the cardiovascular system, and frequent and serious complications of type 1 diabetes (T1DM), has an autoimmune origin. Some diseases of this type, as rheumatoid arthritis, but also Hashimoto thyroiditis or celiac disease are associated with a higher incidence of heart disease. So far no studies evaluated the preclinical phase of development of atherosclerosis (cIMT) in young patients with T1DM and the comorbid additional autoimmune diseases. was evaluation of cIMT (carotid intima media thickness) carotid arteries and the risk factors of atherosclerosis in young patients with type 1 diabetes according to the comorbid autoimmune diseases and a comparison group of patients with known vascular complications and a group of healthy people. The study involved a group of 90 adolescents and young adults with T1DM in middle age 17,1±3years, with an average disease duration of 10,5±3,3 years. Diabetes patients were divided into 4 groups - diabetes without complications - C, diabetes with celiac disease - CC, diabetes with Hashimoto's thyroiditis - CH, diabetes with vascular complications - CN. The control group (K) consisted of 22 healthy age-matched volunteers. In statistical analysis rated: average A1C of all the years of illness, BMI, blood pressure, lipid values, duration of illness, presence of diabetes complications, daily insulin dose and cIMT thickness of the common carotid artery. cIMT of T1DM patients was significantly higher: 0,470 mm than in healthy: 0,409 mm. In the group with vascular complications of diabetes was found the highest rate of cIMT: 0,501 mm in comparison to the group of diabetes without complications: 0,462 mm, diabetes with celiac disease: 0,462 mm, and diabetes with Hashimoto's thyroiditis: 0,453 mm. HbA1c was highest in the group CN: 9,84±1,5%, compared to CH: 9,04± 1,2%, CC: 8,84±1,8% and C without complications: 8,55±1,2%. BMI was highest in the group CN: 23,3± 4,4kg/m2and CH: 22,6 ± 2,4 kg/m2. It was the same with waist circumference: CN: 79,33± 9,39and CH: 79,2 ± 9,56 cm. Patients with vascular complications were characterized by the higher value of blood pressure and lipids compared to patients with additional autoimmune disease. Coexistence of celiac disease was not associated with a greater value of cIMT and cardiovascular risk factors in young patients with type 1 diabetes. 1. Increased value of cIMT, and thus increased risk of early disease of the cardiovascular system depends primarily on metabolic compensation and classic risk factors for atherosclerosis. 2. The coexistence of additional autoimmune disease does not significantly affect the value of cIMT in the study population. 3. Young patients with diabetes type 1 and coexisting Hashimoto disease have greater BMI and waist circumference, what can lead to earlier macroangiopathy in the future.

A prediction model for renal artery stenosis using carotid ultrasonography measurements in patients undergoing coronary angiography.

BackgroundCarotid intima-media thickness (CIMT) and carotid atherosclerotic plaque (CAP) are well-known indicators of atherosclerosis. However, few studies have reported the value of CIMT and CAP for predicting renal artery stenosis (RAS). We investigated the predictive value of CIMT and CAP for RAS and propose a model for predicting significant RAS in patients undergoing coronary angiography (CAG).MethodsConsecutive patients who underwent renal angiography at the time of CAG in a single center in 2011 were included. RAS ≥50% was considered significant. Multiple logistic regression analysis with step-down variable selection method was used to select the best model for predicting significant RAS and bootstrap resampling was used to validate the best model. A scoring system for predicting significant RAS was developed by adding the closest integers proportional to the coefficients of the regression formula.ResultsSignificant RAS was observed in 60 of 641 patients (9.6%) who underwent CAG. Hypertension, diabetes, significant coronary artery disease (CAD) and chronic kidney disease (CKD) stage ≥3 were more prevalent in patients with significant RAS. Mean age, CIMT and number of anti-hypertensive medications (AHM) were higher and body mass index (BMI) and total cholesterol level were lower in patients with significant RAS. Multiple logistic regression analysis identified significant CAD (odds ratio (OR) 5.6), unilateral CAP (OR 2.6), bilateral CAP (OR 4.9), CKD stage ≥3 (OR 4.8), four or more AHM (OR 4.8), CIMT (OR 2.3), age ≥67 years (OR 2.3) and BMI <22 kg/m2 (OR 2.4) as independent predictors of significant RAS. The scoring system for predicting significant RAS, which included these predictors, had a sensitivity of 83.3% and specificity of 81.6%. The predicted frequency of the scoring system agreed well with the observed frequency of significant RAS (coefficient of determination r2 = 0.957).ConclusionsCIMT and CAP are independent predictors of significant RAS. The proposed scoring system, which includes CIMT and CAP, may be useful for predicting significant RAS in patients undergoing CAG.